RESUMO Objetivos: analisar a percepção dos profissionais de saúde sobre aleitamento materno exclusivo em unidades de Estratégia Saúde da Família do município de Macaé. Métodos: estudo qualitativo realizado em quatro unidades de Estratégia Saúde da Família no município de Macaé, estado do Rio de Janeiro. Entrevistaram-se 30 profissionais de saúde entre março e maio de 2019. Os conteúdos textuais foram processados no software IRaMuTeQ® pela Classificação Hierárquica Descendente. Resultados: os profissionais utilizam diferentes estratégias para ações de promoção, proteção e apoio ao aleitamento materno nas consultas de pré-natal, mas determinantes sociais e culturais são questões importantes que interferem nesse processo, sendo essencial o envolvimento da família para o sucesso dessa prática. Considerações Finais: os profissionais de saúde, incluindo os enfermeiros, necessitam de treinamento e capacitação para fortalecer o apoio e a rede social da gestante e inserir a família nas diferentes estratégias utilizadas para melhorar a adesão ao aleitamento materno exclusivo.

ABSTRACT Objectives: to analyze the perception of health professionals about exclusive breastfeeding in Family Health Strategy units in the city of Macaé. Methods: qualitative study carried out in four units of the Family Health Strategy in the city of Macaé, Rio de Janeiro. Thirty health professionals were interviewed from March to May 2019. Textual contents were processed in the IRaMuTeQ® software by the Descending Hierarchical Classification. Results: professionals use different strategies for actions to promote, protect and support breastfeeding in prenatal consultations, but social and cultural determinants are important issues that interfere in this process, the involvement of the family being essential for the success of this practice. Final Considerations: health professionals, including nurses, need training and qualification to strengthen the support and social network of pregnant women and insert the family in the different strategies used to improve adherence to exclusive breastfeeding.

RESUMEN Objetivos: analizar la percepción de los profesionales de la salud sobre la lactancia materna exclusiva en las unidades de la Estrategia Salud de la Familia de la ciudad de Macaé. Métodos: estudio cualitativo realizado en cuatro unidades de la Estrategia Salud de la Familia en la ciudad de Macaé, Rio de Janeiro. Treinta profesionales de la salud fueron entrevistados de marzo a mayo de 2019. Los contenidos textuales fueron procesados en el software IRaMuTeQ® por la Clasificación Jerárquica Descendente. Resultados: los profesionales utilizan diferentes estrategias de acciones para promover, proteger y apoyar la lactancia materna en las consultas prenatales, pero los determinantes sociales y culturales son cuestiones importantes que interfieren en este proceso, siendo el involucramiento de la familia fundamental para el éxito de esta práctica. Consideraciones Finales: los profesionales de la salud, incluidos los enfermeros, necesitan capacitación y capacitación para fortalecer el apoyo y la red social de la gestante e insertar a la familia en las diferentes estrategias utilizadas para mejorar la adherencia a la lactancia materna exclusiva.

A doença de Chagas é uma doença parasitária (Trypanosoma cruzi), endêmica em 21 países da América e que as migrações a dispersaram em diferentes continentes. Uma das primeiras manifestações desta doença são as alterações disautonômicas ou disfunção autonômica. A gravidade desse funcionamento inadequado do sistema nervoso autônomo é mensurável, de modo que a evolução e/ou progressão da doença pode ser verificada alterando os estudos clínicos e detectando anticorpos antimuscarínicos. Esses anticorpos estão presentes em 30% dos infectados e aparecem muito cedo, uma vez instalada a parasitose; Além disso, outros estudos, como a dispersão do QT (> 65 mseg) e a variabilidade da freqüência cardíaca (<100 mseg), mostram valores anormais. A utilização de novos paradigmas de atendimento, diagnóstico e tratamentos adequados são essenciais para prevenir o desenvolvimento desta doença cardíaca.

Chagas disease is a parasitic disease (Trypanosoma cruzi), endemic in 21 countries of America and that migrations have dispersed it in different continents. One of the earliest manifestations of this disease is dysautonomic alterations or autonomic dysfunction. The severity of this inadequate functioning of the autonomic nervous system is measurable, so that the evolution and/or progression of the disease can be verified by altering clinical studies and detecting antimuscarinic antibodies. These antibodies are present in 30% of those infected and appear very early once the parasitosis is installed; In addition, other studies, such as QT dispersion (> 65 ms) and heart rate variability (<100 ms) show abnormal values. The use of new paradigms of care, diagnosis and appropriate treatments are essential to prevent the development of this heart disease.

La enfermedad de Chagas es una enfermedad parasitaria (Trypanosoma cruzi), endémica en 21 países de América y que las migraciones la han dispersado en distintos continentes. Una de las manifestaciones más precoces de esta enfermedad son las alteraciones disautonómicas o disfunción autonómica. La severidad de este inadecuado funcionamiento del sistema nervioso autónomo resulta mensurable, de modo que la evolución y/o progresión de la enfermedad puede constatarse mediante la alteración de estudios clínicos y detección de anticuerpos antimuscarínicos. Estos anticuerpos están presentes en un 30% de los infectados y aparecen muy precozmente una vez instalada la parasitosis; además otros estudios, como la dispersión del QT (>65 mseg) y la variabilidad de la frecuencia cardíaca (<100 mseg) presentan valores anormales. La utilización de nuevos paradigmas de atención, diagnóstico y tratamientos adecuados son imprescindibles para prevenir el desarrollo de esta cardiopatía.

ABSTRACT Objectives To identify the closest person to the pregnant woman, who acts as her primary support source, and evaluate the relationship quality through the instrument quality with the persons close to her and their influence on breastfeeding. Method Quantitative, descriptive, and exploratory study with a consecutive non-probabilistic sample of 152 pregnant women, in Health Units in a medium-sized municipality in the western region of Paraná, during the year 2019, to answer the research question “does the quality of the relationship between women in pregnancy and their primary source of support have implications for breastfeeding?. The “Quality of the relationship with the closest people scale - ARI” was used to obtain the data, which classifies the bond using points that can vary from 40 to 128, and the higher, the higher will be the quality of the bond with that person. The data were analyzed using descriptive statistics. Results Women identified the partner/husband (58.6%) and other family members (40.1%) as the most important and active people as their primary support source. The average score was 103.5, indicating that the relationship is healthy and positive aspects predominate. Conclusion The more positive the results, the greater the support received by the pregnant woman and, consequently, the greater the influence for the woman to initiate and maintain exclusive breastfeeding. Implications for the clinical practice The scale used can be applied regularly in primary care for nurses to identify fragile bonds that would influence breastfeeding.

RESUMEN Objetivos Identificar a la persona cercana a la mujer embarazada, que actúa como su principal fuente de apoyo, así como evaluar la calidad de esta relación por medio del instrumento cualidad de la relación con las personas cercanas a ella y su influencia en la lactancia materna. Método Estudio cuantitativo, descriptivo y exploratorio, realizado con una muestra consecutiva no probabilística de 152 gestantes, en Unidades de Salud de un municipio mediano de la región oeste de Paraná, durante el año 2019, para responder a la pregunta de investigación “¿la calidad de la relación de las mujeres en gestación con su fuente de apoyo principal tiene implicaciones para la lactancia materna? La escala “Calidad de la relación con personas cercanas - ARI” se utilizó para obtener los datos, que clasifican el vínculo mediante puntos que pueden variar de 40 a 128, cuanto mayor sea la calidad, mayor el vínculo con esa persona. Los datos se analizaron mediante estadística descriptiva. Resultados Las mujeres identificaron a la pareja / esposo (58.6%) y otros miembros de la familia (40.1%) como las personas más importantes y activas como su principal fuente de apoyo. El puntaje promedio fue de 103.5, lo que indica que la relación es saludable y predominan los aspectos positivos. Conclusión Cuanto más positivos sean los resultados, mayor será el apoyo recibido por la mujer embarazada y, en consecuencia, mayor será la influencia para que la mujer inicie y mantenga la lactancia materna exclusiva. Implicaciones para la práctica clínica La escala utilizada puede aplicarse regularmente en la atención primaria para que las enfermeras identifiquen los vínculos frágiles que influirían en la lactancia materna.

RESUMO Objetivos Identificar a pessoa próxima à gestante, que atua como sua fonte de apoio primária, bem como avaliar a qualidade dessa relação por meio do instrumento qualidade da relação com as pessoas próximas e sua influência no aleitamento materno. Método Estudo quantitativo, descritivo e exploratório realizado com uma amostra não probabilística consecutiva de 152 gestantes, em Unidades de Saúde de município de médio porte na região Oeste do Paraná, durante o ano de 2019, para responder à pergunta de pesquisa “a qualidade da relação da mulher na gestação com a sua fonte de apoio primária tem implicações na amamentação? Utilizou-se, para obtenção dos dados, a escala “Qualidade da relação com as pessoas próximas-ARI”, que classifica o vínculo por meio de pontos que podem variar de 40 a 128, sendo que quanto maior, também maior será a qualidade do vínculo com aquela pessoa. Os dados foram analisados por estatística descritiva. Resultados As mulheres identificaram o companheiro/esposo (58,6%) e outros membros da família (40,1%) como as pessoas mais importantes e atuantes como sua fonte de apoio primária. A média do escore foi de 103,5, apontando que o relacionamento é saudável e predominam aspectos positivos. Conclusão Quanto mais positivos os resultados, maior é o suporte recebido pela gestante e, consequentemente, maior a influência para que a mulher inicie e mantenha o aleitamento materno exclusivo. Implicações para a prática clínica A escala utilizada pode ser aplicada com regularidade na atenção primária para o enfermeiro identificar vínculos frágeis que influenciariam a amamentação.

RESUMO Objetivos Identificar a pessoa próxima à gestante, que atua como sua fonte de apoio primária, bem como avaliar a qualidade dessa relação por meio do instrumento qualidade da relação com as pessoas próximas e sua influência no aleitamento materno. Método Estudo quantitativo, descritivo e exploratório realizado com uma amostra não probabilística consecutiva de 152 gestantes, em Unidades de Saúde de município de médio porte na região Oeste do Paraná, durante o ano de 2019, para responder à pergunta de pesquisa “a qualidade da relação da mulher na gestação com a sua fonte de apoio primária tem implicações na amamentação? Utilizou-se, para obtenção dos dados, a escala “Qualidade da relação com as pessoas próximas-ARI”, que classifica o vínculo por meio de pontos que podem variar de 40 a 128, sendo que quanto maior, também maior será a qualidade do vínculo com aquela pessoa. Os dados foram analisados por estatística descritiva. Resultados As mulheres identificaram o companheiro/esposo (58,6%) e outros membros da família (40,1%) como as pessoas mais importantes e atuantes como sua fonte de apoio primária. A média do escore foi de 103,5, apontando que o relacionamento é saudável e predominam aspectos positivos. Conclusão Quanto mais positivos os resultados, maior é o suporte recebido pela gestante e, consequentemente, maior a influência para que a mulher inicie e mantenha o aleitamento materno exclusivo. Implicações para a prática clínica A escala utilizada pode ser aplicada com regularidade na atenção primária para o enfermeiro identificar vínculos frágeis que influenciariam a amamentação.

ABSTRACT Objectives To identify the closest person to the pregnant woman, who acts as her primary support source, and evaluate the relationship quality through the instrument quality with the persons close to her and their influence on breastfeeding. Method Quantitative, descriptive, and exploratory study with a consecutive non-probabilistic sample of 152 pregnant women, in Health Units in a medium-sized municipality in the western region of Paraná, during the year 2019, to answer the research question “does the quality of the relationship between women in pregnancy and their primary source of support have implications for breastfeeding?. The “Quality of the relationship with the closest people scale - ARI” was used to obtain the data, which classifies the bond using points that can vary from 40 to 128, and the higher, the higher will be the quality of the bond with that person. The data were analyzed using descriptive statistics. Results Women identified the partner/husband (58.6%) and other family members (40.1%) as the most important and active people as their primary support source. The average score was 103.5, indicating that the relationship is healthy and positive aspects predominate. Conclusion The more positive the results, the greater the support received by the pregnant woman and, consequently, the greater the influence for the woman to initiate and maintain exclusive breastfeeding. Implications for the clinical practice The scale used can be applied regularly in primary care for nurses to identify fragile bonds that would influence breastfeeding.

RESUMEN Objetivos Identificar a la persona cercana a la mujer embarazada, que actúa como su principal fuente de apoyo, así como evaluar la calidad de esta relación por medio del instrumento cualidad de la relación con las personas cercanas a ella y su influencia en la lactancia materna. Método Estudio cuantitativo, descriptivo y exploratorio, realizado con una muestra consecutiva no probabilística de 152 gestantes, en Unidades de Salud de un municipio mediano de la región oeste de Paraná, durante el año 2019, para responder a la pregunta de investigación “¿la calidad de la relación de las mujeres en gestación con su fuente de apoyo principal tiene implicaciones para la lactancia materna? La escala “Calidad de la relación con personas cercanas - ARI” se utilizó para obtener los datos, que clasifican el vínculo mediante puntos que pueden variar de 40 a 128, cuanto mayor sea la calidad, mayor el vínculo con esa persona. Los datos se analizaron mediante estadística descriptiva. Resultados Las mujeres identificaron a la pareja / esposo (58.6%) y otros miembros de la familia (40.1%) como las personas más importantes y activas como su principal fuente de apoyo. El puntaje promedio fue de 103.5, lo que indica que la relación es saludable y predominan los aspectos positivos. Conclusión Cuanto más positivos sean los resultados, mayor será el apoyo recibido por la mujer embarazada y, en consecuencia, mayor será la influencia para que la mujer inicie y mantenga la lactancia materna exclusiva. Implicaciones para la práctica clínica La escala utilizada puede aplicarse regularmente en la atención primaria para que las enfermeras identifiquen los vínculos frágiles que influirían en la lactancia materna.

ABSTRACT Introduction: In late 2019, a new coronavirus named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) that causes respiratory-related illness was reported in Wuhan, China. This virus can attack human lung cells causing a disease called coronavirus disease 2019 (COVID-19), which can lead to pneumonia and acute respiratory distress syndrome. Objective: Describe the structural characteristics of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Methods: A review was written from 47 bibliographic references. Articles and information from national and international journals available in the PubMed, Scopus, Medline, SciELO databases were used. The quality, reliability and validity of the selected articles were analyzed to carry out an adequate review. Analysis-synthesis and logical deduction methods were applied. Development: An introduction to the general aspects of the structure of SARS-CoV-2 is provided by stating the characteristics of the structural and non-structural proteins encoded by the viral genome, which provides the basis for understanding viral entry mechanisms to the host cell, and may be useful to stimulate the search for novel insights and possible therapeutic targets to fight the infection. Conclusions: Knowledge of the structure of the SARS-CoV-2 virus and the characteristics of the structural and non-structural proteins provides the basis for understanding the viral mechanisms of infection and the strategies for developing effective therapeutics.

RESUMEN Introducción: A finales de 2019 se informó el brote de un nuevo coronavirus en Wuhan, China, llamado Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) que causa alteraciones en el aparato respiratorio. Este virus puede atacar las células humanas del pulmón causando una enfermedad denominada enfermedad por coronavirus 2019 (COVID-19), que puede producir neumonía y un síndrome de dificultad respiratoria aguda. Objetivo: Describir las características estructurales del virus SARS-CoV-2. Métodos: Se realizó una revisión bibliográfica a partir de 47 referencias. Se utilizaron artículos e información de revistas nacionales e internacionales disponibles en las bases de datos PubMed, Scopus, Medline, SciELO. Para llevar a cabo una revisión adecuada, se analizaron la calidad, fiabilidad y validez de los artículos seleccionados. Se aplicaron métodos de análisis-síntesis y deducción lógica. Desarrollo: Se proporciona una introducción de los aspectos generales de la estructura del SARS-CoV-2. Se enuncian las características de las proteínas estructurales y no estructurales codificadas por el genoma viral, lo que provee la base para comprender los mecanismos virales de entrada a la célula huésped. El artículo resulta de utilidad para estimular la búsqueda de nuevos conocimientos y posibles objetivos terapéuticos para combatir la infección. Conclusiones: El conocimiento sobre la estructura del virus SARS-CoV-2 y las características de las proteínas estructurales y no estructurales que lo forman ampara significativamente las bases para entender los mecanismos virales de la infección y las estrategias para el desarrollo terapéutico efectivo.

Abstract The main objective of this paper is to calculate and evaluate the behavior of coastal morphodynamics in the northern coast of the state of Veracruz over the past 45 years (1973-2017) from regional and local perspectives. This study included three sites suitable for establishing engineering prototypes for the use of wave power and its conversion into electricity micro-generation in the coastal towns Barra de Cazones, Palma Sola, and Villa Rica. To this end, we used geospatial data of aerial photographs, ortho- photos and satellite images for different years (1973, 1986, 1995, 2000, 2011, and 2017) to identify and demarcate the shoreline based on Boak and Turner (2005). Subsequently, this attribute was classified according to its prevailing process (progradation or regression) in the DSAS module (USGS, 2012) to determine the shoreline change rates. Besides, a baseline was set to determine the potential future impacts of installing the engineering prototypes. According to the availability of inputs, the northern zone was approached regionally for the period 2000-2017, while Barra de Ca- zones and Palma Sola covered the years 1995-2017, and Villa Rica encompassed the years 1973-2017. The results in terms of the net shoreline movement (NSM) show an overall regional trend toward the prevalence of progradation in the northern coast. Progradation values reach up to +27 m near river mouths, dune fields, and anthropized areas, with figures higher than +90 m in some localities. Coastal regression shows values as high as -97 m and -27 m in fluvial- marine and wind-marine environments, as well as in highly anthropized areas. Barra de Cazones shows three distinctive sectors. The first shows a net shoreline regression of -16 m at Playa Chaparrales. The second sector, more widespread, comprises approximately 60% of the local coast, with pro- gradation values of up to +26 m. Finally, the third sector, in its northern part around the fluvial-marine bar near the Cazones river mouth, shows a regressive process reaching values between -16 and -27 m. Palma Sola displays an overall trend towards shoreline progradation, reaching its peak value in Palma Sola beach, with +51.59 m over 22 years. The most significant regression is located in the La Loma cliffs, with -28.29 m. Unlike the figures found for the progradation zones, regressive processes correspond to abrasive coasts (La Loma and Miradores), except for the Barra Palma Sola mouth and, with less intensity, the adjacent Playa Andrea. Finally, in Villa Rica, the entire abrasive mound coastline maintains regressive process rates. The greatest regression was recorded in the front cliff of the Villa Rica mound, with -17.03 m. Maximum progradation values of +90.27 m occur to the south of the mound. The southern sector shows greater dynamism, with values from -12 m to +90 m, corresponding to the characteristics of a cumulative coastline. At a regional scale, the statistical result of the endpoint rate (EPR) shows that most data range from -1 to +2 m/ year, dominated by progradation, in the period 2000-2011 In the period 2011-2017, 50% of the data varied from -3 to +1 m/year. At specific sites, the structural-geological context, whether frontal lavic spills (Miradores-La Loma and the Villa Rica mound) or tectonic ascents of coastal blocks (Barra de Cazones), largely determines the morphogenetic development of the coastal relief and its most recent morphodynamics. Its variations according to the end point rate (EPR) indicate that progradation is the dominant process in Palma Sola and Villa Rica, whereas regression is prevalent in Barra de Cazones. In general, the northern coast of Veracruz shows a predominance of progradation processes. Isolated localities show prevalent regressive processes in response to the local physical-geographic conditions, which are in turn determined by the geological-geomorphological context and the presence of human settlements related to tourist- recreational activities.

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ABSTRACT Objective to translate, culturally adapt, and validate the Calidad de la relación con su persona cercana Scale into Brazilian Portuguese. Methods a methodological study, whose steps were: initial translation; translation synthesis; back-translation; pre-final version development by a panel of nine experts; pre-final version content validity, with 14 judges; pre-test with 30 pregnant women; reliability analysis; sending the translated version to the two authors of the original instrument. Results outliers were reviewed and adjusted during translation and adaptation. The scale achieved conceptual and idiomatic equivalence. Content validity index was 0.92 and Cronbach’s Alpha was 0.869. The general score in the application ranged from 59 to 124, with an average of 94.4. Conclusion after translation and adaptation, the scale was entitled Qualidade da Relação com a Pessoa Próxima, achieving semantic and idiomatic equivalence.

RESUMO Objetivo traduzir, adaptar culturalmente e validar a Escala Calidad de la relación con su persona cercana para o português brasileiro. Métodos estudo metodológico, cujas etapas foram: tradução inicial; síntese das traduções; retrotradução; elaboração da versão pré-final, por comitê de nove especialistas; validação do conteúdo da versão pré-final, com 14 juízes; pré-teste, com 30 gestantes; análise da confiabilidade; e envio da versão traduzida para as duas autoras do instrumento original. Resultados os termos discrepantes foram revistos e ajustados durante o processo de tradução e adaptação. A escala alcançou equivalência conceitual e idiomática. O índice de validade de conteúdo foi de 0,92 e o Alfa de Cronbach 0,869. O escore geral na aplicação variou de 59 a 124, com média de 94,4. Conclusão após tradução e adaptação, a escala foi denominada Qualidade da Relação com a Pessoa Próxima, alcançando equivalência semântica e idiomática.

A doença de Chagas é um importante problema de saúde pública nas Américas, amplamente disseminado em todo o mundo, tanto por migrações externas quanto internas, sendo a insuficiência cardíaca uma das complicações mais graves da cardiomiopatia chagásica, com um impacto severo em ambos os casos. individual como em sua família, não apenas com afetação na qualidade de vida, mas com um número significativo de complicações cardiológicas, como arritmias severas e complexas, acidentes vasculares cerebrais e até mesmo a morte súbita. Também é de alto custo em tratamentos médicos, hospitalizações, uso de dispositivos eletrônicos; transplantes, etc. Um grupo de especialistas latino-americanos realizou uma atualização com base em sua experiência, acompanhada de uma importante revisão bibliográfica, a fim de atualizar os diagnósticos clínicos e complementares usuais e de alta complexidade, bem como os tratamentos atualmente disponíveis para essa complicação, e deve adaptar os mesmos para a disponibilidade de centros de saúde.

Chagas disease is a important public health problem throughout America, extended worldwide, both by external and internal migrations, with heart failure being one of the most serious complications of chagasic cardiomyopathy, with severe repercussions on both the individual and his family, not only with involvement in the quality of life, but with a significant number of cardiological complications such as severe and complex arrhythmias, strokes and even sudden death. As well, It is expensive in medical treatments, hospitalizations, use of electronic devices; transplants, etc. A group of Latin American experts have made an update based on their experience accompanied by an important bibliographic review in order to update the usual clinical and complementary diagnoses and of high complexity, as well as the treatments currently available for this complication, and they must be adapted to the availability of health care centers.

La enfermedad de Chagas es un importante problema de salud pública en toda América, extendida a nivel mundial, tanto por las migraciones externas como las internas, siendo la insuficiencia cardíaca una de las complicaciones más graves de la miocardiopatía chagásica, con severa repercusión tanto en el individuo como en su familia, no sólo con afectación en la calidad de vida, sino con un número importante de complicaciones cardiológicas como las arritmias severas y complejas, los accidentes cerebrovasculares y aun la muerte súbita. También es de alto costo en tratamientos médicos, internaciones, utilización de dispositivos electrónicos; trasplantes, etc. Un grupo de expertos latinoamericanos han realizado una actualización basada en la experiencia del mismo acompañado de una importante revisión bibliográfica con la finalidad de actualizar los diagnósticos clínicos y complementarios habituales y de alta complejidad, así como los tratamientos disponibles actualmente para esta complicación, debiéndose adecuar los mismos a la disponibilidad de los centros de atención sanitaria.

Abstract: At present the geomorphometric studies of relief and the digital mapping are an essential geomorphological platform for delimitation of natural synthetic units, so indispensable to the territorial organization, and others applied researches as the optimization of agricultural land use, microlocalization of settlement human, designation of forest programs and even for military strategic plans, among many social and productive utilities. Thus, this article aims to provide detailed information on analytical geomorphological methods and interpretations of morphography and energy for Mexico’s relief, considering two calculations according to unit area: density contour (km/km2) and maximum difference of heights (m/km2) - both relief índices -, with the support of GIS ArcView, ArcGIS, and ArcInfo software. A review of existing national atlases revealed that not all countries have morphometric data on their reliefs. Indeed, mapping of this type was only found, in chronological order, in the National Atlas of Cuba (1970), the Atlas of the Slovak Socialist Republic (Slovak Cartography (1983), the National Atlas of Hungary (Geographic Research Institute of the Hungarian Academy of Sciences (1989), the New National Atlas of Cuba (1989), and the National Atlas of Mexico (1990), all on a small scale. In other national atlases, there are only hypsometric and slope steepness maps. The stages for mapping the geomorphometric units of Mexico’s relief were: (1) Construction of the morphographic map: a) Calculation of density contours, b) Data analysis and reclassification, c) Spatial generalization by minimum mappable area, and d) Smoothing of geographic limits; (2) Obtaining a relief's energy map: a) Construction of the Digital Elevation Model (DEM), b) Calculations for the relief's energy map, c) Data reclassification, and d) Spatial generalization; (3) Production of a map of the relief’s geomorphometric units: a) Overlaying of the morphographic and relief's energy maps, b) Spatial statistics, and c) Map of geomorphometric relief units: and 4) Definition, according to morphographic contour, of the two predominant classes of the relief's energy. The morphographic map (density of contours in km/km2) shows nine range classes: less than 1.0, from 1.0 to 2.0, from 2.1 to 3, from 3.1 to 4, from 4.1 to 5, from 5.1 to 6, from 6.1 to 7, from 7.1 to 8.0, and more than 8.0. On the other hand, the map of the relief's energy has 9 ranges (m/km2): less than 10.0, from 10.1 to 20.0, from 20.1 to 50.0, from 50.1 to 100.0, from 100.1 to 200.0, from 200.1 to 300.0, from 300.1 to 400.0, from 400.1 to 500.0, and over 500.0. An analysis of this country’s territory reveals that very highly dissected mountainous relief, with dissection values ranging from 501 to 1 300 m/km2, evidences a monolithic location pattern associated with major breakups due to erosion in the central portion of the Sierra Madre Occidental and, in a more isolated way, in its southern portion; in the central sector of the Sierra Madre del Sur in the State of Guerrero; in the sierras of Miahuatlán and Juárez, in the State of Oaxaca; and in very scattered sectors of the southwestern part of the Sierra Madre de Chiapas and the Sierra Madre Oriental. These orogenic regions have land areas characterized by greater ascending widths and intensities in terms of neotectonic movements responsible for the formation of Mexico’s modern relief. In contrast, morphometric units belonging to the vertical dissection category from 21 to 50 m/km2 exhibit moderately dissected, hilly relief typical of high and mid plains formed by a weaker neotectonic process. Lastly, morphometric units with dissection values between 0 and 20 m/km2 stretch along the plains of the coastal states on the Gulf of Mexico, including karstified plains in the Yucatán Peninsula. Units in this category also stretch along the coastal plains of the Baja California Peninsula, the states of Sonora and Sinaloa, and the Pacific Coast in the State of Chiapas. They can also be found in isolated patches on the coastal plains of the Sierra Madre del Sur, on the plains of the Central Mexican Plateau, and along depressed areas of the Trans-Mexican Neovolcanic Belt, where they occupy countless graben depressions, as well as among volcanic edifices throughout the region. The present methodology for determining geomorphometric unities in Mexico’s relief at a scale of 1:250 000, supported by a GIS platform, using density contours as the morphographic parameter for the country’s relief, provided rather precise results consistent with the relief’s mathematical-statistical and geomorphological realities. The cartographic expression at a 1:250 000 scale included 122 map sheets of Mexico representing several different levels of data, as morphographical, morphometric (relief's energy) and topographic, all of great significance for the preparation of other issues geomorphological mapping.

Resumen: En la actualidad los estudios geomorfométricos del relieve y su representación cartográfica digital constituyen una plataforma geomorfológica esencial para la delimitación de unidades sintéticas naturales, indispensables para la organización territorial y para las investigaciones aplicadas a la optimización del uso agrícola de suelo, la microlocalización de asentamientos humanos, la designación de programas forestales e, inclusive, para los planes estratégicos militares, entre muchas utilidades socioproductivas. En este sentido, el presente trabajo persigue precisar los métodos y las interpretaciones geomorfológicas sobre la morfografía y la energía del relieve mexicano, considerando para ello dos cálculos por unidad de área: densidad de curvas de nivel (km/km2) como base morfográfica, y diferencia máxima de alturas (m/km2) como base morfométrica, con apoyo en los software SIG ArcView, ArcGis y ArcInfo. Las etapas del levantamiento cartográfico de las unidades geomorfométricas del relieve mexicano fueron: 1) construcción del mapa morfográfico: a) cálculo de la densidad de curvas de nivel, b) análisis y reclasificación de datos, c) generalización espacial por área mínima cartografiable y d) suavizado de límites geográficos; 2) elaboración de la energía del relieve: a) construcción del MDE, b) cálculo de la energía del relieve y c) reclasificación de datos, y 3) obtención del mapa de las unidades geomorfométricas del relieve: a) superposición de los mapas morfográfico y de energía del relieve, b) estadística espacial y c) asignación por contorno morfográfico de las dos clases de energía del relieve predominantes. Finalmente, la metodología arrojó resultados bastante precisos y coherentes entre las realidades matemático-estadística y geomorfológica del relieve.

Abstract: Due to their geological nature, beaches are susceptible to changes over a relatively short period of time. Composed mainly of recently formed rocks, the scarcely consolidated structure of the substrate makes beaches vulnerable to the action of waves, tides, currents, wind, changes in sea level and human activity. Beach dynamics is marked by different degrees of fragility. In tropical regions, especially in the Caribbean, extreme hydro-meteorological phenomena such as hurricanes and cold fronts associated with extra-tropical storms significantly accelerate the erosion and accretion processes along the coast. The geographical location of the Cuban archipelago, at the margins of the Tropic of Cancer (its northernmost latitude is 27°17’ N), makes it susceptible to the combined action of hurricanes (between June and November) and cold fronts (between November and March). This very fact makes the study of coastal morphodynamic changes a subject of the utmost importance in sustainable-development projects and environmental planning, including the preservation of coastal natural resources. In Cuba, several authors have reported a coastal retreat of 1 to 3 m per year in western beaches, as well as an average loss of sand of about 50 000 m3 per year in the famous Varadero beach. The latter case is mainly due to the extraction of sand from the underwater platform between 1968 and 1978 for construction purposes. This paper addresses the morphodynamic processes taking place at Bailén beach, on the southwestern Cuban coast, as observed during a 10-year period, from 2003 to 2013. Transversal topographic measurements were taken at the beachfront and coastline at 15 observation stations along 2 140 m of beach in 2007, 2010 and 2013. These measurements were then compared to the data available for 2003. Estimated volumes of accreted and eroded sand for the period 2003-2007 indicate remarkable changes in beach morphology and evidence the vulnerability of coastal systems to extreme events, such as those unleashed by hurricane Ivan in 2004. The most important morphological changes observed included an increase of 0.20 to 0.50 m in dune height in some cases, and a decrease in others in the order of 0.15 to 0.40 m. Finally, granulometric tests were conducted to establish the spatial and temporal variations in the diameter of sand grains. To the north side of the beach, the maximum recession rate was 2.0 m per year, and sand grains were larger. Both measurements are indicative of the impact of buildings constructed at the front side of dunes and the beach berm on beach morphology. In the southern sector, on the other hand, the maximum accretion reached 8.0 m per year, whereas the average value was 2.3 m per year. During the 10 years of analysis, beach recovery has been characterized by a low resilience to the impact of hurricanes and other meteorological events. There is a clear spatial correlation between the inadequate location of buildings less than 30 meters from the shore on dunes and berms, where beach dynamics is most intense, and the development of intensive erosive processes, as observed in the northern sector of Bailén beach. The slow recovery of the initial coastline position translates into a steady increase in the average diameter of sediments. The low level of resilience in these beach stretches becomes even more evident when hydro-meteorological events occur. For beach recovery projects through local sand repositioning to be successful, the beachfront must be closely monitored, recording measurements of both sediment dynamics and the effects of wind and water on a transversal profile. Also, to ensure an effective regeneration of this natural resource, an average volume of sand per linear meter of beach must be established. Finally, the demolition of old buildings located at the berm and the front side of dunes, and the prohibition of further construction in these sites, should contribute to restore the morphodynamic balance of this beach and increase the quality of tourism services.

Resumen: En la actualidad, el análisis de los cambios morfodinámicos de las costas constituye una de las direcciones ambientales e ingenieriles de mayor significado para su planeación y su desarrollo sostenible, así como para la preservación y la protección de sus recursos naturales. Se presentan las tendencias morfodinámicas de la playa Bailén, localizada en la costa suroccidental de Cuba, entre los años 2003 y 2013. Se aplicaron mediciones topográficas del perfil transversal de playa y de la posición de la línea de costa en 15 estaciones de observación, a lo largo de 2 140 m de playa, en los años 2007, 2010 y 2013, comparadas con la posición del año 2003. Los volúmenes de arena acrecionada o erosionada en el período 2003-2007 fueron estimados después de los impactos del huracán Iván del año 2004. Finalmente, se realizaron ensayos granulométricos para establecer las tendencias espacio-temporales en el comportamiento del diámetro promedio de los granos de arena. Para el sector norte de la playa, la tasa máxima de retroceso fue de -2.0 m/año y los análisis granulométricos de las arenas demostraron enriquecimiento en su fracción gruesa. Ambos procesos reflejan la influencia directa de la inadecuada ubicación de las construcciones civiles en la porción frontal de las dunas y en la berma. Por otra parte, en el sector sur el valor máximo de acreción fue de +8.0 m/año y el promedio alcanzó +2.3 m/año. Durante los diez años analizados se observa un bajo nivel de resiliencia en la recuperación de la playa.

The research focuses on revealing the main morphotectonic expressions of relief, as a contribution to the study of moderate seismicity of territory. Morphostructural analysis combined with results of analysis of structures, to mesoscopic scale, provide elements of the preferred direction of the tectonic forces that determined the contemporary relief. A total of 44 outcrops were described and 686 structural elements measured (extension fracture, shear and hybrid fracture, axes and axial planes of folds). Morphotectonics interpretations and geomorphological indexes allowed to reveal morphostructural block differentiation, transverse to Pinar transcurrent fault, with potential seismogenic character and also conclude on the main and subordinate directions of tectonic efforts which generated the substrate's mesostructures and the relief 's morphostructures, significant parameters in characterizing regional seismotectonics. Special attention deserves the "back pressure" generated on the Pinar fault trace, located to north of La Conchita, which present a differentiation in stepped microblocks and displaced horizontally, indicating a remarkable deformation with characteristics seismic hazard for San Cristóbal and Candelaria towns.

La investigación se enfoca en revelar las principales expresiones morfotectónicas del relieve, como contribución al estudio de la sismicidad moderada del territorio. El análisis morfoestructural se combina con resultados del análisis de estructuras a escala mesoscópica, para aportar elementos sobre la dirección preferencial de los esfuerzos tectónicos que determinaron el relieve contemporáneo. En total se describieron 44 afloramientos y se midieron 686 elementos estructurales (fracturas de extensión, de cizalla e híbridas, ejes y planos axiales de pliegues). Las interpretaciones morfotectónicas y de índices geomorfológicos permitieron revelar la diferenciación morfoestructural en bloques, transversales a la falla sinestral Pinar, de potencial carácter sismogénico y, además, concluir sobre las direcciones principales y subordinadas de los esfuerzos tectónicos que generaron las mesoestructuras del substrato y las morfoestructuras del relieve, parámetros significativos en la caracterización sismotectónica regional. Atención especial merece el "lomo de presión" generado sobre la traza de la falla Pinar, al norte de la localidad La Conchita, el que presenta una diferenciación en microbloques escalonados y desplazados horizontalmente, indicando una notable deformación, cuya geodinámica sugiere una amenaza sísmica para los pueblos de San Cristóbal y Candelaria.

This paper describes the process of English-Spanish translation and adaptation of the "Woman Abuse Screen" for use in research. The original screen was initially translated into Spanish by two bilingual translators-interpreters, followed by a content review conducted by experts to ensure that the screen included relevant aspects of the conceptualization of violence. The Spanish translation "Cuestionario de Abuso en contra de la Mujer" (CACM) was tested with 217 pregnant women initiating prenatal care in outpatient clinics in Monterrey, Mexico. Exploratory factor analysis with Varimax rotation grouped the nine items on three factors (sexual, physical and psychological violence) with an explained variance of 79.87%. A reliability coefficient of 0.86 was obtained (Cronbach Alpha). It is concluded that CACM is easy to answer and provides information on previous and present violence experienced by the women. CACM may be utilized in practice and research for screening of interpersonal violence.

Este artículo describe el proceso de traducción y adaptación del inglés-español del instrumento "Woman Abuse Screen" para uso en investigación. El cuestionario original fue traducido al español por dos traductores e intérpretes bilingües, y posteriormente se condujo una revisión de contenido por expertos asegurándose que incluía elementos relevantes del concepto "violencia". El instrumento traducido "Cuestionario de Abuso en contra de la Mujer" (CACM) fue puesto a prueba con 217 mujeres que iniciaron su control prenatal en clínicas en Monterrey, México. El análisis factorial exploratorio con rotación Varimax agrupó nueve reactivos en tres factores (violencia sexual, física y psicológica) con varianza explicada de 79.87%. El coeficiente de confiabilidad obtenido fue 0.86 (Alfa de Cronbach). Se concluye que CACM es un instrumento fácil de contestar y que entrega información sobre el tipo de violencia que está siendo víctima la mujer en el presente o el pasado. CACM puede ser utilizado en investigación y/o práctica clínica.

A principal questão que envolve o diagnóstico audiológico infantil é a determinação de procedimentos que configurem resultados confiáveis e objetivos, que possam ser utilizados na predição dos limiares auditivos por frequência específica. OBJETIVO: Correlacionar os achados do potencial evocado auditivo de estado estável (PEAEE) com outros exames em crianças com perda auditiva neurossensorial. MATERIAL E MÉTODO: Estudo prospectivo de coorte contemporânea com corte transversal. 23 crianças de ambos os gêneros e com idades entre 1 e 7 anos realizaram PEAEE, audiometria de reforço visual, potencial evocado auditivo de tronco encefálico (PEATE) clique e tone burst e medida do reflexo acústico para aplicação da regra de predição do limiar auditivo a partir do reflexo acústico. RESULTADOS: A correlação entre o PEAEE e audiometria variou de 0.70 a 0.93, para o PEATE-clique (2k e 4kHz) variou de 0.83 a 0.89, para o tone burst variou de 0.73 a 0.93. A concordância entre o PEAEE e a regra de predição do limiar auditivo foi considerada moderada. CONCLUSÃO: Houve correlação significativa entre o PEAEE e audiometria, assim como para o PEATE clique (2k e 4kHz) e para o PEATE tone burst. O reflexo acústico pode ser usado para acrescentar informações ao diagnóstico infantil.

The main issue regarding pediatric audiology diagnosis is determining procedures to configure reliable results which can be used to predict frequency-specific hearing thresholds. AIM: To investigate the correlation between auditory steady-state response (ASSR) with other tests in children with sensorineural hearing loss. METHODS: Prospective cross-sectional contemporary cohort study. Twenty-three children (ages 1 to 7; mean, 3 years old) were submitted to ASSR, behavioral audiometry, click audiometry brain stem response (ABR), tone burst ABR, and predicting hearing level from the acoustic reflex. RESULTS: the correlation between behavioral thresholds and ASSR was (0.70- 0.93), for the ABR tone burst it was (0.73 -0.93), for the ABR click it was (0.83-0.89) only at 2k and 4 kHz. The match between the ASSR and the hearing threshold prediction rule was considered moderate. CONCLUSION: there was a significant correlation between the ASSR and audiometry, as well as between ABR click (2k and 4 kHz) and for the ABR tone burst. The acoustic reflex can be used to add information to diagnosis in children.

The Chiapas State territory constitutes one of the Mexican regions with more absence of detailed geomorphological studies. The present work approaches the general geomorphological analysis of the relief, at 1:100 000 scale, with the purpose of reveal the morphometric and morphogenetic regularities, and chronological relative of the northwestern extreme of this region. The principles adopted for their morphogenetic classification were: I- Relief's basic categories; II- Altitudinal level of their subcategories; III-Specific morphogenetic type; IV- Relief's relative dating; and V-Forms of the relief. In the formation of the northwestern Chiapas relief the neotectonic uplifts determined the stepped morphostructural pattern, the energy and the disection of the current relief, and the conditioning of the intensity of the modelling exogenous processes on differentiated geologic substratum, that consolidated the extension and sedimentary thickness of the accumulative plains of the middle-lower thirds of the rivers Grijalva, Pichucalco, Ostuacán, Platanar and others. The quaternary and recent volcanic activity of El Chichón determined covering of piroclastic material of tranquiandesitic composition, that modified the pre-existent relief and built extensive mesiform premountains in Nuevo Xochimilco. In general, in this region exist 19 morphogenetic types (7 of mountains and premountains, 3 of hills, 7 of plains and 2 of depressions).

El territorio chiapaneco constituye una de las regiones mexicanas con mayor ausencia de estudios geomorfológicos detallados. Este trabajo aborda el análisis geomorfológico general del relieve, a escala 1:100 000, con la finalidad de revelar las regularidades morfométricas, morfogenéticas y cronológicas relativas del extremo noroccidental de dicha región. Los principios adoptados para su clasificación morfogenética fueron: I-Categorías básicas del relieve; II-Piso altitudinal de sus subcategorías; III-Tipo morfogenético específico; IV-Datación relativa del relieve; y V-Formas del relieve. En la formación del relieve noroccidental chiapaneco los ascensos neotectónicos determinaron el escalonamiento morfoestructural, la energía y el desmembramiento del relieve actual, y el acondicionamiento de la intensidad de los procesos degradativos del modelado exógeno sobre su substrato geológico diferenciado, lo que consolidó la extensión y potencia sedimentaria de las planicies acumulativas de los tercios medio e inferior de los ríos Grijalva, Pichucalco, Ostuacán, Platanar y otros. La actividad volcánica cuaternaria y reciente de El Chichón ha determinado el desarrollo de coberturas de materiales piroclásticos de composición traquiandesítica, que modificaron el relieve pre-existente y edificaron extensas premontañas mesiformes en la zona Nuevo Xochimilco. En general, se presentan 19 tipos morfogenéticos (siete de montañas y premontañas, tres de lomeríos, siete de planicies y dos de depresiones).

Partindo da hipótese de que alterações da função de orelha média possam prejudicar a captação das EOAs, é possível que a ausência destas, em lactentes, esteja associada a discretas alterações timpanométricas. OBJETIVO: Verificar a associação entre resposta de EOAT e alteração imitanciométrica com a sonda de 226Hz em lactentes. MÉTODOS: Estudo de coorte contemporânea com corte transversal. Foram avaliados 20 lactentes com ausência de EOAT (grupo pesquisa) e 101 lactentes com presença de EOAT (grupo comparação), com idades variando entre o nascimento e oito meses. Os lactentes foram submetidos a: timpanometria; pesquisa dos limiares de reflexo acústico contralateral com estímulos de 0,5k, 1k, 2k, 4kHz e ruído de faixa larga; emissões otoacústicas (transiente e por produtos de distorção). O potencial evocado auditivo de tronco encefálico para pesquisa do limiar de resposta foi realizado no grupo pesquisa. RESULTADOS: Observou-se diferença estatisticamente significante entre os grupos (p<0,05), caracterizada pela redução na altura timpanométrica e aumento do limiar de reflexo acústico no grupo pesquisa e a ocorrência de discreto comprometimento de orelha média, no grupo pesquisa, associada às respostas eletrofisiológicas normais. CONCLUSÃO: O uso combinado da timpanometria e do reflexo acústico, em lactentes, acrescenta precisão no diagnóstico de alteração de orelha média.

Considering the hypothesis that middle ear changes can impair the recording of otoacoustic emissions, it is possible that absent otoacoustic emissions in infants could be associated with a light tympanometric change. AIM: To study the association between transient otoacoustic emissions and changes in acoustic immittance measurements with 226Hz probe tone in neonates. METHODS: Cross-sectional contemporary cohort study. 20 infants with no transient otoacoustic emissions (study group) and 101 infants with transient otoacoustic emissions (control group), with ages ranged from birth to eight months, were assessed. Infants were submitted to: admittance tympanometry; contralateral acoustic reflex threshold with stimulus of 0.5, 1, 2, 4 kHz and broad band noise; transient and distortion product otoacoustic emissions. The auditory brain response was used to study the threshold in neonates without transient otoacoustic emissions. RESULTS: Significant statistical differences were observed between the groups (p < 0.005), characterized by reduction in tympanometric configuration and increase acoustic reflex thresholds in the study group. These data suggest the occurrence of middle ear mild impairment in infants without transient otoacoustic emissions associated with normal auditory brain response. CONCLUSION: tympanometry associated with acoustic reflex adds accuracy to the diagnosis of middle ear abnormalities.