Resumen: Este artículo analiza la centralidad de las políticas públicas de seguridad y justicia en América Latina y el Caribe a partir de diversas técnicas de investigación teórico (análisis documental y bibliográfico) y trabajo de campo (visitas “in loco” y observaciones participantes), realizadas entre 2015 y 2021. Se parte del supuesto de que la violencia y las inseguridades son abordadas como un obstáculo flagrante para el desarrollo humano y la consolidación del estado de derecho en la región. Se identifica, basado en la literatura especializada y estudio comparado de estas políticas públicas, la relevancia del papel que juega el liderazgo político del estado y el compromiso cívico de varios actores sociales en torno a una gobernanza territorial integrada e integral de políticas de seguridad pública Ciudadana dedicados a salvar y preservar vidas. Resumen análisis bibliográfico visitas in loco participantes, participantes , participantes) 201 2021 región identifica vidas 20 202 2

Abstract: This article analyzes the centrality of public security and justice policies in Latin America and the Caribbean based on various theoretical research techniques (documental and bibliographical analysis) and fieldwork (“in loco” visits and participant observations), undertaken between 2015 and 2021. It starts from the assumption that violence and insecurities are approached as a flagrant obstacle to human development and the consolidation of the rule of law in the region. It is identified, in the comparison of the specialized literature and in the comparative study of these public policies, the relevance of the role played by the political leadership of the State and the civic engagement of several social actors around an integrated and integral territorial governance of citizen public security policies. Despite a punitive political culture and a history of authoritarian governments in the region, there are, after all, key principles and concepts for a new type of governance of citizen security (and justice) in Brazil and in the region aimed at saving and preserve lives. Abstract documental analysis loco observations, observations , observations) 201 2021 identified all lives 20 202 2

Resumo: Este artigo analisa a centralidade das políticas públicas de segurança e justiça na América Latina e no Caribe com base em diversas técnicas de pesquisa teórica (análise documental e bibliográfica) e de campo (visitas “in loco” e observações participantes), empreendidas entre 2015 e 2021. Parte-se do pressuposto de que as violências e inseguranças são abordadas como um flagrante obstáculo ao desenvolvimento humano e à consolidação do estado de direito na região. Identifica-se, no cotejo da literatura especializada e no estudo comparado dessas políticas públicas, a relevância do papel desempenhado pela liderança política do estado e pelo engajamento cívico de diversos atores sociais em torno de uma governança territorial integrada e integral das políticas de segurança pública cidadã. Inobstante a uma cultura política punitiva e a um histórico de governos autoritários na região, vislumbram-se, afinal, princípios e conceitos-chave para uma governança de novo tipo da segurança cidadã (e justiça) no Brasil e na região voltada a salvar e a preservar vidas. Resumo análise bibliográfica visitas in loco participantes, participantes , participantes) 201 2021 Partese Parte se Identificase, Identificase Identifica se, Identifica-se vislumbramse, vislumbramse vislumbram vislumbram-se afinal conceitoschave conceitos chave vidas 20 202 2

Abstract This work aims to model per capita water consumption in schools in the city of Joinville-SC. As the school environment is largely responsible for the transmission of knowledge, including information on water conservation, 26 public schools were selected for this research. A survey was carried out on the use of water, through visits and a questionnaire to the management team of each school. The data collected allowed the characterization of schools and a preliminary diagnosis of water use. A descriptive analysis of per capita water consumption was performed, with values ranging from 5.15 to 18.59 liters/student/day. Correlation analysis, multiple linear regression, Bayesian linear regression and geographically weighted regression were used. The results of the correlation analysis reveal that the higher the average income in the neighborhood where the school is located and the area per student ratio, the higher the per capita water consumption. On the other hand, the number of students has a negative correlation with per capita consumption. In the statistical modeling, the independent variable area per student ratio was significant. JoinvilleSC. JoinvilleSC Joinville SC. SC Joinville-SC knowledge conservation 2 research performed 515 5 15 5.1 1859 18 59 18.5 litersstudentday liters day liters/student/day used hand modeling significant 51 1 5. 185 18.

Resumo Este artigo tem como objetivo a modelagem estatística do consumo de água per capita em escolas da cidade de Joinville, SC. Levando em consideração que o ambiente escolar é grande responsável pela transmissão de conhecimentos, inclusive acerca da conservação da água, foram selecionadas para objetos de estudo desta pesquisa 26 escolas públicas da rede estadual de ensino fundamental e médio. Efetivou-se um levantamento sobre a utilização da água, por meio de visitas e questionário à direção de cada escola. Os dados coletados permitiram a caracterização das escolas e um diagnóstico preliminar do uso da água, com valores de indicador de consumo variando entre 5,15 e 18,59 litros/aluno/dia. Foi feita a análise de correlação entre as variáveis e posterior modelagem do consumo de água nas escolas, usando regressão linear múltipla, regressão linear Bayesiana e regressão geograficamente ponderada. Os resultados da análise de correlação revelam que quanto maior a renda média no bairro em que a escola está localizada e a razão área por aluno, maior o indicador de consumo. Por outro lado, o número de alunos apresenta correlação negativa com o indicador de consumo. Na modelagem estatística, a variável independente razão área por aluno apresentou-se significativa. Joinville SC conhecimentos 2 médio Efetivouse Efetivou se 515 5 15 5,1 1859 18 59 18,5 litrosalunodia litros dia litros/aluno/dia múltipla ponderada lado apresentouse apresentou significativa 51 1 5, 185 18,

Resumen (Objetivo). Se evaluó el manglar de Chacarita en el Pacífico Central de Costa Rica, a través de la composición florística y las poblaciones de moluscos asociados de interés comercial, con el fin de proponer actividades de aprovechamiento sustentables en el manglar. (Metodología). Mensualmente y durante un año, se realizaron visitas al área de estudio, con el propósito de establecer una base florística de árboles de mangle y medir el almacenamiento de carbono en el lugar, además, de recolectar moluscos bivalvos para analizar el estado de las poblaciones, con base en las abundancias de organismos hallados y otras características como las longitudes y la masa de estos. En los mangles, se obtuvo el diámetro de la altura de pecho (DAP en cm), la altura (m), el índice de valor de importancia (IVI) y las reservas de carbono (Mg C·ha-1). En cuanto a los moluscos, se examinaron cuatro especies de interés comercial, evaluando la longitud (cm), la masa (g) y el índice gonadosomático. Finalmente, se realizaron valoraciones económicas de los datos obtenidos en el manglar, del turismo e información histórica de pesca para el acopio de Chacarita. (Resultados). Se hallaron cinco especies de mangles, Rhizophora mangle, Rizophora racemosa, Laguncularia racemosa, Avicennia germinans y Pelliciera rhizophorae; P. rhizophorae fue la de mayor índice de valor de importancia. Se obtuvo un almacenamiento de carbono equivalente a 78.49 Mg C·ha-1. Se contabilizaron 357 organismos, de los cuales el 18 % correspondió a Anadara similis, 37.5 % a Anadara tuberculosa, 41.46 % a Leukoma spp. y 3.08 % a Mytella guyanensis. Tomando en cuenta el valor económico de las reservas de carbono y los moluscos bivalvos presentes en los muestreos, se obtuvieron valoraciones económicas de 9812.63 USD·ha-1 y 28 USD·ha-1, respectivamente. (Conclusiones). Las bajas densidades poblacionales de moluscos, especialmente del género Anadara, hacen necesario establecer medidas de gestión que permitan recuperar las poblaciones de estos. La presente investigación propone actividades de aprovechamiento sustentables, como turismo comunitario con fines educativos y culturales.

Resumo (Objetivo). O mangue de Chacarita, no Pacífico Central da Costa Rica, foi avaliado por meio da composição florística e das populações de moluscos associados de interesse comercial, com o objetivo de propor atividades de uso sustentável no mangue. (Metodologia). Foram feitas visitas mensais à área de estudo durante um ano para estabelecer uma base florística de árvores do mangue e medir o armazenamento de carbono no local, bem como para coletar moluscos bivalves para analisar o status das populações, com base na abundância de organismos encontrados e em outras características, como comprimento e massa de tais organismos. Nos manguezais, foram obtidos o diâmetro à altura do peito (DAP em cm), a altura (m), o índice de valor de importância (IVI) e as reservas de carbono (Mg C-ha-1). No que diz respeito aos moluscos, foram examinadas quatro espécies de interesse comercial., avaliando o comprimento (cm), a massa (g) e o índice gonadossomático. Por fim, foram feitas avaliações econômicas de dados de mangue, turismo e informações históricas de pesca para a coleção Chacarita. (Resultados). Foram encontradas cinco espécies de mangue, Rhizophora mangle, Rizophora racemosa, Laguncularia racemosa, Avicennia germinans e Pelliciera rhizophorae; a P. rhizophorae apresentou o índice de valor de importância mais alto. Foi obtido um armazenamento de carbono equivalente a 78.49 Mg C-ha-1. Foram calculados um total de 357 organismos, dos quais 18% correspondeu a Anadara similis, 37.5% Anadara tuberculosa, 41.46% Leukoma spp. e 3.08% Mytella guyanensis. Levando em conta o valor econômico das reservas de carbono e dos moluscos bivalves presentes nas amostras, foram obtidas avaliações econômicas de US$ 9812.63 ha-1 e US$ 28 ha-1, respectivamente. (Conclusões). As baixas densidades populacionais de moluscos, especialmente do gênero Anadara tornam necessário o estabelecimento de medidas de manejo para permitir a recuperação dessas populações. Esta pesquisa propõe atividades de uso sustentável, como o turismo comunitário para fins educacionais e culturais.

Abstract (Objective). The floristic composition and populations of associated molluscs of commercial interest of the Chacarita mangrove forest on the Central Pacific of Costa Rica were evaluated to guide proposals for sustainable exploitation activities in the mangrove forest. (Methodology). Monthly visits to the study area were conducted for one year to establish a floristic baseline of mangrove trees and measure carbon storage. Additionally, bivalve molluscs were collected to analyze the state of their populations based on the abundances of organisms found, as well as other characteristics such as length and mass. Data regarding the mangrove trees included their diameter at breast height (DBH, cm), height (m), importance value index (IVI), and carbon reserves (Mg C·ha-1). Four mollusc species of commercial interest were analyzed, using data on their length (cm), weight (g), and gonodosomatic index. Economic evaluations were also conducted using data obtained from the mangrove forest, as well as tourism and historical fishing data for the collection of Chacarita. (Results). Five species of mangroves were identified: Rhizophora mangle, Rizophora racemosa, Laguncularia racemosa, Avice germinans, and Pelliciera rhizophorae, while P. rhizophorae had the highest importance value index. The study revealed a carbon storage equivalent to 78.49 Mg C·ha-1. A total of 357 organisms were counted, with Anadara similis accounting for 18% of the total count, followed by Anadara tuberculosa (37.5%), Leukoma spp. (41.46%), and Mytella guyanensis (3.08%). When considering the economic value of carbon stocks and the bivalve molluscs obtained from the samples, economic valuations of 9,812.63 USD·ha-1 and 28 USD·ha-1 were determined, respectively. (Conclusions). The low population densities of molluscs, particularly those belonging to the Anadara genus, necessitate the establishment of management measures to facilitate the recovery of these mollusk populations. This research proposes sustainable use activities such as community tourism for educational and cultural purposes.

Abstract Equitable and permanent access to public services is not always a priority for local management, especially in those territories and historically neglected populations. This contribution argues that in Copoya, a mostly ejido locality in the Metropolitan Zone of Tuxtla Gutiérrez, state and community service for drinking water supply is inefficient. The situation has worsened with urban growth and demand for land throughout the twentieth century. Interviews, field visits and press releases show that residents, due to the lack of water, look for alternatives such as purchasing pipes, backyard wells and untreated water systems. These alternatives do not solve the underlying issue and deepen their poverty and socio-territorial inequality. The article concludes that poor investment in projects does not allow a solution for the supply in the short and medium term.

Resumen El acceso equitativo y permanente a servicios públicos no siempre es una prioridad para la gestión local, en especial en territorios y poblaciones históricamente rezagadas. Esta contribución sostiene que en Copoya, localidad mayoritariamente ejidal de la Zona Metropolitana de Tuxtla Gutiérrez, el servicio estatal y comunitario por el suministro de agua potable no es eficiente. El problema se agudizó con el crecimiento urbano y la demanda por la tierra durante el siglo XX. A partir de entrevistas, recorridos de campo y notas de prensa, se destaca que la escasez del líquido lleva a sus residentes a buscar alternativas como la compra de pipas, pozos de traspatio y sistemas de agua no tratada que no resuelven el tema de fondo y que profundizan la pobreza y la desigualdad socioterritorial. Se concluye que la inexistencia de proyectos de inversión no permite una salida para el abastecimiento en el corto y mediano plazo.

ABSTRACT Introduction: The importance of dietitians in dialysis units is indisputable and mandatory in Brazil, but little is known about the practices adopted by these professionals. Objective: To know practices adopted in routine nutritional care, focusing on nutritional assessment tools and treatment strategies for people at risk or diagnosed with malnutrition. Methodology: Electronic questionnaire disseminated on social media and messaging applications. It included questions that covered dietitians’ demographic and occupational profile characteristics and of the dialysis unit, use and frequency of nutritional assessment tools, nutritional intervention strategies in cases of risk or diagnosis of malnutrition, prescription and access to oral supplements. Results: Twenty four percent of the Brazilian dialysis units (n = 207) responded electronically. The most used nutritional assessment tools with or without a pre-established frequency were dietary surveys (96%) and Subjective Global Assessment (83%). The strategies in cases of risk or presence of malnutrition used most frequently (almost always/always) were instructions to increase energy and protein intake from foods (97%), and increasing the frequency of visits (88%). The frequency of prescribing commercial supplements with standard and specialized formulas was quite similar. The availability of dietary supplements by the public healthcare system to patients varied between regions. Conclusion: Most dietitians use various nutritional assessment tools and intervention strategies in cases of risk or malnutrition; however, the frequency of use of such tools and strategies varied substantially. Introduction Brazil professionals Objective care Methodology applications unit Results n 207 electronically preestablished pre established 96% 96 (96% 83%. 83 83% . (83%) almost always/always alwaysalways always 97%, 97 97% , (97%) 88%. 88 88% (88%) similar regions Conclusion however substantially 20 9 (96 8 (83% (97% (88% 2 (9 (83 (97 (88 ( (8

Resumo Introdução: A importância da atuação do nutricionista em unidades de diálise é indiscutível e obrigatória no Brasil, porém pouco sabemos sobre as práticas adotadas por esses profissionais. Objetivo: Conhecer práticas adotadas na rotina dos atendimentos nutricionais, com foco nas ferramentas de avaliação nutricional e nas estratégias de tratamento das pessoas com risco ou diagnóstico de desnutrição. Metodologia: Questionário eletrônico divulgado em mídias sociais e aplicativos de mensagens. Incluiu questões que abrangiam características do perfil demográfico e ocupacional do profissional e da unidade de diálise, utilização e frequência de ferramentas de avaliação nutricional, estratégias de intervenção nutricional em casos de risco ou diagnóstico de desnutrição e prescrição e acesso a suplementos alimentares orais. Resultados: Foram recebidos eletronicamente o equivalente a 24% das unidades de diálise brasileiras (n = 207). As ferramentas de avaliação nutricional mais utilizadas com ou sem frequência pré-estabelecida foram inquéritos dietéticos (96%) e Avaliação Global Subjetiva (83%). As estratégias em casos de risco ou presença de desnutrição utilizadas com mais frequência (quase sempre/sempre) foram a orientação de incremento energético e proteico por meio de alimentos (97%) e o aumento da periodicidade das visitas (88%). A frequência de prescrição de suplemento industrializado de fórmula padrão e especializada foi bastante semelhante. A disponibilização de suplementos alimentares pelo Sistema Único de Saúde aos pacientes variou entre as regiões. Conclusão: A maior parte dos nutricionistas utiliza diversas ferramentas de avaliação nutricional e estratégias de intervenção em casos de risco ou desnutrição, porém a frequência de utilização de tais ferramentas e estratégias foi bastante variada. Introdução Brasil profissionais Objetivo nutricionais Metodologia mensagens orais Resultados 24 n 207. 207 . 207) préestabelecida pré estabelecida 96% 96 (96% 83%. 83 83% (83%) quase sempre/sempre sempresempre sempre 97% 97 (97% 88%. 88 88% (88%) semelhante regiões Conclusão variada 2 20 9 (96 8 (83% (97 (88% (9 (83 (88 ( (8

ABSTRACT Introduction: The importance of dietitians in dialysis units is indisputable and mandatory in Brazil, but little is known about the practices adopted by these professionals. Objective: To know practices adopted in routine nutritional care, focusing on nutritional assessment tools and treatment strategies for people at risk or diagnosed with malnutrition. Methodology: Electronic questionnaire disseminated on social media and messaging applications. It included questions that covered dietitians’ demographic and occupational profile characteristics and of the dialysis unit, use and frequency of nutritional assessment tools, nutritional intervention strategies in cases of risk or diagnosis of malnutrition, prescription and access to oral supplements. Results: Twenty four percent of the Brazilian dialysis units (n = 207) responded electronically. The most used nutritional assessment tools with or without a pre-established frequency were dietary surveys (96%) and Subjective Global Assessment (83%). The strategies in cases of risk or presence of malnutrition used most frequently (almost always/always) were instructions to increase energy and protein intake from foods (97%), and increasing the frequency of visits (88%). The frequency of prescribing commercial supplements with standard and specialized formulas was quite similar. The availability of dietary supplements by the public healthcare system to patients varied between regions. Conclusion: Most dietitians use various nutritional assessment tools and intervention strategies in cases of risk or malnutrition; however, the frequency of use of such tools and strategies varied substantially. Introduction Brazil professionals Objective care Methodology applications unit Results n 207 electronically preestablished pre established 96% 96 (96% 83%. 83 83% . (83%) almost always/always alwaysalways always 97%, 97 97% , (97%) 88%. 88 88% (88%) similar regions Conclusion however substantially 20 9 (96 8 (83% (97% (88% 2 (9 (83 (97 (88 ( (8

Resumo Introdução: A importância da atuação do nutricionista em unidades de diálise é indiscutível e obrigatória no Brasil, porém pouco sabemos sobre as práticas adotadas por esses profissionais. Objetivo: Conhecer práticas adotadas na rotina dos atendimentos nutricionais, com foco nas ferramentas de avaliação nutricional e nas estratégias de tratamento das pessoas com risco ou diagnóstico de desnutrição. Metodologia: Questionário eletrônico divulgado em mídias sociais e aplicativos de mensagens. Incluiu questões que abrangiam características do perfil demográfico e ocupacional do profissional e da unidade de diálise, utilização e frequência de ferramentas de avaliação nutricional, estratégias de intervenção nutricional em casos de risco ou diagnóstico de desnutrição e prescrição e acesso a suplementos alimentares orais. Resultados: Foram recebidos eletronicamente o equivalente a 24% das unidades de diálise brasileiras (n = 207). As ferramentas de avaliação nutricional mais utilizadas com ou sem frequência pré-estabelecida foram inquéritos dietéticos (96%) e Avaliação Global Subjetiva (83%). As estratégias em casos de risco ou presença de desnutrição utilizadas com mais frequência (quase sempre/sempre) foram a orientação de incremento energético e proteico por meio de alimentos (97%) e o aumento da periodicidade das visitas (88%). A frequência de prescrição de suplemento industrializado de fórmula padrão e especializada foi bastante semelhante. A disponibilização de suplementos alimentares pelo Sistema Único de Saúde aos pacientes variou entre as regiões. Conclusão: A maior parte dos nutricionistas utiliza diversas ferramentas de avaliação nutricional e estratégias de intervenção em casos de risco ou desnutrição, porém a frequência de utilização de tais ferramentas e estratégias foi bastante variada. Introdução Brasil profissionais Objetivo nutricionais Metodologia mensagens orais Resultados 24 n 207. 207 . 207) préestabelecida pré estabelecida 96% 96 (96% 83%. 83 83% (83%) quase sempre/sempre sempresempre sempre 97% 97 (97% 88%. 88 88% (88%) semelhante regiões Conclusão variada 2 20 9 (96 8 (83% (97 (88% (9 (83 (88 ( (8

Abstract Introduction Unplanned hospital returns are frequent and may be preventable. Objective To comprehend the reasons for unplanned hospital readmission and return to the Outpatient Department (OPD) and Emergency Department (ED) within 60 days after discharge following head and neck surgery (HNS) at a tertiary care center in Saudi Arabia. Methods In the present retrospective study, the medical records of all patients who underwent HNS for benign and malignant conditions between January 2015 and June 2022 were reviewed in terms of demographic data, comorbidities, and reasons for hospital return. Results Out of 1,030 cases, 119 (11.55%) returned to the hospital within 60 days after discharge, 19 of which (1.84%) were readmitted. In total, 90 (8.74%) patients returned to the OPD, and 29 (2.82%), to the ED. The common reasons for readmission included infections (26.32%) and neurological symptoms (21.05%). For OPD visits, the common causes were hematoma (20%) and neurological symptoms (14.44%). For ED returns, the frequent causes were neurological symptoms (20.69%) and equipment issues (17.24%). Compared with nonreadmitted patients, readmitted patients had a higher preoperative baseline health burden when examined using the American Society of Anesthesiologists (ASA) score (p = 0.004) and the Cumulative Illness Rating Scale (CIRS; p = 0.002). Conclusion The 60-day rates of unplanned hospital return to the OPD and ED were of 8.74% and 2.82% respectively, and 1.84% of the patients were readmitted. Hematoma, infections, and neurological symptoms were common causes. Addressing the common reasons may be beneficial to decrease postoperative hospital visits. preventable (OPD (ED 6 (HNS Arabia study 201 202 data comorbidities 1030 1 030 1,03 cases 11 11.55% 1155 55 (11.55% 184 84 (1.84% total 9 874 8 74 (8.74% 2 2.82%, 282 , 82 (2.82%) 26.32% 2632 26 32 (26.32% 21.05%. 2105 21.05% . 21 05 (21.05%) visits 20% 20 (20% 14.44%. 1444 14.44% 14 44 (14.44%) 20.69% 2069 69 (20.69% 17.24%. 1724 17.24% 17 24 (17.24%) ASA (ASA 0.004 0004 0 004 CIRS (CIRS 0.002. 0002 0.002 002 0.002) 60day day 8.74 2.82 respectively 1.84 Hematoma 103 03 1,0 11.55 115 5 (11.55 18 (1.84 87 7 (8.74 28 (2.82% 26.32 263 3 (26.32 210 21.05 (21.05% (20 144 14.44 4 (14.44% 20.69 206 (20.69 172 17.24 (17.24% 0.00 000 00 8.7 2.8 1.8 10 1, 11.5 (11.5 (1.8 (8.7 (2.82 26.3 (26.3 21.0 (21.05 (2 14.4 (14.44 20.6 (20.6 17.2 (17.24 0.0 8. 2. 1. 11. (11. (1. (8. (2.8 26. (26. 21. (21.0 ( 14. (14.4 20. (20. 17. (17.2 0. (11 (1 (8 (2. (26 (21. (14. (17. (21 (14 (17

ABSTRACT Introduction Vesicovaginal fistula (VVF) is the most common urogenital fistula due to iatrogenic cause, primarily associated with gynecologic surgery (1). Although both conservative and surgical management may be considered, the optimal treatment is still uncertain and several studies were published using different techniques (open, laparoscopic or robotic) and approaches (extravesical, transvesical or transvaginal) (2–5). In this context, we aim to report our initial experience repairing VVF with Single-Port (SP) Transvesical (TV) access. Materials and Methods Four patients with a diagnosis of VVF underwent SP-TV VVF repair between May 2022 and December 2023. Diagnosis was confirmed by cystoscopy, cystogram and in two cases by CT Urogram. Under general anesthesia, before robotic time, patients were placed in lithotomy position and a preliminary cystoscopy was performed. Fistula was noted and a 5fr stent was placed through the fistulous tract. Two ureteral stents were placed. Then, with patient supine, a transverse suprapubic 3cm incision and 2cm cystotomy were made for SP access. First step was to mark and remove fistula tract to the vagina. The edges of the vagina and bladder were dissected in order to have a closure free of tension and to create three different layers to close: vagina, muscularis layer of the bladder and mucosal layer of the bladder. A bladder catheter was placed, and the two ureteral stents were removed at the end of procedure. Results Mean age was 53 years old and three out of 4 patients developed VVF after gynecologic surgery. Two patients underwent VVF repair 6 and 8 months after total hysterectomy. One patient developed VVF after total hysterectomy and oophorectomy followed by radiation therapy. Last patient developed VVF after previous urological procedure. Fistula diameter was between 11 and 15mm. Operative time was 211 min, including preliminary cystoscopy, stents placement and SP-access. All patients were discharged on the same day with a bladder catheter, successfully removed between post-operative day 14-18 after negative cystogram. Only in one case a ureteral stent was left because the fistula was closed to the ureteral orifice and we reported one case of UTI twelve days after surgery, treated with outpatient antibiotics. Mean follow-up was 8 months, patients were scheduled for regular follow-up visits and no recurrence was reported. All patients have at least 3 months of post-operative follow-up. Conclusions Our experience suggests that SP Transvesical VVF repair may be considered as a safe and feasible minimally invasive treatment for small/medium fistulae (10-15mm). (VVF cause 1. 1 . (1) open, open (open extravesical, extravesical (extravesical transvaginal 2–5. 25 2–5 2 5 (2–5) context SinglePort Single Port (SP TV (TV access SPTV 202 2023 Urogram anesthesia performed fr Then supine cm close procedure therapy 15mm mm 21 min SPaccess. SPaccess SP-access postoperative post operative 1418 14 18 14-1 antibiotics followup follow up followup. up. smallmedium small medium 1015mm. 1015mm 10 (10-15mm) (1 2– (2–5 20 141 14- (10-15mm ( (2– (2

Abstract Objective: To evaluate exclusive breastfeeding at discharge and hospital length-of-stay in pre-term infants undergoing or not the Kangaroo-Mother Care Method (KMC). Methods: A retrospective cohort study was conducted including preterm infants < 1800 g admitted to the neonatal unit of a KMC reference center. The infants were grouped into the KMC group and the non-KMC group. Multiple logistic and Poisson regressions were performed to evaluate the association between the KMC and two outcomes, exclusive breastfeeding at discharge, and hospital length-of-stay, adjusted for potential confounders. Results: 115 mother-infant dyads were included, 78 in the KMC group and 37 in the non-KMC group. In the bivariate analysis, the KMC group had a lower prevalence of maternal adverse conditions (6% vs. 32%, p < 0.001), a higher number of prenatal visits (median 6 vs. 3.5, p < 0.001), higher gestational ages (median 32 vs. 31 weeks, p < 0.05), higher birth weights (median 1530 vs. 1365 g, p < 0.01), a lower prevalence of necrotizing enterocolitis (3.8% vs. 16.2%, p < 0.05), parenteral nutrition (50% vs. 73%, p < 0.05), and deep vascular access (49.7% vs. 78.4%, p < 0.01), a higher prevalence of exclusive breastfeeding (65% vs. 8%, p < 0.001) and a shorter length of hospital stay (median 28 vs. 42 days, p < 0.001). In the multiple regression analysis, the KMC group was 23 times more likely to be exclusively breastfed at discharge (OR = 23.1; 95% CI = 4,85–109,93) and had a 19% reduction in the hospital length-of-stay (IDR = 0.81; 95% CI = 0.76–0.86) compared to the non-KMC group. Conclusions: The KMC is associated with better short-term neonatal outcomes and should be encouraged in all Brazilian maternity hospitals. Objective lengthofstay pre term KangarooMother Kangaroo Mother KMC. . (KMC) Methods 180 center nonKMC non lengthofstay, stay, confounders Results 11 motherinfant mother infant included 7 3 analysis 6% (6 vs 32% 0.001, 0001 0.001 , 0 001 median 35 5 3.5 weeks 0.05, 005 0.05 05 0.05) 153 136 0.01, 0.01 01 0.01) 3.8% 38 8 (3.8 162 16 2 16.2% 50% 50 (50 73 73% 49.7% 497 49 (49.7 784 4 78.4% 65% 65 (65 8% days 0.001. OR 23.1 231 1 95 4,85–109,93 48510993 85 109 93 19 IDR 0.81 081 81 0.76–0.86 076086 76 86 Conclusions shortterm short hospitals (KMC 18 ( 000 0.00 00 3. 0.0 15 13 3.8 (3. 16.2 (5 49.7 (49. 78.4 23. 9 4,85–109,9 4851099 10 0.8 08 0.76–0.8 07608 0. (3 16. 49. (49 78. 4,85–109, 485109 0.76–0. 0760 (4 4,85–109 48510 0.76–0 076 4,85–10 4851 0.76– 07 4,85–1 485 0.76 4,85– 48 0.7 4,85 4,8 4,

Abstract Background Chagas disease (CD) is a serious public health problem in Latin America. Benznidazole (BNZ) is used for the treatment of CD and, despite its wide use, little information is available about its toxicity and mechanisms of adverse drug reactions (ADR). Objectives To identify and classify clinical and laboratory adverse reactions caused by BNZ in terms of causality and severity. Methods Prospective cohort study from January 2018 to December 2021. Treatment follow-up included visits and biochemical tests (complete blood count, liver and kidney function tests) before, during and after treatment. ADR were classified according to causality and severity. In the statistical analysis, the significance level was set at p<0.05. Results Forty patients with chronic CD were included. A high prevalence of ADR was observed 161 ADR in 30 patients [90%]; of these, 104 (64.6%) were classified as possible and 57 (35.4%) as probable. The ADR were classified as moderate and mild. Of the 40 patients, nine (22.5%) discontinued treatment. ADR associated with treatment discontinuation and interventions were those that affected the dermatological system, central and peripheral nervous system and sense organs such as ageusia. Mild hematological and biochemical changes such as lymphopenia were observed after 30 days of treatment. Conclusion Many patients were able to complete the treatment even with ADR, which can be attributed to the successful follow-up strategy with symptomatic treatment and counseling, leading to patient’s awareness of symptoms and treatment adherence. (CD America (BNZ use ADR. . (ADR) severity 201 2021 followup follow up count before analysis p005 p 0 05 p<0.05 16 3 90% 90 [90%] these 10 64.6% 646 64 6 (64.6% 5 35.4% 354 35 4 (35.4% probable mild 22.5% 225 22 (22.5% ageusia counseling patient s adherence (ADR 20 202 p00 p<0.0 1 9 [90% 64.6 (64.6 35.4 (35.4 22.5 2 (22.5 p0 p<0. [90 64. (64. 35. (35. 22. (22. p<0 [9 (64 (35 (22 p< [ (6 (3 (2 (

Resumo Fundamento A Doença de Chagas (DC) representa um grave problema de saúde pública na América Latina. O Benznidazol (BNZ) é utilizado para o tratamento DC e, apesar do seu amplo uso, poucas informações estão disponíveis sobre sua toxicidade e mecanismos das Reações Adversas ao Medicamento (RAM). Objetivos Identificar e classificar as reações adversas clínicas e laboratoriais ocasionadas pelo uso do BNZ quanto à sua causalidade e gravidade. Métodos Estudo de coorte prospectivo realizado no período de janeiro de 2018 a dezembro de 2021. O acompanhamento do tratamento incluiu consultas e análises laboratoriais antes, 30 e 60 dias após o início do tratamento. As RAM foram classificadas quanto à causalidade e gravidade. Na análise estatística o nível de significância adotado foi p<0,05. Resultados Participaram do estudo 40 pacientes com DC crônica, observou-se alta prevalência de RAM com um total de 161 em 30 (90%) pacientes. Destas, 104 (64,6%) foram classificadas como possíveis e 57 (35,4%) como prováveis. As reações foram classificadas em moderadas e leves. Dos 40 pacientes, nove (22,5%) suspenderam o tratamento. As RAM associadas à interrupção e intervenções foram as que afetaram o sistema dermatológico, sistema nervoso central e periférico ou que culminaram em ageusia. Após 30 dias de tratamento, alterações hematológicas e bioquímicas leves foram observadas como linfopenia. Conclusão Apesar do elevado percentual de RAM, muitos pacientes foram capazes de completar o tratamento, o que se atribui ao êxito da estratégia de acompanhamento com intervenções de tratamento sintomático juntamente ao aconselhamento, levando à compreensão da sintomatologia e manutenção do tratamento. (DC Latina (BNZ RAM. . (RAM) gravidade 201 2021 antes 3 6 p005 p 0 05 p<0,05 4 crônica observouse observou 16 90% 90 (90% Destas 10 64,6% 646 64 (64,6% 5 35,4% 354 35 (35,4% prováveis 22,5% 225 22 (22,5% dermatológico ageusia linfopenia aconselhamento (RAM 20 202 p00 p<0,0 1 9 (90 64,6 (64,6 35,4 (35,4 22,5 2 (22,5 p0 p<0, (9 64, (64, 35, (35, 22, (22, p<0 ( (64 (35 (22 p< (6 (3 (2

Abstract The article exposes the public policy of closing the border of the Dominican Republic against the Haitian population since 1937, a situation that has been beneficial for global corporations that have increased their profit margins by taking advantage of the context of poverty, violence, and racism experienced by the Haitian population. The case of the textile corporation Compagnie Développement Industriel (CODEVI) is studied, which has placed an industrial site on the Haitian-Dominican border line. Methodologically, an anthropological and geographical study was carried out, consisting of interviews and visits to both workers and company officials, in addition to a documentary review of the economic policy of both countries and the legislation regulating transnational corporations. In this way, the creative political, legal, technical, and territorial devices used to exploit cheap Haitian labor are exposed, evidencing the national and racial segregation imposed by the textile company. It is concluded that this system of labor exploitation generates great economic profits in exchange for a minimal investment that does not contribute significantly to overcome the extreme poverty experienced by workers living in the impoverished Haitian border town of Ouanaminthe.

Resumen En el presente artículo se analiza la política racial de cierre de frontera que desde 1937 se ha instaurado en la zona dominico-haitiana, situación que ha resultado beneficiosa para corporativos globales que han incrementado sus márgenes de ganancia aprovechando el contexto de pobreza, violencia y racismo que vive la población haitiana. Se estudia el caso de la empresa textil Compagnie Développement Industriel (CODEVI), la cual ha desarrollado un sofisticado emplazamiento industrial sobre esta línea fronteriza. Metodológicamente se realiza un trabajo antropológico y geográfico que consistió en entrevistas y visitas tanto a personas trabajadoras como funcionarias de la empresa, además de una revisión documental de la política económica de ambos países y de legislaciones de corporaciones trasnacionales. De este modo, se exponen los ingeniosos dispositivos políticos, legales, técnicos y territoriales utilizados para explotar la mano de obra barata haitiana, evidenciando la segregación nacional y racial que impone la empresa textil. Se concluye que este sistema de explotación laboral obtiene grandes ganancias económicas a cambio de una mínima inversión que no contribuye significativamente a superar la extrema pobreza que viven trabajadores y trabajadoras que residen en la depauperada ciudad fronteriza haitiana de Ouanaminthe.

BACKGROUND: Despite inpatient rehabilitation many stroke survivors struggle with community reintegration on returning home. The environment to which the stroke survivor returns affects and may limit participation in home and community-based activities. AIM: To describe stroke survivors' lived experiences of the environmental barriers and facilitators to community reintegration in an under resourced urban metropolitan sub-district in the Western Cape, South Africa. METHODS: A descriptive, qualitative study design with a phenomenological emphasis used semi-structured interviews to collect the data from purposefully selected stroke survivors who had been discharged for more than one year following inpatient rehabilitation. Supporting data were collected from interviews with two occupational therapists providing rehabilitation services to the stroke survivors. Deductive priori coding of semi-structured interviews with 11 stroke survivors, based on the environment subsystems described in the Person-Environment-Occupation-Performance (PEOP) model explored the barriers and facilitators to their community reintegration. FINDINGS: Of the six environmental sub systems in the PEOP model the systems and policy, access to information and health education, social determinants of health in the form of poor rehabilitation planning and loss of income as well as the built and natural environment presented the greatest barriers to the stroke survivor participants' community reintegration. However, reintegration was facilitated by social support and social capital, social determinants of health in the form of support groups as well as assistive technologies. CONCLUSION: Community reintegration continues to be a challenge for stroke survivors in an under-resourced urban sub-district due to environmental barriers associated with factors such as poor social support, inadequate implementation of policies and systems, poor compliance with home programmes, low socioeconomic status, poor access within the built and natural environment and inappropriate assistive devices. Several facilitators that occupational therapists can focus on to enable community reintegration included ensuring effective social support, access to community-based organisations, the introduction of home visits and provision of appropriate assistive devices. IMPLICATIONS FOR PRACTICE All stroke survivors must receive a comprehensive discharge plan to facilitate adequate access to continued rehabilitation and support for successful community reintegration. • There must be a specific referral to primary health care rehabilitation services on discharge from hospital. • Occupational therapists at community level have the responsibility to: o advocate for, or assist stroke survivors to self-advocate, the removal of inter-sectoral environmental barriers that limit their community reintegration and community participation, o where possible provide services in the home and involve midlevel workers when conducting home visits to enable successful reintegration into the home and resumption of occupational roles where possible, o look to other resources in their community that can assist in facilitating the community reintegration of stroke survivors to enable access to health, education, productive activities, and social and leisure participation opportunities, o improve their collaboration with the communities that they service.

Abstract Primary Health Care (PHC) proved to be an important part of the prevention, control and treatment measures against COVID-19, a situation in which it was challenged to keep up its provision of regular services as well. This article identifies the main arrangements made to provide PHC care in the context of the COVID-19 pandemic. An integrative literature review of articles found in PubMed, SciELO and LILACS databases was performed using the descriptors “Primary Health Care” and “COVID-19”. Findings were analyzed considering three questions: Information and Communication Technologies (ICT), Organizations of Work Processes and Non-COVID Chronic Diseases. The use of different forms of ICT to provide PHC is highlighted regarding patients with respiratory symptoms and chronic patients. Changes in team composition, service flows, physical spaces and working hours were also introduced. Although strategies aimed at monitoring chronic patients and at remote care may have helped minimize deterioration of their health, the decrease in the number of visits performed during this period could have resulted in an increased demand for PHC in post-pandemic years. (PHC prevention COVID19, COVID19 COVID 19, 19 well COVID-1 pandemic PubMed COVID19. . “COVID-19” questions ICT, , (ICT) NonCOVID Non Diseases composition flows introduced health postpandemic post years COVID1 1 COVID- “COVID-19 (ICT “COVID-1 “COVID- “COVID

Resumo A Atenção Primária à Saúde (APS) demonstrou ser parte importante das medidas de prevenção, controle e tratamento do COVID-19, ao mesmo tempo em que foi desafiada a manter a oferta dos serviços regulares. O objetivo deste artigo é identificar os principais arranjos desenvolvidos para ofertar cuidados na APS na pandemia do COVID-19. A revisão integrativa foi realizada nas bases de dados PubMed, SciELO e LILACS por meio dos descritores “Atenção Primária à Saúde” e “COVID-19”. Os resultados foram analisados por meio de três questões: Tecnologias de Informação e Comunicação (TIC), Organizações dos Processos de Trabalho e Doenças Crônicas Não-COVID. Ganha grande destaque o uso das TIC no cuidado ofertado na APS, tanto para pacientes com sintomas respiratórios quanto para pacientes crônicos. Alterações na composição das equipes, fluxos de atendimento, espaços físicos e horários de atendimento também foram implantadas. Ainda que estratégias que visaram o monitoramento dos pacientes crônicos e o atendimento remoto podem ter contribuído para minimizar os agravos à saúde desses usuários, a diminuição dos atendimentos realizados neste período poderá resultar em uma grande demanda para a APS nos anos pós-pandemia. (APS prevenção COVID19, COVID19 COVID 19, 19 COVID-19 regulares COVID19. 19. PubMed . “COVID-19” questões TIC, , (TIC) NãoCOVID. NãoCOVID Não COVID. Não-COVID equipes implantadas usuários póspandemia. póspandemia pós pandemia. pós-pandemia COVID1 1 COVID-1 “COVID-19 (TIC COVID- “COVID-1 “COVID- “COVID

Abstract In Ecuador, Artisanal and Small-Scale Mining, MAPE, is an activity of national relevance. Historically there are three provinces with great potential and mining tradition, which are: El Oro, Zamora Chinchipe and Azuay. In this sense, in the province of El Oro, a large percentage of the economically active population depends directly or indirectly on the exploitation of highly profitable minerals. The key aspects for the development of underground operations of the MAPE regime are the drilling and blasting activities, where there is a great opportunity for improvement, efficiently managing the design of the grid, the execution of the drilling, the amount of explosive and the way it is charged, which are the factors that define the result of the blasting; same that is valued in function of the depth of cut or advance and of the uniformity of the structure of the section. For the development of this research, the baseline survey was carried out through technical visits to the study sector (Zaruma - Portovelo mining district), where traditional work procedures were observed, and then, based on the experimental method, technical variations were made in regarding the firing diagram, specific charge, specific perforation and type of explosive. These traditional (empirical) procedures, based on the driller's field experience, cause, among other things, the inefficiency of the advance, problems to maintain the dimensions of the section, over breaking of the working fronts, and one of the most relevant factors, the insecurity of the personnel who in many cases remain inside the mine for more than 10 hours.The main results show that the best tests were those that used the emulsion/ANFO (Amonium Nitrate Fuel Oil) combination, obtaining an advance percentage of approximately 95%, considered optimal within the operation. It was also evidenced that the Ammonium Nitrate commonly used in ASM needs a specific charge of greater power to meet the objective of the blasting.

Resumen En Ecuador, la Minería Artesanal y de Pequeña Escala, MAPE, es una actividad de relevancia nacional. Históricamente existen tres provincias de amplio potencial y de tradición minera, que son: El Oro, Zamora Chinchipe y Azuay. En este sentido, en la provincia de El Oro, gran porcentaje de la población económicamente activa, depende directa o indirectamente de la explotación de minerales de alta rentabilidad. Uno de los aspectos clave para el desarrollo de las operaciones subterráneas del régimen MAPE, son las actividades de perforación y voladura, en donde existe una gran oportunidad de mejora, gestionando de manera eficiente el diseño de la malla, la ejecución de la perforación, la cantidad de explosivo y la forma de cargado, que son los factores que definen el resultado de la voladura; mismo que es valorado en función de la profundidad de corte o avance y de la uniformidad de la estructura de la sección. Para el desarrollo de esta investigación se realizó el levantamiento de la línea base mediante visitas técnicas al sector de estudio (distrito minero Zaruma - Portovelo), donde se observaron los procedimientos tradicionales de trabajo, para luego, con base al método experimental realizar variaciones técnicas en cuanto al diagrama de disparo, carga específica, perforación específica y tipo de explosivo. Estos procedimientos tradicionales (empíricos), basados en la experiencia de campo del perforista, ocasiona entre otras cosas la ineficiencia del avance, problemas para mantener las dimensiones de la sección, sobre rotura de los frentes de trabajo, y uno de los factores más relevantes, la inseguridad del personal que en muchos casos permanece en el interior de la mina por más de 10 horas. Entre los principales resultados se obtuvo que los mejores ensayos fueron los que se utilizó la combinación emulsión/ANFO (Amonium Nitrate Fuel Oil), obteniendo un porcentaje de avance de aproximadamente 95%, considerado dentro de la operación como óptimo. Así también se evidenció que el Nitrato de Amonio de uso habitual en la MAPE, necesita una carga específica de mayor poder para cumplir con el objetivo de la voladura.

Resumen Las especies del género Juniperus han sido ampliamente utilizadas por los seres humanos como fuente de fitoquímicos, en medicina tradicional y para su aprovechamiento maderable; sin embargo, poco se conoce hasta ahora de los usos etnobotánicos de las especies caribeñas y en particular de los taxones distribuidos en La Española, actualmente clasificados bajo diferentes categorías de amenaza. Este trabajo tuvo como objetivo reconstruir el espectro de las aplicaciones etnobotánicas dadas a Juniperus gracilior var. gracilior por moradores de 14 comunidades rurales en la vertiente sur de la Cordillera Central de República Dominicana. Estos asentamientos humanos se ubican próximos a cinco relictos poblacionales de Juniperus gracilior var. gracilior, en los que se localiza en condiciones naturales aproximadamente 80 % de los individuos del taxón. Mediante exploraciones de campo, visita y entrevistas estructuradas se recopiló información que indica que 74.1 % de sus usos corresponden a propósitos maderables, 25 % a medicina tradicional con importante eficiencia en el tratamiento de enfermedades respiratorias, digestivas y del ciclo menstrual, el resto (0.9 %) se utilizan con fines ornamentales y artesanales. Los datos obtenidos en este estudio proveen una base de conocimiento esencial para el desarrollo de estrategias de conservación, gestión y aprovechamiento sostenible de la especie.

Abstract The species of the genus Juniperus have been widely used by humans as a source of phytochemicals, in traditional medicine and for timber harvesting; however, little has been known so far about the ethnobotanical uses of Caribbean species and in particular the taxa of Hispaniola, currently classified under different threat categories. This work aimed to reconstruct the spectrum of ethnobotanical uses given to Juniperus gracilior var. gracilior by the inhabitants of 14 rural communities on the southern slope of the Central Mountain Range. These human settlements are located near five population relicts of the gracilior variety where approximately 80 % of the individuals of the taxon are found in natural conditions. Through field explorations, visits and structured interviews with local people, information was collected that indicates that 74.1 % of the variety is used for timber for different applications, 25 % for traditional medicine with important efficiency in the treatment of respiratory, digestive and menstrual cycle diseases, and 0.9 % for ornamental and handicraft uses. The data obtained in this study provide basic knowledge for the development of conservation strategies, management, and sustainable utilization of the species.