Abstract: Introduction: Traditional communities are groups of socially organized individuals with common economic, socio-environmental, and cultural behaviors. Brazil’s indigenous communities are a prime example of these groups, suffering the impact of urbanization, the growth of chronic diseases, epidemics, and increased food insecurity. Experience report: To describe the health team’s experiences in the use of a data management tool for care in an indigenous community in northeastern Brazil. Methodology: This is an experience report on the use of a digital tool to assist actions in a traditional community. The health team was divided into community health agents and medical students. Discussion: The description of the experiences and analysis of the narratives resulted in identifying 258 citations, classified into 12 categories related to the study scope. Of these, issues related to benefits of the tool were the most commonly mentioned (43.41%), where the subgroups addressed different reflections. The second most cited category referred to the tool’s limitations (15.11%), with the need for an internet connection being the critical point. This research, therefore, shows the tool’s advantages in health care but also explains weaknesses inherent to its use, raising important issues of this experience and stimulating similar practices. Conclusion: This experience report, as a scientific method, addresses essential experienced issues related to the practical applicability of a digital tool in an indigenous community. Although it is undeniable that there are obvious points of weakness, these did not compromise the positive result of the experience, and care was improved.

Resumo: Introdução: As comunidades tradicionais são grupos de indivíduos socialmente organizados que partilham comportamentos econômicos, socioambientais e culturais comuns. Entre elas, destacam-se as comunidades indígenas no Brasil, que vêm sofrendo o impacto da urbanização, do crescimento de doenças crônicas e epidemias e do aumento da insegurança alimentar. Relato de experiência: Este estudo teve como objetivo descrever as experiências da equipe de saúde, quanto ao uso de uma ferramenta de gestão de dados na assistência, em uma comunidade indígena no Nordeste brasileiro. Trata-se de um relato de experiência do uso de uma ferramenta digital nas ações assistenciais em uma comunidade tradicional. A equipe de saúde foi dividida em dois grupos: agentes comunitários de saúde e estudantes de Medicina. Discussão: A descrição das experiências e a análise das narrativas resultaram na identificação de 258 citações, que foram classificadas em 12 categorias, relacionadas ao objeto de estudo. Dentre estas, as questões ligadas aos benefícios da ferramenta foram as mais mencionadas (43,41%), em que os subgrupos abordaram diferentes reflexões. A segunda categoria mais citada se referia às limitações da ferramenta (15,11%), sendo a necessidade do sinal de internet o ponto crítico. Ou seja, esta pesquisa mostra vantagens da ferramenta na atenção à saúde, mas também explicita fragilidades inerentes ao seu uso, de modo a trazer questões importantes dessa vivência e estimular práticas semelhantes. Conclusão: Esse relato de experiência, como método científico, traz importantes questões vivenciadas, relacionadas à aplicabilidade prática de uma ferramenta digital em uma comunidade indígena. Apesar de ser inegável que há pontos de fragilidade evidentes, eles não comprometeram o resultado afirmativo da vivência, melhorando a assistência.

Resumo As tomografias de tórax geralmente incluem o abdome superior, o que implica a avaliação das estruturas abdominais superiores. Nosso objetivo é resumir os achados incidentais mais comuns do abdome superior que não requerem imagem ou tratamento adicional em pacientes submetidos a tomografia computadorizada de tórax sem contraste para investigar sintomas ou doenças torácicas. Achados incidentais comuns do fígado, vesícula biliar, baço, glândulas adrenais, rins, retroperitônio e alterações que podem mimetizar lesões nesses órgãos serão revisados. O radiologista torácico deve estar ciente de tais achados e relatar quando nenhuma investigação adicional for necessária, para evitar excesso de exames, especialmente com radiação ionizante, proteger os pacientes de intervenções médicas e de preocupações.

Abstract Chest scans usually include the upper abdomen, leading radiologists to evaluate the upper abdominal structures. The aim of this article is to summarize the most common incidental upper abdominal findings that do not require further imaging or management in patients undergoing unenhanced computed tomography of the chest for the investigation of thoracic symptoms or diseases. We review common incidental findings of the liver, gallbladder, spleen, adrenal glands, kidney, and retroperitoneum, as well as findings that mimic other lesions. Thoracic radiologists should be aware of such typical findings and report when no further investigation is needed, thus avoiding unnecessary imaging examinations, protecting patients from additional medical interventions, and allaying patient concerns.

Resumo Objetivo: Avaliar a concordância interobservador entre radiologistas para os critérios atuais da Fleischner Society para categorias diagnósticas de pneumonia intersticial usual (PIU) em tomografia computadorizada (TC). Materiais e Métodos: Cinco observadores categorizaram independentemente as imagens de TC de 44 pacientes com doença pulmonar intersticial que foram submetidos a biópsia pulmonar empregando as últimas categorias de diagnóstico da Sociedade Fleischner para UIP. Também foram avaliadas presença, extensão e distribuição dos achados de imagem mais relevantes, bem como a confiança no diagnóstico mais provável e em até três hipóteses diagnósticas. Resultados: Houve concordância moderada a alta para as categorias diagnósticas entre os observadores (κ = 0,59-0,61). A concordância interobservador para a pontuação binária foi alta (κ = 0,77-0,79), enquanto para a presença de faveolamento foi considerada de alta a muito alta (κ = 0,81-0,96). Houve concordância em uma das três hipóteses diagnósticas em apenas 36,4% dos casos. Baixa concordância foi encontrada para o diagnóstico mais provável (κ = 0,19-0,21). Conclusão: A concordância entre observadores para os critérios atuais de TC da Fleischner Society para UIP foi moderada a alta entre observadores com diferentes níveis de experiência. Houve baixa concordância nas hipóteses diagnósticas e quanto ao grau de confiança no diagnóstico primário.

Abstract Objective: To assess interobserver agreement among radiologists regarding the current Fleischner Society diagnostic criteria for usual interstitial pneumonia (UIP) patterns on computed tomography (CT). Materials and Methods: Using the Fleischner Society criteria for UIP CT patterns, five raters, working independently, categorized the high-resolution CT (HRCT) scans of 44 patients with interstitial lung disease who underwent lung biopsy. The raters also evaluated the presence, extent, and distribution of the most relevant imaging findings, as well as indicating their level of confidence in the most likely diagnosis and in up to three diagnostic hypotheses. Results: There was moderate to substantial interobserver agreement regarding the UIP patterns on HRCT—kappa statistic (κ) = 0.59-0.61. Interobserver agreement for the binary scores was substantial (κ = 0.77-0.79), whereas that for the presence of honeycombing was almost perfect (κ = 0.81-0.96). There was agreement regarding at least one of the three diagnostic hypotheses in only 36.4% of the cases. For the level of confidence in the most likely diagnosis, there was only slight to fair agreement (κ = 0.19-0.21). Conclusion: Interobserver agreement regarding the current Fleischner Society CT criteria for UIP was moderate to substantial among raters with varying levels of experience. There was only slight to fair agreement regarding the diagnostic hypotheses and for the level of confidence in the most likely diagnosis.

ABSTRACT Background: the competency-based curricular approach favors the active learning of students, which allows them to develop competencies that can be projected beyond the classroom. Objective: to determine the impact of the application of active methodologies in the development of collaborative work skills and conceptual learning in Medicine students. Methods: a longitudinal quasi-experimental design was used with a control group and three experimental groups, it was carried out in 2019. The sample comprised 84 students (cohorts 2018 and 2019) of the Medicine degree. Active methodologies were applied to three experimental groups and the traditional expository class was used in the control group. The Group Interaction Self-Report (AIG) was the instrument used to measure collaborative work and the conceptual map to evidence the development of conceptual learning, with a Cronbach's Alpha of 0.92 and 0.88, respectively. Statistical analysis considered the Friedman Rank Test for more than two related samples. Results: the application of active intervention methodologies favored the development of collaborative work and the level of conceptual learning compared to the control group (expository methodology), which did not achieve statistically significant results (p> .05). Conclusions: active learning in students was favored by active intervention methodologies, which allowed a development of conceptual learning with a greater degree of reflection to the extent that collaborative work was developed, which in turn was strengthened over time.

RESUMEN Fundamento: el enfoque curricular por competencias favorece el aprendizaje activo de los discentes, lo que permite desarrollar competencias que pueden proyectarse más allá del aula. Objetivo: determinar el impacto de la aplicación de metodologías activas en el desarrollo de las competencias de trabajo colaborativo y aprendizaje conceptual en estudiantes de la carrera de Medicina. Métodos: se utilizó un diseño cuasiexperimental de corte longitudinal con un grupo control y tres grupos experimentales, realizado en 2019. La muestra fue 84 alumnos (cohortes 2018 y 2019) de la carrera de Medicina. Se aplicó metodologías activas a tres grupos experimentales y se utilizó la clase expositiva tradicional en el grupo control. El Autoinforme de Interacción Grupal (AIG) fue el instrumento utilizado para medir el trabajo colaborativo y el mapa conceptual para evidenciar el desarrollo del aprendizaje conceptual, con un de Alfa de Cronbach de 0,92 y 0,88, respectivamente. El análisis estadístico consideró la Prueba de Rangos de Friedman para más de dos muestras relacionadas. Resultados: la aplicación de las metodologías activas de intervención favorecieron el desarrollo del trabajo colaborativo y el nivel de aprendizaje conceptual en comparación al grupo control (metodología expositiva), el cual no logró resultados estadísticamente significativos (p> ,05). Conclusiones: el aprendizaje activo en los discentes fue favorecido por metodologías activas de intervención, que permitieron un desarrollo del aprendizaje conceptual con un mayor grado de reflexión en la medida en que se desarrolló el trabajo colaborativo, lo que a su vez se fortaleció en el tiempo.

Abstract: The main objective of this study is to analyze the relationship between member diversity in boards of directors and the adoption of corporate governance practices in 204 Chilean companies during the period 2015-2019. A descriptive-correlational analysis is performed, generating trees of significant correlations and regressions to assess relationships between variables. The results show the existence of significant correlations between the diversity of the boards of directors and the variables that classify shareholders and define risk management. Gender diversity positively and significantly affects the adoption of corporate governance practices. Nationality diversity positively and significantly affects practices related to shareholders and risk management. It is concluded that diversity in both gender and nationality encourages the adoption of good corporate governance practices.

Resumen: El objetivo de este estudio es analizar la relación de la diversidad de los integrantes del directorio con la adopción de prácticas de gobierno corporativo de 204 sociedades chilenas durante el período 2015 -2019. Para ello se realizó un análisis descriptivo - correlacional, generando árboles de correlaciones significativas y regresiones que determinan la relación entre variables. Los resultados muestran la existencia de correlaciones significativas entre la diversidad de los directorios, en relación con las variables que clasifican a los accionistas y las que definen la gestión de riesgos. Se aprecia que la diversidad de género incide positiva y significativamente en la adopción de prácticas de gobierno corporativo. Además, la diversidad de nacionalidad incide positiva y significativamente en las prácticas relacionadas con la dimensión accionistas y también con la gestión de riesgos. Se concluye que la diversidad de género y nacionalidad fomentan la adopción de buenas prácticas de gobierno corporativo.

ABSTRACT Background: Antimicrobial compounds are associated with a wide range of adverse events (AE) and some of them can be potentially preventable. Aim: To characterize AE associated with antimicrobial compounds. Patients and Methods: Retrospective analysis of AEs reported to the National Pharmacological Surveillance System from 2014 to 2017 in a regional hospital. Severity, causality and preventability were analyzed. Results: Sixty events were observed in 56 patients aged 2 months to 96 years. Cases were registered mostly in hospitalized patients. The most frequent AEs were skin disorders (56.7%), followed by hepatobiliary (13.3%), and CNS events (10%). Blood, kidney, respiratory gastrointestinal and immunological disorders were less frequently registered, including cases with anaphylactic shock and Stevens-Johnson syndrome (SJS). Causal analysis indicated a definitive association in 8.3%, probable in 70% and possible in 22%. Skin lesions were mostly associated with beta-lactams, hepatobiliary disorders with antituberculosis drugs and CNS manifestations with carbapenems. Cutaneous, neurological, and hepatobiliary events appeared at a median of 4, 2.5 and 10.5 days after starting the medication, respectively. AEs were managed with withdrawal of the suspected drug (83.3%) and other auxiliary therapies. AEs were categorized as severe in 22% and one case with SJS had a fatal outcome (1.7%). Preventability analysis revealed 25% of potentially avoidable events. Conclusions: Antimicrobial AE involved a wide diversity of compounds, occurred in different hospitalization units, affected patients of a wide age range and attacked different systems or organs. An important fraction was potentially avoidable.

Antecedentes: Los compuestos antimicrobianos están asociados a una amplia gama de eventos adversos (EA) y algunos de ellos pueden ser potencialmente prevenibles. Objetivos: Caracterizar los EA asociados a compuestos antimicrobianos. Pacientes y Métodos: Análisis retrospectivo de EA reportados al Sistema Nacional de Farmacovigilancia desde 2014 la 2017 en un hospital regional. Se incluyó un análisis de gravedad, causalidad y de posible prevención. Resultados: Se observaron 60 eventos en 56 pacientes de 2 meses a 96 años. Los casos se registraron principalmente en pacientes hospitalizados. Los EA más frecuentes fueron los trastornos de la piel (56,7%), seguidos de los hepatobiliares (13,3%) y del sistema nervioso central (10%). Los hematológicos, renales, respiratorios, gastrointestinales e inmunológicos se registraron con menos frecuencia, incluidos casos con shock anafiláctico y síndrome de Stevens-Johnson (SSJ). El análisis de causalidad indicó una asociación definitiva en 8.3%, probable en 70% y posible en 21.7%. Las lesiones cutáneas se asociaron principalmente a betalactámicos, los trastornos hepatobiliares a fármacos antituberculosos y las manifestaciones del SNC a carbapenémicos. Los eventos cutáneos, neurológicos y hepatobiliares se presentaron en una mediana de 4, 2,5 y 10,5 días después de iniciar el medicamento, respectivamente. Los EA se manejaron con el retiro del fármaco sospechoso (83,3%) y otras terapias auxiliares. Los EA se clasificaron como graves (21,7%) y un caso con SSJ tuvo un desenlace fatal (1,7%). Un 25% de los eventos fue potencialmente evitable. Conclusiones: Los resultados de este trabajo revelan que los AE por antimicrobianos involucran una amplia diversidad de compuestos, ocurren en diferentes unidades de hospitalización, afectan a pacientes de un amplio rango de edad y atacan diferentes sistemas u órganos.

ABSTRACT Introduction: competency-based curriculum allows learners to learn in dynamic contexts to develop competencies beyond the classroom. Active methodologies such as Problem-based Learning, Project-based Learning and Case Studies were used to develop critical thinking in future health care professionals. Objective: to determine the impact of the application of active methodologies in the development of competencies such as critical thinking in medical students. Methods: longitudinal quasi-experimental design with one control group and three experimental groups, conducted in 2019. The sample comprised 84 students (cohorts 2018 and 2019) of the Medicine major. Active methodologies were applied to three experimental groups. The Halpern's test allowed measuring critical thinking, with Cronbach's Alpha: 0.724. The statistical analysis considered the Wilcoxon signed ranks test and Friedman's rank test for two or more related samples, respectively. SPSS version 21 was used for the analysis of quantitative data. Results: the application of active intervention methodologies favored the development of critical thinking skills related to verbal reasoning, argument analysis and probability and uncertainty in comparison to the control group (expository methodology) where it was not statistically significant (p> 0,05). Conclusions: active learning in the students was favored by active intervention methodologies, which, in addition to contributing to the development of critical thinking, allowed strengthening it over time.

RESUMEN Introducción: el curriculum por competencias permite a los estudiantes aprender en contextos dinámicos para desarrollar competencias más allá del aula. Se utilizaron metodologías activas como el Aprendizaje Basado en Problemas, Aprendizaje Basado en Proyectos y Estudio de Casos, para el desarrollo del pensamiento crítico en los futuros profesionales de la salud. Objetivo: determinar el impacto de la aplicación de metodologías activas en el desarrollo de competencias como el pensamiento crítico en estudiantes de la carrera de Medicina. Métodos: diseño cuasi-experimental de corte longitudinal con un grupo control y tres grupos experimentales, realizado en 2019. La muestra fue 84 alumnos (cohortes 2018 y 2019) de la carrera de Medicina. Se aplicaron metodologías activas a tres grupos experimentales. El Test de Halpern permitió medir el pensamiento crítico, con Alfa de Cronbach: 0,724. El análisis estadístico consideró la Prueba de los Rangos con signo de Wilcoxon y la Prueba de Rangos de Friedman para dos o más muestras relacionadas, respectivamente. Se utilizó SPSS versión 21 para el análisis de los datos cuantitativos. Resultados: la aplicación de las metodologías activas de intervención favoreció el desarrollo de las habilidades del pensamiento crítico relacionadas con el razonamiento verbal, análisis de argumento y la probabilidad e incertidumbre, en comparación al grupo control (metodología expositiva) donde no fue estadísticamente significativo (p> 0,05). Conclusiones: el aprendizaje activo en los estudiantes fue favorecido por metodologías activas de intervención, las que además de contribuir al desarrollo del pensamiento crítico, permitieron fortalecerlo en el tiempo.

Purpose: The aim of the present study was to investigate the role of occlusion time in dynamic changes of autonomic activation during reactive hyperemia. Methods: Healthy subjects (n = 30) in the age range of 18–25 years participated in this study. Vascular reactivity was assessed by measuring the dynamic changes in finger pulse volume amplitude (PVA) and  pulse transit time relative to the RR intervals in the test (occluded arm) and control arm (contralateral non-occluded arm) during 1, 3 and 5 minute of occlusion using two separate Photoplethysmographic sensors. Heart Rate Variability was computed from a simultaneously acquired ECG signal to monitor the dynamic changes in cardiac autonomic nervous activity. Time-varying analysis of all signals were shown every 1 second in average response graphs. Results: Time-varying analysis of vascular and autonomic response during reactive hyperemia demonstrated the presence of a characteristic response pattern with an increase in the Sympathetic index and a decrease in Parasympathetic index at 8 to 10 seconds, an increase in heart rate at 20 seconds and a progressive increase in PVA during the first 60 seconds after occlusion regardless of the time spent in the procedure. Moreover, a decrease in pulse transits time relative to RR intervals,  followed by an increase regardless of the occlusion time was evidenced.  Conclusions: Early cardiovascular sympathetic activation is independent of occlusion time during reactive hyperemia, which suggests this is a vascular autonomic reflex response involved in the generation of the physiological phenomenon of reactive hyperemia.

Objetivo: El objetivo del presente estudio fue investigar el papel del tiempo de oclusión en los cambios dinámicos de la activación autónoma durante la hiperemia reactiva.Métodos: Participaron en este estudio sujetos sanos (n = 30) en el rango de edad de 18 a 25 años. La reactividad vascular se evaluó midiendo los cambios dinámicos en la amplitud del volumen del pulso del dedo (PVA) y el tiempo de tránsito del pulso en relación con los intervalos RR en la prueba (brazo ocluido) y el brazo de control (brazo contralateral no ocluido) durante 1, 3 y 5 minutos. de oclusión utilizando dos sensores fotopletismográficos separados. La variabilidad de la frecuencia cardíaca se calculó a partir de una señal de ECG adquirida simultáneamente para controlar los cambios dinámicos en la actividad nerviosa autónoma cardíaca. El análisis variable en el tiempo de todas las señales se mostró cada segundo en gráficos de respuesta promedio.Resultados: El análisis variable en el tiempo de la respuesta vascular y autonómica durante la hiperemia reactiva demostró la presencia de un patrón de respuesta característico con un aumento en el índice simpático y una disminución en el índice parasimpático a los 8 a 10 segundos, un aumento en la frecuencia cardíaca a los 20 segundos y un aumento progresivo de PVA durante los primeros 60 segundos después de la oclusión independientemente del tiempo transcurrido en el procedimiento. Además, se evidenció una disminución en el tiempo de tránsitos del pulso en relación con los intervalos RR, seguido de un aumento independientemente del tiempo de oclusión.Conclusiones: La activación simpática cardiovascular temprana es independiente del tiempo de oclusión durante la hiperemia reactiva, lo que sugiere que se trata de una respuesta refleja autonómica vascular involucrada en la generación del fenómeno fisiológico de hiperemia reactiva.

Objetivo: O objetivo do presente estudo foi investigar o papel do tempo de oclusão nas mudanças dinâmicas da ativação autonômica durante a hiperemia reativa.Métodos: Participaram deste estudo indivíduos saudáveis ​​(n = 30) na faixa etária de 18 a 25 anos. A reatividade vascular foi avaliada medindo as mudanças dinâmicas na amplitude do volume do pulso do dedo (PVA) e tempo de trânsito do pulso em relação aos intervalos RR no teste (braço ocluído) e braço controle (braço não ocluído contralateral) durante 1, 3 e 5 minutos de oclusão usando dois sensores fotopletismográficos separados. A variabilidade da frequência cardíaca foi calculada a partir de um sinal de ECG adquirido simultaneamente para monitorar as mudanças dinâmicas na atividade nervosa autonômica cardíaca. A análise variável no tempo de todos os sinais foi mostrada a cada 1 segundo em gráficos de resposta média.Resultados: A análise variável no tempo da resposta vascular e autonômica durante a hiperemia reativa demonstrou a presença de um padrão de resposta característico com um aumento no índice simpático e uma diminuição no índice parassimpático em 8 a 10 segundos, um aumento na frequência cardíaca em 20 segundos e aumento progressivo do PVA durante os primeiros 60 segundos após a oclusão, independentemente do tempo despendido no procedimento. Além disso, foi evidenciada uma diminuição no tempo de trânsito de pulso em relação aos intervalos RR, seguida de um aumento independente do tempo de oclusão.Conclusões: A ativação simpática cardiovascular precoce independe do tempo de oclusão durante a hiperemia reativa, o que sugere que se trata de uma resposta reflexa autonômica vascular envolvida na geração do fenômeno fisiológico de hiperemia reativa.

Background: The Sustained Weight Test (SWT) is an isometric exercise test that has great practical value for carrying out massive studies on hypertension, however, is insufficient knowledge of the dynamics of cardiac autonomic regulation during this test. The aim of this study was to determine variations in the dynamics of cardiac autonomic regulation and in hemodynamic response during SWT in hypertensive subjects. Methods: A quasi-experimental study was conducted on 15 hypertensive patients of both sexes, paired with 30 normotensive individuals, measuring arterial blood pressure, entropy sample and the Heart Rate Variability (HRV) in time-frequency with the Continuous Wavelet Transform Morlet-type (CWT  morlet) through the electrocardiographic signal of the polygraph AD Instruments in the functional states of Rest and SWT. Results: A significant increase in heart rate and blood pressure was found, as well as a decrease in sample entropy in the functional states of normotensive and hypertensive patients. In hypertensive patients, an early response pattern increased with multiple fluctuations during SWT in the time-frequency analysis of HRV with the CWT morlet. Conclusions: SWT produces an increase in blood pressure, which is more frequent and evident in hypertensive subjects. Cardiac autonomic regulation during SWT increases the sympathetic and decreases the parasympathetic components, manifesting itself in hypertensive patients with a pattern of imbalance in the regulation of both sympathetic and parasympathetic response.

Abstract: This article uses the approaches of the analysis of social networks (ARS) and the “cultural social biography of things”, to account for the patrimonial practices of the mayor and historian Benjamín Vicuña Mackenna in the organization of the Colony Exhibition (1873). These approaches applied to the field of historical studies of cultural heritage, allow to inves tigate how personal ties, as conditions of possibility of social structures, are key pieces, in the configuration and management of what has been recognized as cultural heritage. On the other hand, it favors the understanding of the conformation of the collections, exhibitions, as well as the various procedures applied to heritage assets, in a specific historical context.

Resumen: El artículo utiliza los enfoques del análisis de redes sociales (ARS) y la “biografía cultural de las cosas”, para dar cuenta de las prácticas patrimoniales del intendente e histo riador Benjamín Vicuña Mackenna en la organización de la Exposición del Coloniaje (1873). Estos enfoques aplicados al campo de los estudios históricos del patrimonio cultural per miten indagar cómo los vínculos personales, en tanto que condiciones de posibilidad de las estructuras sociales, son piezas claves, en la configuración y gestión de aquello que se ha reconocido como patrimonio cultural. Por otro lado, favorece la comprensión de la confor mación de colecciones, exposiciones, así como de diversas gestiones aplicadas a los bienes patrimoniales, en un contexto histórico determinado.

Abstract This paper seeks to analyze regional dimensions of food security as a development issue, and its geographic imbalances in Mexico. Through the application of principal component analysis, an index was developed at the municipal and regional level. In addition to combining information for different variables which are consolidated into a single measurement, this index numerically synthesizes three of the four dimensions with which the problem is measured: access, availability and biological utilization. Meanwhile, the Dalenius-Hodges stratification method was used to establish food security ranges at different regional scales. The results show that the socioeconomic and geographic inequalities caused by the development models historically applied in Mexico affect the population’s internal food security throughout its regional areas.

Resumen El presente trabajo busca analizar las dimensiones regionales de la seguridad alimentaria y sus desequilibrios territoriales en México. Mediante la aplicación del método de componentes principales, se elaboró un índice a nivel municipal y regional que, además de combinar información de variables diversas que se concentran en una medida única, sintetiza numéricamente tres de las cuatro dimensiones con que se mide la problemática: acceso, disponibilidad y utilización biológica. A la par se empleó el método de estratificación Dalenius-Hodges para establecer rangos de seguridad alimentaria a distintas escalas regionales. Los resultados muestran que las desigualdades socioeconómicas y territoriales, provocadas por los modelos de desarrollo aplicados en el pasado, afectan la seguridad alimentaria de la población en sus espacios regionales.

Abstract: The article presents in an interpretative and critical way the main theses structuring the work of Hartmut Rosa, namely: his theory of modern acceleration; his observations on the types of alienation that arise with it; and the forms of overcoming a state of alienation both within social life and in terms of the relationship nature-humanity, under the concept of resonance. Issues such as modern temporal structures (acceleration), the lack of synchronies between politics and economy, and the obstacles to emancipation (i.e., alienation), as well as the possible ways of confronting modern pathologies (resonance) are key points in Rosa’s diagnosis and critique. All of them are grounded on common questions about the origin of modernity, its main features and its later state of development. Two moments in Rosa’s trajectory are identified: one closer to a theory of society - in the case of acceleration -, and one approaching a normative philosophy - when dealing with alienation and resonance.

Resumen: El artículo expone de manera interpretativa y crítica las principales tesis que estructuran la obra de Hartmut Rosa, y que se resumen en: una teoría de la aceleración moderna; sus observaciones sobre los tipos de alienación surgen que con ella; y las formas de superación de una relación alienada tanto en la vida social como en el vínculo naturaleza-humanidad bajo el concepto de resonancia. Temas tales como las estructuras temporales modernas (aceleración), las faltas de sincronía entre política/economía y los obstáculos ante las posibilidades de emancipación (alienación), así como las posibles formas de hacer frente a las patologías modernas (resonancia) serán claves en el diagnóstico y crítica de Rosa. A todos estos temas subyacen preguntas comunes sobre el origen de la modernidad, sus características y su estado actual. Se identifican dos momentos en su obra: un primero, más cercano a una teoría de la sociedad (en el caso de la aceleración), y un segundo momento más próximo a una filosofía normativa (cuando se discute sobre alienación y resonancia).

ABSTRACT Introduction: At present it is indispensable to study type 2 diabetes mellitus with low-cost techniques due to the health load it represents. In this context the sustained weight test acquires great value as a Cuban static isometric exercise for the study of heart rate variability. Objective: Determine autonomic and hemodynamic electrophysiological responses at baseline state and during the sustained weight test in healthy subjects and type 2 diabetic patients. Methods: A non-observational quasi-experimental before-after study was conducted at the University of Medical Sciences of Santiago de Cuba based on a control group of 60 patients (30 healthy and 30 with type 2 diabetes mellitus). Results: Diabetics had a higher BMI (p = 0.004). At baseline state significant differences were found between healthy subjects and diabetic patients. In most of the heart rate variability parameters analyzed and during the sustained weight tests, the only variables that showed significant differences were SBP (p = 0.022), FB (p = 0.001) and FA (p = 0.015). The results obtained from the sustained weight test were the following: very significant variations of hemodynamic parameters (p < 0.001), significant FA (p = 0.023) and FB/FA (p = 0.046) variations in healthy subjects, and significant differences in hemodynamic variables in diabetic patients. Conclusions: A lower response by the autonomic nervous system was determined in diabetic patients versus healthy subjects, signaling deterioration of that system and reduced sympathetic and parasympathetic activity.

RESUMEN Introducción: En la actualidad se hace imprescindible el estudio de la diabetes mellitus tipo 2 a partir de técnicas poco costosas en función de la carga sanitaria que representa, es entonces donde la prueba del peso sostenido gana valor como ejercicio isométrico estático cubano en el estudio de la variabilidad de la frecuencia cardíaca. Objetivo: Determinar las respuestas electrofisiológicas autonómicas y hemodinámicas en estado basal y durante la prueba del peso sostenido en pacientes sanos y con diabetes tipo 2. Métodos: Se realizó un estudio en la Universidad de Ciencias Médicas de Santiago de Cuba, no observacional, cuasi-experimental, de tipo antes-después con grupo control de 60 pacientes (30 sanos y 60 con diabetes mellitus tipo 2). Resultados: Los diabéticos presentaron mayor IMC (p = 0,004). En estado basal se experimentaron diferencias significativas entre pacientes sanos y diabéticos. En la mayoría, los parámetros de la variabilidad de la frecuencia cardíaca analizados y durante la prueba del peso sostenido, solo se observaron diferencias significativas en las variables TAS (p = 0,022), BF (p = 0,001) y AF (p = 0,015). Al realizar la prueba del peso sostenido se encontraron variaciones muy significativas (p < 0,001) de los parámetros hemodinámicos, y variaciones significativas de AF (p = 0,023) y BF/AF (p = 0,046) en pacientes sanos; y en diabéticos, diferencias significativas de las variables hemodinámicas. Conclusiones: Se determinó una menor respuesta en pacientes diabéticos con respecto a los sanos del sistema nervioso autónomo, lo que expresa un deterioro de este y una disminución de la actividad simpática y parasimpática.

The present research describes the degree of adoption of corporate governance practices of 203 Chilean open anonymous companies during the three-year 2015-2017, in compliance with Rule of General Character N°385, the aforementioned practices must be reported annually to the securities market regulator, called the Commission for the Financial Market. The data analysis, within a confidence interval of 95%, was divided into two stages. First, with a descriptive statistical analysis, and secondly, the presentation of the levels of adoption at the market level, categories and principles for the periods 2015, 2016 and 2017. In both stages, it was established that the degree of adoption is low (close to 30%), and that in the three years of study no interest to make significant improvement in the adoption of corporate governance practices has been evidenced by the corporations.

La presente investigación describe el grado de adopción de las prácticas de gobiernos corporativos de 203 sociedades anónimas abiertas chilenas, durante el trienio 2015 - 2017, en cumplimiento de la Norma de Carácter General N°385, las mencionadas prácticas deben ser reportadas anualmente al regulador del mercado de valores en Chile, llamado Comisión para el Mercado Financiero. Los datos fueron analizados dentro de un intervalo de confianza del 95%, dividiéndose en una primera etapa en un análisis estadístico descriptivo de los datos, y en una segunda parte presentando los niveles de adopción a nivel de mercado, categorías y principios para los períodos 2015, 2016 y 2017. En ambas etapas, se estableció que el grado de adopción es bajo (cercano al 30%) y que en los tres años de estudio no se ha evidenciado interés por parte de las sociedades en generar avances significativos en la adopción de prácticas de gobierno corporativo.