Resumen México es uno de los pocos países que combinan un gran legado pesquero y agrícola. No obstante, a pesar de sus contribuciones sociales y en la producción de alimentos, las políticas públicas mexicanas, en gran medida, han abandonado a los pequeños productores a lo largo de las últimas cuatro décadas. Además, se les ha relegado como el eslabón más débil dentro de las lógicas económicas del régimen alimentario mundial. Desde que México firmó el primer Tratado de Libre Comercio de América del Norte, los pescadores artesanales y los pequeños agricultores se han enfrentado a cinco problemas centrales: el desmantelamiento de los medios de producción, la erosión de las capacidades organizativas, lógicas comerciales desventajosas que limitan el acceso a mercados favorables, la occidentalización de las dietas y frecuentes periodos de inseguridad alimentaria. Este estudio aborda la siguiente pregunta de investigación, ¿cómo, frente a los procesos de exclusión del actual régimen alimentario, el abandono de las políticas públicas y la desarticulación de la mayoría de las capacidades organizativas sectoriales en México, pueden los pescadores y agricultores de pequeña escala, así como los consumidores urbanos y rurales, mejorar las realidades productivas, comerciales y alimentarias dentro de sus propios contextos de vida? Introducimos un enfoque transdisciplinario novedoso para un contexto específico, basado en nuestra experiencia de investigación con comunidades pesqueras y agrícolas de la Península de Yucatán. Finalmente, esbozamos nichos de innovación que podrían conducir a la relocalización de sistemas alimentarios regionales a través de complementariedades entre las zonas costeras y del interior.

Abstract Mexico is one of the few countries that combine fishing and agricultural legacies. Despite the social importance and central role of food production, Mexican public policies have largely abandoned small-scale producers over the last four decades. Moreover, they have been relegated to the status of weakest link in the economic logic of the global food regime. Since Mexico signed the first North American Free Trade Agreement, small-scale fishers and farmers have faced five main problems: dismantling of means of production, erosion of organizational capabilities, disadvantageous commercial logic that limits access to favorable markets, westernization of diets, and frequent periods of food insecurity. This study addresses the following research question, how, in the face of the exclusion processes of the current food regime, the abandonment of public policies and erosion of most of the sectoral organizational capacities in Mexico, can small-scale fishers and farmers, as well as urban and rural consumers improve their productive, commercial and food problems within their living contexts? We introduced a novel transdisciplinary context-specific approach, based on our research experience in fishing and farming communities of the Yucatan Peninsula. Finally, we outline innovation niches that could lead to relocate regional food systems through complementarities between coastal and inland areas.

Resumen Introducción : Objetivo: comparar sensibilidad diag nóstica de videocolposcopia con inteligencia artificial (IA) auxiliar, con la videocolposcopia común realizada por colposcopistas. Métodos : Estudio descriptivo de corte transversal retrospectivo, en 782 historias clínicas anonimizadas del Sistema Informático para el Tamizaje (SITAM), de mujeres a las cuales se les efectuaron videocolposcopia con IA y colposcopías con videocolposcopio común rea lizadas por especialistas, con sus biopsias (gold standard). Se evaluó la relación entre los resultados de videocol poscopia con IA y videocolposcopia común con resulta dos de las biopsias. Se calculó precisión global de cada procedimiento diagnóstico. Se determinó sensibilidad y concordancia de los resultados de la videocolposcopia con IA, con el gold standard. Resultados : Se analizaron 395 historias clínicas de pacientes con videocolposcopia con IA y 387 con vi deocolposcopia común. La precisión diagnóstica de resultados fue 80% (IC 95%: 75-83%) en videocolposco pias con IA y 65% (IC 95%: 60-69%) en videocolposcopia común (p<0.001). Los resultados de videocolposcopia con IA y colposcopia común se correlacionaron signifi cativamente con los resultados de las biopsias, rs=0.75 vs. rs=0.57 respectivamente (p<0.001). La sensibilidad de videocolposcopia con IA fue 96% (IC 95%: 94-98%), y 93% (IC 95%: 89-95%) en colposcopías comunes. La concordancia general de las impresiones colposcópicas clasificadas por videocolposcopia con IA y enfermedad fue mayor que la de la interpretación colposcópica de los colposcopistas (90% frente a 83%, Kappa 0.59 frente a 0.47, p<0.001). Conclusión : La alta precisión diagnóstica de video colposcopia con IA permite aumentar la sensibilidad del estudio y mejorar la detección precoz de lesiones precursoras de neoplasias cervicouterinas.

Abstract Introduction : To compare the diagnostic sensitivity of artificial intelligence (AI) assisted videocolposcopy with standard videocolposcopy performed by specialist colposcopists. Methods : A descriptive retrospective cross-sectional study, 782 anonymized medical records from the Com puterized System for Screening (SITAM) of women who underwent videocolposcopy with AI and colposcopy with common videocolposcopy performed by specialists, with their corresponding biopsies (gold standard) were analyzed. The relationship between the results of IA videocolposcopy and regular videocolposcopy and the results of biopsies was evaluated. The overall accuracy of each diagnostic procedure was calculated. The sensitiv ity and concordance of the results of AI videocolposcopy with the gold standard (biopsy) were determined. Results : A total of 395 patient records of patients with IA videocolposcopy and 387 with regular vi-deocolposcopy were analyzed. The accuracy of results was 80% (IC 95%: 75-83%) in IA videocolposcopy and 65% (IC 95%: 60-69%) in regular videocolposcopy (p<0.001). Videocolposcopy results with IA and com mon colposcopy were significantly correlated with bi opsy results, rs=0.75 vs. rs=0.57 respectively (p<0.001). The sensitivity of videocolposcopy with AI was 96% (95% CI: 94-98%), and 93% (95% CI: 89-95%) for regu lar colposcopy. The overall agreement of colposcopic impressions classified by videocolposcopy with AI and disease was higher than that of colposcopic interpretation by colposcopists (90% vs. 83%, Kappa 0.59 vs. 0.47, p<0.001). Conclusion : The high diagnostic accuracy of AI vi-deocolposcopy allows obtaining highly sensitive studies that help in the early detection of precursor lesions of cervical neoplasia.

Resumen El objetivo del artículo es realizar un análisis comparado de mediano plazo que permita conocer la evolución y fuentes de la competitividad de México y sus principales socios comerciales: Estados Unidos, China y Canadá, que ocupan el primer, segundo y tercer o cuarto sitio, respectivamente. En el análisis se incluye a Brasil en su condición de primera economía de América Latina. Nuestro país recibe los beneficios del elevado superávit de intercambio con socios del “Tratado México, Estados Unidos y Canadá”; estos beneficios contrastan por el abultado déficit con China y otras economías asiáticas. Una de las claves de esta problemática radica en la competitividad y el modelo de industrialización del país. Al respecto, se presenta una investigación documental acorde al enfoque sistémico-neoinstitucional que retoma los estudios del Foro Económico Mundial de Davos (FEM) y el Banco Mundial (BM). Los resultados revelan una divergencia entre las evaluaciones del FEM que apuntan a una evolución favorable de la competitividad global de México y el BM que detecta un deterioro de las condiciones para hacer negocios vinculada a la normatividad institucional regulatoria. En el análisis se jerarquizan las ventajas competitivas de México y las debilidades o fallas que las obstaculizan en el periodo 2011-2019.

Abstract This article aims to carry out a medium-term comparative analysis that allows us to know the evolution and sources of competitiveness of Mexico and its main trading partners: The United States, China, and Canada, which occupy the first, second, and third place, respectively. The analysis includes Brazil as the leading economy in Latin America. Our country benefits from the high trade surplus with partners of the United States-Mexico-Canada Agreement. These benefits contrast with the large deficit with China and other Asian economies. One of the keys to this problem links the country’s competitiveness and industrialization model. In this regard, documentary research is presented according to the systemic-neo-institutional approach that takes up the World Economic Forum of Davos and the World Bank studies. The results reveal a divergence between the WEF’s assessments, which point to a favorable evolution of Mexico’s global competitiveness, and the World Bank, which detects a deterioration in the conditions for doing business with allies to institutional regulatory norms. The analysis ranks Mexico’s competitive advantages and the weaknesses or failures that balk them in the 2011-2019 period.

ABSTRACT The aim of the study was to update and assess the content validity of the Palmore-Neri-Cachioni Questionnaire on Basic Knowledge of Old Age. Three gerontology specialists were involved in the update. Two rounds of content validation were carried out. The Content Validity Index at item level was used, translated by the modified Kappa and the Content Validity Ratio, adopting scores ≥ 0.78, 0.74 and 1.00, respectively. Overall content validity was assessed by the Content Validity Index at scale level according to the mean, assuming a cut-off point of 0.90. A meeting was held with the author of the Brazilian version for clarification. The pilot study was conducted with individuals from the target population and assessed by the agreement rate, with a cut-off point of 80%. The answers to seven items were updated, 14 items were revised and after the second round, the overall validity of the instrument was 0.96. Four items and the instruction were discussed with the author. The pilot study had 34 respondents and was satisfactory. It was possible to obtain the Palmore-Neri-Cachioni Questionnaire | Updated and Revised (2022), which showed content and face validity when applied to a sample of health professionals and managers.

RESUMO O objetivo do estudo foi atualizar e avaliar a validade de conteúdo do Questionário Palmore-Neri-Cachioni de Conhecimentos Básicos sobre a Velhice. A atualização contou com três especialistas em gerontologia. Realizou-se duas rodadas de validação de conteúdo. Utilizou-se o Índice de Validade de Conteúdo a nível de item, traduzido pelo Kappa modificado e a Razão de Validade de Conteúdo, adotando pontuações ≥ 0,78, 0,74 e 1,00, respectivamente. A validade de conteúdo global foi avaliada pelo Índice de Validade de Conteúdo a nível de escala de acordo com a média, assumindo ponto de corte de 0,90. Uma reunião com a autora da versão brasileira foi realizada para esclarecimentos. O estudo piloto foi conduzido com indivíduos da população alvo e avaliado pela taxa de concordância, com ponto de corte 80%. Atualizou-se as respostas de sete itens, 14 itens foram revisados e após a segunda rodada, a validade geral do instrumento foi de 0,96. Quatro itens e a instrução foram discutidos com a autora. O estudo piloto contou com 34 respondentes e alcançou satisfatoriedade. Foi possível obter o Questionário Palmore-Neri-Cachioni | Atualizado e Revisado (2022) que evidenciou validade de conteúdo e de face quando aplicado a uma amostra de profissionais e gestores de saúde.

RESUMEN Introducción: Las variaciones de los diferentes análisis cefalométricos disponibles han demostrado que muchas de sus normas no se ajustan a todos los pacientes, lo cual pudiera deberse a que surgieron en poblaciones y contextos con características diferentes. Objetivo: Validar un análisis cefalométrico diseñado para adolescentes santiagueros. Métodos: Se realizó una investigación de desarrollo en la Clínica Estomatológica Provincial Docente Mártires del Moncada de Santiago de Cuba desde enero de 2021 hasta febrero de 2023. Se estudiaron dos muestras aleatorias, una de especialistas para la selección de las variables a incluir en el diseño del análisis cefalométrico y otra de expertos para la validación del mismo. La validación de aspecto, contenido y criterio fue realizada aplicando los criterios de Moriyama. Resultados: El análisis cefalométrico CefaloSan contó con 32 medidas agrupadas en seis áreas, que permitieran hacer un análisis dentario, esqueletal, dentoesqueletal, determinante, estructural interno y de los tejidos blandos. En la validación se obtuvo una calificación global de concordancia entre todos los expertos respecto a los cinco criterios, evaluados con la máxima puntuación. Consideraron que CefaloSan es comprensible, pues presenta componentes definidos y un tema justificable, derivándose de datos que pueden obtenerse, además, es sensible a variaciones. El nivel de aceptación del instrumento superó 80 %, resultado que fue estadísticamente significativo. Conclusiones: El análisis cefalométrico propuesto constituye una herramienta que permitirá lograr un diagnóstico más completo del paciente, contextualizándolo a las características propias de los cubanos y a las necesidades diagnósticas.

ABSTRACT Introduction: The variations of the different cephalometric analyses available have shown that many of their standards do not fit all patients, which could be due to the fact that they emerged in populations and contexts with different characteristics. Objective: To validate a cephalometric analysis designed for adolescents from Santiago de Cuba. Methods: A development investigation was carried out at Mártires del Moncada Provincial Stomatological Clinic in Santiago from Cuba from January, 2021 to February, 2023. Two random samples were studied, one of specialists for the selection of the variables to include in the design of the cephalometric analysis and another of experts for its validation. The validation of aspect, content and criterion was carried out implementing the Moriyama criteria. Results: The cephalometric analysis CefaloSan had 32 measures grouped in six areas that allowed to make a dental, skeletical, dentoskeletical, detemining, structural internal and of the soft tissues analysis. In the validation a global qualification of agreement was obtained among all the experts regarding the five criteria, evaluated with the maximum punctuation. They considered that CefaloSan is comprehensible, because it presents defined components and a justifiable topic, being derived from data that can be obtained and it is also sensitive to variations. The level of acceptance of the instrument exceeded 80 %, result that was statistically significant. Conclusions: The cephalometric analysis proposed constitutes a tool that will allow to achieve a more complete diagnosis of the patient, contextualizing it to the typical characteristics of Cubans and the diagnostic necessities.

ABSTRACT Foundation: The assessment of pain requires the use of valid and reliable scales that allow identifying its presence, intensity and characteristics, for better management and treatment. Objective: To determine the scales’ validity and reliability for assessing pain in the Intensive Care Unit at the Paquito González Cueto University Pediatric Hospital in Cienfuegos. Methods: An instrument validation study was carried out from January to November 2023. The Wong Baker scale and the visual analogue scale were chosen; face, legs, activity, crying and consolation scale (Face, Legs, Activity, Cry and Consolability), and Pain Indicator Behaviors Scale. Linguistic and cultural adaptation, content validation, internal consistency, temporal stability, construct and criterion validity were carried out. Kendall's W concordance coefficient (content validity), Bartlett's sphericity test and Kaiser's normalization criterion (construct validity), Pearson's correlation coefficient (temporal stability) and global Cronbach's Alpha coefficient (internal consistency) were calculated. Results: The scales are understandable from linguistic and cultural analysis. Content validation with agreement coefficient of Kendall's W 0.233. Construct validity with Kaiser Meyer Olkim (KMO) 0.902 and Bartlett chi square test of sphericity= 1921.253. Temporal stability with Pearson correlation coefficient 0.827 and 0.917. Internal consistency with global Cronbach's Alpha coefficient 0.861. Conclusions: The scales reflect valid conditions and criteria in the assessment of pain in the Pediatric Intensive Care Unit.

RESUMEN Fundamento: La valoración del dolor requiere de la utilización de escalas válidas y confiables, que permitan identificar su presencia, intensidad y características, para su mejor manejo y tratamiento. Objetivo: Determinar la validez y confiabilidad de las escalas para la valoración del dolor en la Unidad de Cuidados Intensivos en el Hospital Pediátrico Universitario Paquito González Cueto de Cienfuegos. Métodos: Se realizó un estudio de validación de instrumentos, de enero a noviembre de 2023. Se escogieron la escala de Wong Baker, la escala visual analógica; escala rostro, piernas, actividad, llanto y consuelo (Face, Legs, Activity, Cry and Consolability), y Escala de conductas indicadoras de dolor. Se realizó la adaptación lingüística y cultural, la validación de contenido, consistencia interna, estabilidad temporal, validez de constructo y de criterio. Se calculó el coeficiente de concordancia W de Kendall (validez de contenido), prueba de esfericidad de Bartlett y criterio de normalización de Kaiser (validez de constructo), coeficiente de correlación de Pearson (estabilidad temporal) y coeficiente Alfa de Cronbach global (consistencia interna). Resultados: Las escalas son comprensibles desde el análisis lingüístico y cultural. Validación de contenido con coeficiente de concordancia de W de Kendall 0,233. Validez de constructo con Kaiser Meyer Olkim (KMO) 0,902 y prueba de esfericidad de Bartlett chi cuadrado= 1921,253. Estabilidad temporal con coeficiente de correlación de Pearson 0,827 y 0,917. Consistencia interna con coeficiente Alfa de Cronbach global 0,861. Conclusiones: Las escalas reflejan condiciones y criterios válidos en la valoración del dolor en la Unidad de Cuidados Intensivos Pediátricos.

RESUMO O objetivo do estudo foi atualizar e avaliar a validade de conteúdo do Questionário Palmore-Neri-Cachioni de Conhecimentos Básicos sobre a Velhice. A atualização contou com três especialistas em gerontologia. Realizou-se duas rodadas de validação de conteúdo. Utilizou-se o Índice de Validade de Conteúdo a nível de item, traduzido pelo Kappa modificado e a Razão de Validade de Conteúdo, adotando pontuações ≥ 0,78, 0,74 e 1,00, respectivamente. A validade de conteúdo global foi avaliada pelo Índice de Validade de Conteúdo a nível de escala de acordo com a média, assumindo ponto de corte de 0,90. Uma reunião com a autora da versão brasileira foi realizada para esclarecimentos. O estudo piloto foi conduzido com indivíduos da população alvo e avaliado pela taxa de concordância, com ponto de corte 80%. Atualizou-se as respostas de sete itens, 14 itens foram revisados e após a segunda rodada, a validade geral do instrumento foi de 0,96. Quatro itens e a instrução foram discutidos com a autora. O estudo piloto contou com 34 respondentes e alcançou satisfatoriedade. Foi possível obter o Questionário Palmore-Neri-Cachioni | Atualizado e Revisado (2022) que evidenciou validade de conteúdo e de face quando aplicado a uma amostra de profissionais e gestores de saúde. PalmoreNeriCachioni Palmore Neri Cachioni Velhice gerontologia Realizouse Realizou se Utilizouse Utilizou item 078 0 78 0,78 074 74 0,7 100 1 00 1,00 respectivamente média 090 90 0,90 esclarecimentos concordância 80 80% Atualizouse Atualizou rodada 096 96 0,96 3 satisfatoriedade 2022 (2022 saúde 07 7 0, 10 1,0 09 9 0,9 8 202 (202 1, 20 (20 2 (2 (

ABSTRACT The aim of the study was to update and assess the content validity of the Palmore-Neri-Cachioni Questionnaire on Basic Knowledge of Old Age. Three gerontology specialists were involved in the update. Two rounds of content validation were carried out. The Content Validity Index at item level was used, translated by the modified Kappa and the Content Validity Ratio, adopting scores ≥ 0.78, 0.74 and 1.00, respectively. Overall content validity was assessed by the Content Validity Index at scale level according to the mean, assuming a cut-off point of 0.90. A meeting was held with the author of the Brazilian version for clarification. The pilot study was conducted with individuals from the target population and assessed by the agreement rate, with a cut-off point of 80%. The answers to seven items were updated, 14 items were revised and after the second round, the overall validity of the instrument was 0.96. Four items and the instruction were discussed with the author. The pilot study had 34 respondents and was satisfactory. It was possible to obtain the Palmore-Neri-Cachioni Questionnaire | Updated and Revised (2022), which showed content and face validity when applied to a sample of health professionals and managers. PalmoreNeriCachioni Palmore Neri Cachioni Age out used Ratio 078 0 78 0.78 074 74 0.7 100 1 00 1.00 respectively mean cutoff cut off 090 90 0.90 clarification rate 80 80% updated round 096 96 0.96 3 satisfactory 2022, 2022 , (2022) managers 07 7 0. 10 1.0 09 9 0.9 8 202 (2022 1. 20 (202 2 (20 (2 (

Abstract: The present work aims to examine the apparent benefits and effects of free trade based on the dynamics of the former General Agreement on Tariffs and Trade (GATT) and its successor, the World Trade Organization (WTO). The eminently ideological nature of the tax premises is denounced according to which its effects are intrinsically beneficial for developing and underdeveloped economies in the generality of the assumptions. In this sense, an attempt is made to demonstrate that the reference institutions have consistently perpetuated the drifts that the "center-periphery" analytical model historically denounced to the latter's detriment. The methodology used has involved a literature review of the GATT system and the international trade framework of the WTO, based on a critical examination of these in relation to the theses of both classical and contemporary structuralist economics. The study's results indicate that the multilateral trade system, along with the trade policies of hegemonic nations, through the functioning first of the GATT and then of the WTO, has resulted in endemically detrimental effects for peripheral economies. In this sense, the implications of this research suggest the need for a reexamination, both at the national and interregional levels, of the currently inequitable terms governing international trade, along with a more active promotion, at both levels, of development policies that prove to be beneficial for economically disadvantaged countries.

Resumen: El presente trabajo tiene como propósito examinar los aparentes beneficios y efectos del libre comercio a partir de la dinámica propia del que fuera el General Agreement on Tariffs and Trade (GATT) y su sucesora, la Organización Mundial de Comercio (OMC). Se denuncia el carácter eminentemente ideológico de las premisas tributarias según las cuales sus efectos son, en la generalidad de los supuestos, intrínsecamente provechosos para las economías en desarrollo y subdesarrolladas. En este sentido, se intenta demostrar que las instituciones de referencia han perpetuado consistentemente las derivas que el modelo analítico "centro-periferia" históricamente denunciara en detrimento de esta última. La metodología empleada ha consistido en la revisión bibliográfica del sistema GATT y el esquema de comercio internacional de la OMC, a partir de un examen crítico de estas últimas en función de las tesis de la economía estructuralista cepalina tanto clásica como contemporánea. Los resultados del estudio señalan que el sistema multilateral comercial y las propias políticas comerciales de las naciones hegemónicas, a través del funcionamiento primero del GATT y luego de la OMC, han supuesto efectos endémicamente disvaliosos para las economías periféricas. Las implicaciones de la presente investigación sugieren la necesidad del reexamen tanto en el ámbito nacional como interregional de los términos -actualmente poco equitativos- que rigen el comercio internacional, y de una promoción más activa, en ambos espacios, de aquellas políticas de desarrollo que sean provechosas para los países económicamente desfavorecidos. Clasificación JEL: F01; F12; F13; F53; F60; F63.

ABSTRACT Introduction: Cervical cancer is the third leading cause of death from malignancies worldwide, affecting mainly low- and middle-income countries. By 2020 an incidence of 604,000 new cases was estimated. Objective: To characterize the main hospital indicators of the Cervical Cancer Early Diagnosis Program. Methods: An observational, descriptive and cross-sectional study was carried out to characterize the main hospital indicators of the Program in the Neck Pathology Service of the General Hospital Dr. Bruno Zayas Alfonso of Santiago de Cuba, from January 2020 to December 2022. The study population consisted of 443 women. The data collected were analyzed using descriptive statistic techniques, expressed in frequency and percentages. Results: Of the women studied, 60.9 %had cervical intraepithelial lesion of high degree of malignancy, with 32.6 % positive for cervical cancer. The overall percentage of useless cytological tests was 2.07 and no cells from the processing zone was 4.01, both quality indicators. There was a high significance in terms of the overall coverage rate of women at risk (K=0.615), showing that the results of the cytology largely reflect the diagnosis of histology, with a good agreement. Conclusions: Cervical-vaginal cytology remains the most valuable diagnostic method for detecting cervical intraepithelial neoplasm and early-stage carcinoma in large populations

RESUMEN Introducción: El cáncer cervicouterino ocupa el tercer lugar como causa de defunción por neoplasias malignas a nivel mundial, afectando principalmente a los países de ingresos bajos y medianos. Hacia el 2020 se estimó una incidencia de 604 000 nuevos casos. Objetivo: Caracterizar los principales indicadores hospitalarios del Programa de Diagnóstico Precoz del Cáncer Cervicouterino. Métodos: Se realizó un estudio observacional, descriptivo y transversal, que permitió caracterizar los principales indicadores hospitalarios del Programa en el Servicio de Patología de Cuello del Hospital General Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, de enero del 2020 a diciembre del 2022. La población de estudio estuvo constituida por 443 mujeres. Los datos recopilados fueron analizados mediante técnicas de estadística descriptiva, expresándose en frecuencia y porcentajes. Resultados: De las mujeres estudiadas, 60,9 % presentaron lesión intraepitelial cervical de alto grado de malignidad, con 32,6 % positivo a cáncer cervicouterino. El porcentaje global de pruebas citológicas no útiles fue de 2,07 y sin células de la zona de transformación, de 4,01; ambos indicadores de calidad. Existió una alta significación en cuanto a la tasa de cobertura global de las mujeres en riesgo (K=0,615), demostrando que los resultados de la citología reflejan en gran medida los diagnósticos de la histología, con una buena concordancia. Conclusiones: La prueba citológica cérvico-vaginal sigue siendo el método diagnóstico de mayor valor para detectar neoplasia intraepitelial cervical y carcinoma en estadio precoz en grandes masas de población.

Resumo Introdução: a escassez de debates sobre o cuidado de enfermagem às gestantes com doença falciforme no país e a urgente necessidade de intervenção e melhorias na assistência de enfermagem prestada às essas mulheres, motivaram este estudo. Além disso, em instrumentos para uso em pesquisa e/ou na prática clínica, a validade é um atributo essencial. Objetivo: desenvolver e validar um instrumento para cuidados às gestantes com doença falciforme. Materiais e método: estudo metodológico, de validação de conteúdo com juízas(es) especialistas. O instrumento foi estruturado com 19 diagnósticos de enfermagem que abordaram as dimensões biológica, psíquica e social, e 126 intervenções de enfermagem. Utilizou-se a técnica Delphi, com participação de 18 juízas(es). Os resultados foram analisados por meio do índice de validade de conteúdo e nível de concordância acima de 0,80. Resultados: dos 145 itens analisados, 22 (15,17 %) apresentaram índice de validade de conteúdo < 0,80, e os ajustes sugeridos pelas(os) juízas(es) foram implementados. O índice de validade de conteúdo geral do instrumento foi calculado em 0,87. O instrumento alcançou parámetros aceitáveis de validade de conteúdo, segundo o critério utilizado. Conclusões: destaca-se o potencial do instrumento, que pode ser aprimorado a partir do seu uso, como recurso na orientação das práticas de enfermagem voltadas às mulheres grávidas com doença falciforme, nos âmbitos da atenção primária à saúde e da rede hospitalar.

Resumen Introducción: la escasez de debates sobre la atención de enfermería a gestantes con anemia de células falciformes en el país y la urgente necesidad de intervención y mejora de los cuidados de enfermería prestados a esas mujeres motivaron la realización de este estudio. Además, la validez es un atributo esencial en los instrumentos para uso en investigación y/o práctica clínica. Objetivo: elaborar y validar un instrumento de atención a gestantes con anemia de células falciformes. Material y método: estudio metodológico, de validación de contenido con jueces/as expertos/as. El instrumento se estructuró con 19 diagnósticos de enfermería que abordaban las dimensiones biológica, psicológica y social, y 126 intervenciones de enfermería. Se utilizó la técnica Delphi, con la participación de 18 jueces/as. Los resultados se analizaron utilizando el índice de validez de contenido y un nivel de acuerdo superior a 0,80. Resultados: de los 145 ítems analizados, 22 (15,17 %) tenían un índice de validez de contenido < 0,80, y se aplicaron los ajustes sugeridos por los/las jueces/as. El índice global de validez de contenido del instrumento se calculó en 0,87. El instrumento alcanzó parámetros de validez de contenido aceptables, según los criterios utilizados. Conclusiones: se destaca el potencial del instrumento, que puede ser perfeccionado a través de su utilización como recurso para orientar las prácticas de enfermería dirigidas a gestantes con anemia de células falciformes, tanto en la atención primaria de salud como en la red hospitalaria.

Abstract Introduction: The lack of discussions on nursing care for pregnant women with sickle cell disease in Brazil and the urgent need for intervention and improvements in the nursing care provided to these women sparked this study. In addition, validity is an essential attribute for instruments used in research and/or clinical practice. Objective: To develop and validate an instrument covering the care of pregnant women with sickle cell disease. Materials and methods: This is a methodological, content validation study conducted with specialist judges. The instrument was structured with 19 nursing diagnoses that addressed the biological, psychological, and social dimensions, as well as 126 nursing interventions. The Delphi technique was used with the participation of 18 judges. The results were analyzed using the content validity index and a level of agreement above 0.80. Results: Of the 145 items analyzed, 22 (15.17 %) scored a content validity index < 0.80, and the adjustments suggested by the judges were implemented. The instrument’s general content validity index was calculated at 0.87. The instrument reached acceptable content validity parameters, according to the criteria used. Conclusions: The instrument’s potential stands out, and it can be improved through its use as a resource for guiding nursing practices directed to pregnant women with sickle cell disease, both in primary health care and in hospital networks.

RESUMEN Objetivo: validar el contenido y apariencia de un sitio web para adolescentes que viven con Diabetes Mellitus. Método: investigación metodológica basada en el marco teórico DADI (definición, arquitectura, diseño, implementación). En la validación de contenido participaron 16 profesionales de la salud, quienes respondieron a un cuestionario creado mediante Google Forms® con 19 ítems relacionados con objetivos, estructura/presentación, relevancia. La validación de la apariencia del sitio web fue realizada por 12 profesionales de Tecnologías de la Información a través de un cuestionario con 15 ítems divididos en dos dominios (apariencia y diseño). Resultados: el Índice de Validez de Contenido general fue de 0,98, todos los ítems evaluados obtuvieron valores de concordancia > 0,80. El coeficiente Kappa global fue de 0,6374, considerado estadísticamente significativo (valor de p <0,0001). El Índice de Validez de Apariencia presentó un Índice general de 0,91 (por encima de 0,9 se considera validado). Conclusión: el sitio web para adolescentes que viven con Diabetes Mellitus fue validado en contenido y apariencia, configurándose como una tecnología educativa con información segura, necesaria y pertinente para ayudar a los adolescentes que viven con Diabetes Mellitus a comprender esta condición crónica y apoyarlos en el autocuidado de forma segura y efectiva. Objetivo Método definición, definición (definición arquitectura diseño implementación. implementación . implementación) 1 salud Forms objetivos estructurapresentación estructura presentación estructura/presentación relevancia diseño. diseño) Resultados 098 0 98 0,98 080 80 0,80 06374 6374 0,6374 valor <0,0001. 00001 <0,0001 0001 <0,0001) 091 91 09 9 0, validado. validado) Conclusión efectiva 08 8 0,8 0637 637 0,637 0000 <0,000 000 063 63 0,63 <0,00 00 06 6 0,6 <0,0 <0, <0 <

ABSTRACT Objective: to validate the content and appearance of a website for adolescents living with Diabetes Mellitus. Method: this is methodological research based on the DADI (Definition, Architecture, Design, Implementation) theoretical framework. A total of 16 health professionals participated in content validity, who answeres a questionnaire prepared on Google Forms® with 19 items related to objectives, structure/presentation, relevance. Website appearance validity was carried out by 12 Information Technology professionals through a questionnaire with 15 items divided into two domains (appearance and design). Results: the overall Content Validity Index was 0.98, and all items assessed obtained agreement values > 0.80. The overall Kappa coefficient was 0.6374, considered statistically significant (p-value <0.0001). The Appearance Validity Index presented a general index of 0.91 (above 0.9 considered validated). Conclusion: the website for adolescents living with Diabetes Mellitus was validated in terms of content and appearance, creating an educational technology with safe, necessary and pertinent information to help adolescents living with Diabetes Mellitus understand this chronic condition and support them in self-care safely and effectively. Objective Method Definition, Definition (Definition Architecture Design Implementation framework 1 Forms objectives structurepresentation structure presentation structure/presentation relevance design. design . design) Results 098 0 98 0.98 080 80 0.80 06374 6374 0.6374 pvalue p value <0.0001. 00001 <0.0001 0001 <0.0001) 091 91 above 09 9 0. validated. validated) Conclusion safe selfcare self care effectively 08 8 0.8 0637 637 0.637 0000 <0.000 000 063 63 0.63 <0.00 00 06 6 0.6 <0.0 <0. <0 <

RESUMO Objetivo: validar o conteúdo e a aparência de um website para adolescentes que convivem com Diabetes Mellitus. Método: pesquisa metodológica embasada no referencial teórico DADI (definição, arquitetura, design, implementação, avaliação). Participaram da validação de conteúdo 16 profissionais da área da saúde, os quais responderam a um questionário elaborado no Google Forms® com 19 itens, relacionados aos objetivos, estrutura/apresentação, relevância. A validação da aparência do website foi realizada por 12 profissionais da Tecnologia da Informação, por meio de um questionário com 15 itens divididos em dois domínios (aparência e designer). Resultados: o Índice de Validade de Conteúdo geral foi de 0,98, todos os itens avaliados obtiveram valores de concordância >0,80. O coeficiente de Kappa geral foi 0,6374, considerado estatisticamente significativo (p-value<0,0001). O Índice de Validade de Aparência apresentou Índice geral de 0,91 (acima de 0,9 considerado validado). Conclusão: o website para adolescentes que convivem com Diabetes Mellitus foi validado, quanto ao conteúdo e à aparência, configurando-se como uma tecnologia educacional com informações seguras, necessárias e pertinentes para auxiliar os adolescentes que convivem com Diabetes Mellitus na compreensão dessa condição crônica e subsidiá-los para o autocuidado com segurança e eficácia. Objetivo Método definição, definição (definição arquitetura design implementação avaliação. avaliação . avaliação) 1 saúde Forms objetivos estruturaapresentação estrutura apresentação estrutura/apresentação relevância Informação designer. designer designer) Resultados 098 0 98 0,98 080 80 >0,80 06374 6374 0,6374 pvalue<0,0001. pvalue00001 pvalue p value<0,0001 value 0001 (p-value<0,0001) 091 91 acima 09 9 0, validado. validado validado) Conclusão configurandose configurando se seguras subsidiálos subsidiá los eficácia 08 8 >0,8 0637 637 0,637 pvalue<0,0001 pvalue0000 value00001 value<0,000 000 (p-value<0,0001 >0, 063 63 0,63 pvalue<0,000 pvalue000 value0000 value<0,00 00 (p-value<0,000 >0 06 6 0,6 pvalue<0,00 pvalue00 value000 value<0,0 (p-value<0,00 > pvalue<0,0 pvalue0 value00 value<0, (p-value<0,0 pvalue<0, value0 value<0 (p-value<0, pvalue<0 value< (p-value<0 pvalue< (p-value< (p-value

Abstract The development of radio frequency circuits is currently guided mainly through two objectives, which are size reduction and performance improvement of devices. Within a reception or transmission channel, the division and/or combination of power are the most delicate stages due to their large dimensions and high insertion losses, particularly in the case of dividers/combiners based on planar technologies. In this context, this study proposes an analysis and design of a new broadband power divider and combiner using stepped impedance. The power divider/combiner developed is designed to cover a broad frequency spectrum ranging from 1 GHz to 4 GHz, including wireless applications such as Global Mobile Communications Systems (GSM), Industrial, Scientific and Medical (ISM), and Sub-6 GHz 5th Generation (5G) applications. The proposed circuit was analyzed using the stepped transmission line impedance method and designed by Advanced Design System (ADS) on an Epoxy-FR4 substrate with a dielectric constant of 4.4 and a thickness of 1.58 mm. The achieved results showed excellent characteristics in terms of transmission across the input and output terminals, mismatches at all three terminals, and isolation among output terminals. A prototype was built and the measured results showed good agreement with those obtained by simulation. objectives devices channel andor losses dividerscombiners dividers combiners technologies context dividercombiner GSM, GSM , (GSM) Industrial ISM, ISM (ISM) Sub6 Sub 6 Sub- th 5G G (5G ADS (ADS EpoxyFR4 EpoxyFR Epoxy FR4 FR Epoxy-FR 44 4. 158 58 1.5 mm terminals simulation (GSM (ISM 15 5 1.

RESUMEN Objetivo: validar una tecnología educativa como recurso didáctico para la enseñanza de enfermería en salud mental. Método: estudio metodológico, realizado mediante acuerdo entre jueces expertos y el público objetivo, para validar el contenido y evaluar la apariencia de un juego educativo. En el estudio participaron 11 jueces expertos y 114 estudiantes de dos universidades. Para la validación se utilizó el Índice de Validez de Contenido. Resultados: la evaluación del recurso docente-pedagógico alcanzó un Índice Global de Validez de Contenido igual al 88,5%. Los ítems 7 y 9 obtuvieron un Índice de Validez de Contenido Individual inferior al 78%. Ante lo anterior, dichos ítems fueron reevaluados y ajustados de acuerdo a los cambios sugeridos. Para los dominios evaluados respecto a la apariencia del juego educativo se obtuvieron porcentajes que estuvieron entre 85,9% y 97,3%. Conclusión: las evaluaciones provocaron ajustes en el contenido teórico-científico del juego, haciéndolo apto para su uso como recurso educativo para la disciplina de salud mental en cursos de enfermería. Objetivo Método metodológico objetivo 1 universidades Resultados docentepedagógico docente pedagógico 885 88 5 88,5% 78 78% anterior sugeridos 859 85 85,9 973 97 3 97,3% Conclusión teóricocientífico teórico científico 8 88,5 85, 97,3 88, 97,

ABSTRACT Objective: to validate an educational technology as a teaching resource for teaching mental health nursing. Method: this is a methodological study, carried out through agreement among expert judges and the target audience, for content validity and appearance assessment of an educational game. A total of 11 expert judges and 114 students from two universities participated in the study. For validity, the Content Validity Index was used. Results: the teaching-pedagogical resource assessment reached an overall Content Validity Index equal to 88.5%. Items 7 and 9 obtained an Individual Content Validity Index of less than 78%. In view of this, these items were reassessed and adjusted according to suggested changes. For the domains assessed regarding educational game appearance, percentages were obtained that were between 85.9% and 97.3%. Conclusion: the assessments triggered adjustments to the game’s theoretical-scientific content, making it capable of being used as an educational resource for the mental health discipline in nursing courses. Objective Method study audience 1 Results teachingpedagogical pedagogical 885 88 5 88.5% 78 78% changes 859 85 85.9 973 97 3 97.3% Conclusion games s theoreticalscientific theoretical scientific courses 8 88.5 85. 97.3 88. 97.

RESUMO Objetivo: Validar uma tecnologia educacional como recurso didático para o ensino de enfermagem em saúde mental. Método: Estudo metodológico, realizado através da concordância entre os juízes especialistas e do público-alvo, para a validação do conteúdo e avaliação da aparência de um jogo educacional. Participaram do estudo 11 juízes especialistas e 114 alunos de duas universidades. Para a validação, foi utilizado o Índice de Validade de Conteúdo. Resultados: A avaliação do recurso didático-pedagógico atingiu um Índice de Validade de Conteúdo Global igual a 88,5%. Os itens 7 e 9 obtiveram um Índice de Validade de Conteúdo Individual inferior a 78%. À vista disso, esses itens foram reavaliados e ajustados conforme as alterações sugeridas. Para os domínios avaliados referentes à aparência do jogo educacional, foram obtidos percentuais que estiveram entre 85,9% e 97,3%. Conclusão: As avaliações desencadearam adequações no conteúdo teórico-científico do jogo, tornando-o apto a ser empregado como recurso educacional da disciplina de saúde mental nos cursos de enfermagem. Objetivo Método metodológico públicoalvo, públicoalvo público alvo, alvo público-alvo 1 universidades Resultados didáticopedagógico pedagógico 885 88 5 88,5% 78 78% disso sugeridas 859 85 85,9 973 97 3 97,3% Conclusão teóricocientífico teórico científico tornandoo tornando 8 88,5 85, 97,3 88, 97,

ABSTRACT Since the industrial revolution, human activities have emitted approximately 2,500 Gt of CO2, increasing the concentration of atmospheric CO2 by 50 % compared to pre-industrial levels. To better understand the potential for mitigating greenhouse gas (GHG) emissions through proper management of degraded pasture areas, we conducted a systematic literature review and identified 23 publications reporting carbon sequestration values for pastures managed under different conditions in the south and southeast regions of Brazil. From this dataset, 17 publications considered to be in line with the research premises were selected to estimate the potential for soil carbon sequestration (SEQ) through pasture recovery in the southern region of Brazil, using conservative and regenerative agricultural management practices. Results show that managed pastures can sustain carbon sequestration rates of around 2.50 Mg C ha-1 yr-1 over approximately 20 years. However, due to the numerous variables influencing SEQ rates, the limited number of publications, and the lack of data for some variables among them, a more extensive analysis of publications and data is needed to establish causal and preponderance relationships regarding the effect of each variable on the found SEQ rates. Under current pasture occupation conditions in Brazil’s south region, it is estimated these areas could sequester between 0.433 and 1.273 Gt CO2 at the end of 20 years if managed under appropriate practices. These numbers are not representative to reduce atmospheric CO2 concentration from legacy emissions and significantly mitigate physical impacts of climate change, reinforcing the importance of prioritizing the reduction of global GHG emissions as the primary mitigation strategy. On the other hand, from the perspective of mitigating the national agricultural sector’s annual GHG emissions, this potential cannot be considered negligible. Carbon sequestration by soils under agricultural management can play a vital role in mitigating climate change, integrating the set of necessary solutions and actions for a Paris Agreement goals compatible trajectory of limiting global warming to between 1.5 and 2 °C by the end of the century. revolution 2500 500 2,50 CO 5 preindustrial pre levels (GHG Brazil dataset 1 (SEQ practices 250 2.5 ha1 ha ha- yr1 yr yr- However them Brazils s 0433 0 433 0.43 1273 273 1.27 change strategy hand sectors sector negligible 15 1. century 2,5 25 2. 043 43 0.4 127 27 1.2 2, 04 4 0. 12

RESUMEN Introducción: En el proceso de rehabilitación cardiovascular integral del paciente convaleciente de infarto agudo de miocardio, un autocuidado adecuado es fundamental para promover la responsabilidad de las personas en el cuidado de su salud, al favorecer el bienestar físico y psicológico, y su reinserción en la vida social. Objetivo: Validar el cuestionario de conductas de autocuidado diseñado para pacientes convalecientes de infarto agudo de miocardio. Métodos: Desde el paradigma de investigación cuantitativo, se asumió un diseño no experimental y un tipo de estudio instrumental. Para la validación del cuestionario se utilizó el coeficiente de validez de contenido propuesto por Hernández - Nieto, mediante la selección de nueve jueces expertos que asumieron cuatro criterios de evaluación (coherencia, claridad, relevancia y suficiencia) con escala ordinal de cinco posibles respuestas, para valorar el grado de acuerdo respecto a cada ítem y al instrumento en general; para medir la fiabilidad, se aplicó el coeficiente Alpha de Cronbach que expresa la consistencia interna del instrumento. Conclusiones: Las propiedades psicométricas del cuestionario, en términos de validez de contenido y fiabilidad, lo convierten en un instrumento apropiado para medir las conductas de autocuidado en pacientes convalecientes de infarto agudo de miocardio.

ABSTRACT Introduction: an adequate self-care is essential in the process of comprehensive cardiovascular rehabilitation of patients convalescent from acute myocardial infarction in order to promote people's responsibility in caring for their health, by promoting physical and psychological well-being and their reintegration into social life. Objective: to validate a self-care behaviour questionnaire designed for patients convalescent from acute myocardial infarction. Methods: a quantitative research, with a non-experimental design and an instrumental study were assumed. The content validity coefficient proposed by Hernández and Nieto was used to validate the questionnaire by means of the selection of 9 expert judges who assumed four evaluation criteria (coherence, clarity, relevance and sufficiency) with an ordinal scale of five possible responses, to assess the degree of agreement regarding each item and the instrument in general; Cronbach's alpha coefficient was applied to measure reliability, which expresses the internal consistency of the instrument. Results: the questionnaire is composed of 34 ítems distributed in three dimensions (physical, psychological and social) and three indicators to choose the answer (always, sometimes and never); excellent validity and agreement were demonstrated. A global Cronbach's Alpha coefficient was obtained in the internal consistency analysis, which shows high intrinsic homogeneity of the instrument. Conclusions: the psychometric properties of the questionnaire, in terms of content validity and reliability, make it an appropriate instrument to measure self-care behaviours in patients convalescent from acute myocardial infarction.