ABSTRACT
La determinación del porcentaje de pérdida en pacientes lesionados con múltiples secuelas por riesgos de trabajo resulta un verdadero reto para el perito, esto adquiere mayor relevancia cuando en el fuero judicial se pueden presentar discrepancias en los criterios para el uso o no de fórmulas matemáticas para el cálculo. La fórmula de suma combinada, creada por el Médico Forense Víctor Balthazard, no es más que un ordenamiento de una regla de tres que ordena los porcentajes otorgados a cada secuela de mayor a menor para evitar que el porcentaje final sobrepase el 100%, o bien que resulte en un porcentaje mayor que una secuela única puntuada en el baremo y que por gravedad en la intensidad de la misma resulte con un porcentaje menor al calculado por la secuela múltiple y que se ha utilizado en fueros laborales y de seguridad social alrededor del mundo. El Baremo contenido en el Código de Trabajo no establece explícitamente la forma en que se calcula el porcentaje de pérdida por secuelas múltiples, lo cual brinda libertad al perito para utilizar fórmulas, como lo es la fórmula de suma combinada, que permite calcular de forma congruente las pérdidas sucesivas sin sobrepasar a la persona más allá de su capacidad general total del 100% o de otorgar porcentajes mayores a secuelas de mayor gravedad que la suma de las pérdidas por el evento que se está valorando.
The determination of the percentage of loss in injured patients with multiple sequelae due to occupational hazards is a real challenge for the expert, this becomes even more relevant when in the judicial system there may be discrepancies in the criteria for the use or not of mathematical formulas for the calculation. The combined sum formula, created by the Forensic Physician Victor Balthazard, is nothing more than an arrangement of a rule of three that orders the percentages given to each sequel from highest to lowest to avoid that the final percentage exceeds 100%, or that it results in a higher percentage than a single sequel scored in the scale and that due to the severity in the intensity of the same results in a lower percentage than that calculated for the multiple sequel and that has been used in labor and social security courts around the world. The Schedule contained in the Labor Code does not explicitly establish the way in which the percentage of loss for multiple sequelae is calculated, which gives the expert the freedom to use formulas, such as the combined sum formula, which allows a congruent calculation of the successive losses without exceeding the person's total general capacity of 100% or to grant higher percentages to sequelae of greater severity than the sum of the losses for the event being valued.
Subject(s)
Risk Assessment/methods , Forensic Sciences/methods , Costa Rica , Forensic MedicineABSTRACT
El abordaje onto epistémico de este ensayo se desarrolla en tres grandes miradas: un desarrollo gnoseológico orientado a precisar diferentes posicionamientos de la economía feminista como un movimiento político, herramienta de lucha y resistencia para enfrentar un modelo económico misógino, patriarcal, excluyente y a espaldas de la vida. Seguidamente, se precisan aspectos relevantes de su historicidad, partiendo de las figuras más resaltantes de la economía neoclásica. El hombre dentro de esta perspectiva (Homus Economicus), es el motor de la producción de riqueza, el agente económico por excelencia. Modelo donde no aparecen las relaciones sociales, las mujeres, la vida Solo producir y consumir. Finalmente, se destaca toda una serie de avances y desafíos. Dentro de estas nuevas perspectivas, se pone especial atención a las relaciones de cuidado y afecto que se producen en los hogares como trabajo no remunerado. El cuidado de la vida humana toma el escenario, exigiendo nuevas perspectivas de análisis y la ampliación de fronteras a fin de destacar su relevancia social y económica; a partir de la utilización de estrategias para la valoración de la producción doméstica incorporando nuevas propuestas sobre el manejo de las estadísticas con lentes de género. El presupuesto gubernamental, se debe presentar desagregado y analizado el efecto de políticas de gastos e ingresos de manera diferenciada y situada(AU)
The ontologic epistemic approach in this essay is developed in three main perspectives: a gnoseological development aimed at specifying different positions of feminist economics as a political movement, a tool of struggle and resistance to face a misogynistic, patriarchal, exclusionary economic model behind the back of life. Next, relevant aspects of its historicity are specified, starting from the most outstanding figures of neoclassical economics. Man within this perspective (Homus Economicus), is the engine of the production of wealth, the economic agent par excellence. Model where social relationships, women, life do, not appear... Just produce and consume. Finally, a whole series of advances and challenges are highlighted. Within these new perspectives, special attention is paid to the relationships of care and affection that occur in households as unpaid work. The care of human life takes the stage, demanding new perspectives of analysis and the expansion of borders in order to highlight its social and economic relevance; from the use of strategies for the valuation of domestic production, incorporating new proposals on the management of statistics with gender lenses. The government Budget, should be presented disaggregated, and the effect of expenditure and revenue policies should be analyzed in a differentiated and situated manner(AU)
Subject(s)
Models, Economic , Feminism , Employee Grievances , Work-Life BalanceABSTRACT
Economic valuation of ecosystem services is a new concept in forest management. Economic valuation provides basis for payment for ecosystem services (PES). Therefore, objective of this study was to evaluate eco-tourism and carbon stock services of the Maindam valley, District Swat, Pakistan. For the carbon stock calculation, a sample size of 155 plots of 0.1 hectare (Ha) was taken using preliminary survey at 95% confidence interval and 10% allowable error. The data for tourism services was collected from owners of all the hotels, 100 tourists and key informants of the area at 10% sampling intensity on pretested questionnaire for twenty years period (1997-2017). Results showed that Miandam valley has carbon stock worth US$ 16,306,000 while the value of eco-tourism was US$ 1,578,458 on annual basis. The results also showed that trend of tourism has drastically declined after the 9/11 incident for foreigners and locals and the situation was further deteriorated during the era of Talibanization or militancy from 2008-2011. This study recommends implementation of PES strategy at the rate of 5%, thus a total of US$ 78,922 can be earned from eco-tourism and carbon crediting in the study area annually, which could play important role in sustainable forest management.
A valoração econômica dos serviços ecossistêmicos é um novo conceito no manejo florestal. A avaliação econômica fornece base para o pagamento por serviços ecossistêmicos (PES). Portanto, o objetivo deste estudo foi avaliar o ecoturismo e os serviços de estoque de carbono do vale de Miandam, distrito Swat, Paquistão. Para o cálculo do estoque de carbono, um tamanho de amostra de 155 parcelas de 0,1 hectare (ha) foi tirado, usando pesquisa preliminar com intervalo de confiança de 95% e erro admissível de 10%. Os dados para serviços de turismo foram coletados de proprietários de todos os hotéis, 100 turistas e informantes-chave da área em 10% de intensidade de amostragem em questionário pré-testado para um período de 20 anos (1997-2017). Os resultados mostraram que o vale de Miandam tem estoque de carbono no valor de US$ 16.306.000, enquanto o valor do ecoturismo foi de US$ 1.578.458 anualmente. Os resultados também mostraram que a tendência do turismo diminuiu drasticamente para estrangeiros e locais após o incidente de 11 de Setembro, e a situação se agravou ainda mais durante a era da talibanização ou militância de 2008-2011. Este estudo recomenda a implementação da estratégia de PES na taxa de 5%, portanto um total de US$ 78.922 pode ser ganho com ecoturismo e crédito de carbono na área de estudo anualmente, o que pode desempenhar um papel importante no manejo florestal sustentável.
Subject(s)
Forests , Tourism/legislation & jurisprudenceABSTRACT
Abstract Economic valuation of ecosystem services is a new concept in forest management. Economic valuation provides basis for payment for ecosystem services (PES). Therefore, objective of this study was to evaluate eco-tourism and carbon stock services of the Maindam valley, District Swat, Pakistan. For the carbon stock calculation, a sample size of 155 plots of 0.1 hectare (Ha) was taken using preliminary survey at 95% confidence interval and 10% allowable error. The data for tourism services was collected from owners of all the hotels, 100 tourists and key informants of the area at 10% sampling intensity on pretested questionnaire for twenty years period (1997-2017). Results showed that Miandam valley has carbon stock worth US$ 16,306,000 while the value of eco-tourism was US$ 1,578,458 on annual basis. The results also showed that trend of tourism has drastically declined after the 9/11 incident for foreigners and locals and the situation was further deteriorated during the era of Talibanization or militancy from 2008-2011. This study recommends implementation of PES strategy at the rate of 5%, thus a total of US$ 78,922 can be earned from eco-tourism and carbon crediting in the study area annually, which could play important role in sustainable forest management.
Resumo A valoração econômica dos serviços ecossistêmicos é um novo conceito no manejo florestal. A avaliação econômica fornece base para o pagamento por serviços ecossistêmicos (PES). Portanto, o objetivo deste estudo foi avaliar o ecoturismo e os serviços de estoque de carbono do vale de Miandam, distrito Swat, Paquistão. Para o cálculo do estoque de carbono, um tamanho de amostra de 155 parcelas de 0,1 hectare (ha) foi tirado, usando pesquisa preliminar com intervalo de confiança de 95% e erro admissível de 10%. Os dados para serviços de turismo foram coletados de proprietários de todos os hotéis, 100 turistas e informantes-chave da área em 10% de intensidade de amostragem em questionário pré-testado para um período de 20 anos (1997-2017). Os resultados mostraram que o vale de Miandam tem estoque de carbono no valor de US$ 16.306.000, enquanto o valor do ecoturismo foi de US$ 1.578.458 anualmente. Os resultados também mostraram que a tendência do turismo diminuiu drasticamente para estrangeiros e locais após o incidente de 11 de Setembro, e a situação se agravou ainda mais durante a era da talibanização ou militância de 2008-2011. Este estudo recomenda a implementação da estratégia de PES na taxa de 5%, portanto um total de US$ 78.922 pode ser ganho com ecoturismo e crédito de carbono na área de estudo anualmente, o que pode desempenhar um papel importante no manejo florestal sustentável.
ABSTRACT
Abstract Economic valuation of ecosystem services is a new concept in forest management. Economic valuation provides basis for payment for ecosystem services (PES). Therefore, objective of this study was to evaluate eco-tourism and carbon stock services of the Maindam valley, District Swat, Pakistan. For the carbon stock calculation, a sample size of 155 plots of 0.1 hectare (Ha) was taken using preliminary survey at 95% confidence interval and 10% allowable error. The data for tourism services was collected from owners of all the hotels, 100 tourists and key informants of the area at 10% sampling intensity on pretested questionnaire for twenty years period (1997-2017). Results showed that Miandam valley has carbon stock worth US$ 16,306,000 while the value of eco-tourism was US$ 1,578,458 on annual basis. The results also showed that trend of tourism has drastically declined after the 9/11 incident for foreigners and locals and the situation was further deteriorated during the era of Talibanization or militancy from 2008-2011. This study recommends implementation of PES strategy at the rate of 5%, thus a total of US$ 78,922 can be earned from eco-tourism and carbon crediting in the study area annually, which could play important role in sustainable forest management.
Resumo A valoração econômica dos serviços ecossistêmicos é um novo conceito no manejo florestal. A avaliação econômica fornece base para o pagamento por serviços ecossistêmicos (PES). Portanto, o objetivo deste estudo foi avaliar o ecoturismo e os serviços de estoque de carbono do vale de Miandam, distrito Swat, Paquistão. Para o cálculo do estoque de carbono, um tamanho de amostra de 155 parcelas de 0,1 hectare (ha) foi tirado, usando pesquisa preliminar com intervalo de confiança de 95% e erro admissível de 10%. Os dados para serviços de turismo foram coletados de proprietários de todos os hotéis, 100 turistas e informantes-chave da área em 10% de intensidade de amostragem em questionário pré-testado para um período de 20 anos (1997-2017). Os resultados mostraram que o vale de Miandam tem estoque de carbono no valor de US$ 16.306.000, enquanto o valor do ecoturismo foi de US$ 1.578.458 anualmente. Os resultados também mostraram que a tendência do turismo diminuiu drasticamente para estrangeiros e locais após o incidente de 11 de Setembro, e a situação se agravou ainda mais durante a era da talibanização ou militância de 2008-2011. Este estudo recomenda a implementação da estratégia de PES na taxa de 5%, portanto um total de US$ 78.922 pode ser ganho com ecoturismo e crédito de carbono na área de estudo anualmente, o que pode desempenhar um papel importante no manejo florestal sustentável.
Subject(s)
Ecosystem , Conservation of Natural Resources , Pakistan , Carbon/analysis , ForestsABSTRACT
RESUMEN Belén de los Andaquíes, Caquetá, ubicado en el piedemonte amazónico, es reconocido como municipio verde de Colombia, por su riqueza hídrica y paisajística. Es una zona con experiencia y potencial en la instauración de pagos por servicios ambientales PSA, como instrumento económico para incentivar la conservación de bosques, en la zona de influencia directa a la quebrada la Mono, una de las fuentes hídricas de relevancia en el suministro de agua, para el consumo humano en la población. Se empleó el método de valoración contingente, para hallar la disponibilidad a pagar DAP de los habitantes del área urbana, por la conservación de los bosques, para la protección del servicio ecosistémico de regulación hídrica. La DAP fue positiva y esto evidencia que la comunidad puede experimentar aumentos en el bienestar económico, a raíz de una medida de protección ambiental. Existe viabilidad económica y relevancia social al implementar estos instrumentos de política ambiental, para proteger servicios ecosistémicos importantes, en la mitigación y en la adaptación al cambio climático.
ABSTRACT Belén de los Andaquíes, Caquetá, located in the Amazon piedmont, is recognized as a green municipality of Colombia, for its wealth of water and landscapes. It is an area with experience and potential in the establishment of payments for environmental services PES, as an economic instrument to encourage the conservation of forests in the area of direct influence of the Mono stream, one of the most important sources of water for human consumption in the population. The contingent valuation method was used to find the willingness to pay WTPs of the inhabitants of the urban area for the conservation of forests for the protection of the ecosystem service of water regulation. The WTP was positive value, and this is evidence that the community can experience increases in economic welfare as a result of an environmental protection measure. There is economic viability and social relevance in implementing these environmental policy instruments to protect ecosystem services important for climate change mitigation and adaptation.
ABSTRACT
Objective:Based on UPLC-Q-TOF/MS, to screen a panel of plasma metabolite biomarkers for TB diagnosis and evaluate its diagnostic efficacy.Methods:102 active TB patients [49 males, 53 females, age 40.0(24.0, 48.5) years] from Shanghai Pulmonary Hospital and Shanghai East Hospital from January 2017 to January 2018, 100 TB-IGRA positive patients [55 males, 45 females, age 44.0(37.0, 52.0) years] and 96 healthy controls [55 males, 41 females, age 43.0(32.2, 52.8) years] from Shanghai East Hospital were randomly enrolled. UPLC-Q-TOF/MS technology was used to detect small molecule metabolites in plasma. Combined with multivariate statistical methods VIP and univariate statistic analysis Student's t-test, the main differential metabolites in the plasma of patients with active tuberculosis were filtered. The ROC curve was analyzed for the differential metabolites, and the AUC value, specificity, and sensitivity for diagnosis were used to screen metabolic biomarkers with diagnostic potential. Results:All the samples examined resulted in 10 266 variables, and 1 153 substances were identified by qualitative retrieval through the human metabolome database. After pairwise comparison of samples from the three groups, differential metabolites that simultaneously satisfied VIP > 1 and P<0.05 were plotted into a Venn diagram, and the resulting intersection set contained 38 major differential metabolites. The ROC curve analysis of 38 major metabolites showed that the area under the curve of lactic acid, dopamine, 9-pentadecenoic acid, and 12,13-dihydroxy octadecadienoic acid in the diagnosis of active tuberculosis were 0.92, 0.98, 0.94, and 0.94, respectively, the specificity was both more than 90% and the sensitivity was both more than 80%. The specificity and sensitivity of four metabolites in the combined diagnosis of active tuberculosis were both 94%. Conclusion:Lactic acid, dopamine, 9-pentadecenoic acid, and 12, 13-dihydroxy octadecadienoic acid can be used as potential metabolic biomarkers for tuberculosis diagnosis.
ABSTRACT
OBJECTIVE To evaluate th e effects of comprehensive drug cost control in China ，and to provide reference for further improving the effects of cost control. METHODS Entropy method was used to establish a comprehensive evaluation index system of the comprehensive drug cost control effect from the respective of drug price control ability ，drug cost control ability and patient affordability. The comprehensively evaluate the effects of drug cost control in 31 provinces （autonomous regions and municipalities）during 2016-2020. The k-means cluster method was used to analyze the effects of comprehensive drug cost control in various provinces. RESULTS & CONCLUSIONS During the period of 2016-2020，the total score of comprehensive drug cost control effect of 31 provinces were 14.64，16.71，17.58，17.57，17.88，respectively. The results of cluster analysis were similar to the ranking of entropy method. Medical and health system reform policy had entered a stable period after achieving phased results ； the effects of comprehensive drug cost control was characterized by regional steps in 31 provinces；the effects of comprehensive drug cost control were better in developed coastal areas and some provinces and cities of western regions ，followed by provinces and cities in central China ；however，comprehensive drug cost control in 3 provinces of northeast China showed poor effect. The effects of comprehensive drug cost control in pilot cities of comprehensive medical reform were significantly improved. It is suggested that the successful experience of pilot cities of comprehensive medical reform should be promoted nationwide ，and policies such as volume-based drug procurement ，medical insurance drug price negotiation ，and diagnosis-related groups / diagnosis-intervention packet payment method reform should be further deepened.
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RESUMO Os sistemas de recuperação de biogás contribuem para a mitigação de gases do efeito estufa, além de agregarem valor econômico ao processo de decomposição anaeróbia da matéria orgânica. O presente trabalho busca analisar os potenciais energéticos e a viabilidade econômica de implementação de um sistema de recuperação de biogás de aterro sanitário (cenário 1) ou de uma usina de digestão anaeróbia (cenário 2) para o Consórcio do Maciço de Baturité no estado do Ceará, Brasil. Para isso, foi estimada a projeção populacional, seguida da estimativa da produção de biogás pelo software LandGEM. Para o sistema de recuperação de biogás do aterro sanitário, foi obtida a potência ótima de 460 kW, com geração de energia máxima de 3.223.680 kWh/ano, enquanto, para a usina de digestão anaeróbia, foram obtidos valores de potência e energia de 252 kW e 1.986.754,86 kWh, respectivamente. De acordo com a análise econômica, ambos os projetos possuem inviabilidade de implementação, todavia o preço da unidade de energia gerada (kWh) é 42,42% maior para a usina de digestão anaeróbia em relação ao do sistema de recuperação de biogás do aterro sanitário. A metodologia aplicada pode ser utilizada para estudos preliminares em outros tipos de consórcio, contribuindo para melhores gerenciamento de resíduos e aproveitamento energético de sistemas de biogás no país.
ABSTRACT Biogas recovery systems contribute to the mitigation of greenhouse gases, besides adding economic value to the anaerobic decomposition of organic matter. This research aims to analyze the energy potentials and economic feasibility of implementing a landfill biogas recovery system (scenario 1) and an anaerobic digestion plant (scenario 2) for the Baturité Massif Consortium in the state of Ceará, Brazil. To that end, a population projection followed by an estimate of biogas production were made using the LandGEM software. For the biogas recovery system of the landfill, an optimum power of 460 kW and a maximum energy generation of 3,223,680 kWh/yr were obtained, whereas the anaerobic digestion plant resulted a power and energy of 252 kW and 1,986,754.86 kWh respectively. According to the economic analysis, both projects are unfeasible, but the price of the energy unit generated (kWh) is 42.42% higher for the anaerobic digestion plant than for the biogas recovery system of the landfill. The methodology applied can be used for preliminary studies in other consortiums, contributing to a better waste management and energy use of biogas systems in the country.
ABSTRACT
Resumen Introducción: Los servicios ecosistémicos (SE) de provisión suministrados por los agroecosistemas de huertos familiares (AEHF) se refieren a los beneficios tangibles que las personas obtienen del ecosistema. Aunque los AEHF, han sido ampliamente estudiados, pocos son los trabajos que evidencian su abordaje desde una perspectiva integral, la cual incorpore características biofísicas y económicas al mismo tiempo. Objetivo: Realizar un análisis integral los servicios ecosistémicos de provisión suministrados por agroecosistemas de huertos familiares del Estado de México. Métodos: Se recopilo información sobre los SE de provisión (identificación, usos, destinos y generación de ingresos) mediante entrevistas semiestructuradas, cuestionarios, inventarios de especies, observaciónes directas, y recorridos en campo entre Marzo a Diciembre de 2019 en tres comunidades rurales, con la participación de 42 familias propietarias de los huertos familiares. Resultados: Se identificaron un total de seis SE de provisión asociados a 212 especies, las cuales fueron distribuidas en 172 géneros y 82 familias. Los Principales usos que los propietarios de los huertos dieron a los SE de provisión fueron ornamentales (51 %), seguidos de los alimenticios (39 %) y medicinales (32 %), donde especies como Cymbopogon citratus, Persea americana, Punica granatum, Zea mays e Inga jinicuil, tuvieron los mayores valores de uso (V. U. = 4). El destino de la producción fue autoconsumo, venta e intercambio; siendo el primero, la principal estrategia de sobrevivencia utilizada por los hogares. La venta de productos comestibles en fresco, así como de sus derivados represento ingresos brutos promedio de 1 333.47 USD/año para los propietarios de los huertos familiares. Conclusiones: Los servicios ecosistémicos de provisión proporcionados por los huertos familiares son vistos como una fuente importante de recursos, los cuales permiten satisfacer necesidades múltiples de los hogares rurales, catalogados en pobreza extrema.
Abstract Introduction: Provisioning ecosystem services (ES) provided by agroecosystems of family orchards (AEFO) refer to the tangible benefits that people obtain from the ecosystem. Although AEFO have been widely studied, few studies show their approach from an integral perspective, which incorporates biophysical and economic characteristics at the same time. Objective: To carry out an integral analysis of provisioning ecosystem services provided by agroecosystems of family orchards from State of Mexico. Methods: Information about provisioning ecosystem services (identification, uses, destination and income generation) were collected between March to December 2019 from three rural communities by involving 42 families with a family orchard using semi-structured interviews, questionnaires, species inventories, direct observation and field trips. Results: A sum of six provisioning ecosystem services were identified, which were associated to 212 species, distributed in 172 genera and 82 families. The main uses that the owners of the orchards gave to provisioning ES were ornamental (51 %), followed by food (39 %) and medicinal (32 %), where species such as Cymbopogon citratus, Persea americana, Punica granatum, Zea mays e Inga jinicuil, had the highest use values (U. V. = 4). The destination of the production was self-consumption, sale and exchange, being the first the main survival strategy used by households. Sale of edible products in fresh, as well as their derivatives, represented an average gross income of 1 333.47 USD/year for the owners of the family orchards. Conclusions: Provisioning ecosystem services provided by family orchards seen as an important source of resources, which allow the households of rural communities classified in extreme poverty to cover multiple needs.
Subject(s)
Ecosystem , Sustainable Agriculture , MexicoABSTRACT
RESUMO O número de municípios e estados brasileiros que estão aderindo ao pagamento por serviços ambientais (PSA) vem crescendo ao longo dos últimos anos. Por meio de uma pesquisa documental e científica, buscou-se compreender a evolução de quase 20 anos de experiências brasileiras em PSA hídricos. A investigação foi fundamentada em um inventário das iniciativas (já encerradas ou em desenvolvimento), de sua localização, da base legal e dos métodos de valoração. Considerando o universo amostral de 68 iniciativas brasileiras de PSA hídricos, observaram-se: maior concentração dos programas no sul e sudeste, com tendência à expansão para as demais regiões brasileiras, especialmente a Centro-Oeste; e as primeiras iniciativas de PSA hídricos do Brasil adotavam o pagamento por valor fixo, sem a consideração da qualidade biótica das propriedades rurais, padrão que foi gradualmente substituído pelo cálculo do custo de oportunidade da terra e pela inclusão de indicadores físico-ambientais e socioeconômicos nas metodologias de valoração. O estudo permite concluir que, na última década, existe a tendência de os programas de PSA hídricos adotarem metodologias com abordagem interdisciplinar e sistêmica para valoração da provisão de serviços ambientais.
ABSTRACT The number of Brazilian municipalities and states engaging in payment for environmental services (PES) has been increasing over the last few years. Through a documentary and scientific research, we sought to understand the evolution of almost 20 years of Brazilian experiences in hydrological PES. The research was based on an inventory of the initiatives (already finished or under development), their location, legal basis, and valuation methods. Considering the sampling universe of 68 Brazilian hydrological PES initiatives, we observed: higher concentration of programs in the South and Southeast, with a tendency to expand them to other Brazilian regions, especially the Midwest; the first initiatives of hydrological PES in Brazil adopted the payment of a fixed value, without considering the biotic quality of the rural properties, a pattern which was gradually replaced by the calculation of the opportunity cost of land and the inclusion of physical-environmental indicators and socioeconomic factors in the valuation methodologies. The study allows to conclude that, in the last decade, there has been a tendency for hydrological PES programs to adopt methodologies with an interdisciplinary and systemic approach to assess the provision of environmental services.
ABSTRACT
Resumen: Introducción: los cuidados paliativos (CP) son un marcador de calidad de asistencia en terapia intensiva; sin embargo, han sido poco evaluados en Uruguay. La detección proactiva de pacientes mediante disparadores de consultas es una estrategia que podría optimizar el acceso a los CP. Objetivos: determinar la prevalencia y las características de los disparadores de consulta de CP en pacientes críticos. Analizar la utilización de recursos en estos pacientes. Material y método: estudio de cohorte, retrospectivo, que incluyó pacientes ingresados a unidad de cuidados intensivos (UCI) entre marzo de 2016 y febrero de 2019. Los disparadores analizados fueron: a) presencia de tumor con metástasis; b) estadía en UCI 50% por encima de la media (14 días); c) >75 años con disfunción orgánica múltiple, y d) >80 años con dos o más comorbilidades graves. Resultados: se analizaron 2.850 pacientes. El 26% (734) presentó al menos un disparador de consulta con CP. El más prevalente: estadía en UCI 50% por encima de la media (18%). Estos pacientes presentaron mayor edad: 61 (43-75) vs 54 (36-65) años (p < 0,001) y mayor gravedad, SAPSIII de 60 (48-74) vs 47 (35-61) puntos (p<0,001). Requirieron más asistencia respiratoria mecánica (ARM) 87% vs 55% (p <0,001), vasopresores 48% vs 24% (p< 0,001) y hemodiálisis 8% vs 4% (p<0,001). Presentaron mayor estadía 18 (9-27) vs 4 (2-8) días, (p<0,001) y tiempo en ARM 14 (7-23) vs 3 (1- 6) días (p<0,001). Conclusiones: la cuarta parte de los pacientes en UCI activaron al menos un criterio de CP, presentaron mayor gravedad y utilizaron más sostén de soporte vital.
Summary: Introduction: palliative care (PC) constitutes a marker of the quality of intensive care assistance. However, it has not been thoroughly assessed in Uruguay. Proactive detection of patients by means of "consultation triggers" should be considered a strategy to optimize access to PC. Objetives: to determine the prevalence and characteristics of Palliative Care consultation triggers in critical patients. To analyse the use of resources in these patients. Method: retrospective cohort study of patients admitted in the ICU between March 2016 and February 2019. The following triggers were identified: a) a tumor with metastasis; length of stay at the ICU 50% over the average (14 days), c) >75 years old with multiple organic dysfunction and d) >80 years old with 2 or more severe comorbidities Results: 2.850 patients were analysed. 26% (734) presented at least one consultation trigger with PC. Length of stay at the ICU 50% over average (18%). These patients presented higher average age 61 (43-75) versus 54 (36-65) years old (p < 0.001), and increased severity, SAPSIII of 60 (48-74) compared to 47 (35-61) points (p<0.001); 87% required mechanical ventilation compared to 55% (p <0.001), vasopressors 48% compared to 24% (p< 0.001) and hemodialysis 8% compared to 4% (p<0.001). 18 presented a longer stay (9-27) compared to 4 (2-8) days, (p<0.001) and time on mechanical ventilation 14 (7-23) compared to 3 (1- 6) days (p<0.001). Conclusions: 25 percent of patients in the ICU activated at least one criterion for PC, they were in a more severe condition and used more mechanical ventilation.
Resumo: Introdução: os cuidados paliativos (CP) são um marcador de qualidade da atenção em Terapia Intensiva, porém, pouco avaliados no Uruguai. A detecção proativa de pacientes usando "gatilhos de consulta" é uma estratégia que pode otimizar o acesso aos CP. Metas: determinar a prevalência e as características dos critérios de elegibilidade de CP em pacientes críticos. Analisar o uso de recursos nesses pacientes. Materiais e métodos: estudo de coorte retrospectivo, incluindo pacientes internados na UTI entre março de 2016 e fevereiro de 2019. Os critérios analisados foram: a) presença de tumor com metástase, b) permanência na UTI 50% acima da média (14 dias), c ) >75 anos com disfunção de múltiplos órgãos e d) >80 anos com 2 ou mais comorbidades graves. Resultados: 2.850 pacientes foram analisados. 26% (734) apresentaram pelo menos 1 critério de elegibilidade para CP. O mais prevalente foi a permanecia na UTI 50% superior à média (18%). Esses pacientes tinham mais de 61 anos (43-75) vs 54 (36-65) anos (p <0,001) e condições mais graves, SAPSIII de 60 (48-74) vs 47 (35-61) pontos (p <0,001). Necessitaram mais ventilação mecânica assistida (AVM) 87% vs 55% (p <0,001), vasopressores 48% vs 24% (p <0,001) e hemodiálise 8% vs 4% (p <0,001). Tiveram uma permanência mais prolongada 18 (9-27) vs 4 (2-8) dias, (p <0,001) e tempo em AVM 14 (7-23) vs 3 (1-6) dias (p <0,001). Conclusões: um quarto dos pacientes internados na UTI ativou pelo menos um critério de elegibilidade para CP, apresentou maior gravidade e utilizou mais suporte vital.
Subject(s)
Palliative Care , Critical Care/organization & administration , Cohort Studies , Process Assessment, Health CareABSTRACT
Introducción: La variabilidad climática tiene efectos importantes sobre las diferentes actividades económicas que se desarrollan en zonas costeras y que emplean servicios ecosistémicos para su funcionamiento. Actualmente, no existen metodologías integrales que permitan realizar un proceso de valoración teniendo en cuenta todas las variables y las interacciones entre ellas. Objetivo: Proponer una aproximación metodológica que incluya de manera integral las diferentes etapas en el proceso de valoración económica de servicios ecosistémicos en zonas costeras, ante la variabilidad climática. Métodos: Se realizó una revisión bibliográfica, consulta a expertos y se empleó un ejemplo de aplicación usando la actividad turística de buceo con tiburones martillos en la Isla del Coco. Resultados: La aproximación metodológica propuesta inicia con la caracterización socioeconómica y ambiental de la actividad que emplea el recurso natural como insumo, posteriormente se realiza una identificación y caracterización de las variables ambientales que afectan el recurso natural y los efectos que la variación de este recurso tiene sobre la actividad económica. Conclusiones: Las variables que conforman el sistema climático, que tienen relación con los recursos naturales y las actividades económicas, al ser influenciadas por fenómenos externos, producen efectos que deben ser analizados por medio de aproximaciones metodológicas integrales, dentro de las cuales uno de los pasos es la metodología de valoración, que permitan generar recomendaciones de política que contribuyan a minimizar esos efectos.
Introduction: Climate variability has important effects on the different economic activities that take place in marine areas. Currently, there are no comprehensive methodologies to carry out an assessment process that consider all the variables and interactions between them. Objective: To propose a methodological approach that comprehensively includes the different stages in the process of economic valuation of ecosystem services in coastal areas, in the face of climate variability. Methods: A bibliographic review, expert consultations and an application of a methodological example using the impact over shark diving activities at Isla del Coco were conducted. Results: The proposed methodological approach begins with the socio-economic and environmental characterization of the activity that uses a natural resource as input, followed by the identification and characterization of the environmental variables that affect the natural resource and of the effects that the variation of this resource has on the economic activity. Conclusions: The variables that make up the climate system, which relate to natural resources and economic activities, being influenced by external phenomena, produce effects that must be analyzed by comprehensive methodological approximations, within which one of the steps is the valuation methodology, that will allow generating policy recommendations that help to minimize these effects.
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The Cerrado is the second largest biome in Brazil and presents an immeasurable and still underexplored ecological diversity. Despite the exuberance of its endemic species, it is one of the 25 global hotspots, due to a high natural biodiversity wealth along with an expressive environment destruction. In this study, we surveyed the knowledge on medicinal use of Cerrado plants held by individuals living in a predominantly Cerrado region. A semi-structured individual questionnaire for qualitative socio-economic characterization and medicinal use of plants was applied to Public Health Service users of the city of Assis, State of Sao Paulo, Brazil. This study was approved by the Ethics Committee of the Assis Regional Hospital (Protocol 4812010). Out of 149 respondents, 90.6% reported knowledge and/or use of plants for therapeutic purposes. Among 115 mentioned plant species, only 11.4% belong to the Cerrado. We also evaluated how matching were the reported uses and the respective published data from scientific studies on the plants' medicinal properties. It was verified that for the few Cerrado plants cited, the respondents described several medicinal applications not scientifically described. More precisely, 60.5% of all medicinal applications were not found in the scientific literature. Besides that, many of the therapeutic effects described in the literature for the Cerrado species were not cited by the interviewed population. Our results indicate a relative unawareness of people on the medicinal potential of the native species of their residence region. We suggest that strengthening connection between popular and scientific knowledge, along with spreading such knowledge, could contribute for an improved valuation about the Cerrado biome and consecutive preservation of it.KEYWORDS: Popular knowledge. Scientific knowledge. Valuation about the biome. INTRODUCTION Use of medicinal plants dates back to ancient times (DUTRA et al., 2016) and, over time, accumulated empirical evidence produced from popular knowledge has enabled incorporation of phytotherapy into traditional medicine with positive results (SANTOS et al., 2011). With the advent of ethnobotany and ethnopharmacology, many of these plants began to be safely used in the production ofherbal medicines for treatment of different diseases, such as infections, tissue inflammation, and pain (EKOR, 2014). It is currently known that several secondary metabolites produced by plants not only protect themselves from herbivory and pathogens, for instance (FÜRSTENBERG-HÄGG; ZAGROBELNY; BAK, 2013; SANCHÉZ-SANCHÉZ; MORQUECHO-CONTRERAS, 2017), but also have beneficial effects on human health (TAIZ; ZEIGER, 2010). However, in many countries, including those that hold a large biodiversity, the native medicinal flora is still barely studied by scientific methods (RIBEIRO et al., 2014). The Cerrado is the second largest biome after the Amazon in Brazil. Although the extensive area of 2,036,448 km2 occupied nowadays by this biome (BARBOSA, 2017), much of the Cerrado has already been transformed into pasture, grain crops or devastated for other uses (KLINK; MACHADO, 2005). Currently, only 8,21% of its total area is fully protected (BARBOSA, 2017). As a result, it is one of the most threatened biomes in the world. According to Mittermeier et al. (2005), the Brazilian Cerrado is one of the 25 global hotspots, areas with concentration of endemic species and exceptional ongoing destruction. Many communities resident in Cerrado regions are comprised of poor people with restricted access to public health services and often dependent Received: 14/05/18 Accepted: 20/11/19
O Cerrado é o segundo maior bioma do Brasil, apresenta uma diversidade ecológica imensurável e ainda pouco explorada. Apesar da exuberância de suas espécies endêmicas, é um dos 25 hotspots globais, pois apresenta alta riqueza natural em termos de biodiversidade e destruição expressiva de seu meio ambiente. Neste estudo, pesquisamos o conhecimento sobre o uso medicinal de plantas do Cerrado entre indivíduos que vivem em uma região predominantemente do Cerrado. Um questionário individual semiestruturado com perguntas de caráter socioeconômicas qualitativas e referentes ao uso medicinal de plantas foi aplicado aos usuários do Serviço de Saúde Pública da cidade de Assis, Estado de São Paulo, Brasil. Este estudo foi aprovado pelo Comitê de Ética do Hospital Regional de Assis (Protocolo 4812010). Dos 149 entrevistados, 90,6% relataram conhecimento e / ou uso de plantas para fins terapêuticos. Entre as 115 espécies de plantas mencionadas, 11,4% pertencem ao Cerrado. Também avaliamos a correlação entre os usos relatados e os respectivos dados publicados em estudos científicos sobre as propriedades medicinais das plantas.Verificou-se que, para as poucas plantas de Cerrado citadas, os entrevistados descreveram diversas aplicações medicinais não descritas cientificamente. Mais precisamente, 60,5% do total das aplicações medicinais não foram encontrados na literatura científica. Além disso, muitos dos efeitos terapêuticos descritos na literatura para as espécies do Cerrado não foram citados pela população entrevistada. Portanto, sugerimos que o fortalecimento da conexão entre conhecimento popular e científico, aliado à disseminação desse conhecimento, poderia contribuir para uma maior valorização do bioma Cerrado e consequentemente a preservação do mesmo.
Subject(s)
Plants, Medicinal , Grassland , Brazil , Ecosystem , BiodiversityABSTRACT
Alzheimer∗ s disease (AD) is a typical central nervous degenerative disease characterized by progressive cognitive impairment and behavioral damage, which is associated with the major pathological manifestations of extracellular amyloid deposition, intracellular neurofibrillary tangles, and neuron loss. Mild cognitive impairment ( MCI) is a kind of cognitive impairment status between normal cognition and AD, which is linked with a high risk of converting into AD. Previous studies mostly establish the animal models with clinical AD characteristics for mechanism research, drug screening, and new drug development. In recent years, researchers have attempted to establish animal models with clinical MCI characteristics, trying to intervene ear-ly at MCI stage to effectively prevent the occurrence of AD. There are many types of AD experimental animal models, and the MCI model should be distinguished from the AD model. Based on the systematic introduction of the characteristics of AD and MCI, this study aims to preliminarily evaluate the commonly used AD and MCI experimental animal models, providing sug-gestions for the research of AD and MCI.
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RESUMO Objetivo: avaliar o efeito das intervenções breves na redução do consumo de álcool em utentes de uma Unidade de Saúde Familiar. Método: estudo pré-experimental, avaliação antes e depois (quatro meses) de 205 utentes (grupo único). Utilizou-se o Alcohol Use Disorders Identification Test (AUDIT). A coleta ocorreu em Coimbra, Portugal, nos meses de maio/junho e setembro/outubro de 2019. Utilizou-se o teste Wilcoxon para avaliação dos efeitos das intervenções. Resultados: na primeira avaliação, 189 (92,2%) encontravam-se na zona I; 15 (7,3%) na zona II e 1 (0,5%) na zona IV. No seguimento, quatro meses após as intervenções com os 15 utentes que pontuaram zona 2, teve-se perda da amostra de 5, demonstrando que 10 (60%) pontuaram zona I, 3 (30%) zona II e 1 (10%) zona III. Conclusão: as intervenções breves são recursos efetivos na detecção precoce do consumo de álcool, sendo necessários à disseminação nos cuidados primários à saúde.
RESUMEN: Objetivo: Evaluar el efecto de intervenciones breves en la reducción de ingesta alcohólica de usuarios de una Unidad de Salud Familiar. Método: Estudio preexperimental, evaluación antes y después (cuatro meses) de 205 usuarios (grupo único). Se utilizó Alcohol Use Disorders Identification Test (AUDIT). Datos recolectados en Coímbra, Portugal, en mayo/junio y setiembre/octubre de 2019. Se aplicó test Wilcoxon para evaluar el efecto de las intervenciones. Resultados: En la primera evaluación, 189 (92,2%) estaba en zona I; 15 (7,3%) en zona II y 1 (0,5%) en zona IV. En el seguimiento, cuatro meses después de las intervenciones con los 15 usuarios de zona II, se observó pérdida de la muestra de 5, expresando que 10 (60%) puntuaron como zona I, 3 (30%) zona II; y 1 (10%), zona III. Conclusión: Las intervenciones breves constituyen recursos efectivos para detección precoz del consumo alcohólico, siendo necesaria su diseminación en atención primaria de salud.
ABSTRACT Objective: to evaluate the effect of brief interventions in decreasing alcohol use in users of a Family Health Unit. Method: a pre-experimental study, before and after evaluation (four months) of 205 users (single group). The Alcohol Use Disorders Identification Test (AUDIT) was used. Data collection took place in Coimbra, Portugal, in May/June and September/October 2019. The Wilcoxon test was used to assess the effects of the interventions. Results: in the first assessment, 189 (92.2%) were in zone I; 15 (7.3%) in zone II and 1 (0.5%) in zone IV. In the follow-up, four months after the interventions with the 15 users who scored zone 2, there was a sample loss of 5, showing that 10 (60%) scored zone I, 3 (30%) zone II and 1 (10%) zone III. Conclusion: brief interventions are effective resources in the early detection of alcohol use, which are necessary for dissemination in primary health care.
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RESUMO Unidades de conservação são espaços protegidos que prestam serviços ambientais continuamente para toda a sociedade. O Serviço de Proteção aos Mananciais de abastecimento público (SPM) é um desses serviços. Como previsto no art. 47 do Sistema Nacional de Unidades de Conservação (SNUC), Lei nº 9.985, de 2000 (BRASIL, 2004b), deve contribuir financeiramente para a proteção e implementação da unidade aquele usuário do recurso hídrico que se beneficiar da proteção proporcionada por ela. O pagamento pelo serviço ambiental a que a unidade de conservação faz jus deve ser valorado com a participação de seus usuários e divulgação de seus valores para que esses usuários conheçam as consequências de perdas dos serviços ecossistêmicos. Valorar esse serviço é o objetivo deste trabalho.
ABSTRACT Conservation Units are Protected Areas that continuously provide environmental services to society. An example is the Public Water Supply Watershed Protection Service (SPM). As provided in art. 47, Law 9.985 of 2000 (BRASIL, 2004b), the National System of Conservation Units (SNUC): should contribute financially to the protection and implementation of the unit those users of water resources that benefit from the protection afforded by it. The payment for environmental services that the protected area deserves should be valued with the participation of all users, who should be aware of the value of the ecosystem services provided and the consequences of losing such services. Valuing this service is the goal of this work.
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Aims: The aims of the current paper is to provide a comparative analysis of the water ecosystem in the state of Jammu & Kashmir in India and to highlight economic potentiality of the two nerve tributaries; “Dal Lake” and “River Jhelum” to the farmers and other communities of the Kashmiri society. Study Design: The temperate region of Kashmir valley is bestowed with many water bodies in the form of springs, lakes and rivers. Kashmir region is world famous for its lakes viz; “Dal Lake”, “Wulur Lake”, “Mansbal Lake”, “Anchar Lake”, “Nigeen Lake”; springs viz; Kokarnag, Verinag, Achabal and “River Jhelum” etc. “Dal Lake” and “River Jhelum” are known to be the nerve tributaries of the valley and various communities are dependent on these water bodies for their livelihood. Methodology: Contingent valuation method and willingness to pay techniques were used to analyse the data and interpret the results. Results: The results revealed that economic value associated with the selected water bodies was worth millions of US$. Most of the population in the valley depends on these water bodies for their livelihood. In addition, the results reveal that over the years, pollution and encroachment of these water bodies has increased manifold reducing the width, depth and recreational value of these water bodies. Though every stakeholder is willing to pay for the restoration of these water bodies, however, little or no attention is being paid by the local government towards their, management, sustenance and conservation. Conclusion: The study concludes that over the years, due to growth of population in the valley along with the ever increasing influx of floating population in terms of tourist arrivals, the selected water bodies (Dal Lake & River Jhelum) came under heavy stress, culminating into the deterioration of their aesthetic and recreational value besides drastic reduction in their revenue generation for their poor water quality and mismanagement. The restoration of these water bodies, which in addition of providing employment to the stakeholders in huge numbers also generate revenue worth millions of US$, demands devising a pragmatic policy by the government towards their conservation and restoration of their lost glory through efficient management and monitoring system.
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Resumen Introducción: En la actualidad, hay muchas fluctuaciones del entorno económico mundial y la demanda y la oferta de activos o productos actúan como una fuerza que determina los precios según los cuales estos se compran y se venden, pero en ocasiones, el precio reflejado de una acción no representa el precio de generación de valor en el tiempo. Objetivo: Valorar el desempeño y la evolución de los múltiplos financieros en el tiempo de la empresa Ecopetrol de Colombia, proyectando el precio de la acción en el mercado secundario a cinco años. Materiales y métodos: Se consideraron cinco fases: análisis de la información de la empresa de Ecopetrol suministrada por Bloomberg; generación de una estructura de ponderación de los múltiplos financieros mediante un primer modelo lineal dinámico bayesiano; proyección de las variables utilizadas en la valoración para los próximos cinco años; cálculo de los múltiplos financieros de los resultados teóricos y, finalmente, realización de simulaciones de Montecarlo en función de distribuciones probabilísticas establecidas para cada variable de entrada. Resultados: Con los valores obtenidos a través de la simulación y el precio de la acción en el mercado secundario, se calculó un indicador relativo de comparación (IRC), con la intención de establecer proyecciones mediante un segundo modelo lineal dinámico bayesiano, logrando un procedimiento novedoso de estimación a mediano plazo del valor de la acción para la empresa Ecopetrol en cinco años futuros: del 2016 al 2020. Conclusiones: Mediante este procedimiento, fue posible comprobar y aplicar la valoración de empresas mediante múltiplos financieros, sin necesidad de utilizar empresas comparables ni competidoras en el mismo mercado.
Abstract Introduction: Currently, there are many fluctuations in the global economic environment and the demand and supply of assets or products act as a force that determines the prices according to which they are bought and sold, but sometimes, the price reflected in an action does not it reflects the price of generating value over time. Objective: Assess the performance and evolution of the financial multiples in the time of the company Ecopetrol de Colombia, projecting the price of the stock in the secondary market to five years. Material and methods: Five phases were considered: analysis of the information provided by Bloomberg of the Ecopetrol company, generation of a structure of weighting of the financial multiples through a first Bayesian Dynamic Linear Model, projection of the variables used in the valuation for the next five years, calculation of the financial multiples of the theoretical results and finally perform Montecarlo simulations based on probabilistic distributions established for each input variable Results: With the values obtained through the simulation and the price of the action in the secondary market, a Relative Comparison Indicator (CRI) was calculated, with the intention of establishing projections through a second Bayesian Dynamic Linear Model, achieving a novel procedure of medium-term estimate of the share value for the company Ecopetrol in five (5) future years: from 2016 to 2020. Conclusions: Through this procedure, it was possible to verify and apply the valuation of companies through financial multiples, without the need to use comparable companies or competitors in the same market.
Resumo Introdução: Atualmente, existem muitas flutuações do entorno econômico mundial, a demanda e a oferta de ativos ou produtos que agem como uma força que determina os preços segundo os quais estes, compram-se e vendem-se, mas às vezes, o preço refletido de uma ação não representa o preço da geração do valor no tempo. Objetivo: Avaliar o desempenho e a evolução dos multiplicadores financeiros no tempo da empresa Ecopetrol na Colômbia, projetando o preço da ação no mercado secundário para cinco (5) anos. Materiais e métodos: Consideram-se cinco fases: análise da informação da empresa de Ecopetrol fornecida pelo Bloomberg; geração de uma estrutura de ponderação dos multiplicadores financeiros mediante um primeiro modelo linear dinâmico bayesiano; projeção das variáveis utilizadas na valoração para os próximos cinco anos; cálculo dos multiplicadores financeiros dos resultados teóricos e, finalmente, a realização de simulações de Montecarlo em função de distribuições probabilísticas estabelecidas para cada variável de entrada. Resultados: Com os valores obtidos através da simulação e o preço da ação no mercado secundário, calculou-se um indicador de comparação relativo (ICR), com a intenção de estabelecer projeções mediante um segundo modelo linear dinâmico bayesiano, conseguindo um procedimento inovador da estimativa de médio prazo do valor da ação para empresa Ecopetrol nos futuros cinco (5) anos: de 2016 à 2020. Conclusões: Através deste procedimento, foi possível comprovar e aplicar a valoração de empresas mediante multiplicadores financeiros, sem necessidade de utilizar empresas concorrentes comparáveis no mesmo mercado.
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Resumen Objetivo: Determinar las características de las aplicaciones móviles de salud en español a través de una clasificación funcional con la finalidad de conocer aspectos de demanda como de oferta de las mismas. Materiales y métodos: Se trata de un estudio descriptivo que implica una clasificación funcional de las aplicaciones móviles de salud en español, que incluye cuatro variables de cada aplicación móvil de salud en español: sistema operativo (Android y iOS), población objetivo (paciente, profesional o público en general), categoría y pago (gratuitas y de paga), donde las principales aplicaciones móviles referidas a salud en español fueron obtenidas de tres métodos de valoración que abarcan un total de 113 aplicaciones móviles de salud en español. Resultados: Se presentan las características de las aplicaciones móviles de salud en español por método de valoración. Se hizo la clasificación funcional de las 19 aplicaciones móviles de salud en español con distintivo Saludable, donde la mayoría de ellas utilizan ambos sistemas operativos (Android y iOS) y 6 de cada 10 aplicaciones móviles tienen un contenido dirigido a profesionales sanitarios. De las 50 aplicaciones móviles de salud en español por parte de App Date se encontró que el 98% utilizan el sistema operativo de iOS y se utilizan para proporcionar información principalmente. Respecto a las 46 aplicaciones móviles de salud en español del índice iSYScore utilizan ambos sistemas operativos (Android y iOS) y las categorías de las aplicaciones se dan alrededor de distintas enfermedades. Conclusiones: Las aplicaciones móviles de salud en español son una herramienta de gran utilidad para pacientes, profesional o público en general debido a que acerca al paciente a su enfermedad mejorando el control del tratamiento, el monitoreo y la relación con el profesional.
Abstract Objective: To determine the characteristics of mobile health applications in Spanish through a functional classification to know aspects of demand as well as their supply. Materials and methods: This is a descriptive study involving a functional classification of Spanish health mobile applications, which includes four variables of each health mobile application in Spanish: operating system (Android and iOS), target population (patient, Professional or general public), category and payment (free and pay), where the main mobile applications related to health in Spanish were obtained from three valuation methods that cover a total of 113 mobile health applications in Spanish. Results: The characteristics of mobile health applications in Spanish are presented by valuation method. The functional classification was made in the 19 health mobile applications with the distinctive in Spanish of Saludable, where most of them use both operating systems (Android and iOS) and 6 out of 10 mobile applications have content aimed at health professionals. App 50 health mobile applications in Spanish have found that 98% use the iOS operating system and are mainly used to provide information. Regarding the 46 mobile health applications in Spanish of the iSYScore index use both operating systems (Android and iOS) and categories of applications are around different diseases. Conclusions: Mobile health applications in Spanish are a useful tool for patients, professionals or the public because it brings patients closer to their illness, improving treatment control, monitoring and relationship with the professional.
Resumo Objetivo: Determinar as características das aplicativos móveis de saúde em espanhol através de uma classificação funcional a fim de conhecer seus aspectos relacionados a demanda e oferta. Materiais e métodos: Trata-se de um estudo descritivo envolvendo uma classificação funcional dos aplicativos móveis de saúde em espanhol, que inclui quatro variáveis: sistema operacional (Android e iOS), população-alvo (paciente, profissional ou público em geral), categoria e pagamento (gratuitos e pagos), onde os principais aplicativos móveis de saúde foram obtidas por meio de tres métodos de avaliação realizados em um total de 113 aplicativos móveis de saúde em espanhol. Resultados: Apresentam-se as características dos aplicativos móveis de saúde em espanhol pelo método de avaliação. Foi realizada a classificação funcional de 19 aplicativos móveis de saúde em espanhol com o selo de qualidade Saudável, onde a maioria usa os dois sistemas operacionais (Android e iOS) e 6 em cada 10 aplicativos móveis tem conteúdo destinado a profissionais da saúde. Dos 50 aplicativos móveis de saúde em espanhol pela App Date, encontrou-se que 98% utilizam o sistema operacional iOS e sáo usados, principalmente, para fornecer informações. Em relação aos 46 aplicativos móveis de saúde em espanho do índice iSYScore, ambos sistemas operacionais (Android e iOS) são utilizados e as categorias dos aplicativos sáo definidas de acordo com as diferentes enfermidades. Conclusões: Os aplicativos móveis de saúde espanhol são uma ferramenta muito útil para os pacientes, os profissionais e o público ou geral porque permite ao paciente compreender sua enfermidade, melhorando o controle do tratamento, monitoramento e relacionamento com o profissional de saúde.
Résumé Objectif: Déterminer les caractéristiques des applications mobiles de santé en espagnol en réalisant une classification fonctionnelle afin de connaitre les aspects de l'offre et de la demande. Matériaux et méthodes: Une étude descriptive a permis de réaliser une classification fonctionnelle des applications mobiles de santé en espagnol selon quatre variables: systeme d'exploitation (Android et iOS), population cible (patient, professionnel et grand public), catégorie de paiement (gratuit et payant). Les principales applications mobiles de santé en espagnol ont été répertoriées au moyen de trois méthodes d'évaluation réunissant un total de 113 applications. Résultats: Les caractéristiques des applications mobiles de santé en espagnol sont présentées pour chaque méthode d'évaluation. La classification fonctionnelle des 19 applications mobiles de santé en espagnol ayant la distinction AppSaludable a permis d'établir que la plupart d'entre elles utilisent deux systemes d'exploitation (Android et iOS) et que 6 de ces applications sur 10 ont un contenu destiné aux professionnels de santé. D'autre part, parmi les 50 applications mobiles de santé en espagnol indiquées para App Date, 98% utilisent le systeme d'exploitation iOS et servent principalement a fournir des informations. Finalement, les 46 applications mobiles de santé en espagnol de l'index iSYScore utilisent les deux systemes d'exploitation (Android et iOS) et leurs catégories se réferent a différentes maladies. Conclusions: Les applications mobiles de santé en espagnol sont des outils tres utiles pour les patients, les professionnels ou le grand public parce qu'ils familiarisent le patient avec sa maladie, ce qui permet d'améliorer le contróle du traitement, le suivi et la relation avec le professionnel.