Resumen El objetivo de este trabajo es describir y analizar la asociación entre PGI/PGII (indicador de atrofia gástrica con H. pylori-CagA y factores asociados a estilo de vida como ingesta calórica, obesidad y hábitos nocivos entre adultos mayores positivos por H. pylori en Costa Rica utilizando modelos de ecuaciones estructurales multigrupo (SEM). Con una muestra de 1748 adultos mayores del estudio CRELES, se utilizó un SEM para analizar las relaciones entre PGI/PGII, CagA, ingesta calórica, obesidad y hábitos nocivos difieren por sexo, edad y áreas de riesgo. Los SEMs propuestos exhibieron un buen ajuste en hombres (RMSEA = 0.039), mujeres (RMSEA = 0.000), área de bajo riesgo (RMSEA = 0.038), áreas de riesgo medio (RMSEA = 0.042), individuos menores de 80 años (RMSEA = 0.038) e individuos de 80 años o más (RMSEA = 0.042), mientras que hubo un ajuste aceptable en áreas de alto riesgo (RMSEA = 0.061). Los SEMs ajustados mostraron que CagA predice la relación PGI/II en la dirección esperada con efectos proporcionales al área de riesgo, pero no por sexo y edad. Todos los indicadores medibles de obesidad (IMC, brazos y cintura) mostraron coeficientes estandarizados significativos con efectos similares entre los grupos por sexo, edad y área de riesgo. No se encontraron otros efectos o diferencias significativas. Proponemos un modelo SEM bien ajustado para las posibles relaciones entre CagA y PGI/II y el nivel de riesgo del área geográfica en adultos mayores. No se encontraron diferencias en las variables analizadas entre hombres y mujeres ni entre los grupos de edad.

Abstract The aim of this work is to describe and analyze the association of PGI/PGII ratio (indicator of gastric atrophy) with H. pylori-CagA and life style factors such as caloric intake, obesity, and harmful habits amongst H. pylori-positive elderly people infected in Costa Rica using an exploratory multigroup structural equations model (SEM). Using a sample of 1748 H. pylori-positive elderly people from CRELES first wave study, a SEM was employed analyze if the relationships between PGI/PGII ratio with levels of H. pylori-CagA, caloric intake, obesity, and harmful habits, differs by sex, age and risk areas subgroups. The proposed SEMs exhibited a good fit in males (RMSEA = 0.039), females (RMSEA = 0.000), low-risk area (RMSEA = 0.038), middle-risk area (RMSEA = 0.042), individuals under 80 years (RMSEA = 0.038) and individuals aged 80 and over (RMSEA = 0.042), while an acceptable fit was observed for the high-risk area (RMSEA = 0.061). Fitted SEMs showed that CagA predicted PG-ratio as expected, with effects increasing with the risk area, but similar between sex and age groups. All indicators measuring obesity (BMI, arms, and waist) showed significant standardized coefficients, with similar effects between sex, age and risk area groups. No other significant effects or differences between groups were identified. We propose a good-fitted SEM model for the possible relationships between CagA and PG ratio and the geographical risk area level for elderly people. No differences were observed on measured parameters between male and female population, or between under 80 years and older individuals.

Abstract Aim: To document the recent experiences on the implementation of sampling and culturing Helicobacter pylori in Costa Rica, to compare it with other diagnostic methods: rapid urease test and histopathology and to describe the diagnoses associated with the obtained isolates. Methods: Descriptive research involving patients who visited the digestive endoscopy department of the Clínica Bíblica hospital in San José, Costa Rica between February and July of 2019 for gastroscopy. Gastric biopsies were obtained and histopathological analysis, rapid urease test, and bacteriological culture for Helicobacter pylori were performed. For culture techniques, the sample was transported in an in-house semi-solid medium. Biopsy fragments were macerated and plated on Skirrow agar and Helicobacterselective in-house agar, and incubated in microaerophilic atmosphere for 48 hours to 10 days. Culture positivity was determined by observation of the colonial morphology and microscopic observation; Gram staining and biochemical tests (urease, catalase, and oxidase) were used for bacterial identification. Results: 44 patients (mean aged 50.6 ± 10.0 years old, 54.5% male) were included in the study. Helicobacter pylori was recovered in biopsies from 27 patients (61.4% success rate). Bacterial growth was similar regardless the culture medium, but the physiological state of the bacteria was better in the Helicobacter-selective agar than in Skirrow. The weekly recovery rate increased to reach a 100% recovery plateau on week 11. Culture was compared with the rapid urease test in 27 patients, and the concordance between both methods using Cohen's kappa coefficient was 0.48. Whilst the culture detected Helicobacter pylori in 56% of the patients, and the rapid urease test in 37%, the combination of both allowed a 60% rate. The most frequent endoscopic diagnosis in patients with positive cultures were erythematous gastritis and chronic superficial gastritis, and the predominant histopathological diagnosis was chronic atrophic gastritis. Culture-based diagnosis was consistent with the histopathology detection of Helicobacter pylori in 80.4% of the cases. Conclusions: The implementation of H. pylori culture in Costa Rica is possible. This study had a 61.4% recovery rate. The combination of culture with rapid urease test and histopathology increases the probability of an accurate and timely diagnosis. We recommend that, based on previously described protocols such as ours, each laboratory adjusts the conditions to allow a good recovery rate and implement H. pylori diagnostic methods most suitable to their routine activities.

Resumen Objetivo: Determinar la viabilidad del cultivo de la bacteria Helicobacter pylori en Costa Rica por medio de la documentación de toma de muestras, la comparación del diagnóstico histopatológico y la descripción de los diagnósticos asociados a los aislamientos obtenidos con los resultados de la ureasa rápida. Métodos: Investigación descriptiva que involucró a pacientes de entre los 35 y 70 años, de ambos sexos, que asistieron al Servicio de Endoscopia Digestiva del Hospital Clínica Bíblica entre febrero y junio del 2019 para estudio gastroscópico. Se obtuvieron biopsias gástricas para diagnóstico histopatológico, prueba de ureasa rápida y cultivo de Helicobacter pylori. Para este último, se transportaron las biopsias en un medio de transporte semisólido, se maceró el tejido y se cultivó enagar Skirrow y agar selectivo para Helicobacter; una placa de cada medio se incubó a 37 °C en microaerofilia entre 48 horas y 10 días. La positividad del cultivo se realizó por observación de la morfología colonial y la bacteria se identificó por análisis microscópico al fresco, tinción de Gram y pruebas bioquímicas (catalasa, ureasa y oxidasa). Resultados: Se incluyó a 44 pacientes (edad: 50.6 ± 10.0, 54.5% masculinos). Se recuperó Helicobacter pylori en biopsias de 27 pacientes (61.4% de éxito). La recuperación de la bacteria fue similar en el medio Skirrow y en el selectivo para Helicobacter. El porcentaje de éxito de recuperación semanal aumentó durante el estudio hasta alcanzar un éxito del 100% en la semana 11. Se comparó el cultivo con la ureasa rápida en 27 pacientes y la concordancia entre ambos métodos fue de un coeficiente kappa de Cohen de 0.48. El cultivo detectó la bacteria en un 56% de los pacientes, la ureasa rápida en un 37% y la combinación de ambas técnicas permitió la detección en un 60%. El diagnóstico endoscópico más frecuente en los pacientes con cultivo positivo fue la gastritis eritematosa y gastritis crónica superficial y el diagnóstico histopatológico predominante fue gastritis crónica con atrofia gástrica. El diagnóstico por cultivo coincidió con la detección por azul de toluidina en un 80.4% de los casos. Conclusiones: Se puede implementar el cultivo de Helicobacter pylori en Costa Rica. Este estudio tuvo un porcentaje de recuperación de la bacteria de 61.4%. La combinación del método de cultivo con la prueba de ureasa rápida y la detección histológica contribuye a un diagnóstico certero y oportuno. Recomendamos que, con base en protocolos descritos en esta investigación, cada laboratorio estandarice las condiciones que le permitan un buen porcentaje de recuperación y una implementación adaptada a sus actividades de rutina.

Abstract Introduction Interpersonal negotiation skills (INS) comprise actions used to solve social situations between interacting individuals involving different needs or desires. These abilities are part of one’s social competence and may be impaired in some psychiatric conditions. There are few validated psychometric tools for measuring INS in the literature. This pilot study aimed to investigate some basic psychometric properties of the Brazilian version of the Interpersonal Negotiation Strategies Interview (INSI) in children and adolescents. Methods We developed a new version of the INSI adapted to the Brazilian culture using eight different dilemmas in dyadic situations (with peers and adults), presented visually as drawings on cards. A group of psychologists and psychiatrists chose and adapted the dilemmas formerly proposed by the original version. The same scoring criteria as for the original instrument were used. A total of 20 children and adolescents were included in this pilot study. We investigated test reliability using measures of interrater reliability, test-retest, and internal consistency. The content validity of the INSI was also evaluated by comparison with scores from the Child Behavior Checklist-Revised (CBCL). Results Internal consistency and test-retest evaluations were acceptable (rater 1: α = 0.77; rater 2: α = 0.72); the reliability of the instrument was excellent (K = 0.078; intraclass correlation coefficient = 0.98; 95% confidence interval 0.97-0.99); and content validity was strongly significant (p < 0.001). Conclusions Preliminary results suggest that this version of the INSI has good interrater reliability and internal consistency and constitutes a promising tool to assess social competence.

Abstract Purpose: To evaluate the quality of referrals for a first Rheumatology consultation at a tertiary care center in a southern Brazilian capital (Porto Alegre, RS), having as background findings from a similar survey performed in 2007/2008. Since then, our state has implemented referral protocols and a triage system with teleconsulting support exclusively for referrals from locations outside the capital, permitting a comparison between patients screened and not screened by the new system. Methods: Physicians of the Rheumatology Service at Hospital Nossa Senhora da Conceição prospectively collected information regarding first visits over a 6-month period (Oct 2017 to March 2018). We recorded demographic characteristics, diagnostic hypotheses, date of referral, and the municipality of origin (within the state of Rio Grande do Sul). We considered adequate referrals from primary health care when a systemic autoimmune inflammatory disease (SIRD) was suspected at first evaluation by the attending rheumatologist. Results: Three hundred fifty-seven patients/appointments were eligible for analysis (193 from the capital and 164 from small and medium towns). In 2007/2008, suspected SIRD occurred in 76/260 (29.2%) and 73/222 (32.9%) among patients from the capital and outside counties, respectively (P = 0.387). In 2017/2018, suspected SIRD occurred in 75/193 (38.9%) and 111/164 (67.7%) in patients from the capital and outside counties, respectively (difference: 28.8, 95% CI: 19.0 to 38.9, P < 0.001), indicating a marked improvement in referrals submitted to the new triage system. Conclusion: The quality of Rheumatology referrals in our state improved over the 10-year interval under study, particularly among patients from locations submitted to referral protocols and teleconsulting support.

Abstract Nowadays, it is widely accepted that experience can modify multiple aspects of the functioning and structure of the brain; however, there is still a long way to go to understand the mechanisms behind these modifications. In order to understand the relationship between experience and brain plasticity, models and paradigms have been adapted from cognitive neurosciences; one of them has been music training. In the last decades, this paradigm has strengthened because it allows us to understand the structural and functional modifications produced by training. It has been demonstrated that musicians compared to non-musicians present larger sizes of specific brain regions, in particular, the prefrontal cortex, which is associated with a better performance in executive functions tasks. In addition, long-term neurophysiological changes have been identified in people who play an instrument. A relationship between playing an instrument and better performance in executive functions has been identified. However, the evidence of this effect is contradictory. Executive functions are a series of general control processes that help regulate thinking and behavior. Some research indicates that learning an instrument is associated with better performance in working memory, but not regarding tasks related to inhibitory control and cognitive flexibility. However, other studies have revealed significant differences between musicians and non-musicians, both in working memory and tasks of cognitive flexibility as well as in inhibitory control. It is possible that the contradictory results are due to the methodological diversity through which this topic has been addressed, since some studies have carried out experimental and quasi-experimental designs, and others have developed correlational approaches. In addition, different theoretical models have been used to evaluate executive functions. For this study, we work with the theoretical model of Miyake et al. (2000), which is a solid theoretical-empirical proposal about three clearly differentiable executive functions: inhibitory control, cognitive flexibility, and working memory. A meta-analysis was performed with the purpose of identifying the effect of playing an instrument on executive functions as well as identifying the moderator variables. By doing this, we wanted to clarify the problem in question and the controversial results; therefore, empirical studies comparing musicians against non-musicians were included. The comparison group should not have been exposed to musical training, the participants should not present motor or cognitive disabilities, and finally, studies should report means and standard deviations for the scores on executive functions tasks. We included papers published between January 2000 and July 2017. The moderator variables studied were: age in months at the time of evaluation, age at which training began, and total years of training. The coding strategy allowed us to identify a total of 42 294 articles. The titles and abstracts were analyzed and those that did not meet the inclusion criteria were eliminated. This procedure allowed the detection of 24 articles for future analysis, and 12 out of them were finally selected. These 12 articles contributed to 60 effect sizes and 513 participants. The results showed that musicians have a better performance in executive functions tasks when they are compared to non-musicians, d = .712, n = 60, IC95% = (.57; .85), p < .0001. Additionally, the analysis of moderating variables revealed that the practice of an instrument equally benefits all executive functions, and the most important benefit occurs in older adults and children. Results support the hypothesis that the high level of difficulty involved with learning to play an instrument can influence a better performance in executive functions tasks. Our study points out the need of designing research that allows the scientific community to investigate the effect of prolonged musical training over time.

Resumen Se ha sugerido que la práctica profesional de un instrumento musical esta relacionada con mejores puntajes en tareas de funciones ejecutivas. Con el fin de examinar sistemáticamente esta hipótesis se realizó un metaanálisis para identificar el efecto de la interpretación de un instrumento en las funciones ejecutivas, así como las variables que podrían moderar dicho efecto. El metaanálisis incluyó estudios empíricos que: (1) compararon los puntajes en medidas de funciones ejecutivas entre músicos y no músicos; (2) reportaron las medias y desviaciones estándar; (3) el grupo de comparación no recibió entrenamiento musical; y (4) los participantes no presentaron discapacidad motora o cognitiva. Se identificó que los músicos, en comparación con los no músicos, muestran mejores puntajes en tareas de funciones ejecutivas (d = .712). Los resultados apoyan la hipótesis de que la práctica de un instrumento musical está relacionada con mejores puntuaciones en tareas de funciones ejecutivas.

RESUMEN En los últimos años, las estrategias de operación y control en los sistemas de distribución han cambiado debido al aumento en la conexión de las fuentes de generación distribuidas (DGs). Las pequeñas redes locales con usuarios de electricidad y DGs se conocen como microrredes. Estas microrredes pueden funcionar de forma independiente (aislada) o en colaboración (interconectadas) con la red principal u otras microrredes. Algunas ventajas de las microrredes interconectadas incluyen la reducción de pérdidas, aumento en la confiabilidad y la operación descentralizada bajo condiciones de falla. No obstante, cuando una microrred opera en modo aislado, sus características eléctricas cambian y, en consecuencia, la gravedad de las perturbaciones de calidad de potencia podrían aumentar, así como su impacto negativo en dispositivos electrónicos (cargas y dispositivos DG). Este artículo presenta una revisión literaria exhaustiva de los estudios existentes sobre perturbaciones de calidad de potencia en microrredes aisladas e identifica las necesidades más relevantes de investigación futura sobre este tema. Se analiza información detallada para comparar las diferencias entre los niveles de perturbaciones en microrredes interconectadas y aisladas. En el caso de perturbaciones causadas por armónicos, se analiza también el impacto de las diferentes configuraciones de microrredes.

ABSTRACT In recent years, operation and control strategies in distribution systems have changed due to the increase in the connection of distributed generation sources (DGs). Small local networks with electricity users and DGs are known as microgrids. These microgrids can operate independently (islanded) or in collaboration (interconnected) with the main network or other microgrids. Some advantages of interconnected microgrids include the reduction of losses, an increase in reliability, and decentralized operation under fault conditions. Nevertheless, when a microgrid operates in islanded mode, its electrical characteristics change and, consequently, the severity of power quality disturbances can increase, as well as their negative impact on electronic devices (loads and DG devices). This paper presents a comprehensive literature review of existing studies on power quality disturbances in islanded microgrids and identifies the most relevant needs for future research on this topic. Detailed information is analyzed to compare the differences between disturbance levels in both interconnected and islanded microgrids. In the case of harmonic disturbances, the impact of the different microgrid configurations is also analyzed.

Resumo Objetivos: Avaliar a presença de síndrome das pernas inquietas, movimento periódico das pernas e distúrbios do sono em adolescentes do sexo feminino com dor musculoesquelética idiopática por meio da escala do sono e da polissonografia e comparar esses dados em adolescentes sem histórico de dor. Método: Foram recrutados 26 adolescentes diagnosticados com dor musculoesquelética idiopática acompanhados em um ambulatório de dor e 25 controles saudáveis pareados por idade e escolaridade. Avaliamos os critérios da síndrome das pernas inquietas de acordo com o Grupo Internacional de Estudos de Síndrome das Pernas Inquietas, a Escala de Distúrbios do Sono em Crianças, a polissonografia noturna e os sintomas de ansiedade. Resultados: A idade média dos adolescentes com dor musculoesquelética idiopática foi 13,9 ± 1,6 anos e dos controles foi 14,4 ± 1,4 anos. Um adolescente no grupo de controle (4%) e nove pacientes com dor musculoesquelética idiopática (34,6%) atenderam aos critérios da síndrome das pernas inquietas (p = 0,011). Não observamos diferenças significativas nos escores da Escala de Distúrbios do Sono em Crianças entre os grupos em todos os componentes: distúrbios do início e da manutenção do sono (p = 0,290), distúrbios respiratórios do sono (p = 0,576), distúrbios do despertar (p = 0,162), distúrbios da transição sono-vigília (p = 0,258), sonolência diurna excessiva (p = 0,594) e hiperidrose do sono (p = 0,797). Os parâmetros neurofisiológicos, respiratórios e o movimento periódico das pernas foram semelhantes nos dois grupos. Ansiedade não foi associada à síndrome das pernas inquietas (p = 0,11). Três pacientes com dor musculoesquelética idiopática (11,5%) apresentaram síndrome das pernas inquietas e movimento periódico das pernas simultaneamente, situação ausente no grupo de controle. Conclusão: As adolescentes do sexo feminino com dor musculoesquelética idiopática apresentaram critérios para síndrome das pernas inquietas com mais frequência do que as adolescentes saudáveis. Contudo, não observamos mudanças relevantes nas variáveis do sono objetivas e subjetivas.

Abstract Objectives: To assess the presence of restless legs syndrome, periodic leg movement, and sleep disorders in female adolescents with idiopathic musculoskeletal pain through a sleep scale and polysomnography, and to compare these data in adolescents without pain history. Method: Twenty-six adolescents diagnosed with idiopathic musculoskeletal pain followed in a pain outpatient clinic and 25 healthy controls matched by age and education were recruited. The restless legs syndrome criteria were evaluated according to the International Restless Legs Syndrome Study Group, the Sleep Disturbance Scale for Children was completed, nocturnal polysomnography was performed, and anxiety symptoms were recorded. Results: The mean age of idiopathic musculoskeletal pain adolescents was 13.9 ± 1.6 years; in controls, it was 14.4 ± 1.4 years. One adolescent in the control group (4 %) and nine patients with idiopathic musculoskeletal pain (34.6 %) fulfilled the restless legs syndrome criteria (p = 0.011). The authors did not observe significant differences in Sleep Disturbance Scale for Children scores between the groups in all components: disorders of initiating and maintaining sleep (p = 0.290), sleep breathing disorders (p = 0.576), disorders of arousal (p = 0.162), sleep-wake transition disorders (p = 0.258), disorder of excessive daytime somnolence (p = 0.594), and sleep hyperhidrosis (p = 0.797). The neurophysiological, respiratory, and periodic leg movement parameters were similar in both groups. Having anxiety was not associated with restless legs syndrome (p = 0.11). Three patients with idiopathic musculoskeletal pain (11.5 %) presented restless legs syndrome and periodic leg movement simultaneously, which was absent in the control group. Conclusion: Female adolescents with idiopathic musculoskeletal pain present criteria for RLS more frequently than healthy adolescents. However, this study did not observe relevant changes in objective and subject sleep variables.

Abstract Introduction: COVID-19 has paused elective procedures and delayed the diagnosis of multiple pathologies. Different proposals have been recommended for restarting elective procedures, including screening tests and a gradual restart. Objective: To know the perception of Latin American endoscopists regarding the restart of elective procedures, and how the availability of personal protection equipment (PPE) and prior testing may influence this perception. Methods: A web-based survey was developed by endoscopy experts, based in the development of endoscopy, availability of PPE and screening tests, which was distributed via e-mail, social media and direct contact by one author to several societies. Full response was obtained from 168 endoscopists during May 2020. Results: 88% of surveyed endoscopists don’t screen for COVID-19 prior to endoscopy, however, 70% consider this appropriate. 80% affirm having PPE. 94% believe that endoscopic practice must be restarted as soon as possible. Conclusions: Latin American endoscopists with greater amount of PPE and prior testing for SARS-CoV-2 were more willing to restart elective procedures than those in limited scenarios.

Resumen Introducción: COVID-19 ha generado una pausa en la endoscopia electiva, retrasando el diagnóstico de múltiples patologías. Existen varias propuestas para reiniciar las actividades que incluyen el tamizaje por COVID-19 y un reinicio escalonado. Objetivo: Conocer la percepción general de los endoscopistas respecto al reinicio de procedimientos electivos, y la influencia que genera la disponibilidad de equipo de protección personal (EPP) y tamizaje. Metodología: Se encuestan endoscopistas expertos con preguntas enfocadas a la endoscopia durante la pandemia, así como de disponibilidad de EPP y del uso de pruebas de tamizaje de SARS-CoV-2. La encuesta fue distribuida vía e-mail, mensajería instantánea y por contacto directo a distintas sociedades de endoscopia, obteniendo respuesta completa de 168 médicos. Resultados: 88% de los encuestados no practican tamizaje por COVID-19 sin embargo un 70% considera apropiada esta práctica. El 80% afirma contar con EPP adecuado. El 94% de los médicos afirma que deben reiniciarse los procedimientos lo antes posible. Conclusiones: Los endoscopistas latinoamericanos con mayor disponibilidad de EPP, así como la implementación de tamizaje de SARS-CoV-2, presentaron mayor disposición a reiniciar las endoscopias electivas.

Resumen Hicimos un inventario de las mariposas presentes en ocho áreas verdes de importancia socio-ambiental para la ciudad de Bogotá (Colombia)y su región. Se encontraron 45 especies pertenecientes a cuatro familias, Nymphalidae, Pieridae, Lycaenidae y Hesperiidae. La mayor riqueza en el continuo ciudad-región la aportó la familia Nymphalidae, con 23 especies, de las cuales la mayoría son pronophilinos propios de los ecosistemas de alta montaña. Las especies Colias dimera, Dione glycera y Vanessa virginiensis (fueron las mariposas con más amplia distribución. Se plantea que la urbanización como factor modelador del paisaje urbano-regional está afectando la riqueza y distribución de mariposas de Bogotá-Región.

Abstract We carried out an inventory of the butterflies occurring in eight green areas of socio-environmental importance for the city of Bogotá and its region (Cundinamarca, Colombia). We found 45 species belonging to four families, Nymphalidae, Pieridae, Lycaenidae and Hesperiidae. The greatest richness was provided by the Nymphalidae family with 23 species, most of which are pronophilines, typical of high mountain ecosystems. Colias dimera, Dione glycera and Vanessa virginiensis were the more widely distributed species. It is argued that urbanization, as a modeling factor of the urban-regional landscape, is affecting the diversity and distribution of butterflies of Bogotá-Region.

Os métodos utilizados para avaliar a transparência nas administrações locais apresentam notórias diferenças que são influenciadas por fatores como a legislação nacional e as características administrativas. Por conseguinte, é difícil estabelecer um procedimento internacional que se mostre válido para a obtenção de uma imagem global. Conduzimos uma análise comparativa dos procedimentos desenvolvidos pela Transparência e Integridade em Portugal, com aqueles desenvolvidos em Espanha pelo Laboratório de Jornalismo e Comunicação para a Cidadania Plural. Os resultados revelam que as abordagens de diversas matérias, exibem diferenças simultaneamente notáveis e complementares. Nas conclusões, propomos a introdução de novos elementos com o intuito de desenvolver um método baseado numa sintaxe da transparência e na ordem de elementos fundamentais.

The methods used to evaluate the transparency of local administrations present notable differences that are influenced by national legislation and administrative characteristics. Consequently, it is difficult to formulate a valid international procedure to obtain a global picture. We have conducted a comparative analysis of the procedure developed by Transparency and Integrity in Portugal with that designed by the Laboratory of Journalism and Communication for Plural Citizenry in Spain. The results reveal that the approaches, maintained in various disciplines, exhibit notable but complementary differences. In the conclusions we propose new elements to design a method based on a syntax of transparency and order of fundamental elements.

Abstract INTRODUCTION: The prevalence of hepatitis C virus (HCV) infection is affected by demographic, virological, clinical, and lifestyle-related factors and varies in different regions in Brazil or worldwide. The present study aimed to clarify the epidemiological patterns of HCV infection in the interior region of Brazil. METHODS: This study was conducted in the Southern Triangle Macro-region of the state of Minas Gerais, Brazil, according to the guidelines of the National Program for the Prevention and Control of Viral Hepatitis. The participants answered a structured questionnaire on social and epidemiological factors. Immunochromatographic rapid tests were used for the qualitative detection of antibodies against HCV in whole blood (Alere HCV® Code 02FK10) in adult subjects by a free-standing method. RESULTS: Of 24,085 tested individuals, 184 (0.76%) were anti-HCV positive. The majority of anti-HCV-positive individuals were born between 1951 and 1980 (n=146 [79.3%]), with 68 women and 116 men. Identified risk factors included syringe and/or needle sharing (p = 0.003), being in prison (p = 0.004), and having tattoos or piercings (p = 0.005) and were significantly associated with the decade of birth. CONCLUSIONS: The study shows the importance of testing populations at risk for HCV infection, including incarcerated individuals, those with tattoos or piercings, those who share or have shared syringes or needles, and those in high-risk birth cohorts (1950s, 1960s, and 1970s) in the Southern Triangle Macro-region.

Abstract Background: Osteoporosis is a major healthcare concern in Latin America. Factors such as changing demographics, fragmented healthcare systems, and financial considerations may result in a huge increase in the burden of osteoporosis in this region. The aim of this article is to describe the baseline clinical characteristics and fracture history of patients who are prescribed teriparatide in normal clinical practice in Latin America. Methods: We conducted a prospective, multinational, observational study (the Asia and Latin America Fracture Observational Study [ALAFOS]) in 20 countries worldwide to assess the incidence of fractures in postmenopausal women with osteoporosis receiving teriparatide as a part of routine clinical practice in a real-world setting. In this subregional analysis of the ALAFOS study, we report the clinical characteristics, fracture history, risk factors for osteoporosis, comorbidities, previous osteoporosis therapies and health-related quality of life measures at baseline for patients from the four participant Latin American countries: Argentina, Brazil, Colombia, and Mexico. Results: The Latin America subregional cohort included 546 postmenopausal women (mean [SD] age: 71.0 [10.1] years; range: 40-94 years), constituting 18% of the ALAFOS total population. The baseline mean (SD) bone mineral density T-scores were - 3.02 (1.23) at the lumbar spine and - 2.31 (0.96) at the femoral neck; 62.8% of patients had a history of low trauma fracture after the age of 40 years and 39.7% of patients had experienced ≥1 fall in the past year. Osteoporosis medications were used by 70.9% of patients before initiating teriparatide. The median (Q1, Q3) EQ-5D-5 L Visual Analog Scale (VAS) scores for perceived health status at baseline was 70 (50, 80). The mean (SD) worst back pain numeric rating scale score for the overall Latin American cohort was 4.3 (3.4) at baseline. Conclusions: This baseline analysis of the Latin America subregion of the ALAFOS study indicates that patients who are prescribed teriparatide in the four participant countries had severe osteoporosis and high prevalence of fractures. They also had back pain and poor health-related quality of life. The proportions of patients with severe or extreme problems on the EQ-5D-5 L individual domains were lower than those in the overall ALAFOS study population.

Abstract: Purpose: To characterize risk factors of dysphonia in the occupa tional context and vocal abuse and misuse in teachers. Methods: Cross-sectional, descriptive study in which 70 teachers of municipal basic education from the city of Iquique, Chile, were interviewed to detect Occupational and Personal Factors affecting the Phonatory System. The results were analyzed with the SPSS program version 19.0 through descriptive statistics. Results: 80% of teachers surveyed have not received any type of vocal training. The most frequent abuse and vocal misuse behaviors are: increase the intensity of the voice (72.8), shout (57.1%) clearing the throat (41.1%) and low water consumption (75%). In the occupational context, it was found that 82% used their voice more than 6 hours a day, 75% indicated having between 35-41 students per class, 90% working in classrooms built with reverberant material and 58.5% works under constant air cur rents. Conclusions: This study shows the lack of training that teach ers have about the proper use of their voice. There are multiple personal and labor-environmental factors that affect the presence of occupational dysphonia.

Resumen: Objetivos: Caracterizar los factores de riesgo de disfonía en el contexto ocupacional y las conductas de abuso y mal uso vocal en profesores. Metodología: Estudio descriptivo, transversal, en el que se participaron 70 profesores de educación básica municipal de la ciudad de Iquique, Chile, a quienes se les aplicó una encuesta para detectar Factores Ocupacionales y Personales que afectan al Sistema Fonatorio. Los resul tados se analizaron con el programa SPSS versión 19.0 mediante esta dística descriptiva. Resultados: el 80% de los docentes encuestados no ha recibido ningún tipo de entrenamiento vocal. Las conductas de abuso y mal uso vocal más frecuentes son: aumentar la intensidad de la voz (72,8), gritar (57,1%), carraspear (41,1%) y bajo consumo de agua (75%). En el contexto ocupacional se encontró que el 82% utiliza su voz más de 6 horas diarias, el 75% indicó tener entre 35-41 alumnos por clase, el 90% trabaja en salas de clases construidas con material rever berante y el 58,5% trabaja bajo constantes corrientes de aire. Conclusiones: Este estudio da cuenta de la falta de capacitación que poseen los docentes acerca del uso adecuado de su voz. Se presentan múltiples factores personales y laborales-ambientales que repercuten en la presencia de disfonía ocupacional.

Resumen El consumo de quesos frescos está asociado a enfermedades trasmitidas por alimentos (ETA's), y representa riesgos en la transmisión de agentes patógenos, al ser foco de posibles enfermedades para el consumidor. Se recolectaron muestras de queso fresco tipo cuajada provenientes de diferentes municipios del departamento del Quindío, y una muestra de Queso industrial. De cada municipio, se tomaron muestras por triplicado del mismo lote, para un total de 18 muestras, a las cuales se le realizó un análisis microbiológico para identificar Coliformes totales, E. Coli, Staphylococcus Aureus, salmonella y mohos y levaduras. Se encontraron recuentos de coliformes totales y Staphylococcus Aureus, entre 7,417 ± 0.74 Log10 UFC/g y 6.450 ±0.43 Log10 UFC/g respectivamente, siendo estos los más elevados. También, se confirmó presencia de E. Coli en todas las muestras analizadas. Por otra parte, el mayor valor en el recuento de mohos fue de 7.26 ± 0.81 Log10 UFC/g. De todas las muestras analizadas sólo en uno de los municipios se confirmó la presencia en salmonela mediante confirmación bioquímica. Los resultados evidenciaron deficiencias sanitarias en los quesos analizados, y representando esto un riesgo para la salud del consumidor.

Abstract The consume of fresh cheeses is associated with foodborne diseases, representing risks in the transmission of pathogens, being the focus of possible diseases for the consumer. Samples of curd-type fresh cheese from different municipalities of the department of Quindío and a sample of industrial cheese were collected. From each municipality, samples were taken in triplicate from the same lot, for a total of 18 samples, to which a microbiological analysis was carried out to identify total Coliforms, E. Coli, Staphylococcus Aureus, salmonella and molds and yeasts. Coliforms and Staphylococcus Aureus were found between 7,417 ± 0.74 Log10 CFU / g and 6,450 ± 0.43 Log10 CFU / g respectively, these being the highest. Also, presence of E. Coli was confirmed in all samples analyzed. Was confirmed the presence of salmonella with biochemistry test in samples of a municipality. The results showed sanitary deficiencies, representing a risk to the health of the consumer.

Resumo O consumo de quejos frescos está associado a doenças transmitidas por alimentos (ETA) que representam riscos na transmissão de agentes patogênicos, sendo o foco de possíveis doenças para o consumidor. Foram coletadas amostras de queijo fresco de tipo coalho de diferentes municípios do departamento de Quindío e uma amostra de queijo industrial. De cada município, as amostras foram retiradas em triplicado do mesmo lote, para um total de 18 amostras, às quais foi realizada uma análise microbiológica para identificar coliformes totais, E. Coli, Staphylococcus Aureus, salmonelas e fungos e leveduras. As contagens de coliformes totais e Staphylococcus Aureus foram de 7,417 ± 0,74 log10 CFU / g e 6,450 ± 0,43 Log10 CFU / g, respectivamente, sendo o mais alto. Além disso, a presença de E. Coli foi confirmada em todas as amostras analisadas. Por outro lado, o maior valor na contagem de moldes foi de 7,26 ± 0,81 Log10 CFU / g. De todas as amostras analisadas em apenas um dos municípios, a presença em salmonella foi confirmada por confirmação bioquímica. Os resultados mostraram deficiências sanitárias nos queijos analisados, representando um risco para a saúde do consumidor.

Education and creativity are tools of liberation of the human being in the formation of autonomous and valuable people, and in the development of nations in all spheres. Creative stimulation could decrease in universities; it is considered necessary to investigate what attitudes, conceptions and experiences exist among teachers fundamental actors of education around the development of their creativity to motivate the student towards learning. The search for a balance between the creativity of the teacher and the formation of positive affective experiences towards the learning of the students during the teaching-learning process, is necessary of diverse elements, among them: the power of preparation of students and educators within the process, understanding between both and the need for communication. In this sense, this research aims to contribute to foster the creativity of the teacher for the creation of positive affective experiences towards learning through a strategy that contributes to eradicate such an existing problem in the Industrial Engineering career of the University Technological Indoamericana.

La educación y creatividad son herramientas de liberación del ser humano en la formación de personas autónomas y valiosas, y en el desarrollo de las naciones en todo ámbito. La estimulación creativa podría decrecer en las Universidades; se estima necesaria una investigación en donde se indague qué actitudes, concepciones y experiencias existen entre los profesores actores fundamentales de la educación en torno al desarrollo de su creatividad para motivar al estudiante hacia el aprendizaje. La búsqueda de un equilibrio entre la creatividad del docente y la formación de vivencias afectivas positivas hacia el aprendizaje de los estudiantes durante el proceso de enseñanza aprendizaje, se ve necesitada de diversos elementos, entre ellos: el poder de preparación de educandos y educadores dentro del proceso, la comprensión entre ambos y la necesidad de comunicación. En tal sentido esta investigación pretende contribuir a fomentar la creatividad del docente para la creación de vivencias afectivas positivas hacia el aprendizaje a través de una estrategia que contribuya a erradicar tal problemática existente en la carrera de Ingeniería Industrial de la Universidad Tecnológica Indoamericana.