DESAFIOS DA ENERGIA FOTOVOLTAICA E AÇÕES DE SUSTENTABILIDADE PARA O PROGRAMA HABITACIONAL “MINHA CASA, MINHA VIDA”

O Brasil passa por uma crise no seu sistema de abastecimento energético, o que faz com que todos os setores da sociedade tenham de buscar por fontes alternativas de energia, principalmente limpas e renováveis, para suprirem as demandas atuais e futuras. Na busca de uma nova solução para o problema e com o objetivo de verificar a viabilidade do uso da energia solar fotovoltaica para o abastecimento das residências do Programa “Minha Casa, Minha Vida”, em suas faixas 2 e 3, foi realizado um estudo sobre os pontos positivos e negativos da implantação dessa modalidade de geração de energia dentro das faixas do programa. Foi realizada uma pesquisa qualitativa, explicativa, com mais de 1.500 entrevistados cujo objetivo era verificar se a população possui conhecimento e incentiva as ações de sustentabilidade, energia fotovoltaica e incentivos indiretos destas ações das construtoras em seus empreendimentos imobiliários.  Com base nos dados coletados, foi possível verificar que há viabilidade em se implantar nos empreendimentos a geração de energia fotovoltaica, haja visto que as construtoras pioneiras no processo terão um retorno positivo, além de seus clientes, o meio ambiente e a matriz energética brasileira. Atualmente, no país, apenas uma construtora realiza a implantação de sistema fotovoltaico e ações de sustentabilidade no programa de habitação popular “Minha Casa, Minha Vida”, desta forma, será estudado apenas esta construtora

Violência doméstica contra a mulher na visão do agente comunitário de saúde

This study addresses violence against women from the perspective of Community Health Agents and related care practices developed at the basic care level. It aims to understand their opinions and care practices in daily care delivery in order to support training of workers on this theme. The theoretical-methodological reference was gender violence as a social construct and ideology as a social product and guider of health care practices. Data collection was carried out through a questionnaire with closed questions addressing these professionals' positions in relation to facts in the care delivery context. The results showed that positions and conceptions are mostly supported by common perceptions, that is, they do not differ from women victims of violence or lay people in general, which leads to the conclusion that it is necessary to broaden the discussion of this problem, introducing the gender perspective in the acknowledgement and care of women.Se trata de una investigación sobre la visión del agente comunitario de salud acerca de la violencia contra la mujer y las prácticas de los cuidados correspondientes, desarrollados en el sector de la atención básica de salud. Tuvo como objetivo comprender el posición y las prácticas de los cuidados en lo cotidiano del trabajo en salud, para subsidiar procesos de calificación del trabajador al respecto del tema. El marco teórico metodológico fue la violencia de género como constructo social y la ideología como producto social y orientador de las prácticas de salud. La recolección de datos fue realizada mediante aplicación de cuestionario con preguntas cerradas, acerca de la posición delante de hechos de la realidad asistencial. Los resultados mostraron posiciones y concepciones mayoritariamente apoyadas en el sentido común, o sea, no eran diferentes, en nada, de las que tenían las mujeres víctimas de violencia o de las opiniones de los legos en general, llevando a la conclusión de que es necesario ampliar el espacio de discusión del problema, propiciando la introducción de la perspectiva de género en el reconocimiento y en la atención a las mujeres.Trata-se de pesquisa sobre a visão do agente comunitário de saúde acerca da violência contra a mulher e as práticas cuidativas correspondentes, desenvolvidas no nível da atenção básica de saúde. Teve como objetivo compreender o posicionamento e as práticas cuidativas no cotidiano do trabalho em saúde, para subsidiar processos de qualificação do trabalhador a respeito do tema. O referencial teórico-metodológico foi a violência de gênero como construto social e a ideologia como produto social e norteador das práticas de saúde. A coleta de dados foi realizada mediante aplicação de questionário com perguntas fechadas, acerca do posicionamento diante de fatos da realidade assistencial. Os resultados mostraram posições e concepções majoritariamente apoiadas no senso comum, ou seja, nada diferindo das mulheres vítimas de violência ou leigos em geral, levando à conclusão de que é necessário ampliar o espaço de discussão do problema, propiciando a introdução da perspectiva de gênero no reconhecimento e no atendimento às mulheres

Domestic violence against women from the perspective of the community health agent

Trata-se de pesquisa sobre a visão do agente comunitário de saúde acerca da violência contra a mulher e as práticas cuidativas correspondentes, desenvolvidas no nível da atenção básica de saúde. Teve como objetivo compreender o posicionamento e as práticas cuidativas no cotidiano do trabalho em saúde, para subsidiar processos de qualificação do trabalhador a respeito do tema. O referencial teórico-metodológico foi a violência de gênero como construto social e a ideologia como produto social e norteador das práticas de saúde. A coleta de dados foi realizada mediante aplicação de questionário com perguntas fechadas, acerca do posicionamento diante de fatos da realidade assistencial. Os resultados mostraram posições e concepções majoritariamente apoiadas no senso comum, ou seja, nada diferindo das mulheres vítimas de violência ou leigos em geral, levando à conclusão de que é necessário ampliar o espaço de discussão do problema, propiciando a introdução da perspectiva de gênero no reconhecimento e no atendimento às mulheres.Se trata de una investigación sobre la visión del agente comunitario de salud acerca de la violencia contra la mujer y las prácticas de los cuidados correspondientes, desarrollados en el sector de la atención básica de salud. Tuvo como objetivo comprender el posición y las prácticas de los cuidados en lo cotidiano del trabajo en salud, para subsidiar procesos de calificación del trabajador al respecto del tema. El marco teórico metodológico fue la violencia de género como constructo social y la ideología como producto social y orientador de las prácticas de salud. La recolección de datos fue realizada mediante aplicación de cuestionario con preguntas cerradas, acerca de la posición delante de hechos de la realidad asistencial. Los resultados mostraron posiciones y concepciones mayoritariamente apoyadas en el sentido común, o sea, no eran diferentes, en nada, de las que tenían las mujeres víctimas de violencia o de las opiniones de los legos en general, llevando a la conclusión de que es necesario ampliar el espacio de discusión del problema, propiciando la introducción de la perspectiva de género en el reconocimiento y en la atención a las mujeres.This study addresses violence against women from the perspective of Community Health Agents and related care practices developed at the basic care level. It aims to understand their opinions and care practices in daily care delivery in order to support training of workers on this theme. The theoretical-methodological reference was gender violence as a social construct and ideology as a social product and guider of health care practices. Data collection was carried out through a questionnaire with closed questions addressing these professionals' positions in relation to facts in the care delivery context. The results showed that positions and conceptions are mostly supported by common perceptions, that is, they do not differ from women victims of violence or lay people in general, which leads to the conclusion that it is necessary to broaden the discussion of this problem, introducing the gender perspective in the acknowledgement and care of women

Is self-report sleepiness associated with cognitive performance in temporal lobe epilepsy?

Vascouto HD, Rodrigues de Oliveira Thais ME, Osorio CM, et al. Is self-report sleepiness associated with cognitive performance in temporal lobe epilepsy? ARQUIVOS DE NEURO-PSIQUIATRIA. 2018;76(9):575-581.Sleepiness and cognitive impairment are common symptoms observed in patients with epilepsy. We investigate whether self-reported sleepiness is associated with cognitive performance in patients with refractory mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). Seventy-one consecutive patients with MTLE-HS were evaluated with the Stanford Sleepiness Scale (SSS) before neuropsychological evaluation. Their mean SSS scores were compared with controls. Each cognitive test was compared between patients with (SSS >= 3) or without sleepiness (SSS < 3). Imbalances were controlled by regression analysis. Patients reported a significantly higher degree of sleepiness than controls (p < 0.0001). After multiple linear regression analysis, only one test (RAVLT total) remained associated with self-reported sleepiness. Conclusion: Self-reported sleepiness was significantly higher in MTLE-HS patients than controls, but did not affect their cognitive performance. If confirmed in other populations, our results may have implications for decision making about sleepiness screening in neuropsychological settings

TRABALHO DE PARTO E O PARTO: COMPREENSÃO DE MULHERES E DESVELAMENTO DA SOLICITUDE COMO POSSIBILIDADE ASSISTENCIAL

RESUMO Introdução: a implementação das boas práticas no trabalho de parto e parto é uma ação potente para proporcionar mais conforto e oferecer autonomia à mulher durante esse evento. Os profissionais de saúde desempenham papel primordial, pois é preciso que desde o pré-natal a gestante seja orientada quanto ao parto, sendo-lhe garantido mais acesso às informações sobre esse evento. Método: esta é uma investigação de natureza qualitativa com abordagem fenomenológica com base no referencial teórico-filosófico-metodológico de Martin Heidegger, objetivando compreender os significados e desvelar os sentidos do vivido do trabalho de parto e parto. Teve como cenário um centro de parto normal intra-hospitalar no interior do estado de Minas Gerais, Brasil, e foram participantes 15 mulheres que vivenciaram o trabalho de parto vaginal em entrevista aberta realizada nos meses de julho e agosto de 2014 Resultados: da análise compreensiva emergiu a unidade de significado no processo de parturição: que o soro aumenta a dor, o chuveiro ajuda e ao ser escutada se fortalece. A hermenêutica hedeggeriana desvelou os sentidos de estar-com, ser-de-possibilidades, a solicitude substitutivo-dominadora e a solicitude antecipativo-liberatória. Conclusão: a mulher trouxe à luz que a valorização da equipe de Enfermagem e médica não está restrita à execução de tarefas, pois se sente mais bem cuidada quando os profissionais oferecem uma assistência que vê o outro como um ser que tem possibilidades de escolha

Abstracts

Tradução, para a língua inglesa, dos resumos dos artigos publicados nesta edição

Characterization of individuals at high risk of developing melanoma in Latin America: bases for genetic counseling in melanoma

PURPOSE: CDKN2A is the main high-risk melanoma-susceptibility gene, but it has been poorly assessed in Latin America. We sought to analyze CDKN2A and MC1R in patients from Latin America with familial and sporadic multiple primary melanoma (SMP) and compare the data with those for patients from Spain to establish bases for melanoma genetic counseling in Latin America. METHODS: CDKN2A and MC1R were sequenced in 186 Latin American patients from Argentina, Brazil, Chile, Mexico, and Uruguay, and in 904 Spanish patients. Clinical and phenotypic data were obtained. RESULTS: Overall, 24 and 14% of melanoma-prone families in Latin America and Spain, respectively, had mutations in CDKN2A. Latin American families had CDKN2A mutations more frequently (P = 0.014) than Spanish ones. Of patients with SMP, 10% of those from Latin America and 8.5% of those from Spain had mutations in CDKN2A (P = 0.623). The most recurrent CDKN2A mutations were c.-34G>T and p.G101W. Latin American patients had fairer hair (P = 0.016) and skin (P < 0.001) and a higher prevalence of MC1R variants (P = 0.003) compared with Spanish patients. CONCLUSION: The inclusion criteria for genetic counseling of melanoma in Latin America may be the same criteria used in Spain, as suggested in areas with low to medium incidence, SMP with at least two melanomas, or families with at least two cases among first- or second-degree relatives.Genet Med 18 7, 727-736

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.

BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Background A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. Methods This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. Findings Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials