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Multielement concentrations (P, S, Cl, K, Ca, Cr, Mn, Fe, Ni, Cu, Zn, Rb, and Rh) and total mercury (T-Hg) were analyzed in different organs and tissues of Amazonian manatee (Trichechus inunguis). Samples of 27 T. inunguis specimens, maintained in the collection of the Amazonian Center for the Research and Preservation of Aquatic Mammals, were used, situated in an area highly impacted by gold mining in the northern region of the Brazilian Amazon. Samples of aquatic plants used as food by the animals were also analyzed. The elements S, Cl, K, Cr, and Mn accumulated mainly in the musculature, while Fe and Cu were more concentrated in the liver. Trace elements, such as rubidium (Rb) and rhodium (Rh), not previously reported in the organs of animals of the family Trichechidae, were also identified. The averages for T-Hg in the skin, muscle, encephalon, liver, kidney, and lung samples were, respectively, 0.1540 ± 0.1332, 0.0593 ± 0.1044, 0.0517 ± 0.0467, 0.0486 ± 0.0543, 0.0237 ± 0.0336, and 0.0013 ± 0.0032 µg.g−1. The values obtained for the vibrissae samples were below the limit of quantification, which allows for the conclusion that this tissue cannot be used as a contamination marker. It was observed that even when kept in a conservation breeding site, these animals were exposed to non-essential trace elements. Differences in the accumulation of elements were observed between the different organs and tissues analyzed. The presence of contaminants in animals that live in a preservation center, even at low levels, deserves attention. [ABSTRACT FROM AUTHOR]

Total mercury (Hg) levels were determined by cold vapor atomic absorption spectrophotometry (CVAAS) in tissues of two species of carnivorous fishes and in the soft tissue of oysters caught in Sepetiba Bay, Brazil. Hg was distributed unevenly in the organs and tissues of the fish; the mean Hg content was highest in the kidneys (0.048 μg/g wet weight) and lowest in the gills (0.004 μg/g w.w.). Mean Hg levels were higher in the oysters (0.052 μg/g w.w.) than in the fish (0.022 μg/g w.w). The total Hg concentration did not exceed the maximum concentration for food allowed by Brazilian legislation in any of the fish and oyster samples analyzed. Moreover, the Hg concentrations observed were all within the maximum level for fish recommended by the Food and Agriculture Organization (FAO; 0.5 μg/g w.w.). [ABSTRACT FROM AUTHOR]

Purpose: Early integration of pediatric palliative care (PPC) for children with cancer is critical to improving the quality of life of both the patient and family. Understanding physician perceptions of palliative care and perceived barriers to early integration is necessary to develop PPC in Brazil., Methods: The Assessing Doctors' Attitudes on Palliative Treatment survey was modified for use in Brazil. The survey was open from January 2022 to June 2022 and distributed to physicians of all specialties from participating institutions who treat children with cancer. Statistical analysis was complemented by qualitative analysis of open-ended responses., Results: A total of 272 respondents participated. Most respondents reported access to PPC experts for consultation (77.2%) and 34.5% indicated previous palliative care training. Physician knowledge of PPC was generally aligned with WHO guidance (median alignment, 93.0%; range, 80.5%-98.2%). However, about half (53.3%) felt comfortable addressing physical needs of patients receiving PPC, 35.3% addressing emotional needs, 25.8% addressing spiritual needs, and 33.5% addressing grief and bereavement needs. Most respondents (65.4%) felt palliative care should be involved from diagnosis, but only 10.3% stated that this occurred in their setting. The most important barriers identified were physician discomfort (89.0%), limited physician knowledge (88.6%), and lack of home-based services (83.8%)., Conclusion: Despite a strong understanding of the role of palliative care, physicians in Brazil reported low confidence delivering PPC to children with cancer. Additionally, physicians generally believed that PPC should be integrated earlier in the disease trajectory of children with cancer. This work will direct educational and capacity building initiatives to ensure greater access to high-quality PPC for children with cancer in Brazil to address patient and family suffering.

Objective: The aim of this study was to evaluate the impact of study methodology and evaluation type on the selection of studies during the presentation of scientific events., Methods: A prospective, observational, transversal approach was applied to a cohort of studies that were submitted for presentation at the 2021 Brazilian Breast Cancer Symposium. Three forms of criteria (CR) were presented. CR1 was based on six criteria (method, ethics, design, originality, promotion, and social contribution); CR2 graded the studies from 0 to 10 for each study, and CR3 was based on five criteria (presentation, method, originality, scientific knowledge, and social contribution). To evaluate the item correlation, Cronbach's alpha and factorial analysis were performed. For the evaluation of differences between the tests, we used the Kruskal-Wallis and post-hoc Dunn tests. To determine the differences in the study classifications, we used the Friedman test and Namenyi's all-pairs comparisons., Results: A total of 122 studies were evaluated. There was also a good correlation with the items concerning criterion 1 (α=0.730) and 3 (α=0.937). Evaluating CR1 methodology, study design and social contribution (p=0.741) represents the main factor and CR3 methodology, and the scientific contribution (p=0.994) represents the main factor. The Kruskal-Wallis test showed differences in the results (p<0.001) for all the criteria that were used [CR1-CR2 (p<0.001), CR1-CR3 (p<0.001), and CR2-CR3 (p=0.004)]. The Friedman test showed differences in the ranking of the studies (p<0.001) for all studies (p<0.01)., Conclusion: Methodologies that use multiple criteria show good correlation and should be taken into account when ranking the best studies.

This article aims to analyse the magnitude and profile of legal demands for public health goods and services, also verifying the presence of legal demands for neglected tropical diseases (NTDs) in the State of Piauí between 2000-2020. Cross-sectional descriptive study based on the databases of the Court of Justice of Piauí on lawsuits demanding from the Direct Public Administration, goods and health services. A total of 6,658 lawsuits were initially identified. After eligibility analysis, 1,384 cases (20.8%) were analysed, with an increase in demand from 2017. We highlight the characteristics: origin in the capital Teresina (614; 44.4%), 40 to 59 years of age (372; 26.9%), female (761; 55.0%), farmers (123; 8.9%), public legal assistance (1,063; 76.8%), upheld (594; 42.9%). Five (5; 0.4%) lawsuits for NTDs, one visceral leishmaniasis requesting transportation, with granting, four for leprosy (two medicines, one granted, other extinguished without resolution of the merit, one consultation and one exam granted). The judicialization of the right to health is expressive and growing in the State of Piauí. The low demand related to NTDs may translate into limited access not only to health care, but also to the judiciary.

Objective: To characterize databases of the courts of justice of Brazil as a potential tool for research in Collective Health, in its interface with the legal sciences., Methods: Cross-sectional study of quantitative and descriptive nature, focusing on analysis of strategic management and judicial systems., Results: Databases used by the Common Justice in the Federation Units to systematize judicial processes were identified and analyzed. A total of 123 databases were found in the courts of justice per state, with emphasis on the South and Northeast regions, in contrast to the North region, which has a smaller number of systems. This large number of judicial systems limits access to legal operators, and hinders the collection of evidence by health researchers and, consequently, impacts the strategic management of the Executive Branch. There were limitations from design to transparent and democratic data extraction by the users themselves, as well as restricted integration between bases., Conclusions: Although advances have been made in recent years by the courts of justice to unify these databases, the multiplicity of information systems used in the Common State Justice complicates the management of knowledge, limits the development of research, even when carried out by lawyers or researchers in the legal area, as well as generates slow data extraction for public management. It is recognized the need for additional efforts for standardization, as well as for improvement of these databases, expanding access, transparency and integration with a view to a transdisciplinary look between the field of Law and Collective Health.