Key Factors Associated With Pulmonary Sequelae in the Follow-Up of Critically Ill COVID-19 Patients

Introduction: Critical COVID-19 survivors have a high risk of respiratory sequelae. Therefore, we aimed to identify key factors associated with altered lung function and CT scan abnormalities at a follow-up visit in a cohort of critical COVID-19 survivors. Methods: Multicenter ambispective observational study in 52 Spanish intensive care units. Up to 1327 PCR-confirmed critical COVID-19 patients had sociodemographic, anthropometric, comorbidity and lifestyle characteristics collected at hospital admission; clinical and biological parameters throughout hospital stay; and, lung function and CT scan at a follow-up visit. Results: The median [p25–p75] time from discharge to follow-up was 3.57 [2.77–4.92] months. Median age was 60 [53–67] years, 27.8% women. The mean (SD) percentage of predicted diffusing lung capacity for carbon monoxide (DLCO) at follow-up was 72.02 (18.33)% predicted, with 66% of patients having DLCO < 80% and 24% having DLCO < 60%. CT scan showed persistent pulmonary infiltrates, fibrotic lesions, and emphysema in 33%, 25% and 6% of patients, respectively. Key variables associated with DLCO < 60% were chronic lung disease (CLD) (OR: 1.86 (1.18–2.92)), duration of invasive mechanical ventilation (IMV) (OR: 1.56 (1.37–1.77)), age (OR [per-1-SD] (95%CI): 1.39 (1.18–1.63)), urea (OR: 1.16 (0.97–1.39)) and estimated glomerular filtration rate at ICU admission (OR: 0.88 (0.73–1.06)). Bacterial pneumonia (1.62 (1.11–2.35)) and duration of ventilation (NIMV (1.23 (1.06–1.42), IMV (1.21 (1.01–1.45)) and prone positioning (1.17 (0.98–1.39)) were associated with fibrotic lesions. Conclusion: Age and CLD, reflecting patients’ baseline vulnerability, and markers of COVID-19 severity, such as duration of IMV and renal failure, were key factors associated with impaired DLCO and CT abnormalities

Effects of pesticides used in soybean crops to the egg parasitoid Trichogramma pretiosum Efeitos dos agroquímicos utilizados na cultura da soja ao parasitóide de ovos Trichogramma pretiosum

This research aimed to study the effects of different insecticides, herbicides and fungicides on eggs, larvae and pupae of Trichogramma pretiosum. The results showed that studied pesticides had different impact on T. pretiosum. Esfenvalerate 7.5 and spinosad 24.0 grams ha-1 were classified as harmfull (class 4) while clorfluazuron 10.0, methoxyfenozide 19.2, lactofen 165.0, fomesafen 250.0, fluazifop 125.0, glyphosate 960.0 (Gliz® and Roundup Transorb®), azoxistrobin + ciproconazol 60.0 + 24.0, azoxistrobin 50.0 and myclobutanil 125.0 grams ha-1 were chemicals classified as harmless to all imature T. pretiosum stages. All the other chemicals evaluated had different impact on T. pretiosum being classified from harmless (class 1) to harmful (class 4) varying the impact accordingly to the different parasitoid stage. Then, less noxious products should be chosen whenever possible to be used in a soybean IPM program.<br>Este trabalho teve como objetivo estudar os efeitos de diferentes inseticidas, herbicidas e fungicidas em ovos, larvas e pupas de Trichogramma pretiosum. Os resultados mostraram que os pesticidas estudados tiveram efeitos diferentes sobre T. pretiosum. Esfenvalerato 7,5 e espinosade 24,0 gramas ha-1 foram classificados como nocivos (classe 4), enquanto que clorfluazurom 10,0, metoxifenozida 19,2, lactofem 165,0, fomesafem 250,0, fluazifope 125,0, glifosato 960,0 (Gliz® e Roundup Transorb®), azoxistrobina + ciproconazole 60,0 + 24,0, azoxistrobina 50,0 e miclobutanil 125,0 gramas ha-1 foram classificados como seletivos (classe 1) para todas as fases imaturas de T. pretiosum. Todos os demais agroquímicos avaliados tiveram diferentes efeitos em T. pretiosum, sendo classificados de seletivo (classe 1) a nocivo (classe 4), variando o impacto de acordo com as diferentes fases do parasitóide. Portanto, produtos menos nocivos aos inimigos naturais devem ser escolhidos, sempre que possível, para serem usados em um programa de MIP-soja

A intervenção do psicólogo em contextos de educação especial na grande Florianópolis The intervention of the psychologist in special education contexts in greater Florianopolis

A educação especial tem sido um contexto de inserção do psicólogo na área educacional. À luz das políticas de inclusão vigentes, a atuação do psicólogo se volta à promoção de práticas educacionais que favoreçam a participação e aprendizado de todos os alunos. A formação de profissionais na área da educação demanda o estudo das necessidades sociais que irão atender. Somente a partir de dados concretos acerca do contexto e das possibilidades de intervenção pode-se identificar os conhecimentos que deverão ser ensinados. Entretanto, são raros os estudos que investigam as formas contemporâneas de intervenção da psicologia na educação especial. Assim, reunir dados sobre essa atuação permite instrumentalizar a reflexão sobre a formação em psicologia educacional. Esse trabalho é resultado de uma pesquisa qualitativa e exploratória que objetivou descrever as características da atuação de psicólogos da Grande Florianópolis vinculados à instituições de educação especial. Os dados foram coletados por meio de entrevistas semiestruturadas. As categorizações foram decorrentes do dialogo estabelecido nas entrevistas e, portanto, constituídas posteriormente. A análise dos dados permitiu verificar a sobreposição das três formas de intervenção que historicamente definiram a atuação do psicólogo nessa área, a saber, a segregação, a integração e a inclusão, sendo o foco principal de atuação centrada no aluno com queixa escolar e/ou com suspeita de deficiência intelectual. Diante disso, conclui-se esse estudo ressaltando a importância dos psicólogos refletirem sobre as implicações das políticas inclusivas para sua prática profissional.<br>In the field of education, special education has been context in which psychologists have a place. In light of the existing inclusion policies, the work of the psychologist has been directed toward promoting educational practices that benefit all students' participation and learning. The training of professionals in this educational area demands studying the social needs that will be encountered. The only way to identify what kinds of knowledge should be taught is to obtain tangible data about the context and the intervention possibilities. Nevertheless, few studies have been carried out to investigate contemporary forms of psychological intervention in special education. Thus, gathering data about this issue contributes as a basis on which to build reflection and understanding for professional preparation in educational psychology. This article is the result of qualitative and exploratory research designed to describe the procedural characteristics of psychologists working in special education institutions in Greater Florianopolis. The data was collected through semi-structured interviews. The categorization was derived from the exchanges established during the interviews and were therefore constituted at a later moment. The data analysis enabled us to perceive an overlap of three intervention forms that historically define the psychologists' procedure in this area, namely, segregation, integration, and inclusion, with the main procedural focus being on the student with a school grievance and/or suspected of having an intellectual disability. Based on these findings, this paper concludes by highlighting the importance of psychologists reflecting on the implications of inclusive policies in their professional practices