RESUMO: O ensino de anatomia vem se modificando ao longo dos anos, introduzindo métodos tecnológicos, principalmente após o período pandêmico. Questiona-se o uso exclusivo da tecnologia em comparação aos métodos tradicionais de dissecação e aulas teóricas presenciais no que diz respeito à aquisição de conhecimento. Este artigo analisou a percepção de conhecimento de alunos de diversos semestres do curso de Medicina Veterinária, comparando alunos que tiveram aulas apenas online com aqueles que tiveram aulas presenciais de Anatomia Descritiva dos Animais Domésticos. Para tanto, questões foram enviadas por meio de formulário, com preenchimento voluntário e anônimo, e posteriormente analisadas estatisticamente. Os resultados indicam que 11,5% dos alunos que cursaram a disciplina remotamente falharam na aplicação dos conhecimentos em outras disciplinas, enquanto nenhum aluno do ensino presencial relatou o mesmo. A maioria dos alunos, tanto dos grupos remotos quanto dos presenciais, lembram-se do assunto, mas revisam o conteúdo com frequência. Em relação ao conhecimento teórico, o grupo online (80,8%) compreendeu melhor à medida que o curso avançava, comparado a 59,6% do grupo presencial. A ligação entre Anatomia e outras disciplinas foi mais destacada pelo grupo presencial (30,8%) em comparação ao online (15,4%). Ambos os grupos concordam que o contacto físico com peças anatômicas é essencial, mas alguns consideram possível ter um primeiro contacto com imagens ou fotografias 3D. Baseado nesse estudo preliminar, conclui-se que as interações iniciais com a área de Anatomia devem incluir técnicas pedagógicas diversificadas com comunicação empática. A utilização de recursos tecnológicos modernos é um aliado do processo de ensino-aprendizagem, e após a abstração dos conteúdos é possível o uso singular da tecnologia na manutenção e atualização do conhecimento anatômico. RESUMO anos pandêmico Questionase Questiona Veterinária Domésticos formulário anônimo estatisticamente 115 11 5 11,5 mesmo lembramse lembram assunto frequência teórico 80,8% 808 80 8 (80,8% avançava 596 59 6 59,6 30,8% 308 30 (30,8% 15,4%. 154 15,4% . 15 4 (15,4%) essencial 3D D preliminar concluise conclui empática ensinoaprendizagem, ensinoaprendizagem aprendizagem, aprendizagem ensino-aprendizagem anatômico 1 11, 80,8 (80,8 59, 30,8 3 (30,8 15,4 (15,4% 80, (80, 30, (30, 15, (15,4 (80 (30 (15, (8 (3 (15 ( (1

ABSTRACT: Anatomy teaching has been changing over the years, introducing technological methods especially after the pandemic period. An ongoing debate revolves around whether exclusive reliance on technology for anatomy classes, as opposed to traditional methods and face-to-face instruction, enhances knowledge acquisition. This study analyzed the knowledge perception of students from various semesters throughout the Veterinary Medicine course, comparing students who only had online classes with those who had face-to-face classes in Gross Anatomy of Domestic Animals. For this purpose, a questionnaire was distributed for voluntary and anonymous completion, and the responses were subsequently analyzed statistically. The results indicated that 11.5% of the students who took Anatomy remotely failed to apply the knowledge in other subjects, while no face-to-face learning student reported the same. Most students, both remote and face-to-face groups, remember the subject but review the content frequently. Regarding theoretical knowledge, the online group (80.8%) understood better as the course progressed, compared to 59.6% of the face-to-face group. The connection between Anatomy and other subjects was more highlighted by the face-to-face group (30.8%) compared to the online group (15.4%). Both groups agree that physical contact with anatomical specimens is essential; however, some believe that initial exposure through 3D images or photographs is feasible. We concluded based on this preliminary study that the initial interactions with the Anatomy field should include diversified pedagogical techniques with empathetic communication. The use of modern technological resources are allies in the teaching-learning process. Furthermore, after abstracting the contents, technology alone can effectively maintain and update anatomical knowledge. ABSTRACT years period facetoface face instruction acquisition Animals purpose completion statistically 115 11 5 11.5 same frequently 80.8% 808 80 8 (80.8% progressed 596 59 6 59.6 30.8% 308 30 (30.8% 15.4%. 154 15.4% . 15 4 (15.4%) essential however D feasible communication teachinglearning process Furthermore contents 1 11. 80.8 (80.8 59. 30.8 3 (30.8 15.4 (15.4% 80. (80. 30. (30. 15. (15.4 (80 (30 (15. (8 (3 (15 ( (1

Resumo: Introdução: A hipertensão arterial (HA) é a principal causa de morte por doenças cardiovasculares. Apesar dos avanços, o percentual de hipertensos não diagnosticados e não tratados é de 58,4%. A avaliação do dano cognitivo na hipertensão concentra-se na prevenção do acidente vascular cerebral, enquanto o dano funcional é ignorado. Esse manejo inadequado pode ser multifatorial. É objetivo fue analisar a opinião dos médicos sobre a relação entre hipertensão arterial e danos cognitivos. Metodologia: Estudo observacional, descritivo, transversal desenvolvido no período entre agosto de 2020 e agosto de 2023. Análise de dados obtidos a partir de questionário autoaplicável, anônimo e voluntário. Revelar informações sobre o perfil profissional, conhecimento sobre a HA, sua ligação com o comprometimento cognitivo (DC), diagnóstico e tratamento. Resultados: Foram incluídos 222 profissionais, 215 (96,8%) concordam com a existência de ligação entre hipertensão e outros fatores de risco cardiovascular na DC e 218 (98,1%) reconhecem ajudar pacientes com risco de sofrer de D.C. A avaliação da DC é realizada em casos selecionados por 132 (59,4%) participantes e 59 (26,7%) a fazem sempre. Dos que realizam avaliação, 103 (54%) utilizam o Mini Exame do Estado Mental (MEEM), 10 (5,2%) utilizam a Avaliação Cognitiva de Montreal (MoCA) e 9 (4,7%) utilizam o Clock Drawing Test. Em relação à diminuição da pressão arterial em pacientes idosos e a ligação com o risco de DC: 54 (24,3%) não reconhecem risco e 65 (29,2%) reconhecem risco moderado-alto. Em referência à implicação do tratamento de doenças cardiovasculares e DC: 217 (97,7%) reconheceram o efeito benéfico. Discussão: Dado o reconhecimento da ligação entre hipertensão e DC, seria de esperar que a DC fosse investigada na grande maioria, no entanto apenas 26,7% sempre a avaliam. Não há consenso sobre o método, sendo o MEEM o mais utilizado, com baixa aplicação do teste MoCA e/ou Clock Drawing Test, sendo estes últimos os que avaliam a função executiva, majoritariamente alterada nos DC vinculados à HA. Embora o tratamento das doenças cardiovasculares seja reconhecido como benéfico em relação à DC, o controle da HA em idosos é considerado arriscado. É feito um diagnóstico de uma situação em que é evidente uma disparidade entre o que se reconhece como saber e o que se afirma fazer. Conclusões: O papel da doença vascular no dano cerebral funcional é reconhecido, considerando-se necessário conhecer o estado cognitivo dos pacientes, porém há baixa aplicação de testes de triagem que avaliam a função executiva. Nesse contexto, evidencia-se uma lacuna entre o conhecimento e a prática médica.

Abstract: Introduction: High blood pressure (HBP) is the leading cause of death from cardiovascular disease. Despite the advances, the percentage of undiagnosed and untreated hypertensive patients is 58.4%. The evaluation of cognitive damage in HBP focuses on preventing stroke, while functional damage is ignored. This inadequate management may be multifactorial. The objective was to analyze the opinions that doctors have about the relationship between high blood pressure and cognitive damage. Methodology: Observational, descriptive, cross-sectional study developed in the period between August 2020 and August 2023. Analysis of data obtained from a self-administered, anonymous and voluntary questionnaire. Revealing information on the professional profile, knowledge of HBP, its link with cognitive impairment (CD), diagnosis and treatment. Results: 222 professionals were included, 215 (96.8%) agree with the existence of a link between HBP and other cardiovascular risk factors in CD, and 218 (98.1%) acknowledge assisting patients at risk of suffering from CD. The CD evaluation is carried out in selected cases by 132 (59.4%) participants and 59 (26.7%) always do it. Of those who perform evaluation, 103 (54%) use the Mini Mental State Examination (MMSE), 10 (5.2%) use the Montreal Cognitive Assessment (MoCA) and 9 (4.7%) use the Clock Drawing Test. Regarding the decrease in blood pressure in elderly patients and the link with risk of CD: 54 (24.3%) do not recognize risk and 65 (29.2%) recognize a moderate-high risk. In reference to the implication of the treatment of cardiovascular disease and CD: 217 (97.7%) recognized a beneficial effect. Discussion: Given the recognition of the link between HBP and CD, it would be expected that CD would be investigated in the vast majority, however only 26.7% always evaluate it. There is no consensus on the method, the MMSE being the most used, with a low application of the MoCA test and/or Clock Drawing Test, the latter being the ones that evaluate executive function, mostly altered in CD linked to HBP. Although the treatment of cardiovascular disease is recognized as beneficial with respect to CD, the control of HBP in older adults is considered risky. A diagnosis is made of a situation where a disparity is evident between what one recognizes as knowing and what one claims to do. Conclusions: The role of vascular disease in functional brain damage is recognized, considering it necessary to know the cognitive status of patients, however there is a low application of screening tests that evaluate executive function. In this context, a gap between medical knowledge and practice is shown.

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Resumen Antecedentes: la histerectomía en bloque es un procedimiento controvertido y con poca literatura actualizada. Se define como la extirpación del útero grávido con su contenido gestacional in situ, las indicaciones para la realización de esta cirugía son los procesos neoplásicos (como la causa más frecuente( procesos sépticos, enfermedad trofoblástica y hemorragia secundaria a inserción placentaria anómala. Caso clínico: paciente de 45 años con embarazo de 8 semanas y 5 días, según la fecha de última regla, con miomatosis uterina gigante asociada con tromboembolismo pulmonar, quien decide la interrupción voluntaria del embarazo y realizarse la histerectomía en bloque. Conclusiones: la histerectomía en bloque es una cirugía poco realizada en la actualidad, sin embargo, este abordaje quirúrgico es una opción segura y efectiva para la interrupción voluntaria del embarazo, y no se debe descartar entre las alternativas de tratamiento quirúrgico, siempre individualizando cada paciente.

ABSTRACT BACKGROUND: En bloc hysterectomy is defined as the removal of the pregnant uterus with its gestational content in situ. The indications for performing this en bloc surgery are neoplastic processes, as the most frequent cause; septic processes, trophoblastic disease and hemorrhage secondary to abnormal placental insertion, however, it is a controversial procedure, and with little updated literature. CLINICAL CASE: 45-year-old patient with a pregnancy of 8 weeks and 5 days, with giant uterine myomatosis associated with pulmonary thromboembolism who decided to voluntarily terminate the pregnancy, and it was decided to perform en bloc hysterectomy. CONCLUSIONS: En bloc hysterectomy is a surgery rarely performed at present, however, this surgical approach is a safe and effective option for the voluntary termination of pregnancy, and it should not be ruled out among the surgical treatment alternatives, always individualizing each patient.

Summary Vasectomy is usually requested by a couple with children who consider that they have completed their family project. In the clinical practice of the urology office of the Spanish health system, the professional must respond to an increasingly frequent demand: the request for vasectomy in young and childless patients, which raises many doubts in the urologist, regarding the suitability of its realization. Vasectomy causes a supposedly irreversible loss of reproductive function. Performed at the request of healthy, young, childless men, while respecting their autonomy of decision, it can nevertheless be maleficent. This paper aims to provide bioethical arguments concerning the performance of voluntary vasectomy in these cases and to evaluate the basis of the ethical criteria usually invoked to justify it. Subsequently, the legal aspects of vasectomy in Spain and the role of the professional’s conscientious objection are analyzed.

Resumen La vasectomía es solicitada habitualmente por una pareja con hijos que considera que ha completado su proyecto familiar. En la práctica clínica de la consulta de urología del sistema sanitario español, el profesional debe dar respuesta a una demanda cada vez más frecuente: la solicitud de vasectomía en paciente joven y sin hijos, la cual despierta muchas dudas en el urólogo, relativas a la idoneidad de su realización. La vasectomía ocasiona una pérdida pretendidamente irreversible de la función reproductiva. Realizada a petición de varones sanos, jóvenes y sin hijos, respetando su autonomía de decisión, sin embargo, puede resultar maleficente. Este trabajo pretende aportar argumentos bioéticos relativos a la realización de vasectomía voluntaria en estos casos y evaluar los fundamentos de los criterios éticos invocados habitualmente para justificarla. Posteriormente, se analizan los aspectos jurídicos de la vasectomía en España y el papel de la objeción de conciencia del profesional.

Abstract Introduction: The Brazilian Dialysis Survey (BDS) is an annual national survey about patients on chronic dialysis that contributes to health policies. Objective: To report the 2022 epidemiological data from the BDS of the Brazilian Society of Nephrology (BSN). Methods: A survey was carried out in Brazilian chronic dialysis centers using an online questionnaire that included clinical and epidemiological aspects of patients on chronic dialysis, dialysis therapy data, and dialysis center characteristics. Results: Overall, 28% (n = 243) of the centers answered the questionnaire. In July 2022, the estimated total number of patients on dialysis was 153,831. The estimated prevalence and incidence rates of patients per million population (pmp) were 758 and 214, respectively. Of the prevalent patients, 95.3% were on hemodialysis (HD, 4.6% of these on hemodiafiltration) and 4.7% on peritoneal dialysis (PD). Only 1.3% of patients were not vaccinated against COVID-19. The prevalence of anemia (Hb < 10g/dL) was 27% and hyperphosphatemia (P > 5.5mg/dL) reached 30%. The estimated overall crude annual mortality rate was 17.1%. Conclusions: The absolute number and prevalence rate of patients on chronic dialysis continue to increase. A growing number of patients were receiving hemodiafiltration. The mortality rate decreased, probably due to the end of COVID-19 pandemic. The conclusions were drawn in the context of relatively low voluntary participation, which imposed methodological limitations on our estimates. Introduction (BDS policies Objective 202 BSN. BSN . (BSN) Methods characteristics Results Overall 28 n 243 153831 153 831 153,831 pmp (pmp 75 214 respectively 953 95 3 95.3 HD, HD (HD 46 4 6 4.6 hemodiafiltration 47 7 4.7 PD. PD (PD) 13 1 1.3 COVID19. COVID19 COVID 19. 19 Hb 10g/dL 10gdL gdL 10g dL g 27 P 5.5mg/dL 55mgdL mgdL 5 5mg mg 30 30% 171 17 17.1% Conclusions increase decreased COVID-1 pandemic participation estimates 20 (BSN 2 24 15383 15 83 153,83 21 9 95. 4. (PD 1. COVID1 17.1 COVID- 1538 8 153,8 17. 153,

Resumo Introdução: O Censo Brasileiro de Diálise (CBD) é uma pesquisa nacional anual sobre pacientes em diálise crônica que contribui para as políticas de saúde. Objetivo: Informar os dados epidemiológicos de 2022 do CBD da Sociedade Brasileira de Nefrologia (SBN). Métodos: Foi realizada uma pesquisa em centros brasileiros de diálise por meio de um questionário online que incluiu aspectos clínicos e epidemiológicos de pacientes em diálise crônica, dados da terapia dialítica e características do centro de diálise. Resultados: No total, 28% (n = 243) dos centros de diálise ativos cadastrados na SBN responderam ao questionário. Em julho de 2022, o número total estimado de pacientes em diálise era de 153.831. As taxas estimadas de prevalência e incidência de pacientes por milhão (ppm) de habitantes foram 758 e 214, respectivamente. Dos pacientes prevalentes, 95,3% estavam em hemodiálise (HD; 4,6% desses em hemodiafiltração) e 4,7% em diálise peritoneal (DP). Apenas 1,3% dos pacientes não foram vacinados contra a COVID-19. A prevalência de anemia (Hb < 10g/dL) foi de 27% e de hiperfosfatemia (P > 5,5mg/dL) alcançou 30%. A taxa bruta total anual de mortalidade estimada foi de 17,1%. Conclusões: O número absoluto e a taxa de prevalência de pacientes em diálise crônica continuam a aumentar. Um número crescente de pacientes estava em hemodiafiltração. A taxa de mortalidade diminuiu, provavelmente devido ao fim da pandemia da COVID-19. As conclusões foram de um contexto de participação voluntária relativamente baixa, o que impõe limitações metodológicas às nossas estimativas. Introdução (CBD saúde Objetivo 202 SBN. . (SBN) Métodos Resultados 28 n 243 153831 153 831 153.831 ppm (ppm 75 214 respectivamente prevalentes 953 95 3 95,3 HD (HD 46 4 6 4,6 hemodiafiltração 47 7 4,7 DP. DP (DP) 13 1 1,3 COVID19. COVID19 COVID 19. 19 COVID-19 Hb 10g/dL 10gdL gdL 10g dL g 27 P 5,5mg/dL 55mgdL mgdL 5 5mg mg 30 30% 171 17 17,1% Conclusões aumentar diminuiu baixa estimativas 20 (SBN 2 24 15383 15 83 153.83 21 9 95, 4, (DP 1, COVID1 COVID-1 17,1 1538 8 153.8 COVID- 17, 153.

RESUMEN En un entorno donde la falta de conocimiento tributario y la evasión fiscal son desafíos significativos, este estudio se propone analizar estrategias efectivas para mejorar la conciencia tributaria mediante la capacitación en educación fiscal. Se revisaron diversas investigaciones que resaltan la importancia de programas específicos de instrucción tributaria y alianzas con el sistema educativo desde edades tempranas. Los resultados indican que la implementación de programas de capacitación y la promoción de la transparencia en la gestión pública pueden fortalecer la comprensión de los contribuyentes sobre sus obligaciones fiscales, promoviendo así un mayor cumplimiento voluntario. Se concluye que una educación fiscal adecuada, combinada con incentivos fiscales y tecnologías educativas innovadoras, puede contribuir de manera significativa a la formación de una cultura tributaria sólida y al fortalecimiento de la confianza en el sistema tributario.

ABSTRACT In an environment where lack of tax knowledge and tax evasion are significant challenges, this study aims to analyze effective strategies to improve tax awareness through tax education training. Several research studies were reviewed that highlight the importance of specific tax education programs and alliances with the educational system from an early age. The results indicate that the implementation of training programs and the promotion of transparency in public management can strengthen taxpayers' understanding of their tax obligations, thus promoting greater voluntary compliance. It is concluded that adequate tax education, combined with tax incentives and innovative educational technologies, can contribute significantly to the formation of a solid tax culture and to the strengthening of trust in the tax system.

Abstract In 2016, the Peruvian Stock Market Superintendency (SMV, by its Spanish acronym) mandated listed companies to publish a Corporate Sustainability Report in the Peruvian stock market as part of corporate governance policies. This research aims to analyze the evolution of compliance levels with the requirements for the sustainability reports established by the SMV as well as the corporate determinants for listed companies in Peru. This quantitative and explanatory research was conducted using a panel data linear regression analysis with fixed effects for the period 2018-2022, to assess the determinant effect of the independent variables on levels of corporate sustainability reporting compliance. The results show an unsteady increase in the level of sustainability reporting compliance until 2022, mainly in social performance. For the regression model with fixed effects on the year variable, the following are determinants of the level of sustainability reporting compliance: company size, belonging to sectors with higher sustainability impact, and voluntary sustainability reporting.

Resumen Desde el año 2016, la Superintendencia del Mercado de Valores del Perú (SMV) ha establecido la obligatoriedad para las empresas cotizadas de publicar el reporte de sostenibilidad corporativa en el mercado de valores peruano como parte de las políticas de gobierno corporativo. Esta investiga ción tiene como objetivo analizar la evolución del nivel de cumplimiento de los requerimientos para la elaboración de los reportes de sostenibilidad exigidos por la SMV y analizar los determinantes corporativos para las empresas cotizadas en Perú. Este estudio, cuantitativo y explicativo, se realizó mediante un análisis de regresión lineal de datos de panel con efectos fijos para el periodo 2018- 2022, con el fin de evaluar el efecto determinante de las variables independientes sobre el nivel de cumplimiento de los reportes de sostenibilidad corporativa. Los resultados muestran un aumento no sostenido en el nivel de cumplimiento de los informes de sostenibilidad hasta 2022, principalmente en el desempeño social. Para el modelo de regresión con efectos fijos sobre la variable año, los determinantes del nivel de cumplimiento de reporte de sostenibilidad son los siguientes: el tamaño de la empresa, la pertenencia a sectores con mayor impacto en la sostenibilidad y la elaboración voluntaria de reportes de sostenibilidad.

Abstract (Introduction): Green State accreditation program is an instrument created by the Chilean Ministry of the Environment so that Chilean public institutions, on a voluntary basis, can conduct environmental management in their facilities. Among the main purposes of the program, it seeks to encourage the advance of environmental habits in public officials through environmental education. (Objective): To determine if the educational and communicational campaigns promoted by the program have generated changes in the environmental habits and behaviors of civil servants. (Methodology): The combined method was used, and for this purpose a survey was designed, on a universe of 25 000 employees obtaining a sample of 270 cases, with a confidence level of 90 % and an error level of 5 %. In addition, 15 in-depth interviews were conducted. The results were analyzed separately and then a cross analysis was developed. (Results): Officials recognize changes in habits favorable to environmental care in their institutions, although these are not generalized. (Conclusions): While the Green State accreditation program does induce changes in habits and behaviors among public employees, it requires additional reinforcement in the promotion of its educational strategies and modifications in certain requirements to fully achieve its goal in non-formal environmental education. Furthermore, the findings may be useful for Latin American States to adopt pro-environmental actions in the administrative functioning of their public institutions

Resumen (Introducción): El programa Estado Verde es un instrumento de acreditación creado por el Ministerio del Medio Ambiente de Chile para que las instituciones públicas del país, de forma voluntaria, puedan desarrollar una gestión ambiental en sus dependencias. El programa busca, entre sus principales fines, fomentar el desenvolvimiento de hábitos ambientales en las personas funcionarias públicas, mediante la educación ambiental. (Objetivo): Determinar si las campañas educacionales y comunicacionales que promueve el programa han generado cambios en los hábitos y las conductas ambientales del personal público. (Metodología): Se utilizó el método combinado y para ello se elaboró una encuesta, sobre un universo de 25 000 personas funcionarias. Se obtuvo una muestra de 270 casos, con un nivel de confianza del 90 % y de error de 5 %. Asimismo, se aplicaron 15 entrevistas en profundidad. Los resultados se analizaron por separado y luego se efectuó un análisis cruzado. (Resultados): Las personas funcionarias reconocen cambios de hábitos favorables para el cuidado ambiental en sus instituciones, aunque estos no son generalizados. (Conclusiones): Si bien el programa Estado Verde genera cambios de hábitos y conductas en el personal público, requiere un reforzamiento en el fomento de sus estrategias educativas y de modificaciones en algunas exigencias, para un pleno cumplimiento de su objetivo en materia de educación ambiental no formal. Asimismo, los hallazgos pueden ser útiles para que los Estados latinoamericanos adopten acciones proambientales en el funcionamiento administrativo de sus instituciones públicas.

Abstract: Fear is one of the most reviewed emotions in gender studies due to its impact on the experiences of various sociodemographic groups in the contemporary city. Simultaneously, it has been evident how care activities have been reduced in urban design criteria, negatively impacting the quality of life of caregivers. Despite this diagnosis, to date a lack of tools has been identified that allow analyzing the experiences of fear and care in the city. This shortage limits implementing strategies that favor improving public spaces in favor of social integration and care. The article's objective proposes to discuss the design and applicability of an intersectional tool that allows identifying spaces of fear and care in the city, delving into the relationship between citizen experiences and urban design with a gender perspective. Methodologically, for its development, a bibliographic analysis is presented to identify theories and methodologies that support the structuring of the tool, as well as urban design elements with a gender focus to be evaluated by the population. As a result, a tool is presented in a digital platform format structured on the principles of participatory mapping and voluntary geographic information and supported by theories of subjective well-being and citizen science. Finally, the tool for data collection is presented on a free-access citizen participation web platform and app, and alternatives are reflected to incorporate the needs of various sociodemographic groups in urban planning.

Resumen: El miedo es una de las emociones más revisadas en los estudios de género por su impacto sobre las experiencias de diversos grupos sociodemográficos en la ciudad contemporánea. Simultáneamente se ha evidenciado cómo las actividades de cuidado han sido mermadas en los criterios de diseño urbano, impactando negativamente sobre la calidad de vida de las personas cuidadoras. A pesar de este diagnóstico, a la fecha se identifica una carencia de herramientas que permitan analizar las experiencias del miedo y el cuidado en la ciudad. Esta escasez limita la implementación de estrategias que favorezcan la mejora de los espacios públicos en favor de la integración social y los cuidados. El objetivo del artículo propone discutir el diseño y aplicabilidad de una herramienta interseccional que permita identificar los espacios del miedo y el cuidado en la ciudad,profundizando en la relación entre experiencias ciudadanas y diseño urbano con enfoque de género. Metodológicamente, para su desarrollo se presenta un análisis bibliográfico para identificar teorías y metodologías que sustenten la estructuración de la herramienta, así como elementos de diseño urbano con enfoque de género a ser evaluados por la población. Como resultado se muestra una herramienta en formato de plataforma digital estructurada sobre los principios del mapeo participativo e información geográfica voluntaria, sustentada por teorías de bienestar subjetivo y ciencia ciudadana. Finalmente, se presenta la herramienta para el levantamiento de datos en una plataforma web y app de participación ciudadana de libre acceso, y se reflexiona sobre alternativas para incorporar necesidades diversos grupos sociodemográficos en la planificación urbana.

Resumen El objetivo de este artículo es presentar los principales argumentos en torno al concepto de desarrollo sostenible empresarial y describir la influencia que éste ha tenido en las empresas y sus operaciones. Se explica la literatura relevante sobre el desarrollo sostenible, sus desafíos actuales y algunas de las direcciones futuras. La argumentación sugiere que antes de desarrollar campañas verdes en los negocios, todavía hay una serie de cuestiones sin resolver en torno al concepto de desarrollo sostenible. Así mismo, existe una necesidad particular de comprender la motivación real de las empresas para la sostenibilidad. Por ejemplo, a nivel de la industria, el comportamiento de una empresa es un tema complejo de controlar, ya sea a través de parámetros legales preestablecidos o mediante un enfoque voluntario. El interés en las prácticas sostenibles ha creado implicaciones importantes para los gerentes de casi todas las industrias que buscan comprender mejor los argumentos en torno al concepto de desarrollo sostenible y el compromiso que las empresas deben asumir para abordar estos desafíos ambientales. Este artículo contribuye a resaltar los desafíos actuales en torno al concepto de desarrollo sostenible describiendo algunos de los desafíos futuros que enfrentará para brindar una mejor aplicación para las empresas.

Abstract The aim of this paper is to present the main arguments around the concept of sustainable development as a business perspective and the influence that this concept has brought to firms and their operations. It explains relevant literature on sustainable development describing its foundations, their current challenges and some of the future directions along which the concept can achieve its intended purpose. The arguments suggest that before calling for a massive green campaign in business, there are unresolved issues around the concept of sustainable development, there is a particular need to understand the real motivation of firms for sustainable. For example, at the industry level, a firm’s behavior is a complex issue to control - either through pre-established legal parameters or through a voluntary approach. The interest in sustainable practices has created important implications for managers in almost every industry looking to better understand the arguments around the concept of sustainable development and the commitment that firms should make to address these environmental challenges. Research centered only on economic benefits or only on environmental issues can lead to an incomplete vision of the opportunities for firms that both approaches can generate if they are correctly combined.

Resumen: En este artículo se sostiene, en primer lugar, que (1) la persistencia a nivel internacional de debates éticos en torno al estatus moral del nasciturus y (2) el tradicional compromiso deontológico de los profesionales sanitarios con la salud, tanto de la embarazada como del hijo que espera, dotan de pleno sentido y vigencia al derecho a la objeción de conciencia de dichos profesionales. Sin embargo, donde el aborto legal se configura como prestación sanitaria, surge entonces la dificultad de gestionar esa prestación y, al tiempo, el conflicto moral que expresa la objeción de conciencia. Si en una institución sanitaria pública la objeción es generalizada, se plantea una disyuntiva con implicaciones éticas entre derivar a las gestantes a otras instituciones o aplicar estrategias de integración de personal a nivel de servicio de salud. En el caso de España, se ha aprobado este año una reforma de la Ley Orgánica de salud sexual y reproductiva y de la interrupción voluntaria del embarazo (LOSSRIVE), que manifiesta una voluntad más taxativa de que la objeción de conciencia no impida el acceso al aborto en las instituciones sanitarias públicas, estableciéndose previsiones específicas al efecto. A partir de los trabajos parlamentarios identificamos los principales puntos de discrepancia política que remiten a dispares posiciones de fondo sobre el aborto y afectan al propio planteamiento de la reforma, así como a otros elementos no siempre novedosos -algunos de ellos ya estaban en la LOSSRIVE o se venían aplicando a nivel autonómico con el plácet del Constitucional.

Abstract: This article argues, first, that (1) the persistence at the international level of ethical debates on the moral status of nasciturus and (2) the traditional ethical commitment of health professionals to the health of both the pregnant woman and the unborn child, give full sense and validity to the right to conscientious objection of these professionals. However, where legal abortion is configured as a health care service, the difficulty of managing this service and, at the same time, the moral conflict expressed by conscientious objection arises. If, in a public health institution, objection is widespread, there is a dilemma with ethical implications between referring pregnant women to other institutions or implementing staff integration strategies at the health service level. In the case of Spain, a reform of the Organic Law on Sexual and Reproductive Health and the Voluntary Interruption of Pregnancy (LOSSRIVE) was approved this year, which shows a more stringent willingness that conscientious objection does not prevent access to abortion in public health institutions, establishing specific provisions to that effect. Based on the parliamentary work, we identified the main points of political discrepancy, which remit to different basic positions on abortion and affect the very approach of the reform, as well as other not always new elements -some of them were already in the LOSSRIVE or were already being applied at the regional level with the approval of the Constitutional Court.

Resumo: Este artigo argumenta, em primeiro lugar, que (1) a persistência, em nível internacional, de debates éticos sobre o status moral do nascituro e (2) o tradicional compromisso deontológico dos profissionais de saúde com a saúde da gestante e do filho que ela espera, dão pleno sentido e vigência ao direito à objeção de consciência desses profissionais. Entretanto, quando o aborto legal é configurado como um serviço de saúde, surge a dificuldade de gerir esse serviço e, ao mesmo tempo, gerir o conflito moral expresso pela objeção de consciência. Se, em uma instituição de saúde pública, a objeção for generalizada, haverá uma escolha com implicações éticas entre encaminhar as gestantes a outras instituições ou aplicar estratégias de integração de pessoal no nível do serviço de saúde. No caso da Espanha, foi aprovada este ano uma reforma da Lei Orgânica de Saúde Sexual e Reprodutiva e a Interrupção Voluntária da Gravidez (LOSSRIVE) que expressa uma vontade mais constrangedora de garantir que a objeção de consciência não impeça o acesso ao aborto em instituições públicas de saúde, estabelecendo disposições específicas para esse fim. Com base no trabalho parlamentar, identificamos os principais pontos de discrepância política, que remetem a diferentes posições de fundo sobre aborto e afetam a própria aproximação da reforma, assim como outros elementos que nem sempre são novos -alguns deles já estavam no LOSSRIVE ou já estavam sendo aplicados em nível regional com a aprovação do Tribunal Constitucional-.

Resumen (Introducción): El cultivo de madera sostenible pierde terreno ante la producción agrícola y otros usos de la tierra; para contrarrestar esto, es necesario entender de qué manera el ente productor toma decisiones en la adopción voluntaria de sistemas agrícolas. Por consiguiente, deben diseñarse esquemas de manejo ajustados a cómo los pequeños productores gestionan los sistemas productivos de una forma voluntaria. (Objetivo): Identificar los factores que influyen en el proceso de toma de decisiones de los pequeños grupos productores que deben ser considerados para la promoción del cultivo de madera. (Metodología): Se aplicaron encuestas con preguntas abiertas y selección única al 100 % de los entes productores (N = 77) de dos asentamientos del INDER. Por la complejidad de las interacciones entre factores, se simplificó el análisis a cuatro enfoques. La tendencia de los datos se graficó a partir de un modelo de regresión local (LOESS), en el cual la curva de regresión se generó y suavizó con el uso de la función geom_smooth del lenguaje estadístico R. (Resultados): Se identificó un total de 162 interacciones entre factores indirectos y directos, estas mismas se clasificaron en tres grupos según las veces que el sujeto productor cambió de sistema de producción en periodos cortos (cinco años). Así, el Grupo A tuvo una mayor representación en la población con un 67.5 %, le siguieron el Grupo B con un 24.7 % y el Grupo C con un 7.8 %. El 67.5 % no se encontraba de acuerdo en incluir el cultivo de madera. (Conclusiones): Se demostró la existencia de factores de decisión que influyen en cómo el sujeto productor adopta los sistemas agrícolas contrarios al cultivo de madera. La venta segura (VS) es uno de ellos; por lo tanto, hasta que no se ajusten los esquemas de manejo forestal actuales, la posibilidad de una adopción espontánea es mínima y seguirá necesitando de ayudas financieras.

Abstract (Introduction): Sustainable timber cultivation is losing ground to agricultural production and other land uses; To counteract this, it is necessary to understand how the farmer makes decisions. Therefore, management schemes must be designed that adjust to the way in which small farmers manage productive systems on a voluntary basis. (Objective): Identify the factors that influence the decision-making process of small farmers that must be considered for the promotion of timber cultivation. (Methodology): Surveys with open questions and single selection were applied to 100% of the farmers (N = 77) of two INDER settlements. Due to the complexity of the interactions between factors, the analysis was simplified into four approaches. The data trend was plotted from a local regression model (LOESS), in which the regression curve is generated and smoothed with the use of the geom_smooth function of the R statistical language. (Results): A total of 162 interactions between Indirect and Direct factors. They were classified into three groups according to the number of times the farmer changed the production system in short periods (5 years). Group A has a greater representation in the population with 67.5 %, followed by Group B with 24.7 % and Group C with 7.8 %. 67.5 % of the farmers did not agree to include the cultivation of wood. (Conclusions): It was possible to demonstrate the existence of decision factors that influence the way in which the farmers adopt the agricultural systems contrary to the cultivation of wood. Safe selling (VS) is one of them; therefore, until current forest management schemes are adjusted, the possibility of spontaneous adoption is minimal and will continue to require financial aid.

INTRODUCTION: Disability often leaves individuals reliant on caregivers for care and oral hygiene, particularly the young, severely impaired and institutionalised. However, these caregivers may lack adequate knowledge on oral hygiene and proper diet, leading to unhealthy eating habits or cariogenic snacks and increasing the risk of oral diseases throughout their lifetime. AIMS AND OBJECTIVES: To ascertain educators' and caregivers' oral health knowledge, attitudes and practices within the identified special schools, by means of a self-administered questionnaire. DESIGN: A cross-sectional KAP survey design. METHODS: This study was conducted in 22 out of 33 special schools located in eThekwini district which consented to participate in the study. On average, each of the 22 special schools had about 40 educators and caregivers combined. A self-administered questionnaire was used to collect the data. Twenty questionnaires - which is 50% of the targeted population - were sent out to each school, and participation was voluntary. Ultimately, 440 questionnaires (20 questionnaires per school) were sent out. RESULTS: Only 312 of the 440 questionnaires were completed, yielding a response rate of 70.90%. Just over half of the study participants (n=161; 51.6%) believed that brushing twice daily and rinsing with mouthwash is the most important dental self-care practice. Only 46.8% of participants believed that sugar consumption contributes to tooth decay due to bacteria turning sugar into acid. Most respondents (n=205; 65.7%) strongly agreed that brushing and flossing their teeth reduces tooth decay risk, with 221 participants (70.8%) believing they have a responsibility to prevent tooth loss. However, 51.3% of study participants disagreed with the statement that dentures are less troublesome than taking care of natural teeth. About 83.1% of participants brushed their teeth twice daily, with 61.54% brushing for 2-3 minutes. Furthermore, 71.8% of participants used medium bristles and 47.76% replaced their toothbrush every 1-3 months. Most participants agreed that visiting a dentist is necessary, with a small percentage (2.24%) having never visited before. The majority of participants (85.6%) stated that their oral health practices, attitudes and knowledge could influence how oral health education is given to school students. CONCLUSION: The results of the present study showed some inconsistencies in the knowledge, attitudes and practices of the educators and caregivers. Oral health awareness among these individuals is essential and should be done on a regular basis.

Resumen El artículo analiza la experiencia de mujeres sin hijos respecto del acceso a la ligadura de trompas en Manaus/AM, Brasil. Se trata de un estudio netnográfico, con 20 participantes de un grupo privado en una red social. La recolección de datos se realizó mediante la publicación de un guión con posts temáticos, del 21 de junio al 13 de septiembre de 2022, y posterior análisis de contenido. La primera categoría de resultados aborda las dificultades para realizar la cirugía, sus requisitos y el acceso informal al conocimiento de los derechos sexuales y reproductivos. La segunda, la nulidad del consentimiento de las mujeres como principal característica de la atención brindada por los profesionales de la salud. El tercero, el itinerario emocional impuesto a quienes buscan la ligadura de trompas. Se concluye que el consentimiento para la realización de ligadura de trompas es invalidado por los profesionales de la salud, quienes promueven la refundación de la Ley y actúan como representantes de la biopolítica estatal de control de los procesos reproductivos.

Abstract The article analyzes the experience of childless women regarding access to tubal ligation in Manaus/AM, Brazil. This is a netnographic study, with 20 participants from a private group on a social network. Data collection took place through the publication of a script with thematic posts, from June 21st to September 13th, 2022, and subsequent content analysis. The first category of results addresses the difficulties in performing the surgery, its requirements and informal access to knowledge of sexual and reproductive rights. The second, the invalidity of women’s consent as the main characteristic of care provided by health professionals. The third, the emotional itinerary imposed on those seeking tubal ligation. It is concluded that consent to perform tubal ligation is invalidated by health professionals, who act by promoting the refoundation of the Law and acting as representatives of the State’s biopolitics of control of reproductive processes.

Resumo O artigo analisa a experiência de mulheres sem filhos quanto ao acesso à laqueadura em Manaus/AM, Brasil. Trata-se de estudo netnográfico, com 20 participantes do grupo privado de uma rede social. A coleta de dados se deu por meio da publicação de roteiro com postagens temáticas, de 21 de junho a 13 de setembro de 2022, e posterior análise de conteúdo. A primeira categoria de resultados aborda as dificuldades quanto à realização da cirurgia, seus requisitos e o acesso informal ao conhecimento dos direitos sexuais e reprodutivos. A segunda, a invalidez do consentimento da mulher como característica principal do atendimento por profissionais de saúde. A terceira, o itinerário emocional imposto a quem busca a laqueadura. Conclui-se que o consentimento para realização da laqueadura tubária é invalidado por profissionais de saúde, que agem promovendo a refundação da Lei e atuando como representantes da biopolítica de Estado de controle dos processos reprodutivos.

RESUMEN La ataxia en los niños es un signo clínico común e inespecífico que puede tener diversos orígenes. En la ataxia cerebelosa, las principales características implican alteraciones en la postura, la marcha, los movimientos oculares, el tono muscular, los movimientos voluntarios y el habla. La escala breve de calificación de ataxia (BARS, por sus siglas en inglés) evalúa áreas significativas para detectar signos de disfunción cerebelosa. Puede realizarse en poco tiempo e implementarse a partir de los cuatro años. Es una herramienta válida y confiable para evaluar la ataxia en la población pediátrica. El objetivo de este paso a paso es describir la aplicación de la BARS.

ABSTRACT Ataxia in children is a common and nonspecific clinical sign that can have various origins. In cerebellar ataxia, the main characteristics involve alterations in posture, gait, eye movements, muscle tone, voluntary movements, and speech. The Brief Ataxia Rating Scale (BARS) evaluates significant areas to detect signs of cerebellar dysfunction. It can be administered quickly and implemented from the age of four. It is a valid and reliable tool for assessing ataxia in the pediatric population. The objective of this step by step is to describe the application of the BARS.