O direito à profissionalização de adolescentes nos abrigos sociais: uma análise crítica à luz do Estatuto da Criança e do Adolescente

A partir do contexto social e da percepção de que hoje poucos adolescentes provenientes de abrigos no Brasil tem acesso a programas de integração no mercado de trabalho, sentiu-se a necessidade de conhecer como esses adolescentes iniciam suas vidas financeiras e como é efetivada a sua profissionalização. Para a realização do trabalho, foram utilizados como metodologia a pesquisa documental, estudo bibliográfico, análise do documentário “O dia antes de amanhã”, e estudo de casos do programa Núcleo de Formação e trabalho - NUFT. O trabalho foi dividido em três seções: na primeira seção, é abordada sucintamente o direito à profissionalização prevista na CRFB/88, o seu impacto no ECA, a Lei da Aprendizagem, e o trabalho na adolescência. Na segunda seção, tratou-se da legislação pertinente ao abrigamento social no Brasil. Na terceira seção, foi apresentado o decurso do abrigamento de crianças e adolescentes, tendo como enfoque central a situação dos adolescentes que estão em abrigos. Ao final do trabalho, concluiu-se que as instituições de acolhimento social têm se utilizado de estratégias para alcançar a inserção dos adolescentes no mercado de trabalho uma vez que a presença de políticas públicas é limitada, contudo os programas existentes não têm conseguido suprir a grande demanda

Crescimento da Craibeira inoculada com fungos micorrizicos sob diferentes regimes hídricos / Growth of Craibeira inoculated with micorrizic fungi under different water systems

A água é um dos recursos naturais mais preciosos de nosso planeta. A otimização do uso da água é um dos importantes anseios em todo o mundo. Micorrizas são associações simbióticas, de ocorrência generalizada formada por plantas e fungos. Essa associação representa a mais ampla associação mútua que contribui para evolução e tecnologias das plantas terrestres. E, essa simbiose, pode proporcionar ao vegetal de vários benefícios nutricionais, bem como, a maior eficiência no uso da água. Este estudo teve como objetivo avaliar o crescimento da craibeira ( Tabebuia aurea(Silva Manso) Benth. & Hook. F ex S. Moore) inoculada com fungo micorrízico arbuscular (FMA) em diferentes regimes hídricos. O estudo foi feito em delineamento inteiramente casualizado, em casa de conduzida em solo esterilizado, com os fatores: cinco tratamentos com diferentes regimes hídricos (100%, 75%; 50%; 25% e 0% de água disponível no solo), impor com base sem volume total de poros (VTP). Utilizaram-se três classes de solos: Neossolo, Latossolo e Argissolo, esterilizado e os tratamentos com e sem FMA (5x3x2). Foram parâmetros de crescimento vegetal (altura, diâmetro e produção de matéria seca da parte aérea das plantas). Os resultados indicam que a presença de FMA proporcionou um melhor aproveitamento da água pelas mudas de T. aurea(Silva Manso) Benth. & Hook., Nas classes de solos avaliadas

Impactos negativos da administração de hidroxicloroquina e anticoagulante em pacientes com infecção por SARS-COV-2: um ensaio clínico randomizado

Objetivo: Avaliar antimalárico com ou sem tratamento anticoagulante, em pacientes com infecção recente por SARS-COV-2. Métodos: Estudo clínico realizado no Hospital das Clínicas Samuel Libânio da Universidade do Vale do Sapucaí, Pouso Alegre-MG. Aprovado pelo Comitê de Ética (4.034.077) e registrado nos Ensaios Clínicos (NCT04788355). Pacientes suspeitos de COVID-19 foram incluídos na sala de emergência. Os grupos foram: C (controle) com 6 pacientes, A (anticoagulante apixabana) com 9 pacientes, H (hidroxicloroquina) com 5 pacientes e HA (hidroxicloroquina e anticoagulante apixabana) com 8 pacientes. Resultados: não houve diferenças significativas entre os grupos. O grupo HA, no qual houve intervenção com dois medicamentos, apresentou maior número de dias com sintomas (p = 0,037) e piores resultados, quando comparado ao controle: os sintomas mais relevantes foram: tosse (p = 0,001), e anosmia/ageusia (p = 0,011) cefaléia (p = 0,001). Conclusão: O presente estudo teve início quando havia dúvidas sobre o uso de medicamentos como hidroxicloroquina (HCQ) e apixabana (APX). O “n” reduzido foi definido por meio de questões burocráticas e polêmicas independentes das ações dos autores. Nenhum benefício clínico foi associado com HCQ e APX. Houve um aumento no número de dias sintomáticos quando HCQ e APX foram administrados. Apesar das limitações, não houve indicação terapêutica dos medicamentos avaliados.Purpose: To evaluate antimalarial with or without anticoagulant treatment, in patients with recent SARS-COV-2 infection. Methods: Clinical study carried out at Samuel Libânio Clinic Hospital, University of Vale do Sapucaí, Pouso Alegre-MG. Approved by the Ethics Committee (4.034.077) and registered in the Clinical Trials (NCT04788355). Suspected patients for COVID-19 were included in the emergency room. The groups were: C (control) with 6 patients, A (anticoagulant apixaban) with 9 patients, H (hydroxychloroquine) with 5 patients and HA (hydroxychloroquine and anticoagulant apixaban) with 8 patients. Results: there were no significant differences between groups. The HA group, in which there was an intervention with two drugs, presented a greater number of days with symptoms (p = 0.037) and worse results, when compared to the control: most relevant symptoms, were: cough (p = 0.001), and anosmia / ageusia (p = 0.011) headache (p = 0.001). Conclusion: The present study began when there were doubts about the use of drugs such as Hydroxychloroquine (HCQ) and apixaban (APX). The reduced “n” was defined through bureaucratic and polemic issues independent of the authors’ actions. No clinical benefit was associated with HCQ and APX. There was an increase in the number of symptomatic days when HCQ and APX were administered. Despite the limitations, there was no therapeutic indication of the evaluated drugs

Avanços no manejo do Diabetes Mellitus Gestacional (DMG) baseado em ensaios clínicos randomizados: uma revisão integrativa

O diabetes mellitus gestacional (DMG) é definido como qualquer grau de intolerância à glicose, o qual se inicia ou possui um primeiro reconhecimento durante a gestação, com uma prevalência em torno de 2 a 10% entre as gestantes e com importante morbidade tanto para a mãe quanto para o feto. O presente estudo de revisão buscou avaliar novos avanços referentes ao manejo do diabetes mellitus gestacional, documentados por meio de ensaios clínicos randomizados. Trata-se de uma pesquisa de revisão integrativa realizada por meio da base de dados PubMed, que levou em consideração os seguintes critérios de inclusão: testes controlados e randomizados; artigos publicados no último ano (2022-2023); que possuíam texto completo disponível e que abordassem acerca do manejo do DMG. Ficou constatado que a terapia flexível realizada com a medição da circunferência abdominal (CA) fetal por ultrassom se mostrou uma alternativa viável e segura para mãe e feto no manejo do DMG. Ademais, verificou-se que a utilização do monitoramento glicêmico por varredura intermitente apresentou impacto positivo no controle da glicemia e nos hábitos alimentares, além de um impacto significativo na redução de incidência de macrossomia fetal. Além disso, foi visto que uma intervenção dietética com incentivo ao consumo de frutas vermelhas e vegetais folhosos trouxe melhora do controle glicêmico e de outros parâmetros metabólicos e inflamatórios, sendo altamente recomendada. Por fim, o tratamento via telemedicina é eficiente e seguro quando usado no lugar do atendimento presencial padrão para mulheres com DMG

Shedding light on the performance of a pyrosequencing assay for drug-resistant tuberculosis diagnosis

BACKGROUND: Rapid molecular diagnostics, with their ability to quickly identify genetic mutations associated with drug resistance in Mycobacterium tuberculosis clinical specimens, have great potential as tools to control multi- and extensively drug-resistant tuberculosis (M/XDR-TB). The Qiagen PyroMark Q96 ID system is a commercially available pyrosequencing (PSQ) platform that has been validated for rapid M/XDR-TB diagnosis. However, the details of the assay’s diagnostic and technical performance have yet to be thoroughly investigated in diverse clinical environments. METHODS: This study evaluates the diagnostic performance of the PSQ assay for 1128 clinical specimens from patients from three areas of high TB burden. We report on the diagnostic performance of the PSQ assay between the three sites and identify variables associated with poor PSQ technical performance. RESULTS: In India, the sensitivity of the PSQ assay ranged from 89 to 98 % for the detection of phenotypic resistance to isoniazid, rifampicin, fluoroquinolones, and the injectables. In Moldova, assay sensitivity ranged from 7 to 94 %, and in South Africa, assay sensitivity ranged from 71 to 92 %. Specificity was high (94–100 %) across all sites. The addition of eis promoter sequencing information greatly improved the sensitivity of kanamycin resistance detection in Moldova (7 % to 79 %). Nearly all (89.4 %) sequencing reactions conducted on smear-positive, culture-positive specimens and most (70.8 %) reactions conducted on smear-negative, culture-positive specimens yielded valid PSQ reads. An investigation into the variables influencing sequencing failures indicated smear negativity, culture negativity, site (Moldova), and sequencing of the rpoB, gyrA, and rrs genes were highly associated with poor PSQ technical performance (adj. OR > 2.0). CONCLUSIONS: This study has important implications for the global implementation of PSQ as a molecular TB diagnostic, as it demonstrates how regional factors may impact PSQ diagnostic performance, while underscoring potential gene targets for optimization to improve overall PSQ assay technical performance. TRIAL REGISTRATION: ClinicalTrials.gov (#NCT02170441). Registered 12 June 2014. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12879-016-1781-y) contains supplementary material, which is available to authorized users

TRAUMATISMO DENTÁRIO EM DENTES DECÍDUOS: FATORES DE RISCO, CLASSIFICAÇÃO E EFEITOS SOBRE A DENTIÇÃO PERMANENTE.

Dentoalveolar trauma is classified as a high-prevalence injury in childhood, caused by falls, sports accidents, among other situations, to which children are more prone due to their development, including falls from their own height when learning to walk. This article aimed to review the literature regarding dental trauma in childhood and its risk factors, classification, and effects on permanent dentition. The results showed that malocclusion type and lack of lip protection are among the predisposing factors, specifically anterior open bite, Angle Class II Division 1, and mouth breathing. The time elapsed between trauma and dental care significantly influences the patient's prognosis, thus requiring immediate dental consultation upon trauma occurrence. Another important point to consider is the late sequelae of trauma, leading to effects on permanent dentition, with enamel hypoplasia being among the most prevalent. Therefore, it is concluded that early identification and treatment are essential to reduce the impact of dentoalveolar traumas. Basic knowledge about the topic, by parents and/or caregivers of the child as well as schools, is also essential for treatment success.O traumatismo dento-alveolar é classificado como injúrias de alta prevalência na infância, causadas por quedas, acidentes esportivos, entre outras situações, as quais estão mais propensas, devido ao seu desenvolvimento, incluindo quedas da própria altura, ao aprenderem a andar. Este artigo teve como objetivo revisar a literatura a cerca do traumatismo dentário na infância e seus fatores de risco, classificação e efeitos, sobre a dentição permanente. Como resultados obteve-se que o tipo de mal oclusão e a falta de proteção labial estão entre os fatores predisponentes, especificamente presença de mordida aberta anterior, classe II divisão 1 de Angle e respiração bucal. O tempo decorrente entre o trauma e o atendimento odontológico influencia de forma significativa no prognóstico do paciente sendo, portanto, necessária a ida ao consultório quando da ocorrência do trauma. Outro ponto importante a ser levado em consideração, são as sequelas tardias do trauma, levando a efeitos sobre a dentição permanente, dentre as mais prevalentes, a hipoplasia de esmalte. Portanto, conclui-se que a identificação e o tratamento precoce são essenciais para diminuição do impacto dos traumatismos dento-alveolares. O conhecimento básico acerca do tema, por parte dos pais e\ou cuidadores da criança assim como das escolas, também se faz fundamental para o sucesso do tratamento

May Measurement Month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension

Aims Raised blood pressure (BP) is the biggest contributor to mortality and disease burden worldwide and fewer than half of those with hypertension are aware of it. May Measurement Month (MMM) is a global campaign set up in 2017, to raise awareness of high BP and as a pragmatic solution to a lack of formal screening worldwide. The 2018 campaign was expanded, aiming to include more participants and countries. Methods and results Eighty-nine countries participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and environmental factors. Hypertension was defined as a systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 74.9% of screenees provided three BP readings. Multiple imputation using chained equations was used to impute missing readings. 1 504 963 individuals (mean age 45.3 years; 52.4% female) were screened. After multiple imputation, 502 079 (33.4%) individuals had hypertension, of whom 59.5% were aware of their diagnosis and 55.3% were taking antihypertensive medication. Of those on medication, 60.0% were controlled and of all hypertensives, 33.2% were controlled. We detected 224 285 individuals with untreated hypertension and 111 214 individuals with inadequately treated (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) hypertension. Conclusion May Measurement Month expanded significantly compared with 2017, including more participants in more countries. The campaign identified over 335 000 adults with untreated or inadequately treated hypertension. In the absence of systematic screening programmes, MMM was effective at raising awareness at least among these individuals at risk

TRY plant trait database – enhanced coverage and open access

Plant traits - the morphological, anatomical, physiological, biochemical and phenological characteristics of plants - determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait‐based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits - almost complete coverage for ‘plant growth form’. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait–environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives

Search for high-mass diphoton resonances in pp collisions at √s = 8 TeV with the ATLAS detector

This article describes a search for high-mass resonances decaying to a pair of photons using a sample of 20.3  fb−¹ of pp collisions at √s = 8 TeV recorded with the ATLAS detector at the Large Hadron Collider. The data are found to be in agreement with the Standard Model prediction, and limits are reported in the framework of the Randall-Sundrum model. This theory leads to the prediction of graviton states, the lightest of which could be observed at the Large Hadron Collider. A lower limit of 2.66 (1.41) TeV at 95% confidence level is set on the mass of the lightest graviton for couplings of k/M̄Pl=0.1(0.01)

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