914 resultados para Teaching language
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O erro pode ser um sintoma da evolução do aluno, no entanto, a sua correção, quando mal gerida, pode provocar o efeito contrário, levando o erro a fossilizar-se. Nem todos os alunos apreciam a correção: enquanto alguns esperam ser corrigidos, outros evitam o erro ao não participar de forma ativa nas atividades e contexto de sala de aula. Assim sendo, nem todas as estratégias de correção e de remediação são bem recebidas por todos os alunos. Propomos, por essa razão, o recurso às novas tecnologias e aos jogos didáticos, de forma a motivar os alunos para a auto e heterocorreção, encarando o erro como parte do processo de aprendizagem.
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INTRODUCTION: his study evaluated the consumption of major classes of antibiotics, the colonization of the oropharynx of patients on mechanical ventilation, and the risk of ventilator-associated pneumonia (VAP) caused by Staphylococcus aureus in an intensive care unit for adults. METHODS: A case-control study was carried out using colonized patients (cases) by oxacillin-resistant S. aureus (ORSA) and (controls) oxacillin-sensitive S. aureus (OSSA) from May 2009 to August 2010. The occurrence of VAP by S. aureus was also evaluated in the same period. Antibiotic consumption was expressed as the number of defined daily doses (DDD)/1,000 patient-days for glycopeptides, carbapenems, and extended-spectrum cephalosporins. RESULTS: Three hundred forty-six (56.1%) patients underwent mechanical ventilation with a frequency of oropharyngeal colonization of 36.4%, corresponding to 63.5% for ORSA and 36.5% for OSSA. The risk of illness for this organism was significant (p<0.05), regardless of whether colonization/infection was by ORSA or OSSA. The consumption of antibiotics was high, mainly for broad-spectrum cephalosporins (551.26 DDDs/1,000 patient-days). The high density of use of glycopeptides (269.56 DDDs/1,000 patient-days) was related to colonization by ORSA (Pearson r=0.57/p=0.02). Additionally, age >60 years, previous antibiotic therapy, and previous use of carbapenems were statistically significant by multivariate analysis. CONCLUSIONS: There was a significant relationship between the colonization of the oropharyngeal mucosa and the risk of VAP by both phenotypes. The use of glycopeptides was related to colonization by ORSA.
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INTRODUCTION: Vancomycin-resistant enterococci (VRE) can colonize or cause infections in high-risk patients and contaminate the environment. Our objective was to describe theepidemiological investigation of an outbreak of VRE, the interventions made, and their impact on its control. METHODS: We conducted a retrospective, descriptive, non-comparative study by reviewing the charts of patients with a VRE-positive culture in the University Hospital of Campinas State University, comprising 380 beds, 40 of which were in intensive care units (ICUs), who were admitted from February 2008-January 2009. Interventions were divided into educational activity, reviewing the workflow processes, engineering measures, and administrative procedures. RESULTS: There were 150 patients, 139 (92.7%) colonized and 11 (7.3%) infected. Seventy-three percent were cared for in non-ICUs (p = 0.028). Infection was more frequent in patients with a central-line (p = 0.043), mechanical ventilation (p = 0.013), urinary catheter (p = 0.049), or surgical drain (p = 0.049). Vancomycin, metronidazole, ciprofloxacin, and third-generation cephalosporin were previously used by 47 (31.3%), 31 (20.7%), 24 (16%), and 24 (16%) patients, respectively. Death was more frequent in infected (73%) than in colonized (17%) patients (p < 0.001). After the interventions, the attack rate fell from 1.49 to 0.33 (p < 0.001). CONCLUSIONS: Classical risk factors for VRE colonization or infection, e.g., being cared for in an ICU and previous use of vancomycin, were not found in this study. The conjunction of an educational program, strict adhesion to contact precautions, and reinforcement of environmental cleaning were able to prevent the dissemination of VRE.
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O nosso trabalho consiste numa reflexão teórica sobre a aplicação prática da educação estética e das técnicas de teatro no ensino e aprendizagem das línguas e das literaturas. Pretendemos estabelecer relações entre a educação estética e o ensino, visando uma aproximação, em termos didáticos, entre a cultura, as artes e a educação literária e linguística, mas também conduzir a aprendizagem no sentido da observação atenta e refletida para o desenvolvimento do pensamento crítico e autónomo através da ação. A relação da imagem com o texto, tendo em vista a interpretação dramática, é uma forma de consolidar conhecimentos da obra literária inserida num contexto artístico mais amplo, e essa relação, para a realização de jogos dramáticos, serve a concretização em imagem viva, que é a do ator ou intérprete. Mas, acima de tudo, ela visa a formação integral e desenvolve a criatividade. A contemplação e o ato de criar só são possíveis se o aluno usufruir de uma educação estética, que fomenta em grande escala o gosto pelo texto inserido numa determinada cultura e na época em que se produziu. Nesta proposta, incluímos o exercício e a interiorização do conhecimento linguístico através das técnicas teatrais, enquanto práticas intrínsecas ao teatro, numa atitude comunicativa que implica interpretar e compreender, e que fomenta a autonomia do indivíduo. Pretendemos estimular o conhecimento integrado do aluno, associando a estética e as artes à aprendizagem das línguas, como meios impulsionadores da criatividade, da reinvenção e do fazer.
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A língua, nas suas diversas vertentes, tem vindo a ser, desde tempos remotos, alvo de investigação, dada a sua importância como meio de comunicação e de transmissão de pensamento. Nas categorias atribuídas por Cook (2010), a língua tem também uma função social, útil à necessária convivência em comunidade. Esta obrigatória convivência entre povos não é um dado do presente, as constantes invasões, de que nos falam os relatos históricos, permitem-nos constatar a importância da língua nas imposições de poder que uns países exerciam sobre outros. O poder económico é, nos dias de hoje, ditado pela comunicação e informação, resultantes do necessário contacto entre diferentes países. Falar de modernidade implica falar em contágio de culturas, imperativo para a relação dos sujeitos com o meio envolvente. Conceitos como interculturalidade, multilinguismo e multiculturalidade ganham espaço e tornam-se fundamentais para a integração desses indivíduos. O convívio entre pessoas oriundas de diversas partes do mundo é responsável pelo aparecimento de novas necessidades de aprendizagem, muito vocacionadas para o conhecimento de línguas, considerado como um bem essencial. O interesse pelo outro e pela sua língua é extensível ao interesse pela sua cultura. Integrado num universo cada vez maior de aprendentes de português como LE, o presente estudo centra-se num público-alvo muito específico, alunos adultos residentes em Portugal que se encontram a trabalhar em empresas multinacionais, fruto da constante mobilidade a que assistimos atualmente. Sendo esta uma realidade com especificidades que não encontram eco nos estudos empíricos, especialmente dedicados à investigação de estratégias de ensino-aprendizagem de PLE, o trabalho apresentado pretende focar alguns aspetos que possam concorrer para o desenvolvimento teórico em torno desta matéria. Num contexto empresarial, é o professor que se desloca ao local de trabalho dos alunos, onde os mesmos pretendem aprender uma língua estrangeira. A adaptação a estes contextos tem início na observação feita aos alunos, às suas necessidades e características e culmina no contexto físico onde o ensinante exerce a sua atividade. Muitos são os fatores que convergem para o sucesso ou insucesso destas aulas, nas quais o professor tem um papel fundamental. São inúmeras as dúvidas levantadas por si sobre os métodos a utilizar e os materiais a preparar, no sentido de poder melhorar, a cada dia, as suas abordagens pedagógicas e contribuir para o aumento de falantes ativos de português. Não pretendendo assumir-se como uma forma de responder a todas essas questões, o presente estudo debruça-se, essencialmente, sobre o papel do professor em contextos designados como empresariais, aludindo a algumas estratégias a adotar em aula e ao tipo de materiais pedagógicos de que o ensinante se deverá munir, cuja análise é suportada nos resultados obtidos com a aplicação prática de exercícios a alunos adultos, numa ótica de ensino individualizado. Tendo em conta o contexto de aula mencionado, começa-se por fazer uma abordagem teórica à realidade atual marcada pela globalização, seguindo-se a referência a algumas estratégias de aprendizagem em língua estrangeira e à aceção de L1, L2 e LE defendidas por diferentes estudiosos.
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Introduction Vascular access in patients undergoing hemodialysis is considered a critical determinant of bloodstream infection (BSI) and is associated with high morbidity and mortality. The purpose of this study was to investigate the occurrence of BSI in patients with end-stage renal disease using central venous catheters for hemodialysis. Methods A cohort study was conducted in a public teaching hospital in central-western Brazil from April 2010 to December 2011. For every patient, we noted the presence of hyperemia/exudation upon catheter insertion, as well as fever, shivering, and chills during hemodialysis. Results Fifty-nine patients were evaluated. Thirty-five (59.3%) patients started dialysis due to urgency, 37 (62.7%) had BSI, and 12 (20%) died. Hyperemia at the catheter insertion site (64.9%) was a significant clinical manifestation in patients with BSI. Statistical analysis revealed 1.7 times more cases of BSI in patients with hypoalbuminemia compared with patients with normal albumin levels. The principal infective agents identified in blood cultures and catheter-tip cultures were Staphylococcus species (24 cases), non-fermentative Gram-negative bacilli (7 cases of Stenotrophomonas maltophilia and 5 cases of Chryseobacterium indologenes), and Candida species (6). Among the Staphylococci identified, 77.7% were methicillin-resistant, coagulase-negative Staphylococci. Of the bacteria isolated, the most resistant were Chryseobacterium indologenes and Acinetobacter baumannii. Conclusions Blood culture was demonstrated to be an important diagnostic test and identified over 50% of positive BSI cases. The high frequency of BSI and the isolation of multiresistant bacteria were disturbing findings. Staphylococcus aureus was the most frequently isolated microorganism, although Gram-negative bacteria predominated overall. These results highlight the importance of infection prevention and control measures in dialysis units.
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Introduction Surgical site infections (SSIs) often manifest after patients are discharged and are missed by hospital-based surveillance. Methods We conducted a case-reference study nested in a prospective cohort of patients from six surgical specialties in a teaching hospital. The factors related to SSI were compared for cases identified during the hospital stay and after discharge. Results Among 3,427 patients, 222 (6.4%) acquired an SSI. In 138 of these patients, the onset of the SSI occurred after discharge. Neurological surgery and the use of steroids were independently associated with a greater likelihood of SSI diagnosis during the hospital stay. Conclusions Our results support the idea of a specialty-based strategy for post-discharge SSI surveillance.
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IntroductionRecently, pathogen ecology has been recognized as an important epidemiological determinant of healthcare-associated infections (HAIs). Acinetobacter baumannii is one of the most important agents known to cause HAIs. It is widespread in healthcare settings and exhibits seasonal variations in incidence. Little is known about the impact of competition with other hospital pathogens on the incidence of A. baumannii infection.MethodsWe conducted an ecological study, enrolling patients who presented with healthcare-associated bloodstream infections (HA-BSIs) from 2005 to 2010 at a 450-bed teaching hospital in Brazil. HA-BSIs were said to be present when bacteria or fungi were recovered from blood cultures collected at least three days after admission. Monthly incidence rates were calculated for all HA-BSIs (overall or caused by specific pathogens or groups of pathogens). Multivariate Poisson regression models were used to identify the impacts of the incidence of several pathogens on the incidence of A. baumannii.ResultsThe overall incidence rate of HA-BSI caused by A. baumannii was 2.5 per 10,000 patient-days. In the multivariate analysis, the incidence of HA-BSI caused by A. baumanniiwas negatively associated with the incidence rates of HA-BSI due to Staphylococcus aureus (rate ratio [RR]=0.88; 95% confidence interval [CI]=0.80-0.97), Enterobacter spp. (RR=0.84; 95%CI=0.74-0.94) and a pool of less common gram-negative pathogens.ConclusionsOur results suggest that competition between pathogens influences the etiology of HA-BSIs. It would be beneficial to take these findings into account in infection control policies.
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O estudo sobre os textos escritos produzidos por alunos da 7ª classe em Angola foi estabelecido por nós com base na hipótese da existência de dificuldades de escrita. Há bastantes dúvidas entre os docentes angolanos sobre a capacidade dos alunos na elaboração de textos espontâneos. Desta forma, com o objectivo de conhecermos as capacidades de produção de textos escritos pelos alunos do ensino geral no Lubango, de elaborarmos uma tipologia de análise dos erros encontrados e de propormos estratégias de superação das dificuldades apresentadas nos textos dos alunos, fomos à Escola do I Ciclo do Ensino Secundário 27 de Março do Lubango – Huíla recolher as composições da Prova Trimestral para verificar as dificuldades de escrita apresentadas nos textos dos alunos. Partimos de 314 textos, dos quais foi extraída a amostra de 10%, correspondendo a 32 textos seleccionados através da tabela de números aleatórios. Os textos foram analisados com base na tipologia de erros de Sousa (1996). Desta forma, foram detectados erros de substituição, de omissão, de divisão/aglutinação, os quais foram muito significativos e ocorreram em 66,856% dos casos no total. Os erros de substituição maiúsculas/minúsculas, os de adição, de grafias homófonas constituem 30.856% dos casos. Confirmam-se as dificuldades apresentadas pelos alunos que devem merecer tratamento através das propostas de remediação apresentadas. As dificuldades encontradas nos textos destes alunos devem servir de base para a planificação da disciplina de Língua Portuguesa no Ensino Primário de forma a dotar o aluno de competências para a melhoria da comunicação escrita na sala de aula.
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INTRODUCTION: Staphylococcus aureus produces a range of virulence factors such as toxic shock syndrome toxin-1. METHODS: In this cross-sectional study of 345 clinical S. aureus isolates, the presence of the tst gene was assessed by polymerase chain reaction (PCR). RESULTS: The study revealed 53/345 (15.4%) isolates were positive for the tst gene. The tst gene was present in 18.1% of methicillin-susceptible S. aureus (MSSA) isolates and 11.6% of methicillin-resistant S. aureus (MRSA) isolates (p = 0.136). CONCLUSIONS: These results reveal the remarkable risk of S. aureus infections in hospitals, regardless of methicillin-resistance status.
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A presente dissertação aborda o ensino do português no Japão. Para tal, sentimos a necessidade de fazer uma contextualização, falando das relações entre Portugal e o Japão desde os primeiros portugueses a pisarem terras nipónicas até ao ensino da língua portuguesa na actualidade e problemáticas do mesmo. Iremos, ainda, analisar os conteúdos culturais de dois manuais de PLE e reflectir sobre a adequabilidade dos mesmos para aprendentes japoneses de língua portuguesa.
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INTRODUCTION : In this study, clinical-laboratory and epidemiological characteristics are described for a group of 700 individuals with HIV (human immunodeficiency virus)/AIDS (acquired immunodeficiency syndrome) in the ART (antiretroviral therapy) era at a teaching hospital that provides a quaternary level of care, with an emphasis on opportunistic infections (OIs), co-infections and immune profile. METHODS : A retrospective cross-sectional study of AIDS cases was conducted from 1998 to 2008 by reviewing medical records from the Base Hospital/FUNFARME (Fundação Faculdade Regional de Medicina), São José do Rio Preto, São Paulo, Brazil. RESULTS: The individuals were 14 to 75 years of age, and 458 were males. Heterosexuals accounted for 31.1% of all patients. Eighty-three percent were on ART, and 33.8% of those presented difficulties with treatment adherence. OIs were analyzed from medical records, and Pneumocystis jiroveci pneumonia was the most prevalent, regardless of the LTCD4+ (TCD4+ Lymphocytes) levels. Individuals whose viral loads were ≥10,000 showed a 90% greater chance of neurotoxoplasmosis. For P. jiroveci pneumonia, neurotoxoplasmosis, esophageal candidiasis, pulmonary tuberculosis and neurocryptococcosis, the chances of infection were higher among patients with LTCD4+ levels below 200 cells/mm3. HIV/hepatitis C virus (HCV) and HIV/hepatitis B virus (HBV) co-infections were significantly associated with death. CONCLUSIONS : OIs remain frequent in the ART era even in populations where the access to medical care is considered satisfactory.
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ABSTRACTINTRODUCTION: Monte Carlo simulations have been used for selecting optimal antibiotic regimens for treatment of bacterial infections. The aim of this study was to assess the pharmacokinetic and pharmacodynamic target attainment of intravenous β-lactam regimens commonly used to treat bloodstream infections (BSIs) caused by Gram-negative rod-shaped organisms in a Brazilian teaching hospital.METHODS: In total, 5,000 patients were included in the Monte Carlo simulations of distinct antimicrobial regimens to estimate the likelihood of achieving free drug concentrations above the minimum inhibitory concentration (MIC; fT > MIC) for the requisite periods to clear distinct target organisms. Microbiological data were obtained from blood culture isolates harvested in our hospital from 2008 to 2010.RESULTS: In total, 614 bacterial isolates, including Escherichia coli, Enterobacterspp., Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa, were analyzed Piperacillin/tazobactam failed to achieve a cumulative fraction of response (CFR) > 90% for any of the isolates. While standard dosing (short infusion) of β-lactams achieved target attainment for BSIs caused by E. coliand Enterobacterspp., pharmacodynamic target attainment against K. pneumoniaeisolates was only achieved with ceftazidime and meropenem (prolonged infusion). Lastly, only prolonged infusion of high-dose meropenem approached an ideal CFR against P. aeruginosa; however, no antimicrobial regimen achieved an ideal CFR against A. baumannii.CONCLUSIONS:These data reinforce the use of prolonged infusions of high-dose β-lactam antimicrobials as a reasonable strategy for the treatment of BSIs caused by multidrug resistant Gram-negative bacteria in Brazil.
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Abstract: INTRODUCTION: In Brazil, culling of seropositive dogs is one of the recommended strategies to control visceral leishmaniasis. Since infectiousness is correlated with clinical signs, control measures targeting symptomatic dogs could be more effective. METHODS: A cross-sectional study was carried out among 1,410 dogs, predictive models were developed based on clinical signs and an indirect immunofluorescence antibody test. RESULTS: The validated predictive model showed sensitivity and specificity of 86.5% and 70.0%, respectively. CONCLUSIONS: Predictive models could be used as tools to aid control programs in focusing on a smaller fraction of dogs contributing more to infection dissemination.