Ansiedade traço-estado, risco de depressão e ideação suicida em gestantes de alto risco

A gestação é um período na vida da mulher que requer atenção especial devido às diversas modificações físicas, hormonais, psíquicas e de inserção social. Nesse contexto, surge a necessidade de responder à seguinte questão norteadora: as gestantes de alto risco apresentam níveis elevados de ansiedade traço-estado, risco de depressão e ideação suicida? Este estudo tem como objetivo avaliar os níveis de ansiedade traço e estado, risco de depressão e ideação suicida em gestantes de alto risco atendidas pelo serviço de saúde de Alagoas, Brasil. É um estudo transversal, descritivo, com abordagem quantitativa. A pesquisa foi realizada com amostra de 247 gestantes de alto risco, nos quatro e únicos ambulatórios de referência para gestação de alto risco no estado de Alagoas. Foram utilizados quatro instrumentos de coleta de dados: formulário de identificação, Inventário de Ansiedade Traço-Estado, Escala de Depressão e Escala de Ideação Suicida. A análise dos dados foi descritiva, utilizando a frequência relativa e a análise bivariada através dos testes qui-quadrado, Kolmogorov-Smirnov, Mann-Whitney e Correlação de Pearson. Em relação ao nível de ansiedade, obteve-se ansiedade-estado classificada como alta (9,7%), moderada (53,4%) e baixa (36,8%) e ansiedade-traço classificada como alta (7,7%), moderada (59,5%) e baixa (32,8%). Foram identificadas 62,8% de gestantes com risco de depressão e 2,4% com ideação suicida. Quanto maior o nível de depressão, maior o risco de ter ansiedade traço-estado moderada e alta (p < 0,00). Os principais fatores de risco encontrados neste estudo são baixa escolaridade (p < 0,00), baixa renda familiar (p < 0,00) e gravidez não planejada (p < 0,00). Não houve relação entre depressão e tentativa de suicídio em gestantes de alto risco. O estudo evidencia que gestantes de alto risco apresentam ansiedade traço e estado moderada/alta e risco de depressão.There was no relationship between depression and suicide attempt in high-risk pregnant women. The study shows thathigh-risk pregnant women have moderate/high trait/state anxiety and risk for depressio

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine