Problematizações do currículo-experiência no entre-lugar da educação infantil e do ensino fundamental: possíveis contribuições para o ensino fundamental de nove anos.

Esse texto é um convite para discutir alguns atravessamentos colocados nas escolas a partir da implementação e implantação do Ensino Fundamental de Nove Anos, como política de governo reorganiza os espaçostempos da escola, impõe um currículo prescrito, uma avaliação por objetivos e coloca em discussão o que é ser criança e viver a infância na escola. Como objetivo principal, busca problematizar o processo de implementação e implantação do Ensino Fundamental de Nove Anos no município de Vitória-ES e suas implicações no entre-lugar da Educação Infantil e Ensino Fundamental. Para tanto foi necessário estar no cotidiano escolar, viver, sentir e conversar com os sujeitos praticantes: as crianças alunos; as professoras e as pedagogas. Nesse sentido, três movimentos foram realizados: o primeiro movimento consiste em um levantamento de dados documentais, pareceres, leis, diretrizes no âmbito nacional e municipal que determinaram a obrigatoriedade do Ensino Fundamental de Nove Anos; o segundo movimento consiste em trazer para análise alguns artigos publicados na Associação Nacional de Pós-Graduação e Pesquisa em Educação (ANPED) em quatro Grupos de Trabalho (GT) que abordam o tema Ensino Fundamental de Nove Anos, e também textos que circulam nas escolas e que foram organizados pelo Ministério da Educação e Cultura (MEC); o terceiro movimento consiste na pesquisa realizada em um Centro Municipal de Educação Infantil (CMEI) e em uma Escola Municipal de Ensino Fundamental (EMEF) no município de Vitória, no decorrer dos anos de 2011 e 2012, onde foi possível conversar com as crianças alunos de duas turmas do 1º ano, com as professoras e pedagogas. Utiliza como aporte teórico-metodológico as pesquisas nos/dos/com os cotidianos (CERTEAU 1994; ALVES 2001; FERRAÇO 2003) onde foi possível a apropriação de diferentes instrumentos de pesquisa, como: o diário de campo, recurso importante na intenção de capturar movimentos, falas e expressões; as conversas como tentativa de aproximação com os sujeitos para um fazer com e as oficinas de literatura como dispositivo de criação e produção de outros modos de pensar a criança e a infância. Na tentativa de discutir o lugar da criança no Ensino Fundamental de Nove Anos o conceito de devir-criança de Deleuze (1997) ajuda a pensar no movimento da criança como presença potente que produz outros modos de vida mais belos e intensos na escola e no currículo. O conceito de entre-lugar de Bhabha (2007) fortalece as discussões entre CMEI e EMEF como espaços tempos de negociações. As discussões de Kohan (2003) colocam em debate o lugar da infância que não indica um tempo cronológico, mas pensa em um encontro com a infância, com a experiência da infância. E Larrosa (2004) que com o conceito de experiência nos ajuda a pensarem um currículo-experiência, currículo esse que não está localizado no documento prescrito, nos espaços tempos da Educação Infantil ou do Ensino Fundamental, também não se localiza na criança, ou em uma dada infância, mas na composição com a escola, com as crianças, com as infâncias e isso só é possível no encontro com a criança que existe em nós

Correlação entre estado nutricional e ingestão alimentar em pacientes de hemodiálise

BACKGROUND: Patients in end-stage renal disease often suffer from poor appetite, various comorbidities, and dietary restrictions. Despite regular hemodialysis, nutritional imbalances are frequently reported. Aiming to correlate nutritional status with food ingestion, a prospective study was done in an outpatient group. METHODS: Stable patients undergoing chronic hemodialysis for at least 3 months (n = 44) were investigated by dietary recall and standard anthropometric, biochemical, and bioimpedance determinations, including subjective and objective global assessment. The mean age of the group was 47.0 ± 16.9 years, and 63.6% were men. Body mass index was 22.2 ± 3.9 kg/m² (mean ± SD), calorie intake was 1471 ± 601 kcal/day (20.7 ± 6.7 kcal/kg/day), and protein ingestion was 74.3 ± 16.6 g protein/day (1.2 g/kg/day). Dietary and clinical findings were correlated with nutritional indices by linear regression analysis. RESULTS: Malnutrition estimated by subjective global assessment was very common (>;90%), despite the fact that body mass index and serum albumin were within an acceptable range in the majority of the population. Objective global assessment yelded roughly comparable numerical findings, with 6.8% being well nourished, 61.4% at nutritional risk or lightly undernourished, 29.6% moderately malnourished, and 2.3% severely malnourished. Total calorie intake was devoid of associations, but protein, carbohydrate, and lipid input positively correlated with triceps skinfold (P=.02). Lipid ingestion was the only marker directly associated with arm circumference, and it correlated with body mass index, as well as with total body fat (bioimpedance analysis) (POBJETIVOS: Pacientes em fase final de enfermidade renal frequentemente sofrem de falta de apetite, várias comorbidades e restrições dietéticas, e a despeito de hemodiálise regular, desequilíbrios nutricionais são frequentemente relatados. Com o propósito de correlacionar estado nutricional com ingestão alimentar, um estudo prospectivo foi realizado com pacientes ambulatoriais. MÉTODOS: Doentes estáveis sibmetidos a hemodiálise crônica por no mínimo 3 meses (n= 44) foram investigados mediante recordatório alimentar e determinações convencionais antropométricas, bioquímicas e de bioimpedância , incluindo-se avaliação global subjetiva e também objetiva. A idade do grupo era de 47.0 ± 16.9 anos com 63.6% de homens. O índice de massa corporal situava-se em 22.2 ± 3.9 kg/m2, a ingestão calórica foi de 1471 ± 601 kcal/dia (20.7 ± 6.7 kcal/kg/dia) e o consumo proteico atingiu 74.3 ± 16.6 g proteina/dia (1.2 g/kg/dia) . As variáveis dietéticas e clínicas foram correlacionadas com os índices nutricionais através da análise de regressão linear. RESULTADOS: A desnutrição estimada pela avalia;áo global subjetiva foi muito comum (>;90%), apesar de que o índice de massa corporal e a taxa de albumina estavam aceitáveis na maioria da população. A avaliação objetiva global evidenciou resultados numericamente parecidos, com 6,8% bem nutridos, 61,4% com risco nutricional ou desnutrição leve, 29,6% no patamar moderado e 2,3% exibindo desnutrição grave. O ganho calórico total não apresentou associações, todavia ingressos de proteina, carboidratos e lípides se correlacionaram positivamente com a prega cutânea do tríceps (P=0.02). Apenas a ingestão lipídica associou-se diretamente com a circunferência do braço, demonstrando ainda correlação com o índice de massa corporal bem como com a gordura corpórea total (bioimpedância) (

Correlation of nutritional status and food intake in hemodialysis patients

BACKGROUND: Patients in end-stage renal disease often suffer from poor appetite, various comorbidities, and dietary restrictions. Despite regular hemodialysis, nutritional imbalances are frequently reported. Aiming to correlate nutritional status with food ingestion, a prospective study was done in an outpatient group. METHODS: Stable patients undergoing chronic hemodialysis for at least 3 months (n = 44) were investigated by dietary recall and standard anthropometric, biochemical, and bioimpedance determinations, including subjective and objective global assessment. The mean age of the group was 47.0 &plusmn; 16.9 years, and 63.6% were men. Body mass index was 22.2 &plusmn; 3.9 kg/m² (mean &plusmn; SD), calorie intake was 1471 &plusmn; 601 kcal/day (20.7 &plusmn; 6.7 kcal/kg/day), and protein ingestion was 74.3 &plusmn; 16.6 g protein/day (1.2 g/kg/day). Dietary and clinical findings were correlated with nutritional indices by linear regression analysis. RESULTS: Malnutrition estimated by subjective global assessment was very common (>90%), despite the fact that body mass index and serum albumin were within an acceptable range in the majority of the population. Objective global assessment yelded roughly comparable numerical findings, with 6.8% being well nourished, 61.4% at nutritional risk or lightly undernourished, 29.6% moderately malnourished, and 2.3% severely malnourished. Total calorie intake was devoid of associations, but protein, carbohydrate, and lipid input positively correlated with triceps skinfold (P=.02). Lipid ingestion was the only marker directly associated with arm circumference, and it correlated with body mass index, as well as with total body fat (bioimpedance analysis) (P <.001). CONCLUSIONS: 1) Bioimpedance analysis was useful and was correlated with clinical findings; 2) Lipid intake was the best dietary index in this experience, surpassing protein or total energy; 3) Despite its shortcomings, dietary recall was useful in the assessment of hemodialysis patients

AB0583 REFERRAL PATTERN AND TREATMENT OF POLYMYALGIA RHEUMATICA IN GENERAL PRACTICE: AN INTERNATIONAL QUESTIONNAIRE BASED STUDY

Background In most countries polymyalgia rheumatica (PMR) is diagnosed and managed by both general practitioners (GP) and rheumatologists. However, the referral pattern from GP’s to specialist around the world has not been described. The initial prednisolone dose recommended by EULAR/ACR is between 12.5 and 25 mg1, but little is known about whether these guidelines are followed everywhere by GP’s in clinical practice2.Objectives This study aims to describe the refererral pattern and treatment strategy for PMR in general practice in several countries worldwide.Methods An English language questionnaire was drafted by a working group of rheumatologists and GP’s from 6 different countries. The questionnaire contained questions on: 1: Respondent, 2: Referral pattern and 3: Prednisolone. Questionnaires were distributed to GP’s via members of the International PMR/GCA study group. Answers were collected via an online survey tool (Redcap), from 3rd of November 2021 to 27th of January 2022. Countries with more than 15 responders to the questionnaire were included in the analysis.Results Data from 11 countries were analysed. Referral patterns differed widely among countries (Table 1). Almost all patients initially seen by rheumatologists were returned to GP’s for treatment. In all countries a proportion of the GP’s prescribed higher initial prednisolone doses than recommended, with a large variation between countries (Table 1).Conclusion Although many patients were referred to the hospital for initial PMR diagnosis or during the disease course, a large proportion of patients received treatment in general practice worldwide. GPs frequently use a higher starting dose of prednisolone and shorter treatment duration than recommended by EULAR/ACR

Polymerase chain reaction of peripheral blood as a tool for the diagnosis of visceral leishmaniasis in children

The diagnosis of visceral leishmaniasis (VL) generally requires the use of invasive tests for the collection of infected tissue (aspirates of bone marrow, spleen, liver or lymph nodes). This difficulty has led to the search for safer and less painful techniques to confirm the occurrence of the disease in children. Polymerase chain reaction (PCR) is a method that is advantageous in that it allows the use of peripheral blood samples for diagnosis. This paper reports the utilisation of PCR on peripheral blood samples to diagnose VL in 45 children in Mato Grosso do Sul, Brazil. This technique is compared with methods carried out using tissue collected by invasive procedures, including direct microscopy, culture and detection of Leishmania DNA by PCR in bone marrow aspirates. The results show that PCR of peripheral blood provides great sensitivity (95.6%) that is similar to that from the PCR of bone marrow aspirates (91.1%) and higher than that achieved with microscopy (80%) or culture (26.7%) methods. PCR of peripheral blood proved to be a suitable tool for the diagnosis of VL in children because it is highly sensitive and safe, with tissue collection being less invasive than in traditional tests

Comparison of Interferon-γ Release Assay to Two Cut-Off Points of Tuberculin Skin Test to Detect Latent Mycobacterium tuberculosis Infection in Primary Health Care Workers

BackgroundAn interferon-γ release assay, QuantiFERON-TB (QFT) test, has been introduced an alternative test for the diagnosis of latent Mycobacterium tuberculosis infection (LTBI). Here, we compared the performance of QFT with tuberculin skin test (TST) measured at two different cut-off points among primary health care work (HCW) in Brazil.MethodsA cross-sectional study was carried out among HCWs in four Brazilian cities with a known history of high incidence of TB. Results of the QFT were compared to TST results based on both ≥5 mm and ≥10 mm as cut-off points.ResultsWe enrolled 632 HCWs. When the cut-off value of ≥10 mm was used, agreement between QFT and TST was 69% (k = 0.31), and when the cut-off of ≥5 mm was chosen, the agreement was 57% (k = 0.22). We investigated possible factors of discordance of TST vs QFT. Compared to the TST-/QFT- group, risk factors for discordance in the TST+/QFT- group with TST cut-off of ≥5 mm included age between 41-45 years [OR = 2.70; CI 95%: 1.32-5.51] and 46-64 years [OR = 2.04; CI 95%: 1.05-3.93], BCG scar [OR = 2.72; CI 95%: 1.40-5.25], and having worked only in primary health care [OR = 2.30; CI 95%: 1.09-4.86]. On the other hand, for the cut-off of ≥10 mm, BCG scar [OR = 2.26; CI 95%: 1.03-4.91], being a household contact of a TB patient [OR = 1.72; CI 95%: 1.01-2.92] and having had a previous TST [OR = 1.66; CI 95%: 1.05-2.62], were significantly associated with the TST+/QFT- group. No statistically significant associations were found among the TST-/QFT+ discordant group with either TST cut-off value.ConclusionsAlthough we identified BCG vaccination to contribute to the discordance at both TST cut-off measures, the current Brazilian recommendation for the initiation of LTBI treatment, based on information gathered from medical history, TST, chest radiograph and physical examination, should not be changed