Software educativo para la asignatura Estratificación de Riesgos Medioambientales / Educational software for the subject Stratification of Environmental Risks

Se realizó una investigación relacionada con la innovación tecnológica, en la Facultad de Enfermería-Tecnología de la Salud de Santiago de Cuba, durante el curso escolar 2019-2020, con el objetivo de diseñar un software educativo para la asignatura Estratificación de Riesgos Medioambientales, dirigido a los estudiantes de técnico medio en Vigilancia y Lucha Antivectorial. Se utilizaron los métodos teóricos: análisis-síntesis, histórico-lógico, modelación, sistémico-estructural e inductivo-deductivo; y empíricos: observación y análisis documental. La muestra fue de 44 estudiantes y 6 profesores escogidos al azar. Se concluye que el software propuesto es factible, pertinente y necesario como medio de enseñanza; proporciona información actualizada, su navegación es fácil y amena, y permite la autoevaluación de los estudiantes al interactuar con él mismo, lo que contribuye a mejorar el trabajo independiente.

An investigation related to the technological innovation was carried out in the Health Nursing-Technology Faculty from Santiago de Cuba, during the school course 2019-2020, aimed at designing an educational software for the subject Stratification of Environmental Risks, directed to medium technician students in Surveillance and Vector Control. The theoretical methods used were: analysis-synthesis, historical-logical, modelation, systemic-structural and inductive-deductive; and the empiric methods were: observation and documental analysis. The sample had 44 students and 6 professors chosen at random. It was concluded that the proposed software is feasible, pertinent and necessary as teaching aid; provides up-to-date information, it is easy and interesting to surf internet, and allows the self-appraisal of students in the interaction with themselves, what contributes to improve the independent work.

Sarcoidosis ocupacional o ambiental: diagnóstico enigmático con muchos progenitores para un mismo síndrome / Occupational or environmental sarcoidosis: enigmatic diagnosis with many parents to the same syndrome

RESUMEN Es conocida desde hace más de veinte años, la posibilidad de que fármacos o anti cuerpos monoclonales utilizados en el tratamiento de diferentes enfermedades pueden ocasionar la aparición de un síndrome símil sarcoidosis. Ciertas líneas de evidencia han sugerido que determinados lugares de trabajo están asociados con el riesgo de sarcoidosis En sarcoidosis, diferentes exposiciones pueden estar relacionadas con otros compromi sos viscerales. La afección presenta más de una causa y provocar fenómenos disímiles de la enfermedad o fenotipo. De las enfermedades ocupacionales de pulmón, la que más se asemeja es la beriliosis. Cuando la causa es de origen laboral, su reconocimiento es primordial para admitir un tratamiento eficaz mediante el retiro del trabajador afectado de la exposición y para establecer una intervención dirigida a la prevención primaria mediante las secciones especializadas en seguridad e higiene industrial. Por lo tanto, y por lo expuesto, debe considerarse que la sarcoidosis es un síndrome con cuantiosos factores etiológicos probables, a lo que hay que asociar tanto el fenotipo como la sensibilidad individual ante una noxa determinada. Esto hace que, en forma periódica, se publiquen casos en los que la clínica y el cuadro histológico de granuloma epitelioide no caseoso hallado en biopsias, se vincule a un determinado riesgo ambiental y/o laboral.

SUMMARY It has been known for more than 20 years, the possibility that drugs or monoclonal anti bodies used in the treatment of different diseases can cause a Sarcoidosis-like syndrome. Certain lines of evidence have suggested that certain workplaces are associated with the risk of Sarcoidosis. In Sarcoidosis, different exposures may be related to visceral involvement. The condition has more than one cause and brings about dissimilar pheno mena of the disease or phenotype. Of the occupational lung diseases, the one that most closely resembles it, is Berylliosis. When the cause is of occupational origin, its recognition is essential to allow effective treatment by removing the affected worker from exposure and to establish an intervention aimed at primary prevention through sections specialized in industrial hygiene and security. Therefore, it must be considered that Sarcoidosis is a syndrome with nume rous probable etiological factors, to which both the phenotype and individual susceptibility to a given toxic effect must be associated. Due to what has been stated, this means that cases are periodically publis hed in which the clinical and histological features of non-caseous epithelioid granuloma found in biopsies are linked to a certain environmental and/or occupational risk.

Environmental Planning and Non-Communicable Diseases: A Systematic Review on the Role of the Metabolomic Profile.

Non-communicable diseases (NCDs) are the major cause of death worldwide and have economic, psychological, and social impacts. Air pollution is the second, contributing to NCDs-related deaths. Metabolomics are a useful diagnostic and prognostic tool for NCDs, as they allow the identification of biomarkers linked to emerging pathologic processes. The aim of the present study was to review the scientific literature on the application of metabolomics profiling in NCDs and to discuss environmental planning actions to assist healthcare systems and public managers based on early metabolic diagnosis. The search was conducted following PRISMA guidelines using Web of Science, Scopus, and PubMed databases with the following MeSH terms: "metabolomics" AND "noncommunicable diseases" AND "air pollution". Twenty-nine studies were eligible. Eleven involved NCDs prevention, eight addressed diabetes mellitus, insulin resistance, systemic arterial hypertension, or metabolic syndrome. Six studies focused on obesity, two evaluated nonalcoholic fatty liver disease, two studied cancer, and none addressed chronic respiratory diseases. The studies provided insights into the biological pathways associated with NCDs. Understanding the cost of delivering care where there will be a critical increase in NCDs prevalence is crucial to achieving universal health coverage and improving population health by allocating environmental planning and treatment resources.

Risco ambiental provocado por resíduos de medicamentos na cidade do Rio de Janeiro, Brasil, durante a pandemia por SARS-Cov19 / Environmental risk caused by drug waste in the city of Rio de Janeiro, Brazil, during the SARS-Cov19 pandemic

Resumo Foi avaliada a relação entre a distribuição de medicamentos usados na pandemia por SARS-COV-19 no município do Rio de Janeiro e o nível de risco ambiental estimado provocado por seus resíduos. Foi coletada a quantidade de medicamentos distribuídos pelas unidades de atenção primária à saúde (APS) entre 2019 e 2021. O quociente de risco (QR) correspondeu à razão entre a concentração ambiental preditiva estimada (PECest), obtida pelo consumo e excreção de cada fármaco, e a sua concentração preditiva não efetiva (PNEC). Os PECest da azitromicina e da ivermectina aumentaram entre 2019 e 2020, tendo uma queda em 2021 provavelmente devido ao desabastecimento. Já o da dexclorfeniramina (DEX) e da fluoxetina (FLU) tiveram uma queda, retornando o crescimento em 2021. Enquanto o PECest do diazepam (DIA) aumentou ao longo desses três anos, o etinilestradiol (EE2) diminuiu, possivelmente pela priorização da APS no tratamento da COVID-19. Os maiores QR foram de FLU, EE2 e AZI. O padrão de consumo desses medicamentos não refletiu seu risco ambiental, pois os mais consumidos possuem baixa toxicidade. Vale destacar que alguns dados podem estar subestimados devido ao incentivo que foi dado durante a pandemia para o consumo de determinados grupos de fármacos.

Abstract The relationship between the distribution of medicines used in the Pandemic by SARS-COV-19 in the municipality of Rio de Janeiro and the estimated level of environmental risk caused by their residues was evaluated. The amount of medicines distributed by primary health care (PHC) units between 2019 and 2021 were collected. The risk quotient (RQ) corresponded to the ratio between the estimated predictive environmental concentration (PECest) obtained by the consumption and excretion of each drug and its non-effective predictive concentration (PNEC). Between 2019 and 2020, the PECest of azithromycin (AZI) and ivermectin (IVE) increased between 2019 and 2020, with a decrease in 2021 probably due to shortages. Dexchlorpheniramine (DEX) and fluoxetine (FLU) fell, returning to growth in 2021. While the PECest of diazepam (DIA) increased over these 3 years, ethinylestradiol (EE2) decreased possibly due to the prioritization of PHC in the treatment of COVID-19. The largest QR were from FLU, EE2 and AZI. The consumption pattern of these drugs did not reflect their environmental risk because the most consumed ones have low toxicity. It is worth noting that some data may be underestimated due to the incentive given during the pandemic to the consumption of certain groups of drugs.

Agregación familiar para cardiopatía isquémica

RESUMEN Fundamento: la cardiopatía isquémica es una entidad nosológica de origen multifactorial con predisposición genética y susceptible a cambios ambientales. Objetivo: determinar la existencia de agregación familiar para cardiopatía isquémica en pacientes atendidos en consulta de cardiología en el Hospital General Docente Vladimir Ilich Lenin de Holguín. Métodos: se realizó un estudio observacional, analítico de casos y controles (estudio de agregación familiar). La muestra quedó conformada por 60 nuevos pacientes con el diagnóstico de cardiopatía isquémica (casos) y por otros 60 pacientes sin diagnóstico de enfermedad coronaria (controles), pareadas en la razón 1:1. Se emplearon como variables: sexo, edad, antecedentes familiares de cardiopatía isquémica y factores de riesgo ambientales. Se utilizó el estadígrafo Chi cuadrado. Luego se calculó el Odds Ratio para conocer la magnitud de asociación mediante la razón de productos cruzados. Resultados: en el grupo casos existió una mayor frecuencia en el antecedente familiar para cardiopatía isquémica, fue más elevada para los familiares de primer grado con 31 familiares y un 41,3 %. La hiperlipidemia se presentó como el factor de riesgo de mayor frecuencia con 36,7 % en el grupo casos y 37,1 % en el grupo controles. Se determinó un riesgo aproximadamente 4 veces mayor de padecer cardiopatía isquémica en aquellos individuos con historia familiar positiva de primer grado, mientras que los pacientes con hiperlipidemia tienen 4,8 más riesgo de padecer cardiopatía isquémica. Conclusiones: existe agregación familiar para cardiopatía isquémica y se mostró un riesgo mayor de enfermar los pacientes con historia familiar positiva para la enfermedad, principalmente con familiares de primer grado y con hiperlipidemia.

ABSTRACT Background: ischemic heart disease is a nosological entity of multifactorial origin with genetic predisposition and susceptible to environmental changes. Objective: to determine the existence of familial aggregation for ischemic heart disease in patients seen in the cardiology clinic at the Vladimir Ilich Lenin General Teaching Hospital in Holguín. Methods: an analytical observational study of cases and controls (family aggregation study) was carried out. The sample was made up of 60 new patients with a diagnosis of ischemic heart disease (cases) and another 60 patients without a diagnosis of coronary heart disease (controls), paired in a 1:1 ratio. The following variables were used: sex, age, family history of ischemic heart disease and environmental risk factors: smoking, hyperlipidemia, high blood pressure and sedentary lifestyle. The Chi square statistician was used by the Mantel-Haenszel method. The odds ratio (OR) was then calculated to determine the magnitude of association through the ratio of cross products. Results: in the case group there was a higher frequency in the family history for ischemic heart disease, being higher for first degree relatives with 31 relatives and 41.3 %. Hyperlipidemia was the most frequent risk factor with 36.7 % in the case group and 37.1 % in the control group. An approximately 4-fold increased risk of suffering from ischemic heart disease was determined in those individuals with a positive first-degree family history, while patients with hyperlipidemia have a 4.8 times greater risk of suffering from ischemic heart disease. Conclusions: there is family aggregation for ischemic heart disease and a higher risk of getting sick was shown in patients with a positive family history for the disease, mainly with first-degree relatives and with hyperlipidemia.

Factores sociales y ambientales relacionados con el asma bronquial en niños de los consultorios 1 y 2 de Caonao, Cienfuegos

RESUMEN Fundamento el asma bronquial es un importante problema de salud y causa frecuente de morbimortalidad. En su génesis influyen factores humanos, sociales, ambientales y económicos. Objetivo: identificar factores sociales y ambientales relacionados con la severidad del asma bronquial en niños, atendiendo a sus características clínicas y demográficas. Métodos se realizó un estudio descriptivo de corte transversal en 46 niños con asma bronquial pertenecientes a los consultorios médicos 1 y 2 del policlínico Área VIII de Cienfuegos, durante el período de noviembre 2019 a mayo de 2020. Se utilizaron variables sociales y demográficas. Resultados: predominó el sexo masculino; las edades entre 13-16 y 17-19 años fueron las más afectadas, en ambos grupos con antecedentes familiares de asma. Estuvieron expuestos al hábito de fumar de familiares 31 infantes y se relacionó con las crisis moderadas persistentes. La mayoría de los niños necesitó tratamiento farmacológico. Predominó el hacinamiento que influyó en la aparición de infecciones respiratorias. Prevalecieron las familias moderadamente funcionales, hubo un predominio de las viviendas clasificadas de regulares. Conclusiones: existe relación directa entre la severidad de las manifestaciones clínicas del asma y los factores de riesgo que las condicionan. Se requiere de un trabajo educativo sistemático para su prevención.

ABSTRACT Background: bronchial asthma is an important health problem and a frequent cause of morbidity and mortality. Human, social, environmental and economic factors influence its genesis. Objective: to identify social and environmental factors related to the severity of bronchial asthma in children, based on their clinical and demographic characteristics. Methods: a descriptive cross-sectional study was carried out in 46 children with bronchial asthma belonging to medical offices 1 and 2 of the Area VIII polyclinic in Cienfuegos, from November 2019 to May 2020. Social and demographic variables were used. Results: the male sex predominated; ages between 13-16 and 17-19 years old were the most affected, in both groups with a family history of asthma. 31 infants were exposed to the smoking habit of family members and it was related to persistent moderate crises. Most of the children required pharmacological treatment. Overcrowding prevailed, which influenced the appearance of respiratory infections. Moderately functional families prevailed, there was a predominance of dwellings classified as regular. Conclusions: bronchial asthma requires systematic educational work for its prevention. There is a direct relationship between the severity of the clinical manifestations and the risk factors that condition it.

Prioritising well-being and resilience to 'build back better': insights from a Dominican small-scale fishing community.

Climate change is increasing the severity of extreme weather events, particularly hurricanes, presenting a significant challenge to Caribbean coastal communities. In the aftermath of a major disaster, government interventions typically prioritise infrastructure, assets, and the economy through rebuilding roads, reviving economic sectors, and providing financial compensation. This is driven by a focus on macro-level quantitative indicators rather than by local, multidimensional subjective and relational factors, closer to lived experiences and livelihoods. Using frameworks outlining social well-being and agency, this paper explores strategies used by a fisheries-dependent community in Dominica to recover from Hurricane Maria in 2017 and pursue well-being. The findings highlight the importance of multidimensional well-being, particularly relational and subjective dimensions, including existing social networks, and personal relationships critical for recovery after Maria. Furthermore, the paper demonstrates how recovery initiatives that concentrate solely on material well-being, such as employment, can undermine agency in the capacity of a community to recover and build resilience.

Reliability of HOME FAST BRAZIL-Self-Reported Version for Community-Dwelling Older Adults.

Objective: Verify the intra- and inter-rater reliability of the HOME FAST BRAZIL-Self-reported version and correlate household environmental risks with the history of falls by community-dwelling older adults. Method: Cross sectional study with 50 community-dwelling older adults who were screened by the cut-off point of the Mini Mental State Exam and replied to the HOME FAST BRAZIL-Self-reported version using two evaluators, on three occasions. The reliability analysis was determined by the Intra-class Correlation Coefficient (ICC), considering ICC > 0.70 as adequate. To test the correlations, the Spearman test was used. Results: The mean age of the participants was 73.2 ± 5.8 years. The inter- rater reliability of HOME FAST BRAZIL-Self-reported version was ICC 0.83 (IC95%, 0.70-0.90) and the Intra- reliability ICC 0.85 (IC95%, 0.74-0.91). A risk of falls was verified in 88% of the sample and four environmental risks presented significant correlations with the history of falls. Conclusions: The HOME FAST BRAZIL-Self-reported version presented adequate reliability for the evaluation of household environmental risks for community-dwelling older adults. Risks such as inadequate armchairs/ sofas, the absence of anti-slip mats in the shower recess, the presence of pets and inadequate beds require attention in the evaluation of household risks, due to their correlation with the occurrence of falls.

Caracterización geográfica de la exposición a fluoruros en Colombia, mediante uso de fuentes de información de vigilancia en salud pública, durante 2012 ­ 2018 / Geographic characterization of fluorides exposure in Colombia, using public health surveillance information sources, during 2012 ­ 2018

Objetivo: caracterizar geográficamente, en territorio colombiano, las fuentes de agua potable y los índices colectivos de fluorosis dental que indican exposición a fluoruro a nivel comunitario. Métodos: se realizó un estudio descriptivo a partir de dos fuentes de información: el Subsistema de Información de Vigilancia de Calidad de Agua Potable (SIVICAP) y el Sistema de Vigilancia en Salud Pública (Sivigila). Los análisis se realizaron desde 2012 hasta 2018, implementando ponderación de los riesgos por exposición a fluoruro en agua para determinar los siguientes niveles de riesgo: sin riesgo, riesgo para fluorosis dental y riesgo para fluorosis esquelética. Se cálculo el índice colectivo de fluorosis (ICF) dental y se presentaron los resultados en mapas geográficos. Resultados: los departamentos de Nariño, Boyacá, Quindío, Valle del Cauca y Cundinamarca presentaron el mayor número de muestras de agua analizadas (60,5 %); 14 presentaron concentraciones superiores a 4 ppm y 10 municipios concentraciones entre 1,01 y 4 ppm. La vigilancia centinela de la exposición a flúor mostró que 3 municipios presentaron ICF >3, lo que significa un riesgo muy grave. En cuanto al riesgo grave se encontraron 52 municipios de 21 departamentos, principalmente en la región Andina y Caribe. Nariño fue el departamento con mayor número de municipios en riesgo grave. Conclusiones: se identificaron riesgos ambientales en agua, y biológicos por altos índices colectivos de fluorosis dental, que, espacialmente, se ubican en la región Andina, aunque los riesgos en agua se pueden explicar porque en esta región se realiza con mayor frecuencia vigilancia de calidad del agua.

Objective: To geographically characterize in colombian territory, drinking water sources and the collective indices of dental fluorosis which indicate fluoride exposure at the community level. Methods: A descriptive study was carried out from two sources of information: the drinking water quality surveillance information subsystem (SIVICAP) and the public health surveillance system (Sivigila). The analyzes were performed from 2012 to 2018, weighting the risks for exposure to fluoride in water, to determine the following risk levels: no risk, dental fluorosis risk and risk for skeletal fluorosis. The collective dental fluorosis index (ICF) was calculated, the results were represented on geographical maps. Results: the departments of Nariño, Boyacá, Quindío, Valle del Cauca and Cundinamarca presented the highest number of water samples (60.5%). 14 municipalities had concentrations above 4 ppm, and 10 municipalities had concentrations between 1.01 and 4 ppm. Sentinel surveillance of fluoride exposure showed that three municipalities presented ICF> 3, meaning a very serious risk. Regarding serious risk, 52 municipalities from 21 departments were found, mainly in the Andean and Caribbean region. Nariño was the department with the highest number of municipalities at serious risk. Conclusions: environmental risks in water and biological risks were identified due to high collective indices of dental fluorosis, which are spatially located in the Andean region. The risks in water can be explained because in this region water quality surveillance is carried out more frequently.

Intensidade de ruídos e conscientização da equipe de enfermagem no centro de materiais e esterilização / Noise intensity and raising awareness of the nursing team at the Materials and Sterilization Center / Intensidad de ruido y conciencia del personal de enfermería del Centro de Materiales y Esterilización

Objetivo: Identificar a intensidade sonora, por meio de decibéis (dB), no Centro de Material e Esterilização (CME) e orientar os colaboradores quanto à importância dos protetores auriculares como equipamento de proteção individual (EPI). Método: Trata-se de um estudo descritivo, do tipo relato de experiência. Utilizou-se o aplicativo Sound Meter para medir a intensidade de ruído no CME. A pesquisa foi realizada em hospital de grande porte de São Paulo, no período de uma semana, em 2018. Resultados: Os ruídos mais intensos foram mensurados no expurgo (93,0 dB), na área de preparo (92,3 dB), nas áreas de esterilização a baixa temperatura (91,6 dB) e a vapor (87,9 dB), diferentemente da percepção dos colaboradores. A conscientização da equipe deu-se por exposição dos resultados mensurados e discussão sobre importância do EPI. Conclusão: Verificaram-se ruídos mais intensos nas áreas de trabalho com maior número de maquinários, e houve divergência entre a intensidade do ruído mensurado e o percebido pelo profissional. Medidas educativas reflexivas são necessárias para a conscientização sobre a importância e adesão ao uso do EPI.

Objective: To identify the sound intensity, through decibels (dB), in the Materials and Sterilization Center (MSC) and to guide employees on the importance of ear protectors as personal protective equipment (PPE). Method: This is a descriptive and case report study. Sound Meter application was used to measure noise intensity in the MSC. Research was carried out in a large hospital in São Paulo City, for one week, in 2018. Results: The most intense noises were measured in the purge (93.0 dB), in the preparation area (92.3 dB), in sterilization areas at low temperature (91.6 dB), and steam sterilization (87.9 dB) different from the perception of collaborators. The team's awareness was based on the exposure of the measured results and discussion about the importance of PPE. Conclusion: There were more intense noises in the work areas with a higher number of machinery, and there was a divergence between the intensity of noise measured and that perceived by the professional. Reflective educational measures are needed to raise awareness about the importance of adhering to PPE.

Objetivo: Identificar la intensidad sonora, mediante decibeles (dB), en el Centro de Material y Esterilización (CME) y orientar a los empleados sobre la importancia de los protectores auditivos como equipo de protección personal (EPP). Método: Se trata de un estudio descriptivo, del tipo informe de caso, La aplicación Sound Meter fue utilizada para medir la intensidad del ruido en el CME. La investigación se llevó a cabo en un gran hospital de São Paulo, durante una semana, en 2018. Resultados: Los ruidos más fuertes se midieron en la purga (93,0 dB), em el área de preparación (92,3 dB), en las áreas de esterilización a baja temperatura (91,6 dB) y vapor (87,9 dB), diferente a la percepción de los empleados. El equipo tomó conciencia al exponer los resultados medidos y discutir la importancia del EPI. Conclusión: Hubo ruido más intenso en las áreas de trabajo con mayor número de máquinas y hubo divergencia entre la intensidad del ruido medido y el percibido por el profesional. Las medidas educativas reflexivas son necesarias para sensibilizar sobre la importancia y adherencia al uso del EPI.

Agregación familiar en individuos con hipertensión arterial esencial y factores de riesgo / Family Aggregation in Individuals with Essential Arterial Hypertension and Risk Factors

RESUMEN Fundamento: la hipertensión arterial es la elevación constante de las cifras de tensión arterial con un origen poligénico y mutifactorial. Es la hipertensión arterial una enfermedad de alta incidencia y prevalencia a nivel mundial. Objetivo: demostrar la agregación familiar para hipertensión arterial esencial y factores de riesgo en individuos afectados. Método: se realizó una investigación observacional, analítica, longitudinal y retrospectiva, de caso/ control a partir de la consulta de referencia para enfermedades crónicas no transmisibles en Banes, provincia Holguín durante el período octubre 2019 marzo 2020. El universo abarcó la totalidad de individuos diagnosticados y sus familias. Por muestreo aleatorio simple, se obtuvo la muestra de 91 casos. Se conformó el grupo control a razón de 3:1 que incluyó 273 individuos. Fueron cumplidos los requisitos bioéticos. Se aplicaron criterios de inclusión/exclusión. Fueron utilizados los estadígrafos: Chi cuadrado, Odd Ratio (OR), incluidos p e intervalo de confianza. Se operacionalizaron las variables: edad, sexo, grado de consanguinidad y factores de riesgo. Se obtuvo el árbol genealógico. Resultados: los grupos de edades 56-65 años y 66 años y más, resultaron los más afectados. Predominó el sexo masculino (53,9 %). Los familiares de primer y segundo grado de consanguinidad mostraron la mayor incidencia de la enfermedad. Se encontró asociación entre la enfermedad y el antecedente familiar de esta (X2=321,4), con un riesgo incrementado para los familiares de los casos respecto a los controles (OR=10,93). Los factores de riesgo predominantes fueron: tabaquismo (OR=2,18) y el antecedente familiar de enfermedad (OR=0,74). Se demostró la asociación de factores de riesgo con la enfermedad (X2=176,9). Conclusiones: la hipertensión arterial esencial es una enfermedad multifactorial, compleja y poligénica con agregación familiar demostrada.

ABSTRACT Background: arterial hypertension is the constant elevation of blood pressure figures with a polygenic and multifactorial origin. Hypertension is a disease of high incidence and prevalence worldwide. Objective: to demonstrate the familial aggregation for essential arterial hypertension and risk factors in affected individuals. Method: an observational, analytical, longitudinal and retrospective case / control investigation was carried out from the reference consultation for chronic non-communicable diseases in Banes, Holguín province during the period from October 2019 to March 2020. The universe covered all individuals diagnosed and their families. By simple random sampling, the sample of 91 cases was obtained. The control group was formed at a ratio of 3:1 which included 273 individuals. Bioethical requirements were met. Inclusion / exclusion criteria were applied. The following statistics were used: Chi square, Odd Ratio (OR), including p and confidence interval. The variables were operationalized: age, sex, degree of consanguinity, and risk factors. The genealogical tree was obtained. Results: the age groups 56-65 years and 66 years and over, were the most affected. The male sex predominated (53.9 %). First and second-degree relatives of consanguinity showed the highest incidence of the disease. An association was found between the disease and its family history (X2 = 321.4) with an increased risk for relatives of the cases compared to the controls (OR = 10.93). The predominant risk factors were: smoking (OR = 2.18) and family history of disease (OR = 0.74). The association of risk factors with the disease was demonstrated (X2 = 176.9). Conclusions: essential arterial hypertension is a multifactorial, complex and polygenic disease with demonstrated familial aggregation.

Agregación familiar y factores de riesgo de cáncer de mama en individuos afectados / Family Aggregation and Risk Factors for Breast Cancer in Affected Individuals

RESUMEN Fundamento el cáncer de mama es una enfermedad sistémica, multifactorial, polimorfa que se desarrolla en mujeres sin antecedentes familiares de la enfermedad. La posibilidad de herencia familiar se describe en 15-20 % de los casos. Objetivo: determinar la agregación familiar para cáncer de mama y los factores de riesgo asociados a este padecimiento. Método: se realizó un estudio analítico, retrospectivo, tipo caso y control, a partir de individuos que acudieron a la consulta municipal de riesgo genético, ubicada en el Policlínico Universitario César Fornet Frutos del municipio Banes, provincia Holguín en el período julio-diciembre de 2019 con el objetivo de comprobar la existencia o no de agregación familiar del cáncer de mama. Por muestreo aleatorio simple, se obtuvo la muestra conformada por 47 casos y 141 controles. Las variables operacionalizadas fueron: antecedentes personales y familiares de enfermedad oncológica, edad, menarquia, edad a la menopausia, ingestión de píldora anticonceptiva, edad de nacimiento de primer hijo, lactancia materna, ingestión de alcohol, hábito de fumar, historia familiar. Se aplicó un cuestionario diseñado a los fines del estudio. El cálculo de Chi cuadrado y Odds Ratio permitieron estimar asociación entre variables y la magnitud de asociación. Resultados: predominó el grupo de edad de 60-69 años. Los factores de riesgo hábito de fumar (OR=4,1), la ingestión de píldora anticonceptiva (OR=3,1), y el alcohol (OR=2,8) presentaron la mayor asociación a la enfermedad. Se propuso una estrategia de asesoramiento genético a partir de los resultados. Conclusiones: la confluencia de factores genéticos y ambientales, determina la agregación familiar del cáncer de mama.

ABSTRACT Foundation: breast cancer is a systemic, multifactorial, polymorphic disease that develops in women with no family history of the disease. The possibility of family inheritance is described in 15-20 % of cases. Objective: to determine the family aggregation for breast cancer and the risk factors associated with this disease. Method: an analytical, retrospective, case-control type study was carried out, from individuals who attended the municipal genetic risk consultation located at the César Fornet Frutos University Polyclinic, Banes municipality, Holguín province in the period July-December 2019 aimed at verifying the existence or not of family aggregation of breast cancer. By simple random sampling, the sample consisting of 47 cases and 141 controls was obtained. The sample, consisting of 47 cases and 141 controls, was obtained by simple random sampling. The variables were: personal and family history of oncological disease, age, menarche, age at menopause, contraceptive pill ingestion, first child age of birth, breastfeeding, alcohol intake, smoking, family history. A questionnaire designed for the purposes of the study was applied. The Chi square calculation and Odds Ratio allowed estimating association between variables and the magnitude of association. Results: the age group of 60-69 years prevailed. The risk factors for smoking (OR = 4.1), ingestion of the contraceptive pill (OR = 3.1), and alcohol (OR = 2.8) had the highest association with the disease. A genetic counseling strategy was proposed based on the results. Conclusions: confluence of genetic and environmental factors determines family aggregation of breast cancer.

The HOME FAST BRAZIL self-report version: translation and transcultural adaptation into Brazilian Portuguese.

OBJECTIVE: To translate and cross-culturally adapt the Home Falls and Accidents Screening Tool Self-report into Brazilian Portuguese and to correlate with the history of falls. METHODS: The translation and transcultural adaptation process followed international parameters. The Home Falls and Accidents Screening Tool Brazil Self-report, the Mini-Mental State Examination and the history of falls were applied to 10 elderly in the pre-test and to 41 in the final. Demographic and anthropometric data were also evaluated. Spearman correlation coefficient was performed. RESULTS: The participants considered the questionnaire easy to understand and did not report any doubts to answer the final version. There was significant correlation between: Home Falls and Accidents Screening Tool Brazil Self-report score and number of falls (ρ = 0.31, p = 0.02) and the lighting and bathroom domains with presence of falls at home (ρ = 0.44, p = 0.00 and ρ = 0.33, p = 0.02, respectively). The questionnaire indicated fall's risk scoring, 10(±2). CONCLUSION: The Home Falls and Accidents Screening Tool Brazil Self-report showed to be comprehensible and feasible tool for self-assessment of domiciliary falls risk in Brazilian older people. The scores indicated fall's risk and were associated with the history of falls.

The Brazilian version of the Home Falls and Accidents Screening Tool (HOME FAST): translation, cross-cultural adaptation, validation and reliability / Versão brasileira do Home Falls and Accidents Screening Tool (HOME FAST): tradução, adaptação transcultural, validação e confiabilidade

Abstract Objective: to translate and cross-culturally adapt the Home Falls and Accidents Screening Tool - HOME FAST into Brazilian Portuguese and to evaluate its construct validity and intra-and inter-rater reliability. Method: a cross-sectional study was carried out that included older people aged 60 years or older. Translation and cross-cultural adaptation were carried out in the following stages: 1. Translation, 2. Synthesis, 3. Back translation, 4. Expert panel (review and pre-final version), 5. Pre-testing, 6. Analysis by the expert panel and the final version of the instrument. The Berg Balance Scale - BBS was used to test construct validity (Spearman correlation coefficient). Additionally, intra-and inter-rater reliability analysis was conducted using the Intraclass Correlation Coefficient (ICC) and the Bland-Altman plot. Results were considered significant at p<0.05. Results: the HOME FAST-Brazil was applied to 53 older people with a mean age of 71(5) years; 79% (42) of whom were female and 21% (11) of whom were male. The translation and cross-cultural adaptation process resulted in similar versions among translations. The correlation of the total score of HOME FAST-Brazil with the BBS was ρ=-0.241, p=0.041. The reliability rate was ICC=0.99 and 0.92 (intra-and inter-rater, respectively). Conclusion: The HOME FAST-Brazil, translated and cross-culturally adapted to Brazilian Portuguese, was shown to have construct validity and excellent intra-and inter-rater reliability.

Resumo Objetivo: traduzir e adaptar transculturalmente o Home Falls and Accidents Screening Tool - HOME FAST para o português brasileiro e avaliar sua validade de construto e confiabilidade intra e inter avaliador. Método: Trata-se de um estudo transversal que incluiu idosos com idade igual ou superior a 60 anos. O processo para a tradução e adaptação transcultural seguiu as etapas: 1. Tradução, 2. Síntese, 3. Retrotradução, 4. Comitê de especialistas (revisão e versão pré-final), 5. Pré-teste, 6. Análise pelo comitê de especialistas e versão final do instrumento. A Escala de Equilíbrio de Berg - EEB foi usada para testar a validade de construto (Coeficiente de Correlação de Spearman). Adicionalmente, para análise da confiabilidade intra e inter avaliador foi utilizado o Coeficiente de Correlação Intraclasse (CCI) e o diagrama de Bland-Altman. Os resultados foram considerados significativos quando p<0,05. Resultados: O HOME FAST-Brasil foi aplicado em 53 idosos com média de idade de 71(5) anos, sendo 79% (42) mulheres e 21% (11) homens. O processo de tradução e adaptação transcultural resultou em versões similares entre as traduções. A correlação entre a pontuação total do HOME FAST-Brasil com a EEB foi ρ=-0,241, p=0,041. Os valores dos testes de confiabilidade foram CCI=0,99 e 0,92 (intra e inter avaliador, respectivamente). Conclusão: O HOME FAST-Brasil, traduzido e adaptado transculturalmente para o português brasileiro, apresentou validade de construto e excelente confiabilidade inter e intra-avaliador.

The HOME FAST BRAZIL self-report version: translation and transcultural adaptation into Brazilian Portuguese

Abstract Objective: To translate and cross-culturally adapt the Home Falls and Accidents Screening Tool Self-report Into Brazilian Portuguese and to correlate with the history of falls. Methods: The translation and transcultural adaptation process followed international parameters. The Home Falls and Accidents Screening Tool Brazil Self-report, the Mini-Mental State Examination and the history of falls were applied to 10 elderly in the pre-test and to 41 in the final. Demographic and anthropometric data were also evaluated. Spearman correlation coefficient was performed. Results: The participants considered the questionnaire easy to understand and did not report any doubts to answer the final version. There was significant correlation between: Home Falls and Accidents Screening Tool Brazil Self-report score and number of falls (p = 0.31, p = 0.02) and the lighting and bathroom domains with presence of falls at home (p = 0.44, p = 0.00 and p = 0.33, p = 0.02, respectively). The questionnaire indicated fall's risk scoring, 10(±2). Conclusion: The Home Falls and Accidents Screening Tool Brazil Self-report showed to be comprehensible and feasible tool for self-assessment of domiciliary falls risk in Brazilian older people. The scores indicated fall's risk and were associated with the history of falls.(AU)

Greener synthesis of chemical compounds and materials.

Modern trends in the greener synthesis and fabrication of inorganic, organic and coordination compounds, materials, nanomaterials, hybrids and nanocomposites are discussed. Green chemistry deals with synthesis procedures according to its classic 12 principles, contributing to the sustainability of chemical processes, energy savings, lesser toxicity of reagents and final products, lesser damage to the environment and human health, decreasing the risk of global overheating, and more rational use of natural resources and agricultural wastes. Greener techniques have been applied to synthesize both well-known chemical compounds by more sustainable routes and completely new materials. A range of nanosized materials and composites can be produced by greener routes, including nanoparticles of metals, non-metals, their oxides and salts, aerogels or quantum dots. At the same time, such classic materials as cement, ceramics, adsorbents, polymers, bioplastics and biocomposites can be improved or obtained by cleaner processes. Several non-contaminating physical methods, such as microwave heating, ultrasound-assisted and hydrothermal processes or ball milling, frequently in combination with the use of natural precursors, are of major importance in the greener synthesis, as well as solventless and biosynthesis techniques. Non-hazardous solvents including ionic liquids, use of plant extracts, fungi, yeasts, bacteria and viruses are also discussed in relation with materials fabrication. Availability, necessity and profitability of scaling up green processes are discussed.

Soil Contamination by a Lead Smelter in Brazil in the View of the Local Residents.

A primary lead smelter operated in Santo Amaro City in Brazil from 1960 to 1993, leaving approximately 500,000 tons of industrial dross containing 2⁻3% of lead and other toxic elements that contaminated the industry grounds and the urban environment. This study aimed to present the local residents' perception towards soil contamination by the smelter. In a cross-sectional study, 208 residents from randomly selected households were interviewed about dross hazards and proposals for its management. A city map depicts the distribution and concentration of lead, cadmium, arsenic, zinc, nickel, and antimony, measured in the soil of the 39 households with visible smelter dross. Only one site complies with the soil quality reference values; 27 (69.2%) call for preventive measures, and 11 (28.2%) require intervention. The smelter dross continues widely spread over the city. Thirty (76.9%) out of the 39 residents were able to recognize the smelter dross on household surroundings. However, this ability was not associated with the concentrations of toxic elements in the soil of their residences and surroundings. The smelter and the local Prefecture were most frequently held liable for taking soil cleanup actions. The most frequently (38.0%) cited solution for managing the dross found in the households was "to provide the residents with information about health risks related to the dross".

Maternidade de adolescentes de periferias sociais e urbanas: algumas análises à luz da Psicologia Ambiental / Motherhood among poor teenagers belonging to social and urban outskirts: analysis under the light of environmental psychology

Esse artigo apresenta reflexões sobre a procriação de adolescentes de periferias sociais e urbanas de duas grandes cidades do Estado de São Paulo (BR), Santos e Santo André, baseando-se em conceitos da Psicologia Ambiental, a partir de três estudos realizados anteriormente com adolescentes grávidas e mães pobres. Naquelas condições sócio-ambientais, a gravidez pareceu diretamente associada a carências advindas de modelos que apresentam necessidades que aquelas adolescentes não podiam prover. A procriação de adolescentes pobres numa sociedade globalizada, com desafios de busca de uma forma de desenvolvimento que seja sustentável, é entendida como um fenômeno psicossocial, que deve ser tratado de forma interdisciplinar, uma vez que alcança âmbitos maiores, de ordem ética e política.(AU)

This paper presents considerations, based on concepts of environmental psychology, about breeding of poor teenagers belonging to the urban outskirts of large cities from the state of São Paulo, Brazil. Under these environmental and social conditions, pregnancy seems to be directly associated with lacks existing in the current models, which present needs that cannot be fulfilled by these teenagers. The breeding of poor teenagers in a globalized society, with the challenge of searching for a form of self-supported development, is understood as a psychosocial phenomenon, which must be handled with an inter-disciplinary approach, since it reaches larger realms, such as ethics and politics.(AU)