MOVIMENTO DA DIDÁTICA NA FORMAÇÃO DOCENTE: reverberações de nosso tempo

This article aims to inspire discussions about didactics as a movement in defense of quality teacher education, in the direction of the necessary changes that must occur for the consolidation of practices that may question the environment and thus build alternatives committed to the sovereignty of the people. That said, the study focused on the following question: What is the meaning of didactics in our time? To this end, it was presented as an objective to reflect on the circumstances that involve didactics today in the horizon of teacher education. Methodologically, the research followed the qualitative approach, and the bibliographic study was the method. The theoretical contribution was based on authors such as Candau (2020), Freire (2018; 2019), Marin (2018), Pimenta (2019) and Saviani (2008). Thus, it highlights the need for permanent discussions on pedagogical practices, when considering didactics in the context of critical conception as a way of modifying the current scenario that hinders social transformation.Este artículo tiene como objetivo inspirar discusiones sobre la didáctica como movimiento en defensa de la formación docente de calidad, en la dirección de los cambios necesarios que deben ocurrir para consolidar prácticas que cuestionen el medio ambiente y así construir alternativas comprometidas con la soberanía de los pueblos. Dicho esto, el estudio se centró en la siguiente pregunta: ¿Cuál es el significado de la didáctica en nuestro tiempo? Para ello, se planteó como objetivo reflexionar sobre las circunstancias que envuelven a la didáctica hoy en el horizonte de la formación docente. Metodológicamente, la investigación siguió el enfoque cualitativo y el estudio bibliográfico fue el método. El aporte teórico se basó en autores como Candau (2020), Freire (2018; 2019), Marin (2018), Pimenta (2019) y Saviani (2008). Así, destaca la necesidad de discusiones permanentes sobre las prácticas pedagógicas, al considerar la didáctica en el contexto de la concepción crítica como una forma de modificar el escenario actual que dificulta la transformación social.Este artigo visa a inspirar discussões acerca da didática como movimento em defesa de uma formação docente de qualidade, no rumo das necessárias mudanças que devem ocorrer para a consolidação de práticas que venham a questionar o meio e assim construir alternativas comprometidas com a dignidade do povo. Isto posto, o estudo debruçou-se sobre o seguinte questionamento: Qual o sentido da didática em nosso tempo? Para tanto, apresentou-se como objetivo refletir sobre as circunstâncias que envolvem a didática na atualidade no horizonte da formação docente. Metodologicamente, a pesquisa seguiu a abordagem qualitativa e teve como método o estudo bibliográfico. O aporte teórico baseou-se em autores como Candau (2020), Freire (2018; 2019), Marin (2018), Pimenta (2019) e Saviani (2008). Destarte, realça a necessidade de discussões permanentes sobre as práticas pedagógicas, ao considerar a didática no âmbito da concepção crítica como via de modificar o cenário atual que obstaculiza a transformação social. &nbsp

Genomic epidemiology unveils the dynamics and spatial corridor behind the Yellow Fever virus outbreak in Southern Brazil

Despite the considerable morbidity and mortality of yellow fever virus (YFV) infections in Brazil, our understanding of disease outbreaks is hampered by limited viral genomic data. Here, through a combination of phylogenetic and epidemiological models, we reconstructed the recent transmission history of YFV within different epidemic seasons in Brazil. A suitability index based on the highly domesticated Aedes aegypti was able to capture the seasonality of reported human infections. Spatial modeling revealed spatial hotspots with both past reporting and low vaccination coverage, which coincided with many of the largest urban centers in the Southeast. Phylodynamic analysis unraveled the circulation of three distinct lineages and provided proof of the directionality of a known spatial corridor that connects the endemic North with the extra-Amazonian basin. This study illustrates that genomics linked with eco-epidemiology can provide new insights into the landscape of YFV transmission, augmenting traditional approaches to infectious disease surveillance and control

COMPLICAÇÕES DA DERIVAÇÃO VENTRÍCULO-PERITONEAL EM PACIENTES PEDIÁTRICOS: UMA REVISÃO INTEGRATIVA

Introduction: Hydrocephalus is characterized by the accumulation of cerebrospinal fluid (CSF) in the cerebral ventricular system, leading to increased intracranial pressure and dilatation of the ventricles. In children, it is manifested by irritability, accelerated growth of the head circumference, and signs of intracranial hypertension. Ventriculoperitoneal shunt (PVD) is a common surgical technique for CSF drainage. Objective: To analyze the complications associated with PVD in pediatric patients, identifying risk factors, patterns of occurrence, and clinical outcomes, to improve care and clinical outcomes. Methodology: An integrative review was carried out in consultation with PubMed and SciELO. Descriptors such as "ventriculoperitoneal shunt," "complications," "hydrocephalus," "infection," and "malfunction" were used. Articles from the last five years, in Portuguese and English, addressing complications of PVD were included. Out-of-scope, full-text, and duplicate studies were excluded. A total of 11 articles were selected for analysis. Results: We included 11 articles that highlighted complications such as infections, device malfunctions, obstructions, and abdominal complications. Shunt infections occur in up to 15% of pediatric cases, often within the first 6 to 12 months postoperatively. Distal catheter malfunction is common and requires frequent surgical revisions. Rare complications include abdominal pseudocysts, distal catheter extrusion, and gram-negative bacterial infections, with high rates in the first few days after shunt insertion. Frequent revisions increase the risk of complications. Conclusions: PVD, although effective, has several complications that impact the quality of life of pediatric patients. Infections and system malfunctions are the most common complications. Multidisciplinary management and preventive strategies are essential to optimize clinical outcomes and quality of life for patients.Introducción: La hidrocefalia se caracteriza por la acumulación de líquido cefalorraquídeo (LCR) en el sistema ventricular cerebral, lo que conduce a un aumento de la presión intracraneal y a la dilatación de los ventrículos. En los niños, se manifiesta por irritabilidad, crecimiento acelerado de la circunferencia cefálica y signos de hipertensión intracraneal. La derivación ventriculoperitoneal (PVD, por sus siglas en inglés) es una técnica quirúrgica común para el drenaje del LCR. Objetivo: Analizar las complicaciones asociadas a la EVP en pacientes pediátricos, identificando factores de riesgo, patrones de ocurrencia y resultados clínicos, para mejorar la atención y los resultados clínicos. Metodología: Se realizó una revisión integradora en consulta con PubMed y SciELO. Se utilizaron descriptores como "derivación ventriculoperitoneal", "complicaciones", "hidrocefalia", "infección" y "disfunción". Se incluyeron artículos de los últimos cinco años, en portugués e inglés, que abordaron las complicaciones de la EVP. Se excluyeron los estudios fuera de alcance, de texto completo y duplicados. Se seleccionaron un total de 11 artículos para el análisis. Resultados: Se incluyeron 11 artículos que destacaron complicaciones como infecciones, mal funcionamiento del dispositivo, obstrucciones y complicaciones abdominales. Las infecciones por derivación ocurren hasta en el 15% de los casos pediátricos, a menudo dentro de los primeros 6 a 12 meses después de la operación. El mal funcionamiento del catéter distal es común y requiere revisiones quirúrgicas frecuentes. Las complicaciones raras incluyen pseudoquistes abdominales, extrusión de catéter distal e infecciones bacterianas gramnegativas, con tasas altas en los primeros días después de la inserción de la derivación. Las revisiones frecuentes aumentan el riesgo de complicaciones. Conclusiones: La EVP, aunque efectiva, tiene varias complicaciones que impactan en la calidad de vida de los pacientes pediátricos. Las infecciones y el mal funcionamiento del sistema son las complicaciones más comunes. El manejo multidisciplinario y las estrategias preventivas son esenciales para optimizar los resultados clínicos y la calidad de vida de los pacientes.Introdução: A hidrocefalia é caracterizada pelo acúmulo de líquido cefalorraquidiano (LCR) no sistema ventricular cerebral, levando ao aumento da pressão intracraniana e dilatação dos ventrículos. Em crianças, manifesta-se por irritabilidade, crescimento acelerado do perímetro cefálico e sinais de hipertensão intracraniana. A derivação ventrículo-peritoneal (DVP) é uma técnica cirúrgica comum para drenagem do LCR. Objetivo: Analisar as complicações associadas à DVP em pacientes pediátricos, identificando fatores de risco, padrões de ocorrência e desfechos clínicos, para melhorar os cuidados e resultados clínicos. Metodologia: Realizou-se uma revisão integrativa consultando PubMed e SciELO. Utilizaram-se descritores como "ventriculoperitoneal shunt," "complications," "hydrocephalus," "infection," e "malfunction". Foram incluídos artigos dos últimos cinco anos, em português e inglês, abordando complicações da DVP. Excluíram-se estudos fora do escopo, não disponíveis em texto completo e duplicados. Selecionaram-se 11 artigos para análise. Resultados: Foram integrados 11 artigos que destacaram complicações como infecções, mau funcionamento do dispositivo, obstruções e complicações abdominais. Infecções de shunt ocorrem em até 15% dos casos pediátricos, frequentemente nos primeiros 6 a 12 meses pós-cirurgia. O mau funcionamento do cateter distal é comum e requer revisões cirúrgicas frequentes. Complicações raras incluem pseudocistos abdominais, extrusão distal do cateter e infecções bacterianas gram-negativas, com altas taxas nos primeiros dias após a inserção do shunt. Revisões frequentes aumentam o risco de complicações. Conclusões: A DVP, embora eficaz, apresenta várias complicações que impactam a qualidade de vida dos pacientes pediátricos. Infecções e mau funcionamento do sistema são as complicações mais comuns. A gestão multidisciplinar e estratégias preventivas são essenciais para otimizar os resultados clínicos e a qualidade de vida dos pacientes

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

Characterization of Publications on Burns in Brazil and Changes Resulting from Trauma in Brazil: Systematic Review of the Literature

Objective: Characterize the profile of scientific publications on burns in Brazil and systemic changes resulting from the trauma. Methods and results: This is a bibliographical, retrospective and descriptive research with a quantitative approach. It was held between April and May, 2016 in the databases Latin American and Caribbean Center on Health Sciences (LILACS); Nursing Database (BDENF); Medical Literature Analysis and Retrieval System Online (MEDLINE), Scientific Electronic Library Online (SciELO) and the Journal Portal of Higher Education Personnel Improvement Coordination (CAPES). After the analysis of the inclusion criteria (articles available in full, in Portuguese, published between 2011 and 2015), there were 49 productions, and 16 were selected. Analyzing the sample for the event characteristics, it was observed a higher incidence of accidents in males. The main causes of burns were heated by liquid, followed by direct flame. Regarding the classification, the most frequent injury was the 2nd degree, but also there were burns reports with mixed classification. Also, the upper limbs and trunk were the body parts most affected. In addition to these data, it was also highlighted the most frequent types of systemic changes caused by burns, which were respiratory complications, infection and/or sepsis and metabolic sequels.  Conclusion: The study showed the need to characterize of the publications in burns, since the crossing of this information provides a better understanding of the main causal factors, distribution and identification of risk groups. It also enables the planning of prevention strategies to help to reduce accidents, favoring the reduction of injuries and the number of hospitalizations. Moreover, it is extremely important that health professionals know about the epidemiological profile, to provide support in the evaluation and organization of care, and to prevention campaigns, aiming to decrease burn rates. Keywords: Profile; Burns; Burn Units

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