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)

Online distance mathematics education in Brazil: research, practice and policy

In this article, we address online distance mathematics education research and practice in Brazil, which are relative newcomers to the educational scene. We present the national context of education in Brazil, highlighting the organization of the educational system, and also a summary of national legislation on distance education and an overview of digital inclusion in the country. We outline the potential and relevance of distance education for the Brazilian educational system and show how it could intervene in the system. With respect to research and practice in online mathematics education, we present support for research, examples of studies and highlight different aspects being addressed, including its essential components. In addition, we discuss the synergy between distance education and teacher education, and mathematics distance education and modeling, as well as other initiatives in the national scenario.

Higher education in evening courses in Brazil: history, growth and public policies at the beginning of the XXI Century

There are three distinct and complementary objectives in this article in order to clarify the higher education outline in Brazil, specifically evening courses (classes are held on weekdays, generally from 7:00 pm to 10:30 pm) and thesecurrent sector policies. The first objective is to present a short historical overview on the establishment of evening courses in Brazil, including those in the higher education level, occurred on the middle of last century. The second objective is to demonstrate the growth of evening higher education in Brazil, considering that in 1998, of the 2.1 million college enrollments, 55.3% were enrolled in evening courses; in 2010, twelve years later, of the 5.4 million students enrolled, there were 63.5% enrolled in evening courses. This expansion is due to the growing need of many students who must work while attending college, to defray costs of the study as well as personal and family costs. The reality of the working student is hostile considering external factors, such as transport problems, public security and lack of legislation for flexible working hours. The third objective is to discuss current public policies to expand eveningopenings in public institutions which represent nowadays only 16.1% of the 3.4 million enrollments for evening classes, including federal (6.8%), state (7.0%) and municipal (2.3%) institutions. In the third objective it is included the discussion of programs for scholarships and tuition loans. The methodology applied was to rescue historical information on the establishment and the expansion of evening courses in Brazil, analyzing the current general Brazilian policies and the specific ones from the State of São Paulo. The research results pointed to the importance of federal programs for scholarships and tuition loans for students from private institutions such as the 1,382,484 scholarships since 2004 (PROUNI Program) and the 847,000 tuition loans since 1999 (FIES Program). Important steps have been made by the Brazilian government. Considering that there are 3,987,424 enrollments in private institutions, the effectiveness of the programs for scholarships and tuition loans is still insufficient to meet the universal benefits for the student’s needs. Evening courses became the real instrument of social inclusion for many Brazilian youths and must be expanded quantitatively and qualitatively, with aggressive public policies, including also, scholarships and tuition loans.

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.

Association between education in EOL care and variability in EOL practice: a survey of ICU physicians

This study investigated the association between physician education in EOL and variability in EOL practice, as well as the differences between beliefs and practices regarding EOL in the ICU. Physicians from 11 ICUs at a university hospital completed a survey presenting a patient in a vegetative state with no family or advance directives. Questions addressed approaches to EOL care, as well physicians' personal, professional and EOL educational characteristics. The response rate was 89%, with 105 questionnaires analyzed. Mean age was 38 +/- A 8 years, with a mean of 14 +/- A 7 years since graduation. Physicians who did not apply do-not-resuscitate (DNR) orders were less likely to have attended EOL classes than those who applied written DNR orders [0/7 vs. 31/47, OR = 0.549 (0.356-0.848), P = 0.001]. Physicians who involved nurses in the decision-making process were more likely to be ICU specialists [17/22 vs. 46/83, OR = 4.1959 (1.271-13.845), P = 0.013] than physicians who made such decisions among themselves or referred to ethical or judicial committees. Physicians who would apply "full code" had less often read about EOL [3/22 vs. 11/20, OR = 0.0939 (0.012-0.710), P = 0.012] and had less interest in discussing EOL [17/22 vs. 20/20, OR = 0.210 (0.122-0.361), P < 0.001], than physicians who would withdraw life-sustaining therapies. Forty-four percent of respondents would not do what they believed was best for their patient, with 98% of them believing a less aggressive attitude preferable. Legal concerns were the leading cause for this dichotomy. Physician education about EOL is associated with variability in EOL decisions in the ICU. Moreover, actual practice may differ from what physicians believe is best for the patient.

Effectiveness of individual resource-oriented joint protection education in people with rheumatoid arthritis. A randomized controlled trial

the modern joint protection (JP) concept for people with rheumatoid arthritis (RA) is an active coping strategy to improve daily tasks and role performance by changing working methods and using assistive devices. Effective group JP education includes psycho-educational interventions. The Pictorial Representation of Illness and Self Measure (PRISM) is an interactive hands-on-tool, assessing (a) the individual's perceived burden of illness and (b) relevant individual resources. Both issues are important for intrinsic motivation to take action and change behaviour. This study compared individual conventional JP education (C-JP) with PRISM-based JP education (PRISM-JP).

Curriculum survey on tobacco education in European dental schools

Dental professionals need adequate education in tobacco use prevention and cessation skills. The aim of this study was to identify the level of integration of tobacco education in undergraduate curricula of European dental schools.