Journal articles on the topic 'Chile. Ley no. 20.021'

En este artículo presentamos un estudio comparado e iushistórico del matrimonio civil en Colombia, destacando los principales requisitos y los procedimientos establecidos en las constituciones de 1853, 1863 y la carta política de 1886, en relación a las normas que consagran el matrimonio civil (Ley 20 de julio de 1853), el Código Civil de 1873 (Ley 84) y el Civil de 1887 (Ley 57 ); identificamos además los “trasplantes legales” (o transferencias normativas) del Código Civil de la República de Chile (Andrés Bello, 1857).

Desde los albores de la humanidad, la actividad cinegética ha sido proveedora de sustentos alimenticios básicos. En la actualidad, la caza ha perdido esta centralidad, considerándose como una alternativa productiva y de ocio más para las comunidades rurales. En Chile, así como en otros países, esta actividad se ha legislado y reglamentado en las últimas décadas. De este modo, la vigente ley N°19.473 de 1996 y su reglamento (Decreto Supremo N°5 de 1998) son el marco básico que rige la caza en Chile. Pasados más de 20 años desde su entrada en vigor, y en atención a la laguna científica y académica imperante sobre el particular en el país, planteamos este trabajo con el objetivo de analizar la normativa y organismos chilenos implicados en el rubro, así como también las asociaciones y sus formas de organizarse y practicar la actividad cinegética. Finalmente, se descubre que en Chile la actividad cinegética es muy minoritaria. Además, persiste una visión tradicional y poco productiva, en la que el asociacionismo y el número de cotos de caza es reducido.

El enfoque de la discapacidad constituye actualmente una perspectiva que pretende hacerse cargo de la incorporación de la dimensión social en la comprensión de la salud mental, y su hegemonía en Chile es visible en el diseño de las legislaciones y políticas públicas sobre salud mental durante los últimos 20 años. Sin embargo, tanto este enfoque de la salud mental como las respectivas legislaciones y políticas desarrolladas, presentan importantes dificultades para hacerse cargo de la situación de justicia y ciudadanía de este grupo de personas. Estas dificultades del enfoque se hacen particularmente evidentes cuando se requiere garantizar el ejercicio de una ciudadanía activa, ya que los aspectos relativos a la ciudadanía han demostrado tener un efecto terapéutico sobre las deficiencias o trastornos mentales. La urgente necesidad de una ley de salud mental para Chile demanda el desafío de diseñar una legislación que se haga cargo de las particularidades de la discapacidad mental, pero además la posibilidad histórica de incluir efectivamente la perspectiva de las personas con discapacidad mental y sus familias en la discusión de una nueva ley.

El establecimiento de espacios de participación es un desafío abierto para gran parte de los Estados latinoamericanos. Su óptimo funcionamiento dependería de factores adicionales a la gestión institucional. Este artículo indaga cómo los Consejos Comunales de Organizaciones de la Sociedad Civil (COSOC) responden a requerimientos de gobernanza y deliberación democrática, que articulados con elementos de capital social y cultural, son componentes fundamentales del ejercicio de participación ciudadana. Para explorar este planteamiento, se tomó el caso del Consejo de la Sociedad Civil (COSOC), Chile. Los datos surgen del proyecto para la instalación del cosoc (Ley 20 500), ejecutado en la región del Biobío, Chile, en 2017. La metodología es mixta, predominantemente cualitativa, basada en el análisis de talleres participativos con apoyo de datos descriptivos tomados de las encuestas. Los principales resultados apuntan a la operatividad y eficacia de la participación y al valor que esta adquiere a partir de las condiciones del contexto y demanda social, es decir, cuestiones como la información disponible, el nivel de asociatividad, la formación cívica, las asimetrías de poder, entre otras. Las anteriores, variables vinculadas a la estructura y condiciones de los espacios promovidos y a la calidad de los procesos democráticos en la región.

El 20 de abril de 2009 entró en vigencia en Chile la Ley de Transparencia, que asegura a los ciudadanos el acceso a la información pública. Si bien el balance de este régimen es positivo, importa analizar los núcleos de conflictos que se generan cuando se deben conciliar derechos e intereses jurídicos tutelados por el ordenamiento jurídico chileno, como la protección de la vida privada y datos personales. El artículo analiza la situación de la protección de datos personales en el ordenamiento jurídico chileno. Por una parte, argumenta que el derecho a la protección de los datos personales traspasa la clásica división del ámbito de lo público y lo privado, pues en ambos campos es necesario cautelarlo. Por otro lado, el trabajo busca aportar al debate para la construcción de estándares de actuación para los organismos públicos que permitan compatibilizar la transparencia con la protección de datos personales.

Existen al menos dos Convenios Internacionales asociados a la Justicia de Familia que han sido suscritos y ratificados por Chile, por tanto, ley de la República, que operan desde hace años en una aparente opacidad. La complejización del sistema social ha obligado a la visibilización de dichos Convenios, especialmente ante fenómenos tales como los movimientos migratorios y la constitución de familias con características de transnacionalidad. La ejecución en Chile del “Convenio de Nueva York de 1956 para la Obtención de Alimentos en el Extranjero” y el “Convenio de La Haya de 1980 sobre los Aspectos Civiles de la Sustracción de Niños, Niñas y Adolescentes”, tras los fenómenos enunciados, han permitido la observación de algunas prácticas asociadas a los géneros, las edades y la paternidad/maternidad, distinciones que intentaremos develar en el presente artículo.Palabras clave: Convenios Internacionales, Familias Transnacionales, Migraciones. Aplicação de Convênios Internacionais em matéria de Família e seu envolvimento com fenômenos contemporâneosRESUMOHá pelo menos dois Acordos Internacionais relacionados com a Justiça de Família que tem sido assinados e ratificados pelo Chile, portanto, lei da República, que operam há anos numa opacidade aparente. A complexidade do sistema social tem forçado a visibilidade de ditos Convênios, especialmente a fenômenos como a migração e a constituição de famílias com caraterísticasda transnacionalidade. A execução no Chile do “Convênio de Nova Iorquede 1956 para a obtenção de alimentos no Exterior” e “a Convenção da Hayade 1980 sobre os Aspectos Civis do Rapto de Crianças e Adolescentes”, apósdos fenômenos enunciados, têm permitido a observação de algumas práticasassociadas aos gêneros, as idades e a paternidade / maternidade, distinçõesque tentam-se revelar no presente artigo.Palavras-chave: Convênios Internacionais, Famílias Transnacionais,Migrações. Application of International Conventions related to familyissues and their link to contemporary phenomena. ABSTRACTThere are at least two international conventions associated with Family Lawthat have been signed and ratified by Chile, which have been operating foryears in apparent opacity.The complexity of the social system has forced the visibility of thoseConventions, especially in connection with migration and the formation oftransnational families.The implementation in Chile of the “Convention on the Recovery Abroadof Maintenance, New York 20 June 1956” and “Convention of 25 October1980 on the Civil Aspects of International Child Abduction”, based on theaforementioned phenomena, have allowed the observation of some practicesassociated with gender, age and paternity/maternity, which we will discussin this article.Keywords: International Conventions, Transnational Families, Migrations.

Abstract Background Parents and caregivers look to pediatric health care providers for guidance on feeding, safety issues, and child-care products for children, but trainees have infrequent first-hand exposure to child products marketed to parents. Objective To conduct a pilot study to assess an experiential field trip as a novel method of enhancing medical knowledge in ambulatory pediatric feeding and safety. Methods Resident physicians and medical students visited a local children's store, where they took part in an interactive store tour, product discussions, and product demonstrations led by a physician educator. Participants also completed a 20-question pretest and a 20-question posttest related to common ambulatory pediatric feeding and safety issues, based on recent American Academy of Pediatrics (AAP) policy statements and practice guidelines. Results Sixty-seven medical students and resident physicians participated in the study. Overall, participants' short-term knowledge significantly increased from 9.9 ± 2.6 to 15.4 ± 2.2 questions correct (P = .001), with statistically significant gains (P < .001) on both the feeding and safety sections of the test. There were no differences in improvement based on participant's student or resident status, residency program type, program year, sex, or parental status. Ninety-five percent of the participants believed that their knowledge was enhanced by this approach, and participants uniformly agreed that this field trip was valuable to their pediatric training and that such field trip sessions should continue. Conclusions The inclusion of experiential learning through an interactive field trip in the curriculum of medical training was acceptable and feasible and showed short-term improvements in knowledge of AAP safety and feeding concepts.

Purpose: To analyze the effects of a 9-week plyometric training program on the sprint times (5, 10, 20, and 30 m), change-of-direction speed (modified T test and modified Illinois test), jumping (squat jump, countermovement jump, countermovement jump with arms, and horizontal 5-jump test), upper-body strength (right and left handgrip, back extensor strength, and medicine ball throw), and balance (Y and stork balance tests) of female handball players. Methods: Athletes were randomly divided into experimental (n = 21; age = 13.5 [0.3] y) and control (n = 20; age = 13.3 [0.3] y) groups. Training exercises and matches were performed together, but the experimental group replaced a part of their normal regimen by biweekly upper- and lower-limb plyometric training. Results: Both groups improved performance, but to a greater extent in the experimental group compared with controls for 20- and 30-m sprint times (Δ% = 9.6, P < .05, d = 0.557 and Δ% = 20.9, P < .001, d = 1.07, respectively), change of direction (T test: P < .01, Δ% = 14.5, d = 0.993 and Illinois test: P < .01, Δ% = 7.9, d = 0.769), vertical and horizontal jumping (P < .05), all measures of upper-limb strength (P < .001), and left-leg stork balance (P < .001, Δ% = 49.9, d = 1.07). Conclusions: A plyometric training program allows female junior handball players to improve important components of their physical performance.

Este artículo de reflexión es el resultado de la revisión analítica, interpretativa y crítica de los documentos, leyes y jurisprudencia relacionada con el derecho al olvido de los pederastas, la pedofilia y la pederastia, cumpliendo con los objetivos principales de clarificar los conceptos objeto de discusión y formular posibles alternativas frente a las escasas limitaciones para la vinculación al mercado laboral de quienes han sido condenados por delitos sexuales contra menores de catorce años. Mediante la utilización del tipo de investigación dogmática, descriptiva y de análisis estático de precedente se logró concluir que la pedofilia, al ser una enfermedad incurable, debe ser tratada con el fin de evitar su materialización en la pederastia y, como medida preventiva de delitos, el Congreso de la República de Colombia ostenta la misión de reglar el manejo de las bases de datos de los condenados por estos delitos a través de una ley estatutaria. Referencias American Psychiatric Association. (2014). DSM-5. Guía de Consulta de los Criterios Diagnósticos del DSM-5. Argentina: Editorial Médica Panamericana.Bertini, C., De Luca, S., Fariña, N., Ganduglia, A. y Sisini, N. (2005). El maltrato hacia los niños. En Giberti, E. (Comp.), Abuso sexual y malos tratos contra niños, niñas y adolescentes. Perspectiva psicosocial y social (239-258). Buenos Aires, Argentina: Espacio Editorial.Bohórquez, L. y Bohórquez, J. (2008). Diccionario Jurídico Colombiano (8a. ed.). Bogotá, Colombia: Editora Jurídica Nacional.Botero Martínez, J. (2014). Sobre la Inimputabilidad: ¿Algo más que decir? ¿Los estados similares son una causal autónoma o amplificadora de la inimputabilidad? Sentido y alcance de los “estados similares”. Opinión Jurídica, 13(25), 207-208.Botero Bernal, J. (Comp.). (2018). Código Penal Colombiano (Ley 599 de 2000). Recuperado de http://perso.unifr.ch/derechopenal/assets/files/legislacion/l_20160208_02.pdfCastillero, O. (s.f.). Diferencias entre pedofilia y pederastia. Recuperado de https://psicologiaymente.net/clinica/diferencias-pedofilia-pederastiaCongreso de la República de Colombia. (s.f.). Proyecto de Ley “por el cual se tutela el derecho al libre desarrollo sexual de las niñas y niños menores de 14 años”. Recuperado de http://www.legisaldia.com/BancoMedios/Archivos/pl-041-16c-base-de-datos-pedofilos.pdf-------. (1991). Ley 12 de 1991 “por medio de la cual se aprueba la Convención sobre los Derechos del Niño adoptada por la Asamblea General de las Naciones Unidas el 20 de noviembre de 1989”. Recuperado de https://www.unidadvictimas.gov.co/sites/default/files/documentosbiblioteca/ley-12-de-1991.pdf-------. (1993). Ley 65 de 1993 “por la cual se expide el Código Penitenciario y Carcelario”. Recuperado de http://wp.presidencia.gov.co/sitios/normativa/leyes/Documents/Juridica/Ley%2065%20de%201993.pdf-------. (2000). Ley 599 de 2000 “por la cual se expide el Código Penal”. Recuperado de https://www.unodc.org/res/cld/legislation/can/codigo-penal_html/Codigo_Penal.pdf-------. (2002). Ley 734 de 2002 “por la cual se expide el Código Disciplinario Único”. Recuperado de http://secretariageneral.gov.co/transparencia/marco-legal/normatividad/ley-734-2002-------. (2004). Ley 890 de 2004 “aplicable a procesos de Ley 600 de 2000”. Recuperado de http://www.cortesuprema.gov.co/corte/index.php/2018/05/10/ley-890-de-2004-aplicable-a-procesos-de-ley-600-de-2000/-------. (2006). Ley 1098 de 2006 “por la cual se expide el Código de la Infancia y la Adolescencia”. Recuperado de https://www.icbf.gov.co/cargues/avance/docs/ley_1098_2006.htm-------. (2008). Ley 1236 de 2008 “por medio de la cual se modifica algunos artículos del Código Penal relativos a delitos de abuso sexual”. Recuperado de http://www.oas.org/dil/esp/ley_1236_de_2008_colombia.pdf-------. (2009). Ley 1336 de 2009, “por medio del cual se adiciona y robustece la Ley 679 de 2001, de lucha contra la explotación, la pornografía y el turismo sexual con niños, niñas y adolescentes”. Recuperado de https://diario-oficial.vlex.com.co/vid/robustece-pornografia-adolescentes-61325313-------. (2016). Proyecto de Ley Estatutaria Nº 112 de 2016 “por medio de la cual se crea el Registro Nacional de Ofensores Sexuales”. Recuperado de http://leyes.senado.gov.co/proyectos/images/documentos/Textos%20Radicados/proyectos%20de%20ley/2016%20-%202017/PL%20112-16%20REGISTRO%20NACIONAL%20DE%20OFENSORES%20SEXUALES.pdf-------. (2018). Ley 1918 de 2018 “por medio de la cual se establece el régimen de inhabilidades a quienes hayan sido condenados por delitos sexuales contra menores, se crea el Registro de inhabilidades y se dicta otras disposiciones”. Bogotá, Colombia. Recuperado de http://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=87420Consejo Superior de Política Criminal. (s.f.). Consejo Superior de Política Criminal. Recuperado de http://www.politicacriminal.gov.co/Portals/0/Conceptos/ConceptosCSPC/2016/22%20CSPC%20PLE%20112,%20PL%2087S%20y%2041C%20(Registro%20agresores%20sexuales).pdfCorte Constitucional. República de Colombia. (Junio de 1992). Sentencia T-414/92. [MP Ciro Angarita Barón]. Bogotá, Colombia. Recuperado de http://www.corteconstitucional.gov.co/relatoria/1992/t-414-92.htm-------. (Julio de 1992). Sentencia T-444/92. [MP Alejandro Martínez Caballero]. Bogotá, Colombia. Recuperado de http://www.corteconstitucional.gov.co/relatoria/1992/T-444-92.htm-------. (Marzo de 1995). Sentencia SU-082/95. [MP Jorge Arango Mejía]. Bogotá, Colombia. Recuperado de https://vlex.com.co/tags/sentencia-su-082-95-corte-constitucional-565292-------. (Septiembre de 2002). Sentencia T-729/02. [MP Eduardo Montealegre Lynett]. Bogotá, Colombia. Recuperado de http://www.corteconstitucional.gov.co/relatoria/2002/t-729-02.htm-------. (Diciembre de 2002). Sentencia T-1066/02. [MP Jaime Araujo Rentería]. Bogotá, Colombia. Recuperado de http://www.corteconstitucional.gov.co/relatoria/2002/c-1066-02.htm-------. (Marzo de 2003). Sentencia C-185/03. [MP Eduardo Montealegre Lynett]. Bogotá, Colombia. Recuperado de http://www.corteconstitucional.gov.co/relatoria/2003/C-185-03.htm-------. (Enero de 2008). Sentencia C-061 de 2008. [MP Nilson Pinilla Pinilla]. Bogotá, Colombia. Recuperado de http://www.corteconstitucional.gov.co/relatoria/2008/C-061-08.htm-------. (Marzo de 2008). Sentencia T-284/08. [MP Clara Inés Vargas Hernández]. Bogotá, Colombia. Recuperado de http://www.corteconstitucional.gov.co/relatoria/2008/T-284-08.htm-------. (Octubre de 2008). Sentencia C-1011/08. [MP Jaime Córdoba Triviño]. Bogotá, Colombia. Recuperado de http://www.corteconstitucional.gov.co/relatoria/2008/C-1011-08.htm-------. (Marzo de 2010). Sentencia T-164/10. [MP Jorge Iván Palacio Palacio]. Bogotá, Colombia. Recuperado de http://www.corteconstitucional.gov.co/relatoria/2010/T-164-10.htm-------. (Junio de 2012). Sentencia SU-458/12. [MP Adriana María Guillén Arango]. Bogotá, Colombia. Recuperado de http://www.corteconstitucional.gov.co/RELATORIA/2012/SU458-12.htm-------. (Mayo de 2015). Sentencia T-277-15. [MP María Victoria Calle Correa]. Bogotá, Colombia. Recuperado de http://www.corteconstitucional.gov.co/relatoria/2015/t-277-15.htmCorte Suprema de Justicia. República de Colombia. (Agosto de 2015). Sentencia 20889. [MP Patricia Salazar Cuellar]. Bogotá, Colombia. Recuperado de http://legal.legis.com.co/document?obra=jurcol&document=jurcol_0606b12290a641419649d2c5ec3b8486Christopher’s Law (Sex Offender Registry), 2000 S.O. Recuperado de https://www.ontario.ca/laws/statute/00c01Cifuentes, S., Grupo Centro de Referencia Nacional sobre Violencia e Instituto Nacional de Medicina Legal y Ciencias Forenses. (2015). Exámenes médico legales por presunto delito sexual. Colombia, 2015. Recuperado de http://www.medicinalegal.gov.co/documents/20143/49523/Violencia+sexual.pdfDada, C. (17 de agosto de 2018). Pensilvania es el caso de abuso más preocupante en EE. UU. El Espectador. Recuperado de https://www.elespectador.com/noticias/el-mundo/pensilvania-es-el-caso-de-abuso-mas-preocupante-en-ee-uu-articulo-806746Echeburúa, E. y Guerricaechevarría, C. (2009). Abuso Sexual en la Infancia: Víctimas y agresores. Un enfoque clínico. Barcelona, España: Editorial Ariel.Fondo de las Naciones Unidas para la Infancia (UNICEF). (2006). Convención sobre los Derechos del Niño. Recuperado de http://www.un.org/es/events/childrenday/pdf/derechos.pdfGobierno de España. Ministerio de la Presidencia, Relaciones con las Cortes e Igualdad. (28 de julio 2015). Ley 26/2015 “de modificación del sistema de protección a la infancia y a la adolescencia”. Recuperado de https://www.boe.es/buscar/act.php?id=BOE-A-2015-8470Humanium. (s.f.). Declaración de Ginebra sobre los Derechos del Niño, 1924. Recuperado de https://www.humanium.org/es/ginebra-1924/-------. (s.f.). Declaración de los Derechos del Niño, 1959. Recuperado de https://www.humanium.org/es/declaracion-1959/Instituto Colombiano de Bienestar Familiar (ICBF). (2017). Tratados y Convenios Internacionales en materia de niñez y de familia. Recuperado de https://www.icbf.gov.co/tratados-y-convenios-internacionales-en-materia-de-ninez-y-de-familia.Legislación Informática de Estados Unidos. (1994). Jacob Wetterling Crimes against Children and Sexually Violent Offender Registration Act. Recuperado de http://www.informatica-juridica.com/legislacion/estados-unidos/Lopera, G. y Arias, D. (2010). Principio de Proporcionalidad y Derechos Fundamentales en la Determinación Judicial de la Pena. Bogotá, Colombia: Panamericana Formas e Impresos.López, F., Carpintero, E., Hernández, A., Martin M. y Fuertes, A. (1995). Prevalencia y consecuencias del abuso sexual al menor en España. Child Abuse & Neglect, 19(9), 1039-1050.Lozano, C. (2013). ¿Qué es el Estado social y democrático de derecho? Bogotá, Colombia: Imprenta Nacional de Colombia.Ministerio de la Protección Social. (2007). Resolución No. 2346 “por la cual se regula la práctica de evaluaciones médicas ocupacionales y el manejo y contenido de las historias clínicas ocupacionales”. Recuperado de https://vlex.com.co/vid/-495385211Ministerio del Interior y Seguridad Pública. Subsecretaría del Interior. (19 de junio de 2012). Ley 20594 de 2012 “Crea inhabilidades para condenados por delitos sexuales contra menores y establece registro de dichas inhabilidades”. Recuperado de https://www.leychile.cl/Navegar?idNorma=1041136Ministerio de Tecnologías de la Información y las Telecomunicaciones. (2012). Decreto 019 de 2012 “por el cual se dicta normas para suprimir o reformar regulaciones, procedimientos y trámites innecesarios existentes en la Administración Pública”. Recuperado de https://www.mintic.gov.co/portal/604/w3-article-3567.htmlMontes, R. (24 de mayo de 2018). Catorce sacerdotes suspendidos en Chile por denuncias de abusos sexuales. El País. Recuperado de https://elpais.com/internacional/2018/05/23/america/1527042814_750171.htmlNaciones Unidas. (s.f.). Declaración Universal de los Derechos Humanos. Recuperado de http://www.un.org/es/universal-declaration-human-rights/Oficina del Alto Comisionado para los Derechos Humanos (ACNUDH). (2018). Pacto Internacional de Derechos Civiles y Políticos. Recuperado de https://www.ohchr.org/sp/professionalinterest/pages/ccpr.aspxOrganización de los Estados Americanos (OEA). (2015). Declaración Americana de los Derechos y Deberes del Hombre. Recuperado de http://www.oas.org/es/cidh/mandato/Basicos/declaracion.aspOrganización Panamericana de la Salud. (2017). INSPIRE. Siete estrategias para poner fin a la violencia contra los niños y las niñas. Recuperado de https://www.unodc.org/documents/justice-and-prison-reform/Child-Victims/Executive_Summary-Spanish.pdfPresidencia de la República de Colombia. (2012). Decreto Ley 019 de 2012 “por el cual se dicta normas para suprimir o reformar regulaciones, procedimientos y trámites innecesarios existentes en la Administración Pública”. Bogotá, Colombia. Recuperado de http://wsp.presidencia.gov.co/Normativa/Decretos/2012/Documents/Enero/10/Dec1910012012.pdfQuamtum Future Group. (2014). Depredadores entre nosotros: entrevista con la doctora Anna Salter – SOTT Talk Radio. Recuperado de https://es.sott.net/article/40250-Depredadores-entre-nosotros-Entrevista-con-la-Dra-Anna-Salter-SOTT-Talk-Radio.República de Colombia. (1991). Constitución Política de Colombia. Recuperado de http://www.corteconstitucional.gov.co/inicio/Constitucion%20politica%20de%20Colombia.pdfRicaurte, A. (2017). Exámenes médico legales por presunto delito sexual. En Instituto Nacional de Medicina Legal y Ciencias Forenses (Eds.), Forensis 2016, Datos para la Vida (pp. 352-398). Bogotá, Colombia: Imprenta Nacional.Rodríguez, A. (2016). Pedófilos sin obstáculos: ¿A quién están protegiendo las leyes? Programa Séptimo día. Caracol televisión [Archivo de video]. Recuperado de http://noticias.caracoltv.com/septimo-dia/pedofilos-sin-obstaculos-quien-estan-protegiendo-las-leyesStekel, W. (1954). Infantilismo Psicosexual. Enfermedades psíquicas infantiles en los adultos. Buenos Aires, Argentina: Ediciones Imán.Tamayo, J. (15 de agosto de 2018). La pederastia, cáncer con metástasis. El País. Recuperado de https://elpais.com/autor/juan_jose_tamayo/aUniversidad Externado de Colombia. (2015). Luces y sombras del Derecho al olvido. Recuperado de http://dernegocios.uexternado.edu.co/comercio-electronico/colombia-luces-y-sombras-del-derecho-al-olvido/World Health Organization. (WHO). (2016). INSPIRE, Siete estrategias para poner fin a la violencia contra los niños. Recuperado de https://www.who.int/violence_injury_prevention/violence/inspire/INSPIRE_ExecutiveSummary_ES.pdf

Evaluation of the safety profile of vaccines in patients with rheumatic diseases requires an assessment of their impact on disease activity. The effect of antipneumococcal vaccination on the activity of systemic juvenile idiopathic arthritis (sJIA) has not been studied so far. Objective. To evaluate the dynamics of sJIA activity after immunization with pneumococcal 13-valent conjugate vaccine (PCV13) of patients receiving biologicals. Patients and methods. This study included patients with sJIA in remission or active disease receiving biologicals during inpatient treatment and vaccinated with PCV13. To evaluate the effect of immunization on sJIA activity, we measured serum levels of high-sensitivity C-reactive protein (hs-CRP) and calprotectin. In addition to that, we assessed the number of new cases, when concentration of these markers was above the upper limit (UL) 4 weeks after PCV13 administration. Results. In 18 out of 53 patients in remission (34%) and 3 out of 25 patients with active sJIA (12%), hs-CRP levels were undetectable (0.1 mg/L) at both time-points (baseline and after 4 weeks). Among those with detectable hs-CRP levels in at least one time-point 4 weeks after vaccination, patients in remission (n = 35) had no significant changes in hs-CRP (median -0.17 mg/mL; 95% CI -0.84…0.41), whereas patients with active sJIA (n = 22) demonstrated a 3-fold decrease in hs-CRP level (median -0.94 mg/mL (95% CI -3.93…0.05). We observed no significant difference in calprotectin levels in the groups. Concentration of hs-CRP above the UL 4 weeks after vaccination was detected in 2 out of 53 sJIA patients in remission (4%) and none of the patients with active sJIA. Сoncentration of calprotectin above the UL 4 weeks after vaccination was detected in 8 out 53 (15%) and 5 out 25 (20%) sJIA patients in remission and with active disease, respectively. Conclusion. Vaccination against pneumococcal infection in patients with sJIA led to an increase in the level of highly sensitive laboratory markers of sJIA activity in 4–20% of patients. Key words: disease activity, safety, high-sensitivity C-reactive protein, biological drugs, calprotectin, juvenile idiopathic arthritis, pneumococcal 13-valent conjugate vaccine

El objetivo de este trabajo es evaluar un proyecto fotovoltaico como fuente de energía alternativa en el sector de salud primaria como estudio de caso, desde la perspectiva económica y social. La evaluación se basó en variables técnicas y económicas bajo los criterios de Valor Actual Neto (VAN) y Tasa interna de retorno (TIR), valorizando las reducciones de carbono (CO2) y utilizando la tasa de descuento social del Ministerio de Desarrollo Social. Los resultados son favorables y sugieren la ejecución de este proyecto como iniciativa de política pública. Sin embargo, queda en evidencia que en periodos de invierno no se cubre las necesidades energéticas, haciendo imprescindible diversificar la matriz con fuentes tradicionales. Palabras Clave: Energía solar fotovoltaica, sector salud, sustentabilidad, evaluación social. Referencias [1]Fondo Nacional de Salud (FONASA), Boletin Estadístico 2016-2017. Disponible: https://www.fonasa.cl/sites/fonasa/adjuntos/Boletin_Estadistico_2016_2017_2018. [2]Cisterna L, Améstica-Rivas L, Piderit M. Proyectos fotovoltaicos en generación distribuida ¿Rentabilidad privada o sustentabilidad ambiental?. Revista Politécnica. 2020; 45(2): en prensa. Disponible: https://revistapolitecnica.epn.edu.ec/ojs2/index.php/revista_politecnica2/issue/view/39. [3]Medina J. La dieta de dióxido de carbono CO2. Conciencia Tecnológica. 2010; 39: 50-53. Disponible: https://www.redalyc.org/articulo.oa?id=94415753009. [4]Mardones C. Muñoz, T. Impuesto al CO2 en el sector eléctrico chileno: efectividad y efectos macroeconómicos. Economía Chilena. 2017; 20(1): 4-25. Disponible: https://www.bcentral.cl/web/guest/articulos-publicados. [5]Ministerio del Medio Ambiente, Tercer Informe de Actualización Bienal de Chile, 2018. Disponible: https://mma.gob.cl/wp-content/uploads/2019/07/2018_NIR_CL.pdf. [6]Gallego Y, Arias R, Casas L, Sosa R. Análisis de la implementación de un parque fotovoltaico en la Universidad Central de las Villas. Ingeniería Energética, 2018; 39(2): 82-90. Disponible: http://rie.cujae.edu.cu/index.php/RIE/article/view/531. [7]Arias R, Pérez I. Nueva metodología para determinar los parámetros de un módulo fotovoltaico. Ingeniería Energética. 2018; 39(1): 38-47. Disponible: http://rie.cujae.edu.cu/index.php/RIE/article/view/557. [8]Plá J, Bolzi C, Durán J.C. Energía Solar Fotovoltaica. Generación Distribuida conectada a la red. Ciencia e Investigación. 2018; 68(1), 51-64. Disponible: http://aargentinapciencias.org/wp-content/uploads/2018/03/tomo68-1/4-Duran-cei68-1-5.pdf. [9]Hou G, Sun H, Jiang Z, Pan Z, Wang Y, Zhang X, Zhao Y, Yao Q. Life cycle assessment of grid-connected photovoltaic power generation from crystalline silicon solar modules in China. Applied Energy. 2016; 164 (15): 882-890. Disponible: https://doi.org/10.1016/j.apenergy.2015.11.023. [10]Baharwani V, Meena N, Dubey A, Brighu U, Mathur J. Life Cycle Analysis of Solar PV System: A Review. International Journal of Environmental Research and Development. 2014; 4(2): 183-190. Disponible: https://www.ripublication.com/ijerd_spl/ijerdv4n2spl_14.pdf [11]Rojas-Hernández I, Lizana F. Tiempo de recuperación de la energía para sistemas fotovoltaicos basados en silicio cristalino en Costa Rica. Ingeniería Energética. 2018; 39 (3):195-202. Disponible: http://rie.cujae.edu.cu/index.php/RIE/article/view/544. [12]World Economic Forum. Informe Energía. 2017. Disponible: https://es.weforum.org/agenda. [13]Zou L, Wang L, Lin A, Zhu H., Peng Y, Zhao Z. Estimation of global solar radiation using an artificial neural network based on an interpolation technique in southeast China. Journal of Atmospheric and Solar-Terrestrial Physics. 2016; 146: 110-122 Disponible: https://doi.org/10.1016/j.jastp.2016.05.013. [14]Crawley D, Lawrie, L, Winkelmann F, Buhl W, Huang C, Pedersend C, Strand R, Liesen R, Fisher D, Witte M, Glazer J. EnergyPlus: creating a new-generation building energy simulation program. Energy and Buildings. 2001; 33(4): 319-331.Disponible: https://doi.org/10.1016/S0378-7788(00)00114-6. [15]Larrain S, Stevens C, Paz M. Las fuentes renovables de energía y el uso eficiente. 2002. LOM Ediciones, Chile Disponible: http://www.archivochile.com/Chile_actual/patag_sin_repre/03/chact_hidroay-3%2000010.pdf. [16]World Economic Forum. Cuatro países que lideran las tendencias de energía solar en América Latina y el Caribe, 2017.Disponible: https://es.weforum.org/agenda/2017/05/cuatro-paises-que-lideran-las-tendencias-de-energia-solar-en-america-latina-y-el-caribe/. [17]Ministerio de Energía. Ley 20.571, Regula el pago de las tarifas eléctricas de las generadoras residenciales. 2012. Disponible: https://www.leychile.cl/Navegar?idNorma=1038211. [18]Comisón Nacional de Energía (CNE) de Chile. Reporte mensual sector energético. 2019; 50. Disponible: https://www.cne.cl. [19]Ministerio de Energía, Programa de Techos Solares Públicos, Reporte de costos. 2018. Disponible: http://www.minenergia.cl/techossolares/wp-content/uploads/2017/04/Reporte-de-Costos-de-Adjudicacion-2018-233x300.jpg. [20]Löhr W, Gauer K, Serrano N, Zamorano A. Igarss 2014. Eficiencia Energética en Hospitales Públicos. Editorial GTZ- Dalkia. Santiago de Chile. [21]Smith M, De Titto E. Hospitales sostenibles frente al cambio climático: huella de carbono de un hospital público de la ciudad de Buenos Aires. Revista Argentina Salud Pública. 2018; 9(36): 7-13. Disponible: http://rasp.msal.gov.ar/rasp/articulos/volumen36/7-13.pdf. [22]Chung J, Meltzer, D. Estimate of the carbon footprint of the US health care sector. Jama. 2009; 302(18):1970-1972. Disponible: https://jamanetwork.com/journals/jama/article-abstract/184856. [23]Nope A, García R, Bobadilla A. Método para la implementación de sistemas solares activos en establecimientos hospitalarios, estudio de caso en el hospital clínico del sur, Concepción, Chile. En Proceedings of the 3rd International Congress on Sustainable Construction and Eco-Efficient Solutions. Sevilla. 2017; 451-464. Disponible: https://idus.us.es/xmlui/handle/11441/58969. [24]Compañía General de Electricidad, Tarifa de Suministro. 2018 Disponible: http://www.cge.cl/wp-content/uploads/2019/08/Publicacion-CGE-2019-08-01-Suministro-electrico.pdf. [25]Ministerio de Desarrollo Social, Precio Social del Carbono. 2018. Disponible: http://sni.ministeriodesarrollosocial.gob.cl/download/precio-social-co2-2017/?wpdmdl=2406.

Purpose This paper aims to optimize feed moisture contents, barrel temperatures, blending ratios of maize and lupine for processing of protein-rich best quality extruded product using a twin-screw extruder. Design/methodology/approach A three-factor three-level response surface methodology by Box-Behnken Design was applied to evaluate the effect of selected processing conditions of blending ratios of lupine (10-20 per cent), barrel temperatures (120°C-150°C) and feed moisture content (14-18 per cent) on functional, nutritional and sensory characteristics of produced snack food. Findings The results of functional properties such as radial expansion ratio, bulk density, water absorption index, water solubility index observed as 0.71-1.2, 0.33-0.92 g/cc, 4.4-6.4 per cent and 10.2-15.1 per cent, respectively. The snack food showed the moisture 5.6-7.2 per cent, protein 8.1-18.1 per cent, fiber 1.6-2.7 per cent, ash 1.6-2.2 per cent and carbohydrate 64.8-81.4 per cent. The independent variables (lupine blending ratio, barrel temperature and feed moisture content) posed significant effects on expansion ration (p = 0.0030), bulk density (p = 0.0026), water absorption index (p = 0.0075) and water-solubility index (p = 0.0116). Higher blending ratio of lupine was increase in the bulk density and water solubility index, but decrease in expansion ratio and water absorption index of snack food. Higher feed moisture content was led to a reduction in expansion ratio and water-soluble index of snack food. Whereas, higher feed moisture contents was lead to rise in bulk density and water absorption index. Fiber (p = 0.0145), ash (p = 0.0343) and carbohydrate (p = 0.0001) contents were significantly depended on blending ratio. Blending of lupine 15.06 per cent, barrel temperature of 150 °C and feed moisture content of 14.0 per cent produced the snack food with desirability value of 72.8 per cent. Originality/value Protein malnutrition is one of the major problems in child development in under developed countries including Ethiopia. Maize is a top producer in the country but least appreciated for cost. Lupine is one of the undervalued produce consumed in Ethiopia after boiling. Still data on the utilization of maize and lupine in the extruded snack preparation was very limited. Optimization of moisture and barrel temperatures for this snack was not reported clearly yet.

Relevance. In the Kyrgyz Republic, the measles and rubella elimination program has been implemented in accordance with the strategy of the World Health Organization (WHO) for 20 years, which uses a two-fold immunization tactic against measles at the age of 12 months and 6 years, which is complemented by clean-up campaigns. Despite the high coverage of vaccinations with both the first and second doses, there are epidemic rises in infection, reaching in 2018 (15.9), 2019 (36.4) and 2020 (11.2) per one hundred thousand population. In the years of recent epidemic ups, a high incidence among young children revealed. The epidemiological situation with measles that has developed in recent years has made it necessary to study the state of specific measles immunity in different age groups, to determine the vulnerable population group and assess the quality of vaccination work.The aim of the work: to assess the epidemic process of measles at the present stage and the state of specific immunity in the population of the Kyrgyz Republic to identify groups at high risk of infection.Materials and methods. In the course of the work, descriptive-evaluative and analytical epidemiological research methods are used. The materials are statistical reporting data on the incidence of measles from 1987 to 2020 and 568 blood serum samples taken from residents of Bishkek and Jalal-Abat region in the following indicator age groups: 1-4 years old n = 122; 5-9 years old n = 108; 10-14 years old n = 114; 15-19 years old n = 77; 20-29 years old n = 103; 30 years and older n = 44. The level of anti-measles antibodies is determined by enzymelinked immunosorbent assay (ELISA) using the VectorMeasles-IgG test system manufactured by VEKTOR BEST, Russia. The method of retrospective analysis of the incidence of measles in the Kyrgyz Republic in long-term dynamics, by age groups, according to vaccination history is used. The method of retrospective analysis of the incidence of measles in the Kyrgyz Republic in longterm dynamics, by age groups, according to vaccination history is used. The data obtained statistically processed using the Excel program. The critical level of significance is p = 0.05. Descriptive statistics – mean and standard error of the mean (data are presented as M ± m) for quantitative variables, for qualitative variables – determination of proportion.Results and Discussions. The introduction of specific prophylaxis of measles led to decrease the incidence of measles, 15 times on average, mortality also decreased, however, despite the effectiveness of vaccination, cyclical increases in infection persisted, seasonality in intra-annual dynamics, school-age children began to get sick more often. To change the situation, including in order eliminating primary postvaccination failures, in 1986 a second dose of vaccine introduced into the vaccination schedule for children 6 years old, which led to decrease the incidence to single case and in some years to the complete absence of measles cases. However, in 2018, the importation of measles from bordering countries led to an epidemic outbreak with the number of cases of 1004. The incidence rate increased from 0.1 in 2017 to 15.9 per 100 thousand population in 2018. At the subnational level, a clean-up campaign carried out among children aged two to five years. However, due to the lack of vaccine, the target group covered less than 50% and the increase in the incidence of measles in 2019 continued to 2377 people (36.4 per 100 thousand population). A slight decrease in the incidence of measles outlined in 2020, when 733 cases were registered. The highest percentage of cases is among children under one year old, 43.3% (2019) and 52.7% (2020), who are not vaccinated by age. In second place in importance is the age group of children from one to four years old, an extensive incidence rate is 29.5% (2019) and 39.3% (2020). The data of serological studies confirmed the formation of a high-risk group for measles infection among preschool children, where the proportion of seronegatives is 36%; this is probably due to not post-vaccination failures, but rather to a high proportion of children who are not vaccinated for various reasons. This hypothesis confirmed by the high percentage of unvaccinated children of this age in the structure of the sickindividuals. All this casts doubt on the official data on the coverage of children of this age with preventive vaccinations (95.7%) and indicates the accumulation of contingents susceptible to measles. The results of our research are consistent with the data obtained by other researchers.Conclusion. The analysis showed the need for regular monitoring of the organization of the vaccination work to control the reliable accounting of the child contingent needed to immunization, based on the population census, as well as to identify the validity of medical withdrawals. To prevent the growth of refusals from vaccinations, it is advisable to expand the forms of work with the population to develop commitment to vaccination. We believe that in combination, this will increase the real coverage of measles vaccinations for children, reduce the number of sources of infection and indirectly reduce the risk of infection in children of the first year of life.

Este trabajo es un estudio analítico y comparativo entre el régimen de contrato laboral vigente en Ecuador y el contrato de teletrabajo que busca resolver el problema legal de establecer si la relación laboral de teletrabajo configurada como contrato de trabajo puede estar sujeta a las reglas generales de los contratos o reglas específicas del contrato de vivienda contempladas en el Código de Trabajo Ecuatoriano. Como el teletrabajo no está reconocido por la legislación laboral ecuatoriana, el trabajo se divide en tres capítulos diferentes que buscan solucionar el problema legal mencionado. Se exponen todas las características, elementos y demás cuestiones relevantes al régimen de contratación laboral, sirviendo de antecedente para el análisis comparativo antes mencionado. Posteriormente, se hace una descripción y análisis de la figura del teletrabajo, así como sus características y elementos que lo convierten en una figura diferente y única. Finalmente, se hizo un análisis del trabajo a domicilio (modalidad que está regulada por la legislación laboral ecuatoriana) para luego pasar a compararlo con el teletrabajo. El resultado de esta comparación es determinar si es legalmente posible regular. Palabras Clave: teletrabajo, legislación laboral, contrato de trabajo. Referencias [1]N. Samaniego, «El teletrabajo en el Ecuador,» agosto 2016. [En línea]. Disponible: http://dspace.uniandes.edu.ec/bitstream/123456789/6133/1/TUSDMDL002-2017.pdf. [Último acceso: 09 Septiembre 2020]. [2]P. Alvarez, «Teletrabajo en la experiencia extranjera, » octubre 2018. [En línea]. Disponible: https://obtienearchivo.bcn.cl/obtienearchivo?id=repositorio/10221/25913/2/PA_Teletrabajo_2018.pdf. [Último acceso: 09 09 2020]. [3]M. Palacios, «El teletrabajo: hacia una regulación garantista en el Ecuador,» Quito, 2017. [4]J. Espinosa, «Los Efectos del Condicionamiento del Plazo de un Contrato de Trabajo a la Duración de un Contrato de Servicios Complementarios en Base al Artículo 169 numeral 3ero del Código de Trabajo,» Quito, 2015. [5]Constitución de la República del Ecuador, «Legislación laboral y de Seguridad Social Tomo I,» Pudeleco, Quito, 2016. [6]H. Chiriboga, «Historia del Derecho Laboral como instrumento político del Ecuador,» Guayaquil, 2017. [7]G. Blacio, «La vulneración de los principios constitucionales del trabajo, en cuanto a la exoneración del pago de utilidades a los operarios y aprendices de losartesanos,» Loja , 2016. [8]P. Arpi, «Estrategias para promover el teletrabajo en las empresas del sector privado del Ecuador para mejorar el empleo y la productividad,» Quito, 2018. [9]P. Martín, Teletrabajo y comercio electrónico, Madrid (España): Secretaría General Técnica, 2018. [10]G. Poveda, Abril 2018. [En línea]. Disponible: https://www.eumed.net/actas/18/empresas/18-una-revision-al-teletrabajo.pdf. [Último acceso: 09 09 2020]. [11]Organización Internacional del Trabajo, «Las dificultades y oportunidades del teletrabajo para los trabajadores y empleadores en los sectores de serviciosde tecnología de la información y las comunicaciones (TIC) y financieros,» 2016. [En línea]. Disponible: https://www.ilo.org/wcmsp5/groups/public/---ed_dialogue/---sector/documents/publication/wcms_531116.pdf. [Último acceso: 09 09 2020]. [12]E. Villa, «Beneficios e impactos del teletrabajo en el talento humano: una revisión de literatura,» CEA,vol. 2, nº 4, pp. 59-73, 2016. [13]Ministerio de Trabajo, Agosto 2016. [En línea]. Disponible: http://www.trabajo.gob.ec/wp-content/uploads/2016/10/Acuerdo_Teletrabajo_WEB.pdf. [Últimoacceso: 09 09 2020]. [14]C. Vélez, «Análisis de la norma jurídica sobre el teletrabajo en Ecuador y sus vacíos legales,» Enero 2020. [En línea]. Diponible: http://dspace.uniandes.edu.ec/bitstream/123456789/11164/1/PIUAMDL001-2020. pdf. [Último acceso: 09 09 2020]. [15]R. Hernández, Metodología de la investigación. Las rutas cuantitativa, cualitativa y mixta, México D.F. (México): McGraw Hill, 2018. [16]M. Bonilla y A. López, «Ejemplificación del proceso metodológico de la teoría fundamentada,» Scielo, pp. 305-315, 2016. [17]R. Buenaño, «El fututo del trabajo, teletrabajo y su influencia en la relación laboral,» Derecho Ecuador, 15 05 2020. [En línea]. Disponible: https://www.derechoecuador.com/el-futuro-del-trabajo-teletrabajo-y-su-influencia-en-la-relacion-laboral. [Último acceso: 10 09 2020]. [18]Ministerio del Trabajo y Previsión Social, «Ley 21220 Modifica el código del trabajo en materia de trabajo a distancia,» BCN, Santiago de Chile, 2020. [19]A. Mello y A. Acuña, «Primer Informe Estado del Teletrabajo en América Latina y El Caribe,» Ita Lac, América Latina y El Caribe, 2017. [20]C. Valera, «El teletrabajo en la legislación peruana y latinoamericana,» La Ley, Lima (Perú), 2020. [21]J. Rodríguez, «Teletrabajo en Panamá,» 06 03 2020. [En línea]. Disponible: https://www.dentonsmunoz.com/es/insights/articles/2020/march/6/teleworking-in-panama. [Último acceso: 11 09 2020]. [22]J. Hewitt, A. Acuña y A. Formoso, « Informe del Estado del Teletrabajo en Costa Rica,» CIIDTT, San José, 2017.

Abstract Background Cytomegalovirus infection can cause significant morbidity and mortality after transplantation. Cytomegalovirus retinitis (CMVR) can be a major complication of tissue invasive CMV disease in transplant recipients. There are little data regarding the contemporary incidence and outcomes of CMVR among pediatric transplant recipients. Methods We performed a retrospective cohort analysis of allogeneic hematopoietic (allo-HCT) and solid organ transplant (SOT) recipients who received medical care at Nationwide Children’s Hospital (NCH) from 1/1/10–11/30/20 and had a diagnosis of CMVR to describe the incidence, timing post-transplant, ocular manifestations, management, and outcomes. Basic demographic and clinical data, pre-transplant donor/recipient CMV serostatus, and post-transplant CMV infection data were collected. Graft-specific CMV surveillance and prophylaxis strategies were performed according to NCH hospital guidelines. During the study period, quantitative plasma CMV PCR assays included copies/mL (2010–2013) and WHO international standard IU/mL (2013–2020). Results During the 10-year study period, 347 patients underwent allo-HCT (N=214) or SOT (N=133; heart N=46, liver N=36, kidney N= 52; 1 patient had concomitant kidney and liver transplantation); median age was 8.6 years [range 0.1–25.9] and 198 (56.5%) were male. In total, 98 patients had CMV DNAemia post-transplant, and CMVR was diagnosed in 3 (HCT=2, SOT=1), for an overall CMVR incidence of 0.86% among all transplant recipients and occurring in 3% of patients with CMV DNAemia. No CMVR was diagnosed in patients without CMV DNAemia. An ophthalmologic examination was performed in 58 (59%) of patients with any DNAemia compared with 67 (27%) of patients without DNAemia. CMVR was diagnosed on funduscopic examination a median of 183 days [range 34–512] post-transplant based on visual symptomatology (N=2) or by routine eye screening prompted by DNAemia (N=1). CMV DNAemia at the time of CMVR was 1,463 copies/mL, 3,000, and 14,204 IU/mL; all patients had prolonged (&gt;3 months) CMV detection before CMVR. One SOT recipient had concomitant pathology confirming CMV gastrointestinal tract disease. Two of the 3 CMVR cases occurred in the setting of genotypic UL94 CMV resistance mutations (A594V, H520Q)(Figure 1). Two patients were already receiving CMV antiviral therapy (maribavir N=1; valganciclovir=1) at the time of CMVR diagnosis. After the CMVR diagnosis, all patients were prescribed systemic foscarnet. Adjunctive therapies included concurrent intravitreal antiviral therapy (ganciclovir N=1; foscarnet N=1) and adoptive immunotherapy with CMV antiviral specific T-cells (N=1, HCT). Improvement of ocular symptoms occurred in 2 patients at 15 and 20 days after starting targeted CMV antiviral therapy; one patient developed permanently impaired vision. Conclusion CMVR remains as an important complication in transplant recipients. Although CMVR incidence was low in our cohort of transplant recipients, it occurred most frequently in cases of CMV resistance, prolonged DNAemia, and led to permanent visual impairment in 1 of 3 patients. The development of resistant CMV may have a role in the occurrence, progression, and severity of CMVR. Additional pediatric-specific data are needed to better characterize CMVR and inform optimal prevention strategies.

En este trabajo se analizó el nivel de percepción de los estudiantes sobre la calidad del servicio los centros universitarios. Para ello participaron 684 estudiantes de pregrado de un programa de estudios elegidos aleatoriamente, a quienes se les aplicó una escala que intenta calcular lo que se espera del servicio educativo. Se encontró que el nivel de percepción es aceptable con tendencia a ser buena sobre la calidad del servicio que presta la universidad, no se encontraron diferencias estadísticamente significativas según la ocupación del estudiante, sin embargo, si se hallaron diferencias según género y centro de estudios evaluados. Por lo tanto, la calidad del servicio aceptado por el estudiante de la universidad se ve reflejada en el aspecto físico, la modernización y el equipamiento, precisando que el personal administrativo debe capacitarse mejor para brindar una adecuada atención al usuario. Palabras Clave: Calidad del servicio, estudiantes, atención al usuario. Referencias [1]Ministerio de Educación, «MINEDU: Ley Universitaria 30220,» 2015. [En línea]. Disponible en: http://www.minedu.gob.pe/reforma-universitaria/pdf/ley_universitaria.pdf. [Último acceso: 15 10 2020]. [2]D. Ceballos, «La Calidad Educativa en la realidad Universitaria Peruana frente al Contexto Latinoamericano,» Flumen, Revista de la Universidad Católica Santo Toribio de Mogrovejo, vol. 7, nº 1, pp. 3-8, 2014. [3]S. Carrasco, Metodología de la investigación científica. Pautas metodológicas para diseñar y elaborar el proyecto de investigación, Lima: Editorial San Marcos E.I.R.L., 2019. [4]J. C. Vergara y Q. V. Manuel, «Análisis de la calidad en el servicio y satisfacción de los estudiantes de Ciencias Económicas de la Universidad de Cartagena mediante un modelo de ecuaciones estructurales,» Revista electrónica de investigación educativa, vol. 13, nº 1, pp. 108-122, 2011. [5]L. Muñoz y J. I. Pérez, «Calidad del servicio de uso de aulas para la enseñanza-aprendizaje desde la perspectiva del estudiante,» Universidad, Ciencia y Tecnología, vol. 17, nº 69, pp. 161-169, 2013. [6]P. I. Palominos, L. E. Quezada, C. A. Osorio, J. A. Torres y L. M. Lippi, «Calidad de los servicios educativos según los estudiantes de una universidad pública en Chile,» Revista iberoamericana de educación superior, vol. 7, nº 18, pp. 130-142, 2016. [7]N. Maneiro, A. Mejías y M. L. Romero, «Evaluación de la calidad de los servicios, una experiencia en la educación superior Venezolana,» Investigación Arbitrada, vol. 12, nº 43, pp. 797-804, 2008. [8]A. Parasuraman, V. Zeithaml y L. Berry, «SERVQUAL: A Multiple-Item Scale for Measuring Consumer Perceptions of Service Quality.,» Journal of Retailing, vol. 64, nº 1, pp. 12-40, 1988. [9]F. Ganga, N. Alarcón y L. Pedraja, «Medición de calidad de servicio mediante el modelo SERVQUAL: el caso del Juzgado de Garantía de la ciudad de Puerto Montt - Chile,» Ingeniare. Revista chilena de ingeniería, vol. 27, nº 4, pp. 668-681, 2019. [10] J. Inquilla, W. Calsina y B. Velazco, «La calidad educativa y administrativa vista desde dentro: caso Universidad Nacional del Altiplano - Puno -Perú 2017,» Comuni@cción, vol. 8, nº 1, pp. 5-15, 2017. [11]A. Mejías y A. Agustín, «Modelo para medir la calidad del servicio en los estudiantes universitarios de postgrado,» Universidad, Ciencia y Tecnología, vol. 9, nº 34, pp. 81-85, 2005. [12]L. D. Sánchez y R. Panduro, «Sociabilización del concepto de calidad y licenciamientoen las universidades del Perú. Lima 2020,» IGOBERNANZA, vol. 3, nº10, pp. 11-28, 2020. [13]L. A. Rivera, Gestión de información académica y el desarrollo del capital humano en las universidades públicas licenciadas, Lima: Universidad Peruana de las Américas, 2019. [14]S. Carrasco, Metodología de la Investigación Científica. Pautas metodológicas para diseñar y elaborar el proyecto de investigación, Lima: Editorial San Marcos, 2019. [15]A. Mejías, O. Reyes y N. Maneiro, «Calidad de los Servicios en la Educación Superior Mexicana: Aplicación del Servqualing en Baja California.,» Revista Investigación y Ciencia, vol. 14, nº 34, pp. 36-41, 2006. [16]J. Arciniegas y A. Mejías, «Percepción de la calidad de los servicios prestados por la Universidad Militar Nueva Granada con base en la escala Servqualing,con análisis factorial y análisis de regresión múltiple,» Comuni@cción, vol. 8, nº 1, pp. 1-11, 2017. [17]D. Frias, Análisis de la consistencia interna de las puntuaciones de un instrumento de medida, Valencia: Universidad de Valencia, 2020. [18]J. L. Ventura, «Tamaño del efecto para la U de Mann-Whitney: aportes al artículo de Valdivia-Peralta et al.,» Revista chilena de neuro-psiquiatría, vol. 54, nº4, pp. 353-354, 2016. [19]M. Tomczak y E. Tomczak, «Se revisó la necesidad de informar las estimaciones del tamaño del efecto. Una descripción general de algunas medidas recomendadas del tamaño del efecto,» Trends Sport Sciences, vol. 1, nº 21, pp. 19-25, 2014. [20]J. Cohen, «A power primer,» Psychological Bulletin, vol. 112, nº 1, pp. 155-159, 1992.

BackgroundUnlicensed medications are used all the time in the management of diseases in childhood. Tolvaptan (Jinarc®) is a vasopressin V2-receptor antagonist licensed for use to slow the progression of cyst development and renal insufficiency of ADPKD in adults with CKD stage 1 to 3 with evidence of rapidly progressing disease. Studies of animal models implicate the antidiuretic hormone arginine vasopressin and its messenger cyclic adenosine monophosphate (cAMP) as promoters of kidney-cyst cell proliferation and luminal fluid secretion. The suppression of vasopressin release by means of high water intake, genetic elimination of vasopressin, and vasopressin V2-receptor blockade all reduce the cyst burden and protect kidney function1 A Phase 3 trial showed that Tolvaptan, as compared with placebo, slowed down the increase in total kidney volume and decline in kidney function in adults (average 39 yrs) with ADPKD over a 3-year period.2 ADPKD is the most common form of polycystic kidney disease (PKD) typically late in onset and results from mutation of either of two genes: PKD1 and PKD2. Autosomal recessive polycystic kidney (ARPKD), the other form of PKD, is 20 times less common, presents primarily in infancy and childhood, is typically more severe, and commonly associated with hypertension. ARPKD results from mutation of PKHD1. In spite of these differences, there is growing evidence to suggest that ADPKD and ARPKD are more related than previously suspected.3 Bilineal inheritance of PKD1 abnormalities has been reported to cause extremely severe disease resembling ARPKD.4 The use of Tolvaptan in the management of PKD in children is therefore expected to become more important.AimTo describe the first known UK use of Tolvaptan in a neonate with severe ADPKD and the role of the hospital pharmacist in facilitating the use.MethodThe role descriptor of hospital pharmacists produced by the World Health Organisation (WHO) was adapted and used to map the pharmaceutical challenges of using Tolvaptan in this child. The descriptor include: (i) Promotion of rational prescribing of drugs, (ii) Use of specialist pharmacists networks to gain greater expertise; (iii) Monitor compliance and therapeutic response and report adverse drug reactions; (iv) ensure supply of high quality products; (v) partake in planning and implementation of clinical trials.ResultsThe use of Tolvaptan for indication other than hyponatraemia and other endocrine uses are not routinely commissioned by NHS England. In view of the exceptionality of this case – a severe neonatal form of ADPKD with estimated prevalence of the order of 1 in tens of millions, an Individual Funding Request (IFR) application was made and was approved. The application was supported by financial information provided by the hospital pharmacist who facilitated the application process. Using available information and formulation knowledge, a suspension was eventually recommended and was well tolerated. This resulted in approximately 85% reduction in the cost of treatment over six months. Tolvaptan produced the expected aquaresis and blood pressure reduction. Initial dose of 0.1 mg/kg/day was used and increased according to weight and clinical response. Initial monitoring parameters, which included 4 hourly blood pressure, urine and electrolytes and hepatic function, were recommended. Electrolyte supplements were adjusted accordingly. At 2-month review point, there was no oedema of leg and face but the kidneys were still enlarged. The long term effect on cyst burden and kidney function is being evaluated and will feed into the IFR process.ConclusionThe use of unlicensed medications in children poses a number of pharmaceutical challenges and can be managed through a multidisciplinary approach to treatment intervention. It also re-enforce the paediatric formulation challenge to pharmaceutical companies in which formulation needs are prioritised and existing data are better used to facilitate paediatric formulation development.

The process of the school inclusion disabilities students’ cannot be broadly understood when the family is disregarded. The objective of this study was to characterize the needs of relatives of students who presented some kind of disability, in the schooling process of the regular education system in the city of Dourados/MS, and reflect upon rapprochement possibilities of school and family, based on such characterization. Survey research was developed through interviews, applied individually to 59 families of students with disabilities enrolled in four municipal schools. The most evident need expressed by family members was of receiving information. Few relatives affirmed they were able to rely on the contribution of other, non-relative caretakers and revealed high concern related to the future of the child with disabilities, as well as to their health. Frustration and anxiety (and also marital problems) were also revealed when the child with disabilities is not able to perform everyday tasks. On the other hand, the study revealed that family members have potential, such as making use of adaptation strategies, acceptance and positive perceptions regarding the disability. Most of the families have shown that they are satisfied with the school professionals and have expressed a desire to contribute to the better development of their children. With the presented profile, it is possible for school professionals to plan actions aimed at addressing such needs to some extent, as well as to enhance the present strengths, walking towards the empowerment of these families.ResumoO processo de inclusão escolar do aluno com deficiência não pode ser compreendido de forma ampla quando o âmbito familiar é desconsiderado. O objetivo geral do trabalho consistiu em caracterizar as necessidades de familiares de alunos que apresentavam algum tipo de deficiência, em processo de escolarização na rede regular de ensino de Dourados/MS, e refletir sobre possibilidades de aproximação entre escola e família, com base em tal caracterização. Foi desenvolvida pesquisa de levantamento por meio da realização de entrevistas, aplicadas individualmente junto a 59 familiares de alunos com deficiência matriculados em quatro escolas municipais. A necessidade mais evidente manifestada pelos familiares foi a de receber informações. Além disso, poucos familiares relataram poder contar com a colaboração de outros cuidadores fora da família e manifestaram elevado índice de preocupação relacionado ao futuro do filho com deficiência, assim como à saúde do mesmo. Também foi manifestada frustração e ansiedade quando o filho com deficiência não consegue desempenhar as tarefas do cotidiano, assim como problemas conjugais. Por outro lado, o estudo revelou que os familiares apresentam potencialidades, tais como fazer uso de estratégias de adaptação, aceitação e percepções positivas em relação à deficiência. Em sua maioria as famílias demonstraram satisfação com os profissionais da escola e manifestaram o desejo de contribuir para o melhor desenvolvimento de seus filhos. Diante do perfil apresentado, é possível para os profissionais da escola planejar ações que visem suprir tais necessidades, assim como potencializar os pontos fortes já apresentados, caminhando na direção do empoderamento dessas famílias.ResumenEl proceso de inclusión escolar del estudiante con discapacidad no puede ser comprendido de forma amplia cuando el ámbito familiar es desconsiderado. El objetivo general del trabajo consistió en caracterizar las necesidades de los familiares de los estudiantes que presentaban algún tipo de discapacidad, en el proceso de escolarización en la red regular de enseñanza de Dourados/MS, así como reflexionar sobre las posibilidades de acercamiento entre la escuela y la familia. Se desarrolló una investigación de la encuesta por medio de la realización de entrevistas, aplicadas individualmente junto a 59 familiares de alumnos con discapacidad matriculados en cuatro escuelas municipales. Con relación a las necesidades, la más evidente manifestada por los familiares fue la de recibir información. Además, pocos familiares relataron poder contar con la colaboración de otros cuidadores fuera de la familia y manifestaron un alto índice de preocupación relacionado al futuro de su hijo con discapacidad, al igual que la salud del mismo. También se manifestó frustración y ansiedad cuando su hijo con discapacidad no logra desempeñar las tareas de lo cotidiano, así como problemas conyugales. Por otro lado, el estudio reveló que los familiares presentan potencialidades, tales como hacer uso de estrategias de adaptación, aceptación y percepciones positivas en relación a la discapacidad. En su mayoría las familias demostraron su satisfacción con los profesionales de la escuela y manifestaron el deseo de contribuir aún mejor desarrollo de sus hijos. Ante el perfil presentado, es posible para los profesionales de la escuela planificar acciones que apunten a suplir tales necesidades, así como potenciar los puntos fuertes ya presentados, caminando hacia el empoderamiento de esas familias.Palabras clave: Familia, Relación escuela-familia, Inclusión escolar.Palavras-chave: Família, Relação escola-família, Inclusão educacional.Keywords: Family, Family school relationship, Educational inclusion.ReferencesAIELLO, A. R. Família inclusiva. In: PALHARES, M. S.; MARTINS, S. C. T. (Orgs). Escola inclusiva. 1ª edição. São Carlos: EdUFSCar, 2002, 286 p.ARAÚJO, R. M. Empoderando pais para a luta pelos direitos de seus filhos com deficiência: pesquisa ação emancipatória. 2011. 187 f. Dissertação (Mestrado em Educação Especial). Universidade Federal de São Carlos, São Carlos, 2011.BARBOSA, A. J. G.; DESSEN, M. A.; SILVA, N. L. P. Ajustamento conjugal. Comparação entre casais com e sem filhos com deficiência intelectual. Revista Psico-USF, Bragança Paulista, v. 20, n. 2, p. 297-308, 2015. Disponível em: <www.scielo.br http://dx.doi.org/10.1590/1413-82712015200210>. Acesso em 10 de agosto de 2016.BOGO, M. L. F.; CAGNINI, Z. V. S.; RADUENZ, M. Momento do diagnóstico de deficiência: sentimentos e modificação na vida dos pais. 2014. Disponível em <https://psicologado.com/psicologia-geral/desenvolvimento-humano/momento-do-diagnostico-de-deficiencia-sentimentos-e-modificacoes-na-vida-dos-pais> Acesso em 20 de dezembro de 2015.BRASIL. Lei nº 9.394, de 20 de dezembro 1996. Diretrizes e Bases da Educação Nacional. Disponível em: <http://www.planalto.gov.br/ccivil_03/leis/L9394.htm>. Acesso 20 de maio de 2015.BRASIL. Lei nº 12.435, de 6 de Julho de 2011. Altera a Lei nº 8742, de dezembro de 1993 que dispõe sobre a organização da Assistência Social. Disponível em: <http://www.planalto.gov.br/ccivil_03/_ato2011-2014/2011/lei/l12435.htm>. Acesso em 12 de agosto de 2016.BRASIL. Lei nº. 13.146, de 06 de julho de 2015. Lei Brasileira de Inclusão da Pessoa com Deficiência. Disponível em: <http://www.sdh.gov.br/sobre/acesso-a-informacao/licitacoes-e-contratos/termos-de-cooperacao/cooperacao internacional/editais-2015/2o-semestre/projeto-oei-bra-08-001-edital-no-63-2015>. Acesso em: 10/07/2015.BRONFENBRENNER, U. A ecologia do desenvolvimento humano: experimentos naturais e planejados. Trad. Maria Adriana Veríssimo Veronese. 1ª edição. Porto Alegre: Artes Médicas, 1996, 267 p.BRONFENBRENNER, U. Bioecologia do desenvolvimento humano: tornando os seres humanos mais humanos. Trad. André de Carvalho-Barreto. 1ª edição. Porto Alegre: Artmed, 2011.BRUNHARA, F.; PETEAN, E. B. L. Mães e filhos especiais: reações, sentimentos e explicações à deficiência da criança. Revista Paidéia, 1999. Disponível em http://www.scielo.br/pdf/paideia/v9n16/04.pdf Acesso em 30 de setembro de 2016BURD, M. Novas configurações familiares: desafios e soluções para terapia familiar com pacientes crônicos. Rio de Janeiro: Wak Editora, 2015.CASTRO, M.; REGATTIERI, M. Interação família-escola: subsídios para práticas escolares. Brasília: UNESCO, MEC, 2009.CIA, F.;CHRISTOVAM, A. C. C. Comportamentos de pais e professores para promoção da relação família e escola de pré-escolares incluídos. Revista Educação Especial, v. 29, n. 54 p. 133-146, jan. /abr. 2016. Santa Maria. Disponível em: <http://www.ufsm.br/revistaeducacaoespecial>. Acesso em 10 de julho de 2016.COZBY, P. C. Métodos de pesquisa em ciências do comportamento. Tradução Paula Inez Cunha Ganade, Emma Otta; revisão técnica José de Oliveira Siqueira. São Paulo: Atlas, 2003.GUALDA, D. S.; BORGES, L.; CIA, F. Famílias de crianças com necessidades educacionais especiais: recursos e necessidades de apoio. 2013. Disponível em: <http://cascavel.ufsm.br/revistas/ojs2.2.2/index.php/educacaoespecial/article/view/5379>. Acesso em: 20 de agosto de 2015.GUALDA, D. S.; BORGES, L.; CIA, F. Relação Família e Escola e Educação Especial: Opinião de Professores. Revista Educação: Teoria e Prática. Jan.-abr. 2015, Vol. 25 Issue 48, p168-185. 18p.HANSEL, A. F.; BOLSANELLO, M. A. O Envolvimento Parental nos Programas de Estimulação Precoce. In: SHIZUKO, D. F. et al. (Org.) Família e educação especial. Londrina: ABPEE, 2009. 136 p. (Série Estudos Multidisciplinares de Educação Especial, n. 7).MARCONDES, K. H. B.; SIGOLO, S. R. R. L. Comunicação e Envolvimento: Possibilidades de Interconexões entre Família-escola. 2012. Disponível em: <http://www.scielo.br/pdf/paideia/v22n51/11.pdf>. Acesso em: 10 de maio de 2015.MARTINS, M. F. A. Efeitos de um programa de atenção diversificado às mães de alunos severamente prejudicados. 2006. 165f. Tese (Doutorado em Educação Especial). Universidade Federal de São Carlos, São Carlos, 2006.MATURANA, A. P. P. M.; CIA, F. Educação especial e a relação família-escola: análise da produção científica de teses e dissertações. Revista Quadrimestral da Associação Brasileira de Psicologia Escolar e Educacional, São Paulo, v. 19, n. 2, p. 349-358, mai./ago. de 2015.MENDONÇA, C. Desafio da Inclusão Escolar e a Importância da Parceria entre a Escola e a Família: um Estudo de Caso. 2014. Disponível em: <http://repositorio.uniceub.br/bitstream/235/6170/1/20905140.pdf>. Acesso em 03 de junho de 2015.MILLER, N. B. Ninguém é perfeito. Tradução Lúcia Helena Reily. - Campinas, SP: Papirus, 1995. - (Coleção educação especial).OLIVEIRA, I. G. de; POLETTO, M. Vivências emocionais de mães e pais de filhos com deficiência. SPAGESP - Sociedade de Psicoterapias Analíticas Grupais do Estado de São Paulo, Revista da SPAGESP, 16(2), 102-119, 2015.PANIAGUA, G. As famílias de crianças com necessidades educativas especiais. In: COLL, C.; MARCHESI, A.; PALACIOS, J. e col, tradução de Fátima Murad, Desenvolvimento psicológico e educação: transtornos de desenvolvimento e necessidades educativas especiais, volume 3, 2ª edição, Porto Alegre: Artmed, 2004.POLONIA, A. C.; DESSEN, M. A. Família e a escola como contextos de desenvolvimento humano. 2007. Disponível em <http://www.scielo.br/pdf/paideia/v17n36/v17n36a03.pdf>. Acesso em 10 de novembro de 2016SÁ, S. M. P.; RABINOVICH, E. P. Compreendendo a família da criança com deficiência física. Revista Brasileira de Crescimento e Desenvolvimento Humano, 16(1): 68-84, 2006.SILVA, A. M. Buscando componentes da parceria colaborativa na escola entre família de crianças com deficiência e profissionais. 2007. 122 f. Dissertação (Mestrado em Educação Especial). Universidade Federal de São Carlos, São Carlos, 2007.SILVA, A. M. Conhecendo as necessidades de familiares de alunos de educação infantil especial. Monografia de Graduação em Psicologia. São Carlos: Universidade Federal de São Carlos - UFSCar, 2004.SILVA, A. M.; CABRAL, L. S. A.; MARTINS, M, de F. A. Abordagem relacional entre família e escola inclusiva sob as perspectivas de professores. Revista Interfaces da Educ., Paranaíba, v.7, n.19, p.191-205, 2016.SZYMANZKI, H. A relação família/escola: desafios e perspectivas. 1ª ed. Brasília: Plano Editora, 2003, 96 p.TAANILA, A.; SYRJALA, L.; KOKKONEM, J. JARVELIN, R. Coping of parents with physically and/or intellectually disabled children. Child: Care, Health & Developmental, 28 (1), 2002, 73-86.TAVARES. C. M. M.; NOGUEIRA. Relação Família-Escola: possibilidades e desafios para a construção de uma parceria. Revista Formação Docente, v. 5, n. 1, 2013.TURNBULL, H. R.; GUESS, D.; TURNBULL, A. P. Vox populiand baby doe. Mental Retardation, v. 26, p.127 - 132, 1988.

El objetivo del estudio fue analizar el nivel de compromiso laboral según factores sociolaborales en colaboradores de dos gobiernos locales, el estudio se realizó en 477 colaboradores de gestión local elegidos aleatoriamente, a quienes se les aplicó la escala UWES-17 (Utrecht Work Engagement Scale). Se encontró que el nivel de compromiso laboral en los colaboradores es de nivel medio, no se encontraron diferencias estadísticamente significativas según sexo y condición laboral, sin embargo, si se hallaron diferencias según centro de trabajo. En conclusión, el nivel de compromiso laboral en los colaboradores se debe a que aún no han experimentado totalmente un estado psicológico positivo hacia su trabajo, para poder dedicarse, involucrarse, entusiasmarse y sentirse bien en su espacio laboral. Palabras Clave: compromiso laboral, colaboradores, gobiernos locales. Referencias [1]Ley Orgánica de Municipalidades. Ley N° 27972, Perú. [2]T. d. J. Cárdenas y A. Jaik, El Engagement (ilusión por el trabajo) y los factores que lo integran, Durango: Fundación Dialnet, 2013. [3]A. Juarez, «Engagement laboral, una concepción científica: entrevista con Wilmar Schaufeli,» Liberabit, vol. 21, nº 2, pp. 187-194, 2015. [4]B. L. Rich, J. A. Lepine y E. R. Crawford, «Job engagement: Antecedents and effects on,» Academy of Management Journal, vol. 53, nº 3, pp. 617-635, 2010. [5]D. Álvarez, C. Castro y G. Vila, «Actitudes y engagement en el trabajo como antecedentes del comportamiento altruista,» Revista Venezolana de Gerencia, vol. 19, nº 65, pp. 23-42, 2014. [6]S. Carrasco, Metodología de la investigación científica. Pautas metodológicas para diseñar y elaborar el proyecto de investigación, Lima: Editorial San Marcos E.I.R.L., 2019. [7]R. Benítez y A. R. Del Aguila, «Compromiso en el trabajo y prácticas de recursos humanos de alto rendimiento en organizaciones de acción social. El caso deAspromanis,» Lan Harremanak - Revista de Relaciones Laborales, vol. 32, nº 1, pp. 159-179, 2015. [8]M. M. Chiang, I. I. Fuentealba y R. A. Nova, «Relación Entre Clima Organizacional y Engagement, en Dos Fundaciones Sociales, Sin Fines de Lucro, de laRegión del Bio Bio,» Ciencia & trabajo, vol. 19, nº 59, pp. 105-112, 2017. [9]M. J. Foncubierta y J. M. Sánchez, «Hacia la Felicidad laboral: Atender motivaciones y eliminar temores digitales,» RETOS. Revista de Ciencias de la Administración y Economía, vol. 9, nº 18, pp. 239-257, 2019. [10]R. R. Romero y F. Palacini, «Relación entre niveles de engagement y niveles de intención de rotación en empleados de dos empresas privadas de Asunción,» Revista Científica de la UCSA, vol. 7, nº 2, pp. 3-25, 2020. [11]J. Pérez y X. L. Pedraza, «Medición del work engagement y su relación con la comunicación, liderazgo y TIC en una empresa editorial mexicana,» SIGNOS, vol. 11, nº 1, pp. 37-53, 2019. [12]W. Schaufeli y A. Bakker, UWES – Utrecht Work Engagement Scale, manual preliminar, Utrecht: Unidad de Psicología de la Salud Ocupacional Universidad de Utrecht, 2003. [13]C. A. Contreras, «Determination of the level of work Engagement among employees of an oil and gas facility offshore in Mexico,» Ciencia & trabajo, vol. 17,nº 52, pp. 37-42, 2015. [14]C. Flores, M. Fernández, A. Juárez, C. Merino y M. Guimet, «Entusiasmo por el trabajo (engagement): un estudio de validez en profesionales de la docencia en Lima, Perú,» Liberabit, vol. 21, nº 2, pp. 195-206, 2015. [15]F. J. López y C. Chiclana, «Engagement, una plataforma para el desarrollo de la persona,» Comunicación y Hombre, vol. 14, nº 1, pp. 53-62, 2017. [16]F. Luna y M. Ross, «Cultura organizacional y engagement en colaboradores de una empresa agroindustrial de Lambayeque,» Tesis de grado, Universidad Señor de Sipán, Pimentel, Perú, 2017. [17]K. S. Diaz, «Engagement entre dos instituciones financieras de Chiclayo,» Tesis de grado, Universidad Señor de Sipán, Pimentel, Perú, 2016. [18]J. Amozorrutia, (2017, abril, 19). La emoción de sentirse bien en el Trabajo. «Great Place to Work,» [En línea]. Disponible: https://www.greatplacetowork.com.pe/publicaciones/otros/blog/la-emocion-de-sentirsebien-en-el-trabajo. [Último acceso: 22 julio 2020]. [19]D. Pérez, J. Peralta y P. Fernández-Davila, «Influencia de variables organizacionales en la calidad de vida laboral de funcionarios del sector público de saluden el extremo norte de Chile,» Universitas Psychologica, vol. 13, nº 2, pp. 541-551, 2014. [20]M. F. Gutiérrez, «Compromiso organizacional y compromiso con el trabajo en instituciones de gestión pública,» Tesis de maestría, Universidad Nacional deEducación, Lima, Perú, 2019. [21]L. V. Chero y L. V. Cordova, «Cultura Organizacional y su relación con el Engagement Laboral en los Colaboradores de la Municipalidad Distrital de Independencia, » Huaraz, Tesis de grado, Universidad César Vallejo, Lima, Perú, 2018. [22]R. A. Herrera y W. A. Álvarez, «El engagement en las organizaciones: caso de un municipio en Ecuador,» Revista de Ciencias Sociales y Humanisticas, vol. 3, nº 16, pp. 89-107, 2019. [23]E. T. Sancho, «Compromiso organizacional según variables sociolaborales en trabajadores de una institución educativa de Lima Metropolitana,» Tesis de grado, Universidad San Ignacio de Loyola, Lima, Perú, 2018. [24]U. Hallberg y W. Schaufeli, Utrecht Work Engagement (UWES), Utrecht , 1999. [25]D. Frías, Apuntes de consistencia interna de las puntuaciones de un instrumento de medida, Valencia: Universidad de Valencia, 2019. [26]J. L. Ventura, «Tamaño del efecto para la U de Mann-Whitney: aportes al artículo de Valdivia-Peralta et al.,» Revista chilena de neuro-psiquiatría, vol. 54, nº4, pp. 353-354, 2016. [27]R. J. Grissom, «Probability of the superior outcome of one treatment over another.,» Journal of Applied Psychology, vol. 79, nº 2, pp. 314-316, 1994. [28]M. Tomczak y E. Tomczak, «The need to report effect size estimates revisited. An overview of some recommended measures of effect size,» Trends SportSciences, vol. 1, nº 21, pp. 19-25, 2014. [29]S. Domínguez, «Magnitud del efecto, una guía rápida, » Educación Médica, vol. 19, nº 4, pp. 251-254, 2018.

Hoy por hoy, la responsabilidad social empresarial (RSE) es una nueva forma de enfocar las organizaciones, y de tener un poco de conciencia o respeto hacia los diferentes medios o entornos en los cuales éstas desarrollan sus actividades empresariales. Aparte de ello se puede mencionar que, aunque no existe una gran cantidad de organizaciones pertenecientes al sector secundario, encargado de transformar la materia prima en un bien final, existe una amplia cantidad de pequeñas y medianas empresas (Pymes) del sector primario en la región amazónica, que realizan actividades como la extracción de madera, carbón, peces, producción de ganado, entre otras, acciones que perjudican toda la biodiversidad de la Amazonía colombiana. El presente artículo es de enfoque cualitativo y tipo metodológico descriptivo, ya que se buscó caracterizar el impacto de la RSE en la Amazonía colombiana por parte de las pequeñas y medianas empresas. Referencias: Acero, R. (2016). Lineamientos estratégicos para la incorporación congruente de la variable ambiental en los planes y esquemas de ordenamiento territorial de Colombia (Tesis de Maestría). Universidad de Chile. Recuperado de http://mgpa.forestaluchile.cl/Tesis/Acero%20Ronald.pdf Agudelo, E. (2015). Bases científicas para contribuir a la gestión de la pesquería comercial de bagres (familia pimelodidae) en la Amazonía colombiana y sus zonas de frontera. Recuperado de https://ddd.uab.cat/record/142475 Agudelo, S. (2009). Responsabilidad Social Empresarial, Una mirada desde Colombia. Revista de Negocios Internacionales, 2(1), 3‐11. Altuna, M. (2013). Los Factores de la Responsabilidad Social: El Análisis de las Pequeñas y Medianas Empresas Manufactureras Guipuzcoanas. Azkoaga, 16, 149-172. Anónimo. (s.f.). La RSE. “Modelo de Buena Práctica Empresarial”. Recuperado de https://aprendeenlinea.udea.edu.co/revistas/index.php/ tgcontaduria/article/viewFile/323512/20780676 Arenas, A., Escobar, E., Acosta, J., Monsalve, L. y Oyola, E. (2012). RSE “Moda o Compromiso Real” (Trabajo de Grado). Universidad de Medellín. Medellín, Colombia. Recuperado de http://repository.udem.edu.co/bitstream/handle/11407/357/ Responsabilidad%20social%20empresarial.%20%E2%80%9CModa% 20o%20compromiso%20 real%E2%80%9D.pdf?sequence=1&isAllowed=y Aristimuño, M. y Rodríguez, C. (2014), Responsabilidad social universitaria. Su gestión desde la perspectiva de directivos y docentes. Estudio de caso: una pequeña universidad latinoamericana. Interciencia, 39(6), 375-382. Baltera, P., Díaz, E. y Dussert, J. (2005). Responsabilidad Social Empresarial, Alcances y Potencialidades en Materia Laboral. Cuaderno de Investigación N° 25. Recuperado de http://www.dt.gob.cl/portal/1626/articles-88984_recurso_1.pdf Barrena, A. (2012). La protección de las especies silvestres, especial tratamiento de la protección en situ (Tesis doctoral). Universidad de Alicante. Recuperada de https://rua.ua.es/dspace/handle/10045/28038Bencomo, T. (2007). Desarrollo de las TIC y la formación profesional. http://www.saber.ula.ve/bitstream/handle/123456789/25149/articulo1.pdf; jsessionid=A8697326F48141C4F9366A86EA3CED46?sequence=2 Buriticá, L. (2011). La RSE y su Relación Teórica con la Gestión del Talento Humano. Universidad de Manizales (Tesis de Maestría). Universidad de Manizales. Recuperado de http://ridum.umanizales.edu.co:8080/xmlui/bitstream/handle/6789/297/Buritica_ Castro_Lida_Marcela_ 2011.pdf?sequence= Camejo, A. y Cejas, M. (2009). Responsabilidad social: factor clave de la gestión de los recursos humanos en las organizaciones del siglo XXI. Nómadas, Critical Journal of Social and Juridical Sciences, 21(1), 127-142. Cardona, C. y Giraldo, L. (2010). Estandarización de Indicadores de Responsabilidad Social Empresarial Propuestas por Organizaciones de Reconocimiento Mundial (Trabajo de Grado). Universidad Tecnológica de Pereira. Recuperado de http://repositorio.utp.edu.co/dspace/bitstream/handle/11059/1549/ 658408C268. pdf;jsessionid=A24F7FD84FFE4F942F3159EE7AB68BF7?sequence=1 Congreso de la República de Colombia. (2000). Ley 590 de 2000 “por la cual se dicta disposiciones para promover el desarrollo de las micro, pequeñas y medianas empresas”. Bogotá, Colombia. Recuperada de http://www.alcaldiabogota.gov.co/sisjur/normas/Norma1.jsp?i=12672 Curatola, G. (2011). Patrones de distribución espacial de Triplaris Americana en Tambopata, Perú. Pontificia Universidad Católica del Perú. Recuperado de http://tesis.pucp.edu.pe/repositorio/handle/123456789/454 De La Cuadra, F. (2013). Cambio climático, movimientos sociales y políticas públicas, una vinculación necesaria. Recuperado de https://journals.openedition.org/polis/9651 Delgado, V. y Olarte, M. (2012). Responsabilidad social corporativa en el sector de la televisión. Un estudio longitudinal de las memorias de sostenibilidad. Revista Internacional de Investigación en Comunicación aDResearch ESIC, 6(6), 112-129. Delgado, Y., Herrera, N. y Gallón, C. (2014). La Responsabilidad Social Empresarial: una mirada a la aplicación en el sector transporte público automotor. Trabajos de Grado Contaduría Pública, 8(1), 1-29. Duque, Y., Cardona, M. y Rendón, J. (2013). Responsabilidad Social Empresarial: Teorías, índices, estándares y certificaciones. Cuadernos de Administración, 29(50), 196-206. Escamilla, S., Jiménez, I. y Prado, C. (2013). La Responsabilidad Social Empresarial, una forma de crear valor. Madrid, España: Editorial Académica Española. Fernández, C. (2012). Responsabilidad Social Empresarial: Cultura y Medio ambiente (Tesis de Posgrado). Recuperado de http://repositorio.uchile.cl/handle/2250/112084 Franco, C. (s.f.). Dinámica de construcción de una nueva sociedad desde los negocios. Recuperado de http://interamerican-usa.com/articulos/Gob-Corp-Adm/Responsabilidad%20Social%20Carolina%20Franco[1].pdf García, M. y Duque, J. (2012). Gestión Humana y Responsabilidad Social Empresarial: un enfoque estratégico para la vinculación de prácticas responsables a las Organizaciones. Libre Empresa, 17, 13-37. Gil, F. (2013). La responsabilidad social universitaria desde la perspectiva ambiental: universidad y desarrollo sustentable (Tesis de Maestría). Universidad Nacional Autónoma de México. Recuperado de http://132.248.9.195/ptd2013/agosto/0700625/0700625.pdf Gómez, M. (2010). La Gestión y la Información sobre la Responsabilidad Social Empresarial de las PYMES: la Necesidad de Diferenciación. Contaduría Universidad de Antioquia, 56, 15-40. Gómez-Villegas, M. y Quintanilla, D. (2012). Los informes de Responsabilidad Social Empresarial: su evolución y tendencias en el contexto internacional colombiano. Cuadernos de Contaduría, 13(32), 121-158. Gómez, H. (2014). Responsabilidad Social Empresarial en la municipalidad de Huehuetenango (Trabajo de Grado). Universidad Rafael Landívar. Recuperado de http://biblio3.url.edu.gt/Tesario/2014/01/01/Gomez-Helen.pdf Guerra, F., Higuera, K., Molina, F. y Villagrán, P. (2015). Estudio comparativo sobre responsabilidad social entre empresas y países. Recuperado de http://repositorio.uchile.cl/bitstream/handle/2250/131943/ Estudio%20comparativo %20sobre% 20responsa.pdf Henao, J. (2013). La Responsabilidad Social Empresarial como Estrategia de Gestión en la Organización Pranha S.A. (Tesis de Maestría). Universidad Nacional de Colombia. Recuperado de http://www.bdigital.unal.edu.co/12095/1/7711507.2013.pdf Lara, M. (2003). La responsabilidad social de la empresa: implicaciones contables. España: Editorial Edisofer S.L. López, I. (2014). El cambio climático, ¿reto para la Responsabilidad Social Empresarial? Revista Internacional de Organizaciones, 13, 39-53. Mantilla, M. (2012). Responsabilidad Social Empresarial y Población Indígena Colombiana. Bogotá, Colombia: Fondo de Publicaciones de la Universidad Sergio Arboleda. Méndez-Beltrán, J. y Peralta-Borray, D. (2014). Reflexiones respecto a la Responsabilidad Social Empresarial y la creación de valor económico desde la perspectiva de los proveedores. Cuadernos de Contabilidad, 15(38), 625-645. Meza, A. (2007). La Responsabilidad Social Empresarial como factor de competitividad (Trabajo de Grado). Pontificia Universidad Javeriana, Bogotá, Colombia. Recuperado de http://www.javeriana.edu.co/biblos/tesis/economia/tesis27.pdf Milian, L. (2015). Responsabilidad social corporativa. Origen y evolución del concepto de RSC en el entorno empresarial europeo y español. Recuperado de https://repositorio.comillas.edu/rest/bitstreams/7232/retrieve Montoya, J. (2011). Plan de educación ambiental para el desarrollo sostenible en los colegios de la institución La Salle. Recuperado de https://www.tesisenred.net/handle/10803/41714 Montoya, B. y Martínez, P. (Coord.). (2012). Responsabilidad Social Empresarial: Una Respuesta Ética ante los Desafíos Globales. Recuperado de http://www.kas.de/wf/doc/kas_37565-1522-4-30.pdf?140425034037 Navarro, F. (2008). Responsabilidad Social Corporativa: Teoría y Práctica. Recensiones, Revista del Ministerio de Trabajo e Inmigración, 76, 193-195. Núñez, I., González, E. y Barahona, A. (2003). La biodiversidad: historia y contexto de un concepto. Interciencia, 28(7), 387-393. Observatorio de Responsabilidad Social Corporativa. Comisión Europea. (2001). Libro Verde: Fomentar un Marco Europeo para la Responsabilidad Social de las Empresas. Recuperado de https://observatoriorsc.org/libro-verde-fomentar-un-marco-europeo-para-la-responsabilidad-social-de-las-empresas/ Ortiz, P. (2009). La Responsabilidad Social Empresarial como base de la estrategia competitiva de HZX (Trabajo de Grado). Pontificia Universidad Javeriana, Colombia. Recuperado de https://repository.javeriana.edu.co/handle/10554/9169 Pérez, C. (2014). Acuerdos ambientales multilaterales para la conservación de la biodiversidad. Análisis de cumplimiento en Chile (Tesis de Maestría). Universidad de Chile. Recuperado de http://mgpa.forestaluchile.cl/Tesis/Perez%20Cristian.pdf Porter, M. & Kramer, M. (2011). Creating Shared Value. Recuperado de https://hbr.org/2011/01/the-big-idea-creating-shared-value Puentes, R., Antequeras, J. y Velasco, M. (2008). La responsabilidad social corporativa y su importancia en el espacio europeo de educación superior. Recuperado de https://dialnet.unirioja.es/servlet/articulo?codigo=2740076 Rodríguez, Y., Alemán, R., Domínguez, J., Soria, S., Hernández, H. Salazar, C. y Jara, A. (2016). Efecto de dos abonos orgánicos (compost y biol) sobre el desarrollo morfológico de Beta vulgaris L. var. cicla bajo condiciones de invernadero. Revista Amazónica Ciencia y Tecnología, 5(2), 103-117. Ruiz, J. (2013). Diseño de Modelo de Responsabilidad Social Empresarial en PYME Constructora Araucana (Tesis de Maestría). Universidad Nacional de Colombia sede Orinoquia. Recuperado de http://www.bdigital.unal.edu.co/10192/1/7709579.2013.pdf Saavedra, M. (2011). La Responsabilidad Social Empresarial y las Finanzas. Cuadernos de administración, 27(46), 39-54. Sabogal, J. (2008). Aproximación y cuestionamientos al concepto RSE. Revista Facultad de Ciencias Económicas, 16(1), 179-195. Sánchez-Calero, J. (2013). La Responsabilidad Social Empresarial y la buena administración. GCG Globalización, Competitividad y Gobernabilidad, 7(3), 103-114. Sanín, S. y Redondo, J. (2008). Aplicación de Responsabilidad Social Empresarial (RSE) en el Proyecto de Infraestructura Vial Concesión Santa Marta - Paraguachón con respecto a los stakeholders comunitarios (Trabajo de Grado). Fundación Universidad del Norte. Barranquilla. Recuperado de http://manglar.uninorte.edu.co/bitstream/handle/10584/ 127/39.773.438.%20doc. pdf? sequence=1 Sarmiento, S. (2011). La Responsabilidad Social Empresarial: gestión estratégica para la supervivencia de las empresas. Revista Dimens, 9(2), 6-15. Vargas, O. (2011). Restauración ecológica: Biodiversidad y conservación. Acta Biológica Colombiana, 16(2), 221-246. Vargas, L. (2017). Estrategias de gestión empresarial sostenible para el complejo turístico Paraíso escondido de la ciudad Ibarra. Recuperado de http://dspace.uniandes.edu.ec/handle/123456789/5827 Vásquez, Y. (2015). Evaluación sociocultural de servicios ecosistémicos del Parque Nacional de Cutervo, región Cajamarca-Perú (Tesis de Maestría). Universidad de Chile. Recuperada de http://mgpa.forestaluchile.cl/Tesis/Vasquez%20Yaneth.pdf Vives, A. y Peinado-Vara, E. (Eds.). (2011). Responsabilidad Social Empresarial. La responsabilidad social de la empresa en América Latina. Recuperado de https://publications.iadb.org/bitstream/handle/11319/5383/ La%20responsabilidad%20social%20de%20la%20empresa%20en% 20Am%C3%A9rica%20Latina %20.pdf?sequence=1 World Resources Institute (WRI), Unión Internacional para la Conservación de la Naturaleza (UICN) y Programa de las Naciones Unidas para el Medio Ambiente (PNUMA). (1992). Estrategia Global para la Biodiversidad. Guía para quienes toman decisiones. Recuperado de http://pdf.wri.org/estrategiabiodiversidadespguia_bw.pdf

The pandemic that occurred this year created conditions that changed the activities of parents and children, the role of parents working outside the home often led to a lack of parental involvement in child development, especially the development of independence. The conditions of the Covid-19 pandemic have caused parents and children to be in one place at the same time. This study aims to determine the effect of parental involvement and maternal employment status on the independence of children aged 7-8 years in the Covid-19 pandemic situation. This quantitative research uses a comparative causal ex-post facto design, with groups of working mothers and groups of non-working mothers. The sample of each group was 60 people who were randomly selected. The findings of the study with the calculation of the two-way ANOVA test obtained the value of Fo = 4.616> F table = 3.92 or with p-value = 0.034 <α = 0.05, indicating that there is an interaction between parental involvement and maternal employment status on children's independence, and Based on the results of hypothesis testing, there is no effect of parental involvement and mother's work status on the independence of the child even though there are differences in the average results of children's independence. Keywords: Children's Independence, Parental Involvement and Mothers' Employment References: Areepattamannil, S., & Santos, I. M. (2019). Adolescent students’ perceived information and communication technology (ICT) competence and autonomy: Examining links to dispositions toward science in 42 countries. Computers in Human Behavior. https://doi.org/10.1016/j.chb.2019.04.005 Benner, A. D., Boyle, A. E., & Sadler, S. (2016). Parental Involvement and Adolescents’ Educational Success: The Roles of Prior Achievement and Socioeconomic Status. Journal of Youth and Adolescence, 45(6), 1053–1064. https://doi.org/10.1007/s10964-016-0431-4 Chusniatun, Kuswardhani, & Suwandi, J. (2014). Peran ganda pengembangan karier guru-guru perempuan. Jurnal Pendidikan Ilmu Sosial, 24(2), 53–66. Cohen, J. (1994). The earth is round (p < .05). (Vol. 49). American Psychologist,. DeLuca, C., Pyle, A., Braund, H., & Faith, L. (2020). Leveraging assessment to promote kindergarten learners’ independence and self-regulation within play-based classrooms. Assessment in Education: Principles, Policy & Practice, 27(4), 394–415. https://doi.org/10.1080/0969594X.2020.1719033 Dong, C., Cao, S., & Li, H. (2020). Young children’s online learning during COVID-19 pandemic: Chinese parents’ beliefs and attitudes. Children and Youth Services Review. https://doi.org/10.1016/j.childyouth.2020.105440 Eisenberg, N., Valiente, C., Morris, A. S., Fabes, R. A., Cumberland, A., Reiser, M., Gershoff, E. T., Shepard, S. A., & Losoya, S. (2003). Longitudinal relations among parental emotional expressivity, children’s regulation, and quality of socioemotional functioning. Developmental Psychology, 39(1), 3–19. https://doi.org/10.1037/0012-1649.39.1.3 Gassman-Pines, A., Ananat, E. O., & Fitz-Henley, J. (2020). COVID-19 and parent-Child psychological well-being. Pediatrics, 146(4). https://doi.org/10.1542/peds.2019-3211 Grolnick, W. S., Benjet, C., Kurowski, C. O., & Apostoleris, N. H. (1997). Predictors of Parent Involvement in Children’s Schooling. 11. Gürbüztürk, O., & Şad, S. N. (2010). Turkish parental involvement scale: Validity and reliability studies. Procedia - Social and Behavioral Sciences, 2(2). https://doi.org/10.1016/j.sbspro.2010.03.049 Gusmaniarti, G., & Suweleh, W. (2019). Analisis Perilaku Home Service Orang Tua terhadap Perkembangan Kemandirian dan Tanggung Jawab Anak. Aulad : Journal on Early Childhood. https://doi.org/10.31004/aulad.v2i1.17 Hatzigianni, M., & Margetts, K. (2014). Parents’ beliefs and evaluations of young children’s computer use. Australasian Journal of Early Childhood. https://doi.org/10.1177/183693911403900415 Hornby, G., & Lafaele, R. (2011). Barriers to parental involvement in education: An explanatory model. Educational Review, 63(1), 37–52. https://doi.org/10.1080/00131911.2010.488049 Iftitah, S. L., & Anawaty, M. F. (2020). Peran Orang Tua Dalam Mendampingi Anak Di Rumah Selama Pandemi Covid-19. JCE (Journal of Childhood Education), 4(2), 71. https://doi.org/10.30736/jce.v4i2.256 Jeynes, W. H. (2005). Effects of Parental Involvement and Family Structure on the Academic Achievement of Adolescents. Marriage & Family Review, 37(3), 99–116. https://doi.org/10.1300/J002v37n03_06 Kadir. (2017). Statistika Terapan. PT Raja Grafindo Persada. Komala. (2015). Mengenal dan Mengembangkan Kemandirian Anak Usia Dini Melalui Pola Asuh Orang Tua dan Guru. Tunas Siliwangi, 1(1), 31–45. Kumpulainen, K., Sairanen, H., & Nordström, A. (2020). Young children’s digital literacy practices in the sociocultural contexts of their homes. Journal of Early Childhood Literacy, 20(3), 472–499. https://doi.org/10.1177/1468798420925116 Levitt, M. R., Grolnick, W. S., Caruso, A. J., & Lerner, R. E. (2020). Internally and Externally Controlling Parenting: Relations with Children’s Symptomatology and Adjustment. Journal of Child and Family Studies, 29(11), 3044–3058. https://doi.org/10.1007/s10826-020-01797-z Lie, A., & Prasasti, S. (2004). Menjadi Orang Tua Bijak 101 Cara Membina Kemandirian dan Tanggung Jawab Anak. PT. Alex Media. Livingstone, S., Mascheroni, G., Dreier, M., Chaudron, S., & Lagae, K. (2015). How parents of young children manage digital devices at home: The role of income, education and parental style. 26. Mikelić Preradović, N., Lešin, G., & Šagud, M. (2016). Investigating Parents’ Attitudes towards Digital Technology Use in Early Childhood: A Case Study from Croatia. Informatics in Education, 15(1), 127–146. https://doi.org/10.15388/infedu.2016.07 Moonik, P., Lestari, H. H., & Wilar, R. (2015). Faktor-Faktor Yang Mempengaruhi Keterlambatan Perkembangan Anak Taman Kanak-Kanak. E-CliniC, 3(1), 124–132. https://doi.org/10.35790/ecl.3.1.2015.6752 Ogg, J., & Anthony, C. J. (2020). Process and context: Longitudinal effects of the interactions between parental involvement, parental warmth, and SES on academic achievement. Journal of School Psychology. https://doi.org/10.1016/j.jsp.2019.11.004 Pek, L. S., & Mee, R. W. M. (2020). Parental Involvement On Child’s Education At Home During School Lockdown. Jhss (Journal Of Humanities And Social Studies). https://doi.org/10.33751/jhss.v4i2.2502 Porumbu, D., & Necşoi, D. V. (2013). Relationship between Parental Involvement/Attitude and Children’s School Achievements. Procedia - Social and Behavioral Sciences, 76, 706–710. https://doi.org/10.1016/j.sbspro.2013.04.191 Raeff, C. (2010). Independence and Interdependence in Children’s Developmental Experiences. Child Development Perspectives, 4(1), 31–36. https://doi.org/10.1111/j.1750-8606.2009.00113.x Rantina, M. (2015). Peningkatan Kemandirian Melalui Kegiatan Pembelajaran Practical Life. Jurnal Pendidikan Usia Dini, 9, 181–200. https://doi.org/DOI: https://doi.org/10.21009/JPUD.091 Rihatno, T., Yufiarti, Y., & Nuraini, S. (2017). Pengembangan Model Kemitraan Sekolah Dan Orangtua Pada Pendidikan Anak Usia Dini. JPUD - Jurnal Pendidikan Usia Dini. https://doi.org/10.21009/jpud.111.08 Rika Sa’diyah. (2017). Pentingnya Melatih Kemandirian Anak. Jurnal KORDINAT, 16, 31–46. Yulianti, K., Denessen, E., & Droop, M. (2019). Indonesian Parents’ Involvement in Their Children’s Education: A Study in Elementary Schools in Urban and Rural Java, Indonesia. In School Community Journal. Zhang, D., Zhao, J. L., Zhou, L., & Nunamaker, J. F. (2004). Can e-learning replace classroom learning? Communications of the ACM, 47(5), 75–79. https://doi.org/10.1145/986213.986216

La investigación se fundamenta en la normativa vigente y las sanciones correspondientes por evasión tributaria a las pequeñas y medianas empresas. El estudio se basó en analizar las contribuciones tributarias de todos los sectores económicos y la gestión que realiza el SRI para combatir las empresas fantasmas. El objetivo del estudio fue determinar los principales delitos que existen y las sanciones correspondientes por cada infracción. El diseño metodológico fue de orden mixto. Cualitativo porque se realizó un análisis descriptivo de los principales delitos especificados en el COIP Art. 298. Cuantitativo porque se analizó e interpretó datos económicos acerca de las PYMES, contribuciones tributarias generales y evasión de impuestos. Los resultados revelaron que las PYMES generan un alto valor tributario, por ende, existe incremento de empresas fantasmas que evaden impuestos y no existe una adecuada gestión para combatir este problema. Palabras Clave: Contribución tributaria, PYMES, evasión de impuestos, empresas fantasmas. Referencias [1]I. Quispe, “La evasión tributaria y su influencia en las micro y pequeñas empresas del sector comercio distrito de quilmaná provincia de cañete, periódo 2018,” 2019. [2]E. Cobos, “Los impuestos financian el 70% del sector público,” Rev. Gestión, no. El petróleo pierde revancha, pp. 1–2, 2018, [En línea]. Disponible en: https://revistagestion. ec/index.php/economia-y-finanzas-analisis/los-impuestos-financian-el-70-del-sector-publico. [Último acceso: 4 de mayo de 2020] [3]J. Yañez, “Evasión Tributaria : Atentado a la Equidad,” Cent. Estud. Tribut. Univ. Chile, pp. 171–206, 2015, [En línea]. Disponible en: https://revistaestudiostributarios.uchile.cl/index.php/RET/article/view/39874%0Ahttps://revistaestudiostributarios.uchile.cl/index.php/RET/article/view/39874/41444. [Último acceso: 4 de mayo de 2020]. [4]J. Benítez, R. Granda, R. Noboa, E. Villegas, I. Valero, and S. López, “Incidencia De Las Obligaciones Tributarias En Las Utilidades De Mipymes En Ecuador,caso comercial “su hacienda” del cantón general Antonio Elizalde (Bucay) Del Año 2014,” Rev. Caribeña Ciencias Soc., vol. 11, no. 2016_05, pp. 61–67, 2016. [5]M. Tamariz, “La evasión tributaria en la legislación ecuatoriana,” Universidad de Cuenca, 2015. [6]M. D. Echaiz and M. S. Echaiz, “La elusión tributaria : Análisis crítico de la actual normatividad y propuestas para una futura reforma,” Derecho Soc., p. 17,2014. [7]J. Sánchez, F. Esparza, I. Gaibor, and M. Barba, “La evasión tributaria originada en el uso de comprobantes de venta/Evaluation of micro and small enterprises of the popular and solidarity economy prior to participating in a Business Round,” KnE Eng., vol. 2020, pp.149–163, 2020, doi: 10.18502/keg.v5i2.6231. [8]SRI, “SRI investiga a nuevas empresas que presuntamente evaden impuestos con la falsificación de facturas,”Quito, 2017. [En línea]. Disponible en: https://www.sri.gob.ec/web/guest/detalle-noticias?idnoticia=412. [Último acceso: 4 de mayo de 2020]. [9]C. Yance, L. Solis, I. Burgos, I. Hermida, “La importancia de las Pymes en México,” Rev. Obs. la Econ. Latinoam. Ecuador, p. 22, 2017. [10]J. García, S. Galarza, and A. Altamirano, “Importancia de la administración eficiente del capital de trabajo en las Pymes,” Rev. Cienc. UNEMI, vol. 10,no. 2528–7737, pp. 30–39, 2017, [En línea]. Disponible en: http://ojs.unemi.edu.ec/ojs/index.php/cienciaunemi/article/view/495. [Último acceso: 4 de mayo de 2020]. [11]R. E. Ron Amores and V. A. Sacoto Castillo, “Las PYMES ecuatorianas: Su impacto en el empleo como contribución del PIB PYMES al PIB total,” Espacios,vol. 38, no. 53, 2017. [12]M. Maldonado, “Cultura Tributaria De Las Mipymes Y Su Incidencia En El Contexto Socio-Económico Ecuatoriano.,” Rev. Sur Acad., vol. 1, no. 8, pp. 43–50, 2017. [13]D. D. Delgado and G. P. Chávez, “Las pymes en el Ecuador y sus fuentes de financiamiento,” Rev. Obs. la Econ. Lationamericana, no. Abril, pp. 1–18, 2018, [En línea]. Disponible en: https://www.eumed.net/rev/oel/2018/04/pymes-ecuador-financiamiento.html. [Último acceso: 4 de mayo de 2020] [14]Asamblea Constituyente, “Codigo Organico Integral Penal,” Noticias, p. 1, 2015, [En línea]. Disponible en: https://www.mendeley.com/import/. [Último acceso: 4 de mayo de 2020]. [15]R. Hernández, Metodología de la investigación, vol. 3, no. 2. 2015. [16]M. Saltos, “El delito tributario en ecuador,” vol. 11, no. 1390, pp. 43–46, 2017. [17]M. Caguana, “Defraudación tributaria según el Código Orgánico Integral Penal (COIP)”. Tesis de maestría. Universidad de Cuenca, 2015. [18]Asamblea Constituyente, “Ley Reformatoria para la Ewuidsd Tributaria del Ecuador,” Quito, 2018. [19]W. Carrillo, P. Sánchez, and G. Carrillo, “Recaudación de impuestos por domicilio fiscal Ecuador: zona de planificación tres (Chimborazo, Cotopaxi, Tungurahua, Pastaza), 2007-2018,” Bolentín Coyunt., vol. 1, no. 21,p. 22, 2019, doi: 10.31164/bcoyu.21.2019.693. [20]W. G. Torres, “La recaudación de impuestos cayó casi un 35% en un año,” Primicias, 2020, [En línea]. Disponible en: https://www.primicias.ec/noticias/economia/sri-recaudacion-tributaria-dura-caida-abril/. [Último acceso: 4 de mayo de 2020] [21]V. Calderon, M. García, and J. Espinoza, “Las empresas fantasmas en ecuador: caracterización, socios y empresas relacionadas,” 2017. [22]SRI, “Intercambio de información y cooperación con entidades gubernamentales y judiciales para el combate al fraude fiscal , lavado de activos y delitosconexos,” 2018, [En línea]. Disponible en: https://ciatorg.sharepoint.com/sites/cds/Conocimientos/EventosInstitucionales/Asambleas/2018/es/Presentaciones/pdf/2.2_Ecuador.pdf. [Último acceso: 4 de mayo de 2020].

This paper presents a theoretical investigation with the objective of identifying the basic competences to be acquired and developed in the language teaching-learning process, especially in virtual contexts. The study herein presented, of bibliographic nature, evidences a discussion and reflections on the theme competences and the representativeness of the communicative-digital domain, in the production and sharing of information, in the written and oral modality. The results achieve three basic skills : interacion through Information and Communication Technologies, creation of digital contents and sharing digital contents in the target language.ResumoEste artigo apresenta uma investigação teórica, com o objetivo de identificar as competências básicas a serem adquiridas e desenvolvidas no processo de ensino-aprendizagem de línguas, especialmente em contextos virtuais. O estudo em questão, de natureza bibliográfica, evidencia uma discussão e reflexões sobre a temática competências e a representatividade do domínio comunicativo-digital na produção e compartilhamento de informações, na modalidade escrita e oral. Os resultados evidenciam três competências básicas: interação por meio das Tecnologias de Informação e Comunicação, criação de conteúdos digitais e compartilhamento de conteúdos na língua-alvo.Resumen Este artículo presenta una investigación teórica con el objetivo de identificar las competencias básicas que vayan a ser adquiridas y desarrolladas en el proceso de enseñanza y aprendizaje de lenguas, especialmente en contextos virtuales. El estudio en cuestión, de naturaleza bibliográfica, evidencia una discusión y reflexiones sobre el tema competencias y la representatividad del dominio comunicativo-digital, en la producción y el intercambio de información, en la modalidad escrita y oral. Los resultados comprenden tres competencias básicas: interacción por medio de las Tecnologías de Información y Comunicación, creación de contenidos digitales e intercambio de contenidos en la lengua.Palavras-chave: Ensino de línguas, Competências, Competência comunicativa, Tecnologias.Keywords: Language Teaching, Competences, Communicative competence, Technologys.Palabras claves: Enseñanza de lenguas, Competencias, Competencia cumunicativa, Tecnologías.ReferencesALCARÁ, Adriana Rosecler et al. Fatores que influenciam o compartilhamento da informaçaõ e do conhecimento. Perspectivas em Ciência da Informação, v.14, n.1, p. 170-191, jan./abr., 2009. Disponível em: http://www.scielo.br/pdf/pci/v14n1/v14n1a12. Acesso em: 15 mar. 2019.AREA MOREIRA, Manuel. La alfabetización en la sociedad digital. In: Alfabetización digital y competencias informacionales. Colección Fundación Telefónica. Espanha: Editorial Ariel, p. 3-40, 2012.BARBERO ANDRÉS, J. et al. Las competencias básicas en el área de Lenguas Extranjeras. Cuadernos de Educación de Catábria. Cantabria: Consejería de Educación de Cantabria, 2008.BAEZA, Adrián. La enseñanza basada en Competencias. Chile: Universidad de Chile, 2006.BOLÍVAR BOTÍA, Antonio. Competencias básicas y ciudadanía. Caleidoscopio, revista de contenidos educativos del CEP de Jaén, n. 1, 2008. Disponível em: https://www.researchgate.net/publication/28241033_Competencias_basicas_y_ciudadania. Acesso em: 12 set. 2019.BRASIL. Lei nº 11.161/2005. Lei que dispõe sobre o ensino da língua espanhola, de 05 de agosto de 2005. Disponível em: http://www.planalto.gov.br/ccivil_03/_Ato2004-2006/2005/Lei/L11161.htm. Acesso em: 1 out. 2019.BRASIL. Ministério da Educação. Secretaria da Educação Básica. Fundamentos pedagógicos e estrutura geral da BNCC. Brasília, DF, 2017. Disponível em: http://portal.mec.gov.br/index.php?option=com_docman&view=download&alias=56621-bnccapresentacao-fundamentos-pedagogicos-estrutura-pdf&category_slug=janeiro 2017-pdf&Itemid=30192>. Acesso em: 12 set. 2019.CABRERIZO DIAGO, Jesús; RUBIO ROLDÁN, María Julia; CASTILLO ARREDONDO, Santiago. Programación por competencias: Formación y práctica. Madri: Pearson, Prentice Hall, 2008, 456p.CANQUIZ, Liliana; INCIARTE, Alicia. Desarrollo de Perfiles académico-profesionales basados en competencias. Maracaibo: LUZ, 2006.CANQUIZ R., Liliana; INCIARTE G., Alicia. Metodología para el diseño de perfiles basados en el enfoque de competencias. Laurus Revista de Educación, vol. 15, núm. 29, Caracas, Venezuela, p. 33-52, enero-abril, 2009. Disponível em: http://www.redalyc.org/pdf/761/76120642003.pdf. Acesso em: 12 set. 2019.CASSANY, Daniel. En-línea: leer y escribir en la red. Barcelona: Anagrama, 2012, 272 p.CHOMSKY, Noam. Aspectos da teoria da sintaxe. Arménio Amado, 1965, 372 p.COELHO, Iandra Maria Weirich da Silva. Inovação e Tecnologia: caminhos para o ensino de línguas adicionais. Curitiba: CRV, 2016, 239 p.COELHO, Iandra Maria Weirich da Silva. O domínio comunicativo-digital e as competências em línguas adicionais: conceitos e implicações pedagógicas. In: COELHO, Iandra Maria Weirich da Silva. Competências no ensino-aprendizagem de línguas: pressupostos, práticas e reflexões. Campinas-SP: Pontes Editores, 2019, p.93-119, 507 p.CONSELHO DA EUROPA. Quadro Europeu Comum de Referência para as línguas: Aprendizagem, ensino, avaliação. Porto: Asa Editores, 2001.CONSELHO DA EUROPA. Recomendación del parlamento europeo y del consejo. Las competencias clave para el aprendizaje permanente, 2006. Disponível em: http://eur-lex.europa.eu/legal content/ES/TXT/HTML/?uri=CELEX. Acesso em: 10 jan. 2020.CONSUELO PEREZ, Luiza. El uso del correo electrónico (asincrónico) y de las salas electrónicas de conversación (sincrónico) en la clase de español como lengua extranjera. ASELE – Actas, 2001. Disponível em: https://cvc.cervantes.es/ensenanza/biblioteca_ele/asele/pdf/12/12_0477.pdf. Acesso em: 12 set. 2019.DURAND, Jean-Pierre. O Modelo da competência: uma nova roupagem para velhas ideias. Revista Latinoamericana de Estudios del Trabajo, México, v. 7, n. 14, p. 203-228, 2001.FREITAS, Henrique, et al. Sphinx aprendiz. Canoas: Sphinx, 2008.GARAGORRI YARZA, Xabier. Propuestas curriculares basadas en competencias en el ámbito europeo. Aula de Innovación Educativa, n. 161, Espanha, 2007, p. 56-59. Dispnonível em: http://ardilladigital.com/DOCUMENTOS/EDUCACION%20ESPECIAL/COMPETENCIAS/Propuestas%20Curriculares%20en%20el%20ambito%20europeo%20%20Garagorri%20-%20articulo.pdf. Acesso em: 10 jan. 2020.HYMES, Dell. H. On communicative competence. In: BRUMFIT, Christopher; JOHNSON, Keith. The communicative approach to language teaching. Oxford: OUP, 1979.ILLERA, José Luis Rodríguez; ROIG, Anna Escofet. Ensino e aprendizagem de competências comunicacionais em ambientes virtuais. In: COLL, César; MONEREO, Charles (Orgs.). Psicologia da Educação Virtual: aprender e ensinar com as tecnologias da informação e da comunicação. Porto Alegre: Artmed, p. 329 – 345, 2010. INTEF. Marco Común de Competencia Digital docente. Espanha, 2017. Disponível em: http://educalab.es/documents/10180/12809/MarcoComunCompeDigiDoceV2.pdf. Acesso em: 12 set. 2019.LITTO, Fredric Michael; FORMIGA, Manuel Marcos Maciel (Orgs.). Educação a distância: o estado da arte. São Paulo: Pearson Education do Brasil, 2009, 480 p.MACHADO, Lucília Regina de Souza. O “Modelo de competências” e a regulamentação da base curricular nacional e de organização do ensino médio. Trabalho e Educação, Belo Horizonte, n. 4, p. 79-95, ago./dez. 1998. Disponível em: https://seer.ufmg.br/index.php/trabedu/article/view/7490. Acesso em: 12 set. 2019.MANRÍQUEZ PANTOJA, Luis. ¿Evaluación en competencias?. Estudios Pedagógicos, XXXVIII, Nº 1, p. 355-366, 2012.MECD. Ministerio de Educación, Cultura y Deporte. Ley Orgánica de Educación (2006/962/CE). Descreve as relações entre as competências, os conteúdos e os critérios de avaliação da Educação primária, educação secundária obrigatória e o Bachalerado. Boletín Oficial del Estado, núm. 25, p. 6986 – 7003, de 29 de janeiro de 2015. Disponível em: https://www.boe.es/buscar/doc.php?id=BOE-A-2015-738. Acesso em: 12 jan. 2020.MECD. Enseñanza tradicional versus enseñanza por competencias. Blog del Centro Nacional de Innovación e Investigación Educativa. Madri, 2013. Disponível em: http://blog.educalab.es/cniie/2013/04/21/ensenanza-tradicional-versus-ensenanza-por-competencias/. Acesso em: 10 jan. 2020.MECD. Ministerio de Educación y Ciencia de España. Evaluación General de diagnóstico 2009: Marco de la evaluación, Madri, 2009.MULLOR, María del Carmen Mondragón. Enseñanza y aprendizaje de la gramática y ortografía en la educación secundaria obligatoria a través de los libros de texto. 2013. 660 f. Tese de Doutorado. Universidade de Almería, Departamento de Filología Española y Latina, Almería, 2013.OECD. (2010). Are the New Millenium Learners Making the Grade? Technology use and educational performance in PISA. Centre for Educational Research and Innovation.ORGANIZACIÓN para la Cooperación y el Desarrollo Económico (OCDE). La definición y seleción de competencias clave: Resumen ejecutivo. 2005. Disponível em: http://deseco.ch/bfs/deseco/en/index/03/02.parsys.78532.downloadList.94248.DownloadFile.tmp/2005.dscexecutivesummary.sp.pdf. Acesso em: 5 fev. 2020.PARLAMENTO EUROPEU E CONSELHO. Recomendación del Parlamento Europeo y del Consejo sobre las competencias clave para el aprendizaje permanente, de 18 de dezembro de 2006. Diario Oficial de la Unión Europea, L394/310, 2006. Disponível em: https://eur-lex.europa.eu/legal-content/ES/TXT/?uri=celex%3A32006H0962. Acesso em: 12 set. 2019.PERRENOUD, Philippe. Dez novas competências para ensinar. Tradução de Chittoni Ramos. Porto Alegre: Artmed, 2000, 162 p.PERRENOUD, Philippe; THURLER, Monica Gather. As Competências para Ensinar no Século XXI: A Formação dos Professores e o Desafio da Avaliação. Tradução de Cláudia Schilling e Fátima Murad. Porto Alegre: Artmed Editora, 2002, 176 p.RAMOS, M. N. A. Pedagogia das competências: autonomia ou adaptação? São Paulo: Cortez, 2001.REDECKER, Christine; PUNIE Yves. European Framework for the Digital Competence of Educators: DigCompEdu, Luxembourg: Publications Office of the European Union, 2017. Disponível em: https://ec.europa.eu/jrc/en/publication/eur-scientific-and-technical-research-reports/european-framework-digital-competence-educators-digcompedu. Acesso em: 5 jan. 2020.RICHARDS, Jack C.; RODGERS,Theodore S. Enfoques y métodos em la enseñanza de idiomas. Tradução José M. Castrillo y María Condor. Madri: Edinumen, 2003, 288 p.SALGANIK, Laura Hersh et al. Proyectos sobre Competencias en el Contexto de la OCDE: Análisis de base teórica y conceptual. Neuchatel, Suiça, 1999. Disponível em: http://deseco.ch/bfs/deseco/en/index/03/02.parsys.59225.downloadList.58329.DownloadFile.tmp/1999.proyectoscompetencias.pdf. Acesso em: 15 fev. 2020.SALGANIK, Laura Hersh; RYCHEN, Dominique Simona. Las competencias clave para el bienestar personal, social y económico. José Manuel Pomares Olivares (tradução). Colección Aulae. Espanha, Andaluzia: Ediciones Aljibe, 2006, 212 p.SPRESSOLA, N. A. Instrumento para avaliar as competências no trabalho de tutoria na modalidade EAD. 2010. 114 f. Dissertação (Mestrado em Engenharia de Produção) - Escola de Engenharia de São Carlos, Universidade de São Paulo, São Carlos, 2010. Disponível em: http://www.teses.usp.br/teses/disponiveis/18/18157/tde-11012011-101157/publico/NilvaniaAparecidaSpressoladefinitiva.pdf. Acesso em: 12 jan. 2020.UNESCO. Enfoques estratégicos sobre las TICS en educación en América Latina y el Caribe. Oficina de Santiago, Chile, 2013. Disponível em: http://www.unesco.org/new/fileadmin/MULTIMEDIA/FIELD/Santiago/images/ticsesp.pdf. Acesso em: 11 jan. 2020.VERGNANO-JUNGER, Cristina. Compreensão leitora em meio virtual: a autopercepção de alunos universitários de espanhol. Abehache, ano 4, n. 7, p. 2017-235, 2014. Disponível em: http://www.hispanistas.org.br/arquivos/revistas/sumario/revista7/217-235.pdf. Acesso em: 12 set. 2019.VIVANCOS, J. Tratamiento de la información y competencia digital. Madrid: Alianza Editorial, 2010, 187 p.ZABALA, Antoni; ARNAU, Laia, Como aprender e ensinar competências. Tradução de Carlos Henrique Lucas Lima. Porto Alegre: Artmed, 2010, 198 p.e2820081

The pandemic of COVID-19 has afflicted every individual and has initiated a cascade of directly or indirectly involved events in precipitating mental health issues. The human species is a wanderer and hunter-gatherer by nature, and physical social distancing and nationwide lockdown have confined an individual to physical isolation. The present review article was conceived to address psychosocial and other issues and their aetiology related to the current pandemic of COVID-19. The elderly age group has most suffered the wrath of SARS-CoV-2, and social isolation as a preventive measure may further induce mental health issues. Animal model studies have demonstrated an inappropriate interacting endogenous neurotransmitter milieu of dopamine, serotonin, glutamate, and opioids, induced by social isolation that could probably lead to observable phenomena of deviant psychosocial behavior. Conflicting and manipulated information related to COVID-19 on social media has also been recognized as a global threat. Psychological stress during the current pandemic in frontline health care workers, migrant workers, children, and adolescents is also a serious concern. Mental health issues in the current situation could also be induced by being quarantined, uncertainty in business, jobs, economy, hampered academic activities, increased screen time on social media, and domestic violence incidences. The gravity of mental health issues associated with the pandemic of COVID-19 should be identified at the earliest. Mental health organization dedicated to current and future pandemics should be established along with Government policies addressing psychological issues to prevent and treat mental health issues need to be developed. References World Health Organization (WHO) Coronavirus Disease (COVID-19) Dashboard. Available at: https://covid19.who.int/ [Accessed on 23 August 2020] Sim K, Chua HC. The psychological impact of SARS: a matter of heart and mind. CMAJ. 2004; 170:811e2. https://doi.org/10.1503/cmaj.1032003. Wu P, Fang Y, Guan Z, Fan B, Kong J, Yao Z, et al. The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk. Can J Psychiatr. 2009; 54:302e11. https://doi.org/10.1177/070674370905400504. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020; 395:912e20. https://doi.org/10.1016/S0140-6736(20)30460-8. Robertson E, Hershenfield K, Grace SL, Stewart DE. The psychosocial effects of being quarantined following exposure to SARS: a qualitative study of Toronto health care workers. Can J Psychiatr. 2004; 49:403e7. https://doi.org/10.1177/070674370404900612. Barbisch D, Koenig KL, Shih FY. Is there a case for quarantine? Perspectives from SARS to Ebola. Disaster Med Public Health Prep. 2015; 9:547e53. https://doi.org/10.1017/dmp.2015.38. Jeong H, Yim HW, Song YJ, Ki M, Min JA, Cho J, et al. Mental health status of people isolated due to Middle East Respiratory Syndrome. Epidemiol Health. 2016;38: e2016048. https://doi.org/10.4178/epih.e2016048. Liu X, Kakade M, Fuller CJ, Fan B, Fang Y, Kong J, et al. Depression after exposure to stressful events: lessons learned from the severe acute respiratory syndrome epidemic. Compr Psychiatr. 2012; 53:15e23. https://doi.org/10.1016/j.comppsych.2011.02.003 Chadda RK, Deb KS. Indian family systems, collectivistic society and psychotherapy. Indian J Psychiatry. 2013;55: S299‑ https://dx.doi.org/10.4103%2F0019-5545.105555. Grover S, Sahoo S, Mehra A, Avasthi A, Tripathi A, Subramanyan A, et al. Psychological impact of COVID‑19 lockdown: An online survey from India. Indian J Psychiatry. 2020; 62:354-62. https://doi.org/ 10.4103/psychiatry.IndianJPsychiatry _427_20. Hawkley LC, Cacioppo JT. Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Ann Behav Med. 2010; 40: 218–27. https://dx.doi.org/10.1007%2Fs12160-010-9210-8. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13. https://doi.org/10.1016/S0140-6736(20)30211-7. Bhandari S, Sharma R, Singh Shaktawat A, Banerjee S, Patel B, Tak A, et al. COVID-19 related mortality profile at a tertiary care centre: a descriptive study. Scr Med. 2020;51(2):69-73. https://doi.org/10.5937/scriptamed51-27126. Baumeister RF, Leary MR. The need to belong: desire for interpersonal attachments as a fundamental human motivation. Psychol Bull. 1995; 117: 497–529. https://doi.org/10.1037/0033-2909.117.3.497. Caspi A, Harrington H, Moffitt TE, Milne BJ, Poulton R. Socially isolated children 20 years later: risk of cardiovascular disease. Arch Pediatr Adolesc Med. 2006; 160(8):805-11. https://doi.org/10.1001/archpedi.160.8.805. Eaker ED, Pinsky J, Castelli WP. Myocardial infarction and coronary death among women: psychosocial predictors from a 20-year follow-up of women in the Framingham Study. Am J Epidemiol. 1992; 135(8):854-64. https://doi.org/10.1093/oxfordjournals.aje.a116381. Luo Y, Hawkley LC, Waite LJ, Cacioppo JT. Loneliness, health, and mortality in old age: a national longitudinal study. Soc Sci Med. 2012 Mar; 74(6):907-14. https://dx.doi.org/10.1016%2Fj.socscimed.2011.11.028. Olsen RB, Olsen J, Gunner-Svensson F, Waldstrøm B. Social networks and longevity. A 14-year follow-up study among elderly in Denmark. Soc Sci Med. 1991; 33(10):1189-95. https://doi.org/10.1016/0277-9536(91)90235-5. Patterson AC, Veenstra G. Loneliness and risk of mortality: a longitudinal investigation in Alameda County, California. Soc Sci Med. 2010; 71(1):181-6. https://doi.org/10.1016/j.socscimed.2010.03.024. Savikko N, Routassalo P, Tilvis RS, Strandberg TE, Pitkalla KH. Predictors and subjective causes of loneliness in an aged population. Arch Gerontol Geriatrics. 2005; 41:3;223-33. https://doi.org/10.1016/j.archger.2005.03.002. Health Advisory for Elderly Population of India during COVID19. Available at: https://www.mohfw.gov.in/pdf/AdvisoryforElderlyPopulation.pdf [Accessed on 13 August 2020]. Dicks D, Myers R, Kling A. Uncus and amygdala lesions: effects on social behavior in the free-ranging rhesus monkey. Science. 1969; 165:69–71. https://doi.org/10.1126/science.165.3888.69. Kanai R, Bahrami B, Duchaine B, Janik A, Banissy MJ, Rees G. Brain structure links loneliness to social perception. Curr Biol. 2012; 22(20):1975-9. https://dx.doi.org/10.1016%2Fj.cub.2012.08.045. Bender AR, Daugherty A, Raz N. Vascular risk moderates associations between hippocampal subfield volumes and memory. J Cogn Neurosci. 2013; 25:1851–62. https://doi.org/10.1162/jocn_a_00435. Raz N. Diabetes: brain, mind, insulin–what is normal and do we need to know? Nat Rev Endocrinol. 2011; 7:636–7. https://doi.org/10.1038/nrendo.2011.149. Colcombe SJ, Erickson KI, Naftali R, Andrew GW, Cohen NJ, McAuley E, et al. Aerobic fitness reduces brain tissue loss in aging humans. J Gerontol A Biol Sci Med Sci. 2003; 58:176–80. https://doi.org/10.1093/gerona/58.2.m176. Maass A, Düzel S, Goerke M, Becke A, Sobieray U, Neumann K, et al. Vascular hippocampal plasticity after aerobic exercise in older adults. Mol Psychiatry. 2015; 20, 585–93. https://doi.org/10.1038/mp.2014.114. Wilson RS, Krueger KR, Arnold SE, Schneider JA, Kelly JF, Barnes LL, et al. Loneliness and Risk of Alzheimer Disease. Arch Gen Psychiatry. 2007;64(2):234–240. https://doi.org/10.1001/archpsyc.64.2.234. Kogan JH, Frankland PW, Silva AJ. Long-term memory underlying hippocampus-dependent social recognition in mice. Hippocampus. 2000;10(1):47-56. https://doi.org/10.1002/(sici)1098-1063(2000)10:1%3C47::aid-hipo5%3E3.0.co;2-6. Yorgason JT, España RA, Konstantopoulos JK, Weiner JL, Jones SR. Enduring increases in anxiety-like behavior and rapid nucleus accumbens dopamine signaling in socially isolated rats. Eur J Neurosci. 2013;37(6):1022-31. https://doi.org/10.1111/ejn.12113. Bledsoe AC, Oliver KM, Scholl JL, Forster GL. Anxiety states induced by post-weaning social isolation are mediated by CRF receptors in the dorsal raphe nucleus. Brain Res Bull. 2011;85(3-4):117-22. https://dx.doi.org/10.1016%2Fj.brainresbull.2011.03.003. Lukkes JL, Engelman GH, Zelin NS, Hale MW, Lowry CA. Post-weaning social isolation of female rats, anxiety-related behavior, and serotonergic systems. Brain Res. 2012; 1443:1-17. https://dx.doi.org/10.1016%2Fj.brainres.2012.01.005. Ago Y, Araki R, Tanaka T, Sasaga A, Nishiyama S, Takuma K, et al. Role of social encounter-induced activation of prefrontal serotonergic systems in the abnormal behaviors of isolation-reared mice. Neuropsychopharmacology. 2013; 38(8):1535-47. https://doi.org/10.1038/npp.2013.52. Veenema AH. Early life stress, the development of aggression and neuroendocrine and neurobiological correlates: what can we learn from animal models? Front Neuroendocrinol. 2009;30(4):497-518. https://doi.org/10.1016/j.yfrne.2009.03.003. Zhao X, Sun L, Jia H, Meng Q, Wu S, Li N, et al. Isolation rearing induces social and emotional function abnormalities and alters glutamate and neurodevelopment-related gene expression in rats. Prog Neuropsychopharmacol Biol Psychiatry. 2009;33(7):1173-1177. https://doi.org/10.1016/j.pnpbp.2009.06.016. Sciolino NR, Bortolato M, Eisenstein SA, Fu J, Oveisi F, Hohmann AG, et al. Social isolation and chronic handling alter endocannabinoid signaling and behavioral reactivity to context in adult rats. Neuroscience. 2010;168(2):371-86. https://dx.doi.org/10.1016%2Fj.neuroscience.2010.04.007. Ghasemi M, Phillips C, Trillo L, De Miguel Z, Das D, Salehi A. The role of NMDA receptors in the pathophysiology and treatment of mood disorders. Neurosci Biobehav Rev. 2014; 47:336-358. https://doi.org/10.1016/j.neubiorev.2014.08.017. Olivenza R, Moro MA, Lizasoain I, Lorenzo P, Fernández AP, Rodrigo J, et al. Chronic stress induces the expression of inducible nitric oxide synthase in rat brain cortex. J Neurochem. 2000;74(2):785-791. https://doi.org/10.1046/j.1471-4159.2000.740785.x. Maeng S, Zarate CA Jr, Du J, Schloesser RJ, McCammon J, Chen G, et al. Cellular mechanisms underlying the antidepressant effects of ketamine: role of alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid receptors. Biol Psychiatry. 2008;63(4):349-352. https://doi.org/10.1016/j.biopsych.2007.05.028. Kalia LV, Kalia SK, Salter MW. NMDA receptors in clinical neurology: excitatory times ahead. Lancet Neurol. 2008;7(8):742-755. https://dx.doi.org/10.1016%2FS1474-4422(08)70165-0. Waxman EA, Lynch DR. N-methyl-D-aspartate Receptor Subtypes: Multiple Roles in Excitotoxicity and Neurological Disease. The Neuroscientist. 2005; 11(1), 37–49. https://doi.org/10.1177/1073858404269012. Hermes G, Li N, Duman C, Duman R. Post-weaning chronic social isolation produces profound behavioral dysregulation with decreases in prefrontal cortex synaptic-associated protein expression in female rats. Physiol Behav. 2011;104(2):354-9. https://dx.doi.org/10.1016%2Fj.physbeh.2010.12.019. Sestito RS, Trindade LB, de Souza RG, Kerbauy LN, Iyomasa MM, Rosa ML. Effect of isolation rearing on the expression of AMPA glutamate receptors in the hippocampal formation. J Psychopharmacol. 2011;25(12):1720-1729. https://doi.org/10.1177/0269881110385595. Toua C, Brand L, Möller M, Emsley RA, Harvey BH. The effects of sub-chronic clozapine and haloperidol administration on isolation rearing induced changes in frontal cortical N-methyl-D-aspartate and D1 receptor binding in rats. Neuroscience. 2010;165(2):492-499. https://doi.org/10.1016/j.neuroscience.2009.10.039. Alò R, Avolio E, Mele M, Storino F, Canonaco A, Carelli A et al. Excitatory/inhibitory equilibrium of the central amygdala nucleus gates anti-depressive and anxiolytic states in the hamster. Pharmacol Biochem Behav. 2014; 118:79-86. https://doi.org/10.1016/j.pbb.2014.01.007. St JP, Petkov VV. Changes in 5-HT1 receptors in different brain structures of rats with isolation syndrome. General pharmacology. 1990;21(2):223-5. https://doi.org/10.1016/0306-3623(90)90905-2. Miachon S, Rochet T, Mathian B, Barbagli B, Claustrat B. Long-term isolation of Wistar rats alters brain monoamine turnover, blood corticosterone, and ACTH. Brain Res Bull. 1993;32(6):611-614. https://doi.org/10.1016/0361-9230(93)90162-5. Van den Berg CL, Van Ree JM, Spruijt BM, Kitchen I. Effects of juvenile isolation and morphine treatment on social interactions and opioid receptors in adult rats: behavioural and autoradiographic studies. Eur J Neurosci. 1999;11(9):3023-3032. https://doi.org/10.1046/j.1460-9568.1999.00717.x. Vanderschuren LJ, Stein EA, Wiegant VM, Van Ree JM. Social play alters regional brain opioid receptor binding in juvenile rats. Brain Res. 1995;680(1-2):148-156. https://doi.org/10.1016/0006-8993(95)00256-p. Moles A, Kieffer BL, D'Amato FR. Deficit in attachment behavior in mice lacking the mu-opioid receptor gene. Science. 2004;304(5679):1983-1986. https://doi.org/10.1126/science.1095943. Panksepp J, Herman BH, Vilberg T, Bishop P, DeEskinazi FG. Endogenous opioids and social behavior. Neurosci Biobehav Rev. 1980;4(4):473-487. https://doi.org/10.1016/0149-7634(80)90036-6. Gong JP, Onaivi ES, Ishiguro H, Liu Q, Tagliaferro PA, Brusco A, et al. Cannabinoid CB2 receptors: immunohistochemical localization in rat brain. Brain Res. 2006;1071(1):10-23. https://doi.org/10.1016/j.brainres.2005.11.035. Breivogel CS, Sim-Selley LJ. Basic neuroanatomy and neuropharmacology of cannabinoids. Int Rev Psychiatry 2009; 21:2:113-121. https://doi.org/10.1080/09540260902782760. Haj-Mirzaian A, Amini-Khoei H, Haj-Mirzaian A, Amiri S, Ghesmati M, Zahir M, et al. Activation of cannabinoid receptors elicits antidepressant-like effects in a mouse model of social isolation stress. Brain Res Bull. 2017; 130:200-210. https://doi.org/10.1016/j.brainresbull.2017.01.018. Banach M, Piskorska B, Czuczwar SJ, Borowicz KK. Nitric Oxide, Epileptic Seizures, and Action of Antiepileptic Drugs. CNS & Neurological Disorders - Drug Targets 2011;10: 808. https://doi.org/10.2174/187152711798072347. Förstermann U, Sessa WC. Nitric oxide synthases: regulation and function. Eur Heart J. 2012;33(7):829-37, 837a-837d. https://dx.doi.org/10.1093%2Feurheartj%2Fehr304. Hu Y, Wu D, Luo C, Zhu L, Zhang J, Wu H, et al. Hippocampal nitric oxide contributes to sex difference in affective behaviors. PNAS. 2012, 109 (35) 14224-14229. https://doi.org/10.1073/pnas.1207461109. Khan MI, Ostadhadi S, Zolfaghari S, Mehr SE, Hassanzadeh G, Dehpour, A et al. The involvement of NMDA receptor/NO/cGMP pathway in the antidepressant like effects of baclofen in mouse force swimming test. Neuroscience Letters. 2016; 612:52-61. https://doi.org/10.1016/j.neulet.2015.12.006. Matsumoto K, Puia G, Dong E, Pinna G. GABAA receptor neurotransmission dysfunction in a mouse model of social isolation-induced stress: Possible insights into a non-serotonergic mechanism of action of SSRIs in mood and anxiety disorders. Stress. 2007; 10:1:3-12. https://doi.org/10.1080/10253890701200997. Zlatković J, Filipović D. Chronic social isolation induces NF-κB activation and upregulation of iNOS protein expression in rat prefrontal cortex. Neurochem Int. 2013;63(3):172-179. https://doi.org/10.1016/j.neuint.2013.06.002. Haj-Mirzaian A, Amiri S, Kordjazy N, Momeny M, Razmi A, Balaei MR, et al. Lithium attenuated the depressant and anxiogenic effect of juvenile social stress through mitigating the negative impact of interlukin-1β and nitric oxide on hypothalamic-pituitary-adrenal axis function. Neuroscience. 2016; 315:271-285. https://doi.org/10.1016/j.neuroscience.2015.12.024. Larson HJ. The biggest pandemic risk? Viral misinformation. Nature 2018; 562:309. https://doi.org/10.1038/d41586-018-07034-4. Zarocostas J. How to fight an infodemic. Lancet 2020; 395:676. https://doi.org/10.1016/S0140-6736(20)30461-X. World Health Organization, 2019. Ebola Virus Disease – Democratic Republic of the Congo. Geneva, Switzerland: WHO. Available at: https://www.who.int/csr/don/28-november-2019-ebola-drc/en/ [Accessed on August 8, 2020] Times of India. Covid-19: doctors gone to collect samples attacked in Indore. Available at: https://timesofindia.indiatimes.com/videos/news/covid-19-doctors-goneto- collect-samples-attacked-in-indore/videoshow/74942153.cms; 2020 [Accessed on August 8, 2020]. Withnall A. Coronavirus: why India has had to pass new law against attacks on healthcare workers. The Independent. April 23, 2020. Semple K. “Afraid to be a nurse”: health workers under attack. The New York Times. 2020 Apr 27. The Economist. Health workers become unexpected targets during COVID-19. The Economist. May 11, 2020. Turan B, Budhwani H, Fazeli PL, Browning WR, Raper JL, Mugavero MJ, et al. How does stigma affect people living with HIV? The mediating roles of internalized and anticipated HIV stigma in the effects of perceived community stigma on health and psychosocial outcomes. AIDS Behav. 2017; 21: 283–291. https://doi.org/10.1007/s10461-016-1451-5. James PB, Wardle J, Steel A, Adams J. An assessment of Ebola-related stigma and its association with informal healthcare utilisation among Ebola survivors in Sierra Leone: a cross sectional study. BMC Public Health. 2020; 20: 182. https://doi.org/10.1186/s12889-020-8279-7. Aljazeera, 2020. Iran: Over 700 Dead after Drinking Alcohol to Cure Coronavirus. Aljazeera. Available at: https://www.aljazeera.com/ news/2020/04/iran-700-dead-drinking-alcohol-cure-coronavirus200427163529629.html. (Accessed June 4, 2020) Delirrad M, Mohammadi AB, 2020. New methanol poisoning outbreaks in Iran following COVID-19 pandemic. Alcohol Alcohol. 55: 347–348. https://doi.org/10.1093/alcalc/agaa036. Hassanian-Moghaddam H, Zamani N, Kolahi A-A, McDonald R, Hovda KE. Double trouble: methanol outbreak in the wake of the COVID-19 pandemic in Iran-a cross-sectional assessment. Crit Care. 2020; 24: 402. https://doi.org/10.1186/s13054-020-03140-w. Soltaninejad K. Methanol Mass Poisoning Outbreak: A Consequence of COVID-19 Pandemic and Misleading Messages on Social Media. Int J Occup Environ Med. 2020;11(3):148-150. https://dx.doi.org/10.34172%2Fijoem.2020.1983. Islam MS, Sarkar T, Khan SH, Kamal AM, Hasan SMM, Kabir A, et al. COVID-19–Related Infodemic and Its Impact on Public Health: A Global Social Media Analysis. Am J Trop Med Hyg. 2020; 00(0):1–9. https://doi.org/10.4269/ajtmh.20-0812. Hawryluck L, Gold W, Robinson S, Pogorski S, Galea S, Styra R. SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis. 2004;10(7):1206–1212. https://dx.doi.org/10.3201%2Feid1007.030703. Lee S, Chan LYY, Chau AAM, Kwok KPS, Kleinman A. The experience of SARS-related stigma at Amoy Gardens. Soc Sci Med. 2005; 61(9): 2038-2046. https://doi.org/10.1016/j.socscimed.2005.04.010. Yoon MK Kim SY Ko HS Lee MS. System effectiveness of detection, brief intervention and refer to treatment for the people with post-traumatic emotional distress by MERS: a case report of community-based proactive intervention in South Korea. Int J Ment Health Syst. 2016; 10: 51. https://doi.org/10.1186/s13033-016-0083-5. Reynolds DL, Garay JR, Deamond SL, Moran MK, Gold W, Styra R. Understanding, compliance and psychological impact of the SARS quarantine experience. Epidemiol Infect. 2008; 136: 997-1007. https://dx.doi.org/10.1017%2FS0950268807009156. Marjanovic Z, Greenglass ER, Coffey S. The relevance of psychosocial variables and working conditions in predicting nurses' coping strategies during the SARS crisis: an online questionnaire survey. Int J Nurs Stud. 2007; 44(6): 991-998. https://doi.org/10.1016/j.ijnurstu.2006.02.012. Bai Y, Lin C-C, Lin C-Y, Chen J-Y, Chue C-M, Chou P. Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatr Serv. 2004; 55: 1055-1057. https://doi.org/10.1176/appi.ps.55.9.1055. Ministry of Health and Family Welfare. Available at: https://www.mohfw.gov.in/pdf/Guidelinesforhomequarantine.pdf [Accessed on 25 August 2020]. Ministry of Health and Family Welfare. Available at: https://www.mohfw.gov.in/pdf/RevisedguidelinesforHomeIsolationofverymildpresymptomaticCOVID19cases10May2020.pdf [Accessed on 25 August 2020]. Ministry of Health and Family Welfare. Available at: https://www.mohfw.gov.in/pdf/AdvisoryformanagingHealthcareworkersworkinginCOVIDandNonCOVIDareasofthehospital.pdf (Accessed on 25 August 2020). Ministry of Health and Family Welfare. Available at: https://www.mohfw.gov.in/pdf/RevisedguidelinesforInternationalArrivals02082020.pdf [Accessed on 25 August 2020]. Cost of the lockdown? Over 10% of GDP loss for 18 states. Available at: https://timesofindia.indiatimes.com/india/cost-of-the-lockdown-over-10-of-gdp-loss-for-18-states/articleshow/76028826.cms [Accessed on 21 August 2020]. Jorda O, Singh SR, Taylor AM. Longer-Run Economic Consequences of Pandemics. Federal Reserve Bank of San Francisco Working Paper. 2020-09. https://doi.org/10.24148/wp2020-09. Firdaus G. Mental well‑being of migrants in urban center of India: Analyzing the role of social environment. Indian J Psychiatry. 2017; 59:164‑ https://doi.org/10.4103/psychiatry.indianjpsychiatry_272_15. National Crime Record Bureau. Annual Crime in India Report. New Delhi, India: Ministry of Home Affairs; 2018. 198 migrant workers killed in road accidents during lockdown: Report. Available at: https://www.hindustantimes.com/india-news/198-migrant-workers-killed-in-road-accidents-during-lockdown-report/story-hTWzAWMYn0kyycKw1dyKqL.html [Accessed on 25 August 2020]. Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. 2020; 20:689-96. https://doi.org/10.1016/S1473-3099(20)30198-5. Dalton L, Rapa E, Stein A. Protecting the psychological health of through effective communication about COVID-19. Lancet Child Adolesc Health. 2020;4(5):346-347. https://doi.org/10.1016/S2352-4642(20)30097-3. Centre for Disease Control. Helping Children Cope with Emergencies. Available at: https://www.cdc.gov/childrenindisasters/helping-children-cope.html [Accessed on 25 August 2020]. Liu JJ, Bao Y, Huang X, Shi J, Lu L. Mental health considerations for children quarantined because of COVID-19. Lancet Child & Adolesc Health. 2020; 4(5):347-349. https://doi.org/10.1016/S2352-4642(20)30096-1. Sprang G, Silman M. Posttraumatic Stress Disorder in Parents and Youth After Health-Related Disasters. Disaster Med Public Health Prep. 2013;7(1):105-110. https://doi.org/10.1017/dmp.2013.22. Rehman U, Shahnawaz MG, Khan NH, Kharshiing KD, Khursheed M, Gupta K, et al. Depression, Anxiety and Stress Among Indians in Times of Covid-19 Lockdown. Community Ment Health J. 2020:1-7. https://doi.org/10.1007/s10597-020-00664-x. Cao W, Fang Z, Hou, Han M, Xu X, Dong J, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Research. 2020; 287:112934. https://doi.org/10.1016/j.psychres.2020.112934. Wang C, Zhao H. The Impact of COVID-19 on Anxiety in Chinese University Students. Front Psychol. 2020; 11:1168. https://dx.doi.org/10.3389%2Ffpsyg.2020.01168. Kang L, Li Y, Hu S, Chen M, Yang C, Yang BX, et al. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. Lancet Psychiatry 2020;7(3): e14. https://doi.org/10.1016/s2215-0366(20)30047-x. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 2020;3(3): e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976. Lancee WJ, Maunder RG, Goldbloom DS, Coauthors for the Impact of SARS Study. Prevalence of psychiatric disorders among Toronto hospital workers one to two years after the SARS outbreak. Psychiatr Serv. 2008;59(1):91-95. https://dx.doi.org/10.1176%2Fps.2008.59.1.91. Tam CWC, Pang EPF, Lam LCW, Chiu HFK. Severe acute respiratory syndrome (SARS) in Hongkong in 2003: Stress and psychological impact among frontline healthcare workers. Psychol Med. 2004;34 (7):1197-1204. https://doi.org/10.1017/s0033291704002247. Lee SM, Kang WS, Cho A-R, Kim T, Park JK. Psychological impact of the 2015 MERS outbreak on hospital workers and quarantined hemodialysis patients. Compr Psychiatry. 2018; 87:123-127. https://dx.doi.org/10.1016%2Fj.comppsych.2018.10.003. Koh D, Meng KL, Chia SE, Ko SM, Qian F, Ng V, et al. Risk perception and impact of severe acute respiratory syndrome (SARS) on work and personal lives of healthcare workers in Singapore: What can we learn? Med Care. 2005;43(7):676-682. https://doi.org/10.1097/01.mlr.0000167181.36730.cc. Verma S, Mythily S, Chan YH, Deslypere JP, Teo EK, Chong SA. Post-SARS psychological morbidity and stigma among general practitioners and traditional Chinese medicine practitioners in Singapore. Ann Acad Med Singap. 2004; 33(6):743e8. Yeung J, Gupta S. Doctors evicted from their homes in India as fear spreads amid coronavirus lockdown. CNN World. 2020. Available at: https://edition.cnn.com/2020/03/25/asia/india-coronavirus-doctors-discrimination-intl-hnk/index.html. [Accessed on 24 August 2020] Violence Against Women and Girls: the Shadow Pandemic. UN Women. 2020. May 3, 2020. Available at: https://www.unwomen.org/en/news/stories/2020/4/statement-ed-phumzile-violence-against-women-during-pandemic. [Accessed on 24 August 2020]. Gearhart S, Patron MP, Hammond TA, Goldberg DW, Klein A, Horney JA. The impact of natural disasters on domestic violence: an analysis of reports of simple assault in Florida (1999–2007). Violence Gend. 2018;5(2):87–92. https://doi.org/10.1089/vio.2017.0077. Sahoo S, Rani S, Parveen S, Pal Singh A, Mehra A, Chakrabarti S, et al. Self-harm and COVID-19 pandemic: An emerging concern – A report of 2 cases from India. Asian J Psychiatr 2020; 51:102104. https://dx.doi.org/10.1016%2Fj.ajp.2020.102104. Ghosh A, Khitiz MT, Pandiyan S, Roub F, Grover S. Multiple suicide attempts in an individual with opioid dependence: Unintended harm of lockdown during the COVID-19 outbreak? Indian J Psychiatry 2020; [In Press]. The Economic Times. 11 Coronavirus suspects flee from a hospital in Maharashtra. March 16 2020. Available at: https://economictimes.indiatimes.com/news/politics-and-nation/11-coronavirus-suspects-flee-from-a-hospital-in-maharashtra/videoshow/74644936.cms?from=mdr. [Accessed on 23 August 2020]. Xiang Y, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. The Lancet Psychiatry 2020;(3):228–229. https://doi.org/10.1016/S2215-0366(20)30046-8. Van Bortel T, Basnayake A, Wurie F, Jambai M, Koroma A, Muana A, et al. Psychosocial effects of an Ebola outbreak at individual, community and international levels. Bull World Health Organ. 2016;94(3):210–214. https://dx.doi.org/10.2471%2FBLT.15.158543. Kumar A, Nayar KR. COVID 19 and its mental health consequences. Journal of Mental Health. 2020; ahead of print:1-2. https://doi.org/10.1080/09638237.2020.1757052. Gupta R, Grover S, Basu A, Krishnan V, Tripathi A, Subramanyam A, et al. Changes in sleep pattern and sleep quality during COVID-19 lockdown. Indian J Psychiatry. 2020; 62(4):370-8. https://doi.org/10.4103/psychiatry.indianjpsychiatry_523_20. Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. Lancet Psychiatry. 2020;7(4): P300-302. https://doi.org/10.1016/S2215-0366(20)30073-0. Dubey S, Biswas P, Ghosh R, Chatterjee S, Dubey MJ, Chatterjee S et al. Psychosocial impact of COVID-19. Diabetes Metab Syndr. 2020; 14(5): 779–788. https://dx.doi.org/10.1016%2Fj.dsx.2020.05.035. Wright R. The world's largest coronavirus lockdown is having a dramatic impact on pollution in India. CNN World; 2020. Available at: https://edition.cnn.com/2020/03/31/asia/coronavirus-lockdown-impact-pollution-india-intl-hnk/index.html. [Accessed on 23 August 2020] Foster O. ‘Lockdown made me Realise What’s Important’: Meet the Families Reconnecting Remotely. The Guardian; 2020. Available at: https://www.theguardian.com/keep-connected/2020/apr/23/lockdown-made-me-realise-whats-important-meet-the-families-reconnecting-remotely. (Accessed on 23 August 2020) Bilefsky D, Yeginsu C. Of ‘Covidivorces’ and ‘Coronababies’: Life During a Lockdown. N. Y. Times; 2020. Available at: https://www.nytimes.com/2020/03/27/world/coronavirus-lockdown-relationships.html [Accessed on 23 August 2020]

This article seeks to deepen the debate on leadership, exploring specifcities of the Brazilian context on this topic, more specifically the principle of democratic management. The reflection focuses on both topics, explaining the path of the debate on democratic management since the mid-eighties of the twentieth century, passing through the Federal Constitution of 1988, the Law of Guidelines and Bases of National Education - Law number 9.394/96) and arriving on the most recent context, where the National Education Plan (PNE), of 2014, incorporates the subject to its goals. Considerations are presented on program contents of two national training programs: the Distance Training Program for School Managers (Progestão) and the National School Program for Managers of Basic Public Education (PNEGEB), also known as School of Managers. The main regulatory frameworks for democratic management are focused on relevant legislation. The study allows us to suggest the hypothesis that the principle of democratic management, associated with a political leadership, would have preponderated in the literature and initiatives of formation of school directors in the country, being the more technical dimension of the subject a little prioritized theme. In this sense, it can be said that the topic of leadership, as it is configured in other contexts, has become a repressed demand in Brazilian educational policy.ResumoEste artigo procura aprofundar o debate sobre liderança, explorando especificidades do contexto brasileiro em relação a esta temática, mais especificamente o princípio da gestão democrática. A reflexão detém-se sobre os dois temas, explicitando a trajetória do debate sobre gestão democrática desde meados dos anos oitenta do século XX, passando pela Constituição Federal de 1988, a Lei de Diretrizes e Bases da Educação Nacional – LDB (Lei nº 9.394/96) e chegando ao contexto mais recente, onde o Plano Nacional de Educação (PNE) de 2014 incorpora o assunto às suas metas. São apresentadas considerações sobre conteúdos programáticos de dois programas nacionais de formação: o Programa de Capacitação a Distância para Gestores Escolares (Progestão) e o Programa Nacional Escola de Gestores da Educação Básica Pública (PNEGEB), também conhecido como Escola de Gestores. Os principais marcos regulatórios da gestão democrática são focalizados na legislação pertinente. O estudo permite sugerir a hipótese de que o princípio da gestão democrática, associado a uma liderança de natureza política, teria preponderado na literatura e iniciativas de formação de diretores escolares no país, sendo a dimensão mais técnica do assunto um tema pouco priorizado. Nesse sentido, pode-se dizer que o tema da liderança, tal como se configura em outros contextos, tem se constituído em demanda reprimida na política educacional brasileira.ResumenEste artículo busca profundizar el debate sobre liderazgo, explorando especificidades del contexto brasileño en relación a esta temática, más específicamente el principio de la gestión democrática. La reflexión se detiene sobre los dos temas, explicitando la trayectoria del debate sobre gestión democrática desde mediados de los años ochenta del siglo XX, pasando por la Constitución Federal de 1988, la Ley de Directrices y Bases de la Educación Nacional - LDB (Ley nº 9.394/96) y llegando al contexto más reciente, donde el Plan Nacional de Educación (PNE), de 2014, incorpora el asunto a sus metas. Se presentan consideraciones sobre contenidos programáticos de dos programas nacionales de formación: el Programa de Capacitación a Distancia para Gestores Escolares (Progestão) y el Programa Nacional Escuela de Gestores de la Educación Básica Pública (PNEGEB), también conocido como Escuela de Gestores. Los principales marcos regulatorios de la gestión democrática se centran en la legislación pertinente. El estudio permite sugerir la hipótesis de que el principio de la gestión democrática, asociado a un liderazgo de naturaleza política, habría preponderado en la literatura e iniciativas de formación de directores escolares en el país, siendo la dimensión más técnica del tema un tema poco priorizado. En ese sentido, se puede decir que el tema del liderazgo, tal como se configura en otros contextos, se ha constituido en demanda reprimida en la política educativa brasileña.Keywords: Leadership and democratic management, Educational legislation, Public policies, Scholar managers training.Palavras-chave: Liderança e gestão democrática, Legislação educacional. Políticas públicas, Formação de gestores escolares.Palabras claves: Liderazgo y gestión democrática, Legislación educativa, Políticas públicas, Formación de gestores escolares.ReferencesALMEIDA, Bruno Luiz Teles de. Construindo uma gestão democrática no Estado da Bahia: contribuições do Curso de Especialização em Gestão Escolar promovido pelo Programa Escola de Gestores. Universidade Federal da Bahia. 2015. Dissertação de Mestrado, 2015. Disponível em: https://repositorio.ufba.br/ri/handle/ri/17694. Acesso em: 27 out. 2018.BENTO, António; OLIVEIRA, Maria Isabel. A liderança escolar a três dimensões: diretores, professores e alunos. Bragança: Ideias em prática, 2013. Disponível em: https://bibliotecadigital. ipb.pt/handle/10198/9560. Acesso em: 18 ago. 2018.BIANCO, Mônica de Fátima; SOUZA, Eloísio Moulin de; SOUZA-REIS, Antônio Marcos. A nova gestão pública: um estudo do Pró-gestão focado em dois projetos prioritários no estado do Espírito Santo. Revista Gestão e Planejamento, Salvador, v. 15, n. 1, p. 118-143, jan./abr. 2014.BOLIVAR, Antonio. El liderazgo pedagógico de la dirección escolar en España: limitaciones y acciones. In: LIMA, Licinio; SÁ, Virginio (orgs.). O Governo das escolas: democracia, controlo e performatividade. Ribeirão: Edições Humus, 2017, p. 151-171. Acesso em: 18 ago. 2018.BOLIVAR, Antonio; YÁÑEZ, Julián López; MURILLO, F. Javier. Liderazgo en las instituciones educativas. Una revisión de líneas de investigación. School leadership. A review of current research perspectives. Red de Investigación sobre Liderazgo y Mejora Educativa (RILME). Revista Fuentes, 14, 2013, pp. 15-60. Disponível em: http://institucional.us.es/revistas/fuente/14/Firma%20invitada.pdf> Acesso em: 18 ago. 2018.BRASIL. Constituição Federal de 1988. Disponível em http://www.planalto.gov.br/ccivil _03/constituicao/ConstituicaoCompilado.Htm. Acesso 6 dez. 2018.BRASIL. Lei nº 9.394, de 20 de dezembro de 1996. Estabelece as diretrizes e bases da educação nacional. Disponível em http://www.planalto.gov.br/ccivil_03/Leis/l9394.htm. Acesso 14 jun. 2018.BRASIL. MEC. INEP. Desempenho dos alunos na Prova Brasil: diversos caminhos para o sucesso escolar nas redes municipais de ensino. Brasília: Instituto Nacional de Estudos e Pesquisas Educacionais, 2008.BRASIL. MEC. UNICEF. UNDIME. Aprova Brasil: o direito de aprender – boas práticas em escolas públicas avaliadas pela Prova Brasil. 2. ed. Brasília: MEC.UNICEF, 2007. Disponível em: <https://www.unicef.org/brazil/pt/aprova_final.pdf> Acesso em: 07 ago. 2018.BRASIL. MEC. UNICEF. UNDIME. Redes de aprendiizagem: boas práticas de municipios que garantem o direito de aprender.BRASIL. Presidência da República. Casa Civil. Subchefia para Assuntos Jurídicos. Lei nº 13.005, de 25 de junho de 2014. Aprova o Plano Nacional de Educação – PNE e dá outras providências.BROOKE, Nigel; SOARES, José Francisco (orgs.). Pesquisa em eficácia escolar: origem e trajetórias. Belo Horizonte: Editora UFMG, 2008.BUENO, Edna Maria Gomes da Silva. A dimensão pedagógica do papel do diretor na gestão escolar: análise do Progestão - programa de capacitação a distância para gestores escolares da Secretaria de Educação do Estado de São Paulo. 2007. Dissertação (Mestrado em Educação e Formação). Universidade Católica de Santos, Santos, 2007. Disponível em: http://biblioteca.unisantos.br:8181/handle/tede/112>. Acesso em: 27 out. 2018.EVANGELISTA, Karla Karine Nascimento Fahel. Formação de gestores escolares: um estudo em escolas públicas do Ceará. 2016. Dissertação de Mestrado. Programa de Pós-Graduação em Educação. Universidade Estadual do Ceará. Fortaleza, 2016.FAORO, Raymundo. Os donos do poder: formação do patronato político brasileiro. Rio de Janeiro: Globo, 3ª ed, revista, 2001.FERNANDES, Cássia do Carmo Pires; TEIXEIRA, Beatriz de Basto. Avaliação do Programa Escola de Gestores: os desafios da pesquisa com egressos. Revista Temas em Educação, João Pessoa, v. 24, n.1, p.78-90, jan-jun. 2015.FERNANDES, Cássia do Carmo Pires. O programa escola de gestores da educação básica e seus efeitos para a formação de gestores escolares em Minas Gerais. 2014. Dissertação de Mestrado. Universidade Federal de Juiz de Fora. 2014. Disponível em: https://repositorio.ufjf.br/jspui/handle/ufjf/184> Acesso em: 27 out. 2018.FERREIRA, Maria Salonilde. A IV Conferência Brasileira de Educação: algumas considerações. Revista Educação em Questão. V. 1. N. 1. Jan./Jun. 1987. Disponível em: https://periodicos.ufrn.br/educacaoemquestao/article/view/12026> Acesso em: 26 out. 2018.HONORATO, Hercules Guimarães. O gestor escolar e suas competências: a liderança em discussão. Disponível em http://www.anpae.org.br/iberoamericano2012/Trabalhos/ HerculesGuimaraesHonorato_res_int_GT8.pdf. Acesso em: 26 out. 2018.INEP. Relatório do 2º Ciclo de Monitoramento das Metas do Plano Nacional de Educação. Brasília, 2018. Disponível em http://portal.inep.gov.br/informacao-da-publicacao/-/asset_publisher/6JYIsGMAMkW1/document/id/1476034. Acesso em 31 out. 2018.LEITHWOOD, K.; DAY, C.; SAMMONS, P; HARRIS, Alma; HOPKINS, D. Successful school leardership. What it is and how it influences pupil learning. National College for School Leadership. Research Report n° 800. University of Nottingham. 2006. Disponível em http://www.nysed.gov/common/nysed/files/principal-project-file-55-successful-school-leadership-what-it-is-and-how-it-influences-pupil-learning.pdf. Acesso em 31 out. 2018.LIMA, Licinio; SÁ, Virginio (orgs.). O Governo das escolas: democracia, controlo e performatividade. Ribeirão: Edições Humus, 2017. LÜCK, Heloísa. Dimensões da gestão escolar e suas competências. Curitiba: Editora Positivo, 2009.LÜCK, Heloísa. Liderança em gestão escolar. Petrópolis: Vozes, 2008.LÜCK, Heloísa. Mapeamento de práticas de seleção e capacitação de diretores escolares. Estudos e pesquisas. São Paulo: Fundação Victor Civita, 2011, p. 167-225. Disponível em: http://www.fvc.org.br/pdf/livro2-03-mapeamento.pdf. Acesso em: 25 set. 2016.MAGALDI, Ana Maria; GONDRA, José G. A reorganização do campo educacional no Brasil: manifestações, manifestos e manifestantes. Rio de Janeiro: 7Letras, 2003.MELO, Marisete Fernandes de. Programa nacional escola de gestores para a educação básica: um olhar sobre a proposta e execução na Paraíba (2010 - 2012). 2017. Dissertação de Mestrado. Universidade Federal da Paraíba. Mestrado Profissional em Políticas Públicas, Gestão e Avaliação da Educação, 2017. Disponível em https://repositorio.ufpb.br/ jspui/handle/tede/9320. Acesso em 31 out. 2018.NOGUEIRA, Danielle Xabregas Pamplona. Programa de Capacitação a Distância de Gestores Escolares – Progestão no Estado do Pará: um estudo sobre a implementação do curso de especialização, no período de 2001 a 2002. 2008. Dissertação(Mestrado em Educação). Universidade de Brasília, Brasília, 2008. Disponível em: http://repositorio.unb.br/handle/10482/1845. Acesso em: 27 out. 2018.OLIVEIRA, Ana Cristina Prado de. Gestão, liderança e clima escolar. Curitiba: Appris, 2018.OLIVEIRA, Ana Cristina Prado de; CARVALHO, Cynthia Paes de. Gestão escolar, liderança do diretor e resultados educacionais no Brasil. Rev. Bras. Educ. 2018, vol.23, p. 1-18. Disponível em: http://www.scielo.br/pdf/rbedu/v23/1809-449X-rbedu-23-e230015.pdf. Acesso em: 19 ago. 2018.OLIVEIRA, Ana Cristina Prado de; WALDHELM, Andrea Paula Souza. Liderança do diretor, clima escolar e desempenho dos alunos: qual a relação? Ensaio: aval. pol. públ. Educ., Rio de Janeiro, v. 24, n. 93, p. 824-844, out./dez. 2016. Disponível em http://www.scielo.br/pdf/ensaio/v24n93/1809-4465-ensaio-24-93-0824.pdf. Acesso em 12 jun. 2018. PENA, Anderson Córdova. Um conceito para liderança escolar: estudo realizado com diretores de escolas da rede pública estadual de Minas Gerais. 2013. Universidade Federal de Juiz de Fora. Tese de Doutorado. 2013. Disponível em: https://repositorio.ufjf.br/jspui/ handle/ufjf/2426. Acesso em 31 out. 2018.PINHEIRO, Camila Mendes; DAL RI, Neusa Maria. Democratização da educação na década de 1980: o Fórum da Educação na Constituinte e a IV Conferência Brasileira de Educação 1986. Disponível em: http://www.histedbr.fe.unicamp.br/acer_histedbr/jornada/ jornada11/artigos/8/artigo_simposio_8_749_mila_pinheiro_@hotmail.com.pdf Acesso em: 26 out. 2018.PINHEIRO, Camila Mendes. O Fórum Nacional em Defesa da Escola Pública e o princípio de gestão democrática na Constituição Federal de 1988. 2015. 234 f. Dissertação (mestrado). Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Filosofia e Ciências, 2015. Disponível em: http://hdl.handle.net/11449/ 124369. Acesso em: 26 out. 2018.POLON, Thelma Lucia P. Perfis de liderança e seus reflexos na gestão escolar. In: 34ª Reunião Anual da ANPED, 2011, Anais... Natal/RN: Centro de Convenções, 2011.ROMANO, Alessandro Segala; OLIVEIRA, Márcia Pacini de. A gestão participativa e o papel da liderança do diretor na educação profissional. Revista InSIET: Revista In Sustentabilidade, Inovação & Empreendedorismo Tecnológico, São Paulo, v. 2 n. 2, agosto/dezembro de 2015.RUA, Maria das Graças. Análise de políticas públicas: conceitos básicos. s. d.SCOTUZZI, Claudia Aparecida Sorgon. Gestão democrática nas escolas e progestão: que relação é esta?. 2008. Dissertação (mestrado). Universidade Estadual Paulista, Instituto de Biociências de Rio Claro, 2008. Disponível em: <http://hdl.handle.net/11449/90065> Acesso em: 27 out 2018.SILVA, Givanildo da; SILVA, Alex Vieira da; SANTOS, Inalda Maria dos Santos. Concepções de gestão escolar pós–LDB: o gerencialismo e a gestão democrática. Revista Retratos da Escola, Brasília, v. 10, n. 19, p. 533-549, jul./dez. 2016.SILVA, Luís Gustavo Alexandre da; ALVES, Miriam Fábia. Gerencialismo na escola pública: contradições e desafios concernentes à gestão, à autonomia e à organização do trabalho escolar. RBPAE - v. 28, n. 3, p. 665-681, set/dez. 2012. SOTTANI, Natália Bazoti Brito; MARIANO, Sandra Regina Holanda; MORAES, Joysi; DIAS, Bruno Francisco. Políticas públicas de formação de diretores de escolas públicas no Brasil: Uma análise do Programa Nacional Escola de Gestores da Educação Básica (PNEGEB). ARCHIVOS ANALÍTICOS DE POLÍTICAS EDUCATIVAS / EDUCATION POLICY ANALYSIS ARCHIVES, v. 26, p. 153, 2018.SOUZA, Celina. Introdução Políticas Públicas: uma revisão da literatura. Sociologias, Porto Alegre, ano 8, nº 16, jul/dez 2006, p. 20-45. TEODORO, António. Considerações breves sobre transdiciplinaridade de um campo de estudos. Revista de Humanidades e Tecnologias. s.d. p. 117-121. Disponível em: http://recil.ulusofona.pt/bitstream/handle/10437/2356/1019.pdf?sequence=1. Acesso em: 08 dez. 2018.UNESCO. El liderazgo escolar em América Latina y el Caribe: un estado del arte com base en ocho sistemas escolares de la región. Oficina Regional de Educación para América Latina y el Caribe (OREALC/UNESCO Santiago). 2014. Disponível em http://unesdoc.unesco.org/images/0023/002327/232799s.pdf. Acesso em 31 out. 2018.VAILLANT, Denise. Liderazgo escolar, evolución de políticas y prácticas y mejora de la calidad educativa. 2015. Disponivel em http://www.maestro100puntos.org.gt/ sites/default/files/liderazgo-escolar-evolucion-de-politicas-mejora-de-la-calidad-unesco.pdf. Acesso em 31 out. 2018.VIDAL, Eloisa Maia; VIEIRA, Sofia Lerche. Meta 19. In: INEP Plano Nacional de Educação PNE 2014 - 2024: Linha de Base. Brasília, DF: Inep, 2015. p. 313 – 334. Disponível em http://portal.inep.gov.br/informacao-da-publicacao/-/asset_publisher/6JYIsGMAMkW1/ document/id/493812. Acesso em 31 out. 2018.VIEIRA, Sofia Lerche. Poder local e educação no Brasil: dimensões e tensões. RBPAE. v.27, n.1, p. 123-133, jan./abr. 2011. Disponível em file:///C:/Users/elois/Downloads/ 19972-72432-1-PB.pdf. Acesso em 31 out. 2018.WEINSTEIN, José. (org.). Liderazgo educativo en las escuelas: nueve miradas. Santiago de Chile, Salesianos Impresores, 2016.

La prevalencia de personas con discapacidad en Chile asciende al 20% de su población, de los cuales un porcentaje cercano al 12% asiste a establecimientos educacionales especiales, quienes en su mayoría, presentan discapacidad intelectual, condición que se relaciona a comorbilidades y menor condición física. El año 2018, entró en vigencia la ley Nº 21.015 que incentiva a las empresas a la contratación e inclusión laboral de personas con discapacidad, sin embargo no existen programas y estrategias gubernamentales orientadas a promover el bienestar general y el desarrollo condición física en el ciclo escolar para la transferencia mundo laboral de personas con discapacidad intelectual.

Abstract Background Infantile hypercalcemia is an autosomal recessive disorder caused either by mutations in the CYP24A1 gene (20q13.2) or in the SLC34A1 gene (5q35.3). This disease is characterized by hypercalcemia, hypercalciuria and nephrocalcinosis in paediatric patients. Maternal uniparental disomy of chromosome 20 [UPD(20)mat], resulting in aberrant expression of imprinted transcripts at the GNAS locus, is a poorly characterized condition. UPD(20)mat patients manifest a phenotype similar to that of Silver-Russell syndrome and small for gestational age-short stature. Case presentation We report here the genetic and clinical characterization of a male child with a phenotype of infantile hypercalcemia, postnatal growth retardation, and minor dysmorphic features. Genetic analysis using a next generation sequencing panel revealed a homozygous pathogenic variant of CYP24A1. The absence of the variant in the father led to microsatellite segregation analysis, suggestive of UPD. SNP-array revealed a large terminal copy neutral loss of heterozygosity leading to CYP24A1 homozygosity. SNP-array data of parent–child trio confirmed a UPD(20)mat responsible for both infantile hypercalcemia and Silver-Russell syndrome-like traits. Conclusion This is the first report of uniparental disomy of chromosome 20 revealed by infantile hypercalcemia related to CYP24A1 biallelic homozygous variants, underlying the importance of controlling allelic segregation in cases of homozygosity.

AbstractThe weathering front is the boundary beneath Earth’s surface where pristine rock is converted into weathered rock. It is the base of the “critical zone”, in which the lithosphere, biosphere, and atmosphere interact. Typically, this front is located no more than 20 m deep in granitoid rock in humid climate zones. Its depth and the degree of rock weathering are commonly linked to oxygen transport and fluid flow. By drilling into fractured igneous rock in the semi-arid climate zone of the Coastal Cordillera in Chile we found multiple weathering fronts of which the deepest is 76 m beneath the surface. Rock is weathered to varying degrees, contains core stones, and strongly altered zones featuring intensive iron oxidation and high porosity. Geophysical borehole measurements and chemical weathering indicators reveal more intense weathering where fracturing is extensive, and porosity is higher than in bedrock. Only the top 10 m feature a continuous weathering gradient towards the surface. We suggest that tectonic preconditioning by fracturing provided transport pathways for oxygen to greater depths, inducing porosity by oxidation. Porosity was preserved throughout the weathering process, as secondary minerals were barely formed due to the low fluid flow.

Abstract Background Child marriage in Malawi is a significant problem with 42.1% of women 20–24 married by age 18. In 2017 the Malawi government formalized legislation to make marriage under age 18 illegal; violators are subject to fines. While leveraging laws to reduce child marriage is common, the enactment of laws and their enforcement has led to some novel practices. One such practice observed in Malawi is marriage withdrawal, where the community intervenes when a child marriage has taken place to force the girl to return to her natal home. Methods This paper is a qualitative analysis of perceptions regarding marriage withdrawal. We conducted focus group discussions and in-depth interviews with married and unmarried adolescents, parents of adolescents, and key community members in Mangochi and Nkhata Bay. Data were collected as part of an evaluation of the More Than Brides Alliance program aimed at delaying marriage and improving access to sexual and reproductive health services in Malawi. Results The knowledge that violation of marriage laws entails substantial fines is widespread and marriage withdrawals are seen by some respondents as a way of enforcing the spirit of child marriage laws while avoiding fines. Some respondents suggest that enforcement of marriage laws has an unintended effect of driving marriages underground. One important disconnect between the laws and the realities of child marriage practices in these communities is that the law holds parents responsible for the marriage and for preventing it, while parents do not necessarily exercise control, particularly when the marriage is precipitated by pregnancy. While parents and other adults view withdrawals as an acceptable resolution of a problematic child marriage, girls noted many drawbacks for withdrawn girls such as stigma and limited education and livelihood opportunities once withdrawn. Conclusions Our exploration of perceptions about marriage laws suggest that the imposition of fines may have some unintended consequences, both driving the practice underground and encouraging practices to evade fines, and may be associated with unintended consequences for adolescent girls. Programs to address child marriage should include other approaches that address more distal drivers including poverty and lack of alternatives to child marriage. Trial registration This work is part of an RCT registered August 4, 2016 in the AEA RCT registry identified as: AEARCTR-0001463. See: https://www.socialscienceregistry.org/trials/1463

Abstract Background The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people’s movements and reduced public services, leading to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community. Methods Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March–May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites. Results Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%. Conclusion Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.

El propósito del presente artículo expone como el diagnóstico de VIH ha afectado a mujeres chilenas en su rol de trabajadoras, conociéndolo desde su propia perspectiva. Es una investigación cualitativa, donde se entrevistan a 3 mujeres sero positivo de edad entre los 20 y 65 años, que cuentan con experiencia laboral previo al diagnóstico de VIH. Los resultados identifican un antes y después del diagnóstico de VIH, donde para mantener su rol de trabajadoras ocultan su diagnóstico al empleador y a sus compañeros de trabajo por miedo a ser discriminada; dan a conocer abiertamente su diagnóstico al contexto social que se desenvuelven para evitar prejuicios; o cambian su rubro laboral. De esta manera, se reconoce que la ley del SIDA de Chile no logra cubrir una protección real que permita el respeto, fiscalización y responsabilidad de estas normas, siendo vulnerados los derechos de las mujeres que viven con VIH. Las mujeres diagnosticadas sufren apartheid ocupacional e injusticia ocupacional, ya que no logran realizar su rol como trabajadoras debido a la desinformación que existe en la sociedad frente al VIH y a los estigmas que se encuentran en torno a ella, desencadenando prejuicios sociales históricos que han favorecido que mujeres vivan ocultando su realidad.

Abstract Objectives Adolescent pregnancy is a global public health concern and one in five adolescents live in India, where early marriage is widely practiced. We sought to examine linkages between adolescent pregnancy and child undernutrition using a holistic approach. Methods Data were from India's 2015–2016 National Family Health Surveys. Primiparous women aged 15–49 years who gave birth between 2010 and 2015 (n = 60,096) were classified based on age at first birth: ≤19 years (adolescence), 20–24 years (young adulthood), and ≥25 years (adulthood). Multivariable regression and structural equation models were used to understand how adolescent pregnancy is linked to child undernutrition through women's education and bargaining power, nutritional status, health service use, child feeding and living conditions. Results Overall, 24% of first births among Indian women aged 15–49 years in 2016 occurred during adolescence, with large state and district variability (from 4% to 45% for states and 1% to 62% for districts). Compared to children born to adult mothers, those born to adolescent mothers had lower z-scores for height-for-age (mean difference: -0.53 SD), weight-for-age (-0.40 SD), and weight-for-height (-0.16 SD). Compared to adult mothers, adolescent mothers were shorter (-1.2 cm), more likely to be underweight (+ 18%) and anemic (+ 8%), had lower education (-3.0 years), less bargaining power (-7% to -15%), and lived in poorer households (-0.66 SD) with poorer sanitation (-28%). Adolescent mothers were less likely to access health services (-4% to -15%) and had poorer complementary feeding practices (-3% to -9%). These intermediate factors were predictive of child anthropometry, with the strongest links being women's education, socioeconomic status, and weight. Conclusions Adolescent pregnancy is related to maternal nutritional status, education, access to nutrition and health services, complementary feeding practices, and living conditions; together, these are associated with child undernutrition. Policies and programs to delay marriage are likely to help break the intergenerational cycle of poverty and undernutrition in India. Funding Sources Bill & Melinda Gates Foundation through POSHAN, led by International Food Policy Research Institute.

Abstract Background In Haiti where there are high rates of maternal and neonatal mortality, efforts to reduce mortality and improve maternal newborn child health (MNCH) must be tracked and monitored to measure their success. At a rural Haitian hospital, local surveillance efforts allowed for the capture of MNCH indicators. In March 2018, a new stand-alone maternity unit was opened, with increased staff, personnel, and physical space. We aimed to determine if the new maternity unit brought about improvements in maternal and neonatal outcomes. Methods We conducted an interrupted time series analysis using data collected between July 2016 and October 2019 including 20 months before the opening of the maternity unit and 20 months after. We examined maternal-neonatal outcomes such as physiological (vaginal) births, caesarean birth, postpartum hemorrhage (PPH), maternal deaths, stillbirths and undesirable outcomes (eclampsia, PPH, perineal laceration, postpartum infection, maternal death or stillbirth). Results Immediately after the opening of the new maternity, the number of physiological births decreased by 7.0% (β = − 0.070; 95% CI: − 0.110 to − 0.029; p = 0.001) and there was an increase of 6.7% in caesarean births (β = 0.067; 95% CI: 0.026 to 0.107; p = 0.002). For all undesirable outcomes, preintervention there was an increasing trend of 1.8% (β = 0.018; 95% CI: 0.013 to 0.024; p < 0.001), an immediate 14.4% decrease after the intervention (β = − 0.144; 95% CI: − 0.255 to − 0.033; p = 0.012), and a decreasing trend of 1.8% through the postintervention period (β = − 0.018; 95% CI: − 0.026 to − 0.009; p < 0.001). No other significant level or trend changes were noted. Conclusions The new maternity unit led to an upward trend in caesarean births yet an overall reduction in all undesirable maternal and neonatal outcomes. The new maternity unit at this rural Haitian hospital positively impacted and improved maternal and neonatal outcomes.

AbstractThe chemical composition of snow provides insights on atmospheric transport of anthropogenic contaminants at different spatial scales. In this study, we assess how human activities influence the concentration of elements in the Andean mountain snow along a latitudinal transect throughout Chile. The concentration of seven elements (Al, Cu, Fe, Li, Mg, Mn and Zn) was associated to gaseous and particulate contaminants emitted at different spatial scales. Our results indicate carbon monoxide (CO) averaged at 20 km and nitrogen oxide (NOx) at 40 km as the main indicators of the chemical elements analyzed. CO was found to be a significant predictor of most element concentrations while concentrations of Cu, Mn, Mg and Zn were positively associated to emissions of NOx. Emission of 2.5 μm and 10 μm particulate matter averaged at different spatial scales was positively associated to concentration of Li. Finally, the concentration of Zn was positively associated to volatile organic compounds (VOC) averaged at 40 km around sampling sites. The association between air contaminants and chemical composition of snow suggests that regions with intensive anthropogenic pollution face reduced quality of freshwater originated from glacier and snow melting.

Abstract Background Soil-transmitted helminthiasis is a neglected tropical disease, thriving in environments of poverty and disadvantage. Our objective was to determine the prevalence and intensity of four soil transmitted helminths (STH) among primary school children in the Ngorongoro Conservation Area (NCA), Tanzania. Methods A cross-sectional study was performed between May 15th and June 2nd, 2014. Six of 20 primary schools were chosen, based on elevation, designated low elevation ecozone (LEE) or high elevation ecozone (HEE). A total of 340 children from standards one to four were recruited. Height and weight of each child was determined and body mass index (BMI) was calculated. Stool samples were analyzed using the Kato-Katz, Wisconsin, and Baermann techniques to detect STH eggs and larvae. An interviewer-administered questionnaire on socio-demographic variables was used to capture information from the school’s headmaster and a checklist was used to assess sanitation facilities. Results STHs identified included Ascaris (presumably lumbricoides), Trichuris (presumably trichiura), hookworms (presumably Ancylostoma duodenale and/or Necator americanus), and Strongyloides (presumably stercoralis). The overall prevalence of STH infection was 29.0% in LEE and 34.0% in HEE. Prevalence was 34.3% and 28.2% in males versus females, respectively. Ascaris sp. were only identified in HEE, prevalence of Trichuris sp. and hookworms were significantly higher in HEE compared to LEE, and Strongyloides spp. prevalence was lower in HEE. Intensity of Trichuris sp. was significantly higher in HEE and lower for hookworms. We did not detect a significant relationship between BMI and helminth intensity; however, BMI was lower in lower elevations and in males vs. females. Sanitation practices are taught at the schools, but challenges were identified when implementing. Latrine facilities were available and latrine-cleaning routines were practiced; however, hand washing practices were challenging due to restricted water availability. Conclusions Significant differences in prevalence in HEE and LEE exist, and STH infections are still very common among school children suggesting that anthelminthic intervention and education may be necessary in this region. Based on this outcome, the study area in the NCA would be classified as a medium risk area, where periodic treatment recommendations should be based on prevalence estimations in the different ecozones. Trial registration Ethics approval was obtained from the Catholic University of Health and Allied Sciences (CUHAS; Lake Zone Institutional Review Board MR/53/100/307)); the Conjoint Health Research Ethics Board (CHREB) at the University of Calgary in Canada (Study ID REB14-0127); the National Institute of Medical Research (NIMR) of Tanzania; and the Tanzania Commission for Science and Technology (COSTEC).

Abstract Background The systematic of several marine diphyllobothriid tapeworms of pinnipeds has been revised in recent years. However, 20 species of Diphyllobothrium from phocids and otariids are still recognized as incertae sedis. We describe a new species of Diphyllobothrium from the intestine of California sea lions Zalophus californianus (Lesson) (type-host) and South American sea lions Otaria flavescens (Shaw). Methods Zalophus californianus from the Pacific coast of the USA and O. flavescens from Peru and Argentina were screened for parasites. Partial fragments of the large ribosomal subunit gene (lsrDNA) and the cytochrome c oxidase subunit 1 (cox1) mitochondrial gene were amplified for 22 isolates. Properly fixed material from California sea lions was examined using light and scanning electron microscopy. Results A total of four lsrDNA and 21 cox1 sequences were generated and aligned with published sequences of other diphyllobothriid taxa. Based on cox1 sequences, four diphyllobothriid tapeworms from O. flavescens in Peru were found to be conspecific with Adenocephalus pacificus Nybelin, 1931. The other newly generated sequences fall into a well-supported clade with sequences of a putative new species previously identified as Diphyllobothrium sp. 1. from Z. californianus and O. flavescens. A new species, Diphyllobothrium sprakeri n. sp., is proposed for tapeworms of this clade. Conclusions Diphyllobothrium sprakeri n. sp. is the first diphyllobothriid species described from Z. californianus from the Pacific coast of North America, but O. flavescens from Argentina, Chile and Peru was confirmed as an additional host. The present study molecularly confirmed the first coinfection of two diphyllobothriid species in sea lions from the Southern Hemisphere.

Abstract Background LCAT (lecithin-cholesterol acyltransferase) deficiency is characterized by two distinct phenotypes, familial LCAT deficiency (FLD) and Fish Eye disease (FED). This is the first systematic review evaluating the ethnic distribution of LCAT deficiency, with particular emphasis on Latin America and the discussion of three Mexican-Mestizo probands. Methods A systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic review and Meta-Analysis) Statement in Pubmed and SciELO. Articles which described subjects with LCAT deficiency syndromes and an assessment of the ethnic group to which the subject pertained, were included. Results The systematic review revealed 215 cases (154 FLD, 41 FED and 20 unclassified) pertaining to 33 ethnic/racial groups. There was no association between genetic alteration and ethnicity. The mean age of diagnosis was 42 ± 16.5 years, with fish eye disease identified later than familial LCAT deficiency (55 ± 13.8 vs. 41 ± 14.7 years respectively). The prevalence of premature coronary heart disease was significantly greater in FED vs. FLD. In Latin America, 48 cases of LCAT deficiency have been published from six countries (Argentina (1 unclassified), Brazil (38 FLD), Chile (1 FLD), Columbia (1 FLD), Ecuador (1 FLD) and Mexico (4 FLD, 1 FED and 1 unclassified). Of the Mexican probands, one showed a novel LCAT mutation. Conclusions The systematic review shows that LCAT deficiency syndromes are clinically and genetically heterogeneous. No association was confirmed between ethnicity and LCAT mutation. There was a significantly greater risk of premature coronary artery disease in fish eye disease compared to familial LCAT deficiency. In FLD, the emphasis should be in preventing both cardiovascular disease and the progression of renal disease, while in FED, cardiovascular risk management should be the priority. The LCAT mutations discussed in this article are the only ones reported in the Mexican- Amerindian population.

Abstract Background Despite ibuprofen widely recognized safety profile, an increase of suspected adverse events has been reported in the last decade in parallel with its growing over-the-counter use. The aims of this study were to assess the therapeutic approach to the feverish child and to evaluate the main indications and the most frequent adverse events related to ibuprofen administration in children. Methods A specific questionnaire-form regarding the management of ibuprofen therapy in children was distributed among a sample of pediatricians all over the Italian territory between September and October 2020. An electronic data collection through a specifically designed web-based platform was performed among the participating pediatricians. Results One-hundred-eighty-one pediatricians completed the survey. In case of fever, 177 (98%) participants prescribe paracetamol, while only 4 (2%) preferred ibuprofen as first choice. One-hundred-twenty-eight pediatricians (71%) administer paracetamol alone, while 53 (29.2%) use the combined/alternating treatment with ibuprofen. Ibuprofen is mostly administered for musculoskeletal pain (30%), upper respiratory tract infection (20%), headache (15%) and post-surgical pain (9%). Sixty-three (35%) out of 181 participating pediatricians reported 191 adverse events during ibuprofen administration. The most common were gastrointestinal (GI), with GI bleeding being reported in 30/191 cases (15.7%), epigastric pain in 29/191 (15.1%), non-specified abdominal pain in 22/191 (11.1%) and nausea/vomiting in 21/191 (11%). Severe adverse events including kidney damage (3.1%), complicated infections (0.5%), pneumonia associated empyema (0.5%), soft tissue infection (0.5%) and disseminated intravascular coagulation (0.5%) were also reported. The adverse events led to a hospitalization in 12% of children. In 53/191 cases (28%) the adverse events were related to a wrong dosage or prolonged therapy or errors in frequency of administration. Conclusions This survey demonstrate a sufficient awareness of Italian pediatricians regarding ibuprofen-prescribing patterns with the only possible concern related to the relatively high percentage of pediatricians performing a combining/alternating use of paracetamol and ibuprofen. The reported adverse events were mild in most of the cases and often related to errors in dosage, frequency and treatment duration, emphasizing the need for a major caution of both practitioners and patients in their use.

Abstract Introduction Healthy Beginnings is an established nurse-led early childhood obesity prevention program that promotes healthy infant feeding practices and active play in the early years of life. To improve engagement with culturally and linguistically diverse populations, the Healthy Beginnings program delivered by telephone was culturally adapted and implemented with Arabic- and Chinese-speaking mothers in Sydney, Australia. The cultural adaptation process has been published separately. In this article, we aimed to evaluate the feasibility of the culturally adapted program. Methods In 2018–2019, the culturally adapted Healthy Beginnings program was implemented with Arabic- and Chinese-speaking women recruited from antenatal clinics in Sydney. At four staged timepoints (from third trimester until 6 months of age), mothers were sent culturally adapted health promotion booklets and text messages and offered four support calls from bi-cultural child and family health nurses in Arabic and Chinese. A mixed methods evaluation included a) baseline and 6-month telephone surveys, followed by b) semi-structured follow-up interviews with a subset of participating mothers and program delivery staff. Main outcomes of this feasibility study were reach (recruitment and retention), intervention dose delivered (number of nurse support calls completed) and acceptability (appropriateness based on cognitive and emotional responses). Results At recruitment, 176 mothers were eligible and consented to participate. Of 163 mothers who completed the baseline survey, 95% completed the program (n = 8 withdrew) and 83% completed the 6-month survey (n = 70 Arabic- and n = 65 Chinese-speaking mothers). Most mothers (n = 127, 78%) completed at least one nurse support call. The qualitative analysis of follow-up interviews with 42 mothers (22 Arabic- and 20 Chinese-speaking mothers) and 10 program delivery staff highlighted the perceived value of the program and the positive role of bi-cultural nurses and in-language resources. Mothers who completed more nurse support calls generally expressed greater acceptability. Conclusions The culturally adapted Healthy Beginnings program was feasible to deliver and acceptable to Arabic- and Chinese-speaking mothers. Our results highlight the importance of in-language resources and individualised bi-cultural nurse support by telephone for supporting culturally and linguistically diverse migrant families with infant feeding and active play. These findings support the potential for program refinements and progression to an effectiveness trial.

Abstract Background Universities, as innovation drivers in science and technology worldwide, should be leading the Great Transformation towards a carbon–neutral society and many have indeed picked up the challenge. However, only a small number of universities worldwide are collecting and publishing their carbon footprints, and some of them have defined zero emission targets. Unfortunately, there is limited consistency between the reported carbon footprints (CFs) because of different analysis methods, different impact measures, and different target definitions by the respective universities. Results Comprehensive CF data of 20 universities from around the globe were collected and analysed. Essential factors contributing to the university CF were identified. For the first time, CF data from universities were not only compared. The CF data were also evaluated, partly corrected, and augmented by missing contributions, to improve the consistency and comparability. The CF performance of each university in the respective year is thus homogenized, and measured by means of two metrics: CO2e emissions per capita and per m2 of constructed area. Both metrics vary by one order of magnitude across the different universities in this study. However, we identified ten universities reaching a per capita carbon footprint of lower than or close to 1.0 Mt (metric tons) CO2e/person and year (normalized by the number of people associated with the university), independent from the university’s size. In addition to the aforementioned two metrics, we suggested a new metric expressing the economic efficiency in terms of the CF per $ expenditures and year. We next aggregated the results for all three impact measures, arriving at an overall carbon performance for the respective universities, which we found to be independent of geographical latitude. Instead the per capita measure correlates with the national per capita CFs, and it reaches on average 23% of the national impacts per capita. The three top performing universities are located in Switzerland, Chile, and Germany. Conclusion The usual reporting of CO2 emissions is categorized into Scopes 1–3 following the GHG Protocol Corporate Accounting Standard which makes comparison across universities challenging. In this study, we attempted to standardize the CF metrics, allowing us to objectively compare the CF at several universities. From this study, we observed that, almost 30 years after the Earth Summit in Rio de Janeiro (1992), the results are still limited. Only one zero emission university was identified, and hence, the transformation should speed up globally.

Abstract Background Concerns about the safety and efficacy of vaccines in patients with autoimmune diseases (AID) have led to contradictions and low vaccination coverage in this population, who are at a higher risk of infections, including by human papillomavirus (HPV). Although HPV vaccines have been recommended for immunocompromised patients, there is still a lack of data to support its use for AID patients, such as juvenile dermatomyositis (JDM) patients. The aim of this study was to assess the safety and immunogenicity of the quadrivalent HPV (qHPV) vaccine in a cohort of JDM patients. Methods JDM patients aged from 9 to 20 years and healthy controls (HC) were enrolled to receive a 3-dose schedule of qHPV vaccine from March/2014 to March/2016. Study visits were performed before the first dose, 1 month after the second and third doses, and 6 months after the third dose. Participants completed a diary of possible adverse events for 14 days following each dose of vaccination (AEFV). Disease activity and current therapy were analyzed at each visit for JDM patients. In addition, serum samples from all participants were collected to test antibody concentrations against HPV16 and 18 at each visit. Participant recruitment was conducted in ten Brazilian centres. From 47 eligible JDM patients and 41 HC, 42 and 35, respectively, completed the 3-dose schedule of the vaccine, given that five JDM patients and two HC had received doses prior to their inclusion in the study. Results The AEFVs presented by the participants were mild and in general did not differ between JDM and HC groups. No severe AEFVs were related to the vaccination. Disease activity was stable, or even improved during the follow-up. One month after the third dose of the vaccine the JDM group presented seropositivity of 100% for HPV16 and 97% for HPV18, similarly to the HC group, who presented 100% for both serotypes (p = 1.000). Six months after the third dose the seropositivity for the patient group was 94% for both HPV types. Conclusions The HPV vaccination in this cohort of JDM patients was safe and immunogenic. Since the seropositivity against HPV16 and 18 was very high after the 3-dose schedule, this regimen should be recommended for JDM patients. Trial registration Brazilian Clinical Trials Registry, number: RBR-9ypbtf. Registered 20 March 2018 – Retrospectively registered.

Abstract Introduction The Lancet Commission for Global Surgery identified an adequate surgical workforce as one indicator of surgical care accessibility. Many countries where women in surgery are underrepresented struggle to meet the recommended 20 surgeons per 100,000 population. We evaluated female surgeons’ experiences globally to identify strategies to increase surgical capacity through women. Methods Three database searches identified original studies examining female surgeon experiences. Countries were grouped using the World Bank income level and Global Gender Gap Index (GGGI). Results Of 12,914 studies meeting search criteria, 139 studies were included and examined populations from 26 countries. Of the accepted studies, 132 (95%) included populations from high-income countries (HICs) and 125 (90%) exclusively examined populations from the upper 50% of GGGI ranked countries. Country income and GGGI ranking did not independently predict gender equity in surgery. Female surgeons in low GGGI HIC (Japan) were limited by familial support, while those in low income, but high GGGI countries (Rwanda) were constrained by cultural attitudes about female education. Across all populations, lack of mentorship was seen as a career barrier. HIC studies demonstrate that establishing a critical mass of women in surgery encourages female students to enter surgery. In HICs, trainee abilities are reported as equal between genders. Yet, HIC women experience discrimination from male co-workers, strain from pregnancy and childcare commitments, and may suffer more negative health consequences. Female surgeon abilities were seen as inferior in lower income countries, but more child rearing support led to fewer women delaying childbearing during training compared to North Americans and Europeans. Conclusion The relationship between country income and GGGI is complex and neither independently predict gender equity. Cultural norms between geographic regions influence the variability of female surgeons’ experiences. More research is needed in lower income and low GGGI ranked countries to understand female surgeons’ experiences and promote gender equity in increasing the number of surgical providers.

Abstract Background Emotional distress in mothers inhibits the let-down reflex, thus affecting breastfeeding self-efficacy. A breastfeeding mother may have to cope with both physical discomfort and psychological distress. However, literature on initiatives to improve breastfeeding rates has focused mainly on providing community-based peer support, or social policies. The aim of this review is to assess evidence on the effectiveness of a broad range of psychological interventions to facilitate breastfeeding for mothers facing difficulties around the time of delivery. Methods The review of the literature is derived from a search on Cochrane Library, PubMed, EBSCOhost, and PsycINFO for papers published since 1980. The approach was to explore quantitative and qualitative parameters. Quantitative parameters included breastfeeding initiation, duration, and composition. Qualitative parameters recorded the evaluation of maternal perceptions on breastfeeding success. The high heterogeneity of the studies led to a narrative review; 20 selected papers that report on breastfeeding outcomes and psychological programs met the inclusion criteria. Results The evidence on breastfeeding support through psychotherapy is heterogeneous and scant. Out of the included studies, 11 were randomized controlled trials, two were non-randomised trials, and two used a quasi-experimental design. None of the studies reported an increase in adverse breastfeeding outcomes. Three studies failed to report an association between psychological procedures and improved breastfeeding outcomes. A literature review showed that 17 (85%) analyses support stress-releasing techniques to facilitate breastfeeding. Conclusions This review suggests that relaxation interventions carefully tailored to address perinatal emotional distress may lead to important health benefits, including improvement in breastfeeding outcomes. There is also some indication that psychotherapy support while breastfeeding may have more impact than routine counselling. Conversely, this review did not find an association between self-hypnosis and breastfeeding outcomes. Data from this study can be used in designing prevention programs and future research with appropriate theoretical underpinning.

At the beginning of his recent collection of essays in queer studies, Jeffrey Escoffier makes the assertion at once portentous and banal that “the moment of acknowledging to oneself homosexual desires and feelings … and then licensing oneself to act ... is the central drama of the homosexual self.” That “moment of self-classification,” he explains, “is an emergency – sublime, horrible, wonderful – in the life of anyone who must confront it.” (1) In the theatre of my own biography, I am unsure how or when I first played out this epiphanic drama of queer self-acknowledgment, but I can vividly recall the first time someone else enacted it for me. In elementary school, at the age of ten, a fellow pupil cornered me in the school playground and announced with calculated precocity to anyone who cared to listen that I was, as he put it, “a homo.” Unlike some of my congregated peers whose chorus of “what’s a homo?” provoked a dizzying exchange of infantile misinformation, I was only too well aware of the term’s meaning and, shocked that my queerness should not only be revealed but also be so transparently legible that even a boorish bully might detect it, slid away in fearful embarrassment. What proved most unsettling to me, however, was that my nascent homosexuality should have been evidenced in this playground spectacle of queer exposure, not on the basis of same-sex desire but, rather, on that of passionate devotion to a woman. Earlier that day, our schoolteacher had directed us to write and then read aloud to the class a composition entitled, “My Hero.” Where most of my classmates wrote predictable tributes to normative role models of the time like Neil Armstrong, Greg Chappell, Muhammad Ali, and even Jesus Christ, I penned an effusive homage to, what I described in the essay as, that “radiant star of stage and screen, Miss Julie Andrews”. It was this profession of ardent affection for a female film star that led directly to my schoolyard outing. As my accuser put it when explicating the deductive rationale behind his sexual detection, “Only a homo would love Julie Andrews!” Even at age ten, the paradoxical (il)logic of this formulation was so glaring as to all but slap me hard across the face – an action transposed from the metaphoric to the literal by my playground adversary who, not content to let “the homo” escape too readily or lightly, pursued me across the schoolyard and pushed me face-first into the asphalt. How could my declaration of desire for a female star – which in strictly definitional terms should have seemed, if anything, eminently heterosexual – be taken so assuredly as a marker of homosexuality? Why and how could my loving Julie Andrews provoke such an explosive manifestation of juvenile homophobia? The answers to these questions were already known, if only intuitively and, thus, only partially, to the ten-year old me. Like many other elements of my childhood, my love for Julie Andrews formed part of what I was fast recognizing was an ever-expanding and ever-consolidating category of bad object-choices – a diverse array of cultural and social cathexes variously abjectified, proscribed or deemed otherwise inconsonant with dominant modes of sexual selfhood. Redefined as a symptom of sexual dissonance, my devotion to Andrews suddenly became a catalytic signifier of shame, a palpable marker of my failure to achieve heteronormality and, thus, another attachment to cache away in the cavernous closet of protogay childhood. That this scenario will sound instantly familiar to many is evidence of the extent to which a politics of shame is routinely mobilized – most potently, though by no means exclusively, in childhood – to stigmatize and thus discipline queer subjectivities. Much of the breathtaking success with which mainstream culture is able to install and mandate a heteronormative economy depends directly on its ability to foster a correlative economy of queer shame through which to disgrace and thus delegitimate all that falls outside the narrow purview of straight sexualities. Not that such processes of juridical stigmatization are necessarily successful. Shameful and shameless are, after all, but a suffix apart and a good deal of the productivity of queer cultures – as of queer lives – resides precisely in the extraordinary capacity they obtain for not only clinging stubbornly and defiantly to the outlawed objects of their desire but investing these objects with a near-inexhaustible source of vitalizing energy. The scene of my schoolyard shaming may have effected a public occlusion of my love for Julie Andrews, but it in no way quelled or attenuated that love. Indeed, transformed into a sign of my developing homosexuality, my attachment to Andrews became more than ever an integral component of my subjectivity and an indefatigable resource for survival in the face of what I perceived to be an unaccommodating social world. Eve Kosofsky Sedgwick dubs these survivalist dynamics of queer culture “reparative” in the sense given the term by object-relations theory as an affirmative impulse to repair or make good the losses of subjective constitution. Unlike the competing paranoid positionality which in object-relations theory is understood to fracture the world into colliding part-objects and is marked by “hatred, envy, and anxiety”, the reparative dynamic is marked by love and seeks to reassemble or repair the subject’s world into “something like a whole” that is “available both to be identified with and to offer one nourishment and comfort in turn.” (Sedgwick, 8) For Sedgwick, this idea of a reparative impulse speaks powerfully to the inventive and obstinate ways in which queer subjects negotiate spaces of self-affirmation in the face of a hostile environment, or as she evocatively puts it, the ways in which queer “selves and communities succeed in extracting sustenance from ... a culture whose avowed desire has often been not to sustain them.” (35) As a paradigmatic example of and governing trope for this reparative tradition of queer survivalism, Sedgwick offers, significantly for my purposes, the image of the proto-queer child or adolescent ardently (over)attached to a cultural text or object, passionately investing that text or object with almost talismanic properties to repair or make good a damaged socius . “Such a child,” she writes, “is reading for important news about herself, [even] without knowing what form that news will take; with only the patchiest familiarity with its codes; without, even, more than hungrily hypothesizing to what questions this news may proffer an answer.” (2-3) This characterization of a reparatively positioned proto-queer reader resonates profoundly with my own fiercely loving attachments to Julie Andrews. Much of the energy of these attachments – certainly in childhood and, perhaps less urgently but no less decisively, in adulthood – springs directly from the reparative performances to which this particular star has been cast in the playhouse of my own imaginary. To wit: a cherished ritual from childhood. In the days when I was growing up, the days before VCRs and cable television, my Andrews fandom was of necessity organized not so much around her film texts as around her recordings. While I had seen her films and these were vital, generative sites for my fan passions, the primary focus for those passions – where they were practised, indulged, nurtured – was her vocal recordings. On long, listless afternoons, returned home from school, I would rush to the living room, position myself firmly in front of the family hi-fi and blissfully listen my way through my expansive collection of Julie Andrews LPs. My favourite, without doubt, was the soundtrack recording for The Sound of Music, which I would play and replay for hours on end. I can still recall the palpable sense of breathless anticipation when, unsheathed from its cover and reverently placed on the turntable, the disc would crackle to life. A whispering breath of wind, an echo of birdsong, a rapid swell of violins, and Julie’s inimitable voice would break forth in fortissimo triumph, leaping through the speakers and enveloping the room with melodic abundance. To augment the sense of excitement, I would, while listening, gaze intently at the record cover with its celebrated image of Julie leaping in mid-flight like a preternatural oread, her skirt billowing up with carefree delight, arms swinging open in joyous welcome, effortlessly holding aloft a guitar case and a travelling bag, twin symbols of musical expressivity and liberating escape. Projecting myself into the scene, I would twirl with Julie in imaginary freedom, riding the crest of her crystalline voice in rapturous transport from the suburban mundanity of family, school, and straightness. Invested with the attentive love and astonishing creativity of juvenile fandom, Andrews provided not just the promissory vision of a life different from and infinitely freer than the one I knew, but the fantasmatic means through which to achieve and sustain this process of transcendence. If I loved Julie Andrews as a child it was because that love functioned as a process through which to resist and transfigure the oppressive banalities of the heteronormative everyday. Though unaware of it at the time, my childhood mobilization of a female star as a vehicle of, and for, quotidian transcendence has a long and rich pedigree in queer cultures, especially gay male cultures. From the enthusiasms of the nineteenth century dandies for operatic primi donne and the fervent gay cult followings in the mid-twentieth century of Hollywood stars such as Judy Garland and Bette Davis, to contemporary queer celebrations of dancefloor goddesses, diva worship has been a staple of gay male cultural production where it has sustained a spectacularly diverse array of insistently queer pleasures. While loath to generalize its heterogeneous functions and values, I submit that much of the enduring vitality of diva worship in gay male cultures resides in the commodious scope it affords for reparative cultural labour. Indeed, most critical discussions of gay diva worship posit in some fashion that gay men engage divas as imaginary figures of therapeutic empowerment. “At the very heart of gay diva worship”, opines Daniel Harris, is “the almost universal homosexual experience of ostracism and insecurity” and the desire to “elevate [one]self above [one’s] antagonistic surroundings.” (Harris, 10) Wayne Koestenbaum similarly claims that "gay culture has perfected the art of mimicking a diva – of pretending, inside, to be divine – to help the stigmatized self imagine it is received, believed, and adored." (Koestenbaum, 133) Tuned to the chord of reparative amelioration, diva worship emerges here as a vital practice of affective queer enfranchisement: the restoration of a functional selfhood and the provision of emotional resources through which to transcend – and survive – the often violent deformations of a heteronormative world. That such processes of male homosexual affirmation should be articulated through ardent devotion to a woman might seem a strange paradox. But just as love and sex are never inevitable correspondents, the presence of a heterosexual passion inscribed at the very heart of gay male culture by its long histories of diva worship is a sure – and welcome – sign of the irrepressible waywardness of desire and its stubborn refusal to fit the impoverished scripts that we nominate sexuality. Works Cited Escoffier, Jeffrey. American Homo: Community and Perversity. Berkeley: University of California Press, 1998. Harris, Daniel. The Rise and Fall of Gay Culture. New York: Hyperion, 1997. Koestenbaum, Wayne. The Queen's Throat: Opera, Homosexuality, and the Mystery of Desire. New York: Poseidon Press, 1993. Sedgwick, Eve Kosofsky. “Paranoid Reading and Reparative Reading; or, You’re So Paranoid, You Probably Think This Introduction Is About You.” Novel Gazing: Queer Readings in Fiction. Durham: Duke University Press, 1997. Citation reference for this article Substitute your date of access for Dn Month Year etc... MLA Style Farmer, Brett. "Loving Julie Andrews" M/C: A Journal of Media and Culture 5.6 (2002). Dn Month Year < http://www.media-culture.org.au/0211/lovingjulie.php>. APA Style Farmer, B., (2002, Nov 20). Loving Julie Andrews. M/C: A Journal of Media and Culture, 5,(6). Retrieved Month Dn, Year, from http://www.media-culture.org.au/0211/lovingjulie.html

There are three stages in internet dating: first, the emailing back and forth; second, the phone conversation; and third, the meeting for 'coffee'. But before we discuss the three stages, here are some hints about the preliminary work you have to do. At the outset, you have to trawl through the thousands of people who have placed their profiles on the site. This is aided by limiting your search to a certain age spread, and your city or region. Then you can narrow it down further by checking educational background, whether they have kids, whether they write in New Age jargon, etc You have to try to assess, from their self-descriptions, which ones are likely to be compatible. You also scrutinise their photos, of course, as they will yours — but don't trust these images entirely — more on that later. Self-description. Almost without exception, women and men who describe their main interests as 'romantic walks on the beach and candle-lit dinners' have no real interests and as much personality as a lettuce. Those who say what matters to them is "good food and wine with a classy guy/lady" have a personality, but it's a repugnant one. Here is a useful binary opposition that could provide a useful key to gauging compatibility: people vary in terms of their degree of interiority and exteriority. People with interiority have the ability to think a little abstractly, can discuss emotions, probably read books as well as watch films. They analyse life rather than just describing it. People mainly given to exteriority find their pleasure in doing things — like boating or nightclubs or golf. They see themselves in the world in a different way. Of course, we are all a mixture of the two — and perhaps the best bet is someone who isn't at one extreme end of the spectrum or the other. Useful tip 1. The 'spiritual woman': for reasons unclear, and despite the fact that Australia is one of the most pagan nations on Earth, a disproportionate number of women, rather than men, claim to be religious. Perhaps because in general, women are still more inclined to interiority than men. But most religious women don't expect a partner to be. Instead, the people to be very careful about are the New Agers — they are a large and growing sub-group and apparently spend much of their time devouring books on spirituality, personal growth and self-love. If you have any sort of intellect, or are just a middling humanist who occasionally ponders "Is this all there is? " these people will drive you nuts with their vague platitudes about knowing their inner child. On the other hand, if they seem terrific in all other respects, you can probably gain their respect by saying in a reflective manner, "Is this all there is?" If you can arrange to be gazing at the star-stained night sky while saying this, all the better. This may seem calculating, but we are all putting on a performance when courting. A lot of single people have self-esteem and loneliness issues, and a personal God, the universe, and astrology make them feel less lonely. Useful tip 2: say that although you don't subscribe to mainstream religion, you feel close to some kind of spirituality when gardening — and add how you love to plant herbs. Some okay herbs to mention are: Rosemary, Thyme, Sage. Chuck a couple of these weed-like green things in your garden just in case. Useful tip 3: no matter what else you do, at all costs avoid anyone who smacks of fundamentalism. This cohort takes the Bible literally, think dinosaurs roamed the planet only a few years before Shakespeare, want gay people to admit they are an abomination - and above all, fundos cannot be reasoned with — not in your lifetime. They are deeply insecure and frightened people — which is sad, so be sympathetic to their plight - but don't get drawn into the vortex. Besides, talking about the approach of Armageddon every date gets a bit tedious. Education: It is usually best to pick someone who has an approximately similar level of education to yourself. Having a tertiary education often gives a person a different way of seeing themselves, and of perceiving others. On the other hand, it is possible to do a five year degree in a narrow professional area and know nothing at all useful about human beings and how they operate. (Ref: engineers, dentists, gynaecologists). There are high school graduates who are better-read and more intelligent than most products of a university. So it is up to the individual case. It is a plus to be interested in your partner's work, but not essential. It can be a minus to be in the same field. Ask yourself this: if you were living with this person and you asked them at night how their day had been, would the answer send you to sleep in less than a minute? A lovely man or woman who is an accountant will likely wax lyrical about having just discovered a $245 error in a billing data base. Their face will be flushed with pride. Can your respond appropriately? How often? Or the love of your life may work in an oncology ward, and regale you with the daily triumph of removing sputum from the chests of the moribund. Are you strong enough for that? And worst of all, you may go out with a writer or poet, who regularly drones on about how their rival always gets friendly reviews from his/her newspaper mates, even though they write books full of derivative, precious crap. Sense of humour (SOH): Most men and women will claim in their profile to have a sense of humour — to love to laugh — and, surprisingly often, to have a 'wicked sense of humour'. This is a difficult personal quality to get a bearing on. You may yourself be the kind of person who tricks themselves into thinking their date has a great sense of humour simply because they laughed at your jokes. That is not having a SOH. Having a SOH is possessing the ability to make others laugh — it is active as well as passive. Do they make you laugh? Are their emails touched with wit and whimsy — or just shades of cute? Is one of their close friends, the one who actually possesses a SOH, helping write their emails? It has been known to happen. You will gain a better sense of the SOH situation during the phone call, and definitely during the coffee. Interests: Most internet websites give people the chance to describe themselves by jotting down their favourite music, books, movies, sport. Often this is pretty much all you will know about what interests them, and it is an imperfect instrument. Many internet dating women say they like all music except heavy metal. Why there is this pervasive, gut-wrenching female fear of the E, A and B chords played loudly is a mystery. Anyway, some of those bands even throw in a G or C#m. But who cares. If you are a bloke, hide your Acca Dacca CDs and buy some world music CDs. New Agers of either sex will have collections full of warbling pan pipes, waterfalls and bird calls. If they are a great person in other respects, then you'll just have to get used to the flock of magpies and whip birds in the dining or bedroom. Photographs: Now, the photo on the profile is only a vague guide. It is useful for confirming the person belongs to homo sapiens, but not a lot else. Some people get a professional pic taken, but most include happy snaps, and that is a blow struck for candidness. The more the photo looks like a "glamour" shot, the softer the focus, the less reliable it is. You can get some idea of whether someone is attractive, handsome, cute or weird from the photo. But — and this is really important — they will always look different in the flesh. They will have grown a beard, cut or streaked their hair, and you will for the first time notice they have a nose the size of the AMP building. Fortunately for men, though women are not oblivious to the looks factor, they tend to be more tolerant and less shallow about it. There is a recent trend for women and men with children to put he most attractive and least manic one in the profile photo with them. This signifies: a) love me, love my kid, because I'm proud of James/Jessica/Jade; b) family values; c) at least my kid only has one head. Stage One. The first stage is in some ways the most enjoyable. It is low risk, low stress, you have the pleasurable experience of a comfortable adventure. There is anticipation, getting to know someone, being complimented on your fascinating emails and witty humour (if it's going well), and all the while wearing an old t-shirt and dirty, checked shorts or fluffy slippers. There is the extreme luxury of re-inventing yourself, of telling your favourite story (your own life-story) again and again to a new audience, the little joys of self-disclosures, the discoveries of like-interests, the occasion when they add at the bottom of their letter "looking forward to hearing from you soon". The writing stage is where you try to establish whether you have intellectual, emotional and cultural compatibility — and whether the person is sincere and relatively well-balanced (I stress 'relatively' — no one is perfect). The discovery process is one of exchanging increasingly personal information — work history, enthusiasms and dislikes, family background. She will want to know whether you are 'over' your last girlfriend/partner/wife. Not surprisingly. A lot of internet men are still bitter about their ex — either that, or they rave on about the saintliness of their ex. If encouraged, women will also tell you about the bastard who refused to pay maintenance. There are clearly a lot of those bastards out there. Both of these practices are unwise on the first coffee if you don't want to scare your potential partner off. In reality, you probably are still seething with hurt and injustice as a result of your last dumping, and maybe even the one before that. You may lie in bed at night thinking nostalgically of your ex's face — but this is a dark secret which you must never reveal. People will ask you to be open, but they don't want that open. Involve your friends: without exception, your close friends will enjoy being part of the process when you are deciding which men or women to contact on the internet. You first make a long short list by browsing through the hundreds of profiles. Print off those profiles, then get your friends to sort through them with you. If you have experience in being on selection panels for jobs, this will help. It is a quite complex matter of weighing up a whole range of variables. For example, candidate A will be gorgeous and sexy, have compatible interests, bearable taste in music, be the right age, but have two small children and live on the other side of town. Candidate B will be less attractive, but still look pretty good, have no children, and a very interesting job. Candidate C will be attractive, have two teenage children with whom he/she shares custody, a worthy but dull job, but seems to have an especially self-aware and witty personality. It's tough work rating these profiles, and the best you can do is whittle them down to a top three, and write to all of them. In the emailing stage, you will get more data to either enhance or diminish their desirability. And remember, no one is perfect: if you find someone with a beautiful brain and body who loves Celine Dion — just put up with it. As Buddhists point out, suffering cannot be avoided if you are to live a full life. But let your friends help you with that selection process — they will remind you of important issues that somehow escape your attention; such as: you really don't like other people's children in reality, just in theory. The last time you went out with someone who was newly broken up or divorced he/she hadn't got over his/her girlfriend/husband. Anyone who describes themselves as a 'passionate playmate' is probably unbalanced and tries to find male/female acceptance through over-sexualising or infantalising themselves. It means nothing that someone describes their children as "beautiful" — all mothers/fathers think that, even of the most ghastly, moronic offspring. You really don't like nightclubs any more and you are an awkward dancer. The last time you fell in love with, and tried to rescue, someone with serious emotional 'issues', it led to unimaginable misery, and you swore in future to leave such rescues to the professionals. And so on. Listen to your friends — they know you. And your bad choices impinge on their lives too. Writing is a powerful means of constructing a 'self' to project to others. There is a Thomas Hardy story about a young man who meets a beautiful girl at a fair — but he must return to London. They agree to write to each other. Only the beautiful girl is illiterate, so she asks her employer, an older woman, to ghost-write her love letters to the young man, and the employer kindly agrees. The young man falls in love with the soul and mind of the sensitive and intelligent writer of the letters and assumes the beautiful young girl has authored them. The employer also falls in love with him through his letters. Only on the day he marries the girl does he discover that he has married the wrong woman. This tale tells us about the richness of the written word, but it omits an important point — you can be intrigued and drawn to someone through his or her e-mails, but find on meeting him or her that there is no chemistry at all. Works Cited This creative non-fiction article was based on primary research. The largest Australian internet dating service is RSVP (www.rsvp.com.au). I mainly used that for my research and ensuing coffees/participant observation. There are other sites I checked out, including: www.datenet.com.au www.AussieMatchMaker.com.au www.findsomeone.com.au www.VitalPartners.com.au www.personals.yahoo.com.au There are also internet dating site guides such as: www.shoptheweb.com.au/dating.shtml www.theinternetdatingguide.com www.moonlitwalks.com www.singlesites.com/Australian_Dating.htm Citation reference for this article Substitute your date of access for Dn Month Year etc... MLA Style Neilsen, Philip. "An extract from 'The Internet of Love'" M/C: A Journal of Media and Culture 5.6 (2002). Dn Month Year < http://www.media-culture.org.au/0211/internet.php>. APA Style Neilsen, P., (2002, Nov 20). An extract from "The Internet of Love". M/C: A Journal of Media and Culture, 5,(6). Retrieved Month Dn, Year, from http://www.media-culture.org.au/0211/internet.html