Educação inclusiva: um estudo de caso sobre o trabalho docente na educação infantil

A educação inclusiva é apoiada pela legislação brasileira, na qual se garante o acesso educacional de todos os educandos. Neste sentido, torna-se necessário observar desde o início, com a Educação Infantil, quais são as ações educativas que estão sendo realizadas para garantir o direito dos alunos PAEE. Deste modo, este estudo de caso teve como objetivo verificar com se dá o trabalho pedagógico com alunos PAEE em uma sala de aula comum na educação infantil. Participou do estudo uma professora da rede regular de ensino da etapa de educação infantil. A coleta dos dados ocorreu em uma escola de uma cidade do interior do estado de São Paulo. Para alcançar o objetivo proposto, a participante respondeu a um roteiro semiestruturado de questões por meio da técnica de entrevista que abordou dados de identificação e quatro eixos temáticos, sendo eles: Informações sobre o aluno PAEE; Trabalho docente; Escola e Família e Educação Inclusiva. Foram realizadas análises qualitativas por eixos temáticos com os dados obtidos por meio das entrevistas. Como resultado, constatou-se a realização de um trabalho pedagógico voltado à inclusão de sua aluna, assim como a necessidade de maior colaboração entre os profissionais da escola e maior participação por parte da família

A prática pedagógica no atendimento educacional especializado para o aluno com deficiência intelectual

The Specialized Educational Service - AEE is geared towards meeting the needs of students with disabilities at times opposite to regular school classes. The present study aimed to describe the pedagogical practice of a special education teacher to develop the logical-mathematical thinking of students with intellectual disabilities in a specialized support room - AEE of a state school in a city in the interior of São Paulo. It is a qualitative, descriptive and exploratory study, characterized by a case study. For data collection, the following instruments were used: open interview and participant observation. The results showed that the teacher's pedagogical practice is focused on the teacher/student relationship, on social interaction and on stimulating learning, aiming at building knowledge to overcome difficulties.El Servicio Educativo Especializado - AEE está orientado a satisfacer las necesidades de los estudiantes con discapacidades en momentos opuestos a las clases escolares regulares. El presente estudio tuvo como objetivo describir la práctica pedagógica de un maestro de educación especial para desarrollar el pensamiento lógico-matemático de los estudiantes con discapacidad intelectual en una sala de apoyo especializada: AEE de una escuela estatal en una ciudad del interior de São Paulo. Es un estudio cualitativo, descriptivo y exploratorio, caracterizado por un estudio de caso. Para la recopilación de datos, se utilizaron los siguientes instrumentos: entrevista abierta y observación participante. Los resultados mostraron que la práctica pedagógica del profesor se centra en la relación profesor/alumno, en la interacción social y en el aprendizaje estimulante, con el objetivo de construir conocimiento para superar las dificultades.O Atendimento Educacional Especializado – AEE está voltado para atender as necessidades dos alunos com deficiência em horários opostos aos das aulas do ensino regular. O presente estudo teve por objetivo descrever a prática pedagógica de uma professora de educação especial para desenvolver o pensamento lógico-matemático dos alunos com deficiência intelectual em uma sala de apoio especializado – AEE de uma escola estadual de uma cidade do interior paulista. Trata-se de um estudo qualitativo, de cunho descritivo e exploratório, caracterizando-se por um estudo de caso. Para coleta de dados utilizou-se os seguintes instrumentos: entrevista aberta e observação participante. Os resultados apontaram que a prática pedagógica da professora está voltada para a relação professor/aluno, na interação social e na estimulação do aprendizado, visando a construção do conhecimento para a superação das dificuldades

Immunohistochemical expression of E-cadherin and beta-catenin in ameloblastomas and tooth germs

OBJECTIVE: The aim was to analyze the expression of E-cadherin and beta-catenin in ameloblastomas and tooth germs to determine their roles in cell differentiation processes and invasiveness compared with odontogenesis. STUDY DESIGN: Twenty-one ameloblastoma cases (16 solid and 5 unicystic tumors) and 5 tooth germs were submitted to the immunohistochemical detection of E-cadherin and beta-catenin. Immunoreactivity was evaluated using descriptive and semiquantitative analysis, investigating the location and intensity of staining. The Fisher exact test was performed, and P values of <.05 were considered to indicate statistical significance. RESULTS: There was no statistically significant difference in the expression of E-cadherin and beta-catenin between solid and unicystic ameloblastomas (P = .59; P = .63; respectively). The same was found when comparing solid and unicystic ameloblastomas with the tooth germs for both E-cadherin (P = .53; P = .44; respectively) and beta-catenin (P = .12; P = .16; respectively). Nuclear staining of beta-catenin was observed in only 4 cases (3 solid and 1 unicystic tumor). CONCLUSION: The results showed no differences in the expression of E-cadherin or beta-catenin between tooth germs and solid and unicystic ameloblastomas. The expression of these molecules seems mainly to be related to the process of cell differentiation

GUILLAIN-BARRÉ SYNDROME AND TRANSVERSE MYELITIS WITH ANTI-SSA AND FAN POSITIVES POST-VACCINATION AGAINST H1N1

&nbsp; A Síndrome de Guillain-Barré (SGB) caracteriza-se por uma neuropatia periférica inflamatória adquirida aguda associada à hiperproteinorraquia enquanto a Mielite Transversa (MT) é uma inflamação&nbsp;da medula espinal que compromete toda a secção transversal medular ou se estende ao longo de três corpos vertebrais rostrocaudalmente.&nbsp;O presente artigo descreve o caso de uma paciente de 57 anos que deu entrada no pronto-socorro com quadro de paraparesia flácida e parestésica em membros inferiores e membros superiores e que evoluiu com nível sensitivo em T4 associado a FAN: 1:320 com padrão nuclear pontilhado fino, ANTI-SSA: 240 e eletroforese de proteínas com fração gama aumentada após 15 dias&nbsp;de vacinação contra o vírus H1N1.&nbsp;O diagnóstico&nbsp;de SGB foi confirmado com base em quadro clínico, análise de líquor&nbsp;e eletroneumiografia instituindo-se tratamento com imunoglobulina humana IV por 5 dias. A MT simultânea ao quadro&nbsp;foi corroborada com quadro clínico&nbsp;e exames de imagem&nbsp;sendo&nbsp;realizado pulsoterapia com metilprednisolona por 5 dias e ciclofosfamida. Hipóteses diagnósticas de Lúpus Eritematoso Sistêmico (LES) e Síndrome de Sjögren (SS) foram levantadas porém não foram confirmadas devido à incompatibilidade de dados clínicos e laboratoriais. A paciente evoluiu com melhora parcial do quadro dentro do esperado. Uma revisão da literatura constatou um relato de caso semelhante no qual foi&nbsp;observado evidência sorológica IgM&nbsp;para o Vírus Caxumba, contudo, tal fato não foi observado no presente relato.Guillain-Barré Syndrome (GBS) is characterized by acute acquired peripheral inflammatory neuropathy associated with hyperproteinrachia, whereas Transverse Myelitis (TM) is an inflammation of the entire cross section or is longitudinally extensive along three vertebral body segments rostrocaudally. The article describes a case of a 57-year-old female patient who was admitted to the emergency room with flaccid paraparesis and paresthesia in upper and lower extremities and developed a sensory T4 level with positive ANF: 1:320 with fine nuclear dot pattern, ANTI-SSA: 240 and protein electrophoresis showing hypergammaglobulinemia, 15 days post H1N1 vaccination. The diagnosis of GBS was confirmed based on clinical status, cerebrospinal fluid analysis and electroencephalography and treated with human immunoglobulin IV for 5 days; the TM was corroborated with patient clinical condition and imaging tests and pulse therapy was performed along with methylprednisolone for 5 days and cyclophosphamide. Diagnostic hypotheses of Systemic Lupus Erythematosus (SLE) and Sjögren's Syndrome (SS) were raised but not confirmed due to the incompatibility of clinical and laboratory data. The patient evolved with partial improvement of the clinical condition as expected. A review of the literature found a similar case in which IgM serological evidence for the Mumps Virus was observed, however, this was not observed in the present report

A IMPORTÂNCIA DA EQUIPE MULTIDISCIPLINAR NA REABILITAÇÃO DE PACIENTES CRÍTICOS: AVALIANDO A COLABORAÇÃO ENTRE PROFISSIONAIS DE SAÚDE NA REABILITAÇÃO DE PACIENTES DE UTI

The rehabilitation of critically ill patients in the Intensive Care Unit (ICU) requires a multidisciplinary approach, bringing together intensivist physicians, physiotherapists, nurses, psychologists, occupational therapists, and speech therapists. This collaboration is essential to provide holistic care, going beyond medical treatment. Coordination led by intensivist physicians, along with physiotherapists, nurses, and mental health professionals, plays a crucial role in early mobilization, preserving muscle and respiratory function, psychosocial assessment, and patient reintegration. Effective communication among these professionals is vital to optimize outcomes, reduce complications, and improve the patient's quality of life. This integrated approach not only enhances the patient experience but also reduces ICU stay duration, lowers mortality rates, and promotes quicker recovery post-discharge. The combined efforts of the multidisciplinary team highlight the importance of a holistic approach, integrating psychological, spiritual, and familial aspects. Efficient communication humanizes care and prevents hospital errors. Collaboration among healthcare professionals, focusing on a multidisciplinary approach, is crucial to providing a comprehensive and high-quality care plan for critically ill patients in the ICU, representing a significant advancement in healthcare services for this group.A reabilitação de pacientes críticos na Unidade de Terapia Intensiva (UTI) exige uma abordagem multidisciplinar, unindo médicos intensivistas, fisioterapeutas, enfermeiros, psicólogos, terapeutas ocupacionais e fonoaudiólogos. Essa colaboração é essencial para oferecer cuidados holísticos, indo além do tratamento médico. A coordenação liderada pelos médicos intensivistas, junto aos fisioterapeutas, enfermeiros e profissionais de saúde mental, desempenha papel crucial na mobilização precoce, preservação da função muscular e respiratória, avaliação psicossocial e reintegração do paciente. A comunicação eficaz entre esses profissionais é vital para otimizar os resultados, reduzir complicações e melhorar a qualidade de vida do paciente. Essa abordagem integrada não só melhora a experiência do paciente, mas também reduz o tempo de internação na UTI, diminui a taxa de mortalidade e promove uma recuperação mais rápida após a alta. A atuação conjunta da equipe multidisciplinar destaca a importância da abordagem holística, integrando aspectos psicológicos, espirituais e familiares. A comunicação eficiente humaniza o cuidado e evita erros hospitalares. A colaboração entre os profissionais de saúde, com foco na abordagem multidisciplinar, é crucial para proporcionar um plano de cuidados completo e de alta qualidade aos pacientes críticos na UTI, representando um avanço significativo nos serviços de saúde para esse grupo

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

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 &lt;= 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

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Educação inclusiva: um estudo de caso sobre o trabalho docente na educação infantil

A educação inclusiva é apoiada pela legislação brasileira, na qual se garante o acesso educacional de todos os educandos. Neste sentido, torna-se necessário observar desde o início, com a Educação Infantil, quais são as ações educativas que estão sendo realizadas para garantir o direito dos alunos PAEE. Deste modo, este estudo de caso teve como objetivo verificar com se dá o trabalho pedagógico com alunos PAEE em uma sala de aula comum na educação infantil. Participou do estudo uma professora da rede regular de ensino da etapa de educação infantil. A coleta dos dados ocorreu em uma escola de uma cidade do interior do estado de São Paulo. Para alcançar o objetivo proposto, a participante respondeu a um roteiro semiestruturado de questões por meio da técnica de entrevista que abordou dados de identificação e quatro eixos temáticos, sendo eles: Informações sobre o aluno PAEE; Trabalho docente; Escola e Família e Educação Inclusiva. Foram realizadas análises qualitativas por eixos temáticos com os dados obtidos por meio das entrevistas. Como resultado, constatou-se a realização de um trabalho pedagógico voltado à inclusão de sua aluna, assim como a necessidade de maior colaboração entre os profissionais da escola e maior participação por parte da família