RISK FACTORS ASSOCIATED WITH SUICIDE IN DOLESCENCE: INTEGRACTIVE REVIEW FROM 2004 TO 2019

Introdução: O suicídio na adolescência constitui-se num importante problema de saúde pública mundial e, é desencadeado por diversos fatores socioeconômicos e culturais. Trata-se de uma doença incapacitante visto que são graves e negativos os impactos psicossociais que decorrem das tentativas de suicídio tanto para o indivíduo, quanto para seus familiares. O estudo objetiva descrever os principais fatores de risco associados ao suicídio na adolescência, presentes na literatura. Método: É um estudo de revisão integrativa realizado a partir de dados secundários obtidos, por meio de busca de artigos no período de 2004 a 2019, acessando as bases de dados Scientific Electronic Library Online (SCIELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Cochrane Library, Web of Science, PubMed. Resultados e discussão: A maioria dos estudos apontam que as mu¬lheres estão mais propensas à ideação suicida e os homens, à prática do ato suicida. Os principais estudos sobre o tema indicam a depressão como sendo o principal fator de gatilho que impulsiona uma mudança de ideação suicida para um intento suicida. Pesquisas sugerem que a automutilação não suicida é um preditor robusto de futuras tentativas de suicídio; no entanto, automutilação não-suicida raramente tem sido considerada dentro de uma estrutura de ideação para ação. Abuso de substâncias psicoativas e, problemas nos núcleos familiar e escolar configuram fortes preditores de comportamento suicida entre os adolescentes. Conclusão: O suicídio é um fenômeno complexo que traz consequências negativas não só para família da vítima, mas também para o meio social no qual o adolescente está inserido. As adversidades da infância (especialmente as violências físicas e abusos sexuais) são poderosos indicadores do início e persistência de comportamentos suicidas. Logo, a escola, principal local em que adolescente convive, tem papel estratégico para a promoção e proteção da saúde dos alunos em conjunto com ações governamentais de apoio à prevenção do suicídio.    Palavras-chave: autolesão não suicida; Suicídio; Tentativas de suicídio; Adolescência, fatores para suicídio. ABSTRACT Introduction: The suicide in the adolescence consist in an important problem of world public health, and is triggered by several socioeconomic and cultural factors. It is an incapacitating disease since the psychosocial impacts resulting from suicide attempts are serious and negative. This study aims to describe the main risk factors associated with suicide in adolescence, present in the literature. Method: This is an integrative review study based on secondary data obtained through the search of articles from 2004 to 2019, by accessing the Scientific Electronic Library Online (SCIELO), Latin American and Caribbean Literature databases Health Sciences (LILACS), Cochrane Library, Web of Science, PubMed. Results and discussion: Most studies indicate that women are more prone to suicidal ideation and men suicidal acts. Major studies on the subject indicate that depression is the main trigger factor that drives a shift from suicidal ideation to a suicidal attempt. Research suggests that non-suicidal self-mutilation is a robust predictor of future suicide attempts; however, non-suicidal self-mutilation has rarely been considered within a framework of ideation for action. Abuse of psychoactive substance and problems in the family and school nuclei are strong predictors of suicidal behavior among adolescents. Conclusion: Suicide is a complex phenomenon that has negative consequences not only for the victim’s family but also for the social environment in which the adolescent is inserted. The adversities of childhood (especially physical violence and sexual abuse) are powerful indicators of the onset and persistence of suicidal behavior. Therefore, the school, the main place where adolescents live, plays a strategic role in promoting and protecting students’ health in conjunction with government actions to support suicide prevention. Key-words: non suicide self-injury; Suicide; Suicide attempts; Adolescence, factors for suicide.ABSTRACT Introduction: The suicide in the adolescence consist in an important problem of world public health, and is triggered by several socioeconomic and cultural factors. It is an incapacitating disease since the psychosocial impacts resulting from suicide attempts are serious and negative. This study aims to describe the main risk factors associated with suicide in adolescence, present in the literature. Method: This is an integrative review study based on secondary data obtained through the search of articles from 2004 to 2019, by accessing the Scientific Electronic Library Online (SCIELO), Latin American and Caribbean Literature databases Health Sciences (LILACS), Cochrane Library, Web of Science, PubMed. Results and discussion: Most studies indicate that women are more prone to suicidal ideation and men suicidal acts. Major studies on the subject indicate that depression is the main trigger factor that drives a shift from suicidal ideation to a suicidal attempt. Research suggests that non-suicidal self-mutilation is a robust predictor of future suicide attempts; however, non-suicidal self-mutilation has rarely been considered within a framework of ideation for action. Abuse of psychoactive substance and problems in the family and school nuclei are strong predictors of suicidal behavior among adolescents. Conclusion: Suicide is a complex phenomenon that has negative consequences not only for the victim’s family but also for the social environment in which the adolescent is inserted. The adversities of childhood (especially physical violence and sexual abuse) are powerful indicators of the onset and persistence of suicidal behavior. Therefore, the school, the main place where adolescents live, plays a strategic role in promoting and protecting students’ health in conjunction with government actions to support suicide prevention. Keywords: non suicide self-injury; Suicide; Suicide attempts; Adolescence, factors for suicide&nbsp

ASPECTOS EPIDEMIOLÓGICOS DA LEISHMANIOSE VISCERAL NO ESTADO DO TOCANTINS NO PERÍODO DE 2007 A 2017

Introdução: A Leishmaniose Visceral (LV) é uma doença tratável e curável, considerada uma Doença Tropical Negligenciada pela OMA. Atinge principalmente as camadas mais vulneráveis da população e apresenta uma mudança no seu padrão de transmissão, passando a acometer zonas urbanas, como a capital do estado do Tocantins, Palmas. O estudo objetiva identificar dados epidemiológicos da doença no Tocantins, os comparando com os dados nacionais. Método: É um estudo epidemiológico realizado a partir de dados secundários obtidos através do Sistema Nacional de Informação de Agravos de Notificação e no Sistema de Informação sobre Mortalidade no intervalo de janeiro de 2007 a dezembro de 2017.  Resultados: No período de abrangência, 3658 casos de LV foram diagnosticados, alcançando incidência máxima de 34,6 casos por 100.000 habitantes no ano de 2011. O estado manteve taxas de letalidade abaixo das médias nacionais nesse período, com exceção do ano de 2010. É uma doença mais comum no sexo masculino, raça parda e em pessoas de escolaridade até o ensino fundamental incompleto. Discussão: Na última década, o Tocantins apresentou níveis de incidência até 1730% maiores que a taxa nacional, demonstrando a histórica associação da doença com a parcela da população em situação de pobreza. Dos diagnosticados, 3,5% apresentavam infecção pelo HIV. As taxas de letalidade têm demonstrado ascensão gradativa Conclusão: No Tocantins, a LV mantém principal incidência na população pediátrica na faixa de 1 a 4 anos e na população adulta na faixa de 20 a 39 anos. Em mortalidade, são mais acometidos os menores de 1 ano e os que se encontram entre 40 e 59 anos. Devido aos preocupantes números apresentados, medidas devem ser tomadas para que haja controle dessa zoonose na população tocantinense.   Palavras-chave: Leishmaniose Visceral; Doenças Negligenciadas; Medicina Tropical; Epidemiologia; Sistemas de Informação. ABSTRACT Introduction: Visceral Leishmaniasis (LV) is a treatable and curable disease, considered a Tropical Disease Neglected by AOM. It reaches mainly the most vulnerable sections of the population and presents a change in its transmission pattern, starting to hit urban areas, such as the state capital of Tocantins, Palmas. This study aims to identify epidemiological data on the disease in Tocantins, comparing it with national data. Method: This is an epidemiological study based on secondary data obtained through the National Information System for Notifiable Diseases and in the Mortality Information System from January 2007 to December 2017. Results: During the study period, 3658 cases of LV were diagnosed, reaching a maximum incidence of 34.6 cases per 100,000 inhabitants in 2011. The state maintained lethality rates below national averages in this period, except for the year 2010. It is a more common disease in males, brown race and in people of schooling until elementary school incomplete. Discussion: In the last decade, Tocantins presented levels of incidence up to 1730% higher than the national rate, demonstrating the historical association of the disease with the portion of the population living in poverty. Of those diagnosed, 3.5% had HIV infection. Conclusion: In Tocantins, LV maintains a main incidence in the pediatric population in the range of 1 to 4 years and in the adult population in the range of 20 to 39 years. In mortality, those under the age of 1 are more affected and those between 40 and 59 years old. Due to the worrying figures presented, measures must be taken to control this zoonosis in the population of Tocantinss. Keywords: Leishmaniasis, Visceral; Neglected Diseases; Tropical Medicine; Epidemiology; Information Systems

PAPEL DA INTELIGÊNCIA ARTIFICIAL NA PREDIÇÃO DE EVENTOS CARDÍACOS

Artificial Intelligence (AI) plays a crucial role in predicting cardiac events, offering advanced analytical tools to evaluate medical data. By processing large sets of information, AI identifies subtle patterns, enabling early detection of potential heart risks. This innovative approach not only improves diagnostic accuracy but also contributes to more effective preventive interventions by promoting proactive management of cardiovascular health. Objectives: Explore the crucial role played by artificial intelligence in predicting cardiac events. Methodology: Data collection was conducted through the following databases: Nursing Database (BDENF), Scientific Electronic Library Online (SCIELO), PubMed, Latin American Caribbean Literature in Health Sciences (LILACS). Various types of publications were consulted, including scientific articles, monographs and magazines, with the aim of obtaining relevant information on the topic. Results and Discussions: The effectiveness of Artificial Intelligence in predicting cardiac events, demonstrating remarkable accuracy rates and an ability to identify complex patterns in medical data. This approach offers a promising prospect for improving the prevention and management of cardiac conditions. In the discussion, it is relevant to consider potential challenges, such as clinical interpretation of results and the continued need for large-scale validation. The integration of AI into clinical practice suggests significant advances, but ethical and regulatory issues also deserve attention to ensure the responsible implementation of this technology. Conclusion: In summary, the use of Artificial Intelligence in predicting cardiac events demonstrates promising effectiveness, providing valuable insights for medical practice. While the results are encouraging, it is imperative to continue refining and validating these approaches while carefully considering ethical and regulatory aspects. The potential positive impact of AI on cardiovascular health is evident, pointing to significant developments in the prevention and treatment of heart conditions.A Inteligência Artificial (IA) desempenha um papel crucial na predição de eventos cardíacos, oferecendo avançadas ferramentas analíticas para avaliar dados médicos. Ao processar grandes conjuntos de informações, a IA identifica padrões sutis, permitindo uma detecção precoce de potenciais riscos cardíacos. Esta abordagem inovadora não apenas aprimora a precisão diagnóstica, mas também contribui para intervenções preventivas mais eficazes, promovendo uma gestão proativa da saúde cardiovascular. Objetivos: Explorar o papel crucial desempenhado pela inteligência artificial na predição de eventos cardíacos. Materiais e Métodos: A coleta de dados foi conduzida por meio dos bancos de dados: Base de Dados em Enfermagem (BDENF), Scientific Electronic Library Online (SCIELO), PubMed, Literatura Latino-Americana do Caribe em Ciências da Saúde (LILACS). Foram consultados diversos tipos de publicações, incluindo artigos científicos, monografias e revistas, com o objetivo de obter informações relevantes sobre o tema. Resultados e Discussões: A eficácia da Inteligência Artificial na predição de eventos cardíacos, evidenciando taxas de acertos notáveis e uma capacidade de identificar padrões complexos nos dados médicos. Essa abordagem oferece uma perspectiva promissora para melhorar a prevenção e o gerenciamento de condições cardíacas. Na discussão, é relevante considerar desafios potenciais, como a interpretação clínica dos resultados e a necessidade contínua de validação em larga escala. A integração da IA na prática clínica sugere avanços significativos, mas questões éticas e regulatórias também merecem atenção para garantir a implementação responsável dessa tecnologia. Conclusão: Em resumo, a utilização da Inteligência Artificial na predição de eventos cardíacos demonstra promissora eficácia, proporcionando insights valiosos para a prática médica. Embora os resultados sejam encorajadores, é imperativo continuar refinando e validando essas abordagens, considerando cuidadosamente os aspectos éticos e regulatórios. O potencial impacto positivo da IA na saúde cardiovascular é evidente, apontando para uma evolução significativa na prevenção e no tratamento de condições cardíacas

APLICABILIDADE DA CIF NA REABILITAÇÃO FÍSICA DE PACIENTES COM LESÃO RAQUIMEDULAR: ESTUDO DE REVISÃO INTEGRATIVA

Spinal cord injury (SCI) is characterized by partial or total dysfunction of the spinal cord, resulting in interruption of motor and sensory nerve tracts. This can lead to alterations. The aim of this article is to review the available information on the application of the ICF as an assessment tool in patients with spinal cord injury, especially in the field of multiprofessional physical rehabilitation. It is a nonsystematic literature review study using the Scientific Electronic Library Online (SciELO) and BIREME databases, including studies published between the years 2014 and 2024 addressing the ICF assessment scale and focusing on Multiprofessional Physical Rehabilitation in Rehabilitation for patients with spinal cord injury. Among the reviewed studies, researchers identified a series of challenges related to bodily functions, daily activities, participation in society, and environmental factors faced by people with spinal cord injury. The use of the ICF revealed several limitations both in the functionality of individuals with SCI and in the application of the instrument itself. Therefore, there is an urgent need for more studies on the applicability of the ICF in this population, as well as for training professionals for its proper use.A lesão medular (LM) é caracterizada pela disfunção parcial ou total da medula espinhal, resultando na interrupção dos tratos nervosos motores e sensoriais. Isso pode levar a alterações. O objetivo deste artigo é revisar as informações disponíveis sobre a aplicação da CIF como instrumento de avaliação em pacientes com lesão medular, especialmente, no campo da reabilitação física multiprofissional. É um estudo de revisão bibliográfica assistemática utilizando as bases de dados Scientific Electronic Library Online (SciELO), e BIREME incluindo para pesquisa estudos publicados entre o ano 2014 á 2024 abordando a escala avaliativa CIF e com foco na Reabilitação Física Muliptofissional na Reabilitação para pacientes com lesão medular. Entre os estudos revisados, os pesquisadores identificaram uma série de desafios relacionados às funções corporais, atividades diárias, participação na sociedade e fatores ambientais enfrentados por pessoas com lesão medular. A utilização da CIF revelou diversas limitações tanto na funcionalidade dos indivíduos com LM quanto na própria aplicação do instrumento. Portanto, há uma necessidade premente de mais estudos sobre a aplicabilidade da CIF nessa população, assim como de capacitar profissionais para sua utilização adequada

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

Estudo comparativo entre o tonômetro de aplanação de Goldmann e o tonômetro de contorno dinâmico de Pascal no glaucoma primário de ângulo aberto e olhos normais

OBJETIVO: Comparar as medidas da pressão intra-ocular (PIO) obtidas com o tonômetro de aplanação de Goldmann (TAG) e o tonômetro de contorno dinâmico (TCD) e correlacioná-las com a espessura central da córnea (ECC). MÉTODOS: Estudo transversal, com os pacientes divididos em dois grupos: glaucoma primário de ângulo aberto (GPAA) e olhos normais (ON). As medidas da PIO foram obtidas em todos os pacientes com o TAG e o TCD. Um examinador realizou as tonometrias com o TAG e outro examinador com o TCD. A ECC foi obtida pelo paquímetro ultrassônico. Os resultados foram avaliados através do teste Z para amostras independentes, teste t de Student para amostras relacionadas, teste de correlação linear de Pearson e gráfico de Bland-Altman. RESULTADOS: Foram incluídos 134 olhos de 71 pacientes. O grupo GPAA foi constituído por 85 olhos de 45 pacientes e o grupo ON por 49 olhos de 26 indivíduos com olhos normais. Não houve diferença significativa da ECC entre os dois grupos em ambos os olhos (p= 0,54 OD; p= 0,71 OE). As tonometrias realizadas com o TCD foram maiores nos dois grupos (GPAA: p< 0,01; ON: p= 0,01). Houve correlação significativa entre as tonometrias do TAG e do TCD nos dois grupos separados ou em conjunto (p< 0,001). Não houve correlação significativa entre o TAG ou o TCD e a ECC, exceto no olho direito dos dois grupos em conjunto (p= 0,03; r² = 0,07). O gráfico de Bland-Altman mostrou pouca concordância entre os dois procedimentos. CONCLUSÃO: Nenhum dos métodos mostrou boa correlação com a ECC. Houve pouca concordância entre os dois métodos, sendo maiores, as tonometrias obtidas com o TCD. As medidas realizadas no TCD parecem ser menos influenciadas pelos valores da ECC do que as medidas realizadas no TAG

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine