Políticas Públicas de Prevenção do Suicídio no Brasil: uma revisão sistemática

O presente trabalho reflete sobre a negligência histórica da prevenção do suicídio como objeto de políticas públicas no Brasil, a partir de elementos teóricos do processo de formação de agenda e formulação. Foram realizadas entrevistas semi-estruturadas com especialistas (da área da psicologia clínica e da gestão de políticas municipais de saúde) e pesquisa de dados secundários (bibliografia especializada na área da Saúde Pública). Analisa-se neste trabalho as dificuldades para que a questão da prevenção do suicídio seja valorizada como objeto organizador de um vetor de ação no campo da saúde, como tem potencial epidemiológico para ser. Argumentase que problemas como o tabu, a subnotificação, o atendimento, a abordagem da mídia, o acesso aos métodos, o abuso de substâncias químicas, entre outros, estão na raiz do processo da negligência do tema no sistema de saúde

Suicide rates and trends in Sao Paulo, Brazil, according to gender, age and demographic aspects: a joinpoint regression analysis

Objective: To evaluate suicide rates and trends in Sao Paulo by sex, age-strata, and methods. Methods: Data was collected from State registry from 1996 to 2009. Population was estimated using the National Census. We utilized joinpoint regression analysis to explore temporal trends. We also evaluated marital status, ethnicity, birthplace and methods for suicide. Results: In the period analyzed, 6,002 suicides were accrued with a rate of 4.6 per 100,000 (7.5 in men and 2.0 in women); the male-to-female ratio was around 3.7. Trends for men presented a significant decline of 5.3% per year from 1996 to 2002, and a significant increase of 2.5% from 2002 onwards. Women did not present significant changes. For men, the elderly (> 65 years) had a significant reduction of 2.3% per year, while younger men (25-44 years) presented a significant increase of 8.6% from 2004 onwards. Women did not present significant trend changes according to age. Leading suicide methods were hanging and poisoning for men and women, respectively. Other analyses showed an increased suicide risk ratio for singles and foreigners. Conclusions: Specific epidemiological trends for suicide in the city of Sao Paulo that warrant further investigation were identified. High-risk groups - such as immigrants - could benefit from targeted strategies of suicide prevention

ESTUDO ECOLÓGICO SOBRE SUICÍDIO E HOMICÍDIO NO ESTADO DE MINAS GERAIS, BRASIL

Suicide and homicide are known public health problem. The objective was to evaluate correlations between suicide, homicide and sociodemographic variables through an ecological study. Mortality and sociodemographic data were collected from the Ministry of Health and the National Census, aggregated by micro-regions. The data were analyzed using correlation and multiple linear regression. Suicide rates for the total population, men and women were 5.7; 9.0 and 2.4 per 100 000 inhabitants, respectively. Suicide rates for the total population were higher in the central and southern regions. The suicide ranged from 1.2 (Nanuque) to 16.3 (Diamantina). Homicide rates for the total population, men and women were 18.6; 33.6 and 4.0 per 100 000, respectively. The homicide rates for the total population ranged from 1.9 (Sao Lourenço) to 41.8 (Mantena). The highest rates occur in the northwest and northeast regions. Among men, suicide and homicide were negatively correlated (r -0.28, p<0.05). Different sociodemographic variables were found to be associated with suicide and homicide in the regressions. Suicide showed a spatial pattern suggesting that it is related to high socioeconomic status. Homicide presented the inverse spatial pattern. New researches at different levels and states are needed to elucidate these phenomena.Suicídio e homicídio são conhecidos problemas de saúde pública. O objetivo desse trabalho foi avaliar a relação entre suicídio, homicídio e variáveis sociodemográficas num estudo ecológico em Minas Gerais. Os dados foram coletados pelo Ministério da Saúde e pelo Censo Nacional, agregados por microrregiões. Utilizaram-se correlação e regressão linear múltipla na análise. As taxas de suicídio para a população total, homens e mulheres foram 5,7; 9,0 e 2,4 por 100 mil habitantes, respectivamente. O suicídio apresentou maiores taxas na região central e sul. As taxas de suicídio para população total variaram de 1,2 (Nanuque) a 16,3 (Diamantina). As taxas de homicídio para a população total, homens e mulheres foram 18,6; 33,6 e 4,0 por 100 000 habitantes, respectivamente. As taxas de homicídio para a população total variaram de 1,9 (São Lourenço) a 41,8 (Mantena). As maiores taxas ocorrem na região noroeste e nordeste. Entre os homens, suicídio e homicídio foram negativamente correlacionados (r -0,28, p<0,05). Diferentes variáveis sociodemográficas foram associadas ao suicídio e homicídio nas regressões. Suicídio apresentou um padrão espacial, sugerindo que ele está relacionado com alto nível socioeconômico. Homicídio apresentou o padrão inverso. Novos estudos em outros níveis e estados são necessários para esclarecer esses fenômenos

Retrato geoepidemiológico das pessoas assistidas por organização não governamental de apoio ao câncer / Geoepidemiological portrait of people assisted by cancer supporting non-governmental organization

Justificativa e Objetivos: O câncer é considerado importante problema de saúde pública e as organizações não governamentais vem ganhando mais reconhecimento na assistência ao indivíduo, agindo como parceiras dos setores público e privado. O objetivo foi descrever o retrato geoepidemiológico dos indivíduos com câncer assistidos por uma organização não governamental. Método:  Estudo transversal, descritivo, a partir dos cadastros de indivíduos com câncer realizados entre maio de 2002 e maio de 2017, obtidos do banco de dados da organização não governamental. Para a descrição do perfil epidemiológico foram utilizadas as variáveis idade, sexo, local de residência, estado civil, renda, situação de acompanhamento junto à associação e localização do tumor. A distribuição espacial foi feita por meio da construção de mapas temáticos. Resultados: No período analisado, 2732 indivíduos foram assistidos. Os tumores dos órgãos digestivos (23,17%) foram os mais prevalentes, seguido de câncer de mama (16,73%) e órgão genitais masculinos (12,88%). Verificou-se que a maioria dos assistidos era idosos, casados e com renda familiar entre 1 e 2 salários mínimos. A análise espacial evidenciou que o município sede apresentou o maior número de indivíduos assistidos (1394), seguido pelos municípios vizinhos.  Conclusão: Entender o perfil dos indivíduos que procuram pelo apoio de organização não governamental no enfrentamento do câncer é fundamental para colocar em discussão e dar mais direcionamento ao processo de cuidado oferecido por essas instituições

The ASTRO-H X-ray Observatory

The joint JAXA/NASA ASTRO-H mission is the sixth in a series of highly successful X-ray missions initiated by the Institute of Space and Astronautical Science (ISAS). ASTRO-H will investigate the physics of the high-energy universe via a suite of four instruments, covering a very wide energy range, from 0.3 keV to 600 keV. These instruments include a high-resolution, high-throughput spectrometer sensitive over 0.3-2 keV with high spectral resolution of Delta E < 7 eV, enabled by a micro-calorimeter array located in the focal plane of thin-foil X-ray optics; hard X-ray imaging spectrometers covering 5-80 keV, located in the focal plane of multilayer-coated, focusing hard X-ray mirrors; a wide-field imaging spectrometer sensitive over 0.4-12 keV, with an X-ray CCD camera in the focal plane of a soft X-ray telescope; and a non-focusing Compton-camera type soft gamma-ray detector, sensitive in the 40-600 keV band. The simultaneous broad bandpass, coupled with high spectral resolution, will enable the pursuit of a wide variety of important science themes.Comment: 22 pages, 17 figures, Proceedings of the SPIE Astronomical Instrumentation "Space Telescopes and Instrumentation 2012: Ultraviolet to Gamma Ray

Hitomi (ASTRO-H) X-ray Astronomy Satellite

The Hitomi (ASTRO-H) mission is the sixth Japanese x-ray astronomy satellite developed by a large international collaboration, including Japan, USA, Canada, and Europe. The mission aimed to provide the highest energy resolution ever achieved at E  >  2  keV, using a microcalorimeter instrument, and to cover a wide energy range spanning four decades in energy from soft x-rays to gamma rays. After a successful launch on February 17, 2016, the spacecraft lost its function on March 26, 2016, but the commissioning phase for about a month provided valuable information on the onboard instruments and the spacecraft system, including astrophysical results obtained from first light observations. The paper describes the Hitomi (ASTRO-H) mission, its capabilities, the initial operation, and the instruments/spacecraft performances confirmed during the commissioning operations for about a month

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase&nbsp;1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation&nbsp;disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age&nbsp; 6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score&nbsp; 652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc&nbsp;= 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N&nbsp;= 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in&nbsp;Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in&nbsp;Asia&nbsp;and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701