A web-based educational therapy intervention associated with physical exercise to promote health in fibromyalgia in Brazil: the Amigos De Fibro (Fibro Friends) study protocol.

Health education is one of the main items to enable health promotion to patients with fibromyalgia. The objective of the study "Amigos de Fibro (Fibro Friends)" is to evaluate the impact of an educational intervention associated with physical exercise based on the web in promoting health and quality of life of patients with fibromyalgia in Brazil. A study with a randomized controlled trial approach will be carried out. The sample will consist of 24 participants, divided into two groups, with 12 individuals each. The experimental group will participate in meetings with lectures, debates, conversation rounds and exercises by a multidisciplinary team. Physical exercises will also be performed in an online environment. On the other hand, the control group will receive an e-book of education and self-care. Primary outcomes will be quality of life. The secondary outcomes will be sociodemographic and health profile, pain intensity, sleep quality, self-care agency, usage and costs of health and social care services, viability of the program and program participation. In addition, a qualitative evaluation process will be carried out with the participants. After the intervention, the data of both groups will be collected again, as well as after 3, 6, and 12 months to verify the effect and the maintenance of the intervention. The results will provide data for studies to consider the use of this tool in the future by professionals working in the field of rheumatology. The protocol was registered in the Brazilian Registry of Clinical Trials RBR-3rh759 ( https://trialsearch.who.int/Trial2.aspx?TrialID=RBR-3rh759 ). Date of registration: 07/02/2020]

Medidas de mitigação ao atropelamento de fauna em rodovias federais concedidas no Brasil

O desenvolvimento socioeconômico de diversos paí­ses está relacionado   expansão e manutenção da infraestrutura rodoviária. No Brasil, o modo rodoviário é o mais utilizado, todavia, as rodovias podem causar impactos negativos   biodiversidade, pois contribuem para a fragmentação de hábitats e a redução de fluxos biológicos. Dentre os principais impactos causados pelas rodovias, destaca-se o atropelamento da fauna, de forma que medidas de mitigação para esse impacto se tornam necessárias. Com base nos dados coletados até o ano de 2017, o presente estudo tem por objetivo apresentar informações quanto  s medidas mitigadoras ao atropelamento de fauna silvestre presentes nas rodovias federais concedidas do Brasil. Foram cadastradas 461 medidas de mitigação, mais 627 dispositivos de engenharia que podem ser utilizados como passagens, sendo que, desse total, 334 encontram-se nas proximidades de áreas legalmente protegidas. Existem 158 medidas em fase de planejamento para serem implementadas

Artistas sobre outras obras

Sobre arte e viagem pode-se estabelecer um paralelo continuado, irónico, expressivo. Entre as duas, a síntese do signo, a justaposição associativa. A viagem mostra o mundo, a viagem mostra quem somos. A caminho se desenha, se imagina, se fantasia, se mente. Neste ensejo, e neste mote da descoberta, se apreentam os 16 artigos que compõem o número 26 da revista Estúdio.info:eu-repo/semantics/publishedVersio

Hemofilia adquirida A e B principais apresentações clínicas da doença de Pott em crianças: Hemofilia adquirida A e B main clinical presentations of Pott disease in children

A hemofilia é uma doença sanguínea caracterizada por distúrbios nos mecanismos de coagulação do sangue, podendo ser de origem hereditária ou adquirida. A hemofilia adquirida ocorre devido à produção de autoanticorpos contra a atividade pró-coagulante dos fatores VIII (Hemofilia A) e IX (Hemofilia B). O objetivo desse trabalho é a realização de um estudo observacional e exploratório sobre os artigos publicados nos últimos 5 anos sobre a hemofilia adquirida A e B, uma vez que é uma enfermidade considerada rara. Dos 68 resultados obtidos na pesquisa, apenas 7 abordaram de forma objetiva sobre o tema, sendo utilizados na confecção do estudo. Segundo a literatura, as manifestações clínicas envolvem sangramento mucocutâneo, urogenital e gastrointestinal, e são mais prevalentes em idosos. Em crianças, o sangramento pode ser menos expressivo, provocando dúvidas quanto ao diagnóstico. O tratamento da hemofilia envolve a reposição dos fatores de coagulação deficientes e o uso de imunossupressores, ainda que nas obras analisadas apenas o tratamento hemostático tenha sido descrito, revelando uma carência de estudos sobre o uso de imunossupressores nos casos de hemofilia adquirida

A Relação Entre Transtornos do Sono e Transtornos Psiquiátricos: Abordagens Diagnósticas e Terapêuticas

Objective: This article aims to explore the complex relationship between sleep disorders and psychiatric disorders, highlighting diagnostic and therapeutic approaches to effectively manage this comorbidity. Understanding this interaction is crucial for providing integrated and personalized care to patients, improving their quality of life and mental health. Introduction: Sleep disorders and psychiatric disorders often coexist, mutually influencing each other and presenting unique challenges in diagnosis and treatment. This review examines the interrelations between these conditions, providing a comprehensive overview of available diagnostic and therapeutic approaches to manage this complex comorbidity. Methodology: A review of the medical literature was conducted using databases such as PubMed, PsycINFO, and Scopus, focusing on studies that investigated the relationship between sleep disorders and psychiatric disorders, as well as diagnostic and therapeutic approaches for this comorbidity. Studies providing insights into the pathophysiology, differential diagnosis, and treatment strategies for this complex interaction were included. Results: The results highlight the significant prevalence of comorbidities between sleep disorders and psychiatric disorders, suggesting a bidirectional interaction between these conditions. Diagnostic approaches, such as screening questionnaires, detailed clinical interviews, and objective sleep assessments, are essential for identifying and differentiating symptoms associated with each condition. Regarding therapeutic approaches, both non-pharmacological interventions, such as cognitive-behavioral therapy for insomnia and sleep hygiene, and pharmacological treatments, such as antidepressants and hypnotics, have been effective in managing these comorbidities. Conclusion: The relationship between sleep disorders and psychiatric disorders is complex and multifaceted, requiring an integrated approach in diagnosis and treatment. Accurate diagnostic strategies are essential for differentiating symptoms of each condition and guiding the treatment plan. Additionally, comprehensive therapeutic approaches, including both non-pharmacological and pharmacological interventions, can help improve the quality of life and overall well-being of patients affected by this challenging comorbidity.Objetivo: Este artigo tem como objetivo explorar a complexa relação entre transtornos do sono e transtornos psiquiátricos, destacando as abordagens diagnósticas e terapêuticas para manejar eficazmente essa comorbidade. A compreensão dessa interação é crucial para fornecer um cuidado integrado e personalizado aos pacientes, melhorando sua qualidade de vida e saúde mental. Introdução: Transtornos do sono e transtornos psiquiátricos frequentemente coexistem, influenciando-se mutuamente e apresentando desafios únicos no diagnóstico e tratamento. Esta revisão examina as inter-relações entre essas condições, fornecendo uma visão abrangente das abordagens diagnósticas e terapêuticas disponíveis para manejar essa comorbidade complexa. Metodologia: Foi realizada uma revisão da literatura médica utilizando bases de dados como PubMed, PsycINFO e Scopus, com foco em estudos que investigaram a relação entre transtornos do sono e transtornos psiquiátricos, bem como abordagens diagnósticas e terapêuticas para essa comorbidade. Foram incluídos estudos que forneceram insights sobre a fisiopatologia, diagnóstico diferencial e estratégias de tratamento para essa interação complexa. Resultados: Os resultados destacam a prevalência significativa de comorbidades entre transtornos do sono e transtornos psiquiátricos, sugerindo uma interação bidirecional entre essas condições. Abordagens diagnósticas, como questionários de triagem, entrevistas clínicas detalhadas e avaliações objetivas do sono, são essenciais para identificar e diferenciar os sintomas associados a cada condição. Quanto às abordagens terapêuticas, tanto intervenções não farmacológicas, como terapia cognitivo-comportamental para insônia e higiene do sono, quanto tratamentos farmacológicos, como antidepressivos e hipnóticos, têm sido eficazes no manejo dessas comorbidades. Conclusão: A relação entre transtornos do sono e transtornos psiquiátricos é complexa e multifacetada, exigindo uma abordagem integrada no diagnóstico e tratamento. Estratégias diagnósticas precisas são essenciais para diferenciar os sintomas de cada condição e guiar o plano de tratamento. Além disso, abordagens terapêuticas abrangentes, que incluem intervenções não farmacológicas e farmacológicas, podem ajudar a melhorar a qualidade de vida e o bem-estar geral dos pacientes afetados por essa comorbidade desafiadora

Estimating the global conservation status of more than 15,000 Amazonian tree species

Estimates of extinction risk for Amazonian plant and animal species are rare and not often incorporated into land-use policy and conservation planning. We overlay spatial distribution models with historical and projected deforestation to show that at least 36% and up to 57% of all Amazonian tree species are likely to qualify as globally threatened under International Union for Conservation of Nature (IUCN) Red List criteria. If confirmed, these results would increase the number of threatened plant species on Earth by 22%. We show that the trends observed in Amazonia apply to trees throughout the tropics, and we predict thatmost of the world’s >40,000 tropical tree species now qualify as globally threatened. A gap analysis suggests that existing Amazonian protected areas and indigenous territories will protect viable populations of most threatened species if these areas suffer no further degradation, highlighting the key roles that protected areas, indigenous peoples, and improved governance can play in preventing large-scale extinctions in the tropics in this century

Geography and ecology shape the phylogenetic composition of Amazonian tree communities

AimAmazonia hosts more tree species from numerous evolutionary lineages, both young and ancient, than any other biogeographic region. Previous studies have shown that tree lineages colonized multiple edaphic environments and dispersed widely across Amazonia, leading to a hypothesis, which we test, that lineages should not be strongly associated with either geographic regions or edaphic forest types.LocationAmazonia.TaxonAngiosperms (Magnoliids; Monocots; Eudicots).MethodsData for the abundance of 5082 tree species in 1989 plots were combined with a mega-phylogeny. We applied evolutionary ordination to assess how phylogenetic composition varies across Amazonia. We used variation partitioning and Moran's eigenvector maps (MEM) to test and quantify the separate and joint contributions of spatial and environmental variables to explain the phylogenetic composition of plots. We tested the indicator value of lineages for geographic regions and edaphic forest types and mapped associations onto the phylogeny.ResultsIn the terra firme and várzea forest types, the phylogenetic composition varies by geographic region, but the igapó and white-sand forest types retain a unique evolutionary signature regardless of region. Overall, we find that soil chemistry, climate and topography explain 24% of the variation in phylogenetic composition, with 79% of that variation being spatially structured (R2 = 19% overall for combined spatial/environmental effects). The phylogenetic composition also shows substantial spatial patterns not related to the environmental variables we quantified (R2 = 28%). A greater number of lineages were significant indicators of geographic regions than forest types.Main ConclusionNumerous tree lineages, including some ancient ones (>66 Ma), show strong associations with geographic regions and edaphic forest types of Amazonia. This shows that specialization in specific edaphic environments has played a long-standing role in the evolutionary assembly of Amazonian forests. Furthermore, many lineages, even those that have dispersed across Amazonia, dominate within a specific region, likely because of phylogenetically conserved niches for environmental conditions that are prevalent within regions

Geography and ecology shape the phylogenetic composition of Amazonian tree communities

Aim: Amazonia hosts more tree species from numerous evolutionary lineages, both young and ancient, than any other biogeographic region. Previous studies have shown that tree lineages colonized multiple edaphic environments and dispersed widely across Amazonia, leading to a hypothesis, which we test, that lineages should not be strongly associated with either geographic regions or edaphic forest types. Location: Amazonia. Taxon: Angiosperms (Magnoliids; Monocots; Eudicots). Methods: Data for the abundance of 5082 tree species in 1989 plots were combined with a mega-phylogeny. We applied evolutionary ordination to assess how phylogenetic composition varies across Amazonia. We used variation partitioning and Moran\u27s eigenvector maps (MEM) to test and quantify the separate and joint contributions of spatial and environmental variables to explain the phylogenetic composition of plots. We tested the indicator value of lineages for geographic regions and edaphic forest types and mapped associations onto the phylogeny. Results: In the terra firme and várzea forest types, the phylogenetic composition varies by geographic region, but the igapó and white-sand forest types retain a unique evolutionary signature regardless of region. Overall, we find that soil chemistry, climate and topography explain 24% of the variation in phylogenetic composition, with 79% of that variation being spatially structured (R$^{2}$ = 19% overall for combined spatial/environmental effects). The phylogenetic composition also shows substantial spatial patterns not related to the environmental variables we quantified (R$^{2}$ = 28%). A greater number of lineages were significant indicators of geographic regions than forest types. Main Conclusion: Numerous tree lineages, including some ancient ones (>66 Ma), show strong associations with geographic regions and edaphic forest types of Amazonia. This shows that specialization in specific edaphic environments has played a long-standing role in the evolutionary assembly of Amazonian forests. Furthermore, many lineages, even those that have dispersed across Amazonia, dominate within a specific region, likely because of phylogenetically conserved niches for environmental conditions that are prevalent within regions

Local hydrological conditions influence tree diversity and composition across the Amazon basin

Tree diversity and composition in Amazonia are known to be strongly determined by the water supplied by precipitation. Nevertheless, within the same climatic regime, water availability is modulated by local topography and soil characteristics (hereafter referred to as local hydrological conditions), varying from saturated and poorly drained to well-drained and potentially dry areas. While these conditions may be expected to influence species distribution, the impacts of local hydrological conditions on tree diversity and composition remain poorly understood at the whole Amazon basin scale. Using a dataset of 443 1-ha non-flooded forest plots distributed across the basin, we investigate how local hydrological conditions influence 1) tree alpha diversity, 2) the community-weighted wood density mean (CWM-wd) – a proxy for hydraulic resistance and 3) tree species composition. We find that the effect of local hydrological conditions on tree diversity depends on climate, being more evident in wetter forests, where diversity increases towards locations with well-drained soils. CWM-wd increased towards better drained soils in Southern and Western Amazonia. Tree species composition changed along local soil hydrological gradients in Central-Eastern, Western and Southern Amazonia, and those changes were correlated with changes in the mean wood density of plots. Our results suggest that local hydrological gradients filter species, influencing the diversity and composition of Amazonian forests. Overall, this study shows that the effect of local hydrological conditions is pervasive, extending over wide Amazonian regions, and reinforces the importance of accounting for local topography and hydrology to better understand the likely response and resilience of forests to increased frequency of extreme climate events and rising temperatures