ABSTRACT Cuba faces a complex situation related to the warranty of the pillars of food and nutrition security; due to the international economic crisis, the irrational use of natural resources and the impact of climate change; a situation that gets worse due to the lack of financial resources and the effects of the coronavirus pandemic. In this scene, the Cuban State and Government´s bet to approve the Plan of Food Sovereignty and Nutrition Education and its consequent legal instrumentation, the Law of Food Sovereignty and Food and Nutrition Security. The present article contains the construction process of these legal regulations, the novel methodologies used for their elaboration, and the systematization of good practices and lessons learned in this legislative process.

RESUMEN Cuba enfrenta un contexto complejo para garantizar los pilares de la seguridad alimentaria y nutricional; producto de la crisis económica internacional, la utilización irracional de los recursos naturales y el impacto del cambio climático, la cual se acentúa con la carencia de recursos financieros y los efectos de la pandemia del coronavirus. Ante este escenario, el Estado y Gobierno cubanos apostaron por aprobar un Plan de Soberanía Alimentaria y Educación Nutricional y su instrumentación jurídica, la Ley Soberanía Alimentaria y Seguridad Alimentaria y Nutricional y su Reglamento. El presente artículo aborda el proceso de construcción de estas normas legales, las metodologías novedosas utilizadas para su elaboración, con una sistematización de las buenas prácticas y lecciones aprendidas en este proceso legislativo.

Abstract Dairy production in Ecuador is a source of economic income for many small and medium producers, however the lack of technical advice leads to problems in the quality of milk, and affects their production volume. The purpose of this investigation was to conduct a pilot plan to improve the quality of milk produced by 57 small producers from different parishes of the cantons of Quito, Rumiñahui and San Miguel de los Bancos in the province of Pichincha, through a training plan in good milking practices and feeding strategies. Two initial samplings were carried out (between October and November 2021) prior to the training, and two final samplings (in June 2022) to measure the impact of the training. A total of 1.273 samples were collected, of these only 4.02 % (52/1273) (of the samples) complied with the reference values of the national regulations, while 95.98 % (1243/1273) did not comply with any of the evaluated parameters; however, the vast majority of the milk is suitable for human consumption, yet its nutritional quality needs to be improved. We were able to reduce considerably (although not statistically) the somatic cell count (SC, from an initial average of 623530 CS ml-1 to 365660 CS ml-1 after training, being correlated with the significant increase in the percentage of lactose between the initial and final sampling; there were also significant differences in the percentage of fat and total solids, although in these two cases their values decreased after training (fat from 2.58 % in the initial sampling to 2.10 % in the final sampling and total solids of 11, 44 % to 11.00 %);showed no significant differences between samples. It is concluded that the training was beneficial since the considerable decrease in the somatic cell count increased the volume of milk production of the small producers, and therefore their economic income. For the rest of the parameters, it is recommended to reinforce training in nutrition, feeding, pasture management, etc., in order to increase their values, as well as to maintain constant training programs for producers, supported by academia, private and public entities.

Resumen La producción láctea en Ecuador es una fuente de ingresos económicos para muchos pequeños y medianos productores; sin embargo, la falta de asesoría técnica conlleva a que tengan problemas en la calidad de la leche y se vea afectado su volumen de producción, por lo que la presente investigación tuvo como finalidad realizar un plan piloto para el mejoramiento de la calidad de leche producida por 57 pequeños productores de diferentes parroquias de los cantones Quito, Rumiñahui y San Miguel de los Bancos de la provincia de Pichincha, mediante un plan de capacitación en buenas prácticas de ordeño y estrategias de alimentación. Se realizaron 2 muestreos iniciales (entre octubre y noviembre de 2021), previo a la capacitación, y 2 muestreos finales (en junio de 2022) para medir el impacto de estas. Se recolectaron 1.273 muestras, donde solamente el 4,02 % (52/1.273) de las mismas, cumplen con los valores referenciales de la normativa nacional, mientras que el 95,98 % (1.243/1.273) no cumple con alguno de los parámetros evaluados; sin embargo, la gran mayoría de dicha leche sí es apta para el consumo humano, pero requiere ser mejorada en su calidad nutricional. Se logró disminuir considerablemente (aunque no estadísticamente) el conteo de células somáticas, de un promedio inicial de 623.530 CS ml-1 a 365.660 CS ml-1 luego de la capacitación, siendo correlacionado con el aumento significativo del porcentaje de lactosa entre el muestreo inicial y el final; también existió diferencias significativas en el porcentaje de grasa y sólidos totales, aunque en estos dos casos disminuyeron sus valores luego de la capacitación (grasa de 2,58 % en el muestreo inicial a 2,10 % en el final y sólidos totales de 11,44 % a 11,00 %). El resto de los parámetros no mostraron diferencias significativas entre los muestreos. Se concluye que la capacitación fue beneficiosa, pues la disminución considerable del conteo de células somáticas aumentó el volumen de producción de leche de los pequeños productores y, por ende, sus ingresos económicos. Para el resto de los parámetros se recomienda reforzar las capacitaciones de nutrición, alimentación, manejo de pasturas, etc., para incrementar sus valores, así como mantener constantes programas de capacitación a los productores, apoyados desde la academia, la empresa privada y entidades públicas.

Resumo: O Ensino Superior em todo o mundo durante a pandemia da COVID-19 foi obrigado a repensar, atendendo à diretriz estabelecida pela Organização Mundial da Saúde (OMS) para mitigar o impacto na população. A Costa Rica não foi exceção relativamente à situação que se vivia e especificamente na Universidade de Ciências Médicas (UCIMED), que na ausência de um plano de contingência, viveu uma transição do ensino presencial para o virtual. A presente investigação se focou nos desafios vivenciados pelos docentes dos cursos de Fisioterapia e Nutrição, no período de março a junho de 2020, com a virtualização emergencial. As informações foram coletadas pelo meio de pesquisa desenvolvida no Google Forms®. Uma vez tabulado, foi analisado, interpretado e comparado entre carreiras, aplicando estatística descritiva e revisão bibliográfica para compreender a situação mundial. O estudo determinou que a didática do curso representava um grande desafio para o corpo docente; principalmente a avaliação da aprendizagem, a participação dos estudantes, o uso de ferramentas virtuais e problemas de conectividade. Ao comparar as carreiras, identificou-se que pouca formação, menos anos de experiência docente e baixa interação com plataformas virtuais foram fatores que aumentaram a percepção dos desafios. Ao enfrentá-los, enriqueceu-se a experiência docente na gestão das TIC e com ela a transformação do Ensino Superior.

Resumen: La educación superior a nivel mundial durante la pandemia COVID-19 se vio obligada a replantearse, dada la directriz establecida por la Organización Mundial de la Salud (OMS) para mitigar el impacto en la población. Costa Rica no fue la excepción respecto a la circunstancia que se vivía y, específicamente, la Universidad de Ciencias Médicas (UCIMED), ante la ausencia de un plan de contingencia, experimentó una transición de la enseñanza presencial a virtual. Debido a ello, la presente investigación tuvo un enfoque cuantitativo y exploró los desafíos que experimentó el personal docente de las carreras de Fisioterapia y Nutrición, durante el periodo de marzo a junio del 2020, con la virtualización de emergencia. La información se recopiló a través de un cuestionario elaborado en Google Forms®; una vez tabulada, se analizó, interpretó y comparó entre carreras, apli- cando estadística descriptiva y una revisión bibliográfica para comprender la situación a nivel mundial. El estudio determinó que la didáctica del curso representó un alto desafío para el cuerpo docente; principalmente, la evaluación del aprendizaje, la participación del estudiantado, el uso de las herramientas virtuales y los problemas de conectividad. Al comparar las carreras, se identificó que la poca capacitación, la menor cantidad de años de experiencia docente y la baja interacción con plataformas virtuales, fueron factores que aumentaron la percepción de los desafíos. A partir de la confrontación de los desafíos, se enriqueció la experiencia docente en el manejo de las tecnologías de la información y comunicación (TIC) y con ello la transformación de la educación superior.

Abstract: During the COVID-19 pandemic, higher education worldwide was forced to restructure itself according to guidelines established by the World Health Organization (WHO) to mitigate the impact of the pandemic on the population. Costa Rica was no exception. In the absence of a contingency plan, the University of Medical Sciences (UCIMED) underwent a transition from face-to-face to virtual teaching. This study focused on the challenges experienced by physical therapy and nutrition faculty during the period from March to June 2020, due to the emergency virtualization. The information was collected through a Google Forms® survey; once tabulated, the data was analyzed, interpreted and compared between the professions, implementing descriptive statistics and a bibliographic review to better understand the situation at a global level. The study showed that the didactics of the course was a great challenge for the teachers, mainly in terms of learning assessment, student participation, use of virtual tools and connectivity problems. When comparing professions, it was found that limited training, fewer years of teaching experience, and less interaction with virtual platforms were factors that increased the perception of challenges. Confronting the challenges enriched the teaching experience in terms of ICT management and thus the transformation of higher education.

RESUMEN El objetivo de este artículo es identificar la prevalencia de deserción en los alumnos de la Licenciatura en Nutrición (LN) de una universidad pública de México, las causas relacionadas con la deserción y agruparlas de acuerdo a sus características. Se realizó un estudio descriptivo en dos fases, en la fase 1 se identificaron los datos históricos de deserción del programa educativo. En la fase 2, se aplicó una encuesta de construcción propia con preguntas abiertas y cerradas, de la cual se obtuvo la respuesta de 75 estudiantes desertores. La encuesta incluyó un análisis dicotómico (sí, no) de 18 factores asociados a la deserción escolar, totalizando 22 al incorporar los aspectos cualitativos obtenidos de la opción de respuesta "otros"; estos factores se agruparon en seis categorías. Se encontró una tasa de deserción escolar del 18% para el plan de estudios actual y el intermedio y hasta el 33% en el primer plan de estudios. De los desertores detectados, el 58.6% lo hizo en el primer año de estudios. El 66% de los desertores reprobaron al menos una unidad de aprendizaje y tienen una calificación promedio de 72.71, por debajo de la media general de la LN del centro universitario (91.8). De los desertores, el 49.3% identificó el cambio de carrera como su motivo de abandono, este factor forma parte de la categoría de "causas vocacionales" que ocupó el primer lugar con el 72%, seguido de "aspectos personales" con el 49.3% incluyendo 3 casos de maternidad; y en tercer lugar la categoría de "aspectos económicos" (26.7%). El principal motivo de deserción de los alumnos de la LN son los aspectos vocacionales relacionados con la búsqueda de otra carrera.

ABSTRACT The objective of this article is to identify the prevalence of dropout in students from the bachelor's degree in nutrition (LN) at a public university in Mexico, the causes related to dropout, and group them according to their characteristics. A descriptive study was carried out in two phases; in phase 1, the historical data on attrition from the educational program were identified. In phase 2, we applied a self-constructed survey with open and closed questions and obtained a response from 75 dropout students. The survey included a dichotomous analysis (yes, no) of 18 factors associated with school dropout, totaling 22 when incorporating the qualitative aspects obtained from the "other" response option; these factors were grouped into six categories. A dropout rate of 18 % was found for the current and intermediate curriculum and up to 33 % in the first curriculum. Of the dropouts detected, 58.6 % came to pass in the first year of studies. The 66 % of the dropouts have failed at least one subject; their average grade is 72.71, below the general average from the LN of the university center (91.8). Of the dropouts, 49.3 % identified career change as their reason for dropping out, which is part of the category of "vocational causes" that ranked first with 72 %, followed by "personal aspects" with 49.3 % including 3 cases of maternity; and in third place the category of "economic aspects" (26.7 %). The main reason for dropout among LN students is vocational aspects related to the search for another career.

SUMMARY OBJECTIVE: This study aimed to explore and analyze the therapeutic effect of the combination of Bifidobacterium animalis subsp. lactis BB-12® and Lactobacillus rhamnosus GG on underweight and malabsorption in premature infants. METHODS: This is a retrospective study. The clinical data of 68 premature infants admitted to Beijing United Family Hospital (Private Secondary Comprehensive Hospital, Chaoyang District, Beijing, China) from January 2016 to January 2022 were analyzed retrospectively. Preterm infants less than 37 weeks of gestational age admitted to the neonatal intensive care unit were included in the study. Patients with intestinal malformations, necrotizing enterocolitis, etc., who require long-term fasting were excluded. A telephone follow-up was performed 3-6 months after discharge. They were classified as treatment groups A and B according to the treatment plan. The treatment group A included parenteral nutrition, enteral nutrition, etc. In treatment group B, based on treatment group A, the premature infants were treated with Bifidobacterium animalis subsp. lactis BB-12® and Lactobacillus rhamnosus GG. The time to regain birthweight and the weight on day 30 were compared between the two groups, as was the duration of transition from parenteral nutrition to total enteral nutrition. RESULTS: The time of weight regain birthweight in group B was shorter than that in group A (t=-2.560; t=-4.287; p<0.05). The increase of weight on day 30 in group B was significantly higher than that in group A (t=2.591; t=2.651; p<0.05). The time from parenteral nutrition to total enteral nutrition in group B was shorter than that in group A (z=-2.145; z=-2.236; p<0.05). CONCLUSION: In the treatment of premature infants, the combination of Bifidobacterium animalis subsp. lactis BB-12® and Lactobacillus rhamnosus GG can have a better therapeutic effect on the underweight and malabsorption of premature infants, and this treatment method can be popularized in clinics. OBJECTIVE subsp BB12® BB12 BB 12® 12 BB-12 METHODS 6 Private District China 201 202 retrospectively 3 malformations enterocolitis etc longterm long term excluded followup follow up 36 3- discharge plan RESULTS t=2.560 t2560 t t= 2.560 2 560 (t=-2.560 t=4.287 t4287 4.287 4 287 t=-4.287 p<0.05. p005 p p<0.05 . 0 05 p<0.05) t=2.591 t2591 591 (t=2.591 t=2.651 t2651 651 z=2.145 z2145 z z= 2.145 145 (z=-2.145 z=2.236 z2236 2.236 236 z=-2.236 CONCLUSION clinics BB1 1 BB-1 20 t=2.56 t256 2560 2.56 56 (t=-2.56 t=4.28 t428 4287 4.28 28 t=-4.28 p00 p<0.0 t=2.59 t259 59 (t=2.59 t=2.65 t265 65 z=2.14 z214 2145 2.14 14 (z=-2.14 z=2.23 z223 2236 2.23 23 z=-2.23 BB- t=2.5 t25 256 2.5 5 (t=-2.5 t=4.2 t42 428 4.2 t=-4.2 p0 p<0. (t=2.5 t=2.6 t26 z=2.1 z21 214 2.1 (z=-2.1 z=2.2 z22 223 2.2 z=-2.2 t=2. t2 25 2. (t=-2. t=4. t4 42 4. t=-4. p<0 (t=2. z=2. z2 21 (z=-2. 22 z=-2. t=2 (t=-2 t=4 t=-4 p< (t=2 z=2 (z=-2 z=-2 (t=- t=- (t= (z=- z=- (t (z= (z

Resumen El plan de estudios de la Licenciatura en Nutrición contempla contenidos que fueron seleccionados para el logro de los objetivos curriculares. En este trayecto, estudiantes y docentes son actores esenciales a la hora de emitir sus opiniones. Se consideran las percepciones como el proceso por el cual las personas organizan, interpretan y responden a la información del mundo que las rodea. Teniendo en cuenta que el plan de estudios de la Licenciatura en Nutrición de la Facultad de Bioquímica y Ciencias Biológicas se mantiene vigente desde la creación de la carrera en el año 2005, y desde entonces no ha sido revisado, era necesario realizar este trabajo para analizar la situación actual a partir de la percepción de dichos agentes. Se realizó un trabajo de tipo descriptivo transversal, de diseño cuanti-cualitativo, mediante la aplicación de encuestas y grupos de discusión dirigidos a estudiantes avanzados y docentes de la carrera en el último semestre de 2018 y primer trimestre de 2019. Los resultados muestran que ambos actores tienen opiniones coincidentes sobre la introducción de contenidos relacionados con la nutrición en los primeros años, como también sobre la incorporación al plan de estudios de asignaturas afines a nutrición infantil y técnicas dietéticas. La discrepancia entre sus opiniones se presenta al valorar si el plan es coherente con las necesidades del licenciado y si responde al entorno socioeconómico.

Abstract The study plan of the Nutrition Degree includes contents that were selected to achieve the curricular objectives. In this journey, students and teachers are essential actors, when it comes to issuing their opinions. Perceptions are considered as the process by which people organize, interpret and respond to information from the world around them. Bearing in mind that the study plan of the Bachelor of Nutrition at the Faculty of Biochemistry and Biological Sciences has been in force since the creation of the degree in 2005, and has not been revised since then, it became necessary to carry out this work to analyze the current situation from the perception of said agents. A cross-sectional descriptive work, of a quantitative-qualitative design, was carried out through the application of surveys and discussion groups aimed at advanced students and teachers of the career in the last semester of 2018 and the first quarter of 2019. The results show that both actors have coincident opinions on the introduction of contents related to nutrition in the early years, in addition to the incorporation into the curriculum of subjects related to child nutrition and dietary techniques. The discrepancy in their opinions arises when assessing whether the plan is consistent with the needs of the graduate and whether it responds to the socioeconomic environment.

Resumo O plano de estudos da Licenciatura em Nutrição inclui conteúdos que foram selecionados para atingir os objetivos curriculares. Nessa jornada, alunos e professores são atores essenciais, na hora de emitir suas opiniões. As percepções são consideradas como o processo pelo qual as pessoas organizam, interpretam e respondem às informações do mundo ao seu redor. Tendo em conta que o plano de estudos da Licenciatura em Nutrição da Faculdade de Bioquímica e Ciências Biológicas está em vigor desde a criação da licenciatura em 2005, não tendo sido revisto desde então, tornou-se necessário realizar este trabalho para analisar a situação atual a partir da percepção dos referidos agentes. Foi realizado um trabalho descritivo transversal, de desenho quantitativo-qualitativo, através da aplicação de inquéritos e grupos de discussão dirigidos a alunos avançados e professores da carreira no último semestre de 2018 e primeiro trimestre de 2019. Os resultados mostram que ambos os atores têm opiniões coincidentes sobre a introdução de conteúdos relacionados à nutrição nos anos iniciais, além da incorporação no currículo de assuntos relacionados à nutrição infantil e técnicas dietéticas. A discrepância de opiniões surge na hora de avaliar se o plano é condizente com as necessidades do egresso e se responde ao ambiente socioeconômico.

RESUMO Objetivo: Visa explorar associações e diferenças de gênero entre comportamentos de busca de OHI (busca de informações de saúde on-line) e letramento em e-Saúde (saúde eletrônica) entre estudantes universitários chineses. Métodos: Questionários on-line da escala de letramento em e-Saúde e comportamentos de busca de OHI criados no software Wenjunxing foram utilizados nesta pesquisa. Testes qui-quadrado, teste t e análise de correlação de Pearson foram realizados utilizando SPSS para análise de dados. Resultados: Dos 5.383 participantes, 72,4% eram meninas, 77,5% viviam em áreas rurais, 51,2% eram formados em artes liberais, 76,6% tinham pais com baixa escolaridade. As pontuações médias do C-eHEALS de meninos e meninas foram 26,53 ± 5,861 e 26,84 ± 5,816, respectivamente, sem diferença significativa (P = 0,084). Os três principais comportamentos de busca de IHO para meninos e meninas, bem como para os grupos baixo e alto do C-eHEALS, foram “encontrar informações sobre exercícios físicos”; “ler ou compartilhar informações de saúde através das redes sociais”; “encontrar informações sobre nutrição e dieta”, todos com diferenças significativas de gênero e de letramento em e-Saúde. Conclusões: As diferenças de gênero e de letramento em e-Saúde devem ser focadas na intervenção ao desenvolver e implementar formação de intervenção em e-Saúde para pais e adolescentes em escolas e comunidades. Objetivo online on line eSaúde Saúde eletrônica chineses Métodos pesquisa quiquadrado, quiquadrado qui quadrado, quadrado qui-quadrado dados Resultados 5383 5 383 5.38 participantes 724 72 4 72,4 775 77 77,5 rurais 512 51 2 51,2 liberais 766 76 6 76,6 escolaridade CeHEALS C eHEALS 2653 26 53 26,5 5861 861 5,86 2684 84 26,8 5816 816 5,816 respectivamente P 0,084. 0084 0,084 . 0 084 0,084) CeHEALS, eHEALS, encontrar físicos físicos” ler sociais sociais” dieta, dieta , dieta” eSaúde. Saúde. Conclusões comunidades 538 38 5.3 7 72, 77, 51, 76, 265 26, 586 86 5,8 268 8 581 81 5,81 008 0,08 08 3 5. 58 5, 00 0,0 0,

ABSTRACT Objective: to explore associations and gender differences between OHI-seeking (online health information seeking) behaviors and eHealth (electronic health) literacy among Chinese university students. Methods: Online questionnaires of eHealth literacy scale and OHI-seeking behaviors created in software Wenjunxing were used in this survey. Chi-squared tests, t-test, and Pearson correlation analysis were performed using SPSS for data analysis. Results: Among 5,383 participants, 72.4% were girls, 77.5% lived in rural areas, 51.2% majored in liberal arts, 76.6% with low education parents. The average C-eHEALS scores of boys and girls were 26.53 ± 5.861 and 26.84 ± 5.816, respectively, with no significant difference (P = 0.084). The top three OHI-seeking behaviors for boys and girls, as well as for the C-eHEALS low and high groups, were “finding information about physical exercises” “reading or sharing health information via social media” “finding information about nutrition and diet”, all of which had significant gender and eHealth literacy differences. Conclusions: Gender and eHealth literacy differences should be focused for intervention when developing and implementing eHealth intervention training for parents and adolescents in schools and communities. Objective OHIseeking OHI seeking online electronic students Methods survey Chisquared Chi squared tests ttest, ttest t test, test t-test Results 5383 5 383 5,38 participants 724 72 4 72.4 775 77 77.5 areas 512 51 2 51.2 arts 766 76 6 76.6 CeHEALS C eHEALS 2653 26 53 26.5 5861 861 5.86 2684 84 26.8 5816 816 5.816 respectively P 0.084. 0084 0.084 . 0 084 0.084) groups finding exercises reading media diet, diet , diet” Conclusions communities 538 38 5,3 7 72. 77. 51. 76. 265 26. 586 86 5.8 268 8 581 81 5.81 008 0.08 08 3 5, 58 5. 00 0.0 0.

RESUMEN Objetivo: Explorar las asociaciones y las diferencias de género entre el comportamiento de búsqueda de OHI (información sanitaria en línea) y los conocimientos sobre e-Salud (salud electrónica) entre estudiantes universitarios chinos. Métodos: Se utilizaron cuestionarios en línea de la escala de conocimientos en e-Salud y conductas de búsqueda de OHI creadas con el software Wenjunxing. En el análisis de los datos, se utilizó el programa SPSS para llevar a cabo las pruebas de chi-cuadrado, pruebas t y análisis de correlación de Pearson. Resultados: De los 5.383 participantes, el 72,4% estaba formado por muchachas, el 77,5% vivía en zonas rurales, el 51,2% era licenciado en Humanidades y el 76,6% tenía padres con bajo nivel educativo. Las puntuaciones medias del C-eHEALS para chicos y chicas fueron 26,53 ± 5,861 y 26,84 ± 5,816, respectivamente, sin diferencias significativas (P = 0,084). Las tres conductas principales de búsqueda de la OHI para muchachos y muchachas, así como para los grupos de C-eHEALS bajo y alto, fueron “encontrar información sobre ejercicio físico”; “leer o compartir información sobre salud a través de las redes sociales”; “encontrar información sobre nutrición y dietas”, todos ellos con diferencias significativas de género y de aprendizaje sobre e-Salud. Conclusiones: Las diferencias de género y de conocimientos en e-Salud deben centrarse en la intervención a la hora de desarrollar e implementar la formación en cibersalud para padres y adolescentes en escuelas y comunidades. Objetivo eSalud Salud electrónica chinos Métodos Wenjunxing datos chicuadrado, chicuadrado chi cuadrado, cuadrado chi-cuadrado Pearson Resultados 5383 5 383 5.38 participantes 724 72 4 72,4 muchachas 775 77 77,5 rurales 512 51 2 51,2 766 76 6 76,6 educativo CeHEALS C eHEALS 2653 26 53 26,5 5861 861 5,86 2684 84 26,8 5816 816 5,816 respectivamente P 0,084. 0084 0,084 . 0 084 0,084) alto encontrar físico físico” leer sociales sociales” dietas, dietas , dietas” eSalud. Salud. Conclusiones comunidades 538 38 5.3 7 72, 77, 51, 76, 265 26, 586 86 5,8 268 8 581 81 5,81 008 0,08 08 3 5. 58 5, 00 0,0 0,

The study analyzed the impacts of two probiotics (Ecobiol® and GutCare®) on growth performance, carcass and cut yields, intestinal morphometry and lesion score, biochemical parameters, and short-chain fatty acid concentration in chickens using a challenge model combining coccidiosis vaccine and Clostridium perfringens. A total of 880 one-day-old male broilers (Cobb 500) were randomly assigned to four treatments with 10 replicates and 22 birds per experimental unit (EU). The treatments consisted of: PC: positive control with the inclusion of 80 g ton-1 of Enramax® (8% enramycin) until 35 d of age; NC: negative control without the inclusion of growth-promoting probiotic; BA: NC with the inclusion of 1000 g ton-1 of Ecobiol® (Bacillus amyloliquefaciens - CECT 5940); BS: NC with the inclusion of 500 g ton-1 of GutCare® (Bacillus subtilis - DSM 32315). Diets used maize-soybean meal in a three-phase plan. Broiler chickens on the BA and BS diets had higher feed consumption, body weight gain, and improved feed conversion efficiency at 28 and 42 d when compared to the birds in the negative control. Broiler chickens fed PC, BA, and BS diets had a higher villus height and absorption area in the jejunum at 28 d, compared to the birds in the negative control. There was more butyric acid production by the intestinal microbiota at 28 d of age in broilers on the BA diet. Supplementing with 1000 g/ton of BA and 500 g/ton of BS effectively substituted the 8% enramycin antibiotic, enhancing broiler growth during an induced intestinal challenge.

ABSTRACT Introduction: Pedagogical action can be a determining factor for family education in the nutritional area, and as a based on it, improve indicators directly related to health such as the body mass index in children. Objective: To evaluate the effects of a plan of pedagogical actions to enhance child nutrition in the rural sector of the canton Riobamba. Methods: Descriptive, explanatory research, of correlational order and longitudinal orientation, intervening with a nutritional pedagogical plan for 88 families and their children (5-7 years); the body mass index was compared at two moments of the intervention process. Results: A significant improvement in body mass index (p=0,000) is evidenced according to the Wilcoxon test at the end of the intervention process, with 68 positive ranges (72.27% of the cases studied improved their body weight to a medium healthy weight level), and 20 ties (22.73% maintained their low weight condition). Conclusions: Intervention plans with pedagogical actions can improve child nutrition in low-income rural areas. However, it is recommended to assess family particularities, given that a notable percentage of the sample did not improve their low weight condition.

RESUMEN Introducción: El accionar pedagógico puede ser un factor determinante para la educación familiar en el área nutricional, y en función de ello, mejorar indicadores directamente relacionados con la salud como el índice de masa corporal en niños. Objetivo: Evaluar los efectos de un plan de acciones pedagógicas para potenciar la nutrición infantil en el sector rural del cantón Riobamba. Métodos: Investigación descriptiva explicativa, de orden correlacional y orientación longitudinal, interviniendo con un plan pedagógico nutricional a 88 familias y sus niños (5-7 años), comparando el índice de masa corporal en dos momentos del proceso de intervención. Resultados: Se evidencia una mejora significativa en el índice de masa corporal (p = 0,000), según la prueba de Wilcoxon al finalizar el proceso de intervención, con 68 rangos positivos (72,27 % de los casos estudiados mejoraron su peso corporal a un nivel de peso saludable medio), y 20 empates (22,73 % mantuvo su condición de bajo peso). Conclusiones: Los planes de intervención con acciones pedagógicas pueden mejorar la nutrición infantil en sectores rurales de bajos ingresos. Sin embargo, se requiere como recomendación valorar las particularidades familiares, atendiendo a que un porcentaje notable de la muestra estudiada no mejoró su condición de bajo peso.

SUMMARY OBJECTIVE: Various studies have reported that certain long non-coding RNA levels are unusually low in the intestines of celiac disease patients, suggesting that this may be associated with the inflammation observed in celiac disease. Despite these studies, the research aimed at uncovering the potential role of long non-coding RNAs in the pathogenesis of autoimmune diseases like celiac disease remains insufficient. Therefore, in this study, we plan to assess long non-coding RNA polymorphisms associated with autoimmunity in children diagnosed with celiac disease according to the European Society for Paediatric Gastroenterology Hepatology and Nutrition criteria. METHODS: DNA was isolated from paraffin tissue samples of 88 pediatric celiac disease patients and 74 healthy pediatric individuals. Single-nucleotide polymorphism genotyping of five long non-coding RNA polymorphisms associated with autoimmunity (LINC01934-rs1018326, IL18RAP-rs917997, AP002954.4-rs10892258, UQCRC2P1-rs6441961, and HCG14 rs3135316) was conducted using the TaqMan single-nucleotide polymorphism genotyping assays with the LightCycler 480. RESULTS: In our study, the genotypic and allelic frequency distribution of LINC01934-rs1018326 and AP002954.4-rs10892258 polymorphisms was found to be statistically significant in the comparison between the two groups (p<0.05). According to the multiple genetic model analyses, the LINC01934-rs1018326 polymorphism was observed to confer a 1.14-fold risk in the recessive model and a 1.2-fold risk in the additive model for pediatric celiac disease. Similarly, the AP002954.4-rs10892258 polymorphism was found to pose a 1.40-fold risk in the dominant model and a 1.7-fold risk in the additive model. CONCLUSION: Our study results draw attention to the LINC01934-rs1018326 and AP002954.4-rs10892258 polymorphisms in celiac disease and suggest that these polymorphisms may be associated with inflammation in autoimmune diseases like celiac disease. OBJECTIVE noncoding non coding insufficient Therefore criteria METHODS 8 7 individuals Singlenucleotide Single nucleotide LINC01934rs1018326, LINC01934rs1018326 LINCrs LINC01934 rs1018326, rs1018326 LINC rs (LINC01934-rs1018326 IL18RAPrs917997, IL18RAPrs917997 ILRAPrs IL18RAP rs917997, rs917997 IL RAP IL18RAP-rs917997 AP002954.4rs10892258, AP0029544rs10892258 APrs AP002954.4 rs10892258, AP002954 4 rs10892258 AP UQCRC2P1rs6441961, UQCRC2P1rs6441961 UQCRCPrs UQCRC2P1 rs6441961, rs6441961 UQCRC P UQCRC2P1-rs6441961 HCG HCG1 rs3135316 singlenucleotide single 480 RESULTS LINC01934-rs101832 AP002954.4rs10892258 AP002954.4-rs1089225 p<0.05. p005 p p<0.05 . 0 05 (p<0.05) analyses 1.14fold 114fold fold 1.14 1 14 1.2fold 12fold 1.2 2 Similarly 1.40fold 140fold 1.40 40 1.7fold 17fold 1.7 CONCLUSION LINC01934rs101832 LINC0193 rs101832 (LINC01934-rs101832 RAPrs IL18RAPrs91799 ILRAP rs91799 IL18RAP-rs91799 4rs10892258 AP0029544rs1089225 AP0029544 AP002954. AP00295 rs1089225 UQCRC2P1rs644196 UQCRCP UQCRC2P rs644196 UQCRC2P1-rs644196 rs313531 48 LINC01934-rs10183 AP002954.4rs1089225 AP002954.4-rs108922 p00 p<0.0 (p<0.05 14fold 114 1.1 2fold 12 1. 40fold 140 1.4 7fold 17 LINC01934rs10183 LINC019 rs10183 (LINC01934-rs10183 IL18RAPrs9179 rs9179 IL18RAP-rs9179 4rs1089225 AP0029544rs108922 AP0029 rs108922 UQCRC2P1rs64419 rs64419 UQCRC2P1-rs64419 rs31353 LINC01934-rs1018 AP002954.4rs108922 AP002954.4-rs10892 p0 p<0. (p<0.0 11 LINC01934rs1018 LINC01 rs1018 (LINC01934-rs1018 IL18RAPrs917 rs917 IL18RAP-rs917 4rs108922 AP0029544rs10892 AP002 rs10892 UQCRC2P1rs6441 rs6441 UQCRC2P1-rs6441 rs3135 LINC01934-rs101 AP002954.4rs10892 AP002954.4-rs1089 p<0 (p<0. LINC01934rs101 LINC0 rs101 (LINC01934-rs101 IL18RAPrs91 rs91 IL18RAP-rs91 4rs10892 AP0029544rs1089 AP00 rs1089 UQCRC2P1rs644 rs644 UQCRC2P1-rs644 rs313 LINC01934-rs10 AP002954.4rs1089 AP002954.4-rs108 p< (p<0 LINC01934rs10 rs10 (LINC01934-rs10 IL18RAPrs9 rs9 IL18RAP-rs9 4rs1089 AP0029544rs108 AP0 rs108 UQCRC2P1rs64 rs64 UQCRC2P1-rs64 rs31 LINC01934-rs1 AP002954.4rs108 AP002954.4-rs10 (p< LINC01934rs1 rs1 (LINC01934-rs1 IL18RAPrs IL18RAP-rs 4rs108 AP0029544rs10 UQCRC2P1rs6 rs6 UQCRC2P1-rs6 rs3 LINC01934-rs AP002954.4rs10 AP002954.4-rs1 (p LINC01934rs (LINC01934-rs 4rs10 AP0029544rs1 UQCRC2P1rs UQCRC2P1-rs AP002954.4rs1 AP002954.4-rs 4rs1 AP0029544rs AP002954.4rs 4rs

ABSTRACT Objective: The purpose of the present study was to examine the association of oxidative stress markers with sarcopenia in the general United States population under the age of 60. Methods: We used the National Health and Nutrition Examination Survey data from 2011‒2014 and performed Restricted Cubic Spline (RCS) plots, weighted multivariable logistic regression analysis to calculate ratio ratios and 95% Confidence Intervals, and subgroup analysis based on age, sex, hypertension, diabetes mellitus, and body mass index stratification to determine the association of markers of oxidative stress with the prevalence of sarcopenia. Results: The present analysis included a total of 8,782 participants. Firstly, the RCS plots showed a roughly L-shaped curve association of total bilirubin and serum iron with a prevalence of sarcopenia. Secondly, albumin was negatively and linearly associated with the risk of sarcopenia. Finally, with the increase in gamma-glutamyl transferase, the prevalence of sarcopenia showed a trend of first rising and then declining as a result of the iron increase. Conclusions: We demonstrated a nonlinear association between markers of oxidative stress and sarcopenia. The need to focus more on levels of oxidative stress in the body could provide better prevention strategies for sarcopenia. Objective 60 Methods 20112014 2011 2014 2011‒201 (RCS 95 Intervals sex hypertension mellitus Results 8782 8 782 8,78 participants Firstly Lshaped L shaped Secondly Finally gammaglutamyl gamma glutamyl transferase Conclusions 6 2011201 201 2011‒20 9 878 78 8,7 201120 20 2011‒2 87 7 8, 20112 2 2011‒

Resumen Introducción: Prácticas alimentarias inadecuadas ocasionan sobrepeso y obesidad infantil, hábitos que se aprenden en la familia y el entorno social; en México, la prevalencia incrementó un 1.1% en relación al 2012. Contar con planes de cuidados de enfermería brindará una orientación para disminuir obesidad en la familia al fomentar hábitos nutricionales saludables. Objetivo: Diseñar planes de cuidados de enfermería dirigido a padres de niños con sobrepeso u obesidad, factibles de implementar dentro del entorno familiar. Metodología: Se empleó la propuesta para elaboración del plan de cuidados de enfermería de la Comisión Permanente de Enfermería en México. La delimitación del problema fue mediante valoración a 30 padres/madres con hijos/as de 5 a 11 años que padecían sobrepeso u obesidad. La construcción de los planes de cuidados se realizó según el análisis de la valoración mediante la Teoría Enfermera del Déficit del Autocuidado, la taxonomía North American Nursing Diagnosis Associaton, Nursing Outcomes Classification y Nursing Interventions Classification, clasificadas de acuerdo con sistemas enfermeros propuestos por Orem. Resultados: Se identificaron factores condicionantes básicos como hábitos nutricionales deficientes en la familia, obesidad y sobrepeso en escolares, a partir de los cuales se crearon cinco planes de cuidados: desempeño ineficaz del rol, conductas de mantenimiento ineficaz de la salud, conocimiento deficiente, tendencia a adoptar conductas de riesgo para la salud y dinámica de alimentación ineficaz del preescolar y escolar. Conclusiones: Continuar el desarrollo de planes de cuidados para prevenir y disminuir obesidad en la niñez que aumente o mejore su calidad de vida.

Abstract Introduction: Inadequate dietary practices causes childhood overweight and obesity, habits that are learned in the family and social environment; in Mexico, prevalence increased by 1.1% compared to 2012. Having Nursing Care Plans will provide guidance to reduce obesity in the family by promoting healthy nutritional habits. Objective: To design nursing care plans aimed at parents of overweight or obese children, feasible to implement within the family environment. Methodology: The proposal for the preparation of the nursing care plan of the Permanent Commission of Nursing in Mexico was used. The delimitation of the problem was by assessing 30 parents with children from 5 to 11 years old who were overweight or obese; the construction of the care plans were carried out according to the analysis using the Nurse Theory of Self-Care Deficit, the North American Nursing Diagnosis Association taxonomy, the Nursing Outcomes Classification, and the Nursing Interventions Classification, these classified according to nursing systems proposed by Orem. Results: Basic conditioning factors were identified, such as poor nutritional habits in the family, and obesity and overweight in schoolchildren, from which five care plans were created: Ineffective role performance, ineffective health maintenance behaviors, deficient knowledge, tendency to adopt risk behaviors for health and ineffective eating dynamics at preschool and school. Conclusion: Continue the development of care plans to prevent and reduce obesity in childhood that increases or improves their quality of life.

Abstrato Introdução: Práticas alimentares inadequadas causam sobrepeso e obesidade na infância, hábitos que são aprendidos no ambiente familiar e social; no México, a prevalência aumentou 1,1% em relação a 2012. A existência de Planos de Cuidados de Enfermagem dará orientação para reduzir a obesidade na família, promovendo hábitos nutricionais saudáveis. Objetivo: Elaborar planos de atenção à enfermagem voltados para pais de crianças com sobrepeso ou obesidade, é viável implementar dentro do ambiente familiar. Metodologia: Foi utilizada a proposta para a elaboração do plano de cuidados de enfermagem da Comissão Permanente de Enfermagem no México. A delimitação do problema foi avaliando 30 pais com crianças de 5 a 11 anos com sobrepeso ou obesidade; a construção dos planos de cuidados foi realizada de acordo com a análise utilizando a Teoria da Enfermeira do Défice de Autocuidado, a taxonomia da Associação Norte-Americana de Diagnóstico de Enfermagem, a Classificação dos Resultados de Enfermagem, e a Classificação das Intervenções de Enfermagem, estas classificadas de acordo com os sistemas de enfermagem propostos por Orem. Resultados: Foram identificados factores condicionantes básicos, tais como maus hábitos nutricionais na família, e obesidade e excesso de peso em crianças em idade escolar, a partir dos quais foram criados cinco planos de cuidados: Desempenho ineficaz do papel, comportamentos ineficazes de manutenção da saúde, conhecimento deficiente, tendência para adoptar comportamentos de risco para a saúde e dinâmica alimentar ineficaz na pré-escola e na escola. Conclusões: Continuar o desenvolvimento de planos assistenciais de prevenção e redução da obesidade na infância que aumente ou melhore sua qualidade de vida.

'n Onderwysstelsel is 'n raamwerk wat in die onderwysbehoeftes van 'n bepaalde teikengroep voorsien. Onderwysstelsels bestaan uit verskillende komponente en elemente om doeltreffende onderwys aan die hele teikengroep met bepaalde onderwysbehoeftes te verskaf. Hierdie komponente sluit die onderwysstelselbeleid, onderwysstelseladministrasie, onderwysstruktuur en ondersteuningsdienste in. Vir 'n onderwysstelsel om doeltreffend te funksioneer is dit nodig dat alle komponente volgens 'n bepaalde plan meewerk. Nuwe uitdagings word voortdurend aan onderwysstelsels gestel en daar is gedurig verandering in tegnologie, die gemeenskap, die teikengroep en die kurrikulum. Om te verseker dat doeltreffende onderrig in die onderwys-situasie plaasvind, is onderwys afhanklik van bykomende hulp van buite die onderwys. Hierdie ondersteuningsdienste (bykomende hulp) is noodsaaklik vir die doeltreffende funksionering van onderwys en lewer 'n bydrae tot die doeltreffendheid van onderwys. Die behoefte aan spesifieke tipes onderwysondersteuningsdienste verskil ten opsigte van verskillende onderwysstelsels, aangesien die behoeftes van die betrokke teikengroepe van mekaar kan verskil. Hierdie studie bestudeer onderwysondersteuningsdienste vir leerders as 'n komponent en element van die onderwysstelsel in die BRICS-lidlande en identifiseer die beste praktyke in die onderwysondersteuningsdienste in die lidlande. Die doel van die studie is gesetel in die feit dat daar in die verlede kommer by verskeie onderwysowerhede bestaan het ten opsigte van ondersteuningsdienste wat nie optimaal funksioneer nie en sodoende nie in die onderwysbehoeftes van onderwysers en leerders, asook onderrigaktiwiteite en -strukture, voorsien nie. Die navorsing is uitgevoer vanuit 'n kwalitatiewe navorsingsbenadering binne die raamwerk van die interpretivistiese navorsingsparadigma met behulp van dokumentontleding as metode van datagenerering. Die volgende temas uit die literatuurondersoek is geïdentifiseer: inklusiewe onderwys; hulpverlening aan leerders deur middel van mediese en tandheelkundige dienste; maatskaplike dienste; en voedingsdienste. Hierdie navorsing vorm deel van 'n groter BRICS-navorsingsprojek. Die BRICS-lidlande is as deelnemende lande vir die studie gekies aangesien al vyf lidlande betrokke is by die identifisering van hul behoeftes en die vestiging van aksieplanne om uiteindelik in die onderwysbehoeftes van die teikengroep te voorsien.

An education system is a framework that meets the educational needs of a particular target group. Education systems consist of different components and elements to provide effective education to the target group with specific educational needs. These components include the education system policy, education system administration, education structure and support services. For the effective functioning of an education system, it is necessary that all components collaborate. New challenges are constantly being posed to education systems, and changes in technology, the community, the target group and the curriculum are constantly occurring. To ensure effective teaching in the education situation, education depends on additional help from service providers which do not form part of the education system. These support services (additional assistance) are essential for the effective functioning of education and contribute to the effectiveness of teaching. The need for specific types of educational support services differs with respect to different education systems, as the needs of particular target groups may differ from one another. This study investigates educational support services for learners as an element of the education system in the ERICS member countries and identifies the best practices in the educational support services of these countries. The aim of the study derives from the fact that there have been concerns among various education authorities regarding support services that do not function optimally and do not meet the educational needs of teachers and learners, as well as teaching activities and structures. There is a lack of research on specifically the nature of the component "support services to learners in the ERICS countries". Therefore, the problem was addressed by using a comparative view of the education component of support services to learners in the ERICS countries in order to identify challenges and best practices and make recommendations to improve these support services to learners. The research was conducted using a qualitative research approach within the framework of the interpretivist research paradigm by using a document analysis as the method of data generation. Various types of documents were used, which had mainly been found through the use of the search engines Google Scholar and SAePublications, as well as books and academic journals. After careful study of the documents, all data relevant to the study were screened and categorised so that themes could be identified. The following themes were identified: inclusive education; assistance to learners employing the aid of medical and dental services; social services; and nutrition services. The ERICS member countries were selected as participating countries for the study, as all five member countries are involved in identifying their needs and establishing action plans to ultimately meet the educational needs of the target group.

Resumen Objetivo: el asesoramiento dietético proporcionado a través de un programa de intervención nutricional (PIN) es recomendado por las guías clínicas renales para prevenir o tratar la desnutrición, puediendo mejorar la calidad de vida (CV) y la supervivencia en pacientes en hemodiálisis (HD). El objetivo de este estudio fue evaluar el efecto de un PNI personalizado sobre el estado nutricional y su impacto en la calidad de vida y la mortalidad en pacientes dializados. Material y métodos: estudio de intervención de 12 meses de duración, con seguimiento periódico de los pacientes en el que se midieron los parámetros nutricionales al inicio, a los 6 y 12 meses. La CV fue evaluada por el cuestionario Kidney Disease Quality of Life versión 1.2 (KDQOL-SF) al inicio y al final del estudio. Todos los pacientes dializados recibieron consultas individualizadas con un dietista. El contenido del programa de educación nutricional incluyó un plan de alimentación personalizado y materiales educativos sobre nutrición para el manejo de fluidos, electrolitos y vitamina D. Resultados: se incluyeron un total de 75 pacientes. Después del PIN, los niveles de proteínas viscerales, fósforo, potasio y vitamina D habían mejorado significativamente (p < 0,001). El porcentaje de pacientes bien nutridos aumentó un 30 % (p < 0,001). Al final del estudio, los pacientes bien nutridos mejoraron significativamente las puntuaciones en las áreas de resumen general del KDQOL-SF, redujeron la preocupación por las restricciones dietéticas y de líquidos (p < 0,001) y la tasa de supervivencia fue de 12 meses superior (p < 0,01). Conclusión: los resultados de este estudio sugieren que el PIN personalizado contribuyó a mejorar el estado nutricional, la calidad de vida y la supervivencia en pacientes en HD.

Abstract Objective: dietary advice provided through a nutritional intervention program (NIP) is recommended by renal clinic guidelines to prevent or treat malnutrition, that could improve quality of life (QoL) and survival in hemodialysis (HD) patients. This study set out to evaluate the effect of a personalized NIP on the nutritional status and its impact on QoL and mortality in dialyzed patients. Material and methods: this was a 12-month intervention study with regular follow-up in which nutritional parameters were measured at baseline and after 6 and 12 months. QoL was assessed by the Kidney Disease Quality of Life version 1.2 (KDQOL-SF) at baseline and at the end of the study. All dialyzed patients received individualized consultations with a trained dietitian. The content of the nutritional education program included a personalized meal plan and educational materials addressing nutrition to manage fluids, electrolytes, and vitamin D. Results: a total of 75 patients were included. After the NIP, visceral proteins, phosphorous, potassium and vitamin D levels had improved significantly (p < 0.001). The percentage of well-nourished patients increased by 30 % (p < 0.001). At the end of the study, the well-nourished patients had significantly improved scores on the general summary areas of the KDQOL-SF, reduced worry concerning fluid and dietary restrictions (p < 0.001), and the survival rate was 12 months longer (p < 0.01). Conclusion: the results of this study suggest that personalized NIP contributed to improved nutritional status, QoL and survival in HD patients.

Abstract In the realm of health sciences, various educational strategies exist to foster an interest in scientific research, aiming to acquaint students with processes involving evidence-based decision-making. This study compiles initiatives implemented in health science programs to promote and develop research competencies (RC) among undergraduate students. Scopus, Web of Science, MEDLINE (via PubMed), and SciELO databases were used for the search. The focus was on identifying educational interventions that assessed/measured research competencies. Original articles implemented in programs such as Human Medicine, Dentistry, Pharmacy and Biochemistry, Obstetrics, Nursing, Medical Technology, and Nutrition were included. Numerous initiatives were found under designations like “research project,”“research program,”“research mentorship,”“reading clubs,” etc. Although these terms appeared under various designations, some are more common in Spanish (such as research groups and Student Scientific Societies), while others are used not only for developing research competencies but also for fostering transversal and communication skills (like poster presentations). In health science programs, multiple curricular initiatives have focused on developing research competencies. Implementing a range of initiatives in a curriculum is advisable to offer diverse learning experiences.

Resumen En las ciencias de la salud existen múltiples estrategias educativas para fomentar el interés por la investigación científica; esto con la finalidad de familiarizar al estudiante con los procesos que involucran la toma de decisiones basada en evidencia. Se recopilaron las iniciativas que se han implementado en los programas de las ciencias de la salud que tienen la finalidad de fomentar y desarrollar competencias investigativas (CI) en estudiantes de pregrado. Se utilizaron las bases de datos Scopus, Web of Science, MEDLINE (vía PubMed) y SciELO. La búsqueda se orientó en identificar intervenciones educativas que valoraron/midieron las competencias investigativas. Se incluyeron artículos originales implementados en los programas de Medicina Humana, Odontología, Farmacia y Bioquímica, Obstetricia, Enfermería, Tecnología Médica y Nutrición. Se encontraron múltiples iniciativas con las denominaciones de: “proyecto de investigación”, “programa de investigación”, “mentoría en investigación”, “clubes de lectura”, etc. Aunque estos términos se hallaron bajo diferentes denominaciones, algunos de ellos son más frecuentes en el español (tales como los semilleros de investigación y las Sociedades Científicas Estudiantiles) y otros no solo se aplican para la formación de competencias investigativas, sino también para la formación de competencias transversales y comunicativas (como la presentación de pósteres). En los programas de las ciencias de la salud existen múltiples iniciativas curriculares que se han centrado en la formación de competencias investigativas. La implementación de múltiples iniciativas en un plan de estudios es recomendable para otorgar variadas formas de experiencias de aprendizaje.