RELATÓRIO DE ESTÁGIO CURRICULAR SUPERVISIONADO EM LETRAS - LÍNGUA PORTUGUESA

Este Relatório de Estágio Curricular Supervisionado em Letras - Língua Portuguesa, da Unoesc Xanxerê, pretende analisar e compreender que a função da escola consiste em preparar os educandos para que eles se apropriem do saber historicamente construído, fazendo com que se tornem capazes de tomar decisões e construir espaços de ação no grupo social. Por conseguinte, é importante utilizar recursos metodológicos adequados para o processo de ensino-aprendizagem atingir seus objetivos. Compreende-se a importância do papel do professor de Letras para que a função social inerente à língua ocorra nas suas práticas de uso pelos alunos. Em vista disso, na intervenção docente de Estágio, realizada na Escola de Educação Básica João Winckler, do município de Xanxerê, no período entre 2015 e 2016, optou-se pela sequência didática, procedimento que proporciona articular a leitura e a produção de textos de um gênero-discursivo específico com apoio em atividades intencionadas, relacionadas e sequenciadas, com a finalidade de contribuir, sobremaneira, no aprendizado dos discentes nos ensinos Fundamental e Médio, ponderarando os conhecimentos já adquiridos pelo aluno para gerar o progresso do conhecimento no processo de ensino-aprendizagem. O trabalho com os gêneros em sala de aula abriu um leque de variedades e opções de atividades realizadas pelos alunos. Robusteceu a responsabilidade do acadêmico-professor por mediar esse conhecimento ao aluno, não só apresentando a ele os gêneros como também dando suporte aos discentes para terem mais segurança no manejo da Língua Portuguesa

Aspectos microbiológicos, clínicos e epidemiológicos de infecções relacionadas à assistência à saúde causadas por pseudomonas aeruginosa em um hospital universitário / Microbiological, clinical and epidemiological aspects of healthcare-associated infections caused by pseudomonas aeruginosa in a university hospital

Pseudomonas aeruginosa é um importante agente de infecção relacionada à assistência à saúde (IRAS), sendo frequentemente relacionada a infecções crônicas e a elevadas taxas de mortalidade. O objetivo deste trabalho foi avaliar aspectos microbiológicos, clínicos e epidemiológicos de IRAS causadas por P. aeruginosa em um hospital universitário na cidade de Uberaba/MG. Foi realizada a análise de prontuários físicos e eletrônicos de pacientes diagnosticados com IRAS por P. aeruginosa, no período de janeiro de 2015 a outubro de 2019. Este estudo encontra-se em conformidade com a legislação vigente e foi aprovado pelo Comitê de Ética em Pesquisa (3.176.163). Foram analisados 100 prontuários, não havendo diferenças significativas entre sexo ou idades. No setor de Clínica Médica foi identificado o maior número de casos de IRAS por P. aeruginosa (18%), seguido por UTI Adulta (16%) e Pronto Socorro Adulto (12%). A frequência de óbitos foi de 47%, havendo variação entre os diferentes setores hospitalares (p<0,0001). As principais infecções foram sepse (46%) e infecção do trato urinário (40%). Diferentes terapias antimicrobianas foram prescritas no período avaliado, sendo as intervenções com imipenem e vancomicina as mais frequentes (n = 46). A coleta de dados epidemiológicos regionais sobre IRAS, que possam fomentar políticas de saúde pública, deve ser incentivada nos diferentes serviços de saúde visando a adequação da implementação de ações de controle de infecções e promoção da saúde

Predictors of health activation for patients with chronic kidney disease undergoing hemodialysis

Introduction: the quality of self-care in patients with chronic kidney disease (CKD) is important to improve quality of life, increase survival and reduce complications. Self-care can be evaluated by measuring the health activation of these patients. Objectives: evaluating the health activation of patients with CKD undergoing hemodialysis (HD) compared to a normative group (health self-reported subjects), and to identify the social, demographic and clinical determinants that are associated with the health activation. Method: cross-sectional, analytical, descriptive and quantitative study approved by the local ethics committee and conducted in a public and a private outpatient hemodialysis clinic. Participants were patients with CKD on HD (focal group) and subjects on a normative group. All of them answered the questionnaire of sociodemographic and clinical characterization and the instrument "Patient Activation Measure" (PAM13). For scores comparisons were used the Mann-Whitney test. Regarding the evaluation of the linear effect of the variables of profile on PAM13, multiple linear regression was used, including the evaluation of the two groups and only for patients with CKD. Results: the study included in each group. Regarding the characteristics of the CKD patients, there was a predominance of males (59%), incomplete high school or less (68%). Most of them too was from a private administration clinic (53%) and reported having already presented some type of complication stemming from CKD (57%). Regarding the evaluation of activation, the activation scores did not differ between the two groups (median of 56.4 in CKD patients and 56.4 in normative group, p > 0.05) and the activation scores of both groups corresponded to activation level 3 with 34.5% of prevalence (p > 0.05). When the two groups were analyzed together, schooling (Bi = 5.38; p= 0.002), practice physical activity (Bi = 4.2; p= 0.019) and the number of people who co-reside (Bi = -2.22; p= 0.001) influenced the activation score. In the CKD patients, independently, the variables that influenced the activation score were gender (Bi = -4.69; p = 0.050); schooling (Bi = 6.55; p = 0.008); type of clinic of origin (Bi = -5.48; p = 0.02) and the presence of complications related to CKD (Bi = -5.25; p = 0.026). Conclusion: activation scores did not differ between the patients with CKD on HD and the health subjects. Schooling, practice physical activity and number of people residing with the individual were predictors of health activation in both groups. For the CKD patients group, the variables that influenced positively the activation was schooling; and that influenced negatively was the gender, type of clinic of origin and the presence of complications related to CKD

Effects of salinity on the physiology of Salvinia auriculata Aubl. (Salviniales, Pteridophyta)

Salvinia auriculata Aubl. is reported to occur in different zones of the Capibaribe River, Pernambuco State, Brazil. This river varies in salinity in different areas. This study evaluated the growth, photosynthesis and pigment contents of S. auriculata at different salinity levels. Plant sections were collected in the Cursaí Reservoir, located in the municipality of Paudalho, Pernambuco, and were brought to a greenhouse, where they were put in glass flasks filled with 250 mL of liquid, placed on benches. The plants were exposed for 40 h to salinity levels of 0, 17 and 34, obtained with reservoir freshwater, 1:1 freshwater:seawater and pure seawater, respectively. At the end of the experimental period, the plants in salt water showed color changes, with brownish leaves. In addition, plant growth rates decreased. Salinity and time had a negative influence on photosynthetic responses such as Fv/Fm, ETRmax and ETR, which showed reductions under the highest salinity treatment. Response patterns may help to explain S. auriculata occurrence, and its distribution can be regulated by salinity

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

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt