Pessoas públicas e os limites da liberdade de informação: a legitimidade do direito ao esquecimento e sua repercussão lesiva

O presente trabalho tem como objetivo analisar a aplicação do direito ao esquecimento na internet, especialmente em relação às celebridades. Tal escolha tem como motivação a modernidade do tema e a rara produção doutrinária e jurisprudencial, consequência da inovação tecnológica sobre os meios de comunicação e de acesso à informação, em especial a internet, devido à rapidez com que as notícias são disponibilizadas. Tendo em vista a atualidade do tema e as possíveis dúvidas em sua aplicação, buscou-se estudar as suas diversas vertentes, através de pesquisa doutrinária e jurisprudencial. Através do exame do Projeto de Lei 7881/2014, verifica-se se o limite de proteção dos direitos da personalidade, principalmente no que tange à privacidade e intimidade, pode ser aplicado às pessoas públicas da mesma forma que é aplicado às pessoas “comuns”. Para tanto, foi feita uma análise para verificar se há uma colisão de direitos fundamentais, envolvendo direito à privacidade de intimidade de um lado, e a liberdade de expressão de outro. Constatada a colisão, realiza-se uma pesquisa jurisprudencial sobre o direito ao esquecimento para observar, nas diferentes decisões, se os benefícios concedidos ao direito que se sobressaiu justificam a limitação do outro direto. Por fim, procede-se a um breve estudo sobre o âmbito de proteção dos direitos da personalidade das celebridades, e a hipótese de aplicação do direito ao esquecimento a essas pessoas. Diante de todas as análises tratadas, a conclusão foi que as celebridades possuem um regime diferenciado de proteção da privacidade. No entanto, os direitos fundamentais não são passíveis de renúncia plena. Nesses casos, deverá ser verificada a inexistência do interesse público, para que seja possível determinar o direito ao esquecimento.http://repositorio.uniceub.br/retrieve/22696/21154238.pd

Risk factors for the increasing trend in low birth weight among live births born by vaginal delivery, Brazil

OBJECTIVE: To identify risk factors for low birth weight (LBW) among live births by vaginal delivery and to determine if the disappearance of the association between LBW and socioeconomic factors was due to confounding by cesarean section. METHODS: Data were obtained from two population-based cohorts of singleton live births in Ribeirão Preto, Southeastern Brazil. The first one comprised 4,698 newborns from June 1978 to May 1979 and the second included 1,399 infants born from May to August 1994. The risks for LBW were tested in a logistic model, including the interaction of the year of survey and all independent variables under analysis. RESULTS: The incidence of LBW among vaginal deliveries increased from 7.8% in 1978--79 to 10% in 1994. The risk was higher for: female or preterm infants; newborns of non-cohabiting mothers; newborns whose mothers had fewer prenatal visits or few years of education; first-born infants; and those who had smoking mothers. The interaction of the year of survey with gestational age indicated that the risk of LBW among preterm infants fell from 17.75 to 8.71 in 15 years. The mean birth weight decreased more significantly among newborns from qualified families, who also had the highest increase in preterm birth and non-cohabitation. CONCLUSIONS: LBW among vaginal deliveries increased mainly due to a rise in the proportion of preterm births and non-cohabiting mothers. The association between cesarean section and LBW tended to cover up socioeconomic differences in the likelihood of LBW. When vaginal deliveries were analyzed independently, these socioeconomic differences come up again.OBJETIVO: Identificar fatores de risco para o baixo peso ao nascer (BPN) entre nascidos vivos de parto vaginal e verificar se o desaparecimento da associação entre BPN e fatores socioeconômicos foi devido ao confundimento pela cesariana. MÉTODOS: Foram estudadas duas coortes de base populacional de recém-nascidos únicos de parto vaginal em Ribeirão Preto, Sudeste do Brasil. A primeira incluiu 4.698 crianças nascidas entre junho de 1978 e maio de 1979 e a segunda 1.399 crianças nascidas entre maio e agosto de 1994. Os riscos de BPN foram testados num modelo de regressão logística, incluindo interações entre ano da pesquisa e todas as variáveis independentes em análise. RESULTADOS: A incidência de BPN entre partos vaginais aumentou de 7,8% em 1978/79 para 10% em 1994 para crianças do sexo feminino, para os primogênitos, para nascidos de mães sem companheiro, para nascidos de mães que fizeram menor número de consultas pré-natais ou com menos anos de estudo e para nascidos de mães fumantes. A interação entre ano do parto e idade gestacional indicou que o risco de BPN entre os nascidos prematuros caiu de 17,8 para 8,7 em 15 anos. A média do peso ao nascer reduziu-se mais entre os filhos de famílias mais qualificadas, que tiveram o maior aumento nos nascimentos pré-termo e nas mães sem companheiro. CONCLUSÕES: O BPN entre partos vaginais aumentou principalmente devido ao incremento nos nascimentos pré-termo e nas mães sem companheiro. A associação entre cesariana e BPN tendeu a encobrir as diferenças socioeconômicas na probabilidade do BPN. Na análise dos partos vaginais isoladamente, as diferenças socioeconômicas reapareceram

Epidemiological and Clinical Characteristics of Pediatric and Adolescent Obesity Enrolled in a Tertiary Referral Center

Objective: To describe some demographic, clinical and laboratory characteristics of obese children and adolescents admitted in an obesity ambulatory of a referral center located in the southeastern region of Brazil. Methods: This is a cross-sectional and observational study and the data (age, gender, type of delivery, birthweight, age of birth, breastfeeding, laboratory tests and maternal body mass index [BMI]) were collected from medical records. Results: The study included 89 patients, of which 45 (50.6%) were male. The mean age was 68.9 months, 50 (55.6%) were first-born, 51 (57.3%) were exclusively breastfed during the 1st 6 months of life, and 18 (20.1%) did not receive breast milk. The mean age of the mothers was 29 years old, 87 (98%) did prenatal assistance, and 69 (77.6%) had a BMI > 25 kg/m2. The results also showed that cesarean delivery (42.6%), low birthweight (6.7%), prematurity (8.7%) and early introduction of artificial food (20.1%) was not predominant among the patients. A total of 25 (28%) subjects had total cholesterol > 170 mg/dL, 35 (39.3%) with LDL-cholesterol > 110 mg/dL, 34 (38.2%) had HDL-cholesterol < 40 mg/dL, and 6 (6.7%) with triglycerides > 130 mg/dL. All of the patients had at least one altered biochemical test. Conclusion: Healthy lifestyle promotion should be included in every pediatric primary care program, and all children should receive counseling about healthy nutrition and physical activity since birth. Reducing childhood obesity is a major public health priority and primary prevention programs are a critical part to address the problem

Comparison of methods for final height assessment in adolescents with a normal variant short stature

Introduction: patients with low stature normal variant growth have peculiar evolutionary patterns making it difficult to precisely define when final stature will be reached, since prediction methods are based on parameters of difficult quantification, such as bone age. Objective: To assess the agreement between two methods for prediction of final height based on family target range regarding the final height reached by adolescents with a diagnosis of normal variant short stature.  Methods: Thirty-three subjects were evaluated using height of parents for the calculation of family target range and Bayley-Pinneau and Tanner-Whitehouse methods for prediction of final height. Spearman correlation coefficient was calculated to correlate final height with the mean of the family target range, and the St. Laurent concordance coefficient was used to assess concordance between final stature and predictive methods. Results:  87.9% (29/33) subjects kept short stature at the end of growth and 90.9% (30/33) had a final height within family target range. A very strong positive correlation (Cs = 0.77; p < 0.01) was observed between parental mean and final height. Bayley-Pinneau method showed a 0.47 concordance coefficient with final height (95% CI: 0.34; 0.57), and Tanner-Whitehouse 3 method showed a concordance coefficient of 0.58 (95% CI: 0.41; 0.75). Conclusion: The strong positive correlation observed demonstrates the significant influence of parental height on final height. Neither method showed good concordance when used as a predictor of final height, with height values being overestimated

Diferença notável nas taxas de parto cesariano em hospital público e hospital privado no Brasil

This paper evaluates the association of maternal variables and of variables related to prenatal and delivery care with cesarean sections at a public and at a private maternity. A retrospective cross-sectional study was performed at a public maternity clinic (2,889 deliveries) and at a private maternity clinic (2,911 deliveries) in the city of Ribeirão Preto, São Paulo State, Brazil. The prevalence of cesarean sections was 18.9% at the public maternity clinic and 84.3% at the private one. The factors associated with cesarean sections at both hospitals were: mothers from other cities, aged > 25 years and with hypertension. Having more than one child was a protective factor. At the public hospital, cesarean sections were more frequent on Wednesdays and from 12:00 to 23:59 hours of any day of the week, whereas at the private hospital they occurred on any day, though were less common on Sundays, and at any time except in the early morning. At the private hospital, cesarean sections were more frequent when performed by the doctor who had provided the prenatal care. Non-medical factors were more associated with cesarean sections in the private maternity clinic than biological or clinical factors related to pregnancy.Este artigo avalia a associação de variáveis maternas e aquelas relacionadas ao cuidado pré-natal e ao parto com a ocorrência de cesáreas em um hospital público e em um hospital privado. Um estudo de corte transversal, retrospectivo, foi desenvolvido em uma maternidade pública (2.889 partos) e em uma maternidade privada (2.911 partos) em Ribeirão Preto, São Paulo, Brasil. A prevalência de cesárea foi 18,9% e 84,3%, respectivamente, na maternidade pública e na particular. Os fatores associados ao parto cesariano nos dois hospitais foram: mães procedentes de outras cidades, com idade > 25 anos e hipertensas. Ter mais de um filho foi fator protetor. No hospital público, a cesárea foi mais freqüente às quartas-feiras e das 12h00min às 23h59min de qualquer dia da semana, enquanto no hospital privado prevaleceram em qualquer dia, exceto aos domingos, e em qualquer horário, exceto de madrugada. Neste hospital, a cesárea foi mais freqüente quando realizada pelo médico que acompanhou o pré-natal. Fatores não médicos foram mais associados com os partos operatórios na maternidade privada do que fatores biológicos ou clínicos das gestantes

Insufficient birth weight: factors associated in two cohorts of newborns in Ribeirão Preto, São Paulo, Brazil

OBJETIVO: Avaliar fatores associados ao aumento das taxas de peso insuficiente (PI) em duas coortes de recém-nascidos (RN) vivos e de parto único de Ribeirão Preto, São Paulo, separadas por 15 anos (1978/79 e 1994). MÉTODOS: Foram estudados 6.223 partos em 1978/79 e 2.522 em 1994, excluindo-se os RN de baixo peso. Associação entre PI e variáveis independentes (idade, trabalho, escolaridade e tabagismo maternos, abortos e natimortos prévios, número de filhos, situação conjugal, visitas de pré-natal, tipo de parto e hospital, categoria de internação, renda familiar, idade gestacional e sexo do RN) foi analisada por cálculo da Odds Ratio (OR) bruto e intervalo de confiança 95%, seguida de regressão logística múltipla. RESULTADOS: Em 1978/79, na análise ajustada, idade materna <20 anos (p=0,014), renda familiar <5 salários-mínimos (p=0,030), menos de quatro consultas de pré-natais (p=0,003), parto vaginal (p<0,001), sexo feminino (p<0,001), tabagismo materno (p<0,001) e prematuridade (p<0,001) estiveram associados a PI. Em 1994, os fatores associados ao PI foram: trabalho materno fora do lar (p=0,020), sexo feminino (p<0,001), tabagismo materno (p<0,001) e prematuridade (p<0,001). CONCLUSÕES: Variáveis socioeconômicas que atuaram em 1978/79 desapareceram em 1994, restando o sexo do RN, o hábito de fumar e a prematuridade nos dois períodos. Como houve diminuição do tabagismo materno e não houve modificação na proporção de nascimentos do sexo feminino, uma explicação para o aumento do PI seria o aumento nos nascimentos pré-termo entre as duas coortes.OBJECTIVE: To evaluate factors associated to the increase in insufficient birth weight (IBW) rates in two population-based-cohorts of singletons born alive in Ribeirão Preto, São Paulo, Brazil, separated by 15 years (1978/79 and 1994). METHODS: The first cohort (1978/79) comprised 6,223 newborns and the second (1994), 2,522, excluding low birth weight newborns. Independent variables association with IBW (maternal age, work, schooling and smoking; previous abortion, previous stillbirth, number of live births, maternal marital status, family income, occupation group, type of hospital, mode of insurance, number of antenatal visits, type of delivery; newborn gender and gestational age) were analyzed. The Odds Ratio (OR) was determined using a logistic regression model and 95% confidence limits were calculated. RESULTS: In 1978/79, maternal age <20 years (p=0.014), family income <5 minimum Brazilian wages (p=0.030), <4 antenatal visits (p=0.003), vaginal delivery (p<0.001), female newborn gender (p<0.001), maternal smoking (p<0.001) and preterm birth (p<0.001) were associated with IBW. In 1994, maternal work outside home (p=0.020), female newborn gender (p<0.001), maternal smoking (p<0.001) and preterm births (p<0.001) were associated with IBW. CONCLUSIONS: Socioeconomics variables associated with IBW in 1978/79 were not determinants in 1994. Newborn gender, maternal smoking and preterm birth remained significant determinants of IBW in both moments. Considering the decrease in rate of maternal smoking and the maintenance of female births, the increase in IBW could be explained by increasing rates of preterm birth in this interval of 15 years.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Risk factors associated with preterm birth: identification, prediction and evaluation in the BRISA cohort

Problem: Preterm birth is the leading cause of death and can result in significant long-term loss of physical and psychological capacity among survivors.Background: An estimated 15 million babies are born preterm every year. Prediction models based on machine learning methods have reported promising results.Aims: To identify risk factors associated with preterm birth and to develop and validate a prediction model for this outcome in a Brazilian birth cohort.Methods: Cross-sectional study of all births that occurred in Ribeirão Preto-SP and of one in three births that occurred in São Luís-MA, Brazil, in 2010. Questionnaires were applied to obtain pregnancy-related data. Multivariate adaptive regression splines were used to determine the independent variables. Preterm birth, defined as birth before 37 weeks gestational age, was the dependent variable. A random forest model was developed and its performance was evaluated by ROC analysis.Findings: The preterm birth rates were 12.7% (RP) and 14.1% (SL). The prediction and validation accuracies of the RF-based model were 91.3% and 85.5% respectively. The model can be applied starting in the third month of gestation and is more effective in identifying preterm infants with GA&lt;31 weeks and 6 days (AUC=0.98).Discussion: It was possible to build a prediction model based on easily accessible low-cost data, without the need for complementary tests, providing results similar to those of other studies.Conclusions: Previous preterm birth and prenatal care were determinants. The use of an application for individualized patient monitoring an early stage can have positive effects on the quality of life of mother and child

Comparação entre duas coortes de mães adolescentes em município do Sudeste do Brasil

OBJECTIVE: To compare the prevalence of pregnancy among adolescents and analyze trends in some social and biological variables among two cohorts of adolescent mothers in Ribeirão Preto, Brazil, during 1978/79 and 1994. METHODS: Two cohorts of adolescent mothers were interviewed shortly after delivery, comprising 943 women in the first survey (1978/79) and 499 in the second (1994). Both surveys covered more than 98% of births in all childbirth clinics. Only singleton livebirths from adolescent mothers living in the municipality were included in the analysis. The Chi-square test was used for statistical analysis, with a 0.05 significance level. RESULTS: The percentage of adolescent mothers increased from 14.1% in 1978/79 to 17.5% in 1994 (pOBJETIVO: Comparar a prevalência de gravidez na adolescência e analisar variáveis sociobiológicas relacionadas ao binômio mãe-filho entre duas coortes de mães adolescentes de nascidos vivos em Ribeirão Preto (1978-1979 e 1994). MÉTODOS: Foram entrevistadas mães adolescentes logo após o parto, sendo 943 em 1978/79 e 499 em 1994, abrangendo nascidos vivos de parto único, de famílias residentes em Ribeirão Preto, SP. Foi utilizado o teste do qui-quadrado, com nível de significância de 0,05. RESULTADOS: O percentual de mães adolescentes aumentou de 14,1% em 1978/79 para 17,5% em 1994 (