RESUMEN
Substance use disorders have significant consequences for patients and those around them. A qualitative systematic review was conducted to examine the effectiveness of religiosity and spirituality (R/S) interventions based on Judeo-Christian principles during the multidisciplinary treatment of patients with substance dependence disorder. Studies of patients of both sexes, at any age, of any nationality, and from any geographic location who were participating in treatment programs with religious elements explicitly tied to Christianity or Judaism were eligible for inclusion. Other religious interventions were excluded. Seven electronic databases were searched to identify eligible intervention studies published in English until August 2021. Two reviewers independently screened studies and extracted data. JBI tools were used to assess risk of bias. Of 146 articles retrieved for full text reading, five were ultimately included in this review published from July 2008 to August 2021. The R/S interventions used in the included studies were music therapy in a religious context, reading of the Bible or Torah, reflexive readings, personal prayer and reflection, and religiously integrated cognitive behavioral psychotherapy with or without a comparison group. Despite the broad search, there were found only a small number of studies and little homogeneity in the data of patients that reported positive impacts of treatments. Well-designed controlled studies are needed to truly investigate the efficacy of Judeo-Christian religious interventions for helping people with substance use problems, so as to strengthen the evidence of the benefits of these type of approaches in the treatment of drug addicts.
Asunto(s)
Terapia Cognitivo-Conductual , Musicoterapia , Trastornos Relacionados con Sustancias , Masculino , Femenino , Humanos , Trastornos Relacionados con Sustancias/terapia , Conducta Sexual , CristianismoRESUMEN
Knowledge and understanding of the functioning of watersheds is essential for constructing future scenarios that aim to minimize instability. However, new approaches including variables, methods, and techniques into traditional methodologies contribute to environmental planning and management of such territorial units. This study aims to propose a model based on a multicriterion spatial approach for the analysis of the geomorphometric environmental fragility of watersheds. This study was conducted in the Murundú-Paiol watershed, located in the state of São Paulo, Brazil. Morphometric, geological, pedological, hypsometric, slope, land use, and land cover data were evaluated and integrated using geotechnologies for processing and analytical hierarchy process (AHP) considering a weighted linear combination for an integrated spatial analysis of the watershed. The study area shows a greater predisposition to fragility in areas of flat and smooth reliefs, especially around the main river, where there is a greater presence of anthropic areas. The methodology proposed here, which uses a multicriterion spatial approach and AHP, combined with technical and scientific data, allows replicating the model to another watersheds. Modeling was validated in a cooperative way using an in-field, traditional method. The watershed evaluated showed that 49.13% and 26.83% of lands have medium and low fragility, respectively, while about 17% of lands have a high fragility and their management should be a priority. Modeling correlates strongly and positively with fragility class detailing, and field areas corroborate the model proposed here. This evidenced a robust analysis of factors that affect the geomorphometric environmental fragility of watersheds. The method is efficient in contributing to environmental planning and management of this territorial unit.
Asunto(s)
Monitoreo del Ambiente , Ríos , BrasilRESUMEN
This study presents an approach on the evaluation of potential laminar erosion in the Ribeirão Sucuri Grande watershed. It is located in the northeast of the state of Goiás, Brazil, a conservation area under strong anthropogenic pressure. A Mamdani fuzzy inference system was designed using linguistic variables, pertinence functions, and a set of rules associated to a traditional laminar erosion prediction model through the environmental conditioners slope, erodibility, and degree of soil protection. The laminar erosion prediction model associated with fuzzy logic is a qualitative evaluation of erosive potential capable of being spatialized with a greater level of detail, increasing the traditional classification by two levels. The processing of environmental and soil conditioning factors using the fuzzy logic resulted in values between 2.5 and 9.1, which places the basin at a low to very high laminar erosion potential. The results indicate areas that demand a greater attention regarding soil management; 56.89% of the area has a medium to high laminar erosion and high to very high erosion (6.99%).
Asunto(s)
Conservación de los Recursos Naturales , Lógica Difusa , Pradera , Movimientos del Agua , Brasil , Monitoreo del Ambiente , Ríos , SueloRESUMEN
BACKGROUND: Rhabdomyolysis is a potential threat after bariatric surgey. The severity ranges from asymptomatic elevations of serum muscle enzyme levels to life-threatening cases associated with muscle necrosis, compartment syndrome, acute renal failure and cardiac arrest. METHODS: We studied 98 consecutive obese patients who underwent primary uncomplicated bariatric surgery during a 1-year period. A database was created for all patients (sex, age, BMI, duration of the operation); serum creatinine phosphokinase (CPK) was systematically measured before surgery and on the first and second postoperative day. RESULTS: The study sample consisted of 35 males (35.7%) and 63 females (64.3%) with preoperative CPK level 156.6 +/- 41.1 U/L (40 to 220), 24 hours postoperatively 1,075.2 +/- 596.5 U/L, (85 to 2,790 U/L) and 48 hours postoperatively 967.3 +/- 545.3 U/L (79 to 2,630). There was no difference in mean BMI (P=0.1) and mean duration of operation (P=0.5) between males and females. However, a statistically significant difference in mean elevation of CPK between males and females (P=0.003) was found. The variables sex, age, weight and duration of surgery were analyzed by multivariate logistic regression, but did not show a statistically significant difference. CONCLUSION: Rhabdomyolysis is a potentially fatal complication of surgical procedures in obese patients, and can be minimized with simple measures such as additional padding, aggressive hydration and urine alkalinization. Diagnosis requires a high level of physician awareness.
Asunto(s)
Derivación Gástrica/efectos adversos , Rabdomiólisis/etiología , Adolescente , Adulto , Índice de Masa Corporal , Creatina Quinasa/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Rabdomiólisis/sangre , Rabdomiólisis/diagnóstico , Rabdomiólisis/prevención & control , Factores de Riesgo , Factores de TiempoRESUMEN
PURPOSE: verify the cytological and histological aspects of the regeneration of fragments of autologous and heterotopic spleen implanted in peritoneal cavity and subcutaneous screen in Wistar albino rats. METHODS: forty four Wistar rats were assigned to one of two groups A (n=22) and B (n=22), which received their implants in subcutaneous screen and peritoneal cavity, respectively, under anesthesia. Those groups were redistributed in two other subgroups A1 (n=11) and B1 (n=11), which received one and four splenic fragments in the areas of study. The remaining spleen was guided for cytological and histological processing, and was used as a control group. After five weeks, they were submitted to euthanasia, and peritoneal cavity opening took place as well as subcutaneous screen was taken off in order to search for regenerated splenic tissue. Cytological and histological assessment in the regenerated splenic tissue was performed, and the results were compared to the control group. Statistical analysis no parametric tests (p => 0.05) were used for. RESULTS: there were no statistically significant differences in relation to regenerated splenic tissue in subcutaneous screen (n=22) and the peritoneal cavity (n=22). In relation between presence and absence of regeneration, they're no statistically significant differences (p = 0.182). Cytological and histological assessment did not show any statistically significant difference in relation to the control group. CONCLUSION: regeneration of autologous and heterotopic splenic tissue in mice is viable, and occurs frequently. Cytological and histological aspects are similar to normal spleen.