International consensus on standard outcome measures for neurodevelopmental disorders: A consensus statement

Importance: The use of evidence-based standardized outcome measures is increasingly recognized as key to guiding clinical decision-making in mental health. Implementation of these measures into clinical practice has been hampered by lack of clarity on what to measure and how to do this in a reliable and standardized way. Objective: To develop a core set of outcome measures for specific neurodevelopmental disorders (NDDs), such as attention-deficit/hyperactivity disorder (ADHD), communication disorders, specific learning disorders, and motor disorders, that may be used across a range of geographic and cultural settings. Evidence Review: An international working group composed of clinical and research experts and service users (n = 27) was convened to develop a standard core set of accessible, valid, and reliable outcome measures for children and adolescents with NDDs. The working group participated in 9 video conference calls and 8 surveys between March 1, 2021, and June 30, 2022. A modified Delphi approach defined the scope, outcomes, included measures, case-mix variables, and measurement time points. After development, the NDD set was distributed to professionals and service users for open review, feedback, and external validation. Findings: The final set recommends measuring 12 outcomes across 3 key domains: (1) core symptoms related to the diagnosis; (2) impact, functioning, and quality of life; and (3) common coexisting problems. The following 14 measures should be administered at least every 6 months to monitor these outcomes: ADHD Rating Scale 5, Vanderbilt ADHD Diagnostic Rating Scale, or Swanson, Nolan, and Pelham Rating Scale IV; Affective Reactivity Index; Children’s Communication Checklist 2; Colorado Learning Disabilities Questionnaire; Children’s Sleep Habits Questionnaire; Developmental-Disability Children’s Global Assessment Scale; Developmental Coordination Disorder Questionnaire; Family Strain Index; Intelligibility in Context Scale; Vineland Adaptive Behavior Scale or Repetitive Behavior Scale–Revised and Social Responsiveness Scale; Revised Child Anxiety and Depression Scales; and Yale Global Tic Severity Scale. The external review survey was completed by 32 professionals and 40 service users. The NDD set items were endorsed by more than 70% of professionals and service users in the open review survey. Conclusions and Relevance: The NDD set covers outcomes of most concern to patients and caregivers. Use of the NDD set has the potential to improve clinical practice and research

CONTEXTO DA GESTANTE EM SITUAÇÃO DE RUA: A REALIDADE NO MUNICÍPIO DE RIO BRANCO – ACRE

This study aimed to demonstrate the context of homeless pregnant women living in the municipality of Rio Branco – Acre. This is an exploratory study with a qualitative approach conducted with nine women who had children on the streets. Data were collected through semi-structured interviews and analyzed through Bardin's content analysis. Most of the participants were aged 25 to 29 years, with low schooling, single, of brown race/skin color, had lived on the streets for more than ten years and had had an average of one homeless child. The motivation for choosing the streets was the fact that they sought to have more freedom, in addition to the use of drugs and scarce economic conditions. None had undergone prenatal care because they felt ashamed of their condition and feared that they would not be attended. Most of the babies were born in a hospital setting and all were given up for adoption. For them, homeless pregnancy was very difficult, as they faced many difficulties such as lack of food, adequate clothing and a comfortable place to rest. The results point to the need to establish more consistent public policies in order to meet the needs of pregnant women living on the streets in the region.Este estudio tuvo como objetivo demostrar el contexto de las mujeres embarazadas sin hogar que viven en el municipio de Rio Branco – Acre. Se trata de un estudio exploratorio con abordaje cualitativo realizado con nueve mujeres que tenían hijos en la calle. Los datos fueron recolectados a través de entrevistas semiestructuradas y analizados a través del análisis de contenido de Bardin. La mayoría de los participantes tenían entre 25 y 29 años, con baja escolaridad, solteros, de raza marrón / color de piel, habían vivido en las calles durante más de diez años y habían tenido un promedio de un niño sin hogar. La motivación para elegir las calles fue el hecho de que buscaban tener más libertad, además del uso de drogas y las escasas condiciones económicas. Ninguna había recibido atención prenatal porque se sentían avergonzadas de su condición y temían que no fueran atendidas. La mayoría de los bebés nacieron en un entorno hospitalario y todos fueron dados en adopción. Para ellas, el embarazo sin hogar fue muy difícil, ya que enfrentaron muchas dificultades, como la falta de alimentos, ropa adecuada y un lugar cómodo para descansar. Los resultados apuntan a la necesidad de establecer políticas públicas más consistentes para satisfacer las necesidades de las mujeres embarazadas que viven en las calles de la región.Objetivou-se demostrar o contexto das gestantes em situação de rua residentes no municipio de  Rio Branco – Acre. Trata-se de um eestudo exploratório, de abordagem qualitativa realizado junto a nove mulheres que tiveram filhos em situação de rua. A coleta de dados se deu por meio de entrevista semiestruturada e analisados através da análise do conteúdo de Bardin. A maioria das participantes encontrava-se na faixa etária de 25 a 29 anos, com baixa escolaridade, solteiras, da raça/cor da pele parda, moravam nas ruas há mais de dez anos e haviam tido em média um filho em situação de rua. A motivação para a escolha das ruas  foi o fato de buscarem ter mais liberdade, além do uso de drogas e as condições econômicas escassas. Nenhuma  havia realizado o pré-natal por sentirem vergonha  de sua condição e receio que não fossem atendidas. A maioria dos bebês nasceu em ambiente hospitalar e todos foram entregues para adoção. Para elas a gravidez em situação de rua foi muito difícil, pois enfrentaram muitas dificuldades como a falta de alimentos, roupas adequadas e local confortável para descansar. Os resultados apontam para a necessidade da constituição de políticas públicas mais consistentes afim de atender as necessidades das gestantes em situação de rua na região.Objetivou-se demostrar o contexto das gestantes em situação de rua residentes no municipio de  Rio Branco – Acre. Trata-se de um eestudo exploratório, de abordagem qualitativa realizado junto a nove mulheres que tiveram filhos em situação de rua. A coleta de dados se deu por meio de entrevista semiestruturada e analisados através da análise do conteúdo de Bardin. A maioria das participantes encontrava-se na faixa etária de 25 a 29 anos, com baixa escolaridade, solteiras, da raça/cor da pele parda, moravam nas ruas há mais de dez anos e haviam tido em média um filho em situação de rua. A motivação para a escolha das ruas  foi o fato de buscarem ter mais liberdade, além do uso de drogas e as condições econômicas escassas. Nenhuma  havia realizado o pré-natal por sentirem vergonha  de sua condição e receio que não fossem atendidas. A maioria dos bebês nasceu em ambiente hospitalar e todos foram entregues para adoção. Para elas a gravidez em situação de rua foi muito difícil, pois enfrentaram muitas dificuldades como a falta de alimentos, roupas adequadas e local confortável para descansar. Os resultados apontam para a necessidade da constituição de políticas públicas mais consistentes afim de atender as necessidades das gestantes em situação de rua na região

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.

BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Background A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. Methods This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. Findings Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials

MOTILIDADE, VIGOR E QUALIDADE ACROSSOMAL DO SÊMEN DESCONGELADO DE VARRÃO EM DIFERENTES DILUENTES

ABSTRACT The objective of this study was to determine a diluent that would provide good maintenance of the boar's semen viability after thawing. The following diluents were used: Beltsville Thawing Solution (BTS), BTS + 3-indole acetic acid (IAA) and Androhep (ADHP). The 24 ejaculates were analyzed in natura and after dilution, regarding sperm vigor and motility and acrosome integrity. Then, a total of 10,2 x109 spermatozoa were removed from each ejaculate, which were equally distributed among the different experimental treatments. The ejaculates were diluted in equal parts (1:1) at 30 oC and incubated for 2 hours before starting the freezing curve. Subsequently the semen was packed in 0,5 mL vats, at a concentration of 112 x106 spermatozoa/mL, submitted to nitrogen vapor for 4 minutes and then immersed in liquid nitrogen (-196 oC). Samples were thawed in a water bath at (37 °C/30s), then the contents were resuspended in the different diluents (1:5). The samples were evaluated as many as the same characteristics of semen in natura. In the statistical analysis, the Mann-Whitney tests were used, with a confidence interval of 5%. The BTS diluent had better sperm motility and vigor compared to ADPH in 5 minutes of incubation, but there were no significant differences on the same evaluations when the treatments were incubated for 1 hour. The acrosomal integrity of the ADPH diluent provided a higher number of intact spermatozoa (p<0.05) in relation to the other treatments. A extender that favors the conservation of a better sperm quality after thawing, still needs to be developed.Objetivou-se determinar um diluente que proporcionasse uma boa manutenção da viabilidade do sêmen do varrão, após descongelação. Foram utilizados os seguintes diluentes: Beltsville Thawing Solution (BTS), BTS + ácido 3-indol acético (IAA) e Androhep (ADHP). Os 24 ejaculados foram analisados in natura e após diluição, quanto ao vigor, motilidade espermática e integridade do acrossoma. Em seguida, foi retirado de cada ejaculado um total de 10,2 x109 espermatozoides, que foram repartidos igualmente entre os diferentes tratamentos experimentais. Os ejaculados foram diluídos em partes iguais (1:1) a 30 oC, permanecendo incubados por 2 horas, antes de iniciar a curva de congelação. Posteriormente, o sêmen foi envazado em palhetas de 0,5 mL, em uma concentração de 112 x106 sptz/mL, submetidos a vapor de nitrogênio por quatro minutos, em seguida, mergulhado no nitrogênio líquido (-196 oC). As amostras foram descongeladas em banho-maria à temperatura de (37 ºC/30s), em seguida, o conteúdo foi ressuspenso nos diferentes diluentes (1:5). As amostras foram avaliadas quantos às mesmas características do sêmen in natura. Na análise estatística, foram utilizados os testes de Mann-Whitney, com intervalo de confiança de 5%. O diluente BTS apresentou motilidade e vigor espermático melhores, em relação aquele contendo ADPH, em 5 minutos de incubação; porém, não houve diferenças significativas sobre as mesmas avaliações, quando os tratamentos foram incubados por 1 hora. A integridade acrossomal do diluente ADPH proporcionou maior número de espermatozoides íntegros (p<0,05), em relação aos demais tratamentos. Um diluente que favoreça a conservação de uma melhor qualidade espermática após descongelação ainda precisa ser desenvolvido

Um modelo de inferência para a classificação de resultados processuais da Justiça Estadual

Este artigo tem como objetivo apresentar um modelo de inferência para classificar processos jurídicos relacionados à Justiça Estadual utilizando dados documentados de jurisprudência, tais como: comentários dos juízes realizados durante os veredictos, classes jurídicas do processo e UF. Os dados foram extraídos de websites de cortes judiciais, como o Portal do Tribunal de Justiça do Estado de Minas Gerais e o Poder Judiciário do Estado de Alagoas. Em toda a base de dados, foi realizada uma seleção no campo textual da descrição da sentença para extrair as leis que foram consideradas nos veredictos. Para tal seleção, o atributo de publicação e a quantidade de ocorrências da lei na base de dados foram considerados. As técnicas utilizadas para realizar a mineração de dados e classificar os processos como procedentes ou improcedentes foram a árvore de decisão e as redes neurais artificiais. Os testes realizados mostraram resultados satisfatórios e superiores ao valor comum para classificação de dados de jurisprudência, de normalmente 60%

"Receber não é compor": música e emoção na religião do Santo Daime

O objetivo do presente artigo é investigar a música na religião do Santo Daime em especial entre adeptos e líderes de duas igrejas ligadas à "linha do Padrinho Sebastião Mota de Melo" na cidade do Rio de Janeiro. Mais especificamente, analiso a interpretação nativa sobre a gênese dos hinos religiosos em sua relação com os pensamentos, sentimentos e subjetividade, refletida nas noções de sagrado e nas diferenciações hierárquicas dentro do grupo. O suporte teórico está ancorado nos campos da etnomusicologia e da antropologia das emoções.<br>The aim of the present article is to investigate the music from Santo Daime- religion especially among members and leaders from both churches that belong to "Padrinho Sebastião Mota de Melo's spiritual line" in the city of Rio de Janeiro. More specifically, I analyze the native interpretation on genesis of the religious hymns in its relation with the thoughts, feelings and subjectivity, reflected in the notion of sacred and the hierarchic differentiations of the group. The theoretical support for the analysis is anchored in the fields of ethnomusicology and anthropology of emotions

International Consensus on Standard Outcome Measures for Neurodevelopmental Disorders: A Consensus Statement.

ImportanceThe use of evidence-based standardized outcome measures is increasingly recognized as key to guiding clinical decision-making in mental health. Implementation of these measures into clinical practice has been hampered by lack of clarity on what to measure and how to do this in a reliable and standardized way.ObjectiveTo develop a core set of outcome measures for specific neurodevelopmental disorders (NDDs), such as attention-deficit/hyperactivity disorder (ADHD), communication disorders, specific learning disorders, and motor disorders, that may be used across a range of geographic and cultural settings.Evidence reviewAn international working group composed of clinical and research experts and service users (n = 27) was convened to develop a standard core set of accessible, valid, and reliable outcome measures for children and adolescents with NDDs. The working group participated in 9 video conference calls and 8 surveys between March 1, 2021, and June 30, 2022. A modified Delphi approach defined the scope, outcomes, included measures, case-mix variables, and measurement time points. After development, the NDD set was distributed to professionals and service users for open review, feedback, and external validation.FindingsThe final set recommends measuring 12 outcomes across 3 key domains: (1) core symptoms related to the diagnosis; (2) impact, functioning, and quality of life; and (3) common coexisting problems. The following 14 measures should be administered at least every 6 months to monitor these outcomes: ADHD Rating Scale 5, Vanderbilt ADHD Diagnostic Rating Scale, or Swanson, Nolan, and Pelham Rating Scale IV; Affective Reactivity Index; Children's Communication Checklist 2; Colorado Learning Disabilities Questionnaire; Children's Sleep Habits Questionnaire; Developmental-Disability Children's Global Assessment Scale; Developmental Coordination Disorder Questionnaire; Family Strain Index; Intelligibility in Context Scale; Vineland Adaptive Behavior Scale or Repetitive Behavior Scale-Revised and Social Responsiveness Scale; Revised Child Anxiety and Depression Scales; and Yale Global Tic Severity Scale. The external review survey was completed by 32 professionals and 40 service users. The NDD set items were endorsed by more than 70% of professionals and service users in the open review survey.Conclusions and relevanceThe NDD set covers outcomes of most concern to patients and caregivers. Use of the NDD set has the potential to improve clinical practice and research