SUICIDE, SOCIAL TIES AND FACEBOOK: ethnographic analysis with groups on digital social media

Inserted in the field of communication in strong dialogue with socio-anthropology, from the methodological approach of ethnography to the internet, this article identifies the existence of groups on digital social media that create spaces to share content related to suicide. The main results point to three issues: first, suicide is an act of communication on the internet. Second, digital social media enables other ways of creating social bonds. These bonds, perceived as intermediate bonds, can collaborate to prevent and combat self-inflicted death. Third, the absence of institutional organizations that mediate content sharing in groups that, especially, are composed of members considered vulnerable and at risk. Mostly, these groups are occupied by young people.Insertado en el campo de la comunicación en fuerte diálogo con la socioantropología, desde el abordaje metodológico de la etnografía hasta internet, este artículo identifica la existencia de grupos en las redes sociales digitales que crean espacios para compartir contenidos relacionados con el suicidio. Los principales resultados apuntan a tres cuestiones: en primer lugar, el suicidio es un acto de comunicación en Internet. En segundo lugar, las redes sociales digitales permiten otras formas de crear vínculos sociales. Estos vínculos, percibidos como vínculos intermedios, pueden colaborar para prevenir y combatir la muerte autoinfligida. En tercer lugar, la ausencia de organizaciones institucionales que medien en el intercambio de contenido en grupos que, especialmente, están compuestos por miembros considerados vulnerables y en riesgo. En su mayoría, estos grupos están ocupados por jóvenes.Inserido no campo da comunicação em forte diálogo com a socioantropologia, a partir da abordagem metodológica de etnografia para a internet, este artigo identifica a existência de grupos na mídia social digital que criam espaços para compartilhar conteúdos relacionados ao suicídio. Os principais resultados apontam para três questões: primeiro, o suicídio é um ato de comunicação na internet. Segundo, a mídia social digital possibilita outras formas de criação de laços sociais. Esses laços, percebidos como laços intermediários, podem colaborar para a prevenção e combate da morte autoprovocada. Terceiro, a ausência de organizações institucionais mediadoras do compartilhamento de conteúdos nos grupos que, especialmente, são compostos por membros considerados vulneráveis e de risco. Majoritariamente, esses grupos são ocupados por jovens

SUICIDIO, LAZOS SOCIALES Y FACEBOOK: análisis etnográfico con grupos en redes sociales

Inserido no campo da comunicação em forte diálogo com a socioantropologia, a partir da abordagem metodológica de etnografia para a internet, este artigo identifica a existência de grupos na mídia social digital que criam espaços para compartilhar conteúdos relacionados ao suicídio. Os principais resultados apontam para três questões: primeiro, o suicídio é um ato de comunicação na internet. Segundo, a mídia social digital possibilita outras formas de criação de laços sociais. Esses laços, percebidos como laços intermediários, podem colaborar para a prevenção e combate da morte autoprovocada. Terceiro, a ausência de organizações institucionais mediadoras do compartilhamento de conteúdos nos grupos que, especialmente, são compostos por membros considerados vulneráveis e de risco. Majoritariamente, esses grupos são ocupados por jovens.Inserted in the field of communication in strong dialogue with socio-anthropology, from the methodological approach of ethnography to the internet, this article identifies the existence of groups on digital social media that create spaces to share content related to suicide. The main results point to three issues: first, suicide is an act of communication on the internet. Second, digital social media enables other ways of creating social bonds. These bonds, perceived as intermediate bonds, can collaborate to prevent and combat self-inflicted death. Third, the absence of institutional organizations that mediate content sharing in groups that, especially, are composed of members considered vulnerable and at risk. Mostly, these groups are occupied by young people.  Insertado en el campo de la comunicación en fuerte diálogo con la socioantropología, desde el abordaje metodológico de la etnografía hasta internet, este artículo identifica la existencia de grupos en las redes sociales digitales que crean espacios para compartir contenidos relacionados con el suicidio. Los principales resultados apuntan a tres cuestiones: en primer lugar, el suicidio es un acto de comunicación en Internet. En segundo lugar, las redes sociales digitales permiten otras formas de crear vínculos sociales. Estos vínculos, percibidos como vínculos intermedios, pueden colaborar para prevenir y combatir la muerte autoinfligida. En tercer lugar, la ausencia de organizaciones institucionales que medien en el intercambio de contenido en grupos que, especialmente, están compuestos por miembros considerados vulnerables y en riesgo. En su mayoría, estos grupos están ocupados por jóvenes

Pensando a etnografia na pesquisa em Comunicação:: contribuições de abordagens decoloniais e feministas

This article aims to point out contributions of decolonial thinking to rethink ethnographic research practices in Communication. For this, it is intended to produce a debate reflecting logics of field research in dialogue with Anthropology. It seeks to identify elements that can be developed in its methodological aspects and that contemplate ethical and political issues, going through the research stages through dialogic, didactic and more democratic lenses. It is understood that alternative practices combined with the decolonial perspective can be used in the development of ethnographies. Our argument seeks in decolonial theoretical conceptions to suggest that ethnography can be a more collaborative theoretical methodological approach, attentive to coloniality in research.Este artigo tem como objetivo refletir sobre a pesquisa etnográfica na Comunicação a partir de contribuições de abordagens decoloniais e feministas. Para isso, produzimos um debate acerca de lógicas de pesquisa do campo em diálogo com a Antropologia. Compreendemos a pesquisa etnográfica como uma abordagem que busca ser abrangente e que pode dar conta de aspectos holísticos, utilizando diferentes práticas de escuta, de colaboração e de escrita. Buscamos apontar, a partir de contribuições de perspectivas decoloniais e feministas, que a etnografia pode ser um processo teórico metodológico preocupado com a participação mútua e colaborativa, com as imposições interpretativas, com as lentes colonizadoras de gênero, raça e classe (principalmente, mas não apenas), e com uma linguagem e escrita mais democrática

Programa de Pós-Graduação em Enfermagem - Mestrado Profissional - Universidade Federal de Ciências da Saúde de Porto Alegre

Trata-se de um e-book que reúne a produção intelectual e técnica de professores, alunos e egressos da graduação e pós-graduação do Programa de Pós-Graduação em Enfermagem - Mestrado Profissional - da Universidade Federal de Ciências da Saúde de Porto Alegre

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Hippocampus and dentate gyrus of the Cebus monkey: architectonic and stereological study

Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratory of Investigations in Neurodegeneration and Infection. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratory of Investigations in Neurodegeneration and Infection. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratory of Investigations in Neurodegeneration and Infection. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratory of Investigations in Neurodegeneration and Infection. Belém, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil / Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratório de Neuroanatomia Funcional. Belém, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil / Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratório de Neuroanatomia Funcional. Belém, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil / Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratório de Neuroanatomia Funcional. Belém, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil / Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratório de Neuroanatomia Funcional. Belém, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil / Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratório de Neuroanatomia Funcional. Belém, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil / Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratório de Neuroanatomia Funcional. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratory of Investigations in Neurodegeneration and Infection. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratory of Investigations in Neurodegeneration and Infection. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratory of Investigations in Neurodegeneration and Infection. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratory of Investigations in Neurodegeneration and Infection. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratory of Investigations in Neurodegeneration and Infection. Belém, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil / Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratório de Neuroanatomia Funcional. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratory of Investigations in Neurodegeneration and Infection. Belém, PA, Brasil.Behavioral, electrophysiological, and anatomical assays of non-human primates have provided substantial evidence that the hippocampus and dentate gyrus are essential for memory consolidation. However, a single anatomical and stereological investigation of these regions has been done in New World primates to complement those assays. The aim of the present study was to describe the cyto-, myelo-, and histochemical architecture of the hippocampus and dentate gyrus, and to use the optical fractionator method to estimate the number of neurons in the hippocampal pyramidal and granular neurons in the dentate gyrus of the Cebus monkey. NeuN immunolabeling, lectin histochemical staining with Wisteria floribunda agglutinin (WFA), enzyme-histochemical detection of NADPH-diaphorase activity and Gallyas silver staining were used to define the layers and limits of the hippocampal fields and dentate gyrus. A comparative analysis of capuchin (Cebus apella) and Rhesus (Macaca mulatta) monkeys revealed similar structural organization of these regions but significant differences in the regional distribution of neurons. C. apella were found to have 1.3 times fewer pyramidal and 3.5 times fewer granular neurons than M. mulatta. Taken together the architectonic and stereological data of the present study suggest that hippocampal and dentate gyrus neural networks in the C. apella and M. mulatta may contribute to hippocampal-dentate gyrus-dependent tasks in different proportions

Corrigendum to Hippocampus and dentate gyrus of the Cebus monkey: architectonic and stereological study

Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratory of Investigations in Neurodegeneration and Infection. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratory of Investigations in Neurodegeneration and Infection. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratory of Investigations in Neurodegeneration and Infection. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratory of Investigations in Neurodegeneration and Infection. Belém, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil / Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratório de Neuroanatomia Funcional. Belém, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil / Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratório de Neuroanatomia Funcional. Belém, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil / Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratório de Neuroanatomia Funcional. Belém, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil / Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratório de Neuroanatomia Funcional. Belém, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil / Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratório de Neuroanatomia Funcional. Belém, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil / Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratório de Neuroanatomia Funcional. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratory of Investigations in Neurodegeneration and Infection. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratory of Investigations in Neurodegeneration and Infection. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratory of Investigations in Neurodegeneration and Infection. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratory of Investigations in Neurodegeneration and Infection. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratory of Investigations in Neurodegeneration and Infection. Belém, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil / Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratório de Neuroanatomia Funcional. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratory of Investigations in Neurodegeneration and Infection. Belém, PA, Brasil

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p &lt; 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p &lt; 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p &lt; 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease

Association of Country Income Level With the Characteristics and Outcomes of Critically Ill Patients Hospitalized With Acute Kidney Injury and COVID-19

Introduction: Acute kidney injury (AKI) has been identified as one of the most common and significant problems in hospitalized patients with COVID-19. However, studies examining the relationship between COVID-19 and AKI in low- and low-middle income countries (LLMIC) are lacking. Given that AKI is known to carry a higher mortality rate in these countries, it is important to understand differences in this population. Methods: This prospective, observational study examines the AKI incidence and characteristics of 32,210 patients with COVID-19 from 49 countries across all income levels who were admitted to an intensive care unit during their hospital stay. Results: Among patients with COVID-19 admitted to the intensive care unit, AKI incidence was highest in patients in LLMIC, followed by patients in upper-middle income countries (UMIC) and high-income countries (HIC) (53%, 38%, and 30%, respectively), whereas dialysis rates were lowest among patients with AKI from LLMIC and highest among those from HIC (27% vs. 45%). Patients with AKI in LLMIC had the largest proportion of community-acquired AKI (CA-AKI) and highest rate of in-hospital death (79% vs. 54% in HIC and 66% in UMIC). The association between AKI, being from LLMIC and in-hospital death persisted even after adjusting for disease severity. Conclusions: AKI is a particularly devastating complication of COVID-19 among patients from poorer nations where the gaps in accessibility and quality of healthcare delivery have a major impact on patient outcomes

Liver injury in hospitalized patients with COVID-19: An International observational cohort study

Background: Using a large dataset, we evaluated prevalence and severity of alterations in liver enzymes in COVID-19 and association with patient-centred outcomes.MethodsWe included hospitalized patients with confirmed or suspected SARS-CoV-2 infection from the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) database. Key exposure was baseline liver enzymes (AST, ALT, bilirubin). Patients were assigned Liver Injury Classification score based on 3 components of enzymes at admission: Normal; Stage I) Liver injury: any component between 1-3x upper limit of normal (ULN); Stage II) Severe liver injury: any component &amp; GE;3x ULN. Outcomes were hospital mortality, utilization of selected resources, complications, and durations of hospital and ICU stay. Analyses used logistic regression with associations expressed as adjusted odds ratios (OR) with 95% confidence intervals (CI).ResultsOf 17,531 included patients, 46.2% (8099) and 8.2% (1430) of patients had stage 1 and 2 liver injury respectively. Compared to normal, stages 1 and 2 were associated with higher odds of mortality (OR 1.53 [1.37-1.71]; OR 2.50 [2.10-2.96]), ICU admission (OR 1.63 [1.48-1.79]; OR 1.90 [1.62-2.23]), and invasive mechanical ventilation (OR 1.43 [1.27-1.70]; OR 1.95 (1.55-2.45). Stages 1 and 2 were also associated with higher odds of developing sepsis (OR 1.38 [1.27-1.50]; OR 1.46 [1.25-1.70]), acute kidney injury (OR 1.13 [1.00-1.27]; OR 1.59 [1.32-1.91]), and acute respiratory distress syndrome (OR 1.38 [1.22-1.55]; OR 1.80 [1.49-2.17]).ConclusionsLiver enzyme abnormalities are common among COVID-19 patients and associated with worse outcomes