42 research outputs found

    Campus, campo, cidade... Itinerários de uma ludoteca

    Get PDF
    Muitas vezes as atividades lúdicas são vistas como não promotoras da aprendizagem, sendo excluídas das propostas pedagógicas e do cotidiano da infância. Com o propósito de incorporar o lúdico às práticas escolares regulares e mostrar os diversos benefícios das mesmas, a ludoteca da Universidade Federal de Viçosa implementa atividades de formação social, realizando vivências lúdicas e culturais no campus universitário. Quando a ludoteca itinerante se desloca para além do campus para desenvolver o trabalho em escolas localizadas nas áreas urbanas e rurais, suas atividades alcançam distantes e diferentes lugares. Nesse trabalho articulado com a rede pública de ensino, a realização de diagnósticos, a coleta de informações para iniciar as discussões temáticas, são atividades que antecedem as vivências lúdicas. Como resultado do trabalho, registrou-se aumento do interesse social das escolas por ações que valorizem o brincar, para a formação profissional da equipe que nela atua e dos demais educadores, além de ampliar o acesso dos alunos às brincadeiras no cotidiano infantil

    Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

    Get PDF
    Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

    Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

    Get PDF
    BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

    Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

    Get PDF
    Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

    Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

    Get PDF
    Contains fulltext : 172380.pdf (publisher's version ) (Open Access

    Fatores sociodemográficos e clínicos associados à hemorragia pós-parto numa maternidade

    No full text
    Objective: Checking the sociodemographic and clinical factors associated with the prevalence of postpartum hemorrhage (PPH) in a maternity school. Materials and methods: A quantitative cross-sectional study in a maternity hospital in Salvador, Bahia, Brazil. In data collection, we used a standardized form that contained sociodemographic and clinical data from the medical records of 83 women for the period of 2018. Stata version 14 software was used in the analyses. Bivariate analysis was conducted using Pearson’s or Fisher’s exact tests. Poisson regression was performed with robust variation in multivariate analysis. Prevalence ratios (PR) and respective 95 % confidence intervals were estimated. The significance level of the tests was 5 %. Results: The prevalence of PPH was 38.6 % and 25.6 % for atony as the cause. In the bivariate analysis, there was an association between PPH and non-breastfeeding in the first hour of life (p = 0.039). In the multivariate analysis, it was identified that multiparous women had an increase in the prevalence of PPH by almost twice (PR = 1.97). Not breastfeeding in the first hour of life increased this prevalence more than four times (PR = 4.16). Conclusions: Monitoring multiparous women during birth care and encouraging breastfeeding in the first hour of life may decrease the prevalence of PPH.Objetivo: investigar os fatores sociodemográficos e clínicos associados à prevalência de hemorragia pós-parto (HPP) em uma maternidade escola. Materiais e métodos: estudo quantitativo de corte transversal, numa maternidade de Salvador, Bahia, Brasil. Na coleta de dados, utilizou-se formulário padronizado que continha dados sociodemográficos e clínicos dos prontuários de 83 mulheres referentes ao período de 2018. Nas análises, utilizou-se o software STATA versão 14. Foi conduzida análise bivariada, por meio dos testes de Pearson ou exato de Fisher. Realizou-se regressão de Poisson com variação robusta na análise multivariada. Foram estimadas razões de prevalência (RP) e respectivos intervalos de confiança de 95 %. O nível de significância dos testes foi de 5 %. Resultados: a prevalência de HPP foi de 38,6 % e de 25,6 % para atonia como causa. Na análise bivariada, evidenciou-se associação entre HPP e não amamentação na primeira hora de vida (p = 0,039). Na análise multivariada, identificou-se que mulheres multíparas tiveram incremento na prevalência de HPP em quase duas vezes (RP = 1,97). Não amamentar na primeira hora de vida aumentou essa prevalência em mais de quatro vezes (RP = 4,16). Conclusões: monitorizar multíparas durante a assistência ao parto e incentivar o aleitamento materno na primeira hora de vida pode diminuir a prevalência de HPP.Objetivo: investigar los factores sociodemográficos y clínicos asociados a la prevalencia de hemorragia posparto (HPP) en una maternidad de enseñanza. Materiales y métodos: estudio cuantitativo de corte transversal, en una maternidad de Salvador, Bahia, Brasil. En la recolección de los datos, se empleó formulario estandarizado que contenía datos sociodemográficos y clínicos de los historiales de 83 mujeres referentes al período de 2018. En los análisis, se utilizó el software STATA versión 14. Se realizó análisis bivariado, por medio de las pruebas de Pearson o exacto de Fisher. Además, regresión de Poisson con variación robusta en el análisis multivariado. Se estimaron razones de prevalencia (RP) y respectivos intervalos de confianza del 95 %. El nivel de significancia de las pruebas fue del 5 %. Resultados: la prevalencia de HPP fue del 38,6 % y del 25,6 % para atonía como causa. En el análisis bivariado, se evidenció asociación entre HPP y no lactancia en la primera hora de vida (p = 0,039). En el análisis multivariado, se identificó que mujeres multíparas tuvieron incremento en la prevalencia de HPP en casi dos veces (RP = 1,97). No lactar en la primera hora de vida aumentó esta prevalencia en más de cuatro veces (RP = 4,16). Conclusiones: monitorear multíparas durante la asistencia al parto e incentivar la lactancia materna en la primera hora de vida puede reducir la prevalencia de la HPP

    Fatores sociodemográficos e clínicos associados à hemorragia pós-parto numa maternidade

    No full text
    13 páginasObjective: Checking the sociodemographic and clinical factors associated with the prevalence of postpartum hemorrhage (PPH) in a maternity school. Materials and methods: A quantitative cross-sectional study in a maternity hospital in Salvador, Bahia, Brazil. In data collection, we used a standardized form that contained sociodemographic and clinical data from the medical records of 83 women for the period of 2018. Stata version 14 software was used in the analyses. Bivariate analysis was conducted using Pearson’s or Fisher’s exact tests. Poisson regression was performed with robust variation in multivariate analysis. Prevalence ratios (PR) and respective 95 % confidence intervals were estimated. The significance level of the tests was 5 %. Results: The prevalence of PPH was 38.6 % and 25.6 % for atony as the cause. In the bivariate analysis, there was an association between PPH and non-breastfeeding in the first hour of life (p = 0.039). In the multivariate analysis, it was identified that multiparous women had an increase in the prevalence of PPH by almost twice (PR = 1.97). Not breastfeeding in the first hour of life increased this prevalence more than four times (PR = 4.16). Conclusions: Monitoring multiparous women during birth care and encouraging breastfeeding in the first hour of life may decrease the prevalence of PPH.Objetivo: investigar los factores sociodemográficos y clínicos asociados a la prevalencia de hemorragia posparto (HPP) en una maternidad de enseñanza._x000D_ _x000D_ Materiales y métodos: estudio cuantitativo de corte transversal, en una maternidad de Salvador, Bahia, Brasil. En la recolección de los datos, se empleó formulario estandarizado que contenía datos sociodemográficos y clínicos de los historiales de 83 mujeres referentes al período de 2018. En los análisis, se utilizó el software STATA versión 14. Se realizó análisis bivariado, por medio de las pruebas de Pearson o exacto de Fisher. Además, regresión de Poisson con variación robusta en el análisis multivariado. Se estimaron razones de prevalencia (RP) y respectivos intervalos de confianza del 95 %. El nivel de significancia de las pruebas fue del 5 %._x000D_ _x000D_ Resultados: la prevalencia de HPP fue del 38,6 % y del 25,6 % para atonía como causa. En el análisis bivariado, se evidenció asociación entre HPP y no lactancia en la primera hora de vida (p = 0,039). En el análisis multivariado, se identificó que mujeres multíparas tuvieron incremento en la prevalencia de HPP en casi dos veces (RP = 1,97). No lactar en la primera hora de vida aumentó esta prevalencia en más de cuatro veces (RP = 4,16)._x000D_ _x000D_ Conclusiones: monitorear multíparas durante la asistencia al parto e incentivar la lactancia materna en la primera hora de vida puede reducir la prevalencia de la HPP

    Fatores sociodemográficos e clínicos associados à hemorragia pós-parto numa maternidade

    No full text
    Objective: Checking the sociodemographic and clinical factors associated with the prevalence of postpartum hemorrhage (PPH) in a maternity school. Materials and methods: A quantitative cross-sectional study in a maternity hospital in Salvador, Bahia, Brazil. In data collection, we used a standardized form that contained sociodemographic and clinical data from the medical records of 83 women for the period of 2018. Stata version 14 software was used in the analyses. Bivariate analysis was conducted using Pearson’s or Fisher’s exact tests. Poisson regression was performed with robust variation in multivariate analysis. Prevalence ratios (PR) and respective 95 % confidence intervals were estimated. The significance level of the tests was 5 %. Results: The prevalence of PPH was 38.6 % and 25.6 % for atony as the cause. In the bivariate analysis, there was an association between PPH and non-breastfeeding in the first hour of life (p = 0.039). In the multivariate analysis, it was identified that multiparous women had an increase in the prevalence of PPH by almost twice (PR = 1.97). Not breastfeeding in the first hour of life increased this prevalence more than four times (PR = 4.16). Conclusions: Monitoring multiparous women during birth care and encouraging breastfeeding in the first hour of life may decrease the prevalence of PPH.Objetivo: investigar los factores sociodemográficos y clínicos asociados a la prevalencia de hemorragia posparto (HPP) en una maternidad de enseñanza. Materiales y métodos: estudio cuantitativo de corte transversal, en una maternidad de Salvador, Bahia, Brasil. En la recolección de los datos, se empleó formulario estandarizado que contenía datos sociodemográficos y clínicos de los historiales de 83 mujeres referentes al período de 2018. En los análisis, se utilizó el software STATA versión 14. Se realizó análisis bivariado, por medio de las pruebas de Pearson o exacto de Fisher. Además, regresión de Poisson con variación robusta en el análisis multivariado. Se estimaron razones de prevalencia (RP) y respectivos intervalos de confianza del 95 %. El nivel de significancia de las pruebas fue del 5 %. Resultados: la prevalencia de HPP fue del 38,6 % y del 25,6 % para atonía como causa. En el análisis bivariado, se evidenció asociación entre HPP y no lactancia en la primera hora de vida (p = 0,039). En el análisis multivariado, se identificó que mujeres multíparas tuvieron incremento en la prevalencia de HPP en casi dos veces (RP = 1,97). No lactar en la primera hora de vida aumentó esta prevalencia en más de cuatro veces (RP = 4,16). Conclusiones: monitorear multíparas durante la asistencia al parto e incentivar la lactancia materna en la primera hora de vida puede reducir la prevalencia de la HPP.Objetivo: investigar os fatores sociodemográficos e clínicos associados à prevalência de hemorragia pós-parto (HPP) em uma maternidade escola. Materiais e métodos: estudo quantitativo de corte transversal, numa maternidade de Salvador, Bahia, Brasil. Na coleta de dados, utilizou-se formulário padronizado que continha dados sociodemográficos e clínicos dos prontuários de 83 mulheres referentes ao período de 2018. Nas análises, utilizou-se o software STATA versão 14. Foi conduzida análise bivariada, por meio dos testes de Pearson ou exato de Fisher. Realizou-se regressão de Poisson com variação robusta na análise multivariada. Foram estimadas razões de prevalência (RP) e respectivos intervalos de confiança de 95 %. O nível de significância dos testes foi de 5 %. Resultados: a prevalência de HPP foi de 38,6 % e de 25,6 % para atonia como causa. Na análise bivariada, evidenciou-se associação entre HPP e não amamentação na primeira hora de vida (p = 0,039). Na análise multivariada, identificou-se que mulheres multíparas tiveram incremento na prevalência de HPP em quase duas vezes (RP = 1,97). Não amamentar na primeira hora de vida aumentou essa prevalência em mais de quatro vezes (RP = 4,16). Conclusões: monitorizar multíparas durante a assistência ao parto e incentivar o aleitamento materno na primeira hora de vida pode diminuir a prevalência de HPP
    corecore