RESUMEN Objetivos. Evaluar las comorbilidades asociadas a la mortalidad en pacientes adultos hospitalizados por COVID-19 de diferentes grupos de edad en hospitales de Lima y Callao. Materiales y métodos. En este estudio de cohorte retrospectiva analizamos datos de pacientes adultos hospitalizados por COVID-19, notificados al Sistema Nacional de Vigilancia Epidemiológica del Ministerio de Salud de Perú de marzo a octubre del 2020. Se estimaron riesgos relativos con intervalos de confianza al 95% mediante modelos de regresión de Poisson con varianza robusta para evaluar las comorbilidades asociadas a la mortalidad por grupos de edad: jóvenes (18-29 años), adultos (30-59 años) y mayores (≥60 años). Resultados. Se incluyeron 2366 jóvenes, 23781 adultos y 25356 adultos mayores en el análisis. Los adultos mayores presentaron la mortalidad más alta (63,7%) en comparación con adultos (27,1%) y jóvenes (8,5%). Independientemente del grupo de edad, la presencia de enfermedad neurológica, enfermedad renal, enfermedad hepática y cáncer se asoció a un mayor riesgo de mortalidad. Adicionalmente, la enfermedad cardiovascular fue también un factor de riesgo en los jóvenes; la obesidad, la diabetes, la enfermedad cardiovascular, la enfermedad pulmonar crónica y la inmunodeficiencia en los adultos; y la obesidad y la enfermedad pulmonar crónica en los mayores. Conclusiones: Independientemente de los grupos de edad, los individuos con enfermedad neurológica crónica, enfermedad renal, enfermedad hepática y cáncer tendrían un alto riesgo de morir por la COVID-19.

ABSTRACT Objectives. To evaluate comorbidities associated with mortality in adult patients hospitalized due to COVID-19 in hospitals in Lima and Callao. Materials and methods. In this retrospective cohort study, we analyzed data from adult patients hospitalized due to COVID-19 reported to the National Epidemiological Surveillance System of the Peruvian Ministry of Health from March to October 2020. We estimated relative risks with 95% confidence intervals using Poisson regression models with robust variance to assess comorbidities associated with mortality by age group: young adults (18-29 years), adults (30-59 years) and older adults (≥60 years). Results. We included 2366 young adults, 23,781 adults and 25,356 older adults. Older adults had the highest mortality (63.7%) compared to adults (27.1%) and young adults (8.5%). Regardless of age group, the presence of neurological disease, renal disease, liver disease, and cancer was associated with an increased risk of mortality. Additionally, cardiovascular disease was also a risk factor in young adults; obesity, diabetes, cardiovascular disease, chronic lung disease, and immunodeficiency in adults; and obesity and chronic lung disease in the elderly. Conclusions. Regardless of age groups, individuals with chronic neurologic disease, renal disease, liver disease, and cancer were at high risk of death from COVID-19.

ABSTRACT Objectives. To evaluate comorbidities associated with mortality in adult patients hospitalized due to COVID-19 in hospitals in Lima and Callao. Materials and methods. In this retrospective cohort study, we analyzed data from adult patients hospitalized due to COVID-19 reported to the National Epidemiological Surveillance System of the Peruvian Ministry of Health from March to October 2020. We estimated relative risks with 95% confidence intervals using Poisson regression models with robust variance to assess comorbidities associated with mortality by age group: young adults (18-29 years), adults (30-59 years) and older adults (≥60 years). Results. We included 2366 young adults, 23,781 adults and 25,356 older adults. Older adults had the highest mortality (63.7%) compared to adults (27.1%) and young adults (8.5%). Regardless of age group, the presence of neurological disease, renal disease, liver disease, and cancer was associated with an increased risk of mortality. Additionally, cardiovascular disease was also a risk factor in young adults; obesity, diabetes, cardiovascular disease, chronic lung disease, and immunodeficiency in adults; and obesity and chronic lung disease in the elderly. Conclusions. Regardless of age groups, individuals with chronic neurologic disease, renal disease, liver disease, and cancer were at high risk of death from COVID-19.

RESUMEN Objetivos. Evaluar las comorbilidades asociadas a la mortalidad en pacientes adultos hospitalizados por COVID-19 de diferentes grupos de edad en hospitales de Lima y Callao. Materiales y métodos. En este estudio de cohorte retrospectiva analizamos datos de pacientes adultos hospitalizados por COVID-19, notificados al Sistema Nacional de Vigilancia Epidemiológica del Ministerio de Salud de Perú de marzo a octubre del 2020. Se estimaron riesgos relativos con intervalos de confianza al 95% mediante modelos de regresión de Poisson con varianza robusta para evaluar las comorbilidades asociadas a la mortalidad por grupos de edad: jóvenes (18-29 años), adultos (30-59 años) y mayores (≥60 años). Resultados. Se incluyeron 2366 jóvenes, 23781 adultos y 25356 adultos mayores en el análisis. Los adultos mayores presentaron la mortalidad más alta (63,7%) en comparación con adultos (27,1%) y jóvenes (8,5%). Independientemente del grupo de edad, la presencia de enfermedad neurológica, enfermedad renal, enfermedad hepática y cáncer se asoció a un mayor riesgo de mortalidad. Adicionalmente, la enfermedad cardiovascular fue también un factor de riesgo en los jóvenes; la obesidad, la diabetes, la enfermedad cardiovascular, la enfermedad pulmonar crónica y la inmunodeficiencia en los adultos; y la obesidad y la enfermedad pulmonar crónica en los mayores. Conclusiones: Independientemente de los grupos de edad, los individuos con enfermedad neurológica crónica, enfermedad renal, enfermedad hepática y cáncer tendrían un alto riesgo de morir por la COVID-19.

ABSTRACT Objective: to develop a care-educational technology similar to a health navigation program for men during the COVID-19 pandemic. Methods: a methodological and qualitative study of a care-educational technology of health navigation program, structured by Program Development Cycle, with 16 patient navigators and 10 professional navigators. It used reflective thematic content analysis and an adaptation model for data processing. Results: the “Fala-M@ano-COVID-19”; navigation program was developed by: I) Observation of reality, problem mapping, needs assessment: content selection, creation of domains and questions; II) Theoretical-conceptual and methodological definition, creation of product under the elaboration of care plans, based on theory, process and taxonomies by a flowchart of operationalization of actions; and III) Self-assessment: qualitative research with professional navigators. Final considerations: the technology developed, with theoretical and methodological support, allowed to derive a viable navigation program compatible with reality based on the audience’s needs.

RESUMEN Objetivo: desarrollar una tecnología cuidado-educativa similar a un programa de navegación en salud para hombres durante la pandemia de COVID-19. Métodos: estudio metodológico y cualitativo de una tecnología asistencial-educativa como un programa de navegación en salud, estructurado por el Ciclo de Desarrollo del Programa, con 16 navegandos y 10 navegadores. Se utilizó el análisis de contenido temático reflexivo y un modelo de adaptación para el procesamiento de datos. Resultados: el programa de navegación “Fala-M@ano-COVID-19”; fue desarrollado por: I) Observación de la realidad, mapeo de problemas, evaluación de necesidades: selección de contenidos, creación de dominios y preguntas; II) Definición teórico-conceptual y metodológica, creación del producto bajo la elaboración de planes de cuidados, fundamentados en teoría, proceso y taxonomías mediante un diagrama de flujo de operacionalización de acciones; y III) Autoevaluación: investigación cualitativa con navegadores. Consideraciones finales: la tecnología desarrollada, con sustento teórico y metodológico, permitió derivar un programa de navegación viable compatible con la realidad a partir de las necesidades del público.

RESUMO Objetivo: desenvolver uma tecnologia cuidativo-educacional do tipo programa de navegação em saúde para homens na pandemia de COVID-19. Métodos: estudo metodológico e qualitativo de uma tecnologia cuidativo-educacional do tipo programa de navegação em saúde, estruturado pelo Program Development Cycle, com 16 navegandos e 10 navegadores. Usou análise de conteúdo temática reflexiva e modelo de adaptação para tratamento dos dados. Resultados: o programa de navegação “Fala-M@ano-COVID-19” foi desenvolvido por: I) Observação da realidade, mapeamento do problema, levantamento das necessidades: seleção de conteúdo, criação de domínios e perguntas; II) Definição teórico-conceitual e metodológica, criação do produto sob elaboração de planos de cuidados, pautados em teoria, processo e taxonomias por um fluxograma de operacionalização das ações; e III) Autoavaliação: pesquisa qualitativa com os navegadores. Considerações finais: a tecnologia desenvolvida, com suporte teórico e metodológico, permitiu derivar um programa de navegação viável e compatível à realidade com base nas necessidades do público.

SUMMARY The obstruction of the nasolacrimal conduct or dacryostenosis is the result of an incomplete canalization of such a conduct. The clinical manifestations start 2-3 weeks after birth and are characterized by epiphora and muco-purulent discharge. Dacryostenosis may lead to several complications such as acute dacrocystitis, that is a suppurative inflammation characterized by pain, erythema and swollen that can evolve to a lacrimal abscess, pre-septal cellulitis, orbital cellulitis, orbital abscess, cavernous sinus thrombosis, thrombosis of the superior ophthalmic vein and meningitis.

RESUMEN La obstrucción del conducto nasolacrimal (OCNL) o dacrioestenosis consiste en una canalización incompleta de dicho conducto. El cuadro clínico se presentó a las 2-6 semanas de edad y se caracteriza por epifora y secreción mucopurulenta. Genera diversas complicaciones, como la dacriocistitis aguda, una inflamación supurativa caracterizada por dolor, eritema e hinchazón; que puede evolucionar a un absceso lagrimal, celulitis preseptal y puede complicarse a celulitis orbitaria, absceso orbitario, trombosis del seno cavernoso, trombosis de la vena oftálmica superior y meningitis. Se presenta el caso de un lactante de siete meses 28 días de vida extrauterina con antecedente de prematuridad, diagnóstico de Tetralogía de Fallot y dacrioestenosis en ojo derecho. A su ingreso a emergencia, se evidenció eritema, aumento de calor local, secreción sero-amarillenta, consistencia dura con dolor a la palpación y edema periorbitario derecho. Clínicamente se concluyó en el diagnóstico de dacriocistitis aguda.

RESUMO Objetivo: investigar as habilidades auditivas de resolução e ordenação temporal em pessoas que gaguejam. Métodos: estudo observacional transversal analítico e comparativo entre o grupo estudo e o controle. Realizado numa Clínica-Escola de Fonoaudiologia de uma instituição de ensino com pessoas que gaguejam atendidos em projeto de extensão universitária, bem como por voluntários sem distúrbio de comunicação, no período de 13 meses. Os procedimentos realizados foram anamnese de percepção auditiva, imitanciometria, audiometria tonal e vocal para descartar alteração na audição. Para os participantes que atenderam aos critérios de elegibilidade, realizou-se a avaliação das habilidades de resolução e ordenação com os seguintes testes: Gaps in Noise; Random Gap Detection Test; Pitch Pattern Sequence; e Duration Pattern Sequence. Após a realização dos testes descritos acima, os dados obtidos foram alocados em planilha digital para análise estatística descritiva e inferencial. Resultados: o grupo estudo apresentou alteração nas habilidades de resolução e ordenação temporal. Verificou-se, também, a diferença estatisticamente significante nos achados avaliativos dos grupos estudo e controle, quando comparados, para todos os testes realizados nas avaliações. Conclusão: observou-se alteração das habilidades de resolução e ordenação temporal nos indivíduos com gagueira, independentemente do gênero ou idade cronológica.

ABSTRACT Purpose: to investigate the auditory skills of temporal resolution and ordering in people who stutter. Methods: an observational, cross-sectional, analytical, and comparative research between study and control groups conducted at a speech-language-hearing teaching clinic of an academic institution, comprising people who stutter (who attended a public outreach program) and volunteers without communicative disorders, for 13 months. The procedures used were auditory perception anamnesis, acoustic immittance, and pure-tone and speech audiometry to discharge hearing changes. The participants who met the eligibility criteria had their resolution and ordering skills assessed with the Gaps-in-Noise, Random Gap Detection, Pitch Pattern Sequence, and Duration Pattern Sequence tests and the data obtained were entered into a spreadsheet for descriptive and inferential statistical analyses. Results: the study group presented changes in temporal resolution and ordering. A statistically significant difference was also verified comparing the assessment findings of the study and control groups, in all the assessment tests. Conclusion: temporal resolution and ordering changes were observed in the people presented with stuttering, regardless of sex or chronological age.

Sesquiterpene lactones are an important class of secondary metabolites frequently isolated from Vernonanthura genus that present a variety of biological properties, including antiproliferative activity. Due to the limitation of pharmacological studies on Vernonanthura nudiflora, the aim of this work was to investigate their antioxidant potential and antiproliferative activity against human tumor cells, as well as to isolate and identify the chemical constituents present in their aerial parts. The phytochemical investigation resulted in the isolation of the sesquiterpene lactones piptocarphins A, B, D, and a new hirsutinolide derivative, 8α-tigloyloxy-10α-hydroxy-hirsutinolide, besides triterpenes, glycosylated steroids, flavonoids, and one chlorogenic acid derivative. Also, other sesquiterpene lactones were identified by ultra-high performance liquid chromatography-high resolution tandem mass spectrometry (UHPLC-HRMS/MS) from dichloromethane fraction. This fraction showed activity against the tumor cells tested, mainly against leukemia, glioma, ovarian and kidney, with growth inhibitory activity (GI50) less than 0.80 µg mL-1. Piptocarphins A and B, in mixture, showed strong activity against all human cancer cell lines tested, with GI50 values ≤ 0.15 µg mL-1. Piptocarphin D was selective for glioma and resistant ovarian cell lines. The new hirsutinolide derivative showed potent activity against breast (GI50= 0.96 µg mL-1) and resistant ovarian (GI50 = 3.60 µg mL-1) cell lines.

RESUMO Os atributos físico-químicos de sistemas emulsionados são influenciados pelas características de suas gotículas de fase interna (concentração, tamanho e morfologia), as quais podem ser modificadas não apenas pelos componentes da formulação, mas também pela metodologia analítica empregada. Desta forma, o objetivo deste trabalho envolveu a caracterização físico-química de emulsões cosméticas obtidas a partir de diferentes tensoativos, bem como a introdução da tomografia de coerência óptica (OCT) como a técnica analítica utilizada para a caracterização morfológica e determinação do tamanho de partícula das formulações. Três emulsões foram preparadas, diferindo no tipo e concentração do tensoativo empregado, e seus tamanhos de gotícula foram avaliados por meio das técnicas de microscopia óptica, difração a laser e OCT. As técnicas de microscopia óptica e difração a laser forneceram tamanhos de partícula médios menores de 6.0 µm, não detectados pela técnica de OCT, que permitiu apenas a identificação de partículas maiores pertencentes à fase interna dos sistemas emulsionados. Os resultados reforçam a introdução da OCT como metodologia promissora para a caracterização morfológica de emulsões cosméticas; no entanto, a técnica requer aprimoramento para garantir maior sensibilidade na análise de partículas de menor tamanho.

ABSTRACT The physicochemical attributes of emulsified systems are influenced by the characteristics of their internal phase droplets (concentration, size and morphology), which can be modified not only by the formulation components, but also by the analytical methodology employed. Thus, the aim of this work involved the physicochemical characterization of cosmetic emulsions obtained from different surfactants, as well as the introduction of the optical coherence tomography (OCT) as the analytical technique employed for the morphological characterization and particle size determination of the formulations. Three emulsions were prepared, differing at the type and concentration of the surfactant used, and their droplet sizes were evaluated through optical microscopy, laser diffraction and OCT. The microscopic analysis and the laser diffraction techniques provided an average particle size minor than 6.0 µm, not detected by the OCT technique, which could identify only bigger particles of the emulsified systems' internal phase. The results testify that OCT was suitable for the morphological characterization of cosmetic emulsions; however, the technique needs to be improved to ensure a better sensitivity in the analysis of smaller particles.

El presente artículo enfatiza, por medio del empoderamiento, sobre la posibilidad del ejercicio del derecho a la salud para personas privadas de la libertad. Desde la óptica de la calidad de vida como componente fundamental de la salud, se presume que en Colombia existe un serio deterioro, específicamente de la salud bucal y su promoción, en estas personas. A lo anterior se le suma evidencia jurídica de la deficiente infraestructura humana y física de las cárceles, la falta de reconocimiento de los problemas de salud bucal y la problemática manifiesta del estado de la salud bucal de esta población en países en vías de desarrollo. Cabe destacar que la responsabilidad estatal respecto al derecho a la salud se ve maximizada en esta población al ser considerada como vulnerable y subordinada a este. El presente artículo pretende, desde una perspectiva académica, valorar la promoción de la salud bucal en personas privadas de la libertad.

A lo anterior se le suma evidencia jurídica de la deficiente infraestructura humana y física de las cárceles, la falta de reconocimiento de los problemas de salud bucal y la problemática manifiesta del estado de la salud bucal de esta población en países en vías de desarrollo. Cabe destacar que la responsabilidad estatal respecto al derecho a la salud se ve maximizada en esta población al ser considerada como vulnerable y subordinada a este. El presente artículo pretende, desde una perspectiva académica, valorar la promoción de la salud bucal en personas privadas de la libertad. This article emphasizes, through empowerment, the possibility to exercise the right to health in people deprived of their freedom. From the standpoint of quality of life as a fundamental component of health, it is presumed that in Colombia there exists a serious deterioration specifically in oral health and its promotion in people deprived of freedom. To what was said above it can be added the legal evidence of the poor human and physical infrastructure of prisons, the lack of recognition of oral health problems and the problems evidenced in the oral health status of this population in underdeveloped countries. It is important to highlight that the State responsibility regarding the right to health is maximized in this population when it is considered as vulnerable and subordinated to it. This article aims to assess the promotion of oral health in people deprived from freedom from an academic perspective.

In order to effectively address the problems derived from global environmental change, environmental scientists, citizens and decision-makers now recognize the need to integrate more fully the human or social component into ecological research. We propose that to achieve this integration, Long-Term Socio-Ecological Research (LTSER) networks offer an ideal platform, because such sites enable research at ecological, cultural, and political local scales, and at the same time allow addressing these issues at a global scale. However, this socio-ecological work still requires better articulation of programs developed at multiple geographic, ecological and political scales. In addition, until now the social component considered in LTSER programs has focused on economic factors, omitting ethical dimensions. A central reason for this omission is the lack of methodologies to systematically integrate ethics into LTSER programs. As a contribution to resolve this limitation, here we develop a methodological approach that we call “field environmental philosophy.” It integrates ecological research and environmental ethics into biocultural education and conservation through an interrelated four-step cycle: i) interdisciplinary ecological and philosophical research, ii) composition of metaphors, and communication through simple narratives, iii) design of guided field experiences with an ecological and ethical orientation, and iv) implementation of in situ conservation areas. This cycle has been defined a posteriori, by analyzing successful experiences of biocultural research, education and conservation program at the Omora Ethnobotanical Park (OEP) in the Cape Horn Biosphere Reserve (CHBR). The Masters of Science in Subantarctic Conservation at the University of Magallanes (UMAG) adopted this cycle as a structured methodology to design theses and academic curricula for students who are creating innovative educational and ecotourism activities, such as “Ecotourism with a Hand Lens” and “Ethical Birding.” To articulate the programs at multiples scales, the OEP functions at the local scale as a research center in the CHBR, at the national level as a cofounder and southernmost site of the Chilean LTSER network coordinated by the Institute of Ecology and Biodiversity (IEB), Chile, and at the international level as a reserve and field station of the Subantarctic Biocultural Conservation Program that is coordinated by UMAG, IEB and the University of North Texas (UNT). This organization of nested units has permitted to synergistically articulate the work at local, national and international scales. Collaborative research has led to the discovery of biological and cultural diversity singularities in the remote Magellanic subantarctic ecoregion, enabled education and conservation work with multiple social actors and institutions, and has strengthened the incorporation of environmental philosophy into socio-ecological research. In this way, OEP’s program is contributing to broaden the definition of the social (“S”) component in LTSER, and to generate methodologies to integrate, at multiple scales, ecological and ethical dimensions into socio-ecological research, as well as biocultural education and conservation programs, which could be implemented and assessed at other LTER sites.

Para resolver los problemas derivados del cambio medioambiental global, los científicos y tomadores de decisiones reconocen que es necesario integrar más ampliamente el componente social o factor humano en la investigación ecológica. Proponemos que para lograr esta integración las redes de Sitios de Estudios Socio-Ecológicos a Largo Plazo (SESELP) ofrecen una plataforma ideal, porque los sitios permiten abordar singularidades ecológicas, culturales y políticas a escala local, a la vez que integrar escalas globales a través del trabajo colaborativo en redes de sitios. Sin embargo, este trabajo socioecológico todavía requiere articular de mejor manera los programas desarrollados a múltiples escalas geográficas, ecológicas y políticas. Además, hasta el momento el componente social considerado en los programas SESELP ha sido fundamentalmente económico, dejando fuera la dimensión ética. La integración de la ética de manera sistemática en los programas SESELP está severamente limitada por la carencia de metodologías. Para contribuir a resolver esta limitación, hemos desarrollado una aproximación metodológica que denominamos “filosofía ambiental de campo”. Esta aproximación integra las ciencias ecológicas y la ética ambiental en educación y conservación biocultural a largo-plazo a través de un ciclo de cuatro pasos interrelacionados: i) investigación interdisciplinaria ecológica y filosófica, ii) composición de metáforas y comunicación a través de relatos simples, iii) diseño de experiencias de campo guiadas con un sentido ecológico y ético, y iv) habilitación de áreas de conservación in situ. Este ciclo se ha definido a posteriori analizando las experiencias efectivas del programa de investigación, educación y conservación biocultural del Parque Etnobotánico Omora, en la Reserva de Biosfera Cabo de Hornos (RBCH). El programa de Magíster en Ciencias con mención en Conservación Subantártica de la Universidad de Magallanes (UMAG) está adoptando este ciclo como una metodología estructurada para el diseño de tesis y mallas curriculares de estudiantes que están generando innovadoras actividades educativas y de ecoturismo, como el “Ecoturismo con Lupa” y el “Birding Ético”. Para articular programas de trabajo múltiples escalas, el Parque Omora funciona a escala local como un centro de investigación en la RBCH, a nivel nacional como cofundador y sitio más austral de la red chilena SESELP coordinada por el Instituto de Ecología y Biodiversidad (IEB), y a nivel internacional como una reserva y estación de campo del Programa de Conservación Biocultural Subantártica, coordinado por la UMAG, IEB y la Universidad de North Texas (UNT). Esta organización en unidades anidadas ha permitido articular de manera sinérgica el trabajo a escalas locales, nacionales e internacionales. La investigación colaborativa ha: 1) conducido al descubrimiento de singularidades de la diversidad biológica y cultural en la remota ecorregión subantártica de Magallanes, 2)ha posibilitado programas de educación y conservación trabajando con múltiples actores sociales e instituciones, y 3) incorporado la filosofía ambiental en la investigación socioecológica. De esta manera, el programa del Parque Omora contribuye a ampliar la definición del componente social (“S”) en las redes SESELP, y a generar metodologías para integrar, a múltiples escalas, dimensiones ecológicas y éticas en programas de investigación socioecológica, como también de educación y conservación biocultural, que podrían ser implementadas y evaluadas en otros sitios o redes SESELP.

O cabelo é uma fibra natural formada por queratina, uma proteína composta por teor elevado de enxofre proveniente da cistina. As propriedades principais do cabelo dependem de sua geometria, estrutura física. Características físicas e mecânicas das fibras capilares envolvem propriedades que melhoram: elasticidade, maciez, volume, maleabilidade, facilidade para o ato de pentear e brilho. A avaliação de tais propriedades do cabelo pode ser obtida por métodos diversos, como: microscopia óptica e eletrônica, mensuração da resistência mecânica, determinação do brilho e tomografia por coerência óptica (OCT).

The hair thread is a natural fiber formed by keratin, a protein containing high concentration of sulfur coming from the amino acid cystine. The main physical proprieties of the hair depend mostly on its geometry; the physical and mechanical properties of hair involve characteristics to improve: elasticity, smoothness, volume, shine, and softness due to both the significant adherence of the cuticle scales and the movement control (malleability), as well as the easiness of combing, since they reduce the fibers static electricity. The evaluation of these effects on hair may be carried out by several methods, as: optical and electron microscopy, mechanical resistance measuring, shine evaluation and optical coherence tomography (OCT).

A informação genética e as tecnologias são cada vez mais importantes no cuidado em saúde, não somente nos países desenvolvidos, mas no mundo todo. Vários fatores globais prometem aumentar a futura demanda para pesquisa e serviços de saúde em genética moralmente conscientes. Embora os enfermeiros sejam o maior grupo profissional, prestando cuidado de saúde no mundo todo, eles não tomaram a liderança rumo a esse desafio. Insights, a partir da análise feminista, ajudam a esclarecer algumas das relações sociais e dos obstáculos culturais que têm impedido a integração da tecnologia genética na área da enfermagem. Um modelo alternativo é sugerido - o modelo transdisciplinar -, o qual foi desenvolvido inicialmente por uma enfermeira e introduzido, na década de 1970, na prestação do cuidado em saúde e no serviço social para crianças com déficit de desenvolvimento. Esse modelo holístico permite que todo profissional de saúde tenha a mesma voz ao determinar como o cuidado de saúde em genética será globalizado.

Genetic information and technologies are increasingly important in health care, not only in technologically advanced countries, but world-wide. Several global factors promise to increase future demand for morally conscious genetic health services and research. Although they are the largest professional group delivering health care world-wide, nurses have not taken the lead in meeting this challenge. Insights from feminist analysis help to illuminate some of the social institutions and cultural obstacles that have impeded the integration of genetics technology into the discipline of nursing. An alternative model is suggested - the transdisciplinary model - which was developed initially by a nurse and introduced in the 1970s into the delivery of health care and social services for children with developmental disabilities. This holistic model enables all health care professionals to have an equal voice in determining how genetic health care will be globalized.

Osteoporosis is a major public health problem, affecting millions of people worldwide. The associated health care costs are growing in parallel with increases in elderly populations, and it is expected that the number of osteoporotic fractures will double over the next 50 years. The best way to address osteoporosis is prevention. Some interventions to maximize and preserve bone mass have multiple health benefits and are cost-effective. For example, modifications to diet and lifestyle can help to prevent osteoporosis, and could potentially lead to a significant decrease in fracture rates; and exercise is a valuable adjunct to programmes aimed at alleviating the risks and symptoms of osteoporosis. Practising exercise at a young age helps maximize the mineral density of bones while they are still growing and maturing, and continuing to excercise minimizes bone loss later in life. Not only does exercise improve bone health, it also increases muscle strength, coordination, balance, flexibility and leads to better overall health. Walking, aerobic exercise, and t'ai chi are the best forms of exercise to stimulate bone formation and strengthen the muscles that help support bones. Encouraging physical activity at all ages is therefore a top priority to prevent osteoporosis.

La osteoporosis constituye un importante problema de salud pública que afecta a millones de personas en todo el mundo. Sus costos sanitarios están aumentando conforme crece la población de edad avanzada, y se prevé que el número de fracturas osteoporóticas se duplique a lo largo de los próximos 50 años. La mejor forma de abordar el problema de la osteoporosis es la prevención. Algunas intervenciones destinadas a incrementar y conservar la masa ósea reportan múltiples beneficios para la salud y son rentables. Por ejemplo, las modificaciones de la dieta y del estilo de vida pueden ayudar a prevenir la osteoporosis, y podrían dar lugar a una importante reducción de las tasas de fracturas; el ejercicio es un valioso complemento de los programas destinados a reducir el riesgo y aliviar los síntomas de la osteoporosis. La realización de ejercicio durante la juventud ayuda a aumentar la densidad mineral ósea mientras los huesos todavía están creciendo y madurando, y su continuación reduce la pérdida ósea en fases posteriores de la vida. Además de mejorar la salud ósea, el ejercicio fortalece los músculos, la coordinación, el equilibrio y la flexibilidad, y mejora la salud en general. El caminar, el ejercicio aeróbico y el taichi son las mejores formas de ejercicio para estimular la formación ósea y fortalecer los músculos que ayudan a sostener los huesos. Por consiguiente, el fomento de la actividad física a todas las edades constituye una prioridad absoluta para prevenir la osteoporosis.

L'ostéoporose constitue un problème de santé publique majeur qui touche des millions de gens dans le monde. L'augmentation des coûts des soins de santé qui lui sont associés va de pair avec l'augmentation du nombre des personnes âgées, et on s'attend que le nombre des fractures ostéoporotiques double au cours des 50 prochaines années. La meilleure attaque contre l'ostéoporose est la prévention. Certaines mesures visant à augmenter ou à préserver la masse osseuse offrent de multiples avantages sur le plan de la santé et sont d'un bon rapport coût/efficacité. Ainsi, des changements dans le régime alimentaire et le mode de vie peuvent contribuer à prévenir l'ostéoporose, et pourraient éventuellement diminuer de manière sensible le taux de fractures ; l'exercice, par ailleurs, est un complément précieux aux programmes visant à réduire les risques et les symptômes d'ostéoporose. L'exercice physique pratiqué dès le plus jeune âge contribue à augmenter la densité minérale osseuse de l'enfant en pleine croissance, et sa poursuite réduit la perte osseuse à l'âge adulte. L'exercice non seulement améliore la santé des os, mais il renforce également les muscles, la coordination, l'équilibre, la souplesse et permet d'avoir dans l'ensemble une meilleure santé. La marche, l'aérobic, le tai-chí sont tout particulièrement indiqués pour stimuler la formation osseuse et renforcer les muscles de soutien. Encourager l'exercice physique à tous âges est donc une priorité absolue pour prévenir l'ostéoporose.