Optimising antibacterial utilisation in Argentine intensive care units: a quality improvement collaborative.

BACKGROUND: There is limited evidence from antimicrobial stewardship programmes in less-resourced settings. This study aimed to improve the quality of antibacterial prescriptions by mitigating overuse and promoting the use of narrow-spectrum agents in intensive care units (ICUs) in a middle-income country. METHODS: We established a quality improvement collaborative (QIC) model involving nine Argentine ICUs over 11 months with a 16-week baseline period (BP) and a 32-week implementation period (IP). Our intervention package included audits and feedback on antibacterial use, facility-specific treatment guidelines, antibacterial timeouts, pharmacy-based interventions and education. The intervention was delivered in two learning sessions with three action periods along with coaching support and basic quality improvement training. RESULTS: We included 912 patients, 357 in BP and 555 in IP. The latter had higher APACHE II (17 (95% CI: 12 to 21) vs 15 (95% CI: 11 to 20), p=0.036), SOFA scores (6 (95% CI: 4 to 9) vs 5 (95% CI: 3 to 8), p=0.006), renal failure (41.6% vs 33.1%, p=0.009), sepsis (36.1% vs 31.6%, p<0.001) and septic shock (40.0% vs 33.8%, p<0.001). The days of antibacterial therapy (DOT) were similar between the groups (change in the slope from BP to IP 28.1 (95% CI: -17.4 to 73.5), p=0.2405). There were no differences in the antibacterial defined daily dose (DDD) between the groups (change in the slope from BP to IP 43.9, (95% CI: -12.3 to 100.0), p=0.1413).The rate of antibacterial de-escalation based on microbiological culture was higher during the IP (62.0% vs 45.3%, p<0.001).The infection prevention control (IPC) assessment framework was increased in eight ICUs. CONCLUSION: Implementing an antimicrobial stewardship program in ICUs in a middle-income country via a QIC demonstrated success in improving antibacterial de-escalation based on microbiological culture results, but not on DOT or DDD. In addition, eight out of nine ICUs improved their IPC Assessment Framework Score.

Estratégias educacionais para o PET-Saúde Interprofissionalidade no sudoeste de Goiás, Brasil: uma abordagem qualitativa / Educational strategies for PET-Health Interprofessionality in Southwestern Goiás state, Brazil: a qualitative approach

Resumo O objetivo desse estudo é apresentar intervenções educacionais no contexto do PET-I, realizadas no ensino e no serviço de saúde de um município no sudoeste de Goiás, a partir da análise dos grupos focais e dos portfólios realizados pelos participantes, de forma longitudinal. Foi realizado um estudo descritivo exploratório, de abordagem qualitativa, fundamentado nas bases teórico-conceituais e metodológicas da EIP, no período de agosto de 2019 a novembro de 2020. Observou-se que os discentes perceberam a participação no PET-I como uma oportunidade de interagir com outras profissões, além da sua própria e de associar teoria à prática e atuar como protagonistas. Os participantes acreditam que trabalhar em conjunto para fornecer o melhor atendimento aos pacientes requer uma compreensão básica das diferentes perspectivas, funções e responsabilidades de todos os profissionais envolvidos no trabalho. Eles enfatizaram conversas informais, reuniões e até mesmo discussões de casos como uma oportunidade para permitir que todos entendessem as opiniões e atribuições do profissional e aprofundassem seu entendimento da importância da comunicação colaborativa.

Abstract This study aimed to present educational interventions in the context of the Education Program through PET-Health Interprofessionality (PET-I), carried out in teaching and in healthcare service of a municipality of Goiás state, based on the analysis of focus groups and portfolios made by participants. A descriptive exploratory study with a qualitative approach was carried out, based on the theoretical-conceptual and methodological foundations of interprofessional education, from August 2019 to November 2020. It was observed that students perceived participation in PET-I as an opportunity to interact with other professions, to associate theory with practice and to act as leading actors. Participants believe that working together to provide the best care for patients requires a basic understanding of the different perspectives and responsibilities of professionals involved. They emphasized informal conversations, meetings, and case discussions as opportunities to understand professional's opinions and assignments, and deepen their understanding of the importance of collaborative communication.

Unveiling the intricacies of BPA and BPS: comprehensive insights into its toxic effects using a cutting-edge microphysiological system.

Concerns over Bisphenol A (BPA) and its substitute, Bisphenol S (BPS), have led to innovative exploration due to potential adverse health effects. BPS, replacing BPA in some regions to avoid toxic impacts, remains insufficiently studied. Besides this, the organ-on-a-chip technology emerges as a transformative solution in drug discovery and chemiclas toxicity testing, minimizing costs and aligning with ethical standards by reducing reliance on animal models, by integrating diverse tissues and dynamic cell environments enhances precision in predicting organ function. Here, we employ a 3-organ-on-a-chip microfluidic device with skin, intestine, and liver cultures to assess the effects of BPA and BPS via topical and oral administration. Our evaluation focused on gene markers associated with carcinogenicity, systemic toxicity, and endocrine disruption. BPA exhibited expected absorption profiles, causing liver injury and genetic modulation in related pathways. BPS, a safer alternative, induced adverse effects on gene expression, particularly in topical absorption, with distinct absorption patterns. Our findings underscore the urgency of addressing BPA and BPS toxicity concerns, highlighting the crucial role of organ-on-a-chip technology in understanding associated health risks. The study promotes the organ-on-a-chip methodology as a valuable tool for safe drug development and disease treatments, offering a novel liver toxicity screening alternative to traditional animal tests. This contributes to advancing comprehension of the biological effects of these compounds, fostering improved safety assessments in human health.

The evaluation of skin sensitization potential of the UVCB substance diisopentyl phthalate by in silico and in vitro methods.

Diisopentyl phthalate (DiPeP) is primarily used as a plasticizer or additive within the production of polyvinyl chloride (PVC), and has many additional industrial applications. Its metabolites were recently found in urinary samples of pregnant women; thus, this substance is of concern as relates to human exposure. Depending upon the nature of the alcohol used in its synthesis, DiPeP may exist either as a mixture consisting of several branched positional isomers, or as a single defined structure. This article investigates the skin sensitization potential and immunomodulatory effects of DiPeP CAS No. 84777-06-0, which is currently marketed and classified as a UVCB substance, by in silico and in vitro methods. Our findings showed an immunomodulatory effect for DiPeP in LPS-induced THP-1 activation assay (increased CD54 expression). In silico predictions using QSAR TOOLBOX 4.5, ToxTree, and VEGA did not identify DiPeP, in the form of a discrete compound, as a skin sensitizer. The keratinocyte activation (Key Event 2 (KE2) of the adverse outcome pathway (AOP) for skin sensitization) was evaluated by two different test methods (HaCaT assay and RHE assay), and results were discordant. While the HaCaT assay showed that DiPeP can activate keratinocytes (increased levels of IL-6, IL-8, IL-1α, and ILA gene expression), in the RHE assay, DiPeP slightly increased IL-6 release. Although inconclusive for KE2, the role of DiPeP in KE3 (dendritic cell activation) was demonstrated by the increased levels of CD54 and IL-8 and TNF-α in THP-1 cells (THP-1 activation assay). Altogether, findings were inconclusive regarding the skin sensitization potential of the UVCB DiPeP-disagreeing with the results of DiPeP in the form of discrete compound (skin sensitizer by the LLNA assay). Additional studies are needed to elucidate the differences between DiPeP isomer forms, and to better understand the applicability domains of non-animal methods in identifying skin sensitization hazards of UVCB substances.

Using "Adopt a Bacterium" as an e-learning tool for simultaneously teaching microbiology to different health-related university courses.

The COVID-19 pandemic has posed challenges for education, particularly in undergraduate teaching. In this study, we report on the experience of how a private university successfully addressed this challenge through an active methodology applied to a microbiology discipline offered remotely to students from various health-related courses (veterinary, physiotherapy, nursing, biomedicine, and nutrition). Remote teaching was combined with the "Adopt a Bacterium" methodology, implemented for the first time on Google Sites. The distance learning activity notably improved student participation in microbiology discussions, both through word cloud analysis and the richness of discourse measured by the Shannon index. Furthermore, feedback from students about the e-learning approach was highly positive, indicating its effectiveness in motivating and involving students in the learning process. The results also demonstrate that despite being offered simultaneously to students, the methodology allowed for the acquisition of specialized knowledge within each course and sparked student interest in various aspects of microbiology. In conclusion, the remote "Adopt a Bacterium" methodology facilitated knowledge sharing among undergraduate students from different health-related courses and represented a valuable resource in distance microbiology education.

Using active learning strategies during a quality improvement collaborative: exploring educational games to enhance learning among healthcare professionals.

BACKGROUND: The Breakthrough Series model uses learning sessions (LS) to promote education, professional development and quality improvement (QI) in healthcare. Staff divergences regarding prior knowledge, previous experience, preferences and motivations make selecting which pedagogic strategies to use in LS a challenge. AIM: We aimed to assess new active-learning strategies: two educational games, a card game and an escape room-type game, for training in healthcare-associated infection prevention. METHODS: This descriptive case study evaluated the performance of educational strategies during a Collaborative to reduce healthcare-associated infections in Brazilian intensive care units (ICUs). A post-intervention survey was voluntarily offered to all participants in LS activities. RESULTS: Seven regional 2-day LS were held between October and December 2022 (six for adult ICUs and one for paediatric/neonatal ICUs). Of 194 institutions participating in a nationwide QI initiative, 193 (99.4%) participated in these activities, totalling 850 healthcare professionals. From these, 641 participants responded to the survey (75.4%). The post-intervention survey showed that the participants responded positively to the educational activities. CONCLUSION: The participants perceived the various pedagogical strategies positively, which shows the value of a broad and diverse educational approach, customised to local settings and including game-based activities, to enhance learning among healthcare professionals.

Flexible gold standards for transcription factor regulatory interactions in Escherichia coli K-12: architecture of evidence types.

Post-genomic implementations have expanded the experimental strategies to identify elements involved in the regulation of transcription initiation. Here, we present for the first time a detailed analysis of the sources of knowledge supporting the collection of transcriptional regulatory interactions (RIs) of Escherichia coli K-12. An RI groups the transcription factor, its effect (positive or negative) and the regulated target, a promoter, a gene or transcription unit. We improved the evidence codes so that specific methods are incorporated and classified into independent groups. On this basis we updated the computation of confidence levels, weak, strong, or confirmed, for the collection of RIs. These updates enabled us to map the RI set to the current collection of HT TF-binding datasets from ChIP-seq, ChIP-exo, gSELEX and DAP-seq in RegulonDB, enriching in this way the evidence of close to one-quarter (1329) of RIs from the current total 5446 RIs. Based on the new computational capabilities of our improved annotation of evidence sources, we can now analyze the internal architecture of evidence, their categories (experimental, classical, HT, computational), and confidence levels. This is how we know that the joint contribution of HT and computational methods increase the overall fraction of reliable RIs (the sum of confirmed and strong evidence) from 49% to 71%. Thus, the current collection has 3912 reliable RIs, with 2718 or 70% of them with classical evidence which can be used to benchmark novel HT methods. Users can selectively exclude the method they want to benchmark, or keep for instance only the confirmed interactions. The recovery of regulatory sites in RegulonDB by the different HT methods ranges between 33% by ChIP-exo to 76% by ChIP-seq although as discussed, many potential confounding factors limit their interpretation. The collection of improvements reported here provides a solid foundation to incorporate new methods and data, and to further integrate the diverse sources of knowledge of the different components of the transcriptional regulatory network. There is no other genomic database that offers this comprehensive high-quality architecture of knowledge supporting a corpus of transcriptional regulatory interactions.

"Measuring the health and fiscal outcomes of solid waste management operations by intergovernmental arrangements: The case of public consortia in Brazil".

This study estimates the health-related and public expenditure impacts of the solid waste services provided by public consortia in Brazilian Municipalities from the enactment of Public Consortia law (2005) to 2019. To conduct the analysis, we applied the econometric method of staggered difference-in-differences to publicly available datasets at the municipality level. The results show that the operation of solid waste services by public consortia had statistically significant effects in reducing hospitalizations caused by Schistosomiasis, Diarrhea/gastroenteritis (up to 5 years age) and other intestinal diseases. The results also indicate a positive impact on the reduction of environmental expenses in treated municipalities, supporting the idea that a Solid Waste Consortium can serve as a local coordinator and improve health and fiscal indicators simultaneously. The findings provide quantitative evidence that policymakers at the local and regional level can use to better understand the benefits of adhering to public consortia when preparing new investments and operation developments for this sector. This paper contributes to the literature of applied research in solid waste by shedding light on the underexplored theme of the intergovernmental cooperative arrangements, which can be instrumental in accelerating and enhancing the development of solid waste services.

A 30-Year Review on Nanocomposites: Comprehensive Bibliometric Insights into Microstructural, Electrical, and Mechanical Properties Assisted by Artificial Intelligence.

From 1990 to 2024, this study presents a groundbreaking bibliometric and sentiment analysis of nanocomposite literature, distinguishing itself from existing reviews through its unique computational methodology. Developed by our research group, this novel approach systematically investigates the evolution of nanocomposites, focusing on microstructural characterization, electrical properties, and mechanical behaviors. By deploying advanced Boolean search strategies within the Scopus database, we achieve a meticulous extraction and in-depth exploration of thematic content, a methodological advancement in the field. Our analysis uniquely identifies critical trends and insights concerning nanocomposite microstructure, electrical attributes, and mechanical performance. The paper goes beyond traditional textual analytics and bibliometric evaluation, offering new interpretations of data and highlighting significant collaborative efforts and influential studies within the nanocomposite domain. Our findings uncover the evolution of research language, thematic shifts, and global contributions, providing a distinct and comprehensive view of the dynamic evolution of nanocomposite research. A critical component of this study is the "State-of-the-Art and Gaps Extracted from Results and Discussions" section, which delves into the latest advancements in nanocomposite research. This section details various nanocomposite types and their properties and introduces novel interpretations of their applications, especially in nanocomposite films. By tracing historical progress and identifying emerging trends, this analysis emphasizes the significance of collaboration and influential studies in molding the field. Moreover, the "Literature Review Guided by Artificial Intelligence" section showcases an innovative AI-guided approach to nanocomposite research, a first in this domain. Focusing on articles from 2023, selected based on citation frequency, this method offers a new perspective on the interplay between nanocomposites and their electrical properties. It highlights the composition, structure, and functionality of various systems, integrating recent findings for a comprehensive overview of current knowledge. The sentiment analysis, with an average score of 0.638771, reflects a positive trend in academic discourse and an increasing recognition of the potential of nanocomposites. Our bibliometric analysis, another methodological novelty, maps the intellectual domain, emphasizing pivotal research themes and the influence of crosslinking time on nanocomposite attributes. While acknowledging its limitations, this study exemplifies the indispensable role of our innovative computational tools in synthesizing and understanding the extensive body of nanocomposite literature. This work not only elucidates prevailing trends but also contributes a unique perspective and novel insights, enhancing our understanding of the nanocomposite research field.

Anclaje de Contenidos Mediante Metodologías Activas y Videos, una Experiencia de Postítulo

El anclaje es el proceso que permite insertar lo nuevo en el entramado de esquemas preexistentes. Posibilita instrumentalizar el contenido en la comunicación. En formación de especialistas, anclamos contenidos con un diagnóstico situacional. El propósito de este ensayo fue, anclar contenidos de masticación y dinámica mandibular en profesionales, estudiantes del programa de especialización en Periodoncia, Facultad de Odontología, Universidad de Chile. El programa posee la unidad de rehabilitación en periodonto reducido (un crédito, 5 sesiones). Esta se imparte con diagnóstico situacional y metodologías activas: aula reversa y discusión de grupo pequeño. Los contenidos masticación y dinámicamandibular se anclaron mediante estas metodologías con videos, para estimular la identificación de patrones; contenido anclado es identificado. Se incentivó la reflexión individual y colectiva y se compararon los estudiantes de las promociones 2020 (telemática) y 2022 (presencial). Los estudiantes fueron codificados del 1 al 14. Caracterización de la cohorte 2020: 4 hombres, 4 mujeres; 5.75 años de egreso promedio, 2 U. Desarrollo, 1 U. de Concepción, 2 U. de Talca, 2 U. de Chile y 1 U de los Andes. Caracterización cohorte 2022: 3 mujeres, 3 hombres; 6 años de egreso promedio, 5 U. de Chile y 1 U. de La Frontera. La cohorte 2020 identificó patrones en la segunda sesión, a excepción de los estudiantes 5 y 7 que lo hicieron en la quinta sesión. Durante la reflexión colectiva, predominaron liderazgos transformacionales. De la cohorte 2022, solo el estudiante 14 identificó patrones en la segunda sesión y todos sus compañeros lo hicieron en la quinta sesión. Durante la reflexión colectiva, predominaron liderazgos transaccionales. En educación de profesionales, iguales metodologías, aplicadas telemáticamente o de manera presencial para anclar nuevos contenidos, se vieron influenciadas por los estilos de liderazgos de los estudiantes, que favorecieron o retardaron la identificación de patrones.

Anchoring is the process that allows new information to be inserted into the framework of pre-existing schemes. Allows to instrumentalize the content in communication. In During the training of specialists, we anchor contents with a situational diagnosis. The purpose of this essay was to anchor contents of mastication and mandibular dynamics in professionals, students in the specialization program in Periodontics, of the Faculty of Dentistry, Universidad de Chile. The program has a rehabilitation unit in reduced periodontium (one credit, 5 sessions). This is taught with situational diagnosis and active methodologies: Reverse classroom and small group discussion. The chewing and mandibular dynamics contents were anchored through these methodologies with videos, to stimulate the identification of patterns; pinned content is identified. Individual and collective reflection was encouraged and students from the 2020 (telematic) and 2022 (in-person) classes were compared. Students were coded from 1 to 14. Characterization of the 2020 cohort: 4 men, 4 women; 5.75 years of average graduation, 2 from U. del Desarrollo, 1 U. de Concepción, 2 U. de Talca, 2 U. de Chile and 1 U. de Los Andes. Cohort characterization 2022: 3 women, 3 men; 6 years of average graduation, 5 U. de Chile and 1 U. de La Frontera. The 2020 cohort identified patterns in the second session, except for students 5 and 7 who did so in the fifth session. During the collective reflection, transformational leadership predominated. Of the 2022 cohort, only student 14, was able to identify patterns in the second session, while all of her classmates did so in the fifth session. During the collective reflection, transactional leadership predominated. In teaching professionals, the same methodologies, applied telematically or in person to anchor new content, were influenced by the leadership styles of the students, which favored or delayed the identification of the patterns.

Characterization and applicability of a novel physiologically relevant 3D-tetraculture bronchial model for in vitro assessment of respiratory sensitization.

Chemical Respiratory Allergy (CRA) is triggered after exposure to Low Molecular Weight (LMW) sensitizers and manifests clinically as asthma and rhinitis. From a risk/toxicity assessment point of view, there are few methods, none of them validated, for evaluating the respiratory sensitization potential of chemicals once the in vivo-based models usually employed for inhalation toxicity addressment do not comprise allergenicity endpoints specifically. Based on that, we developed, characterized, and evaluated the applicability of a 3D-tetraculture airway model reconstructed with bronchial epithelial, fibroblasts, endothelial and monocytic cell lines. Moreover, we exposed the tissue to maleic anhydride (MA) aerosols to challenge the model and subsequently assessed inflammatory and functional aspects of the tissue. The reconstructed tissue presented phenotypic biomarkers compatible with human bronchial epithelium, and MA aerosol exposure triggered an increased IL-8 and IL-6 production, reactive oxygen species (ROS) formation, and apoptosis of epithelial cells. Besides, augmented IL-8 production by monocytic cells was also found, correlating with dendritic cell activation within the co-culture model after MA exposure. Our results demonstrated that the 3D-tetraculture bronchial model presents hallmarks related to human airways' structure and function. Additionally, exposure to a respiratory sensitizer induced inflammatory and functional alterations in the reconstructed tissue, rendering it a valuable tool for exploring the mechanistic framework of chemically induced respiratory sensitization.

Multiple names for multi-scope analytical methods, more than a semantic issue.

The use of multiple names for multi-scope analytical methods is often confusing. More precise classification to better accommodate the scope of analytical validation and application is needed.

Metodologias ativas no ensino da Prótese Parcial Removível durante a COVID-19: um relato de experiência da Universidade Federal da Paraíba / Metodologías activas em la enseñanza de Prótesis Parcial Removible durante laCOVID-19: relato de experiencia de la Universidade Federal da ParaíbaResumen / Active methodologies in teaching the Removable Partial Denture course during COVID-19: an experience report

Este estudo objetiva apresentar a experiência do componente curricular Prótese Parcial Removível (PPR) da Universidade Federal da Paraíba com a implementação de metodologias ativas, como gamificação, sala de aula invertida e case-based learning(CBL), no ensino à distância, visando sedimentar o aprendizado quanto ao planejamento de arcos parcialmente desdentados. As atividades foram realizadas de forma síncrona e assíncrona, utilizando como casos os esquemas bidimensionais e fotografias de arcosparcialmente desdentados, baseando-se no conceito de sala de aula invertida, no qual os alunos apresentavam os casos e os professores atuavam como mediadores nas discussões. Observou-se um grande engajamento e participação ativa dos alunos na construção do seuconhecimento. A inserção dessas metodologias no ensino remoto funcionou como um eixo motivacional para os alunos, fomentando a aprendizagem e estimulando o desenvolvimento de competências no planejamento em PPR previamente ao atendimento clínico (AU).

Este estudio tiene como objetivo presentar la experiencia del componente curricular Prótesis Parcial Removible de la Universidade Federal da Paraíba con la implementación de metodologías activas, como gamificación, aula invertida y aprendizaje basado en casos, en educación a distancia, con el objetivo de consolidar el aprendizaje sobre la planificación de arcadas parcialmente edéntulas. Las actividades se realizaron de forma sincrónica y asincrónica, utilizando diagramas bidimensionales y fotografías de arcos parcialmente edéntulos como casos, basados en el concepto de aula invertida, en la que los estudiantes presentaban los casos y los docentes actuaban como mediadores en las discusiones. Hubo un gran compromiso y participación activa de los estudiantes en la construcción de su conocimiento. La inclusión de estas metodologías en la enseñanza a distancia funcionó como eje motivacional de los estudiantes, favoreciendo el aprendizaje y estimulando el desarrollo de habilidades en la planificación de la Prótesis Parcial Removible previa a la atención clínica (AU).

This study aims to present the experience of RPD course at the Universidade Federal da Paraíba using active methodologies such as gamification, flipped classroom and case-based learning (CBL) in distance learning, aiming to consolidate learning in planningpartially edentulous arches. Activities were carried out synchronously and asynchronously using two-dimensional schemes and photographs of partially edentulous arches as "cases" and based on the concept of the flipped classroom, where students presented the cases and the teachers acted as mediators in the discussions. Excellent engagement and active participation of students in their knowledge construction were observed. The insertion of these methodologies in remote teaching acted as a motivational axis for the students, promoting learning and stimulating development of competences in RPD planning prior to clinical care (AU).

Brazilian National Network of Alternative Methods (RENAMA) 10th Anniversary: Meeting of the Associated Laboratories, May 2022.

The Brazilian National Network of Alternative Methods (RENAMA), which is linked to the Ministry of Science, Technology and Innovation, is currently comprised of 51 laboratories from CROs, academia, industry and government. RENAMA's aim is to develop and validate new approach methodologies (NAMs), as well as train researchers and disseminate information on their use - thus reducing Brazilian, and consequently Latin American, dependence on external technology. Moreover, it promotes the adoption of NAMs by educators and trained researchers, as well as the implementation of good laboratory practice (GLP) and the use of certified products. The RENAMA network started its activities in 2012, and was originally comprised of three central laboratories - the National Institute of Metrology, Quality and Technology (INMETRO); the National Institute of Quality Control in Health (INCQS); and the National Brazilian Biosciences Laboratory (LNBio) - and ten associated laboratories. In 2022, RENAMA celebrated its 10th anniversary, a milestone commemorated by the organisation of a meeting attended by different stakeholders, including the RENAMA-associated laboratories, academia, non-governmental organisations and industry. Ninety-six participants attended the meeting, held on 26 May 2022 in Balneário Camboriú, SC, Brazil, as part of the programme of the XXIII Brazilian Congress of Toxicology 2022. Significant moments of the RENAMA were remembered, and new goals and discussion themes were established. The lectures highlighted recent innovations in the toxicological sciences that have translated into the assessment of consumer product safety through the use of human-relevant NAMs instead of the use of existing animal-based approaches. The challenges and opportunities in accepting such practices for regulatory purposes were also presented and discussed.

As Escrevivências no ensino de Terapia Ocupacional sobre/com as juventudes / "Escrevivências" in the teaching of Occupational Therapy for/with youth / Las Escrevivências en la enseñanza de la Terapia Ocupacional sobre/con las juventudes

Há um imperativo de se pensar uma formação graduada em Terapia Ocupacional atenta às necessidades juvenis. Nesse sentido, hipotetizamos que as Escrevivências de Conceição Evaristo poderiam mediar a aprendizagem crítica sobre as juventudes. O objetivo deste artigo é investigar o processo de ensino e aprendizagem estético, ético e político de estudantes de Terapia Ocupacional por meio de um projeto de ensino pautado nas Escrevivências. Trata-se de uma pesquisa educacional que se utilizou de informações pedagógicas de uma disciplina ministrada remotamente. Estudantes estabeleceram contato com jovens diversos para pensar aspectos coletivos dentro de narrativas singulares de vida. Os achados provêm da análise do diário de campo da monitora, da transcrição das monitorias virtuais, do trabalho final e de um grupo focal. Identificamos processos cognitivos relevantes ligados à alteridade. Quanto à aprendizagem estética, crítico-social e ético-política, debatemos as limitações.(AU)

It is imperative to think about graduate training in occupational therapy that is mindful of the needs of young people. In this regard, we hypothesized that the writings of Conceição Evaristo can help mediate critical learning about youth. The aim of this study was to investigate the aesthetic, ethical and political teaching and learning process of occupational therapy students based on a teaching project grounded in these writings. We conducted an educational study using pedagogical information from a remotely taught subject. Students established contact with various young people to think about collective aspects within singular life narratives. The findings resulted from the analysis of the field diary of the subject monitor, transcriptions of online tutoring, the students' end of course project and a focus group. We identified relevant cognitive processes linked to otherness. We also discuss the limitations of aesthetic, critical-social and ethical-political learning.(AU)

Existe el imperativo de pensar en una formación graduada en Terapia Ocupacional que esté atenta a las necesidades juveniles. En ese sentido, lanzamos la hipótesis de que las Escrevivências de Conceição Evaristo podrían mediar el aprendizaje crítico sobre las juventudes. El objetivo de este artículo es investigar el proceso de enseñanza y aprendizaje estético, ético y político de estudiantes de terapia ocupacional a partir de un proyecto de enseñanza con base en las Escrevivências. Se trata de una investigación educativa que utilizó informaciones pedagógicas de una asignatura dictada remotamente. Los estudiantes establecieron contactos con jóvenes diversos para pensar aspectos colectivos dentro de narrativas singulares de vida. Los hallazgos provienen del análisis del diario de campo de la monitora, de la transcripción de los monitoreos virtuales, del trabajo final y de un grupo focal. Identificamos procesos cognitivos relevantes vinculados a la alteridad. Con relación al aprendizaje estético, crítico-social y ético-político, discutimos las limitaciones.(AU)

Polypharmacy and Drug Interactions in the COVID-19 Pandemic.

The COVID-19 pandemic generated a great impact on health systems. We compared evolution, polypharmacy, and potential drug-drug interactions (P-DDIs) in COVID-19 and non-COVID-19 hospitalizations during first wave of pandemic. Prescriptions for hospitalized patients ≥ 18 years (COVID-19 and non-COVID-19 rooms) between April and September 2020 were included. The computerized medical decision support system SIMDA and the physician order entry system Hdc.DrApp.la were used. Patients in COVID-19 rooms were divided into detectable and non-detectable, according to real-time reverse transcription polymerase chain reaction (RT-PCR). Number of drugs, prescribed on day 1, after day 1, and total; polypharmacy, excessive polypharmacy, and P-DDIs were compared. 1,623 admissions were evaluated: 881 COVID-19, 538 detectable and 343 non-detectable, and 742 non-COVID-19. Mortality was 15% in COVID-19 and 13% in non-COVID-19 (RR [non-COVID-19 vs. COVID-19]: 0.84 [95% CI] [0.66-1.07]). In COVID-19, mortality was 19% in detectable and 9% in non-detectable (RR: 2.07 [1.42-3.00]). Average number of drugs was 4.54/patient (SD ± 3.06) in COVID-19 and 5.92/patient (±3.24) in non-COVID-19 (p<0.001) on day 1 and 5.57/patient (±3.93) in COVID-19 and 9.17/patient (±5.27) in non-COVID-19 (p<0.001) throughout the hospitalization. 45% received polypharmacy in COVID-19 and 62% in non-COVID-19 (RR: 1.38 [1.25-1.51]) and excessive polypharmacy 7% in COVID-19 and 14% in non-COVID-19 (RR: 2.09 [1.54-2.83]). The frequency of total P-DDIs was 0.31/patient (±0.67) in COVID-19 and 0.40/patient (±0.94) in non-COVID-19 (p=0.022). Hospitalizations in the COVID-19 setting are associated with less use of drugs, less polypharmacy and less P-DDIs. Detectable patients had higher mortality.

Validation of a method to assess the severity of medication administration errors in Brazil.

INTRODUCTION: Medication errors are frequent and have high economic and social impacts; however, some medication errors are more likely to result in harm than others. Therefore, it is critical to determine their severity. Various tools exist to measure and classify the harm associated with medication errors; although, few have been validated internationally. METHODS: We validated an existing method for assessing the potential severity of medication administration errors (MAEs) in Brazil. Thirty healthcare professionals (doctors, nurses and pharmacists) from Brazil were invited to score 50 cases of MAEs as in the original UK study, regarding their potential harm to the patient, on a scale from 0 to 10. Sixteen cases with known harmful outcomes were included to assess the validity of the scoring. To assess test-retest reliability, 10 cases (of the 50) were scored twice. Potential sources of variability in scoring were evaluated, including the occasion on which the scores were given, the scorers, their profession and the interactions among these variables. Data were analysed using generalisability theory. A G coefficient of 0.8 or more was considered reliable, and a Bland-Altman analysis was used to assess test-retest reliability. RESULTS: To obtain a generalisability coefficient of 0.8, a minimum of three judges would need to score each case with their mean score used as an indicator of severity. The method also appeared to be valid, as the judges' assessments were largely in line with the outcomes of the 16 cases with known outcomes. The Bland-Altman analysis showed that the distribution was homogeneous above and below the mean difference for doctors, pharmacists and nurses. CONCLUSION: The results of this study demonstrate the reliability and validity of an existing method of scoring the severity of MAEs for use in the Brazilian health system.

Enseñanza de deportes de colaboración y oposición: análisis comparativo entre metodologías comprensivas y modelo tradicional / Collaborative and opposition sports teaching: comparative analysis between comprehensive methodologies and the traditional model / Ensino colaborativo e de oposição do esporte: análise comparativa entre metodologias integrais e o modelo tradicional

El propósito del estudio fue determinar el efecto que produce la aplicación de una unidad de enseñanza de los deportes de colaboración y oposición diseñada en base a dos propuestas del modelo pedagógico comprensivo: el Teaching Games for Understanding y la Didáctica Cognitiva, en comparación a un modelo tradicional de enseñanza. La muestra estuvo conformada por alumnos(as) de 5° a 8° básicos (12 a 14 años). Mediante metodología observacional, fueron evaluadas las principales acciones de juego eficientes en las dimensiones de ataque y defensa, en momentos de test y retest, a un grupo control (GC) y otro experimental (GE). El análisis de varianza (MANOVA) y las comparaciones por pares con corrección de Bonferroni aplicadas con un alfa de 0.05, evidenciaron diferencias significativas entre ambos grupos, de las acciones motoras de lanzamiento en zona eficaz (GE: 74,3% GC: -16,7%) y Pase simple (GE: -27,1% - GC: -3,1%). Mientras que, mediante el análisis descriptivo de las tasas de ocurrencia, se encontraron diferencias de las acciones motoras de Anticipación (GE:211,1% - GC:20%), marcación eficiente (GE: 330,8% - GC: -7,1%) y desmarcación (GE: 400% - GC: 0%). Los hallazgos de ambos análisis muestran que la aplicación de metodologías comprensivas en la enseñanza de los deportes de colaboración y oposición en el contexto de educación física escolar, mejoran la calidad de las acciones de juego, en comparación a un modelo tradicional de enseñanza.

The purpose of the study was to determine the effect produced by the application of a teaching unit for collaborative and oppositional sports designed on the basis of two proposals of the comprehensive pedagogical model: Teaching Games for Understanding and Cognitive Didactics, compared to a traditional teaching model. The sample consisted of students from 5th to 8th grade (12 to 14 years old). By means of observational methodology, the main efficient game actions in the dimensions of attack and defense were evaluated, in test and retest moments, to a control group (CG) and an experimental group (EG). The analysis of variance (MANOVA) and pairwise comparisons with Bonferroni correction applied with an alpha of 0. 05, showed significant differences between both groups in the motor actions of throwing in the effective zone (EG: 74.3% - CG: -16.7%) and simple passing (EG: -27.1% - CG: -3.1%), while descriptive analysis of the occurrence rates showed differences in the anticipation motor actions (EG: 211.1% - CG: 20%), efficient tackling (EG: 330.8% - CG: -7.1%) and untacking (EG: 400% - CG: 0%). The findings of both analyses show that the application of comprehensive methodologies in the teaching of collaborative and oppositional sports in the context of school physical education improves the quality of the game actions, compared to a traditional teaching model.

O objetivo do estudo foi determinar o efeito produzido pela aplicação de uma unidade de ensino de esportes colaborativos e opostos projetada com base em 2 propostas do modelo pedagógico integral: Jogos de ensino para a compreensão e didática cognitiva, em comparação com um modelo de ensino tradicional. A amostra foi composta por alunos da 5ª à 8ª série (12 a 14 anos). Por meio de metodologia observacional, foram avaliadas as principais ações de jogo eficientes nas dimensões de ataque e defesa, nos momentos de teste e reteste, em um grupo controle (GC) e um grupo experimental (GE). A análise de variância (MANOVA) e as comparações por pares com correção de Bonferroni aplicada com alfa de 0,05, mostraram diferenças significativas entre ambos os grupos, das ações motoras de lançamento na zona efetiva (GE: 74,3% GC: -16,7% ) e passe simples (GE: -27,1% - GC: -3,1%). Já pela análise descritiva das taxas de ocorrência, foram encontradas diferenças nas ações motoras de Antecipação (GE: 211,1% - GC: 20%), marcação eficiente (GE: 330,8% - GC: -7,1%) e desmarcação (GE: 400% - GC: 0%). Os resultados de ambas as análises mostram que a aplicação de metodologias abrangentes no ensino de esportes colaborativos e de oposição no contexto da educação física escolar melhora a qualidade das ações de jogo, em comparação com um modelo de ensino tradicional.

What should we talk about? Contributions from Freirean Thematic Investigation in health education with adolescents.

Adolescence is an essential stage of life for developing actions related to health promotion, especially in health education (HE). Public policies advocate for the expansion of participative technologies in this field, as well as different theoretical and methodological perspectives subsidize these. Among these, Paulo Freire's reference guide is practiced in Brazil and around the world. From the Freirean perspective, Thematic Investigation (TI) defines the content of the educational practice. This paper describes a methodological proposal of the Freirean Thematic Investigation for developing health educational practices and promoting health among adolescents. Initially, we describe the conception of the Freirean rationale that sets the grounds for the proposed method: human being, dialogical education and reality and their connections with HE with adolescents in a critical perspective. The methodological proposal is systematized into five stages: (i) Approaching adolescents and the field of educational practices; (ii) Reading reality; (iii) Seminars for analyzing reality reading and preparing the codifications; (iv) Critical analysis of reality; and (v) Planning educational practices. The TI confronts the adult-centric perspectives that characterize adolescent health care. Moreover, as a praxis, TI is a process of reflection and action with adolescents, allowing for not only the discovery of the themes that build educational practices but also for solutions (untested feasibility) for the individual and collective problems experienced by adolescents concerning their health.

Rutin: Family Farming Products' Extraction Sources, Industrial Applications and Current Trends in Biological Activity Protection.

In vitro and in vivo studies have demonstrated the bioactivity of rutin, a dietary flavonol naturally found in several plant species. Despite widespread knowledge of its numerous health benefits, such as anti-inflammatory, antidiabetic, hepatoprotective and cardiovascular effects, industrial use of rutin is still limited due to its low solubility in aqueous media, the characteristic bitter and astringent taste of phenolic compounds and its susceptibility to degradation during processing. To expand its applications and preserve its biological activity, novel encapsulation systems have been developed. This review presents updated research on the extraction sources and methodologies of rutin from fruit and vegetable products commonly found in a regular diet and grown using family farming approaches. Additionally, this review covers quantitative analysis techniques, encapsulation methods utilizing nanoparticles, colloidal and heterodisperse systems, as well as industrial applications of rutin.