Importância do voto de auto exclusão na triagem dos doadores de sangue / Importance of confidential unit exclusion for screening blood donors

O voto de auto exclusão (VAE) é uma última oportunidade dada ao doador de definir confidencialmente se sua doação é adequada ao uso transfusional, por este fazer parte ou não de um grupo vulnerável para doenças transmissíveis, sendo este considerado uma medida adicional de segurança. O objetivo desse estudo foi analisar nos anos de 2014 e 2015, o perfil epidemiológico dos doadores de sangue auto excluídos do HEMOCE de Fortaleza/CE, identificar os perfis sorológicos nestes doadores e correlacionar o voto de auto exclusão com os resultados dos testes sorológicos. O projeto foi submetido ao Comitê de Ética em Pesquisa da Universidade Federal do Ceará e aprovado com o número do Parecer: 1.847.147. Foi realizado um estudo retrospectivo e descritivo com base nos relatórios fornecidos pelo HEMOCE e analisados estatisticamente, através do software Statistical Packcage for the Social Sciences (SPSS) versão 17.0 para Windows, considerando uma confiança de 95% para todas as análises. Os resultados mostraram que no ano de 2014 houve 59.496 doadores, destes 332 (0,55%) se auto excluíram, e no ano de 2015, de 62.283 doadores, 282 (0,45%) foram auto excluídos através do voto de auto exclusão. Em ambos os anos, prevaleceu o sexo masculino, adultos jovens, solteiros e possuidores do terceiro grau incompleto. A coleta de sangue foi principalmente no âmbito interno e o principal tipo de doação foi a espontânea. Quanto à sorologia, no ano de 2014 obteve 1,8% de soropositividade, apresentando um caso de hepatite C e HIV e quatro de sífilis, já no ano de 2015, ocorreu 2,8% de positividade nos marcadores sorológicos avaliados, sendo dois casos de doença de Chagas, um de HTLV e cinco casos de sífilis. Não houve diferença estatística dos resultados sorológicos entre os anos de 2014 e 2015, já quando correlacionados os testes sorológicos com o VAE, os não auto excluídos obtiveram maior positividade em hepatite B em 2014 e doença de Chagas e sífilis em 2015. Observamos que o VAE não foi totalmente eficaz.

Diagnóstico dos resíduos de demolição e construção no Brasil/ Diagnosis of demolition and construction waste in Brazil

Os Resíduos de Demolição e Construção - RDC apresentam sérios problemas de ordem estética, ambiental e de saúde pública, devido principalmente ao crescimento urbano desordenada e a falta de locais adequados para disposição final desses materiais o que justifica o objetivo desta pesquisa, que é verificar quais fatores tem influenciado os RDCs no Brasil. O método aplicado foi o dedutivo. Esta pesquisa foi exploratória de natureza aplicada. A coleta dos dados secundários foi efetuada a partir de acesso a plataforma de dados livres do Panorama dos Resíduos Sólidos no Brasil publicado pela Associação Brasileira de Empresas de Limpeza Pública e Resíduos Especiais – ABRELPE. Foi efetuada uma análise quantiqualitativa do crescimento populacional e do índice de RDC coletado entre os anos de 2014 e 2018, para verificar a correlação entre essas variáveis em cada Região do Brasil e verificar quais variáveis influenciam esta problemática. A cinco Regiões do Brasil não apresentaram o crescimento populacional como fator de forte influência na taxa de RDC coletados no quinquênio desta análise, dessa forma outros fatores estão atrelados a esta ação como: Perdas no processamento relacionadas a ineficiência nos métodos de trabalho e mão de obra desqualificada além de perdas nos estoques: associado ao armazenamento inadequado dos materiais, assim como o excesso de estoque. Houve tendencia de diminuição de coleta dos RDC nas cinco Regiões brasileiras mesmo com o crescimento populacional constante. Entretanto, a Região Norte apresenta as menores produções per captas das cinco regiões brasileira, sendo influenciada pela baixa influencia econômica da construção civil deste período. A variável crescimento populacional não tem influência direta com os RDC coletados nas cinco regiões do país

Impactos ambientais no solo advindos do processo de abertura e duplicação de rodovias / Environmental impacts on the soil resulting from the opening and duplication of highways

Um dos maiores impactos causados pelas rodovias ocorre justamente durante o período de operação, no qual, o mau gerenciamento das áreas ou a falta de planejamento territorial facilitam o surgimento de entraves ambientais. Estes fatos justificam esta pesquisa, cujo objetivo é efetuar uma avaliação dos principais impactos ambientais no solo avindos do processo de abertura e duplicação de rodovias. Esta análise prioriza documentos secundários, que tem por objetivo reunir estudos semelhantes, publicados, avaliando-os criticamente em sua metodologia e reunindo-os numa análise estatística, para posterior seleção das variáveis. Foram analisadas minuciosamente as variáveis objeto desta pesquisa: supressão vegetal, compactação, erosão (Erodibilidade e Erosividade), deslizamento e contaminação do solo. No processo de busca no banco de dados, foram analisados 64 trabalhos acadêmicos referentes às cinco variáveis. A análise dos dados obtidos indicou que a supressão vegetal apresentou maior frequência relativa (fr=29,6%), no que fomenta que tal impacto demonstra ser abordado com bastante frequência por pesquisadores, se comparado com as demais, superada apenas pela variável Erosão (fr=32,8%). Quanto à contaminação do solo, a análise dos dados obtidos indicou que a frequência relativa (fi=9,3%) dos artigos observados abordam esse impacto, o que representa o menor percentual em relação às demais variáveis. Dessa forma, torna-se necessário abordar de forma conjunta e igualitária todos os impactos ambientais causados na abertura e duplicação de rodovias, pois há carência de pesquisas que abordem diretamente as variáveis analisadas neste trabalho, com destaque para a contaminação do solo, que apresentou a menor frequência, a qual evidencia tal problemática.

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

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified

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

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants.

BACKGROUND: Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. METHODS: We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. FINDINGS: The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. INTERPRETATION: Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. FUNDING: WHO

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. Copyright (C) 2021 World Health Organization; licensee Elsevier

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings