PREVALENCE OF MAJOR DEPRESSION IN PATIENTS WITH BREAST CANCER

Introduction: breast cancer is one of the main causes of death among women in Brazil and worldwide. The diagnosis of breast neoplasms usually represents an emotional burden, and it may lead to adjustment reactions and even be the trigger for affective disorders (mainly depression), anxiety or psychosis. The Beck Depression Inventory (BDI) is one of the most used mechanisms for the evaluation of depression in research and in clinics. Depression prevalence in patients with cancer varies from 3% to 55% among different studies. Methodological variation, different instruments to assess depression and different cut-off points for diagnosis contribute to the huge discrepancy in current findings. In general, the more specifically depression is defined and evaluated, the lower the rates of prevalence are reported. Many articles fail to demonstrate a statistical significance in the relationship between depression and cancer-specific factors. This suggests that risk factors for depression in those patients are more related to the patient as contextual variables and premorbid factors of personality – and not to the cancer or its treatment. Objective: to determine the prevalence of major depression in women with breast cancer. Methods: a cross-sectional study was conducted in women with breast cancer. The sample consisted of 51 patients who answered the Beck Depression Inventory (BDI). The presence of depression was considered in cases where the scores were above 20. A questionnaire with additional data about the patients such as age, marital status, ethnicity, education, family income, family history of depression and breast cancer, and cancer-related variables including staging, months since diagnosis, treatment modality, type of surgery, alopecia occurring were used. Descriptive analysis and test of association (chi-square) were conducted. Results: the prevalence of major depression was 5.9%, similar to that observed in community samples. Subsyndromal depressive symptoms had a score of 21.6% (BDI scores from 16 to 20). Chi-square test was conducted and showed no statistically significant relationship between the classification of BDI and the variables tested (characteristics related to patient and cancer-specific). This indicates that the isolated context of the variables does not influence the event of depression. Conclusion: the prevalence of major depression in women with breast neoplasms was 5.9%

Aceptación final 21 septiembre

ABSTRACT: The maned wolf feeds mainly on fruits and small vertebrates. The diet of maned wolf was studied at Águas Emendadas Ecological Station (AEES) through 328 faecal samples collected from November 1996 to August 1999. To evaluate the seasonal variation in food availability, the fruit phenology of the wolf's fruit, the main food item in maned wolf's diet, was monitored counting the fruits produced in 20 marked plants. Fructification phenology of fleshy fruit plants in the cerrado habitat of AEES was recorded monitoring five plots of 100 x 20 m, where the number of fruit producing species and individuals were recorded. The diet composition was 60% vegetal items and 40% animal ones. The wolf's fruit, other fruits and small mammals were the most frequent consumed categories, but armadillos, wolf's fruit, medium size mammals, and small mammals were the most important categories considering biomass. Maned wolves are generalist, with a broad diet, and consume most of the food items according to their availability. However, wolves are selective with regard to some food items, particularly the wolf's fruit during the dry season. RESUMEN: Hábitos alimentarios del aguará guazú (Chrysocyon brachyurus) en el dominio del Cerrado, Brasil. El aguará guazú se alimenta principalmente de frutos y vertebrados pequeños. Si bien se ha obtenido mucha información acerca de la dieta del aguará guazú, datos sobre la ecología trófica de esta especie en reservas pequeñas del Cerrado son importantes para establecer estrategias de conservación. Se estudió la dieta del aguará guazú en la Estación Ecológica de Águas Emendadas (EEAE) a través de 328 muestras de heces colectadas entre noviembre de 1996 y agosto de 1999. Para evaluar la variación estacional en la disponibilidad de alimentos se analizó la fenología frutal de Solanum lycocarpum, el principal componente de la dieta de este cánido, contando los frutos producidos en 20 plantas marcadas. Se estudió la fenología de fructificación de plantas con frutos carnosos en el ambiente de Cerrado de la EEAE en cinco parcelas de 100 x 20 m, registrándose el número de especies productoras de frutos y sus individuos. La composición de la dieta fue de 60% de ítems vegetales y de 40% de ítems animales. Solanum lycocarpum, otros frutos y los micromamíferos fueron las categorías consumidas con mayor frecuencia, pero considerando la biomasa las categorías más importantes fueron los armadillos, el Solanum lycocarpum y los mamíferos medianos y pequeños. El aguará guazú es generalista, con una dieta amplia, consumiendo la mayor parte del ali-38 FHG Rodrigues et al

A contribuição da telemedicina na desmistificação de notícias falsas no combate ao Coronavírus : The contribution of telemedicine in demystifying fake news in the fight against Coronavirus

O presente artigo objetivou investigar como a telessaúde vem contribuindo para o processo de comunicação efetiva na assistência em saúde durante a pandemia de coronavírus, colaborando para o combate à desinformação e desmistificando fake news. Trata-se de revisão integrativa da literatura com levantamento bibliográfico realizado entre janeiro e março de 2022 nas bases de dados Scientific Electronic Library Online (Scielo), Cochrane Library e PubMed. Após as etapas de seleção, 8 artigos foram escolhidos para compor a amostra. Tais artigos foram destrinchados nos seguintes tópicos: a relatividade da percepção da gravidade da pandemia; notícias falsas e o (des)pudor do Presidente da República; a telemedicina/telessaúde como ferramenta para a elucidação na pandemia. Realizou-se uma investigação de quais fatores interferem na compreensão de risco de situações epidêmicas, de como a divulgação de informações inexatas afetam esse processo ao influenciar toda a sociedade, e como os profissionais de saúde detêm a atribuição de desmistificar tais notícias

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Educomunicação e suas áreas de intervenção: Novos paradigmas para o diálogo intercultural

oai:omp.abpeducom.org.br:publicationFormat/1O material aqui divulgado representa, em essência, a contribuição do VII Encontro Brasileiro de Educomunicação ao V Global MIL Week, da UNESCO, ocorrido na ECA/USP, entre 3&nbsp;e 5 de novembro de 2016. Estamos diante de um conjunto de 104 papers executivos, com uma média de entre 7 e 10 páginas, cada um. Com este rico e abundante material, chegamos ao sétimo e-book publicado pela ABPEducom, em seus seis primeiros anos de existência. A especificidade desta obra é a de trazer as “Áreas de Intervenção” do campo da Educomunicação, colocando-as a serviço de uma meta essencial ao agir educomunicativo: o diálogo intercultural, trabalhado na linha do tema geral do evento internacional: Media and Information Literacy: New Paradigms for Intercultural Dialogue