Background: Living in a rural or remote area is frequently associated with impaired access to health services, which directly affects the possibility of early diagnosis and appropriate monitoring of diseases, mainly non-communicable ones, because of their asymptomatic onset and evolution. Point-of-care devices have emerged as useful technologies for improving access to several laboratory tests closely patients' beds or homes, which makes it possible to eliminate the distance barrier. Objective: To evaluate the application of point-of-care technology for glycated hemoglobin (HbA1c) estimation in the assessment of glycemic control and identification of new diagnoses of diabetes in primary care among rural communities in a Brazilian municipality. Conclusion: The application of point-of-care devices for HbA1c level measurement improved the access to this test for people living in rural or remote areas. Thus, it was possible to include this technology in the routine activities of primary health care teams, which increased the rates of new diagnoses and identification of patients with uncontrolled glycemia. Volume 8 - 2021 | https://doi.org/10.3389/fmed.2021.734306 Background: Living in a rural or remote area is frequently associated with impaired access to health services which directly affects the possibility of early diagnosis and appropriate monitoring of diseases because of their asymptomatic onset and evolution Point-of-care devices have emerged as useful technologies for improving access to several laboratory tests closely patients' beds or homes which makes it possible to eliminate the distance barrier Objective: To evaluate the application of point-of-care technology for glycated hemoglobin (HbA1c) estimation in the assessment of glycemic control and identification of new diagnoses of diabetes in primary care among rural communities in a Brazilian municipality Materials and Methods: We included individuals aged 18 years or older among rural communities in a Brazilian municipality participants were assessed for anthropometrics and capillary glycemia during routine primary care team activities at health fairs and in patient groups Participants previously diagnosed with diabetes but without recent HbA1c test results or those without a previous diagnosis but with random capillary glycemia higher than 140 mg/dL were considered positive and were tested for HbA1c by using a point-of-care device 600 (65.7%) had no previous diagnosis of diabetes 58/600 (9.7%) refused capillary glycemia screening and 542/600 (90.7%) were tested 73/542 (13.5%) cases without a previous diagnosis of diabetes 31/73 (42.5%) had HbA1c levels that were considered indicative of prediabetes and 16/73 (21.9%) were newly diagnosed with diabetes 313/913 (34.3%) were previously diagnosed with diabetes Recent HbA1c results were unavailable for 210/313 (67.1%) These individuals were tested using point-of-care devices 143/210 (68.1%) had HbA1c levels higher than target levels (>7% and >8% for adults and elderly individuals Conclusion: The application of point-of-care devices for HbA1c level measurement improved the access to this test for people living in rural or remote areas it was possible to include this technology in the routine activities of primary health care teams which increased the rates of new diagnoses and identification of patients with uncontrolled glycemia this study aimed to evaluate the application of point-of-care technology for HbA1c estimation in the assessment of glycemic control and identification of new diagnoses of diabetes in primary care among rural communities in a Brazilian municipality This application study was conducted with a cross-sectional analysis The analysis included individuals aged 18 years or older residing in rural areas covered by family health units with or without a previous diagnosis of diabetes from September 2019 to February 2020 The municipality where the study was conducted is in northeastern Brazil and has a total area of 3,254,186 km2. Its estimated population is 338,480 inhabitants, of which approximately 12% live in rural areas (18) The rural area selected has 18 primary health care units with 100% coverage of the rural population through the family health program The municipality has a highly complex public laboratory that performs most laboratory tests for the patients attended to via the local public health system The farthest rural unit is 82 km away from the municipal laboratory and the location of the municipal laboratory The units included in the study were named BHU 1 to 4 Map of the municipality with the geospatial distribution of the basic health units in the rural area of study HbA1c measurements were performed in two ways health fairs were conducted in the rural family health team's coverage area the equipment was taken to the corresponding BHU on pre-scheduled dates on which patient groups were attended to at the units patient group activities are part of the routine of family health teams These activities involve educational initiatives and assessments conducted by nurses and physicians Participants with measurements higher than the corresponding threshold values were attended to by the physician at the unit a portable device for the measurement of HbA1c was provided at the BHU for the days on which activities were scheduled for patient groups with diabetes or hypertension particularly for those with an indication to repeat the HbA1c test The criteria for HbA1c level evaluation were the same as those applied at health fairs and included individuals for whom a new measurement was indicated subsequent measurements were suspended from March 2020 The study was approved by the Ethics Committee on Research in Human Beings of the Multidisciplinary Institute in Health–Campus Anísio Teixeira (Opinion number: 3.357.963) The requirement of patient's informed consent was waived because the study could not be conducted without a waiver and involved no more than minimal risk according to the HbA1c threshold for each age group Main characteristics of the participants who visited the health fairs and patient groups Results of the screening for capillary glycemia and diagnosis confirmation by HbA1c testing performed using point-of-care test devices Comparison of the characteristics of the participants with a previous diagnosis of diabetes according to the glycemic status assessed using the HbA1c point-of-care test we demonstrated the application of point-of-care devices for the measurement of HbA1c levels in the detection of new cases and monitoring of glycemic control in patients with diabetes in four rural areas in a Brazilian municipality The equipment was included in routine activities of the primary health care teams 16 new cases of diabetes and 31 individuals with prediabetes were identified 210 had no HbA1c results in the past 3 months of which 68.1% had HbA1c levels higher than the control threshold Although the areas we studied are covered by the family health program with primary care units located in these locations the efforts of the health teams have not been sufficient to identify individuals with diabetes those with high potential for the development of diabetes or those with inadequately controlled blood glucose levels The higher prevalence of HbA1c level exceeding the control threshold was associated with the adult age group (age of < 65 years) In addition to living outside the urban center this group of individuals may face other barriers to accessing health services such as the working hours of the primary care units in the localities or of the public laboratory for collecting blood samples for the measurement of HbA1c These services generally operate on working days and during business hours which makes it impossible for the rural population to participate in these activities during these periods because it interferes with their work the availability of point-of-care devices in routine health actions performed on alternative days such as weekends is one of the causes of the highest rate of non-control in this group The main international guidelines for the management of diabetes as well as the Brazilian guidelines define the need for at least two confirmatory tests to confirm the diagnosis of diabetes after a random capillary blood glucose level ≥ 140 mg/dL This decision was based on the low probability that an individual with hyperglycemia associated with HbA1c levels that reflect the average blood glucose levels in the last 3 months we present the possibility of overestimating the newly diagnosed patients in the studied population and highlight that these patients were referred for diagnostic confirmation to the physicians at the health units in their localities Primary care attributes include health education, screening and management of NCDs, and referral of patients to specialized care (23) some of the cases considered as those of new diagnoses of diabetes had an HbA1c level > 8% It is expected that these individuals had already presented symptoms of hyperglycemia they had not yet been diagnosed with the condition There may have been several direct causes for this finding such as the neglect of symptoms and the consequent inertia in seeking health care the absence of screening for diabetes in the localities or even a delay in conducting diagnostic examinations All these possibilities converge to a root cause: the difficulty in accessing health services and the consequent failure in the early detection of diabetes the estimated cost for the local health system with complications related to diabetes ranges from 17,047.90 to 591,467.00 dollars only for patients from these four locations whose HbA1c levels were higher than the control threshold Given the findings obtained with the application of point-of-care for HbA1c measurement in rural communities we believe that the cost-effectiveness ratio of the initiative is even more favorable when compared to testing in laboratories we highlight that providing HbA1c testing to diagnose and monitor diabetes will not necessarily correspond to health improvements in a previous study on the same population although the reduction in the mean HbA1c was not significant we observed a reduction of HbA1c by one percentage point in 38% of the included patients which suggests a significant reduction in their cardiovascular risk and probably reflects revised pharmacotherapy and reinforcement of the efforts of the healthcare team combined with life style changes adopted by the patients the follow-up of these patients was interrupted due to the COVID-19 pandemic and most patients were only examined once during the follow-up our results may be overestimated because of a potentially biased population sample as it may be possible that only patients with a relatively low self-perceived health status sought out the health services health fairs and patient groups are part of the routine activities of primary care teams in Brazil and our study was designed to assess the application of the HbA1c-POC technology in a real-world scenario we believe the participants of this study represent we demonstrated that the use of point-of-care devices to measure HbA1c can increase access for people living in rural or remote areas It was possible to include the technology in the routine activities of primary health care teams which led to new diagnoses and identification of many patients with an uncontrolled glycemic status in a health system that had failed to regularly monitor HbA1c levels The raw data supporting the conclusions of this article will be made available by the authors The studies involving human participants were reviewed and approved by Ethics Committee on Research in Human Beings of the Multidisciplinary Institute in Health–Campus Anísio Teixeira Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements and VC contributed to the study conception and design and the manuscript draft were performed by MC DR and LP actively contributed to the critical revision of the manuscript All authors contributed to the article and approved the submitted version This work was funded by the Medtronic Foundation under Grant Number 255790 from CAF America This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior–Brasil (CAPES)–Finance Code 001 The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the international diabetes federation diabetes atlas Impact of remote location on quality care delivery and relationships to adverse health outcomes in patients with diabetes and chronic kidney disease A model for point of care testing for non-communicable disease diagnosis in resource-limited countries Point-of-care testing for haemoglobin A1c in remote Australian indigenous communities improves timeliness of diabetes care Differences in the prevalence of diabetes risk-factors among first Nation métis and non-aboriginal adults attending screening clinics in rural Alberta Chronic disease patients' experiences with accessing health care in rural and remote areas: a systematic review and qualitative meta-synthesis rurality and the need for care: access to health services in South West England 8. IBGE. Pesquisa Nacional por Amostra de Domicílios (PNAD). (2015). Available online at: https://censo2010.ibge.gov.br/ Google Scholar 9. International Diabetes Federation (IDF). Bruxelas. (2019). Available online at: https://diabetesatlas.org/ (accessed November Diabetes care in Brazil: program to improve primary care access and quality-PMAQ Quality of care of patients with diabetes in primary health services in Southeast Brazil Description of a new predictive modeling approach that correlates the risk and associated cost of well-defined diabetes-related complications with changes in glycated hemoglobin (HbA1c) Predictions of diabetes complications and mortality using HbA1c variability: a 10-year observational cohort study Changes in HbA1c during the first six years after the diagnosis of type 2 diabetes mellitus predict long-term microvascular outcomes CrossRef Full Text | Google Scholar HbA1c: a review of analytical and clinical aspects PubMed Abstract | CrossRef Full Text | Google Scholar Cost-effectiveness of point-of-care A1C tests in a primary care setting 18. Instituto Brasileiro de Geografia e Estatística (IBGE). Cidades E Municípios. (2021). Available online at: https://www.ibge.gov.br/cidades-e-estados/ba/vitoria-da-conquista.html (accessed April 08 Google Scholar Performance of point-of-care HbA1c test devices: implications for use in clinical practice - a systematic review and meta-analysis Community-based interventions to improve the control of non-communicable diseases in underserved rural areas in Brazil: a before-and-after study Rural health around the world: challenges and solutions PubMed Abstract | CrossRef Full Text | Google Scholar Community-based interventions for detection and management of diabetes and hypertension in underserved communities: a mixed-methods evaluation in Brazil Primary care experiences in 25 years of journal ciência and saúde coletiva: a review of the scientific literature PubMed Abstract | CrossRef Full Text | Google Scholar Rumel D and Oliveira MG (2021) Improving Access to the Glycated Hemoglobin Test in Rural Communities With Point-of-Care Devices: An Application Study Received: 07 July 2021; Accepted: 29 October 2021; Published: 22 November 2021 Copyright © 2021 Camargo, Passos, Mistro, Soares, Kochergin, Carvalho, Macedo, Cortes, Souza, Rumel and Oliveira. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) distribution or reproduction in other forums is permitted provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited in accordance with accepted academic practice distribution or reproduction is permitted which does not comply with these terms *Correspondence: Marianne Silveira Camargo, bWFyaWFubmVfY2FtYXJnb0Bob3RtYWlsLmNvbQ== Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher 94% of researchers rate our articles as excellent or goodLearn more about the work of our research integrity team to safeguard the quality of each article we publish You don't have permission to access the page you requested What is this page?The website you are visiting is protected.For security reasons this page cannot be displayed Swiss specialty chemicals producer Clariant has agreed to acquire Geosol's 50% stake and take full control of the Brazil's Companhia Brasileira de Bentonita (CBB) Financial terms of the arrangement were not announced the company has been operated as a 50:50 joint venture of Clariant and Geosil a provider of analytical services for mineral exploration which is still subject to regulatory approval the Swiss company will gain a state-of-the-art bentonite production facility at Vitória da Conquista in the state of Bahia CBB has a strong market position for products used in Iron Ore Pelletizing (IOP) oil & mining drilling and civil engineering in Latin America Along with providing a modern production facility for its Functional Minerals business unit in Brazil Clariant said the transaction will allow it to secure strategic raw clay reserves for its growing bleaching earth operations in Jacareí Clariant CEO Hariolf Kottmann said the acquisition is in line with the specialty chemicals producer's "strategy to capture profitable growth opportunities in emerging markets." He said CBB offers "excellent access to markets with great potential" such as agriculture and feed additives and also lays the groundwork for further innovation head of the Ffunctional Materials business said the investment reflects Clariant's commitment to the growing bentonite business in Latin America "It strengthens our global position and gives us the opportunity to fully implement the technology and application know-how proven and applied around the world." CHEManager Spotlight is an exclusive event tailored for practitioners and decision-makers in the chemical industry This part of our event series delves into the latest trends and innovations in logistics to streamline your operations and drive efficiency CHEManager Innovation Pitch supports innovation in the chemistry and life sciences start-up scene and start-ups to present their companies to the industry Your browser does not support JavaScript, or it is disabled．Please check the site policy for more information Asia & World World Brazil--Two dams gave way in the northeastern Brazilian state of Bahia after weeks of heavy rains swamping already swollen local rivers as flooding hit towns across the region on the Verruga river near the city of Vitoria da Conquista in southern Bahia A second dam gave way to rising water levels in Jussiape bringing more alerts for residents to move to safer ground There were no reports of deaths or injuries caused by the dam failures fire brigade teams rescued residents trapped in their homes in the downtown area that was under water there are waves almost 2 meters high," shopkeeper Luiz Constancia told Reuters Rescuers rowed dinghies along flooded streets to reach trapped families or take them supplies One man paddled on an inflatable mattress to reach a home Residents said the level of the Cachoeira river that runs through the town located 30 kms from the coastal port city of Ilheus was the highest in 50 years said all residents close to the collapsed Igua dam had been evacuated Lemos said the flooding threatened to cut off the BR-116 highway a major truck route between northeastern and southern Brazil Bahia Governor Rui Castro said at least 400,000 people have been impacted by the heavy rains and thousands evacuated from some 67 towns facing emergency situations due to floods caused by heavy rainfall for almost two months "Thousands of people have had to leave their homes because the water rose one or two meters even three meters in some places," he told reporters on Saturday The rains have caused 18 deaths in Bahia since the beginning of November including a 60-year-old ferry owner who drowned on the swollen Rio das Contas river weather officials said December rainfall has been six times greater than the average Thailand issues new flood warnings from seasonal rain Flooding threat hangs over Thai capital Bangkok 20 missing in Atami in rain-triggered landslide floods leave at least 28 dead in northern China Families honor torrential rain disaster victims at memorials Atami landslide claims 3rd life; Suga vows full rescue effort Information on the latest cherry blossom conditions Please right click to use your browser’s translation function.) A series based on diplomatic documents declassified by Japan’s Foreign Ministry Here is a collection of first-hand accounts by “hibakusha” atomic bomb survivors chefs and others involved in the field of food introduce their special recipes intertwined with their paths in life A series about Japanese-Americans and their memories of World War II In-house News and Messages No reproduction or republication without written permission This was a large increase from previous years; the homicide rate grew from 16.9 murders per 100,000 people in 2015 to 27.3 per 100,000 in 2018 Media outlets rank the most dangerous cities in different ways but certain cities make their appearance on most such lists Ten of these cities have been listed below Baltimore has earned a reputation for violent crime and its per capita murder rate is 58.64 per 100,000 people and the Baltimore Sun reported a string of shootings and murders during the coronavirus crisis in early May The West Warren Avenue and McKinley Street area was mentioned as being particularly dangerous and the Sun claimed that people living there had a one in 13 chance of becoming a crime victim St. Louis was the highest-ranking American city on the list with a murder rate of 64.54 for every 100,000 people A report by Security.org showed that for every 1,000 residents one out of 10 would fall victim to robbery Louis ranked as even more dangerous than the city as a whole Cape Town is the second largest city in South Africa and has a murder rate of 68.28 for every 100,000 people; Africanews.com rated it as the most dangerous city on the continent This same article reported that from November 2018 to May 2019 more than 2,000 murders were recorded and that the city averages eight murders each day Much of this brutal violence is gang-related This entire country is known for its violent society; from 2005 to 2015 averaging eight to 14 violent deaths every day Local police blamed this on the Premeiro Comando da Capital (PCC) Brazil’s most notorious crime organization Natal’s per capita murder rate was 102.6 deaths per 100,000 people Venezuela’s capital Caracas also has a high per capita murder rate This number may be a result of the ways the city’s government operates; it has been known to clash violently with opposing protest groups One website described Caracas as “essentially lawless,” adding that much of the crime is not reported and goes unpunished Wikipedia claimed that as many as 98 percent of the crimes here are not recorded These twin cities combine to make one of the most popular resort areas in Mexico but there have been many reports of violence here Their murder rate is 111.3 deaths per 100,000 people and much of this could be the result of crime organizations competing to fill the void left by the infamous drug lord “El Chapo.” Acapulco is located in the Mexican state of Guerrero There are armed groups that operate outside of the government and they are known to set up roadblocks and exhibit violent behavior Acapulco was a mecca for tourists in its heyday but the influx of drug cartels has made people more hesitant to travel here; travel advisories have been issued to warn tourists about Acapulco’s high levels of crime and kidnapping Mexico’s second most dangerous place to live is the city of Juárez which has a murder rate of 104.54 per capita violence towards women increased dramatically Turf wars between rival groups caused additional violence starting in 2007 Though efforts by the Mexican Armed Forces and Federal Police have reduced the crime rates somewhat Tijuana is technically in Mexico and is adjacent to the United States border in Baja It is the most visited border city on the planet Tijuana is known to attract people fleeing the U.S. which has played a part in human trafficking The murder rate here was 134.24 deaths per 100,000 people photos and original descriptions © 2025 worldatlas.com The fourteen-year-old boy who died after injecting himself with a crushed butterfly suffered agonising symptoms for seven days before he died Davi Nunes Moreira, 14, died in hospital in Planalto, Brazil last Thursday after telling staff he had injected a solution made of crushed butterfly into his leg Believed to have carried out the dangerous procedure as part of an 'online challenge' Moreira began vomiting and struggled to walk before admitting his mistake The youngster was taken into hospital by his father and remained in the Vitória da Conquista general hospital for a week The Civil Police of Bahia continue to investigate the tragedy and are awaiting expert reports to clarify the cause of death, per local media. Luiz Fernando D. Relvas, a specialist at Hospital Santa Marcelina, told Brazilian news site VivaBem that 'it could have been an embolism, an infection, or an allergic reaction'. 'We don't know how he prepared this mixture or the size of the fragments he managed to inject into the body,' he said. 'There may have been air left inside, which could lead to an embolism,' adding that such a condition can lead to sudden deterioration and death. Investigators are also reportedly exploring the possibility that toxins from the mix could have caused Moreira's body to shut down as he went into septic shock. Moreira reportedly denied that he had injected himself after seeing the 'experiment' performed online, though details have been contested in Brazilian media. He is understood to have told his father initially that he had hurt himself while playing after picking up a limp. As his condition got worse, Moreira admitted what he had done, and his father found a syringe under his pillow, local media reports. Moreira is said to have told medics that he went into a chemist for supplies before mixing a dead butterfly in water and injecting the liquid into his right leg. Civil Police in Vitoria da Conquista, leading the investigation, said that an autopsy will help clarify the cause of death. Last April, an online influencer from Brazil nearly required amputation after taking part in an ill-advised viral trend for her two million followers. 'Thammy MC' was left unable to walk after standing in a bucket of ice and salt for an online 'dare' that turned her feet black and nearly required the amputation of her toes. 'We spent 15 minutes with our feet on the ice with coarse salt,' she said, recounting the horror. 'When I took my foot out I never felt such pain in my life. Three of my toes had turned black when it came out of the ice bucket.' Thammy was treated at a clinic where she was told she was at risk of thrombosis, and that she could have developed necrosis had she remained in the ice another minute. Unable to put any pressure on her feet, she said she now gets around the house by being dragged around in a garden chair by her mother, who pushes her from room to room. Major terror attack 'was just HOURS away' before it was foiled by the special forces and police:... Victim of acid attack 'plotted by his ex-partner who teamed up with a gang' dies in hospital six... We are trapped in unsellable newbuild homes after a £52m dual carriageway was built on our... Horror as $4.5M influencer-laden yacht SINKS off Miami... after glam women made a rookie maritime... How Meghan's biggest cheerleader brokered Harry's disastrous BBC interview - three months after... Woman dead and three others including a child injured after car ploughed into pedestrians: Man, 49,... 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No one seems to have shared their thoughts on this topic yetLeave a comment so your voice will be heard first. {{message}} View upcoming auction estimates and receive personalized email alerts for the artists you follow Madalena Santos Reinbolt: uma cabeça cheia de planetas [Madalena Santos Reinbolt: a Head Full of Planets] is the first solo exhibition devoted to the work of Madalena Santos Reinbolt (Vitória da Conquista the artist is acknowledged for her complex embroidery pieces made of hundreds of vibrant color lines—the so-called “wool paintings.” In them Reinbolt depicted everyday life in the countryside and in the city Santos Reinbolt remained on the fringes of traditional art circuits of her time and it was only in recent years that her work began to draw more attention Even today museums and art spaces remain silent regarding the pioneering spirit of her production something that MASP’s show intends to mitigate proposing the debate around her history and contribution to Brazilian art Madalena Santos Reinbolt: uma cabeça cheia de planetas [Madalena Santos Reinbolt: a Head Full of Planets] gathers 44 works and is accompanied by a catalog devoted entirely to the artist The Museu de Arte de São Paulo Assis Chanteubriand (MASP) features from November 25 2023 the first solo exhibition of Madalena Santos Reinbolt (1919 - 977) entitled: Madalena Santos Reinbolt: uma cabeça cheia de planetas (Madalena Santos Reinbolt: A Head.. 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Suscribe x MercoPress, en Español Montevideo, May 5th 2025 - 11:13 UTC yellow fever virus transmission continues to expand towards the Atlantic coast of Brazil in areas not deemed to be at risk for yellow fever transmission prior to the revised risk assessment published by WHO in the Disease Outbreak News of 27 January 2017 and supported by the scientific and technical advisory group on geographical yellow fever risk mapping (GRYF)  The revised risk assessment was based on epidemiological evidence and ecological factors The expanded areas at risk of yellow fever transmission remain the same as in the Disease Outbreak News of 27 January 2017 and the WHO travel advice of 31 January 2017 • Espírito Santo State: at risk for yellow fever transmission with the exception of the urban area of Vitoria • Rio de Janeiro State: at risk for yellow fever transmission in the following northern municipalities bordering Minas Gerais and Espírito Santo States: Bom Jesus do Itabapoana; Cambuci; Cardoso Moreira; Italva; Itaperuna; Laje do Muriae; Miracema; Natividade; Porciuncula; Santo Antonio de Padua; São Fidelis; São Jose de Uba; Varre-Sai; Campos dos Goytacazes; São Francisco de Itabapoa; São João da Barra Currently there is no evidence of yellow fever virus transmission in the large metropolitan areas of the East Coast such as Rio de Janeiro The determination of new areas considered to be at risk for yellow fever transmission is preliminary and updates will be provided regularly and considering that travelers for the Carnival in the next few weeks may take side tours outside the main cities the current advice by the WHO Secretariat for international travelers going to areas of Brazil deemed to be at risk Vaccination against yellow fever at least 10 days prior to the travel as per Annex 7 of the International Health Regulations (2005) a single dose of a yellow fever vaccine approved by WHO is sufficient to confer sustained immunity and life-long protection against yellow fever disease Travelers with contraindications for yellow fever vaccine (children below 9 months people with severe hypersensitivity to egg antigens and severe immunodeficiency) or over 60 years of age should consult their health professional for advice; adoption of measures to avoid mosquito bites; awareness of symptoms and signs of yellow fever; seeking care in case of symptoms and signs of yellow fever while travelling and upon return from areas at risk for yellow fever transmission For 2017 updates on yellow fever vaccination requirements and WHO vaccination recommendations for travelers see Annex and country list on the WHO International Travel and Health website Commenting for this story is now closed.If you have a Facebook account, become a fan and comment on our Facebook Page The ad-free version is ready for purchase on iOS mobile app today we couldn't find that page";var n=e.querySelector("h2");return n&&n.remove(),{staticContent:e,title:t}},d=function(e){var t=document.createElement("button");return t.innerText=e,t.classList.add("error-page-button"),t},f=function(e){var t=document.createElement("div");t.id="recirculation-404",t.classList.add("brand-hint-bg");var n="\n \n \n \n \n \n '.concat(e,' Tick here if you would like us to send you the author’s response "Gigi" Paiva on the attack at Internationals Master 2010 / Photo: Gustavo Aragão/GRACIEMAG.com The leader of the Rio de Janeiro chapter of Alliance Jiu-Jitsu academy Alexandre “Gigi” Paiva paid a recent visit to the team affiliate in Vitória da Conquista the Jiu-Jitsu professor held a highly sought-after seminar and shared some of his technique In the video below Gigi demonstrates a simple and effective guard pass Heed how important it is to defend your neck as well as to grab the opponent’s wrist and belt is to keep the opponent’s wrist and hand trapped against the ground “I can’t let my opponent get his wrist off the ground This way I undermine any chances he might have for defense,” Paiva taught Share how you like passing open guard with us in the comments field below Pragmatic88Slot Gacor When President Jair Bolsonaro (PSL) referred to Northeastern Brazilians as "Paraíba," he used a term loaded with prejudice—an act punishable stance by law according to linguists and lawyers heard by Folha The origin of the term is linked to the northeastern migratory flows to the Southeast from the 1960s in particular from Bahia to São Paulo and Paraiba to Rio de Janeiro "This generic designation of 'baiano' was created in São Paulo and 'paraíba' in Rio because of tension," said Dante Lucchesi professor of letters at UFF (Fluminense Federal University) and a reference in the area of sociolinguistics marginalized population on the outskirts of these cities as the migrants from the Northeast were migrants in a conversation with Minister Onyx Lorenzoni (RS) captured by an open microphone before a breakfast with journalists Bolsonaro used the term to refer to governors of the Northeast There has to be nothing with this guy," he said the president denied that he had used the expression pejoratively and stated that he referred to the governors of Maranhão and Paraíba (João Azevedo "the term 'paraíba' is loaded with prejudice in Rio de Janeiro," where Bolsonaro it is clearly a derogatory term that reflects a prejudiced stance unfortunately on the part of the president The increasing influx of northeastern migrants in the second half of the 20th century and Brazil's population became mostly urban generated the tension that Lucchesi speaks of in 2015 more than 2 million Bahians were living in the state of São Paulo (5% of the population) and 330,000 Paraibas in Rio de Janeiro (2% of the population) Read the article in the original language The file could not be found for a number of reasons such as the file being moved or deleted. Please check your spelling and if you still can't get to the right page try heading to the homepage for a look around If you still have problems, try contacting us and we'll do what we can to help you. Click here to get back to where you came from. Tornadoes wreaked havoc across parts of Nebraska and Iowa on Friday, demolishing dozens of homes, causing the collapse of an industrial building, and injuring at least five people, extending a spell of severe weather that began the day before. In Nebraska, particularly in Omaha and Waverly, a tornado struck, leading to the collapse of an industrial building, injuring at least three people, and prompting a widespread emergency response, authorities reported. Social media images from Iowa also depicted widespread damage and destroyed buildings in Minden, a city just over 100 miles west of Des Moines. Governor Kim Reynolds issued a disaster proclamation for Pottawattamie County, where, according to the sheriff’s office, a tornado passed through. Deputy Chief Ben Houchin said the sheriff’s office responded to an industrial building at Garner Industries around 3 p.m. in Lancaster County, Nebraska, and found it “nearly fully collapsed” with several people trapped inside. Three individuals were transported to a hospital with non-life-threatening injuries, he added, noting that around 70 people were inside when the tornado struck. The sheriff’s office also received reports of a train derailment in Waverly, Chief Houchin said, adding, “They did not need any emergency assistance, so we are hoping it’s very minor.” blogdomarcelo@gmail.com // The journalistic website Blog do Marcelo launched by the Journalist Marcelo Türme Krieg in April 2008 originally in Brazil emerged as an alternative in the online journalistic scenario in America facilitated access to and understanding of regional We use cookies to enhance your browsing experience, serve personalized ads or content, and analyze our traffic. By clicking "Accept All", you consent to our use of cookies. We use cookies to help you navigate efficiently and perform certain functions. You will find detailed information about all cookies under each consent category below. The cookies that are categorized as "Necessary" are stored on your browser as they are essential for enabling the basic functionalities of the site. We also use third-party cookies that help us analyze how you use this website, store your preferences, and provide the content and advertisements that are relevant to you. These cookies will only be stored in your browser with your prior consent. You can choose to enable or disable some or all of these cookies but disabling some of them may affect your browsing experience. Necessary cookies are required to enable the basic features of this site, such as providing secure log-in or adjusting your consent preferences. These cookies do not store any personally identifiable data. Functional cookies help perform certain functionalities like sharing the content of the website on social media platforms, collecting feedback, and other third-party features. Analytical cookies are used to understand how visitors interact with the website. These cookies help provide information on metrics such as the number of visitors, bounce rate, traffic source, etc. Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors. Advertisement cookies are used to provide visitors with customized advertisements based on the pages you visited previously and to analyze the effectiveness of the ad campaigns. New York City, the bustling metropolis renowned for its diversity and opportunities, presents a myriad of employment options across various sectors. Whether you’re seeking a career in finance, technology, healthcare, or the arts, New York has something to offer for everyone. Here are the top 10 job opportunities currently available in the city that never sleeps: With Wall Street at its heart, New York City is a global financial hub, constantly in need of skilled financial analysts. These professionals analyze market trends, assess investment opportunities, and provide crucial insights to guide financial decisions for both corporations and individuals. As technology continues to drive innovation, software engineers are in high demand in New York City’s thriving tech sector. From startups to established tech giants, companies are seeking talented individuals to develop cutting-edge software solutions across various platforms and industries. The healthcare industry in New York City is vast and ever-growing, creating a constant need for registered nurses. These compassionate professionals play a vital role in providing quality patient care, whether in hospitals, clinics, or home healthcare settings, making nursing one of the most sought-after professions in the city. In the competitive landscape of New York City, marketing managers play a crucial role in helping companies stand out and reach their target audience. From crafting compelling campaigns to analyzing market data, these professionals drive brand awareness and business growth across diverse industries. As a center for commerce and culture, New York City has a thriving legal sector with opportunities for attorneys specializing in various areas such as corporate law, intellectual property, and litigation. Lawyers in New York enjoy a dynamic environment, working on high-profile cases and transactions that shape the city’s landscape. With its vibrant arts scene and creative industries, New York City offers ample opportunities for graphic designers to showcase their talents. From designing logos and branding materials to creating digital assets for marketing campaigns, graphic designers play a crucial role in visual communication across diverse sectors. In an age where data is king, skilled data analysts are in high demand across industries seeking to harness the power of data-driven insights. In New York City, companies rely on data analysts to interpret complex data sets, identify trends, and make informed business decisions to stay ahead of the competition. As one of the most dynamic real estate markets globally, New York City offers lucrative opportunities for real estate agents. Whether dealing with residential properties, commercial spaces, or luxury estates, agents in the Big Apple leverage their local knowledge and negotiation skills to facilitate successful transactions in this fast-paced market. With the increasing threat of cyber attacks, cybersecurity analysts play a crucial role in safeguarding organizations’ digital assets and sensitive information. In New York City, businesses across sectors prioritize cybersecurity measures, creating a high demand for skilled professionals adept at detecting and mitigating cyber threats. New York City remains a global fashion capital, attracting aspiring fashion designers from around the world. From haute couture to streetwear, designers in the city have the opportunity to showcase their creativity and innovation on international platforms, contributing to the ever-evolving landscape of fashion. In conclusion, New York City offers a diverse range of job opportunities across industries, making it an attractive destination for professionals seeking to advance their careers and pursue their passions in one of the world’s most dynamic cities. In Paris, a panel of experts advising UNESCO highlighted the proliferation of this technology and its broader impact beyond isolated medical advancements. Marcello Ienca, from the Technical University of Munich, stressed the historic significance of developing tools to understand and modify human brain function. Alongside scientists Nataliya Kosmyna and entrepreneur Ryota Kanai, Ienca emphasized the imminent availability of this technology and the crucial need for ethical guidance. We use cookies to enhance your browsing experience We use cookies to help you navigate efficiently and perform certain functions You will find detailed information about all cookies under each consent category below The cookies that are categorized as "Necessary" are stored on your browser as they are essential for enabling the basic functionalities of the site We also use third-party cookies that help us analyze how you use this website and provide the content and advertisements that are relevant to you These cookies will only be stored in your browser with your prior consent You can choose to enable or disable some or all of these cookies but disabling some of them may affect your browsing experience Necessary cookies are required to enable the basic features of this site such as providing secure log-in or adjusting your consent preferences These cookies do not store any personally identifiable data Functional cookies help perform certain functionalities like sharing the content of the website on social media platforms Analytical cookies are used to understand how visitors interact with the website These cookies help provide information on metrics such as the number of visitors Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors Advertisement cookies are used to provide visitors with customized advertisements based on the pages you visited previously and to analyze the effectiveness of the ad campaigns