Online teaching and learning: Experiences of students in a nursing college during the onset of COVID-19

Background: The world has entered the Fourth Industrial Revolution. Utilisation of technology is inevitable. For the past years, the coronavirus disease 2019 (COVID-19) pandemic has halted normal operations, including in the physical classroom for nursing students. Students and facilitators had to move to a remote way of teaching and learning, utilising online teaching and learning. However, students and facilitators were not ready to use online teaching and learning. This not only resulted in numerous challenges, but also became an eye-opener for best practices and intervening strategies. Objectives: To explore and describe experiences of students in a nursing college with regard to online teaching and learning during the onset of the COVID-19 pandemic. Method: A qualitative, exploratory, descriptive and contextual research design was adopted. A purposive, nonprobability sampling approach was used to select participants from second year, third year and fourth year. First-year student nurses were excluded because they did not commence with classrooms at that time. Results: Seven themes emerged, namely knowledge, confidence, training, equipment, clinical exposure, course extension and flexibility, and all themes had subthemes. Conclusion: It is evident that students had more negative experiences during online teaching and learning than positive experiences.

Atenção ao parto e nascimento em Maternidades da Rede Cegonha/Brasil: avaliação do grau de implantação das ações / Labor and childbirth care in maternities participating in the "Rede Cegonha/Brazil": an evaluation of the degree of implementation of the activities

Resumo O artigo analisa o grau de implantação das Boas Práticas de Atenção ao Parto e Nascimento conforme preconizado pela Rede Cegonha (RC) a partir da configuração de uma matriz de julgamento para o Brasil e grandes regiões. Foram elegíveis para a avaliação todos os 606 hospitais públicos e mistos das regiões de saúde que dispunham de plano de ação da RC em 2015. Foram utilizados três diferentes métodos de coleta de dados: entrevista pessoal com gestores, profissionais de saúde e puérperas; análise documental; e observação in loco. A matriz foi composta com as cinco diretrizes da RC. Para julgamento da adequação da implantação, foi utilizado como parâmetro: adequado; parcialmente adequado e não adequado. Todas as diretrizes foram avaliadas como parcialmente adequada, exceto a ambiência que foi não adequado. A atenção ao parto e nascimento encontra-se em estágios diferenciados de implantação com variações entre as grandes regiões. As regiões Sul e Sudeste, apresentaram situação privilegiada quanto ao grau de implantação da maioria dos itens analisados. Os resultados evidenciam que a avaliação das ações da RC deve fazer parte do alicerce de informações empregadas no direcionamento de políticas e regulamentação na atenção hospitalar ao parto e nascimento.

Abstract Using a judgment framework, this article analyzes the degree of implementation of the best practices in labor and childbirth care contained in the guidelines of the Rede Cegonha (RC) across Brazil. The study eligibility criteria were public and mixed hospitals located in a health region with a RC action plan in place in 2015, resulting in a total of 606 facilities distributed across the country. Three different data collection methods were used: face-to-face interviews with managers, health professionals and puerperal women; document analysis; and on-site observation. The framework was built around the five guidelines of the Labor and Childbirth component of the RC. Degree of implantation was rated as follows: adequate; partially adequate and inadequate. The performance of maternity facilities was rated as partially adequate for all guidelines except for hospital environment, which was rated as inadequate. A huge variation in degree of implementation was observed across regions, with the South and Southeast being the best-performing regions in most items. The results reinforce the need for an ongoing evaluation of the actions developed by the RC to inform policy-making and the regulation of labor and childbirth care.

Atenção ao parto por enfermeira obstétrica em maternidades vinculadas à Rede Cegonha, Brasil - 2017 / Delivery care by obstetric nurses in maternity hospitals linked to the Rede Cegonha, Brazil - 2017

Resumo O objetivo foi avaliar se a presença da enfermeira na atenção ao parto em maternidades da Rede Cegonha promove o acesso às boas práticas de atenção obstétrica ao trabalho de parto e parto. Avaliação conduzida em 2017, nas 606 maternidades do SUS que aderiram a essa política estratégica em todos os estados do Brasil. Utilizamos dados coletados com gestores das maternidades e puérperas. A análise ocorreu em dois níveis: hospitalar, com ou sem assistência ao parto por enfermeiras; e profissional, que assistiu ao parto vaginal, médico ou enfermeira. Como variáveis dependentes incluímos boas práticas e intervenções no parto vaginal e na taxa de cesariana. Foram incluídas na análise dos partos vaginais 5.016 puérperas e no cálculo da taxa de cesariana 9.692. Análises múltiplas foram ajustadas por região geográfica, localização, porte da maternidade, cor da pele e paridade da puérpera. Maternidades com enfermeira na assistência ao parto usam mais partograma; e menos ocitocina, litotomia, episiotomia e cesariana. Em partos assistidos por enfermeiras foi mais frequente o preenchimento do partograma e menor a chance de litotomia e episiotomia. A inserção da enfermeira na assistência ao parto vaginal tem se mostrado bem sucedida, trazendo às mulheres um parto mais fisiológico e respeitoso.

Abstract This study aimed to assess whether nurses' presence in delivery care in maternity hospitals linked to the Rede Cegonha program promotes access to best obstetric practices during labor and delivery. We conducted an evaluative study in 2017 in all 606 SUS maternity hospitals that joined this strategic policy in all Brazilian states. We collected data from maternity hospital managers and puerperae. The analysis was performed at two levels: hospital with or without a nurse in delivery care; and professionals that attended vaginal delivery, whether doctors or nurses. We used best practices and interventions for vaginal deliveries and cesarean section rates as dependent variables. We included 5.016 subjects for analyses of vaginal deliveries and 9.692 to calculate cesarean section rates. Multiple regressions were adjusted for geographic region, maternity hospital size, and puerperae skin color and parity. Maternity hospitals with nurses in delivery care used more the partograph and less oxytocin, lithotomy, episiotomy, and cesarean section. Deliveries attended by nurses had more frequent use of the partograph and a lower likelihood of lithotomy and episiotomy. The inclusion of nurses in vaginal delivery care has successfully brought women closer to a more physiological and respectful delivery.

Best Practices on HVAC Design to Minimize the Risk of COVID-19 Infection within Indoor Environments

Abstract The spread of Coronavirus is causing in the society all around the world a considerable degree of fear, worry and concern and particularly among healthcare workers that are at increased risk for infection. This paper gathers the strategy/guidelines to reduce the contamination in Intensive care unit (ICU) and in all the hospital environment. The ASHRAE and REHVA guidelines applied the UV-C Lamps, Pressure control filtration, Restroom actions and Humidity control to reduce the coronavirus disease (Covid-19) in ICU. The role of infection control in the design of hospitals is increasing every day. This paper highlights the role of heating, ventilating and air-conditioning minimizing the risk of infection from airborne transmission within the built environment through the application of best practices.

Minimum quality threshold in pre-clinical sepsis studies (MQTiPSS): quality thresholds for study design and humane modeling endpoints / 中华危重病急救医学

Preclinical animal studies are mandatory before new treatments can be tested in clinical trials. However, their use in developing new therapies for sepsis has been controversial because of limitations of the models and inconsistencies with the clinical conditions. In consideration of the revised definition for clinical sepsis and septic shock (Sepsis-3), a Wiggers-Bernard Conference was held in Vienna in May 2017 to propose standardized guidelines on preclinical sepsis modeling. The participants conducted a literature review of 260 most highly cited scientific articles on sepsis models published between 2003 and 2012. The review showed, for example, that mice were used in 79% and euthanasia criteria were defined in 9% of the studies. PartⅠof this report details the recommendations for study design and humane modeling endpoints that should be addressed in sepsis models. The first recommendation is that survival follow-up should reflect the clinical time course of the infectious agent used in the sepsis model. Furthermore, it is recommended that therapeutic interventions should be initiated after the septic insult replicating clinical care. To define an unbiased and reproducible association between a new treatment and outcome, a randomization and blinding of treatments as well as inclusion of all methodological details in scientific publications is essential. In all preclinical sepsis studies, the high standards of animal welfare must be implemented. Therefore, development and validation of specific criteria for monitoring pain and distress, and euthanasia of septic animals, as well as the use of analgesics are recommended. A set of four considerations is also proposed to enhance translation potential of sepsis models. Relevant biological variables and comorbidities should be included in the study design and sepsis modeling should be extended to mammalian species other than rodents. In addition, the need for source control (in case of a defined infection focus) should be considered. These recommendations and considerations are proposed as "best practices" for animal models of sepsis that should be implemented.

Minimum quality threshold in pre-clinical sepsis studies (MQTiPSS): quality thresholds for study design and humane modeling endpoints / 中华危重病急救医学

Preclinical animal studies are mandatory before new treatments can be tested in clinical trials. However, their use in developing new therapies for sepsis has been controversial because of limitations of the models and inconsistencies with the clinical conditions. In consideration of the revised definition for clinical sepsis and septic shock (Sepsis-3), a Wiggers-Bernard Conference was held in Vienna in May 2017 to propose standardized guidelines on preclinical sepsis modeling. The participants conducted a literature review of 260 most highly cited scientific articles on sepsis models published between 2003 and 2012. The review showed, for example, that mice were used in 79% and euthanasia criteria were defined in 9% of the studies. PartⅠof this report details the recommendations for study design and humane modeling endpoints that should be addressed in sepsis models. The first recommendation is that survival follow-up should reflect the clinical time course of the infectious agent used in the sepsis model. Furthermore, it is recommended that therapeutic interventions should be initiated after the septic insult replicating clinical care. To define an unbiased and reproducible association between a new treatment and outcome, a randomization and blinding of treatments as well as inclusion of all methodological details in scientific publications is essential. In all preclinical sepsis studies, the high standards of animal welfare must be implemented. Therefore, development and validation of specific criteria for monitoring pain and distress, and euthanasia of septic animals, as well as the use of analgesics are recommended. A set of four considerations is also proposed to enhance translation potential of sepsis models. Relevant biological variables and comorbidities should be included in the study design and sepsis modeling should be extended to mammalian species other than rodents. In addition, the need for source control (in case of a defined infection focus) should be considered. These recommendations and considerations are proposed as "best practices" for animal models of sepsis that should be implemented.

Narrativas de sostenibilidad en emprendedores sociales de Lima metropolitana / Narratives of sustainability in social entrepreneurs of Lima, Perú

El aprecio por prácticas sostenibles (APS) es una dimensión psicológica actitudinal que la literatura actual define como componente relevante del comportamiento emprendedor social. El presente estudio busca comprender la manera en que esta dimensión se gesta y hace consistente en las narrativas de vida de 10 líderes de emprendimientos sociales de Lima Metropolitana, buscando dar fundamento vivencial a un constructo que, si bien está definido conceptualmente, no ha sido abordado desde las experiencias personales que lo hacen posible. A través de una metodología cualitativa de enfoque narrativo, y bajo una presentación temática de los resultados se identificaron dos grandes narrativas: la Autotrascendencia social y las Prácticas sostenibles, que dan cuenta de un proceso por el cual la persona se posiciona en una consciencia crítica de interconexión y pensamiento sistémico con los otros, para luego ejecutar y diseminar prácticas emprendedoras responsables en beneficio de la sociedad y el mundo. Los resultados brindan insumos para considerar posibles programas de formación sobre sostenibilidad en diferentes etapas de la educación de las personas

Appreciation for sustainable practices (ASP) is an attitudinal psychological dimension that current literature defines as a relevant component of social entrepreneurial behavior. The present study seeks to understand how this dimension is developed and it's consistent in the life narratives of 10 leaders of social enterprises in Lima, in order to state a construct that, although conceptually defined, has not been addressed from the personal experiences that make it possible. Through a qualitative methodology of narrative approach, and under a thematic presentation of the results, two major narratives were identified: Social self-transcendence and Sustainable practices. Both account for a process by which a person develops a critical awareness of interconnection and systemic thinking, to further execute and disseminate responsible entrepreneurial practices for the benefit of society and the world. The results provide inputs to consider possible training programs on sustainability in different stages of people's education

Boas Práticas em Unidades de Alimentação e Nutrição Escolares de um município do estado do Rio de Janeiro - Brasil / Best Practices in School Food and Nutrition Units of a municipality in the state of Rio de Janeiro - Brazil

Resumo O objetivo deste trabalho foi analisar as condições higiênico-sanitárias em nove Unidades de Alimentação e Nutrição Escolares (UANE) de um município do Rio de Janeiro (Brasil). Uma Lista de Verificação de Boas Práticas na Alimentação Escolar, proposta e validada por Stedefeldt et al., com itens pontuados e agrupados em seis Blocos Temáticos (BT), foi aplicada. Os resultados da pontuação total (P) por BT e da pontuação final (PF) foram obtidos utilizando o Programa Ferramenta para as Boas Práticas na Alimentação Escolar®. Os resultados da P nas UANE foram comparados com a classificação da Resolução de Diretoria Colegiada nº 275, de 2002, da Agência Nacional de Vigilância Sanitária, e os da PF foram utilizados para a classificação das UANE. Todas as UANE se encontraram parcialmente adequadas para o BT edificação. Para os BT manipuladores, processos/procedimentos, higienização ambiental e equipamentos para temperatura controlada, a maioria apresentou resultados parcialmente adequados e inadequados. A maioria da UANE apresentou-se adequada para o BT recebimento. Os resultados da PF classificaram a maior parte das UANE (66,7%) como risco sanitário regular, indicando a necessidade de realização de medidas corretivas para as Boas Práticas nas UANE e oferta de refeições seguras ao público escolar.

Abstract The scope of this study was to analyze the hygienic-sanitary conditions in nine School Food and Nutrition Units (UANE) of a municipality in the state of Rio de Janeiro (Brazil). A Best Practices in School Food Checklist proposed and validated by Stedefeldt et al., containing items scored and grouped into six thematic blocks (BT) was applied. The total score (P) results per BT and the final score (PF) were obtained using the Best Practices in School Food software®. The P results in UANE were compared with the classification of Collegiate Board Resolution No. 275 of 2002 of the National Health Surveillance Agency2 and PF results were used for UANE classification. All the UANE results were partially suitable for BT building. For BT handlers, processes/procedures, environmental hygiene and equipment for controlled temperature, most had partially adequate and inadequate results. Most UANE were adequate for BT reception. The PF results classified most UANE (66.7%) as standard health risks, indicating the need for corrective measures for Best Practices in UANE and the supply of safe and healthy meals to schoolchildren.

Valoración de buenas prácticas docentes a través de observación sistemática / Assessing of Good Teaching Practicesthrough Systematic Observation

Las buenas prácticas docentes requieren del diseño de distintas formas de medición al ser un tema de especial relevancia para determinar la calidad de la educación superior. Una gran parte de las buenas prácticas corresponden a comportamientos desarrollados por el profesor en el aula de clase, lo que se puede medir y analizar mediante metodología observacional. Se seleccionaron diez profesores de la Universidad de La Laguna (España) y siete de la Universidad de Guadalajara (México), codificando sus comportamientos mediante una escala de calificación y los patrones comportamentales de interacción con el alumnado mediante el Protocolo de Observación de Funciones Docentes (PROFUNDO_UNI). El análisis secuencial de retardos extrajo patrones significativos relacionados con la retroalimentación a las preguntas del alumnado, el refuerzo dado y el fomento a la participación de los estudiantes.

The best teaching practices, an issue of particular relevance in determining the quality of higher education, requires different forms of measuring design. A big part of good practice in teacher performance corresponds to behaviors developed by the teacher in the classroom, which can be measured and analyzed using observational methodology. The study evaluates ten teachers from the University of La Laguna (Spain) and seven from Guadalajara (Mexico). Their behavior was coded using a rating scale and the behavioral interaction patterns with students were coded using the Observational Protocol of Teaching Functions (Protocolo de Observación de Funciones Docentes, PROFUNDO_UNI). The lag sequential analysis extracted significant patterns related to the feedback given to questions from the students, the reinforcement and the encouragement given to the students for their participation.

Safety Management Practices in Small and Medium Enterprises in India

BACKGROUND: Small and medium enterprises (SMEs) are often the main pillar of an economy. Minor accidents, ergonomics problems, old and outdated machinery, and lack of awareness have created a need for implementation of safety practices in SMEs. Implementation of healthy working conditions creates positive impacts on economic and social development. METHODS: In this study, a questionnaire was developed and administered to 30 randomly chosen SMEs in and around Mumbai, Maharashtra, and other states in India to evaluate safety practices implemented in their facilities. The study also looked into the barriers and drivers for technology innovation and suggestions were also received from the respondent SMEs for best practices on safety issues. RESULTS: In some SMEs, risks associated with safety issues were increased whereas risks were decreased in others. Safety management practices are inadequate in most SMEs. Market competitiveness, better efficiency, less risk, and stringent laws were found to be most significant drivers; and financial constraints, lack of awareness, resistance to change, and lack of training for employees were found to be main barriers. CONCLUSION: Competition between SMEs was found to be major reason for implementation of safety practices in the SMEs. The major contribution of the study has been awareness building on safety issues in the SMEs that participated in the project.

De la bioseguridad al control de infecciones en Estomatología / From biosafety to infection control in dentistry

Durante las prácticas estomatológicas, tanto los pacientes como el personal de servicio se encuentran en continua exposición al contacto con agentes biológicos a través de la saliva, sangre o secreciones del tracto respiratorio. Es por eso que el cumplimiento de las normas de bioseguridad en los laboratorios o durante el tratamiento de los desechos es fundamental para disminuir el riesgo al que están sometidos. Sin embargo, se necesitan además de otras recomendaciones que se encuentran contenidas específicamente en los programas de prevención y control de infecciones y que no forman parte de los manuales de bioseguridad. Objetivos: relacionar las normas y principios de la bioseguridad con los principios de los programas de prevención y control de infecciones en Estomatología, e identificar los aspectos a tener en cuenta en la elaboración de dichos programas. Métodos: se realizó una revisión bibliográfica en las principales bases de datos médicas (Scielo, Pubmed, EBSCO, Hinari) de artículos científicos y programas de diversos países relacionados con la prevención y control de infecciones para Estomatología. Además se consultó el Manual de bioseguridad contenido en el anexo 28 del Programa Nacional de Atención Estomatológica Integral a la Población. Resultados: se recopilaron datos sobre los aspectos comunes y no comunes entre los principios de bioseguridad y los principios de los programas de prevención y control de infecciones para Estomatología. Por otra parte, se obtuvo información relacionada con los aspectos a tener en cuenta en la elaboración de estos. Conclusiones: es necesario considerar las normas de bioseguridad en la elaboración e implementación de un programa de prevención y control de infecciones para los servicios estomatológicos...

During the performance of dental procedures, both patients and staff are under permanent risk of contact with biological agents from saliva, blood and respiratory secretions. Hence the importance of complying with biosafety standards in laboratories and during the performance of waste disposal tasks. Moreover, alongside the recommendations contained in biosafety manuals, attention should also be paid to those included in infection prevention and control programs. Objectives: relate biosafety standards and principles to the principles contained in infection prevention and control programs for dentistry, and identify the aspects to be borne in mind when developing such programs. Methods: A bibliographic review was conducted in the main medical databases (Scielo, Pubmed, EBSCO, Hinari) of scientific papers and programs from various countries related to infection prevention and control in dentistry. The Biosafety Manual contained in Annex 28 of the National Comprehensive Dental Care Program was also consulted. Results: data were collected about similarities and differences between biosafety principles and the principles contained in infection prevention and control programs for dentistry. Additionally, information was obtained about the aspects to bear in mind when designing such programs. Conclusions: biosafety standards should be considered when developing and implementing an infection prevention and control program for dental services...

The retrospective chart review: important methodological considerations / 보건의료교육평가

In this paper, we review and discuss ten common methodological mistakes found in retrospective chart reviews. The retrospective chart review is a widely applicable research methodology that can be used by healthcare disciplines as a means to direct subsequent prospective investigations. In many cases in this review, we have also provided suggestions or accessible resources that researchers can apply as a "best practices" guide when planning, conducting, or reviewing this investigative method.

Urgent Work: Developing a Gender-Responsive Approach for Girls in the Juvenile Justice System / Trabajo urgente: desarrollando una respuesta con perspectiva de género para niñas en el Sistema de Justicia Juvenil

This paper reviews the prevalence of girls in the U.S. juvenile justice system, compares national and international incarceration rates, and reviews the profile needs of justice-involved girls. The authors offer their Model as an example of how to develop a gender-responsive approach to girls in the justice system, including a description of how the model was operationalized in a community in the United States. Critical developments and emerging opportunities for each of the Model's components: advocacy, model programming, public education, training and technical assistance, gender responsive tools, systems accountability, and evaluation are highlighted. Lessons learned are offered as a springboard for conversations about how the international community can individually assess their needs and resources and work together to improve the response to girls. The paper concludes with recommendations for choosing, evaluating, and implementing best-practice approaches for meaningful reform.

Este artículo revisa la prevalencia de niñas en el Sistema de Justicia Juvenil de Estados Unidos, compara las tasas de encarcelamiento nacional e internacional y examina las necesidades de un perfil de las niñas involucradas. Los autores ofrecen su modelo como ejemplo para desarrollar una aproximación dirigida al género femenino en el Sistema de Justicia, incluyendo una descripción de su operacionalización en una comunidad de los Estados Unidos. En los desarrollos críticos y la emergencia de oportunidades para cada uno de los componentes del modelo, se destacan: la promoción legislativa y las políticas, el modelo de programación, la educación pública, la capacitación y asistencia técnica, las herramientas sensibles al género, los sistemas de responsabilidad y la evaluación. Las lecciones aprendidas se presentan como plataforma para la interlocución sobre la manera en que la comunidad internacional puede, en forma individual, evaluar necesidades y recursos, y trabajar conjuntamente para dar una mejor respuesta a las niñas. El artículo concluye con recomendaciones para escoger, evaluar e implementar mejores prácticas para una reforma significativa.

Modelo conceitual para avaliação de práticas e estratégias climáticas: resultados de sua aplicação nos setores automotivo e de papel e celulose no Brasil / Environmental practices and strategies assessmente model: results of its application to the automotive and pulp & paper sectors in Brazil

A alta concentração de gases de efeito estufa está provocando mudanças climáticas com forte impacto, inclusive no ambiente competitivo das empresas. Assim, algumas empresas já estão adotando práticas e estratégias climáticas em função não somente das legislações restritivas ao carbono, mas também para assegurarem sua vantagem competitiva. Contudo, há uma escassez de ferramentas gerenciais para avaliar o quanto tais práticas e estratégias são adequadas a esse novo contexto. Este artigo apresenta um modelo conceitual desenvolvido com base em benchmarks (melhores práticas) internacionais, para auxiliar as empresas na avaliação das suas práticas e estratégias climáticas, e mostra como o modelo foi aplicado no Brasil em dois setores representativos de sua economia: o automotivo e o de papel e celulose. Identifica as práticas e estratégias climáticas que precisam ser melhoradas nesses setores, quando comparadas com as internacionais. Na aplicação do modelo, foram testadas cinco hipóteses referentes às principais variáveis do modelo proposto. Para tanto, realizaram-se testes estatísticos: teste t-student, para comparação com as práticas internacionais, e teste não paramétrico Kruskal-Wallis, para verificar diferenças entre as médias dos dois setores investigados. Com base nos resultados, são feitas recomendações para futuras pesquisas e para outras empresas preocupadas em adotar práticas e estratégias climáticas eficazes.