Valoración del impacto de la legislación argentina sobre alérgenos alimentarios: cinco años de una travesía con aciertos y desafíos / Assessment of the impact of the argentine legislation on food allergens: five years of a journey with successes and challenges / Avaliação do impacto da legislação argentina sobre alérgenos alimentares: cinco anos de uma caminho de desafios e sucessos

Resumen Las alergias alimentarias representan un problema de salud pública. La declaración de alérgenos en el rótulo implicó un avance fundamental para la gestión del riesgo, ya que evitar el alimento desencadenante mediante el rotulado adecuado constituye actualmente una medida insustituible de cuidado para la población susceptible. Se realizó una valoración del impacto de la legislación nacional en referencia a la declaración de alérgenos alimentarios entre 2017 y 2022. Se utilizaron los motores de búsqueda interna de la Administración Nacional de Medicamentos, Alimentos y Tecnología Médica (ANMAT) para los retiros de productos alimenticios del mercado y se contrastó como herramienta de medición indirecta para la valoración del impacto de la implementación del Artículo 235 séptimo del Código Alimentario Nacional (CAA). Se analizaron 43 productos (galletitas, fideos, chocolates, alimentos a base de vegetales). El 53,5% (23 sobre un total de 43) presentaba declaración de alérgenos. El 70% de los mismos (16 sobre un total de 23) fueron categorizados "con inconsistencias" y el 14% (6 productos de 43) utilizaba etiquetado precautorio. El paradigma reactivo del control de alimentos sobresalió por sobre el de las auditorías, los programas de monitoreo y, en suma, sobre los programas de prevención, ya que el sistema se activó fundamentalmente por la vía reactiva de las denuncias. Esto representó un 72% de los productos categorizados.

Abstract Food allergies represent a public health problem. The declaration of allergens on the label implied a fundamental advance for risk management, since avoiding the triggering food through proper labelling is currently an irreplaceable measure of care for the susceptible population. An assessment of the impact of the national legislation was carried out in reference to the declaration of food allergens between 2017 and 2022. The ANMAT internal search engines were used for the withdrawals of food products from the market and contrastlised as an indirect measurement tool for the impact assessment of the implementation of Section 235 seventh of the Argentine Food Code (CAA, for its acronym in Spanish). Forty-three products (biscuits, noodles, chocolates, vegetable-based foods) were analysed. The allergen declaration was present in 53.5% (23 out of a total of 43). Some inconsistencies were present in 70% of them (16 out of a total of 23) and 14% (6 products out of 43) used precautionary labelling. The reactive paradigm of food control stood out above that of audits, monitoring programmes and, in short, prevention programmes, since the system was activated fundamentally through the reactive route of complaints. This represented 72% of the categorised products.

Resumo As alergias alimentares representam um problema de saúde pública. A declaração de alérgenos no rótulo envolveu um avanço fundamental para a gestão do risco, visto que evitar os alimentos que desencadeiam as alergias, por meio de uma rotulagem adequada, é atualmente uma medida insubstituível de cuidado para a população suscetível. Foi realizada uma avaliação do impacto da legislação nacional referida à declaração de alérgenos alimentares entre 2017 e 2022. Os motores de busca interna da ANMAT (Administração Nacional de Medicamentos, Alimentos e Tecnologia Médica) foram utilizados para as retiradas de produtos alimentares do mercado e contrastados como uma ferramenta indireta de medição para a avaliação do impacto da aplicação do artigo 235 sétimo, do CAA (Código Alimentar Nacional). Foram analisados 43 produtos (biscoitos, macarrão, chocolates, alimentos à base de vegetais). 53,5% (23 de um total de 43) apresentavam declaração de alérgenos, 70% deles (16 de um total de 23) foram categorizados "com inconsistências" e 14% (6 produtos de 43) utilizavam rotulagem de precaução. Destacou-se o paradigma "reativo" do controle de alimentos por sobre o controle das auditorias, dos programas de monitoramento e, em resumo, dos programas de prevenção, visto que o sistema foi ativado fundamentalmente pela via reativa das reclamações. Isso representou 72% dos produtos categorizados.

Promoción de la salud en la Universidad Médica a 35 años de la Declaración de Edimburgo / Health promotion at the Medical University 35 years after the Edinburgh Declaration i: en

En este artículo se realiza una breve descripción de lo que se entiende por promoción de la salud y su relación con la Declaración de Edimburgo; informe final de la Conferencia Mundial de Educación Médica realizada en 1988. Asimismo, se vincula el propósito de la educación médica (a profesionales de la salud) según esta proclamación y su operativización a través del movimiento de Universidades Promotoras de Salud, que no solo busca formar profesionales en este contexto, sino que la institución genere condiciones y entornos favorecedores de salud y bienestar. Se reflexiona que para cumplir este propósito y las recomendaciones de la Declaración de Edimburgo es necesario fusionar los criterios, las variables y los estándares de la calidad formativa e institucional con los componentes indispensables para ser una universidad promotora de salud.

This article provides a brief description of what is meant by health promotion and its relationship with the Edinburgh Declaration; final report of the World Conference on Medical Education held in 1988. Also, the purpose of medical education (for health professionals) is linked according to this proclamation and its operationalization through the Health Promoting Universities' movement, which not only seeks to train professionals in this context, but also for the institution to create conditions and environments that promote health and well-being. It is reflected that in order to fulfill this purpose and the recommendations of the Edinburgh Declaration it is necessary to merge the criteria, variables and standards to achieve educational and institutional quality with the indispensable components to be a health promoting university.

Estratégias para pessoas com deficiência em períodos de emergência em saúde pública, em especial a pandemia de COVID-19 / Strategies for persons with disabilities in public health emergencies, especially the COVID-19 pandemic

Resumo O objetivo foi descrever estratégias e políticas de atenção às pessoas com deficiência em períodos de emergência em saúde pública, em especial na COVID-19. Foram incluídos 29 estudos e 49 estratégias agrupadas em oito categorias: 1) habitação, mobilidade e infraestrutura; 2) trabalho, ocupação e renda; 3) assistência social; 4) telessaúde; 5) atenção integral à saúde; 6) planejamento e gestão; 7) comunicação; e 8) educação. O panorama das estratégias pode orientar políticas públicas, com ações viáveis que promovam equidade para as pessoas com deficiência.

Abstract This study aimed to describe strategies and policies necessary to provide care for people with disabilities during periods of public health emergencies, especially COVID-19. Twenty-nine studies and 49 strategies were included, grouped into eight categories: 1) housing, mobility, and infrastructure; 2) work, occupation, and income; 3) social assistance; 4) telehealth; 5) comprehensive health care; 6) planning and management; 7) communication; and 8) education. The overview of the strategies can help to guide public policies, with feasible actions that promote more significant equity for disabled people.

Toward a better understanding of cardiovascular risk in the transgender and gender-diverse community: a supplement to the Tijuana Declaration / El camino hacia una mejor comprensión del riesgo cardiovascular en la comunidad transgénero y diferentes géneros: un suplemento a la Declaración de Tijuana

Abstract On World Heart Day 2022, the Mexican Society of Cardiology, the Inter-American Society of Cardiology, and the World Heart Federation collaborated on a communication regarding the increased risk of adverse cardiovascular health outcomes in transgender and gender-diverse (TGD) individuals. This document, called the Tijuana Declaration, urged the global cardiovascular community to work toward understanding and mitigating this problem. This article aims to unpack the numerous factors that lead to it. An example is the social stigma faced by members of the TGD community, which leads to increased stress and risk for cardiovascular complications. TGD patients are also more likely to have insufficient access to health care, and those that do receive care are often faced with providers that are not adequately educated about the unique needs of their community. Finally, there is some evidence to suggest that gender-affirming hormone therapies have an impact on cardiovascular health, but studies on this subject often have methodological concerns and contradictory findings. Decreasing the incidence of adverse cardiovascular events in this community requires interventions such as educational reform in the medical community, an increase in research studies on this topic, and broader social initiatives intended to reduce the stigma faced by TGD individuals.

Resumen En el Día Mundial del Corazón 2022, la Sociedad Mexicana de Cardiología, la Sociedad Interamericana de Cardiología y la Federación Mundial del Corazón colaboraron en una comunicación sobre el aumento del riesgo de resultados adversos para la salud cardiovascular en individuos transgénero y de género diverso (TGD). Este documento, conocido como la Declaración de Tijuana, instó a la comunidad cardiovascular global a trabajar en la comprensión y mitigación de este problema. Este artículo tiene como objetivo desentrañar los numerosos factores que lo provocan. Un ejemplo es el estigma social enfrentado por los miembros de la comunidad TGD, lo que conduce a un aumento del estrés y el riesgo de complicaciones cardiovasculares. Los pacientes TGD también tienen más probabilidades de tener un acceso insuficiente a la atención médica, y aquellos que la reciben a menudo se enfrentan a proveedores que no están adecuadamente educados sobre las necesidades únicas de su comunidad. Finalmente, hay evidencia que sugiere que las terapias hormonales de afirmación de género tienen un impacto en la salud cardiovascular, pero los estudios sobre este tema a menudo tienen preocupaciones metodológicas y hallazgos contradictorios. Disminuir la incidencia de eventos cardiovasculares adversos en esta comunidad requiere intervenciones como la reforma educativa en la comunidad médica, un aumento en los estudios de investigación sobre este tema e iniciativas sociales más amplias destinadas a reducir el estigma enfrentado por los individuos TGD.

Organ commercialism, trafficking and transplant tourism

The gap between demand and supply of organs continues to widen worldwide, encouraging transplant commercialism. While solid organ commerce is most prevalent in impoverished countries, commercialisation of body parts such as tissues is prevalent in economically developed countries. A number of international legal instruments and transplant societies define, condemn, and criminalise these practices and have issued statements related to organ commercialism. In contrast, limited attention has been paid to illicit and unethical activities associated with the procurement and clinical use of tissues. In India, The Transplantation of Human Organs (Amendment) Act, 2011, has taken multiple measures to combat organ and tissue commerce and as a result the number of such instances seems to be on the decline. However, the fight against unethical organ procurement through the internet and the social media is challenging and requires the cooperation of global bodies. Keywords: Organ trade, Declaration of Istanbul, tissue commerce, organ transplants, transplant tourism

Influencia del etiquetado nutricional en la decisión de compra de estudiantes universitarios / Influence of Nutritional Labeling on the Purchase Decision of University Students

Resumen: Antecedentes: el etiquetado nutricional permite a los consumidores tomar mejores decisiones sobre alimentación, lo que contribuye a combatir las enfermedades crónicas no transmisibles. Objetivo: determinar cómo influye la interpretación del etiquetado nutricional, presente en los alimentos industrializados en Colombia, en la decisión de compra de estudiantes de pregrado del área de la salud de la Universidad CES. Materiales y métodos: se realizó un estudio observacional descriptivo en 76 estudiantes de quinto semestre de programas de pregrado del área de la salud. Resultados: la frecuencia en el uso del etiquetado nutricional se asoció con el sexo (p = 0,036), el tipo de programa (p < 0,001) y el conocimiento de la función del etiquetado nutricional (p = 0,000). La buena interpretación del etiquetado nutricional no condicionó la frecuencia en su uso (p = 0,095); además, el nivel de interpretación del etiquetado nutricional no se asoció con el sexo ni con el tipo de programa de pregrado. Finalmente, se encontró que la decisión de compra estaba influenciada por la costumbre (p = 0,018) y la publicidad (p = 0,008) y no por la interpretación del etiquetado nutricional. Conclusiones: aunque el uso del etiquetado nutricional es más frecuente entre las mujeres, los estudiantes de Nutrición y Dietética y entre quienes conocen la función del etiquetado nutricional, la decisión de compra no está influenciada por su interpretación.

Abstract: Background: Nutritional labeling enables consumers to make better food choices, helping to fight chronic non-communicable diseases. Objective: To determine the influence of the interpretation of the nutritional labeling, present in industrialized foods in Colombia, on the purchase decision of undergraduate students in the health area of the CES University. Material and Methods: A descriptive observational study was carried out in a population of 76 fifth-semester students enrolled in the undergraduate programs of the health area. Results: The frequency of nutrition labeling use was associated with sex (p=0.036), the type of undergraduate program (p<0.001), and knowledge of the function of the nutrition labeling (p=0.000). A good interpretation of the nutrition labeling does not condition the frequency of its use (p=0,095). Additionally, the level of interpretation of the nutritional labeling was not associated with sex, nor the type of undergraduate program. Finally, it was found that the purchase decision was influenced by custom (p=0.018) and advertising (p=0,008), and not by the interpretation of the nutrition labeling. Conclusions: Although the use of nutrition labeling is more frequent among women, among students of Nutrition and Dietetics, and among those who are aware of the role of nutrition labeling, the purchase decision is not influenced by its interpretation.

Bioética, cooperação internacional, solidariedade e compartilhamento de benefícios: do HIV/AIDS à COVID-19 / Bioética, cooperación internacional, solidaridad y aprovechamiento compartido de beneficios: del HIV/AIDS a la COVID-19 / Bioethics, international cooperation, solidarity and benefit sharing: from HIV/AIDS to COVID-19

O objetivo do trabalho é analisar o direito de acesso aos benefícios do desenvolvimento científico-tecnológico, tendo as vacinas contra aCOVID-19 como referência de estudo. O texto se sustenta metodologicamente em artigos da Declaração Universal sobre Bioética e Direitos Humanos da UNESCO(DUBDH) que tem relação direta com a situação proposta. O estudo inicia com a apresentação da DUBDH e breve histórico de seus pressupostos básicos. Com base nos Artigos 21 e 24 que tratam respectivamente das Práticas Transnacionais e Cooperação Internacional, a reflexão indica mudanças significativas recentes com relação à universalidade do acesso à saúde, substituída nas instâncias da Organização Mundial da Saúde (OMS) e Banco Mundial pela proposta de cobertura universal à saúde, com significado e alcance bastante diversos. A partir do Artigo 13 da DUBDH, que trata da Solidariedade e Cooperação, o texto defende o conceito de solidariedade cooperativa, fundamentado na concepção clássica bilateral de solidariedade como ajuda de países poderosos a outros mais necessitados, embora essa possibilidade seja com frequência substituída por situações da chamada solidariedade exploratória. Finalmente, com base no Artigo 15, que trata do Compartilhamento de Benefícios ­central para o presente estudo ­é apresentada uma análise comparativa entre: a) fatos históricos relacionados com a permissão para quebra de patentes no âmbito da Organização Mundial do Comércio (OMC) que possibilitaram acesso amplo às terapias antirretrovirais para controle do HIV/AIDS; e b) fatos que passaram acontecer a partir de 2020 com a pandemia de COVID-19 com relação ao direito do acesso às vacinas.

This paper aims to analyze the right to access the benefits of scientific and technological development, using the vaccines against COVID-19 as a study case. The text is methodologically supported by articles in the UNESCOUniversal Declaration on Bioethics and Human Rights (DBHR) that have a direct relationship with the proposed situation. The study begins with the presentation of the DUBDH and a brief history of its basic assumptions. Based on Articles 21 and 24, which deal respectively with TransnationalPractices and International Cooperation, the reflection indicates recent significant changes in relation to the universality of access to health, replaced in the instances of the World Health Organization (WHO) and World Bank for the proposal of universalhealth coverage, with a very different meaning and scope. Based on Article 13 of the DUBDH, which deals with Solidarity and Cooperation, the text defends the concept of cooperative solidarity, based on the classic bilateral conception of solidarity as help from rich countries to others most in need, although this possibility is with frequency replaced by situations of the so-called exploratory solidarity. Finally, based on Article 15, which deals with Sharing of Benefits ­central to the present study ­a comparative analysis is presented between: a) historical facts related to the permission to break patents within the scope of the World Trade Organization (WTO) that enabled broad access to antiretroviral therapies to control HIV/AIDS; and b) facts that have happened since 2020 with the COVID-19 pandemic regarding the right of access to vaccines.

El objetivo del trabajo es analizar el derecho de acceso a los beneficios del desarrollo científico y tecnológico, utilizando vacunas contra COVID-19 como referencia del estudio. El texto se apoya metodológicamente en artículos de la Declaración Universal sobre Bioética y Derechos Humanos de la UNESCO(DUBDH) que tienen una relación directa con la situación propuesta. El estudio comienza con la presentación de la DUBDH y un breve histórico de sus supuestos básicos. Con base en los artículos 21 y 24, que tratan respectivamente de Prácticas Transnacionales y Cooperación Internacional, la reflexión señala cambios significativos recientes en relación a la universalidad de acceso a la salud, reemplazada en las instancias de la Organización Mundial de la Salud (OMS) y Banco Mundial por la propuesta de cobertura universal de salud, con un significado y alcance muy diferente. Con base en el artículo 13 de la DUBDH, que trata de Solidaridad y Cooperación, el texto defiende el concepto de solidaridad cooperativa, partiendo de la clásica concepción bilateral de la solidaridad como ayuda de los países ricos a otros más necesitados, aunque esta posibilidad es sustituidacon frecuencia por situaciones de la llamada solidaridad exploratoria. Finalmente, conbase en el artículo 15, que trata del Aprovechamiento Compartido de los Beneficios ­fundamental para el presente estudio­se presenta un análisis comparativo entre: a) hechos históricos relacionados con el permiso para romper patentes en el ámbito de laOrganización Mundial del Comercio (OMC) que permitió un amplio acceso a terapias antirretrovirales para controlar el VIH/SIDA; y b) hechos ocurridos desde 2020 con la pandemia de COVID-19 en relación al derecho de acceso a las vacunas.

Registros nacionais de anomalias congênitas no mundo: aspectos históricos e operacionais / Registros nacionales de anomalías congénitas en el mundo: aspectos históricos y operativos / National congenital anomaly registers in the world: historical and operational aspects

Objetivo: Identificar registros de anomalias congênitas com cobertura nacional existentes no mundo, destacando suas principais características históricas e operacionais. Métodos: Revisão documental, mediante busca na base Medline/Pubmed e consulta a dados provenientes de relatórios, documentos oficiais e sítios eletrônicos. Foram incluídos trabalhos com relato de pelo menos um registro nacional. Resultados: Foram identificados 40 registros nacionais de anomalias congênitas em 39 países diferentes. Todos os registros incluídos no estudo localizavam-se em países de renda alta ou média superior, com concentração na Europa. A maior parte dos registros foi de base populacional, de notificação compulsória e com tempo limite para notificação de até 1 ano de idade. O registro brasileiro apresentou a maior cobertura anual. Conclusão: Os registros discutidos apresentaram características diversas, relacionadas à realidade de cada país. Os resultados apresentados fornecem subsídios para a temática da vigilância das anomalias congênitas, sobretudo em locais onde se deseja implementar tal atividade.

Objetivo: Identificar registros de anomalías congénitas con cobertura nacional existentes en el mundo, destacando sus principales características históricas y operativas. Métodos: Revisión documental de literatura en la base de datos Medline/Pubmed y datos de informes, documentos oficiales y sitios web. Se incluyeron trabajos con informes de al menos un registro nacional. Resultados: Se identificaron 40 registros nacionales de anomalías congénitas en 39 países diferentes. Todos los registros incluidos se ubicaron en países de ingresos altos y medianos altos, con una concentración en Europa. La mayoría de los registros eran de base poblacional, con notificación obligatoria y un límite de tiempo de notificación de hasta 1 año. El registro brasileño presentá la cobertura anual más alta. Conclusión: Los registros discutidos presentaban características diferentes y relacionadas con la realidad de cada país. Los resultados presentados proporcionan subsidios para la vigilancia de anomalías congénitas, especialmente en lugares que deseen implementar dicha actividad.

Objective: To identify registers of congenital anomalies with national coverage currently available around the world, highlighting their main historical and operational characteristics. Methods: This was a documentary study by means of a Medline database search (via PubMed) and searches involving reports, official documents and websites. Studies reporting at least one national registry were included. Results: 40 registers of national congenital anomalies were identified in 39 different countries. All registers included in the study were concentrated in upper-middle or high-income countries located in Europe. Most of the registers were population-based, compulsory notification and with a time limit for notification of up to 1 year of age. The Brazilian register showed the highest annual coverage. Conclusion: The registers analyzed showed different characteristics, related to the reality of each country. The results presented provide support for the theme of congenital anomalies surveillance, especially in places where such activity is intended to be implemented.

Salud y sus determinantes socio culturales en la Venezuela actual. Retos y desafíos en salud pública / Health and its socio-cultural determinants in current Venezuela. A challenge in public health

El concepto de salud-enfermedad es un proceso dinámico que involucra la consideración de los determinantes socio culturales. Objetivo: explorar los determinantes de la salud venezolana identificando las principales tendencias, retos y desafíos que en materia de salud pública enfrenta Venezuela y, el impacto de los determinantes socioculturales en la condición de salud. Métodos: Partiendo de revisiones bibliográficas y fuentes analíticas se utilizó como referencia el marco de acción de la OMS para el fortalecimiento de los sistemas de salud utilizando como descriptores de búsqueda retos, desafíos, determinantes de salud, inequidades en salud. Resultados: Dentro de los desafíos se señalan la reducción de las iniquidades en salud, la mejoría de la calidad de la atención y de los sistemas de información y reformulación de los mecanismos de rendición de cuenta y de evaluación de políticas, premisas fundamentales para el fortalecimiento del sistema de salud, caracterizado por la inexistencia al derecho de la salud, ausencia de información epidemiológica y sanitaria, distorsión del modelo oficial salud-enfermedad, debilitamiento de la promoción de la salud y deterioro sistemático y progresivo del sector salud. Conclusiones: la investigación deja de manifiesto, la necesidad de resolver el problema de la fragmentación del financiamiento y de la prestación de servicios, tomando en consideración los elementos para una optimización de la calidad de vida en un sentido global, a fin de solventar las insuficiencias de cobertura y de acceso efectivo a los servicios públicos de salud de los hogares venezolanos(AU)

The concept of health-disease is a dynamic process that involves the consideration of socio-cultural determinants. Objective: to explore the determinants of Venezuelan health, identifying the main trends, challenges, and challenges that Venezuela faces in terms of public health, and the impact of sociocultural determinants on the health condition. Methods: Based on bibliographic reviews and analytical sources, it was used as references the WHO action framework for strengthening health systems using challenges, health determinants, health inequities as search descriptors. Results: Among the challenges are the reduction of inequities in health, the improvement of the quality of care and information systems and the reformulation of the mechanisms of accountability and evaluation of policies, fundamental premises for the strengthening of the health system, characterized by the non-existence of the right to health, absence of epidemiological and health information, distortion of the official health-disease model, weakening of health promotion and systematic and progressive deterioration of the health sector. Conclusions: the research reveals the need to solve the problem of the fragmentation of financing and the provision of services, taking into account the elements for an optimization of the quality of life in a global sense, in order to solve the insufficiencies coverage and effective access to public health services for Venezuelan households(AU)

Academic Exchange at WFAS Turkey 2019 and Review of RCTs Conducted in China / 全日本鍼灸学会雑誌

The WFAS Annual Conference 2019 was held between November 14th and 17th at Kaya Palazzo Hotel, Antalya, Turkey. The WFAS executive committee was convened on the 14th. In the EC (Executive Committee) meeting, the JSAM proposed inclusion of the Declaration of Helsinki (DoH) in the WFAS Code of Ethics. Other issues discussed in the EC meeting included approval of the special consultative status by the the United Nations ECOSOC (Economic and Social Council) and preparation of the next WFAS symposium in the Netherlands in 2020. Individual presentations and other exhibitions in the symposium are also introduced in the present report. In addition, recent large-scale RCTs of acupuncture conducted in China were reviewed.

Analysis of Class II Common Problems in the Registration of / 中国医疗器械杂志

From the perspective of technical review, this paper made statistics on the supplement contents of

De una crisis alimentaria anunciada a la emergencia humanitaria en Venezuela / From a food crisis to a humanitarian emergency in Venezuela

La crisis alimentaria anunciada por científicos en el año 2007 se ha convertido en una emergencia humanitaria en el 2021. Se fueron gestando una economía desequilibrada, elevados precios de alimentos, falta de servicios básicos como el agua, servicios sanitarios, trayendo como consecuencia una hiperinflación de 3713%, un salario mínimo que cubre 0,88% de la canasta alimentaria, 97% de inseguridad alimentaria, 15% de desnutrición aguda y 30% de baja talla en menores de 5 años y la movilización de 4,6 millones venezolanos. Este trabajo analiza las percepciones sobre una crisis alimentaria en Venezuela, factores asociados y estrategias para mejorarla desde la mirada de profesionales de la alimentación y nutrición en el año 2007. Se seleccionó intencionalmente 51 profesionales, de los cuales 10 sujetos respondieron una entrevista confidencial y electrónica. La categorización y análisis de las entrevistas se complementó con referencias de otros autores, para la construcción de la teoría. La mayoría de los entrevistados admitió una crisis alimentaria en el 2007, con factores asociados de índole político, económico, de servicios y hasta moral. Como recomendaciones surge: "reorientar las políticas agrícolas, pecuarias, de educación, trabajo y remuneración entre otras, relacionadas directa e indirectamente con el sector de los alimentos, para lograr abastecer los mercados y permitir que los alimentos puedan llegar a la población". Esta aproximación de la crisis alimentaria permitió comprender cómo la crisis se exacerbó hasta convertirse en una emergencia humanitaria agravada por la pandemia. Se ha perdido toda una generación de venezolanos por enfermedad, muerte, oportunidades y migraciones(AU)

The food crisis announced by scientists in 2007 has become a humanitarian emergency in 2021. An unbalanced economy, high food prices, lack of basic services such as water, sanitation, were brewing, resulting in a hyperinflation of 3713%, a minimum wage that covers 0.88% of the food basket, 97% of the population with food insecurity, 15% of acute malnutrition and 30% of stunting in children under 5 y. and the migration of 4.6 million Venezuelans. This manuscript analyzes the perceptions of a food crisis in Venezuela, associated factors and strategies to improve it from the perspective of food and nutrition professionals in 2007. Fifty-one professionals were intentionally selected, of which 10 subjects answered a confidential and electronic interview. The categorization and analysis of the interviews was complemented with references from other authors, for the construction of the theory. Most of those interviewed admitted a food crisis in 2007, with associated factors of a political, economic, essential utilities and even moral nature. As recommendations arise: "reorient agricultural, livestock, education, work and remuneration policies, among others, directly and indirectly related to the food sector, in order to supply markets and allow food to reach the population." This approach to the food crisis made it possible to understand how the crisis exacerbated into a humanitarian emergency aggravated by the pandemic. A whole generation of Venezuelans has been lost to illness, death, opportunities, and migration(AU)

La Farmacovigilancia en Cuba y la Infranotificaciones de Reacciones Adversas a los Medicamentos / Pharmacovigilance in Cuba and Adverse Reactions to Drugs Underreporting / Farmacovigilância em Cuba e Subnotificações de Reções Adversas a Medicamentos / Pharmacovigilance à Cuba et Sous-déclaration des Réactions Indésirables aux Médicaments

Resumen Objetivo: Efectuar una revisión de los conocimientos sobre la Farmacovigilancia, el suministro de información sobre sospechas de RAM, que es tanto un deber moral para el médico y otros profesionales de salud como un aspecto de la atención al paciente y la infranotificación de estos reportes. Material y métodos: La revisión fue realizada en las bases de datos LILACS, PAHO, SciELO, EMBASE, PubMed e Infomed, los motores de búsqueda Google y Google Scholar donde se colocaron palabras claves para la búsqueda de la información en artículos originales, tesis, otros artículos de revisión bibliográfica y revistas de elevado índice de citación publicados desde 1937 a 2017, en los idiomas español o inglés. Resultados: Se identificaron 100 artículos, de los cuales 30 fueron seleccionados como útiles verificados para actualizar los conceptos relacionados con las disciplinas de Farmacovigilancia. En la práctica clínica existen varios factores que pueden dificultar la detección de las RAM y como consecuencia contribuir a la infranotificación. Conclusiones: La infranotificación en Farmacovigilancia es una realidad mundial, observándose que la mayoría de las publicaciones analizadas que proceden de Europa (Alemania, España y Reino Unido) y en países de América Latina como Colombia, reconocen bajos índices de notificación.

Abstract Object: The article proposes a pharmacovigilance knowledge review, the provisión of information on suspicion of AMR, which is both a moral duty for the doctor and other health professionals and an aspect of patient care and the underreporting of them. Materials and methods: The review was carried out in the databases LILACS, PAHO, SciELO, EMBASE, PubMed and Infomed, the Google search engines and Google Scholar where keywords were placed for the search of the information in original articles, theses, other articles of bibliographic review and high citation index journals published from 1937 to 2017, in Spanish or English. Results: Consequently 100 articles were identified, 30 of which were selected as verified tools to update the concepts related to Pharmacovigilance discipline. There are several factors in clinical practice that can hinder the detection of ADR and it could contribute to under-reporting. Conclusión: In pharmacovigilance the under-reporting is a global reality, noting that most of the analyzed publications come from Europe (Germany, Spain and the United Kingdom) and in Latin American countries such as Colombia, recognize low reporting rates.

Resumo Objetivo: O artigo propõe uma revisao de literatura sobre farmacovigilancia, fornecendo informações sobre suspeitas de RAM, que é um dever moral para os médicos e outros profissionais de saúde como um aspecto da assistencia ao doente e subnotificação desses relatórios. Materiais e métodos: A pesquisa foi realizada nas bases de dados LILACS, PAHO, SciELO, EMBASE, PubMed e Infomed, nos motores de busca Google e Google Scholar, onde foram colocadas as palavras-chave para encontrar as informações em artigos originais, teses, outros artigos de revisão bibliográfica e de revistas de alto índice de citação publicados de 1937 a 2017, em espanhol ou inglês. Resultados: Foram identificados 100 artigos, dos quais 30 foram selecionados como instrumentos importantes para atualização dos conceitos relacionados á disciplina de farmacovigilancia. Na prática clínica, existem vários fatores que podem dificultar a detecção de RAM e, consequentemente, contribuir para uma subnotificação Conclusão: Na farmacovigilãncia, a subnotificação é uma realidade mundial, observando que a maioria das publicações analisadas provenientes da Europa (Alemanha, Espanha e Reino Unido) e dos países latino-americanos como a Colõmbia, reconhecem baixos índices de notificação.

Résumé Objectif: Procéder á une revue de littérature des connaissances sur la pharmacovigilance et la fourniture d'informations sur la suspicion de Réactions Indésirables aux Médicaments (RIM), qui est autant un devoir moral pour le médecin et pour d'autres professionnels de la santé qu'un aspect des soins aux patients, ainsi que sur la sous-déclaration. Matériaux et méthodes: La revue a été réalisée á l'aide des bases de données LILACS, PAHO, SciELO, EMBASE, PubMed et INFOMED, et des moteurs de recherche Google et Google Scholar, en utilisant des mots clés pour chercher des informations dans des articles originaux, théses, articles de revue de littérature et revues ayant des indices de citations élevés, publiés entre 1937 et 2017, en espagnol ou en anglais. Résultats: 100 articles ont été identifiés, dont 30 ont été sélectionnés comme utiles pour actualiser les concepts en relation avec les disciplines impliquées dans la pharmacovigilance. Dans la pratique clinique, plusieurs facteurs peuvent entraver la détection des RIM et, par conséquent, contribuer á la sous-déclaration. Conclusions: La sous-déclaration en pharmacovigilance est une réalité mondiale. Dans la plupart des publications analysées provenant d'Europe (Allemagne, Espagne et Royaume-Uni) et des pays d'Amérique latine comme la Colombie, on a pu observer la reconnaissance d'un faible taux de déclaration.

Inspiration of the Astana Declaration to the prevention and control of non-communicable diseases in China / 中华流行病学杂志

2018 witnessed the 40th anniversary of the Alma-Ata Declaration. On October 25, 2018, the World Health Organization issued a new Astana Declaration, which reiterates and further develops the concept and core elements of primary health care. It is also proposes that the implementation of the primary health care concept will facilitate to cope with the increasing burden of non-communicable diseases in different countries. Based on the analysis on the policies and practices of the prevention and control of non-communicable diseases in China, this paper points out that the "government-leading, multi-sectoral collaboration, social mobilization and participation by all people" which we have always emphasized is just the application of this primary health care concept, and the Astana Declaration also brings a new and important inspiration to the prevention and control of non-communicable diseases in China.

Declaration of Astana and preventive medicine in China / 中华预防医学杂志

At the time of the 40th anniversary of the Alma-Ata Declaration, the World Health Organization member states signed the Declaration of Astana. From Health For All to Universal Health Coverage, primary health care is consistantly identified as the key to achieving human health, and preventive services are critical and central component of primary health care. China has provided valuable experience for primary health care to countries around the world. However, with significant socioeconomic changes and rapid population aging, the contexts of primary health care and prevention services in China has undergone tremendous changes. Chronic diseases have become major burden of disease. System development and institution building, health service delivery system development, and the entire society of the country with large population are encountering new and serious challenges. On the basis of reviewing the development of preventive medical services in China for 40 years, Authors analyzes strengths and weaknesses of preventive services in China and looks forward to the challenges and opportunities in the coming decades, from perspective of primary, secondary and tertiary prevention strategies, and proposes suggestions for future development.

Los juegos cooperativos y el acceso a la información desde la extensión universitaria / Cooperative Games and Access to Information from the University Extension

Resumen Desde el proyecto de extensión universitaria "Conocimiento, Paz y Gestión Social" durante el mes de noviembre del 2016 se desarrolló un taller en la comunidad de Guararí de Heredia, Costa Rica, titulado: Cada Pollo con su Rollo, donde participaron doce mujeres con edades entre los 12 y los 18 años y seis varones con edades entre los 10 y los 17 años. Empleando un lenguaje sencillo, se utilizó el juego cooperativo como metodología participativa, con el propósito de accesar a la información y a procesos de alfabetización informacional en materia de Derechos Humanos. Como resultado, los participantes identificaron la existencia de un conjunto de derechos plasmados en la Declaración Universal de los Derechos Humanos, que los faculta para vivir y para participar activamente en sus comunidades sin importar su condición económica, social y cultural.

Abstract From the project of academical extension "Knowledge, Peace and Social Management" during the month of November of 2016 a workshop in the community of Guararía in Heredia, Costa Rica titled in Spanish as "Cada Pollo Con Su Rollo" was developed. In which twelve women in between the ages of 12 and 18 and six boys in between the ages 10 and 17 participated. Using simple language, the cooperative game was used as a participative methodology, with the purpose of accessing information and informal alphabetization processes in the subject of human rights. As a result, the participants identified the existence of a grouping of rights captured in the Universal Declaration of Human Rights, that empowers them to live and actively participate in their communities no matter what their economic, social and cultural condition might be.

Consent from new patient at first registration

Just as the patient can take a proper decision only if full information is available to him/her, the doctor can take the most appropriate decision for a patient only if the patient provides full and up-to-date information. Unfortunately this does not happen all the time. The Ministry of Health and Family Welfare recommends the Charter of Patients Rights which also includes a specific section on responsibilities of patients and their family members. Based on the legal principle that consent is a contract between two parties, we followed a systematic procedure to develop consensus recommendation for obtaining patient consent in the normal practice setting at first registration/ presentation.

The São Paulo Declaration (1998): Nothing Dates More Rapidly than the Present

The Sao Paulo Declaration (1998) committed leisure professionals to extending Rights, Inclusion and Social Order in leisure customs and practice. The engine for this intervention consisted of the twin processes of globalization and cosmopolitanism. Both were seen as dissolving economic and political barriers. The Declaration did not make use of the term 'world society'. On the other hand it clearly defined itself to be part of a global movement that addressed leisure for all. In the last 20 years, the progress made n fulfilling the terms of the Declaration has been disappointing. Economic barriers of wealth inequality and uneven development in globalization and cosmopolitanism have blocked many aspects of the Rights, Inclusion and Order articulated in the Declaration. This paper examines how far globalization and cosmopolitanism have progressed in achieving the principle that 'all persons have the right to leisure.' It examines data on wealth inequality, debt and unemployment rates to consider some of the concrete impediments. It concludes by maintaining that there is a need to go beyond the Sao Paulo Declaration by addressing the economic and political barriers that currently prevent leisure from being a right for all.(AU)

The Revision and Significance of 2017 Declaration of Geneva / 中国医学伦理学

Compared with the version of the Declaration of Geneva in 2006,the new revision in 2017 has great change and supplement,emphasizing the maintenance of the patient's autonomy.WMA (the World Medical Association) moved the all items of patients' rights to the beginning of the oath to highlight independent decision-making of patients in the medical ethics,and following the physician's professional responsibility.In terms of the structure,the declaration pay more attention of physicians themselves,and in content,it added and deleted some statements,and modified some words in detail.The revision of the Geneva declaration in 2017 improved the framework of the declaration and perfected the content of the declaration;raised the professional requirements for physicians and emphasized humanistic concern.Taking medical environment,economic and technological development into consideration,the further revision of the Declaration of Geneva should meet and adapt to the professional spirit of contemporary physicians.