Adherence to healthy ways of life through counselling by health care professionals

OBJETIVO: Estimar la prevalencia y factores asociados a la incorporación de modos saludables de vida MÉTODOS: Estudio transversal conducido con usuarios mayores de 19 años de una unidad básica de salud de Belo Horizonte, MG- Brasil, entre 2009 y 2010. La muestra fue seleccionada para estimar la proporción de personas que incorporaron modos saludables de vida (alimentación saludable y práctica de actividad física) mediante asesoría realizada por profesionales de salud y los factores sociodemográficos, alimenticios y de salud asociados. Adicionalmente, se analizaron los beneficios y dificultades percibidas para la incorporación de modos saludables de vida. Se realizó análisis descriptivo, univariado (Chi-cuadrado de Pearson o Exacto de Fisher) y multivariado mediante Regresión de Poisson. RESULTADOS: de los 417 participantes, sólo 40,8% recibió la asesoría, de los cuales 50,9% presentaron incorporación. En el análisis multivariado, la incorporación se asoció con la percepción de que la alimentación era saludable (RP= 1,67; IC95% 1,15;2,43) y la participación en servicio público de promoción de la salud (RP= 1,55; IC95% 1,18;2,03). Mayor disposición y reducción de peso se mencionaron como principales beneficios de la incorporación mientras que la dificultad para cambiar hábitos y la falta de tiempo fueron las barreras más relatadas. CONCLUSIONES: La adopción de modos de vida más saludables requiere el planteamiento de estrategias que favorezcan la incorporación, así como la participación de los profesionales en la realización de asesoría como acción de promoción de la salud que genere mayor autonomía y calidad de vida, sustentado por políticas y programas de promoción de la salud.OBJETIVO: Estimar a prevalência e fatores associados à adesão a modos saudáveis de vida. MÉTODOS: Estudo transversal conduzido com usuários maiores de 19 anos de uma unidade básica de saúde de Belo Horizonte, MG, entre 2009 e 2010. A amostra foi selecionada para estimar a proporção de pessoas que aderiram a modos saudáveis de vida (alimentação saudável e prática de atividade física) mediante aconselhamento realizado por profissionais de saúde e os fatores sociodemográficos, alimentares e de saúde associados. Adicionalmente, foram analisados os benefícios e dificuldades percebidas para a adesão a modos saudáveis de vida. Realizou-se análise descritiva, univariada (Qui-quadrado de Pearson ou Exato de Fisher) e multivariada mediante Regressão de Poisson. RESULTADOS: Dos 417 participantes, apenas 40,8% recebeu o aconselhamento, dos quais 50,9% apresentaram adesão. Na análise multivariada, a adesão foi associada com a percepção de ser ter uma alimentação era saudável (RP = 1,67; IC95% 1,15;2,43) e a participação em serviço público de promoção da saúde (RP = 1,55; IC95% 1,18;2,03). Maior disposição e redução de peso foram referidas como principais benefícios da adesão, enquanto a dificuldade para mudar hábitos e falta de tempo foram as barreiras mais relatadas. CONCLUSÕES: A adoção de modos de vida mais saudáveis requer a proposição de estratégias que favoreçam a adesão, bem como a participação dos profissionais na realização do aconselhamento como ação de promoção da saúde que gere maior autonomia e qualidade de vida, sustentado por políticas e programas de promoção da saúde.OBJECTIVE: To estimate the prevalence of factors associated with adherence to healthy ways of life. METHODS: This is a cross-sectional study carried out with users aged over19 from a primary health care unit in Belo Horizonte, MG, Southeastern Brazil, from 2009 to 2010. The sample was selected to estimate the proportion of people who adhere to healthy ways of life (healthy eating and physical activity) through counseling conducted by health care professionals, and associated socio-demographic, dietary and health factors. Additionally, the perceived benefits from the adherence to healthy ways of life and their possible barriers were verified. Descriptive analysis, univariate (Chi-square Test or Fisher's Exact) and multivariate by Poisson Regression were performed. RESULTS: Of the 417 users selected for the survey, only 40.8% received counseling, of which 50.9% demonstrated adherence. In multivariate Poisson regression, adherence was associated with the perception of food being healthy (PR = 1.67, 95%CI 1.15;2.43) and participation in the public service health campaigns(PR = 1.55, 95%CI 1.18;2.03). The main reported benefits of adherence were greater willingness and weight loss and, the most commonly reported barriers were difficulty of changing habits and lack of time. CONCLUSIONS: Adopting healthier lifestyles requires the proposing of strategies that promote adherence, as well as the participation of professionals in implementing counseling as a health promoting action that generates greater autonomy and quality of life among those involved, supported by policies and programs promoting health

A RAZÃO MACUNAÍMICA: UM BRASIL ENTRE BRASIS

Na tentativa de não contaminar nosso olhar com uma fortuna crítica expressiva de Macunaíma (1928), buscamos, nessas linhas que seguem, realizar uma leitura interna da obra, na qual os diálogos com outras ideias surgiram subordinados a tal leitura e a partir dos arquivos individuais e anteriores – para usarmos um termo de Wright Mills do ensaio “Do artesanato intelectual” (1959) – de cada autora/o deste trabalho. Nesta tarefa, percebemos a rapsódia como um mito original nacional que explora o conflito e a hibridização dos polos antitéticos da questão da integração nacional, em diálogo com um tipo de visão dicotômica do pensamento brasileiro. Nas aventuras do “herói de nossa gente”, o mosaico cultural no qual convivem o antigo e o moderno, o indígena da floresta e o homem de negócios, o mito e a razão, as figuras folclóricas e a indústria, “o brasileiro falado e o português escrito”, nos é apresentado por uma dualidade (e nos encontros) entre o mato-virgem, lugar incaracterístico, universo mítico, desgeografizado, não letrado, cujo tempo e espaço não obedecem a um padrão racional e secularizado, e a cidade de São Paulo, corpórea, lugar das máquinas, das Letras e da civilização. Sugerimos que as tensões, os impasses e as ambivalências que constituem essa dualidade formalizam esteticamente uma “razão macunaímica”, apresentando ao leitor um Brasil que vive entre Brasis, sem sínteses resolutivas e em embates não necessariamente felizes e tranquilos, mas, por vezes, violentos e devastadores

Aconselhamento sobre modos saudáveis de vida na Atenção Primária e práticas alimentares dos usuários

This cross-sectional study examines a counseling program on healthy lifestyles run by health care professionals to establish the adoption of healthy dietary practices by patients attending a primary health care unit. Participants in the study included 417 clients of the unit, the majority of whom were women (78.9%), with an average age of 39 years, a high incidence of excessive weight, (59.1%), important dietary inadequacies, and with a contrastingly low frequency of receiving counseling (40.8%). Clients receiving counseling displayed more appropriate consumption of candy/gum (p=0.031), softdrinks (p=0.036), salty foods (p=0.037), artificial flavorings (p=0.005) and eggs (p=0.010). Adoption of healthy dietary practices was more common among older individuals and women (pEstudio seccional que apunta a verificar la efectivización de consejos sobre hábitos de vida saludables por profesionales de salud y su asociación con la adopción de prácticas alimentarias saludables en Servicio de Atención Básica de Salud. Participaron 417 pacientes, mayoritariamente mujeres (78,9%), con mediana etaria de 39 años, alta prevalencia de exceso de peso (59,1%) y alimentación inadecuada, contrastándose con la baja frecuencia de aconsejado (40,8%). Aún así, los pacientes aconsejados presentaron mayor adecuación en el consumo de caramelos/chicles (p=0,031), refrescos gasificados (p=0,036), pasteles fritos (p=0,037), condimentos industrializados (p=0,005) y huevos (p=0,010). La adopción de prácticas alimentarias saludables fue más frecuente entre los de mayor edad y las mujeres (pTrata-se de estudo seccional para verificar a realização de aconselhamento sobre modos saudáveis de vida por profissionais de saúde e sua associação com a adoção de práticas alimentares saudáveis em serviço de Atenção Primária à Saúde. Participaram 417 usuários, a maioria mulheres (78,9%), com mediana de idade de 39 anos, elevada prevalência de excesso de peso (59,1%) e inadequações alimentares importantes, contrastando com a baixa frequência de aconselhamento (40,8%). Mas, ainda assim, os usuários aconselhados apresentaram maior adequação no consumo de balas/goma de mascar (p=0,031), refrigerante comum (p=0,036), salgados (p=0,037), temperos industrializados (p=0,005) e ovos (p=0,010). A adoção de práticas alimentares saudáveis foi mais frequente entre os mais velhos e as mulheres (

Extranodal NK/T-cell lymphoma, nasal type with extensive cardiopulmonary involvement

Extranodal NK/T-cell lymphoma, nasal type (ENKTL-NT) is a rare type of Non-Hodgkin’s lymphoma, which usually presents with extranodal involvement and affects the nasal/upper aerodigestive tract in the classical presentation. Herein, we report the case of a 31-year-old, previously healthy, male patient diagnosed with ENKTL-NT with the involvement of the lung parenchyma and heart. Unfortunately, due to the rapid disease progression, the diagnosis was performed only at the autopsy. The authors highlight the rare clinical presentation of this type of lymphoma, as well as the challenging anatomopathological diagnosis in necrotic samples

EDUCAÇÃO AMBIENTAL ALIADA AO MÉTODO DE RECUPERAÇÃO POR PLANTIO EM UMA NASCENTE LOCALIZADA NA ÁREA URBANA DO MUNICIPIO DE ITAPIRA – SP

Currently, concern for the environment is present in the lives of most of the population. Studies on the state of conservation of water sources and the structure of its riparian show is extremely important to support programs of restoration of these ecosystems. This article discusses the importance of restoring vegetation by tillage in a permanent preservation area located around two springs found in the urban perimeter of Itapira – SP through environmental education programs developed by the Department of Agriculture and Environment with the members of the Intermunicipal Consortium of Sanitation Water Circuit and surrounding residents. These vegetation belts exert barrier function and protection of watercourses, serving as ecological corridors, linking forest fragments, allowing the transit of animals and removing them from isolation and fixation of atmospheric carbon, thereby contributing to the reduction of greenhouse effect. The study seeks to further subsidize the authorities and society to raise awareness and preservation of the natural environment, since there is a lack of information and concern about the possible threat of water scarcity that is both trumpets around the world..Atualmente, a preocupação com o ambiente está presente na vida de grande parte da população. Estudos sobre o estado de conservação de nascentes e a estrutura de suas matas ciliares se mostram de extrema importância para embasar programas de recomposição desses ecossistemas.  Neste artigo discute-se a importância da recomposição vegetal por plantio direto em uma área de preservação permanente localizada ao redor de duas nascentes encontradas no perímetro urbano do município de Itapira – SP através de ações de educação ambiental desenvolvidas pela Secretaria de Agricultura e Meio Ambiente junto aos integrantes do Consorcio Intermunicipal de Saneamento Básico do Circuito das Águas e moradores do entorno. Essas faixas de vegetação exercem a função de barreira e proteção dos cursos d’água, servindo como corredores ecológicos, unindo fragmentos de matas, permitindo o trânsito de animais e retirando-os do isolamento e a fixação do carbono atmosférico, contribuindo assim para a redução do efeito-estufa. O estudo procura ainda, subsidiar as autoridades e a sociedade para a conscientização e preservação do meio natural, uma vez que há carência de informações e a preocupação com a possível ameaça de escassez hídrica que tanto se alardeia pelo mundo todo

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

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt