Fome no estado de Santa Catarina: evolução, raízes e perspectivas em período de múltiplas crises

O objetivo do artigo é discutir a evolução da fome em Santa Catarina à luz dosdados divulgados pelo IIº Inquérito Nacional sobre Insegurança Alimentar no Contextoda Pandemia da Covid-19 (IIº VIGISAN / 2022) da Rede Brasileira de Pesquisa emSoberania e Segurança Alimentar e Nutricional (Rede PENSSAN). O Inquérito apontouque 40,6% da população catarinense viviam com algum grau de insegurança alimentar(IA) e que 4,6% dos catarinenses viviam em situação análoga à fome (IA Grave), o quecorrespondia a 338 mil pessoas. Em uma linha histórica, essas informações mostramque a fome é persistente em Santa Catarina, apesar de ser marginalizada na agenda dosgovernos e ocultada quando mensurada pelos rendimentos salariais médios e pelosindicadores de desenvolvimento humano, para fins de comparação com as demaisunidades federativas brasileiras. Três aspectos parecem sintetizar os motivos para oaumento da fome em Santa Catarina: o desmonte das estruturas nacionais de proteçãosocial; a incompetência da gestão pública em relação à crise socioeconômica e sanitária;e a desestruturação do Sistema de Segurança Alimentar e Nutricional. A falta deinvestimento e os retrocessos nas políticas públicas de segurança alimentar e nutricionalse apoiam em um ideário negacionista da existência da fome no estado. Estruturar efortalecer políticas públicas de combate à fome e de garantia do direito humano àalimentação adequada é condição indispensável para superar a situação apresentadapelos dados do VIGISAN e evitar que novas crises e catástrofes resultem em um cenáriotão trágico como o que foi vivenciado entre 2020 e 2022

Uso de drogas ilícitas na gestação: quais os malefícios à integridade do bebê?

The aim was to describe the main negative results in the baby's integrity and in its development resulting from the use of legal/illicit drugs by the pregnant woman during pregnancy. this is an integrative literature review, with a bibliographic survey from 2015 to 2020 in databases and electronic libraries SciELO, MEDLINE, LILACS, BDENF, Index Psychology Technical-Scientific Journals and Virtual Health Library (VHL). Using the descriptors: “illicit drugs, pregnancy and children”. Ten articles that were part of the inclusion criteria were analyzed. It was evident that the consumption of legal/illicit drugs during pregnancy can cause irreversible damage to the baby/child and, despite this topic being considered an important public health problem, it lacks studies, and further research is needed for greater understanding of this situation.Objetivou-se descrever os principais resultados negativos na integridade do bebê e no seu desenvolvimento decorrentes do uso de drogas lícitas/ilícitas pela gestante durante a gravidez. trata-se de uma revisão integrativa da literatura, com levantamento bibliográfico do período de 2015 a 2020 nas bases de dados e bibliotecas eletrônicas SciELO, MEDLINE, LILACS, BDENF, Index Psicologia Periódicos Técnico-Científicos e Biblioteca Virtual de Saúde (BVS). Utilizando os descritores: “drogas ilícitas, gravidez e crianças”. Foram analisados 10 artigos que fizeram parte dos critérios de inclusão. Evidenciou-se que o consumo de drogas lícitas/ilícitas durante a gravidez pode acarretar danos irreversíveis ao bebê/criança e, que apesar desse tema ser considerado um importante problema de saúde pública, carece de estudos, sendo necessário então, novas pesquisas para um maior entendimento dessa conjuntura

Uso de drogas ilícitas na gestação: quais os malefícios à integridade do bebê?

The aim was to describe the main negative results in the baby's integrity and in its development resulting from the use of legal/illicit drugs by the pregnant woman during pregnancy. this is an integrative literature review, with a bibliographic survey from 2015 to 2020 in databases and electronic libraries SciELO, MEDLINE, LILACS, BDENF, Index Psychology Technical-Scientific Journals and Virtual Health Library (VHL). Using the descriptors: “illicit drugs, pregnancy and children”. Ten articles that were part of the inclusion criteria were analyzed. It was evident that the consumption of legal/illicit drugs during pregnancy can cause irreversible damage to the baby/child and, despite this topic being considered an important public health problem, it lacks studies, and further research is needed for greater understanding of this situation.Objetivou-se descrever os principais resultados negativos na integridade do bebê e no seu desenvolvimento decorrentes do uso de drogas lícitas/ilícitas pela gestante durante a gravidez. trata-se de uma revisão integrativa da literatura, com levantamento bibliográfico do período de 2015 a 2020 nas bases de dados e bibliotecas eletrônicas SciELO, MEDLINE, LILACS, BDENF, Index Psicologia Periódicos Técnico-Científicos e Biblioteca Virtual de Saúde (BVS). Utilizando os descritores: “drogas ilícitas, gravidez e crianças”. Foram analisados 10 artigos que fizeram parte dos critérios de inclusão. Evidenciou-se que o consumo de drogas lícitas/ilícitas durante a gravidez pode acarretar danos irreversíveis ao bebê/criança e, que apesar desse tema ser considerado um importante problema de saúde pública, carece de estudos, sendo necessário então, novas pesquisas para um maior entendimento dessa conjuntura

Quais razões levam jovens universitários da área de saúde a fazerem uso de automedicação?

The aim was to identify the reasons that lead to self-medication in students in the health area, and to catalog the main medications used. This is an integrative literature review that identified articles related to the subject in the Virtual Health Library (VHL) database. They were selected by the descriptors: Self-medication, University and Analgesics, between the periods of 2015 to 2020, in Portuguese, English and Spanish. Incomplete texts, duplicates and theses were used as exclusion criteria. Totaling 10 eligible articles. It resulted from the synthesis of articles ordered by means of tables, in which it was possible to evidence a high prevalence of self-medication among university students, drug classes, and their determinants. In conclusion, there was a need to implement educational actions to clarify the risk related to self-medication.Objetivou-se identificar os motivos que conduzem a automedicação em estudantes na área da saúde, e catalogar os principais medicamentos utilizados. Trata-se de uma revisão integrativa da literatura que identificou na base de dados da Biblioteca Virtual em Saúde (BVS) artigos relacionados a temática. Foram selecionados mediante os descritores: Automedicação, Universidade e Analgésicos, entre os períodos de 2015 a 2020, em Português, Inglês e Espanhol. Foram utilizados como critérios de exclusão textos incompletos, duplicados e teses. Totalizando 10 artigos elegíveis. Resultou-se através da síntese dos artigos ordenados por meio de tabelas, nos quais, foi possível evidenciar alta prevalência da automedicação entre os universitários, as classes medicamentosas, e seus determinantes. Por conclusão, constatou-se a necessidade de implementar ações educacionais para o esclarecimento do risco relacionado a automedicação

Quais razões levam jovens universitários da área de saúde a fazerem uso de automedicação?

The aim was to identify the reasons that lead to self-medication in students in the health area, and to catalog the main medications used. This is an integrative literature review that identified articles related to the subject in the Virtual Health Library (VHL) database. They were selected by the descriptors: Self-medication, University and Analgesics, between the periods of 2015 to 2020, in Portuguese, English and Spanish. Incomplete texts, duplicates and theses were used as exclusion criteria. Totaling 10 eligible articles. It resulted from the synthesis of articles ordered by means of tables, in which it was possible to evidence a high prevalence of self-medication among university students, drug classes, and their determinants. In conclusion, there was a need to implement educational actions to clarify the risk related to self-medication.Objetivou-se identificar os motivos que conduzem a automedicação em estudantes na área da saúde, e catalogar os principais medicamentos utilizados. Trata-se de uma revisão integrativa da literatura que identificou na base de dados da Biblioteca Virtual em Saúde (BVS) artigos relacionados a temática. Foram selecionados mediante os descritores: Automedicação, Universidade e Analgésicos, entre os períodos de 2015 a 2020, em Português, Inglês e Espanhol. Foram utilizados como critérios de exclusão textos incompletos, duplicados e teses. Totalizando 10 artigos elegíveis. Resultou-se através da síntese dos artigos ordenados por meio de tabelas, nos quais, foi possível evidenciar alta prevalência da automedicação entre os universitários, as classes medicamentosas, e seus determinantes. Por conclusão, constatou-se a necessidade de implementar ações educacionais para o esclarecimento do risco relacionado a automedicação

Multidimensional evaluation of a 12-month intensive outpatient program for the treatment of substance use disorder. Experience in Argentina

Objetivo: Evaluar la eficacia de un tratamiento ambulatorio intensivo (TAI) para el trastorno por uso de sustancias (TUS) utilizando un enfoque multidimensional. Métodos: Se incluyeron todos los pacientes admitidos consecutivamente en una institución privada entre mayo de 2019 y mayo de 2020. El programa duró 12 meses y consistió en un conjunto de intervenciones médicas, psicosociales y recreativas, con una intensidad ≥ 9 horas/semana. La eficacia fue evaluada comparando los puntajes en el Índice de Severidad de Adicción (ASI) a lo largo del programa y en el cuestionario WHOQOL-Bref al inicio y al finalizar. En 15 pacientes se realizó una nueva medición seis meses después de concluido el tratamiento. Resultados: se incluyeron 41 participantes (73% hombres, edad 42,8 ± 16 años). 14 participantes abandonaron (media 88 días). En los participantes que completaron el tratamiento, se observaron mejoras en los índices de alcohol y drogas (a los 3 meses), en problemas médicos (a los 6 meses), en las relaciones sociales y familiares (a los 9 meses) y en problemas psicológicos (a los 12 meses) así como en las cuatro dimensiones del WHOQOL-Bref. Estas mejoras persistieron en la evaluación 6 meses post-alta cuando sólo un empeoramiento leve en la dimensión de problemas psicológicos del ASI fue objetivado. Conclusión: Este es uno de los pocos estudios realizados en un ámbito latinoamericano que evalúa la eficacia de un TAI para el TUS. Confirma trabajos previos de países desarrollados, mostrando los beneficios potenciales de la implementación de TAIs en nuestra región.Objective: The purpose of this study was to asess the efficacy of an intensive outpatient treatment (IOT) for substance use disorder (SUD) using a multidimensional approach. Methods: All the patients consecutively admitted to a private institution between May 2019 and May 2020 were invited to participate in the study. The program consisted in a 12-month set of psychosocial, medical and recreative interventions requiring an attendance of at least 9 hours per week. Efficacy was evaluated at admission and every three months by the Addiction Severity Index (ASI). Quality of life was evaluated at admission and at the end of the treatment by the WHOQOL-Bref questionnaire. A comparison of parameters obtained at admission between the group that completed and the one that abandonned the treatment was also performed to detect potential predictors of early dropout. Six months after the end of the treatment, the participants were contacted in order to repeat an evaluation through the ASI and the WHOQOL-Bref scales. Results: 41 participants (73% male, age 42.8 ± 16 years) were included. 14 participants dropped out at a median time of 88 days. Among those who completed the treatment improvements were observed in different clinical dimensions: in alcohol and drug consumption (3 months), in medical problems (6 months), in family/social relationships (9 months), in psychological scores (12 months) and in the four dimensions of WHOQOL-Bref. No changes were observed in legal problems and in the employment status. Only legal problems and family/social relationships at admission were significantly different among patients who completed versus those who dropped-out. Six months after discharge, no differences in WHOQOL-Bref scores were observed in the 15 participants who could be located and accepted the assessment. A little but statistically significant worsening was observed in the psychological problems dimension of the ASI in post-discharge follow-up. The rest of the ASI dimensions remained unchanged 6 months after concluding the treatment. Conclusion: This is one of the few studies performed in a latinamerican setting assessing the efficacy of a long-term IOT for SUD. It confirms previous works from developed countries, showing the potential benefits of IOTs implementation in our region.Fil: Pavlovsky, Federico. No especifíca;Fil: Irazoqui, Gustavo. No especifíca;Fil: Faur, Rebeca. No especifíca;Fil: Groisman, Rafael. No especifíca;Fil: Sullivan machado, Oriana. No especifíca;Fil: Gersberg, Laura. No especifíca;Fil: Mirelman, Marcelo. No especifíca;Fil: Gargiulo, Verónica. No especifíca;Fil: Rabade, Berenice. No especifíca;Fil: Habib, Martin. No especifíca;Fil: Berrio Cuartas, Diana Milena. No especifíca;Fil: Garcia, Luciana. No especifíca;Fil: Wikinski, Silvia Ines. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Farmacologia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Association Between Race/Ethnicity and COVID-19 Outcomes in Systemic Lupus Erythematosus Patients From the United States: Data From the COVID-19 Global Rheumatology Alliance

OBJECTIVE: To determine the association between race/ethnicity and COVID-19 outcomes in individuals with systemic lupus erythematosus (SLE). METHODS: Individuals with SLE from the US with data entered into the COVID-19 Global Rheumatology Alliance registry between March 24, 2020 and August 27, 2021 were included. Variables included age, sex, race, and ethnicity (White, Black, Hispanic, other), comorbidities, disease activity, pandemic time period, glucocorticoid dose, antimalarials, and immunosuppressive drug use. The ordinal outcome categories were: not hospitalized, hospitalized with no oxygenation, hospitalized with any ventilation or oxygenation, and death. We constructed ordinal logistic regression models evaluating the relationship between race/ethnicity and COVID-19 severity, adjusting for possible confounders. RESULTS: We included 523 patients; 473 (90.4%) were female and the mean ± SD age was 46.6 ± 14.0 years. A total of 358 patients (74.6%) were not hospitalized; 40 patients (8.3%) were hospitalized without oxygen, 64 patients (13.3%) were hospitalized with any oxygenation, and 18 (3.8%) died. In a multivariable model, Black (odds ratio [OR] 2.73 [95% confidence interval (95% CI) 1.36–5.53]) and Hispanic (OR 2.76 [95% CI 1.34–5.69]) individuals had higher odds of more severe outcomes than White individuals. CONCLUSION: Black and Hispanic individuals with SLE experienced more severe COVID-19 outcomes, which is consistent with findings in the US general population. These results likely reflect socioeconomic and health disparities and suggest that more aggressive efforts are needed to prevent and treat infection in this population

Geographic patterns of tree dispersal modes in Amazonia and their ecological correlates

Aim: To investigate the geographic patterns and ecological correlates in the geographic distribution of the most common tree dispersal modes in Amazonia (endozoochory, synzoochory, anemochory and hydrochory). We examined if the proportional abundance of these dispersal modes could be explained by the availability of dispersal agents (disperser-availability hypothesis) and/or the availability of resources for constructing zoochorous fruits (resource-availability hypothesis). Time period: Tree-inventory plots established between 1934 and 2019. Major taxa studied: Trees with a diameter at breast height (DBH) ≥ 9.55 cm. Location: Amazonia, here defined as the lowland rain forests of the Amazon River basin and the Guiana Shield. Methods: We assigned dispersal modes to a total of 5433 species and morphospecies within 1877 tree-inventory plots across terra-firme, seasonally flooded, and permanently flooded forests. We investigated geographic patterns in the proportional abundance of dispersal modes. We performed an abundance-weighted mean pairwise distance (MPD) test and fit generalized linear models (GLMs) to explain the geographic distribution of dispersal modes. Results: Anemochory was significantly, positively associated with mean annual wind speed, and hydrochory was significantly higher in flooded forests. Dispersal modes did not consistently show significant associations with the availability of resources for constructing zoochorous fruits. A lower dissimilarity in dispersal modes, resulting from a higher dominance of endozoochory, occurred in terra-firme forests (excluding podzols) compared to flooded forests. Main conclusions: The disperser-availability hypothesis was well supported for abiotic dispersal modes (anemochory and hydrochory). The availability of resources for constructing zoochorous fruits seems an unlikely explanation for the distribution of dispersal modes in Amazonia. The association between frugivores and the proportional abundance of zoochory requires further research, as tree recruitment not only depends on dispersal vectors but also on conditions that favour or limit seedling recruitment across forest types