Tuberculosis/HIV/AIDS coinfection in Porto Alegre, RS/Brazil - invisibility and silencing of the most affected groups

OBJECTIVE: To analyze how belonging to certain social groups contributes to constituting the vulnerabilities associated with illnesses due to tuberculosis/HIV/AIDS coinfection. METHODOLOGYThis is a qualitative study carried out in the city of Porto Alegre, state of Rio Grande do Sul, in regions of high social vulnerability. Twenty coinfected people were interviewed in specialized health services between August and December 2016. The analysis was based on the frameworks The Sound of Silence and Vulnerability and Human Rights. RESULTS: Socioeconomic conditions were decisive for the constitution of the vulnerability conditions. Processes of people invisibilization, and the silencing of their voices, in a scenario marked by economic, racial and gender inequalities, contributed for their health needs not to be understood and effectively taken into account in the services actions. FINAL CONSIDERATIONS: The more effective strategies are to legitimize voices and to understand the needs of those affected by coinfection, the greater the chances that programmatic responses to the problem will be successful

Identifying critically important vascular access outcomes for trials in haemodialysis : an international survey with patients, caregivers and health professionals

BACKGROUND: Vascular access outcomes reported across haemodialysis (HD) trials are numerous, heterogeneous and not always relevant to patients and clinicians. This study aimed to identify critically important vascular access outcomes. METHOD: Outcomes derived from a systematic review, multi-disciplinary expert panel and patient input were included in a multilanguage online survey. Participants rated the absolute importance of outcomes using a 9-point Likert scale (7-9 being critically important). The relative importance was determined by a best-worst scale using multinomial logistic regression. Open text responses were analysed thematically. RESULTS: The survey was completed by 873 participants [224 (26%) patients/caregivers and 649 (74%) health professionals] from 58 countries. Vascular access function was considered the most important outcome (mean score 7.8 for patients and caregivers/8.5 for health professionals, with 85%/95% rating it critically important, and top ranked on best-worst scale), followed by infection (mean 7.4/8.2, 79%/92% rating it critically important, second rank on best-worst scale). Health professionals rated all outcomes of equal or higher importance than patients/caregivers, except for aneurysms. We identified six themes: necessity for HD, applicability across vascular access types, frequency and severity of debilitation, minimizing the risk of hospitalization and death, optimizing technical competence and adherence to best practice and direct impact on appearance and lifestyle. CONCLUSIONS: Vascular access function was the most critically important outcome among patients/caregivers and health professionals. Consistent reporting of this outcome across trials in HD will strengthen their value in supporting vascular access practice and shared decision making in patients requiring HD

Periodontal therapy and treatment of hypertension-alternative to the pharmacological approach. A systematic review and meta-analysis

Aim: Quantitative comparison of the effects of intensive (IPT) or conventional (CPT) periodontal treatment on arterial blood pressure, endothelial function and inflammatory/metabolic biomarkers. / Materials and methods: A systematic search was conducted to identify randomized controlled trials (RCT) of IPT (supra and subgingival instrumentation). Eight RCTs were included in the meta-analysis. Difference in change of systolic blood pressure (SBP) and diastolic blood pressure (DBP) before and after IPT or CPT were the primary outcomes. The secondary outcomes included: endothelial function and selected inflammatory/anti-inflammatory (CRP, IL-6, IL-10, IFN-γ) and metabolic biomarkers (HDL, LDL, TGs). / Results: The overall effect estimates (pooled Weighted Mean Difference (WMD)) of the primary outcome for SBP and DBP was −4.3 mmHg [95%CI: −9.10–0.48], p = 0.08 and −3.16 mmHg [95%CI: −6.51–0.19], p = 0.06 respectively. These studies were characterized by high heterogeneity. Therefore, random effects model for meta-analysis was performed. Sub-group analyses confirmed statistically significant reduction in SBP [WMD = −11.41 mmHg (95%CI: −13.66, −9.15) P < 0.00001] and DBP [WMD = −8.43 mmHg (95%CI: −10.96,−5.91)P < 0.00001] after IPT vs CPT among prehypertensive/hypertensive patients, while this was not observed in normotensive individuals. The meta-analyses showed significant reductions in CRP and improvement of endothelial function following IPT at all analysed timepoints. / Conclusions: IPT leads to improvement of the cardiovascular health in hypertensive and prehypertensive individuals

Soil-induced impacts on forest structure drive coarse woody debris stocks across central Amazonia

PublishedJournal Article© 2014, © 2014 Botanical Society of Scotland and Taylor & Francis. Background: Coarse woody debris (CWD) is an essential component in tropical forest ecosystems and its quantity varies widely with forest types. Aims: Relationships among CWD, soil, forest structure and other environmental factors were analysed to understand the drivers of variation in CWD in forests on different soil types across central Amazonia. Methods: To estimate CWD stocks and density of dead wood debris, 75 permanent forest plots of 0.5 ha in size were assessed along a transect that spanned ca. 700 km in undisturbed forests from north of the Rio Negro to south of the Rio Amazonas. Soil physical properties were evaluated by digging 2-m-deep pits and by taking auger samples. Results: Soil physical properties were the best predictors of CWD stocks; 37% of its variation was explained by effective soil depth. CWD stocks had a two-fold variation across a gradient of physical soil constraints (i.e. effective soil depth, anoxia and soil structure). Average biomass per tree was related to physical soil constraints, which, in turn, had a strong relationship with local CWD stocks. Conclusions: Soil physical properties appear to control average biomass per tree (and through this affect forest structure and dynamics), which, in turn, is correlated with CWD production and stocks

Astrobiological Complexity with Probabilistic Cellular Automata

Search for extraterrestrial life and intelligence constitutes one of the major endeavors in science, but has yet been quantitatively modeled only rarely and in a cursory and superficial fashion. We argue that probabilistic cellular automata (PCA) represent the best quantitative framework for modeling astrobiological history of the Milky Way and its Galactic Habitable Zone. The relevant astrobiological parameters are to be modeled as the elements of the input probability matrix for the PCA kernel. With the underlying simplicity of the cellular automata constructs, this approach enables a quick analysis of large and ambiguous input parameters' space. We perform a simple clustering analysis of typical astrobiological histories and discuss the relevant boundary conditions of practical importance for planning and guiding actual empirical astrobiological and SETI projects. In addition to showing how the present framework is adaptable to more complex situations and updated observational databases from current and near-future space missions, we demonstrate how numerical results could offer a cautious rationale for continuation of practical SETI searches.Comment: 37 pages, 11 figures, 2 tables; added journal reference belo

Fauna used in popular medicine in Northeast Brazil

<p>Abstract</p> <p>Background</p> <p>Animal-based remedies constitute an integral part of Brazilian Traditional Medicine. Due to its long history, zootherapy has in fact become an integral part of folk medicine both in rural and urban areas of the country. In this paper we summarize current knowledge on zootherapeutic practices in Northeast of Brazil, based on information compiled from ethnobiological scientific literature.</p> <p>Methods</p> <p>In order to examine the diversity of animals used in traditional medicine in Northeast of Brazil, all available references or reports of folk remedies based on animals sources were examined. 34 sources were analyzed. Only taxa that could be identified to species level were included in assessment of medicinal animal species. Scientific names provided in publications were updated.</p> <p>Results</p> <p>The review revealed that at least 250 animal species (178 vertebrates and 72 invertebrates) are used for medicinal purposes in Northeast of Brazil. The inventoried species comprise 10 taxonomic categories and belong to 141 Families. The groups with the greatest number of species were fishes (n = 58), mammals (n = 47) and reptiles (n = 37). The zootherapeutical products are used for the treatment of different illnesses. The most widely treated condition were asthma, rheumatism and sore throat, conditions, which had a wide variety of animals to treat them with. Many animals were used for the treatment of multiple ailments. Beyond the use for treating human diseases, zootherapeutical resources are also used in ethnoveterinary medicine</p> <p>Conclusion</p> <p>The number of medicinal species catalogued was quite expressive and demonstrate the importance of zootherapy as alternative therapeutic in Northeast of Brazil. Although widely diffused throughout Brazil, zootherapeutic practices remain virtually unstudied. There is an urgent need to examine the ecological, cultural, social, and public health implications associated with fauna usage, including a full inventory of the animal species used for medicinal purposes and the socio-cultural context associated with their consumption.</p

Secular evolution versus hierarchical merging: galaxy evolution along the Hubble sequence, in the field and rich environments

In the current galaxy formation scenarios, two physical phenomena are invoked to build disk galaxies: hierarchical mergers and more quiescent external gas accretion, coming from intergalactic filaments. Although both are thought to play a role, their relative importance is not known precisely. Here we consider the constraints on these scenarios brought by the observation-deduced star formation history on the one hand, and observed dynamics of galaxies on the other hand: the high frequency of bars and spirals, the high frequency of perturbations such as lopsidedness, warps, or polar rings. All these observations are not easily reproduced in simulations without important gas accretion. N-body simulations taking into account the mass exchange between stars and gas through star formation and feedback, can reproduce the data, only if galaxies double their mass in about 10 Gyr through gas accretion. Warped and polar ring systems are good tracers of this accretion, which occurs from cold gas which has not been virialised in the system's potential. The relative importance of these phenomena are compared between the field and rich clusters. The respective role of mergers and gas accretion vary considerably with environment.Comment: 18 pages, 8 figures, review paper to "Penetrating Bars through Masks of Cosmic Dust: the Hubble Tuning Fork Strikes a New Note", Pilanesberg, ed. D. Block et al., Kluwe