A agulha e a linha... tecendo fios na relação família, criança e aprendizagem

The relationship between family and school today is the subject of discussion among educators, pedagogical coordinators and school management, because as instances socializing, the school and the family are fundamental institutions in the development of the child. With the goal of presenting the importance of family in the teaching and learning process of the child, the family problem and its influence on children's learning, as well as the possibilities and conditions that this can play in school performance, the research is justified by bringing up the need to develop works in which we can raise the awareness of parents and guardians of the importance of their involvement in the learning process of the child. Methodologically, are of bibliographical research and had as primary sources of research: books, articles and academic theses. We take as theoretical reference, authors such as: Engels (2002), which deals with the history of the family; Casarin (2007), which emphasizes the relationship of family and school; and Castro and Regattieri (2010), that trace the family institutions and school education over the years. The data were organized from the proposed objectives, and were as follows: (1) the family and his conceptual reflections and its historical context; (2) the influence/interference of family problems and their relationship with learning; and, (3) the analysis of the close relationship between the child and family, school, learning, which provided a parallel vision of these relationships.A relação entre família e escola hoje é tema de discussão entre educadores, coordenadores pedagógicos e gestão escolar, pois como instâncias socializadoras, a escola e a família constituem-se em fundamentais instituições no desenvolvimento da criança. Com o objetivo de apresentar a importância da família no processo de ensino e aprendizagem da criança, partido do problema da família e sua influência na aprendizagem da criança, assim como das possibilidades e condições adequadas que esse possa desempenhar no rendimento escolar, a pesquisa se justifica por trazer à tona a necessidade de desenvolver trabalhos em que possamos conscientizar os pais e responsáveis da importância do seu envolvimento no processo de aprendizagem da criança. Metodologicamente, nos valemos da pesquisa bibliográfica e tivemos como fontes primárias de pesquisa: livros, artigos e teses acadêmicas. Assumimos como referencial teórico, autores como Engels (2002), que trata da história da família; Casarin (2007), que enfatiza a relação da família e escola; e, Castro e Regattieri (2010), que traçam a educação nas instituições família e escola ao longo dos anos. A exposição dos dados foram organizados a partir dos objetivos propostos, e ficaram seguinte forma: (1) a família e suas reflexões conceituais e seu contexto histórico; (2) a influência/interferência dos problemas familiares e sua relação com a aprendizagem; e, (3) a análise da estreita relação entre a família, escola, criança e aprendizagem, que proporcionou uma visão paralela destas relações

Perfil de dissertações com enfoque na saúde da mulher em uma pós-graduação em enfermagem*

Aim: to identify the profile of the theses produced in the Graduate Program in Nursing of the Federal University of Rio Grande do Norte that focus on the area of women's health. Methods: descriptive and documentary study with a quantitative approach. A survey of theses from 2000-2012 was conducted between the months of August to October 2012, in which 22 theses were selected. The data were registered in a check list, compiled on Microsoft Excel and analyzed using descriptive statistics. Results: the results showed the predominance of qualitative and exploratory-descriptive studies and the Symbolic Interactionism was identified as the main methodological framework. Regarding the thematic areas, the obstetric nursing stood out, with issues related to prenatal care and the Basic Health Units were the primary place of study. Conclusion: the theses analyzed converge to publications from other graduate programs on this subject. However, the need to explore emerging issues in this area is recognized.Objetivo: identificar el perfil de las disertaciones producidas en el Programa de Postgrado en Enfermería de la Universidade Federal do Rio Grande do Norte con foco en el área de la salud de la mujer. Método: investigación descriptiva, documental, con enfoque cuantitativo. Se revisó el período 2000-2012, entre agosto y octubre de 2012, seleccionando 22 disertaciones. Los datos fueron compilados en un check list, y analizadosmediante estadística descriptiva. Resultados: se identificó el predominio de estúdios cualitativos, exploratorio-descriptivo, con el Interaccionismo Simbólico como principal marco metodológico utilizado. En cuanto a las áreas temáticas, la enfermería obstétricase destacó con temas relacionados con pre-natal, siendo las Unidades Básicas de Salud el principal local de estudio. Conclusión: las disertaciones analizadas convergen con publicaciones de otros programas de postgrado sobre esta temática. Sin embargo, se reconoce la necesidad de explorar nuevas cuestiones en este campo de conocimiento.Objetivo: identificar o perfil das dissertações produzidas no Programa de Pós-Graduação em Enfermagem da Universidade Federal do Rio Grande do Norte com enfoque na área de saúde da mulher. Método: pesquisa descritiva, documental, com abordagem quantitativa. Realizou-se levantamento de 2000-2012, entre agosto e outubro de 2012, selecionando-se 22 dissertações. Os dados foram registrados em um check list, compilados no Microsoft Excel e analisados pela estatística descritiva. Resultados: identificou-se predomínio de estudos qualitativos, exploratório-descritivos, tendo o Interacionismo Simbólico como o principal referencial metodológico utilizado. Quanto às áreas temáticas, a enfermagem obstétrica destacou-se com assuntos referentes ao pré-natal, sendo as Unidades Básicas de Saúde o local de estudo prioritário. Conclusão: as dissertações analisadas convergem a publicações de outros programas de pós-graduação acerca desta temática. Entretanto, reconhece-se a necessidade de explorar assuntos emergentes neste campo do saber

Brazilian recommendations on the safety and effectiveness of the yellow fever vaccination in patients with chronic immune-mediated inflammatory diseases

Background: In Brazil, we are facing an alarming epidemic scenario of Yellow fever (YF), which is reaching the most populous areas of the country in unvaccinated people. Vaccination is the only effective tool to prevent YF. In special situations, such as patients with chronic immune-mediated inflammatory diseases (CIMID), undergoing immunosuppressive therapy, as a higher risk of severe adverse events may occur, assessment of the risk-benefit ratio of the yellow fever vaccine (YFV) should be performed on an individual level. Main body of the abstract: Faced with the scarcity of specific orientation on YFV for this special group of patients, the Brazilian Rheumatology Society (BRS) endorsed a project aiming the development of individualized YFV recommendations for patients with CIMID, guided by questions addressed by both medical professionals and patients, followed an internationally validated methodology (GIN-McMaster Guideline Development). Firstly, a systematic review was carried out and an expert panel formed to take part of the decision process, comprising BRS clinical practitioners, as well as individuals from the Brazilian Dermatology Society (BDS), Brazilian Inflammatory Bowel Diseases Study Group (GEDIIB), and specialists on infectious diseases and vaccination (from Tropical Medicine, Infectious Diseases and Immunizations National Societies); in addition, two representatives of patient groups were included as members of the panel. When the quality of the evidence was low or there was a lack of evidence to determine the recommendations, the decisions were based on the expert opinion panel and a Delphi approach was performed. A recommendation was accepted upon achieving ≥80% agreement among the panel, including the patient representatives. As a result, eight recommendations were developed regarding the safety of YFV in patients with CIMID, considering the immunosuppression degree conferred by the treatment used. It was not possible to establish recommendations on the effectiveness of YFV in these patients as there is no consistent evidence to support these recommendations. Conclusion: This paper approaches a real need, assessed by clinicians and patient care groups, to address specific questions on the management of YFV in patients with CIMID living or traveling to YF endemic areas, involving specialists from many areas together with patients, and might have global applicability, contributing to and supporting vaccination practices. We recommended a shared decision-making approach on taking or not the YFV

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

Prevalência e fatores associados à incontinência urinária em mulheres idosas

Objective: To verify the prevalence of urinary incontinence (UI) complaints and associated factors among elderly women in the municipality of Petrolina / PE. Methods: Exploratory cross-sectional study conducted in 2009 with 172 elderly women who were assessed regarding sociodemographic, socioeconomic and lifestyle characteristics. UI was assessed using The International Consultation on Incontinence Questionnaire - Short Form (ICIQSF) in addition to questions on obstetrics and comorbidities. Data were computed with a 95% confidence interval using STATA 9.0. Results: The urinary incontinence was present in 81 (47.1%) elderly women. The age group older than 75 years was associated with UI (PR1.57 CI 95% 1.57 - 11.09). Regarding the association with occupation, it was verified that both the retired elders (PR 4.64 CI 95% 0.98 - 21.98) and housewives (PR 6.25 CI 95% 1.14 - 34.12) were more likely to report UI, but only the association with the housewife condition was significant. With regard to diabetes, elderly women who had the disease (PR 1.57 CI 95% 1.16 - 2.13) were more likely to report urinary incontinence when compared to elderly women without diabetes. Conclusion: There was a high prevalence of urinary incontinence among elderly women, which accounted for almost half of the women assessed and was associated with older age, housewives and diabetes. doi:10.5020/18061230.2014.p216Objetivo: Verificar la prevalencia de queja de Incontinencia Urinaria (IU) y los factores asociados en mujeres mayores Del municipio de Petrolina/PE. Métodos: Estudio transversal y exploratorio realizado en 2009 con 172 mujeres mayores en lãs cuales se evaluaron las características socio demográficas, sócio económicas y el estilo de vida. Para investigar la IU se utilizo del International Consultation on Incontinence Questionnaire – Short Form” (ICIQ-SF) y otras preguntas sobre obstetrícia y comorbilidades. Los datos fueron evaluados con intervalo de confianza del 95% utilizando el STATA® 9.0. Resultados: La queja de IU se presentó en 81 (47,1%) mujeres mayores. La franja de edad de mujeres mayores de 75 años estuvo asociada a la IU (RP 1,57 IC95% 1,57-11,09). Al asociar la IU y la ocupación se noto que las mujeres mayores jubiladas (RP 4,64 IC95% 0,98-21,98) y las amas de casa (RP 6,25 IC95% 1,14-34,12) refirieron más IU, sin embargo, solamente la asociación de la condición de ama de casa fue significativa. Respecto a la diabetes, las mujeres mayores que tenían la enfermedad (RP 1,57 IC95% 1,16-2,13) presentaron mayor frecuencia de queja de IU al comparar con aquellas sin diabetes. Conclusión: Se encontró una elevada prevalencia de IU en mujeres mayores que corresponde casi a la mitad de las mujeres investigadas con asociación entre las que tienen más edad, las amas de casa y diabéticas. doi:10.5020/18061230.2014.p216Objetivo: Verificar a prevalência da queixa de Incontinência Urinária (IU) e os fatores associados em idosas no município de Petrolina/PE. Métodos: Estudo transversal e exploratório realizado em 2009 com 172 idosas nas quais se avaliaram características sociodemográficas, socioeconômicas e estilo de vida. Para investigar a IU utilizou-se o International Consultation on Incontinence Questionnaire – Short Form” (ICIQ-SF) acrescido de questões obstétricas e de comorbidades. Dados trabalhados com intervalo de confiança a 95% utilizando o STATA® 9.0. Resultados: A queixa de IU esteve presente em 81 (47,1%) idosas. A faixa etária maior que 75 anos de idade estava associada à IU (RP 1,57 IC95% 1,57-11,09). Na associação com ocupação notou-se que tanto as idosas aposentadas (RP 4,64 IC95% 0,98-21,98) quanto as donas de casa (RP 6,25 IC95% 1,14-34,12) tinham maior ocorrência de referir IU, mas apenas a associação com a condição dona de casa foi significante. Quanto ao diabetes, idosas que tinham a doença (RP 1,57 IC95% 1,16-2,13) tinham maior frequência de referir queixa de IU quando comparadas às idosas sem diabetes. Conclusão: Encontrou-se uma elevada prevalência de Incontinência Urinária em idosas, correspondendo a quase metade das mulheres investigadas, estando associada às idosas de maior idade, donas de casa e diabéticas. doi:10.5020/18061230.2014.p21

Analysis of deaths occurred in households during the pandemic by COVID-19 in a Brazilian Amazon Region: an epidemiological approach

Universidade do Estado do Pará. Programa de Pós-Graduação em Biologia Parasitária na Amazônia. Belém, PA, Brasil / Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Programa de Pós-Graduação em Epidemiologia e Vigilância em Saúde. Ananindeua, PA, Brasil.Secretaria de Saúde do Estado do Pará. Belém, PA, Brazil.Secretaria de Saúde do Estado do Pará. Belém, PA, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Laboratório de Geoprocessamento. Ananindeua, PA, Brasil.Universidade do Estado do Pará. Programa de Pós-Graduação em Biologia Parasitária na Amazônia. Belém, PA, Brasil / Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Programa de Pós-Graduação em Epidemiologia e Vigilância em Saúde. Ananindeua, PA, Brasil / Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Programa de Pós-graduação em Pesquisa Clínica em Doenças Infecciosas. Rio de Janeiro, RJ, Brazil.Universidade Federal Rural da Amazônia. Belém, PA, Brazil.Universidade Federal Rural da Amazônia. Belém, PA, Brazil.Secretaria de Saúde do Estado do Pará. Belém, PA, Brazil.Universidade do Estado do Pará. Programa de Pós-Graduação em Biologia Parasitária na Amazônia. Belém, PA, Brasil / Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.In the absence of an analysis of deaths at home from an epidemiological perspective, this study aims to analyze and describe the epidemiological profile of deaths at home assessed by the Death Ceremony Service (DCS) during the SARS-CoV-2 pandemic in the metropolitan region of the Brazilian Amazon, Belém do Pará. A descriptive, quantitative, secondary-based study based on the databases of the Mortality Information System (SIM), referring to the deaths that occurred from March 1 to March 27 June 2020. The variables worked were related to the profile and the causes in the death certificate. The causes of home deaths in 2019 were used to compare with 2020. In the indicated period, 1,203 deaths occurred, an increase of 454% in relation to 2019. The male gender (57.30%), the age group of 60+ (80.80%) and brown race (77.70%) were the most frequent. The main cause of death Acute myocardial infarction (15.05%) followed by COVID-19 (10.29%). During the pandemic, the majority of home deaths were not directly caused by COVID-19, however, they were influenced by it due to the need for social isolation, with the impossibility of obtaining the proper diagnosis or proper treatment, due to the impossibility of on-site care or lack of immediate response

Fluid overload: clinical outcomes in pediatric intensive care unit

Objective: The aim of this study was to analyze the effects of fluid overload related to mechanical ventilation, renal replacement therapy, and evolution to discharge or death in critically ill children. Methods: A retrospective study in a Pediatric Intensive Care Unit for two years. Patients who required invasive ventilatory support and vasopressor and/or inotropic medications were considered critically ill. Results: 70 patients were included. The mean age was 6.8 ± 6 years. There was a tolerable increase in fluid overload during hospitalization, with a median of 2.45% on the first day, 5.10% on the third day, and 8.39% on the tenth day. The median fluid overload on the third day among those patients in pressure support ventilation mode was 4.80% while the median of those who remained on controlled ventilation was 8.45% (p = 0.039). Statistical significance was observed in the correlations between fluid overload measurements on the first, third, and tenth days of hospitalization and the beginning of renal replacement therapy (p = 0.049) and between renal replacement therapy and death (p = 0.01). The median fluid overload was 7.50% in patients who died versus 4.90% in those who did not die on the third day of hospitalization (p = 0.064). There was no statistically significant association between death and the variables sex or age. Conclusions: The fluid overload on the third day of hospitalization proved to be a determinant for the clinical outcomes of weaning from mechanical ventilation, initiation of renal replacement therapy, discharge from the intensive care unit, or death among these children