RESUMEN Este documento analiza la cartografa social en el sector pesquero de Oaxaca, México. El objetivo principal es representar el sistema pesquero a través de la identificación de los actores clave, sus relaciones y el territorio. La metodología incluyó tres fases: 1) documental, para establecer el marco teórico; 2) de campo, con la aplicación de 110 encuestas a pescadores utilizando la técnica de bola de nieve; y 3) de resultados, con el análisis y presentación de los datos. Los principales resultados muestran que el sector agroalimentario, al cual pertenece el sector pesquero, enfrenta retos como potencializar las capacidades de producción, abastecimiento, transformación, comercialización y distribución. Se identificaron los principales actores gubernamentales, empresariales y de educación superior involucrados. En cuanto al sistema pesquero en Oaxaca, se mapearon los contextos político-legislativo, geográfico, de sustentabilidad y sanidad, financiero y comercial, de capital humano, productivo e infraestructural, así como el contexto regional de las zonas Costa e Istmo. Se destaca la importancia de reconocer las relaciones históricas que han marcado la pesca en México, especialmente en Oaxaca, uno de los estados con mayores índices de pobreza y rezago. CLASIFICACIÓN JEL: P42, J01, J54, Y90

RESUMO Este artigo analisa o mapeamento social no setor de pesca em Oaxaca, México. O principal objetivo é representar o sistema de pesca por meio da identificação dos principais atores, suas relações e o território. A metodologia incluiu três fases: l) documental, para estabelecer a estrutura teórica; 2) campo, com a aplicação de 110 pesquisas a pescadores usando a técnica de bola de neve; e 3) resultados, com a análise e apresentação dos dados. Os principais resultados mostram que o setor agroalimentar, ao qual pertence o setor pesqueiro, enfrenta desafios como o fortalecimento das capacidades de produção, fornecimento, processamento, comercialização e distribuição. Foram identificados os principais atores governamentais, empresariais e de ensino superior envolvidos. Com relação ao sistema de pesca em Oaxaca, foram mapeados os contextos político-legislativo, geográfico, de sustentabilidade e saúde, financeiro e comercial, de capital humano, produtivo e de infraestrutura, bem como o contexto regional das zonas da Costa e do Istmo. O estudo destaca a importância de reconhecer as relações históricas que marcaram a pesca no México, especialmente em Oaxaca, um dos estados com os mais altos índices de pobreza e atraso. CLASSIFICAÇÃO JEL: P42, J01, J54, Y90

ABSTRACT This document analyzes social cartography in the fishing sector of Oaxaca, Mexico. The main objective is to represent the fishing system through the identification of the key actors, their relationships and the territory The methodology included three phases: 1) documentary to establish the theoretical framework; 2) field, with the application of 110 surveys to fishermen using the snowball technique; and 3) results, with the analysis and presentation of the data. The main results show that the agri-food sector; to which the fishing sector belongs, faces challenges such as enhancing production, supply, transformation, marketing and distribution capacities. The main government, business and higher education actors involved were identified. Regarding the fishing system in Oaxaca, the political-legislative, geographical, sustainability and health, financial and commercial, human capital, productive and infrastructural contexts were mapped, as well as the regional context of the Coast and Isthmus areas. The importance of recognizing the historical relationships that have marked fishing in Mexico is highlighted, especially in Oaxaca, one of the states with the highest rates of poverty and backwardness. JEL CLASSIFICATION: P42, J01, J54, Y90

Hierdie sewe-jaar longitudinale opvoedingstudie evalueer drie akademiese afleweringsmodusse vir deeltydse MBA-studente in hul Bemarkingsbestuursmodule, naamlik vol kontak (20172019), vol aanlyn tydens COVID-19 se harde inperking (2020-2021 en die daaropvolgende gemengde modus (2022-2023). Die studie het ten doel om te bepaal of die afleweringsmodus studente se akademiese prestasie beduidend beïnvloed. Die eenrigting-variansie-analise (EVA) het beduidende verskille tussen die afleweringsmodusse vir individuele opdragte (normatiewe assessering) en groepgevallestudies (summatiewe assessering) geïdentifiseer. Daar was ook betekenisvolle verskille tussen die akademiese prestasie ten opsigte van die finale saamgestelde portefeulje van kennis (wat as eksamen dien). Hierdie portefeulje bestaan uit 'n prakties-toegepaste bemarkingsplan. Die post-hoc toetse het getoon dat studente aansienlik beter gevaar het tydens die gemengde afleweringsmodus in individuele opdragte, terwyl die volledige aanlyn modus laer punte vir die groepgevallestudies gehad het. Beide die gemengde en volledige kontakmodusse het beduidende opeenvolgende verbetering vir die groepgevallestudies getoon, wat in elke gevallestudie verbetering getoon het namate die semester gevorder het. Dit verskil van volledige aanlyn onderrig. Die gemengde modus het ook aansienlik beter gevaar in die eksamen- en finale modulepunte en het selfs beter gevaar as volkontakklasse.

The COVID-19 pandemic significantly transformed the tertiary education landscape. Traditional contact universities were forced abruptly to adopt a full-distance education mode, a situation neither the students nor lecturers were prepared for. Many lectures and teaching activities were developed on the fly as universities struggled to roll out the needed support in double-time for lecturers and students. This new normal for education required integrating technology, advanced communication software, revised assessment techniques, and recognising the need for flexible and adaptable approaches to teaching and learning. Students also evolved and gained technological proficiency, adaptability, time management, soft skills, social media proficiency, and an awareness of health and well-being. Albeit uncertain in redefining the new normal, universities continue to provide quality education. However, exactly how university education should be delivered to a new breed of students in a new business environment is a challenge. This is even more so in the case of executive MBA students. After the hard lockdown and restrictions were lifted on 21 September 2020, the North-West University Business School started to explore other modes of academic content delivery. Reinstating a full contact delivery mode was not an option because of remaining restrictions. High technological investment, online-educated lecturers and students, and benefits and developments during online learning now form a new normal for the Business School. Which teaching method, or rather, which mode of delivery, is the most relevant and adequate? Should the MBA lectures return to the historic full-contact delivery mode, stick with the newly established full online mode, or attempt to integrate the benefits of both into a hybrid mode of delivering business education to a new breed of technology-savvy students? This study, therefore, examines the academic performance of the different delivery modes by comparing data of Executive MBA Marketing management students at the NWU Business School in South Africa. The study examines the academic performance of these students from 2017 up to 2023. The panel database consists of Executive MBA students'marks for the module in Marketing Management from 2017 up to 2023. The database contains marks for individual assignments, groupwork case studies, final individual- and groupwork marks, exam marks and the final module mark. The final assessment is a portfolio of evidence comprising a detailed marketing plan for a product, service, or organisation of choice. The mode of delivery served as the dependent variable, while the independent variables comprised the marks for each assignment (groupwork, individual and portfolio of evidence). Three delivery modes were compared, namely full-contact (2017-2019), full-online (2020-2021), and the post-pandemic hybrid mode currently in effect (2022-2023). The data comprised 630 cases. However, the analysis of variance (ANOVA) used 532 cases to compare the different groupwork assignments (230 full-contact students, 159 full-online students, and 143 hybrid students). Cronbach's alpha coefficient measured the data's reliability, and one-way ANOVA determined significant differences (p<.05) between the academic performance of the three delivery modes. The analysis confirmed that significant differences exist between the modes of delivery for individual assignments, group case studies and exams (p<.05). The Tukey ab post-hoc tests showed that students performed significantly better during the hybrid delivery mode in individual assignments (69.2%) than full contact (63.8%). Regarding the individual assignment, the full online (63.8%) and full contact (63.7%) delivery modes perform significantly worse than the hybrid (69.2%) delivery mode. Regarding the first group case study (Group Assignment 1), full online performs (67.3%) significantly worse than hybrid (71.1%) and full contact (73.6%) delivery modes. There is no significant difference between the hybrid and full contact delivery modes. In the second, third, and fourth group case studies (Group Assignments 2, 3 & 4), the hybrid delivery mode (82.37%, 75.4%, 82.7%) outperforms the full contact (75.4, 80.1%, 86.6%) and full-online (71.4%, 71.4%, 67.8%) modes. The hybrid delivery mode, therefore, proves to be more conducive towards academic performance in group work. Finally, in considering the final module mark, the hybrid delivery mode (71.0%) is significantly higher than the other two delivery modes. However, there is no significant difference between full online (67.5%) and full-contact (67.2%) delivery modes regarding the final module mark. Nevertheless, it is noteworthy that the better performance in the final module marks is a function of the groupwork where the students analysed case studies together. There are no significant differences in the exam marks between the delivery modes, so better academic performance in the hybrid mode of delivery where groupwork is concerned culminates in the better module mark. Based on the findings, it is evident that the hybrid mode of delivery results in the best academic performance. This observation is based on three reasons, namely 1) students performed better in both the normative and summative assessments during hybrid tuition; 2) there is continuous progressive learning throughout the semester regarding the group case studies (summative assessment). They learn to improve and hone their skills to analyse better and apply business solutions to real-life problems experienced by organisations. This is based on students' improving marks in the group case studies as they become more proficient in analysing and answering the applied case studies because they learn from each case study; and 3) the students perform better academically in their normative assessments and earn higher final module marks (partially due to reason 2). It is concluded that the hybrid delivery mode facilitates the academic performance of post-pandemic executive MBA Marketing management students. JEL KODES: I23, I21, M30

Abstract Considering that currently in Mexico there is a trend toward greater consumption of natural products that benefit health and that, in the long term, do not produce adverse effects, the objective of this research is to evaluate if the main extracts and by-products derived from the roselle flower can be considered strategic, based on its properties, impact on health, value chain and that Mexico is one of the 10 main producers worldwide. For this, the following method was used: a) research on the roselle flower and its benefits to humans were compiled and analyzed; b) the information was analyzed with the Delphi tool; c) a dendrogram was developed to categorize the relevance in its use, and, d) the value chain of the processes that make up its supply chain was analyzed to determine its conditions and potential. The results show that it does not present toxic or mutagenic activity and that it has a great impact in 3 aspects: alternative medicine, as a disinfectant and food supplement. It was found that its value chain is incipient, but with potential in: planting regions, research centers and links with the industrial sector for its use, marketing and sales coverage.

Resumen Actualmente, en México existe la tendencia hacia un mayor consumo de productos naturales que beneficien la salud y a largo plazo no produzcan efectos negativos, por lo cual, el objetivo de esta investigación es evaluar si los principales extractos y subproductos de la flor de jamaica se pueden considerar estratégicos, en función de sus propiedades, impacto en la salud, cadena de valor, pues México es uno de los 10 principales productores a nivel mundial. Para esto, se utilizó el siguiente método: a) se recopilaron y analizaron investigaciones sobre la flor de jamaica y beneficios al ser humano; b) se analizó la información con la herramienta Delphi; c) se desarrolló un dendrograma para categorizar la relevancia en su uso, y, d) se determinaron las condiciones y potencial de la cadena de valor de los procesos que integran su cadena de suministro. Los resultados muestran que no presenta actividad tóxica o mutagénica y que tiene un gran impacto en 3 vertientes: medicina alternativa, como desinfectante y complemento alimenticio. Se encontró que su cadena de valor es incipiente, pero con potencial en: regiones de siembra, centros de investigación y vinculación con el sector industrial para su aprovechamiento, cobertura de comercialización y venta.

Resumen Introducción : Las consecuencias económicas de la cobertura obligatoria, vía judicial, de medicamentos de alto precio constituye un problema creciente, que amerita conocer sus características locales para aportar posibles soluciones. Objetivo : Identificar medicamentos, enfermedades, impacto económico y factores contextuales de la ju dicialización de medicamentos de alto precio (MEP) Argentina. Métodos : Estudio descriptivo cuali-cuantitativo que analizó retrospectivamente recursos de amparos legales por MEP de tres bases de datos nacionales y provinciales durante 4 años, evaluando relación existente entre am paros con aprobación regulatoria, inclusión de los MEP al paquete de beneficios y relación con notas periodísticas. Resultados : Se incluyeron 405 amparos provenientes principalmente del Ministerio de Salud Nacional. Los tres medicamentos más judicializados fueron nusiner sen (21.7%), palbociclib (5.9%) y agalsidasa-alfa (4.7%). Solo el 69.4% de los medicamentos se encontraban aprobados para la comercialización en Argentina al momento del amparo; el 45.7% se encontraban incorpo rados al Sistema Único de Reintegros y el 16.8% contaban con informe de la Comisión Nacional de Evaluación de Tecnologías Sanitarias y Excelencia Clínica (CONETEC), negativa en el 87.1% de casos. El tiempo promedio des de la solicitud hasta la provisión del medicamento fue de 150 días. Se observó una correlación temporal entre la aparición del MEP en la prensa nacional gráfica y la presentación de amparos de dicho MEP. Conclusiones : La judicialización se concentró en medicamentos de altísimo precio para enfermedades poco frecuentes u oncológicas. Los fallos fueron mayo ritariamente a favor del demandante, siendo los tiempos de acceso al medicamento prolongados. Los medios de comunicación anticiparon los procesos judiciales.

Abstract Introduction : The economic consequences of manda tory coverage, through judicial means, of high-priced medications constitutes a growing problem, which mer its knowing its local characteristics to provide possible solutions. Objective : To identify medications, diseases involved, economic impact and contextual factors of the judi cialization of high-priced medications in the Argentine Health System(MEP). Methods : Quali-quantitative descriptive study that retrospectively analyzed legal protection resources by MEP from three national and provincial databases from January 2017 to December 2020, evaluating the exist ing relationship between lawsuits with regulatory ap proval, inclusion in benefit packages and relationship with journalistic articles for the three most frequently prosecuted drugs. Results : 405 lawsuits were included, mainly from the Ministry of National Health. The three most prosecuted medications were nusinersen (21.7%), palbociclib (5.9%) and agalsidase-alfa (4.7%). Only 69.4% of medications were approved for marketing in Argentina at the time of the protection; 45.7% were incorporated into the Single Reimbursement System, and 16.8% had a report from the National Commission for the Evaluation of Health Technologies and Clinical Excellence (CONETEC), which was negative in 87.1% of cases. The average time from request to provision of the medication was 150 days. A temporal correlation was observed between the appear ance of the MEP in the national graphic press and the appeals occurrence. Conclusions : Judicialization focused on very high-priced medications for rare or oncological diseases. The rulings were mostly in favor of the plaintiff, and access times to the medication took a long time. The mass media anticipated the judicial processes.

Abstract Digital marketing is one of the dimensions of the food environment that increasingly influences eating habits. It is one of the factors contributing to increased consumption of out-of-home foods, which has been associated with negative health outcomes. In this context, the objective of the study was to analyze the content of Instagram posts featuring retail food outlets that sell prepared foods in Montevideo, the capital city of Uruguay. A multi-step approach to analyze Instagram posts of food outlets selling prepared foods available on a meal delivery app. A total of 293 Instagram accounts were identified, which generated 5,454 posts between August 15th, 2020, and February 15th, 2021. The visual and textual content of the posts were analyzed using deductive-inductive coding. Results showed that the great majority (80%) of the outlets available in the meal ordering app had an Instagram account, most of which (68%) posted content in their feed in the 6-months period considered in the present work. The Instagram accounts promoted a diversity of dishes, foods, and beverages; most of which typically contain excessive amounts of sugars, fat, saturated fats, and/or sodium (burger, pizza, ice-cream, sandwiches and wraps, pastries, cakes and desserts). Instagram posts included several marketing techniques to increase persuasiveness, including price promotions, and cues to establish interactions with users. The visual and textual content of the posts promoted the food outlets by referring to a wide range of topics, which can be regarded as an attempt to maximize the persuasiveness of the post by triggering both systematic and heuristic information processing. These results show that marketing of food outlets selling prepared foods on Instagram is a relevant characteristic of the digital food environment that needs to be addressed as part of comprehensive marketing regulations.

Resumen El marketing digital es una de las dimensiones de los entornos alimentarios que influye de forma creciente en los hábitos alimentarios. Es uno de los factores que contribuyen al aumento del consumo de alimentos fuera del hogar, el cual se ha asociado a resultados negativos para la salud. En este contexto, el objetivo del estudio fue analizar el contenido de las publicaciones en Instagram de establecimientos minoristas que venden alimentos preparados en Montevideo, la capital de Uruguay. Se utilizó un enfoque de múltiples pasos para analizar las publicaciones de Instagram de los establecimientos de comida que venden comidas preparadas disponibles en una aplicación de pedidos de comidas. Se identificaron 293 cuentas de Instagram, que generaron 5.454 publicaciones entre el 15 de agosto de 2020 y el 15 de febrero de 2021. El contenido visual y textual de las publicaciones se analizó mediante codificación deductiva-inductiva. Los resultados mostraron que la gran mayoría (80%) de los establecimientos disponibles en la aplicación de pedidos de comida tenían una cuenta de Instagram, la mayoría de los cuales (68%) publicaron contenido en el periodo de 6 meses considerado en el presente trabajo. Las cuentas de Instagram promocionaron una gran variedad de platos, alimentos y bebidas, la mayoría de los cuales suelen contener una cantidad excesiva de azúcares, grasas, grasas saturadas y/o sodio (hamburguesas, pizzas, helados, sándwiches y wraps, bollería, pasteles y postres). Las publicaciones incluyeron varias técnicas de marketing para aumentar la capacidad de persuasión, tales como promociones de precios y pistas para establecer interacciones con los usuarios. El contenido visual y textual de las publicaciones promocionaba los establecimientos de comida haciendo referencia a una amplia gama de temas, lo que puede considerarse como un intento de maximizar la persuasión de las publicaciones mediante la activación de un procesamiento de la información tanto sistemático como heurístico. Estos resultados muestran que el marketing digital de establecimientos de comida que venden alimentos preparados es una característica relevante de los entornos alimentarios digitales que debe abordarse como parte de una normativa integral de regulación de publicidad.

Abstract Objective To carry out a narrative review on the use of marketing strategies in child nutrition, as well as potential implications for health professionals and children. Data source Searches were carried out on the PubMed, SciELO, and Google platforms, using the terms “child nutrition” or “industrialized baby food” or “infant formula” or “breast milk” or “breastfeeding” and “marketing”, with original articles, review articles, institutional reports, institutional position documents and websites considered relevant to the topic being analyzed. Data synthesis Children's food marketing started with the industrialization of food and the resulting actions aimed at increasing sales and meeting commercial interests. Since its inception to the present, infant formulas have been the most widely used products, which has impacted breastfeeding practices. International and national institutions, that care for children's health, are searching for strategies to limit the abusive marketing of industrialized children's foods. Marketing strategies interfere with medical knowledge and actions, potentially influencing the guidance provided by pediatricians to families, and finally, compromising healthy eating practices at a critical period in life, with possible long-term effects. Conclusions Health professionals, especially pediatricians, must provide the best care for children and families, and need to maintain the search for quality scientific information, not influenced by conflicts of interest. Updated and critical knowledge on the part of healthcare professionals can curb marketing strategies that aim to influence their actions. nutrition PubMed SciELO platforms formula breast milk “breastfeeding marketing, , “marketing” articles reports analyzed Childrens Children s interests present products institutions childrens foods families finally life longterm long term effects information interest “marketing

RESUMEN El cacao ha aportado sustanciales ingresos a la economía ecuatoriana, al punto de llamársele “pepa de oro” desde el siglo XIX, por ser la base de las primeras industrias y entidades bancarias y dinamizador del desarrollo socio-económico. En la cadena de producción y comercialización cacaotera intervienen múltiples actores, estableciéndose interrelaciones para posicionar los productos del cacao en el mercado interno, pero destinando la mayor parte a la exportación. Este estudio analiza el proceso de comercialización de productos a partir de la identificación de sus principales canales. Sobre la base de una metodología mixta con enfoque descriptivo, se caracterizó el producto y su comercialización a partir de los resultados de una encuesta a actores del sector comercio de la provincia de Manabí. Se demuestra la preferencia por el consumo de productos del cacao procedentes de distribuidoras locales con políticas de pago flexibles, ciclos operativos de reposición de productos y respetuosas de las normativas legales y sanitarias. Entre los derivados con mayor consumo se encuentra el chocolate en polvo y el chocolate en barra, con preferencias hacia los envases en funda y sachets. Los resultados pueden ser generalizados a otras localidades, para potenciar la comercialización de productos derivados del cacao.

ABSTRACT Cocoa has contributed substantial income to the Ecuadorian economy, to the point of being called “golden nugget” since the 19th century, for being the basis of the first industries and banking entities and driving socio-economic development. Multiple actors intervene in the cocoa production and marketing chain, establishing interrelationships to position cocoa products in the domestic market, but allocating the majority to export. This study analyzes the product marketing process by identifying its main channels. Based on a mixed methodology with a descriptive approach, the product and its marketing were characterized based on the results of a survey of actors in the commerce sector in the province of Manabí. The preference for the consumption of cocoa products from local distributors with flexible payment policies, operational product replacement cycles and respect for legal and health regulations is demonstrated. Among the derivatives with the greatest consumption are chocolate powder and chocolate bars, with preferences towards packaging in cases and sachets. The results can be generalized to other locations, to enhance the marketing of cocoa products.

Abstract The aim of this study was to characterize in the retail outlets the marketing strategies used in food and non-alcoholic beverages aimed at children, adolescents, and their parents or guardians (shoppers) which influence the purchase of products of high energy content and low nutritional value in Costa Rica. Data collection was carried out in 2018 with an observation guide applied at the retail outlets (RO) (n: 12) and a questionnaire aimed at parents or guardians (shoppers) (n: 72) of the child and adolescent population. The study found that the marketing strategy most frequently used in the entry, cash and exit area the retail outlets was price reduction (79,0, 87.5 and 88,0%, respectively).There is a frequent and varied use of marketing strategies in retail outlets for calorie-dense food products with an excess of critical nutrients that are relevant in public health due to their association with obesity and non-communicable diseases.

Resumen El objetivo del presente estudio fue caracterizar en los puntos de venta de Costa Rica las estrategias de mercadeo utilizadas en alimentos y bebidas no alcohólicas dirigidas a la población infantil, adolescente y a sus padres o tutores (compradores), que influyen en la compra de productos de alto contenido energético y bajo valor nutricional. La recolección de datos se realizó en el 2018 mediante una guía de observación aplicada al punto de venta (n:12) y un cuestionario dirigido a los padres o tutores (n: 72) de la población infantil y adolescente. Se encontró que la estrategia de mercadeo utilizada con mayor frecuencia en el área de entrada, caja y salida del punto de venta fue la reducción de precios (79,0; 87,5 y 88,0%, respectivamente). En los puntos de venta existe un empleo frecuente y variado de estrategias de mercadeo de productos alimenticios densamente calóricos y con un exceso de nutrientes críticos que son relevantes en salud pública por su asociación con la obesidad y enfermedades no transmisibles.

Abstract Despite of the global unity against COVID-19 pandemic, the threat of SARS-CoV-2 variants on the lives of human being is still not over. SARS-CoV-2 pandemic has urged the need of rapid viral detection at earliest. To cope with gradually expanding scenario of SARS-CoV-2, accurate diagnosis is extremely crucial factor which should be noticed by international health organizations. Limited research followed by sporadic marketing of SARS-CoV-2 rapid pharmaceutical detection kits raises critical questions against quality assurance and quality control measures. Herein we aimed to interrogate effectivity and specificity analysis of SARS-CoV-2 pharmaceutical rapid detection kits (nasopharyngeal swab based) using conventional gold standard triple target real-time polymerase chain reaction (USFDA approved). A cross-sectional study was conducted over 1500 suspected SARS-CoV-2 patients. 100 real time-PCR confirmed patients were evaluated for pharmaceutical RDT kits based upon nasopharyngeal swab based kits. The SARS-CoV-2 nasopharyngeal swab based rapid diagnostic kit (NSP RDTs) analysis showed 78% reactivity. Among real time PCR confirmed negative subjects, 49.3% represented false positivity. The positive predictive analysis revealed 67.82%, while negative predictive values were 64.40%. The NSP RDTs showed limited sensitivities and specificities as compared to gold standard real time PCR. Valid and authentic detection of SARS-CoV-2 is deemed necessary for accurate COVID-19 surveillance across the globe. Current study highlights the potential consequences of inadequate detection of SARS-CoV-2 and emerging novel mutants, compromising vaccine preventable diseases. Current study emphasizes need to wake higher authorities including strategic organizations for designing adequate measures to prevent future SARS-CoV-2 epidemics. COVID19 COVID 19 COVID-1 SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- earliest SARSCoV2, 2, realtime USFDA approved. approved . approved) crosssectional cross sectional 150 10 timePCR 78 reactivity subjects 493 49 3 49.3 positivity 6782 67 82 67.82% 6440 64 40 64.40% globe mutants diseases epidemics COVID1 1 COVID- SARS-CoV 15 7 4 49. 678 6 8 67.82 644 64.40 67.8 64.4 67. 64.

Resumo Apesar da unidade global contra a pandemia de COVID-19, a ameaça das variantes do SARS-CoV-2 na vida do ser humano ainda não acabou. A pandemia de SARS-CoV-2 alertou para a necessidade de detecção viral rápida o mais cedo possível. Para lidar com o cenário de expansão gradual do SARS-CoV-2, o diagnóstico preciso é um fator extremamente crucial que deve ser observado pelas organizações internacionais de saúde. Pesquisa limitada seguida de comercialização esporádica de kits de detecção farmacêutica rápida de SARS-CoV-2 levanta questões críticas contra a garantia de qualidade e as medidas de controle de qualidade. Aqui, objetivamos questionar a eficácia e a análise de especificidade dos kits farmacêuticos de detecção rápida de SARS-CoV-2 (baseados em swab nasofaríngeo) usando a técnica de reação em cadeia da polimerase em tempo real padrão-ouro convencional (aprovado pelo USFDA). Um estudo transversal foi realizado em 1.500 pacientes suspeitos de SARS-CoV-2. Cem pacientes confirmados por PCR em tempo real foram avaliados para kits farmacêuticos de RDT baseados em kits baseados em swabs nasofaríngeas. A análise do kit de diagnóstico rápido baseado em swab nasofaríngeo SARS-CoV-2 (NSP RDTs) mostrou 78% de reatividade. Entre os indivíduos negativos confirmados por PCR em tempo real, 49,3% representaram falsa positividade. A análise preditiva positiva revelou 67,82%, enquanto os valores preditivos negativos foram de 64,40%. Os NSP RDTs mostraram sensibilidades e especificidades limitadas em comparação com a PCR em tempo real padrão-ouro. A detecção válida e autêntica do SARS-CoV-2 é considerada necessária para a vigilância precisa de COVID-19 em todo o mundo. O estudo atual destaca as possíveis consequências da detecção inadequada de SARS-CoV-2 e novos mutantes emergentes, comprometendo doenças evitáveis por vacina. O estudo atual enfatiza a necessidade de alertar autoridades superiores, incluindo organizações estratégicas, para projetar medidas adequadas para prevenir futuras epidemias de SARS-CoV-2. COVID19, COVID19 COVID 19, 19 SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- acabou possível SARSCoV2, 2, saúde Aqui padrãoouro padrão ouro aprovado USFDA. USFDA . USFDA) 1500 1 500 1.50 SARSCoV2. 2. nasofaríngeas 78 reatividade 493 49 3 49,3 positividade 6782 67 82 67,82% 6440 64 40 64,40% padrãoouro. ouro. COVID-1 mundo emergentes vacina superiores estratégicas COVID1 SARS-CoV 150 50 1.5 7 4 49, 678 6 8 67,82 644 64,40 COVID- 15 5 1. 67,8 64,4 67, 64,

RESUMEN Se estimaron las tendencias en la prevalencia de la obesidad y el sobrepeso en estudiantes chilenos de educación primaria y secundaria, antes y después de las regulaciones introducidas en Chile en el 2016 sobre la comercialización y disponibilidad de productos hipercalóricos, con un alto contenido de azúcares, sodio o grasas saturadas. Se utilizaron datos del Mapa Nutricional de Chile, una encuesta en la que se midió el índice de masa corporal (IMC) de la población estudiantil de las escuelas públicas. Tomando los umbrales de IMC definidos por la Organización Mundial de la Salud, se calculó la prevalencia del sobrepeso y la obesidad para cada año entre el 2013 y el 2019 en estudiantes de jardín de infancia (4 años), preescolar (5 años), primer grado (6 años) y noveno grado (14 años). En los estudiantes de noveno grado, la prevalencia del sobrepeso y la obesidad aumentó en 2 puntos porcentuales durante los 3 años posteriores a la introducción de las regulaciones del 2016. En el caso de los grupos de jardín de infancia, preescolar y primer grado, el sobrepeso y la obesidad disminuyeron entre 1 y 3 puntos porcentuales un año después de la introducción de las regulaciones, pero al año siguiente volvieron a los niveles anteriores. La introducción de las regulaciones alimentarias de Chile no estuvo seguida de una disminución continua de la obesidad en la población estudiantil de primaria y secundaria. En las investigaciones futuras se deberá examinar si la población infantil de Chile y otros países mantiene niveles altos de sobrepeso y obesidad a pesar de las regulaciones alimentarias diseñadas para reducir el consumo de productos y bebidas obesogénicos, así como las características específicas que adopta este problema de salud.

ABSTRACT We estimated trends in the prevalence of obesity and overweight among Chilean primary and secondary students before and after Chile’s 2016 regulations on the marketing and availability of foods high in energy, total sugars, sodium, or saturated fat. We used data from Chile’s Survey of Nutrition, which measured the body mass index (BMI) of students in government-funded schools. Using BMI thresholds defined by the World Health Organization, we calculated the prevalence of overweight and obesity for each year from 2013 to 2019 among students attending pre-kindergarten (age 4 years), kindergarten (age 5 years), first grade (6 years), and ninth grade (14 years). In ninth grade students, overweight and obesity prevalence rose by 2 percentage points over the 3 years after introduction of the 2016 regulations. In pre-kindergarten, kindergarten, and first grade, overweight and obesity fell 1 to 3 percentage points 1 year after the regulations were introduced, but rebounded to previous levels the next year. Chile’s food regulations were not followed by a sustained decline in obesity in primary- and secondary-school students. Future research should examine whether and how children in Chile and other countries maintain high levels of overweight and obesity despite food regulations designed to reduce consumption of obesogenic foods and beverages.

RESUMO Foram estimadas tendências de prevalência da obesidade e do sobrepeso em alunos chilenos do ensino fundamental e médio antes e depois da regulamentação de 2016 da propaganda e disponibilidade de alimentos com alto teor calórico ou ricos em açúcares totais, sódio ou gorduras saturadas no Chile. Foram utilizados dados obtidos da Pesquisa em Nutrição do Chile, que aferiu o índice de massa corporal (IMC) de escolares da rede pública. Com base nos limiares de IMC definidos pela Organização Mundial da Saúde (OMS), calculou-se a prevalência anual de sobrepeso e obesidade em crianças na pré-escola (4 anos), no jardim da infância (5 anos), no primeiro ano (6 anos) e no nono ano (14 anos) em cada ano no período entre 2013 e 2019. Entre os alunos do nono ano, a prevalência de sobrepeso e obesidade aumentou 2 pontos percentuais nos 3 anos que se seguiram à introdução da regulamentação de 2016. Entre os alunos da pré-escola, do jardim de infância e do primeiro ano, ocorreu uma redução de 1 a 3 pontos percentuais na prevalência de sobrepeso e obesidade um ano após a introdução da regulamentação, mas os níveis voltaram a subir no ano seguinte. A regulamentação de alimentos não resultou em um declínio sustentado da obesidade nos alunos do ensino fundamental e médio do Chile. Pesquisas futuras devem ser realizadas para avaliar se, e como, a prevalência de sobrepeso e obesidade nas crianças chilenas e de outros países se mantém alta a despeito da regulamentação de alimentos visando à redução do consumo de alimentos e bebidas obesogênicos.

RESUMEN Introducción: La vacunación ha sido una de las intervenciones sanitarias más costo-efectivas, por su impacto en el control de las enfermedades inmunoprevenibles. La pandemia ocasionada por SARS-CoV-2 condujo al desarrollo mundial de más de doscientas vacunas en diferentes fases de investigación con diversas plataformas. Objetivo: Caracterizar la evaluación del control de calidad de las vacunas contra SARS-CoV-2 y los eventos adversos de las aprobadas contra otros agentes patógenos en las diferentes etapas del ensayo preclínico y clínico. Métodos: Se realizó una búsqueda en Google Académico y PubMed/Medline de artículos publicados entre 1969 y marzo de 2021. Se seleccionaron los de mayor relevancia. Desarrollo: Las vacunas se desarrollaron en un corto tiempo ante la pandemia de COVID-19, sin comprometer el adecuado control de los ensayos clínicos. Aunque resultan seguras, no están exentas de eventos adversos; por ello se debe vigilar su seguridad durante el proceso de poscomercialización. Muchas de ellas han comprometido su seguridad. Conclusiones: Las vacunas deben poseer inmunogenicidad, eficacia y seguridad comprobadas. Los eventos adversos pueden surgir en cualquier etapa de la investigación; por tanto, resulta fundamental la vigilancia en la fase de poscomercialización.

ABSTRACT Introduction: Vaccination has been one of the most cost-effective health interventions, due to its impact on the control of immunopreventable diseases. The pandemic caused by SARS-CoV-2 led to the worldwide development of more than two hundred vaccines in different phases of research with diverse platforms. Objective: To characterize the quality control assessment of vaccines against SARS-CoV-2 and adverse events of those approved against other pathogens at different stages of preclinical and clinical trials. Methods: We searched Google Scholar and PubMed/Medline for articles published between 1969 and March 2021. The most relevant articles were selected. Development: Vaccines were developed in a short time in the face of the COVID-19 pandemic, without compromising the adequate control of clinical trials. Although they are safe, they are not free of adverse events; therefore, their safety should be monitored during the post-marketing process. Many of them have compromised their safety. Conclusions: Vaccines should possess proven immunogenicity, efficacy and safety. Adverse events can arise at any stage of research; therefore, post-marketing surveillance is essential.

ABSTRACT This research analyzes the improvement of the health service through applications for the patient through the personal digital space My Health, which allows citizens to have their health information and other services online to improve the patient -doctor relationship. A case study was carried out at Sant Llorenç de Viladecans hospital, focused on My Health application, whose function is, precisely, to improve promotion strategies to address aspects such as the expectations, needs or client characteristics. The results showed that Mi Salud App improves the patient satisfaction rate; older users tend to use the application more, despite a certain lack of knowledge about the app, and the use of private data is a secondary issue for them. Generally, it is concluded that this type of tools is effective in achieving such objectives, so it is advisable to delve into their use to streamline and to improve services.

RESUMEN En esta investigación se analiza la mejora del servicio de la salud mediante aplicaciones para el paciente, a través del espacio digital personal Mi Salud, que permite a la ciudadanía disponer de su información de salud y de otros servicios en línea para mejorar la relación médico-paciente. Se realizó un estudio de caso en el hospital Sant Llorenç de Viladecans, focalizado en la aplicación Mi Salud, cuya función es, precisamente, mejorar las estrategias de promoción para abordar aspectos como las expectativas, necesidades o características de los clientes. Los resultados mostraron que Mi Salud mejora el índice de satisfacción de los pacientes; que los usuarios de más edad tienden a utilizar más la aplicación, pese a cierto desconocimiento sobre la app, y que el uso de los datos privados es una cuestión secundaria para estos. De manera global se concluye que este tipo de herramientas son eficaces para la consecución de tales objetivos, por lo que resulta recomendable ahondar en su uso para la agilización y mejora de los servicios.

ABSTRACT Introduction: Periodization allows us to analyze the history of processes and recognize relevant changes from the present. The Cuban HIV prevention strategy has national and international results, however, there are few publications on its historical course. Objectives: Describe the periods and milestones that characterize the HIV prevention strategy. Method: The methodology was qualitative, the techniques of participant observation, documentary review and expert interviews are used. Results: From 1983 to 2021, four periods were identified, called preparation and first steps; strengthening the strategy; decentralization of prevention and post-COVID-19 reorientation actions and services. The milestones were identified in the areas of epidemiological surveillance, social marketing of condoms, intersectorality, and the care and participation of key populations. Conclusions: The periodization of the strategy shows different approaches applied over time, the spiral development of the different actors in society towards social inclusion and the participation of the social sectors and government. The milestones make visible the transition of the HIV prevention strategy from a vision predominantly focused on the provision of health services by the health sector to a shared perspective, with key populations, the social sectors and the government.

RESUMEN Introducción: La periodización permite analizar la historia de los procesos y reconocer desde el presente los cambios relevantes. La estrategia cubana de prevención del VIH tiene resultados nacionales e internacionales, sin embargo, existen pocas publicaciones sobre su decursar histórico. Objetivos: Describir los períodos e hitos que caracterizan la estrategia de prevención del VIH. Método: Se utilizó el método cualitativo, con técnicas de observación participante, revisión documental y entrevista a expertos. Resultados: De 1983 a 2022, se identificaron cuatro períodos, denominados preparación y primeros pasos; fortalecimiento de la estrategia; descentralización de las acciones y servicios de prevención y reorientación post COVID-19. Los hitos se identificaron en las áreas de vigilancia epidemiológica, mercadeo social de condones, intersectorialidad y la atención y participación de las poblaciones clave. Conclusiones: La periodización de la estrategia muestra diferentes enfoques aplicados a través del tiempo, el desarrollo en espiral de los diferentes actores de la sociedad hacia la inclusión social y la participación de los sectores sociales y gobierno. Los hitos visibilizan el tránsito de la estrategia de prevención del VIH desde una visión predominantemente centrada en la provisión de servicios de salud por el sector sanitario a una perspectiva compartida, con las poblaciones clave los sectores sociales y gobierno.

Se analizan las dinámicas de la regionalización en municipios rurales remotos y las posibles implicaciones de las brechas de la atención en la comercialización de la salud. Se trata de un estudio de caso múltiple, con enfoque cualitativo, que realizó 76 entrevistas semiestructuradas a los gestores del municipio, de la región y del estado. Los resultados mostraron que, principalmente en los estados de la Región Norte, el diseño regional no reflejó la dinámica social de las poblaciones y creó flujos inadecuados y rutas indeseables. La agenda política municipal frecuentemente priorizó intereses dispares a la regionalización y los temas de ruralidad no movilizaron a los gestores para construir una planificación regional específica. Las enmiendas parlamentarias fueron esenciales para invertir en sanidad, y los gestores señalaron las relaciones clientelares para obtener estos recursos, muchas veces condicionadas por el alineamiento político-ideológico. La escasez de servicios públicos favoreció la dependencia del sector privado y la comercialización de la salud en diferentes situaciones. Las grandes distancias y la falta de servicios públicos en las cercanías de municipios rurales remotos hicieron que la oferta del Sistema Único de Salud local dependiera eminentemente del contrato con proveedores privados que negociaban al por menor o mediante paquetes de servicios. Finalmente, ante las necesidades no cumplidas y las brechas de atención, en los municipios rurales remotos, los agentes del mercado de la salud (empresas proveedoras de insumos, consultorías, profesionales de la salud y servicios de transporte) ocuparon las brechas en la prestación pública mediante muchas veces el control de los precios, de la oferta y de la disponibilidad de los servicios.

This article analyzed the dynamics of regionalization in municipalities within hinterlands and the possible implications of gaps in care for the marketing of health. This is a multiple case study with a qualitative approach, involving 76 semi-structured interviews with municipal, regional, and state managers. The results show that, particularly in the Northern states, the regional scheme did not reflect the social dynamics of the populations and created inadequate flows and unwanted routes. The municipal political agenda often prioritized interests other than that of regionalization, and rural problems did not mobilize managers to build specific regional planning. Parliamentary amendments were essential for investment in healthcare and the managers pointed to clientelistic relationships to obtain such resources, often conditioned by political-ideological alignment. The scarcity of public services favored dependence on the private sector and the commercialization of health in different situations. The great distances and the lack of public services in municipalities in the hinterland made the local public health system offer eminently dependent on contracts with private providers who negotiated on a retail basis or via service packages. Lastly, in the wake of unmet needs and gaps in care in remote rural municipalities, players in the healthcare market ₋ companies supplying inputs, consultants, healthcare professionals, and transportation services ₋ filled the gaps in public provision, sometimes controlling prices, supply and availability of services.

Analisam-se a dinâmica da regionalização em municípios rurais remotos e as possíveis implicações dos vazios assistenciais na comercialização da saúde. Trata-se de um estudo de casos múltiplos, com abordagem qualitativa, por meio de 76 entrevistas semiestruturadas com gestores municipais, regionais e estaduais. Os resultados revelam que, particularmente nos estados da Região Norte, o desenho regional não repercutia a dinâmica social das populações e criava fluxos inadequados e rotas indesejadas. A agenda política municipal priorizava, muitas vezes, interesses díspares à regionalização e as questões da ruralidade não mobilizavam os gestores para a construção de um planejamento regional específico. Emendas parlamentares ocupavam um lugar imprescindível para o investimento em saúde e os gestores apontaram relações clientelistas para obter tais recursos, condicionada e corriqueiramente, pelo alinhamento político-ideológico. A escassez de serviços públicos favorecia a dependência do setor privado e a comercialização da saúde em diferentes situações. As grandes distâncias e a ausência de serviços públicos nas proximidades dos municípios rurais remotos tornavam a oferta do Sistema Único de Saúde (SUS) local eminentemente dependente do contrato com prestadores privados que negociavam no varejo ou por meio de pacotes de serviços. Por fim, na esteira das necessidades não atendidas e dos vazios assistenciais, nos municípios rurais remotos, agentes do mercado da saúde - empresas de fornecimento de insumos, consultorias, profissionais de saúde e serviços de transporte - ocupavam as brechas da provisão pública, algumas vezes controlando preços, oferta e disponibilidade dos serviços.

Analisam-se a dinâmica da regionalização em municípios rurais remotos e as possíveis implicações dos vazios assistenciais na comercialização da saúde. Trata-se de um estudo de casos múltiplos, com abordagem qualitativa, por meio de 76 entrevistas semiestruturadas com gestores municipais, regionais e estaduais. Os resultados revelam que, particularmente nos estados da Região Norte, o desenho regional não repercutia a dinâmica social das populações e criava fluxos inadequados e rotas indesejadas. A agenda política municipal priorizava, muitas vezes, interesses díspares à regionalização e as questões da ruralidade não mobilizavam os gestores para a construção de um planejamento regional específico. Emendas parlamentares ocupavam um lugar imprescindível para o investimento em saúde e os gestores apontaram relações clientelistas para obter tais recursos, condicionada e corriqueiramente, pelo alinhamento político-ideológico. A escassez de serviços públicos favorecia a dependência do setor privado e a comercialização da saúde em diferentes situações. As grandes distâncias e a ausência de serviços públicos nas proximidades dos municípios rurais remotos tornavam a oferta do Sistema Único de Saúde (SUS) local eminentemente dependente do contrato com prestadores privados que negociavam no varejo ou por meio de pacotes de serviços. Por fim, na esteira das necessidades não atendidas e dos vazios assistenciais, nos municípios rurais remotos, agentes do mercado da saúde - empresas de fornecimento de insumos, consultorias, profissionais de saúde e serviços de transporte - ocupavam as brechas da provisão pública, algumas vezes controlando preços, oferta e disponibilidade dos serviços. Analisamse Analisam se Tratase Trata múltiplos qualitativa 7 municipais estaduais Norte indesejadas priorizava específico recursos corriqueiramente políticoideológico. políticoideológico político ideológico. ideológico político-ideológico situações SUS (SUS fim insumos consultorias pública preços

Se analizan las dinámicas de la regionalización en municipios rurales remotos y las posibles implicaciones de las brechas de la atención en la comercialización de la salud. Se trata de un estudio de caso múltiple, con enfoque cualitativo, que realizó 76 entrevistas semiestructuradas a los gestores del municipio, de la región y del estado. Los resultados mostraron que, principalmente en los estados de la Región Norte, el diseño regional no reflejó la dinámica social de las poblaciones y creó flujos inadecuados y rutas indeseables. La agenda política municipal frecuentemente priorizó intereses dispares a la regionalización y los temas de ruralidad no movilizaron a los gestores para construir una planificación regional específica. Las enmiendas parlamentarias fueron esenciales para invertir en sanidad, y los gestores señalaron las relaciones clientelares para obtener estos recursos, muchas veces condicionadas por el alineamiento político-ideológico. La escasez de servicios públicos favoreció la dependencia del sector privado y la comercialización de la salud en diferentes situaciones. Las grandes distancias y la falta de servicios públicos en las cercanías de municipios rurales remotos hicieron que la oferta del Sistema Único de Salud local dependiera eminentemente del contrato con proveedores privados que negociaban al por menor o mediante paquetes de servicios. Finalmente, ante las necesidades no cumplidas y las brechas de atención, en los municipios rurales remotos, los agentes del mercado de la salud (empresas proveedoras de insumos, consultorías, profesionales de la salud y servicios de transporte) ocuparon las brechas en la prestación pública mediante muchas veces el control de los precios, de la oferta y de la disponibilidad de los servicios. múltiple cualitativo 7 municipio estado Norte indeseables específica sanidad recursos políticoideológico. políticoideológico político ideológico. ideológico político-ideológico situaciones Finalmente empresas insumos consultorías transporte precios

This article analyzed the dynamics of regionalization in municipalities within hinterlands and the possible implications of gaps in care for the marketing of health. This is a multiple case study with a qualitative approach, involving 76 semi-structured interviews with municipal, regional, and state managers. The results show that, particularly in the Northern states, the regional scheme did not reflect the social dynamics of the populations and created inadequate flows and unwanted routes. The municipal political agenda often prioritized interests other than that of regionalization, and rural problems did not mobilize managers to build specific regional planning. Parliamentary amendments were essential for investment in healthcare and the managers pointed to clientelistic relationships to obtain such resources, often conditioned by political-ideological alignment. The scarcity of public services favored dependence on the private sector and the commercialization of health in different situations. The great distances and the lack of public services in municipalities in the hinterland made the local public health system offer eminently dependent on contracts with private providers who negotiated on a retail basis or via service packages. Lastly, in the wake of unmet needs and gaps in care in remote rural municipalities, players in the healthcare market ₋ companies supplying inputs, consultants, healthcare professionals, and transportation services ₋ filled the gaps in public provision, sometimes controlling prices, supply and availability of services. approach 7 semistructured semi structured states routes planning resources politicalideological ideological alignment situations packages Lastly inputs consultants professionals provision prices