O monitoramento de processos de ensino e aprendizagem no tema propriedades dos materiais

Neste trabalho discutimos parte dos resultados de uma pesquisa de cinco anos, realizada com estudantes de ensino médio de um sistema privado de ensino, no que se refere ao monitoramento de processos de ensino e aprendizagem em Química. A construção de uma escala de proficiência baseadana Teoria de Resposta ao Item (TRI) possibilitou a discussão dos dados referentes à proficiência dos estudantes do ensino médio em alguns tópicos de propriedades específicas dos materiais. O objetivo foi fornecer elementos para um ensino mais orientado pelas singularidades e demandas de cada estudante. Teoricamente, as disciplinas curriculares deveriam estar organizadas em um continuum de dificuldadecrescente em termos de habilidades cognitivas requeridas. Contudo, uma crença recorrente entre docentes é a de que tal complexidade deve-se somente aos tópicos de conteúdos. Nossa hipótese inicial foi a de que tal crença não se sustenta e compromete pensar outros modos de organização curricula

AVALIAÇÃO HIGIÊNICO-SANITÁRIA DA VENDA DE PESCADO NO MUNICÍPIO DE CAUCAIA

Fish consumption has increased significantly in recent years in Brazil, especially in the Northeast. Despite the large fish trade in the region of the municipality of Caucaia in Ceará, it is not known about the quality, hygienic and, sanitary conditions of the fish sold in this locality. Therefore, the objective of this study was to evaluate the hygienic-sanitary conditions of Caucaia’s fish outlets, as well as the freshness characteristics of this product marketed in this municipality. Twenty-two fish outlets were visited (3 in the center of Caucaia and 19 beach huts). It was observed that the points of sale located in both the urban center and the beach region did not obey the binary shelf-temperature time and did not present adequate conservation infrastructures, where 50% of the visited establishments did not have basic sanitation. All fish marketing sites in the municipality did not follow the rules of good handling and hygiene practices. In addition, the marketed fish presented characteristics that were outside the quality standards for consumption. In view of this, it can be concluded that establishments that sell fish in the municipality of Caucaia present inadequate conditions for handling and conservation of products, characterizing as a potential risk to the food safety of consumers.O consumo de pescado tem aumentado muito nos últimos anos no Brasil, principalmente na região Nordeste. Apesar do grande comércio de pescado na região do município de Caucaia no Ceará, não se conhece sobre a qualidade do pescado vendido nessa localidade, condições higiênico-sanitárias dos estabelecimentos. Diante disso, o objetivo deste trabalho foi avaliar as condições higiênico-sanitárias dos pontos de venda de pescado em Caucaia, assim como as características de frescor desse produto comercializado nesse município. Foram visitados 22 postos de venda de pescado (3 no centro de Caucaia e 19 barracas de praia). Observou-se que os pontos de vendas localizados tanto no centro urbano quanto na região praiana não obedeciam ao binário tempo de prateleira-temperatura e não apresentavam infraestruturas adequadas de conservação, onde 50% dos estabelecimentos visitados não dispunham de saneamento básico. Todos os locais de comercialização de pescado do município não seguiam às normas de boas práticas de manipulação e higiene. Além disso, o pescado comercializado apresentava características fora dos padrões de qualidade para consumo. Diante disso, pode-se concluir que os estabelecimentos que comercializam pescado no município de Caucaia apresentam condições inadequadas de manipulação e conservação dos produtos, caracterizando-se como um risco potencial à segurança alimentar dos consumidores

Enfermagem e o brincar: prevenção de acidentes com pré-escolares/Nursing and play: prevention of accidents with preschoolers

Este, objetiva relatar a expeciência na utilização de práticas lúdicas como estratégias preventivas de acidentes em crianças na fase pré-escolar. As atividades foram realizadas com duas professoras e 40 crianças com idades entre 4 e 5 anos, em duas creches do interior do Ceará, Brasil. Para tal, foram utilizadas práticas lúdicas sobre prevenção de acidentes, por meio de cartazes; teatro de fantoches; bonecos para simulação; jogos; dramatizações e contação de história. Assim, ocorreram nove encontros, abordando os temas pertinentes, que vão desde as quedas até acidentes automobilísticos. As estratégias adotadas proporcionaram a interação dos alunos e viabilizaram a discussão sobre as temáticas abordadas. Conclui-se que, o lúdico permitiu a participação e o aprendizado das crianças e tem o potencial para a redução de acidentes na infância, uma vez que, essas crianças podem atuar como multiplicadores de conhecimento

Avaliação de estrutura prisional para assistência de enfermagem à saúde materno-infantil / Evaluation of prison structure for nursing assistance to childhood and children

O Sistema Único de Saúde apresenta como uma de suas diretrizes o atendimento integral. Dentre os diversos ambientes para realizar atendimento em saúde encontra-se o ambiente prisional, que apresenta diversas limitações quanto a assistência e apresenta-se como um ambiente pouco priorizado nas questões de saúde, apesar de todas as determinações do Plano Nacional de Saúde no Sistema Penal e legislações específicas. Além disso, a população carcerária feminina apresenta demandas diferenciadas em relação à saúde, como por exemplo, a manutenção dos filhos no ambiente penal em média até os 18 meses de idade. Desta forma, o objetivo deste trabalho foi avaliar a estrutura oferecida para a realização do trabalho em saúde em uma penitenciária feminina. A pesquisa foi realizada em dois momentos: a observação da assistência de enfermagem prestada às mães e crianças e verificação da estrutura oferecida para a assistência em saúde, bem como entrevista, norteada por questionário, aos profissionais de saúde. Observou-se que a referida penitenciária segue, dentro de suas limitações, as recomendações contidas no plano estadual de saúde no sistema penitenciário (Ceará), todavia há necessidade de uma estrutura compatível com a demanda de mulheres, assim como ações educativas em saúde para minimizar disseminação de doenças

Seguridad de las drogas biológicas y sintéticas dirigidas utilizadas en pacientes con enfermedades reumáticas inmunomediadas. Datos del registro BIOBADASAR 3.0

Introducción: conocer la seguridad de las drogas actualmente disponibles para el tratamiento de las enfermedades reumáticas es muy importante al momento de tomar decisiones terapéuticas objetivas e individualizadas en la consulta médica diaria. Asimismo, datos de la vida real amplían el conocimiento revelado por los ensayos clínicos. Objetivos: describir los eventos adversos (EA) reportados, estimar su frecuencia e identificar los factores relacionados con su desarrollo. Materiales y métodos: se utilizaron datos BIOBADASAR, un registro voluntario y prospectivo de seguimiento de EA de tratamientos biológicos y sintéticos dirigidos en pacientes con enfermedades reumáticas inmunomediadas. Los pacientes son seguidos hasta la muerte, pérdida de seguimiento o retiro del consentimiento informado. Para este análisis se extrajeron datos recopilados hasta el 31 de enero de 2023. Resultados: se incluyó un total de 6253 pacientes, los cuales aportaron 9533 ciclos de tratamiento, incluyendo 3647 (38,3%) ciclos sin drogas modificadoras de la enfermedad biológicas y sintéticas dirigidas (DME-b/sd) y 5886 (61,7%) con DME-b/sd. Dentro de estos últimos, los más utilizados fueron los inhibidores de TNF y abatacept. Se reportaron 5890 EA en un total de 2701 tratamientos (844 y 1857 sin y con DME-b/sd, respectivamente), con una incidencia de 53,9 eventos cada 1000 pacientes/año (IC 95% 51,9-55,9). La misma fue mayor en los ciclos con DME-b/sd (71,1 eventos cada 1000 pacientes/año, IC 95% 70,7-77,5 versus 33,7, IC 95% 31,5-36,1; p<0,001). Las infecciones, particularmente las de la vía aérea superior, fueron los EA más frecuentes en ambos grupos. El 10,9% fue serio y el 1,1% provocó la muerte del paciente. El 18,7% de los ciclos con DME-b/sd fue discontinuado a causa de un EA, significativamente mayor a lo reportado en el otro grupo (11,5%; p<0,001). En el análisis ajustado, las DME-b/sd se asociaron a mayor riesgo de presentar al menos un EA (HR 1,82, IC 95% 1,64-1,96). De igual manera, la mayor edad, el mayor tiempo de evolución, el antecedente de enfermedad pulmonar obstructiva crónica, el diagnóstico de lupus eritematoso sistémico y el uso de corticoides se asociaron a mayor riesgo de EA. Conclusiones: la incidencia de EA fue significativamente superior durante los ciclos de tratamientos que incluían DME-b/sd

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Study of the doubly charmed tetraquark T+cc

Quantum chromodynamics, the theory of the strong force, describes interactions of coloured quarks and gluons and the formation of hadronic matter. Conventional hadronic matter consists of baryons and mesons made of three quarks and quark-antiquark pairs, respectively. Particles with an alternative quark content are known as exotic states. Here a study is reported of an exotic narrow state in the D0D0π+ mass spectrum just below the D*+D0 mass threshold produced in proton-proton collisions collected with the LHCb detector at the Large Hadron Collider. The state is consistent with the ground isoscalar T+cc tetraquark with a quark content of ccu⎯⎯⎯d⎯⎯⎯ and spin-parity quantum numbers JP = 1+. Study of the DD mass spectra disfavours interpretation of the resonance as the isovector state. The decay structure via intermediate off-shell D*+ mesons is consistent with the observed D0π+ mass distribution. To analyse the mass of the resonance and its coupling to the D*D system, a dedicated model is developed under the assumption of an isoscalar axial-vector T+cc state decaying to the D*D channel. Using this model, resonance parameters including the pole position, scattering length, effective range and compositeness are determined to reveal important information about the nature of the T+cc state. In addition, an unexpected dependence of the production rate on track multiplicity is observed

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.

BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Background A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. Methods This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. Findings Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials