Programa de Educación Tutorial en salud bucal : la experiencia en atención primaria en el centro de salud de Itapoã-DF

Este artigo apresenta o relato de experiência do Programa de Educação Tutorial em Odontologia da Universidade de Brasília, durante o período de março a dezembro de 2010. O cenário de prática das atividades de campo é a Regional Administrativa do Itapoã, no Distrito Federal, e a atuação do grupo tutorial acontece junto às Equipes de Saúde da Família por meio de rotinas educativo-preventivas em saúde bucal durante as visitas domiciliares, atividades clínicas e desenvolvimento de pesquisas. Alunos e preceptores estão sendo capazes de reconhecer os determinantes sociais do processo saúdedoença, analisar os indicadores de saúde bucal da população, aprimorar práticas educativas utilizadas na Estratégia Saúde da Família e promover saúde no âmbito da comunidade. As principais dificuldades encontradas dizem respeito a limitação de espaço físico e de recursos capazes de atender a demanda do grupo tutorial e das famílias assistidas. Esta experiência tutorial junto à Estratégia Saúde da Família possibilita um aprendizado que vai muito mais além do que a tradição de ensino bio-tecnicista da odontologia, bem como permite aos discentes de odontologia da UnB ‘vivenciar uma experiência real’ e refletir sobre os conhecimentos teóricos obtidos nos ‘bancos da universidade’. _________________________________________________________________________________________________________________ ABSTRACTThis paper presents an experience report of the Tutorial Program in Dentistry from the University of Brasília, during the period from March to December, 2010. The scenario of practice is the Itapoã - an Administrative Area of the Distrito Federal - and the activities of the tutorial group take place in partnership with the Family Health Team through a preventive educational oral health routine during home visits, as well as clinical activities and development of research. Students and preceptors are being able to recognize the social determinants of the health-disease process, analyze oral health indicators of the population, improve educational practices and promote health within the community. The main barriers of the tutorial group are the lack of physical space and dental equipment capable of meeting the demand of the tutorial group and assisted families. This tutorial experience within the Family Health Strategy provides a learning experience that goes far beyond the tradition of teaching bio-technicalities of dentistry, as well as allows dental students real to live through a real field experience and reflect on the theoretical knowledge obtained from the ‘university seats’. _________________________________________________________________________________________________________________ RESUMENEste documento presenta el relato de la experiencia del Programa de Educación Tutorial en Odontología de la Universidad de Brasília, durante el período de Marzo a Diciembre de 2010. El escenário de práctica de las actividades de campo es el Sector Regional Administrativo de Itapoã, en el Distrito Federal, donde el trabajo del grupo tutorial acompaña el trabajo de los Equipos de Salud de la Família a través de la educación preventiva de rutina en la salud bucal de la población, mejorando las prácticas educativas utilizadas en la estrategia de salud familiar y promoviendo la salud en la comunidad. Las principales dificultades se refieren a la limitación del espacio físico y el equipo dental capaces de satisfacer la demanda del grupo tutorial y de las famílias atendidas. Esta actividad tutorial con la Estrategia de Salud de la Família ofrece una experiencia de aprendizaje que vá más allá de la tradición de la enseñanza de técnicas bio-odontológicas, así como permite a los estudiantes de odontología de la UnB “pasar una verdadera experiencia” y reflexionar sobre el conocimiento teórico obtenido en “los bancos de datos de la universidad”

Assistência de enfermagem ao portador de síndrome de Fournier: um relato de experiência / Nursing assistance to patients with Fournier syndrome: na experience report

Introdução: A Síndrome de Fournier é uma doença infecciosa polimicrobiana grave, e diante do avanço acelerado da doença, é essencial que a equipe de saúde detenha conhecimentos a respeito da patologia, para que promova intervenções com rapidez e eficácia, no que tange ao diagnóstico e tratamento adequado, a partir de um plano de cuidados integral e individualizado, uma vez que com intervenções tardias o paciente pode apresentar quadro clínico avançado, como a sepse generalizada e consequente morte. Objetivo: Realizar um relato de experiência a partir da assistência de um paciente com Síndrome de Fournier no contexto da Graduação em enfermagem para desenvolvimento do raciocínio clínico e pensamento crítico em saúde, mediante a implementação das etapas do processo de enfermagem. Métodos: Trata-se de estudo qualitativo de caráter narrativo e reflexivo do tipo relato de experiência. A experiência se deu em uma enfermaria de cirurgia vascular com alunos da enfermagem no segundo ano de uma Universidade Pública Estadual. Foi utilizado o Processo de Enfermagem. Resultados: Foi realizado o raciocínio clínico e pensamento crítico em saúde, mediante a implementação das etapas do processo de enfermagem, com auxílio dos diagnósticos, intervenções e resultados de enfermagem para uma assistência adequada ao portador de Síndrome de Fournier, a qual deve ser embasada na rigorosa monitoração dos sinais vitais e a constante avaliação da área lesionada, assim como os cuidados de enfermagem na administração de medicamentos conforme o tratamento indicado. Conclusão: este trabalho pode servir como um exemplo de experiência no contexto das graduações em enfermagem no que tange ao alcance do aprendizado do Processo de Enfermagem para o planejamento e a implementação dos cuidados de enfermagem ao paciente adulto e idoso, clínico e cirúrgico, institucionalizados, em tratamento hospitalar

Eu quero saber: 60 perguntas e respostas sobre a COVID-19

COVID-19 is caused by the new coronavirus SARS-CoV-2 and the first cases were reported in December 2019 in Wuhan Province in China. Subsequently, the virus quickly reached Europe, the United States and landed in Brazil. Even after four months of the first confirmed case in the city of São Paulo (March 4, 2020), many doubts remain or arise as researchers learn more about COVID-19 and the rate at which the disease progresses. Interestingly, the concern about seeking to know more about the new disease and about the measures to combat it began to appear in the speeches and questions of patients and visitors of our Laboratory of the Research Group on Cardiorespiratory Evaluation and Rehabilitation (GECARE) of the Department of Physiotherapy at the Federal University of Rio de Janeiro (UFRJ). This allowed us to exercise a fundamental approach in the context of health care, to inform from listening to patients' doubts. Break the logic of imposing information. In this sense, GECARE's scientific initiation, master's and doctoral students began to catalog doubts about COVID-19. This happened based on groups of messages maintained with patients during the period of social distance for guidance and monitoring of health conditions. Then, we set up a multiprofessional health team to answer the questions and compiled this 3rd E-book on COVID-19 from our group. We believe that our patients' doubts and the quick question and answer format will allow people in general to know more about the context of COVID-19.A COVID-19 é provocada pelo novo coronavírus SARS-CoV-2 e os primeiros casos foram notificados em dezembro de 2019 na Província de Wuhan na China. Na sequência, rapidamente o vírus alcançou a Europa, Estados Unidos e desembarcou no Brasil. Mesmo depois de quatro meses do primeiro caso confirmado na cidade de São Paulo (04 de março de 2020), muitas dúvidas permanecem ou surgem à medida que os pesquisadores conhecem mais sobre a COVID-19 e na proporção que a doença avança. Interessantemente, a inquietação pela busca em saber mais sobre a nova doença e sobre as medidas para combatê-la começou a surgir nas falas e perguntas dos pacientes e frequentadores do nosso Laboratório do Grupo de Pesquisa em Avaliação e Reabilitação Cardiorrespiratória (GECARE) do Departamento de Fisioterapia da Universidade Federal do Rio de Janeiro (UFRJ). Isso nos permitiu exercitar uma abordagem fundamental no contexto do cuidado em saúde, informar a partir da escuta das dúvidas dos pacientes. Quebrar a lógica da imposição da informação. Neste sentido, os alunos de iniciação científica, mestrado e doutorado do GECARE começaram a catalogar as dúvidas sobre a COVID-19. Isso aconteceu a partir dos grupos de mensagens mantidos com os pacientes durante o período de distanciamento social para orientações e acompanhamento das condições de saúde. Na sequência, montamos um time multiprofissional de saúde para responder as questões e compilamos neste 3º E-book sobre COVID-19 do nosso grupo. Acreditamos que as dúvidas dos nossos pacientes e o formato rápido de perguntas e respostas permitirão que as pessoas em geral possam conhecer mais sobre o contexto da COVID-19

Mapping density, diversity and species-richness of the Amazon tree flora

Using 2.046 botanically-inventoried tree plots across the largest tropical forest on Earth, we mapped tree species-diversity and tree species-richness at 0.1-degree resolution, and investigated drivers for diversity and richness. Using only location, stratified by forest type, as predictor, our spatial model, to the best of our knowledge, provides the most accurate map of tree diversity in Amazonia to date, explaining approximately 70% of the tree diversity and species-richness. Large soil-forest combinations determine a significant percentage of the variation in tree species-richness and tree alpha-diversity in Amazonian forest-plots. We suggest that the size and fragmentation of these systems drive their large-scale diversity patterns and hence local diversity. A model not using location but cumulative water deficit, tree density, and temperature seasonality explains 47% of the tree species-richness in the terra-firme forest in Amazonia. Over large areas across Amazonia, residuals of this relationship are small and poorly spatially structured, suggesting that much of the residual variation may be local. The Guyana Shield area has consistently negative residuals, showing that this area has lower tree species-richness than expected by our models. We provide extensive plot meta-data, including tree density, tree alpha-diversity and tree species-richness results and gridded maps at 0.1-degree resolution

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio