Global patterns of allochthony in stream-riparian meta-ecosystems.

Ecosystems that are coupled by reciprocal flows of energy and nutrient subsidies can be viewed as a single "meta-ecosystem." Despite these connections, the reciprocal flow of subsidies is greatly asymmetrical and seasonally pulsed. Here, we synthesize existing literature on stream-riparian meta-ecosystems to quantify global patterns of the amount of subsidy consumption by organisms, known as "allochthony." These resource flows are important since they can comprise a large portion of consumer diets, but can be disrupted by human modification of streams and riparian zones. Despite asymmetrical subsidy flows, we found stream and riparian consumer allochthony to be equivalent. Although both fish and stream invertebrates rely on seasonally pulsed allochthonous resources, we find allochthony varies seasonally only for fish, being nearly three times greater during the summer and fall than during the winter and spring. We also find that consumer allochthony varies with feeding traits for aquatic invertebrates, fish, and terrestrial arthropods, but not for terrestrial vertebrates. Finally, we find that allochthony varies by climate for aquatic invertebrates, being nearly twice as great in arid climates than in tropical climates, but not for fish. These findings are critical to understanding the consequences of global change, as ecosystem connections are being increasingly disrupted.

Factors associated with the hospitalization of users referred from primary health care to follow-up in Psychosocial Care Centers in the city of São Paulo, Brazil. / Fatores associados à internação de usuários encaminhados pela atenção primária para acompanhamento em Centros de Atenção Psicossociais do município de São Paulo, Brasil.

This study evaluated factors associated with hospitalization related to the mental health of people undergoing follow-up in Psychosocial Care Centers (CAPS, in Portuguese) in the city of São Paulo, Brazil, referred from Primary Health Care (PHC). This was an evaluative study conducted with 297 individuals in 24 adult CAPS. This study analyzed the prevalence ratios (PR) and their respective 95% confidence intervals (95% CI), obtained through Poisson Regression with robust variance. A statistically significant association was found with hospitalization during follow-ups in CAPS: having health insurance and/or medical plan; waiting time between the diagnosis and the first consultation with a non-medical professional of more than seven days; not having received medical advice regarding how long to use medication; not having received a psychopharmaceutical prescription at PHC; and having a medical history of the hospitalization due to mental health. The results warn of the need to expand access to the more socially vulnerable population, in addition to a restructuring of the services in order to provide more interactive and inclusive practices geared toward the singularities of the users.

Avaliaram-se os fatores associados à internação relacionadas à saúde mental de pessoas em acompanhamento nos Centros de Atenção Psicossocial (CAPS) do município de São Paulo, encaminhadas pela atenção primária (APS). Pesquisa avaliativa com 297 pessoas em 24 CAPS Adulto. Analisaram-se as razões de prevalência (RP) e seus respectivos intervalos de confiança de 95% (IC), obtidas por meio da regressão de Poisson com variância robusta. Mostraram associação estatisticamente significativa com a internação durante o acompanhamento no CAPS: ter plano de saúde/convênio médico; tempo de espera entre diagnóstico e primeiro atendimento com profissional não médico maior que sete dias; não ter sido orientado sobre o tempo de uso da medicação; não receber prescrição de psicofármaco na APS; e ter histórico de ocorrência de internação por saúde mental. Os resultados alertam para a necessidade de ampliação do acesso à população com maior vulnerabilidade social, além de uma reestruturação dos serviços para a oferta de prática mais articuladas e inclusivas, voltadas às singularidades dos usuários.

Fatores associados à internação de usuários encaminhados 1 pela atenção primária para acompanhamento em Centros de Atenção Psicossociais do município de São Paulo, Brasil / Factors associated with the hospitalization of users referred from primary health care to follow-up in Psychosocial Care Centers in the city of São Paulo, Brazil

Avaliaram-se os fatores associados à internação relacionadas à saúde mental de pessoas em acompanhamento nos Centros de Atenção Psicossocial (CAPS) do município de São Paulo, encaminhadas pela atenção primária (APS). Pesquisa avaliativa com 297 pessoas em 24 CAPS Adulto. Analisaram-se as razões de prevalência (RP) e seus respectivos intervalos de confiança de 95% (IC), obtidas por meio da regressão de Poisson com variância robusta. Mostraram associação estatisticamente significativa com a internação durante o acompanhamento no CAPS: ter plano de saúde/convênio médico; tempo de espera entre diagnóstico e primeiro atendimento com profissional não médico maior que sete dias; não ter sido orientado sobre o tempo de uso da medicação; não receber prescrição de psicofármaco na APS; e ter histórico de ocorrência de internação por saúde mental. Os resultados alertam para a necessidade de ampliação do acesso à população com maior vulnerabilidade social, além de uma reestruturação dos serviços para a oferta de prática mais articuladas e inclusivas, voltadas às singularidades dos usuários.

Fatores associados à internação de usuários encaminhados pela atenção primária para acompanhamento em Centros de Atenção Psicossociais do município de São Paulo, Brasil / Factors associated with the hospitalization of users referred from primary health care to follow-up in Psychosocial Care Centers in the city of São Paulo, Brazil

Resumo Avaliaram-se os fatores associados à internação relacionadas à saúde mental de pessoas em acompanhamento nos Centros de Atenção Psicossocial (CAPS) do município de São Paulo, encaminhadas pela atenção primária (APS). Pesquisa avaliativa com 297 pessoas em 24 CAPS Adulto. Analisaram-se as razões de prevalência (RP) e seus respectivos intervalos de confiança de 95% (IC), obtidas por meio da regressão de Poisson com variância robusta. Mostraram associação estatisticamente significativa com a internação durante o acompanhamento no CAPS: ter plano de saúde/convênio médico; tempo de espera entre diagnóstico e primeiro atendimento com profissional não médico maior que sete dias; não ter sido orientado sobre o tempo de uso da medicação; não receber prescrição de psicofármaco na APS; e ter histórico de ocorrência de internação por saúde mental. Os resultados alertam para a necessidade de ampliação do acesso à população com maior vulnerabilidade social, além de uma reestruturação dos serviços para a oferta de prática mais articuladas e inclusivas, voltadas às singularidades dos usuários.

Abstract This study evaluated factors associated with hospitalization related to the mental health of people undergoing follow-up in Psychosocial Care Centers (CAPS, in Portuguese) in the city of São Paulo, Brazil, referred from Primary Health Care (PHC). This was an evaluative study conducted with 297 individuals in 24 adult CAPS. This study analyzed the prevalence ratios (PR) and their respective 95% confidence intervals (95% CI), obtained through Poisson Regression with robust variance. A statistically significant association was found with hospitalization during follow-ups in CAPS: having health insurance and/or medical plan; waiting time between the diagnosis and the first consultation with a non-medical professional of more than seven days; not having received medical advice regarding how long to use medication; not having received a psychopharmaceutical prescription at PHC; and having a medical history of the hospitalization due to mental health. The results warn of the need to expand access to the more socially vulnerable population, in addition to a restructuring of the services in order to provide more interactive and inclusive practices geared toward the singularities of the users.

Associated factors with vaccine hesitancy in mothers of children up to two years old in a Brazilian city.

This study aims to evaluate maternal vaccine hesitancy and its associated factors. This is a cross-sectional study of a probabilistic sample of 450 mothers of children born in 2015, living in a Brazilian city, and who was, at the time of data collection, more than two years old. We used the tool proposed by the World Health Organization (10-item Vaccine Hesitancy Scale). To assess its structure, we performed, exploratory and confirmatory factor analyses. We performed linear regression models to evaluate the factors associated with vaccine hesitancy. The factor analysis showed two components for the vaccine hesitancy scale: lack of confidence in vaccines and risk perception of vaccines. High family income was associated with lower vaccine hesitancy (greater confidence in vaccines and lower risk perception of vaccines), while the presence of other children, regardless of birth order, in the family was associated with lower confidence in vaccines. A good rapport with health professionals, willingness to wait for the vaccination and the getting vaccinated through campaigns were associated with greater confidence in vaccines. The deliberate delay or decision not to vaccinate their children and previous experience with adverse reactions to the vaccine were associated with lower confidence in vaccines and greater risk perception of vaccines. Health care providers, especially nurses, play a relevant role to address vaccine hesitancy, guiding vaccination through a trustworthy rapport.

Hesitação da vacina da febre amarela e sua relação com influências contextuais, individuais ou de grupo e questões específicas da vacina: uma revisão de escopo / Yellow fever vaccine hesitancy and its relationship with contextual, individual, or group influences and vaccine-specific issues: a scoping review

Resumo A hesitação vacinal é um fenômeno com potencial para reduzir as taxas de cobertura vacinal, como observado na vacina contra febre amarela (VFA), propiciar epidemias e a reintrodução de doenças imunopreveníveis controladas. O objetivo deste estudo é mapear junto à literatura científica a relação entre a falta de informação, a segurança da vacina e os eventos adversos e a hesitação vacinal da VFA. Foi realizada uma revisão de escopo nas bases Biblioteca Virtual em Saúde (BVS), National Library of Medicine (PubMed), SCOPUS, Embase e Web of Science utilizando descritores controlados (DeCS/MeSH) e não controlados. Foram selecionados 11 artigos publicados nos idiomas inglês, espanhol e português, sem delimitação de tempo e que atenderam aos critérios de inclusão. Estiveram relacionados à hesitação vacinal da VFA informações falsas, conhecimento inadequado sobre o imunizante, falta de tempo para se vacinar, aceitação da vacina, insegurança na vacina e medo dos eventos adversos. Este estudo reforça a importância do acesso a informações adequadas, orientações sobre a segurança e os eventos adversos da VFA e pode auxiliar na elaboração de estratégias de saúde pública para mitigar a hesitação vacinal.

Abstract Vaccine hesitancy is a phenomenon with the potential to reduce vaccination coverage rates, as observed with the yellow fever vaccine (YFV), leading to epidemics and the reintroduction of controlled immunopreventable diseases. This study, together with the scientific literature, aims to map the relationship among the lack of information, vaccine safety and adverse events, and vaccine hesitancy concerning YFV. A scoping review was conducted in the Virtual Health Library (VHL), National Library of Medicine (PubMed), SCOPUS, Embase, and Web of Science databases, using controlled (DeCS/MeSH) and uncontrolled descriptors. In this work, we selected eleven articles, published in English, Spanish, and Portuguese, with no time limits, which met the inclusion criteria. False information, inadequate knowledge about the immunizer, lack of time to take a vaccination, acceptance of the vaccine, vaccine safety, and fear of adverse events were related to vaccine hesitancy. This study reinforces the importance of access to adequate information, provides guidance on YFV safety and adverse events, and can aid in the development of public health strategies to mitigate hesitancy.

Yellow fever vaccine hesitancy and its relationship with contextual, individual, or group influences and vaccine-specific issues: a scoping review. / Hesitação da vacina da febre amarela e sua relação com influências contextuais, individuais ou de grupo e questões específicas da vacina: uma revisão de escopo.

Vaccine hesitancy is a phenomenon with the potential to reduce vaccination coverage rates, as observed with the yellow fever vaccine (YFV), leading to epidemics and the reintroduction of controlled immunopreventable diseases. This study, together with the scientific literature, aims to map the relationship among the lack of information, vaccine safety and adverse events, and vaccine hesitancy concerning YFV. A scoping review was conducted in the Virtual Health Library (VHL), National Library of Medicine (PubMed), SCOPUS, Embase, and Web of Science databases, using controlled (DeCS/MeSH) and uncontrolled descriptors. In this work, we selected eleven articles, published in English, Spanish, and Portuguese, with no time limits, which met the inclusion criteria. False information, inadequate knowledge about the immunizer, lack of time to take a vaccination, acceptance of the vaccine, vaccine safety, and fear of adverse events were related to vaccine hesitancy. This study reinforces the importance of access to adequate information, provides guidance on YFV safety and adverse events, and can aid in the development of public health strategies to mitigate hesitancy.

A hesitação vacinal é um fenômeno com potencial para reduzir as taxas de cobertura vacinal, como observado na vacina contra febre amarela (VFA), propiciar epidemias e a reintrodução de doenças imunopreveníveis controladas. O objetivo deste estudo é mapear junto à literatura científica a relação entre a falta de informação, a segurança da vacina e os eventos adversos e a hesitação vacinal da VFA. Foi realizada uma revisão de escopo nas bases Biblioteca Virtual em Saúde (BVS), National Library of Medicine (PubMed), SCOPUS, Embase e Web of Science utilizando descritores controlados (DeCS/MeSH) e não controlados. Foram selecionados 11 artigos publicados nos idiomas inglês, espanhol e português, sem delimitação de tempo e que atenderam aos critérios de inclusão. Estiveram relacionados à hesitação vacinal da VFA informações falsas, conhecimento inadequado sobre o imunizante, falta de tempo para se vacinar, aceitação da vacina, insegurança na vacina e medo dos eventos adversos. Este estudo reforça a importância do acesso a informações adequadas, orientações sobre a segurança e os eventos adversos da VFA e pode auxiliar na elaboração de estratégias de saúde pública para mitigar a hesitação vacinal.

Effectiveness of physical therapy interventions on post-stroke spasticity: An umbrella review.

BACKGROUND: Post-stroke spasticity is often one of the primary impairments addressed in rehabilitation. However, limited guidance exists on the effectiveness of physical therapy (PT) interventions for post-stroke spasticity. OBJECTIVE: To evaluate the quality of evidence of PT interventions for post-stroke spasticity. METHODS: Ovid (Medline), Cochrane Library, CINAHL, Scopus, PEDro, and PROSPERO were searched to identify reviews based on the following criteria: 1) published between 2012 and 2021, 2) participants older than 18 years old, 3) post-stroke spasticity, 4) PT interventions, 5) clinical or neurophysiological measures of spasticity as primary outcomes. Assessment of Multiple Systematic Reviews 2 and the Grades of Recommendations Assessment, Development, and Evaluation assessed methodological quality. RESULTS: Eight articles were included in the analysis. No high-quality evidence was found. Moderate quality evidence exists for transcutaneous electrical nerve stimulation, neuromuscular electrical stimulation, resistance training, and lower extremity ergometer training with or without functional electrical stimulation. Low quality evidence exists for dynamic stretching, botulinum toxin with constraint-induced movement therapy, and static stretching using positional orthoses. CONCLUSION: Findings suggest that PT should prioritize a combination of active strategies over passive interventions, but further studies are needed prioritizing analyses of the movement system in managing post-stroke spasticity in conjunction with medical therapies.

Nutrition and Health Programming and Outreach in Grocery Retail Settings: A Community Coalition in Action.

Grocery stores can provide a conducive environment for interventions targeting healthy eating and access to health services, particularly in low-income communities. A wide array of organizations deliver nutrition and related programs in community settings, but rarely in a coordinated fashion. Collaboration of local health promotion organizations with grocery stores could increase consumers' access to and selection of healthy foods and related services. This evaluation of the In-Store Programming and Outreach Coalition (IPOC) uses thematic analysis of first-person accounts from coalition members. To our knowledge, this is the first study of such a coalition. We present perspectives from six stakeholders about the IPOC strengths, challenges, and recommendations for strengthening the delivery of in-store interventions. Themes identified include partnership, increased client reach and cross-referrals, conflicting work schedules, leadership, and recommendations to identify coalition leaders and expand services to other grocery stores. We conclude that grocery stores can offer a suitable setting for programming and community outreach through coalitions.

In Silico Characterization of the Physicochemical and Biological Properties of the Pink (Pleurotus djamor var. salmoneostramineus) Oyster Mushroom Chromoprotein.

Cap color is an important commercial trait for oyster mushrooms. Various pigment constituents determine a diverse color. However, the pigments of oyster mushrooms are still ambiguous. The pink oyster mushroom (Pleurotus salmoneostramineus or Pleurotus djamor) chromoprotein is one of the few proteins belonging to this fungus that has a record of its sequence of amino acid residues. However, even though there are studies about this chromoprotein isolation, purification, and crystallization, the current information focused on its 3-dimensional model and the cofactor and prosthetic group (3H-indol-3-one) binding sites is unreliable and fragmented. Therefore, in this study, using free online servers such as Prot pi, GalaxyWEB, MIB, and CB-Dock2, a structural analysis and the prediction of its physicochemical and biological properties were conducted, to understand the possible function of this chromoprotein. The obtained results showed that this molecule is a protein with a molecular weight of 23 712.5 Da, an isoelectric point of 7.505, with oligomerization capacity in a dimer and glycation in the Ser6 residue. In addition, the participation of the residues Leu5, Leu8, Lys211, Ala214, and Gln215 in the binding of the prosthetic group to the protein was highlighted; as well as Ser6 and Pro7 are important residues for the interaction of the Mg2+ ion and eumelanin. Likewise, morphological changes based on different culture conditions (light/dark) showed that this protein is constitutive expressed and independent of blue light. The findings in this study demonstrate that pink chromoprotein is a melanosomal protein, and it possibly has a critical role in melanogenesis and the melanin polymerization. However, more experimental studies are needed to predict a possible mechanism of action and type of enzymatic activity.

Delayed vaccination the children up to 2 years of age.

OBJECTIVE: To analyze factors associated with vaccination delay in children up to 2 years of age. METHODS: Cross-sectional study with primary data from a probabilistic sample of 388 children born in 2015. The data were described using absolute and relative frequencies. For the analysis of factors associated with vaccination delay, Cox proportional risk regression was performed, considering the time from birth to the first vaccination delay as a dependent variable and as sociodemographic, economic, behavioral aspects related to health services as independent variables. RESULTS: The delayed vaccination rate was 88.66%. Variables associated with delayed vaccination were: mother's health problems during delivery or in the first 7 days (HR: 0.68; 95% CI: 0.48-0.96); hospitalization of the child in the first 2 years of life (HR: 1.52; 95% CI: 1.10-2.11); mother's poor bond with health professionals at the health unit (HR: 1.75; 95% CI: 1.01-3.03); purposeful decision to delay or not to vaccinate the child (HR: 1.56; 95% CI: 1.14-2.13). CONCLUSIONS: The factors associated with health care, such as the mother's health problems, the child's hospitalization in the first 2 years of life, and the bond between the mother and the health professionals affect the timeliness of vaccine doses.

Mortality due to hepatocellular carcinoma associated with hepatitis B and C viruses in the state of São Paulo, Brazil.

OBJECTIVE: This study aimed to describe and analyze the temporal and spatial distribution of deaths due to hepatocellular carcinoma (HCC) associated with hepatitis B (HBV) and C viruses (HCV) in the state of São Paulo. METHODS: This is an ecological study of HCC deaths associated with HBV and HCV in the state of São Paulo, from 2009 to 2017, with data from the Mortality Information System (SIM). The temporal trend was analyzed by linear regression with Prais-Winsten estimation. Deaths were described according to sociodemographic characteristics by means of absolute and relative frequencies and were spatially distributed according to the regional health department. RESULTS: It is found that 26.3% of deaths due to HCC were associated with HBV or HCV. A higher proportion of deaths due to HCC associated with HCV was observed (22.2%) when compared to HBV (3.9%). The mortality rate due to HCC associated with HBV showed a downward trend, and the mortality rate due to HCC associated with HCV showed a steady trend. Deaths of males, white individuals, those who aged from 50 to 59 years, and those who had 8-11 years of schooling predominated. Spatial analysis revealed a heterogeneous distribution of deaths in the state of São Paulo. CONCLUSIONS: The downward trend in mortality rates due to HCC associated with HBV shows an important advance in the disease control. However, the mortality rate due to HCC associated with HCV has remained stable throughout the study period. The spatial distribution of deaths may contribute to raise hypotheses for deeper knowledge of these diseases in the regions.

Mortality due to hepatocellular carcinoma associated with hepatitis B and C viruses in the state of São Paulo, Brazil / Mortalidade por carcinoma hepatocelular associado às hepatites virais B e C no estado de São Paulo, Brasil

ABSTRACT: Objective: This study aimed to describe and analyze the temporal and spatial distribution of deaths due to hepatocellular carcinoma (HCC) associated with hepatitis B (HBV) and C viruses (HCV) in the state of São Paulo. Methods: This is an ecological study of HCC deaths associated with HBV and HCV in the state of São Paulo, from 2009 to 2017, with data from the Mortality Information System (SIM). The temporal trend was analyzed by linear regression with Prais-Winsten estimation. Deaths were described according to sociodemographic characteristics by means of absolute and relative frequencies and were spatially distributed according to the regional health department. Results: It is found that 26.3% of deaths due to HCC were associated with HBV or HCV. A higher proportion of deaths due to HCC associated with HCV was observed (22.2%) when compared to HBV (3.9%). The mortality rate due to HCC associated with HBV showed a downward trend, and the mortality rate due to HCC associated with HCV showed a steady trend. Deaths of males, white individuals, those who aged from 50 to 59 years, and those who had 8-11 years of schooling predominated. Spatial analysis revealed a heterogeneous distribution of deaths in the state of São Paulo. Conclusions: The downward trend in mortality rates due to HCC associated with HBV shows an important advance in the disease control. However, the mortality rate due to HCC associated with HCV has remained stable throughout the study period. The spatial distribution of deaths may contribute to raise hypotheses for deeper knowledge of these diseases in the regions.

RESUMO: Objetivos: Este estudo tem como objetivo descrever e analisar a distribuição temporal e espacial dos óbitos por carcinoma hepatocelular associados às hepatites virais B e C no estado de São Paulo. Métodos: Estudo ecológico dos óbitos por carcinoma hepatocelular associados a hepatites virais B e hepatites virais C no estado de São Paulo, de 2009 a 2017, com dados do Sistema de Informação sobre Mortalidade. A tendência temporal foi analisada por regressão linear, com método de Prais-Winsten. Os óbitos foram descritos segundo as características sociodemográficas, por meio de frequências absolutas e relativas, e foram espacialmente distribuídos segundo departamento regional de saúde. Resultados: Dos óbitos por carcinoma hepatocelular, 26,3% foram associados a hepatites virais B ou hepatites virais C. Observou-se maior proporção de óbitos por carcinoma hepatocelular associado a hepatites virais C (22,2%) quando comparada àquela associada a hepatites virais B (3,9%). A taxa de mortalidade por carcinoma hepatocelular associado a hepatites virais B apresentou tendência de queda, no entanto a taxa de mortalidade por carcinoma hepatocelular associado a hepatites virais C apresentou tendência estacionária. Predominaram óbitos de pacientes do sexo masculino, de cor branca, de 50-59 anos e com oito a 11 anos de estudo. A análise espacial revelou distribuição heterogênea dos óbitos no estado de São Paulo. Conclusão: A tendência de queda nas taxas de mortalidade por carcinoma hepatocelular associado a hepatites virais B revela um importante avanço no controle do agravo. Entretanto, a taxa de mortalidade por carcinoma hepatocelular associado a hepatites virais C vem-se mantendo estável ao longo do período estudado. A distribuição espacial dos óbitos pode contribuir para levantar hipóteses com vistas ao conhecimento mais aprofundado desses agravos nas regiões.

Fatores associados à hesitação materna em vacinar e à situação vacinal de crianças de até dois anos de idade em Araraquara-SP / Factors associated with maternal hesitation in vaccinating and vaccination status of children up to two years of age in Araraquara-SP

Introdução: A vacinação é considerada uma das mais importantes intervenções de saúde pública. A queda nas coberturas brasileiras desencadeou preocupação acerca do possível impacto da hesitação vacinal nas metas do Programa Nacional de Imunização. Objetivo: Avaliar a hesitação materna em vacinar e a situação vacinal de crianças de até dois anos de idade. Métodos: Estudo transversal com análise de dados primários de inquérito vacinal de uma amostra probabilística estratificada das crianças nascidas em 2015 no município de Araraquara (SP). Foram coletados dados sociodemográficos e econômicos; informações de vacinação da caderneta de saúde da criança; características, informações de saúde da mãe, gravidez, parto e puerpério; características e informações de saúde da criança; aspectos relacionados à vacinação; atitudes maternas frente à vacinação; e informações sobre o uso da internet no cuidado da criança. A análise foi realizada por meio da regressão de Poisson com variância robusta, regressão de Cox e regressão linear. Resultados: As coberturas no inquérito vacinal para cada vacina específica variaram de 86 a 100%; já para o esquema completo a variação foi de 77% (12 meses) a 69% (24 meses), com heterogeneidade em suas distribuições espaciais. Orientação dos profissionais de saúde sobre vacinação no período de pré-natal ou pós parto, problemas de saúde materna durante o parto ou nos primeiros sete dias e relatos de reação adversa à vacina na criança foram associados à completude do calendário vacinal. Além disso, 89% das crianças atrasaram alguma dose de vacina, com as seguintes variáveis associadas a esse atraso: problemas de saúde da mãe durante o parto ou nos primeiros sete dias; internação da criança nos primeiros dois anos de vida; vínculo fraco da mãe com os profissionais de saúde da unidade de saúde; e, atraso proposital ou decisão de não vacinar a criança. Ainda, alta renda familiar foi associada à maior confiança nas vacinas e menor percepção de risco delas, enquanto a presença de outros filhos, independentemente da ordem de nascimento, na família foi associada a menor confiança nas vacinas. O bom relacionamento com os profissionais de saúde, a disposição para aguardar a aplicação da vacina e o hábito da vacinação nas campanhas foram associados à maior confiança nas vacinas. Já o atraso deliberado ou a decisão de não vacinar seus filhos e a experiência anterior com reações adversas à vacina foram associados com menor confiança nas vacinas e maior percepção de risco das vacinas. Conclusão: O estudo aponta para as altas coberturas vacinais, mas com distribuição espacial heterogênea. Ainda, destaca a importância das orientações dos profissionais de saúde sobre os benefícios e a segurança da vacina, desempenhando um papel relevante ao abordar a hesitação vacinal, orientando a vacinação através de uma relação de confiança.

Introduction: The vaccination is considered by public health as one of the most important interventions. The Brazilian vaccine coverage has fallen off and triggered off preoccupation concerning the impact of vaccine hesitancy in the Immunization National Program. Objective: To analyze the maternal hesitance and the vaccine status of the children up to two years old. Methods: The method was a cross-sectional study of primary data extracted from one stratified probabilistic sample of the children that was borned in 2015 from Araraquara municipality (SP). It was gathered: sociodemographic and economic data; information from the vaccine booklet; mothers characteristic and health information; pregnancy, delivery and postpartum period; aspects related to the vaccination; motherly attitudes towards the vaccination; and information about the use of the internet applied to child care. The Poisson regression, Cox regression and Linear regression were used in the analysis. Result: The coverage in the vaccine survey for each specific vaccine varied from 86 to 100%; yet, for the complete schedule the variation was of 77% (12 months) and 69% (24 months) with heterogeneity in its space distributions. The guidance from health professionals on vaccination for the mother; mother's health problems during the delivery or in the first seven days and reports of a previous episode of adverse reaction to the vaccine were associated with the completeness of the vaccination schedule. Moreover, the delayed vaccination rate was 88.66%. Variables associated with delayed vaccination were: mother's health problems during the delivery or in the first seven days; hospitalization of the child in the first two years of life; mother's poor bond with health professionals at the health unit; purposeful decision to delay or not to vaccinate the child. Still, familys high income was associated with greater confidence in vaccines and lower risk perception of vaccines, while the presence of other children, regardless of birth order, in the family was associated with lower confidence in vaccines. The good relationship with health professionals, the willingness to wait for the vaccine application, and the habit of vaccinating on campaign were associated with greater confidence in vaccines. The deliberate delay or the decision to not vaccinate their children and previous experience with adverse reactions to the vaccine were associated with lower confidence in vaccines and greater risk perception of vaccines. Conclusions: The study indicates the high vaccine coverage, but with heterogeneity in its space distributions. Even more, it highlights the importance of guidance from health professionals on vaccination about the advantages and vaccine safety, because they develop a relevant role in the vaccine hesitance, guiding the vaccination through a confidence relationship.

Impacts of detritivore diversity loss on instream decomposition are greatest in the tropics.

The relationship between detritivore diversity and decomposition can provide information on how biogeochemical cycles are affected by ongoing rates of extinction, but such evidence has come mostly from local studies and microcosm experiments. We conducted a globally distributed experiment (38 streams across 23 countries in 6 continents) using standardised methods to test the hypothesis that detritivore diversity enhances litter decomposition in streams, to establish the role of other characteristics of detritivore assemblages (abundance, biomass and body size), and to determine how patterns vary across realms, biomes and climates. We observed a positive relationship between diversity and decomposition, strongest in tropical areas, and a key role of abundance and biomass at higher latitudes. Our results suggest that litter decomposition might be altered by detritivore extinctions, particularly in tropical areas, where detritivore diversity is already relatively low and some environmental stressors particularly prevalent.

Productive Infection of Human Breast Cancer Cell Lines with Human Cytomegalovirus (HCMV).

Breast cancer is the leading cause of cancer deaths among women worldwide. There are many known risk factors for breast cancer, but the role of infectious disease remains unclear. Human cytomegalovirus (HCMV) is a widespread herpesvirus that usually causes little disease. Because HCMV has been detected in breast tumor biopsy samples and is frequently transmitted via human breast milk, we investigated HCMV replication in breast tumor cells. Four human breast cancer cell lines with different expression profiles for the key diagnostic markers of the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2), were infected with a bacterial artificial chromosome-derived HCMV clinical strain TB40/E tagged with green fluorescent protein (GFP). Fluorescence microscopy confirmed that all four breast cancer cell lines supported virus entry. RNA was isolated from infected cells and the expression of immediate early (UL123), early (UL54), and late (UL111A) genes was confirmed using PCR. Viral proteins were detected by immunoblotting, and viral progeny were produced during the infection of breast tumor cells, as evidenced by subsequent infection of fibroblasts with culture supernatants. These results demonstrate that breast tumor cells support productive HCMV infection and could indicate that HCMV replication may play a role in breast cancer progression.

Computerized immunization record agreement in Araraquara, São Paulo, Brazil, 2018. / Concordância do registro informatizado de imunização de Araraquara, São Paulo, 2018.

OBJECTIVE: To describe agreement between the Juarez System immunization data and information in vaccination record booklets and vaccination coverage in children aged 12 to 24 months. METHODS: This was a descriptive study to assess the vaccination status at 12 and 24 months of age of children born in 2015 and recorded on the Juarez System. The levels of agreement between the Juarez System data and the information in vaccination record booklets were verified. RESULTS: 429 children were included. It was found that agreement ranged between 84.1% and 99.1%. The vaccine survey found that coverage for each vaccine ranged from 86.01% to 100% and for the full schedule, from 77.1% (12 months) to 68.8% (24 months). The spatial distributions of vaccine coverage ranged from 28% to 100%. CONCLUSION: There was excellent agreement between the data, with high vaccination coverage, but heterogeneity in their spatial distributions.

Factors Associated with the Completeness of the Vaccination Schedule of Children at 12 and 24 Months of Age in a Brazilian Medium-Size Municipality.

PURPOSE: To analyse the factors associated with the completeness of the vaccination schedule of children at 12 and 24 months of age, in a Brazilian municipality. DESIGN AND METHODS: Cross-sectional study conducted in Araraquara-São Paulo with a probabilistic sample of 388 children born in 2015. The completeness of the vaccination schedule at 12 and 24 months of age was considered a dependent variable. Socioeconomic and demographic characteristics, use of health services and vaccination were the independent variables. For analysis, descriptive statistics and Poisson regression with robust variance were used. RESULTS: The completeness of the vaccination schedule at 12 and 24 months of age was identified in 77.1% and 68.8% of children, respectively. Coverage at 12 months was greater among children of mothers who received guidance from health professionals on vaccination or had health problems during childbirth or in the first seven days. Those who reported a previous episode of adverse reaction to the vaccine, coverage was lower. Coverage at 24 months was greater among those who received guidance from health professionals on vaccination or had health problems during childbirth or in the first seven days. Those who reported a previous episode of adverse reaction to the vaccine, coverage was lower. CONCLUSIONS: This study points to the importance of guiding health professionals, particulary nurses, on the vaccination and vaccine safety. CLINICAL IMPLICATIONS: It is necessary the competent act of the health professionals in of immunization programs, as they are able to provide clear and accurate information of the vaccination.

Latitude dictates plant diversity effects on instream decomposition.

Running waters contribute substantially to global carbon fluxes through decomposition of terrestrial plant litter by aquatic microorganisms and detritivores. Diversity of this litter may influence instream decomposition globally in ways that are not yet understood. We investigated latitudinal differences in decomposition of litter mixtures of low and high functional diversity in 40 streams on 6 continents and spanning 113° of latitude. Despite important variability in our dataset, we found latitudinal differences in the effect of litter functional diversity on decomposition, which we explained as evolutionary adaptations of litter-consuming detritivores to resource availability. Specifically, a balanced diet effect appears to operate at lower latitudes versus a resource concentration effect at higher latitudes. The latitudinal pattern indicates that loss of plant functional diversity will have different consequences on carbon fluxes across the globe, with greater repercussions likely at low latitudes.

Agreement of the computerized immunization record of Araraquara, São Paulo, Brazil, 2018 / Concordancia del registro de vacunación computarizado de Araraquara, São Paulo, Brasil, 2018 / Concordância do registro informatizado de imunização de Araraquara, São Paulo, 2018

Objective: To describe the agreement between the immunization data of the Juarez System and the information in the vaccination booklet and vaccination coverage in children aged 12 to 24 months. Methods: Descriptive study to assess the vaccination status at 12 and 24 months of age of children born in 2015 and registered in the Juarez System. The levels of agreement between the Juarez System data and the information in the vaccination booklet were verified. Results: 429 children were included. it was found that the agreement varied between 84.06 and 99.06%. The coverage (vaccine survey) for each vaccine ranged from 86% to 100% and for the complete schedule, 77.1% (12 months) and 68.8% (24 months). The spatial distributions of vaccine coverage ranged from 28% to 100%. Conclusion: excellent agreement between the data, high vaccination coverage, but heterogeneity in their spatial distributions.

Objetivo: Descrever a concordância entre os dados de imunização do Sistema Juarez e as informações da caderneta de vacinação e as coberturas vacinais em crianças de 12 a 24 meses. Métodos: Estudo descritivo, para avaliar a situação vacinal aos 12 e 24 meses de idade de crianças nascidas em 2015 e registradas no Sistema Juarez. Foram verificados os níveis de concordância entre os dados do Sistema Juarez e as informações da caderneta de vacinação. Resultados: Foram incluídas 429 crianças. Verificou-se que a concordância variou entre 84,06 e 99,06%. As coberturas no inquérito vacinal para cada vacina variaram de 86 a 100%; e para o esquema completo, de 77,1 (12 meses) a 68,8% (24 meses). As distribuições espaciais da cobertura vacinal foram de 28 a 100%. Conclusão: Observou-se ótima concordância entre os dados, com altas coberturas vacinais, muito embora heterogeneidade em suas distribuições espaciais.