Association between adiposity and systemic atherosclerosis: a protocol of a cross-sectional autopsy study.

IntroductionAdiposity has been associated with atherosclerosis in clinical studies. However, few autopsy studies have investigated this association, and they had only examined the coronary artery disease. Moreover, most studies had small sample sizes and were limited to middle-aged or young adults. Our aim is to investigate the association between adiposity and systemic atherosclerosis in an autopsy study.Methods and analysisA sample of 240 deceased with 30 years or more will be evaluated. The sample size was calculated using the lowest correlation coefficient found in previous studies (r=0.109), assuming a power of 90% and α=0.05. We will collect information about sociodemographics, frequency of previous contact of the deceased's next of kin and cardiovascular risk factors. We will measure neck, waist and hip circumferences, weight, height and abdominal subcutaneous tissue thickness, and then we will calculate the body mass index, waist-to-hip ratio, waist-to-height ratio and body shape index. We will also weigh the pericardial and abdominal visceral fat, the heart, and we will measure the left ventricular wall thickness. We will evaluate the presence of myocardial infarction, the degree of atherosclerosis in the aorta, carotid, coronary and cerebral arteries and plaque composition in carotid, coronary and cerebral arteries. For each individual, we will fix arterial and adipose tissue samples in 10% formalin and freeze another adipose tissue sample at -80°C for future studies.Ethics and disseminationEthical approval was granted by the Ethics Committee of University of Sao Paulo Medical School, Brazil. Results will be submitted for publication in a peer-reviewed journal

Oficinas multiprofissionais:: educação em saúde para idosos de uma comunidade

Objetivos: Descrever o processo de elaboração de oficinas de promoção da saúde voltadas a um grupo de convivência para idosos e compartilhar a experiência de uma equipe de residentes multiprofissionais na construção de metodologias para se discutir saúde dentro de grupos. Métodos: Entre 2007 e 2009, a equipe de residentes multiprofissionais acompanhou um grupo de convivência, constituído de aproximadamente quarenta idosos. Foram observadas as principais demandas em saúde a serem trabalhadas junto ao grupo e desenvolvidas oficinas para promoção da saúde. Resultados: Os temas trabalhados nas oficinas foram osteoporose, diabetes mellitus, dislipidemia, planejando o futuro e relações de cuidado. Os residentes construíram materiais didáticos, como cartazes, folders, bolsas coloridas, cartões ilustrativos, que ilustraram os temas abordados de forma lúdica. As oficinas possibilitaram que os participantes fossem agentes ativos no processo de aprendizagem e de fazer saúde, o que pressupõe benefícios à saúde física, mental e social desse grupo

A reutilização de materiais reciclavéis como estratégia de educação ambiental aplicada à saúde em comunidade ribeirinha da região amazônica / The reuse of recyclable materials as environmental education strategy applied to health in a river community of the amazon region

Objetivo: Este trabalho tem como objetivo apresentar um relatório das atividades realizadas por uma equipe multiprofissional e estudantes de graduação, nas oficinas “Brincando com garrafa PET” (Polietileno Tereftalato) e “Construindo uma Horta Vertical”. Relato de Experiencia:  As oficinas foram desenvolvidas na Comunidade de São José do Lago do Arara, Caapiranga-AM. Para elaboração das atividades utilizou-se de garrafas PET, terra, pedras, sementes, barbante, tesouras e fitas adesivas. Inicialmente foi ministrado breves palestras para introdução do assunto, seguidas pelas atividades práticas de confecção dos instrumentos (Horta e brinquedos).  Discussão: Durante as atividades, as crianças mostraram-se bastante interessadas no processo de confecção da horta, e na praticidade desse processo, permitindo que replicassem esse procedimento em casa com a ajuda dos pais e responsáveis. Ademais, a oficina com garrafas PET apresentou características semelhantes que estimularam o interesse do público alvo, assim como uma participação massiva destes. Essa atividade apresentou um enfoque predominante na reciclagem de materiais descartáveis e na produção de brinquedos, voltando-se aos aspectos gerados pela poluição do meio ambiente. Conclusão: Ambas atividades permitiram aumentar a reutilização de resíduos recicláveis, atuando na redução da contaminação da comunidade por resíduos não biodegradáveis. 

Reflexões acerca dos desafios enfrentados pela equipe multidisciplinar quanto à integralidade do cuidado na Atenção Primária à Saúde

This study proposes a reflection on the challenges faced by the multidisciplinary team in relation to comprehensive care in Primary Health Care. It was a theoretical-reflective study, exploratory in nature and with a qualitative approach. This was divided into two main parts. In the first part, entitled "Comprehensiveness of care in Primary Health Care through Comprehensiveness", the fundamental concepts related to the comprehensiveness of care in Primary Health Care are discussed, highlighting the importance of a holistic approach that considers the physical, emotional, social and cultural aspects of users. In the second part, called "Promotion of comprehensiveness by the multidisciplinary team in Primary Health Care", reflections are presented on the actions and attitudes that can be adopted by the multidisciplinary team to promote comprehensive care in everyday practice, highlighting the importance of effective communication , home visits, reception and interdisciplinary collaboration. By addressing these themes, the study sought to contribute to the improvement of assistance in Primary Health Care, aiming to guarantee a comprehensive and user-centered approach.Este estudo propõe uma reflexão sobre os desafios enfrentados pela equipe multidisciplinar em relação à integralidade do cuidado na Atenção Primária à Saúde. Tratou-se de um estudo teórico-reflexivo, de natureza exploratória e abordagem qualitativa. Este foi dividido em duas partes principais. Na primeira parte, intitulada "Abrangência do cuidado na Atenção Primária à Saúde através da Integralidade", são discutidos os conceitos fundamentais relacionados à integralidade do cuidado na Atenção Primária à Saúde, destacando a importância de uma abordagem holística que considere os aspectos físicos, emocionais, sociais e culturais dos usuários. Na segunda parte, denominada "Promoção da integralidade pela equipe multidisciplinar na Atenção Primária à Saúde", são apresentadas reflexões sobre as ações e atitudes que podem ser adotadas pela equipe multidisciplinar para promover a integralidade do cuidado na prática cotidiana, destacando a importância da comunicação efetiva, da visita domiciliar, do acolhimento e da colaboração interdisciplinar. Ao abordar esses temas, o estudo buscou contribuir para o aprimoramento da assistência na Atenção Primária à Saúde, visando garantir uma abordagem integral e centrada no usuário

A família como sujeito: a centralidade do cuidado e do conhecimento na orientação familiar em saúde

The derived attribute family orientation recognizes the family as the main source of physical, emotional and social support. This emphasizes the centrality of care by providing an environment for learning and internalizing self-care practices and healthy habits since childhood. Furthermore, it offers emotional and affective support, being a crucial space for recovery and coping with illnesses. This study proposed to explore the importance of the family as a subject of health care, highlighting the centrality of care and knowledge in family guidance. This is a reflective study, of a qualitative nature, which took as assumptions the attributes of PHC, in particular the derived attribute “family guidance” proposed by Bárbara Starfield based on the discussions of the Research Group "Technological Assistance Models and Promotion of Health" from the School of Nursing of the University of São Paulo. In this way, it explores the importance of the family as a subject of health care and knowledge in family guidance. The family acts in the coordination of care, serving as a point of contact between different health service providers. Therefore, the importance of family guidance and knowledge in promoting health and strengthening family ties is undeniable, contributing to the development of healthier and more resilient communities.O atributo derivado orientação familiar reconhece a família como a principal fonte de apoio físico, emocional e social. Este enfatiza a centralidade do cuidado ao proporcionar um ambiente de aprendizado e internalização de práticas de autocuidado e hábitos saudáveis desde a infância. Além disso, oferece suporte emocional e afetivo, sendo um espaço crucial para a recuperação e o enfrentamento de doenças. Este estudo propôs explorar a importância da família como sujeito da atenção em saúde, destacando a centralidade do cuidado e do conhecimento na orientação familiar. Trata-se de um estudo reflexivo, de natureza qualitativa, que tomou como pressupostos os atributos da APS, em especial o atributo derivado “orientação familiar” propostos por Bárbara Starfield a partir das discussões do Grupo de Pesquisa "Modelos Tecno-Assistenciais e a Promoção da Saúde" da Escola de Enfermagem da Universidade de São Paulo. Desta forma, explora a importância da família como sujeito da atenção em saúde e o conhecimento na orientação familiar. A família atua na coordenação do cuidado, servindo como ponto de contato entre os diferentes prestadores de serviços de saúde. Assim, é inegável a importância da orientação familiar e do conhecimento na promoção da saúde e no fortalecimento dos laços familiares, contribuindo para o desenvolvimento de comunidades mais saudáveis e resilientes

Estimating the global conservation status of more than 15,000 Amazonian tree species

Estimates of extinction risk for Amazonian plant and animal species are rare and not often incorporated into land-use policy and conservation planning. We overlay spatial distribution models with historical and projected deforestation to show that at least 36% and up to 57% of all Amazonian tree species are likely to qualify as globally threatened under International Union for Conservation of Nature (IUCN) Red List criteria. If confirmed, these results would increase the number of threatened plant species on Earth by 22%. We show that the trends observed in Amazonia apply to trees throughout the tropics, and we predict thatmost of the world’s >40,000 tropical tree species now qualify as globally threatened. A gap analysis suggests that existing Amazonian protected areas and indigenous territories will protect viable populations of most threatened species if these areas suffer no further degradation, highlighting the key roles that protected areas, indigenous peoples, and improved governance can play in preventing large-scale extinctions in the tropics in this century

Geographic patterns of tree dispersal modes in Amazonia and their ecological correlates

Aim: To investigate the geographic patterns and ecological correlates in the geographic distribution of the most common tree dispersal modes in Amazonia (endozoochory, synzoochory, anemochory and hydrochory). We examined if the proportional abundance of these dispersal modes could be explained by the availability of dispersal agents (disperser-availability hypothesis) and/or the availability of resources for constructing zoochorous fruits (resource-availability hypothesis). Time period: Tree-inventory plots established between 1934 and 2019. Major taxa studied: Trees with a diameter at breast height (DBH) ≥ 9.55 cm. Location: Amazonia, here defined as the lowland rain forests of the Amazon River basin and the Guiana Shield. Methods: We assigned dispersal modes to a total of 5433 species and morphospecies within 1877 tree-inventory plots across terra-firme, seasonally flooded, and permanently flooded forests. We investigated geographic patterns in the proportional abundance of dispersal modes. We performed an abundance-weighted mean pairwise distance (MPD) test and fit generalized linear models (GLMs) to explain the geographic distribution of dispersal modes. Results: Anemochory was significantly, positively associated with mean annual wind speed, and hydrochory was significantly higher in flooded forests. Dispersal modes did not consistently show significant associations with the availability of resources for constructing zoochorous fruits. A lower dissimilarity in dispersal modes, resulting from a higher dominance of endozoochory, occurred in terra-firme forests (excluding podzols) compared to flooded forests. Main conclusions: The disperser-availability hypothesis was well supported for abiotic dispersal modes (anemochory and hydrochory). The availability of resources for constructing zoochorous fruits seems an unlikely explanation for the distribution of dispersal modes in Amazonia. The association between frugivores and the proportional abundance of zoochory requires further research, as tree recruitment not only depends on dispersal vectors but also on conditions that favour or limit seedling recruitment across forest types

Geography and ecology shape the phylogenetic composition of Amazonian tree communities

AimAmazonia hosts more tree species from numerous evolutionary lineages, both young and ancient, than any other biogeographic region. Previous studies have shown that tree lineages colonized multiple edaphic environments and dispersed widely across Amazonia, leading to a hypothesis, which we test, that lineages should not be strongly associated with either geographic regions or edaphic forest types.LocationAmazonia.TaxonAngiosperms (Magnoliids; Monocots; Eudicots).MethodsData for the abundance of 5082 tree species in 1989 plots were combined with a mega-phylogeny. We applied evolutionary ordination to assess how phylogenetic composition varies across Amazonia. We used variation partitioning and Moran's eigenvector maps (MEM) to test and quantify the separate and joint contributions of spatial and environmental variables to explain the phylogenetic composition of plots. We tested the indicator value of lineages for geographic regions and edaphic forest types and mapped associations onto the phylogeny.ResultsIn the terra firme and várzea forest types, the phylogenetic composition varies by geographic region, but the igapó and white-sand forest types retain a unique evolutionary signature regardless of region. Overall, we find that soil chemistry, climate and topography explain 24% of the variation in phylogenetic composition, with 79% of that variation being spatially structured (R2 = 19% overall for combined spatial/environmental effects). The phylogenetic composition also shows substantial spatial patterns not related to the environmental variables we quantified (R2 = 28%). A greater number of lineages were significant indicators of geographic regions than forest types.Main ConclusionNumerous tree lineages, including some ancient ones (>66 Ma), show strong associations with geographic regions and edaphic forest types of Amazonia. This shows that specialization in specific edaphic environments has played a long-standing role in the evolutionary assembly of Amazonian forests. Furthermore, many lineages, even those that have dispersed across Amazonia, dominate within a specific region, likely because of phylogenetically conserved niches for environmental conditions that are prevalent within regions

Geography and ecology shape the phylogenetic composition of Amazonian tree communities

Aim: Amazonia hosts more tree species from numerous evolutionary lineages, both young and ancient, than any other biogeographic region. Previous studies have shown that tree lineages colonized multiple edaphic environments and dispersed widely across Amazonia, leading to a hypothesis, which we test, that lineages should not be strongly associated with either geographic regions or edaphic forest types. Location: Amazonia. Taxon: Angiosperms (Magnoliids; Monocots; Eudicots). Methods: Data for the abundance of 5082 tree species in 1989 plots were combined with a mega-phylogeny. We applied evolutionary ordination to assess how phylogenetic composition varies across Amazonia. We used variation partitioning and Moran\u27s eigenvector maps (MEM) to test and quantify the separate and joint contributions of spatial and environmental variables to explain the phylogenetic composition of plots. We tested the indicator value of lineages for geographic regions and edaphic forest types and mapped associations onto the phylogeny. Results: In the terra firme and várzea forest types, the phylogenetic composition varies by geographic region, but the igapó and white-sand forest types retain a unique evolutionary signature regardless of region. Overall, we find that soil chemistry, climate and topography explain 24% of the variation in phylogenetic composition, with 79% of that variation being spatially structured (R$^{2}$ = 19% overall for combined spatial/environmental effects). The phylogenetic composition also shows substantial spatial patterns not related to the environmental variables we quantified (R$^{2}$ = 28%). A greater number of lineages were significant indicators of geographic regions than forest types. Main Conclusion: Numerous tree lineages, including some ancient ones (>66 Ma), show strong associations with geographic regions and edaphic forest types of Amazonia. This shows that specialization in specific edaphic environments has played a long-standing role in the evolutionary assembly of Amazonian forests. Furthermore, many lineages, even those that have dispersed across Amazonia, dominate within a specific region, likely because of phylogenetically conserved niches for environmental conditions that are prevalent within regions