Necessidade de cuidados paliativos em pacientes com insuficiência cardíaca avançada internados em um hospital terciário

Objective: To evaluate the need for palliative care in patients with advanced Congestive Heart Failure (CHF) hospitalized in a cardiology ward. Method: Application of the World Health Organization Palliative Needs tool (NECPAL) with the assistant physician, patient and/or caregiver for evaluation of indication of Palliative Care (PC). Results: 82 patients with a diagnosis of class III/IV Heart Failure or ejection fraction less than or equal to 40% in echocardiography of the last 12 months were included: Mean age 68 ± 20 years, 51 male patients and 31 female patients. Forty-three patients (52.4%) were married or in consensual union and ten (12%) lived alone. The death of 46 patients (56.1%) in the subsequent 12 months would not surprise their physician, and forty-five patients (55%) had palliative care indication according to the NECPAL. Conclusion: About half of patients hospitalized for class III/IV Heart Failure would have an indication of Palliative Care for the relief of suffering caused by the disease

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

Qualidade de vida de um grupo de elite da polícia militar no período pandêmico

Objetivo: avaliar a qualidade de vida de um grupo de elite da polícia militar no período pandêmico. Método: estudo descritivo, transversal e quantitativo, realizado em outubro a dezembro de 2020, com policiais militares da cidade de Anápolis, Goiás. Utilizou-se dois instrumentos, um para levantamento de dados sociodemográficos e outro sobre avaliação da qualidade de vida (WHOQOL-Bref). Calculou-se a média dos escores do WHOQOL-Bref conforme modelo estatístico disponibilizado pelo Grupo WHOQOL. Resultados: entre 55 policiais participantes, prevaleceu o sexo masculino (96,4%) e faixa etária de 30 a 39 anos (41,8%). Os policiais avaliaram a qualidade de vida como boa (58,2%) ou muito boa (36,4%). Informaram estarem satisfeitos (56,4%) ou muito satisfeitos (29,1%). O maior escore foi para o domínio relações sociais (79,37) e o menor para o meio ambiente (71,93). Conclusão: os policiais militares avaliados consideram a qualidade de vida boa ou muito boa, e encontram-se satisfeitos com a saúde. Há, no entanto, fragilidades encontradas na qualidade de vida