text:
texto em Português
nova página do texto(beta)
Inglês (pdf) | Português (pdf)
Curriculum ScienTI
Ambiente & Sociedade
versão impressa ISSN 1414-753Xversão On-line ISSN 1809-4422
Ambient. soc. vol.20 no.4 São Paulo out./dez. 2017
http://dx.doi.org/10.1590/1809-4422asoc0295r1v2042017
MEDICATION DISPOSAL: A REFLECTION ABOUT POSSIBLE SANITARY AND ENVIRONMENTAL RISKS
HAYSSA MORAES PINTEL RAMOS 1
VANESSA RESENDE NOGUEIRA CRUVINEL 2
MICHELINE MARIE MILWARD DE AZEVEDO MEINERS 3
CAMILA ARAÚJO QUEIROZ 4
DAYANI GALATO 5
1. Sanitation Specialist, Master in Health Sciences and Technologies, Brasília University (UnB). Email: hayssaramos@hotmail.com
2. Professor of the Collective Health Department at Ceilândia Faculty, Brasília University (UnB). Email:vanessarcruvinel@gmail.com
3. Professor of the Pharmacy Department at Ceilândia Faculty, Brasília University (UnB). Email: michelinemeiners@gmail.com
4. Pharmacy Department of Ceilândia Faculty, Brasília University (UnB). Email: camilaqueiroz01@gmail.com
5. Professor of the Post-Graduation Program in Health Sciences and Technologies at Brasília University (UnB). Email: dayanigalato@gmail.com
This article has analyzed the drug disposal form by the population of Distrito Federal (DF), reflecting about its possible health and environmental risks. For that, an exploratory cross-sectional study was conducted based on interviews with residents of all Territorial Planning Units in DF. Among the 393 interviewees, 73.8% had a stock of medicines at home, 78.9% had already discarded drugs, which were mostly done in the common waste (73,6%). Adequate discharge was strongly associated with greater schooling (p = 0,027), higher economic classification (p = 0,005), male sex (p = 0,006) and with receiving information about the subject (p <0,001). It is noted that the inappropriate disposal of drugs is common. It presents the need to incorporate the theme into specific policies and media.
Keywords: Drug Residues; Public Health; Environmental Health; Medical Waste
Este artículo muestra cómo la población del Distrito Federal (DF) se deshace de los medicamentos, teniendo en cuenta sus posibles riesgos medioambientales y de salud. Por lo tanto, llevamos a cabo un estudio exploratorio transversal basado en entrevistas con residentes de todas las Unidades de Planificación Territorial del Distrito Federal. Entre los 393 encuestados el 73,8% tenían un stock de medicamentos en sus hogares, el 78,9% realizó la eliminación de los medicamentos y el 73,6% lo hizo por medio de la basura. La eliminación adecuada está fuertemente asociada a la educación superior (p = 0,027), mayor estatus económico (p = 0,005), el sexo masculino (p = 0,006) y el hecho de haber recibido información sobre el tema (p <0,001). Se observa que la eliminación inadecuada de medicamentos es común. Suscita la necesidad de incorporar el tema de las políticas específicas y los medios de comunicación.
Palabras-clave : Residuos de Medicamentos; Salud Pública; Salud Ambiental; Residuos Sanitarios
Scientific advancements in the healthcare field and research on new treatments have brought unquestionable benefits to the population's health, fact that also led to a considerable increase in the manufacturing of new formulas, as well as in the amount of medication available for trade and consumption (PINTO et al., 2014).
If, on the one hand, the scientific advancements brought great contributions to improve the quality of life, to combat illnesses and to reduce morbidity and mortality rates, on the other hand, it contributed to self-medication practices defined by Vilarino et al. (1998) as the use of medications without previous medical prescription, i.e., patient decides the drug to take themselves.
According to the World Health Organization (WHO), self-medication can be beneficial for public healthcare systems since, in many cases, it avoids the collapse of the system due to the assistance to transitory cases or to less emergency ones (CASTRO et al., 2006). However, when self-medication is irrationally practiced it can lead to effects related to increased mistakes in disease diagnosis, to the use of insufficient or excessive dosage, and to the emergence of adverse events (OMS, 2016; CASTRO et al., 2006).
In addition to the aforementioned issues, the irrational use of medication, lack of fractioned sales, free sample distribution by laboratories, and the media, which encourages self-medication and treatment abandonment, significantly help accumulating a large amount of useless medication in people's residences. These medications can then be further disposed in inappropriate areas (ALENCAR et al., 2014; BUENO, WEBER & OLIVEIRA, 2009). Such situation can be worsened in the country due to lack of programs to recall expired medication from residences (SOUZA & FALQUETO, 2015).
Solid residues (SR) are any material, substance, object or good, resulting from human activities in society, discarded in their solid and semi-solid state (BRASIL, 2010). The different SR types are categorized as residential, commercial, street and free fairs, healthcare services, harbors, airports, bus and train stations, industrial, agricultural and construction debris residues (BRASIL, 2006). Healthcare Services Residues (HSR) produced in any establishment providing human or animal healthcare assistance demand different attention, because they represent sanitary and environmental risks (BRASIL, 2010).
Nowadays, HSRs are regulated by the RDC Resolution n. 306/ 2004 of the National Sanitation Surveillance Agency (Agência Nacional de Vigilância Sanitária - ANVISA) and by Resolution n. 358/ 2005 of the National Environment Council (Conselho Nacional do Meio Ambiente - CONAMA), which address the technical and legal guidelines for HSR management, treatment and final disposal in Brazil. According to these resolutions, HSRs are categorized in five groups: A (biological), B (chemical), C (radio-active waste), D (common) and E (sharp). Drugs are categorized as group B residues, which holds chemical substances capable of representing risk for public health or for the environment depending on their flammability, corrosivity, reactivity and toxicity (Brasil, 2006). The Federal District (Distrito Federal - DF) also counts on District Law n. 4.352/2009, which addresses HSRs and on Law n. 5092/ 2013 that discusses drug stores' duty to recall expired medication for proper disposal.
In 2012, Brazil witnessed a great advancement in the SR field after Law n. 12.305/ 2010 was sanctioned. This law created the Solid Residues National Policy (Política Nacional de Resíduos Sólidos - PNRS) and has been boosting important debates even about the reversed logistics, in face of the responsibility held by all the actors involved in products' life cycle.
Based on data from the Brazilian Geography and Statistics Institute (Instituto Brasileiro de Geografia e Estatística - IBGE), back in 2008, approximately 50.8% of all Brazilian counties were using open dumps (landfills) as the final destination for residues. Such reality remains in the DF, which houses the popularly known "structural landfill"; more precisely describing: the biggest landfill in Latin America. The practice of disposing medications in containers developed for common or residential residues (Group D), as well as in the public sewage network, is common in the population and it has been triggering the interest of the scientific community, since these residues can contaminate the soil, water, rivers, lakes, oceans and groundwater (PINTO et al., 2014; BILA & DEZOTTI, 2003; ZAPARROLI et al., 2011). According to Borges et al. (2016), drugs diluted in the water used in water treatment stations currently represent a challenge to sanitation companies.
Besides the environmental risks caused by inappropriate disposal, different authors have been weighing about waste collectors' exposure to medications discarded as common residues (Group D), i.e., they are discarded without any previous treatment. Based on Pinto et al. (2014), the inappropriate disposal of medications enables waste collectors' to inadequately absorb these residues from the soil by reusing their packages.
Falqueto & Kligerman (2010) state that the sanitation reality in the country is impaired by processes used to treat and dispose residues of biological and chemical nature. The legislation shows advancements in this field; however, residue management practices remain largely defective when it comes to treatment and final disposal aspects, mainly to drug residues. It happens due to the pharmacological characteristics of these medications, which can become toxic to the environment and to humans, fact that justifies the need of further research and studies about the topic.
Nowadays, still there is no consolidated policy about the disposal of medication from residences. Accordingly, the aim of the present investigation was to analyze the way DF population disposes medications and to reflect about the possible sanitary and environmental risks from the exposure to such discarded medications. Moreover, it aimed at listing some of the actions pointed out by the interviewees in order to sensitize the population about the need of an appropriate discard.
Study design, population and sampling
Cross-sectional exploratory design based on interviews. The study was conducted in the Federal District. The OpenEpii software was used to calculate the sample size. The entire DF population, which was estimated in 2,852,750 inhabitants by IBGE in 2013 (at 5% error level and 95% confidence level) was taken into consideration.
The sample counted on 393 subjects selected by convenience. Participants in the research were approached in public places such as malls, free fairs, squares and parks in the seven different Territorial Planning Units (Unidades de Planejamento Territorial - UPT) in order to gather residents from different administrative regions and, consequently, to hold individuals from different schooling and income levels (Figure 1).
Figure 1: Federal District Territorial Planning Units (Unidades de Planejamento Territorial do Distrito Federal). Source: adapted from the Territorial Ordering Direction Plan (Plano Diretor de Ordenamento Territorial/ DF, 2009).
The inclusion criteria consisted of being over 18 years old and of living in one of the seven UPTs. The exclusion criteria were based on not-finishing the interview schedule.
Data collection and research variables
Data collection was performed through interviews guided by a structured script comprising closed questions. The interviews were conducted from June to September 2016 with the help of volunteer students from the academic extension projects called "Stop, Think, Discard" (Pare, Pense, Descarte - PPD) and "Access to and Use of Medication" (Acesso e Uso de Medicamentos - AMUR) of Brasília University, Ceilândia Faculty (UNB - Fce). The volunteers were previously instructed through a handbook about how to conduct data collection. The handbook comprised questions related to the aims of the research, about the inclusion and exclusion criteria, as well as information about how to approach interviewees, the reading, about the signing of the Informed Free Consent Form (Consentimento Livre e Esclarecido - TCLE) and relevant information about the interview script. Meetings were periodically conducted in order to guide and clarify doubts with the researchers. A pre-test was performed with 10% of the total sample in order to adjust the questionnaire.
The interview script was divided in three parts: 1) interviewees' socio-demographic aspects (sex, age, schooling, marital status, occupation, residence location, economic and race/color classification [The Brazilian Economic Classification Criterion (Critério de Classificação Econômica Brasil - CCEB) by the Survey Companies Association (Associação de Empresas de Pesquisaii -) was used to set the economic classification; 2) health and drug treatment conditions of people in their houses: use of medications (by the family and by the interviewee), frequency of use, the presence of somebody in the house with any chronic disease, the presence of home pharmacy (family stock), variation in the expiring dates, medication storage, the presence of children in the house, medication in the reach of children (when the height from the floor to the medication in the house was shorter than 150 centimeters) and report of intoxication with medication; 3) questions related to medication disposal in the house such as: discard occurrence, reasons for the discard, places used for the discard, last place where the discard was done, information about proper discard (it was taken into consideration whether the local institutions that received medication residues gave them adequate final environmental destination "healthcare units and drug stores), risks related to inappropriate disposal (according to the interviewee's viewpoint) and important actions to sensitize the general population about proper disposal (also according to the interviewee's viewpoint). Answers were written in the interview script itself.
Moreover, the class of the already disposed medications was also investigated, and the Anatomical Therapeutic Chemical (ATC) was adopted to identify the anatomic group (http://www.whocc.no/atc_ddd_index/). Theoretical references from other studies were herein used to define the variables (BUENO, WEBER & OLIVEIRA, 2009; VAZ, FREITAS & CIRQUEIRA, 2011; PINTO et al., 2014; ROCHA et al., 2009; GASPARINI, GASPARINI & FRIGIERI, 2011).
Data organization and analysis
Data collected through the interviews were tabulated and analyzed in the Epidata ® 3.0 software, which created a data entrance frame based on the interview script. The Statistical Package of Social Science (SPSS) 20.0 software was also used and the descriptive statistics was applied to assess the results. The normal variables were presented in absolute numbers and proportions, and the numerical variables were expressed in central tendency (mean and median) and dispersion means (standard and multiple deviation). The chi-square test was adopted to identify factors associated with inappropriate disposal, as well as Fisher's exact test at 5% significance (p≤ 0.05), whenever necessary.
The present research was approved by the Research and Ethics Committee of the Health School of Brasília University under Opinion n. 1.517.670/2016; interviewees had to sign the TCLE in order to participate in the research.
The total of 639 individuals were approached, but 244 of them did not live in the Federal District or did not accept to participate in the research; two individuals did not complete the interview; thus, the final sample counted on 393 interviewees. Residence locations were divided according to the seven UPTs.
Table 1 depicts the prevalence of women; most interviewees had completed high school. The mean age of the participants was 35.2 years (± 14.1) and the median was 32 years, 18 was the minimum age and 89 the maximum one. When it comes to marital status, 49% of the interviewees declared themselves single and 45.8% lived in Western UTPs. Economic classification showed 23.4% of participants living with mean income R$ 2.409,00 according to the Brazilian Economic Classification Criterion (ABEP, 2014); 38% of the subjects in the sample declared themselves brown.
Table 1: Socio-demographic characteristics and residence locations according to the seven Territorial Planning Units of the Federal District's interviewees, 2016.
Variables N %
Female 254 64.6
Male 139 35.4
Age (in years)
18-29 142 36.1
30-39 83 21.1
50-59 27 6.9
60 or older 28 7.1
Non-informed 52 13.2
Complete elementary school 12 3.0
Incomplete elementary school 32 8.1
High School degree 159 40.4
Incomplete High school 34 8.7
College Degree 93 23.7
Incomplete higher education 62 15.8
Non-declared 1 0.3
Single 195 49.6
Married 146 37.2
Widow/widower 9 2.3
Divorced 22 5.6
Common law marriage 16 4.0
Assistant/sales person 143 36.4
Student 64 16.3
Education professional 27 6.9
Public server 20 5.0
housewife / retired 45 11.5
Healthcare professional 16 4.0
Other professions 18 4.6
Unemployed Non-informed 39 21 10.0 5.3
Residence location
Downtown 15 3.8
Central neighborhoods 1 16 4.0
Central neighborhoods 2 64 16.3
West side 180 45.8
South 52 13.3
East side 24 6.1
North 42 10.7
Economic classification *
A 32 8.1
B1 42 10.7
C1 84 21.3
D-E 26 6.7
Non-declared 54 13.8
Color/race
White 130 33.1
Black 63 16.0
Yellow 34 8.7
Brown 149 38.0
Indigenous 9 2.2
* The Brazilian Classification Criterion was used in this variable.
Thirty percent (30% / n=118) of the 393 interviewees reported to have or to live with someone who has some type of chronic disease; hypertension 30.5% (n=36) and diabetes 16.9% (n=20) stood out among them.
Table 2 presents the medication use by the interviewees, which corresponded to 61.8%, the frequency of daily use was 46.3%. With regard to the home medication stock, 73.8% of interviewees reported to have a home stock and the check on the expiring dates is performed by 75.2% of them - 66.5% at the time to take the medication - and 43.1% of the interviewees reported to store the medications in the kitchen. There were children in the homes of 56.7% of the interviewees, 85.7% of them stated that medications are not stored at the children's reach and 38.6% used to keep them between 1m and 1.5m from the floor. Of the 23 reports on intoxication (5.95 of the sample), there were children (0-12 years old) involved in 17.3% of them.
Table 2: Medication use by the interviewee or a family member, frequency of use, home pharmacy, checking on the expiring date, storage and children living in the house (data collected from the Federal District population in 2016).
Medication use (Family members)
Yes 299 76.1
No 89 22.6
Does not know 5 1.3
Medication use (interviewee)
No 150 38.2
Frequency of use (interviewee / n= 243)
Sometimes 70 28.8
Regularly 19 7.8
Everyday 115 47.3
Every once in a while Did not answer 36 03 14.8 1.3
Home pharmacy (n= 393)
Checking on the expiring data (n=290)
Time checking on the expiring date * (n= 218)
At purchase 92 42.2
At the time to take it 145 66.5
When the home pharmacy is checked 36 16.5
Others 1 0.4
Storage * (n=290)
Kitchen 125 43.1
Bedroom 116 40
Bathroom 35 12.0
Living room 13 4.5
Laundry area 9 3.1
Other 3 1.0
Children living in the house
Medications on children's reach (**) (n=223)
Yes 32 14.3
Storage height (n=223)
Shorter than 1 meter 17 7.6
Between 1 and 1.5 meters 86 38.6
between 1.6 and 2 meters 20 8.9
Higher than 2 meters 46 20.7
Did not answer 54 24.2
Report on intoxication with medication (n=393)
Yes 23 5.9
* The answer for this variable was of multiple choice nature and it led to a percentage higher than 100%; **estimated through the height from the floor chosen to store the medications.
Table 3 shows that 78.9% of the interviewees used to dispose medications mainly due to expired dates (62.9%). The most often discarded medications were anti-inflammatory and antibiotics for systemic use (26.3%), and medication for the respiratory tract (24.2%). Most interviewees declared to have never received any information about proper medication disposal (80.7%). Regarding the variable 'local to discard the medications', 34.8% of them reported to not use proper disposal procedures and 45.0% had never thought about such issue. Medication disposal followed the discard of common residues (73.65) and some other interviewees stated to have disposed them in the sink (8.7%) or in the toilet (7%).
Table 3: Medication disposal according to the interviewees' practices, as well as motives, anatomic group, information and disposal places used by residents in the seven Federal District Territorial Planning Units, 2016.
Medication disposal (n=393)
Motive to discard* (n=310)
Was not using them 67 21.6
Expired date 195 62.9
Leftovers 57 18.3
Abandoned the treatment 13 4.1
All options above 9 2.9
Anatomic groups of the discarded medications * (n=310)
Eating tract and metabolism 27 8.7
Blood and blood production organs 19 6.1
Cardiovascular system 51 16.5
H- Hormonal system and preparations 51 16.5
J- Anti-inflammatory and antibiotics for systemic use 81 26.3
N- Nervous system, 29 9.4
R- respiratory tract 75 24.2
Report to have received information about discard (n= 393)
Where did the information come from* (n=76)
Healthcare unit 4 5.3
Media 9 11.8
College/university 9 11.8
Lecture 6 7.8
Supermarket 1 1.3
Does not remember 49 64.4
How the discard was done* (n=310)
Garbage can for common residues 221 71.3
Sink 38 12.3
Toilet 25 8.0
Healthcare unit 13 4.2
Drug stores 8 2.6
University 4 1.3
Last form of discard* (n=310)
Sink 27 8.7
Did not answer 8 2.6
* the answer for this variable was of multiple choice nature and it led to a percentage higher than 100% on the answers.
Table 4 depicts the associations between the interviewees profile and the report about proper disposal, i.e., when the disposal was done in healthcare units and drug stores. It is worth mentioning that the number of subjects in this table refers to those who have answered to the item 'last form of discard', which was shown in the table above.
Table 4: Association between the interviewees' profile and the proper discard done by residents in the seven federal District Territorial Planning Units, 2016.
Exposure variable Proper disposal - n (%) Inappropriate disposal - n (%) p (*) value
Sex (n=302)
Male 8 (3.9)
12 (12.4) 197 (96.1)
85 (87.5) 0.006
Age (n=273)
Older than 32 years 8 (5.9)
7 (5.1) 127 (94.1)
131 (94.9) 0.757
Schooling (n=301)
Higher education 7 (4.0)
Marital Status (n=289)
Others 8 (5.6)
12 (7.7) 134 (94.4)
Residence location (n=302)
Downtown areas
15 (6.1) 53 (91.4)
Economic classification (n=302)
A and B
C, D and E 15 (11.0)
Skin color (n=302)
Non-white 8 (7.3)
Performs selective collection (n=266)
No 13 (7.2)
Information about disposal (n=302)
No 17 (29.3)
3 (1.2) 41 (70.7)
241 (98.8) <0.001(**)
*values were significant when p≤ 0.05; **the p value was found through Fisher's exact test.
The total of 53.9% of the interviewees reported to be aware of the risks associated with medication disposal and the following risks stood out among them: environment contamination (20.6%), damage to the public health and to the population in general (17.8%), water and soil contamination (14.3%), waste collectors' intoxication (14.0%), microorganisms' resistance and food contamination (2.4%); more than one item could have been cited by the interviewees.
With regard to the actions taken to solve problems generated by this type of residue, 23.2% of the interviewees considered that the fractioned sales of medications based on the needs of the prescribed treatment would be crucial to reduce medication leftovers since it would avoid expired dates and unnecessary disposals. Information in the media about proper disposal was pointed by the interviewees as a strategic point, 22.4% of them reported that such medium would be ideal. When it comes to the awareness about and addressment of this topic in teaching institutions, 17.5% of them stated that it is important taking actions like these and 37.9% said that combined actions are feasible to be taken, besides being more effective to sensitize the population.
Medications are essential for health maintenance; however, the access to them, the way they are used and discarded have become a complex problem to public health. Although the scientific community is interest in proper medication disposal, little has been done in order to inform and sensitize the population and managers about the good practices of medication use and disposal. According to data of the Federal Pharmacy (Council Conselho Federal de Farmácia - CFF), Brazil ranks the sixth position among the biggest medication consumption markets in the world. There is the expectation that up to 2018 the country will reach the fourth position, behind the United States, china and Japan (CFF, 2017). Estimates show that 10.3 to 19.8 thousand tons of medications will be discarded, approximately 6.7 thousand tons every year, by counties holding more than 100,000 inhabitants (CFF, 2013). Such reality is even more concerning in the Federal District since it has the biggest landfill in Latin America, the so called "structural landfill", and because it is the capital of the country.
The sampling group was mostly composed of women and it may be justified by the fact that women are more prone to answer to interview scripts. Interviewees' age group varied from 18 to 89 years; 36.1% of them were in the age group between 18 and 39 years; 40.5% of the interviewees finished high school, 34.4% were working as assistants or sales person; most of them (36.4%) lived in Western UPTs (Ceilândia, which is the Administrative Region presenting the highest urban density in the DF, approximately 600 thousand inhabitants) (ANUÁRIODF, 2017).
Medication use was reported by 61.8% of the interviewees, and such data corroborate the research by São Paulo State Regional Pharmacy Council and by CFF from 2013, which approaches the massive expansion of the drugs and medications market in Brazil in the last few years (CFF, 2013). Hypertension (30.5%) was the most prevalent chronic disease among the interviewees, or among people living in their houses, which was followed by diabetes (16.9%). Similar results were found by Bueno, Weber & Oliveira (2009) in Ijuí County, RS, where approximately 41.1% of the interviewees reported these health issues. Based on results of the 2013 National Health Research, the prevalence of medications used to treat chronic disease is high in Brazil, about 80% is used to treat hypertension, diabetes and asthma (TAVARES et al., 2015). The present results evidence that 47.3% of the interviewees declared to make daily use of medications, and it meets the prevalence of the reported chronic conditions, hypertension 30.5% (n=360) followed by diabetes 16.9% (n=20), which suggests continuous medication use.
Home medication stocks were pointed out by 73.8% of the interviewees, and this number is lower than that recorded by Bueno, Weber & Oliveira (2009), who had 91.6% of their interviewees reporting to have a home stock. Vaz, Freitas & Cirqueira (2011), in a study conducted in Brasília, in Vicente Pires Administrative Region, which is also located in the DF, had 97% of their interviewees stating to have medications in their home stock, also known as home pharmacy.
Medications must be in perfect conditions and in the correct expiring date in order to have effective action. These aspects are relevant for treatment efficiency and for the user's safety. After the date has expired, medications must be properly discarded in order to avoid problems such as lack of effectiveness, adverse reactions, among others (ROCHA et al., 2009). Accordingly, checking the expiring date is extremely important and, as for the current study, it was reported by 75.2% of the interviewees; most of them said that they check on the expiring date at the time to take the medicine.
The main storage places pointed out by the interviewees were the kitchen (43.15) and the bedroom (40%). Similar results were found in the studies by Bueno, Weber & Oliveira (2009) and Ribeiro and Heinichk (2010). According to Fernandes & Petrovick (2004), it is recommended to avoid storing medications in hot and humid places; therefore, it is necessary paying close attention to the storage places, due to the risk of contamination and of temperature variations in the environment. It is important highlighting that lack of care with the home pharmacy can change the effectiveness and the safety of medication use. The storage place must be protected from light, heat and humidity in order to avoid possible product degradation (BUENO, WEBER & OLIVEIRA, 2009). Yet, based on Ribeiro and Heineck (2010), when medication storage is not appropriate, the pharmaceutical formula loses its stability and it turns the medication inappropriate to use. Accordingly, the authors suggest the need of implementing education processes in families that make use of medication. At this point, it is necessary emphasizing the role played by community health agents and by health professionals in sensitizing and encouraging families to make rational use and proper storage of their medications.
Although approximately 85% of the interviewees had reported that medication storage is not at children's reach, the prevalent height was at most 1.5 meters from the floor. Schenkel (1996) reinforces that the easy access to medication is a risk factor for child intoxication. It is possible inferring that the height reported by the responsible caregivers is of easy access to children who often climb chairs and benches or other places to play; therefore, it poses high risk of accidents due to possible intoxication by accidental use. Similar results were pointed out by Gasparini, Gasparini & Frigieri (2011), Beckhauser, Valgas & Galato (2012) and Bueno, Weber & Oliveira (2009). According to Schenkel et al. (2005), it is common recording child intoxication with medication stored in inappropriate places, or in places of easy access (unlocked), in Brazil. Data of the National System of Toxic-pharmacologic Information (Sistema Nacional de Informações Tóxico Farmacológicas - SINITOX) from 2013 recorded 63,841,008 cases of intoxication with medication, of which 255 resulted in the patient's death, thus drawing lethality index 0.40% (SINITOX, 2017).
The reason declared for medication disposal was, in most cases, expired dates (62.9%). The main medication disposal form was the disposal with common residues. These data corroborate data recorded in other studies (BUENO, WEBER & OLIVEIRA, 2009; PINTO et al., 2014; GASPARINI, GASPARINI & FRIGIERI, 2011; ROCHA et al., 2009; MAIA & GIORDANO, 2012). A previous study conducted in Brasília, in Vicente Pires Administrative Region by Vaz, Freitas & Cirqueira (2011) showed that 78% of the interviewees living in this region disposed of medications along with common residues, i.e., they discarded medications as they did with residues that do not represent biological, chemical or radiological risk. According to Pinto et al. (2014), such inappropriate disposal puts waste collectors in contact with these medical residues, since they can absorb them from contaminated soil.
Anti-inflammatory and antibiotic medications were the most discarded therapeutic class of medication among the interviewees, which were followed by drugs that act in the respiratory tract. These results corroborate the study by Pinto et al. (2014), which was conducted in Paulínia County, São Paulo State. The occurrence of residual drugs in the aquatic and terrestrial environments has been the subject of interest among many environmental concerns resulting from inadequate medication disposal (BILLA & DEZOTTI, 2003; DAUGHTON, 2003; GHISELLI, 2007; MARTINEZ, 2009). Although the hypothesis about the changes in the functioning of the endocrine system of some species exposed to environmental contamination due to inappropriate medication disposal has been around since the XX century (GHISELLI, 2007), the emission of pharmaceutical products in the environment remains a shortly discussed subject in face of its international relevance (DAUGHTON, 2003). Few researchers work with this research line in Brazil, namely: environmental contamination with drugs (GHISELLI, 2007; MEDEIROS, MOREIRA & LOPES, 2014).
The concern with these products lies on their possible effects on human health and on the environment, including on animal species. Chemical substances suspect of causing changes in the endocrine system are potentially associated with diseases such as testicle, breast and prostate cancer, with low sperm rates, with physical deformities and disfunction in reproductive organs, with thyroid disfunction and with changes related to the neurological system (CARVALHO et al., 2009). Studies also point out the adverse effects on the physiology of animal species, for example, the feminization of fish related to the exposure to the substances, mainly to hormones like those found in contraconceptives (GHISELLI, 2007). Besides the endocrine influences, the antibiotics group is another concern of scientists, since it is the most prevalent class discarded, according to the present results. The uncontrolled use of antibiotics leads to two important environmental issues: one of them regards the water resources and the other one lies on the fact that some microorganisms create resistance to these drugs and promote the development of resistant bacteria (GHISELLI, 2007). This situation gains importance since, according to interviews, they are the medications more often disposed by the interviewees.
The locations seen as adequate for the delivery or destination of these residues are the drug store networks prepared for medical residue collection, healthcare units, hospitals and supermarkets that have agreements with companies responsible for medication residue collection. Based on Medeiros, Moreira & Lopes (2014), places that make residue management systems available - through which the population can safely discard their non-used or expired medication - avoid these medications to be thrown in the common garbage, in the sewage network or to accumulate in patients' houses.
According to the legislation in effect in the country, the proper final disposal forms for these residues are their discard in landfills (when the residue is sealed or inactivated through previous treatment), in landfills with sewage and groundwater protection, through incineration and through chemical decomposition (EICKHOFF, HEINECK & SEIXAS, 2009). It is important emphasizing that the collection of medication residues generated in residences in Brasília can be performed by some drug stores, as well as by the public healthcare units.
Although the Federal District can count on Law n. 5092/2013, which addresses the duty of drug stores to receive expired medication in order to dispose it, such law was never actually followed. In order to mitigate the problem, the DF State Health Bureau (Secretaria de Estado de Saúde do DF - SES/DF) recommends health units to receive expired medications from the population in order to give them the adequate destination. Therefore, medication residues received by the DF Healthcare units are sent to the outsource company responsible for treating and disposing them. Information about the flows set on discard, treatment and final disposal is essential for the environmental awareness of the population. Thus, SES/DF defined a flowchart describing the route between the medication collection in these locations and its final disposal (OLIVEIRA et al., 2016). It is worth mentioning that the process adopted to manage these residues is not simple, since it involves human, physical, logistic and financial resources (OLIVEIRA et al., 2016).
According to Souza & Falqueto (2015), the rational use of medications and their proper disposal is not an isolated attitude but a combined action that must be put in place by the Government, patients, caregivers, family members, health professionals, policymakers, industries and sellers. Each one of these actors must properly perform their roles and competences within the global process. Data in the current study allowed verifying that most of the interviewees never had any information about the appropriate disposal of their medications, although some of them reported to have seen discussions about the topic in the media or in lectures in teaching institutions.
Habit changing regarding disposal forms already in practice and the final disposal procedures have shown a small change (92.4% and 91.7%, respectively) in comparison to previously adopted procedures. Results show significant association among sex (male), higher schooling levels (higher education) and better economic classifications (A and B classes), besides the report that interviewees had already received information about proper disposal forms. Chaves et al. (2015) identified significant difference between schooling level and inappropriate medication disposal and it corroborates data in the present study. These associations reinforce the importance of informing, educating and sensitizing the population about the risks of inadequate disposal. It is necessary to further investigate the variable 'sex' in order to better understand the association between the male gender and proper disposal.
Less than half of the interviewees (53.9%) reported to know the risks of inappropriate disposal, although many of them referred to the risks and damages it could represent to public health, to the environment and to waste collectors. Risks of medication residues to the environment depend, in the first place, on the degree of toxicity, and in the second place, on their concentration range in ecosystems (environmental persistence), which is related to residue permanence time in the environment due to its resistance to chemical and biological degradation associated with natural processes (VAZ, FREITAS & CIRQUEIRA, 2011). Besides factors related to the environment and to public health, waste collectors' contact with these residues also represent potential risk to health. It is worth highlighting that there are traces showing that these professionals may reuse these products for their own consumption or for their kin (RAMOS, 2015a).
Estimates predict that there are approximately 398,348 people living as waste collectors in Brazil. Southeastern states concentrate the largest number of waste collectors in the country (42%), which is followed by the Northeastern states (30%) (DAGNINO & JOHANSEN, 2017). The Federal District has approximately 33 institutions working with recyclable materials, and they count on the cooperation of approximately 2,362 collectors. In 2015, these cooperatives were responsible for recovering approximately 75,000 tons of SR through selective collection or through organic matter composting processes (RDRS, 2015). Although these professionals have their register in the Brazilian Occupation Classification (Classificação Brasileira de Ocupação - CBO) since 2002, they face great vulnerability in their work routine (CBO, 2002).
Information in the media was the most prevalent proposal among the actions suggested by the interviewees. According to Bueno, Weber & Oliveira (2009), lack of information, mainly lack of attitude, can contribute to people perform inappropriate disposal. Yet, based on Jacobi (2005), the population's lack of responsibility mainly results from disinformation, from lack of environmental awareness and from deficits in the community practices based on citizens' participation and involvement. Accordingly, it is necessary reinforcing the role played by information in the outspreading of the importance of adequate disposals.
Another important point highlighted by the interviewees concerned the fractioned sale of medications. Although Decree n. 5.775/2006 (BRASIL, 2006), which addresses medication fractioning, is already in effect, many industries still did not fit to the changes.
Well succeeded experiences have been recorded in Canada, Mexico, Portugal and Colombia. These actions aim at sensitizing the population about the importance of proper final medication disposal (CFF, 2013). Therefore, it is possible saying that such situation can be reversed as long as there is more information available to the society and more interest of all political spheres in the relevance of the herein addressed issue, fact that could improve the current scenario.
There are manifestations of state legislation in the entire Brazilian territory. Torres (2015) listed all the juridical rules concerning medication disposal in Brazil; eighteen federal units had 28 rules, all together. Bahia, Goiás, Mato Grosso, Minas Gerais, Rio de Janeiro, Rio Grande do Norte, São Paulo and Tocantins are the states that still do not have rules (TORRES, 2015). However, most of them count on the voluntary participation of private companies that perform post-consumption disposal. In São Paulo, for instance, there are projects such as the proper medication disposal; the conscient disposal developed by BHS, known as Ecomed; and the medication safe devolution promoted by the Medical School of São Paulo University. All these projects aim at receiving expired medications in order to give them an appropriate environmental destination. Besides these initiatives, different states such as Rio Grande do Sul, Santa Catarina and Paraná already have companies that aim at promoting appropriate medication disposal (MEDEIROS, MOREIRA & LOPES, 2014).
According to the aforementioned, it is possible seeing that inappropriate medication disposal practices can harm the environment and the population's health. Many interviewees are aware of the risks. The lack of legislation to define the practices at residences remains a challenge and deserves attention, given the complexity of the problem.
The present research aimed at understanding how medication disposal is performed by the population, as well as at verifying the action interviewees would think necessary to make feasible strategies to sensitize the public sphere and the population about the discard and final disposal of residues, so that they will be environmentally disposed in order to avoid risks for the public health, for the environment and for waste collectors.
There is no doubt that information in the media is a relevant strategy; however, teaching institutions are essential since they allow the construction of enrichment and learning spaces (RAMOS et al, 2015b). Therefore, Jacobi (2005) takes into account the role played by educators and teachers, which is crucial to boost the changes capable of creating an education system committed with the formation of critical views about values and with ethics, in order to build an environmentally sustainable society.
It is worth highlighting that the appropriate HSR also evidences the need of sensitizing health professionals (BENTO & COSTA, 2015) who are responsible for prescribing and stopping medications, besides the residues they generate in the healthcare units assisting the general population (ALLEVATO, 2014). Therefore, it is possible inferring that these professionals play an important role in the HSR management process.
An integrative review performed by Bento & Costa (2015) showed that, although professionals acknowledge the importance and relevance of the subject, most health professionals do not know the HSR disposal and management phases. According to the results shown in the aforementioned review, it becomes essential reflecting about the importance of inserting the topic in the curriculum matrix of professional formation in health-field majors.
It is known that nowadays subjects related to residues are of great relevance; mainly when it comes to residues with contamination potential. Many studies (BUENO, WEBER & OLIVEIRA, 2009; PINTO et al., 2014; GASPARINI, GASPARINI & FRIGIERI, 2011; ROCHA et al., 2009; UEDA et al., 2009; EICKHOFF, HEINECK & SEIXAS, 2009) have been pointing out these challenges, mainly the ones related to the need of laws that also address the responsibility of the general population, besides the intense supervision of laws already in effect.
Although the study is successful in its aims and results, it is necessary mentioning that it presented methodological limitations. One of them concerns the interviewees' memory bias due to the recalling period. Moreover, there may be limitations linked to the sampling process, which was based on convenient choices. The study was performed in crowded places at day light time, and it may have impaired the participation of some working-class representatives in the research. Another limitation was the number of refusals, mainly in high-class DF neighborhoods, fat that can explain why the survey was conducted in public places on business hours. Therefore, many people were looking forward to meeting their appointments (school, work, among others) or to go back home.
Results allowed concluding that medication disposal remains inappropriate according to more than half of the interviewees, and it proves the need of providing information and of sensitizing society as a whole, given the high risk placed by these residues, which can compromise people's quality of life.
Some strategies have been weighed in order to minimize the problem, but the lack of a specific policy to the destination given to medication of home use contribute to the bad practices. Most of the interviewees declared not to know the risks related to these residues. Even those who knew the importance of the subject, said that they did not know the importance of and the best way to promote a safe disposal.
Results also showed that the variable 'to have received information' was the most associated with proper disposal, as well as variables 'schooling level' and 'economic classification'. Such result reinforces the importance of education actions in the mass communication means in order to sensitize the population and change the current reality.
Successful projects concerning medication collection must be encouraged due to the benefits they bring to human health and to the environment. These programs are crucial, since they help diminishing the amount of medication inappropriately disposed and give the population the opportunity to discard them in an environmentally safe way.
Besides, educating patients about proper destinations is one of the most important steps. Health professionals involved in caregiving must encourage their patients to practice the rational use and disposal of their medications and of all HSRs that place sanitary and environmental risks.
ABEP. Associação Brasileira de Empresas de Pesquisa. Critério de Classificação Econômica Brasil, 2014. [ Links ]
ABNT. Associação Brasileira de Normas Técnicas. NBR. 10.04 Resíduos sólidos: Classificação. São Paulo, 2004 [ Links ]
ANUÁRIO DF. Anuário do Distrito Federal. Ceilândia é reduto da nova classe média. Disponível em:< http://www.anuariododf.com.br/regioes-administrativas/ra-ix-ceilandia/>. Acesso em: 20 de jul. 2017. [ Links ]
ALENCAR, T.O.S. et al. Descarte de medicamentos: uma análise da prática no Programa Saúde da Família. Ciência & Saúde Coletiva, v. 19, n. 7, p. 2157-2166, 2014. [ Links ]
ALLEVATO, C.G. Resíduos de Serviços de Saúde: o conhecimento dos profissionais que atuam no contexto hospitalar. Dissertação de mestrado, 2014. [ Links ]
BECKHAUSER, G.C.; VALGAS, C.; GALATO, D. Perfil do estoque domiciliar de medicamentos em residências com crianças. Revista Ciências Farmacêuticas Básica e Aplicada, v. 33, n. 4, p. 583-589, 2012. [ Links ]
BENTO, D.G.; COSTA, R. Estado da arte acerca dos resíduos de serviço de saúde. Revista Eletrônica Estácio Saúde, v. 4, n. 2, 2015. [ Links ]
BILA, D.M.; DEZOTTI, M. Fármacos no meio ambiente. Química Nova, v. 26, n. 4, p. 523-530, 2003. [ Links ]
BORGES, R.M. et al. Uso de filtros de carvão ativado granular associado a microrganismos para remoção de fármacos no tratamento de água de abastecimento. Revista Engenharia Sanitária e Ambiental, v 21, p.1-13, 2016. [ Links ]
BRASIL. Lei n° 12.305, de 2 de agosto de 2010. Institui a Política Nacional de Resíduos Sólidos; altera a Lei n 9.605, de 12 de fevereiro de 1998; e dá outras providências. Diário Oficial da República Federativa do Brasil, Brasília, 2010. [ Links ]
____ Ministério do Trabalho e Emprego. Classificação Brasileira de Ocupação - CBO. Brasília-DF, 2002. [ Links ]
____ Ministério da Saúde. Agência Nacional de Vigilância Sanitária. Manual de Gerenciamento de resíduos de serviços de saúde. Brasília: Ministério da Saúde, 2006. [ Links ]
____Decreto n° 5.775, de 10 de maio de 2006. Dispõe sobre o fracionamento de medicamentos, dá nova redação aos arts. 2oe 9odo Decreto no74.170, de 10 de junho de 1974, e dá outras providências. Diário Oficial da República Federativa do Brasil. Brasília, 2006. [ Links ]
____Lei Distrital nº 4.352, de 30 de Junho de2009. Dispõe sobre o tratamento e a disposição final dos resíduos dos serviços de saúde. Distrito Federal, 2009. [ Links ]
____Resolução n° 306, de 07 de dezembro de 2004. Dispõe sobre o Regulamento Técnico para o gerenciamento de resíduos de serviços de saúde. Agência Nacional de Vigilância Sanitária. Diário Oficial da República Federativa do Brasil, Brasília, 2004. [ Links ]
____Resolução n° 358, de 29 de abril de 2005. Dispõe sobre a destinação final dos resíduos de serviços de saúde e dá outras providências. Conselho Nacional do Meio Ambiente. Diário Oficial da República Federativa do Brasil, Brasília, 2005. [ Links ]
____Lei Distrital n° 5.092, 04 de maio de 2013. Dispõe sobre a obrigatoriedade de farmácias e drogarias receberem medicamentos com prazo de validade vencido para descarte. Distrito Federal, 2013. [ Links ]
BUENO, C.S.; WEBER, D.; OLIVEIRA, K.R. Farmácia caseira e descarte de medicamentos no bairro Luiz Fogliatto do município de Ijuí - RS. Revista Ciências Farmacêutica Básica Aplicada, v. 30, n. 2, p. 203-210, 2009. [ Links ]
CARVALHO, E.V.; FERREIRA, E.M.L.; SANTOS, C. Aspectos legais e Toxicológicos do descarte de medicamentos. Revista Brasileira Toxicologia, n. 22, p. 1-8, 2009. [ Links ]
CASTRO, H.C. et al. Automedicação: entendemos o risco? Infarma, v.18, n. 9-10, 2006. [ Links ]
CFF. Conselho Federal de Farmácia. Logística Reversa: Brasil busca solução para descarte inadequado de medicamentos. Farmácia Brasileira. n. 87. 2013. [ Links ]
CFF. Conselho Federal de Farmácia. Farmácias de elite. Disponível em: <http://www.cff.org.br/noticia.php?id=3879.> Acesso em: 20 de jul. 2017. [ Links ]
CHAVES, G.L.D. et al. Descarte de medicamentos vencidos e em desuso: um levantamento do comportamento dos consumidores em São Mateus/ES. Revista eletrônica em gestão, educação e tecnologia ambiental, v. 2, p.1083-1096, 2015. [ Links ]
DAGNINI, R.S.; JOHANSEN, I.C. Os catadores no Brasil: características demográficas e socioeconômicas dos coletores de material reciclável, classificadores de resíduos e varredores a partir do censo demográfico de 2010. Economia solidária e políticas públicas. Mercado de trabalho, v 62, 2017. [ Links ]
DAUGHTON, C.G. Cradle-to-cradle stewardship of drugs for minimizing their environmental disposition while promoting human health. I. Rationale for and Avenues toward a Green Pharmacy. Environ Health Perspect. v.111, p.757-774, 2003. [ Links ]
EICKHOFF, P.; HEINECK, I.; SEIXAS, L.J. Gerenciamento e destinação final de medicamentos: uma discussão sobre o problema. Revista Brasileira Farmácia, v.90, n.1, p.64-68, 2009. [ Links ]
FALQUETO, E.; KLIGERMAN, D.C.; ASSUMPÇÃO, R.F. Como realizar o correto descarte de resíduos de medicamentos? Ciência & Saúde Coletiva, v. 15, n. Supl. 2, p. 3283-3293, 2010. [ Links ]
FERNANDES. L.C, PETROVICK, P.R. Os medicamentos na farmácia caseira. In: SCHENKEL EP. Cuidados com os medicamentos. 4. ed. Porto Alegre- UFRGS, p. 39-42, 2004. [ Links ]
GASPARINI, J.C.; GASPARINI, A.R.; FRIGIERI, M.C. Estudo do descarte de medicamentos e consciência ambiental no município de Catanduva-SP. Revista Ciências e Tecnologias, v. 2, n. 1, p. 38-51, 2011. [ Links ]
GHISELLI, G.; JARDIM, W.F. Interferentes endócrinos no ambiente. Química Nova, v.30, n.3, 2007. [ Links ]
IBGE. Instituto Brasileiro de Geografia e Estatística. Síntese de Indicadores 2008. Disponível em:< https://ww2.ibge.gov.br/home/estatistica/populacao/trabalhoerendimento/pnad2008/>. Acesso em: 20 Jul. 2017. [ Links ]
JACOBI, P.R. Educação Ambiental: o desafio da construção de um pensamento crítico, complexo e reflexivo. Educação e Pesquisa, São Paulo, v. 31, n. 2, p. 233-250, 2005. [ Links ]
MAIA, M.; GIORDANO, F. Estudo da situação atual de conscientização da população de Santos a respeito do descarte de medicamentos. Revista Ceciliana. v. 4, p. 24-28, 2012. [ Links ]
OLIVEIRA, W.L. Descarte correto de medicamentos: uma responsabilidade dos farmacêuticos que atuam na atenção primária. Experiências exitosas de farmacêuticos no SUS. Conselho Federal de Farmácia, n° 4, p. 16-24, 2016. [ Links ]
OMS. Organização Mundial de Saúde. The role of Pharmacist in self care-medication. Disponível em: <http://apps.who.int/medicinedocs/pdf/whozip32e/whozip32e.pdf>. Acesso em: 10 nov. 2016. [ Links ]
PDOT. Plano de Ordenamento Territorial do Distrito Federal. Secretaria de Estado de Gestão do Território e Habitação. Disponível em: <http://www.segeth.df.gov.br/images/pdot/doc_tecnicos/documento_tecnico_pdot_adin_plc172011.pdf>. Acesso em 11 de nov. 2016. [ Links ]
PINTO, G. M. F. et al. Estudo do descarte residencial de medicamentos vencidos na região de Paulínia (SP), Brasil. Revista Engenharia Sanitária e Ambiental, v.19, n.3, p. 219-224, 2014. [ Links ]
MEDEIROS, M. S. G.; MOREIRA, L. M. F.; LOPES C. C. G. O. Descarte de medicamentos: programas de recolhimento e novos desafios. Revista de Ciências Farmacêuticas Básica e Aplicada, v. 35, n. 4, 2014. [ Links ]
RAMOS, H.M.P. O impacto do descarte inadequado dos resíduos de saúde aos catadores de materiais recicláveis de Ceilândia-DF. Trabalho de conclusão de curso - Universidade de Brasília. UnB, 2015a. [ Links ]
RAMOS, H.M.P. et al. Educação ambiental em uma cooperativa de catadores de resíduos sólidos - Ceilândia-DF. In: 7° Encontro Nacional da Associação Nacional de Pós-Graduação e Pesquisa em Ambiente e Sociedade. Brasília. 2015b. [ Links ]
RIBEIRO, M. A.; HEINECK, I. Estoque domiciliar de medicamentos na comunidade ibiaense acompanhada pelo Programa Saúde da Família, em Ibiá-MG, Brasil. Revista Saúde e Sociedade, v.19 n.3, 2010. [ Links ]
ROCHA, B.S. et al. Caracterização dos medicamentos descartados por usuários da farmácia popular do Brasil/farmácia escola da Universidade Federal do Rio Grande do Sul (UFRGS). In: 9° Salão de Extensão da Universidade Federal do Rio Grande do Sul. Porto Alegre, 2009. [ Links ]
SCHENKEL, E. P. Cuidados com os medicamentos. Porto Alegre: Editora da Universidade Federal do Rio Grande do Sul, 1996. [ Links ]
SCHENKEL, E.P.; FERNANDES, L.C.; MENGUE, S.S. Como são armazenados medicamentos nos domicílios. Acta farmacêutica Bonaerense, v.24, n.2, p.266-270, 2005. [ Links ]
SINITOX. Sistema Nacional de Informações Tóxico Farmacológicas. Disponível em: < https://sinitoxdados.icict.fiocruz.br/> Acesso em: 20 de jul. 2017. [ Links ]
SOUZA, C.D.F.A.; FALQUETO, E. Descarte de Medicamentos no Meio Ambiente no Brasil. Revista Brasileira Farmácia, v. 96 n.2, p.1142-1158, 2015. [ Links ]
TAVARES, N.U.L. et al. Uso de medicamentos para tratamento de doenças crônicas não transmissíveis no Brasil: resultados da Pesquisa Nacional de Saúde, 2013. Epidemiologia e Serviços de Saúde, Brasília, v.24, n.2, p. 315-323, 2015. [ Links ]
TORRES, A.C.G. Pertinência da normativa estadual e distrital sobre logística reversa aplicada ao setor de medicamentos no Brasil. Caderno Ibero Americano de Direito Sanitário. Brasília, v.5, p. 41-59, 2016. [ Links ]
UEDA, J, et al. Impacto ambiental do descarte de fármacos e estudo da conscientização da população a respeito do problema. Revista Ciências do ambiente, v.5, n.1, p. 1-6, 2009. [ Links ]
VAZ, K.V.; FREITAS, M.M.; CIRQUEIRA, J.Z. Investigação sobre a forma de descarte de medicamentos vencidos. Cenarium Pharmacêutico, v.4, n.4, 2011. [ Links ]
VILARINO, J.F. et al. Perfil da automedicação em município do Sul do Brasil. Revista Saúde Pública, v. 32 n.1, p 43-49. 1998. [ Links ]
ZAPARROLI, I.D.; CAMARA, M.R.G.; BECK, C. Medidas mitigadoras para a indústria de fármacos Comarca de Londrina-PR. Brasil: impacto ambiental do despejo de resíduos em corpos hídricos. In: 3°International Workshop Advanced in Cleaner Production. Cleaner Production Initiatives and Challenges for a Sustainable World. São Paulo, 2011. [ Links ]
i(www.openepi.com).
iihttp://www.abep.org/criterio-brasil
Received: December 23, 2016; Accepted: December 01, 2017
This is an open-access article distributed under the terms of the Creative Commons Attribution License
Anppas / Revista Ambiente e Sociedade
revistaambienteesociedade@gmail.com


 The Gibbering Horror of Howard Ghormley a Top 3 three live short film movie.
Steeped in an atmosphere of paranoia and foreboding, but no more frightening than an episode of The Twilight Zone, from which it seems to borrow.
Unique camera positions, added film grain and washed out exposure add to the aforementioned atmosphere. The montage editing of the perpetually turning bicycle gears mirror both the circular events at the house and the repetition of thought, or perhaps recurring nightmares.
Notes passed under a door create an intriguing perplexity and later alarm when the recipient of the notes is revealed. What's not revealed is if the events are a dream, a state of mind, or some bizarre reality.


Hello to everyone. I hope that all is well with everyone. We really enjoyed the Steel City Con. The guests were amazing and the attendees were so amazing. It is always fun to interact with the people at the Steel City Con. Our upcoming shows include the Wayne Toy Show on September 2 and of course the Mid Atlantic Nostalgia Convention in Hunt Valley Maryland on Thursday September 13 to Saturday September 15. I am looking forward to attending the MANC as we believe it is our best show of the year.
Hello everyone and welcome back to the pdclassicdvds.com blog. I would like to invite all of my customers to our next few shows. We are not doing any shows in July but August 5 we will once again be at the Wayne Toy and Collectibles show at the Firehouse. Then on Friday August 10-Sunday August 12 we will be at the Steel City Con in Monroeville - just outside of Pittsburgh. September 2 we will be at the Wayne show at the Firehouse again and then Thursday September 13-Saturday 15 we will be at the Mid-Atlantic Nostalgia Convention in Hunt Valley Maryland. October 7 we will be in Wayne again and on Saturday November 3 we will be doing the Pulp Adventurecon in Bordentown NJ. The next day - November 4 we will be at the Firehouse show in Wayne again. When you come to a show you can take advantage of our show special - 3 single disc titles for only $20.00. I hope to see you all at our next show.
We would like to thank all our Long Island customers who came to see us at the Long Island Toy Show at Hofstra University. It was great to see all of you and we would like to thank you for your business. On Sunday August 6th we will be, as usual, at the Wayne Toy and Collectibles Show at the Firehouse. During the weekend of August 11-13 we will once again be at the Steel City Con. It is an excellent show with plenty of great guests. We will also be there of course with plenty of great horror and sci-fi films, vintage TV shows, classic cartoons, cliffhanger serials and comic books on DVD.
We are looking forward to being a dealer once again at the Pulp Adventurecon in Bordentown. We will be there with plenty of comic books on DVD. Of course we will have a collection of classic horror and sci-fi films, vintage TV, favorite old cartoons, and cliffhanger serials. Please visit us. We look forward to seeing you.
It has been a while since out last post but here it is. We are at the MANC in Hunt Valley and having a great time. We are meeting so many great people who love the same type of stuff that we like. We are connecting with old friends and making new ones. If you have never attended this convention you are missing quite a treat. If you live in the area there is still time to come to the show as it is open today (Friday) and tomorrow. Come to our table and if you mention that you saw this blog you will receive 10% off of your order. Have a great day and mayb we will see you at the show. All the best!
It is 6:10 PM on Friday afternoon. Once again having a wonderful time at the MANC. The fans here are so great and knowlegable and a joy to talk to. Martin Grams, once again, has done a fantastic job on this convention. If you have not visited this convention you have to make it your business to come either tomorrow if you are in the area or next year - September 18-20, 2014. I wish everyone a great day. Take care.
Well, just got back from the 3 day Steel City Con. It is always nice to meet people who share a similar interest as myself. The customers that I met at the show were informed, clever and very nice. It seemed like of all the merchandise that was brought to the show - sci-fi films seemed to be the favorite among most of the crowd. Just wanted to make a couple of observations (1) sometimes "stars" can be a little rude. For example Rowdy Roddy Piper made fans wait in line for almost two hours while he hung out in his hotel room.
After all the weather issues the last couple of weeks I am really looking forward to the Pulp Convention in Bordentown. Once again a chance to talk to people who like pulps and other related materials like movie serials, old time radio shows and digital comic books from the Golden and Silver Age. Hope that everyone who wants to attend will be able to because of the gas situation. To all my customers please come and support this show. We have to work to keep shows like this alive so we can all share in our passion for nostalgia and the simpler things in life. In a world that is so complicated and difficult it is a pleasure to go to these shows and talk to fans of the greatest entertainment in the world. Looking forward to seeing everyone there.
Halloween will be here before you know it. For me Halloween has always been a time when I can catch up again with some of my favorite horror movies. You can never go wrong with the classic Universal horror films like Frankenstein, Dracula, the Wolfman, the Invisible Man, the Creature and so many others like the Black Cat, Raven, and Murders at the Rue Morgue. In fact this Wednesday some friends and I are going to see a classic double feature on the big screen Frankenstein and the Bride of Frankenstein at the Paramus Theater. It should be great watching two fantastic films on the big screen. I also try to watch some of my favorites in sci-fi that are also scary like Invasion of the Body Snatchers, Forbidden Planet, The Day the Earth Stood Still and of course The Thing From Another World. All of these classics as well as many more are on our website and available for purchase before Halloween. I wish everyone a safe and fun Halloween and please stay in touch by blog or come to one of our shows. Take care everyone.
Thanks to the wonderful shows in Monroeville near Pittsburgh and the MANC near Baltiimore we were able to acquire new titles for the website. We will be working on putting them up soon. Over the last couple of weeks many new titles were added to our site. Please check out the increased inventory. Going to the toy and nostalgia shows are so much fun. Customers at the shows are so incredibly informed about so many of the different types of topics discussed at these shows.


text:
ABOUT PENNY PRICE LAVIN
Throughout her life, Penny has been dedicated to bringing light, understanding and healing through energy medicine and through the mass media.
ONE LIGHT HEALING TOUCH™ – INSTRUCTOR/ PRACTITIONER
Penny is the Associate Director of One Light Healing Touch and has been a Practitioner since 2000. She became a Certified Instructor in 2006, where she deeply enjoys teaching the Basic Training and helping students open, learn, heal and grow. Penny is a Master Instructor, where she teaches many of the courses in One Light Healing Touch, and Ron Lavin serves as the Guest Lecturer. Penny has studied energy medicine, mental-imagery, mind-body techniques, Shamanic teachings and practices, REIKI and spiritual studies throughout her life, and has presented One Light Healing Touch at numerous NY Centers and given countless print, radio and zoom interviews. Penny was an intuitive and spiritual child, felt strong connections with her past-lives, and spontaneously began practicing color healing when she was 11, where she achieved some very positive results. She has practiced energy medicine since 1985.
"I took the Zoom Basic training with Penny Lavin and found that Zoom was an ideal platform for learning One Light Healing Touch energy healing. Penny is an excellent instructor and she made the program as interactive and fun as a physical classroom can be. I enjoyed the structure, the many practices and the tools I learned in the School. It is a remarkable and life-changing course." – Sonia N. Aug. 2020, Canada.
"I repeated the Zoom Basic Training and it is an authentic, heart-opening and life-changing program! Penny is an outstanding instructor. Her knowledge is comprehensive and she has a high-level of care and empathy for the students." – Ana D. Jan. 2021, London.
"I attended the Basic Training with Penny in LA. She is a master Instructor, and her intention catapults the energy healings, enabling the students to become more proficient healers! I am so grateful for the teachings and experiences that I received during the Training. Penny created a beautiful and nurturing safe space, which allowed me to change and grow in every way. How magnificent! I found my purpose and to be practicing as an energy healer has been the most precious gift!" – Julie C. March, 2018, Los Angeles
"Penny is a skilled healer and wonderful Instructor. She is psychic, wise, and has a charming sense of humor." – Lena M., 2018. Los Angeles
"Penny has profound soul power. I sensed she could feel, see and understand many things about me, even those that I am not yet aware of."- A. J., 2018.
Penny giving an energy healing session.
PENNY PRICE LAVIN'S MEDIA WORK
Throughout her media career Penny has focused her work on producing programming in the fields of body, mind & spirit, human potential, health, energy medicine, the environment, and issues that could help contribute to the greater good.
Penny's latest documentary is her Telly-winning documentary, THE HEALING FIELD: Exploring Energy and Consciousness, which features renowned experts, including Ron Lavin, Bruce Lipton and many more. It was seen PBS and it can be streamed on GAIA.com, in English, German, French and Spanish. (Gaia.com is one of the largest, holistic digital platforms in the world.) Penny's documentary is also available at Beyond Words and Amazon (Via Streaming and as a DVD) (See Products)
Penny directing The Healing Field documentary.
Penny's book based on the documentary is called, THE HEALING FIELD: Exceptional Healing Practices To Change Your Life. It's been awarded ***** US Review of Books, (2021) and Book Excellence Awards, (2021). It is available on Amazon in print and ebook formats. (See Products)
Penny has worked in media as a producer, director, writer for 30+ years where she is known as Penny Price and she is the recipient of MAGGIE, EMMY, CHRIS and TELLY Awards. Some of the national programs where she worked include: The Mike Douglas Show, Good Morning America, NBC Magazine, Geraldo, and Kids Are People Too.
In 1995 Penny launched Penny Price Media, dedicated to producing uplifting and empowering programming. Some of her award-winning programs include: SHINING SOUL – The Life and Legacy of Helen Keller; which won 1st prize at the Houston Film Festival, and SPLENDORS OF THE SPIRIT: Swedenborg's Quest for Insight – US Film & Video Festival, Silver Award – and both were seen on PBS and can be streamed on GAIA.com. Many of her programs received ***Stars by the Video Librarian, including: HEALING EXERCISES FOR BODY, MIND & SPIRIT, and A COURSE IN MIRACLES with Marianne Williamson.
Penny directing the Shining Soul documentary.
"Great work Penny on your documentary and book, THE HEALING FIELD! Your strong positive Yang Q is like the wind in the sails driving you forward in this masterful work, while your calm professionalism is evidence of your enduring nurturing Yin Qi."- Jack Lim, Qigong Grandmaster
"You are a most enlightened producer in this and related fields, and your work is so formative to helping the new paradigm emerge. It was wonderful working with you on the documentary, The Healing Field." – Beverly Rubik, Ph.D., Institute of Frontier Science
"I saw on a daily basis her boundless energy and amazing creativity. Her ability to organize all her knowledge and ideas into one coherent program is legendary." — Steve North, Sr. Producer, Geraldo & CNBC
"My long association with Penny Price is one of my fondest memories: She's among the best and brightest of all the producers I've worked with over the past three decades. She is a rare combination of intelligence, talent, and compassion." — Geraldo Rivera
"Penny is one of best producers in television. She helped me and my guests communicate with maximum effectiveness, and she structured the programs with style and expertise, and she engaged the audience in both heart and mind." — Barbara DeAngelis, Ph.D
"Thank you Penny. Your energy, positive attitude, experience, and professionalism really created a fantastic atmosphere to work in." — Anthony Carillo, yoga instructor, IRON YOGA DVD.
"We watched the documentary SHINING SOUL. Filmmaker Penny Price has created a monumental feat. The whole experience of watching it is truly something from another world, an Everest experience for the soul." — Shining Soul screening attendee

redpajama_set_name: RedPajamaCommonCrawl


"From my perspective, it covered all of the pertinent information & was as"
"Instructor made all topics interesting, never boring. Great refresher. Provided in-depth analysis of complex topics, easy to understand."
"Brought into perspective how utilities are prepairing for the competitive environment."
"Joel was very informative & entertaining. Took very complicated concepts and mixing humor & examples, made them easy to understand."
"There wasn't a lot of jargon. You explained things in plain English and made dry material fun and interesting. Relating information to real companies is a plus."
"Prof. Berk is an energetic speaker. He is able to present the material required and interject with related stories or examples to drive his points home."
"Sheds light on what goes on with our accountants, and what analysis need to be done when making decisions. A complex subject taught simplistically for the layman."
"Found the class basic enough for me to grasp some accounting concepts & challenging enough to maintain my interest & increase knowledge."
"Had a really bad attitude prior to class-didn't want to come, etc. but I can say that I genuinely enjoyed the past 2 days & I feel that what I learned will give me better understanding of company & why we make the decisions we do."
"Very knowledgeable, experienced instructor. Very good reference data in binder. Good pace & rapport development. Outstanding calibre of seminar leader."


text:
Innovation And Investment In 3D Printing Surges
Jonathan Shieber	@jshieber / 6 years
Although the technology hasn't yet lived up to its hype as the harbinger of a new industrial revolution, investments in 3D printing technology have surged in 2014.
Last year, spending on 3D printing and additive manufacturing hit $3.07 billion dollars, according to a report from industry analyst group Wohlers Associates. That number is projected to reach $12.8 billion by 2018, and $21 billion by 2020, according to the group.
Meanwhile 54 companies launched or raised capital with an eye toward tapping this growing market in 2014, according to data from CrunchBase. It's the highest number of investments the sector has seen, and at $72 million of disclosed investments, it's the most amount of venture capital committed to the sector.
Admittedly, these numbers are still small, but the growth of the industry seems assured thanks to innovation coming from new business models, marketplaces and technologies that continue to expand the possibilities for manufacturers of all stripes.
Over the course of the year, companies have emerged with on-demand manufacturing businesses for everything from customized soles, to headphones, and even cars.
Beyond the businesses that are launching to take advantage of 3D printing, entrepreneurs are continuing to innovate with manufacturing techniques and marketplaces for makers to sell their wares.
In fact, a Harvard University professor has launched Voxel8, and raised an undisclosed amount of capital from Braemar Energy Ventures and another secret investor to manufacture the first desktop electronics printer that can print both thermoplastics and conductive ink.
Spun out of research conducted by Professor Jennifer Lewis at Harvard University and the University of Illinois (which both hold an equity stake in the company), Voxel8 is aiming to expand the universe of printed products to include electronics.
Lewis' team at Voxel8 have already printed a functioning quad copter, and 3D circuit boards. The printer can also make near field antennas, USB flash drives, and other objects with embedded electronics, the company said.
Meanwhile, the capital available for 3D printing technologies keeps expanding. In October, Autodesk announced its Spark Investment Fund, a $100 million investment vehicle that will invest in startups developing businesses around 3D printing.
"Numerous industries recognize the value of tapping into entrepreneurs or startups with better ideas and approaches, and 3D printing is no exception," said Samir Hanna, Autodesk's VP of consumer products and 3D printing, at the time.


India's exports to China has reached $12.7 billion during April-December 2018 on account of growth in shipments of marine products, chemicals, plastics, petroleum products, grapes and rice, the commerce ministry said Friday.
It said that the ministry has identified and shared with Indian exporters and other stakeholders, specific items where the US would lose competitiveness in China and where India had an export potential and encouraged the exporters to seize this opportunity.
Several B2B meetings with Chinese buyers were facilitated through the Indian embassy in Beijing, it said in a statement.
"India's exports to China have grown after several years. India is poised to achieve its highest ever exports to China this fiscal. Between April-December 2018, exports were $12.7 billion which is closer to last year's exports of $13.33 billion," it added.
It said the growth in the exports has been driven by marine products, organic chemicals, plastics, petroleum products, grapes and rice.
It also said that while some of India's concerns have been addressed, more efforts are required for greater market penetration in China.
"India is hopeful of soon signing protocols for export of Indian soybean meals, cakes and pomegranates to China in the near future, as these are in advanced stages of discussion," it said.
It added that discussions are on with the Chinese side for early announcement of Chinese import quotas for sugar and rice for 2019 so that Indian exporters are able to plan their exports well in time.
"In light of US duties on Chinese products, similar steps have been taken with regard to Indian exports to the US also," the ministry said.


text:
Contract team
Wildfire team
Back to all blogs
Web 2.0.1.9 – is it time for publishing's 'vinyl moment'?
Fifteen years ago, a new phrase entered the digital lexicon: Web 2.0. At the time it sounded futuristic and progressive, ushering in a series of dimensions that would shape the modern internet. Social media, podcasts, blogging and user generated content emerged from the primordial information soup, which had been little more than a collection of globally accessible but ultimately one-way information portals.
Phrases like Web 2.0 will get you thrown out of a chatroom (if such a thing still exists) in 2019. But if it sounds old hat in the age of cloud computing, crowdfunding, virtual reality and 'artificial intelligence', don't be fooled. We are still living in the same information era.
That's not to say that nothing has changed. How quickly did the excitable fanfare hailing the industrial possibilities of 'big data' evolve to become the war cry of privacy protesters? The social web – touted as the last word in democratisation – is being blamed for generational mental health issues and divisive social patterns. The dismantling of monopolies at the hands of plucky, 'disruptive' start-ups has metamorphosed into an unassailable industrial titan – the FAANGs (Facebook, Amazon, Apple, Netflix and Google).
It's a grim summary.
Predicting the future of technology is a fool's errand. But there is hope. The realisation that people do not change when the technology does should instruct our progress. Is the ability to publish akin to knowing what will interest a reader? No. Can we trust everyone to have an equal understanding of balance when reporting facts? Clearly not. Is publishing about to have its 'vinyl moment' after years of weathering the digital storm? Very possibly.
Paddy Smith, January 2019
Unit 2.4 Paintworks, Arnos Vale
Bristol, BS4 3EH
info@wildfirecomms.co.uk
Mon / Thu 09:00 - 17:30
Copyright 2019 © Wildfire Comms Ltd. All rights reserved. Terms & Conditions


Here's a first. While studios choose different venues to launch movie trailers online, Universal's teaser trailer for Fast Five will make its debut on the Facebook page of the film's star, Vin Diesel. Diesel has developed a following of about 20 million fans, putting him in the top five celebrities who have sites. After Diesel posts the teaser on http://www.facebook.com/VinDiesel, other cast members who have active social media platforms–including Paul Walker and Dwayne Johnson–will post their teaser on their sites. I will probably pull it off Youtube. It will be up within the hour.


Welcome to Canobie Lake Park's Virtual Box Office.
We accept American Express, MasterCard and VISA as forms of payment. In just a few clicks you can purchase tickets online, print them at home and zip right into the Park --- just for fun. See you soon!
2019 Good Any One Day admission. This ticket is good for anyone 48 inches or taller, or under age 60.
2019 Good Any One Day admission. This ticket is good for anyone under 48 inches tall or age 60 plus. Height or age will be verified at the turnstile (seniors, please have your ID ready for the attendant, thank you).
Select the type of parking pass (weekday or weekend) you would like to purchase, once added to your cart you will be prompted to select the date of your visit. Limited spots available.
Standard vehicles only in a standard parking spot. Limos, RVs, trailers, and other oversized vehicles are not eligible for preferred parking and will be directed to a different parking area. Canobie Lake Park assumes no responsibility in the care, custody or control of your vehicle or its contents.
Please print out your ticket, place on dashboard, and follow the BLUE LINE in our parking lot to the DAPPER LOT.


Fast delivery. Good price. Bought for my daughter and I see her sitting on it v often, so should be quite ok. Tho it took me a while to find the cozy position.
Very nice to sit in. But design can be improved as we have to pour out the beads when we need to wash the cover. It's better if the beads are in a separate bag and we can remove the cover when we need to wash.
Bean Bag is quite empty, will be good if there is an option to top up/ refill.
Ordered large size but the item received is smaller than advertised. Beans only half filled. And no extra grey bag as promised. Only a white dust bag. Not recommended.
Hi Seller, Received item my family loves it.
Please note that qxpress do not deliver at specific timing, they deliver by route. thus sending us messages or memo about only deliver at night time will be ignore.
I have received thr product but it didn't come with additional Grey cover as mentioned.
Also to double check, is this how the bean bag is supposed to be? Ordered the largest size assuming it would be bigger and fuller however its just about less than half filled. When sitting on it even with adjustments, due to not being very filled, its quite uncomfortable and easy for one to slip off. To be honest im not really happy about this as not only is there missing items from my ordee but the one bean bag i did recieve is quite disappointing.
Just received a call. Will deal about it.
Hi, i ordered 2 of the extra large bean bags but upon opening the package, theres only one inside. Please send the missing order soon.
Also missing: the stated free grey covers. Included in package is a pink bag (will return if needed) I just require the other bean bag i ordered and the grey covers.


Moe just didn't seem like himself. That was worrying his buddies to the core.
There are oodles of people all around this commonwealth who claim they are the most passionate Kentucky Wildcats sports fans of all.
But there is a small group of guys in Central Kentucky — Chris and Larry, Will and Van Meter, James and Moe — who do far more than talk the Big Blue talk.
When the Kentucky Wildcats compete, these guys are there.
Yet early last spring, when Moe showed up for the Kentucky games at Cliff Hagan Stadium, he didn't have his normal pep.
"He kept trying to come to the games, he'd show up, but you could tell something wasn't right," said Van Meter Alford. "We were really worried about him."
The reason Moe, 62, was not getting his normal enjoyment from Wildcats baseball was a dire one.
Doctors said the lymphoma was all over his body. If the cancer wasn't bad enough, Moe was also suffering from the infectious disease known as histoplasmosis.
He checked into the hospital on April 15. So advanced was the cancer, doctors told Moe's family he was not apt to live past July.
In the meantime, the chemotherapy he was taking to fight the lymphoma often seemed worse than the cancer.
Moe's weight, in excess of 200 pounds before he got sick, dwindled into the 140s.
"At one point, he was on tube feeding and, as a family, we got the impression that the doctors thought it was time to end that. It was really, really, really bad," said Tony Marcus, Moe's son.
"But Dad never stopped fighting and I just felt as long as he was fighting, I was going to fight right along with him."
Eventually, Moe rallied, came off the feeding tube, and started regaining some strength.
Through his time in the Navy, a couple of marriages and the births of a son and daughter, a constant in Moe's life has been his love for UK sports.
Across the decades, he has gathered autographs from Kentucky Wildcats sports figures (among others) on baseballs. His collection is now well over 3,000 signed balls.
In recent years, Moe has been a member of the Committee of 101, the volunteers who serve as ushers at UK sporting events.
"There's no more adamant Kentucky fan in the world," said Tony Marcus.
In his time of need, the guy who has spent so much time supporting UK athletes in non-marquee sports has gotten a payback he never anticipated.
One day in his room in a Lexington Veteran's Administration hospital, Moe looked up and saw a stranger.
Jon Lipsitz is in his first year as Kentucky's women's soccer coach. For that reason, he and Moe had never met.
Yet Lipsitz not only came to visit; he brought along much of his team.
"I was so flattered," said Moe. "All the young ladies were just super nice."
At Craig Skinner's summer volleyball camp, someone told the UK coach about Moe. Skinner didn't recognize the name.
When he was later approached again about Moe by Kalb, Skinner figured if Moe was as big a Kentucky volleyball fan as was being reported, he should pay him a visit.
So on a Sunday, Skinner went to the VA hospital. When he saw Moe's face, "I placed him," the UK coach said. "I've seen him at a ton of games."
As the two talked, Skinner was seized by inspiration.
"He'd been in the hospital for quite a time, but you could still see the passion for UK sports in his eyes," the coach said. "So I asked the nurse, what would we have to do to get him to be able to come to a game?"
Skinner soon had it set up for Moe to get a pass out of the hospital. The coach offered to send a UK van to get him and bring him to Memorial Coliseum.
Instead, on the night of Sept. 8, Tony Marcus picked his dad up and took him to Kentucky's volleyball match against Cincinnati.
Skinner brought Moe down to sit right behind the Kentucky bench.
Now, likely it was a coincidence. But on the night when it had a guy who will flat not quit on life sitting behind its bench, Kentucky dug out from losing the first two games to score a dramatic five-game victory over Cincinnati.
"Maybe his spirit had some effect on the outcome of the match," Skinner said.
Though it wore him out physically, being there definitely had some effect on the spirit of Moe.
"It meant so much to me," Moe said. "It made my day. Heck, it made my month."
On Friday, Moe was scheduled to come home from the hospital. Back in the spring, that's a trip few thought he would be making.
Long-term, a lymphoma that has spread throughout one's body is a stern foe. But Moe plans to fight all the way.
"I've still got a lot of living I want to do," he said.
After all, along with his buddies, Moe still has so many UK games in so many sports left to attend.


Developing great technology ideas, building your MVP and raising capital comes easy for many tech entrepreneurs launching their "next big thing". Unfortunately, as many organizations find out, attackers always seem to have the upper hand against startups with limited resources and no dedicated security staff to protect them. This session will dive into the world of cyber crime with early stage companies as the focus. We'll discuss the various types of adversaries you're likely to face, how they will attack, and what they will steal along with innovative techniques you can immediately use to defend yourself and your startup from an event that can quickly result in an exit of the wrong type.
Nick has nearly two decades of experience building and running security programs and services. At Rapid7 he leads a team that advises customers on how to mitigate and respond to threats using data-driven analysis that empowers more relevant, timely, and impactful decisions. He has presented to audiences all over the world, TEDx Naperville, DEF CON, Black Hat and a keynote at RSA. Prior to Rapid7, he spent 10 years as the Senior Vice President of Trustwave's SpiderLabs. Additional career highlights include leading the Trustwave Incident Response team to deliver more than 500 investigations globally each year, as well as authoring what later became known as the Payment Application Data Security Standard (PA-DSS), which is now the industry gold standard. Outside of the business world, he is the co-creator of the I Am The Cavalry movement and creator of THOTCON, a Chicago-based hacking conference.


text:
package de.sebhn.algorithm.exercise1.helper;

import de.sebhn.algorithm.exercise1.helper.direction.LeftUp;
import de.sebhn.algorithm.exercise1.helper.direction.Right;
import de.sebhn.algorithm.exercise1.helper.direction.RightDown;
import de.sebhn.algorithm.exercise1.helper.direction.RightUp;
import de.sebhn.algorithm.exercise1.helper.direction.Up;

public class GridVisitor {

  public static OutputCounter findPath(Grid grid, GraphMatrix matrix) {
    int startingPoint = grid.getConverter().convert(new Position(0, 0));
    int endPoint =
        grid.getConverter().convert(new Position(grid.getTargetNumber(), grid.getTargetNumber()));
    int size = grid.getSize();
    OutputCounter outputCounter = new OutputCounter(grid);
    matrix.findAllPath(startingPoint, endPoint, new boolean[size * size], outputCounter);
    return outputCounter;
  }

  public static GraphMatrix createPossibleEdges(Grid grid) {
    int gridSize = grid.getSize();
    GraphMatrix matrix = new GraphMatrix(gridSize * gridSize);
    PositionToIntConverter converter = grid.getConverter();
    boolean isGoneRightUp = false, isGoneRightDown = false, isGoneLeftUp = false, isGoneUp = false,
        isGoneRight = false;
    for (int y = 0; y < gridSize; y++) {
      for (int x = 0; x < gridSize; x++) {
        boolean walkedAllDirections = false;
        Position currentPosition = new Position(x, y);
        while (!walkedAllDirections) {
          if (RightUp.isAllowedToWalk(currentPosition,
              RightUp.getNewPosition(currentPosition, grid), grid) && !isGoneRightUp) {
            Position position = RightUp.getNewPosition(currentPosition, grid);
            matrix.addEdge(converter.convert(currentPosition), converter.convert(position));
            isGoneRightUp = true;
          } else if (RightDown.isAllowedToWalk(currentPosition,
              RightDown.getNewPosition(currentPosition, grid), grid) && !isGoneRightDown) {
            Position position = RightDown.getNewPosition(currentPosition, grid);
            matrix.addEdge(converter.convert(currentPosition), converter.convert(position));
            isGoneRightDown = true;
          } else if (LeftUp.isAllowedToWalk(LeftUp.getNewPosition(currentPosition, grid), grid,
              currentPosition) && !isGoneLeftUp) {
            Position position = LeftUp.getNewPosition(currentPosition, grid);
            matrix.addEdge(converter.convert(currentPosition), converter.convert(position));
            isGoneLeftUp = true;
          } else if (Up.isAllowedToWalk(currentPosition, Up.getNewPosition(currentPosition, grid),
              grid) && !isGoneUp) {
            Position position = Up.getNewPosition(currentPosition, grid);
            matrix.addEdge(converter.convert(currentPosition), converter.convert(position));
            isGoneUp = true;
          } else if (Right.isAllowedToWalk(currentPosition,
              Right.getNewPosition(currentPosition, grid), grid) && !isGoneRight) {
            Position position = Right.getNewPosition(currentPosition, grid);
            matrix.addEdge(converter.convert(currentPosition), converter.convert(position));
            isGoneRight = true;
          } else {
            // System.out.println(String.format(
            // "Possible directions on " + currentPosition
            // + " rightup=%s rightdown=%s leftup=%s up=%s right=%s",
            // isGoneRightUp, isGoneRightDown, isGoneLeftUp, isGoneUp, isGoneRight));
            isGoneRightUp = false;
            isGoneRightDown = false;
            isGoneLeftUp = false;
            isGoneUp = false;
            isGoneRight = false;
            walkedAllDirections = true;
          }
        }
      }
    }
    return matrix;
  }
}

redpajama_set_name: RedPajamaGithub