32 research outputs found

    A participação do associado nas associações de solidariedade social

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    Social Economy is currently recognized as a social pillar of modern political states, consisting of a diverse list of legal and juridical persons. In their midst, social solidarity associations, persons with a social and legal status are one of the central figures in the action of this sector. Portuguese legal framework is influenced and conditioned by fundamental rights that integrate it and, in some circumstances, contrast or conflict. Naturally, this is also the case in Social Economy and with its actors as legal persons, particularly with social solidarity associations. These organizations act under a list of guidance principles founded on fundamental principles. Through the analysis of literature, consulting national and international legislation, decisions of Portuguese courts and academic works in areas such as sociological, legal, and doctrinal law, it is intended to analyse and reflect on the rights and freedoms applicable in the establishment of rules for the organization and governance of social solidarity associations. For this purpose, the plan and framework of the Social Economy will be defined, analysing associations in general as collective persons, focusing on the rights that affect them. The principle of freedom of association and statutory autonomy will be confronted with the principle of equality and the right to democratic participation with these organizations.A Economia Social é atualmente reconhecida como um pilar económico, social e político dos modernos Estados Sociais de Direito, constituída por um diverso e heterogéneo rol de entes jurídicos. No seu seio, operam as associações de solidariedade social, pessoas coletivas que gozam do estatuto de Instituições Particulares de Solidariedade Social (IPSS), as quais, em razão dos fins prosseguidos, são uma das figuras centrais da ação deste setor. O ordenamento jurídico português é influenciado e condicionado por direitos fundamentais que, em determinadas situações, contrastam ou conflituam. Naturalmente, tal oposição entre direitos também se verifica na Economia Social, designadamente com os seus agentes principais, particularmente com as associações de solidariedade social, pessoas coletivas de direito privado e de utilidade social. Estas entidades estão, além disso, sujeitas à obediência de uma série de princípios orientadores, alguns deles fundados nos direitos fundamentais. Através da análise de literatura, da consulta de legislação nacional e de legislação de outros ordenamentos jurídicos, das decisões de tribunais portugueses e de obras de carácter sociológico, jurídico e doutrinal pretende-se analisar e refletir sobre quais direitos e liberdades deverão prevalecer no estabelecimento de regras para a organização e governação das associações de solidariedade social. Para esse desiderato, irá proceder-se à definição e enquadramento da Economia Social no plano social, político e jurídico, à análise das associações em geral e dos direitos e deveres que sobre elas impendem. De seguida, irá confrontar-se o princípio de liberdade de associação e a autonomia estatutária com o princípio da igualdade e a salvaguarda do direito de participação democrática do associado nessas organizações

    Diretriz da Sociedade Brasileira de Cardiologia sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas

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    This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.  Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities.   Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.  The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.  The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.     Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou. A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica. Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas. A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica. A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.    Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.&nbsp

    Pervasive gaps in Amazonian ecological research

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    Pervasive gaps in Amazonian ecological research

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    Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

    Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

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    Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

    Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

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    BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

    Pervasive gaps in Amazonian ecological research

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    Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

    Oral health status of institutionalized elderly in Goiânia- GO, Brazil, 2003

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    Submitted by Luciana Ferreira ([email protected]) on 2020-03-23T12:17:05Z No. of bitstreams: 2 Artigo - Sandra Cristina Guimarães Bahia Reis - 2005.pdf: 63607 bytes, checksum: 2a02789ef7e19918c56769952f1f3a1d (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Approved for entry into archive by Luciana Ferreira ([email protected]) on 2020-03-23T15:03:11Z (GMT) No. of bitstreams: 2 Artigo - Sandra Cristina Guimarães Bahia Reis - 2005.pdf: 63607 bytes, checksum: 2a02789ef7e19918c56769952f1f3a1d (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2020-03-23T15:03:11Z (GMT). No. of bitstreams: 2 Artigo - Sandra Cristina Guimarães Bahia Reis - 2005.pdf: 63607 bytes, checksum: 2a02789ef7e19918c56769952f1f3a1d (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2005Objetivo: conhecer a condição de saúde bucal de idosos institucionalizados na cidade de Goiânia-GO. Método: estudo transversal utilizando a metodologia do Projeto SB-2000, Brasil do Ministério da Saúde. A amostra foi constituída de todos os indivíduos com idade igual ou maior que 60 anos (n=289) residentes nas instituições públicas e filantrópicas de longa permanência da cidade de Goiânia-GO (n=10) em 2003. As condições estudadas foram cárie, uso e necessidade de prótese, doença periodontal e alterações de tecido mole. Resultados: A faixa etária variou de 60 a 103 anos. As prevalências de cárie e edentulismo foram 100% e 69,20%, respectivamente. O CPOD médio foi 30,17, havendo predomínio do componente extraído. Quase a metade (49,48%) usava e 80,28% necessitavam de alguma prótese. O tipo de prótese mais comum foi a total: 45,33% dos examinados usavam este tipo de prótese na arcada superior e 24,57% na inferior; enquanto 59,17% e 51,21% necessitavam na arcada superior e inferior, respectivamente. De acordo com o Índice Periodontal Comunitário (CPI), apenas 3 (3,37%) dos idosos apresentaram todos os sextantes sadios. A pior condição mais freqüente foi o cálculo, observado em 55,06% dos indivíduos e 29,02% dos sextantes. Quanto ao Índice de Perda de Inserção Periodontal (PIP), houve predomínio das perdas de 0 a 3mm como pior condição em 37,08% dos indivíduos e 24,04% dos sextantes. Alterações de tecido mole foram encontradas em 13,49% dos indivíduos. Conclusão: A situação de saúde bucal dos idosos institucionalizados em Goiânia é precária, especialmente devido à alta prevalência de cárie e edentulismo.Objective: To assess the oral health status of the institutionalized elderly in the city of Goiânia in the state of Goiás, Brazil. Method: A cross-sectional study was carried out based on the SB-2000 Project undertaken by the Brazilian Ministry of Health. The sample was formed by people aged 60 years and above (n=289), living in Goiânia in public and philanthropic institutions for the elderly during 2003 (n=10). Conditions investigated included dental caries, use of and need for prostheses, periodontal status, and soft tissue lesions. Results: The age of the elderly involved in the study ranged from 60 to 103 years. Prevalence of caries and edentulousness was 100% and 69.20% respectively. The mean DMFT (decayed, missing and filled teeth) totaled 30.17% and, of these, tooth extraction was the main component. Nearly half (49.48%) of the sample was using prostheses and 80.28% were in need of some form of it. The most common type of prosthesis was complete denture: 45.33% of the individuals were using them in the upper and 24.57% in the lower maxilla; whilst 59.17% and 51.21% needed them in the upper and lower maxilla respectively. According to the Community Periodontal Index (CPI), only 3 of the elderly (3.37%) had all sextants sound. The most serious condition was calculus, found in 55.06% of individuals and in 29.02% of the sextants. Regarding the Attachment Loss Index (ALI), the most common condition was loss from 0 to 3mm in 37.08% of the individuals and in 24.04% of the sextants. Soft tissue lesions were found in 13.49% of the elderly. Conclusion: The oral health status of institutionalized elderly in Goiânia is poor, mainly due to the high prevalence of caries and edentulism

    ARTIGO: POTENCIAL PRODUTIVO DE CULTIVARES FRANCESAS DE BATATA PARA O ESTADO DE MINAS GERAIS

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    Considerando a grande importância sócio-econômica da cultura da batata para o Estado de Minas Gerais e a necessidade de desenvolver material genético com maior potencial produtivo, que atendam aos interesses dos produtores e consumidores, conduziram-se ensaios na região Sul de Minas e Campos das Vertentes, durante as safras de outono e inverno, avaliando 12 cultivares introduzidas da França, com os objetivos de selecionar aquelas com melhor desempenho agronômico. Utilizaram-se Ágata e Monalisa como padrão para o mercado de tubérculos in natura e Atlantic e Lady Roseta como padrão para o processamento industrial na forma de frituras. As cultivares Oceania, Colorado, Soléia, Selecta Opaline, Floriane e Emeraude destacaram como genótipos produtivos e adaptados às diferentes condições ambientais de ultivo. Emeraude, Floriane e Opaline apresentaram tubérculos com formato alongado e boa aparência, características importantes no mercado de batata in natura. As cultivares Colorado com tubérculos alongados e Oceania, com tubérculos ovalados, apresentaram bom conteúdo de matéria seca e são recomendadas para o processamento industrial na forma de palitos e batata palha, respectivamente.Palavras-chave: Solanum tuberosum; Produção; Qualidade; Utilização

    Diretriz da SBC sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas – 2023

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    Note: These guidelines are for information purposes and should not replace the clinical judgment of a physician, who must ultimately determine the appropriate treatment for each patient
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