ATENÇÃO PRIMÁRIA À SAÚDE DO IDOSO: MODELO CONCEITUAL DE ENFERMAGEM

Estudio cuyo intuito fue elaborar un modelo conceptual acerca del papel del enfermero en la atención básica a la salud del anciano. Se realizaron revisión y análisis documental de 40 documentos normativos brasileños que regulan la atención básica y/o relacionados al anciano. Se obtuvieron los datos entre abril y agosto de 2015. Se consensuaron las informaciones en los cuatro metaparadigmas de la enfermería. El ser humano fue la persona de >60 años; la salud/enfermedad: el conjunto de factores físicos, psicológicos, sociales, económicos, culturales y ambientales que están presentes durante el proceso de envejecimiento; y el ambiente: atención básica, un conjunto de acciones de salud, en ámbito individual y colectivo, que abarca promoción y protección de la salud, prevención de agravios, diagnóstico, tratamiento, rehabilitación, reducción de daños y manutención de la salud; el enfermero presenta responsabilidad de administración y cuidado a la salud. El modelo representa las concepciones específicas del anciano, salud/enfermedad, ambiente, así como las atribuciones del enfermero en la atención básica.O objetivo deste estudo foi elaborar um modelo conceitual sobre o papel do enfermeiro na atenção primária à saúde do idoso. Foi realizada revisão e análise documental de 40 documentos normativos brasileiros que regulam a atenção primária e/ou relacionados ao idoso, com coleta de dados entre abril e agosto de 2015. As informações foram consensuadas nos quatro metaparadigmas da enfermagem. O ser humano foi a pessoa de >60 anos; a saúde/doença: o conjunto de fatores físicos, psicológicos, sociais, econômicos, culturais e ambientais que permeiam o envelhecimento; e o ambiente: atenção primária, um conjunto de ações de saúde, no âmbito individual e coletivo, que abrange promoção e proteção da saúde, prevenção de agravos, diagnóstico, tratamento, reabilitação, redução de danos e manutenção da saúde; o enfermeiro, apresenta responsabilidade de gerência e cuidado à saúde. O modelo reflete as concepções específicas do idoso, saúde/doença, ambiente, bem como as atribuições do enfermeiro na atenção primária.The present study aimed to develop a conceptual model on the role of nurses in care to the elderly in primary health care services. Literature review and document analysis of 40 Brazilian normative documents that regulate primary care and/or care related to the elderly, and data was collected between April and August 2015. Consensus was obtained on information related to the four nursing meta paradigms. The human being was the person aged > 60 years; health/ disease: the set of physical, psychological, social, economic, cultural and environmental factors that pervade aging; and the environment: primary health care, a set of individual and collective health actions, covering health promotion and protection, disease prevention, diagnosis, treatment, rehabilitation, reduction of damage and health maintenance; the nurse, who is responsible for management and health care. The model reflects the concepts related to the elderly, health/disease environment, as well as nursing assignments in primary care

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

Understanding the clinical spectrum of complicated Plasmodium vivax malaria: a systematic review on the contributions of the Brazilian literature

The resurgence of the malaria eradication agenda and the increasing number of severe manifestation reports has contributed to a renewed interested in the Plasmodium vivax infection. It is the most geographically widespread parasite causing human malaria, with around 2.85 billion people living under risk of infection. The Brazilian Amazon region reports more than 50% of the malaria cases in Latin America and since 1990 there is a marked predominance of this species, responsible for 85% of cases in 2009. However, only a few complicated cases of P. vivax have been reported from this region. A systematic review of the Brazilian indexed and non-indexed literature on complicated cases of vivax malaria was performed including published articles, masters' dissertations, doctoral theses and national congresses' abstracts. The following information was retrieved: patient characteristics (demographic, presence of co-morbidities and, whenever possible, associated genetic disorders); description of each major clinical manifestation. As a result, 27 articles, 28 abstracts from scientific events' annals and 13 theses/dissertations were found, only after 1987. Most of the reported information was described in small case series and case reports of patients from all the Amazonian states, and also in travellers from Brazilian non-endemic areas. The more relevant clinical complications were anaemia, thrombocytopaenia, jaundice and acute respiratory distress syndrome, present in all age groups, in addition to other more rare clinical pictures. Complications in pregnant women were also reported. Acute and chronic co-morbidities were frequent, however death was occasional. Clinical atypical cases of malaria are more frequent than published in the indexed literature, probably due to a publication bias. In the Brazilian Amazon (considered to be a low to moderate intensity area of transmission), clinical data are in accordance with the recent findings of severity described in diverse P. vivax endemic areas (especially anaemia in Southeast Asia), however in this region both children and adults are affected. Finally, gaps of knowledge and areas for future research are opportunely pointed out

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

ATENÇÃO PRIMÁRIA À SAÚDE DO IDOSO: MODELO CONCEITUAL DE ENFERMAGEM

Estudio cuyo intuito fue elaborar un modelo conceptual acerca del papel del enfermero en la atención básica a la salud del anciano. Se realizaron revisión y análisis documental de 40 documentos normativos brasileños que regulan la atención básica y/o relacionados al anciano. Se obtuvieron los datos entre abril y agosto de 2015. Se consensuaron las informaciones en los cuatro metaparadigmas de la enfermería. El ser humano fue la persona de >60 años; la salud/enfermedad: el conjunto de factores físicos, psicológicos, sociales, económicos, culturales y ambientales que están presentes durante el proceso de envejecimiento; y el ambiente: atención básica, un conjunto de acciones de salud, en ámbito individual y colectivo, que abarca promoción y protección de la salud, prevención de agravios, diagnóstico, tratamiento, rehabilitación, reducción de daños y manutención de la salud; el enfermero presenta responsabilidad de administración y cuidado a la salud. El modelo representa las concepciones específicas del anciano, salud/enfermedad, ambiente, así como las atribuciones del enfermero en la atención básica.O objetivo deste estudo foi elaborar um modelo conceitual sobre o papel do enfermeiro na atenção primária à saúde do idoso. Foi realizada revisão e análise documental de 40 documentos normativos brasileiros que regulam a atenção primária e/ou relacionados ao idoso, com coleta de dados entre abril e agosto de 2015. As informações foram consensuadas nos quatro metaparadigmas da enfermagem. O ser humano foi a pessoa de >60 anos; a saúde/doença: o conjunto de fatores físicos, psicológicos, sociais, econômicos, culturais e ambientais que permeiam o envelhecimento; e o ambiente: atenção primária, um conjunto de ações de saúde, no âmbito individual e coletivo, que abrange promoção e proteção da saúde, prevenção de agravos, diagnóstico, tratamento, reabilitação, redução de danos e manutenção da saúde; o enfermeiro, apresenta responsabilidade de gerência e cuidado à saúde. O modelo reflete as concepções específicas do idoso, saúde/doença, ambiente, bem como as atribuições do enfermeiro na atenção primária.The present study aimed to develop a conceptual model on the role of nurses in care to the elderly in primary health care services. Literature review and document analysis of 40 Brazilian normative documents that regulate primary care and/or care related to the elderly, and data was collected between April and August 2015. Consensus was obtained on information related to the four nursing meta paradigms. The human being was the person aged > 60 years; health/ disease: the set of physical, psychological, social, economic, cultural and environmental factors that pervade aging; and the environment: primary health care, a set of individual and collective health actions, covering health promotion and protection, disease prevention, diagnosis, treatment, rehabilitation, reduction of damage and health maintenance; the nurse, who is responsible for management and health care. The model reflects the concepts related to the elderly, health/disease environment, as well as nursing assignments in primary care

Identificação de áreas prioritárias para a vigilância e controle de dengue e outras arboviroses transmitidas pelo Aedes aegypti no município de Natal-RN: relato de experiência

Resumo OBJETIVO: relatar a experiência denominada vigi@dengue realizada no município de Natal-RN, Brasil, em out/2015-maio/2016. MÉTODOS: os indicadores entomológicos foram obtidos a partir das armadilhas de oviposição, e os indicadores epidemiológicos, das notificações no Sistema de Informação de Agravos de Notificação (Sinan-dengue) on-line, da busca ativa de casos e detecção de RNA viral (RTq-PCR) em artrópodes e amostras de soro humano; definiram-se níveis de risco baseados nesses indicadores, estabelecendo-se categorias de intervenções para cada nível. RESULTADOS: identificação precoce do surgimento de epidemia em três áreas da cidade, com orientação do trabalho de campo para áreas mais vulneráveis; Natal-RN apresentou índice de positividade de ovitrampas (IPO) de 40% e índice de densidade de ovos (IDO) de 51 ovos∕ovitrampa; identificou-se cocirculação dos arbovírus CHIKV, DENV-1 e DENV-3 em Natal-RN. CONCLUSÃO: a estratégia identificou precocemente o surgimento de epidemias localizadas; foi útil à orientação das medidas de controle para as áreas de maior risco

Unraveling the genetic background of individuals with a clinical familial hypercholesterolemia phenotype

Familial hypercholesterolemia (FH) is a common genetic disorder of lipid metabolism caused by pathogenic/likely pathogenic variants in LDLR, APOB, and PCSK9 genes. Variants in FH-phenocopy genes (LDLRAP1, APOE, LIPA, ABCG5, and ABCG8), polygenic hypercholesterolemia, and hyperlipoprotein (a) [Lp(a)] can also mimic a clinical FH phenotype. We aim to present a new diagnostic tool to unravel the genetic background of clinical FH phenotype. Biochemical and genetic study was performed in 1,005 individuals with clinical diagnosis of FH, referred to the Portuguese FH Study. A next-generation sequencing panel, covering eight genes and eight SNPs to determine LDL-C polygenic risk score and LPA genetic score, was validated, and used in this study. FH was genetically confirmed in 417 index cases: 408 heterozygotes and 9 homozygotes. Cascade screening increased the identification to 1,000 FH individuals, including 11 homozygotes. FH-negative individuals (phenotype positive and genotype negative) have Lp(a) >50 mg/dl (30%), high polygenic risk score (16%), other monogenic lipid metabolism disorders (1%), and heterozygous pathogenic variants in FH-phenocopy genes (2%). Heterozygous variants of uncertain significance were identified in primary genes (12%) and phenocopy genes (7%). Overall, 42% of our cohort was genetically confirmed with FH. In the remaining individuals, other causes for high LDL-C were identified in 68%. Hyper-Lp(a) or polygenic hypercholesterolemia may be the cause of the clinical FH phenotype in almost half of FH-negative individuals. A small part has pathogenic variants in ABCG5/ABCG8 in heterozygosity that can cause hypercholesterolemia and should be further investigated. This extended next-generation sequencing panel identifies individuals with FH and FH-phenocopies, allowing to personalize each person’s treatment according to the affected pathway