Achieving efficient water management at the Federal University of São Paulo, Brazil

In 2015, the water crisis affecting the São Paulo Metropolitan Region reached its peak. The Federal Government published an Ordinance stablishing good practices in the management and use of water and electricity. This work aimed to verify if the management actions performed at the Universidade Federal de São Paulo were effective for water consumption reduction. It was analyzed secondary data of the monthly water consumption at campuses and Rectory, from 2014 to 2016. Statistical analyses were carried out comparing the water consumption between the periods pre- and post-intervention, which occurred in February 2015. The results show that the intervention reduced per capita water consumption by 33% in 2015 and 35% in 2016, saving up more than 65,000 m3 of water. These management actions were effective, and helped the academic population to achieve a more efficiently use of water and financial resources, becoming more sustainable.In 2015, the water crisis affecting the São Paulo Metropolitan Region reached its peak. The Federal Government published an Ordinance establishing good practices in the management and use of water and electricity. This work aims to verify if management actions performed at the Federal University of São Paulo were effective for water consumption reduction. We assessed measures such as awareness campaigns, water reuse, water pressure regulator installation, identification of leaks, irrigation and washing of floors reduction. It was analyzed secondary data of the monthly water consumption at campuses and Rectory, from 2014 to 2016. Statistical analyses were carried out comparing the water consumption between the pre and post-intervention periods, which occurred in February 2015. The results show that the intervention reduced per capita water consumption by 33% in 2015 and 35% in 2016, saving up more than 65,000 m3 of water. These management actions proved to be effective, and the academic population achieved a more efficient use of water and financial resources, becoming more sustainable

Chemical components separation with the use of Botulinum toxin A: a critical review for correction of ventral hernia

Introdução: Hérnias ventrais são um resultado prevalente de cirurgias abdominais que podem representar um desafio cirúrgico em casos complexos, principalmente devido à tensão na musculatura da parede abdominal. A falha na correção cirúrgica pode levar a necessidade de um tratamento mais mórbido, além de um considerável impacto socioeconômico. Para que o risco de complicações seja menor, o uso da toxina botulínica A (TBA) pode ser uma alternativa pré-operatória para reduzir a tensão da parede abdominal, através de uma paralisia sustentada e reversível. Esta revisão crítica da literatura propõe avaliar o uso adjacente de TBA em correções de hérnias ventrais cirúrgicas. Métodos: Usando o banco de dados PubMed, as palavras-chave “ventral hernia” e “botullinum toxin” foram pesquisadas usando o operador “AND”. Os artigos foram selecionados com base em sua relevância e informações atualizadas. Os desfechos de interesse incluíram a mudança na largura do defeito da hérnia ventral e no comprimento do músculo da parede abdominal lateral, dor, recidiva de hérnia e complicações. Resultados: Foram encontrados 20 artigos de 2009 a 2018. Foram excluídos artigos devido à técnica irrelevante, uso de modelos animais e falta de dados sobre resultados. Redução da espessura da parede abdominal aumentando seu comprimento, menos dor perioperatória, redução de hérnia e correção com menos tensão foram observados após o uso da injeção de BTA. Nenhuma complicação ocorreu durante as aplicações. Conclusão: O uso de TBA parece ser uma alternativa promissora no manejo de hérnias ventrais devido à sua capacidade de reduzir a tensão na parede abdominal. No entanto, mais estudos são necessários para determinar a eficácia deste método.Background: Ventral hernias are prevalent results in abdominal surgeries and may represent a surgical challenge in complex cases, mainly due to tension in abdominal wall musculature. Failure of surgical correction may lead to a more morbid treatment, in addition to a considerable socioeconomic impact. In order to have a lower risk of complications, the use of botulinum toxin A (BTA), may be a preoperative alternative to reduce abdominal wall tension by causing sustained and reversible paralysis. This critical review of the literature proposes to evaluate the adjacent use of BTA in surgical ventral hernias corrections. Methods: Using the PubMed database, the keywords ‘ventral hernia’, and ‘botulinum toxin’ were searched using the Boolean operator AND. Articles were selected based on their relevance and updated information. The outcomes of interest included the change in ventral hernia defect width and in lateral abdominal wall muscle length, pain, hernia recurrence and complications. Results: A total of 20 articles from 2009 to 2018 were found. We excluded some articles due to irrelevant technique, use of animal models and lack of outcome data. Reduction of the abdominal wall thickness increasing its length, less perioperative pain, hernia reduction and the correction with less tension were observed after the use of BTA injection. No complications occurred during applications. Conclusion: The use of BTA seems to be a promising alternative in the management of ventral hernias due to its capacity of reducing tension in the abdominal wall. However, more studies are necessary to determine the efficacy of this method

Chemical components separation with the use of botulinum toxin A: a critical review for correction of ventral hernia

Background: Ventral hernias are prevalent results in abdominal surgeries and may represent a surgical challenge in complex cases, mainly due to tension in abdominal wall musculature. Failure of surgical correction may lead to a more morbid treatment, in addition to a considerable socioeconomic impact. In order to have a lower risk of complications, the use of botulinum toxin A (BTA), may be a preoperative alternative to reduce abdominal wall tension by causing sustained and reversible paralysis. This critical review of the literature proposes to evaluate the adjacent use of BTA in surgical ventral hernias corrections.Methods: Using the PubMed database, the keywords ‘ventral hernia’, and ‘botulinum toxin’ were searched using the Boolean operator AND. Articles were selected based on their relevance and updated information. The outcomes of interest included the change in ventral hernia defect width and in lateral abdominal wall muscle length, pain, hernia recurrence and complications.Results: A total of 20 articles from 2009 to 2018 were found. We excluded some articles due to irrelevant technique, use of animal models and lack of outcome data. Reduction of the abdominal wall thickness increasing its length, less perioperative pain, hernia reduction and the correction with less tension were observed after the use of BTA injection. No complications occurred during applications.Conclusion: The use of BTA seems to be a promising alternative in the management of ventral hernias due to its capacity of reducing tension in the abdominal wall. However, more studies are necessary to determine the efficacy of this method

Development of an instrument to evaluate the knowledge that the patient with hepatic cirrhosis has about his disease and treatment

Introdução: cirrose hepática (CH) é uma doença com alta morbidade e mortalidade no Brasil. Seu tratamento é complexo e requer desde mudanças no estilo de vida até se submeter a grandes cirurgias, como o transplante hepático. Para alcançar os melhores resultados é necessário que o paciente tenha uma boa aderência ao tratamento. Estudos indicam que o conhecimento do paciente sobre sua condição clínica é um fator determinante na aderência. Objetivos: criar um instrumento que meça o conhecimento que um paciente com CH tem sobre sua doença e seu tratamento. Methodologia: o processo de desenvolvimento do instrument foi dividido em 3 estágios: construção do instrument (1º estágio), avaliação do conteúdo e claridade do instrument (2º estágio) e avaliação da confiabilidade do instrument (3º estágio). Results: um instrument para avaliar o conhecimento do paciente cirrótico sobre sua doença foi feito, analisado por especialistas e aprovado pelos critérios propostos. Conclusions: 1) O desenvolvimento do instrumento seguiu os passos descritos na literatura. 2) As sugestões dos avaliadores foram seguidas na reestruturação das questões, tornando-as mais claras e relevantes para a proposta do instrumento. 3) Foi possível alcançar de forma satisfatória a proposta de construção do instrumento.Introduction: hepatic cirrhosis (HC) is a disease with high morbidity and mortality in Brazil. Its treatment is complex and requires from lifestyle changes to large surgeries such as liver transplantation. To reach the best treatment results, it is necessary to guarantee a good patient’s adherence to the treatment. Studies indicate that the patient’s self-knowledge about his or her clinical condition is a determining factor in its adherence. Objectives: to assist in the design of an instrument that evaluates knowledge about the disease and treatment of HC. Methodology: The development process of the instrument will be divided into 3 stages: construction of the instrument (1st stage), evaluation of content validity and clarity of the instrument (2nd stage) and assessment of the reliability of the instrument (3 rd stage). Results: an instrument to evaluate the cirrhotic patient knowledge about the disease was made, analyzed by specialists and approved in the criteria proposed. Conclusions: 1) The development of the instrument followed the steps described in literature. 2) The suggestion of the evaluators allowed to restructure the questions making them clearer and more relevant to the proposal of the instrument. 3) it was possible to achieve satisfactorily the proposal of the construction of the instrument

Cost analysis of the strategic planning of the integrated urban solid waste system in Campo Grande, Mato Grosso do Sul

The worldwide trend of population growth and municipal solid waste generation suggests the application of tools to assess the sustainability of management systems, aiming at more conscious decision-making. The arrival of the circular economy concept and the Brazilian National Solid Waste Policy aroused discussions and greater concern with the products' life cycle and waste reduction. Thus, the present study aimed to economically evaluate the strategic planning of the urban solid waste management system in Campo Grande, Mato Grosso do Sul, complementing the analysis of environmental impacts previously carried out, aiming to support sustainable decision making. Results showed that the landfill with energy recovery, despite being environmentally favorable, is not economically viable for the local reality. Investments in improving the efficiency of selective collection and sorting of recyclables, as well as a composting unit, are environmentally beneficial and profitable, despite the significant costs involved. It was concluded, then, that the Campo Grande Selective Collection Plan has realistic and environmentally and economically feasible goals that must be implemented urgently in order to improve the quality of life of the population and reduce environmental impacts, both locally and globally

Cisto de Bartholin, uma revisão bibliográfica

Os cistos ou abscessos de Bartholin são predominantemente encontrados em mulheres em idade fértil, sua incidência é mais frequente e observada no início da puberdade aumentando com a idade até a menopausa, podendo afetar significativamente a vida de uma mulher. A dor e o inchaço podem impedir atos do cotidiano como sentar, caminhar e ter relações sexuais. O diagnóstico é frequentemente clínico porém massas atípicas podem exigir imagens adicionais, biópsia de tecido ou excisão completa. Em alguns casos, os cistos podem ficar aumentados e dolorosos ou infectados. As opções de tratamento estão disponíveis para alívio dos sintomas, bem como para preocupações cosméticas. Antibióticos podem ser necessários em caso de infecção secundária. Pacientes na pós-menopausa podem precisar de mais investigações para descartar a possibilidade de câncer. Cistos e abscessos de Bartholin sintomáticos são responsáveis ​​por um número significativo de todas as consultas ginecológicas por ano

Reasons and factors related to non-adherence to breast and cervical cancer screening in primary health care in São José do Rio Preto - SP after the COVID-19 pandemic

Objective: To identify the reasons and factors associated with non-adhence of mammogram and Pap smear. Methods: This cross-sectional observational study was conducted through interviews with women between 25 and 69 years-old in basic health units. Results: 441 women were included in the study, 404 of whom were eligible for cervical cancer screening and 208 for breast cancer screening. Mammogram adherence was associated with educational level (p<0.001), family history of breast cancer (p=0.047), self-assessment of health status (p<0.001) and prior knowledge about age group (p<0.001) and frequency (p<0.001) of screening recommended by the Ministry of Health. However, the decision of undergo cervical cancer screening exam was associated with age (p=0.012), self-assessment of health status (p<0.001) and prior knowledge about age group (p<0.001) and frequency (p=0.027) of exam. In both groups, the main reasons for non-adherence to screening were: lack of time, difficulty scheduling appointments and/or tests, and the SARS-Cov-2 pandemic. Conclusion: Socioeconomic factors and health education influence the decision to participate in the secondary prevention of these neoplasms. Thus, health policies should be intensified addressing these topics to increase the adherence rate to exams.Objetivo: Identificar os motivos e os fatores associados à não realização da mamografia e do exame de Papanicolaou. Métodos: Este estudo observacional transversal foi conduzido por meio de entrevistas com mulheres de 25 a 69 anos em unidades básicas de saúde. Resultados: Foram incluídas 441 mulheres no estudo, sendo 404 elegíveis para o rastreamento do câncer de colo do útero e 208 para o rastreamento de câncer de mama. A realização da mamografia foi associada ao nível de educação (p<0,001), histórico familiar de câncer de mama (p=0,047), autoavaliação do estado de saúde (p<0,001) e conhecimento prévio sobre a faixa etária (p<0,001) e frequência (p<0,001) do rastreamento preconizada pelo Ministério da Saúde. Contudo, a adesão ao exame de rastreamento do câncer cervical foi associada à idade (p=0,012), autoavaliação do estado de saúde (p<0,001) e conhecimento prévio sobre a faixa etária (p<0,001) e frequência (p=0,027) do exame. Em ambos os grupos, os principais motivos da não adesão ao rastreamento foram: falta de tempo, dificuldade no agendamento na consulta e/ou exame e a pandemia de SARS-Cov-2. Conclusão: Fatores socioeconômicos e educação em saúde influenciam a decisão de participar da prevenção secundária dessas neoplasias. Desse modo, as políticas de saúde devem ser intensificadas, abordando esses tópicos para elevar as taxas de adesão aos exames

Huariqueando: huariques app in Metropolitan Lima

El sector gastronómico ha sido uno de los más afectados por la pandemia, debido a la cuarentena obligatoria que paralizaron los negocios en el país, miles de empresarios/emprendedores cerraron las puertas de sus locales. Muchos de ellos no contaban con delivery, redes sociales y/o logística para operar; sin embargo, a pesar de las restricciones supieron como reinventarse en medio de la crisis sanitaria. Según INEI, la economía peruana tuvo un crecimiento del 2,86%, siendo el sector de alojamiento y restaurante los más favorecidos con un incremento del 30,37% en enero del 2022, esto se debe a que el Gobierno Peruano ha disminuido las restricciones como el incremento de aforos al 100%, entre otras. (INEI, 2022). Para el presente trabajo de investigación se realizó la validación del problema, propuesta de valor, modelo de negocio, prototipos de baja y alta fidelidad, validaciones técnicas de solución y se desarrolló la proyección del plan financiero. A través de la metodología aplicada en nuestra investigación, pudimos delimitar nuestro mercado potencial siendo personas que les gusta descubrir nuevos lugares para ir a comer o que necesiten recomendación de nuevos lugares, pertenecientes al NSE B y C de las zonas centro y oeste de Lima Metropolitana y que tengan entre 22 a 32 años. Como resultado de nuestra proyección de ventas podemos decir que nuestro proyecto es viable y escalable ya que genera valor, presenta una TIR de 48.01%, la cual es mayor a las tasas de retorno que ofrece el mercado en la actualidad.The gastronomic sector has been one of the most affected by the pandemic, due to the mandatory quarantine, the continuous contagion waves that paralyzed business in the country and forced thousands of businessmen/entrepreneurs to close their business. Many of them did not have delivery service, social networks and/or logistics to operate adequately; despite the restrictions, they knew how to reinvent themselves and survive during the health crisis. According to INEI, the peruvian economy had a growth of 2.86%, with the accommodation and restaurant sector being the most favored with an increase of 30.37% in January 2022, due to Peruvian Government has reduced restrictions such as, increase in capacity to 100%, entry to public establishments guaranteeing the 3 doses of vaccination, among others. (INEI, 2022). For the present research work, we execute the validation of the problem, value proposition, business model, interviews, technical solution validations. Through the methodology applied in our research, we were able to define our potential market in Metropolitan Lima. Our potential consumers are people who like to discover new places and eat at good price or those who need information/recommendation of new places, who belong to socioeconomic level B and C of the central and western areas of Metropolitan Lima between 22 to 32 years. As a result of our sales projection, we can say that our project is viable and scalable since it generates value, it presents an IRR of 48.01%, which is higher than the rates of return offered by the market today.Trabajo de investigació