Este artigo analisou a gestão federal da Política Nacional de Atenção Integral Saúde do Homem (PNAISH) sob uma perspectiva histórico-crítica. Foi realizada análise documental do processo de implementação da política entre 2009 e 2024 contido no arquivo da Coordenação de Atenção à Saúde do Homem (COSAH). A análise de conteúdo resultou nas seguintes categorias temáticas: organização e gestão da COSAH; processo de revisão da PNAISH; e desafios e frentes estratégicas para a implementação da PNAISH. Foram encontradas fragilidades na institucionalização da coordenação, além de uma revisão da política, em 2021, marcada pelo discurso neoconservador, que excluiu as menções a gênero e direitos sexuais e reprodutivos. Esses princípios epistemológicos da PNAISH foram retomados em 2023 com ações de qualificação da Atenção Primária para abordagem das repercussões do machismo e do patriarcado sobre a saúde de homens, mulheres e crianças.

Este artículo analizó la gestión federal de la Política Nacional de Atención Integral Salud del Hombre (PNAISH), bajo una perspectiva histórico-crítica. Se realizó un análisis documental del proceso de implementación de la política entre 2009 y 2024, contenida en el archivo de la Coordinación de Atención a la Salud del Hombre (COSAH). El análisis de contenido resultó en las siguientes categorías temáticas: organización y gestión de la COSAH; proceso de revisión de la PNAISH; y desafíos y frentes estratégicos para la implementación de la PNAISH. Se encontraron fragilidades en la institucionalización de la coordinación, además de una revisión de la política, en 2021, marcada por el discurso neoconservador que excluyó las menciones a género y derechos sexuales y reproductivos. Esos principios epistemológicos de la PNAISH se retomaron en 2023 a partir de acciones de calificación de la atención primaria para el abordaje de las repercusiones del machismo y del patriarcado sobre la salud de hombres, mujeres y niños.

This study analyzed federal government management of the National Policy for Comprehensive Men's Health Care (PNAISH) from a critical historical perspective. We analyzed documents addressing the policy implementation process between 2009 and 2024 contained in the archives of the National Office for the Coordination of Men’s Healthcare (COSAH). The content analysis resulted in the following thematic categories: COSAH organization and management; the PNAISH review process; and challenges and key strategic areas for implementing the PNAISH. We found weaknesses in the institutionalization of coordination, in addition to a policy review in 2021 marked by neoconservative discourse excluding gender and sexual and reproductive rights. These epistemological principles of the PNAISH were revisited in 2023, stemming from actions to improve the quality of primary care addressing the effects of machismo and patriarchy on men’s, women’s and children’s health.

Abstract Despite the implementation of preventive care services in the workplace, resistance persists among female survivors of female survivors of intimate partner violence (VAW) to seek help. In this context, a study was conducted with the aim of determining the prevalence of VAW and the factors associated with the intention to seek help among these workers. The study employed a quantitative approach with a descriptive-correlational design and was conducted with a sample of 142 female employees from a bank in La Paz, Bolivia, which has developed initiatives to prevent VAW. The findings revealed that 45.1% of the workers had experienced some form of violence from their partners or ex-partners throughout their relationships. Additionally, factors directly related to the intention to seek help were identified, such as attitudes that disapprove of self-sufficiency in resolving these cases (rs = .390; p < .05) and a state of complacency that minimizes the importance of addressing the problem (rs = .369; p < .05). It is concluded that, beyond sociodemographic factors, erroneous beliefs limit the intention to seek help through available support channels within the organization or other specialized centers.

Resumen A pesar de la implementación de servicios de atención preventiva en el lugar de trabajo, persiste la resistencia entre las trabajadoras sobrevivientes de violencia contra las mujeres (VcM) en relaciones de pareja a buscar ayuda. En este contexto, se realizó una investigación con el objetivo de determinar la prevalencia de VcM y los factores relacionados con la intención de buscar ayuda entre estas trabajadoras. El enfoque del estudio es cuantitativo con un diseño descriptivo-correlacional, y se realizó en una muestra de 142 funcionarias de un banco en La Paz, Bolivia que ha desarrollado iniciativas para prevenir la VcM. Los hallazgos revelaron que el 45,1 % de las trabajadoras había experimentado algún tipo de violencia por parte de sus parejas o exparejas a lo largo de su relación. Además, se identificaron factores relacionados de forma directa con la intención de buscar ayuda, tales como las actitudes que desaprueban la autosuficiencia en la resolución de estos casos (rs = .390; p<0.05) y un estado de conformismo que minimiza la importancia de afrontar el problema (rs= .369; p<0.05). Se concluye que, más allá de los factores sociodemográficos, son las creencias erróneas las que limitan la intención de buscar ayuda en los canales de atención disponibles dentro de la organización o en otros centros especializados.

Abstract The International Monetary Fund (IMF) and the Argentine State have maintained a close and constant relationship since 1957, especially, in times of economic crisis. This article studies the last financial assistance the country received from the international organization in 2018, debt renegotiated between 2022-2023. Using official data, recent bibliography and press releases, the findings suggest from a historical and sociological approach that the economic and social problems that affect the country in a cyclical manner, are not the result of its relationship with the IMF, but rather, of the inability of the business class and political authorities to exercise control over its economic policy. Indebtedness is a mechanism that compensates for the productive backwardness of the economy, hyperinflation and Argentina's seventy-year fiscal deficit.

Resumen El Fondo Monetario Internacional (FMI) y el Estado argentino mantienen una relación estrecha y constante desde 1957, especialmente en momentos de crisis económica. Este artículo estudia la última asistencia financiera que recibió el país por parte del organismo internacional en 2018, deuda renegociada entre 2022-2023. Empleando datos oficiales, bibliografía reciente y notas de prensa, los hallazgos, desde un enfoque histórico y sociológico, sugieren que los problemas y crisis que afectan a Argentina de manera cíclica no son resultado de su relación con el FMI, sino de la incapacidad de la clase empresarial y las autoridades de gobierno de ejercer control sobre su política económica. El endeudamiento es un mecanismo que compensa el rezago productivo de la economía, la hiperinflación y el déficit fiscal de Argentina desde hace setenta años.

Abstract This article proposes an erotetic approach to define the ecocritical research program, analyzing the interrelationship between the conceptual frameworks of ecology and literary critical theory. A common structure based on problem agendas is suggested, enriching both scientific practice and teaching. The main objective is to demonstrate how the formulation of questions significantly contributes to the creation of open problem agendas that guide research, fostering the development of new hypotheses and promoting interdisciplinarity in research programs facing ecological challenges. The methodology includes a review of the theoretical structure of ecocriticism and how problem agendas provide methodological flexibility, allowing for the reformulation of questions as new data, technologies, and approaches emerge. The results highlight the importance of questioning in environmental sciences to redefine new research agendas, integrating conceptual frameworks not unified by a central theory. Ecocriticism is framed as a research program structured erotetically, much like ecology. The conclusions emphasize the interdependence between questions, problem agendas, and critical reflection on the scientific method, underscoring the creativity and utility of questioning and abductive hypotheses for a more suitable scientific practice, aligned with the urgency of the ecological crisis.

Resumen Este artículo propone un enfoque erotético para definir el programa de investigación ecocrítico, analizando la interrelación entre los marcos conceptuales de la ecología y la teoría crítica literaria. Se sugiere una estructura común basada en agendas de problemas que enriquecen, tanto la práctica científica como la enseñanza. El objetivo principal es mostrar cómo la formulación de preguntas contribuye de manera significativa a la creación de agendas de problemas abiertos que guían la investigación, fomentando el desarrollo de nuevas hipótesis y promoviendo la interdisciplinariedad en los programas de investigación ante los desafíos ecológicos. La metodología incluye una revisión de la estructura teórica de la ecocrítica y de cómo las agendas de problemas aportan flexibilidad metodológica, permitiendo reformular preguntas a medida que surgen nuevos datos, tecnologías y enfoques. Los resultados destacan la importancia de los cuestionamientos en las ciencias ambientales para redefinir nuevas agendas de investigación, integrando marcos conceptuales no unificados por una teoría central. La ecocrítica se configura como un programa de investigación estructurado de manera erotética, al igual que la ecología. Las conclusiones subrayan la interdependencia entre preguntas, agendas de problemas y la reflexión crítica sobre el método científico, enfatizando en la creatividad y utilidad de los cuestionamientos e hipótesis retroductivas, para una práctica científica más adecuada y ajustada a la urgencia de la crisis ecológica.

Abstract Introduction: This study examines the contagion patterns of intentional homicide in Mexico between 2016 and 2022, in the context of clashes between rival organized crime groups. Objective: To determine which of the two opposing hypotheses about the spread of homicides in Mexico has greater empirical support. We consider: a) the centrifugal hypothesis, which posits that organized crime groups can move their activities to new regions, spreading the conflict, and b) the centripetal hypothesis, which suggests that when one criminal organization attacks another in a different region, the resulting violence feeds back into the conflict in its region of origin. Methodology: Spatial regression techniques and modified spatial matrices are employed to assess these hypotheses. To define each spatial unit's neighbors, the disparity between victims' places of residence and death is utilized. Conclusions: Our analysis strongly supports the centrifugal hypothesis, albeit not entirely dismissing the centripetal perspective.

Resumen Introducción: este trabajo examina los patrones de contagio del homicidio doloso en México entre 2016 y 2022, en el contexto de los enfrentamientos entre grupos rivales del crimen organizado. Objetivo: determinar cuál de las dos hipótesis opuestas sobre la propagación de los homicidios en México cuenta con mayor soporte empírico. Consideramos: a) la hipótesis centrífuga, que postula que los grupos del crimen organizado pueden trasladar sus actividades a nuevas regiones, propagando el conflicto, y b) la hipótesis centrípeta, que sugiere que cuando una organización criminal ataca a otra en una región diferente, la violencia generada retroalimenta el conflicto en su región de origen. Metodología: utilizando técnicas de regresión espacial y matrices espaciales modificadas, examinamos estas hipótesis, con las relaciones de vecindad definidas por la diferencia entre los lugares de residencia y defunción de personas asesinadas con armas de fuego y explosivos. Conclusiones: nuestros resultados respaldan sólidamente la hipótesis centrífuga, aunque no se descarta por completo la hipótesis centrípeta.

Abstract The present study focused on the organization of a nuclear curriculum and its relationship with the development of investigative skills. Its main objective was to analyze existing experiences on the implementation of nuclear curricula with the purpose of proposing a strategy to enhance research competencies in teachers and researchers in Ecuador. To this end, a systematic review of the literature was carried out following the principles of the PRISMA declaration. The search was carried out in Google Scholar, selecting 34 articles that address the conception of the nuclear curriculum, its relationship with medical training and science teaching, as well as approaches for the development and evaluation of research competencies. The results highlighted the importance of implementing a core curriculum with research competencies as a crucial tool to guarantee essential skills and promote research in the educational field. Key practices such as interdisciplinary collaboration, early orientation toward research projects, and the use of technologies to enhance research teaching were identified. Finally, it is concluded that the effective implementation of a nuclear curriculum with investigative competencies requires appropriate pedagogical strategies that promote research as an integral part of the training process.

Resumen El presente estudio se centró en la organización de un currículum nuclear y su relación con el desarrollo de competencias investigativas. Su objetivo principal fue analizar las experiencias existentes sobre la implementación de currículos nucleares con el propósito de proponer una estrategia para potenciar las competencias investigativas en docentes e investigadores en Ecuador. Para ello, se realizó una revisión sistemática de la literatura siguiendo los principios de la declaración PRISMA. La búsqueda se llevó a cabo en Google Académico, seleccionando 34 artículos que abordan la concepción del currículum nuclear, su relación con la formación médica y la enseñanza de las ciencias, así como enfoques para el desarrollo y evaluación de competencias investigativas. Los resultados destacaron la importancia de implementar un currículum nuclear con competencias investigativas como una herramienta crucial para garantizar habilidades esenciales y fomentar la investigación en el ámbito educativo. Se identificaron prácticas clave como la colaboración interdisciplinaria, la orientación temprana hacia proyectos de investigación y el uso de tecnologías para mejorar la enseñanza en investigación. Finalmente, se concluye que la implementación efectiva de un currículum nuclear con competencias investigativas requiere estrategias pedagógicas adecuadas que promuevan la investigación como parte integral del proceso formativo.

Abstract This study analyzes the effect of ethical leadership on organizational commitment, considering work self-efficacy as a mediating variable. Structural equation modeling is used to analyze the proposed relationships. The sample consists of 448 professionals in the Colombian electricity sector. Ethical leaders increase organizational commitment, specifically the affective, normative, and perceived investment dimensions (Continuance 2), but not the perspective of lack of job opportunities (Continuance 1). Work self-efficacy explains how ethical leadership influences the analyzed dimensions of organizational commitment, with the exception of the lack of job opportunities (Continuance 1). Ethical leadership seeks to meet the socio-emotional needs of followers. When employees feel listened to and valued by the leader, they voluntarily choose to increase their commitment. However, when employees feel trapped in an organization and experience a constant sense of obligation, their discouragement intensifies, and they withdraw emotionally until they are disconnected from the positive effects of ethical leadership and work self-efficacy.

Resumen Este estudio analiza el efecto del liderazgo ético sobre el compromiso organizacional teniendo en cuenta a la autoeficacia laboral como variable mediadora. Para examinar las relaciones propuestas se utiliza un modelo de ecuaciones estructurales. La muestra está compuesta por 448 profesionales pertenecientes al sector eléctrico colombiano. Los líderes éticos incrementan el compromiso organizacional, específicamente, las dimensiones afectiva, normativa y de inversiones percibidas (Continuidad 2), pero no la perspectiva de falta de oportunidades laborales (Continuidad 1). La autoeficacia laboral explica cómo el liderazgo ético influye en las dimensiones analizadas del compromiso organizacional, con excepción de la falta de oportunidades laborales (Continuidad 1). El liderazgo ético busca satisfacer las necesidades socioemocionales de los seguidores. Cuando los empleados se sienten escuchados y valorados por el líder, optan voluntariamente por aumentar su compromiso. Sin embargo, cuando los empleados se sienten atrapados en una organización y experimentan una sensación constante de obligación, su desánimo se intensifica y se retraen emocionalmente hasta desconectarse de los efectos positivos del liderazgo ético y de la autoeficacia laboral.

RESUMO Com foco no ensino em saúde, o objetivo do texto é apontar a aplicabilidade dos acúmulos teóricos dos marcadores sociais da diferença e da interseccionalidade para a compreensão de processos de cuidado, saúde, adoecimento e vulnerabilização. A partir da experiência docente em uma graduação em medicina, discute-se como a perspectiva de análise articulada dos marcadores sociais da diferença complexifica a compreensão da determinação social da saúde e se aplica à realidade da formação em saúde brasileira. O artigo está organizado em duas partes. Na primeira, discute-se a importância dos marcadores sociais raça e gênero, bem como da perspectiva interseccional, para pensar a constituição de corpos e sujeitos diversos. Já na segunda parte, focaliza-se o diálogo com o campo da saúde coletiva, destacando políticas do Sistema Único de Saúde que mobilizam marcadores sociais e retomando pesquisas brasileiras que elucidam a importância do tema para o ensino em saúde. Assim, por meio de perspectiva transdisciplinar na interface entre ciências sociais e saúde coletiva, o artigo busca contribuir para a organização desse amplo debate que, especialmente a partir de 2010, tomou corpo no Brasil e busca avançar para uma formação em saúde mais comprometida com a equidade, a diversidade e os direitos humanos.

ABSTRACT Focusing on health teaching, the objective of the text is to point out the applicability of theoretical accumulations of social markers of differences and intersectionality for understanding processes of care, health, illness and vulnerability. Based on teaching experience in an undergraduate medical course, it discusses how the perspective of articulated analysis of social markers complicates the understanding of the social determination of health and applies to the reality of Brazilian health training. The article is organized into two parts. The first discusses the importance of race and gender, as well as the intersectional perspective, to think about the constitution of diverse bodies and subjects. The second part focuses on direct dialogue with the field of collective health, highlighting Unified Health System (SUS) policies mobilize social markers and resuming Brazilian research that elucidates the importance of such debate for health teaching. Thus, through an interdisciplinary perspective at the interface between social sciences and collective health, the article seeks to contribute to the organization of this debate that, especially since 2010, has taken shape in the Brazil and seeks to advance towards health training that is more committed to equity, diversity and human rights.

RESUMEN Se presenta un sistema de recomendación creado para optimizar la designación de profesores en el área de Gestión Computacional. La problemática radica en la subjetividad y poca eficiencia y para abordarlo se emplean técnicas de machine learning, específicamente el filtrado colaborativo y el análisis predictivo, con el propósito de mejorar la selección en función de experiencia, formación académica, destrezas pedagógicas y contentamiento. Se recopiló información de los últimos cinco años a través de encuestas a estudiantes y evaluaciones de desempeño en la docencia, identificando patrones en las asignaciones previas y predecir qué persona se ajusta mejor a los cursos futuros. Las asignaturas consideradas: Organización y Arquitectura Computacional, Sistemas Operativos, Redes de Computadoras, Seguridad Informática, entre otros. Como resultados, se demuestra una gran precisión, incrementando la satisfacción y optimizando el desempeño académico a comparación de métodos tradicionales. En conclusión, existe una contribución significativa en la mejora de la calidad educativa.

ABSTRACT A recommendation systen created to optimize the appointment of professors in the area of Computational Management is presented. The problem lies in subjectivity and lack of efficiency, and to address it, machine learning techniques are used, specifically collaborative filtering and predictive analysis, with the purpose of improving selection based on experience, academic training, pedagogical skills and contentment. Information from the last five years was collected through student surveys and teaching performance evaluations, identifying patterns in previous assignments and predicting which person is best suited for future courses. The subjects considered: Computer Organization and Architecture, Operating Systems, Computer Networks, Computer Security, among others. As a result, great accuracy is demonstrated, increasing satisfaction and optimizing academic performance compared to traditional methods. In conclusion, there is a significant contribution to the improvement of educational quality.

Abstract Introduction: The World Health Organization (WHO) points out that infection by enteroparasites can affect ~3.5 billion people around the world. Hemodialysis (HD) patients may be more susceptible to infections by opportunistic pathogens due to impaired immune function. We evaluated enteroparasite infection in a sample of HD-patients from two dialysis centers and in a control group. Methods: Fecal samples were processed using the Hoffmann-Pons-Janner, Ritchie, Willis, and Rugai techniques. Patients with kidney failure from two dialysis centers undergoing HD for more than 3 months were included. The control group consisted of relatives of the patients without overt CKD. The TaqMan PCR and multiplex real-time PCR were carried out for detection of Cryptosporidium spp. and C. parvum and to differentiate the Entamoeba (E.) histolytica/E. dispar complex, respectively Results: A total of 97 HD patients and 42 controls were enrolled in the study. Fifty (51.5%) fecal samples from the HD group were positive for enteroparasites, as were 26 (61.9%) from the control group (P = 0.260). S. stercoralis was the single helminth detected and was only present in HD-patients. Coproscopy detected seven positive samples for the E. histolytica/E. dispar complex, three from HD patients and four from controls: by PCR, all samples were positive for the non-pathogenic E. dispar. Safranin-stained fecal smear slides were all negative for Cryptosporidium spp. However, by PCR, amplification for Crypstosporidium spp. was seen in six samples, all from the HD patients. Two of the species were classified as C. hominis by PCR-RFLP Conclusions: Enteroparasite infection as detected by traditional techniques were not more prevalent in HD patients, but S. stercoralis was only found in these patients. It is noteworthy that Cryptosporidium spp. infection, also affecting only HD patients, could only be detected by molecular biology techniques. Introduction WHO (WHO 35 5 ~3. world (HD function HDpatients Methods HoffmannPonsJanner, HoffmannPonsJanner Hoffmann Pons Janner, Janner Hoffmann-Pons-Janner Ritchie Willis included CKD realtime real time spp C E (E. histolyticaE histolytica histolytica/E complex Results 9 4 study 51.5% 515 51 (51.5% 2 61.9% 619 61 (61.9% P 0.260. 0260 0.260 . 0 260 0.260) S HDpatients. nonpathogenic non pathogenic Safraninstained Safranin stained However PCRRFLP RFLP Conclusions ~3 (E 51.5 (51.5 61.9 6 (61.9 026 0.26 ~ 51. (51. 61. (61. 02 0.2 (51 (61 0. (5 (6 (

Resumo Introdução: A OMS aponta que infecções por enteroparasitos podem afetar ~3,5 bilhões de pessoas globalmente. Pacientes em hemodiálise (HD) podem ser mais suscetíveis a infecções por patógenos oportunistas devido à função imunológica prejudicada. Avaliamos a infecção por enteroparasitos em pacientes em HD de dois centros de diálise e um grupo controle Métodos: Amostras fecais foram processadas pelas técnicas de Hoffmann, Pons&Janner, Ritchie, Willis e Rugai. Incluímos pacientes com insuficiência renal, de dois centros de diálise, em HD por mais de três meses. O grupo controle consistiu em familiares dos pacientes sem DRC evidente. PCR TaqMan e PCR Multiplex em tempo real foram realizadas para detecção de Cryptosporidium spp. e C. parvum e para diferenciar o complexo Entamoeba (E.) histolytica/E. dispar, respectivamente Resultados: 97 pacientes em HD e 42 controles foram incluídos no estudo. Cinquenta (51,5%) amostras fecais do grupo HD foram positivas para enteroparasitos, assim como 26 (61,9%) do grupo controle (P = 0,260). S. stercoralis foi o único helminto detectado, presente apenas nos pacientes em HD. A coproscopia detectou sete amostras positivas para o complexo E. histolytica/E. dispar, três de pacientes em HD e quatro controles: através da PCR, todas as amostras foram positivas para E. dispar não patogênica. As lâminas de esfregaço fecal coradas com safranina foram todas negativas para Cryptosporidium spp. Entretanto, através da PCR, observou-se amplificação para Crypstosporidium spp. em seis amostras, todas de pacientes em HD. Duas das espécies foram classificadas como C. hominis por PCR-RFLP Conclusões: A infecção por enteroparasitos, detectada por técnicas tradicionais, não foi mais prevalente em pacientes em HD, mas o S. stercoralis foi encontrado exclusivamente entre eles. Vale ressaltar que a infecção por Cryptosporidium spp., que também afetou somente pacientes em HD, pôde ser detectada somente por técnicas de biologia molecular. Introdução 35 3 5 ~3, globalmente (HD prejudicada Métodos Hoffmann PonsJanner Pons Janner Pons&Janner Ritchie Rugai renal meses evidente spp C E (E. histolyticaE histolytica histolytica/E Resultados 9 4 estudo 51,5% 515 51 (51,5% 2 61,9% 619 61 (61,9% P 0,260. 0260 0,260 . 0 260 0,260) S detectado patogênica Entretanto observouse observou se PCRRFLP RFLP Conclusões tradicionais eles molecular ~3 (E 51,5 (51,5 61,9 6 (61,9 026 0,26 ~ 51, (51, 61, (61, 02 0,2 (51 (61 0, (5 (6 (

Abstract Introduction: Multicenter research initiatives in Brazilian dialysis centers are scarce. We described the recruitment and implementation phases of the SARC-HD study, aimed at investigating sarcopenia and its impact on adverse clinical outcomes. Methods: The SARC-HD is a cohort study being conducted with patients on hemodialysis in Brazil. The recruitment phase was defined as the period from the invitation to the center until the start of patient enrollment, whereas the implementation phase lasted from then until the completion of enrollment and baseline data collection. Upon implementation, a structured questionnaire was distributed to collect feedback from principal investigators. Results: 21 centers from three Brazilian regions consented to participate, with two dropping out. Ten principal investigators oversaw the 19 sites. Nine centers (47%) were funded entirely by health insurance companies. A total of 1525 patients were screened for eligibility and 1008 were enrolled, with a 66.1% recruitment rate. Recruitment and baseline data collection took 12 [interquartile range: 5–15] weeks. Qualitative content analysis identified barriers such as a lack of infrastructure and logistics for research. Facilitators included the management and organization of the steering committee. Data collection challenges were mainly reported with the subjective 7-point global assessment and the international physical activity questionnaire. The main challenge for the ongoing maintenance phase will be the lack of standardized information in electronic health records. Conclusions: The recruitment and implementation phases of the multicenter SARC-HD study were feasible. Barriers and facilitators identified by principal investigators may help future multicenter initiatives to integrate research-related tasks into clinical routine, facilitating successful experiences. Introduction scarce SARCHD SARC HD outcomes Methods Brazil Results 2 participate out 1 sites 47% 47 (47% companies 152 100 enrolled 661 66 66.1 rate interquartile range 5–15 515 5 15 weeks committee 7point point 7 records Conclusions feasible researchrelated related routine experiences 4 (47 10 6 66. 5–1 51 (4 5– (

Resumo Introdução: Pesquisa multicêntrica em centros de diálise brasileiros são escassas. Descrevemos as fases de recrutamento e implementação do estudo SARC-HD, visando investigar a sarcopenia e seu impacto em desfechos clínicos adversos. Métodos: O SARC-HD é um estudo de coorte realizado com pacientes em hemodiálise no Brasil. A fase de recrutamento foi considerada o período entre convite ao centro e início da inclusão de pacientes, enquanto a fase de implementação durou a partir de então até a conclusão do recrutamento e coleta de dados basais. Após a implementação, um questionário estruturado foi distribuído para coletar feedback dos principais pesquisadores. Resultados: 21 centros de três regiões brasileiras consentiram em participar, com duas desistências. Dez pesquisadores principais supervisionaram 19 locais. Nove centros (47%) eram totalmente financiados por planos de saúde. 1525 pacientes foram avaliados para elegibilidade e 1008 foram incluídos, com taxa de recrutamento de 66,1%. Recrutamento e coleta de dados basais levaram 12 semanas [intervalo interquartil: 5–15]. A análise qualitativa de conteúdo identificou barreiras como falta de infraestrutura e logística para pesquisa. Os facilitadores incluíram gestão e organização do comitê gestor. Os desafios da coleta de dados foram relatados principalmente quanto à avaliação global subjetiva de 7 pontos e o questionário internacional de atividade física. O principal desafio para a fase de manutenção será a falta de informações padronizadas nos prontuários eletrônicos. Conclusões: As fases de recrutamento e implementação do estudo multicêntrico SARC-HD foram viáveis. Barreiras e facilitadores identificados pelos pesquisadores principais podem auxiliar futuras iniciativas multicêntricas a integrar tarefas relacionadas à pesquisa na rotina clínica, facilitando experiências bem-sucedidas. Introdução escassas SARCHD, SARCHD SARC HD, HD adversos Métodos Brasil Resultados 2 participar desistências 1 locais 47% 47 (47% saúde 152 100 incluídos 661 66 66,1% intervalo interquartil 5–15. 515 5–15 . 5 15 5–15] gestor física eletrônicos Conclusões viáveis clínica bemsucedidas. bemsucedidas bem sucedidas. sucedidas bem-sucedidas 4 (47 10 6 66,1 51 5–1 (4 66, 5– (

PURPOSE: Osteoporosis and fragility fractures are expected to rise in a rapidly aging South African population. However, currently, there are limited prevalence studies available for this population METHODS: We assessed the prevalence of osteoporosis from all Dual-energy X-ray absorptiometry (DEXA) scans on referral to a tertiary academic hospital in Johannesburg, South Africa. All DEXA scans were analyzed between January 01, 2006, and December 31, 2021. The World Health Organization (WHO) criteria were used to diagnose osteoporosis RESULTS: Of the 2264 DEXA scans analysed, 880 were osteoporotic (96.4% females, 3.6% males), with an overall osteoporosis prevalence of 38.8% (CI 38.6-40.8). The prevalence increased with age. Bone mineral density T-scores were lower in subjects with lower body mass index. The vertebral body with the highest prevalence of fractures was thoracic level T12. There were no significant differences when comparing T-scores by various bony regions between males and females above age 50 CONCLUSION: In those referred for DEXA scans, this study found a high prevalence of osteoporosis, especially in the older South African population, with notable levels in postmenopausal women. Being underweight was associated with increased severity. We also found a higher incidence of vertebral deformities with increasing age

South Africa is host to the single richest early hominin fossil record worldwide, including many examples of the endemic species Australopithecus africanus fossils. This species was first described by Raymond Dart in 1925 from the deposits near the town of Taung. Later, many more fossils, of different species and genera, were found in the caves of the Sterkfontein and Makapan Valleys. To understand this rich and diverse fossil record, we must understand how the landscape formed (cave formation processes) and changed (mining), when this happened (geochronology), and how the fossils were accumulated and modified (taphonomy). Here we provide a review of these themes to mark the centenary of the Taung Child discovery. We mark this moment in our field by critically reflecting on the role of extractive practices, especially centred around past mining of the Caves and the exclusion of many members of research teams. The South African Fossil Hominid sites provide a unique opportunity to expand our understanding of the intersection between human evolution and changing environmental conditions, as the karstic landscape and remnant cave systems preserve both fossils and sedimentary archives of past environmental change. We offer a perspective on future research areas: more standardised excavation practices and techniques to raise the quality of data collected from the caves and new techniques to date and extract palaeoclimate data from cave deposits themselves, to provide novel insights into the world of the early australopiths. SIGNIFICANCE: This review introduces the reader to the important fossil remains and palaeoclimate archives preserved within South Africa, highlighting the key species Australopithecus africanus and marking the centenary of its first description from the site of Taung. We review the geological and exploration history of the South African hominin fossil sites and discuss how they are intrinsically linked. We explore the impact of past extractive practices on the fossil and palaeoclimatic archives for past, current and future research. We go on to emphasise members of research teams who have been crucial to the discovery and recovery of fossils but have often been excluded and remained unnamed.

Abstract Freestanding birth centers (FBCs) in Brazil are regulated to provide care for women with a straightforward pregnancy. The systematization of the literature on FBCs can broaden our knowledge of these facilities. We conducted a scoping review to answer the following research question: “What are the characteristics of the model of care in freestanding birth centers in Brazil?”. Relevant studies covering any period and in any language were included. Searches were performed of platforms, databases, repositories, and institutional websites. The searches followed the stages set out in the JBI Manual for Evidence Synthesis and the review protocol was registered with the OSF. A total of 85 documents were selected, involving ten FBCs. The maternal and neonatal outcomes described by the studies were categorized as follows: respect for women’s autonomy and needs; humanized evidenced-based care; feeling safe with and confident in care providers; use of integrative and complementary health practices; positive maternal experience and neonatal outcomes; and welcoming and comfortable environment. The findings reinforce that care delivery in FBCs is grounded in the biopsychosocial model of health care and that the physical environment and organization of these facilities and approach to childbirth are structured around the needs of pregnant people and their babies.

Resumo Os centros de parto normal peri-hospitalares (CPNp) são regulamentados no Brasil para atenção às mulheres e bebês de risco habitual. Sistematizar a produção científica pode ampliar o conhecimento sobre esses estabelecimentos. Realizou-se uma revisão de escopo a partir da questão: “quais são as características do modelo de atenção dos CPNp brasileiros?” Foram incluídos estudos sem delimitação temporal e em qualquer idioma. As buscas foram feitas em portais, bases de dados, repositórios e sites institucionais. As etapas da revisão foram guiadas pelo JBI Manual for Evidence Synthesis, e seu protocolo registrado na plataforma OSF. Foram selecionados 85 documentos, que abordam dez CPNp. Os estudos descrevem desfechos maternos e neonatais categorizados, entre outros, em: respeito à autonomia e às necessidades maternas; cuidado humanizado e baseado em evidências; confiança e segurança nos profissionais; uso de práticas integrativas e complementares em saúde; experiência materna e desfecho neonatal positivos; cuidado em ambiente acolhedor e confortável. Os resultados reforçam que os CPNp produzem um cuidado pautado no modelo biopsicossocial de saúde, cujas necessidades dos usuários são a base das estruturas física, organizacional, filosófica e assistencial dessas instituições.

Resumen Los Centros de Parto Normal Perihospitalarios (CPNp) están regulados en Brasil para atender a mujeres y bebés en riesgo normal. Sistematizar la producción científica puede ampliar el conocimiento sobre estos establecimientos. Se realizó una revisión de alcance a partir de la pregunta: “¿Cuáles son las características del modelo de atención del CPNp brasileño?”. Se incluyeron estudios sin delimitación temporal y en cualquier idioma. Las búsquedas se realizaron en portales, bases de datos, repositorios y sitios web institucionales. Los pasos de revisión fueron guiados por el Manual de Síntesis de Evidencia del JBI y su protocolo registrado en la plataforma OSF. Fueron seleccionados 85 documentos, que abordan diez CPNp. Los estudios describen resultados maternos y neonatales categorizados, entre otros, en respeto por la autonomía y las necesidades maternas; atención humanizada y basada en evidencia; confianza y seguridad en los profesionales; uso de Prácticas Integrativas y Complementarias de Salud; experiencia materna positiva y resultado neonatal; atención en un ambiente acogedor y confortable. Los resultados refuerzan que los CPNp producen atención basada en el modelo biopsicosocial de salud, cuyas necesidades de los usuarios son la base de las estructuras físicas, organizativas, filosóficas y de atención de estas instituciones.

Abstract The study analyzed the socio-environmental determination of health in five sugarcane-producing municipalities in Pernambuco. This participatory, qualitative research was conducted from January to August 2022. Workshops were held in the participating communities to build the Participatory Rural Diagnosis of protective and destructive processes of global, community, and individual socio-environmental health dimensions. The communities pointed to social inequalities, productive deregulation, environmental degradation, labor exploitation, violence, and illness as the main processes affecting the territories. Despite this, protective processes were related to the social function of land and the right to agrarian reform, family farming, solidarity and community organization ties, and individual and family self-care practices. The diagnosis points to the need to build public policies for equity, protection, and reparation of the eco-social health of territories affected by sugarcane cultivation, burdened with intense use of pesticides and burning and over-exploited labor, among other socio-environmental problems.

Resumo O estudo analisou a determinação socioambiental da saúde em cinco municípios produtores de cana-de-açúcar em Pernambuco. Trata-se de uma pesquisa participante com abordagem qualitativa, realizada no período de janeiro a agosto de 2022. Foram realizadas oficinas nas comunidades participantes para a construção do Diagnóstico Rural Participativo dos processos protetores e destrutivos de dimensão global, comunitária e individual da saúde socioambiental. As comunidades apontaram as iniquidades sociais, a desregulamentação produtiva, degradação ambiental, exploração pelo trabalho, violência e adoecimento como os principais processos que acometem os territórios. Apesar disso, os processos protetores foram relacionados à função social da terra e o direito à reforma agrária; à agricultura familiar; aos laços de solidariedade e organização comunitária, bem como às práticas de autocuidado individual e familiar. O diagnóstico aponta para a necessidade da construção de políticas públicas de equidade, proteção e reparação da saúde ecossocial dos territórios afetados pelo cultivo da cana-de-açúcar, onde há intenso uso de agrotóxicos, prática de queimadas e superexploração do trabalho, dentre outros problemas socioambientais.

Resumen El estudio analizó la determinación socioambiental de la salud en cinco municipios productores de caña de azúcar de Pernambuco, Brasil. Se trata de una investigación participativa con enfoque cualitativo, realizada de enero a agosto de 2022. Se realizaron talleres en las comunidades participantes para construir el Diagnóstico Rural Participativo de procesos protectores y destructivos de las dimensiones global, comunitaria e individual de la salud socioambiental. Las comunidades señalaron las inequidades sociales, la desregulación productiva, la degradación ambiental, la explotación laboral, la violencia y las enfermedades como los principales procesos que afectan los territorios. Pese a ello, los procesos protectores estuvieron relacionados con la función social de la tierra y el derecho a la reforma agraria; a la agricultura familiar; vínculos de solidaridad y organización comunitaria, así como prácticas de autocuidado individual y familiar. El diagnóstico apunta a la necesidad de construir políticas públicas de equidad, protección y reparación de la salud eco-social de los territorios afectados por el cultivo de la caña de azúcar, donde existe un uso intenso de pesticidas, quemas y sobreexplotación del trabajo, entre otros problemas socioambientales.