A atuação do sistema de garantia dos direitos da criança e do adolescente no enfrentamento ao abuso sexual infanto-juvenil em Miracema do Tocantins

This monographic work deals with the performance of the Child and Adolescent Rights Guarantee System in the face of child and juvenile sexual abuse in Miracema do Tocantins in the year 2018. In this sense, the objective is to analyze how and what has been the performance of the System of Guarantee of the Rights of Children and Adolescents in coping with sexual abuse in the municipality. Specifically, it is proposed to: map the System for Guaranteeing the Rights of Children and Adolescents in the municipality; identify the social actors and their competencies within the strategic axes; to discuss the actions of the social actors of the System of Guarantee of Rights in facing the sexual abuse of children and adolescents. The research proposal was based on the conception that the articulated and integrated performance of the SGDCA is fundamental to guarantee the protection of the rights of children and adolescents, through care, defense and accountability. Thus, the methodological procedures used were: data collection through semi-structured interviews, carried out with the professionals of the bodies that make up the strategic axes of the SGDCA, within the scope of qualitative research, based on the categories of the dialectical-critical method. Therefore, 5 professionals were interviewed, from the following bodies: CREAS, Guardianship Council, Public Prosecutor's Office, Precinct and Municipal Council for the Rights of Children and Adolescents. However, from the empirical research, it was found that the SGDCA is disjointed, fragmented, making it difficult to protect the rights of the child and the adolescent, regarding the breaking of the violent cycle, accountability of the aggressor and resolving cases, which perpetuation of situations of violence.O presente trabalho monográfico versa sobre a atuação do Sistema de Garantia dos Direitos da Criança e do adolescente no enfrentamento ao abuso sexual infanto-juvenil em Miracema do Tocantins no ano de 2018. Nesse sentido, objetivou-se analisar qual e como tem sido a atuação do Sistema de Garantia dos Direitos da Criança e do Adolescente no enfrentamento ao abuso sexual no município. Especificamente, propõe-se em: mapear o Sistema de Garantia dos Direitos da Criança e do Adolescente no município; identificar os atores sociais e suas competências dentro dos eixos estratégicos; discutir as ações dos atores sociais do Sistema de Garantia dos Direitos no enfrentamento ao abuso sexual de crianças e adolescentes. A proposta da pesquisa se baseou na concepção de que a atuação articulada e integrada do SGDCA é fundamental para garantir a proteção dos direitos de crianças e adolescentes, por meio do atendimento, defesa e responsabilização. Dessa forma, os procedimentos metodológicos utilizados foram: coleta de dados por meio de entrevistas semiestruturadas, realizadas com os profissionais dos órgãos que compõem os eixos estratégicos do SGDCA, no âmbito da pesquisa qualitativa, fundamentadas sobre as categorias do método dialético-crítico. Portanto, foram entrevistados 5 profissionais, dos seguintes órgãos: CREAS, Conselho Tutelar, Ministério Público, Delegacia e Conselho Municipal dos Direitos Criança e do Adolescente. Contudo, a partir da pesquisa empírica, constatou-se que o SGDCA se encontra desarticulado, fragmentado, dificultando a proteção dos direitos da criança e do adolescente, no que tange ao rompimento do ciclo violento, responsabilização do agressor e resolutividade dos casos, o que implica em perpetuação das situações de violências

Intercellular interactions between mast cells and stromal fibroblasts obtained from canine cutaneous mast cell tumours

Mast cell tumours (MCTs) are the most frequent malignant skin neoplasm in dogs. Due to the difficulty in purifying large numbers of canine neoplastic mast cells, relatively little is known about their properties. A reproducible in vitro model is needed to increase the understanding about the phenotype and functional properties of neoplastic mast cells. In the present study, we describe the establishment of primary cocultures of neoplastic mast cells from canine cutaneous MCTs and cancer-associated fibroblasts. We confirmed the inability of canine neoplastic mast cells to remain viable for long periods in vitro without the addition of growth factors or in vivo passages in mice. Using a transwell system, we observed that mast cell viability was significantly higher when there is cell-to-cell contact in comparison to non-physical contact conditions and that mast cell viability was significantly higher in high-grade than in low-grade derived primary cultures. Moreover, the use of conditioned medium from co-cultured cells led to a significantly higher tumoral mast cell viability when in monoculture. Signalling mechanisms involved in these interactions might be attractive therapeutic targets to block canine MCT progression and deserve more in-depth investigations

Accuracy of mucocutaneous leishmaniasis diagnosis using polymerase chain reaction : systematic literature review and meta-analysis

The diagnosis of mucocutaneous leishmaniasis (MCL) is hampered by the absence of a gold standard. An accurate diagnosis is essential because of the high toxicity of the medications for the disease. This study aimed to assess the ability of polymerase chain reaction (PCR) to identify MCL and to compare these results with clinical research recently published by the authors. A systematic literature review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA Statement was performed using comprehensive search criteria and communication with the authors. A meta-analysis considering the estimates of the univariate and bivariate models was performed. Specificity near 100% was common among the papers. The primary reason for accuracy differences was sensitivity. The meta-analysis, which was only possible for PCR samples of lesion fragments, revealed a sensitivity of 71% [95% confidence interval (CI) = 0.59; 0.81] and a specificity of 93% (95% CI = 0.83; 0.98) in the bivariate model. The search for measures that could increase the sensitivity of PCR should be encouraged. The quality of the collected material and the optimisation of the amplification of genetic material should be prioritised

Relação entre veiculação hídrica e gastroenteropatias / Connection between water vehiculation and gastrointestinal diseases

Introdução: As doenças gastrointestinais representam uma importante questão de saúde pública. Os estudos relacionam fatores ambientais ao aparecimento de doenças, como as doenças do trato gastrointestinal, que estão muito presentes na Atenção Primária à Saúde. A falta de saneamento básico compromete a qualidade de vida da população. Objetivo: Analisar a relação entre a veiculação hídrica e as doenças do trato gastrointestinal. Método: Trata-se de uma revisão integrativa, que utilizou os seguintes Descritores em Ciência e Saúde (DeCS): qualidade da água, poluição da água e gastroenteropatias em português, aplicados na Biblioteca Virtual em Saúde (BVS), e em inglês, aplicados no U.S. National Library of Medicine and the National Institutes of Health (PUBMED). Selecionaram-se os artigos publicados entre 2015 e 2020, com estudos realizados em populações humanas, nos idiomas português, inglês e espanhol e que respondiam à questão norteadora. Resultados: A maioria dos artigos encontrados foi do ano de 2017 e estavam disponíveis no PUBMED, no idioma inglês, tendo os Estados Unidos como país sede e apresentando como população de estudo mais prevalente as pessoas que tinham relação com rios, praias e córregos, já que apresenta maior ligação com o objetivo de pesquisa. A partir de diferentes estudos verificou-se que a veiculação hídrica e as doenças gastrointestinais estão intimamente ligadas, de tal forma que a poluição da água aumenta a incidência dessas doenças. Conclusão: Infere-se que as doenças do trato gastrointestinal compreendem um impasse para o avanço da saúde pública, portanto, políticas para melhorar a qualidade da água, dentre elas o saneamento básico, devem ser implantadas

Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil : data from the Brazilian Type 1 Diabetes Study Group

Background: In type 1 diabetes mellitus (T1DM) management, enhancing health-related quality of life (HRQoL) is as important as good metabolic control and prevention of secondary complications. This study aims to evaluate possible regional differences in HRQoL, demographic features and clinical characteristics of patients with T1DM in Brazil, a country of continental proportions, as well as investigate which variables could influence the HRQoL of these individuals and contribute to these regional disparities. Methods: This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), by analyzing EuroQol scores from 3005 participants with T1DM, in 28 public clinics, among all geographical regions of Brazil. Data on demography, economic status, chronic complications, glycemic control and lipid profile were also collected. Results: We have found that the North-Northeast region presents a higher index in the assessment of the overall health status (EQ-VAS) compared to the Southeast (74.6 ± 30 and 70.4 ± 19, respectively; p < 0.05). In addition, North- Northeast presented a lower frequency of self-reported anxiety-depression compared to all regions of the country (North-Northeast: 1.53 ± 0.6; Southeast: 1.65 ± 0.7; South: 1.72 ± 0.7; Midwest: 1.67 ± 0.7; p < 0.05). These findings could not be entirely explained by the HbA1c levels or the other variables examined. Conclusions: Our study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of people with T1DM and contribute to these regional disparities

Regional differences in clinical care among patients with type 1 diabetes in Brazil: Brazilian Type 1 Diabetes Study Group

Background\ud To determine the characteristics of clinical care offered to type 1 diabetic patients across the four distinct regions of Brazil, with geographic and contrasting socioeconomic differences. Glycemic control, prevalence of cardiovascular risk factors, screening for chronic complications and the frequency that the recommended treatment goals were met using the American Diabetes Association guidelines were evaluated.\ud \ud Methods\ud This was a cross-sectional, multicenter study conducted from December 2008 to December 2010 in 28 secondary and tertiary care public clinics in 20 Brazilian cities in north/northeast, mid-west, southeast and south regions. The data were obtained from 3,591 patients (56.0% females and 57.1% Caucasians) aged 21.2 ± 11.7 years with a disease duration of 9.6 ± 8.1 years (<1 to 50 years).\ud \ud Results\ud Overall, 18.4% patients had HbA1c levels <7.0%, and 47.5% patients had HbA1c levels ≥ 9%. HbA1c levels were associated with lower economic status, female gender, age and the daily frequency of self-blood glucose monitoring (SBGM) but not with insulin regimen and geographic region. Hypertension was more frequent in the mid-west (32%) and north/northeast (25%) than in the southeast (19%) and south (17%) regions (p<0.001). More patients from the southeast region achieved LDL cholesterol goals and were treated with statins (p<0.001). Fewer patients from the north/northeast and mid-west regions were screened for retinopathy and nephropathy, compared with patients from the south and southeast. Patients from the south/southeast regions had more intensive insulin regimens than patients from the north/northeast and mid-west regions (p<0.001). The most common insulin therapy combination was intermediate-acting with regular human insulin, mainly in the north/northeast region (p<0.001). The combination of insulin glargine with lispro and glulisine was more frequently used in the mid-west region (p<0.001). Patients from the north/northeast region were younger, non-Caucasian, from lower economic status, used less continuous subcutaneous insulin infusion, performed less SBGM and were less overweight/obese (p<0.001).\ud \ud Conclusions\ud A majority of patients, mainly in the north/northeast and mid-west regions, did not meet metabolic control goals and were not screened for diabetes-related chronic complications. These results should guide governmental health policy decisions, specific to each geographic region, to improve diabetes care and decrease the negative impact diabetes has on the public health system.We thank Mrs. Karianne Aroeira Davidson, Mrs. Anna Maria Ferreira, Mrs. Elisangela Santos and Sandro Sperandei for their technical assistance.This work was supported by grants from Farmanguinhos/Fundação Oswaldo Cruz/National Health Ministry, the Brazilian Diabetes Society, Fundação do Amparo à Pesquisa do Estado do Rio de Janeiro, and Conselho Nacional de Desenvolvimento Científico e Tecnológico do Brasil

Pervasive gaps in Amazonian ecological research

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