Alimentando os doentes: um imperativo ético e um direito

Editorial de la Dra. Diana Cárdena

Ethical aspects in the nutritional management of patients with COVID-19

La pandemia de SARS-CoV-2 ha generado importantes cuestionamientos éticos en el contexto clínico de la atención a los pacientes y en la investigación de la enfermedad. Los cuestionamientos clínicos surgieron porque el enfoque de la ética clínica en condiciones normales ha tenido que equilibrarse con un marco éticamente sólido para la atención de la emergencia de salud pública del COVID-19. Es decir, que el actuar médico no se centra únicamente en los deberes hacia la atención del paciente, sino que debe enfocarse en la población para promover la igualdad de las personas y la equidad en la distribución de riesgos y beneficios a la sociedad. Debido a que los médicos, nutriólogos, enfermeros y otros profesionales de la salud están capacitados para atender a las personas, el cambio de la práctica centrada en el paciente a la atención al paciente guiada por consideraciones de salud pública crea una gran tensión.1 Esto puede ser especialmente difícil cuando se trata de alimentar a los pacientes hospitalizados con formas severas de la enfermedad y se hace con escasos recursos.The SARS-CoV-2 pandemic has generated important ethical questions in the clinical context of patient care and in disease research. The clinical questions arose because the clinical ethics approach under normal conditions has had to be balanced with an ethically sound framework for the care of the COVID-19 public health emergency. In other words, medical action is not only focused on the duties towards patient care, but must focus on the population to promote equality of people and equity in the distribution of risks and benefits to society. Because doctors, nutritionists, nurses, and other health professionals are trained to care for people, the shift from patient-centered practice to patient care guided by public health considerations creates great tension.1 This it can be especially difficult when trying to feed hospitalized patients with severe forms of the disease and done with scant resources

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