Abstract Introduction: The nursing area should perform a comprehensive assessment of adolescents and young people to be able to have an early intervention in the risk habits of this part of the population. Objective: Know how the consumption of energy drinks affects the mental health of adolescents and young adults. Methodology: Systematic review using selected reports for systematic reviews and PRISMA meta-analysis, searching Web Of Science, Medline, Scopus and Pubmed databases with descriptors such as energy drinks, mental health, young adult and adolescent. The inclusion criteria included articles published between 2017 and 2022, in Spanish, English or Portuguese, in the population aged 13 to 25, excluding secondary research, editorials, letters to the editor and expert opinions, not available in full text. Identifying 372 articles, leaving a sample of 10 for analysis and methodological evaluation using CASPe guidelines. Data used were duly referenced, respecting and identifying their authors. Results: The majority were studies using cross-sectional design. Frequent consumption of energy drinks increased levels of anxiety, depression, aggression and suicidal risk, with male adolescents being more affected. Conclusions: Although there was evidence of a relationship between energy drink consumption and mental health risks, most of the research used cross-sectional designs, so it was not possible to determine causality or direction of effect. In order to study the effect of energy drink consumption in depth, longitudinal studies and interventions are required since consumption is frequent and mental health problems are on the rise.

Abstrato Introdução: A área de enfermagem deve realizar uma avaliação abrangente dos adolescentes e jovens para poder intervir precocemente nos hábitos de risco dessa parcela da população. . Objetivo: Conhecer como o consumo de bebidas energéticas afeta a saúde mental de adolescentes e adultos jovens. Metodologia: Revisão sistemática usando relatórios selecionados para revisões sistemáticas e meta-análise PRISMA, pesquisando nos bancos de dados Web Of Science, Medline, Scopus e Pubmed com descritores como bebidas energéticas, saúde mental, adultos jovens e adolescentes. Os critérios de inclusão foram artigos publicados entre 2017 e 2022, em espanhol, inglês ou português, na população de 13 a 25 anos, excluindo pesquisas secundárias, editoriais, cartas ao editor ou opiniões de especialistas, não disponíveis em texto completo. Identificando 372 artigos, restando uma amostra de 10 para análise e avaliação metodológica utilizando as diretrizes do CASPe. Os dados utilizados foram devidamente referenciados, respeitando e identificando seus autores. Resultados: A maioria era de estudos com desenho transversal. O consumo frequente de bebidas energéticas aumentou os níveis de ansiedade, depressão, agressão e risco de suicídio, sendo os adolescentes do sexo masculino os mais afetados. Conclusões: Embora houvesse evidências de uma relação entre o consumo de bebidas energéticas e os riscos à saúde mental, a maioria das pesquisas utilizou desenhos transversais, de modo que não foi possível determinar a causalidade ou a direção do efeito. Para estudar o efeito do consumo de bebidas energéticas em profundidade, são necessários estudos longitudinais e intervenções, já que o consumo é frequente e os problemas de saúde mental estão aumentando.

Resumen Introducción: Enfermería debe realizar una valoración integral de adolescentes y jóvenes para poder intervenir en forma temprana sobre hábitos de riesgo. Objetivo: Conocer cómo afecta el consumo de bebidas energéticas en la salud mental de adolescentes y adultos jóvenes. Metodología: Revisión sistemática empleando informes preferidos para revisiones sistemáticas y metaanálisis PRISMA, realizando búsqueda en bases de datos Web Of Science, Medline, Scopus y Pubmed con descriptores bebidas energéticas, salud mental, adulto joven y adolescente, los criterios de inclusión fueron; artículos publicados entre 2017 y 2022, en idioma español, inglés o portugués, en población de 13 a 25 años, excluyendo investigaciones secundarias, editoriales, cartas al editor u opiniones de expertos, no disponibles en texto completo. Identificando 372 artículos, quedando una muestra de 10 para análisis y evaluación metodológica mediante pautas CASPe. Los datos utilizados fueron debidamente referenciados, respetando e identificando a sus autores. Resultados: La mayoría fueron estudios con diseño transversal, el ser consumidor frecuente de bebidas energéticas aumentó niveles de ansiedad, depresión, agresividad y riesgo suicida, siendo más afectados los adolescentes de género masculino. Conclusiones: Si bien se evidenció relación entre consumo de bebidas energéticas y riesgos para la salud mental, la mayoría de las investigaciones utilizaron diseños transversales, por lo cual no fue posible determinar causalidad o dirección del efecto. Se requieren estudios longitudinales e intervenciónes para estudiar con profundidad el consumo de bebidas energizantes, debido a que el consumo es frecuente y los problemas de salud mental van en aumento.

RESUMEN Una de las dificultades que afecta la salud ocupacional de los docentes universitarios en Ecuador son los riesgos laborales. El objetivo es analizar los riesgos laborales con la finalidad de fortalecer el bienestar ocupacional desde una mirada integral. Tipificamos los riesgos laborales en ergonómicos, psicosociales, y organizacionales para la toma de decisiones. Se sugieren políticas para la prevención de riesgos, creando un ambiente laboral adecuado, que den cuenta de una labor formativa de calidad. Se utilizaron métodos teóricos y empíricos del enfoque mixto de investigación, con una aproximación fáctica realizada por docentes de la Universidad Técnica Estatal de Quevedo, Ecuador.

ABSTRACT One of the difficulties affecting the occupational health of university teachers in Ecuador is occupational hazards. The objective is to analyze occupational risks in order to strengthen occupational wellbeing from an integral point of view. We classify occupational risks into ergonomic, psychosocial, and organizational risks for decision-making. We suggest policies for risk prevention, creating an adequate work environment, which will provide quality training. Theoretical and empirical methods of the mixed research approach were used, with a factual approach carried out by teachers of the Universidad Técnica Estatal de Quevedo, Ecuador.

ABSTRACT Unhealthy diets, preventable risk factors for noncommunicable diseases (NCDs), pose a growing challenge that coexists with pre-existing and persistent malnutrition problems. These also coexist and interact synergistically with climate change dynamics, which threaten the sustainability of food systems, and are silently intersected by gender dynamics. States have adopted measures to address these issues, including regulations to promote healthy diets and prevent food loss and waste. However, state responses to problems with frequently common causes are often adopted in a fragmented manner, with elements that are contradictory to each other and the human rights framework. This paper presents the aforementioned discussions by comparing regulatory initiatives from three countries, Colombia, Chile, and Argentina, analyzing their internal compatibility and alignment with the international human rights framework. Finally, it proposes ideas to reconcile the diverse agendas from a comprehensive perspective.

RESUMEN Las dietas malsanas, factores de riesgo prevenibles de enfermedades no transmisibles (ENT), constituyen un reto creciente, que coexiste con problemas preexistentes y persistentes de desnutrición. Éstos, además, conviven e interactúan sinérgicamente con dinámicas de cambio climático, que amenazan la sostenibilidad de los sistemas alimentarios, y son atravesadas silenciosamente por dinámicas de géneros. Los Estados han adoptado medidas para abordar estas problemáticas, entre ellas, normas para promover la alimentación saludable y prevenir la pérdida y desperdicios de alimentos. No obstante, las respuestas estatales a problemas cuyas causas son frecuentemente comunes se adoptan de manera fragmentada, con elementos contradictorios entre sí y con el marco de derechos humanos. El presente trabajo presenta las anteriores discusiones comparando las iniciativas regulatorias de tres países, Colombia, Chile y Argentina, analizando su compatibilidad hacia el interior y el marco internacional de derechos humanos. Finalmente, plantea ideas disparadoras para reconciliar las diversas agendas desde una mirada integral.

Abstract Objective: To examine the association between dependence, nutritional assessment, frailty, and sarcopenia screening in Peruvian older adults (OA). Material and Methods: This was a cross-sectional observational study. Participants were adults aged ≥ 60 years from the District of Miraflores, Peru. Data were collected on various variables, including sociodemographic information, comprehensive geriatric assessment, body composition assessment, and biochemical analysis. Results: A total of 100 participants were included, 67% of whom were female. Among the participants, 29% were mildly dependent, with none being severely dependent. The dependent group had significantly higher scores in sarcopenia screening (p<0.001) and daytime sleepiness (p<0.001), while reporting less frequent consumption of unhealthy foods (p=0.047). Conclusions: Older adults with dependence were associated with older age, daytime sleepiness, higher sarcopenia risk scores, and lower consumption of unhealthy foods compared to those without dependence issues.

Resumen Objetivo: Asociar la dependencia con valoración nutricional, fragilidad y un screening de Sarcopenia en los personas mayores (PM) peruanas. Material y Métodos: Estudio observacional transversal. Participaron en este estudio PM de ≥ 60 años, pertenecientes al Distrito de Miraflores, Perú. Se obtuvo información sobre diferentes variables: sociodemográficas, valoración geriátrica integral, las relacionadas con evaluación de la composición corporal y análisis bioquímico. Resultados: Participaron 100 PM, de los cuales 67% eran del sexo femenino, el 29% de los participantes presento dependencia leve, ninguno presento dependencia severa. El grupo de personas con dependencia presenta significativamente un mayor puntaje en el screening de sarcopenia (p<0,001) y somnolencia diurna (p<0,001). Por el contrario, consumen con menos frecuencia alimentos poco saludables (p=0,047) y tienen un mayor consumo de alimentos saludables (p<0,05). Conclusiones: Las personas mayores con dependencia se asocian con mayor edad, somnolencia diurna, mayor puntaje en riesgo de sarcopenia y un mayor consumo de alimentos saludables en comparación con aquellas que no presentan problemas de dependencia.

ABSTRACT The territories ofNuestra Américahave been subjected to natural and sociopolitical dynamics that put them at risk. However, governmental authorities have preferred to implement strategies borrowed from the so-called developed countries rather than to develop their own strategies based on local past-experiences and knowledge. Therefore, from the need to reflect on the importance of construct proposals for the integral resilience of the territories, considering the characteristics and potential of local ecosystems and sociocultural aspects, the historical particularities and political ecology aspects stand out. Those are important in the construction or strengthening of resilience in Nuestra América.

RESUMEN Los territorios de Nuestra América han estado sometidos a dinámicas naturales y sociopolíticas que los ponen en riesgo. Sin embargo, las autoridades gubernamentales han preferido implementar estrategias de países considerados desarrollados, en lugar de aprender de las experiencias pasadas y emplear el conocimiento local. Por tanto, a partir de la necesidad de reflexionar sobre la importancia de construir propuestas para la resiliencia integral de los territorios, teniendo en cuenta las características y potencialidades ecosistémicas y socioculturales locales, se destacan las particularidades históricas y los aspectos de ecología política a considerar al pensar en la construcción o fortalecimiento de resiliencia en Nuestra América.

RESUMEN En este trabajo se argumenta cómo la formación para la ciudadanía se constituye en uno de los pilares fundamentales y de los principales desafíos de las IES para contribuir a la formación integral de los estudiantes, a partir de la indisoluble relación entre educación y ciudadanía. Por ello, esta formación no debe limitarse a los niveles primarios, básicos o medios de la educación. Se considera un modo privilegiado a través del cual cada IES y particularmente la Universidad de El Salvador, puede cumplir su responsabilidad social, mejorando la calidad y pertinencia educativa, asumiendo un compromiso más consciente, sistemático y planificado de la formación para la ciudadanía de los estudiantes. Para el desarrollo de la investigación se utilizaron los métodos teóricos: analítico-sintético e histórico-lógico y los empíricos: revisión documental y observación directa. Como resultado se llegó a la conclusión de que las universidades, deben volver su mirada hacia sí mismas, reflexionar crítica y autocríticamente sobre su razón de ser en el actual contexto histórico de las sociedades latinoamericanas, para evitar el riesgo de caer en la irrelevancia educativa e institucional y de ser menos pertinentes frente a las nuevas exigencias que les impone la sociedad en pleno siglo XXI.

ABSTRACT This work argues how training for citizenship constitutes one of the fundamental pillars and of the main challenges of HEIs to contribute to the comprehensive training of students, based on the indissoluble relationship between education and citizenship. Therefore, not be limited to primary, basic or middle levels of education. It is considered a privileged way through which, particularly the University of El Salvador (UES), can fulfill their social responsibility by improving the quality and relevance of their education and assuming training in a more committed, conscious, systematic and planned way. for the citizenship of students. To develop the research, the analytical-synthetic and historical-logical methods were used as theoretical methods, and documentary review and direct observation were used as empirical methods. As a result of the research, the conclusion was reached that universities must turn their gaze towards themselves, reflect critically and self-critically on their reason for being in the current historical context of Latin American societies, to avoid the risk of falling into educational and institutional irrelevance and being less relevant to the new demands that society imposes on them in the 21st century.

Abstract Data mining in the context of criminal occupation risk focuses on the application of analytical techniques to identify patterns, trends and correlations that may indicate the presence of illegal armed groups in the territories. The study presents the calculation of the risks of occupation by the illegal groups Clan del Golfo, Ejército de Liberación Nacional (ELN) and Los Pachelly in the municipalities of the department of Antioquia in Colombia. For this purpose, the databases used correspond to open sources such as the Statistical, Criminal, Contraventional and Operational Information System of the National Police (SIEDCO), the Directorate of Criminal Investigation and INTERPOL (DIJIN), the Colombian Drug Information System (SIDCO), the Ministry of Defence, the National Institute of Legal Medicine, the Land Observatory, the Unit for the Attention and Integral Reparation of Victims, the Ombudsman’s Office, the Directorate of Substitution of Illicitly Used Crops, the E. S.E. Hospital Carisma, the Departmental Information Directorate-Government of Antioquia, the National Administrative Department of Statistics (DANE) and the Ministry of National Education. We also used the Cross Industry Standard Process for Data Mining (CRISP-DM) methodology and combined principal component analysis (PCA) and the Fuzzy c-Means (FCM) technique to identify in the data the social, economic, labour, educational and criminal variables that most contribute to the risk of the presence of criminal structures in the municipalities, which allowed us to classify them as low risk, medium risk, medium-high risk, high risk and very high risk. The results show that 26% of the municipalities would have a high risk for the Clan del Golfo, 11% for the ELN and another 12% for Los Pachelly. Furthermore, it was found that the results can be used in a prototype of an integrated early warning system to detect risks of criminal occupation.

Resumo A mineração de dados no contexto do risco de ocupação criminosa concentra-se na aplicação de técnicas analíticas para identificar padrões, tendências e correlações que possam indicar a presença de grupos armados ilegais nos territórios. O estudo apresenta o cálculo dos riscos de ocupação pelos grupos ilegais Clan del Golfo, Ejército de Liberación Nacional (ELN) e Los Pachelly nos municípios do departamento de Antioquia, na Colômbia. Para isso, os bancos de dados utilizados correspondem a fontes abertas, como o Sistema de Informação Estatística, Criminosa, Contravencional e Operacional da Polícia Nacional, a Direção de Investigação Criminosa e Interpol, o Sistema de Informação sobre Drogas da Colômbia, o Ministério da Defesa, o Instituto Nacional de Medicina Legal, o Observatório da Terra, a Unidade de Atenção e Reparação Integral de Vítimas, a Defensoria do Povo, a Direção de Substituição de Cultivos de Uso Ilícito, o E.S.E. Hospital Carisma, o Centro de Estudos de Drogas e o Centro de Estudos de Drogas da Colômbia. S.E. Hospital Carisma, a Direção de Informação Estadual-Governo de Antioquia, o Departamento Administrativo Nacional de Estatística e o Ministério de Educação Nacional. També musamos a metodologia Cross Industry Standard Process for Data Mining e combinamos a análise de componentes principais e a técnica Fuzzy c-Means (FCM) para identificar nos dados as variáveis sociais, econômicas, trabalhistas, educacionais e criminais que mais contribuem para o risco de presença de estruturas criminosas nos municípios, o que permitiu classificá-los como de baixo risco, médio risco, médio-alto risco, alto risco e muito alto risco. Os resultados mostram que 26 % dos municípios estão em alto risco para o Clã do Golfo, 11 % para o ELN e outros 12 % para Los Pachelly. Além disso, verificou-se que os resultados podem ser usados em um protótipo de um sistema integrado de alerta precoce para detectar riscos de ocupação criminosa.

Resumen La minería de datos en el contexto del riesgo de ocupación criminal, se centra en la aplicación de técnicas analíticas para identificar patrones, tendencias y correlaciones que puedan indicar la presencia de grupos armados ilegales en los territorios. El estudio presenta el cálculo de los riesgos de ocupación por parte de los grupos ilegales Clan del Golfo, Ejército de Liberación Nacional (ELN) y Los Pachelly en los municipios del departamento de Antioquia en Colombia. Para ello, las bases de datos utilizadas corresponden a fuentes abiertas como el Sistema de Información Estadístico, Delincuencial, Contravencional y Operativo de la Policía Nacional (SIEDCO), la Dirección de Investigación Criminal e INTERPOL (DIJIN), el Sistema de Información de Drogas de Colombia (SIDCO), el Ministerio de Defensa, el Instituto Nacional de Medicina Legal, el Observatorio de Tierras, la Unidad para la Atención y Reparación Integral a las Víctimas, la Defensoría del Pueblo, la Dirección de Sustitución de Cultivos de Uso Ilícito, la E.S.E. Hospital Carisma, la Dirección de Información Departamental-Gobernación de Antioquia, el Departamento Administrativo Nacional de Estadística (DANE) y el Ministerio de Educación Nacional. Asimismo, utilizamos la metodología Cross Industry Standard Process for Data Mining (CRISP-DM) y se combinó el análisis de componentes principales (ACP) y la técnica Fuzzy c-Means (FCM) para identificar en los datos las variables sociales, económicas, laborales, educacionales y criminales que mayormente aportan al riesgo de presencia de las estructuras criminales en los municipios, lo que permitió clasificarlos en riesgo bajo, riesgo medio, riesgo medio-alto, riesgo alto y riesgo muy alto. Los resultados muestran que el 26 % de los municipios tendrían un riesgo alto para el Clan del Golfo, el 11 % con el ELN y otro 12 % para Los Pachelly. Además, se encontró que los resultados pueden utilizarse en un prototipo de un sistema integrado de alerta temprana para detectar riesgos de ocupación criminal.

RESUMEN Introducción: Los factores y riesgos psicosociales laborales han adquirido mayor relevancia para el análisis y transformación de las dinámicas laborales en las últimas décadas. Sin embargo, resulta compleja la comprensión y diferenciación entre estos conceptos, lo cual dificulta su gestión efectiva. Se propone debatir sobre la dialéctica de los factores psicosociales: de riesgo, protectores y riesgos psicosociales, su diferenciación y su gestión eficaz. Desarrollo: Se dialoga con definiciones ofrecidas por diferentes expertos sobre los factores psicosociales laborales: de riesgo, protectores y los riesgos psicosociales, arribando a una comprensión de su diferenciación y su dialéctica en la práctica. A su vez, se recomiendan pautas de acción para una gestión eficaz de la seguridad y salud laboral, que integre los factores psicosociales desde un enfoque proactivo, para potenciar el desarrollo humano en el trabajo. Conclusiones: Se sugiere un marco de referencia para una gestión integral, integrada y participativa de la seguridad y salud en el trabajo en las organizaciones laborales, con énfasis en un enfoque psicosocial y proactivo.

ABSTRACT Introduction: Psychosocial work factors and risks have acquired greater relevance for the analysis and transformation of work dynamics in recent decades. However, the understanding and differentiation between these concepts is complex, which makes their effective management difficult. It is proposed to debate the dialectic of psychosocial factors: risk, protective and psychosocial risks, their differentiation and effective management. Development: There is dialogue with definitions offered by different experts on psychosocial work factors: risk, protective and psychosocial risks, arriving at an understanding of their differentiation and dialectic in practice. At the same time, action guidelines are recommended for effective management of occupational health and safety, which integrates psychosocial factors from a proactive approach, to enhance human development at work. Conclusions: A frame of reference is suggested for a comprehensive, integrated and participatory management of safety and health at work in labor organizations, with emphasis on a psychosocial and proactive approach.

ABSTRACT Introduction: Chronic kidney disease is a global health problem. Its most serious manifestation, chronic kidney failure, affects the Cuban context and determines the growth of patients on hemodialysis. The objective of the text is to evaluate the main results of the diagnosis and characterization of the problematic situation in a psychosocial study with patients with Chronic Renal Failure in the Hemodialysis room of the Florida municipality, of the county of Camagüey. Method: It is an experimental participatory action research, which takes place between January 2023 and December 2024, which constitutes the output of the research project System of psychosocial actions for the improvement of comprehensive care for patients with non-communicable diseases. The universe is made up of 56 patients and the sample is made up of 22, who receive purifying and conservative treatment, 22 family members and 12 service professionals. The research instrument par excellence was the participant survey. Results: The age of the patients is not definitive of an age group; men predominate; A high percentage of patients are found to have low tolerance for adherence to treatment and insufficient development of psychosocial skills and declare the need to possess knowledge to achieve health states that lead to survival. Discussion: There is no coincidence with what was found in the determination of the prevalence age groups for the disease, but specialists insist that the disease is not exclusive to a specific period of life; recognize the importance of the patient's knowledge of risk factors for prevention, promotion and health education and highlight the need for communication and empathy between health personnel and the patient, to achieve favorable results and emotional states in the face of the disease and treatment.

RESUMEN Introducción: La enfermedad renal crónica es un problema de salud a nivel mundial, su manifestación más grave, la insuficiencia renal crónica, incide en el contexto cubano y determina el crecimiento de pacientes en hemodiálisis. El objetivo del texto es valorar los principales resultados del diagnóstico y caracterización de la situación problémica en un estudio de carácter psicosocial con pacientes con Insuficiencia Renal Crónica en la sala de Hemodiálisis del municipio Florida, de la provincia de Camagüey. Método: Es una investigación-acción participativa de corte experimental, que se desarrolla entre enero 2023 y diciembre del 2024 la cual constituye salida del proyecto de investigación Sistema de acciones psicosociales para el perfeccionamiento de la atención integral a los pacientes con enfermedades no transmisibles. El universo está constituido por 56 pacientes y la muestra por 22, que reciben tratamiento depurador y conservador, 22 familiares y 12 profesionales del servicio. El instrumento de investigación por excelencia fue la encuesta a participantes. Resultados: La edad de los pacientes no es definitiva de un grupo etario; predominan los hombres; se constata un elevado por ciento de pacientes con poca tolerancia a la adherencia al tratamiento e insuficiente desarrollo de las habilidades psicosociales y declaran la necesidad de poseer conocimientos para lograr estados de salud que conlleven a la sobrevida. Discusión: No existe coincidencia con lo constatado en la determinación de los grupos etarios de prevalencia para la enfermedad, pero los especialistas insisten en que la enfermedad no es privativa de un período de vida específico; reconocen la importancia del conocimiento de los factores de riesgo por el paciente para la prevención, promoción y educación en salud y resaltan la necesidad de la comunicación y la empatía entre el personal de salud y el paciente, para lograr resultados y estados emocionales favorables ante la enfermedad y el tratamiento.

BACKGROUND: Maintaining or promoting employment in the presence of disability or reducing the impact of disability on employability should be the adopted focus to decrease the negative impact that disability has on the economy and just as important on the livelihood and well-being of exposed insured individuals. Group risk disability insurance protects an employee's income when illness or injury result in work disability. To achieve this, factors that promote the success of rehabilitation and support for return-to-work of employees following illness and injury need to be understood from an insurance perspective. OBJECTIVES: To explore principles of disability claims management during the rehabilitation and work reintegration stage using a multi-stakeholder approach for the purpose of successful return to work. METHODS: An exploratory qualitative design was used to collect data via semi-structured interviews with 26 purposively selected participants. Interviews were audio-recorded, data were transcribed and analysed thematically. Qualitative research was used to understand the necessary role players in the work reintegration process, factors that hinder and promote work reintegration and best practice principles for Disability Claims Management (DCM). RESULTS: Three themes emerged from the study; (i) role players and their functions with collaboration is integral to disability claims management, (ii) various factors promote and restrict return-to-work planning, and (iii) best practice principles in the DCM pathway that promote return-to-work. These principles include behavioural economics as the central principle, with resource identification and competency, governance, role engagement and education and awareness as supporting principles. CONCLUSION: Collaborative and integrated approaches by role players within a workers' family unit, health system, employer structure and insurance compensation are required for positive return-to-work outcomes. The various role players are responsible for creating policies, structures, intervention strategies, and environments that foster return-to-work. IMPLICATIONS FOR PRACTICE • An integrated approach is required for optimal RTW outcomes as employers' policies restrict work integration. • A collaborative approach by all role players involved in DCM, focusing on positive RTW outcomes is required in the RTW process • Occupational therapists can influence employer incapacity and disability policies in order to keep people employed and productive in the presence of medical conditions with the application of reasonable accommodations where necessary. • Occupational therapists are suitably positioned to outline workplace environment and other supports required to guide and support employees through rehabilitation and RTW and in ensuring that employees who can remain at work while on a partial or fully insured benefit, can engage optimally in aspects of work function.

Abstract This research was carried out in the Agricultural Transportation Company of Pinar del Río province, due to the need to define the vulnerabilities of the risk integral management system implemented by this organization. The objective of this article is focused on analyzing the current state of the risk integral management in the Agricultural Transportation Company of Pinar del Río, which will allow knowing the vulnerabilities in the process to improve quality, protection and safety without compromising efficiency and sustainability. The historical-logical method was used in order to analyze the evolution, operation and development of risk integral management in companies of the transport sector; the analysis-synthesis, which allowed revealing the essential relations and more general characteristics of risk integral management. Among the research techniques used were the interview, survey, checklists and documentary analysis, whose results were processed to arrive at conclusions with the help of the statistical method, as well as the Ishikawa diagram, to determine the cause-effect relationships in the risk integral management process. As main results of the diagnosis, the insufficient risk integral management in the company stands out, where the causes and subcauses are determined by each stage of the risk management life cycle, being the identification stage the one with the highest number, however, each of the problems detected have an impact on the other functions due to the systemic nature of the process.

Resumo Esta pesquisa foi realizada na Empresa de Transporte Agropecuário de Pinar del Río, na província de Pinar del Río, devido à necessidade de definir as vulnerabilidades do sistema de gerenciamento integrado de riscos implementado por essa organização. O objetivo deste artigo é analisar o estado atual do gerenciamento integrado de riscos na Empresa de Transporte Agrícola de Pinar del Río, o que nos permitirá identificar as vulnerabilidades do processo para melhorar a qualidade, a proteção e a segurança sem comprometer a eficiência e a sustentabilidade. O método histórico-lógico foi usado para analisar a evolução, o funcionamento e o desenvolvimento do gerenciamento integrado de riscos em empresas do setor de transportes, e o método de análise-síntese foi usado para revelar as relações essenciais e as características mais gerais do gerenciamento integrado de riscos. As técnicas de pesquisa utilizadas incluíram entrevistas, pesquisas, listas de verificação e análise documental, cujos resultados foram processados para se chegar a conclusões usando o método estatístico, bem como o diagrama de Ishikawa para determinar as relações de causa e efeito no processo de gerenciamento integrado de riscos. Os principais resultados do diagnóstico destacam a insuficiência do gerenciamento integrado de riscos na empresa, em que as causas e subcausas são determinadas por cada etapa do ciclo de vida do gerenciamento de riscos, sendo a etapa de identificação a que apresenta o maior número; no entanto, cada um dos problemas detectados tem impacto sobre as outras funções devido à natureza sistêmica do processo.

Resumen La presente investigación se desarrolló en la Empresa de Transporte Agropecuario de la provincia de Pinar del Río, por la necesidad de definir las vulnerabilidades del sistema de gestión integral de riesgos que implementa dicha organización. El objetivo del presente artículo se centra en analizar el estado actual de la gestión integral de riesgos en la empresa de Transporte Agropecuario de Pinar del Río, lo que permitirá conocer las vulnerabilidades en el proceso para mejorar la calidad, protección y seguridad sin comprometer la eficiencia y la sustentabilidad. Se utilizó el método histórico-lógico a fin de analizar la evolución, funcionamiento y desarrollo de la gestión integral de riesgos en empresas del sector del transporte y el análisis-síntesis, que permitió revelar las relaciones esenciales y características más generales de la gestión integral de riesgos. Entre las técnicas de investigación empleadas, se encuentran la entrevista, encuesta, las listas de verificación y el análisis documental, cuyos resultados fueron procesados para arribar a conclusiones con ayuda del método estadístico, así como el diagrama de Ishikawa, para determinar las relaciones causa-efecto en el proceso de gestión integral de riesgos. Como principales resultados del diagnóstico, resalta la insuficiente gestión integral de los riesgos en la empresa, donde las causas y subcausas están determinadas por cada etapa del ciclo de vida de la gestión de riesgos, siendo la etapa de identificación la de mayor número, sin embargo, cada una de las problemáticas detectadas impactan en las demás funciones debido al carácter sistémico del proceso.

Abstract This study investigated access to health care among female prisoners in the state of Ceará, Brazil, and screened for common mental disorders. We conducted an analytical cross-sectional study in the only female prison in the state. Ninety detainees participated in the study. All participants were either pregnant or postpartum women or had one or more of the following health problems: hypertension, diabetes mellitus, tuberculosis, syphilis, hepatitis B, HIV/AIDS. The data were collected using a structured questionnaire. The findings reveal that access to health care was limited, violating the fundamental rights of the prisoners. Screening for diseases on admission to prison was limited, especially among non-pregnant women. Differences in health care were found between health conditions, with priority being given to pregnant and postpartum women. Most of the inmates (68.24%) were found to be at risk for common mental disorders (SRQ score > 7). A positive correlation was found between age and mental health problems (p = 0.0002). Despite legislation guaranteeing access to health care in prisons, the prison system is unprepared to meet the health needs of female prisoners with comorbidities and pregnant and puerperal women. Ceará Brazil crosssectional cross sectional hypertension mellitus tuberculosis syphilis B HIVAIDS HIV AIDS HIV/AIDS questionnaire limited nonpregnant non conditions 68.24% 6824 68 24 (68.24% SRQ 7. 7 . 7) p 0.0002. 00002 0.0002 0 0002 0.0002) prisons 68.24 682 6 2 (68.24 0000 0.000 000 68.2 (68.2 0.00 00 68. (68. 0.0 (68 0. (6 (

Resumo O estudo analisa o acesso ao cuidado em saúde de mulheres encarceradas no estado do Ceará, rastreando transtornos mentais comuns. Estudo analítico, transversal, de natureza quantitativa, desenvolvido na única penitenciária feminina do Ceará. Participaram 90 detentas, todas com alguma das seguintes questões de saúde: gestantes, puérperas, portadoras de hipertensão arterial sistêmica, diabetes mellitus, tuberculose, sífilis, hepatite B ou HIV/Aids. Os dados foram coletados por entrevista estruturada. Evidenciou-se acesso limitado à atenção à saúde das detentas, violando direitos básicos sob tutela do Estado. Foram constatadas limitações de exames de rastreamento de doenças nas presidiárias na ocasião de seu acesso ao cárcere, principalmente as que não se encontravam grávidas no momento do encarceramento. Houve diferenças entre as distintas condições de saúde analisadas, com prioridade da atenção às gestantes e puérperas. Entre as detentas, 68,24% apresentavam risco de transtornos mentais comuns (SRQ > 7). Houve correlação positiva entre idade e saúde mental (p = 0,0002). Embora exista legislação pertinente de garantia de acesso à saúde no cárcere, o sistema prisional está despreparado para atender às necessidades de portadoras de comorbidades, gestantes e puérperas. Ceará analítico transversal quantitativa 9 detentas puérperas sistêmica mellitus tuberculose sífilis HIVAids HIV Aids HIV/Aids estruturada Evidenciouse Evidenciou Estado cárcere encarceramento analisadas 6824 68 24 68,24 SRQ 7. 7 . 7) p 0,0002. 00002 0,0002 0 0002 0,0002) comorbidades 682 6 2 68,2 0000 0,000 000 68, 0,00 00 0,0 0,

Resumo O estudo analisa o acesso ao cuidado em saúde de mulheres encarceradas no estado do Ceará, rastreando transtornos mentais comuns. Estudo analítico, transversal, de natureza quantitativa, desenvolvido na única penitenciária feminina do Ceará. Participaram 90 detentas, todas com alguma das seguintes questões de saúde: gestantes, puérperas, portadoras de hipertensão arterial sistêmica, diabetes mellitus, tuberculose, sífilis, hepatite B ou HIV/Aids. Os dados foram coletados por entrevista estruturada. Evidenciou-se acesso limitado à atenção à saúde das detentas, violando direitos básicos sob tutela do Estado. Foram constatadas limitações de exames de rastreamento de doenças nas presidiárias na ocasião de seu acesso ao cárcere, principalmente as que não se encontravam grávidas no momento do encarceramento. Houve diferenças entre as distintas condições de saúde analisadas, com prioridade da atenção às gestantes e puérperas. Entre as detentas, 68,24% apresentavam risco de transtornos mentais comuns (SRQ > 7). Houve correlação positiva entre idade e saúde mental (p = 0,0002). Embora exista legislação pertinente de garantia de acesso à saúde no cárcere, o sistema prisional está despreparado para atender às necessidades de portadoras de comorbidades, gestantes e puérperas.

Abstract This study investigated access to health care among female prisoners in the state of Ceará, Brazil, and screened for common mental disorders. We conducted an analytical cross-sectional study in the only female prison in the state. Ninety detainees participated in the study. All participants were either pregnant or postpartum women or had one or more of the following health problems: hypertension, diabetes mellitus, tuberculosis, syphilis, hepatitis B, HIV/AIDS. The data were collected using a structured questionnaire. The findings reveal that access to health care was limited, violating the fundamental rights of the prisoners. Screening for diseases on admission to prison was limited, especially among non-pregnant women. Differences in health care were found between health conditions, with priority being given to pregnant and postpartum women. Most of the inmates (68.24%) were found to be at risk for common mental disorders (SRQ score > 7). A positive correlation was found between age and mental health problems (p = 0.0002). Despite legislation guaranteeing access to health care in prisons, the prison system is unprepared to meet the health needs of female prisoners with comorbidities and pregnant and puerperal women.

ABSTRACT Introduction: A narrative review was carried out of the studies published from 2016 to 2021 on the clinical, etiological, imaging and therapeutic aspects of the different clinical forms of vascular cerebral disease in the elderly. The databases of Medline (PubMed), SciELO, Cochrane and Google Scholar were consulted. Original articles, published in peer-reviewed journals, that included patients over 65 years of age, with a diagnosis of cerebral vascular disease, were taken into account. Objective: Update on the particularities of cerebral vascular disease in older adults. Development: In cerebrovascular disease of the elderly, particular conditions are observed: biological, psychological and social, which are less frequent or may even be absent in younger age groups. Large vessel atherosclerosis, cardioembolism, small vessel disease, and cerebral amyloid angiopathy are the predominant etiologies, although other causes may exist. Vascular cognitive impairment represents the second cause of dementia and is a clinical form of presentation of cerebral vascular disease in this age group. Conclusions: Cerebrovascular disease in the elderly presents particular characteristics that are summarized in: greater comorbidity and richness of risk factors, which require a systemic, dialectically interrelated and personalized diagnostic approach, in which neuroimaging occupies a unique place. importance; which, in interaction with the clinic, will allow a more comprehensive diagnosis and evolutionary follow-up of these patients.

RESUMEN Introducción: Se realizó una revisión narrativa de los estudios publicados desde 2016 hasta 2021 sobre los aspectos clínicos, etiológicos, imagenológicos y terapéuticos de las diferentes formas clínica de la enfermedad cerebral vascular en los ancianos. Se consultaron las bases de datos de Medline (PubMed), SciELO, Cochrane y Google Académico. Se tuvieron en cuenta los artículos originales, publicados en revistas con revisión por pares, que incluyeran pacientes mayores de 65 años, con diagnóstico de enfermedad vascular cerebral. Objetivo: Actualizar sobre las particularidades de la enfermedad vascular cerebral en el adulto mayor. Desarrollo: En la enfermedad cerebrovascular del adulto mayor se observan condiciones particulares: biológicas, psicológicas y sociales, que son menos frecuente o incluso pueden estar ausentes, en los grupos etarios más jóvenes. La arterioesclerosis de grandes vasos, el cardioembolismo, la enfermedad de pequeños vasos y la angiopatía cerebral amiloidea constituyen las etiologías predominantes, aunque pueden existir otras causas. El deterioro cognitivo vascular representa la segunda causa de demencia y es una forma clínica de presentación de la enfermedad vascular cerebral en este grupo etario. Conclusiones: La enfermedad cerebrovascular en el adulto mayor, presenta características particulares que se resumen en: mayor comorbilidad y riqueza de factores de riesgo, que obligan a un enfoque diagnóstico sistémico, dialécticamente interrelacionado y personalizado, en el cual las neuroimágenes ocupan un lugar de singular importancia; que, en interacción con la clínica, permitirán un diagnóstico y seguimiento evolutivo más integral de estos pacientes.

Abstract The Basel large exposures standard, addressed to banks, is in the process of being implemented, and although the new rule is reducing the limit for the large credit exposures in banks, and is geared to better control the portfolio risk parameters that make a portfolio more prone to losses due to credit concentration, it is important to know the share of risk and capital implicit to this new rule. In this work, the implicit add-ons for credit risk concentration are determined through a Monte Carlo credit risk model, and the results are compared with current capital requirements. The author also analyzed the complete Basel framework to understand how the concentration risk is addressed in an integrated approach rather than with a specific capital supplement.

Resumen La regulación de Basilea sobre grandes exposiciones está en proceso de implementación y, aun que es una regulación que reduce el límite del tamaño para las exposiciones de gran tamaño en los bancos y está orientada a un mejor control de los parámetros de riesgo que ocasiona que los portafolios se inclinen más a tener pérdidas grandes por concentración de crédito, es importante conocer la porción de riesgo de crédito y capital que lleva implícita. En este trabajo se determinan, mediante una simulación Montecarlo a través de un modelo de riesgo de crédito, los add-ons implícitos (o añadidos implícitos) debidos a la concentración de crédito, y se comparan con los requisitos actuales de capital. Al mismo tiempo, se analiza el marco completo de Basilea para entender cómo se aborda el riesgo de crédito de concentración, esto es, de forma integral, más que mediante un suplemento particular de capital.