CONTRIBUIÇÃO DA EXTENSÃO NA EDUCAÇÃO AMBIENTAL VOLTADA À GESTÃO DE RECURSOS HÍDRICOS

A Educação Ambiental (EA) é essencial para concretizar a gestão dos recursos hídricos numa bacia hidrográfica e a Extensão é o canal de interação dialógica, pois suas ações protagonizam a interação necessária para a troca de saberes (BRASIL, 2007), com desenvolvimento de inter-relações entre universidade, comunidade da bacia e atores sociais envolvidos nesta gestão. A participação social destes atores na gestão descentralizada, integrada e participativa dos recursos hídricos é garantida pelos comitês de bacia, parceiros naturais nas ações de EA. Buscando contribuir para a concretização desta gestão nas bacias dos rios Araranguá e Urussanga, comprometidas na qualidade de suas águas, elaborou-se, em parceria com os comitês destas bacias, o projeto de extensão “A gestão de recursos hídricos nas bacias dos rios Araranguá e Urussanga: conscientização e capacitação de seus atores sociais”, vinculado à Unidade Acadêmica Humanidades, Ciência e Educação (UNA HCE) da Universidade do Extremo Sul Catarinense (UNESC), entidade membro destes comitês. Desenvolvido ao longo dos anos de 2014 e 2015, o projeto teve como objetivo geral planejar, organizar e acompanhar as atividades dos planos de trabalho dos Comitês de bacia dos rios Araranguá e Urussanga. A Educação Ambiental voltada à gestão dos recursos hídricos perpassa a maioria das atividades desenvolvidas pelo projeto, ressaltando-se os cursos de capacitação de atores sociais e comunidade da bacia e os cursos nas escolas dos municípios integrantes da bacia do rio Araranguá, por ser a escola referência importante na comunidade e ter relevante papel na formação das pessoas e no incentivo à cidadania ambiental

CÂNCER DE ESTÔMAGO: FATORES DE RISCO, PREVENÇÃO E TRATAMENTO

Introduction: Stomach cancer poses a major challenge to public health worldwide. This disease is responsible for thousands of deaths every year and significantly impacts the quality of life of patients. Objective: The objective is to increase knowledge about stomach cancer by identifying the main risk factors, as well as the best prevention and treatment strategies. Methodology: A descriptive and qualitative literature review was conducted, analyzing scientific articles related to the research topic. Selection criteria included complete articles published in Portuguese between 2017 and 2022, while exclusion criteria involved duplicate articles, unavailable texts, publications in languages other than Portuguese, and studies published more than 5 years ago. Analysis and discussion of results: There are several risk factors that can increase the likelihood of developing stomach cancer. Among them, infection by the Helicobacter pylori bacterium is one of the most significant. Prevention plays a fundamental role in reducing the incidence of stomach cancer, and adopting simple measures can make a difference. Avoiding smoking and excessive alcohol consumption are essential steps in this process, as these habits are associated with a higher risk of developing the disease. Conclusion: In conclusion, stomach cancer represents a significant challenge to global health, but prevention and adequate treatment play a crucial role in reducing its incidence and increasing survival rates.Introdução: O câncer de estômago representa um grande desafio para a saúde pública em todo o mundo. Essa doença é responsável por milhares de mortes todos os anos e afetam significativamente a qualidade de vida dos pacientes. Objetivo: é aumentar o conhecimento sobre o câncer de estomago, identificando os principais fatores de risco, bem como as melhores estratégias de prevenção e tratamento. Metodologia: uma revisão bibliográfica de caráter descritivo e abordagem qualitativa, com análise de literaturas científicas que nos remetam ao objeto de pesquisa. Utilizamos como critérios de seleção da literatura, artigos completos, publicados em português, no período de 2017-2022, e os critérios de exclusão os artigos repetidos, publicações com textos indisponíveis, fora da língua vernácula e estudos com mais de 5 anos de publicação, fora do recorte temporal. Analise e discussão dos resultados: Existem diversos fatores de risco que podem aumentar a probabilidade de desenvolver câncer de estômago. Entre eles, a infecção pela bactéria Helicobacter pylori é um dos mais significativos. prevenção desempenha um papel fundamental na redução da incidência do câncer de estômago, e adotar medidas simples pode fazer a diferença. Evitar o tabagismo e o consumo excessivo de álcool são passos essenciais nesse processo, uma vez que esses hábitos estão associados a um maior risco de desenvolver essa doença Conclusão: Em conclusão, o câncer de estômago representa um desafio significativo para a saúde global, mas a prevenção e o tratamento adequado desempenham um papel crucial na redução de sua incidência e no aumento das taxas de sobrevivência

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research