A CONSTRUÇÃO DO CONHECIMENTO MEDIADA PELO TUTOR PRESENCIAL

Esse estudo tem por objetivo identificar a contribuição dos tutores presenciais do polo de apoio presencial da Palhoça do curso de Administração da Universidade Federal de Santa Catarina no processo de criação do conhecimento. Quanto aos procedimentos metodológicos a presente pesquisa pode ser classificada como qualitativa, descritiva, estudo de caso e bibliográfica. Como resultados pode-se destacar que o acompanhamento efetivo do tutor presencial, desde o momento da socialização até a internalização do conhecimento é de suma importância para a criação do conhecimento dos alunos. Destaca-se o papel do tutor no estímulo ao uso das ferramentas tecnológicas e no incentivo a participação atuante dos alunos no processo de aprendizagem. Constatou-se que a mediação do tutor no processo de criação do conhecimento contribuiu para o aumento da participação dos alunos nas atividades do polo de apoio presencial, bem como na melhoria dos índices de aproveitamento

The CNIC-Polypill reduces recurrent major cardiovascular events in real-life secondary prevention patients in Spain: The NEPTUNO study.

To evaluate the effectiveness of a cardiovascular polypill including aspirin, ramipril and atorvastatin (CNIC-Polypill), on the incidence of recurrent major cardiovascular events (MACE) and risk factor control in patients with established atherosclerotic cardiovascular disease (ASCVD) vs different pharmacological therapeutic strategies. Retrospective, observational study using data from electronic-health records. Patients were distributed into 4 different cohorts: CNIC-Polypill (case cohort) vs 3 control cohorts: same monocomponents taken separately (Monocomponents), equipotent drugs (Equipotent) and other drugs not included in the previous cohorts (Other therapies). Patients were followed for 2 years or until MACE or death. After propensity score matching, a total of 6456 patients (1614 patients per cohort) were analysed. After 2 years, the risk of recurrent MACE was lower in the CNIC-Polypill cohort compared to the control groups (22%; p = 0.017, 25%; p = 0.002, 27%; p = 0.001, higher in the Monocomponents, Equipotent and Other therapies cohorts, respectively). The incremental proportion of patients who achieved blood pressure (BP) and low-density lipoprotein cholesterol (LDLc) control from baseline was higher in the CNIC-Polypill cohort vs control cohorts (BP controlled patients: +12.5% vs + 6.3%; p < 0.05, +2.2%; p < 0.01, +2.4%; p < 0.01, LDLc controlled patients: +10.3% vs + 4.9%; p < 0.001, +5.7%; p < 0.001, +4.9%; p < 0.001, respectively). Medication persistence was higher in patients treated with the CNIC-Polypill (72.1% vs 62.2%, 60.0% and 54.2%, respectively; p < 0.001) at study end. In secondary prevention patients, compared with control groups, treatment with the CNIC-Polypill was associated with significant reductions in the accumulated incidence of recurrent MACE, improved BP and LDLc control rates, and increased medication persistence.FerrerS

Educação a Distância: uma Análise sobre o Programa Nacional de Formação Docente UAB.

Com o advento das novas tecnologias e suas múltiplas possibilidades de uso, verifica-se que várias instituições estão começando a ofertar programas educacionais a distância. A UFSC é uma das instituições que aderiram ao ensino a distância com o incentivo de um projeto da UAB, a partir de 2005. Para preparar os professores para esta nova realidade, foi criado o Programa Nacional de Formação da UAB, uma parceria entre a UFSC e a UFSM. Este programa tem como objetivo capacitar professores e servidores técnico-administrativos para atuarem nos programas de EaD das Instituições Federais de Ensino Superior da região Sul. Quanto aos procedimentos metodológicos, a pesquisa classifica-se como aplicada com base qualitativa, descritiva, estudo de caso, com coleta de dados documental, bibliográfica e por meio de entrevistas semi-estruturadas. Os resultados do estudo indicam que o programa de capacitação pretende discutir e estabelecer políticas e práticas educacionais, constituindo uma identidade nacional, respeitadas as peculiaridades regionais para a modalidade a distância. O curso está previsto em dois momentos, um presencial e outro a distância. Observa-se que não há um modelo a seguir e, portanto, o mesmo possui algumas dificuldades inerentes, principalmente, à falta de experiência, que estão sendo superadas à medida que aparecem

Iniciativas para el desarrollo sostenible del Área de Conservación Arenal- Huetar Norte, Costa Rica

El presente proyecto tiene como zona de estudio el Área de Conservación Arenal- Huetar Norte (ACA-HN), concretamente los cantones de Upala, Los Chiles y Guatuso. El propósito del proyecto es promover el desarrollo sostenible de la zona mediante los pilares de la educación y la economía. Para ello se elabora un manual de educación ambiental de la cuenca de río Frío y así poder solventar algunas de las carencias en educación que tienen los docentes de las escuelas de la cuenca hidrográfica. Por otro lado, se diagnostica la cadena de valor sobre usos alternativos de la biodiversidad, específicamente zoocriaderos de mariposas diurnas, en los cantones de Upala y Los Chiles. Por último, se trata la información de la zona de estudio con Sistemas de Información Geográfica (SIG) para elaborar mapas que ilustren los proyectos anteriores y el proyecto sobre el diagnóstico de la industria de turismo local.El present projecte té com a zona d'estudi "el Área de Conservación Arenal-Huetar Norte" (ACA-HN), concretament els cantons de "Upala, Los Chiles" i "Guatuso". El propòsit del projecte és promoure el desenvolupament sostenible de la zona mitjançant els pilars de l'educació i l'economia. Per aquest motiu, es realitza un manual d'educació ambiental de la conca de "río Frío" per a poder resoldre algunes de les mancances en educació que presenten els docents de les escoles de la conca hidrogràfica. D'altra banda, es diagnostica la cadena de valor sobre usos alternatius de la biodiversitat, específicament de les granges de papallones diürnes, en els cantons de "Upala" i "Los Chiles". Per últim, es tracta la informació de la zona d'estudi amb Sistemes d'Informació Geogràfica (SIG) per elaborar mapes que il·lustrin els projectes anteriors i el projecte sobre el diagnòstic de la indústria de turisme local.The Project study area is "Área de Conservación Arenal-Huetar Norte (ACA-HN)", specifically "Upala", "Los Chiles" and "Guatuso" municipalities. The main goal is to promote sustainable development through education and economy aspects. In order to solve some of the teachers education lacks, it is made an environmental handbook about "río Frío" basin. On the other hand, is diagnosed the value chain about alternative biodiversity uses, specifically butterflies farms, in "Upala" and "Los Chiles". Finally, the study area information is used with Geographical Information Systems (GIS) to elaborate maps that illustrate the previous projects and the local industry diagnostic project

Economic Burden Associated with the Treatment with a Cardiovascular Polypill in Secondary Prevention in Spain: Cost-Effectiveness Results of the NEPTUNO Study.

PURPOSE The aim of this study was to estimate health-care resources utilization, costs and cost-effectiveness associated with the treatment with CNIC-Polypill as secondary prevention of atherosclerotic cardiovascular disease (ASCVD) compared to other treatments, in clinical practice in Spain. PATIENTS AND METHODS An observational, retrospective study was performed using medical records (economic results [healthcare perspective], NEPTUNO-study; BIG-PAC-database) of patients who initiated secondary prevention between 2015 and 2018. Patients were followed up to 2 years (maximum). Four cohorts were balanced with a propensity-score-matching (PSM): 1) CNIC-Polypill (aspirin+atorvastatin+ramipril), 2) Monocomponents (same separate drugs), 3) Equipotent (equipotent drugs) and 4) Other therapies ([OT], other cardiovascular drugs). Incidence of cardiovascular events, health-care resources utilization and healthcare and non-healthcare costs (2020 Euros) were compared. Incremental cost-effectiveness ratios per cardiovascular event avoided were estimated. RESULTS After PSM, 1614 patients were recruited in each study cohort. The accumulated incidence of cardiovascular events during the 24-month follow-up was lower in the CNIC-Polypill cohort vs the other cohorts (19.8% vs Monocomponents: 23.3%, Equipotent: 25.5% and OT: 26.8%; p<0.01). During the follow-up period, the CNIC-Polypill cohort also reduced the health-care resources utilization per patient compared to the other cohorts, particularly primary care visits (16.6 vs Monocomponents: 18.7, Equipotent: 18.9 and OT: 21.0; p<0.001) and hospitalization days (2.3 vs Monocomponents: 3.4, Equipotent: 3.7 and OT: 4.0; p<0.001). The treatment cost in the CNIC-Polypill cohort was lower than that in the other cohorts (€4668 vs Monocomponents: €5587; Equipotent: €5682 and OT: €6016; p<0.001) (Difference: -€919, -€1014 and -€1348, respectively). Due to the reduction of cardiovascular events and costs, the CNIC-Polypill is a dominant alternative compared to the other treatments. CONCLUSION CNIC-Polypill reduces recurrent major cardiovascular events and costs, being a cost-saving strategy as secondary prevention of ASCVD.This study was funded by Ferrer.S

Disección del septo interventricular como complicación de endocarditis aórtica

oai:ojs.imagenretic.org:article/5We report a case of infective aortic endocarditis complicated with perivalvular pseudoaneurysm diseccting perimembranous ventricular septum. This clinical case is a good example of 3D-echocardiography and cardiac-CT usefulness in anatomic and functional assessment of infective endocarditis complications.Se trata de un caso de endocarditis aórtica infecciosa complicada con un pseudoaneurisma perivalvular que se extiende disecando la porción perimembranosa del septo interventricular. Este caso clínico constituye un claro ejemplo de la utilidad de la ecocardiografía tridimensional y la cardio-TC en la valoración anatómica y funcional de las complicaciones de la endocarditis infecciosa

Indicadores de calidad en cardiología. Principales indicadores para medir la calidad de los resultados (indicadores de resultados) y parámetros de calidad relacionados con mejores resultados en la práctica clínica (indicadores de práctica asistencial). INCARDIO (Indicadores de Calidad en Unidades Asistenciales del Área del Corazón): Declaración de posicionamiento de consenso de SEC/SECTCV

ResumenLa práctica clínica cardiológica requiere una organización compleja que influya en los resultados globales y puede diferir sustancialmente entre distintos hospitales y comunidades. El objetivo de este documento de consenso es definir indicadores de calidad en cardiología, incluidos los indicadores para medir la calidad de los resultados (indicadores de resultados) y los parámetros de calidad relacionados con mejores resultados en la práctica clínica (indicadores de práctica asistencial). El documento está destinado principalmente al sistema de asistencia sanitaria de España y puede servir de base para documentos similares en otros países.AbstractCardiology practice requires complex organization that impacts overall outcomes and may differ substantially among hospitals and communities. The aim of this consensus document is to define quality markers in cardiology, including markers to measure the quality of results (outcomes metrics) and quality measures related to better results in clinical practice (performance metrics). The document is mainly intended for the Spanish health care system and may serve as a basis for similar documents in othe rcountries

Mortality Attributable to Environmental Tobacco Smoke Exposure in Spain in 2020

Introduction and objectives: Exposure to environmental tobacco smoke (ETS) is associated with increased mortality and morbidity. The objective of this study was to estimate the impact of ETS exposure in Spain on mortality in 2020 in the population aged 35 years and over. Methods: A method of estimating attributable mortality (AM) based on the prevalence of ETS exposure was applied. Prevalence data were obtained from a representative study conducted in Spain and the relative risks were derived from a meta-analysis. AM point estimates are presented along with 95% confidence intervals (95% CI), calculated using a bootstrap naive procedure. AM, both overall and by smoking habit, was estimated for each combination of sex, age group, and cause of death (lung cancer and ischemic heart disease). A sensitivity analysis was performed. Results: A total of 747 (95% CI 676–825) deaths were attributable to ETS exposure, of which 279 (95% CI 256–306) were caused by lung cancer, and 468 (95% CI 417–523) by ischemic heart disease. Three quarters (75.1%) of AM occurred in men and 60.9% in non-smokers. When chronic obstructive pulmonary disease and cerebrovascular disease are included, the burden of AM is estimated at 2242 deaths. Conclusions: ETS exposure is associated with 1.5% of all deaths from lung cancer and ischemic heart disease in the population aged 35 and over. These data underline the need for health authorities to focus on reducing exposure to ETS in all settings and environmentsInstituto de Salud Carlos III (ISCIII), reference: PI22/00727, co-funded by the European UnionS

Elaboração do livro-texto: o caso do Programa Nacional de Formação em Administração Pública

Este estudo tem como objetivo construir o mapa conceitual da produção do livro-texto do Programa Nacional de Formação em Administração Pública - PNAP e identificar a equipe envolvida no processo. O estudo é caracterizado como exploratório, descritivo, estudo de caso, com caráter bibliográfico e qualitativo. A partir dos fundamentos teóricos referentes à Educação a Distância e mapas conceituais associado a análise prática do processo existente no PNAP, construiu-se o mapa conceitual.  Esta construção contribuiu para que se identificasse o real fluxo de produção organizando as etapas envolvidas

Nicotine and Cardiovascular Health: When Poison is Addictive – a WHF Policy Brief

Nicotine is universally recognized as the primary addictive substance fuelling the continued use of tobacco products, which are responsible for over 8 million deaths annually. In recent years, the popularity of newer recreational nicotine products has surged drastically in many countries, raising health and safety concerns. For decades, the tobacco industry has promoted the myth that nicotine is as harmless as caffeine. Nonetheless, evidence shows that nicotine is far from innocuous, even on its own. In fact, numerous studies have demonstrated that nicotine can harm multiple organs, including the respiratory and cardiovascular systems. Tobacco and recreational nicotine products are commercialized in various types and forms, delivering varying levels of nicotine along with other toxic compounds. These products deliver nicotine in profiles that can initiate and perpetuate addiction, especially in young populations. Notably, some electronic nicotine delivery systems (ENDS) and heated tobacco products (HTP) can deliver concentrations of nicotine that are comparable to those of traditional cigarettes. Despite being regularly advertised as such, ENDS and HTP have demonstrated limited effectiveness as tobacco cessation aids in real-world settings. Furthermore, ENDS have also been associated with an increased risk of cardiovascular disease. In contrast, nicotine replacement therapies (NRT) are proven to be safe and effective medications for tobacco cessation. NRTs are designed to release nicotine in a slow and controlled manner, thereby minimizing the potential for abuse. Moreover, the long-term safety of NRTs has been extensively studied and documented. The vast majority of tobacco and nicotine products available in the market currently contain nicotine derived from tobacco leaves. However, advancements in the chemical synthesis of nicotine have introduced an economically viable alternative source. The tobacco industry has been exploiting synthetic nicotine to circumvent existing tobacco control laws and regulations. The emergence of newer tobacco and recreational nicotine products, along with synthetic nicotine, pose a tangible threat to established tobacco control policies. Nicotine regulations need to be responsive to address these evolving challenges. As such, governments should regulate all tobacco and non-medical nicotine products through a global, comprehensive, and consistent approach in order to safeguard tobacco control progress in past decades