Pediatric tuberculosis in the metropolitan area of Rio de Janeiro

Aim: To evaluate the clinical characteristics, diagnostic approach, and treatment outcomes of tuberculosis (TB) in children living in a high-burden metropolitan area. Methods: This was a retrospective study, based on a medical chart review, involving children under 15 years old treated for TB between 2007 and 2016, in four primary health units (PHU) and three reference centers (RC) in five cities of Rio de Janeiro metropolitan area. Factors associated with TB treatment setting, microbiological diagnosis, and treatment outcomes were evaluated. Results: A total of 544 children were enrolled; 71% were treated in PHU, 36% were under 5 years old, and 72% had pulmonary TB (PTB). The HIV prevalence was 10% (31/322). Fifty-three percent had at least one microbiological test for TB, 68% of them (196/287) had TB confirmed. Among 222 children with previous TB contact, information on LTBI was available for 78 (35%), and only 17% (13/78) were treated. Extrapulmonary TB (56% vs 32%), microbiologically confirmed TB (77% vs 60%), and HIV positivity (18.5% vs 4.0%) were significantly more frequent in RC. Treatment in RC (odds ratio (OR) 3.08, 95% confidence interval (CI) 1.74–5.44) and PTB (OR 2.47, 95% CI 1.34–4.56) were independently associated with a microbiological diagnosis of TB. The treatment success rate was 85%. In the logistic regression analysis, HIV-infected children had a 2.5-fold higher risk of an unfavorable outcome (OR 2.53, 95% CI 1.0–6.38; p = 0.05). Conclusions: Opportunities for TB prevention and early TB treatment are missed due to suboptimal close contact screening. Microbiological diagnosis of TB and drug susceptibility testing in children should be made available through more sensitive and accessible tests

Diagnosis of pulmonary tuberculosis in children and adolescents: comparison of two versions of the Brazilian Ministry of Health scoring system

The aim of this study was to evaluate the concordance between two versions of the scoring system (2011 and 2019), recommended by the Brazilian Ministry of Health, for the diagnosis of pulmonary tuberculosis (PTB) in children and adolescents. A retrospective descriptive study was performed to assess the medical records of children and adolescents with PTB, in TB units from Brazilian cities located in Rio de Janeiro, Minas Gerais, and Parana States, from January 1st, 2004, to December 1st, 2018. Patients aged 0 to 18 years old with a diagnosis of PTB were included. The comparison between the two scoring systems showed a moderate concordance according to the κ coefficient value = 0.625. Fourteen patients showed a reduction in the TB score, going from 30 points in the 2011, to 25 points or less in the 2019 one. Seventy one percent of these 14 patients had radiological changes suggestive of PTB and 86% had tuberculin skin tests greater than 10 mm. The study concluded that a moderate agreement was observed between the 2011 and 2019 scoring systems, with an increase in the number of patients scoring 25 points or less in 2019, which can eventually hinder the diagnosis of PTB

Socioeconomic and environmental evaluation of recovery systems and use of sugarcane straw

Orientadores: Luis Augusto Barbosa Cortez, Marcelo Pereira da CunhaTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia AgrícolaResumo: A colheita de cana crua, sem queima, tem sido imposta principalmente por questões ambientais e com vistas ao aproveitamento integral da cana-de-açúcar. Questões econômicas, ambientais e sociais induzem à mecanização da colheita, o que pode proporcionar melhores condições de trabalho e o aproveitamento da palha, com a eliminação da queima prévia. Parte da palha pode ser utilizada para cobertura do solo, melhorando o reciclo de nutrientes, a retenção de água e redução da erosão. Outra parte da palha poderá ser recolhida, enviada para a indústria e utilizada para geração de eletricidade e/ou para produção de etanol de 2ª geração. Este trabalho, com auxílio da Biorrefinaria Virtual de Cana-de-açúcar (BVC/CTBE), empregou as metodologias de insumo-produto e análise de ciclo de vida (ACV) para analisar os impactos socioeconômicos e ambientais do recolhimento e aproveitamento da palha de cana-de-açúcar no setor sucroenergético, considerando (i) a tecnologia de colheita existente (colhedora Convencional) e em desenvolvimento (Estrutura de Tráfego Controlado ¿ ETC, proposta de mecanização com redução e controle do tráfego), (ii) a parcela de palha recolhida, (iii) a forma de recolhimento e transporte e (iv) seu uso. Avaliou-se, também, a viabilidade econômica de cada rota tecnológica considerada. Verificou-se que a colheita integral é economicamente vantajosa na fase agrícola e que a redução da densidade de carga pode ser compensada com menor perda de colmos, devido à redução de potência dos extratores da colhedora. O enfardamento apresenta custos elevados para pequenas frações de recolhimento devido à redução na capacidade operacional das máquinas. A análise do modelo verticalizado de produção (fase agrícola e industrial) mostrou que a baixa eficiência da estação de limpeza a seco interfere diretamente nos rendimentos da indústria, diminuindo a vantagem da colheita integral. A proposta de recolher palha através de colheita integral com palha repicada apresentou bons resultados nas simulações, reduzindo o custo de transporte e melhorando a eficiência de separação da palha na indústria. Considerando o modelo verticalizado de produção, fardos 7,5 t/ha (com colhedora convencional) e Integral sem ponteiro repicada (ETC) apresentam maiores valores para TIR, 12,0% e 14,2%, respectivamente. A fase agrícola responde por 80% a 90% dos impactos ambientais, variando de acordo com o cenário e a categoria de impacto analisada. O uso e produção de fertilizantes e corretivos são os itens que mais ocasionam os impactos ambientais, seguidos de uso de óleo diesel. Em termos socioeconômicos, a colheita integral apresenta maior valor de produção e PIB; já os cenários com fardos apresentam maior remuneração mensal média por emprego e número de empregos gerados em função do maior número de operações mecanizadas demandando mais mão de obra. O resultado principal do estudo mostra que os cenários com ETC apresentam maior eficiência econômica e a proposta de recolhimento através de colheita integral com palha sem ponteiro e repicada apresentou maior atratividade econômica com menores impactos ambientais. Esta pesquisa demonstra a importância de desenvolvimento de tecnologias que permitam melhor aproveitamento da biomassaAbstract: Harvesting of green sugarcane, without burning, has been imposed mainly by environmental issues and aiming to take full advantage of sugarcane. Economic, environmental and social issues induce mechanical harvesting, which can provide better working conditions and the use of straw, with the elimination of the previous burning. Part of the straw can be used for soil coverage, enhancing the recycling of nutrients, water retention and reducing erosion. Another part of the straw can be collected, sent to the industry and used for bioelectricity generation or production of 2nd generation ethanol. This paper, with the support of Virtual Sugarcane Biorefinery (VSB), applied input-output and life cycle analysis methodologies to analyze the socioeconomic and environmental impacts of collection and utilization of straw sugarcane, considering (i) harvesting of sugarcane existing (conventional harvester) and developing (ETC - Controlled Traffic Structure ¿ proposed mechanization of reduction and traffic control) technologies, (ii) fraction of gathered straw, (iii) form of collection and transportation and (iv) use of straw. It was also evaluated economic viability of each technological route considered. It was found that the integral harvest system is economically advantageous in the agricultural phase, and that the load density reduction is almost matched with lower loss of stalks due to the reduced power of the harvesters¿ exhauster. The baling system shows higher costs of small fractions straw recovery due to reduction of the machines operational capacity. The verticalized production model analysis (agricultural and industry fases) showed that the low efficiency of dry cleaning station directly interferes with the industry output, reducing the advantage of the integral harvest system. The proposal to collect straw through integral harvest with chopping presented good results in simulations, reducing the cost of transport of straw and improving industrial productivity with better separation of straw. Considering the verticalized production model, 7,5 ton/ha baling (with conventional harvester) and integral harvest system chopped without tops (ETC) present higher values of IRR, 12,0% and 14,2%, respectively. Regarding environmental impacts, it was found that agricultural phase represents 80% ¿ 90% of the environmental impacts, varying according to the analyzed scene and the impact category. The use and production of fertilizers and soil correctors are the items that cause the most environmental impacts followed by the use of diesel. In socioeconomic terms the integral harvest system presents higher production value and GDP (Gross Domestic Product); the baling scenes present higher average monthly income per job and number of generated jobs due to higher number of mechanized operations requiring more manpower. The main result of this study shows that ETC scenes present higher economic efficiency and the recovery proposal of integral harvest system chopped without tops presented higher economic prospects with lower environmental impacts. This paper shows the importance of technology development which permits better use of biomassDoutoradoMaquinas AgricolasDoutora em Engenharia Agrícol

Technological sceneries and demand of labor training by the sugarcane agricultural sector at the state of São Paulo

Orientadores: Oscar Antonio Braunbeck, Julieta Teresa Aier de OliveiraDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia AgrícolaResumo: No Brasil, o setor sucroalcooleiro viveu um momento de grandes investimentos, impulsionado principalmente pelo aumento da frota de automóveis do tipo "flex fuel", e pela expectativa de aumento das exportações, considerando a meta de adição de etanol à gasolina no mundo todo. Governo e organizações privadas estão se conscientizando da necessidade de ações para aumentar a produção e a produtividade. Dentre tais medidas, estão a ampliação das áreas de plantio, a otimização do processo de plantio e colheita da cana-de-açúcar, bem como a otimização da produção de etanol. No entanto, as referidas medidas para elevar a produtividade implicam questões ambientais, econômicas, sociais e tecnológicas, ganhando expressão com o processo de mecanização. Este trabalho tem por objetivo analisar a qualificação de mão-de-obra no processo de implantação da mecanização do setor agrícola sucroalcooleiro. Para tanto, foram considerados quatro cenários de mecanização: Cenário I - Tradicional, Cenário II - Mecanizado, Cenário III - Informatizado e Cenário IV - Auxílio Mecânico, e o grau de qualificação da mão-de-obra requerida em cada um deles. Foram visitadas três usinas sucroalcooleiras, duas que representam o cenário I e uma unidade que representa o cenário II, de acordo com o índice de mecanização empregado, e realizada uma projeção para os cenários III e IV, visando identificar as carências de qualificação da mão-de-obra no setor. Verificou-se que a mecanização assim como as tecnologias associadas, como a agricultura de precisão, exige funcionários com escolaridade e capacitação acima da encontrada no quadro de funcionários das usinas pesquisadas, principalmente no que se refere ao plantio e corte manual, situação que aponta para a necessidade de um programa mais abrangente de qualificação e treinamento para o setorAbstract: The Brazilian sugar and alcohol sector is going through a process of large investments driven mostly by the growing fleet of flex fuel automobiles, and also by expectations about increasing exports of ethanol for worldwide blending with gasoline. Government and private organizations are becoming aware of the need for actions required to increase production and productivity. Among these actions are the increase of farming areas, optimization of the planting and harvesting processes as well as the ethanol production process. Along with those changes several questions arise related to environmental, economical, social and technological matters, in which agricultural mechanization is included. The objective of this work is to analyze the need for labor qualification in the processes of rapid mechanization that is taking place. For the study three mechanization sceneries were considered: scenery I- Traditional, scenery II- mechanized, scenery III- computerized and scenery IV- mechanically aided. Labor qualification required was analyzed in all three cases. Three sugar mills were visited, two of them can be included in scenery I and the third one in scenery II; scenery III and scenery IV are just a future view according to the present trends. In all cases labor qualification shortages were identified. It was found that increasing mechanization labels are associated with higher level of labor qualification at the mills. Mechanizations of the planting and harvesting operations together with the still incipient applications of precision farming require higher qualified labor than manual planting and harvesting operationsMestradoMaquinas AgricolasMestre em Engenharia Agrícol

Pressupostos teórico-metodológicos e didático-pedagógicos da unidade curricular ética profissional na Unifesp

Resumo: O objetivo deste artigo é refletir sobre a ética na formação profissional, na particularidade da Unidade Curricular de Ética Profissional na graduação em Serviço Social da Unifesp. Realizou-se pesquisa bibliográfica, documental e sistematização de experiências. Os resultados apontam para a importância do compartilhamento dos pressupostos teórico-filosóficos e das estratégias didático-pedagógicas no desenvolvimento das disciplinas específicas de ética, em coerência com as diretrizes curriculares da Abepss

Serviço social e formação permanente: possibilidades de superação de cotidianos de alienação

Abstract This article presents the importance of ongoing training for social workers as a possibility of contributing to professional work from a critical perspective and affirmation of a specific ethical-political project. The study discusses education in class society and the meaning of ongoing education in a counter-hegemonic direction to the interests of capital, presenting a reflection on the education’s role in an emancipatory way. The article resumes the principles of the Ongoing Education Policy of the Federal Council of Social Work (CFESS) of Regional Councils of Social Service (CRESS) (2012). Also, it points out the challenges and opportunities in the implementation of this policy and construction of democratic spaces of graduate qualifications, emphasizing the importance of ongoing training regarding two aspects. The first is the necessary suspension of the life routine, so one can contribute to the daily life, when returning, through actions aligned with a professional political, ethical project. Second, the potential for ongoing training as a strategy to maintain the hegemony of a professional and education project.Resumo O presente artigo apresenta a importância da formação permanente para o serviço social como possibilidade de contribuição para o trabalho profissional numa perspectiva crítica e de afirmação de nosso projeto ético-político. Para tanto, realiza uma discussão acerca da educação na sociedade de classes e o sentido da formação permanente em uma direção contra-hegemônica aos interesses do capital, apresentando uma reflexão sobre seu papel numa perspectiva emancipatória. Retoma os princípios da Política de Educação Permanente do Conjunto Conselho Federal de Serviço Social (CFESS), Conselhos Regionais de Serviço Social (CRESS) (2012), apontando os desafios e possibilidades presentes na efetivação desta política e na construção de espaços democráticos de formação após a graduação, ressaltando sua importância, aqui compreendida sob dois aspectos: a necessária suspensão da cotidianidade para o retorno a esta, de maneira a contribuir criticamente com ações alinhadas ao projeto ético político profissional e, sua potência enquanto estratégia na manutenção da hegemonia de nosso projeto profissional e de formação

Nitric oxide reduces oxidative damage induced by water stress in sunflower plants

Drought is one of the main environmental constraints that can reduce plant yield. Nitric oxide (NO) is a signal molecule involved in plant responses to several environmental stresses. The objective of this study was to investigate the cytoprotective effect of a single foliar application of 0, 1, 10 or 100 µM of the NO donor sodium nitroprusside (SNP) in sunflower plants under water stress. Water stressed plants treated with 1μM SNP showed an increase in the relative water content compared with 0 μM SNP. Drought reduced the shoot dry weight but SNP applications did not result in alleviation of drought effects. Neither drought nor water stress plus SNP applications altered the content of photosynthetic pigments. Stomatal conductance was reduced by drought and this reduction was accompanied by a significant reduction in intercellular CO2 concentration and photosynthesis. Treatment with SNP did not reverse the effect of drought on the gas exchange characteristics. Drought increased the level of malondialdehyde (MDA) and proline and reduced pirogalol peroxidase (PG-POD) activity, but did not affect the activity of superoxide dismutase (SOD). When the water stressed plants were treated with 10 μM SNP, the activity of PG-POD and the content of proline were increased and the level of MDA was decreased. The results show that the adverse effects of water stress on sunflower plants are dependent on the external NO concentration. The action of NO may be explained by its ability to increase the levels of antioxidant compounds and the activity of ROS-scavenging enzymes

Exploring propositions about perceptions of energy security: an international survey

This study investigates how energy users from government, industry, civil society, and academia perceive of energy security challenges. It also analyzes how demographic characteristics influence such perceptions, and how geography, economic structure, modes of domestic energy production, and culture shape energy security priorities. Its primary source of data is a four-part survey distributed in seven languages (English, Mandarin, Portuguese, Russian, Arabic, German, and Japanese) to 2167 respondents in Brazil, China, Germany, India, Kazakhstan, Japan, Papua New Guinea, Saudi Arabia, Singapore, and the United States. These countries were selected because they represent a mix of urban and rural populations, developed and developing economies, import- and export-oriented energy trading flows, communist and capitalist societies, liberalized and state-owned energy markets, and small and large geographic sizes. The survey results are used to test four propositions about energy security related to the education, age, occupation, and gender of respondents, as well five propositions about national energy priorities and the interconnected attributes of security of supply, energy efficiency, energy research and development, energy trade, diversification and decentralization, affordability, environmental quality, climate change, and energy governance

Technical and economic assessment of trash recovery in the sugarcane bioenergy production system

Mechanized sugarcane (Saccharum spp.) harvest without burning has been increasingly adopted in Brazil, increasing trash availability on the field. This study aims at showing the importance of using an integrated framework tool to assess technical and economic impacts of integral harvesting and baling trash recovery strategies and different recovery rates as well as its implications in the sugarcane production, transport and processing stages. Trash recovery using baling system presents higher costs per unit of mass of recovered trash in comparison to system in which trash is harvested and transported with sugarcane stalks (integral harvesting system). However, the integrated agricultural and industrial assessment showed that recovering trash using baling system presents better economic results (higher internal rate of return and lower ethanol production cost) than the integral harvesting system for trash recovery rates higher than 30 %. Varying trash recovery fraction, stalks productivity and mean transport distance for both integral harvesting and baling systems, sensitivity analyses showed that higher trash recovery fractions associated with higher stalks yields and long transport distances favors baling system, mainly due to the reduction of bulk load density for integral harvesting system under those conditions

Technical and economic assessment of trash recovery in the sugarcane bioenergy production system

Mechanized sugarcane (Saccharum spp.) harvest without burning has been increasingly adopted in Brazil, increasing trash availability on the field. This study aims at showing the importance of using an integrated framework tool to assess technical and economic impacts of integral harvesting and baling trash recovery strategies and different recovery rates as well as its implications in the sugarcane production, transport and processing stages. Trash recovery using baling system presents higher costs per unit of mass of recovered trash in comparison to system in which trash is harvested and transported with sugarcane stalks (integral harvesting system). However, the integrated agricultural and industrial assessment showed that recovering trash using baling system presents better economic results (higher internal rate of return and lower ethanol production cost) than the integral harvesting system for trash recovery rates higher than 30 %. Varying trash recovery fraction, stalks productivity and mean transport distance for both integral harvesting and baling systems, sensitivity analyses showed that higher trash recovery fractions associated with higher stalks yields and long transport distances favors baling system, mainly due to the reduction of bulk load density for integral harvesting system under those conditions