Challenges of health and well-being in the world according to SDG indicators. / Desafíos de salud y bienestar en el mundo según indicadores ODS.

This study reviews the current state of the good health and well-being indicators included in the Sustainable Development Goals (SDG), identifying the most significant challenges faced by countries in the world and in the Americas region. The HJ-Biplot multivariate technique is used to represent variances and covariances between 16 SDG 3 indicators, reported as of 2022, based on data from 176 countries, including 31 countries of the American continent. The findings show that indicators such as life expectancy at birth, universal health coverage and satisfied demand for family planning are key characteristics of developed countries. In contrast, developing countries still face significant challenges in terms of promoting maternal health, the well-being of children and the control of communicable and chronic diseases. For this reason, in the framework of the 2030 Agenda, it is necessary to continue working on public policy actions that enable making progress in the implementation of programs to improve the health and well-being of the population, especially in lower-income countries.

En este estudio se analiza el estado actual de los indicadores de salud y bienestar pertenecientes a los objetivos de desarrollo sostenible (ODS), identificando los desafíos más significativos que se presentan entre los países del mundo y en la región de las Américas. Se utiliza la técnica multivariante HJ-Biplot para representar las variaciones y covariaciones existentes entre 16 indicadores del ODS 3, reportados al año 2022, según datos de 176 países, entre ellos, 31 del continente americano. Los resultados obtenidos muestran que indicadores como la esperanza de vida al nacer, la cobertura sanitaria universal y la demanda de planificación familiar satisfecha, caracterizan a los países desarrollados. En contraste, los países en vía de desarrollo aún registran retos importantes para favorecer la salud materna, el bienestar de los niños y en el control de enfermedades trasmisibles y crónicas. Por ello, en el marco de la Agenda 2030, es necesario continuar trabajando en acciones de política pública que permitan avanzar en la implementación de programas para mejorar la salud y el bienestar de la población, en especial entre las naciones de menores ingresos.

Desafíos de salud y bienestar en el mundo según indicadores ODS / Challenges of health and well-being in the world according to SDG indicators

Resumen En este estudio se analiza el estado actual de los indicadores de salud y bienestar pertenecientes a los objetivos de desarrollo sostenible (ODS), identificando los desafíos más significativos que se presentan entre los países del mundo y en la región de las Américas. Se utiliza la técnica multivariante HJ-Biplot para representar las variaciones y covariaciones existentes entre 16 indicadores del ODS 3, reportados al año 2022, según datos de 176 países, entre ellos, 31 del continente americano. Los resultados obtenidos muestran que indicadores como la esperanza de vida al nacer, la cobertura sanitaria universal y la demanda de planificación familiar satisfecha, caracterizan a los países desarrollados. En contraste, los países en vía de desarrollo aún registran retos importantes para favorecer la salud materna, el bienestar de los niños y en el control de enfermedades trasmisibles y crónicas. Por ello, en el marco de la Agenda 2030, es necesario continuar trabajando en acciones de política pública que permitan avanzar en la implementación de programas para mejorar la salud y el bienestar de la población, en especial entre las naciones de menores ingresos.

Abstract This study reviews the current state of the good health and well-being indicators included in the Sustainable Development Goals (SDG), identifying the most significant challenges faced by countries in the world and in the Americas region. The HJ-Biplot multivariate technique is used to represent variances and covariances between 16 SDG 3 indicators, reported as of 2022, based on data from 176 countries, including 31 countries of the American continent. The findings show that indicators such as life expectancy at birth, universal health coverage and satisfied demand for family planning are key characteristics of developed countries. In contrast, developing countries still face significant challenges in terms of promoting maternal health, the well-being of children and the control of communicable and chronic diseases. For this reason, in the framework of the 2030 Agenda, it is necessary to continue working on public policy actions that enable making progress in the implementation of programs to improve the health and well-being of the population, especially in lower-income countries.

Análisis multidimensional de la evolución de la pandemia de la COVID-19 en países de las Américas

[RESUMEN]. Objetivo. Evaluar la evolución de pandemia de la COVID-19 entre los países de las Américas, comparando datos de los sistemas de salud previo a la llegada del virus a la Región, frente a los casos y muertes acumuladas antes del despliegue de las estrategias de inmunización de la población, y el estado actual de la vacunación. Métodos. Se realizo un análisis multivariante HJ-Biplot y análisis de cluster, para 28 países de la Región de las Américas, en tres momentos del tiempo: diciembre de los años 2019, 2020 y 2021. Resultados. En el continente americano se observa heterogeneidad en las acciones implementadas para contener la pandemia, la cual se refleja en diferentes grupos de naciones. Conclusiones. No todos los países de la Región de las Américas contaban con las condiciones de salubridad necesarias para afrontar la contención de la COVID-19. A cierre de 2019 Estados Unidos, Canadá, Brasil y Cuba se observaban con ventajas frente a los demás países de la Región, sin embargo, la pertinencia de las acciones implementadas durante el año 2020 para contener la pandemia, generaron diferentes grupos de países según la prevalencia de contagios y muertes. En tal momento, Bolivia, Ecuador y México, presentaban niveles críticos de letalidad. A cierre de 2021, tras la implementación de los planes de vacunación, Argentina, Brasil, Canadá, Chile, Colombia, Costa Rica, Cuba, Panamá, Estados Unidos y Uruguay registran más del 60% de su población con el esquema de vacunación completo.

[ABSTRACT]. Objective. To evaluate the evolution of the COVID-19 pandemic in countries of the Americas, comparing health system data from before the appearance of the virus in the Region, accumulated cases and deaths before the deployment of public immunization strategies, and the current state of vaccination. Methods. An HJ-Biplot multivariate analysis and cluster analysis were performed for 28 countries in the Region of the Americas at three points in time: December 2019, December 2020, and December 2021. Results. In the Americas, heterogeneity was observed in the actions implemented to contain the pandemic, and this was reflected in different groups of countries. Conclusions. Not all countries in the Region of the Americas had the health conditions necessary to contain COVID-19. At the end of 2019, the United States, Canada, Brazil, and Cuba had advantages over other countries in the Region; however, actions implemented during 2020 to contain the pandemic created different groups of countries in terms of the prevalence of infections and deaths. At the end of 2020, Bolivia, Ecuador, and Mexico had critical levels of mortality. At the end of 2021, after the implementation of vaccination plans, more than 60% of the population of Argentina, Brazil, Canada, Chile, Colombia, Costa Rica, Cuba, Panama, the United States, and Uruguay had completed the vaccination schedule.

[RESUMO]. Objetivo. Avaliar a evolução da pandemia da COVID-19 entre os países das Américas, comparando os dados dos sistemas de saúde antes da chegada do vírus à região em relação aos casos e mortes acumuladas antes da implementação de estratégias de imunização da população e a situação atual da vacinação. Métodos. Foi realizada uma análise multivariada HJ-Biplot e uma análise de agrupamentos para 28 países da região das Américas, em três períodos: dezembro de 2019, de 2020 e de 2021. Resultados. No continente americano, observa-se heterogeneidade nas ações implementadas para conter a pandemia, o que se reflete nos diferentes grupos de nações. Conclusões. Nem todos os países da região das Américas contavam com as condições sanitárias necessárias para conter a COVID-19. No fim de 2019, Estados Unidos, Canadá, Brasil e Cuba tinham uma vantagem sobre os demais países da região. No entanto, a pertinência das ações implementadas durante o ano de 2020 para conter a pandemia gerou diferentes grupos de países segundo a prevalência de contágios e mortes. Naquele momento, Bolívia, Equador e México apresentavam níveis críticos de letalidade. No fim de 2021, após a implementação dos planos de vacinação, Argentina, Brasil, Canadá, Chile, Colômbia, Costa Rica, Cuba, Panamá, Estados Unidos e Uruguai registravam mais de 60% de sua população com esquema vacinal completo.

Análisis multidimensional de la evolución de la pandemia de la COVID-19 en países de las Américas / Multidimensional analysis of the evolution of the COVID-19 pandemic in countries of the Americas / Análise multidimensional da evolução da pandemia da COVID-19 em países das Américas

RESUMEN Objetivo. Evaluar la evolución de pandemia de la COVID-19 entre los países de las Américas, comparando datos de los sistemas de salud previo a la llegada del virus a la Región, frente a los casos y muertes acumuladas antes del despliegue de las estrategias de inmunización de la población, y el estado actual de la vacunación. Métodos. Se realizo un análisis multivariante HJ-Biplot y análisis de cluster, para 28 países de la Región de las Américas, en tres momentos del tiempo: diciembre de los años 2019, 2020 y 2021. Resultados. En el continente americano se observa heterogeneidad en las acciones implementadas para contener la pandemia, la cual se refleja en diferentes grupos de naciones. Conclusiones. No todos los países de la Región de las Américas contaban con las condiciones de salubridad necesarias para afrontar la contención de la COVID-19. A cierre de 2019 Estados Unidos, Canadá, Brasil y Cuba se observaban con ventajas frente a los demás países de la Región, sin embargo, la pertinencia de las acciones implementadas durante el año 2020 para contener la pandemia, generaron diferentes grupos de países según la prevalencia de contagios y muertes. En tal momento, Bolivia, Ecuador y México, presentaban niveles críticos de letalidad. A cierre de 2021, tras la implementación de los planes de vacunación, Argentina, Brasil, Canadá, Chile, Colombia, Costa Rica, Cuba, Panamá, Estados Unidos y Uruguay registran más del 60% de su población con el esquema de vacunación completo.

ABSTRACT Objective. To evaluate the evolution of the COVID-19 pandemic in countries of the Americas, comparing health system data from before the appearance of the virus in the Region, accumulated cases and deaths before the deployment of public immunization strategies, and the current state of vaccination. Methods. An HJ-Biplot multivariate analysis and cluster analysis were performed for 28 countries in the Region of the Americas at three points in time: December 2019, December 2020, and December 2021. Results. In the Americas, heterogeneity was observed in the actions implemented to contain the pandemic, and this was reflected in different groups of countries. Conclusions. Not all countries in the Region of the Americas had the health conditions necessary to contain COVID-19. At the end of 2019, the United States, Canada, Brazil, and Cuba had advantages over other countries in the Region; however, actions implemented during 2020 to contain the pandemic created different groups of countries in terms of the prevalence of infections and deaths. At the end of 2020, Bolivia, Ecuador, and Mexico had critical levels of mortality. At the end of 2021, after the implementation of vaccination plans, more than 60% of the population of Argentina, Brazil, Canada, Chile, Colombia, Costa Rica, Cuba, Panama, the United States, and Uruguay had completed the vaccination schedule.

RESUMO Objetivo. Avaliar a evolução da pandemia da COVID-19 entre os países das Américas, comparando os dados dos sistemas de saúde antes da chegada do vírus à região em relação aos casos e mortes acumuladas antes da implementação de estratégias de imunização da população e a situação atual da vacinação. Métodos. Foi realizada uma análise multivariada HJ-Biplot e uma análise de agrupamentos para 28 países da região das Américas, em três períodos: dezembro de 2019, de 2020 e de 2021. Resultados. No continente americano, observa-se heterogeneidade nas ações implementadas para conter a pandemia, o que se reflete nos diferentes grupos de nações. Conclusões. Nem todos os países da região das Américas contavam com as condições sanitárias necessárias para conter a COVID-19. No fim de 2019, Estados Unidos, Canadá, Brasil e Cuba tinham uma vantagem sobre os demais países da região. No entanto, a pertinência das ações implementadas durante o ano de 2020 para conter a pandemia gerou diferentes grupos de países segundo a prevalência de contágios e mortes. Naquele momento, Bolívia, Equador e México apresentavam níveis críticos de letalidade. No fim de 2021, após a implementação dos planos de vacinação, Argentina, Brasil, Canadá, Chile, Colômbia, Costa Rica, Cuba, Panamá, Estados Unidos e Uruguai registravam mais de 60% de sua população com esquema vacinal completo.

Associations between Screen-Based Activities, Physical Activity, and Dietary Habits in Mexican Schoolchildren.

Screen-based activities are associated with increased risk of obesity and contribute to physical inactivity and poor dietary habits. The primary aim of this study was to examine the associations among screen-based activities, physical activity, and dietary habits in school-aged children in Guadalajara, Puerto Vallarta, and Mexico City, Mexico. The secondary aim was to examine these associations across sex. The School Physical Activity and Nutrition survey was used to assess screen-based activities (TV watching, video game use, computer use), physical activity, and dietary habits. Organized activity/sports participation, unhealthy dietary habits, and household income were correlated with screen-based activities. While TV watching was associated with decreased participation in organized activity/sports participation, computer and video game use was associated with increased organized activity/sports participation. Boys engaged in more TV watching and video game use compared to girls. All screen-based activities were associated with age among boys; whereas video game and computer use were associated with higher income among girls. These findings suggest a need for sex- and age-specific strategies that acknowledge the differential use of screen-based activities across sex and age. Future research should continue to identify underlying correlates linking screen-based activities with health behaviors to inform strategies to reduce screen-time in Mexican children.

Humanización de los servicios de salud en Iberoamérica: una revisión sistemática de la literatura / Humanizing Health Care Services in Ibero-America: A Systematic Review of Literature / Humanização dos serviços de saúde na Ibero-América: uma revisão sistemática da literatura

Resumen La humanización es un imperativo ético que contribuye a salvaguardar la dignidad humana en armonía con los principios bioéticos y la reglamentación deontológica que regulan las prácticas en un contexto de salud. El presente estudio tiene como objetivo conocer los avances sobre el abordaje de la humanización en salud en Iberoamérica en los últimos diez años, a través de una revisión sistemática. Frente a los hallazgos, se evidencia que los avances apuntan a la comprensión del fenómeno a partir de las aproximaciones teóricas, el creciente interés por el tema en los últimos años y la generación de políticas, programas y estrategias que deben fortalecerse desde una mirada integral del ser humano.

Abstract Humanization is an ethical imperative that contributes to safeguarding human dignity in harmony with bioethical principles and deontological regulations that govern health care practices. The present study aims to explore the advances in the humanization of Ibero-American health care in the last ten years through a systematic review. Results show that such advances point to understanding the phenomenon based on theoretical approaches, a growing interest in the subject in recent years, and the creation of policies, programs and strategies that should be strengthened from a comprehensive view of the human being.

Resumo A humanização é um imperativo ético que contribui para salvaguardar a dignidade humana em harmonia com os princípios bioéticos e com a regulamentação deontológica que determinam as práticas em um contexto de saúde. Este estudo tem o objetivo de conhecer os avanços sobre a abordagem da humanização em saúde na Ibero-América nos últimos dez anos, por meio de uma revisão sistemática da literatura. Diante dos resultados, torna-se evidente que os avanços apontam à compreensão do fenômeno a partir das aproximações teóricas, do crescente interesse pelo tema nos últimos anos e da criação de políticas, programas e estratégias que devem ser fortalecidos sob um olhar integral do ser humano.

Word-wide meta-analysis of Quercus forests ectomycorrhizal fungal diversity reveals southwestern Mexico as a hotspot.

Quercus is the most diverse genus of ectomycorrhizal (ECM) host plants; it is distributed in the Northern and Southern Hemispheres, from temperate to tropical regions. However, their ECM communities have been scarcely studied in comparison to those of conifers. The objectives of this study were to determine the richness of ECM fungi associated with oak forests in the Cuitzeo basin in southwestern Mexico; and to determine the level of richness, potential endemism and species similarity among ECM fungal communities associated with natural oak forests worldwide through a meta-analysis. The ITS DNA sequences of ECM root tips from 14 studies were included in the meta-analysis. In total, 1065 species of ECM fungi have been documented worldwide; however, 812 species have been only found at one site. Oak forests in Europe contain 416 species, Mexico 307, USA 285, and China 151. Species with wider distributions are Sebacinaceae sp. SH197130, Amanita subjunquillea, Cenococcum geophilum, Cortinarius decipiens, Russula hortensis, R. risigallina, R. subrubescens, Sebacinaceae sp. SH214607, Tomentella ferruginea, and T. lapida. The meta-analysis revealed (1) that Mexico is not only a hotspot for oak species but also for their ECM mycobionts. (2) There is a particularly high diversity of ECM Pezizales in oak seasonal forests from western USA to southwestern Mexico. (3) The oak forests in southwestern Mexico have the largest number of potential endemic species. (4) Globally, there is a high turnover of ECM fungal species associated with oaks, which indicates high levels of alpha and beta diversity in these communities.

Synthetic Peptides Derived from Bovine Lactoferricin Exhibit Antimicrobial Activity against E. coli ATCC 11775, S. maltophilia ATCC 13636 and S. enteritidis ATCC 13076.

Linear, dimeric, tetrameric, and cyclic peptides derived from lactoferricin B-containing non-natural amino acids and the RWQWR motif were synthesized, purified, and characterized using RP-HPLC, MALDI-TOF mass spectrometry, and circular dichroism. The antibacterial activity of peptides against Escherichia coli ATCC 11775, Stenotrophomonas maltophilia ATCC 13636, and Salmonella enteritidis ATCC 13076 was evaluated. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined. The synthetic bovine lactoferricin exhibited antibacterial activity against E. coli ATCC 11775 and S. enteritidis ATCC 13076. The dimeric peptide (RRWQWR)2K-Ahx exhibited the highest antibacterial activity against the tested bacterial strain. The monomeric, cyclic, tetrameric, and palindromic peptides containing the RWQWR motif exhibited high and specific activity against E. coli ATCC 11775. The results suggest that short peptides derived from lactoferricin B could be considered as potential candidates for the development of antibacterial agents against infections caused by E. coli.

Características clínicas del paciente diabético después de un evento de cetoacidosis / Clinical characteristics of the diabetic patient after a ketoacidosis event

Objetivo. Describir las características clínicas y terapéuticas de los pacientes después de un evento de cetoacidosis diabética (CAD). Material y métodos. Estudio descriptivo, tipo serie de casos. Se revisó 127 historias clínicas de pacientes con diagnóstico de crisis hiperglicémicas, 90 de los cuales tuvieron diagnóstico de CAD, en el Hospital Nacional Arzobispo Loayza de Lima. Cuarenta pacientes fueron ubicados, firmaron el consentimiento informado y fueron entrevistados. Se evaluó los siguientes parámetros clínicos y metabólicos: sexo, edad, glicemia, hemoglobina glicosilada (Hb1Ac), nuevo evento de CAD, índice de masa corporal (IMC) y tratamiento postevento (dieta y tratamiento). Resultados. Veintisiete (67,5%) fueron mujeres. La edad promedio fue 49,53 ± 14,88 años. El tiempo de enfermedad de diabetes mellitus (DM) promedio fue 60,5 ± 70,45 meses y el tiempo después del evento de CAD promedio fue 21,3 ± 8,47 meses. En 50% de pacientes fue un debut de DM. La glucosa promedio fue 157,50 ± 83,24 mg/dL, el nivel de Hb1Ac promedio fue 8,05 ± 2%. El IMC promedio fue 28,01 ± 5 kg/m2. La terapia recibida postevento de CAD fue: 9 (22,5%) pacientes con insulinoterapia, 19 (47,5%) antidiabéticos orales (todos tenían DM-2); 2 (5%) recibieron solo dieta y ejercicio y 10 (25%) no seguían ningún tratamiento. Tres (7,5%) presentaron un nuevo evento de CAD (dos pacientes tenían DM-1 y uno tenía DM-2). Conclusión. En el seguimiento, postevento de CAD, la mayoría de los pacientes tenía un comportamiento clínico como de DM-2.

Objetive. To describe the clinical and therapeutic characteristics of patients after an event of diabetic ketoacidosis (DKA). Material and methods. A descriptive, case series. We reviewed 127 medical records with diagnosis of hyperglycemic crisis, 90 of whom had a diagnosis of DKA, in the Hospital Nacional Arzobispo Loayza, Lima. Forty patients were contacted, signed an informed consent and were interviewed. We evaluated the following clinical and metabolic parameters: sex, age, blood glucose, Hb1Ac, new event of DKA, body masss index (BMI) and the treatment after the event of DKA (diet and treatment). Results. Twenty-seven (67,5%) were women. The mean age was 49,53 ± 14,88 years. The mean disease duration of diabetes mellitus (DM) was 60,5 ± 70,45 months and the mean time after the event of DKA 21,3 ± 8,47 months. A debut of DM ocurred in 50% of DKA cases. The mean glucose was 157,50 ± 83,24 mg/dL, the mean BMI was 28,01 ± 5 kg/m2. The therapy given after the event of CAD was: 9 (22,5%) patients with. 19 (47,5%) oral agents (all of whom had DM2), 2 (5%) only diet and exercise and 10 (25%) without any treatment. There (7,5%) had new DKA event, 2 patients had DMI and DM2 1 had. Conclusions. On follow up, after an episode of DKA the majority of patients have a similar clinical behavior as patients with diabetes mellitus type 2.

Quinolizidine alkaloid composition in different organs of Lupinus aschenbornii

Lupinus aschenbornii S. Schauer, Fabaceae, grows in the Central Highlands of Mexico, at altitudes between 2800 to 4300 m above sea level. The alkaloid patterns in organs of L. aschenbornii were analyzed by Gas-Liquid Chromatography-Mass Spectrometry (GLC-MS). Quinolizidine alkaloids (QA) were identified according to their mass fragmentation patterns, in combination with their Kovats retention indeces. Total QA content in organs differed substantially: seed contained 3.3 mg/g dry weight, flowers 2.8 mg/g DW, leaves 1.9 mg/g DW, stems 1.5 mg/g DW, and pods 1.4 mg/g DW. Roots do not accumulate QA and their profiles differed considerably: while seed stored N-formylangustifoline (17 percent), 17-oxolupanine (16 percent), multiflorine (11 percent) and an unidentified alkaloid (n.i.) 2869 (11 percent) as main QA, sparteine was absent. In flowers, sparteine reached 73 percent, in leaves up to 80 percent, in stems up to 32 percent and in pods up to 96 percent. Other QA present were lupanine (32 percent in stem, 9 percent in flower and 7 percent in seed); N-formylangustifoline (9 percent in stem and 4 percent in flower); multiflorine (6 percent in stem and 3 percent in flower). Differences in QA profile might be a strategy of lupins to avoid adaptation of possible predators because the different QA have different pharmacological properties.

Depressive symptomatology in children and adolescents with chronic renal insufficiency undergoing chronic dialysis.

This paper presents a descriptive study, using the Birleson Scale to determine the frequency of depressive symptomatology in children and adolescents with chronic renal insufficiency (CRI) undergoing hemodialysis (HD) and chronic peritoneal dialysis (CPD). There were 67 patients (40 female and 27 male) with a mean age of 14.76 ± 2.71 years, duration of illness ≥3 months, 43 (64.18%) patients with CPD and 24 (35.82%) undergoing HD. The frequency of high occurrence, low occurrence, and absence of depressive symptomatology was 10.45% (n = 7), 43.28% (n = 29), and 46.27% (n = 31), respectively; all of the seven (100%) patients with high occurrence of depressive symptomatology were female (P = 0.04), and none of these (0%) had a friend to confide in (P = 0.03). Depressive symptomatology in patients with CPD was associated with a lower weekly K(t)/V compared to those without depressive symptomatology (2.15 ± 0.68 versus 2.52 ± 0.65; P = 0.01). There was no association with patient age, caregiver, time and dialysis type, anemia, bone disease, nutritional or financial status, origin, schooling, or employment.

Identification, cloning, and sequencing of different cytokine genes in four species of owl monkey.

Non-human primates could prove to be suitable models for the study of infectious diseases such as malaria, tuberculosis, and hepatitis; the molecules of their immune systems are in the process of being fully characterized. Due to the relevance of cytokines in the modulation of the immune response, a molecular analysis of these proteins in non-human primates from the Aotus genus was carried out. Peripheral blood mononuclear cells from four species of Aotusmonkey were obtained and their mRNAs for interleukin-2 (IL-2), IL-4, IL-6, IL-10, interferon-gamma (IFN), and tumor necrosis factor (TNF)-alpha were characterized. This study shows a high degree of conservation between nucleotide and amino acid sequences of cytokines from different Aotus species and those from humans. The TNF-alpha molecules were identical in amino acid sequences for both.

Sexualidad y reproducción: Una encuesta en el nivel de educación media básica / Sexuality and reproduction: A survey at Basic Medium Education

Se aplicó una encuesta de 50 preguntas a 362 alumnos del nivel de educación media básica con la intención de determinar el estado que guarda la educación sexual en ese nivel. Los objetivos fueron: establecer los temas sobre sexualidad y reproducción de mayor interés para los alumnos, definir cual era la participación concreta de la escuela en tal educación, identificar los docentes idóneos y explorar posibles diferencias en conocimientos y actitudes de acuerdo al grado escolar y sexo. Los resultados mostraron diferencias significativas en la edad por grados, pero no por sexo. En 50% se encontró participación directa de los padres en la educación sexual; sus características de escolaridad y ocupación permiten vislumbrar buenas posibilidades para mejorarla mediante el incremento del apoyo escolar y de grupos multidisciplinarios. No se encontraron diferencias significativas de actitudes por grados escolares. El porcentaje de respuestas acerca de conocimientos sobre sexualidad y reproducción que estaban apegadas a la currícula fue bajo y existe gran asbstencionismo; los alumnos del segundo grado mostraron superioridad estadística en algunos aspectos teóricos, mientras los del tercero se inclinaron por otros de tipo más práctico. Las principales fuentes de educación sexual fueron los padres y los maestros; 81% reportó haberla recibido dentro de la escuela, 51% en la materia de ciencias naturales y 12% en la de orientación. Se sugiere como estrategia educativa un esquema de complejidad progresiva por grados escolares con la finalidad de alcanzar no sólo actitudes preventivas sino lograr prácticas afectivas en este sentido.(au)