Curso de culinária profissional e segurança alimentar em um estabelecimento prisional de criciúma – sc

Este projeto de extensão visa acabar com a ociosidade das apenadas, bem como criar alternativa de retorno à sociedade e ao mercado de trabalho com uma qualificação profissional. Realiza aulas práticas e teóricas sobre culinária e boas práticas de manipulação de alimentos conforme estabelece a ANVISA (Agência Nacional de Vigilância Sanitária) através da resolução RDC n.º 216/2004 (BRASIL, 2004). O objetivo é capacitar as reeducandas e fornecer as ferramentas necessárias para o bom desempenho no mercado de trabalho como cozinheiras ou auxiliares de cozinha, qualificando-as para trabalhar em unidades de alimentação e nutrição comerciais ou institucionais. Participam 10 alunas por turma no primeiro e no segundo semestre do ano, respectivamente, totalizando 20 alunas anuais com carga horária de 51 horas por turma, divididas em aulas práticas e teóricas ministradas 2 vezes/semana. O projeto teve início no ano de 2011, e até 2015 foram oito turmas formadas, totalizando 80 alunas qualificadas. As reeducandas mesmo estando dentro do estabelecimento carcerário conseguem pôr em prática os conhecimentos adquiridos. Atualmente são servidas em média oitocentas refeições para detentos e agentes. Dentre as ações colocadas em prática pode-se citar a maneira adequada e o aumento da frequência que lavam as mãos durante as atividades, o não uso de adornos e maquiagem durante a preparação das refeições, separação de utensílios para cada tipo de alimento (crus e cozidos), preocupação com a higiene do local, utensílios e equipamentos; utilização de solução clorada para higienização de hortaliças, vegetais e frutas; inclusão de novas preparações no cardápio, melhor aceitabilidade das refeições servidas e menos desperdício de alimentos. Pôde-se promover segurança alimentar no presídio, diminuir a ociosidade, além de qualificar profissionalmente as apenadas e oportunizar a inclusão das mesmas no mercado de trabalho.Palavras-chave: Curso de Culinária; Boas Práticas de Manipulação; Segurança Alimentar; Presídio

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Resumos concluídos - Neurociências

Resumos concluídos - Neurociência

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.13Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt