Pregnant teenagers treated at the obstetric center of a university hospital

According to the definition of the World Health Organization, adolescence is the phase of life between 10 and 19 years of age, a period marked by physiological and biopsychosocial changes, in which pregnancy is considered a risk factor for both mother and fetus from the biomedical point of view. Several factors have been associated with teenage pregnancy with negative maternal and neonatal impacts, such as: social vulnerability, low levels of education, income, and sexual education. This is a descriptive cross-sectional study with a quantitative approach, which aimed to identify obstetric factors and neonatal outcomes of greater frequency among pregnant adolescents treated at the obstetric center of a university hospital. Data collection was performed through a logbook of daily procedures at the obstetric center, so that all parturients under 19 years of age treated in 2018 were included in the study. The variables studied were age, parity, type of delivery, gestational age, diagnosis of syphilis and HIV, number of prenatal consultations, and insertion of an intrauterine device (IUD). As for the newborn, the following were analyzed: weight and hospital destination after birth. The data were processed using the SOFA.5.2 software (Statistics Open for All) and the significance level established was 95%, with a value of (P ≤ 0.05). Three thousand four hundred and thirty pregnant women were evaluated. There was a birth rate of 19.3% among adolescents, with a correlation between the low weight of the newborn with the longest hospital stay and the number of prenatal visits, and also the identification of low insertion of contraceptive methods immediately after delivery. Adolescent pregnancy was correlated with low-birth-weight newborns and a longer stay in neonatal units, consequences often associated with the insufficient number of prenatal consultations. Public health policies for the inclusion of qualified nursing professionals in the management of insertion of the intrauterine device for the prevention of subsequent pregnancies deserve special attention

COMPETÊNCIA PARA O CUIDADO GINECOLÓGICO NA ATENÇÃO PRIMÁRIA À SAÚDE SOB A ÓTICA DAS ENFERMEIRAS

Objetivo: descrever cuidados ginecológicos de enfermagem realizados com competência na Atenção Primária à Saúde sob a ótica das enfermeiras. Método: pesquisa convergente assistencial realizada com 31 enfermeiras no sul do Brasil, por meio de oficinas temáticas, no período de agosto a setembro de 2020. Os dados foram analisados mediante a proposta de Creswell, apoiado pelo software IRAMUTEQ®. Resultados: emergiram quatro categorias, sendo elas (des) conhecimento das competências para realização do cuidado ginecológico; (in) satisfação profissional e o desenvolvimento de competências para o cuidado ginecológico; protagonismo e autonomia da enfermeira para realizar o cuidado ginecológico com competência na consulta de enfermagem; importância da busca pelo conhecimento para o cuidar com competência. Considerações finais: o estudo possibilitou descrever os cuidados ginecológicos de enfermagem, identificar as barreiras e fragilidades no processo de cuidado ginecológico, comentar e discutir a necessidade constante da busca do conhecimento para manutenção e aquisição da competência. Descritores: Competência Profissional. Ginecologia. Cuidado de Enfermagem. Atenção Primária à Saúde

Planejamento estratégico em saúde e educação permanente em saúde: embasamentos para mudanças no perfil assistencial / Strategic planning in health and continuing education in health: grounds for changes in the assistance profile

Introdução: O Planejamento Estratégico em Saúde é importantíssimo não apenas para organizar os serviços de Saúde como também para promover resolutividade dos problemas, pois ele visa atingir os nós críticos que estão presentes no momento e propor ações eficazes para a realidade. Objetivo: Descrever os momentos do planejamento estratégico em saúde, a partir de um caso fictício sobre a morte precoce de uma paciente com câncer de mama. Metodologia: Realizou-se a seleção de estudos que versassem sobre as ações referentes à prevenção desta neoplasia e a constituição do planejamento em saúde, sendo que os estudos incluídos neste, forneceram embasamento para a aplicação prática. Resultados: Observou-se que a falta de planejamento para a efetivação das ações em saúde é prejudicial para a resolutividade da assistência. Assim, a revisão demonstrou a importância da utilização deste para proporcionar redução dos casos de câncer de mama. A necessidade de um trabalho articulado em rede com atividades efetivas na saúde da mulher, recursos financeiros suficientes para subsidiar todo o processo e utilizados conscientemente, se encaixando nas reais necessidades e indicadores epidemiológicos e profissionais aptos para os atendimentos e diagnóstico precoce, reforçando aqui a necessidade de se realizar Educação Permanente nos serviços de Saúde

Climate change and mental health of Indigenous peoples living in their territory: a concept mapping study

BackgroundThe alarming increase in annual deforestation rates has had devastating consequences in climate change, and it is affecting Indigenous people, who depend entirely on the land for survival and has also weakened the rainforest's crucial role in stabilizing the global climate. Recognizing and respecting Indigenous people's needs and social, economic, and historical conditions influence health and healthcare. This study aimed to conduct online concept mapping workshops with university students to identify perceived important and feasible actions for improving the mental health of Indigenous people living in their territory in association with climate change.MethodsConcept mapping, a participatory mixed methodology, was conducted virtually with 20 Indigenous students at two universities in Brazil. A focus prompt was developed from consultations with Indigenous stakeholders and read—“To improve the mental health of Indigenous peoples in their territory during climate change crises, it is necessary to….”ResultsUniversity students organized 42 unique statements in 6 clusters that cover a wide range of topics: family support, 0.68 (SD 0.19); respect and understanding, 0.37 (SD 0.08); improvement actions, 0.52 (SD 0.07); public policies in favor of Indigenous people's mental health, 0.24 (0.09); health actions, 0.15 (SD 0.08); Indigenous training in health and its importance in improving mental health 0.32 (SD 0.07).ConclusionThese clusters range from community initiatives, public policies, health actions, and strengthening professional services in Indigenous communities. These all provide numerous concrete ideas for developing interventions designed to address mental health challenges associated with climate change

Convalescent plasma for COVID-19 in hospitalised patients : an open-label, randomised clinical trial

Background: The effects of convalescent plasma (CP) therapy in hospitalised patients with coronavirus disease 2019 (COVID-19) remain uncertain. This study investigates the effect of CP on clinical improvement in these patients. Methods: This is an investigator-initiated, randomised, parallel arm, open-label, superiority clinical trial. Patients were randomly (1:1) assigned to two infusions of CP plus standard of care (SOC) or SOC alone. The primary outcome was the proportion of patients with clinical improvement 28 days after enrolment. Results: A total of 160 (80 in each arm) patients (66.3% critically ill, 33.7% severely ill) completed the trial. The median (interquartile range (IQR)) age was 60.5 (48–68) years; 58.1% were male and the median (IQR) time from symptom onset to randomisation was 10 (8–12) days. Neutralising antibody titres >1:80 were present in 133 (83.1%) patients at baseline. The proportion of patients with clinical improvement on day 28 was 61.3% in the CP+SOC group and 65.0% in the SOC group (difference −3.7%, 95% CI −18.8–11.3%). The results were similar in the severe and critically ill subgroups. There was no significant difference between CP+SOC and SOC groups in pre-specified secondary outcomes, including 28-day mortality, days alive and free of respiratory support and duration of invasive ventilatory support. Inflammatory and other laboratory marker values on days 3, 7 and 14 were similar between groups. Conclusions: CP+SOC did not result in a higher proportion of clinical improvement on day 28 in hospitalised patients with COVID-19 compared to SOC alone

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

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