CONDIÇÕES SENSÍVEIS À ATENÇÃO PRIMÁRIA EM HOSPITAL DE REFERÊNCIA PEDIÁTRICA NO MARANHÃO / AMBULATORY CARE SENSITIVE CONDITIONS IN A PEDIATRIC REFERRAL HOSPITAL IN MARANHÃO

Introdução: As Condições Sensíveis à Atenção Primária (CSAP) são um excelente indicador da efetividade dessa atenção. Objetivo:Analisar as internações no setor de pediatria de um Hospital Universitário no Maranhão, em 2012, em estudo descritivo eretrospectivo. Métodos: Dados de prontuários de pacientes até 16 anos e 11 meses de idade foram avaliados pelo software IBMSPSS Statistics 20, tendo como parâmetro a Lista Brasileira de CSAP. Para frequências de CSAP por faixa etária aplicou-se teste de2 x de aderência, com 5% de significância. Resultados: Das 506 internações, 17% foram por CSAP, 51% do sexo masculino e 36%da faixa etária de 1 a 4 anos; 50% eram residentes na capital do estado e 65,1% em zona urbana; em 57% dos municípios de residêncianão havia Unidade Básica de Saúde da Família. A média do tempo de internação foi 23,2 dias. O grupo CSAP mais frequentefoi o das pneumonias (25,5%). Conclusão: As internações por CSAP mais frequentes foram Pneumonias e Infecções nos rins etrato urinário e a faixa etária com mais internações foi a de 1 a 4 anos, sendo semelhantes a outros estudos e são um alerta paraa investigação dos determinantes da população e para melhorias na Atenção Primária.Palavras-chave: Atenção Primária. Condições Sensíveis à Atenção Primária. Hospitalização.AbstractIntroduction: The Ambulatory Care Sensitive Conditions (ACSC) are an excellent indicator of the effectiveness of this care.Objective: It was analyzed hospitalizations in the pediatric sector of a University Hospital in Maranhão in 2012, in a descriptiveand retrospective study. Methods: Secondary data, collected in medical records of patients of up to 16 years old, were analyzedby IBM SPSS Statistics 20 software, classified according to Brazilian List of ACSC. To analyze frequencies of ACSC among age2 groups was applied x test of adherence and 5% of significance. Results: Among 506 hospitalizations, 17% were by ACSC, malesex (51%) and age 1 to 4 years old (36%); 50% were resident on the capital of state and 65,1% were from urban areas; and 57%did not have support of Family Health Strategy. Mean hospitalization time was of 23,2 days. The most frequent ACSC group waspneumonias (25,5%). Conclusion: The hospitalizations by ACSC the most frequent groups were Pneumonias and Kidney andurinary tract infections and the age range with more hospitalizations was 1 to 4 years, being similar to other studies and are analert for investigation of the determinants of the population and for improvements in Primary Care.Keywords: Primary Health Care. Ambulatory Care Sensitive Conditions. Hospitalization

Registro e perfil ecotoxicológico de produtos para controle de Aedes aegypti

Introduction: Arboviruses transmitted by Aedes aegypti have big relevance for public health worldwide, with chemical vector control being an important mitigation strategy. Nevertheless, the intensive use of insecticides is associated with resistance and environmental toxicity. That is why it is essential to develop and regulate new products, effective and sustainable. Objective: To describe the requirements for regulation of insecticides and repellents in Brazil, in the light of international guidelines. To present, comparatively, the active ingredients approved in Brazil, United States (USA) and the European Union (EU). Finally, to conduct a survey of ecotoxicological studies from active ingredients used for vector control. Method: Narrative review of national and international regulatory instruments, scientific literature, consultation with regulatory agencies and assess to ECOTOX Knowledgebase. Results: Brazilian requirements are in line with international standards. All insecticides active ingredients available in the USA have a monograph approved in Brazil by the National Health Surveillance Agency; the EU was more restrictive. There are fewer topical repellents available in Brazil and in the EU, compared to the USA. Many of the insecticides approved for vector control pose a risk to non-target organisms. However, we did not identify studies for some of them in the researched database. Conclusions: The EU seems  to be the most restrictive agency when it comes to registering insecticides. Specific guides on development of innovative products for vector control are needed, as well as greater transparency in research instruments at the Brazilian agency website. This review also reiterates the necessity of more ecotoxicological analysis regarding insecticides, considering their potential environmental hazard. Introdução: Arboviroses transmitidas pelo Aedes aegypti têm grande relevância para a saúde pública, sendo o controle químico do vetor uma importante estratégia de mitigação. Entretanto, o uso intensivo de pesticidas está associado a seleção de insetos resistentes e impacto ambiental. Por isso, é essencial desenvolver e regulamentar novos produtos, eficazes e sustentáveis. Objetivo: Descrever os requisitos para regulação  de inseticidas e repelentes no Brasil, à luz de orientações internacionais. Comparar os ativos regulamentados no país com os disponíveis nos Estados Unidos (EUA) e União Europeia (UE). Por fim, realizar um levantamento de estudos ecotoxicológicos dos ativos empregados no controle vetorial. Método: Revisão narrativa de instrumentos regulatórios nacionais e internacionais, literatura científica, consulta a agências regulatórias e ao ECOTOX Knowledgebase. Resultados: As normas brasileiras trazem exigências consoantes com as internacionais. Todos os ativos disponíveis nos EUA têm monografia aprovada pela Anvisa; já a UE mostrou-se mais restritiva. Há menos repelentes tópicos disponíveis no Brasil e na UE, comparando-se com EUA. Muitos dos inseticidas aprovados para controle vetorial representam risco para organismos não alvo. Ainda assim, não identificamos quaisquer estudos para alguns dos produtos no banco de dados pesquisado. Conclusões:  A UE mostrou-se a agência mais restritiva com relação ao registro de inseticidas. Existe a necessidade de guias com orientações específicas sobre o desenvolvimento de produtos inovadores para o controle do mosquito, bem como de ferramentas de busca com maior transparência na página da agência brasileira. Finalmente, esta revisão reitera a importância de análises ecotoxicológicas mais abrangentes para os produtos em questão, considerando seu potencial dano ambiental

Hepatocyte growth factor is upregulated in ischemic retina and contributes to retinal vascular leakage and neovascularization

In patients with macular edema due to ischemic retinopathy, aqueous levels of hepatocyte growth factor (HGF) correlate with edema severity. We tested whether HGF expression and activity in mice with oxygen-induced ischemic retinopathy supports a role in macular edema. In ischemic retina, HGF was increased in endogenous cells and macrophages associated with retinal neovascularization (NV). HGF activator was increased in and around retinal vessels potentially providing vascular targeting. One day after intravitreous injection of HGF, VE-cadherin was reduced and albumin levels in retina and vitreous were significantly increased indicating vascular leakage. Injection of VEGF caused higher levels of vitreous albumin than HGF, and co-injection of both growth factors caused significantly higher levels than either alone. HGF increased the number of macrophages on the retinal surface, which was blocked by anti-c-Met and abrogated in chemokine (C-C motif) ligand 2 (CCL2)−/− mice. Injection of anti-c-Met significantly decreased leakage within 24 hours and after 5 days it reduced retinal NV in mice with ischemic retinopathy, but had no effect on choroidal NV. These data indicate that HGF is a pro-permeability, pro-inflammatory, and pro-angiogenic factor and along with its activator is increased in ischemic retina providing support for a potential role of HGF in macular edema in ischemic retinopathies.Fil: Lorenc, Valeria Erika. Universidad Austral. Facultad de Ciencias Biomédicas. Instituto de Investigaciones en Medicina Traslacional. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones en Medicina Traslacional; Argentina. University Johns Hopkins; Estados UnidosFil: Lima e Silva, Raquel. University Johns Hopkins; Estados UnidosFil: Hackett, Sean F.. University Johns Hopkins; Estados UnidosFil: Fortmann, Seth D.. University Johns Hopkins; Estados UnidosFil: Liu, Yuanyuan. University Johns Hopkins; Estados UnidosFil: Campochiaro, Peter A.. University Johns Hopkins; Estados Unido

Ecocide in the Cerrados (Brazilian Savanna): agribusiness, water spoliation and pesticide contamination

Com 65 milhões de anos, os Cerrados constituem-se de intensa biodiversidade, que tem relação com sua abundância em águas e a dinâmica do ciclo hidrológico, perenizando rios de seis das oito regiões hidrográficas do país e transbordando suas águas para outros países do subcontinente americano. O bioma abriga diversos povos e comunidades tradicionais que constituíram modos de vida e saberes ancestrais. Nas últimas décadas, o Estado vem implementando nesse território políticas de desenvolvimento subordinadas ao neoextrativismo e à acumulação por espoliação de grandes corporações. Assim, os Cerrados têm sido invadidos pela expansão do agronegócio, que resultam em intensa conflitividade no bioma, além de tentar exterminar os modos de vida dos diferentes povos. Foram reunidas informações e análises para caracterizar o Ecocídio dos Cerrados, onde mais de 110 milhões de hectares do bioma estão ocupados pelo agronegócio – com área plantada para produzir 75% das commodities soja-cana-milho-algodão cultivadas no Brasil e as áreas de pastagem destinadas à produção de carne bovina. Isso implica na destruição de 52% da vegetação nativa e no consumo de 91,8% das águas superficiais e subterrâneas usadas na irrigação por pivôs centrais, resultando na migração de nascentes, na interrupção dos fluxos dos rios e na redução dos volumes dos aquíferos, como se aprofunda na análise dos conflitos em curso no oeste da Bahia e na bacia dos rios Formoso e Javaés/TO. A isso, somam-se os impactos do uso intensivo de agrotóxicos sobre todas as formas de vida – são mais de 600 milhões de litros de venenos anualmente, concentrando 73,5% do total de agrotóxicos consumidos no país em 2018, sobre a saúde humana resulta em taxas de intoxicação exógena e câncer infanto-juvenil nos Cerrados maiores que as médias nacionais. Os Cerrados caracterizam-se como zona de sacrifício do desenvolvimento brasileiro, em que natureza e povos são saqueados para garantir a acumulação de poucos, num processo de Ecocídio que é o produto moderno-colonial racista no bioma.At 65 million years old, the Cerrados biome is constituted of wide biodiversity related to its water’s abundance and hydrological cycle’s dynamics, perpetuating rivers in six of eight Brazilian river basins and overflowing its waters to other countries of the South American subcontinent. The biome hosts a diverse set of traditional communities that constituted livelihoods based on their ancestral knowledge. In recent decades, the Brazilian State has been implementing development policies in these territories that are subordinated to neo-extractivism and growth by the plunder of large corporations. Thus, the Cerrados biome was invaded by the agribusiness accelerated expansion that results in intense conflicts, threatening or refraining the livelihood of different populations. Information and analysis were gathered to characterize the Cerrados biome Ecocide, where around 120 million acres are destined to produce 75% of Brazilian commodities soy-cane-corn-cotton, which destroyed 52% of the native vegetation, and consumed 91.8% of surface water and groundwater in pivot irrigation systems, resulting in the migration of springs, the interruption of river flows and the reduction of aquifer volumes, as observed in the analysis of ongoing conflicts in western Bahia and the basin of the Formoso and Javaés rivers, in Tocantins State. Also, the impacts of intensive use of pesticides on all forms of life are observed: there are more than 600 million liters of poison annually, concentrating 73.5% of the total pesticides consumed in the country in 2018, which, regarding human health, results in rates of exogenous poisoning and childhood cancer higher than the national averages. The Cerrado biome is characterized as a sacrificial zone of the Brazilian development model where nature, and populations, are plundered to guarantee the growth of few in an Ecocide process that is a modern-colonial racist product in this territory

Consumer Knowledge about Dietary Relevance of Fruits and Vegetables: A Study Involving Participants from Portugal and France

Fruits and vegetables are recommended as low-calorie foods that contribute to the proper intake of necessary micronutrients, macronutrients, and bioactive compounds with health benefits. However, the recommendations for the dietary intake of these foods fail to be attained in most European countries. For this reason, promoting more knowledge about the health effects of fruits and vegetables is essential to decrease the incidence of chronic diseases. This study was conducted to investigate the knowledge of the health benefits of fruits and vegetables among the population of Portugal and France. The present work involved a questionnaire survey of 639 participants (257 from Portugal and 382 from France). The results revealed that most participants were young females (68.9%) with good education (76%) and an average weight range. They consumed a varied diet (57%) but had body dissatisfaction (63.2%). The respondents had good knowledge about the health effects of fruits and vegetables. However, the French population knew more about the theme than the Portuguese. Portuguese individuals were more likely to have incomplete information. Gender and education significantly influenced knowledge levels, with females and highly educated individuals demonstrating greater understanding. Dissatisfaction with body weight drives individuals to seek nutrition information. This investigation enhances our comprehension of the factors that affect knowledge of vegetable and fruit consumption among young adults in Portugal and France. Moreover, it highlights the importance of implementing focused educational programs to enhance nutrition literacy, particularly for less-aware demographic groups. Going forward, a more in-depth analysis of these factors could assist in creating more efficient strategies to encourage healthier dietary habits and improve nutrition literacy among these communities.info:eu-repo/semantics/publishedVersio

O assistente social no enfrentamento a violência contra o idoso nas instituições de longa permanência / The social worker in facing violence against elderly in long-staying institutions

O estudo objetiva, mediante discussão bibliográfica, entender a relação do aumento da expectativa de vida no Brasil com o abandono de idosos, investigar os efeitos causados nos idosos em detrimento do abandono e discutir a ação do assistente social no enfrentamento a violência contra o idoso na proteção social especial de alta complexidade do Sistema Único de Assistência Social. São expostos dados recentes das modificações na pirâmide etária, demonstrando o acréscimo lento do número de crianças e adolescentes de modo paralelo ao aumento de cidadãos em idade ativa e idosos. Ademais, apresenta-se o que consta nas legislações no tocante aos maus tratos e abandono de idosos, quais são os problemas frequentes entre os idosos que sofrem essa violência e como o assistente social intervenciona nesses casos. Conclui-se que o abandono não deriva apenas da negligência familiar, mas muitas vezes da falta de suporte do Estado para atender a esse público

Reverse and Forward Engineering of Local Voltage Control in Distribution Networks

The increasing penetration of renewable and distributed energy resources in distribution networks calls for real-time and distributed voltage control. In this paper we investigate local Volt/VAR control with a general class of control functions, and show that the power system dynamics with non-incremental local voltage control can be seen as distributed algorithm for solving a well-defined optimization problem (reverse engineering). The reverse engineering further reveals a fundamental limitation of the non-incremental voltage control: the convergence condition is restrictive and prevents better voltage regulation at equilibrium. This motivates us to design two incremental local voltage control schemes based on the subgradient and pseudo-gradient algorithms respectively for solving the same optimization problem (forward engineering). The new control schemes decouple the dynamical property from the equilibrium property, and have much less restrictive convergence conditions. This work presents another step towards developing a new foundation -- network dynamics as optimization algorithms -- for distributed realtime control and optimization of future power networks

A collagen IV-derived peptide disrupts α5β1 integrin and potentiates Ang2/Tie2 signaling

The angiopoietin (Ang)/Tie2 signaling pathway is essential for maintaining vascular homeostasis, and its dysregulation is associated with several diseases. Interactions between Tie2 and α5 β1 integrin have emerged as part of this control; however, the mechanism is incompletely understood. AXT107, a collagen IV–derived peptide, has strong antipermeability activity and has enabled the elucidation of this previously undetermined mechanism. Previously, AXT107 was shown to inhibit VEGFR2 and other growth factor signaling via receptor tyrosine kinase association with specific integrins. AXT107 disrupts α5 β1 and stimulates the relocation of Tie2 and α5 to cell junctions. In the presence of Ang2 and AXT107, junctional Tie2 is activated, downstream survival signals are upregulated, F-actin is rearranged to strengthen junctions, and, as a result, endothelial junctional permeability is reduced. These data suggest that α5 β1 sequesters Tie2 in nonjunctional locations in endothelial cell membranes and that AXT107-induced disruption of α5 β1 promotes clustering of Tie2 at junctions and converts Ang2 into a strong agonist, similar to responses observed when Ang1 levels greatly exceed those of Ang2. The potentiation of Tie2 activation by Ang2 even extended to mouse models in which AXT107 induced Tie2 phosphorylation in a model of hypoxia and inhibited vascular leakage in an Ang2-overexpression transgenic model and an LPS-induced inflammation model. Because Ang2 levels are very high in ischemic diseases, such as diabetic macular edema, neovascular age-related macular degeneration, uveitis, and cancer, targeting α5 β1 with AXT107 provides a potentially more effective approach to treat these diseases.Fil: Mirando, Adam C.. University Johns Hopkins; Estados UnidosFil: Shen, Jikui. University Johns Hopkins; Estados UnidosFil: Silva, Raquel Lima E.. University Johns Hopkins; Estados UnidosFil: Chu, Zenny. University Johns Hopkins; Estados UnidosFil: Sass, Nicholas C.. University Johns Hopkins; Estados UnidosFil: Lorenc, Valeria Erika. University Johns Hopkins; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Green, Jordan J.. University Johns Hopkins; Estados Unidos. AsclepiX Therapeutics; Estados UnidosFil: Campochiaro, Peter A.. University Johns Hopkins; Estados UnidosFil: Popel, Aleksander S.. University Johns Hopkins; Estados UnidosFil: Pandey, Niranjan B.. University Johns Hopkins; Estados Unidos. AsclepiX Therapeutics; Estados Unido

Actitudes de los estudiantes españoles ante la ampliación de los derechos sociales de hijos de inmigrantes: Un análisis de los valores como discurso legitimador

En este artículo se analizan las relaciones entre los valores y las actitudes ante las políticas de acción afirmativa a favor de los hijos de inmigrantes en España. En el estudio participaron 110 estudiantes de una universidad pública española. Los participantes debían indicar cuál era su actitud ante la posible creación de un sistema de cuotas de acceso a la universidad para hijos de inmigrantes. Los resultados nos llevan a distinguir, por una parte, los discursos estructurados alrededor de los valores de mérito y esfuerzo personal, que sirvieron como justifi cación de las actitudes más contrarias a un sistema de cuotas para inmigrantes y, por otra, aquellos otros centrados en los valores de igualdad, asociados con posiciones más ambivalentes