Heat waves and mortality in the Brazilian Amazon: Effect modification by heat wave characteristics, population subgroup, and cause of death.

BACKGROUND: The Brazilian Amazon faces overlapping socio-environmental, sanitary, and climate challenges, and is a hotspot of concern due to projected increases in temperature and in the frequency of heat waves. Understanding the effects of extreme events on health is a central issue for developing climate policies focused on the population's health. OBJECTIVES: We investigated the effects of heat waves on mortality in the Brazilian Amazon, examining effect modification according to various heat wave definitions, population subgroups, and causes of death. METHODS: We included all 32 Amazonian municipalities with more than 100,000 inhabitants. The study period was from 2000 to 2018. We obtained mortality data from the Information Technology Department of the Brazilian Public Healthcare System, and meteorological data were derived from the ERA5-Land reanalysis dataset. Heat waves were defined according to their intensity (90th; 92.5th; 95th; 97.5th and 99th temperature percentiles) and duration (≥2, ≥3, and ≥4 days). In each city, we used a time-stratified case-crossover study to estimate the effects of each heat wave definition on mortality, according to population subgroup and cause of death. The lagged effects of heat waves were estimated using conditional Poisson regression combined with distributed lag non-linear models. Models were adjusted for specific humidity and public holidays. Risk ratios were pooled for the Brazilian Amazon using a univariate random-effects meta-analysis. RESULTS: The pooled relative risks (RR) for mortality from total non-external causes varied between 1.03 (95% CI: 1.01-1.06), for the less stringent heat wave definition, and 1.18 (95% CI: 1.04-1.33) for the more stringent definition. The mortality risk rose as the heat wave intensity increased, although the increase from 2 to 3, and 3-4 days was small. Although not statistically different, our results suggest a higher mortality risk for the elderly, this was also higher for women than men, and for cardiovascular causes than for non-external or respiratory ones. CONCLUSIONS: Heat waves were associated with a higher risk of mortality from non-external causes and cardiovascular diseases. Heat wave intensity played a more important role than duration in determining this risk. Suggestive evidence indicated that the elderly and women were more vulnerable to the effects of heat waves on mortality.

Prevalência de Blastocystis sp. em moradores de uma comunidade quilombola na região pantaneira do estado de Mato Grosso / Prevalence of Blastocystis sp. in inhabitants of a quilombola community in the pantanal region of Mato Grosso state / Prevalencia de Blastocystis sp. en habitantes de una comunidad quilombola de la región del pantanal del estado de Mato Grosso

Introdução: Blastocystis sp. é o parasito mais comum encontrado nos estudos de prevalência de parasitas intestinais em diferentes populações. Objetivo: determinar a prevalência do parasita intestinal Blastocystis sp. em moradores da comunidade quilombola Distrito Nossa Senhora Aparecida do Chumbo localizada em uma área rural do Município de Poconé-MT. Método: Trata-se de um estudo epidemiológico descritivo e quantitativo que determinou a prevalência do parasita intestinal Blastocystis sp. que ocorreu nos meses de dezembro de 2021 a maio de 2022. A amostra final foi composta por 114 participantes. Na identificação das formas evolutivas dos parasitas intestinais nas amostras fecais foi empregado o método de Hoffman. As amostras foram analisadas com auxílio do microscópio óptico e as lâminas foram coradas com lugol, para identificação das formas evolutivas dos parasitos. Para análise descritiva foi realizado a frequência absoluta e percentual. Foram realizados cálculos para determinar a prevalência total de parasitos intestinais e a prevalência por tipo de parasitas. Resultados: A prevalência total foi de 75%, deste a maior ocorrência foi apresentada por Blastocystis sp. Conclusão: Sugerimos, que a alta prevalência deste parasito que tem por via de contaminação fecal- oral, esteja associada à falta de um saneamento adequado, bem como ao acesso da água de qualidade.

Introduction: Blastocystis sp. is the most common parasite found in studies of intestinal parasite prevalence in different populations. Objective: To determine the prevalence of the intestinal parasite Blastocystis sp. in residents of the quilombola community of Distrito Nossa Senhora Aparecida do Chumbo located in a rural area of the Municipality of Poconé-MT. Method: This is a descriptive and quantitative epidemiological study that determined the prevalence of the intestinal parasite Blastocystis sp. that occurred in the months from December 2021 to May 2022. The final sample consisted of 114 participants. The Hoffman method was used to identify the evolutionary forms of the intestinal parasites in the fecal samples. The samples were analyzed with the aid of an optical microscope and the slides were stained with lugol to identify the evolutive forms of the parasites. For descriptive analysis, absolute and percentage frequency was performed. Calculations were performed to determine the total prevalence of intestinal parasites and the prevalence by type of parasites. Results: The total prevalence was 75%, of this the highest occurrence was presented by Blastocystis sp. Conclusion: We suggest, that the high prevalence of this parasite that has a fecal-oral contamination route, is associated with the lack of proper sanitation, as well as access to quality water.

Introducción: Blastocystis sp. es el parásito más común encontrado en estudios de prevalencia de parásitos intestinales en diferentes poblaciones. Objetivo: Determinar la prevalencia del parásito intestinal Blastocystis sp. en residentes de la comunidad quilombola del Distrito Nossa Senhora Aparecida do Chumbo localizada en una zona rural del Municipio de Poconé-MT. Método: Se trata de un estudio epidemiológico descriptivo y cuantitativo que determinó la prevalencia del parásito intestinal Blastocystis sp. ocurrida en los meses de diciembre de 2021 a mayo de 2022. La muestra final estuvo compuesta por 114 participantes. Se utilizó el método Hoffman para identificar las formas evolutivas de los parásitos intestinales en las muestras fecales. Las muestras se analizaron con la ayuda de un microscopio óptico y los portaobjetos se tiñeron con lugol para identificar las formas evolutivas de los parásitos. Para el análisis descriptivo se calcularon las frecuencias absolutas y porcentuales. Se realizaron cálculos para determinar la prevalencia total de parásitos intestinales y la prevalencia por tipo de parásitos. Resultados: La prevalencia total fue de 75%, de esta la mayor ocurrencia la presentó Blastocystis sp. Conclusión: Sugerimos, que la alta prevalencia de este parásito que tiene por vía de contaminación fecal-oral, está asociada a la falta de saneamiento adecuado, así como al acceso a agua de calidad.

Dispositional mindfulness, emotional regulation and perceived stress among nursing students.

OBJECTIVE: To investigate the correlation between dispositional mindfulness, emotional regulation and perceived stress and to verify factors associated with dispositional mindfulness among nursing students. METHOD: A correlational, cross-sectional study with public undergraduate students. The following instruments were used: Mindful Attention Awareness Scale, Emotional Regulation Questionnaire and Perceived Stress Scale. Analyzes were performed using t tests, Pearson's correlation and multiple linear regression. RESULTS: The study included 330 students. There was no correlation between dispositional mindfulness and general emotional regulation score and/or perceived stress and a weak correlation with the emotional regulation dimension emotional suppression. Being in psychological treatment and psychoactive substance use were associated with decreased dispositional mindfulness. Age, sufficient sleep hours and emotional suppression were associated with an increase in this variable. CONCLUSION: There was a relationship between dispositional mindfulness only with emotional suppression, in addition to the connection of this variable with the perception of sufficient sleep hours, age, use of alcohol or psychoactive substances, undergoing psychological/psychiatric follow-up and emotional suppression.

Dispositional mindfulness, emotional regulation and perceived stress among nursing students / Mindfulness disposicional, regulación emocional y estrés percibido en estudiantes de enfermería / Atenção plena disposicional, regulação emocional e estresse percebido em estudantes de enfermagem

ABSTRACT Objective: To investigate the correlation between dispositional mindfulness, emotional regulation and perceived stress and to verify factors associated with dispositional mindfulness among nursing students. Method: A correlational, cross-sectional study with public undergraduate students. The following instruments were used: Mindful Attention Awareness Scale, Emotional Regulation Questionnaire and Perceived Stress Scale. Analyzes were performed using t tests, Pearson's correlation and multiple linear regression. Results: The study included 330 students. There was no correlation between dispositional mindfulness and general emotional regulation score and/or perceived stress and a weak correlation with the emotional regulation dimension emotional suppression. Being in psychological treatment and psychoactive substance use were associated with decreased dispositional mindfulness. Age, sufficient sleep hours and emotional suppression were associated with an increase in this variable. Conclusion: There was a relationship between dispositional mindfulness only with emotional suppression, in addition to the connection of this variable with the perception of sufficient sleep hours, age, use of alcohol or psychoactive substances, undergoing psychological/psychiatric follow-up and emotional suppression.

RESUMEN Objetivo: Investigar la correlación entre mindfulness disposicional, regulación emocional y estrés percibido y verificar factores asociados al mindfulness disposicional en estudiantes de enfermería. Método: Estudio transversal, correlacional con estudiantes de universidades públicas. Los instrumentos fueron utilizados: Mindful Attention Awareness Scale, Emotional Regulation Questionnaire y Perceived Stress Scale. Los análisis se realizaron mediante pruebas t, correlación de Pearson y regresión lineal múltiple. Resultados: Participaron 330 estudiantes. No hubo correlación entre mindfulness disposicional y puntuación general de regulación emocional y/o estrés percibido y una débil correlación con la dimensión de regulación emocional supresión de emociones. Estar en tratamiento psicológico y el consumo de sustancias psicoactivas se asociaron con una disminución del mindfulness disposicional. La edad, la suficiencia de horas de sueño y la supresión emocional se asociaron con un aumento de esta variable. Conclusión: Hubo relación entre el mindfulness disposicional solo con la supresión de emociones, además de la conexión de esta variable con la percepción de suficientes horas de sueño, edad, consumo de alcohol o sustancias psicoactivas, estar en seguimiento psicológico/psiquiátrico y supresión emocional.

RESUMO Objetivo: Investigar a correlação entre atenção plena disposicional, regulação emocional e estresse percebido e verificar fatores associados à atenção plena disposicional em estudantes de enfermagem. Método: Estudo correlacional, transversal, com estudantes de universidade pública. Foram utilizados os instrumentos: Mindful Attention Awareness Scale, Emotional Regulation Questionnaire e Perceived Stress Scale. Análises foram realizadas por meio de testes t, correlação de Pearson e regressão linear múltipla. Resultados: Participaram 330 estudantes. Identificou-se ausência de correlação entre a atenção plena disposicional e escore geral de regulação emocional e/ou estresse percebido e correlação fraca com a dimensão de regulação emocional supressão das emoções. Estar em tratamento psicológico e uso de substância psicoativas se associou à diminuição da atenção plena disposicional. Já idade, suficiência de horas de sono e supressão emocional se associaram ao aumento desta variável. Conclusão Houve relação entre a atenção plena disposicional apenas com a supressão das emoções, além de ligação desta variável com percepção de horas suficientes de sono, idade, uso de álcool ou substâncias psicoativas, estar em acompanhamento psicológico/psiquiátrico e supressão emocional.

The effect of ambient temperature on blood pressure of patients undergoing hemodialysis in the Pantanal-Brazil.

The objective was to analyze the association of changes in pre-dialysis systolic and diastolic blood pressure with air temperature in a municipality in the Brazilian Pantanal, a tropical climate area. Longitudinal panel study, with analysis of mixed effects models of 133 hemodialysis patients in the city of Cáceres-Mato Grosso in 2014. Air temperature showed an inverse association with pre-dialysis systolic and diastolic blood pressure. With each increase of 1 °C in the mean air temperature, the pre-dialysis systolic blood pressure decreases -0.730mmHg (p ≤ 0.000) and the pre-dialysis diastolic blood pressure decreases -0.280mmHg (p ≤ 0.000). The estimated effect was greater for systolic blood pressure, but both pre-dialysis blood pressure measures are reduced with an increase in lag (up to two days), even when adjusted for relative air humidity. Air temperature is determinant for changes in pre-dialysis systolic and diastolic blood pressure in hemodialysis patients. The temperature effect was greater for systolic blood pressure than for diastolic blood pressure.

Identificação da fístula arteriovenosa e suas complicações pelos enfermeiros dos serviços de entrada de Cáceres - MT / Identification of arteriovenous fistula and its complications by the entry services nurses of Cáceres-MT

Objetivo: verificar o conhecimento dos enfermeiros sobre a identificação da fístula arteriovenosa e suas complicações nos serviços de entrada do município de Cáceres ­ MT. Métodos: estudo descritivo, transversal, nas Unidades Básicas de Saúde e Pronto Atendimento Médico de Cáceres ­ MT. Coleta de dados por meio de questionário estruturado autoaplicável com 14 enfermeiros. Resultados: o perfil caracteriza-se da seguinte forma: 64,5% trabalham na unidade básica de saúde, 63,6% são do sexo feminino, com idade de 30-39 anos (42,8%) e 71,4% têm especialização. Todos já atenderam e reconhecem a fístula, 85,7% já realizaram a palpação, 57,1% relatam que sabem identificar o frêmito, 85,7% nunca puncionaram e 50% realizaram a prescrição. Todos reconhecem pelo menos uma complicação, flebite e hematoma sendo as mais citadas. Houve confusão em 14% dos cuidados prescritos. Conclusão: os enfermeiros do município de Cáceres que trabalham nos serviços de entrada reconhecem a fístula e conhecem suas complicações, mas apresentam dificuldades em relação a prescrições de enfermagem próprias para fístula arteriovenosa.

Objective: to verify the knowledge of entry services nurses about the identification of arteriovenous fistula and its complications, in the city of Cáceres ­ MT. Methods: cross-sectional descriptive study at the Basic Health Units and Emergency Medical Care facilities of Cáceres ­ MT. Data was collected through a selfadministered structured questionnaire with 14 nurses. Results: the profile is characterized by 64.5% working in the basic health unit, female (63.6%), ages 30-39 (42.8%), and 71.4% having a specialization. All have already attended and recognize fistula, 85.7% have already done palpation, 57.1% report knowing how to identify fremitus, 85.7% never did a puncture, and 50% made the prescription. All recognize at least one complication, phlebitis and hematoma being the most frequently cited. There was confusion in 14% of the prescribed care. Conclusion: the nurses from the city of Cáceres who work in entry services recognize fistula and know its complications, but present difficulties regarding nursing prescriptions for arteriovenous fistula.

Evaluation of surveillance of contacts of new tuberculosis cases in the state of Mato Grosso - Brazil.

OBJECTIVE: To evaluate surveillance of contacts of new tuberculosis cases in the state of Mato Grosso from 1999 to 2004. METHODS: This was a descriptive epidemiological study based on data from the Tuberculosis Case Registry Database. The number of new tuberculosis cases, the number of contacts (estimated, investigated, and uninvestigated), and the tuberculosis incidence rate were analyzed by age bracket. The mean rate of contacts investigated for each case of tuberculosis by age bracket was calculated per year of study. The cases of pulmonary tuberculosis with and without contacts investigated were analyzed by sputum smear microscopy results. RESULTS: In 2004, there were 41.3 cases of tuberculosis per 100,000 inhabitants in the state of Mato Grosso. The south-central region presented the highest incidence rate (57 cases/100,000 inhabitants) and a 15% rate of contacts investigated. Among those younger than 15 years, 63 contacts (60.5%) were investigated, whereas among those aged 15 or older, 389 (8.9%) were investigated. In 1999, the mean rate of contacts investigated statewide was 0.02 (0.5%), and, in 2004, it reached 0.42 (10.5%). The percentage of contacts investigated was 40% higher among the contacts of contagious cases (OR = 1.4; 95% CI: 1.08-1.83). CONCLUSIONS: The percentage of contacts investigated is very low, principally among adults. The adoption of the standards for investigation of tuberculosis contacts proposed by the Brazilian National Ministry of Health Department of Health Surveillance has not ensured that this group at highest risk of developing active tuberculosis be given priority at health care facilities in the state of Mato Grosso.

Avaliação da vigilância de contatos de casos novos de tuberculose no Estado de Mato Grosso - Brasil / Evaluation of surveillance of contacts of new tuberculosis cases in the state of Mato Grosso - Brazil

OBJETIVO: Avaliar as ações de vigilância de contatos de casos novos de tuberculose em Mato Grosso no período de 1999 a 2004. MÉTODOS: Estudo epidemiológico descritivo baseado em dados do Sistema de Informação de Agravos de Notificação-Tuberculose. O número de casos novos de tuberculose, o número de contatos (estimados, examinados e não examinados) e a taxa de incidência de tuberculose foram analisados segundo a faixa etária. Calculou-se, por ano de estudo, a média de contatos examinados para cada caso de tuberculose segundo a faixa etária. Os casos de tuberculose pulmonar com e sem contatos examinados foram analisados segundo o resultado da baciloscopia. RESULTADOS: Em 2004, Mato Grosso apresentou 41,3 casos de tuberculose por 100 mil habitantes. A mesorregião centro-sul apresentou a maior taxa de incidência (57 casos/100 mil habitantes) e uma taxa de 15 por cento de contatos examinados. Entre os menores de 15 anos, examinaram-se 63 contatos (60,5 por cento), enquanto entre aqueles com 15 anos ou mais, examinaram-se 389 contatos (8,9 por cento). Em 1999, a média de contatos examinados em Mato Grosso foi de 0,02 (0,5 por cento), e, em 2004, ela alcançou 0,42 (10,5 por cento). O percentual de contatos examinados foi 40,0 por cento maior entre os contatos de casos bacilíferos (OR = 1,4; IC95 por cento: 1,08-1,83). CONCLUSÕES: O percentual de contatos examinados é muito baixo, principalmente entre os adultos. A normatização do exame de contatos de tuberculose pela Secretaria de Vigilância em Saúde do Ministério da Saúde não tem sido suficiente para garantir que esse grupo de maior risco de adoecimento seja priorizado pelos serviços de saúde de Mato Grosso.

OBJECTIVE: To evaluate surveillance of contacts of new tuberculosis cases in the state of Mato Grosso from 1999 to 2004. METHODS: This was a descriptive epidemiological study based on data from the Tuberculosis Case Registry Database. The number of new tuberculosis cases, the number of contacts (estimated, investigated, and uninvestigated), and the tuberculosis incidence rate were analyzed by age bracket. The mean rate of contacts investigated for each case of tuberculosis by age bracket was calculated per year of study. The cases of pulmonary tuberculosis with and without contacts investigated were analyzed by sputum smear microscopy results. RESULTS: In 2004, there were 41.3 cases of tuberculosis per 100,000 inhabitants in the state of Mato Grosso. The south-central region presented the highest incidence rate (57 cases/100,000 inhabitants) and a 15 percent rate of contacts investigated. Among those younger than 15 years, 63 contacts (60.5 percent) were investigated, whereas among those aged 15 or older, 389 (8.9 percent) were investigated. In 1999, the mean rate of contacts investigated statewide was 0.02 (0.5 percent), and, in 2004, it reached 0.42 (10.5 percent). The percentage of contacts investigated was 40 percent higher among the contacts of contagious cases (OR = 1.4; 95 percent CI: 1.08-1.83). CONCLUSIONS: The percentage of contacts investigated is very low, principally among adults. The adoption of the standards for investigation of tuberculosis contacts proposed by the Brazilian National Ministry of Health Department of Health Surveillance has not ensured that this group at highest risk of developing active tuberculosis be given priority at health care facilities in the state of Mato Grosso.