Gamma-ray sources imaging and test-beam results with MACACO III Compton camera.

Hadron therapy is a radiotherapy modality which offers a precise energy deposition to the tumors and a dose reduction to healthy tissue as compared to conventional methods. However, methods for real-time monitoring are required to ensure that the radiation dose is deposited on the target. The IRIS group of IFIC-Valencia developed a Compton camera prototype for this purpose, intending to image the Prompt Gammas emitted by the tissue during irradiation. The system detectors are composed of Lanthanum (III) bromide scintillator crystals coupled to silicon photomultipliers. After an initial characterization in the laboratory, in order to assess the system capabilities for future experiments in proton therapy centers, different tests were carried out in two facilities: PARTREC (Groningen, The Netherlands) and the CNA cyclotron (Sevilla, Spain). Characterization studies performed at PARTREC indicated that the detectors linearity was improved with respect to the previous version and an energy resolution of 5.2 % FWHM at 511 keV was achieved. Moreover, the imaging capabilities of the system were evaluated with a line source of 68Ge and a point-like source of 241Am-9Be. Images at 4.439 MeV were obtained from irradiation of a graphite target with an 18 MeV proton beam at CNA, to perform a study of the system potential to detect shifts at different intensities. In this sense, the system was able to distinguish 1 mm variations in the target position at different beam current intensities for measurement times of 1800 and 600 s.

Influence of the background in Compton camera images for proton therapy treatment monitoring.

Objective. Background events are one of the most relevant contributions to image degradation in Compton camera imaging for hadron therapy treatment monitoring. A study of the background and its contribution to image degradation is important to define future strategies to reduce the background in the system.Approach. In this simulation study, the percentage of different kinds of events and their contribution to the reconstructed image in a two-layer Compton camera have been evaluated. To this end, GATE v8.2 simulations of a proton beam impinging on a PMMA phantom have been carried out, for different proton beam energies and at different beam intensities.Main results. For a simulated Compton camera made of Lanthanum (III) Bromide monolithic crystals, coincidences caused by neutrons arriving from the phantom are the most common type of background produced by secondary radiations in the Compton camera, causing between 13% and 33% of the detected coincidences, depending on the beam energy. Results also show that random coincidences are a significant cause of image degradation at high beam intensities, and their influence in the reconstructed images is studied for values of the time coincidence windows from 500 ps to 100 ns.Significance. Results indicate the timing capabilities required to retrieve the fall-off position with good precision. Still, the noise observed in the image when no randoms are considered make us consider further background rejection methods.

Analysis of Doberman Pinscher and Toy Poodle samples with targeted next-generation sequencing.

Next-generation sequencing (NGS) technologies have enabled the identification of many causal variants of genetic disorders, the development of parentage tests and the analysis of multiple traits in domestic animals. In this study, we evaluated the performance of a Canine Targeted Genotyping-by-Sequencing (GBS) custom panel (Thermo Fisher Scientific, Waltham, Ma, USA) in a cohort of 95 dog DNA samples, comprising 76 Doberman Pinschers and 19 Toy Poodles from Argentina. The used panel included 383 targets (228 parentage SNVs, 137 genetic disorder markers and 18 trait markers). While paternity analysis showed correct duo (97.4%; LOD > 2.98E+13) and trio (100%; LOD > 2.20E+15) parentage assignment, the panel resulted still insufficient for excluding close relatives in inbred populations. In this sense, close relatives were wrongly assigned as parents in 12.6% of duos and 0.3% of trios. We detected 17 polymorphic markers (genetic disorders, n = 4; hair type, n = 3; coat color, n = 10) and estimated their allele frequencies in the studied breeds. The accuracy of targeted GBS results were evaluated for three markers that were associated with Progressive rod-cone degeneration, von Willebrand disease type 1 and dilated cardiomyopathy by pyrosequencing and Sanger sequencing genotyping, showing 94-100% concordance among assays. The targeted GBS custom panel resulted cost-effective strategy to study the prevalence of genetic disorders and traits in a large number of samples and to analyze genetic interactions between previously reported variants. Once assays based on AgriSeq technology were standardized, their uses are a good strategy for large-scale routine genetic evaluation of animal populations.

Joint image reconstruction algorithm in Compton cameras.

Objective.To demonstrate the benefits of using an joint image reconstruction algorithm based on the List Mode Maximum Likelihood Expectation Maximization that combines events measured in different channels of information of a Compton camera.Approach.Both simulations and experimental data are employed to show the algorithm performance.Main results.The obtained joint images present improved image quality and yield better estimates of displacements of high-energy gamma-ray emitting sources. The algorithm also provides images that are more stable than any individual channel against the noisy convergence that characterizes Maximum Likelihood based algorithms.Significance.The joint reconstruction algorithm can improve the quality and robustness of Compton camera images. It also has high versatility, as it can be easily adapted to any Compton camera geometry. It is thus expected to represent an important step in the optimization of Compton camera imaging.

EVIPNet Americas: Overcoming barriers to integrate scientific evidence and health policies in the Americas

In response to the challenges created by the COVID-19 pandemic to the role of evidence in policymaking, the World Health Organization (WHO) in collaboration with the Pan American Health Organization (PAHO) convened the first Global Evidence-to-Policy (E2P) Summit.This summit brought together different stakeholders from all WHO Regions to identify common challenges, share lessons learned, and provide recommendations to support evidence-informed decisionmaking as a catalyst for policy and societal changes

Image reconstruction for a multi-layer Compton telescope: an analytical model for three interaction events.

Compton Cameras are electronically collimated photon imagers suitable for sub-MeV to few MeV gamma-ray detection. Such features are desirable to enable in vivo range verification in hadron therapy, through the detection of secondary Prompt Gammas. A major concern with this technique is the poor image quality obtained when the incoming gamma-ray energy is unknown. Compton Cameras with more than two detector planes (multi-layer Compton Cameras) have been proposed as a solution, given that these devices incorporate more signal sequences of interactions to the conventional two interaction events. In particular, three interaction events convey more spectral information as they allow inferring directly the incident gamma-ray energy. A three-layer Compton Telescope based on continuous Lanthanum (III) Bromide crystals coupled to Silicon Photomultipliers is being developed at the IRIS group of IFIC-Valencia. In a previous work we proposed a spectral reconstruction algorithm for two interaction events based on an analytical model for the formation of the signal. To fully exploit the capabilities of our prototype, we present here an extension of the model for three interaction events. Analytical expressions of the sensitivity and the System Matrix are derived and validated against Monte Carlo simulations. Implemented in a List Mode Maximum Likelihood Expectation Maximization algorithm, the proposed model allows us to obtain four-dimensional (energy and position) images by using exclusively three interaction events. We are able to recover the correct spectrum and spatial distribution of gamma-ray sources when ideal data are employed. However, the uncertainties associated to experimental measurements result in a degradation when real data from complex structures are employed. Incorrect estimation of the incident gamma-ray interaction positions, and missing deposited energy associated with escaping secondaries, have been identified as the causes of such degradation by means of a detailed Monte Carlo study. As expected, our current experimental resolution and efficiency to three interaction events prevents us from correctly recovering complex structures of radioactive sources. However, given the better spectral information conveyed by three interaction events, we expect an improvement of the image quality of conventional Compton imaging when including such events. In this regard, future development includes the incorporation of the model assessed in this work to the two interaction events model in order to allow using simultaneously two and three interaction events in the image reconstruction.

Design For The First Narrowband Filter For The Dark Energy Camera: Optimizing The LAGER Survey For Z ~ 7 Galaxies.

We present the design for the first narrowband filter NB964 for the Dark Energy Camera (DECam), which is operated on the 4m Blanco Telescope at the Cerro Tololo Inter-American Observatory. The NB964 filter profile is essentially defined by maximizing the power of searching for Lyman alpha emitting galaxies (LAEs) in the epoch of reionization, with the consideration of the night sky background in the near-infrared and the DECam quantum efficiency. The NB964 filter was manufactured by Materion in 2015. It has a central wavelength of 964.2 nm and a full width at half maximum (FWHM) of 9.2 nm. An NB964 survey named LAGER (Lyman Alpha Galaxies in the Epoch of Reionization) has been ongoing since December 2015. Here we report results of lab tests, on-site tests and observations with the NB964 filter. The excellent performances of this filter ensure that the LAGER project is able to detect LAEs at z ~ 7 with a high efficiency.

A clumpy and anisotropic galaxy halo at redshift 1 from gravitational-arc tomography.

Every star-forming galaxy has a halo of metal-enriched gas that extends out to at least 100 kiloparsecs, as revealed by the absorption lines that this gas imprints on the spectra of background quasars. However, quasars are sparse and typically probe only one narrow beam of emission through the intervening galaxy. Close quasar pairs and gravitationally lensed quasars have been used to circumvent this inherently one-dimensional technique, but these objects are rare and the structure of the circumgalactic medium remains poorly constrained. As a result, our understanding of the physical processes that drive the recycling of baryons across the lifetime of a galaxy is limited. Here we report integral-field (tomographic) spectroscopy of an extended background source-a bright, giant gravitational arc. We can thus coherently map the spatial and kinematic distribution of Mg ɪɪ absorption-a standard tracer of enriched gas-in an intervening galaxy system at redshift 0.98 (around 8 billion years ago). Our gravitational-arc tomography unveils a clumpy medium in which the absorption strength decreases with increasing distance from the galaxy system, in good agreement with results for quasars. Furthermore, we find strong evidence that the gas is not distributed isotropically. Interestingly, we detect little kinematic variation over a projected area of approximately 600 square kiloparsecs, with all line-of-sight velocities confined to within a few tens of kilometres per second of each other. These results suggest that the detected absorption originates from entrained recycled material, rather than in a galactic outflow.

DNA profile of dog feces as evidence to solve a homicide.

Dog fecal samples were collected at the crime scene and from the shoes of the suspect to see whether they could be linked. DNA was genotyped using a 145bp fragment containing a 60bp hotspot region of the mitochondrial DNA (mtDNA) control region. Once the species origin was identified, sequences were aligned with the 23 canine haplotypes defined, showing that evidence and reference had 100% identity with haplotype 5. The frequency of haplotype 5 and the exclusion power of the reference population were 0.056 and 0.89, respectively. The forensic index showed that it was 20 times more likely that the evidence belonged to the reference dog than to some other unknown animal. The results support that the mtDNA hypervariable region 1 (HV1) is a good alternative for typing in trace or degraded casework samples when the STR panel fails, and demonstrate the utility of domestic animal samples to give additional information to solve human legal cases.

Invited review: Fermented milk as antihypertensive functional food.

Over the past decade, interest has risen in fermented dairy foods that promote health and could prevent diseases such as hypertension. This biological effect has mainly been attributed to bioactive peptides encrypted within dairy proteins that can be released during fermentation with specific lactic acid bacteria or during gastrointestinal digestion. The most studied bioactive peptides derived from dairy proteins are antihypertensive peptides; however, a need exists to review the different studies dealing with the evaluation of antihypertensive fermented milk before a health claim may be associated with the product. Thus, the objective of this overview was to present available information related to the evaluation of fermented milk containing antihypertensive peptides by in vitro and in vivo studies, which are required before a fermented functional dairy product may be introduced to the market. Although commercial fermented milks with antihypertensive effects exist, these are scarce and most are based on Lactobacillus helveticus. Thus, a great opportunity is available for the development of functional dairy products with new lactic acid bacteria that support heart health through blood pressure- and heart rate-lowering effects. Hence, the consumer may be willing to pay a premium for foods with important functional benefits.

Structural elucidation of supramolecular alpha-cyclodextrin dimer/aliphatic monofunctional molecules complexes.

The structural elucidation of 2α-cyclodextrin/1-octanethiol, 2α-cyclodextrin/1-octylamine and 2α-cyclodextrin/1-nonanoic acid inclusion complexes by nuclear magnetic resonance (NMR) spectroscopy and molecular modeling has been achieved. The detailed spatial configurations are proposed for the three inclusion complexes based on 2D NMR method. ROESY experiments confirm the inclusion of guest molecules inside the α-cyclodextrin (α-CD) cavity. On the other hand, the host-guest ratio observed was 2:1 for three complexes. The detailed spatial configuration proposed based on 2D NMR methods were further interpreted using molecular modeling studies. The theoretical calculations are in good agreement with the experimental data.

Association of canine juvenile generalized demodicosis with the dog leukocyte antigen system.

Demodectic mange is a well-known parasitic skin disease characterized by the presence of a larger than normal number of Demodex mites (Demodex canis) in the skin of dogs. Recent research has suggested that major histocompatibility complex (MHC) class II expression is higher in the skin of dogs suffering from demodicosis than in normal ones. We have investigated whether canine Dog Leukocyte Antigen (DLA) class II alleles are associated with canine juvenile generalized demodicosis (JGD). In the present study, the analysis of microsatellite markers (FH2202, FH2975 and FH2054) linked to DLA was made in Boxer, Argentinean Mastiff and mixed breed dogs. DNA samples from 56 dogs affected with the disease and 60 breed-matched controls collected in Argentina were analysed. A highly significant association, in some of the analysed markers, in all breeds with the presence of demodicosis was observed with P < 0.05 and odds ratio (OR) > or =5. The results of this study suggest that an underlying DLA association exists with demodicosis in dogs and that this may represent an important immunological risk factor in the aetiology of this condition. This information could be used in the future to develop diagnostic tests to prevent canine JGD.

Framingham-Grundy, REGICOR y SCORE en la estimación del riesgo cardiovascular del paciente hipertenso. Concordancias y discrepancias (CICLO-RISK) / Framingham-Grundy, REGICOR and SCORE in cardiovascular risk estimation in hypertensive patients. Agreements and disagreements (CICLO-RISK)

Introducción y objetivos. Evaluar concordancias y discrepancias en la estimación del riesgo cardiovascular en pacientes hipertensos con las escalas Framingham-Grundy, REGICOR y SCORE. Pacientes y métodos. Diseño: estudio descriptivo transversal. Sujetos: 453 pacientes hipertensos de 30 a 74 años (60,5 % mujeres) seleccionados por muestreo aleatorio en dos centros de salud. Edad media: 63,69 años. Mediciones: edad, sexo, presión arterial, glucemia, lípidos, tabaquismo y riesgo cardiovascular calculado con las escalas Framingham-Grundy y REGICOR para estimar el riesgo coronario en 10 años, y SCORE para estimar el riesgo de muerte cardiovascular en 10 años. Resultados. Framingham: riesgo coronario medio, 14,26 % (IC95 %: 13,45 ÷ 15,07); varones, 18,16 %, y mujeres, 11,72 % (p < 0,05). REGICOR: riesgo coronario medio, 4,96 % (IC95 %: 4,67 ÷ 5,26); varones, 5,88 %, y mujeres, 4,36 % (p < 0,05). SCORE: riesgo de muerte cardiovascular, 2,94 % (IC95 %: 2,64-3,24); varones, 4,01 %, y mujeres, 2,24 % (p < 0,05). Hay correlación positiva intensa, entre 0,80 y 0,85 (p < 0,01), al comparar las tres escalas. Presentan riesgo cardiovascu lar alto-muy alto el 22,5 % con Framingham, el 0,7 % con REGICOR y el 17 % con SCORE (p < 0,05). La concordancia estimada con el Índice Kappa fue: Framingham y REGICOR, 0,045; Framingham y SCORE, 0,619, y SCORE y REGI COR, 0,063. Conclusiones. Encontramos una correlación positiva intensa entre las tres escalas, aunque la ecuación de REGICOR estima un riesgo cardiovascular entre dos y tres veces inferior a las otras dos. Sin embargo, hay importantes discrepancias a la hora de clasificar a los pacientes según niveles de riesgo, especialmente entre la ecuación de REGICOR con Framingham-Grundy y SCORE

Introduction and objectives. To evaluate agreements and disagreements in cardiovascular risk estimation in hypertensive patients with Framingham-Grundy, REGICOR and SCORE scales. Patients and methods. Design: cross-sectional descriptive study. Subjects: 453 hypertensive patients, aged 30-74 years (60.5 % women) selected by random sampling in two health centres. Mean age was 63.69 years. Measurements: age, sex, blood pressure, glycaemia, lipids, smokers and cardiovascular risk calculated with Framingham-Grundy and REGICOR scales to estimate coronary risk in 10 years, and SCORE to estimate cardiovascular mortality risk in 10 years. Results. Framingham: mean coronary risk, 14.26 % (IC95 %: 13.45 ÷ 15.07); men, 18.16 %, and women, 11.72 % (p < 0.05). REGICOR: mean coronary risk, 4.96 % (IC95 %: 4.67 ÷ 5.26); men, 5.88 %, and women, 4.36 % (p < 0.05). SCORE: mean cardiovascular mortality risk, 2.94 % (IC95 %: 2.64-3.24); men, 4.01 %, and women, 2.24 % (p < 0.05). There is strong positive correlation, between 0.80 and 0,85 (p < 0.01), when we compare the three scales. The proportion of high and very high-risk patients was 22.5 % with Framingham, 0.7 % with REGICOR and 17 % with SCORE (p < 0.05). The agreement considered with Kappa index was: Framingham and REGICOR, 0.045; Framingham and SCORE, 0.619, and SCORE and REGICOR, 0.063. Conclusions. We found strong positive correlation between the three scales, although cardiovascular risk estimate with REGICOR is between two and three times lower than other two. Nevertheless, there are important disagreements when we classified the patients according levels risk, especially between REGICOR with Framingham-Grundy and SCORE

Mejora de la calidad del proceso asistencial a los factores de riesgo cardiovascular en el paciente hipertenso. Eficacia de una intervención (ciclo-risk) / Improvement of quality of the health care process for cardiovascular risk factors in hypertensive patient. Efficacy of an intervention (cycle-risk)

Introducción. El objetivo es determinar la calidad del proceso de atención de los factores de riesgo cardiovascular en el paciente hipertenso y evaluar la efectividad de una intervención sobre los profesionales. Material y métodos. Estudio cuasiexperimental que incluye dos centros de salud urbanos. Un centro fue elegido para recibir una intervención de mejora de calidad (419 hipertensos) y otro para recibir la atención habitual (430 hipertensos). Previamente a la intervención y un año después se evaluó el nivel de cumplimiento de las normas técnicas de la hipertensión, hiperlipemia, diabetes y obesidad de la cartera de servicios de Atención Primaria en una escala de 0 a 100. La intervención de mejora de calidad consistió en audit, feed-back, sesiones de formación e implementación de guías clínicas. Resultados. En la evaluación basal la media de cumplimiento de las normas técnicas fue similar en los dos grupos (74 puntos en el grupo de intervención y 73 en el grupo control). En la evaluación posintervención la media de cumplimiento fue de 83 en el grupo de intervención y de 71 en el grupo control. El efecto de la intervención ha sido un incremento medio de las normas técnicas de 11 puntos a favor del grupo de intervención. El nivel de cumplimiento mejoró de forma significativa en el grupo de intervención en la mayoría de las normas técnicas. Conclusiones. La intervención de mejora de calidad realizada con los profesionales de grupo de intervención tiene un efecto positivo en la mejora global de la calidad asistencial y especialmente en los criterios con puntuación más deficientes en la evaluación inicial

Introduction. The objective is to determine the quality of the cardiovascular risk factors care process in the hypertensive patient and evaluate the effectiveness of an intervention on the professions. Material and methods. Quasi-experimental study that includes two urban health sites. One site was chosen to receive a quality improvement intervention (419 hypertensive) and another health site was chosen to receive the usual care (430 hypertensives). Prior to the intervention and one year after, compliance levels of the technical standards of hypertension, hyperlipemia, diabetes and obesity of the Primary Health Care Services portfolio were evaluated on a scale of 0 to 100. The quality improvement intervention consisted in audit, feed-back, training sessions and implementation of clinical guides. Results. The man compliance of the technical standads in the baseline evaluation was similar in both groups, 74 points in the intervention group and 73 in the control group. In the post-intervention evaluation, the mean compliance was 83 in the intervention group and 71 in the control group. The effect of the intervention was a mean increase of the technical standards of 11 points in favor of the intervention group. Compliance level improved significantly in the intervention group in most of the technical standards. Conclusions. The quality improvement intervention conducted with the intervention group professionals has a positive effect on global improvement of health care quality and especially in the criteria with more deficient scores in the initial evaluation

Characterization of the cholesteric phase of filamentous bacteriophage fd for molecular alignment.

Residual dipolar couplings arise from small degrees of alignment of molecules in a magnetic field and have proven to provide valuable structural information. Colloidal suspensions of rod-shaped viruses and bacteriophages constitute a frequently employed medium for imparting such alignment onto biomolecules. The stability and behavior of the liquid crystalline phases with respect to solution conditions such as pH, ionic strength, and temperature vary, and characterization should benefit practical applications as well as theoretical understanding. In this Communication we describe the pH dependence of the cholesteric liquid crystalline phase of the filamentous bacteriophage fd and demonstrate that the alignment tensor of the solute protein is modulated by pH. We also report the interesting observation that the relative sign of the residual dipolar coupling changes at low pH values. In addition, we demonstrate that the degree of alignment inversely scales with the lengths of the phage particles for phages with identical mass and charge per unit length.

Characterization of surfactant liquid crystal phases suitable for molecular alignment and measurement of dipolar couplings.

Media employed for imparting partial alignment onto solute molecules have recently attracted considerable attention, since they permit the measurement of NMR parameters for solute biomolecules commonly associated with solid state NMR. Here we characterize a medium which is based on a quasi-ternary surfactant system comprising cetylpyridinium bromide/hexanol/sodium bromide. We demonstrate that dilute solutions of this system can exist in liquid crystalline phases which orient in the magnetic field and allow the measurement of residual dipolar couplings under a variety of conditions. The present system is extremely versatile and robust, tolerating different buffer conditions, temperature ranges and concentrations.

Domain organization of the 39-kDa receptor-associated protein.

The 39-kDa receptor-associated protein (RAP) is an endoplasmic reticulum resident protein that binds to the low density lipoprotein receptor-related protein (LRP) as well as certain members of the low density lipoprotein receptor superfamily and antagonizes ligand binding. In order to identify important functional regions of RAP, studies were performed to define the domain organization and domain boundaries of this molecule. Differential scanning calorimetry (DSC) experiments revealed that the process of thermal denaturation of RAP is highly reversible and occurs in a broad temperature range with two well resolved heat absorption peaks. A good fit of the endotherm was obtained with four two-state transitions suggesting these many cooperative domains in the molecule. A number of recombinant fragments of RAP were expressed in bacteria, and their domain composition and stability were characterized by DSC, circular dichroism, and fluorescence spectroscopy. The results confirmed that RAP is composed of four independently folded domains, D1, D2, D3, and D4, that encompass residues 1-92, 93-163, 164-216, and 217-323, respectively. The first and the fourth domains preserved their structure and stability when isolated, whereas the compact structure of the fragment corresponding to D2 seems to be altered when isolated from the parent molecule. Isolated D3 was partially degraded during isolation from bacterial lysates. The isolated D4 was capable of binding with high affinity to LRP whereas neither D1 nor D2 bound. At the same time a fragment containing both D1 and D2 exhibited high affinity binding to LRP. These facts combined with the thermodynamic analysis of the melting process of the fragments containing D1 and D2 indicate that these two domains interact with each other and that the proper folding of the second domain into a native-like active conformation requires presence of the first domain.

Proyecto de intervención comunitaria en una ciudadela del Consejo Popular José María Heredia / Project of communitarian intervention in one ciudadela of the Popular Council Jose Maria Heredia

Se elaboró un proyecto de intervención para modificar de forma positiva hábitos, prácticas, riesgos y necesidades de los habitantes de la ciudadela San Gerónimo 404 del Consejo Popular José María Heredia.Este proyecto tuvo como antecedentes un estudio descriptivo y la aplicación de técnicas cualitativas de investigación, que nos llevó a una caracterización de la población que allí reside, y a la identificación de sus necesidades sentidas. Para ello se aplicó dos modelos de encuestas (Individual y por familia), aplicación del método de Hanlon y el grupo focal. Se comprobó la hipotesis de la cual partimos al llegar al conocimiento basada en la existencia de condiciones ambientales precarias y socio-culturales que están influyendo negativamente en el estado de salud, lo que sirvió de justificación al proyecto, con el que se pretende elevar el nivel, calidad y estilo de vida de estas familias

Proyecto de intervención comunitaria en una ciudadela del Consejo Popular José María Heredia / Project of communitarian intervention in one ciudadela of the Popular Council Jose Maria Heredia

Se elaboró un proyecto de intervención para modificar de forma positiva hábitos, prácticas, riesgos y necesidades de los habitantes de la ciudadela San Gerónimo 404 del Consejo Popular José María Heredia.Este proyecto tuvo como antecedentes un estudio descriptivo y la aplicación de técnicas cualitativas de investigación, que nos llevó a una caracterización de la población que allí reside, y a la identificación de sus necesidades sentidas. Para ello se aplicó dos modelos de encuestas (Individual y por familia), aplicación del método de Hanlon y el grupo focal. Se comprobó la hipotesis de la cual partimos al llegar al conocimiento basada en la existencia de condiciones ambientales precarias y socio-culturales que están influyendo negativamente en el estado de salud, lo que sirvió de justificación al proyecto, con el que se pretende elevar el nivel, calidad y estilo de vida de estas familias