A importância do material didático no ensino a distância

The purpose of this article is to discuss the importance of didactic material for the development of EaD (distance education or distance learning) courses, however, we chose here as Distance Learning. It is undeniable that Higher Education in Brazil has taken a huge leap in recent years. Part of this growth is due to the offer of distance education, which, given the flexibility of the hours and student autonomy, has attracted an increasing interest in the student public, spread over different age groups. From this perspective, we discuss a little about the didactic material used in distance education, directly linked to the student's teaching and learning process. In this sense, to highlight, through the examination of bibliographies on the theme, the value of didactic materials to promote teaching and learning EaD. Conceived from the philosophy of the educational institution, they function as a sort of business card of the institution. For this reason, they must undergo a constant process of evaluation, revision and updating to ensure quality in the educational action. The teaching material used - printed or virtual - is essential, since it exposes the organization, development and dynamism of the teaching and learning process. Identifying and characterizing EaD learning tools, between the various media available and the types of teaching materials can help to understand how much they are essential in EaD.Este artículo tiene por objetivo discutir la importancia del material didáctico para el desarrollo de los cursos EaD (Educación a Distancia o Enseñanza a Distancia), sin embargo, optamos aquí como Enseñanza a Distancia. Es innegable que la educación superior en Brasil ha dado un enorme salto en los últimos años. Parte de ese crecimiento se debe a la oferta de la enseñanza a distancia que, ante la flexibilidad de horarios y la autonomía del alumno, ha despertado interés cada vez mayor en el público estudiantil, esparcidos por diferentes edades. En esta perspectiva, se discute un poco sobre el material didáctico utilizado en la educación a distancia, directamente ligado al proceso de enseñanza y aprendizaje del alumno. En este sentido, evidenciar, a través del examen de bibliografías sobre el tema, el valor de los materiales didácticos para el fomento de la enseñanza y del aprendizaje EaD. Diseñados a partir de la filosofía de la institución de enseñanza, funcionan como una especie de tarjeta de visita de la institución. Necesitan, por eso mismo, pasar por constante proceso de evaluación, revisión y actualización para garantizar la calidad en la acción educativa. El material didáctico utilizado - impreso o virtual- es esencial, ya que expone la organización, el desarrollo y el dinamismo del proceso de enseñanza y aprendizaje. Identificar y caracterizar las herramientas de aprendizaje EaD, entre los diversos medios disponibles y los tipos de materiales didácticos, puede ayudar a comprender lo imprescindibles en la EaD.Este artigo tem por objetivo discutir a importância do material didático para o desenvolvimento dos cursos EaD (Educação a Distância ou Ensino a Distância), no entanto, optamos aqui como Ensino à Distância. É inegável que a educação Superior no Brasil deu um enorme salto nos últimos anos. Parte desse crescimento se deve à oferta do ensino à distância que, diante da flexibilidade de horários e da autonomia do aluno, tem despertado interesse cada vez maior no público estudantil, espalhados por diferentes faixas etárias. Nessa perspectiva, discute-se um pouco sobre o material didático utilizado na educação à distância, diretamente ligado ao processo de ensino e aprendizagem do aluno. Nesse sentido, evidenciar, através do exame de bibliografias sobre o tema, o valor dos materiais didáticos para fomento do ensino e da aprendizagem EaD. Concebidos a partir da filosofia da instituição de ensino, funcionam como uma espécie de cartão de visitas da instituição. Necessitam, por isso mesmo, passar por constante processo de avaliação, revisão e atualização para garantir a qualidade na ação educativa. O material didático utilizado – impresso ou virtual- é essencial, uma vez que expõe a organização, o desenvolvimento e o dinamismo do processo de ensino e aprendizagem. Identificar e caracterizar as ferramentas de aprendizagem EaD, entre as diversas mídias disponíveis e os tipos de materiais didáticos pode ajudar a compreender o quanto são imprescindíveis na EaD

Characterization of hepatitis B virus X gene quasispecies complexity in mono-infection and hepatitis delta virus superinfection

Hepatitis B X gene; Hepatitis B virus; Hepatitis delta virusHepatitis B gen X; Virus d'hepatitis B; Virus d'hepatitis deltaHepatitis B gen X; Virus de hepatitis B; Virus de hepatitis deltaBACKGROUND: Hepatitis delta virus (HDV) seems to strongly suppress hepatitis B virus (HBV) replication, although little is known about the mechanism of this interaction. Both these viruses show a dynamic distribution of mutants, resulting in viral quasispecies. Next-generation sequencing is a viable approach for analyzing the composition of these mutant spectra. As the regulatory hepatitis B X protein (HBx) is essential for HBV replication, determination of HBV X gene (HBX) quasispecies complexity in HBV/HDV infection compared to HBV mono-infection may provide information on the interactions between these two viruses. AIM: To compare HBV quasispecies complexity in the HBX 5' region between chronic hepatitis delta (CHD) and chronic HBV mono-infected patients. METHODS: Twenty-four untreated patients were included: 7/24 (29.2%) with HBeAg-negative chronic HBV infection (CI, previously termed inactive carriers), 8/24 (33.3%) with HBeAg-negative chronic hepatitis B (CHB) and 9/24 (37.5%) with CHD. A serum sample from each patient was first tested for HBV DNA levels. The HBX 5' region [nucleotides (nt) 1255-1611] was then PCR-amplified for subsequent next-generation sequencing (MiSeq, Illumina, United States). HBV quasispecies complexity in the region analyzed was evaluated using incidence-based indices (number of haplotypes and number of mutations), abundance-based indices (Hill numbers of order 1 and 2), and functional indices (mutation frequency and nucleotide diversity). We also evaluated the pattern of nucleotide changes to investigate which of them could be the cause of the quasispecies complexity. RESULTS: CHB patients showed higher median HBV-DNA levels [5.4 logIU/mL, interquartile range (IQR) 3.5-7.9] than CHD (3.4 logIU/mL, IQR 3-7.6) (P = n.s.) or CI (3.2 logIU/mL, IQR 2.3-3.5) (P < 0.01) patients. The incidence and abundance indices indicated that HBV quasispecies complexity was significantly greater in CI than CHB. A similar trend was observed in CHD patients, although only Hill numbers of order 2 showed statistically significant differences (CHB 2.81, IQR 1.11-4.57 vs CHD 8.87, 6.56-11.18, P = 0.038). There were no significant differences in the functional indices, but CI and CHD patients also showed a trend towards greater complexity than CHB. No differences were found for any HBV quasispecies complexity indices between CHD and CI patients. G-to-A and C-to-T nucleotide changes, characteristic of APOBEC3G, were higher in CHD and CI than in CHB in genotype A haplotypes, but not in genotype D. The proportion of nt G-to-A vs A-to-G changes and C-to-T vs T-to-C changes in genotype A and D haplotypes in CHD patients showed no significant differences. In CHB and CI the results of these comparisons were dependent on HBV genotype. CONCLUSION: The lower-replication CHD and CI groups show a trend to higher quasispecies complexity than the higher-replication CHB group. The mechanisms associated with this greater complexity require elucidation.Supported by the Instituto de Salud Carlos III, grants PI15/00856 and PI17/02233; co-financed by the European Regional Development Fund (ERDF

INCIDÊNCIA DE CONSUMO DE BEBIDA ALCOÓLICA ENTRE AS VÍTIMAS DE SUICÍDIO NO DISTRITO FEDERAL

Suicide is motivated by multiple causes, and the abusive consumption of alcoholic beverages can be an important sign that individuals do not have physical and emotional control of themselves. To estimate the incidence of alcohol consumption, immediately before suicide, among people who died in 2018 in the Brazilian Federal District. This is a population-based study, of a descriptive and exploratory nature, of all deaths which occurred in the Brazilian Federal District from January 1 to December 31, 2018. Data were collected from the Mortality Information System and Police reports. The incidence and respective 95% confidence intervals were calculated. This study was approved by the Research Ethics Committee. The incidence of alcohol consumption just before the suicide was 18.6% (CI 95%: 18.56% to 18.62%). Males, blacks, trade workers, those without a partner, young people, and individuals with less than 8 years of study had the highest indicators. There was a greater percentage of alcohol consumption in the fall/winter, at the end of the month, in rural areas, in people who had never attempted suicide before and when the modus operandi was choking or hanging. The consumption of drugs, such as methamphetamine, ecstasy, amphetamine, and cannabis, was observed together with alcoholic beverages. The results of this research signaled an important public health problem, which is the use of alcohol to potentially encourage suicide. Effective public policies to tackle the abusive consumption of alcoholic beverages and suicide are necessary.O suicídio é motivado por múltiplas causas e o consumo abusivo de bebidas alcoólicas pode ser um sinal importante de que os indivíduos não têm controle físico e emocional de si mesmos. Estimar a incidência do consumo de álcool, imediatamente antes do suicídio, entre as pessoas que morreram em 2018 no Distrito Federal. Trata-se de um estudo de base populacional, de caráter descritivo e exploratório, de todos os óbitos ocorridos no Distrito Federal de 1º de janeiro a 31 de dezembro de 2018. Os dados foram coletados do Sistema de Informações sobre Mortalidade e relatórios policiais. Foram calculados os intervalos de confiança de 95%. Este estudo foi aprovado pelo Comitê de Ética em Pesquisa. A incidência de consumo de álcool pouco antes do suicídio foi de 18,6% (IC 95%: 18,56% a 18,62%). Homens, negros, trabalhadores do comércio, aqueles sem parceiro, jovens e indivíduos com menos de 8 anos de estudo apresentaram os maiores indicadores. Houve maior percentual de consumo de álcool no outono/inverno, no final do mês, em áreas rurais, em pessoas que nunca haviam tentado suicídio antes e quando o modus operandi estava engasgando ou pendurado. O consumo de drogas, como metanfetamina, ecstasy, anfetamina e cannabis, foi observado juntamente com bebidas alcoólicas. Os resultados desta pesquisa sinalizaram um importante problema de saúde pública, que é o uso de álcool para potencialmente incentivar o suicídio. São necessárias políticas públicas eficazes para enfrentar o consumo abusivo de bebidas alcoólicas e o suicídio.El suicidio está motivado por múltiples causas, y el consumo abusivo de bebidas alcohólicas puede ser una señal importante de que las personas no tienen control físico y emocional de sí mismos. Estimar la incidencia del consumo de alcohol, inmediatamente antes del suicidio, entre las personas que murieron en 2018 en el Distrito Federal de Brasil. Se trata de un estudio poblacional, de carácter descriptivo y exploratorio, de todas las muertes ocurridas en el Distrito Federal de Brasil del 1 de enero al 31 de diciembre de 2018. Los datos se recopilaron del Sistema de Información de Mortalidad y de los informes de la Policía. Se calcularon la incidencia y los respectivos intervalos de confianza del 95%. Este estudio fue aprobado por el Comité de ética de la investigación. La incidencia del consumo de alcohol justo antes del suicidio fue del 18,6% (CI 95%: 18,56% a 18,62%). Los hombres, los negros, los trabajadores del comercio, los que no tienen pareja, los jóvenes y los individuos con menos de 8 años de estudio tenían los indicadores más altos. Había un mayor porcentaje de consumo de alcohol en otoño/invierno, a finales de mes, en las zonas rurales, en personas que nunca habían intentado suicidarse antes y cuando el modus operandi se estaba asfixiando o ahorcando. El consumo de drogas, como la metanfetamina, el éxtasis, la anfetamina y el cannabis, se observó junto con las bebidas alcohólicas. Los resultados de esta investigación indicaron un importante problema de salud pública, que es el uso del alcohol para fomentar potencialmente el suicidio. Las políticas públicas eficaces para hacer frente al consumo abusivo de bebidas alcohólicas y el suicidio so

INCIDÊNCIA DE CONSUMO DE BEBIDA ALCOÓLICA ENTRE AS VÍTIMAS DE SUICÍDIO NO DISTRITO FEDERAL

Suicide is motivated by multiple causes, and the abusive consumption of alcoholic beverages can be an important sign that individuals do not have physical and emotional control of themselves. To estimate the incidence of alcohol consumption, immediately before suicide, among people who died in 2018 in the Brazilian Federal District. This is a population-based study, of a descriptive and exploratory nature, of all deaths which occurred in the Brazilian Federal District from January 1 to December 31, 2018. Data were collected from the Mortality Information System and Police reports. The incidence and respective 95% confidence intervals were calculated. This study was approved by the Research Ethics Committee. The incidence of alcohol consumption just before the suicide was 18.6% (CI 95%: 18.56% to 18.62%). Males, blacks, trade workers, those without a partner, young people, and individuals with less than 8 years of study had the highest indicators. There was a greater percentage of alcohol consumption in the fall/winter, at the end of the month, in rural areas, in people who had never attempted suicide before and when the modus operandi was choking or hanging. The consumption of drugs, such as methamphetamine, ecstasy, amphetamine, and cannabis, was observed together with alcoholic beverages. The results of this research signaled an important public health problem, which is the use of alcohol to potentially encourage suicide. Effective public policies to tackle the abusive consumption of alcoholic beverages and suicide are necessary.O suicídio é motivado por múltiplas causas e o consumo abusivo de bebidas alcoólicas pode ser um sinal importante de que os indivíduos não têm controle físico e emocional de si mesmos. Estimar a incidência do consumo de álcool, imediatamente antes do suicídio, entre as pessoas que morreram em 2018 no Distrito Federal. Trata-se de um estudo de base populacional, de caráter descritivo e exploratório, de todos os óbitos ocorridos no Distrito Federal de 1º de janeiro a 31 de dezembro de 2018. Os dados foram coletados do Sistema de Informações sobre Mortalidade e relatórios policiais. Foram calculados os intervalos de confiança de 95%. Este estudo foi aprovado pelo Comitê de Ética em Pesquisa. A incidência de consumo de álcool pouco antes do suicídio foi de 18,6% (IC 95%: 18,56% a 18,62%). Homens, negros, trabalhadores do comércio, aqueles sem parceiro, jovens e indivíduos com menos de 8 anos de estudo apresentaram os maiores indicadores. Houve maior percentual de consumo de álcool no outono/inverno, no final do mês, em áreas rurais, em pessoas que nunca haviam tentado suicídio antes e quando o modus operandi estava engasgando ou pendurado. O consumo de drogas, como metanfetamina, ecstasy, anfetamina e cannabis, foi observado juntamente com bebidas alcoólicas. Os resultados desta pesquisa sinalizaram um importante problema de saúde pública, que é o uso de álcool para potencialmente incentivar o suicídio. São necessárias políticas públicas eficazes para enfrentar o consumo abusivo de bebidas alcoólicas e o suicídio.El suicidio está motivado por múltiples causas, y el consumo abusivo de bebidas alcohólicas puede ser una señal importante de que las personas no tienen control físico y emocional de sí mismos. Estimar la incidencia del consumo de alcohol, inmediatamente antes del suicidio, entre las personas que murieron en 2018 en el Distrito Federal de Brasil. Se trata de un estudio poblacional, de carácter descriptivo y exploratorio, de todas las muertes ocurridas en el Distrito Federal de Brasil del 1 de enero al 31 de diciembre de 2018. Los datos se recopilaron del Sistema de Información de Mortalidad y de los informes de la Policía. Se calcularon la incidencia y los respectivos intervalos de confianza del 95%. Este estudio fue aprobado por el Comité de ética de la investigación. La incidencia del consumo de alcohol justo antes del suicidio fue del 18,6% (CI 95%: 18,56% a 18,62%). Los hombres, los negros, los trabajadores del comercio, los que no tienen pareja, los jóvenes y los individuos con menos de 8 años de estudio tenían los indicadores más altos. Había un mayor porcentaje de consumo de alcohol en otoño/invierno, a finales de mes, en las zonas rurales, en personas que nunca habían intentado suicidarse antes y cuando el modus operandi se estaba asfixiando o ahorcando. El consumo de drogas, como la metanfetamina, el éxtasis, la anfetamina y el cannabis, se observó junto con las bebidas alcohólicas. Los resultados de esta investigación indicaron un importante problema de salud pública, que es el uso del alcohol para fomentar potencialmente el suicidio. Las políticas públicas eficaces para hacer frente al consumo abusivo de bebidas alcohólicas y el suicidio so

Use of glucocorticoids megadoses in SARS-CoV-2 infection in a spanish registry: SEMI-COVID-19

Objective To describe the impact of different doses of corticosteroids on the evolution of patients with COVID-19 pneumonia, based on the potential benefit of the non-genomic mechanism of these drugs at higher doses. Methods Observational study using data collected from the SEMI-COVID-19 Registry. We evaluated the epidemiological, radiological and analytical scenario between patients treated with megadoses therapy of corticosteroids vs low-dose of corticosteroids and the development of complications. The primary endpoint was all-cause in-hospital mortality according to use of corticosteroids megadoses. Results Of a total of 14,921 patients, corticosteroids were used in 5,262 (35.3%). Of them, 2,216 (46%) specifically received megadoses. Age was a factor that differed between those who received megadoses therapy versus those who did not in a significant manner (69 years [IQR 59-79] vs 73 years [IQR 61-83]; p < .001). Radiological and analytical findings showed a higher use of megadoses therapy among patients with an interstitial infiltrate and elevated inflammatory markers associated with COVID-19. In the univariate study it appears that steroid use is associated with increased mortality (OR 2.07 95% CI 1.91-2.24 p < .001) and megadose use with increased survival (OR 0.84 95% CI 0.75-0.96, p 0.011), but when adjusting for possible confounding factors, it is observed that the use of megadoses is also associated with higher mortality (OR 1.54, 95% CI 1.32-1.80; p < .001). There is no difference between megadoses and low-dose (p.298). Although, there are differences in the use of megadoses versus low-dose in terms of complications, mainly infectious, with fewer pneumonias and sepsis in the megadoses group (OR 0.82 95% CI 0.71-0.95; p < .001 and OR 0.80 95% CI 0.65-0.97; p < .001) respectively. Conclusion There is no difference in mortality with megadoses versus low-dose, but there is a lower incidence of infectious complications with glucocorticoid megadoses

MORTALITY TREND FROM CARDIAC ISCHEMIC DISEASES IN THE FEDERAL DISTRICT FROM 2010 TO 2018

Esse estudo avaliou a tendência de mortalidade por Doenças Isquêmicas Cardíacas no Distrito Federal, conforme as variáveis faixa etária, sexo e distribuição geográfica por Região Administrativa do estado. Foi realizado estudo ecológico do tipo séries temporais, entre 2010 e 2018. No período estudado, foram contabilizados 7.645 óbitos para o desfecho, uma média de idade de 70,3 anos (±14,1 anos), com mediana de 72 anos. A maioria dos indivíduos encontrava-se na faixa etária maior ou igual a 60 anos (77,3%), era sexo masculino (57,9%), possuía de um a três anos de estudo (30,8%), era solteiro, viúvo ou divorciado (55%) e de raça/cor branca (53,2%). Em suma, identificou-se a tendência crescente de mortalidade geral e para pessoas do sexo masculino devido a Doenças Isquêmicas Cardíacas e estacionária para as faixas etárias investigadas.This study evaluated the trend of mortality due to Cardiac Ischemic Diseases in the Federal District according to the variables age group, gender, and geographic distribution by Administrative Region of the state. An ecological study of the time series was conducted between 2010 and 2018. In the period studied, 7,645 deaths were recorded for the outcome, mean age of 70.3 years (±14.1 years), with a median of 72 years. Most individuals were in the age group greater than or equal to 60 years (77.3%), were male (57.9%), had one to three years of schooling (30.8%), were single, widowed or divorced (55%) and white race/color (53.2%). In a total, the growing trend of mortality in general&nbsp; &nbsp;and for males due to Cardiac and stationary Ischemic&nbsp;&nbsp; Diseases was identified for the age groups investigated

TENDÊNCIA DE MORTALIDADE POR DOENÇAS ISQUÊMICAS CARDÍACAS NO DISTRITO FEDERAL DE 2010 A 2018

This study evaluated the trend of mortality due to Cardiac Ischemic Diseases in the Federal District according to the variables age group, gender, and geographic distribution by Administrative Region of the state. An ecological study of the time series was conducted between 2010 and 2018. In the period studied, 7,645 deaths were recorded for the outcome, mean age of 70.3 years (±14.1 years), with a median of 72 years. Most individuals were in the age group greater than or equal to 60 years (77.3%), were male (57.9%), had one to three years of schooling (30.8%), were single, widowed or divorced (55%) and white race/color (53.2%). In a total, the growing trend of mortality in general&nbsp; &nbsp;and for males due to Cardiac and stationary Ischemic&nbsp;&nbsp; Diseases was identified for the age groups investigated.Esse estudo avaliou a tendência de mortalidade por Doenças Isquêmicas Cardíacas no Distrito Federal, conforme as variáveis faixa etária, sexo e distribuição geográfica por Região Administrativa do estado. Foi realizado estudo ecológico do tipo séries temporais, entre 2010 e 2018. No período estudado, foram contabilizados 7.645 óbitos para o desfecho, uma média de idade de 70,3 anos (±14,1 anos), com mediana de 72 anos. A maioria dos indivíduos encontrava-se na faixa etária maior ou igual a 60 anos (77,3%), era sexo masculino (57,9%), possuía de um a três anos de estudo (30,8%), era solteiro, viúvo ou divorciado (55%) e de raça/cor branca (53,2%). Em suma, identificou-se a tendência crescente de mortalidade geral e para pessoas do sexo masculino devido a Doenças Isquêmicas Cardíacas e estacionária para as faixas etárias investigadas

Frequency and Characteristics of familial melanoma in Spain: the FAM-GEM-1 Study.

Familial history of melanoma is a well-known risk factor for the disease, and 7% melanoma patients were reported to have a family history of melanoma. Data relating to the frequency and clinical and pathological characteristics of both familial and non-familial melanoma in Spain have been published, but these only include patients from specific areas of Spain and do not represent the data for the whole of Spain. PATIENTS AND METHODS: An observational study conducted by the Spanish Group of Melanoma (GEM) analyzed the family history of patients diagnosed with melanoma between 2011 and 2013 in the dermatology and oncology departments. RESULTS: In all, 1047 patients were analyzed, and 69 (6.6%) fulfilled criteria for classical familial melanoma (two or more first-degree relatives diagnosed with melanoma). Taking into account other risk factors for familial melanoma, such as multiple melanoma, pancreatic cancer in the family or second-degree relatives with melanoma, the number of patients fulfilling the criteria increased to 165 (15.8%). Using a univariate analysis, we determined that a Breslow index of less than 1 mm, negative mitosis, multiple melanoma, and a history of sunburns in childhood were more frequent in familial melanoma patients, but a multivariate analysis revealed no differences in any pathological or clinical factor between the two groups. CONCLUSIONS: Similar to that observed in other countries, familial melanoma accounts for 6.6% of melanoma diagnoses in Spain. Although no differences in the multivariate analysis were found, some better prognosis factors, such as Breslow index, seem more frequent in familial melanoma, which reflect a better early detection marker and/or a different biological behavior

Maternal anemia and birth weight : a prospective cohort study

Objective To investigate the association between maternal anemia and low/insufficient birth weight. Design A prospective cohort study of pregnant women who underwent prenatal care at the healthcare units in a municipality of northeast Brazil together with their newborn infants was carried out. The pregnant women were classified as having anemia when the hemoglobin level was below 11 g/dl. Infants who were born full term weighing less than 2500 grams were classified as low birth weight, and those weighing between 2500 and 2999 grams were classified as insufficient weight. The occurrence of maternal anemia and its association with birth weight was verified using crude and adjusted Relative Risk (RR) estimates with their corresponding 95% confidence intervals (95%CIs). Results The final sample was comprised of 622 women. Maternal anemia was considered a risk factor for low/insufficient birth weight, after adjusting the effect measurement for maternal age, family income, urinary infection, parity, alcoholic beverage consumption during pregnancy and gestational body mass index: RRadjusted = 1.38 [95% CI: 1.07 to 1.77]. Conclusions Maternal anemia was associated with low/insufficient birth weight, representing a risk factor for the gestational outcomes studied