ABSTRACT This article presents ethnographic notes and critical reflections I made as a participant observer at the public hearing for Case n. 0011-18-CN, concerning equal marriage, held on March 29, 2019. Guided by the questions "Why is the recognition of equal marriage a subject of dispute?" and "How does the recognition of equal marriage become a moral field of dispute?", it examines the legal, symbolic and procedural mechanisms that emerged during the debate and approval of one of the protective measures the Constitutional Court had to consider recognizing this civil right in Ecuador. This note provides theoretical-methodological insights and some empirical findings derived from my ethnographic work as part of a broader research project on citizenship regimes.

RESUMEN Este artículo recoge mis anotaciones y mis reflexiones etnográficas, como observadora participante, en la audiencia pública del caso n.° 0011-18-CN -matrimonio igualitario- del 29 de marzo del 2019. Orientada por las preguntas ¿por qué el reconocimiento del matrimonio igualitario es un campo de disputa? y ¿cómo el reconocimiento del matrimonio igualitario se convierte en un campo de disputa del orden moral?, se examinan los mecanismos legales -simbólicos y procedimentales- que se produjeron a través del debate y anuencia en torno a una de las acciones de protección que la Corte Constitucional ecuatoriana tuvo que procesar para reconocer este derecho civil. Esta nota presenta algunos aprendizajes teórico-metodológicos y hallazgos empíricos desprendidos del ejercicio etnográfico dentro de un programa de investigación más amplio.

Abstract In 2017, Decree 1421 was issued in Colombia, according to which all schools in the country were to welcome students with disabilities and offer them quality opportunities for their entry, permanence and graduation. The Ministry of Education (MEN, 2017a) gave a deadline of five years for this policy to be implemented in the national territory, counted from its approval. The objective of this research is to characterize the pedagogical practices, knowledge and institutional conditions (pedagogical and administrative type) in which a sample of Colombian teachers work, six years after the decree was issued. For this purpose, a transectional non-experimental quantitative design was used and a scale was applied to 249 teachers of early childhood education, elementary school, junior high school and vocational middle school. Based on the findings obtained, it can be concluded that there is a positive change in the pedagogical practices and knowledge of those teachers who have training in inclusion and who work in private schools that receive students with these life trajectories. Even so, the institutional conditions of the teachers surveyed still do not respond to inclusive institutional projects. Since, at the time of writing this paper, we did not find other similar studies in the country, these results are discussed in the light of international research on the subject and in the framework of national policy, and allow extrapolating the challenges faced by the Colombian educational system in welcoming students with disabilities.

Resumen En 2017 se expidió en Colombia el decreto 1421, según el cual todas las escuelas del país debían acoger estudiantes con discapacidad y ofrecerles oportunidades de calidad para su ingreso, permanencia y egreso. El Ministerio de Educación dio un plazo de cinco años, contados a partir de su aprobación, para que esta política se implementara en todo el territorio nacional. El objetivo de esta investigación es caracterizar las prácticas pedagógicas, los conocimientos y las condiciones institucionales (de tipo pedagógico-administrativo), en las que labora una muestra de docentes colombianos, seis años después de expedido el decreto. Para ello, se utilizó un diseño cuantitativo no experimental transeccional y la aplicación de una escala a 249 maestros y maestras de distintos niveles educativos. Con base en los hallazgos obtenidos, puede concluirse que hay un cambio positivo en las prácticas pedagógicas y los conocimientos de aquellos docentes que cuentan con formación en inclusión y que laboran en colegios que acogen alumnado con estas trayectorias de vida. Aun así, las condiciones institucionales del profesorado encuestado todavía no responden a proyectos inclusivos. Estos resultados se discuten a la luz de los retos que enfrenta el sistema educativo colombiano en pro de atender alumnado con discapacidad.

Resumen La cartografía temática es un insumo principal para planificación territorial en Ecuador, por lo que es indispensable que sea validada. El Instituto Geográfico Militar es el ente encargado de la gestión y aprobación de cartografía en el país, y que, desde el año 2018, ejecuta proyectos de generación de geoinformación temática a escala 1: 5 000; utilizando, como enfoque científico, la ecología de paisaje y, para la validación de cartografía temática, métodos estadísticos (no probabilísticos) y técnicas de muestreo, a fin de comparar los modelos cartográficos generados con la realidad del territorio, aplicando la matriz de confusión. En este sentido, este artículo presenta la metodología para determinar sitios de muestreo para campo de tres ciudades: Quito, Guayaquil y Cuenca. Los resultados indicaron, en cuanto a la validación de cartografía de Capacidad de Acogida, que dichas ciudades tuvieron un 77 %, 47 % y 79 %, respectivamente, de coincidencia modelo-realidad, con un índice kappa de 0.66, 0.16 y 0.63, respectivamente.

Resumo A cartografia temática é um dos principais insumos para o planejamento territorial no Equador, portanto, é essencial que seja validada. O Instituto Geográfico Militar é a entidade responsável pela gestão e aprovação da cartografia no país e que, desde 2018, executa projetos para a geração de geoinformação temática na escala 1: 5 000; utilizando, como abordagem científica, a ecologia da paisagem e, para a validação da cartografia temática, métodos estatísticos (não probabilísticos) e técnicas de amostragem, a fim de comparar os modelos cartográficos gerados com a realidade do território, aplicando a matriz de confusão. Nesse sentido, este artigo apresenta a metodologia para determinar os locais de amostragem de campo para três cidades: Quito, Guayaquil e Cuenca. Os resultados indicaram, em termos de validação do mapeamento da capacidade de carga, que essas cidades tiveram 77%, 47% e 79%, respectivamente, de coincidência entre modelo e realidade, com um índice kappa de 0,66, 0,16 e 0,63, respectivamente.

Abstract Thematic cartography is a main input for territorial planning in Ecuador, so it is essential that it be validated. The Instituto Geográfico Militar is the entity in charge of the management and approval of cartography in the country, since 2018, has been implementing thematic geoinformation generation projects at a scale of 1: 5 000; using, as a scientific approach, landscape ecology and, for thematic mapping validation, statistical methods (non-probabilistic) and sampling techniques, in order to compare the cartographic models generated with the reality of the territory, applying the confusion matrix. This article presents the methodology to determine sampling sites for field of three cities: Quito, Guayaquil and Cuenca. The results indicated, in terms of the validation of Reception Capacity cartography, that these cities had a 77 %, 47 % and 79 % respectively of model-reality match, with a kappa index of 0.66, 0.16 and 0.63, respectively.

Resumen El objetivo de este estudio observacional y retrospectivo fue evaluar el punto de corte de 100 mg/dL para glucemia en ayunas alterada (GAA) en una población adulta ambulatoria de la Argentina en 2023. Se obtuvo aprobación del Comité de Ética. Se utilizó Chi cuadrado y concordancia Kappa. Se incluyeron 510 individuos. Se obtuvieron los siguientes resultados para GAA (diferencia en porcentaje estadísticamente significativa entre 100 mg/dL y 110 mg/dL, p=0,0001): total (36 vs. 10); mujeres (31 vs. 9); hombres (51 vs. 14); <40 años (24 vs. 3); ≥40 años (46 vs. 17); mujeres ≥40 años (40 vs. 16); hombres ≥40 años (60 vs. 19). La concordancia fue entre pobre y moderada. El valor de 100 mg/dL clasificó un 26% más de personas con GAA que el valor 110 mg/dL, lo que evidencia su impacto en la prevención de la diabetes, en particular en hombres ≥40 años.

Resumo O objetivo deste estudo observacional e retrospectivo foi avaliar o ponto de corte de 100 mg/dL para glicemia em jejum alterada (GJA) em uma população adulta ambulatorial da Argentina em 2023. A aprovação foi obtida do Comitê de Ética. Qui-quadrado e concordância Kappa foram utilizados. Foram incluídos 510 indivíduos. Os seguintes resultados foram obtidos para GJA (diferença estatisticamente significativa em percentual entre 100 mg/dL e 110 mg/dL; p=0,0001): total (36 vs. 10); mulheres (31 vs. 9); homens (51 vs. 14); <40 anos (24 vs. 3); ≥40 anos (46 vs. 17); mulheres ≥40 anos (40 vs. 16); homens ≥40 anos (60 vs. 19). A concordância foi entre pobre-e moderada. O valor de 100 mg/dL classificou 26% mais pessoas com GJA do que o valor de 110 mg/dL, demonstrando seu impacto na prevenção do diabetes, principalmente em homens ≥40 anos.

Abstract The aim of this observational and retrospective study was to evaluate the value of 100 mg/dL for impaired fasting glucose (IFG) in an adult outpatient population from Argentina, in 2023. Approval was obtained from the Ethics Committee. Chi-square test and Kappa agreement were used. A total of 510 individuals were included. The following results were obtained for IFG (statistically significant difference in percentage between 100 mg/dL and 110 mg/dL; p=0.0001): total (36 vs. 10); women (31 vs. 9); men (51 vs. 14); <40 years old (24 vs. 3); ≥40 years old (46 vs. 17); women ≥40 years old (40 vs. 16); men ≥40 years old (60 vs. 19). Agreement ranged from poor to moderate. The value of 100 mg/dL classified 26% more people with IFG than the value of 110 mg/dL, making evident its impact on the prevention of diabetes, particularly in men ≥40 years of age.

Abstract Background: Patent Ductus Arteriosus (PDA) is the most common congenital heart disease, particularly prevalent among preterm newborns (PTNB) and those with low birth weight. Surgical closure is traditionally considered after the failure of pharmacological treatment. The aim was to analyze the immediate and long-term outcomes of surgical PDA closure in PTNB. Methods: This analytical study evaluated PTNB who underwent PDA surgery between January 2002 and December 2023 at the Hospital Clínico Regional “Dr. Guillermo Grant Benavente” in Concepción, Chile. The databases were reviewed with prior approval from the Ethical-Scientific Committee. PTNB were defined as those with a gestational age (GA) of less than 37 weeks. Data analysis was performed using SPSS® v29, and survival rates were graphed using the Kaplan-Meier method. Results: Since 1993, a total of 263 cases have been recorded in the PDA protocol registry. During the study period, 167 cases were identified, of which 131 (78.3%) were PTNB. Among them, 65 (49.6%) were male. The average GA was 26.4±2.3 weeks and the average birth weight was 900±348 grams. Pharmacological treatment failed in all cases included. At the time of surgery, the average age was 35.0±43.2 days, and the average weight was 1,443±1,716 grams. A left posterolateral thoracotomy with an extrapleural approach and primary closure with clips was performed. Immediate complications included post-ligation syndrome in 42 (32.1%) cases and atelectasis in 14 (10.7%) cases. There was no intraoperative mortality. The 30-day mortality rate was 15 (11.5%) cases. The 10-year survival rate was 82.4%. Conclusion: Clipping is the preferred technique at our center and has shown results comparable to other series. Mortality was mainly due to medical comorbidities such as sepsis and respiratory tract immaturity.

Resumen Antecedentes: El Ductus Arterioso Persistente (DAP) es la cardiopatía congénita más frecuente. Es más prevalente en recién nacidos de pretérmino (RNPT) y bajo peso al nacer. El cierre quirúrgico está indicado tradicionalmente tras el fracaso del cierre farmacológico. El objetivo es analizar los resultados inmediatos y alejados del cierre quirúrgico del DAP en RNPT. Métodos: Estudio analítico de RNPT operados por DAP en el período desde enero-2002 y diciembre-2023 en el Hospital Clínico Regional “Dr. Guillermo Grant Benavente”, Concepción-Chile. Se revisaron bases de datos previa aprobación de Comité Ético-Científico. Se consideró RNPT <37 semanas de edad gestacional (EG). Se utilizó SPSS® v29, se graficó supervivencia mediante método de KaplanMeier. Resultados: En el período de análisis hubo 167 casos, de es de los cuales 131 (78,3%) eran RNPT. Fueron hombres 65 (49,6%) y la edad gestacional (EG) promedio fue 26,4±2,3 semanas, con peso al nacer de 900±348 gramos. Todos los casos tuvieron tratamiento farmacológico previo. Al momento de la cirugía, la edad promedio era 35,0±43,2 días y el peso promedio 1.443±1.716 gramos. Se realizó una toracotomía posterolateral izquierda, con abordaje extrapleural y cierre principalmente mediante clipaje. Las complicaciones inmediatas fueron: síndrome post ligadura en 42 (32,1%) y atelectasia en 14 (10,7%). No hubo mortalidad intraoperatoria. A 30 días post cirugía fallecieron 15 casos, (11,5%) La supervivencia a 10 años fue 82,4%. Conclusiones: El cierre mediante clipaje es la técnica de elección en nuestro centro y demostró resultados comparables a diferentes series incluidas en la discusión. La mortalidad fue debida principalmente a comorbilidades médicas como sepsis e inmadurez del tracto respiratorio.

RESUMEN: A lo largo de la historia, el conocimiento sobre las meninges ha evolucionado desde los primeros registros en el papiro de Edwin Smith hasta la actualidad, donde se ha descrito SLYM, una cuarta meninge que separa el espacio subaracnoideo en un compartimiento superficial y otro profundo, a la que se le atribuyen funciones de barrera semipermeable y de nicho de células inmunes para la vigilancia y protección del sistema nerviosos central. La FIPAT contiene un grupo de terminologías que son mundialmente aceptadas para la descripción de las estructuras del cuerpo humano, sin embargo, en Terminologia Anatomica, Ter- minologia Neuroanatomica y Terminologia Histologica, aún no se encuentra incluido el término SLYM para representar una cuarta meninge, quizás porque sea un reciente descubrimiento. El objetivo de este estudio fue sugerir un nuevo término que concuerde con los lineamientos de la FIPAT y con las reglas de Terminología Anatómica Regular (RAT) en reemplazo de SLYM, además de proponer su inclusión en Terminologia Anatomica, Terminologia Neuroanatomica y Terminologia Histologica, previa revisión y aprobación por parte del comité respectivo de la FIPAT. Se revisó el acrónimo SLYM y los elementos que lo conforman (membrana subaracnoidea de tipo linfática), desde un enfoque etimológico, este análisis estuvo acompañado de una revisión a las reglas RAT aceptadas por la FIPAT, que fueron consideradas para examinar su cumplimiento por parte del acrónimo SLYM. Se encontró que SLYM, al igual que los términos que lo componen no cumplen totalmente con las reglas RAT. El acrónimo SLYM no proporciona una descripción adecuada de la estructura que representa, lo que contradice las reglas RAT. Se propone el término Suprapiamater como alternativa, para su inclusión en Terminologia Anatomica, Terminologia Neuroanatomica y Terminologia Histologica, basado en elementos latinos que describen su ubicación y función, mejorando la precisión y claridad en la comunicación científica.

SUMMARY: Throughout history, knowledge about the meninges has evolved from the first records in the Edwin Smith papyrus to the present, where SLYM, a fourth meninge that separates the subarachnoid space into a superficial compartment and another, has been described deep, to which semipermeable barrier and immune cell niche functions are attributed for the surveillance and protection of the central nervous system. The FIPAT contains a group of terminologies that are globally accepted for the description of the structures of the human body, however, in Terminologia Anatomica, Terminologia Neuroanatomica and Terminologia Histologica, the term SLYM to represent a fourth meninge is not yet included, perhaps because be a recent discovery. The objective of this study was to suggest a new term that agrees with the FIPAT guidelines and with the Regular Anatomical Terminology (RAT) rules to replace SLYM, in addition to proposing its inclusion in Terminologia Anatomica, Terminologia Neuroanatomica and Terminologia Histologica, previously review and approval by the respective FIPAT committee. The acronym SLYM and the elements that make it up (Subarachnoid Lymphatic-like Membrane) were reviewed from an etymological approach. This analysis was accompanied by a review of the RAT rules accepted by FIPAT, which were considered to examine their compliance by the acronym SLYM. It was found that SLYM, like the terms that compose it, do not fully comply with the RAT rules. The SLYM acronym does not provide an adequate description of the structure it represents, which contradicts the RAT rules. The term suprapiamater is proposed as an alternative, for inclusion in Terminologia Anatomica, Terminologia Neuroanatomica and Terminologia Histologica, based on Latin elements that describe its location and function, improving precision and clarity in scientific communication.

Abstract The federalisation of science and technology in Argentina has gained momentum with the enactment of Law 27.614/2021 and the implementation, since 2022, of a ministerial budgetary program for this purpose. This article seeks to assess the territorial impact of Equipar Ciencia, one of the instruments associated with this funding. For this purpose, we analyse provincial data from the three main phases of allocation (June 2022-June 2023) and discuss the results in light of official statements and technical aspects of this and other science policy instruments. The provincial distribution of Equipar is consistent with a logic of positive discrimination, taking into account inequalities of origin and favouring the approval of a significant part of applications from less developed provinces, as opposed to what happens with scientific projects of the I+D+i Agency or the entry of researchers to CONICET. This dissociation does not facilitate a coherent policy of territorial deconcentration of public investment. Among the different institutional resistances, the federalisation funds and Equipar continue to be managed in a centralised manner.

Resumo A federalização da ciência e a tecnologia na Argentina ganhou impulso com a sanção da Lei 27.614/2021 e a implementação, desde 2022, de um programa orçamentário ministerial para esse fim. Este artigo procura avaliar o impacto territorial do Equipar Ciência, um dos instrumentos associados ao referido financiamento. Para isso, são analisados os dados provinciais das três principais rondas de repasse (junho 2022-junho 2023) e são discutidos os resultados a luz de declarações de agentes públicos bem como aspectos técnicos deste e outros instrumentos da política científica. A distribuição provincial do Equipar enquadra-se numa lógica de discriminação positiva, tendo em conta as desigualdades de origem e favorecendo a aprovação de boa parte dos pedidos de províncias de menor desenvolvimento relativo, ao contrário do que acontece com os projetos científicos da Agência I+D+i ou o ingresso de pesquisadores no CONICET. Esta dissociação não permite uma política consistente de desconcentração territorial do investimento público. Entre as diversas inércias institucionais, os fundos de federalização e o Equipar continuam a ser geridos de forma centralizada.

Resumen La federalización de la ciencia y la tecnología en Argentina ha ganado impulso con la sanción de la ley 27.614/2021 y la instrumentación, desde 2022, de un programa presupuestario ministerial para tal fin. Este artículo busca evaluar el impacto territorial del Equipar Ciencia, uno de los instrumentos asociados a dicho financiamiento. Para ello, se analizan datos provinciales de las tres principales rondas de adjudicación (junio de 2022-junio de 2023) y se discuten los resultados a la luz de declaraciones de funcionarios y aspectos técnicos de este y otros instrumentos de la política científica. La distribución provincial del Equipar se condice con una lógica de discriminación positiva, atendiendo a las desigualdades de origen y favoreciendo la aprobación de buena parte de las solicitudes de provincias de menor desarrollo relativo, lo contrario a lo que ocurre con los proyectos científicos de la Agencia I+D+i o el ingreso de investigadores al CONICET. Esta disociación no permite una política consistente de desconcentración territorial de la inversión pública. Entre las diversas inercias institucionales, los fondos de federalización y el Equipar continúan siendo gestionados de forma centralizada.

Resumen El objetivo del studio fue determinar los índices de reprobación de los cursos de la malla curricular de la Licenciatura en Odontología de la Universidad de Costa Rica de las cohortes del 2007 al 2014. Se utilizaron los datos de 736 expedientes. Las variables consideradas fueron: sexo, edad de ingreso, nacionalidad, estado civil, hijos, lugar y colegio de procedencia, nota de examen de admisión y cursos aprobados. Los datos se obtuvieron del Sistema de Aplicaciones Estudiantiles, los expedientes físicos y del Tribunal Supremo de Elecciones de Costa Rica. Se realizó estadística descriptiva, análisis bivariado y multivariado. El 98% de los estudiantes fueron costarricenses, el 68% mujeres, el 79% ingresó según la nota de admisión, el 43% ingresó con una edad de 18 años o menos, el 50% provenía de un colegio público, el 77% residía en la Gran Área Metropolitana y el 95% eran solteros y permanecieron sin hijos. El abandono de los estudios se presentó mayoritariamente en los primeros 4 ciclos de la carrera de odontología. Los cursos de la malla curricular que menor tasa de éxito total obtuvieron fueron cursos de servicio: Química General, Química Orgánica y Matemática Elemental. De los cursos propios la Clínica de Odontopediatría y Ortodoncia y la Clínica de Endodoncia fueron los cursos con más reprobación. Hubo una diferencia estadísticamente significativa entre la aprobación del curso de física y el colegio de procedencia. En la Licenciatura de Odontología de la Universidad de Costa Rica la reprobación es alta en los primeros cuatro ciclos de la Carrera, que es cuando más se imparten cursos de servicio. Respecto a los cursos propios, la Clínica de Odontopediatría y Ortodoncia y la Clínica de Endodoncia fueron los que obtuvieron la menor tasa de éxito.

Abstract The main objective of this study was to determine the failure rates of the courses in the curriculum of the Dentistry degree program at the University of Costa Rica for the cohorts from 2007 to 2014. Data from 736 records were used. The variables considered were the following: gender, age at admission, nationality, marital status, children, domicile, previous high school attended, admission exam scores, and approved courses. The data were obtained from the Student Application System, physical records, and the Supreme Electoral Tribunal of Costa Rica. Descriptive, bivariate, and multivariate analyses were performed. Among the students, 98% were Costa Rican, 68% were female, 79% were admitted based on their admission exam scores, 43% were admitted at the age of 18 or younger, 50% came from public schools, 77% resided in the Greater Metropolitan Area, and 95% were single and childless. The majority of study dropouts occurred in the first four cycles of the dentistry degree. The courses with the lowest overall success rate in the curriculum were service courses: General Chemistry, Organic Chemistry, and Elemental Mathematics. Among the core courses, the Pediatric Dentistry and Orthodontics Clinic and the Endodontics Clinic had the highest failure rates. Moreover, there was a statistically significant difference between the approval rates of the physics course and the school of origin. In the Dentistry degree program at University of Costa Rica, the failure rate is high in the first four cycles of the program, which is when service courses are mainly offered. As fo the core courses, the Pediatric Dentistry and Orthodontics Clinic and the Endodontics Clinic had the lowest success rates.

Abstract Objetivo: Avaliar a concordância da terapêutica com medicamentos modificadores de prognóstico (MMP) em pessoas com insuficiência cardíaca crónica com fração de ejeção reduzida (P-CICFEr), em cuidados de saúde primários (CSP) na região Centro de Portugal, com as diretrizes da Sociedade Europeia de Cardiologia (ESC) de agosto de 2021. Métodos: Estudo observacional transversal de uma amostra representativa do tamanho, intervalo de confiança de 95% e margem de erro de 8%, da população com CICFEr em 31/dezembro/2021. Foram estudados idade, sexo, ano de diagnóstico da introdução da Classificação Internacional para Cuidados Primários-2 (ICPC-2, K-77), anos desde o último ecocardiograma, MMPs para P-CICFEr e outras terapêuticas para P-CICFEr. Participaram, convidadas por conveniência, 11 Unidades de Saúde Familiar após parecer positivo da Comissão de Ética. Resultados: Num universo de n=2.381 pessoas com insuficiência cardíaca (PCIC) encontraram-se n=453 (19,0%) (P-CICFEr) estudando-se uma amostra representativa de n=133 (5,6%), n=95 homens (71,4%). Verificou-se prescrição de medicamentos inibidores do sistema renina-angiotensina-aldosterona (iSRAA) 91,0%, de betabloqueadores em 75,2%, de antagonistas mineralocorticoides em 40,6%, de inibidores da SGLT2 em 44,4%, de inibidores da neprilisina em 38,3% e de diuréticos de ansa em 72,2%. A terapêutica farmacológica quádrupla verificou-se em n=28 (21,1%) P-CICFEr e a tripla em n=38 (28,6%). Verificou-se idade média de 74,3±11,6 anos, 75,1±4,0 no homem e 76,6±6,0 na mulher, p=0,088. A mediana de tempo desde o diagnóstico ICPC-2 foi de 6,0 anos no homem e de 4,0 anos na mulher, p=0,031. O tempo mediano desde o último ecocardiograma foi de três anos, p=0,750. Conclusão: Os medicamentos modificadores de prognóstico, segundo as diretrizes mais recentes da ESC para a CICFEr, estavam subutilizados em 50,4% dos casos. Apesar dos resultados encontrados é necessária reflexão acerca das barreiras que os médicos possam encontrar para aplicar as diretrizes em P-CICFEr.

Resumo Objective: To evaluate the accordance of prognostic medicines prescription (PMP), for persons with chronic heart failure with reduced ejection fraction (P-CHFrEF), attended in primary health care units in Central Portugal, with the European Society of Cardiology (ESC) 2021 August, guidelines. To know about mean age, median time since the diagnosis and last echocardiogram performance in P-CHFrEF. Methods: Observational, cross-sectional study of a random size representative sample, 95% confidence interval, and 8% error margin of the P-CHFrEF of a population on 31st December 2021. Age, gender, year of International Classification for Primary Care-2 (ICPC-2, K-77) problem classification input data, years since the last echocardiogram, ongoing PMP and the use of other chronic heart failure (CHF) drugs were gathered. Data were obtained from 11 Portugal Primary Health Care Units, invited by convenience, after an Ethics Committee approval. Results: From a universe of n=2,381 persons with CHF, n=453 (19.0%) P-CHFrEF was found. A size representative sample of P-CHFrEF of n=133 (5.6%), n=95 males (71.4%) was studied. Prescription of a renin-angiotensin system inhibitor (RAAS-I) was ongoing in 91.0%, beta-blocker (BB) in 75.2%, mineralocorticoid antagonists (MRA) in 40.6%, inhibitors of the sodium-glucose cotransporter-2 (SGLT2i) in 44.4%, neprilisine inhibitors 38.3% and loop diuretics in 72.2%. The optimized medical quadruple therapy was established in 28 patients (21.1%) and the triple one in 38 (28.6 %). Mean age was of 74.3±11.6 years, males 73.4±11.0 and females 76.6±12.9, p=0.088. The median time since the diagnosis was 6.0 for men and 4.0 for women, p=0.031. The median time since the last echocardiogram was 3.0, p=0.750 between genders. Conclusion: According to the 2021 ESC guidelines, prognostic modifying medicines were underused for 50.4% of P-CHFrEF. Even with these results, a reflection must be made, on the barriers physicians encounter, to comply with the ESC guidelines in such patients.

Resumo O Acordo União Europeia-Mercado Comum do Sul, negociado desde o início de 2000, possui objetivos que vão além das relações comerciais. A cooperação proposta traz em seu conjunto a redução de barreiras tarifárias e não tarifárias, investimentos para o desenvolvimento de tecnologias, transporte, educação e, sobretudo, a promoção do desenvolvimento sustentável. Considerado como um dos maiores acordos inter-regionais, são grandes as perspectivas de uma próxima conclusão. Sopesando as questões que dificultam sua conclusão, o presente artigo tem como objetivo analisar, por meio de pesquisa bibliográfica e estudo documental, as implicações dos diversos cenários para a definitiva aprovação do Acordo. Para tanto, buscou-se estudar seu contexto histórico, desde a proposta inicial, passando pelas negociações e diversas interrupções ocorridas, para então avaliar o estado da arte e as perspectivas de concretização. A partir da análise realizada, concluiu-se que houve melhoria nas expectativas sobre a aprovação do Acordo, considerando a mudança recente no contexto político do Brasil e as diversas forças que têm sido realizadas nesse sentido. Contudo, as negociações são permeadas por influências políticas e cenários dinâmicos, que podem inviabilizar o consenso pretendido. A importância do presente estudo está relacionada às crescentes discussões sobre os efeitos do Acordo, principalmente no que tange à efetividade das cláusulas socioambientais negociadas, questão que pode ser analisada em trabalhos futuros, que avaliem a efetividade das cláusulas propostas e a possibilidade de harmonização das normas e políticas adotadas no âmbito das duas regiões.

Abstract The EU-Mercosur agreement, negotiated more than 20 years ago, has objectives that go beyond trade relations. The proposed cooperation includes the reduction of tariff and non-tariff barriers, investment in technology development, transportation, education, and, above all, the promotion of sustainable development. Considered as one of the largest interregional agreements, the prospects for its future conclusion are great. Considering the issues that make its conclusion difficult, this article aims to analyze, through bibliographical research and documentary study, the implications of the different scenarios for a definitive approval of the Agreement. To this end, its historical context has been studied, from the initial proposal, through the negotiations and the various interruptions that have occurred, to then evaluate the state of the art and the prospects for completion. From the analysis carried out, it was concluded that expectations regarding the approval of the agreement have improved, considering the recent changes in the Brazilian political context and the various forces that have been exerted in this regard. However, the negotiations are permeated by political influences and dynamic scenarios that make the intended consensus unfeasible. The importance of the present study is related to the growing discussions about the impact of the agreement, mainly regarding the effectiveness of the negotiated socio-environmental clauses, an issue that can be analyzed in future work, which evaluates the effectiveness of the proposed clauses and the possibility of harmonizing standards and policies adopted within the two regions.

The leader plays a challenging role in public organizations. The context demands specific competencies from leaders to play their role effectively and contribute to achieving institutional objectives. However, measurement instruments still need to be used to meet this context. Thus, this research aimed to create and verify the psychometric validity of an instrument for measuring leadership skills for federal educational institutions. To achieve this objective, the study of a functionalist paradigm, exploratory and descriptive character, with a quantitative approach, adopted survey research. Following approval of the project by the Research Ethics Committee, the prepared electronic questionnaire was disseminated to 1,387 permanent and active employees of a Federal Higher Education Institution. The final sample consisted of 314 respondents. Data analysis was conducted using descriptive statistics, Exploratory Factor Analysis (AFE), and Confirmatory Factor Analysis (CFA). AFC validated a model with 06 factors, each competence measured originated 03 factors: one related to the knowledge variables; another of skills; and, a factor of attitudes. Furthermore, the AFC confirmed the theory's three basic elements of competence. The AFEs, in turn, indicated the independence between the two competencies, clearly demonstrated by the separation of factors. The study is relevant because it presents the creation process and psychometric properties of a scale for measuring leadership competencies in public higher education.

El líder desempeña un papel desafiante en las organizaciones públicas. El contexto exige de los líderes ciertas habilidades para que puedan desempeñar su rol de manera efectiva y contribuir al logro de los objetivos institucionales, sin embargo, aún no existen instrumentos de medición que atiendan a este contexto. Así, esta investigación tuvo como objetivo crear y verificar la validez psicométrica de un instrumento para medir habilidades de liderazgo para instituciones educativas federales. Para lograr este objetivo, el estudio de un paradigma funcionalista, de carácter exploratorio y descriptivo, con enfoque cuantitativo, adoptó la investigación por encuesta. Tras la aprobación del proyecto por el Comité de Ética en Investigación, el cuestionario electrónico preparado se distribuyó a 1.387 empleados permanentes y activos de una institución federal de educación superior. La muestra final estuvo compuesta por 314 encuestados. El análisis de los datos se realizó mediante estadística descriptiva, Análisis Factorial Exploratorio (AFE) y Análisis Factorial Confirmatorio (AFC). AFC validó un modelo con 06 factores, cada competencia medida originó 03 factores: uno relacionado con las variables de conocimiento; otro de habilidades; y, un factor de actitudes. Además, la AFC confirmó los tres elementos básicos de competencia que aporta la teoría. Las AFE, por su parte, señalaron la independencia entre ambas competencias, claramente demostrada por la separación de factores. El estudio es relevante porque presenta el proceso de creación y propiedades psicométricas de una escala para medir habilidades de liderazgo para la educación superior pública.

O líder exerce uma função desafiadora nas organizações públicas. O contexto demanda dos líderes algumas competências para que eles possam desempenhar seu papel de forma efetiva e possam contribuir ao alcance dos objetivos institucionais, porém, ainda não há instrumentos de mensuração que atendam esse contexto. Assim, esta pesquisa teve como objetivo criar e verificar a validade psicométrica de um instrumento de mensuração das competências de liderança para instituições de ensino federais. Para atingir este objetivo, o estudo de paradigma funcionalista, caráter exploratório e descritivo, com abordagem quantitativa, adotou pesquisa de levantamento (survey). A partir da aprovação do projeto pelo Comitê de Ética em Pesquisa, o questionário eletrônico elaborado foi divulgado aos 1.387 servidores efetivos e ativos de uma Instituição Federal de Ensino Superior. A amostra final foi composta por 314 respondentes. A análise dos dados ocorreu por meio da estatística descritiva, da Análise Fatorial Exploratória (AFE) e da Análise Fatorial Confirmatória (AFC). A AFC validou um modelo com 06 fatores, cada competência mensurada originou 03 fatores: um relativo às variáveis de conhecimento; outro das habilidades; e, um fator das atitudes. Além disso, a AFC confirmou os três elementos básicos da competência trazidos pela teoria. As AFE’s, por sua vez, indicaram a independência entre as duas competências, demonstrada de forma clara pela separação dos fatores. O estudo é relevante pois apresenta o processo de criação e as propriedades psicométricas de uma escala de mensuração de competências de liderança para o ensino superior público.

Resumo: No sistema educacional da Costa Rica, observa-se um aumento nas opções para o ensino médio; contudo, a diversidade de ofertas e modalidades disponíveis carece de clareza. Neste manuscrito, trabalhamos com diretores de centros educativos, supervisores de circuitos educativos e funcionários administrativos dos escritórios centrais do Ministério da Educação Pública (MEP) da Costa Rica para responder às seguintes questões de pesquisa: Quais os critérios para a mudança ou abertura de modalidades e ofertas educativas no ensino secundário na Costa Rica? Quais os caminhos administrativos e de gestão curricular para aprovação de vagas ou alterações de modalidades e ofertas? e finalmente, como pode ser descrito o processo de gestão de mudanças ou abertura de modalidades ou ofertas do MEP? Foi utilizada uma metodologia descritiva/exploratória, além de entrevistas e de um análise documental. Verificou-se que a partir da gestão curricular e administrativa não existe uma classificação clara destas propostas educacionais nem um percurso único para os processos de abertura, mudança e encerramento destas opções educativas. A gestão administrativa e curricular é complexa, pois envolve diferentes instâncias do MEP, entre as quais nem sempre há coordenação. Existem diversas rotas para a criação, alteração e encerramento de modalidades e ofertas educativas, e o aspecto orçamentário desempenha um papel crucial na aprovação. Essas constatações são discutidas à luz do direito das pessoas a uma educação de qualidade e ao seu pleno desenvolvimento educacional e profissional.

Resumen: En el sistema educativo costarricense, ha existido un crecimiento en las opciones educativas para educación secundaria, sin embargo, no existe claridad sobre las distintas ofertas y modalidades disponibles. En esta investigación realizada en la Universidad Nacional de Costa Rica, se trabajó con personas directoras de centros educativos, personal administrativo de oficinas centrales del Ministerio de Educación Pública de Costa Rica (MEP) y supervisores de circuitos educativos, para responder las siguientes preguntas de investigación: ¿cuáles son los criterios para el cambio o apertura de modalidades y ofertas educativas en educación media en Costa Rica? ¿Cuáles son las rutas de gestión administrativa y curricular para la aprobación de aperturas o cambios de modalidades y ofertas? Y, por último, ¿cómo se puede describir el proceso de gestión de cambio o apertura de modalidades u ofertas desde el MEP? Para ello, se utilizó una metodología de tipo descriptivo/exploratorio mediante entrevistas y análisis documental. Se encontró que, desde la gestión curricular y administrativa, no hay una clara tipificación de estas propuestas educativas, tampoco existe una única ruta para los procesos de apertura, cambio y cierre de estas opciones educativas. La gestión administrativa y curricular es compleja, pues intervienen distintas instancias del MEP, entre las cuales no siempre hay coordinación, se cuenta con distintas rutas para la creación, cambio y cierre de las modalidades y ofertas educativas, además, el aspecto presupuestario juega un papel clave en la aprobación. Finalmente, se discuten estos hallazgos a la luz del derecho de las personas de tener una educación de calidad, así como su pleno desarrollo educativo y profesional.

Abstract: The Costa Rican educational system has seen an increase in the number of educational options for secondary education; however, there is a lack of clarity regarding the different offerings and modalities available. For this paper, we interviewed school principals, educational circuit supervisors, and administrative personnel from the central offices of the Costa Rican Ministry of Public Education (MEP) to answer the following research questions What are the criteria used to change or introduce educational modalities and offerings in secondary education in Costa Rica? What are the administrative and curricular management processes to approve the introduction or modification of modalities and offerings? And finally, how can we describe the process to introduce changes or new modalities or offerings in the MEP? This study used a descriptive/exploratory methodology, including interviews and documentary analysis. In terms of curricular and administrative management, the study found that there is no clear typification of these educational proposals, nor is there a clear process for the introduction, modification and closure of such educational options. The administrative and curricular management is complex, as it involves different departments within the MEP, which do not always have the necessary coordination, and that there are a number of possible processes to introduce, modify and close educational modalities and offerings, also budgets play a key role in the approval of such proposals. These findings are discussed in the light of the right of individuals to quality education and to fully develop their educational and professional potential.

ABSTRACT The limitations and proposals to improve the relations between the academy and decision-makers in the socioeconomic sphere are exposed, considering the key role of management cadres at all levels of the economy. Although the complexity of the economy indicates that it cannot be left alone to the economists; This should not imply extreme positions that underestimate and ignore their contribution, their different criteria and alternative solutions to problems. Approval of decisions with genuinely democratic methods must also be considered. Until now, frankly vulgar conceptions about the economy and in particular about the business system have been evidenced, which have been justified on repeated occasions, under a false defense of the ideology in the socialist transition

RESUMEN Se exponen las limitaciones y propuestas para perfeccionar las relaciones entre la academia y los decisores en la esfera socioeconómica, considerando el papel clave de los cuadros de dirección en todos los niveles de la economía. Si bien la complejidad de la economía indica que no se puede dejar solo a los economistas, ello no debe implicar posiciones extremas que subestiman e ignoran su aporte, sus diferentes criterios y alternativas de solución de los problemas. Debe considerarse también la aprobación de las decisiones con métodos auténticamente democráticos. Hasta la actualidad se han evidenciado concepciones francamente vulgares sobre la economía y en particular para el sistema empresarial, las cuales se han justificado en reiteradas ocasiones, bajo una defensa falsa de la ideología en la transición socialista

Abstract Neutral language (non-binary language) and gender ideology issues have been highlighted at the state of Santa Catarina after the decree 1.329/2021 which expressly prohibits educational institutions and axamination boards from using gender inflection, especially in written language form, wich, according the decree, would increase the number of p ortuguese words, against the grammatical rules of the language. In this context, this article aims to study, from a feminist perspective, the movement to encourage the debate on gender flexion and the articulation of discourses such as “gender ideology” and “defense of the Portuguese language” in Santa Catarina, considering the tensions in the field of politics and law. This qualitative approach, under an inductive method, use monographic, theoretical and documentary research techniques, in which it is intended to answer the problem: how was the articulation of “gender ideology” and “defense of the Portuguese language” guidelines in the approval of the decree that suppresses the debate in Santa Catarina? From this analysis, which does not revolve the quality of neutral language itself, it is concluded that the political and institutional action that faces the debate on neutral language in the state does not have a democratic character. nonbinary non binary 13292021 1 329 2021 1.329/202 inflection form wich words context study perspective defense law approach method monographic techniques problem analysis itself character 1329202 32 202 1.329/20 132920 3 20 1.329/2 13292 2 1.329/ 1329 1.329 132 1.32 13 1.3 1.

Resumo As questões da linguagem neutra e da ideologia de gênero ganharam destaque no ano de 2021 em Santa Catarina a partir da publicação do decreto 1.329/2021 que, dentre outras questões, veda expressamente as instituições de ensino e bancas examinadoras de seleção de concursos públicos a utilização de novas formas de flexão de gênero, especialmente na linguagem escrita, uma vez que, segundo o decreto, o aumento no número de palavras da língua portuguesa é contrário às regras gramaticais consolidadas. Neste contexto, o presente artigo visa estudar, sob uma perspectiva feminista, o movimento de supressão do debate sobre flexão de gênero e a articulação de discursos como a “ideologia de gênero” e “defesa da língua portuguesa” em Santa Catarina, considerando as tensões produzidas no campo da política e do direito. Trata-se de um estudo de abordagem qualitativa, sob método indutivo, com técnicas de pesquisa monográfica, teórica e documental, em que se pretende responder ao problema: de que forma se articularam posicionamentos de “ideologia de gênero” e “defesa da língua portuguesa” na aprovação do decreto que suprime o debate emSanta Catarina? A partir dessa análise, que não gira em torno da qualidade da linguagem neutra em si, conclui-se que a atuação política e institucional que enfrenta o debate sobre a linguagem neutra no estado não possui caráter democrático ao tolher o debate público sobre tema referente à educação e à cidadania. 202 13292021 1 329 1.329/202 escrita consolidadas contexto estudar feminista defesa direito Tratase Trata qualitativa indutivo monográfica documental problema análise si concluise conclui cidadania 20 1329202 32 1.329/20 2 132920 3 1.329/2 13292 1.329/ 1329 1.329 132 1.32 13 1.3 1.

It is human nature to see the world as imperfect, because people strive towards improving existing and designing new systems. The education system is one such system which is regarded as being a challenge in South Africa, since it affects the quality of education received by every young South African. The serious nature of dysfunctionality could be attributed to the lack of competent leadership in schools. Learners' education and examination results are being impaired by inadequate teaching, dysfunctional school management, inefficient procedures and poor resources, which foster low educational standards. Leadership practices make a significant contribution to the desired outcomes of a school. Department heads are responsible for educational leadership; however, as they rarely receive leadership training, it is impossible for them to acquire the knowledge and skills to prepare them for their task as educational leaders. There is a dire need for educational leaders who could run a school professionally. The principal and staff should be professional leaders and managers capable of establishing a culture of learning and effectiveness. The purpose of this study was to establish if department heads have the required knowledge and skills to prepare them for their leadership and management role in a secondary school, how they see their competence in this regard, to identify the gaps regarding their preparation as effective educational leaders, and to submit proposals for improving the preparation of department heads for their leadership role. The research methodology was based on quantitative research strategies whereby the research question could accordingly be answered by means of a once-off cross-sectional survey obtained from a random cluster sampling of secondary schools in a district with approximately 70 schools in the Free State province. Self-designed questionnaires, which had to be completed by all the department heads at the schools, were used. A total of 186 department heads participated in the investigation. Ethical approval to conduct the research was obtained from the North-West University. Descriptive statistics and exploratory factor analysis were used to identify latent variables. Cronbach's alpha coefficient was used to determine the reliability of the variables involved. Hierarchical linear models were used to determine relationships among variables. The results showed that the heads of department view training and development as important, but they also indicated that they did not receive management training before their appointment in their position. Finally, suggestions are provided for improving the preparation of department heads.

Alle bestaande stelsels, waaronder onderwysstelsels, verander voortdurend. Die onderwys-stelsel is een van die stelsels in Suid-Afrika wat as 'n uitdaging gesien word, omdat dit die gehalte van onderrig beïnvloed. Die ernstige aard van disfunksionaliteit kan toegeskryf word aan die gebrek aan bevoegde leierskap in skole. Leerders se opvoeding en eksamenuitslae word benadeel deur swak onderrig, disfunksionele skoolbestuur, ondoeltreffende prosedures en swak hulpbronne, wat lae onderwysstandaarde tot gevolg het. Leierskapspraktyke lewer 'n groot bydrae tot die gewenste uitkomste van 'n skool. Departementshoofde is verantwoordelik vir onderrigleierskap, maar aangesien hulle selde leierskapsopleiding ontvang, is dit vir hulle onmoontlik om kennis en vaardighede op te doen om hulle voor te berei vir hulle taak as onderrigleiers. Daar is 'n ernstige behoefte aan onderrigleiers wat 'n skool professioneel kan bestuur. Die skoolhoof en personeel moet professionele leiers en bestuurders wees, sodat 'n kultuur van leer en effektiwiteit geskep kan word. Die doel van hierdie ondersoek was om te bepaal of departementshoofde oor die nodige kennis en vaardighede beskik om die leierskap- en bestuursrol in 'n sekondêre skool te vervul, hoe departementshoofde hulle bevoegdheid in hierdie verband sien, wat die leemtes ten opsigte van die voorbereiding van departementshoofde vir hulle taak/rol as effektiewe onderrigleiers is, en om voorstelle ter verbetering van die voorbereiding van departementshoofde vir hul leierskapsrol te maak. Die navorsingsmetodologie is gebaseer op kwantitatiewe navorsingstrategieë waarvolgens die navorsingsvraag beantwoord kon word deur middel van 'n eenmalige dwarsdeursnitopname wat verkry is met behulp van ewekansige trossteekproefneming by sekondêre skole in 'n distrik in die Vrystaat. Daar is gebruik gemaak van selfontwerpte vraelyste wat deur al die departementshoofde van die betrokke skole voltooi moes word. 'n Totaal van 186 departements-hoofde het aan die ondersoek deelgeneem. Etiese goedkeuring om die studie te onderneem is van die Noordwes-Universiteit verkry. Beskrywende statistiek (frekwensies, persentasies, gemiddeldes en standaardafwykings) en eksploratiewe faktorontleding is gebruik om onderliggende latente veranderlikes te identifiseer. Cronbach se alfa-koëffisiënt is gebruik om die betroubaarheid van betrokke veranderlikes te bepaal. Hiërargiese lineêre modelle is gebruik om verbande met biografiese en demografiese veranderlikes te bepaal. In hierdie studie is bevind dat daar 'n duidelike verband tussen onderrig en leierskap is en dat die meeste van die departementshoofde kwaliteitonderrig belangrik ag en as 'n prioriteit in hul departemente sien. Die departementshoofde in hierdie studie is ook van mening dat die leiding van skoolbestuurspanne die kwaliteit van onderrig in die departement beïnvloed. Departementshoofde vir wie onderrig, leierskap en leerderprestasie belangrik is, heg ook hoë waarde aan opleiding en voorbereiding. In hierdie studie is ook bevind dat departementshoofde oor die algemeen nie bestuursopleiding ontvang het voor hul aanstelling in dié posisie nie. Sommige van die departementshoofde kon staatmaak op die kennis wat hulle opgedoen het tydens hul kollege- of universiteitsopleiding, wat hulle voorberei het vir hulle taak. 'n Klein aantal van die departementshoofde was oortuig dat hul voordiensopleiding nie van waarde was nie en dat hulle nie voorbereid was vir hul rol as beginnerdepartementshoofde nie.