ABSTRACT Organic residue in the substrate and the availability of light influence the production of high-quality seedlings for ex situ cultivation of native forest species. This study aimed to evaluate the effect of doses of chicken manure incorporated in the soil and shading levels on the morphophysiological responses and quality of Alibertia edulis (Rich.) A. Rich seedlings. Five doses of chicken manure (CM) were tested, 0.00, 2.08, 4.16, 6.24, and 8.32 g CM kg-1 soil, under two shade conditions, 0% (full sun) and 50% shading. At 215 days after transplanting, the maximum height obtained for A. edulis was 47.35 cm with 5.64 g CM kg-1 soil under 50% shade. Shaded seedlings had a higher number of leaves. The maximum leaf and root areas were 796.64 and 118.83 cm2 with 5.32 and 4.21 g CM kg-1 soil, respectively, both under 50% shade. Seedlings in 0% shade had lower physiological indices. Shading levels did not affect stomatal limitation, but CM contributed to physiological efficiency. Shoot biomass was higher under 50% shade with higher CM doses. The highest quality indexes occurred with 3.98 and 6.28 g kg-1 CM under 0 and 50% shade, respectively. A. edulis seedlings responded positively to the addition of CM to the soil and presented plasticity under contrasting light conditions. A. edulis seedlings produced under 50% shading with the addition of 6.24 g CM kg-1 soil presented high morphophysiological and seedling quality indicators. The addition of 4.32 g CM kg-1 soil contributed to high seedling quality under full sun conditions.

RESUMO O uso de resíduo orgânico no substrato e a disponibilidade de luz influenciam na obtenção de mudas de elevada qualidade para o cultivo ex situ de espécies florestais nativas. Objetivou-se com este estudo avaliar o efeito de doses de cama de frango incorporadas ao solo e níveis de sombreamento sobre as respostas morfofisiológicas e qualidade de mudas de Alibertia edulis (Rich.) A. Rich. Foram estudadas cinco doses de cama de frango (CF): 0,00; 2,08; 4,16; 6,24 e 8,32 g kg-1 sob duas condições de sombreamento: 0% (pleno sol) e 50% de sombreamento. Aos 215 dias após o transplantio, a máxima altura da A. edulis foi 47,35 cm com 5,64 g CF kg-1 solo sob 50% de sombreamento. Mudas sombreadas tiveram maior número de folhas. A máxima área foliar e radicular foi de 796,64 e 118,83 cm2 com 5,32 g e 4,21 g CF kg-1 solo, respectivamente, ambos sob 50% de sombra. Mudas sob 0% de sombra tiveram menores índices fisiológicos. Os níveis de sombreamento não afetaram a limitação estomática, mas a CF contribuiu na eficiência fisiológica. As biomassas da parte aérea foram maiores sob 50% de sombra com maiores doses de CF. Os maiores índices de qualidade ocorreram com 3,98 e 6,28 g CF kg-1 solo sob 0 e 50% de sombra, respectivamente. Mudas de A. edulis responderam positivamente à adição de CF ao solo e apresentaram plasticidade às condições contrastantes de luz. Mudas de A. edulis produzidas em 50% de sombra com adição de 6,24 g CF kg-1 solo apresentaram maiores indicadores morfofisiológicos e qualidade de mudas. A adição de 4,32 g CF kg-1 solo contribuiu na qualidade de mudas sob pleno sol.

Abstract Background Diversified crop systems provide several advantages for crop production and the agricultural ecosystem. In contrast, growing the same crop for consecutive years increases weeds, insects, and diseases issues, adding further cost to crop production owing to their management. Objective The objective was to evaluate the effects of six different winter cover crops and compare the impacts of a diversified rotation system in contrast to the succession system, combined with three different post-emergence herbicide management looking up to soybean yield, aboveground mass production, and weed density impact. Methods The experiment was performed over 2014 to 2018, using a randomized block design with four replications. Cover crop treatments were 1) fallow 2) wheat 3) rye 4) rye + turnip 5) rye + vetch 6) black oats. At the time of cover crop termination, weed density was counted and aboveground mass was measured. The crop rotation system was an alternated soybean and corn using three different post-emergence herbicide treatments, and the succession system was soybean each year. When a significant effect was observed after test F, the Tukey test (p ≤ 0.05) was applied to compare treatment effects. Results Rye + vetch as a cover crop, rotation system, and herbicide usage showed a higher impact on weed density. Rye + turnip has produced more aboveground biomass. Soybean yield was higher after wheat. Conclusions Cover crops implementation, crop rotation system, and herbicide usage have increased biomass production and crop yield, and reduced weed density showing integrated weed management as a key strategy for production systems.

ABSTRACT Purpose: Demonstrate the pivotal role of environmental information amongst all the project collaborators and to present the products resulting from the processing of recycling materials. Method: The research is pragmatic, and the main tool used was an open interview with four of the street collectors, out of a team of 12 members, and their manager. The location of the research was the “Gota do Óleo” Association in Eunápolis, Bahia, Brazil. Result: The results demonstrate that “Gota do Óleo” Association has an important role in the education of the local community concerning environmental information. It also demonstrates the importance of the association as a source of income for the families of the local street collectors. They use credible environmental information from official agencies and disseminate quality information in their social media platforms. The main products from the association are: brooms, clothesline ropes, bottles and soap. The association also promotes conferences on environmental education in schools and private companies. Conclusion: There is a visible vacuum relative to the involvement of public libraries and professionals of information technology to mediate reliable environmental information to the general public, while this is a fertile field for their work. Local initiatives are crucial for rescuing the ecosystem, and an important source of income for the families.

RESUMO Objetivo: Demonstrar como a informação ambiental permeia o trabalho dos colaboradores do projeto e apresentar os produtos advindos do processamento dos materiais recicláveis. Método: A pesquisa é qualitativa, o instrumento utilizado foi a entrevista aberta com quatro catadores e o gestor, sendo a população de 12 catadores. O lócus da pesquisa foi a Associação Gota do Óleo, em Eunápolis, na Bahia. Resultado: Os resultados demonstraram que a associação exerce uma função importante na educação ambiental da população e é também importante fonte de renda para as famílias de catadores, utilizando informação ambiental de qualidade advinda principalmente de órgãos oficiais e disseminado informação de qualidade em suas redes sociais. Os principais produtos da associação são: vassoura, vassourão, cordas de varal de garrafas pet e sabão. A associação promove também palestras em escolas e empresas, com a finalidade de educação ambiental. Conclusões: Percebe-se um vazio quanto à atuação de bibliotecas e profissionais da informação, sendo este um campo fértil para a atuação dos mesmos enquanto mediadores da informação ambiental de qualidade. Iniciativas locais são imprescindíveis para a recuperação do ecossistema, bem como importante fonte de renda para as famílias.

ABSTRACT Clinical data: Infant, 11-month-old, male, diagnosis of Tetralogy of Fallot with retrotracheoesophageal course of the brachiocephalic vein. Usual findings of Tetralogy of Fallot on physical examination. Technical description: Chest radiography showed slightly reduced pulmonary vascular markings and no cardiomegaly. Normal preoperative electrocardiogram with postoperative right bundle branch block. Usual findings of Tetralogy of Fallot on echocardiogram. Postoperative computed tomography angiography confirmed left brachiocephalic vein with anomalous retrotracheoesophageal course, configuring a U-shaped garland vein, in addition to postoperative findings of total correction of Tetralogy of Fallot. Operation: Complete surgical repair was performed with pulmonary valve commissurotomy and placement of bovine pericardial patch to solve right ventricular outflow tract obstruction, pulmonary trunk enlargement, and ventricular septal defect closure. Comments: Systemic venous drainage may show variations in patients with Tetralogy of Fallot. These abnormalities are usually of little clinical relevance, as they are asymptomatic. We presented a rare case of retrotracheoesophageal course of an anomalous left brachiocephalic vein with intraoperative diagnosis, confirmed by imaging during postoperative follow-up, without compromising clinical management or surgical approach.

Abstract This study examined how basic psychological needs satisfaction can predict youth participants’ life skills development according to gender and sport type. A sample of 461 Brazilian youth sport participants (325 boys and 136 girls) ranging between 10 and 17 years was included. Data collection was conducted through the Life Skills Scale for Sport and Basic Needs Satisfaction in Sport Scale. Overall, the three subscales of basic psychological needs satisfaction explained a significant amount of the variance in eight life skills (R2 range = .02 to .08 p < .05) and total life skills (R2 = .07; p < .001) in male athletes. Concerning female athletes, multiple regression analyses revealed significant variance only for teamwork (R2=.09; p<.01) and goal setting (R2= .06; p<.05). Regarding the type of sport, the model presented a significant amount of the variance in eight life skills (R2 range = .02 to .05 p < .05) and total life skills (R2 = .08; p < .001) in team sports. Lastly, in individual sports, multiple regression analyses revealed significant variance only on goal setting (R2= .04; p<.05). Findings showed that youth sport coaches could focus on youth participants’ basic psychological needs when trying to foster life skills development across sport contexts. Based on these findings, several suggestions for improving future research and practice in this area are presented.

Resumo Este estudo examinou como a satisfação das necessidades psicológicas básicas pode prever o desenvolvimento de competências para a vida dos jovens participantes de acordo com o género e o tipo de desporto. Foi incluída uma amostra de 461 atletas juvenis brasileiros (325 meninos e 136 meninas) com idades entre 10 e 17 anos. A coleta de dados foi realizada por meio da Escala de Habilidades para a Vida no Esporte e da Escala de Satisfação de Necessidades Psicológicas Básicas no Esporte. No geral, as três subescalas de satisfação de necessidades psicológicas básicas explicaram uma quantidade significativa da variância em oito habilidades para a vida (faixa R2 = 0,02 a 0,08 p < 0,05) e habilidades para a vida totais (R2 = 0,07; p < 0,001) em atletas masculinos. Em relação às atletas femininas, as análises de regressão múltipla revelaram variância significativa apenas para trabalho em equipe (R2=0,09; p<0,01) e estabelecimento de metas (R2= 0,06; p<0,05). Em relação ao tipo de esporte, o modelo apresentou uma quantidade significativa de variância em oito habilidades para a vida (faixa R2 = 0,02 a 0,05 p < 0,05) e habilidades para a vida totais (R2 = 0,08; p < 0,001) em equipes. Esportes. Por último, nos desportos individuais, as análises de regressão múltipla revelaram variância significativa apenas no estabelecimento de metas (R2= 0,04; p<0,05). Os resultados mostraram que os treinadores desportivos juvenis podem concentrar-se nas necessidades psicológicas básicas dos jovens participantes ao tentarem promover o desenvolvimento de competências para a vida em contextos desportivos. Com base nestas conclusões, são apresentadas uma série de sugestões para melhorar futuras pesquisas e práticas nesta área.

■ ABSTRACT Introduction: Using electric current is essential in our daily activities; however, its contact with living tissue can cause mild to severe or fatal burns. As it is a public health problem, knowledge of its epidemiology is essential for the development of health programs. Method: Cross-sectional study of data recorded in the medical records of patients treated for electrical burns at the Burns Unit of the Hospital de Clínicas of the Universidade Federal de Uberlândia between 2013 and 2019. Results: 26 patients were admitted, the majority of whom were male (76 .9%) and adults (30.7%), victims of high voltage current (65.4%) at work (57.7%), which most affected the upper extremities (80.7%), with children all female (15.3%). The average percentage of burned area was 14. 5% and the % of those treated with skin autograft was 53.8%. The average hospital stay was 40 days, and 3.8% went to the Intensive Care Unit. No deaths were recorded during the period. Conclusion: The incidence of patients treated for electrical burns is low, affecting victims in all age groups and with a predominance of adult males in their workplace. The most common surgical treatment was skin autograft. Health promotion, prevention, and protection policies regarding the dangers of electrical currents would not be practiced and disseminated among our domestic, working, or employing population, unlike what occurs in most developed countries.

■ RESUMO Introdução: O uso da corrente elétrica é imprescindível nas nossas atividades do cotidiano, porém, seu contato com tecidos vivos pode provocar queimaduras desde leves até graves ou fatais. Por se tratar de um problema de saúde pública, o conhecimento de sua epidemiologia é essencial para o desenvolvimento de programas em saúde. Método: Estudo transversal de dados registrados nos prontuários dos pacientes atendidos por queimadura elétrica na Unidade de Queimados do Hospital de Clínicas da Universidade Federal de Uberlândia entre os anos de 2013 e 2019. Resultados: Foram admitidos 26 pacientes, a maioria de sexo masculino (76,9%) e adultos (30,7%), vítimas de corrente de alta voltagem (65,4%) no trabalho (57,7%), que mais afetou as extremidades superiores (80,7%), sendo as crianças todas do sexo feminino (15,3%). O percentual médio de área queimada foi de 14,5% e o percentual de tratados com autoenxerto de pele foi de 53,8%. A média de permanência hospitalar foi de 40 dias e 3,8% deles foram para a Unidade de Terapia Intensiva. Não se registraram óbitos durante o período. Conclusão: A incidência de pacientes atendidos por queimadura elétrica é baixa, acometendo vítimas em todas as faixas etárias e com predomínio em indivíduos adultos do sexo masculino em seu local de trabalho. O tratamento cirúrgico mais realizado foi o autoenxerto de pele. As políticas de promoção, prevenção e proteção em saúde no que diz respeito aos perigos da corrente elétricas não estariam sendo praticadas e difundidas em nossa população doméstica, laboral ou empregadora, diferentemente como ocorre em grande parte dos países desenvolvidos.

Resumen Introducción: El angioedema hereditario es una enfermedad genética autosómica dominante, asociada con aumento de las concentraciones de bradicinina. Se clasifica en tres tipos, de acuerdo con la enzima C1-INH. El diagnóstico se establece por las manifestaciones clínicas y los estudios de laboratorio. El tratamiento consiste profilaxis a corto y largo plazo, y protocolo para el control de las crisis. Reporte del caso: Paciente femenina de 40 años, que acudió al servicio de Urgencias por edema labial, sin reacción al tratamiento con corticosteroides. Se detectaron concentraciones bajas de IgE, C4 e inhibidores de la esterasa C1. Se estableció el diagnóstico de angioedema hereditario. Actualmente se mantiene en tratamiento profiláctico con danazol y plasma fresco congelado para el control de las crisis. Conclusiones: El angioedema hereditario es una enfermedad que afecta considerablemente la calidad de vida; por tanto, debe diagnosticarse de forma oportuna y establecer un plan de tratamiento eficaz, con la intención de prevenir o reducir las complicaciones.

Abstract Introduction: Hereditary angioedema is an autosomal dominant genetic disease, associated with increased levels of bradykinin. It is classified into 3 types according to the C1-INH enzyme. The diagnosis is clinical and laboratory. Its treatment is divided into short- and long-term and crisis prophylaxis. Case report: 40-year-old female patient who came to the emergency service for labial edema without resolution with corticosteroids. The tests for IgE, C4 and C1 esterase inhibitors had a low result. She currently uses danazol prophylactically and fresh frozen plasma in crises. Conclusion: Since it is a disease that considerably affects the quality of life, hereditary angioedema must be diagnosed and an effective treatment plan made to prevent or reduce its complications.

RESUMEN El manejo de cultivos y la rotación de herbicidas han influido en la sostenibilidad de los sistemas de producción. El uso de cultivos de cobertura y herbicidas de pre y post-emergencia son herramientas importantes que ayudan a los agricultores a desarrollar estrategias y conservar el sistema agrícola. En este contexto, el objetivo de esta investigación fue evaluar diferentes cultivos de cobertura previos al establecimiento del cultivo de maíz en relación con la producción de materia seca, el efecto en la disminución de la población de malezas y el aumento del rendimiento del maíz. Además, la influencia de los herbicidas de pre y postemergencia en el cultivo de verano, observándose el comportamiento en relación a malezas, daño al cultivo y rendimiento del cultivo. El experimento se realizó durante los años 2018-2019 en Sertão/RS - Brasil. El arreglo experimental fue de bloques al azar con cuatro repeticiones. Los tratamientos utilizados fueron tres diferentes cultivos de cobertura de invierno que preceden al cultivo de maíz × cuatro herbicidas de preemergencia × cuatro herbicidas de postemergencia, totalizando 192 unidades experimentales. Al analizar los resultados, la atrazina y la atrazina + simazina utilizadas en preemergencia tuvieron más influencia en la reducción del número de malezas, y el herbicida glufosinato de amônio promovió el mayor control de malezas en postemergencia. La amicarbazona y el glifosato resultaron en la mejor combinación para el rendimiento de maíz en pre y postemergencia, respectivamente. El centeno + nabo + arveja como cultivo de cobertura dieron como resultado una mayor producción de biomasa, una reducción más significativa del número de malezas y un aumento del rendimiento del maíz.

ABSTRACT Crop management and herbicide rotation have influenced the sustainability of production systems. The cover crops use and pre-and post-emergence herbicides are important tools that help farmers’ strategies and conserve the agricultural system. In this context, the objective of this research was to evaluate the dry matter production of different cover crops before the establishment of corn, the effect on decreasing weed population, and the increase in corn yield. In addition, the influence of pre-and post-emergence herbicides on summer cultivation, observing the behavior concerning weeds, crop injury, and crop yield. The experiment was conducted during the years 2018-2019 in Sertão/RS - Brazil. The experimental arrangement was of randomized blocks with four replications. The treatments used were three different winter cover crops preceding corn cultivation × four pre-emergence herbicides × four post-emergence herbicides, totaling 192 experimental units. Going through the results, atrazine and atrazine + simazine used in pre-emergence had more influence on weed number reduction, and the post-emergence ammonium glufosinate herbicide promoted the highest weed control in post-emergence. Amicarbazone and glyphosate resulted in the best combination for corn yield using in pre-and post-emergence, respectively. Rye + turnip + vetch as cover crop resulted in higher biomass production, more significant weed number reduction, and increase corn yield.

RESUMEN La neuralgia del glosofaríngeo es una patología rara donde hay dolor agudo y punzante en la fosa amigdalina, ángulo de la mandíbula y base de la lengua. Su principal causa es la compresión neurovascular la cual se puede diagnosticar con una resonancia cerebral. Su manejo es médico, principalmente; con fármacos, especialmente, carbamazepina y oxcarbazepina; y si no hay respuesta, va a cirugía mediante descompresión microvascular e interposición de material blando (politetrafluoroetileno), con o sin transección del IX par craneal. Se presenta el caso de una mujer de 64 años, hipertensa controlada, con dolor característico, que con 5 fármacos antineuropáticos y 1 derivado de opioides no cedía el dolor. La resonancia cerebral con secuencia FIESTA muestra una compresión neurovascular del IX PC con la PICA izquierda. Se le realiza descompresión microvascular del IX PC, con resolución de la sintomatología y sin recurrencia, saliendo de alta pronto. Se concluye que el manejo quirúrgico de esta patología en casos refractarios al tratamiento médico es una opción con buenas tasas de éxito y baja morbilidad.

ABSTRACT Glossopharyngeal neuralgia is a rare pathology, with a sharp and stabbing pain in the tonsillar fossa, angle of the jaw and base of the tongue. Its main etiology is neurovascular compression, which can be diagnosed with a brain MRI. Its management is mainly medical with drug, especially carbamazepine and oxcarbazepine, and if there is no response, surgery is performed through microvascular decompression and interposition of soft material (polytetrafluoroethylene) with or without transection of IX cranial nerve. We present the case of a 64-year-old woman, with controlled hypertension, with classic pain, who did not relieve pain with 5 antineuropathic drugs and 1 opioid derivative. Brain MRI with FIESTA sequence shows a neurovascular compression of the glossopharyngeal nerve with the left PICA. Microvascular decompression of the glossopharyngeal nerve was performed, with resolution of the symptoms and without recurrence, and she was discharged soon. We concluded that the surgical management of this pathology in refractory cases to medical treatment is an option with good success rates and low morbidity.

RESUMO O envelhecimento da população levanta várias questões sociais e relacionadas com a saúde, sendo que este fenómeno é particularmente acentuado na Europa, onde políticas de promoção do Envelhecimento Ativo estão a ser desenvolvidas. Na Educação, o envelhecimento dos professores coloca desafios significativos à profissão. O projeto REKINDLE+50 desenvolveu um programa de formação sobre o uso de Tecnologias de Informação e Comunicação (TIC) para professores com o intuito paralelo de promover as capacidades e motivação de professores com mais de 50 anos. Aqui reportamos sobre a avaliação, pré e pós-formação, de capacidades neuropsicológicas (funções executivas “cool” e “hot”), autorrelatos afetivos e satisfação profissional. Verificámos que a formação estava associada a um aumento da satisfação com a natureza do próprio trabalho de professor e com as condições materiais de trabalho. Não houve alterações significativas nas medidas neuropsicológicas nem afetivas antes e depois da formação. Também verificámos que a satisfação profissional estava positivamente associada com funções executivas “hot” e negativamente associada a sintomas afetivos (ansiedade e depressão subclínicas). Estes resultados, embora provisórios, sugerem que a formação teve um impacto positivo na satisfação profissional dos professores e que pode ter implicações para a promoção do envelhecimento ativo destes profissionais. No geral, o envelhecimento dos professores permanece um desafio para o futuro. As políticas de promoção do Envelhecimento Ativo oferecem uma visão estratégica sobre como lidar com esta questão, mas uma compreensão mais detalhada das alterações cognitivas e afetivas relacionadas com a idade é provavelmente necessária para a criação de medidas efetivas.

RESUMEN El envejecimiento de la población plantea varios problemas sociales y relacionados con la salud, y este fenómeno es particularmente pronunciado en Europa, donde se están desarrollando políticas para promover el Envejecimiento Activo. En Educación, el envejecimiento de los docentes plantea importantes desafíos a la profesión. El proyecto REKINDLE+50 desarrolló un programa de formación sobre el uso de las Tecnologías de la Información y la Comunicación (TIC) para profesores con el objetivo paralelo de promover las habilidades y la motivación de los profesores mayores de 50 años. Aquí informamos sobre la evaluación, previa y posterior a la formación, de las habilidades neuropsicológicas (funciones ejecutivas “cool” y “hot”), autoinformes afectivos y satisfacción laboral. Encontramos que la formación se asoció con una mayor satisfacción con la naturaleza del propio trabajo del profesor y con las condiciones materiales de trabajo. No hubo cambios significativos en las medidas neuropsicológicas o afectivas antes y después del entrenamiento. También encontramos que la satisfacción laboral se asoció positivamente con las funciones ejecutivas “hot” y negativamente con los síntomas afectivos (ansiedad y depresión subclínicas). Estos resultados, aunque provisionales, sugieren que la formación tuvo un impacto positivo en la satisfacción laboral del profesorado y que puede tener implicaciones para la promoción del envejecimiento activo de estos profesionales. En general, el envejecimiento de los docentes sigue siendo un desafío para el futuro. Las políticas para promover el envejecimiento activo ofrecen una visión estratégica sobre cómo abordar este problema, pero es probable que se necesite una comprensión más detallada de los cambios cognitivos y afectivos relacionados con la edad para crear medidas efectivas.

ABSTRACT The aging of the population raises several social and health related issues and is particularly high in Europe, where policies promoting Active Aging are being pursued. In Education, the aging of the teaching workforce poses significant challenges to the profession. The REKINDLE+50 project developed a training program on Information and Communications Technology (ICT) use for teachers with the parallel intent of promoting the abilities and motivation of teachers over 50 years old. Here we report on the pre- and post-test assessment of neuropsychological abilities (“cool” and “hot” executive functions), self-reported affective functioning and job satisfaction. We found that the training program was associated with increased satisfaction with the nature of the teachers’ work and with material working conditions. There were no significant changes in neuropsychological nor affective measures before and after the program. We also found that job satisfaction was positively associated with “hot” executive functions and negatively linked to affective symptoms (sub-clinical anxiety and depression). These findings, although tentative, suggest that the training program had a positive impact on teacher job satisfaction, and may have potential implications for the promotion of active aging in teachers. Overall, the aging of teachers remains a challenge for the future. The policies for promoting Active Aging provide a strategic outlook on how to tackle this issue, but a more detailed understanding of age-related cognitive and affective changes is likely required to devise effective measures.

ABSTRACT Introduction: Pediatric heart transplantation is the definitive therapy for children with end-stage heart failure. This paper describes our initial experience in pediatric heart transplantation in a tertiary center in Brazil Methods: This is a historical prospective descriptive cohort study based on a review of the medical records of children undergoing heart transplantation at Hospital de Base and Hospital da Criança e Maternidade de São José do Rio Preto. Variables were displayed as frequency, mean, or median. Statistical analysis and Kaplan-Meier actuarial curve were obtained with the aid of Microsoft® Excel® 2019 and STATSDirect version 3.3.5. Results: Between January 2010 and December 2020, ten children underwent bicaval orthotopic heart transplantation, 30% of which were under one year of age. Nine patients had end-stage heart failure (International Society for Heart and Lung Transplantation-Heart Failure D) and 50% of the recipients were transplanted under conditions of progressive clinical deterioration (Interagency Registry for Mechanically Assisted Circulatory Support ≤ 2). Forty percent of the recipients had a panel-reactive antibody > 20% on virtual crossmatch. In the postoperative period, 80% of patients required high dose of inotropic support (vasoactive-inotropic score > 10) for > 48 hours. The death-free survival rate at 131 months was 77.1±14.4%. Most patients (88.9%) in late follow-up had an episode of active cytomegalovirus infection. Cellular rejection, with or without clinical repercussion, was present in 44.4% of the patients. Conclusion: Pediatric heart transplantation produces acceptable and feasible outcomes as definitive therapy for children with end-stage heart failure.

We debate whether intellectual property (IP) protection of medical products and devices required to prevent, treat and contain COVID-19 should be waived, as proposed by South Africa and India, under the World Trade Organization (WTO)'s Agreement on Trade-related aspects of Intellectual Property Rights (TRIPS Agreement). We discuss existing public policy mechanisms under the TRIPS Agreement and how these have been implemented at national level in Africa, and find that these have proven inadequate and that they have been sub-optimally implemented. We then consider the TRIPS Waiver proposal which has been tabled due to the inadequacy of existing mechanisms and outline the EU's counter proposal which is founded on existing mechanisms. Both proposals have served at multiple WTO council meetings and would have been the subject of the 2021 WTO Ministerial Conference, which was postponed and is now set to be held in June 2022. Meanwhile, the proposal has been the subject of negotiations between India, South Africa, the EU and the USA ('the quad') and, as of May 2022, has been opened for consideration by all Members. Whatever the outcome of WTO deliberations, African states must take necessary national IP regulatory reforms and cooperate at sub-regional and continental level to improve access to medical products and devices to meet their citizenry's healthcare needs. SIGNIFICANCE: • There is need for a sustainable and comprehensive intellectual property framework that is responsive to health emergencies. Existing public policy mechanisms have not proven effective. • Adaptation and innovation are required at the international norm-setting level as evidenced by the two in-progress proposals for a TRIPS Agreement waiver and for an International Treaty on Pandemics. Both are contested and may only actualise in the medium to long term. • In the context of such uncertainty and delay, timely action should be taken at national level, through legislative reform coupled with necessary manufacturing capacity, which will be boosted by cooperation between African states.

ABSTRACT Objective: To analyze the association between variables related to the management of Primary Health Care (PHC) services and professional characteristics at the beginning of the COVID-19 pandemic. Materials and Methods: Cross-sectional, survey-type study, carried out through convenience sampling, using the snowball method, which included 259 PHC professionals in the states of Mato Grosso do Sul and São Paulo, working in management and direct care in the initial period of the pandemic. A virtual semi-structured questionnaire was applied. The variables "state", "professional category" and "function" were considered independent variables and "supply of human and material resources", as well as "management support" were considered dependent variables. The association between variables was assessed using Fisher's exact test. The significance level adopted was 0.05. The project was approved by the ethics committee with the code number 31493920.8.0000.0021. Results: Health professionals perceive weaknesses in the supply of material and human resources, as well as dissatisfaction with logistics regarding municipal management (40%). The perception of flow and transport logistics also varied among professionals working in care and management (p≤0.05). Conclusion: Professionals perceive municipal management of the pandemic, in different aspects, as inadequate. Therefore, it is necessary to implement public and management policies that value PHC services and their professionals, ensuring adequate working conditions, which can reflect in better care and satisfaction for users of the Brazilian Unified Health System.

RESUMEN Objetivo: Analizar la asociación entre variables relacionadas con la gestión de los servicios de Atención Primaria de Salud (APS) y las características profesionales al inicio de la pandemia de COVID-19. Material y Método: Estudio transversal, de tipo survey, realizado por muestreo de conveniencia, utilizando el método de bola de nieve, que incluyó a 259 profesionales de salud de la APS en los estados de Mato Grosso do Sul y São Paulo, quienes se desempeñaban en gestión y atención directa durante el período inicial de la pandemia. Se aplicó un cuestionario virtual semiestructurado. Las variables "estado", "categoría profesional" y "función desempeñada" fueron consideradas variables independientes y la "oferta de recursos humanos y materiales", además del "apoyo a la gestión" se consideraron variables dependientes. La asociación entre variables se evaluó mediante la prueba exacta de Fisher. El nivel de significación adoptado fue de 0,05. El proyecto fue aprobado por el comité de ética a través del código CAAE n.° 31493920.8.0000.0021. Resultados: Los profesionales perciben debilidades en la oferta de recursos materiales y humanos e insatisfacción con la logística relativa a la gestión municipal (40%). La percepción del flujo y la logística del transporte fue diferente entre los profesionales que se desempeñan en el cuidado y la gestión (p≤0,05). Conclusión: Los profesionales perciben la gestión municipal de la pandemia, en diferentes aspectos, como inadecuada. Es necesario implementar políticas públicas y de gestión que valoricen los servicios de APS y a sus profesionales, asegurando condiciones de trabajo adecuadas que se reflejen en una mejor atención y satisfacción de los usuarios del Sistema Único de Salud de Brasil.

RESUMO Objetivo: Analisar a associação entre variáveis relacionadas à gestão de serviços da Atenção Primária à Saúde e características profissionais no início da pandemia da COVID-19. Material e Método: Estudo transversal, tipo survey, realizado por meio de amostragem por conveniência, a partir do método bola de neve, que contemplou 259 profissionais de saúde da APS do Mato Grosso do Sul e São Paulo, atuantes na gestão e na assistência direta, no período inicial da pandemia. Foi aplicado um questionário semiestruturado virtual. As variáveis "estado", "categoria profissional" e "função exercida" foram consideradas variáveis independentes; as variáveis "oferta de recursos humanos e de materiais" e "apoio da gestão", variáveis dependentes. A associação entre variáveis foi avaliada por meio do teste exato de Fisher. O nível de significância adotado foi 0,05. O projeto foi aprovado pelo comitê de ética através do CAAE n.° 31493920.8.0000.0021. Resultados: Os profissionais percebem fragilidades na oferta de recursos materiais e humanos e insatisfação quanto à logística no que se refere à gestão municipal (40%). A percepção quanto a logística de fluxos e transporte foi diferente entre profissionais que atuam na assistência e na gestão (p ≤ 0,05). Conclusão: Os profissionais percebem a gestão municipal da pandemia, em diferentes aspectos, como inadequada. Faz-se necessária a implementação de políticas públicas e de gestão que valorizem os serviços de APS e seus profissionais, garantindo condições adequadas de trabalho, o que refletirá em um melhor atendimento e satisfação para os usuários do Sistema Único de Saúde.

Abstract Aim: The purpose of this study was to conduct an integrative review aiming to critically analyze the concept of sport development and the different variables that influence this process. Methods: We restricted the search to scientific journals in the area of sports science that published studies related to the social sciences and are indexed in the Scientific Journal Rankings (SJR). In total, 23 scientific journals were analyzed and the final sample of this review consisted of 65 articles. Results: Our findings highlighted that sport development is immersed in specific social, political, and economic factors that influence the extent to which different stakeholders can implement strategies and provide resources to improve participation and performance in sports. In addition to the quantitative aspect, researchers indicate the need for specific strategies that also enable the participation of women, people with disabilities, and other groups that historically have faced constraints to participate in sports. Despite the interesting criteria used to evaluate the sport development, they should be used with caution because most studies were conducted in English-speaking countries reflecting a tendency to report features only of the Western culture. Conclusion: The different stakeholders, strategies, and resources found in this review reinforce that there is no single way to develop sports, as different possibilities may be used according to the characteristics of each context. It also indicates the need to move research to unexplored fields and socio-cultural contexts to increase the reach that sport-based programs may have.