A relação cultura e natureza e a diversidade dos agroecossitemas camponeses: uma percepção estético-visual

Este artigo aborda a relação cultura/natureza a partir da manifestação do cultivo e da conservação de sementes crioulas na mesorregião da Zona da Mata, em Minas Gerais. O trabalho é resultante de uma pesquisa qualitativa realizada com agricultores(as) familiares camponeses(as) inseridos(as) na rede de agroecologia local. Para tanto, ancoramo-nos em três instrumentos de coleta de dados como estratégia metodológica. São eles: pesquisa documental, entrevistas semiestruturadas e análise estético-visual das fotografias e dos vídeos enviados pelos(as) entrevistados(as). Verificou-se que as sementes crioulas são fruto dos significados-usos e da percepção estética de agricultores(as) em relação ao agroecossistema no qual estão inseridos(as). As sementes crioulas diversificam as paisagens e simbolizam a resistência ontológica da agricultura familiar camponesa. A sua diversidade e a memória biocultural a elas associada são fundamentais no manejo agroecológico dos agroecossistemas. A memória biocultural desses(as) agricultores(as) expressa conhecimentos reveladores de outras formas de se relacionar com os ecossistemas e de viver e habitar o território, evidenciando cosmologias, que não correspondem às perspectivas dominantes de desenvolvimento definidas pela sociedade moderna capitalista

Perfil epidemiológico das gestantes cadastradas no sistema SISAB (e-SUS) no município de Porto Nacional – TO no período de 2020 a 2022

INTRODUÇÃO:O pré-natal, acompanhamento essencial desde a descoberta até o parto, busca garantir a saúde da gestante e do feto. O e-SUS APS, estratégia do Ministério da Saúde, visa reestruturar dados da Atenção Primária à Saúde e demonstrar a importância do acolhimento, sensibilização e realização das seis consultas, preconizadas pelo Programa de Humanização no Pré-Natal e Nascimento. O pré-natal bem estruturado inclui anamnese, exame físico, e a participação da família, promovendo a saúde materna e neonatal. Logo, O aumento global de problemas durante a gestação destaca a necessidade de abordagens integradas e humanizadas. MATERIAL E METODOS: A pesquisa analítica, observacional e retrospectiva focou em gestantes cadastradas no e-SUS em Porto Nacional – TO (2020 a 2022). Desenhos analíticos buscam associar exposição a efeitos específicos, enquanto estudos observacionais registram dados sem intervenção direta. O delineamento retrospectivo, baseado em registros passados, exige credibilidade nos dados. Utilizando o SIAB, a análise descritiva e estatística descritiva examinou variáveis como sexo ao nascer, idade da mãe, tipo de gravidez, parto, duração da gestação, estado civil e consultas pré-natais. RESULTADOS E DISCUSSÃO: A pesquisa abordou parâmetros sociodemográficos destacando a preocupação com o número de consultas pré-natal. A importância do acolhimento e sensibilização para garantir as seis consultas recomendadas foi enfatizada a todo momento. A pesquisa indicou desafios na assistência pré-natal, enfatizando a necessidade de ações educativas para melhorar o índice de captação e garantir acompanhamento adequado. CONCLUSÃO: O estudo destaca o desafio de envolver gestantes em acompanhamento pré-natal, enaltecendo, abordagens efetivas devido à vulnerabilidade social. A baixa frequência de consultas (abaixo do ideal de 6) é observada reforçando a necessidade de ações educativas em saúde. Conclui-se que o estudo é crucial para alertar a população sobre os riscos associados à falta de controle pré-natal, enfatizando a importância de estratégias eficazes para engajar gestantes e promover cuidados adequado

Inclusão escolar de alunos portadores de Transtorno do Espectro Autista na educação infantil: uma revisão sistemática: School inclusion of students with Autistic Spectrum Disorder in early childhood education: a systematic review

Este artigo debate o problema da inclusão escolar de crianças com transtorno do espectro autista (TEA). Para estabelecer o debate, foi feito um levantamento bibliográfico e referencial para uma revisão sistemática do tema. O objetivo é clarificar os conceitos de inclusão escolar e TEA para debater como é feito o processo educacional de crianças com TEA. Sendo assim, a partir da pesquisa científica de descritores como “inclusão escolar”, “transtorno do espectro autista”, foi observado, pelos diversos autores trabalhados, que ainda há muito o que se debater e trabalhar para que ocorra a inclusão escolar de crianças com TEA. Apesar das muitas tentativas, erros e acertos, o tema ainda é pouco trabalhado e divulgado, visto que há poucos profissionais capacitados na área

Multicenter validation of PIM3 and PIM2 in Brazilian pediatric intensive care units

ObjectiveTo validate the PIM3 score in Brazilian PICUs and compare its performance with the PIM2.MethodsObservational, retrospective, multicenter study, including patients younger than 16 years old admitted consecutively from October 2013 to September 2019. We assessed the Standardized Mortality Ratio (SMR), the discrimination capability (using the area under the receiver operating characteristic curve – AUROC), and the calibration. To assess the calibration, we used the calibration belt, which is a curve that represents the correlation of predicted and observed values and their 95% Confidence Interval (CI) through all the risk ranges. We also analyzed the performance of both scores in three periods: 2013–2015, 2015–2017, and 2017–2019.Results41,541 patients from 22 PICUs were included. Most patients aged less than 24 months (58.4%) and were admitted for medical conditions (88.6%) (respiratory conditions = 53.8%). Invasive mechanical ventilation was used in 5.8%. The median PICU length of stay was three days (IQR, 2–5), and the observed mortality was 1.8% (763 deaths). The predicted mortality by PIM3 was 1.8% (SMR 1.00; 95% CI 0.94–1.08) and by PIM2 was 2.1% (SMR 0.90; 95% CI 0.83–0.96). Both scores had good discrimination (PIM3 AUROC = 0.88 and PIM2 AUROC = 0.89). In calibration analysis, both scores overestimated mortality in the 0%–3% risk range, PIM3 tended to underestimate mortality in medium-risk patients (9%–46% risk range), and PIM2 also overestimated mortality in high-risk patients (70%–100% mortality risk).ConclusionsBoth scores had a good discrimination ability but poor calibration in different ranges, which deteriorated over time in the population studied

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ

Biocultural memory and agroecology: cultivation and conservation of creole seeds

A memória biocultural, enquanto uma expressão da cultura em interação com a natureza, que se baseia nas observações do ambiente mantidas, transmitidas e aperfeiçoadas com o tempo, influência diretamente a diversidade agrícola dos agroecossistemas, especificamente as sementes crioulas. O objetivo dessa dissertação é compreender a relação entre cultura e natureza expressa no cultivo e na conservação das sementes crioulas por camponeses que praticam a agroecologia. A pesquisa foi conduzida com os/as agricultores/as envolvidos na rede de agroecologia da Zona da Mata de Minas Gerais e orientada a partir de perspectivas teórico- epistemológicas pós-modernas e decoloniais. O processo de coleta dos dados de pesquisa foi dividido em três etapas: a análise documental, as entrevistas semiestruturadas e a antropologia visual. Esses dados foram organizados e analisados a partir da análise de conteúdo temática. A escrita desta dissertação foi organizada em cinco capítulos. Sendo o primeiro uma Introdução Geral em que se apresenta a história e a organização da rede agroecológica na Zona da Mata de Minas Gerais, as questões e os objetivos de pesquisa, as abordagens teórico-epistemológicas e o desenho metodológico da pesquisa. Os demais capítulos apresentam-se na forma de artigos, que respondem a cada uma das questões de pesquisa desta dissertação. O artigo um está intitulado “A relação cultura e natureza e a diversidade dos agroecossitemas camponeses” e objetiva compreender a relação entre cultura e natureza e como esta relação se expressa no cultivo e na conservação das sementes crioulas no território da Zona da Mata-MG. O artigo dois está intitulado “As sementes crioulas e a sua importância para a autonomia camponesa” e objetiva entender a relação entre as sementes crioulas e a autonomia camponesa e a soberania alimentar. Por fim, o artigo três está intitulado “As relações de reciprocidade camponesa e a conservação das sementes crioulas” e objetiva compreender a importância das trocas de sementes crioulas para o cultivo e a conservação das mesmas e como as relações de reciprocidade permeiam essas trocas de sementes crioulas na Zona da Mata de Minas Gerais. Palavras-chave: Agrobiodiversidade. Agricultura Familiar. Cultura. Natureza.Biocultural memory, as an expression of culture in interaction with nature, which is based on observations of the environment maintained, transmitted and improved over time, directly influences the agricultural diversity of agroecosystems, specifically landrace seeds. The objective of this dissertation is to understand the relationship between culture and nature expressed in the cultivation and conservation of landrace seeds by peasant farmers who practice agroecology. The research was conducted with the farmers involved in the agroecology network of the Zona da Mata of Minas Gerais and oriented from postmodern and decolonial theoretical- epistemological perspectives. The data collection process was divided into three stages: document analysis, semi-structured interviews, and visual anthropology. These data were organized and analyzed based on thematic content analysis. The writing of this dissertation was organized into four chapters. The first is a General Introduction that presents the history and organization of the agroecological network in the Zona da Mata of Minas Gerais, the research questions and objectives, the theoretical-epistemological approaches, and the methodological design of the research. The other chapters are presented in the form of articles, which answer each of the research questions of this dissertation. Chapter one is entitled "The relationship between culture and nature and the diversity of peasant agroecosystems" and aims to understand the relationship between culture and nature and how this relationship is expressed in the cultivation and conservation of landrace seeds in the territory of Zona da Mata-MG. Chapter two is entitled “Landrace seeds and their importance for peasant autonomy” and aims to understand the relationship between landrace seeds and peasant autonomy and food sovereignty. Finally, chapter three is entitled "Peasant reciprocity relations and the conservation of landrace seeds" and aims to understand the importance of exchanges of landrace seeds for their cultivation and conservation and how the reciprocity relations permeate these exchanges of landrace seeds in the Zona da Mata of Minas Gerais. Keywords: Agrobiodiversity. Family farming. Culture. Nature.Coordenação de Aperfeiçoamento de Pessoal de Nível Superio

Datasheet1_Multicenter validation of PIM3 and PIM2 in Brazilian pediatric intensive care units.pdf

ObjectiveTo validate the PIM3 score in Brazilian PICUs and compare its performance with the PIM2.MethodsObservational, retrospective, multicenter study, including patients younger than 16 years old admitted consecutively from October 2013 to September 2019. We assessed the Standardized Mortality Ratio (SMR), the discrimination capability (using the area under the receiver operating characteristic curve – AUROC), and the calibration. To assess the calibration, we used the calibration belt, which is a curve that represents the correlation of predicted and observed values and their 95% Confidence Interval (CI) through all the risk ranges. We also analyzed the performance of both scores in three periods: 2013–2015, 2015–2017, and 2017–2019.Results41,541 patients from 22 PICUs were included. Most patients aged less than 24 months (58.4%) and were admitted for medical conditions (88.6%) (respiratory conditions = 53.8%). Invasive mechanical ventilation was used in 5.8%. The median PICU length of stay was three days (IQR, 2–5), and the observed mortality was 1.8% (763 deaths). The predicted mortality by PIM3 was 1.8% (SMR 1.00; 95% CI 0.94–1.08) and by PIM2 was 2.1% (SMR 0.90; 95% CI 0.83–0.96). Both scores had good discrimination (PIM3 AUROC = 0.88 and PIM2 AUROC = 0.89). In calibration analysis, both scores overestimated mortality in the 0%–3% risk range, PIM3 tended to underestimate mortality in medium-risk patients (9%–46% risk range), and PIM2 also overestimated mortality in high-risk patients (70%–100% mortality risk).ConclusionsBoth scores had a good discrimination ability but poor calibration in different ranges, which deteriorated over time in the population studied.</p

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research