O ensino de química na educação de jovens e adultos do ensino médio no município de Itumbiara-GO

For this study, a research was conducted in order to answer the question "What chemistry teaching has been developed in the Youth and Adult Education (EJA) ?". The research provides an overview of the object to the proposed changes, leading students to live with different realities and investigating the issue of contextualization based on the daily lives of these students related to the subject of chemistry. The methodology focuses ethnographic research of the case study, in which a case is studied in depth using the participant observation. In the survey data a mixed qualitative and quantitative approach was used. The work involved 6 schools that offer adult education high school; 6 directors of these schools; 6 coordinators who work in adult education; 6 Chemistry teachers and 123 students of the EJA, level high school, enrolled in the 1st, 2nd, 3rd and 4th periods. The first stage of the research consisted of questionnaires in schools where everyone involved responded closed and open questions applied to each specific group. In the second stage two schools were selected in order to conduct a deeper knowledge of adult education through practical activities of Chemistry and subsequent interview conducted in groups with students. Three teachers were also interviewed to enable a deepening of issues relating to EJA and Chemistry Teaching. The interviews were analyzed by the technique of Discursive Textual Analysis (ATD). The main issues addressed in the questionnaires and interviews were on the school structure, reasons that lead students to drop out or remained in adult education and those who make the stay, the view of those involved of the importance of chemistry discipline for students of EJA and how this should be offered. It is necessary that we need to promote changes in the chemistry class and its activities, respecting the experiences and experience already gained by the student during his life story. Another factor to be highlighted is the need for ongoing training of teachers working in adult education. Note that your continued education is given more by the experience and the ways in which they try to overcome adverse situations. The Chemistry subject taught is not agree with the principles of EJA and practiced curriculum is just an adaptation or content reduction from the regular curriculum. The improvement in chemistry teaching of EJA will take place through a dialogue between those involved in the process, clearer educational policies and willingness to implement change. Thus the teaching of chemistry contribute to the students of the EJA are actually scientifically literate and integrated into society.

Infecções por enterobacteriaceae resistente aos carbapenêmicos em hospital de ensino: epidemiologia e caracterização molecular

Introduction: The production of KPC (Klebsiella pneumoniae carbapenemase) has become an important mechanism of carbapenem-resistance among Enterobacteriaceae strains. In Brazil, KPC is already widespread and its incidence has increased significantly, reducing treatment options. The “perfect storm” combination of the absence of new drug developmentand the emergence of multidrug-resistant strains resulted in the need for the use of older drugs, with greater toxicity, such as polymyxins. Aims: To determine the occurrence of carbapenemase-producing strains in carbapenem-resistant Enterobacteriaceae isolated from patients with nosocomial infection/colonization during September/2014 to August/2015, to determine the risk factors associated with 30-day- mortality and the impact of inappropriate therapy. Materials and Methods: We performed a case control study to assess the risk factors (comorbidities, invasive procedures and inappropriate antimicrobial therapy) associated with 30-day-mortality, considering the first episode of infection in 111 patients. The resistance genes blaKPC, blaIMP, blaVIM and blaNDM-1 were detected by polymerase chain reaction technique. Molecular typing of the strains involved in the outbreak was performed by pulsed field gel electrophoresis technique. The polymyxin resistance was confirmed by the microdilution broth method. Results: 188 episodes of carbapenem-resistant Enterobacteriaceae infections/colonizations were detected; of these, 122 strains were recovered from the hospital laboratory. The presence of blaKPC gene were confirmed in the majority (74.59%) of these isolates. It was not found the presence of blaIMP , blaVIM and blaNDM-1 genes. K. pneumoniae was the most frequent microorganism (77,13%), primarily responsible for urinary tract infections (21,38%) and infections from patients of the Intensive Care Unit (ICU) (61,38%). Multivariate statistical analysis showed as predictors independently associated with mortality: dialysis and bloodstream infection. The Kaplan-Meier curve showed a lower probability of survival in the group of patients receiving antibiotic therapy inappropriately. Antimicrobial use in adult ICU varied during the study period, but positive correlation between increased incidence of strains and the consumption was not observed. In May and July 2015, the occurrence rates of carbapenem-resistant Enterobacteriaceae KPC-producing per 1000 patient-days were higher than the control limit established, confirming two outbreaks, the first caused by colistin-susceptible KPC-producing K. pneumoniae isolates, with a polyclonal profile and the second by a dominant clone of colistin-resistant (≥ 32 μg/mL) KPC-producing K. pneumoniae. The cross transmission between patients became clear by the temporal and spatial relationships observed in the second outbreak, since some patients occupied the same bed, showing problems in hand hygiene adherence among healthcare workers and inadequate terminal disinfection of environment. The outbreak was contained when the ICU was closed to new admissions. Conclusions: The study showed an endemicity of K. pneumoniae KPC-producing in adult ICU, progressing to an epidemic monoclonal expansion, resulted by a very high antibiotic consumption of carbapenems and polymyxins and facilitated by failures in control measures the unit.