Este trabalho aborda a efetividade da Política Nacional de Saúde Integral LGBT quanto ao atendimento de pessoas trans em Araguaína-TO. O desenho do atendimento de saúde nas Unidades Básicas de Saúde desse segmento constitui um desafio acadêmico pela complexidade da questão que envolve Estado, Município e União em regime de corresponsabilidade. A análise proposta se refere ao respeito do nome social dessas pessoas quando precisam do SUS para acompanhamento da hormoneoterapia e a necessidade de atenção médica multidisciplinar, principalmente, quando é manifestada pelo usuário/a necessidade da cirurgia de transgenitalização.
O presente trabalho tem por objetivo apresentar possibilidades de uso da tecnologia na gestão da informação científica, em sua divulgação e na transformação do conhecimento em forma digital, acessível a todas as pessoas, sem restrição. Para tanto, as teorias que subsidiam este trabalho são a information literacy, a virtual literacy, a media literacy e a digital literacy. Essas teorias são as bases da competência de uso da tecnologia com seus elementos centrais para o processo de divulgação científica mediante recursos educativos. A seguir, destacaremos as referências e os padrões de uso dessa competência para esse trabalho, sua aplicação e a viabilização de procedimentos.
RESUMO O objetivo do trabalho foi caracterizar a produção científica acerca do Movimento dos Trabalhadores Rurais Sem Terra (MST) até 2016, com ênfase na identificação e na análise dos trabalhos que tratem do tema 'saúde', buscando identificar os problemas e a necessidade de saúde da população vinculada ao MST, bem como as concepções, projetos e práticas de saúde desse Movimento. Trata-se de uma revisão integrativa da literatura, que analisou 108 trabalhos capturados nas bases BVS e Capes, sendo que, destes, 15 tratam especificamente das questões de saúde. Os resultados evidenciam a precariedade das condições de vida e de saúde das populações acampadas e assentadas e revelam a multiplicidade de problemas e necessidades de saúde não atendidas de grupos específicos, a exemplo dos trabalhadores, mulheres e crianças. Observa-se, entre as lideranças do Movimento, uma concepção abrangente de Saúde e uma diversidade de posições com relação à participação do MST nas instâncias de controle social do SUS. Conclui-se apontando a necessidade de aprofundamento dos estudos sobre a capacidade de o movimento sanitário incorporar os movimentos do campo em sua base de sustentação, principalmente se o MST tem sido um aliado no processo de Reforma Sanitária Brasileira.
This study was designed to evaluate the effects of different supplementation plans on the nutrient intake, apparent total-tract digestibility, grazing behavior, growth performance, and carcass characteristics of beef cattle under grazing conditions from ages 4 to 18 months old. The beef calves grazed Brachiaria decumbens in four seasons: rainy-dry transition, dry, dry-rainy transition, and rainy. Forty-four animals (11 per treatment) were randomly assigned to one of four nutritional plans of supplementation defined by the quantity of supplement offered: control, low, medium, and high supplementation. There was no difference (P > 0.10) in dry matter intake (DMI). However, animals receiving medium and high supplementation had decreased (P < 0.10) forage dry matter intake (FDMI) compared with those under non- and low supplementation. The DMI and FDMI were lower (P < 0.10) in the dry season. During the rainy season, the grazing time decreased (P < 0.10) for animals receiving supplementation compared with non-supplemented ones, but was similar between medium and high supplementation. The performance and carcass characteristics were greater (P < 0.10) for high and medium supplementation compared with low and control. In conclusion, increasing the supplementation plans for beef cattle in tropical pastures increases the nutrient intake but decreases FDMI. The performance also increases with the supplementation plan; however, the growth rate is affected by the grazing season.
<p>Objetivou-se avaliar o efeito da substituição do farelo de soja pelo farelo de algodão em suplementos múltiplos sobre as características nutricionais e desempenho produtivo de novilhas de corte em fase de recria em pastagens de <em>Brachiaria decumbens </em>no período da seca. Foram utilizadas 24 novilhas de corte nelore com idade e peso médio inicial de 8 meses e 210±6 kg, respectivamente. O delineamento foi inteiramente casualizado com quatro tratamentos e seis repetições. Os suplementos continham aproximadamente 30% de proteína bruta (PB) e substituição progressiva do farelo de soja pelo farelo de algodão em 0, 50 e 100%. Aos animais do tratamento controle foi fornecida apenas mistura mineral <em>ad libitum </em>e aos demais tratamentos foram fornecidos 1,0 kg/animal/dia de suplemento. Não houve diferença de GMD entre os animais suplementados e os animais controle (P>0,10). A suplementação aumentou apenas o consumo de proteína bruta (PB) (P<0,10). O nível de substituição de farelo de soja pelo farelo de algodão não afetou (P>0,10) o consumo nos animais suplementados. A suplementação ampliou os coeficientes de digestibilidade aparente (P<0,10) da MO, PB, CFN e NDT com exceção do EE e da FDNcp (P>0,10). Observou-se efeito linear positivo (P<0,10) do nível de substituição de farelo de soja pelo farelo de algodão sobre a digestibilidade da MO, CNF e NDT. Houve efeito da suplementação e do nível de substituição (P<0,10) sobre o teor de nitrogênio ureico no soro e nitrogênio ureico na urina. Não houve efeito da suplementação e do nível de substituição sobre o fluxo de nitrogênio microbiano ao intestino (NMIC) e eficiência de síntese de proteína microbiana (EFM) (P>0,10). Foi verificado efeito linear decrescente (P<0,10) da substituição sobre a relação nitrogênio microbiano/ nitrogênio ingerido (NMICR). Conclui-se que a substituição do farelo de soja pelo farelo de algodão em suplementos múltiplos durante a época seca não prejudica o desempenho produtivo de novilhas de corte.</p>
Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long- term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
Background: Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods: This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings: Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16-30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77-0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50-0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80-0·88; p<0·001), and full lockdowns (0·57, 0·54-0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation: Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services.