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An adapted version of the Wechsler Preschool and Primary Scale of Intelligence--Third Edition (WPPSI-III) was administered to assess cognitive functioning among 1,253 5-year-old children from the Malnutrition and Enteric Disease (MAL-ED) study--an international, multisite study investigating multiple aspects of child development. In this study, the factor structure and invariance of the WPPSI-III were examined across seven international research sites located in Bangladesh, Brazil, India, Nepal, Pakistan, South Africa, and Tanzania. Using a multiple indicator multiple cause (MIMIC) modeling approach, the findings supported the validity of a fluid reasoning dimension (comprised of block design, matrix reasoning, and picture completion subscales) across each of the seven sites, although the scores were noninvariant. Accordingly, these scores are recommended for research purposes and understanding relationships between variables but not for mean comparisons or clinical purposes.

The Bayley's Scales of Infant and Toddler Development-Third Edition (Bayley-III) were used to measure the development of 24-month-old children (N = 1,452) in the Interactions of Malnutrition and Enteric Infections: Consequences for Child Health and Development (MAL-ED) study (an international, multisite study on many aspects of child development). This study examined the factor structure and measurement equivalence/invariance of Bayley-III scores across 7 international research sites located in Bangladesh, Brazil, India, Nepal, Pakistan, Peru, and South Africa. Exploratory and confirmatory factor analyses were used to identify the factor structure of Bayley-III scores. Subsequently, reliability analyses and item response theory analyses were applied, and invariance was examined using multiple-indicator, multiple-cause modeling. The findings supported the validity, but not invariance, of Bayley-III language scores at all seven sites and of the cognitive and motor scores at six sites. These findings provide support for the use of scores for research purposes, but mean comparison between sites is not recommended. Impact and Implications: In measurement, validity refers to the extent to which we are measuring what we intend to measure and the appropriateness of inferences we make based on our measurements. The validity of scores from measures often varies across cultures, and this study examined the validity of a measure of child development among children from sites in seven low- and middle-income countries. The findings indicate that the majority of the scores are valid for research, but measurement differences are evident such that it is not appropriate to compare mean scores across sites. [Co-written with the MAL-ED Network Investigators.]

This Ph.D. report is based on the authors' attempts to develop an experiment to test an affect-centred methodology for hospital architectural design. The study was initially planned to count on the participation of different stakeholders, such as patients and designers. However, in 2019, the COVID-19 pandemic in Brazil made it impossible for designers and architects to conduct in-person doctoral research in hospital environments. As a result, the original project had to be re-evaluated, focusing on the designer's role as a purpose-oriented participant, which added complexity to the methodology. Virtual meeting technology and various design tools were used to overcome these obstacles, adapting the study to the digital environment. A learning period was necessary for the researchers to achieve a level of interaction that resembled in-person relationships as closely as possible. However, only one-third of the participants – from an interdisciplinary group of 16 designers – completed their involvement in the research. Reasons they mentioned for dropping off the study included experiencing cognitive challenges such as keeping the focus of attention and losing interest. This raises concerns about the potentially irreparable damage caused to research involving users' in-person interactions in healthcare environments during such an unprecedented time. [ABSTRACT FROM AUTHOR]

Mango anthracnose disease (MAD) is a destructive disease of mangoes, with estimated yield losses of up to 100% in unmanaged plantations. Several strains that constitute Colletotrichum complexes are implicated in MAD worldwide. All mangoes grown for commercial purposes are susceptible, and a resistant cultivar for all strains is not presently available on the market. The infection can widely spread before being detected since the disease is invincible until after a protracted latent period. The detection of multiple strains of the pathogen in Mexico, Brazil, and China has prompted a significant increase in research on the disease. Synthetic pesticide application is the primary management technique used to manage the disease. However, newly observed declines in anthracnose susceptibility to many fungicides highlight the need for more environmentally friendly approaches. Recent progress in understanding the host range, molecular and phenotypic characterization, and susceptibility of the disease in several mango cultivars is discussed in this review. It provides updates on the mode of transmission, infection biology and contemporary management strategies. We suggest an integrated and ecologically sound approach to managing MAD. [ABSTRACT FROM AUTHOR]

The literature in the field of health management mentions a concept called new public management (NPM), introduced in Brazil and France at the end of the 20th century. The objective of the study was to analyze the repercussions of the work of nurses in primary health care in Brazil and France under the influence of NPM. This is an excerpt of a double-titled thesis, which is a research intervention with nurses from two Brazilian states and five French departments. Data were produced between February 2019 and July 2021. The public policy Health on the Hour acted as an institutional transducer, provoking a reduction in access and producing effects on professional practices. In both countries, NPM amplified the predominance of technical and quantifiable acts, the focus on individual care, and the loss of autonomy. Nurses reported insurmountable situations, using the metaphor "Sophie's choice". The results showed that making dilemmatic decisions has been the daily routine of nurses, which has not resulted in debureaucratization and higher quality of care. [ABSTRACT FROM AUTHOR]

Congenital anomalies (CA) are a relevant problem for global public health, affecting about 3% to 6% of newborns worldwide. In Brazil, these are the second main cause of infant mortality. Thus, extensive studies are needed to demonstrate the impact of these anomalies on births and deaths. The present study describes the temporal trends of prevalence and infant mortality due to CA among live births in Brazil and regions, from 2001 to 2018, using the related data between the Live Birth Information System (SINASC, acronym in Portuguese) and the Mortality Information System (SIM, acronym in Portuguese). The prevalence and infant mortality due to CA has increased in Brazil and in most regions, especially in the Northeast and North. CAs in the musculoskeletal system were the most frequent at birth (29.8/10,000 live births), followed by those in the circulatory system (12.7/10,000 live births), which represented the primary cause of death in this group. The applied linkage technique made it possible to correct the national prevalence of CA by 17.9% during the analyzed period, after retrieving the anomalies reported in SIM, thereby proving to be a good tool to improve the quality of information on anomalies in Brazil. Key words Congenital anomalies, Record linkage, Children's health. [ABSTRACT FROM AUTHOR]

Drought indices are a numerical representation of drought conditions aimed to provide quantitative assessments of the magnitude, spatial extent, timing, and duration of drought events. Since the adverse effects of droughts vary according to the characteristics of the event, the socioeconomic vulnerabilities, exposed communities or environments, there is a profusion of drought indicators to assess drought impacts in different sectors. In this study, we evaluated the performance of two drought indices, the Standardized Precipitation Index—SPI and Standardized Precipitation Evapotranspiration Index—SPEI over Brazil derived from gridded meteorological information over the period 1980–2019. Firstly, we compared the gridded derived indices against the same indices derived from weather station data and available from a global dataset for time scales of 3, 6, 12, 24 months. Then we analyzed the spatio-temporal trends in SPI and SPEI time-series, which revealed statistically significant trends toward drier conditions across central Brazil for all time scales, though with more intensity for time scales of 12 months and larger. Trends were more significant in magnitude for SPEI than SPI, indicating an important role in the increase in evaporation, driven by increasingly higher temperatures. Finally, we demonstrated that climate signals are already having a disruptive effect on the country's energy security. [ABSTRACT FROM AUTHOR]

Background: Modifiable risk factors exert crucial impact on dementia.Objective: We sought to answer the question: do two modifiable risk factors, schooling level and physical activity (PA), affect cognitive function similarly in each sex?Methods: This cross-sectional study was conducted in 2019 and 2021, and the survey was applied to the residents of the metropolitan area of Santos, a seashore of Sao Paulo State. Four hundred and twenty-two participants (women = 254 and men = 168) were eligible. Baecke questionnaire for the elderly was applied for the classification as physically inactive (PI) or active (PA). Cognitive function was assessed by the Mini-Mental State Examination (MMSE) and the Clinical Dementia Rating (CDR). Participants were also stratified by schooling status for both sexes.Results: Higher education had a sex-independent positive influence on MMSE and CDR (p < 0.001). PA influences positively MMSE in older women (PI: 25±5 and PA: 27±3, p < 0.03), but has no effect in older men (26±5 and 25±5, p > 0.05). Concordantly, older women who were PA (1.7 and 0 %) showed a lower prevalence of dementia compared with PI (6.2 and 2.1%), for mild and moderate respectively. Active older women had higher odds of improving the MMSE score (OR: 1.093; 95% CI: 1.008-1.186) than men (OR: 0.97 (95% CI: 0.896-1.051).Conclusion: Education affects cognitive function equally in Brazilian elderly whereas older women are more responsive to the beneficial effects of PA for dementia than men. [ABSTRACT FROM AUTHOR]

Background: Shigella infections cause inflammation, which has been hypothesized to mediate the associations between Shigella and child development outcomes among children in low-resource settings. We aimed to assess whether early life inflammation and Shigella infections affect school-aged growth and cognitive outcomes from 6–8 years of age. Methodology/principal findings: We conducted follow-up assessments of anthropometry, reasoning skills, and verbal fluency in 451 children at 6–8 years of age in the Brazil, Tanzania, and South Africa sites of MAL-ED, a longitudinal birth cohort study. We estimated the associations between Shigella burden and inflammation with linear growth at 2, 5, and 6–8 years of age, and with the cognitive test scores using linear regression and adjusting for potential confounding variables. We also assessed whether inflammation mediated the associations between Shigella and school-aged outcomes using a regression-based approach to mediation analysis. A high prevalence of Shigella was associated with a 0.32 (95% CI: 0.08, 0.56) z-score lower height-for-age z-score (HAZ) at 6–8 years compared to a low prevalence of Shigella. Intestinal inflammation had a smaller association with HAZ at 6–8 years. Shigella burden had small and consistently negative associations with cognitive outcomes in Brazil and Tanzania, but not South Africa, and the estimates were not statistically significant. Systemic inflammation was strongly associated with lower verbal fluency scores in Brazil (semantic fluency z-score difference: -0.57, 95% CI: -1.05, -0.10; phonemic fluency z-score difference: -0.48, 95% CI: -0.93, -0.03). There was no evidence that intestinal inflammation mediated the association between Shigella and HAZ or cognitive outcomes. Conclusions/significance: While Shigella infections were consistently associated with long-term deficits in linear growth, the estimates of the negative associations between Shigella and cognitive outcomes were imprecise and only observed in the Brazil and Tanzania sites. Systemic inflammation was strongly associated with lower semantic and phonemic fluency scores in Brazil only, highlighting the site-specificity of effects. Author summary: Shigella infections are common among children in low-resource settings and cause inflammation, which may contribute to poor child development outcomes. We studied children from birth to 6–8 years of age in Brazil, Tanzania, and South Africa to assess whether Shigella infections and markers of inflammation in the first 2 years of life were associated with child development outcomes at school age, including height and cognitive assessment scores. Shigella infections were consistently associated with long-term deficits in linear growth. However, the associations between Shigella and cognitive outcomes were smaller, not statistically significant, and inconsistent across the three sites. There was no evidence that inflammation caused by Shigella explained the associations between Shigella and school-aged outcomes. Systemic inflammation was strongly associated with lower cognitive assessment scores in Brazil but not in the other sites, highlighting the differences in determinants of child development across settings. Quantifying the impact and understanding mechanisms for the effect of early life exposures to Shigella on long-term cognitive outcomes remains challenging. [ABSTRACT FROM AUTHOR]

The Brazilian Policy of Comprehensive Care for People with Rare Diseases (BPCCPRD) was established by the Ministry of Health to reduce morbidity and mortality and improve the quality of life of people with rare diseases (RD). Several laboratory tests, most using molecular genetic technologies, have been incorporated by the Brazilian Public Health System, and 18 specialised centres have so far been established at university hospitals (UH) in the capitals of the Southern, Southeastern and Northeastern regions. However, whether the available human and technological resources in these services are appropriate and sufficient to achieve the goals of care established by the BPCCPRD is unknown. Despite great advances in diagnosis, especially due to new technologies and the recent structuring of clinical assessment of RD in Brazil, epidemiological data are lacking and when available, restricted to specific disorders. This position paper summarises the performance of a nationally representative survey on epidemiology, clinical status, and diagnostic and therapeutic resources employed for individuals with genetic and non-genetic RD in Brazil. The Brazilian Rare Disease Network (BRDN) is under development, comprising 40 institutions, including 18 UH, 17 Rare Diseases Reference Services and five Newborn Screening Reference Services. A retrospective study will be initially conducted, followed by a prospective study. The data collection instrument will use a standard protocol with sociodemographic data and clinical and diagnostic aspects according to international ontology. This great collaborative network is the first initiative of a large epidemiological data collection of RD in Latin America, and the results will increase the knowledge of RD in Brazil and help health managers to improve national public policy on RD in Brazil. [ABSTRACT FROM AUTHOR]

Copyright of Paideia (0103863X) is the property of Paideia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Fish populations that reside in completely isolated freshwater ecosystems are rare worldwide. The Vila Velha State Park (VVSP), located in southern Brazil, is recognized for its arenitic formations called sinkholes (furnas), which are completely isolated. Fish populations within, such as those of Psalidodon aff. fasciatus, often develop vertebral malformations due to this isolation from other conspecifics and other species. In this study, we analyzed geometric morphology in digital radiographs to identify congenital deformations of Psalidodon aff. fasciatus in Furna 2 of VVSP. We found many fish with spinal deformities, including wide variation in the number of caudal vertebrae and corporal deformations related to a flattened body and spinal curvature. Females were more affected than males. We also demonstrated that these deformations reflect inbreeding and an absence of gene flow in the population. In conclusion, isolated populations such as fish species in furnas are potential models for evo-devo research. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this review is to address the barriers limiting access to diagnosis and treatment of systemic lupus erythematosus (SLE) and lupus nephritis (LN) in Brazil, specifically for patients in the public healthcare system, arguably those with the least access to innovation. Design: A selected panel of Brazilian experts in SLE/LN were provided with a series of relevant questions to address in a multi-day conference. During the conference, responses were discussed and edited by the entire group through numerous drafts and rounds of discussion until a consensus was achieved. Results: The authors propose specific and realistic recommendations for implementing access to innovative diagnostic tools and treatment alternatives for SLE/LN in Brazil. Moreover, in creating these recommendations, the authors strived to address barriers and impediments for technology adoption. The multidisciplinary care required for SLE/LN necessitates the collective participation of all involved stakeholders. Conclusion: A great need exists to expand the adoption of innovative diagnostic tools and treatments for SLE/LN not only in Brazil but also in most countries, as access issues remain an urgent demand. The recommendations presented in this article can serve as a strategy for new technology adoption in other countries in a similar situation. [ABSTRACT FROM AUTHOR]

Roundup® is one of the most widely marketed glyphosate-based herbicides in the world. There are many different formulations of this brand that differ from each other in glyphosate concentration, salts and adjuvants, including surfactants, which are labelled as "inert" compounds. Several studies have shown that these formulations are highly toxic to fish, even compared with pure glyphosate. However, mechanisms underlying this toxicity are not fully understood. In this context, this study evaluated the effects of exposure to Roundup Original® (RO), Roundup Transorb® (RT), and Roundup WG® (RWG) on the behavioural patterns of the livebearer Jenynsia multidentata. This fish naturally inhabits agricultural areas in southern Brazil and Argentina where glyphosate is used extensively. In the experiment, animals were exposed to the herbicides for 96 h, at the environmentally relevant concentration of 0.5 mg/L of glyphosate. Swimming performance, anxiety, aggressiveness, long-term memory and male sexual activity were recorded. The formulation RWG negatively affected swimming performance, thigmotaxia and long-term memory consolidation. Conversely, RT reduced the sexual performance of males. These results confirm that Roundup® formulations are extremely harmful and also that they have different targets of toxicity, affecting behaviours that are essential for fish survival. [ABSTRACT FROM AUTHOR]

Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The creation of Open Educational Resources (OER) has as its basic principle to provide democratic access to knowledge. To achieve this purpose, OER should be made available in Learning Object Repositories (LOR), and they must have open access. The objective of this research is to identify the use of LOR in pedagogical practices and the support material to be an OER. Data were collected from scientific articles, published from 2014 to 2018, available from the Web of Science, Scopus, DOAJ, ERIC, Redalyc and in institutional repositories of scientific publications made available in Brazil and Spain. The search consisted in identifying articles that reported proposals for teaching-learning practices, using open access resources and repositories. Applying the systematic review methods, 1,201 publications were initially retrieved, and from this list, 42 articles were selected for reading and analysis, as they present relevant content with the theme of this research. It was possible to identify teaching initiatives using OER, practices with the objective of acquiring technological knowledge and using it to promote participatory and collaborative learning with the use of OER. However, it was not possible to identify consolidated practices in the publications, as the OERs presented were not available for free use and, therefore, distanced themselves from the concept of open access. [ABSTRACT FROM AUTHOR]

Background: Investigation based solely on clinical history background is not sufficient to prove drug allergy and may lead to search for more expensive and potentially less effective alternative drugs. There are too few health centers that perform such tests in Brazil. Objectives: The aim of the present work was to structure and to systematize a service for in vivo drug skin testing in a public university hospital. Methods: The project was structured as follows: a) Divulgation about the service among health professionals and also among patients; b) Active search for suspicious cases; d) Referral to the allergist consultation; c) Performance of skin prick, intradermal and/or epicutaneous tests when requested. Results: Disclosure about the service was done through informal talk, workshop, flyers, advertisement. Active search for suspicious cases was done at the Dermatology Outpatient Clinics, Walter Cantídio Hospital School, Brazil. Ninety patients were evaluated by the allergist, and from these, 68 were submitted to drug skin tests. Thirty-five patients out of 68 presented clinical manifestations up to 2 h after drug intake and 33, more than 2h after drug intake. The drugs most implicated were NSAIDS and β-lactam drugs. Seventy-seven tests carried out. For immediate reading, 41 puncture tests and 12 intradermal tests were performed. For delayed reading, 24 epicutaneous tests were done. Two patients presented positive prick test to dipyrone. Conclusion: For implementing an adequate and effective service for drug skin testing, technical and practical training of health professionals about drug safety is necessary, besides interdisciplinary collaboration and an adequate support by the hospital managers. [ABSTRACT FROM AUTHOR]

Lernaea cyprinacea is a lernaeid copepod also known as anchor worm. This species is considered one of the most invasive ectoparasites on fishes, with a worldwide distribution. In Brazil, L. cyprinacea has spread in almost the entire country, being recorded parasitizing both native and farmed fishes. Post-metamorphic adult females of L. cyprinacea were recorded for the first-time parasitizing larvae and juveniles of the native fish Piabarchus stramineus sampled in the Taquari River, Upper Paranapanema River, São Paulo State, Brazil. The lernaeids were found attached to the base of the fins, with a preference for the pelvic fin (43.7% of parasitized hosts). The presence of these parasites on larvae/juveniles resulted in deformations in the host bodies and modification of the caudal peduncle angulation. The findings of L. cyprinacea infecting P. stramineus raises concern about the dispersal of this invasive parasite in natural areas and the deleterious effects of this parasite, especially in young fishes. [ABSTRACT FROM AUTHOR]

Copyright of Revista Eletrônica de Enfermagem is the property of Revista Eletronica de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims: Cardiac resynchronization therapy (CRT) is an established procedure for patients with heart failure. However, trials evaluating its efficacy did not include patients with chronic Chagas cardiomyopathy (CCC). We aimed to assess the role of CRT in a cohort of patients with CCC.Methods and results: This retrospective study compared the outcomes of CCC patients who underwent CRT with those of dilated (DCM) and ischaemic cardiomyopathies (ICM). The primary endpoint was all-cause mortality and the secondary endpoints were the rate of non-advanced New York Heart Association (NYHA) class 12 months after CRT and echocardiographic changes evaluated at least 6 months after CRT. There were 115 patients in the CCC group, 177 with DCM, and 134 with ICM. The annual mortality rates were 25.4%, 10.4%, and 11.3%, respectively (P < 0.001). Multivariate analysis adjusted for potential confounders showed that the CCC group had a two-fold [hazard ratio 2.34 (1.47-3.71), P < 0.001] higher risk of death compared to the DCM group. The rate of non-advanced NYHA class 12 months after CRT was significantly higher in non-CCC groups than in the CCC group (DCM 74.0% vs. ICM 73.9% vs. 56.5%, P < 0.001). Chronic Chagas cardiomyopathy and ICM patients had no improvement in the echocardiographic evaluation, but patients in the DCM group had an increase in left ventricular ejection fraction and a decrease in left ventricular end-diastolic diameter.Conclusion: This study showed that CCC patients submitted to CRT have worse prognosis compared to patients with DCM and ICM who undergo CRT. Studies comparing CCC patients with and without CRT are warranted. [ABSTRACT FROM AUTHOR]

Copyright of Revista CESUMAR: Ciências Humanas e Sociais Aplicadas is the property of Revista Cesumar - Ciencias Humanas e Sociais Aplicadas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Identifying the genetic etiology in a person with hearing loss (HL) is challenging due to the extreme genetic heterogeneity in HL and the population-specific variability. In this study, after excluding GJB2 variants, targeted resequencing of 180 deafness-related genes revealed the causative variants in 11 of 19 (58%) Brazilian probands with autosomal recessive HL. Identified pathogenic variants were in MYO15A (10 families) and CLDN14 (one family). Remarkably, the MYO15A p.(Val1400Met) variant was identified in eight families from the city of Monte Santo in the northeast region of Brazil. Haplotype analysis of this variant was consistent with a single founder. No other cases with this variant were detected among 105 simplex cases from other cities of northeastern Brazil, suggesting that this variant is confined to a geographical region. This study suggests that it is feasible to develop population-specific screening for deafness variants once causative variants are identified in different geographical groups. [ABSTRACT FROM AUTHOR]

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Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• Existing circular economy (CE) conceptualizations are based on formally organized developed markets. • A large part of world's employed population make their living from informal sector circular economy. • Informal low-income contexts are rich in necessity-driven value retaining practices for materials and goods. • Academic and policy discourses currently tend to omit these necessity-driven CE practices. • Reaching the full potential of CE globally calls for knowledge of necessity-driven CE. Low-income informal sector contexts are rife in practices that retain value of materials and goods, but in the academic literature and policy debates these practices are seldom considered as part of the circular economy (CE). This is a major omission in CE discourse, as over 60 percent of the world's employed population is in the informal sector and many of them make their living from circularity practices. Hence, our paper advances a globally covering understanding of CE by focusing on local practices constituting CE in the overlooked contexts of low-income informal markets of emerging economies, and on the motives behind the practices. To that end we introduce the notion of Necessity-Driven Circular Economy, defined as a set of locally embedded and interlinked formal and informal practices aimed at restoring and retaining the value of goods and materials for as long as possible, based on economic necessity and opportunities for income generation. We substantiate this conceptual work with our empirical findings from low-income urban communities in Brazil, India, and Tanzania. This allows us to capture the essential characteristics of necessity-driven circular economy. These characteristics draw attention to the social and cultural embeddedness and the interweaving of consumption and production in necessity-driven circular economy, as opposed to the dominant techno-economic and industry-focused circular economy conceptualizations that are typical in academic discourse and portray developed country contexts. Finally, we discuss conceptual and practical relevance of necessity-driven circular economy and point out its system-level implications for policymakers and businesses. [ABSTRACT FROM AUTHOR]

Recent studies using molecular data showed that the species traditionally treated as Viguiera Kunth in South America should be transferred to Aldama La Llave. After carrying out a taxonomic study of the 35 Brazilian species of Aldama, we propose three new combinations for binomials and two for varieties, plus a new variety, 20 new synonyms and 25 lectotypifications. [ABSTRACT FROM AUTHOR]

Objective: evaluate prenatal care for adolescents in health units, in accordance with the attributes of Primary Health Care (PHC) guidelines. Method: quantitative study conducted with health professionals, using the Primary Care Assessment Tool-Brazil to assess the presence and extent of PHC attributes. Results: for all the participating units, the attribute Access scored ≤6.6; the attributes Longitudinality, Coordination (integration of care), Coordination (information systems) and Integrality scored ≥6.6, and the Essential Score ≤6.6. Comparing basic units with family health units, the attribute scores were equally distributed; Accessibility scored ≤6.6, the others attributes scored ≥6.6; however, in the basic units, the Essential Score was ≤6.6 and, in the family health units, ≥6.6. Conclusion: expanding the coverage of family health units and the training of professionals can be considered strategies to qualify health care.

As has happened in many other countries, Brazil has also witnessed an evident change in the question of accessibility over the last twenty years. In line with this theme, that of old age has only become evident in the last two decades. For a long period of time, the elderly have been systematically ignored as an object of investigation and have not been contemplated with consistent public social policies. Therefore, the main objective of this research is to verify the conditions of physical accessibility that allow the elderly to use public spaces, taking as a study case the São Gonçalo square and the Solón de Lucena Park, in the city of João Pessoa - PB, identifying the biological and functional losses suffered by elderly people due to the aging process and verifying the specific physical needs of this segment of the population. Qualitative methods were adopted, such as systematic observations with the production of behaviour maps, in addition to a review of the literature and analysis of the data. The research identified problems related to the physical accessibility of the elderly to public spaces that generate difficulties for displacement, use, information and orientation, contributing to the planning and ergonomic guidelines which aim at improving these environments, such as the use of different and contrasting colours on the urban furniture and floor, for example. [ABSTRACT FROM AUTHOR]

Abstract: Mucopolysaccharidosis type VI (MPS VI, Maroteaux–Lamy syndrome) is a lysosomal storage disease caused by deficiency of arylsulphatase B. The incidence of MPS VI is very low, usually less than 1 case for every 1,000,000 newborns. In Northeast Brazil we identified in the county of Monte Santo (52,360 inhabitants) thirteen patients with MPS VI. The aim of this work was to identify the mutation(s) present in these patients and analyze intragenic SNPs to define possible haplotypes. The 13 MPS VI patients were found to be homozygous for the p.H178L mutation. All patients have the same haplotype for the intragenic SNPs. Based on current data, the prevalence of MPS VI in this region is estimated as 1:5,000 newborns. These results, together with pedigree analysis, strongly suggest a founder effect accounting for the high frequency of p.H178L mutation in this area. This reinforces the need of a comprehensive community genetics program for this area. [Copyright &y& Elsevier]

This qualitative study assesses how women, in situations of domestic violence and examined at the Institute of Forensic Medicine, deal with this adversity and identifies protection strategies to cope with it, considering the support required and obtained from their relational and institutional environments. Ten women were interviewed and the data were analyzed using thematic content analysis. Search for help primarily occurs in the women's social milieu, with family and friends and health and legal services being sought. In such a quest, established bonds may either become an obstacle to coping and make these women vulnerable to violence or protect and strengthen them during coping. In the identification of these women's social and health needs, the aggravating circumstances of violence are only superficially addressed by professionals. New strategies to implement professional actions should be devised in order to provide integral and humanized care. [ABSTRACT FROM AUTHOR]

Objective: to evaluate the cognition and motor development, self care, language, socialization and the nutritional status of child with zero to six years old. Method: 48 children attending a philanthropic day care called Casa da Criança, living in Diamantina Town (Jequitinhonha Valley, Minas Gerais, Brazil) participated in this study. For data collection it was used the following instruments and proceedings: Portage Inventory application, nutritional evaluation and social and economic questionnaire. Results: the partial correlation analyses demonstrated that there were significant correlations within the following pair of variables: cognition x language, socialization x self care and motor x weight/height and weight/age. Discussion: we perceived the necessity of implantation of a program for child development stimulation in the day care that integrate health and education, which may be planned into the Portage Inventory perspective. The use of instruments in this study makes possible the children repertory optimization, the educators training and the family orientation to the children stimulation. Conclusion: an intervention based on the Portage Inventory shows as promising tool to the healthy interaction between the children and parents/caregivers. [ABSTRACT FROM AUTHOR]

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Copyright of Cultures et Conflits is the property of Centre d'Etudes sur les Conflits, Revue Cultures & Conflits and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Simple Summary: Culicoides genus insects are spread throughout the world, and some species are vectors of important human and animal diseases. Genetic identification, as well as the local occurrence of these insects, are fundamental to the development of risk profiles and entomological surveillance of transmitted diseases. We investigated the Culicoides occurrence in Alagoas State, northeastern Brazil. Midges were captured with light traps, being morphologic and genetic identified. After PCR analysis and GenBank database comparison, it was confirmed that the captured midges belong to Culicoides insignis. This was the first formal report of Culicoides insignis occurrence in Alagoas State, northeastern Brazil. The species of the Culicoides genus are hematophagous, and some of them are vectors of important human and animal diseases. This group of insects is distributed worldwide, varying according to local species. Knowledge of the geographic distribution of specific species is crucial for the development and implementation of control strategies. The aim of this work was to investigate the occurrence of Culicoides in the state of Alagoas in northeast Brazil. Midges were captured with CDC light traps, and their identification and morphological analyses were performed by the Ceratopogonidae Collection of the Oswaldo Cruz Foundation (FIOCRUZ/CCER) in Rio de Janeiro, Brazil. Morphological analyses were performed using the key to Culicoides from the guttatus group and comparison with other deposited specimens. DNA sequencing, genetic analysis and comparison with sequences in the Genbank database, confirmed the identification of the flies as Culicoides insignis. This was the first formal report of C. insignis being found in Alagoas. [ABSTRACT FROM AUTHOR]

In order to produce carotenoids with antioxidant potential from the wild yeast Rhodotorula mucilaginosa, Sporidiobolus pararoseus and Pichia fermentans, isolated from the ecosystem of Escudo Sul-Rio Grandense (Brazil), cultivations were performed with: raw glycerol and corn steep liquor (M1), sugar cane molasses and corn steep liquor (M2) and Yeast Malt (YM) broth. Production of β -carotene more than 63% was obtained in all the experiments. The antioxidant activity of the extracts was analyzed by the methods DPPH, ABTS and FRAP. S. pararoseus is highlighted, showing 635 and 830 μg.L−1 of carotenoids in M1 and M2, respectively. The extracts of P. fermentans in M2 were promising in relation to the antioxidant activity, presented results not reported in the literature until the present moment. Based on these results and the importance of obtaining carotenoid compounds from alternative sources, the proposed means, as well as the yeasts used, were shown to be promising choices. The use of agroindustrials media and microorganisms isolated from the ecosystems intensify the importance of this study providing new sources of biocompounds from the biodiversity and biotechnological potential of Brazil. Image 1 - Yeasts were cultivated in agroindustrial byproducts; - Antioxidant capacity was determined in carotenogenic extracts of yeasts; - The main carotenoids of the extracts were identified. [ABSTRACT FROM AUTHOR]

• This series details 14 asymptomatic normocephalic newborns with confirmed congenital Zika infection. • All newborns presented Zika virus (ZIKV) positivity by reverse transcriptase polymerase chain reaction. • This series corroborates the neonatal screening for ZIKV in endemic areas. Fourteen asymptomatic normocephalic newborns with confirmed congenital Zika infection were investigated. All newborns presented Zika virus (ZIKV) positivity on reverse transcriptase polymerase chain reaction. Following ZIKV-specific NS5 gene fragment sequencing in one child, phylogenetic analysis revealed that this isolate belonged to the Asian genotype, and clustered closely with other sequences previously isolated in north-east and northern regions of Brazil. [ABSTRACT FROM AUTHOR]

Congenital heart defects (CHD) are the most common type of congenital defects. Despite having much better-defined risk factors nowadays, the etiology of most CHDs remains unknown. In only 10 to 15 % of cases, a well-established causal relationship can be defined. To identify risk factors for critical and/or complex congenital heart disease as well as to estimate the current prevalence of these conditions in newborns. The present case-control study was matched by maternal age and newborn sex, performed between 2014 and 2016 by active search, involving interviews and the analysis of medical records, as well as clinical evaluation in newborns with critical or complex CHD. Our study was performed in the maternity and neonatology departments of four major public hospitals in the city of Salvador, Bahia-Brazil. Sixty-one cases of critical and/or complex congenital heart disease were identified, with 122 controls selected at random from 20,917 live births during the study period. The prevalence of critical and/or complex CHD was 292 cases per 100,000 births. The most frequent kinds of complex CHD were coarctation of the aorta and interrupted aortic arch. Our reduced conditional logistic regression model identified the following risk factors: Number of pregnancies (odds ratio [OR]: 8.97 [1.75–46], p = 0.009), and known maternal (OR: 6.62 [1.23–35.81], p = 0.028) or paternal (OR: 8.88 [2.31–35.63] p = 0.002) family history of malformations. We observed a high prevalence of critical and complex CHD in the studied population. The final conditional logistic regression model identified a history of three or more pregnancies and a known paternal family history of malformations as independent risk factors for critical congenital heart disease. [ABSTRACT FROM AUTHOR]

Abstract: Risk factors for development of multiple sclerosis (MS) are still a matter of debate. Latitude gradient, vitamin D deficiency and season of birth are among the most investigated environmental factors associated with the disease. Several international studies suggest that birth in spring is a substantial risk factor for MS. We investigated the season of birth as a potential risk for MS in different geographical regions of Brazil. We conducted a cross-sectional retrospective study with 2257 clinically definite MS patients enrolled in 13 Brazilian MS clinics in the south, southeast, and northeast regions of Brazil. Demographic and clinical data relating to date of birth and clinical features of the disease were collected and analysed, and subsequently compared with birth date among the general Brazilian population. The distribution of date of birth of MS patients showed an increase in spring and a decrease in autumn, with no difference being observed in the other seasons. In conclusion, season of birth is a probable risk factor for MS in most parts of Brazil. These findings may be related to the role that vitamin D plays in MS pathogenesis. [Copyright &y& Elsevier]

Introduction: Brazil is experiencing a nutritional transition characterized by a reduction in the prevalence of nutritional deficits and an increase in overweight and obesity, not only in adults but also in children and adolescents. Objectives: This study was designed to evaluate the factors associated with overweight and obesity in Brazilian 5-year-old preschoolers. Methods: A cross-sectional study of a cohort of 232 preschoolers born in Diamantina/Minas Gerais, Brazil, was undertaken. The data, including socioeconomic status, anthropometry, diet, previous history of the preschoolers and family history, were collected between July of 2009 and July of 2010. To identify the factors associated with overweight and obesity, a logistic regression and a hierarchical model were undertaken. Results: Overweight and obesity occurred in 17.2% of the preschoolers. After adjusting for mother's obesity, per capita income, protective food intake, weight gain at age 0-4 months and time spent playing, the factors associated with overweight and obesity that reached statistical significance were mother's obesity [OR = 3.12 (95%CI 1.41-6.91), P = 0.01], weight gain of more than 0.85 kg/month in the first four months of life [OR = 2.16 (95 % CI 1.01-4.64), P = 0.04] and lower per capita income [OR = 0.32 (95%CI 0.13-0.79), P = 0.01]. Conclusion: The results show that more weight gain during the first four months of life and being born of mothers with obesity increased the odds of overweight/ obesity in the preschoolers, while lower per capita income was a protective factor. [ABSTRACT FROM AUTHOR]

Cystic fibrosis (CF) is the most common autosomal recessive disease in the European (Caucasian) population, with an incidence of 1:2,000 to 1:8,000. The ΔF508 mutation (66%) is predominant among more than 1,300 different mutations of the CFTR gene. The population of the state of Bahia, in northeastern Brazil, is highly admixed (mainly African and Portuguese descendants), and so far, no study has been carried out to assess the molecular basis of CF in this population. We determined the Δfrequency in 503 individuals from the general population of Salvador, the capital of the state of Bahia, and in 144 CF patients from several cities in Bahia. In the general population samples we found 4 individuals heterozygous for the ΔF508 mutation (allele frequency of 0.4%). This frequency was lower than that found in the state of Rio de Janeiro, in southeastern Brazil, and similar to that reported for the state of Paraná, in the far south. In the CF patients we found 9 heterozygous individuals and 8 homozygous individuals (allele frequency of 8.68%) for the ΔF508 mutation. This frequency is considerably lower than the average frequency of CF in the world population and in the Brazilian CF population of European ancestry (47%). These data could be explained by the intense admixture among the population in Bahia, and they suggest a heterogeneous molecular basis for CF in this area of Brazil. [ABSTRACT FROM AUTHOR]

Background: Transcatheter aortic valve implantation (TAVI) has established itself as the preferential strategy to approach severe aortic stenosis. Information on procedural improvements and nationwide results obtained with the technique throughout the past decade are unknown., Objectives: To assess the temporal variation of the demographic profile, procedural characteristics, and in-hospital outcomes of patients undergoing TAVI procedures at the Rede D'Or São Luiz., Methods: Observational registry comprising 29 national institutions, comparing the characteristics of the TAVI procedures performed from 2012 to 2017 (Group 1) to those performed from 2018 to 2023 (Group 2). The statistical significance level adopted was p < 0.05., Results: This study assessed 661 patients, 95 in Group 1 and 566 in Group 2, with a mean age of 81.1 years. Group 1 patients had a higher prevalence of New York Heart Association functional class III or IV and STS risk score > 8%. In addition, they more often underwent general anesthesia, transesophageal echocardiographic monitoring, and access through femoral dissection. Group 2 patients had a higher success rate of the TAVI procedure (95.4% versus 89.5%; p = 0.018), lower mortality (3.9% versus 11.6%; p = 0.004), and less often needed permanent pacemaker implantation (8.5% versus 17.9%; p = 0.008)., Conclusions: The 10-year temporal trends analysis of the TAVIDOR Registry shows a reduction in patients' clinical complexity over time. Furthermore, the advance to minimalistic implantation techniques, added to the technological evolution of the devices, may have contributed to the favorable outcomes observed among those whose implantation occurred in the last 5 years studied.

Background: The consumption of ultra-processed foods has increased worldwide and has been related to the occurrence of obesity and other non-communicable diseases. However, little is known about the environmental effects of ultra-processed foods. We aimed to assess the temporal trends in greenhouse gas emissions (GHGE), water footprint, and ecological footprint of food purchases in Brazilian metropolitan areas, and how these are affected by the amount of food processing., Methods: In this time-series study, we used data from five Brazilian Household Budget Surveys (1987-88, 1995-96, 2002-03, 2008-09, 2017-18) to calculate GHGE, water footprint, and ecological footprint per 1000 kcal of food and beverages purchased. Food items were classified into NOVA food groups: unprocessed or minimally processed foods (G1); processed culinary ingredients (G2); processed foods (G3); and ultra-processed foods (G4). We calculated the proportion each NOVA food group contributes to daily kcal per person. Linear regression was performed to evaluate trends of the environmental impacts across the years., Findings: Between 1987-88 and 2017-18, diet-related GHGE increased by 21% (from 1538·6 g CO 2 equivalent [CO 2 e] per 1000 kcal [95% CI 1473·3-1604·0] to 1866·0 g CO 2 e per 1000 kcal [1788·0-1944·0]; p trend <0·0001), diet-related water footprint increased by 22% (from 1447·2 L/1000 kcal [95% CI 1400·7-1493·8] to 1769·1 L/1000 kcal [1714·5-1823·7]; p trend <0·0001), and diet-related ecological footprint increased by 17% (from 9·69 m 2 /1000 kcal [95% CI 9·33-10·05] to 11·36 m 2 /1000 kcal [10·91-11·81]; p trend <0·0001). We found that the change in the environmental indicators over time varied between NOVA food groups. We did not find evidence of a change in the environmental indicators for G1 foods over time. GHGE from G2 foods decreased by 18% (p trend <0·0001), whereas GHGE from G4 foods increased by 245% (p trend <0·0001). The water footprint from G2 foods decreased by 17% (p trend <0·0001) whereas the water footprint from G4 foods increased by 233% (p trend <0·0001). The ecological footprint from G2 foods decreased by 13% (p trend <0·0001), whereas the ecological footprint from G3 foods increased by 49% (p trend <0·0001) and from G4 foods increased by 183% (p trend <0·0001). We found no significant change in contribution by any other NOVA food groups to any of the three environmental indicators over the study period., Interpretation: The environmental effects of the Brazilian diet have increased over the past three decades along with increased effects from ultra-processed foods. This means that dietary patterns in Brazil are becoming potentially more harmful to human and planetary health. Therefore, a shift in the current trend would be needed to enhance sustainable healthy food systems., Funding: Science and Technologies Facilities Council-Global Challenges Research Fund., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2021 The Authors(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Objectives: to identify and analyze possibilities for recognizing health needs in the nurses' work at Family Health Strategy., Methods: a qualitative study with interviews and observation of the nurses' work in the countryside of São Paulo. The empirical material was subjected to thematic content analysis and interpreted in the light of the health work process., Results: two themes emerged: Possibilities utilized and Possibilities neglected to recognize health needs. Careful observation, welcoming, attention, listening, bonding and dialogue developed by nurses, in live work in action with users, touched on the possibilities, which, taken advantage of, were evidenced in care in spontaneous demand, scheduled consultation, examination gynecological and group activities., Final Considerations: nurses are able to recognize health needs, which can expand their clinical practice and interprofessionality in Family Health.

Background: The Self-Reporting Questionnaire (SRQ) is a screening instrument that has been shown to be an effective measure of depression in postpartum women and is widely used in developing nations., Methods: The SRQ was administered to 2028 mothers from eight nations at two time points: one and six months postpartum. All data were obtained from the Interactions of Malnutrition and Enteric Infections: Consequences for Child Health and Development (MAL-ED) study. The sample included women from MAL-ED sites in Bangladesh, Brazil, India, Nepal, Pakistan, Peru, South Africa, and Tanzania. This study examined three aspects of validity of SRQ scores including (a) structural validity, (b) cross-cultural invariance, and (c) invariance over time., Results: A 16-item, one-factor structure with items reflecting somatic symptoms removed was deemed to be superior to the original structure in this postpartum population. Although differential item functioning (DIF) across sites was evident the one-factor model was a good fit to the data from seven sites, and the structure was invariant across the one- and six-month time points., Limitations: Findings are based on data from self-report scales. No information about the clinical status of the participants was available., Conclusions: Overall, findings support the validity of a modified model of the SRQ among postpartum women. Somatic symptoms (e.g., headaches, not sleeping well) may not reflect internalizing problems in a postpartum population. Implications for researchers and practitioners are discussed., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Mucopolysaccharidosis type VI (MPS VI - Maroteaux-Lamy syndrome) is a globally rare lysosomal storage disease caused by a deficiency of arylsulfatase B. However, in Monte Santo, a poor and isolated rural region in Northeast Brazil with large family sizes and high rates of community endogamy and parental consanguinity (α = 0.00483), 9 living and 4 now deceased individuals in 11 kindreds have been diagnosed with MPS VI, all with the same p.H178L missense founder mutation. A further 33 deceased persons have been identified by family members as exhibiting the disease phenotype. Detailed pedigrees were constructed for the 13 genomically confirmed MPS VI patients, with blood samples collected from 236 unaffected family members to determine the prevalence of the p.H178L mutation. A total of 98 (20.8%) mutant alleles and 374 (79.2%) normal alleles were identified, with 41.5% of the individuals heterozygous for the p.H178L mutation and 58.5% homozygous for the normal allele. A significant number of other family members with a 50 or 25% chance of being heterozygous for the p.H178L mutation were unavailable for testing. The data indicate a compelling case for community-based neonatal screening in conjunction with further initiatives among MPS VI family members to promote genetic education and genetic counselling., (© 2014 S. Karger AG, Basel)