Os desafios da efetivação dos Direitos das Pessoas com Deficiência: meios institucionais no plano internacional para a busca da autonomia e da isonomia

Um dos temas que vem ganhando atenção dos estudiosos é o da questão da autonomia e da isonomia da pessoa com deficiência como condições para sua dignidade. O motivo desse interesse surgiu com a Convenção Internacional sobre os Direitos das Pessoas com Deficiência e seu Protocolo Facultativo, assinados em Nova York, em 30 de março de 2007, que foram incorporados ao catálogo de nossos direitos fundamentais, através do Decreto Legislativo no 186/2008, que aprovou tais textos, nos moldes do art 5o, parágrafo 3o, da Carta Magna. Destarte, este capítulo se dedica ao assunto acima e subdivide-se em quatro partes: - a primeira voltada para o exame da tutela jurídica da dignidade da pessoa com deficiência assegurado pelo Poder Constituinte Originário; - a segunda destinada a considerações sobre os direitos à isonomia e autonomia presentes na Convenção Internacional sobre os Direitos das Pessoas com Deficiência; - a terceira referente a essa mesma temática, entretanto, no âmbito do Estatuto da Pessoa com Deficiência, com foco específico sobre o art 4o desta lei; - a quarta destinada aos mecanismos de implementação da Convenção Internacional das Pessoas com Deficiência e respectivo Protocolo Facultativo. Nesse ponto, pois, reside o objetivo desse trabalho, qual seja realizar ponderações sobre um contributo que poderia advir acaso um Tribunal Constitucional Internacional fosse instituído, servindo de upgrad para os direitos humanos e, neste caso, inclusive como ferramenta protetiva para a pessoa com deficiência. Trata-se de pesquisa teórica com levantamento documental. Para tanto, foram empregues os métodos dialético, coleta de jurisprudência, histórico, indutivo

Violence against aged people: a new issue?

O envelhecimento da população mundial é um fato concreto e de conhecimento público. O Brasil inicia seu processo de transição demográfica seguindo o padrão mundial: o aumento do número de idosos com possibilidade de atingir elevadas faixas etárias, o que traz a necessidade de pesquisas nesse campo, devido à demanda apresentada por essa nova parcela da população. A questão da violência doméstica contra idosos tem se ampliado e sugere necessidade de maior campo de investigação nessa área, dado o risco suposto ao qual essa população mais idosa está submetida. O objetivo deste artigo é verificar os estudos relacionados ao tema já realizados no Brasil e em diferentes países, com enfoque epidemiológico. O trabalho apresenta diversos pontos de abordagem da violência contra idosos, considerando questões relacionadas à cultura do envelhecimento, ações de políticas públicas, atuação de equipes de saúde, definição do termo abordado, aspectos legais e éticos da violência contra o idoso. Tal estudo permite ao pesquisador analisar os diferentes aspectos que envolvem a temática, demonstrando a necessidade de pesquisas específicas direcionadas ao tema.The world population is getting older and this is a very well known fact. The demographic transition of the Brazilian population is just beginning, and follows the world pattern: an increase in the number of older persons with an actual chance of reaching higher ages. As a consequence, there is the need of new studies to supply data about this new aspect of the population demands. Household violence against old persons has been growing and this strongly recommends that special research studies should be conducted, in view of the risk to which these individuals are exposed. The objective of this study is to list and analyze Brazilian and international studies related to aged persons, in light of an epidemiological point of view. The article presents many ways of approaching violence against old people, considering the culture of aging, actions of public policies, the practice of health teams, and legal and ethical aspects of violence against aged people. Such a study allows the researcher to analyze different aspects of the theme, showing the need of specific research on the elderly

Suporte telefônico na adesão á alimentação saudável de pacientes com diabetes mellitus tipo 2

Objective: To verify the effects of telephone support on adherence to healthy eating practices among patients with type 2 diabetes mellitus. Methods: This was a clinical trial with 63 patients with type 2 diabetes mellitus; 36 patients were allocated to the intervention group (G1) and 27 patients to the control group (G2). For G1, telephone support was provided, consisting of four telephone calls addressing food planning, types and portions of food, and healthy foods. For G2, normal care was given in their health facility. The effects of telephone support on healthy eating were measured at baseline (T1) and at four months after the intervention (T2).Results: In G1, 16 (44.44%) patients joined at T1, which dropped to 14 (38.88%) by T2. In G2, 8 (29.62%) patients started at T1 and the number rose to 9 (33.33%) by T2. After the G1 intervention, there was an increase in the consumption of fruits and vegetables, a reduction in the consumption of fatty foods and foods high in sugar, and an increase in meal frequency. A significant difference was noted in reduced fasting blood glucose among non-adherent patients and reduced Hb1Ac among adherent patients from G1. Conclusion: The four-month intervention using telephone support proved insufficient to increase adherence to healthy eating. However, there was an increase in consumption of fruits and vegetables and a decrease in the consumption of fatty foods, foods high in sugar, and soft drinks.Objetivo: Investigar los efectos de la asistencia telefónica en la adhesión a la práctica de una dieta saludable de los pacientes con diabetes mellitus tipo 2.Métodos: Se realizó un ensayo clínico que involucró a 63 pacientes con diabetes mellitus tipo 2, 36 pacientes asignados al grupo de intervención (G1) y 27 en el grupo control (G2). Para el G1 se llevó a cabo una intervención de asistencia telefónica que correspondía a cuatro llamadas telefónicas que abordan: la planificación de comidas, tipos y porciones de comida y la comida sana. Para G2, se llevó a cabo la atención habitual en sus unidades. Los efectos de la asistencia telefónica en la dieta sana se midieron al inicio del estudio (T1) y después de la intervención (T2) en cuatro meses.Resultados: En  G1, 16 (44,44%) pacientes se unieron en T1, disminuyendo para 14 (38.88%) en T2. En el  G2, 08 (29,62%) pacientes se unieron en T1 y aumentó a 09 (33,33%) en T2. Hubo un aumento del consumo de frutas y verduras, reducción el consumo de alimentos ricos en grasas y alta en la tasa de azúcar, así como un aumento en el fraccionamiento de las comidas después de la intervención en G1. Hubo una diferencia significativa en la reducción de los niveles de glucosa en ayuno en los pacientes no adherentes y em la reducción de Hb1Ac entre los pacientes adherente G1.Conclusión: Los efectos de la asistencia telefónica después de la intervención de cuatro meses resultó insuficiente para aumentar la adherencia a una alimentación sana, pero observó un aumento del consumo de frutas y verduras y la disminución del consumo de alimentos ricos en grasas y alto contenido de azúcar y refrescos.Objetivo: Verificar os efeitos do suporte telefônico na adesão á prática de uma alimentação saudável de pacientes com diabetes mellitus tipo 2. Métodos: Tratou-se de um ensaio clínico do qual participaram 63 pacientes com diabetes mellitus tipo 2, sendo 36 pacientes alocados para o grupo intervenção (G1) e 27 para o grupo controle (G2). Para o G1, foi conduzida uma intervenção de suporte telefônico que correspondeu a quatro ligações telefônicas abordando: planejamento alimentar, tipos e porções de alimentos e alimentos saudáveis. Para o G2, foi conduzido o cuidado usual em sua unidade de saúde. Os efeitos do suporte telefônico na alimentação saudável foram medidos no início (T1) e após a intervenção (T2) em quatro meses.Resultados: No G1, 16 (44,44%) pacientes aderiram no T1, diminuindo para 14 (38,88%) no T2. No G2, 08 (29,62%) pacientes aderiram no T1 e aumentou para 09 (33,33%) no T2. Houve aumento do consumo de frutas, verduras e legumes, redução do consumo de alimentos gordurosos e ricos em açúcar além de aumento no fracionamento das refeições após a intervenção no G1. Observou-se diferença significativa na redução da glicemia de jejum entre os pacientes não aderentes e na redução da Hb1Ac entre os pacientes aderentes do G1. Conclusão: Os efeitos do suporte telefônico após a intervenção de quatro meses mostrou-se insuficiente para aumentar a adesão à alimentação saudável, porém observamos o aumento de consumo de frutas, verduras e legumes e diminuição do consumo de alimentos gordurosos e ricos em açúcar e refrigerantes

Organizational commitment, job satisfaction and their possible influences on intent to turnover

Purpose – The purpose of this paper is to investigate the extent to which the organizational commitment and job satisfaction influence intent to turnover. Design/methodology/approach – Following a quantitative approach regarding methodological aspects of this research, a case study was carried out in a company of information technology and communication located in Porto Digital, in the Northeast of Brazil. A data collection technique with 172 forms, a self-administered form with 18 closed questions with a Likert-type scale and an open questionnaire were used. In this analysis, Statistical Package for the Social Sciences (SPSS) software was used as the technique; besides the descriptive statistics, a correlation was made between dependent variables (intention of rotation) and independent variables (affective, normative, instrumental and work satisfaction). The level of organizational commitment in its three dimensions (affective, normative and instrumental), the job satisfaction in its five dimensions (satisfaction with nature of the task, with leadership, with colleagues, with salary and promotions) and the level of intent to turnover from the respondents were investigated. Findings – The results suggest that affective and normative commitments and satisfaction with pay, satisfaction with promotions and satisfaction with the nature of the work are correlated with the intention of negative turnover significantly. Among the demographic factors, only the age showed a negative correlation with intent to turnover. By performing multiple regression analysis, we identified that the variables that most impacted the turnover intention are affective commitment, satisfaction with salary and normative commitment. The qualitative portion of this study was accomplished through a content analysis of the open question of the form. Finally, one of the main considerations is the findings that revealed variables other than those adopted in the study, which influence the permanence of the respondents. Research limitations/implications – Among the limitations of the research a single case study is highlighted that replicates the experience in other ICT companies to verify if the results found are similar in other organizations and in other segments. The findings direct the construction and validation of new scales, the creation of qualitative protocols to identify the variables that influence the retention of a specific group of individuals to serve as a guide for the elaboration of a questionnaire, as well as creation of surveys of longitudinal nature to correlate the data of intention of rotation with the effective turnover. Practical implications – Based on the results, organizations can reduce voluntary evasion by adjusting actions, policies and practices, directing those responsible for People Management to attract and retain good employees. It should be emphasized that voluntary turnover should be treated as one of the management indicators of greater relevance by organizations, representing a thermometer of all human capital management. Social implications - The monitoring of employment and unemployment levels is part of the public policy agenda for generating employment and income in Brazil. For organizations, employee turnover can and should be managed and monitored so that appropriate levels are found and their consequences are minimized through effective solutions. The results are important both for technology-based organizations and for all stakeholders interested in the subject as the public power. Originality/value – Although in the international literature turnover is a topic of study for many years, in the Brazilian context, there is a shortage of research on the subject, specifically in the sector of advanced technology where there is a great lack of skilled labor, a fierce competition and where to keep employees standard high becomes a survival factor. This study may contribute to the exploration in the local literature, as it will help locate the academy on the Brazilian reality and open the doors to new research works on turnover and its possible correlations with other variables besides organizational commitment and job satisfaction

Violência contra idosos: uma questão nova?

The world population is getting older and this is a very well known fact. The demographic transition of the Brazilian population is just beginning, and follows the world pattern: an increase in the number of older persons with an actual chance of reaching higher ages. As a consequence, there is the need of new studies to supply data about this new aspect of the population demands. Household violence against old persons has been growing and this strongly recommends that special research studies should be conducted, in view of the risk to which these individuals are exposed. The objective of this study is to list and analyze Brazilian and international studies related to aged persons, in light of an epidemiological point of view. The article presents many ways of approaching violence against old people, considering the culture of aging, actions of public policies, the practice of health teams, and legal and ethical aspects of violence against aged people. Such a study allows the researcher to analyze different aspects of the theme, showing the need of specific research on the elderly.O envelhecimento da população mundial é um fato concreto e de conhecimento público. O Brasil inicia seu processo de transição demográfica seguindo o padrão mundial: o aumento do número de idosos com possibilidade de atingir elevadas faixas etárias, o que traz a necessidade de pesquisas nesse campo, devido à demanda apresentada por essa nova parcela da população. A questão da violência doméstica contra idosos tem se ampliado e sugere necessidade de maior campo de investigação nessa área, dado o risco suposto ao qual essa população mais idosa está submetida. O objetivo deste artigo é verificar os estudos relacionados ao tema já realizados no Brasil e em diferentes países, com enfoque epidemiológico. O trabalho apresenta diversos pontos de abordagem da violência contra idosos, considerando questões relacionadas à cultura do envelhecimento, ações de políticas públicas, atuação de equipes de saúde, definição do termo abordado, aspectos legais e éticos da violência contra o idoso. Tal estudo permite ao pesquisador analisar os diferentes aspectos que envolvem a temática, demonstrando a necessidade de pesquisas específicas direcionadas ao tema

Posibilidades de cuidados a la pareja serodiscordante al VIH durante el embarazo

Objective: Understanding the meaning of pregnancy for heterosexual couples facing serodiscordant situation for HIV, aiming at construction of care possibilities based on subjectivity. Method: Phenomenological research, theoretical-philosophical-methodological framework by Martin Heidegger. Research was conducted in a University Hospital in the countryside of Southern Brazil, from September 2013 to May 2014 through a phenomenological interview, with participation of eleven couples. Results: For the couples, pregnancy is part of life when they wish to have a child, even when one or both of them already have children from previous relationships. In addition, it is part of life when they consider the risks and do not want to have children in such circumstances anymore, but it happened unexpectedly. Conclusion: Understanding reproductive needs and demands of these couples is an aid for qualification and improvement of care as a contribution to nursing care planning towards reproductive health of these couples.Objetivo: Comprender el significado del embarazo para las parejas heterosexuales serodiscordantes al VIH con el propósito de establecer cuidados basados en la subjetividad. Método: Estudio fenomenológico, de referencial teórico, filosófico, metodológico heideggeriano. Se empleó entrevista fenomenológica a once parejas participantes del estudio en el Hospital Universitario de una ciudad en la región Sur de Brasil en el periodo de septiembre de 2013 a mayo de 2014. Resultados: Para las parejas el embarazo forma parte de sus experiencias, ya sea porque desean tener hijos con el/la compañero/a, incluso si uno o ambos ya tienen hijos provenientes de relación anterior. Asimismo forma parte al considerar los riesgos y no desean tener más hijos en estas circunstancias, pero ocurre lo inesperado al quedarse embarazada. Conclusión: Comprender las necesidades y demandas reproductivas de estas parejas es importante para la calificación, el mejoramiento de los cuidados y la planificación de la asistencia ofrecida por el personal de enfermería a la salud reproductiva de estas personas

Trypanosoma cruzi I and IV Stocks from Brazilian Amazon Are Divergent in Terms of Biological and Medical Properties in Mice

Background: In the Brazilian Amazon, clinical and epidemiological frameworks of Chagas disease are very dissimilar in relation to the endemic classical areas of transmission, possibly due to genetic and biological characteristics of the circulating Trypanosoma cruzi stocks. Twenty six T. cruzi stocks from Western Amazon Region attributed to the TcI and TcIV DTUs were comparatively studied in Swiss mice to test the hypothesis that T. cruzi clonal structure has a major impact on its biological and medical properties. Methodology/Principal Findings: Seventeen parameters were assayed in mice infected with 14 T. cruzi strains belonging to DTU TcI and 11 strains typed as TcIV. In comparison with TcI, TcIV stocks promoted a significantly shorter pre-patent period (p<0.001), a longer patent period (p<0.001), higher values of mean daily parasitemia (p = 0.009) and maximum of parasitemia (p = 0.015), earlier days of maximum parasitemia (p<0.001) and mortality (p = 0.018), higher mortality rates in the acute phase (p = 0.047), higher infectivity rates (p = 0.002), higher positivity in the fresh blood examination (p<0.001), higher positivity in the ELISA at the early chronic phase (p = 0.022), and a higher positivity in the ELISA at the late chronic phase (p = 0.003). On the other hand TcI showed higher values of mortality rates in the early chronic phase (p = 0.014), higher frequency of mice with inflammatory process in any organ (p = 0.005), higher frequency of mice with tissue parasitism in any organ (p = 0.027) and a higher susceptibility to benznidazole (p = 0.002) than TcIV. Survival analysis showing the time elapsed from the day of inoculation to the beginning of the patent period was significantly shorter for TcIV strains and the death episodes triggered following the infection with TcI occurred significantly later in relation to TcIV. The notable exceptions come from positivity in the hemocultures and PCR, for which the results were similar. Conclusion/Significance: T. cruzi stocks belonging to TcI and TcIV DTUs from Brazilian Amazon are divergent in terms of biological and medical properties in mice.publishersversionpublishe

Exposure to magnetic fields and childhood acute lymphocytic leukemia in São Paulo, Brazil

Background: Epidemiological studies have identified increased risks of leukemia in children living near power lines and exposed to relatively high levels of magnetic fields. Results have been remarkably consistent, but there is still no explanation for this increase. in this study we evaluated the effect of 60 Hz magnetic fields on acute lymphocytic leukemia (ALL) in the State of São Paulo, Brazil. Methods: This case-control study included ALL cases (n = 162) recruited from eight hospitals between January 2003 and February 2009. Controls (n = 565) matched on gender, age, and city of birth were selected from the São Paulo Birth Registry. Exposure to extremely low frequency magnetic fields (ELF MF) was based on measurements inside home and distance to power lines. Results: for 24 h measurements in children rooms, levels of ELF MF equal to or greater than 0.3 microtesla (mu T), compared to children exposed to levels below 0.1 mu T showed no increased risk of ALL (odds ratio [OR] 1.09; 95% confidence interval [95% CI] 0.33-3.61). When only nighttime measurements were considered, a risk (OR 1.52; 95% CI 0.46-5.01) was observed. Children living within 200 m of power lines presented an increased risk of ALL (OR 1.67; 95% CI 0.49-5.75), compared to children living at 600 m or more of power lines. for those living within 50 m of power lines the OR was 3.57 (95% CI 0.41-31.44). Conclusions: Even though our results are consistent with the small risks reported in other studies on ELF MF and leukemia in children, overall our results do not provide support for an association between magnetic fields and childhood leukemia, but small numbers and likely biases weaken the strength of this conclusion. (C) 2011 Elsevier B.V. All rights reserved.Univ São Paulo, Fac Saude Publ, Dept Epidemiol, BR-01255 São Paulo, BrazilAssoc Brasileira Compatibilidade Eletromagnet, São Paulo, BrazilHosp Amaral Carvalho, Jau, BrazilUniv São Paulo, Fac Med, BR-14049 Ribeirao Preto, BrazilUniversidade Federal de São Paulo, Inst Oncol Pediat, São Paulo, BrazilHosp Infantil Darcy Vargas, São Paulo, BrazilSanta Casa Misericordia São Paulo, São Paulo, BrazilHosp Santa Marcelina, São Paulo, BrazilUniv Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USAUniversidade Federal de São Paulo, Inst Oncol Pediat, São Paulo, BrazilWeb of Scienc