Las niñas y niños en el proceso migratorio: una realidad que continúa vigente

El proceso migratorio ha sido una actividad constante para el ser humano desde sus alboresa nivel global y las razones por las que ha decidido hacerlo responden a las necesidades desupervivencia a lo largo de la historia, en el caso latinoamericano y particularmente a nivel delterritorio ecuatoriano, la crisis económica y la inestabilidad política empujaron al crecimiento deldesempleo e inestabilidad social. La referida migración se la realizó en condiciones de ilegalidady con grandes deudas a personas o entidades ilegales, que imponían intereses económicoselevados, por lo tanto, dichas deudas debían pagarse lo antes posible y para lograrlo, quienesmigraban debían afrontar condiciones de vida casi infrahumanas, con el in de ahorrar y poderenviar las remesas necesarias para el pago de sus haberes. bicha situación colocó a quienmigraba en posición heroica dentro del círculo familiar y a nivel de toda la sociedad, porquedebido a las remesas que ingresaban al país, y la dolarización, la economía a nivel nacional selogró estabilizar, aumentando el circulante monetario y con ello el acceso a bienes y serviciosque años antes no habían estado al alcance de la población en general, debido a los altos costosque representaba adquirirlos. En este contexto, la ausencia de padres y/o madres estabajustiicado dentro del entorno familiar, otorgando patente de corso en beneicio de mayoresaccesos económicos y prácticas sociales diferentes a las de los progenitores.palabras clave: migración, jóvenes, familia, niñas y niños

As crianças no processo migratório: Uma realidade que continua vigente

O processo migratório tem sido uma atividade constante para o ser humano desde o início, em nível global, e as razões pelas quais se toma a decisão de migrar respondem às necessidades de sobrevivência ao longo da história. No caso latino-americano e, particularmente, no do território equatoriano, a crise econômica e a instabilidade política levaram ao crescimento do desemprego e à instabilidade social. A referida migração foi realizada em condições de ilegalidade e por meio de grandes dívidas com pessoas ou entidades ilegais, que impunham juros elevados e, portanto, tais dívidas deveriam ser pagas o mais rápido possível. Para isso, aqueles que migravam tinham de enfrentar condições de vida quase sub-humanas, com o objetivo de economizar e poder enviar as remessas necessárias para o pagamento dos seus bens. Tal situação colocou quem migrava em posição heróica dentro do círculo familiar e da sociedade como um todo, porque, devido às remessas que chegavam ao país, e à dolarização, a economia conseguiu se estabilizar em nível nacional, aumentando a circulação do dinheiro e, com isso, o acesso a bens e serviços que anos antes não estavam ao alcance da população em geral, devido aos altos custos de aquisição. Neste contexto, a ausência de pais e/ou mães estava justiicada dentro do entorno familiar, recebendo carta branca em benefício de maiores acessos econômicos e práticas sociais diferentes das práticas dos progenitores.palavras chave: migração, jovens, família, crianças

Global Retinoblastoma Presentation and Analysis by National Income Level.

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

Guía didáctica para educadores comunitarios de niños de 4 a 5 años en la Provincia de Tungurahua, Parroquia de Quisapincha

El sustento teórico del presente trabajo considera varios aspectos que servirán para conocer mejor a niños de 4 a 5 años dentro de su propio contexto, para lo cual, se cuenta con la perspectiva de varios autores que nos ayudarán a sustentar la base conceptual. Ha sido necesario revisar diversas teorías, tanto en el aspecto psicológico como en el pedagógico, así como un acercamiento a los procesos evolutivos y logros de estándares sobre todo en el aspecto sicomotor, que deberían poseer los niños comprendidos en las edades ya mencionadas. Se habla también de la influencia del educador sobre los niños y el efecto que genera la interacción enseñanza – aprendizaje, para esto se ha tratado aspectos referentes a valores y lenguaje, los mismos que juegan un papel muy importante en esta etapa de la vida, ya que de estos dependerá el desarrollo socio-afectivo y cognitivo, en las posteriores etapas del desarrollo

As crianças no processo migratório: Uma realidade que continua vigente

The migratory process has been a constant activity for human beings since its dawn, at a global scale, and the reasons for the decision to migrate are related to survival needs throughout history. In the case of Latin America, and particularly in the equatorian territory, the economic crisis and the political instability led to the growth of unemployment and social instability. This migration occurs in ilegal conditions and through great debts to ilegal individuals or entities, who impose elevated interest rates, meaning that such debts must be paid off as soon as possible. In order to do so, those who migrate have to face nearly subhuman standards of living, with the intent of saving up and sending off the necessary transfers for the payments of their assets. This situation put those who migrate at a heroic position within their own families, and within society as a whole, because the money transfers that came into the country and dollarization caused the economy to stabilize at a national level, increasing the circulation of money and with it the access to goods and services that years before weren't at the reach of the general population due to its high costs. In this context, the absence of parents was justified within the family, receiving a carte blanche in the face of benefits such as a wider economic access and different social practices than the previous generation.O processo migratório tem sido uma atividade constante para o ser humano desde o início, em nível global, e as razões pelas quais se toma a decisão de migrar respondem às necessidades de sobrevivência ao longo da história. No caso latino-americano e, particularmente, no do território equatoriano, a crise econômica e a instabilidade política levaram ao crescimento do desemprego e à instabilidade social. A referida migração foi realizada em condições de ilegalidade e por meio de grandes dívidas com pessoas ou entidades ilegais, que impunham juros elevados e, portanto, tais dívidas deveriam ser pagas o mais rápido possível. Para isso, aqueles que migravam tinham de enfrentar condições de vida quase sub-humanas, com o objetivo de economizar e poder enviar as remessas necessárias para o pagamento dos seus bens. Tal situação colocou quem migrava em posição heróica dentro do círculo familiar e da sociedade como um todo, porque, devido às remessas que chegavam ao país, e à dolarização, a economia conseguiu se estabilizar em nível nacional, aumentando a circulação do dinheiro e, com isso, o acesso a bens e serviços que anos antes não estavam ao alcance da população em geral, devido aos altos custos de aquisição. Neste contexto, a ausência de pais e/ou mães estava justificada dentro do entorno familiar, recebendo carta branca em benefício de maiores acessos econômicos e práticas sociais diferentes das práticas dos progenitores.El proceso migratorio ha sido una actividad constante para el ser humano desde sus albores a nivel global y las razones por las que ha decidido hacerlo responden a las necesidades de supervivencia a lo largo de la historia, en el caso latinoamericano y particularmente a nivel del territorio ecuatoriano, la crisis económica y la inestabilidad política empujaron al crecimiento del desempleo e inestabilidad social. La referida migración se la realizó en condiciones de ilegalidad y con grandes deudas a personas o entidades ilegales, que imponían intereses económicos elevados, por lo tanto, dichas deudas debían pagarse lo antes posible y para lograrlo, quienes migraban debían afrontar condiciones de vida casi infrahumanas, con el fin de ahorrar y poder enviar las remesas necesarias para el pago de sus haberes. Dicha situación colocó a quien migraba en posición heroica dentro del círculo familiar y a nivel de toda la sociedad, porque debido a las remesas que ingresaban al país, y la dolarización, la economía a nivel nacional se logró estabilizar, aumentando el circulante monetario y con ello el acceso a bienes y servicios que años antes no habían estado al alcance de la población en general, debido a los altos costos que representaba adquirirlos. En este contexto, la ausencia de padres y/o madres estaba justificado dentro del entorno familiar, otorgando patente de corso en beneficio de mayores accesos económicos y prácticas sociales diferentes a las de los progenitores

Disponibilidade, acúmulo e toxidez de cádmio e zinco em milho cultivado em solo contaminado Cadmium and zinc availability, accumulation and toxicity in maize grown in a contaminated soil

O crescente acúmulo de metais pesados em solos, como conseqüência de atividades antrópicas, tem causado grande interesse nos estudos de extratores destes elementos, bem como no estabelecimento de seus níveis tóxicos críticos em solos. Um experimento foi realizado em casa de vegetação com os objetivos de: (a) estudar a eficiência de diferentes extratores (DTPA, EDTA, Mehlich-1 e Mehlich-3) na avaliação da disponibilidade de Cd e Zn para plantas de milho cultivadas em solo corrigido e não corrigido com calcário; (b) avaliar o efeito da aplicação de Cd e Zn no crescimento e acúmulo desses metais em plantas de milho, e (c) identificar sintomas visuais de toxidez e alterações anatômicas em folhas e raízes de milho expostas a esses metais. Para tanto, plantas de milho foram cultivadas durante 30 dias em um Argissolo Vermelho-Amarelo que recebeu doses crescentes de Cd (0, 1, 3, 5, 10 e 20 mg kg-1) ou de Zn (0, 10, 30, 50, 100 e 150 mg kg-1) com ou sem uma dose de calcário necessária à elevação do pH a 6,0. Ao final do período de cultivo, as plantas foram analisadas quanto aos teores de Cd e Zn, os quais foram correlacionados com os teores desses no solo por ocasião do plantio. Correlações altamente significativas foram encontradas entre todos os extratores testados e os teores de metais absorvidos pelas plantas. O aumento das doses de metais promoveu redução da produção de biomassa, além de aumentar o conteúdo destes metais nas plantas. Os níveis críticos tóxicos de Cd para o Argissolo variaram de 8,7 a 13,1 mg kg-1, enquanto para Zn esses valores situaram-se entre 74,1 e 110,7 mg kg-1, respectivamente, para solos com e sem calagem, dependendo do extrator considerado. Os sintomas visuais de toxidez de Cd foram clorose, encarquilhamento e enrolamento de folhas. Para Zn, os sintomas tóxicos mais comuns foram clorose internerval e marginal, associada à necrose no ápice e margens das folhas. O aumento da lignificação das paredes celulares da epiderme e colênquima, do tecido vascular e da endoderme foi associado a níveis críticos tóxicos de Cd e de Zn no solo.<br>A greenhouse experiment was carried out to evaluate: (a) the soil Cd and Zn availability to maize plants with and without liming, using the DTPA, EDTA, Mehlich-1, and Mehlich-3 extractants; (b) The effect of Cd and Zn doses on plant growth and metal accumulation in maize; and (c) toxicity symptoms and anatomical changes in leaves and roots exposed to Cd and zinc. Maize was grown for 30 days in soil contaminated with either Cd (0, 1, 3, 5, 10, 20 mg kg-1) or Zn (0, 10, 30, 50, 100, 150 mg kg-1). Highly significant correlations were found between all extractants tested and metal plant contents. The metal addition to soil reduced biomass production and increased Cd and Zn plant contents. The critical toxicity value for Cd in soil varied from 8.7 to 13.1 mg kg-1, whereas for Zn this value lied between 74.1 to 110.7 mg kg-1, depending on liming and extractant type. Interveinal and marginal chlorosis together with necrosis in the leaf apex and along the margins were observed for Zn treatments. On the other hand, leaf chlorosis, shriveling and curling were the most common symptoms in cadmium-damaged plants. Increased cell wall lignification in vascular tissues, epidermis, collenchyma, and endoderm cells were associated to critical toxicity values of Cd and Zn in soil

Global Retinoblastoma Presentation and Analysis by National Income Level

This cross-sectional analysis reports the retinoblastoma stage at diagnosis across the world during a single year, investigates associations between clinical variables and national income level, and investigates risk factors for advanced disease at diagnosis. Key PointsQuestionIs the income level of a country of residence associated with the clinical stage of presentation of patients with retinoblastoma? FindingsIn this cross-sectional analysis that included 4351 patients with newly diagnosed retinoblastoma, approximately half of all new retinoblastoma cases worldwide in 2017, 49.1\% of patients from low-income countries had extraocular tumor at time of diagnosis compared with 1.5\% of patients from high-income countries. MeaningThe clinical stage of presentation of retinoblastoma, which has a major influence on survival, significantly differs among patients from low-income and high-income countries, which may warrant intervention on national and international levels. ImportanceEarly diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. ObjectivesTo report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and ParticipantsA total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and MeasuresAge at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. ResultsThe cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4\%) were female. Most patients (n=3685 {[}84.7\%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n=2638 {[}62.8\%]), followed by strabismus (n=429 {[}10.2\%]) and proptosis (n=309 {[}7.4\%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5\%) patients having intraocular retinoblastoma and 2 (0.3\%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1\%) having extraocular retinoblastoma and 94 of 498 (18.9\%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 {[}95\% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 {[}95\% CI, 4.30-7.68]). Conclusions and RelevanceThis study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

Risk of COVID-19 after natural infection or vaccinationResearch in context

Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health

Risk of COVID-19 after natural infection or vaccinationResearch in context

Summary: Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health