Saúde e reparação integral de comunidades camponesas em territórios da transposição do rio São Francisco / Health and comprehensive repair of peasant communities in territories of the São Francisco River transposition

Resumo A saúde é um complexo de situações de condições de vida alinhadas a contextos e lugares no tempo. O processo de reparação a partir do entendimento ampliado da saúde é um conjunto de direitos, ações e medidas protagonizadas por diferentes sujeitos nas diversas dimensões da vida. Este artigo tem como objetivo analisar as percepções e ações de reparação direcionadas a camponeses que sofreram perdas materiais e simbólicas no decurso das obras da transposição do Rio São Francisco, em Sertânia, Pernambuco. Trata-se de um estudo de caso com abordagem qualitativa. Os sujeitos desta pesquisa foram camponeses maiores de 18 anos, sem especificação de sexo, residentes em três comunidades nas proximidades do canal Eixo Leste da transposição. Foram realizadas entrevistas semiestruturadas nas comunidades e uma oficina participativa. Observou-se que há uma insuficiência no reconhecimento dos direitos de reparação pelos habitantes e, consequentemente, uma não efetivação das ações desenvolvidas nesse aspecto. As ações de reparação focaram compensações monetárias para a perda de bens materiais, porém sendo muitas vezes subdimensionadas ou até mesmo ausentes. É imprescindível que a reparação seja pensada na perspectiva da complexidade do caso, considerando todas as dimensões da saúde e da vida.

Abstract Health is a complex of situations of living conditions aligned to contexts and places at a given time. The redress process based on the expanded understanding of health is a set of rights, actions, and measures carried out by different subjects in the different dimensions of life. This article aims to analyze the perceptions and redress actions directed to peasants who suffered material and symbolic losses during the transposition of the São Francisco River, in Sertânia, Pernambuco. This is a case study with a qualitative approach. The subjects of this research were peasants over 18 years of age, of without specifying gender, living in three peasant communities near the Eixo Leste of the transposition. Semi-structured interviews and a participatory workshop were carried out in the communities. An insufficiency in the recognition of reparation rights by the inhabitants and, consequently, a non-effectiveness of the actions developed to that end were observed. Remedial actions focused on monetary compensation from the loss of material goods, but were often undersized or even absent. It is essential that the repair be thought of from the perspective of the complexity of the case, considering all dimensions of health and life.

What does the video head impulse test tell us about post-caloric vestibular recruitment?

Abstract Objective: The vestibular recruitment observed in caloric testing is a new tool in the study of the vestibulo-ocular reflex. This study aimed to determine the sensitivity and specificity of the video head impulse test to detect post-caloric vestibular recruitment. Method: In this cross-sectional study, all participants underwent the standard otoneurological assessment of the service, caloric test, and video head impulse test. A non-linear mixed model was used to test for associations. Results: The study group consisted of 250 (89 male and 161 female) patients, with a mean age of 54.84 years. The control group comprised 35 participants, 18 men and 17 women, with a mean age of 40.42 years. Sex and age had no effect on group responses. There was no difference between the study and control groups regarding the interaction between recruitment and gain (p = 0.7487); recruitment and overt (p = 0.7002) and covert saccades (p = 1.0000); and recruitment and anti-compensatory saccades in the contralateral ear (p = 0.3050). The video head impulse test had a sensitivity of 51% and a specificity of 50% as a predictor of post-caloric recruitment. Conclusion: The video head impulse test results showed no relevance in predicting post-caloric vestibular recruitment.

Measurement of buccolingual inclination of posterior teeth and the curve of Wilson in patients with different sagittal skeletal patterns using cone-beam computed tomography / 口腔疾病防治

Objective@# To study the buccolingual inclination of posterior premolars and molars and the curve of Wilson in patients with different sagittal skeletal patterns, to explore the compensation mechanism of horizontal inclination of posterior teeth in patients with different sagittal skeletal patterns and to provide a reference for the control of posterior tooth inclination in the treatment of bone malocclusion.@*Methods@#This study was reviewed and approved by the Ethics Committee, and informed consent was obtained from the patients. Ninety CBCT scans of adults and ninety scans of adolescents before orthodontic treatment were evaluated in this cross-sectional study. There were 30 skeletal Class I, Class Ⅱ, and Class Ⅲ patients in the adult group and adolescent group. The inclination angles of posterior teeth and the curve of Wilson of first and second molars were measured, and data were analyzed between adolescents and adults with different sagittal skeletal patterns.@*Results @#Compared with skeletal Class Ⅰ adult patients, the upper posterior molar inclination of skeletal Class Ⅱ patients was significantly lower, and the lower posterior molar inclination was significantly higher. Compared with skeletal ClassⅠ adult patients, the upper posterior molar inclination of skeletal Class Ⅲ adult patients was higher, and the lower posterior molar inclination was significantly lower. The Wilson curve of the second molar in skeletal Class Ⅱ adult patients was significantly higher than that in the other groups. Compared with skeletal ClassⅠ adolescent patients, skeletal Class Ⅲ adolescent patients had a significantly higher upper posterior molar inclination; however, no difference was found between the inclination of the posterior teeth between skeletal Class Ⅰ, Class Ⅱ and Class Ⅲ adolescent patients. Comparing adolescent and adult samples, in skeletal Class Ⅱ patients, adults showed more lingual inclination than adolescents in the upper posterior teeth and less lingual inclination in the lower posterior teeth except for the mandibular first molar. Comparing adolescent and adult samples, in skeletal Class Ⅲ patients, adults showed more lingual inclination than adolescents in the lower posterior teeth except for the mandibular second molars and showed no difference in the upper posterior teeth.@*Conclusions@#The inclination of the posterior teeth and the curve of Wilson show significant differences between the three sagittal skeletal patterns. Compared with those of skeletal Class Ⅰ patients, the posterior teeth of skeletal Class Ⅱ patients show more lingual inclination in the upper arch and less lingual inclination in the lower arch. Meanwhile, posterior teeth of skeletal Class Ⅲ patients show more lingual inclination in the lower arch and maintain the inclination in the upper arch.

A Novel Robotic Bronchoscopic Surgical System / 中国医疗器械杂志

Transbronchil biopsy has the characteristic of less trauma and quick recovery compared to percutaneous aspiration biopsy. In order to automate this procedure, it requires the development of a robotic surgical system that combines electromagnetic navigation and flexible endoscope. The robotic surgical system introduced herein consists of flexible endoscope, remote-control handle, electromagnetic navigation and dexterous manipulators. The robotic system supports lung bronchial model segmentation and reconstruction, automatic bronchial path planning, real-time navigation and visual biopsy. In the control of the endoscopic catheter, an elasticity compensation algorithm was proposed to improve the location accuracy of the catheter and operational efficiency. Clinical trials proved that the robotic system had high positioning accuracy, was intuitive to operate, and could improve the biopsy efficiency, shorten the learning time, reduce the burden of surgical operations, and lower radiation exposure and infection rate.

Pérdida localizada de la superficie dental: enfoque de Dahl con restauraciones directas de resinas a mano alzada en el sector anterior. Informe de Caso

La pérdida de superficie dental se define como una condición en la que el desgaste de la estructura dental es excesivo según la edad. Esta pérdida patológica se relaciona comúnmente con una combinación de factores como erosión, abrasión, atricción o parafunción. La técnica de Dahl es una alternativa válida que resuelve los inconvenientes surgidos en este tipo de situaciones como ser la compensación dentoalveolar. Este caso corresponde a un paciente de 63 años que acudió al Hospital Dental de la Universidad de Manchester, derivado por su odontólogo particular. Al momento del examen clínico se constató pérdida moderada a severa de la superficie dental palatina e incisal localizada en el sector anterior de los dientes, sobremordida profunda y compensación alveolar dental. Fueron realizadas restauraciones directas a mano alzada de canino a canino. Luego del relleno incisal se constató una mordida abierta posterior de aproximadamente 1 a 1,5 mm. El contacto oclusal posterior fue restablecido totalmente en 3 meses.

A perda da superfície dentária é definida como uma condição em que o desgaste da estrutura dentária é excessivo de acordo com a idade, essa perda patológica está comumente relacionada a uma combinação de fatores, sendo eles: erosão, abrasão, atrito ou parafunção. Uma abordagem restauradora nestas situações representa um desafio para a reabilitação oral principalmente pela Compensação dentoalveolar. A técnica de Dahl é uma alternativa válida para resolver este problema. Este caso corresponde a um paciente de 63 anos que procurou o Hospital Odontológico da Universidade de Manchester, encaminhado por seu dentista particular. No momento do exame clínico, observou-se perda moderada da superfície dentária no setor anterior, sobremordida profunda e compensação alveolar dentária. Foram realizadas restaurações diretas da mão livre do canino para o canino. Após o enchimento incisal, observou-se mordida aberta posterior de aproximadamente 1 a 1,5 mm. O contato oclusal total foi restabelecido em 3 meses.

Tooth Surface Loss (TSL) is defined as a condition in which the wear of the tooth structure is excessive according to age. This pathological loss is commonly related to a combination of factors such as erosion, abrasion, attrition, or parafunction. The Dahl technique is a valid alternative that solves the problems that arise in this type of situation, such as dentoalveolar compensation. This case describes a 63-year-old patient who attended the Dental Hospital of the University of Manchester, referred by his private dentist. At the time of the clinical examination, moderate to severe loss of the palatal and incisal tooth surface located in the anterior sector of the teeth, deep overbite and dental alveolar compensation were found. Direct free-hand restorations were performed from canine to canine. After incisal filling, a posterior open bite of approximately 1 to 1.5 mm was observed. Posterior occlusal contact was completely restored in 3 months.

Beneficiários de planos privados de saúde que utilizaram a rede pública de hemodiálise ambulatorial no Brasil entre 2012 e 2019 / Beneficiaries of private health plans that used the public outpatient hemodialysis network in Brazil between 2012 and 2019 / Beneficiarios de planes privados de salud que utilizaron la red pública de hemodiálisis ambulatoria en Brasil entre 2012 y 2019

O ressarcimento ao Sistema Único de Saúde (SUS) é a interface mais visível da relação entre saúde pública e privada, e sua análise pode ampliar o conhecimento sobre o uso do SUS pelo setor suplementar. O presente estudo objetivou caracterizar os beneficiários de planos privados de saúde que realizaram hemodiálise no SUS entre 2012 e 2019 em relação a: sexo, faixa etária, região de residência, características dos planos privados de saúde e das operadoras e a assistência prestada a eles. Visou também comparar características dos planos privados de saúde e modalidade das operadoras daqueles beneficiários com dados dos demais beneficiários do Brasil. Construiu-se uma base centrada no indivíduo a partir de dados da Agência Nacional de Saúde Suplementar (ANS); informações sobre beneficiários do Brasil foram consultadas no Departamento de Informática do SUS (DATASUS). Utilizou-se distribuições de frequências para resumir os dados, padronização por idade e sexo para características dos planos privados de saúde e modalidade das operadoras, e razão para comparar frequências. Um total de 31.941 beneficiários realizou hemodiálise no SUS, 11.147 (34,9%) destes fora de seu município de residência, e 6.423 (20,11%) utilizaram o SUS por 25 meses ou mais. Comparados aos demais beneficiários do Brasil, aqueles que realizaram hemodiálise no SUS estavam vinculados mais frequentemente a planos privados de saúde antigos (razão, r = 2,41), coletivos por adesão (r = 1,76), individuais/familiares (r = 1,36), ambulatoriais (r = 4,66), municipais (r = 3,88) e/ou a filantropias (r = 7,32). Planos privados de saúde com características restritivas podem ter dificultado o acesso dos beneficiários que realizaram hemodiálise no SUS às redes de suas operadoras, e representado mais um fator que pode ter influenciado o uso do SUS por aqueles beneficiários, mesmo com a cobertura prevista em seus contratos.

Reimbursement to Brazilian Unified National Health System (SUS) is the most visible interface of the public-private relationship and its analysis can expand our understanding of the use of SUS by the supplementary sector. The study aims to characterize the beneficiaries of private health plans who underwent hemodialysis in the SUS, from 2012 to 2019, in relation to: gender, age group, region of residence, characteristics of the private health plans and the operators and of the care provided to them. The characteristics of the private health plans and the modality of the operators of the beneficiaries where then compared with data of the other beneficiaries in Brazil. An individual-centered database was constructed based on data from the Brazilian National Supplementary Health Agency (ANS); information on beneficiaries in Brazil was consulted in Brazilian Health Informatics Department (DATASUS). Frequency distributions were used to summarize the data, standardization by age and sex for characteristics of the private health plans and modality of the operators and ratio to compare frequencies. A total of 31,941 beneficiaries underwent hemodialysis in the SUS, 11,147 (34.9%) outside their municipality of residence, and 6,423 (20.11%) used the SUS for 25 months or more. When compared with other beneficiaries in Brazil, those who underwent hemodialysis in the SUS were more frequently linked to old private health plans (ratio, r = 2.41), collective by adherence (r = 1.76), individual/family (r = 1.36), outpatient (r = 4.66), municipal (r = 3.88), and/or philanthropic (r = 7.32). Private health plans with restrictive characteristics may have hindered the access of beneficiaries who performed hemodialysis in SUS to the networks of their operators and have represented one more among the factors that may have influenced the use of SUS by those beneficiaries, even with coverage provided for in their contracts.

El resarcimiento al Sistema Único de Salud (SUS) es la interfaz más visible de la relación público-privada y su análisis puede ampliar el conocimiento sobre el uso del SUS por el sector suplementario. El estudio tuvo como objetivo caracterizar a los beneficiarios de planes privados de salud que realizaron hemodiálisis en el SUS, entre 2012 y 2019, con relación a: género, rango de edad, región de residencia, características de los planes privados de salud y de los operadores y a la asistencia prestada a ellos; y comparar características de los planes privados de salud y modalidad de los operadores de aquellos beneficiarios con datos de los demás beneficiarios de Brasil. Se construyó una base centrada en el individuo a partir de datos de la Agencia Nacional de Salud Suplementaria (ANS); las informaciones sobre los beneficiarios en Brasil fueron consultadas en el Departamento de Informática del SUS (DATASUS). Se utilizaron distribuciones de frecuencia para resumir los datos, la estandarización por edad y género para las características de los planes privados de salud y la modalidad de los operadores y la relación para comparar frecuencias. Un total de 31.941 beneficiarios se sometieron a hemodiálisis en el SUS, 11.147 (34,9 %) fuera de su municipio de residencia y 6.423 (20,11 %) utilizaron el SUS por 25 meses o más. Comparados a los demás beneficiarios de Brasil, los beneficiarios que se sometieron a hemodiálisis en el SUS estaban vinculados más frecuentemente a planes privados de salud antiguos (razón, r = 2,41), colectivos por adhesión (r = 1,76), individuales/familiares (r = 1,36), ambulatorios (r = 4,66), municipales (r = 3,88) y/o a filantropías (r = 7,32). Planes privados de salud con características restrictivas pueden haber dificultado el acceso de los beneficiarios que realizaron hemodiálisis en el SUS a las redes de sus operadores y pueden haber representado un factor más entre los que pueden haber influido en el uso del SUS por aquellos beneficiarios, incluso con cobertura prevista en sus contratos.

A responsabilização de empresas por acidentes de trabalho no judiciário trabalhista de São Paulo - TRT15 / The liability of companies for work accidents in the São Paulo labor judiciary - TRT15

Resumo A teoria do risco ou da responsabilidade objetiva dispensa a comprovação da culpa ou do dolo e tem como requisitos a ocorrência do dano e o nexo causal. Embora a constituição disponha a responsabilidade por acidente de trabalho como subjetiva, se tem observado na doutrina e no judiciário a adoção da responsabilidade objetiva em alguns casos de acidentes e doenças ocupacionais. Este estudo tem por objetivo analisar decisões do Tribunal Regional do Trabalho da 15ª Região - São Paulo para conhecer em que situações a corte tem utilizado a responsabilidade objetiva. A pesquisa quanti-qualitativa, de caráter exploratório e descritivo, foi desenvolvida com base em análise documental e revisão bibliográfica. A pesquisa documental foi realizada em acórdãos que continham o descritor "acidente de trabalho", disponíveis na base de dados do Tribunal Regional do Trabalho da 15ª Região, julgados no período entre 11/11/2015 e 10/11/2017. Os resultados indicaram que, do total de 559 casos julgados, em 275 a decisão foi de procedência, sendo 15% por responsabilidade objetiva. Considerando apenas os casos procedentes, a responsabilidade objetiva apareceu em 30,5% deles. Esse percentual revela que já é expressiva nessa corte a tomada de decisão com base na noção de responsabilidade objetiva, e que tal adoção tem potencial para afetar práticas de prevenção de acidentes.

Abstract The risk theory or objective liability dispenses proof of guilt or intent and requires only the occurrence of damage and the causal link. Although the constitution establishes the responsibility for work accidents as subjective, it has been observed in the doctrine and in the judiciary the adoption of objective liability in some cases of accidents and occupational diseases. This study aims to analyze the decisions of the Regional Labor Court of the 15th Region - São Paulo to know in which situations the court has used objective liability. The quantitative-qualitative, exploratory and descriptive research was developed based on document analysis and literature review. The document research was carried out in judgments that contained the descriptor "work accident," available in the database of the Regional Labor Court of the 15th Region, judged between 11/11/2015 and 10/11/2017. The results indicated that, of the total of 559 cases judged, in 275 the decision was founded, being 15% by objective liability. Considering only the founded cases, objective liability appeared in 30.5% of them. This percentage reveals that decision-making based on the notion of objective liability is already expressive in this court, and that such adoption has the potential to affect accident prevention practices.

Meta-analysis of the efficacy of small incision lenticule extraction for astigmatism correction after cyclotorsion compensation / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the efficacy of and without small incision lenticule extraction(SMILE)with cyclotorsion compensation for astigmatism correction.METHODS: PubMed, Web of Science, EMBASE, Cochrane and CNKI, VIP, CBM, and Wan Fang Data were searched for clinically controlled studies from January 2010 to August 2022, including an experimental group with cyclotorsion compensation during SMILE and a control group without cyclotorsion compensation during SMILE. After literature screening, quality evaluation, and data extraction by two researchers independently, the Meta-analysis of uncorrected distance visual acuity(UDVA), residual astigmatism, vector analysis indicators for measuring the astigmatism correction including absolute value of angle of error(|AE|)and magnitude error(ME), and post-operative total higher order aberrations, spherical aberration and coma was carried out with Stata 16.0 software.RESULTS: Seven studies with a total of 846 eyes(442 in the experimental group, 404 in the control group)were finally included. The Meta-analysis showed that there were significant differences in the percentage of eyes with residual astigmatism ≥1.00D(OR=0.17, 95%CI: 0.06～0.49, P<0.01), |AE|(WMD=-1.56, 95%CI: -2.68～-0.45, P<0.01), the coma(WMD=0.06, 95%CI: -0.08～-0.04, P<0.01), and the total higher order aberrations(WMD=-0.04, 95%CI: -0.06～-0.02, P<0.01). However, there were no differences in the postoperative UDVA(WMD=0.00, 95%CI: -0.02～0.01, P=0.54), residual astigmatism(WMD=0.08, 95%CI: -0.02～0.18, P=0.10), ME(WMD=-0.01, 95%CI: -0.14～0.12, P=0.85), and the spherical aberration(WMD=0.03, 95%CI: -0.07～0.13, P=0.52).CONCLUSION: Cyclotorsion compensation in SMILE can reduce the angular error caused by eye rotation during astigmatism correction. It also decreases postoperative residual astigmatism. Overall, the SMILE with cyclotorsion compensation is superior in clinical efficacy of the precise correction of astigmatism.

Influential factors of the efficacy of tinnitus multivariate integrated sound therapy for the treatment of subjective tinnitus / 中国基层医药

Objective:To investigate the influential factors of the efficacy of tinnitus multivariate integrated sound therapy (T-MIST) in the treatment of subjective tinnitus.Methods:A total of 431 patients with subjective tinnitus who received treatment in The First Affiliated Hospital of Xiamen University from June 2019 to June 2020 were included in this study. A cross-sectional study method was used to conduct refined testing on tinnitus patients using the T-MIST matching platform. The severity of tinnitus patients was evaluated using the Tinnitus handicap inventory scale. SPSS software was used to analyze the factors affecting the effectiveness of the T-MIST for subjective tinnitus based on patients' basic characteristics.Results:Multivariate logistic regression analysis showed that compared with patients with short-term tinnitus, OR (95% CI) was 1.982 (1.033-3.804), P = 0.040, in patients with 3-12 months of disease duration, OR (95% CI) was 2.411 (1.322-4.396), P = 0.004 in patients with > 12 months of disease duration. With the increase in tinnitus handicap inventory score, the efficacy of T-MIST became better [ OR (95% CI) = 1.014 (1.004-1.024), P = 0.007]. The efficacy of T-MIST was better in the hearing compensation-effective patients [ OR (95% CI) = 0.133 (0.081-0.216), P < 0.001]. Conclusion:The course of the disease, tinnitus handicap inventory score, and effective hearing compensation are the influential factors of T-MIST. They can provide evidence for the treatment of subjective tinnitus.

Compensación Ambiental en Costa Rica: Legislación y alcances

Introducción: La compensación ambiental es un instrumento técnico-jurídico de gestión ambiental utilizado para compensar el daño ambiental debido a los impactos irreversibles e inevitables de proyectos de desarrollo. Por lo general, las regulaciones de compensación se incluyen en la legislación ambiental nacional. Este artículo resume la legislación de compensación ambiental en Costa Rica, un país con una reconocida tradición de conservación y conciencia ambiental. Nuestro objetivo es describir cómo se formula la compensación en ese país e identificar posibles vacíos regulatorios. Métodos: Realizamos una revisión sistemática de la legislación ambiental a través del Sistema Costarricense de Información Jurídica (http://www.pgrweb.go.cr/scij/avanzada_pgr.aspx), considerando tanto normativa como pronunciamientos sobre medidas de compensación y mitigación. Resultados: La Constitución Política de Costa Rica reconoce el medio ambiente sano como un derecho fundamental de todos los ciudadanos. Actualmente se encuentran en vigencia al menos siete leyes que tratan de temas ambientales y sus respectivos reglamentos. Esta voluminosa legislación tiene como objetivo proteger los recursos naturales regulando su uso y creando un conjunto de áreas silvestres protegidas. Sin embargo, la legislación es algo repetitiva y abierta a interpretación, lo que facilita la confusión. Las acciones que requieren compensación están reguladas de manera general, lo que dificulta establecer cuándo y cómo aplicarlas. Además, la compensación se considera en función de cuándo se identifica el daño y no debido a su nivel de impacto ambiental. Asimismo, la normativa no hace explícitos los principios y objetivos que sustentan las medidas compensatorias ni cómo deben llevarse a cabo, mencionando brevemente algunas acciones que no aseguran que la pérdida ambiental neta sea cero. Conclusiones: Esta revisión revela la necesidad de estandarizar los mecanismos para determinar las medidas compensatorias a nivel regulatorio, analizando además las estrategias que se seguirán para asegurar la proporcionalidad y la equivalencia ecológica. La legislación debe enfatizar la importancia de la compensación como práctica positiva, la cual debe ser incorporada dentro de los lineamientos del Estudio de Impacto Ambiental.

Introduction: Environmental compensation is a technical-legal instrument of environmental management used to offset damage due to non-reversible and unavoidable impacts. Usually, offset regulations are included in national environmental legislations. This paper summarizes environmental compensation legislation in Costa Rica, a country with a recognized conservation tradition and environmental awareness. Our goal is to describe how compensation is formulated in that country and identify possible regulations gaps. Methods: We carried out a systematic review of environmental legislation through the Costa Rican Legal Information System (http://www.pgrweb.go.cr/scij/avanzada_pgr.aspx), considering both regulations and pronouncements on compensation measures and mitigation. Results: The Political Constitution of Costa Rica recognizes a healthy environment as a fundamental right for all citizens. At least seven laws dealing with environmental issues and their respective regulations are currently enforced. This bulky legislation aims to protect natural resources by regulating their use and creating an assemblage of protected wild areas. However, the legislation is somewhat repetitive and open to interpretation, facilitating confusion. Actions requiring compensation are regulated in a general way, making it difficult to establish when and how to apply them. In addition, compensation is considered based on when the damage is identified and not on its level of environmental impact. Furthermore, the regulations do not make explicit the principles and goals that support the compensatory measures or how they should be carried out, briefly mentioning some actions that do not ensure that the net environmental loss is zero. Conclusions: This review reveals the need to standardize the mechanisms to determine compensatory measures at the regulatory level, also analyzing the strategies that will be followed to ensure proportionality and ecological equivalence. The legislation must emphasize the importance of compensation as a positive practice, which must be incorporated within the guidelines of the Environmental Impact Study.

Aplicación del Método Hectárea de Hábitat en compensación ambiental: El caso del Embalse Río Piedras, Costa Rica

Introducción: La compensación ambiental es la alternativa final para enfrentar los impactos de proyectos de desarrollo que no pueden ser evitados, reducidos o mitigados. La compensación de hábitats pretende sustituir recursos ecológicamente equivalentes. El Método Hectárea de Hábitat se diseñó inicialmente para evaluar la equivalencia ecológica de vegetación nativa y emplea puntajes de indicadores relativos a un hábitat de referencia. La suma de estos puntajes mide la condición estructural del ambiente de manera relativa a la referencia, cuantificando el número de hectáreas necesarias para compensar la pérdida de un hábitat similar. Aunque el método no está exento de limitaciones, los valores se pueden estimar a partir de datos de campo recogidos sin ambigüedad, de forma reproducible, con menos sesgos que métodos más cualitativos. En este artículo, usamos una modificación del Método Hectárea de Hábitat para determinar el área equivalente necesaria para compensar la pérdida de hábitat en un área silvestre protegida en Costa Rica. Metodología: Trabajamos en la Reserva Biológica Lomas de Barbudal, Pacífico norte de Costa Rica, un área silvestre protegida donde se inundarán cerca de 113 hectáreas para el Embalse de Río Piedras. En una propiedad previamente identificada como un sitio potencial de compensación, evaluamos indicadores de paisaje, suelo, estructura de la vegetación y servicios ecosistémicos; asignamos los puntajes en relación con el sitio a inundar. Resultados: El puntaje de la condición ambiental en el sitio de compensación fue de 44,7% (±15,9%) del sitio inundado. En consecuencia, considerando la incertidumbre de nuestras mediciones, compensar la pérdida de cada hectárea requeriría entre 2.23 y 3.49 hectáreas de un ambiente similar. Conclusión: Se necesitan entre 2.23 y 3.49 hectáreas de reemplazo, para compensar la pérdida de hábitat en el Embalse de Río Piedras.

Introduction: Environmental compensation is the final alternative to face the impacts of development projects that cannot be avoided, reduced, or mitigated. The offset of affected habitats or environmental elements usually substitutes ecologically equivalent resources. The Habitat-Hectare Method was initially designed to assess the ecological equivalence of native vegetation, and employs indicator scores relative to a reference habitat. The sum of these scores measures the structural condition of the environment against the reference, quantifying the number of hectares needed to compensate for the loss of similar habitat. Although it is not exempt from limitations, the values can be estimated from field data collected without ambiguity, in a reproducible way, with less bias than more qualitative methods. In this paper, we use a modification of the Habitat-Hectare Method to determine the equivalent area needed to compensate for habitat loss in a protected wilderness in Costa Rica. Methods: We worked in the Lomas de Barbudal Biological Reserve, north Pacific of Costa Rica, a protected wilderness where nearly 113 hectares will be flooded for the Río Piedras Reservoir. In a property previously identified as a potential compensation site, we assessed indicators for landscape, soil, vegetation structure, and ecosystem services; the scores were assigned in relation to the environment found at the flood site. Results: The environmental condition score at the compensation site was 44.7% (±15.9%) of the impact site. Consequently, considering the uncertainty in our measurements, compensating for the loss of each hectare would require between 2.23 and 3.49 hectares of a similar environment. Conclusion: Between 2.23 and 3.49 hectares of are needed to compensate for the loss of habitat in the Río Piedras Reservoir.

Compensación dentro de la Evaluación Ambiental en la Secretaría Técnica Nacional Ambiental (SETENA), Costa Rica

Introducción: La ley Orgánica del Ambiente 7554, señala a la Secretaría Técnica Nacional Ambiental (SETENA) como la institución encargada de evaluar y dar seguimiento a las medidas de compensación ambiental en Costa Rica. Objetivo: Exponer el marco jurídico y legislación que rige y aplica la SETENA en el tema de compensación ambiental. Métodos: Se describe brevemente un caso de estudio sobre como la compensación ha sido implementada en el país. Resultados: SETENA interpreta la compensación ambiental como un conjunto de medidas y acciones generadoras de beneficios ambientales que: 1) son proporcionales a impactos o perjuicios ambientales causados por el desarrollo de los proyectos siempre que no se puedan adoptar medidas de prevención, corrección o mitigación; y 2) constituyen una herramienta a utilizar durante la etapa de gestión ambiental, en la fase constructiva u operativa, cuando se evidencien incumplimientos a los compromisos ambientales adquiridos, faltas a la normativa ambiental, o daños ambientales identificados después de obtener la licencia ambiental para el proyecto. Conclusión: SETENA define los Planes de Compensación Ambiental como un procedimiento que sirve de guía para establecer la toma de acciones. Las medidas de compensación se establecen de acuerdo con el tipo de proyecto y hallazgos encontrados durante el monitoreo, por lo que no hay una estandarización para estos planes de compensación.

Introduction: The Organic Law of the Environment No. 7554 designates the National Environmental Technical Secretary (Spanish Acronym - SETENA) as the institution in charge of evaluating and following up on environmental compensation measures in Costa Rica. Objective: To expose the legal framework and legislation that governs and applies SETENA about environmental compensation in this country. Methods: A case study on how compensation has been implemented in the country is briefly described. Results: SETENA interprets environmental compensation as a set of measures and actions that generate environmental benefits that: 1) are proportional to the environmental impacts or damages caused by the development projects, provided that prevention, correction, or mitigation measures cannot be adopted; and 2) is a tool to be used during the environmental management stage, in the construction or operational phase, when there is evidence of non-compliance with the acquired environmental commitments, lack of environmental regulations, or environmental damage identified after reaching environmental approval for the project. Conclusion: SETENA defines the Environmental Compensation Plan as a procedure that serves as a guide to establish the actions to take. The compensation measures are dictated concerning the type of project and the findings encountered during its monitoring, which is why there is no standardization of these compensation plans.

Compensación en un sistema fluvial: el caso del Río Parismina, Costa Rica

Introducción: La construcción del Proyecto Hidroeléctrico (PH) Reventazón fue el sexto desarrollo en el cauce principal del río Reventazón en el Caribe de Costa Rica. Objetivo: Este proyecto identificó impactos residuales y acumulativos en el sistema fluvial principal, y aquí describimos cómo se compensaron esos impactos. Métodos: Con base en estudios de línea base, se cuantificó el hábitat perdido en el río Reventazón por el proyecto hidroeléctrico, particularmente en el área que actualmente ocupa su embalse y el tramo hasta la presa PH Angostura. Además, se evaluó la ganancia ambiental que resultaría de la protección de los ríos Parismina-Dos Novillos, que forman parte del mismo sistema de drenaje. La potencial compensación se cumplió declarando el Parismina-Dos Novillos como sistema fluvial libre de barreras, es decir, libre de futuras represas hidroeléctricas, y promoviendo una serie de programas de gestión que se implementaron en las riberas de esos ríos. Para demostrar la no pérdida de biodiversidad se utilizó una expresión que compara la mejora esperada en la calidad del hábitat acuático en el río Parismina-Dos Novillos con la pérdida de hábitat acuático en el río Reventazón. Resultados: Por decreto ejecutivo, el programa para la conservación y uso sustentable del sistema fluvial Parismina-Dos Novillos fue declarado de interés público como río sin barreras y denominado ''Programa de Compensación Fluvial Parismina y Dos Novillos''. Además, se estableció el Corredor Biológico Pez Bobo, que incluye el mencionado sistema fluvial y que protege su biodiversidad. Conclusiones: El Programa de Compensación Fluvial de Parismina brinda una alternativa para compensar los impactos residuales en los sistemas acuáticos. Podría servir como marco de referencia para lograr ganancias ambientales en estos sistemas fluviales.

Introduction: The construction of the Reventazón Hydroelectric Project (PH) was the sixth development in the main channel of the Reventazón river in the Caribbean of Costa Rica. Objective: This project identified residual and cumulative impacts on the main river system, and here we describe how those impacts were compensated. Methods: Based on baseline studies, the habitat lost in the Reventazón River due to the hydroelectric project was quantified, particularly in the area currently occupied by its reservoir and the section up to the PH Angostura dam. In addition, the environmental gain that would result from protecting the Parismina-Dos Novillos rivers, which are part of the same drainage system, was evaluated. The potential compensation was fulfilled by declaring the Parismina-Dos Novillos as a river system free of barriers, that is, free of future hydroelectric dams, and by promoting a series of management programs that were implemented on the banks of those rivers. To demonstrate the non-loss of biodiversity, an expression was used that compares the expected improvement in the quality of the aquatic habitat in the Parismina-Dos Novillos river with the loss of aquatic habitat in the Reventazón river. Results: By executive decree, the program for the conservation and sustainable use of the Parismina-Dos Novillos fluvial system was declared of public interest as a river without barriers and called the ''Parismina and Dos Novillos Fluvial Compensation Program.'' In addition, the Bobo-Fish Biological Corridor was established, including this river system and protecting its biodiversity. Conclusions: The Parismina Fluvial Compensation Program provides an alternative to compensate for residual impacts on aquatic systems. It could serve as a reference framework to achieve environmental gains in these riverine systems.

Compensation in Class III Malocclusions: Analysis of Tooth Crown Inclination on Digital Dental Casts / Compensação da Má Oclusão de Classe III: Análise da Inclinação das Coroas dos Dentes em Modelos Digitais

The objective of this study was to evaluate the tooth crown inclination in maxillary and mandibular arches in Class III malocclusion individuals, to identify the presence and magnitude of compensation. The study was conducted on 46 plaster casts of individuals with Class III malocclusion, of both genders (25 males and 21 females), with mean age 21 years and 1 month, with indication for compensatory orthodontic treatment. The dental casts models were scanned and the tooth crown inclinations were measured and compared with standard values by the independent t test. All tests considered a significance level of 5% (p<0.05). According to the results there was extensive variation in tooth inclination in Class III malocclusions. Values distribution for incisors highlighted the significant concentration of maxillary incisors in the area of positive values, compared with a very expressive concentration of mandibular incisors in the area of negative values. Compared with normal standards, in Class III malocclusions, the maxillary posterior teeth exhibited smaller palatal inclination than normal, while the mandibular incisors and second molars presented greater lingual inclination. It was concluded that the analysis of inclinations of all crowns of both dental arches in Class III malocclusions, compared with normal standards, evidenced the presence of natural compensation for maxillary posterior teeth, with reduced palatal inclination, as well as increased lingual inclination in mandibular incisors. The parameters of compensation naturally present in Class III malocclusions described, especially in lower incisors, would help clinicians when compensatory treatment is considered. (AU)

O objetivo deste estudo foi avaliar a inclinação das coroas dentárias nas arcadas superior e inferior em indivíduos com má oclusão de Classe III, para identificar a presença e a magnitude da compensação. O estudo foi realizado em 46 modelos de gesso de indivíduos com má oclusão de Classe III, de ambos os sexos (25 homens e 21 mulheres), com média de idade de 21 anos e 1 mês, com indicação de tratamento ortodôntico compensatório. Os modelos de gesso foram digitalizados e as inclinações da coroa dos dentes foram medidas e comparadas com os valores de normalidade pelo teste t independente. Todos os testes estatísticos adotaram um nível de significância de 5% (p <0,05). De acordo com os resultados, houve grande variação na inclinação dentária nas más oclusões de Classe III. A distribuição dos valores para os incisivos destacou a concentração significativa de incisivos superiores na área de valores positivos, em comparação com uma concentração muito expressiva de incisivos inferiores na área de valores negativos. Comparados aos padrões de normalidade, nas más oclusões de Classe III, os dentes posteriores superiores exibiram inclinação palatina menor que o normal, enquanto os incisivos e segundos molares inferiores apresentaram inclinação lingual maior. Concluiu-se que a análise das inclinações de todas as coroas de ambas as arcadas dentárias nas más oclusões de Classe III, comparadas aos padrões de normalidade, evidenciou a presença de compensação natural para os dentes posteriores superiores, com diminuição da inclinação palatina, bem como aumento da inclinação lingual dos incisivos inferiores. Os parâmetros de compensação naturalmente presentes nas más oclusões de Classe III descritos, especialmente nos incisivos inferiores, podem auxiliar o clínico quando o tratamento compensatório é considerado. (AU)

Evidências de validade do Inventário de Compensação de Young (YCI) para a população do Rio Grande do Sul / Validity evidence of the Young Compensation Inventory (YCI) for the population of Rio Grande do Sul / Evidencias de validez del Inventario de Compensación Young (YCI) para la población de Rio Grande do Sul

O objetivo deste estudo foi examinar a estrutura fatorial e as evidências de validade do Inventário de Compensação de Young (YCI) para a população do Rio Grande do Sul. Contou-se com a participação de 504 adultos da população geral, com média de idade de 34,2 anos (DP = 12,9). Os instrumentos utilizados foram o Questionário de Esquemas de Young - Versão Breve (YSQ-S3), a Escala de Avaliação dos Sintomas (SCL-90-R) e o YCI. Os dados foram coletados através de plataforma online. Realizou-se a análise fatorial exploratória, para verificar a distribuição dos itens em fatores comuns, e a validade convergente, com correlação não paramétrica de Spearman com a SCL-90-R e o YSQ-S3. Foram interpretados quatro fatores: Dominação e Manipulação (α =0,85 ω=0,71); Obsessão e Organização (α =0,75 ω=0,75); Rebeldia e Independência (α =0,73 ω=0,69); e Busca de Reconhecimento (α =0,81 ω=0,91). A validade de construto mostrou-se adequada conforme a teoria. Concluiu-se que a versão adaptada apresenta boas propriedades psicométricas. (AU)

This study aimed to examine the factorial structure and evidence of validity of the Young Compensation Inventory (YCI) for the population of the state of Rio Grande do Sul. For this purpose, 504 adults from the general population participated, with a mean age of 34.2 years (SD = 12.9). The instruments used were the Young Schema Questionnaire - Brief Version (YSQ-S3), the Symptom Checklist-90 (SCL-90-R), and the YCI. Data were collected using an online platform. Exploratory factor analysis was performed to verify the distribution of items in common factors, and convergent validity, with a non-parametric Spearman correlation with SCL-90-R and YSQ-S3. Four factors were interpreted: Domination and Manipulation (α = 0.85 ω = 0.71); Obsession and Organization (α = 0.75 ω = 0.75); Rebellion and Independence (α = 0.73 ω = 0.69); and Search for Recognition (α = 0.81 ω = 0.91). The result of construct validity proved to be adequate according to the theory. It was concluded that the adapted version has good psychometric properties. (AU)

El objetivo de este estudio fue examinar la estructura factorial y las evidencias de validez del Young Compensation Inventory (YCI) para la población de Rio Grande do Sul. Participaron 504 adultos de la población general, con una edad media de 34,2 años (DS = 12,9). Los instrumentos utilizados fueron el Young Scheme Questionnaire - Versión breve (YSQ-S3), la Escala de Evaluación de Síntomas (SCL-90-R) y el YCI. Los datos se recogieron a través de una plataforma online. Se realizó un análisis factorial exploratorio para verificar la distribución de los ítems en factores comunes, y la validez convergente, con la correlación no paramétrica de Spearman con SCL-90-R y YSQ-S3. Se interpretaron cuatro factores: Dominación y Manipulación (α =0,85 ω=0,71); Obsesión y Organización (α =0,75 ω=0,75); Rebeldía e Independencia (α =0,73 ω=0,69); y Búsqueda de Reconocimiento (α =0,81 ω=0,91). La validez de constructo demostró ser adecuada según la teoría. Se concluyó que la versión adaptada presenta buenas propiedades psicométricas. (AU)

Transforming HR practices with Behavioral Economics

Behaviors Economics is presently a thriving field of research for many researchers. It offers a descriptive model of decision making which is entirely different from the traditional decision making models of economics. This research paper is an attempt to bring insights from Behavioral Economics which can help Human Resource personnel to address the issues like Dynamic Inconsistency and incentive design strategies. The author argues that the insight from Behavioral Economics can transform HR practices. HR managers and leaders stand to benefit from the emerging evidence from the lab and field of behavioral economics that calls for s rethinking of traditional decision making model

Experimental analysis of clinical applicability of individualized customized materials / 中国辐射卫生

@#<b>Objective</b> To study the feasibility of clinical application of an individualized customized material. <b>Methods</b> Five batches of individualized customized materials were randomly selected, from which 10 cm × 11 cm samples were intercepted for experimental analysis. Among them, 10 cm × 10 cm materials were selected to perform dosimetric analysis and HU change analysis before and after irradiation with a radiotherapy dose for breast cancer of 50 Gy as the irradiation basis. The center Point 1 on the lower surface of the individualized material and the center Point 2 of the solid water volume were selected for dosimetric analysis before and after the sample is irradiated. After reaching a sufficient amount of irradiation, the 1 cm × 10 cm materials intercepted in the center position and the remaining 1 cm × 10 cm materials after the first sampling were sent to the material science laboratory for analysis of physical properties of density, viscosity, hardness, and tear strength. <b>Results</b> In the comparative analysis of HU values before and after exposure, after receiving 50 Gy dose irradiation, the difference rate of HU value was 5.252%, which was close to the expected 5% difference rate in clinical medicine. In the dosimetric analysis of Point 1 and Point 2, the dose in the irradiated samples was significantly higher than that in the unirradiated samples; the dose in Point 1 increased by 3.742%, and the dose in Point 2 increased by 2.039%. Before and after irradiation, except for the physical density which showed a significant difference, there was no significant difference in viscosity, hardness, and tear strength. <b>Conclusion</b> The individualized customized material can meet the requirements of routine clinical medicine.

Vestibular recruitment: new application for an old concept / Recrutamento vestibular: nova aplicação para um conceito antigo

Abstract Introduction Vestibular recruitment is a sign of hyperexcitability of central vestibular neurons and may be characteristic of peripheral vestibular damage. Objective To define the post-caloric recruitment index and its ability to predict the stage of vestibular compensation and peripheral lesion. Methods First of all, we demonstrated that larger values in the cold post-caloric stimulation compared to warm stimulation were equivalent to vestibular recruitment observed during the sinusoidal harmonic acceleration test. In the next step, patients with vestibular complaints and asymptomatic controls were submitted to the caloric test. We calculated post-caloric recruitment index for the control group. Among the study group, we analyzed the relation between post-caloric recruitment and unilateral weakness as well as the types of vestibular diagnoses. Results Mean post-caloric recruitment was 17.06% and 33.37% among the control and study group, respectively. The ratio between post-caloric recruitment and unilateral weakness was 1.3 in the study group. Among recruiting subjects, no significant difference of unilateral weakness from the lesioned or healthy side was observed. We found no differences in vestibular diagnoses between recruiting and non-recruiting subjects. Conclusion Post-caloric recruitment index identified asymmetric vestibular tonus and central compensation. The normal value was established at 17.06%.

Resumo Introdução O recrutamento vestibular é um sinal de hiperexcitabilidade dos neurônios vestibulares centrais e pode ser característico de lesão vestibular periférica. Objetivo Definir o índice de recrutamento pós‐calórico e sua capacidade de predizer o estágio de compensação vestibular e lesão periférica. Método Em primeiro lugar, demonstramos que valores maiores na estimulação pós‐calórica fria em relação à estimulação quente foram equivalentes ao recrutamento vestibular observado durante o teste de aceleração harmônica sinusoidal. Na etapa seguinte, os pacientes com queixas vestibulares e controles assintomáticos foram submetidos à prova calórica. Calculamos o índice de recrutamento pós calórico para o grupo controle. No grupo de estudo, analisamos a relação entre o recrutamento pós‐calórico e predomínio labiríntico, bem como os tipos de diagnósticos vestibulares. Resultados O recrutamento pós‐calórico médio foi de 17,06% e 33,37% nos grupos controle e estudo, respectivamente. A razão entre o recrutamento pós‐calórico e o predominício labiríntico foi de 1,3 no grupo de estudo. Nos sujeitos com recrutamento, não foi observada diferença significativa de predominício labiríntico do lado lesionado ou saudável. Não encontramos diferenças de diagnóstico vestibular entre sujeitos com recrutamento e sem recrutamento. Conclusão O índice de recrutamento pós‐calórico identificou tônus vestibular assimétrico e compensação central. O valor normal foi estabelecido em 17,06%.

Judicial Vulnerability on the Exercise of Orthodontics: Construction and Validation of a Questionnaire

Abstract Objective: To develop and validate a questionnaire to measure the vulnerability of orthodontists, measuring the risks of being involved in civil liability lawsuits. Material and Methods: In-depth interviews were performed with three groups: G1- law professionals, G2 - orthodontists, and G3 - orthodontic patients. From the analysis of the content of Bardin, domains for the construction of the first version of the 53-question questionnaire were identified. The questionnaire was submitted to experts for validation, inclusion and exclusion of questions, but maintaining the 53-question format. It was submitted to the test-retest phases and verification of internal consistency. Results: 247 professionals answered the final version of the questionnaire. The intraclass correlation coefficient was 88.8%. Cronbach's alpha was 0.946, with high internal consistency. The Kaiser-Meyer-Olkin and Bartlett's tests confirmed internal consistency showing the values of 0.909 and significance of <0.001, respectively. From the total score and factorial analysis, the sample was divided into three groups of judicial vulnerability. Conclusion: The results of this study demonstrated that the questionnaire is a valid tool to measure the risks of involvement in civil liability lawsuits by orthodontists. It presented a multidimensional character and might be applied as well as face to face or online, without prejudice to quality (AU).

Thoughts on fund compensation of adverse events following immunization in China / 上海预防医学

After the promulgation and implementation of the Vaccine Administration Law of the People’s Republic of China， the compensation of suspected adverse reactions in China is to be reformed and innovated. There have been attempts at compensation through government finance and insurance， but there has been no precedent for a fund of vaccine-related compensation in China， which means that this could be a new method of solving disputes of compensation for vaccine-related incidences and enhancing public confidence in vaccination. It is suggested that under the current system， we can select a province as a pilot to explore the fund compensation mechanism. The fund comes from special financial allocation， special taxation of vaccine enterprises， fund investment income， charitable donation and other channels. Through a special fund management organization， the independent identification and compensation process can be realized， so as to shorten the current compensation procedure， improve the amount of compensation， ultimately protect the interests of all parties， and promote the steady development of vaccination.