Acesso da população LGBTQ+ aos serviços públicos de saúde: entraves e perspectivas

Garantir o atendimento à saúde é uma prerrogativa de todos os cidadãos. Como forma de cumprimento desse direito foi criada pelo Ministério da Saúde, a Política Nacional de Saúde LGBTQIA+, vindo a tornar-se um grande diferencial desta população. Objetivou-se descrever as dificuldades de acesso da população LGBTQIA+ aos serviços públicos de saúde. O presente estudo tratou-se de uma revisão integrativa de literatura dos anos de 2016 a 2020, desenvolvida através de busca em acervos disponíveis online, nas bases de dados LILACS, BDENF, SciELO e MEDLINE, entre os meses de fevereiro a outubro de 2020. Os principais fatores que dificultam o acesso da população LGBTQIA+ aos serviços de saúde. A ausência de integralidade e humanização no atendimento, discriminação e preconceito, não aceitação do profissional à opção de gênero do paciente e práticas de violência psicológica, verbal e emocional. Cabe ao Estado e às instituições de saúde realizar treinamento, bem como abordar a temática na graduação, para que sejam reduzidas as incidências discriminatórias e preconceituosas contra a população LGBTQ+, além de proporcionar-lhes maior acessibilidade à sua saúde. &nbsp

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

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

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

ANÁLISE DO PERFIL EPIDEMIOLÓGICO DE MENINGITE NA REGIÃO METROPOLITANA DE BELÉM-PA EM UM PERÍODO DE 10 ANOS (2010 A 2019).

OBJETIVO: Avaliar o perfil epidemiológico da meningite na Região Metropolitana de Belém-PA (RMB) entre o período de 2010 e 2019. MÉTODOS: Trata-se de um estudo ecológico, quantitativo e descritivo. Foram coletados dados das notificações de meningite atendidas na RMB no período entre 2010 e 2019 disponibilizados no Sistema de Informação de Agravos de Notificação (SINAN). Os dados foram tabulados em planilhas do Microsoft Office Excel 2019 e do BioEstat v5.3, nos quais as análises estatísticas (média, desvio padrão e teste-t) foram feitas. Posteriormente, houve a interpretação dos dados conforme os objetivos. RESULTADOS: A meningite na RMB apresentou caráter endêmico - notado pelo contínuo aparecimento anual de novos casos - alta incidência (15,55 casos /100mil hab.) e aumento significativo do número de notificações no período estudado. A maioria dos casos atendidos era proveniente do município de Belém, da cor parda, do sexo masculino e das faixas entre 20 e 39 anos e menores de 14 anos. Quanto a etiologia, as meningites bacterianas foram as mais comuns. E, dentre elas, foi predominante a meningite tuberculosa, seguida das meningocócica e pneumocócica. Por fim, foi encontrado um percentual importante da mortalidade por meningite (11,6%). CONCLUSÃO: A meningite se mostrou ainda ser um considerável problema de saúde pública na RMB. Os resultados sugerem a necessidade da intensificação de ações de combate na região, principalmente por meio de ações preventivas, como intensificação de campanhas de vacinação e de campanhas educativas sobre essa doença e a importância de seguir corretamente o calendário vacinal

Chromium accumulation in maize and cowpea after successive applications of composted tannery sludge

<div><p>ABSTRACT. Chromium (Cr) accumulation in soil and plants has been reported after successive applications of tannery sludge, which is a matter of concern because Cr can promote environmental contamination and affect the food chain. In this study, we evaluated the growth of and Cr accumulation in maize and cowpea after seven years of consecutive applications of composted tannery sludge (CTS) under field conditions. The experiment consisted of application of CTS at five levels: 0 (control), 2.5, 5, 10, and 20 Mg ha-1 (dry basis). The growth of and Cr accumulation in maize and cowpea were evaluated at 75 and 65 days after plant emergence, respectively. CTS application increased the shoot biomass of maize and cowpea. Accumulation of Cr was similar for both plant species, with higher accumulation in roots. However, Cr accumulation in grains differed as the CTS doses increased; cowpea accumulated more Cr while maize did not accumulate more Cr in grains with higher CTS doses. In conclusion, application of CTS led to higher growth of maize and cowpea plants, and both species exhibited similar Cr accumulation in roots and shoots.</p></div

Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial

Background: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. Methods: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group). The BALANCE Program included a unique nutritional education strategy to implement recommendations from guidelines, adapted to the use of affordable and regional foods. Adherence to diet was evaluated by the modified Alternative Healthy Eating Index. The primary end point was a composite of all-cause mortality, cardiovascular death, cardiac arrest, myocardial infarction, stroke, myocardial revascularization, amputation, or hospitalization for unstable angina. Secondary end points included biochemical and anthropometric data, and blood pressure levels. Results: From March 5, 2013, to Abril 7, 2015, a total of 2534 eligible patients were randomly assigned to either the BALANCE Program group (n = 1,266) or the control group (n = 1,268) and were followed up for a median of 3.5 years. In total, 235 (9.3%) participants had been lost to follow-up. After 3 years of follow-up, mean modified Alternative Healthy Eating Index (scale 0-70) was only slightly higher in the BALANCE group versus the control group (26.2 ± 8.4 vs 24.7 ± 8.6, P <.01), mainly due to a 0.5-serving/d greater intake of fruits and of vegetables in the BALANCE group. Primary end point events occurred in 236 participants (18.8%) in the BALANCE group and in 207 participants (16.4%) in the control group (hazard ratio, 1.15; 95% CI 0.95-1.38; P =.15). Secondary end points did not differ between groups after follow-up. Conclusions: The BALANCE Program only slightly improved adherence to a healthy diet in patients with established CVD and had no significant effect on the incidence of cardiovascular events or death. © 2019 The Author