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Se realizó una investigación relacionada con la innovación tecnológica, en la Facultad de Enfermería-Tecnología de la Salud de Santiago de Cuba, durante el curso escolar 2019-2020, con el objetivo de diseñar un software educativo para la asignatura Estratificación de Riesgos Medioambientales, dirigido a los estudiantes de técnico medio en Vigilancia y Lucha Antivectorial. Se utilizaron los métodos teóricos: análisis-síntesis, histórico-lógico, modelación, sistémico-estructural e inductivo-deductivo; y empíricos: observación y análisis documental. La muestra fue de 44 estudiantes y 6 profesores escogidos al azar. Se concluye que el software propuesto es factible, pertinente y necesario como medio de enseñanza; proporciona información actualizada, su navegación es fácil y amena, y permite la autoevaluación de los estudiantes al interactuar con él mismo, lo que contribuye a mejorar el trabajo independiente.

An investigation related to the technological innovation was carried out in the Health Nursing-Technology Faculty from Santiago de Cuba, during the school course 2019-2020, aimed at designing an educational software for the subject Stratification of Environmental Risks, directed to medium technician students in Surveillance and Vector Control. The theoretical methods used were: analysis-synthesis, historical-logical, modelation, systemic-structural and inductive-deductive; and the empiric methods were: observation and documental analysis. The sample had 44 students and 6 professors chosen at random. It was concluded that the proposed software is feasible, pertinent and necessary as teaching aid; provides up-to-date information, it is easy and interesting to surf internet, and allows the self-appraisal of students in the interaction with themselves, what contributes to improve the independent work.

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This study analyzed the meteorological and hydrological droughts in a typical basin of the Brazilian semiarid region from 1994 to 2016. In recent decades, this region has faced prolonged and severe droughts, leading to marked reductions in agricultural productivity and significant challenges to food security and water availability. The datasets employed included a digital elevation model, land use and cover data, soil characteristics, climatic data (temperature, wind speed, solar radiation, humidity, and precipitation), runoff data, images from the MODIS/TERRA and AQUA sensors (MOD09A1 and MODY09A1 products), and soil water content. A variety of methods and products were used to study these droughts: the meteorological drought was analyzed using the Standardized Precipitation Index (SPI) derived from observed precipitation data, while the hydrological drought was assessed using the Standardized Soil Index (SSI), the Nonparametric Multivariate Standardized Drought Index (NMSDI), and the Parametric Multivariate Standardized Drought Index (PMSDI). These indices were determined using water balance components, including streamflow and soil water content, from the Soil Water Assessment Tool (SWAT) model, and evapotranspiration data from the Surface Energy Balance Algorithm for Land (SEBAL). The findings indicate that the methodology effectively identified variations in water dynamics and drought periods in a headwater basin within Brazil's semiarid region, suggesting potential applicability in other semiarid areas. This study provides essential insights for water resource management and resilience building in the face of adverse climatic events, offering a valuable guide for decision-making processes.

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Irazú is one of the largest and most active volcanoes in Costa Rica. We present the tephro-chronostratigraphy of the last 2.6 ka of the Irazú volcano based on detailed field work and C14 radiometric dating, as well as a revision of the geological and historical records. In the stratigraphic record we identified at least 30 tephra units. Eight of them corresponding to the historical period (i.e., after 1700 A.D.), separated by repose periods of different durations. The distribution of the deposits, the volcanic morphologies (craters and pyroclastic cones) and the radiometric ages indicate that most of this recent eruptive activity has occurred from the summit of Irazú along an E-W fissure (~ 4 km long). Toward the west of the summit, near the Sapper hill may be the source of the oldest eruptions at 200 A.D., while the La Laguna cone, located to the east of the summit, could have formed around 1540 A.D., and Main Crater to the west could have formed around sixteenth-seventeenth century. Since then, the historical eruptions (i.e., 1723-1724, 1917-1921, 1924, 1928, 1930, 1933, 1939-1940 and 1963-1965) have been sourced from this crater, but not all of them are registered in the stratigraphy. The eruption frequency of Irazú during this period ranges from 23 to 100 years, with a major event about every 80 years. Irazu's eruptions have been mainly phreatomagmatic and Strombolian, including some phreatic explosions. We present a detailed tephro-chronostratigraphy that will help to building temporal analysis for hazard assessment and risk management plans to face future eruptions at Irazú.

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The use of tailings dams in the mining industry is recurrent and a matter of concern given the risk of collapse. The planning of tailings dam's emplacement usually attends construction design criteria and site geotechnical properties, but often neglects the risk of installing the depositional facilities in potentially unstable landscapes, namely those characterized by steep slopes and(or) high drainage densities. In order to help bridging this gap, the present study developed a framework model whereby geomorphologic vulnerability is assessed by a set of morphometric parameters (e.g., drainage density; relief ratio; roughness coefficient). Using the Ribeirão Ferro-Carvão micro-basin (3265.16 ha) as test site, where six dams currently receive tailings from the mining of iron-ore deposits in the Brumadinho region (Minas Gerais, Brazil) and one has collapsed in 25 January 2019 (the B1 dam of Córrego do Feijão mine of Vale, S.A.), the risk of dam instability derived from geomorphologic vulnerability was assessed and alternative suitable locations were highlighted when applicable. The results made evident the location of five dams (including the collapsed B1) in high-risk regions and two in low-risk regions, which is preoccupying. The alternative locations represent 58 % of Ribeirão Ferro-Carvão micro-basin, which is a reasonable and workable share. Overall, the study exposed the fragility related with tailings dams' geography, which is not restricted to the studied micro-basin, because dozens of active tailings dams exist in the parent basin (the Paraopeba River basin) that can also be vulnerable to geomorphologically-dependent hydrologic hazards such as intensive erosion, valley incision or flash floods. Attention to this issue is therefore urgent to prevent future tragedies related with tailings dams' breaks, in the Paraopeba River basin or elsewhere, using the proposed framework model as guide.

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RESUMEN Es conocida desde hace más de veinte años, la posibilidad de que fármacos o anti cuerpos monoclonales utilizados en el tratamiento de diferentes enfermedades pueden ocasionar la aparición de un síndrome símil sarcoidosis. Ciertas líneas de evidencia han sugerido que determinados lugares de trabajo están asociados con el riesgo de sarcoidosis En sarcoidosis, diferentes exposiciones pueden estar relacionadas con otros compromi sos viscerales. La afección presenta más de una causa y provocar fenómenos disímiles de la enfermedad o fenotipo. De las enfermedades ocupacionales de pulmón, la que más se asemeja es la beriliosis. Cuando la causa es de origen laboral, su reconocimiento es primordial para admitir un tratamiento eficaz mediante el retiro del trabajador afectado de la exposición y para establecer una intervención dirigida a la prevención primaria mediante las secciones especializadas en seguridad e higiene industrial. Por lo tanto, y por lo expuesto, debe considerarse que la sarcoidosis es un síndrome con cuantiosos factores etiológicos probables, a lo que hay que asociar tanto el fenotipo como la sensibilidad individual ante una noxa determinada. Esto hace que, en forma periódica, se publiquen casos en los que la clínica y el cuadro histológico de granuloma epitelioide no caseoso hallado en biopsias, se vincule a un determinado riesgo ambiental y/o laboral.

SUMMARY It has been known for more than 20 years, the possibility that drugs or monoclonal anti bodies used in the treatment of different diseases can cause a Sarcoidosis-like syndrome. Certain lines of evidence have suggested that certain workplaces are associated with the risk of Sarcoidosis. In Sarcoidosis, different exposures may be related to visceral involvement. The condition has more than one cause and brings about dissimilar pheno mena of the disease or phenotype. Of the occupational lung diseases, the one that most closely resembles it, is Berylliosis. When the cause is of occupational origin, its recognition is essential to allow effective treatment by removing the affected worker from exposure and to establish an intervention aimed at primary prevention through sections specialized in industrial hygiene and security. Therefore, it must be considered that Sarcoidosis is a syndrome with nume rous probable etiological factors, to which both the phenotype and individual susceptibility to a given toxic effect must be associated. Due to what has been stated, this means that cases are periodically publis hed in which the clinical and histological features of non-caseous epithelioid granuloma found in biopsies are linked to a certain environmental and/or occupational risk.

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Milk and its derivatives are basic foods in Peru, especially for children. The Junín region, in the central Andes, is one of the leading dairy basins. However, the safety of milk is affected by mining-metallurgical activities, wastewater dumping, organic residues, and inappropriate use of organophosphate fertilizers in agriculture whose contaminants reach the food chain, putting human health at risk. The purpose of this study was to evaluate the bioaccumulation of lead (Pb), cadmium (Cd), and arsenic (As) in milk produced on a representative farm in central Peru, which uses phosphorous agrochemicals and is adjacent to a small mineral concentrator and a municipal solid waste dump, and to evaluate the potential risk for the Peruvian population of 2-85 years considering three levels of daily intake by age, which constitutes the innovative contribution of the study. These three elements were quantified by flame atomic absorption spectrometry following standardized procedures. The mean contents of Pb (0.062 mg/kg), Cd (0.014 mg/kg), and As (0.030 mg/kg) in milk exceeded the maximum limits allowed by international standards. At all ages, the target quotient hazard followed a descending order of As > Pb > Cd, being > 1 in the case of As. The hazard index was >1 for children under 7, 9, and 11 years of age in the scenarios of low, medium, and high milk intake. The information is valid for formulating policies to prevent adverse health effects and develop standards and awareness programs, monitoring, and control of heavy metals in milk in Peru.

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Trust in institutions is fundamental for the stability and proper functioning of democracies, particularly in matters of high public sensitivity, such as food safety. This study aimed to assess trust levels in different sources of information and respondents' evaluation of the performance of government agencies responsible for controlling food-related hazards. Individuals interviewed in three environments (hospitals/clinics, supermarkets, universities, N = 1000) answered a face-to-face questionnaire in the Federal District of Brazil, and another population (health surveillance employees at the municipal, state and federal levels; N = 1017) answered the questionnaire online. About 60% of the population interviewed considered government performance to be low/very low. Scientists/universities, medical doctors (MD)/health professionals, and nongovernmental organizations (NGOs) were judged to be the most reliable sources of information on food hazards, while the food industry, supermarkets and social media inspired the lowest trust. Individuals from the hospitals/clinics group had significantly higher trust in MD/health professionals, media and websites than the two other Federal District groups. In general, income and education were the most predictive factors for the results, being negatively associated with assessment of government performance and trust in most information sources. In the Federal District, there was a negative association between trust levels in the government and worry about pesticides and genetically modified food, but a positive association between trust in NGOs and worry on these hazards. The results point to the need for the implementation of more effective communication strategies by institutions in which the population has low trust levels, such as government and food companies.

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BACKGROUND: The occupational activities carried out in hospital environments pose occupational risks to professionals. In psychiatric hospitals, due to the characteristics of the patients treated, professionals are also subjected to other risks, such as physical aggression. OBJECTIVE: This research aimed to identify the systemic context, highlighting the cause-and-effect relationships that culminate in occupational accidents that occurred with the nursing staff in a psychiatric hospital in Brazil. METHODS: The current study is an applied research and was divided into three stages. First, the collection of data related to the case study was made and accidents were analyzed and occupational hazards were identified. In the second stage, from the collected information, occupational safety indicators were defined. Lastly, in the third stage, the qualitative aspect of System Dynamics was applied to perform the systemic analysis and to identify how the different variables were related. RESULTS: The results showed that physical aggression was the main cause of accidents. Regarding safety indicators, while both the level of use of Personal Protective Equipment (PPE) by professionals and the high level of PPE protection were positive aspects, the level of training of professionals to use PPE was a negative aspect. The Causal Link Diagram (CLD) showed that the perception of risk influenced the level of use of PPE and those organizational measures influenced the accident rate. CONCLUSION: In conclusion, the systemic analysis of the system dynamics can optimize the diagnostic process of occupational accidents in psychiatric hospitals, and especially help to identify the cause and effect among the variables involved.

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Non-communicable diseases (NCDs) are the major cause of death worldwide and have economic, psychological, and social impacts. Air pollution is the second, contributing to NCDs-related deaths. Metabolomics are a useful diagnostic and prognostic tool for NCDs, as they allow the identification of biomarkers linked to emerging pathologic processes. The aim of the present study was to review the scientific literature on the application of metabolomics profiling in NCDs and to discuss environmental planning actions to assist healthcare systems and public managers based on early metabolic diagnosis. The search was conducted following PRISMA guidelines using Web of Science, Scopus, and PubMed databases with the following MeSH terms: "metabolomics" AND "noncommunicable diseases" AND "air pollution". Twenty-nine studies were eligible. Eleven involved NCDs prevention, eight addressed diabetes mellitus, insulin resistance, systemic arterial hypertension, or metabolic syndrome. Six studies focused on obesity, two evaluated nonalcoholic fatty liver disease, two studied cancer, and none addressed chronic respiratory diseases. The studies provided insights into the biological pathways associated with NCDs. Understanding the cost of delivering care where there will be a critical increase in NCDs prevalence is crucial to achieving universal health coverage and improving population health by allocating environmental planning and treatment resources.

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Vegetables, especially those eaten raw, have been implicated in several foodborne disease outbreaks. Since multiple vegetable matrices and hazards are involved, risk managers have to prioritize those with the greatest impact on public health to design control strategies. In this study, a scientific-based risk ranking of foodborne pathogens transmitted by leafy green vegetables in Argentina was performed. The prioritization process included hazard identification, evaluation criteria identification and definition, criteria weighting, expert survey design and selection and call for experts, hazard score calculation, hazard ranking and variation coefficient, and result analysis. Regression tree analysis determined four risk clusters: high (Cryptosporidum spp., Toxoplasma gondii, Norovirus), moderate (Giardia spp., Listeria spp., Shigella sonnei), low (Shiga toxin-producing Escherichia coli, Ascaris spp., Entamoeba histolytica, Salmonella spp., Rotavirus, Enterovirus) and very low (Campylobacter jejuni, hepatitis A virus and Yersinia pseudotuberculosis). Diseases caused by Norovirus, Cryptosporidium spp. and T. gondii do not require mandatory notification. Neither viruses nor parasites are included as microbiological criteria for foodstuff. The lack of outbreak studies did not allow to accurately identify vegetables as a source of Norovirus disease. Information on listeriosis cases or outbreaks due to vegetable consumption was not available. Shigella spp. was the main responsible for bacterial diarrhea, but it has not been epidemiologically associated with vegetable consumption. The quality of the available information for all hazards studied was very low and low. The implementation of good practice guidelines throughout the entire vegetable production chain could prevent the presence of the identified hazards. The current study allowed the identification of vacancy areas and could help reinforce the need for performing epidemiological studies on foodborne diseases potentially associated with vegetable consumption in Argentina.

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Background: Firefighting involves exposure of firefighters to risks related to this activity, serious injuries, and occupational diseases are recorded. There are other consequences such as thermal and emotional stress. This systematic review is proposed in order to analyze the risks and consequences faced by these workers and thus provide elements to improve safety management systems in institutions. Method: A descriptive observational study of systematic literature review on the risks and consequences of exposure to firefighters' activity was proposed, and the information was analyzed and described based on the available data and according to the variables determined. Results: The studies showed data on mechanical, physical, chemical, psychosocial risks, workers' perception and resilience, and epidemiological data. Information related to firefighters' activity on falls and slips, exposure to noise, and high concentrations of carbon monoxide is detailed. In addition, the relationship between burnout, cognitive, and physical fatigue as adverse effects on health and performance is mentioned. Conclusions: Among the preventive measures, the use of personal protective equipment is suggested, incorporation in prevention programs of information on exposure to risk factors, as well as the implementation of models that can predict the perception of workers, additionally, the generation of management systems with safety climate models for fire departments.

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Resumo Foi avaliada a relação entre a distribuição de medicamentos usados na pandemia por SARS-COV-19 no município do Rio de Janeiro e o nível de risco ambiental estimado provocado por seus resíduos. Foi coletada a quantidade de medicamentos distribuídos pelas unidades de atenção primária à saúde (APS) entre 2019 e 2021. O quociente de risco (QR) correspondeu à razão entre a concentração ambiental preditiva estimada (PECest), obtida pelo consumo e excreção de cada fármaco, e a sua concentração preditiva não efetiva (PNEC). Os PECest da azitromicina e da ivermectina aumentaram entre 2019 e 2020, tendo uma queda em 2021 provavelmente devido ao desabastecimento. Já o da dexclorfeniramina (DEX) e da fluoxetina (FLU) tiveram uma queda, retornando o crescimento em 2021. Enquanto o PECest do diazepam (DIA) aumentou ao longo desses três anos, o etinilestradiol (EE2) diminuiu, possivelmente pela priorização da APS no tratamento da COVID-19. Os maiores QR foram de FLU, EE2 e AZI. O padrão de consumo desses medicamentos não refletiu seu risco ambiental, pois os mais consumidos possuem baixa toxicidade. Vale destacar que alguns dados podem estar subestimados devido ao incentivo que foi dado durante a pandemia para o consumo de determinados grupos de fármacos.

Abstract The relationship between the distribution of medicines used in the Pandemic by SARS-COV-19 in the municipality of Rio de Janeiro and the estimated level of environmental risk caused by their residues was evaluated. The amount of medicines distributed by primary health care (PHC) units between 2019 and 2021 were collected. The risk quotient (RQ) corresponded to the ratio between the estimated predictive environmental concentration (PECest) obtained by the consumption and excretion of each drug and its non-effective predictive concentration (PNEC). Between 2019 and 2020, the PECest of azithromycin (AZI) and ivermectin (IVE) increased between 2019 and 2020, with a decrease in 2021 probably due to shortages. Dexchlorpheniramine (DEX) and fluoxetine (FLU) fell, returning to growth in 2021. While the PECest of diazepam (DIA) increased over these 3 years, ethinylestradiol (EE2) decreased possibly due to the prioritization of PHC in the treatment of COVID-19. The largest QR were from FLU, EE2 and AZI. The consumption pattern of these drugs did not reflect their environmental risk because the most consumed ones have low toxicity. It is worth noting that some data may be underestimated due to the incentive given during the pandemic to the consumption of certain groups of drugs.

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Contaminated irrigation water is among many potential vehicles of human pathogens to food plants, constituting significant public health risks especially for the fresh produce category. This review discusses some available guidelines or regulations for microbiological safety of irrigation water, and provides a summary of some common methods used for characterizing microbial contamination. The goal of such exploration is to understand some of the considerations that influence formulation of water testing guidelines, describe priority microbial parameters particularly with respect to food safety risks, and attempt to determine what methods are most suitable for their screening. Furthermore, the review discusses factors that influence the potential for microbiologically polluted irrigation water to pose substantial risks of pathogenic contamination to produce items. Some of these factors include type of water source exploited, irrigation methods, other agro ecosystem features/practices, as well as pathogen traits such as die-off rates. Additionally, the review examines factors such as food safety knowledge, other farmer attitudes or inclinations, level of social exposure and financial circumstances that influence adherence to water testing guidelines and other safe water application practices. A thorough understanding of relevant risk metrics for the application and management of irrigation water is necessary for the development of water testing criteria. To determine sampling and analytical approach for water testing, factors such as agricultural practices (which differ among farms and regionally), as well as environmental factors that modulate how water quality may affect the microbiological safety of produce should be considered. Research and technological advancements that can improve testing approach and the determination of target levels for hazard characterization or description for the many different pollution contexts as well as farmer adherence to testing requirements, are desirable.

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BACKGROUND: The working population is exposed daily to unavoidable climatic conditions due to their occupational settings. Effects of the weather such as rain, heat, and air pollution may increase the risk of diseases, injuries, accidents, and even death during labor. OBJECTIVE: This paper aims to summarize the impacts of climate change on workers' health, safety and performance, identifying the risks, affected workplaces and the range of methodological approaches used to assess this problem. METHODS: A thorough systematic mapping was conducted in seven scientific international databases: Emerald, IEEE Xplore, Science Direct, Scielo, Scopus, SpringerLink, and Web of Science. Three research questions guided the extraction process resulting in 170 articles regarding the impacts of climate change on occupational health and safety. RESULTS: We found an accentuated trend in observational studies applying primary and secondary data collection. Many studies focused on the association between rising temperatures and occupational hazards, mainly in outdoor work settings such as agriculture. The variation of temperature was the most investigated impact of climate change. CONCLUSIONS: We established a knowledge base on how to explore the impacts of climate change on workers' well-being and health. Researchers and policymakers benefit from this review, which explores the suitable methods found in the literature and highlights the most recurring risks and their consequences to occupational health and safety.

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A dor musculoesquelética é um problema frequente nos profissionais da enfermagem e várias medidas vêm sendo pesquisadas a fim de diminui-la, entretanto, poucos estudos abordam a influência do aumento da resiliência desses profissionais no controle da sua dor. Desta maneira, o objetivo deste trabalho foi identificar associação entre resiliência e dor musculoesquelética, em diferentes regiões anatômicas, referida por profissionais de enfermagem. Trata-se de estudo observacional transversal com 321 profissionais de enfermagem. Foram utilizados questionário sociodemográfico e laboral, questionário nórdico de sintomas osteomusculares, escala analógica da dor e escala de resiliência. Para análise foi utilizado estatística descritiva e analítica, através dos testes Mann-Whitney U e Kruskal Wallis. Foi verificada relação da dor com características sociodemográficas, laborais e resiliência, analisadas. 261 (81,3%) afirmaram ter apresentado dor musculoesquelética no último ano e as regiões mais acometidas foram partes superior e inferior das costas s e ombros. Identificou-se associação entre intensidade da dor e dor musculoesquelética em todas as regiões corporais investigadas (p < 0,05), idade (p = 0,015), categoria profissional (p = 0,032), tempo de atuação na enfermagem (p = 0,003) e turno de trabalho (p = 0,012), e correlação entre resiliência e dor musculoesquelética no pescoço (p = 0,010) e quadril e coxas (p = 0,009). Sendo assim, a elevada resiliência está associada ao melhor controle da dor musculoesquelética, em especial, na região do pescoço, de enfermeiros.

Musculoskeletal pain is a frequent problem in nursing professionals, and several treatments have been researched to reduce it; however, few studies address the influence of increased resilience of these professionals in controlling their pain. Thus, this study aimed to identify an association between resilience and musculoskeletal pain reported by nursing professionals in different anatomical regions. This is a cross-sectional observational study with 321 nursing professionals. A sociodemographic and work questionnaire, a Nordic musculoskeletal symptoms questionnaire, an analog pain scale, and a resilience scale were used. Descriptive and analytical statistics were used for analysis, using the Mann-Whitney U and Kruskal Wallis tests. The relationships between pain and sociodemographic, work, and resilience characteristics were analyzed. 261 (81.3%) reported having had musculoskeletal pain in the last year, and the most affected regions were the upper and lower backs and shoulders. An association was identified between pain intensity and musculoskeletal pain in all investigated body regions (p < 0.05), age (p = 0.015), professional category (p = 0.032), length of experience in nursing (p = 0.003), and work shift (p = 0.012). A correlation was also observed between resilience and musculoskeletal pain in the neck (p = 0.010) and hip and thighs (p = 0.009). Thus, high resilience is associated with better control of musculoskeletal pain among nurses, especially in the neck region.

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Objetivo: analisar a percepção dos profissionais de saúde em centro cirúrgico com relação as suas condutas voltadas à biossegurança e à segurança do paciente no contexto da COVID-19. Método: estudo qualitativo realizado por meio de entrevistas semiestruturadas com profissionais de saúde de um centro cirúrgico, no período de março a junho de 2021. Utilizou-se Bardin para análise dos dados. Resultados: participaram 36 profissionais de saúde, contando com técnicos de enfermagem, enfermeiros e médicos. A análise de dados resultou em 2222 unidades de registros e 191 unidades de significação distribuídas nas seguintes categorias: "Conhecimento/importância da temática"; "Biossegurança e segurança do paciente na prática profissional"; "Percepção dos profissionais em relação as suas condutas voltadas à biossegurança e segurança do paciente" Conclusão: evidenciou-se o fortalecimento das medidas de biossegurança e segurança do paciente decorrente à preocupação da contaminação por COVID-19.

Objective: to analyze the perception of health professionals in the operating room regarding their biosafety and patient safety behaviors in the context of COVID-19. Method: qualitative study carried out through semi-structured interviews with health professionals from a surgical center, from March to June 2021. Bardin was used for data analysis. Results: 36 health professionals participated, including nursing technicians, nurses and doctors.Data analysis resulted in 2222 units of records and 191 units of meaning distributed in the following categories: "Knowledge/importance of the theme"; "Biosafety and patient safety in professional practice"; "Perception of professionals in relation to their conduct aimed at biosafety and patient safety" Conclusion: the strengthening of biosafety and patient safety measures was evidenced due to the concern of contamination by COVID-19.

Objetivo: analizar la percepción de los profesionales de la salud en el quirófano sobre sus comportamientos de bioseguridad y seguridad del paciente en el contexto de la COVID-19. Método: estudio cualitativo realizado a través de entrevistas semiestructuradas con profesionales de la salud de un centro quirúrgico, de marzo a junio de 2021. Se utilizó Bardin para el análisis de datos. Resultados:participaron 36 profesionales de la salud, entre técnicos de enfermería, enfermeros y médicos.El análisis de datos resultó en 2222 unidades de registro y 191 unidades de significado distribuidas en las siguientes categorías: "Conocimiento/importancia del tema"; "Bioseguridad y seguridad del paciente en la práctica profesional"; "Percepción de los profesionales en relación a su conducta encaminada a la bioseguridad y seguridad del paciente" Conclusión: se evidenció el fortalecimiento de las medidas de bioseguridad y seguridad del paciente ante la preocupación por la contaminación por COVID-19.

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This field note examines the disaster risk construction process in Lima, Peru. More commonly experienced hazard contexts are considered in the light of the COVID-19 pandemic. We provide an empirical analysis based on Lima-wide data and using findings from a single case study settlement to illustrate more general conclusions. We attempt to reveal how exposure and vulnerability factors signify that very different hazards, including COVID-19, predominantly affect the same population groups. Underlying causes and drivers, all related to different expressions of urban inequality, include problems of access to suitable urban land, land trafficking and invasion, State exclusion from social housing and basic services, unsafe building practice and corruption. The research confirms the usefulness of a social construction approach to disaster risk, based on the notion of underlying causes and drivers, and the need to reconfigure urban planning processes, breaking sector silos and encouraging integrated intersectoral and interspatial approaches.

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So far in this century, six very large-magnitude earthquakes (MW ≥ 7.8) have ruptured separate portions of the subduction zone plate boundary of western South America along Ecuador, Peru, and Chile. Each source region had last experienced a very large earthquake from 74 to 261 y earlier. This history led to their designation in advance as seismic gaps with potential to host future large earthquakes. Deployments of geodetic and seismic monitoring instruments in several of the seismic gaps enhanced resolution of the subsequent faulting processes, revealing preevent patterns of geodetic slip deficit accumulation and heterogeneous coseismic slip on the megathrust fault. Localized regions of large slip, or asperities, appear to have influenced variability in how each source region ruptured relative to prior events, as repeated ruptures have had similar, but not identical slip distributions. We consider updated perspectives of seismic gaps, asperities, and geodetic locking to assess current very large earthquake hazard along the South American subduction zone, noting regions of particular concern in northern Ecuador and Colombia (1958/1906 rupture zone), southeastern Peru (southeasternmost 1868 rupture zone), north Chile (1877 rupture zone), and north-central Chile (1922 rupture zone) that have large geodetic slip deficit measurements and long intervals (from 64 to 154 y) since prior large events have struck those regions. Expanded geophysical measurements onshore and offshore in these seismic gaps may provide critical information about the strain cycle and fault stress buildup late in the seismic cycle in advance of the future great earthquakes that will eventually strike each region.

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The construction industry has high accident rates. The sector is exploring various tools to improve safety management, training, and awareness to achieve zero accidents. This work focuses on extended reality (XR), which encompasses virtual reality (VR), augmented reality (AR), and mixed reality (MR) technologies. Several authors have developed training experiences for construction safety in XR environments with positive conclusions about their effectiveness. However, there is no standardization regarding the evaluation methods used in the sector, and many experiences do not use any method. This lack is critical, as whenever the aim is to evaluate the degree of awareness of security issues, the implementation of evaluation systems is indispensable to make known the methods used in the literature to evaluate the effectiveness of the experiences and represent support for future research. This research identifies developments in XR experiences and analyzes the validation methods through a systematic review using the PRISMA methodology. It identifies two evaluation methods, objective and subjective, which are each broken down into four categories. The results show the types of evaluation, safety-related purposes, and safety application objectives used by the database classification.

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OBJECTIVE: This study assessed the risk factors for sustaining a snake bite, the prehospital measures employed, and the clinical needs of patients admitted with confirmed envenomation. METHODOLOGY: Data was collected at a single center, a rural secondary care hospital in Trinidad and Tobago. A cross-sectional method was used that enrolled all consenting patients requiring admission following clinical confirmation of snake envenomation during the period 2017-2019. Data collection involved a review of the patient record from the emergency room and hospital admission to establish the clinical need during the time of admission which was defined as the administration of medication, need for surgery, and critical care intervention. Data collection also involved a patient interview to establish demographics, prehospital measures employed, and assessment of the risk factors associated with sustaining the snake bite. RESULTS: 29 patients were admitted for snakebite envenomation during 2017-2019 and all patients consented to enrolment. Of these patients, 22 were male and most commonly were within the age range of 18-40 years old. 34.5% of patients were farmers and 68.9% of patients identified being bitten by the Mapepire Balsain snake. 65.5% of patients reported being unaware of the risk of snake bites and 82.8% were not wearing boots, with the lower limb being the most common bite site among 55.2%. 41.4% of bites were sustained during work-related activity while 34.5% of bites were sustained during recreational activity. Prehospital measures were employed by 18 of the 29 patients with the most common types being irrigation (10.3%), cutting (6.9%), tourniquets (44.8%), pressure immobilization (6.9%), topical applications (3.4%), and ingestion of a substance (6.9%). 34.5% received hospital care within 1 hour of the bite while 55.2% arrived at the hospital between 1 and 4 hours of being bitten. The clinical challenges of these patients included local reactions (82.8%), coagulopathy (72.4%), compartment syndrome (17.2%), cellulitis (3.4%), and dislocated shoulder (3.4%). The clinical needs of these patients included vitamin K (13.8%), antibiotics (93.1%), tetanus shots (17.2%), analgesia (6.8%), and anti-venom (82.7%). 10.3% of patients required debridement and 3.4% required a fasciotomy. The average stay in the hospital was 3.8 days. There were no documents of deaths or need for critical care. CONCLUSION: Persons are most likely to be envenomated by the M. Balsain in Trinidad. These patients are commonly males ranging anywhere from 18 to 40 years presenting local reactions and coagulopathy needing admittance to the hospital. While the majority of patients requiring admission performed some type of prehospital measure, very few did so with pressure immobilization. Furthermore, the majority of patients had a prolonged time before presenting to the hospital; this is a potential area for improvement in the health system through education and sensitization. There was a significant utilization of resources on these patients when taking into consideration their clinical needs, medication, and hospital stay; primary prevention should be a focus through the education of groups who are at higher risk for a venomous snake encounter.