PERCEPÇÃO DE IDOSOS SOBRE ALZHEIMER

Objetivo: verificar o conhecimento produzido pelos pesquisadores a respeito da percepção dos idosos sobre a doença de Alzheimer (DA). Método: revisão integrativa da literatura com levantamento bibliográfico realizado na Biblioteca Virtual em Saúde (BVS), MEDLINE e nos bancos de dados do Portal de Periódicos Capes. Resultados: a amostra final foi constituída por onze artigos científicos, selecionados pelos critérios de inclusão previamente estabelecidos. Observou-se a incipiência de arti­gos científicos publicados sobre a Doença de Alzheimer com metodologia qualitativa que utilize a Teoria das Representações Sociais (RS). Conclusão: verificou-se a necessidade de pesquisas para investigar o comportamento de idosos frente a doença de Alzheimer tendo como aporte teórico a teoria das RS para que em um futuro próximo se acumule subsídios com base científica criando possibilidades de haver promoções de intervenções como políticas de saúde, com finalidade precípua de melhorar a qualidade de vida dos idosos. Descritores: Percepção, Idoso, Doença de Alzheimer

pesquisa online multicêntrica

Investigar os fatores associados à prática do sexo sob o efeito de drogas (chemsex) entre homens que fazem sexo com homens (HSH) durante período de isolamento social, no contexto da pandemia da COVID-19. Inquérito multicêntrico online, aplicado aos territórios de Brasil e Portugal em abril de 2020, enquanto os dois países vivenciavam medidas sanitárias restritivas para a doença. Os participantes foram recrutados valendo-se de uma adaptação do método respondent driven sampling (RDS) ao ambiente virtual. Os dados foram coletados usando redes sociais e aplicativos de encontro voltados a HSH. Utilizamos regressão logística bivariada e multivariada para a produção das odds bruto (OR) e ajustado (ORa). Em um universo de 2.361 sujeitos, 920 (38,9%) realizaram a prática do chemsex, que, em 95% dos casos, foi realizada com parceiro casual. Aumentaram as chances de se envolver em chemsex: morar no Brasil (ORa = 15,4; IC95%: 10,7-22,1); não estar em isolamento social (ORa = 4,9; IC95%: 2,2-10,9); fazer sexo casual durante o distanciamento social (ORa = 52,4; IC95%: 33,8-81,4); fazer sexo grupal (ORa = 2,9; IC95%: 2,0-4,4); não apresentar nenhum tipo de sintoma para a COVID-19 (ORa = 1,3; IC95%: 1,1-1,8); não residir com o parceiro (ORa = 1,8; IC95%: 1,2-2,6) e estar em uso da profilaxia pré-exposição (ORa = 2,6; IC95%: 1,8-3,7). A ocorrência de chemsex foi elevada, sobretudo no Brasil, onde o isolamento social proposto não sensibilizou os HSH à adesão. The aim of this study was to investigate factors associated with sex practice under the effect of drugs (chemsex) among men who have sex with men (MSM) during the period of social isolation in the context of the COVID-19 pandemic. A multicenter online survey was applied to Brazil and Portugal in April 2020 when the two countries were under restrictive health measures due to the pandemic. Participants were recruited with an adaptation of the respondent driven sampling (RDS) method in the online environment. Data were collected using social networks and dating apps for MSM. We used bivariate and multivariate logistic regression to produce crude (OR) and adjusted odds ratios (aOR). In a universe of 2,361 subjects, 920 (38.9%) reported engaging in chemsex practice, which involved casual partners in 95% of the cases. Higher OR of engaging in chemsex were associated with Brazil (aOR = 15.4; 95%CI: 10.7-22.1), not being in social isolation (aOR = 4.9; 95%CI: 2.2-10.9), engaging in casual sex during social distancing (aOR = 52.4; 95%CI: 33.8-81.4), group sex (aOR = 2.9; 95%CI: 2.0-4.4), not presenting any symptom of COVID-19 (aOR = 1.3; 95%CI: 1.1-1.8), not living with the sex partner (aOR = 1.8; 95%CI: 1.2-2.6), and using pre-exposure prophylaxis (aOR = 2.6; 95%CI: 1.8-3.7). The occurrence of chemsex was high, especially in Brazil, where the proposed social distancing did not gain adherence by MSM. El objetivo fue investigar los factores asociados a la práctica del sexo bajo el efecto de drogas (chemsex), entre hombres que practican sexo con hombres (HSH) durante el período de aislamiento social en el contexto de la pandemia de la COVID-19. Se realizó una encuesta multicéntrica en línea, aplicada al territorio de Brasil y Portugal en abril de 2020, mientras los dos países vivían medidas sanitarias restrictivas por la COVID-19. Los participantes se reclutaron mediante una adaptación del método respondent driven sampling (RDS) al ambiente virtual. Los datos fueron recabados usando redes sociales y aplicaciones de encuentros dirigidos a HSH. Utilizamos la regresión logística bivariada y multivariada para la producción de las odds ratio brutas (OR) y ajustadas (ORa). En un universo de 2.361 sujetos, 920 (38,9%) realizaron la práctica del chemsex, que en el 95% de los casos se realizó con una pareja casual. Aumentaron las oportunidades de implicarse en chemsex: vivir en Brasil (ORa = 15,4; IC95%: 10,7-22,1); no estar en aislamiento social (ORa: = 4,9; IC95%: 2,2-10,9); practicar sexo casual durante el distanciamiento social (ORa = 52,4; IC95%: 33,8-81,4); practicar sexo grupal (ORa = 2,9; IC95%: 2,0-4,4); no presentar ningún tipo de síntoma de COVID-19 (ORa = 1,3; IC95%: 1.1-1.8); no residir con la pareja (ORa = 1,8; IC95%: 1,2-2,6) y estar usando la profilaxis previa a la exposición (ORa = 2,6; IC95%: 1,8-3,7). La ocurrencia de chemsex fue elevada, sobre todo en Brasil, donde el aislamiento social propuesto no sensibilizó a los HSH a la adhesión.publishersversionpublishe

Cost-utility analysis of outpatient parenteral antimicrobial therapy (OPAT) in the brazilian national health system

Outpatient parenteral antimicrobial therapy (OPAT) has been used for decades in different countries to reduce hospitalization rates, with favorable clinical and economic outcomes. This study assesses the cost-utility of OPAT compared to inpatient parenteral antimicrobial therapy (IPAT) from the perspective of a public university hospital and the Brazilian National Health System (Unified Health System -SUS). Methods: Prospective study with adult patients undergoing OPAT at an infusion center, compared to IPAT. Clinical outcomes and quality-adjusted life year (QALY) were assessed, as well as a micro-costing. Cost-utility analysis from the hospital and SUS perspectives were conducted by means of a decision tree, within a 30-day horizon time. Results: Forty cases of OPAT (1112 days) were included and monitored, with a favorable outcome in 97.50%. OPAT compared to IPAT generated overall savings of 31.86% from the hospital perspective and 26.53% from the SUS perspective. The intervention reduced costs, with an incremental cost-utility ratio of -44,395.68/QALY for the hospital and -48,466.70/QALY for the SUS, with better cost-utility for treatment times greater than 14 days. Sensitivity analysis confirmed the stability of the model. Conclusion: Our economic assessment demonstrated that, in the Brazilian context, OPAT is a cost-saving strategy both for hospitals and for the SUS193341352FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP2014/50045-

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

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)

Núcleos de Ensino da Unesp: artigos 2008

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq