Resumo Este projeto teve como objetivo identificar os impactos dos modelos de negócios atuais (agilidade de negócios) e dos principais controles de produtividade (KPIs), mais relevantes em um subsetor de pequenos restaurantes franqueados na Costa Rica (2020-2023). Para o qual se desenvolve uma investigação qualitativa, com entrevistas a 31 gestores de pequenos restaurantes que utilizam franquias nacionais e estrangeiras, para determinar diversas subcategorias de análise e estabelecer denominadores comuns que permitiram a superação da pandemia e a estruturação de uma análise de inclusão e exclusão, para priorizar os aspectos críticos de sucesso, a análise das causas, consequências e efeitos utilizando o método Root Cause para propor melhorias duradouras, sendo a principal constatação: a rigidez do modelo de franquia, a limitada agilidade do negócio e o uso de acesso limitado a maior tecnologia, principalmente devido ao custo e ao conhecimento, dificultou o enfrentamento do Cisne Negro da Pandemia por COVID-19).

Résumé Ce projet visait à identifier les impacts des modèles commerciaux actuels (agilité commerciale) et des contrôles clés de productivité (KPI), les plus pertinents dans un sous- secteur des petits restaurants franchisés au Costa Rica (2020- 2023). Pour lequel une enquête qualitative est développée, avec des entretiens avec 31 gérants de petits restaurants qui utilisent des franchises nationales et étrangères, pour déterminer diverses sous-catégories d’analyse et établir des dénominateurs communs qui nous ont permis de surmonter la pandémie et la structuration d’une analyse d’inclusion et d’exclusion, pour prioriser les aspects critiques du succès, l’analyse des causes, conséquences et effets selon la méthode Root Cause pour proposer des améliorations durables, le principal constat étant : la rigidité du modèle de franchise, l’agilité commerciale limitée et l’utilisation d’un accès limité L’essor de la technologie, principalement en raison du coût et des connaissances, a rendu plus difficile la lutte contre le cygne noir de la pandémie por COVID-19).

Abstract This project aimed to identify the impacts of current business models (business agility) and key productivity controls (KPIs), most relevant in a subsector of small franchised restaurants in Costa Rica (2020-2023). For which a qualitative investigation is developed, with interviews with 31 small restaurant managers who use national and foreign franchises, to determine various subcategories of analysis and establish common denominators that allowed us to overcome the pandemic and the structuring of an analysis of inclusion and exclusion, to prioritize the critical aspects of success, the analysis of the causes, consequences and effects using the Root Cause method to propose long-lasting improvements, the main finding being: the rigidity of the franchise model, the limited business agility, and the use Limited access to greater technology, mainly due to cost and knowledge, made it more difficult to face the Black Swan of the Pandemic por COVID-19).

Resumen Este proyecto buscó identificar los impactos de los actuales modelos de negocio (agilidad empresarial) y los controles clave de productividad (KPIs) más relevantes en un subsector de restaurantes pequeños franquiciados en Costa Rica (2020- 2023), por lo que se realizó una investigación cualitativa con entrevistas a 31 gerentes de restaurantes pequeños, usuarios de franquicia nacional y extranjera, para determinar así diversas subcategorías de análisis y establecer con esto denominadores comunes que permitieron sobrepasar la pandemia y la estructuración de un análisis de inclusión y exclusión, asimismo, para jerarquizar los aspectos críticos de éxito, el análisis de las causas, consecuencias y efectos mediante el método de Causa-Raíz para proponer mejoras de larga duración. Este es el principal hallazgo: la rigidez del modelo de franquicia, la limitada agilidad empresarial y el uso limitado de mayor tecnología, principalmente por costo y conocimiento, que hicieron más difícil afrontar el “Cisne negro” de la Pandemia por COVID-19).

ABSTRACT. The grain production area in the Brazilian agricultural region known as SEALBA, especially in Alagoas State, has seen significant growth in recent years. This study aims to contribute to sustainable regional development by evaluating the effects of inoculation, co-inoculation, and the application of starter mineral nitrogen (N), either individually or in combination, on soybean growth and yield. Eight field experiments were conducted from 2018 to 2021 in two municipalities within Alagoas, covering soybean cultivation areas ranging from the first to the fourth year. The experiments followed a randomized complete block design with four replications, employing a factorial arrangement of treatments. The first factor encompassed five levels related to inoculation technologies and N management: 1) Inoculation with Bradyrhizobium; 2) Inoculation with Bradyrhizobium combined with N basal fertilization; 3) Co-inoculation of Bradyrhizobium + Azospirillum; 4) Co-inoculation of Bradyrhizobium + Azospirillum + N fertilization at the base; and 5) Control treatment without microbiological inputs or nitrogen fertilizers. The second factor involved the evaluation of different soybean cultivars, with two materials assessed in 2018 and three cultivars in 2019, 2020, and 2021. Results demonstrated that seed inoculation with Bradyrhizobium led to increased soybean grain yield in first-year cultivation areas. However, N basal fertilization, commonly known as starter fertilization, did not result in yield improvements compared to the use of microbiological inputs alone. Soybean cultivars BRS 9383 IPRO and FTR 3191 IPRO exhibited greater responsiveness to seed inoculation with Bradyrhizobium. ABSTRACT SEALBA State years coinoculation, coinoculation co co-inoculation N, , (N) combination 201 202 year replications treatments management 1 2 3 Coinoculation Co 4 base 5 fertilizers 2019 2020 firstyear However alone 938 319 (N 20 93 31 9

There have been significant and rapid improvements in information and communication technology (ICT) since the early 1990s. Subsequent global changes have increased with the onset of the Fourth Industrial Revolution and have dictated pedagogical transformation. Many countries have moved from traditional approaches of education to 21st-century Learning (21CL). 21CL is ICT-aligned, inquiry-based, and includes the development of affective abilities. School leadership influences all structures and individuals directly in a school. It has the potential to be one of the cornerstones of the paradigm shift to 21CL. I investigated how school leadership is developed to facilitate 21CL and how it can be improved. I required quantitative and qualitative data to achieve the research objectives. Therefore, I adopted a mixed methods research approach that is underpinned by the positivist and interpretivist paradigms. I used a case study design. The data collection methods I employed were questionnaires, semi-structured interviews, and focus group interviews. Phase one of the research involved the quantitative data collection from twenty-five schools, of which five schools were purposely sampled for the second qualitative phase. The use of transformational leadership, strategic leadership, system leadership, and ecological leadership in enacting 21CL featured prominently in the reviewed literature. However, the research findings show that, largely, these four leadership theories were not incorporated in leadership development in South Africa. The results also show that school leadership development specifically designed for 21CL, was limited. The leadership training that is available focused more on administrative tasks instead of on leadership theories and skills to facilitate 21CL. I recommend that further research be conducted in both private and public schools in other South African provinces.

Abstract Objective To evaluate the functionality in patients with adhesive capsulitis undergoing suprascapular nerve block (SSNB). Methods A before-and-after clinical prospective study in a single center was conducted with patients with secondary adhesive capsulitis treated with four nerve blocks based on anatomical limits. The sample was non-probabilistic, and it was obtained after a routine appointment at a specialized outpatient clinic. The instruments used for evaluation were the International Classification of Functioning, Disability and Health (ICF) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, which were applied at baseline (T0), one week after the fourth SSNB (T4), and three months after the first SSNB (T12). The paired t-test was used to compare the means of the ICF checklist items and DASH in the different: T0xT4;T4xT12;and T0xT12). The probability of rejecting the null hypothesis was 5%. Results The sample was composed of 25 individuals with a mean age of 58.16 years; 16 of them were female. The duration of the pain symptoms ranged from 2 to 16 months, with a mean of 5.92 months. The ICF checklist showed that all domains had already improved in T4 except for the environmental factors, which only improved at 03 months (p = 0.037). The patients reported improvements in shoulder function in T4, which increased more in T12, at the end of data collection (p = 0.019). Conclusion The SSNB technique is effective in patients with adhesive capsulitis after4 weeks of application, with improvements in individual's functionality lasting for 12 weeks. SSNB. . (SSNB) beforeandafter before limits nonprobabilistic, nonprobabilistic non probabilistic, probabilistic non-probabilistic clinic Functioning (ICF Arm (DASH questionnaire T0, T0 T , (T0) (T4) T12. T12 (T12) ttest t test different T0xT4T4xT12and TxTTxTand T0xT4 T4xT12 xT T0xT12. T0xT12 TxT T0xT12) 5 5% 5816 58 58.1 years 1 female 592 92 5.9 factors 0 p 0.037. 0037 0.037 037 0.037) 0.019. 0019 0.019 019 0.019) application individual s (SSNB (T0 (T4 T1 (T12 T0xT T4xT1 T0xT1 581 58. 59 9 5. 003 0.03 001 0.01 01 (T (T1 T4xT 00 0.0 0.

Resumo Objetivo Avaliar a funcionalidade em pacientes com capsulite adesiva submetidos a bloqueio do nervo supraescapular (BNSE). Métodos Um estudo clínico prospectivo do tipo antes e depois foi realizado em um único centro com pacientes com capsulite adesiva secundária tratados com quatro bloqueios baseados em limites anatômicos. A amostra foi não probabilística, tendo sido obtida após consulta de rotina em ambulatório especializado. Os instrumentos utilizados para avaliação foram a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) e o questionário de Disfunções do Braço, Ombro e Mão (DASH), que foram aplicados antes da intervenção (T0), uma semana após o quarto BNSE (T4),etrêsapósoprimeiroBNSE(T12).AsmédiasdositensdaCIFedoDASHnos diferentes tempos (T0 x T4; T4 x T12; e T0 x T12) foram comparadas por meio do teste t pareado. A probabilidade de rejeitar a hipótese nula foi de 5%. Resultados A amostra foi composta por 25 indivíduos com média de idade de 58,16 anos; 16 eram mulheres. A duração dos sintomas dolorosos variou de 2 a 16 meses, com média de 5,92 meses. A CIF mostrou que todos os domínios já haviam melhorado em T4 à exceção dos fatores ambientais, que só melhoraram aos 3 meses (p = 0,037). Os pacientes já relataram melhora na função do ombro em T4 emaisainda em T12,ao finaldacoletadedados (p = 0,019). Conclusão A técnica de BNSE é eficaz em pacientes com capsulite adesiva após 4 semanas de aplicação, com melhora da funcionalidade do indivíduo e sua manutenção até 12 semanas. BNSE. . (BNSE) anatômicos probabilística especializado Funcionalidade (CIF Braço DASH, DASH , (DASH) T0, T (T0) T4,etrêsapósoprimeiroBNSET12.AsmédiasdositensdaCIFedoDASHnos T4etrêsapósoprimeiroBNSET12AsmédiasdositensdaCIFedoDASHnos TetrêsapósoprimeiroBNSETAsmédiasdositensdaCIFedoDASHnos ,etrêsapósoprimeiroBNSE T12 .AsmédiasdositensdaCIFedoDASHnos etrêsapósoprimeiroBNSE AsmédiasdositensdaCIFedoDASHnos (T pareado 5 5% 5816 58 58,1 anos 1 mulheres 592 92 5,9 ambientais p 0,037. 0037 0,037 0 037 0,037) T12ao Tao ao 0,019. 0019 0,019 019 0,019) aplicação (BNSE (DASH etrêsapósoprimeiroBNSET12 etrêsapósoprimeiroBNSET T1 581 58, 59 9 5, 003 0,03 03 001 0,01 01 etrêsapósoprimeiroBNSET1 00 0,0 0,

Resumen El objetivo de este proyecto fue realizar la reconfiguración del laboratorio de química de la Sede del Caribe de la Universidad de Costa Rica como un espacio educativo universitario, con el fin de estudiar los distintos factores que incluyen en el aprendizaje en este sitio. Posteriormente, se decidió hacer un mejoramiento en los aspectos como seguridad (en donde se contempló una redistribución del espacio) y recursos; con la finalidad de ver la influencia de estos dos factores en el aumento de la percepción de aprendizaje del estudiantado. Para poder determinarlo se realizó una encuesta a los estudiantes de Ingeniería Química que cursan tercer y cuarto año de carrera, pues ellos se desarrollaron en los dos ambientes de trabajo. Como resultado se obtuvo que se aumentó la seguridad un 30 % y se mejoró la percepción del estudiante en cuanto a la adquisición de conocimientos al hacer las mejoras de seguridad y recursos disponibles.

Abstract The objective of this project was to reconfigure the chemistry laboratory of the Caribbean campus of the University of Costa Rica as a university educational space in order to study the different factors that influence learning at this site. Subsequently, it was decided to make an improvement in aspects such as security (where a redistribution of space was contemplated) and resources; to see the influence of these two factors in increasing the perception of student learning. With the objective of determine this, a survey was carried out on Chemical Engineering students who are in their third and fourth year of study, since they developed in both work environments. Security was increased by 30% and student perception of knowledge acquisition was improved by making security improvements and esources available.

RESUMEN Objetivos. Determinar los cambios en las características clínicas y desenlaces intrahospitalarios de los pacientes hospitalizados por COVID-19 en un hospital privado de Caracas durante dos años de pandemia. Materiales y métodos. Estudio retrospectivo, observacional, de pacientes hospitalizados por COVID-19. Se investigó la correspondencia entre las olas de ingresos hospitalarios con las variantes circulantes del SARS-CoV-2 en la población general del Distrito Capital y estado Miranda. Resultados. Se incluyeron 1025 pacientes (569 hombres y 456 mujeres), con edad promedio de 62,9 DE: 16,2 años. Cuatro olas de ingresos hospitalarios fueron identificadas: primera (marzo-noviembre 2020) 150/1025 (14,6%) casos; segunda (diciembre-2020 a mayo-2021) 415/1025 (40,5%) casos; tercera (junio-diciembre 2021) 344/1025 (33,6%) casos; cuarta (enero-febrero 2022) 116/1025 (11,3%) casos. La edad promedio fue mayor en la cuarta ola (primera 64,0±15,7, segunda 61,4±15,8, tercera 62,1±16,5, y cuarta ola 68,5±16,4), mientras que la proporción de pacientes masculinos (primera 66,7%, segunda 58,8%, tercera 50,3%, y cuarta 44,8%), los pacientes con enfermedad grave-crítica (primera 65,3%, segunda 57%, tercera 51,7% y cuarta 44,8%), la estadía intrahospitalaria (primera 9,1±6,0, segunda 9,0±7,3, tercera 8,8±7,7, y cuarta 6,9±5,0 días), los ingresos a la UCI (primera 23,3%, segunda 15,7%, tercera 14,0%, y cuarta 11,2%; p=0,027) y la mortalidad (primera 21.8%, segunda 10,7%, tercera 9,1%, y cuarta 7,1%; p<0,001) disminuyeron progresivamente con el tiempo. Conclusiones. Los resultados muestran menor frecuencia de casos severos y mejoría de los desenlaces intrahospitalarios en dos años de pandemia. Es probable que los cambios en las variantes circulantes, las mejoras del manejo de la enfermedad y la vacunación hayan influido sobre estos resultados.

ABSTRACT Objectives. To determine changes in the clinical characteristics and in-hospital outcomes of patients hospitalized for COVID-19 in a private hospital in Caracas during two years of the pandemic. Materials and Methods. Retrospective, observational study of patients hospitalized for COVID-19. We evaluated the correspondence between waves of hospital admissions and circulating variants of SARS-CoV-2 in the general population of the Capital District and Miranda state. Results. A total of 1025 patients (569 men and 456 women) were included, with a mean age of 62.9 SD: 16.2 years. Four waves of hospital admissions were identified: first (March-November 2020) 150/1025 (14.6%) cases; second (December 2020 to May 2021) 415/1025 (40.5%) cases; third (June-December 2021) 344/1025 (33.6%) cases; fourth (January-February 2022) 116/1025 (11.3%) cases. The mean age was higher in the fourth wave (first: 64.0±15.7, second: 61.4±15.8, third: 62.1±16.5, and fourth wave: 68.5±16.4), while the proportion of male patients (first: 66.7%, second: 58.8%, third: 50.3%, and fourth wave: 44.8%), patients with severe-critical illness (first: 65.3%, second: 57%, third: 51.7%, and fourth wave: 44.8%), in-hospital stay (first: 9.1±6.0, second: 9.0±7.3, third: 8.8±7.7, and fourth wave: 6.9±5.0 days), ICU admissions (first: 23.3%, second: 15.7%, third: 14.0%, and fourth wave: 11.2%; p=0.027) and mortality (first: 21. 8%, second: 10.7%, third: 9.1%, and fourth wave: 7.1%; p<0.001) progressively decreased over time. Conclusions. The results show lower frequency of severe cases and improvement of in-hospital outcomes in two years of the pandemic. Changes in circulating variants, improvements in disease management and vaccination are likely to have influenced these results.

ABSTRACT Objectives. To determine changes in the clinical characteristics and in-hospital outcomes of patients hospitalized for COVID-19 in a private hospital in Caracas during two years of the pandemic. Materials and Methods. Retrospective, observational study of patients hospitalized for COVID-19. We evaluated the correspondence between waves of hospital admissions and circulating variants of SARS-CoV-2 in the general population of the Capital District and Miranda state. Results. A total of 1025 patients (569 men and 456 women) were included, with a mean age of 62.9 SD: 16.2 years. Four waves of hospital admissions were identified: first (March-November 2020) 150/1025 (14.6%) cases; second (December 2020 to May 2021) 415/1025 (40.5%) cases; third (June-December 2021) 344/1025 (33.6%) cases; fourth (January-February 2022) 116/1025 (11.3%) cases. The mean age was higher in the fourth wave (first: 64.0±15.7, second: 61.4±15.8, third: 62.1±16.5, and fourth wave: 68.5±16.4), while the proportion of male patients (first: 66.7%, second: 58.8%, third: 50.3%, and fourth wave: 44.8%), patients with severe-critical illness (first: 65.3%, second: 57%, third: 51.7%, and fourth wave: 44.8%), in-hospital stay (first: 9.1±6.0, second: 9.0±7.3, third: 8.8±7.7, and fourth wave: 6.9±5.0 days), ICU admissions (first: 23.3%, second: 15.7%, third: 14.0%, and fourth wave: 11.2%; p=0.027) and mortality (first: 21. 8%, second: 10.7%, third: 9.1%, and fourth wave: 7.1%; p<0.001) progressively decreased over time. Conclusions. The results show lower frequency of severe cases and improvement of in-hospital outcomes in two years of the pandemic. Changes in circulating variants, improvements in disease management and vaccination are likely to have influenced these results.

RESUMEN Objetivos. Determinar los cambios en las características clínicas y desenlaces intrahospitalarios de los pacientes hospitalizados por COVID-19 en un hospital privado de Caracas durante dos años de pandemia. Materiales y métodos. Estudio retrospectivo, observacional, de pacientes hospitalizados por COVID-19. Se investigó la correspondencia entre las olas de ingresos hospitalarios con las variantes circulantes del SARS-CoV-2 en la población general del Distrito Capital y estado Miranda. Resultados. Se incluyeron 1025 pacientes (569 hombres y 456 mujeres), con edad promedio de 62,9 DE: 16,2 años. Cuatro olas de ingresos hospitalarios fueron identificadas: primera (marzo-noviembre 2020) 150/1025 (14,6%) casos; segunda (diciembre-2020 a mayo-2021) 415/1025 (40,5%) casos; tercera (junio-diciembre 2021) 344/1025 (33,6%) casos; cuarta (enero-febrero 2022) 116/1025 (11,3%) casos. La edad promedio fue mayor en la cuarta ola (primera 64,0±15,7, segunda 61,4±15,8, tercera 62,1±16,5, y cuarta ola 68,5±16,4), mientras que la proporción de pacientes masculinos (primera 66,7%, segunda 58,8%, tercera 50,3%, y cuarta 44,8%), los pacientes con enfermedad grave-crítica (primera 65,3%, segunda 57%, tercera 51,7% y cuarta 44,8%), la estadía intrahospitalaria (primera 9,1±6,0, segunda 9,0±7,3, tercera 8,8±7,7, y cuarta 6,9±5,0 días), los ingresos a la UCI (primera 23,3%, segunda 15,7%, tercera 14,0%, y cuarta 11,2%; p=0,027) y la mortalidad (primera 21.8%, segunda 10,7%, tercera 9,1%, y cuarta 7,1%; p<0,001) disminuyeron progresivamente con el tiempo. Conclusiones. Los resultados muestran menor frecuencia de casos severos y mejoría de los desenlaces intrahospitalarios en dos años de pandemia. Es probable que los cambios en las variantes circulantes, las mejoras del manejo de la enfermedad y la vacunación hayan influido sobre estos resultados.

RESUMO Esta pesquisa tem como objetivo melhorar a competência motora e as relações sociais em estudantes com dificuldades de coordenação e/ou sociais, por meio de um programa abrangente de reforço das habilidades motoras. Para isso, o estudo está dividido em quatro fases. Na primeira, foram selecionados entre os 60 alunos participantes do terceiro curso de educação infantil, aqueles suscetíveis de apresentar dificuldades de movimento e/ou de relações sociais, após a aplicação de uma série de testes de filtragem. Na segunda e terceira fases, avaliou-se a competência motora por meio da Bateria de Avaliação de Movimentos para Crianças (Mabc-2) e se implementou um programa de alfabetização física orientada ao desenvolvimento das habilidades motoras básicas; para, finalmente, na quarta fase, comprovar se houve melhora na competência motora e nas relações sociais dos participantes. Após a aplicação da intervenção, melhorias significativas entre as médias pré e post na dimensão equilíbrio, pontaria e captura e pontuação global , bem como uma melhoria significativa em amigo positivo. O que nos sugere a continuar trabalhando nesta linha para promover o desenvolvimento adequado dos alunos na fase infantil, tanto no nível motor quanto no social.

RESUMEN El objetivo del presente estudio fue mejorar la competencia motriz y las relaciones sociales en alumnado con dificultades de coordinación y/o sociales a través de un programa integral de refuerzo motriz. Para ello, el estudio se dividió en cuatro fases. En la primera fase se seleccionaron, de entre los 60 niños participantes de tercer curso de Educación infantil, aquellos susceptibles de sufrir dificultades de movimiento y/o déficit en sus relaciones sociales, tras la aplicación de una serie de pruebas filtro. En la segunda y tercera fase se evaluó la competencia motriz, mediante la Batería de evaluación del movimiento para niños (MABC-2) y se implementó un programa de alfabetización física orientado al desarrollo de las habilidades motrices básicas para, finalmente, en la cuarta fase, comprobar si se había producido alguna mejora en la competencia motriz y en las relaciones sociales del alumnado participante. Tras la aplicación de la intervención se comprobaron mejoras significativas entre las medias pre y post en la dimensión equilibrio, puntería y atrape y puntuación global, además de una mejora significativa en amigo positivo. Estos resultados invitan a seguir trabajando en esta línea para favorecer un adecuado desarrollo de los alumnos de la etapa de infantil, tanto a nivel motriz como a nivel social.

ABSTRACT The goal of this study was to improve motor competence and social relationships among students with coordination and / or social difficulties, through an integrative reinforcement program, from motor skills. For that purpose, the study was divided into four phases. In the first one, from among 60 children participating in the third year of Early Childhood Education, those who were susceptible to suffer difficulties with movement and / or deficits in their social relationships were selected, after having applied different filter tests. In the second and third phase, motor competence was evaluated through the Children's Movement Assessment Battery (MABC-2) and a physical literacy program was implemented aimed at the development of basic motor skills. Finally, in the fourth phase, it was checked whether there had been any improvement in the motor competence and social relations of the participating students. After intervention, significant improvements were found between the pre and post averages in the dimension balance, aim and catch and overall score, plus a significant improvement in positive friend. These results invite us to continue working to promote the adequate development among students in the infant stage, both at the motor and social levels.

Resumen El siguiente texto tiene como finalidad establecer cómo los avances científicos y tecnológicos que posee el fenómeno de la cuarta revolución industrial de pueden constituir mejoras en las garantías procesales penales dentro del estándar de más allá de toda duda razonable, a través de la inclusión de la Inteligencia Artificial y el Big Data en el marco del derecho probatorio en relación con elementos como: la prueba, la valorización de la prueba, la sana crítica y los medios probatorios.

Abstract The purpose of the following text is to establish how the scientific and technological advances that the phenomenon of the fourth industrial revolution possesses can constitute improvements in criminal procedural guarantees within the standard beyond all reasonable doubt, through the inclusion of Intelligence. Artificial and Big Data within the framework of evidentiary law in relation to elements such as: evidence, assessment of evidence, sound criticism and evidence.

Resumo Introdução A associação entre o tratamento da deficiência maxilar transversa e a recuperação das funções auditivas e vocais ganhou atenção nos últimos anos. Objetivo Avaliar os efeitos da expansão rápida da maxila na função auditiva e vocal em crianças sem fissura labiopalatina e com fissura labiopalatina bilateral com deficiência maxilar transversa. Método Foram recrutados para este estudo 53 pacientes (26 sem fissura e 27 com fissura labiopalatina bilateral; média de 11,1 ± 1,8 anos) que necessitam de expansão rápida da maxila para correção de arcos maxilares estreitos. Oito subgrupos foram estabelecidos com base no grau de perda auditiva. Registros audiométricos e timpanométricos de tons puros foram obtidos para cada indivíduo em quatro períodos. Os primeiros registros foram obtidos antes da expansão rápida da maxila (T0), o segundo após a expansão (T1) (média de 0,8 meses), o terceiro após três meses (T2) (média de 3 meses) e o quarto no fim do período de retenção (T3) (média de 6 meses). Anova e o teste post-hoc de Tukey HSD foram usados para análise dos dados. Além disso, a análise da voz foi feita com um programa PRAAT atualizado em um laboratório de fala computadorizadaem T0 e T2. Foi usado um teste t de amostras pareadas para comparação dos valores médios dos parâmetros de voz em T0 e T2 nos dois grupos. Resultados O tratamento com expansão rápida da maxila produziu um aumento significativo nos níveis auditivos e nos volumes da orelha média de todos os pacientes sem fissura e pacientes com fissura labiopalatina bilateral e níveis auditivos normais e com perda auditiva condutiva leve, durante os períodos de observação T0-T1, T1-T2, T0-T2 e T0-T3 (p < 0,05). Aumento significativo foi observado nos volumes da orelha média direita durante os períodos T0-T1, T0-T2 e T0-T3 em pacientes sem fissura e com perda auditiva moderada. Para a análise de voz, diferenças significantes foram observadas apenas entre a frequência fundamental média T0 e T2 (F0) e a porcentagem de jitter (p < 0,05) no grupo sem fissura. No grupo com fissura, não foram observadas diferenças significantes para nenhum parâmetro de voz entre os períodos T0 e T2. Conclusão A correção da anatomia palatal pela expansão rápida da maxila tem um efeito benéfico tanto na melhoria da audição quanto na função normal da orelha média em pacientes sem fissura e com fissura labiopalatina bilateral. Da mesma forma, a expansão rápida da maxila influencia significativamente a qualidade da voz em pacientes sem fissura, sem efeito significativo em pacientes com fissura labiopalatina bilateral.

Abstract Introduction The association between the treatment of transverse maxillary deficiency and the recovery of hearing and voice functions has gained attention in recent years. Objective This prospective controlled trial aimed to evaluate the effects of rapid maxillary expansion on hearing and voice function in children with non-cleft lip palate and bilateral cleft lip palate with transverse maxillary deficiency Methods 53 patients (26 non-cleft and 27 bilateral cleft lip palate; mean age, 11.1 ± 1.8 years) requiring rapid maxillary expansion for correction of narrow maxillary arches were recruited for this trial. Eight sub-groups were established based on the degree of hearing loss. Pure-tone audiometric and tympanometric records were taken for each subject at four different time periods. The first records were taken before rapid maxillary expansion (T0), the second after expansion (T1) (mean, 0.8 months), the third after three months (T2) (mean, 3 months) and the fourth at the end of retention period (T3) (mean, 6 months). ANOVA and Tukey HSD post-hoc tests were used for data analysis. Additionally, voice analysis was done using an updated PRAAT software program in a computerized speech lab at T0 and T2. A paired-samplet-test was used for comparisons of mean values of T0 and T2 voice parameters within both groups. Results Rapid maxillary expansion treatment produced a significant increase in the hearing levels and middle ear volumes of all non-cleft and bilateral cleft lip palate patients with normal hearing levels and with mild conductive hearing loss, during the T0-T1, T1-T2, T0-T2, and T0-T3 observation periods (p < 0.05). The significant increase was observed in right middle ear volumes during the T0-T1, T0-T2 and T0-T3 periods in non-cleft patients with moderate hearing loss. For voice analysis, significant differences were observed only between the T0 and T2 mean fundamental frequency (F0) and jitter percentage (p < 0.05) in the non-cleft group. In the cleft group, no significant differences were observed for any voice parameter between the T0 and T2 periods. Conclusion Correction of the palatal anatomy by rapid maxillary expansion therapy has a beneficial effect on both improvements in hearing and normal function of the middle ear in both non-cleft and bilateral cleft lip palate patients. Similarly, rapid maxillary expansion significantly influences voice quality in non-cleft patients, with no significant effect in BCLP patients.

Abstract: Educational materials, whatever their nature, are part of the teaching programs and as such, must be subject to constant review by the educational system and, from there, seek the improvements required by the teaching-learning process in any area of knowledge. In this sense, a case study was carried out at the Yarinacocha Intercultural Bilingual Application Educational Institution (IE), located in the district of Yarinacocha, Coronel Portillo province, Department of Uyacaly, belonging to the Yarinacocha population located in the Peruvian Amazon. Research that aimed to analyze the evaluations of the modules of use of didactic materials oriented to the development of mathematical capacities, in students of the fourth grade. Research that allowed assessing the importance of the six components of didactic suitability and explaining the implicit ontosemiotic complexity in the didactic processes, based on the objective and subjective structure of the modules for the use of mathematics teaching materials.

Resumen: Los materiales educativos, sea cual sea su naturaleza, son parte de los programas de enseñanza y como tal, deben ser objeto de revisión constante por parte del sistema educativo y, a partir de allí, buscar las mejoras que requiere el proceso de enseñanza-aprendizaje en cualquier área del conocimiento. En este sentido, se llevó a cabo un estudio de caso en la Institución Educativa (IE) Aplicación Bilingüe Intercultural Yarinacocha, ubicada en el distrito de Yarinacocha, provincia Coronel Portillo, Departamento de Uyacaly, perteneciente a la población Yarinacocha situada en la Amazonia peruana. Investigación que tuvo por objetivo analizar las valoraciones de los módulos de uso de materiales didácticos orientados al desarrollo de capacidades matemáticas, en estudiantes del cuarto grado de Educación Básica. Investigación que permitió valorar la importancia de los seis componentes de la idoneidad didáctica y explicar la complejidad ontosemiótica implícita en los procesos didácticos, a partir de la estructura objetiva y subjetiva de los módulos para el uso de materiales de enseñanza de la matemática.

ABSTRACT The objective was to evaluate an educational intervention for healthy eating habits based on the Colación BKN program, among preschool and schoolchildren, carried out in 2013-2018. We conducted a longitudinal study with cross-sectional data among preschool and school-age children (up to the fourth grade) over four years in 14 schools in the Metropolitan Region of Chile. The intervention program consisted of fruit delivery, nutrition education and improvements in physical activity and school food kiosks, with active participation of teachers and parents. There was an improvement in knowledge of healthy foods in children and excellent user satisfaction. Overweight and obesity did not increase during 2016 and 2018, but increased in 2015 and 2017. In similar not-intervened schools there was an increase of overweight and obesity compared with Colación BKN schools. For food consumption, there was a decrease in consumption of candy and soft drinks in preschool students and all children consumed more than three portions of fruits and vegetables per day, which is greater than the national average of two portions per day in the general population. Conclusions: There was a successful increase in fruit and vegetable consumption with nutrition education and promotion of healthy habits, such as physical activity and healthy food consumption.

RESUMEN El objetivo fue evaluar una intervención educativa en hábitos de alimentación saludable basada en el programa Colación BKN en pre-escolares y escolares entre los años 2013-2018. Diseño longitudinal con comparación de cortes trasversales en escolares de prekínder a cuarto año básico durante 4 años en 14 escuelas de la Región Metropolitana de Chile. El programa consistió en entrega de fruta como colación, educación alimentaria, mejora de la actividad física y kioscos escolares, con participación de profesores y familias. Como resultado se observó una mejoría de los conocimientos en alimentación saludable de los niños, con una excelente satisfacción de usuarios. Sobrepeso y obesidad se mantuvieron el 2016 y 2018, pero aumentaron el 2015 y 2017. En escuelas similares no intervenidas el exceso de peso fue mayor con respecto a las del programa. Hubo una tendencia a disminuir el consumo de dulces y bebidas azucaradas en prekínder y kínder entre 2014 y 2017 y el consumo de 3 porciones al día de frutas y verduras en niños intervenidos fue superior al promedio nacional de 2 porciones al día.Conclusiones: Hubo un aumento exitoso en el consumo de frutas y verduras, educación alimentaria y actividad física para el cambio hacia hábitos más saludables.

Resumo Introdução: A doença pulmonar obstrutiva crónica (DPOC), é um importante problema de saúde pública que tem influência sobre a qualidade de vida. Requerem-se intervenções que reduzam seu impacto. Objetivo: Determinar o efeito de uma atividade educativa grupal sobre a qualidade de vida de pessoas com DPOC, que assistem a uma instituição de quarto nível durante setembro-2017 e junho-2018, em Bogotá, Colômbia. Métodos: Desenho quase-experimental. A variável independente foi a atividade educativa grupal e a variável dependente, a qualidade de vida, medida com o Questionário Respiratório de Saint George (SGRQ). Os pacientes foram aleatorizados com uma tabela gerada por computador. O grupo controle (n=30) recebeu a intervenção usual e o grupo experimental (n=30) uma atividade educativa grupal desenhada sob recomendações internacionais, ministrada pelo pessoal de enfermagem. Excluíram-se pacientes com assistência a atividades grupais durante os últimos dois meses. Resultados: A média da qualidade de vida pós- intervenção foi 41% e 32% para o grupo controle e experimental, respetivamente, reduziram-se dois pontos ao respeito da medição inicial. A dimensão de atividade foi a mais comprometida. Não se encontraram diferenças estatisticamente significativas na análise intragrupal nem na intergrupal. Discussão: A leve melhora pós-intervenção nas dimensões de atividade e impacto, assim como as variáveis sociodemográficas são congruentes com outros estudos. Os resultados podem guardar relação com a quantidade de atividades desenvolvidas. Conclusões: A atividade grupal não gera melhora estatisticamente significativa na qualidade de vida das pessoas com DPOC. Encontrou-se uma melhora clínica nas dimensões de atividade e impacto, assim como na pontuação global.

Abstract Introduction: Chronic obstructive pulmonary disease (COPD) is an important public health problem which affects the quality of life. Consequently, interventions aimed at reducing these impacts are necessary. Objective: To determine the effect of an educational group activity on the quality of life of persons with COPD being attended in a fourth level institution in Bogota, Colombia, in september, 2017 and june, 2018. Methods: The study design was quasi-experimental. The independent variable was the educational group activity, and the dependent variable was the quality of life measured by the St George's Respiratory Questionnaire (SGRQ). Patients were randomized using a computer generated table. The control group (n=30) received the usual intervention while the experimental group (n=30) had an educational group activity designed under international recommendations and given by the nursing staff. Patients who had had other group activities during the last two months were excluded. Results: The post intervention quality of life mean was 41% and 32% for the control and experimental groups respectively. The most compromised dimension was activity. No statistically significant differences were found in the within-group and between-group analyzes. Discussion: The slight post intervention improvement in the dimensions of activity and impact is consistent with other similar studies, but results might vary in relation to the activities performed. Conclusions: This group activity did not induce a statistically significant improvement in the overall quality of life of persons living with COPD, nevertheless, slight improvements were found in the dimensions of activity, impact, and total score.

Resumen Introducción: La enfermedad pulmonar obstructiva crónica (EPOC), es un importante problema de salud pública que repercute sobre la calidad de vida. Se requieren intervenciones que reduzcan su impacto. Objetivo: Determinar el efecto de una actividad educativa grupal sobre la calidad de vida de personas con EPOC, que asisten a una institución de cuarto nivel durante septiembre-2017 y junio-2018, en Bogotá, Colombia. Métodos: Diseño cuasi-experimental. La variable independiente fue la actividad educativa grupal y la variable dependiente la calidad de vida, medida con el Cuestionario Respiratorio de Saint George (SGRQ). Los pacientes se aleatorizaron con una tabla generada por computador. El grupo control (n=30) recibió la intervención usual y el grupo experimental (n=30) una actividad educativa grupal diseñada bajo recomendaciones internacionales, impartida por el personal de enfermería. Se excluyeron pacientes con asistencia a actividades grupales durante los últimos dos meses. Resultados: La media de la calidad de vida pos-intervención fue 41% y 32% para el grupo control y experimental, respectivamente, se redujeron dos puntos con respecto a la medición inicial. La dimensión de actividad fue la más comprometida. No se encontraron diferencias estadísticamente significativas en el análisis intragrupal ni intergrupal. Discusión: La leve mejoría pos-intervención en las dimensiones de actividad e impacto, así como las variables sociodemográficas son congruentes con otros estudios. Los resultados pueden guardar relación con la cantidad de actividades desarrolladas. Conclusiones: La actividad grupal no genera mejoría estadísticamente significativa en la calidad de vida de las personas con EPOC. Se identificó una mejoría clínica en las dimensiones de actividad e impacto, así como en la puntuación global.

Resumen Este artículo presenta nuevas estimaciones de la función de emparejamiento para el departamento del Valle del Cauca con base en información del Servicio Público del SENA para el período entre el primer trimestre de 2008 y el cuarto trimestre de 2014. Los resultados muestran que la eficiencia en los procesos de emparejamiento del Valle del Cauca no se puede lograr solamente a través de mejoras en los procesos de búsqueda, sino que depende también de la existencia de un componente de ocupaciones fuerte y tradicional que se mantiene en el tiempo, pero que evidencia un desajuste estructural (cambio técnico sesgado hacia ocupaciones profesionales). JEL: C23, J24, J63.

Resumo Este artigo apresenta novas estimativas da função de emparelhamento para o departamento de Valle del Cauca com base em informações do Serviço Público do SENA para o período entre o primeiro trimestre de 2008 e o quarto trimestre de 2014. Os resultados mostram que a eficiência nos Processos de Emparelhamento do Valle del Cauca não podem ser alcançados apenas através de melhorias nos processos de busca, mas também depende da existência de um componente profissional forte e tradicional que seja mantido ao longo do tempo, mas que evidencia um desequilíbrio estrutural (mudança tendenciosa na direção de ocupações profissionais). JEL: C23, J24, J63.

Abstract This article presents new estimations for Valle del Cauca’s matching function using information from the SENA’s Public Service record between the first quarter of 2008 and the fourth quarter of 2014. The results show that efficiency in the matching processes in Valle del Cauca cannot only be attained through improvements in the search processes. This is because it also depends on the presence of a strong and traditional-employment component that is stable over time, and evidence is provided of a structural mismatch (technical change biased towards professional occupations). JEL: C23, J24, J63.

Résumé L’article présente de nouvelles estimations de la fonction d’appariement pour le département de Valle del Cauca, Colombie, à partir des données du Service public du SENA pour la période entre le premier trimestre de 2008 et le quatrième trimestre de 2014. Les résultats montrent que l’efficience des processus d’appariement du Valle del Cauca ne peut être atteinte uniquement à travers des améliorations dans les processus de recherche, mais qu’elle dépend également de l’existence d’un composant de métiers fort et traditionnel qui se maintient dans le temps, mais présente un désajustement structurel (changement technique biaisé vers des activités professionnelles). JEL: C23, J24, J63.

Abstract Objective: To describe and evaluate the management of medical supplies by an interdisciplinary team in order to promote their rational use in the nursing home setting. Methods: An interdisciplinary team was set up, coordinated by a Pharmacy Unit including representatives of 18 elderly nursing homes (1,599 beds). Team interventions were assessed in terms of improvements in the management of wound care supplies. In addition, a retrospective descriptive study was carried out on those patients with pressure ulcers, in order to consider future interventions. Results: The team interventions led to a selection of 15% of the 180 wound care supplies from the public tender process. The monthly savings in wound dressing material purchases was at least 17%. Furthermore, a reduction in consumption greater than 50% was found in 7 centres. The prevalence of ulcers was 5.59%. A fourth of these ulcers were originated outside nursing homes. Conclusions: The creation of an interdisciplinary team, in which the pharmacist gets closer to patient needs, and where nurses share responsibility for the selection and management of medical supplies, leads to positive results and represents an opportunity for improvement in elderly care.

Resumen Objetivo: Describir y evaluar la gestión de los productos sanitarios por un equipo interdisciplinar con la finalidad de racionalizar su utilización en el ámbito de la atención sociosanitaria. Métodos: Se creó un equipo interdisciplinar coordinado por un servicio de farmacia con representantes de 18 residencias para personas mayores dependientes (1.599 plazas asistenciales). Las intervenciones del equipo se valoraron en términos de mejora en la gestión de los productos sanitarios para curas. Además, se realizó un estudio descriptivo retrospectivo de los pacientes con úlceras por presión para considerar futuras intervenciones. Resultados: Las intervenciones del equipo resultaron en una selección del 15% de los 180 productos sanitarios para curas a partir del concurso público. El ahorro mensual en las compras de productos para cuidado de las úlceras fue como mínimo de un 17%. Además, se constató una reducción en el consumo superior al 50% en 7 centros. La prevalencia de úlceras fue del 5,59%. La cuarta parte de las úlceras tuvo un origen externo a la residencia. Conclusiones: La formación de un equipo interdisciplinar, en el que el farmacéutico se aproxima a las necesidades del paciente, y los profesionales de enfermería comparten la responsabilidad en la selección y gestión de los productos sanitarios, conduce a resultados positivos y supone una oportunidad de mejora en la atención a los mayores.