Abstract Background: The Trans-Mexican Volcanic Belt (TMVB) in central Mexico is characterized by peaks of high altitude and geologic instability. In this zone, Pinus strobiformis and Pinus ayacahuite form a contact zone with Pinus veitchii. The taxonomical circumscription of white pines in Central Mexico has been unstable, especially regarding the status of P. veitchii. Questions: What are the species boundaries of the montane Mexican white pines species complex? Is Pinus veitchii a hybrid or an independently evolving lineage? Studied species: Pinus strobiformis, Pinus veitchii and Pinus ayacahuite species complex. Study site and dates: United States of America and Mexico from 2003 to 2022. Methods: We performed multivariate analyses on 10 morphological characters and characterized the climatic niche divergence and the genetic differentiation using SNPs. Results: Our results showed that P. veitchii is morphologically similar to P. strobiformis, but does not have intermediate morphological values with P. ayacahuite. The ecological niche differentiation was not significant. Genetic analyses showed P. veitchii as an independent lineage with evidence of admixture with P. ayacahuite, suggesting a gene flow but not a hybrid origin. Conclusions: Two of the three lines of evidence support three independent lineages. Environmental information showed niche conservatism, morphology and genetic structure showed differentiation of all three taxa, with a greater morphological similarity between P. strobiformis and P. veitchii, and genetic analyses recovered evidence of introgression, suggesting a complex demographic history in the Trans Mexican Volcanic Belt.

Resumen: Antecedentes: La Faja Volcánica Trans Mexicana (TMVB) se caracteriza por picos de gran altitud e inestabilidad geológica. En esta zona, Pinus strobiformis y Pinus ayacahuite forman una zona de contacto con Pinus veitchii. La circunscripción taxonómica de los pinos blancos en el Centro de México ha sido inestable, especialmente en lo que respecta a P. veitchii. Preguntas: ¿Cuáles son los límites de especies del complejo de pinos blancos mexicanos? ¿Es Pinus veitchii un híbrido o un linaje independiente? Especies estudiadas: Complejo de especies Pinus strobiformis, Pinus veitchii y Pinus ayacahuite. Lugar y fechas del estudio: Estados Unidos de América y México de 2003 a 2022. Métodos: Realizamos análisis multivariados de 10 caracteres morfológicos y caracterizamos la divergencia de nichos climáticos y la diferenciación genética utilizando SNPs. Resultados: Nuestros resultados mostraron que P. veitchii es morfológicamente similar a P. strobiformis, pero no parece tener valores morfológicos intermedios con P. ayacahuite. La diferenciación de nichos ecológicos entre especies no fue significativa. Los análisis genéticos mostraron a P. veitchii como un linaje independiente con evidencia de introgresión con P. ayacahuite, lo que sugiere flujo génico pero no origen híbrido. Conclusiones: Dos de las tres líneas de evidencia respaldan tres linajes independientes. La información ambiental mostró conservadurismo de nicho, la morfología y la estructura genética mostraron diferenciación de los tres taxones, y los análisis genéticos recuperaron cierta mezcla entre las poblaciones de P. veitchii y P. ayacahuite, lo que sugiere una compleja historia demográfica en la Faja Volcánica Trans Mexicana.

Resumen: Las asociaciones docentes han sido un agente clave en los procesos de reforma escolar. Esta investigación se ha enfocado en comprender su papel en los procesos de negociación macrosocial con el Estado, aun cuando las reivindicaciones docentes ocurren también en el espacio escolar y en el terreno de las relaciones micropolíticas. Desde un estudio cualitativo con características narrativas de 30 entrevistas a docentes chilenas(os), se buscó describir y comprender el papel de las organizaciones y el profesorado organizado en el contexto escolar. Los resultados muestran que este profesorado ocupa un lugar de reconocimiento en la trama micropolítica escolar, que se erige para negociar el poder con los cuerpos directivos y defender a los pares de las regulaciones del Estado. Se discuten las implicancias de la asociación docente en otro nivel de las luchas del profesorado.

Abstract: Teachers’ associations have been a key agent in school reform processes. This research has focused on understanding their role in macro-social negotiation processes with the State, even though teachers’ demands also occur within the school sphere and in the field of micro-political relations. Based on a qualitative study with narrative characteristics of 30 interviews with Chilean teachers, we aimed to describe and understand the role of organizations and organized teachers within the school context. The results show that organized teachers are recognized within the school micro-political framework, and that they are involved in negotiating power with the governing bodies and defending their peers from State regulations. The implications of teachers' associationism at another level of teachers' political struggles are discussed.

Abstract Neuromyelitis optica (NMO), myasthenia gravis (MG), and ulcerative colitis (UC) are disorders in which various autoimmune pathophysiological mechanisms are involved, some of them being shared. According to the literature, these diseases are associated with other autoimmune disorders. However, there are no published cases about the coexistence of these three entities as a continuum of autoimmune manifestations. Here, we present the case of a patient who presented UC posteriorly, MG treated with thymectomy, and finally, met the criteria for NMO, treated with rituximab.

Abstract Introduction: Guillain-Barré syndrome (GBS) is the most frequent cause of acute flaccid paralysis. However, few studies have investigated short-term prognostic factors. Objectives: The objectives of the study were to describe the clinical characteristics of a sample of GBS patients treated at the General Hospital of Mexico and to identify the prognostic factors at discharge. Methods: A descriptive and analytical cohort study, including patients with GBS, was conducted from April 2020 to May 2022. Demographic information, comorbidities, clinical variants, neurophysiological alterations, modified Erasmus GBS Outcome Score (mEGOS) and Erasmus GBS Respiratory Insufficiency Score scales, etc., were collected. Functional recovery at discharge was measured with Hughes scales and Medical Research Council (MRC). A case-control analysis was performed among patients with good and poor functional recovery on discharge based on the Hughes scale. Results: Total sample was 69 patients: 74% men and 26% women, mean age: 43.7 ± 16.3 years; 38 (55%) patients presented classic variant, 22 pure motor variant (31%). Evolution time: 6.8 ± 6.7 days. Most common Hughes score at admission was 4 points (n = 54, 78%). 87% (n = 60) received plasmapheresis. 23 (33.3%) presented an axonal pattern and 46 (66.6%) demyelinating. On discharge, 31 patients had Hughes 3 or less (ambulatory) and 27 Hughes 4 or greater (non-ambulatory). When performing factor analysis, it was found that mEGOS, MRC, total lymphocytes, and creatine phosphokinase (CPK) were associated with the prognosis at discharge. Conclusions: The most frequent clinical variant was the classic (sensitive-motor) with demyelinating alteration; the factors related to better recovery at discharge were mEGOS, MRC on admission, total lymphocyte count, and serum CPK levels.

RESUMEN Introducción: La rápida transmisión y los síntomas graves asociados con la infección aguda por el virus de la chikungunya (CHIKV) en niños lo convierten en un problema de salud altamente preocupante. Objetivo: Este estudio tuvo como objetivo describir las características de la infección aguda por el virus de la chikungunya en niños del Departamento de Caaguazú, Paraguay. Materiales y métodos: Un estudio retrospectivo fue realizado en el Departamento de Caaguazú, Paraguay, en 2023, con todos los pacientes que acudieron al Hospital Regional dentro de los 5 días posteriores al desarrollo de síntomas característicos de la infección aguda por CHIKV y que dieron positivo para el virus mediante RT-PCR. Pacientes con infecciones por Dengue o Zika fueron excluidos. Se recogieron datos sobre las características clínicas mediante un formulario normalizado de registro de casos y se creó un conjunto de datos electrónicos para su análisis. Resultados: Se incluyeron en el estudio un total de 461 niños. 51,6% eran mujeres. Los casos se dividieron en grupos según la edad pediátrica: lactantes (0-23 meses, n=88, 19,1 %), preescolares (2-5 años, n=115, 24,9%), escolares (6-11 años, n=163, 35.4%), and adolescentes (12-17 años and 11 meses, n=95, 20.6 %). La mialgia (64,6%) y la artralgia (63.7%) fueron más prevalentes en escolares y adolescentes. El vómito (89%), la cefalea (89,4%) y el dolor retroorbitario (95%) fueron más comunes en preescolares, escolares y adolescentes, mientras que la erupción cutánea (39,5%) y las petequias (18,5%) fueron más prevalentes en lactantes. Cuatro niños fallecieron durante el período de estudio. Conclusión: La epidemia de virus de la CHIKV de 2023 en Paraguay tuvo diferentes presentaciones clínicas dependiendo de la edad de los niños afectados, con resultados fatales ocurriendo en un pequeño porcentaje de casos.

ABSTRACT Introduction: The rapid transmission and severe symptoms associated with acute chikungunya virus (CHIKV) infection in children make it a highly concerning health issue. Objective: This study aimed to describe the characteristics of acute chikungunya virus infection in children from the Department of Caaguazú, Paraguay. Material and Methods: A retrospective observational study was conducted in the Department of Caaguazú, Paraguay, in 2023, with all patients who came to the Regional Hospital within 5 days of developing characteristic symptoms of acute CHIKV infection and tested positive for the virus by RT-PCR. Patients with Dengue or Zika infections were excluded. We collected data on clinical characteristics using a standardized case record form and created an electronic dataset for analysis. Results: A total of 461 children were included in the study. 51.6% were women. Cases were divided into groups based on pediatric age: infants (0-23 months, n=88, 19.1%), preschoolers (2-5 years, n=115, 24.9%), schoolchildren (6-11 years, n=163, 35.4%), and adolescents (12-17 years and 11 months, n=95, 20.6%). Schoolchildren and adolescents experienced a higher prevalence of myalgia (64.6%) and arthralgia (63.7%). Vomiting (89%), headache (89.4%), and retro-orbital pain (95%) were more common in preschoolers, schoolchildren, and adolescents, while rash (39.5%) and petechiae (18.5%) were more prevalent in infants. Four children died during the study period. Conclusion: The 2023 CHIKV virus epidemic in Paraguay had different clinical presentations depending on the age of the affected children, with fatal outcomes occurring in a small percentage of cases.

RESUMEN Introducción: Dentro de las actividades del semillero de Seguridad y Salud en el Trabajo Informal (SST-IN) durante el año 2022 en la ciudad de Bogotá se trabajó sobre una iniciativa de investigación inspirada en las experiencias del semillero en su búsqueda de entendimiento de factores que contribuyan al trabajo digno en el contexto de informalidad laboral. Objetivo: Determinar las condiciones de trabajo de una muestra de bicidomiciliarios que trabajan con plataformas digitales de la ciudad de Bogotá, en el año 2022. Métodos: En esta investigación se utilizó la metodología de estudio de caso obteniendo datos con diversos instrumentos como entrevistas, observaciones, revisión de la literatura, enfocado en factores de riesgo, peligros, enfermedades y accidentes o incidentes a los que se exponen los trabajadores, se evaluaron los resultados de las condiciones subestándar que se han presentado en los bicidomiciliarios, con base en la matriz descrita por la Guía Técnica Colombiana GTC45, con alcance y propuestas de mejora a corto plazo para este grupo de trabajadores informales. Resultados: Se identificaron en los trabajadores de plataformas digitales diferentes riesgos a los cuales están expuestos durante su jornada laboral basadas en la GTC45 y a las condiciones que se enfrentan día a día, además de describir variables sociodemográficas y aspectos de percepción del riesgo. Conclusión: Los aspectos insatisfactorios se refirieron a los medios y condiciones de trabajo como el clima, el uso inadecuado de los elementos de protección personal y la falta de capacitación.

ABSTRACT Introduction: Among the activities of the Safety and Health in Informal Work (SST-IN) seedbed during the year 2022 in the city of Bogota, a research initiative inspired by the experiences of the seedbed in its search for understanding factors that contribute to decent work in the context of labor informality was worked on. Objective: To determine the working conditions of a sample of bicycle workers who work with digital platforms in the city of Bogota, in the year 2022. Methods: In this research, the case study methodology was used, obtaining data with various instruments such as interviews, observations, literature review, focused on risk factors, hazards, diseases and accidents or incidents to which workers are exposed, evaluating results of sub-standard conditions that have occurred to the delivery bike workers, based on the matrix described by the Colombian Technical Guide GTC45, with scope and proposals for improvement in the short term for this group of informal workers. Results: Different risks to which digital platform workers are exposed to during their workday were identified based on the GTC45, and the conditions they face on a daily basis; in addition, sociodemographic variables and aspects of perception were described. Conclusion: The unsatisfactory aspects referred to work environments and conditions such as climate, inadequate use of personal protection elements and lack of training.

ABSTRACT The evolution of the training of communicators in Latin America, influenced by changing curricular models, raises questions about the relevance of social innovation. This article addresses these concerns by sharing the experience of the Seminar on Communication and Innovation Processes in the Bachelor's Degree in Social Communication at the National University of Cordoba, developed between 2021 and 2023. Preliminary results of a qualitative exploratory study are presented. This study took into account the three cohorts of the Seminar in order to analyse the pedagogical-didactic strategies implemented. In conclusion, the seminar approaches the teaching of innovation from three dimensions (theoretical frameworks, relationship with communication studies and teaching praxis), promoting a comprehensive and critical training with the purpose of opening new perspectives to response to social problems.

RESUMEN La evolución de la formación de comunicadores en América Latina, influenciada por modelos curriculares cambiantes, plantea cuestionamientos sobre la relevancia de la innovación social. Este artículo aborda estas inquietudes a través de la presentación de la experiencia del Seminario de Comunicación y Procesos de Innovación en la Licenciatura de Comunicación Social de la Universidad Nacional de Córdoba, desarrollado de 2021 a 2023. Se presentan los resultados preliminares de un estudio exploratorio cualitativo que ha tomado en cuenta las tres cohortes del seminario para analizar las estrategias pedagógico-didácticas implementadas. En conclusión, el seminario enfoca la enseñanza de la innovación desde tres dimensiones (marcos teóricos, relación con estudios de comunicación y praxis docente), fomentando una formación integral y crítica, con el propósito de abrir nuevas perspectivas en la resolución de problemáticas sociales.

Abstract: Introduction: Transfusion leads to complications and mortality in cardiac surgery, with an incidence of 40-90%. There are scales that predict transfusion risk, however, they differ in the number and type of variables; furthermore, few have been compared in Mexican population. Objective: To evaluate the Transfusion Risk Understanding Scoring Tool (TRUST) and Transfusion Risk and Clinical Knowledge (TRACK) scales for risk of transfusion in cardiovascular surgery in the Mexican population. Material and methods: Observational, retrospective, comparative study. It included 300 patients older than 18 years who underwent elective cardiovascular surgery. The area under the curve (AUC) of the TRACK and TRUST scores and their relationship with the transfusion variable were evaluated using the ROC curve. The inferential statistics implemented were Student’s t and χ2. Results: There were 83 women (27.7%) and 217 men (72.3%). 227 Patients (75.7%) were transfused; the majority with hematocrit > 35% (82.2%). Sensitivity, specificity, and AUC to identify high and very high risk patients of the TRACK scale were: 76%, 50% and 0.702, respectively; for the TRUST scale were: 68%, 57% and 0.69, respectively. Conclusions: The TRACK and TRUST scales are useful for transfusion risk stratification in elective cardiac surgery in our population.

Resumen: Introducción: La transfusión conlleva complicaciones y mortalidad en cirugía cardíaca, con incidencia de 40-90%. Existen escalas que predicen riesgo transfusional; sin embargo, difieren en el número y tipo de variables; además, pocas han sido comparadas en la población mexicana. Objetivo: Evaluar las escalas Transfusion Risk Understanding Scoring Tool (TRUST) y Transfusion Risk and Clinical Knowledge (TRACK) para riesgo de transfusión en cirugía cardiovascular en población mexicana. Material y métodos: Estudio observacional, retrospectivo, comparativo. Incluyó 300 pacientes sometidos a cirugía cardiovascular electiva mayores de 18 años. Se evaluó mediante curva ROC el área bajo la curva (AUC) de los puntajes TRACK y TRUST y su relación con la variable hemotransfusión. La estadística inferencial fue mediante t de Student y χ2. Resultados: Fueron 83 mujeres (27.7%) y 217 hombres (72.3%). Se transfundieron 227 pacientes (75.7%); la mayoría con hematocrito > 35% (82.2%). La sensibilidad, especificidad y AUC para identificar pacientes de riesgo alto y muy alto de la escala TRACK fueron: 76%, 50% y 0.702, respectivamente; para la escala TRUST fueron: 68%, 57% y 0.69, respectivamente. Conclusiones: Las escalas TRACK y TRUST son útiles para la estratificación de riesgo de transfusión en cirugía cardíaca electiva en nuestra población.

ABSTRACT Purpose To develop an assessment protocol for speech motor planning with phonologically balanced stimuli for Brazilian Portuguese, including all necessary variables for this diagnosis. Methods Three stages were carried out: In the first, word lists were built with the main criterion being syllabic and accentual patterns. From the survey conducted in Stage 1, the words that composed the first version of the protocol lists in Stage 2 were selected, and grouped into two fundamental tasks for diagnosing acquired apraxia of speech (AOS): repetition and Reading Aloud (RA). In Stage 3, the occurrence of words was investigated using the Brazilian Corpus (PUC-SP) - Linguateca database, and a statistical analysis was performed to verify if the repetition and RA lists were balanced in terms of the occurrences. Thus, the lists were distributed in quartiles and submitted to both descriptive and bivariate analyses. A significance level of 5% (p<0.05) was adopted. Results After completion of all stages, the words that composed the lists of the repetition and RA tasks were obtained. Finally, other tasks considered essential for the assessment of AOS, such as diadochokinetic rates and the board for spontaneous oral emission, were then added to the protocol. Conclusion The developed protocol contains the tasks considered standard for the assessment of AOS according to the international literature, which makes this instrument important for diagnosing this disorder in speakers of Brazilian Portuguese. Portuguese diagnosis out patterns 1 selected (AOS) RA. . (RA) 3 PUCSP PUC SP (PUC-SP database occurrences Thus analyses 5 p<0.05 p005 p 0 05 (p<0.05 adopted obtained Finally emission literature (AOS (RA p<0.0 p00 (p<0.0 p<0. p0 (p<0. p<0 (p<0 p< (p< (p

RESUMO Objetivo Elaborar um protocolo de avaliação do planejamento motor da fala com estímulos fonologicamente balanceados para o português brasileiro e que contemple todas as variáveis necessárias para este diagnóstico. Método Foram realizadas três etapas: Na primeira, construíram-se listas de palavras cujo critério principal foram os padrões silábicos e acentuais. Do levantamento realizado na Etapa 1, procedeu-se à seleção dos vocábulos que compuseram a primeira versão do protocolo na Etapa 2, reunidas em duas tarefas: de repetição e de Leitura em Voz Alta (LVA). Em seguida, investigou-se a ocorrência das palavras usando a base de dados do Corpus Brasileiro (PUC-SP) - Linguateca. Na etapa 3 realizou-se a análise estatística para verificar se as listas de repetição e de LVA estavam equilibradas quanto à ocorrência das palavras. Assim, as listas foram distribuídas em quartis e foram analisadas de forma descritiva e bivariada. O nível de significância utilizado foi de 5%. Resultados Após a realização de todas as etapas, foi possível obter as palavras que compuseram as listas das tarefas de repetição e de LVA. Finalmente, foram então acrescidas ao protocolo as demais tarefas consideradas essenciais para a avaliação da apraxia como as taxas diadococinéticas e a prancha para a emissão oral espontânea. Conclusão O protocolo desenvolvido contém as tarefas consideradas padrão para a avaliação da apraxia de fala pela literatura internacional, o que torna esse instrumento importante para o diagnóstico desse distúrbio em falantes do português brasileiro. etapas construíramse construíram acentuais 1 procedeuse procedeu 2 . (LVA) seguida investigouse investigou PUCSP PUC SP (PUC-SP Linguateca realizouse realizou Assim bivariada 5 5% Finalmente espontânea internacional (LVA

RESUMEN Los desafíos socioambientales contemporáneos se caracterizan por su elevada complejidad, lo que resulta en una creciente vulnerabilidad socioecológica. Por ello, para comprender estos problemas es necesario analizar los múltiples factores que influyen en su origen y desarrollo. Presentamos, a partir de una revisión de fuentes secundarias, un primer análisis de la avalancha de lodo, residuos y materia orgánica que ocurrió en junio de 2019 en la cabecera del municipio de San Gabriel, en el estado de Jalisco, México. Si bien este desastre ambiental se ha atribuido principalmente a la expansión del cultivo de aguacate, se argumenta que otros factores, incluida la urbanización espontánea, también desempeñan un papel significativo. A través de este análisis, se explora la complejidad socioambiental subyacente que contribuyó a la vulnerabilidad socioecológica y, en última instancia, desencadenó la avalancha en San Gabriel. Se concluye con reflexiones generales, resaltando la importancia de abordar la gestión de políticas ambientales desde una perspectiva colaborativa que involucre a todos los sectores sociales.

ABSTRACT Contemporary socio-environmental challenges are characterized by their high complexity, resulting in increasing socio-ecological vulnerability. Therefore, in order to understand these problems, it is necessary to analyse the multiple factors that influence their origin and development. We present, from a review of secondary sources, a first analysis of the landslide of mud, debris and organic matter that occurred in June 2019 in the head of the municipality of San Gabriel, in the state of Jalisco, Mexico. While this environmental disaster has been attributed primarily to the expansion of avocado cultivation, it is argued that other factors, including spontaneous urbanization, also play a significant role. Through this analysis, the underlying socio-environmental complexity that contributed to the socioecological vulnerability and ultimately triggered the landslide in San Gabriel is explored. To conclude with general reflections, highlighting the importance of approaching environmental policy management from a collaborative perspective involving all social sectors.

Resumo Objetivo: Comparar uso e preenchimento da caderneta da criança entre mães beneficiárias ou não do Programa Bolsa Família. Métodos: Estudo transversal com mães de crianças menores de 6 anos em unidades de saúde de Salvador-BA, entre janeiro e fevereiro de 2023. A caderneta da criança foi avaliada quanto ao uso (ter a caderneta, estar com ela em mãos e tê-la lido) e preenchimento (curvas de crescimento, fichas de avaliação do desenvolvimento e completude vacinal). Utilizaram-se estatística descritiva e teste qui-quadrado, com nível de significância de 5%. Resultados: Das 411 participantes do estudo, 66% eram beneficiárias do programa. Houve diferença significativa entre os grupos quanto ao uso da caderneta: ter a caderneta (p < 0,001), estar com ela em mãos (p = 0,037) e tê-la lido (p < 0,001). Quanto ao preenchimento, houve diferença significativa apenas na completude vacinal (p = 0,005). Conclusão: Houve diferença significativa quanto ao uso e à completude vacinal, comparando-se mães beneficiárias e não beneficiárias do Programa Bolsa Família. Objetivo Família Métodos SalvadorBA, SalvadorBA Salvador BA, BA Salvador-BA 2023 têla tê la curvas crescimento vacinal. . vacinal) Utilizaramse Utilizaram se quiquadrado, quiquadrado qui quadrado, quadrado qui-quadrado 5 5% Resultados 41 estudo 66 programa p 0,001, 0001 0,001 , 0 001 0,001) 0,037 0037 037 0,001. 0,005. 0005 0,005 005 0,005) Conclusão comparandose comparando 202 4 000 0,00 00 0,03 003 03 20 0,0 2 0,

Resumen Objetivo: Comparar uso y registro del carné de control pediátrico (CCP) entre madres beneficiarias y no beneficiarias del Programa Bolsa Familia (PBF). Métodos: Estudio transversal entre enero y febrero del 2023 con madres de niños < 6años, en unidades de salud de Salvador-Bahía. Se evaluó CSN en términos de uso (tener el carné, tenerlo en mano y haberlo leído) y registro (curvas de crecimiento, formularios del desarrollo y vacunación). Se utilizó estadística descriptiva y prueba de chi-cuadrado. Resultados: De los 411 participantes, el 66% fueron del PBF. Hubo diferencia significativa entre los grupos respecto al uso del CCP: tenerlo (p < 0,001), concurrir con él (p = 0,037) haberlo leído (p < 0,001). Respecto al registro, hubo diferencia significativa sólo en vacunación (p = 0,005). Conclusión: Hubo diferencia significativa en el uso y cumplimiento de la vacunación, comparando madres beneficiarias y no beneficiarias del PBF. Objetivo CCP (CCP PBF . (PBF) Métodos 202 6años años SalvadorBahía. SalvadorBahía Salvador Bahía. Bahía Salvador-Bahía tener curvas crecimiento vacunación. vacunación) chicuadrado. chicuadrado chi cuadrado. cuadrado chi-cuadrado Resultados 41 participantes 66 p 0,001, 0001 0,001 , 0 001 0,001) 0,037 0037 037 0,001. 0,005. 0005 0,005 005 0,005) Conclusión (PBF 20 4 6 000 0,00 00 0,03 003 03 2 0,0 0,

Abstract Objective: To compare child health booklet (CHB) use and filling out among mothers who were or were not Bolsa Família Program (BFP) beneficiaries. Methods: Cross-sectional study with mothers of children <6years attending health centers in Salvador, Bahia, Brazil, between January-February/2023. The CHB was evaluated regarding its use (having a CHB, having it in hand, and having read it) and filling out (growth curves, development monitoring forms, and vaccination completeness). Descriptive statistics and the chi-square test were used. Results: Of the 411 study participants, 66% were BFP beneficiaries. Significant differences were found between the groups regarding CHB use: having a CHB (p < 0.001), having it in hand (p = 0.037), and having read it (p < 0.001). Significant difference in vaccination completeness was found (p = 0.005). Conclusion: There was a significant difference in CHB use and vaccination completeness when comparing mothers who were BFP beneficiaries and those who were not. Objective (CHB (BFP Methods Crosssectional Cross sectional 6years years Salvador Bahia Brazil JanuaryFebruary/2023. JanuaryFebruary2023 JanuaryFebruary January February/2023. February 2023 January-February/2023 growth curves forms completeness. . completeness) chisquare chi square used Results 41 participants 66 p 0.001, 0001 0.001 , 0 001 0.001) 0.037, 0037 0.037 037 0.037) 0.001. 0.005. 0005 0.005 005 0.005) Conclusion JanuaryFebruary/2023 JanuaryFebruary202 February2023 February/2023 202 January-February/202 4 6 000 0.00 00 003 0.03 03 JanuaryFebruary/202 JanuaryFebruary20 February202 February/202 20 January-February/20 0.0 JanuaryFebruary/20 JanuaryFebruary2 February20 February/20 2 January-February/2 0. JanuaryFebruary/2 February2 February/2 January-February/ JanuaryFebruary/ February/ January-February

ABSTRACT Introduction. Chikungunya virus (CHIKV) infection typically presents as an acute febrile illness that is self-limiting and predominantly characterized by severe polyarthralgia and myalgia. Objective. The purpose of this study was to describe the clinical characteristics of acute chikungunya virus infection in an adult population. Materials and Methods. This was a descriptive, cross-sectional, observational study. The study population included adults from a specific region of Paraguay during the CHIKV epidemic in 2022-2023. Inclusion criteria encompassed all patients who presented to the hospital within five days after developing typical symptoms of acute CHIKV infection, confirmed by RT-PCR, and after excluding the presence of dengue and Zika. Results. A total of 803 adults were included, with an average age of 45.13 ± 18.63 years and a male/female ratio of 1:1.79. At epidemiological weeks 8, 10, 11, 78, 120, and 132 cases were documented, respectively. The most common clinical manifestations were fever in 97% of the cases (n=583), arthralgia and arthritis in 86.03% (n=653), myalgias in 77.08% (n=585), and headache in 73.91% (n=561). There were 6 deaths (0.75% of the total cases). Conclusion. The clinical presentation of CHIKV during the 2023 epidemic in Paraguay is consistent with previous descriptions in other regions. The disease generated a significant number of medical consultations and led to saturation of the public health system, which was fatal in a small percentage of cases.

RESUMEN Introducción. La infección por el virus del Chikunguña (CHIKV) se presenta típicamente como una enfermedad febril aguda que es autolimitada y se caracteriza predominantemente por poliartralgia y mialgias graves. Objetivo. el propósito de este estudio fue describir las características clínicas de la infección aguda por el virus del Chikunguña en una población adulta. Materiales y Método. Este fue un estudio observacional, descriptivo y transversal. La población de estudio incluyó adultos de una región específica de Paraguay durante la epidemia de CHIKV en 2022-2023. Los criterios de inclusión abarcaron a todos los pacientes que se presentaron el Hospital Regional dentro de los cinco días posteriores al desarrollo de síntomas típicos de CHIKV, confirmados por RT-PCR, y tras excluir dengue y Zika. Resultados. Se incluyeron un total de 803 adultos, con una edad media de 45,13 ± 18.63 años y una proporción de género masculino/femenino de 1:1.79. En las semanas epidemiológicas 8, 10 y 11 se documentaron 78, 120 y 132 casos, respectivamente. Las manifestaciones clínicas más comunes fueron fiebre en el 97% de los casos (n=583), artralgia y artritis en el 86,03% (n=653), mialgias en el 77,08% (n=585) y cefalea en el 73,91% (n=561). Hubo 6 muertes (0,75% del total de casos). Conclusión. La presentación clínica de CHIKV durante la epidemia 2023 en Paraguay es consistente con descripciones previas en otras regiones. La enfermedad generó un número significativo de consultas médicas y llevó a la saturación del sistema de salud pública, siendo fatal en un pequeño porcentaje de casos.

Resumo Objetivo: Comparar uso e preenchimento da caderneta da criança entre mães beneficiárias ou não do Programa Bolsa Família. Métodos: Estudo transversal com mães de crianças menores de 6 anos em unidades de saúde de Salvador-BA, entre janeiro e fevereiro de 2023. A caderneta da criança foi avaliada quanto ao uso (ter a caderneta, estar com ela em mãos e tê-la lido) e preenchimento (curvas de crescimento, fichas de avaliação do desenvolvimento e completude vacinal). Utilizaram-se estatística descritiva e teste qui-quadrado, com nível de significância de 5%. Resultados: Das 411 participantes do estudo, 66% eram beneficiárias do programa. Houve diferença significativa entre os grupos quanto ao uso da caderneta: ter a caderneta (p < 0,001), estar com ela em mãos (p = 0,037) e tê-la lido (p < 0,001). Quanto ao preenchimento, houve diferença significativa apenas na completude vacinal (p = 0,005). Conclusão: Houve diferença significativa quanto ao uso e à completude vacinal, comparando-se mães beneficiárias e não beneficiárias do Programa Bolsa Família.

Abstract Objective: To compare child health booklet (CHB) use and filling out among mothers who were or were not Bolsa Família Program (BFP) beneficiaries. Methods: Cross-sectional study with mothers of children <6years attending health centers in Salvador, Bahia, Brazil, between January-February/2023. The CHB was evaluated regarding its use (having a CHB, having it in hand, and having read it) and filling out (growth curves, development monitoring forms, and vaccination completeness). Descriptive statistics and the chi-square test were used. Results: Of the 411 study participants, 66% were BFP beneficiaries. Significant differences were found between the groups regarding CHB use: having a CHB (p < 0.001), having it in hand (p = 0.037), and having read it (p < 0.001). Significant difference in vaccination completeness was found (p = 0.005). Conclusion: There was a significant difference in CHB use and vaccination completeness when comparing mothers who were BFP beneficiaries and those who were not.

Resumen Objetivo: Comparar uso y registro del carné de control pediátrico (CCP) entre madres beneficiarias y no beneficiarias del Programa Bolsa Familia (PBF). Métodos: Estudio transversal entre enero y febrero del 2023 con madres de niños < 6años, en unidades de salud de Salvador-Bahía. Se evaluó CSN en términos de uso (tener el carné, tenerlo en mano y haberlo leído) y registro (curvas de crecimiento, formularios del desarrollo y vacunación). Se utilizó estadística descriptiva y prueba de chi-cuadrado. Resultados: De los 411 participantes, el 66% fueron del PBF. Hubo diferencia significativa entre los grupos respecto al uso del CCP: tenerlo (p < 0,001), concurrir con él (p = 0,037) haberlo leído (p < 0,001). Respecto al registro, hubo diferencia significativa sólo en vacunación (p = 0,005). Conclusión: Hubo diferencia significativa en el uso y cumplimiento de la vacunación, comparando madres beneficiarias y no beneficiarias del PBF.

Abstract Objective: To evaluate the impact of an individualized educational intervention on knowledge, self-care of the feet, glycemic control, risk of ulceration and incidence of ulcers in patients with type 2 diabetes. Material and Methods: The intervention study, was carried out on 65 outpatients, over 35 years of age, with type 2 diabetes, patients were randomly distributed into two groups: the control group (35), who received a manual on foot care, and the intervention group (30), who received the intervention, a foot care kit, and manual. Follow-up was done at three and six months after the intervention. Statistical analysis included the Chi-square test, Wilcoxon test and the ANOVA test of repeated measures. Results: The intervention improved knowledge and foot self-care in the intervention group with significant differences between groups (p=.001), but not the glycemic control or the ulceration risk. Conclusions: The program "Your Feet Call You" was partially effective, and this study can be ordinarily replicated in first-level institutions to improve self-care and prevent foot ulceration in the medium term.

Resumen Objetivo: Evaluar el impacto de una intervención educativa individualizada en los conocimientos, autocuidado de los pies, control glucémico, riesgo de ulceración e incidencia de úlceras en pacientes con diabetes tipo 2. Material y Métodos: Estudio de intervención realizado en 65 pacientes ambulatorios, mayores de 35 años, con diabetes tipo 2, distribuidos aleatoriamente en dos grupos: grupo control (35) quien recibió un manual de cuidado de los pies, y grupo intervención (30) quien recibió la intervención, un kit de cuidado de los pies y un manual. El seguimiento se realizó a los tres y seis meses después de la intervención. El análisis estadístico incluyó la prueba de Chi-cuadrado, prueba de Wilcoxon y prueba ANOVA de mediciones repetidas. Resultados: La intervención mejoró los conocimientos y el autocuidado de pies en el grupo de intervención, con diferencias significativas entre grupos (p=.001), pero no mejoró el control glucémico ni el riesgo de ulceración. Conclusiones: El programa “tus pies te llaman” fue efectivo parcialmente, este estudio puede ser replicado en instituciones de primer nivel de forma ordinaria para mejorar el autocuidado y prevenir la ulceración del pie a mediano plazo.