Levantamento dos distúrbios do sono no âmbito da APAC Santa Luzia-MG seguido da proposta de uma abordagem multidisciplinar / Survey of sleep disorders in the framework from APAC Santa Luzia-MG followed by the proposal for a multidisciplinary approach

Introdução: O projeto de extensão (A)penas Humanos, desenvolvido pela Pontifícia Universidade Católica de Minas Gerais, baseado em intervenções interdisciplinares e multidisciplinares, visa prestar assistência aos recuperandos que vivem na Associação de Proteção e Assistência aos Condenados (APAC). Em casos de desequilíbrios de sono desencadeados pela privação de liberdade, existe uma possibilidade de desenvolvimento de transtornos do sono que podem estar acompanhados de alterações psíquicas e cognitivas. Objetivos: Levantar dados sobre os distúrbios do sono no âmbito da APAC Santa Luzia-MG, seguido da proposta de uma abordagem multidisciplinar com recuperandos. Metodologia: Visando a promoção de saúde, dentro diretrizes da política de extensão da PUC MINAS, os extensionistas do curso de Fisioterapia, juntamente com os da Psicologia e Filosofia, propuseram uma oficina multidisciplinar cujo intuito foi abordar o assunto Higiene do Sono, nos contextos fisiológicos, psicológicos e espirituais, após aplicação da Escala de Sonolência de Epworth (ESE). Resultados: A partir da aplicação da ESE, foi possível observar um déficit na qualidade do sono dos recuperandos. A abordagem utilizada para exposição do assunto proporcionou um feedback satisfatório por parte daqueles que aderiram à proposta multidisciplinar voltada para promoção de saúde. Conclusão: A partir do presente estudo, foi possível levantar a demanda para o desenvolvimento de um projeto de pesquisa mais aprofundado

Principais complicações clínicas em pacientes submetidos à abdominoplastia pós-bariátrica / Main clinical complications in patients undergoing post-bariatric abdominoplasty

Este estudo, a partir de uma revisão narrativa de literatura, objetivou analisar as  principais complicações e suas prevalências nas cirurgias de abdominoplastia em  pacientes submetidos à intervenção bariátrica. Segundo a Sociedade Brasileira de  Cirurgia Bariátrica e Metabólica, a cirurgia bariátrica é o tratamento mais eficaz para  obesidade moderada à grave. Contudo, apesar dos inúmeros benefícios, este tipo de  procedimento tem como consequência flacidez com excesso de pele e de tecido  subcutâneo, principalmente no abdômen. Isso afeta a qualidade de vida dos pacientes que  são submetidos a essa cirurgia. Portanto, para remodelar o contorno do corpo e diminuir  o excesso de pele, preconiza-se a realização da abdominoplastia. Devido aos diferentes  biotipos, comorbidades e deficiências nutricionais dos pacientes, ao tipo de intervenção  cirúrgica e à complexidade do procedimento, há risco aumentado de complicações em  pacientes pós-bariátricos, com alta taxa de prevalência. Dentre os principais problemas  estão: seroma, infecção, deiscência, atelectasia, porém, ainda, é necessária uma  investigação sobre cada modo cirúrgico e as principais complicações relacionadas a ele,  além de um trabalho multiprofissional para determinar a melhor técnica para cada  paciente, a fim de reduzir os riscos de complicações

Diagnósticos de enfermagem e as suas relações com a população em situação de rua na cidade de Manaus – AM / Nursing diagnosis and their relations with the population in street situation in the city of Manaus - AM

A população em situação de rua é um fenômeno que vem crescendo acerca dos anos, segundo o decreto 7.053 de 23 de dezembro de 2009, considera-se população em situação de rua o grupo populacional heterogêneo que possui em comum a pobreza extrema. Objetivos: Levantar diagnósticos de enfermagem da taxonomia NANDA-I em um grupo de moradores de rua cadastrados no projeto social “Pai Resgatando Vida” na cidade de Manaus-AM onde se fez necessário compreender e identificar seus perfis e suas deficiências do modo em que possa aprimorar a promoção a saúde através da sistematização da Assistência de Enfermagem do (SAE). Metodologia: Trata-se de uma pesquisa de campo, não experimental, de natureza qualitativa exploratória e descritiva, realizada entre abril a maio de 2022, com o auxílio de um instrumento que foi um questionário semiestruturado, foram coletados dados sociodemográficos e diagnósticos de enfermagem através das respostas dos entrevistados. Resultado: No estudo foi identificado 19 diagnósticos de enfermagem através das características definidoras da NANDA-I, a maioria dos entrevistados são do sexo feminino 63% e 33% do sexo masculino, 40% do sexo feminino possui idade de 30 a 39 anos, do sexo masculino 40% possui idade de 25 a 29 anos. Conclusão: Diante das condições que vivem essa população, foi possível contribuir em uma melhor assistência humanizada, integral e individualizada através dos diagnósticos e intervenções de Enfermagem, além de refletir sobre suas problemáticas necessidades de vulnerabilidade, e garantir o direito dessa população de ter acesso à saúde

Rarity of monodominance in hyperdiverse Amazonian forests.

Tropical forests are known for their high diversity. Yet, forest patches do occur in the tropics where a single tree species is dominant. Such "monodominant" forests are known from all of the main tropical regions. For Amazonia, we sampled the occurrence of monodominance in a massive, basin-wide database of forest-inventory plots from the Amazon Tree Diversity Network (ATDN). Utilizing a simple defining metric of at least half of the trees ≥ 10 cm diameter belonging to one species, we found only a few occurrences of monodominance in Amazonia, and the phenomenon was not significantly linked to previously hypothesized life history traits such wood density, seed mass, ectomycorrhizal associations, or Rhizobium nodulation. In our analysis, coppicing (the formation of sprouts at the base of the tree or on roots) was the only trait significantly linked to monodominance. While at specific locales coppicing or ectomycorrhizal associations may confer a considerable advantage to a tree species and lead to its monodominance, very few species have these traits. Mining of the ATDN dataset suggests that monodominance is quite rare in Amazonia, and may be linked primarily to edaphic factors

Local hydrological conditions influence tree diversity and composition across the Amazon basin

Tree diversity and composition in Amazonia are known to be strongly determined by the water supplied by precipitation. Nevertheless, within the same climatic regime, water availability is modulated by local topography and soil characteristics (hereafter referred to as local hydrological conditions), varying from saturated and poorly drained to well-drained and potentially dry areas. While these conditions may be expected to influence species distribution, the impacts of local hydrological conditions on tree diversity and composition remain poorly understood at the whole Amazon basin scale. Using a dataset of 443 1-ha non-flooded forest plots distributed across the basin, we investigate how local hydrological conditions influence 1) tree alpha diversity, 2) the community-weighted wood density mean (CWM-wd) – a proxy for hydraulic resistance and 3) tree species composition. We find that the effect of local hydrological conditions on tree diversity depends on climate, being more evident in wetter forests, where diversity increases towards locations with well-drained soils. CWM-wd increased towards better drained soils in Southern and Western Amazonia. Tree species composition changed along local soil hydrological gradients in Central-Eastern, Western and Southern Amazonia, and those changes were correlated with changes in the mean wood density of plots. Our results suggest that local hydrological gradients filter species, influencing the diversity and composition of Amazonian forests. Overall, this study shows that the effect of local hydrological conditions is pervasive, extending over wide Amazonian regions, and reinforces the importance of accounting for local topography and hydrology to better understand the likely response and resilience of forests to increased frequency of extreme climate events and rising temperatures

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

Unidad de excelencia María de Maeztu CEX2019-000940-MAim: 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