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.

Impact of educational interventions on adverse drug events reporting

Spontaneous adverse drug events (ADE) reporting is the main source of data for assessing the risk/benefit of drugs available in the pharmaceutical market. However, its major limitation is underreporting, which hinders and delays the signal detection by Pharmacovigilance (PhV). To identify the techniques of educational intervention (EI) for promotion of PhV by health professionals and to assess their impact. A systematic review was performed in the PUBMED, PAHO, LILACS and EMBASE databases, from November/2011 to January/2012, updated in March/2013. The strategy search included the use of health descriptors and a manual search in the references cited by selected papers. 101 articles were identified, of which 16 met the inclusion criteria. Most of these studies (10) were conducted in European hospitals and physicians were the health professionals subjected to most EI (12), these studies lasted from one month to two years. EI with multifaceted techniques raised the absolute number, the rate of reporting related to adverse drug reactions (ADR), technical defects of health technologies, and also promoted an improvement in the quality of reports, since there was increased reporting of ADR classified as serious, unexpected, related to new drugs and with high degree of causality. Multifaceted educational interventions for multidisciplinary health teams working at all healthcare levels, with sufficient duration to reach all professionals who act in the institution, including issues related to medication errors and therapeutic ineffectiveness, must be validated, with the aim of standardizing the Good Practice of PhV and improve drug safety indicators.

Estratégias pedagógicas no ensino da clínica ampliada na atenção primária à saude: percepções e vivências dos alunos de graduação médica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

O Estágio Supervisionado e sua Contribuição para a Formação Inicial do Professor

Pós-graduação em Educação - FCT

Medicinal plants in pregnancy and lactation: perception of the health risk and practical educational group in Araraquara, São Paulo State, Brazil

The use of medicinal plants among pregnant women and lactating is a common practice in diverse countries. However, many medicinal plants are contraindicated during pregnancy and lactating, due to various adverse effects, such as teratogenic, embryotoxic and abortive effects, exposing these women, their fetus and babies to health unknown risks. Thus, the purpose of this commentary, was to analyze the perception about the use of medicinal plants by pregnant women and lactating registered in the "baby on board" NGO, Araraquara, São Paulo state, Brazil, between 2010 at 2013. The group was constituted by 48 women, between the first and last trimester of pregnancy or whilst breastfeeding. Information was collected during group meetings by oral interview, using a questionnaire, as script. The nature of the study was a qualitative analysis. The results were based on reports about the use of medicinal plants by pregnant women during group meetings: use, indication of use, knowledge about risks. All participants received written and oral information about the study and they gave a written informed consent. The use of medicinal plants is a reality among pregnant and lactating women of the "baby on board" NGO. They reported that they feel that "natural" products are not harmful for their health. The primary information sources for the majority of women about medicinal plants during pregnancy are family, neighbors and herbalists. The plants most cited (in popular name in Brazil) were: senna, chamomile, boldo, lemon balm, lemon grass. They were used mainly for: nausea, heartburn, indigestion, flatulence, intestinal and abdominal pain, anxiety, intestinal constipation and low milk production. The pregnant and lactating women lacked knowledge about the health risks of the use of medicinal plants and herbal medicines in pregnancy and lactation. They also reported difficulties in clarifying some questions about the use of medicinal plants with their doctors. The results of the present study showed that educative actions about the rational use of medicinal plants in pregnancy and breastfeeding could be part of the operating protocols to promote the maternal and child health programs in Araraquara. Thus, our results also suggest the importance of creating institutionalized places, to the implementation of continued education programs about rational use of medicinal plants in pregnancy and lactation. These targeted programs are not only for health professionals, but also for community members, pregnant women and breastfeeding. Our results pointed out the importance of guidance of doctors and healthcare professionals on the scientific studies about medicinal plants and herbal medicines and the risk/benefit of using herbs during pregnancy. Finally, it is noted the importance of the health professionals to inform women of childbearing on risks to their health, as well as on possibilities of utilization of herbs during fertile period, giving special attention to the potential risk of self-medication.

O estudo das novas legislações de estágio e o contexto no curso de serviço social da FCHS - UNESP- Campus de Franca

Pós-graduação em Serviço Social - FCHS

Information and Communication Technologies for Educational Development: The Case of Cybercafés at Obafemi Awolowo University, Ile-Ife, Nigeria

This study examines the use of Cybercafés/Internet resources and the evaluation of their usefulness. About eight Cybercafés located in the university community were used in this study. Questionnaires, interviews with the Cybercafé owners, staff and users as well as personal observations made during inspection of these cafés were used in this study. The data were analysed according to the background of the Internet users. The richness and high speed, accuracy, and authority were used by users to judge the quality of the Internet. Information such as the establishment of the café's facilities, membership and the future of the Cybercafés were also looked into. Finally, one can clearly see that the dominating impact of digital technology has crossed the Rubicon of controversy. The result of the survey shows that forty percent of the users learnt to use the internet by self instruction, thirty five percent learnt from colleagues or friends. Those in the sciences use the internet the most, the channel mostly used in obtaining information is the search engines. A large number of students, faculties and researchers make use of the internet in obtaining information. Many of those of those users make use of the Cybercafés in the university community.

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.

Age-Group differences in perception of competence, goal orientatiom attitudes, and practice of pshysical activity of girls who attend military schools

[EN]This study analysed the differences in self-perception, goal orientation and participation in physical activity (PA) in girls (N= 244) attending military schools. Girls had moderately higher levels of perceived competence, and there were no significant differences between age-groups. The figure for task-orientation was higher than ego-orientation. Girls expressed a positive attitude toward school and PE. Most girls did not practiced PA outside school, but 63,9% were involved in school sports. It seems that the military educational institutions are being successful in helping students to adopt physically active lifestyles. The development of perception of competence, task-orientation, and favourable attitudes seem to be important factors to enhance the levels of PA among students.

Designing a Liberal Arts Curriculum that Develops the Capacity for Effective Practice

A new agenda has been coalescing for residential liberal arts education in the United States. At its core are various forms of experiential learning that had long been relegated to the margins of institutions in which pure intellectual achievement was largely separated from, and prized above, practical application of knowledge. Recent years have brought growing student interest in opportunities to engage in experiential learning, including community service, internships, student-faculty research partnerships, study abroad, or co-operative education. All types of colleges and universities have been investing in these programs and in curricular modifications intended to begin integrating them into a coherent educational program. With support from several major associations, foundations, and research collaborations, this twenty-first century reframing of the aims of education has included a persistent call for better evaluative data to gauge the extent to which college students are actually meeting learning goals that faculty are being encouraged to specify more fully.

Liberal Education, Effective Practice, and Diversity

This session will be based on three presentations that focus on the relationship between liberal education, effective practice and diversity from different perspectives. George Kuh will present data indicating that the educational benefits of "high impact" learning experiences (such as experiential education and undergraduate research), which are significant for all students, are often greater for students from underserved and minority backgrounds than for their majority counterparts. Armando Bengochea will discuss the ways in which an emphasis on effective practice can enhance the educational experiences of students of color within a liberal arts curriculum. Steve Stemler will report on research showing that including practice-oriented criteria in assessments of student achievements and capabilities can assist colleges and universities in identifying and educating minority students with high potential to succeed both in college and beyond college.

Designing a Liberal Arts Curriculum that Develops the Capacity for Effective Practice

A new agenda has been coalescing for residential liberal arts education in the United States. At its core are various forms of experiential learning that had long been relegated to the margins of institutions in which pure intellectual achievement was largely separated from, and prized above, practical application of knowledge. Recent years have brought growing student interest in opportunities to engage in experiential learning, including community service, internships, student-faculty research partnerships, study abroad, or co-operative education. All types of colleges and universities have been investing in these programs and in curricular modifications intended to begin integrating them into a coherent educational program. With support from several major associations, foundations, and research collaborations, this twenty-first century reframing of the aims of education has included a persistent call for better evaluative data to gauge the extent to which college students are actually meeting learning goals that faculty are being encouraged to specify more fully.

An outline of competencies and the appropriate postgraduate educational pathways in implant dentistry

The use of dental implants has become a widely accepted and well-documented treatment option offering to both patients and dentists an alternative to traditional treatment modalities and at the same time opening a brand new area in dental postgraduate education. As such, it is necessary to define the competencies that the graduate student/dentist will need at the different levels of clinical practice in Implant Dentistry and the educational pathways that are required to convey those competencies in a structured manner. The present position paper provides an initial suggestion for the knowledge, skills and behaviour necessary for a graduate student to practice implant dentistry at the different levels of clinical complexity. An outline of the necessary competencies and structure of various levels of postgraduate university courses is provided together with different educational approaches to support them. The present paper should be evaluated as a platform for discussion for future development of postgraduate curricula in implant dentistry rather than a manual on how to design and operate such curricula.

Effects of an educational patient safety campaign on patients' safety behaviours and adverse events

Rationale, aims and objectives  The study aims to investigate the effects of a patient safety advisory on patients' risk perceptions, perceived behavioural control, performance of safety behaviours and experience of adverse incidents. Method  Quasi-experimental intervention study with non-equivalent group comparison was used. Patients admitted to the surgical department of a Swiss large non-university hospital were included. Patients in the intervention group received a safety advisory at their first clinical encounter. Outcomes were assessed using a questionnaire at discharge. Odds ratios for control versus intervention group were calculated. Regression analysis was used to model the effects of the intervention and safety behaviours on the experience of safety incidents. Results  Two hundred eighteen patients in the control and 202 in the intervention group completed the survey (75 and 77% response rates, respectively). Patients in the intervention group were less likely to feel poorly informed about medical errors (OR = 0.55, P = 0.043). There were 73.1% in the intervention and 84.3% in the control group who underestimated the risk for infection (OR = 0.51, CI 0.31-0.84, P = 0.009). Perceived behavioural control was lower in the control group (meanCon  = 3.2, meanInt  = 3.5, P = 0.010). Performance of safety-related behaviours was unaffected by the intervention. Patients in the intervention group were less likely to experience any safety-related incident or unsafe situation (OR for intervention group = 0.57, CI 0.38-0.87, P = 0.009). There were no differences in concerns for errors during hospitalization. There were 96% of patients (intervention) who would recommend other patients to read the advisory. Conclusions  The results suggest that the safety advisory decreases experiences of adverse events and unsafe situations. It renders awareness and perceived behavioural control without increasing concerns for safety and can thus serve as a useful instrument for communication about safety between health care workers and patients.

Prediction of Trabecular Bone Anisotropy from Quantitative Computed Tomography using Supervised Learning and a Novel Morphometric Feature Descriptor

Patient-specific biomechanical models including local bone mineral density and anisotropy have gained importance for assessing musculoskeletal disorders. However the trabecular bone anisotropy captured by high-resolution imaging is only available at the peripheral skeleton in clinical practice. In this work, we propose a supervised learning approach to predict trabecular bone anisotropy that builds on a novel set of pose invariant feature descriptors. The statistical relationship between trabecular bone anisotropy and feature descriptors were learned from a database of pairs of high resolution QCT and clinical QCT reconstructions. On a set of leave-one-out experiments, we compared the accuracy of the proposed approach to previous ones, and report a mean prediction error of 6% for the tensor norm, 6% for the degree of anisotropy and 19◦ for the principal tensor direction. These findings show the potential of the proposed approach to predict trabecular bone anisotropy from clinically available QCT images.