Current and Future Applications of Virtual, Augmented, and Mixed Reality in Cardiothoracic Surgery.

BACKGROUND: This review aims to examine the existing literature to address currently used virtual, augmented, and mixed reality modalities in the areas of preoperative surgical planning, intraoperative guidance, and postoperative management in the field of cardiothoracic surgery. In addition this innovative technology provides future perspectives and potential benefits for cardiothoracic surgeons, trainees, and patients. METHODS: A targeted, nonsystematic literature assessment was performed within the Medline and Google Scholar databases to help identify current trends and to provide better understanding of the current state-of-the-art extended reality (XR) modalities in cardiothoracic surgery. Related articles published up to July 2020 were included in the review. RESULTS: XR is a novel technique gaining increasing application in cardiothoracic surgery. It provides a 3-dimensional and realistic view of structures and environments and offers the user the ability to interact with digital projections of surgical targets. Recent studies showed the validity and benefits of XR applications in cardiothoracic surgery. Examples include XR-guided preoperative planning, intraoperative guidance and navigation, postoperative pain and rehabilitation management, surgical simulation, and patient education. CONCLUSIONS: XR is gaining interest in the field of cardiothoracic surgery. In particular there are promising roles for XR applications in televirtuality, surgical planning, surgical simulation, and perioperative management. However future refinement and research are needed to further implement XR in the aforementioned settings within cardiothoracic surgery.

Creative Approaches for Assessing Long-term Outcomes in Children.

Advances in new technologies, when incorporated into routine health screening, have tremendous promise to benefit children. The number of health screening tests, many of which have been developed with machine learning or genomics, has exploded. To assess efficacy of health screening, ideally, randomized trials of screening in youth would be conducted; however, these can take years to conduct and may not be feasible. Thus, innovative methods to evaluate the long-term outcomes of screening are needed to help clinicians and policymakers make informed decisions. These methods include using longitudinal and linked-data systems to evaluate screening in clinical and community settings, school data, simulation modeling approaches, and methods that take advantage of data available in the digital and genomic age. Future research is needed to evaluate how longitudinal and linked-data systems drawing on community and clinical settings can enable robust evaluations of the effects of screening on changes in health status. Additionally, future studies are needed to benchmark participating individuals and communities against similar counterparts and to link big data with natural experiments related to variation in screening policies. These novel approaches have great potential for identifying and addressing differences in access to screening and effectiveness of screening across population groups and communities.

Simulation for Foregut and Bariatric Surgery: Current Status and Future Directions.

Simulation offers the opportunity to practice in a safe, controlled, and standardized environment. Surgical simulation, in particular, is very attractive because it avoids learning and practicing surgical skills in the operating room. Many simulators are currently available such as box-lap trainers, virtual-reality platforms, cadavers, live animals, animal-based tissue blocks, and synthetic/artificial models. Endoscopic interventions can be practiced with high-fidelity virtual simulators. Box-lap trainers help practicing basic laparoscopic skills. Cadavers and live animals offer realism to train entire foregut and bariatric procedures. However, limited availability and high expenses often restrict their use. Ex vivo simulators with animal tissue blocks have been recently developed and appear to be a realistic and cost-effective alternative. Three-dimensional printing and real-time navigation systems have also emerged as promising training tools. Overall, further efforts are needed to develop a formal simulation curriculum with validated simulators for foregut and bariatric surgery.

Simulation in Hernia Surgery: Where Do We Stand?

Simulation seems to be the best method of improving medical attitude, technical skills, and operating times. A literature review of the available data in simulation for hernia surgery was performed. Surgical simulation has been included as a main requirement in residency programs and endorsed by several surgical societies. However, evaluating how simulation affects patient's outcomes is challenging. In addition, simulation training represents an institutional economic burden that could undermine its implementation and development. Published data support that simulation-based training is a highly efficient tool, thus, its implementation should be strongly encouraged.

The impact of surgical simulation on patient outcomes: a systematic review and meta-analysis.

The use of simulation in surgical training is ever growing. Evidence suggests such training may have beneficial clinically relevant effects. The objective of this research is to investigate the effects of surgical simulation training on clinically relevant patient outcomes by evaluating randomized controlled trials (RCT). PubMed was searched using PRISMA guidelines: "surgery" [All Fields] AND "simulation" [All Fields] AND "patient outcome" [All Fields]. Of 119 papers identified, 100 were excluded for various reasons. Meta-analyses were conducted using the inverse-variance random-effects method. Nineteen papers were reviewed using the CASP RCT Checklist. Sixteen studies looked at surgical training, two studies assessed patient-specific simulator practice, and one paper focused on warming-up on a simulator before performing surgery. Median study population size was 22 (range 3-73). Most articles reported outcome measures such as post-intervention Global Rating Scale (GRS) score and/or operative time. On average, the intervention group scored 0.42 (95% confidence interval 0.12 to 0.71, P = 0.005) points higher on a standardized GRS scale of 1-10. On average, the intervention group was 44% (1% to 87%, P = 0.04) faster than the control group. Four papers assessed the impact of simulation training on patient outcomes, with only one finding a significant effect. We found a significant effect of simulation training on operative performance as assessed by GRS, albeit a small one, as well as a significant reduction to operative time. However, there is to date scant evidence from RCTs to suggest a significant effect of surgical simulation training on patient outcomes.

Simulation of Implant Impingement After Spinal Corrective Fusion Surgery in Patients with Previous Total Hip Arthroplasty: A Retrospective Case Series.

STUDY DESIGN: A retrospective case series. OBJECTIVE: The aim of this study was to introduce the prevention of total hip arthroplasty (THA) dislocation using an implant impingement simulation after spinal corrective fusion and to verify the outcomes. SUMMARY OF BACKGROUND DATA: A high dislocation rate was found among patients who underwent spinal deformity corrective fusion with previous THA. To avoid dislocation, an appropriate position of the stem and cup is important, but the pelvic inclination may change after corrective fusion for spinal deformity. METHODS: Twelve consecutive patients (two men, 10 women; average age, 72.1 [range, 55-81] years during spine surgery) with previous THA were included. Data were retrospectively retrieved from a single-center's prospectively collected database of adult spinal deformity operation. Before surgery, anterior implant impingement simulation in THA was performed using computed tomography-based software. The tolerable pelvic tilt (PT) in which the anterior implant impingement occurred in the hip at the 120° flexion position was measured. The lumbar lordosis angle was deliberately reduced during spinal surgery according to the tolerable PT. The effect of the implant impingement simulation was verified by comparison with patients who underwent surgery before simulation (before 2014). RESULTS: THA dislocation occurred in six patients: four of five (80%) in the non-simulation, and two of seven (28.6%) in the simulation group. The difference between the preoperative and tolerable PT angles was-25° to 33°, and three patients had negative angles. In these three patients, the risk of anterior impingement and THA dislocation significantly increased with correction of lumbar lordosis if the PT was anterior. Two patients experienced repeated THA dislocation with postoperative and tolerable PT angle differences of 2° and -23°. CONCLUSION: Our simulation of anterior implant impingement and subsequent adjustment of the degree of spinal correction was useful to prevent dislocation. However, this method did not prevent dislocation in some patients.Level of Evidence: 4.

Current and future usefulness and potential of virtual simulation in improving outcomes and reducing complications in endovascular treatment of unruptured intracranial aneurysms.

BACKGROUND: Simulation training has been used in the aviation industry and surgical specialties for many years, but integration into neurointerventional practice is lagging behind. OBJECTIVE: To investigate how neurointerventionalists perceive the usefulness and limitations of simulation tools for the treatment of unruptured intracranial aneurysms (UIAs), and to identify simulation applications that were perceived to be most valuable for endovascular UIA treatment. METHODS: A web-based international multidisciplinary survey was conducted among neurointerventionalists. Participants were asked for their perceptions on the usefulness of current simulation tools and the potential impact of future simulation tools in endovascular UIA treatment. They identified simulation applications that could add most value to endovascular UIA treatment and help to specifically reduce endovascular UIA treatment complications. RESULTS: 233 neurointerventionalists from 38 countries completed the survey, most of whom (157/233 (67.4%)) had access to a simulator as a trainee, but only 15.3% used it frequently. Most participants (117/233 (50.2%)) considered currently available simulation tools relatively useful for endovascular UIA treatment, with greater value for trainees than for staff. Simulation of new devices (147/233 (63.1%)) and virtual practice runs in individual patient anatomy (119/233 (51.1%)) were considered most valuable for reducing endovascular UIA treatment complications. CONCLUSION: Although neurointerventionalists perceived currently available simulation tools relatively useful, they did not use them regularly during their training. A priori testing of new devices and practice runs in individual patient anatomy in a virtual environment were thought to have the greatest potential for reducing endovascular UIA treatment complications.

Desenvolvimento e otimização de sistemas conservantes empregando os conceitos de Qualidade por Design (QbD) e Tecnologia Analítica de Processos (PAT) / Development and optimization of preservative systems using Quality by Design (QbD) and Process Analytical Technology (PAT) concepts

Recentemente, produtos farmacêuticos e cosméticos com concentrações mínimas de parabenos e outros conservantes ganharam e apelo comercial e de segurança, devido à controvérsia sobre a segurança dos conservantes. No entanto, o uso de conservantes é essencial para garantir a conservação microbiana de produtos cosméticos e farmacêuticos durante o seu uso. Neste trabalho, desenvolveu-se um método quimiométrico de espectroscopia no infravermelho com Fourier transform near-infrared (FTIR) para prever a eficácia de sistemas conservantes em produtos farmacêuticos e cosméticos tópicos usando os conceitos de Quality by design (QbD) e Process Analytical Technology (PAT). A abordagem de QbD foi usada para determinar a eficácia antimicrobiana frente aos microrganismos: Candida albicans (ATCC 10231), Escherichia coli (ATCC 8739) e Staphylococcus aureus (ATCC 6538), em funções das concentrações de parabenos, e determinar a região de Design Space, empregando o delineamento de compóstio central (CCD) Todas as 15 formulações preparadas foram analisadas utilizando um espectrofotômetro (FTIR) equipado com aparato de Attenuated Total Reflectance (ATR). Os modelos de regressão por Partial Least Squares (PLS) para predição dos "slopes" das curvas de morte microbiana em função dos espectros ATR/FTIR foram bem ajustados, com R2 e R2-predição de 0,9937 e 0,8921, 0,9947 e 0,8783, e 0,9957 e 0,9222 para Candida albicans (ATCC 10231), Escherichia coli (ATCC 8739) e Staphylococcus aureus (ATCC 6538), respectivamente. O método FTIR proposto aplicado em uma abordagem de PAT foi capaz de prever a eficácia do sistema conservante em tempo reduzido. Este método de predição de silício permitirá um controle lote-a-lote da eficácia do sistema conservante de produtos farmacêuticos e cosméticos

Recently, pharmaceuticals and cosmetics with minimal concentrations of parabens and other preservatives have gained and commercial and safety appeal due to controversy over the safety of preservatives. However, the use of preservatives is essential to ensure the microbial conservation of cosmetic and pharmaceutical products during use. In this work, a chemometric method of infrared spectroscopy with Fourier transform (FTIR) was developed to predict the effectiveness of preservative systems in pharmaceutical products and topical cosmetics using the concepts of Quality by design (QbD) and Process Analytical Technology (PAT). The QbD approach was used to determine antimicrobial efficacy against candida albicans (ATCC 10231), Escherichia coli (ATCC 8739) and Staphylococcus aureus (ATCC) microorganisms 6538), in functions of paraben concentrations, and determine the Design Space region, employing the design of central composite (CCD). All 15 prepared formulations were analyzed using a spectrophotometer (FTIR) equipped with Attenuated Total Reflectance (ATR). The Partial Least Squares (PLS) regression models for the prediction of the slopes of microbial death curves as a function of ATR /FTIR spectra were well adjusted, with R2 and R2-prediction 0.9937 and 0.8921, 0.9947 and 0.8783, and 0.9957 and 0.9222 for Candida albicans (ATCC 10231), Escherichia coli (ATCC 8739) and Staphylococcus aureus (ATCC 6538)respectively. The proposed FTIR method applied in a PAT approach was able to predict the effectiveness of the preservative system in reduced time. This method in silico prediction will allow a batch-to-lot control of the effectiveness of the preservative system of pharmaceuticals and cosmetics

Toward in silico Identification of Tumor Neoantigens in Immunotherapy.

Cancer immunotherapy includes cancer vaccination, adoptive T cell transfer (ACT) with chimeric antigen receptor (CAR) T cells, and administration of tumor-infiltrating lymphocytes and immune-checkpoint blockade such as anti-CTLA4/anti-PD1 inhibitors that can directly or indirectly target tumor neoantigens and elicit a T cell response. Accurate, rapid, and cost-effective identification of neoantigens, however, is critical for successful immunotherapy. Here, we review computational issues for neoantigen identification by summarizing the various sources of neoantigens and their identification from high-throughput sequencing data. Several opinions are presented to inspire further discussions toward improving neoantigen identification. Continuing efforts are required to improve the sensitivity and specificity of bona fide neoantigens, taking advantage of the development of high-throughput sequencing techniques for effective and personalized cancer immunotherapy.

Development of a Patient Scheduling System for a Radio Diagnosis Department.

Health care organizations worldwide are constantly under pressure to deliver quality services. Reducing the waiting time of patients is considered to be a significant issue in hospitals. In this study, a radio-diagnosis department in a healthcare organization is considered. The present study mainly focuses on the queuing system of a computed tomography scan section of a public hospital in South India. Simulation is used as an aid to study the behavior of the system. This article also contributes a Visual Basic with Applications based excel tool to tackle the need for a user-friendly tool for scheduling the patients.

Simple and Rapid Creation of Customized 3-dimensional Printed Bolus Using iPhone X True Depth Camera.

PURPOSE: Three-dimensional printing has produced customized bolus during radiation therapy for superficial tumors along irregular skin surfaces. In comparison, traditional bolus materials are often difficult to manipulate for a proper fit. Current 3-dimensional printed boluses are made from either preexisting computed tomography scans or complex surface scanning methods. Herein, we introduce an inexpensive, convenient approach to generate a 3-dimensional printed bolus from surface scanning technology available in common smartphones. METHODS AND MATERIALS: A three-dimensional printed bolus was designed using surface scans from iPhone X true depth cameras and a low-cost 3-dimensional printer. The percentage density infill was adjusted to achieve tissue equivalence. To evaluate the clinical feasibility, fit against the skin surface and radiation dose distribution were compared with those of the traditional bolus. RESULTS: We fabricated a customized 3-dimensional printed bolus for different areas of the face using an iPhone X camera and inexpensive commercially available 3-dimensional printer. When printed at 100% density, the bolus material approximated soft tissue/water and provided an equivalent dose distribution to that found with standard bolus materials on direct comparison. The bolus material is inexpensive and produces an ideal fit with the scanned anatomy. CONCLUSIONS: We present a simplified method of highly customized bolus production that requires minimal experience with computer modeling programs and can be accomplished with an iPhone true depth camera.

Changing the way we train surgeons in the 21th century: A narrative comparative review focused on box trainers and virtual reality simulators.

The traditional method of acquiring surgical skills by observing and assisting in surgical procedures involving human beings has been challenged during the past several years. Lessons obtained from aviation suggested that the use of simulators is related to reduced costs, increased efficiency in performing certain tasks and above all safety. A shift in paradigm is also required in modern surgical training. The development of endoscopic surgery allowed for the incorporation of medical simulators into training programmes. A review of the literature was conducted using specific inclusion and exclusion criteria, for articles published up to July 31th, 2018. Relevant studies were identified using computerized bibliographic searches of MEDLINE database. The keywords that were used in various combinations were: "Medical Simulators", "Surgical Training", "Laparoscopy", "Surgical Skills", "Box trainers", "Virtual reality simulators", "Surgical Education". Surgical training with box trainers and/or virtual reality simulators confers a significant benefit in terms of surgical skills development, increases patient safety and reduces costs. Nevertheless, the use of virtual reality simulators was significantly more expensive. Simulation training allows trainees to learn from their mistakes, to repeat surgical tasks multiple times so as to establish muscle memory, and enhance skill competency with the aid of informative feedback. Simulators are necessary for the development of the skills required to meet the specific needs of endoscopic surgery in the 21st century. Teaching hospitals should introduce simulation training programmes in order to increase efficiency, reduce costs and improve patient safety. As medical advancements continue to transform the way we perform surgery day by day, simulation training will play a pivotal role in every surgical specialty.

Uso de la simulación en la enseñanza de la patología quirúrgica / Simulation as a teaching tool in Macroscopic and Microscopic Surgical Pathology / Uso de simulação no ensino de patologia cirúrgica macroscópica e microscópica

La enseñanza médica en el pregrado ha sufrido múltiples reformas con el fin de ajustarla a los nuevos retos que plantea esta disciplina en la actualidad. La patología no es ajena a estos cambios, los cuales se han reflejado en la disminución del tiempo dedicado a su enseñanza; al respecto, se han generado diversas opiniones que van desde proponer su completa eliminación de los currículos hasta darle mayor énfasis. La simulación como técnica de enseñanza no es un concepto nuevo en medicina y para el campo de la patología es una oportunidad para optimizar el tiempo de docencia, generar más estudio independiente entre los estudiantes y estimular el aprendizaje en las nuevas generaciones. En esta revisión se mostrarán los diferentes trabajos de simulación realizados en esta área.

Multiple reforms to undergraduate medical education have been carried out to fit to the new challenges posed by current medicine. Pathology is no stranger to these changes and has been reflected in the decrease in the time dedicated to its teaching, with such diverse opinions between completely eliminating pathology from undergraduate curricula or to give it greater emphasis. Simulation is not a new concept in medicine and for pathology is an opportunity to optimize teaching time, generate more independent study among students and stimulate learning to new generations. In this review we will show the different works that have been done in pathology simulation.

Teve várias reformas na educação médica de graduação para conseguir se ajustar aos novos desafios da medicina atual. A patologia não é estranha a essas mudanças e se refletiu na diminuição do tempo dedicado ao seu ensino, com opiniões tão diversas entre eliminar completamente a patologia dos currículos de graduação e dar-lhe maior ênfase. Simulação não é um conceito novo em Medicina e, para a patologia, é uma oportunidade de otimizar o tempo de ensino, gerar um estudo mais independente entre os alunos e estimular o aprendizado para as novas gerações. Nesta revisão, mostraremos os diferentes trabalhos que foram realizados em simulação em patologia.

Development of a validated computer-based preoperative predictive model for pseudarthrosis with 91% accuracy in 336 adult spinal deformity patients.

OBJECTIVEPseudarthrosis can occur following adult spinal deformity (ASD) surgery and can lead to instrumentation failure, recurrent pain, and ultimately revision surgery. In addition, it is one of the most expensive complications of ASD surgery. Risk factors contributing to pseudarthrosis in ASD have been described; however, a preoperative model predicting the development of pseudarthrosis does not exist. The goal of this study was to create a preoperative predictive model for pseudarthrosis based on demographic, radiographic, and surgical factors.METHODSA retrospective review of a prospectively maintained, multicenter ASD database was conducted. Study inclusion criteria consisted of adult patients (age ≥ 18 years) with spinal deformity and surgery for the ASD. From among 82 variables assessed, 21 were used for model building after applying collinearity testing, redundancy, and univariable predictor importance ≥ 0.90. Variables included demographic data along with comorbidities, modifiable surgical variables, baseline coronal and sagittal radiographic parameters, and baseline scores for health-related quality of life measures. Patients groups were determined according to their Lenke radiographic fusion type at the 2-year follow-up: bilateral or unilateral fusion (union) or pseudarthrosis (nonunion). A decision tree was constructed, and internal validation was accomplished via bootstrapped training and testing data sets. Accuracy and the area under the receiver operating characteristic curve (AUC) were calculated to evaluate the model.RESULTSA total of 336 patients were included in the study (nonunion: 105, union: 231). The model was 91.3% accurate with an AUC of 0.94. From 82 initial variables, the top 21 covered a wide range of areas including preoperative alignment, comorbidities, patient demographics, and surgical use of graft material.CONCLUSIONSA model for predicting the development of pseudarthrosis at the 2-year follow-up was successfully created. This model is the first of its kind for complex predictive analytics in the development of pseudarthrosis for patients with ASD undergoing surgical correction and can aid in clinical decision-making for potential preventative strategies.

Towards a Complete In Silico Assessment of the Outcome of Cochlear Implantation Surgery.

Cochlear implantation (CI) surgery is a very successful technique, performed on more than 300,000 people worldwide. However, since the challenge resides in obtaining an accurate surgical planning, computational models are considered to provide such accurate tools. They allow us to plan and simulate beforehand surgical procedures in order to maximally optimize surgery outcomes, and consequently provide valuable information to guide pre-operative decisions. The aim of this work is to develop and validate computational tools to completely assess the patient-specific functional outcome of the CI surgery. A complete automatic framework was developed to create and assess computationally CI models, focusing on the neural response of the auditory nerve fibers (ANF) induced by the electrical stimulation of the implant. The framework was applied to evaluate the effects of ANF degeneration and electrode intra-cochlear position on nerve activation. Results indicate that the intra-cochlear positioning of the electrode has a strong effect on the global performance of the CI. Lateral insertion provides better neural responses in case of peripheral process degeneration, and it is recommended, together with optimized intensity levels, in order to preserve the internal structures. Overall, the developed automatic framework provides an insight into the global performance of the implant in a patient-specific way. This enables to further optimize the functional performance and helps to select the best CI configuration and treatment strategy for a given patient.

Design considerations in clinical trials with cure rate survival data: A case study in oncology.

For clinical trials with time-to-event as the primary endpoint, the clinical cutoff is often event-driven and the log-rank test is the most commonly used statistical method for evaluating treatment effect. However, this method relies on the proportional hazards assumption in that it has the maximal power in this circumstance. In certain disease areas or populations, some patients can be curable and never experience the events despite a long follow-up. The event accumulation may dry out after a certain period of follow-up and the treatment effect could be reflected as the combination of improvement of cure rate and the delay of events for those uncurable patients. Study power depends on both cure rate improvement and hazard reduction. In this paper, we illustrate these practical issues using simulation studies and explore sample size recommendations, alternative ways for clinical cutoffs, and efficient testing methods with the highest study power possible.

Virtual Reality Surgical Simulation: Implications for Resection of Intracranial Gliomas.

Surgical simulation has the potential to play important roles in surgical training and preoperative planning. The advent of virtual reality (VR) with tactile haptic feedback has revolutionized surgical simulation, creating a novel environment for residents to learn manual skills without compromising patient safety. This concept is particularly relevant in neurosurgical training where the acquired skill set demands performance of technically challenging tasks under pressure and where the consequences of error are significant. The evolution of VR simulation is discussed here within the context of neurosurgical training and its implications for resection of intracranial gliomas. VR holds the promise of providing a useful educational tool for neurosurgical residents to hone their surgical skills and for neurosurgeons to rehearse specific segments of the surgery prior to the actual operation. Also discussed are several important issues related to simulation and simulation-based training that will need to be addressed before widespread adoption of VR simulation as a useful technology.

BrainFrame: a node-level heterogeneous accelerator platform for neuron simulations.

OBJECTIVE: The advent of high-performance computing (HPC) in recent years has led to its increasing use in brain studies through computational models. The scale and complexity of such models are constantly increasing, leading to challenging computational requirements. Even though modern HPC platforms can often deal with such challenges, the vast diversity of the modeling field does not permit for a homogeneous acceleration platform to effectively address the complete array of modeling requirements. APPROACH: In this paper we propose and build BrainFrame, a heterogeneous acceleration platform that incorporates three distinct acceleration technologies, an Intel Xeon-Phi CPU, a NVidia GP-GPU and a Maxeler Dataflow Engine. The PyNN software framework is also integrated into the platform. As a challenging proof of concept, we analyze the performance of BrainFrame on different experiment instances of a state-of-the-art neuron model, representing the inferior-olivary nucleus using a biophysically-meaningful, extended Hodgkin-Huxley representation. The model instances take into account not only the neuronal-network dimensions but also different network-connectivity densities, which can drastically affect the workload's performance characteristics. MAIN RESULTS: The combined use of different HPC technologies demonstrates that BrainFrame is better able to cope with the modeling diversity encountered in realistic experiments while at the same time running on significantly lower energy budgets. Our performance analysis clearly shows that the model directly affects performance and all three technologies are required to cope with all the model use cases. SIGNIFICANCE: The BrainFrame framework is designed to transparently configure and select the appropriate back-end accelerator technology for use per simulation run. The PyNN integration provides a familiar bridge to the vast number of models already available. Additionally, it gives a clear roadmap for extending the platform support beyond the proof of concept, with improved usability and directly useful features to the computational-neuroscience community, paving the way for wider adoption.

The game as strategy for approach to sexuality with adolescents: theoretical-methodological ections / El juego como estrategia de abordaje de la sexualidad en los adolescentes: exiones teórico-metodológicas / O jogo como estratégia para abordagem da sexualidade com adolescentes: reflexões teórico-metodológicas

ABSTRACT Objective: To describe the Papo Reto [Straight Talk] game and reflect on its theoretical-methodological basis. Method: Analytical study on the process of elaboration of the Papo Reto online game, destined to adolescents aged 15-18 years, with access to the Game between 2014 and 2015. Results: the interactions of 60 adolescents from Belo Horizonte and São Paulo constituted examples of the potentialities of the Game to favor the approach to sexuality with adolescents through simulation of reality, invention and interaction. Based on those potentialities, four thinking categories were discussed: the game as pedagogic device; the game as simulation of realities; the game as device for inventive learning; and the game empowering the interaction. Conclusion: By permitting that the adolescents take risks on new ways, the Game allows them to become creative and active in the production of senses, in the creation of their discourses and in the ways of thinking, feeling and acting in the sexuality field.

RESUMEN Objetivo: describir el juego Papo Reto, y aportar reflexiones desde sus bases teórico-metodológicas. Método: estudio de análisis sobre el proceso de elaboración del juego en línea Papo Reto, destinado a los adolescentes de 15 a 18 años, y que lo accedieron entre 2014 y 2015. Resultados: las interacciones de sesenta adolescentes de la ciudad de Belo Horizonte y São Paulo mostraron potencialidades de este juego en abordar la sexualidad en adolescentes a través de la simulación de realidades, creación e interacción. En base a estas potencialidades se han puestas en discusión cuatro categorías: el juego como herramienta pedagógica; como simulación de realidades; como herramienta de aprendizaje inventiva y como el que promueve la interacción. Conclusión: por permitir que los adolescentes se arriesguen en nuevos caminos, el juego les ayuda a convertirse en seres creativos activos en la producción de sentidos, en la creación de sus discursos y en las formas de pensar, sentirse y actuar en el tema de la sexualidad.

RESUMO Objetivo: descrever o jogo Papo Reto e refletir sobre suas bases teórico-metodológicas. Método: estudo analítico sobre o processo de elaboração do jogo on-line Papo Reto, destinado a adolescentes de 15 a 18 anos, com acesso ao Jogo entre 2014 e 2015. Resultados: as interações de 60 adolescentes de Belo Horizonte e de São Paulo constituíram exemplos das potencialidades do Jogo para favorecer a abordagem sobre sexualidade com adolescentes por meio da simulação de realidades, da invenção e da interação. Com base nessas potencialidades, quatro categorias reflexivas foram discutidas: o jogo como dispositivo pedagógico; como simulação de realidades; como dispositivo para a aprendizagem inventiva; e o jogo potencializa a interação. Conclusão: ao permitir que os adolescentes se arrisquem por novos caminhos, o Jogo possibilita que se tornem criativos ativos na produção de sentidos, na criação de seus discursos e nas formas de pensar, sentir e agir no campo da sexualidade.