Alta hospitalar responsável: validação de conteúdo de atividades do enfermeiro

Objetivo: Desenvolver e validar uma lista de atividades a serem realizadas pelo enfermeiro na alta hospitalar responsável.Método: Estudo de validação de conteúdo. Os 14 itens gerados foram organizados em uma escala Likert e submetidos à apreciação de juízes, através da Técnica Delphi. Avaliou-se relevância, clareza nos enunciados e ordem sequencial de execução. O consenso para as respostas foi pré-estabelecido em 0,80 e calculado o índice de validade de conteúdo dos itens.Resultados: Oito profissionais participaram da validação da listagem construída. Na Delphi 1, o índice de validade de conteúdo variou de 0,70 (contato pós alta e agendamento de visita domiciliar) a 1,0 e, na Delphi 2, encontrou-se variação de 0,60 (contato telefônico pós alta) a 1,0.Conclusão: Foram validadas 13 das 14 atividades propostas. A listagem de atividades construída pode contribuir para o processo de alta segura, a continuidade e integralidade do cuidado e, ainda, para a redução das readmissões. Palavras-chave: Alta do paciente. Continuidade da assistência ao paciente. Avaliação de processos em cuidados de saúde. Avaliação em enfermagem. Estudo de validação

Recaudación del impuesto predial para lograr el desarrollo sostenible

El desarrollo sostenible a nivel mundial busca lograr un balance entre el desarrollo económico, la preservación del medio ambiente y el bienestar de la sociedad. La recaudación del impuesto predial se ha vuelto crucial para lograr este objetivo, ya que genera ingresos para el desarrollo del estado. Sin embargo, se han observado deficiencias en su determinación, lo cual impide la generación de los recursos necesarios para un desarrollo sostenible. El impuesto predial se aplica tanto a los terrenos como a las construcciones, abarcando incluso aquellos terrenos que hayan sido ganados a los ríos y el mar, esta recaudación financiera puede ser utilizada para financiar servicios públicos y proyectos de desarrollo urbano, como infraestructuras, transporte, hospitales y escuelas. Además, el impuesto predial puede incentivar prácticas sostenibles al ofrecer descuentos a propietarios que adopten medidas ecológicas, como energía solar y eficiencia energética. Finalmente, se puede decir que la recaudación del impuesto predial desempeña un papel crucial en el fomento del desarrollo sostenible al mejorar la calidad de vida, estimular el crecimiento económico y preservar el medio ambiente. Es fundamental que tanto las autoridades como los ciudadanos colaboren de manera conjunta para su correcta gestión y uso responsable en pos de un futuro más sostenible

Dual effect of Plasmodium-infected erythrocytes on dendritic cell maturation

<p>Abstract</p> <p>Background</p> <p>Infection with <it>Plasmodium </it>is the cause of malaria, a disease characterized by a high inflammatory response in the blood. Dendritic cells (DC) participate in both adaptive and innate immune responses, influencing the generation of inflammatory responses. DC can be activated through different receptors, which recognize specific molecules in microbes and induce the maturation of DC.</p> <p>Methods</p> <p>Using <it>Plasmodium yoelii</it>, a rodent malaria model, the effect of <it>Plasmodium</it>-infected erythrocytes on DC maturation and TLR responses have been analysed.</p> <p>Results</p> <p>It was found that intact erythrocytes infected with <it>P. yoelii </it>do not induce maturation of DC unless they are lysed, suggesting that accessibility of parasite inflammatory molecules to their receptors is a key issue in the activation of DC by <it>P. yoelii</it>. This activation is independent of MyD88. It was also observed that pre-incubation of DC with intact <it>P. yoelii</it>-infected erythrocytes inhibits the maturation response of DC to other TLR stimuli. The inhibition of maturation of DC is reversible, parasite-specific and increases with the stage of parasite development, with complete inhibition induced by schizonts (mature infected erythrocytes). <it>Plasmodium yoelii</it>-infected erythrocytes induce a broad inhibitory effect rendering DC non-responsive to ligands for TLR2, TLR3, TLR4, TLR5, TLR7 and TLR9.</p> <p>Conclusions</p> <p>Despite the presence of inflammatory molecules within <it>Plasmodium</it>-infected erythrocytes, which are probably responsible for DC maturation induced by lysates, intact <it>Plasmodium</it>-infected erythrocytes induce a general inhibition of TLR responsiveness in DC. The observed effect on DC could play an important role in the pathology and suboptimal immune response observed during the disease. These results help to explain why immune functions are altered during malaria, and provide a system for the identification of a parasite-derived broad inhibitor of TLR-mediated signaling pathways.</p

Daily Plasmodium yoelii infective mosquito bites do not generate protection or suppress previous immunity against the liver stage

<p>Abstract</p> <p>Background</p> <p>Human populations that are naturally subjected to <it>Plasmodium </it>infection do not acquire complete protection against the liver stage of this parasite despite prolonged and frequent exposure. However, sterile immunity against <it>Plasmodium </it>liver stage can be achieved after repeated exposure to radiation attenuated sporozoites. The reasons for this different response remain largely unknown, but a suppressive effect of blood stage <it>Plasmodium </it>infection has been proposed as a cause for the lack of liver stage protection.</p> <p>Methods</p> <p>Using <it>Plasmodium yoelii </it>17XNL, the response generated in mice subjected to daily infective bites from normal or irradiated mosquitoes was compared. The effect of daily-infected mosquito bites on mice that were previously immunized against <it>P. yoelii </it>liver stage was also studied.</p> <p>Results</p> <p>It was observed that while the bites of normal infected mosquitoes do not generate strong antibody responses and protection, the bites of irradiated mosquitoes result in high levels of anti-sporozoite antibodies and protection against liver stage <it>Plasmodium </it>infection. Exposure to daily infected mosquito bites did not eliminate the protection acquired previously with a experimental liver stage vaccine.</p> <p>Conclusions</p> <p>Liver stage immunity generated by irradiated versus normal <it>P. yoelii </it>infected mosquitoes is essentially different, probably because of the blood stage infection that follows normal mosquito bites, but not irradiated. While infective mosquito bites do not induce a protective liver stage response, they also do not interfere with previously acquired liver stage protective responses, even if they induce a complete blood stage infection. Considering that the recently generated anti-malaria vaccines induce only partial protection against infection, it is encouraging that, at least in mouse models, immunity is not negatively affected by subsequent exposure and infection with the parasite.</p

Clustering of unhealthy lifestyle behaviors, self-rated health and disability

The main objective was to identify sociodemographic characteristics of the population at risk for a greater clustering of unhealthy behaviors and to evaluate the association of such clustering with self-rated health status and disability. Data come from the 2017 Spanish National Health Survey with a sample of 21,947 participants of 15 years of age or older. Based on tobacco consumption, risk drinking, unbalanced diet, sedentarism, and body mass index <18.5/≥25 we created two indicators of risk factor clustering: 1) Number of unhealthy behaviors (0-5); and 2) Unhealthy lifestyle index (score: 0-15). Self-rated health was dichotomized into "optimal" and "suboptimal," and disability was classified as "no disability," "mild," and "severe" based on the Global Activity Limitation Index (GALI). We estimated prevalence ratios (PR) adjusted for covariates using generalized linear models using the clustering count variable, and dose-response curves using the unhealthy lifestyle index. Most participants (77.4%) reported 2 or more risk factors, with men, middle-age individuals, and those with low socioeconomic status being more likely to do so. Compared to those with 0-1 risk factors, the PR for suboptimal health was 1.26 (95% CI:1.18-1.34) for those reporting 2-3 factors, reaching 1.43 (95% CI:1.31-1.55) for 4-5 factors. The PR for severe activity limitation was 1.66 (95% CI:1.35-2.03) for those reporting 2-3 factors and 2.06 (95% CI:1.59-2.67) for 4-5 factors. The prevalence of both health indicators increased in a non-linear fashion as the unhealthy lifestyle index score increased, increasing rapidly up to 5 points, slowing down between 5 and 10 points, and plateauing afterwards.This work was supported by the Institute of Health Carlos III, Ministry of Science and Innovation [grant number PI19CIII/00021.N

Work conditions and precarity of the public high schools

O objetivo deste trabalho consistiu em analisar o perfil dos professores de geografia e história do Ensino Médio público de duas escolas do interior do estado de São Paulo, tendo como referencial teórico-metodológico a perspectiva crítico-dialética, analisando as condições de trabalho dos professores e suas possíveis influências na prática de ensino.The objective of this work conssited in analyze the profile of the geography and history teachers from the Public High School from two schools of the state of São Paulo countryside, having as theorical-methodological referencial the critic-dialetic perspective, analyzing the working conditions from the teachers as its possible influences in the educational practices

AS CONDIÇÕES DE TRABALHO DE PROFESSORES TEMPORÁRIOS NO ENSINO SUPERIOR

The State University of Minas Gerais (UEMG) has a high staff of temporary professor. In this scenario, we question the implications of temporary hiring for teaching work at UEMG, in one of its academic units. In this perspective, this article aims to analyze the working conditions of temporary professor, also called convened at UEMG, in one of its academic units. We consider that there is still a small number of academic publications on state public higher education institutions (HEIs) in terms of temporary contracts, with even fewer academic and scientific productions on this situation experienced by UEMG. For this reason, this article assumes academic and social relevance. The bibliographic survey referring to neoliberal policies, to the flexibilization of work, to state public universities and also about teaching work, presente a Marxist bias, added to the Bourdieusian theory. The research approach is chacarcterized as qualitative, having been adopted as data collection procedures, the bibliographic survey and semi-structured interviews carried out with 10 convened teachers from UEMG. We seek to reconcilie the contente analysis proposed by Bardin with teh concepts of habitus, field, and capitals in Bourdieu. The precarious working conditions due to the interruption of labor contracts and disputes in the simplified slection process (PSS) cause discomfort among teachers and negative consequences of academic productivism.A Universidade do Estado de Minas Gerais (UEMG) possui um quadro de docentes temporários elevado. Nesse cenário, problematizamos as implicações da contratação temporária para o trabalho docente na UEMG, em uma de suas unidades acadêmicas. Nessa perspectiva, o presente artigo tem por objetivo analisar as condições de trabalho dos professores temporários, também chamados de convocados da UEMG, em uma de suas unidades acadêmicas. Consideramos que ainda há um número reduzido de publicações acadêmicas sobre as instituições de ensino superior (IES) públicas estaduais no que tange às contratações temporárias, sendo ainda menores as produções acadêmicas e científicas sobre esta situação vivenciada pela UEMG, o que demonstra a relevância acadêmica e social deste artigo. O levantamento bibliográfico referente às políticas neoliberais, à flexibilização do trabalho, às universidades públicas estaduais e sobre o trabalho docente, apresenta um viés marxista, somado à teoria bourdieusiana. A abordagem da pesquisa se caracteriza como qualitativa, tendo sido adotados como procedimentos de coleta de dados, o levantamento bibliográfico e entrevistas semiestruturadas realizadas com 10 professores convocados da UEMG. Buscamos conciliar a análise de conteúdo proposta por Bardin com os conceitos de habitus, campo e capitais em Bourdieu. As precárias condições de trabalho em face da interrupção dos contratos trabalhistas e disputas no processo seletivo simplificado (PSS) provocam um mal-estar entre os docentes e consequências negativas para a produtividade acadêmica