Feelings of nurses who work with cancer patients in terminal phase Sentimentos de enfermeiros que atuam junto a pacientes com câncer em fase terminal

Objetivo: identificar os sentimentos de enfermeiros que atuam junto a pacientes com câncer em fase terminal. Métodos: pesquisa qualitativa, realizada com 10 enfermeiros do setor de oncologia de um Hospital de Teresina, Piauí, Brasil. Coleta de dados realizada por meio de entrevista semiestruturada, submetida à análise temática. Obtenção de parecer favorável pelo Comitê de Ética em Pesquisa da Faculdade Santo Agostinho, conforme parecer N°350/10. Resultados: para os enfermeiros, uma das maiores ansiedades enfrentadas é o lidar com a morte, vista como fenômeno doloroso e de difícil aceitação. A maioria dos profissionais admitiu o despreparo no manejo e enfrentamento desta condição, experienciando de forma conflituosa, amarga e cruel tal vivência. Conclusão: mediante a fragilidade dos sentimentos dos enfermeiros, urge apoio ao profissional da área oncológica com formações de grupos de apoio ao profissional, a fim de compartilhar experiências e minimizar o sofrimento emocional. Descritores: Enfermagem; Oncologia; Saúde Mental

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

Enhanced estrogenic effects of biotransformed soy extracts

Soy isoflavones have been associated with several beneficial effects to human health including estrogenic action. Due to the risks associated with pharmaceutical hormone replacement therapy, soy extracts rich in isoflavones and metabolites appear as a safe alternative for menopausal women. This study aimed to improve the process conditions for biotransformation of soymilk polyphenols by tannase to obtain higher amounts of isoflavone aglycones and metabolites such as equol. The estrogenic potential of the extracts was evaluated in in vitro assays. The results showed that the aglycones increased 36–46 times after reaction with tannase and proved that it is possible to produce equol in soymilk using an enzymatic bioprocess, without gut microbial intervention. Moreover, the soymilk biotransformed by tannase presented higher estrogenic action in the MCF-7 BUS cell line assay, making it a promising nutraceutical with possible effects in the attenuation or treatment of menopause symptoms48117124COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPSem informação17367-7, 201

Feelings of nurses who work with cancer patients in terminal phase

Objective: To identify the feelings of nurses who work with cancer patients in terminal phase. Methods: It is a qualitative research conducted with 10 nurses from the oncology department of a hospital in Teresina, Piauí, Brazil. Data collection occurred through semi-structured interviews submitted to thematic analysis. The Research Ethics Committee of the Santo Agostinho College approved the study under protocol No. 350/10. Results: One of the biggest anxieties nurses face is dealing with death, seen as a painful phenomenon and difficult to accept. Most professionals admitted not being prepared to manage and cope with this condition, experiencing it in a conflicting, bitter, and cruel way. Conclusion: Given the fragility of nurses’ feelings, there is a urgent need to aid oncology professionals by creating professional support groups in order to share experiences and minimize the emotional distress.Objetivo: identificar os sentimentos de enfermeiros que atuam junto a pacientes com câncer em fase terminal. Métodos: pesquisa qualitativa, realizada com 10 enfermeiros do setor de oncologia de um Hospital de Teresina, Piauí, Brasil. Coleta de dados realizada por meio de entrevista semiestruturada, submetida à análise temática. Obtenção de parecer favorável pelo Comitê de Ética em Pesquisa da Faculdade Santo Agostinho, conforme parecer N°350/10. Resultados: para os enfermeiros, uma das maiores ansiedades enfrentadas é o lidar com a morte, vista como fenômeno doloroso e de difícil aceitação. A maioria dos profissionais admitiu o despreparo no manejo e enfrentamento desta condição, experienciando de forma conflituosa, amarga e cruel tal vivência. Conclusão: mediante a fragilidade dos sentimentos dos enfermeiros, urge apoio ao profissional da área oncológica com formações de grupos de apoio ao profissional, a fim de compartilhar experiências e minimizar o sofrimento emocional.Objetivo: Identificar los sentimientos de enfermeros que trabajan con pacientes con cáncer terminal. Métodos: Investigación cualitativa, con 10 enfermeros del departamento de oncología de un hospital de Teresina, Piauí, Brasil. Recogida de datos realizada a través de entrevistas semiestructuradas sometidas a análisis temático. Obtención de dictamen favorable del Comité de Ética de la Facultad de San Agustín, según parecer Nº 350/10. Resultados: Para los enfermeros, una de las mayores preocupaciones se fue con la muerte, vista como dolorosa y difícil de aceptar. La mayoría de los profesionales admitió falta de preparación en la gestión y hacer frente a esta condición, experimentando una forma de confrontación, amarga y cruel esta experiencia. Conclusión: Por la fragilidad de los sentimientos de los enfermeros, insta apoyar la oncología profesional con la formación de grupos profesionales con el fin de compartir experiencias y minimizar el estrés emocional

Educomunicação: caminhos entre a pesquisa e a formação, no II Congresso Internacional de Comunicação e Educação

A herança cultural representada pelos papers propostos e aprovados pela comissão científica do II Congresso Internacional de Comunicação e Educação e VIII Encontro Brasileiro de Educomunicação, está na publicação em quatro diferentes e-books, disponibilizados na plataforma de publicações do site da ABPEducom (www.abpeducom.com.br).  O presente volume – o segundo a ser disponibilizado ao público – volta-se, mais especificamente, a dois eixos temáticos, relacionados, respectivamente, à pesquisa e à formação no campo da Educomunicação. Pesquisa e formação são dois eixos fundamentais para garantir o que se define como coerência epistemológica entre teoria e prática. E é sobre esta perspectiva que os artigos reunidos neste e-book devem ser recebidos e confrontados. Falamos inicialmente sobre uma coerência epistemológica no interior do próprio produto analisado. Sinalizamos com isto que os autores podem ter desenvolvido abordagens não necessariamente alinhadas aos referenciais da Educomunicação na perspectiva defendida, por exemplo, pelo NCE-USP. O fato não desautoriza o texto, ao contrário: se foram incluídos no livro é porque trabalham com pensamentos e ações com os quais a Educomunicação pode e deve estar dialogando, especialmente nos âmbito do uso das TIC e na implementação de programas de educação mediática e informacional

Effect of lung recruitment and titrated Positive End-Expiratory Pressure (PEEP) vs low PEEP on mortality in patients with acute respiratory distress syndrome - A randomized clinical trial

IMPORTANCE: The effects of recruitment maneuvers and positive end-expiratory pressure (PEEP) titration on clinical outcomes in patients with acute respiratory distress syndrome (ARDS) remain uncertain. OBJECTIVE: To determine if lung recruitment associated with PEEP titration according to the best respiratory-system compliance decreases 28-day mortality of patients with moderate to severe ARDS compared with a conventional low-PEEP strategy. DESIGN, SETTING, AND PARTICIPANTS: Multicenter, randomized trial conducted at 120 intensive care units (ICUs) from 9 countries from November 17, 2011, through April 25, 2017, enrolling adults with moderate to severe ARDS. INTERVENTIONS: An experimental strategy with a lung recruitment maneuver and PEEP titration according to the best respiratory-system compliance (n = 501; experimental group) or a control strategy of low PEEP (n = 509). All patients received volume-assist control mode until weaning. MAIN OUTCOMES AND MEASURES: The primary outcome was all-cause mortality until 28 days. Secondary outcomes were length of ICU and hospital stay; ventilator-free days through day 28; pneumothorax requiring drainage within 7 days; barotrauma within 7 days; and ICU, in-hospital, and 6-month mortality. RESULTS: A total of 1010 patients (37.5% female; mean [SD] age, 50.9 [17.4] years) were enrolled and followed up. At 28 days, 277 of 501 patients (55.3%) in the experimental group and 251 of 509 patients (49.3%) in the control group had died (hazard ratio [HR], 1.20; 95% CI, 1.01 to 1.42; P = .041). Compared with the control group, the experimental group strategy increased 6-month mortality (65.3% vs 59.9%; HR, 1.18; 95% CI, 1.01 to 1.38; P = .04), decreased the number of mean ventilator-free days (5.3 vs 6.4; difference, −1.1; 95% CI, −2.1 to −0.1; P = .03), increased the risk of pneumothorax requiring drainage (3.2% vs 1.2%; difference, 2.0%; 95% CI, 0.0% to 4.0%; P = .03), and the risk of barotrauma (5.6% vs 1.6%; difference, 4.0%; 95% CI, 1.5% to 6.5%; P = .001). There were no significant differences in the length of ICU stay, length of hospital stay, ICU mortality, and in-hospital mortality. CONCLUSIONS AND RELEVANCE: In patients with moderate to severe ARDS, a strategy with lung recruitment and titrated PEEP compared with low PEEP increased 28-day all-cause mortality. These findings do not support the routine use of lung recruitment maneuver and PEEP titration in these patients. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01374022