Antimicrobial resistance (AMR), in which microbes adapt to and resist current therapies, is a well-recognised global problem that threatens to reverse gains made by modern medicine in the last decades. AMR is a complex issue; however, at its core, it is driven by the overuse and inappropriate use of antimicrobials. Socioeconomic factors have been identified as significant contributors to the emergence and exacerbation of AMR, especially in populations facing inadequate access to healthcare, poor sanitation services and high morbidity and mortality rates. Weak healthcare systems and water, sanitation and hygiene have been highlighted as fundamental risk factors for AMR emergence and transmission. Behavioural factors, such as purchasing antibiotics without a prescription from a registered healthcare professional, not completing the prescribed course or overly prolonged courses of antibiotics, using antibiotics to treat viral infections, lack of access to quality antibiotics, and the proliferation of substandard or falsified (SF) drugs, have also been identified as significant contributors to AMR. Low- and middle-income countries have a higher incidence of antibiotics being dispensed without a prescription than higher-income countries.

Resumen Durante las últimas décadas en Puno, Perú, la problemática de la contaminación se fue agudizando por la acción combinada del crecimiento desordenado de la población urbana, gestión deficiente de residuos sólidos, descarga de aguas servidas sin tratamiento en la bahía del lago Titicaca y prácticas de sanidad e higiene inadecuadas; situaciones que afectan severamente el ambiente y la salud humana. El objetivo del estudio fue caracterizar las actitudes y comportamientos proambientales de la población de la ciudad de Puno en relación al saneamiento, la contaminación y la gestión ambiental. La investigación es no experimental, cuantitativa, trans¬versal, descriptiva, correlacional y nivel de análisis micro. El universo de estudio fue la población mayor de 18 años del área urbana, que comprende 97.264 habitantes; la muestra, deter¬minada al azar simple, fue de 382 personas. Se aplicó un cuestionario estructurado. El análisis descriptivo, inferencial y prueba de hipótesis se realizó con el software estadístico SPSS. Los resultados señalan que las actitudes ambientales de la mayoría de la población son positivas respecto a factores y fuentes de contaminación y efectos en la salud humana; contrariamente, las prácticas ambientales son inadecuadas en gestión ambiental en el hogar y condiciones de sanidad e higiene en la vivienda. Se concluye, que la mejora sostenible de actitudes y comportamientos proambientales, demanda de una nueva política pública de educación ambiental, cuya implementación incorpore la participación efectiva de la sociedad civil con base a un sistema de incentivos.

Abstract During the last decades in Puno, Peru, the problem of contamination has worsened due to the combined action of the disorderly growth of the urban population, poor management of solid waste, discharge of untreated sewage into the bay of Lake Titicaca and practices of inadequate sanitation and hygiene, severely affecting the environment and human health. The objective of the study was to characterize the pro-environmental attitudes and behaviors of the city’s population of Puno in relation to sanitation, pollution and environmental management. The research is nonexperimental, quantitative, cross-sectional, descriptive, correlational and micro level of analysis. The universe of study was the population over 18 years of age in the urban area, which comprises 97,264 inhabitants; the sample, determined at simple random, was 382 people. A structured questionnaire was applied. Descriptive and inferential analysis and hypothesis testing were performed with SPSS statistical software. The results indicate that the environmental attitudes of the majority of the population are positive regarding factors and sources of pollution and effects on human health. On the contrary, environmental practices are inadequate in environmental management in the home and health and hygiene conditions in the home. It is concluded that the sustainable improvement of pro-environmental attitudes and behaviors demands a new public policy of environmental education, whose implementation incorporates the effective participation of civil society based on an incentive system.

Resumen El presente artículo reconstruye el nacimiento y funcionamiento del proyecto de divulgación higiénica organizado por las autoridades de Yucatán entre 1915 y 1930, y reflexiona sobre si la educación y la propaganda higiénica cobraron importancia en las estrategias seguidas por las autoridades revolucionarias para salvaguardar la salud de los habitantes del estado. También describe el proceso de transformación de las instituciones de salubridad que desembocó en la creación de organismos como las delegaciones sanitarias en diversas áreas de Yucatán.

Abstract This article reconstructs the creation and functionality of the hygienic dissemination project, organized by the Yucatan authorities between 1915 and 1930, and ponders on whether hygienic education and propaganda became important for revolutionary authorities in their quest to safeguard the state’s citizens’ health. This paper also describes the transformation process of health institutions that led to the creation of organizations such as health delegations in various areas of Yucatán.

RESUMEN Introducción: El estudio de los viajeros es importante y ha resultado una variable asociada significativamente con el número de casos de covid-19. Objetivo: Caracterizar a los viajeros infectados por el SARS-CoV-2 según variables epidemiológicas y sociodemográficas de interés. Métodos: Se realizó un estudio ecológico de series temporales, de viajeros procedentes del exterior, residentes en Santiago de Cuba o cuyo destino final era esta provincia, que arribaron al país entre el 11 de marzo del 2020 y el 11 de noviembre del 2022. Las fuentes de información fueron los registros de viajeros establecidos por el Centro Provincial de Higiene, Epidemiologia y Microbiología de esta provincia y del Laboratorio Provincial de Microbiología. Resultados: Fueron recibidos 64 984 viajeros, de los cuales 568 resultaron positivos, con predominio de los asintomáticos y del diagnóstico al quinto día del arribo. Conclusiones: El control sobre los viajeros influyó en el patrón de transmisión de la enfermedad; en tanto, la realización de una segunda prueba al quinto día permitió hallar un porcentaje elevado de positividad. Algunas características de la morbilidad en este grupo de casos se diferenciaron de la incidencia en la población general, tales como las formas clínicas, la edad y la distribución espacial.

ABSTRACT Introduction: The study of travelers is important and has been a variable significantly associated with the number of covid-19 cases. Objective: To characterize the travelers infected with SARS-CoV-2 according to epidemiologic and sociodemographic variables of interest. Methods: An ecological study of temporary series was carried out, of travelers from abroad, residents in Santiago de Cuba or whose final destination was this province, that arrived at the country between March 11, 2020 and November 11, 2022. The sources of information were the travelers’ records established by the Provincial Center of Hygiene, Epidemiology and Microbiology of this province and the results of polymerase chain reaction tests of the Provincial Laboratory of Microbiology. Results: Sixty-four thousand nine-hundred eighty four travelers were received, of which 568 were positive, with prevalence of the asymptomatic and the diagnosis at the fifth day of arrival. Conclusions: The control on the travelers influenced in the pattern of transmission of the disease; as long as, the realization of a second test at the fifth day allowed to find a high percentage of positivity. Some characteristics of morbidity in this group of cases differed from the incidence in the general population, such as the clinical forms, age and space distribution.

RESUMEN Introducción: Las infecciones asociadas a la atención médica (IAAS), también conocidas como infecciones nosocomiales o infecciones adquiridas en el hospital, comienzan dentro de las 48 horas posteriores a la hospitalización, dentro de los 30 días posteriores al alta hospitalaria o 90 días después de someterse a procedimientos quirúrgicos. Objetivo: El estudio tuvo como objetivo describir el cumplimiento con los cinco momentos para la higiene de manos (HH) de los trabajadores de la salud (TDS) en un hospital. Metodología: Se realizó un estudio observacional prospectivo del 1 al 30 de junio de 2020 en un hospital pediátrico. La adherencia de los TDS con los cinco momentos de HH fue registrada por observación directa de manera ciega a los participantes, utilizando la hoja informativa para HH de la OMS. En las filas se registraron los cinco momentos de contacto con los pacientes: antes de tocar a un paciente, antes de un procedimiento aséptico limpio, después de exponerse a fluidos corporales, después de tocar a un paciente y después de tocar el entorno del paciente. También se registraron las acciones realizadas: lavado de manos, fricción con alcohol en gel, omisión o uso de guantes. Los datos fueron analizados en SPSS V 21. El protocolo fue aprobado por el comité de ética institucional. Resultados: Durante el período de estudio, se realizaron 2,595 observaciones a 104 TDS. Eran residentes pediátricos en un 38.5%, enfermeras en un 32.7% y pediatras en un 28.8%. La adherencia global a los cinco momentos de HH de los participantes fue del 64.5% (1673/2595). Antes de tocar a un paciente, la adherencia fue del 86.9%. Las enfermeras se adhirieron en un 69%, los pediatras en un 68.6% y los residentes pediátricos en un 57.2%. Discusión: El porcentaje global de cumplimiento con los cinco momentos de HH del personal médico y de enfermería del hospital pediátrico fue del 64.5%. Las enfermeras tuvieron el mayor porcentaje de adherencia. El cumplimiento del lavado de manos fue mayor antes del contacto con los pacientes.

ABSTRACT Introduction: Healthcare-associated infections (HAIs), also known as nosocomial infections or hospital-acquired infections, begin within 48 hours of hospitalization, within 30 days after hospital discharge, or 90 days after undergoing surgical procedures. Objective: The study aimed to describe the compliance with the five moments for hand hygiene (HH) of the healthcare workers (HCWs) in a hospital. Methods: A prospective observational study was conducted from June 1 to 30,2020 in a pediatric hospital. HCWs compliance with the five moments of HH was registered by direct observation blindly to the participants, using the fact sheet for HH of the WHO. In the rows, the five moments of contact with the patients were recorded: before touching a patient, before clean aseptic procedure, after body fluid exposure risk, after touching a patient and after touching patient surroundings. The actions performed, also was registered: hand washing, alcohol hand friction, omission, or use of gloves. Data were analyzed in SPSS V 21. The protocol was approved by the institutional review board. Results: During the study period, 2.595 observations to 104 HCWs were made. They were pediatric residents 38.5 %, nurses 32.7 % and pediatricians 28.8 %. A global compliance with the five moments of HH of the participants were 64.5% (1673/2595). Before touching a patient, the adherence was 86,9%. The nurses adhered in 69%, pediatrician in 68.6 % and the pediatric residents in 57.2%. Discussion: The global percentage of compliance with the five moments of HH of the medical and nursing staff of the pediatric hospital was 64.5%. Nurses had the highest percentage of adherence. Handwashing compliance was higher before contact with the patients.

ABSTRACT Introduction: Oral health is crucial for children's development, speech, nutrition, and self-esteem. Maintaining good oral health during childhood prevents serious dental issues in adulthood and reduces the need for costly treatments later on. Objective: To assess the knowledge level, attitudes, and practices regarding oral health among children aged 6 to 12 years at a school located in the metropolitan area of Asunción. Results: A total of 202 children participated in the study, of whom 51.0% were male, with a mean age of 9 years (SD = 4.24 years). Approximately 55% of the children had gingivitis. Primary teeth cavities were present in 35.6% of the participants, while 48.9% had cavities in their permanent teeth. Regarding dietary knowledge, 98.02% of the participants correctly identified foods harmful to dental health. Most children learned brushing techniques from their parents; however, consistent parental supervision was reportedly lacking. Conclusion: Despite demonstrating good knowledge and generally adequate oral hygiene practices, nearly half of the children had cavities in their permanent teeth. The data suggest that the lack of regular parental supervision of brushing techniques could be a significant contributing factor to dental caries.

RESUMEN Introducción: La salud bucal en niños es esencial para su desarrollo, habla, nutrición y autoestima. Además, previene problemas odontológicos graves en la edad adulta y evita costosos tratamientos futuros. Objetivo: Determinar el nivel de conocimiento, actitud y práctica sobre salud oral en niños de 6 a 12 años de una escuela del área metropolitana de Asunción. Resultado: Participaron 202 niños, donde el 51,0% correspondió al sexo masculino, con edad media de 9 ± 4,24 años. El 55% de los niños presentó gingivitis. El 35,6% posee caries en dientes primarios mientras que el 48,9% presenta caries en dientes permanentes. El 98,02% de los participantes respondió correctamente la pregunta sobre alimentos perjudiciales para los dientes. Sobre la práctica de higiene bucal, en la mayoría de los niños la enseñanza de la técnica de cepillado estuvo a cargo de los padres, sin embargo, reportan que estos no siempre los controlan. Conclusión: Los niños tuvieron buen conocimiento, actitud positiva y prácticas adecuadas de higiene bucal, sin embargo, la mitad de ellos presentaba caries en dientes permanentes. Se sugiere que la falta de supervisión diaria por parte de los padres en la técnica de cepillado podría ser un factor contribuyente.

ABSTRACT Healthcare workers' handwashing is essential for preventing Healthcare-Associated Infections. Non-compliance with this correct practice promotes the spread of pathogenic microorganisms. The objective was to identify the hand hygiene situation of healthcare personnel in the Urology service at Clinics Hospital in 2023. The study was observational, correlational, and conducted at Clinics Hospital. The study population consisted of 27 healthcare personnel. Regarding sociodemographic data, 52% are male and 48% are female. The average age predominantly falls within the ranges of 20 to 29 years (33%) and 40 to 49 years (45%). Regarding the presence of common bacteria on the hands of healthcare personnel, Staphylococcus spp. was identified in 54% of cases, while Pseudomonas was found in minimal amounts (4%), and there was no development of bacteria after 6 days of incubation on average (42%). Regarding antibiotic resistance among healthcare personnel, 28% corresponded to Erythromycin, 24% to Clindamycin, 17% to Oxacillin, 9% to Rifampicin, 7% to Trimethoprim+Sulfamethoxazole, and 5% to the following: Ciprofloxacin, Tetracycline, Gentamicin, with the vast majority showing resistance to Gram-positive microorganisms like Staphylococcus aureus. Healthcare personnel demonstrate acceptable performance in preventing bacterial presence, although there is still room for improvement. It is recommended to review and strengthen practices to prevent bacterial presence.

RESUMEN El lavado de manos de los trabajadores de la salud es esencial para prevenir Infecciones Asociadas a la Atención de la Salud. La falta de cumplimiento con esta práctica correcta favorece a la propagación de Microorganismos patógenos. El objetivo fue identificar la situación de Higiene de manos del profesional de la salud del servicio de Urología. Hospital de Clínicas 2023. El estudio fue observacional, correlacional, se llevó a cabo en Hospital de Clínicas. La población de estudio fue de 27 personales de salud. En cuanto a los datos sociodemográficos el 52% son hombres y mujeres 48%. La edad promedio se sitúa predominantemente en los rangos de 20 a 29 años 33% y 45% de 40-49 años. En lo que respecta a la presencia de bacterias comunes en las manos del profesional de la salud, se identificó principalmente la presencia del 54% de Staphylococcus spp., mientras que Pseudomonas se encontró en cantidades mínimas 4% y que no desarrollaron Bacterias a los 6 días de incubación un promedio de 42%. En cuanto a la resistencia a los antibióticos por parte del profesional de la salud el 28% corresponde a Eritromicina el 24% Clindamicina, el 17% Oxacilina el 9% a Rifampicina el 7% Trimeroprima+Sulfametazol y con 5% los siguientes: Ciprofloxacina, Tetraciclina, Gentamicina, la gran mayoría con resistencia a Microorganismos Gram (+) como *Staphylococcus aureus. El profesional de la salud demuestra un desempeño aceptable en la prevención de la presencia bacteriana, aunque aún existe margen de mejora, se recomienda revisar y fortalecer prácticas para prevenir la presencia bacteriana.

RESUMEN Introducción: En Cuba se dispone de un sistema de normas cubanas de seguridad y salud en el trabajo como instrumentos que estandarizan los métodos de medición y los criterios de evaluación del ruido en los puestos y áreas de trabajo, pero carece de una guía de buenas prácticas que permita el empleo de los resultados de las evaluaciones como potenciales pruebas para la investigación científica del factor de riesgo. Objetivo: Proponer los requisitos mínimos para una guía de buenas prácticas en el estudio del factor de riesgo ruido laboral. Métodos: Se desarrolla un proceso de búsqueda de consenso entre expertos, a través de la técnica de los cuatro procesos de resolución de problemas para proponer los requisitos mínimos que se deben considerar en las evaluaciones de ruido laboral. Resultados: Se establecieron los requisitos mínimos necesarios en los estudios de ruido respetando las normativas nacionales, lo que se estructuró en los siguientes elementos: glosario de términos, métodos de medición por el objetivo que se persigue, criterios de evaluación del ruido, métodos de medición por el tipo de puesto de trabajo (puestos de trabajos fijos, variables y aleatorios), finalidad de las evaluaciones, requisitos medibles, utilidad del mapa de ruido y requisitos informativos. Conclusiones: La guía elaborada propone mejoras metodológicas dentro de la investigación experimental del ruido laboral, ella no obliga sino solo recomienda una estrategia investigativa, da espacio a las interpretaciones personales y referencias elaboradas como verdades hipotéticas consensuadas, las que a futuro pueden incidir en nuevas propuestas metodológicas y normativas.

ABSTRACT Introduction: In Cuba it exists a system of Cuban norms of security and health in the work like instruments that standardize the mensuration methods and the approaches of evaluation of the noise in the positions and work areas, but it lacks a guide of good practical that allows the employment of the results of the evaluations like potentials tests for the scientific investigation of the factor of risk. Objective: To propose the minimum requirements for a guide of good practical in the study of the factor of risk labor noise. Methods: A process of consent search is developed among experts, through the technique of the four processes of resolution of problems to propose the minimum requirements that should be considered in the evaluations of labor noise. Results: The necessary minimum requirements settled down in the studies of noise respecting the normative ones national, what was structured in the following elements: glossary of terms, mensuration methods for the objective that is pursued, approaches of evaluation of the noise, mensuration methods for the type of work position (positions of fixed works, variables and aleatory), purpose of the evaluations, requirements metrological, utility of the map of noise and informative requirements. Conclusions: The elaborated guide proposes methodological improvements inside the experimental investigation of the labor noise, she doesn't force but alone it recommends an investigative strategy, it gives space to the personal interpretations and references elaborated as truths hypothetical, those that can impact in new methodological and normative proposals to future.

RESUMEN Introducción: El envejecimiento poblacional y el aumento de enfermedades crónicas han incrementado la prevalencia de discapacidad en adultos mayores. Evaluar la capacidad funcional en actividades básicas de la vida diaria (ABVD) es esencial para mantener la independencia y calidad de vida. Este estudio se enfocó en evaluar la capacidad funcional de adultos mayores en ABVD en el ámbito familiar de Asunción en el año 2023. Materiales y métodos: Se realizó un estudio observacional, descriptivo, de corte transversal, en noviembre del 2023, con 91 adultos mayores (≥65 años) de Asunción, en hogares familiares. Se aplicaron encuestas mediante Google Formulario y se utilizó el Índice de Barthel para medir la capacidad funcional. El muestreo fue no probabilístico por bola de nieve. Se empleó estadística descriptiva e inferencial, con un nivel de significancia de p≤0,05. Se respetaron los aspectos éticos de la investigación. Resultados: Participaron 91 adultos mayores, con una edad promedio de 79 años±8,2. El 62,6% fueron mujeres y 41,8% del grupo de edad de 75 a 84 años. Según el Índice de Barthel, el 59,3% necesita ayuda para cortar alimentos y el 34,1% depende de otra persona para la higiene personal. El 28,6% tiene incontinencia en deposiciones y el 30,8% en micción. La puntuación promedio del Índice de Barthel fue 68,5±33,9, indicando dependencia leve en el 61,5% de los participantes. El 77% de los adultos mayores reciben cuidados de un familiar. Conclusión: Un alto porcentaje de los adultos mayores mostró algún grado de dependencia, especialmente en actividades de alimentación e higiene. La edad avanzada y el sexo femenino se asociaron con mayores niveles de dependencia. La mayoría de los adultos mayores dependieron de familiares para su cuidado, destacando la necesidad de fortalecer las redes de apoyo y capacitar a los cuidadores informales.

ABSTRACT Introduction: Population aging and the increase in chronic diseases have raised the prevalence of disability in older adults. Evaluating functional capacity in basic activities of daily living (BADL) is essential to maintaining independence and quality of life. This study focused on evaluating the functional capacity of older adults in BADL within the family setting of Asunción in 2023. Material and methods: An observational, descriptive, cross-sectional study was conducted in November 2023, with 91 older adults (≥65 years) from Asunción, in family homes. Surveys were administered via Google Forms, and the Barthel Index was used to measure functional capacity. The sampling was non-probabilistic snowball sampling. Descriptive and inferential statistics were employed, with a significance level of p≤0.05. Ethical aspects of the research were respected. Results: Ninety-one older adults participated, with an average age of 79 years±8.2. Of these, 62.6% were women and 41.8% were in the age group of 75 to 84 years. According to the Barthel Index, 59.3% needed help cutting food, and 34.1% depended on another person for personal hygiene. Additionally, 28.6% had bowel incontinence, and 30.8% had urinary incontinence. The average Barthel Index score was 68.5±3.9, indicating mild dependence in 61.5% of participants. Furthermore, 77% of older adults received care from a family member. Conclusion: A high percentage of older adults showed some degree of dependence, especially in activities related to feeding and hygiene. Advanced age and female sex were associated with higher levels of dependence. Most older adults relied on family members for care, highlighting the need to strengthen support networks and train informal caregivers.

Resumen: La pandemia de Covid ha sido un hecho sin precedentes en el sector de la construcción, que ha generado una serie de impactos, por lo que muchos investigadores han desarrollado estudios para identificarlos. Sin embargo, muchos de estos estudios se han centrado en los impactos negativos y no se han centrado en recoger las oportunidades generadas. Por tal motivo, el siguiente estudio tiene como objetivo identificar las oportunidades generadas en el mediano plazo a raíz de la pandemia COVID-19 en proyectos de construcción, considerando el caso del sector construcción peruano. Para ello, el estudio comienza con una revisión de la literatura donde se identifican las principales oportunidades, las cuales son validadas mediante juicio de expertos. En la siguiente etapa se encuestó a profesionales peruanos; los resultados fueron procesados y categorizados utilizando el RII (Índice de Importancia Relativa) y finalmente se discutieron los resultados. Las principales oportunidades generadas por el COVID-19 son un mayor énfasis en los programas de higiene, el uso de tecnología de trabajo remoto y la aceleración de la digitalización en los proyectos. Esta investigación ayudará a los profesionales del sector de la construcción a explotar las oportunidades de eventos disruptivos similares al COVID-19 que puedan surgir en el futuro.

Abstract: The Covid pandemic has been an unprecedented event in the construction sector, which has generated a series of impacts, for which many researchers have developed studies to identify them. However, many of these studies have focused on the negative impacts and have not focused on collecting the opportunities generated. For this reason, the following study aims to identify the opportunities generated in the medium term because of the COVID-19 pandemic in construction projects, considering the case of the Peruvian construction sector. To this end, the study begins with a literature review where the main opportunities are identified, which are validated by expert judgment. In the next stage, Peruvian professionals were surveyed; the results were processed and categorized using the RII (Relative Importance Index), and finally, the results were discussed. The main opportunities generated by COVID-19 are greater emphasis on hygiene programs, the use of remote work technology, and the acceleration of digitalization in projects. This research will help professionals in the construction sector to exploit the opportunities of disruptive events like COVID-19 that may arise in the future.

ABSTRACT The Yunguyo coastline has been subject to a growing process of severe contamination as a result of anthropic action. The study analyzes the pro-environmental concerns and behaviors of the Yunguyo population regarding environmental management, coastal pollution and effects on human health. The research design is non-experimental, transversal; the approach is quantitative, of a descriptive and correlational nature, level of micro analysis and socio-environmental dimension. The study population comprises 17,343 people over 18 years of age; the sample determined at simple random was 332 heads of family. The data collection technique is the survey through a structured questionnaire. Results: The environmental concerns of the majority of the population are positive regarding sanitation, sources of contamination of the coastal coastline and negative effects on human health. The pro-environmental behaviors of the majority of the urban population of Yunguyo are adequate in environmental management, sanitation and hygiene conditions at home, and access to public social services. Conclusion: There is a relationship between concerns and pro-environmental behaviors of the population regarding environmental management and contamination of the coastal coastline.

RESUMEN El litoral costero de Yunguyo viene siendo objeto de un proceso creciente de contaminación severa producto de la acción antrópica. El estudio analiza las preocupaciones y comportamientos proambientales de la población de Yunguyo sobre gestión ambiental, contaminación del litoral costero y efectos en la salud humana. El diseño de investigación es no experimental, transversal; el enfoque es cuantitativo, de carácter descriptivo y correlacional, nivel de análisis micro y dimensión socioambiental. La población del estudio comprende 17 343 personas mayores de 18 años; la muestra determinada al azar simple fue de 332 jefes de familia. La técnica de recolección de datos es la encuesta a través de un cuestionario estructurado. Resultados: Las preocupaciones ambientales de la mayoría de la población son positivas respecto a saneamiento, fuentes de contaminación del litoral costero y efectos negativos en la salud humana. Los comportamientos proambientales de la mayoría de la población urbana de Yunguyo son adecuados en gestión ambiental, condiciones de sanidad e higiene en el hogar y acceso a servicios sociales públicos. Conclusión: Existe relación entre preocupaciones y comportamientos proambientales de la población respecto a gestión ambiental y contaminación del litoral costero.

The resurgence of monkeypox, subsequent to its designation as a Public Health Emergency of International Concern by the World Health Organization in 2022, underscores the critical need for rigorous infection control protocols within dental settings. Due to the inherent nature of dental procedures, that involve working in close proximity to patients and potential exposure to infectious bodily fluids, the dental profession faces significant challenges in mitigating the transmission of mpox. This update provides a comprehensive review of the virological characteristics, transmission pathways, and clinical presentation of mpox, with particular emphasis on its oral manifestations and the implications for dental practitioners. It delineates both standard and enhanced infection control measures, including the application of personal protective equipment, stringent hand hygiene practices, meticulous environmental disinfection, and the prudent management of aerosol-generating procedures. Additionally, is addresses the importance of patient screening, isolation of suspected cases, and the education of both dental staff and patients regarding the transmission and prevention of mpox. The necessity for dental professionals to maintain vigilance, remain current with evolving guidelines, and implement comprehensive infection control strategies is emphasized, highlighting the pivotal role of dental practices in the early detection and control of mpox transmission during the ongoing outbreak.

BACKGROUND. Pathology of the hand causes functional impairment, with downstream effects for patient occupation, and consequently presents a socioeconomic burden. Investigation of the epidemiology of hand pathology in KwaZulu-Natal (KZN) can help reduce the burden of disease. Identifying where the greatest need is can direct patient awareness initiatives, medical training and appropriate allocation of resources. OBJECTIVES. To establish the prevalence of hand pathology at regional hospitals that offer orthopaedic services in KZN, to describe the patients most commonly affected by these pathologies and to identify the most common pathologies. METHODS. A cross-sectional investigation of hospital records and charts of patients presenting for orthopaedic care across all 10 regional hospitals in KZN that offer orthopaedic services was undertaken for 1 week's duration (June 2022). Patients were categorised into hand pathology (HP) and general orthopaedic pathology (OP) groups, which were each subdivided into trauma and non-trauma subgroups. Demographic details were collected for all patients. For HP patients, additional detail was collected regarding diagnosis, mechanism, admission and management. The prevalence of HP was calculated as a factor of all orthopaedic presentations. RESULTS. During the investigation, 2 335 patients presented to orthopaedic services. HP represented 21% of these cases. The majority (17%, 406/2 335) were related to trauma and represented 23% of all the traumatic orthopaedic presentations. Distal radius (DR) fractures were the most common hand injury (46%, 188/406) and a large proportion of trauma to the bony elements of the hand were open injuries (23%, 93/406). The remainder of HP cases comprised the non-traumatic group (4%, 91/2 335) and were predominantly infections (68%, 62/91), and many patients with non-traumatic hand pathology required surgery (60%, 55/91) and admission (56%, 52/91). CONCLUSION. HP represents approximately one-fifth of all orthopaedic presentations to regional health facilities in KZN offering orthopaedic care, and close to a quarter of orthopaedic trauma occurs in the hand. Based on these findings, targeted efforts to improve community awareness of precautions against trauma to the hand, osteopaenia and hand hygiene are suggested as preventive measures. Medical training should emphasise the appropriate management of DR fractures and hand infections, and resources should be differentially allocated to the management of these debilitating HPs to decrease the burden of disease.

INTRODUCTION: The school setting is critical for supporting oral health self-care practices among learners with special needs. However, not much is known about how educators and caregivers engage with these initiatives AIMS AND OBJECTIVES: The study aimed to explore educators' and caregivers' perspectives on an implemented oral health promotion event conducted in special schools in the eThekwini district DESIGN: An exploratory qualitative research design METHODS: An oral health promotion event was conducted in 22 special schools; thereafter, purposive sampling was used to select educators and caregivers (7 participants) for a focus group discussion (FGD). One FGD was held per school (22 focus groups). Thematic analysis was used to analyse the data RESULTS: The emergent themes included updated oral health self-care practices, perceived improvement in knowledge and oral hygiene skills and challenges in translating perceived improvements in knowledge into practice. Participants stated that the toothbrushing process and the three-step routine of toothbrushing were the most informative aspect of the event. However, lack of resources, financing and limited available time were cited as potential barriers to implementing such events CONCLUSION: Participants believed that such initiatives were valuable but that they must be implemented consistently and should be sustainable

RESUMO: O objetivo deste estudo é a determinação de alguns parâmetros de qualidade de pestilos de uva e amoreira (couros) vendidos em Elazig. Para tanto, um total de 45 amostras de pestil de frutas, sendo 23 de uva e 22 de amoreira, foram analisadas quanto às suas propriedades físicas, químicas e microbiológicas. Em pestils de uva e amoreira, os valores médios de L* (claridade/escuridão) foram 42.72 e 44.81, os valores de a* (vermelhidão) foram 10.29 e 9.07, e os valores de b* (amarelo) foram 20.90 e 20.90, respectivamente. Nas amostras de pestil de uva e amoreira, os valores de espessura foram 1.62 e 1.34, os valores de pH foram 3.82 e 4.75, os valores de acidez (como ácido cítrico) foram 0.63 e 0.22%, os valores de aw foram 0,602 e 0.627, os valores de matéria seca foram 68.78% e 72.99%, os valores de cinzas foram 2.25% e 0.64%, os valores de cinzas insolúveis em HCl a 10% foram 0.20 e 0.29, e os valores Brix foram 18.83 e 19.36, respectivamente. As contagens de TMAB, coliformes, Staphylococcus-Micrococcus e fungos de levedura foram 4.72 e 4.48, 1.30 e 1.89, 2.11 e 2.12 e 2.04 e 2.11 log10 ufc/g, respectivamente, em todas as amostras examinadas. Em 14 das amostras (31.11%), o número total de microrganismos aeróbios mesófilos foi >5 log10 ufc/g. Escherichia coli e Salmonella spp. não foram encontrados em nenhuma das amostras. No entanto, verificou-se que as amostras continham níveis significativos de bolor de levedura. Não houve diferença entre os grupos em termos microbiológicos na análise estatística (P > 0,05). De acordo com o estudo atual, não houve produção padrão e não foram observadas regras de higiene suficientes no processo de produção de pestil em empresas familiares em Elazig. Por outro lado, foram obtidas informações essenciais sobre alguns parâmetros físicos, químicos e microbiológicos de qualidade das polpas de uva e amora-preta comercializadas em mercados e lojas de Elazig.

ABSTRACT: The aim of this study is the determination some quality parameters of grape and mulberry pestils (leathers) sold in Elazig. For this purpose, a total of 45 fruit pestil samples, of which 23 were grape pestils and 22 were mulberry pestils, were analyzed for their physical properties, chemical properties, and microbiological characteristics. In grape and mulberry pestils, the average L* (lightness/darkness) values were 42.72 and 44.81, a* (redness) values were 10.29 and 9.07, and b* (yellow) values were 20.90 and 20.90, respectively. In grape and mulberry fruit pestil samples, the thickness values were 1.62 and 1.34, pH values were 3.82 and 4.75, acidity values (as citric acid) were 0.63 and 0.22%, aw values were 0.602 and 0.627, dry matter values were 68.78% and 72.99 %, ash values were 2.25% and 0.64%, insoluble ash values in 10% HCl were 0.20 and 0.29, and Brix values were 18.83 and 19.36, respectively. TMAB, coliform, Staphylococcus-Micrococcus, and yeast-mold counts were found to be 4.72 and 4.48, 1.30 and 1.89, 2.11 and 2.12, and 2.04 and 2.11 log10 cfu/g, respectively, in all samples examined. In 14 of the samples (31.11%), the total number of mesophilic aerobic microorganisms was found to be >5 log10 cfu/g. Escherichia coli and Salmonella spp. were not found in any of the samples. However, the samples were found to contain significant levels of yeast-mold. There was no difference between the groups in microbiological terms in statistical analysis (P > 0.05). According to the current study, there was no standard production and not enough hygiene rules were observed in the pestil production process in family businesses in Elazig. On the other hand, essential information was obtained on some physical, chemical and microbiological quality parameters of grape and blackberry pulps sold in markets and stores in Elazig.