Impacto na epidemiologia da sepse tardia após a mudança do protocolo de antimicrobianos em uma UTIN de um serviço universitário

Advances in neonatology resulted in reducing the mortality rate and the consequent increase in survival of newborn pre terms (PTN). On the other hand, there was also a considerable increase in the risk of developing health care-related infection (HAI) in its most invasive, especially for bloodstream. This situation is worrying, and prevent the occurrence of it is a challenge and becomes one of the priorities in the Neonatal Intensive Care Unit (NICU). Sepsis is the main cause of death in critical neonates and affects more than one million newborns each year, representing 40% of all deaths in neonates. The incidence of late sepsis can reach 50% in NICUs. Currently the major responsible for the occurrence of sepsis in developed countries is the coagulase negative Staphylococcus (CoNS), followed by S. aureus. The cases of HAIs caused by resistant isolates for major classes of antimicrobial agents have been increasingly frequent in the NICU. Therefore, vancomycin has to be prescribed more frequently, and, today, the first option in the treatment of bloodstream infections by resistant Staphylococcus. The objectives of this study were to assess the impact on late sepsis in epidemiology III NICU after the change of the use of antimicrobials protocol; check the frequency of multiresistant microorganisms; assess the number of neonates who came to death. This study was conducted in NICU Level III HC-UFU. three study groups were formed based on the use of the proposed late sepsis treatment protocol, with 216 belonging to the period A, 207 B and 209 to the C. The work was divided into three stages: Period A: data collected from neonates admitted to the unit between September 2010 to August 2011. was using treatment of late sepsis: with oxacillin and gentamicin, oxacillin and amikacin, oxacillin and cefotaxime. Period B: data were collected from March 2012 to February 2013. Data collection was started six months after protocol change. Due to the higher prevalence of CoNS, the initial protocol was changed to vancomycin and cefotaxime. Period C: data were collected from newborns inteerne in the unit from September 2013 to August 2014. Data collection was started six months after the protocol change, which occurred in March 2013. From the 632 neonates included in this study, 511 (80,8%) came from the gynecology and obstetrics department of the HC-UFU. The mean gestational age was 33 weeks and the prevailing sex was male (55,7%). Seventy-nine percent of the studied neonates were hospitalized at the NICU HC-UFU III because of complications related to the respiratory system. Suspicion of sepsis took to hospitalization in the unit of 1,9% of newborns. In general, the infection rate was 34,5%, and the most frequent infectious sepsis syndrome 81,2%. There was a tendency to reduce the number of neonates who died between periods A 11 and C (p = 0,053). From the 176 cases of late sepsis, 73 were clinical sepsis and 103 had laboratory confirmation, with greater representation of Gram positive bacteria, which corresponded to 67.2% of the isolates and CoNS the most frequent micro-organism (91,5%). There was a statistically significant difference in the reduction of isolation of Gram positive microorganisms between periods A and C (p = 0,0365) as well as in reducing multidrug-resistant CoNS (A and B period p = 0,0462 and A and C period, p = 0,158). This study concluded that: the CoNS was the main microorganism responsible for the occurrence of late sepsis in neonates in the NICU of HC-UFU; the main risk factors for the occurrence of late sepsis were: birth weight <1500 g, use of PICC and CUV, need for mechanical ventilation and parenteral nutrition, SNAPPE> 24 and length of stay more than seven days; the new empirical treatment protocol late sepsis, based on the use of vancomycin associated cefepime, it was effective, since promoted a reduction in insulation CoNS blood cultures between the pre and post implementation of the Protocol (A and C, respectively); just as there was a reduction in the number of newborns who evolved to death between periods A and C.

A docência na educação superior: narrativas das diferenças políticas de sujeitos surdos

Deaf teachers presence at superior education triggers a series of reactions due to cultural differences. They feel the discomfort. The cultural difference defies the established power relations. From that emerge the trading spaces with their constant shocks about problems that affect the deaf teacher participation. The thesis goes through practice, resistance, resilience and political thinking of the deaf teacher at the Superior Education. Authors like: Foucault (2004), Hall (2009), Bhabha (1998), Touraine (2009) and Veiga-Netto (2010) underlie the concept of power relations that permeate this study. Perlin (2003); Ladd (2002) subsidize with the cultural focus. The investigation came from the question: How deaf teachers make their political stands in power relations established to the construction of their narratives at Superior Education? It had the goal of identify and chart the deaf teachers narratives at Superior Education. Leaving from the interview-narrative qualitative approach it was constituted a corpus with the collected narratives. These narratives were identified in order to achieve a thematic map express in the last chapter where the constant facts of the trading spaces of Superior Education shocks unfolds. The results point to an infinity of debates. The deaf teachers do not only present initial conditions of distress, doubt and difficulty at Superior Education, but also the disposition to discuss more the everyday power chains, waged by trading spaces. The identification of the narratives was vitally important to confirm the value of cultural and linguistic recognition as strategy for new politics to the structural power relations at the university context.

Formação inicial do professor de matemática com uso de tecnologias da informação e comunicação no contexto da escola pública

This paper intends to analyze which contribution for teachers formative training the participation on extension projects can bring to the bachelors in Mathematics teaching. The research was conducted during the developing of a Project from the Program of Extension - Programa de Extensão UFU/Comunidade (PEIC) in a municipal school located in a country zone from Uberlândia-MG. The research was constituted by a series of activities with students from the ninth year of the Fundamental Education, Middle School. The main focus is the work developed by two bachelors of Mathemactics teaching from the Federal University from Uberlândia who were part of the PEIC team. This present research intends to answer the following question: How the extension project “Information technology and communication on Mathematics problem resolution in country zone schools” has contribited to reinforce and to (re)criate the fomative experiences of students from the Mathematics teaching course who have developed such project? The presente study is from a qualitative nature and has made use of the partaker searching methodology. The presente paper was organized in three chapters. On chapter I evidence is given to theoretical discussion made, having as main references the works of Larrosa, Ponte e Shön. Chapter II brings the description of the three activities that were developed and aplied during the PEIC Project, which are: Problems in the Park, Inaccessible Hight and Lili Game. On chapter III, the data analysis is presented. The data was obtained through instruments of registration such as: camera recording, photografic material, meetings reports, field notes, surveys and semi-structured interviews. The initial hypothesis aim is on the fact that the participation on extention projects during the graduation course can bring rich contribution for the teachers to be, since it’s going to provide the knowledge and chalenge close to the one from the future profession. With the analysis of the obtained results from the colected data, it was possible to conclude that the PEIC has provided the bachelors in Mathematics teching the opportunity of recreate and potenciate their formative experiences. Such opportunity happened in situations that involved, for example, planning makings, development of colective work, softwares usage, different school spaces and the direct interaction with school bureaucracy. Beyond that, it was possible to work with the cocepts of reflection in action in a way to contribute to the professional development of the future Mathematics teachers. Thereby, in our final considerations, is possible to conclude that extension projects performed during the graduation course can bring great contributions to the professional formation of the bachelors in Mathematics teaching, among them we highlight the potentiation of the previous formative experiences and the development of colective work and behavior related to a reflexive teacher.