EDUCAÇÃO AMBIENTAL ALÉM DO MEIO AMBIENTE: CONSIDERAÇÕES SOBRE RELAÇÕES SOCIOPOLÍTICAS NOS MODELOS DE ENSINO

Existem diferentes concepções de Educação Ambiental. Cada concepção é formulada conforme os interesses de um dado grupo ou momento social. Lucie Sauvé, em “Uma cartografia das correntes em Educação Ambiental”, descreve os princípios dos quais partem as principais ideias que circundam os discursos em EA. Neste trabalho, fez-se uma breve revisão sobre os modelos de EA, confrontando o modelo hegemônico capitalista com a concepção política. As discussões foram norteadas a partir das correntes descritas por Sauvé. Entendeu-se que a EA fundamentada na crítica social busca superação de uma visão ingênua e fragmentada dentro do processo educativo, propiciando a aquisição de ferramentas culturais que se direcionem contra valores capitalistas, no qual degrada o coletivo e deturpa os reais objetivos da EA. A concepção política da EA permite que vejamos as questões sociais de modo crítico, vendo o mundo determinado historicamente, sendo movido por interesses e conflitos sociais. A construção de uma proposta política dentro da EA deve ser realizada coletivamente, levando em consideração a problematização das questões sociais, na qual se insere o educando

Animal trafficking: what they say high school students?

O tráfico de animais é todo comércio ilegal de espécies nativas de uma determinada região, o que muitas vezes passa despercebido pela sociedade. Neste sentido, o presente trabalho teve como objetivo compreender as concepções de alunos do Ensino Médio sobre o tráfico de animais silvestres, considerando a escola como um espaço de disseminação de saberes, e reportando que a mesma deve atuar discutindo questões como esta, de modo a levar o alunado a uma visão crítica reflexiva. A pesquisa se caracteriza como qualitativa, e mediante seu objetivo, como estudo de caso. O objeto de coleta de dados foi o questionário, aplicado a alunos da 3º série do Ensino Médio de uma escola da rede pública da cidade de Montes Claros de Goiás – GO. Foi possível notar que, mesmo conhecendo a ilegalidade e também as injúrias causadas pelo tráfico, ainda existe uma parcela de alunos que possuem animais silvestres em cativeiro. Nesse ponto, ressalta-se a necessidade de que a escola volte seu olhar para a temática, a fim de sensibilizar a população sobre a importância de se evitar condutas que fomentem o tráfico de animais.Animal trafficking is the illegal trade of all species native to a region that is part of the wildlife. This fact often goes unnoticed by society. In this sense, the present study aimed to point out the concepts of high school students about wildlife trafficking, considering that the school is a space for the dissemination of knowledge, must act discussing issues like this in order to bring the student body to a critical and reflective about the vision of the subject. The research is characterized as qualitative, and upon your goal, as a case study. The object of data collection was semi-structured questionnaire administered to students in third year high school students in a school of public schools in the city of Montes Claros de Goiás - GO (16 ° 00'26 "S 51 ° 23 '52 "O). Participated in the survey a total of 58 students, of which 91.37% said they had heard about the pet trade, and only a minority of 8.63% said they had no knowledge on the subject. The first indicated that the topic was presented to them via newspapers, magazines, television and the Internet, backs up this point that the school was not mentioned Regarding their perception about what comes to animal trafficking, the student body at most (97%) suggests that it is a "cruel manner of mistreatment of wild animals", mentioning the removal of these beings from their natural habitat. Also cited the maintenance of the animal in captivity where they are deprived of liberty. Some students reported that many people have seen creating wildlife. Yet others (3%) claimed that they have had or still have wild animals as pets. The last factor can be explained by the large contact these students with the rural environment as the city's economy is based primarily on agro-pastoral activities, with many students living in the countryside and having direct contact with wildlife. Given the results achieved by the questionnaire, it was concluded that the studied group understands what comes to animal trafficking. However, it was noticeable that even knowing the illegality and also the injuries caused by traffic, there is still a portion of students who keep wild animals in captivity. At this point, we emphasize the need for the school turns his sights on the topic in order to raise awareness about the importance of avoiding behaviors that promote animal trafficking

Determination of clusters and factors associated with dengue dispersion during the first epidemic related to Dengue virus serotype 4 in Vitoria, Brazil

Dengue occurrence is partially influenced by the immune status of the population. Consequently, the introduction of a new Dengue virus serotype can trigger explosive epidemics in susceptible populations. The determination of clusters in this scenario can help to identify hotspots and understand the disease dispersion regardless of the influence of the population herd immunity. The present study evaluated the pattern and factors associated with dengue dispersion during the first epidemic related to Dengue virus serotype 4 in Vitoria, Espirito Santo state, Brazil. Data on 18,861 dengue cases reported in Vitoria from September 2012 to June 2013 were included in the study. The analysis of spatial variation in temporal trend was performed to detect clusters that were compared by their respective relative risk, house index, population density, and income in an ecological study. Overall, 11 clusters were detected. The time trend increase of dengue incidence in the overall study population was 636%. The five clusters that showed a lower time trend increase than the overall population presented a higher incidence in the beginning of the epidemic and, compared to the six clusters with higher time trend increase, they presented higher relative risk for their inhabitants to acquire dengue infection (P-value = 0.02) and a lower income (P-value < 0.01). House index and population density did not differ between the clusters. Early increase of dengue incidence and higher relative risk for acquiring dengue infection were favored in low-income areas. Preventive actions and improvement of infrastructure in low-income areas should be prioritized in order to diminish the magnitude of dengue dispersion after the introduction of a new serotype

DIMENSÕES QUALITATIVAS E QUANTITATIVAS DO TRABALHO HOSPITALAR: INTERFACE COM A CULTURA DE SEGURANÇA DO PACIENTE

Objetivou-se analisar a cultura de segurança do paciente entre a equipe multiprofissional hospitalar quanto às dimensões que tratam do qualitativo organizacional e o quantitativo de pessoal. Procedeu-se pesquisa descritiva, quantitativa, com a participação de 71 profissionais de um hospital de ensino público do interior do Paraná, que responderam ao questionário “Hospital Survey on Patient Safety Culture”. A análise estatística descritiva foi procedida às dimensões de aprendizado organizacional (qualitativa) e dimensão de pessoal (quantitativa) do referido instrumento. A maioria (67,6%) dos sujeitos legitimou percepção favorável ao aprendizado organizacional contínuo, contudo, 91,6% dos profissionais sinalizaram que o hospital empregador não propicia quantitativo adequado de pessoal para o atendimento seguro, além das pessoas estarem expostas à elevada carga de trabalho e continuamente atuarem sob tensão. Concluiu-se que, através desta dualidade na percepção dos participantes, fica evidente a maior e melhor atenção das lideranças à provisão de capital humano adequado no serviço. Descritores: Segurança do Paciente; Cultura Organizacional; Downsizing Organizacional; Gestão da Qualidade; Administração Hospitalar.

Relationship between clinical-epidemiological parameters and outcomes of patients with COVID-19 admitted to the intensive care unit: a report from a Brazilian hospital

BackgroundPeople in low-income countries, especially those with low socio-economic conditions, are likelier to test positive for SARS-CoV-2. The unequal conditions of public health systems also increase the infection rate and make early identification and treatment of at-risk patients difficult. Here, we aimed to characterize the epidemiological profile of COVID-19 patients in intensive care and identify laboratory and clinical markers associated with death.Materials and methodsWe conducted an observational, descriptive, and cross-sectional study in a reference hospital for COVID-19 treatment in the Southern Region of Bahia State, in Brazil, to evaluate the epidemiological, clinical, and laboratory characteristics of COVID-19 patients admitted to the intensive care unit (ICU). Additionally, we used the area under the curve (AUC) to classify survivors and non-survivors and a multivariate logistic regression analysis to assess factors associated with death. Data was collected from the hospital databases between April 2020 and July 2021.ResultsThe use of bladder catheters (OR 79.30; p &lt; 0.0001) and central venous catheters (OR, 45.12; p &lt; 0.0001) were the main factors associated with death in ICU COVID-19 patients. Additionally, the number of non-survivors increased with age (p &lt; 0.0001) and prolonged ICU stay (p &lt; 0.0001). Besides, SAPS3 presents a higher sensibility (77.9%) and specificity (63.1%) to discriminate between survivors and non-survivor with an AUC of 0.79 (p &lt; 0.0001).ConclusionWe suggest that multi-laboratory parameters can predict patient prognosis and guide healthcare teams toward more assertive clinical management, better resource allocation, and improved survival of COVID-19 patients admitted to the ICU

Subacute Cognitive Impairment in Individuals With Mild and Moderate COVID-19: A Case Series

Background: Previous reported neurologic sequelae associated with SARS-CoV-2 infection have mainly been confined to hospital-based patients in which viral detection was restricted to nasal/throat swabs or to IgM/IgG peripheral blood serology. Here we describe seven cases from Brazil of outpatients with previous mild or moderate COVID-19 who developed subacute cognitive disturbances. Methods: From June 1 to August 15, 2020, seven individuals 18 to 60 years old, with confirmed mild/moderate COVID-19 and findings consistent with encephalopathy who were observed >7 days after respiratory symptom initiation, were screened for cognitive dysfunction. Paired sera and CSF were tested for SARS-CoV-2 (IgA, IgG ELISA, and RT-PCR). Serum and intrathecal antibody dynamics were evaluated with oligoclonal bands and IgG index. Cognitive dysfunction was assessed by the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and the Clock Drawing Test (CDT). Results: All but one of our patients were female, and the mean age was 42.6 years. Neurologic symptoms were first reported a median of 16 days (IQR 15–33) after initial COVID-19 symptoms. All patients had headache and altered behavior. Cognitive dysfunction was observed mainly in phonemic verbal fluency (MoCA) with a median of six words/min (IQR 5.25–10.75) and altered visuospatial construction with a median of four points (IQR 4–9) (CDT). CSF pleocytosis was not detected, and only one patient was positive for SARS-Co Conclusions: A subacute cognitive syndrome suggestive of SARS-CoV-2-initiated damage to cortico-subcortical associative pathways that could not be attributed solely to inflammation and hypoxia was present in seven individuals with mild/moderate COVID-19

Serotype influences on dengue severity: a cross-sectional study on 485 confirmed dengue cases in Vitória, Brazil

Abstract Background Dengue is caused by a RNA virus of the family Flaviviridae, which presents four serotypes (DENV-1 to DENV-4) capable of inducing hemorrhage. The purpose of this study was to evaluate the influence of serotype on the outcome of dengue. Methods This cross-sectional study included data from dengue cases with serotyping results that occurred between 2009 and 2013 in Vitória, Espírito Santo, Brazil. Data were accessed through the Information System for Notifiable Diseases. Chi-square test, Fisher exact test, Mann–Whitney U test, and logistic regression were performed to assess associations between different serotypes and dengue severity, while considering gender and age. Results The sample consisted of 485 laboratory confirmed dengue cases, of which 46.4 % were females, with median age of 26 years. Regarding overall samples, 77.3 % were caused by DENV-1, 16.1 % by DENV-4, 6.4 % by DENV-2, and 0.2 % by DENV-3. Severe dengue affected 6.6 % of all cases, of which 32.3 % of the cases caused by DENV-2, 6.4 % of those caused by DENV-4, 4.5 % of those caused by DENV-1, and none of those caused by DENV-3. Severe dengue was found to be seven times more frequent among cases of DENV-2 than among those of the other serotypes. Conclusions The present study found that cases of DENV-2 had a higher proportion of severe dengue than among those of DENV-1 and DENV-4. Consequently, early detection of serotypes circulating in the territory could be an important approach to prevent increasing numbers of severe outcomes during dengue outbreaks by predicting the health support needed for early diagnoses and treatment of dengue cases

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure &lt;= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

ESTUDO CIENCIOMÉTRICO DA ESPÉCIE VEGETAL DO CERRADO Physocalymma scaberrimum

O Cerrado destaca-se entre os biomas brasileiros, pois apresenta uma rica biodiversidade, o que estimula diversos autores a proporem trabalhos sobre diferentes espécies vegetais e animais. Isso colabora para o desenvolvimento sustentável e conservação desse bioma. Physocalymma scaberrimum Pohl (Lythraceae), conhecida popularmente como "pau-de-rosas", é uma espécie arbórea encontrada no Cerrado Brasileiro, reconhecida por seu potencial madeireiro e de reflorestamento. Recentemente, a utilização desta planta pela medicina popular foi investigada. O presente artigo propôs o levantamento dos trabalhos já publicados sobre P. scaberrimum, destacando a área de concentração e a finalidade destes estudos. A pesquisa bibliográfica foi feita nas bases de dados SciELO, Science Direct, Scopus e ISI Web of Knowledge, utilizando os seguintes termos: Physocalymma scaberrimum, Physocalymma, scaberrimum e Lythraceae. Esta pesquisa revelou a existência de poucos trabalhos a respeito desta espécie vegetal, com a maioria dos trabalhos concentrados nas áreas de Filogenia e Palinologia