Anais e resumos do XXXII Congresso Brasileiro de Zoologia: Desafios e Perspectivas para a zoologia na América Latina

Annals, meeting reports, symposia and abstracts of the 32rd Brazilian Congress of Zoology.Anais, resumos de reuniões, simpósios e resumos apresentados no XXXII Congresso Brasileiro de Zoologia.O Congresso Brasileiro de Zoologia é um evento bienal que visa congregar pessoas interessadas em estudos zoológicos (profissionais, estudantes, professores e pesquisadores); promover, incentivar e divulgar os avanços nos estudos da fauna neotropical; incrementar a formação e o reconhecimento do zoólogo como elemento indispensável no inventário e estudo do patrimônio natural dos países, especialmente na América Latina, região com maior diversidade de espécies no mundo. Esta 32ª. edição foi realizada entre os dias 26 de fevereiro a 02 de março de 2018 em Foz do Iguaçu, Paraná, pelo Programa de Pós-raduação em Biodiversidade Neotropical da Universidade Federal da Integração Latino-Americana. Teve por tema “Desafios e perspectivas para a Zoologia na América Latina”, visando promover uma discussão prolífica sobre a integração de pessoas de diferentes países para o avanço da pesquisa e conservação da diversidade animal da Região Neotropical. O tema é considerado essencial para uma região de tríplice fronteira, como Foz do Iguaçu, de grande diversidade natural e cultural e, em uma escala mais ampla, considerado importante para toda a América Latina. A programação científica contou com oito palestras plenárias de pesquisadores internacionalmente renomados e 17 simpósios de temas específicos, cobrindo temas de grande interesse para a Zoologia brasileira. Participaram do evento 1441 congressistas e foram apresentados 1235 trabalhos, sendo 219 em sessões orais. Destaca-se que a maioria dos participantes foi de graduandos (641) e pós-graduandos (292) e maioria de mulheres (61%). Tivemos congressistas de 12 países além do Brasil. Esta edição do CBZ refletiu claramente o quanto a zoologia no Brasil é realizada por colaborações e o quão diversa é nossa comunidade. Agradecemos a participação de todos os congressistas, convidados, monitores, patrocinadores e equipe de apoio, que contribuíram para que esta edição do evento fosse um sucesso.Itaipu Binacional, Petrobras, Eletrobras Furnas, Ministério de Minas e Energia, Governo Federal. Apoio: CNPq, CAPES, Parque das Aves, Parque Tecnológico Itaipu, Iguassu Convention & Visitors Bureau

Health system barriers and facilitators to medication adherence for the secondary prevention of cardiovascular disease: a systematic review

Background: Secondary prevention is cost-effective for cardiovascular disease (CVD), but uptake is suboptimal. Understanding barriers and facilitators to adherence to secondary prevention for CVD at multiple health system levels may inform policy. Objectives: To conduct a systematic review of barriers and facilitators to adherence/persistence to secondary CVD prevention medications at health system level. Methods: Included studies reported effects of health system level factors on adherence/persistence to secondary prevention medications for CVD (coronary artery or cerebrovascular disease). Studies considered at least one of β blockers, statins, angiotensin–renin system blockers and aspirin. Relevant databases were searched from 1 January 1966 until 1 October 2015. Full texts were screened for inclusion by 2 independent reviewers. Results: Of 2246 screened articles, 25 studies were included (12 trials, 11 cohort studies, 1 cross-sectional study and 1 case–control study) with 132 140 individuals overall (smallest n=30, largest n=63 301). 3 studies included upper middle-income countries, 1 included a low middle-income country and 21 (84%) included high-income countries (9 in the USA). Studies concerned established CVD (n=4), cerebrovascular disease (n=7) and coronary heart disease (n=14). Three studies considered persistence and adherence. Quantity and quality of evidence was limited for adherence, persistence and across drug classes. Studies were concerned with governance and delivery (n=19, including 4 trials of fixed-dose combination therapy, FDC), intellectual resources (n=1), human resources (n=1) and health system financing (n=4). Full prescription coverage, reduced copayments, FDC and counselling were facilitators associated with higher adherence. Conclusions: High-quality evidence on health system barriers and facilitators to adherence to secondary prevention medications for CVD is lacking, especially for low-income settings. Full prescription coverage, reduced copayments, FDC and counselling may be effective in improving adherence and are priorities for further research

Exploring the Barriers to and Facilitators of Using Evidence-Based Drugs in the Secondary Prevention of Cardiovascular Diseases Findings From a Multistakeholder, Qualitative Analysis

Abstract: Background Health-system barriers and facilitators associated with cardiovascular medication adherence have seldom been studied, particularly in low- and middle-income countries where uptake rates are poorest. Objectives: This study sought to explore the major obstacles and facilitators to the use of evidence-supported medications for secondary prevention of cardiovascular disease using qualitative analysis in 2 diverse countries across multiple levels of their health care systems. Methods: A qualitative descriptive study approach was implemented in Hamilton, Ontario, Canada, and Delhi, India. A purposeful sample (n = 69) of 23 patients, 10 physicians, 2 nurse practitioners, 5 Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy physicians, 11 pharmacists, 3 nurses, 4 hospital administrators, 1 social worker, 3 nongovernmental organization workers, 2 pharmaceutical company representatives, and 5 policy makers participated in interviews in Hamilton, Ontario, Canada (n = 21), and Delhi, India (n = 48). All interviews were digitally recorded and transcribed followed by directed content analysis to summarize and categorize the interviews. Results: Themes that emerged across the stakeholder groups included: medication counseling; monitoring adherence; medication availability; medication affordability and drug coverage; time restrictions; and task shifting. The depth of verbal medication counseling provided varied substantially between countries, with prescribers in India unable to convey relevant information about drug treatments due to time constraint and high patient load. Canadian patients reported drug affordability as a common issue and very few patients were familiar with government subsidized drug programs. In India, patients purchased medications out-of-pocket from private, community pharmacies to avoid long commutes, lost wages, and unavailability of medications from hospitals formularies. Task shifting medication-refilling and titration to nonphysician health workers was accepted and supported by physicians in Canada but not in India, where many of the physicians considered a high level of clinical expertise a precondition to carry out these tasks skillfully. Conclusions: Our findings reveal context-specific, health system factors that affect the patient's choice or ability to initiate and/or continue cardiovascular medication. Strategies to optimize cardiovascular drug use should be targeted and relevant to the health care system