ESTUDO DOS FATORES DE RISCO CARDIOVASCULAR EM ADOLESCENTES

As doenças cardiovasculares (DCV) constituem um importante problema na saúde pública, pois são consideradas as principais causas de morte e incapacidade que acometem a população adulta e, já podem se manifestar na adolescência. Objetivou-se com o presente estudo identificar e descrever os principais fatores de risco cardiovascular em adolescentes, bem como os impactos na saúde dessa faixa etária. Foram selecionados nove artigos das bases de dados SciELO, LILACS e PubMed. Após a leitura analítica e ordenamento das informações dos estudos, a genética, o uso de drogas lícitas e ilícitas, a síndrome metabólica e obesidade, o peso ao nascer e a hipertensão arterial foram considerados os principais fatores de risco para doenças cardiovasculares. Com a revisão bibliográfica, chegou-se a conclusão que as avaliações dos fatores de risco possuem importância não só epidemiológica, mas também de caráter preventivo, pois as DCV são mais suscetíveis à adolescentes que possuem fatores de risco combinados

Comportamento Sedentário e Atividade Física de Escolares de uma Região de Baixa Renda no Brasil: Associações com Variáveis Maternas

Introduction: In the last decade, an increasing number of studies investigated markers of Sedentary Behavior (SB) and Physical Activity (PA) in school-age children since they lead to nutritional status changes in this group. Objective: To analyze associations between maternal factors and SB and PA of schoolchildren. Methods: This is a cross-sectional study involving 410 mothers of children enrolled between the first and the fifth year in municipal schools of Santa Cruz, RN, Brazil. By applying questionnaires, socioeconomic variables of the family, maternal data, and habits related to SB and PA on weekdays and weekends were investigated. Pearson’s chi-square test and Fisher’s exact test were used to test associations. Results: It was observed that income below one minimum wage and less maternal education were associated with greater active transportation among children (69.3%, p = 0.012 and 68.4%, p = 0.022, respectively). Children from low-income families (65.4%, p = 0.016) and who had six and seven siblings (8.2%, p = 0.023 and 7.6%, p = 0.037, respectively) presented lower SB at the weekend. Low level of maternal education was associated with reduced PA during the week (70.8%, p = 0.024). Conclusion: Socioeconomic (i.e., family income and number of siblings) and maternal factors (i.e., level of education) are important indicators for time spent on sedentary behavior and physical activity of schoolchildren.Introdução: Na última década, um número crescente de estudos tem se preocupado em investigar marcadores de Comportamento Sedentário (CS) e Atividade Física (AF) em crianças na idade escolar, por serem reconhecidos como causadores de alterações do estado nutricional nesta faixa etária. Objetivo: Analisar os fatores associados maternos sobre o CS e AF de escolares. Método: Trata-se de uma pesquisa com delineamento transversal, envolvendo 410 mães de crianças matriculadas entre o primeiro e quinto ano nas escolas municipais de Santa Cruz, RN, Brasil. Por meio da aplicação de questionários, foram investigadas variáveis socioeconômicas da família, dados maternos e hábitos relacionados ao CS e AF dos escolares, nos dias da semana e no final de semana. Para testar associações foi utilizado o teste Qui-quadrado de Pearson e Teste Exato de Fisher. Resultados: Foi observado que uma renda inferior a um salário mínimo e menor escolaridade materna foram associados com maior deslocamento ativo das crianças (69,3%, p = 0,012 e 68,4% p = 0,022, respectivamente). As crianças de famílias com baixa renda (65,4%, p = 0,016) e que tinham seis e sete irmãos (8,2%, p = 0,023 e 7,6%, p = 0,037, respectivamente) apresentam menor CS no final de semana. Um menor grau de escolaridade materna foi associado com uma menor prática de AF durante a semana (70,8%, p = 0,024). Conclusão: Conclui-se que os fatores socioeconômicos (i.e., renda familiar e número de irmãos) e maternos (i.e., nível de escolaridade) são importantes indicadores para o tempo dispendido em comportamento sedentário e atividade física de escolare

A INFLUÊNCIA DO AMBIENTE FAMILIAR NA MANIFESTAÇÃO DO TRANSTORNO DE PERSONALIDADE NARCISISTA

The manifestation of Narcissistic Personality Disorder (NPD) is often influenced by various factors, with the family environment being an important component. Family dynamics play a crucial role in the development of this disorder, impacting the formation of the individual's self-image and patterns of interpersonal relationships. In this context, understanding the influence of the family environment on the expression of NPD is fundamental to effectively address this complex psychological condition. Objectives: To investigate and understand the specific influence of the family environment on the manifestation of narcissistic personality disorder, exploring interaction patterns, parental styles, and family dynamics that may contribute to the development of this disorder. Methodology: Articles found were read, and inclusion and exclusion criteria were applied. Within the inclusion criteria, original articles addressing the investigated topic and allowing full access to the study's content were considered, published between 2016 and 2023, in Portuguese and English. The research was conducted through online access to the databases of the National Library of Medicine (PubMed MEDLINE), Scientific Electronic Library Online (SCIELO), Latin American and Caribbean Health Sciences Literature (LILACS) in February 2024. Results and Discussions: The complexity of treating narcissistic personality disorder (NPD) is highlighted. Psychopharmacological treatments have shown limited efficacy, being more useful in comorbidities with other conditions. Several psychotherapeutic approaches were explored, with Dialectical Behavioral Therapy and Schema-Focused Therapy standing out, as well as psychoanalytic approaches such as Transfer-Centered Psychotherapy and Mentalization-Based Therapy. However, regardless of the approach, narcissistic patients are challenging to treat due to difficulty in accepting the diagnosis and lack of empathy. Motivation for change often arises from external crises, making therapeutic commitment fragile. Therapists' countertransference is also a challenge, with difficult-to-manage negative feelings that, when understood, can provide valuable information about the patient's internal world. In summary, the results highlight the need for therapeutic strategies adapted to the complexity of NPD, considering the specific characteristics of narcissistic patients and the inherent challenges in the therapeutic process. Conclusion: In conclusion, addressing Narcissistic Personality Disorder (NPD) demands a deep understanding of therapeutic nuances. The results underscore the complexity in the effectiveness of psychopharmacological treatments and the importance of specific psychotherapeutic approaches. Difficulty in accepting the diagnosis, lack of empathy, and challenges in countertransference emphasize the need for adapted therapeutic strategies. Amidst these challenges, the pursuit of realistic treatment goals and the creation of therapeutic contracts are crucial. These findings underline the importance of continuing research and refining therapeutic approaches to effectively manage NPD.The manifestation of Narcissistic Personality Disorder (NPD) is often influenced by various factors, with the family environment being an important component. Family dynamics play a crucial role in the development of this disorder, impacting the formation of the individual's self-image and patterns of interpersonal relationships. In this context, understanding the influence of the family environment on the expression of NPD is fundamental to effectively address this complex psychological condition. Objectives: To investigate and understand the specific influence of the family environment on the manifestation of narcissistic personality disorder, exploring interaction patterns, parental styles, and family dynamics that may contribute to the development of this disorder. Methodology: Articles found were read, and inclusion and exclusion criteria were applied. Within the inclusion criteria, original articles addressing the investigated topic and allowing full access to the study's content were considered, published between 2016 and 2023, in Portuguese and English. The research was conducted through online access to the databases of the National Library of Medicine (PubMed MEDLINE), Scientific Electronic Library Online (SCIELO), Latin American and Caribbean Health Sciences Literature (LILACS) in February 2024. Results and Discussions: The complexity of treating narcissistic personality disorder (NPD) is highlighted. Psychopharmacological treatments have shown limited efficacy, being more useful in comorbidities with other conditions. Several psychotherapeutic approaches were explored, with Dialectical Behavioral Therapy and Schema-Focused Therapy standing out, as well as psychoanalytic approaches such as Transfer-Centered Psychotherapy and Mentalization-Based Therapy. However, regardless of the approach, narcissistic patients are challenging to treat due to difficulty in accepting the diagnosis and lack of empathy. Motivation for change often arises from external crises, making therapeutic commitment fragile. Therapists' countertransference is also a challenge, with difficult-to-manage negative feelings that, when understood, can provide valuable information about the patient's internal world. In summary, the results highlight the need for therapeutic strategies adapted to the complexity of NPD, considering the specific characteristics of narcissistic patients and the inherent challenges in the therapeutic process. Conclusion: In conclusion, addressing Narcissistic Personality Disorder (NPD) demands a deep understanding of therapeutic nuances. The results underscore the complexity in the effectiveness of psychopharmacological treatments and the importance of specific psychotherapeutic approaches. Difficulty in accepting the diagnosis, lack of empathy, and challenges in countertransference emphasize the need for adapted therapeutic strategies. Amidst these challenges, the pursuit of realistic treatment goals and the creation of therapeutic contracts are crucial. These findings underline the importance of continuing research and refining therapeutic approaches to effectively manage NPD

ATENÇÃO INTEGRAL AO PACIENTE EM URGÊNCIAS E EMERGÊNCIAS.

Comprehensive patient care in urgent and emergency situations is essential to guarantee the quality and effectiveness of healthcare. This study presents an integrative review of the literature that explores approaches and strategies to provide this comprehensive care, considering the complexity of these scenarios. Through the analysis of several studies and specialized literature, the main elements that make up comprehensive care for patients in critical situations are identified. These approaches include effective screening, interprofessional communication, application of updated clinical protocols, and consideration of the patient's psychosocial needs. The literature review highlights the importance of training the healthcare team and adequately coordinating resources to ensure comprehensive and effective care for patients in urgencies and emergencies. Comprehensive patient care in urgencies and emergencies is a complex challenge, but fundamental to the success of healthcare in these contexts. This study highlights the need for interdisciplinary approaches, well-defined protocols and effective communication between the healthcare team to ensure that all dimensions of the patient's health are considered. Additionally, attention to the patient's psychosocial and emotional needs plays a critical role in recovery and overall well-being. Therefore, investing in team training and adequate coordination of resources is essential to provide comprehensive care to patients in urgent and emergency situations.A atenção integral ao paciente em situações de urgência e emergência é fundamental para garantir a qualidade e a eficácia dos cuidados de saúde. Este estudo apresenta uma revisão integrativa da literatura que explora abordagens e estratégias para fornecer essa atenção integral, considerando a complexidade desses cenários. Através da análise de diversos estudos e literatura especializada, identificam-se os principais elementos que compõem a atenção integral ao paciente em situações críticas. Estas abordagens incluem a triagem eficaz, a comunicação interprofissional, a aplicação de protocolos clínicos atualizados e a consideração das necessidades psicossociais do paciente. A revisão bibliográfica destaca a importância da capacitação da equipe de saúde e da coordenação adequada dos recursos para garantir uma atenção integral e eficaz ao paciente em urgências e emergências. A atenção integral ao paciente em urgências e emergências é um desafio complexo, mas fundamental para o sucesso dos cuidados de saúde nesses contextos. Este estudo destaca a necessidade de abordagens interdisciplinares, protocolos bem definidos e comunicação eficaz entre a equipe de saúde para garantir que todas as dimensões da saúde do paciente sejam consideradas. Além disso, a atenção às necessidades psicossociais e emocionais do paciente desempenha um papel crítico na recuperação e no bem-estar geral. Portanto, investir na formação da equipe e na coordenação adequada dos recursos é essencial para proporcionar uma atenção integral ao paciente em situações de urgência e emergência

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

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection