¿A Terra É Plana Ou Redonda? Uma Experiência com Alunos de Educação Básica

The text presents an experience on the teaching of elementary notions of Natural Sciences to primary and secondary education students, looking not only to present concepts that students must memorize without understanding, and following what didactics says, so that young people reflect on information that they obtain by themselves, or that is provided to them, detect the limits of their previous ideas and come to construct others congruent with what the sciences say. It deals with a topic from the field of Earth and Space sciences, little attended in the Mexican curriculum, but which is part of the scientific culture that every citizen of the 21st century should have.El texto presenta una experiencia sobre la enseñanza de nociones elementales de Ciencias Naturales a estudiantes de Educación Primaria y Secundaria, que buscó no reducirse a presentar conceptos que los alumnos deben memorizar sin entender; así, se trató de seguir lo que dice la didáctica actual para que los jóvenes reflexionen sobre información que obtienen por sí mismos –o que se les proporciona–, detecten los límites de sus ideas previas y lleguen a construir otras congruentes con lo que dicen las Ciencias. Se maneja un tema del ámbito de las ciencias de la Tierra y el Espacio, poco atendido por el currículo mexicano, pero que es parte de la cultura científica que todo ciudadano del siglo XXI debería tener.O texto apresenta uma experiência de ensino de noções elementares de Ciências Naturais a alunos do ensino fundamental e médio, que buscou não se reduzir a apresentar conceitos que os alunos devem memorizar sem compreender, procurando seguir o que diz a didática atual para que os jovens. refletem sobre as informações que obtêm por si mesmas, ou que lhes são fornecidas, detectam os límites de suas ideias anteriores e passam a construir outras congruentes com o que dizem as ciências. Trata-se de um tema da área das ciências da Terra e do Espaço, pouco abordado no currículo mexicano, mas que faz parte da cultura científica que todo cidadão do século XXI deve ter

Melhoria da Atenção aos Idosos na UBS/ESF Enedino Monteiro, Coari/AM

MARTÍNEZ, Ismael Rizo. Melhoria da atenção aos idosos na UBS/ESF Enedino Monteiro, Coari/AM. 2016. 96f. Trabalho de Conclusão de Curso (Especialização). Especialização em Saúde da Família. Universidade Aberta do SUS / Universidade Federal de Pelotas, Pelotas. A população idosa é a parcela populacional que mais cresce atualmente no Brasil e no mundo. No país, os idosos representam 8,6% da população total, neste intuito, é importante garantir a atenção integral à saúde desta população tendo em vista o grande número de pessoas nesta faixa etária. O objetivo desta intervenção foi melhorar a atenção aos idosos na UBS/ESF Enedino Monteiro, Coari/AM. Esta foi realizada em doze semanas e as ações foram organizadas nos quatro eixos pedagógicos do curso: organização e gestão do serviço, monitoramento e avaliação, qualificação da prática clínica e engajamento público. Foram cadastrados 180 (74,7%) idosos da área de abrangência da unidade de saúde, sendo que todos os 180 (100%), tiveram avaliação multidimensional rápida, exame clínico apropriado, foram rastreadas para Hipertensão Arterial Sistêmica e Diabetes Mellitus as com diabetes tiveram exame apropriado dos pés, todos os cadastrados também tiveram solicitação de exames complementares, prescrição de medicamentos da Farmácia Popular, os idosos acamados ou com problemas de locomoção foram também cadastrados e receberam visita domiciliar. Os cadastrados receberam avaliação da necessidade de atendimento odontológico, primeira consulta odontológica programática, tiveram avaliação de alterações de mucosa bucal, avaliação de necessidade de prótese dentária, os faltosos faltosas às consultas receberam busca ativa, registro na ficha de acompanhamento/espelho, Caderneta de Saúde da Pessoa Idosa, avaliação de risco para morbimortalidade em dia, avaliação para fragilização na velhice, avaliação de rede social e receberam orientação nutricional, sobre prática regular de atividade física e higiene bucal. Sendo assim, tivemos bons resultados mesmo em um curto período de intervenção, aumentando o vínculo da comunidade com a nossa equipe, ainda vamos ampliar ainda mais a cobertura e qualidade do serviço. Igualmente, esperamos que a gestão valorize e fortaleça esse trabalho, dando condições para sua continuidade. Palavras-Chave: Saúde da família; Atenção Primária à Saúde; Saúde do Idoso; Assistência Domicilia

Conocimientos, Actitudes y Prácticas sobre métodos anticonceptivos en adolescentes de 4° y 5° año del Instituto Nacional Autónomo de San Rafael del Sur, Departamento de Managua en el periodo del 1° de Agosto al 31 de Octubre del 2017

Actualmente Nicaragua sigue enfrentando problemas de salud propios del subdesarrollo, provocando afectación directa e indirectamente a grupos vulnerables como son los adolescentes. Hasta hace poco Los Adolescentes se les ha brindado la atención en el ámbito de salud que ellos demandan, con el fortalecimiento e impulso de Programas de Salud Sexual y Reproductiva que este grupo de población necesita.El mal uso y manejo incorrecto de los Métodos Anticonceptivos en los Adolescentes provoca cada día mayores efectos importantes en el buen desarrollo de su proceso evolutivo. Las infecciones por el vih-sida, embarazos no deseados, la agudización de los problemas socioeconómicos familiares son solo un pequeño ejemplo de los trastornos provocados por una sexualidad no orientada de forma adecuada y por una deficiente base de información que provoca un mayor impacto negativo en nuestra población y sobre todo en los estratos sociales más vulnerables, en donde se destaca la población adolescente, ya que es un hecho que las infecciones y los embarazos adolescentes en Nicaragua van aumentando año con año.El impacto socioeconómico que conllevan estos problemas, hace que la información acerca de los Métodos Anticonceptivos hacia los adolescentes sea un tema de especial interés, sobre todo porque en ellos descansa el futuro socioeconómico de Nicaragua, y representan la fuerza productiva de nuestro país. Su desarrollo dentro de un ambiente positivo y fortalecido conllevará a crear cada día mejores condiciones como individuos en el proceso productivo de la nación.La adolescencia es una etapa crítica en el desarrollo del ser humano pues hay mucha inseguridad e inmadurez y por otro lado un sentimiento de invencibilidad, un comportamiento normativo, con el fin de sentirse aceptados por los demás, factores que conllevan muchas veces a prácticas de riesgo.Debido a la importancia que reviste el tema se realizó un estudio en una muestra de 170 adolescentes del 4° y 5°| año de Secundaria del Instituto Nacional Autónomo de San Rafael del Sur, Departamento de Managua, en el periodo del 1° de Agosto al 31 de Octubre del 2017, aplicándose una encuesta dirigida a los adolescentes en estudio para valorar los conocimientos, actitudes y prácticas sobre los Métodos Anticonceptivos.De los 170 estudiantes encuestados el 58.2% correspondió al grupo de 14 a 16 años y el 41.8% al grupo de edad de 17 a 19 años. Respecto al sexo, el 70.0% correspondió al sexo femenino, y el 30.0% al masculino. En la escolaridad encontramos que el 64.1% cursaba 4to año y un 35.9 % se encontraban en 5to año. Según el estado civil predominó el soltero con un 94.1%. En cuanto a la tendencia religiosa de los adolescentes en estudio, en el 43.5% profesaban la religión católica, el 34.7% evangélica, y el 21.8% pertenecían a otro tipo de religiones.De manera general encontramos un buen nivel de conocimientos y actitudes favorables en los adolescentes, pero un mal nivel de prácticas, con respecto al uso y manejo de los métodos anticonceptivos. Lo que nos hace reflexionar en el papel que se está desempeñando en materia preventiva para que los adolescentes adopten prácticas sexuales seguras que disminuyan los riesgos de infecciones de transmisión sexual o embarazos no deseados. Cabe señalar que un buen nivel de conocimientos no conlleva a prácticas adecuadas, pero si es importante a la hora de tomar decisiones.Los medios de comunicación masivos juegan un rol importante ya que es la radio y televisión (94.1%), el centro escolar (82.4%), son el medio que los adolescentes destacaron como principal fuente de donde obtienen información sobre los métodos anticonceptivos.Es con sus amigos (95.3%), principalmente con quienes los adolescentes hablan sobre este tema, seguidos de los médicos (84.1%).Es necesario que la población en general, maestros, padres de familia y adolescentes tomen conciencia de la magnitud del problema acerca del uso y manejo de los métodos anticonceptivos en nuestro país, ya que nos afecta a todos, repercutiendo en la calidad de vida, las oportunidades de desarrollo económico, causando severos daños en el seno de la famili

Obstetric complications and genetic risk for schizophrenia: Differential role of antenatal and perinatal events in first episode psychosis

Background: Obstetric complications (OCs) are key contributors to psychosis risk. However, it is unclear whether they increase psychosis vulnerability independently of genetic risk, in interaction with it, or are a manifestation of psychosis proneness. We examined the role of distinct types of OCs in terms of psychosis risk and tested whether they interact differently with genetic vulnerability, whilst accounting for other known environmental risk factors. Study Design: 405 participants (219 first episode psychosis patients and 186 healthy volunteers) underwent a comprehensive assessment of OCs, measured using the Lewis-Murray scale and divided into complications of pregnancy, abnormalities of foetal growth and development, and complications of delivery. Participants were compared in terms of history of OCs, polygenic risk score for schizophrenia (PRS-SZ) and interactions between these. Results: Both complications of pregnancy and abnormalities of foetal growth were significantly associated with case–control status (p = 0.02 and 0.03, respectively), whereas complications of delivery were not. PRS-SZ showed a significant association with psychosis (p = 0.04), but there were no significant interactions between genetic risk for schizophrenia and OCs, either when these were considered globally or separated based on their timeframe. Conclusions: We observed no significant interaction between genetic and obstetric vulnerability, yet distinct types of OCs may have a different impact on psychosis risk, based on their nature and timeframe. Examining their differential role might clarify their relative contributions to this risk

Importance of lysosomal cysteine proteases in lung disease

The human lysosomal cysteine proteases are a family of 11 proteases whose members include cathepsins B, C, H, L, and S. The biology of these proteases was largely ignored for decades because of their lysosomal location and the belief that their function was limited to the terminal degradation of proteins. In the past 10 years, this view has changed as these proteases have been found to have specific functions within cells. This review highlights some of these functions, specifically their roles in matrix remodeling and in regulating the immune response, and their relationship to lung diseases

VAMP3/Syb and YKT6 are required for the fusion of constitutive secretory carriers with the plasma membrane

The cellular machinery required for the fusion of constitutive secretory vesicles with the plasma membrane in metazoans remains poorly defined. To address this problem we have developed a powerful, quantitative assay for measuring secretion and used it in combination with combinatorial gene depletion studies in Drosophila cells. This has allowed us to identify at least three SNARE complexes mediating Golgi to PM transport (STX1, SNAP24/29 and Syb; STX1, SNAP24/29 and YKT6; STX4, SNAP24 and Syb). RNAi mediated depletion of YKT6 and VAMP3 in mammalian cells also blocks constitutive secretion suggesting that YKT6 has an evolutionarily conserved role in this process. The unexpected role of YKT6 in plasma membrane fusion may in part explain why RNAi and gene disruption studies have failed to produce the expected phenotypes in higher eukaryotes

Emerging evidence for the modulation of exocytosis by signalling lipids

Membrane fusion is a key event in exocytosis of neurotransmitters and hormones stored in intracellular vesicles. In this process, soluble N-ethylmaleimide sensitive factor attachment protein receptor (SNARE) proteins are essential components of the exocytotic molecular machinery, while lipids have been seen traditionally as structural elements. However, the so-called signalling lipids, such as sphingosine and arachidonic acid, interact with SNAREs and directly modulate the frequency and mode of fusion events. Interestingly, recent work has proved that the sphingosine analogue FTY-720, used in the treatment of multiple sclerosis, mimics the effects of signalling lipids. In the present Review, we discuss recent investigations suggesting that endogenous signalling lipids and synthetic analogues can modulate important physiological aspects of secretion, such as quantal release, vesicle recruitment into active sites, vesicle transport and even organelle fusion in the cytosol. Therefore, these compounds are far from being merely structural components of cellular membranes

Circulating microRNAs in sera correlate with soluble biomarkers of immune activation but do not predict mortality in ART treated individuals with HIV-1 infection: A case control study

Introduction: The use of anti-retroviral therapy (ART) has dramatically reduced HIV-1 associated morbidity and mortality. However, HIV-1 infected individuals have increased rates of morbidity and mortality compared to the non-HIV-1 infected population and this appears to be related to end-organ diseases collectively referred to as Serious Non-AIDS Events (SNAEs). Circulating miRNAs are reported as promising biomarkers for a number of human disease conditions including those that constitute SNAEs. Our study sought to investigate the potential of selected miRNAs in predicting mortality in HIV-1 infected ART treated individuals. Materials and Methods: A set of miRNAs was chosen based on published associations with human disease conditions that constitute SNAEs. This case: control study compared 126 cases (individuals who died whilst on therapy), and 247 matched controls (individuals who remained alive). Cases and controls were ART treated participants of two pivotal HIV-1 trials. The relative abundance of each miRNA in serum was measured, by RTqPCR. Associations with mortality (all-cause, cardiovascular and malignancy) were assessed by logistic regression analysis. Correlations between miRNAs and CD4+ T cell count, hs-CRP, IL-6 and D-dimer were also assessed. Results: None of the selected miRNAs was associated with all-cause, cardiovascular or malignancy mortality. The levels of three miRNAs (miRs -21, -122 and -200a) correlated with IL-6 while miR-21 also correlated with D-dimer. Additionally, the abundance of miRs -31, -150 and -223, correlated with baseline CD4+ T cell count while the same three miRNAs plus miR- 145 correlated with nadir CD4+ T cell count. Discussion: No associations with mortality were found with any circulating miRNA studied. These results cast doubt onto the effectiveness of circulating miRNA as early predictors of mortality or the major underlying diseases that contribute to mortality in participants treated for HIV-1 infection

Comparative effectiveness and safety of non-vitamin K antagonists for atrial fibrillation in clinical practice: GLORIA-AF Registry

Background and purpose: Prospectively collected data comparing the safety and effectiveness of individual non-vitamin K antagonists (NOACs) are lacking. Our objective was to directly compare the effectiveness and safety of NOACs in patients with newly diagnosed atrial fibrillation (AF). Methods: In GLORIA-AF, a large, prospective, global registry program, consecutive patients with newly diagnosed AF were followed for 3 years. The comparative analyses for (1) dabigatran vs rivaroxaban or apixaban and (2) rivaroxaban vs apixaban were performed on propensity score (PS)-matched patient sets. Proportional hazards regression was used to estimate hazard ratios (HRs) for outcomes of interest. Results: The GLORIA-AF Phase III registry enrolled 21,300 patients between January 2014 and December 2016. Of these, 3839 were prescribed dabigatran, 4015 rivaroxaban and 4505 apixaban, with median ages of 71.0, 71.0, and 73.0 years, respectively. In the PS-matched set, the adjusted HRs and 95% confidence intervals (CIs) for dabigatran vs rivaroxaban were, for stroke: 1.27 (0.79–2.03), major bleeding 0.59 (0.40–0.88), myocardial infarction 0.68 (0.40–1.16), and all-cause death 0.86 (0.67–1.10). For the comparison of dabigatran vs apixaban, in the PS-matched set, the adjusted HRs were, for stroke 1.16 (0.76–1.78), myocardial infarction 0.84 (0.48–1.46), major bleeding 0.98 (0.63–1.52) and all-cause death 1.01 (0.79–1.29). For the comparison of rivaroxaban vs apixaban, in the PS-matched set, the adjusted HRs were, for stroke 0.78 (0.52–1.19), myocardial infarction 0.96 (0.63–1.45), major bleeding 1.54 (1.14–2.08), and all-cause death 0.97 (0.80–1.19). Conclusions: Patients treated with dabigatran had a 41% lower risk of major bleeding compared with rivaroxaban, but similar risks of stroke, MI, and death. Relative to apixaban, patients treated with dabigatran had similar risks of stroke, major bleeding, MI, and death. Rivaroxaban relative to apixaban had increased risk for major bleeding, but similar risks for stroke, MI, and death. Registration: URL: https://www.clinicaltrials.gov. Unique identifiers: NCT01468701, NCT01671007. Date of registration: September 2013

Anticoagulant selection in relation to the SAMe-TT2R2 score in patients with atrial fibrillation. the GLORIA-AF registry

Aim: The SAMe-TT2R2 score helps identify patients with atrial fibrillation (AF) likely to have poor anticoagulation control during anticoagulation with vitamin K antagonists (VKA) and those with scores >2 might be better managed with a target-specific oral anticoagulant (NOAC). We hypothesized that in clinical practice, VKAs may be prescribed less frequently to patients with AF and SAMe-TT2R2 scores >2 than to patients with lower scores. Methods and results: We analyzed the Phase III dataset of the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF), a large, global, prospective global registry of patients with newly diagnosed AF and ≥1 stroke risk factor. We compared baseline clinical characteristics and antithrombotic prescriptions to determine the probability of the VKA prescription among anticoagulated patients with the baseline SAMe-TT2R2 score >2 and ≤ 2. Among 17,465 anticoagulated patients with AF, 4,828 (27.6%) patients were prescribed VKA and 12,637 (72.4%) patients an NOAC: 11,884 (68.0%) patients had SAMe-TT2R2 scores 0-2 and 5,581 (32.0%) patients had scores >2. The proportion of patients prescribed VKA was 28.0% among patients with SAMe-TT2R2 scores >2 and 27.5% in those with scores ≤2. Conclusions: The lack of a clear association between the SAMe-TT2R2 score and anticoagulant selection may be attributed to the relative efficacy and safety profiles between NOACs and VKAs as well as to the absence of trial evidence that an SAMe-TT2R2-guided strategy for the selection of the type of anticoagulation in NVAF patients has an impact on clinical outcomes of efficacy and safety. The latter hypothesis is currently being tested in a randomized controlled trial. Clinical trial registration: URL: https://www.clinicaltrials.gov//Unique identifier: NCT01937377, NCT01468701, and NCT01671007