Neurologists Preferences on Basic and Advanced Cardiac Imaging Utilization in Ischemic Stroke Patients.

INTRODUCTION: It is unknown how cardiac imaging studies are used by neurologists to investigate cardioembolic sources in ischemic stroke patients. METHODS: Between August 12, 2023, and December 8, 2023, we conducted an international survey among neurologists from Europe, North America, South America, and Asia, to investigate the frequency of utilization of cardiac imaging studies for the detection of cardioembolic sources of ischemic stroke. Questions were structured into deciles of percentage utilization of transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), ECG-gated cardiac computed tomography (G-CCT), and cardiac magnetic resonance imaging (CMRI). We estimated the weighted proportion (x¯) of utilization of each cardiac imaging modality, both globally and by continent. We also investigated the use of head and neck computed tomography angiography (CTA) as an emerging approach to the screening of cardioembolic sources. RESULTS: A total of 402 neurologists from 64 countries completed the survey. Globally, TTE was the most frequently used cardiac imaging technology (x¯ = 71.2%), followed by TEE (x¯ = 15.8%), G-CCT (x¯ = 10.9%), and CMRI (x¯ = 7.7%). Findings were consistent across all continents. A total of 288 respondents routinely used a CTA in the acute ischemic stroke phase (71.6%), but the CTA included a non-gated CCT in only 15 cases (5.2%). CONCLUSIONS: This survey suggests that basic cardiac imaging is not done in all ischemic stroke patients evaluated in 4 continents. We also found a substantially low utilization of advanced cardiac imaging studies. Easier to adopt screening methods for cardioembolic sources of embolism are needed.

Suicide Risk Moderates the Relationship Between Stressful Life Events, the Suicidal Narrative, and the Suicide Crisis Syndrome: A Brazilian Cross-Sectional Study.

BACKGROUND: Stressful life events are associated with higher odds of suicidal thoughts and behaviors. Furthermore, stressful life events can trigger specific symptoms, including the suicidal narrative and suicide crisis syndrome, resulting in an increased risk of suicidal thoughts and behaviors. This study examined the moderating role of suicide risk in the relationship between stressful life events, the suicidal narrative, and the suicide crisis syndrome. METHODS: 2,260 adults completed an online survey recruited through advertisements on social media. The level of emotional distress was assessed through the Suicide Narrative Inventory, Suicide Crisis Inventory-2, Stressful Life Events Questionnaire, and Mini International Neuropsychiatric Interview. The PROCESS macro (Hayes) was used to analyze the moderation models. RESULTS: Stressful life events were positively correlated with the suicidal narrative and suicide crisis syndrome. The effects of stressful life events on suicidal narrative and suicide crisis syndrome were strongest when suicide risk was low and weakest when suicide risk was high. CONCLUSIONS: These findings suggest that including stressful life events as part of suicide risk assessment in general and clinical settings is critical to managing treatment for suicidal thoughts and developing adaptive coping.

The HOPE study: evaluating the impact of an online educational resource for heavy menstrual bleeding on the patient-physician dynamic.

The Heavy menstrual bleeding: Evidence-based Learning for best Practice (HELP) Group developed an educational website about heavy menstrual bleeding (HMB). The "HMB improving Outcomes with Patient counseling and Education" (HOPE) project examined the website's impact on women's knowledge, confidence, and consultations with healthcare providers (HCPs). HOPE was a quantitative online survey of gynecologists and women with HMB in Brazil. After an initial consultation, patients had unlimited access to the website and completed a survey. HCPs also completed a survey about the sconsultation. After a second consultation, HCPs and patients completed another survey. HCP surveys assessed their perception of patients' awareness, understanding, and willingness to discuss HMB. Patient surveys assessed their knowledge, experience, and confidence in discussing HMB. Forty HCPs recruited 400 women with HMB. Based on HCP perceptions at the first consultation, 18 percent of patients had "good knowledge" or "very good knowledge" of HMB, increasing to 69 percent after patients had visited the website. Before and after visiting the website, 34 percent and 69 percent of patients, respectively, regarded their HMB knowledge as "goo.d" Additionally, 17 percent of women reported their anxiety as "highest" during the first consultation; this decreased to 7 percent during the second consultation. After visiting the HELP website, patients' knowledge of HMB improved and they were less anxious.

Impacts of COVID-19 on the Chilean salmon: A first approach to the effects of the pandemic in the industry.

Chile is the second largest producer of salmon in the world and is an important pillar of the national economy. Any disruption in how the industry functions will have economic and social effects. The objective of this study was to evaluate the impact of the COVID-19 pandemic on the Chilean salmon industry. An online survey was sent to the highest positions in the industry: presidents, managers, and chiefs of salmon companies. Of the 52 respondents, 75% indicated that operations were moderately affected by the pandemic. More than 70% reported a decrease in their company's production and sales. Work absenteeism was a concern for 88%, and the implementation of sanitary measures was considered effective and relevant to prevent the spread of the virus. However, there were no statistically significant differences (p-value > 0.05) between the degree of impact on operations by company size, or between absenteeism and company size. The information obtained in this study is a first look into understanding the impacts of the pandemic on the Chilean salmon industry in the year 2020.

COVID-19 pandemic implications in paediatric and congenital heart surgery in Brazil.

INTRODUCTION: The Coronavirus Disease 2019 (COVID-19) pandemic negatively impacted global healthcare. Consequences in Pediatric and Congenital Heart Surgery programmes and mortality of congenital heart patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-Cov-2) is still to be determined. OBJECTIVE: To study the COVID-19 pandemic implications in Brazilian Pediatric and Congenital Heart Surgery programmes. METHODS: We conducted a national online survey covering all states that perform Pediatric and Congenital Heart Surgery from 10 November to 22 November, 2020, using a Google forms questionnaire. We formulated questions related to impact on surgical volume, case-mix, and mortality. Then we asked about short-term post-operative COVID-19 infection and outcomes. RESULTS: We received responses from 46 centres representing all states where there were a Pediatric and Congenital Heart Surgery programme and all high-volume centres across the country. All but one centre experienced a significant decrease in surgical volume, and 23.9% of the responders revealed less than one-quarter of volume decrement. On the other hand, in over 70% of the centres, there was a significant surgical volume reduction. In addition to this, there was a shift in case-mix in 41 centres (89.1%) towards more complex cases. More than one-third of the responders revealed increased mortality in 2020 compared to previous years, and 43.5% of the programmes (20 centres) had at least one patient contaminated by SARS-Cov-2, accounting for 48 patients. Mortality in post-operative infected patients was 45.8% (22 patients). CONCLUSIONS: In general, Brazilian Pediatric and Congenital Heart Surgery programmes were severely affected by decreased surgical volume, unbalanced case-mix towards more complex cases, and increased mortality. Almost half of the programmes related post-operative COVID-19 contamination with high mortality.

Consumer Profile and Product Knowledge Affect the Usefulness of a Quality Label as a Tool to Differentiate a Product: A Chilean Survey.

Quality labels are useful tools to differentiate food products, but only if consumers recognise them and associate them with specific characteristics. An online survey was conducted to investigate whether Chilean consumers knew about Novillo de Osorno, for which a quality label is being developed. The survey was divided into five blocks: lifestyles, meat consumption and purchase habits, meat choice behaviour, knowledge about Novillo de Osorno, and consumers' socio-demographic information. The place of residence and consumer gender, age, or income were important cues in defining consumers' lifestyles, meat consumption and purchase habits. Respondents could be grouped into three main groups: 1. Younger people: urban with medium-high incomes, which search only for pleasure; 2. Foodies uninvolved and Females uninvolved: females with the highest income level that chose food for nutritional reasons; and 3. Traditional people: men older than 55 with low incomes, living in the Northern areas and interested in taste and in the meat's origin. Nearly 60% of respondents had never heard about Novillo de Osorno. Hence, the supply chain has an opportunity to extend the market. Since price and confidence in the origin are important cues, they must be considered in the design of promotion strategies.

Challenges faced by people with epilepsy on ketogenic diet therapy and their caregivers during the COVID-19 pandemic in Brazil.

BACKGROUND: Although ketogenic diet therapy (KDT) is a well-established, nonpharmacologic therapeutic option for patients with pharmacoresistant epilepsy, its availability is still not widespread. The COVID-19 pandemic may have further restricted the access of people with pharmacoresistant epilepsy (PWE) to KDT. Thus, we evaluated the experiences of Brazilian PWE and their caregivers during the first year of the pandemic. METHODS: An online self-assessed survey containing 25 questions was distributed via social media to be answered by PWE treated with KDT or their caregivers through Google Forms from June 2020 to January 2021. Mental health was assessed using the DASS and NDDI-E scales. RESULTS: Fifty adults (>18 yo), of whom 68% were caregivers, answered the survey. During the pandemic, 40% faced adversities in accessing their usual healthcare professionals and 38% in obtaining anti-seizure medication (ASM). Despite these issues, 66% of those on KDT could comply with their treatment. Those struggling to maintain KDT (34%) named these obstacles mainly: diet costs, social isolation, food availability, and carbohydrate craving due to anxiety or stress. An increase in seizure frequency was observed in 26% of participants, positively associated with difficulties in obtaining ASM [X2 (1, N = 48) = 6.55; p = 0.01], but not with KDT compliance issues. CONCLUSIONS: People with pharmacoresistant epilepsy and undergoing KDT, as well as their caregivers, faced additional challenges during the COVID-19 pandemic, not only difficulties in accessing healthcare and KDT maintenance but also on seizure control and mental health.

Religious Affiliations Influence Health-Related and General Decision Making: A Brazilian Nationwide Survey.

Approximately 90% of the world's population is involved in some spiritual/religious practice, and this dimension has a relevant role in life. Many studies demonstrate the associations between spirituality/religiosity (S/R), and physical, mental, and social health. Systematic reviews have indicated positive associations; however, the mechanisms behind religious coping are not fully understood. The present study aimed to examine the role of religious affiliation in general (ordinary) and health-related decisions. A nationwide, population-based, cross-sectional study was conducted in Brazil using a self-administered online survey. How much religious affiliation influences decision making was investigated. A total of 1133 participants were included, who were classified as Catholics (43.9%), Evangelicals (18.7%), spiritualists (12.8%), non-religious (11.9%), and others (12.7%). Most participants (66.5%) believed that their religious affiliations had moderate to high influences on their decisions. Participants rated the influence as high in marriage (62.7%), in donations (60.1%), in volunteering (55%), in friendships (53.9%), and in work (50.5%). Concerning health-related decisions, the influence was rated as high in drug use (45.2%), in accepting medical recommendations (45%), and in smoking (43.2%). The influence of religious affiliation on general decision making was significantly correlated for dietary restrictions (r = 0.462), alcohol consumption (r = 0.458), drug use (r = 0.441), tobacco consumption (r = 0.456), and refusal of medical recommendations (r = 0.314). Improving the understanding of how a patient's beliefs, practices, and experiences affect their health may help healthcare practitioners to take into account religious considerations, not only regarding influences on habits but also regarding adherence to medical treatment advice.

Current practice of rectal biopsies for the diagnosis of Hirschsprung's disease in Latin America: an international online survey.

PURPOSE: The gold standard for the diagnosis of Hirschsprung's disease (HD) is a rectal biopsy. The sample may be obtained using a transanal excisional biopsy (TEB) or suction technique. Rectal suction biopsy (RSB) is not a standard procedure in Latin-America. AIM: To evaluate the current practice in rectal biopsy for HD among pediatric surgeons. METHODS: We distributed an online questionnaire among Latin-American pediatric surgeons. RESULTS: One hundred forty-nine pediatric surgeons from 15 countries completed the anonymous survey (71.4% of Latin-American countries), grouped into 81.9% pediatric surgeons; 8.9% pediatric colorectal surgeons, 8.9% trainees, and 1 pediatric colorectal surgeon fellow. 50.4% reported less than 5 new patients with HD per year, 36.2% 5-10 new cases, and 13.4% more than 10. Only 14.1% of surgeons have access to perform a RSB in the diagnostic work-up of patients with suspected HD, 90% in our study perform an TEB under general anesthesia. When we ask if they could perform both procedures in babies up to 6 months, 52.3% indicate that they prefer an RSB, and for patients older than 6 months, 35.4% favor an RSB. Regarding the number of samples obtained performing an TEB, 30.9% get one biopsy, 29.5% two biopsies, and 39.6% three or more samples. Surgeons obtained the most proximal biopsy at a median of 2.3 cm (range 1-4 cm) above the pectinate line. 67.8% of surgeons prescribed antibiotic prophylaxis. Overall, 16.1% experienced complications, including rectal blood loss (n = 18), and rectal perforation (n = 3). The most frequently used staining methods for rectal biopsies are hematoxylin/eosin (87%), calretinin (56, 8%), and acetylcholinesterase (21.9%). CONCLUSIONS: In Latin-America, the accessibility for RSB is limited only 18 out of 149 surgeons have access to rectal suction tool. There is no consensus regarding sample number, site of proximal biopsy, and antibiotics use. The complications associated with the procedure seems to be less than reported with RSB. Therefore, we should standardize this common surgical practice and establish universal guidelines for rectal biopsy procedure (RBP).

Impact of training volume and experience on amateur Ironman triathlon performance.

PURPOSE: To investigate the association between training volume, sleep time, signs and symptoms of excessive training (overtraining), and  previous triathlon experience with overall and split race times in the Ironman distance triathlon. METHODS: Ninety-nine triathletes (19 women and 80 men) answered an online survey containing questions about anthropometric characteristics (body mass and height), weekly training volume (hours per day and days per week), previous experience in Ironman distance triathlon race, and signs and symptoms of excessive training. Data of race times of all participants were collected by a single race (the Ironman Brazil 2019 - Florianópolis). All surveys were collected between 28 and 30 days before the race. The athlete was instructed to answer the questions according to what was happening in the week before completing the survey. RESULTS: Total race time did not differ among those who trained up to 14 h per week (11:28:46±01:54:30 h:min:sec), between 15 and 20 h per week (11:37:31±01:20:26 h:min:sec) or more than 20 h per week (11:30:18±01:31:28 h:min:sec) (p = 0.922). Total race time of the triathletes who presented (12:42:22±01:49:36 h:min:sec) or no (11:23:06±01:29:02 h:min:sec) unintentional body mass loss (p = 0.006), feeling (12:46:17±02:03:13 h:min:sec) or no (11:24:09±01:28:07 h:min:sec) of decreased performance (p = 0.009) or feeling (12:08:58±01:47:12 h:min:sec) or no (11:16:34±01:24:53 h:min:sec) loss of energy (p = 0.011) in the week prior to the race were significantly different. Triathletes who had a previous experience in Ironman races achieved a better performance (11:15:21±01:32:04 h:min:sec) than those without previous experience (12:06:38±01:32:10 h:min:sec) (p = 0.010). CONCLUSION: In summary, high volumes of training (more than 20 h per week), when performed forty days before a race, may not have a positive impact on performance compared to lower volumes of training (up to 14 h per week). However, athletes who had a previous experience in Ironman race presented better results in swimming splits and overall race time. Moreover, the presence of overtraining symptoms, such as unintentional loss of weight, sensation of fatigue and/or performance decrease impact negatively triathlon performance.

Knowledge About COVID-19 in Brazil: Cross-Sectional Web-Based Study.

BACKGROUND: COVID-19 is a highly transmissible illness caused by SARS-CoV-2. The disease has affected more than 200 countries, and the measures that have been implemented to combat its spread, as there is still no vaccine or definitive medication, have been based on supportive interventions and drug repositioning. Brazil, the largest country in South America, has had more than 140,000 recorded deaths and is one of the most affected countries. Despite the extensive quantity of scientifically recognized information, there are still conflicting discussions on how best to face the disease and the virus, especially with regard to social distancing, preventive methods, and the use of medications. OBJECTIVE: The main purpose of this study is to evaluate the Brazilian population's basic knowledge about COVID-19 to demonstrate how Brazilians are managing to identify scientifically proven information. METHODS: A cross-sectional study design was used. An original online questionnaire survey was administered from June 16 to August 21, 2020, across all five different geopolitical regions of the country (ie, the North, Northeast, Center-West, Southeast, and South). The questionnaire was comprised of questions about basic aspects of COVID-19, such as the related symptoms, conduct that should be followed when suspected of infection, risk groups, prevention, transmission, and social distancing. The wrong questionnaire response alternatives were taken from the fake news combat website of the Brazilian Ministry of Health. Participants (aged ≥18 years) were recruited through social networking platforms, including Facebook, WhatsApp, and Twitter. The mean distributions, frequencies, and similarities or dissimilarities between the responses for the different variables of the study were evaluated. The significance level for all statistical tests was less than .05. RESULTS: A total of 4180 valid responses representative of all the states and regions of Brazil were recorded. Most respondents had good knowledge about COVID-19, getting an average of 86.59% of the total score with regard to the basic aspects of the disease. The region, education level, age, sex, and social condition had a significant association (P<.001) with knowledge about the disease, which meant that women, the young, those with higher education levels, nonrecipients of social assistance, and more economically and socially developed regions had more correct answers. CONCLUSIONS: Overall, Brazilians with social media access have a good level of basic knowledge about COVID-19 but with differences depending on the analyzed subgroup. Due to the limitation of the platform used in carrying out the study, care should be taken when generalizing the study findings to populations with less education or who are not used to accessing social networking platforms.

Physical Activity and Sociodemographic Profile of Brazilian People during COVID-19 Outbreak: An Online and Cross-Sectional Survey.

The Coronavirus Disease 2019 (COVID-19) outbreak has created an unprecedented impact on global health and further aggravated the physical inactivity pandemic. For this reason, the understanding of sociodemographic variables in the context of physical activity levels are important for the field of public health in order to assist in relevant public health decisions. Our main aim was to characterize sociodemographic variables and physical activity levels and their association with COVID-19 aspects. We applied an online Google survey with closed questions in Brazilian people of different age and regions, both sexes and physical activity levels (n = 1.726). Our main results were that participants who had symptoms of COVID-19 had the highest percentage of level 1 of physical activity (the lowest level according to the classification used) and those who showed no symptoms had the highest percentage of levels 2 and 3 of physical activity; that is, close to the light/moderate levels of physical activity. This cross-sectional study in the Brazilian population provided important sociodemographic data and COVID-19 aspects regarding the level of physical activity. It is possible to assume that the regular practice of physical activity could positively impact health status and quality of life and be a tool in the field of public health to cope (from a physical and mental point of view) with disease scenarios that require quarantine.

Treatment of Capillary Hemangioblastoma in Von Hippel-Lindau Disease: Case Report and Online Survey of Treatment Preferences among Experts.

This case report aims to describe the diagnosis, treatment, and evolution of bilateral, asymmetrical retinal capillary hemangioblastomas treated with argon laser and intravitreal anti-vascular endothelial growth factor and also reports the results of an online survey of treatment preferences among retina and vitreous specialists. A previously healthy 23-year-old female presented to our Retina Department complaining of progressive visual loss in her right eye. Visual acuity at admission was 20/300 in her right eye and 20/20 in her left eye. Anterior segment findings were unremarkable and fundoscopy revealed the presence of retinal capillary hemangioblastomas in both eyes. In the right eye, the hemangioblastoma was associated with pronounced exudation and macular edema; in the left eye, the lesion was quiescent. After a complete anamnesis and genetic counseling, Von Hippel-Lindau disease was diagnosed. Treatment with laser photocoagulation was performed on both eyes. One dose of 0.5 mg intravitreal ranibizumab was applied to the right eye. Two months after treatment, the right eye demonstrated improved visual acuity (20/100). Moreover, an important decrease in tumor dimensions and a reduction of vessel tortuosity was seen in both eyes. At 18 months of follow-up, the patient maintains a good visual acuity without recurrence of the treated tumors. Laser treatment should be considered as the primary treatment option for patients with capillary hemangioblastomas with and without exudation and can be combined with intravitreal antiangiogenics if exudation is significant. Inactive smaller lesions without exudation are likely to have an excellent response to laser treatment alone. Management should be individualized since no consensus between experts has been reached.

Utilización de probióticos, antisecretores y zinc en la gastroenteritis aguda en pediatría en Uruguay / Use of probiotic, antisecretory drugs and zinc for acute gastroenteritis in Uruguayan pediatric patients / Uso de probióticos, drogas anti-secretoras e zinco em gastroenterite aguda em pediatria no Uruguai

Resumen: Introducción: luego de la difusión de las sales de rehidratación oral, que resultó en una radical disminución en la morbimortalidad por gastroenteritis aguda (GEA), existe interés creciente en tratamientos destinados a reducir su duración. Objetivo: conocer la utilización de los tratamientos para disminuir la duración de la GEA (probióticos, antisecretores, zinc) por los pediatras uruguayos. Método: encuesta online difundida a través de la Sociedad Uruguaya de Pediatría. Resultados: n=245 encuestas de pediatras procedentes de 17/19 departamentos del país (59% Montevideo). El 39,4% no indica probióticos en tratamiento de GEA; 5,8% lo indica siempre, y 49% en algunas situaciones (15,2% ingreso hospitalario; 21,2% inmunodeprimidos). La elección se basa en 13% en evidencia científica y 47,9% por disponibilidad en el lugar de cobertura. El 32,2% conoce adecuadamente el impacto en la duración de la diarrea. El 61,4% nunca utiliza antisecretores y 24,9% lo utiliza (96,6% racecadotrilo; 3,4% loperamida) en algunas situaciones (56,7% <5 años; 41,6% >5 años; 21,6% en pacientes que requieren internación). El 22% conoce adecuadamente el impacto de su utilización en la duración de la diarrea. En relación con el uso de zinc, 76,3% lo utiliza en algunas situaciones (64% pacientes desnutridos; 46% pacientes internados; 31% >6 meses y 26% <6 meses), y 6,9% lo utiliza siempre). Conclusiones: existe una amplia utilización de probióticos y zinc y un escaso uso de antisecretores en nuestro medio. Los pediatras uruguayos reconocen el posible rol de estos fármacos en la GEA. Un alto porcentaje de los pediatras no conoce la evidencia que fundamenta su uso. Es necesaria la implementación de programas de educación médica continua para guiar su uso.

Summary: Introduction: there is an increasing interest regarding treatments that shorten the duration of acute gastroenteritis (AG) in children, although little is known about it in Uruguay. Aim: that Uruguayan pediatricians get acquainted with probiotics, antisecretory drugs and zinc treatments. Methods: online survey sent to pediatricians members of the Uruguayan Pediatrics Association. Results: n=245 surveys carried out by pediatricians at 17/19 departments in Uruguay (59% from Montevideo). 39.4% stated they had not used probiotics to treat AG, 5.8% had always used it and 49% used it depending on the situation (15.2% used it with inpatients and 21.2% with immune depressed children). The choice of probiotics was based: 13% on scientific evidence and 47.9% on availability. 32.2% of pediatricians knew the real impact of probiotics on the duration of AG. 61.4% did not use antisecretory drugs and 24.9% used them depending on the situation (56.7% <5 years old, 41.6% >5 years, 21.6% inpatients). 96.6% of them chose Racecadotril and 3.4% Loperamide. 22% were aware of the real impact of the duration of AG. 76.3% of pediatricians used zinc to treat GEA in some situations (64% malnourished children, 46% inpatients, 31% >6 months, 26% <6 months) and 6.9% always used it. Conclusion: while probiotics and zinc are widely used, antisecretory drugs are slightly used as AG treatments in Uruguay. Uruguayan pediatricians identify the potential useful role of these treatments for AG, although many of them are not aware of its real use, so it is necessary to offer permanent medical training programs in this respect.

Resumo: Introdução: há um interesse crescente em tratamentos para reduzir a duração da gastroenterite aguda (GA) em pediatria, embora ainda há pouco conhecimento do tratamento no Uruguai. Objetivo: que os pediatras uruguaios se familiarizem com os tratamentos com probióticos, medicamentos anti-secretores e zinco. Métodos: pesquisa online enviada aos pediatras da Sociedade Uruguaia de Pediatria. Resultados: n = 245 pesquisas realizadas por pediatras em 17/19 departamentos do Uruguai (59% de Montevidéu). 39,4% afirmaram não ter usado probióticos para tratar a GEA, 5,8% sempre usaram e 49% usaram dependendo da situação (15,2% usaram com pacientes internados e 21,2% com imunossuprimidos). A escolha dos probióticos foi baseada: 13% na evidência científica e 47,9% na disponibilidade. 32,2% dos pediatras conheciam o real impacto dos probióticos na duração da GA. 61,4% não faziam uso de drogas antisecretoras e 24,9% usaram dependendo da situação (56,7% <5 anos, 41,6% ± 5 anos, 21,6% internados). 96,6% deles escolheram Racecadotril e 3,4% Loperamida. 2% conheciam o impacto real na duração da GA. 76,3% dos pediatras usaram zinco para tratar a GA em algumas situações (64% das crianças desnutridas, 46% dos pacientes internados, 31% >6 meses, 26% <6 meses) e 6,9% sempre usaram. Conclusão: os probióticos e o zinco são amplamente utilizados, enquanto os antisecretores são pouco usados no Uruguai. Pediatras uruguaios tem identificado o potencial papel útil desses tratamentos para a GA, embora muitos deles ainda não conheçam seu uso real, por isso é necessário oferecer programas permanentes de capacitação médica nesse assunto.

Religious landscape in Brazil: Comparing different representative nationwide approaches to obtain sensitive information in healthcare research.

Although the basis of religious studies start with demographics, nation-wide data are often extracted from face-to-face interviews (leading to a social-desirability bias) and in studies not originally designed to assess religion. This study aims to understand the religious landscape in Brazil and to investigate the feasibility of carrying out a representative nation-wide survey without interviewers, comparing it with other representative face-to-face surveys. We conducted a nationwide online survey representing all regions in Brazil. These results were compared with five other Brazilian representative surveys. A total of 1169 individuals completed the online questionnaires. The percentage of participants according to the gender and in relation to the Brazilian region was quite similar for all surveys. However, the online survey had the higher level of education among all surveys. In relation to the religious characteristics, the percentage of each variable varied from survey to survey. Those surveys originally designed to assess religion tended to yield more religious affiliations and less ceiling effects. The online survey was able to identify more diverse religious affiliations and more balanced responses in the religious attendance and importance of religion in life. The present study found that, even in nation-wide representative surveys, there are important differences in the results obtained while investigating religion. These differences could be associated with the type of data collection (face-to-face and online), the design of the study (originally designed to investigate religion or not) and options and the type of the questions used.

An Assessment of the Relationships between Extreme Weather Events, Vulnerability, and the Impacts on Human Wellbeing in Latin America.

Climate change and variability are known to have an influence on human wellbeing in a variety of ways. In Latin America, such forces are especially conspicuous, particularly in respect of extreme climatological, hydrological, and weather events (EWEs) and climate-sensitive disasters (CSDs). Consistent with the need to study further such connections, this paper presents an analysis of some of the vulnerabilities of environmental health issues and climate-related impacts that are focusing on EWEs and CSDs in Latin American countries. The research includes an analysis of the (i) human and socio-economic development; (ii) geographical and socio-economic determinants of vulnerability and adaptability of environmental health issues (exposure, sensitivity, and adaptive capacity); (iii) occurrence of CSDs from 1988 to 2017 and their direct impacts on human wellbeing (Total death and Affected people); (iv) an online survey on the perceptions of the effects of EWEs on human wellbeing in a sample of countries in the region; and (v) discussion of possible solutions. The socio-economic and development indices, and the International Disaster Database (EM-DAT) and Climate-Risk Index (CRI) disaster statistics suggest that the impacts of CSDs are primarily related to socio-economic determinants of human wellbeing and health inequalities. Also, >80% respondents to the survey say that the leading causes of climate-related human impacts are the lack of (i) public awareness; (ii) investment and (iii) preparedness. The paper concludes by adding some suggestions that show how countries in Latin America may better cope with the impacts of Climate-sensitive Disasters.