Coping with Gender Dysphoria in a Rural Environment during Adolescence

Gender dysphoria is socially more visible and discussed today, but still underdiagnosed. It refers to distress and/or impaired function caused by inconsistency between the sex assigned at birth and gender identification. Clinical manifestations are variable. Lack of training and investment in gender issues make the diagnosis and management in primary care complex, particularly in conservative and isolated communities, with poor access to information and specialized health services. We describe the diagnosis of gender dysphoria and use of a patient centered multidisciplinary and family approach in a 12-year-old rural born adolescent, assigned female at birth. Our aim is to raise awareness of early symptoms and signs of gender dysphoria and problems faced by transgender people and their families during childhood, leading to gender dysphoria, and we hope our successful approach might improve healthcare provision for these patients, particularly in rural areas

Análise do nível de Maturidade em Gestão do Conhecimento em uma Instituição Pública de Ensino Superior

Knowledge Management, as a sub-area of Information Science, has as its theme the analysis of its Maturity, which aims to identify the stage at which a particular Institution is positioned, combining theory with practice. Public Higher Education Institutions are objects of this theme, given that they are based on knowledge, with a view to promoting services to society. In this sense, this research is guided by the objective of analyzing the level of Maturity in Knowledge Management in a Public Institution of Higher Education, located in Minas Gerais, Brazil. This is a descriptive-quantitative investigation, which adopts an online survey and the Kaiser-Meyer-Olkin criteria, Cronbach's Alpha and Pearson's r criteria together with the p-value to confer dimensionality, reliability and validity to the indicators created. The Mean, Standard Deviation and 95% Confidence Interval are used to compute Maturity. As a result, the Public Higher Education Institution analyzed is positioned at maturity level two out of five, with 10 actions being presented for its elevation to the next stage. The limitation of this research was that it was applied in only one Public Institution of Higher Education. The analysis of other Public Institutions of Higher Education is a suggestion for future research, in order to carry out a comparative study of Maturity of Knowledge Management in Brazilian Institutions.La Gestión del Conocimiento, como subárea de las Ciencias de la Información, tiene como tema el análisis de su Madurez, que tiene como objetivo identificar la etapa en la que se encuentra posicionada una determinada Institución, combinando la teoría con la práctica. Las Instituciones de Educación Superior Públicas son objeto de este tema, dado que se basan en el conocimiento, con miras a promover servicios a la sociedad. En ese sentido, esta investigación se orienta por el objetivo de analizar el nivel de Madurez en la Gestión del Conocimiento en una Institución Pública de Educación Superior, ubicada en Minas Gerais, Brasil. Esta es una investigación descriptiva-cuantitativa, que utiliza una encuesta en línea y los criterios de Kaiser-Meyer-Olkin, Alpha de Cronbach y r de Pearson junto con el valor p para conferir dimensionalidad, confiabilidad y validez a los indicadores creados. La media, la desviación estándar y el intervalo de confianza del 95 % se utilizan para calcular el vencimiento. Como resultado, la Institución de Educación Superior Pública analizada se posiciona en el nivel de madurez dos de cinco, presentándose 10 acciones para su elevación a la siguiente etapa. El análisis de otras Instituciones Públicas de Educación Superior es una sugerencia para futuras investigaciones, con el fin de realizar un estudio comparativo de la Madurez de la Gestión del Conocimiento en las Instituciones Brasileñas.A Gestão do Conhecimento, enquanto subárea da Ciência da Informação, tem por temática a análise de sua Maturidade, que visa identificar o estágio em que determinada Instituição se posiciona, aliando a teoria à prática. As Instituições Públicas de Ensino Superior são objetos desta temática, haja vista que se fundam sobre o conhecimento, com vistas a promover serviços à sociedade. Nesse sentido, esta pesquisa é regida pelo objetivo de analisar o nível de Maturidade em Gestão do Conhecimento em uma Instituição Públicas de Ensino Superior, situada em Minas Gerais, Brasil. Trata-se de uma investigação descritiva-quantitativa, que faz de um survey on-line e dos critérios Kaiser-Meyer-Olkin, Alfa de Cronbach e r de Pearson junto ao p-valor para conferir dimensionalidade, confiabilidade e validade aos indicadores criados. A Média, Desvio Padrão e Intervalo de Confiança 95% são utilizados para o computo da Maturidade. Por resultado, a Instituição Públicas de Ensino Superior analisada se posiciona no nível de maturidade dois de cinco níveis possíveis, sendo apresentadas 10 ações para sua elevação ao próximo estágio. A análise de outras Instituições Públicas de Ensino Superior é sugestão de pesquisa futura, de modo a realizar um estudo comparativo de Maturidade da Gestão do Conhecimento em Instituições brasileiras

Nutritive Value and Bioactivities of a Halophyte Edible Plant: Crithmum maritimum L. (Sea Fennel)

Research funded by FEDER/COMPETE and Fundação para a Ciência e Tecnologia (FCT) via grants UIDB/00313/2020 and UIDP/00313/2020 to CQC, LA/P/0045/2020 to ALiCE, UIDB/50020/2020 and UIDP/50020/2020 to LSRE-LCM, and UIDB/MAR/04292/2020 to MARE, and to the Integrated Programme of SR&TD “Smart Valorization of Endogenous Marine Biological Resources Under a Changing Climate” (Centro-01-0145-FEDER-000018) and to Rede Nacional de Ressonância Magnética Nuclear (RNRMN, UC-NMR).Crithmum maritimum L. (sea fennel), an edible xerophyte of coastal habitats, is considered an emerging cash crop for biosaline agriculture due to its salt-tolerance ability and potential applications in the agri-food sector. Here, the nutritional value and bioactive properties of sea fennel are described. Sea fennel leaves, flowers, and schizocarps are composed of carbohydrates (>65%) followed by ash, proteins, and lipids. Sea fennel’s salty, succulent leaves are a source of omega-6 and omega-3 polyunsaturated fatty acids, especially linoleic acid. Extracts obtained from flowers and fruits/schizocarps are rich in antioxidants and polyphenols and show antimicrobial activity against Staphylococcus aureus, Staphylococcus epidermis, Candida albicans, and Candida parapsilosis. Plant material is particularly rich in sodium (Na) but also in other nutritionally relevant minerals, such as calcium (Ca), chlorine (Cl), potassium (K), phosphorus (P), and sulfur (S), beyond presenting a potential prebiotic effect on Lactobacillus bulgaricus and being nontoxic to human intestinal epithelial Caco-2 model cells, up to 1.0% (w/v). Hence, the rational use of sea fennel can bring nutrients, aroma, and flavor to culinary dishes while balancing microbiomes and contributing to expanding the shelf life of food products.info:eu-repo/semantics/publishedVersio

Nosocomial Bloodstream Infections in Brazilian Pediatric Patients: Microbiology, Epidemiology, and Clinical Features

Background: Nosocomial bloodstream infections (nBSIs) are an important cause of morbidity and mortality and are the most frequent type of nosocomial infection in pediatric patients.Methods: We identified the predominant pathogens and antimicrobial susceptibilities of nosocomial bloodstream isolates in pediatric patients (<= 16 years of age) in the Brazilian Prospective Surveillance for nBSIs at 16 hospitals from 12 June 2007 to 31 March 2010 (Br SCOPE project).Results: in our study a total of 2,563 cases of nBSI were reported by hospitals participating in the Br SCOPE project. Among these, 342 clinically significant episodes of BSI were identified in pediatric patients (<= 16 years of age). Ninety-six percent of BSIs were monomicrobial. Gram-negative organisms caused 49.0% of these BSIs, Gram-positive organisms caused 42.6%, and fungi caused 8.4%. the most common pathogens were Coagulase-negative staphylococci (CoNS) (21.3%), Klebsiella spp. (15.7%), Staphylococcus aureus (10.6%), and Acinetobacter spp. (9.2%). the crude mortality was 21.6% (74 of 342). Forty-five percent of nBSIs occurred in a pediatric or neonatal intensive-care unit (ICU). the most frequent underlying conditions were malignancy, in 95 patients (27.8%). Among the potential factors predisposing patients to BSI, central venous catheters were the most frequent (66.4%). Methicillin resistance was detected in 37 S. aureus isolates (27.1%). of the Klebsiella spp. isolates, 43.2% were resistant to ceftriaxone. of the Acinetobacter spp. and Pseudomonas aeruginosa isolates, 42.9% and 21.4%, respectively, were resistant to imipenem.Conclusions: in our multicenter study, we found a high mortality and a large proportion of gram-negative bacilli with elevated levels of resistance in pediatric patients.Pfizer, Inc.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Inst Oncol Pediat IOP GRAAC, São Paulo, BrazilHosp Israelita Albert Einstein, São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, São Paulo, BrazilHosp 9 Julho, São Paulo, BrazilSanta Casa Porto Alegre, Porto Alegre, RS, BrazilHosp Conceicao, Porto Alegre, RS, BrazilHosp Base, Brasilia, DF, BrazilHosp Walter Cantidio, Fortaleza, Ceara, BrazilHosp Diadema, São Paulo, BrazilHosp Espanhol, Salvador, BA, BrazilHosp Coracao, Natal, RN, BrazilHosp UNIMED, Natal, RN, BrazilHosp Clin Goiania, Goiania, Go, BrazilHosp Rim & Hipertensao, São Paulo, BrazilUniv Fed Triangulo Mineiro, Uberaba, MG, BrazilVirginia Commonwealth Univ, Richmond, VA USAUniversidade Federal de São Paulo UNIFESP, São Paulo, BrazilFAPESP: 2006/57700-0Web of Scienc

Conhecimentos sobre prevenção da SIDA entre profissionais e acadêmicos da área de saúde

Este estudo exploratório foi realizado pelas alunas e alunos da Disciplina de Enfermagem nas Doenças Transmissíveis. Foram analisadas as respostas de 52 questionários distribuídos entre acadêmicos de enfermagem, de medicina, médicos, dentistas, enfermeiros e auxiliares de enfermagem que assistem pacientes com SIDA e enfermeiros que não assistem pacientes com SIDA. Estes questionários versaram sobre medidas de prevenção da transmissão sexual, normal de biossegurança, testes diagnósticos, direitos do paciente e do trabalhador e alterações no atendimento aos portadores desta patologia.This work is a exploratory research based on the analysis of the answers to the questionaires of 52 students and health care professionals knowledge about AIDS sexual prevention, biossecurity, diagnosis tests, patients and workers rights and the modifications of nursing and medica/ care to this kind of diseaseTrata se de un estudio exploratório acerca del conocimiento de la prevención de la SIDA, normas de seguridad biológica, pruebas diagnósticas, derechos de /os enfermos y trabajadores con SIDA y de esa mfermedad. Fueron analizados las respuestas de 52 cuestionários de estudientes de enfermería, nédicos, odontólogos, enfermeras y ajudantes de enfermería

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI &lt;18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school&#x2;aged children and adolescents, we report thinness (BMI &lt;2 SD below the median of the WHO growth reference) and obesity (BMI &gt;2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit