7 research outputs found
Comparações de medidas de qualidade de vida entre mulheres e homens em hemodiálise
OBJETIVO: Comparar homens e mulheres, tratados cronicamente por hemodiálise, quanto a escores de qualidade de vida relacionada com saúde (QVRS) e avaliar potenciais influências da idade e comorbidades. MÉTODOS: Corte transversal dos dados da linha de base de 254 mulheres e 349 homens participantes do estudo PROHEMO, sendo desenvolvido em unidades de diálise de Salvador. Utilizando a versão do Kidney Disease Quality of Life Short Form (KDQOL-SF), validada para a população brasileira, foram determinados os escores das escalas: sumário do componente físico [PCS], sumário do componente mental [MCS] e sintomas/problemas relacionados à doença renal. Os escores do PCS e MCS foram determinados utilizando as oito escalas genéricas do KDQOL-SF. Regressão linear múltipla foi usada para estimar diferenças de escores (DE) entre homens e mulheres, ajustadas para idade, anos em hemodiálise, insuficiência cardíaca, doença cerebrovascular, diabetes, doença arterial periférica e níveis séricos de hemoglobina e albumina. RESULTADOS: Médias de idade de mulheres e homens foram, respectivamente, 48,1±14,1 e 49,4±14,0 anos. As mulheres apresentaram menores escores em todas as escalas genéricas de QVRS. Apresentaram também médias significantemente menores (POBJECTIVE: To compare men and women on chronic hemodialysis in relation to their scores in health-related quality of life (HRQOL) and evaluate the potential influence of age and comorbidities on the comparison. METHODS: Cross-section of the baseline data of 254 women and 349 men, participants of the PROHEMO Study that has been developed in dialysis units of Salvador. By using the version of the Kidney Disease Quality of Life Short Form KDQOL-SF, validated for the Brazilian population, the following scores were determined: physical component summary (PCS), mental component summary [MCS] and the scale for symptoms/problems related to renal disease. The PCS and MCS scores were derived from the eight generic KDQOL-SF scales. Multiple linear regression was used to estimate differences in the scores of men and women (DS), adjusted for age, years on hemodialysis, heart failure, cerebrovascular disease, peripheral vasculopathy, diabetes, serum hemoglobin and serum albumin. RESULTS: Mean ages were 48.1±14.1 and 49.4±14.0 years for women and men, respectively. Women had lower scores for all generic HRQOL scales. They also had significantly (P<0.001) lower scores for PCS (DS = 2.4 points), MCS (DS = 3 points) and symptoms/problems (DS = 6.6 points). Differences were independent of comorbidties and greater in the group over 49 years of age. CONCLUSION: Data indicate that for several scales of HRQOL, women treated chronically by hemodialysis had lower scores than men. Lower scores in women were observed for different age groups, independently of comorbidities
Série de casos: avaliação de uma intervenção baseada em Mindfulness no estresse percebido e qualidade de vida de estudantes de medicina: Case series: evaluation of a Mindfulness-based intervention in perceived stress and quality of life of medical students
Introdução: estudantes universitários estão submetidos ao estresse resultante da sobrecarga de atividades curriculares e da constante pressão no ambiente acadêmico, o que pode gerar efeitos negativos nos estudos, no estado emocional e na saúde. O protocolo Mindfulness Based Stress Reduction (MBSR) tem demonstrado efeitos positivos para reduzir os sintomas associados ao estresse. Objetivos: avaliar os impactos do curso “Programa On-line de Qualidade de Vida Baseado em Mindfulness” na redução do estresse e na melhora da qualidade de vida em uma amostra de estudantes de medicina. Método: trata-se de uma pesquisa descritiva, exploratória e transversal, de amostragem do tipo “por conveniência”, que recrutou 33 graduandos em medicina da Univaço (Ipatinga, MG). Foram quantificados escores de qualidade de vida, estresse percebido, atenção e consciência plenas, facetas de Mindfulness e autocompaixão, antes e após participarem de um curso on-line de Mindfulness, com duração de 8 semanas. Resultados: a amostra apresentou média de idade de 22,6 anos na pré-intervenção e de 21,8 na pós-intervenção, predomínio do sexo feminino (pré-intervenção: 66,7% e pós-intervenção: 87,5%), prevalência de graduandos do 2° ano do curso na pré-intervenção (33%) e 4° ano do curso no pós-intervenção (50%) e preponderância de indivíduos solteiros (pré-intervenção: 93,9% e pós-intervenção: 100%). Houve diminuição da média de estresse percebido (36,3 para 23,6: redução de 34,9%) e das facetas de Mindfulness (122,7 para 120.5: redução de 1,8%), além de um aumento do escore total de qualidade de vida (67,6 para 78,8: ganho de 16,6%), da atenção e consciência plenas (47,5 para 60,0: ganho de 26,3%) e da autocompaixão (71,5 para 83,3: ganho de 16,3%). Conclusão: a presente pesquisa contribui para perspectivas de que as práticas de Mindfulness estão diretamente relacionadas à diminuição dos níveis de estresse e, consequentemente, a uma melhora da qualidade de vida de estudantes universitários
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20
[1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics
Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data
NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics
Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data