RESUMEN La bacteriemia por Staphylococcus aureus se define como el aislamiento de dicho germen en al menos un cultivo de sangre. Las metástasis infecciosas se originan por diseminación hematógena y su posterior localización en un sitio distinto al órgano en donde se originó el proceso infeccioso. La prevalencia en la presentación de estos focos infecciosos secundarios es baja en la edad pediátrica, por lo que representa un desafío diagnóstico. Se presenta el caso de un paciente pediátrico con una celulitis facial por Staphylococcus aureus, con metástasis infecciosas y evolución tórpida.

Resumen: Introducción: El fentanilo ofrece buena eficacia anestésica, con menores efectos sobre el sistema nervioso simpático, al mantener un mejor estado hemodinámico, pero su efecto en combinación con otros anestésicos en embarazadas no está del todo descrito. Objetivo: Evaluar la eficacia anestésica y seguridad de la anestesia multimodal con fentanilo en mujeres embarazadas durante la cesárea. Material y métodos: Ensayo clínico, controlado, aleatorizado, doble ciego; en mujeres embarazadas programadas para cesárea, distribuidas en tres grupos: grupo FBMD: fentanilo 70 μg + bupivacaína hiperbárica 0.1%, 2 mg, + morfina 100 μg + dexmedetomidina 5 μg; grupo BFM: bupivacaína hiperbárica 0.25%, 5 mg, + fentanilo 25 μg + morfina 100 μg, y el grupo BM: bupivacaína hiperbárica 0.375%, 7.5 mg, + morfina 100 μg. Se evaluó la eficacia anestésica previo a la incisión, durante la disección de la pared abdominal, al ingreso a cavidad abdominal, en la revisión de correderas parietocólicas y en el postquirúrgico inmediato, así como, los signos vitales. Resultados: Se analizaron 180 mujeres. El grupo FBMD mostró mayor eficacia anestésica en la revisión de correderas parietocólicas (p = 0.01) y en el postquirúrgico inmediato (p = 0.0001), así como mayor seguridad con mejor control hemodinámico a los minutos uno y 10 (p = 0.02 y p = 0.03, respectivamente). Conclusiones: La anestesia multimodal con FBMD demuestra mejor eficacia anestésica y seguridad sobre el control hemodinámico.

Abstract: Introduction: Fentanyl offers good anesthetic efficacy and fewer effects on the sympathetic nervous system with better hemodynamic status, but its effect in combination with other anesthetics in pregnant women has not been fully described. Objective: To evaluate the anesthetic efficacy and safety of multimodal anesthesia with fentanyl in pregnant women undergoing caesarean section. Material and methods: Controlled, randomized, double blinded clinical trial; in pregnant women scheduled for cesarean section distributed in 3 groups: FBMD group: fentanyl 70 μg + hyperbaric bupivacaine 0.1%, 2 mg, + morphine 100 μg + dexmedetomidine 5 μg; BFM group: hyperbaric bupivaine 0.25%, 5 mg, + fentanyl 25 μg + morphine 100 μg, and group BM: hyperbaric bupivacaine 0.375%, 7.5 mg, + morphine 100 μg. The anesthetic efficacy was evaluated: prior to the incision, during the dissection of the abdominal wall, upon entry to the abdominal cavity, in the revision of parietocolic slides and in the immediate postoperative period, as well as the vital signs. Results: 180 women were analyzed. The FBMD group showed greater anesthetic efficacy in the revision of parietocolic slides (p = 0.01) and in the immediate postoperative period (p = 0.0001) and greater safety, showing better hemodynamic control at minutes 1 and 10 (p = 0.02 y p = 0.03 respectively). Conclusions: Multimodal anesthesia with FMBD shows better anesthetic efficacy and safety over hemodynamic control.

Resumo O artigo analisa a presença material de obras literárias nas escolas argentinas. Revisa a responsabilidade do Estado na distribuição de bens materiais e simbólicos por meio da análise de políticas públicas de leitura e o fornecimento de coleções literárias desenvolvidas durante o período 2010-2015, da Diretoria de Políticas Socioeducativas do Ministério Nacional da Educação, e seus possíveis efeitos sobre o cânone literário escolar. Se indaga particularmente, na presença de autores e títulos recortados da literatura infantil e juvenil incluídos nas bibliotecas literárias estudadas.

Resumen El artículo analiza la presencia material de obras literarias en las escuelas argentinas. Revisa la responsabilidad estatal en la distribución de bienes materiales y simbólicos mediante el análisis de políticas públicas de lectura y provisión de colecciones literarias desarrolladas durante el período 2010-2015, desde la Dirección de Políticas Socioeducativas del Ministerio de Educación de la Nación, y sus posibles efectos sobre el canon literario escolar. Se indaga, particularmente en la presencia de autores y títulos del recorte literatura infantil y juvenil incluidos en las bibliotecas literarias estudiadas.

Abstract The article analyzes the material presence of literary plays in Argentinian schools. It checks the state responsability in the distribution of material and symbolic goods through the analysis of reading in public politics and the supply of literary collections developed during the period 2010-2015, from de Social and Educational Direction of the Ministry of Education of the Nation, and its possible effects on the school literary standards. It is inquired, particularly on the presence of authors and titles of children and adolescent’s literature included in the literary libraries studied.

Resumen Introducción: El estigma relacionado con la COVID-19 hacia los profesionales de la salud influye negativamente en su desempeño laboral y bienestar, sin embargo, este tema no ha sido suficientemente investigado. Objetivo: Determinar la frecuencia y las variables asociadas al estigma relacionado con el COVID-19 hacia los trabajadores de la salud en una población universitaria de México. Materiales y métodos: Estudio transversal. Se envió un cuestionario en línea a 1.054 estudiantes de entre 18 y 29 años. Se analizaron variables demográficas, religión, miedo al COVID-19 y su asociación con el estigma-discriminación hacia el personal de salud relacionado con la COVID-19 (variable dependiente). Se realizó un análisis bivariado y un modelo lineal generalizado para calcular las razones de prevalencia ajustadas. Resultados: La proporción de estigma-discriminación alto fue de 12,4% y se asoció con miedo alto a la COVID-19 RPa=1,51 (IC=95% 1,06-2,23). Conclusión: Los hallazgos destacan la importancia de establecer programas para reducir la estigmatización relacionada con COVID-19 hacia los profesionales de la salud.

Abstract Introduction: COVID-19-related stigma towards healthcare professionals negatively influences their job performance and well-being, however, this issue has not been sufficiently investigated. Objective: To determine the frequency and variables associated with COVID-19-related stigma toward health care workers in a university population in Mexico. Materials and methods: Cross-sectional study. An online questionnaire was sent to 1,054 students between 18 and 29 years of age. Demographic variables, religiosity, fear of COVID-19 and its association with COVID-19-related stigma-discrimination towards health workers (dependent variable) were analyzed. Bivariate analysis and a generalized linear model were performed to calculate adjusted prevalence ratios. Results: The proportion of high stigma-discrimination was 12.4% and was associated with high fear of COVID-19 RPa= 1.51 (95% CI 1.06 - 2.23). Conclusion: The findings highlight the importance of establishing programs to reduce COVID-19-related stigmatization towards healthcare professionals.

Resumo A revisão fornece uma descrição do conceito e das propriedades associadas à organização saudável a partir da abordagem da psicologia positiva. Para mapear as evidências científicas publicadas entre 2011 e 2020, foi utilizada a metodologia revisão de escopo (Scoping review), e para examinar o conteúdo e as características metodológicas das publicações, nesta revisão de escopo foi realizada uma análise temática. Tendo em vista que a maioria dos estudos identificados faz uso do modelo de organização saudável e resiliente, fica evidente que há espaço significativo para sua aplicação e benefícios, principalmente em contextos latino-americanos. Discutem-se os desafios da adoção de um arcabouço conceitual de saúde mais abrangente, considerando a natureza multidimensional e dinâmica da saúde, numa perspectiva sistêmica.

Abstract The review describes the concept and properties associated with a healthy organization from the positive psychology approach. To map the scientific evidence published between 2011 and 2020, the scoping review methodology was employed; and to examine the content and methodological characteristics of the publications, a thematic analysis was performed in this scoping review. Given that most of the studies identified using the healthy and resilient organization model, it is clear that there is a significant space for its application and benefits, especially in Latin American contexts. The challenges of adopting a more comprehensive health conceptual framework, taking into account the multidimensional and dynamic nature of health, from a systemic perspective, are discussed.

Resumen La revisión proporciona una descripción del concepto y las propiedades asociadas a la organización saludable desde el enfoque de la psicología positiva. Para mapear la evidencia científica publicada entre el año 2011 y 2020, se empleó la metodología de revisión de alcance, y para examinar el contenido y las características metodológicas de las publicaciones, en esta revisión de alcance se efectuó un análisis temático. Dado que la mayoría de los estudios identificados hacen uso del modelo de organización saludable y resiliente, es evidente que existe un espacio significativo frente a su aplicación y beneficios, sobre todo en contextos latinoamericanos. Se discuten los desafíos de adoptar un marco conceptual de salud más integral, teniendo en cuenta el carácter multidimensional y dinámico de la salud, desde una perspectiva sistémica. Clasificación JEL: I31.

Abstract: Early administration of oral colostrum has been recommended in very-low-birth-weight (VLBW) preterm infant care. Objective: To evaluate the clinical effect of early colostrum administration on in-hospital outcome and lactation of VLBW preterm infants compared with historical control in an Intensive Care Unit. Subjects and Method: descriptive cohort study with historical control of VLBW preterm infants who did or did not receive early oral colostrum, born 1.6 years before and 1.4 years after this protocol, with information collected from the database of infants under 1500 grams at birth and in the colostrum protocol registry. Children born to HIV+ mothers, with hepatitis, chemotherapy, and those born with malformations incompatible with life were excluded. The main perinatal, morbidity, nutritional, and breastfeeding data at discharge were compared. Results: 94 patients were born pre-colostrum and 64 in the protocol period (post-colostrum). The groups were comparable in perinatal history. No difference was observed in infectious, respiratory, or gastrointestinal morbidity, progress in enteral feeding, days of parenteral nutrition, and length of hospital stay. There were signi ficant differences in the percentage breastfeeding at discharge (52 vs. 69%, p < 0.037) and in average breast milk volume at discharge (70 vs. 102 ml/k/day, p < 0.012) in the post-colostrum group. Conclusions: Early colostrum administration to preterm infants was associated with a higher volume of maternal milk at discharge, being a good benefit in VLBW preterm infant care.

Resumen: Introducción: El uso precoz de calostro oral ha sido recomendado en el cuidado del prematuro de muy bajo peso de nacimiento. Objetivo: Evaluar el efecto de la administración precoz de calostro comparado con control histórico en la evolución intrahospitalaria y lactancia de recién nacidos prematuros de muy bajo peso de nacimiento (MBPN) en una Unidad de Cuidado Intensivo. Sujetos y Método: Estudio de cohorte descriptivo con control histórico de prematuros MBPN que recibieron o no calostro oral precoz, nacidos 1,6 años pre y 1,4 años post este protocolo, con la información reunida en base de datos de menores de 1.500 g al nacer y en registro del protocolo de calostro. Se excluyeron los hijos de madre VIH+, con hepatitis, quimioterapia y los nacidos con malformaciones incompatibles con la vida. Se compararon los principales datos perinatales, de morbilidad, nutricionales y lactancia al alta. Resultados: 94 pacientes nacidos pre-calostro y 64 en período de protocolo (post-calostro). Los grupos fueron comparables en antecedentes perinatales. No se observó diferencia en la morbilidad infecciosa, respiratoria o gastrointestinal, en avance en aporte enteral, días de nutrición parenteral y duración de hospitalización. Se observó diferencia significativa en el porcentaje con lactancia al alta (52 vs 69%, p < 0,037) y en volumen promedio de leche materna al alta (70 vs 102 ml/k/día, p < 0,012) en el grupo post-calostro. Conclusiones: El uso de calostro oral precoz fue posible de realizar y se asoció con mayor volumen de leche materna al alta, constituyendo una intervención beneficiosa en el cuidado del prematuro de muy bajo peso de nacimiento.

ABSTRACT The context of the crisis of the state’s child protection network in Chile led to an analysis of the rights approach used in a non-governmental project that was innovative and complemented the national network. The case was studied using mixed methodologies, integrating various tools that mainly came together in an ethnography of the natural environment of the project. The study shows that the rights approach is articulated on a declaratory level and on a rather different practical one: a) the former can be aligned with human rights; b) the latter has two antagonistic forms: i) exo-efficacy and ii) personal values, but not self-efficacy. The study’s conclusions include recommendations for the inclusion of the rights approach in child protection programs.

RESUMEN El contexto de crisis de la red de protección del Estado a la infancia en Chile motivó un análisis desde el Enfoque de Derechos en el proyecto de una corporación no gubernamental, innovador y complementario a la red estatal. El estudio de caso fue realizado a partir de metodologías mixtas, integrando diversas herramientas que se conjuntaron principalmente en una etnografía en el medio natural del proyecto. Los resultados evidencian que el Enfoque de Derechos se articula en un nivel declarativo y en otro práctico de distinto cariz: a) el primero puede adscribirse alineado con los derechos humanos; b) el segundo ajustado a dos formas antagónicas: i) exoeficacia, y ii) valores personales, pero no autoeficacia. A manera de conclusión, damos recomendaciones para la inclusión del Enfoque de Derechos en programas de protección a la niñez y juventudes en el contexto chileno.

RESUMO A inteligência é concebida como um processo cognitivo que permite ao ser humano apresentar soluções para os problemas da vida quotidiana, bem como desenvolver competências conceptuais, práticas e sociais. Nesse sentido, a presente pesquisa teve como objetivo estabelecer o conhecimento por parte dos professores da disciplina de Matemática para a identificação e detecção de alunos com características de Dotação Intelectual ou Genialidade nas Instituições de Ensino da província de Pichincha. A pesquisa foi realizada com abordagem quantitativa, o que permitiu a coleta e análise dos dados. Além da revisão bibliográfica e com o objetivo de coletar informações sobre a variável Dotação Intelectual, foram aplicados dois instrumentos a 1.135 professores da disciplina de Matemática, distribuídos em 214 instituições públicas, privadas, municipais e estaduais do tesouro. Conclui-se que há dificuldades em identificar alunos com Dotação Intelectual ou Gênio. Por outro lado, grande parte da população investigada possui conhecimentos básicos sobre as características das pessoas com dotes intelectuais, o que lhes permite detectar esses alunos em suas salas de aula. Em todos os indicadores, a população é heterogênea no nível de respostas. Nesse ínterim, é fundamental gerar espaços de reflexão da academia e do Ministério da Educação sobre a importância do ensino e da formação de novos e antigos professores no trabalho pedagógico de Dotação Intelectual ou Genialidade para uma sociedade justa e justa com respeito à diversidade.

ABSTRACT Intelligence is conceived as a cognitive process that allows the human being to provide solutions to problems of daily life, as well as to develop conceptual, practical and social skills. In this sense, the present research aimed to establish the knowledge on the part of the teachers of the subject of Mathematics for the identification and detection of students with characteristics of Intellectual Endowment or Geniality in the Educational Institutions of the province of Pichincha. The research was carried out with a quantitative approach, which allowed the collection and analysis of data. In addition to the bibliographic review and with the purpose of collecting information on the Intellectual Endowment variable, two instruments were designed, validated and applied to 1,135 teachers of mathematics subject, distributed in 214 publics, private, municipal and fiscal institutions. It is concluded that there are difficulties for the identification of students with intellectual endowment or genius. On the other hand, a large part of the investigated population has basic knowledge about the characteristics of people with intellectual endowments, which allows them to detect these students within their classrooms. In all indicators, the population is heterogeneous in its level of responses. Meanwhile, it is essential to generate spaces for reflection from the academy and the Ministry of Education on the importance of teaching and training new and old teachers in pedagogical work on intellectual endowment or genius to achieve a fair and just society with respect to the diversity.

RESUMEN La inteligencia es concebida como un proceso cognitivo que permite al ser humano dar soluciones a los problemas de la vida diaria, así como desarrollar habilidades conceptuales, prácticas y sociales. En ese sentido, la presente investigación tuvo como objetivo establecer el conocimiento por parte de los/las docentes de la asignatura de Matemática para la identificación y detección de estudiantes con características de Dotación Intelectual o Genialidad en las Instituciones Educativas de la provincia de Pichincha. La investigación se realizó con enfoque cuantitativo, lo que permitió la recolección y el análisis de datos. Además de la revisión bibliográfica y con la finalidad de recolectar información sobre la variable Dotación Intelectual, se aplicaron dos instrumentos a 1135 docentes de la asignatura de Matemática, distribuidos en 214 instituciones públicas, privadas, municipales y fisco misionales. Se concluye que existen dificultades para la identificación de estudiantes con Dotación Intelectual o Genialidad. Por otro lado, gran parte de la población investigada posee el conocimiento básico sobre las características de las personas con dotación intelectual, lo cual les permite detectar a estos estudiantes dentro de sus aulas. En todos los indicadores, la población se muestra heterogénea en su nivel de respuestas. En tanto, es imprescindible generar espacios de reflexión desde la academia y el Ministerio de Educación sobre la importancia de enseñar y capacitar a los y las docentes noveles y antiguos en el quehacer pedagógico sobre la Dotación Intelectual o Genialidad para lograr una sociedad equitativa y justa con respecto a la diversidad.

Abstract Introduction: Sarcopenia is characterized by loss of strength and muscle mass. Patients with diabetes mellitus who are under hemodialysis treatment show decreased physical activity and changes in their food intake, which also leads to the presence of sarcopenia. On the other hand, peripheral neuropathy and peripheral arterial disease commonly appear as chronic complications of diabetes mellitus. Methods: A cross-sectional, observational study was carried out in diabetes mellitus patients on hemodialysis. For the assessment of sarcopenia, muscle strength, physical performance and muscle mass percentage were measured. Muscle strength was calculated with a dynamometer, while physical performance was evaluated in seconds by means of a walk test with a stopwatch; muscle mass percentage was obtained using a scale with bioelectrical impedance. Sarcopenia was considered severe when there was low muscle strength and percentage in addition to low physical performance. Peripheral neuropathy was assessed by exploring touch and pressure sensibility with the Semmes-Weinstein monofilament test and deep sensibility with a 128 Hz tuning fork. The ankle-brachial index was the measurement taken for the peripheral arterial disease classification. Results: The final analysis was performed with 33 patients, whose time on hemodialysis was 3.57 ± 2.56 years. The prevalence of severe sarcopenia and sarcopenia was 90.8% and that of pre-sarcopenia was 9% of all patients. On the other hand, 78.1% were found to be patients with loss of deep sensibility, while the percentage of patients with loss of sensibility to pressure and touch was 54.5%. A correlation was found between the sarcopenia parameters and the time of evolution of renal failure and age. Conclusion: Sarcopenia occurs, in its different stages, in practically all diabetes mellitus patients undergoing hemodialysis; there is a relationship with the patient's age and hemodialysis time.

Resumen Introducción: La sarcopenia se caracteriza por pérdida de fuerza y masa muscular. Los pacientes con diabetes mellitus que se encuentran bajo tratamiento en hemodiálisis tienen disminución de actividad física y cambios en su ingestión alimentaria, lo que propicia también la presencia de sarcopenia; por otro lado, la neuropatía periférica y enfermedad arterial periférica aparecen comúnmente como complicaciones crónicas de la diabetes mellitus. Material y métodos: Se realizó un estudio transversal, observacional, en pacientes con diabetes mellitus y hemodiálisis. Para la evaluación de la sarcopenia se midió fuerza muscular, rendimiento físico y cantidad de masa muscular. Se midió fuerza muscular con dinamómetro, mientras que el rendimiento físico se evaluó con el tiempo en segundos de marcha con cronómetro, la cantidad de músculo de obtuvo utilizando una báscula con bioimpedancia. Se consideró sarcopenia severa cuando existía baja fuerza y cantidad muscular además de bajo rendimiento físico. La neuropatía periférica se evaluó explorando la sensibilidad a la presión y el tacto con el monofilamento de Semmes-Weinstein y sensibilidad profunda con un diapasón de 128 Hz. El índice tobillo-brazo fue la medición tomada para la clasificación de enfermedad arterial periférica. Resultados: El análisis final se realizó con 33 pacientes. Con un tiempo en hemodiálisis de 3,57 ± 2,56 años. La prevalencia de sarcopenia severa y sarcopenia fue de 90,8% y la de pre-sarcopenia de 9% del total de los pacientes; por otro lado, se encontró al 78,1% los pacientes con pérdida de la sensibilidad profunda, mientras que el porcentaje de los pacientes con pérdida de la sensibilidad a la presión y al tacto fue de 54,5%. Se encontró correlación entre los parámetros de sarcopenia y el tiempo de evolución de la insuficiencia renal y la edad. Conclusión: La sarcopenia se presenta, en sus diferentes etapas, en prácticamente todos los pacientes con diabetes mellitus sometidos a hemodiálisis; existe relación con la edad del paciente y el tiempo de hemodiálisis.

Resumen Introducción: a pesar de los avances en la cobertura de la seguridad social en salud, la población colombiana enfrenta barreras al acceso. En salud bucal, si bien el plan de beneficios es amplio, la cobertura de los servicios a cargo de las EPS es baja. Objetivo: analizar la cobertura de los servicios odontológicos entre la población afiliada en Medellín en 2015. Métodos: estudio mixto con un componente central cuantitativo para estimar la cobertura esperada, según necesidad normativa y necesidad expresada, y la cobertura real a partir de registros de prestación de servicios de los afiliados que en 2015 accedieron a servicios odontológicos en la red de seis EPS. También se desarrolló un componente cualitativo, a partir de entrevistas a referentes de salud bucal en las EPS. Resultados: para atender las necesidades de la población afiliada se requerían en el año 9.6 millones de actividades de protección específica y detección temprana, siguiendo los lineamientos normativos, y 6.8 millones de actividades para atender los diagnósticos de caries y periodontitis. La cobertura real apenas habría sido del 10,6%, y en las EPS del estudio entre 16% y 23%. Conclusión: la brecha entre los servicios necesarios y los prestados supera el 70%, lo cual puede deberse especialmente a factores sociales y culturales y a una baja demanda inducida. A la par con mayores recursos, esto debe ser tenido en cuenta para mejorar la cobertura y lograr un mayor impacto en salud bucal.

Abstract Introduction: despite the advances in coverage in social security in health, the Colombian population still faces access barriers. In oral health, although the benefit plan is broad, the coverage of services provided by Health Maintenance Organizations (HMOs)* is low. Objective: analyze dental services coverage among users in Medellín in the year 2015. Methods: mix study with a quantitative approach to estimate expected coverage, according to normative need and expressed need, and real coverage based on service provision records referring to Medellín users who accessed dental services in the HMO network in 2015. A qualitative approach was also conducted via interviews with oral health referents in six HMOs. Results: in order to meet the needs of the affiliated population, 9,6 million specific protection and early detection activities were required in the year, following the normative guidelines, and 6,8 million activities to assist caries and periodontitis patients. Real coverage would have hardly been 10.6% of the city’s population, and in the studied HMOs this value would have been 16% to 23%. Conclusion: the gap between the necessary services and those provided exceeds 70%, which is mainly due to social and cultural factors and low induced demand. In addition to greater resources, this must be taken into account to improve coverage and achieve a greater impact on oral health.

ABSTRACT The screening of certain chemical markers associated with the burning of fuels (gasoline, diesel, firewood, pellets, and kerosene) is carried out. The studied markers correspond to phenolic compounds present in emitted gases. Identification and quantification were performed by solid phase extraction followed by high-performance liquid chromatography with diode-array detection (HPLC-DAD). The volatile phenolic derivatives detected and quantified in these experiments were phenol (Ph), 2-nitrophenol (2-NPh), 4-nitrophenol (4-NPh), o-hydroxyphenol (2-HPh), 2-methoxyphenol (2-MetPh), 4-methoxyphenol(4-MetPh) and 2,4-dinitrophenol. The emissions from firewood- and pellet-burning heaters contain mainly o-hydroxyphenol, 4-methoxyphenol, and Ph. In the emissions from gasoline-powered vehicles, only Ph was detected, and in those of diesel-powered vehicles, only 2-NPh and 4-NPh were detected. Kerosene-burning heaters did not exhibit measurable amounts of phenolic compounds in their emissions. The controlled irradiation of the emissions from the burning of firewood and pellets using a photochemical camera showed high degrees of stability of these compounds. The studied phenolic derivatives did not photolyse or were not formed by the photochemical pathway; therefore, their origin is clearly primary, which allows their use as combustion tracers in a particular atmosphere. The presence of Ph derivatives in the Santiago atmosphere indicates the existence of mobile sources (daytime) and the use of firewood (night-time). The presence of 2-NPh and 4-NPh derivatives in the air would be strongly associated with the use of mobile sources that use diesel. In contrast, catechol is associated with the burning of wood for heating.

Abstract: Objective: To assess the assumption of ‘equity’ of Mexico’s resident-selection assessment tool, the Examen Nacional para Aspirantes a Residencias Médicas (ENARM). Materials and methods: Official ENARM-2016 and -2017 databases were analyzed. Differences in the absolute number of correct answers (multivariable linear regression) and the number of applicants reaching their specialty minimum score (SMS) per test day (odds ratio [OR]) were calculated. Applicants affected by test-day inequity were estimated. Results: There were 36 114 applicants in 2016, and 38 380 in 2017. In 2016, day-2 applicants had significantly higher scores and more reached the SMS than on days 1-3-4 (OR 1.55), and 5 (OR 3.8); 3 565 non-passing applicants were affected by inequity (equivalent to 44.64% of those selected). In 2017, day-1 and -2 applicants had significantly higher scores and more reached the SMS than on days 3-4 (OR 1.85), and 5 (OR 4.04); 3,155 non-passing applicants were affected by inequity (37.2% of those selected). Conclusion: Analysis of official ENARM databases does not support the official attribution of equity, suggesting the test should be redesigned.

Resumen_ Objetivo: Evaluar el atributo de “equidad” asignado al Examen Nacional para Aspirantes a Residencias Médicas (ENARM). Material y métodos: Se analizaron las bases de datos oficiales del ENARM 2016 y 2017. Se compararon las diferencias inter-día de respuestas correctas (regresión linear multivariable) y de sustentantes que alcanzaron el puntaje mínimo de su especialidad (PME) (razón de momios [RM]). Se estimó a los afectados por la inequidad. Resultados: Hubo 36 114 sustentantes en 2016 y 38 380 en 2017. Los días 2 (ENARM-2016) y 1-2 (ENARM-2017) registraron puntajes significativamente más altos, y más sustentantes alcanzaron el PME que en los días 1-3-4 (RM 1.55) y 5 (RM 3.8) en 2016, y los días 3-4 (RM 1.85) y 5 (RM 4.04) en 2017. Se estimó que cuatro de cada diez sustentantes que aprobaron el ENARM no lo hubieran hecho si el examen fuera equitativo. Conclusión: Los resultados sugieren que el atributo de equidad del ENARM está en duda.

Abstract: Objective: To assess the assumption of ‘equity’ of Mexico’s resident-selection assessment tool, the Examen Nacional para Aspirantes a Residencias Médicas (ENARM). Materials and methods: Official ENARM-2016 and -2017 databases were analyzed. Differences in the absolute number of correct answers (multivariable linear regression) and the number of applicants reaching their specialty minimum score (SMS) per test day (odds ratio [OR]) were calculated. Applicants affected by test-day inequity were estimated. Results: There were 36 114 applicants in 2016, and 38 380 in 2017. In 2016, day-2 applicants had significantly higher scores and more reached the SMS than on days 1-3-4 (OR 1.55), and 5 (OR 3.8); 3 565 non-passing applicants were affected by inequity (equivalent to 44.64% of those selected). In 2017, day-1 and -2 applicants had significantly higher scores and more reached the SMS than on days 3-4 (OR 1.85), and 5 (OR 4.04); 3,155 non-passing applicants were affected by inequity (37.2% of those selected). Conclusion: Analysis of official ENARM databases does not support the official attribution of equity, suggesting the test should be redesigned.

Resumen_ Objetivo: Evaluar el atributo de “equidad” asignado al Examen Nacional para Aspirantes a Residencias Médicas (ENARM). Material y métodos: Se analizaron las bases de datos oficiales del ENARM 2016 y 2017. Se compararon las diferencias inter-día de respuestas correctas (regresión linear multivariable) y de sustentantes que alcanzaron el puntaje mínimo de su especialidad (PME) (razón de momios [RM]). Se estimó a los afectados por la inequidad. Resultados: Hubo 36 114 sustentantes en 2016 y 38 380 en 2017. Los días 2 (ENARM-2016) y 1-2 (ENARM-2017) registraron puntajes significativamente más altos, y más sustentantes alcanzaron el PME que en los días 1-3-4 (RM 1.55) y 5 (RM 3.8) en 2016, y los días 3-4 (RM 1.85) y 5 (RM 4.04) en 2017. Se estimó que cuatro de cada diez sustentantes que aprobaron el ENARM no lo hubieran hecho si el examen fuera equitativo. Conclusión: Los resultados sugieren que el atributo de equidad del ENARM está en duda.

Resumo: A biodiversidade e os ecossistemas são elementos importantes para enfrentar as crises socioeconômicas e ambientais nacionais e globais, uma vez que proporcionam novas oportunidades de desenvolvimento. Incorporar a biodiversidade na vida cotidiana é uma oportunidade de ouro para promover o uso sustentável da biodiversidade e dos serviços ecossistêmicos. A conservação e a restauração da biodiversidade, dos ecossistemas e de seus serviços associados mostram potencial para um novo desenvolvimento social e econômico, como fonte de geração de emprego e renda, redução da pobreza e da desigualdade socioeconômica. A diversidade biológica brasileira também se expressa em sua imensa diversidade cultural, com uma grande variedade de detentores de conhecimento indígenas e tradicionais. Esses povos possuem vasto conhecimento sobre agrobiodiversidade, pesca, manejo do fogo, medicina natural, entre outros de valor comercial, cultural e espiritual. As principais conclusões deste Sumário para Tomadores de Decisão é que as mudanças no uso da terra e as mudanças climáticas tenham sido - e continuarão sendo ao longo deste século - os principais vetores da perda de biodiversidade e serviços ecossistêmicos no país. Intervenções políticas em diferentes níveis (do local ao nacional, do público ao privado) e a aplicação das leis existentes (mecanismos regulatórios e incentivos) são necessárias para promover a mitigação dos impactos negativos sobre a biodiversidade e a perda de serviços ecossistêmicos. O Brasil já possui uma ampla variedade de instrumentos de política e opções de governança socioambiental, bem como compromissos globais (ODS, Metas de Aichi, Acordo de Paris) relacionados à possibilidade de um futuro sustentável. Entretanto, o controle ineficiente da gestão ou a falta de incentivo para cumprir as regras traz riscos para a consolidação do caminho para esse futuro. O país tem instituições fortes e capazes, mas problemas de infraestrutura, processos lentos, medidas ineficazes e conflitos judiciais, sociais e ecológicos impedem a realização de um desempenho eficiente. Há uma falta de comunicação entre a ciência e a sociedade que precisa ser melhorada por meio do estabelecimento de um fluxo efetivo que torne a comunicação inclusiva e representativa, alcançando os tomadores de decisão públicos e privados. Esforços permanentes para integrar essas duas esferas de conhecimento na sociedade são desejáveis para criar confiança entre os formuladores de políticas e os pesquisadores.

Abstract: Biodiversity and ecosystems are important elements for addressing national and global socioeconomic and environmental crises, since they provide new development opportunities, for example, as source of job and income creation, and reduction in poverty and socioeconomic inequity. Brazilian biological diversity is also expressed in its immense cultural diversity, with a great variety of knowledge holders. These peoples possess vast knowledge on agrobiodiversity, fishing, fire management, natural medicine, among others of commercial, cultural and spiritual value. The main conclusions of this Summary for Police Makers is that land use changes and climate changes have been - and will continue to be throughout this century - the main drivers that result in the loss of biodiversity and ecosystem services in the country. Political interventions at different levels (from local to national, from public to private) and the enforcement of existing laws (regulatory mechanisms and incentives) are required to cope with the mitigation of the negative impacts of biodiversity and ecosystem services loss. Brazil has already a wide variety of policy instruments and socioenvironmental governance options, as well as global commitments (ODS, Aich Targets, Paris Agreement) related to the objective of a sustainable future. However, inefficient management control or lack of incentive to comply with the rules pose risks to consolidating the path to this future. The country has strong and capable institutions, but infrastructural problems, slow processes, inefficient measurements and judicial, social and ecological conflicts obstruct a proficient performance. There is a lack of communication between science and society which needs to be improved by establishing an effective flow that makes communication inclusive and representative, reaching public and private decision makers. Permanent efforts to integrate Science and policy knowledges are desirable to build confidence between policy makers and researchers.

Abstract The main objective of this work is to zonify the landslide risk for the canton of Riobamba, using multivariate statistical procedures and Geographic Information Systems (GIS) as a methodological alternative that allows authorities and governmental entities in charge of Cantonal Risk Management to make decisions optimal for the benefit of citizens who live in the riskiest areas as well as the environment in general. Likewise, a methodology developed by the scientific team of Spatial Data Infrastructure in Europe (INSPIRE, 2012) is presented, which relates key variables for the analysis of information among them: Vulnerability, Exposure and Risk; for the Riobamba canton, 13% of its surface has a high risk of occurrence of mass removal phenomena.

Resumen El objetivo principal de este trabajo es zonificar el riesgo por deslizamientos para el cantón Riobamba, empleando procedimientos de estadística multivariada y Sistemas de Información Geográfica (SIG) como una alternativa metodológica que permita a autoridades y entes gubernamentales encargados de la Gestión del Riesgo Cantonal tomar decisiones óptimas en pro del beneficio de la ciudadanía que habitan las zonas más riesgosas así como para el entorno en general. Asimismo, se presenta una metodología desarrollada por el equipo científico de Infraestructura de Datos Espaciales en Europa (INSPIRE, 2012) que relaciona variables clave para el análisis de información entre ellos: Vulnerabilidad, Exposición y Riesgo; para el cantón Riobamba el 13% de su superficie tiene un alto riesgo de ocurrencia de fenómenos de remoción en masa.