Perioperative cardiac arrest and its mortality in children. A 9-year survey in a Brazilian tertiary teaching hospital

Background: the incidence of perioperative cardiac arrest and mortality in children is higher than in adults. This survey evaluated the incidence, causes, and outcome of perioperative cardiac arrests in a pediatric surgical population in a tertiary teaching hospital between 1996 and 2004.Methods: the incidence of cardiac arrest during anesthesia was identified from an anesthesia database. During the study period, 15 253 anesthetics were performed in children. Data collected included patient demographics, surgical procedures (elective, urgent, or emergency), ASA physical status classification, anesthesia provider information, type of surgery, surgical areas, and outcome. All cardiac arrests were reviewed and grouped by the cause of arrest and death into one of four groups: totally anesthesia-related, partially anesthesia-related, totally surgery-related, or totally child disease or condition-related.Results: There were 35 cardiac arrests (22.9 : 10 000) and 15 deaths (9.8 : 10 000). Major risk factors for cardiac arrest were neonates and children under 1 year of age (P < 0.05) with ASA III or poorer physical status (P < 0.05), in emergency surgery (P < 0.05), and general anesthesia (P < 0.05). Child disease/condition was the major cause of cardiac arrest or death (P < 0.05). There were seven cardiac arrests because of anesthesia (4.58 : 10 000) - four totally (2.62 : 10 000) and three partially related to anesthesia (1.96 : 10 000). There were no anesthesia attributable deaths reported. The main causes of anesthesia attributable cardiac arrest were respiratory events (71.5%) and medication-related events (28.5%).Conclusions: Perioperative cardiac arrests were relatively higher in neonates and infants than in older children with severe underlying disease and during emergency surgery. The fact that all anesthesia attributable cardiac arrests were related to airway management and medication administration is important in prevention strategies.

Perioperative cardiac arrest: a study of 53718 anaesthetics over 9 yr from a Brazilian teaching hospital

Background. Little information exists regarding factors influencing perioperative cardiac arrests and their outcome. This survey evaluated the incidence, causes and outcome of perioperative cardiac arrests in a Brazilian tertiary general teaching hospital between April 1996 and March 2005.Methods. The incidence of cardiac arrest during anaesthesia was prospectively identified from an anaesthesia database. There were 53 718 anaesthetics during the study period. Data collected included patient characteristics, surgical procedures (elective, urgent or emergency), ASA physical status classification, anaesthesia provider information, type of surgery, surgical areas and outcome. All cardiac arrests were retrospectively reviewed and grouped by cause of arrest and death into one of four groups: totally anaesthesia related, partially anaesthesia related, totally surgery related or totally patient disease or condition related.Results. One hundred and eighty-six cardiac arrests (34.6:10 000) and 118 deaths (21.97:10 000) were found. Major risk factors for cardiac arrest were neonates, children under 1 yr and the elderly (P < 0.05), male patients with ASA III or poorer physical status (P < 0.05), in emergency surgery (P < 0.05) and under general anaesthesia (P < 0.05). Patient disease/condition was the major cause of cardiac arrest or death (P < 0.05). There were 18 anaesthesia-related cardiac arrests (3.35:10 000)-10 totally attributed (1.86:10 000) and 8 partially related to anaesthesia (1.49:10 000). There were 6 anaesthesia-related deaths (1.12:10 000)-3 totally attributable and 3 partially related to anaesthesia (0.56:10 000 in both cases). The main causes of anaesthesia-related cardiac arrest were respiratory events (55.5%) and medication-related events (44.5%).Conclusions. Perioperative cardiac arrests were relatively higher in neonates, infants, the elderly and in males with severe underlying disease and under emergency surgery. All anaesthesia-related cardiac arrests were related to airway management and medication administration which is important for prevention strategies.

Polyclonal endemicity of Pseudomonas aeruginosa in a teaching hospital from Brazil: molecular typing of decade-old strains

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Predictors of adherence to influenza vaccination for healthcare workers from a teaching hospital: a study in the prepandemic era

Introduction: Even before the 2009 pandemics, influenza in healthcare workers (HCW) was a known threat to patient safety, while Influenza vaccine coverage in the same group was generally low. Identification of predictors for HCW adherence to Influenza vaccination has challenged infection control committees. Methods: Our group conducted a cross-sectional survey in December 2007, interviewing 125 HCWs from a teaching hospital to identify adherence predictors for Influenza vaccination. The outcomes of interest were: A - adherence to the 2007 vaccination campaign; B - adherence to at least three yearly campaigns in the past five years. Demographic and professional data were assessed through univariate and multivariate analysis. Results: of the HCWs interviewed, 43.2% were vaccinated against Influenza in 2007. However, only 34.3% of HCWs working in healthcare for more than five years had adhered to at least three of the last five vaccination campaigns. Multivariate analysis showed that working in a pediatric unit (OR = 7.35, 95% I = 1.90-28.44, p = 0.004) and number of years in the job (OR = 1.32, 95%CI = 1.00-1.74, p = 0.049) were significant predictors of adherence to the 2007 campaign. Physicians returned the worst outcome performances in A (OR = 0.40, 95%CI = 0.16-0.97, p = 0.04) and B (OR = 0.17, 95%CI = 0.05-0.60, p = 0.006). Conclusions: Strategies to improve adherence to Influenza vaccination should focus on physicians and newly-recruited HCWs. New studies are required to assess the impact of the recent Influenza A pandemics on HCW-directed immunization policies.

Nothing too much: reflecting about the role of contextualization in science teaching

The contextualization and discussion about the science role in the social and economical development are unquestionably important for the science teaching process. It doesn't mean, however, that the scientific-theoretic knowledge and the strategies involved in its construction and application might be neglected. In this way, a dangerous situation is created when the contextualization is assumed as a unique and primordial target in science education. This paper presents a research carried out with 15 future chemistry teachers and the results show a worrying "supervalorization", of the contextualization beside other equally important aspects of the chemical knowledge.

Teaching in the community: Changing and implementing a new curriculum

The Faculdade de Medicina de Botucatu is changing to, and implementing a new curriculum aimed at integrating teaching and learning in the community. Emphasis is on preparing the community settings for teaching, learning and providing health care. A particular task is staff development with emphasis on problem-based learning (PBL) and training medical and nursing students in the leadership to participate in this process. The new curriculum includes the gradual introduction of clinical practice during First Year, integration of the basic sciences with clinical sciences, through integrated modules studied in small groups, and maintenance of the two year clerkship. The undergraduates are introduced gradually to the community: 8% of the total curriculum during First Year, 10% during Second Year, 10% during Third Year, 20% during Fourth Year, 30% during Fifth and Sixth Years. The basic health units at primary care level, and the regional specialty outpatients and hospitals at the second level, are the main teaching sites. An Education Development Committee was established to discuss the strategies for supporting the changes and to structure the planning for promoting the gradual transformation of staff development. After 18 months of implementation of the curriculum, there followed discussions and monitoring of the objectives of changes in medical education at our school. Successful implementation of the new curriculum would fail, if the objectives were not absorbed by every member of the implementation Committee.

Inclusão digital: estratégia de co-participação de idosos no lazer virtual = Digital inclusion: strategies for elderly co-participation in virtual leisure

Pós-graduação em Ciências da Motricidade - IBRC

Intraoperative and Anesthesia-Related Cardiac Arrest and Its Mortality in Older Patients: A 15-Year Survey in a Tertiary Teaching Hospital

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Genetic determinants of methicillin resistance and virulence among Staphylococcus aureus isolates recovered from clinical and surveillance cultures in a Brazilian teaching hospital

Aims. To quantify the presence of SCCmec types and virulence genes among Staphylococcus aureus colonizing and infecting patients from a teaching hospital. Methods. We analyzed 225 and 84 S. aureus isolates recovered from surveillance and clinical cultures, respectively. Strains were studied for the presence and type of SCCmec, as well as for several virulence genes. Univariate and multivariable analysis were performed in order to identify predictors of invasiveness (defined as isolation from clinical cultures). Results. The presence of SCCmec types III (OR, 2.19, 95% CI, 1.08-4.45) and IV (OR, 5.28 95% CI, 1.35-20.63) and of genes coding for exfoliative toxin B (etb, OR, 6.38, 95% CI, 1.48-27.46) and Panton-Valentine leukocidin (pvl, OR, 2.38, 95% CI, 1.16-4.86) was independently associated with invasiveness. Conclusions. SCCmec types III and IV and virulence genes are associated with greater invasiveness of S. aureus. Patients colonized with methicillin-resistant S. aureus, as well as with strains harboring etb or pvl, may be prone to develop invasive disease. Infection-preventing strategies should be more intensively applied to this group.

Subtitling as a pedagogical tool for language teaching in journalism

This study was designed to present and discuss some results produced by a research involving the use of English subtitles of some news videos from the webiste Reuters.com (http://www.reuters.com) with pedagogical reasons in a Brazilian context (Academic English for Journalism). We have developed the research during two semesters at UNESP (Universidade Estadual Paulista Júlio de Mesquita Filho). The professor in charge of the study has chosen the students of Journalism as the audience to whom the videos were presented. The assumptions of many theorists and experts in Audiovisual Translation were adopted as our Theoretical Sources. The first step of the study was the assessment of the syllabus of each course. This was very helpful as a guidance in order to choose the most relevant and interesting videos for students. After the evaluation of academic and professional interests, we chose some videos to insert appropriate subtitles, according to some strategies suggested by Panayota Georgakopoulou and Henrik Gottlieb. Finally we presented the videos during the English classes. At the first time, they were presented without subtitles just to notice the comprehension level of the students. After that, the videos were presented with English subtitles. As we first assumed, the students haven’t had the whole comprehension of specific details during the first presentation, they have just used their previous knowledge and the visual aids to help them in a superficial understanding of the news. As the subtitles appear, the process of communication was finally accomplished.

Strategies and Precise Vocabulary Knowledge: Exploring the Relationships Among Mathematics Vocabulary, Problem Solving, and Confidence

In this action research study I focused on my eighth grade pre-algebra students’ abilities to attack problems with enthusiasm and self confidence whether they completely understand the concepts or not. I wanted to teach them specific strategies and introduce and use precise vocabulary as a part of the problem solving process in hopes that I would see students’ confidence improve as they worked with mathematics. I used non-routine problems and concept-related open-ended problems to teach and model problem solving strategies. I introduced and practiced communication with specific and precise vocabulary with the goal of increasing student confidence and lowering student anxiety when they were faced with mathematics problem solving. I discovered that although students were working more willingly on problem solving and more inclined to attempt word problems using the strategies introduced in class, they were still reluctant to use specific vocabulary as they communicated to solve problems. As a result of this research, my style of teaching problem solving will evolve so that I focus more specifically on strategies and use precise vocabulary. I will spend more time introducing strategies and necessary vocabulary at the beginning of the year and continue to focus on strategies and process in order to lower my students’ anxiety and thus increase their self confidence when it comes to doing mathematics, especially problem solving.

Student Writing Performance: Identifying the Effects when Combining Planning and Revising Instructional Strategies

The purpose of the current study is to identify the impact of teaching students to revise their stories on writing production (Total Words Written; TWW), writing accuracy (Percent Correct Writing Sequences; %CWS), number of critical story elements included in stories, and quality of writing. Three third-grade and one fourth-grade student who were experiencing difficulties in the area of writing were involved in the study. The students were first taught to plan their stories using the evidence-based program, Self-Regulated Strategy Development (SRSD), which has frequently been implemented to teach students to plan their stories. Students were then taught to revise their stories using SRSD procedures modified for instruction in revision strategies. Student progress was evaluated through a multiple-probe design across tasks and a multiple-probe design across participants, which allowed for experimental control over time and across story probes. In addition to the previously mentioned variables, student’s acceptability of the intervention and their attitudes toward writing were also assessed. Results indicated that instruction in revising increased student writing accuracy beyond the effects of instruction in planning. Additionally, although instruction in planning was shown to increase writing production, number of critical story elements, and quality of writing, instruction in revising produced additional improvement in these variables as well. Finally, results indicated that students liked the intervention and their attitudes toward writing generally increased. Implications for practice and future research directions will be discussed. Advisor: Merilee McCurdy

African American and Teaching in Higher Education IS a Course on Race and Culture

Using theoretical applications, the authors present an overview of theories that highlight approaches for teaching culturally sensitive content, personal experiences as educator and colleague in a predominantly white college campus and strategies for addressing culturally insensitive experiences in and outside the classroom. Presenters focus on the recruitment and retention of people of color and stress the need for today's predominantly white institutions to become more knowledgeable, tolerant and sensitive about their environments in an effort to make them more accepting.

SCIENTIFIC LANGUAGE RHETORIC: FROM THE THEORETICAL BASIS TO THE PRODUCTION OF DIDACTIC MATERIAL FOR UNDERGRADUATE CHEMISTRY TEACHING

This work is part of a study that focused on analyzing the contributions of didactic activities related to scientific language rhetoric characteristics aimed at developing students' abilities to identify such characteristics in chemistry scientific texts and critical reading of those texts. In this study, we present the theoretical basis adopted to determine the scientific discourse characteristics and for the production of the didactic material used in those activities. Latour, Coracini and Campanario studies on persuasive rhetorical strategies present in scientific articles aided the production of such material.

Investigating strategies and indicators for sustainable campus: Comparison and synergies between University of Bologna and Delft University of Technology

Sustainable development is one of the biggest challenges of the twenty fist-century. Various university has begun the debate about the content of this concept and the ways in which to integrate it into their policy, organization and activities. Universities have a special responsibility to take over a leading position by demonstrating best practices that sustain and educate a sustainable society. For that reason universities have the opportunity to create the culture of sustainability for today’s student, and to set their expectations for how the world should be. This thesis aim at analyzing how Delft University of Technology and University of Bologna face the challenge of becoming a sustainable campus. In this context, both universities have been studied and analyzed following the International Sustainable Campus Network (ISCN) methodology that provides a common framework to formalize commitments and goals at campus level. In particular this work has been aimed to highlight which key performance indicators are essential to reach sustainability as a consequence the following aspects has been taken into consideration: energy use, water use, solid waste and recycling, carbon emission. Subsequently, in order to provide a better understanding of the current state of sustainability on University of Bologna and Delft University of Technology, and potential strategies to achieve the stated objective, a SWOT Analysis has been undertaken. Strengths, weaknesses, opportunities and threats have been shown to understand how the two universities can implement a synergy to improve each other. In the direction of framing a “Sustainable SWOT” has been considered the model proposed by People and Planet, so it has been necessary to evaluate important matters as for instance policy, investment, management, education and engagement. Regarding this, it has been fundamental to involve the main sustainability coordinators of the two universities, this has been achieved through a brainstorming session. Partnerships are key to the achievement of sustainability. The creation of a bridge between two universities aims to join forces and to create a new generation of talent. As a result, people can become able to support universities in the exchange of information, ideas, and best practices for achieving sustainable campus operations and integrating sustainability in research and teaching. For this purpose the project "SUCCESS" has been presented, the project aims to create an interactive European campus network that can be considered a strategic key player for sustainable campus innovation in Europe. Specifically, the main key performance indicators have been analyzed and the importance they have for the two universities and their strategic impact have been highlighted. For this reason, a survey was conducted with people who play crucial roles for sustainability within the two universities and they were asked to evaluate the KPIs of the project. This assessment has been relevant because has represented the foundation to develop a strategy to create a true collaboration.