Práticas de leitura e escrita no Ensino Superior por uma acadêmica surda usuária de Libras na perspectiva da Educação de Jovens e Adultos

Esta pesquisa traz uma discussão sobre o letramento de uma estudante surda no Ensino Superior, que estabelece um diálogo entre os Estudos dos Surdos  e a Educação de Jovens e Adultos no Brasil. Dessa forma, delineamos uma reflexão sobre a trajetória educacional de uma graduanda surda  que apresenta  dificuldades de leitura e de escrita do Português. Nesse sentido, ainda que ela esteja no ensino superior, foi requisitado, por parte dos docentes e da Pró reitoria de ensino da universidade em que ela está matriculada, ações voltadas para o letramento em Libras e em Português, visando a permanência da estudante no ambiente acadêmico. Nesse sentido, este artigo propõe descrever três momentos de atuação, cada qual voltado para atender necessidades distintas. Os resultados das ações desenvolvidas apontam que as práticas de letramento precisam dialogar com as necessidades do educando, o que para a estudante surda envolveu a ampliação do usos da língua de sinais e o acesso aos diferentes gêneros textuais pertinentes ao ensino superior

Prognostic factors for outcomes of patients with refractory or relapsed acute myelogenous leukemia or myelodysplastic syndromes undergoing allogeneic progenitor cell transplantation

AbstractAllogeneic progenitor cell transplantation is the only curative therapy for patients with refractory acute myelogenous leukemia or myelodysplastic syndromes. To identify prognostic factors in these patients, we performed a retrospective analysis of transplantation outcomes. Patients were selected if they had undergone an allogeneic transplantation between January 1988 and January 2002 and were not in remission or first untreated relapse at the time of transplantation. A total of 135 patients were identified. The median age was 49.5 years (range, 19-75 years). At the time of transplantation, 39.3% of patients had not responded to induction therapy, 37% had not responded to first salvage therapy, and 23.7% were beyond first salvage. Forty-one patients (30%) received unrelated donor progenitor cells. Eighty patients (59%) received either a reduced-intensity or a nonmyeloablative regimen. A total of 104 (77%) of 135 patients died, with a median survival time of 4.9 months (95% confidence interval, 3.9-6.6 months). The median progression-free survival was 2.9 months (95% confidence interval, 2.5-4.2 months). A Cox regression analysis showed that Karnofsky performance status, peripheral blood blasts, and tacrolimus exposure during the first 11 days after transplantation were predictive of survival. These data support the use of allogeneic transplantation for patients with relapsed or refractory acute myelogenous leukemia/myelodysplastic syndromes and suggest that optimal immune suppression early after transplantation is essential for long-term survival even in patients with refractory myeloid leukemias

Association of dietary flavan-3-ol intakes with plasma phenyl-γ-valerolactones: analysis from the TUDA cohort of healthy older adults

Background: Dietary polyphenols, including flavan-3-ols (F3O), are associated with better health outcomes. The relationship of plasma phenyl-γ-valerolactones (PVLs), the products of colonic bacterial metabolism of F3O, with dietary intakes is unclear. Objectives: To investigate whether plasma PVLs are associated with self-reported intakes of total F3O and procyanidins+(epi)catechins. Design: We measured 9 PVLs by uHPLC-MS-MS in plasma from adults (>60y) in the Trinity-Ulster-Department of Agriculture (TUD study (2008 to 2012; n=5,186) and a follow-up subset (2014 to 2018) with corresponding dietary data (n=557). Dietary (poly)phenols collected by FFQ were analyzed using Phenol-Explorer. Results: Mean (95% confidence interval [CI]) intakes were estimated as 2283 (2213, 2352) mg/d for total (poly)phenols, 674 (648, 701) for total F3O, and 152 (146, 158) for procyanidins+(epi)catechins. Two PVL metabolites were detected in plasma from the majority of participants, 5-(hydroxyphenyl)-γ-VL-sulfate (PVL1) and 5-(4'-hydroxyphenyl)-γ-VL-3'-glucuronide (PVL2). The 7 other PVLs were detectable only in 1-32% of samples. Self-reported intakes (mg/d) of F3O (r = 0.113, P = 0.017) and procyanidin+(epi)catechin (r = 0.122, P = 0.010) showed statistically significant correlations with the sum of PVL1 and PVL 2 (PVL1+2). With increasing intake quartiles (Q1-Q4), mean (95% CI) PVL1+2 increased; from 28.3 (20.8, 35.9) nmol/L in Q1 to 45.2 (37.2, 53.2) nmol/L in Q4; P = 0.025, for dietary F3O, and from 27.4 (19.1, 35.8) nmol/L in Q1 to 46.5 (38.2, 54.9) nmol/L in Q4; P = 0.020, for procyanidins+(epi)catechins. Conclusions: Of 9 PVL metabolites investigated, 2 were detected in most samples and were weakly associated with intakes of total F3O and procyanidins+(epi)catechins. Future controlled feeding studies are required to validate plasma PVLs as biomarkers of these dietary polyphenols

Capacitação dos Agentes Comunitários com enfoque em Tuberculose na Atenção Básica/ Training Community Agents with a focus on Tuberculosis in Primary Care

Introdução: A tuberculose (TB) é uma doença muito antiga. Os primeiros registros desta infecção remontam  séculos antes de Cristo. Ainda hoje, a tuberculose é considerada um problema de saúde pública mundial, embora haja diferenças nas taxas de mortalidade, no declínio de incidência e na prevalência entre os países. Nesse contexto, destaca-se a atuação importante de uma equipe multidisciplinar no combate à tuberculose e busca ativa de sintomáticos respiratórios. O agente comunitário de saúde (ACS) está inserido na atenção básica em meio a Estratégia Saúde da Família (ESF), e representa o elo entre a comunidade e a equipe de saúde realiza um trabalho na dimensão técnica através de ações de monitoramento de grupos específicos, doenças prevalentes e de risco, através de visitas domiciliares e informação em saúde com base no saber epidemiológico e clínico. Diante disso, mostra-se a imporância em avaliar o grau de conhecimento dos agentes comunitários de saúde sobre o tema da tuberculose. Objetivo: Avaliar o desempenho dos Agentes Comunitários de Saúde (ACS) de quatro Estratégias de Saúde da Família de Belém-Pará sobre a tuberculose antes e após processo de capacitação sobre o tema. Metodologia: Estudo longitudinal, prospectivo, descritivo, de caráter quantitativo realizado nas  ESF dos grupos A, B, C e D todas localizadas no município de Belém, Pará, tendo como referência para a educação em saúde a Cartilha para o Agente Comunitário de Saúde – Tuberculose do Ministério da Saúde. Etilizou-se questionário semiestruturado, autoaplicável, composto por dez questões de múltipla escolha contendo apenas um item com a resposta correta. Resultados: Foram analisados um total de 27 participantes, onde todos foram avaliados antes e após proposta intervencionista. Ao se comparar o desempenho dos ACS nos testes de conhecimento após a intervenção, verificou-se que os grupo A, C e D, apresentaram significativo aumento no número de acertos, sendo p < 0,05, exceto no grupo B com p>0,05. Conclusão: A presente pesquisa aponta que a proposta de intervenção e capacitação dos Agentes Comunitários em Saúde é efetiva na melhoria do nível de conhecimento destes. Desta forma, cabe ressaltar a importância da educação em saúde, em especial, dentro do âmbito da Estratégia Saúde da Família, uma vez elucidado o impacto desta capacitação sobre aspectos relevantes ao tratamento, prevenção e outros aspectos da tuberculose

Associations Between Extreme Temperatures and Cardiovascular Cause-Specific Mortality: Results From 27 Countries.

BACKGROUND Cardiovascular disease is the leading cause of death worldwide. Existing studies on the association between temperatures and cardiovascular deaths have been limited in geographic zones and have generally considered associations with total cardiovascular deaths rather than cause-specific cardiovascular deaths. METHODS We used unified data collection protocols within the Multi-Country Multi-City Collaborative Network to assemble a database of daily counts of specific cardiovascular causes of death from 567 cities in 27 countries across 5 continents in overlapping periods ranging from 1979 to 2019. City-specific daily ambient temperatures were obtained from weather stations and climate reanalysis models. To investigate cardiovascular mortality associations with extreme hot and cold temperatures, we fit case-crossover models in each city and then used a mixed-effects meta-analytic framework to pool individual city estimates. Extreme temperature percentiles were compared with the minimum mortality temperature in each location. Excess deaths were calculated for a range of extreme temperature days. RESULTS The analyses included deaths from any cardiovascular cause (32 154 935), ischemic heart disease (11 745 880), stroke (9 351 312), heart failure (3 673 723), and arrhythmia (670 859). At extreme temperature percentiles, heat (99th percentile) and cold (1st percentile) were associated with higher risk of dying from any cardiovascular cause, ischemic heart disease, stroke, and heart failure as compared to the minimum mortality temperature, which is the temperature associated with least mortality. Across a range of extreme temperatures, hot days (above 97.5th percentile) and cold days (below 2.5th percentile) accounted for 2.2 (95% empirical CI [eCI], 2.1-2.3) and 9.1 (95% eCI, 8.9-9.2) excess deaths for every 1000 cardiovascular deaths, respectively. Heart failure was associated with the highest excess deaths proportion from extreme hot and cold days with 2.6 (95% eCI, 2.4-2.8) and 12.8 (95% eCI, 12.2-13.1) for every 1000 heart failure deaths, respectively. CONCLUSIONS Across a large, multinational sample, exposure to extreme hot and cold temperatures was associated with a greater risk of mortality from multiple common cardiovascular conditions. The intersections between extreme temperatures and cardiovascular health need to be thoroughly characterized in the present day-and especially under a changing climate

Associations Between Extreme Temperatures and Cardiovascular Cause-Specific Mortality: Results From 27 Countries

Background: Cardiovascular disease is the leading cause of death worldwide. Existing studies on the association between temperatures and cardiovascular deaths have been limited in geographic zones and have generally considered associations with total cardiovascular deaths rather than cause-specific cardiovascular deaths. Methods: We used unified data collection protocols within the Multi-Country Multi-City Collaborative Network to assemble a database of daily counts of specific cardiovascular causes of death from 567 cities in 27 countries across 5 continents in overlapping periods ranging from 1979 to 2019. City-specific daily ambient temperatures were obtained from weather stations and climate reanalysis models. To investigate cardiovascular mortality associations with extreme hot and cold temperatures, we fit case-crossover models in each city and then used a mixed-effects meta-analytic framework to pool individual city estimates. Extreme temperature percentiles were compared with the minimum mortality temperature in each location. Excess deaths were calculated for a range of extreme temperature days. Results: The analyses included deaths from any cardiovascular cause (32 154 935), ischemic heart disease (11 745 880), stroke (9 351 312), heart failure (3 673 723), and arrhythmia (670 859). At extreme temperature percentiles, heat (99th percentile) and cold (1st percentile) were associated with higher risk of dying from any cardiovascular cause, ischemic heart disease, stroke, and heart failure as compared to the minimum mortality temperature, which is the temperature associated with least mortality. Across a range of extreme temperatures, hot days (above 97.5th percentile) and cold days (below 2.5th percentile) accounted for 2.2 (95% empirical CI [eCI], 2.1–2.3) and 9.1 (95% eCI, 8.9–9.2) excess deaths for every 1000 cardiovascular deaths, respectively. Heart failure was associated with the highest excess deaths proportion from extreme hot and cold days with 2.6 (95% eCI, 2.4–2.8) and 12.8 (95% eCI, 12.2–13.1) for every 1000 heart failure deaths, respectively. Conclusions: Across a large, multinational sample, exposure to extreme hot and cold temperatures was associated with a greater risk of mortality from multiple common cardiovascular conditions. The intersections between extreme temperatures and cardiovascular health need to be thoroughly characterized in the present day—and especially under a changing climate.Clinical Perspective_ What Is New?: This study provided evidence from what we believe is the largest multinational dataset ever assembled on cardiovascular outcomes and environmental exposures; Extreme hot and cold temperatures were associated with increased risk of death from any cardiovascular cause, ischemic heart disease, stroke, and heart failure; For every 1000 cardiovascular deaths, 2 and 9 excess deaths were attributed to extreme hot and cold days, respectively. _ What Are the Clinical Implications?: Extreme temperatures from a warming planet may become emerging priorities for public health and preventative cardiology; The findings of this study should prompt professional cardiology societies to commission scientific statements on the intersections of extreme temperature exposure and cardiovascular health.This study was supported by the Kuwait Foundation for the Advancement of Science (CB21-63BO-01); the US Environmental Protection Agency (RD-835872); Harvard Chan National Institute of Environmental Health Sciences Center for Environmental Health (P01ES009825); the UK Medical Research Council (MR/R013349/1); the UK Natural Environment Research Council (NE/R009384/1); the European Union’s Horizon 2020 Project Exhaustion (820655); the Australian National Health and Medical Research Council (APP 2000581, APP 1109193, APP 1163693); the National Institute of Environmental Health Sciences–funded HERCULES Center (P30ES019776); the MCIN/AEI/10.13039/501100011033 (grant CEX2018-000794-S); the Taiwanese Ministry of Science and Technology (MOST 109–2621-M-002–021); the Environmental Restoration and Conservation Agency, Environment Research and Technology Development Fund (JPMEERF15S11412); the São Paulo Research Foundation; and Fundação para a Ciência e a Tecnlogia (SFRH/BPD/115112/2016)info:eu-repo/semantics/publishedVersio

Perfil sociodemográfico da população da vila da barca/Sociodemographic profile of the population from vila da barca

INTRODUÇÃO – Aspectos demográficos e socioeconômicos devem ser compreendidos como fatores que interferem na saúde e a geração periódica de informações de base populacional constitui uma ferramenta para monitorar e avaliar o acesso e a prestação aos serviços públicos de saúde. OBJETIVO - Traçar o perfil sociodemográfico dos usuários dos serviços de saúde da Vila da Barca, área II e verificar a prevalência de doenças crônicas ou outras. METODOLOGIA - Análise transversal, quantitativa e descritiva de dados obtidos dos cadastros de famílias, respeitando critérios éticos, e escolha randômica e estratificada da amostra. RESULTADOS – 46,8% homens e 53,2% mulheres, com predominância de adultos. Prevalência de HAS e diabetes. Baixo nível de escolaridade e renda familiar. Grupos familiares pardos e residentes em casas de alvenaria. DISCUSSÃO – População mais tempo exposta a fatores de risco de doenças crônicas, agravadas por fatores genéticos/raciais, instrução e nível socioeconômicos. CONCLUSÃO – População predominantemente nas faixas adulta e idosa, com prevalência de HAS e diabetes, baixa renda e escolaridade, 35% de desempregados e autodenominadas “pardos”

Joint effect of heat and air pollution on mortality in 620 cities of 36 countries

Background: The epidemiological evidence on the interaction between heat and ambient air pollution on mortality is still inconsistent. Objectives: To investigate the interaction between heat and ambient air pollution on daily mortality in a large dataset of 620 cities from 36 countries. Methods: We used daily data on all-cause mortality, air temperature, particulate matter ≤ 10 μm (PM10), PM ≤ 2.5 μm (PM2.5), nitrogen dioxide (NO2), and ozone (O3) from 620 cities in 36 countries in the period 1995-2020. We restricted the analysis to the six consecutive warmest months in each city. City-specific data were analysed with over-dispersed Poisson regression models, followed by a multilevel random-effects meta-analysis. The joint association between air temperature and air pollutants was modelled with product terms between non-linear functions for air temperature and linear functions for air pollutants. Results: We analyzed 22,630,598 deaths. An increase in mean temperature from the 75th to the 99th percentile of city-specific distributions was associated with an average 8.9 % (95 % confidence interval: 7.1 %, 10.7 %) mortality increment, ranging between 5.3 % (3.8 %, 6.9 %) and 12.8 % (8.7 %, 17.0 %), when daily PM10 was equal to 10 or 90 μg/m3, respectively. Corresponding estimates when daily O3 concentrations were 40 or 160 μg/m3 were 2.9 % (1.1 %, 4.7 %) and 12.5 % (6.9 %, 18.5 %), respectively. Similarly, a 10 μg/m3 increment in PM10 was associated with a 0.54 % (0.10 %, 0.98 %) and 1.21 % (0.69 %, 1.72 %) increase in mortality when daily air temperature was set to the 1st and 99th city-specific percentiles, respectively. Corresponding mortality estimate for O3 across these temperature percentiles were 0.00 % (-0.44 %, 0.44 %) and 0.53 % (0.38 %, 0.68 %). Similar effect modification results, although slightly weaker, were found for PM2.5 and NO2. Conclusions: Suggestive evidence of effect modification between air temperature and air pollutants on mortality during the warm period was found in a global dataset of 620 cities.Funding: Massimo Stafoggia, Francesca K. de’ Donato, Masna Rai and Alexandra Schneider were partially supported by the European Union’s Horizon 2020 Project Exhaustion (Grant ID: 820655). Jan Kyselý and Aleš Urban were supported by the Czech Science Foundation project (22-24920S). Joana Madureira was supported by the Fundação para a Ciência e a Tecnologia (FCT) (grant SFRH/BPD/115112/2016). Masahiro Hashizume was supported by the Japan Science and Technology Agency (JST) as part of SICORP, Grant Number JPMJSC20E4. Noah Scovronick was supported by the NIEHS-funded HERCULES Center (P30ES019776). South African Data were provided by Statistics South Africa, which did not have any role in conducting the study. Antonio Gasparrini was supported by the Medical Research Council-UK (Grants ID: MR/V034162/1 and MR/R013349/1), the Natural Environment Research Council UK (Grant ID: NE/R009384/1), and the European Union’s Horizon 2020 Project Exhaustion (Grant ID: 820655).info:eu-repo/semantics/publishedVersio