Abstract This article is based on a qualitative methodology sustained by in-depth interviews with 76 migrant women victims of sexual slavery in Mexico selected through chain sampling. The objective is to analyse the modus operandi used by criminal groups involved in the sexual enslavement of migrant women in Mexico. Six categories of perpetrators profit from sexual slavery in Mexico: drug cartels, prostitution networks, nightclub owners, pseudo-modeling agencies, freelance slavers and boyfriendpimps. Their modus operandi involves the recruitment of victims through internet advertisements, deception, infatuation, purchase or kidnapping, and the subjugation of slaves through imprisonment, domination by means of threats, extortion, rape or torture. These groups exercise the right of ownership over the victims in order to buy, sell, abuse or kill them. Some victims are released, but most do not escape. Those who try to flee or refuse to obey the perpetrators are severely disciplined.

Resumo Este artigo baseia-se em uma metodologia qualitativa baseada em entrevistas em profundidade com 76 mulheres migrantes vítimas de escravidão sexual no México, selecionadas por meio de amostragem em cadeia. O objetivo é analisar o modus operandi usado por grupos criminosos envolvidos na escravidão sexual de mulheres migrantes no México. Seis categorias de perpetradores lucram com a escravidão sexual no México: cartéis de drogas, redes de prostituição, donos de boates, pseudoagências de modelos, escravizadores freelancers e “namoradocafetão”. Seu modus operandi implica o recrutamento de vítimas por meio de anúncios na internet, engano, conquista, compra ou sequestro, e a subjugação das escravas por meio de prisão, da dominação por meio de ameaças, da extorsão, do estupro ou da tortura. Esses grupos exercem o direito de propriedade sobre as vítimas para comprá-las, vendê-las, abusá-las ou matá-las. Algumas vítimas são libertadas, mas a maioria não consegue escapar. Aquelas que tentam fugir ou se recusam a obedecer aos vitimários são severamente punidas.

Resumen Este artículo está basado en una metodología cualitativa sustentada en entrevistas (Anexo 1) en profundidad con 76 mujeres migrantes víctimas de esclavitud sexual en México seleccionadas por el procedimiento del muestreo en cadena. El objetivo es analizar los modus operandi utilizados por los grupos criminales involucrados en México en la esclavitud sexual de mujeres migrantes. Seis categorías de victimarios se lucran en México con la esclavitud sexual: los cárteles de las drogas, las redes de prostitución, los propietarios de locales nocturnos, las seudoagencias de modelos, los esclavistas freelancers y los novios-padrotes. Sus modus operandi implican la captación de las víctimas mediante anuncios en internet, el engaño, el enamoramiento, la compra o el secuestro, y el sometimiento de las esclavas haciendo uso de la reclusión, la dominación por medio de amenazas, la extorsión, la violación o la tortura. Estos grupos ejercen el derecho de propiedad sobre las víctimas para comprarlas, venderlas, maltratarlas o quitarles la vida. Algunas víctimas son liberadas; pero la mayor parte no logran escapar. Quienes tratan de huir o se niegan a obedecer a los victimarios son disciplinadas de modo severo.

Abstract Now that the transfer of educational competences to the municipalities has become compulsory, it is important to analyse whether there are differences between those who agreed to take part in the pilot projects that have been implemented for several years, thus gaining experience, and those who refused this process until it became compulsory in 2019. Does this experience help us understand the different positions of local players? To answer this question, we mobilised the information gathered as part of a project to draw up educational charters covering one district in the country, using a mixed methodology with the aim of contributing to reflection on this process. As well as noting the emergence of the CIM (intercity communities) as a strategic agent for regional educational planning, which adds complexity to the process, it was possible to observe that among the municipalities with previous experience in the process of transferring competences, there is a greater propensity to view the local government as the promoter of a municipal strategy without major problems, while in the other municipalities the idea that it can only be a partner for the schools stands out.

Resumen Ahora que la transferencia de las competencias educativas a los municipios se ha convertido en obligatoria, es importante analizar si existen diferencias entre los que aceptaron participar en los proyectos piloto que se han puesto en marcha durante varios años, adquiriendo así experiencia, y los que rechazaron este proceso hasta que se convirtió en obligatorio en 2019. ¿Ayuda esta experiencia a comprender las diferentes posiciones de los agentes locales? Para responder a esta pregunta, movilizamos la información recabada en el marco de un proyecto de elaboración de cartas educativas en un distrito del país, utilizando una metodología mixta con el objetivo de contribuir a la reflexión sobre este proceso. Además de constatar la emergencia de las CIM (comunidades intermunicipales) como agente estratégico para la planificación educativa regional, lo que añade complejidad al proceso, fue posible observar que entre los municipios con experiencia previa en el proceso de transferencia de competencias, hay una mayor propensión a considerar al municipio como promotor de una estrategia municipal sin mayores problemas, mientras que en los demás municipios destaca la idea de que sólo puede ser un socio de las escuelas.

Resumo Concretizada a obrigatoriedade da transferência de competências educativas para os municípios, importa analisar se há diferenças entre os que aceitaram integrar os projetos piloto implementados desde há vários anos, ganhando assim experiência, e os que recusaram esse processo até ele se tornar obrigatório em 2019. Será que essa experiência ajuda a compreender os diferentes posicionamentos dos intervenientes locais? Para responder a esta questão mobilizámos a informação recolhida no âmbito de um projeto de elaboração de cartas educativas abrangendo um distrito do país, utilizando uma metodologia mista com o objetivo de contribuir para a reflexão sobre este processo. Para além de se ter verificado a emergência das CIM (comunidades intermunicipais) como agente estratégico de planeamento educativo regional, o que vem acrescentar complexidade ao processo, foi possível observar que entre os concelhos com experiências prévias no processo de transferência de competências se identifica uma maior propensão para encarar sem grandes problemas a autarquia enquanto promotora de uma estratégia concelhia, enquanto nos outros concelhos se destaca a ideia de que ela não pode ser mais do que parceira das escolas.

Résumé Maintenant que le transfert des compétences éducatives aux municipalités est devenu obligatoire, il est important d’analyser s’il existe des différences entre ceux qui ont accepté de participer aux projets pilotes mis en œuvre depuis plusieurs années, acquérant ainsi de l’expérience, et ceux qui ont refusé ce processus jusqu’à ce qu’il devienne obligatoire en 2019. Cette expérience permet-elle de comprendre les différentes positions des acteurs locaux? Pour répondre à cette question, nous avons mobilisé les informations recueillies dans le cadre d’un projet d’élaboration de chartes éducatives couvrant un district du pays, en utilisant une méthodologie mixte dans le but de contribuer à la réflexion sur ce processus. Outre l’émergence des CIM (communautés interurbaines) comme agents stratégiques de la planification éducative régionale, qui complexifie le processus, il a été possible d’observer que parmi les municipalités ayant une expérience préalable du processus de transfert de compétences, il y a une plus grande propension à considérer le gouvernement local comme le promoteur d’une stratégie municipale sans problème majeur, alors que dans les autres municipalités, l’idée qu’il ne peut être qu’un partenaire de l’école s’impose.

This article presents an ethical analysis for the practice of jaw wiring as an independent weight loss intervention by dentists. The four foundational principles of autonomy, nonmaleficence, beneficence and justice serve as a framework for evaluating the ethical dimensions of the practice, and whether it can be justified. The ethical analysis of this weight loss procedure requires dentists to debate the potential benefits with possible harms, while respecting the autonomy and desires of the patient. While patients possess a fundamental right to autonomous decision-making, conceding to their autonomy is not absolute and dentists need to balance their decisions with considerations of beneficence and nonmaleficence. The ethical analysis concludes that dentists who refuse requests to independently perform jaw wiring for purely weight loss purposes are ethically justified within the principlist framework when the principles of nonmaleficence and beneficence are at stake. The wellbeing and health of the patient, as well as professional obligations, justify their refusal.

The Mine Health and Safety Act No. 29 of 1996, as amended, embeds an occupational health and safety management system that facilitates communication between representatives of the state, capital, and labour. In underground mines, two communication loops between these role players serve to separate the production chain of command from the political tripartite relations. Worker-elected health and safety representatives are involved in both communication loops, but are severely constrained in escalating their occupational health and safety concerns to the legal-political level. This has a direct bearing on the exercise of the Right to Refuse Dangerous Work (RRDW). As previously reported, health and safety representatives were found to primarily consult their production supervisors in preference to their trade-union representatives. This follow-up article presents production supervisor perspectives on the RRDW. The study demonstrates how, for mineworkers, the two distinct communication subsystems constrain, rather than facilitate, implementation of the RRDW.

Resumen: El objetivo fue analizar la visión de los jueces federales brasileños sobre las implicaciones de la vacunación contra la COVID-19. Se realizó un estudio con jueces federales brasileños, quienes recibieron una encuesta elaborada con preguntas de opción múltiple sobre la vacunación contra la COVID-19, abordando temas como su obligatoriedad, aplicación de medidas coercitivas, reticencia a vacunarse, grupos prioritarios, acciones de Agência Nacional de Vigilancia Sanitaria (Anvisa), el papel del Poder Judicial y los pasaportes de inmunidad. Respondieron a la encuesta 254 de los 1.300 jueces federales que actúan en todos los estados. La mayoría de los encuestados tiene título de licenciatura o especialización (59,1%) y actúa como juez desde hace más de 10 años (63,8%). Gran parte de los jueces (87,7%) está de acuerdo con la obligatoriedad de la vacuna para adultos y niños y adolescentes (66,1%). Más del 75% de los jueces cree que todos los niveles de gobierno pueden imponer sanciones a quienes se nieguen a vacunarse. El 93% de los jueces confía en la vacunación, el 56,1% rechaza los movimientos antivacunas y el 75,2% cree que las acciones de Anvisa deben ser respetadas. Las acciones del Poder Judicial con relación a la pandemia de COVID-19 son aprobadas por el 62,6% de los jueces, y el 88,2% apoya los pasaportes de inmunidad. Existe un vínculo directo entre la vacunación obligatoria, la confianza en la vacuna y la adopción de pasaportes de inmunidad. La mayoría de los jueces federales está de acuerdo con la vacunación obligatoria para niños y adultos, apoya la aplicación de sanciones en caso de rechazo de la vacunación, desaprueba los movimientos antivacunas, está de acuerdo con las acciones de Anvisa y apoya la intervención del Poder Judicial con relación a la pandemia de COVID-19. Resumen COVID19. COVID19 COVID 19. 19 COVID19, 19, coercitivas vacunarse prioritarios Anvisa, , (Anvisa) inmunidad 25 1300 1 300 1.30 estados 59,1% 591 59 (59,1% 63,8%. 638 63,8% . 63 8 (63,8%) 87,7% 877 87 7 (87,7% 66,1%. 661 66,1% 66 (66,1%) 75 93 561 56 56,1 752 2 75,2 respetadas COVID-1 626 62 6 62,6 882 88 88,2 COVID1 (Anvisa 130 30 1.3 59,1 5 (59,1 63,8 (63,8% 87,7 (87,7 66,1 (66,1% 9 56, 75, COVID- 62, 88, 13 3 1. 59, (59, 63, (63,8 87, (87, 66, (66,1 (59 (63, (87 (66, (5 (63 (8 (66 ( (6

Abstract: The aim was to analyze the perception of Brazilian federal judges on the implications of COVID-19 vaccination. A study was carried out with Brazilian federal judges, who received a survey designed with multiple-choice questions on COVID-19 vaccination, covering topics such as its mandatory aspect, the application of coercive measures, hesitation to vaccinate, priority groups, the duties of Brazilian Health Regulatory Agency (Anvisa, acronym in Portuguese), the role of the Judiciary branch, and immunity passports. A total of 254 out of 1,300 federal judges from all states responded to the survey. Most respondents have a Bachelor’s degree or a specialization (59.1%) and have been judges for more than 10 years (63.8%). A great majority of the judges (87.7%) agree with vaccine mandates for adults and for children and adolescents (66.1%). Over 75% of judges believe that all levels of government can impose sanctions on those who refuse to get vaccinated. The judges trust vaccination 93% of the time, 56.1% reject anti-vaccination movements, and 75.2% believe that Anvisa duties should be respected. The Judiciary branch actions concerning the COVID-19 pandemic are approved by 62.6% of judges, and 88.2% support immunity passports. There is a direct connection among mandatory vaccination, trust in the vaccine, and the adoption of immunity passports. Most federal judges agree with vaccine mandates for children and adults, support the application of sanctions for vaccination refusal, disapprove of anti-vaccination movements, agree with Anvisa’s duties, and support judicial intervention in relation to the COVID-19 pandemic. Abstract COVID19 COVID 19 COVID-1 multiplechoice multiple choice aspect measures vaccinate groups Anvisa, (Anvisa Portuguese, Portuguese , Portuguese) passports 25 1300 1 300 1,30 Bachelors Bachelor s 59.1% 591 59 (59.1% 63.8%. 638 63.8% . 63 8 (63.8%) 87.7% 877 87 7 (87.7% 66.1%. 661 66.1% 66 (66.1%) 75 vaccinated 93 time 561 56 56.1 antivaccination anti movements 752 2 75.2 respected 626 62 6 62.6 882 88 88.2 refusal Anvisas COVID1 COVID- 130 30 1,3 59.1 5 (59.1 63.8 (63.8% 87.7 (87.7 66.1 (66.1% 9 56. 75. 62. 88. 13 3 1, 59. (59. 63. (63.8 87. (87. 66. (66.1 (59 (63. (87 (66. (5 (63 (8 (66 ( (6

Resumo: O objetivo foi analisar a visão de juízes federais brasileiros sobre as implicações da vacinação contra a COVID-19. Foi realizado um estudo com juízes federais brasileiros, que receberam uma pesquisa elaborada com questões de múltipla escolha sobre a vacinação contra a COVID-19, abordando temas como sua obrigatoriedade, aplicação de medidas coercitivas, hesitação vacinal, grupos prioritários, ações da Agência Nacional de Vigilância Sanitária (Anvisa), o papel do Poder Judiciário e os passaportes de imunidade. Responderam à pesquisa 254 dos 1.300 juízes federais atuantes em todos os estados. A maioria dos entrevistados possui bacharelado ou especialização (59,1%) e atua como juiz há mais de 10 anos (63,8%). Grande parte dos juízes (87,7%) concorda com a obrigatoriedade da vacina para adultos e crianças e adolescentes (66,1%). Mais de 75% dos juízes acreditam que todos os níveis de governo podem impor sanções para aqueles que se recusam a ser vacinados. 93% dos juízes confiam na vacinação, 56,1% rejeitam movimentos antivacinação e 75,2% acreditam que as ações da Anvisa devem ser respeitadas. As ações do Judiciário referentes à pandemia da COVID-19 são aprovadas por 62,6% dos juízes e 88,2% apoiam passaportes de imunidade. Existe uma ligação direta entre a vacinação obrigatória, a confiança na vacina e a adoção de passaportes de imunidade. A maioria dos juízes federais concorda com a obrigatoriedade da vacina para crianças e adultos, apoia a aplicação de sanções no caso de recusa de vacinação, desaprova movimentos antivacinação, concorda com as ações da Anvisa e apoia a intervenção do Judiciário em relação à pandemia da COVID-19. Resumo COVID19. COVID19 COVID 19. 19 COVID19, 19, coercitivas vacinal prioritários Anvisa, , (Anvisa) imunidade 25 1300 1 300 1.30 estados 59,1% 591 59 (59,1% 63,8%. 638 63,8% . 63 8 (63,8%) 87,7% 877 87 7 (87,7% 66,1%. 661 66,1% 66 (66,1%) 75 vacinados 93 561 56 56,1 752 2 75,2 respeitadas COVID-1 626 62 6 62,6 882 88 88,2 obrigatória COVID1 (Anvisa 130 30 1.3 59,1 5 (59,1 63,8 (63,8% 87,7 (87,7 66,1 (66,1% 9 56, 75, COVID- 62, 88, 13 3 1. 59, (59, 63, (63,8 87, (87, 66, (66,1 (59 (63, (87 (66, (5 (63 (8 (66 ( (6

Resumen: El objetivo fue analizar la visión de los jueces federales brasileños sobre las implicaciones de la vacunación contra la COVID-19. Se realizó un estudio con jueces federales brasileños, quienes recibieron una encuesta elaborada con preguntas de opción múltiple sobre la vacunación contra la COVID-19, abordando temas como su obligatoriedad, aplicación de medidas coercitivas, reticencia a vacunarse, grupos prioritarios, acciones de Agência Nacional de Vigilancia Sanitaria (Anvisa), el papel del Poder Judicial y los pasaportes de inmunidad. Respondieron a la encuesta 254 de los 1.300 jueces federales que actúan en todos los estados. La mayoría de los encuestados tiene título de licenciatura o especialización (59,1%) y actúa como juez desde hace más de 10 años (63,8%). Gran parte de los jueces (87,7%) está de acuerdo con la obligatoriedad de la vacuna para adultos y niños y adolescentes (66,1%). Más del 75% de los jueces cree que todos los niveles de gobierno pueden imponer sanciones a quienes se nieguen a vacunarse. El 93% de los jueces confía en la vacunación, el 56,1% rechaza los movimientos antivacunas y el 75,2% cree que las acciones de Anvisa deben ser respetadas. Las acciones del Poder Judicial con relación a la pandemia de COVID-19 son aprobadas por el 62,6% de los jueces, y el 88,2% apoya los pasaportes de inmunidad. Existe un vínculo directo entre la vacunación obligatoria, la confianza en la vacuna y la adopción de pasaportes de inmunidad. La mayoría de los jueces federales está de acuerdo con la vacunación obligatoria para niños y adultos, apoya la aplicación de sanciones en caso de rechazo de la vacunación, desaprueba los movimientos antivacunas, está de acuerdo con las acciones de Anvisa y apoya la intervención del Poder Judicial con relación a la pandemia de COVID-19.

Resumo: O objetivo foi analisar a visão de juízes federais brasileiros sobre as implicações da vacinação contra a COVID-19. Foi realizado um estudo com juízes federais brasileiros, que receberam uma pesquisa elaborada com questões de múltipla escolha sobre a vacinação contra a COVID-19, abordando temas como sua obrigatoriedade, aplicação de medidas coercitivas, hesitação vacinal, grupos prioritários, ações da Agência Nacional de Vigilância Sanitária (Anvisa), o papel do Poder Judiciário e os passaportes de imunidade. Responderam à pesquisa 254 dos 1.300 juízes federais atuantes em todos os estados. A maioria dos entrevistados possui bacharelado ou especialização (59,1%) e atua como juiz há mais de 10 anos (63,8%). Grande parte dos juízes (87,7%) concorda com a obrigatoriedade da vacina para adultos e crianças e adolescentes (66,1%). Mais de 75% dos juízes acreditam que todos os níveis de governo podem impor sanções para aqueles que se recusam a ser vacinados. 93% dos juízes confiam na vacinação, 56,1% rejeitam movimentos antivacinação e 75,2% acreditam que as ações da Anvisa devem ser respeitadas. As ações do Judiciário referentes à pandemia da COVID-19 são aprovadas por 62,6% dos juízes e 88,2% apoiam passaportes de imunidade. Existe uma ligação direta entre a vacinação obrigatória, a confiança na vacina e a adoção de passaportes de imunidade. A maioria dos juízes federais concorda com a obrigatoriedade da vacina para crianças e adultos, apoia a aplicação de sanções no caso de recusa de vacinação, desaprova movimentos antivacinação, concorda com as ações da Anvisa e apoia a intervenção do Judiciário em relação à pandemia da COVID-19.

Abstract: The aim was to analyze the perception of Brazilian federal judges on the implications of COVID-19 vaccination. A study was carried out with Brazilian federal judges, who received a survey designed with multiple-choice questions on COVID-19 vaccination, covering topics such as its mandatory aspect, the application of coercive measures, hesitation to vaccinate, priority groups, the duties of Brazilian Health Regulatory Agency (Anvisa, acronym in Portuguese), the role of the Judiciary branch, and immunity passports. A total of 254 out of 1,300 federal judges from all states responded to the survey. Most respondents have a Bachelor’s degree or a specialization (59.1%) and have been judges for more than 10 years (63.8%). A great majority of the judges (87.7%) agree with vaccine mandates for adults and for children and adolescents (66.1%). Over 75% of judges believe that all levels of government can impose sanctions on those who refuse to get vaccinated. The judges trust vaccination 93% of the time, 56.1% reject anti-vaccination movements, and 75.2% believe that Anvisa duties should be respected. The Judiciary branch actions concerning the COVID-19 pandemic are approved by 62.6% of judges, and 88.2% support immunity passports. There is a direct connection among mandatory vaccination, trust in the vaccine, and the adoption of immunity passports. Most federal judges agree with vaccine mandates for children and adults, support the application of sanctions for vaccination refusal, disapprove of anti-vaccination movements, agree with Anvisa’s duties, and support judicial intervention in relation to the COVID-19 pandemic.

ABSTRACT BACKGROUND: Advance Directive documents allow citizens to choose the treatments they want for end-of-life care without considering therapeutic futility. OBJECTIVES: To analyze patients’ and caregivers’ answers to Advance Directives and understand their expectations regarding their decisions. DESIGN AND SETTING: This study analyzed participants’ answers to a previously published trial, conceived to test the document’s efficacy as a communication tool. METHODS: Sixty palliative patients and 60 caregivers (n = 120) registered their preferences in the Advance Directive document and expressed their expectations regarding whether to receive the chosen treatments. RESULTS: In the patient and caregiver groups, 30% and 23.3% wanted to receive cardiorespiratory resuscitation; 23.3% and 25% wanted to receive artificial organ support; and 40% and 35% chose to receive artificial feeding and hydration, respectively. The participants ignored the concept of therapeutic futility and expected to receive invasive treatments. The concept of therapeutic futility should be addressed and discussed with both the patients and caregivers. Legal Advanced Directive documents should be made clear to reduce misinterpretations and potential legal conflicts. CONCLUSION: The authors suggest that all citizens should be clarified regarding the futility concept before filling out the Advance Directives and propose a grammatical change in the document, replacing the phrase “Health Care to Receive / Not to Receive” with the sentence “Health Care to Accept / Refuse” so that patients cannot demand treatments, but instead accept or refuse the proposed therapeutic plans. TRIAL REGISTRATION: ClinicalTrials.gov ID NCT05090072 URL: https://clinicaltrials.gov/ct2/show/NCT05090072. BACKGROUND endoflife end life OBJECTIVES decisions SETTING trial s tool METHODS 6 n 120 RESULTS groups 30 233 23 3 23.3 resuscitation 25 support 40 35 hydration respectively conflicts CONCLUSION Health Refuse plans REGISTRATION ClinicalTrialsgov ClinicalTrials gov NCT NCT0509007 URL https//clinicaltrials.gov/ct2/show/NCT05090072. httpsclinicaltrialsgovct2showNCT05090072 httpsclinicaltrialsgovctshowNCT https //clinicaltrials.gov/ct2/show/NCT05090072. clinicaltrials ct2 show ct https://clinicaltrials.gov/ct2/show/NCT05090072 12 2 23. 4 NCT050900 https//clinicaltrials.gov/ct2/show/NCT05090072 httpsclinicaltrialsgovct showNCT httpsclinicaltrialsgovct2showNCT0509007 clinicaltrialsgovct2showNCT05090072 clinicaltrialsgovctshowNCT //clinicaltrials.gov/ct2/show/NCT05090072 https://clinicaltrials.gov/ct2/show/NCT0509007 1 NCT05090 https//clinicaltrials.gov/ct2/show/NCT0509007 httpsclinicaltrialsgovct2showNCT050900 clinicaltrialsgovct clinicaltrialsgovct2showNCT0509007 //clinicaltrials.gov/ct2/show/NCT0509007 https://clinicaltrials.gov/ct2/show/NCT050900 NCT0509 https//clinicaltrials.gov/ct2/show/NCT050900 httpsclinicaltrialsgovct2showNCT05090 clinicaltrialsgovct2showNCT050900 //clinicaltrials.gov/ct2/show/NCT050900 https://clinicaltrials.gov/ct2/show/NCT05090 NCT050 https//clinicaltrials.gov/ct2/show/NCT05090 httpsclinicaltrialsgovct2showNCT0509 clinicaltrialsgovct2showNCT05090 //clinicaltrials.gov/ct2/show/NCT05090 https://clinicaltrials.gov/ct2/show/NCT0509 NCT05 https//clinicaltrials.gov/ct2/show/NCT0509 httpsclinicaltrialsgovct2showNCT050 clinicaltrialsgovct2showNCT0509 //clinicaltrials.gov/ct2/show/NCT0509 https://clinicaltrials.gov/ct2/show/NCT050 NCT0 https//clinicaltrials.gov/ct2/show/NCT050 httpsclinicaltrialsgovct2showNCT05 clinicaltrialsgovct2showNCT050 //clinicaltrials.gov/ct2/show/NCT050 https://clinicaltrials.gov/ct2/show/NCT05 https//clinicaltrials.gov/ct2/show/NCT05 httpsclinicaltrialsgovct2showNCT0 clinicaltrialsgovct2showNCT05 //clinicaltrials.gov/ct2/show/NCT05 https://clinicaltrials.gov/ct2/show/NCT0 https//clinicaltrials.gov/ct2/show/NCT0 httpsclinicaltrialsgovct2showNCT clinicaltrialsgovct2showNCT0 //clinicaltrials.gov/ct2/show/NCT0 https://clinicaltrials.gov/ct2/show/NCT https//clinicaltrials.gov/ct2/show/NCT clinicaltrialsgovct2showNCT //clinicaltrials.gov/ct2/show/NCT

Abstract Human displacements were directly impacted by the necropolitical measures adopted by States to contain the COVID-19 pandemic. Brazil, in particular, adopted selective, excluding measures typical of a (permanent and widespread) state of exception, which had a severe and disproportionate impact, especially on migrants of Venezuelan nationality. As a methodology, the deductive method is used, starting from the study of selective border control as a practice of the state of exception and the understanding of the international migrant as a human refuse, to, from this, study the (dis)proportionality of (necropolitical) measures adopted by the Brazilian State to contain the expansion of the new coronavirus, especially those aimed at Venezuelan flows to the country. As a method of procedure, the history and research technique are indirect documentation. Thus, it was evident that through selective border control, the Brazilian state sought, as responses to the COVID-19 sanitary crisis, opportunely to prevent the access of uninteresting people to the country and, in the name of control and protection of some "higher lives”, discriminated and promoted the disposability of those “inferior”, such as those of Venezuelan nationality. COVID19 COVID 19 COVID-1 pandemic Brazil particular permanent widespread impact nationality methodology used refuse this disproportionality dis proportionality (necropolitical coronavirus procedure documentation Thus sought crisis higher lives, lives , lives” inferior, inferior “inferior” COVID1 1 COVID- “inferior

Resumo Os deslocamentos humanos foram diretamente impactados pelas medidas necropolíticas adotadas pelos Estados para conter a pandemia da COVID-19. O Brasil, especialmente, adotou medidas seletivas, excludentes típicas de um (permanente e generalizado) estado de exceção, que impactaram de forma severa e desproporcional em especial os migrantes de nacionalidade venezuelana. Como metodologia, utiliza-se o método dedutivo, partindo-se do estudo do controle seletivo de fronteiras como prática do estado de exceção e a compreensão do migrante internacional como um refugo humano, para, a partir disso, estudar a (des)proporcionalidade das medidas (necropolíticas) adotadas pelo Estado brasileiro para conter a expansão do novo coronavírus, em especial, a destinada aos fluxos venezuelanos ao país. Como método de procedimento, o histórico, e a técnica de pesquisa, a documentação indireta. Assim, evidenciou-se que por meio do controle seletivo de fronteiras o estado brasileiro buscou, como respostas à crise sanitária da COVID-19, oportunamente, impedir o acesso daqueles desinteressantes ao país e, em nome do controle e proteção de algumas “vidas superiores”, discriminou e promoveu a descartabilidade daquelas “inferiores”, como as de nacionalidade venezuelana. COVID19. COVID19 COVID 19. 19 COVID-19 Brasil especialmente seletivas permanente generalizado venezuelana metodologia utilizase utiliza se dedutivo partindose partindo humano disso desproporcionalidade des proporcionalidade (necropolíticas coronavírus procedimento histórico pesquisa indireta Assim evidenciouse evidenciou buscou COVID19, 19, oportunamente vidas superiores, superiores , superiores” inferiores, inferiores “inferiores” COVID1 1 COVID-1 “inferiores COVID-

Resumen Este artículo trata de una apuesta por herramientas conceptuales que puedan romper con las grandes narrativas heroicas de orígenes y autores. Se trata de delinear otras prácticas psi y de investigación que propongan rupturas en las formas y actos establecidos por el mandato social imperante, que pide a los psicólogos hablar por los otros. La apuesta del artículo es afirmar gestos clínicos que rechacen modelos de pensamiento impuestos y propongan formas de investigar-trabajar como fabricantes-de-interiores-en-vuelta. Pretende rechazar prácticas basadas en una “matriz colonial de poder” que se expresa en la precariedad de las relaciones laborales y la explotación. Se pregunta: ¿cuál es la naturaleza de nuestro presente? ¿En qué nos estamos convirtiendo? ¿Qué hemos hecho frente a la matriz colonial de poder? Frente a los marcos y cruces coloniales, el artículo considera que las prácticas necropolíticas son intolerables y se basa en el principio ético-político y estético de los ataques a otras prácticas de investigación y pensamiento, que corroboran los cruces contracoloniales. autores imperante otros investigartrabajar investigar trabajar fabricantesdeinterioresenvuelta. fabricantesdeinterioresenvuelta fabricantes interiores vuelta. vuelta fabricantes-de-interiores-en-vuelta poder explotación pregunta cuál presente En convirtiendo Qué coloniales éticopolítico ético político contracoloniales

Resumo O presente artigo trata de uma aposta em ferramentas conceituais que possam romper com as grandes narrativas heróicas de origens e autores. Debruça-se em delinear outras práticas psi e de pesquisa que proponham rupturas nas formas e atos estabelecidos pelo mandato social reinante, que solicita que psicólogas falem pelos outros. A aposta do artigo é afirmar gestos clínicos que recusem modelos impostos de pensamento e propor modos de pesquisar-trabalhar como fabricantes-de-interiores-em-revolta. Ambiciona recusar práticas pautadas em uma “matriz colonial de poder” que se expressa nas relações de trabalho precárias e de exploração. Interroga-se: qual a natureza do nosso presente? O que estamos nos tornando? O que temos feito no enfrentamento da matriz colonial de poder? Contrário aos marcos e atravessamentos coloniais, o artigo considera intoleráveis as práticas necropolíticas e se situa a partir do princípio ético-político e estético de investidas por outras práticas de pesquisa e de pensamento, que corroborem travessias-navegantes contra-coloniais. autores Debruçase Debruça reinante outros pesquisartrabalhar pesquisar trabalhar fabricantesdeinterioresemrevolta. fabricantesdeinterioresemrevolta fabricantes interiores revolta. revolta fabricantes-de-interiores-em-revolta poder exploração Interrogase Interroga Interroga-se tornando coloniais éticopolítico ético político travessiasnavegantes travessias navegantes contracoloniais. contracoloniais contra coloniais. contra-coloniais

Abstract The present article is about a bet on conceptual tools that can break with the great heroic narratives of origins and authors. It is about delineating other psi and research practices that propose ruptures in the forms and acts established by the reigning social mandate, which asks psychologists to speak for others. The bet of the article is to affirm clinical gestures that refuse imposed models of thinking and to propose ways of research-working as makers-of-interiors-in-turn. It aims to refuse practices based on a “colonial matrix of power” that is expressed in precarious work relations and exploitation. It asks itself: what is the nature of our present? What are we becoming? What have we been doing in confronting the colonial matrix of power? Contrary to colonial frameworks and crossings, the article considers that necropolitical practices are intolerable, and it is based on the ethical-political and aesthetic principle of investing in other practices of research and thinking, which corroborate counter-colonial crossings. authors mandate others researchworking working makersofinteriorsinturn. makersofinteriorsinturn makers interiors turn. turn makers-of-interiors-in-turn power exploitation itself becoming crossings intolerable ethicalpolitical ethical political countercolonial counter

ABSTRACT Waste pickers constitute a marginalized demographic engaged in the collection of refuse, facing considerable occupational hazards that heighten their susceptibility to contract infectious diseases. Moreover, waste pickers contend with societal stigmatization and encounter barriers to accessing healthcare services. To explore the viral profile of waste pickers potentially linked to their occupational environment, we conducted a metagenomic analysis on 120 plasma specimens sampled from individuals employed at the Cidade Estrutural dumpsite in Brasilia city, Brazil. In total, 60 blood donors served as a comparative control group. Specimens were pooled and subjected to Illumina NextSeq 2000 sequencing. Viral abundance among waste pickers revealed the presence of significant pathogens, including HIV, HCV, and Chikungunya, which were not detected in the control group. Additionally, elevated levels of anelloviruses and Human pegivirus-1 were noted, with a comparable incidence in the control group. These findings underscore the utility of metagenomics in identifying clinically relevant viral agents within underserved populations. The implications of this study extend to informing public health policies aimed at surveilling infectious diseases among individuals facing socioeconomic disparities and limited access to healthcare resources. refuse Moreover services environment 12 city Brazil total 6 group 200 sequencing pathogens HIV HCV Chikungunya Additionally pegivirus1 pegivirus 1 pegivirus- noted populations resources 20 2

SUMMARY OBJECTIVE: Intraoperative complications of hysteroscopy, such as the creation of a false passage, cervix dilatation failure, and uterine perforation, may require suspension of the procedure. Some patients refuse a new procedure, which delays the diagnosis of a possible serious uterine pathology. For this reason, it is essential to develop strategies to increase the success rate of hysteroscopy. Some authors suggest preoperative use of topical estrogen for postmenopausal patients. This strategy is common in clinical practice, but studies demonstrating its effectiveness are scarce. The aim of this study was to evaluate the effect of cervical preparation with promestriene on the incidence of complications in postmenopausal women undergoing surgical hysteroscopy. METHODS: This is a double-blind clinical trial involving 37 postmenopausal patients undergoing surgical hysteroscopy. Participants used promestriene or placebo vaginally daily for 2 weeks and then twice a week for another 2 weeks until surgery. RESULTS: There were 2 out of 14 (14.3%) participants with complications in the promestriene group and 4 out of 23 (17.4%) participants in the placebo group (p=0.593). The complications were difficult cervical dilation, cervical laceration, and vaginal laceration. CONCLUSION: Cervical preparation with promestriene did not reduce intraoperative complications in postmenopausal patients undergoing surgical hysteroscopy. OBJECTIVE hysteroscopy passage failure perforation procedure pathology reason practice scarce METHODS doubleblind double blind 3 surgery RESULTS 1 14.3% 143 (14.3% 17.4% 174 17 (17.4% p=0.593. p0593 p p=0.593 . 0 593 (p=0.593) dilation laceration CONCLUSION 14.3 (14.3 17.4 (17.4 p059 p=0.59 59 (p=0.593 14. (14. 17. (17. p05 p=0.5 5 (p=0.59 (14 (17 p0 p=0. (p=0.5 (1 p=0 (p=0. ( p= (p=0 (p= (p

Abstract Introduction: For decades, Mexico's northern border has been the center of national and international attention for the level of violence generated by organized crime, human trafficking and illicit activities linked to drug trafficking. Due to the economic and social impact of insecurity and violence, there is a need to develop educational actions that promote the construction of a culture of security and peace among adolescents. This study analyzes the role of Mantente REAL in the construction of norms and values that promote inclusive school relationships, conflict resolution, values oriented to selfcare, and the common good among students. Methodology: This study analyzes qualitative information that was collected in 2018 in the context of the implementation of the substance use prevention program Mantente REAL. Information from 10 focus groups with students (n=8) and teachers (n=2) who participated in the program was analyzed. Result: Findings indicate that learning life skills, and using the strategies of the acronym REAL -Refuse, Explain, Avoid and Leave- foster peace and citizenship students participating in the program. Conclusions: Participants engaged in individual and collective efforts to prevent problems such as substance use, bullying and other forms of violence. Recommendations highlight the need to investigate further the potential benefits of implementing school-based interventions with multiple outcomes.

Resumen Introducción: Por décadas, la frontera norte de México ha sido el centro de atención nacional e internacional debido al nivel de violencia generado por el tráfico de personas y las actividades ilícitas vinculadas al tráfico de sustancias adictivas. El impacto económico y social de la inseguridad demanda el diseño de acciones educativas que promuevan la construcción de una cultura de seguridad y paz en personas adolescentes. Este estudio analiza el rol del programa Mantente REAL en el establecimiento de normas y valores que fomentan la convivencia escolar inclusiva y la resolución de conflictos, orientadas al cuidado individual y al bien común. Metodología: Se analiza información cualitativa recopilada en 2018 dentro del programa de prevención de uso de sustancias Mantente REAL. Los datos fueron extraídos de 10 grupos focales, con estudiantes (n = 8) y profesores (n = 2), quienes participaron en el programa. Resultados: Los hallazgos indican que el aprendizaje de habilidades de vida y el uso de las estrategias del acrónimo REAL (Rechaza, Explica, Aléjate y Levántate) ayudan a crear la paz y la ciudadanía en población estudiantil. Conclusiones: Los participantes construyeron metas individuales y colectivas para evitar problemas como el uso de sustancias, el acoso escolar y otras formas de violencia.

Abstract Introduction: Residency in general practice and family medicine (GP/FM) is essential for acquiring knowledge and skills. As patients play a fundamental role in residents’ training, it is important to understand their perception of GP/FM residents. Objectives: To evaluate patients’ perception of the role of GP/FM residents and their trust in the medical care provided by them at USF Santiago de Leiria, a family unit in Portugal. Methods: Cross-sectional study with a convenience sample of 450 patients of USF Santiago through a questionnaire consisting of a sociodemographic survey and questions designed to assess patients' perception of the role of GP/FM residents. Results: We obtained 405 valid questionnaires, where 87.7% of patients reported having already had an appointment with a resident and 57.0% reported that they had been previously explained what medical residency was. Of the patients who had already been consulted by a resident, the majority believed that residency was important for the training of family physicians (95.0%). When asked whether they accepted the consultation to be carried out by a resident, 94.2% responded affirmatively, however when asked whether they felt free to refuse to be seen by a resident, only 70.1% replied positively. Of the total sample, 93.3% reported feeling comfortable communicating their problems to residents and 96.0% felt confident in the care they received from them. Conclusions: Although there is still some lack of knowledge about what residency is, most patients believe that residency in general practice is important for the training of future family physicians and accept their consultations to be carried out by residents.

Resumo Introdução: A formação especializada em medicina geral e familiar (MGF) é essencial para a aquisição de conhecimentos e competências. Tendo os utentes um papel fundamental na formação dos médicos internos é importante compreender a perceção dos utentes sobre os médicos internos de MGF. Objetivos: Avaliação da perceção dos utentes da USF Santiago de Leiria sobre o papel dos médicos internos de MGF e a confiança nos cuidados médicos por estes prestados. Método: Estudo transversal com uma amostra de conveniência de 450 utentes da USF Santiago através de um questionário constituído por um inquérito sociodemográfico e questões desenhadas para avaliar a perceção dos utentes sobre o papel dos médicos internos de MGF. Resultados: Foram obtidos 405 questionários válidos: 87,7% dos utentes referiam já terem tido uma consulta com um médico interno e 57,0% referiam que já lhes tinha sido explicado previamente o que era o internato médico. Dos doentes que já tinham sido consultados por um médico interno, a maioria acreditava que o internato era importante para a formação dos médicos de família (95,0%). Quando questionados sobre se aceitavam que a consulta fosse realizada por um médico interno, 94,2% responderam afirmativamente; quando inquiridos sobre se sentiam que tinham liberdade para recusar serem vistos por um médico interno apenas 70,1% responderam positivamente. Do total da amostra 93,3% referiam sentir-se confortáveis para comunicar os seus problemas aos médicos internos e 96,0% sentiam confiança nos cuidados que destes recebiam. Conclusões: Apesar de haver ainda algum desconhecimento sobre o que é um médico interno, a maioria dos utentes acredita que o internato em MGF é importante para a formação dos futuros médicos de família e aceitam que as suas consultas sejam realizadas por médicos internos.

Abstract Conscientious objection is defined as the right to refuse the practice of an act of his profession, when this action conflicts with their conscience, offending his ethical, moral, religious, philosophical, ideological, or humanitarian principles. This was called into question in the report entitled “The situation of sexual and reproductive health and rights in the EU, in the frame of women’s health”, better known as the Matic Report, approved by the European Parliament. In this report, it was proposed to consider “conscientious objection as a refusal to provide medical care”. However, this is a right that should be considered inalienable. It is necessary to guarantee not only the autonomy of the patient but also that of the health care professional.

Resumo A objeção de consciência é referida como o direito de o médico recusar a prática de ato próprio da sua profissão quando essa mesma prática entre em conflito com a sua consciência, ofendendo os seus princípios éticos, morais, religiosos, filosóficos, ideológicos ou humanitários. O direito em questão foi posto em causa no relatório “A situação da saúde e dos direitos sexuais e reprodutivos da UE, no contexto da saúde das mulheres”, vulgarmente conhecido como Relatório Matic, aprovado pelo Parlamento Europeu. No referido documento propôs-se a consideração da “objeção de consciência como uma recusa de prestação de cuidados médicos”. No entanto, aquela deve ser considerada um direito inalienável. Neste sentido, e no âmbito desta problemática, é necessário garantir não só a autonomia do doente, como também a do próprio profissional de saúde, procurando um equilíbrio entre ambas.

Recently, the Supreme Court of Nigeria in Tega Esabunor v Faweya & Ors (2019) LPELR 46961 (SC) dismissed an appeal seeking to quash the order of a magistrate court for the transfusion of blood to a baby. The appellants contended that the court had no jurisdiction to make the order. The crux of the case was whether the parents' right to consent to the child's treatment based on religious beliefs supersedes the child's right to live, thus reflecting the tension between a parent's right to give consent to the choice of treatment for their child, and the court's power to override such rights through the inherent parens patriae jurisdiction of the state. The case also reflects the tension between the freedom of a parent to practise their religion and the right of a child to live, in the medical context. This article examines the findings of the Supreme Court in Tega Esabunor's case, considering whether the court's decision is in line with the generally accepted practice on when the state can intervene if persons with parental responsibility refuse medical treatment for an incompetent child because of religious beliefs. Cases from other jurisdictions are analysed to ascertain the position of foreign courts. It is submitted that the Supreme Court's judgment reflects accepted international practice regarding parental refusal of consent for medical treatment of a child.