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Journal articles on the topic 'Roupas infantis'

Author: Grafiati
Published: 4 June 2021
Last updated: 1 February 2022

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1

Maschietto, Cassia Manso Maschietto, Clarita Maria de Godoy Ferro, and Gabriel Carlos Souza Santos. "O gênero e as roupas: a moda infantil na categorização dos corpos." Revista Arqueologia Pública 6, no. 1 (June 9, 2015): 92. http://dx.doi.org/10.20396/rap.v6i1.8635736.

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O presente artigo tem como materialidade em análise a moda infantil. Considerando o pensamento arqueológico pós-processualista e a teoria de gênero, o artigo analisa de que forma esse vestuário carrega intensas categorizações que acabam por enquadrar os sujeitos em condutas préestabelecidas, convergindo para um cenário de controle dos corpos segundo interesses ideológicos em voga. Foram escolhidas para análise duas marcas brasileiras de roupas infantis que hoje abrangem um significativo mercado e que optam por separar suas roupas por critérios de gênero: Lilica Ripilica/ Tigor T. Tigre e Alakazoo. Em contraposição, apresentar-se-á também a marca sueca Polarn O. Pyret, que opta por não realizar a divisão por questões de gênero, mas sim por critérios etários.
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Mendes, Fabiana Da Conceição. "Plano de Empreendimento: LOJA DE ROUPAS E ARTIGOS INFANTIS." Cadernos de Gestão e Empreendedorismo 5, no. 1 (December 21, 2017): 21. http://dx.doi.org/10.32888/cge.v5i1.12703.

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Através da observação direta do empreendedor no mercado de Itaipuaçu, município de Maricá/RJ, foi identificada uma demanda por um estabelecimento que oferte produtos infantis. Dessa forma, realizou-se este plano para abertura de uma loja de roupas e artigos infantis. A empresa busca atender ao público local, no que tange a produtos infantis, classe média, com faixa etária de usuários de 0 a 14 anos. Visa ofertar produtos de qualidade, excelência no atendimento e bom preço. Os principais objetivos são: Atender as necessidades dos clientes com roupas e acessórios, calçados, brinquedos, higiene pessoal e cosméticos, utilidades, passeios e enxoval; E ser líder do ramo no comércio local, sendo reconhecida como uma loja atrativa que supre as expectativas dos clientes. Em termos de faturamento, nos 3 anos iniciais de sua existência, a empresa espera pagar seus custos e despesas, recuperar o investimento inicial e começar a ter lucro. Para concretizar o Plano de Negócios, com vistas à locação do imóvel, adequação, legalização e aquisições tanto para composição da loja, quanto de suprimentos para comercializar, presume-se a necessidade de um investimento aproximado de R$100.000,00 (cem mil reais).
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Frederico, Elias, and Andre Ricardo Robic. "DETERMINANTES DA SATISFAÇÃO DO CONSUMIDOR NO PROCESSO DE SELEÇÃO DE ROUPAS INFANTIS." Revista de Negócios 13, no. 1 (November 26, 2008): 76. http://dx.doi.org/10.7867/1980-4431.2008v13n1p76-92.

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4

Camargo, Marcus Vinicius Guio de. "Séries de animação brasileiras e as narrativas de marca." Diálogo com a Economia Criativa 4, no. 11 (August 20, 2019): 177. http://dx.doi.org/10.22398/2525-2828.411177-188.

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Este artigo tem a finalidade de apresentar um panorama das séries de animação brasileiras produzidas por meio de uma estratégia de branded content, bem como propor a discussão da utilização das narrativas de marca como forma de fomento de produções de séries animadas, averiguando a importância de discutir o uso da animação nas estratégias de comunicação em um momento pertinente para a pesquisa de diferentes modelos de negócio. Para isso, dissertaremos acerca do processo de desenvolvimento e veiculação de três séries de animação brasileiras, sendo duas infantis e uma adulta, com conteúdos elaborados por marcas: Dino Aventuras, cujo personagem é o mascote dos produtos da marca Danone; Mundo Ripilica, que possui como protagonista a personagem Lilica, mascote de uma linha de roupas infantis da marca Marisol; e Mão de Vaca Show, animação veiculada na internet e produzida pelo Itaú.
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Camões, Luciane de Sena, and Vilma Brício. "O MUNDO COR DE ROSA: AS REPRESENTAÇÕES DE GÊNERO NAS PROPAGANDAS DA HELLO KITTY." Revista Margens Interdisciplinar 6, no. 7 (May 22, 2016): 351. http://dx.doi.org/10.18542/rmi.v6i7.2829.

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Este artigo é parte da pesquisa tematizada “O mundo cor de rosa: as representações de gênero nas propagandas da Hello Kitty” que teve como objetivo problematizar, em particular da “Hello Kitty School”, enquanto marca de produtos infantis femininos. A análise das propagandas mostrou que as representações de infância destacadas por estas oscilam entre o consumo dos produtos e a veiculação de padrões considerados próprios de meninas, que enfatizam a erotização dos corpos pois evidenciam atributos considerados femininos, como a preocupação com a beleza, com o corpo, com roupas, com a adequação a moda do momento, a qual é reforçada pela presença da cor rosa marcando o sentimentalismo e as emoções das meninas. A mídia pela sua predominância no meio social e cultural precisa ser posta em debate de modo que adultos e crianças reflitam sobre os significados de infância e gênero por nela veiculadas.Palavras–chave: Mídia. Publicidade. Representação. Infância. Gênero.
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Paiva, Simone de Souza, Marli Teresinha Gimeniz Galvão, Lorita Marlena Freitag Pagliuca, and Paulo César de Almeida. "Comunicação não-verbal durante cuidados prestados aos filhos por mães com Vírus da Imunodeficiência Humana." Acta Paulista de Enfermagem 23, no. 1 (2010): 108–13. http://dx.doi.org/10.1590/s0103-21002010000100017.

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OBJETIVO: Analisar a comunicação não verbal durante os cuidados prestados a filhos menores de seis meses por mães portadoras do vírus da imunodeficiência humana (HIV). MÉTODOS: Estudo desenvolvido em ambiente experimental com cinco mães HIV+, no segundo semestre de 2007. Utilizou-se como recurso de coleta de dados a filmagem de cuidados maternos (banho, troca de roupas, mamadeira, brincar e ninar) dispensados ao filho. As cenas foram analisadas em face dos aspectos da comunicação não-verbal. RESULTADOS: Analise estatística indica diferença entre os cuidados em todas as manifestações da comunicação. Entre os cuidados, a troca de roupas e o banho foram os cuidados mais instrumentais. A comunicação não-verbal é utilizada pela mãe para demonstrar apego ao filho e para perceber anormalidades. CONCLUSÃO: Os resultados demonstram necessidade de incentivar a mãe a interagir com seu filho durante todos os cuidados, promovendo estímulos para o desenvolvimento infantil.
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Ventura, Elvira Cruvinel Ferreira. "O rei está nu?: pensando fenomenologicamente A roupa nova do imperador." Cadernos EBAPE.BR 2, no. 1 (March 2004): 01–11. http://dx.doi.org/10.1590/s1679-39512004000100005.

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Foram dois os objetivos da autora neste ensaio: apreender a essência da fenomenologia, ou seja, compreendê-la fenomenologicamente, e reorganizar sua "rede" de pensamento, buscando chegar mais próximo do objeto de estudo de sua tese. O propósito não foi o de entender e apresentar "tudo" sobre fenomenologia, mas aquilo que para a autora ficou de essencial no conceito. A partir dessa experiência é que pôde lançar um olhar fenomenológico sobre seu objeto de estudo. O conto infantil A roupa nova do imperador, de Hans Christian Andersen, foi um gerador de idéias, utilizado para ilustrar questões relevantes.
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Caldwell, Claire, Victoria MacBean, Katie Hunt, and Anne Greenough. "Parental views on attending neonatal intensive care ward rounds." BMJ Paediatrics Open 3, no. 1 (April 2019): e000449. http://dx.doi.org/10.1136/bmjpo-2019-000449.

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ObjectivesTo ascertain parental views regarding taking part in neonatal unit ward rounds.DesignA service evaluation project.SettingTertiary neonatal intensive care unit.PatientsParent(s) of infants receiving care on the neonatal unit.InterventionsStructured interviews conducted at the cot side.Main outcome measuresParents were asked if they knew when ward rounds occurred, whether they had attended ward rounds and if they had not what were the factors inhibiting them from doing so, their experience of attending ward rounds and whether they were concerned about issues of confidentiality.Results23 of 24 consecutive parents agreed to be interviewed. The median age of their infants was 14 (range 3 – 123) days when they were interviewed. Eighty-five per cent were able to identify when a nursing handover or doctor’s ward round occurred. Seventy-five per cent of parents had attended at least one ward round and the median score in terms of usefulness was 5 out of 5. Reasons for not attending included time and cost to travel to the unit, their partners were working and having other children. Parents volunteered that the nurses proactively updated them as soon as they arrived, hence making regular attendance less important. Regarding confidentiality, 85% were not concerned if other people overheard information about their baby, unless the news was bad.ConclusionsParents recognised the value of attending ward rounds and generally found it a positive experience, but emphasised limitations on their ability to attend.
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Caraciola, Carolina Boari. "Fulla." Signos do Consumo 11, no. 2 (July 31, 2019): 52–65. http://dx.doi.org/10.11606/issn.1984-5057.v11i2p52-65.

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Este artigo analisará a influência da religião islâmica na formação da personalidade infantil. Enquanto a boneca Barbie representa tudo o que uma menina ocidental supostamente quer ser, em relação a comportamento e padrões de beleza, a boneca Fulla caracteriza a jovem muçulmana, com traços árabes, roupas que cobrem a totalidade do corpo, um véu que esconde seus cabelos, tapete para rezar, além de um livro de orações. Por meio da análise semiótica da boneca Fulla e de suas principais manifestações, fica evidente que a constituição da marca, suas expressividades e posicionamentos refletem o ethos islâmico. Mais do que uma boneca ou uma marca, Fulla representa o contexto cultural no qual a menina, público consumidor do produto, está inserida, reforçando os códigos religiosos e de conduta.
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Ahmad, Kaashif A., Ashley Darcy-Mahoney, Amy S. Kelleher, Dan L. Ellsbury, Veeral N. Tolia, and Reese H. Clark. "Longitudinal Survey of COVID-19 Burden and Related Policies in U.S. Neonatal Intensive Care Units." American Journal of Perinatology 38, no. 01 (October 19, 2020): 093–98. http://dx.doi.org/10.1055/s-0040-1718944.

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Objective This study aimed to determine the prevalence of confirmed novel coronavirus disease 2019 (COVID-19) disease or infants under investigation among a cohort of U.S. neonatal intensive care units (NICUs). Secondarily, to evaluate hospital policies regarding maternal COVID-19 screening and related to those infants born to mothers under investigation or confirmed to have COVID-19. Study Design Serial cross-sectional surveys of MEDNAX-affiliated NICUs from March 26 to April 3, April 8 to April 19, May 4 to May 22, and July 13 to August 2, 2020. The surveys included questions regarding COVID-19 patient burden and policies regarding infant separation, feeding practices, and universal maternal screening. Results Among 386 MEDNAX-affiliated NICUs, responses were received from 153 (42%), 160 (44%), 165 (45%), 148 (38%) across four rounds representing an active patient census of 3,465, 3,486, 3,452, and 3,442 NICU admitted patients on the day of survey completion. Confirmed COVID-19 disease in NICU admitted infants was rare, with the prevalence rising from 0.03 (1 patient) to 0.44% (15 patients) across the four survey rounds, while the prevalence of patients under investigation increased from 0.8 to 2.6%. Hospitals isolating infants from COVID-19-positive mothers fell from 46 to 20% between the second and fourth surveys, while centers permitting direct maternal breastfeeding increased 17 to 47% over the same period. Centers reporting universal severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) screening for all expectant mothers increased from 52 to 69%. Conclusion Among a large cohort of NICU infants, the prevalence of infants under investigation or with confirmed neonatal COVID-19 disease was low. Policies regarding universal maternal screening for SARS-CoV-2, infant isolation from positive mothers, and direct maternal breastfeeding for infants born to positive mothers are rapidly evolving. As universal maternal screening for SARS-CoV-2 becomes more common, the impact of these policies requires further investigation. Key Points
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11

Qadir, S. A. l., M. Umar, A. Rehman, H. U. Nisa, Z. Fatima, and F. Rehman. "Weaning Practices in Mothers of Infants age 6 to 12 months visiting Sandeman Provincial Hospital, Quetta." Pakistan Journal of Medical and Health Sciences 15, no. 6 (June 30, 2021): 1400–1403. http://dx.doi.org/10.53350/pjmhs211561400.

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Background: Weaning can be described as gradually increasing the amount of foods other than breast 's milk in the infant's diet. Breast feeding for the first four to six months is recommended by the WHO for a full-term healthy child by a healthy mother. Aim: To find weaning-related factors that contribute, strengthen, and enable mothers of infants under the age of 12 months to obey or not obey guidance for proper infant feeding by World Health Organization's (WHO-2009) Methods: The current research was a cross-sectional descriptive study. From March 2020 to January 2021, pre design performa was used to collect data from 100 mothers of infants under the age of 12 months who lived in Quetta City and visited at OPD department of Sandeman Provincial Hospital in Quetta. .The multiple rounds of data collection were done. The data was analyzed by SPSS 20. Statistical test like chi- square test was applied to obtain the required results. Results: Total 100 babies consist of 41(41%) male and 59(59%) femaleenrolled. The mothers in the sample were on average 27.2 ± 4.2 years old with the age range of 20-40 years. Results showed that mothers of 6-8 months’ kids 18(45%) fully aware about the importance of weaning and feed their children with different soft food along with breast feeding which increased at the age of 8-12 month as 22(73.33%).Majority of mothers, i.e63% were housewives. The social status showed lower middle income 34% and 41% of research participants belonged to the middle income group.The findings showed that 61% mothers had inadequate knowledge about proper child feeding and weaning practice compare with other group as 39% with p-value 0.01. Conclusion: Mothers should be well informed about the benefits and importance of weaning, as well as the age in which weaning should begin and the different forms of weaning diets available. This target can be met with the assistance of LHWs and LHVs, as well as the use of social media. It is important to stress the importance of continuing to breastfeed after weaning. Key words: Mothers; Practices; Infants: Weaning.
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Marino, Luise V., Mark J. Johnson, Nigel J. Hall, Natalie J. Davies, Catherine S. Kidd, M. Lowri Daniels, Julia E. Robinson, Trevor Richens, Tara Bharucha, and Anne-Sophie E. Darlington. "The development of a consensus-based nutritional pathway for infants with CHD before surgery using a modified Delphi process." Cardiology in the Young 28, no. 7 (April 29, 2018): 938–48. http://dx.doi.org/10.1017/s1047951118000549.

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AbstractIntroductionDespite improvements in the medical and surgical management of infants with CHD, growth failure before surgery in many infants continues to be a significant concern. A nutritional pathway was developed, the aim of which was to provide a structured approach to nutritional care for infants with CHD awaiting surgery.Materials and methodsThe modified Delphi process was development of a nutritional pathway; initial stakeholder meeting to finalise draft guidelines and develop questions; round 1 anonymous online survey; round 2 online survey; regional cardiac conference and pathway revision; and final expert meeting and pathway finalisation.ResultsPaediatric Dietitians from all 11 of the paediatric cardiology surgical centres in the United Kingdom contributed to the guideline development. In all, 33% of participants had 9 or more years of experience working with infants with CHD. By the end of rounds 1 and 2, 76 and 96% of participants, respectively, were in agreement with the statements. Three statements where consensus was not achieved by the end of round 2 were discussed and agreed at the final expert group meeting.ConclusionsNutrition guidelines were developed for infants with CHD awaiting surgery, using a modified Delphi process, incorporating the best available evidence and expert opinion with regard to nutritional support in this group.
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Weston, Cindy, S. Adil Husain, Christopher L. Curzon, Steve Neish, Gemma T. Kennedy, Krista Bonagurio, and Kevin Gosselin. "Improving Outcomes for Infants with Single Ventricle Physiology through Standardized Feeding during the Interstage." Nursing Research and Practice 2016 (2016): 1–7. http://dx.doi.org/10.1155/2016/9505629.

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Congenital heart disease is identified as the most common birth defect with single ventricle physiology carrying the highest mortality. Staged surgical palliation is required for treatment, with mortality historically as high as 22% in the four- to six-month period from the first- to second-stage surgical palliation, known as the interstage. A standardized postoperative feeding approach was implemented through an evidence-based protocol, parent engagement, and interprofessional team rounds. Five infants with single ventricle physiology preprotocol were compared with five infants who received the standardized feeding approach. Mann-WhitneyUtests were conducted to evaluate the hypotheses that infants in the intervention condition would consume more calories and have a positive change in weight-to-agez-score (WAZ) and shorter length of stay (LOS) following the first and second surgeries compared to infants in the control condition. After the protocol, the change in WAZ during the interstage increased by virtually one standard deviation from 0.05 to 0.91. Median LOS dropped 32% after the first surgery and 43% after the second surgery. Since first- and second-stage palliative surgeries occur within the same year of life, this represents savings of$500,000 to$800,000 per year in a 10-infant model. The standardized feeding approach improved growth in single ventricle infants while concurrently lowering hospital costs.
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Jinzenji, Mônica Y., Ana M. Galvão, and Simone A. Silva. "Memórias sobre a infância no meio rural: a escola e os outros espaços de sociabilidade (Minas Gerais — Brasil, 1920-1950)." Revista Portuguesa de Educação 25, no. 2 (September 30, 2013): 09. http://dx.doi.org/10.21814/rpe.3000.

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Este trabalho analisa as representações sobre a infância por mulheres originárias de comunidades rurais do estado de Minas Gerais, na primeira metade do século XX, que migraram para Belo Horizonte quando adultas e que residem num bairro periférico da capital mineira. Utilizou-se entrevistas realizadas com 13 mulheres, dados demográficos e a legislação educacional do período. Nas entrevistas, a recorrente afirmação "eu não tive infância" pode ser compreendida pela contraposição feita por elas a uma suposta vivência infantil ideal, relacionada aos meios socialmente privilegiados, e à infância da atualidade, da qual elas se excluem. As memórias evocadas se referem à intensa rotina de trabalhos na roça e nas casas dos outros, à dificuldade em frequentar a escola, à precariedade das roupas, à ausência de brinquedos, mas também a momentos alegres de brincadeiras e à participação nas comemorações religiosas. Família, trabalho e religião concorrem com a escola como importantes espaços de sociabilidade.Palavras-chaveInfância; Escola rural; Mulheres; Espaços de sociabilidade
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Oliveira Carvalho, Francione. "A cultura boliviana na escola e o “fazer especial” como ampliação e descolonização da experiência estética." PRACS: Revista Eletrônica de Humanidades do Curso de Ciências Sociais da UNIFAP 11, no. 1 (November 8, 2018): 93. http://dx.doi.org/10.18468/pracs.2018v11n1.p93-103.

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<p>Em um mundo aberto à circulação do capital, mas não das pessoas, as que migram em busca de melhores condições econômicas e sociais precisam vencer tanto os percalços inerentes ao processo migratório como a hostilidade de muitas comunidades que as recebem e, muitas vezes, as rejeitam. Situações de discriminação e intolerância que diminuem e não reconhecem a humanidade do Outro. A educação infantil e a primária não estão imunes a esta questão, portanto, este trabalho discute as ações realizadas em duas escolas municipais da cidade de São Paulo na promoção da diversidade e do reconhecimento das tradições culturais sul-americanas com destaque para as de origem boliviana. A partir da pergunta: “O que você aprendeu com os seus pais?”, as crianças das escolas apresentadas levaram objetos, imagens, álbuns de fotografias, comidas, roupas, danças e compartilharam tradições, memórias e fazeres que possibilitaram experiências estéticas que ampliaram os territórios da arte e da cultura.</p>
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Segel, Sally, Jason Hashima, William Thomas Gregory, Alison Edelman, Hong Li, and Jeanne-Marie Guise. "A New Approach to Postpartum Rounds: Patient-Centered Collaborative Care Improves Efficiency." Journal of Graduate Medical Education 2, no. 1 (March 1, 2010): 67–72. http://dx.doi.org/10.4300/jgme-d-09-00060.1.

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Abstract Objective At our institution, traditional postpartum rounds were time consuming and inefficient with a low percentage (approximately 12%) of patients meeting the goal of being discharged by 11:00 am. A patient-centered collaborative care (PCCC) initiative was implemented to improve discharge efficiency, staff communication, and patient satisfaction. We investigated whether this paradigm shift to PCCC could improve clinical inefficiencies and timely discharge. Methods The PCCC rounding system was created by a representative group of physicians, residents, nurses, case managers, and social workers. An intervention study was conducted to examine the impact of PCCC during which physicians, residents, medical students, nurses, case managers, and social workers made rounds together. Efficiency data were collected for patients whose infants were delivered by the obstetric service for a 1-month period before and 6 months after implementing PCCC. Comparisons were made on the time of discharge and whether Foley catheter removal affected discharge time. χ2 test, Wilcoxon 2-sample test, and Pearson correlation coefficient were used where appropriate. Results Three hundred five patients were included in this analysis, of which 156 participated in traditional postpartum rounds and 149 in PCCC rounds. Discharge efficiency significantly improved with PCCC rounds, with 20.8% of patients being discharged by 11:00 am as compared to 11.5% for traditional postpartum rounds (P = .03). Early Foley catheter removal was significantly associated with time to discharge order (Pearson correlation coefficient, 0.22; P = .01) and discharge time (Pearson correlation coefficient, 0.28; P = .002). Conclusions Patient-centered collaborative care rounds improve the efficiency of postpartum care and discharge time.
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Arruda, Aline Oliveira, Márcia Tavares, and Lanaiza do Nascimento Silva Araújo. "PERFORMATIZANDO A LEITURA DO TEXTO DRAMÁTICO INFANTIL: UMA PROPOSTA PARA SALA DE AULA." Revista Leia Escola 19, no. 2 (September 4, 2019): 53–66. http://dx.doi.org/10.35572/rle.v19i2.1516.

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Um determinado modo de ler o texto literário pode oportunizar ao discente um novo direcionamento para compreender a significação de palavras e sentidos, cuja experimentação pode ser viável por meio de outros meios metodológicos, como por exemplo, a performance, uma vez que a leitura se desenvolve de forma oralizada (e em movimento), individual e em grupo. Nessa perspectiva, objetivamos apresentar uma proposta de leitura do texto dramático infantil para a sala de aula por meio da leitura do texto Maria Roupa de Palha, de Lourdes Ramalho (2008), destacando o método performático como instrumento para se ler o texto dramatúrgico. Metodologicamente, discorremos sobre a leitura do texto dramático, traremos informações sobre a autora estudada, bem como a obra corpus de nossa investigação, e apresentamos uma proposta para ser desenvolvida com alunos do Ensino Fundamental. Nossos pressupostos teóricos estão fundamentados principalmente em Kefalás (2010; 2018), Grazioli (2007) e Camaroti (2005), dentre outros.
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Webbe, James William Harrison, James M. N. Duffy, Elsa Afonso, Iyad Al-Muzaffar, Ginny Brunton, Anne Greenough, Nigel J. Hall, et al. "Core outcomes in neonatology: development of a core outcome set for neonatal research." Archives of Disease in Childhood - Fetal and Neonatal Edition 105, no. 4 (November 15, 2019): 425–31. http://dx.doi.org/10.1136/archdischild-2019-317501.

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BackgroundNeonatal research evaluates many different outcomes using multiple measures. This can prevent synthesis of trial results in meta-analyses, and selected outcomes may not be relevant to former patients, parents and health professionals.ObjectiveTo define a core outcome set (COS) for research involving infants receiving neonatal care in a high-income setting.DesignOutcomes reported in neonatal trials and qualitative studies were systematically reviewed. Stakeholders were recruited for a three-round international Delphi survey. A consensus meeting was held to confirm the final COS, based on the survey results.ParticipantsFour hundred and fourteen former patients, parents, healthcare professionals and researchers took part in the eDelphi survey; 173 completed all three rounds. Sixteen stakeholders participated in the consensus meeting.ResultsThe literature reviews identified 104 outcomes; these were included in round 1. Participants proposed 10 additional outcomes; 114 outcomes were scored in rounds 2 and 3. Round 1 scores showed different stakeholder groups prioritised contrasting outcomes. Twelve outcomes were included in the final COS: survival, sepsis, necrotising enterocolitis, brain injury on imaging, general gross motor ability, general cognitive ability, quality of life, adverse events, visual impairment/blindness, hearing impairment/deafness, retinopathy of prematurity and chronic lung disease/bronchopulmonary dysplasia.Conclusions and relevanceA COS for clinical trials and other research studies involving infants receiving neonatal care in a high-income setting has been identified. This COS for neonatology will help standardise outcome selection in clinical trials and ensure these are relevant to those most affected by neonatal care.
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Robertson, Fiona, Adriece Al Rifai, and Jenny Machell. "P27 Introduction of oral caffeine rounds on the neonatal units." Archives of Disease in Childhood 103, no. 2 (January 19, 2018): e2.30-e2. http://dx.doi.org/10.1136/archdischild-2017-314585.36.

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AimApnoea of prematurity is common in babies born at less than 34 weeks gestation due to immature respiratory control systems.1–4 The current mainstay of treatment in the UK is a methylxanthine – caffeine – which acts as a respiratory stimulant. Our local guideline follows the Caffeine for Apnea of Prematurity (CAP) study with a single loading dose followed by 24-hourly maintenance doses, given either intravenously or orally1.In August 2012 a UK licenced oral caffeine product was launched, however various safety concerns were raised over this product and its presentation which led to delays in use on our Neonatal Units (NNUs). Unfortunately the single patient, single use product would also lead to a massive increase in our oral caffeine spend – with the cost of an average dose of oral caffeine rising from just £0.13 to £24.41. This equates to an annual cost increase of approximately £53,140 – around a 150-fold increase from the previous £360 per annum. We have therefore considered and implemented a new initiative to avoid unacceptable cost pressures within the neonatal service.MethodsConsideration was made to administering caffeine doses in ‘rounds’ on NNU to allow doses for more than one patient from a single bottle.However, there were a number of issues to overcome – the oral caffeine rounds would require the product to be used outside of its licence. We also needed to be sure that limiting the timing of caffeine administration to standard times on the NNUs – provisionally twice daily rounds at 10:00 and 22:00 – would not affect its therapeutic and potentially toxic effects in this vulnerable patient group.Savings as a result of this initiative were to be tracked for one year post implementation.ResultsTotal savings in the first 10 months following implementation were £15,945 – a projected saving of £19 134 per annum. There have been no reports of any adverse clinical outcomes related to timing of caffeine doses.ConclusionGiven the success of this initiative we plan to move towards a once daily oral caffeine round on our NNUs at 10:00. The majority of babies currently receive their dose at this time but formal implementation will lead to further cost savings. A morning oral caffeine round will also help to minimise the at least theoretical risk of the CNS stimulant effects and cardiac effects of caffeine, principally tachycardia, disrupting a baby’s sleep pattern. There is some evidence of this in the literature although these effects are more common at supratherapeutic levels.ReferencesNottingham Neonatal Service. Clinical guideline B7 – Use of caffeine in apnoea of prematurityMay 2016.Schmidt B, Roberts RS, Davis P, et al. Caffeine for Apnea of Prematurity Trial Group. Caffeine therapy for apnea of prematurity. N Engl J Med2006;354(20):2112–21.Henderson-Smart DJ, Steer PA. Caffeine versus theophylline for apnea in preterm infants. Cochrane Database of Systematic Reviews2010:Issue 1.Art No:CD000273.Henderson-Smart DJ, De Paoli AG. Methylxanthine treatment for apnea in preterm infants. Cochrane Database of Systematic Reviews2010:Issue 12.Art. No:CD0001.
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Discenza, Deb. "Infant Massage in the NICU." Neonatal Network 29, no. 5 (September 2010): 334–35. http://dx.doi.org/10.1891/0730-0832.29.5.334.

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MOTHERS OF BABIES IN THE NICU face a serious challenge: bonding with their infants despite doctors’ rounds, medical equipment, and requirements for minimal stimulation. When her infant becomes stable enough for touch, what can a mother do to provide comfort to her child? One approach is infant massage. There is much neonatal nurses can do to promote the connection between mother and child through infant massage. Infant Massage USA’s executive director, Linda Storm, discusses this approach and its benefits for baby and parent in the interview that follows.
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Cuttini, Marina, Ileana Croci, Liis Toome, Carina Rodrigues, Emilija Wilson, Mercedes Bonet, Janusz Gadzinowski, Domenico Di Lallo, Lena Carolin Herich, and Jennifer Zeitlin. "Breastfeeding outcomes in European NICUs: impact of parental visiting policies." Archives of Disease in Childhood - Fetal and Neonatal Edition 104, no. 2 (June 28, 2018): F151—F158. http://dx.doi.org/10.1136/archdischild-2017-314723.

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ObjectiveThe documented benefits of maternal milk for very preterm infants have raised interest in hospital policies that promote breastfeeding. We investigated the hypothesis that more liberal parental policies are associated with increased breastfeeding at discharge from the neonatal unit.DesignProspective area-based cohort study.SettingNeonatal intensive care units (NICUs) in 19 regions of 11 European countries.PatientsAll very preterm infants discharged alive in participating regions in 2011–2012 after spending >70% of their hospital stay in the same NICU (n=4407).Main outcome measuresWe assessed four feeding outcomes at hospital discharge: any and exclusive maternal milk feeding, independent of feeding method; any and exclusive direct breastfeeding, defined as sucking at the breast. We computed a neonatal unit Parental Presence Score (PPS) based on policies regarding parental visiting in the intensive care area (range 1–10, with higher values indicating more liberal policies), and we used multivariable multilevel modified Poisson regression analysis to assess the relation between unit PPS and outcomes.ResultsPolicies regarding visiting hours, duration of visits and possibility for parents to stay during medical rounds and spend the night in unit differed within and across countries. After adjustment for potential confounders, infants cared for in units with liberal parental policies (PPS≥7) were about twofold significantly more likely to be discharged with exclusive maternal milk feeding and exclusive direct breastfeeding.ConclusionUnit policies promoting parental presence and involvement in care may increase the likelihood of successful breastfeeding at discharge for very preterm infants.
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Shinwari, Ibrahim, Ahmad Wali Aminee, Kirti Warvadekar, Payal Gupta, Deepika Nayar Chaudhery, and Manoj Kumar Raut. "Infant and young child feeding practices in two provinces of Afghanistan: results from two rounds of large country-lot quality assurance sampling surveys." International Journal Of Community Medicine And Public Health 5, no. 11 (October 25, 2018): 4761. http://dx.doi.org/10.18203/2394-6040.ijcmph20184565.

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Background: As per NNS 2013, about 58% of the infants aged 0-5 months were exclusively breastfed. The data also shows that only 41% infants 6-8 months of age were introduced solid, semi-solid and soft foods. Further only 28% of children aged 6-23 months received foods from four or more food groups during last 24 hours preceding the survey. Suboptimal IYCF practices are therefore considered to be an important contributor to the high rates of under nutrition in Afghanistan. The program monitoring at two time points was conducted to inform the program about the current status of the program activities and any course correction required. It was also meant to inform the government and other stakeholders on the feasibility of program strategies in improving IYCF practices and recommendations for scale-up programs.Methods: The program monitoring was performed before and after the (IYCN) program roll out in Wardak and Laghman provinces of Afghanistan. To understand and monitor the status of process and program indicators, a Large Country-Lot Quality Assurance Sampling (LC-LQAS) study design was adopted.Results: Minimum acceptable diet was observed to be 54% (95% CI: 46%, 61%) in the second round, which was 44% (95% CI: 35%, 53%) in the first round.Conclusions: Minimum acceptable diet among the children of age group 6-23 months was found to be consistently doing well in both the rounds. LC-LQAS was found to be an apt method to estimate the IYCN indicators at time points with low resource use.
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Bhatia, Mrigesh, Laxmi Kant Dwivedi, Mukesh Ranjan, Priyanka Dixit, and Venkata Putcha. "Trends, patterns and predictive factors of infant and child mortality in well-performing and underperforming states of India: a secondary analysis using National Family Health Surveys." BMJ Open 9, no. 3 (March 2019): e023875. http://dx.doi.org/10.1136/bmjopen-2018-023875.

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ObjectivesThis paper analyses the patterns and trends in the mortality rates of infants and children under the age of 5 in India (1992–2016) and quantifies the variation in performance between different geographical states through three rounds of nationally representative household surveys.DesignThree rounds of cross-sectional survey data.SettingThe study is conducted at the national level: India and its selected good-performing states, namely Haryana, Kerala, Maharashtra, Punjab and Tamil Nadu, and selected poor-performing states, namely Bihar, Chhattisgarh, Madhya Pradesh and Uttar Pradesh.ParticipantsAdopting a multistage, stratified random sampling, 601 509 households with 699 686 women aged 15–49 years in 2015–2016, 109 041 households with 124 385 women aged 15–49 years in 2005–2006, and 88 562 households with 89 777 ever married women in the age group 13–49 years in 1992–1993 were selected.ResultsThrough the use of maps, this paper clearly shows that the overall trend in infant and child mortality is on a decline in India. Computation of relative change shows that majority of the states have witnessed over 50% reduction in both infant and under-5 mortality rates from National Family Health Survey (NFHS)-I to NFHS-4. However, the improvements are not evenly distributed, and there is huge variation in performance between states over time. Funnel plots show that the most populous states like Uttar Pradesh Bihar and Madhya Pradesh have underperformed consistently across the survey period from 1992 to 2016. Regression analysis comparing high-performing and low-performing states revealed that female infants and women with shorter birth intervals had greater risk of infant deaths in poor-performing states.ConclusionAttempts to reduce infant and child mortality rates in India are heading in the right direction. Even so, there is huge variation in performance between states. This paper recommends a mix of strategies that reduce child and infant mortality among the high-impact states where the biggest improvements can be expected, including the need to address neonatal mortality.
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Weber, Ann M., Marta Rubio-Codina, Susan P. Walker, Stef van Buuren, Iris Eekhout, Sally M. Grantham-McGregor, Maria Caridad Araujo, et al. "The D-score: a metric for interpreting the early development of infants and toddlers across global settings." BMJ Global Health 4, no. 6 (November 2019): e001724. http://dx.doi.org/10.1136/bmjgh-2019-001724.

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IntroductionEarly childhood development can be described by an underlying latent construct. Global comparisons of children’s development are hindered by the lack of a validated metric that is comparable across cultures and contexts, especially for children under age 3 years. We constructed and validated a new metric, the Developmental Score (D-score), using existing data from 16 longitudinal studies.MethodsStudies had item-level developmental assessment data for children 0–48 months and longitudinal outcomes at ages >4–18 years, including measures of IQ and receptive vocabulary. Existing data from 11 low-income, middle-income and high-income countries were merged for >36 000 children. Item mapping produced 95 ‘equate groups’ of same-skill items across 12 different assessment instruments. A statistical model was built using the Rasch model with item difficulties constrained to be equal in a subset of equate groups, linking instruments to a common scale, the D-score, a continuous metric with interval-scale properties. D-score-for-age z-scores (DAZ) were evaluated for discriminant, concurrent and predictive validity to outcomes in middle childhood to adolescence.ResultsConcurrent validity of DAZ with original instruments was strong (average r=0.71), with few exceptions. In approximately 70% of data rounds collected across studies, DAZ discriminated between children above/below cut-points for low birth weight (<2500 g) and stunting (−2 SD below median height-for-age). DAZ increased significantly with maternal education in 55% of data rounds. Predictive correlations of DAZ with outcomes obtained 2–16 years later were generally between 0.20 and 0.40. Correlations equalled or exceeded those obtained with original instruments despite using an average of 55% fewer items to estimate the D-score.ConclusionThe D-score metric enables quantitative comparisons of early childhood development across ages and sets the stage for creating simple, low-cost, global-use instruments to facilitate valid cross-national comparisons of early childhood development.
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Gnanasekaran, Sruthy, and Natarajan P. "An observational cohort study on the etiology and outcomes of neonates with thumb in flexion sign." International Journal of Contemporary Pediatrics 8, no. 1 (December 23, 2020): 138. http://dx.doi.org/10.18203/2349-3291.ijcp20205520.

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Background: One constant observation by Pediatricians during postnatal rounds is that many of the early neonates exhibit a sign with thumb adducted and flexed over the palm and the rest of the fingers flexed over the thumb. In an otherwise normal neonate with no obvious etiological factors, we do come across TIF sign in more than half of the early neonate. This study attempts to know weather this sign is physiological or pathological and what would be the neurological outcome of the neonates exhibiting this sign in the early neonatal period.Methods: The study was conducted in the department of Pediatrics (post-natal ward in) of Sri Venkateshwara Medical College Hospital & Research centre, Ariyur, Puducherry, a tertiary care hospital loacted in a rural area.Results: Among 227 study participants 152(67%) had TIF sign. The infants born after history of fetal distress had higher incidence of TIF sign (76.1%) with a p value 0.05. One significant finding was that all the 7 infants who had language delay had history TIF sign within 7 days of life. The p value was 0.01.Conclusions: The pathological view of the TIF sign is, perhaps, a sign of minimal insult to the developing brain from which it recovers over a period of few months. From our study we conclude that the incidence of TIF sign was about 67 %. Thumb in Flexion sign has clinical significance with etiological factors like fetal distress in apparently healthy full-term infants. The secondary outcome of TIF sign was isolated language delay which was present in babies who had TIF sign within first week of life without neurological deficits up to 1 year of life with statistical significance. Hence it is recommended that the neonates with this sign need periodic neurological evaluation.
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Khodyakov, Dmitry, Shahla M. Jilani, Stephanie Dellva, and Laura J. Faherty. "Informing the Development of a Standardized Clinical Definition of Neonatal Abstinence Syndrome: Protocol for a Modified-Delphi Expert Panel." JMIR Research Protocols 10, no. 9 (September 7, 2021): e25387. http://dx.doi.org/10.2196/25387.

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Background Neonatal abstinence syndrome (NAS) is a postnatal withdrawal syndrome that most commonly results from prenatal opioid exposure. Every 15 minutes, an infant is born in the United States with signs of NAS. The field lacks a standardized clinical definition of NAS, complicating discussions on programmatic and policy development to support opioid-exposed mothers and infants. Objective The goal of this paper is to describe a protocol for a systematic expert panel process to inform the development of a clinical definition of NAS. Methods We will conduct two three-round online modified-Delphi panels using the ExpertLens system and will follow the recommendations for Conducting and REporting of DElphi Studies (CREDES). One panel will focus on developing key components of a clinical definition of NAS, and the second panel will focus on neonatal opioid withdrawal syndrome (NOWS), which is a term that has come into use to differentiate opioid-exposed infants from infants exposed to other substances in utero. However, there is lack of agreement on the precise clinical definition of NOWS and how it is distinct from or overlaps with NAS. Each panel will complete two rating rounds and a discussion round using a similar protocol. We will analyze all rating data descriptively and determine the presence of agreement within and between the two panels. We will also perform thematic analysis of the qualitative comments to contextualize the panel findings. Results The panels were convened between October 29 and December 17, 2020. Their results were disseminated and discussed at a national conference on NAS that took place on March 17-18, 2021. Conclusions A standardized clinical definition of NAS will help to better characterize NAS incidence and to design effective clinical, public health, and policy interventions to support opioid-exposed mother-infant dyads. International Registered Report Identifier (IRRID) DERR1-10.2196/25387
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Bezerra, Tarita Almirão dos Santos, Ronaldo Rodrigues Teixeira Junior, and Diovani Cavalheiro Palha. "A produção de regras através de brincadeiras em um atendimento clínico comportamental infantil." Perspectivas em Análise do Comportamento 4, no. 2 (August 28, 2017): 70–91. http://dx.doi.org/10.18761/perspectivas.v4i2.111.

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Esse trabalho busca através do relato de um caso clínico infantil, demonstrar como brincadeiras e a produção de regras podem interferir em outros comportamentos de uma criança. O trabalho foi baseado nos registros dos atendimentos de Kissylla (nome fictício), de seis anos, que foi levada pela mãe à terapia. O caso tinha como queixa principal o roubo e a formulação do caso indicou que esse comportamento estava relacionado à dificuldades da cliente com relação ao seguimento generalizado de regras e questões a dificuldades no estabelecimento de vínculo afetivo com a mãe. As intervenções foram conduzidas através de brincadeiras e treino em sessão das situações problema com a criança e com a mãe e tinham como objetivo a formação de novas regras e aumento da proximidade entre mãe e filha. Inicialmente, a criança ganhava prêmios por seguir as regras das brincadeiras (reforço arbitrário), depois passou a ser mais controlada pela atenção da mãe (reforço natural). Após 41 sessões, observou-se a mudança em diversos operantes relacionados ao seguimento de regras, como por exemplo, não trapacear nos jogos e maior qualidade na interação com a família, tendo sido dada alta à cliente. O comportamento de roubar não foi foco do atendimento e deixou de ocorrer nos nove últimos meses da terapia.
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Fox, Andy. "1 Developing consensus on hospital prescribing indicators of potential harm for infants and children." Archives of Disease in Childhood 103, no. 2 (January 19, 2018): e2.1-e2. http://dx.doi.org/10.1136/archdischild-2017-314585.1.

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AimsTo develop a list of hospital based paediatric prescribing indicators that can be used to assess the impact of electronic prescribing or clinical decision support tools on paediatric prescribing errors.BackgroundMedication errors are a major cause for concern in the NHS. Prescribing is part of the medication use process and is a complex task requiring an understanding of medicines, disease processes, and patient parameters. Systematic reviews have reported that medication errors occur in as many as 50% of hospital admissions and prescribing error rates in the UK hospitals vary between 9% and 15%.Prescribing for children is further complicated by the need to take into account weight, altered physiology and pharmacokinetics. Prescribing error rates of 13.1% have been reported in children with a potentially greater impact due to the nature of the patients.Electronic prescribing (EP) while relatively uncommon in UK hospitals is an important tool in reducing prescribing errors. EP systems have been shown to have a positive impact on prescribing errors, however methodologies vary and the reduction in harm is rarely investigated. A standard tool to allow an evaluation of the harm reduction is desirable and currently does not exist for the paediatric setting.MethodsTwo rounds of an electronic consensus method (eDelphi) were carried out with 21 expert panellists from the UK. Panellists were asked to score each prescribing indicator for its likelihood of occurrence and severity of outcome should the error occur. The scores were combined to produce a risk score and a median score for each indicator calculated. The degree of consensus between panellists was defined as the proportion that gave a risk score in the same category as the median. Indicators were included if a consensus of 80% or higher was achieved and were in the high risk categories.ResultsAn expert panel consisting of 8 pharmacists and 13 paediatricians with a total of 437 years of clinical experience completed an exploratory round and two rounds of scoring. This identified 41 paediatric prescribing indicators with a high risk rating and greater than 80% consensus. The most common error type within the indicators was wrong dose (n=19) and the most common drug classes were antimicrobials (n=10) and cardiovascular (n=7).ConclusionsA set of 41 paediatric prescribing indicators describing potential harm for the hospital setting have been identified by an expert panel. The indicators provide a standardised method of evaluation of prescribing data on both paper and electronic systems. They can also be used to assess implementation of clinical decision support systems or other quality improvement initiatives.
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Leanos, Shirley, Jennifer Coons, George W. Rebok, Daniel J. Ozer, and Rachel Wu. "Development of the Broad Learning Adult Questionnaire." International Journal of Aging and Human Development 88, no. 3 (July 9, 2018): 286–311. http://dx.doi.org/10.1177/0091415018784695.

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Infants and children experience an intense form of intellectual engagement associated with learning a variety of new skills. A recent theory proposes that such broad learning experiences may be the key to maximal cognitive development not just during infancy and childhood but also during adulthood. To begin investigating this possibility, the present questionnaire on broad learning in adulthood builds on prior research on need for cognition, intellectual engagement, personal growth, and leisure activities. After several rounds with preliminary versions of the questionnaire, the final version consists of 28 items. Responses were gathered from two mTurk samples to measure scale reliability and to assess model fit. In the end, we obtained a satisfactory measure of broad learning that consists of six separate reliable scales. Once this questionnaire is validated in future studies, perhaps it could be used as a predictor for cognitive development during adulthood and for interventions inducing broad learning.
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Feuer, Ralph, Chelsea M. Ruller, Naili An, Jenna M. Tabor-Godwin, Ross E. Rhoades, Sonia Maciejewski, Robb R. Pagarigan, et al. "Viral Persistence and Chronic Immunopathology in the Adult Central Nervous System following Coxsackievirus Infection during the Neonatal Period." Journal of Virology 83, no. 18 (July 1, 2009): 9356–69. http://dx.doi.org/10.1128/jvi.02382-07.

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ABSTRACT Coxsackieviruses are significant human pathogens, and the neonatal central nervous system (CNS) is a major target for infection. Despite the extreme susceptibility of newborn infants to coxsackievirus infection and viral tropism for the CNS, few studies have been aimed at determining the long-term consequences of infection on the developing CNS. We previously described a neonatal mouse model of coxsackievirus B3 (CVB3) infection and determined that proliferating stem cells in the CNS were preferentially targeted. Here, we describe later stages of infection, the ensuing inflammatory response, and subsequent lesions which remain in the adult CNS of surviving animals. High levels of type I interferons and chemokines (in particular MCP-5, IP10, and RANTES) were upregulated following infection and remained at high levels up to day 10 postinfection (p.i). Chronic inflammation and lesions were observed in the hippocampus and cortex of surviving mice for up to 9 months p.i. CVB3 RNA was detected in the CNS up to 3 months p.i at high abundance (∼106 genomes/mouse brain), and viral genomic material remained detectable in culture after two rounds of in vitro passage. These data suggest that CVB3 may persist in the CNS as a low-level, noncytolytic infection, causing ongoing inflammatory lesions. Thus, the effects of a relatively common infection during the neonatal period may be long lasting, and the prognosis for newborn infants recovering from acute infection should be reexplored.
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Cristhina de Medeiros Batista, Agda, Maria Gabriella Conceição Gabriel, Sabrina Xavier de Oliveira, Angelita Lúcia de Albuquerque Sousa, and Lúcia Maria Temóteo. "GÊNERO E SEXUALIDADE NA UNIVERSIDADE - UMA DISCUSSÃO POSSÍVEL?" Revista interdisciplinar em saúde 6, no. 5 (November 25, 2019): 3–18. http://dx.doi.org/10.35621/23587490.v6.n5.p3-18.

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Objetivo: Discutir a temática de gênero e sexualidade na universidade. Método: Trata-se de uma pesquisa de intervenção de abordagem qualitativa, realizada em uma Instituição de Ensino Superior localizada no interior da Paraíba. A amostra foi composta por vinte e dois discentes concluintes de um curso da área da saúde. Para realização da intervenção foram planejados três encontros, nos quais aplicaram-se questionários, rodas de conversa e apresentação de vídeos sobre a temática. Resultados: Como resultado, viu-se como o machismo ainda se faz presente no nosso contexto social, sendo perpetuado em discursos como “na questão de roupa curta, eu deixaria de usar em respeito ao meu namorado”. A partir de tais concepções, nota-se a necessidade de discussões e reflexões que envolvam a temática. Outro aspecto constatado com base nessa pesquisa refere-se às brincadeiras infantis, as quais alguns discentes achavam errada a ideia de meninos brincarem com objetos culturalmente direcionados a meninas, já que supostamente estes brinquedos os “tornariam” homossexuais. Verificou-se também o modo como as concepções patriarcais estão enraizadas no ambiente acadêmico, assim como no cotidiano em geral. Considerações finais: As falas dos participantes evidenciam a necessidade de discutir a temática do gênero e da sexualidade na universidade, visto que, apesar desse assunto ter certa visibilidade atualmente, os indivíduos ainda confundem muito as novas denominações de gênero, bem como a temática no geral. Desse modo, é necessário que essas discussões façam parte do meio acadêmico como forma de desconstruir o pensamento que, na maioria das vezes, é repassado de maneira distorcida. Palavras chave: Gênero; Sexualidade; Ensino Superior; Machismo.
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STOTHARD, J. RUSSELL, JOSÉ C. SOUSA-FIGUEIREDO, MARTHA BETSON, HELEN K. GREEN, EDMUND Y. W. SETO, AMADOU GARBA, MOUSSA SACKO, et al. "Closing the praziquantel treatment gap: new steps in epidemiological monitoring and control of schistosomiasis in African infants and preschool-aged children." Parasitology 138, no. 12 (August 24, 2011): 1593–606. http://dx.doi.org/10.1017/s0031182011001235.

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SUMMARYWhere very young children come into contact with water containing schistosome cercariae, infections occur and schistosomiasis can be found. In high transmission environments, where mothers daily bathe their children with environmentally drawn water, many infants and preschool-aged children have schistosomiasis. This ‘new’ burden, inclusive of co-infections with Schistosoma haematobium and Schistosoma mansoni, is being formally explored as infected children are not presently targeted to receive praziquantel (PZQ) within current preventive chemotherapy campaigns. Thus an important PZQ treatment gap exists whereby infected children might wait up to 4–5 years before receiving first treatment in school. International treatment guidelines, set within national treatment platforms, are presently being modified to provide earlier access to medication(s). Although detailed pharmacokinetic studies are needed, to facilitate pragmatic dosing in the field, an extended ‘dose pole’ has been devised and epidemiological monitoring has shown that administration of PZQ (40 mg/kg), in either crushed tablet or liquid suspension, is both safe and effective in this younger age-class; drug efficacy, however, against S. mansoni appears to diminish after repeated rounds of treatment. Thus use of PZQ should be combined with appropriate health education/water hygiene improvements for both child and mother to bring forth a more enduring solution.
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Francino Barrera, Giovanni Francisco, Sergio Rodrigo Jiménez Torres, Camila Constanza de Jesús Coloma Díaz, Diana Carolina Delgado Vásquez, and Daniela Francisca Verdugo Millar. "Efectos de un programa de ejercicios de control postural en el equilibrio corporal y precisión de lanzamiento en tiro con arco en categoría infantil y cadetes (Effects of a postural control exercise program on body balance and accuracy of throwing in arch." Retos, no. 37 (October 4, 2019): 291–96. http://dx.doi.org/10.47197/retos.v37i37.70956.

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El objetivo de este estudio fue el determinar los efectos de un programa de ejercicios de control postural sobre el equilibrio estático y la precisión de lanzamiento del tiro con arco en atletas de la serie infantil (12-14 años) y cadetes (15-17 años). Participaron 12 deportistas para cada serie. Se realizó la prueba de medición de equilibrio a través del Standing Stork Test (ojos abiertos/cerrados) y de la prueba asertividad en la precisión de lanzamiento (6 rondas) en el blanco previo y posterior a la intervención de ejercicios. Ésta última consistió en un programa de entrenamiento de equilibrio bi/unipodal durante 8 semanas. Los resultados mostraron un aumento significativo del equilibrio unipodal con ojos abiertos del grupo infantil en ambas piernas; pero sin cambios en la modalidad de ojos cerrados. La serie cadetes arrojó una diferencia significativa en la prueba de equilibrio unipodal con ojos abiertos sólo en la pierna dominante (derecha); sin cambios en la pierna izquierda, como tampoco diferencias en la modalidad ojos cerrados. La prueba de asertividad del tiro con arco sólo mejoró en el grupo infantil, pero no en la serie cadetes post intervención. Es posible que el entrenamiento de equilibrio postural estático haya optimizado patrones de control postural y visomotores en edades tempranas (bajo los 15 años) en comparación al grupo de cadetes, para así mejorar la precisión del tiro. Se recomienda el potenciar estos ejercicios en edades tempranas para fomentar las destrezas propias del deporte de tiro con arco.Abstract: The objective of this study was to determine the effects of a postural control exercise program on static balance and accuracy of archery throwing in infant (12-14 years old) and cadet (15-17 years old) categories. A total of 12 athletes per each category took part in the study. As measurement tests, we used the Standing Stork Test (open / closed eyes) for balance and the assertiveness in target launch precision test (6 rounds) before and after the exercise intervention. This consisted of a bi / unipedal balance training program lasting 8 weeks. The results showed a significant increase in unipedal equilibrium with open eyes in the infant group and for both legs; however, no changes were detected in the closed-eye modality. The cadet category showed significant differences in the unipedal equilibrium test with open eyes only for the dominant leg (right); no changes were found for the left leg, nor in the closed-eye modality. The assertiveness test of the archery only improved in the infant group, whereas in cadets it did not change at post-test. It is possible that static postural balance training optimized patterns of postural and visuomotor control at early ages (under 15 years old) compared to the group of cadets, and therefore the throwing accuracy was enhanced. It is recommended to endorse these exercises at early ages so to empower the skills needed in the sport of archery.
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Baqays, Abdulsalam, Marghalara Rashid, Wendy Johannsen, Hadi Seikaly, and Hamdy El-Hakim. "What are parents’ perceptions related to barriers in diagnosing swallowing dysfunction in children? A grounded theory approach." BMJ Open 11, no. 3 (March 2021): e041591. http://dx.doi.org/10.1136/bmjopen-2020-041591.

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ObjectivesSwallowing dysfunction (SwD) is under-reported in otherwise healthy infants and toddlers (OHITs). The identification of parental perceptions of factors that may hinder the diagnosis could help clinicians manage these children in a more expeditious manner. This study investigated the barriers to diagnosing SwD, as reported by the families.DesignGrounded theory study.SettingThis study was performed in a tertiary care paediatric centre in Canada.ParticipantsParents of OHITs were recruited using purposeful sampling.InterventionWe used detailed, semistructured, in-person interviews and the audiotapes and transcriptions were thematically analysed. From the parental insights, we built a framework composed of three themes of barriers.ResultTen parents of OHITs with SwD were interviewed. The children presented with recurrent coughing, choking, cold-like symptoms, recurring/consistent illnesses and feeding difficulties. They were managed with multiple rounds of antibiotics and diagnosed with allergies, asthma or recurrent viral infections before considering SwD. The three emerging themes are false beliefs about SwD among parents and some physicians, parent-related barriers and physician-related barriers. These barriers had severely impacted the parents, impairing work productivity and leading to work-related reprimands and changes in the family dynamics.ConclusionThis study suggests that there are several barriers that face the parents of OHITs when seeking a diagnosis of SwD and initiating appropriate management. These barriers likely interact with one another and amplify their effects on the family and the child. A common denominator is a lack of education regarding SwD, its clinical manifestations and the available expertise to manage this condition.
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Williams, John V., Zhifeng Chen, Gabriella Cseke, David W. Wright, Christopher J. Keefer, Sharon J. Tollefson, Ann Hessell, et al. "A Recombinant Human Monoclonal Antibody to Human Metapneumovirus Fusion Protein That Neutralizes Virus In Vitro and Is Effective Therapeutically In Vivo." Journal of Virology 81, no. 15 (May 23, 2007): 8315–24. http://dx.doi.org/10.1128/jvi.00106-07.

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ABSTRACT Human metapneumovirus (hMPV) is a recently discovered paramyxovirus that is a major cause of lower-respiratory-tract disease. hMPV is associated with more severe disease in infants and persons with underlying medical conditions. Animal studies have shown that the hMPV fusion (F) protein alone is capable of inducing protective immunity. Here, we report the use of phage display technology to generate a fully human monoclonal antibody fragment (Fab) with biological activity against hMPV. Phage antibody libraries prepared from human donor tissues were selected against recombinant hMPV F protein with multiple rounds of panning. Recombinant Fabs then were expressed in bacteria, and supernatants were screened by enzyme-linked immunosorbent assay and immunofluorescent assays. A number of Fabs that bound to hMPV F were isolated, and several of these exhibited neutralizing activity in vitro. Fab DS7 neutralized the parent strain of hMPV with a 60% plaque reduction activity of 1.1 μg/ml and bound to hMPV F with an affinity of 9.8 ×10−10 M, as measured by surface plasmon resonance. To test the in vivo activity of Fab DS7, groups of cotton rats were infected with hMPV and given Fab intranasally 3 days after infection. Nasal turbinates and lungs were harvested on day 4 postinfection and virus titers determined. Animals treated with Fab DS7 exhibited a >1,500-fold reduction in viral titer in the lungs, with a modest 4-fold reduction in the nasal tissues. There was a dose-response relationship between the dose of DS7 and virus titer. Human Fab DS7 may have prophylactic or therapeutic potential against severe hMPV infection.
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Wilhelm, Jess, Tanmay Mahapatra, Aritra Das, Sunil Sonthalia, Sridhar Srikantiah, Christine Galavotti, Hemant Shah, and Andreea A. Creanga. "From direct engagement to technical support: a programmatic evolution to improve large community health worker programs in Bihar, India." BMJ Global Health 6, no. 4 (April 2021): e004389. http://dx.doi.org/10.1136/bmjgh-2020-004389.

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IntroductionIn 2011, through a multipartner Integrated Family Health Initiative (IFHI), CARE started supporting maternal and neonatal health (MNH) improvement goals in 8 of 38 districts in Bihar, India. The programme included a frontline health worker (FHW) component offering health advice through household visits and benefited from CARE’s direct engagement during IFHI, which then evolved into statewide Technical Support Unit (TSU) to the Government of Bihar in 2014.MethodsUsing eight rounds of state-representative household surveys with mothers of infants aged 0–2 months (N=73 093) linked with two facility assessments conducted during 2012–2017, we assessed changes in FHW visit coverage, intensity and quality between IFHI and TSU phases. Using logistic regression models, we ascertained associations between FHW outputs and three MNH core practices: ≥3 antenatal care check-ups (ANC3+), institutional delivery and early breastfeeding initiation.ResultsWomen’s receipt of 1+ FHW visits declined from 60.2% (IFHI phase) to 46.3% (TSU phase) in the eight IFHI districts, being below 40% statewide during the TSU phase. Despite a parallel decline in FHW visit quality measured as the number of health advice received, all three outcomes improved during the TSU versus IFHI phase in IFHI districts. We found significant positive associations between all three outcomes and receipt of 1+ FHW visits and programme phase (TSU vs IFHI) in the eight IFHI districts. During the TSU phase, receipt of 2+ FHW visits in the third trimester increased the odds of women receiving ANC3+ (adjusted OR (aOR)=1.21; 95% CI: 1.13 to 1.31), delivering in a facility (aOR=1.64; 95% CI: 1.51 to 1.77) and initiating breast feeding early (aOR=1.18; 95% CI: 1.05 to 1.18). Independent of the number and timing of FHW visits, we also found positive associations between women reporting higher than lower quality of FHW interactions and receiving outcome-specific advice and all three MNH outcomes.ConclusionImplementation of large community-based interventions under the technical support model should be continuously and strategically evaluated and adapted.
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Whitehead, Stephen S., Cai-Yen Firestone, Ruth A. Karron, James E. Crowe, William R. Elkins, Peter L. Collins, and Brian R. Murphy. "Addition of a Missense Mutation Present in the L Gene of Respiratory Syncytial Virus (RSV) cpts530/1030 to RSV Vaccine Candidate cpts248/404 Increases Its Attenuation and Temperature Sensitivity." Journal of Virology 73, no. 2 (February 1, 1999): 871–77. http://dx.doi.org/10.1128/jvi.73.2.871-877.1999.

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ABSTRACT Respiratory syncytial virus (RSV) cpts530/1030 is an attenuated, temperature-sensitive subgroup A vaccine candidate derived previously from cold-passaged RSV (cpRSV) by two sequential rounds of chemical mutagenesis and biological selection. Here,cpts530/1030 was shown to be highly attenuated in the upper and lower respiratory tracts of seronegative chimpanzees. However, evaluation in seropositive children showed that it retains sufficient replicative capacity and virulence to preclude its direct use as a live attenuated vaccine. Nucleotide sequence analysis of the genome of cpts530/1030 showed that it had acquired two nucleotide substitutions (compared to its cpts530 parent), both of which were in the L gene: a silent mutation at nucleotide position 8821 (amino acid 108) and a missense mutation at nucleotide position 12458 resulting in a tyrosine-to-asparagine change at amino acid 1321, herein referred to as the 1030 mutation. It also contained the previously identified 530 missense mutation at nucleotide 10060 in the L gene. The genetic basis of attenuation ofcpts530/1030 was defined by the introduction of the 530 and 1030 mutations into a cDNA clone of cpRSV, from which recombinant RSV was derived and analyzed to determine the contribution of each mutation to the temperature sensitivity (ts) and attenuation (att) phenotypes of cpts530/1030. The 530 mutation, derived from cpts530, was previously shown to be responsible for the ts and attphenotypes of that virus. In the present study, the 1030 mutation was shown to be responsible for the increased temperature sensitivity ofcpts530/1030. In addition, the 1030 mutation was shown to be responsible for the increased level of attenuation ofcpts530/1030 in the upper and lower respiratory tracts of mice. The 530 and 1030 mutations were additive in their effects on thets and att phenotypes. It was possible to introduce the 1030 mutation, but not the 530 mutation, into an attenuated vaccine candidate with residual reactogenicity in very young infants, namely, cpts248/404, by use of reverse genetics. The inability to introduce the 530 mutation into thecpts248/404 virus was shown to be due to its incompatibility with the 248 missense mutation at the level of L protein function. The resulting rA2cp248/404/1030 mutant virus was more temperature sensitive and more attenuated than thecpts248/404 parent virus, making it a promising new RSV vaccine candidate created by use of reverse genetics to improve upon an existing vaccine virus.
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MOREIRA DA SILVA, MARIANA. "O USO DA ETNOGRAFIA ANTROPOLÓGICA NA EDUCAÇÃO INFANTIL MARIANA MOREIRA DA SILVA Graduação em Pedagogia pelo Centro Universitário Assunção (2009); Especialista em Psicomotricidade pela Faculdade FMU (2016); Professora de Educação Infantil e Ensino Fundamental I - na EMEF Assad Abdala. RESUMO A pesquisa realizada demonstra a importância de trabalhar a etnografia antropológica na educação infantil. Com ênfase no uso da etnografia pude observar uma prática pedagógica consciente e reflexiva, despida de preconceitos, em que educadores tiveram a necessidade de conhecer mais sobre os seus educandos, tiveram a necessidade de buscar um outro olhar sobre eles para aprimorar sua prática, onde aprendiam à medida que ensinavam e se ensinavam à medida que refletiam sobre a prática e sobre si. A unidade de ensino analisada propõe a reflexão da prática docente por meio visitas domiciliares aos educandos e do diário de campo, com intuito de ter uma educação inclusiva, humanista, crítica e reflexiva. Palavras-chave: Etnografia; Antropologia; Educação. INTRODUÇÃO A pesquisa realizada tem como proposta enfatizar a importância de trabalhar a etnografia antropológica na educação infantil, dentro dos CEI´s conveniados com a prefeitura de São Paulo, na cidade de São Paulo- SP. A pesquisa demonstrará como o uso da etnografia antropológica pode contribuir para a ação pedagógica consciente e reflexiva. Para acompanhar a mudança da prática docente por meio da etnografia antropológica foram realizadas: entrevistas com a direção e coordenação pedagógica. A etnografia antropológica é realizada por visitas domiciliares aos educandos e escritos da prática docente no diário de campo. USO DA ETNOGRAFIA ANTROPOLÓGICA NA EDUCAÇÃO INFANTIL Um dos principais focos da educação, seja ela infantil, juvenil ou para adultos é fomentar o ensino- aprendizagem de modo crítico, reflexivo e consciente. Dentre as mais diversas aprendizagens encontra-se a cultura. Segundo Severino (2002), a cultura, além de ser uma intervenção do homem sobre a natureza, é um fator social. Social quando se estabelece entre gerações, ao inserir as mais novas na cultura das gerações mais velhas. Social por inserir essa geração no mercado de trabalho e social por se estabelecer uma prática social, ao utilizar a educação como mediadora de cultura. Quando a educação media a cultura, media por vezes dentro de uma instituição de ensino e aí entra o papel da etnografia antropológica na educação infantil. Segundo Dauster (1997) a antropologia busca entender a cultura e a vida social, uma ciência social baseada na observação do outro, de modo a buscar o real sentido das relações entre as pessoas. Essa observação do outro, vem unida de descrições, um trabalho de campo também nomeado de etnografia, que contribui para a experiência pessoal. Quando a antropologia se refere a cultura, amplia o seu olhar para diferentes culturas, com o intuito de valorizar os diversos aspectos e relações, a fim de destruir os estereótipos muitas vezes construídos pelo simples fato de ser diferente. Embora a educação aconteça principalmente dentre contextos escolares, as aprendizagens acontecem mesmo antes dos discentes entrarem para a escola. Todos esses conhecimentos adquiridos contribuem para a formação da personalidade cultural, fator muito estudado pela psicanálise. Nesse contexto de múltiplas aprendizagens adquiridas para a formação do sujeito atua a educação crítica e reflexiva, pois atua não apenas na construção de conhecimentos, pensasse em quem é esse educando e quem ele virá a ser. Humanizando assim a educação e todos envolvidos nela. A formação do sujeito, a sua personalidade cultural formasse à medida que ele aprende sobre o mundo. Quanto mais o sujeito aprende sobre o mundo, mais ele aprende sobre si e assim se constitui como pessoa. Para compreender quem é esse educando foram traçadas algumas medidas afim de melhorar a prática docente no CEI, despindo-a de preconceitos. Para entender melhor esse conhecer, entrevistei a Diretora Rosangela Santos Barbosa e perguntei: - “porque as professoras faziam anualmente visitas as casas dos seus educandos ?” Rosangela relatou que certa vez ouviu algumas críticas de uma das educadoras. A educadora reclamava da higiene pessoal e de vestuário que acarretavam mau cheiro em um dos seus educandos. A mesma queria marcar uma reunião com o pai da criança para relatar suas observações e cobrar mudanças na higiene. Foi então que a Rosangela sugeriu que a professora marcasse uma visita domiciliar ao seu educando, para o conhecer melhor e a partir de então poder conversar com o pai. A educadora voltou da visita muito sensibilizada e com um outro olhar sobre o pai e a criança. O menino fora abandonado pela mãe com apenas dez dias, segundo o pai ela mergulhou no mundo das drogas e ele passou a cuidar sozinho do filho. Conseguiu um emprego em que pudesse levá-lo e buscá-lo do CEI. Infelizmente não tinha muitas condições financeiras e moravam em um barraco de madeira de apenas um cômodo. O pai lavava e secava a roupa no cômodo, pois não tinha área externa. Assim nem a pele da criança e nem a roupa pegavam sol, por isso tinham o cheiro úmido. Contudo, o pai era extremamente dedicado e afetuoso com o seu filho. Foi a partir de então que a Rosangela resolveu expandir essa mudança de olhar e implementou as visitas domiciliares como parte do Projeto Político Pedagógico do CEI. Ela disse que as visitas mudaram a prática docente, pois as educadoras despiam-se dos preconceitos quando conheciam a vida de seus educandos. Elas passavam a não impor a sua cultura, e a aceitar os educandos do modo como eles eram. As visitas domiciliares não só mudavam o olhar das educadoras, mudava o olhar de toda a comunidade escolar. As famílias respeitavam mais o trabalho realizado no CEI, criavam parceria entre a escola e a família, pois diziam-se vistas de fato. O CEI passou a ser mais respeitado e não sofria mais com o vandalismo. Dewey fala muito desse processo cultural, o descreve como contínuo e interno. Onde a identidade cultural é pluricultural, configurada a partir das influências de suas emigrações. E onde houver dois ou mais envolvidos no processo de ensino- aprendizagem, essa cultura se tornará intercultural. Pois, sempre se estabelecerá uma troca, embora sejam diferentes haverá uma comunicação. A comunicação e troca faz com que as relações e os aprendizados se tornem significativos ao valorizar o educando e sua experiência. A etnografia antropológica permite olhar o educando com outros, atendo-se a heterogeneidade e diversidade sociocultural que o torna singular. Olhar a singularidade de cada um e assim poder realizar um trabalho que seja rico para todos, assim trabalha a antropologia na educação, ela busca entender as diferenças e as especificidades de conhecimento e cultura socialmente construídos, a construção de um saber de fronteira. A antropologia estuda o humano com todas as suas especificidades e singularidades e seu modo de socialização. Mas, como entender o humano com suas especificidades e singularidades? Faz- se necessário uma reflexão filosófica, compreender para então explicar, ou seja, uma metodologia de pesquisa. A compreensão e reflexão são fatores inerentes a análise, uma analogia as reflexões antropológicas e pedagógicas. A antropologia como metodologia de pesquisa é empírica e por isso, muito importante no campus de resultados do processo pedagógico. É necessário fundamentar a pesquisa. Pensar a ação, essa síntese dialética entre a antropologia empírica e a reflexão filosófica fundem o ambiente e a história de vida dos envolvidos no processo de ensino-aprendizagem, estabelecida por vezes em um currículo oculto. E sobre o pensar da ação docente perguntei a coordenadora pedagógica Joice Damaceno sobre o diário de campo. O diário de campo é um caderno onde as educadoras fazem o registro de uma atividade do seu dia a dia, diariamente. Esse registro pode ser uma atividade, pode ser um momento espontâneo de ações das crianças, que pode levar a reflexões sobre a prática docente. De acordo com Vieira (1999) o diário é objeto de investigação do fenômeno educativo. Propicia a tomada de consciência por meio da reflexão de quem se é, em constante mudança da prática pedagógica. Uma reflexão que leva a consciência da ação. O que você poderia me dizer sobre o diário de campo? Como você vê a mudança da prática docente a partir dos registros das atividades? Joice Damaceno: O registro escrito permite a prática de pensar e escrever sobre o que se fez.... Não só nos faz seres pensantes como nos dá oportunidade de sair do automático, de se distanciar do ato e pensar sobre ele. Isso gera mudança , melhoras, readaptações. Paulo Freire (1981) também se refere ao ato de pensar, de refletir, de se transformar e se formar por meio da pesquisa. Pois, a pesquisa permite com que se ensine e se aprenda sobre o que se ensinou. E quando o resultado da pesquisa ou da reflexão é colocado em prática, não apenas se ensina ou se aprende, se pesquisa ou se reflete novamente. A educação é um movimento permanente e dinâmico. A educação é- como tudo o mais que é humano e é criação de seres humanos- uma dimensão, uma esfera Inter direcionada e interligada a outras, um elo, uma trama (no bom sentido da palavra) na teia de símbolos e saberes, de sentidos e significados, como também de códigos, de instituições que configuram uma cultura, uma pluralidade interconectada (não raro, entre acordos e conflitos) de culturas e entre culturas, situadas em uma ou entre várias sociedades. (GUSMÃO, 2009, p.12) CONSIDERAÇÕES FINAIS Por isso, o fazer antropológico é capaz de transformar e ser transformado, é uma crítica constante da ação, um desafio. Ensinar aprendendo e aprender ensinando. Compreender que a escola não é o único meio de se ter conhecimento e cultura na formação e constituição do indivíduo e sua subjetividade. Compreender que a educação ultrapassa a fronteira dos muros escolares. Compreender que esse educando não é apenas aluno, compreender que ele é sujeito que se constitui por sua singularidade e isso só é possível, pois este está inserido em um contexto plural, regado de historicidade pessoal e social. Esse educando torna-se indivíduo quando adquire o domínio de si, quando se diferencia dos outros. Mesmo integrado socialmente é singular, é único e quão difícil é olhar o subjetivo de cada um. Quão rico é despertar esse olhar, desse outro olhar, que não é superficial, que não vê apenas estereótipos, que consegue ir além e consegue olhar como um todo envolvido por todas as suas partes. Poder se familiarizar com o outro, aceitar a cultura dele sem impor a sua relativizando o processo de socialização, tornando ambos mais humanos de modo a incluir um conhecimento sem que seja necessário excluir outro ou adaptar, ou seja, promover de fato a interação social. REFERÊNCIAS GOMES, Roberto. Crítica da razão Tupiniquim. 3ª ed.- São Paulo: Editora Cortez, 1983. SEVERINO, Antonio Joaquim. Educação, sujeito e história. São Paulo: Olha d´ Água, 2002. BRANDÃO, Carlos Rodrigues. Entre Paulo e Boaventura. Algumas aproximações entre o saber e a pesquisa, 2003. Disponível em:< http://www.googleacademico.com.br/2003/publicação-de-artigos-cientificos.htm/ DAUSTER, Tania. Antropologia e Educação- Um saber de fronteira. 26ª Reunião anual da Anped: mesa redonda as ciências sociais e a pesquisa. Poços de Caldas, out. 2003. Disponível em:< http://www.googleacademico.com.br/2007/publicação-de-artigos-científicos.htm/ DAUSTER, Tania. Um outro olhar: entre a antropologia e a educação. Caderno CEDES vol. 18 n. 43 Campinas, 1997. Disponível em:< http://www.scielo.br/1997/dx.doi.org/10.1590/50101-32621997000200004publcação-de-artigos-científicos.htm/ GUSMÃO, Neusa Maria Mendes. Por uma antropologia da educação no Brasil. Coleção Temas & Educação, 2010. Disponível em:." Revista Territórios 03, no. 02 (February 26, 2021): 209–14. http://dx.doi.org/10.53782/77.

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A pesquisa realizada demonstra a importância de trabalhar a etnografia antropológica na educação infantil. Com ênfase no uso da etnografia pude observar uma prática pedagógica consciente e reflexiva, despida de preconceitos, em que educadores tiveram a necessidade de conhecer mais sobre os seus educandos, tiveram a necessidade de buscar um outro olhar sobre eles para aprimorar sua prática, onde aprendiam à medida que ensinavam e se ensinavam à medida que refletiam sobre a prática e sobre si. A unidade de ensino analisada propõe a reflexão da prática docente por meio visitas domiciliares aos educandos e do diário de campo, com intuito de ter uma educação inclusiva, humanista, crítica e reflexiva.
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Agarwal, Archana M., N. Scott Reading, Kimberly Frizzell, Wei Shen, Shelly Sorrells, Mohamed E. Salama, Josef T. Prchal, Hassan M. Yaish, Jay L. Patel, and Robert D. Christensen. "Using a Next Generation Sequencing Panel to Discover the Obscure Causes of Hereditary Hemolytic Anemias." Blood 128, no. 22 (December 2, 2016): 2433. http://dx.doi.org/10.1182/blood.v128.22.2433.2433.

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Abstract Hereditary hemolytic anemias are a heterogeneous group of disorders with consequences ranging from non-anemic hemolysis to severe life-threatening anemia. However, the late morbidity in patients without transfusions is often underappreciated because of erythropoietic compensatory stimulation inducing hematopoiesis by erythroferrone/hepcidin axis. Principal causes of hereditary hemolytic anemias are germline mutations of red cell cytoskeleton (e.g. hereditary spherocytosis and elliptocytosis/pyropoikilocytosis) or enzyme deficiencies (e.g. Glucose 6 phosphate dehydrogenase deficiency and pyruvate kinase deficiency). Routine morphological and biochemical analysis may be inconclusive and misleading particularly in transfusion-dependent infants and children. Molecular studies have not been extensively used to diagnose these disorders due to the complex genetic nature of these disorders, and multi-gene disorders. In these cases, patients may undergo multiple rounds of single gene testing, which can be very costly and time consuming. The advent of next generation sequencing (NGS) methods in the clinical laboratory has made diagnosing complex genetic disorders feasible. Our diagnostic panel includes 28 genes encoding cytoskeletal proteins and enzymes, and covers the complete coding region, splice site junctions, and, where appropriate, deep intronic or regulatory regions. Targeted gene capture and library construction for next-generation sequencing (NGS) was performed using Sure Select kit (Agilent Technologies, Santa Clara, USA). Prior to sequencing on the Illumina Next Seq, (Illumina Inc) instrument, indexed samples are quantified using qPCR and then pooled. Samples were sequenced using 2x150 paired end sequencing. We now report the first 68 patients evaluated using our NGS panel. The age of the patients ranged from newborn to 62 years. These patients presented with symptoms ranging from mild lifelong anemia to severe hemolytic anemia with extreme hyperbilirubinemia. Genetic variants were classified using the American College of Medical Genetics (ACMG) guidelines. We identified pathogenic variants in 11 patients and likely pathogenic variants in 12 others, the majority of these were novel. Many variants with unknown significance were also identified that could potentially contribute to disease. The most commonly mutated genes were SPTB and SPTA1, encoding spectrin subunits. Some complex interactions were uncovered i.e. SPTA1 mutations along with alpha LELY leading to hereditary pyropoikilocytosis; Spectrin variants along with Gilbert syndrome causing severe hyperbilirubinemia in neonates; and Spectrin variants in combination with PKLR and G6PD variants. Our results demonstrate that many patients with hemolytic anemia harbor complex combinations of known and novel mutations in RBC cytoskeleton/enzyme genes, but their clinical significance is further augmented by polymorphisms of UGT1A1 gene contributing to severe neonatal hyperbilirubinemia and its consequences. To conclude, next-generation sequencing provides a cost-effective and relatively rapid approach to molecular diagnosis, especially in instances where traditional testing failed. We have used this technology successfully to determine the molecular causes of hemolytic anemia in many cases with no prior family history. Disclosures Yaish: Octapharma: Other: Study investigator.
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Mondragón, Izveidy, Eduardo Arias, Alfonso Huante, and Luisa Díaz. "#58: Identification of the most frequent mistakes in the prescription of antibiotics using the “Time-out” strategy, in a pediatric hospital in Mexico City." Journal of the Pediatric Infectious Diseases Society 10, Supplement_2 (June 1, 2021): S21. http://dx.doi.org/10.1093/jpids/piab031.052.

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Abstract Background In 2019, the CDC estimated that each year more 2.8 million antibiotic resistant infections ocurr in the United States and more than 35,000 pepole die a a result.Usually in pediatrics, antibiotics are the most prescribed, reviews have demonstrated that 37 to 61% of hospitalized infants and children receive antibiotics and 20 to 50% of these prescriptions are unnecessary either the dosage or duration are incorrect. Antibiotic resistance is an increasing worldwide problem. Effective antimicrobial stewardship programs has been demostrated reduce the inappropriate use and optimizing antimicrobial selection, dosing, route, and duration of terapy, limiting the consequences such adverse drug, resistance and cost.4 The antibiotic time-out consists in reassessment of the continuing need and choise of aantibiotics when the clinical picture is clearer and we have more diagnostic information. Currently, in our institution there is no established stewardship program and the costs attributable to antimicrobial use have been estimated at 1.6 million dollars. The goal of this project was to identify the most common prescription mistakes using the “Time-out” strategy because of its structured applicability and simplified revision that guides antimicrobial use. Methods From May to October 2020, we carried out a time out evaluation for different antimicrobial prescriptions in the five main wards of the INP; it consisted of data collection through a mobile application where the prescriptions were documented and evaluated. We answered three questions: 1) Based on the patient′s clinical course and diagnostic test, is the use of these antibiotics justified? 2)Is the dose, interval and route of administration correct? 3) What is the estimated duration of treatment? An infectious disease specialist evaluated the antimicrobial prescriptions daily and, if necessary, modified or adjusted it during rounds. Our evaluation was carried out between 24 and 72 hours of treatment initiation. Results For a 6 month period, 196 antimicrobial prescriptions were evaluated through the time-out strategy. Of them, 48% were from de group of cephalosporins followed by the glycopeptides (16%) and carbapenems (14.3%). In 23% of cases they were not medically justified and 53% of them required either discontinuation, narrowing of broadening of spectrum. The prevalence of antibiotic prescription errors was 23%. In 30% of cases it was a dose per kg of body weight error, 61% total dose per day and 9% in duration of treatment. Of note, there were 26% of these prescriptions were instances where the antimicrobials were not prescribed by a pediatric infectious disease specialist where 67% was not found to be justified upon evaluation and 72% required discontinuation. Conclusions The implementation of an antimicrobial control program made it possible to identify the most common mistakes in antibiotic prescription in our hospital, confirming the relevance of these programs to reduce the inappropriate use of antimicrobial prescriptions, limiting the consequences such adverse effects drug, antimicrobial resistance and healthcare cost.
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Liu, Zhi-Jian, Ioana Nitulescu, Henry Pelish, Matthew Shair, and Martha Sola-Visner. "Mediator Kinase Inhibition Triggers a Phenotypic Switch from Neonatal to Adult-like Megakaryopoiesis." Blood 126, no. 23 (December 3, 2015): 1171. http://dx.doi.org/10.1182/blood.v126.23.1171.1171.

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Abstract Several recent studies have demonstrated substantial biological differences between cord blood (CB)- and adult peripheral blood (PB)-derived megakaryocytes (MKs). Specifically, neonatal (CB) progenitors proliferate at a much higher rate than adult (PB) progenitors, and generate 10-fold more MKs per progenitor when cultured with thrombopoietin (Tpo). The highly proliferative neonatal MKs undergo cytoplasmic maturation without polyploidization, which ultimately generates large numbers of small, low ploidy, but fully mature MKs. Adult MKs, in contrast, undergo successive rounds of endomitosis to reach much higher ploidy levels, and maturation is coupled with polyploidization, so that MKs with the highest ploidy levels are also the most mature. The molecular mechanisms underlying these developmental differences are just beginning to be elucidated. Here, we investigated the effects of cortistatin A (CA), a highly specific small molecule inhibitor of cyclin-dependent kinase 8 (CDK8) and its paralog CDK19, on megakaryopoiesis. CDK8 and CDK19, together with CCNC (Cyclin C), MED12/MED12L and MED13/MED13L, form "CDK modules" which can associate with Mediator, a 26-subunit complex that acts as a bridge between transcription factors and the transcriptional machinery to coordinate gene expression. The Mediator complex has been implicated in developmental disorders and cancer. CB-derived MK progenitors treated with CA from day 7 to day 14 of culture exhibited a dose-dependent reduction in proliferation (6.2±1.7 vs. 24.9±2.2 fold expansion in treated vs. control cultures; p=0.003), accompanied by an increase in ploidy levels to those comparable to adult PB-derived MKs (34±6% vs. 8.9±0.9% MKs with ploidy ≥8N in treated vs. control cultures; p=0.014). MK maturation, evaluated by CD42b surface expression level, also increased with advancing ploidy in CA-treated MKs, in a manner similar to that observed in adult MKs, and CA-treated mature MKs were capable of pro-platelet formation in vitro. These changes were not observed when undifferentiated CB-derived CD34+ or CD41-negative cells were treated, indicating that the effect was specific to committed MK progenitors. CA treatment induced the expected decrease in STAT-1 phosphorylation at Serine 727, a specific site of CDK8-mediated phosphorylation, confirming effective CDK8 inhibition in treated MKs. Next, we used microarray to evaluate the gene expression profile of CB-derived MKs following CA treatment for 4 and 8 hours vs. untreated cells. These studies revealed significant CA-induced changes in the MK gene expression profile. By Gene Set Enrichment Analysis (GSEA), CA treatment significantly upregulated genes that were downregulated in CB- vs. PB-derived MKs. Furthermore, genes upregulated by CA in CB-derived MKs were also upregulated in the megakaryoblastic cell line SET2 (Pelish, Liau et al., Nature, in press), suggesting that the gene expression program affected in SET2 cells is likely the same one affected in neonatal MKs. At the protein level, we observed time- and dose-dependent increases in RUNX-1 in CA-treated vs. control MKs. In summary, this study demonstrated that treatment with CA induced a phenotypic switch from neonatal to adult-like megakaryopoiesis, accompanied by changes in the MK gene expression profile. These findings indicate a novel role for Mediator kinases in the regulation of megakaryopoiesis, and potentially on the developmental differences between neonatal and adult MKs. These studies open the door to a better understanding of and to potential novel therapies for a number of developmental stage-specific megakaryocyte and platelet disorders, which exclusively or more severely affect neonates and infants, including the thrombocytopenia/absent radius (TAR) syndrome and the transient myeloproliferative disorder associated with trisomy 21 and GATA1s mutations. Disclosures No relevant conflicts of interest to declare.
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42

Editores, Os. "Os Desafios do Tempo Presente." Laborare 4, no. 7 (September 7, 2021): 3–5. http://dx.doi.org/10.33637/2595-847x.2021-118.

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A edição da Revista Laborare que estamos apresentando reflete a gravidade do momento que se enfrenta. Um momento de crise acerca do que deve representar o Estado e de como devem agir suas instituições. O Direito do Trabalho está no centro dessa crise, pois regula a relação social fundante, aquela que permite ou impede a sobrevivência física. É por meio do trabalho remunerado que em uma sociedade como a nossa se obtém o dinheiro necessário para comprar comida, vestir e morar. Então, quem não tem trabalho não tem, no limite, condições de sobreviver. O reconhecimento dessa realidade, assim como a tensão causada pelos movimentos de trabalhadores e a própria necessidade do sistema de que haja consumo, exigiu ao longo dos anos a construção de teias de proteção social. O Direito do Trabalho revelou-se como o limite da exploração possível, como bem demonstra artigo publicado nessa edição. Nosso modelo de organização social funda-se na propriedade privada e na assimilação de tudo, inclusive pessoas (força de trabalho) e recursos naturais à condição de mercadoria a ser negociada. Sem a convicção de que somos proprietários da força de trabalho, talvez nos revoltássemos com o fato de que o acesso à comida, roupa, remédio ou casa só se dá, em regra, através do dinheiro que se obtém pela troca de trabalho por salário. Um salário que só existe se a propriedade privada (força de trabalho) for negociada no mercado. É justamente o Direito do Trabalho que revela, com mais nitidez, que o que aparece como exercício da liberdade de trabalhar é, na realidade, trabalho obrigatório, na medida em que constitui condição para a sobrevivência física. Eis porque é tão grave todo o movimento que há décadas busca esvaziar o conceito de vínculo de emprego e que nesta revista é enfrentado no artigo que trata da uberização do trabalho. O que hoje vivemos não é apenas a crise dessa compreensão histórica da necessidade de impor limites à troca entre capital e trabalho. É a imposição de uma nova ordem, na qual trabalho infantil, violência contra a mulher e outras questões, que pensávamos superadas, voltam a ser defendidas por pessoas que ocupam cargos públicos. Daí porque é tão importante a discussão travada nos artigos sobre as repercussões da pandemia no contrato de aprendizagem e sobre o trabalho da mulher. Velhos temas tão insistemente presentes em um país que já atinge a trágica cifra de 14,8 milhões de desempregados. Segundo os dados do primeiro trimestre de 2021, divulgados pelo IBGE, já são 86,7 milhões trabalhadores informais. Pessoas que trocam trabalho por salário, mas não tem o vínculo reconhecido, não fruem férias, não podem adoecer, porque se não trabalham nada recebem, embora as contas do mês, com as quais garantem casa e comida, sigam chegando. As questões trazidas nos artigos aqui reunidos são, em verdade, feridas nunca tratadas de uma história de desrespeito aos direitos mais elementares de quem vive do trabalho. E ganham uma profundidade dolorida a partir do momento em que, diante da crise de 2008 e sem saber como lidar com a reação social de 2013, inicia-se um processo de fragilização do compromisso com a ordem constitucional de 1988, que tem como ponto de referência simbólica o golpe que retira do poder a primeira mulher eleita Presidenta da República. Romper com o respeito ao direito liberal de voto, retirando justamente uma mulher do cargo, sob um discurso que mira exclusivamente em um partido dos trabalhadores e, portanto, também no metalúrgico que antes ocupou a Presidência, é a caricatura do que somos: um país fundado sob a lógica patriarcal, autoritária e racista. Em uma tal sociedade, fazer valer direitos sociais é um grande desafio. Por isso, nesses pouco mais de trinta anos que nos separam da Constituição de 1988 nunca conseguimos, nem mesmo sob o governo de um partido dos trabalhadores, fazer valer efetivamente o direito de proteção contra a despedida, o direito à repartição adequada da renda e da terra, o direito ao emprego decente. As fórmulas precarizantes que hoje são identificadas a partir do neologismo da uberização sempre estiveram presentes. Não há dúvida, porém, que o desrespeito se aprofunda quando o discurso oficial se desconecta completamente do pacto firmado em 1988. Eis a profundidade da crise que hoje enfrentamos e que está bem representada pelas legislações que vêm sendo editadas durante a pandemia, cujo conteúdo precariza mais e mais, desfigura mais e mais o Direito do Trabalho, inclusive no que se refere à destruição das normas de segurança e saúde no trabalho. A tais legislações soma-se uma jurisprudência avessa à proteção social. A discussão que se trava no artigo que trata da uberização do trabalho nos auxilia a compreender o drama social que mal se esconde nessas opções políticas de desamparar cada vez mais o povo brasileiro. É certo que esse não é um movimento que se circunscreve à realidade brasileira, nem tampouco poderá ser enfrentado, sem que haja uma profunda reflexão e revisão inclusive do nosso ensino jurídico. Para auxiliar na indicação de caminhos possíveis para o tensionamento e a mudança que se impõe como urgente nesse quadro, temos também nessa edição um artigo que trata da importância de um estudo crítico do Direito do Trabalho, a partir de experiências de extensão universitária. Uma experiência de leitura que nos fará seguir firmes na esperança de superação dessa etapa sombria da nossa história recente. Outros desafios, talvez ainda mais trágicos, já foram enfrentados pela classe trabalhadora e por quem lida com o Direito do Trabalho no Brasil. A leitura e a reflexão sobre os temas jurídicos aqui reunidos é já, sem dúvida, um modo saudável de atuar politicamente, no sentido mais amplo e positivo que essa palavra pode alcançar. Boa leitura! Os editores
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43

Oliveira, Marta Regina Furlan de, Larissa Delgado Bueno da Silva, and Jaqueline Delgado Paschoal. "Os lugares da infância nos editoriais de moda: uma análise sobre a adultização da criança na sociedade do consumo." Revista on line de Política e Gestão Educacional, November 30, 2020, 1856–72. http://dx.doi.org/10.22633/rpge.v24iesp3.14361.

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Este estudo teve o propósito de analisar criticamente as concepções de criança nos editoriais da moda, bem como avaliar se estes podem contribuir para o desenvolvimento precoce da “adultização” do consumidor infantil. Acredita-se que os discursos dos editoriais de moda infantil ditam padrões de beleza e de comportamentos semelhantes ao mundo adulto, principalmente em relação às roupas, acessórios, padrões estéticos e aos meios de consumo. Além disso, a Indústria da propaganda nem sempre considera as particularidades infantis ao vender seus produtos, contribuindo assim, para o processo de adultização das crianças. A metodologia utilizada foi a pesquisa bibliográfica e pesquisa documental à luz dos fundamentos da Teoria Crítica e de autores que dialogam com essa perspectiva teórica. Os resultados da pesquisa indicam que as grandes marcas, em especial aquelas direcionados ao público infantil, induzem as crianças a ambientes e situações de domínio adulto, bem como aos meios de consumo. Por isso, a importância da família e da escola como espaços de reflexão e combate frente à indústria cultural.
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44

Schmidt Visentini, Íngrid. "Construindo o Gênero na Escola: Ações Visíveis e Invisíveis." RELACult - Revista Latino-Americana de Estudos em Cultura e Sociedade 5, no. 4 (May 5, 2019). http://dx.doi.org/10.23899/relacult.v5i4.1268.

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O presente estudo busca analisar os papéis de gênero no ambiente escolar, observando a construção de gênero em uma dicotomia entre feminino e masculino e de que forma isso se dá a partir das ações das crianças e do professor/professora com a respectiva influência ou não de fatores tanto internos quanto externos ao ambiente escolar. Observa-se que meninos e meninas são dissociados conforme seus gêneros. As crianças apreendem e reproduzem que há uma separação entre os gêneros feminino e masculino e esse aprendizado é construído a partir de questões aparentemente simples, tais como: o banheiro o qual devem frequentar, as roupas as quais devem usar, as cores designadas como adequadas e os tipos de brinquedos que devem brincar. Na educação infantil, essa distinção também está presente e acontece desde o formar a fila dos meninos e a fila das meninas. Além dessas ações visíveis bem direcionadas, as próprias crianças, em momentos nos quais não há a imposição de papéis de gênero, tendem a reproduzir a dicotomia do masculino e do feminino como quem adota e adere ao papel social que lhe é atribuído. Tendo em vista esta perspectiva de estrutura e agência na qual se conjugam ações visíveis e invisíveis, buscamos analisar a vigorosa lógica dicotômica que “compartimenta” meninas e meninos no contexto da vida escolar.
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45

Elgersma, Kristin M., Anne Chevalier McKechnie, Tipper Gallagher, Anna L. Trebilcock, Karen F. Pridham, and Diane L. Spatz. "Feeding infants with complex congenital heart disease: a modified Delphi survey to examine potential research and practice gaps." Cardiology in the Young, December 11, 2020, 1–12. http://dx.doi.org/10.1017/s1047951120004370.

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Abstract Objective: To determine clinical consensus and non-consensus in regard to evidence-based statements about feeding infants with complex CHD, with a focus on human milk. Areas of non-consensus may indicate discrepancies between research findings and practice, with consequent variation in feeding management. Materials and Methods: A modified Delphi survey validated key feeding topics (round 1), and determined consensus on evidence-based statements (rounds 2 and 3). Patients (n=25) were an interdisciplinary group of clinical experts from across the United States of America. Descriptive analysis used SPSS Statistics (Version 26.0). Thematic analysis of qualitative data provided context for quantitative data. Results: Round 1 generated 5 key topics (human milk, developing oral feeding skills, clinical feeding practice, growth failure, and parental concern about feeding) and 206 evidence-based statements. The final results included 110 (53.4%) statements of consensus and 96 (46.6%) statements of non-consensus. The 10 statements of greatest consensus strongly supported human milk as the preferred nutrition for infants with complex CHD. Areas of non-consensus included the adequacy of human milk to support growth, need for fortification, safety, and feasibility of direct breastfeeding, issues related to tube feeding, and prevention and treatment of growth failure. Conclusions: The results demonstrate clinical consensus about the importance of human milk, but reveal a need for best practices in managing a human milk diet for infants with complex CHD. Areas of non-consensus may lead to clinical practice variation. A sensitive approach to these topics is needed to support family caregivers in navigating feeding concerns.
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46

Trindade, Kayc Araujo, Carlos Alfonso Alva Alvarado, and Neuma Rubia Figueiredo Santana. "Sistema para aproveitamento de água de chuva para fins não potáveis e sua viabilidade econômica em escola municipal no município de Lagarto/SE." Scientia Plena 13, no. 10 (November 30, 2017). http://dx.doi.org/10.14808/sci.plena.2017.109909.

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O aproveitamento de água da chuva é uma fonte alternativa de abastecimento que vem sendo utilizado para combater os períodos de estiagem e as altas tarifas atribuídas ao consumo de água. A disponibilidade hídrica da região nordeste é baixa, além disso, a região sofre com a seca devido ao seu clima semiárido e a contaminação dos principais mananciais, sendo cada vez mais necessário armazenar água para tais períodos. Essa pesquisa visou realizar um estudo para aproveitar água da chuva na Unidade Municipal de Ensino Infantil (U.M.E.I.) Raimundo José de Carvalho, captando as águas que caem sobre a cobertura e armazenando em um reservatório para abastecer as bacias sanitárias, máquina de lavar roupas e torneira de jardim. Junto com o consumo de água, as altas tarifas são fatores determinantes para a redução do consumo da creche que hoje tem custos de aproximadamente R$2000,00 de consumo de água. Analisou-se as instalações presentes, sistema de micro drenagem, local para instalação de reservatórios e dimensionou-os pelo método de Rippl, método da simulação e método de Azevedo Neto. Os resultados obtidos, determinou-se que o reservatório terá capacidade de 40 mil litros divididos em dois de 20 mil litros e que haverá um conjunto moto bomba para conduzir a água para os reservatórios superiores. A implantação desse sistema pode contribuir com uma economia financeira na faixa de R$ 900,00 mensais e um tempo de retorno de aproximadamente três anos e meio, evidenciando excelente relação custo x benefício.
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47

Higashimoto, Yuki, Masaru Ihira, Yu Miyazaki, Ayumi Kuboshiki, Sayaka Yoshinaga, Hiroyuki Hiramatsu, Ryota Suzuki, et al. "Monitoring Shedding of Five Genotypes of RotaTeq Vaccine Viruses by Genotype-Specific Real-Time Reverse Transcription-PCR Assays." Journal of Clinical Microbiology 56, no. 6 (March 21, 2018). http://dx.doi.org/10.1128/jcm.00035-18.

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ABSTRACTRotaTeq (RV5) is a widely used live attenuated pentavalent rotavirus (RV) vaccine. Although fecal shedding of RV vaccine strains persists for long time periods, it is unclear how each vaccine strain replicates in intestinal tissue and is excreted in stool. To examine this issue, we established RV5 genotype-specific real-time reverse transcription-PCR (RT-PCR) assays. Five real-time RT-PCR assays were designed for the VP7 gene in genotypes G1, G2, G3, G4, and G6. All assays exhibited excellent linearity, and the detection limit was 1 infectious unit (IU)/reaction for G2, G4, and G6 and 10 IUs/reaction for G1 and G3. No cross-reactivity was observed among G genotypes. The inter- and intra-assay coefficients of variation were less than 3%. The assays were used to examine 129 stool samples collected from eight infants who received RV5. In cases 1 and 2, who received three rounds of vaccination, RV shedding decreased gradually with the number of vaccinations. G1 and G6 shedding appeared to be predominant in comparison to shedding of the other genotypes. Patterns of fecal shedding of the five genotypes of vaccine viruses differed between the eight vaccine recipients. RV5 genotype-specific real-time RT-PCR assays will be useful to study the molecular biology of RV5 replication in infants and experimental animals.
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48

Chaturvedi, Sarika, Girish Tillu, Anil Kale, Aruna Pendse, Ashwini Kulkarni, Deepali Ambike, Madhumita Krishnan, et al. "Protocol for Infant Massage in Home Settings: An e-Delphi Approach for Consensus Guidance Integrating Traditional Wisdom with Modern Medicine." Journal of Tropical Pediatrics 67, no. 3 (June 1, 2021). http://dx.doi.org/10.1093/tropej/fmab043.

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Abstract Infant massage is a highly prevalent traditional practice in India and other parts of Asia. Clear guidance on safe and effective uses of infant massage is lacking especially in the contemporary times when the traditional knowledge is on the verge of extinction and preparations may differ from in the past. This paper presents a consensus guidance in the form of a standardized protocol for routine massage of infants in home settings. Furthermore, a feasible method to develop an integrative protocol involving traditional and modern medicine experts is described. A modified e-Delphi method was used to develop the protocol. A group of seventeen experts, including academicians and practitioners from disciplines as modern paediatrics, Ayurveda paediatrics, Physiotherapy and Naturopathy participated in three rounds of a Delphi study to evolve the consensus guidance. The present protocol for massage of infants born beyond 34 weeks of gestation and weighing above 1.8 kg is recommended for use by care givers. This provides guidance on the preparation for infant massage such as when to begin massaging the infant, checking fitness of the infant for massage, the appropriate time, environment, person and substance for infant massage and a detailed description of the procedure for infant massage. Paediatricians, obstetricians and other child care practitioners can use this protocol to guide care givers on how to peform infant massage.
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49

Quirke, Fiona A., Patricia Healy, Elaine Ní Bhraonáin, Mandy Daly, Linda Biesty, Tim Hurley, Karen Walker, et al. "Multi-Round compared to Real-Time Delphi for consensus in core outcome set (COS) development: a randomised trial." Trials 22, no. 1 (February 15, 2021). http://dx.doi.org/10.1186/s13063-021-05074-2.

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Abstract Background The Delphi method is used in a wide variety of settings as a method of building consensus on important issues. Traditionally, the Delphi method uses multiple rounds of a survey to allow for feedback of other participants’ survey responses in between rounds. By informing participants about how others answer a question or prioritise specific topics, it allows for diverse opinions to inform the consensus process. For this reason, the Delphi method is popular as a consensus building approach in developing core outcome sets (COS), i.e. the minimum agreed set of standardised outcomes that should be measured and reported in studies on a specific health condition. In a COS setting, participants prioritise the importance of outcomes for inclusion in a COS. This usually involves participating in multiple rounds of a survey that can span several weeks or months. Challenges with participant retention have been highlighted in previous COS. We will compare a three-round with a Real-Time Delphi approach on prioritised outcomes. This trial is embedded within the COHESION study which is developing a COS for interventions treating neonatal encephalopathy. Methods One hundred and eighty stakeholders (parents/caregivers of infants diagnosed and treated with neonatal encephalopathy, healthcare providers and researchers) will be randomised using stratified randomisation to take part in either the Multi-Round or Real-Time Delphi. Stakeholders will rate the importance of the same set of outcomes in both arms. We will compare the prioritised outcomes at the end of both surveys as well as other parameters such as feedback, initial condition and iteration effects. Discussion This trial will provide evidence to inform decisions on the use of Multi-Round compared to Real-Time Delphi survey methods. Trial registration NCT04471103. Registered on 14 July 2020.
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50

Souza, Fernanda Lara Lara. "ATIVIDADES LÚDICAS NA PREVENÇÃO DE PARASITOSES INTESTINAIS: Uma proposta de Educação Permanente em Saúde." Revista Eixos Tech 5, no. 1 (August 9, 2018). http://dx.doi.org/10.18406/2359-1269v5n12018150.

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Introdução: A incidência das parasitoses intestinais é considerada um dos maiores índices de mortalidade infantil representando para a saúde pública do Brasil, um grave problema, principalmente para a classe populacional mais carente, fatores como saneamento básico precário, má manipulação de alimentos, ausência de boa higiene. Neste cenário as crianças são as mais acometidas principalmente devido aos hábitos inadequados de higiene, expondo um sistema imune ainda em formação, estando até esta fase ineficiente para a eliminação destes organismos parasitários. A educação é um componente nobre na complexa teia preventiva das doenças parasitárias. Sendo a escola local fundamental para a mediação e transmissão de conceitos, hábitos de vida, valores e atitudes, possuindo impacto na formação da criança e do adolescente, essa instituição contribui para o desenvolvimento de atitudes saudáveis. Considera-se a educação permanente um importante fator na modificação de hábitos, pelo fato da mudança ser o ápice do presente estudo acerca da prevenção de parasitoses intestinais. Objetivo: Promover a educação permanente em saúde, por meio de atividades lúdicas e sensibilizar crianças quanto importância de hábitos de higiene para a prevenção de parasitoses intestinais. Metodologia: Trata-se de um relato de experiência. O relato é uma ferramenta de estudo descritiva, que apresenta uma reflexão sobre uma ação ou um conjunto delas, abordando um acontecimento vivenciado no âmbito profissional, de interesse da comunidade científica. A educação permanente em saúde foi proposta como tema objetivo da disciplina Projeto Integrador IV. Resultados: A partir da problemática parasitoses intestinais foram desenvolvidas atividades voltadas ao público infantil. O decorrer do presente estudo aconteceu no Centro Municipal de Educação Infantil (CEMEI), na cidade de Passos- MG. A escola conta com 150 crianças das quais, a faixa etária de 3 a 4 anos participaram da dinâmica. O desenvolver da atividade deu-se, por meio, de um teatro educativo. A sinopse de uma menina que não possuía bons hábitos de higiene pessoal e alimentar e por consequência acaba por contrair vermes. De forma a buscar a atenção das crianças foram utilizadas roupas coloridas, desenhos explicativos e objetos confeccionados. Para enfatizar a importância da higiene pessoal, foi apresentada uma música incentivando a lavagem das mãos. Foram então, distribuídos “flyer”, para que as crianças pudessem levar para casa, sensibilizando também os adultos responsáveis. Conclusão: A escola mostrou-se com um campo extremamente eficiente na divulgação e promoção da saúde. As atividades lúdicas, em forma de teatro, alcançaram os objetivos esperados, uma vez que despertou interesse do público alvo e permitiu a sensibilização para bons hábitos de higiene. Recomenda-se que a escola possa ser observada como um meio estreito de comunicação com a saúde e suas competências de prevenção, promoção e proteção.
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