Repercussões de doença renal crônica na rotina familiar de crianças em hemodiálise

The objective of this research was to analyze the repercussions of Chronic Kidney Disease (CKD) on the routines of families with children on hemodialysis treatment. It is an exploratory study and the method used was the qualitative approach. The 10 participants were responsible for/the primary caretaker of children with CKD undergoing hemodialysis treatment in a reference hospital for the treatment of pediatric kidney diseases, located in Belém/PA. The categories which emerged during the research process pointed out the main changes that occurred in the family routine according to the perception of the caretaker. Such categories were divided into: “The perception of the caretakers on the main changes in the family routine”, “The most worrying days”, and “The calmest days”. These categories include the abandonment of significant activities, modifications in the daily life routine such as eating habits, moving to a different city and hence the separation of the child and the caretaker from other family members. Thus, the knowledge of this rarely explored topic by occupational therapists is considered relevant as, once the occupational repercussions of CKD in the family routine are known, interventions can be enhanced, which could support a more humanized and systematic care. Nesta pesquisa objetivou-se analisar as repercussões da DRC na rotina familiar de crianças em tratamento de hemodiálise. Trata-se de um estudo exploratório, com abordagem qualitativa dos dados. Participaram 10 responsáveis/cuidadores principais de crianças com DRC em tratamento de hemodiálise, em um hospital de referência no tratamento de doenças renais pediátricas em Belém/PA. As categorias analisadas evidenciam a percepção das cuidadoras sobre as principais alterações na rotina familiar, são elas: “A percepção das cuidadoras sobre as principais alterações na rotina familiar”; “Os dias mais preocupantes” e “Os dias mais tranquilos”. Seus conteúdos incluem o abandono de atividades significativas, alterações nas Atividades de Vida Diária como alimentação, a mudança de cidade e consequentemente o afastamento da criança e cuidadora dos demais membros da família. Considera-se relevante o conhecimento deste tema pelos terapeutas ocupacionais pois, uma vez conhecidas as repercussões ocupacionais da DRC na rotina familiar as intervenções podem ser aprimoradas e favorecer uma atenção mais humanizada e sistematizada

Prevalência do infarto agudo do miocárdio em mulheres e fatores de risco associados

This article aims to analyze the risk factors associated with acute myocardial infarction in women. The study is an Integrative Literature Review based on a retrospective cross-sectional study of a descriptive nature and a qualitative data approach. The research was carried out in six stages: elaboration of the research question; search and sampling – establishment of inclusion and exclusion criteria; data extraction; evaluation and critical analysis of the data obtained; analysis and synthesis of studies with interpretation of results; presentation of the review. For the guiding research question, the PICO strategy was considered. The selection of articles was made in the databases PubMed, Medical Literature Analysis and Retrievel System Online (MedLine), Science Direct and Latin American and Caribbean Literature in Health Sciences (Lilacs). In the search strategy, combinations of descriptors were considered according to the indications of each database, namely the Health Sciences Descriptors (DeCS) of the Virtual Health Library (VHL) and Medical Subject Headings (MeSH). The most prevalent risk factors associated with acute myocardial infarction in women are: advanced age, hormone replacement therapy, use of oral contraceptives, genetic predisposition and emotional overload. Therefore, it is important to encourage health education related to search strategies aimed at early diagnosis of this clinical condition in females. Targeted anamnesis is essential for the aforementioned condition in order to obtain a good prognosis.Este artículo tiene como objetivo analizar los factores de riesgo asociados al infarto agudo de miocardio en la mujer. El estudio es una Revisión Integrativa de la Literatura basada en un estudio transversal retrospectivo de carácter descriptivo y enfoque de datos cualitativos. La investigación se desarrolló en seis etapas: elaboración de la pregunta de investigación; búsqueda y muestreo – establecimiento de criterios de inclusión y exclusión; extracción de datos; evaluación y análisis crítico de los datos obtenidos; análisis y síntesis de estudios con interpretación de resultados; presentación de la reseña. Para la pregunta rectora de la investigación se consideró la estrategia PICO. La selección de artículos se realizó en las bases de datos PubMed, Medical Literature Analysis and Retrievel System Online (MedLine), Science Direct y Latin American and Caribbean Literature in Health Sciences (Lilacs). En la estrategia de búsqueda se consideraron combinaciones de descriptores según las indicaciones de cada base de datos, concretamente los Descriptores en Ciencias de la Salud (DeCS) de la Biblioteca Virtual en Salud (BVS) y los Medical Subject Headings (MeSH). Los factores de riesgo más prevalentes asociados al infarto agudo de miocardio en la mujer son: edad avanzada, terapia de reemplazo hormonal, uso de anticonceptivos orales, predisposición genética y sobrecarga emocional. Por lo tanto, es importante incentivar la educación en salud relacionada con estrategias de búsqueda encaminadas al diagnóstico precoz de esta condición clínica en el sexo femenino. La anamnesis dirigida es fundamental para obtener un buen pronóstico de la enfermedad antes mencionada.Este artigo tem por objetivo analisar os fatores de risco associados ao infarto agudo do miocárdio em mulheres. O estudo se trata de uma Revisão Integrativa de Literatura baseada em um estudo transversal retrospectivo de caráter descritivo e abordagem qualitativa dos dados. A pesquisa foi realizada em seis etapas: elaboração da questão de pesquisa; busca e amostragem – estabelecimento de critérios de inclusão e exclusão; extração de dados; avaliação e análise crítica dos dados obtidos; análise e síntese dos estudos com interpretação dos resultados; apresentação da revisão. Para a questão norteadora da pesquisa, foi considerada a estratégia PICO. A seleção dos artigos foi feita nas bases de dados PubMed, Medical Literature Analysis and Retrievel System Online (MedLine), Science Direct e Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs). Na estratégia de busca foram consideradas combinações de descritores conforme as indicações de cada base de dados, sendo eles os Descritores em Ciências da Saúde (DeCS) da  Biblioteca Virtual em Saúde (BVS) e Medical Subject Headings (MeSH). Os fatores de risco mais prevalentes associados ao infarto agudo do miocárdio em mulheres são: idade avançada, terapia de reposição hormonal, uso de anticoncepcionais orais, predisposição genética e sobrecarga emocional. Dessa forma, é importante o estímulo da educação em saúde relacionada a estratégias de busca que visem o diagnóstico precoce dessa condição clínica no sexo feminino. A anamnese direcionada é fundamental para o quadro supracitado a fim de se obter bom prognóstico

SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio

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 un derstanding 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,5–7 vast areas of the tropics remain understudied.8–11 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 underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities 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 or ganism 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 ne glected 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 lostinfo:eu-repo/semantics/publishedVersio

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

Geography and ecology shape the phylogenetic composition of Amazonian tree communities

Aim: Amazonia hosts more tree species from numerous evolutionary lineages, both young and ancient, than any other biogeographic region. Previous studies have shown that tree lineages colonized multiple edaphic environments and dispersed widely across Amazonia, leading to a hypothesis, which we test, that lineages should not be strongly associated with either geographic regions or edaphic forest types. Location: Amazonia. Taxon: Angiosperms (Magnoliids; Monocots; Eudicots). Methods: Data for the abundance of 5082 tree species in 1989 plots were combined with a mega-phylogeny. We applied evolutionary ordination to assess how phylogenetic composition varies across Amazonia. We used variation partitioning and Moran\u27s eigenvector maps (MEM) to test and quantify the separate and joint contributions of spatial and environmental variables to explain the phylogenetic composition of plots. We tested the indicator value of lineages for geographic regions and edaphic forest types and mapped associations onto the phylogeny. Results: In the terra firme and várzea forest types, the phylogenetic composition varies by geographic region, but the igapó and white-sand forest types retain a unique evolutionary signature regardless of region. Overall, we find that soil chemistry, climate and topography explain 24% of the variation in phylogenetic composition, with 79% of that variation being spatially structured (R$^{2}$ = 19% overall for combined spatial/environmental effects). The phylogenetic composition also shows substantial spatial patterns not related to the environmental variables we quantified (R$^{2}$ = 28%). A greater number of lineages were significant indicators of geographic regions than forest types. Main Conclusion: Numerous tree lineages, including some ancient ones (>66 Ma), show strong associations with geographic regions and edaphic forest types of Amazonia. This shows that specialization in specific edaphic environments has played a long-standing role in the evolutionary assembly of Amazonian forests. Furthermore, many lineages, even those that have dispersed across Amazonia, dominate within a specific region, likely because of phylogenetically conserved niches for environmental conditions that are prevalent within regions

Geography and ecology shape the phylogenetic composition of Amazonian tree communities

AimAmazonia hosts more tree species from numerous evolutionary lineages, both young and ancient, than any other biogeographic region. Previous studies have shown that tree lineages colonized multiple edaphic environments and dispersed widely across Amazonia, leading to a hypothesis, which we test, that lineages should not be strongly associated with either geographic regions or edaphic forest types.LocationAmazonia.TaxonAngiosperms (Magnoliids; Monocots; Eudicots).MethodsData for the abundance of 5082 tree species in 1989 plots were combined with a mega-phylogeny. We applied evolutionary ordination to assess how phylogenetic composition varies across Amazonia. We used variation partitioning and Moran's eigenvector maps (MEM) to test and quantify the separate and joint contributions of spatial and environmental variables to explain the phylogenetic composition of plots. We tested the indicator value of lineages for geographic regions and edaphic forest types and mapped associations onto the phylogeny.ResultsIn the terra firme and várzea forest types, the phylogenetic composition varies by geographic region, but the igapó and white-sand forest types retain a unique evolutionary signature regardless of region. Overall, we find that soil chemistry, climate and topography explain 24% of the variation in phylogenetic composition, with 79% of that variation being spatially structured (R2 = 19% overall for combined spatial/environmental effects). The phylogenetic composition also shows substantial spatial patterns not related to the environmental variables we quantified (R2 = 28%). A greater number of lineages were significant indicators of geographic regions than forest types.Main ConclusionNumerous tree lineages, including some ancient ones (>66 Ma), show strong associations with geographic regions and edaphic forest types of Amazonia. This shows that specialization in specific edaphic environments has played a long-standing role in the evolutionary assembly of Amazonian forests. Furthermore, many lineages, even those that have dispersed across Amazonia, dominate within a specific region, likely because of phylogenetically conserved niches for environmental conditions that are prevalent within regions

Uso de telas pela população pediátrica e seus impactos oftalmológicos a curto e a longo prazo: uma revisão sistemática : Use of screens by the pediatric population and its short and long-term ophthalmological impacts: a systematic review

Ao se discorrer sobre a formação e formatação da nossa sociedade, pode-se notar que cada vez mais esta está permeada pela tecnologia e pelos sistemas integrativos, processo esse benéfico para comunicação, gestão e tomada de decisões para além de ser uma ferramenta de trabalho e entretenimento, porém, com a progressiva quantidade de horas que ficamos expostos a este tipo de tecnologia também podem acarretar prejuízos a acuidade visual dos usuários. Juntamente a isso, nota-se que as crianças estão tendo cada vez mais precocemente acesso os equipamentos eletrônicos e deixando de lado as brincadeiras, desta forma a partir de uma pesquisa qualitativa, feita a partir de um levantamento bibliográfico, pode-se dispor que esta busca compreender quais são os sintomas e efeitos do uso excessivo deste tipo de ferramenta e algumas formas de tratamento e profilaxia que podem ser dispostas sobre o tema, com enfoque na população pediátrica

Mapping density, diversity and species-richness of the Amazon tree flora

Using 2.046 botanically-inventoried tree plots across the largest tropical forest on Earth, we mapped tree species-diversity and tree species-richness at 0.1-degree resolution, and investigated drivers for diversity and richness. Using only location, stratified by forest type, as predictor, our spatial model, to the best of our knowledge, provides the most accurate map of tree diversity in Amazonia to date, explaining approximately 70% of the tree diversity and species-richness. Large soil-forest combinations determine a significant percentage of the variation in tree species-richness and tree alpha-diversity in Amazonian forest-plots. We suggest that the size and fragmentation of these systems drive their large-scale diversity patterns and hence local diversity. A model not using location but cumulative water deficit, tree density, and temperature seasonality explains 47% of the tree species-richness in the terra-firme forest in Amazonia. Over large areas across Amazonia, residuals of this relationship are small and poorly spatially structured, suggesting that much of the residual variation may be local. The Guyana Shield area has consistently negative residuals, showing that this area has lower tree species-richness than expected by our models. We provide extensive plot meta-data, including tree density, tree alpha-diversity and tree species-richness results and gridded maps at 0.1-degree resolution