Simulação realística como uma ferramenta extensionista para graduação em enfermagem: um relato de experiência

The aim was to report the experiences of the project and its positive effects on the development of the clinical reasoning of the undergraduates, as a result of the experience with realistic simulation in the faculty of nursing. It is a descriptive, retrospective and cross-sectional report, based on the experience of the project team. In addition to planning meetings for activities carried out by the project, 74 posts were made on social media and 3 meetings were held at virtual events. There was a good response from all event participants, and numerous positive feedbacks on the published content. Realistic simulation promotes the development of clinical reasoning, greater autonomy and improved communication between patient and nurse. In addition, it prepares students for the numerous challenges of the clinical-hospital environment, promoting greater safety and, consequently, better performance in nursing care.Objetivou-se relatar as experiências do projeto e seus efeitos positivos no desenvolvimento do raciocínio clínico dos graduandos, em decorrência da vivência com simulação realística na faculdade de enfermagem. Trata-se de um relato descritivo, retrospectivo e transversal, realizado mediante a experiência vivenciada pela equipe do projeto. Além de reuniões de planejamento das atividades realizadas pelo projeto, foram feitas 74 postagens nas mídias sociais e 3 encontros em eventos virtuais. Houve um bom retorno de todos os participantes dos eventos, e inúmeros feedbacks positivos acerca dos conteúdos publicados. A simulação realística promove o desenvolvimento do raciocínio clínico, maior autonomia e a melhoria na comunicação entre o paciente e o enfermeiro. Além disso, prepara os estudantes para os inúmeros desafios do ambiente clínico-hospitalar, promovendo maior segurança e, consequentemente, melhor desempenho nos cuidados de enfermagem

Simulação realística como uma ferramenta extensionista para graduação em enfermagem: um relato de experiência

The aim was to report the experiences of the project and its positive effects on the development of the clinical reasoning of the undergraduates, as a result of the experience with realistic simulation in the faculty of nursing. It is a descriptive, retrospective and cross-sectional report, based on the experience of the project team. In addition to planning meetings for activities carried out by the project, 74 posts were made on social media and 3 meetings were held at virtual events. There was a good response from all event participants, and numerous positive feedbacks on the published content. Realistic simulation promotes the development of clinical reasoning, greater autonomy and improved communication between patient and nurse. In addition, it prepares students for the numerous challenges of the clinical-hospital environment, promoting greater safety and, consequently, better performance in nursing care.Objetivou-se relatar as experiências do projeto e seus efeitos positivos no desenvolvimento do raciocínio clínico dos graduandos, em decorrência da vivência com simulação realística na faculdade de enfermagem. Trata-se de um relato descritivo, retrospectivo e transversal, realizado mediante a experiência vivenciada pela equipe do projeto. Além de reuniões de planejamento das atividades realizadas pelo projeto, foram feitas 74 postagens nas mídias sociais e 3 encontros em eventos virtuais. Houve um bom retorno de todos os participantes dos eventos, e inúmeros feedbacks positivos acerca dos conteúdos publicados. A simulação realística promove o desenvolvimento do raciocínio clínico, maior autonomia e a melhoria na comunicação entre o paciente e o enfermeiro. Além disso, prepara os estudantes para os inúmeros desafios do ambiente clínico-hospitalar, promovendo maior segurança e, consequentemente, melhor desempenho nos cuidados de enfermagem

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Multi-messenger searches via IceCube’s high-energy neutrinos and gravitational-wave detections of LIGO/Virgo

We summarize initial results for high-energy neutrino counterpart searches coinciding with gravitational-wave events in LIGO/Virgo\u27s GWTC-2 catalog using IceCube\u27s neutrino triggers. We did not find any statistically significant high-energy neutrino counterpart and derived upper limits on the time-integrated neutrino emission on Earth as well as the isotropic equivalent energy emitted in high-energy neutrinos for each event

In-situ estimation of ice crystal properties at the South Pole using LED calibration data from the IceCube Neutrino Observatory

The IceCube Neutrino Observatory instruments about 1 km3 of deep, glacial ice at the geographic South Pole using 5160 photomultipliers to detect Cherenkov light emitted by charged relativistic particles. A unexpected light propagation effect observed by the experiment is an anisotropic attenuation, which is aligned with the local flow direction of the ice. Birefringent light propagation has been examined as a possible explanation for this effect. The predictions of a first-principles birefringence model developed for this purpose, in particular curved light trajectories resulting from asymmetric diffusion, provide a qualitatively good match to the main features of the data. This in turn allows us to deduce ice crystal properties. Since the wavelength of the detected light is short compared to the crystal size, these crystal properties do not only include the crystal orientation fabric, but also the average crystal size and shape, as a function of depth. By adding small empirical corrections to this first-principles model, a quantitatively accurate description of the optical properties of the IceCube glacial ice is obtained. In this paper, we present the experimental signature of ice optical anisotropy observed in IceCube LED calibration data, the theory and parametrization of the birefringence effect, the fitting procedures of these parameterizations to experimental data as well as the inferred crystal properties.</p

Non-standard neutrino interactions in IceCube

Non-standard neutrino interactions (NSI) may arise in various types of new physics. Their existence would change the potential that atmospheric neutrinos encounter when traversing Earth matter and hence alter their oscillation behavior. This imprint on coherent neutrino forward scattering can be probed using high-statistics neutrino experiments such as IceCube and its low-energy extension, DeepCore. Both provide extensive data samples that include all neutrino flavors, with oscillation baselines between tens of kilometers and the diameter of the Earth. DeepCore event energies reach from a few GeV up to the order of 100 GeV - which marks the lower threshold for higher energy IceCube atmospheric samples, ranging up to 10 TeV. In DeepCore data, the large sample size and energy range allow us to consider not only flavor-violating and flavor-nonuniversal NSI in the μ−τ sector, but also those involving electron flavor. The effective parameterization used in our analyses is independent of the underlying model and the new physics mass scale. In this way, competitive limits on several NSI parameters have been set in the past. The 8 years of data available now result in significantly improved sensitivities. This improvement stems not only from the increase in statistics but also from substantial improvement in the treatment of systematic uncertainties, background rejection and event reconstruction