Common mental disorders and sociodemographic characteristics: baseline findings of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Objective: To assess the prevalence of common mental disorders (CMD) and the association of CMD with sociodemographic characteristics in the Brazilian Longitudinal Study of Adult Health (ELSABrasil) cohort. Methods: We analyzed data from the cross-sectional baseline assessment of the ELSA-Brasil, a cohort study of 15,105 civil servants from six Brazilian cities. The Clinical Interview Schedule-Revised (CIS-R) was used to investigate the presence of CMD, with a score X 12 indicating a current CMD (last week). Specific diagnostic algorithms for each disorder were based on the ICD-10 diagnostic criteria. Prevalence ratios (PR) of the association between CMD and sociodemographic characteristics were estimated by Poisson regression. Results: CMD (CIS-R score X 12) was found in 26.8% (95% confidence intervals [95%CI] 26.1-27.5). The highest burden occurred among women (PR 1.9; 95%CI 1.8-2.0), the youngest (PR 1.7; 95%CI 1.5-1.9), non-white individuals, and those without a university degree. The most frequent diagnostic category was anxiety disorders (16.2%), followed by depressive episodes (4.2%). Conclusion: The burden of CMD was high, particularly among the more socially vulnerable groups. These findings highlight the need to strengthen public policies aimed to address health inequities related to mental disorders

Caregiver perceptions of children who have complex communication needs following a home-based intervention using augmentative and alternative communication in rural Kenya: an intervention note:Home-based intervention using AAC in rural Kenya

A high level of unmet communication need exists amongst children with developmental disabilities in sub-Saharan Africa. This study investigated preliminary evidence of the impact associated with a home-based, caregiver-implemented intervention employing AAC methods, with nine children in rural Kenya who have complex communication needs. The intervention used mainly locally-sourced low-tech materials, and was designed to make use of the child's strengths and the caregiver's natural expertise. A pretest-posttest design was used in the study. Data were gathered using an adapted version of the Communication Profile, which was based on the International Classification of Functioning, Disability, and Health (ICF) framework. The non-parametric Wilcoxon signed-rank test was applied to data from the first two sections of the Communication Profile-Adapted. Qualitative analysis was conducted on the final section. The data provided evidence of statistically significant positive changes in caregiver perceptions of communication at the levels of Body Structure and Function, and Activities for Communication. Also, analysis of the Participation for Communication section revealed some expansion to the children's social activities. The potential impact of the home-based intervention would benefit from investigation on a larger scale. Limitations of the study are discussed

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Supporting the aviation industry: a traveler-centered approach

The aviation industry is fundamental to today's connected global economies, rapidly and effectively linking people, places and cultures. However, aviation struggles to provide a high quality of service; air travelers typically report dissatisfaction and frustration with their experiences. This paper describes fieldwork in the form of 63 interviews that aims to understand the needs of air travelers in order to improve user experiences during and around air travel. Three themes from this traveler-centered user research process are presented and the design of FlyTalk, a mobile phone application inspired by this data and tailored to the needs of air travelers is described. FlyTalk collates existing information about airports and their procedures, presents this to users in a location and context aware interface and seamlessly integrates social media features connecting travelers with both their service providers and each other. This paper argues air travel is an important but overlooked domain for HCI practitioners and that mobile applications that meet user needs in this scenario have the potential to reduce travel costs while improving traveler satisfaction

The availability of teaching–pedagogical resources used for promotion of learning in teaching human anatomy

José Aderval Aragão,1,5 Ana Terra Fonseca-Barreto,2 Ciro José Brito,1,3 Danilo Ribeiro Guerra,1 José Carlos Nunes-Mota,4 Francisco Prado Reis5 1Master's Degree Program in Physical Education, Universidade Federal de Sergipe (UFS), Aracaju, Sergipe, Brazil; 2School of Medicine, Universidade Federal de Sergipe (UFS), Aracaju, Sergipe, Brazil; 3Department of Physical Education, Universidade Federal de Sergipe (UFS), Aracaju, Sergipe, Brazil; 4Department of Morphology, (UFS), Aracaju, Sergipe, Brazil; 5School of Medicine, Universidade Tiradentes (UNIT), Aracaju, Sergipe, Brazil Abstract: Five hundred students attending higher education institutions in northeastern Brazil responded to questionnaires about their anatomy classes; students represented a variety of different health sciences disciplines. Analysis of the responses revealed the participation of teaching assistants in a large percentage of classes and the use of teaching resources, particularly images, from conventional radiographs to magnetic resonance images. The number of classes for cadaver dissection and the number of students with access to that type of class were small. In most cases, dissection was performed according to anatomic regions or systems. Medicine and nursing students had the highest number of practical dissection classes. Most students were assessed using practical and theoretical tests. Findings revealed conditions similar to those found elsewhere. Resources should be renewed and used to improve teaching for students whose courses demand the study of human anatomy. Keywords: educational assessments, gross anatomy, dissection, education medical undergraduate, anatomic model

Avaliação da competência de idosos diabéticos para o autocuidado

Estudo descritivo, de corte transversal e correlacional, que objetivou avaliar as competências de idosos com diabetes para o autocuidado, por meio da utilização da Escala para Identificação da Competência do Diabético para o Autocuidado, e os fatores pessoais associados ao resultado. A população do estudo foi composta por idosos cadastrados nas unidades básicas de saúde de Fortaleza, CE, Brasil. Da amostra, apenas 6% dos idosos foram considerados competentes para o autocuidado em diabetes e os fatores que se destacaram como influenciadores de baixa pontuação foram a baixa escolaridade e a diminuição da acuidade visual. Conforme os resultados, devido ao reduzido número de idosos considerados competentes para a prática do autocuidado, verifica-se a importância do desenvolvimento de ações de promoção da saúde direcionados para essa parcela da população, devendo-se estimular a prática do autocuidado, bem como avaliar as competências para execução da mesma, de modo a facilitar o direcionamento de ações de saúde

Ocean Eddies' Influence on Lula Field, Santos Basin, Brazil

ABSTRACT Current data measured by an instrumented mooring line deployed at the Santos Basin, in a water depth of 2200 m, show a mean velocity of 0.20 m/s with no preferential direction. Extreme current events detected were associated with the presence of a pair of eddies with a dipole configuration. The jet stream created by the interaction of the cyclone-anticyclone pair was able to generate speeds up to 1.2 m/s at the first hundred meters of the water column. An investigative study with sea surface height anomaly fields processed from environmental satellites clearly shows the eddy structure during extreme current events