Tendencia del programa de intervención en DemoMinga, como estrategia para mejorar las dislipidemias y glucemia en la población Norma Luisa, Minga Guazú / Trend of the DemoMinga intervention program as a strategy to improve dyslipidemia and glycemia in the Norma Luisa population, Minga Guazú

Antecedentes: Las enfermedades no transmisibles siguen siendo un problema creciente en el mundo, sobre todo en los países de mediano y bajo ingresos. Los programas de intervención comunitaria se enfocan en su disminución mediante cambios en estilos de vida más saludables. Objetivos: Analizar la tendencia del programa de intervención en actividad física y nutrición, como estrategia para mejorar las dislipidemias y glucemia en los participantes del proyecto DemoMinga. Materiales y métodos: Estudio con enfoque cuantitativo. Diseño de investigación acción participativa, de carácter longitudinal, prospectivo. La población estuvo constituida por los participantes del Proyecto DemoMinga. Se determinó en cada participante: colesterol total, triglicéridos y glucemia en ayunas. Las muestras fueron procesadas en el Centro de Investigaciones Médicas de la FACISA-UNE. Se determinaron indicadores de tendencia central (mediana) de cada una de las variables. Resultados: Hubo mayor participación del sexo femenino, con predominio de personas con menos de 45 años. Las mediciones químicas arrojaron una tendencia de disminución a partir del quinto año de intervención, con talleres de cocina saludable incluyendo uso de aceite alto oleico, y actividad física. Sin embargo, la prueba no arrojó diferencias significativas de las mediciones entre la línea de base y el corte a los 6 años. Conclusión: El estudio resalta la importancia de los programas de intervención mediante terapias integrales para la promoción y prevención de las enfermedades cardiometabólicas a largo plazo.

Background: Non-communicable diseases remain a growing problem worldwide, especially in middle and low-income countries. Community intervention programs are focused on reducing their prevalence through promoting healthier lifestyle changes. Objectives: To analyze the trend of the physical activity and nutrition intervention program as a strategy to improve dyslipidemia and glycemia among participants of the DemoMinga project. Materials and methods: This study employed a quantitative approach with a participatory action research design, characterized as longitudinal and prospective. The population consisted of participants from the DemoMinga Project. For each participant, total cholesterol, triglycerides, and fasting glycemia were measured. Samples were processed at the Medical Research Center of FACISA-UNE. Indicators of central tendency (median) were determined for each of the variables. Results: There was a higher participation of females, with a predominance of individuals under the age of 45. Chemical measurements showed a decreasing trend starting from the fifth year of intervention, involving healthy cooking workshops that included the use of high oleic oil and physical activity. However, the test did not yield significant differences in measurements between the baseline and the 6-year cutoff. Conclusion: The study highlights the significance of intervention programs using comprehensive therapies for the long-term promotion and prevention of cardiometabolic diseases.

Tendencia del programa de intervención en DemoMinga, como estrategia para mejorar las dislipidemias y glucemia en la población Norma Luisa, Minga Guazú

Antecedentes: Las enfermedades no transmisibles siguen siendo un problema creciente en el mundo, sobre todo en los países de mediano y bajo ingresos. Los programas de intervención comunitaria se enfocan en su disminución mediante cambios en estilos de vida más saludables. Objetivos: Analizar la tendencia del programa de intervención en actividad física y nutrición, como estrategia para mejorar las dislipidemias y glucemia en los participantes del proyecto DemoMinga. Materiales y métodos: Estudio con enfoque cuantitativo. Diseño de investigación acción participativa, de carácter longitudinal, prospectivo. La población estuvo constituida por los participantes del Proyecto DemoMinga. Se determinó en cada participante: colesterol total, triglicéridos y glucemia en ayunas. Las muestras fueron procesadas en el Centro de Investigaciones Médicas de la FACISA-UNE. Se determinaron indicadores de tendencia central (mediana) de cada una de las variables. Resultados: Hubo mayor participación del sexo femenino, con predominio de personas con menos de 45 años. Las mediciones químicas arrojaron una tendencia de disminución a partir del quinto año de intervención, con talleres de cocina saludable incluyendo uso de aceite alto oleico, y actividad física. Sin embargo, la prueba no arrojó diferencias significativas de las mediciones entre la línea de base y el corte a los 6 años. Conclusión: El estudio resalta la importancia de los programas de intervención mediante terapias integrales para la promoción y prevención de las enfermedades cardiometabólicas a largo plazo.

Background: Non-communicable diseases remain a growing problem worldwide, especially in middle and low-income countries. Community intervention programs are focused on reducing their prevalence through promoting healthier lifestyle changes. Objectives: To analyze the trend of the physical activity and nutrition intervention program as a strategy to improve dyslipidemia and glycemia among participants of the DemoMinga project. Materials and methods: This study employed a quantitative approach with a participatory action research design, characterized as longitudinal and prospective. The population consisted of participants from the DemoMinga Project. For each participant, total cholesterol, triglycerides, and fasting glycemia were measured. Samples were processed at the Medical Research Center of FACISA-UNE. Indicators of central tendency (median) were determined for each of the variables. Results: There was a higher participation of females, with a predominance of individuals under the age of 45. Chemical measurements showed a decreasing trend starting from the fifth year of intervention, involving healthy cooking workshops that included the use of high oleic oil and physical activity. However, the test did not yield significant differences in measurements between the baseline and the 6-year cutoff. Conclusion: The study highlights the significance of intervention programs using comprehensive therapies for the long-term promotion and prevention of cardiometabolic diseases.

A study establishing sensitivity and accuracy of smartphone photography in ophthalmologic community outreach programs: Review of a smart eye camera

Purpose: Diseases affecting the cornea are a major cause of corneal blindness globally. The pressing issue we are facing today is the lack of diagnostic devices in rural areas to diagnose these conditions. The aim of the study is to establish sensitivity and accuracy of smartphone photography using a smart eye camera (SEC) in ophthalmologic community outreach programs. Methods: In this pilot study, a prospective non?randomized comparative analysis of inter?observer variability of anterior segment imaging recorded using an SEC was performed. Consecutive 100 patients with corneal pathologies, who visited the cornea specialty outpatient clinic, were enrolled. They were examined with a conventional non?portable slit lamp by a cornea consultant, and the diagnoses were recorded. This was compared with the diagnoses made by two other consultants based on SEC videos of the anterior segment of the same 100 patients. The accuracy of SEC was accessed using sensitivity, specificity, PPV, and NPV. Kappa statistics was used to find the agreement between two consultants by using STATA 17.0 (Texas, USA). Results: There was agreement between the two consultants to diagnosing by using SEC. Above 90% agreements were found in all the diagnoses, which were statistically significant (P?value < 0.001). More than 90% sensitivity and a negative predictive value were found. Conclusion: SEC can be used successfully in the community outreach programs like field visits, eye camps, teleophthalmology, and community centers, where either a clinical setup is lacking or ophthalmologists are not available.

Impact of a formal manual small-incision cataract surgery curriculum in an American ophthalmology residency program

Purpose: Global ophthalmology educational activities often include the ability of ophthalmology residents to partake in low?resource clinical care at home and abroad. Low?resource surgical techniques have become a pillar of education during formalized global ophthalmology fellowships. A formal manual small?incision cataract surgery (MSICS) curriculum was started in the University of Colorado’s residency training program to meet the growing demand for this surgical skill and to allow for more sustainable outreach work from our graduates. The survey was conducted to collect evaluations on the value of formal MSICS training within a United States–based residency program. Methods: This was a survey study in a US ophthalmology residency program. A formal MSICS curriculum was created that included didactic lectures on epidemiology of global blindness, MSICS technique, and how MISCS compared to phacoemulsification in terms of cost and sustainability in low?resource settings, followed by a formal wet lab experience. Residents were then exposed to MSICS procedures in the operating room (OR) under supervision of an experienced MSICS surgeon. An anonymous online survey was conducted on three consecutive cohorts of recently graduated senior ophthalmology residents from 2019 to 2021 with the aim of eliciting opinions about and outcomes from the new curriculum. Results: Fifteen graduating senior residents comprised the three cohorts with a 100% survey response rate. All residents agreed or strongly agreed that “MSICS is a valuable skill to have”. Eighty percent of respondents agreed or strongly agreed that “exposure to MSICS has increased my likelihood of doing any type of outreach work in the future” and 86.67% agreed or strongly agreed that “exposure to MSICS increased my understanding about sustainable outreach work”. The average number of cases assisted or performed per resident was 8.2 (SD 2.7, range 4–12). Conclusion: A formal MSICS curriculum for US?based ophthalmology residents was well?received by the trainees. The majority felt it increased their likelihood of pursuing and improved their understanding of sustainable outreach work. The curriculum, which included lectures, wet lab training, and formal teaching in the OR, could add value to a residency program’s curriculum. Furthermore, a formal domestic program can avoid ethical pitfalls that can be seen with resident teaching during international mission work.

Experiências em divulgação científica e sensibilização da população: importância do controle mecânico do vetor Aedes aegypti / Experiences in scientific outreach and public awareness: the importance of mechanical control of the Aedes aegypti vector / Experiencias en divulgación científica y sensibilización de la población: importancia del control mecánico del vector Aedes aegypti

Aedes aegypti é o principal vetor dos agentes etiológicos de dengue, zika e chikungunya, doenças para as quais não existem vacinas totalmente eficazes. Alternativas de controle visando mitigar essas arboviroses são primordiais. Entre essas, o controle mecânico aborda práticas de eliminação e/ou limpeza de criadouros do vetor. Neste relato, apresentamos e avaliamos criticamente ações realizadas pelo grupo, ocorridas entre 2016 e 2019, nas quais divulgamos informação científica clara através do diálogo com a população. Os métodos utilizados foram: 1) palestras em escolas (público infantojuvenil) utilizando slides, fotos e vídeos; 2) oficinas (público misto), estande com material in vivo do ciclo de vida do Aedes, jogos e desenhos. Analisamos dez palestras em escolas do ensino fundamental e médio e vinte oficinas realizadas em diferentes regiões do Brasil. Concluímos que tais ações e suas análises críticas devem ser realizadas continuamente para que sejam bem-sucedidas

Aedes aegypti is the main vector of dengue, zika, and chikungunya etiological agents, diseases for which no effective vaccines are available. Control alternatives aimed at mitigating these arboviruses are essential. Among such, mechanical control addresses practices of elimination and/or cleaning of vector breeding sites. Here, we presented and critically evaluated actions carried out by ourselves. These actions took place between 2016 and 2019, where we disseminated clear scientific information through dialogue with the population. The following methods were employed: 1) lectures in schools (children and youth audiences) using slides, photos, and videos; 2) workshops (mixed audience), stand with in vivo material from the Aedeslife cycle, games, and drawings. Ten lectures in elementary and high schools and twenty workshops held in different regions of Brazil were analyzed. It was concluded that such actions and their critical analyzes must be carried out continuously to be successful

Aedes aegypti es el principal vector de los agentes etiológicos del dengue, zika y chikungunya, enfermedades para las que no existen vacunas totalmente eficaces. Las alternativas de control para mitigar estas arbovirosis son fundamentales. El control mecánico, representa una de estas alternativas, aborda prácticas de eliminación y/o limpieza de criaderos del vector. En este informe presentamos y evaluamos de manera crítica las acciones realizadas por el grupo entre los años 2016 y 2019. Presentamos información científica clara a través del diálogo con la población mediante los siguientes métodos: 1) conferencias en escuelas (público infantil) utilizando diapositivas, fotos y videos; 2) Talleres (público mixto), stand con material in vivo del ciclo de vida del Aedes, juegos y dibujos. Analizamos diez conferencias en escuelas (primarias y secundarias) y veinte talleres realizados en diferentes regiones de Brasil. Concluimos que tales acciones y el análisis crítico de las mismas deben llevarse a cabo de manera continua para que resulten exitosas.

Impact of comprehensive eye examination in identifying the ocular co-morbidities in patients screened for cataract surgery through the out-reach activities

Purpose: To evaluate the impact of comprehensive eye examination in identifying the ocular co?morbidities in patients presenting for cataract surgery through the community screening program. Methods: This was a hospital?based retrospective cross?sectional descriptive study in a tertiary eye care institute. Comprehensive eye examination was performed for all patients screened for cataract surgery through the out?reach activities. Patients suspected to have any ocular co?morbidity were revaluated by sub?specialty trained ophthalmologists, and further management was planned. The demographic details of patients, sub?specialty consultation, final diagnosis, and type of the treatment received by these patients were recorded. Results: During the study period, 4022 patients were referred to the base hospital for cataract surgery, of whom 922 (22.9%) needed a specialist opinion. Glaucoma (238) and retinal disorders (232) constituted half (51%) of these referrals. There were 313 (33.9%) patients having co?morbidities because of corneal, oculoplastic, and neuro?ophthalmic conditions. After specialist review, 397 (43.1%) patients underwent only cataract surgery, 55 patients (5.9%) underwent combined surgeries, and 168 (18.2%) patients underwent other procedures. Cataract surgery was not performed in 470 (50.9%) patients, of which 302 were prescribed glasses or managed medically. Conclusion: All patients screened for cataract surgery through out?reach programs require a comprehensive eye examination to identify ocular diseases other than cataract. Provisions must be made for providing alternative or additional treatment in those with various ocular co?morbidities.

Self-leadership of nurses in a critical care outreach service: The development of a conceptual framework

Background: Globally, critical care outreach services (CCOS) were implemented in health care facilities; however, compliance with guidelines is poor. The authors have noticed that a gap exists in the literature on how self-leadership might influence nurses' implementation of CCOS. Self-leadership is about leadership applied to oneself. Critical care outreach services assist nurses with the nursing care of a patient whose health is declining. Leadership is needed for the successful implementation of CCOS. Aim: This article aims to outline the method the authors followed for developing the conceptual framework for how self-leadership amongst nurses influenced the functioning of CCOS. Setting: The research was conducted at a private hospital in Pretoria. Methods: A qualitative approach was followed to provide an accurate description of nurses' experiences on their self-leadership in a CCOS. The practice-oriented theory of Dickoff (1968) was the reasoning map for developing and constructing the conceptual framework. Results: Bedside nurses experienced the following self-leadership strategies: constructive thought patterns, natural rewards and behaviours focused on their implementation of CCOS. Conclusion: The conceptual framework was part of another study and provided the authors with a rationale that guided the authors with the development of self-leadership strategies in a CCOS. Contribution: The conceptual framework provided the authors with an understanding of how nurses' self-leadership influenced the implementation of CCOS. The conceptual framework can also assist in developing training programmes for nurses to improve their self-leadership and ultimately improve nurses' competence in providing quality nursing care to patients.

Reflexión sobre las competencias docentes en los institutos superiores tecnológicos en Ecuador / Reflection about teaching competencies in Ecuadorian Higher Technological Institutes

Introducción: El desempeño de los institutos superiores tecnológicos depende en última instancia de su capital humano, con las competencias requeridas para garantizar el desempeño exitoso del proceso educativo. Objetivo: Exponer las competencias docentes que se necesitan en la actualidad para dar respuesta a las demandas de la formación superior tecnológica en Ecuador. Desarrollo: En la actualidad se han producido cambios importantes en el proceso de enseñanza aprendizaje, de forma que se priorizan los enfoques centrados en el estudiante y un amplio uso de las tecnologías de la información y las comunicaciones, así como las exigencias de la constante actualización en los saberes y habilidades de tecnólogo superior en la profesión específica. Asimismo, el desarrollo profesional y el desempeño exitoso de la institución educativa también demanda que los docentes posean competencias relacionadas no solo con la docencia, sino también con el resto de las funciones universitarias como: la investigación, la vinculación con la sociedad y la gestión de la institución educativa. En respuesta a estas demandas, los docentes de los institutos superiores tecnológicos deben adquirir competencias específicas para las cuatro funciones: docencia, investigación, vinculación con la sociedad y gestión. Conclusiones: Los institutos superiores tecnológicos deben realizar adecuadas estrategias de gestión de su capital humano, que posibiliten la obtención de las competencias necesarias para el desarrollo de la carrera profesional de los docentes, y, sobre esta base, contribuir al éxito sostenido de estas instituciones en respuesta a las demandas de la sociedad ecuatoriana(AU)

Introduction: The functioning of higher technological institutes ultimately depends on their human capital, as far as they possess the competencies required for guaranteeing the successful advance of the educational process. Objective: To show the teaching competencies currently needed to respond to the demands of higher technological training in Ecuador. Development: Currently, there have been important changes in the teaching-learning process, in such a way that student-centered approaches, as well as a wide use of information and communication technologies, are prioritized, together with the demands of continuous updating regarding the knowledge and skills of a graduate technologist for the specific profession. Also, professional development and the successful functioning of any educational institution demand that professors possess competencies related not only to teaching, but also to the rest of the university functions, such as research, society outreach and management of the educational institution. In response to these demands, professors of higher technological institutes must acquire specific competencies for the four functions: teaching, research, connection with society and management. Conclusions: Higher technological institutes must implement adequate strategies for managing their human capital, which make it possible to obtain the necessary competencies for the development of the professional career of professors, and, based on this, contributing to the sustained success of these institutions in response to the demands of the Ecuadorian society(AU)

A Extensão Universitária no Instituto de Nutrição Josué de Castro da Universidade Federal do Rio de Janeiro / University outreach at Instituto de Nutrição Josué de Castro of the Universidade Federal do Rio de Janeiro

A extensão universitária é um processo educativo, científico e cultural que aproxima a universidade da sociedade. Este trabalho, apresentado na modalidade "Perspectivas", busca relatar a inserção da extensão universitária nos cursos de graduação do Instituto de Nutrição Josué de Castro (INJC), da Universidade Federal do Rio de Janeiro (UFRJ), ressaltando a análise das ações extensionistas para a formação de estudantes. As principais áreas contempladas nas ações guardam forte relação com os cursos de Gastronomia e de Nutrição do Instituto. Em junho de 2021, o INJC contava com 39 ações ativas registradas no sistema de gestão acadêmica da UFRJ, distribuídas em 30 projetos, seis eventos e três cursos, contemplando, assim, as áreas temáticas de Saúde, Cultura, Educação, Meio Ambiente e Trabalho, Tecnologia e Comunicação. Essas ações disponibilizam 288 vagas para alunos de graduação da UFRJ, acolhendo estudantes do INJC e de outros centros universitários, em especial das Ciências Humanas e Sociais, tendo como público-alvo diferentes faixas etárias, grupos populacionais e territórios. Apesar da diversidade dos objetos de trabalho, a alimentação apresenta-se como tema transversal nas três modalidades de ações realizadas. Nota-se uma firme tendência de fortalecimento das atividades universitárias de extensão, seja pela obrigatoriedade da creditação de carga horária para o corpo discente ou pelo compromisso da universidade em responder às demandas sociais, equiparando-as efetivamente à pesquisa no que tange à valorização acadêmica e institucional.

University outreach is an educational, scientific and cultural process that brings the university closer to society. This work, presented in the "Perspectives" modality, seeks to report the inclusion of university outreach in the undergraduate degree programs of the Instituto de Nutrição Josué de Castro (INJC) (Josué de Castro Nutrition Institute), at the Universidade Federal do Rio de Janeiro (UFRJ) (Federal University of Rio de Janeiro). It emphasizes the analysis of outreach activities for students' education. The main areas covered by the actions are strongly related to the Institute's Gastronomy and Nutrition courses. In June 2021, INJC presented 39 ongoing activities registered in UFRJ's academic management system, namely 30 projects, 6 events and 3 courses, covering the thematic areas of Health, Culture, Education, Environment and Work, Technology and Communication. These activities offer 288 vacancies for undergraduate students at UFRJ, not only from INJC but also from other colleges, especially in the human and social sciences. They are targeted at different ages, populational groups and territories. Despite the diversity of the objects of work, food is a theme present in all the 3 types of activities carried out. There is a firm tendency to strengthen university outreach activities, either through the mandatory credit completion by students or through the university's commitment to respond to social demands. This way, it receives at the same level of importance as novice research, when considering academic and institutional quality recognition

Em busca da definição contemporânea de "ligas acadêmicas" baseada na experiência das ciências da saúde / A la búsqueda de la definición contemporánea de "ligas académicas" basada en la experiencia del área de la salud / In search of the contemporary definition of "academic leagues" based on the health sciences' experience

Este estudo buscou uma definição contemporânea de Ligas Acadêmicas, segundo a experiência de oito Ligas em duas universidades públicas com campus no interior do estado do Ceará. As Ligas estavam igualmente divididas entre os cursos de graduação em Enfermagem e em Medicina. A coleta de dados ocorreu em documentos, entrevistas e observações e, posteriormente, foi realizada análise de conteúdo. Foram evidenciados, de um lado, os riscos da adesão a práticas assistencialistas e ao especialismo corporativo; e, de outro, o protagonismo estudantil e as interações entre ensino, pesquisa e extensão. Sugere-se como definição de Ligas que elas correspondem a coletivos estudantis configurados como programa regular longitudinal de extensão universitária, efetivadas mediante supervisão docente direta e indireta, sob apoio intelectual e prático da universidade e da rede de serviços de saúde, estando orientadas à aprendizagem e ao desenvolvimento profissional em torno de um tema específico previsto nas Diretrizes Curriculares Nacionais do(s) curso(s). (AU)

Este estudió buscó una definición contemporánea de Ligas Académicas según la experiencia de ocho Ligas en dos universidades públicas con campus en el interior del Estado de Ceará, región nordeste de Brasil. Las Ligas estaban igualmente divididas entre los cursos de graduación de enfermería y en medicina. La colecta de datos se realizó mediante documentos, entrevistas y observaciones y, posteriormente, se realizó el Análisis de Contenido. Por un lado, se pusieron en evidencia, los riesgos de la adhesión a prácticas asistencialistas y el especialismo corporativo; por otro, el protagonismo estudiantil y las interacciones entre enseñanza, investigación y extensión. Se sugiere como definición de Ligas que éstas correspondan a grupos de estudiantes configurados como un programa regular longitudinal de extensión universitaria, efectuado a través de la supervisión directa e indirecta del profesorado, bajo el apoyo intelectual y práctico de la universidad y de la red de servicios de salud, estando orientadas al aprendizaje y desarrollo profesional en torno a un tema específico previsto en las Directrices Curriculares Nacionales de la(s) asignatura(s). (AU)

This study sought a contemporary definition of 'academic leagues', based on the experience of 8 ALs in 2 public universities that have campuses in the countryside of the State of Ceará, Brazil. The ALs were equally divided between the undergraduate courses in Nursing and Medicine. Data collection took place in documents, interviews, and field observation and, subsequently, the data obtained underwent content analysis. On the one hand, the risks of adhering to clinical practices and corporate specialism have been shown; on the other hand, student protagonism and the interactions between university teaching, research, and outreach have been as well. The suggested definition of ALs is that they: a) correspond to student groups configured as a regular and longitudinal university outreach program; b) are carried out through direct and indirect professor oversight, relying on intellectual and practical support from the university and the health service network; and c) are oriented towards professional learning and growth around a specific theme provided for in the Brazilian National Curriculum Guidelines for the respective courses. (AU)

Narrativas oníricas e a partilha de experiências (extra)ordinárias / Narrativas oníricas y la compartición de experiencias (extra)ordinarias / Oneiric narratives and the sharing of (extra)ordinary experiences

As narrativas oníricas são fragmentos de experiências extra(ordinárias) que podem produzir interpelações sobre o lugar social ocupado pelo sonhante e por aquelas pessoas que exercitam a escuta, construindo espaços de partilha sobre imaginários, impressões e afetos. Neste artigo refletimos sobre as diferentes funções que a experiência de narrar e escutar o conteúdo onírico exerce em uma comunidade, e abordamos a relação entre os sonhos e os períodos de crise política e sanitária no contexto das universidades públicas brasileiras, como a imposta pela pandemia do Covid-19. Como objeto de análise, destacamos um sonho apresentado em projeto de extensão universitária e apontamos dimensões de tratamento do material onírico que podem nos ajudar a encontrar pistas para outras formas de habitarmos a sociedade. (AU)

Las narrativas oníricas son fragmentos de experiencias extra(ordinarias) que pueden producir interpelaciones sobre el lugar social ocupado por la persona que sueña y por las personas que ejercitan el escuchar, construyendo espacios de compartición sobre imaginarios, impresiones y afectos. En este artículo reflexionamos sobre las diferentes funciones que la experiencia de narrar y escuchar el contenido onírico ejerce para una comunidad y abordamos la relación entre los sueños y los períodos de crisis política y sanitaria en el contexto de las universidades públicas brasileñas, como la impuesta por la pandemia de Covid-19. Como objeto de análisis, destacamos un sueño presentado en proyecto de extensión universitaria y señalamos dimensiones de tratamiento del material onírico que pueden ayudarnos a encontrar pistas para otras formas de habitar la sociedad. (AU)

Oneiric narratives are fragments of extra(ordinary) experiences that may raise questions about the social place occupied by the dreamer and those people who exercise listening, building spaces of sharing about imaginary, impressions and affections. In this article we reflect on the different functions that the experience of narrating and listening to oneiric content produce in a community, while addressing the relationship between dreams and periods of political and health crisis in the context of Brazilian public universities, such as those imposed by the Covid-19 pandemic. As the object of analysis, we highlight a dream presented in a university outreach project, pointing out dimensions of treatment of oneiric material that help us to find clues for other ways to inhabit society. (AU)

Comparison of cataract surgery refractive outcomes in a tertiary hospital and an outreach cataract service centre

@#Objective: The aim of this study was to compare the postoperative refractive outcome after cataract surgery between a hospital-based and an outreach-based cataract service centre. Methods: This study was conducted at the Hospital Selayang (HS), Selangor, Malaysia, a tertiary referral centre and an outreach-based cataract service centre (Pusat Pembedahan Katarak MAIWP, PPKM). Data was sourced from the Cataract Surgery Registry (CSR) in the National Eye Database (NED). Results: A total of 2318 surgeries were analysed. PPKM achieved postoperative refraction outcome within ±1.0D in 94.3% of cases compared with 88.4% in Selayang Hospital. Mean absolute prediction error was also better in PPKM (0.39±0.27D vs. 0.33±0.24D, p<0.001). Multivariate analysis showed that the tertiary hospital, persons of Chinese ethnicity, history of uveitis, previous history of ocular surgery and intraoperative complications as significant independent predictive factors for poor refractive outcomes. Conclusion: The outreach-based cataract service centre, which incorporates streamlined process designs and workflows, achieved superior refractive outcomes within ±1 dioptre after cataract surgery compared to a tertiary hospital.

A Questionnaire Survey of Home Care Nurses’ Attitudes, Difficulties, and Self-reported Practices for Palliative Care in a Community without Specialists to Identify Interventional Targets of Palliative Care Outreach

Palliative care outreach in communities without specialists is important, but its effectiveness has not yet been clarified in Japan. The current study aimed to identify interventional targets of palliative care outreach in home care in a community without specialists. We conducted a questionnaire survey (five-point scale) of home care nurses’ attitudes, difficulties, and practices for palliative care among 39 nurses working at five visiting nurse stations in Tome city. Difficulties in “symptom palliation” and “communication with medical practitioners” were high. Nurses tended to have low confidence and high motivation. Items with particularly low confidence were “communication with home care physicians” and “staff support”. Practices in “communication with physicians” and “coordination with care person” were low. Our survey identified enhancement of face to face relationships and support for home care nurses to improve their skills and confidence as interventional targets for palliative care outreach.

El proceso de formación de líderes estudiantiles desde la Extensión Universitaria en la carrera Cultura Física / O processo de formação de líderes estudantis dede a extensão universitária na carreira Cultura Física / The process of formation of student leaders from the University Outreach Department in the degree of Physical Culture

Resumen En la presente investigación, se ofrece una concentración teórica acerca del proceso de formación de líderes estudiantiles en las carreras pedagógico-deportivas. El objetivo general estuvo dirigido a diseñar una estrategia que contribuya al proceso de formación de líderes estudiantiles desde la Extensión Universitaria en la carrera Cultura Física, de la Universidad de Pinar del Río "Hermanos Saíz Montes de Oca". Se presentaron los resultados correspondientes a sus dos primeras tareas investigativas. El enfoque general de la investigación fue el dialéctico-materialista y se utilizaron métodos del nivel teórico y del nivel empírico como el análisis de documentos, la entrevista y la encuesta. El estudio investigativo realizado acerca del proceso de formación de líderes estudiantiles, desde la Extensión Universitaria, se centra en la realidad de la universidad cubana, desde una mirada crítica acerca del encargo social que tiene un profesional de la carrera Cultura Física para cumplir con su meta de manera competitiva. Constituyen premisas fundamentales el desempeño activo del estudiante en la socialización y cooperación durante la ejecución de las actividades que realiza en el contexto universitario y en la comunidad.

Resumo Na presente investigação, é oferecida uma concentração teórica sobre o processo de formação de líderes estudantis nas carreiras pedagógico-desportivas. O objetivo geral foi orientado para conceber uma estratégia que contribua para o processo de formação de líderes estudantis da extensão universitária na carreira da Cultura Física, na Universidade de Pinar del Río. Foram apresentados os resultados correspondentes às suas duas primeiras tarefas de investigação. A abordagem geral da investigação foi a dialética-materialista e foram utilizados métodos do nível teórico e empírico, tais como a análise de documentos, a entrevista e o inquérito. O estudo de investigação realizado sobre o processo de formação de líderes estudantis, a partir da extensão universitária, centra-se na realidade da universidade cubana, de um ponto de vista crítico sobre a tarefa social que um profissional da carreira da Cultura Física tem de cumprir o seu objetivo de uma forma competitiva. O desempenho ativo do estudante na socialização e cooperação durante a execução das atividades que desenvolve no contexto universitário e na comunidade constitui premissas fundamentais.

Abstract In the present research, a theoretical concentration is offered about the process of formation of student leaders in the pedagogical-sports careers. The general objective was directed to design a strategy that contributes to the formation process of student leaders from the university extension in the Physical Culture career, of the University of Pinar del Río. The results corresponding to its first two research tasks were presented. The general approach of the research was the dialectical-materialistic one, and methods from the theoretical level and from the empirical level were used, such as the analysis of documents, the interview and the survey. The research study carried out about the process of formation of student leaders, from the university extension, is centered in the reality of Cuban university, from a critical look about the social assignment that a professional of Physical Culture has to fulfill his/her goal in a competitive way. The active performance of the student in the socialization and cooperation during the execution of the activities that he/she carries out in the university context and in the community constitute fundamental premises.

The anti-cancer League and public outreach for cancer control in Peru / A liga Anticancerosa e a sensibilização pública ao controle do câncer na sociedade peruana

Abstract Peru's first cancer control public outreach scheme started in the 1910s, but ground to a standstill as it attained official governmental recognition in 1926 as the Liga Anti-Cancerosa (LAC). This paper explains the developments leading to that earliest effort to enlist a coalition of State health agencies, physicians, and lay people in a campaign to publicize early signs of this disease, as well as the medical and political reasons for and implications of its decline. Besides highlighting the importance of professional initiatives shaping cancer activism, contextualizing the rise and fall of the LAC calls attention to the effects that hospitalization of cancer treatment had on aspects of cancer care that were not directly treatment-related, such as public outreach.

Resumo O primeiro programa peruano de sensibilização pública para controle do câncer iniciou na década de 1910, mas arrefeceu quando reconhecido pelo governo como Liga Anticancerosa (LAC), em 1926. Este artigo aborda os avanços que conduziram aos pioneiros esforços de recrutamento de agências governamentais de saúde, médicos e leigos na divulgação sobre os primeiros sinais da doença, assim como as motivações políticas e médicas e as implicações de seu declínio. Além de assinalar a importância de iniciativas profissionais no ativismo na temática do câncer, a contextualização da ascensão e declínio da LAC chama a atenção para os reflexos da hospitalização no tratamento do câncer sobre aspectos indiretamente relacionados ao tratamento, como os esforços de sensibilização pública.

Educação popular e Extensão Universitária em Segurança Alimentar e Nutricional e Direito Humano à Alimentação Adequada e Saudável: um caminho metodológico possível / Popular Education and University Outreach in Food and Nutition Security and the Human Right to Adequate and Healty Food: a possible methodological path

Introdução: A temática da segurança alimentar e nutricional e do direito humano à alimentação adequada e saudável tornou-se uma questão política no Brasil, no período de 2003 a 2016. No entanto, a tarefa de manutenção de direitos sociais não estava concluída e hoje encontra-se politicamente ameaçada, demandando a conscientização e mobilização de segmentos da sociedade civil para a compreensão crítica da realidade e a retomada da construção de caminhos possíveis para a exigibilidade do direito e garantia da segurança alimentar e nutricional. Objetivo: Este trabalho buscou relatar a experiência e evidenciar as expressões pedagógicas dos princípios da educação popular ao longo do processo de ensino-aprendizagem da edição de 2018 do curso, realizado no município de Colinas do Sul, Goiás. Métodos: Na Universidade de Brasília, em 2018, instituiu-se um Programa de Extensão e Ação Continuada, o MultiplicaSAN. Dentre suas atividades, estava a realização de um curso de formação e promoção da cultura de direitos visando à formação da sociedade civil nas temáticas de segurança alimentar e nutricional e direito humano à alimentação adequada e saudável, utilizando como referência a pedagogia freireana e os princípios da Política de Educação Popular. Resultados: A experiência do projeto de extensão proporcionou aprofundamento sobre a educação popular, mostrando a riqueza da construção do conhecimento junto com uma comunidade de trabalhadoras. Conclusão: Revelou, ainda, o potencial transformador de um processo educativo pautado nos princípios da educação popular: amorosidade, dialogicidade, conscientização, construção do conhecimento, a partir da realidade concreta, transformação do mundo e sistematização do conhecimento na formação de educadoras e educandas. (AU)

Introduction: The theme of food and nutrition security and the human right to adequate and healthy food became a political issue in Brazil, from 2003 to 2016. However, the task of maintaining social rights was not completed and today it is politically threatened, demanding the awareness and mobilization of segments of civil society for an understanding of reality and the resumption of the construction of possible paths for the enforceability of the law and guarantee of food and nutritional security. Objective: This work sought to report the experience and highlight the pedagogical expressions of the principles of popular education throughout the teaching-learning process of the 2018 edition of the course, held in the municipality of Colinas do Sul, Goiás. Methods: At the University of Brasília, in 2018, an Outreach Program, MultiplicaSAN, was instituted. Among its activities, there was a course to promote the culture of rights aiming at the formation of civil society in the themes of food and nutritional security and the human right to adequate and healthy food, using Freire's pedagogy and the principles of Popular Education Policy. Results: The experience of the outreach program provided an in-depth look at popular education, showing the wealth of knowledge construction together with a community of female workers. Conclusion: It also revealed the transformative potential of an educational process based on the principles of popular education: lovingness, dialogicity, awareness, construction of knowledge, based on concrete reality, transformation of the world and systematization of knowledge in the teaching-learning process of educators and students. (AU)

Desafios do Brincar com Idosos: Narrativas de Estudantes de Medicina do Programa Amigos do Sorriso / Challenges of Playing with the Elderly: Medicine Students Narratives of the Amigos do Sorriso Program

Resumo: Introdução: O programa de extensão Amigos do Sorriso foi construído a partir da compreensão da extensão universitária como integrante da formação dos estudantes, ao proporcionar vivências e trocas na aproximação entre a academia e a sociedade em geral. Os participantes são estudantes da área da saúde e desenvolvem atividades lúdicas com foco no processo de humanização, na educação em saúde e nos seus efeitos multiplicadores. Desde 2010, o programa realiza atividades quinzenais numa instituição de longa permanência para idosos (Ilpi), com o objetivo de oportunizar momentos lúdicos, com estratégias criativas e comunicativas, no sentido de ressignificar a velhice por meio do brincar. Este artigo tem como objetivos descrever as vivências e compreender quais foram os aprendizados desenvolvidos pelos estudantes de Medicina nesse âmbito. Método: Trata-se de uma pesquisa qualitativa, desenvolvida a partir de 13 narrativas redigidas entre 2018 e 2019 por estudantes de Medicina que participaram das atividades lúdicas na Ilpi. Realizou-se análise temática de conteúdo dos materiais em diálogo com os referenciais teóricos e a literatura relacionada. Resultados: As três categorias temáticas foram: o brincar com o idoso, construção artesanal da comunicação e partilha entre gerações sobre o envelhecer. Os extensionistas discutiram as diversas formas do brincar, sua relação com a promoção da saúde e as especificidades de desenvolver atividades lúdicas com o idoso. Utilizaram diversas formas de comunicação para interação com os idosos, conversando, ouvindo e contando histórias e respeitando os silêncios, o que provocou encontros e desencontros, todos disparados pelo brincar. Discutiram sobre o processo de envelhecimento, a saúde do idoso, a velhice asilar e o próprio encontro de gerações por meio do qual puderam refletir sobre si mesmos. Conclusões: As atividades na Ilpi proporcionaram aos estudantes a percepção da potência das estratégias lúdicas, promotoras da autonomia e saúde, sem infantilização dos idosos. Possibilitaram o reconhecimento de estratégias para aproximação e vínculo, respeitando limites individuais e coletivos, ao compartilharem histórias e sentimentos de forma empática. Dessa forma, destaca-se o desenvolvimento de competências para o futuro médico, tanto gerais como para o cuidado com as pessoas idosas, no reconhecimento de que todos estão envolvidos no universo do florescer do envelhecimento.

Abstract: Introduction: The community outreach program Amigos do Sorriso (Friends of Smiling) is based on the understanding that community outreach programs are part of academic training because they provide experiences that result in exchanges between the students and the society. The participants are undergraduate students from the healthcare field, who develop ludic activities focusing on humanization, health education and the resulting multiplying effects. Since 2010, fortnightly activities have been conducted at an old people's home with the aim of offering playful experiences involving creative and communicative strategies, in order to give new meaning to old age through playing. The objective of this article is to describe these experiences and understand what the medicine students have learned from them. Methods: this article presents a qualitative study, based on 13 narratives written between 2018 and 2019 by undergraduate medicine students who were involved in activities at the old people's home. The content was analyzed from a thematic perspective and correlated to the theoretical framework. Results: Three thematic categories were identified: playing with the elderly, handcrafted construction of communication and sharing between generations about aging. The participants discussed the different forms of play, its relations with health promotion and the specific characteristics of developing Ludic activities with the elderly. Through play they were also able to explore various forms of communication: talking, listening, sharing stories, and respecting the moments of silence, that led to agreement and disagreement. Finally, they discussed the aging process, elderly heath, elderly people in care and the contact itself between generations, allowing the students to reflect on themselves. Conclusions: The activities in the old people's home enabled the students to appreciate the potential that strategies of play offer in terms of promoting autonomy and health, without infantilizing the elderly. It allowed them to identify strategies to form closer relationships and ties with the elderly subjects, respecting individual and collective boundaries when sharing stories and feelings with empathy. Hence the highlight of the program was the development of skills, both general and specific for elderly care, among future medics, recognizing that the aging is a process that involves us all.

The Characteristics of Students Who Had Attempted Self-Injury or Suicide in Chungcheongdo ‘Professional School Visits Outreach Project’ / 신경정신의학

OBJECTIVES: This study examined the characteristics of students who participated in the ‘Professional School Visits Outreach Project’ and evaluated the factors affecting self-injury or suicidal attempts.METHODS: In a cross-sectional study, psychiatrists or mental health professionals conducted a semi-structured interview with 296 students, families, and teachers in Chungcheong province and recorded the socioeconomic status (SES), past psychiatric history, current clinical symptoms, and mental status exams. Logistic regression analysis was performed on the variables with differences between the students who had attempted self-harm or suicide and those who had not.RESULTS: The subjects of this study belonged to a relatively low SES. In addition, their provisional diagnosis was mainly attention-deficit/hyperactivity disorder (38.5%) or depression (29.1%). Approximately 18.2% of students had attempted self-injury or suicide. The variables with differences between students who had attempted self-harm or suicide and those who had not, were female [odds ratio (OR) 2.878, p=0.002], provisional diagnosis of depression (OR 3.045, p=0.001), and a history of bullying victim (OR 1.927, p=0.048). Although the risks of self-injury or suicidal attempts were not increased by child abuse alone, it was increased in girls who experienced both childhood abuse and bullying victim (OR 4.222, p=0.002).CONCLUSION: The ‘Professional School Visits Outreach Project’ provides therapeutic opportunities for low SES and high-risk adolescents with multiple difficulties, such as child abuse, bullying victim, and suicidal behaviors. In addition, the recurrent experience of trauma in girls appears to increase the risk of adolescent self-injury or suicidal attempts.

A pesquisa-intervenção como pesquisa-apoio: o caso do POP RUA / Intervention research as research-support: the case of POP RUA

Resumo Este artigo discute a produção de conhecimento no campo da saúde pública, desenvolvendo a ideia de pesquisa-apoio como uma modulação da pesquisa-intervenção participativa no campo da saúde. A pesquisa-intervenção participativa foi usada e aperfeiçoada pelo Grupo de Pesquisa Enativos, da Universidade Federal Fluminense, envolvendo a Gestão Autônoma da Medicação (GAM) no campo saúde mental. Nestas experiências os problemas do campo modularam as práticas de pesquisa, cujo sentido era produzir de autonomia e aumentar o grau de participação nas práticas de saúde. Esta pesquisa utilizou-se da mesma abordagem metodológica das pesquisas-intervenções na GAM, na interface entre atenção básica e saúde mental, em uma equipe de consultório na Rua do Rio de Janeiro, chamada POP RUA. Este artigo é um misto de relato e ensaio que analisa a transformação da pesquisa-intervenção em pesquisa-apoio com o POP RUA, propondo o apoio como método para produzir conhecimento nas pesquisas qualitativas, no escopo das pesquisas-intervenção. Tal transformação é possível pois são apoiados os processos de produção de saúde entendidos como inseparáveis de processos de produção de conhecimento e produção de cuidado.

Abstract This article discusses the production of knowledge in the field of public health, developing the idea of research-support as a modulation of participatory intervention research in the field of health. Participatory intervention research was used and perfected by Enativos Research Group of Universidade Federal Fluminense, in the scope of Gaining Autonomy & Medication Management (GAM) in the field of mental health. In these experiments, the production of autonomy and the increase of participation in health practices were in question. The issues of the field have ended up modifying their own research practices. This research used the same methodological approach of the intervention researches at GAM, in the interface between basic care and mental health, in a service of Street Outreach Clinic team (Consultório na Rua); in Rio de Janeiro, called POP RUA. This article is a mixture of report and essay which analyzes the transformation of intervention research into research-support with POP RUA, proposing support as a method to produce knowledge in qualitative research, in the scope of intervention research. Such transformation is possible because health production processes understood as inseparable from processes of knowledge production and care production are supported.

Liga de Anatomia Aplicada (LAA): as Múltiplas Perspectivas sobre Participar de uma Liga Acadêmica / League of Applied Anatomy (LAA): Multiple Perspectives on Participation in an Academic League

RESUMO Relata-se a experiência dos membros da Liga Acadêmica de Anatomia Aplicada (LAA) da Universidade do Estado do Rio de Janeiro (Uerj), sejam eles ligantes, gestores ou orientadores. A motivação para esse trabalho reside no desejo de apontar a importância dessas organizações estudantis e seu impacto sobre os alunos, considerando o recente crescimento e criação de diversas ligas. O modelo tradicional de ensino praticado pela maioria das academias no Brasil, caracterizado por uma relação vertical entre professores e alunos, justifica, ao menos em parte, a limitação criativa dos alunos, e consequentemente, dos futuros profissionais. É nesse panorama que as ligas acadêmicas são necessárias, buscando aguçar o espírito crítico dos alunos e tornar palpáveis os assuntos contemplados pela grade curricular tradicional, que, devido aos cronogramas e horários extenuantes, permanecem abstratos e pouco atrativos, contribuindo para a desmotivação e quebra de expectativa dos alunos ingressantes. Nesse sentido, também se busca atender às demandas dos novos acadêmicos, ansiosos pela aplicação prática do conteúdo abordado no ciclo básico. Todas as atividades precisam ser bem organizadas para que atinjam seus objetivos. Assim, os orientadores devem garantir a supervisão, os gestores devem ser bem selecionados, e a divisão de tarefas deve ser efetiva, de modo a conquistar o engajamento dos ligantes. Todo esse trabalho, seja para a produção de conteúdos científicos, seja para a composição de palestras, cursos ou simpósios, influencia diretamente o modo de pensar de cada parte envolvida. Junto a todo o processo descrito, a base para desenvolver as atividades consiste no tripé ensino-pesquisa-extensão, que complementa a aprendizagem, desenvolve a investigação e contribui para a disseminação dos saberes acadêmicos e o cumprimento do dever social. Neste trabalho, é possível entender o impacto que uma liga tem na formação dos estudantes de Medicina e no constante estímulo à atualização do docente. Assim, foram recolhidos depoimentos e aplicados questionários que ratificam a importância da liga no crescimento tanto pessoal, quanto profissional, nas diversas esferas, e como essas atividades extracurriculares têm se mostrado benéficas na aquisição de novas experiências para discentes e docentes.

ABSTRACT This article reports on the experience of members of the Academic League of Applied Anatomy, in Portuguese "Liga de Anatomia Aplicada (LAA)" of Universidade do Estado do Rio de Janeiro (Uerj), whether listeners, organizers or advisers. The motivation behind this article consists in the desire to address the importance of academic organizations and their impact on students, considering the recent growth and inauguration of various leagues. The traditional model of education, practiced in the majority of Brazilian, is characterized by a vertical relationship between the teacher and the students. This view partly the creative limitation imposed on the students and on future professionals. Therefore, Academic Leagues are necessary, as a means of improving, students' critical thinking and solidifying a subject that has already been taught in the curricula but that, due to exhausting schedules and rigid time frames, remains abstract and unappealing to the students, resulting in a lack of motivation and disappointed expectations. The league seeks to meet the demands of recently enrolled students, eager to apply in practice subjects still only seen in theory during the basic cycle of school. However, all the activities need to be well organized if they are to achieve their goals. Teachers must ensure supervision, the league's board of directors must be well-selected, and the division of tasks must be effective, in order to ensure the engagement of all the participants. All this work, whether for the production of scientific content, planning of lectures, courses or symposia, directly impacts the thought processes of all those involved. Alongside the whole process described, the basis of all this evolution is the teaching, research and extension activities, which complement the learning; develop research, and contribute to the dissemination of academic knowledge and the fulfillment of social duty. This paper shows the impact that a league has on the formation of medical students and on the constant encouragement for teachers to update their skills. Therefore, statements were collected and questionnaires conducted, to confirm the importance of the League for personal and professional growth in various spheres, and show how these extracurricular activities have proven to be beneficial in enabling students and teachers to acquire new experiences.