Formação de professores da educação infantil: orientações quanto ao aspecto psíquico do desenvolvimento de bebês / Formación de profesores de educación infantil: orientación sobre el aspecto psíquico del desarrollo infantil / Formation of early childhood education teachers: guidance on the psychic aspect of infant development / Formation des enseignants de l'éducation de la petite enfance: conseils sur l'aspect psychique du développement du nourrisson

O estudo buscou realizar uma articulação entre os campos da Saúde Coletiva, a Educação e a Psicanálise, com a finalidade de construir uma prática comprometida com o cuidado de crianças, que se encontram em creches, bem como enfatizando os aspectos da constituição psíquica. Objetivou-se verificar os efeitos de uma intervenção baseada na Metodologia Indicadores de Risco para o Desenvolvimento Infantil ­ IRDI e na ação educativa de professores de uma creche. O estudo consistiu em uma pesquisa-ação através de narrativas de vida escritas e encontros de formação com os professores. Por intermédio das narrativas, bem como dos diálogos estabelecidos nos encontros de formação, foram observados atravessadores envolvidos nas relações entre o cuidar e o educar no contexto da creche. Por fim, assinalou-se ainda a importante contribuição de processos formativos como amparo ao fazer prático dos docentes

El estudio tuvo como objetivo realizar una articulación entre los campos de la Salud Colectiva, la Educación y el Psicoanálisis, con el fin de construir una práctica comprometida con el cuidado de los niños que se encuentran en las guarderías, enfatizando los aspectos de la constitución psíquica. El objetivo fue verificar los efectos de una intervención basada en la Metodología de Indicadores de Riesgo para el Desarrollo Infantil - IRDI sobre la acción educativa de los docentes de una guardería. El estudio consistió en una investigación-acción a través de narrativas de vida escritas y reuniones de formación con profesores. A través de las narrativas, así como de los diálogos en las reuniones de formación, se observaron los intermediarios involucrados en las relaciones entre el cuidado y la educación en el contexto de la guardería. También se señaló la importante contribución de los procesos formativos como apoyo a la formación práctica de los docentes

The study aimed to perform an articulation between the fields of Collective Health, Education and Psychoanalysis, in order to build a practice committed to the care of children who are in daycare centers, emphasizing the aspects of the psychic constitution. The objective was to verify the effects of an intervention based on the Methodology Risk Indicators for Child Development - IRDI on the educational action of teachers of a daycare center. The study consisted of an action research through written Life Narratives and formation meetings with teachers. Through the narratives, as well as the dialogues in the formation meetings, the middlemen involved in the relations between caring and educating in the context of daycare were observed. It was also pointed out the important contribution of formative processes as support to the practical making of teachers

L'étude visait à réaliser une articulation entre les domaines de la santé collective, de l'éducation et de la psychanalyse, afin de construire une pratique engagée dans la prise en charge des enfants qui sont dans les garderies, en mettant l'accent sur les aspects de la constitution psychique. L'objectif était de vérifier les effets d'une intervention basée sur la méthodologie Indicateurs de risque pour le développement de l'enfant - IRDI sur l'action éducative des enseignants d'une garderie. L'étude consistait en une recherche-action à travers des récits de vie écrits et des réunions de formation avec des enseignants. À travers les récits, ainsi que les dialogues dans les réunions de formation, les intermédiaires impliqués dans les relations entre les soins et l'éducation dans le contexte de la garderie ont été observés. Il a également été souligné l'importante contribution des processus de formation en tant que soutien à la création pratique des enseignants

Unilateral Thyroid Lobectomy as Day Care Procedure: A Cross Sectional Study with Literature Review on the Safety and Cost Effectiveness

Abstract Introduction Thyroid nodules are common globally in almost one fifth of the adult population. The gold standard treatment for thyroid nodule is thyroid lobectomy or total thyroidectomy depending upon the diagnosis. Thyroidectomy has a few known complications but, as per the ATA consensus statement, it is a safe surgery to be done as a day care procedure. Objective To access the feasibility and safety of thyroid lobectomy as a day care surgery and its effect on decreasing overall financial burdens. Methods This retrospective chart review was done from 2006 to 2022. A total of 736 patients underwent thyroid lobectomy among which only 56 were done as day care surgery. Data analysis was done using the IBM SPSS Statistics for Windows, Version 23.0 (IBM Corp., Armonk, NY, USA). Results A total of 40% of the population was male. The mean age of the study population was 42 years. Bethesda II was the most encountered diagnosis, with a rate of 69%. The majority of patients were discharged after 6 hours of postoperative observation. The only complication encountered was seroma, which was seen in two patients. Conclusion Thyroid lobectomy appears to be a safe procedure with a drastic difference in overall cost as a day care procedure. We recommend switching the practice of inpatient thyroid lobectomy to a day care procedure in carefully selected candidates. The major hurdle in day care lobectomy can be approval from insurance.

Comparison of Multimodal Strategies to Enhance Recognition of Child Development Milestones among Childcare Providers during a Virtual or In-person Conference / Comparación de estrategias multimodales para mejorar el reconocimiento de los hitos del desarrollo infantil entre los proveedores de servicios de guardería durante una conferencia virtual o presencial / Comparação de estratégias multimodais para melhorar o reconhecimento de indicadores de desenvolvimento infantil entre o pessoal encargado do cuidado das crianças durante conferência virtual ou presencial

Introduction: Evaluations of knowledge obtained during conferences, whether in person or virtually, are rarely documented, in part because of the complexity of including an assessment, the pretesting involved, confidentiality concerns, and differences among attendees in terms of their education, language, and willingness to be evaluated. Objective: During a conference in the United States, we compared the recognition of developmental milestones using two different multimodal communication strategies (video vs. oral presentation) among three groups of childcare providers. Methods: Cross-sectional study with repeated measures. One hour before the conference completion, two groups (one virtual and one in-person) received an 8-minute multimodal presentation on child developmental milestones at 4 months (cartoon video); a control group, during the face-to-face conference, received an 8-minute multimedia presentation (oral via PowerPoint) on child developmental milestones at 4 months. The three groups responded twice to a scale to measure their recognition of developmental milestones before the lecture began and fifteen minutes before the end of the 2 ½ hours lecture. Results: Attendees, both in person and via the virtual modality, had significantly better recognition of developmental milestones at 4 months of age compared to the control group adjusted for age and education levels. Conclusion: These results suggest the advantages of a multimodal presentation using video versus an oral presentation during lectures to increase recognition of children's developmental milestones, which are complex and varied. Similarly, such a strategy may be effective regardless of the different characteristics related to the educational level or age of the set of participants attending a conference.

Introducción: las evaluaciones de los conocimientos obtenidos durante conferencias, tanto en persona como de forma virtual, rara vez se documentan, en parte debido a la complejidad de incluir una evaluación, las pruebas previas que conlleva, las preocupaciones sobre la confidencialidad y las diferencias entre los asistentes en cuanto a su nivel educativo, lenguaje y disposición a ser evaluados. Objetivo: se comparó el reconocimiento de los indicadores del desarrollo infantil durante una conferencia en los Estados Unidos utilizando dos estrategias de comunicación multimodal diferentes (presentación de vídeo vs. presentación oral) entre tres grupos de personal a cargo del cuidado de los niños. Métodos: estudio transversal con medidas repetidas. Una hora antes de finalizar la conferencia, dos grupos (uno virtual y otro presencial) recibieron una presentación multimodal de 8 minutos sobre los indicadores del desarrollo infantil a los 4 meses (en vídeo con dibujos animados); un grupo de control, durante la conferencia presencial, recibió una presentación multimedia de 8 minutos (oral mediante PowerPoint) sobre los indicadores del desarrollo infantil a los 4 meses. Resultados: los tres grupos respondieron dos veces a una escala para medir el reconocimiento de los indicadores del desarrollo infantil antes de que empezara la conferencia y quince minutos antes de que terminara la conferencia de 2½ horas. Los asistentes, tanto en persona como a través de la modalidad virtual, tuvieron un reconocimiento significativamente mayor de los indicadores del desarrollo infantil a los 4 meses de edad en comparación con el grupo de control, ajustado por edad y niveles de educación. Conclusión: estos resultados sugieren las ventajas de una presentación multimodal con vídeo en comparación con una presentación oral durante las conferencias para aumentar el reconocimiento de los indicadores del desarrollo infantil, que son complejos y variados. Asimismo, dicha estrategia puede ser eficaz independientemente de las diferentes características relacionadas con el nivel educativo o la edad del grupo de participantes que asisten a una conferencia.

ntrodução: as avaliações de conhecimentos obtidos durante conferências, tanto pessoalmente quanto de forma virtual, rara vez são documentadas, em parte, devido à complexidade de incluir uma avaliação, o pré-teste envolvido, questões de confidencialidade e diferenças entre os participantes em termos de nível educacional, linguagem e vontade de ser avaliado. Objetivo: foi comparado o reconhecimento dos indicadores de desenvolvimento infantil durante uma conferencia nos Estados Unidos usando duas estratégias de comunicação multimodal diferentes (apresentação de vídeo versus apresentação oral) em três grupos de pessoal a cargo do cuidado de crianças. Métodos: estudo transversal com medidas repetidas. Uma hora antes de finalizar a conferência, dois grupos (um virtual e outro presencial) receberam apresentação multimodal de 8 minutos sobre os indicadores de desenvolvimento infantil aos 4 meses (em vídeo com quadrinhos animados); um grupo de controle, durante a conferencia presencial, recebeu uma apresentação multimídia de 8 minutos (oral mediante PowerPoint) sobre os indicadores de desenvolvimento infantil aos 4 meses. Resultados: os três grupos responderam duas vezes a uma escala para medir o reconhecimento dos indicadores de desenvolvimento infantil antes de começar a conferencia e quinze minutos antes de terminar a conferencia de 2½ horas. Os assistentes, tanto em pessoa quanto em modalidade virtual, tiveram um reconhecimento significativamente maior dos indicadores de desenvolvimento infantil a 4 meses de idade em comparação com o grupo de controle, ajustado por idade e níveis de educação. Conclusão: estes resultados sugerem as vantagens de uma apresentação multimodal com vídeo em comparação com uma apresentação oral durante as conferencias para aumentar o reconhecimento dos indicadores de desenvolvimento infantil, que são complexos e variados. Mesmo assim, tal estratégia pode ser eficaz independentemente das diferentes caraterísticas relacionadas com o nível educativo ou a idade do grupo de participantes que assistem a uma conferencia.

Study on Evaluation of Anaesthetic Pain Management in Day Care Surgery

Background: Daycare surgeries are those surgical procedures in which the patients are admitted and discharged on the same day. As daycare surgeries surged, there is a need to have an anaesthetic agent which can be efficient and also causes fewer side effects. This study effectively analyses the efficacy and safety profile of the two most popular anaesthetic agents used in daycare surgeries. Methods: This is a retrospective study that was conducted between January 2022 and March 2022. The included patients were between 25 years and 65 years old. The outcomes were based on several factors like the efficacy of the anaesthesia (based on 4-point scale, recovery time and appearance of any side effects. Results: The efficacy of the anaesthetic action was assessed by the 4-point scale of anaesthetic effect, which showed a better outcome with sevoflurane. The Recovery Time in Group 1 was 19.92�24 minutes while in Group 2 it was 25.04�03 minutes. The findings reveal that the numbers of patients with complications are more in Group 1 as compared to Group 2 patients. Conclusion: Daycare surgery has increased and so, there is need to find an anesthetic agent which can efficiently be used. Anaesthetic efficiency is quite higher in sevoflurane as compared to desflurane. In the case of each complication, sevoflurane proved to have lesser complications as compared to desflurane. Sevoflurane is a better alternative to desflurane in daycare surgery as the anaesthetic agent of choice.

Aspectos esenciales para realizar los cuidados en guarderías privadas desde la perspectiva de las cuidadoras / Essential Aspects, from the Perspective of Childcare Workers, for Providing Care in Private Daycare Centers

Introducción: El nuevo modelo económico cubano ha posibilitado la aparición de guarderías privadas, pero se desconocen qué aspectos deben ser considerados como esenciales para ejercer los cuidados desde la perspectiva de las cuidadoras Objetivo: Explorar aspectos esenciales para realizar los cuidados en guarderías privadas desde la perspectiva de las cuidadoras. Métodos: Estudio cualitativo de tipo exploratorio, realizado entre junio y septiembre de 2021 con 12 cuidadoras que laboran en guarderías privadas del municipio Santa Clara, provincia Villa Clara, Cuba. Los datos se obtuvieron mediante dos rondas de entrevistas; las narrativas fueron procesadas mediante análisis de contenido. Resultados: De la primera entrevista se manifestaron las siguientes categorías: higiene y protección para el cuidado, alimentación del niño, rutinas (sueño), problemas relacionados con el cuidado y rutinas (juego). De la segunda entrevista emergieron tres categorías: necesidad de un manual para la preparación, necesidad de un sitio digital para consulta y necesidad de curso de formación. Conclusiones: Se destaca la necesidad de garantizar en la guardería la higiene adecuada y disminuir el riesgo de accidentes; la preparación de alimentos y dietas; las rabietas, caídas y la fiebre como problemas más comunes; las rutinas de descanso y la rutina de juego y su influencia para el desarrollo armónico de los niños, además que las cuidadoras deberían recibir formación a través de un manual específico para guarderías privadas; algún sitio de consulta en internet y un curso preparatorio(AU)

Introduction: The new Cuban economic model has made possible the appearance of private daycare centers, but there is lack of knowledge concerning what aspects, from the perspective of childcare workers, should be considered as essential to perform caregiving. Objective: To explore, from the perspective of childcare workers, essential aspects of care in private daycare centers. Methods: Qualitative and exploratory study carried out between June and September 2021 with twelve childcare workers from private daycare centers in Santa Clara Municipality, Villa Clara Province, Cuba. The data were obtained through two rounds of interviews; the answers were processed through content analysis. Results: The following categories emerged from the first interview: hygiene and protection for care, child feeding, routines (sleep), problems related to care and routines (playing). Three categories emerged from the second interview: the need for a training manual, the need for a virtual consultation site, and the need for a training course. Conclusions: The need is highlighted to guarantee adequate hygiene in the daycare center and reduce the risk of accidents; diet and food preparation; tantrums, falls and fever as the most common problems; rest and playing routines, as well as their influence on harmonious child development; together with the fact that childcare workers should receive training through a specific manual designed for private daycare centers, any type of virtual consultation site and training course(AU)

Low frequency of SARS-CoV2 infection in daycare centers during the reopening of school activities in the Southeast's poor area of Brazil

ABSTRACT SARS-Cov2 has already infected over 482 million people and caused more than 6.1 million deaths. The beginning of the pandemic has led the health authorities of several countries to adopt non-pharmacological preventive measures such as daycare closures. The reopening took place when the country had the highest rates of infection and mortality (mainly due to the gamma variant (P.1) outbreak) and the beginning of the vaccination program. Therefore, we aimed to investigate the prevalence of SARS-CoV2 in daycare after educational activities resumed. The study was conducted in seven childcare facilities. Swab samples from the nasopharynx were collected from children and staff members. The viral RNA was obtained through PureLink RNA extraction kit purification and SARS-CoV2 presence was detected using the All plex SARS-CoV2 kit. The study population included 201 participants, including daycare workers and children. The average age of the workers and children is 40 and 3 years old, respectively. Among the children, 47.5% are female and among the workers, 91.4%. One (0.5%) test came out positive for the presence of SARS-CoV-2, which was from a sample of an asymptomatic childcare worker, and no secondary infections were detected. Considering that the return to daycare activities occurred during a period with a high number of deaths and a lack of vaccines throughout the country, the small number of cases indicates the effectiveness of the several preventive measures used by daycare centers in preventing SARS-CoV2 transmission.

Revisão integrativa sobre doenças parasitárias em crianças de creches brasileiras / Integrative review on parasitic diseases in children in brazilian day care centers

As parasitoses intestinais constituem um importante problema de Saúde Pública, especialmente entre os pré-escolares, devido à imaturidade do sistema imune. Assim, este estudo objetivou realizar uma revisão integrativa dos estudos publicados entre os anos de 2010 a 2017 sobre parasitoses intestinais e os fatores associados ao desenvolvimento em crianças matriculadas em creches brasileiras. Foi realizada busca bibliográfica através das bases de dados Medline, Lilacs e SciELO, utilizando os descritores: infecção, parasitoses, diarreia e creches, e seus correspondentes em inglês: "infection", "parasitc diseases", "diarrhea" e "child day care centers". No caso das buscas no Medline o descritor Brazil também foi usado. Foram identificados 59 estudos, dos quais 11 foram incluídos no presente trabalho. Foi observado variação de 19,4% a 98,4% de parasitos e, a Giardia duodenalis foi o mais prevalente em crianças entre um e seis anos de idade, gênero masculino, com baixo peso, advindas de residências com alta densidade familiar e nível socioeconômico baixo. As análises mostraram a importância da compreensão dos fatores de risco para a incidência de parasitos, indicando a necessidade da promoção de estratégias efetivas para prevenção e controle das infecções parasitárias no país, visto que, tais infecções influenciam diretamente no desenvolvimento da criança, e em alguns casos, evoluindo a óbito.

Intestinal parasitosis is an important public health issue especially among pre-school children due to the immaturity of their immune system. Thus, this study aimed at carrying out an integrative review of studies published between 2010 and 2017 regarding intestinal parasites and associated factors in children registered in Brazilian day care centers. A bibliographic survey was performed through the Medline, Lilacs, and SciELO databases using the following descriptors: infection, parasitic diseases, diarrhea, and child day care centers, as well as their corresponding translations in Portuguese: "infecção", "parasitoses", "diarreia" and "creches". In the case of Medline searches, the descriptor Brazil was also used. Fifty-nine studies were identified, from which, 11 were included in this study. A variation of 19.4% to 98.4% of parasites could be observed, with Giardia duodenalis being the most prevalent in children between one and six years old, male, with low weight, coming from homes with high family density and low socioeconomic status. The analyzes showed the importance of understanding the risk factors for the incidence of parasites, showing the need to promote effective strategies for the prevention and control of parasitic infections in the country, since such infections have direct influence on the child's development, and in some cases, even evolving to death.

Vigilância do desenvolvimento de crianças em creche: um estudo sobre o olhar materno / Vigilancia del desarrollo infantil en la guardería: un estudio sobre la mirada materna / Surveillance of child development in a daycare center: a study on the maternal perspective

Resumo Objetivo Compreender a percepção materna acerca da vigilância do desenvolvimento de crianças menores de três anos que frequentam creche. Método Estudo qualitativo com nove mães de crianças menores de três anos, matriculadas em uma creche do município de João Pessoa-PB, vinculada a uma Unidade de Saúde da Família. Os dados foram coletados por meio de entrevistas semiestruturadas e submetidos à análise temática. Resultados A vigilância do desenvolvimento de crianças que frequentam creche encontra-se fragilizada, visto que a maioria das mães não costumam levar a criança para a unidade de saúde, para o acompanhamento do crescimento e desenvolvimento, e a inserção dos profissionais de saúde na creche ainda é limitada. Entretanto, as mães reconhecem a creche como cenário ideal para a promoção do desenvolvimento infantil e a importância da atuação dos profissionais de saúde nesse cenário. Conclusão e implicações para prática São necessárias ações conjuntas da creche com a Unidade de Saúde da Família para a atenção integral e vigilância do desenvolvimento infantil.

Resumen Objetivo Comprender la percepción materna sobre la vigilancia del desarrollo de los niños menores de tres años que asisten a la guardería. Metodo Estudio cualitativo con nueve madres de niños menores de tres años, inscriptos en una guardería de la ciudad de João Pessoa-PB, vinculada a una Unidad de Salud de la Familia. Los datos se recopilaron a través de entrevistas semiestructuradas y se sometieron a análisis temático. Resultados La vigilancia del desarrollo de los niños que asisten a la guardería se debilita, ya que la mayoría de las madres no llevan al niño a la guardería, para monitorear el crecimiento y desarrollo, y la inclusión de profesionales de la salud en la guardería aún es limitada. Sin embargo, las madres reconocen la guardería como un escenario ideal para la promoción del desarrollo infantil y la importancia del desempeño de los profesionales de la salud en este ámbito. Conclusión e implicaciones para la práctica Son necesarias acciones conjuntas de la guardería y la Unidad de Salud de la Familia para lograr la atención integral y vigilancia del desarrollo infantil.

Abstract Objective To understand the maternal perception about the surveillance of the development of children under three years old who attend a daycare center. Method A qualitative study with nine mothers of children under the age of three, enrolled in a daycare center in João Pessoa-PB, linked to a Family Health Unit. Data was collected through semi-structured interviews and subjected to thematic analysis. Results The monitoring of the development of children attending a daycare center is weakened, since most mothers do not take the child to childcare in order to monitor growth and development, and the inclusion of health professionals in the daycare center is still limited. However, the mothers recognize the daycare center as an ideal setting for the promotion of child development and the importance of health professionals in this setting. Conclusion and implications for the practice Joint actions of the daycare center with the Family Health Unit are necessary for comprehensive care and surveillance of child development.

Educador suficientemente bom: uma releitura winnicottiana dos indicadores do IRDI / Good enough caregiver: IRDI methodology indicators as read from Winnicott / Educador suficientemente bueno: una relectura winnicottiana de los indicadores del IRDI

Este artigo aborda o conceito de educador suficientemente bom. Tal construção teórica parte da releitura winnicottiana dos indicadores da metodologia IRDI (Indicadores de Risco para o Desenvolvimento Infantil). Assim, buscar-se-á compreender de que maneiras os educadores dos berçários e maternais auxiliam a dar andamento aos processos do amadurecimento dos bebês dos quais cuidam, utilizando-se, para isso, da teoria do amadurecimento proposta pelo psicanalista inglês D. W. Winnicott. Compreende-se que os profissionais das creches contribuem de forma importante para a constituição psíquica dos bebês, pois proporcionam continuidade aos principais processos desta: integração, personalização e capacidade para relacionamentos. Nesse sentido, esses educadores, quando atuando de maneira suficientemente boa, proporcionam continuidade e suplência ao papel do cuidador primordial, na maioria das vezes, exercido pela figura materna. Considerando o potencial constitutivo do fazer dos educadores de berçários e maternais, evidencia-se a necessidade e a relevância de propostas de formação especializadas para esses profissionais.

This paper addresses the concept of a good enough caregiver. Such notion is based on the view of IRDI (Clinical Risk Indicators for Child Development) methodology indicators according to Winnicott's approach. We seek to understand in what ways daycare children caregivers facilitate the maturational processes of the babies they care for, based on D. W. Winnicott's theory of emotional development. It is understood that daycare centres caregivers play a significant role in the psychic constitution of babies, considering they provide an extension to processes such as integration, personalization and socialization. When acting out in a good enough manner, they help to create a sense of continuity and their role substitutes that of the babies’ primordial caregiver, often performed by the mother figure. Because their work has a potentially constitutive role in children’s lives, it becomes clear not only that these professionals need specialized training, but how relevant this training is.

Este artículo intenta abordar el concepto de un educador suficientemente bueno. Esta noción se basa en los indicadores de la metodología IRDI (Indicadores de riesgo clínico en el desarrollo infantil) según propone Winnicott. Por lo tanto, buscamos comprender de qué manera los educadores de guarderías y otros centros de educación infantil facilitan los procesos de maduración de los bebés a los que cuidan, según la teoría del desarrollo emocional de D. W. Winnicott. Se entiende que los educadores de guarderías desempeñan un papel importante en la constitución psíquica de los bebés ya que proporcionan una extensión de sus procesos tales como la integración, la personalización y la socialización. Así, esos educadores cuando actúan de manera suficientemente buena, ayudan a crear un sentido de continuidad y suplencia al papel del cuidador primordial de los bebés, a menudo realizado por la figura de la madre. Teniendo en cuenta que su trabajo tiene potencialmente un papel constitutivo en la vida de los niños, quedan claras la necesidad y la relevancia de una capacitación especializada para estos profesionales.

Predominance of Giardia duodenalis AII sub-assemblage in young children from Salvador, Bahia, Brazil / Predominio del subconjunto AII de Giardia duodenalis en niños pequeños de Salvador, Bahía, Brasil

Introduction. Giardia duodenalis is an intestinal protozoan with a high prevalence in children of developing countries. Molecular studies revealed a great genetic diversity of G. duodenalis, with assemblages A and B found mainly in humans. Despite its importance, the information on the molecular epidemiology of human giardiasis is still limited in Brazil. Objective. To characterize G. duodenalis molecular isolates in children from Salvador, Bahia, Brazil. Materials and methods. Giardia duodenalis positive fecal samples were obtained from 71 children from two day care centers and 39 users of a clinical analysis laboratory. Samples were analyzed by PCR-RFLP of the glutamate dehydrogenase (gdh) and beta-giardin genes and by the sequencing of beta-giardin. Results. Of the 110 G. duodenalis samples, 80 (72.7%) amplified one or both target genes. Of these, 62 (77.5 %) were identified as assemblage A and 18 (22.5%) as assemblage B. The subassemblage AII was identified in 58.8% (n=47) of isolates followed by the sub-assemblage AI (18.8%, n=15), BIV (11.2%, n=9), and BIII (5.0%, n=4). The AII sub-assemblage was the most frequent in children of both day care centers whereas AI was found only in the group attended at the clinical laboratory. Sub-assemblage AII predominated in children under two years. Conclusions. The higher frequency of AII sub-assemblage suggests that anthroponotic transmission is more common in Salvador, but that zoonotic transmission pathways are also present and a change in susceptibility to different molecular patterns of Giardia may occur during child growth.

Introducción. Giardia duodenalis es un protozoo intestinal de gran prevalencia en los niños de los países en desarrollo. En estudios moleculares se ha evidenciado la gran diversidad genética de G. duodenalis y se han identificado los conjuntos A y B, principalmente en humanos. A pesar de su importancia, el conocimiento de la epidemiología molecular de la giardiasis humana aún es limitado en Brasil. Objetivo. Caracterizar los aislamientos moleculares de G. duodenalis de muestras tomadas a niños de Salvador, Bahía, Brasil. Materiales y métodos. Las muestras fecales positivas para G. duodenalis se obtuvieron de 71 niños de dos guarderías y de 39 usuarios de un laboratorio de análisis clínicos. Las muestras se analizaron mediante PCR-RFLP de los genes gdh y beta-giardin, y secuenciación de beta-giardin. Resultados. De las 110 muestras de G. duodenalis, en 80 (72,7 %) se amplificaron uno o ambos genes. De estos, 62 (77,5 %) se identificaron como pertenecientes al conjunto A y 18 (22,5 %) al B. El subconjunto AII se identificó en el 58,8 % (n=47) de los aislamientos, seguido del AI en el 18,8% (n=15), el BIV en el 11,2% (n=9) y el BIII en el 5,0% (n=4). El subconjunto AII fue el más frecuente en los niños de ambas guarderías, en tanto que el AI solo se encontró en el grupo atendido en el laboratorio clínico. El subconjunto AII predominó en los niños menores de dos años. Conclusiones. La mayor frecuencia del subconjunto AII sugiere que la transmisión antroponótica es más común en Salvador, pero también existen vías de transmisión zoonóticas, y que pueden ocurrir cambios en la sensibilidad frente a diferentes patrones moleculares de Giardia durante el crecimiento infantil.

Vulnerability to infectious and contagious diseases in daycare center teachers: an observational study

Background: The risks caused by infectious and contagious diseases in the school environment are of importance to the conduct of early childhood education in the contemporary world. In this work authors aimed to analyze vulnerability to infectious and contagious diseases in daycare center teachers who work in public institutions in the Municipality of Fortaleza-CE, Brazil.Methods: This was aquanti-qualitative study approach of the descriptive, cross-sectional type, of an exploratory nature. This study was carried out with 30 daycare center teachers from the Municipality of Fortaleza from October to November 2016. Results: The main infectious and contagious diseases that affect children in the daycare center were high rates of two or three comorbidities per child. Regarding the workplace risk to the teachers’ health, 58.6% of the teachers consider that the working in the daycare center does not bring greater risks of illness and 41.4% believe it does.Conclusions: Stress due to the presence of students with viral infections who need to remain in the daycare center, lack of hygiene, rest and inadequate nutrition contribute to the vulnerability to illnesses in the teachers.

A Survey of Cardiac Rehabilitation of Elderly Patients with Heart Failure in Day-care Facilities within a Metropolitan Area / The Japanese Journal of Rehabilitation Medicine

Objective：To identify related challenges and develop improvement plans, we examined the status of cardiac rehabilitation of elderly patients with heart failure in day-care facilities within a metropolitan area.Methods：A mail questionnaire survey was conducted among 126 day-care facilities registered with the Japan Association for Day Care. The questionnaire consisted of 14 questions regarding the following：1) facility attributes；2) difficulties in managing patients with heart failure and the solutions applied；3) rehabilitation service contents and methods to manage risks in the facility, including sudden changes in patient conditions；and 4) if acceptance of patients with heart failure was difficult, the cause of the difficulty.Results：The response rate was 41％．Physical therapists were the largest professional group, accounting for 67.8％ of all respondents. As for facility users, 70.4％ were aged ≥75 years. Patients with heart failure were treated in 87.6％ of the facilities. The challenges of cardiac rehabilitation in the day-care facilities are summarized in 3 points as follows：1) an increasing number of elderly patients with heart failure in communities, 2) lack of preparedness to manage patients with heart failure in community-based cardiac rehabilitation, and 3) insufficient medical information sharing between facilities and hospitals.Conclusion：The results highlight the importance of creating guidelines on cardiac rehabilitation for community-dwelling elderly patients with heart failure and facility-hospital sharing tools that specify information useful for both parties to provide appropriate cardiac rehabilitation in day-care facilities.

A Survey of Cardiac Rehabilitation of Elderly Patients with Heart Failure in Day-care Facilities within a Metropolitan Area / The Japanese Journal of Rehabilitation Medicine

Objective：To identify related challenges and develop improvement plans, we examined the status of cardiac rehabilitation of elderly patients with heart failure in day-care facilities within a metropolitan area.Methods：A mail questionnaire survey was conducted among 126 day-care facilities registered with the Japan Association for Day Care. The questionnaire consisted of 14 questions regarding the following：1) facility attributes；2) difficulties in managing patients with heart failure and the solutions applied；3) rehabilitation service contents and methods to manage risks in the facility, including sudden changes in patient conditions；and 4) if acceptance of patients with heart failure was difficult, the cause of the difficulty.Results：The response rate was 41％．Physical therapists were the largest professional group, accounting for 67.8％ of all respondents. As for facility users, 70.4％ were aged ≥75 years. Patients with heart failure were treated in 87.6％ of the facilities. The challenges of cardiac rehabilitation in the day-care facilities are summarized in 3 points as follows：1) an increasing number of elderly patients with heart failure in communities, 2) lack of preparedness to manage patients with heart failure in community-based cardiac rehabilitation, and 3) insufficient medical information sharing between facilities and hospitals.Conclusion：The results highlight the importance of creating guidelines on cardiac rehabilitation for community-dwelling elderly patients with heart failure and facility-hospital sharing tools that specify information useful for both parties to provide appropriate cardiac rehabilitation in day-care facilities.

Nursery Educators' Implicit Mentalizing / A Capacidade de Mentalização Implícita de Educadoras de Berçário / La Capacidad de Mentalización Implícita de Educadoras de Guarderías Infantiles

Abstract Mentalizing capacity refers to people's ability to interpret their own and other's behavior in terms of mental states. This can be accomplished through implicit mentalizing, which tends to be employed by people most of the time, tends to be procedural and generally requires minimal attention and reflection. This study sought to assess the implicit mentalizing of nursery teachers that work with babies between four and eighteen months of age in Early Childhood Education schools. Four nursery teachers participated in the study. The following instruments were employed: Sociodemographic and Professional Data Questionnaire and video recordings of observation sessions - analized through the indicators teachers' response in the babies' actions; and references to mental states in the teachers' vocalizations. The results indicated that two of the participants stood out positively, while the other two exhibited greater difficulties. These results are discussed, along with factors that potentially interfere with mentalizing capacity. The study points out the importance of future research on the subject, focused on developing instruments and planning interventions aimed at improving mentalizing capacity so as to promote mental health.

Resumo Capacidade de mentalização refere-se à possibilidade de um indivíduo entender seus comportamentos e os dos outros em termos de estados mentais, o que pode ser feito a partir de sua capacidade de mentalização implícita. Esta tende a ser empregada pelo sujeito na maior parte do tempo, a ser procedural e a demandar pouca atenção e reflexão. Este estudo objetivou avaliar a capacidade de mentalização implícita de educadores de berçário que atuam com bebês, entre quatro a dezoito meses de idade, em escolas de Educação Infantil. Participaram quatro educadoras. Empregaram-se os instrumentos: Ficha de Dados Sociodemográficos e Profissionais e filmagem das observações - analisada através dos indicadores respostas das educadoras frente às ações dos bebês e referências a estados mentais no discurso. Os resultados sugerem que duas participantes destacaram-se positivamente e as demais apresentaram dificuldades nesses dois indicadores. Discutem-se tais resultados e possíveis fatores intervenientes na capacidade de mentalização. Aponta-se a importância de novos estudos sobre a temática para a construção de instrumentos e planejamento de intervenções que almejem aprimorar a capacidade de mentalização para promover saúde mental.

Resumen La capacidad de mentalización se refiere a la posibilidad de un individuo entender sus comportamientos y los de otros en términos de estados mentales, lo que puede hacerse a partir de su capacidad de mentalización implícita. Esta tiende a ser empleada por el sujeto en la mayor parte del tiempo, a ser procedural ya demandar poca atención y reflexión. Este estudio objetivó evaluar la capacidad de mentalización implícita de educadores de guarderías infantiles que actúan con bebés, entre cuatro a dieciocho meses de edad, en escuelas de Educación Infantil. Participaron cuatro educadoras. Se emplearon los instrumentos: Ficha de Datos Sociodemográficos y Profesionales y filmación de las observaciones - analizada a través de los indicadores respuestas de las educadoras frente a las acciones de los bebés y referencias a estados mentales en el discurso. Los resultados sugieren que dos participantes se destacaron positivamente y los demás presentaron dificultades en estos dos indicadores. Se discuten tales resultados y posibles factores intervinientes en la capacidad de mentalización. Se apunta la importancia de nuevos estudios sobre la temática para la construcción de instrumentos y planificación de intervenciones que anhelan mejorar la capacidad de mentalización para promover salud mental.

Hemorrhoidectomy versus rubber band ligation in treatment of second and third degree hemorrhoids: a comparative study

Background: Optimum surgical intervention for low-grade haemorrhoids is unknown. Haemorrhoidal artery ligation (HAL) has been proposed as an efficacious, safe therapy while rubber band ligation (RBL) is a commonly used Out patient treatment.Methods: We compared recurrence after HAL versus RBL in patients with grade II-III haemorrhoids. The diagnosis of hemorrhoids is primarily based on the proctoscopic  examination. The study evaluates comparative results of rubber band ligation (RBL) and hemorrhoidectomy. This study was conducted over a period of 1 year from January 2017 to December 2017. It includes 50 patients having second- or third-degree primary hemorrhoids who attended surgical OPD of Tertiary Care Hospital in Gujarat. These 50 patients were selected randomly and divided into two groups of 25 patients each (hemorrhoidectomy group and RBL group). Patients of fissure, fistulae, and malignancy were excluded. All parameters were recorded and finally analysed.Results: Hemorrhoidectomy and RBL are equally effective especially in second-degree hemorrhoids. However, RBL should be considered the first-line treatment in second-degree hemorrhoids because being an outpatient procedure, it is cost effective for the patients, saves many hospital beds for more sick patients, and takes the pressure off the surgical waiting list. Although RBL is not as effective as hemorrhoidectomy in third-degree hemorrhoid, it does improve bleeding and prolapse and is highly recommended for patients who are unfit for surgery.Conclusions: RBL should be considered as the first-line treatment for second-degree hemorrhoid. However, in the third-degree hemorrhoids, hemorrhoidectomy achieves better results, and RBL is recommend as the first-line treatment for those patients in whom there is contraindication for surgery or anesthesia.

Factores de riesgo de afecciones bucodentales en niños de guarderías infantiles no estatales / Risk factors of oral-dental disorders in children from particular daycare houses

Se realizó un estudio observacional, descriptivo, de corte transversal desde enero hasta mayo de 2017 de 93 niños de 1-4 años matriculados en 5 guarderías infantiles no estatales del reparto Sueño de Santiago de Cuba, con el objetivo de identificar los factores riesgo que incidieron en las enfermedades bucales que presentaban. Para recoger la información se confeccionó una planilla elaborada a los efectos y realizó el interrogatorio a padres y niños, además del examen bucal a estos últimos. Entre los factores de riesgo prevalecieron la dieta cariogénica (96,7 %), seguida por el uso del biberón (59,1 %); asimismo, la maloclusión resultó ser la alteración más frecuente, principalmente el resalte aumentado y la mordida abierta. Aunque predominaron los pacientes sin afectación, estaban expuestos a dichos factores. Por tanto, se debe insistir en el diagnóstico precoz de las maloclusiones para minimizar o evitar su impacto negativo sobre la salud de los menores.

An observational, descriptive and cross-sectional study, of 93 children aged 1-4 years registered in 5 non-state daycare houses in Sueño neighborhood of Santiago de Cuba was carried out from January to May, 2017, with the objective of identifying the risk factors which influenced in the oral illnesses that they presented. To collect the information a schedule was made for this aim and an inquiry to parents and children was carried out, besides the oral examination to the last ones. Among the risk factors the cariogenic diet (96.7 %), followed by the use of the baby bottle (59.1 %) prevailed; also, the malocclusion turned out to be the most frequent disorder, mainly the increased prominence and the open bite. Although the patients without disorders prevailed, they were exposed to these factors. Therefore, it should be insisted in the previous diagnosis of malocclusions to minimize or to avoid their negative impact on the health of the children.

Integrated mode among doctors, nurses, pharmacists and patients in day-care chemotherapy of breast cancer care / 中华医院管理杂志

Day-care chemotherapy boasts the advantage of shorter treatment time, higher treatment efficacy and lower patients′ burden, as compared to the conventional hospitalization pattern. In view of treatment needs of patients, better therapeutic outcomes and patient satisfaction, the authors analyzed the problems and shortages in the current management mode of chemotherapy in breast cancer care. With the specialized department taking the lead, a multidisciplinary collaboration was built among doctors, nurses and pharmacists.This integrated new mode combining doctors, nurses, pharmacists and patients together was further optimized. This new mode can provide a safer and easier treatment and set up a whole process management for chemotherapy of breast cancer care.

Microbial Quality Analysis of Foods from Daycare Centers Supported by the Center for Children's Foodservice Management in Daegu

This study examined the microbiological quality of daycare center meals. Six menu items from five daycare centers in Daegu included uncooked processed foods (seasoned cucumber and lettuce salad), post-preparation after cooking processed foods (rolled omelet and seasoned soybean sprout), and cooking processed foods (panbroiled beef with oyster sauce and seasoned pork roast). Microbiological analyses were performed for the aerobic plate counts (APC), coliforms, and Escherichia coli. The analyses were conducted in July and November 2017. The mean APC and coliform count of seasoned cucumber decreased significantly from 4.71 log colony forming units (CFU)/g and 2.50 log CFU/g in July to 4.07 log CFU/g and 1.78 log CFU/g in November, respectively (P < 0.01 and P < 0.001). The APC of panbroiled beef with oyster sauce and seasoned pork roast were significantly lower in July (1.84 and 1.79 log CFU/g) than in November (2.41 and 2.28 log CFU/g) (P < 0.001). The coliform counts of panbroiled beef with oyster sauce and seasoned pork roast were significantly greater in November (2.11 and 1.62 log CFU/g) (P < 0.001). E. coli was not detected. Among the foods prepared using the three preparation processes, the post-preparation after cooking processed foods had the lowest microbial quality. The APC and coliform counts of cooking processed foods were satisfactory in July, with an acceptable rating for pan-broiled beef with oyster sauce in November. Time-temperature control and the prevention of cross-contamination are essential during meal production for food safety, regardless of the season.

Adequação nutricional e desperdício de alimentos em Centros de Educação Infantil / Nutritional adequacy and food waste in Early Childhood Education Centers

Resumo Analisar aspectos quantitativos e qualitativos da alimentação escolar constitui-se de etapa primordial para fazer do Programa Nacional de Alimentação Escolar (PNAE) um espaço efetivo para a promoção da alimentação saudável e formação de sujeitos de direitos. O objetivo deste estudo foi avaliar a adequação nutricional das refeições servidas e consumidas e quantificar o desperdício de alimentos em Centros de Educação Infantil de Maceió/AL. Foram analisadas por três dias não consecutivos, pelo método de pesagem direta, as refeições de 359 crianças (17 e 63 meses). O desperdício de alimentos foi determinado pelo índice de resto-ingestão e o valor nutricional das refeições servidas e consumidas foram comparadas com os valores de referência do PNAE para energia, carboidrato, proteína, lipídio, vitaminas A e C, ferro, cálcio, zinco, magnésio e fibra. Dos 85 alimentos/preparações presentes no cardápio, 58 (68%) apresentaram percentual de resto-ingestão, superior a 10%. As refeições servidas e consumidas atenderam aproximadamente 50% do recomendado para energia e macronutrientes. A diferença entre as médias dos nutrientes ofertados e consumidos foi estatisticamente significante (p < 0,05) para fibra, vitamina A, vitamina C, cálcio, ferro e zinco.

Abstract Analyzing quantitative and qualitative aspects of school meals represents the initial stage to ensure that the National School Food Program (PNAE) is an effective space for the promotion of healthy eating habits and establishing individual rights. The objective of this study was to evaluate the nutritional adequacy of meals served and consumed, as well as quantifying food waste in Child Daycare Centers in Maceió, in the state of Alagoas. All meals served and consumed by 359 children (aged 17 to 63 months) were analyzed by the direct weighing method for three non-consecutive days in all institutions. Food waste was determined by the leftover factor and the nutritional value of meals served and consumed was compared to the PNAE reference values regarding energy, carbohydrates, protein, lipids, vitamins A and C, iron, calcium, zinc, magnesium and fiber. Of the 85 meals/preparations featured on the menu, 58 (68%) revealed a high leftover percentage; in excess of 10%. The meals served and consumed met approximately 50% of the recommended energy and macronutrient values. The difference between the averages of the nutrients offered and consumed was statistically significant (p < 0.05) for fiber, vitamin A, vitamin C, calcium, iron and zinc.

A Produção Científica Nacional na Área de Educação Especial e a Creche / National Scientific Production in the Special Education Area and Daycare

RESUMO: Este artigo tem por objetivo descrever a produção científica na área de Educação Especial sobre o atendimento educacional à faixa etária de zero a três anos, fase inicial da Educação Infantil, nos últimos 25 anos. Utiliza-se como fonte de busca as bases de dados Scientific Electronic Library Online (SciELO), Periódicos Eletrônicos em Psicologia (Pepsic), Portal de Periódicos Capes/MEC; Biblioteca Digital Brasileira de Teses e Dissertações (BDTD); Red de Revistas Científicas da América Latina Y el Caribe, España y Portugal (Redalyc) e, como descritores, os termos "educação especial", "educação inclusiva", "inclusão" e "creche", no período de 1993 a 2017. Foram encontrados 25 trabalhos, dentre eles 17 teses e dissertações e oito artigos. Após leitura minuciosa dos objetivos, métodos e resultados, verificou-se que os temas políticas públicas de Educação Infantil e Educação Especial; creches inclusivas: relatos de casos; formação de profissionais e concepções sobre inclusão contemplam as discussões na área. A inclusão na creche ainda é incipiente, tanto nos documentos oficiais como na prática. No entanto, a formação dos profissionais para essa realidade influencia fortemente na percepção e nas concepções que eles têm das crianças e das atividades nos contextos educacionais. Desse modo, são importantes novos olhares sobre esses contextos, de forma a produzir materiais que possibilitem identificar fragilidades, experiências de sucesso, discussões relevantes que auxiliem na melhora da qualidade dos serviços oferecidos a essa faixa etária.

ABSTRACT: This paper aims to describe the scientific production in the Special Education area upon educational care offered to children aged from zero to three, initial stage of Early Childhood Education for the past 25 years. The database used as a search source were the Scientific Electronic Library Online (SciELO), Periódicos Eletrônicos em Psicologia (PEPSIC), Portal de Periódicos Capes/MEC; Biblioteca Digital Brasileira de Teses e Dissertações (BDTD) and Red de Revistas Científicas da América Latina Y el Caribe, España y Portugal (REDALYC), and, as descriptors, the terms "educação especial" (special education), "educação inclusiva" (inclusive education),"inclusão" (inclusion) and "creche" (daycare facility ), from 1993 to 2017. Twenty five papers, among them seventeen doctoral dissertations and master's theses and eight papers. After a thorough reading of the objectives, methods and results, it was verified that the public policy themes of Early Childhood Education and Special Education; inclusive daycare facilities: case reports; education of professionals and conceptions about inclusion contemplate the discussions in the area. Inclusion in daycare is still incipient, both in official documents and in practice. However, the education of professionals for this reality strongly influences the perception and conceptions they have of children and activities in educational contexts. Therefore, new perspectives on these contexts are important, in order to produce materials that allow us to identify fragilities, successful experiences and relevant discussions that help to improve the quality of the services offered to that age group.