Bananas para vender e histórias para contar: cultura alimentar local e identidades territoriais a partir de mercados orgânicos e agroecológicos

This article addresses the dispute involving the different meanings of the banana in the city of Rio de Janeiro, especially in the Pedra Branca Massif — an area that in the past was part of the city's Rural Zone. More recently, the banana from this location received the Gastronomic Wonders of Rio de Janeiro Award, however, this same banana is accused by environmentalists of being an exotic plant and its producers accused of invading environmental protection areas. From another perspective, the banana for its producers is a market-oriented culture. However, it is also the market (organic/agroecological) that, by making the local banana tree known, also projects the banana tree, the memory of the place and the local food culture. Based on the analysis of discursive bodies — oral and written — about the banana tree, we try to build a context (set of texts) that reveals the social tensions of this territory.O presente artigo trata da disputa de sentidos a respeito da banana na cidade do Rio de Janeiro — especificamente no Maciço da Pedra Branca — área que no passado fazia parte da Zona Rural da cidade. Recentemente, a banana desta localidade ganhou o prêmio Maravilhas Gastronômicas do Rio de Janeiro. Essa mesma banana, no entanto, é acusada por ambientalistas de ser uma planta exótica e seus produtores acusados de invasores de áreas de proteção ambiental. Sob outra perspectiva, a banana para seus produtores é um cultivo orientado ao mercado. Contudo, é também o mercado (orgânico/agroecológico) que ao conferir crescente notoriedade à banana específica, projeta também o bananeiro, a memória do lugar e a cultura alimentar local. Com base na análise de corpos discursivos — orais e escritos — a respeito da banana, buscamos construir um contexto (conjunto de textos) que revela as tensões sociais deste território

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Comunicação oral em redes sociotécnicas orientadas a plantas medicinais: a relação entre informação científica e conhecimento tradicional

Made available in DSpace on 2015-09-28T12:57:40Z (GMT). No. of bitstreams: 2 silvia_baptista_icict_mest_2014.pdf: 4184780 bytes, checksum: 15f761a1daed7a61ef393fd01c3ad346 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2015-04-14Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Programa de Pós-Graduação em Informação e Comunicação em Saúde. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto de Tecnologia em Fármacos. Rio de Janeiro, RJ, Brasil.Os diferentes usos e apropriações das plantas medicinais mobilizam recursos por todo o mundo. Laboratórios, instituições de pesquisa, indústrias investem bilhões de dólares em busca de novas moléculas tendo como ponto de partida o acesso ao conhecimento tradicional associado à biodiversidade. Os povos e comunidades tradicionais e agricultores familiares tem se utilizado de estratégias, muitas vezes insuficientes, para proteger ou negociar o conhecimento constituído por seus antepassados. Consideramos a exclusão das classes populares aos sistemas de decisão política propondo que o estudo de uma unidade territorial poderia dar conta de relacionar as diferentes fragmentações a que a participação política se reporta. Enquanto objeto de estudo, investigamos o conhecimento sobre plantas medicinais tanto do ponto de vista da Saúde Coletiva como da Agroecologia. Esses campos são também como fronteiras epistemológicas para analisar a relação entre informação científica e o conhecimento tradicional na comunicação informal que vincula os atores em redes sociotécnicas de plantas medicinais As redes são delineadas em sua dimensão local a partir de projetos e práticas orientadas à produção e consumo de plantas medicinais entre a zona oeste do Rio de Janeiro e parte da região metropolitana. Utilizamos como procedimentos metodológicos a pesquisa-ação incluindo uma livre apropriação da sistematização em composição com a análise documental, observação participante, entrevistas e reuniões. Como resultado foi identificado o estado de reciprocidade ao conhecimento tradicional em grupos de pesquisa brasileiros e periódicos de comunicação científica, como uma dimensão global das redes observadas. Registramos o papel das feiras agroecológicas como nós da rede e como mercado simbólico. Concluímos que a predominância do conhecimento tradicional na comunicação informal qualifica a rede sociotécnica identificada. Sendo seu elemento mais relevante a reciprocidade. A partir dos resultados apresentados espera-se que o imperativo ético derivado dessa dimensão da dádiva se estenda aos objetos ou quase objetos como elementos críticos da promoção da saúde e inclusão produtiva dos agricultores familiares, povos e comunidades tradicionais.The different uses and appropriations of medicinal plants mobilize resources worldwide. Laboratories, research institutio ns and industries invest billions of dollars in search of new molecules having as a starting point the access to the tradicional knowledge associated with biodiversity. The tradicional people and the traditional communities and family farmers have been us ing strategies, often insufficient, to protect or negotiate the knowledge constituted by their ancestors. We consider the exclusion of the popular classes to political decision systems proposing that the study of a territorial unit could handle to relate the different fragmentations that political participation reports. As an object of study, we investigated the knowledge of medicinal plants from the point of view of Public Health as of Agroecology. These fields are also as epistemological boundaries to examine the relationship between scientific information and traditional knowledge in informal communication that links the actors in socio-technical networks of medicinal plants. The networks are outlined in your local dimension from projects and practices oriented to the production and consumption of medicinal plants between the west of Rio de Janeiro and part of the metropolitan region. We use as methodological procedures the research-action including a free appropriation of systematization in composition with documentary analysis, participant observation, interviews and meetings. As a result it was identified the reciprocity condition to traditional knowledge in brazilian research groups and scientific journals , as a global dimension of the observed netwo rks. We registered the role of agro-ecological fairs as network nodes and as symbolic market. We conclude that the prevalence of traditional knowledge in informal communication qualifies the identified socio-technical network. Being its most important element the reciprocity. From the results presented it’s expected that the ethical imperative derived from this dimension of the gift extends to objects or almost objects as critical elements of health promotion and productive inclusion of family farmers, peoples and traditional communities

Genetic relatedness among clinical strains of Stenotrophomonas maltophilia in tertiary care hospital settings in São Paulo State, Brazil Relação genética entre isolados clínicos de Stenotrophomonas maltophilia em hospitais terciários do Estado de São Paulo, Brasil

Stenotrophomonas maltophilia is a Gram-negative bacillus, which is becoming widely recognized as an important nosocomial pathogen. The main objective of this study was to evaluate the genetic relatedness, by random amplified polymorphic DNA (RAPD) and pulsed-field gel electrophoresis (PFGE) of 86 clinical isolates of S. maltophilia (colonization 22, infection 64) obtained from 79 hospitalized patients, from different geographic regions of São Paulo State. The genotypic analysis performed by RAPD and PFGE was used in 24 isolates for genetic identity confirmation. The results were congruent between the two methods but it was not possible to link genetic profiles with the studied variables, clinical state and geographic area, probably due to the great variability among the strains. The analyses by PFGE confirmed identity in 5 pairs of microorganisms and RAPD, in this study, showed to be a useful tool for investigation of diversity leading the identification of 85 genetic profiles. The genetic diversity shown may be due to re-infection by different strains or co-infection by multiple strains which suggests multiple entry sources of the bacterium in the hospital setting or of acquisition by patient. In this setting, colonization, infection and re-infection occur with unknown frequency, raising the need for the establishment of specific control measures.<br>Stenotrophomonas maltophilia é um bacilo Gram-negativo, conhecido como importante patógeno nosocomial. O principal objetivo desse estudo foi avaliar a relação genética, através da análise randômica do polimorfismo de DNA (RAPD) e eletroforese em gel de campo pulsado (PFGE), de 86 isolados clínicos de S. maltophilia (22 de colonização, 64 de infecção) obtidos de 79 pacientes hospitalizados em diferentes regiões geográficas do estado de São Paulo. A análise genotípica foi realizada através da técnica RAPD e o PFGE foi usado em 24 isolados para confirmar a identidade genética dos mesmos. Os resultados foram coerentes entre os dois métodos, mas não foi possível correlacionar um perfil genético com as variáveis estudadas, estado clínico e área geográfica, provavelmente pela ampla variabilidade entre as linhagens. A análise por PFGE confirmou a identidade genética em 5 pares de microrganismos e o RAPD, neste estudo, mostrou ser uma ferramenta útil para investigação da diversidade, possibilitando identificar 85 perfis genéticos. A diversidade genética observada através do RAPD pode ser devido à re-infecção por diferentes linhagens ou co-infecção por linhagens distintas, sugerindo múltiplas fontes de entrada da bactéria no hospital ou de aquisição pelo paciente. Nesse ambiente, a colonização, infecção e re-infecção ocorrem com freqüência, o que leva à necessidade do estabelecimento de medidas de controle específicas

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.13Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt