Uso de álcool e/ou drogas: avaliação dos aspectos da espiritualidade e religiosos

El estudio tiene por objetivo validar aspectos de espiritualidad y religiosos en usuarios de alcohol y/o drogas. Se trata de un estudio descriptivo exploratorio, de abordaje cuantitativo. Participaron 138 individuos de sexo masculino, vinculados a instituciones para rehabilitación o grupo de mutua ayuda, que respondieron a un cuestionario sociodemográfico, AUDIT-C y la versión brasileña de la Spirituality Self Rating Scale. En la muestra, 47,1% eran usuarios de alcohol y 52,9% de drogas. Los resultados constataron diferencias entre os grupos en relación a los aspectos religiosos: los usuarios de alcohol eran católicos (63,1%) e no practicantes de religión (50,8%) y los usuarios de drogas eran evangélicos (43,1%) e practicaban una religión (72,2%). En relación a los aspectos das prácticas espirituales, no fueran encontradas diferencias entre los grupos. Ambos demostraron hacer distinción entre los conceptos de religiosidad e de espiritualidad. Los resultados amplían la comprensión sobre cómo el enfermero pode implementar o cuidado que leva en consideración los aspectos subjetivos de usuario de substancias psicoactivas en su práctica cotidiana.The aim of this study was to evaluate spiritual and religious aspects in drug and/or alcohol users. It is a descriptive, exploratory study using a quantitative approach. A total of 138 men participated, all with links to rehabilitation institutions or support groups, responding to a socio-demographic questionnaire, the AUDIT-C, and to the Brazilian version of the Spirituality Self Rating Scale. In the sample, 47.1% were alcohol users, 52.9% drug users. The results demonstrated differences between the groups concerning religious aspects: the alcohol users were Catholics (63.1%) or did not practice any religion (50.8%) and the drug users were evangelical (43.1%) or practicing a religion (72.2%). With regards aspects of spiritual practice, no differences were found between the groups. Both were shown to distinguish between the concepts of religiosity and spirituality. The findings broadened understanding of how the nurse can implement care which takes into consideration subjective aspects of the psycho-active substance user in their day-to-day practices.O estudo teve por objetivo avaliar aspectos da espiritualidade e religiosos em usuários de álcool e/ou drogas. Trata-se de estudo descritivo exploratório, de abordagem quantitativa. Participaram 138 indivíduos do sexo masculino, vinculados a instituições para reabilitação ou grupo de mútua ajuda, que responderam a um questionário sociodemográfico, AUDIT-C e a versão brasileira da Spirituality Self Rating Scale. Na amostra, 47,1% eram usuários de álcool e 52,9% de drogas. Os resultados constataram diferenças entre os grupos em relação aos aspectos religiosos: os usuários de álcool eram católicos (63,1%) e não praticantes de religião (50,8%) e os usuários de drogas eram evangélicos (43,1%) e praticavam uma religião (72,2%). Em relação aos aspectos das práticas espirituais, não foram encontradas diferenças entre os grupos. Ambos demonstraram fazer distinção entre os conceitos de religiosidade e de espiritualidade. Os achados ampliam a compreensão sobre como o enfermeiro pode implementar o cuidado que leva em consideração os aspectos subjetivos do usuário de substâncias psicoativas em sua prática cotidiana

Tracking of psychiatric nonpsychotic symptoms among pregnant women from a city in the state of Mato Grosso

Objetivo: rastrear sintomas psiquiátricos não-psicóticos em gestantes atendidas em unidades de Estratégia de Saúde da Família. Métodos: estudo transversal e descritivo, de amostra não-probabilística, envolvendo 36 gestantes, realizado em novembro de 2011 a setembro de 2012, utilizando entrevista estruturada para coleta de dados. A análise foi por meio de estatística descritiva. Resultados: a amostra apresentou idades entre 18 e 40 anos, 69,4% afirmava morar com o marido, 61,1% já tinham filhos e 44,4% estavam trabalhando. Quanto aos sintomas psiquiátricos não-psicóticos evidenciou-se que 61,1% das gestantes os apresentava como nervosismo e ideação suicida. Conclusão: os sintomas psiquiátricos não-psicóticos entre gestantes são bastante comuns, e a gestação pode ser um período favorável ao desenvolvimento dos mesmos, devido a alterações físicas e emocionais decorrentes da gravidez, evidenciando a necessidade de elaborar ações de promoção, prevenção e tratamento de saúde mental

Atitudes de estudantes de enfermagem frente ao usuário de substâncias e percepções sobre o cuidado religioso/espiritual

Objective: To evaluate the impact of an educational intervention on the attitudes of Nursing students towards users of psychoactive substances (excluding alcohol and tobacco) and their perceptions about the religious and spiritual care offered within the health services. Method: Quasi-experimental study. We applied a questionnaire before and one month after an intervention about the comprehensive care of substance users, containing: sociodemographic information, knowledge, the Treatment Spirituality/ Religiosity Scale, and the Drug and Drug Problems Perceptions Questionnaire. For the analyses, we employed the paired Student’s t-test and Pearson’s Coefficient. Results: 62 students participated in this study. After the intervention, there was improvement in the students’ attitudes towards the substance users, but not regarding the perception they already had about the importance of offering religious and spiritual care within the services. Conclusion: We verified the effectiveness of the educational intervention on the improvement of attitudes concerning the care of substance users, yet we point out that the students did not show changes in their perception about the inclusion of the religious and spiritual aspects in the care dedicated to this population

Teachers’ perceptions, difficulties, and actions facing drugs at the school environment

Objetivou-se avaliar a percepção dos professores de ensino médio sobre suas atitudes em relação à abordagem da temática do uso de álcool e outras drogas em seu trabalho. Trata se de um estudo qualitativo, através de perguntas semiestruturadas. Os participantes responderam a um questionário semiestruturado e os dados obtidos foram inseridos no software Atlas.ti, desenvolvendo-se uma análise de conteúdo do tipo temática. Produziram-se três categorias de análise: a compreensão dos professores a respeito de seu papel na discussão sobre substâncias psicoativas; dificuldades na abordagem sobre as substâncias psicoativas no âmbito do trabalho; ações e necessidades destinadas ao trabalho com a temática das substâncias psicoativas na escola. Alguns desses educadores, em sua percepção, não compreendem que discutir o tema álcool e drogas deva fazer parte de suas atribuições por não considerarem ser papel da escola. Os educadores percebem a necessidade de capacitação para trabalhar de forma interdisciplinar com a problemática, não apenas direcionada às suas próprias atuações, mas também em relação às redes de apoio e legislações sobre álcool e drogas. É necessário criar formas práticas de oferecimento de capacitações específicas sobre o uso de substâncias psicoativas aos gestores escolares e educadores, investir na implementação de espaços de discussão e reflexão dentro da escola entre docente e discentes e construir um trabalho em rede intersetorial, visando melhor enfrentamento da problemática em âmbito escolar.We aimed to evaluate the perception of high school teachers about their attitudes when approaching the topic of use of alcohol and other drugs in their work. This is a qualitative study, performed by semi-structured questions. Participants answered to a semi-structured questionnaire and the obtained data were entered into the Atlas.ti software, and thus we developed a thematic content analysis. We produced three categories of analysis: understanding the teachers regarding their role when discussing psychoactive substances; difficulties in approaching psychoactive substances in the work environment; actions and needs aimed at work with the theme of psychoactive substances at school. Some of these educators, in their perception, do not understand that discussing alcohol and drugs should be part of their work because they do not consider it as part of the role of the school. Educators realize the need for training for them to work in an interdisciplinary way with these problems not just directed to their own performances, but also concerning support networks and legislation on alcohol and drugs. It is necessary to create practical ways of providing specific training on the use of psychoactive substances to school managers and educators, investing in the implementation of spaces for discussion and reflection at the school environment between staff and students, and creating an intersectoral networking aimed at better addressing such issue

Intervenção educativa e expectativas positivas sobre o uso do álcool entre estudantes

Objetivou-se avaliar as expectativas positivas sobre o uso recente de álcool por estudantes de ensino Fundamental e Médio antes e após uma intervenção educativa e verificar diferenças na frequência de uso e nas informações sobre essa substância, segundo o sexo. Estudo quase-experimental, realizado com 231 estudantes. Foram utilizados: Formulário sociodemográfico; Inventário de Triagem do Uso de Drogas; Escala de Expectativas Positivas acerca do Álcool, aplicados antes e após 60 dias da intervenção. Foram realizadas análises estatísticas descritivas e inferenciais. A hipótese do estudo não foi confirmada. Para o grupo geral, não foram observadas mudanças significativas nas expectativas positivas sobre o álcool após a intervenção. A frequência de consumo se manteve elevada após a atividade, com destaque para o sexo feminino. Os resultados demonstraram que a intervenção educativa não foi efetiva para influenciar mudanças do uso do álcool, todavia, foi eficaz para a aquisição de informações sobre a substância

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

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ

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

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030