Accidentes de trabajo e índice de masa corporal en vigilantes atendidos en una I.P.S. de salud ocupacional, Bogotá - Colombia, 2015

INTRODUCCIÓN: Todos los individuos dentro de una sociedad tienen derecho a disfrutar de una integridad física, mental y de sus bienes materiales, que en principio debe ser garantizada por el Estado, sin embargo, debido a la ineficacia y falta de alcance en la disponibilidad de hombres y mujeres para cuidar a cada persona y empresa, la Seguridad Privada ha surgido como actividad económica para garantizar éste servicio de manera individualizada. No obstante a ello, poco se sabe acerca de las características de las personas que desempeñan ésta labor, así como las demandas inherentes a ésta actividad económica; sin embargo, en poblaciones económicamente similares, se documenta a través de la literatura la aparente relación entre la condición física del individuo y la presentación de accidentes de trabajo. OBJETIVO: Establecer la relación entre los accidentes de trabajo y el índice de masa corporal (IMC) en vigilantes atendidos en una I.P.S. de Salud Ocupacional en la ciudad de Bogotá-Colombia, durante el año 2015. MATERIALES Y MÉTODOS: Se llevó a cabo un estudio de corte transversal, con datos secundarios de una base de datos de 76 registros, procedentes de las historias clínicas médico ocupacionales realizadas a una población de trabajadores del sector de la Vigilancia o Seguridad Privada, durante su atención en una Institución Prestadora de Salud (I.P.S.) de Salud Ocupacional. Se incluyeron variables sociodemográficas, ocupacionales, las relacionadas con los accidentes de trabajo y el índice de masa corporal. Se obtuvieron las frecuencias univariadas y para las variables de tipo cuantitativo, medidas de tendencia central y dispersión, además de buscar potenciales asociaciones estadísticas, para conocer las variables que se relacionan con el evento estudiado. RESULTADOS: En éste proyecto se destaca que de los trabajadores que desempeñan la actividad económica de Vigilancia y Seguridad Privada, se encuentran en el grupo de 20 a 39 años (56.5%) y pertenecen al género masculino (84.2%); dichos factores contribuyen a la ocurrencia de los accidentes de trabajo (OR de 1.7 y 2.0 respectivamente). Además el I.M.C. de sobrepeso (OR 1.8), la obesidad (OR 1.4); y en sí el cargo de Vigilante concurren a la accidentalidad laboral (OR de 1.1) y con ello al incremento de incapacidad laboral en un 85.5% de 0 a 60 días. CONCLUSIONES: Se deben establecer medidas encaminadas al emprendimiento de sistemas de vigilancia epidemiológica que mitiguen y minimicen el riesgo, con ello la presencia de eventos no deseados en el ámbito laboral para ésta población y la disminución del ausentismo laboral.

The Financial Services Regime in International Economic Law: on the Difficult Relationship between Trade Liberalization and Prudential Measures

The PhD thesis analyses the financial services regime in international economic law from the perspective of the difficult relationship between trade liberalisation and prudential measures. Financial stability plays a fundamental role for the well-being and well-functioning of the global economy, but, it is at the same time a complex sector to regulate and supervise and, especially after the 2007-08 economic crisis, States have tightened up their regulation of financial services, introducing more severe and protectionist prudential measures. However, in an increasingly interconnected global economy, the harmonization of prudential regulation at the international level is an essential step to guarantee integrity, fairness and stability of financial markets and trade. The research analyses the tools at disposition to achieve this aim, the related problematic issues and the perspectives and possible solutions for the future, starting from the World Trade Organization (WTO) legal framework and its General Agreement on Trade in Services (GATS), devoted to discipline trade in services among the WTO Members. Then, the research moves to a second legal instrument, the Free Trade Agreements (FTAs), which has witnessed a remarkable spread in the last decades. Finally, the research addresses the international standards, developed by supranational entities and implemented by an increasing number of States, as they offer rules and guidelines adequate to update the international financial scenario. Nevertheless, the international standards alone cannot be the solution because, first, they are not mandatory, as governments decide voluntarily to apply them and, second, their decision-making process do not respect the requirements of transparency and representative membership. In light of this analysis, the thesis aims at providing an answer to its research question: how to give more certainty to States and economic operators in the planning of the domestic disciplines and business activities in order to provide a sound and stable international financial system.

Adaptable security in the cloud-to-thing continuum

Recent technological advancements have played a key role in seamlessly integrating cloud, edge, and Internet of Things (IoT) technologies, giving rise to the Cloud-to-Thing Continuum paradigm. This cloud model connects many heterogeneous resources that generate a large amount of data and collaborate to deliver next-generation services. While it has the potential to reshape several application domains, the number of connected entities remarkably broadens the security attack surface. One of the main problems is the lack of security measures to adapt to the dynamic and evolving conditions of the Cloud-To-Thing Continuum. To address this challenge, this dissertation proposes novel adaptable security mechanisms. Adaptable security is the capability of security controls, systems, and protocols to dynamically adjust to changing conditions and scenarios. However, since the design and development of novel security mechanisms can be explored from different perspectives and levels, we place our attention on threat modeling and access control. The contributions of the thesis can be summarized as follows. First, we introduce a model-based methodology that secures the design of edge and cyber-physical systems. This solution identifies threats, security controls, and moving target defense techniques based on system features. Then, we focus on access control management. Since access control policies are subject to modifications, we evaluate how they can be efficiently shared among distributed areas, highlighting the effectiveness of distributed ledger technologies. Furthermore, we propose a risk-based authorization middleware, adjusting permissions based on real-time data, and a federated learning framework that enhances trustworthiness by weighting each client's contributions according to the quality of their partial models. Finally, since authorization revocation is another critical concern, we present an efficient revocation scheme for verifiable credentials in IoT networks, featuring decentralization, demanding minimum storage and computing capabilities. All the mechanisms have been evaluated in different conditions, proving their adaptability to the Cloud-to-Thing Continuum landscape.

National Institutes Of Health Consensus Development Project On Criteria For Clinical Trials In Chronic Graft-versus-host Disease: I. The 2014 Diagnosis And Staging Working Group Report.

The 2005 National Institutes of Health (NIH) Consensus Conference proposed new criteria for diagnosing and scoring the severity of chronic graft-versus-host disease (GVHD). The 2014 NIH consensus maintains the framework of the prior consensus with further refinement based on new evidence. Revisions have been made to address areas of controversy or confusion, such as the overlap chronic GVHD subcategory and the distinction between active disease and past tissue damage. Diagnostic criteria for involvement of mouth, eyes, genitalia, and lungs have been revised. Categories of chronic GVHD should be defined in ways that indicate prognosis, guide treatment, and define eligibility for clinical trials. Revisions have been made to focus attention on the causes of organ-specific abnormalities. Attribution of organ-specific abnormalities to chronic GVHD has been addressed. This paradigm shift provides greater specificity and more accurately measures the global burden of disease attributed to GVHD, and it will facilitate biomarker association studies.

Futebol e sociedade : as manifestações da torcida

Universidade Estadual de Campinas. Faculdade de Educação Física

Spatial clustering analysis of the foot-and-mouth disease outbreaks in Mato Grosso do Sul state, Brazil - 2005

In the southern region of Mato Grosso do Sul state, Brazil, a foot-and-mouth disease (FMD) epidemic started in September 2005. A total of 33 outbreaks were detected and 33,741 FMD-susceptible animals were slaughtered and destroyed. There were no reports of FMD cases in other species than bovines. Based on the data of this epidemic, it was carried out an analysis using the K-function and it was observed spatial clustering of outbreaks within a range of 25km. This observation may be related to the dynamics of foot-and-mouth disease spread and to the measures undertaken to control the disease dissemination. The control measures were effective once the disease did not spread to farms more than 47 km apart from the initial outbreaks.

Recent trends in maternal, newborn, and child health in Brazil: progress toward Millennium Development Goals 4 and 5

We analyzed Brazil's efforts in reducing child mortality, improving maternal and child health, and reducing socioeconomic and regional inequalities from 1990 through 2007. We compiled and reanalyzed data from several sources, including vital statistics and population-based surveys. We also explored the roles of broad socioeconomic and demographic changes and the introduction of health sector and other reform measures in explaining the improvements observed. Our findings provide compelling evidence that proactive measures to reduce health disparities accompanied by socioeconomic progress can result in measurable improvements in the health of children and mothers in a relatively short interval. Our analysis of Brazil's successes and remaining challenges to reach and surpass Millennium Development Goals 4 and 5 can provide important lessons for other low- and middle-income countries

Short-term nutritional counseling reduces body mass index, waist circumference, triceps skinfold and triglycerides in women with metabolic syndrome

Background: It is recognized that the growing epidemic of metabolic syndrome is related to dietary and lifestyle changes. Objective: The purpose of this study was to evaluate short-term application of nutritional counseling in women with metabolic syndrome. Methods: This follow-up study was conducted from September to November 2008 with thirty three women >= 35 years old screened clinically for nutritional counseling. Dietary intake was reported, and biochemical and body composition measures were taken at baseline and after three months of follow-up. Results: Of the 33 women evaluated, 29 patients completed the study. The prevalence of type 2 diabetes mellitus, hypertension, dyslipidemia, and obesity was high at 38%, 72.4%, 55.2%, and 75.8%, respectively. At the end of three-months of follow-up, a significant decline in body mass index, waist circumference, triceps skinfold, and triglycerides was observed, as was an increase in calcium and vitamin D intake. The multiple regression analysis showed that changes in body mass index, triceps skinfold, waist circumference and triglyceride levels after nutritional intervention were positively associated with changes in anthropometric (loss of body weight) and biochemical (decrease of TG/HDL-c ratio) parameters. Moreover, waist circumference changes were negatively associated with changes in calcium and vitamin D intake. Conclusion: Short-term nutritional counseling improved some factors of metabolic syndrome. Moreover, the increases in calcium and vitamin D consumption can be associated with the improvement in markers of metabolic syndrome.

Acupuncture and Temporomandibular Disorders: A 3-Month Follow-up EMG Study

Objectives: The purpose of this study was to investigate the levels of electromyographic (EMG) activation and maximal molar bite force before and after a 3-month acupuncture therapy in individuals with temporomandibular disorder (Helkimo Index) from a pool of subjects attending the Special Care Course of the Ribeirao Preto Dental School, Sao Paulo University, Brazil. Design: All 17 patients, aged between 37 and 50 years (44.2 +/- 4.84 years), with an average weight of 71 +/- 9.45 kg and height of 1.64 +/- 0.07 m, were clinically examined with regard to pain and dysfunctions of the masticatory system. The temporomandibular acupuncture points of needling were IG4, E6, E7, B2, VB14, VB20, ID18, ID19, F3, E36, VB34, E44, R3, and HN3. EMG measures were acquired before and after the treatment using a MyoSystem-BR1 electromyographer. The data collected at rest, protrusion, left and right laterality, and clenching were normalized by maximum voluntary contraction. Maximal bite force in right and left molar regions were registered using a dynamometer with a capacity of up to 1000 N, adapted for oral conditions. The highest value out of three recordings was considered to be the individual's maximal bite force. The results were statistically analyzed using the paired t test (SPSS version 15.0) during the comparison before and after treatment. Results: We found decreased EMG activity at rest, protrusion, left and right laterality, and clenching; as well as increased values of maximal bite force after acupuncture treatment. Conclusions: Acupuncture promoted alterations in the EMG activity of masticatory muscles, increased maximal molar bite force, and led to remission of the subjects' painful symptomatology.

Comparison between constant and decreasing rest intervals: influence on maximal strength and hypertrophy

de Souza Jr, TP, Fleck, SJ, Simao, R, Dubas, JP, Pereira, B, de Brito Pacheco, EM, da Silva, AC, and de Oliveira, PR. Comparison between constant and decreasing rest intervals: influence on maximal strength and hypertrophy. J Strength Cond Res 24(7): 1843-1850, 2010-Most resistance training programs use constant rest period lengths between sets and exercises, but some programs use decreasing rest period lengths as training progresses. The aim of this study was to compare the effect on strength and hypertrophy of 8 weeks of resistance training using constant rest intervals (CIs) and decreasing rest intervals (DIs) between sets and exercises. Twenty young men recreationally trained in strength training were randomly assigned to either a CI or DI training group. During the first 2 weeks of training, 3 sets of 10-12 repetition maximum (RM) with 2-minute rest intervals between sets and exercises were performed by both groups. During the next 6 weeks of training, the CI group trained using 2 minutes between sets and exercises (4 sets of 8-10RM), and the DI group trained with DIs (2 minutes decreasing to 30 seconds) as the 6 weeks of training progressed (4 sets of 8-10RM). Total training volume of the bench press and squat were significantly lower for the DI compared to the CI group (bench press 9.4%, squat 13.9%) and weekly training volume of these same exercises was lower in the DI group from weeks 6 to 8 of training. Strength (1RM) in the bench press and squat, knee extensor and flexor isokinetic measures of peak torque, and muscle cross-sectional area (CSA) using magnetic resonance imaging were assessed pretraining and posttraining. No significant differences (p <= 0.05) were shown between the CI and DI training protocols for CSA (arm 13.8 vs. 14.5%, thigh 16.6 vs. 16.3%), 1RM (bench press 28 vs. 37%, squat 34 vs. 34%), and isokinetic peak torque. In conclusion, the results indicate that a training protocol with DI is just as effective as a CI protocol over short training periods (6 weeks) for increasing maximal strength and muscle CSA; thus, either type of program can be used over a short training period to cause strength and hypertrophy.

Identification and control of occupational risks in a Sao Paulo metropolitan region quarry

Crushed stone mining is the third largest mining economy in Brazil, where almost half is produced in the Sao Paulo metropolitan region. The segment registers the highest number of accidents among the extractive industries, which justifies the concern with workers` health and safety, and the importance of controlling occupational hazards. Since 2002, the NR-22 Standard (NR-22: Occupational Health and Safety in Mining) makes compulsory the elaboration of a Risk Management Program that identifies risks and establishes control measures. Considering the crushed stone mining industry importance to the state, this paper evaluates and discusses the risks identified in unit operations during the production process of crushed stone in an open pit mine in order to propose control measures for the development of the Risk Management Program. Although this study refers to a specific quarry, it can be applied to other mines from the same sector since some considerations are made regarding differences in manufacturing processes. The research was based on the identification of the main risks associated with drilling, blasting, load & haulage, crushing and screening through field measurements of some hazardous agents, together with company reports. The results contributed to the choice of the appropriate control measures for the improvement Of workers` health and safety conditions.

Cyanobacteria and Cyanotoxin in the Billings Reservoir (Sao Paulo, SP, Brazil)

The Billings Complex and the Guarapiranga System are important strategic reservoirs for the city of Sao Paulo and surrounding areas because the water is used among other things, for the public water supply. They produce 19,000 liters of water per second and Supply water to 5.4 million people. Crude water is transferred from the Taquacetuba branch of the Billings Complex to the Guarapiranga Reservoir to regulate the water level of the reservoir. The objective of this study was to evaluate the water quality in the Taquacetuba branch, focusing on cyanobacteria and cyanotoxins. Surface water samples were collected in February (summer) and July (winter) of 2007. Analyses were conducted of physical, chemical, and biological variables of he water, cyanobacteria richness and density, and the presence of cyanotoxins. The water was classified as eutrophic-hypereutrophic. Cyanobacteria blooms were observed in both collection periods. The cyanobacteria bloom was most significant in July, reflecting lower water transparency and higher levels of total solids, suspended organic matter, chlorophyll-a, and cyanobacteria density in the surface water. Low richness and elevated dominance of the cyanobacteria were found in both periods. Cylindrospermopsis raciborskii was dominant in February, with 352 661.0 cel mL(-1), and Microcystis panniformis was dominant in July, with 1 866 725.0 cel mL(-1). Three variants of microcystin were found in February (MC-RR, MC-LR, MC-YR), as well as saxitoxin. The same variants of microcystin were found in July, but no saxitoxin was detected. Anatoxin-a and cylindropermopsin were not detected in either period. These findings are of great concern because the water in the Taquacetuba branch, which is transferred into the Guarapiranga Reservoir, is not treated nor managed. It is recommended that monitoring be intensified and more effective measures be taken by the responsible agencies to prevent the process of eutrophication and the consequent development of the cyanobacteria and their toxins.

Linking client and employee perceptions of the organization: A study of client satisfaction with health care services

Client satisfaction with health care sen ices has usually been researched in terms of socio-demographic and predispositional characteristics associated with the client. The present study included organizational characteristics as predictors of client satisfaction with health care services. Participants in the research were clients and employees of an Australian public-sector health care organization who responded to separate client and employee questionnaires. Hierarchical regression analyses indicated that, after controlling for a number of client characteristics, organizational characteristics, as perceived by employees, accounted for a significant proportion of additional variance in client satisfaction with health care services. Results of the present study provided some support for the proposition that employee perceptions of the working environment should be considered in a more comprehensive understanding of client satisfaction with health care services. Limitations of the study highlight practical difficulties in the assessment of client outcomes and methodological complexities in linking individual and organizational processes.

An investigation of the interrelationship between manipulative therapy-induced hypoalgesia and sympathoexcitation

Objective: To investigate a proposed model in which manipulative therapy produces a treatment-specific initial hypoalgesic and sympathoexcitatory effect by activating a descending pain inhibitory system. The a priori hypothesis tested was that manipulative therapy produces mechanical hypoalgesia and sympatho-excitation beyond that produced by placebo or control. Furthermore, these effects would be correlated, thus supporting the proposed model. Design: A randomized, double-blind, placebo-controlled, repeated-measures study of the initial effect of treatment. Setting: Clinical neurophysiology laboratory. Subjects: Twenty-four subjects (13 women and 11 men; mean age, 49 yr) with chronic lateral epicondylalgia (average duration, 6.2 months). Intervention: Cervical spine lateral glide oscillatory manipulation, placebo and control. Outcome Measures: Pressure pain threshold, thermal pain threshold, pain-free grip strength test, upper limb tension test 2b, skin conductance, pileous and glabrous skin temperature and blood flux. Results: Treatment produced hypoalgesic and sympathoexcitatory changes significantly grater than those of placebo and control (p < .03). Confirmatory factor-analysis modeling, which was performed on the pain-related measures and the indicators of sympathetic nervous system function, demonstrated a significant correlation (r = .82) between the latencies of manipulation-induced hypoalgesia and sympathoexcitation. The Lagrange Multiplier test and Wald test indicated that the two latent factors parsimoniously and appropriately represented their observed variables. Conclusions: Manual therapy produces a treatment-specific initial hypoalgesic and sympathoexcitatory effect beyond that of placebo or control. The strong correlation between hypoalgesic and sympathoexcitatory effects suggests that a central control mechanism might be activated by manipulative therapy.

A H-1 MRS study of probable Alzheimer's disease and normal aging: Implications for longitudinal monitoring of dementia progression

In order to evaluate the capability of H-1 MRS to monitor longitudinal changes in subjects with probable Alzheimer's disease (AD), the temporal stability of the metabolite measures N-acetylaspartate and N-acetylas-partylglutamate (NA), total Creatine (Cr), myo-Inositol (mI), total Choline (Chol), NA/Cr, mI/Cr, Chol/Cr and NA/mI were investigated in a cohort of normal older adults. Only the metabolite measures NA, mi, Cr, NA/Cr, mI/Cr, and NA/mI were found to be stable after a mean interval of 260 days. Relative and absolute metabolite measures from a cohort of patients with probable AD were subsequently compared with data from a sample of normal older adult control subjects, and correlated with mental status and the degree of atrophy in the localized voxel. Concentrations of NA, NA/Cr, and NA/mI were significantly reduced in the AD group with concomitant significant increases in mi and mI/Cr. There were no differences between the two groups in measures of Cr, Chol, or Chol/Cr. Significant correlations between mental status as measured by the Mini-Mental State Examination and NA/mI, mI/Cr and NA were found. These metabolite measures were also significantly correlated with the extent of atrophy (as measured by CSF and GM composition) in the spectroscopy voxel. (C) 1999 Elsevier Science Inc.