Continuing education with community health agents: a proposal for care of asthmatic children

The use of active methods in the health worker training process is a guideline that is recommended under the National Continuing Education in Health Policy (PNEPS) for National Health System (SUS) employees. In this study, the authors created an educational intervention for community health agents (CHA) regarding care aimed at children/families with asthma. The aim is to describe an educational action involving community health workers about asthmarelated knowledge, adopting the National Policy on Continuing Education in Health in the context of primary care. This was a 'quantiqualitative' study, with pretest and posttest assessments filled in by the community health workers them-selves, in addition to active approaches in three experiential focus groups, which had their activities recorded and transcribed for later data analysis using the content analysis methodology in accordance with the thematic mode proposed by Bardin. The CHA's knowledge about the myths related to asthma increased after the educational activity. The following themes emerged from the focus groups: Health education for the prevention of respiratory diseases; Meaning attributed to asthma; Firecrackers: demystifying concepts; Trigger factors for asthma; Adapting preventive care; Assessing the knowledge built. The use of active methodologies favored the development of skills among the CHAs, arousing motivation in the educational approach with children/families with asthma.O uso de metodologias ativas nos processos de formação dos trabalhadores de saúde é uma diretriz recomendada na Política Nacional de Educação Permanente em Saúde (PNEPS) para trabalhadores do Sistema Único de Saúde (SUS). Neste estudo, formulou-se uma intervenção educativa para agentes comunitários de saúde (ACS) sobre cuidados dirigidos a crianças/famílias com asma. O objetivo é descrever uma ação educativa com agentes comunitários de saúde sobre conhecimentos relacionados à asma, adotando as diretrizes da PNEPS no contexto da atenção primária. Tratase de estudo 'quantiqualitativo', com avaliação préteste e pósteste autopreenchida pelos agentes comunitários de saúde, além de metodologias ativas em três grupos focais vivenciais, que tiveram sua trajetória gravada e transcrita para posterior análise de dados, com uso da técnica análise de conteúdo na modalidade temática proposta por Bardin. Os conhecimentos dos ACS sobre mitos relacionados à asma apontaram acréscimo após a ação educativa. Dos grupos focais emergiram as temáticas: Educação em saúde para prevenção das doenças respiratórias; Significado atribuído à asma; Bombinhas: desmistificando conceitos; Fatores desencadeantes para asma; Adaptando cuidados preventivos; Avaliando os conhecimentos construídos. A utilização de metodologias ativas favoreceu o desenvolvimento de competências por parte dos ACS, despertando motivação na abordagem educativa junto às crianças/famílias com asma.Universidade Federal de Pernambuco Departamento de EnfermagemUniversidade Federal do CearáUniversidade Federal de Pernambuco Departamento de FonoaudiologiaUniversidade Federal de São Paulo (UNIFESP) Centro de Desenvolvimento do Ensino SuperiorUNIFESP, Centro de Desenvolvimento do Ensino SuperiorSciEL

Emphysematous and xanthogranulomatous pyelonephritis: rare diagnosis

AbstractPyelonephritis is a pyogenic infection of renal parenchyma that involves the renal pelvis. It is generally of easy diagnosis. The present case report aims to describe two different manifestations of this infection: xanthogranulomatous pyelonephritis and emphysematous pyelonephritis, which have poor prognosis and require a more effective treatment. The two cases were women in the fiftieth and sixtieth decade of life, with diabetes mellitus and history of weight loss. The diagnosis of the renal infection was established through computed tomography and the treatment was based in surgical procedure, with favorable outcome

Critical Education in Community Health Literacy for Brazilian Nurses: A Course Evaluation

This article presents an immediate evaluation of a professional development course in community health literacy for Brazilian nurses. An evaluation based on an applied thematic analysis of the accounts of 63 attendees in three Brazilian cities (January 2020) was guided by the following themes: (a) expansion of understanding about community health literacy as a pillar for planning and providing health care; (b) encouragement of innovation in research and/or practice; and (c) plans to incorporate the information shared in the course into professional projects. The evaluation disclosed the complexity of social contexts for health literacy, which is intertwined with ethnocultural diversity and deep socioeconomic disparities, such as restricted access to essential public health services for socially deprived and vulnerable individuals. Expanded understanding about community health literacy is a pillar for care planning and delivery, as well as innovation in research and practice projects. Participants’ evaluations revealed ideas to improve nurses’ practice in promoting community health literacy and empowerment, as well as quality of life and social well-being. Future knowledge dissemination may impact nurses’ clinical practice and management actions, bringing changes in various areas of practice to redesign more socially inclusive actions for clientele. Keywords: Community health literacy; extracurricular education; immediate evaluation; nursing; professional development course

Study of techniques to classify voices affected by pathologies.

Nos últimos anos, várias pesquisas na área de processamento digital de voz estão sendo feitas, no sentido de criar técnicas que auxiliem o diagnóstico preciso por um especialista de patologias do trato vocal de maneira não invasiva, fazendo com que o paciente se sinta confortável na hora do exame. Este trabalho trata da investigação de técnicas para a classificação de vozes afetadas por patologias da laringe, em especial edema de Reinke, visando a construção de um sistema de apoio ao especialista. O sistema de auxílio ao diagnóstico de patologias da laringe, proposto nesta dissertação, é constituido de 3 etapas principais: pré-processamento do sinal de voz, extração de características e classificação. A etapa de pré-processamento consiste na aquisição do sinal de voz, na aplicação de um filtro de pré ênfase para a minimização dos efeitos da radiação dos lábios e da variação da área da glote, seguido da segmentação e janelamento do sinal. Também foi investigada a não utilização da pré-ênfase nessa etapa. Na fase de extração de características, são utilizados coeficientes obtidos a partir da análise por predição linear (coeficientes LPC), coeficientes cepstrais, coeficientes delta-cepstrais e um vetor de características combinando coeficientes LPC e coeficientes cepstrais. A etapa de classificação é dividida em duas partes: classificação entre voz normal e voz afetada por patologia, sem especificar qual patologia, e caso o sinal seja classificado como voz afetada por patologia, tem-se uma segunda parte, a qual é realizada a classificação entre voz afetada por edema de Reinke e voz afetada por outra patologia. Para as duas partes, foram testados 3 diferentes classificadores: Redes Neurais Multilayer Perceptron - MLP, Modelos de Misturas de Gaussianas e Quantização Vetorial. Para diferenciar entre voz normal e voz afetada por patologia, os melhores resultados foram obtidos utilizando Redes Neurais. Para diferenciar entre voz afetada por edema e voz afetada por outra patologia, os melhores resultados foram obtidos utilizando Quantização Vetorial. Em ambos os casos, os melhores resultados foram obtidos ao se utilizar coeficientes cepstrais e sem utilização da pré-ênfase.In recent years, several studies in digital voice processing are being made in order to create techniques to support a noninvasive accurate diagnosis of vocal tract diseases by aspecialist, making the patient feel comfortable during examination. This work deals with the investigation of techniques for classification of voices affected by laryngeal pathologies, especially Reinke’s edema, aiming to build a support system to the specialist. The system for the diagnosis of laryngeal pathologies, proposed here, consists of three main steps: preprocessing the speech signal, feature extraction and classification. Preprocessing corresponds the acquisition of voice signal, the application of a pre-emphasis filter for minimizing the radiation effects from the lips and from variation in glottal area, and the signal segmentation and windowing. The non-use of pre-emphasis was also investigated at this point. In the feature extraction step, we use coefficients obtained from the linear prediction analysis (LPC coefficients), cepstral coefficients, delta-cepstral coefficients, and afeature vectorc ombining LPC and cepstral coefficients. The classification is divided into two parts: classification of normal voice versus voice affected by pathology, without specifying which pathology, and if the signal is classified as voice affected by pathology, second part happens, which is performed by the classification between voice affected by Reinke’s edema and voice affected by other pathology. For both parties, 3 different classifiers were tested: Neural Networks Multilayer Perceptron - MLP, Gaussian Mixture Models and Vector Quantization. To differentiate between normal voice and voice affected by pathology, the best results were obtained using Neural Networks. To differentiate between voice affected by edema and voice affected by pathology, the best results were obtained using vector quantization. In both cases, the best results were obtained when usingcepstral coefficients and withoutuse of pre-emphasis