Candidemia em hospitais de alta complexidade no Brasil: revisão narrativa da literatura.

TCC(graduação) - Universidade Federal de Santa Catarina. Centro de Ciências da Saúde. Farmácia.Nos últimos anos, as infecções hospitalares fúngicas por espécies do gênero Candida vêm aumentando progressivamente. As manifestações clínicas da candidíase variam desde uma infecção localizada, até a disseminação pela corrente sanguínea com o envolvimento de múltiplos órgãos, no caso de candidemia e candidíase invasiva. O presente trabalho tem por objetivo descrever os casos de candidemia em hospitais de alta complexidade do Brasil, revisar os métodos de identificação taxonômica de Candida spp., juntamente com os métodos utilizados no diagnóstico da candidemia; os procedimentos terapêuticos utilizados no tratamento da candidemia e a susceptibilidade aos antifúngicos das espécies, através de uma revisão dos casos entre os anos 2016 e 2021. Pela análise dos artigos foi possível observar que a principal espécie isolada continua sendo Candida albicans, porém outras espécies, como C. parapsilosis, C. tropicalis, C. glabrata, C. krusei, C. guilliermondii e C. auris; vêm destacando se no âmbito das infecções hospitalares. Seu diagnóstico tem interesse não só epidemiológico, mas também clínico, fazendo necessário o uso de exames laboratoriais adequados para identificação das espécies e testes de sensibilidade aos antifúngicos. Os principais antifúngicos com ação para Candida spp., utilizados foram os poliênicos; anfotericina B, os azólicos e, como primeira escolha terapêutica nos quadros de candidemia, as equinocandinas. Eles podem ser administrados como monoterapia ou em associações de medicamentos, de acordo com a gravidade do quadro clínico e o perfil de susceptibilidade antifúngica. Além disso, foram observados certos graus de resistência aos antifúngicos utilizados durante terapia medicamentosa dos pacientes, entre eles ao fluconazol e eventualmente em casos mais raros as equinocandinas. Com isso, pode-se concluir que são necessários estudos de vigilância multicêntrica e contínua de candidemia nos hospitais de alta complexidade de todo Brasil para detectar as tendências regionais da distribuição das espécies de Candida e o surgimento de resistência antifúngica precocemente.In recent years, as nosocomial fungal infections by species of the genus Candida increase progressively. The clinical manifestations of candidiasis range from a localized infection, to dissemination through the bloodstream with the involvement of multiple organs, in the case of candidemia and invasive candidiasis. The present work aims to describe the cases of candidemia in hospitals of high complexity in Brazil, to review the taxonomic identification methods of Candida spp., together with the methods used in the diagnosis of candidemia; therapeutic procedures used in the treatment of candidemia and susceptibility to antifungals of the species, through a review of the cases between the years 2016 and 2021. By analyzing the articles, it was possible to observe that a main type of Candida albicans remains, but other species, such as C. parapsilosis, C. tropicalis, C. glabrata, C. krusei, C. guilliermondii and C. auris; standing out in the context of hospital references. Its diagnosis is not only of epidemiological, but also clinical interest, making it necessary to use adequate laboratory tests for species identification and antifungal sensitivity tests. The main antifungal agents with action against Candida spp., Used were polyenes; amphotericin B, azoles and, as the first therapeutic choice in candidemia conditions, such as echinocandins. They can be administered as monotherapy or in drug combinations, depending on the severity of the clinical picture and the antifungal susceptibility profile. In addition, certain degrees of resistance to antifungal agents used during drug therapy of patients were observed, including fluconazole and occasionally in rarer cases such as echinocandins. Thus, it can be seen that they are included in multicentric and continuous surveillance studies of candidemia in high complexity hospitals throughout Brazil to detect regional trends in the distribution of Candida species and the early emergence of antifungal resistance

O consentimento na proteção de dados: análise da legislação brasileira e das propostas de regulação do Projeto de Lei 4060/12

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O direito à explicação diante de decisões totalmente automatizada : uma análise acerca de seus fundamentos e contornos na lei geral de proteção de dados

A presente dissertação tem por objetivo examinar os fundamentos e os contornos do direito à explicação de decisões totalmente automatizadas na Lei Geral de Proteção de Dados Pessoais, a fim de estabelecer balizas para a sua aplicação. Para tanto, o trabalho utiliza-se do método dedutivo de abordagem, com consulta a materiais bibliográficos, jurisprudência e legislações, e encontra-se dividido em duas partes. A primeira parte trata das decisões automatizadas. Aborda-se as vantagens, mas também os riscos envolvidos nesses processos decisórios. Ainda, busca-se averiguar como as decisões totalmente automatizadas são disciplinadas nas leis de proteção de dados, a fim de se perquirir se essas decisões são, a priori, permitidas ou proibidas. A segunda parte desta dissertação trata do direito à explicação, procurando demonstrar que esse é um instrumento importante para assegurar o devido processo informacional. Após a exposição do debate acerca da previsão ou não desse direito no Regulamento Geral de Proteção de Dados da União Europeia, busca-se delinear os contornos do direito à explicação na Lei nº 13.709/2018. São analisados os fundamentos desse direito, o seu conteúdo e os desafios relacionados a sua efetividade. Conclui-se que, na LGPD, esse direito encontra fundamento no princípio da transparência (artigo 6º, VI), no artigo 20, § 1º, que assegura ao titular de dados o direito de obter “informações claras e adequadas a respeito dos critérios e dos procedimentos utilizados para a decisão automatizada”, bem como no fato de ser pressuposto para o exercício de outros direitos, especialmente, do direito à revisão. No que diz respeito ao conteúdo, chegou se à conclusão de que: (i) o direito à explicação não pressupõe a divulgação do código-fonte do algoritmo; (ii) o conteúdo dependerá do contexto do tratamento de dados e do destinatário da informação; (iii) as informações fornecidas devem permitir que o titular de dados exerça seus outros direitos, como o de contestar a decisão. No tocante à efetividade, foram apontados os principais desafios e foi destacado o fato de que a efetividade desse direito dependerá da atuação de diversos agentes, principalmente da Autoridade Nacional de Proteção de Dados.This dissertation aims to examine the foundations and contours of the right to explanation of fully automated decisions in the “Lei Geral de Proteção de Dados”, in order to establish guidelines for its application. To this end, the work uses the deductive method of approach, with consultation of bibliographic materials, jurisprudence and legislation, and is divided into two parts. The first part deals with automated decisions. It addresses the advantages, but also the risks involved in these decision-making processes. Still, it seeks to find out how fully automated decisions are disciplined in data protection laws, in order to investigate whether these decisions are, a priori, allowed or prohibited. The second part of this dissertation deals with the right to explanation, trying to demonstrate that this is an important instrument to ensure the informational due process. After exposing the debate about whether or not this right is foreseen in the General Data Protection Regulation of the European Union, it seeks to outline the contours of the right to explanation in Law nº 13.709/2018. The foundations of this right, its content and the challenges related to its effectiveness are analyzed. It is concluded that, in the LGPD, this right is based on the principle of transparency (article 6, VI), in article 20, § 1, which guarantees the data subject the right to obtain “clear and adequate information regarding the criteria and of the procedures used for the automated decision”, as well as in the fact that it is presupposed for the exercise of other rights, especially the right to review. With regard to content, the conclusion was reached that: (i) the right to an explanation does not presuppose the disclosure of the algorithm's source code; (ii) the content will depend on the context of data processing and the recipient of the information; (iii) the information provided must allow the data subject to exercise their other rights, such as to contest the decision. Regarding effectiveness, the main challenges were pointed out and the fact that the effectiveness of this right will depend on the performance of several agents, mainly the National Data Protection Authority

O profiling e a proteção de dados pessoais

O objetivo do presente trabalho é analisar o profiling à luz da disciplina da proteção de dados pessoais. Para tanto, dividiu-se o estudo em três partes. Na primeira parte, abordar-se-á a origem e o desenvolvimento da disciplina da proteção de dados pessoais, destacando as suas gerações de leis e os seus princípios. Ademais, tratar-se-á do enquadramento do direito à proteção de dados pessoais na categoria de direito fundamental e analisar-se-á a regulação da disciplina da proteção de dados no direito brasileiro. A segunda parte será dedicada ao estudo do profiling, sendo explicado o seu conceito, o seu funcionamento, os possíveis âmbitos de aplicação desta técnica de processamento de dados e os seus aspectos positivos. Estabelecidas as bases sobre as quais se assentam a disciplina da proteção de dados pessoais e a técnica do profiling, esses temas serão aproximados na terceira parte deste trabalho. Nesta parte, serão apresentados os riscos envolvidos na perfilização e apontada a necessidade de tutela por parte do Direito. Por fim, analisar-se-á o tratamento dispensado ao profiling no Regulamento Geral de Proteção de Dados da União Europeia e na Lei Geral de Proteção de Dados brasileira.The present work aims to analyze the profiling in the light of Data Protection Regulation. For that, the study was divided into three parts. The first part will approach the origin and development of the Data Protection Regulation, highlighting its generations of laws and its principles. In addition, this work will discuss the framework of Data Protection Regulation as a Fundamental Right and will analyze the Brazilian General Law of Data Protection. The second part will be devoted to the study of profiling, explaining its concept, its operation, the possible scope of this data processing technique and its positive aspects. Established the bases on which are based the Data Protection Regulation and the technique of profiling, these themes will be approximated in the third part of this work. In this part, the risks involved in the profile will be presented and pointed out by the need for guardianship by the Law. Finally, we will analyze the treatment of profiling in the General Data Protection Regulation of the European Union and in the Brazilian General Law of Data Protection

Sound hunters: an invitation for a soundwalk on the local community

This worshop is based on the pilot project "Sound Hunters: Towards a Pedagogy based on Listening and Sound Exploration in Early Childhood", that the authors are implementing in a non-formal educational context in Portugal. This workshop emerges from "a double call" that has recently been made in the field of music education. A call that asks, on the one side, for a new perspective on the concept of "music" - that might include the entire soundscape that surrounds us (Landy, 2007; Solomos, 2020) - and, on the other side, for more inclusive and democratic practices in music education, that might create learning opportunities for all children (Benedict et al. 2015; Hess, 2017; Wright, 2015). In this workshop we aim to give a contribution to this double call by inviting participants for a soundwalk, that will be used as a means to (re)connect participants with the local soundscape through active and attentive listening (Clarke, 2005; Deans, Brown & Dilkes, 2005), and to introduce the idea of Sound Ecology (Schaffer, 1977; Truax, 2019; Etmektsoglou, 2019). Departing from a previously prepared roadmap, and divided into 4 small groups, participants will take a route through the conference venue, while focusing on listening to the sounds that surround them, a process that has been defined as a Soundwalk (Westerkamp, 2011; Behrent, 2018 ). This route will have several stopping points where participants will find diverse listening tools such as "prepared headphones", devices for recording and manipulate sounds, "listening acoustic cones", among others. The purpose of these apparatus is to invite and facilitate different interactions with sounds, so that participants can engage in meaningful and active listening experiences related with the surrounding soundscape. In the end, participants will share their experiences with the group in an informal conversation, where they will be invited to talk about important moments and key events experienced during the soundwalk. This conversation will be guided by the authors and aims to better understand how the soundwalk affected participants' feelings and ideas about their sonic worlds, their relationships with sounds, the local landscape and local community, and their ideas about music. At the end of the workshop it is expected that the participants might be able to: (i) Identify sound as part of each person's sensory experience; (ii) Identify, describe and compare different sounds and soundscapes; (iii) Explore, in a creative way, different sound sources and tools related to the perception and appropriation of sound; (iv) Explore the idea of Sound Ecology, relating sounds with the diverse environments in which they usually participate; (v) reflect and rethink their ideas and conceptions of "music" and "musical". Target audience: Children (2-5 years old), their families, educators, musicians, researchers and general public.publishe

Fenologia reprodutiva e biometria de frutos e sementes de três espécies de Byrsonima Rich. ex Kunth (Malpighiaceae) no Parque do Bacaba, Nova Xavantina - Mato Grosso

Este trabalho teve como objetivo estudar a fenologia reprodutiva e a biometria de frutos e sementes de Byrsonima verbascifolia, B. crassa e B. orbignyana, espécies ocorrentes no Parque do Bacaba, em Nova Xavantina, Mato Grosso, visando auxiliar no planejamento de extração e comercialização dos frutos. As observações fenológicas foram realizadas entre maio de 2006 e abril de 2007. Foram avaliadas as características biométricas de 200 frutos de cada espécie. A floração ocorre durante a estação seca e no início das chuvas. A frutificação está associada aos períodos de maior precipitação na região e a dispersão durou aproximadamente três meses para cada espécie. Os pesos médios dos frutos de B. crassa, B. orbignyana e B. verbascifolia foram, respectivamente: 0,30±0,05 g, 2,41±0,51 g e 3,81±1,99 g. A polpa contribuiu com 67,79%, 84,38% e 88,11% do peso total do fruto de B. crassa, B. orbignyana e B. verbascifolia, respectivamente. As espécies apresentaram tendência para frutos achatados e endocarpos compridos. B. verbascifolia e B. orbignyana se mostraram mais adequadas para comercialização por apresentar os maiores frutos e o maior rendimento de polpa. Entretanto, deve haver manejo racional e sustentável das áreas exploradas para que a coleta dos frutos não cause erosão genética das espécies

Increased physical activity and fitness above the 50th percentile avoid the threat of older adults becoming institutionalized: A cross-sectional pilot study.

Objective: To analyze the impact of physical fitness and physical activity on the threat of older adults without cognitive impairment becoming institutionalized. Methods: This cross-sectional study involved 195 non-institutionalized (80.1±4.4yrs) and 186 institutionalized (83.8±5.2yrs) participants. Cognitive impairment was assessed using Mini-Mental State Examination, measures of physical fitness were determined by the Senior Fitness Test, and physical activity was assessed using the International Physical Activity Questionnaire. Results: Multivariate binary logistic analysis selected 4 main determinants of institutionalization in both genders: the likelihood of becoming institutionalized increased by +18.6% for each additional year of age, while it decreased by -24.8% by each fewer kg/m2 in BMI, by -0.9% for each additional meter performed in the aerobic endurance test and by -2.0% for each additional 100MET-min/wk of physical activity expenditure (p<0.05). Values ≤50th percentile (age ≥81yrs, BMI ≥26.7kg/m2, aerobic endurance 367.6m, and physical activity 693MET-min/wk) were computed using Receiver Operating Characteristics analysis as cut-offs discriminating institutionalized from non-institutionalized older adults. Conclusions: The performance of physical activity, allied to an improvement in physical fitness (mainly BMI and aerobic endurance), may avoid the threat of institutionalization of older adults without cognitive impairment only if they are above the 50th percentile; the following is highly recommend: expending ≥693MET-min/wk on physical activity, being ≤26.7kg/m2 on BMI, and being able to walk ≥367.6m in the aerobic endurance test, especially above the age of 80 years. The discovery of this trigger justifies the development of physical activity programs targeting the pointed cut-offs in old, and very old adults

Estudo sobre a percepção do impacto do sistema cooperativo de agricultura familiar nos municípios de Mafra, Papanduva, e Monte Castelo

A importância da agricultura familiar para o país vem sendo objeto de estudo e discussões tanto na esfera acadêmica como em movimentos sociais e governamentais. No estado de Santa Catarina estima- se que a agricultura familiar representa um universo de 180 mil famílias, ou seja, mais de 90% da população rural, sendo responsável por mais de 70% do valor da produção agrícola e pesqueira do estado. Inúmeros produtores estão buscando o associativismo como uma maneira de fortalecer a agricultura familiar e a pequena propriedade. Este estudo tem como objetivo examinar, através da aplicação de questionários junto aos associados de cooperativas de agricultura familiar do planalto norte catarinense, a percepção do impacto do sistema cooperativo e a relação entre o produtor e a cooperativa. Através da pesquisa de campo, evidenciou- se que a cooperativa possui um papel importante na agricultura familiar, pois para o produtor ela é uma segurança de que sua produção será comercializada e vendida por um preço melhor se comparado à venda individual.  Outro aspecto constatado, é que a cooperativa está atendendo as expectativas dos associados, através da melhoria de sua renda e do trabalho diário

Increased physical activity and fitness above the 50th percentile prevents the institutionalization of elderly people: a cross-sectional pilot study.

Introduction Institutionalization in a nursing home restricts autonomy, most notably free will, free choice, and free action. Decreased physical activity and fitness are predictive of disability and dependence (Rikli & Jones, 2013; Tak, Kuiper, Chorus, & Hopman-Rock, 2014); however little is known about the impact of these factors on institutionalization. Thus, this study aimed to analyze the impact of physical activity and fitness and on the risk of elderly people without cognitive impairment become institutionalized. Methods This cross-sectional study involved 195 non-institutionalized (80.14.4yrs) and 186 institutionalized (83.85.2yrs) participants. Cognitive impairment was assessed using Mini-Mental State Examination, physical activity was assessed using the International Physical Activity Questionnaire, and measures of physical fitness were determined by the Senior Fitness Test. Results: Multivariate binary logistic analysis selected 4 main predictors of institutionalization in both genders. The likelihood of becoming institutionalized increased by +18.6% for each additional year of age, while it decreased by -24.8% by each fewer kg/m2 in BMI, by -0.9% for each additional meter performed in the aerobic endurance test and by -2.0% for each additional 100MET-min/wk of physical activity expenditure (p<0.05). Values ≤50th percentile (age ≥81yrs, BMI≥26.7kg/m2, aerobic endurance ≤367.6m, and physical activity ≤693MET-min/wk) were computed using Receiver Operating Characteristics analysis as cut-offs discriminating institutionalized from non-institutionalized elderly people. Conclusion The performance of physical activity, allied to an improvement in physical fitness (mainly BMI and aerobic endurance) may prevent the institutionalization of elderly people without cognitive impairment only if they are above the 50th percentile; the following is highly recommend: expending ≥693MET-min/wk on physical activity, being ≤26.7kg/m2 on BMI, and being able to walk ≥367.6m in the aerobic endurance test, especially above the age of 80 years. The discovery of this trigger justifies the development of physical activity programs targeting the pointed cut-offs in old, and very old people. References Rikli, R., & Jones, C. (2013). Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years. Gerontologist, 53, 255-267. Tak, E., Kuiper, R., Chorus, A., & Hopman-Rock, M. (2014). Prevention of onset and progression of basic ADL disability by physical activity in community dwelling older adults: a meta-analysis. Ageing Res Rev, 12, 329-338

Probiotics in Dairy Fermented Products

Interest in the role of probiotics for human health began as early as 1908 when Metchnikoff associated the intake of fermented milk with prolonged life (Lourens-Hattingh and Vilijoen, 2001b). However, the relationship between intestinal microbiota and good health and nutrition has only recently been investigated. Therefore, it was not until the 1960’s that health benefit claims began appearing on foods labels. In recent years,there has been an increasing interest in probiotic foods, which has stimulated innovation and fueled the development of new products around the world. Probiotic bacteria have increasinglybeen incorporated into foods in order to improve gut health by maintaining the microbial gastrointestinal balance. The most popular probioticfoodsare produced in the dairy industry because fermented dairy products have been shown to be the most efficient delivery vehicle for live probiotics to date. In this chapter, we will discuss the application of probiotic microorganisms in fermented dairy products, particularly cheeses. In addition, we will also discuss the benefits of probiotic fermented foods on human health