A dificuldade de realização de estudos clínicos com a população pediátrica favorece a prescrição off-label de medicamentos. Paralelamente, existe uma grande diversidade de fontes de informações sobre medicamentos disponíveis para consulta e diferentes formas de expressar doses para a pediatria, podendo resultar em padrões variados no uso de medicamentos. Este estudo avaliou a concordância de fontes de informação, em nível nacional e internacional, que orientam a prescrição pediátrica de antimicrobianos para faringotonsilite, otite média aguda (OMA) e rinossinusite, em relação ao fármaco de escolha, à posologia e aos tipos de referências utilizadas para sua elaboração. Foram selecionados documentos de entidades brasileiras e estrangeiras e as bulas dos medicamentos neles mencionados, totalizando 23 documentos diferentes para as três doenças avaliadas. A classe das penicilinas foi prevalente como terapia de primeira escolha nas três doenças estudadas, contudo houve grande variação nas doses indicadas e no modo como elas são expressas. A idade mínima para uso foi informada em 51,2% das fontes, sendo menos recorrente nas fontes nacionais. A duração do tratamento esteve presente em 66,7% dos fármacos indicados nas fontes. De forma geral, as fontes analisadas para as três doenças avaliadas citam principalmente referências classificadas como artigos de revisão e estudos experimentais, seguidos dos formulários e listas oficiais e consensos, diretrizes e manuais para embasar seus dados. Os resultados encontrados neste estudo reforçam a necessidade de estimular a realização de ensaios clínicos e/ ou estudos de farmacometria para a definição de doses de antimicrobianos para a pediatria, assim como, a harmonização das informações disponibilizadas para orientar a prescrição. / The difficulty of conducting clinical studies with the pediatric population favors off-label prescribing. At the same time, there is easy access to a great diversity of sources of information about drugs and different ways of expressing pediatric doses. These factors have impact on drug prescription and may result in varying standards in the use of medications. The present study assessed, at national and international levels, the agreement of information sources that guide pediatric prescription of antimicrobials for pharyngotonsillitis, acute otitis media (AOM) and rhinosinusitis, in relation to the drug of choice, dosage and types of references used in its preparation. Documents from Brazilian and international entities and the package inserts of the medications mentioned in these documents were selected. To three diseases, was analyzed 23 differents documents. The penicillin class was prevalent as first-line therapy in the three diseases investigated. However, there was great variation in the doses indicated and in the way they are expressed. The minimum age for use was reported in only 51,2% of the sources, being less recurrent in the national sources. Duration of treatment was present in 66,7% of the drugs indicated in the sources. In general, the sources analyzed for the three disorders investigated most often cite references classified as review articles and experimental studies, followed by formularies and official lists and consensus, guidelines and manuals to support their data. The results obtained reinforce the need to encourage clinical trials and/or pharmacometrics studies for establishing dosing recommendations of antimicrobials for pediatric patients, as well as to harmonize the information provided to guide prescriptions.

In 1996, the United States Food and Drug Administration officially approved the use of intravenous recombinant tissue-type plasminogen activator for treatment of acute ischemic stroke, with the requirement that a baseline computed tomography (CT) scan be performed to rule out acute intracerebral or subarachnoid hemorrhage. Today, the American Heart Association (AHA) Stroke Council acknowledges magnetic resonance imaging (MRI) as more sensitive to the detection of ischemia, and yet, guidelines released by the group suggest that either CT or MRI may serve as the primary, hyperacute imaging modality. The AHA recommends that for most cases, non-contrast-enhanced CT scans provide sufficient information for medical management decisions. A systematic review of published literature was conducted to compare current capabilities of CT and MRI in an effort to determine which imaging modality should be used in the setting of acute ischemic stroke. Current research indicates that MRI is comparable to CT in the detection of acute hemorrhage, but superior in the detection of acute ischemia. In addition, MRI has demonstrated the ability to not only identify suitable patients for treatment, but also identify patients whose treatment would be unnecessary and potentially dangerous. Therefore, the hope is that clinical guidelines, like those released by the AHA Stroke Council, will be modified to promote MRI as the primary imaging modality. A modification to the major clinical guidelines will initiate a change in the approach of acute stroke evaluation across all clinical stroke centers.

No description available.

Companies increasingly use business process modeling for documenting and redesigning their operations. However, due to the size of such modeling initiatives, they often struggle with the quality assurance of their model collections. While many model properties can already be checked automatically, there is a notable gap of techniques for checking linguistic aspects such as naming conventions of process model elements. In this paper, we address this problem by introducing an automatic technique for detecting violations of naming conventions. This technique is based on text corpora and independent of linguistic resources such as WordNet. Therefore, it can be easily adapted to the broad set of languages for which corpora exist. We demonstrate the applicability of the technique by analyzing nine process model collections from practice, including over 27,000 labels and covering three different languages. The results of the evaluation show that our technique yields stable results and can reliably deal with ambiguous cases. In this way, this paper provides an important contribution to the field of automated quality assurance of conceptual models.

By facilitating timely diagnosis and treatment initiation, population-wide newborn screening programs have led to important reductions in morbidity and mortality for many rare diseases, including medium-chain acyl-CoA dehydrogenase (MCAD) deficiency and very-long-chain acyl-CoA dehydrogenase (VLCAD) deficiency. Newborn screening has also expanded the spectrum of disease severity for MCAD and VLCAD deficiencies to include a higher proportion of milder cases, raising questions about appropriate disease management. To date there has been no systematic attempt to characterize best management practices in terms of the guidance that is available to those who provide care for MCAD and VCLAD deficiencies; nor has there been an attempt to understand the extent to which current practices align with such currently available guidance. The two projects that are part of this thesis sought to address these research gaps with a particular focus on two key disease-specific management practices we identified in advance as priorities: the use of carnitine supplementation and the recommended duration of fasting. The objective of the first project was to systematically review the quality and content of clinical practice guidelines and/or recommendations for the diagnosis and management of both MCAD and VLCAD deficiencies. Two independent reviewers assessed the eligibility of citations retrieved from a comprehensive search of the peer-reviewed and grey literature. We appraised the quality of the reviewed guidance and extracted information on the content of recommendations. From the 25 guidance documents that met our inclusion criteria, only 7 incorporated evidence reviews, indicating that guidance in this field does not generally meet established methodological standards for the rigorous development of clinical practice guidelines. With respect to content, we identified unclear and inconsistent recommendations regarding fasting times and the use of carnitine supplementation. Further empirical evidence in these areas is necessary to inform the development of future rigorous guidelines. The objective of the second project was to identify actual practices in the management of MCAD deficiency. We conducted a scoping review of published literature on treatment practices around the world and a secondary analysis of data documenting treatments received by participants in a Canadian pediatric cohort study. For the scoping review, citations retrieved from our comprehensive search strategy were screened by two independent reviewers. We extracted information on study characteristics and disease management. Our secondary analysis included longitudinal data for Canadian children with MCAD deficiency, born between 2006 and 2015 and enrolled in a cohort study at one of 13 centres. For both project components, we described carnitine supplementation and fasting times, overall and according to potential indicators of disease severity (genotype, biochemical phenotype). We identified 5 relevant publications in the scoping review and analyzed data for 107 children participating in the Canadian cohort. Management practices related to carnitine supplementation and fasting times for MCAD deficiency were highly variable based on both data sources. There was some evidence of an association between genotype and carnitine use, which, based on the scoping review, may be due to a relationship between genotype and carnitine deficiency. While actual practice was in some ways aligned with the guidance we reviewed in the first project, these results underscore the need for further evidence to address areas of uncertainty that have been prioritized by patients and families, clinicians, and health researchers, including questions regarding the potential to tailor treatment to predicted disease severity and an emphasis on controversial therapies such as carnitine supplementation.

A incorporação da informática nas atividades corriqueiras da execução de desenhos técnicos provocou uma verdadeira revolução nas práticas de ensino destes conteúdos. As pranchetas foram substituídas por computadores, alterando a prática do ensino e o modo de aprender, criando a necessidade de projetar um novo tipo de sala de aula, voltada a atender às novas exigências. Esta pesquisa diagnostica os problemas e identifica as diretrizes que devem nortear este projeto. Para tanto, foram entrevistados professores da área de Desenho Técnico, fabricante de móveis, técnicos em condicionamento ambiental e aplicados questionários aos estudantes deste conteúdo na Universidade Federal do Rio Grande do Sul. O resultado desta pesquisa é um conjunto de diretrizes que se apresenta para auxiliar aos projetistas, fornecendo uma orientação sobre as principais variáveis envolvidas. / The integration of informatics in simple activities of technical drawing performance has led to a real revolution in the teaching practices of these contents. The drawing boards have been substituted by computers, making a change in teaching practice and in the way of learning, giving rise to the necessity of projecting a new kind of classroom aiming to fulfill the new demands. This research recognizes the problems and identifies the guidelines that lead the way to this project. In order to do that interviews with Technical Drawing professors, furniture manufacturers and environmental conditioning technicians were conducted, as well as the use of questionnaires with students of this subject at Federal University of Rio Grande do Sul. The result of this research is a set of guidelines that is presented to help designers, indicating to them trends concerning the main variables involved.

Com abordagem qualitativa o presente estudo identifica as principais características dos 27 cursos de fisioterapia existentes no Rio Grande do Sul e problematiza o processo de formação de fisioterapeutas deste Estado a partir do discurso de coordenadores de cursos de Fisioterapia sobre as práticas desenvolvidas no cotidiano da formação. Para tanto, foi realizado um estudo descritivo a partir de dados disponibilizados pelo Instituto Nacional de Estudos e Pesquisa Anísio Teixeira, tais como categoria administrativa, carga horária, região de abrangência, tempo de existência do curso, dentre outros; e uma entrevista individual semiestruturada com cinco coordenadores de cursos e um representante da coordenação, os quais relataram sobre a formação acadêmica do fisioterapeuta em suas instituições de ensino e a relação do processo de formação em Fisioterapia com o Sistema Único de Saúde. Os dados das entrevistas foram analisados em seus aspectos qualitativos através de análise discursiva. Os elementos analisados dizem respeito a características gerais da formação, estruturas curriculares, práticas pedagógicas, cenários de prática e perspectivas relacionadas à integralidade da atenção. Os resultados acerca dos 27 cursos evidenciaram que 75% dos cursos estão no setor privado, o número de vagas encontra-se entre 30 e 120, a carga varia entre 3540 e 4865 horas/aula, e houve um aumento de 80% no número de cursos nos últimos sete anos, além de outros achados. Os resultados das entrevistas apontam a predominância de movimentos de transformação no interior dos cursos, os quais, em sua maioria, parecem estar preocupados em seguir algumas orientações das Diretrizes Curriculares. Em meio a características tradicionais como a organização dos cursos por disciplinas, a dificuldade de comunicação entre as áreas de conhecimento e a dicotomia entre teoria e prática e entre ensino e serviço, emergem de alguns cursos novas metodologias de ensino, a ampliação dos cenários de prática, a preocupação com habilidades e competências que contemplem a humanização, e a busca pela horizontalidade das ações em saúde, por parte de alguns cursos. Conclui-se que em meio a este cenário de tensões que se estabelecem nos processo de mudanças, importantes transformações vêm ocorrendo; entretanto, com sinalizações de que há muito para ser feito em direção a uma formação de fisioterapeutas coerente com as necessidades sociais que se apresentam. / Using a qualitative approach, this study identifies the main characteristics of the 27 Physical Therapy courses in the State of Rio Grande do Sul and discusses the process of physical therapist formation in this State based on the discourse of Physical Therapy course coordinators on practices developed during the formation. To do so, a descriptive study was carried out based on data available at Anísio Teixeira Brazilian Institute of Studies and Research, such as administrative category, number of hours, region of coverage, time of course existence, among others. A semi-structured interview was also performed, including five course coordinators and a coordination representative, who reported on the academic formation of physical therapists in their teaching institutions and on the relationship between the process of Physical Therapy formation and the Brazilian Unified Health System. Interview data were analyzed in terms of qualitative aspects through discourse analysis. Analyzed elements are relative to general formation characteristics, curricular structures, pedagogical practices, practice scenarios and perspectives related to integrality of care. Results about the 27 courses showed that 75% of courses are in the private sector; number of vacancies is between 30 and 120; number of hours ranges between 3,540 and 4,865 hours; and there was an 80% increase in number of courses over the past seven years, in addition to other findings. Interview results point to a prevalence of transformation movements within courses, most of which seem to be concerned about following some orientations of Curricular Guidelines. Traditional characteristics include course organization by disciplines, communication difficulty between knowledge areas and dichotomy between theory and practice and between teaching and service. On the other hand, some courses showed new teaching methodologies, widening of practice scenarios, concern about skills and competences that include humanization, and search for horizontality in health actions. It can be concluded that major transformations have been occurring within such scenario of tensions established in the process of changes; however, there are signs indicating that there is much to be done toward a physical therapy formation coherent with the current social needs.

Submitted by Isac Macêdo (isac@ioc.fiocruz.br) on 2013-09-22T15:45:10Z No. of bitstreams: 1 DO 2008 - Cristiane Pereira Ferreira.pdf: 1614969 bytes, checksum: e049ca1b4723bc4d825f0bf47ddb1c11 (MD5) / Made available in DSpace on 2013-09-22T15:45:10Z (GMT). No. of bitstreams: 1 DO 2008 - Cristiane Pereira Ferreira.pdf: 1614969 bytes, checksum: e049ca1b4723bc4d825f0bf47ddb1c11 (MD5) / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil. / A educação fundamental tem como principal objetivo formar cidadãos com capacidade de aprender, viver em sociedade e auxiliar o desenvolvimento de valores. O ensino de ciências faz parte deste objetivo. Porém, no Brasil, tem sofrido diversas críticas por não contribuir, em muitos casos, com uma discussão mais crítica para a sociedade. Esta questão, que também se estende às outras disciplinas específicas, vem ocorrendo dentre outros fatores pela polivalência na formação de professores para as séries iniciais da educação básica. Assim, este trabalho teve como objetivo discutir o ensino de ciências na licenciatura em Pedagogia de instituições do Rio de Janeiro. Para tal, foi realizada análise documental das Diretrizes Curriculares, das matrizes curriculares, das ementas e projetos pedagógicos. Também foram entrevistados coordenadores, professores e alunos de cursos de Pedagogia de instituições do Rio de Janeiro, cujos dados foram tratados utilizando a análise temática. Os resultados mostraram que as Diretrizes apenas indicam fatores importantes na formação do professor, porém sua interpretação permite a omissão do ensino de ciências na prática pedagógica das instituições de ensino superior. Ao elaborar seus currículos, as instituições pesquisadas dedicam pouca atenção ao ensino de ciências, o que se confirma nas falas de alguns entrevistados. Outros participantes da pesquisa, que demonstram valorizar o ensino de ciências no curso de Pedagogia, sentem-se limitados pelas condições de trabalho do próprio curso. A partir destes resultados, acredita-se que seja urgente e essencial que a importância do ensino de ciências seja evidenciada em sua apresentação no currículo da licenciatura em Pedagogia como caminho para aproximar a qualidade de formação na escola básica. / The primary education has as goal to train people so as to provide them with the ability to learn, to live in society and also to help them with the development of values. The science education is part of this goal, but in Brazil, it has suffered some criticism for not contributing, in many cases, with a more critical discussion towards society. This question, which also extends to other specific disciplines, has occurred among other factors due to the versatility in teachers' formation towards the initial series of basic education. This study aimed to discuss the presentation of science education in Pedagogy degree in institutions from Rio de Janeiro. For this, we have analyzed documentary Curriculum Guidelines, the curriculum matrices, the syllabus and teaching projects, were also interviewed coordinators, teachers and students to Pedagogy institutions of Rio de Janeiro. Those data were processed using thematic analysis. The results showed that the Curriculum Guidelines only indicate important factors in teacher education, but their interpretation allows the omission of science education in pedagogical practice of higher education institutions. In developing their curriculum, institutions surveyed devote little attention to science education, which is confirmed in the words of some interviewees. Other research participants that demonstrate the value of science education in the Faculty of Education feel limited by the working conditions of the course. From these results, we believe it is urgent and essential that the importance of science education is evident in its presentation in the undergraduate curriculum in pedagogy as a way to approach the quality of education in primary schools.

SILIVERA, Josilda da Cruz. Avaliação do papel das mudanças curriculares (ENEM 2009) e das novas Diretrizes Curriculares Nacionais na perspectiva de aprendizagem entre professores de matemática. 2016. 94f. – Dissertação (Mestrado) – Universidade Federal do Ceará, Programa de Pós-graduação em Educação Brasileira, Fortaleza (CE), 2016. / Submitted by Gustavo Daher (gdaherufc@hotmail.com) on 2016-09-22T13:16:04Z No. of bitstreams: 1 2016_dis_jcsilivera.pdf: 773150 bytes, checksum: 612e4ef5865ef1e9003d482928247fc5 (MD5) / Approved for entry into archive by Márcia Araújo (marcia_m_bezerra@yahoo.com.br) on 2016-09-22T16:30:57Z (GMT) No. of bitstreams: 1 2016_dis_jcsilivera.pdf: 773150 bytes, checksum: 612e4ef5865ef1e9003d482928247fc5 (MD5) / Made available in DSpace on 2016-09-22T16:30:57Z (GMT). No. of bitstreams: 1 2016_dis_jcsilivera.pdf: 773150 bytes, checksum: 612e4ef5865ef1e9003d482928247fc5 (MD5) Previous issue date: 2016 / The National Secondary Education Examination (ENEM) was established in 1998 aiming to be a diagnostic evaluation primarily to assess students and high school courses, and over the years has been taking the place of traditional entrance exam of Federal Institutions of the country's Higher Education and allowing the federal government to develop public policies for basic education. Soon after, in 2009, it was established the 2009 ESMS (also known as New ESMS) establishing a new proposal for the high school, and then in 2012 the New National Curriculum Guidelines for Secondary Education (NDCNEM) they are instituted. This interim the following research problem arose: What is the role of curriculum changes arising from the Proposal of the 2009 ENEM and NDCNEM in the learning process, from the perspective of mathematics teachers from a high school school in the city of Maranguape (EC)? From this problem was elaborated this work in order to evaluate the role curricular changes arising from the 2009 ENEM proposal and NDCNEM in the learning process, from the perspective of mathematics teachers from a school in the city of Maranguape (EC) . As for the approach, the research is qualitative,referring to the goals it is exploratory and explanatory and on the procedures to be treated as field research. The data collection instrument was the interview with structured questionnaire applied to mathematics teachers from a high school school Public Network Maranguape. Given the above we sought to address the perspective of teachers and the curriculum changes which thereby made the ENEM 2009 and NDCNEM. The analysis of this study was performed using the method of content analysis suggested by Bardin author, based on the concept of evaluation of author Ralph Tyler and contributions from other authors, such as Luckesi, Dewey, Rabelo and Sacristan. In addition, it is noted that the study procedures were submitted for review by the Ethics Committee of the Federal University of Ceará. / O Exame Nacional do Ensino Médio (ENEM) foi instituído em 1998 objetivando ser uma avaliação diagnóstica basicamente para avaliar os alunos e os cursos do Ensino Médio, e no decorrer dos anos foi tomando o lugar do vestibular tradicional das Instituições Federais de Ensino Superior do País e possibilitando ao Governo Federal o desenvolvimento de políticas públicas para a Educação Básica. Logo após, no ano de 2009, foi instituído o ENEM de 2009 (conhecido também como Novo ENEM) estabelecendo uma nova proposta para o Ensino Médio, e em seguida, no ano de 2012 as Novas Diretrizes Curriculares Nacionais para o Ensino Médio (NDCNEM) são instituídas. Desse ínterim surgiu o seguinte problema de pesquisa: Qual o papel das mudanças curriculares advindas da Proposta do ENEM de 2009 e das NDCNEM no processo de aprendizagem, na perspectiva dos professores de matemática de uma escola do Ensino médio do município de Maranguape (CE)? A partir deste problema elaborou-se este trabalho com a finalidade de Avaliar o papel as mudanças curriculares advindas da proposta do ENEM de 2009 e das NDCNEM no processo de aprendizagem, na perspectiva dos professores de matemática de uma escola do município de Maranguape (CE). Quanto à abordagem, a pesquisa é de natureza qualitativa, referente aos objetivos ela é exploratória e explicativa e quanto aos procedimentos classifica-se como pesquisa de campo. O instrumento de coleta de dados foi a entrevista com questionário estruturado, aplicado aos professores de matemática de uma escola do Ensino Médio da Rede Pública de Maranguape. Diante do exposto buscou-se abordar a perspectiva dos professores quanto às mudanças curriculares que advieram do ENEM de 2009 e das NDCNEM. A análise deste trabalho foi realizada através do método de análise de conteúdo sugerido pela autora Bardin, embasada na concepção de avaliação do autor Ralph Tyler e contribuições de outros autores, como Luckesi, Dewey, Rabelo e Sacristán. Além disso, salienta-se que os procedimentos desta pesquisa foram submetidos para análise pelo comitê de ética da Universidade Federal do Ceará.

Gráficos e textos são os principais recursos didáticos utilizados na confecção do material instrucional. A linguagem visual tem qualidades diferenciadas que podem ser exploradas no processo de ensino e aprendizagem, tais como a concisão, a obtenção de visão diferenciada a respeito do conteúdo, e a estimulação motivacional. Sabe-se que gráficos de diferentes tipos – fotografias, diagramas e ilustrações – podem ser utilizados de forma efetiva para melhorar o aprendizado. Entretanto, no âmbito educacional, a linguagem verbal sempre foi considerada mais importante em relação à linguagem visual. Como consequência, os profissionais do ensino e de outras áreas relacionadas à produção de materiais instrucionais não sabem utilizar gráficos de forma eficaz para atingir propósitos instrucionais. Portanto, esta pesquisa pretende contribuir para este contexto com a proposição de diretrizes para o projeto de gráficos instrucionais estáticos, que objetivam obter a qualidade dos mesmos. Como fundamentação teórico-metodológica, buscam-se conhecimentos nas áreas do design instrucional e design visual, englobando aspectos desses gráficos, da instrução e aprendizagem, e do âmbito do projeto visual. A metodologia da pesquisa é desenvolvida em três fases principais, nas quais são: levantadas orientações de projeto; sintetizado um conjunto de diretrizes de projeto de gráficos instrucionais estáticos; e verificada a qualidade desses gráficos por meio de avaliação com especialistas. Como principais contribuições desta pesquisa destacam-se: o conjunto de 19 diretrizes projetuais que pode ser utilizado em uma variedade de suportes e tipos de gráficos; o modelo de processo projetual para a concepção de gráficos instrucionais estáticos; e os critérios de qualidade desenvolvidos para os mesmos gráficos que podem ser utilizados também como fatores de análise e avaliação de gráficos. Com a aplicação dessas contribuições, é possível tornar mais eficiente o processo projetual, contribuir para a qualidade dos materiais instrucionais e facilitar a aprendizagem de usuários que utilizarem esses materiais. Além disso, esta pesquisa contribui para o desenvolvimento dos campos teóricos do design instrucional e design visual, especificamente relacionada aos gráficos instrucionais estáticos. / Graphics and texts are the main teaching resources used in the production of instructional material. The visual language has different qualities that can be exploited in the process of teaching and learning, such as brevity, obtaining different view about the content, and the motivational stimulation. It is known that graphics of different kinds – photographs, diagrams and illustrations – can be effectively used to enhance learning. However, the educational level, verbal language has always been considered more important in relation to visual language. As a result, school staff and other areas related to the production of instructional materials do not know how to use graphics effectively to achieve instructional purposes. Therefore, this research aims to contribute to this context to propose guidelines for static instructional graphics design, which aim to get the quality. As theoretical and methodological foundation, are sought knowledge in the areas of instructional design and visual design, encompassing aspects of these graphs, education and learning, and the scope of the visual design. The research methodology is developed in three main phases, in which are raised design guidelines; synthesized a set of static instructional graphics design guidelines; and verified the quality of these graphics through evaluation with experts. The main contributions of this research are: the set of 19 projective guidelines that can be used in a variety of media types and graphics; the design process model for designing static instructional graphics; and quality criteria developed for the same graphics that can also be used as factor analysis and evaluation chart. By applying these contributions, you can make more efficient design process, contribute to the quality of the instructional materials and facilitate the learning of users who use those materials. Additionally, this research contributes to the development of theoretical fields of instructional design and visual design, specifically related to static instructional graphics.