Assessment of the microbiological quality of groundwater in three regions of the Valencian community (Spain)

Urban groundwater development was traditionally constrained by concerns about its quality. This study was conducted in the regions of La Ribera Alta and Ribera Baja and La Plana de Requena-Utiel of the Valencian Community (Valencia, Spain) where population density, demand for drinking water and agricultural activities are high. Groundwater bodies (GWBs) are regarded as management areas within each territory, and were used to establish protection policies. This study analyzed eleven GWBs. We used two databases with microbiological measurements from 154 wells over a 7-year period (2004-2011), risk factors and groundwater information. Wells were grouped according to frequency of microbiological contamination using E. coli measurements, category <1, or wells with low-frequency microbiological contamination and high-frequency wells or category 1-100, according to World Health Organization (WHO) quality criteria of drinking water. Of all wells, 18.12% showed high-frequency microbiological contamination with a majority distribution in the Ribera Alta region (26.98%, p < 0.001). No significant differences were found between the two risk categories for flow, static level, well depth and distance from population centres. This paper reveals that the vulnerability classes established by the Geological and Mining Institute of Spain (IGME) do not match the microbiological results, and that only eight wells with high-frequency contamination coincide with the high vulnerability areas

Exposición a factores ambientales y riesgo de tumores en el sistema nervioso central en niños: revisión sistemática y metaanálisis

Se analiza el riesgo de tumores en el sistema nervioso central en niños en relación con la exposición a factores ambientales como radiaciones (ionizantes, no ionizantes), sustancias químicas (pesticidas, productos de belleza, contaminantes atmosféricos) y alimentos. Se realizó una revisión sistemática y un metaanálisis con estudios identificados en la búsqueda de PubMed (1987-2013). Los resultados obtenidos a partir de los valores de OR muestran que el riesgo de tumores en el sistema nervioso central en niños se asocia significativamente con la exposición de los padres y que el periodo prenatal es una ventana crítica para varios de los factores ambientales considerados. Aunque la fracción de riesgo atribuible a cada factor aún se desconoce, el análisis estadístico permitió determinar asociaciones significativas para factores químicos como pesticidas (OR: 1,93; IC 95 % 1,51-2,47), contaminantes atmosféricos (OR: 1,45; IC 95 % 1,17-1,80) y alimentos con compuestos N-nitroso (OR: 1,96; IC 95 % 1,40-2,73) especialmente durante la exposición prenatal. Abstract. We analyzed the risk of tumors in the central nervous system of children in relation to exposure to environmental factors such as radiation (ionizing, non-ionizing), chemicals (pesticides, cosmetics, air pollutants) and foods. We performed a systematic review and meta-analysis of studies identified through a PubMed search (1987-2013). The results obtained from OR values show that the risk of tumors in the central nervous system of children is significantly associated with parental exposure and that the prenatal period is a critical window for several of the environmental factors considered. Although the risk fraction attributable to each factor is still unknown, a statistical analysis allowed to determine significant relations for chemical factors such as pesticides (OR:1.93; 95% IC 1.51-2.47), air pollutants (OR: 1.45; 95% IC 1.17-1.80) and foods with N-nitrous compounds (OR: 1.96; 95% IC 1.40-2.73) especially for prenatal exposur

Cocirculation and Coinfection Associated to Zika Virus in the Americas

Zika virus, a flavivirus, has arrived to Latin America in 2013. It became evident causing epidemics since 2015, first in Brazil and later in other countries in the region, such as Colombia, with a higher peak in 2016. The World Health Organization (WHO), based on cumulated evidence on its association with Guillain-Barre syndrome (GBS) and microcephaly and other birth defects (also the congenital Zika syndrome, CZS), declared for a period of almost a year, an international public health emergency. Epidemics in the region caused around 1 million cases with also additional complications beyond GBS and the CZS, which in patients with comorbidities lead to deaths. Among the events studied in the region, a number of cases with arboviral coinfections/codetection (dengue and chikungunya) were described and published beginning in Colombia and later in Brazil. In addition to that, cocirculation and still ongoing research on antibody-dependent enhancement (ADE) are challenges for physicians and public health authorities, given the implications for clinical manifestations and serological diagnosis in patients with previous exposition to other flaviviruses. We reviewed such aspects in this chapter

SUB-DIAGNÓSTICO DE DIABETES Y PREDIABETES EN POBLACIÓN RURAL

Introducción: La prediabetes es el estadio temprano donde los niveles de glucosa son más altos de lo normal, pero no lo suficiente para diagnosticar diabetes, está relacionada con la resistencia a la insulina y a la acumulación de grasa visceral. Objetivo: Identificar prevalencia de prediabetes y diabetes sub-diagnosticada en población rural mexicana. Métodos: Estudio transversal en adultos (≥20 años) del norte de Jalisco. Realizamos pruebas casuales de glucosa capilar y una encuesta para definir ayuno o posprandio. La diabetes se definió con una glucemia de ayuno ≥126 mg/dl o casual ≥200 mg/dl. La prediabetes se estableció con glucemia en ayuno de 100 a 125 mg/dl o posprandial de 140 a 199 mg/dl. Resultados: Estudiamos 423 sujetos sin diagnóstico de disglucemia. La diabetes se identificó en 10.6%, la prediabetes en 19.9%. Conclusiones: Este es el primer estudio en México que revela elevado sub-diagnóstico de diabetes y prediabetesABSTRACTIntroduction: Prediabetes is the early stage where glucose levels are higher than normal, but not enough to diagnose diabetes, is related to insulin resistance and visceral fat buildup.. Objective: Estimate prevalence of undiagnosed diabetes and prediabetes in rural Mexican population. Methods: Door to door cross-sectional study in a rural community of Jalisco. Those aged over 19 years who were available at the time were asked to participate. This convenience sample totaled 423 (288 women, 135 men). Participants underwent a capillary glucose test. Previously diagnosed diabetes was determined by self-report. Results: The prevalence of undiagnosed diabetes and prediabetes was 10.6% and 19.9 % respectively. Conclusions: This is the first study that indicates that diabetes and prediabetes has become a major public health problem in rural Mexican population. In this context, casual postprandial glucose test is useful in prediabetes diagnosis.Palabras Clave: prevalencia, diabetes mellitus, estado prediabético, México, prevalence, diabetes, prediabetic stat

Determinantes psicosociales de la adherencia al tratamiento en pacientes diabéticos tipo 2

Objective:To identify the psychosocial factors determiningthe treatment adherence in type 2diabetics (DM2). Materialsand methods: An observational, cross-sectional,and analyticalresearch was performedin 70patientsof the Health Center of Tacoaleche, based on the latestmonthly clinical record,glycemic,number of attendedappointments, and an instrument application that included variables socio-demographics,from the same disease,and psychosocial.Data were submitted to chi-square tests.Results. The 65.7percent were women with 57-yearsold, 54.3percent of them with incomplete elementary education, and 14.3percent illiterate. The 52.9percent was housewivesand the reminder women were devoted to other activities.The average of glucose was170.1mg/dl. All patients had drug treatment with nine years withDM2diagnosis.Only 10percent adhered to diet and physical exercise, 28.6percent attended to the medical appointments, and21.4percent had glycemic control. The most relevant psychosocial determinants (p>0.05) were:perception of available support, intentions to adhere, and disease severity.Conclusions.The lack of adherence to treatment to theDM2suggests implementing the search for new strategies to increase dietaryand exercisehabits. The attendance at scheduled medical appointments and glycemic control are also crucial factors for DM2control.Psychosocially, the health belief model and the theory of reasoned action helped to understand and explain adherence to the treatment.Key words:Psychosocialfactors, adherence to the treatment, type 2diabetes.Objetivo:Identificar los determinantes psicosociales de la adherencia al tratamiento en diabéticos tipo 2(DM2). Materialesy métodos: Se realizó una investigación observacional, transversal y analíticaen 70pacientes del Centro de Salud de Tacoaleche, basada en su último registro clínico mensual, glicemia,número deasistencia a citasy laaplicación deun instrumentoque incluyó variables sociodemográficas, de la enfermedad y psicosociales. La información fue sometida a pruebas deji-cuadrada. Resultados.El 65.7por ciento fueron mujerescon 57añosde edad, el 54.3por ciento con primaria incompleta y 14.3analfabetas. El 52.9por ciento eran amasde casay el resto se dedicaba aotras actividades.La glucosa promedio fue de 170.1mg/dl. Todos los pacientes tenían tratamiento farmacológicodenueveaños con diagnóstico de DM2. Únicamente 10por ciento se adhirieron a dieta y ejercicio, 28.6por ciento cumplieron con las citasmédicas y 21.4tuvieron control glucémico. Los determinantes psicosociales más relevantes (p>0.05) fueron: percepción de apoyo disponible, intenciones de adherir y severidad de la enfermedad. Conclusiones.La falta de apego al tratamiento de laDM2sugiere implementar la búsqueda de nuevas estrategias para incrementar hábitos dietéticosy deejerciciofísico. Tambiénla asistencia a las citasmédicas programadasy el control glicémicoson determinantes cruciales. Psicosocialmente,el modelo de creencias en salud y la teoría de la acción razonada ayudaron a comprender y explicarlaadherenciaal tratamiento. Palabras clave: Factores psicosociales, adherencia al tratamiento, diabetes tipo 2

Content validation of the nursing intervention called Environmental Control: worker safety

Objective: Validating the content of the nursing intervention called Environmental Control: worker safety in Spain. Methods: An exploratory and descriptive study using the Fehring method associated with the Delphi method and a sample of 11 experts in occupational nursing. For the clarity of definition and the activities was used a scale ranging from confusing (1) and clear (7) or vaguely (1) and exactly (7). A Likert scale (1 - totally disagree /5 - totally agree) was used for the nursing action and the need of the activity for its intervention. Results: The nursing action was considered as critical with the mean score of 0.86% (SD=0.23) and 73 % of the experts considered that the title of the intervention exactly identifies the contents of the definition. Conclusion: The intervention was considered valid for occupational health with the need for practical applicability using a system of classification specific for occupational health nursing, with the Nursing Process implementation.Enfermerí

La imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia. Departamento de Boyacá.

El presente informe permite analizar vivencias de la guerra desde la cotidianidad del país, en donde se presentan eventos psicosociales traumáticos que tienen una afectación a nivel personal, familiar y comunitario en las victimas a quienes les han sido vulnerados sus derechos, quienes de manera forzada han tenido que cambiar sus estilos de vida y su cotidianidad impidiéndoles continuar con sus costumbres y sus hábitos. Los hechos violentos han dejado secuelas en sus memorias, en su presente, en su interacción familiar, individual y colectiva, ademas de afectar su proyecto de vida.This report allows us to analyze experiences of war from the daily life of the country, in where traumatic psychosocial events occur that have an affectation on a personal level, family and community in the victims whose rights have been violated, who forced way they have had to change their lifestyles and their daily life preventing them Continue with your customs and habits. The violent events have left sequels in their memories, in your present, in your family, individual and collective interaction, in addition to affecting your life Proyect

Estudo piloto em cuidadores de pacientes com enfermidades neurológicas, sobre o significado e conhecimento de cuidados paliativos

Aim. To describe the meaning attributed to palliative care (PC) by caregivers, as well as their preference with respect to informing the patient and their satisfaction in their caring role. Methodology: Study descriptive transversal, sample intended of 40 caregivers of neurologic patients needing PC. A questionnaire about knowledge of the topic and their burnout status was applied. A descriptive-comparative analysis was carried out with 95% (pObjetivo. Describir el significado que atribuyen cuidadores a los cuidados paliativos (CPS), así como su preferencia respecto a informar al paciente y su satisfacción con el papel de cuidador. Metodología. Estudio descriptivo transversal, muestra intencional de 40 cuidadores de enfermos neurológicos con necesidad de CPS. Se aplicó un cuestionario de conocimientos sobre el tema y sobrecarga. Se realizó análisis descriptivo-comparativo con un intervalo de confianza de 95% (pObjetivo. Descrever o significado que atribuem cuidadores aos cuidados paliativos (CPS), assim como sua preferência com respeito a informar ao paciente e sua satisfação com o papel de cuidador. Metodologia. Estudo descritivo transversal, amostra intencional de 40 cuidadores de enfermos neurológicos com necessidade de CPS. Aplicou-se um questionário de conhecimentos sobre o tema e sobrecarga. Realizou-se análise descritivo-comparativa com um intervalo de confiança de 95% (

La escritura, lenguaje vivo en el aula: una experiencia de autoformación docente en didáctica

The project Teaching Writing, Language Alive in the Classroom: An Experience of Teacher Self-Training in Didactic, developed by the semillando group, comes from a critical look of our practices and concepts about writing and its teaching and learning processes in the first cycle of education. This reflection led us to initiate an investigation in our schools which would allow us to articulate the theoretical conceptions and achievements in the classroom. One of the first results of this process is the transformation of the reflection on the practices in investigative actions, among which these stand out: reading reality, formulating the research project as a guide of the pedagogical practices, the approach to research in the classroom and the formulation of a didactic proposal for the development of writing in the first season.El proyecto surge de una mirada crítica de las prácticas y concepciones sobre los procesos de enseñanza y aprendizaje de la escritura en el aula de primer ciclo. Esta reflexión condujo a iniciar un proceso de investigación que permitiera articular las concepciones teóricas y las realizaciones del aula. Uno de los primeros resultados de este proceso es la transformación de la reflexión sobre las prácticas en acciones investigativas entre las cuales se destacan las siguientes: la lectura de la realidad, la formulación del proyecto de investigación como orientador de la práctica pedagógica, el abordaje de la investigación en el aula y la formulación de una propuesta didáctica para el desarrollo de la escritura significativa en el primer ciclo