INFLUENCE OF THE SOCIAL AND FAMILIAR THE CONTEXT TO THE ATTENTION OF THE ELDERLY IN THE VIEW OFHEALTH PROFESSIONAL

Objetivo: analisar sob a percepção dos profissionais das equipes de saúde da família, a influência do contexto sócio familiar na promoção de cuidados ao idoso. Método: Estudo descritivo, tipo inquérito, realizado em João Pessoa-PB, sendo o universo constituído por 250 profissionais de saúde. Para coleta de dados utilizou-se um questionário, contendo questões relacionadas à avaliação dos serviços de saúde oferecidos ao idoso. Os dados coletados foram submetidos à técnica de análise de conteúdo que apontou três categorias: fatores relacionados ao contexto sócio familiar, aspectos inerentes aos cuidadores, como ao próprio idoso que influenciam na promoção do cuidado na saúde do idoso. Resultados: Destaca-se uma violação aos direitos adquiridos pelos idosos, tais como a violência doméstica (15,2%), abandono familiar (10,8%), violência financeira (10,4%). Quanto aos cuidadores observa-se descompromisso diante do cuidado ao idoso (12,0%), como também despreparo dos cuidadores. Conclusões: Considerando a saúde de uma forma ampliada, tornam-se necessárias mudanças no contexto atual em direção à produção de um ambiente social e cultural mais favorável para a população idosa

Políticas de educação, escolarização e estratégias de nação: a transição Império/República

-O trabalho que estamos realizando é continuação do anterior, que fez um levantamento inédito no Arquivo Municipal de Juiz de Fora, buscando na documentação ali encontrada a percepção da transição da política pública de educação da fase final do Império – décadas de 1870 e 1880 – para as primeiras duas décadas republicanas. Procurou-se dar “voz” as Atas de Exames Escolares, as tabelas de freqüência escolar, as correspondências as mais diversas: entre professores e inspetores escolares, entre inspetores e a presidência da Câmera Municipal, entre os poderes provinciais e a Câmera etc. A despeito de restrição do campo empírico, o município de Juiz de Fora, partimos do suposto de que no espaço reduzido de uma cidade passa-se algo indiciário de um contexto maior, que requer explicação. Esse emaranhado de dados tem nos levado a formulação de novas hipóteses sobre o processo histórico daquela transição. Tais hipóteses nos apontam um paradoxo: a República em suas primeiras décadas foi menos republicana que o Império em matéria educacional. Isto se deveu, talvez, por conta da prevalência de um projeto de nação de reação à antiga fórmula da centralidade monárquica, através do apelo à autonomia da sociedade, porém acompanhada da redução do compromisso estatal com a sustentabilidade das instituições públicas. Nosso levantamento atual tem privilegiado fontes documentais do Arquivo Público Mineiro (belo Horizonte), do Arquivo Nacional (Rio de Janeiro), bem como fonte jornalisticas locais, tais como os jornais: Minas Gerais, Correio de Minas e Jornal do Comércio, todos encontrados na Biblioteca Murilo mendes (JF). O conjunto dessas informações, a medida em que vão sendo levantadas, são colocadas em um Banco de Dados, que será disponibilizado universalmente num provedor fixo da universidade ainda a ser estabelecido

Development and validation of the MMCD score to predict kidney replacement therapy in COVID-19 patients

Abstract Background Acute kidney injury (AKI) is frequently associated with COVID-19, and the need for kidney replacement therapy (KRT) is considered an indicator of disease severity. This study aimed to develop a prognostic score for predicting the need for KRT in hospitalised COVID-19 patients, and to assess the incidence of AKI and KRT requirement. Methods This study is part of a multicentre cohort, the Brazilian COVID-19 Registry. A total of 5212 adult COVID-19 patients were included between March/2020 and September/2020. Variable selection was performed using generalised additive models (GAM), and least absolute shrinkage and selection operator (LASSO) regression was used for score derivation. Accuracy was assessed using the area under the receiver operating characteristic curve (AUC-ROC). Results The median age of the model-derivation cohort was 59 (IQR 47–70) years, 54.5% were men, 34.3% required ICU admission, 20.9% evolved with AKI, 9.3% required KRT, and 15.1% died during hospitalisation. The temporal validation cohort had similar age, sex, ICU admission, AKI, required KRT distribution and in-hospital mortality. The geographic validation cohort had similar age and sex; however, this cohort had higher rates of ICU admission, AKI, need for KRT and in-hospital mortality. Four predictors of the need for KRT were identified using GAM: need for mechanical ventilation, male sex, higher creatinine at hospital presentation and diabetes. The MMCD score had excellent discrimination in derivation (AUROC 0.929, 95% CI 0.918–0.939) and validation (temporal AUROC 0.927, 95% CI 0.911–0.941; geographic AUROC 0.819, 95% CI 0.792–0.845) cohorts and good overall performance (Brier score: 0.057, 0.056 and 0.122, respectively). The score is implemented in a freely available online risk calculator ( https://www.mmcdscore.com/ ). Conclusions The use of the MMCD score to predict the need for KRT may assist healthcare workers in identifying hospitalised COVID-19 patients who may require more intensive monitoring, and can be useful for resource allocation

ABC-SPH risk score for in-hospital mortality in COVID-19 patients : development, external validation and comparison with other available scores

The majority of available scores to assess mortality risk of coronavirus disease 2019 (COVID-19) patients in the emergency department have high risk of bias. Therefore, this cohort aimed to develop and validate a score at hospital admission for predicting in-hospital mortality in COVID-19 patients and to compare this score with other existing ones. Consecutive patients (≥ 18 years) with confirmed COVID-19 admitted to the participating hospitals were included. Logistic regression analysis was performed to develop a prediction model for in-hospital mortality, based on the 3978 patients admitted between March-July, 2020. The model was validated in the 1054 patients admitted during August-September, as well as in an external cohort of 474 Spanish patients. Median (25-75th percentile) age of the model-derivation cohort was 60 (48-72) years, and in-hospital mortality was 20.3%. The validation cohorts had similar age distribution and in-hospital mortality. Seven significant variables were included in the risk score: age, blood urea nitrogen, number of comorbidities, C-reactive protein, SpO/FiO ratio, platelet count, and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829-0.859), which was confirmed in the Brazilian (0.859 [95% CI 0.833-0.885]) and Spanish (0.894 [95% CI 0.870-0.919]) validation cohorts, and displayed better discrimination ability than other existing scores. It is implemented in a freely available online risk calculator (https://abc2sph.com/). An easy-to-use rapid scoring system based on characteristics of COVID-19 patients commonly available at hospital presentation was designed and validated for early stratification of in-hospital mortality risk of patients with COVID-19

ABC₂-SPH risk score for in-hospital mortality in COVID-19 patients

Objectives: The majority of available scores to assess mortality risk of coronavirus disease 2019 (COVID-19) patients in the emergency department have high risk of bias. Therefore, this cohort aimed to develop and validate a score at hospital admission for predicting in-hospital mortality in COVID-19 patients and to compare this score with other existing ones. Methods: Consecutive patients (≥ 18 years) with confirmed COVID-19 admitted to the participating hospitals were included. Logistic regression analysis was performed to develop a prediction model for in-hospital mortality, based on the 3978 patients admitted between March–July, 2020. The model was validated in the 1054 patients admitted during August–September, as well as in an external cohort of 474 Spanish patients. Results: Median (25–75th percentile) age of the model-derivation cohort was 60 (48–72) years, and in-hospital mortality was 20.3%. The validation cohorts had similar age distribution and in-hospital mortality. Seven significant variables were included in the risk score: age, blood urea nitrogen, number of comorbidities, C-reactive protein, SpO2/FiO2 ratio, platelet count, and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829–0.859), which was confirmed in the Brazilian (0.859 [95% CI 0.833–0.885]) and Spanish (0.894 [95% CI 0.870–0.919]) validation cohorts, and displayed better discrimination ability than other existing scores. It is implemented in a freely available online risk calculator (https://abc2sph.com/). Conclusions: An easy-to-use rapid scoring system based on characteristics of COVID-19 patients commonly available at hospital presentation was designed and validated for early stratification of in-hospital mortality risk of patients with COVID-19.</p

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data