Direitas políticas, atores religiosos e projeto conservador no Uruguai: a agenda anti-gênero no centro

Uruguay, like other countries in the region, experienced a conservative political regression after fifteen years of progressive governments, with a neoliberal government, which has promoted a pro-life strategy, and with an unprecedented presence of personalities linked to the military and religious arena. Anti-feminist movements and policies in Uruguay gained new impetus with the change of government in 2020, managing to promote discursive and legal changes. At the center of the discourse and proposals appears the strengthening of the traditional family, hegemonic masculinity and the limitation of rights related to sexual health. The article examines the implementation of the conservative project in Uruguay at two levels of action: in the promotion of legal regulations with anti-feminist content, and in the legitimization of anti-gender discourses on the one hand. On the other hand, the articulation of social, political and religious actors that occurs around this agenda is studied, at the national level and in its transnational articulation. Both levels of action are articulated in public policies that are promoted by the Executive Branch in key ministries such as public health and social development.Uruguay, al igual que otros países de la región, experimentó una regresión política conservadora luego de quince años de gobiernos progresistas, con un gobierno de corte neoliberal, que ha impulsado una estrategia provida, y con una presencia inédita de personalidades vinculadas a los ámbitos religiosos y militares. Los movimientos y políticas antifeministas en Uruguay cobraron nuevo ímpetu con el cambio de gobierno en 2020, logrando impulsar cambios discursivos y legales.  En el centro del discurso y las propuestas aparece el fortalecimiento de la familia tradicional, la masculinidad hegemónica y la limitación de los derechos referidos a la salud sexual. El artículo examina la implantación del proyecto conservador en Uruguay en dos niveles de acción: en la promoción de normativa legal con contenido antifeminista, y en la legitimación de discursos antigénero por un lado. Por otro, se estudia la articulación de actores sociales, políticos y religiosos que se produce en torno a esta agenda, a nivel nacional y en su articulación transnacional. Ambos niveles de acción se articulan en políticas públicas que se impulsan desde el Poder Ejecutivo en ministerios claves como salud pública y desarrollo social.Uruguai, assim como outros países da região, experimenta uma regressão política conservadora após quinze anos de governos progressistas, com um governo neoliberal, que promoveu uma estratégia pró-vida, e com uma presença sem precedentes de personalidades ligadas aos campos religioso e militar. Os movimentos e políticas antifeministas no Uruguai ganharam impulso com a mudança de governo em 2020, promovendo mudanças discursivas e jurídicas. No centro do discurso e das propostas aparecem o fortalecimento da família tradicional, a masculinidade hegemônica e a limitação de direitos relacionados à saúde sexual. O artigo examina a implementação do projeto conservador no Uruguai em dois níveis de ação: na promoção de regulamentações legais com conteúdo antifeminista, e na legitimação de discursos antigênero, por um lado. Por outro lado, estuda-se a articulação de atores sociais, políticos e religiosos que ocorre em torno desta agenda, a nível nacional e na sua articulação transnacional. Ambos os níveis de atuação estão articulados em políticas públicas promovidas pelo Poder Executivo em ministérios-chave como saúde pública e desenvolvimento social

Embryonic development, hatching time and newborn juveniles of Octopus tehuelchus under two culture temperatures

The development of cephalopods early life stages is strongly influenced by environmental variables, especially temperature. Octopus tehuelchus (d'Orbigny, 1834) is an Atlantic Patagonian fishery resource currently being studied as a new species for cultivation; however it is not known how temperature modulates its early life stages. In this work, egg masses were artificially incubated at 13 and 16 °C under controlled aquarium conditions. In each thermal treatment, the stages of embryonic development, embryo morphometry and survival throughout embryogenesis, as well as embryogenesis duration were recorded. After hatching, the morphological description of the juveniles was achieved and survival time in starvation was calculated for both temperatures. At 16 °C the mean embryonic duration was 85 days shorter than at 13 °C. For both thermal treatments, the highest mortalities occurred up to the beginning of organogenesis, and no significant differences in hatching success were observed. The temperature also showed the potential to increase or decrease the juvenile performance at the early post hatching period. This resulted in a significant reduction in size and weight of new born juveniles at 13 °C but also in an average increment of 7 days in their survival in starvation when compared to octopus reared at 16 °C. The chromatophore pattern was similar for both thermal treatments and was characteristic of juveniles of this species. The observed differences seem to show adaptive mechanisms that optimize embryos and juveniles viability under the different environmental temperatures that can be found in the northern Atlantic Patagonian coast. From a practical point of view, our findings are important to define the biological parameters and associated procedures for the cultivation of the early life stages of O. tehuelchus.Fil: Braga, Ramiro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto de Biología de Organismos Marinos; Argentina. Universidad Nacional de la Patagonia "San Juan Bosco"; ArgentinaFil: Van Der Molen, Silvina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto de Biología de Organismos Marinos; ArgentinaFil: Pontones, Julian. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto de Biología de Organismos Marinos; Argentina. Universidad Nacional de la Patagonia "San Juan Bosco"; ArgentinaFil: Ortiz, Nicolás. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto de Biología de Organismos Marinos; Argentin

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Immunocompromised patients with acute respiratory distress syndrome: Secondary analysis of the LUNG SAFE database

Background: The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. Methods: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents. Results: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiogenic shock were their most common risk factors for ARDS. Hospital mortality was higher in immunocompromised than in immunocompetent patients (52.4% vs 36.2%; p &lt; 0.0001), despite similar severity of ARDS. Decisions regarding limiting life-sustaining measures were significantly more frequent in immunocompromised patients (27.1% vs 18.6%; p &lt; 0.0001). Use of noninvasive ventilation (NIV) as first-line treatment was higher in immunocompromised patients (20.9% vs 15.9%; p = 0.0048), and immunodeficiency remained independently associated with the use of NIV after adjustment for confounders. Forty-eight percent of the patients treated with NIV were intubated, and their mortality was not different from that of the patients invasively ventilated ab initio. Conclusions: Immunosuppression is frequent in patients with ARDS, and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent patients, particularly the greater use of NIV as first-line ventilation strategy. Compared with immunocompetent subjects, they have higher mortality regardless of ARDS severity as well as a higher frequency of limitation of life-sustaining measures. Nonetheless, nearly half of these patients survive to hospital discharge. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013

Immunocompromised patients with acute respiratory distress syndrome : Secondary analysis of the LUNG SAFE database

The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. Methods: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents. Results: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiogenic shock were their most common risk factors for ARDS. Hospital mortality was higher in immunocompromised than in immunocompetent patients (52.4% vs 36.2%; p < 0.0001), despite similar severity of ARDS. Decisions regarding limiting life-sustaining measures were significantly more frequent in immunocompromised patients (27.1% vs 18.6%; p < 0.0001). Use of noninvasive ventilation (NIV) as first-line treatment was higher in immunocompromised patients (20.9% vs 15.9%; p = 0.0048), and immunodeficiency remained independently associated with the use of NIV after adjustment for confounders. Forty-eight percent of the patients treated with NIV were intubated, and their mortality was not different from that of the patients invasively ventilated ab initio. Conclusions: Immunosuppression is frequent in patients with ARDS, and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent patients, particularly the greater use of NIV as first-line ventilation strategy. Compared with immunocompetent subjects, they have higher mortality regardless of ARDS severity as well as a higher frequency of limitation of life-sustaining measures. Nonetheless, nearly half of these patients survive to hospital discharge. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013

Educación religiosa en América Latina y el Caribe : reflexiones y voces plurales para caminos pedagógicos interculturales

Compilador: José Mario Méndez Méndez Sección 1. Diversidad de Convicciones: creencias y espiritualidades. Sección 2. Textualidades Sagradas Sección 3. Ciencias de la religión. Sección 4. Expresiones de la diversidad. Sección 5. Religión y Cultura. Sección 6. Aportes pedagógicos. Sección 7. Educación religiosa en América Latina. Sección 8. Educación religiosa y espacios. Sección 9. Aspectos Jurídicos.El presente texto reúne los aportes de muchas personas que-desde diferentes países del continente-desean contribuir a la revisión y transformación intercultural de la educación religiosa en Latinoamérica y el Caribe. Como lo sugiere el título, confluyen aquí reflexiones y voces plurales para caminos pedagógicos interculturales. Cada una de las "voces" que conforman este texto expresa la intención de promover una educación liberadora-intercultural-decolonial, a partir de los desafíos que reconocemos en la realidad latinoamericana-caribeña.This text brings together the contributions of many people who-from different countries of the continent-wish to contribute to the revision and intercultural transformation of religious education in Latin America and the Caribbean. As the title suggests, reflections and plural voices converge here for intercultural pedagogical paths. Each one of the "voices" that make up this text expresses the intention of promoting a liberating-intercultural-decolonial education, based on the challenges that we recognize in the Latin American-Caribbean reality.Universidad Bíblica Latinoamericana, FONAPER, Foro de Educación Religiosa Costarricense, Universidad Regional de Blumenau, UNOCHAOECÓ, Escuela Ecuménica de Ciencias de la ReligiónEscuela Ecuménica de Ciencias de la Religió

Mechanical ventilation in patients with cardiogenic pulmonary edema: a sub-analysis of the LUNG SAFE study

Background: Patients with acute respiratory failure caused by cardiogenic pulmonary edema (CPE) may require mechanical ventilation that can cause further lung damage. Our aim was to determine the impact of ventilatory settings on CPE mortality. Methods: Patients from the LUNG SAFE cohort, a multicenter prospective cohort study of patients undergoing mechanical ventilation, were studied. Relationships between ventilatory parameters and outcomes (ICU discharge/hospital mortality) were assessed using latent mixture analysis and a marginal structural model. Results: From 4499 patients, 391 meeting CPE criteria (median age 70 [interquartile range 59-78], 40% female) were included. ICU and hospital mortality were 34% and 40%, respectively. ICU survivors were younger (67 [57-77] vs 74 [64-80] years, p &lt; 0.001) and had lower driving (12 [8-16] vs 15 [11-17] cmH2O, p &lt; 0.001), plateau (20 [15-23] vs 22 [19-26] cmH2O, p &lt; 0.001) and peak (21 [17-27] vs 26 [20-32] cmH2O, p &lt; 0.001) pressures. Latent mixture analysis of patients receiving invasive mechanical ventilation on ICU day 1 revealed a subgroup ventilated with high pressures with lower probability of being discharged alive from the ICU (hazard ratio [HR] 0.79 [95% confidence interval 0.60-1.05], p = 0.103) and increased hospital mortality (HR 1.65 [1.16-2.36], p = 0.005). In a marginal structural model, driving pressures in the first week (HR 1.12 [1.06-1.18], p &lt; 0.001) and tidal volume after day 7 (HR 0.69 [0.52-0.93], p = 0.015) were related to survival. Conclusions: Higher airway pressures in invasively ventilated patients with CPE are related to mortality. These patients may be exposed to an increased risk of ventilator-induced lung injury. Trial registration Clinicaltrials.gov NCT02010073

Outcome of acute hypoxaemic respiratory failure: insights from the LUNG SAFE Study

Background: Current incidence and outcome of patients with acute hypoxaemic respiratory failure requiring mechanical ventilation in the intensive care unit (ICU) are unknown, especially for patients not meeting criteria for acute respiratory distress syndrome (ARDS). Methods: An international, multicentre, prospective cohort study of patients presenting with hypoxaemia early in the course of mechanical ventilation, conducted during four consecutive weeks in the winter of 2014 in 459 ICUs from 50 countries (LUNG SAFE). Patients were enrolled with arterial oxygen tension/inspiratory oxygen fraction ratio ≤300 mmHg, new pulmonary infiltrates and need for mechanical ventilation with a positive end-expiratory pressure of ≥5 cmH2O. ICU prevalence, causes of hypoxaemia, hospital survival and factors associated with hospital mortality were measured. Patients with unilateral versus bilateral opacities were compared. Findings: 12 906 critically ill patients received mechanical ventilation and 34.9% with hypoxaemia and new infiltrates were enrolled, separated into ARDS (69.0%), unilateral infiltrate (22.7%) and congestive heart failure (CHF; 8.2%). The global hospital mortality was 38.6%. CHF patients had a mortality comparable to ARDS (44.1% versus 40.4%). Patients with unilateral-infiltrate had lower unadjusted mortality, but similar adjusted mortality compared to those with ARDS. The number of quadrants on chest imaging was associated with an increased risk of death. There was no difference in mortality comparing patients with unilateral-infiltrate and ARDS with only two quadrants involved. Interpretation: More than one-third of patients receiving mechanical ventilation have hypoxaemia and new infiltrates with a hospital mortality of 38.6%. Survival is dependent on the degree of pulmonary involvement whether or not ARDS criteria are reached

Mechanical ventilation in patients with cardiogenic pulmonary edema: a sub-analysis of the LUNG SAFE study

Background: Patients with acute respiratory failure caused by cardiogenic pulmonary edema (CPE) may require mechanical ventilation that can cause further lung damage. Our aim was to determine the impact of ventilatory settings on CPE mortality. Methods: Patients from the LUNG SAFE cohort, a multicenter prospective cohort study of patients undergoing mechanical ventilation, were studied. Relationships between ventilatory parameters and outcomes (ICU discharge/hospital mortality) were assessed using latent mixture analysis and a marginal structural model. Results: From 4499 patients, 391 meeting CPE criteria (median age 70 [interquartile range 59-78], 40% female) were included. ICU and hospital mortality were 34% and 40%, respectively. ICU survivors were younger (67 [57-77] vs 74 [64-80] years, p &lt; 0.001) and had lower driving (12 [8-16] vs 15 [11-17] cmH2O, p &lt; 0.001), plateau (20 [15-23] vs 22 [19-26] cmH2O, p &lt; 0.001) and peak (21 [17-27] vs 26 [20-32] cmH2O, p &lt; 0.001) pressures. Latent mixture analysis of patients receiving invasive mechanical ventilation on ICU day 1 revealed a subgroup ventilated with high pressures with lower probability of being discharged alive from the ICU (hazard ratio [HR] 0.79 [95% confidence interval 0.60-1.05], p = 0.103) and increased hospital mortality (HR 1.65 [1.16-2.36], p = 0.005). In a marginal structural model, driving pressures in the first week (HR 1.12 [1.06-1.18], p &lt; 0.001) and tidal volume after day 7 (HR 0.69 [0.52-0.93], p = 0.015) were related to survival. Conclusions: Higher airway pressures in invasively ventilated patients with CPE are related to mortality. These patients may be exposed to an increased risk of ventilator-induced lung injury. Trial registration Clinicaltrials.gov NCT02010073