Efeito do Reiki no nível de ansiedade e nos sinais vitais de acadêmicos de Enfermagem

Objective: Analyze the effect of Reiki on the level of anxiety and vital signs of nursing students.Method: This is a randomized clinical trial, with two groups, control and intervention, and participation of ten nursing students.  Randomization  was  performed  using  sealed  and  shuffled  envelopes (control  and  intervention),  that were distributed in a similar way to those interested in participating in the research. The socio-demographic identification instrument and anxiety inventory, Dash- State –IDATE was applied, beyond the assessment of Vital Signs before and after each session. Descriptive statistics and the Wilcoxon and Mann-Whitney tests were used for data analysis.Results: All participants were female, single and 50% lived alone. Regarding anxiety, in the control group, only the variable “I feel safe” presented statistical significance before and after the study. In the intervention group, the questions “I feel rested”, “I am agitated”, “I feel like a nervous wreck” and “I feel happy” presented statistical significance. In the assessment of vital signs, in the intervention group, statistical significance  was  noted  in  heart  and  respiratory  rate  variations.Conclusion:  The  Reiki  technique  changes  some symptoms related to anxiety after the sessions are applied. And there is still an effect on vital signs, especially on heart and respiratory rate.Objetivo: Analisar o efeito do Reiki no nível de ansiedade e nos sinais vitais de acadêmicos de enfermagem. Método: Trata-se de um ensaio clínico randomizado, com dois grupos, controle e intervenção, e participação de dez acadêmicos de enfermagem. A randomização foi realizada por meio de envelopes selados e embaralhados, contendo um dos dois grupos (controle e intervenção) que foram distribuídos de forma similar aos interessados em participar da pesquisa. Foi aplicado o instrumento de identificação sociodemográfico e inventário de ansiedade Traço- Estado IDATE, e avalição dos Sinais Vitais antes e após cada sessão. Utilizou-se a estatística descritiva e os Testes de Wilcoxon e Mann-Whitney para análise dos dados. Resultados: Todos os participantes eram do sexo feminino, solteiras e, 50% morava sozinha. Com relação à ansiedade, no grupo controle apenas a variável “Sinto-me seguro” apresentou significância estatística antes e após o estudo. Já no grupo intervenção as questões “Sinto-me descansado”, “Estou agitado”, “Sinto-me uma pilha de nervos” e “Sinto-me alegre” apresentaram significância estatística. Na avaliação dos sinais vitais, no grupo intervenção notou-se significância estatística nas variações da frequência cardíaca e respiratória. Conclusão: a técnica Reiki altera alguns sintomas relacionados à ansiedade após a aplicação das sessões. E ainda se percebe efeito nos sinais vitais, em especial na frequência cardíaca e respiratória.

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

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Enterotomia para retirada de fecaloma com evolução de 2 anos: relato de caso

Fecaloma or fecolyte refers to the accumulation of feces that become dry, compacted and retained inside the large intestine where they dehydrate and solidify, leading to intestinal constipation. Its etiology is quite heterogeneous, ranging from infections and intestinal tumors, inadequate water consumption, dehydration, unbalanced diet or ingestion of foreign materials. For the treatment, it is possible to perform drug therapy in order to lubricate the intestinal contents and allow it to be moved to the final portion of the rectum and finally expelled from the organism or, depending on the case, surgical intervention is chosen. In this study, a case of fecaloma treated with enterotomy in Fortaleza will be reported.Fecaloma ou fecólito refere-se ao acúmulo de fezes que ficam secas, compactadas e retidas no intestino grosso onde desidratam e solidificam, levando à constipação intestinal. Sua etiologia é bastante heterogênea, variando desde infecções e tumores intestinais, consumo inadequado de água, desidratação, alimentação desequilibrada ou ingestão de materiais estranhos. Para o tratamento, é possível realizar terapia medicamentosa com o objetivo de lubrificar o conteúdo intestinal e permitir que ele seja deslocado até a porção final do reto e finalmente expelido do organismo ou, dependendo do caso, opta-se pela intervenção cirúrgica. Neste estudo será relatado um caso d

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora