Dançar com a criança: um olhar para a composição e criação em dança com a pequena infância

O presente texto busca destacar alguns fundamentos da dança com educação infantil e despertar um olhar para os processos de criação nesta linguagem artí­stica com a criança pequena, relevando situações da prática in loco. Pretende-se com isso, contribuir com a construção de uma dança alinhada a infância no âmbito das intervenções educativas, a partir do cruzamento interdisciplinar entre dança, educação e infância. Além disso, apresentar uma socialização de experiências em contexto, para fomentar a formação de professores por meio do debate e da sistematização de proposições sensí­veis e criativas. Desta forma, em um diálogo entre as pesquisas de doutoramento (AUTORA 1, 2016) e de mestrado (AUTORA 2, 2013) das autoras, destacou-se a necessidade dos processos de criação em dança com a educação infantil colocarem os pequenos como protagonistas do processo, participando ativamente das decisões, em diálogo com o professor/mediador. Este profissional pode se inspirar nos conhecimentos anteriores advindos das vivências das crianças e contribuir com ideias e sugestões.Ademais, ressalta-se o papel do lúdico como fio condutor das especificidades dessa etapa da vida, uma estratégia interessante de permear as composições em dança. Nesse sentido, é importante que o professor embrenhe-se no universo infantil para oferecer pistas para auxiliar as crianças a estabelecer relações de experiência com o mundo (AUTORA 1, 2016); descobrindo e compondo sua própria dança, por meio da ludicidade

DANÇAS DE UM TEMPO: PEDAGOGIAS DA AUSÊNCIA EM MEIO À PANDEMIA

This paper proposes to reflect about dance, in its educational context, from the situation caused by the Covid-19 pandemic. The question that guides the text comes from the problem of teaching an art of the presence in a remote way: what was it possible to gather from this experience in order to project changes in dance teaching? Thus, the introduction presents the context of remote emergency teaching with reference to dance practice. Following this, three aspects related to dance learning are described: a time for listening, a poetics of distance and a state of being in the present. In the last part, the article draws conclusions on dance and its contributions to this process of artistic pedagogical reformulation, which demanded reinvention from all involved: children, educators and families. KeywordsDance. Art. Education. Pandemic. Distance.Este artigo apresenta um caminho de organização de processos artístico-pedagógicos em dança realizados durante a pandemia de Covid-19. Essa proposição surge a partir das trocas estabelecidas entre cinco artistas/educadoras da dança. A dança, em viés educacional, é uma área do conhecimento que se relaciona com as experiências corporais, artísticas e estéticas que, até a pandemia, eram realizadas prioritariamente de maneira presencial. Com o agravamento da situação sanitária, as práticas artístico-pedagógicas precisaram com emergência ser adaptadas ao ensino remoto. A partir desse cenário, este artigo se propõe a oferecer possibilidades de aprendizagem da dança em caráter remoto e apontar pistas sobre o retorno presencial. Na introdução apresentamos o contexto do ensino remoto emergencial em relação às práticas de dança. Em seguida apresentamos três aspectos relacionados a uma aprendizagem em dança: um tempo da escuta, uma poética da distância e uma permanência no presente. Na última parte tecemos sentidos sobre a presença da dança e suas contribuições neste processo de reformulação artístico-pedagógica que exigiu reinvenções de todas as partes envolvidas: crianças, educadores e famílias. Palavras-chaveDança. Arte. Educação. Pandemia. Distância

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study

Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation