Anxiety and depression in asthma patients: impact on asthma control

OBJECTIVE: There is evidence that asthma is associated with an increase in psychiatric symptoms and mental disorders. This association can make it difficult to achieve asthma control. The purpose of this study was to determine whether the level of asthma control is associated with anxiety and depression. METHODS: A crosssectional study involving 78 patients with confirmed moderate or severe asthma and under regular treatment at the Asthma Outpatient Clinic of the Federal University of São Paulo Hospital São Paulo, in the city of São Paulo, Brazil. The patients were divided into two groups by asthma control status, as assessed by the asthma control test, and were subsequently compared in terms of demographic, clinical, and spirometric data, as well as scores for asthma quality of life and hospital anxiety/depression. RESULTS: The sample was predominantly female. Of the 78 patients, 49 (63%) were classified as having uncontrolled asthma. The prevalence of anxiety and of anxiety+depression was significantly higher among patients with uncontrolled asthma than among those with controlled asthma (78% and 100%; p = 0.04 and p = 0.02, respectively), whereas there were no differences between the two groups in terms of the prevalence of depression, spirometry results, or quality of life score. CONCLUSIONS: In this sample, the prevalence of anxiety symptoms was higher in the patients with uncontrolled asthma than in those with controlled asthma.In the evaluation of asthma patients, the negative impact of mood states ought to be taken into consideration when asthma control strategies are being outlined.OBJETIVO: Existem evidências da associação entre asma e sintomas psiquiátricos e transtornos mentais. Essa associação pode resultar em dificuldades de se atingir o controle da asma. O objetivo deste estudo foi avaliar a associação de ansiedade e depressão com o controle da asma. MÉTODOS: Estudo transversal com 78 pacientes asmáticos com diagnóstico confirmado de asma moderada a grave e regularmente tratados no Ambulatório de Asma do Hospital São Paulo da Universidade Federal de São Paulo (UNIFESP), São Paulo (SP). Os pacientes foram divididos em dois grupos em relação ao status de controle de asma, determinado através do teste de controle da asma, e, posteriormente, comparados em termos de dados demográficos, clínicos e espirométricos, escore do questionário de qualidade de vida para asma e escore da escala hospitalar de ansiedade e depressão. RESULTADOS: A maioria era do sexo feminino. Dos 78 pacientes, 49 (63%) foram classificados como tendo asma não controlada. A prevalência de ansiedade e do binômio ansiedade/depressão foi significantemente maior entre os pacientes não controlados do que nos controlados (78% e 100%; p = 0,04 e p = 0,02, respectivamente), enquanto nem prevalência de depressão, nem os dados espirométricos ou de qualidade de vida diferiram entre os grupos. CONCLUSÕES: Nesta amostra, os pacientes com asma não controlada apresentaram uma maior prevalência de sintomas de ansiedade que aqueles com asma controlada. Na avaliação de pacientes asmáticos, deve-se considerar o impacto negativo dos distúrbios de humor nas estratégias de controle da asma.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Programa de Pós-Graduação em PneumologiaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de PneumologiaUNIFESP, EPM, Programa de Pós-Graduação em PneumologiaUNIFESP, EPM, Depto. de PneumologiaSciEL

Terapia Ocupacional com crianças e jovens em pandemia: análise de processos de trabalho e reflexões para uma prática emancipatória/Occupational Therapy with children and young people during pandemic: analysis of work processes and reflections for an emancipatory practice

Contextualização: A partir de práticas de terapeutas ocupacionais na cidade de São Paulo, durante a pandemia do coronavírus, este artigo apresenta dois processos de trabalhos de terapeutas ocupacionais com crianças e jovens. Síntese dos elementos do estudo: análise dos processos de trabalho das profissionais no âmbito do SUS. Ferramentas específicas fundadas em uma abordagem crítica foram identificadas e descritas: análise do cotidiano com desenvolvimento de recursos adaptativos; análise de elementos da reprodução social; mapeamento, análise, proposição e legitimação de atividades significativas; articulação de recursos materiais para engajamento nestas atividades. Conclusão: Enfatizaram-se as contradições do modo de produção capitalista e das estruturas sociais ao produzir reflexões sobre uma prática situada e contextualizada.. Palavras-chave: Terapia Ocupacional. COVID-19. Infância. Juventude. Saúde Coletiva Abstract Contextualization: Based on the practices of occupational therapists in the city of São Paulo, during the coronavirus pandemic, this article presented two work processes of occupational therapists with children and young people. Synthesis of the study's elements: analysis of the processes of professionals in the work  within the scope of SUS. Specific tools based on a critical approach were identified and described: daily analysis and the development of adaptive resources; analysis of elements of social reproduction; mapping, analysis, proposition and legitimization of meaningful activities; articulation of material resources to engage in these activities. Conclusion: The contradictions of the mode of production and social structures were emphasized while producing reflections on a situated and contextualized practice.Keywords: Occupational Therapy. COVID-19. Childhood youth. Collective Health Resumen Objetivo: A partir de las prácticas de los terapeutas ocupacionales en la ciudad de São Paulo, durante la pandemia del coronavirus, este artículo presentado dos procesos de trabajo de terapeutas ocupacionales con niños y jóvenes. Síntesis de los elementos del estudio: análisis de los procesos de trabajo de los profesionales, en el ámbito del SUS. Se identificaron y describieron herramientas específicas basadas en un enfoque crítico: análisis diario con el desarrollo de recursos adaptativos; análisis de elementos de reproducción social; mapeo, análisis, propuesta y legitimación de actividades significativas; articulación de recursos materiales para participación en estas actividades. Conclusión: Las contradicciones del modo de producción y las estructuras sociales se enfatizaron al producir reflexiones sobre una práctica situada y contextualizada. Palabras clave: Niñez. Colaboración intersectorial. Terapia ocupacional. Participación comunitaria

Diagnósticos de enfermagem relacionados ao politraumatismo em atendimento pré-hospitalar móvel

The aim was to identify the most frequent nursing diagnoses in occurrences of multiple trauma, since this activity, exclusive to nurses, is recognized for its work of excellence in pre-hospital care. The results help nurses to act in the context of trauma emergencies and highlight the potential of nursing diagnoses in prioritizing care for patients who are victims of multiple traumas. It was evidenced that the Acute Pain diagnosis was more prevalent, even though pain is subjective and the target of lived experiences in relation to sensory perception. Then, the diagnosis of Impaired Physical Mobility, which involves the ability to move and the immobilizations performed during care, and then the diagnoses related to oxygenation and breathing, such as Ineffective Breathing Pattern and Impaired Gas Exchange. Specific nursing interventions for the diagnoses found were presented.Objetivou-se identificar os diagnósticos de enfermagem mais frequentes em ocorrências de politraumatismo, uma vez que essa atividade, privativa do enfermeiro, é reconhecida pelo seu trabalho de excelência no atendimento pré-hospitalar. Os resultados auxiliam na atuação do enfermeiro no cenário das emergências em trauma e salientam o potencial dos diagnósticos de enfermagem na priorização da assistência às pacientes vítimas de múltiplos traumas. Evidenciou-se que o diagnóstico Dor Aguda teve mais prevalência, mesmo a dor sendo subjetiva e alvo de experiências vividas em relação a percepção sensorial. Em seguida, o diagnóstico de Mobilidade Física Prejudicada, que envolve a capacidade de mover-se e as imobilizações feitas no atendimento, e então os diagnósticos relacionados à oxigenação e respiração, como Padrão Respiratório Ineficaz e Troca de Gases Prejudicada. Intervenções de enfermagem específicas para os diagnósticos encontrados foram apresentadas

Diagnósticos de enfermagem relacionados ao politraumatismo em atendimento pré-hospitalar móvel

The aim was to identify the most frequent nursing diagnoses in occurrences of multiple trauma, since this activity, exclusive to nurses, is recognized for its work of excellence in pre-hospital care. The results help nurses to act in the context of trauma emergencies and highlight the potential of nursing diagnoses in prioritizing care for patients who are victims of multiple traumas. It was evidenced that the Acute Pain diagnosis was more prevalent, even though pain is subjective and the target of lived experiences in relation to sensory perception. Then, the diagnosis of Impaired Physical Mobility, which involves the ability to move and the immobilizations performed during care, and then the diagnoses related to oxygenation and breathing, such as Ineffective Breathing Pattern and Impaired Gas Exchange. Specific nursing interventions for the diagnoses found were presented.Objetivou-se identificar os diagnósticos de enfermagem mais frequentes em ocorrências de politraumatismo, uma vez que essa atividade, privativa do enfermeiro, é reconhecida pelo seu trabalho de excelência no atendimento pré-hospitalar. Os resultados auxiliam na atuação do enfermeiro no cenário das emergências em trauma e salientam o potencial dos diagnósticos de enfermagem na priorização da assistência às pacientes vítimas de múltiplos traumas. Evidenciou-se que o diagnóstico Dor Aguda teve mais prevalência, mesmo a dor sendo subjetiva e alvo de experiências vividas em relação a percepção sensorial. Em seguida, o diagnóstico de Mobilidade Física Prejudicada, que envolve a capacidade de mover-se e as imobilizações feitas no atendimento, e então os diagnósticos relacionados à oxigenação e respiração, como Padrão Respiratório Ineficaz e Troca de Gases Prejudicada. Intervenções de enfermagem específicas para os diagnósticos encontrados foram apresentadas

Nutritional status and growth of indigenous Xavante children, Central Brazil

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to characterize the nutritional status of Xavante Indian children less than 10 years of age in Central Brazil and to evaluate the hypothesis of an association between child nutrition and socioeconomic differentiation in this population.</p> <p>Methods</p> <p>A cross-sectional study was conducted in July 2006 that included all children under the age of 10 from the Xavante village Pimentel Barbosa in Mato Grosso, Brazil. The data collected included weight, height, and sociodemographic information. Sociodemographic data were used to generate two indices ("income" and "wealth") and to determine the proportion of adults in each household. Descriptive analyses were performed for weight-for-age (W/A), height-for-age (H/A), and weight-for-height (W/H) using the NCHS and the WHO growth references. Univariate and multivariate analyses were conducted using H/A and W/A as a response variables.</p> <p>Results</p> <p>Of a total of 246 children under the age of ten residing in the village, 232 (94.3%) were evaluated. Following the NCHS reference, 5.6% of children under the age of ten presented low W/A and 14.7% presented low H/A. Among children under the age of five, deficit percentages for weight and height were 4.5% and 29.9%, respectively, following the WHO curves. Among children < 2 years of age, H/A index variability was found to be directly related to child's age and inversely related to the proportion of adults in the household. Maternal BMI was positively associated with growth for children from 2 to 4 years of age, explaining 11.5% of the z-score variability for the H/A index. For children 5 years of age and older, the wealth index and maternal height were positively associated with H/A. No significant associations were found using W/A as the dependent variable.</p> <p>Conclusion</p> <p>This study demonstrated that undernutrition, in particular linear growth deficit, is a notable health issue for Xavante children. These findings contrast with the nutritional profile observed among Brazilian children nationally, which is characterized by a sharp decline in child undernutrition in recent decades, even in the poorest regions of the country. This discrepancy calls attention to the persistent health disparities that exist between indigenous and non-indigenous people in Brazil.</p

Environmental Shaping of Sponge Associated Archaeal Communities

Archaea are ubiquitous symbionts of marine sponges but their ecological roles and the influence of environmental factors on these associations are still poorly understood.We compared the diversity and composition of archaea associated with seawater and with the sponges Hymeniacidon heliophila, Paraleucilla magna and Petromica citrina in two distinct environments: Guanabara Bay, a highly impacted estuary in Rio de Janeiro, Brazil, and the nearby Cagarras Archipelago. For this we used metagenomic analyses of 16S rRNA and ammonia monooxygenase (amoA) gene libraries. Hymeniacidon heliophila was more abundant inside the bay, while P. magna was more abundant outside and P. citrina was only recorded at the Cagarras Archipelago. Principal Component Analysis plots (PCA) generated using pairwise unweighted UniFrac distances showed that the archaeal community structure of inner bay seawater and sponges was different from that of coastal Cagarras Archipelago. Rarefaction analyses showed that inner bay archaeaoplankton were more diverse than those from the Cagarras Archipelago. Only members of Crenarchaeota were found in sponge libraries, while in seawater both Crenarchaeota and Euryarchaeota were observed. Although most amoA archaeal genes detected in this study seem to be novel, some clones were affiliated to known ammonia oxidizers such as Nitrosopumilus maritimus and Cenarchaeum symbiosum.The composition and diversity of archaeal communities associated with pollution-tolerant sponge species can change in a range of few kilometers, probably influenced by eutrophication. The presence of archaeal amoA genes in Porifera suggests that Archaea are involved in the nitrogen cycle within the sponge holobiont, possibly increasing its resistance to anthropogenic impacts. The higher diversity of Crenarchaeota in the polluted area suggests that some marine sponges are able to change the composition of their associated archaeal communities, thereby improving their fitness in impacted environments