Interdisciplinaridade e Pandemia / Interdisciplinarity and Pandemic

Este trabalho tem como objetivo partilhar com a comunidade escolar práticas pedagógicas que permitiram desenvolver nos alunos a autonomia para o uso das ferramentas tecnológicas durante a Pandemia de 2020 e apresentar estratégias e roteiros de estudos que mediaram a educação com o uso de TDIC em tempos de Ensino Remoto. Além disso, analisar os elementos presentes no desenvolvimento de aprendizagem dos alunos do Projeto Social Escola da Comunidade que aproximaram as famílias da escola por meio das ferramentas tecnológicas. O presente trabalho possui abordagem qualitativa, decorrente de observação do uso de TDIC e da Interdisciplinaridade, durante a pandemia, com as famílias do Projeto Social Escola da Comunidade na Educação Infantil e 1º ano do Ensino Fundamental. As principais conclusões evidenciam que a atuação do gestor cria um movimento emancipatório e de diálogo nos professores que buscam soluções diante do inesperado, quando esse tem uma prática docente interdisciplinar, ancorada em cinco princípios: humildade, coerência, espera, respeito e desapego.  Estar aberto a novas experiências é fundamental nesse caminho de crescimento e desenvolvimento de novas habilidades. Professor e aluno aprendem num processo de interação um com o outro, pois seguem lado a lado em muitos campos pedagógicos, como o desenvolvimento do conhecimento, o desenvolvimento afetivo emocional, o desenvolvimento das interações pessoais e de atitudes e o desenvolvimento de habilidades de competências

USING ENTRUSTABLE PROFESSIONAL ACTIVITIES IN THE DESIGN OF THREE NEW HEALTHCARE UNDERGRADUATE PROGRAMS: BIOMEDICINE, NURSING AND PSYCHOLOGY

Entrustable Professional Activities (EPAs) can be defined as a unit of professional practice that can be entrusted to a trainee after they have obtained adequate competency. EPAs integrate multiple competencies from several domains and are very useful in designing competency-based curricula. Using EPAs to design medical curricula has been widely described, but their application to curriculum design of other health-related undergraduate programs is scarce. This manuscript critically assesses an educational planning experience of using EPAs to simultaneously design three healthcare undergraduate programs (nursing, biomedicine and psychology) at Faculdade Santa Casa BH, Minas Gerais, Brazil. We present the EPAs for each program, curricula frameworks, educational strategies, and assessment methods. Expert groups of professors and educational specialists defined the core professional activities that would be directly assessed and entrusted to trainees from the three different programs. The expert group then defined the required knowledge, skills, and attitudes for each EPA and selected the appropriate assessment tools to be used in entrustment decisions. The expected entrustment level for each training phase guided the course’s distribution of core and elective courses. The experience of designing a curriculum using EPAs was successful and helped focus on the core activities of each profession. It also provided an opportunity to reflect upon formative and summative assessments throughout the course bringing the challenge of reorienting our teaching practices and assessment approaches. Designing undergraduate curricula of health-related professions using EPAs is feasible and might help operationalize competency-based curricula.  Article visualizations

Manual Friction with Ethyl Alcohol at 70% (<i>w</i>/<i>v</i>) to Disinfect Three-Way Stopcocks

The disinfection procedures aim to reduce the microbial load, but there are doubts about the risks of contamination spreading into the lumens of devices, such as three-way stopcocks (3-WS). This study aimed at an in vitro evaluation of the antibacterial procedure of manual friction of 3-WS intentionally contaminated and to determine the solution dispersion into the lumens. Laboratory experiments were developed in two steps: evaluation of bacterial spread through intentional contamination with Staphylococcus aureus and Pseudomonas aeruginosa, and alcohol dispersion into the 3-WS lumens. After manual friction of the 3-WS with saline solution at 0.85% (w/v) [control group], S. aureus and P. aeruginosa were isolated in the lumens of 55.6% and 27.8% of the devices, respectively. However, after the disinfection of the 3-WS with ethyl alcohol at 70% (w/v), there was no bacterial contamination in the lumens of the 3-WS. On the other hand, the solution dispersion (dye) into the lumens was evidenced by two different techniques: Durham tubes (5.6%) and swabs (46.3%). The manual friction of the 3-WS with ethyl alcohol at 70% demonstrated antibacterial efficacy, but it refers to reflections on the risk of solution diffusion into the venous network and the inherent clinical practice situations and patient safety

Teores de fluoreto na água de propriedades da zona rural do município de Ãguas da Prata, SP.

O objetivo deste trabalho foi avaliar a concentração de fluoreto na água de propriedades da zona rural do Município de Ãguas da Prata, SP. Trinta e três amostras de água foram coletadas de quatro propriedades, no período de fevereiro a abril de 2005. As análises de flúor foram realizadas através de método potenciométrico, utilizando eletrodo seletivo ao íon fluoreto. Os resultados observados foram de 0,18 a 4,60 mg/L, com 72,7% das amostras com concentração de fluoreto abaixo de 0,6 mg/L, que corresponde à concentração mínima necessária estabelecida para água potável. Palavras-chave: análise de água, fluoreto, zona rural. ABSTRACT The present work has the objective to evaluate the fluoride concentration in water of rural zone property of the district of Ãguas da Prata, SP, Brazil. Thirty three coming samples of water were collected from of 4 properties, in the period of February to April of 2005. The fluoride analysis was determinated through electrode of selective ion by the method potentiometric. The concentration of fluoride in water samples ranged from 0,18 to 4,60 mg/l and 72,7% presented fluoride levels below 0,6 mg/L, not according to the Brazilian drinking water standard. Keywords: water analysis, fluoride, rural zone.</div

Oral anticoagulant treatment in rheumatoid arthritis patients with atrial fibrillation results of an international audit

Objective: To describe the prevalence of atrial fibrillation (AF) in patients with rheumatoid arthritis (RA), and to evaluate the proportion of patients with AF receiving guideline-recommended anticoagulation for prevention of stroke, based on data from a large international audit. Methods: The cohort was derived from the international audit SUrvey of cardiovascular disease Risk Factors in patients with Rheumatoid Arthritis (SURF-RA) which collected data from 17 countries during 2014-2019. We evaluated the prevalence of AF across world regions and explored factors associated with the presence of AF with multivariable logistic regression models. The proportion of AF patients at high risk of stroke (CHA2DS2-VASc ≥ 2 in males and ≥ 3 in females) receiving anticoagulation was examined. Results: Of the total SURF-RA cohort (n = 14,503), we included RA cases with data on whether the diagnosis of AF was present or not (n = 7,665, 75.1% women, mean (SD) age 58.7 (14.1) years). A total of 288 (3.8%) patients had a history of AF (4.4% in North America, 3.4% in Western Europe, 2.8% in Central and Eastern Europe and 1.5% in Asia). Factors associated with the presence of AF were older age, male sex, atherosclerotic cardiovascular disease, heart failure and hypertension. Two-hundred and fifty-five (88.5%) RA patients had a CHA2DS2-VASc score indicating recommendation for oral anticoagulant treatment, and of them, 164 (64.3%) were anticoagulated. Conclusion: Guideline-recommended anticoagulant therapy for prevention of stroke due to AF may not be optimally implemented among RA patients, and requires special attention

Diabetes mellitus and cardiovascular risk management in patients with rheumatoid arthritis: An international audit

Aim: The objective was to examine the prevalence of atherosclerotic cardiovascular disease (ASCVD) and its risk factors among patients with RA with diabetes mellitus (RA-DM) and patients with RA without diabetes mellitus (RAwoDM), and to evaluate lipid and blood pressure (BP) goal attainment in RA-DM and RAwoDM in primary and secondary prevention. Methods: The cohort was derived from the Survey of Cardiovascular Disease Risk Factors in Patients with Rheumatoid Arthritis from 53 centres/19 countries/3 continents during 2014-2019. We evaluated the prevalence of cardiovascular disease (CVD) among RA-DM and RAwoDM. The study population was divided into those with and without ASCVD, and within these groups we compared risk factors and CVD preventive treatment between RA-DM and RAwoDM. Results: The study population comprised of 10 543 patients with RA, of whom 1381 (13%) had DM. ASCVD was present in 26.7% in RA-DM compared with 11.6% RAwoDM (p&lt;0.001). The proportion of patients with a diagnosis of hypertension, hyperlipidaemia and use of lipid-lowering or antihypertensive agents was higher among RA-DM than RAwoDM (p&lt;0.001 for all). The majority of patients with ASCVD did not reach the lipid goal of low-density lipoprotein cholesterol &lt;1.8 mmol/L. The lipid goal attainment was statistically and clinically significantly higher in RA-DM compared with RAwoDM both for patients with and without ASCVD. The systolic BP target of &lt;140 mm Hg was reached by the majority of patients, and there were no statistically nor clinically significant differences in attainment of BP targets between RA-DM and RAwoDM. Conclusion: CVD preventive medication use and prevalence of ASCVD were higher in RA-DM than in RAwoDM, and lipid goals were also more frequently obtained in RA-DM. Lessons may be learnt from CVD prevention programmes in DM to clinically benefit patients with RA

An international audit of the management of dyslipidaemia and hypertension in patients with rheumatoid arthritis: results from 19 countries

Aims To assess differences in estimated cardiovascular disease (CVD) risk among rheumatoid arthritis (RA) patients from different world regions and to evaluate the management and goal attainment of lipids and blood pressure (BP). Methods and results The survey of CVD risk factors in patients with RA was conducted in 14 503 patients from 19 countries during 2014-19. The treatment goal for BP was &lt;140/90 mmHg. CVD risk prediction and lipid goals were according to the 2016 European guidelines. Overall, 21% had a very high estimated risk of CVD, ranging from 5% in Mexico, 15% in Asia, 19% in Northern Europe, to 31% in Central and Eastern Europe and 30% in North America. Of the 52% with indication for lipid-lowering treatment (LLT), 44% were using LLT. The lipid goal attainment was 45% and 18% in the high and very high risk groups, respectively. Use of statins in monotherapy was 24%, while 1% used statins in combination with other LLT. Sixty-two per cent had hypertension and approximately half of these patients were at BP goal. The majority of the patients used antihypertensive treatment in monotherapy (24%), while 10% and 5% as a two- or three-drug combination. Conclusion We revealed considerable geographical differences in estimated CVD risk and preventive treatment. Low goal attainment for LLT was observed, and only half the patients obtained BP goal. Despite a high focus on the increased CVD risk in RA patients over the last decade, there is still substantial potential for improvement in CVD preventive measures