Comparación del estrés en universitarios de enfermería de primer año y egresos de la carrera

Objective: To compare stress levels in freshman and senior nursing students. Method: A cross-sectional study was carried out in a public federal university of the state of Bahia, with students who answered questionnaires about sociodemographic variables, academic life, and a scale for assessing stress in nursing students. Chi-square and Fisher’s exact tests were applied to analyze the relationship between variables. To assess proportional trends between ordinal variables and groups, a chi-square test for linear trend was applied. The significance level was 5%. Results: One hundred and fifty-four students participated in the study. There was a tendency to higher stress levels among students in the last year compared to those in the first year, in four out of six domains: Performance of Practical Activities (p=0.00), Professional Communication (p=0.00), Environment (p=0.00) and Professional Education (p=0.00). Conclusion: High levels of stress were observed in students taking the last year. There is a need for broader research that includes other years of the course, an institutional reflection on stress factors and the adoption of an institutional policy that favors a better confrontation of stress factors.Objetivo: Comparar o nível de estresse de universitários de enfermagem ingressantes e concluintes do curso. Método: Estudo transversal, desenvolvido em uma universidade pública federal, do estado da Bahia, com estudantes que responderam a questionários sobre variáveis sociodemográficas, vida acadêmica e a escala para Avaliação de Estresse em Estudantes de Enfermagem. Para avaliar as relações entre as variáveis empregaram-se os testes do Qui-quadrado de Pearson e Exato de Fisher. Para verificar tendências proporcionais entre variáveis do tipo ordinal e os grupos utilizou-se do Teste Qui-Quadrado de Tendência Linear. O nível de significância estatística foi de 5%. Resultados: Participaram 154 estudantes. Houve tendência a maior nível de estresse em estudantes do último ano comparados aos do primeiro, em quatro dos seis domínios: Realização das atividades práticas (p=0,00), Comunicação profissional (p=0,00), Ambiente (p=0,00) e Formação profissional (p=0,00). Conclusão: Constatou-se níveis elevados de estresse no último ano. Ressalta-se a necessidade de ampliação da investigação para outros anos do curso, a reflexão institucional sobre os fatores estressores e a adoção de uma política institucional que propicie melhor enfrentamento dos estressores.Objetivo: Comparar el nivel de estrés de universitarios de enfermería de primer año y egresos de la carrera. Método: Estudio transversal, desarrollado en una universidad pública federal, del Estado de Bahía, con estudiantes que respondieron a cuestionarios acerca de variables sociodemográficas, vida académica y la escala para la Evaluación de Estrés en Estudiantes de Enfermería. Para valorar las relaciones entre las variables, se emplearon las pruebas de Chi cuadrado de Pearson y Exacta de Fisher. A fin de verificar tendencias proporcionales entre variables del tipo ordinal y los grupos, se utilizó la Prueba Chi cuadrado de Tendencia Lineal. El nivel de significación estadística fue del 5%. Resultados: Participaron 154 estudiantes. Hubo tendencia a un mayor nivel de estrés en estudiantes del último año comparados con los del primero, en cuatro de los seis dominios: Realización de las actividades prácticas (p=0,00), Comunicación profesional (p=0,00), Ambiente (p=0,00) y Formación profesional (p=0,00). Conclusión: Se constataron niveles elevados de estrés en el último año. Se subraya la necesidad de ampliación de la investigación a otros años de la carrera, la reflexión institucional acerca de los factores de estrés y la adopción de una política institucional que facilite un mejor enfrentamiento de dichos factores

Amelogênese imperfeita: relato de um caso vivenciado em uma unidade básica de saúde / Amelogenesis imperfecta: report of a case experienced in a basic health unit

O objetivo do estudo foi apresentar um caso clínico de amelogênese imperfeita experienciado em uma Unidade Básica de Saúde do município de Muriaé, Minas Gerais. Mesmo diante das limitações do Sistema Único de Saúde (SUS), visando restabelecer a função e a estética de uma paciente foi realizada a técnica conservadora de restauração em resina composta, escolha permeada pela viabilidade técnica, custo e idade da paciente, sendo necessárias três consultas. Houve melhoria na aparência dos dentes, no sorriso e no bem-estar da paciente, portanto, impactando diretamente na melhora da vida social e resgate da autoestima da paciente. Por fim, do vivenciado, ressalta-se a importância da atuação odontológica ser alicerçada no equilíbrio entre a técnica, a formação científica e a visão humanística na promoção da saúde bucal. 

Um muro de silêncio: a subnotificação do abuso sexual infantil intrafamiliar / A wall of silence: the underreporting of intrafamilial child sexual abuse

Introdução: O abuso sexual infantil acontece no momento em que uma criança é coagida à atividade sexual. Cerca de 80% dos abusos são intrafamiliares, tornando esse tipo de violência um crime velado e de real prevalência desconhecida. Metodologia: Trata-se de uma revisão literária baseada em artigos retirados das bases de dados SciELO e MedLine, por meio da consulta ao DeCs, através do descritor: abuso sexual infantil. Resultado: Foram selecionadas 4 fontes para serem utilizados como referencial para este artigo Discussão: Fatores como o medo de represálias, as ameaças do agressor, a falta de educação sexual, o medo de ser desacreditado e a falta de preparo profissional para o reconhecimento de tal crime favorecem a subnotificação do tipo de violência sexual mais comum contra crianças e adolescentes, a intrafamiliar. Conclusão: O abuso sexual é um crime velado. Evidencia-se a necessidade de mais estudos sobre a real prevalência e medidas de educação, prevenção e proteção para as vítimas

Tetralogia de Fallot no Brasil: compreendendo a existência

Introduction: Tetralogy of Fallot involves four specific heart problems. Firstly, there is pulmonary stenosis, characterized by the narrowing of the pathway that carries blood from the heart to the lungs, hindering blood flow. Right ventricular hypertrophy is another characteristic, where the muscle of the right ventricle of the heart becomes thicker due to increased workload caused by pulmonary stenosis. Methodology: The present study adopted a descriptive epidemiological approach with the aim of analyzing cases of Tetralogy of Fallot among live births in Brazil from 2012 to 2021. Data collection utilized the Live Birth Information System (SINASC), made available by DATASUS. Results: In the group of individuals born with Tetralogy of Fallot, the analysis of variables reveals valuable information about demographic characteristics and perinatal conditions. Regarding the "Race/Ethnicity" variable, out of the 943 cases registered, 588 (62.35%) were classified as white, 51 (5.41%) as black, 10 (1.06%) as yellow, 267 (28.31%) as brown, and 27 (2.86%) had race/ethnicity recorded as unknown. Conclusion: A profound understanding of congenital heart diseases not only saves lives but also significantly improves the quality of life for affected individuals.Introdução: A Tetralogia de Fallot envolve quatro problemas cardíacos específicos. Em primeiro lugar, há a estenose pulmonar, caracterizada pelo estreitamento da via que conduz o sangue do coração para os pulmões, dificultando o fluxo sanguíneo. A hipertrofia ventricular direita é outra característica, onde o músculo do ventrículo direito do coração torna-se mais espesso devido ao aumento da carga de trabalho provocado pela estenose pulmonar. Metodologia: O presente estudo adotou uma abordagem epidemiológica descritiva com o objetivo de analisar os casos de Tetralogia de Fallot entre os nascidos vivos no Brasil no período de 2012 a 2021. Para a coleta de dados, utilizou-se o Sistema de Informações sobre Nascidos Vivos (SINASC), disponibilizado pelo DATASUS Resultado: No grupo de nascidos com Tetralogia de Fallot, a análise das variáveis revela informações valiosas sobre características demográficas e condições perinatais. Em relação à variável "Cor/Raça", dos 943 casos registrados, 588 (62,35%) eram classificados como brancos, 51 (5,41%) como pretos, 10 (1,06%) como amarelos, 267 (28,31%) como pardos, e 27 (2,86%) tiveram a cor/raça registrada como ignorada Conclusão: A compreensão profunda das cardiopatias congênitas não apenas salva vidas, mas também melhora significativamente a qualidade de vida dos indivíduos afetados

Mapping density, diversity and species-richness of the Amazon tree flora

Using 2.046 botanically-inventoried tree plots across the largest tropical forest on Earth, we mapped tree species-diversity and tree species-richness at 0.1-degree resolution, and investigated drivers for diversity and richness. Using only location, stratified by forest type, as predictor, our spatial model, to the best of our knowledge, provides the most accurate map of tree diversity in Amazonia to date, explaining approximately 70% of the tree diversity and species-richness. Large soil-forest combinations determine a significant percentage of the variation in tree species-richness and tree alpha-diversity in Amazonian forest-plots. We suggest that the size and fragmentation of these systems drive their large-scale diversity patterns and hence local diversity. A model not using location but cumulative water deficit, tree density, and temperature seasonality explains 47% of the tree species-richness in the terra-firme forest in Amazonia. Over large areas across Amazonia, residuals of this relationship are small and poorly spatially structured, suggesting that much of the residual variation may be local. The Guyana Shield area has consistently negative residuals, showing that this area has lower tree species-richness than expected by our models. We provide extensive plot meta-data, including tree density, tree alpha-diversity and tree species-richness results and gridded maps at 0.1-degree resolution

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance