Direito à educação da pessoa com transtorno do espectro autista: obstáculos à sua efetivação

The research aims to analyze the right of education of the subject with autism spectrum disorder, the obstacles regarding its implementation and the effects found in the autistic development and social inclusion. The right to education of the person with autism, although guaranteed by the Federal Constitution, encounters several obstacles, especially pedagogical and conceptual, and an expressive resistance from the public and private spheres to enable the educational formation of these people in educational institutions. The method used is the hypothetical-deductive based on documental, doctrine, legislation and jurisprudential research. It is concluded that the realization of the right to education of the person with autism spectrum disorder, although guaranteed by the Federal Constitution of 1988 and by ordinary legislation, encounters innumerable obstacles, both in the public and private spheres, which hinders and prevent the development and social inclusion of people with autism.A pesquisa objetiva analisar o direito à educação da pessoa com transtorno do espectro autista, os obstáculos existentes à sua implementação e os efeitos verificados no desenvolvimento e inclusão social do autista. A efetivação do direito à educação da pessoa com autismo, apesar de garantida constitucionalmente, encontra diversos obstáculos, em especial de ordem pedagógica e conceitual, bem como expressiva resistência das esferas pública e privada em possibilitarem a formação educacional dessas pessoas nas instituições de ensino. O método utilizado é o hipotético-dedutivo, apoiado em pesquisa documental, com base na doutrina, legislação e jurisprudência. Conclui que a efetivação do direito à educação da pessoa com transtorno do espectro autista, embora garantida pela Constituição Federal de 1988 e pela legislação ordinária, encontra inúmeros obstáculos, tanto de ordem pública como privada, o que dificulta e às vezes até mesmo inviabiliza o desenvolvimento e a inclusão social das pessoas com autismo

Transformações na estrutura produtiva da economia paranaense nos anos 80 e 90

This article presents the evolution of the productive structure of the economy of the State of Paraná in the 1980's and 1990's. A set of 5 regional input-output matrices, divided in 32 sectors, was estimated for the years of 1980, 1985, 1990, 1995 and 1999, in order to calculate the field of influence, the Hirschman-Rasmussen and pure linkages and the sectors multipliers. These indicators allowed to identify, besides the key sectors, the evolution of economic and inter-industrial relationships in the period. The results showed trends of diversification in the productive structure of State and of greater commercial opening, both reflected in fewer internal linkages and in production multipliers.Este artigo apresenta a evolução da estrutura produtiva da economia paranaense nas décadas de 1980 e 1990. Para tanto, estimou-se uma série de 5 matrizes de insumo-produto para os anos de 1980, 1985, 1990, 1995 e 1999, divididas em 32 setores, a partir das quais foram calculados o campo de influência, os índices de ligação de Hirschman-Rasmussen e puros e os multiplicadores setoriais. Esses indicadores permitiram identificar, além dos setores-chave, a evolução das relações econômicas e interindustriais no período. Os resultados mostraram tendência de diversificação da estrutura produtiva estadual e de maior abertura comercial, refletida nos menores índices de ligações internas e nos multiplicadores de produção

A não efetividade do hedge para o boi gordo

O objetivo desse artigo é estimar a efetividade e razão ótima do hedge do boi gordo brasileiro, nas praças de Araçatuba, Campo Grande, Três Lagoas, Cuiabá, Goiânia e Noroeste do Paraná, no período de 2002 a 2008. O procedimento metodológico considera as relações de cointegração entre os mercados à vista e futuro, com abordagens dinâmicas para as variâncias e covariâncias. Os resultados não apresentam condições para um hedge efetivo, ao considerar os retornos das séries em logaritmo e não os preços em nível, uma vez que a estacionariedade é atingida na primeira diferença; a adição de um termo de correção de erro, para garantir a relação de longo prazo; assim como correlações e variâncias variantes no tempo. Portanto, o contrato futuro de boi gordo não cumpre seu propósito de diminuição de risco aos hedgers

Coronary artery disease in asymptomatic type-2 diabetic women: a comparative study between exercise test, cardiopulmonary exercise test, and dipyridamole myocardial perfusion scintigraphy in the identification of ischemia

BACKGROUND: Cardiovascular disease is the leading cause of morbidity and mortality among diabetic individuals. Myocardial ischemia is frequently asymptomatic, thus leading to a late diagnosis and worse prognosis. Diabetic women are known to have a cardiovascular death risk higher than that in men. OBJECTIVE: To assess the prevalence of coronary artery disease (CAD) in asymptomatic diabetic women. To compare the results of exercise test (ET), cardiopulmonary exercise test (CPET), and dipyridamole myocardial perfusion scintigraphy (MPS) with the findings of coronary angiography, (ANGI) in order of identify the most accurate method in the detection of significant CAD. METHODS: A total of 104 diabetic women were assessed with ET, CPET and MPS in the period within two months from the ANGI. MIBI-99mTc scintigraphy was performed using the gated-SPECT technique. Pearson's chi-square, Student's t tests were used for the statistical analysis and also the logistic regression analysis. RESULTS: The prevalence of CAD in the group studied was 32.7%. For the ET, an effective test (p=0.045), the chronotropic incompetence (p=0.031), and the exercise time performed (p=0.022) showed a significant association with DAC. For CPET, peak VO2 and HR achieved were associated with CAD (p=0.004 and p=0.025, respectively). Most of the MPS variables showed a significant association with CAD (p=0.001, for all). CONCLUSION: The results obtained may suggest a high prevalence of CAD in diabetic women. Thus, this population should be investigated from the cardiovascular point of view even without cardiac symptom. Of the noninvasive diagnostic methods used, dipyridamole MPS was the one that showed the highest discrimination power in relation to diabetic women with CAD.FUNDAMENTO: A doença cardiovascular é a principal causa de morbi-mortalidade nos diabéticos. A isquemia do miocárdio é freqüentemente assintomática levando ao diagnóstico tardio e pior prognóstico. Sabe-se que a mulher diabética tem risco de morte cardiovascular maior em relação ao sexo masculino. OBJETIVO: Avaliar a prevalência de doença arterial coronariana (DAC) em diabéticas assintomáticas. Comparar os resultados do teste ergométrico (TE), do teste cardiopulmonar (TCP) e da cintilografia do miocárdio sob estímulo farmacológico com dipiridamol (CM) com os achados da cinecoronariografia (CINE) verificando o método de maior acurácia na identificação de DAC significativa. MÉTODOS: Foram avaliadas 104 diabéticas que realizaram TE, TCP e CM no período de dois meses da CINE. As cintilografias com MIBI-99mTc foram realizadas pela técnica de gated-SPECT. A análise estatística foi realizada pelos testes x² de Pearson e t de Student, sendo realizada, ainda, análise de regressão logística. RESULTADOS: A prevalência de DAC no grupo estudado foi de 32,7%. No TE, o teste eficaz (p=0,045), a incompetência cronotrópica (p=0,031) e o tempo de esforço realizado (p=0,022) apresentaram associação significativa com DAC. No TCP, o VO2pico e a FC atingida apresentaram associação com DAC (p=0,004 e p=0,025). A maioria das variáveis da CM mostrou importante associação com DAC (todas com p=0,001). CONCLUSÃO: Os resultados obtidos sugerem elevada prevalência de DAC em pacientes diabéticas assintomáticas, devendo ser essa uma população investigada do ponto de vista cardiovascular. Dos métodos diagnósticos não-invasivos que foram empregados, o que mostrou ter maior poder de discriminação em relação às portadoras de DAC foi a CM com dipiridamol.Universidade Federal de São Paulo (UNIFESP) Instituto Dante Pazzanese de CardiologiaUNIFESP, Instituto Dante Pazzanese de CardiologiaSciEL

Hemoglobin Uptake by Paracoccidioides spp. Is Receptor-Mediated

Iron is essential for the proliferation of fungal pathogens during infection. The availability of iron is limited due to its association with host proteins. Fungal pathogens have evolved different mechanisms to acquire iron from host; however, little is known regarding how Paracoccidioides species incorporate and metabolize this ion. In this work, host iron sources that are used by Paracoccidioides spp. were investigated. Robust fungal growth in the presence of the iron-containing molecules hemin and hemoglobin was observed. Paracoccidioides spp. present hemolytic activity and have the ability to internalize a protoporphyrin ring. Using real-time PCR and nanoUPLC-MSE proteomic approaches, fungal growth in the presence of hemoglobin was shown to result in the positive regulation of transcripts that encode putative hemoglobin receptors, in addition to the induction of proteins that are required for amino acid metabolism and vacuolar protein degradation. In fact, one hemoglobin receptor ortholog, Rbt5, was identified as a surface GPI-anchored protein that recognized hemin, protoporphyrin and hemoglobin in vitro. Antisense RNA technology and Agrobacterium tumefaciensmediated transformation were used to generate mitotically stable Pbrbt5 mutants. The knockdown strain had a lower survival inside macrophages and in mouse spleen when compared with the parental strain, which suggested that Rbt5 could act as a virulence factor. In summary, our data indicate that Paracoccidioides spp. can use hemoglobin as an iron source most likely through receptor-mediated pathways that might be relevant for pathogenic mechanisms

Effects of blood flow restriction therapy in patients with knee osteoarthritis: protocol for an overview of systematic reviews

BackgroundOsteoarthritis (OA) is the most common and prevalent musculoskeletal disease associated with population aging, negatively impacting function and quality of life. A consequence of knee OA is quadriceps muscle weakness. Musculoskeletal rehabilitation using low load exercises, associated with Blood Flow Restriction (BFR) may be a useful alternative to high load exercises when those cannot be tolerated. Several systematic reviews have reported inconclusive results due to discrepancies in study findings, heterogeneity of results, evaluated time points, and research questions explored.ObjectiveTo perform an overview of systematic reviews with meta-analyses, synthesizing the most recent evidence on the effects of muscle strength training with BFR for knee OA.MethodologySystematic reviews that include primary controlled and randomized clinical trials will be considered for inclusion. Articles will be considered only if they present a clear and reproducible methodological structure, and when they clearly demonstrate that a critical analysis of the evidence was carried out using instrumented analysis. Narrative reviews, other types of review, overviews of systematic reviews, and diagnostic, prognostic and economic evaluation studies will be excluded. Studies must include adults aged 40 years and older with a diagnosis of knee OA. Two authors will perform an electronic search with guidance from an experienced librarian. The following databases will be searched: PubMed via MEDLINE, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), PEDro, Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCO host, Web of Science, and the gray literature. The search strategy used in the databases will follow the acronym PICOS (population, intervention, comparison, outcome, and study design). Screening (i.e., titles and abstracts) of studies identified by the search strategy will be selected using Rayyan (http://rayyan.qcri.org). The quality assessment will be performed using the “Assessment of Multiple Systematic Reviews” (AMSTAR-2) tool.Systematic Review RegistrationPROSPERO, CRD42022367209

Mortalidade neonatal em Luanda, Angola: o que pode ser feito para sua redução?

Introduction: One of the main health indicators is infant mortality rate, which is a metric of living conditions and population development. The goal of reducing neonatal mortality requires an adequate knowledge of the real factors at each level of health care so that maternal and human resources are efficiently channeled to the constraint. Countries that have paid special attention to improving health services for the entire pregnancy-puerperal cycle have attained the reduction of infant mortality, especially early neonatal mortality. Objective: The present study aims to describe the profile and analyze the risk factors associated with neonatal mortality in the Angolan context at a tertiary level public maternity hospital, located in Luanda. Methods: This is a retrospective cross-sectional study with a quantitative approach, using secondary data, of provincial base in hospital and ministerial registry instruments from January to December 2012. Results: The results show that the neonatal deaths are not mere occurrences, since they indicate failures of the political powers, professionals of the health system and of the families. Conclusions: This study suggests that the major risk factor for birth mortality in Luanda is the type of delivery (c-section) and that this data is not related to the age of the mother or to premature birth. We also found that there was higher mortality between May and July, during the period of lower rainfall index in the region. However, further studies are needed that may provide a logical framework and arguments for realistic policies to mitigate neonatal mortality.Introdução: Um dos principais indicadores de saúde é a taxa de mortalidade infantil, que é uma métrica de condições de vida e desenvolvimento populacional. A redução da mortalidade neonatal requer um conhecimento adequado dos fatores reais em cada nível de atenção à saúde, de modo que os recursos maternos e humanos sejam eficientemente avaliados. Os países que deram atenção especial à melhoria dos serviços de saúde para todo o ciclo gravídico-puerperal atingiram a redução da mortalidade infantil, especialmente a mortalidade neonatal precoce. Objetivo: O presente estudo tem como objetivo descrever o perfil e analisar os fatores de risco associados à mortalidade neonatal em uma maternidade pública de nível terciário localizada em Luanda, Angola. Método: Trata-se de um estudo retrospectivo de corte transversal com abordagem quantitativa, utilizando dados secundários de base provincial em instrumentos de registro hospitalar e ministerial de janeiro a dezembro de 2012. Resultados: Os resultados mostram que os óbitos neonatais não são meras ocorrências, pois indicam falhas dos poderes políticos, de profissionais do sistema de saúde e das famílias. Conslusão: Este estudo sugere que o maior fator de risco para mortalidade ao nascimento em Luanda é o tipo de parto (c-section) e que este dado não está relacionado com a idade da mãe ou com o nascimento prematuro. Identificamos também que houve maior mortalidade entre os meses de maio a julho, durante o período de menor índice de chuvas na região. No entanto, são necessários mais estudos que possam fornecer um quadro lógico e argumentos para políticas realistas para mitigar a mortalidade neonatal

Investigating academic performance and perceptions of human physiology and exercise physiology courses among undergraduate students of physical education at a Brazilian public university

Purpose To compare the academic performance of undergraduate students in physical education who studied exercise physiology before and after studying human physiology and investigate students’ perceptions of human physiology and exercise physiology courses. Methods This study included 311 undergraduate students pursuing a bachelor’s degree in physical education. Participants were divided into two groups: those who had previously attended and completed the human physiology course (group 1, n = 212, 68.2%) and those who had not previously attended or had attended but failed the human physiology course (group 2, n = 99, 31.8%). The prevalence ratio (PR) and 95% confidence interval (95% CI) were calculated using a Poisson regression model with a robust variance estimator. The second aim comprised 67 students with bachelor’s degrees in physical education who completed an electronic questionnaire about their perceptions of human physiology and exercise physiology curriculum. Results Compared with those who attended human physiology and passed, those who had not previously attended or had attended but failed the human physiology course have a higher PR of 2.37 (95% CI, 1.68–3.34) for failing exercise physiology. Regarding the students’ perceptions of human physiology and exercise physiology courses, most students reported that they were challenging (58.2% and 64.2%, respectively), but they also recognized the importance of these courses for professional practice (59.7% and 85.1%, respectively). Conclusion Human physiology should be considered a prerequisite for an undergraduate course leading to a bachelor’s degree in physical education. Furthermore, students considered human physiology and exercise physiology courses important yet challenging. Therefore, continuous student assessment is vital for improving the teaching–learning process