Geographic and Educational Factors and Risk of the First Peritonitis Episode in Brazilian Peritoneal Dialysis Study (BRAZPD) Patients

Background and objectives Peritonitis remains as the most frequent cause of peritoneal dialysis (PD) failure, impairing patient's outcome. No large multicenter study has addressed socioeconomic, educational, and geographic issues as peritonitis risk factors in countries with a large geographic area and diverse socioeconomic conditions, such as Brazil.Design, setting, participants, & measurements Incident PD patients recruited from 114 dialysis centers and reporting to BRAZPD, a multicenter observational study, from December 2004 through October 2007 were included. Clinical, dialysis-related, demographic, and socioeconomic variables were analyzed. Patients were followed up until their first peritonitis. Cox proportional model was used to determine independent factors associated with peritonitis.Results In a cumulative follow-up of 2032 patients during 22.026 patient-months, 474 (23.3%) presented a first peritonitis episode. In contrast to earlier findings, PD modality, previous hemodialysis, diabetes, gender, age, and family income were not risk predictors. Factors independently associated with increased hazard risk were lower educational level, non-white race, region where patients live, shorter distance from dialysis center, and lower number of patients per center.Conclusions Educational level and geographic factors as well as race and center size are associated with risk for the first peritonitis, independent of socioeconomic status, PD modality, and comorbidities. Clin J Am Soc Nephrol 6: 1944-1951, 2011. doi: 10.2215/CJN.11431210

Influence of educational level on myocardial hypertrophy of hemodialysis patients

Introduction: Chronic renal disease is associated with a high cardiovascular risk. Data from the general population associate cardiovascular diseases with low educational level, but no study has evaluated this association in patients on hemodialysis. Objective: This study aimed at evaluating the association between educational level, hypertension, and left ventricular hypertrophy in patients on chronic hemodialysis. Methods: A standard socioeconomic questionnaire was applied to 79 hemodialysis patients at the Hospital das Clínicas of Faculdade de Medicina de Botucatu, state of São Paulo. Clinical, laboratory and echocardiographic data were obtained from medical records. The patients were divided into two groups according to the median educational level, as follows: G1, patients with three or less years of schooling; G2, patients with more than three years of schooling. Results: Blood pressure, interdialytic weight gain, and variables statistically different in the two groups (p < 0.2) underwent multiple analysis. Independent associations were stated with p < 0.05 in multiple analysis. The mean age of patients was 57 ± 12.8 years, 46 were males (57%), and 53 white (67%). The variables selected for multiple analysis were: age (p = 0.004); educational level (p < 0.0001); body mass index (p = 0.124); left ventricular diameter (p = 0.048); and left ventricular mass index (p = 0.006). Antihypertensive drugs were similar in both groups. Systolic blood pressure (p = 0.006) and years of schooling (p = 0.047) had a significant and independent correlation with left ventricular mass index. Conclusion: In hemodialysis patients, left ventricular mass associated not only with blood pressure but also with educational level.

Tele-education on Leprosy: Evaluation of an Educational Strategy

The purpose of this research was to evaluate educational strategies applied to a tele-education leprosy course. The curriculum was for members of the Brazilian Family Health Team and was made available through the São Paulo Telehealth Portal. The course educational strategy was based on a constructivist learning model where interactivity was emphasized. Authors assessed motivational aspects of the course using the WebMAC Professional tool. Forty-eight healthcare professionals answered the evaluation questionnaire. Adequate internal consistency was achieved (Cronbach's alpha = 0.79). More than 95% of queried items received good evaluations. Multidimensional analysis according to motivational groups of questions (STIMULATING, MEANINGFUL, ORGANIZED, EASY-TO-USE) showed high agreement. According to WebMAC's criteria, it was considered an awesome course. The tele-educational strategies implemented for leprosy disclosed high motivational scores.

The Brazilian pediatric myelodysplastic cooperative group strategies: are they relevant to improve educational approach and correct diagnosis?

Brazil is a wide country with huge contrasts. Its peculiarities can highlight environmental factors that could influence the frequencies of different cancers. The standard treatment and results achieved from several different areas of the country may not be found in others. The establishment of a national cooperative group has the potential to improve outcomes. The The Brazilian Cooperative Group on Pediatric Patients with Myelodysplastic Syndrome (BCG-MDS-PED) was first organized in January 1997 as a working group of hematologists, pediatric oncologists, pediatric-hematologists, molecular biologists and other professionals in order to study pediatric (age < 18 years) MDS. Six distinct subcommittees constituted with members from several universities: cytology, histopathology, clinical, cytogenetics, molecular biology and epidemiology. The goals of the BCG-MDS-PED were: (i) to offer support for diagnosis and orientation for treatment; (ii) educational Support for the colleagues all over the country and (iii) research on pathogenesis and new approaches for pediatric MDS patients. There are socio-economical differences among the five regions of the country. The BCG-MDS-PED believes that it is absolutely necessary to Study the clinical, cellular, molecular and epidemiological aspects of MDS, taking in account these peculiar differences among populations and regions. Since 1997, 114 pediatric cases were referred to the BCG-MDS-PED from 21 centres. Seven Brazilian states have sent cases to the group, 31 patients were referred from universities, 73 patients from pediatric oncology units (foundations) and 10 patients came from private clinics. Some of these patients have been followed up and/or treated by the physician who referred them to the BCG-MDS-PED for confirmation of the initial diagnosis. The majority of these physicians have required orientation on diagnostic and treatment issues, as well as to complete cytogenetic and molecular studies. From these 114 patients, 64 patients were confirmed as MDS. We believe that, the more numerous the MDS-studied cases, the more experienced will be the referee group on clinical and laboratory features on childhood MDS in Brazil. (C) 2002 Published by Elsevier B.V. Ltd.

Psychophysical power functions for estimates of area: Effects of age and educational levels

The purpose of the present study was to verify the memory exponents of power function for area in observers of different age and educational levels (elementary school, high school or undergraduate school), using the psychophysics method of magnitude estimation. For the age level I (17 to 30 years old) there was no difference among educational levels, although for the age level II (45 to 60 years old) the differences were significant. Tn the age level II, there was a tendency for greater variability of the responses for lower educational levels. The data obtained for the age level I did not show the same results, although a significant difference among the three educational levels was observed. We call conclude that the mnemonic processes present different results when we observe the answers from observers with different ages. This result leads us to suppose that the motivational factor related to the stimulus used can interact with the mnemonic processes.

The effectiveness of educational practice in diabetic foot: a view from Brazil

Background: The aim of the present study was to evaluate the prevention and self-inspection behavior of diabetic subjects with foot at ulcer risk, no previous episode, who participated in the routine visits and standardized education provided by the service and who received prescribed footwear. This evaluation was carried out using a questionnaire scoring from 0-10 (high scores reflect worse practice compliance).Results: 60 patients were studied (30 of each sex); mean age was 62 years, mean duration of the disease was 17 years. As for compliance, 90% showed a total score <= 5, only 8.7% regularly wore the footwear supplied; self foot inspection 65%, 28,3% with additional familiar inspection; creaming 77%; proper washing and drying 88%; proper cutting of toe nails 83%; no cuticle cutting 83%; routine shoe inspection 77%; no use of pumice stones or similar abrasive 70%; no barefoot walking 95%.Conclusion: the planned and multidisciplinary educational approach enabled high compliance of the ulcer prevention care needed in diabetic patients at risk for complications. In contrast, compliance observed for the use of footwear provided was extremely low, demonstrating that the issue of its acceptability should be further and carefully addressed. In countries of such vast dimensions as Brazil multidisciplinary educational approaches can and should be performed by the services providing care for patients with foot at risk for complications according to the reality of local scenarios. Furthermore, every educational program should assess the learning, results obtained and efficacy in the target population by use of an adequate evaluation system.

Educational Java applets get in power electronics labs

This paper presents Java applet programs for a WWW (world wide web)-HTML (hypertext markup language)-based multimedia course in basic power electronics circuits. These tools make use of the benefits of Java language to provide a dynamic and interactive approach to simulate steady-state idealized rectifiers (uncontrolled and controlled; single-phase and three-phase). In addition, this paper discusses the development and the use of the Java applet programs to assist the teaching of basics rectifier power electronics circuits, and to serve as a first design tool for basics power electronics circuits in the experiments of the laboratories. In order to validate the developed simulation applets, the results were confronted with results obtained from a well-know simulator package PSPICE. © 2005 IEEE.

Planning nursing teaching: Educational purposes and clinical competence

Thinking about nursing education implies articulating this issue with the expressions of theoretical frameworks, from the perspective of a pedagogical aspect that includes both constructivism and competencies. The objective was to characterize, from a longitudinal view, the construction of care competencies that exist in the teaching plans of nursing undergraduate programs. This exploratory-descriptive study used a qualitative approach. Documentary analysis was performed on the nine teaching plans of undergraduate care subjects. The ethical-legal aspects were guaranteed, so that data was collected only after the study had been approved by the Research Ethics Committee. The data evidenced a curriculum organization centered on subjects, maintaining internal rationales that seem to resist summative organizations. Signs emerge of hardly substantial links between any previous knowledge and the strengthening of critical judgment and clinical reasoning. As proposed, the study contributed with reconsiderations for the teachinglearning process and showed the influence of constructivism on the proposal of clinical competencies.

Synchronizing Brazilian Sign Language (LIBRAS) on videos for Open Digital TV with educational purposes

The TV is a potential midia of communication that affects all social classes and it is available in 98% of Brazilian homes. It has been used as a distributor of educational materials since the 1950s. By 2016 the Open Digital TV (ODTV) in Brazil might cover the entire national territory, replacing the TV with analog signals. Concerns about accessibility for People with Special Needs (PSN) in that media have become more intense since the 1990s worldwide. In Brazil, it is estimated 24.6 million of PSN, 23% of them having some type of hearing loss. Of these, 2.9% are reported as deafs. Brazilian Sign Language (LIBRAS) is considered the first literacy language for deaf people in Brazil. In this context, this paper presents a proposal to facilitate the generation of educational content for ODTV based on two components. One is called SynchrLIBRAS and allows subtitles synchronization in Portuguese and a LIBRAS translator window of videos downloaded from the Web. The second component allows the visualization of this content through the Brazilian System of Digital TV and IPTV - environments that implement the middleware Ginga-NCL. The main focus of this paper is the presentation of the first component: SynchrLIBRAS. This proposal has educational purposes, contributing to teach LIBRAS to people who may collaborate with social inclusion of the deaf people.

Educational robotics as a learning aid for disabled children

Severe disabled children have little chance of environmental and social exploration and discovery, and due this lack of interaction and independency, it may lead to an idea that they are unable to do anything by themselves. This idea is called learned helplessness and is very negative for the child cognitive development and social development as well. With this entire situation it is very likely that the self-steam and mood of this child. Trying to help these children on this situation, educational robotics can offer and aid, once it can give them a certain degree of independency in exploration of environment. The system developed in this work allows the child to transmit the commands to a robot. Sensors placed on the child's body can obtain information from head movement or muscle pulses to command the robot to carry the tasks. Also, this system can be used with a variety of robots, being necessary just a previous configuration. It is expected that, with the usage of this system, the disabled children have a better cognitive development and social interaction, balancing in a certain way, the negative effects of their disabilities. © 2011 IEEE.

Power Electronics course: Analysis and evaluation of the educational software and the environment learning

This paper presents the analysis and evaluation of the Power Electronics course at So Paulo State University-UNESP-Campus of Ilha Solteira(SP)-Brazil, which includes the usage of interactive Java simulations tools and an educational software to aid the teaching of power electronic converters. This platform serves as an oriented course for the lectures and supplementary support for laboratory experiments in the power electronics courses. The simulation tools provide an interactive and dynamic way to visualize the power electronics converters behavior together with the educational software, which contemplates the theory and a list of subjects for circuit simulations. In order to verify the performance and the effectiveness of the proposed interactive educational platform, it is presented a statistical analysis considering the last three years. © 2011 IEEE.

Educative games and expositive lesson: Comparison of educational techniques on sitting posture

Introduction: Studies on education in health are important for the concretion of action of promotion of the health. Objective: To verify the changes of theoretical knowledge on sitting posture, evaluated at two moments (initial and final,) considering two programs of education (expositive lesson and operative groups). Methods: 75 pupils had been citizens, of both the sexes, three 4as series of a public school, evaluated previously (A1) on seated position; group 1 was submitted to a procedure of expositive education, the 2 educative games in the 2 and, the 3 to no intervention. After one week they had been reevaluated (A2). For the moments the test of Wilcoxon was applied and between the Kruskal groups Wallis. Results: In the comparison inside of the groups, of 2 and 3 they had presented increase in the number of rightness on position seated in the after-test, with statistical significant difference, whereas in the group has controlled, such fact did not occur. In the comparison between groups, at the first moment (A1), 2 groups e 3 had not presented significant difference statistical (p > 0,05), however, in as moment notices that it had difference statistics between the three groups (p < 0,01), being that the G3 presented minor frequency of errors (md = 5) in relation to the g2 (md = 8) and g1 (md = 10). Conclusions: It can be affirmed that educative techniques that supply information and promote debates and exchanges of experiences between the participants increase the possibilities of incorporation of the contents related to the sitting posture.

An Educational international partnership responding to local needs: Process evaluation of the Brazil FAIMER Regional Institute

The Brazilian public health system requires competent professionals sensitive to the needs of the population. The Foundation for Advancement of International Medical Education and Research (FAIMER) provides a two-year faculty development programme for health professions educators, aiming to build leadership in education to improve health. A partnership with governmental initiatives and FAIMER was established for meeting these needs. This paper describes the initial process evaluation results of the Brazilian FAIMER Institute Fellowship (FAIMER BR). Methods: Data were analysed for the classes 2007-2010 regarding: application processes; innovation project themes; retrospective post-pre self-ratings of knowledge acquisition; and professional development portfolios. Results: Seventeen of 26 Brazilian states were represented among 98 Fellows, predominantly from public medical schools (75.5%) and schools awarded Ministry of Health grants to align education with public health services (89.8%). One-third (n = 32) of Fellows' innovation projects were related to these grants. Significant increases occurred in all topic subscales on self-report of knowledge acquisition (eff ect sizes, 1.21-2.77). In the follow up questionnaire, 63% of Fellows reported that their projects were incorporated into the curriculum or institutional policies. The majority reported that the programme deepened their knowledge (98%), provided new ideas about medical education (90%) and provided skills for conflict management (63%). One-half of the Fellows reported sustained benefits from the programme listserv and other communications, including breadth of expertise, establishment of research collaboration and receiving emotional support. Conclusion: Contributors to initial programme success included alignment of curriculum with governmental initiatives, curriculum design merging educational technology, leadership and management skills and central role of an innovation educational project responding to local needs.