Espaço de cuidados de enfermagem à saúde do homem e ao câncer de próstata: relato de uma atividade extensionista

The aim of this study is to report the experience from the experience of a fellow, about the development of extensionist actions linked to an extension project with the theme of prevention of prostate cancer and attention to men's health. An experience report is set up based on the observations and experience of the scholarship holder. Interviews were conducted with visitors to the Urology ward of a university hospital to assess their knowledge on the subject of prostate cancer; lectures aimed at clarifying all visitors and users who attend an outpatient unit; and tracking children and siblings of clients diagnosed with prostate cancer. A profile was also created on the social network Instagram, with the aim of disseminating information regarding prostate cancer and other pathologies targeted at the male population. The extensionist project has achieved its health education objectives for improvements in men's health, either by carrying out health promotion and prostate cancer prevention at the university hospital, or by using the social network Instagram to publish content based on scientific references.O objetivo deste estudo é relatar a experiência a partir da vivência de uma bolsista, acerca do desenvolvimento das ações extensionistas vinculadas a um projeto de extensão com a temática de prevenção ao câncer de próstata e atenção à saúde do homem. Configura-se um relato de experiência pautado nas observações e vivência da bolsista. São realizadas entrevistas com visitantes da enfermaria de Urologia de um hospital universitário para avaliar o conhecimento dos mesmos sobre o tema câncer de próstata; palestras visando o esclarecimento de todos os visitantes e dos usuários que comparecem a uma unidade ambulatorial; e rastreamento de filhos e irmãos de clientes com diagnóstico de câncer de próstata. Foi criado também um perfil na rede social Instagram, com o objetivo de disseminar informações relativas ao câncer de próstata e outras patologias direcionadas a população masculina. O projeto extensionista tem atingido seus objetivos de educação em saúde para melhorias na saúde masculina, seja pela realização de promoção à saúde e prevenção do câncer de próstata no hospital universitário, seja pelo uso da rede social Instagram para publicações de conteúdos embasados em referências científicas

Espaço de cuidados de enfermagem à saúde do homem e ao câncer de próstata: relato de uma atividade extensionista

The aim of this study is to report the experience from the experience of a fellow, about the development of extensionist actions linked to an extension project with the theme of prevention of prostate cancer and attention to men's health. An experience report is set up based on the observations and experience of the scholarship holder. Interviews were conducted with visitors to the Urology ward of a university hospital to assess their knowledge on the subject of prostate cancer; lectures aimed at clarifying all visitors and users who attend an outpatient unit; and tracking children and siblings of clients diagnosed with prostate cancer. A profile was also created on the social network Instagram, with the aim of disseminating information regarding prostate cancer and other pathologies targeted at the male population. The extensionist project has achieved its health education objectives for improvements in men's health, either by carrying out health promotion and prostate cancer prevention at the university hospital, or by using the social network Instagram to publish content based on scientific references.O objetivo deste estudo é relatar a experiência a partir da vivência de uma bolsista, acerca do desenvolvimento das ações extensionistas vinculadas a um projeto de extensão com a temática de prevenção ao câncer de próstata e atenção à saúde do homem. Configura-se um relato de experiência pautado nas observações e vivência da bolsista. São realizadas entrevistas com visitantes da enfermaria de Urologia de um hospital universitário para avaliar o conhecimento dos mesmos sobre o tema câncer de próstata; palestras visando o esclarecimento de todos os visitantes e dos usuários que comparecem a uma unidade ambulatorial; e rastreamento de filhos e irmãos de clientes com diagnóstico de câncer de próstata. Foi criado também um perfil na rede social Instagram, com o objetivo de disseminar informações relativas ao câncer de próstata e outras patologias direcionadas a população masculina. O projeto extensionista tem atingido seus objetivos de educação em saúde para melhorias na saúde masculina, seja pela realização de promoção à saúde e prevenção do câncer de próstata no hospital universitário, seja pelo uso da rede social Instagram para publicações de conteúdos embasados em referências científicas

Protocolised non-invasive compared with invasive weaning from mechanical ventilation for adults in intensive care : the Breathe RCT

Background: Invasive mechanical ventilation (IMV) is a life-saving intervention. Following resolution of the condition that necessitated IMV, a spontaneous breathing trial (SBT) is used to determine patient readiness for IMV discontinuation. In patients who fail one or more SBTs, there is uncertainty as to the optimum management strategy. Objective: To evaluate the clinical effectiveness and cost-effectiveness of using non-invasive ventilation (NIV) as an intermediate step in the protocolised weaning of patients from IMV. Design: Pragmatic, open-label, parallel-group randomised controlled trial, with cost-effectiveness analysis. Setting: A total of 51 critical care units across the UK. Participants: Adult intensive care patients who had received IMV for at least 48 hours, who were categorised as ready to wean from ventilation, and who failed a SBT. Interventions: Control group (invasive weaning): patients continued to receive IMV with daily SBTs. A weaning protocol was used to wean pressure support based on the patient’s condition. Intervention group (non-invasive weaning): patients were extubated to NIV. A weaning protocol was used to wean inspiratory positive airway pressure, based on the patient’s condition. Main outcome measures: The primary outcome measure was time to liberation from ventilation. Secondary outcome measures included mortality, duration of IMV, proportion of patients receiving antibiotics for a presumed respiratory infection and health-related quality of life. Results: A total of 364 patients (invasive weaning, n = 182; non-invasive weaning, n = 182) were randomised. Groups were well matched at baseline. There was no difference between the invasive weaning and non-invasive weaning groups in median time to liberation from ventilation {invasive weaning 108 hours [interquartile range (IQR) 57–351 hours] vs. non-invasive weaning 104.3 hours [IQR 34.5–297 hours]; hazard ratio 1.1, 95% confidence interval [CI] 0.89 to 1.39; p = 0.352}. There was also no difference in mortality between groups at any time point. Patients in the non-invasive weaning group had fewer IMV days [invasive weaning 4 days (IQR 2–11 days) vs. non-invasive weaning 1 day (IQR 0–7 days); adjusted mean difference –3.1 days, 95% CI –5.75 to –0.51 days]. In addition, fewer non-invasive weaning patients required antibiotics for a respiratory infection [odds ratio (OR) 0.60, 95% CI 0.41 to 1.00; p = 0.048]. A higher proportion of non-invasive weaning patients required reintubation than those in the invasive weaning group (OR 2.00, 95% CI 1.27 to 3.24). The within-trial economic evaluation showed that NIV was associated with a lower net cost and a higher net effect, and was dominant in health economic terms. The probability that NIV was cost-effective was estimated at 0.58 at a cost-effectiveness threshold of £20,000 per quality-adjusted life-year. Conclusions: A protocolised non-invasive weaning strategy did not reduce time to liberation from ventilation. However, patients who underwent non-invasive weaning had fewer days requiring IMV and required fewer antibiotics for respiratory infections. Future work: In patients who fail a SBT, which factors predict an adverse outcome (reintubation, tracheostomy, death) if extubated and weaned using NIV? Trial registration: Current Controlled Trials ISRCTN15635197. Funding: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 48. See the NIHR Journals Library website for further project information

VÍRUS CHIKUNGUNYA E SUAS IMPLICAÇÕES EPIDEMIOLÓGICAS NO BRASIL E NO MUNDO

O objetivo neste trabalho foi investigar os registros de casos da Febre Chikungunya no Brasil e no mundo, além da possível existência de agravamentos, bem como as formas de controle do vetor. Quanto à abordagem, é uma pesquisa com base em dados bibliográficos obtidos por meio de banco de dados. O trabalho foi realizado no primeiro semestre de 2016, nos componentes de Metodologia Científica, Metodologia da Pesquisa e Produção de Textos, por meio da metodologia ativa Problem Based Learning (PBL). A Febre Chikungunya é uma doença infecciosa febril, causada pelo vírus Chikungunya e transmitida geralmente pelo aedes aegypti. Os primeiros casos da Febre Chikungunya foram relatados em 1952, na Tanzânia, nos quais os enfermos apresentavam quadros febris agudos semelhantes aos da dengue. Entre 1960 e 1990, foram descritos casos esporádicos na África e Ásia (GOMÉZ et al., 2016). Em 2004, no Kenya, ocorreu um grande número de casos. Após, ocorreu disseminação pela região do oceano Índico, Índia e resto da Ásia. Desde esse momento aumentou o número de casos na Itália, e, em 2007, foi descrita uma epidemia de transmissão mosquito-humano-mosquito (GOMÉZ et al., 2016). Depois disso houve uma diminuição do número de casos, até que entre 2011 e 2013 eles aumentaram novamente: República do Congo (11.000), Índia (29) e Camboja (1.500). Em 2012, em Samar (Filipinas), houve 600 casos; no entanto o número real pode ter sido muito maior (GOMÉZ et al., 2016). O vírus possui a capacidade de reemergir rapidamente em algumas áreas climáticas, além disso os viajantes podem propagá-lo de um país a outro, por isso torna-se uma ameaça para os países que não possuem recursos de prevenção e tratamento em casos de epidemias. O primeiro caso da doença no continente americano ocorreu em dezembro de 2013, em San Martín. No mesmo mês, foram confirmados 50 casos em Martinica; acredita-se que foi por meio de transmissão autóctone. No Brasil, o primeiro caso foi registrado em setembro de 2014, no Município de Oiapoque, AP. Mais de mil casos foram registrados em pouco mais de um mês em virtude da ausência de anticorpos e da considerável prevalência dos mosquitos aedes aegypti e aedes albopictus (DONALISIO et al., 2015). Foi confirmada a doença em 31 países da América. O número alto de pessoas infectadas ocorre em razão da migração, das condições climáticas de alguns países que melhoram a sobrevivência do vetor e da falta de imunidade da população (GOMÉZ et al., 2016). Pode-se afirmar que a doença estudada provoca impactos consideráveis à saúde mental do indivíduo, principalmente por causar dor crônica articular e interferir diretamente em atividades cotidianas. Dessa forma, considera-se de extrema importância a atuação multissetorial e um modelo descentralizado de combate ao vetor. A mobilização comunitária é indispensável para que se tenha êxito na campanha de combate ao mosquito, visto que se trata de uma questão, sobretudo, de saúde pública. As principais ações, no que se refere ao governo federal, enfatizam a importância da supervisão em portos, aeroportos e fronteiras, bem como a realização de vistorias periódicas nas residências.   Palavras-chave: Chikungunya. Epidemiologia. Brasil

Doing quantitative research in the learning sciences and CSCL:current developments and applications

While quantitative methods are continuously developed in various fields of origin,such as psychology, the specific applications in the core field of learning sciences and CSCL are less well advanced. In this workshop, we explore and discuss current methodological topics in three relevant fields of empirical research: (1) obtaining data, (2) analyzing data, and (3) sharing data, replicating and integrating findings. Outcomes of the discussions are planned to be published in short guidelines facilitating the application of latest developments in quantitative methods in the learning sciences and CSCL research.<br/

Doing quantitative research in the learning sciences and CSCL:current developments and applications

While quantitative methods are continuously developed in various fields of origin,such as psychology, the specific applications in the core field of learning sciences and CSCL are less well advanced. In this workshop, we explore and discuss current methodological topics in three relevant fields of empirical research: (1) obtaining data, (2) analyzing data, and (3) sharing data, replicating and integrating findings. Outcomes of the discussions are planned to be published in short guidelines facilitating the application of latest developments in quantitative methods in the learning sciences and CSCL research.<br/

Oropharyngeal morphological aspects of Arapaima gigas (Schinz, 1822)

The study of the functional anatomy of the digestive system of fish, in particular the oropharyngeal cavity, is of great importance because it allows inferences about the feeding habit, mechanisms of capture, selection, and processing of food carried out by different species. Thus, the aim of this study was to describe the anatomical adaptations of the oropharyngeal cavity of the pirarucu (Arapaima gigas Schinz, 1822) using scanning electron microscopy (SEM) techniques. The oropharyngeal cavity of six specimens of pirarucu was collected in juvenile phase, from Aquaculture Research Center at the Universidade Federal de Rondônia (UNIR), created for commercial purposes. The anatomical pieces were fixed in 10% buffered formalin and processed for SEM analysis. Anatomically, the oropharyngeal cavity of the pirarucu is composed of five pairs of branchial arches, apical portion of the tongue, floor of the tongue, lower pharyngeal area, and upper pharyngeal plate. In SEM, we observed that the mucosa of the apex of the tongue and the upper pharyngeal roof have a smooth texture and are covered by squamous cells with numerous small openings scattered over the surface. The portions of the floor of the tongue and the lower pharyngeal area, on the other hand, have adaptations in the form of a projectile and numerous sensory papillae, giving a rough texture to the region. Thus, the oropharyngeal cavity of pirarucu is adapted for the capture, apprehension, and swallowing of its prey, with signs of carnivory

Training attention control of very preterm infants: protocol for a feasibility study of the Attention Control Training (ACT)

Background Children born preterm may display cognitive, learning, and behaviour difficulties as they grow up. In particular, very premature birth (gestation age between 28 and less than 32 weeks) may put infants at increased risk of intellectual deficits and attention deficit disorder. Evidence suggests that the basis of these problems may lie in difficulties in the development of executive functions. One of the earliest executive functions to emerge around 1 year of age is the ability to control attention. An eye-tracking-based cognitive training programme to support this emerging ability, the Attention Control Training (ACT), has been developed and tested with typically developing infants. The aim of this study is to investigate the feasibility of using the ACT with healthy very preterm (VP) infants when they are 12 months of age (corrected age). The ACT has the potential to address the need for supporting emerging cognitive abilities of VP infants with an early intervention, which may capitalise on infants’ neural plasticity. Methods/design The feasibility study is designed to investigate whether it is possible to recruit and retain VP infants and their families in a randomised trial that compares attention and social attention of trained infants against those that are exposed to a control procedure. Feasibility issues include the referral/recruitment pathway, attendance, and engagement with testing and training sessions, completion of tasks, retention in the study, acceptability of outcome measures, quality of data collected (particularly, eye-tracking data). The results of the study will inform the development of a larger randomised trial. Discussion Several lines of evidence emphasise the need to support emerging cognitive and learning abilities of preterm infants using early interventions. However, early interventions with preterm infants, and particularly very preterm ones, face difficulties in recruiting and retaining participants. These problems are also augmented by the health vulnerability of this population. This feasibility study will provide the basis for informing the implementation of an early cognitive intervention for very preterm infants. Trial registration Registered Registration ID: NCT03896490. Retrospectively registered at Clinical Trials Protocol Registration and Results System (clinicaltrials.gov)

Therapeutic DNA vaccine induces broad T cell responses in the gut and sustained protection from viral rebound and AIDS in SIV-infected rhesus macaques.

Immunotherapies that induce durable immune control of chronic HIV infection may eliminate the need for life-long dependence on drugs. We investigated a DNA vaccine formulated with a novel genetic adjuvant that stimulates immune responses in the blood and gut for the ability to improve therapy in rhesus macaques chronically infected with SIV. Using the SIV-macaque model for AIDS, we show that epidermal co-delivery of plasmids expressing SIV Gag, RT, Nef and Env, and the mucosal adjuvant, heat-labile E. coli enterotoxin (LT), during antiretroviral therapy (ART) induced a substantial 2-4-log fold reduction in mean virus burden in both the gut and blood when compared to unvaccinated controls and provided durable protection from viral rebound and disease progression after the drug was discontinued. This effect was associated with significant increases in IFN-γ T cell responses in both the blood and gut and SIV-specific CD8+ T cells with dual TNF-α and cytolytic effector functions in the blood. Importantly, a broader specificity in the T cell response seen in the gut, but not the blood, significantly correlated with a reduction in virus production in mucosal tissues and a lower virus burden in plasma. We conclude that immunizing with vaccines that induce immune responses in mucosal gut tissue could reduce residual viral reservoirs during drug therapy and improve long-term treatment of HIV infection in humans