La dinámica del comercio ilegal de armas de fuego en Lima, Perú / The dynamics of the illegal firearms trade in Lima, Peru / A dinâmica do comércio ilegal de armas de fogo em Lima, Peru

El comercio ilegal de armas de fuego representa un problema significativo para mantener el orden y la seguridad del país, pues conlleva la adquisición de armas y municiones sin cumplir la normatividad y las regulaciones proporcionadas por el Estado, desviando la utilización de dichos equipos hacia la delincuencia. La investigación tiene como propósito analizar la dinámica del comercio ilegal de armas de fuego en Lima, Perú, mediante una metodología cualitativa y de diseño fenomenológico hermenéutico. La muestra incluye veinte funcionarios de la Policía Nacional del Perú (PNP) y la Superintendencia Nacional de Control de Servicios de Seguridad, Armas, Municiones y Explosivos de Uso Civil (Sucamec). La información se recolectó por medio de entrevistas semiestructuradas. El estudio concluye que el comercio ilegal de armas de fuego se estructura en tres fases clave: la primera fase determinada por la filtración o desvío de armas del mercado legal al ilegal, debido a la falta de control y fiscalización por las autoridades pertinentes. La segunda fase implica la creación de un mercado ilegal en espacios itinerantes, donde participan diversos actores, como intermediarios y compradores. La tercera y última fase comprende la consumación del delito, incluye la entrega del arma y el pago bajo estrictas medidas de seguridad para asegurar la impunidad de los involucrados.

The illegal trade in firearms represents a significant problem for the maintenance of order and security in the country, as it leads to the acquisition of arms and ammunition without complying with the norms and regulations provided by the State, diverting the use of such equipment towards crime. The purpose of this research is to analyse the dynamics of the illegal firearms trade in Lima, Peru, using a qualitative methodology and a hermeneutic phenomenological design. The sample includes twenty officers from the Peruvian National Police (PNP) and the National Superintendence for the Control of Security Services, firearms, Ammunition and Explosives for Civilian Use (Sucamec). The information was collected through semi-structured interviews. The study concludes that the illegal firearms trade is structured in three key phases: the first phase determined by the leakage or diversion of arms from the legal to the illegal market, due to the lack of control and oversight by the relevant authorities. The second phase involves the creation of an illegal market in itinerant spaces, where various actors, such as intermediaries and buyers, participate. The third and final phase involves the consummation of the crime, including the delivery of the weapon and payment under strict security measures to ensure the impunity of those involved.

O comércio ilegal de armas de fogo representa um problema significativo para a manutenção da ordem e da segurança no país, pois leva à aquisição de armas e munições sem o cumprimento das normas e regulamentos fornecidos pelo Estado, desviando o uso desses equipamentos para o crime. O objetivo desta pesquisa é analisar a dinâmica do comércio ilegal de armas de fogo em Lima, Peru, usando uma metodologia qualitativa e um desenho fenomenológico hermenêutico. A amostra inclui vinte policiais da Polícia Nacional do Peru (PNP) e da Superintendência Nacional de Controle de Serviços de Segurança, Armas, Munições e Explosivos para Uso Civil (Sucamec). As informações foram coletadas por meio de entrevistas semiestruturadas. O estudo conclui que o comércio ilegal de armas de fogo está estruturado em três fases principais: a primeira fase é determinada pelo vazamento ou desvio de armas do mercado legal para o ilegal, devido à falta de controle e fiscalização por parte das autoridades competentes. A segunda fase envolve a criação de um mercado ilegal em espaços itinerantes, onde vários atores, como intermediários e compradores, participam. A terceira e última fase envolve a consumação do crime, incluindo a entrega da arma e o pagamento sob rigorosas medidas de segurança para garantir a impunidade dos envolvidos.

Appréciation des facteurs de risque cardiovasculaires dans le secteur informel: une étude transversale chez des femmes fumeuses de poissons au sud du Bénin / Screening for cardiovascular risk factors in the informal sector: a cross-sectional study among fish-smoking women in southern Benin

Introduction : Les maladies non transmissibles (MNT) sont en augmentation dans plusieurs secteurs d'activité. L'objectif de l'étude était de décrire les facteurs de risque des MNT chez des femmes fumeuses de poissons sur deux sites au Bénin relevant du secteur informel. Méthodes : Il s'agissait d'une étude transversale descriptive qui s'est déroulée pendant un mois du 25 Avril au 26 Mai 2019. La population d'étude a été constituée des femmes fumeuses de poissons des sites de Xwlacodji et de Djeffa ayant au moins deux années d'ancienneté. Les variables étudiées étaient relatives aux caractéristiques socioprofessionnelles, aux facteurs comportementaux et bio cliniques. Le recrutement des participants a été exhaustif. Un questionnaire standardisé inspiré de celui du STEPS-OMS a été utilisé pour la collecte des données. Une analyse descriptive a été effectuée. Résultats : Au total, 81femmes ont été incluses. L'âge médian des femmes était de 40 ans, avec un intervalle interquartile de [25-75] ; 17 (21%) étaient scolarisées ; 39 (48,14%) ont une ancienneté de plus de 20 ans. Les facteurs comportementaux se présentaient comme suit :1,23% tabagisme (cigarette) ; 69,14% consommation régulière de l'alcool ; 46,91% d'insuffisance d'activité physique ; 100% de consommation insuffisante de FEL. En ce qui concerne les facteurs biocliniques il y avait 56,78% de surcharge pondérale ; 32,1% pression artérielle élevée prenant en compte la prise d'antihypertenseur ; 5,4% d'hyperglycémie. Conclusion : La fréquence de certains facteurs de risque des MNT est élevée, la mise en place d'un programme de sensibilisation est nécessaire.

Introduction: Non-communicable diseases (NCDs) are on the increase in several sectors of activity. The aim of the study was to describe the risk factors for NCDs among women fish smokers in two Benin sites in the informal sector. Methods: This was a descriptive cross-sectional study conducted over a one-month period from April 25 to May 26, 2019. The study population consisted of fish-smoking women from the Xwlacodji and Djeffa sites with at least two years of seniority. Variables studied included socioprofessional characteristics, behavioral and bio-clinical factors. Participants were recruited exhaustively. A standardized questionnaire based on the STEPS-OMS questionnaire was used forn data collection. Descriptive analysis was performed. Results: A total of 81 women were included. The median age of the women was 40 years, with an interquartile range of [25-75]; 17 (21%) had attended school; 39 (48.14%) had attended school for more than 20 years. Behavioural factors were: 1.23% smoking; 69.14% regular alcohol consumption; 46.91% insufficient physical activity; 100% insufficient FEL consumption. Bioclinical factors were: 56.78% overweight; 32.1% hypertension with antihypertensive medication; 5.4% hyperglycemia. Conclusion: The frequency of certain risk factors for non-communicable diseases is high, and an awareness program is needed.

Soledad en cuidadores informales de personas con demencia durante la pandemia de COVID-19 / Loneliness in informal caregivers of people with dementia during the COVID-19 pandemic

ANTECEDENTES Y OBJETIVO: La soledad es un factor de riesgo para el desarrollo de enfermedades físicas y mentales, causando disminución en la calidad de vida y un aumento de la mortalidad. El objetivo de este artículo fue determinar los factores predictores de soledad en personas cuidadoras informales de personas con demencia dentro de un contexto de crisis como fue la pandemia por COVID-19 con el fin de identificar e intervenir en dichos factores desde la atención primaria de salud. DISEÑO Y METODOLOGÍA: Este es un estudio cuantitativo de carácter transversal para el cual se realizó un muestreo de conveniencia no probabilístico. Ciento noventa y cinco personas cuidadores informales, por medio de una encuesta en línea, respondieron preguntas sociodemográficas y clínicas sobre ellos mismos (soledad, síntomas ansiosos y depresivos, actividades físicas y mentales, sobrecarga y apoyo psicosocial) y sobre la persona con demencia (cambios en la memoria y en los síntomas conductuales y psicológicos). Los datos fueron recolectados durante 6 meses y se hicieron análisis descriptivos, de correlación y de regresión. RESULTADOS: La baja escolaridad, disminución del ingreso económico, no mantener durante la pandemia las actividades físicas y mentales y la sobrecarga en el cuidador se relacionaron significativamente con mayor soledad, mientras que los factores predictores de la misma fueron la presencia de sintomatología ansiosa depresiva, la baja percepción de apoyo psicosocial y la convivencia de la persona cuidadora con la persona con demencia. CONCLUSIÓN: El riesgo de desarrollar soledad en los cuidadores informales de personas con demencia es alto. Los profesionales de enfermería, particularmente en atención primaria, deben estar alertas a identificar a aquellos cuidadores que conviven con la persona con demencia, que presentan síntomas ansiosos y depresivos y que reportan una baja percepción de apoyo psicosocial dado que son más vulnerables de experimentar soledad percibida.

BACKGROUND AND OBJECTIVE: Loneliness is a risk factor for the development of physical and mental illness, causing decreased quality of life and increased mortality. The aim of this article was to recognise predictors of loneliness in informal caregivers of people with dementia in the context of a crisis such as the COVID-19 pandemic. DESIGN AND METHODOLOGY: 195 informal caregivers, through an online survey, answered sociodemographic and clinical questions about themselves (loneliness, anxious and depressive symptoms, physical and mental activities, overload and psychosocial support) and about the person with dementia (changes in memory and behavioural and psychological symptoms). RESULTS: Low schooling, decreased income, failure to maintain physical and mental activities during the pandemic and caregiver overload were significantly related to increased loneliness, while predictors of loneliness were the presence of depressive anxiety symptoms, low perception of psychosocial support and the caregiver living with the person with dementia. CONCLUSION: The risk of developing loneliness in caregivers of people with dementia is high. Nursing professionals, particularly in primary care, should be on the alert for those caregivers within this group who live with the person with dementia, who present anxious and depressive symptoms and who report a low perception of psychosocial support, as they are more vulnerable to experiencing perceived loneliness.

Sobre el currículo oculto: del buen médico, la jerarquía y el maltrato

Objetivo: Describir las interacciones de algunos estudiantes de dos programas de Medicina en Colombia relacionadas con el currículo oculto. Metodología: Estudio hermenéutico, que utilizó la etnografía y la teoría fundamentada, mediante la aplicación de observación participante en cinco escenarios de práctica y once entrevistas en profundidad. El análisis de los datos se hizo con codificación abierta, axial y selectiva, propias de la teoría fundamentada, lo que generó una matriz del paradigma. Resultados: Estudiar Medicina implica hacer parte de una jerarquía desde inspiradora hasta excesiva. La exigencia de la educación médica por formar un médico incansable e intachable, la competencia para ser admitido a cada rango y el miedo a equivocarse exacerban el funcionamiento negativo de la jerarquía médica. Esta jerarquía se basa en el poder del conocimiento que permite el maltrato. Lo anterior desencadena agotamiento, frustración, desinterés y afecta la ética profesional, aspectos que estropean al médico en formación. Conclusión: El currículo oculto determina la formación del médico más que el currículo formal. Reconocer y reflexionar sobre el currículo oculto desde la comunidad académica permite visibilizar, en futuras reformas curriculares, el papel que este desempeña.

Objective: To describe the interactions of some students from two Medicine programs in Colombia related to the hidden curriculum. Methodology: Hermeneutic study, which used ethnography and grounded theory, through the application of participant observation in five practice scenarios and eleven in-depth interviews. The data analysis was done with open, axial and selective coding, typical of the grounded theory, which generated a matrix of the paradigm. Results: Studying Medicine implies being part of a hierarchy from inspiring to excessive. The demand of medical education to train a tireless and blameless doctor, the competition to be admitted to each rank and the fear of making mistakes exacerbate the negative functioning of the medical hierarchy. This hierarchy is based on the power of knowledge that allows abuse. The above triggers exhaustion, frustration, lack of interest and affects professional ethics, aspects that spoil the doctor in training. Conclusion: The hidden curriculum determines the doctor's training more than the formal curriculum. Recognizing and reflecting on the hidden curriculum from the academic community makes visible, in future curricular reforms, the role it plays.

Objetivo: Descrever as interações de alguns alunos de dois cursos de Medicina da Colômbia em relação ao currículo oculto. Metodologia: Estudo hermenêutico, que utilizou etnografia e teoria fundamentada, por meio da aplicação da observação participante em cinco cenários de prática e onze entrevistas em profundidade. A análise dos dados foi feita com codificação aberta, axial e seletiva, típica da teoria fundamentada, que gerou uma matriz do paradigma. Resultados: Estudar Medicina implica fazer parte de uma hierarquia que vai do inspirador ao excessivo. A exigência da formação médica para formar um médico incansável e irrepreensível, a competição para ser admitido em cada posto e o medo de errar exacerbam o funcionamento negativo da hierarquia médica. Essa hierarquia é baseada no poder do conhecimento que permite o abuso. O exposto acima desencadeia esgotamento, frustração, desinteresse e afeta a ética profissional, aspectos que prejudicam o médico em formação. Conclusão: O currículo oculto determina mais a formação do médico do que o currículo formal. Reconhecer e refletir sobre o currículo oculto da comunidade acadêmica torna visível, em futuras reformas curriculares, o papel que ele desempenha.

A rua como local de trabalho: o caso de entregadores via aplicativos / The street as a workplace: the situation of delivery drivers via apps / La rue comme lieu de travail: la situation des livreurs par l'entremise d'applications

O estudo apresentado neste artigo investigou o contexto em que se dá o trabalho de entregadores via aplicativos, levando em consideração problemas agravados pela pandemia de covid-19, tais como: o fato de ser realizado na rua, o sucateamento de direitos trabalhistas e sua precarização com o fenômeno de uberização. Os resultados apontam impactos negativos na saúde biopsicossocial desses entregadores, evidenciando uma queda da remuneração e uma maior exposição ao vírus. Dentre os impactos, destacam-se o aumento de processos psicopatológicos, além do medo em relação à iminente possibilidade de contrair o coronavírus e contaminar sua rede de apoio social. Desta maneira, conclui-se que a pandemia de covid-19, aliada a políticas de sucateamento dos direitos trabalhistas influenciam diretamente a saúde biopsicossocial desses trabalhadores, empurrando-os para a margem do trabalho formal e potencializando o processo de uberização relacionado a esse modelo de trabalho informal

The study presented in this article examined the work context of delivery drivers via apps, taking into account the problems aggravated by the covid-19 pandemic such as: the fact that the work is carried out on the street, the scrapping of labour rights and the precariousness of their work, due to the phenomenon of uberization. The results reveal negative impacts on the biopsychosocial health of these delivery drivers, highlighting a drop in remuneration and a greater exposure to the virus. Among these impacts, the increase in psychopathological processes as well as the fear of the imminent possibility of contracting the corona-virus and contaminating their social support network are the most visible. In this way, it is concluded that the covid-19 pandemic combined with policies to scrap labour rights have influence on the biopsychosocial health of these workers, pushing them to the margins of formal employement and intensifying the uberiza-tion process related to this informal work model

L'étude presentée dans cet article a examiné le contexte dans lequel des livreurs par l'entremise d'appli-cations travaillent, en tenant compte des problèmes aggravés par la pandémie de covid-19, tels que: le fait que le travail soit effectué dans la rue, la supression des droits du travail et sa précarisation causé par le phénomène d'ubérisation. Les résultats indiquent des impacts négatifs sur la santé biopsychosociale de ces livreurs, montrant une baisse des rémunérations et une plus grande exposition au virus. Parmi ces impacts, attirent l'attention l'augmentation des processus psychopathologiques, de la même manière que la crainte de la possibilité imminente de contracter le coronavirus et de contaminer leur réseau de soutien social. Il est conclu que la pandémie de covid-19 combinée aux politiques de suppression des droits du travail influent directement sur la santé biopsychosociale de ces travailleurs, en les poussant en marge du travail formel et en renforçant le processus d'ubérisation lié à ce modèle de travail informel

IMPACTS OF COVID-19 ON THE INFORMAL SECTOR OF INDIA

The Indian economy is comprised of both the formal or organized sector and the informal or unorganized sector. Both these sectors were severely harmed during the Covid-19 pandemic. The government of India announced an abrupt and sudden lockdown without any prior steps of combating the drawbacks of such an abrupt action. This left the informal sector completely stranded amidst the pandemic. Taking this into consideration, the paper tries to discuss the impacts of the lockdown on the informal sector. While stressing on the adversaries faced by the labourers, the paper addresses the negative impacts of the lockdown on the female workers in the informal sector. Followed by this contextual discussion, the paper attempts to discuss the steps and schemes promulgated by the government for combating this crisis and its limitations. Finally, the paper concludes with an attempt on briefly analyzing the contingencies and suggesting ways forward to meet the exigencies.

Awareness, willingness, and challenges of the informal sector toward state National Health Insurance Services in Benin City, Nigeria

Background: As access to vital health services expands and universal health coverage is attained, health insurance is projected to serve as a critical risk protection for families and small enterprises. Aim: To assess the informal sector’s awareness, willingness, and problems in enrolling in the state national health insurance program. Materials and Methods: This cross-sectional descriptive study was done in Benin City, Nigeria, in the unorganized sector. A self-structured questionnaire was created, distributed, and retrieved for this study, which was conducted among 155 artisans chosen through a stratified random sample procedure. To evaluate the data, Statistical Package for the Social Sciences, SPSS version 22 was used. Results: In total, 138 people (89.0%) are aware of the National Health Insurance Scheme (NHIS), while only 93 people (60.0%) know that Edo state has a state-owned Health Insurance Scheme (SHIS). Only 17 people, or 11.0%, are engaged in the NHIS/SHIS program, whereas 107 people, or 77.5%, have expressed interest. Lack of accessibility to authorized healthcare facilities near house 22 (71.0%) is a significant deterrent to enrollment in the program. Long lines at service points (3.88, 1.093), the time it takes to enroll new members in the program (3.78, 1.101), the time it takes for health maintenance organizations to issue authorization codes (3.62, 1.316), the accessibility of NHIS services outside of registration institutions (3.29, 1.289), and the standard of drugs provided by the SHIS (3.12, 1.358) are all factors that hinder utilization. Sex and place of residence each strongly correlated with readiness to sign up for the program (AOR = 4.234, P = 0.017, 95% CI: 1.293–13.873 and AOR = 5.224, P = 0.007, 95% CI: 1.557–17.530, respectively). Conclusion: The artisans have a low rate of health insurance coverage but are eager to sign up for the program. State policymakers should increase their reach and make enrollment required to attain a higher range.

Transparency of subnational governments: the impact of inequality on transparency / Transparencia de los gobiernos subnacionales: el impacto de la desigualdad en la transparencia / Transparência dos governos subnacionais: o impacto da desigualdade na transparência

Abstract What are the effects of extractive informal institutions on the horizontal accountability process in a developing democracy? This paper presents evidence about the harmful effects of extractive informal institutions on horizontal accountability within subnational governments in Brazil. After three decades of free and competitive elections, the institutional design of oversight institutions for state governments has hardly changed. We explore the hypothesis that more extractive informal institutions, measured by the level of income inequality, is associated with decreasing transparency levels. Given its extensive social, political, and economic diversity embedded in an overall centralized formal institutional framework, Brazil provides an appropriate setting to test the hypothesis that extractive informal institutions responsible for increased income inequality can undermine horizontal accountability in new democracies.

Resumen ¿Cuáles son los efectos de las instituciones informales extractivas sobre el proceso de accountability horizontal en una democracia en desarrollo? Este artículo presenta evidencia sobre los efectos dañinos de las instituciones informales extractivas sobre la accountability horizontal dentro de los gobiernos subnacionales en Brasil. Después de tres décadas de elecciones libres y competitivas, el diseño institucional de las instituciones de supervisión de los gobiernos estatales apenas ha cambiado. Exploramos la hipótesis de que las instituciones informales más extractivas, medidas por el nivel de desigualdad de ingresos, están asociadas con niveles decrecientes de transparencia. Dada su amplia diversidad social, política y económica integrada en un marco institucional formal, general y centralizado, Brasil proporciona un entorno apropiado para probar la hipótesis de que las instituciones informales extractivas, responsables de una mayor desigualdad de ingresos, pueden socavar la accountability horizontal en las nuevas democracias.

Resumo Quais são os efeitos das instituições informais extrativas no processo de accountability horizontal numa democracia em desenvolvimento? Este artigo apresenta evidências sobre os efeitos nocivos das instituições informais extrativistas na accountability horizontal dos governos subnacionais no Brasil. Após três décadas de eleições livres e competitivas, o desenho institucional das instituições de fiscalização dos governos estaduais praticamente não mudou. Exploramos a hipótese de que instituições informais mais extrativas, medidas pelo nível de desigualdade de renda, estão associadas a níveis decrescentes de transparência. Dada a sua extensa diversidade social, política e econômica, inserida num quadro institucional formal centralizado, o Brasil oferece um cenário apropriado para testar a hipótese de que as instituições informais extrativas responsáveis pelo aumento da desigualdade de rendimentos podem minar a accountability horizontal nas novas democracias.

Is chemical exposure present in informal work associated with Sars-CoV-2 infection?

ABSTRACT OBJECTIVE To compare the incidence of covid-19 symptoms between informal home-based workers and a control group and to assess the association of these cases with blood elements concentrations and other relevant risk factors for Sars-Cov-2 infection. METHODS Welders chemically exposed to potentially toxic elements (PTEs) (n = 26) and control participants (n = 25) answered questionnaires on adherence to social distancing and signs and symptoms of the disease for five months during the covid-19 pandemic. After follow-up, covid-19 serology tests were performed on a subsample of 12 chemically exposed workers and 20 control participants. Before the pandemic, PTE concentrations in blood (As, Mn, Ni, Cd, Hg, Sb, Sn, Cu, Zn, and Pb) were measured by ICP-MS. RESULTS The chemically exposed group had higher lead and cadmium levels in blood (p < 0.01). The control group presented lower adherence to social distancing (p = 0.016). Although not significant, welders had a 74% greater chance of having at least one covid-19 symptom compared with control participants, but their adherence to social distancing decreased this chance by 20%. The use of taxis for transportation was a risk factor significantly associated with covid-19 symptoms. CONCLUSION The lower adherence to social distancing among the control group greatly influences the development of covid-19. The literature lacks data linking exposure to PTEs and Sars-Cov-2 infection and/or severity. In this study, despite chemical exposure, working from home may have protected welders against covid-19, considering that they maintained greater social distancing than control participants.

Experiencias interactivas y conversacionales de familias visitantes en "Darwin, la exposición,explorando las especies", en el Museo Trompo Mágico, México / Interactive and conversational experiences of visiting families in "Darwin, the exhibition, exploring species," at the Museo Trompo Mágico, Mexico

Resumen Analizamos el contenido conversacional y las interacciones de diez familias, con el fin de comprender cómo es la experiencia de aprendizaje en una exposición científica. Como herramienta de análisis se utilizó un protocolo que combina aspectos teóricos y empíricos de la interactividad. Los resultados evidencian que las familias participaron activamente en la exhibición, observando y conversando sobre los animales, haciendo preguntas, buscando respuestas y elaborando explicaciones basadas en el pensamiento científico. Los adultos actuaron como facilitadores del aprendizaje y para ello se apoyaron en paneles informativos fomentando la conexión con experiencias previas. Los niños muestran curiosidad, emociones y comportamientos que evidencian sus experiencias de aprendizaje e interés por temas científicos.

Abstract We analyzed the conversational content and interactions of ten families, with the aim of understanding the learning experience of families in a scientific exhibition. As instrument of analysis, it was used a protocol combining theoretical and empirical aspects of interactivity. The results show that the families actively participated in the exhibition, observing and talking about the animals, asking questions, looking for answers and elaborating explanations based on scientific thinking. The adults acted as facilitators of learning and for this they were supported by information panels promoting the connection with previous experiences. Children show curiosity, emotions and behaviors that evidence their learning experiences and interest in scientific topics.

Factores de riesgo asociados a la sobrecarga en cuidadores informales de adultos mayores postrados

Introducción: El envejecimiento de la población es uno de los más importantes fenómenos del siglo XXI. Cada día se hacen más necesarias las investigaciones respecto a este tema. Objetivo: Determinar los factores de riesgo asociados a la sobrecarga en cuidadores informales de adultos mayores postrados del área de salud de Cacocum, Holguín, en el año 2022. Método: Se realizó un estudio observacional descriptivo transversal, en el municipio Cacocum, Holguín, desde el 5 de julio de 2021 hasta el 29 de agosto de 2022. El universo estuvo constituido por 129 cuidadores de adultos mayores postrados (N꓿129) y la muestra por 106 cuidadores informales (n꓿106), obtenida por muestreo no probabilístico intencional. Para determinar la sobrecarga de los cuidadores se utilizó la escala de Zarit. Las variables estudiadas fueron: edad, sexo, nivel educacional, promedio de horas diarias dedicadas al cuidado del enfermo, vínculo del cuidador con el enfermo y presencia de sobrecarga del cuidador. Resultados: Predominó el grupo de edad de 60-69 años y el sexo femenino. Predominaron los cuidadores con el duodécimo grado y los sobrecargados. Existió un predominio de cuidadores con vínculo familiar y una relación significativa con la sobrecarga. Predominaron los cuidadores que dedicaban 18 horas como promedio al día al cuidado del enfermo y existió un predominio de cuidadores que habían dedicado de 3 a 4 años al cuidado del enfermo, se halló una relación significativa con la sobrecarga. Conclusiones: El vínculo del cuidador con el enfermo en cuanto a relación filial y los años dedicados al cuidado del mismo fueron los factores más asociados con el desarrollo de sobrecarga.

Introduction: Population aging is one of the most important phenomenon of the 21st century. Research on this subject is becoming more and more necessary every day. Objective: To determine the risk factors associated with overload in informal caregivers of prostrate older adults in the health area of Cacocum, Holguín, year 2022. Method: A cross-sectional descriptive observational study was carried out in Cacocum, Holguín, from July 5, 2021 to August 29, 2022. A total of 129 caregivers of prostrate older adults (N꓿129) were selected as the study´s universe and the sample consisted of 106 informal caregivers (n꓿106), obtained by nonprobability purposive sampling. The Zarit Scale was used to determine factors associated with overload in caregivers. Variables studied were as follow: age, sex, educational level, daily hours dedicated to caregiving, relationship between the caregiver and the patient, and the manifestation of overload in caregivers. Results: There was predominance in the age group of 60 to 69 years and female sex. Caregivers with twelfth grade of education and manifestation of overloaded were predominant. There was a predominance of caregivers with family ties and a significant relationship with overload. Predominated caregivers who spent an average of 18 hours per day in the care of the patients and the caregivers who had spent 3 to 4 years in caregiving, a significant relationship with overload was found. Conclusions: The relationship established between the caregivers and patients in terms of filial relationship and the years spent in the care provided to the patient were the factors most associated with the development of overload.

Introdução: O envelhecimento populacional é um dos fenômenos mais importantes do século XXI. A pesquisa sobre esse tema está se tornando cada dia mais necessária. Objetivo: Determinar os fatores de risco associados à sobrecarga em cuidadores informais de idosos acamados na área de saúde de Cacocum, Holguín, no ano de 2022. Método: Estudo observacional descritivo transversal realizado no município de Cacocum, Holguín, de 5 de julho de 2021 a 29 de agosto de 2022. O universo foi constituído por 129 cuidadores de idosos acamados (N꓿129) e a amostra por 106 cuidadores informais (n꓿106), obtida por amostragem intencional não probabilística. Para determinar a sobrecarga dos cuidadores foi utilizada a escala de Zarit. As variáveis estudadas foram: idade, sexo, escolaridade, média de horas diárias dedicadas ao cuidado do paciente, vínculo entre cuidador e paciente e presença de sobrecarga do cuidador. Resultados: Predominou a faixa etária de 60 a 69 anos e o sexo feminino. Houve predominância de cuidadores com ensino médio completo e sobrecarregados. Houve predomínio de cuidadores com vínculo burro familiar e uma relação significativa com sobrecarga. Houve predominância de cuidadores que gastam em média 18 horas por dia cuidando do paciente e predominância de cuidadores que passaram de 3 a 4 anos cuidando do paciente, sendo encontrada relação significativa com a sobrecarga. Conclusões: O vínculo do cuidador com o paciente em termos de relação filial e os anos dedicados ao cuidado do paciente foram os fatores mais associados ao desenvolvimento de sobrecarga.

Occupational health and safety challenges among artisanal and small-scale diamond miners in Kimberley, South Africa

Background: Artisanal and small-scale mining (ASM) is a laborious process often executed with rudimentary low-technology mining equipment. It exposes miners to a myriad of occupational hazards, which may increase health and safety disparities between them and formally employed mine workers. Objectives: The objectives of the study were to identify workplace hazards and the associated risks; and to assess the effects of mining activities on the health and environment of artisanal diamond miners in Kimberley, Northern Cape province. Methods: This was an interdisciplinary observational ethnographic study. A workplace assessment was undertaken at seven sites in Kimberley. Participants were conveniently selected; snowballing was used to recruit additional participants. Field notes were recorded from observations. Interview questions included those about the duration of artisanal mining, and the risks faced in the workplace. Data collection included photographic documentation. An inductive and deductive process was used to analyse the data and thematic analysis was conducted. Results: The observed occupational hazards included physical (ultraviolet radiation exposure, injuries due to trauma), respiratory (silica dust exposure), biomechanical (heavy lifting, repetitive movement), and psychological (work-related stress, anxiety) hazards. There was a paucity of access to, and use of, personal protective equipment (PPE). Workers improvised ways to protect themselves, e.g. by using cloths as masks. There was no recourse to formal occupational health services and social safety networks. Conclusion: Occupational health and safety challenges included physical, biomechanical, respiratory, and psychosocial hazards. The mining activities had a detrimental impact on the environment.

Qualitative research on the adherence of mindfulness practice in psychological counseling outpatients / 上海预防医学

ObjectiveTo explore the barriers and facilitators of the adherence of formal practice after mindfulness-based cognitive therapy （MBCT） in psychological counseling outpatients. MethodsOne-on-one interview was conducted in 15 psychological counseling outpatients who attended MBCT at Shanghai Mental Health Center and had been out of treatment 5 months or more. Data was analyzed using thematic analysis. ResultsPoor mood， weak willpower， limited time and space， lack of companionship and supervision， and discomfort with the recording were the five factors that prevented the patients from sticking to their practice. Personality trait， trust， benefit， need for self-care， time/space arrangement， fellow practitioners， therapists， and ease and convenience of practice were the eight factors that promoted the patients to practice. ConclusionThe COM-B model helps therapists and individuals with practice needs to understand the mechanism of formal practice facilitators at a holistic level. Therapists and individuals with practice needs should be concerned about possible barriers on the adherence of formal practice.

Insomnia Burden among Informal Caregivers of Hospitalized Lung Cancer Patients and Its Influencing Factors / 生物医学与环境科学（英文）

OBJECTIVE@#This study aimed to reveal the insomnia burden and relevant influencing factors among informal caregivers (ICs) of hospitalized patients with lung cancer.@*METHODS@#A cross-sectional study on ICs of hospitalized patients with lung cancer was conducted from December 31, 2020 to December 31, 2021. ICs' burden was assessed using the Caregiver Reaction Assessment (CRA), Hospital Anxiety and Depression Scale (HADS), and Insomnia Severity Index (ISI). Linear and logistic regression models were used to identify the influencing factors.@*RESULTS@#Among 289 ICs of hospitalized patients with lung cancer, 83 (28.72%), 53 (18.34%), and 14 (4.84%) ICs experienced mild, moderate, and severe insomnia, respectively. The scores concerning self-esteem, lack of family support, financial problems, disturbed schedule, and health problems were 4.32 ± 0.53, 2.24 ± 0.79, 2.84 ± 1.14, 3.63 ± 0.77, and 2.44 ± 0.95, respectively. ICs with higher Activities of Daily Living Scale (ADLS) scores were associated with a lower risk of insomnia, with an odd ratio ( OR) and 95% confidence interval ( CI) of 0.940 (0.898-0.983). Among the ICs, female gender ( OR = 2.597), alcohol consumption ( OR = 3.745), underlying medical conditions ( OR = 11.765), long-term caregiving experience ( OR = 37.037), and higher monthly expenses ( OR = 5.714) were associated with a high risk of insomnia.@*CONCLUSION@#Of the hospitalized patients with lung cancer, 51.9% experienced insomnia. Patients' ADL, ICs gender, alcohol consumption, underlying medical conditions, caregiving duration, and monthly expenses were influencing factors. Therefore, prompt screening and early intervention for ICs of patients with lung cancer is necessary.

Condiciones ambientales, laborales, hábitos y estilos de vida relacionados con la hipertensión en trabajadores informales, Medellín / Environmental and working conditions, habits and lifestyles related to hypertension in informal workers, Medellín / Condições ambientais, laborais, hábitos e estilos de vida relacionados com a hipertensão em trabalhadores informais, Medellín

Resumen Introducción: la hipertensión arterial (HTA) en trabajadores informales, podría explicarse por sus condiciones laborales, ambientales, hábitos y estilos de vida. Objetivo: determinar condiciones laborales, ambientales, hábitos y estilos de vida, que aportan a la explicación de HTA en trabajadores informales del centro de Medellín, Colombia, 2016. Metodología: estudio descriptivo transversal con intención analítica. Fuentes primarias de información, a un censo de 686 trabajadores en 2016, previa toma de consentimiento informado. Se indagaron condiciones laborales, ambientales, hábitos, estilos de vida y autorreporte de HTA. Se realizó análisis univariado, bivariado y multivariado. Pruebas estadísticas con 95 % de confianza y error del 5 %. Un grupo de trabajadores participó en el diseño y ejecución del trabajo de campo. Proyecto aprobado por comité de Ética Institucional de la Universidad CES, Medellín (septiembre 2015). Resultados: el 20,26 % de los trabajadores tenía HTA. Edad 50(±11,76) años y 23,5 años como venteros, 81,5 % trabaja >8 horas diarias. El 17,2 % fumaba cigarrillo, 23,7 % utilizaba salero en la mesa y 28,9 % eran sedentarios. Mayor hipertensión a mayor edad (RP=12,35), mayor antigüedad en el oficio (RP=1,73) y considerarse obeso (RP=2,61), y menor para quienes no consumían licor (RP=0,48). Explica mayor HTA consumir alimentos fritos (PR=3,14. IC=1,64; 6.00), tener entre 30-44 (PR=10,71.CI: 5,00; 22,94) y 45-59 años (PR=2,69. CI: 1,66; 4,37), y menor HTA, considerarse con sobrepeso (PR=0.54. IC=0.34, 0.78). Conclusiones: las condiciones laborales, hábitos y estilos de vida, aportan a la explicación de HTA. Siendo estas, algunas características que aportan a configurar vulnerabilidad laboral, en esta población trabajadora.

Abstract Introduction: High blood pressure (HBP) in informal workers could be explained, by their working and environmental conditions, habits and lifestyles. Objective: To determine working and environmental conditions, habits and lifestyles, which contribute to the explanation of HBP in informal workers in the downtown area in Medellin, Colombia, 2016. Methodology: Cross-sectional descriptive study with analytical intent. Primary source of information: a census of 686 workers in 2016, after obtaining informed consent. Working and environmental conditions, habits, lifestyles and self-report of HBP were investigated. Univariate, bivariate and multivariate analyzes were performed. Statistical tests show 95% confidence and 5% error. A group of workers participated in the design and execution of the fieldwork. Project approved by the Institutional Ethics Committee of Universidad CES, Medellín September 2015. Results: 20,26% of the workers had HBP. Age 50 (±11,76) years old, and 23,5 years as street vendors, 81,5% work>8 hours a day; 17,2% smoked cigarettes, 23,7% used saltshakers at the table and 28,9% were sedentary. Greater hypertension at older age (PR=12.35), greater seniority in the job (PR=1,73) and considered themselves obese (PR=2,61), and lower HBP for those who did not consume liquor (PR=0,48). Greater HBP is explained in people consuming fried foods (PR=3.14.IC=1,64; 6.00), being between 30-44 (PR=10,71. CI:5,00;22,94) and 45 to 59 years old (PR=2,69.CI: 1.66; 4.37), and a lower HBP for those considered as overweight (PR=0,54. IC=0.34; 0.78). Conclusion: working conditions, habits and lifestyles contribute to the explanation of HBP. These are some characteristics that contribute to configure labor vulnerability in this working population.

Resumo Introdução: a hipertensão arterial (HTA) em trabalhadores informais, poderia explicar-se por suas condições laborais, ambientais, hábitos e estilos de vida. Objetivo: determinar condições laborais, ambientais, hábitos e estilos de vida, que aportam à explicação de HTA em trabalhadores informais do centro de Medellín, Colômbia, 2016. Metodologia: estudo descritivo transversal com intenção analítica. Fontes primarias de informação, a um censo de 686 trabalhadores em 2016, previa toma de consentimento informado. Indagaram-se condições laborais, ambientais, hábitos, estilos de vida e auto reporte de HTA. Realizou-se análise uni variado, bivariado e multivariado. Provas estadísticas com 95 % de confiança e erro do 5 %. Um grupo de trabalhadores participou no desenho e execução do trabalho de campo. Projeto aprovado por comité de Ética Institucional da Universidade CES, Medellín (setembro 2015). Resultados: o 20,26 % dos trabalhadores tinha HTA. Idade 50(±11,76) anos e 23,5 anos como camelôs, 81,5 % trabalha >8 horas diárias. O 17,2 % fumava cigarro, 23,7 % utilizava saleiro na mesa e 28,9 % eram sedentários. Maior hipertensão a maior idade (RP=12,35), maior antiguidade no ofício (RP=1,73) e considerar-se obeso (RP=2,61), e menor para quem não consumiam licor (RP=0,48). Explica maior HTA consumir alimentos fritos (PR=3,14. IC=1,64;6.00), ter entre 30-44 (PR=10,71.CI:5,00;22,94) e 45-59 anos (PR=2,69. CI:1,66;4,37), e menor HTA, considerar-se com sobrepeso (PR=0.54. IC=0.34, 0.78). Conclusões: as condições laborais, hábitos e estilos de vida, aportam à explicação de HTA. Sendo estas, algumas características que aportam a configurar vulnerabilidade laboral, nesta população trabalhadora.

Impacto económico de la falla cardíaca en el cuidador informal / Economic impact of heart failure in the informal caregiver

Resumen Introducción: La insuficiencia cardíaca (IC) es una patología estructural o funcional del corazón que deteriora la capacidad de llenado, generando síntomas que afectan la calidad de vida y la funcionalidad. Es conocido el impacto de esta enfermedad sobre los sujetos que la padecen, pero ha sido poco explorado su impacto económico sobre los cuidadores. Objetivo: Estimar el impacto económico de la IC desde la perspectiva de los cuidadores informales. Resultados: Estudio cuantitativo, tipo evaluación económica parcial. Fueron incluidos 54 sujetos diagnosticados con IC y un cuidador informal por sujeto. La edad promedio de los sujetos con IC fue 70.61 años, la mayoría hombres (64.8%), con un tiempo de diagnóstico de 84 meses y un puntaje de Barthel de 81.94, que representa una dependencia leve. Respecto a los cuidadores, el 48.1% reportaban un vínculo laboral activo; el ingreso mediano fue de $1260.000 COP/mes. El número de horas de cuidado fue de 4.93 h/día. El impacto económico se reflejó en los ingresos mensuales, causando una pérdida de $644,017.50 por actividades de cuidado y en el tiempo laboral una reducción del 30%. El 29% de los ingresos fueron destinados a labores del cuidado; por lo tanto, generaron gastos que redujeron el 71% de los ingresos. De acuerdo con lo anterior, por cada 10 horas de trabajo se destinan 7 horas al cuidado. Conclusiones: La IC impacta de manera negativa la economía de los cuidadores informales de sujetos con esta patología.

Abstract Introduction: Heart failure (HF) is a structural or functional pathology of the heart that impairs filling capacity of this organ, generating symptoms that affect quality of life and functionality in subjects who suffer this disease. This impact on economic life in caregivers of patients with HF has been poorly studied, therefore, there is a lack of information about this topic. Objective: To estimate the economic impact of HF from the perspective of informal caregivers. Type of study: quantitative study, partial economic evaluation type. Population and sample: 54 subjects diagnosed with HF and one informal caregiver per subject were included. Results: The average age of the subjects with HF is 70.61 years, most of them men (64.8%), with a diagnosis time of 84 months and a Barthel score of 81.94 points, which represents a mild dependency. Regarding caregivers, 48.1% reported an active employment relationship, the median income was $1,260,000 COP/month. The number of hours of care is 4.93 hours/day. The economic impact was reflected in monthly income, causing a loss of $644,017.50 due to care activities and a 30% reduction in working time. 29% of income was allocated to care work, therefore, they generated expenses that reduced 71% of income. According to the above, for every 10 hours of work, 7 hours are spent on care. Conclusions: HF negatively impacts the economy of the informal caregiver of subjects with this pathology.

Impacto medioambiental y socioeconómico en la salud generado por la minería artesanal del oro en Colombia

Introducción: Este artículo de revisión sistemática describe el impacto medioambiental y socioeconómico en salud generado por la minería artesanal del oro en Colombia. Para el estudio se tuvieron en cuenta artículos publicados entre 2010 y 2019. El objetivo de esta revisión bibliográfica fue describir el impacto medioambiental y socioeconómico en la salud generado por la minería artesanal del oro en Colombia. Materiales y métodos: Trabajo construido mediante revisión sistemática, usando los siguientes descriptores: minería, sector informal, riesgo a la salud, condiciones de salud. Para esta búsqueda se utilizaron las bases de datos Scopus, Web of Science, ProQuest, Publindex, así como la normatividad colombiana. Resultados: Se desarrollan las categorías ambientales, socioeconómico y salud. En la categoría ambiental se detalla información sobre sostenibilidad ambiental, manejo de vertimientos, pruebas fisicoquímicas y control gubernamental; En la categoría socioeconómica se describen los dilemas entre minería y medio ambiente, el dilema entre pequeña minería o artesanal y minería a gran escala o industrializada, y el conflicto social y económico. En la categoría salud se analizan las afectaciones y la percepción de la población sobre los daños en la salud, la protección laboral, la innovación social y las oportunidades de cambio para una producción más limpia y saludable. Conclusiones: Los estudios realizados se concentran principalmente en el departamento de Antioquia evidenciando la necesidad de realizar investigaciones en otras zonas del país. A pesar de que en Colombia existe legislación minera, se requiere que el gobierno establezca medidas efectivas de control, capacite y socialice a los mineros sobre métodos adecuados de procesamiento del oro, garantizado el desarrollo ambiental, social y protección laboral.

Introduction: This systematic review article describes the environmental and socioeconomic impact on health generated by handmade gold mining in Colombia. For this study articles published between 2010 and 2019 were considered. The objective of this bibliographic review is to describe the environmental and socioeconomic impact on health generated by gold mining in Colombia. Materials and methods: Work constructed through systematic review, using the following descriptors: mining, informal sector, health risk, health conditions. For this search, Scopus, Web of Science, ProQuest, Publindex databases were used, as well as Colombian regulations. Results: The environmental, socioeconomic, and health categories were developed. In the environmental category, information on environmental sustainability, management of discharges, physicochemical tests, and government control is detailed. In the socioeconomic category, the dilemmas between mining and the environment are described, the dilemma between small or artisanal mining and large-scale or industrialized mining, and the social and economic conflict. In the third category, health, the effects and perception of the population regarding health damage, labor protection, social innovation, and opportunities for change for cleaner and healthier production are analyzed. Conclusions: The studies carried out are mainly concentrated in the department of Antioquia, showing the need to carry out research in other areas of the country. Although there is mining legislation in Colombia, the government is required to establish effective control measures, train, and socialize the miners on adequate gold processing methods, guaranteeing the environmental and social development and protection of its miners.

Informais, empreendedores ou precarizados? A trajetória de trabalhadores de comida de rua

Objetivo. Esta pesquisa objetivou a compreensão e a análise da relação entre informalidade, empreendedorismo e precarização de trabalhadores de pequeno porte envolvidos no segmento de comida de rua na cidade de Fortaleza, Estado do Ceará, Brasil. Método. Foram entrevistados, por meio de um roteiro semiestruturado, 10 trabalhadores de comida de rua da cidade de Fortaleza, com idade entre 25 e 73 anos, dentre vendedores de cachorro-quente, milho, tapioca, pastel e outros tipos de produtos alimentícios. Resultados. Uma característica parece surgir como primordial para o trabalhador de comida de rua: ser empreendedor. A falta de perspectiva laboral faz com que os trabalhadores busquem por uma salvação e assim são veiculadas as ideias empreendedoras, focados na informalidade, mas que terminam por reforçar os processos de precarização.

Objective. This research aimed to understand and analyze the entrepreneurial activity of formal and informal micro-business owners involved in the street food segment in the city of Fortaleza, State of Ceará / Brazil. Method. 10 street food micro-business owners from the city of Fortaleza, aged between 25 and 73 years old, among them sellers of hot dogs, corn, tapioca, pastries, and other types of food products, were interviewed, using semi-structured interviews. Results. One characteristic that becomes paramount for contemporary street food micro-business owners is that of being an entrepreneur. The lack of a career perspective in the formal job market makes the micro-business owners regard the street food segment as a kind of salvation from that context, and convey entrepreneurial ideas focused on informality, which ultimately reinforce precariousness processes.

Informal Healthcare Providers of Abortion Services among Three Scheduled Tribes of Jharkhand

Background: There is a dominant role of informal healthcare providers (IHPs) in the current cultural and sociological context of tribal communities. They outnumber formal health‑care providers, thus bridging the gap between existing and nonexisting public health facilities despite not having formal training or accreditation. Objectives: The study examines the role, relevance, and extent of abortion services provided by IHPs‑ in Jharkhand among three Scheduled Tribe groups. Materials and Methods: Based on in‑depth interviews with 15 IHPs and 42 married women among three Scheduled Tribe groups in three districts of Jharkhand, a qualitative study was conducted. Interview guidelines addressed reasons for preferring IHP services, their scope of practice, dissemination, and quality of services. Results: The majority of women seeking abortions used traditional contraceptives, which often resulted in unwanted pregnancies. The economic, cultural, social, access to services, and confidence factors encouraged women to seek abortion services from IHPs. There were differences in the nature of access to abortion services among tribal groups. The Chero and Korwa tribes continued to rely heavily on simpler life technologies that shaped their beliefs and practices regarding reproduction. The Ho tribe, however, preferred to use the formal health‑care system since they were close to a more complex society. Conclusion: IHP plays a significant role in the social structure of Tribes, demonstrating their marginalization in access to formal health‑care services. Eventually, they replaced traditional healers with their function as physicians.

Condiciones socioambientales y prevalencia de enfermedades de la piel en un asentamiento urbano precario de Asunción (Paraguay) / Socio-Environmental Conditions and Prevalence of Skin Diseases in a Precarious Urban Settlement in Asunción (Paraguay) / Condições socioambientais e prevalência de dermatoses em um assentamento urbano precário em Assunção (Paraguai)

Introducción: se buscó analizar la prevalencia de enfermedades dermatológicas de la población de un asentamiento urbano precario próximo al vertedero municipal de Asunción (Paraguay), atendiendo a la exposición de las condiciones socioambientales. Materiales y métodos: estudio descriptivo y transversal con una muestra no probabilística intencional que incluyó a 77 personas de entre 5 meses y 76 años. Resultados: en el momento del examen físico, el 96.2 % de las personas presentó, al menos, una lesión cutánea, y el 79.2 %, una o más enfermedades infecciosas de piel; sin embargo, el 77.9 % no había recu-rrido a consulta médica. Las más sobresalientes fueron las micosis (35.1 %), las bacterianas (35.1 %) y las ectoparasitosis (27.3 %). Se identificó que la prevalencia de enfermedades bacterianas de piel apunta a una posible mayor exposición a condiciones adversas como: un clima subtropical de altas temperaturas y húmedo, una alta relación de convivientes en el hogar por dormitorio, problemas de provisión de agua y suelos de arena en los hogares, así como un sistema de evacuación de excretas deficiente, la presencia de animales con escasa vigilancia sanitaria, la proximidad a arroyos y cauces al aire libre depositarios de materia cloacal y el impacto recurrente de raudales los días de intensa lluvia. Conclusión: los resul-tados sugieren que la alta prevalencia de enfermedades cutáneas infecciosas podría relacionarse con una mayor exposición a condiciones socioambientales locales adversas, que son factores relevantes por tener en cuenta para mejorar la atención a la salud de las enfermedades dermatológicas de la población urbana que habita en un asentamiento urbano precario

Introduction: This study analyzes the prevalence of dermatological diseases in the population of a precarious urban settlement near the municipal landfill of Asunción (Paraguay), in relation to expo-sure to socio-environmental conditions. Materials and methods: descriptive, cross-sectional study with a non-probabilistic purposive sample that included 77 people aged between 5 months and 76 years. Results: at the time of physical examination, 96.2% of the people presented at least one skin lesion and 79.2% one or more infectious skin diseases, but 77.9% had not consulted a doctor. The most prominent were mycoses (35.1%), bacterial (35.1%) and ectoparasitoses (27.3%). It was identified that the preva-lence of bacterial skin diseases points to possible increased exposure to adverse conditions such as: a subtropical climate with high temperatures and humidity, a high ratio of people living in the household per bedroom, water supply problems and sandy soils in homes, as well as a deficient excreta disposal system, the presence of animals with poor sanitary surveillance, proximity to streams and open-air waterways that deposit sewage and the recurrent impact of floods on days of heavy rainfall. Conclusion:the results suggest that the high prevalence of infectious skin diseases could be related to increased exposure to adverse local socio-environmental conditions, which are relevant factors to be taken into to improve the health care of skin diseases in the urban population living in a slum settlement

Introdução: este estudo analisa a prevalência de doenças dermatológicas na população de um assen-tamento urbano precário próximo ao aterro sanitário municipal de Asunción (Paraguai) em relação à exposição às condições socioambientais. Materiais e métodos: estudo descritivo, transversal, com uma amostra não-probabilística de propósito que incluiu 77 pessoas com idade entre 5 meses e 76 anos. Resultados: no momento do exame físico, 96,2% das pessoas tinham pelo menos uma lesão de pele e 79,2% tinham uma ou mais doenças infecciosas de pele, mas 77,9% não tinham consultado um médico. As mais importantes foram micoses (35,1%), bacterianas (35,1%) e ectoparasitoses (27,3%). A preva-lência de doenças bacterianas da pele foi identificada como apontando para um possível aumento da exposição a condições adversas tais como: um clima subtropical com altas temperaturas e umidade, uma alta proporção de pessoas vivendo na casa por quarto, problemas de abastecimento de água e solos arenosos nas habitações, bem como um sistema de eliminação de excrementos deficiente, a presença de animais com vigilância sanitária deficiente, proximidade a riachos e cursos de água abertos que depositam águas residuais, e o impacto recorrente de enchentes em dias de chuvas fortes. Conclusão:Os resultados sugerem que a alta prevalência de doenças infecciosas de pele pode estar relacionada ao aumento da exposição a condições sócio-ambientais locais adversas, que são fatores relevantes a serem considerados para melhorar os cuidados com doenças de pele na população urbana que vive em uma favela