Resumen Introducción: Algunas universidades buscan mejorar la enseñanza en la carrera de medicina, el aprendizaje basado en problema es una alternativa que desplazaría al sistema tradicional. Objetivo: Describir la experiencia educativa y satisfacción de los estudiantes con la aplicación del aprendizaje basado en problema (ABP) en un semestre del internado de medicina del año 2022 en la asignatura de ginecología y obstetricia. Método: Estudio transversal descriptivo a través de la aplicación de una encuesta, se tomó una muestra aleatoria de 150 estudiantes de una población de 450 internos pertenecientes a la Universidad de Guayaquil, Facultad de Medicina, cursando Ginecología-Obstetricia del internado rotativo. Para la recolección de la información, se aplicaron técnicas de investigación e instrumentos de recolección, tanto para información primaria como secundaria. Resultados: Esta estrategia permitió que los estudiantes estén activos, críticos y profundicen los conocimientos adquiridos previamente, de acuerdo a las encuestas planteadas al final de las clases presentaron 80% de satisfacción por esta estrategia. Conclusiones: La estrategia de enseñanza permitió que los internos de medicina tengan una participación más activa, cooperativa y crítica que estuvieron centradas en el estudiante; demostrada por el porcentaje de satisfacción y apoyo en las dificultades presentadas por el docente.

Abstract Introduction: Some universities seek to improve teaching in the medical career, problem-based learning is an alternative that would displace the traditional system. Objective: Describe students’ educational experience and satisfaction with the application of PBL in a semester of the Medicine Internship of the year 2022 in the subject of gynecology and obstetrics. Method: Descriptive cross-sectional study through the application of a survey, a random sample of 150 students was taken from a population of 450 interns belonging to the University of Guayaquil, Faculty of Medicine studying Gynecology-Obstetrics of the rotating internship. For information collection, research techniques and instruments were applied, both for primary and secondary information. Results: This strategy allowed students to be active, and critical and deepen the knowledge previously acquired, according to the surveys raised at the end of the classes presented 80% satisfaction with this strategy. Conclusions: The teaching strategy allowed medical interns to have a more active, cooperative, and critical participation that was student-centered; demonstrated by the percentage of satisfaction and support in the difficulties presented by the teacher.

Abstract Developing effective learning strategies to strengthen mental health professionals’ capacities and deliver evidence-based interventions in their communities is urgent. We developed and evaluated an online training program for the Intervention Guide for Mental, Neurological and Substance Use Disorders in Non-specialized Health Settings. Nine hundred and seventy-five health professionals in Mexico were enrolled in the training program, during the period of social distancing brought about by the COVID-19 pandemic. Participants completed a pre-post online evaluation strategy including Knowledge screening, assessment of Learning Activities, and performance in Programmed-Simulated cases to evaluate knowledge and skills for the assessment, management, and follow-up of Mental, Neurological and Substance Use Disorders. We found that participants improved their knowledge and skills from training on the mhGAP online course. Notably we observed these positive results regardless of sex, profession, institution, or social vulnerability rating of participants, suggesting that this is a relevant training program for primary care staff. These results contribute to the Mental Health Gap Action Programme and advance the use of online teaching and evaluation technologies in this field.

Resumen El desarrollo de estrategias efectivas de aprendizaje para fortalecer las competencias de los profesionales de la salud mental y brindar intervenciones basadas en evidencia en sus comunidades es necesario. El objetivo del presente trabajo fue desarrollar y evaluar un programa de entrenamiento en línea para la Guía de Intervención en Trastornos Mentales, Neurológicos y por Uso de Sustancias en nivel de atención de salud no especializada. Participaron 975 profesionales de la salud mexicanos durante el período de distanciamiento social provocado por la pandemia de COVID-19. Los participantes completaron una evaluación previa y posterior que incluyó un cuestionario de conocimientos, actividades de aprendizaje y la ejecución en casos simulados programados para evaluar el conocimiento y las habilidades para la evaluación, el manejo y el seguimiento de los trastornos mentales, neurológicos y por uso de sustancias. Los resultados indicaron que los participantes mejoraron sus conocimientos y habilidades en función de su participación en el curso en línea, independientemente del sexo, la profesión, la institución o la vulnerabilidad social de los participantes, sugiriendo que se trata de un programa de formación relevante para el personal de atención primaria. Los resultados contribuyen al Programa de Acción para la Brecha de Salud Mental y promueven el uso de tecnologías de evaluación y enseñanza en línea en este campo.

Resumen Brosimum alicastrum Swarts. (conocido localmente como ramón) es una especie del bosque tropical con importancia para el sector alimentario; por tanto, estudiar sus características fisio-técnicas es fundamental. Se determinó la proporción de sexos en tres poblaciones adultas del estado de Yucatán, México. La primera plantación comprendió un total de 312 individuos, 208 machos y 104 hembras; el segundo, 45 árboles masculinos y 29 femeninos (74 árboles) y el tercero, 41 machos y 29 hembras (70 árboles). En promedio, 64% de los árboles eran machos y 34% hembras. En una plantación separada (50 árboles) establecida ad hoc, 30% de los árboles comenzaron a producir flores 7 años después del trasplante, 38% lo hicieron después de 8 años, 28% a los nueve años y 4% a los 10 años, 33 (66%) de los árboles eran machos y 17 (34%) hembras. El experimento comprendió de 2009 a 2019 y no se registraron cambios de sexo durante este tiempo. La producción media de semillas de árboles adultos fue de 145.6 kg árbol-1 año-1. Se realizó un experimento paralelo para dar seguimiento a la retención de hojas, éstas permanecieron en la copa durante más de 40 meses (1 217 días). Adicionalmente se midió el contenido de reguladores del crecimiento vegetal que podrían usarse como marcadores moleculares para seleccionar hembras. Los árboles hembras mostraron mayor contenido de ácido giberélico y citocininas que los árboles machos. La diferencia en el contenido de citocininas entre ambos sexos alcanzó 500%. Se discute la relevancia de estos resultados para el establecimiento de plantaciones comerciales.

Abstract Brosimum alicastrum Swarts (known locally as ramón) is a tropical forest species with importance for the food sector; therefore, studying its physio-technical characteristics is essential. The sex ratio was determined in three adult populations of the state of Yucatán, Mexico. The first plantation comprised a total of 312 individuals, 208 males and 104 females; the second, 45 male and 29 female trees (74 trees) and the third, 41 males and 29 females (70 trees). On average, 64% of the trees were male and 34% female. In a separate plantation (50 trees) established ad hoc, 30% of the trees began to produce flowers 7 years after transplantation, 38% did so after 8 years, 28% at nine years and 4% at 10 years, 33 (66%) of the trees were males and 17 (34%) females. The experiment lasted from 2009 to 2019 and no sex changes were recorded during this time. The average seed production of adult trees was 145.6 kg tree-1 year-1. A parallel experiment was conducted to monitor retention of leaves, they remained in the crown for more than 40 months (1 217 days). Additionally, the content of plant growth regulators that could be used as molecular markers to select females was measured. Female trees showed higher content of gibberellic acid and cytokinins than male trees. The difference in cytokinin content between the sexes reached 500%. The relevance of these results for the establishment of commercial plantations is discussed.

Abstract Objective: To evaluate the quality of activities for the detection of breast cancer in the Strengthening Program for Medical Care in Tabasco in 2016. Materials and Method: A descriptive and retrospective research was carried out, through a documentary analysis using an ad hoc instrument, composed of (46 items) to evaluate the structure, processes and results, when executing the preventive activities of the Breast Cancer Program, included in the Strengthening Program to Medical Attention, operated by 13 Mobile Medical Units, in three municipalities of Tabasco during 2016. Results: In the structure was relevant the reduction in financing to operate the 13 Units, which contributed to the deterioration of activities, and although the number of operational personnel reached 84.62%, it lacked certified training on breast cancer; in the processes, the situational diagnosis was insufficient in 53.8%; the clinical breast examinations reached 25.69% of compliance in the target population, 19% in the teaching of clinical breast self-examination and the preparation of official records in 30.8% and in the results, user satisfaction was low (30.77%) and the impact of the program was not evaluated because it was not carried out in the period studied. Conclusions: The reduction in financing was considered as one of the main factors in the deterioration of the activities that for the detection of breast cancer, were carried out in the 13 Mobile Medical Units assigned to the Strengthening of Medical Care Program, which contributed to its low quality.

Resumen Objetivo: Evaluar la calidad de las actividades para la detección de cáncer de mama en el Programa Fortalecimiento a la Atención Médica en Tabasco en 2016. Hace falta mencionar para evaluarla estructura, procesos y resultados. Material y método: Se realizó una investigación descriptiva y retrospectiva, mediante un análisis documental utilizando un instrumento ad hoc, compuesto por (46 items) para evaluarla estructura, procesos y resultados, al ejecutarlas actividades preventivas del Programa de Cáncer de Mama, incluidas en el Programa Fortalecimiento a la Atención Médica, operadas por13 Unidades Médicas Móviles, en tres municipios de Tabasco durante el año 2016. Resultados: Destacaron en la estructura, la reducción del financiamiento para operar las 13 UMM lo que contribuyó al deterioro de las actividades y aunque la dotación de personal operativo alcanzó 84.62%, carecía de capacitación certificada sobre cáncer de mama; en los procesos, el diagnóstico situacional era insuficiente en 53.8%; las exploraciones clínicas mamarias alcanzaron 25.69% de cumplimiento en la población blanco, 19% en la enseñanza de la autoexploración clínica mamaria y la confección de los registros oficiales en 30.8% fue baja la satisfacción del usuario (30.77%) y no se evaluó el impacto del programa por no realizarse en el período estudiado. Conclusiones: La reducción del financiamiento se consideró como uno de los principales factores en el deterioro de las actividades que para la detección del cáncer mama, se realizaron en las 13 Unidades Médicas Móviles adscritas al Programa Fortalecimiento a la Atención Médica, lo que contribuyó a su baja calidad.

ABSTRACT Introduction: Improving survival of Acute Lymphoblastic Leukemia (ALL) in adult patients has been a challenge. Despite intensive chemotherapy treatment, overall survival is poor. However, several studies demonstrate that young adult patients have better survival when treated with pediatric-based intensive regimens. Considering these results, We decided to treat newly diagnosed ALL patients according to age and risk factors. The goal of this study was to describe the results of this intensive chemotherapy treatment approach for ALL adult patients diagnosed at our institution. Methods: Fifty-eight ALL patients, diagnosed from 2004 to 2013, were included in the analysis. Patients were assigned to either the St. Jude Total Therapy XIIIB high-risk arm (St Jude) or the CALGB 8811 (CALGB). The Kaplan-Meier survival curve was used for the survival analyses and the Cox proportional hazard regression, for multivariable analysis. Results: The overall survival was 22.9% at 10 years. The St. Jude improved survival, compared to the CALGB (p = 0.007), with 32.6% vs. 7.4% survival rate at 10 years. However, no survival benefit was found for patients younger than 20 years old (p = 0.32). The multivariable analysis demonstrated that undetectable minimal residual disease (MRD) and hematopoietic stem cell transplantation (HSCT) had beneficial impact on survival (p = 0.0007 and p = 0.004, respectively). Conclusion: ALL is a disease of poor prognosis for adults. The joint effort to standardize treatment and seek solutions is the way to start improving this scenario.

ABSTRACT This review focuses on the effects and mechanisms of action of amphetamine-type stimulants (ATS) and their adverse effects on the cardiovascular, nervous, and immune systems. ATS include amphetamine (AMPH), methamphetamine (METH, "crystalmeth," or "ice"), methylenedioxymethamphetamine (MDMA, "ecstasy," or "Molly"), MDMA derivatives (e.g., methylenedioxyamphetamine [MDA] and methylenedioxy-N-ethylamphetamine [MDEA]), khat, and synthetic cathinones. The first section of this paper presents an overview of the historical aspects of ATS use, their initial clinical use, and regulations. The second part reviews the acute and chronic impact and the most salient clinical effects of ATS on the central nervous and cardiovascular systems, skin, and mouth. The chemical structure, pharmacokinetics, and classic and non-canonical pharmacological actions are covered in the third section, briefly explaining the mechanisms involved. In addition, the interactions of ATS with the central and peripheral immune systems are reviewed. The last section presents data about the syndemic of ATS and opioid use in the North American region, focusing on the increasing adulteration of METH with fentanyl.

ABSTRACT Introduction: With the development of society, the concept of quality has become essential within health care organizations. However, little is known about the impact of the structural component of the Donabedian model on the quality of care provided by the Specialist Nurses in Rehabilitation Nursing. The purpose of this study is to identify and analysis the factors related to the quality of rehabilitation nursing care in Physical Medicine and Rehabilitation Units in the light of the Donabedian model in the structure dimension. Methodology: Case study of a qualitative nature. We used a non-probability convenience sample, with all participants being RNs from the same service. Data were collected through a semi-structured interview, composed of eight open-ended questions and a set of eight questions for socio-demographic and professional characterization. In data analysis, we used the guidelines for content analysis proposed by Bardin (2009) using the Atlas.ti software. Results and Discussion: From the analysis of the speeches of the 16 participants, in light of the Donabedian model in the thematic area Structure, the following categories emerged: people management and leadership in the service and physical environment and conditions for the functioning of nursing practices. The Donabedian model supported the discussion in conjunction with other references. We found discrepancies in the participants' discourses, specifically regarding the work methodologies and workload distribution related to rehabilitation nursing care. The work method emerges as a hampering contribution for some nurses, while, for others, it is an added value for the accountability of the autonomous practices developed. Conclusion: We can conclude that the nurses identify facilitating and complicating factors within the structure of the service, which interfere with the quality of care.

RESUMEN Introducción: Con el desarrollo de la sociedad, el concepto de calidad se ha convertido en esencial dentro de las organizaciones sanitarias. Sin embargo, poco se sabe sobre el impacto del componente estructural del modelo de Donabedian en la calidad de los cuidados prestados por las Enfermeras Especialistas en Enfermería de Rehabilitación. El objetivo de este estudio es identificar y analizar los factores relacionados con la calidad de los cuidados de enfermería de rehabilitación en las Unidades de Medicina Física y Rehabilitación a la luz del modelo de Donabedian en la dimensión estructura. Metodología: Estudio de casos de carácter cualitativo. Se utilizó una muestra no probabilística de conveniencia, siendo todos los participantes EEER del mismo servicio. Los datos se recogieron a través de una entrevista semiestructurada, compuesta por ocho preguntas abiertas y un conjunto de ocho preguntas de caracterización sociodemográfica y profesional. En el análisis de los datos, se utilizaron las directrices para el análisis de contenido propuestas por Bardin (2009) utilizando el software Atlas.ti. Resultados y Discusión: Del análisis de los discursos de los 16 participantes, a la luz del modelo de Donabedian en el área temática Estructura, surgieron las siguientes categorías: gestión de personas y liderazgo en el servicio y entorno físico y condiciones para el funcionamiento de las prácticas de enfermería. El modelo de Donabedian apoyó la discusión junto con otras referencias. Encontramos discrepancias en los discursos de los participantes, específicamente en lo que se refiere a las metodologías de trabajo y a la distribución de la carga de trabajo relacionada con los cuidados de enfermería de rehabilitación. El método de trabajo surge como una contribución obstaculizadora para algunas enfermeras, mientras que, para otras, es un valor añadido para la responsabilización de las prácticas autónomas desarrolladas. Conclusión: Podemos concluir que los enfermeros identifican factores facilitadores y complicadores dentro de la estructura del servicio, que interfieren en la calidad de los cuidados.

RESUMO Introdução: Com o desenvolvimento da sociedade, o conceito de qualidade tornou-se fundamental no âmbito das organizações de saúde. Contudo pouco ainda se sabe sobre o impacto da componente estrutura do modelo de Donabedian na qualidade dos cuidados prestados pelos Enfermeiros Especialistas em Enfermagem de Reabilitação (EEER). O objetivo deste estudo consiste em identificar e analisar os fatores relacionados com a qualidade dos cuidados de enfermagem de reabilitação nas Unidades de Medicina Física e Reabilitação (MFR) à luz do modelo de Donabedian na dimensão estrutura. Metodologia: Estudo de caso de natureza qualitativa. Utilizamos uma amostra não probabilística de conveniência, sendo todos os participantes, EEER do mesmo serviço. Os dados foram recolhidos através de uma entrevista semiestruturada, constituída por oito perguntas abertas e um conjunto de oito perguntas para a caraterização sociodemográfica e profissional. Na análise dos dados utilizamos as orientações para a análise de conteúdo propostas por Bardin (2009) com recurso ao software Atlas.ti. Resultados e Discussão: Da análise dos discursos dos 16 participantes, à luz do modelo de Donabedian na área temática Estrutura emergiram as seguintes categorias: gestão de pessoas e liderança no serviço e ambiente físico e condições para funcionamento das práticas de enfermagem. O modelo de Donabedian suportou a discussão em conjugação com outros referenciais. Encontramos discrepâncias nos discursos dos participantes, especificamente em relação às metodologias de trabalho e de distribuição da carga de trabalho relativa aos cuidados de enfermagem de reabilitação. O método de trabalho surge como contributo dificultador para alguns enfermeiros, enquanto, para outros é uma mais-valia para a responsabilização das práticas autónomas desenvolvidas. Conclusão: Podemos concluir que os enfermeiros identificam fatores facilitadores e dificultadores no âmbito da estrutura do serviço, que interferem com a qualidade dos cuidados.

Abstract Polyorchidism is a rare condition. Its diagnosis is mostly incidental and its management is still a matter of debate. Herein we report a case of triorchidism and its management. A 6-year-old boy presented with asymptomatic left scrotal swelling. Scrotal ultrasound confirmed hydrocele and described a supernumerary testis on the left side, along with bilateral testicular microlithiasis. Intraoperative examination of the scrotal content confirmed triorchidism: two testicular masses sharing the same epididymis and vas deferens. Preservation of both units was decided and considering the free movement between them and the inherent risk of torsion, a fixation suture was accomplished. The postoperative recovery was uneventful. According to the scarce reports on literature, since testicular drainage into a shared vas deferens was confirmed, no resection was pursued. Considering the increased risk of malignancy, an annual ultrasound follow-up was recommended.

Resumo A poliorquidia é uma condição rara. O seu diagnóstico é sobretudo incidental e a sua orientação clínica é ainda tema de debate. Neste trabalho, os autores reportam um caso de triorquidismo e a sua abordagem clínica. Um rapaz de 6 anos apresentava uma tumefacção escrotal assintomática à esquerda. A ecografia escrotal confirmou a presença de hidrocelo e descreveu um testículo supranumerário à esquerda, bem como microlitíase testicular bilateral. A exploração intra-operatória do conteúdo escrotal confirmou triorquidismo: duas unidades testiculares que partilhavam o mesmo epidídimo e canal deferente. Optou-se pela preservação de ambas as unidades e, considerando o movimento livre entre elas e o risco inerente de torção, foi realizada uma sutura de fixação. O período pós-operatorio não teve intercorrências. De acordo com a escassa literatura disponível, uma vez que se confirmou uma drenagem testicular conjunta para o mesmo canal deferente, não se realizou exérese de nenhum testículo. No entanto, considerando o risco aumentado de malignidade, recomendou-se seguimento anual através de ecografia.

ABSTRACT Introduction: The human immunodeficiency virus (HIV) is the pathogen that causes human immunodeficiency syndrome (AIDS). Its importance lies in the fact that during the year 2020 in the world 37.6 million people lived with HIV, 1.5 million contracted the disease, and there is no vaccine to prevent their infection. Objective: To study the publications on the development of vaccines worldwide using bibliometric statistics on the subject of HIV and its progression in the last 20 years, emphasizing the period of the SARS-CoV-2 pandemic. Methods: A bibliometric statistical analysis was performed using the PubMed (Medline) database. For the qualitative analysis, the SCImago database was used. Results: An increase in publications was observed since 2001, reaching a maximum in 2016. Publications in first quartile journals were considered, with authors with a high H index, with important interactions between them. From 2017 to date, there has been a decrease in the number of articles published. With this method, it is not feasible, for now, to determine that the installation of the pandemic had a negative impact on the publication of articles on this topic. Conclusion: HIV should be established as a priority item in the scientific/medical area, this methodology offers ample possibilities to deepen and understand how science and its development are being approached, particularly in crucial issues such as vaccine research and the HIV.

RESUMEN Introducción: el virus de inmunodeficiencia humana (VIH) es el patógeno causante del síndrome de inmunodeficiencia humana (SIDA). Su importancia radica en que durante el año 2020 en el mundo 37,6 millones de personas vivían con VIH, y 1,5 millones contrajeron la enfermedad, no existe una vacuna para prevenir su infección. Objetivo: estudiar las publicaciones sobre el desarrollo de las vacunas a nivel mundial usando estadística bibliométrica en el tema VIH y su progresión en los últimos 20 años, haciendo énfasis en el periodo de la pandemia por SARS-CoV-2. Métodos: se realizó un análisis estadístico bibliométrico, usando la base de datos PubMed (Medline). Para el análisis cualitativo se utilizó la base SCImago. Resultados: se observó un aumento en las publicaciones desde el año 2001, alcanzando un máximo el año 2016. Se consideraron las publicaciones en revistas del primer cuartil, con autores(as) con elevado índice H, con importantes interacciones entre ellos. Desde el año 2017 a la fecha se observa una disminución en el número de artículos publicados. Con este método no es factible, por ahora, determinar que la instalación de la pandemia impacto negativamente en la publicación de artículos de dicho tema. Conclusión: el VIH debería instaurarse como un ítem prioritario en el área científica/médica, esta metodología ofrece amplias posibilidades para profundizar y comprender cómo se está abordando la ciencia y el desarrollo de esta, en particular en cuestión cruciales como es la investigación en vacunas y el VIH.

Abstract: The effect of the variables temperature, time and amount of enzyme on the degree of hydrolysis and the level of bitterness of the hydrolysates obtained from anchovy (Engraulis ringens) was examined. Anchovy without head, skin, tail, and viscera, is treated in a two-stage enzymatic hydrolysis process by using the response surface method. In the first stage, the Corolase 8000 enzyme is assessed by optimizing the process (60.1°C, 93.4 minutes, and 1.68% enzyme), maximizing the degree of hydrolysis up to a value of 12.8%. In the second stage, the enzyme Corolase 7089 is applied, maximizing the degree of hydrolysis (14.8%) while minimizing bitterness (3.8) by conducting the process at 49.1°C, for 54.3 min, with 0.472% Corolase 7089 enzyme. Mathematical models obtained can be applied in the standardization of a process if the degree of hydrolysis and the level of bitterness that best suits a specific purpose are established.

Resumen: Se examinó el efecto de las variables temperatura, tiempo y cantidad de enzima sobre el grado de hidrólisis y el nivel de amargor de los hidrolizados obtenidos de anchoveta (Engraulis ringens). La anchoveta sin cabeza, piel, cola, ni vísceras, fue sometida a dos etapas de hidrólisis enzimática empleando el método de superficie de respuesta. Primero, se evaluó la enzima Corolasa 8000, el proceso fue optimizado (60.1°C, 93.4 min y 1.68 % de enzima), permitiendo maximizar el grado de hidrólisis hasta 12.8 %. Posteriormente, se empleó la enzima Corolasa 7089, se maximizó el grado de hidrólisis (14.8 %) y minimizó el nivel de amargor (3.8) al trabajar a 49.1°C, durante 54.3 min y utilizando 0.472 % de enzima. Los modelos matemáticos obtenidos pueden ser aplicados en la estandarización de un proceso si se establece el grado de hidrólisis y el nivel de amargor que más se adecúa a un propósito específico.

RESUMO: A mangabeira é uma espécie frutífera cujas populações naturais se encontram fragmentadas por ações antrópicas. Desse modo, são necessários estudos sobre a avaliação do impacto da fragmentação sobre a diversidade e estrutura genética dessas populações para o estabelecimento de estratégias de conservação adequadas. No presente estudo, foram utilizados dados de análises com marcadores microssatélites em simulações computacionais para estimar as taxas de migração e autofecundação de seis populações de mangaba. As populações estudadas estão localizadas nos estados nordestinos do Ceará, Pernambuco e Sergipe. Foram testadas diferentes taxas de autofecundação e migração, e selecionada a combinação que apresentou valores de heterozigosidade observada e esperada mais próximos dos obtidos com marcadores microssatélites. Com base nas simulações, a autofecundação foi de 0,3 e a taxa de migração variou de 0,5 a 0,6, valores que podem ter conduzido ao aumento da endogamia e deriva genética, resultando em baixa diversidade genética. Recomenda-se a expansão da área e a redução de perturbações para promover a ocorrência de polinizadores, que desempenham um papel importante no aumento da diversidade genética.

ABSTRACT: Mangaba tree is a fruit tree species whose natural populations are fragmented by anthropic actions. For this reason, studies assessing the impact of fragmentation on the diversity and genetic structure of these populations are required in order to establish suitable conservation strategies. In our study, we used data from analyzes through microsatellite markers in computer simulations to estimate the rates of migration and selfing of six mangaba populations. The studied populations are located in the northeastern states of Ceará, Pernambuco and Sergipe. We tested different selfing and migration rates and selected the combination that showed values of observed and expected heterozygosity closest to those previously obtained with microsatellite markers. According to our simulations, selfing and migration were moderate. This may have led to an increase in inbreeding and genetic drift, resulting in low genetic diversity. We recommend expanding the area and reducing disturbance to promote the occurrence of pollinators, which play an important role in increasing genetic diversity.

ABSTRACT Objective To describe and compare the clinical characteristics and outcomes of patients admitted to intensive care units during the first and second waves of the COVID-19 pandemic. Methods In this retrospective single-center cohort study, data were retrieved from the Epimed Monitor System; all adult patients admitted to the intensive care unit between March 4, 2020, and October 1, 2021, were included in the study. We compared the clinical characteristics and outcomes of patients admitted to the intensive care unit of a quaternary private hospital in São Paulo, Brazil, during the first (May 1, 2020, to August 31, 2020) and second (March 1, 2021, to June 30, 2021) waves of the COVID-19 pandemic. Results In total, 1,427 patients with COVID-19 were admitted to the intensive care unit during the first (421 patients) and second (1,006 patients) waves. Compared with the first wave group [median (IQR)], the second wave group was younger [57 (46-70) versus 67 (52-80) years; p<0.001], had a lower SAPS 3 Score [45 (42-52) versus 49 (43-57); p<0.001], lower SOFA Score on intensive care unit admission [3 (1-6) versus 4 (2-6); p=0.018], lower Charlson Comorbidity Index [0 (0-1) versus 1 (0-2); p<0.001], and were less frequently frail (10.4% versus 18.1%; p<0.001). The second wave group used more noninvasive ventilation (81.3% versus 53.4%; p<0.001) and high-flow nasal cannula (63.2% versus 23.0%; p<0.001) during their intensive care unit stay. The intensive care unit (11.3% versus 10.5%; p=0.696) and in-hospital mortality (12.3% versus 12.1%; p=0.998) rates did not differ between both waves. Conclusion In the first and second waves, patients with severe COVID-19 exhibited similar mortality rates and need for invasive organ support, despite the second wave group being younger and less severely ill at the time of intensive care unit admission.

Abstract The challenge of understanding the social and academic needs of deaf children in the educational context has been the subject of deep analysis in the literature, but the same does not happen in relation to deaf mothers and the performance of their role as responsible for the education of their children. Often, mothers who are deaf face communicational and attitudinal barriers, requiring adjustments in the family-school relationship, in order to guarantee them the fundamental right to participate in school decisions and in the school life of their students. This study aimed to explore the perspective of mothers who are deaf on their involvement in the school life of their hearing children, in order to identify areas of political action and practices for mobilizing facilitators of family-school relationships. For this, a focus group was held with 10 mothers who are deaf, whose children attended basic education – 1st and 2nd cycles – in Portuguese public schools. The results suggest that, despite the mothers’ willingness and commitment to get involved in their children’s school life, this participation is restricted by the way in which communication and the family-school relationship is traditionally structured. The perceived barriers are associated with the avoidance of situations of interaction with the school, in addition to the concern for the lack of knowledge of their children’s school life. The widespread existence of interpreters in schools or the training of the school community for the use of sign language are some of the changes discussed by mothers who are deaf in achieving their right to participate in the school life of their children.

Resumo O desafio de entender as necessidades sociais e acadêmicas de crianças surdas no contexto educativo tem sido alvo de profunda análise na literatura, mas o mesmo não acontece em relação às mães surdas e ao desempenho do papel de responsáveis pela educação dos seus filhos. Com frequência, as mães surdas enfrentam barreiras de natureza comunicacional e atitudinal, tornando necessárias adequações na relação família-escola, de modo a lhes garantir o direito fundamental de participar nas decisões da escola e da vida escolar dos seus educandos. Assim, com este estudo pretendeu-se explorar a perspectiva de mães surdas sobre o seu envolvimento na vida escolar dos seus filhos ouvintes procurando identificar linhas de ação política e do domínio das práticas que visem a mobilização de facilitadores da relação família-escola. Para isso, realizou-se um grupo focal com 10 mães surdas, cujos filhos frequentavam o ensino básico – 1.º e 2.º ciclos –, de escolas públicas portuguesas. Os resultados sugerem que, apesar da vontade e do empenho das mães surdas para se envolverem na vida escolar dos filhos, esta participação é restringida pela forma como a comunicação e a relação família-escola está tradicionalmente estruturada. As barreiras sentidas estão associadas ao evitamento de situações de interação com a escola, acrescido da preocupação pelo desconhecimento da vida escolar dos seus filhos. A existência generalizada de intérpretes nas escolas ou a formação/capacitação da comunidade escolar para o uso de língua gestual são algumas das mudanças discutidas pelas mães surdas na consecução do seu direito à participação na vida escolar dos seus filhos.

Abstract In the last 18 years, Colombia has seen a modest reduction in income inequality compared to other Latin American countries as measured by the Gini index. However, when the scale is reduced and cities are observed, remarkably diverse trajectories are evident: some cities have had a notable reduction, while others have stagnated. This article focuses on four Colombian cities with divergent trajectories in the evolution of inequality. Through an analysis of income distribution using data from the Continuous Household Survey (2002-2005) and the Extensive Integrated Household Survey - GEIH by its Spanish acronym (2008-2018), and following the decomposition methodology suggested by Azevedo et al. (2013), this article focuses on the role of income from pensions and transfers in the variation of the Gini. Administrative records are used to mark the proposed analyses more robust. The results highlight the differentiated role of transfers in reducing inequality and that of pensions in increasing it.

Resumen En los últimos 18 años, Colombia ha reducido modestamente la desigualdad de ingresos medida con el índice de Gini frente a otros países latinoamericanos. Pero cuando se observa el conjunto de sus ciudades saltan a la vista trayectorias diversas: unas la han reducido notablemente, mientras que en otras hay estancamiento. Este artículo se enfoca en 4 ciudades colombianas con trayectorias divergentes en la evolución de la desigualdad. A través de un análisis de la distribución del ingreso, a partir de datos de la Encuesta Continua de Hogares (2002-2005) y la Gran Encuesta Integrada de Hogares (2008-2018), este artículo se centra en el papel de los ingresos por pensiones y por ayudas en la variación del Gini, y utiliza registros administrativos para robustecer los análisis propuestos. Dentro de los resultados se destaca el diferenciado rol de las ayudas en la reducción de la desigualdad, y el de las pensiones en su aumento.

ABSTRACT This paper explores the Argentinean psychologists' perceptions about the objective and exclusive tasks of psychological intervention. In addition, those activities that can be shared with other professionals who are not psychologists are also investigated. This analysis aims to reveal whether psychologists share a clear position on this issue. The development of their field as a profession demands an introspective attitude towards current psychological practice. This will enable to establish precise guidelines and sustain the psychology professional identity. The research is based on the importance of building a strong identity that promotes the general public's trust in psychologists. To this end, a questionnaire with three open-ended questions was used, followed by a thematic categorical content analysis. The results show inconsistencies in the psychologists' answers to the three questions under study. In the end, the lack of consensus in defining an exclusive objective for psychological intervention is concluded.

RESUMEN Este artículo explora las percepciones de psicólogos argentinos sobre el objetivo y las tareas exclusivas de la intervención psicológica, sumado a las actividades compartidas con profesionales que no son psicólogos. El objetivo de este análisis es revelar si los psicólogos comparten una posición clara respecto a este tema. El desarrollo profesional de este campo demanda una actitud introspectiva hacia las actuales prácticas psicológicas, lo que permitirá establecer directrices precisas y sostener una identidad profesional de la Psicología. La investigación se justifica en la importancia de construir una identidad fuerte que promueva la confianza del público en general en los psicólogos. Con este fin, se utilizó un cuestionario con tres preguntas abiertas, seguido por un análisis temático de contenido. Los resultados evidencian respuestas variables por parte de los psicólogos ante las preguntas bajo estudio. Finalmente, se concluye que existe una falta de consenso en la definición de un objetivo exclusivo para la intervención psicológica.