Effect of location of opening incision on astigmatic correction after small-incision lenticule extraction

published_or_final_versio

Measles outbreak: preliminary report on a case series of the first 8,070 suspected cases, Manaus, Amazonas state, Brazil, February to November 2018

We report an ongoing measles outbreak in Manaus, Amazonas state, Brazil. As at 3 November 2018, 1,631 cases were confirmed corresponding to an incidence of 75.3 per 100,000 inhabitants; all five sanitary districts presented confirmed cases. Reintroduction of measles virus in Manaus is likely related to the current outbreak in Venezuela and due to recent decline in measles vaccine coverage. Given the current scenario, prevention and control measures should target individuals aged 15-29 years

Escola médica e Sistema Único de Saúde (SUS): criação do curso de medicina da Universidade Federal de São Carlos, SP, Brasil (UFSCar) sob perspectiva de docentes e estudantes

A Universidade Federal de São Carlos (UFSCar) implantou seu curso de Medicina em 2006, com currículo baseado em competências e aprendizado prático integrado ao SUS. O objetivo deste trabalho é apresentar uma pesquisa com docentes e graduandos da Primeira Turma da Medicina-UFSCar, realizada por meio da metodologia da História Oral de Vida. As narrativas indicam que o currículo favoreceu o desenvolvimento de competências como: capacidade de busca, pensamento crítico-reflexivo e autogerenciamento do aprendizado, apesar de relatos sobre deficiências em infraestrutura. A prática integrada ao SUS, especialmente nas Unidades de Saúde da Família, aprimorou as dimensões intelectivas, relacionais e afetivas do cuidado, favorecendo a autonomia profissional

Evaluation et suivi de la production agricole en relation avec le climat et l'environnement

Les résultats acquis pendant les quatre ans d'existence du projet régional Espace dans le domaine des cultures pluviales en milieu paysan et ceux obtenus par le projet R3S/PF1 concernant les potentialités agroclimatiques ont été évalués conjointement. L'intégration dans un réseau des actions de ces deux projets a été également appréciée par les chercheurs et techniciens des différents pays présentés. Une attention spéciale a été donnée à l'échange d'informations et surtout à l'association des experts travaillant dans ces projets à la formulation d'un programme visant à perpétuer, d'une part, un dispositif d'observation à partir des résultats du projet Espace et, d'autre part, des actions de recherche pour la mise au point des techniques valorisant les ressources hydrique

Evaluation of health risks of playing sports on synthetic turf pitches with rubber granulate

New research by the Dutch National Institute for Public Health and the Environment (RIVM) indicates that the health risk of playing sports on synthetic turf pitches with an infill of rubber granulate is virtually negligible. Therefore, it is considered safe for people to play sports on such pitches. The research was conducted following public concerns prompted by the Dutch TV programme Zembla called 'Dangerous Play' in October 2016. RIVM hopes that the results of the research will help to answer questions from ministries, municipalities, sports clubs and parents. To evaluate the health risks of playing sports on rubber granulate, it is important to determine which hazardous substances are contained in the granulate and to what extent they may be released. Subsequently, it should be examined how people playing sports can come into contact with these substances and whether this can lead to health effects. Rubber granulate contains numerous substances, such as polycyclic aromatic hydrocarbons (PAHs), metals, plasticisers (phthalates) and bisphenol A (BPA). These substances were found to be released from the granulate in very low amounts. This is because the substances are more or less 'enclosed' in the granulate, which means that the effect of these substances on human health is virtually negligible. What did RIVM investigate? RIVM determined the substances in rubber granulate from 100 sports pitches that are representative of the synthetic turf pitches in the Netherlands. The institute further performed three types of laboratory tests to examine the release of substances from the granulate if a person playing sport comes into contact with them. These 'migration studies' were used to assess to which extent substances can enter the human body via the skin, via the gastrointestinal tract or via the lungs. This was used to calculate human exposure to the released substances and how this can affect health. In addition, RIVM studied the information available in the scientific literature on substances in rubber granulate, their properties and their health effects. Is there a link with leukaemia? No indications were found in the available literature of a link between playing sports on synthetic turf pitches with an infill of rubber granulate and the incidence of leukaemia and lymphoma. No international research has demonstrated this connection. Moreover, it is clear from the composition of the rubber granulate that the chemical substances that are capable of causing leukaemia or lymphoma are either not present (benzene, styrene and 1,3-butadiene) or are present in a very low amount (2-mercaptobenzothiazole). Since the 1980s, a slight rise has been observed in the number of people aged between 10 and 29 who get leukaemia. This trend has not changed since pitches made of synthetic turf were first used in the Netherlands in 2001. Nor does research conducted in the U.S. reveal any increase in the number of new cases of lymphoma in areas where there are relatively many pitches with synthetic turf with an infill of rubber granulate. Information from new American research will be available early 2017. As rubber granulate has been used on football pitches in the United States for a longer period of time (since 1997), it will be possible to analyse over a longer period whether a link exists between playing sports on synthetic turf pitches and getting leukaemia. RIVM is in contact with the researchers and is keeping a sharp eye on the research. Rubber granulate in the environment This research focuses on potential health risks for people who play sports on synthetic turf pitches with an infill of rubber granulate. The research confirms earlier insights showing that the rubber granulate contains metals capable of entering the environment. In particular, zinc was found to be released from the granulate. This metal is not hazardous to humans, but can have consequences for organisms in the soil or surface water. Does rubber granulate meet requirements? Rubber granulate needs to fulfil the regulatory requirements for 'mixtures'. This concentration limit prescribes the maximum permissible amount of certain substances allowed in rubber granulate (there is no limit for how much may be released). This concentration limit concerns substances that are carcinogenic (such as PAHs), hazardous for reproduction or that damage DNA. The amount of PAHs in rubber granulate easily satisfies this concentration limit. The concentration limit for consumer products is far more stringent: it allows far lower amounts of PAHs (100 to 1000 times lower) compared with the concentration limit for mixtures. The amount of PAH in rubber granulate is slightly higher than the concentration limit for consumer products. The European Chemicals Agency (ECHA) is currently conducting research to determine a suitable concentration limit for rubber granulate. RIVM recommends adjusting the concentration limit for rubber granulate to one that is closer to the concentration limit applicable to consumer products. Why is rubber granulate used for football pitches? Rubber granulate is finely crushed rubber particles that are usually made from old car tyres. When used as infill on pitches of synthetic turf, it gives the pitch properties similar to normal turf. It means the ball does not roll too fast and does not bounce too high, and makes the synthetic turf better suited to sliding tackles than it would be without the granulate. Synthetic turf pitches can be used intensively all year around and need less maintenance. A lot is invested nowadays in order to reuse old products as a raw material for new products. This also applies to car tyres. The questions that have arisen about the safety of rubber granulate show that tension may exist between the reuse of materials and concerns about the health risks of new products

ConsExpo Web. Consumer exposure models - model documentation : Update for ConsExpo Web 1.0.2

RIVM has developed a manual for ConsExpo Web. This web application has been developed for use by exposure experts and risk assessors to estimate exposure to chemical substances from various products under various exposure conditions. Exposure assessments provide necessary information for the evaluation of the safety of chemical substances in consumer products. ConsExpo Web is the successor to ConsExpo 4. Using ConsExpo Web, exposure experts and risk assessors from authorities, institutes and companies can assess consumer exposure in a transparent, standardized fashion. There is a wide variety of consumer products, ranging from cosmetics to cleaning products and pest control products. Their use (e.g. how much of the product is used and how frequently) also varies among consumers. ConsExpo Web provides a number of generally applicable exposure assessment models and a database of exposure factors. Together, the models and the database provide a basis on which exposure from a specific product can be estimated. This document provides an overview of ConsExpo Web, an explanation of the exposure and absorption models available in ConsExpo Web and guidance for the careful analysis of the exposure assessment. ConsExpo Web is available via rivm.nl/consexpo. After registration, the use of ConsExpo Web is free