Abortion and race in Brazil, National Abortion Surveys 2016 to 2021. / Aborto e raça no Brasil, Pesquisa Nacional de Aborto 2016 a 2021.

We examine racial differentials in abortion among women in Brazil using data from three editions of the Brazilian National Abortion Survey (PNA), 2016, 2019 and 2021. We test the difference in means in data from separate surveys, combined surveys without reweighting, and combined and reweighted surveys. We also use logistic models for the chance of having an abortion. The results indicate that there is a consistent racial differential in the three editions of PNA, with the percentage of abortions among Black women being higher than among white women. In the combined and reweighted surveys, among Black women of all ages the probability of having had an abortion is 11.03% while among white women it is 7.55%. This means a difference of 3.5 percentage points, which translates into a 46% higher probability for Black women, statistically significant values for a 5% interval. Logistic regressions produce similar results, with an average predicted probability of 12.61% for Black women and 8.90% for white women, also significant. Racial differences remain statistically significant for various combinations of PNA editions. However, in the separate surveys, the difference in means tests are only statistically significant in 2016. Black refers to the group formed by Black and Brown women (pretas and pardas). Due to the small sample size, it is not possible to say much about the differences with Asian and Indigenous women.

Examinamos a realização do aborto segundo cor ou raça das mulheres no Brasil usando dados de três edições da PNA, 2016, 2019 e 2021. Comparamos diferenciais raciais aplicando testes de diferenças de médias a dados de levantamentos separados, levantamentos combinados sem reponderação, e levantamentos combinados e reponderados. Na comparação usamos ainda modelos logísticos para a chance de realização de aborto. Os resultados indicam que há diferencial racial consistente nas três edições da PNA, com os percentuais de aborto entre as mulheres negras sendo mais elevados do que entre as mulheres brancas. Nos levantamentos combinados e reponderados, entre as mulheres negras de todas as idades a probabilidade de ter feito um aborto é de 11,03% enquanto entre as mulheres brancas é de 7,55%. Isso significa uma diferença de 3,5 pontos percentuais, que se traduz em uma probabilidade 46% maior para as negras, valores estatisticamente significantes para um intervalo de 5%. Regressões logísticas produzem resultados similares, com probabilidade média predita das mulheres negras de 12,61% e das mulheres brancas de 8,90%, também significantes. As diferenças raciais persistem estatisticamente significantes para várias combinações de edições da PNA. Porém, nos levantamentos isolados os testes de diferenças de média são estatisticamente significantes apenas em 2016.

Aborto e raça no Brasil, Pesquisa Nacional de Aborto 2016 a 2021 / Abortion and race in Brazil, National Abortion Surveys 2016 to 2021

Resumo Examinamos a realização do aborto segundo cor ou raça das mulheres no Brasil usando dados de três edições da PNA, 2016, 2019 e 2021. Comparamos diferenciais raciais aplicando testes de diferenças de médias a dados de levantamentos separados, levantamentos combinados sem reponderação, e levantamentos combinados e reponderados. Na comparação usamos ainda modelos logísticos para a chance de realização de aborto. Os resultados indicam que há diferencial racial consistente nas três edições da PNA, com os percentuais de aborto entre as mulheres negras sendo mais elevados do que entre as mulheres brancas. Nos levantamentos combinados e reponderados, entre as mulheres negras de todas as idades a probabilidade de ter feito um aborto é de 11,03% enquanto entre as mulheres brancas é de 7,55%. Isso significa uma diferença de 3,5 pontos percentuais, que se traduz em uma probabilidade 46% maior para as negras, valores estatisticamente significantes para um intervalo de 5%. Regressões logísticas produzem resultados similares, com probabilidade média predita das mulheres negras de 12,61% e das mulheres brancas de 8,90%, também significantes. As diferenças raciais persistem estatisticamente significantes para várias combinações de edições da PNA. Porém, nos levantamentos isolados os testes de diferenças de média são estatisticamente significantes apenas em 2016.

Abstract We examine racial differentials in abortion among women in Brazil using data from three editions of the Brazilian National Abortion Survey (PNA), 2016, 2019 and 2021. We test the difference in means in data from separate surveys, combined surveys without reweighting, and combined and reweighted surveys. We also use logistic models for the chance of having an abortion. The results indicate that there is a consistent racial differential in the three editions of PNA, with the percentage of abortions among Black women being higher than among white women. In the combined and reweighted surveys, among Black women of all ages the probability of having had an abortion is 11.03% while among white women it is 7.55%. This means a difference of 3.5 percentage points, which translates into a 46% higher probability for Black women, statistically significant values for a 5% interval. Logistic regressions produce similar results, with an average predicted probability of 12.61% for Black women and 8.90% for white women, also significant. Racial differences remain statistically significant for various combinations of PNA editions. However, in the separate surveys, the difference in means tests are only statistically significant in 2016. Black refers to the group formed by Black and Brown women (pretas and pardas). Due to the small sample size, it is not possible to say much about the differences with Asian and Indigenous women.

Giants of the Amazon: How does environmental variation drive the diversity patterns of large trees?

For more than three decades, major efforts in sampling and analyzing tree diversity in South America have focused almost exclusively on trees with stems of at least 10 and 2.5 cm diameter, showing highest species diversity in the wetter western and northern Amazon forests. By contrast, little attention has been paid to patterns and drivers of diversity in the largest canopy and emergent trees, which is surprising given these have dominant ecological functions. Here, we use a machine learning approach to quantify the importance of environmental factors and apply it to generate spatial predictions of the species diversity of all trees (dbh ≥ 10 cm) and for very large trees (dbh ≥ 70 cm) using data from 243 forest plots (108,450 trees and 2832 species) distributed across different forest types and biogeographic regions of the Brazilian Amazon. The diversity of large trees and of all trees was significantly associated with three environmental factors, but in contrasting ways across regions and forest types. Environmental variables associated with disturbances, for example, the lightning flash rate and wind speed, as well as the fraction of photosynthetically active radiation, tend to govern the diversity of large trees. Upland rainforests in the Guiana Shield and Roraima regions had a high diversity of large trees. By contrast, variables associated with resources tend to govern tree diversity in general. Places such as the province of Imeri and the northern portion of the province of Madeira stand out for their high diversity of species in general. Climatic and topographic stability and functional adaptation mechanisms promote ideal conditions for species diversity. Finally, we mapped general patterns of tree species diversity in the Brazilian Amazon, which differ substantially depending on size class.

National Abortion Survey - Brazil, 2021 / Pesquisa Nacional de Aborto - Brasil, 2021

Abstract The National Abortion Survey 2021 (PNA 2021) utilized face-to-face structured interviews and a self-administered questionnaire placed in a sealed box to collect data on abortions in Brazil. Interviews were held with a nationally representative sample of 2,000 women, randomly selected from among literate women ages 18 to 39 residing in urban areas. We compared some of the results with previous waves of the survey, PNA 2010 and PNA 2016. Findings show that abortion is in decline but remains a major public health issue. Around 10% of the women interviewed in 2021 said they had had at least one abortion in their lives (compared to 15% in 2010). We estimate that nearly one in every seven women (15%) have had an abortion by the age of 40. We identified a decline in the proportion of women who needed to be hospitalized to finalize their abortions (55% in 2010; 43% in 2021; p = 0.003) and in the proportion of women who used medication for the abortion (48% in 2010; 39% in 2021; p = 0.028). Abortion is an event that generally happens early on in women's reproductive lives: the PNA 2021 found that 52% of women were 19 years old or younger when they had their first abortion. Higher rates were detected among respondents with lower educational levels, Black and Indigenous women, and women residing in poorer regions.

Resumo A Pesquisa Nacional de Aborto 2021 (PNA 2021) empregou questionários estruturados face a face e um questionário autoadministrado depositado em uma urna para coletar informações sobre aborto no Brasil. As entrevistas foram realizadas em uma amostra representativa de 2.000 mulheres selecionadas aleatoriamente com idades entre 18 e 39 anos e residentes em áreas urbanas. Comparamos alguns dos resultados com ondas anteriores da pesquisa, PNA 2010 e PNA 2016. O aborto está em declínio, porém segue como importante questão de saúde pública. Cerca de 10% das mulheres em 2021 disseram ter feito ao menos um aborto na vida (15% em 2010). Estimamos que aproximadamente uma em cada sete mulheres (15%) teve um aborto aos 40 anos. Houve declínio na proporção de mulheres que foram hospitalizadas para finalizar o aborto (55% em 2010; 43% em 2021; p = 0,003) e na proporção de mulheres que usaram medicamentos para o aborto (48% em 2010; 39% em 2021; p = 0,028). O aborto é um evento que ocorre no início na vida reprodutiva das mulheres: a PNA 2021 constatou que 52% tinham 19 anos ou menos quando fizeram o primeiro aborto. Taxas mais altas foram detectadas entre as entrevistadas com menor escolaridade, negras e indígenas e residentes em regiões mais pobres.

National Abortion Survey - Brazil, 2021.

The National Abortion Survey 2021 (PNA 2021) utilized face-to-face structured interviews and a self-administered questionnaire placed in a sealed box to collect data on abortions in Brazil. Interviews were held with a nationally representative sample of 2,000 women, randomly selected from among literate women ages 18 to 39 residing in urban areas. We compared some of the results with previous waves of the survey, PNA 2010 and PNA 2016. Findings show that abortion is in decline but remains a major public health issue. Around 10% of the women interviewed in 2021 said they had had at least one abortion in their lives (compared to 15% in 2010). We estimate that nearly one in every seven women (15%) have had an abortion by the age of 40. We identified a decline in the proportion of women who needed to be hospitalized to finalize their abortions (55% in 2010; 43% in 2021; p = 0.003) and in the proportion of women who used medication for the abortion (48% in 2010; 39% in 2021; p = 0.028). Abortion is an event that generally happens early on in women's reproductive lives: the PNA 2021 found that 52% of women were 19 years old or younger when they had their first abortion. Higher rates were detected among respondents with lower educational levels, Black and Indigenous women, and women residing in poorer regions.

Modeling the evolution of deaths from infectious diseases with functional data models: The case of COVID-19 in Brazil.

In this paper, we apply statistical methods for functional data to explore the heterogeneity in the registered number of deaths of COVID-19, over time. The cumulative daily number of deaths in regions across Brazil is treated as continuous curves (functional data). The first stage of the analysis applies clustering methods for functional data to identify and describe potential heterogeneity in the curves and their functional derivatives. The estimated clusters are labeled with different "levels of alert" to identify cities in a possible critical situation. In the second stage of the analysis, we apply a functional quantile regression model for the death curves to explore the associations with functional rates of vaccination and stringency and also with several scalar geographical, socioeconomic and demographic covariates. The proposed model gave a better curve fit at different levels of the cumulative number of deaths when compared to a functional regression model based on ordinary least squares. Our results add to the understanding of the development of COVID-19 death counts.

Interações entre usuários brasileiros sobre enfrentamento e apoio social durante pandemias: um estudo de análise de mídia / Interacciones sobre el apoyo social de afrontamiento durante la pandemia por parte de usuarios brasileños: un estudio de análisis de medios / Interactions about Coping-Social Support during Pandemics by Brazilian Users: a Media Analysis Study

Objective: explore how the Brazilian online community mobilized its own coping resources during the COVID-19 pandemic to deal with mass vaccination concerns, manage and cope with personal stressors brought on by the pandemic, and seek social support. Method: the Canadian Population Health Promotion Model and the Transactional Model of Stress and Coping framed this media content analysis focusing on a socially impactful event: the authorization of COVID-19 vaccinations in Brazil. Results: the retrieval of posts (January-May 2021) found 488 contents distributed as modus operandi (n=117; 24%), coping strategies focused on emotion (n=175; 35.8%), on problem (n=40; 8.1%), on reflection (n=67; 13.7%), and offer of social support (n=89; 18.2%). Among the top-five (n=393; 80.5%) actions and coping strategies, 255 contents about coping strategies with a predominant discourse on emotion-focused coping (n=160; 63.2 %). Conclusion: interactions sustained a feeling of connection and created a context for belonging, support, and motivation.

Objetivo: explorar como a comunidade online brasileira mobilizou seus próprios recursos de enfrentamento durante a pandemia de COVID-19 para lidar com as preocupações com a vacinação em massa, gerenciar e lidar com os estressores pessoais provocados pela pandemia e buscar apoio social. Método: o Modelo Canadense de Promoção da Saúde da População e o Modelo Transacional de Estresse e Coping enquadraram esta análise de conteúdo midiático com foco em um evento de impacto social: a autorização da vacinação contra a COVID-19 no Brasil. Resultados: a recuperação das postagens (janeiro-maio de 2021) encontrou 488 conteúdos distribuídos como modus operandi (n=117; 24%), estratégias de enfrentamento focadas na emoção (n=175; 35,8%), no problema (n=40; 8,1%), na reflexão (n=67; 13,7%) e na oferta de apoio social (n=89; 18,2%). Entre as cinco principais (n=393; 80,5%) ações e estratégias de enfrentamento, 255 conteúdos sobre estratégias de enfrentamento predominaram com discurso de enfrentamento focado na emoção (n=160; 63,2%). Conclusão: as interações mantiveram um sentimento de conexão e criaram um contexto de pertencimento, apoio e motivação.

Objetivo: explorar cómo la comunidad brasileña en línea movilizó sus propios recursos de afrontamiento durante la pandemia de COVID-19 para hacer frente a las preocupaciones sobre la vacunación masiva, gestionar y hacer frente a los factores estresantes personales provocados por la pandemia y buscar apoyo social. Método: el Modelo Canadiense de Promoción de la Salud de la Población y el Modelo Transaccional de Estrés y Afrontamiento enmarcaron este análisis de contenido mediático centrándose en un evento de impacto social: la autorización de la vacunación contra la COVID-19 en Brasil. Resultados: la recuperación de publicaciones (enero-mayo de 2021) encontró 488 contenidos distribuidos como modus operandi (n=117; 24%), estrategias de afrontamiento centradas en la emoción (n=175; 35,8%), en el problema (n=40; 8,1%), en la reflexión (n=67; 13,7%) y en la oferta de apoyo social (n=89; 18,2%). Entre las cinco acciones y estrategias de afrontamiento más destacadas (n=393; 80,5%), 255 contenidos sobre estrategias de afrontamiento con un discurso predominante sobre el afrontamiento centrado en las emociones (n=160; 63,2 %). Conclusión: las interacciones mantuvieron un sentimiento de conexión y crearon un contexto de pertenencia, apoyo y motivación.

Análise de particularidades da participação lusófona em uma Rede de Conhecimentos em Enfermagem / Análisis de las particularidades de la participación lusófona en una Red de Conocimientos de Enfermería / Analysis of the particularities of Lusophone participation in a Nursing Knowledge Network

Resumo Objetivo Descrever o exercício conceitual de reflexão sobre as possibilidades e particularidades da participação das Escolas de Enfermagem e Faculdades de Enfermagem lusófonas na Rede de Conhecimentos em Enfermagem. Método Análise das informações obtidas em um levantamento de recursos institucionais de acordo com o marco conceitual proposto por Prug e Prusak sobre rede de conhecimentos. A ponderação de aspectos positivos e negativos - analisando o aprendizado com as informações - levou em consideração as possíveis soluções para um plano de ação. Resultados Tanto nas ações institucionais para suportar a pesquisa em Enfermagem como nos benefícios almejados com a participação na Rede existe o interesse na internacionalização da pesquisa e no trabalho colaborativo. Com a ampliação dos horizontes da ciência da Enfermagem lusófona, este trabalho visa aumentar o impacto da pesquisa e agilizar a divulgação e a utilização dos resultados, tanto na educação como na clínica. Conclusão e Implicações para a prática A participação das referidas instituições oferece inúmeras possibilidades de demonstrar originalidade, criatividade e perícia de sua prática docente e de pesquisa, favorecendo o compartilhamento de ideias e práticas. A prática de produção científica, por docentes e discentes, pode ser aprimorada pelo refinamento de modos de pensar, criar, produzir e disseminar.

Resumen Objetivo Describir el ejercicio conceptual de reflexión de las posibilidades y particularidades de la participación de facultades de Enfermería de lengua portuguesa en la Red de Conocimientos de Enfermería. Método Análisis de datos obtenidos de un sondeo de recursos institucionales bajo el marco conceptual de Prug y Prusak sobre la red de conocimiento. El planteamiento de aspectos positivos y negativos del aprendizaje abarcó soluciones para elaborar un plan de acción. Resultados En las acciones institucionales de apoyo a la investigación en Enfermería y los beneficios aspirados con la participación en la Red, existe un interés por la internacionalización de la investigación y el trabajo colaborativo -que tiene como objetivo aumentar el impacto de la investigación, estimular la divulgación y el aprovechamiento de los resultados en la enseñanza y la clínica, con la ampliación de los horizontes de la Enfermería de instituciones de habla portuguesa. Conclusión e Implicaciones en la práctica La Red ofrece numerosas posibilidades para las instituciones participantes respecto a la demostración de originalidad, creatividad y experiencia en la práctica docente y de investigación, fomentando el intercambio de ideas y prácticas. La práctica de la producción científica por profesores y estudiantes puede verse mejorada por la reflexión, creación, producción y difusión de conocimientos.

Abstract Objective To describe the conceptual exercise of reflecting on the possibilities and particularities of the participation of Lusophone schools of nursing in the Nursing Knowledge Network. Method An analysis was conducted using information obtained from an environmental scan of institutional resources following the conceptual framework by Prug and Prusak on the knowledge networks. The learnings reported in the analysis are based on the collected information and reflections on the positive and negative aspects of participation, while proposing possible solutions for an action plan. Results There is interest in the internationalization of research and collaborative work both as institutional actions to support nursing research and potential benefits due to participation in the Network. The collaborative work has potential to increase the impact of research, expedite dissemination and use of results both in education and in clinical practice, broadening the horizons of Lusophone nursing science. Conclusion and Implications for practice Participation of these institutions in the Network offers numerous possibilities to demonstrate the originality, creativity and expertise of their teaching and research practice, encouraging the sharing of ideas and practices. The practice of scientific production in all its scenarios by educators and students can be improved through refined ways of thinking, creating, producing, and disseminating knowledge.

Internacionalização para o incremento da produção de conhecimentos em enfermagem: estudo de reflexão / Internationalization to increase the production of knowledge in nursing: a reflection study

Objetivo: refletir sobre oportunidades para a internacionalização da Enfermagem em países lusófonos proporcionadas por uma rede internacional de conhecimentos em Enfermagem. Método: método reflexivo que conduz à percepção modificada de uma dada situação levando a novas ideias, revelando temas de análise e propostas de possíveis soluções através de um plano de ação. A reflexão concentrou-se em diálogos interdisciplinares, inovação conceitual-metodológica e fortalecimento da liderança em Enfermagem. Resultados: a reflexão focalizou: (a) o diálogo além do contexto cultural e científico lusófono para a Rede ser reconhecida como parceiro intelectual substancial; (b) a incorporação de abordagens, referenciais e desenhos de pesquisa multidisciplinares; e (c) a mobilização de conhecimento sobre causas sociais para o fortalecimento da liderança da Enfermagem global nas questões de justiça social e equidade em saúde. Considerações finais: a Enfermagem lusófona possui expertise para inovar com estratégias para reforçar a internacionalização.

Objective: reflect on opportunities for the internationalization of nursing in Lusophone countries provided by an international network of nursing knowledge. Method: a reflexive method leading to the modified perception of a given situation leading to new ideas, revealing themes of analysis and proposals for possible solutions through an action plan. This reflection focused on interdisciplinary dialogues, methodological-conceptual innovation, and strengthening of leadership in nursing. Results: the reflection focused on: 1) the dialogue beyond the Lusophone cultural and scientific context for the network to be recognized as a substantial intellectual partner; 2) the incorporation of multidisciplinary approaches, references, and research designs; and 3) the mobilization of knowledge about social causes to strengthen global nursing leadership in issues of social justice and health equity. Final considerations: Lusophone nursing has expertise to innovate with strategies to strengthen internationalization.

Objetivo: reflexionar sobre las oportunidades de internacionalización de la Enfermería en los países de lengua portuguesa proporcionadas por una red internacional de conocimiento en Enfermería. Método: método reflexivo que conduce a una percepción modificada de una situación que lleva a nuevas ideas, revelando temas de análisis y propuestas de posibles soluciones por medio de un plan de acción. La reflexión se centró en los diálogos interdisciplinarios, la innovación conceptual-metodológica y el fortalecimiento del liderazgo en enfermería. Resultados: la reflexión tuvo como foco: (a) el diálogo más allá del contexto cultural y científico de la lengua portuguesa para que la Red sea reconocida como un socio intelectual sustancial; (b) la incorporación de enfoques, referencias y diseños de investigación multidisciplinarios; y (c) la movilización de conocimiento sobre las causas sociales para fortalecer el liderazgo mundial de enfermería en temas de justicia social y equidad en salud. Consideraciones finales: La Enfermería em países de lengua portuguesa tiene el expertise para innovar con estrategias para reforzar la internacionalización.

La creación de una red de conocimientos en enfermería en países de habla hispana: conceptualización de posibilidades basadas en recursos identificados / The creation of a nursing knowledge network in spanish-speaking countries: conceptualization of possibilities based on identified resources

Se presenta un trabajo conceptual sobre el análisis de los hallazgos del sondeo sobre la conceptualización de los planes de la Red de Conocimientos en Enfermería en los países de habla hispana como parte de la acción internacional de la Red. La información recopilada ha sido revelada por profesores de Chile, Colombia, España, México, Paraguay y Perú. Las respuestas han permitido reflexionar sobre conceptualizaciones y áreas que requieren más exploración para responder de manera efectiva a las lagunas en la enseñanza y la práctica de la investigación en Enfermería. Se presentan las brechas en la investigación que pueden explicarse por la falta de políticas gubernamentales e institucionales para financiar la investigación en Enfermería en áreas que tradicionalmente no se perciben como prioridades de salud pública. Otros temas analizados fueron los obstáculos a la difusión del conocimiento científico en Enfermería, las posibilidades de reforzar la investigación en Enfermería y los beneficios deseados con la participación a la Red. Entre las fortalezas de este sondeo está su originalidad y su potencial para estimular las actividades de cooperación para la producción de conocimiento, en particular, el fortalecimiento de los estudios de posgrado con la movilidad académica y de profesores en proyectos internacionales de investigación multicéntrica, la tutoría y el coaching para la investigación. Las respuestas indican una novedad en las áreas prospectivas de desarrollo profesional para educadores, investigadores, así como áreas de posible adopción de la innovación en la educación para los estudiantes. (AU)

Conceptual work is presented regarding the analysis of information gathered from an environmental scan underpinning the plans for the creation of the Nursing Knowledge Network in Spanish-speaking countries as part of the international action of the Network. The information is structured according to the compilation of baseline information provided by nursing faculty from Chile, Colombia, Spain, Mexico, Paraguay and Peru. The information helped conceptualize and anticipate areas that require further exploration to effectively respond to gaps in Nursing teaching and research practice. The reported gaps in current research can be explained by lack of government and institutional policies to finance nursing research in areas that are not traditionally perceived as public health priorities. Other topics analyzed included obstacles to dissemination of scientific knowledge in Nursing, the possibilities of reinforcing Nursing research and the desired benefits of participating in the Network. Among the strengths of this environmental scan is its originality and potential to stimulate activities of cooperation for the production of knowledge, in particular the strengthening of graduate studies with faculty and students’ mobility in international multicenter research projects, research tutoring and coaching. Information also indicates new prospective areas of professional development for faculty, researchers, as well as areas of possible adoption of innovation in student education. (AU)

Participation of Nursing Students in Evidence-Based Practice Projects: Results of Two Focus Groups.

The development of true evidence-based practice requires that practitioners have the knowledge and skills to research, analyze, and use evidence. These skills must be acquired in pre-graduate training. The objective of the present study was to analyze the contributions of students' participation in knowledge translation projects to clinical practice for evidence-based learning. This was a qualitative, descriptive, and exploratory study that used focus groups. Scripted interviews were administered. The design of the study included five phases and took place in the partnering institutions of the Safety Transition Project, involving fifteen participants. The study was authorized by the Research Ethics Committee. The data were analyzed following the steps encoding the categories, storage and recovery, and (3) interpretation and using computer software (WebQDA®, Ludomédia, Aveiro, Portugal). Four categories were identified: learning evidence; communicating science; evidence-based practice; and developing skills. The successful implementation of evidence-based practice education resulted in students who understand its importance and use it competently. Further research should explore the skills developed by nurses involved in similar projects and their contribution to an EBP culture.

Learning to use evidence at nursing undergraduation: a contribution to collective health. / Aprender a usar evidência na graduação em enfermagem: um contributo para a saúde coletiva.

There is universal agreement that health professionals have not implementing evidence-based practice as would be desirable and recommended by science and international institutions with responsibility for the guidelines issued for health contexts. This focus group with eight participants aimed to understand the perspective of students from the undergraduate nursing course on their involvement in a project of knowledge transfer to the clinic. Qualitative analysis followed the coding steps; storage/retrieval and interpretation of the findings and it was carried out by using a software for qualitative data analysis. This study is authorized by an Ethics Committee and respected the principles inherent to the investigation. The four categories that emerged from the content analysis were: Belonging, Using Evidence, Improving Care and Developing Competencies. The analysis of categories, subcategories and verbatim transcripts allowed us to conclude that participation in transference projects for clinics, according to the students, generates learning opportunities about the implementation and communication of evidence, facilitates integration in the service, participation, collaborative work and the development of transversal skills.

É consensual que os profissionais de saúde não estão a implementar a prática baseada na evidência como seria desejável e recomendado pela ciência e organismos internacionais com responsabilidade sobre as diretrizes emanadas para os contextos de saúde. Este focus group com oito participantes teve por objetivo compreender a perspetiva dos estudantes do curso de graduação em enfermagem sobre o seu envolvimento num projeto de transferência de conhecimento para a clínica. A análise qualitativa seguiu as etapas de codificação, armazenamento/recuperação e interpretação dos achados, e foi efetuada com um software de análise de dados qualitativos. Estudo autorizado por uma comissão de ética e que respeitou os princípios inerentes à investigação. As quatro categorias que emergiram da análise de conteúdo foram: "pertencer", "usar evidência", "melhorar cuidados" e "desenvolver competências". A análise das categorias, subcategorias e verbatins permite concluir que a participação em projetos de transferência para a clínica, na voz dos estudantes, gera oportunidades de aprendizagem sobre a implementação e comunicação de evidência, facilita a integração no serviço, a participação, o trabalho colaborativo e o desenvolvimento de competências transversais.

From Evidence Synthesis to Transfer: Results from a Qualitative Case Study with the Perspectives of Participants.

The increase in health research brings challenges to the production, synthesis, and use of research findings in clinical practice. In the case of undergraduate training in nursing, it is necessary to think about the curricular contents and create opportunities to develop skills for learning evidence-based practice. The objective of this study was to analyze nurses' perspectives regarding the effects of their participation in a project of translation of knowledge into clinical practice during undergraduate nursing education, specifically involving knowledge, attitudes, and competencies related to the use of evidence. This is a qualitative case study grounded in the knowledge-to-action theoretical framework. The participants were 13 nurses who were involved in a project about the translation of knowledge into clinical practice during the last term of their undergraduate course. The data were collected by applying interviews between December 2020 and April 2021. Content analysis was carried out by using the qualitative data analysis software tool webQDA®. The following categories emerged from the content analysis carried out on the material gathered during the interviews: understanding evidence; learning how to use evidence; transferring evidence; adjusting to the context; and observing the advantages of evidence-based practice. Extracurricular activities were perceived as an opportunity to understand what evidence is and observe in loco the advantages of health care for clients, teams, and services. During the project, the participants developed cross-sectional competencies and envisaged changes to their professional activity as a result of changes in their attitude regarding evidence and its use. We concluded that the opportunity to develop evidence-related activities allows for the development of skills and influences the attitude towards evidence-based practice and knowledge use.

Aprender a usar evidência na graduação em enfermagem: um contributo para a saúde coletiva / Learning to use evidence at nursing undergraduation: a contribution to collective health

Resumo É consensual que os profissionais de saúde não estão a implementar a prática baseada na evidência como seria desejável e recomendado pela ciência e organismos internacionais com responsabilidade sobre as diretrizes emanadas para os contextos de saúde. Este focus group com oito participantes teve por objetivo compreender a perspetiva dos estudantes do curso de graduação em enfermagem sobre o seu envolvimento num projeto de transferência de conhecimento para a clínica. A análise qualitativa seguiu as etapas de codificação, armazenamento/recuperação e interpretação dos achados, e foi efetuada com um software de análise de dados qualitativos. Estudo autorizado por uma comissão de ética e que respeitou os princípios inerentes à investigação. As quatro categorias que emergiram da análise de conteúdo foram: "pertencer", "usar evidência", "melhorar cuidados" e "desenvolver competências". A análise das categorias, subcategorias e verbatins permite concluir que a participação em projetos de transferência para a clínica, na voz dos estudantes, gera oportunidades de aprendizagem sobre a implementação e comunicação de evidência, facilita a integração no serviço, a participação, o trabalho colaborativo e o desenvolvimento de competências transversais.

Abstract There is universal agreement that health professionals have not implementing evidence-based practice as would be desirable and recommended by science and international institutions with responsibility for the guidelines issued for health contexts. This focus group with eight participants aimed to understand the perspective of students from the undergraduate nursing course on their involvement in a project of knowledge transfer to the clinic. Qualitative analysis followed the coding steps; storage/retrieval and interpretation of the findings and it was carried out by using a software for qualitative data analysis. This study is authorized by an Ethics Committee and respected the principles inherent to the investigation. The four categories that emerged from the content analysis were: Belonging, Using Evidence, Improving Care and Developing Competencies. The analysis of categories, subcategories and verbatim transcripts allowed us to conclude that participation in transference projects for clinics, according to the students, generates learning opportunities about the implementation and communication of evidence, facilitates integration in the service, participation, collaborative work and the development of transversal skills.

Short-term Covid-19 forecast for latecomers.

The number of new Covid-19 cases is still high in several countries, despite vaccination efforts. A number of countries are experiencing new and severe waves of infection. Therefore, the availability of reliable forecasts for the number of cases and deaths in the coming days is of fundamental importance. We propose a simple statistical method for short-term real-time forecasting of the number of Covid-19 cases and fatalities in countries that are latecomers-i.e., countries where cases of the disease started to appear some time after others. In particular, we propose a penalized LASSO regression model with an error correction mechanism to construct a model of a latecomer country in terms of other countries that were at a similar stage of the pandemic some days before. By tracking the number of cases in those countries, we use an adaptive rolling-window scheme to forecast the number of cases and deaths in the latecomer. We apply this methodology to 45 countries and we provide detailed results for four of them: Brazil, Chile, Mexico, and Portugal. We show that the methodology performs very well when compared to alternative methods. These forecasts aim to foster better short-run management of the healthcare system and can be applied not only to countries but also to different regions within a country. Finally, the modeling framework derived in the paper can be applied to other infectious diseases.

Chronic pain following inguinal herniorrhaphy: perceptions of children and adolescents.

OBJECTIVE: To analyze the perceptions of children and adolescents about chronic postsurgical pain, experienced for three years after outpatient inguinal herniorrhaphy. METHOD: Descriptive, exploratory study, with a qualitative approach. Children and adolescents who reported chronic postsurgical pain were invited from previous quantitative research. The interviews with a semi-structured script were recorded, transcribed, and coded according to content analysis, thematic modality. RESULTS: Twenty children and teenagers participated. They attributed different meanings to chronic persistent postsurgical pain, configuring a bad, uncomfortable, intermittent and limiting experience, which socially isolates, interferes with daily, school, and leisure activities. The report of pain was underestimated and neglected by the children's and adolescents' healthcare team, family members, teachers, and friends. CONCLUSION: Children and adolescents recognize postsurgical pain as persistent pain and seem to perceive that their report is underestimated and neglected by parents and teachers. Additionally, they feel responsible for the presence of pain that affects psychological and social dimensions and imposes damage and fear that leads to the return of the hernia and to death.

Mega-dams and extreme rainfall: Disentangling the drivers of extensive impacts of a large flooding event on Amazon Forests.

Extreme weather events and the presence of mega-hydroelectric dams, when combined, present an emerging threat to natural habitats in the Amazon region. To understand the magnitude of these impacts, we used remote sensing data to assess forest loss in areas affected by the extreme 2014 flood in the entire Madeira River basin, the location of two mega-dams. In addition, forest plots (26 ha) were monitored between 2011 and 2015 (14,328 trees) in order to evaluate changes in tree mortality, aboveground biomass (AGB), species composition and community structure around the Jirau reservoir (distance between plots varies from 1 to 80 km). We showed that the mega-dams were the main driver of tree mortality in Madeira basin forests after the 2014 extreme flood. Forest loss in the areas surrounding the reservoirs was 56 km2 in Santo Antônio, 190 km2 in Jirau (7.4-9.2% of the forest cover before flooding), and 79.9% above that predicted in environmental impact assessments. We also show that climatic anomalies, albeit with much smaller impact than that created by the mega-dams, resulted in forest loss along different Madeira sub-basins not affected by dams (34-173 km2; 0.5-1.7%). The impact of flooding was greater in várzea and transitional forests, resulting in high rates of tree mortality (88-100%), AGB decrease (89-100%), and reduction of species richness (78-100%). Conversely, campinarana forests were more flood-tolerant with a slight decrease in species richness (6%) and similar AGB after flooding. Taking together satellite and field measurements, we estimate that the 2014 flood event in the Madeira basin resulted in 8.81-12.47 ∙ 106 tons of dead biomass. Environmental impact studies required for environmental licensing of mega-dams by governmental agencies should consider the increasing trend of climatic anomalies and the high vulnerability of different habitats to minimize the serious impacts of dams on Amazonian biodiversity and carbon stocks.

Chronic pain following inguinal herniorrhaphy: perceptions of children and adolescents / Dolor crónico tras hernia inguinal: percepciones de niños y adolescentes / Dor crônica após herniorrafia inguinal: percepções de crianças e adolescentes

ABSTRACT Objective: To analyze the perceptions of children and adolescents about chronic postsurgical pain, experienced for three years after outpatient inguinal herniorrhaphy. Method: Descriptive, exploratory study, with a qualitative approach. Children and adolescents who reported chronic postsurgical pain were invited from previous quantitative research. The interviews with a semi-structured script were recorded, transcribed, and coded according to content analysis, thematic modality. Results: Twenty children and teenagers participated. They attributed different meanings to chronic persistent postsurgical pain, configuring a bad, uncomfortable, intermittent and limiting experience, which socially isolates, interferes with daily, school, and leisure activities. The report of pain was underestimated and neglected by the children's and adolescents' healthcare team, family members, teachers, and friends. Conclusion: Children and adolescents recognize postsurgical pain as persistent pain and seem to perceive that their report is underestimated and neglected by parents and teachers. Additionally, they feel responsible for the presence of pain that affects psychological and social dimensions and imposes damage and fear that leads to the return of the hernia and to death.

RESUMEN Objetivo: Analizar las percepciones de niños y adolescentes sobre dolor crónica posoperatoria, vivenciada durante tres años tras hernia inguinal ambulatoria. Método: Estudio descriptivo, exploratorio y de abordaje cualitativo. Niños y adolescentes que relataron dolor crónico posoperatorio fueron invitados desde investigación cualitativa anterior. Las entrevistas con texto semiestructurado fueron grabadas, transcriptas y codificadas según el análisis de contenido, modalidad temática. Resultados: Participaron 20 niños y adolescentes. Ellos atribuyeron diferentes significados al dolor crónico posoperatorio persistente, lo configuraron como una experiencia mala, incomoda intermitente y limitante, que genera aislamiento social, interfiere en las actividades cotidianas, escolares y de ocio. El relato de dolor fue subestimado y negligenciado por el equipo de salud, familiares, profesores y amigos de los niños y adolescentes. Conclusión: Niños y adolescentes reconocen el dolor posoperatorio como dolor persistente y parecen percibir que su relato es subestimado y negligenciado por los padres y profesores. Además, se sienten responsables por la presencia del dolor que afecta dimensiones psicológicas y sociales e impone perjuicios y miedo que remite al regreso de la hernia y la muerte.

RESUMO Objetivo: Analisar as percepções de crianças e adolescentes sobre dor crônica pós-operatória, vivenciada durante três anos após herniorrafia inguinal ambulatorial. Método: Estudo descritivo, exploratório e de abordagem qualitativa. Crianças e adolescentes que referiram dor crônica pós-operatória foram convidados a partir de pesquisa quantitativa anterior. As entrevistas com roteiro semiestruturado foram gravadas, transcritas e codificadas segundo a análise de conteúdo, modalidade temática. Resultados: Participaram 20 crianças e adolescentes. Eles atribuíram diferentes significados à dor crônica pós-operatória persistente, configurando uma experiência ruim, incômoda, intermitente e limitante, que isola socialmente, interfere nas atividades cotidianas, escolares e de lazer. O relato de dor foi subestimado e negligenciado pela equipe de saúde, familiares, professores e amigos das crianças e adolescentes. Conclusão: Crianças e adolescentes reconhecem a dor pós-operatória como dor persistente e parecem perceber que seu relato é subestimado e negligenciado pelos pais e professores. Adicionalmente, sentem-se responsáveis pela presença da dor que afeta dimensões psicológicas e sociais e impõe prejuízos e medo que remete ao retorno da hérnia e à morte.