Construção e validação de cenário de simulação médica no ensino de imunização

Introdução: No ensino médico, o uso da simulação clínica enquanto estratégia pedagógica tem sido cada vez mais presente nos currículos. Entretanto, ainda há uma lacuna sobre o uso da estratégia no ensino de tópicos de Atenção Primária à Saúde. Ao reconhecer as atribuições do profissional médico nesse contexto, torna-se necessário, cada vez mais, a oferta de experiências clínicas simuladas. Objetivo: O estudo teve por objetivo construir e validar três cenários de simulação clínica em imunização para o ensino médico. Material e métodos: Trata-se de um estudo descritivo, de construção e validação. Foram construídos e validados três cenários voltados à imunização na Atenção Primária à Saúde, a saber: imunização do adulto, da criança e da gestante. Todos os cenários foram elaborados com base em sete critérios: conhecimento prévio do aprendiz, objetivos de aprendizagem, fundamentação teórica, preparo do cenário, desenvolvimento do cenário, debriefing e avaliação. Participaram do estudo dezesseis profissionais de saúde. O Índice de Validação de Conteúdo (IVC) adotado foi de 0,80. Resultados: Os cenários obtiveram, em todos os itens, IVC entre 87,50% a 100%, julgados por médicos ou enfermeiros com experiência em simulação e titulação mínima de mestre na área da saúde. Conclusão: Os cenários poderão ser replicados tanto em pesquisas quanto no desenvolvimento de habilidades médicas em estudantes e profissionais. Desde que adaptados, esses cenários poderão, também, ser utilizados para o ensino em outros cursos e profissionais da área da saúde.Introduction: In medical education, the use of clinical simulation as a pedagogical strategy has been increasingly present in curricula. However, there is still a gap in the use of the strategy in teaching Primary Health Care topics. By recognizing the attributions of the medical professional in this context, it becomes increasingly necessary to offer simulated clinical experiences. Objective: The study aimed to construct and validate three clinical simulation scenarios in immunization for medical education. Material and methods: This is a descriptive, construction, and validation study. Three scenarios focused on immunization in Primary Health Care were built and validated, namely: immunization of adults, children, and pregnant women. All scenarios were developed based on seven criteria: prior knowledge of the learner, learning objectives, theoretical background, scenario preparation, scenario development, debriefing, and evaluation. Sixteen health professionals participated in the study. The adopted Content Validation Index (CVI) was 0.80. Results: The scenarios obtained, in all items, CVI between 87.50% to 100%, judged by physicians or nurses with experience in simulation and a minimum master's degree in health care. Conclusion: The scenarios may be replicated both in research and in the development of medical skills in students and professionals. Provided they are adapted, these scenarios may also be used for teaching other healthcare courses and professionals

Avaliação do transporte crítico de pacientes: Uma revisão sistemática

Objective: To evaluate, according to the literature, the main factors considered facilitators and/or aggravating in the transportation of patients in critical condition.Method: This study is a systematic review performed using the PICO method.Results: The selected journals comprised a time space in the last 10 years, with six journals eligible, based on the established criteria. The results report that the themes found in this review demonstrate an alignment between care practice and literature, but, for a transportation without adverse events, there must be a union between the management and the professionals involved.Conclusion: Although the findings demonstrate a great concern regarding the quality of care and team preparation, the authors believe that more studies should be encouraged since teamwork, despite being complex, is the key to performing the procedures with effectiveness.Objetivo: Evaluar, según la literatura, cuáles son los principales factores considerados facilitadores y/o agravantes en la realización del transporte de pacientes en estado crítico.Método: Este estudio se trata de una revisión sistemática realizada con el método PICOResultado: Los periódicos seleccionados comprendían un espacio temporal en los últimos diez años, donde 6 periódicos fueron elegibles, basado en los criterios establecidos. Los resultados relatan que los temas encontrados en esta revisión demuestran una alineación entre la práctica asistencial y la literatura, pero para que el transporte sea realizado sin eventos adversos, es necesario que haya unión entre la gestión y los profesionales involucrados.Conclusión: Aunque los hallazgos demuestren una gran preocupación en relación a la calidad en la asistencia y en la preparación del equipo, los autores creen que más estudios deben ser fomentados una vez que el trabajo en equipo, a pesar de ser complejo, es la clave para la realización de los procedimientos con efectividad.Objetivo: Avaliar segundo a literatura quais são os principais fatores que são considerados facilitadores e/ou agravantes na realização do transporte de pacientes em estado crítico.Método: Este estudo trata-se de uma revisão sistemática realizada com método PICOResultado: Os periódicos selecionados compreendiam um espaço temporal nos últimos dez anos, onde 6 periódicos foram elegíveis, baseado nos critérios estabelecidos. Os resultados relatam que os temas encontrados nesta revisão demonstram um alinhamento entre a prática assistencial e a literatura, porém para que o transporte seja realizado sem eventos adversos, é necessário que haja união entre a gestão e os profissionais envolvidos.Conclusão: Embora os achados demonstrem uma grande preocupação em relação à qualidade na assistência e no preparo da equipe, os autores acreditam que mais estudos devem ser fomentados uma vez que o trabalho em equipe apesar de ser complexo, é a chave para a realização dos procedimentos com efetividade

Specifying Value in GRL for Guiding BPMN Activities Prioritization

In a value-based requirements engineering approach, the stakeholders’ value propositions must be considered ahead in order to prioritize which requirements will be developed first to drive the software development activities. Early requirements approaches like the Goal- Oriented Requirements Language (GRL) focuses on modeling goals, tasks, contributions, and dependencies in order to satisfy the stakeholders’ needs, but do not provide a mechanism to specify value according to stakeholders’ value propositions. Moreover, in software development, after specifying value propositions, there is a need to align goal elements into business process elements in order to prioritize which business process activity is going to be developed next. Thus, we propose a new approach (value@GRL) to improve GRL and prioritize Business Process Model and Notation (BPMN) activities. Value@GRL provides guidelines for specifying value in GRL models according to the stakeholders’ needs and prioritization mechanisms to define BPMN activities\u27 order in an incremental software development

Single femoral tunnel for anterior cruciate ligament reconstruction with bone-patellar tendon-bone graft and lemaire's extra-articular tenodesis as a good alternative for combined anterior cruciate ligament and anterolateral ligament revision surgeries

© 2023 The Authors. Published by Elsevier Inc. on behalf of the Arthroscopy Association of North America.The literature has shown a significant decrease in failure rates when the anterior cruciate ligament (ACL) reconstruction was associated with an extra-articular reinforcement technique such as the anterolateral ligament (ALL) or the iliotibial band tenodesis (ITBT) using the modified Lemaire technique. As much as there is a progressive decrease in the failure rates of ACL reconstructions when the ALL reconstruction technique is associated, there are still and will be cases that will result in graft rupture. These cases will require more alternatives for revision, which are always challenging for the surgeon, where the lateral approaches represent complicating factors, especially because of the distortion of the lateral anatomy (by the previous approach for ALL reconstruction), previous reconstruction tunnels, and the presence of fixation materials. We present here a safe technique that offers great stability to the fixation of the graft and is easy to perform, using a single tunnel for the passage of the ACL and ITBT grafts, allowing a single fixation for both. In this way, we performed a lower-cost surgery, with a lower risk of lateral condyle fracture and tunnel confluence. This technique is indicated to be used in cases of revision after failure of combined ACL reconstruction with ALL.info:eu-repo/semantics/publishedVersio

Antimicrobial Activity of Indigofera suffruticosa

Various organic and aqueous extracts of leaves of Indigofera suffruticosa Mill (Fabaceae) obtained by infusion and maceration were screened for their antibacterial and antifungal activities. The extracts were tested against 5 different species of human pathogenic bacteria and 17 fungal strains by the agar-solid diffusion method. Most of the extracts were devoid of antifungal and antibacterial activities, except the aqueous extract of leaves of I. suffruticosa obtained by infusion, which showed strong inhibitory activity against the Gram-positive bacteria Staphylococcus aureus with a minimal inhibitory concentration (MIC) of 5000 µg ml(−1). The MIC values to dermatophyte strains were 2500 µg ml(−1) against Trichophyton rubrum (LM-09, LM-13) and Microsporum canis. This study suggests that aqueous extracts of leaves of I. suffruticosa obtained by infusion can be used in the treatment of skin diseases caused by dermatophytes

POSITIVISMO E COMPLEXIDADE: INTERFACES E INFLUÊNCIAS NO CONTEXTO DO ENSINO NA GRADUAÇÃO EM ENFERMAGEM

Objetivo: identificar a relação entre as propostas das Diretrizes Curriculares Nacionais do Curso de Graduação em Enfermagem no tocante às competências e habilidades requeridas para a formação do enfermeiro, e as teorias da complexidade e do positivismo. Método: estudo teórico-reflexivo. Resultados: no contexto do ensino e da formação do enfermeiro, a lógica complexa insere-se em razão da necessidade de diálogo entre os diversos saberes. Assim, o positivismo e a teoria da complexidade são visualizados como ideias balizadoras da formação, o que demonstra o fato de que as teorias não se eliminam, mas acabam convivendo e orientando os processos de formação em saúde. Conclusão: a matriz positivista e as características de uma lógica próxima da teoria da complexidade podem ser identificadas nas diversas interfaces do processo formativo do profissional enfermeiro. Por isso, cabe às instituições formadoras, aos docentes e discentes refletir sobre as contribuições de cada corrente.Descritores: Enfermagem; Ensino de Enfermagem; Docente

Antinociceptive and anxiolytic-like effects of Lavandula angustifolia essential oil on rat models of orofacial pain

Nociceptive and inflammatory orofacial pain is highly prevalent in the population, which justifies the search for safer analgesics. There is increasing evidence of the analgesic and anxiolytic potential of Lavandula angustifolia essential oil (LAV EO), which may represent, when administered through inhalation, may represent a safer alternative for pain treatment. Objective: to evaluate whether LAV EO has antinociceptive effect in the formalin test, and anti-hyperalgesic and anxiolytic-like effects in rats subjected to a model of orofacial postoperative pain. Methodology: Female Wistar rats were exposed to LAV EO (5%) by inhalation for 30 minutes. After exposure, animals were injected with formalin (2.5%, 50 μL) or saline into the hind paw or upper lip and the number of flinches or facial grooming time, respectively, were evaluated. Likewise, on day 3 after intraoral mucosa incision, the animals were exposed to LAV EO and facial mechanical, and heat hyperalgesia were assessed. The influence of LAV EO inhalation on anxiety-like behavior was assessed in operated rats by testing them on the open field (OF) and elevated plus maze (EPM). Results: LAV EO reduced the phase II of the paw formalin test and both phases of the orofacial formalin test. On day three post-incision, LAV EO reduced heat and mechanical hyperalgesia, from 30 minutes up to three hours, and reduced the anxiety-like behavior in operated rats without causing locomotor deficit. Conclusion: LAV EO inhalation results in antinociceptive and anxiolytic-like effects in orofacial pain models, which encourages further studies on LAV EO indications and effectiveness on orofacial pain conditions

Performance of pre-sprouted sugarcane seedlings in response to the application of humic acid and plant growth-promoting bacteria

Sugarcane cultivation using pre-sprouted seedlings has decreased the number of stalks used per hectare, increased the multiplication rate, improved seedling health, and increased planting uniformity. However, because this system has been only recently proposed, the number of studies evaluating this new technology is still scarce, particularly those examining the effect of the application of growth-promoting substances on seedling characteristics during the production phase. Here, we hypothesized that it is possible to combine the plant growth-promoting activity of humic acid (HA) with the inoculation of selected strains of plant growth-promoting bacteria (PGPB) to improve the yield of sugarcane seedlings compared with the individual application of these two techniques. The potential of the combined use of HA and PGPB as agricultural inputs was evaluated by conducting an experiment with sugarcane micro cuttings in a greenhouse. Treatments included control, PGPB, HA, and PGPB with HA. At the end of the experiment (60 d after planting), the plants were subjected to biometric evaluation. The results indicated that it was possible to combine HA with selected strains of PGPB (Burkholderia sp.) to improve the yield of seedlings compared with individual HA and PGPB treatments. HA, PGPB, and HA + PGPB increased the total dry matter compared with the control by 23%, 25%, and 36%, respectively. Therefore, the use of HA-based plant regulators in combination with PGPB was more effective than the isolated use of these inputs for the treatment of micro cuttings and improvement of sugarcane seedling yield

Consumo alimentar e balanço de nitrogênio de fisiculturistas em Cuité, Paraíba, Brasil

Background: Sports nutrition has grown substantially. Considering that as compared to sedentary or moderately active individuals, athletes have distinct nutritional requirements, it is important to reflect on the adequacy of food intake as compared to the established recommendations. Thus, the present study evaluated food consumption and nitrogen balance in bodybuilders’ from Cuité-Paraíba, aiming to learn their food and nutritional profiles. Methods: Data were collected using structured questionnaires and 24-hour dietary recalls. Anthropometric evaluations were performed. The analyses were performed on Avanutri®. For both urea determination and nitrogen balance calculations, twenty-four (24) hour urine processing was also performed. Results: The sample consisted of 6 amateur bodybuilders, with a mean age of 22.83 ± 4.53 (standard deviation), weight 72.37 ± 14.34 kg, height 1.68 ± 0.10 meters, and fat percentage of 11.81 ± 2.84%. The majority (5 athletes) was in the hypertrophy period (off-session), and 1 athlete was in definition (pre-contest). The food consumption results indicated that according to established recommendations for the sports modality, the athletes (with high intake of protein, and low carbohydrate consumption) were practicing inadequate eating habits. Testing showed that zinc, and vitamins D, B1, B2, and B6 intake was adequate. It was also observed that 66.67% (n = 4) used dietary supplements. The mean nitrogen balance was 19.15 ± 22.09. Conclusion: The bodybuilders’ diets were hyper-proteic, normo-lipid and hypo-glycemic; being inadequate in magnesium, iron, sodium and vitamins A, B3, C and E. The positive nitrogen balance found for the athletes correlated to their high protein intakes. RESUMO Consumo alimentar e balanço de nitrogênio de fisiculturistas em Cuité, Paraíba, BrasilObjetivos: avaliar o consumo alimentar e o balanço nitrogenado de fisiculturistas da cidade de Cuité-Paraíba, visando conhecer o perfil alimentar e nutricional. Métodos: Para coleta dos dados foram aplicados questionários estruturados, recordatórios alimentares de 24 horas e realizada avaliação antropométrica. As análises foram feitas no Avanutri®. O processamento da urina de 24 horas para determinação da ureia e cálculo do balanço nitrogenado também foi realizado. Resultados: A amostra foi composta por 6 atletas amadores do fisiculturismo, com médias de idade de 22,83 ± 4,53 anos (desvio-padrão), peso de 72,37 ± 14,34 Kg, altura de 1,68 ± 0,10 metros e percentual de gordura de 11,81 ± 2,84 %. A maioria (5 atletas) encontrava-se em período de hipertrofia (off-session) e 1 em período de definição (pré-contest). Os resultados do consumo alimentar indicaram que os hábitos alimentares dos atletas encontram-se inadequados frente às recomendações estabelecidas para a modalidade esportiva, com ingestão elevada de proteína com baixo consumo de carboidratos. Quanto aos micronutrientes, contatou-se que o zinco e as vitaminas D, B1, B2, B6, encontravam-se adequadas. Observou-se ainda que 66,67% (n=4) dos entrevistados fazem uso de suplementos alimentares. O balanço nitrogenado foi de 19,15 ± 22,09. Conclusão: A dieta dos fisiculturistas estava hiperprotéica, normolipídica e hipoglicídica, com inadequação de magnésio, ferro, sódio e das vitaminas A, B3, C e E. O balanço nitrogenado positivo dos atletas acompanhou o alto consumo de proteínas.Objetivos: avaliar o consumo alimentar e o balanço nitrogenado de fisiculturistas da cidade de Cuité-Paraíba, visando conhecer o perfil alimentar e nutricional. Métodos: Para coleta dos dados foram aplicados questionários estruturados, recordatórios alimentares de 24 horas e realizada avaliação antropométrica. As análises foram feitas no Avanutri®. O processamento da urina de 24 horas para determinação da ureia e cálculo do balanço nitrogenado também foi realizado. Resultados: A amostra foi composta por 6 atletas amadores do fisiculturismo, com médias de idade de 22,83 ± 4,53 anos (desvio-padrão), peso de 72,37 ± 14,34 Kg, altura de 1,68 ± 0,10 metros e percentual de gordura de 11,81 ± 2,84 %. A maioria (5 atletas) encontrava-se em período de hipertrofia (off-session) e 1 em período de definição (pré-contest). Os resultados do consumo alimentar indicaram que os hábitos alimentares dos atletas encontram-se inadequados frente às recomendações estabelecidas para a modalidade esportiva, com ingestão elevada de proteína com baixo consumo de carboidratos. Quanto aos micronutrientes, contatou-se que o zinco e as vitaminas D, B1, B2, B6, encontravam-se adequadas. Observou-se ainda que 66,67% (n=4) dos entrevistados fazem uso de suplementos alimentares. O balanço nitrogenado foi de 19,15 ± 22,09. Conclusão: A dieta dos fisiculturistas estava hiperprotéica, normolipídica e hipoglicídica, com inadequação de magnésio, ferro, sódio e das vitaminas A, B3, C e E. O balanço nitrogenado positivo dos atletas acompanhou o alto consumo de proteínas. ABSTRACTDietary intake and nitrogen balance of bodybuilders in Cuité, Paraíba, BrazilBackground: Sports nutrition has grown substantially. Considering that as compared to sedentary or moderately active individuals, athletes have distinct nutritional requirements, it is important to reflect on the adequacy of food intake as compared to the established recommendations. Thus, the present study evaluated food consumption and nitrogen balance in bodybuilders’ from Cuité-Paraíba, aiming to learn their food and nutritional profiles. Methods: Data were collected using structured questionnaires and 24-hour dietary recalls. Anthropometric evaluations were performed. The analyses were performed on Avanutri®. For both urea determination and nitrogen balance calculations, twenty-four (24) hour urine processing was also performed. Results: The sample consisted of 6 amateur bodybuilders, with a mean age of 22.83 ± 4.53 (standard deviation), weight 72.37 ± 14.34 kg, height 1.68 ± 0.10 meters, and fat percentage of 11.81 ± 2.84%. The majority (5 athletes) was in the hypertrophy period (off-session), and 1 athlete was in definition (pre-contest). The food consumption results indicated that according to established recommendations for the sports modality, the athletes (with high intake of protein, and low carbohydrate consumption) were practicing inadequate eating habits. Testing showed that zinc, and vitamins D, B1, B2, and B6 intake was adequate. It was also observed that 66.67% (n = 4) used dietary supplements. The mean nitrogen balance was 19.15 ± 22.09. Conclusion: The bodybuilders’ diets were hyper-proteic, normo-lipid and hypo-glycemic; being inadequate in magnesium, iron, sodium and vitamins A, B3, C and E. The positive nitrogen balance found for the athletes correlated to their high protein intakes