Utilizacion de medicamentos por la poblacion quilombola: pesquisa en el Suroeste de Bahia, Brasil

OBJETIVO Analizar el uso de medicamentos por la población quilombola. MÉTODOS Estudio transversal de base poblacional con 797 quilombolas adultas de Vitória da Conquista, Bahia, Brasil, en 2011. Se utilizó análisis de varianza para comparar los promedios de medicamentos por individuo según variables demográficas, socioeconómicas y de conductuales relacionados con la salud. Se estimaron las prevalencias, tasas de prevalencia y los respectivos intervalos de 95% de confianza. El análisis múltiple fue realizado por medio de regresión de Poisson con varianza robusta. RESULTADOS Los medicamentos más consumidos por la población fueron aquellos que actúan en los sistemas cardiovascular y nervioso. La prevalencia de uso de medicamentos fue de 41,9%, significativamente mayor en las mujeres (50,3%) que en los hombres (31,9%). Posterior al análisis ajustado, el uso de fármacos estuvo asociado al sexo femenino, edad de 60 años y más, nivel económico más alto, peor evaluación de la salud, mayor número de morbilidades auto-referidas y de consultas médicas. CONCLUSIONES Mujeres y ancianos deben ser los grupos de preferencia para el desarrollo de estrategias específicas que garanticen el uso racional de los medicamentos. Es necesaria la promoción de prescripción racional en el cotidiano de los servicios de salud.OBJECTIVE To characterize the medication use by the quilombola population. METHODS A population-based cross-sectional study was conducted with 797 adult quilombola in Vitória da Conquista, BA, Northeastern Brazil, in 2011. Analysis of variance was used to compare means of drugs by subject, according to demographic, socioeconomic and health-related behavior variables. Prevalence, prevalence ratios and their 95% confidence intervals were estimated. Multivariate analysis was carried out using Poisson regression with robust variance. RESULTS The most widely consumed drugs by the population were those for the cardiovascular and nervous systems. Prevalence of medication use was 41.9%, significantly higher among women (50.3%) than men (31.9%). After adjusted analysis, medication use was associated with being female gender, being aged 60 or older, higher economic level, worse self-rated health, greater number of self-reported diseases and number of medical appointments. CONCLUSIONS Strategies to improve rational drug use should preferentially focus on women and older adults. Thus, special attention should be given to promote rational prescription in everyday health services.OBJETIVO Analisar o uso de medicamentos pela população quilombola. MÉTODOS Estudo transversal de base populacional com 797 quilombolas adultos de Vitória da Conquista, BA, em 2011. Utilizou-se análise de variância para comparar as médias de medicamentos por indivíduo segundo variáveis demográficas, socioeconômicas e de comportamentos relacionados à saúde. Foram estimadas as prevalências, razões de prevalência e os respectivos intervalos de confiança de 95%. Análise múltipla foi conduzida por meio de regressão de Poisson com variância robusta. RESULTADOS Os medicamentos mais consumidos pela população foram aqueles que atuam nos sistemas cardiovascular e nervoso. A prevalência de uso de medicamentos foi de 41,9%, significativamente maior nas mulheres (50,3%) do que nos homens (31,9%). Após análise ajustada, o uso de fármacos foi associado a sexo feminino, idade de 60 anos e mais, nível econômico mais alto, pior avaliação da saúde, maior número de morbidades autorreferidas e de consultas médicas. CONCLUSÕES Mulheres e idosos deverão ser os grupos de preferência para o desenvolvimento de estratégias específicas que garantam o uso racional dos medicamentos. É necessária a promoção de prescrição racional no cotidiano dos serviços de saúde

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

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

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 understanding 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,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 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 underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities 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 organism 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 neglected 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 lost

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 understanding 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,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 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 underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities 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 organism 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 neglected 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 lost

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time, and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space. While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes, vast areas of the tropics remain understudied. In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity, but it remains among the least known forests in America and is often underrepresented in biodiversity databases. To worsen this situation, human-induced modifications may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge, 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 organism 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 neglected 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 lost

Influence of environmental factors on benthic macroinvertebrate communities of urban streams in Vereda habitats, Central Brazil Influência de variáveis ambientais na comunidade de macroinvertebrados bentônicos de córregos urbanos de Veredas, Brasil Central

AIM: Veredas and the aquatic and semi-aquatic communities play a key role in watershed protection in the Cerrado Biome. Information about the effects of physical and chemical variables and habitat integrity on benthic communities has been increased in recent years; however, there is no study evaluating the influence of urbanization on macroinvertebrates of Vereda streams. Thus, improving the knowledge of the relationship between abiotic properties and benthic fauna is very important for understanding the functioning of ecological processes and health of aquatic ecosystems. This study investigated the influence of physical and chemical variables on benthic macroinvertebrate communities along a gradient of anthropogenic disturbance in four Vereda streams in Uberlândia (MG), one in a preserved area and three in the urban area; METHODS: samplings were collected during the dry and rainy seasons; RESULTS: principal component analysis separated the stream in the preserved area from those in the urban area by having lower values of BOD, COD, sediment size, conductivity, detergents, pH, deposited solids and total dissolved solids. Pollution sensitive groups (e.g., Ephemeroptera and Trichoptera) were associated to the stream in the preserved area, and more tolerant groups (e.g., Chironomidae and Oligochaeta) had greater abundance in the streams of the urban area. Canonical Correspondence Analysis indicated that dissolved oxygen, conductivity, BOD, oil and grease, and turbidity explained 56% of the variance in the distribution and abundance of macroinvertebrates; CONCLUSIONS: Benthic communities of Vereda streams in urban areas in the Cerrado Biome seem to be highly affected by human activities that increase water organic pollution and sedimentation.OBJETIVO: Veredas e comunidades aquáticas e semi-aquáticas desempenham importante papel na proteção das bacias hidrográficas no Bioma Cerrado. Informações sobre efeitos de variáveis físico-químicas e da integridade do habitat nas comunidades de macroinvertebrados bentônicos têm aumentado nos anos recentes, entretanto, não há estudos avaliando a influência da urbanização nas comunidades de macroinvertebrados em córregos de veredas. Assim, ampliar o conhecimento da relação entre as variáveis abióticas e fauna bentônica é muito importante para a compreensão do funcionamento dos processos ecológicos e da integridade dos ecossistemas aquáticos. Este estudo investigou a influência de variáveis físicas e químicas nas comunidades de macroinvertebrados bentônicos ao longo de um gradiente de distúrbios antrópicos em quatro córregos de Vereda em Uberlândia (MG); um em uma área preservada e três na área urbana MÉTODOS: as amostras foram coletadas nas estações seca e chuvosa RESULTADOS: A análise de componentes principais separou o córrego da área preservada daqueles da área urbana por apresentar menores valores de DBO, DQO, tamanho do sedimento, condutividade, detergentes, pH, sólidos depositáveis e sólidos totais dissolvidos. Grupos sensíveis à poluição (e.g., Ephemeroptera e Trichoptera) foram associados ao córrego da área preservada e grupos mais tolerantes (Chironomidae e Oligochaeta) tiveram maior abundância nos córregos da área urbana. A Análise de Correspondência Canônica indicou que oxigênio dissolvido, condutividade, DBO, óleos e graxas e turbidez explicaram 56% da variação na distribuição e abundância de macroinvertebrados; CONCLUSÕES: comunidades bentônicas de córregos de Vereda em áreas urbanas no Bioma Cerrado parecem ser altamente afetadas pelas atividades humanas que aumentam a poluição orgânica da água e a sedimentação

Influence of environmental factors on benthic macroinvertebrate communities of urban streams in Vereda habitats, Central Brazil

AIM: Veredas and the aquatic and semi-aquatic communities play a key role in watershed protection in the Cerrado Biome. Information about the effects of physical and chemical variables and habitat integrity on benthic communities has been increased in recent years; however, there is no study evaluating the influence of urbanization on macroinvertebrates of Vereda streams. Thus, improving the knowledge of the relationship between abiotic properties and benthic fauna is very important for understanding the functioning of ecological processes and health of aquatic ecosystems. This study investigated the influence of physical and chemical variables on benthic macroinvertebrate communities along a gradient of anthropogenic disturbance in four Vereda streams in Uberlândia (MG), one in a preserved area and three in the urban area; METHODS: samplings were collected during the dry and rainy seasons; RESULTS: principal component analysis separated the stream in the preserved area from those in the urban area by having lower values of BOD, COD, sediment size, conductivity, detergents, pH, deposited solids and total dissolved solids. Pollution sensitive groups (e.g., Ephemeroptera and Trichoptera) were associated to the stream in the preserved area, and more tolerant groups (e.g., Chironomidae and Oligochaeta) had greater abundance in the streams of the urban area. Canonical Correspondence Analysis indicated that dissolved oxygen, conductivity, BOD, oil and grease, and turbidity explained 56% of the variance in the distribution and abundance of macroinvertebrates; CONCLUSIONS: Benthic communities of Vereda streams in urban areas in the Cerrado Biome seem to be highly affected by human activities that increase water organic pollution and sedimentation