O MOVIMENTO FEMEN: GEOPOLÍTICA E NEO-FEMINISMO

O objetivo deste trabalho é apresentar uma discussão sobre as novas geopolíticas em tempos de globalização em que ganha relevância as ações dos movimentos sociais frente aos Estados-nacionais, destacando a atuação do Femen, um grupo feminista que surgiu na Ucrânia em 2008 com a finalidade de combater o machismo, a prostituição e o turismo sexual naquele país. A ampliação das reivindicações do grupo está associada à inserção deste país nas novas relações de poder após o fim da União Soviética e a independência da Ucrânia da órbita de Moscou. Neste sentido, o trabalho aponta as disputas históricas entre a Rus’ Kieviana e os moscovitas; a Revolução Laranja, em 2004 na Ucrânia; os fundamentos e os ataques do Femen e conclui discutindo o futuro do grupo e da Ucrania

RODOVIA BR-163: ENTRE A GEOPOLÍTICA E A GEOECONOMIA

A produção e a circulação de mercadorias dependem, de maneira primordial, da existência de sistemas de engenharia que permitam a fluidez, pelo território, de veículos capazes de efetuar o deslocamento de uma dada produção de um ponto para outro, seja para atender demandas locais ou globais, associadas à produção e ao consumo. Nesse contexto, insere-se a produção de grãos no Brasil, com destaque para a soja e o milho, que tiveram sua produção deslocada ao longo dos últimos 50 anos para o Norte do Brasil. A produção desses grãos engloba desde a plantação até o escoamento das safras, demandando cada vez mais a presença de infraestruturas públicas, em destaque as rodovias construídas pelo Estado, concomitantemente, a presença de capital privado na estrutura de portos de transbordo, veículos, embarcações e silos. Nesse sentido, destaca-se o papel fundamental da rodovia BR-163 e a instalação de portos no município de Itaituba

Transport dynamics on the Brazil-Bolivia border: Guajará-Mirim - Guayaramerín

As fronteiras entre o Brasil e Bolívia nas cidades gêmeas de Guajará Mirim e Guayaramerín possuem interações espaciais constituídas de fluxos rodoviários e fluviais de transporte de cargas e de passageiros que denotam uma dinâmica fronteiriça, possuindo níveis locais e regionais de organização e de normatização que formam distintas redes, denotando a dinamização desta fronteira em particular. Nesse contexto, esse artigo versa sobre a organização espacial dos transportes na fronteira.  The borders between Brazil and Bolivia in the twin cities of Guajará-Mirim and Guayaramerín have spatial interactions consisting of road and river cargo and passenger transport flows that denote border dynamics that have local and regional levels of organization and regulation and that form distinct networks that denote the dynamization of this particular frontier. In this context, this article deals with the spatial organization of border transport

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure &lt;= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

FRONTEIRAS: A DIVISAO DA FRATERNIDADE NO MUNDO

O desafio colocado pelo pensamento anarquista do geógrafo Elisée Reclus diz respeito exatamente a se pensar uma Geografia Política sem Estado. É importante porque a renovação do pensamento nesta área apontou que não era mais possível analisar a Geografia Política tomando como referencia apenas o Estado, mas considerar outros atores sociais que também são fontes de poder. Ora, no final do século XIX, momento crucial de consolidação dos Estados Nacionais, das nacionalidades, de efervescência do movimento socialista, como poderia um Geógrafo propor a extinção dos Estados? Esta discussão remete para uma outra que é a do território dos povos, que, sem Estados e, consequentemente, sem fronteiras, deverão encontrar outros caminhos para assegurar uma unidade sem a referencia a pertencimento estatal. Sua alegria com o surgimento da Internacional Operária é um indicador da possibilidade de atenuação da função de separação dos homens através das fronteiras. No rastro deste pensamento, está uma critica ferrenha ao patriotismo, que só ajudava a dividir mais os povos, pois cada país arrogava-se de ser superior a outros, quebrando fraternidade entre os homens. Reclus defendia um modo de evolução que tivesse por princípio a ação direta da vontade livremente expressa de homens que se associam para uma determinada obra sem preocupações de fronteiras entre as classes e os países. O fato de Reclus defender a ocupação de um território onde os povos possam viver livres diverge, radicalmente, do pensamento de Ratzel, fundador da Geografia Política, que parte do Estado como elemento chave para os estudos políticos em Geografia. O simples fato de abolir as fronteiras estatais dos mapas da Nova Geografia Universal, já demonstra o pensamento de Reclus sobre o poder desta representação cartográfica. Afirmava que a divisão política da Europa era antinatural, e, portanto precária. Especificamente sobre as fronteiras, Reclus afirma que elas devem ser concebidas como móveis; via a necessidade de tornar mais livre o movimento de pessoas e idéias; e que a solidariedade e a fraternidade são os princípios de relação entre os homens, que levariam à cooperação e a troca. Afirma, enfim, que “Todos os limites construídos entre as nações são obras do homem e nada impediria que fossem modificados ou cancelados”. De modo semelhante, seu amigo e também geógrafo anarquista Piotr Kropotikin afirmava que cabia à Geografia ensinar às crianças que todos somos irmãos, independente de nossa nacionalidade

Os transportes e as dinâmicas territoriais no Amazonas

O fluxo de cargas, pessoas e informações está cada dia mais intenso e presente nos mais diversos lugares do mundo e com os mais variados conteúdos técnicos dispostos nos territórios, permitindo o estabelecimento de interações espaciais que envolvem circuitos econômicos multiescalares entre cidades, distritos e vilas. Tal dinâmica se estrutura em diversas regiões, de modos distintos. Nesse sentido, este artigo busca apresentar um panorama dos transportes no estado do Amazonas, destacando os principais modais, a organização espacial e a atuação do Estado e das empresas no estabelecimento de infraestruturas e do controle ou não da circulação.Le flux de marchandises, de personnes et d'informations est de plus en plus intense et présent dans les endroits les plus divers du monde et les contenus techniques les plus variés disponibles sur les territoires, ce qui permet d'établir des interactions spatiales impliquant des circuits économiques multi-échelles entre villes, districts et villes. Ces dynamiques sont structurées dans différentes régions, de différentes manières. En ce sens, cet article vise à présenter une vue d'ensemble du transport dans l'état d'Amazonas, en mettant en évidence les principales modalités, l'organisation spatiale et les performances de l'État et des entreprises dans l'établissement d'infrastructures et le contrôle ou non de la circulation.The flow of cargo, people and information is increasingly intense and present in the most diverse places in the world and with the most varied technical contents available in the territories, allowing the establishment of spatial interactions involving multi-scale economic circuits between cities, districts and towns. Such dynamics are structured in different regions, in different ways. In this sense, this article seeks to present an overview of transportation in the state of Amazonas, highlighting the main modalities, the spatial organization and the performance of the State and companies in the establishment of infrastructures and the control or not of the circulation

Transporte rodoviário de passageiros no Brasil

Circulation between places is an action that marks the history of mankind. With the development of the technical means and the revolutions and evolutions on transportation it is possible to travel hundreds of kilometers in a fraction of the week or daytime. Nevertheless, all this group of techniques that allow such accomplishments on human movement have a complex spatial organization. In this context, this paper aims to point out the spatial organization of the passengers road transportation service in Brazil, highlighting the companies structures and the role played by the state on the organization of this important transportation field. A circulação entre os lugares é uma ação que marca a história da humanidade. Com o advento dos meios técnicos e as revoluções e evoluções dos transportes é possível percorrer centenas de quilômetros em uma fração do dia ou da semana. Porém todo esse conjunto de técnicas que permitem essa proeza do deslocamento humano possui uma organização espacial complexa. Nesse contexto, este artigo busca apontar a organização espacial do serviço de transporte rodoviário de passageiros no Brasil, destacando a estrutura empresarial e o papel do Estado diante da organização desse importante segmento de transporte.