REVISITANDO O CUIDADO EM SAÚDE: REVISÃO DE LITERATURA / NEW LOOK AT THE HEALTH CARE: LITERATURE REVIEW

Introdução: O cuidado é atitude, característica e necessidade própria do ser humano. Cuidadores em saúde (profissional ou não), estão suscetíveis a adoecer e sofrerem suas implicações biopsicossociais. Muitos trabalhos enfatizam a importância do cuidado com a saúde do cuidador familiar, entretanto, poucos são direcionados para o profissional de saúde enquanto pessoa que cuida e demanda cuidados. Objetivo: Realizar levantamento bibliográfico sobre o cuidar e as conseqüências para aquele que cuida, enfocando sobre saúde e estresse profissional. Métodos: Estudo descritivo e bibliográfico em revistas e artigos científicos, sites especializados e livros técnicos sobre o tema. Resultados: O cuidado como profissão requer atenção quanto às experiências, muitas vezes antagônicas, vivenciadas. Os profissionais de saúde convivem com dor e sofrimento humano, doença e morte em suas rotinas laborais. Além disso, a nível hospitalar, possuem carga horária de trabalho excessiva e tem contato constante com situações limites de tensão e perigo de vida para si e para os outros. Assim, associando-se o comprometimento laboral e estresse crônico, o cuidador profissional pode desenvolver a Síndrome de Burnout, caracterizada por sinais e sintomas de ordem física e emocional, identificada por três elementos: Exaustão, Despersonalização e Baixo rendimento profissional. Esta síndrome tem implicações na saúde dos cuidadores em si e naquele que é cuidado. Conclusão: Pesquisas sobre a saúde dos cuidadores em saúde precisam ser estimuladas a fim de que se direcionem as políticas assistências à saúde destes profissionais.Palavras-chave: Cuidados em saúde. Cuidadores. Estresse profissional.AbstractIntroduction: Care is attitude, character and need as a human being. Health caregivers (professional or otherwise), characters - key health - disease process, are likely to suffer illness and biopsychosocial implications. Many studies stress the importance of health care of the family caregiver, however, few are directed to health professionals as a person who cares and demands care. Objective: literature on caring and the consequences for those who care, focusing on health and professional stress. Methods: This descriptive study and bibliographical and scientific articles in magazines, websites and specialized technical books on the subject. Results: The profession requires careful attention as to the experiences, often antagonistic, experienced. Health professionals live with pain and human suffering, disease and death in their daily work. In addition, the hospital level, have excessive workload and has constant contact with extreme situations of tension and danger of life for themselves and others. So, associating the work and commitment chronic stress, the caregiver can develop the professional Burnout Syndrome, characterized by signs and symptoms of physical and emotional, identified by three elements: exhaust you, depersonalization and low employment income. This syndrome has implications for the health of caregivers themselves and the one which is taken care of. Conclusion: Research on the health of caregivers in healthcare need to be encouraged to ensure that policies are to target assistance to the health of these professionals.Keywords: health care. Caregivers. Professional stress

EFEITOS DO EXTRATO DE AROEIRA NO FÍGADO APÓS ISQUEMIA-REPERFUSÃO HEPÁTICA: ESTUDO EXPERIMENTAL EM RATOS

Introdução: A isquemia-reperfusão hepática pode ser um artifício de controle para minimizar o sangramento durante cirurgias,mas há lesões consequentes a essa manobra devido distúrbios microcirculatórios. Objetivo: Estudar a repercussão do uso doextrato de Aroeira sobre o fígado, após isquemia e reperfusão hepática, através de parâmetros histopatológicos e enzimáticos.Métodos: Estudo experimental com 8 ratos machos, da linhagem Wistar, que foram divididos em dois grupos. O Grupo AR recebeudose única diária de extrato de Aroeira, enquanto o Grupo CTR recebia o mesmo volume de água destilada. Após dez dias, osanimais foram submetidos a 30 minutos de isquemia hepática, seguida de reperfusão. Após 8 horas, foi feita a hepatectomiatotal para análise histológica e punção cardíaca para coleta sanguínea. Resultados: O estudo mostrou que 75% dos ratos doGrupo AR tiveram alterações histopatológicas no fígado, especialmente tumefação hepatocelular e alterações na integridade doscapilares sinusoides, mas também foi comum o acometimento de esteatose hepática, necrose celular e inflamação lobular. NoGrupo CTR, 100% dos ratos apresentaram pelo menos duas alterações histopatológicas. As mais comuns foram: tumefaçãohepatocelular, esteatose hepática e mudança da integridade dos capilares sinusoides. Em relação à PCR, 100% dos animais tiveramaumento comparado ao valor de referência para ratos. Já as enzimas hepáticas, ALT e AST, tiveram 1 rato (25%) do Grupo ARcom aumento em relação ao valor de referência, encontrado p= 0.31 para ambas. Conclusão: o extrato de Aroeira não teve repercussõesmicroscópica ou enzimática estatisticamente significantes no fígado após lesão de isquemia-reperfusão hepática.Palavras-chave: Reperfusão. Isquemia. Hepatectomia

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

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

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

Acquired acoria and iris pearls in leprosy: case report

Universidade Federal do Pará. Hospital Universitário Bettina Ferro de Souza. Departamento de Oftalmologia. Belém, PA, Brazil.Universidade Federal do Pará. Hospital Universitário Bettina Ferro de Souza. Departamento de Oftalmologia. Belém, PA, Brazil.Universidade Federal do Pará. Hospital Universitário Bettina Ferro de Souza. Departamento de Oftalmologia. Belém, PA, Brazil.Universidade Federal do Pará. Hospital Universitário João de Barros Barreto. Laboratório de Anatomia Patológica. Belém, PA, Brazil.Universidade Federal do Pará. Hospital Universitário João de Barros Barreto. Laboratório de Investigações em Neurodegeneração e Infecção. Belém, PA, Brazil / Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Laboratório de Microscopia Eletrônica. Ananindeua, PA, Brasil.Universidade Federal do Pará. Hospital Universitário Bettina Ferro de Souza. Departamento de Oftalmologia. Belém, PA, Brazil / Universidade do Estado do Pará. Centro de Ciências Biológicas e da Saúde. Belém, PA, Brazil.Purpose: To describe a case of a patient presenting with acquired acoria and iris pearls, a rare eye manifestation and pathognomonic finding for leprosy; to reinforce clinical, histopathological, and therapeutic aspects of ocular involvement in leprosy. Methods: Case report. Case description: A 62-year-old male presenting with acquired acoria and iris pearls in both eyes due to leprosy also had anterior uveitis and cataract. Histopathological diagnosis of iris pearls was confirmed by the presence of Hansen’s bacilli. Ophthalmological examination revealed improvement of the visual acuity after iridectomy and extracapsular cataract extraction. Conclusions: To our knowledge, this is the first reported case of acquired acoria in a leprosy patient. It led to impaired vision and reversible blindness. Proper diagnosis and ophthalmological treatment of patients with these conditions are essential for the maintenance of a good quality of life

Uma etnologia dos "índios misturados"? Situação colonial, territorialização e fluxos culturais

Até recentemente os estudos sobre os povos e culturas indígenas do Nordeste brasileiro não constituíram um objeto mais sistemático de investigações, parecendo apenas propiciar uma etnologia secundária e menor. Na visão do autor, isso decorreu da dificuldade de aplicação àquelas culturas dos pressupostos da antropologia americanista, a qual opera com modelos societários que enfatizam a descontinuidade cultural, bem como a objetividade e a exterioridade do observado em face do pesquisador e de sua sociedade. Dialogando com diferentes perspectivas teóricas, o autor delineia ou reelabora algumas noções como, respectivamente, as de "territorialização", "situação colonial", "diáspora" e "viagem da volta" que lhe permitem realizar uma análise compreensiva do processo histórico que veio a transformar tais populações nos grupos étnicos atuais. Sugere, ao final, que os estudos que vêm sendo realizados no Brasil e em diferentes partes do mundo sobre "índios misturados" (isto é, relações interétnicas em áreas de colonização muito antiga) podem contribuir para a construção de uma antropologia mais articulada com a história.<br>Until quite recently, indigenous peoples in the Brazilian Northeast were not the object of systematic investigation, rather appearing to inspire a kind of secondary, lesser ethnology. According to the author, this oversight resulted from a difficulty in applying the premises of Americanist anthropology to such cultures, since the latter operates with societal models emphasizing both cultural discontinuity and the objectivity and externality of the observed vis-à-vis the researcher and his/her society. By establishing a dialogue with different theoretical perspectives, the author delineates or reworks several notions, such as "territorialization", "colonial situation", "diaspora", and "return journey", allowing him to produce a comprehensive analysis of the historical process which turned such populations into the current ethnic groups. Finally, he suggests that studies on "mixed Indians" (i.e., relations between ethnic groups in areas of very old colonization) in Brazil and elsewhere can help construct an anthropology that is better articulated with history