CRIANÇAS, NATUREZA E FOTOGRAFIA: UMA EXPERIÊNCIA NO CERRADO

This work aimed to analyze the relationship of children with nature from images obtained by technological instruments and the narratives constructed by these tools. The main intention is to reveal possible perspectives and relationships of these children with the situation they were invited to experience. The methodology is centered on the idea of children as subjects of rights, values the authorship and the children's logic. Initially three moments of relation of the children with the photography was combined: the taking of images in a trail into Cerrado; the analysis of these images and their categorization. Subsequently, the drawings produced by the children was also analyzed, aiming to identify their vision about the visit to the Cerrado. The diversity of children's views on nature and their relation with it was verified. The images portray well the Cerrado and its elements, in different angles, distances, frames, focuses, purposes and senses; the children put themselves in the pictures and drawings and shared, as in a game of negotiation and power, the authorship of some photographs.Este trabajo objetivó analizar la relación de niños con la naturaleza a partir de imágenes obtenidas por instrumentos tecnológicos y las narrativas que construyen. La intención principal es revelar posibles miradas y relaciones de esos niños con la experiencia que fueron invitados a vivir. La metodología, centrada en la concepción del niño como sujeto de derechos, valoriza la autoría y la lógica infantil e inicialmente combinó tres momentos de relación de los niños con la fotografía: la toma de imágenes en una senda de cerrado, el análisis de esas imágenes y su categorización. Posteriormente, se insertó también el análisis de los dibujos producidos por los niños para identificar su visión sobre la visita al cerrado. Se constató la diversidad de miradas infantiles sobre la naturaleza y su relación con ella. Las imágenes retratan bien el cerrado y sus elementos, en diferentes ángulos, distancias, marcos, focos, propósitos y sentidos; los niños se colocaron en las fotos y dibujos y compartieron, como en un juego de negociación y poder, la autoría de algunas fotografías.Este trabalho objetivou analisar a relação de crianças com a natureza, a partir de imagens obtidas por instrumentos tecnológicos, e as narrativas por eles construídas. A intenção principal é revelar possíveis olhares e relações dessas crianças com a experiência que foram convidadas a vivenciar. A metodologia, centrada na concepção de criança como sujeito de direitos, valoriza a autoria e a lógica infantil e, inicialmente, combinou três momentos de relação das crianças com a fotografia: a tomada de imagens em uma trilha de cerrado, a análise dessas imagens e sua categorização. Posteriormente, inseriu-se também a análise dos desenhos produzidos pelas crianças, para identificar sua visão sobre a visita ao cerrado. Constatou-se a diversidade de olhares infantis sobre a natureza e sua relação com ela. As imagens retratam bem o cerrado e seus elementos, em diferentes ângulos, distâncias, enquadramentos, focos, propósitos e sentidos; as crianças se colocaram nas fotos e desenhos e compartilharam, como num jogo de negociação e poder, a autoria de algumas fotografias

Parapneumonic effusions related to Streptococcus pneumoniae: serotype and disease severity trends from 2006 to 2018 in Bristol, UK

Rationale Streptococcus pneumoniae epidemiology is changing in response to vaccination and some data suggest that empyema incidence is increasing. However, differences exist between the UK and US studies. We describe trends in the clinical phenotype of adult pneumococcal pleural infection, including simple parapneumonic effusions (SPE) in the pneumococcal conjugate vaccination (PCV) era.Objectives To determine whether there were differences in pneumococcal disease presentation and severity associated with pleural infection.Methods A retrospective cohort study, all adults ≥16 years admitted to three large UK hospitals, 2006–2018 with pneumococcal disease. 2477 invasive pneumococcal cases were identified: 459 SPE and 100 pleural infection cases. Medical records were reviewed for each clinical episode. Serotype data were obtained from the UK Health Security Agency national reference laboratory.Results Incidence increased over time, including non-PCV-serotype disease. PCV7-serotype disease declined following paediatric PCV7 introduction, but the effect of PCV13 was less apparent as disease caused by the additional six serotypes plateaued with serotypes 1 and 3 causing such parapneumonic effusions from 2011 onwards.Patients with pleural infection had a median survival 468 days (95% CI 340 to 590) vs 286 days (95% CI 274 to 335) in those with SPE. Pleural infection associated with frank pus had lower 90-day mortality than pleural infection without pus (0% vs 29%, p<0.0001). 90-day mortality could be predicted by baseline increased RAPID (Renal, Age, Purulence, Infection source, and Dietary factors) score (HR 15.01, 95% CI 1.24 to 40.06, p=0.049).Conclusions Pneumococcal infection continues to cause severe disease despite the introduction of PCVs. The predominance of serotype 1 and 3 in this adult UK cohort is in keeping with previous studies in paediatric and non-UK studies. Rising non-PCV serotype disease and limited impact of PCV13 on cases caused by serotypes 1 and 3 offset the reductions in adult pneumococcal parapneumonic effusion disease burden observed following the introduction of the childhood PCV7 programme

Serotype Distribution and Disease Severity in Adults Hospitalized with Streptococcus pneumoniae Infection, Bristol and Bath, UK, 2006‒2022

Ongoing surveillance after pneumococcal conjugate vaccination (PCV) deployment is essential to inform policy decisions and monitor serotype replacement. We report serotype and disease severity trends in 3,719 adults hospitalized for pneumococcal disease in Bristol and Bath, United Kingdom, during 2006–2022. Of those cases, 1,686 were invasive pneumococcal disease (IPD); 1,501 (89.0%) had a known serotype. IPD decreased during the early COVID-19 pandemic but during 2022 gradually returned to prepandemic levels. Disease severity changed throughout this period: CURB65 severity scores and inpatient deaths decreased and ICU admissions increased. PCV7 and PCV13 serotype IPD decreased from 2006–2009 to 2021–2022. However, residual PCV13 serotype IPD remained, representing 21.7% of 2021–2022 cases, indicating that major adult PCV serotype disease still occurs despite 17 years of pediatric PCV use. Percentages of serotype 3 and 8 IPD increased, and 19F and 19A reemerged. In 2020–2022, a total of 68.2% IPD cases were potentially covered by PCV20

Parapneumonic effusions related to Streptococcus pneumoniae: serotype and disease severity trends from 2006 to 2018 in Bristol, UK

Rationale Streptococcus pneumoniae epidemiology is changing in response to vaccination and some data suggest that empyema incidence is increasing. However, differences exist between the UK and US studies. We describe trends in the clinical phenotype of adult pneumococcal pleural infection, including simple parapneumonic effusions (SPE) in the pneumococcal conjugate vaccination (PCV) era.Objectives To determine whether there were differences in pneumococcal disease presentation and severity associated with pleural infection.Methods A retrospective cohort study, all adults ≥16 years admitted to three large UK hospitals, 2006–2018 with pneumococcal disease. 2477 invasive pneumococcal cases were identified: 459 SPE and 100 pleural infection cases. Medical records were reviewed for each clinical episode. Serotype data were obtained from the UK Health Security Agency national reference laboratory.Results Incidence increased over time, including non-PCV-serotype disease. PCV7-serotype disease declined following paediatric PCV7 introduction, but the effect of PCV13 was less apparent as disease caused by the additional six serotypes plateaued with serotypes 1 and 3 causing such parapneumonic effusions from 2011 onwards.Patients with pleural infection had a median survival 468 days (95% CI 340 to 590) vs 286 days (95% CI 274 to 335) in those with SPE. Pleural infection associated with frank pus had lower 90-day mortality than pleural infection without pus (0% vs 29%, p<0.0001). 90-day mortality could be predicted by baseline increased RAPID (Renal, Age, Purulence, Infection source, and Dietary factors) score (HR 15.01, 95% CI 1.24 to 40.06, p=0.049).Conclusions Pneumococcal infection continues to cause severe disease despite the introduction of PCVs. The predominance of serotype 1 and 3 in this adult UK cohort is in keeping with previous studies in paediatric and non-UK studies. Rising non-PCV serotype disease and limited impact of PCV13 on cases caused by serotypes 1 and 3 offset the reductions in adult pneumococcal parapneumonic effusion disease burden observed following the introduction of the childhood PCV7 programme