Test-Retest Reliability, Clinical Usefulness, and Telephone Application of the Work Limitation Questionnaire in Individuals Who Returned to Work After Stroke.

PURPOSES: To measure the test-retest reliability and the clinical usefulness of the Work Limitation Questionnaire, and to compare the in-person with the telephone application. METHODS: Cross-sectional, exploratory study. The Work Limitation Questionnaire was answered three times: twice in person, to measure test-retest reliability and clinical usefulness, and once, by telephone, to measure the validity of the telephone application. RESULTS: Fifty-six individuals (32 men) with mild to moderate disabilities after stroke were included. Test-retest reliability was very high (ICC 0.96; 95% CI 0.94 to 0.98; p < 0.01), the clinical usefulness was high (9 out of 12 points), and the correlation between in-person and telephone applications was high (ρ = 0.7; 95% CI 0.5 to 0.9; p < 0.01). The average productivity loss was 4% (SD 5, min-max 0 to 15%). CONCLUSIONS: The Work Limitation Questionnaire showed adequate test-retest reliability and clinical usefulness in individuals with stroke. The telephone application produced comparable results to in-person applications. The participants reported low productivity loss, which may be related to the mild impairments of the included sample.

Occupational accidents in mining workers: scoping review of studies published in the last 13 years.

OBJECTIVE: Mining activity represents one of the most hazardous occupations related to health, with 8% of fatal injuries concentrated in this sector worldwide. Thus, it is crucial to timely identify the factors involved in such injuries. We aimed to explore the sociodemographic and occupational/organisational factors associated with injuries, causative agents and subsequent disabilities and fatality of workers exposed to occupational injuries in the mining sector. DESIGN: A secondary scoping review was conducted following the Joanna Briggs Institute guidelines. DATA SOURCES: Scopus, Embase, Virtual Health Library, SciELO and PubMed databases were searched in February 2022 and updated in October 2023. The protocol was developed in April 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included observational studies published within the last 13 years (2010-2022) which provided information on injuries of the mining workers and reported associated factors as well as health consequences. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers examined the eligibility criteria, screened and coded the extracted information using prevalidated data extraction tools, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews reporting guidelines. RESULTS: A total of 123 studies were found, of which nine were selected for inclusion in this review. Participants were between 15 and 80 years old, and the rate of injuries ranged from 4.4% to 10.6% of reported cases. Among the total selected studies, mechanical agents were identified as the leading cause of injuries in six studies. The factors associated with injuries included age, gender (female) and biochemical characteristics. On the other hand, occupational and organisational factors encompassed work shift, outsourcing (contractors) and less than 2 years of experience in the sector. CONCLUSION: This review emphasises that both work-related and individual characteristics are significantly related factors of injuries. Moreover, commonly reported health consequences of injuries encompass mortality, average days lost and permanent, partial or total disability.

Tendência temporal de internação por queimadura, na faixa etária 0-14 anos, no Brasil, 2012-2022 / Time trend of hospitalization due to burn, in the age group of 0-14 years, in Brazil, 2012-20

Introdução: Queimaduras são lesões teciduais causadas pelo contato com fontes de calor. Representam um problema de saúde pública global. Em crianças causam grandes impactos. A gravidade e intensidade das queimaduras estão relacionadas ao agente etiológico e suas consequências são um grande obstáculo para o paciente. Método: O estudo analisou dados de internações hospitalares por queimaduras em crianças de 2012 a 2022, utilizando informações do SIH-SUS. Foram calculadas taxas de internações por 100.000 habitantes para cada ano, considerando variáveis dependentes. Os pesquisadores utilizaram coeficientes padronizados e regressão linear simples para analisar os dados. Resultados: Incluíram-se dados de 91.091 internações por queimaduras em crianças, 0-14 anos. Verificou-se estabilidade na taxa geral de internações (taxa média 17,963; ß=0,119; p=0,163). No sexo feminino houve tendência de aumento (taxa média 14,346; ß=0,169; p=0,029); no masculino de estabilidade (taxa média 21,426; ß=0,069; p=0,504). O sexo feminino comportou-se com estabilidade em todas as faixas etárias; o masculino com aumento na faixa 0-4 anos (taxa média 42,264; ß=0,613; p=0,003), estabilidade na faixa 5-9 anos (taxa média 14,189; ß=-0,21; p=0,867) e redução na faixa 10-14 anos (taxa média 9,871; ß= -0,328; p=0,007). A Região Sul demonstrou tendência de aumento (taxa média 26,952; ß=1,091; p=0,001). Conclusão: Houve estabilidade na taxa geral de internações. O sexo feminino tendeu ao aumento e o masculino à estabilidade. Houve estabilidade nas regiões brasileiras, exceto no Sul.

Introduction: Burns are tissue injuries caused by contact with heat sources. They represent a global public health problem. They have major impacts on children. The severity and intensity of burns are related to the etiological agent and their consequences are a major obstacle for the patient. Method: The study analyzed data on hospital admissions for burns in children from 2012 to 2022, using information from SIH-SUS. Hospitalization rates per 100,000 inhabitants were calculated for each year, considering dependent variables. The researchers used standardized coefficients and simple linear regression to analyze the data. Results: Data from 91,091 hospitalizations for burns in children, 0-14 years old, were included. There was stability in the general hospitalization rate (mean rate 17.963; ß=0.119; p=0.163). In females there was an increasing trend (mean rate 14.346; ß=0.169; p=0.029); in males, there was stability (mean rate 21.426; ß=0.069; p=0.504). Females behaved with stability in all age groups; the male with an increase in the range 0-4 years (mean rate 42.264; ß=0.613; p=0.003), stability in the range 5-9 years (mean rate 14.189; ß=-0.21; p=0.867) and reduction in the range 10-14 years (mean rate 9.871; ß= -0.328; p=0.007). The South Region demonstrated an increasing trend (mean rate 26.952; ß=1.091; p=0.001). Conclusion: There was stability in the general hospitalization rate. The female sex tended towards increase and the male towards stability. There was stability in Brazilian regions, except in the South.

Epidemiología del trauma de alta energía en Chile: análisis ecológico con registros públicos / Epidemiology of high-energy trauma in Chile: An ecological analysis using public registries

El trauma de alta energía se define como lesiones orgánicas graves resultantes de eventos que generan una gran cantidad de energía cinética, eléctrica o térmica. Constituye una importante preocupación de salud pública, representando el 10% de la mortalidad mundial. El objetivo de este artículo es describir la epidemiología del trauma de alta energía en Chile. Específicamente, se busca comparar la tasa de mortalidad por 100 000 habitantes entre los países miembros de la Organización Mundial de la Salud (OMS), realizar un análisis descriptivo de las notificaciones por Garantías Explícitas en Salud (GES) del problema de salud "politraumatizado", y analizar la tendencia de la tasa de fallecidos por causa externa en Chile. El presente estudio tiene un diseño ecológico, utilizando tres bases de datos de acceso abierto. Primero, se utilizó la base de datos de la OMS sobre fallecidos por accidentes automovilísticos en 2019. Luego, se consultó la base de datos del programa Garantías Explícitas en Salud para el problema "politraumatizado" entre los años 2018 y 2022. Finalmente, se utilizó la base de datos del Departamento de Estadísticas de Salud de Chile sobre causas de muerte entre 1997 y 2020. En 2019, Chile ocupó una posición intermedia en cuanto a la tasa de mortalidad por 100 000 habitantes debido a accidentes de tráfico. Las notificaciones el programa Garantías Explícitas en Salud por politraumatismo fueron predominantemente en hombres de entre 20 y 40 años, afiliados al sistema de salud pública. Por este motivo, el foco principal de prevención debe centrarse en este grupo. La mortalidad por accidentes mostró una tendencia decreciente, identificándose cambios estructurales significativos en los años 2000 y 2007.

High-energy trauma is defined as severe organic injuries resulting from events that generate a large amount of kinetic, electrical, or thermal energy. It represents a significant public health concern, accounting for 10% of global mortality. This article aims to describe the epidemiology of high-energy trauma in Chile. Specifically, it seeks to compare the mortality rate per 100 000 inhabitants among member countries of the World Health Organization (WHO), provide a descriptive analysis of notifications under the Explicit Health Guarantees (GES) for the health issue of polytraumatized patients, and analyze the trend in the mortality rate due to external causes in Chile. This study employs an ecological design using three open-access databases. First, the WHO database on deaths from traffic accidents in 2019 was used. Then, the GES database was consulted for the "Polytraumatized" issue between 2018 and 2022. Finally, the Chilean Department of Health Statistics database on causes of death between 1997 and 2020 was utilized. In 2019, Chile ranked in the middle regarding the mortality rate per 100 000 inhabitants due to traffic accidents. GES notifications for polytrauma predominantly involved men aged 20 to 40 years and those affiliated with the public health system, highlighting a primary focus for prevention efforts. Mortality from accidents showed a decreasing trend, with significant structural changes identified in 2000 and 2007.

Snakebites by venomous snakes in Brazilian serpentaria and zoos over a 10-year period (2012-2021).

Despite the wide range of institutions that maintain venomous snakes in captivity in Brazil there are no comprehensive data on the occurrence of snakebites and envenomations in these places. We examined the range of native and exotic species of venomous snakes kept by Brazilian zoos and serpentaria (scientific and commercial) and assessed the frequency of snakebites in workers handling these snakes during a 10-year period (2012-2021). Twenty-two (73.3%) of 30 institutions returned a standard questionnaire, including 15 serpentaria and 7 zoos that together kept 10,607 venomous snakes in 2022/2023. Commercial and scientific serpentaria had many more snakes (n = 10,550, consisting of 10,499 native specimens and 51 exotic specimens) than zoos (n = 57 native specimens), with two genera accounting for the majority of native species (Bothrops spp. = 84.5% and Crotalus durissus ssp. = 13.5%). Thirty-seven snakebites were reported and involved primarily the hands (33), seven of which occurred during venom extraction and 30 in other circumstances, most of them while handling/manipulating the cages or snake boxes (10) and restraining (9) or feeding (5) the snake. In addition, there were two cases of venom accidently sprayed on the face, including the eyes. Most bites were caused by Bothrops spp. (31), followed by C. durissus ssp. (4), Lachesis muta (1) and Micrurus corallinus (1). Thirty-three bites (89.2%) were treated with antivenom, with four bites to the fingers by Bothrops spp. resulting in local functional sequelae. There were 366,918 venom extractions with a ratio of 1.9 bites/100,000 extractions; no bites were recorded in the six institutions that sedated the snakes prior to venom extraction, which accounted for 22.7% of all extractions. These findings show that although snakebites are rare in Brazilian zoos and serpentaria, severe envenomation may occur. The occurrence of snakebites could be reduced by measures such as sedation of the snakes before venom extraction.

A Falls Prevention Program for People After Stroke in Guyana: An International Collaboration.

OBJECTIVE: The objective was to describe the social, environmental, and cultural adaptations to an existing falls program and assess acceptability and preliminary effectiveness of the program in reducing fear, reducing falls, and improving function among individuals poststroke in Guyana. METHODS: A quasi-experimental pilot study with a pretest/posttest in-group design was developed through a collaboration of researchers in Guyana and the US. Participants took part in the falls prevention program for 8 weeks. Outcome measures included a 10-m walk test, the Five Times Sit to Stand Test, and subjective questionnaires for falls incidence and balance confidence at the beginning and end. RESULTS: Twenty participants completed the study. One participant experienced medical complications, and their data were excluded from analysis. Fifteen participants (78.9%) demonstrated improvements in comfortable and fast walking speed. Twelve participants completed the Five Times Sit to Stand Test. Eleven (91.67%) improved their time at the posttest, with 9 (81.8%) demonstrating a clinically important improvement. Nineteen participants had sustained at least 1 fall prior to the study. Only 1 participant reported a fall during the program. Initially, the majority of participants (11/19) were very concerned about falling. At the end, only 1 was very concerned about falling, and the majority (15/19) were not concerned at all. Posttest surveys of participants indicated acceptability of the program. CONCLUSIONS: This pilot program helped reduce fall risk and improve confidence, gait speed, and community mobility of the study participants. Future research at other rehabilitation departments in Guyana would help increase the generalizability of the program. IMPACT: The program can be used clinically by physical therapists in Guyana, both in departments and as a home program. Shared knowledge and experience of researchers considering research evidence and the environmental, social, and economic conditions of people living in Guyana were important in developing an effective program.

Epidemiology of high-energy trauma in Chile: An ecological analysis using public registries. / Epidemiología del trauma de alta energía en Chile: análisis ecológico con registros públicos.

High-energy trauma is defined as severe organic injuries resulting from events that generate a large amount of kinetic, electrical, or thermal energy. It represents a significant public health concern, accounting for 10% of global mortality. This article aims to describe the epidemiology of high-energy trauma in Chile. Specifically, it seeks to compare the mortality rate per 100 000 inhabitants among member countries of the World Health Organization (WHO), provide a descriptive analysis of notifications under the Explicit Health Guarantees (GES) for the health issue of polytraumatized patients, and analyze the trend in the mortality rate due to external causes in Chile. This study employs an ecological design using three open-access databases. First, the WHO database on deaths from traffic accidents in 2019 was used. Then, the GES database was consulted for the "Polytraumatized" issue between 2018 and 2022. Finally, the Chilean Department of Health Statistics database on causes of death between 1997 and 2020 was utilized. In 2019, Chile ranked in the middle regarding the mortality rate per 100 000 inhabitants due to traffic accidents. GES notifications for polytrauma predominantly involved men aged 20 to 40 years and those affiliated with the public health system, highlighting a primary focus for prevention efforts. Mortality from accidents showed a decreasing trend, with significant structural changes identified in 2000 and 2007.

El trauma de alta energía se define como lesiones orgánicas graves resultantes de eventos que generan una gran cantidad de energía cinética, eléctrica o térmica. Constituye una importante preocupación de salud pública, representando el 10% de la mortalidad mundial. El objetivo de este artículo es describir la epidemiología del trauma de alta energía en Chile. Específicamente, se busca comparar la tasa de mortalidad por 100 000 habitantes entre los países miembros de la Organización Mundial de la Salud (OMS), realizar un análisis descriptivo de las notificaciones por Garantías Explícitas en Salud (GES) del problema de salud "politraumatizado", y analizar la tendencia de la tasa de fallecidos por causa externa en Chile. El presente estudio tiene un diseño ecológico, utilizando tres bases de datos de acceso abierto. Primero, se utilizó la base de datos de la OMS sobre fallecidos por accidentes automovilísticos en 2019. Luego, se consultó la base de datos del programa Garantías Explícitas en Salud para el problema "politraumatizado" entre los años 2018 y 2022. Finalmente, se utilizó la base de datos del Departamento de Estadísticas de Salud de Chile sobre causas de muerte entre 1997 y 2020. En 2019, Chile ocupó una posición intermedia en cuanto a la tasa de mortalidad por 100 000 habitantes debido a accidentes de tráfico. Las notificaciones el programa Garantías Explícitas en Salud por politraumatismo fueron predominantemente en hombres de entre 20 y 40 años, afiliados al sistema de salud pública. Por este motivo, el foco principal de prevención debe centrarse en este grupo. La mortalidad por accidentes mostró una tendencia decreciente, identificándose cambios estructurales significativos en los años 2000 y 2007.

Faith healing: the threat of "Surucucu" and the local cure of Amazon floodplain dwellers.

BACKGROUND: Snakebites are considered a neglected tropical disease responsible for many accidents, some fatal, and are related to poverty. The Brazilian Amazon has the highest incidence of snakebites per inhabitant, with the state of Pará having the most reported cases. For those who have difficult access to hospitals and pharmacies, this issue is even more urgent. METHODS: In this research, we worked together with the population of five riverine communities in Aritapera (Santarém-PA), a fluvial island located in the Lower Amazon floodplain (várzeas), in order to identify the species of venomous snakes and create a record of snakebites in the region and treatments carried out. RESULTS: Dwellers reported a high frequency of encounters throughout the year and mentioned five venomous ethnospecies, although we identified only Bothrops atrox. Approximately 28.7% of the participants had already been bitten, and in 15.8% of the interviews, they mentioned deaths from snakebites. The treatments varied between hospitalization (42.8%), home treatments (23.8%), both together (25.4%) and healers (7.9%). There were cases where no treatment, or just religious treatment, was performed. In general, no serious sequelae were reported. Although home treatments were more common in the past, many people maintained the practice of using them before going to the hospital. Among the most used are Pau X and the fat of the Amazon River Dolphin. The latter appears to be a recent discovery by locals and is considered very efficient both for humans and animals. CONCLUSION: Difficult access to health centers, a lack of energy to store antivenom and a high rate of encounters with snake place Aritapera dwellers in a vulnerable situation regarding snakebite accidents. In this context, they discovered treatments that improved their well-being until hospitalization. As the Amazon River dolphin is an endangered species, the use of its fat requires attention. In this sense, the dissemination of this knowledge is important to encourage studies that investigate which properties of this fat act as counterpoisons. By discovering substitutes that can be incorporated in other rural and remote communities, an economic and ecologically viable option for the health of residents can be promoted, in addition to valuing traditional knowledge.

Effectiveness of Virtual Reality in Occupational Therapy for Post-Stroke Adults: A Systematic Review.

Background: In recent years, there has been a growing use of technological advancements to enhance the rehabilitation of individuals who have suffered from cerebrovascular accidents. Virtual reality rehabilitation programs enable patients to engage in a customized therapy program while interacting with a computer-generated environment. Therefore, our goal was to investigate the effectiveness of virtual reality in occupational therapy for people's rehabilitation after a cerebrovascular accident. Methods: We systematically searched databases (Pubmed/Medline, Scopus, Web of Science, and Science Direct) for randomized controlled trials published within the last 10 years. Studies involving adult stroke survivors undergoing virtual reality-based interventions aimed at improving upper-extremity motor function were included. The quality assessment followed PRISMA guidelines, with the risk of bias assessed using the Cochrane tool (version 6.4) and methodological quality evaluated using GRADEpro. Results: We selected sixteen studies that met the main criteria for the implementation of virtual reality technology. The interventions described in the articles focused mainly on the upper extremities and their fine motor skills. Conclusions: When used in conventional treatments to improve people's motor and cognitive functions after a cerebrovascular accident, virtual reality emerges as a beneficial tool. Additionally, virtual reality encourages adherence to the interventional process of rehabilitation through occupational therapy.

Entrenamiento de fuerza para prevención de caídas en personas mayores: Una revisión sistemática / Strength training to prevent falls on the elderly: A systematic review

RESUMEN Introducción: El entrenamiento de fuerza está asociado con cambios positivos hacia un envejecimiento saludable y con calidad de vida, dado que previenen las lesiones, fragilidad, así como las caídas. Objetivo: El objetivo de este estudio fue evaluar la evidencia científica disponible sobre los efectos del entrenamiento de fuerza en la prevención de caídas en personas mayores. Metodología: Se realizó una búsqueda de artículos científicos en las bases de datos Medline vía PubMed, Web of Science (WOS) y Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) vía Biblioteca Virtual de Salud (BVS) que cumplieran con los criterios de elegibilidad; el análisis se realizó entre el 8 de mayo de 2022 hasta el 11 de octubre de 2022. Resultados: Se seleccionaron 10 artículos; el promedio de edad fue de 75,3 años; en el 90 % de los artículos predominó el sexo femenino. Con respecto a los programas, el 70 % duró 60 minutos y en el 50% predominó ejercicios principalmente de miembros inferiores, y el 60 % de los artículos usó el Timed Up and Go para evaluar sus programas. La totalidad de los artículos demuestran que el entrenamiento de fuerza redujo el riesgo de caídas a corto plazo. Conclusión: Las principales conclusiones apuntan a un cambio favorable en la prevención de caídas a través del análisis de la fuerza, el equilibrio, la tasa de caídas, la aptitud física y/o el miedo a caer tras realizar entrenamiento de fuerza.

ABSTRACT Introduction: Strength training is associated with positive changes towards healthy aging and quality of life since it prevents injuries, frailty, as well as falls. Objective: The objective of this study was to evaluate the available scientific evidence on the effects of strength training in the prevention of falls in the elderly. Methodology: A search for scientific articles was carried out in the databases: Medline via PubMed, Web of Science (WOS) and Latin American and Caribbean Literature in Health Sciences (LILACS) via the Virtual Health Library (VHL) that meet the the eligibility criteria, the analysis was carried out between the date of May 8, 2022 until October 11, 2022. Results: 10 articles were selected; the average age was 75.3 years; in 90 % of the articles the female sex predominated. With respect to the programs, 70 % lasted 60 minutes and in 50 % exercises mainly of the lower limbs predominated, and 60 % of the articles used Timed Up and Go to evaluate their programs. All the articles show that the training of strength reduced the risk of falls in the short term. Conclusion: The main conclusions point to a favorable change in the prevention of falls through the analysis of strength, balance, rate of falls, physical fitness and/or fear of falling after performing strength training.

Evaluación antropométrica biomédica y diseño mecánico conceptual de un sistema robótico para la rehabilitación pasiva de miembros inferiores en pacientes post-accidente cerebrovascular / Biomedical anthropometric evaluation and conceptual mechanical design of robotic system for lower limbs passive-rehabilitation on post-stroke patients

RESUMEN Antecedentes: El accidente cerebrovascular (ACV) es una de las principales causas de discapacidad permanente, ya que puede provocar lesiones cerebrales graves con secuelas físicas significativas, limitando la capacidad de realizar actividades diarias. Objetivo: Esta investigación tuvo como objetivo diseñar un sistema robótico de movimiento pasivo-continuo para la rehabilitación de miembros inferiores en pacientes adultos con ACV, mejorando así las probabilidades de recuperación de su movilidad de marcha. Metodología: Se llevó a cabo el modelado y simulación del sistema robótico mediante Diseño Asistido por Computadora (CAD), utilizando el software de ingeniería Autodesk Inventor Professional 2023. Resultados: Se obtuvieron las posiciones iniciales y finales del sistema robótico, así como la simulación de movimiento pasivo-continuo. Conclusiones: La toma de medidas precisas de un paciente maximiza la posibilidad de implementar un prototipo funcional que contribuya en el proceso de rehabilitación.

ABSTRACT Background: Cerebrovascular accident (CVA) is one of the main causes of permanent disability, as it can cause serious brain injuries with significant physical consequences, limiting the ability to perform daily activities. Objective: This research aimed to design a robotic system of passive-continuous movement for the rehabilitation of lower limbs in adult patients with stroke, thus improving the chances of recovery of their walking mobility. Methodology: Modeling and simulation of the robotic system using Computer Aided Design (CAD), using the engineering software Autodesk Inventor Professional 2023. Results: The initial and final positions of the robotic system were obtained, as well as the simulation of passive-continuous movement. Conclusions: Taking precise measurements of a patient maximizes the possibility of implementing a functional prototype that contributes to the rehabilitation process.

Sediment source fingerprints of natural processes and anthropogenic pressures: A contribution to manage the Paraopeba River basin impacted by the B1 tailings dam collapse.

Understanding the origins of sediment transport in river systems is crucial for effective watershed management, especially after catastrophic events. This information is essential for the development of integrated strategies that guarantee water security in river basins. The present study aimed to investigate the rupture of the B1 tailings dam of the Córrego do Feijão mine, which drastically affected the Brumadinho region (Minas Gerais, Brazil). To address this issue, a confluence-based sediment fingerprinting approach was developed through the SedSAT model. Uncertainty was assessed through Monte Carlo simulations and Mean Absolute Error (MAE). Estimates of the overall average contributions of each tributary were quantified for each station and annually during the period 2019-2021. It was observed that the sampling point PT-09, closest to the dam breach, contributed to almost 80% of the Paraopeba River in 2019. Despite the dredging efforts, this percentage increased to 90% in 2020 due to the need to restore the highly degraded area. Additionally, the main tributaries contributing to sediment increase in the river are Manso River "TT-03" (almost 36%), associated with an area with a high percentage of urban land use, and Cedro stream "TT-07" (almost 71%), whose geology promotes erosion, leading to higher sediment concentration. Uncertainties arise from the limited number of available tracers, variations caused by dredging activities, and reduced data in 2020 due to the pandemic. Parameters such as land use, riparian vegetation degradation, downstream basin geology, and increased precipitation are key factors for successfully assessing tributary contributions to the Paraopeba River. The obtained results are promising for a preliminary analysis, allowing the quantification of key areas due to higher erosion and studying how this disaster affected the watershed. This information is crucial for improving decision-making, environmental governance, and the development of mitigating measures to ensure water security. This study is pioneering in evaluating this methodology in watersheds affected by environmental disasters, where restoration efforts are ongoing.

Assessing the incorporation of latent variables in the estimation of the value of a statistical life.

For many years, the economic literature has recognized the role of attitudes, beliefs, and perceptions in estimating the value of a statistical life (VSL). However, few applications have attempted to include them. This article incorporates the perceived controllability and concern about traffic and cardiorespiratory risks to estimate VSL using a hybrid choice model (HCM). The HCM allows us to include unobserved heterogeneity and improve behavioral realism explicitly. Using data from a choice experiment conducted in Santiago, Chile, we estimate a VSL of US$3.78 million for traffic risks and US$2.06 million for cardiorespiratory risks. We found that higher controllability decreases the likelihood that the respondents would be willing to pay for risk reductions in both risks. On the other hand, concern about these risks decreases the willingness to pay for traffic risk reductions but increases it for cardiorespiratory risk reductions.

A model based on PDCA and data mining approach for the prevention of occupational accidents in the plumbing activity in the construction sector.

BACKGROUND: Occupational accidents in the plumbing activity in the construction sector in developing countries have high rates of work absenteeism. The productivity of enterprises is heavily influenced by it. OBJECTIVE: To propose a model based on the Plan, Do, Check, and Act cycle and data mining for the prevention of occupational accidents in the plumbing activity in the construction sector. METHODS: This cross-sectional study was administered on a total of 200 male technical workers in plumbing. It considers biological, biomechanical, chemical, and, physical risk factors. Three data mining algorithms were compared: Logistic Regression, Naive Bayes, and Decision Trees, classifying the occurrences occupational accident. The model was validated considering 20% of the data collected, maintaining the same proportion between accidents and non-accidents. The model was applied to data collected from the last 17 years of occupational accidents in the plumbing activity in a Colombian construction company. RESULTS: The results showed that, in 90.5% of the cases, the decision tree classifier (J48) correctly identified the possible cases of occupational accidents with the biological, chemical, and, biomechanical, risk factors training variables applied in the model. CONCLUSION: The results of this study are promising in that the model is efficient in predicting the occurrence of an occupational accident in the plumbing activity in the construction sector. For the accidents identified and the associated causes, a plan of measures to mitigate the risk of occupational accidents is proposed.

Insuficiencia cardíaca secundaria a mordedura de serpiente. La visión del intensivista: Reporte de caso / Heart failure secondary to a snake bite. The intensivist's vision: Case Report

RESUMEN Antecedentes: El accidente ofídico es una enfermedad desatendida que afecta a los países tropicales. América Latina es la segunda región después de África, con mayor número de casos a nivel mundial. Su curso clínico incluye lesiones locales hasta afectaciones sistémicas como lesiones renales, hematológicas y neurológicas. Las complicaciones cardiacas son raras, especialmente en pacientes que no tienen factores de riesgo cardiovascular. Hay reportes de infarto agudo de miocardio, pero existe poca información sobre la insuficiencia cardíaca debida a Bothrops spp. Reporte de caso: Presentamos el caso de un hombre de 25 años sin factores de riesgo cardiovascular que fue admitido en la unidad de cuidados intensivos y desarrolló insuficiencia cardíaca con choque cardiogénico y fallo multiorgánico secundario a una mordedura de serpiente. Conclusiones: Aunque el curso clínico característico de un accidente ofídico bothrópico y sus manifestaciones sistémicas están principalmente relacionadas con anomalías de la coagulación, hay complicaciones cardiovasculares dentro de su presentación clínica que, aunque raras, si no se detectan prontamente y no se manejan adecuadamente, están asociadas con alta morbilidad y mortalidad.

ABSTRACT Background: Ophidic accident is a neglected disease that affects tropical countries. Latin America is the second region after Africa, with the most cases worldwide. Local lesions accompany its clinical course up to systemic affectations such as renal, hematological, and neurological lesions. Cardiac complications are rare, especially in patients who do not have cardiovascular risk factors. There are reports of acute myocardial infarction, but there is little information about heart failure due to Bothrops spp. Case report: We present the case of a 25-year-old man without cardiovascular risk factors who was admitted to the intensive care unit and developed heart failure with cardiogenic shock and multi-organ failure secondary to a snake bite. Conclusions: Although the characteristic clinical course of a bothropic ophidian accident and its systemic manifestations are mainly related to coagulation abnormalities, there are cardiovascular complications within its clinical presentation that, although rare, if not detected promptly and not adequately managed, are associated with high morbidity and mortality.

Diagrama de prevenção de quedas para pessoas idosas: revisão integrativa / Diagrama de prevención de caídas para personas mayores: revisión integradora / Fall prevention diagram for older adults: an integrative review

Resumo Objetivo Propor um diagrama de prevenção de quedas para pessoas idosas, baseado no Modelo de Promoção da Saúde de Nola Pender. Métodos A construção do diagrama foi embasada no modelo de Nola Pender e em seus elementos. Para isso, foi realizado um estudo de revisão integrativa, com o objetivo de coletar dados sobre características e experiências individuais, sentimentos e conhecimentos e adoção de comportamento saudável para prevenção de quedas. Após a coleta dessas informações, realizou-se análise de similitude dos estudos selecionados por meio do IRaMuTeQ. Os elementos obtidos da análise de similitude facilitaram o agrupamento dos estudos quanto aos elementos encontrados e, assim, proporcionaram a organização do diagrama de prevenção de quedas. Resultados A amostra final foi constituída de 54 artigos, divididos de acordo com os elementos do modelo de Nola Pender: 36 abordavam características e experiências individuais, 40 sentimentos e conhecimentos, e 20 eram referentes ao comportamento. Os elementos obtidos da análise de similitude geraram um leque semântico de palavras mais frequentes: queda, prevenção, mulher e medo. Já as palavras menos frequentes foram cognição, autoeficácia, transporte e planejamento, os quais contribuíram para a construção do diagrama. Conclusão A partir da revisão, elaborou-se um diagrama, que favoreceu a identificação dos fatores pessoais, barreiras e facilidades, para um comportamento desejável à prevenção de quedas.

Resumen Objetivo Proponer un diagrama de prevención de caídas para personas mayores, basado en el modelo de promoción de la salud de Nola Pender. Métodos La elaboración del diagrama se basó en el modelo de Nola Pender y sus elementos. Para tal fin, se realizó un estudio de revisión integradora con el objetivo de recopilar datos sobre características y experiencias individuales, sentimientos y conocimientos y adopción de un comportamiento saludable para la prevención de caídas. Después de recopilar la información, se realizó un análisis de similitud de los estudios seleccionados mediante IRaMuTeQ. Los elementos obtenidos del análisis de similitud permitieron agrupar los estudios respecto a los elementos encontrados y, de esta forma, proporcionaron la organización del diagrama de prevención de caídas. Resultados La muestra final estuvo compuesta por 54 artículos, divididos de acuerdo con los elementos del modelo de Nola Pender: 36 abordaban características y experiencias individuales, 40 sentimientos y conocimientos y 20 eran sobre el comportamiento. Los elementos obtenidos del análisis de similitud generaron un conjunto semántico de palabras más frecuentes: caída, prevención, mujer y miedo. Por otro lado, las palabras menos frecuentes fueron: cognición, autoeficacia, transporte y planificación, que contribuyeron para la elaboración del diagrama. Conclusión A partir de la revisión, se elaboró un diagrama que favoreció la identificación de los factores personales, barreras y facilidades para un comportamiento conveniente en la prevención de caídas.

Abstract Objective To propose a fall prevention diagram for older adults, based on Nola Pender's Health Promotion Model. Methods Diagram construction was based on Nola Pender's model and its elements. For this, an integrative review study was carried out with the objective of collecting data on individual characteristics and experiences, behavior-specific cognitions and affect and behavioral outcome for fall prevention. After collecting this information, a similarity analysis of the selected studies was carried out using IRaMuTeQ. The elements obtained from similarity analysis facilitated the grouping of studies regarding the elements found and thus provided fall prevention diagram organization. Results The final sample consisted of 54 articles, divided according to the elements of Nola Pender's model: 36 addressed individual characteristics and experiences, 40 referred to behavior-specific cognitions and affect, and 20 referred to behavioral outcome. The elements obtained from the similarity analysis generated a semantic range of the most frequent words: fall, prevention, woman and fear. The least frequent words were cognition, self-efficacy, transportation and planning, which contributed to diagram construction. Conclusion From the review, a diagram was prepared, which favored identifying personal factors, barriers and facilities for a desirable behavior to prevent falls.

Educational strategies for preventing accidents in childhood: a systematic review / Estratégias educacionais para a prevenção de acidentes na infância: uma revisão sistemática / Estrategias educativas para la prevención de accidentes en la infancia: una revisión sistemática

Abstract: Accidents in childhood have a high morbidity and mortality rate and are often preventable, which reinforces the importance of educational measures to prevent unintentional injuries. This study aimed to identify and describe useful educational strategies for preventing childhood accidents in communities. This systematic review was guided by PRISMA (2020) and registered on the PROSPERO platform (ID: CRD42024500956). A search strategy was developed by combining the descriptors "Accident Prevention", "Child", and "Health Education" with the Boolean operator AND, applied to the PubMed/MEDLINE, Web of Science, LILACS, and SciELO databases. A total of 5,037 studies were located, including observational articles published from 2018 to 2023, with children aged 0-12 years and/or their parents/caregivers. The quality of the studies was assessed based on the Qualitative Studies Checklist and the Research Triangle Institute Item Bank instruments. The bibliographic sample consisted of 30 articles, mostly classified as high quality, with a population of 4,510 adults and 54,190 children from various countries. Educational strategies for accident prevention were described, aimed at parents and guardians, children, and both. This review, addressing innovative educational strategies for preventing childhood accidents, highlights playful approaches for children and visual methods for caregivers. Implementation faces challenges related to evaluation and socioeconomic factors, making rigorous criteria and prolonged follow-ups important for continuous effectiveness.

Resumo: Acidentes na infância têm uma alta taxa de morbidade e mortalidade e, muitas vezes, podem ser evitados, o que reforça a importância de medidas educacionais para evitar lesões não intencionais. O objetivo foi identificar e descrever estratégias educacionais úteis para a prevenção de acidentes infantis no contexto da comunidade. Essa revisão sistemática foi orientada pelo PRISMA (2020) e registrada na plataforma PROSPERO (ID: CRD42024500956). Uma estratégia de busca foi desenvolvida combinando os descritores "Accident Prevention" (prevenção de acidentes), "Child" (criança) e "Health Education" (educação em saúde) com o operador booleano AND, aplicado às bases de dados PubMed/MEDLINE, Web of Science, LILACS e SciELO. Foram localizados 5.037 estudos, incluindo artigos observacionais publicados entre 2018-2023, com crianças de 0 a 12 anos e/ou seus pais/cuidadores. A qualidade dos estudos foi avaliada considerando os critérios dos instrumentos Qualitative Studies Checklist e Research Triangle Institute Item Bank. A amostra bibliográfica consistiu em 30 artigos, em sua maioria classificados como de alta qualidade, com uma população de 4.510 adultos e 54.190 crianças de vários países. Foram descritas estratégias educacionais para a prevenção de acidentes, voltadas para pais e responsáveis, crianças e ambos. Esta revisão, que aborda estratégias educacionais inovadoras para a prevenção de acidentes infantis, destaca abordagens lúdicas para crianças e métodos visuais para cuidadores. A implementação enfrenta desafios relacionados à avaliação e a fatores socioeconômicos, tornando critérios rigorosos e acompanhamentos prolongados importantes para a eficácia contínua.

Resumen: Los accidentes en la infancia tienen una alta tasa de morbimortalidad y, muchas veces, son prevenibles, por lo que refuerza la importancia de medidas educativas para prevenir lesiones no intencionales. El objetivo de estudio fue identificar y describir estrategias educativas útiles para la prevención de accidentes en la infancia en el contexto comunitario. Esta revisión sistemática fue guiada por PRISMA (2020) y registrada en la plataforma PROSPERO (ID: CRD42024500956). Se realizó una búsqueda combinando los descriptores "Accident Prevention" (prevención de accidentes), "Child" (niño) y "Health Education" (educación en salud) con el operador booleano AND, aplicado a las bases de datos PubMed/MEDLINE, Web of Science, LILACS y SciELO. Se encontraron 5.037 estudios, que incluye artículos observacionales publicados entre 2018-2023, con niños de 0 a 12 años y/o sus padres/cuidadores. La calidad de los estudios se evaluó considerando los criterios de los instrumentos Qualitative Studies Checklist y Research Triangle Institute Item Bank. La muestra bibliográfica consistió en 30 artículos, en su mayoría clasificados como de alta calidad, realizados con una población de 4.510 adultos y 54.190 niños de varios países. Se describieron estrategias educativas para la prevención de accidentes dirigidas a padres y tutores, niños o ambos. Esta revisión aborda estrategias educativas innovadoras para la prevención de accidentes en la infancia y destaca los enfoques lúdicos para los niños y las técnicas visuales para los cuidadores. La aplicación se enfrenta a desafíos relacionados con la evaluación y los factores socioeconómicos, por lo que los criterios estrictos y los seguimientos prolongados son importantes para mantener su eficacia.

Avaliação do efeito protetivo do fosfato de oseltamivir e do cloreto de gadolínio no quadro de trombocitopenia induzido pelo envenenamento por Bothrops jararaca

Snakebites caused by the Bothrops jararaca snake are an important cause of morbidity and mortality in several regions of Latin America, including Brazil. The venom of these snakes is characterized by being rich in enzymes and toxins that can cause a series of hemotoxic effects in the body. Among these effects, thrombocytopenia is one of the most frequently observed conditions. Thrombocytopenia is characterized by a reduction in the number of circulating platelets in the blood. In the case of Bothrops snakebites, thrombocytopenia occurs due to several mechanisms, including the direct action of venom toxins on the production, destruction or removal of platelets from the circulation. Some studies suggest that one of the mechanisms of platelet destruction in B. jararaca poisoning would be through a process called desialylation, where sialic acid molecules are removed from the platelet surface by the action of neuraminidases. This process interferes with the interaction of platelets with other cells and molecules involved in coagulation, negatively affecting the formation of clots and contributing to an increased risk of bleeding. Oseltamivir phosphate is a medicine used to treat viral infections by inhibiting viral sialidases. Studies have already demonstrated that this drug could inhibit exposure to galactose in platelet surface glycoproteins after desialylation, corroborating the idea that inhibition of desialylation may be the mechanism responsible for the extension of platelet lifespan caused by oseltamivir. Gadolinium chloride (GdCl3) is used as a contrast agent in magnetic resonance imaging tests and has an effect of decreasing the selectivity and activity of Kupffer cells in performing phagocytosis, and is used in experimental models to inhibit the removal of aged platelets from circulation The present work evaluated the effects of oseltamivir phosphate (Tamiflu ®) and gadolinium chloride on thrombocytopenia caused by experimental poisoning with B. jararaca venom in mice, testing the hypothesis that a neuraminidase inhibitor, or an inhibitor of Kupffer cells, could prolong the lifespan of platelets, reducing thrombocytopenia. The data presented suggest that the administration of gadolinium chloride (GdCl3) and/or oseltamivir phosphate does not alter the results of hematological values in mice inoculated with Bothrops jararaca venom within a period of 3h.

Os acidentes ofídicos causados pela serpente Bothrops jararaca são uma importante causa de morbidade e mortalidade em várias regiões da América Latina, incluindo o Brasil. O veneno dessas serpentes é caracterizado por ser rico em enzimas e toxinas que podem causar uma série de efeitos hemotóxicos no organismo. Entre esses efeitos, a trombocitopenia é um dos quadros mais frequentemente observados. A trombocitopenia é caracterizada pela redução no número de plaquetas circulantes no sangue e no caso dos acidentes botrópicos, esse quadro ocorre devido a diversos mecanismos, incluindo ação direta das toxinas do veneno na produção, destruição ou remoção das plaquetas na circulação. Alguns estudos sugerem que um dos mecanismos de destruição das plaquetas no envenenamento por B. jararaca seria por um processo chamado de dessialilação, onde há a remoção de moléculas de ácido siálico da superfície das plaquetas pela ação de neuraminidases. O fosfato de oseltamivir é um medicamento utilizado para tratar infecções virais, a partir da inibição das sialidases virais. Estudos já demonstraram que esse fármaco poderia inibir a remoção de ácido siálico da superfície plaquetária, corroborando com a ideia de que a inibição da dessialilação pode ser o mecanismo responsável pela extensão da vida útil das plaquetas causada pelo oseltamivir. O cloreto de gadolínio (GdCl3) é utilizado como agente de contraste em exames de ressonância magnética e apresenta um efeito de diminuição da seletividade e atividade das células de Kupffer em realizar fagocitose, e é utilizado em modelos experimentais para um efeito de inibição da remoção de plaquetas envelhecidas da circulação. O presente trabalho avaliou os efeitos do fosfato de oseltamivir (Tamiflu ®) e o GdCl3 sobre o quadro de trombocitopenia provocado pelo envenenamento experimental com veneno de B. jararaca, em camundongos, testando a hipótese de que um inibidor de neuraminidases, ou de células de Kupffer, poderiam prolongar a vida útil das plaquetas, reduzindo o quadro de trombocitopenia. Os dados apresentados sugerem que não há diferença estatisticamente significativa nos valores hematológicos de camundongos inoculados com veneno de B. jararaca dentro do período de 3h, previamente tratados com fosfato de oseltamivir e cloreto de gadolínio.

Boletín epidemiológico semana 27: Accidente ofídico / Epidemiological bulletin week 27: Ophidic accident

Las serpientes son animales pertenecientes a la clase Reptilia, orden Squamata y suborden Serpentes. En el mundo, se han identificado cerca de 3 500 especies clasificadas en 465 géneros y 30 familias; de este total, el 20 % son consideradas de importancia médica (venenosas). El accidente ofídico es el cuadro clínico asociado a la lesión causada por la mordedura de una serpiente. Cuando la mordedura involucra la inoculación de veneno y la posterior manifestación de signos o síntomas de envenenamiento se denomina ofidiotoxicosis. Este evento se considera un problema de salud pública, dado que es una enfermedad tropical desatendida con el potencial de causar discapacidad y muerte de forma súbita. En el mundo, se estima que 7 400 personas son mordidas por serpientes a diario, y los fallecimientos asociados al envenenamiento varían entre 220 y 380 al día (2,3). En Colombia, las familias de serpientes más reportadas en el Sistema de Vigilancia son Viperidae (vipéridos), Elapidae (elápidos), Colubridae (colúbridos) y Boidae (boas).

Snakes are animals belonging to the class Reptilia, order Squamata and suborder Serpentes. Around the world, nearly 3,500 have been identified. species classified into 465 genera and 30 families; of this total, 20% are considered of medical importance (poisonous). The ophidic accident is the clinical picture associated with the injury caused by the snake bite. When the bite involves inoculation of poison and the subsequent manifestation of signs or symptoms of poisoning is called ophidiotoxicosis. This event is considered a problem of public health, given that it is a neglected tropical disease with the potential to cause sudden disability and death. In the world, it It is estimated that 7,400 people are bitten by snakes daily, and deaths associated with poisoning vary between 220 and 380 per day (2,3). In Colombia, the snake families most reported in the Surveillance System are Viperidae (viperids), Elapidae (elapids), Colubridae (colubrids) and Boidae (boas).

Urinary symptoms, falls and fear of falling in older people with cognitive impairment / Sintomas urinários, quedas e medo de cair em idosos com comprometimento cognitivo

Abstract Introduction: Among geriatric syndromes, cognitive impairment, urinary incontinence, nocturia, and falls stand out. Older adults with urinary incontinence are more prone to falls and exhibit fear of falling. Objective: To investigate the frequency of urinary incontinence and nocturia and evaluate the association of these variables with falls and fear of falling in older individuals with cognitive impairment. Methods: Cross-sectional study with older adults referred from Basic Health Units with cognitive impairment evaluated between 2019 and 2021. Information on urinary incontinence, nocturia, history of falls, and fear of falling provided by the participants and their caregivers was collected. Data were analyzed using Chi-square tests and univariate logistic regressions. Results: Data from 89 older adults were analyzed, of whom 58.4% had urinary incontinence, 28.1% had nocturia, 67.4% reported fear of falling, and 41.6% reported falls in the last six months. The group with urinary incontinence [χ2(1) = 5.147; p = 0.023] and the group with nocturia [χ2(1) = 4.353; p = 0.037] had significantly higher frequencies of fear of falling. No differences in the frequencies of history of falls were observed between individuals with and without urinary incontinence or nocturia (p > 0.05). Fear of falling was associated with urinary incontinence (OR = 2.833; 95% CI 1.137 - 7.062) and nocturia (OR = 3.365; 95% CI 1.033 - 10.966). Conclusion: Older adults with cognitive impairment have a high frequency of urinary incontinence, nocturia, falls, and fear of falling. Furthermore, there is an association between urinary incontinence, nocturia and fear of falling in this population.

Resumo Introdução: Entre as síndromes geriátricas, destacam-se o comprometimento cognitivo, a incontinência urinária, a noctúria e as quedas. Idosos com incontinência urinária são mais propensos a cair e apresentar medo de cair. Objetivo: Investigar a frequência de incontinência urinária e noctúria e avaliar a associação dessas variáveis com a ocorrência de quedas e com o medo de cair em idosos com comprometimento cognitivo. Métodos: Estudo transversal com idosos encaminhados das Unidades Básicas de Saúde com comprometimento cognitivo avaliados entre os anos de 2019 e 2021. Foram coletadas informações sobre incontinência urinária, noctúria, histórico de quedas e medo de cair, fornecidas pelos idosos e seus acompanhantes. Os dados foram analisados por meio dos testes quiquadrado e regressões logísticas univariadas. Resultados: Foram analisados dados de 89 idosos, dos quais 58,4% apresentavam incontinência urinária, 28,1% apresentavam noctúria, 67,4% tinham medo de cair e 41,6% relataram quedas nos últimos seis meses. O grupo com incontinência urinária [2(1) = 5,147; p = 0,023] e o grupo com noctúria [χ2(1) = 4,353; p = 0,037] apresentaram frequências significativamente maiores de medo de cair. Não foram observadas diferenças das frequências de histórico de quedas entre os indivíduos com e sem incontinência ou noctúria (p > 0,05). O medo de cair mostrouse associado à incontinência (OR = 2,833; IC95% 1,137 - 7,062) e à noctúria (OR = 3,365; IC 95% 1,033 - 10,966). Conclusão: Idosos com comprometimento cognitivo apresentam alta frequência de incontinência urinária, noctúria, quedas e medo de cair. Ademais, há associação da incontinência urinária e da noctúria com o medo de cair nessa população.