Relato de experiência sobre consulta de enfermagem realizada por acadêmicos como estratégia de promoção de saúde / Experience report on the nursing consultation performed by students as a health promotion strategy

Objetivo: Apresentar as experiências e as atividades vividas por acadêmicos de enfermagem sob supervisão de um professor, compartilhando aspectos teóricos e práticos do momento vivido pelos autores neste singular ambiente de assistência de enfermagem como forma de promoção em saúde para prevenção de diabetes mellitus e hipertensão arterial sistêmica. Métodos: Trata-se de um relato de experiência, com característica qualitativa a partir de métodos descritivos e observacionais. Foi realizada uma ação educativa pelos acadêmicos de enfermagem juntamente de um professor, com 93 participantes, em um Centro Universitário localizado na cidade de Niterói/RJ, em maio de 2022. Criou-se um instrumento para aplicação na consulta de enfermagem. Resultados e discussão: A realização das consultas de enfermagem oportunizou o amadurecimento profissional dos graduandos, visto que estes exerceram o raciocínio clínico ao pôr em prática seus conhecimentos teóricos e assistenciais previamente adquiridos no curso. Além disso, o público assistido ressaltou a importância do acolhimento recebido nas consultas, sendo um diferencial na prática do autocuidado. Conclusão: Os acadêmicos identificaram a potencialidade do enfermeiro diante do seu papel como educador em saúde. Diante disso, sugere-se construir consultórios de enfermagem nas universidades ao entender a sua importância na formação do profissional enfermeiro, oportunizando vivências práticas ricas em aprendizado ao reconhecer a realidade do aumento das doenças crônicas não transmissíveis no país

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Versican and Tumor-Associated Macrophages Promotes Tumor Progression and Metastasis in Canine and Murine Models of Breast Carcinoma

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2019-09-30T16:13:26Z No. of bitstreams: 1 Reis, C. D. Versican....pdf: 6212673 bytes, checksum: f0e5f7d54df5fde4549844031d7af599 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2019-09-30T16:50:18Z (GMT) No. of bitstreams: 1 Reis, C. D. Versican....pdf: 6212673 bytes, checksum: f0e5f7d54df5fde4549844031d7af599 (MD5)Made available in DSpace on 2019-09-30T16:50:18Z (GMT). No. of bitstreams: 1 Reis, C. D. Versican....pdf: 6212673 bytes, checksum: f0e5f7d54df5fde4549844031d7af599 (MD5) Previous issue date: 2019Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES).Universidade Federal de Minas Gerais. Institute of Biological Sciences. Department of General Pathology. Belo Horizonte, MG, Brazil / Universidade Federal de Minas Gerais. Institute of Biological Sciences. Laboratory of Pulmonary Immunology and Mechanics. Department of Physiology and Biophysics. Belo Horizonte, MG, Brazil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.Universidade Federal de Minas Gerais. Institute of Biological Sciences. Department of General Pathology. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Institute of Biological Sciences. Department of General Pathology. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Institute of Biological Sciences. Department of General Pathology. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Institute of Biological Sciences. Laboratory of Pulmonary Immunology and Mechanics. Department of Physiology and Biophysics. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Institute of Biological Sciences. Department of General Pathology. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Institute of Biological Sciences. Laboratory of Pulmonary Immunology and Mechanics. Department of Physiology and Biophysics. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Institute of Biological Sciences. Department of Biochemistry and Immunology. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Institute of Biological Sciences. Department of General Pathology. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Institute of Biological Sciences. Department of General Pathology. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Institute of Biological Sciences. Laboratory of Pulmonary Immunology and Mechanics. Department of Physiology and Biophysics. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Institute of Biological Sciences. Department of General Pathology. Belo Horizonte, MG, Brazil.Versican and tumor-associated macrophages (TAMs) are involved in growth and metastases in several cancers. Here, we investigated the potential role of versican, a matrix proteoglycan, and its correlation with TAMs infiltrates in different stages of two different breast cancer models: spontaneous canine mammary gland carcinomas and the murine 4T1 breast cancer model. The stromal versican expression was correlated with TAMs accumulation in tumors with an advanced stage from spontaneous canine mammary carcinoma samples. Versican expression in mice, identified in late stages of tumor progression, was associated to a high number of peri-tumoral infiltrating TAMs. Indeed, TAMs were related to a pro-inflammatory and pro-angiogenic state in the primary tumor. Furthermore, TAMs accumulation was related to versican expression in the lungs and an increased number of pulmonary metastatic nodules with pulmonary mechanical dysfunction, which was due to leukocyte influx in the airways and elevated growth factor levels in the microenvironment. Thus, we suggest that versican and TAMs as attractive targets for breast cancer therapy

PRODUÇÃO DE RECURSOS DIDÁTICOS NA EXTENSÃO: PROPOSTAS DE ENSINO DE CIÊNCIAS USANDO INSTRUMENTOS DIDÁTICOS

A obra Produção de Recursos Didáticos na Extensão: Propostas de Ensino de Ciências Usando Instrumentos Didáticos é produto de pesquisas e trabalhos desenvolvidos no curso de Licenciatura em Biologia da Universidade Federal de Tocantins (UFT), Câmpus de Araguaína, através dos projetos de extensão Futuros Cientistas – Vêm para a Biologia (Coordenadora Lidianne Salvatierra) e Feira de Ciências do Estado do Tocantins (Coordenador Gecilane Ferreira) que possuem como objetivos centrais e confluentes a aproximação de alunos e professores da Educação Básica com a comunidade acadêmica, o fomento do senso de investigação científica de alunos do Ensino Fundamental e Ensino Médio, e apresentação e captação de futuros acadêmicos para o curso de Biologia.Ambos os projetos de extensão são desenvolvidos no âmbito do curso de Biologia com a participação de escolas públicas de Araguaína e demais municípios próximos, e consiste no desenvolvimento de dinâmicas de simulação de pesquisa, onde estudantes da rede básica aprendem mais sobre o curso de Biologia e são convidados a participarem ativamente dos eventos da universidade ainda durante a Educação Básica. Os projetos são de caráter intermitente a fim de contribuir para a diminuição da distância entre a comunidade externa e interna.A presente obra foi pensada em duas partes com objetivos distintos, porém interligados. Uma parte (Parte I) foca nesta obra como um produto acadêmico a partir de projetos de extensão na forma de um material de apoio aos professores de Ciências e Biologia que necessitam criar seus próprios recursos didáticos, e é composta por uma coletânea de comunicações curtas de planejamentos de modelos didáticos de baixo custo. E a segunda parte (Parte II) apresenta artigos completos que abordam a utilização de maquetes didáticas no ensino a partir de diferentes pontos de vistas e outros relatos de experiências provenientes das ações dos projetos de extensão. A seguir cada parte é detalhada, comentada e contextualizada:A Parte I – Coletânea de Comunicações Curtas sobre Modelos Didáticos de Invertebrados apresenta uma série de comunicações curtas sobre o processo de planejamento e confecção de maquetes didáticas de baixo custo com foco no ensino de Zoologia dentro das habilidades EM13CNT202 da Base Nacional Comum Curricular. Todas as comunicações foram elaboradas a fim de que professores e alunos possam utilizar as ideias apresentadas aqui e replicá-las em suas instituições de ensino. Os extensionistas e demais alunos do curso foram incentivados a utilizarem materiaisrecicláveis ou com o menor custo possível sempre pensando na realidade socioeconômica da maioria dos estudantes da rede pública brasileira.A Parte II – Coletânea de Artigos sobre o Uso de Modelos Didáticos reuni seis artigos completos que foram produzidos a partir das experiências promovidas com o desenvolvimento dos projetos de extensão no âmbito da Universidade Federal do Tocantins em colaboração com a comunidade externa. Os artigos possuem caráter de investigação científica sobre o uso de modelos didáticos e também de relato de experiência

Sustainability Agenda for the Pantanal Wetland: Perspectives on a Collaborative Interface for Science, Policy, and Decision-Making

International audienceBuilding bridges between environmental and political agendas is essential nowadays in face of the increasing human pressure on natural environments, including wetlands. Wetlands provide critical ecosystem services for humanity and can generate a considerable direct or indirect income to the local communities. To meet many of the sustainable development goals, we need to move our trajectory from the current environmental destructive development to a wiser wetland use. The current article contain a proposed agenda for the Pantanal aiming the improvement of public policy for conservation in the Pantanal, one of the largest, most diverse, and continuous inland wetland in the world. We suggest and discuss a list of 11 essential interfaces between science, policy, and development in region linked to the proposed agenda. We believe that a functional science network can booster the collaborative capability to generate creative ideas and solutions to address the big challenges faced by the Pantanal wetland

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status

Rare predicted loss-of-function variants of type I IFN immunity genes are associated with life-threatening COVID-19

BackgroundWe previously reported that impaired type I IFN activity, due to inborn errors of TLR3- and TLR7-dependent type I interferon (IFN) immunity or to autoantibodies against type I IFN, account for 15-20% of cases of life-threatening COVID-19 in unvaccinated patients. Therefore, the determinants of life-threatening COVID-19 remain to be identified in similar to 80% of cases.MethodsWe report here a genome-wide rare variant burden association analysis in 3269 unvaccinated patients with life-threatening COVID-19, and 1373 unvaccinated SARS-CoV-2-infected individuals without pneumonia. Among the 928 patients tested for autoantibodies against type I IFN, a quarter (234) were positive and were excluded.ResultsNo gene reached genome-wide significance. Under a recessive model, the most significant gene with at-risk variants was TLR7, with an OR of 27.68 (95%CI 1.5-528.7, P=1.1x10(-4)) for biochemically loss-of-function (bLOF) variants. We replicated the enrichment in rare predicted LOF (pLOF) variants at 13 influenza susceptibility loci involved in TLR3-dependent type I IFN immunity (OR=3.70[95%CI 1.3-8.2], P=2.1x10(-4)). This enrichment was further strengthened by (1) adding the recently reported TYK2 and TLR7 COVID-19 loci, particularly under a recessive model (OR=19.65[95%CI 2.1-2635.4], P=3.4x10(-3)), and (2) considering as pLOF branchpoint variants with potentially strong impacts on splicing among the 15 loci (OR=4.40[9%CI 2.3-8.4], P=7.7x10(-8)). Finally, the patients with pLOF/bLOF variants at these 15 loci were significantly younger (mean age [SD]=43.3 [20.3] years) than the other patients (56.0 [17.3] years; P=1.68x10(-5)).ConclusionsRare variants of TLR3- and TLR7-dependent type I IFN immunity genes can underlie life-threatening COVID-19, particularly with recessive inheritance, in patients under 60 years old

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified