Association of Estimated Glucose Disposal Rate With the Stenosis Severity of Coronary Artery Disease： A Cross-sectional Study / 中山大学学报(医学科学版)

ObjectiveTo investigate the association between estimated glucose disposal rate （eGDR） and the severity of coronary heart disease. MethodsWe conducted a hospital-based cross-sectional study that included 1258 patients （mean age： 62（53-68） years） who underwent coronary angiography for suspected coronary artery disease （53.9% were male）. Insulin resistance level （IR） was calculated according to eGDR formula： eGDR = 21.158 - （0.09 × WC） - （3.407 × hypertension） - （0.551 × HbA1c） ［hypertension （yes = 1 / no = 0）， HbA1c = HbA1c （%）］. Subjects were grouped according to the eGDR quantile. CAD severity was determined by the number of narrowed vessels： no-obstructive CAD group （all coronary stenosis were<50%， n=704）， Single-vessel CAD group （only one involved major coronary artery stenosis≥50%， n=205）， Multi-vessel CAD group （two or more involved major coronary arteries stenosis≥50%， n=349）； Multivariate logistic regression model was used to analyze the association between eGDR and CAD severity. The linear relationship between eGDR and CAD in the whole range of eGDR was analyzed using restricted cubic spline. Subgroup analyses were used to assess the association between eGDR and CAD severity in different diabetic states. Receiver operating characteristic （ROC） curve analysis were used to evaluate the value of eGDR in improving CAD recognition. ResultsA decrease in the eGDR index was significantly associated with an increased risk of CAD severity （OR： 2.79； 95%CI： 1.72~4.55； P<0.001）. In multivariate logistic regression models， individuals with the lowest quantile of eGDR （T1） were 2.79 times more likely to develop multi-vessel CAD than those with the highest quantile of eGDR （T3） （OR： 2.79； 95%CI： 1.72~4.55； P<0.001）. Multivariate restricted cubic spline analysis showed that eGDR was negatively associated with CAD and multi-vessel CAD （P-nonlinear>0.05）. In non-diabetic patients， compared with the reference group （T3）， the T1 group had a significantly increased risk of CAD （OR： 1.42； 95% CI： 1.00~2.01； P<0.05） and multi-vessel CAD （OR： 1.86； 95%CI： 1.21~2.86； P<0.05）. No statistical association was found between eGDR and CAD in diabetic patients. In ROC curve analysis， when eGDR was added to traditional model for CAD， significant improvements were observed in the model's recognition of CAD and multi-vessel CAD. ConclusionOur study shows eGDR levels are inversely associated with CAD and CAD severity. eGDR， as a non-insulin measure to assess IR， could be a valuable indicator of CAD severity for population.

STUDY OF BIOMEDICAL WASTE MANAGEMENT IN DIFFERENT TYPES OF MEDICAL FACILITIES

OBJECTIVE- To study disposal of different types of biomedical waste and to studythe status of BMW management in different level of hospitalsMETHOD-Medical facilities were divided into 4 groups. 10 facilities from each groupwere selected by simple random sampling. Facilities were visited by surveying groupsand specific data about collection and disposal of waste were collected by askingmanagement personnels of hospitals, doctors and staff.RESULT- 90% of single speciality hospitals and 80% of multispeciality hospitals arefollowing proper storage and segregations of BMW.90% of super speciality hospitalshave transportation facilities.60% of super speciality hospitals , 30% of multispecialityand 20% of single speciality hospitals have incinerators. All super speciality hospitalshave autoclave machines, while 70% of single and 50% of multispeciality hospitalshave that. While only 2 out of 10 clinics have an autoclave machine.60% of both clinicsand Superspeciality hospitals are using land disposal as a method of BMWmanagement. 80% of small clinics and 70% of multispeciality hospitals are having dryand wet thermal management.CONCLUSION- Superspeciality hospitals and Single specialty hospitals are usingcostly methods like incineration and autoclave also following guidelines for storage ,segregation and transportation of BMW properly while amongst all most small clinicscan’t afford costly methods so uses cheaper techniques like chemical treatment and dryand wet thermal methods.

Descarte de medicamentos e os impactos ambientais: uma revisão integrativa da literatura / Disposal of drugs and the ensuing environmental impacts: an integrative review of the literature

Resumo O objetivo deste artigo é investigar as evidências nacionais e internacionais disponíveis sobre o descarte de medicamentos e os impactos em matrizes ambientais. Trata-se de uma revisão integrativa da literatura realizada nas bases de dados PubMed, SciELO e Biblioteca Virtual em Saúde (BVS) e que incluiu artigos em inglês, espanhol e português publicados entre 2010 e 2020. Foram selecionados 26 artigos, que evidenciaram o descarte incorreto de medicamentos por profissionais e consumidores devido, principalmente, à falta de conhecimentos sobre os impactos ambientais que esses podem ocasionar. Estudos apontaram a contaminação de água, esgoto e sedimentos por fármacos descartados de forma incorreta. Além disso, observou-se que seres vivos aquáticos podem ser impactados pela presença de medicamentos em matrizes ambientais. O descarte de medicamentos incorreto ainda é uma realidade nas evidências avaliadas, que promove a contaminação de matrizes ambientais e muitas vezes não é removido por estações de tratamento de águas residuárias e interfere no equilíbrio da vida ambiental.

Abstract The scope of this article is to investigate the national and international evidence available on the forms of drug disposal and the presence of drugs in environmental matrices. It involved an integrative review of the literature conducted in the PubMed, SciELO and Virtual Health Library (VHL) databases, which included articles in English, Spanish and Portuguese published between 2010 and 2020. Twenty-six articles were selected, which revealed the incorrect disposal of medicines by professionals and consumers due mainly to the lack of knowledge about the environmental impacts that they may cause. Studies have highlighted the contamination of water, sewage and sediments by incorrectly discarded drugs. Furthermore, it was observed that aquatic living creatures can be impacted by the presence of drugs in environmental matrices. The incorrect disposal of drugs continues to be a reality in the evidence assessed, which leads to the contamination of environmental matrices and is often not removed by wastewater treatment plants and interferes with the equilibrium of environmental life.

A cross-sectional survey to assess the drug disposal practices of unused and expired medicines among lay public visiting a tertiary care hospital in an urban metropolis

Objectives: A cross-sectional survey was conducted to evaluate the knowledge, awareness and practice among the lay public regarding storage and disposal of unused and expired medicines. Materials and Methods: This was an observational, cross-sectional, single-centre and questionnaire-based survey. After obtaining Institutional Ethics Committee approval, the study was conducted using a pre-validated structured questionnaire distributed among the lay public visiting a tertiary care hospital located in an urban metropolitan city. Results: Four hundred of 720 individuals visiting the tertiary care hospital participated in the survey. The results revealed that 75% had never referred to any sources to get the correct information about the proper and safe disposal of medicines and had no knowledge regarding the same. About 12.75% of study participants reported that they were educated regarding the disposal of medicines by their treating physicians (RR: 0.71 [95% CI: 0.51–0.99]) when compared with the other sources of information (18%) with statistically significant contribution made by the physicians (p<0.05). About 67% of the public stored their medicines at room temperature. Majority (83.75%) of the study participants reported that they disposed unused and expired drugs in the dustbin. Only 42.5% of the public knew the detrimental effect of improper drug disposal on human health and our ecosystem. In addition, 80% (320/400) of the participants confirmed that, given the option, they would prefer to return the unused or expired drugs to the pharmacy shops from where the medicines were purchased. Conclusion: There is a need to educate drug consumers/general public about safe and proper disposal of unused/ expired medicines. Health-care professionals, governments and policymakers should offer training to educate the general public about Indian regulations for safe disposal of unused/expired medicines.

Knowledge, attitude, and practice of unused and expired medication disposal among second year medical students

Background: Medications are not only used for disease treatment, but also for diagnosis and prevention of the disease. Not all the prescribed drugs are used by the patients, due to lack of adherence to therapy, there are chances of stocking up the unused or expired drugs at home. It is important to provide practical and scientific guidelines for the safe disposal of expired, unused, and leftover medications. Most developing countries lack standard guidelines for the safe disposal of expired, unused, and leftover medications. There are very few studies conducted in this region to assess the knowledge of the safe disposal of unused drugs. Aims and Objectives: The present study was undertaken to assess the knowledge, attitude, and practice of disposal of unused or expired medications. Materials and Methods: This was cross-sectional, questionnaire-based study conducted among 2nd year undergraduate medical students at a Medical College in South India. The questionnaire included three parts: Part I includes demographic details of the students and questions on knowledge of safe disposal of expire/unused drugs, Part II includes questions on attitude towards the safe disposal of expired/unused drugs, and Part III includes questions on practices toward the safe disposal of expired/unused drugs. The responses received from the participant was analyzed using Microsoft Excel (2019 version), and the results are explained in frequency and percentage. Results: A total of 118 2nd year medical undergraduate students participated in the present study. Out of 118, 62 (52.5%) were female students and 56 (47.4%) were male students. Among all the participants, 98 (83%) of students said that they are aware of medicinal waste. In the present study, 73 (61.8%) students knew about the safe disposal of unused, expired, and leftover medications. Most of the students (93.2%), agreed that unsafe disposal of unused, expired, and leftover medications would adversely affect the environmental, animal as well as human health. And 50% of the students, strongly agreed that educational activities like drug take-back programs should be introduced among the public people. When the students were asked about their practice of keeping expired, unused, or left-over drugs at home, 66.1% (78) of the students said yes and 47.2% (40) of the students said they do not keep the leftover medicine at home. Topical formulations (63.5%) were the most common group of drugs that were stored. The majority of students (73%) reported that they would throw unused/expired medications in dust bins at home. Self-discontinuation is most the common reason for storing drugs in the majority of the study participants (39%). Conclusion: In the present study, the 2nd-year medical undergraduate students had awareness regarding the harmful events associated with improper disposal of unused or expired drugs. But due to lack of information or knowledge of safer methods available, majority of the students were following inappropriate methods for disposing leftover or expired medication at home. Indian Government should provide national level guidelines and conduct awareness programs, mediated through healthcare professionals to bring significant changes about the disposal of unused or expired medications.

Evidence summary for the management of insulin injection-related sharps waste disposal in patients with diabetes mellitus / 中国实用护理杂志

Objective:To retrieve and summarize the best evidence related to the management of insulin injection-related sharps waste disposal in diabetic patients at home and abroad, so as to provide reference for clinical healthcare professionals.Methods:This was a evidence-based research. Evidence on insulin injection-related sharps waste management in patients with diabetes, including guidelines, expert consensus, evidence summaries, best practice information sheet, recommended practices, clinical decisions and systematic reviews was systematically searched from domestic and international databases and professional websites, and the search time frame was from the establishment of the database to December 2021. Evidence was extracted and summarized following a quality evaluation of the literature that met the criteria.Results:A total of 15 papers were included, summarizing 25 pieces of best evidence on four areas including risk assessment and management of sharps waste associated with insulin injections, education and training, and the use of safe devices and sharps containers.Conclusions:Best evidence on the management of insulin injection-related sharps waste disposal provides evidence to support clinical practice for healthcare professionals to standardized sharps waste disposal practices in patients with diabetes.

Discussion on the disposal methods and expiration extending strategy of expired drug in China / 中国药房

China produces about 15 000 tons of expired drugs every year. Standardized destruction of expired drugs consumes a large number of secondary costs， causing huge economic losses. Improper handling will also lead to serious environmental pollution， endanger national health and even endanger public safety. This paper analyzes the hazards， sources and disposal methods， and research status of expired drugs， introduces the Shelf-Life Extension Program of United States， and put forward feasible measures for the recovery， integration and reuse of expired drugs. It is suggested to construct a scientific and reasonable recovery and disposal system of expired drugs in combination with the actual situation in China， explore the strategy of extending the expiration of drugs， and greatly reduce the waste of drug resources.

Descarte de medicamentos domiciliares: uma análise de amostra obtida de uma ação de extensão realizada no município de Seropédica-Rj / Disposal of home medicines: a sample analysis obtained from an extension action carried out in the municipality of Seropédica-Rj / Descarga de medicamentos domiciarios: análisis de muestra obtenido de una acción de extensión realizada en el municipio de la Seropedic-Rj

O Brasil é um dos países que mais consomem medicamentos no mundo, em contrapartida não há uma legislação que regulamente o descarte de medicamentos domiciliares, sendo a maioria deles descartados incorretamente no lixo comum ou esgoto, contaminando o meio ambiente e trazendo prejuízos ambientais, sociais e econômicos. Ao analisar o material foi observado que 95,98% eram sólidos, 2,58 líquidos, 1,51% semissólidos e 0,24% outros. Já em relação às classes terapêuticas 27,25% eram medicamentos de ação cardiovascular, 15,30% de ação gastrointestinal, 15,07% de antimicrobianos, 14,44% de ação no SNC, 10,71% anti-inflamatórios, 5,49% analgésicos e antipiréticos, 3,52% antialérgicos, 3,31% de ação no trato respiratório, 2,83% hormônios e 2,09% outros. E o prejuízo econômico decorrente da perda dos medicamentos foi de aproximadamente R$ 9470,00. Diante do exposto, podemos concluir que o uso irracional de medicamentos, a não adesão terapêutica, a falta de fracionamento, as estratégias do marketing farmacêutico, as prescrições irracionais, a venda sem prescrição e a falta de educação sanitária da população a respeito dos medicamentos levam a um consumo indiscriminado dos mesmos, o que corrobora para o acúmulo nas residências e o descarte incorreto.

Brazil is one of the countries that consume most medicines in the world, in contrast there is no legislation that regulates the disposal of home medicines, most of them being disposed of incorrectly in common garbage or sewage, contaminating the environment and bringing environmental, social and economic damages. When analyzing the material, it was observed that 95.98% were solid, 2.58 liquids, 1.51% semi-solid and 0.24% others. With regard to the therapeutic classes, 27.25% were medicines with a cardiovascular action, 15.30% with a gastrointestinal action, 15.07% with antimicrobials, 14.44% with an CNS action, 10.71% with anti-inflammatories, 5.49% with analgesics and antipyretics, 3.52% with antiallergies, 3.31% with an action on the respiratory tract, 2.83% with hormones and 2.09% others. And the economic loss resulting from the loss of the medicines was approximately R$ 9470.00. In the light of the above, we can conclude that the irrational use of medicines, the non-adherence to treatment, the lack of fractionation, the strategies of pharmaceutical marketing, the irrational prescriptions, the non-prescription sale and the lack of health education of the population regarding the medicines lead to an indiscriminate consumption of the medicines, which corroborates for the accumulation in the residences and the incorrect disposal.

Brasil es uno de los países que más consumen medicinas en el mundo, en contraste, no existe legislación que regule la eliminación de medicinas domésticas, la mayoría de las cuales son descartadas incorrectamente en desechos o aguas residuales comunes, contaminando el medio ambiente y ocasionando pérdidas ambientales, sociales y económicas. Al analizar el material se observó que el 95,98% eran sólidos, 2,58 líquidos, 1,51% semisólidos y 0,24% otros. En cuanto a las clases terapéuticas, el 27,25% fueron medicamentos de acción cardiovascular, el 15,30% de acción gastrointestinal, el 15,07% antimicrobianos, el 14,44% de acción del SNC, el 10,71% antiinflamatorios, el 5,49% analgésicos y antipiréticos, el 3,52% 3,31% de acción en el tracto respiratorio, 2,83% de hormonas y 2,09% de otras. Y la pérdida económica resultante de la pérdida de los medicamentos fue de aproximadamente R$ 9470,00. A la luz de lo que antecede, podemos concluir que el uso irracional de los medicamentos, la no adhesión a la terapia, la falta de fraccionamiento, las estrategias de comercialización farmacéutica, las prescripciones irracionales, la venta sin receta y la falta de educación en la salud de la población sobre los medicamentos conducen a su consumo indiscriminado, lo que corrobora la acumulación en los hogares y la eliminación incorrecta.

Medicamentos vencidos e/ou armazenados no domicílio de estudantes e o correto descarte: um estudo de caso

Objetivos Quantificar e qualificar por classes terapêuticas os medicamentos vencidos e/ou armazenados no domicílio de estudantes dos cursos técnicos do eixo saúde do Colégio Tecnológico Jerônimo Carlos do Prado, em Goiatuba, GO. Metodologia: A pesquisa foi realizada através de coleta de medicamentos em desuso obtidos da farmácia domiciliar dos estudantes por entrega voluntária e anônima. Resultados: Foram coletados 86 medicamentos, dos quais 77,9% estavam com a validade expirada. O número de medicamentos prescritos sem retenção de receita foi maior em relação aos prescritos com retenção de receita e venda livre. A classe terapêutica mais comum foi o anti-inflamatório não-esteroide, seguido dos analgésicos e os antimicrobianos. Alguns medicamentos apresentaram lascas e alteração de cor dos comprimidos e, no caso das soluções, foram encontradas crostas ao redor da tampa, evidenciando oxidação e alteração do produto. Conclusões: Logo, mesmo entre estudantes da área de saúde ocorre a prática do armazenamento de medicamentos e alguns em condições inadequadas. A aquisição racional de medicamentos deve ser um tema imprescindível a ser trabalhado em todos os níveis de ensino e também nas palestras educativas oferecidas pelas Unidades Básicas de Saúde. A população precisa de educação em saúde para apreender sobre as práticas corretas de armazenamento e descarte de medicamentos.

Objetivo: Cuantificar y clasificar los medicamentos por clases terapéuticas vencidos o almacenados en los domicilios de alumnos de cursos técnicos en el eje de salud del Colegio Tecnológico Jeronimo Carlos do Prado, en Goiatuba, GO. Metodología: La investigación se realizó a través de la recolección de medicamentos en desuso obtenidos de la farmacia domiciliaria de los estudiantes por entrega voluntaria y anónima. Resultados: Se recogieron 86 medicamentos, de los cuales el 77,9% estaban vencidos. El número de medicamentos de prescripción sin retención de prescripción fue mayor en relación a los prescritos con retención de prescripción y venta sin receta. La clase terapéutica más común fue el antiinflamatorio no esteroideo, seguido de los analgésicos y los antimicrobianos. Algunas drogas mostraron astillas y cambio de color en los comprimidos y, en el caso de las soluciones, costras alrededor de la tapa, evidenciando oxidación y alteración del producto. Conclusiones: Incluso entre estudiantes del área de la salud, se da la práctica de almacenar medicamentos y algunos en condiciones inadecuadas. La adquisición racional de medicamentos debe ser un tema fundamental a trabajar en todos los niveles educativos y también en las charlas educativas ofrecidas por las Unidades Básicas de Salud. La población necesita educación sanitaria para conocer las prácticas correctas de almacenamiento y disposición de medicamentos.

SUMMARY Aim: To quantify and classify the medicines by therapeutic classes expired or stored in the homes of students of technical courses in the health eje del Colegio Tecnológico Jeronimo Carlos do Prado, in Goiatuba, GO. Methodology: The investigation was carried out through the collection of disused medicines obtained from the home pharmacy of students by voluntary and anonymous delivery. Results: 86 medications were recovered, of which 77.9% were expired. The number of prescription drugs without prescription retention was greater in relation to prescriptions with prescription retention and sale without prescription. The most common therapeutic class was the anti-inflammatory drug on the steroid, followed by analgesics and antimicrobials. Some drugs showed astills and color change in pills and, in the case of solutions, around the tapa, evidencing oxidation and alteration of the product. Conclusions: Even among students from the health area, there is a practice of storing medicines and some in inadequate conditions. The rational acquisition of medicines should be a fundamental issue to work at all educational levels and also in the educational talks offered by the Basic Health Units. The population needs health education to know the correct practices of storage and disposal of medicines.

A cross-sectional assessment of knowledge, attitudes, and practices of safe drug disposal practices in pharmacies

Background: Safe disposal of expired medicines is a problem which is current area of intense discussion among policy makers. This project was conducted to explore the knowledge, attitudes, and practices (KAP) among hospital pharmacies and drug store owners about expired medicines and their disposal. The information generated could be used to plan proper and safe drug disposal practices. Aims and Objectives: This project was conducted to explore the KAP among hospital pharmacies and drug store owners about expired medicines and their disposal. The information generated could be used to plan proper and safe drug disposal practices. Materials and Methods: The target population for the current project were the pharmacies dispensing drugs to patients. Pharmacies situated in the hospitals were also covered in this survey. KAP survey is designed to explore the present concepts about a topic of public interest in the target population. Results: The present study was conducted in 373 participants. Most of the participants (88.37%) believed that expired drugs should be returned to manufacturers and proper disposition is the responsibility of pharmacists (72.6%). However, few others believed that it should be cumulative responsibility of nursing professionals and municipal corporations as well. Most of the pharmacists were of opinion that expiry date is fixed by regulatory body (56.0%) and depends on storage conditions (59.2%) of drugs. Conclusion: An innovative policy needs to be implemented by the health regulators to strengthen the existing drug disposal policies more effectively.

Study of Municipal Solid Waste Management in Ranchi, Jharkhand

Solid waste management (SWM) have becomes a very serious concern globally. The lack of individual responsibilities as well as proper attitude and approach leads to this issue. Rapid industrialization, increase in population and further increase in standard of living and poor waste management have increased the serous health issue. In India we generate about one 1 lakh ton of MSW per day. Almost every ton of MSW is disposed of unscientifically. Though the compostable organic waste ranges between 34-70 percent, improper segregation or no segregation at source has challenged the further treatment and disposal experiments. Ranchi city need to be taken care by various new SWM techniques, proper management skill and adequate care the diseases and improve medical conditions. This paper deals with the proper description of the current MSWM process and the real time scenario where every individual is a source of waste creation. The effect of growing population of last ten years outcome of waste quality and quantity generated throughout these years have been discussed. It is observed that more than 4000 tons of waste per month is being generated. Researches shows that the disposal of solid waste requires 2,700,000 m2 area for the land up to the year 2030. Far sustainable development and effective management it is suggested that implementation of newer technologies, training of common people, and effective implementation of government policies will help to come out of these current issues

Perfil de medicamentos descartados nas farmácias públicas de um município do leste de Minas Gerais / Profile of medicines discarded in the public pharmacies of an eastern municipality of Minas Gerais

O descarte inadequado de medicamentos pode levar a impactos ambientais negativos e deve ser considerado um problema de saúde pública. O presente estudo teve como objetivo levantar dados quantitativos e qualitativos relacionados ao perfil dos medicamentos descartados no município de Governador Valadares - MG. O trabalho foi desenvolvido nas UAPS/ESF que possuíam farmácias, e também na Farmácia Central/Policlínica Municipal. Nesses locais, foi realizada uma análise dos medicamentos descartados no período de julho de 2017 a maio de 2018. Por meio dos dados obtidos nesse período foi possível perceber que as principais classes de medicamentos descartadas foram os inibidores da enzima conversora de angiotensina, antagonistas da angiotensina II, agentes betabloqueadores, diuréticos, hipoglicemiantes, contraceptivos hormonais e agentes modificadores de lipídeos. Além disso, foi realizada uma ação de educação em saúde e aplicado um questionário semiestruturado aos usuários participantes dos grupos operativos. Dos 34 usuários respondentes do questionário, 23 (69,70%) não tinham acesso a informação sobre o local correto de descarte e armazenamento de medicamentos. Após a ação de educação em saúde verificou-se um aumento no quantitativo de medicamentos descartados pelos usuários nas UAPS/ESF Mãe de Deus I e II, Altinópolis III e IV, Santa Rita II, São Pedro I e II e Esperança e Nossa Senhora das Graças. O trabalho desenvolvido permitiu apresentar dados relevantes para a gestão municipal demonstrando a importância do farmacêutico no cuidado em saúde e o caráter epidemiológico local da prevalência das doenças crônico não transmissíveis.

The inadequate disposal of drugs can lead to negative environmental impacts and should be treated as a public health problem. This study aimed at surveying quantitative and qualitative data related to the profile of drugs discarded in the city of Governador Valadares - MG. The work was developed in the UAPS / ESF that had pharmacies, and also in the Central Pharmacy/Municipal Polyclinic. In these locations, an analysis of the drugs discarded between July 2017 and May 2018 was carried out. Through the data obtained in this period, it was possible to notice that the main classes of drugs discarded were angiotensin-converting enzyme inhibitors, angiotensin II antagonists, beta-blocking agents, diuretics, hypoglycemic agents, hormonal contraceptives, and lipid-modifying agents. In addition, a health education action was carried out and a semi-structured questionnaire was applied to users participating in the operating groups. From the 34 users who responded the questionnaire, 23 (69.70%) did not have access to information on the correct place to dispose and store medicines. After the health education action, there was an increase in the amount of drugs discarded by users in the UAPS/ESF Mãe de Deus I and II, Altinópolis III and IV, Santa Rita II, São Pedro I and II, and Esperança and Nossa Senhora das Graças. The work carried out made it possible to present relevant data for municipal management, demonstrating the importance of the pharmacist in health care and the local epidemiological character of the prevalence of chronic non-communicable diseases.

Analysis of Demonstration Function of College Students’ Behavior in Public Health Emergencies / 中国医学伦理学

College students, as an important talent reserve of national social development and the family’s future hope, their actions will bring greater influence to ordinary social groups. By analyzing the information demand of people in public health emergencies and the way of transmitting the disposal information of college students to the people, this paper studied the disposal behaviors of college students during the epidemic prevention and control period, such as information collection and feedback, emotional expression, behavioral norms and information dissemination. It was found that the behavior of college students in dealing with public health emergencies has a certain demonstration and guiding effect on society. In view of this effect, this paper put forward some educational activities, such as rational information analysis, effective relief of emotions, scientific analysis of the present situation, and positive dissemination of network information, so as to expand the demonstration function of college students in dealing with public health emergencies.

Current situation of treatment and disposal of NORM solid waste in China / 中国辐射卫生

@#China has a huge cumulative storage of NORM solid waste, which urgently needs to be treated and disposed of in a scientific and standard way. Through analyzing the current status and technologies of treatment and disposal of NORM solid waste and relevant environmental radiation protection regulations and standards, we put forward suggestions on the improvement of regulations and standards and the applicability of treatment and disposal technologies, to provide a reference for the green and sustainable development of mineral resources in China.

Emergency medical disposal for a case with the wound suspected of radioactive waste water contamination / 中国辐射卫生

A patient with scalp laceration suspected of radioactive waste water contamination had the wound ruled out of radioactive contamination, psychological fear eliminated, and well-healed wound, through rapid emergency medical response and scientific and effective disposal. The treatment process and psychological intervention for batch wounded after a nuclear accident are still applicable to patients with a small amount of sudden radioactive contamination. This article summarizes the relevant disposal process for reference.

mpacto ambiental y riesgos potenciales generados en los rellenos sanitarios: revisión narrativa de la literatur / Environmental Impact and Potential Risks Generated in Sanitary Landfills - Narrative literature review / Impactos ambientais e riscos potenciais dos aterros sanitários: Revisão narrativa da literatura

Introducción: El derecho a un medio ambiente sano posibilita a las personas desarrollarse y vivir de manera satis-factoria. Desafortunadamente, la actividad humana ha impactado en el ambiente y no siempre de forma positiva, y uno de los aspectos perjudiciales para el medio ambiente son los desechos o residuos sólidos y su inadecuado manejo, tratamiento y disposición. Objetivo: Caracterizar el impacto ambiental y riesgos potenciales generados en los rellenos sanitarios. Metodología: Revisión narrativa de la literatura sobre el impacto ambiental y los riesgos potenciales en los relle-nos sanitarios, obtenida en bases de datos como Ovid, Proquest, SciELO, ScienceDirect, Taylor & Francis, Google Scholar, Scopus, Redalyc y Pubmed. Desarrollo y discusión: Los rellenos sanitarios constituyen riesgos potenciales de contingencias que afectan la salud, como enfermedades (respiratorias, cutáneas o gastrointestinales) y accidentes (cortaduras, pinchazos o quemaduras) y daños en el ambiente, como sobrecalentamiento y contaminación atmosférica derivados de la inadecuada disposición de desechos. Entre los factores de riesgo se identifican gases, lixiviados contaminados, material electrónico, olores, incendios, contaminación del agua subterránea por lixiviados, cambio climático global y el incumplimiento de normas en la construcción de rellenos sanitarios. Conclusión: Se advierte un impacto negativo para el medio ambiente y la salud de la población derivado de la inadecuada eliminación de desechos sólidos en los rellenos sanitarios.

Introduction: The right to a healthy environment enables people to develop and live satisfactorily. Unfortunately, human activity has impacted the environment and not always in a positive way, one of the harmful aspects for the environment is the generation of waste products or solid waste and the inadequate, handling, treatment and disposal of them. Objective: To characterize the environmental impact and potential risks generated in landfills. Methodology: A narrative review of the literature regarding the environmental impact and potential risks in landfills was carried out, obtained from databases such as Ovid, Proquest, SciELO, Science-Direct, Taylor & Francis, Google Scholar, Scopus, Redalyc, Pubmed. For the information search, the keywords were considered and for their choice the inclusion and exclusion criteria. Development and Discussion: Landfills demonstrate potential risks of contingencies that affect health, such as diseases (respiratory, cutaneous, gastrointestinal) and accidents (cuts, punctures, burns) and damage to the environment such as overheating and air pollution derived from the in-adequate disposal of waste. Risk factors identify gases, contaminated leachate, electronic material, odors, fires, groundwater contamination by leachate, global climate change and non-compliance with landfill construction. Conclusion: There is a negative impact on the environment and the health of the population derived from the inadequate disposal of solid waste in landfills.

Introdução: O direito a um ambiente saudável permite que as pessoas se desenvolvam e vivam de forma satisfatória. Infelizmente, a atividade humana teve impacto sobre o meio ambiente e nem sempre de forma positiva, e um dos aspetos prejudiciais para o meio ambiente são os resíduos sólidos e seu manejo, tratamento e disposição inadequados. Objetivo: Caracterizar o impacto ambiental e os potenciais riscos gerados nos aterros sanitários. Métodos: Revisão narrativa da literatura sobre o impacto ambiental e os potenciais riscos nos aterros sanitários, obtida de bancos de dados como Ovid, Proquest, SciELO, ScienceDirect, Taylor & Francis, Google Scholar, Scopus, Redalyc e Pubmed. Desenvolvimento e discussão: Os aterros sanitários constituem riscos potenciais de contingencias que afetam a saúde, tais como doenças (respiratórias, cutâneas ou gastrointestinais) e acidentes (cortes, furos ou queimaduras) e danos ao meio ambiente, tais como superaquecimento e poluição atmosférica derivados da inadequada disposição dos resíduos. Os fatores de risco incluem gases, lixiviado contaminado, material eletrônico, odores, incêndios, contaminação de águas subterrânea por lixiviado, mudança climática global e não conformidade com as normas na construção de aterros sanitários.Conclusão: Há um impacto negativo sobre o meio ambiente e a saúde da população devido ao descarte inadequado de resíduos sólidos em aterros sanitários.

Mobilidade de contaminantes em solos arenosos após a aplicação de águas residuárias tratadas produzidas em indústria siderúrgica / Contaminant mobility in sandy soils after application of treated wastewater produced in the steel industry

RESUMO Este trabalho teve como objetivo realizar um estudo de modelagem da dispersão de contaminantes no solo com águas residuárias produzidas e tratadas em uma indústria siderúrgica. Para isso, foram realizados ensaios de coluna de lixiviação utilizando amostras de solo coletadas nas áreas dentro da indústria onde aconteceria o reúso das águas residuárias tratadas nas estações de tratamento da própria siderúrgica. Com base nos ensaios, foram geradas curvas de eluição (breakthrough curves), para análise da mobilidade dos contaminantes no solo, e obtidos os parâmetros de transporte (coeficiente de dispersão, retardamento e dispersividade). As águas residuárias produzidas na siderúrgica apresentam baixas concentrações de metais pesados após o tratamento realizado, sendo apenas o ferro e o zinco, contaminantes de maior preocupação para a disposição no solo. Os solos analisados, com elevado percentual de areia, demonstraram ineficiência na retenção dos contaminantes presentes, aumentando os riscos de contaminação da água subterrânea. Conclui-se que, para a indústria siderúrgica realizar o reúso não potável das águas residuárias, deve-se associar este a técnicas de manejo e conservação do solo que aumentem a capacidade do solo em adsorver contaminantes, ou de impermeabilização na área de resfriamento de placas.

ABSTRACT This research aimed to carry out a modeling study on the dispersion of contaminants in the soil with wastewater produced and treated in a steel industry. For this purpose, column leaching tests were performed using soil samples collected in areas inside the industry where the reuse of treated wastewater would occur. Based on the tests, elution curves (breakthrough curves) were generated to analyze the mobility of contaminants in the soil, and transport parameters were obtained (dispersion coefficient, delay, and dispersivity). The wastewater produced in the steelworks has low concentrations of heavy metals after the wastewater treatment is carried out, with only iron and zinc posing a risk for wastewater disposal. The analyzed soils, with a high percentage of sand, showed a low retention capacity for the contaminants present, increasing the risks of groundwater contamination. Therefore, the non-potable reuse of treated wastewater is possible in the steel industry, but it must be associated with soil management and conservation techniques that increase the capacity of the soil to adsorb its contaminants or the impermeabilization in the area of plate cooling.

Análisis del desecho de medicamentos en Costa Rica durante el 2019, un paso hacia la ecofarmacovigilancia / Analysis of drug waste in Costa Rica during 2019, a step towards Ecopharmacovigilance / Análise de resíduos de drogas na Costa Rica em 2019, um passo em direção à ecofarmacovigilância

RESUMEN Introducción: Según la Organización Mundial de la Salud, el desecho de medicamentos es la eliminación de todos aquellos productos farmacéuticos que han expirado, derramado o contaminado y medicamentos que no son de utilidad y necesitan disponerse de forma adecuada. Objetivo: Caracterizar los medicamentos desechados en Costa Rica durante el 2019, con el sistema de recolección de una empresa de recolección de medicamentos en desuso. Materiales y métodos: Se realizó un estudio observacional, descriptivo-analítico y de corte transversal. El estudio se desarrolló en las instalaciones de la empresa MPD en Curridabat, San José, donde se almacenan los contenedores de la empresa. Los datos obtenidos se depositaron en una base de datos elaborada en Excel 2016. Resultados: En su mayoría los medicamentos encontrados vencidos eran de uso humano, especialmente para adultos, la forma farmacéutica más común fue la enteral, procedentes de los sectores privado y público. Existe una relación significativa entre la condición de los medicamentos y su origen, así como entre el origen y la forma farmacéutica. No existe relación significativa entre la forma farmacéutica de los medicamentos y la condición de estos, tampoco entre la nacionalidad y la condición. Conclusiones: La condición de desuso fue la que más prevaleció dentro de los medicamentos desechados. El principio activo más desechado fue el paracetamol y el principal grupo farmacológico encontrado en los productos desechados fue el de los analgésicos.

SUMMARY Introduction: According to the World Health Organization, the disposal of medicines is the elimination of all those pharmaceutical products that have expired, spilled, or contaminated and medicines that are not useful and need to be disposed of properly. Objective: To characterize the medicines discarded in Costa Rica during 2019, with the collection system of a company that collects disused medicines. Materials and methods: An observational, descriptive-analytical, and cross-sectional study was carried out. The study was carried out at the facilities of the MPD Company in Curridabat, San José, where the company's containers are stored. The data obtained was deposited in a database elaborated in Excel 2016. Results: Most of the expired drugs were for human use, especially for adults, the most common pharmaceutical form was enteral, from the private and national sectors. There is a significant relationship between the condition of the drugs and their origin, as well as between the origin and the pharmaceutical form. There is no significant relationship between the pharmaceutical form of the drugs and their condition, nor between nationality and condition. Conclusions: The condition of disuse was the most prevalent among the discarded drugs. The most discarded active principle was paracetamol and the main pharmacological group found in discarded products was analgesics.

RESUMO Introdução: De acordo com a Organização Mundial da Saúde, o descarte de medicamentos é a eliminação de todos os produtos farmacêuticos vencidos, derramados ou contaminados e os medicamentos que não são úteis e precisam ser descartados de maneira adequada. Objetivo: Caracterizar os medicamentos descartados na Costa Rica durante o 2019, com o sistema de coleta de uma empresa que coleta medica mentos fora de uso. Materiais e métodos: foi realizado um estudo observacional, descritivo-analítico e transversal. O estudo foi realizado nas instalações da empresa MPD em Curridabat, San José, onde estão armazenados os contentores da empresa. Os dados obtidos foram depositados em banco de dados elaborado no Excel 2016. Resultados: A maioria dos medicamentos vencidos era para uso humano, principalmente para adultos, a forma farmacêutica mais comum foi a enteral, do setor privado e nacional. Existe uma relação significativa entre o estado dos medicamentos e sua origem, bem como entre a origem e a forma farmacêutica. Não existe relação significativa entre a forma farmacêutica dos medicamentos e o seu estado de saúde, nem entre a nacionalidade e o estado de saúde. Conclusões: A condição de desuso foi a mais prevalente entre os medicamentos descartados. O princípio ativo mais descartado foi o paracetamol e o principal grupo farmacológico encontrado nos produtos descartados foram os analgésicos.

Gestión de llantas usadas en la ciudad de Tunja, Boyacá (Colombia) / Management of used tires in the city of Tunja, Boyacá (Colombia)

RESUMEN Millones de llantas se producen anualmente para satisfacer la demanda mundial, asociada al incremento en la generación de llantas usadas. Su manejo es un desafío, considerando que la disposición en rellenos sanitarios ya no está permitida en algunos países, incluyendo Colombia, entre otras razones, por su alta resistencia biológica y química a la degradación, por lo cual, su inadecuado manejo y la falta de mecanismos de gestión, genera impactos negativos en la salud y el ambiente. Se realizó un estudio sobre la gestión de llantas usadas en Tunja, Boyacá (Colombia), con el fin de indagar aspectos relacionados con su disposición y manejo, al igual que sobre el conocimiento de programas posconsumo, aprovechamiento y cumplimiento de la normatividad ambiental vigente. Para la recolección de información primaria, se aplicaron encuestas estructuradas, a empresas registradas ante la Cámara de Comercio del municipio, que efectuaran actividades relacionadas con la generación de llantas usadas, tales como servitecas, talleres de mecánica o montallantas. El estudio mostró que los mayores generadores de este residuo son los montallantas, con una media entre 20 y 40 unidades mensuales, en mayor porcentaje de Rines 13 y 14, esto indicaría una proyección de 360 llantas anualmente por establecimiento, sin considerar los sitios no legalmente registrados. De manera general, para el avance en la gestión de llantas usadas en Tunja, se recomienda el desarrollo de alternativas, de manera articulada, entre los diferentes actores directamente involucrados, tales como productores, gestores, distribuidores y comercializadores, consumidores y autoridades ambientales regionales y municipales.

ABSTRACT Millions of tires are produced annually to satisfy the world demand, which is associated with an increase in the generation of used tire. Their management is a challenge considering that disposal in sanitary landfills is not allowed in some countries, including Colombia, due to their high biological and chemical resistance to degradation; therefore, their inadequate handling and the lack of management mechanisms generate negative impacts on health and the environment. A study was conducted on the management of used tires in Tunja, Boyacá (Colombia), to inquire aspects related to their disposal and management in the city, as well as on the knowledge of post-consumer programs, use, and compliance with current environmental regulations. For the collection of primary information, structured surveys were applied to companies registered with the Chamber of Commerce of the municipality that carry out activities related to the generation of used tires, such as service shops, mechanic shops or tire repair shops. The study showed that the largest generators of this waste are tire assemblers, with an average of between 20 and 40 units per month, with a higher percentage of rims 13 and 14, which would indicate a projection of 360 tires annually per establishment, without considering the sites that are not legally registered. In general, for the progress in the management of used tires in Tunja, the development of alternatives is recommended in an articulated manner between the different actors directly involved, such as producers, managers, distributors and marketers, consumers, and regional and municipal environmental authorities.