CONHECIMENTO SOBRE A IMPORTÂNCIA DO DESCARTE CORRETO DE MEDICAMENTOS POR ESTUDANTES DE ENSINO MÉDIO EM PORTO ALEGRE-RS: PROJETO EDUCATIVO DE INTERAÇÃO UNIVERSIDADE-COMUNIDADE

Disposal of medicines is a theme in evolution concerning environmental education, mainly considering the negative effects from disposal in wrong places, like household waste or wastewater system. The present manuscript was developed from a project that works with environment education and health, focusing expired and unused medicines and the importance of their correct disposal, involving high school students in the city of Porto Alegre, Rio Grande do Sul. From the exchange of experiences mediated by the presentation and discussion of educational material, 209 high school students, aged between 15 and 19 years old, from October 2018 to January 2020, participated of a descriptive cross-sectional research. The aim was to evaluate the knowledge of students concerning the correct disposal of expired and unused drugs, through the application of a questionnaire. By descriptive analysis of collected information, it was observed that 82% of the students improperly discard expired and unused medicines, with 49% discarding in dry garbage, 24% in organic waste, 6% in the toilet and 3% in the sink. Of those who dispose correctly (18%), 9% of the students return the medicines to the pharmacy and another 9% to the public health centers. Regarding the reduced number of correct disposal actions, environmental education actions that lead to awareness of the problem that irregular disposal can generate, as well as the transformation of this current scenario, are imperative. It is clear the need for strategies to improve the knowledge about the correct disposal of medicines, especially with the young public, which can disseminate the importance of this action, in favor of the environment and society.O descarte de medicamentos constitui temática em contínua evolução em aspectos educativos ambientais, em especial pelas consequências negativas já conhecidas a partir da disposição deste tipo de resíduo em lixo comum ou em rede de esgoto. O presente artigo origina-se de projeto de extensão que trabalha com educação ambiental e saúde, no foco medicamentos vencidos e em desuso e a importância do seu descarte correto, junto ao ambiente escolar de ensino médio no município de Porto Alegre, Rio Grande do Sul. A partir da troca de experiências mediada pela apresentação e discussão de material educativo, 209 alunos do ensino médio, com idade entre 15 e 19 anos, no período de outubro de 2018 a janeiro de 2020, participaram de pesquisa transversal descritiva. O objetivo foi avaliar os conhecimentos prévios dos alunos sobre o descarte correto de medicamentos vencidos e em desuso (sobras), por meio da aplicação de questionário. Pela análise descritiva dos dados coletados observou-se que 82% dos alunos descartam de forma inadequada os medicamentos vencidos e suas sobras, sendo que 49% descartam em lixo seco, 24% em lixo orgânico, 6% em vaso sanitário e 3% em pia. Daqueles que descartam de modo correto (18%), 9% dos alunos devolvem os medicamentos à farmácia e outros 9% às Unidades de Saúde. Em relação ao quantitativo reduzido de ações corretas de descarte, torna-se imperativo ações de educação ambiental que levem à conscientização da problemática que o descarte irregular pode gerar, bem como à transformação deste cenário. O estudo mostrou a necessidade de estratégias para melhoria no âmbito do conhecimento sobre descarte correto de medicamentos, em especial junto ao público jovem, que pode disseminar a importância desta ação, em prol do meio ambiente e da sociedade

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

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

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

CONHECIMENTO SOBRE A IMPORTÂNCIA DO DESCARTE CORRETO DE MEDICAMENTOS POR ESTUDANTES DE ENSINO MÉDIO EM PORTO ALEGRE-RS: PROJETO EDUCATIVO DE INTERAÇÃO UNIVERSIDADE-COMUNIDADE

Disposal of medicines is a theme in evolution concerning environmental education, mainly considering the negative effects from disposal in wrong places, like household waste or wastewater system. The present manuscript was developed from a project that works with environment education and health, focusing expired and unused medicines and the importance of their correct disposal, involving high school students in the city of Porto Alegre, Rio Grande do Sul. From the exchange of experiences mediated by the presentation and discussion of educational material, 209 high school students, aged between 15 and 19 years old, from October 2018 to January 2020, participated of a descriptive cross-sectional research. The aim was to evaluate the knowledge of students concerning the correct disposal of expired and unused drugs, through the application of a questionnaire. By descriptive analysis of collected information, it was observed that 82% of the students improperly discard expired and unused medicines, with 49% discarding in dry garbage, 24% in organic waste, 6% in the toilet and 3% in the sink. Of those who dispose correctly (18%), 9% of the students return the medicines to the pharmacy and another 9% to the public health centers. Regarding the reduced number of correct disposal actions, environmental education actions that lead to awareness of the problem that irregular disposal can generate, as well as the transformation of this current scenario, are imperative. It is clear the need for strategies to improve the knowledge about the correct disposal of medicines, especially with the young public, which can disseminate the importance of this action, in favor of the environment and society.O descarte de medicamentos constitui temática em contínua evolução em aspectos educativos ambientais, em especial pelas consequências negativas já conhecidas a partir da disposição deste tipo de resíduo em lixo comum ou em rede de esgoto. O presente artigo origina-se de projeto de extensão que trabalha com educação ambiental e saúde, no foco medicamentos vencidos e em desuso e a importância do seu descarte correto, junto ao ambiente escolar de ensino médio no município de Porto Alegre, Rio Grande do Sul. A partir da troca de experiências mediada pela apresentação e discussão de material educativo, 209 alunos do ensino médio, com idade entre 15 e 19 anos, no período de outubro de 2018 a janeiro de 2020, participaram de pesquisa transversal descritiva. O objetivo foi avaliar os conhecimentos prévios dos alunos sobre o descarte correto de medicamentos vencidos e em desuso (sobras), por meio da aplicação de questionário. Pela análise descritiva dos dados coletados observou-se que 82% dos alunos descartam de forma inadequada os medicamentos vencidos e suas sobras, sendo que 49% descartam em lixo seco, 24% em lixo orgânico, 6% em vaso sanitário e 3% em pia. Daqueles que descartam de modo correto (18%), 9% dos alunos devolvem os medicamentos à farmácia e outros 9% às Unidades de Saúde. Em relação ao quantitativo reduzido de ações corretas de descarte, torna-se imperativo ações de educação ambiental que levem à conscientização da problemática que o descarte irregular pode gerar, bem como à transformação deste cenário. O estudo mostrou a necessidade de estratégias para melhoria no âmbito do conhecimento sobre descarte correto de medicamentos, em especial junto ao público jovem, que pode disseminar a importância desta ação, em prol do meio ambiente e da sociedade

Impact of Atrial Fibrillation Ablation on Left Ventricular Filling Pressure and Left Atrial Remodeling

Background: Left ventricular (LV) diastolic dysfunction is associated with new-onset atrial fibrillation (AF), and the estimation of elevated LV filling pressures by E/e' ratio is related to worse outcomes in patients with AF. However, it is unknown if restoring sinus rhythm reverses this process. Objective: To evaluate the impact of AF ablation on estimated LV filling pressure. Methods: A total of 141 patients underwent radiofrequency (RF) ablation to treat drug-refractory AF. Transthoracic echocardiography was performed 30 days before and 12 months after ablation. LV functional parameters, left atrial volume index (LAVind), and transmitral pulsed and mitral annulus tissue Doppler (e' and E/e') were assessed. Paroxysmal AF was present in 18 patients, persistent AF was present in 102 patients, and long-standing persistent AF in 21 patients. Follow-up included electrocardiographic examination and 24-h Holter monitoring at 3, 6, and 12 months after ablation. Results: One hundred seventeen patients (82.9%) were free of AF during the follow-up (average, 18 ± 5 months). LAVind reduced in the successful group (30.2 mL/m2 ± 10.6 mL/m2 to 22.6 mL/m2 ± 1.1 mL/m2, p < 0.001) compared to the non-successful group (37.7 mL/m2 ± 14.3 mL/m2 to 37.5 mL/m2 ± 14.5 mL/m2, p = ns). Improvement of LV filling pressure assessed by a reduction in the E/e' ratio was observed only after successful ablation (11.5 ± 4.5 vs. 7.1 ± 3.7, p < 0.001) but not in patients with recurrent AF (12.7 ± 4.4 vs. 12 ± 3.3, p = ns). The success rate was lower in the long-standing persistent AF patient group (57% vs. 87%, p = 0.001). Conclusion: Successful AF ablation is associated with LA reverse remodeling and an improvement in LV filling pressure