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This study evaluated the effect of using AR technology to develop environmental literacy (RQ1), motivation (RQ2), and perceived cognitive load (RQ3) among high school students. The sample of participants in this study included 155 10th -grade students in general education. They took a semester-long Natural Resource Ecology course. The participants were randomly assigned to one of two groups: experimental (n = 77) and control (n = 78). The use of the immersive application in the experimental group was the only difference between the learning approaches. The main research method was a questionnaire based on three scales: "The Environmental Literacy scale," "the Motivation scale," and "the Cognitive Load scale." To compare the results between the groups and make intra-group comparisons of the periods before and after the intervention, the study use the Student's t-test (p < 0.05). The findings show that the positive effect of the immersive application-based course on students was sufficiently noticeable in terms of environmental literacy (d = 0.612) and motivation (d = 0.673). At the same time, its effect in reducing the cognitive load was slightly more than average (d = 0.549). This evidence represents essential information for potential improvements to programs and courses using technology for environmental and nature conservation education. The findings of this study enable curriculum modifications for high school students. The integration of immersive technologies into education develops and enhances their environmental knowledge and skills. Future research includes introducing and studying a separate ecology course in elementary school.

La educación en el nivel inicial es un espacio diseñado para que los niños exploren nuevosconocimientos, descubran formas de expresar sus ideas y desarrollen habilidades, no obstante,el objetivo fue, determinar como la psicomotricidad ayuda en el desarrollo de la preescriturapor medio de la aplicación y práctica de actividades psicomotrices en los niños educacióninicial. La metodología tiene enfoque cualitativo, de alcance descriptivo, la población es de22 estudiantes y 2 docentes; las técnicas para recolección de información son la observación,la encuesta y la entrevista, los instrumentos son la ficha de observación, el cuestionarioestructurado y el guion de entrevista. Los resultados revelan que la preescritura es una etapamuy difícil y frustrante para los niños, pero cuando se efectúa un correcto desarrollo motriz elproceso de preescritura se convierte en algo fácil y divertido que permite construir sus propiosconocimientos a través de las experiencias obtenidas

The sustainability of coffee production is a concern for producers around the world. To be sustainable, it is necessary to achieve satisfactory levels of coffee productivity and quality. Pests and diseases cause reduced productivity and can affect the quality of coffee beans. To ensure sustainability, producers need to monitor pests that can lead to substantial crop losses, such as the coffee leaf miner, Leucoptera coffeella (Lepidoptera: Lyonetiidae), which belongs to the Lepidoptera order and the Lyonetiidae family. This research aimed to use machine learning techniques and vegetation indices to remotely identify infestations of the coffee leaf miner in coffee-growing regions. Field assessments of coffee leaf miner infestation were conducted in September 2023. Aerial images were taken using remotely piloted aircraft to determine 13 vegetative indices with RGB (red, green, blue) images. The vegetation indices were calculated using ArcGis 10.8 software. A comprehensive database encompassing details of coffee leaf miner infestation, vegetation indices, and crop data. The dataset was divided into training and testing subsets. A set of four machine learning algorithms was utilized: Random Forest (RF), Logistic Regression (LR), Support Vector Machine (SVM), and Stochastic Gradient Descent (SGD). Following hyperparameter tuning, the test subset was employed for model validation. Remarkably, both the SVM and SGD models demonstrated superior performance in estimating coffee leaf miner infestations, with kappa indices of 0.6 and 0.67, respectively. The combined use of vegetation indices and crop data increased the accuracy of coffee leaf miner detection. The RF model performed poorly, while the SVM and SGD models performed better. This situation highlights the challenges of tracking coffee leaf miner infestations in fields with varying ages of coffee plants, different cultivars, and other environmental variables.

Abstract Culturing and genomic sequencing of Mycobacterium tuberculosis (MTB) from tuberculosis (TB) cases is the basis for many research and clinical applications. The alternative, culture-free sequencing from diagnostic samples, is promising but poses challenges to obtain and analyse the MTB genome. Paradoxically, culture is assumed to impose a diversity bottleneck, which, if true, would entail unexplored consequences. To unravel this paradox we generate high-quality genomes of sputum-culture pairs from two different settings after developing a workflow for sequencing from sputum and a tailored bioinformatics analysis. Careful downstream comparisons reveal sources of sputum-culture incongruences due to false positive/negative variation associated with factors like low input MTB DNA or variable genomic depths. After accounting for these factors, contrary to the bottleneck dogma, we identify a 97% variant agreement within sputum-culture pairs, with a high correlation also in the variants’ frequency (0.98). The combined analysis from five different settings and more than 100 available samples shows that our results can be extrapolated to different TB epidemic scenarios, demonstrating that for the cases tested culture accurately mirrors clinical samples.

Purpose: The article aims to identify the determinants of the urbanization process given the magnitude of this phenomenon and also its economic, social and environmental implications and pressure on public authorities to find viable solutions in the context of sustainable development. Design/methodology/approach: The research is based on regression analysis with urbanization growth being the dependent variable and enrollment in higher education, GDP, value added by industry and female labor force as independent variables. Findings: The main factors that favor urbanization are the increase in population, industry value-added and the female labor force. Urbanization is an objective that must be pursued differently by public authorities in developed and developing countries, given the different realities they face-population growth in developing countries, and population aging and international migration in developed countries. Research limitations/implications: The present research has limitations generated by the selection of independent variables, which is why in future directions, the research will consider the use of other indicators such as the number of graduates, exports as percent of GDP or migrations as a percentage of the total population. Given the complexity of the phenomenon of urbanization, future research will focus on groups of countries as they resulted from the clustering made by this article. Practical implications: The impact of higher education on urbanization is low, which is why the intensification of partnerships between municipal authorities and universities could be a solution that ensures not only the transfer of knowledge from academia to the public sector but also from entrepreneurs increasingly aware of the importance of promoting SDGs for urban development in the context of the challenges posed by global warming. The involvement of women in the labor market is essential for the intensification of the urbanization process. The increasing presence of women in the labor market generates an increase in the income of families, an increase in the level of education and an intensification of national and international migration. The research findings can be used by policy and decision-makers to develop appropriate urbanization and education policies and strategies. Originality/value: The existence of inhomogeneous clusters is noticeable, which demonstrates the complexity of the urbanization phenomenon that is present in all countries around the world, but under the influence of different factors such as the export of natural resources (mainly oil) or the intensification of industrial activity. Taking into account the variables used, this study stands out in the multitude of articles published in the international mainstream.

Abstract Background Improving treatment success rates among multi drug-resistant tuberculosis (MDR-TB) patients is critical to reducing its incidence and mortality, but adherence poses an important challenge. Video-based direct observed therapy (vDOT) may provide adherence benefits, while addressing the time and cost burden associated with community treatment supporter (CTS)-DOT. This study explored experiences of patients, family members and healthcare workers with different DOT modalities for adherence support in Eswatini. Methods Between April 2021 and May 2022, thirteen men and five women with MDR-TB, ten healthcare workers, and nine caregivers were purposively sampled to include a range of characteristics and experiences with DOT modalities. Data were generated through individual in-depth interviews and a smartphone messaging application (WhatsApp). Data coding was undertaken iteratively, and thematic analysis undertaken, supported by Nvivo. Results Four themes emerged that reflected participants’ experiences with different DOT modalities, including stigma, efficiency, perceived risks of TB acquisition, and patient autonomy. vDOT was appreciated by patients for providing them with privacy and shielding them from stigmatisation associated with being seen in TB clinics or with community treatment supporters. vDOT was also seen as more efficient than CTS-DOT. Health workers acknowledged that it saved time, allowing them to attend to more patients, while many patients found vDOT more convenient and less expensive by removing the need to travel for in-person consultations. Health workers also appreciated vDOT because it reduced risks of TB acquisition by minimising exposure through virtual patient monitoring. Although many patients appreciated greater autonomy in managing their illness through vDOT, others preferred human contact or struggled with making video recordings. Most family members appreciated vDOT, although some resented feeling removed from the process of supporting loved ones. Conclusions vDOT was generally appreciated by MDR-TB patients, their family members and health workers as it addressed barriers to adherence which could contribute to improved treatment completion rates and reduced workplace exposure. However, patients should be offered an alternative to vDOT such as CTS-DOT if this modality does not suit their circumstances or preferences.

This qualitative study aims to measure the optimization of Search Engine Optimization (SEO) on content containing gender equality values ​​on the mubadalah.id website. This research focuses on the editorial team's and writers' efforts to use SEO on the mubadalah.id website using Computer-Mediated Communication (CMC) theory to optimize asynchronous communication. The values ​​of gender equality are seen from the perspective of Qira'ah Mubadalah, which has three indicators, namely a perspective (minzhar) that humanizes humans, a way of reading (qira'ah) reference texts by placing men and women as subjects and whole human beings, and ways of grouping (qa'idah) experiences, mutuality, or cooperation between men and women. This research uses interview and digital observation methods. The results show that mubadalah.id has a comprehensive SEO strategy, but there is still room for improvement in its implementation.

The coffee leaf miner (Leucoptera coffeella) is a key pest in coffee-producing regions in Brazil. The objective of this work was to evaluate the potential of machine learning algorithms to identify coffee leaf miner infestation by considering the assessment period and Sentinel-2 satellite images generated on the Google Earth Engine platform. Coffee leaf miner infestation in the field was measured monthly from 2019 to 2023. Images were selected from the Sentinel-2 satellite to determine 13 vegetative indices. The selection of images and calculations of the vegetation indices were carried out using the Google Earth Engine platform. A database was generated with information on coffee leaf miner infestation, vegetation indices, and assessment times. The database was separated into training data and testing data. Nine machine learning algorithms were used, including Linear Discriminant Analysis, Random Forest, Support Vector Machine, k-nearest neighbors, and Logistic Regression, and a principal component analysis was conducted for each algorithm. After optimizing the hyperparameters, the testing data were used to validate the model. The best model to estimate miner infestation was RF, which had an accuracy of 0.86, a kappa index of 0.64, and a precision of 0.87. The developed models were capable of monitoring coffee leaf miner infestation.

Abstract Background Machine Learning (ML) plays a crucial role in biomedical research. Nevertheless, it still has limitations in data integration and irreproducibility. To address these challenges, robust methods are needed. Pancreatic ductal adenocarcinoma (PDAC), a highly aggressive cancer with low early detection rates and survival rates, is used as a case study. PDAC lacks reliable diagnostic biomarkers, especially metastatic biomarkers, which remains an unmet need. In this study, we propose an ML-based approach for discovering disease biomarkers, apply it to the identification of a PDAC metastatic composite biomarker candidate, and demonstrate the advantages of harnessing data resources. Methods We utilised primary tumour RNAseq data from five public repositories, pooling samples to maximise statistical power and integrating data by correcting for technical variance. Data were split into train and validation sets. The train dataset underwent variable selection via a 10-fold cross-validation process that combined three algorithms in 100 models per fold. Genes found in at least 80% of models and five folds were considered robust to build a consensus multivariate model. A random forest model was constructed using selected genes from the train dataset and tested in the validation set. We also assessed the goodness of prediction by recalibrating a model using only the validation data. The biological context and relevance of signals was explored through enrichment and pathway analyses using QIAGEN Ingenuity Pathway Analysis and GeneMANIA. Results We developed a pipeline that can detect robust signatures to build composite biomarkers. We tested the pipeline in PDAC, exploiting transcriptomics data from different sources, proposing a composite biomarker candidate comprised of fifteen genes consistently selected that showed very promising predictive capability. Biological contextualisation revealed links with cancer progression and metastasis, underscoring their potential relevance. All code is available in GitHub. Conclusion This study establishes a robust framework for identifying composite biomarkers across various disease contexts. We demonstrate its potential by proposing a plausible composite biomarker candidate for PDAC metastasis. By reusing data from public repositories, we highlight the sustainability of our research and the wider applications of our pipeline. The preliminary findings shed light on a promising validation and application path.

Abstract Background Video-enabled directly observed therapy (video-DOT) has been proposed as an additional option for treatment provision besides in-person DOT for patients with drug-resistant TB (DRTB) disease. However, evidence and implementation experience mainly originate from well-resourced contexts. This study describes the operationalization of video-DOT in a low-resourced setting in Eswatini facing a high burden of HIV and TB amid the emergence of the COVID-19 pandemic. Methods This is a retrospectively established cohort of patients receiving DRTB treatment during the implementation of video-DOT in Shiselweni from May 2020 to March 2022. We described intervention uptake (vs. in-person DOT) and assessed unfavorable DRTB treatment outcome (death, loss to care) using Kaplan-Meier statistics and multivariable Cox-regression models. Video-related statistics were described with frequencies and medians. We calculated the fraction of expected doses observed (FEDO) under video-DOT and assessed associations with missed video uploads using multivariable Poisson regression analysis. Results Of 71 DRTB patients eligible for video-DOT, the median age was 39 (IQR 30–54) years, 31.0% (n = 22) were women, 67.1% (n = 47/70) were HIV-positive, and 42.3% (n = 30) were already receiving DRTB treatment when video-DOT became available. About half of the patients (n = 37; 52.1%) chose video-DOT, mostly during the time when COVID-19 appeared in Eswatini. Video-DOT initiations were lower in new DRTB patients (aHR 0.24, 95% CI 0.12–0.48) and those aged ≥ 60 years (aHR 0.27, 95% CI 0.08–0.89). Overall, 20,634 videos were uploaded with a median number of 553 (IQR 309–748) videos per patient and a median FEDO of 92% (IQR 84–97%). Patients aged ≥ 60 years were less likely to miss video uploads (aIRR 0.07, 95% CI 0.01–0.51). The cumulative Kaplan-Meier estimate of an unfavorable treatment outcome among all patients was 0.08 (95% CI 0.03–0.19), with no differences detected by DOT approach and other baseline factors in multivariable analysis. Conclusions Implementing video-DOT for monitoring of DRTB care provision amid the intersection of the HIV and COVID-19 pandemics seemed feasible. Digital health technologies provide additional options for patients to choose their preferred way to support treatment taking, thus possibly increasing patient-centered health care while sustaining favorable treatment outcomes.

Abstract Objectives Achieving a consensus on a definition for different aspects of radiomics workflows to support their translation into clinical usage. Furthermore, to assess the perspective of experts on important challenges for a successful clinical workflow implementation. Materials and methods The consensus was achieved by a multi-stage process. Stage 1 comprised a definition screening, a retrospective analysis with semantic mapping of terms found in 22 workflow definitions, and the compilation of an initial baseline definition. Stages 2 and 3 consisted of a Delphi process with over 45 experts hailing from sites participating in the German Research Foundation (DFG) Priority Program 2177. Stage 2 aimed to achieve a broad consensus for a definition proposal, while stage 3 identified the importance of translational challenges. Results Workflow definitions from 22 publications (published 2012–2020) were analyzed. Sixty-nine definition terms were extracted, mapped, and semantic ambiguities (e.g., homonymous and synonymous terms) were identified and resolved. The consensus definition was developed via a Delphi process. The final definition comprising seven phases and 37 aspects reached a high overall consensus (> 89% of experts “agree” or “strongly agree”). Two aspects reached no strong consensus. In addition, the Delphi process identified and characterized from the participating experts’ perspective the ten most important challenges in radiomics workflows. Conclusion To overcome semantic inconsistencies between existing definitions and offer a well-defined, broad, referenceable terminology, a consensus workflow definition for radiomics-based setups and a terms mapping to existing literature was compiled. Moreover, the most relevant challenges towards clinical application were characterized. Critical relevance statement Lack of standardization represents one major obstacle to successful clinical translation of radiomics. Here, we report a consensus workflow definition on different aspects of radiomics studies and highlight important challenges to advance the clinical adoption of radiomics. Key Points Published radiomics workflow terminologies are inconsistent, hindering standardization and translation. A consensus radiomics workflow definition proposal with high agreement was developed. Publicly available result resources for further exploitation by the scientific community. Graphical Abstract

PURPOSEMounting data suggest that lower doses of anti-PD(L)1 agents can be as efficacious as label-approved doses at a fraction of its cost. We compare the outcomes of patients treated with low-dose (LD) and with conventional-dose (CD) anti-PD(L)1 agents.METHODSThis observational study evaluates the outcomes of patients with solid malignancies treated with anti-PD(L)1 agents (LD or CD) at Hospital de Base, Brazil. Patients were classified as receiving LD if the dose administered in the first cycle was below the label-approved dose. Efficacy outcomes, including best clinical overall response rate (cORR), clinical progression-free survival (cPFS), and overall survival (OS), were evaluated.RESULTSFrom January 2020 to May 2023, 71 patients were included: 49 (69%) with LD and 22 (31%) with CD agents. The most frequent tumor sites were the lung (41% LD, 22.9% CD) and skin (melanoma; 24.6% LD, 50% CD). Most of the patients were treated with pembrolizumab (65% LD and 72% CD). The mean dose of pembrolizumab was 95.3 mg (1.5 mg/kg) in LD and 168.7 mg (2.12 mg/kg) in CD groups, once a day, q21d (every 21 days). After a median follow-up of 10.9 months, there were no significant differences between LD versus CD in cORR (38.1% v 35.2%, P = .31), cPFS (5.3 m v 7 m, P = .36), and OS (12.8 m v not reached, P = .17). A subgroup analysis with patients receiving pembrolizumab was performed, and similar results were obtained.CONCLUSIONOur study found no differences in cORR, cPFS, and OS between patients treated with LD and CD anti-PD(L)1. LD anti-PD(L)1 could be an alternative to promote accessibility, which warrants further investigation in randomized trials.

Actualmente vivimos en un escenario de crisis de cuidados caracterizado por una creciente demanda de los mismos y por un modelo de provisión deficiente y con escasos recursos. Como respuesta, surgen iniciativas alternativas que articulan de manera colectiva nuevas formas de organización del cuidado. Muchas funcionan de forma autogestionada y se alinean con los principios de la Economía Social y Solidaria y la Economía Feminista. En este contexto, entre 2021 y 2023 hemos llevado a cabo un trabajo etnográfico con el fin de estudiar tres casos del Estado español, mediante 27 entrevistas semiestructuradas, 6 talleres, diversas sesiones de observación participante, así como e-research. La primera es una asociación de trabajado del hogar que presta cuidados principalmente a personas mayores; la segunda, una asociación de familias organizadas en torno a un proyecto de escuela alternativa; y la tercera una cooperativa que elabora alimentos agroecológicos, ofrece catering y facilita la conciliación y la corresponsabilidad del cuidado de criaturas. Estas experiencias y sus participantes habitan espacios de tensión entre la economía del don y las demandas productivo-mercantiles del mercado. Observamos que en ellas persisten sesgos androcéntricos que (re)producen una división sexual del trabajo, manifestada en el reparto desigual de tareas, responsabilidades, funciones y roles, así como en el significado que mujeres y hombres les otorgan. En los tres casos se evidencia también un "estrabismo productivista". El artículo muestra que la teoría del don ofrece un marco que facilita una comprensión más profunda de las relaciones de reciprocidad que sostienen estos proyectos. De este modo, se contextualizan las amenazas, tensiones y contradicciones que socavan las iniciativas comunitarias de cuidado, así como las herramientas feministas desarrolladas en respuesta a ellas, como son, visibilizar y problematizar las desigualdades existentes y practicar el autocuidado. Con ello, se aspira a realizar una contribución a las investigaciones sobre la praxis de la Economía Social y Solidaria desde las perspectivas de la Economía Feminista y la Economía Moral.

Introdução: Vancomicina possui estreito índice terapêutico, e sua ineficácia e toxicidade estão diretamente relacionadas a níveis séricos inadequados. Diretrizes publicadas em 2020 reconhecem que o uso da AUC (área sob a curva) entre 400 e 600 maximiza a eficácia clínica e minimiza o risco quando comparado à dosagem tradicional baseada no vale. Objetivo: Este trabalho tem como objetivo geral avaliar o impacto da reestruturação e implementação de Protocolo de Vancocinemia institucional, utilizando AUC e tomada de decisão pela equipe Médica e de Farmácia Clínica. Como objetivos específicos, garantir as doses corretas de ataque e manutenção, conforme peso real e AUC; garantir avaliação da AUC sempre que necessário, e consequente correção das doses quando indicada. Método: Estudo de coorte retrospectivo, realizado em hospital privado de alta complexidade de São Paulo, com 411 leitos. Em 2018 foi criado o Protocolo de Vancocinemia, coleta somente pelo vale. Em 2023, foi proposta a elaboração e reestruturação do Protocolo institucional, considerando AUC com cálculo através do software Sanford Guide Vancomycin Calculator®, realizada apresentação do protocolo para os farmacêuticos, gestores assistenciais e lideranças, e divulgação por treinamentos internos e comunicados para equipe assistencial, ressaltando a importância da coleta em horários pré-definidos (entre 4° e 5° dose, pico e vale respectivamente). Estabeleceu-se responsabilidade do farmacêutico clínico na programação das coletas e ajuste das doses e/ou intervalos, este junto com o responsável clínico. Definiram-se os seguintes indicadores: Proporção de Prescrições Avaliadas; Proporção de Intervenções realizadas; Proporção de intervenções aceitas e Tempo para atingir AUC alvo. Neste estudo foram incluídos pacientes acima de 28 dias em tratamento com vancomicina intravenosa ≥ 48h entre setembro de 2023 a abril de 2024. Os dados foram obtidos por meio de prontuário eletrônico do serviço e estratificados através de banco de dados no Excel. Resultados: 112 casos prescritos no período, sendo 109 avaliados pelo farmacêutico clínico (97%); desses em 57 houve necessidade de intervenções farmacêuticas ao médico prescritor (52%), e dessas 51 foram aceitas pelo médico (89%). O ?t mediano para obtenção da AUC alvo foi de 2,3 dias. Conclusão: A atualização do Protocolo de Vancocinemia utilizando AUC, mostrou-se uma ferramenta eficiente para garantir níveis séricos adequados e AUC alvo em média com 3 dias.

Introdução: A vancomicina é um glicopeptídeo, indicado para tratamento de infecções graves por bactérias gram-positivas, principalmente Staphylococcus aureus resistentes à meticilina (MRSA). Todavia, alcançar uma dose apropriada requer monitoramento do nível sérico. Estudos experimentais e clínicos mostram a área sob a curva (AUC) como melhor parâmetro para esse monitoramento. Objetivo: O objetivo desse estudo foi avaliar a necessidade de ajuste da dose de vancomicina baseado no cálculo da AUC realizado pelo farmacêutico clínico. Método: Foram avaliados retrospectivamente os prontuários dos pacientes que receberam tratamento com vancomicina no período de setembro de 2023 a abril de 2024. Para obtenção do valor da área sob a curva, os farmacêuticos clínicos utilizaram o software Sanford Guide Vancomycin Calculator®. O cálculo do nível sérico ocorreu após coleta de sangue em dois tempos, pico após administração da quarta dose e vale antes da quinta dose. Resultados: Foram analisados 107 pacientes (103 adultos e 4 crianças). No primeiro cálculo da AUC dos pacientes adultos, 56 (54%) estavam dentro da faixa terapêutica e 47 (46%) estavam fora dos valores de referência. Das AUC fora da faixa terapêutica, 24 (23%) estavam abaixo de 400 μg/mL e 23 (22%) acima de 600 μg/mL, sendo necessária intervenção do farmacêutico clínico junto ao médico para ajuste da dose, obtendo uma aceitabilidade de 89%. Após ajustada a dose, 30 (64%) pacientes finalizaram o tratamento ou tiveram a vancomicina suspensa antes da próxima coleta de nível sérico, 9 (19%) necessitaram de novo ajuste da dose e 8 (17%) entraram dentro da faixa terapêutica. Das 4 crianças que fizeram uso de vancomicina nenhuma atingiu a faixa terapêutica na primeira coleta do nível sérico, 3 (75%) crianças tiveram a terapia substituída após a primeira AUC, e 1 atingiu a faixa terapêutica após dois ajustes de dose. Conclusão: A faixa terapêutica na primeira AUC calculada não foi atingida em aproximadamente metade dos pacientes em uso de vancomicina, sendo necessária intervenção do farmacêutico. Evidencia-se a importância do acompanhamento multiprofissional e presença do farmacêutico clínico no ciclo de monitoramento do nível sérico da vancomicina para viabilizar o ajuste precoce da dose e, consequentemente, redução da falha terapêutica.

Abstract Objectives: to evaluate the associated factors with positive self-perception of oral health in pregnant and postpartum women treated at a reference maternity hospital in the north of Minas Gerais, Brazil. Methods: cross-sectional study with women assisted in an extension project. The sample consisted of women evaluated in the period from 2012 to 2022 who passedthe inclusion and exclusion criteria. The outcome variable was self-perception of oral health, which was dichotomized after the participants’ response options. The analyses were performed using the SPSS 20.0 software. Results: a total of 711 women participated. The positive self-perception of oral health was present in 50.2% of the sample. The associated factors were women without a partner (PR=1.07; CI95%=1.00-1.14; p=0.042), who went to the dentist during pregnancy (PR=1,12; CI95%=1.05-1.19; p

Este estudio longitudinal evaluó el impacto de un programa intensivo de educación física (EF) en el desarrollo integral de estudiantes de educación básica y bachillerato en Ecuador. Utilizando un enfoque mixto, se analizaron los efectos en el rendimiento académico, el bienestar emocional y la integración social de 300 estudiantes, divididos en un grupo experimental y un grupo control. Los resultados mostraron mejoras significativas en las calificaciones de matemáticas y lenguaje en el grupo experimental, así como un aumento en la autoestima y el bienestar subjetivo, medidos a través de la Escala de Autoestima de Rosenberg y la Encuesta de Bienestar Subjetivo. Además, los estudiantes del grupo experimental demostraron una mayor cohesión social y una menor incidencia de conflictos interpersonales en comparación con el grupo control. Estos hallazgos sugieren que la EF tiene un papel crucial en la promoción del desarrollo integral de los estudiantes, no solo desde una perspectiva física, sino también académica, emocional y social. Las implicaciones de este estudio subrayan la necesidad de políticas educativas que fortalezcan la educación física en las escuelas ecuatorianas, asegurando su implementación efectiva y equitativa. Futuras investigaciones deberían explorar los efectos a largo plazo de la EF y cómo su integración en el currículo escolar puede optimizarse para maximizar sus beneficios en diversas dimensiones del desarrollo estudiantil.