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Objective: To describe the health-related quality of life (QOL) in children with cerebral palsy (CP) associated with congenital Zika infection. Methods: Cross-sectional study of a consecutive series of children, followed in a referral multicentric rehabilitation network in Brazil. We invited the caregivers to respond to the Brazilian version of the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILDTM) questionnaire. Statistical analysis was performed with the Statistical Package for the Social Sciences (SPSS) 26.0™. We used absolute and relative frequencies for categorical variables and mean and standard deviation for continuous variables. Results: The sample consisted of 193 children, at mean age of 50.3±7.6 months. We observed a predominance of children with cerebral palsy (CP) with Gross Motor Function Classification System (GMFCS) level V (93.7%). Epilepsy (88.4%) was the most common comorbidity. CPCHILDTM mean scores were activities of daily living (ADL)/personal care 43.2±12.6; positioning, transferring and mobility 33.7±16.5; comfort and emotions 84.4±15.2; communication and social interaction (CoSI) 48.2±24.3; health 70.9±17.1; and overall quality of life (OQOL) 72.1±17.1. Total score was 54.8±11.3. Conclusions: Among children with cerebral palsy (CP) related to congenital Zika syndrome, the quality of life (QOL) scores were very similar to other populations with cerebral palsy (CP). The activities of positioning, transferring and mobility had the greatest impact on health-related quality of life (QOL). Rehabilitation strategies and public policies should prioritize aspects related to mobility for this population.

Publisher's version (útgefin grein), Population movement is a major driver for infectious disease transmission and can impact the success of disease control and elimination strategies. The relationship between disease transmission and permanent migration is well documented, but fewer studies have considered how different types of population mobility affects disease transmission and control programmes. This qualitative study was conducted on two islands of the Bijagós archipelago, Guinea Bissau to understand spatial and temporal population movement, and reasons for these movements, within, between and away from the Bijagós islands. Data were collected on two islands using key informant interviews (n = 8), daily activity-location interviews (n = 30) and focus group discussions (n = 6). Data were analysed thematically using an adapted typology of mobility. Findings revealed that movement within and between islands, and from islands to the mainland, was a common feature of island life for men and women alike. It was usual for trips away from home to last for several months at a time. Five key reasons for travel were identified: subsistence activities; family events; income generating activities; cultural festivities and healthcare. These movements often occurred erratically all year round, with the exception of seasonal travel within and between islands for agricultural purposes. Our study characterised detailed patterns of human mobility in the Bijagós islands as a first step towards understanding the potential impact of different types of mobility on disease exposure, transmission and public health programmes. Short-term mobility may have a significant impact on the spread of infectious diseases with short incubation periods. Predictable movements, such as travel for seasonal agricultural work, should be taken into account for tailoring and increasing the reach of public health interventions. Further research is needed to understand the role of human behaviour and mobility in disease transmission and control across the archipelago., This work was supported by the Medical Research Council grantnumber MR/P023843/1 awarded to David Mabey at the London Schoolof Hygiene & Tropical Medicine.

Orientador(a): Prof(a). Dr(a). Paulo Tadeu Da Silva Dissertação (mestrado) - Universidade Federal do ABC, Programa de Pós Graduação em Filosofia. São Bernardo do Campo, 2021 A presente dissertação é um estudo sobre a centralidade do texto em aulas de filosofia para o Ensino Médio. Ela está redigida em estilo ensaístico, pois, em grande parte, apresenta-se como um relato de experiência do cotidiano em sala de aula e tem como objetivos teorizar uma prática que culmina em uma metodologia didático-pedagógicafilosófica de aula. Ao mesmo tempo, anseia por responder algumas questões fundamentais: Qual a visão de filosofia da professora de filosofia que desenvolve essa narrativa? Como essa visão transparece de forma coerente nas aulas que ministra? Uma contadora de história pode, de fato, ser professora de filosofia? Ao se perguntar sobre tudo isso vai também apresentando seu lugar filosófico como desnaturalização do olhar, perda do chão e possibilidade de reconstrução de sub-versões de mundo. Ao debruçar-se sobre a invenção de um método, apoia-se muito de Paulo Freire, de escuta e leitura de textos. Escuta manifesta em contação de histórias e leitura de texto clássicos da tradição filosófica. Apresenta também uma sugestão de material didático que visa englobar tudo isso e tece uma análise crítica desse mesmo material. Termina apresentando pontos de reflexão despertados pela própria pesquisa em sua incompletude de ser no mundo. This text is a study on the centrality of the text in philosophy classes for High School. It is written in an essay style, because, in large part, it presents itself as an account of everyday experience in the classroom and aims to theorize a practice that culminates in a didactic-pedagogical-philosophical methodology in class. At the same time, it is eager to answer some fundamental questions: What is the philosophy professor's view of philosophy that develops this narrative? How does this vision appear in a coherent way in the classes you teach? Can a storyteller really be a philosophy teacher? When asked about all of this, he also presents his philosophical place as the denaturalization of the gaze, the loss of the ground and the possibility of reconstructing sub-versions of the world. While going through the invention of a method that they have a lot of Paulo Freire, of listening and reading texts. Listening manifests in storytelling and reading classic texts from the philosophical tradition. It also presents a suggestion of didactic material that aims to encompass all of this and makes a critical analysis of that same material. It ends by presenting points of reflection awakened by the research itself in its incompleteness of being in the world.

Em uma análise dos temas lazer, juventude e violência, o Grupo de Estudos em Sociologia e Pedagogia em Esporte e Lazer, da Universidade Federal de Minas Gerais, investigou, usando ferramentas de buscas avançadas, no Portal da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), as publicações entre 2014-2019, as quais articulam esses constructos. Objetivou se apresentar evidências atualizadas sobre o tema e busca auxiliar na reflexão de ações contextualizadas que incluam o lazer para o público jovem. Foram encontrados 11 artigos quando a busca era por binômios, dos quais 7 referentes a lazer e juventude e 4 referentes a lazer e violência. Os pesquisadores concluem que os artigos encontrados no referido portal – 58 do conceito lazer, 4 do binômio lazer e violência e 7 que apresentavam os descritores juventude, violência e exemplos de vivências de lazer – estão concentrados em pesquisadores da sociologia, psicologia, estudos culturais e em pouca expressão nos estudos do lazer. Observa-se pouca contribuição dos pesquisadores do campo do lazer que abordam a articulação de juventude e violência. Contudo, todos os artigos de alguma forma citaram os três temas, ressaltando a importância do desenvolvimento de estudos densos sobre o assunto, que ganha grande relevância no mundo contemporâneo.

Introduction Skin diseases represent a significant public health problem in most low and middle income settings. Nevertheless, there is a relative paucity of high-quality epidemiological data on the prevalence of these conditions. Materials/Methods We conducted two cross-sectional population-based skin-surveys of children (6 months to 9 years old) in the Bijagós Archipelago of Guinea-Bissau during the dry season (February-March 2018) and the wet season (June-July 2018). Following a period of training, a nurse performed a standardised examination for communicable dermatoses for each participant. We calculated the prevalence of each skin condition and investigated demographic associations. Results 1062 children were enrolled in the dry season survey of whom 318 (29.9%) had at least one skin diseases. The most common diagnosis was tinea capitis (154/1062, 14.5% - 95% CI 12.5–16.8%) followed by tinea corporis (84/1062, 7.9% - 95% CI 6.4–9.7%), pyoderma (82/1062, 7.7% - 95% CI 6.2–9.5%) and scabies (56/1062. 5.2% - 95%CI 4.0–6.8%). 320 children were enrolled in the wet season survey of whom 121 (37.8%) had at least one skin problem. Tinea capitis remained the most common diagnosis (79/320, 24.7% - 95% CI 20.1–29.9%), followed by pyoderma (38/320, 11.9% - 95% CI 8.6–16.1%), tinea corporis (23/320, 7.2% - 95% 4.7–10.7%) and scabies (6/320, 1.9% - 95% CI 0.8–4.2%). Conclusions Our study, which utilised robust population-based cluster random sampling methodology, demonstrates the substantial disease burden caused by common communicable dermatoses in this setting. Given these findings, there is a need to consider common dermatoses as part of Universal Health Coverage to deliver ‘skin-health for all’., Author summary Skin conditions are very common in many low and middle income settings but there have been relatively few surveys of skin disease conducted using the best epidemiological approaches. We performed two cross-sectional population-based skin-surveys of children in the Bijagós Archipelago, Guinea-Bissau, using gold-standard sampling methodologies. Skin conditions were extremely common and almost 30% of children had at least one common, infectious skin condition in both surveys. Fungal skin and scalp infections were the most common conditions followed by bacterial skin infections. Our survey demonstrates that common, easily treatable skin conditions are responsible for a high burden of disease in this population. Skin-health should be considered a key component of the Universal Health Coverage agenda.

IntroductionScabies is highly endemic among impoverished populations and has been recently included in the WHO’s list of neglected tropical diseases (NTDs). Community support and behavioural changes are essential for the success of control interventions. This study aimed to explore beliefs, prevention attitudes and health care-seeking behaviours towards scabies in the Bijagós Archipelago of Guinea-Bissau.MethodsData were collected through two methods. Community key informants (community members, community health workers, healthcare workers and traditional healers) were interviewed using snowball sampling. A questionnaire covering perceptions, attitudes and practices was administered to community members using random cluster sampling. Thematic analysis of qualitative data was applied to identify themes. Descriptive statistics were used for quantitative data analysis.ResultsThere was a satisfactory awareness about scabies, but perceptions about disease causation and transmission were imprecise. Misconceptions about personal hygiene as the primary measure for scabies prevention were recurrent. Some participants recognised the importance of early treatment to interrupt transmission. Treatment of close contacts was not considered important. Costs were the main determining factor for treatment choice between traditional healer and the local health centre. Late presentation and delayed treatment were common and associated with poverty and stigmatisation. Scabies impaired quality of life by affecting social interactions, health, fitness to work and school attendance.ConclusionsThere is a need to improve education, recognition, management and affordable access to treatment. Community education, healthcare workers’ training and skin NTDs integrated control programmes should address the challenges highlighted in this study.Authors SummaryScabies is a common skin infection in low income settings. We conducted a study in Guinea-Bissau to explore the knowledge, attitudes and practices about scabies. We conducted interviews with healthcare workers, traditional healers and community members and additionally used an oral-administered questionnaire with a larger sample of community residents. Most individuals had knowledge of scabies and were aware that person to person transmission occurred. However personal and environmental hygiene were both incorrectly identified as particularly important in the transmission of scabies. Cost played a major role in determining where individuals sought care and both poverty and disease associated stigma resulted in delays seeking care. There is a need to improve community and health care worker education about scabies and improve affordable access to treatment.

Natural killer (NK) cells differentiate and mature during the human life course; human cytomegalovirus (HCMV) infection is a known driver of this process. We have explored human NK cell phenotypic and functional maturation in a rural African (Gambian) population with a high prevalence of HCMV. The effect of age on the frequency, absolute number, phenotype, and functional capacity of NK cells was monitored in 191 individuals aged from 1 to 49 years. Increasing frequencies of NK cells with age were associated with increased proportions of CD56dim cells expressing the differentiation marker CD57 and expansion of the NKG2C+ subset. Frequencies of NK cells responding to exogenous cytokines declined with age in line with a decreased proportion of CD57− cells. These changes coincided with a highly significant drop in anti-HCMV IgG titers by the age of 10 years, suggesting that HCMV infection is brought under control as NK cells differentiate (or vice versa). Deletion at the NKG2C locus was associated with a gene dose-dependent reduction in proportions of CD94+ and CD57+ NK cells. Importantly, anti-HCMV IgG titers were significantly elevated in NKG2C−/− children, suggesting that lack of expression of NKG2C may be associated with altered control of HCMV in childhood.

A systems approach provides a global perspective of the different strategies that viruses use to modulate the cellular innate immune response; this may be useful in the design of future viral intervention strategies. Andreas Pichlmair et al. take a systems approach to obtain a global perspective of the different strategies that viruses use to modulate the cellular innate immune response. The results demonstrate that viruses have evolved to exploit a variety of cellular mechanisms, and suggest that the host cell relies on homeostatic regulation across these diverse cellular processes to defend itself against pathogen interference. A central goal of this work is to identify common targets and general network properties in the host antiviral defence system that may be useful in the design of future viral-intervention strategies. Viruses must enter host cells to replicate, assemble and propagate. Because of the restricted size of their genomes, viruses have had to evolve efficient ways of exploiting host cell processes to promote their own life cycles and also to escape host immune defence mechanisms1,2. Many viral open reading frames (viORFs) with immune-modulating functions essential for productive viral growth have been identified across a range of viral classes3,4. However, there has been no comprehensive study to identify the host factors with which these viORFs interact for a global perspective of viral perturbation strategies5,6,7,8,9,10,11. Here we show that different viral perturbation patterns of the host molecular defence network can be deduced from a mass-spectrometry-based host-factor survey in a defined human cellular system by using 70 innate immune-modulating viORFs from 30 viral species. The 579 host proteins targeted by the viORFs mapped to an unexpectedly large number of signalling pathways and cellular processes, suggesting yet unknown mechanisms of antiviral immunity. We further experimentally verified the targets heterogeneous nuclear ribonucleoprotein U, phosphatidylinositol-3-OH kinase, the WNK (with-no-lysine) kinase family and USP19 (ubiquitin-specific peptidase 19) as vulnerable nodes in the host cellular defence system. Evaluation of the impact of viral immune modulators on the host molecular network revealed perturbation strategies used by individual viruses and by viral classes. Our data are also valuable for the design of broad and specific antiviral therapies.

TANK-binding kinase 1 (TBK1) and inducible IκB-kinase (IKK-i) are central regulators of type-I interferon induction. They are associated with three adaptor proteins called TANK, Sintbad (or TBKBP1) and NAP1 (or TBKBP2, AZI2) whose functional relationship to TBK1 and IKK-i is poorly understood. We performed a systematic affinity purification-mass spectrometry approach to derive a comprehensive TBK1/IKK-i molecular network. The most salient feature of the network is the mutual exclusive interaction of the adaptors with the kinases, suggesting distinct alternative complexes. Immunofluorescence data indicated that the individual adaptors reside in different subcellular locations. TANK, Sintbad and NAP1 competed for binding of TBK1. The binding site for all three adaptors was mapped to the C-terminal coiled-coil 2 region of TBK1. Point mutants that affect binding of individual adaptors were used to reconstitute TBK1/IKK-i-deficient cells and dissect the functional relevance of the individual kinase-adaptor edges within the network. Using a microarray-derived gene expression signature of TBK1 in response virus infection or poly(I∶C) stimulation, we found that TBK1 activation was strictly dependent on the integrity of the TBK1/TANK interaction.

TANK-binding kinase 1 (TBK1) is of central importance for the induction of type-I interferon (IFN) in response to pathogens. We identified the DEAD-box helicase DDX3X as an interaction partner of TBK1. TBK1 and DDX3X acted synergistically in their ability to stimulate the IFN promoter, whereas RNAi-mediated reduction of DDX3X expression led to an impairment of IFN production. Chromatin immunoprecipitation indicated that DDX3X is recruited to the IFN promoter upon infection with Listeria monocytogenes, suggesting a transcriptional mechanism of action. DDX3X was found to be a TBK1 substrate in vitro and in vivo. Phosphorylation-deficient mutants of DDX3X failed to synergize with TBK1 in their ability to stimulate the IFN promoter. Overall, our data imply that DDX3X is a critical effector of TBK1 that is necessary for type I IFN induction.