Percepción de dirigentes deportivos locales y funcionarios municipales sobre políticas públicas deportivas locales de la comuna de Linares

La aplicación de las políticas públicas deportivas locales (PPDL) de la comuna de Linares se han visualizado gracias a la aplicación del Plan de Desarrollo Comunal de Actividad Física y Deportes (PDC AFyD) en el período 2018 - 2022 en la comunidad y las organizaciones deportivas locales (OODD), así como de funcionarios del propio municipio. Para conocer la percepción sobre la aplicación de PPDL se aplica una entrevista semiestructurada y confeccionada para tales efectos, a 28 dirigentes deportivos y 18 funcionarios municipales, de un universo muestral total de 127 posibles. Los individuos indican que, pese a ver cambios favorables en el período desconocen el proceso y, por ende, el mecanismo aplicado para el cambio, lo que despotencia la comprensión de la PPDL y el desarrollo de ésta por medio de las propias OODD y el municipio. La aplicación de las PPDL por medio de sus distintas herramientas e instrumentos requiere que se desarrolle bajo un proceso de consulta, pertinencia y complementación entre municipio, OODD, mundo educativo y vecinos beneficiarios; todo dentro de un marco de comunicación e información concreta y permanente que logre involucrar a todos los actores, brindando con ello una cuota de responsabilidad en su ejecución, control y evaluación.

The application of local public policies on sports (LPSP) of the commune of Linares has been visualized thanks to the application of the Communal Development Plan for Physical Activity and Sports (CDP PA&S) in the period 2018 - 2022 in the community and local sports organizations (LSO), as well as officials of the municipality itself. To know the perception of the implementation of LPSP, a semi-structured interview was applied to 28 sports leaders and 18 municipal officials out of a total sample universe of 127 possible. The individuals indicate that, despite seeing favorable changes in the period, they are unaware of the process and, therefore, the mechanism applied for change, which undermines the understanding of the LPSP and its development through the LSOO and the municipality. The application of the LPSP through its different tools and instruments requires that it be developed under a process of consultation, relevance, and complementarity between the municipality, LSOO, the educational world and beneficiary neighbors; all under a framework of communication and concrete and permanent information that manages to involve all the actors, thus providing a share of responsibility in its execution, control, and evaluation.

A implementação das políticas esportivas públicas locais (PEPL) na comuna de Linares foi visualizada graças à implementação do Plano de Desenvolvimento Comunitário para Atividade Física e Esporte (PDC AFyE) no período 2018 - 2022 na comunidade e organizações esportivas locais (OOEE), bem como funcionários do próprio município. Foi realizada uma entrevista semi-estruturada com 28 líderes esportivos e 18 funcionários municipais de um universo de amostra total de 127. Os indivíduos indicam que, apesar de verem mudanças favoráveis no período, não conhecem o processo e, portanto, o mecanismo aplicado para a mudança, o que prejudica a compreensão do PEPL e seu desenvolvimento através do OOEE e do próprio município. A implementação do PEPL através de suas diferentes ferramentas e instrumentos requer um processo de consulta, relevância e complementaridade entre o município, o OOEE, o mundo educacional e os vizinhos beneficiários; tudo isso dentro de uma estrutura de comunicação e informação concreta e permanente que envolva todos os atores, proporcionando assim uma parcela de responsabilidade em sua implementação, controle e avaliação.

Knowledge, Attitude and Practice about Hypertension among adult Population of Letang Municipality, Morang District, Eastern Nepal

Introduction:Hypertension has been identified as one of the major public health and medical challenges with 1/4 adults worldwide estimated to have high blood pressure (BP).Objectives: To assess knowledge, attitude and practices regarding hypertension and to measure the association between socio-demographic characteristics with knowledge, attitude and practice regarding hypertension among adult population.Methods:The cross-sectional study was conducted among the 335 adult populationsin Letang Municipality of Nepal. Semi-structured questionnaire wasused for data collection. Chi-square test was applied to measure the association between socio-demographic characteristics with knowledge, attitude and practice regarding hypertension.Results:Majority of the respondents (67.2) have knowledge about the meaning of hypertension and symptoms of hypertension (52.2%). Mostof the respondents think that regular physical activity (83.9%) and reduce salt intake (84.2%) can be prevent hypertension.Almost 73.4% of respondents didn’t know their blood pressure and never checked their BP regularly(66.6%). Almost 12.8% of the study population sufferingfrom hypertension. The adult Population with age group of 41-60years (62.6%) was seen significantly good knowledge in comparison to other age groups. The study population having educational level SLC and above was seen significantly good knowledge,attitude and practice regarding prevention of hypertension in comparison to below SLC and illiterate. The study population belong to above poverty line had significantly good knowledge,attitude and practice regarding prevention of hypertensionin comparison to below poverty line.Conclusions:We conclude that majority of the study population of Letang Municipality had higher knowledge and positive attitude toward prevention of hypertension but the level of practices was poor.

Interdisciplinaridade em estágio de vivência acadêmica: reconhecimento da atuação profissional no Sistema de Saúde / Interdisciplinarity in an academic experience internship: recognition of professional performance in the Health System / Interdisciplinaridad en prácticas de experiencia académica: reconocimiento de la actuación profesional en el Sistema de Salud

Objetivo: Descrever a experiência de um estágio acadêmico vivenciado por universitários da área da saúde em um município do Baixo Solimões. Síntese dos dados:Trata-se do relato descritivo de um estágio acadêmico extramuro realizado em Manacapuru, Amazonas, ocorrido no período de outubro de 2019 a fevereiro de 2020. A realização da atividade teve a participação de acadêmicos de Medicina, Enfermagem e Odontologia e contou com a aplicação de práticas em saúde direcionadas à atuação individual e coletiva. Tendo como público-alvo os pacientes atendidos por uma Unidade Básica de Saúde (UBS), os universitários auxiliaram na realização de atendimentos eletivos em suas respectivas áreas de atuação e conduziram atividades de educação em saúde como rodas de conversa, gincanas educativas, palestras interativas e educação continuada à equipe da UBS. Conclusão: As práticas e ações em saúde realizadas no período do estágio extramuro proporcionaram uma integração interdisciplinar satisfatória entre os acadêmicos, possibilitando aos mesmos uma vivência apropriada na atenção básica do Sistema Único de Saúde (SUS).

Objective: To describe the experience of an academic internship completed by university students in the health field in a municipality in Baixo Solimões. Data synthesis: This is a descriptive report of an extramural academic internship carried out in Manacapuru, Amazonas, from October 2019 to February 2020. The activity was carried out with the participation of medical, nursing and dentistry students and included the application of health practices aimed at individual and collective action. Having as a target audience the patients assisted by a Primary Health Care (PHC) center, the university students helped in carrying out elective care in their respective fields and conducted health education activities such as conversation circles, educational scavenger hunts, interactive lectures and continuing education for the PHC center team. Conclusion: The health practices and actions carried out during the extramural internship enabled a satisfactory interdisciplinary integration among the students and allowed them to have an appropriate experience in primary care in the Unified Health System (Sistema Único de Saúde ­ SUS).

Objetivo: Describir la experiencia de una pasantía académica vivida por universitarios del área de la salud en un municipio del Baixo Solimões. Síntesis de los datos: Se refiere al informe descriptivo de una pasantía académica extramuros realizado en Manacapuru, Amazonas, ocurrido entre octubre de 2019 y febrero de 2020. La realización de la actividad tuvo la participación de académicos de medicina, enfermería y odontología y contó con la aplicación de prácticas en salud direccionadas a la actuación individual y colectiva. Teniendo como público meta los pacientes atendidos por una Unidad Básica de Salud (UBS), los universitarios ayudaron en la realización de atendimientos electivos en sus respectivas áreas de actuación y condujeron actividades de educación y en salud como charlas, juegos educativos, conferencias interactivas y educación continuada para el equipo de la UBS. Conclusión: Las prácticas y acciones en salud realizadas en el período de la pasantía extramuros proporcionaron una integración interdisciplinar satisfactoria entre los académicos, posibilitando a los mismos una experiencia apropiada en la atención básica del Sistema Único de Salud (SUS).

Correlação entre Qualidade de Vida e o Nível Educacional da População de Maringá/PR / Correlation between Quality-of-Life and the Educational Level of the Population of Maringá/PR

O nível de escolaridade pode influenciar na qualidade de vida de uma população. Deste modo, o objetivo deste estudo foi verificar a correlação entre a qualidade de vida (QV) e o nível educacional da população de Maringá-PR. Trata-se de um estudo de base populacional, transversal, com abordagem quantitativa, realizado com 1237 adultos (18 anos ou mais), de ambos os sexos, residentes no município. Foram aplicados instrumentos para obtenção de dados sobre o Perfil sociodemográfico e o questionário WOQOOL-100. A análise dos dados foi realizada pelo teste de Qui-quadrado de Pearson (X2), sendo adotada a significância de p < 0,05. Houve prevalência de indivíduos com nível bom/muito bom de QV nos domínios psicológico (62,4%), nível de independência (84,9%), relações sociais (77,2%), meio ambiente (60,6%) e espiritualidade (83,3%). Verificou-se associação significativa entre o grau de escolaridade e os domínios de independência (p < 0,001), relações sociais (p = 0,001) e meio ambiente (p = 0,002). Conclui-se que existem melhores índices de QV nos domínios de independência, relações sociais e meio ambiente em indivíduos com maior grau de escolaridade.

The level of education can influence the quality of life of a population. Thus, the objective of this study was to verify the correlation between the quality of life (QoL) and the educational level of the population of Maringá, PR. This is a population-based, cross-sectional study with a quantitative approach, carried out with 1237 adults (18 years and over), of both sexes, residing in the municipality. Instruments were applied to obtain data on the sociodemographic profile and the WHOQOL-100 questionnaire. Data analysis was performed using Pearson's chi-squared test (X2), with a significance of p < 0.05. There was a prevalence of individuals with a good/very good level of QoL in the psychology (62.4%), level of independence (84.9%), social relationships (77.2%), environment (60.6%), and spirituality (83.3%) domains. There was a significant association between the level of education and the domains of independence (p < 0.001), social relationships (p = 0.001), and environment (p = 0.002). It is concluded that there are better QoL indices in the domains of independence, social relationships, and environment in individuals with a higher level of education.

Prediction of trends for fine-scale spread of Oncomelania hupensis in Shanghai Municipality based on supervised machine learning models / 中国血吸虫病防治杂志

OBJECTIVE@#To predict the trends for fine-scale spread of Oncomelania hupensis based on supervised machine learning models in Shanghai Municipality, so as to provide insights into precision O. hupensis snail control.@*METHODS@#Based on 2016 O. hupensis snail survey data in Shanghai Municipality and climatic, geographical, vegetation and socioeconomic data relating to O. hupensis snail distribution, seven supervised machine learning models were created to predict the risk of snail spread in Shanghai, including decision tree, random forest, generalized boosted model, support vector machine, naive Bayes, k-nearest neighbor and C5.0. The performance of seven models for predicting snail spread was evaluated with the area under the receiver operating characteristic curve (AUC), F1-score and accuracy, and optimal models were selected to identify the environmental variables affecting snail spread and predict the areas at risk of snail spread in Shanghai Municipality.@*RESULTS@#Seven supervised machine learning models were successfully created to predict the risk of snail spread in Shanghai Municipality, and random forest (AUC = 0.901, F1-score = 0.840, ACC = 0.797) and generalized boosted model (AUC= 0.889, F1-score = 0.869, ACC = 0.835) showed higher predictive performance than other models. Random forest analysis showed that the three most important climatic variables contributing to snail spread in Shanghai included aridity (11.87%), ≥ 0 °C annual accumulated temperature (10.19%), moisture index (10.18%) and average annual precipitation (9.86%), the two most important vegetation variables included the vegetation index of the first quarter (8.30%) and vegetation index of the second quarter (7.69%). Snails were more likely to spread at aridity of < 0.87, ≥ 0 °C annual accumulated temperature of 5 550 to 5 675 °C, moisture index of > 39% and average annual precipitation of > 1 180 mm, and with the vegetation index of the first quarter of > 0.4 and the vegetation index of the first quarter of > 0.6. According to the water resource developments and township administrative maps, the areas at risk of snail spread were mainly predicted in 10 townships/subdistricts, covering the Xipian, Dongpian and Tainan sections of southern Shanghai.@*CONCLUSIONS@#Supervised machine learning models are effective to predict the risk of fine-scale O. hupensis snail spread and identify the environmental determinants relating to snail spread. The areas at risk of O. hupensis snail spread are mainly located in southwestern Songjiang District, northwestern Jinshan District and southeastern Qingpu District of Shanghai Municipality.

Status and equity of mental health resources allocation in Shanghai Municipality / 预防医学

Objective@#To analyze the current status and equity of mental health resources allocation in Shanghai Municipality, so as to provide data supports to formulate mental health action plans and relevant policies. .@*Methods@#The data pertaining to mental health institutions, actual beds opened, certified or assistant psychiatrists and registered nurses was collected from the Survey of the Current Status on Mental Health Resources in Shanghai Municipality in 2020. The equity of mental health resources allocated by population and geographical area in Shanghai Municipality was evaluated with Lorenz curve and Gini coefficient@*Results@#There were 96 mental health institutions, 15 060 actual beds opened, 257 certified or assistant psychiatrists and 2 887 registered nurses in Shanghai Municipality in 2020, with a physician-to-nurse ratio of 1∶2.30. The greatest numbers of actual beds opened in the department of psychiatrics, the number of certified or assistant psychiatrists and the number of registered nurses per 10 000 residents and per km2 were all found the central urban areas. The numbers of actual beds opened in the department of psychiatrics, the number of certified or assistant psychiatrists and the number of registered nurses per 10 000 residents were 6.06 beds, 0.51 physicians and 1.16 nurses, with Gini coefficients of 0.36, 0.42 and 0.44, respectively, and the numbers of actual beds opened in the department of psychiatrics, the number of certified or assistant psychiatrists and the number of registered nurses per km2 were 2.38 beds, 0.20 physicians and 0.46 nurses, with Gini coefficients of 0.72, 0.76 and 0.75, respectively. @*Conclusions@#There was a gross equity in mental health resources allocated by population and geographical area in Shanghai Municipality in 2020, which showed an improvement as compared to 2015. The equity in mental health resources allocated by geographical area was lower than that by population in Shanghai Municipality.

Prevalence of latent tuberculosis infections among residents in Nanchuan District / 预防医学

Objective@#To investigate the current prevalence of latent tuberculosis infection (LTBI) among residents living in Nanchuan District, Chongqing Municipality, so as to provide the evidence for formulating LTBI control measures.@*Methods@#The residents living in one street and one township from Nanchuan District were randomly selected using the multistage cluster sampling method during the period between January and April, 2020, and their demographic information, smoking history, history of alcohol consumption, history of contacts with tuberculosis patients and Bacillus Calmette-Guérin ( BCG ) vaccination scars were collected. The infection of Mycobacterium tuberculosis was detected using interferon gamma release assay ( IGRA ), and a positive IGRA test and exclusion of active tuberculosis was defined as LTBI. The prevalence of LTBI was descriptively analyzed among the study subjects.@*Results@#Totally 1 000 residents were recruited, including 381 males and 619 females, with a male to female ratio of 0.62∶1. The mean age was ( 45.87±18.40 ) years. Among all participants, there were 222 smokers ( 22.20% ), 247 subjects consuming alcohol (24.70%), 62 subjects with a history of contacts with tuberculosis patients ( 6.20% ) and 904 subjects with BCG scars ( 90.40% ). A total of 198 residents were diagnosed with LTBI (19.80% prevalence), and a higher prevalence rate of LTBI was seen in men than in women ( 23.36% vs. 17.61%; χ2=4.911, P=0.027 ). The prevalence of LTBI was significantly higher in married/divorced/widowed residents than in unmarried residents ( 24.22% vs. 2.01%; χ2=49.514, P<0.001 ), and significantly greater prevalence was found in smokers than in non-smokers ( 27.93% vs. 17.48%; χ2=11.871, P=0.001 ). The prevalence of LTBI appeared a tendency towards a rise with age ( χ2trend=59.100, P<0.001 ) and body mass index ( χ2trend=9.479, P=0.002 ).@*Conclusions@#The prevalence of LTBI is high among residents living in Nanchuan District, notably among elder, male smokers with high body mass index. Risk monitoring and timely interventions are required.

Yateras frente a la COVID-19: 386 días de silencio epidemiológico / Yateras versus COVID-19: 386 days of epidemiological silence

Introducción: No hay un reporte en la literatura científica que analice las causas que permitieron al municipio Yateras ser el único en Cuba en no tener pacientes diagnosticados con COVID-19 entre el 11 de marzo de 2020, fecha del primer reporte en el país, y el 2 de abril de 2021 en que se diagnosticó el primer paciente con la enfermedad. Objetivo: Caracterizar aspectos sociodemográficos de la población del municipio Yateras de la provincia de Guantánamo, en Cuba, durante este período en el cual no se diagnosticaron casos confirmados de la COVID-19. Métodos: Se realizó un estudio descriptivo, retrospectivo y transversal en el período comprendido entre el 11 de marzo de 2020 y el 2 de abril de 2021. El universo lo constituyó la población censada en ese período. Se estudiaron la edad, sexo, características de las viviendas, clasificación de la población según grupos dispensariales y otras condiciones que determinan la vulnerabilidad de los pobladores. Resultados: El 47,1 por ciento de la población fue vulnerable a la pandemia. El 98,8 por ciento presentó alguna comorbilidad o factor de riesgo, sobre todo el antecedente de hipertensión arterial sistémica en 2192 pobladores. El 10,7 por ciento de las viviendas se calificaron como hacinadas y 54,2 por ciento presentaba condiciones inadecuadas. Conclusiones: La mayor proporción de los pobladores de Yateras es vulnerable a la COVID-19, pero las particularidades sociodemográficas de esta población no determinaron el período de silencio epidemiológico que caracterizó al territorio, lo que se supone se debió al control y cumplimiento estricto de un sistema de medidas dirigidas al enfrentamiento de esta enfermedad, mediatizado por la actitud responsable y solidaria de la comunidad yaterana en el logro de esta finalidad(AU)

ABSTRACT Introduction: No report is available in the scientific literature analyzing the reasons why Yateras is the only municipality in Cuba without any COVID-19 patient from 11 March 2020, when the first case was reported in the country, until 2 April 2021, when the first case was diagnosed in the municipality. Objective: Characterize sociodemographic features of the population of the municipality of Yateras, province of Guantánamo, Cuba, during the period when no confirmed COVID-19 cases were diagnosed. Methods: A descriptive cross-sectional retrospective study was conducted in the period extending from 11 March 2020 to 2 April 2021. The study universe was the census-registered population in that period. The variables analyzed were age, sex, household conditions, population classification according to dispensary groups, and other conditions determining the vulnerability of the population. Results: Of the population studied, 47.1 percent was vulnerable to the pandemic. 98.8 percent had some sort of comorbidity or risk factor, mainly an antecedent of systemic arterial hypertension in 2192 inhabitants. 10.7 percent of the households were classified as overcrowded and 54.2 percent had inadequate conditions. Conclusions: A large number of Yateras residents are vulnerable to COVID-19. However, the sociodemographic features of this population did not determine the period of epidemiological silence characterizing the territory, which is thought to have been due to the control and strict compliance with a system of measures aimed at facing the disease, alongside the responsible, supportive attitude of the community toward the achievement of this goal(AU)

The COVID-19 outbreak and the municipal administration responses: resource munificence, social vulnerability, and the effectiveness of public actions / El brote de COVID-19 y las respuestas de la administración municipal: munificencia de recursos, vulnerabilidad social y efectividad de las acciones públicas / O surto da COVID-19 e as respostas da administração municipal: munificência de recursos, vulnerabilidade social e eficácia de ações públicas

Abstract Facing the unprecedented situation of the COVID-19 pandemic, public officials at the municipality-level have no clear benchmarks or tested policies. In this situation, decision-making becomes a controversial process. This article provides insights for public agents in the Brazilian municipalities to deal with the initial stages of the COVID-19 pandemic. We analyzed the actions taken by city halls of the 52 Brazilian municipalities at least thirty days since the first confirmed case of COVID-19. We used a fuzzy-set Qualitative Comparative Analysis (fsQCA) to identify the combinations of contextual factors and public actions that reduced COVID-19 transmission during the critical initial stage. The empirical results show three main paths to guide policy-making: (1) a plural collaboration path involving public and private sectors, operating in a fragile health system; (2) a public action path providing aid programs through intense collaboration inside public bureaucracy; and (3) a resource-based path relying on a well-structured health system.

Resumen Ante una situación sin precedentes de brote de la enfermedad por coronavirus 2019 (COVID-19), los funcionarios públicos a nivel municipal no tienen puntos de referencia claros ni políticas probadas. En esta situación, la toma de decisiones se convierte en un proceso controvertido. Este documento proporciona información para que los agentes municipales brasileños puedan hacer frente a las etapas iniciales del brote de COVID-19. Analizamos las acciones tomadas por los ayuntamientos de los 52 municipios brasileños que llevaban al menos treinta días desde el primer caso confirmado de COVID-19. Utilizamos un análisis cualitativo comparativo de conjunto difuso (fsQCA) para identificar las combinaciones de factores contextuales y acciones públicas que redujeron la transmisión de la COVID-19 durante la etapa inicial crítica. Los resultados empíricos muestran tres caminos principales para guiar la formulación de políticas: (1) un camino de colaboración plural que involucre a los sectores público y privado en presencia de un sistema de salud frágil; (2) una vía de acción pública que proporcione programas de ayuda a través de una intensa colaboración dentro de la burocracia pública; y (3) una ruta basada en los recursos de un sistema de salud bien estructurado.

Resumo Diante de uma situação sem precedentes do surto da doença do coronavírus 2019 (COVID-19), os agentes públicos no nível do município não têm referências claras ou políticas testadas. Nessa situação, a tomada de decisão pode se tornar um processo controverso. Este artigo fornece subsídios para gestores municipais lidarem com os estágios iniciais do surto de COVID-19. Analisamos as ações das prefeituras de todos os 52 municípios brasileiros com pelo menos trinta dias desde o primeiro caso confirmado da COVID-19. Utilizamos a fuzzy-set Comparative Qualitative (fsQCA) para identificar as combinações de fatores contextuais e ações públicas que reduziram a transmissão da COVID-19 durante o estágio inicial crítico. Os resultados empíricos mostram três caminhos principais para orientar a formulação de políticas: (1) um caminho de colaboração plural que envolve os setores público e privado na presença de um sistema de saúde frágil; (2) um caminho de ação pública que forneça programas de ajuda através de intensa colaboração dentro da burocracia pública; e (3) um caminho baseado nos recursos de um sistema de saúde bem estruturado.

Prevalence of cardiovascular risk factors among municipality workers in Chitradurga, South India

Background: Cardiovascular disease (CVD) is the single largest cause for mortality and morbidity in the world. In India, non-communicable diseases (NCDs) were responsible for 53% of deaths and 44% of disability adjusted life years lost. Appropriate assessment and management of cardiovascular risk is vital to prevent fatal and non-fatal heart attacks and strokes and to improve health outcomes in individuals at high risk of cardiovascular events. Diabetes mellitus (DM) and HT are common diseases in adulthood, pre-disposing to many cardiovascular complications, posing a major public health challenge.This study aims to assess the prevalence of cardiovascular risk factors such as diabetes, HT, smoking, alcohol intake, dyslipidaemia and obesity among Municipality workers.Methods: A cross-sectional study was carried out between Jan 2019-June 2019 among 100 Municipality workers in Chitradurga, South India. Socio-demographic details and some of the risk factors such as alcohol intake and smoking history were obtained using a pre-tested, structured questionnaire. Blood pressure & waist circumference were measured by standard methods. Fasting blood sugar & lipid profile were measured.Results: Mean age of study participants was 38.03 years (SD ± 10.9). Out of the study subjects, 21% were known diabetic and 22% were known hypertensive. 34% of the participants had cholesterol level higher than the desirable level of 200 mg/dL. Around 72% had a history of alcohol consumption and 13% had a history of tobacco smoking during the last 1 month. The prevalence of overweight based on BMI (BMI >23) is higher among Municipality workers (56%) compared to the general population (35.4%).Conclusions: Burden of cardiovascular risk factors such as diabetes and HT were high among Municipality Workers of Chitradurga.

Assessment of Disease Morbidity Pattern and Health Care Seeking Behaviour among the Elderly in Calabar Municipality, Cross River State, Nigeria

Aims:This study was aimed at assessing disease morbidity pattern and health care seeking behaviour among the elderly in Calabar Municipality, Cross River State, Nigeria. Study Design:Descriptive cross-sectional study designPlace and Duration of Study:Calabar Municipal Local Government Area, Cross River State between Feburary 2015 to March 2015.Methodology:Multi-stage sampling technique was used to select 200 elderly persons who gave consent to participate in the study. A semi-structured questionnaire was used to collect data from the respondents. Data collected were collated and analysed using IBM SPSS version 20.0 and results were presented in tables. Chi-square was used to test for association between categorical variables Results:The result obtained showed that respondents within the age bracket of 65-69years 74(37.0%) constituted majority followed by those aged 70-74years 56(28.0%) and 75-79years 42(21.0%). More than half of the respondents 110(55%) were females while the remaining 90(45%) were males. This study revealed that malaria 50(23.1%), high blood pressure 43(19.9%) and joint pain/arthritis 31(14.4%) were the most identified health problems suffered by the elderly and the hospital/healthcare centre was where most elderly persons sought for treatment whenever they fall ill. Expenditure on health services received was largely out-of-pocket expenditure 86(43.0%). Other respondents revealed that their children 64(32.0%), relatives/in-laws 28(14.0%), spouse 16(8.0%) and friend(s) 6(3.0%) were responsible for their hospital bills. Most respondents 106(53.0%) who patronized the hospital/health center were satisfied with treatment received. Increasing age and gender were significantly associated with disease morbidity pattern among the elderly (P< .05). Conclusion:Improving geriatrics care through effective implementation of intervention programmes is pivotal to mitigating the rate of disease morbidity among the aged population

O uso da tecnologia da informação e comunicação para caracterizar os municípios: quem são e o que precisam para desenvolver ações de governo eletrônico e smart city / El uso de la tecnología de la información y comunicación para caracterizar a los municipios: quienes son y lo que necesitan para desarrollar acciones de gobierno electrónico y smart city / The use of information and communication technology to characterize municipalities: who they are and what they need to develop e-government and smart city initiatives

Resumo Este estudo explora as características de infraestrutura e uso das tecnologias da informação e comunicação dos municípios brasileiros, refletindo sobre a possibilidade de desenvolverem ações de governo eletrônico e smart cities. Um estudo quantitativo de análise de agrupamentos foi realizado sobre dados da Munic 2014 e identificou quatro clusters: o Sem-tecnologia, o Atento ao cidadão, o Atento à legislação e o Provido de TIC, que sugerem diferentes vias de ação em TIC. Cada grupo de municípios apresenta diferentes necessidades para o desenvolvimento de ações de governo eletrônico e smart cities, que requerem ações específicas para cada um dos quatro clusters.

Resumen Este estudio investiga las características de infraestructura y uso de las tecnologías de la información y comunicación de los municipios brasileños, reflexionando sobre la posibilidad de desarrollo de acciones de gobierno electrónico y de smart cities. Un estudio cuantitativo de análisis de agrupamientos realizado sobre datos de la investigación Munic-2014 identificó cuatro clusters: el Sin-tecnología, el Atento al Ciudadano, el Atento a la legislación y el Provisto de TIC, que sugieren diferentes vías de acción en TIC. Cada grupo de municipios presenta diferentes necesidades para el desarrollo de acciones de gobierno electrónico y smart cities que indican la necesidad de acciones específicas para cada uno de los cuatro clusters.

Abstract This study investigates the infrastructure characteristics and use of information and communication technologies of Brazilian municipalities reflecting on the possibility of developing e-government and smart cities actions. A quantitative study of cluster analysis, using data from the research "Munic 2014", identified four clusters: the Technologyless, the Concerned-on citizen, the Concerned-on legislation, and the ICT Supported, that suggest different courses of action in ICT. Each group of municipalities presents different needs for the development of e-government and smart cities actions that indicate the need for specific actions for each of the four clusters.

Hábito de fumar y salud bucal en adolescentes. Politécnico Israel Moliné Rendón, Limonar, 2015 / Smoking habit and oral health in teenagers. Polytechnic School Israel Moliner Rendón, 2015

Introducción: El hábito de fumar se asocia a múltiples enfermedades entre ellas las bucales. Se estima un comienzo cada vez más precoz entre los adolescentes de 12 y 14 años. Objetivo: Caracterizar el comportamiento del hábito de fumar y su repercusión sobre la salud bucal de los adolescentes del Politécnico Israel Moliné, Limonar, año 2015. Materiales y Métodos: Se realizó un estudio observacional, descriptivo, transversal. El universo estuvo conformado por 129 adolescentes del politécnico Israel Moliné, Limonar. Las variables estudiadas fueron: sexo, práctica del hábito de fumar, tiempo fumando, motivaciones para fumar, afecciones bucales presentes en los fumadores, nivel de conocimientos sobre repercusión del hábito en la salud bucal. Para obtener la información se confeccionó un documento que recogía datos generales y relacionados con el hábito, se realizó el examen bucal y se aplicó un cuestionario sobre la repercusión del mismo en la salud bucal. Resultados: El 41,1 % de los adolescentes practicaba el hábito de fumar que se observó en 45,8 % del total de féminas. Casi la mitad llevaba menos de un año realizándolo, motivados por amigos (66 %) que fuman. La halitosis (77,3 %) y manchas nicotínicas (64,1 %) fueron las afecciones bucales más observadas. El 75,2 % tuvo bajo nivel de conocimientos sobre hábito de fumar y salud bucal. Conclusiones: El hábito prevaleció en el sexo femenino. El entorno de adolescentes repercutió de manera importante. Con poco tiempo de práctica del hábito se observaron afecciones bucales asociadas al mismo. Los adolescentes desconocían la repercusión que tiene este hábito sobre la salud bucal (AU).

Introduction: the smoking habit is associated to several diseases, and among them to the oral ones. Currently it is estimated that this harmful habit has a more and more precocious beginning among Cuban teenagers. Objetive: to characterize smoking behavior and its repercussion on the oral health of teenagers from the Polytechnic School "Israel Moliner Rendón", municipality of Limonar in 2015. Materials and Methods: a descriptive, observational study was carried out in a universe formed by 120 teenagers from the Polytechnic School "Israel Moliner Rendón". The studied variables were sex, smoking habit existence, time spend smoking, smoking motivations, oral diseases presented by smokers, level of knowledge on the repercussion of smoking on oral health. For gathering the information a document was prepared collecting general data and data related with the smoking habit, the oral examination was performed and a questionnaire about the repercussion of smoking on oral health was filled out. Results: 41,1 % of the teenagers practiced the smoking habit, and 45,8 % were female. Almost half of them smoked for less than a year. Halitosis (77,3 %) and nicotine strains (64,1 %) were the predominant oral affections. 75,2 % of the sample showed low level of knowledge about the repercussion of the smoking habit on oral health. Conclusions: the habit prevailed among females. The adolescent surrounding had an important influence. With few time of practicing smoking, there were found oral associated affections. Teenagers did not know the repercussion this habit has on oral health (AU).

Acciones metodológicas para el trabajo de la historia de la enfermería en la localidad / Methodological actions for the work about the history of nursing in the municipality

Introducción: el vínculo del contenido de aprendizaje con la práctica social constituye un enfoque importante para el trabajo con la historia local. Objetivo: diseñar acciones para el tratamiento metodológico de la historia de la enfermería en la localidad desde la actividad curricular. Métodos: investigación descriptiva transversal durante el curso escolar 2015-2016 en la Filial de Ciencias Médicas "Lidia Doce", Sagua la Grande. De un universo constituido por 47 docentes, se seleccionó una muestra de 23, mediante un muestreo probabilístico aleatorio simple. Para obtener la información se utilizó la observación y la encuesta. Resultados: insuficiente trabajo con la historia de la enfermería en la localidad desde los currículos educativos. En el 86,66 por ciento de las clases observadas no fueron abordados aspectos relacionados con el desarrollo de la enfermería en la localidad, historias de vida de personalidades destacadas en sus servicios, valores humanos y participación social. Los docentes presentan carencias en los conocimientos relacionados con la historia de la enfermería en la localidad. Se diseñaron ocho acciones para el trabajo metodológico. Conclusiones: a partir de las insuficiencias identificadas se elaboraron acciones metodológicas que fueron valoradas por especialistas como pertinentes, factibles de aplicar por la disponibilidad de recursos humanos y materiales para ejecutarlas y con calidad científico pedagógica para su implementación(AU)

Introduction: The link between the content of learning and the social practice constitutes an important approach for the working with the local history. Objective: To design actions for the methodological treatment of the history of nursing in the municipality from its syllabus. Methods: A descriptive transverse investigation was made during the school course 2015-2016 in ¨Lidia Doce¨ Medical School in Sagua la Grande The population was constituted by 42 teachers from which a sample of 23 was selected at random by draw. For information observation and survey is used. Results: Insufficient work with the history of nursing in the school syllabuses. In the 86 percent of the classes which were visited, aspects related to the development of nursing in the municipality were not analyzed as well as the history of outstanding personalities, their work, human values and social interaction. Conclusions: From the methodological shortcomings identified actions that were valued by experts as relevant, feasible to implement by the availability of human and material resources to execute scientific and pedagogical quality for its implementation were developed(AU)

Malnutrición por exceso y déficit en niños, niñas y adolescentes, departamento de Antioquia 2015 / Malnutrition by excess and deficiency in children and adolescents, department of Antioquia 2015 / Nutrição deficiente por ingestão excessiva ou exígua em crianças e adolescentes, Departamento de Antioquia 2015

Resumen Objetivo: determinar la prevalencia de malnutrición por exceso y déficit en menores de 17 años del departamento de Antioquia por subregión y municipio. Metodología:estudio transversal con fuente secundaria basado en la información de un estudio poblacional en el departamento de Antioquia. Se calcularon los indicadores de malnutrición por déficit y exceso según peso para la talla, índice de masa corporal (IMC) y talla para la edad y se exploró la asociación conjunta de variables de persona y lugar a través de una regresión multinomial sobre los indicadores mencionados. Resultados y discusión:el riesgo de malnutrición por exceso según el peso para la talla fue del 23% y el de déficit del 7,6%; según el IMC el riesgo de malnutrición por exceso fue del 25,6% y el de déficit del 17,7%. La subregión con mayor riesgo de malnutrición por déficit fue Occidente, 37% siendo Peque el municipio más prevalente, 60,4% en contraste con el Valle de Aburrá que fue la subregión con mayor malnutrición por exceso, donde se destacó el municipio de Titiribí, 46,3%. La malnutrición fue más prevalente los niños hombres menores de 17 años, con asiento en la zona urbana, alimentación insana cuya familia tenía ingresos por debajo de salario mínimo legal vigente para el año 2014 Conclusiones:se deben priorizar intervenciones nutricionales en los menores de 17 años en salud pública en los municipios de la subregión del occidente y del Valle de la Aburrá, especialmente en Peque y Titiribí, donde la malnutrición por déficit y exceso fue mayor.

Abstract Objective: to determine the prevalence of malnutrition by excess and deficiency in children under 17 in the department of Antioquia by subregions and municipalities. Methodology: a cross-sectional study with secondary data sources based on the information retrieved from a population-based study in the department of Antioquia. The indicators of malnutrition by excess and deficiency were calculated based on weight-for-height, body mass index (BMI) and height-for-age. In addition, the joint association of person and place variables was explored through a multinomial regression for the indicators mentioned. Results and discussion: the risk of malnutrition by excess according to weight-for-height values was 23%, and the deficiency 7.6%; according to BMI values, the risk of malnutrition by excess was 25.6% and the deficiency 17.7%. The western subregion had the highest risk of malnutrition by deficiency (37%); in this area, Peque was the municipality with the highest prevalence (60.4%). In contrast, the Aburrá Valley was the subregion with the highest values for malnutrition by excess, where the municipality of Titiribí stood out with 46.3%. Malnutrition was more prevalent among male children under 17 living in urban areas, with unhealthy diets and families with incomes below the current legal minimum wage for the year 2014. Conclusions:it is necessary for public health to prioritize nutrition interventions targeting children under 17 in the municipalities of the western and Valle Aburrá subregions, especially at Peque and Titiribí, where malnutrition by deficit and excess was greater.

Resumo Objetivo: determinar a prevalência de nutrição deficiente por ingestão excessiva ou exígua em menores de 17 anos do Departamento de Antioquia, nas sub-regiões e municípios. Metodologia: estudo transversal com fonte secundária, baseado na informação de uma pesquisa populacional no Departamento de Antioquia. Calcularam-se indicadores de nutrição deficiente por exigüidade e por excesso segundo a altura e os quilogramas, o Índice de Massa Corporal, e a altura para a idade. Também explorou-se a associação conjunta de variáveis de pessoa e lugar, através de uma regressão multinomial sobre os indicadores mencionados. Resultados e discussão: o risco de nutrição deficiente por excesso segundo os quilogramas para a altura foi de 23%, e o risco de nutrição deficiente por exigüidade foi de 7,6%. Segundo o IMC, o risco de nutrição deficiente por excesso foi de 25,6% e por exigüidade de 17,7%. A sub-região de mais alto risco de nutrição deficiente por exigüidade foi Ocidente, com 37%, sendo Peque o município mais prevalente, com 60,4%. Em contraste, El Valle de Aburrá foi a sub-região com maior prevalência de nutrição deficiente por excesso, destacando o município de Titiribí, com 46,3%. A nutrição deficiente mais prevalente foi nos sujeitos masculinos menores de 17 anos que moravam nas áreas urbanas, com alimentação insalubre e família com renda menor ao salário mínimo legal do ano 2014. Conclusões: Deve dar-se prioridade às intervenções nutricionais nos menores de 17 anos nos programas de saúde pública dos municípios da sub-região Ocidente e Valle de Aburrá, especialmente em Peque e Titiribí, onde a nutrição deficiente por exigüidade e excesso foi mais alta.

The research of development status and countermeasures of exercise cardiopulmonary rehabilita-tion in level 2 and above the general hospitals in Chongqing Municipality / 中华医学教育探索杂志

Objective To understand the current development situation and the existing problems and deficiencies of the exercise cardiopulmonary rehabilitation development in Level 2 and above the general hospitals in Chongqing, and to analyze and find out the factors restricting the development of cardiopul-monary rehabilitation in Chongqing, and put forward suggestions for reform and development. Methods Through literature research, field visits and questionnaire survey, the condition of 115 Level Two compre-hensive hospital's rehabilitation and exercise cardiopulmonary rehabilitation development in Chongqing was understood. Among them, 500 questionnaires were sent to 6 hospitals concerned with cardiopulmonary rehabilitation service, and 483 questionnaires were received with 351 valid questionnaires. Epidata3.1 and SPSS 13.0 statistical software were used to gather research data. Results The settings rate of 115 secondary general hospital rehabilitation was 41.7％, while only 6 hospitals carried out cardiac rehabilitation and cardio pulmonary rehabilitation. There were few rehabilitation beds, the basic staffing was inadequate and the medical staff ratio was only 2 to 2.6. Besides, there is a severe shortage of full-time health instructors.Conclusion The clinical sports cardiopulmonary rehabilitation in Chongqing is as following: The construc-tion of hospital related policies is lagging behind, the overall development of rehabilitation therapy is unbal-anced, the development is late and the level of operation is low. While the lack of professional health movement means that instructors and medical staff have cognitive impairment, residents have low accep-tance of sports rehabilitation therapy and there are insufficient pathogens, which are the main factors that restrict the development of cardiopulmonary rehabilitation.

Promoção à saúde da mulher negra no povoado Castelo, Município de Alcântara, Maranhão, Brasil / Promotion of black women's health in Castelo village, municipality of Alcântara, Maranhão, Brazil

Resumo A Política Nacional de Saúde para a Mulher Negra dispõe de um aparato legal que dá suporte a sua implementação, conquistado pelo movimento negro. Tendo como parâmetro as legislações referentes à saúde da população negra e à saúde da mulher, além dos documentos disponibilizados pela Secretaria Municipal de Saúde de Alcântara, este trabalho teve como objetivo geral analisar os serviços básicos de saúde prestados às mulheres negras do povoado Castelo e como objetivos específicos realizar levantamento empírico dos programas e projetos voltados para mulheres negras oferecidos pelo município de Alcântara; verificar se no povoado Castelo há algum atendimento específico para mulheres negras; identificar as principais demandas das mulheres da comunidade ao serviço de saúde local; averiguar como o quesito cor está sendo empregado pela equipe da Estratégia Saúde da Família que atende a comunidade. A metodologia consistiu em identificar, através de documentos disponibilizados pela Secretaria Municipal de Saúde (SEMUS), as ações e serviços voltados para as mulheres na comunidade, e por meio de questionário aplicado aos profissionais, seus conhecimentos sobre a Política Nacional de Saúde Integral da População Negra. Concluímos que, apesar do aparato legal, reconhecido e citado pela SEMUS em seu Plano de Saúde atual, as legislações não têm sido suficientes para que esse segmento social tenha suas peculiaridades reconhecidas. Informações básicas para planejamento de ações específicas, como a coleta do quesito cor, por exemplo, não são realizadas pela SEMUS. Não identificamos nenhuma ação planejada que considere as características raciais e étnicas das mulheres da comunidade.

Abstract The Black Women's Health National Policy has a legal apparatus to support its implementation, conquered by the black movement. Taking as reference the laws relating to the black population's health, women's health, and the documents provided by the Health Secretariat of the Municipality of Alcantara, this study's main objective is to analyze the basic health services provided to black women of Castelo village, and its specific objectives are: to identify municipality of Alcantara's programs and projects facing black women; to check for any specific care for black women in Castelo village; to identify the main demands of the community's women to the local health service; to check how the color data are being collected by the local Family Health Strategy team. The methodology adopted consisted in to identify, through documents provided by the city's Health Secretariat, its actions and services towards the community's black women, and through a questionnaire applied to its professionals, their knowledge about the National Policy for Integral Health of the Black Population. We concluded that, despite the legal apparatus cited by the Health Secretariat's in its current health care plan, these legislation's achievements were not enough to improve the recognition of this social group's peculiarities among its health services. The collection of basic informations, which are necessary to the planning of specific actions, as the color data, is not being performed by the Municipality's Health Secretariat. We have not identified any planned action which considers the racial and ethnic characteristics of this village's women.

Phlebotomine sandfly (Diptera: Psychodidae) diversity and their Leishmania DNA in a hot spot of American Cutaneous Leishmaniasis human cases along the Brazilian border with Peru and Bolivia

In this study, we identified the phlebotomine sandfly vectors involved in the transmission of American Cutaneous Leishmaniasis (ACL) in Assis Brasil, Acre, Brazil, which is located on the Brazil-Peru-Bolivia frontier. The genotyping of Leishmania in phlebotomines was performed using polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism. A total of 6,850 sandflies comprising 67 species were captured by using CDC light traps in rural areas of the municipality. Three sandfly species were found in the state of Acre for the first time: Lutzomyia georgii, Lu. complexa and Lu. evangelistai. The predominant species was Lu. auraensis/Lu. ruifreitasi and Lu. davisi (total 59.27%). 32 of 368 pools were positive for the presence of Leishmania DNA (16 pools corresponding to Lu. davisi, and 16 corresponding to Lu. auraensis/Lu. ruifreitasi), with a minimal infection prevalence of 1.85% in Lu. davisi and 2.05% in Lu. auraensis/Lu. ruifreitasi. The Leishmania species found showed maximum identity with L. (Viannia) guyanensis and L. (V.) braziliensis in both phlebotomine species. Based on these results and similar scenarios previously described along the Brazil/Peru/Bolivia tri-border, the studied area must take into consideration the possibility of Lu. davisi and Lu. auraensis/Lu. ruifreitasi as probable vectors of ACL in this municipality.

Conocimientos y hábitos alimentarios en mujeres diagnosticadas con hipertensión arterial del municipio de Sonsón - Colombia / Nutrition knowledge and eating habits in women diagnosed with hypertension in the municipality of Sonsón - Colombia

Arterial hypertension is a problem for the world public health as it carries, in most cases, cardiovascular, kidney and brain diseases. The objective of this research was to understand the knowledge and eating habits of a group of women diagnosed with hypertension in the municipality of Sonsón-Antioquia. Subjects and methods: The approach used was qualitative, which allowed us to understand the social and cultural factors that influence the feeding of this group of women. The method was ethnography; the techniques of data collection were individual and group interviews. Results: The food changes proposed to the diagnosed patients with arterial hypertension by the health personnel are oriented to reducing foods high ih sodium and salt, but these recommendations are difficult to abide due to factors like food taste. The feeding recommendations offered by the health personnel are framed within nutritional issues that do not always consider the taste or the meanings attributed to food, nor the frequency of their consumption.

La hipertensión arterial es un problema de salud pública mundial porque conlleva, en la mayoría de los casos, a enfermedades cardiovasculares, renales y cerebrales. El objetivo de esta investigación fue indagar sobre los conocimientos y hábitos alimentarios de un grupo de mujeres diagnosticadas con hipertensión arterial en el municipio de Sonsón-Antioquia. Sujetos y métodos: el enfoque utilizado fue cualitativo, el que permitió comprender los factores sociales y culturales que influyen en la alimentación de este grupo de mujeres. El método fue la etnografía; las técnicas de recolección de información fueron entrevistas individuales y grupales. Resultados: Los alimentos que más gustan en los hogares son los fritos, salados y condimentos procesados. Los cambios alimentarios propuestos por parte del personal de salud a las pacientes diagnosticadas con hipertensión arterial, se orientan a disminuir alimentos ricos en sodio y sal, lo cual les resulta difícil de llevar a cabo por factores culturales. Las recomendaciones alimentarias brindadas por el personal de salud se enmarcan en aspectos nutricionales que no siempre consideran los gustos alimentarios, ni los significados atribuidos a los alimentos.

Vascular epiphytes in a remnant of seasonal semideciduous forest in zona da mata, State of Minas Gerais, Brazil / Epífitas vasculares em um remanescente de floresta estacional semidecidual na zona da mata, Minas Gerais, Brasil

This study was performed in a remnant of Seasonal Semideciduous Forest at Fazenda Fortaleza de Sant'Anna, in the municipality of Chácara, Minas Gerais, Brazil (22.0129S, 43.8628W), in an area of ca. 1 ha, via monthly expeditions throughout the year 2012. We found 91 species of vascular epiphytes, distributed in 44 genera and 12 families. The richest families were Orchidaceae (35 spp.), Bromeliaceae (18 spp.), Polypodiaceae (10 spp.), Piperaceae (nine spp.) and Araceae (seven spp.). Two species were recorded for the first time in Minas Gerais: Rodriguezia sticta and Stelis oligantha (Orchidaceae). Rhipsalis oblonga (Cactaceae) was recollected in the state after about 100 years without records. Four species are cited in the list of endangered plants in Minas Gerais: Nematanthus crassifolius (Gesneriaceae) and Cattleya bicolor (Orchidaceae) are in the category "Vulnerable" (VU), Nidularium azureum (Bromeliaceae) and Pleurothallis pectinata (Orchidaceae) are "Critically Endangered" (CR). Nidularium azureum is also cited as CR in the Red Book of Brazilian Flora. Most species were classified as characteristic holoepiphytes and anemochory was the most frequent dispersion syndrome.

O estudo foi realizado em um remanescente de Floresta Estacional Semidecidual, na Fazenda Fortaleza de Sant'Anna, município de Chácara, Minas Gerais, Brasil (22,0129S, 43,8628W), em uma área aproximada de 1 ha, através de expedições mensais durante o ano de 2012. Foram encontradas 91 espécies de epífitas vasculares, distribuídas em 44 gêneros e 12 famílias. As famílias mais ricas foram Orchidaceae (35 spp.), Bromeliaceae (18 spp.), Polypodiaceae (10 spp.), Piperaceae (nove spp.) e Araceae (sete spp.). Duas espécies foram registradas pela primeira vez para Minas Gerais: Rodriguezia sticta e Stelis oligantha (Orchidaceae). Rhipsalis oblonga (Cactaceae) foi recoletada no estado depois de cerca de 100 anos sem registros. Quatro espécies estão presentes na lista de plantas ameaçadas de extinção em Minas Gerais: Nematanthus crassifolius (Gesneriaceae) e Cattleya bicolor (Orchidaceae) na categoria "Vulnerável" (VU), Nidularium azureum (Bromeliaceae) e Pleurothallis pectinata (Orchidaceae) como "Criticamente em Perigo" (CR). Nidularium azureum também é citado como CR no Livro Vermelho da Flora do Brasil. A maioria das espécies foi classificada como holoepífita característica e a síndrome de dispersão mais frequente foi a anemocoria.