Monitoria em introdução a tecnologia assistiva: ampliando o processo de aprendizagem sobre as inovações tecnológicas / Monitoring in introduction to assistive technology: expanding the learning process about technological innovations

A disciplina Introdução a tecnologias assistivas (ITA), possui crédito teórico de 60 horas para o estudo dos principais recursos assistivos. Dentre esses recursos podemos citar:  equipamentos, serviços, estratégias e práticas, que visam auxiliar indivíduos com deficiência, limitação motora, cognitiva e intelectual. O uso da tecnologia assistiva visa preservar a mobilidade e promover autonomia, aumentando a funcionalidade, independência, qualidade de vida e a inclusão social destes indivíduos. Devido aos avanços tecnológicos, tem-se a necessidade de aumentar os níveis de conhecimento dos estudantes de fisioterapia sobre as inovações que estes dispositivos vêm sofrendo com o avanço da medicina moderna. Objetivo:Fornecer e verificar a satisfação dos alunos quanto a materiais sobre os assuntos recorrentes em aulas, e identificar como a tecnologia influencia nestes, além de relatar a experiência na monitoria. Metodologia: O projeto abordou a construção de roteiros das aulas, grupos em redes sociais para melhor comunicação, vídeo chamada para plantão de dúvidas, revisão dos módulos teóricos, visitas virtuais a laboratórios de produtos ortopédicos, suporte ao docente e envio de materiais de inovação tecnológica. O uso de artigos, projetos em andamento e palestras, permitiu abordar novos conceitos com suporte didático direcionado. Os materiais foram elaborados com assuntos que eram ministrados na disciplina, trazendo um olhar tecnológico e inovador a estes. Para avaliar a aplicabilidade e satisfação dos alunos em relação à monitoria e aos materiais disponíveis, foi aplicado um questionário online e anônimo composto por 10 perguntas. Resultados: De acordo com o questionário aplicado, os participantes informaram que procuraram ajuda do monitor de forma remota, e utilizaram os meios de comunicação para tirar dúvidas (grupo no WhatsApp, e vídeo chamadas). Os alunos informaram que discutiram com o monitor para tirar dúvidas sobre os assuntos e atividades propostas, avaliando positivamente a monitoria remota. Quando questionados sobre os materiais disponibilizados pelo monitor, os alunos alegaram que estes apresentavam inovação tecnológica, o que ajudou na compreensão do conteúdo. A monitoria e os materiais propostos para o modelo de aula remoto tiveram um papel importante para a consolidação do conteúdo ministrado, como ferramenta para conhecer novos dispositivos, e novas formas de tecnologia, que auxiliam pessoas com diversos graus de deficiênci

Mudança de decúbito na UTI: uma análise sobre as repercussões hemodinâmicas

A study that aimed to analyze and compare hemodynamic parameters before and after changing position. This is an observational, analytical, cross-sectional study with a quantitative approach, carried out in an intensive care unit. After performing a sample calculation, 27 patients were included in the research who were under continuous hemodynamic monitoring of heart rate, respiratory rate, systolic, diastolic, and mean blood pressure, as well as peripheral oxygen saturation and axillary temperature. There were no statistically significant differences (p> 0.05) in hemodynamic parameters when comparing the pre- and post-change positions. It was concluded that the patients analyzed in the sample did not present hemodynamic repercussions after the change in decubitus, praising this as a safe technique from the hemodynamic point of view and beneficial for the treatment and prevention of health problems of critical patients.Estudo que teve como objetivo analisar e comparar os parâmetros hemodinâmicos antes e após a mudança de decúbito. Trata-se de um estudo observacional, analítico, de delineamento transversal, com abordagem quantitativa, realizado em uma unidade de terapia intensiva. Após realização de cálculo amostral foram inseridos na pesquisa 27 pacientes que estavam sob monitorização hemodinâmica contínua de frequência cardíaca, frequência respiratória, pressão arterial sistólica, diastólica e média, assim como saturação periférica de oxigênio e temperatura axilar. Não foram observadas diferenças estatisticamente significativas (p>0,05) nos parâmetros hemodinâmicos quando comparados os momentos pré e pós-mudança de decúbito. Concluiu-se que os pacientes analisados na amostra não apresentaram repercussões hemodinâmicas após a mudança de decúbito, enaltecendo esta como uma técnica segura do ponto de vista hemodinâmico e benéfica para o tratamento e a prevenção de agravamentos de saúde do paciente crítico

A IMPORTÂNCIA DA ABORDAGEM SOCIOLINGUÍSTICA PARA A FORMAÇÃO DO PROFESSOR DE LÍNGUA PORTUGUESA

O presente trabalho tem por objetivo analisar a formação do professor em que pese sua qualificação profissional para explicar e justificar a questão da variação linguística tanto dentro da sala de aula quanto fora dela. A variação linguística a ser tratada neste texto diz respeito ao Português Padrão e Português Não Padrão, na qual será realizada uma reflexão teórica sobre os cursos de formação de professores tendo como principais sujeitos os assentados de reforma agrária e os professores de Língua Portuguesa. Como resultado é possível inferir que os professores demonstram ter noções sobe as diversidades linguísticas, no entanto, não conseguem explicar e justificar de forma eficiente os fenômenos que correspondem as variedades linguísticas. Desta forma, se na universidade houvesse o estudo da disciplina da Sociolinguística, esta lacuna de conhecimento poderia ser suprida

Prevalence of diabetes-associated gene variants and its association with blood glucose levels in the Algarve population, Portugal

The global rise in incidence of type 2 (T2D) has been called a pandemic, constituting a major public health concern. Although environmental factors play a substantial role in the etiology of T2D, genetic susceptibility has been established as a key component in T2D risk. Given the absence of studies regarding the prevalence of T2D associated variants in the Portuguese population, our aim was to determine the prevalence of disease-associated variants and determine its relative contribution to this phenotype. For this purpose, we have recruited 221 individuals (93 males and 128 females), between 26-91 years old (mean age 57.1), who were enrolled in the Health Centre of S. Brás de Alportel (Algarve). For each participant, we have measured total glucose levels and collected DNA. In addition, each participant has answered an exhaustive questionnaire including socio-demographic information, health history and lifestyle. We have selected and analysed three of the most significant loci previously reported to be associated with T2D in Caucasian populations (TCF7L2 rs7903146, PARPG rs1801282 and FTO rs9939609) and performed an association analysis between glucose levels in this population and the selected gene variants. The mean total population glucose level was 103.85±35.3 g/dl. We found a significant difference in the mean glucose levels between males (mean = 111.5±51.3 g/dl) and females (mean = 98.4±17.6 g/dl) (Mann-Whitney test P < 0.001). The relative allele frequencies of the genotyped variants have been established. Genotype distribution for all investigated SNPs was in Hardy-Weinberg equilibrium. We found a marginal association between glucose levels and genotypes at the TCF7L2 locus (Mann-Whitney test P = 0.045) in females but not in males, with carriers of the T allele displaying higher levels of blood glucose than homozygous for the A allele. This difference is also observed in males, although not reaching significance. No association was found between glucose levels and the other genotyped variants. These results suggest that the pathophysiology of the disease may be different between males and females, or that environmental factors are influencing this trait in males. We are currently investigating the later hypothesis by increasing our sample size and by analysing lifestyle information provided by the participants in order to evaluate gene-environment interactions influencing glucose levels in the Portuguese population.The pilot study of the Portuguese Component of the European Health Examination Survey (EHES) project has received funding from the European Commission/DG Sanco (Agreement number: 20092301 – EHES JA – EAHC). This study has also received funding from the Portuguese Foundation for Science and Technology (FCT) (Project Reference: PTDC/SAU-ESA/101743/2008)

Prevalence of alpha-1 antitrypsin deficiency and hereditary hemochromatosis gene mutations in Algarve, Portugal

Alpha-1 antitrypsin (AAT) deficiency and hereditary hemochromatosis (HH) are two of the most fatal genetic disorders in adult life, affecting million individuals worldwide. They are often under-diagnosed conditions and diagnosis is only made when the patient is already in the advanced stages of damage. AAT deficiency results from mutations in one highly pleiomorphic gene located on chromosome 14, SERPINA 1, being Z and S mutations the most relevant clinically. These mutations will lead to an AAT deficit that compromises the lungs protection, originating emphysema, chronic bronchitis, asthma or even chronic obstructive pulmonary disease (COPD) and it is also strongly associated with various liver diseases. On the other hand, C282Y and H63D mutations in the HFE gene, located on chromosome 6, are reported to be mostly responsible for the iron accumulation in HH disorder, leading to severe damage in different organs. Disease manifestations include cirrhosis, hepatic fibrosis, diabetes mellitus, arthropathy and hepatocarcinoma. Given the insufficient population-based information about the prevalence of these gene variants in the Portuguese population, the aim of this study was to assess their frequency in a representative sample from São Brás de Alportel, in the South of Portugal. To achieve our goal, we have genotyped a total of 208 adult subjects, including 118 females and 90 males (mean age: 58 years, range: 26-91). Regarding AAT deficiency, we found 4,3% MZ, 0,5% SS and 15,4% MS genotypes. The calculated frequency for the Z allele was 2,2% (95% CI: 0-11,7%) and for the S allele was 8,2% (95% CI: 0-17,4%). About HH, we found 1,4% C282Y/H63D, 2,4% H63D/H63D, 5,8% C282Y/N and 23,6% H63D/N genotypes. Frequencies of C282Y and H63D alleles were 3,6% (95% CI: 0-13%) and 14,9% (95% CI: 6-23,8%), respectively. The observed allele frequencies were in Hardy-Weinberg Equilibrium and no association was found with related diseases likely due to the smaller sample available. Our findings show the highest prevalence of Z allele from SERPINA1 gene found, when compared to other populations. The remaining findings are in agreement with previously published studies. Future studies involving a larger sample size will be necessary to evaluate the penetrance of the studied gene mutations and to assess gene-environment interactions that influence disease risk, contributing to reduce the burden of these diseases which can have a great public health impact.The pilot study of the Portuguese Component of the European Health Examination Survey (EHES) project has received funding from the European Commission/DG Sanco (Agreement number: 20092301 – EHES JA – EAHC). This study has also received funding from the Portuguese Foundation for Science and Technology (FCT) (Project Reference: PTDC/SAU-ESA/101743/2008)

Facts related to the collection of biological samples in the National Health Examination Survey - Portuguese Component of the European Health Examination Survey

Abstrat disponível em: http://www.ichg2011.org/cgi-bin/showdetail.pl?absno=11013The objective of the National Health Examination Survey (NHES), which corresponds to the Portuguese component of the European Health Examination Survey (EHES), is to collect health data, related risk factors and biological samples of the Portuguese population, using the EHES recommended methodology. These surveys involve an interview, clinical and physical measurements and blood collection. In this context, we herein describe the pilot study performed in S. Brás de Alportel in the Algarve region. For this pilot study, we have recruited 221 individuals (95 males and 126 females), between 25 and 91 years old, who were enrolled in the Health Centre of S. Brás de Alportel (Algarve). For each participant, we have collected 16.5 ml of total blood, in five different Vacutainer® tubes, which was later processed into serum, plasma and DNA. We have performed several biochemical analyses(total cholesterol, LDL,HDL, glucose, tryglicerides, creatinine, ALT, AST, -GT, CRP and iron) and a complete blood count. From the 221 participants in this pilot study, we were able to collect blood to 219 (99.5%). To 185 of these (84.5%) we were able to collect the total amount of blood. The biochemical analyses were performed in all the samples. The total blood count was performed in 103 samples (47%) due to transport constraints. We have also collected DNA from 210 participants (95.9%). We have created a biobank comprising 1847 serum aliquots and 959 plasma aliquots, which have been stored at - 80°C and 210 DNA aliquots which have been stored at 4°C. In conclusion, during this study, we have optimized the logistics and procedures to perform the large scale study for the NHES and EHES. In addition, we have created a biobank comprising detailed questionnaire data, physical and clinical data and biological samples from a representative sample of S. Brás de Alportel in Algarve, Portugal. This biobank will allow us to perform future studies, including the determination of the prevalence of gene variants of public health interest, the characterization of gene-environment interactions in the development of chronic diseases and the genetic structure of the Portuguese population. The success rate, the quality of the data and of the biological samples was high and comparable to similar studies.Fundação para a Ciência e Tecnologia e European Commission/DG Sanc

Genetic variation at the CY2C19 gene associated with Metabolic Syndrome susceptibility in a South Portuguese population

Metabolic syndrome (MetS) is a cluster of conditions — increased blood pressure, high blood glucose level, excess body fat around the waist and abnormal cholesterol levels — that occur together, increasing the risk of heart disease, stroke and diabetes. In Portugal, the MetS prevalence is estimated to be 27,5% with regional variations, being highest in the Alentejo (30,99%) and lowest in the Algarve (24,42%), constituting a public health problem. Although for clinical settings, a binary definition of MetS enabling a yes or no diagnosis is useful, it is clear that dichotomizing a continuous outcome variable reduces the statistical power of the MetS association studies. Therefore, the aim of the present study is to identify genetic risk factors involved in MetS etiology, using a continuous MetS score. To achieve our goal, a principal component analysis was performed to compute a score using the six normalized risk factors for MetS (waist circumference, diastolic and systolic blood pressure, glucose, triglycerides and HDL blood levels), with a higher MetS score indicating a less favorable MetS profile. After calculating this score, an association study was performed using 37 SNPs in candidate genes involved in MetS related diseases. A total of 206 subjects, including 119 women and 87 men (mean age: 56,31± 16,37 years, range: 26-91 years) were included in this analysis. We found 4 SNPs significantly associated with higher MetS scores (rs4244285 (CYP2C19), rs279871 (GABRA2), rs1647 (NPY) and rs1142345(TPMT)). P-values are 4,36x10-4, 1,3x10-2, 1,7x10-2 and 9,76x10-3 respectively. After correcting for multiple testing only rs4244285 (CYP2C19) remains significant (p=0,016). In addition, we have performed a multiple regression analysis considering the CYP2C19 genotype as the independent variable, adjusted for age. The resulting model explains 17% of the MetS score variance. After adding the remaining SNP genotypes that do not survive the multiple testing correction, the same model is able to explain 23,1% of the score. Our findings support the evidence of an association between CYP2C19 rs4244285 gene polymorphism and the MetS score, emphasizing the importance of lipid metabolism, thought cytochrome P450 enzymes, in the MetS etiology. However, further studies will be necessary to replicate these findings in different populations as well as functional studies to clarify the role of this variant in the etiology of MetS.The pilot study of the Portuguese Component of the European Health Examination Survey (EHES) project has received funding from the European Commission/DG Sanco (Agreement number: 20092301 – EHES JA – EAHC). This study has also received funding from the Portuguese Foundation for Science and Technology (FCT) (Project Reference: PTDC/SAU-ESA/101743/2008)

Violação dos direitos da criança e adolescente: percalços para o trabalho da enfermagem

This study aims to examine the history of complaints of violation of the rights of children and adolescents received by the Child Protection Council Mossoró-RN in 2009 and 2010, and discuss the nursing work against violations. It was used as sources of occurrence reports published by the Child Protection Council. The data was analyzed by the techniques of descriptive statistic using relative and absolute frequencies. Data was presented through graphics and charts that characterize the local situation. The main results indicate the necessity to better understand family relations and the disrespect to the rights of children. To establish public policies to support child we must understand the structure, values, social conditions and relationships that involve the family of children whose rights are violated. With this in mind these factors are identified as mishaps to nursing work, besides the difficulty of recognizing cases and over-capacity of hospitals.O presente estudo visa analisar o histórico das denúncias de violação dos direitos da criança e do adolescente recebidas pelo Conselho Tutelar de Mossoró/RN, no ano de 2009 e 2010, e discutir o trabalho de enfermagem frente as violações. Como fontes foram utilizados os relatórios de ocorrências publicados pelo Conselho Tutelar. Os dados foram analisados pelo emprego das técnicas de estatística descritiva simples utilizando freqüências relativas e absolutas. Os dados foram apresentados através de gráficos e quadros. Os principais resultados apontam à necessidade de se entender melhor as relações familiares e o desrespeito aos direitos da criança. Será necessário entender a estrutura, os valores, as condições sociais e as relações que envolvem as famílias das crianças cujos direitos são violados, para se definirem Políticas Públicas. Identificamse esses fatores como percalços para o trabalho da enfermagem, além da dificuldade de reconhecer os casos, e a super lotação dos hospitais