(Re) significando o brincar na educação infantil a partir da teoria histórico-cultural

This article results of a research work where we sought to understand and analyze the possible contributions of contemporary international authors from the field of Cultural Historical Theory for Early Childhood Education. Social role play was the object chosen for this approach. The research was characterized by bibliographical analysis based on the production of authors who work with the education of children under 5 years, carrying out investigations in both school and non-school environments. The works of two authors for the significant set of productions were chosen for analysis: Marianne Hedegaard and Marylin Fleer. Two concepts presented by the authors are analyzed in the article: 'activity settings' and 'conceptual play'. Both concepts corroborate to understand the important contribution that social role play has for child development, attributing new meanings to it. Therefore, these concepts are presented and exemplified, aiming to think ways to work with play in the Brazilian Early Childhood Education.El presente artículo resulta de trabajo de investigación donde se buscó aprehender, comprender y analizar las posibles contribuciones de autores contemporáneos internacionales del campo de la Teoría Histórico-cultural para la Educación Infantil. La broma de roles sociales fue el objeto de estudio elegido para este enfoque. La investigación se caracterizó por el análisis bibliográfico a partir de la producción de autores que trabajan con la educación de niños menores de 5 años, que realizan investigaciones en ambientes escolares y no escolares. Los trabajos de dos autores fueron elegidos por el conjunto considerable de sus producciones: Marianne Hedegaard y Marylin Fleer. En el artículo se analizan dos conceptos presentados por las autoras: 'ambientes de actividad' y 'juego conceptual'. Ambos corroboran la comprensión del papel que el juego de roles sociales dispone para el desarrollo infantil, atribuyendo nuevos significados al mismo. Por lo tanto, esos conceptos son presentados y ejemplificados, con el objetivo de pensar caminos para jugar en la Educación infantil brasileña.O presente artigo resulta do trabalho de pesquisa onde buscou-se apreender, compreender e analisar as possíveis contribuições de autores contemporâneos internacionais do campo da Teoria Histórico-cultural para a Educação Infantil. A brincadeira de papéis sociais foi o objeto escolhido para essa aproximação. A pesquisa caracterizou-se pela análise bibliográfica a partir da produção de autores que trabalham com a educação de crianças menores de 5 anos, procedendo investigações tanto em ambientes escolares como não escolares. As obras de duas autoras pelo conjunto significativo de produções foram escolhidas para análise: Marianne Hedegaard e Marylin Fleer. Dois conceitos apresentados pelas autoras são analisados no artigo: ‘ambientes de atividades’ e ‘jogo conceitual’.  Ambos corroboram para a compreensão do papel que a brincadeira de papéis sociais possui para o desenvolvimento infantil, atribuindo novos significados ao mesmo. Portanto, esses conceitos são apresentados e exemplificados, objetivando pensarmos caminhos para o brincar na Educação Infantil brasileira

Parámetros fisicoquímicos y microbiológicos de agua de consumo : en la zona aledaña al cementerio de Minga Guazú, Paraguay, 2018

Los parques cementerios pueden ocasionar problemas de salud pública debido a la contaminación por lixiviados que libera el proceso de descomposición de los cadáveres, éstas sustancias pueden infiltrarse a través del suelo y llegar a los depósitos de agua subterránea de las zonas aledañas. El objetivo de este estudio fue determinar el grado de contaminación microbiológica de las muestras de agua de consumo de viviendas de la zona aledaña al cementerio del Km 16 Minga Guazú a través del análisis de concentración de coliformes fecales y totales, aerobios mesófilos, hongos y levaduras, sulfitos reductores, además de estudios fisicoquímicos. Se aplicó un cuestionario a los pobladores de tales viviendas para obtener los datos de la población y determinar las fuentes de consumo de agua. Las muestras fueron recogidas durante los meses de marzo y abril de 2018. Fueron censadas 44 viviendas alrededor del cementerio, de los cuales 13 contaban con pozo común, la mayoría de éstas viviendas también contaban con agua de una red de distribución pública, del cual se estudió una muestra. Los análisis fisicoquímicos fueron realizados por medio de las técnicas de: medición de pH (con potenciómetro), turbidez (con nefelómetro), conductividad y sólidos disueltos (con conductímetro), alcalinidad total, dureza total, dureza de calcio y magnesio (con titulómetro) y oxígeno disuelto (con electrómetro). Los análisis microbiológicos fueron realizados por medio de las técnicas de filtración por membrana y de cultivos en placas Petrifilm® para la determinación de coliformes totales y fecales, aerobios mesófilos, hongos, levaduras y sulfitos reductores. Las 13 muestras de pozo común presentaron coliformes totales y fecales en cantidades que superan el límite establecido para ser considerada agua potable, pero 1 muestra de la red de distribución estaba libre de coliformes fecales. 9 muestras presentaron un recuento de aerobios mesófilos fuera del rango de valores establecido y 9 presentó sulfitos reductores y una sola muestra presentó valores fuera de lo establecido para hongos y levaduras. Con respecto a los análisis fisicoquímicos, las 14 muestras presentaron valores dentro del rango para pH, sólidos disueltos totales, alcalinidad total, dureza total, Calcio y Magnesio; sin embargo, los 14 presentaron la conductividad fuera de lo establecido. La elevada cantidad de microorganismos encontrados podría deberse a la contaminación por lixiviados lo que podría afectar a la salud de la población si ella utiliza estas aguas para consumo sin tomar las debidas medidas de seguridad.Fil: Amarilla Espínola, José Ariel. Universidad Nacional del Este (Paraguay)Fil: Manera Vuyk, Alessandra Alicia. Universidad Nacional del Este (Paraguay)Fil: Meza Arce, Fabián de Jesús. Universidad Nacional del Este (Paraguay)Fil: Quiñonez Bernal, Rocio María del Carmen. Universidad Nacional del Este (Paraguay)Fil: Silva Falabella, Cristel Concepción. Universidad Nacional del Este (Paraguay)Fil: Rolón Garcete, Carmen Elena. Universidad Nacional del Este (Paraguay)Fil: Mereles Aranda, Eva Fabiana. Universidad Nacional del Este (Paraguay)Fil: Sosa Benegas, Gabriela Rocio. Universidad Nacional del Este (Paraguay)Fil: Galeano, Sunilda. Universidad Nacional del Este (Paraguay)Fil: Samudio Legal, Lisa. Universidad Nacional del Este (Paraguay)Fil: Giménez Ayala, Andrea Elizabeth. Universidad Nacional del Este (Paraguay

Poor Regenerative Outcome after Skeletal Muscle Necrosis Induced by Bothrops asper Venom: Alterations in Microvasculature and Nerves

artículo (arbitrado) -- Universidad de Costa Rica, Instituto de Investigaciones Clodomiro Picado. 2011Background: Viperid snakebite envenoming is characterized by prominent local tissue damage, including muscle necrosis. A frequent outcome of such local pathology is deficient skeletal muscle regeneration, which causes muscle dysfunction, muscle loss and fibrosis, thus provoking permanent sequelae that greatly affect the quality of life of patients. The causes of such poor regenerative outcome of skeletal muscle after viperid snakebites are not fully understood. Methodology/Principal Findings: A murine model of muscle necrosis and regeneration was adapted to study the effects of the venom and isolated toxins of Bothrops asper, the medically most important snake in Central America. Gastrocnemius muscle was injected with either B. asper venom, a myotoxic phospholipase A2 (Mtx), a hemorrhagic metalloproteinase (SVMP), or saline solution. At various time intervals, during one month, tissue samples were collected and analyzed by histology, and by immunocytochemical and immunohistochemical techniques aimed at detecting muscle fibers, collagen, endothelial cells, myoblasts, myotubes, macrophages, TUNEL-positive nuclei, and axons. A successful regenerative response was observed in muscle injected with Mtx, which induces myonecrosis but does not affect the microvasculature. In contrast, poor regeneration, with fibrosis and atrophic fibers, occurred when muscle was injected with venom or SVMP, both of which provoke necrosis, microvascular damage leading to hemorrhage, and poor axonal regeneration. Conclusions/Significance: The deficient skeletal muscle regeneration after injection of B. asper venom is likely to depend on the widespread damage to the microvasculature, which affects the removal of necrotic debris by phagocytes, and the provision of nutrients and oxygen required for regeneration. In addition, deficient axonal regeneration is likely to contribute to the poor regenerative outcome in this model.This study was supported by NeTropica (grant 2-N-2008), by Vicerrectoría de Investigación, Universidad de Costa Rica (project 741-A7-604). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Instituto Clodomiro Picado (ICP

Clinical Perspectives on Using Remote Measurement Technology in Assessing Epilepsy, Multiple Sclerosis, and Depression: Delphi Study

Background: Multiple sclerosis (MS), epilepsy, and depression are chronic central nervous system conditions in which remote measurement technology (RMT) may offer benefits compared with usual assessment. We previously worked with clinicians, patients, and researchers to develop 13 use cases for RMT: 5 in epilepsy (seizure alert, seizure counting, risk scoring, triage support, and trend analysis), 3 in MS (detecting silent progression, detecting depression in MS, and donating data to a biobank), and 5 in depression (detecting trends, reviewing treatment, self-management, comorbid monitoring, and carer alert). Objective: In this study, we aimed to evaluate the use cases and related implementation issues with an expert panel of clinicians external to our project consortium. Methods: We used a Delphi exercise to validate the use cases and suggest a prioritization among them and to ascertain the importance of a variety of implementation issues related to RMT. The expert panel included clinicians from across Europe who were external to the project consortium. The study had 2 survey rounds (n=23 and n=17) and a follow-up interview round (n=9). Data were analyzed for consensus between participants and for stability between survey rounds. The interviews explored the reasons for answers given in the survey. Results: The findings showed high stability between rounds on questions related to specific use cases but lower stability on questions relating to wider issues around the implementation of RMT. Overall, questions on wider issues also had less consensus. All 5 use cases for epilepsy (seizure alert, seizure counting, risk scoring, triage support, and trend analysis) were considered beneficial, with consensus among participants above the a priori threshold for most questions, although use case 3 (risk scoring) was considered less likely to facilitate or catalyze care. There was very little consensus on the benefits of the use cases in MS, although this may have resulted from a higher dropout rate of MS clinicians (50%). Participants agreed that there would be benefits for all 5 of the depression use cases, although fewer questions on use case 4 (triage support) reached consensus agreement than for depression use cases 1 (detecting trends), 2 (reviewing treatment), 3 (self-management), and 5 (carer alert). The qualitative analysis revealed further insights into each use case and generated 8 themes on practical issues related to implementation. Conclusions: Overall, these findings inform the prioritization of use cases for RMT that could be developed in future work, which may include clinical trials, cost-effectiveness studies, and the commercial development of RMT products and services. Priorities for further development include the use of RMT to provide more accurate records of symptoms and treatment response than is currently possible and to provide data that could help inform patient triage and generate timely alerts for patients and carers

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

A search for resonances decaying into a Higgs boson and a new particle X in the XH→qqbb final state with the ATLAS detector

A search for heavy resonances decaying into a Higgs boson ($H$) and a new particle ($X$) is reported, utilizing 36.1 fb$^{-1}$ of proton-proton collision data at $\sqrt{s} =$ 13 TeV collected during 2015 and 2016 with the ATLAS detector at the CERN Large Hadron Collider. The particle $X$ is assumed to decay to a pair of light quarks, and the fully hadronic final state $XH \rightarrow q\bar q'b\bar b$ is analysed. The search considers the regime of high $XH$ resonance masses, where the $X$ and $H$ bosons are both highly Lorentz-boosted and are each reconstructed using a single jet with large radius parameter. A two-dimensional phase space of $XH$ mass versus $X$ mass is scanned for evidence of a signal, over a range of $XH$ resonance mass values between 1 TeV and 4 TeV, and for $X$ particles with masses from 50 GeV to 1000 GeV. All search results are consistent with the expectations for the background due to Standard Model processes, and 95% CL upper limits are set, as a function of $XH$ and $X$ masses, on the production cross-section of the $XH\rightarrow q\bar q'b\bar b$ resonance