Immunogenicity and safety of a 4th homologous booster dose of a SARS-CoV-2 recombinant spike protein vaccine (NVX-CoV2373): a phase 2, randomized, placebo-controlled trial

BackgroundThe emergence of SARS-CoV-2 variants has significantly reduced the efficacy of some approved vaccines. A fourth dose of NVX-CoV2373 (5{micro}g SARS-CoV-2 rS + 50{micro}g Matrix-M adjuvant) was evaluated to determine induction of cross-reactive antibodies to variants of concern. MethodsA phase 2 randomized study assessed a fourth dose of NVX-CoV2373 in adults 18-84 years of age (2-dose primary series followed by third and fourth doses at 6-month intervals). Local/systemic reactogenicity was assessed the day of vaccination and for 6 days thereafter. Unsolicited adverse events (AEs) were reported. Immunogenicity was measured before, and 14 days after, fourth dose administration using anti-spike neutralization assays against the ancestral SARS-CoV-2 strain and Omicron sublineages. Antigenic cartography assessed antigenic distances between ancestral and variant strains. ResultsAmong 1283 enrolled participants, 258 were randomized to receive the 2-dose primary series, of whom 104 received a third dose, and 45 received a fourth dose of NVX-CoV2373. The incidence of local/systemic reactogenicity events increased after the first three doses of NVX-CoV2373, and leveled off after dose four. Unsolicited AEs were reported in 9% of participants after dose 4 (none severe or serious). Neutralization antibody titers increased following booster doses. Antigenic cartography demonstrated reductions in antigenic distance between ancestral and variant SARS-CoV-2 strains with increased number of NVX-CoV2373 doses. ConclusionsA fourth dose of NVX-CoV2373 enhanced immunogenicity without increasing reactogenicity. Antigenic cartography demonstrated a more universal-like response against SARS-CoV-2 variants after a fourth dose of NVX-CoV2373, indicating that updates to the vaccine composition may not be warranted. Trial registration numberNCT04368988

Antiulcer and Antioxidant Activity of a Lectin from Mucuna pruriens Seeds on Ethanol- induced Gastropathy: Involvement of Alpha-2 Adrenoceptors and Prostaglandins.

ETHNOPHARMACOLOGICAL RELEVANCE: Mucuna pruriens (Mp) belongs to Leguminosae family, it is native of tropical regions and used to treat several maladies such as urinary, neurological, and menstruation disorders, constipation, edema, fever, tuberculosis, ulcers, diabetes, arthritis, dysentery, and cardiovascular diseases. Mp seeds are rich in bioactive compounds, for instance, lectins, a heterogeneous group of proteins and glycoproteins with a potential role as therapeutic tools for several conditions, including gastric disorders. This study investigated the acute toxicity, gastroprotective, and antioxidant activities of a lectin from Mucuna pruriens seeds (MpLec) on ethanol-induced gastropathy model in mice. MATERIAL AND METHODS: Mice received MpLec (5 or 10 mg/kg; i.v.) and were observed for acute toxicity signs; in another experimental series, mice were pre-treated with MpLec (0.001; 0.01 or 0.1 mg/kg, i.v.), ranitidine (80 mg/kg, p.o.), or saline (0.3 mL/30g, i.v.) before ethanol 99.9% (0.2 mL/animal, p.o.), and euthanized 30 min after ethanol challenge. Macroscopic and microscopic gastric aspects, biochemical parameters (tissue hemoglobin levels, iron-induced lipid peroxidation, GSH content, SOD activity, and gastric mucosal PGE2) were measured. Additionally, pharmacological tools (yohimbine, indomethacin, naloxone, L-NAME) were opportunely used to clarify MpLec gastroprotective mechanisms of action. RESULTS: No toxicity signs nor death were observed at acute toxicity tests. MpLec reduced ethanol-induced gastric damage, edema, and hemorrhagic patches formation, as well as decreased lipid peroxidation, SOD activity, and increased GSH content. Yohimbine and indomethacin prevented MpLec effects, suggesting the involvement of alpha-2 adrenoceptors and prostaglandins in the MpLec-mediated effects. CONCLUSION: MpLec does not present toxicity signs and shows gastroprotective and antioxidant activities via alpha-2 adrenoceptors and prostaglandins in the ethanol-induced gastropathy model.

Acute Kidney Injury after Cardiac Surgery in Patients Without Chronic Kidney Disease.

INTRODUCTION: Among patients undergoing cardiac surgery, the occurrence of acute renal injury appears to be associated with worse prognosis and increased mortality. The objective of this study was to evaluate risk factors and the impact this complication on mortality and survival after cardiac surgery among patients without chronic kidney disease. METHODS: In this retrospective study, we reviewed the medical records of 142 patients who underwent elective coronary artery bypass grafting, valve replacement (single or multiple), or both (simultaneously) at a tertiary care hospital. RESULTS: Among the 142 patients evaluated, the mean age was 58.28±13.87 years and 80 (56.33%) were female. The postoperative incidence of acute renal injury was 43.66%. Univariate analysis between the groups with and without acute renal injury revealed no significant differences, whereas multivariate analysis showed that risk factors for acute renal injury included valve replacement (OR=4.7, P=0.002, 95% CI=1.76-12.62, age (OR=1.044, P=0.012, 95% CI=1.01-1.07), previous cardiac surgery (OR=36.1, P=0.015, 95% CI=1.99-653.85), postoperative use of the vasoactive drug norepinephrine (OR=3.32, P=0.013, 95% CI=1.29-8.58) and dobutamine (OR=5.3, P=0.019, 95% CI=1.32-21.64). In our sample, there were 30 deaths, of which 25 had acute kidney injury. Survival was also lower among the patients with this complication, especially those who had required hemodialysis (OR=2.60, P<0.001, 95% CI=1.01-6.70) or had previously undergone cardiac surgery (OR=3.68, P<0.001, 95% CI=1.09-12.37). CONCLUSION: Our findings underscore the importance of identifying risk factors for developing acute renal injury after cardiac surgery, which can further the development of effective renoprotective strategies.

Capacitação do familiar cuidador na adesão à prevenção e ao controle da hipertensão arterial / Training of the family caregiver for adherence to prevention and control of arterial hypertension / Capacitación del cuidador familiar para la adhesión de la prevención y el control de la hipertensión arterial

OBJETIVO: Analisar o impacto de uma tecnologia educativa em saúde na capacitação do familiar cuidador no controle da hipertensão arterial e na prevenção do risco deste agravo. MÉTODOS: Pesquisa participante com a aplicação de uma Tecnologia Educativa em Saúde (TES) ­ Capacitação do familiar cuidador na adesão à prevenção e/ou controle da hipertensão arterial, com um grupo de oito familiares cuidadores (FC), de um Serviço de Assistência Domiciliar de um hospital público de Fortaleza, Ceará, realizada entre julho e outubro de 2016. RESULTADOS: Na primeira entrevista, observou-se que os FC revelaram algum conhecimento sobre hipertensão arterial (HA), modo de descoberta ou diagnóstico, fatores de risco, cronicidade e risco/gravidade. Após a aplicação da TES, ocorreu a apreensão do conhecimento acerca das condutas de controle da HA e de prevenção dos seus fatores de risco, embora de modo irregular sob os aspectos quantitativos e qualitativos em todas as condutas. As experiências vivenciadas pelos FC com a TES emergiram vários significados: incentivo para o autocuidado e para o cuidado do familiar; emponderamento para o cuidado; valorização da saúde; e adoção de hábitos saudáveis. CONCLUSÃO: A aplicação da TES com os familiares cuidadores promoveu o envolvimento no autocuidado, no cuidado na família e na comunidade, difundindo o saber construído.

OBJECTIVE: To analyze the impact of a health education technology on the training of the family caregiver for the control and prevention of arterial hypertension. METHODS: Participant observation was used along with a Health Education Technology (HET) ­ Training of the family caregiver for adherence to prevention and/or control of arterial hypertension ­ with a group of eight family caregivers (FC) of a Home Care Service of a public hospital in Fortaleza, Ceará, between July and October 2016. RESULTS: In the first interview, the FC demonstrated some knowledge about arterial hypertension (AH), discovery or diagnosis method, risk factors, chronicity and risk/severity. After the use of HET, they acquired knowledge about the conduct related to AH control and prevention of its risk factors; however, knowledge acquisition occurred in an irregular manner regarding the quantitative and qualitative aspects of the conduct. FC's experiences with the HET gave rise to several meanings: self-care and family care encouragement; empowerment for care; health enhancement; and adoption of healthy habits. CONCLUSION: The use of the HET with family caregivers promoted involvement in self-care, family care and community care, thus disseminating the knowledge built.

OBJETIVO: Analizar el impacto de una tecnología educativa en salud para la capacitación del cuidador familiar para el control de la hipertensión arterial y la prevención del riesgo de ese agravio. MÉTODOS: Investigación participante con la aplicación de una Tecnología Educativa en Salud (TES) ­ Capacitación del cuidador familiar para la adhesión de la prevención y/o del control de la hipertensión arterial con un grupo de ocho cuidadores familiares (CF) de un Servicio de Atención Domiciliaria de un hospital público de Fortaleza, Ceará, realizada entre julio y octubre de 2016. RESULTADOS: Se observó en la primera entrevista que los CF revelaron algún conocimiento sobre la hipertensión arterial (HA), el modo de descubrimiento del diagnóstico de la enfermedad, los factores de riesgo, la cronicidad y el riesgo/la gravedad. Después de la aplicación de la TES, se dio la aprensión del conocimiento sobre las conductas del control de la HA y de la prevención de sus factores de riesgo, aunque de modo irregular bajo los aspectos cuantitativos y cualitativos de todas las conductas. Emergieron varios significados de las experiencias vividas por los CF con las TES: el incentivo para el autocuidado y para el cuidado del familiar, el empoderamiento para el cuidado, la valorización de la salud y la adopción de hábitos saludables. CONCLUSIÓN: La aplicación de la TES con los cuidadores familiares promovió el envolvimiento para el autocuidado, el cuidado con la familia y la comunidad difundiendo el saber que ha sido construido.

Acute kidney injury after cardiac surgery in patients without chronic kidney disease

Abstract Introduction: Among patients undergoing cardiac surgery, the occurrence of acute renal injury appears to be associated with worse prognosis and increased mortality. The objective of this study was to evaluate risk factors and the impact this complication on mortality and survival after cardiac surgery among patients without chronic kidney disease. Methods: In this retrospective study, we reviewed the medical records of 142 patients who underwent elective coronary artery bypass grafting, valve replacement (single or multiple), or both (simultaneously) at a tertiary care hospital. Results: Among the 142 patients evaluated, the mean age was 58.28±13.87 years and 80 (56.33%) were female. The postoperative incidence of acute renal injury was 43.66%. Univariate analysis between the groups with and without acute renal injury revealed no significant differences, whereas multivariate analysis showed that risk factors for acute renal injury included valve replacement (OR=4.7, P=0.002, 95% CI=1.76-12.62, age (OR=1.044, P=0.012, 95% CI=1.01-1.07), previous cardiac surgery (OR=36.1, P=0.015, 95% CI=1.99-653.85), postoperative use of the vasoactive drug norepinephrine (OR=3.32, P=0.013, 95% CI=1.29-8.58) and dobutamine (OR=5.3, P=0.019, 95% CI=1.32-21.64). In our sample, there were 30 deaths, of which 25 had acute kidney injury. Survival was also lower among the patients with this complication, especially those who had required hemodialysis (OR=2.60, P<0.001, 95% CI=1.01-6.70) or had previously undergone cardiac surgery (OR=3.68, P<0.001, 95% CI=1.09-12.37). Conclusion: Our findings underscore the importance of identifying risk factors for developing acute renal injury after cardiac surgery, which can further the development of effective renoprotective strategies.

Qualification of the family caregiver to the application of the Educational Technology in Health.

OBJECTIVE: To evaluate the changes in the participation of the family caregiver in the treatment of the hypertensive person with the application of the Educational Technology in Health (ETH). METHOD: Participant research carried out in a Primary Health Care Unit with 11 family caregivers (FC). The ETH was elaborated based on health education and applied in ten meetings between June and August 2016. We organized the results into categories. RESULTS: FCs experienced learning experiences through the exchange of information, socialization of experiences, and linkage establishments. The FCs were encouraged to share their doubts and experiences, so that, supported by listening to the professional, they felt welcomed and determined to fulfill their role with hypertensive relatives. Final considerations: The changes that have taken place have been highlighted in the learning of FCs and their commitment to family and self-care, as well as to the conviction that the family environment is indicated to make these changes effective.

Qualification of the family caregiver to the application of the Educational Technology in Health / Capacitación del familiar cuidador con la aplicación de la Tecnología Educativa en Salud / Capacitação do familiar cuidador com a aplicação da Tecnologia Educativa em Saúde

ABSTRACT Objective: To evaluate the changes in the participation of the family caregiver in the treatment of the hypertensive person with the application of the Educational Technology in Health (ETH). Method: Participant research carried out in a Primary Health Care Unit with 11 family caregivers (FC). The ETH was elaborated based on health education and applied in ten meetings between June and August 2016. We organized the results into categories. Results: FCs experienced learning experiences through the exchange of information, socialization of experiences, and linkage establishments. The FCs were encouraged to share their doubts and experiences, so that, supported by listening to the professional, they felt welcomed and determined to fulfill their role with hypertensive relatives. Final considerations: The changes that have taken place have been highlighted in the learning of FCs and their commitment to family and self-care, as well as to the conviction that the family environment is indicated to make these changes effective.

RESUMEN Objetivo: Evaluar los cambios en la participación del familiar cuidador en el tratamiento de la persona hipertensa con la aplicación de la Tecnología Educativa en Salud (TES). Método: Encuesta participante realizada en una Unidad de Atención Primaria en Salud con 11 familiares cuidadores (FC). La TES ha sido elaborada basada en la educación en salud y aplicada en diez encuentros entre junio y agosto de 2016.Organizamos los resultados en categorías. Resultados: Los FCs vivenciaron experiencias de aprendizaje a cambio de informaciones, socialización de experiencias, y establecimientos de vínculos. Los FCs eran incentivados a compartir sus dudas y sus experiencias, de manera que, amparados por la escucha del profesional, ellos se sintiesen acogidos y determinados a cumplir su papel junto a los familiares hipertensos. Consideraciones finales: Los cambios ocurridos se destacaron en el aprendizaje de los FCs y en el compromiso de estos con el familiar y con el autocuidado, así como en la convicción de que el ambiente familiar es indicado a la efectividad de esos cambios.

RESUMO Objetivo: Avaliar as mudanças na participação do familiar cuidador no tratamento da pessoa hipertensa com a aplicação da Tecnologia Educativa em Saúde (TES). Método: Pesquisa participante realizada em uma Unidade de Atenção Primária em Saúde com 11 familiares cuidadores (FC). A TES foi elaborada baseada na educação em saúde e aplicada em dez encontros entre junho e agosto de 2016. Organizamos os resultados em categorias. Resultados: Os FCs vivenciaram experiências de aprendizagem pela troca de informações, socialização de experiências, e estabelecimentos de vínculos. Os FCs eram incentivados a compartilhar suas dúvidas e suas experiências, de modo que, amparados pela escuta do profissional, eles se sentissem acolhidos e determinados a cumprir seu papel junto aos familiares hipertensos. Considerações finais: As mudanças ocorridas se destacaram na aprendizagem dos FCs e no compromisso destes com o familiar e com o autocuidado, bem como na convicção de que o ambiente familiar é indicado à efetivação dessas mudanças.

Heme oxygenase-1/biliverdin/carbon monoxide pathway downregulates hypernociception in rats by a mechanism dependent on cGMP/ATP-sensitive K+ channels.

OBJECTIVE AND DESIGN: To investigate the role of heme oxygenase-1 (HO-1), carbon monoxide (CO), and biliverdin (BVD) in the zymosan-induced TMJ arthritis in rats. MATERIALS AND METHODS: Mechanical threshold was assessed before and 4 h after TMJ arthritis induction in rats. Cell influx, myeloperoxidase activity, and histological changes were measured in the TMJ lavages and tissues. Trigeminal ganglion and periarticular tissues were used for HO-1, TNF-α, and IL-1ß mRNA time course expression and immunohistochemical analyses. Hemin (0.1, 0.3, or 1 mg kg-1), DMDC (0.025, 0.25, or 2.5 µmol kg-1), biliverdin (1, 3, or 10 mg kg-1), or ZnPP-IX (1, 3 or 9 mg kg-1) were injected (s.c.) 60 min before zymosan. ODQ (12.5 µmol kg-1; s.c.) or glibenclamide (10 mg kg-1; i.p.) was administered 1 h and 30 min prior to DMDC (2.5 µmol kg-1; s.c), respectively. RESULTS: Hemin (1 mg kg-1), DMDC (2.5 µmol kg-1), and BVD (10 mg kg-1) reduced hypernociception and leukocyte migration, which ZnPP (3 mg kg-1) enhanced. The effects of DMDC were counteracted by ODQ and glibenclamide. The HO-1, TNF-α, and IL-1ß mRNA expression and immunolabelling increased. CONCLUSIONS: HO-1/BVD/CO pathway activation provides anti-nociceptive and anti-inflammatory effects on the zymosan-induced TMJ hypernociception in rats.

Analgesic and anti-inflammatory actions on bradykinin route of a polysulfated fraction from alga Ulva lactuca.

We investigated structural features of polysaccharides from Ulva lactuca and their effects on the classical models of nociception and inflammation. Crude extract was obtained by enzymatic digestion and isolated by ion exchange chromatography on DEAE-cellulose. The fraction with higher yield was used in the tests (SP-Ul). Swiss mice received SP-Ul (1, 3 or 9mg/kg; i.v.), 30min prior to injection of 0.8%-acetic acid or 1%-formalin or prior to a thermal stimulus. At same doses, SP-Ul was tested on Wistar rats on paw edema elicited by different irritants (carrageenan, dextran, bradykinin, histamine or serotonin). The results of infrared characterization indicated the presence of hydroxyl groups, sulfate, uronic acid and glycosidic linkages in all SP fractions spectrums. SP-Ul decreased significantly the antinociception in response to acetic acid or formalin (second phase), but not in the hot-plate test, suggesting that its analgesia occurs through a peripheral mechanism. SP-Ul did not reduce carrageenan-induced paw edema as supported by both histological and myeloperoxidase activity assessments. However, SP-Ul (1mg/kg; s.c.) reduced dextran-elicited edema, showing vascular anti-inflammatory effect, with bradykinin as major target because it did not reduce histamine- and serotonin-induced paw edemas. Therefore, SP-Ul acts on bradykinin pathway in its antinociceptive and anti-inflammatory responses.

Dual effects of a lectin from the green seaweed Caulerpa cupressoides var. lycopodium on inflammatory mediators in classical models of inflammation.

OBJECTIVE: Wide biotechnological investigations of only a limited number of seaweed lectins have been performed. We previously demonstrated the anti-nociceptive and anti-inflammatory effects of a lectin isolated from the green seaweed Caulerpa cupressoides var. lycopodium (CcL). Herein, we further studied the mechanisms of action of CcL. METHODS: Classical acute inflammation models induced by different flogistic agents were used to evaluate the anti-inflammatory action of CcL. CcL was injected locally into the rat paw to verify a possible pro-inflammatory outcome. RESULTS: CcL (0.1, 1 or 10 mg/kg; i.v.) reduced the carrageenan-induced rat paw edema and neutrophilic infiltration, which was not altered by either mucin (inhibitor of CcL carbohydrate-binding site) or ZnPP-IX (specific HO-1 inhibitor). Immunohistochemical analyses showed that CcL (1 mg/kg) reduced the expression of the cytokines IL-1ß, TNF-α, IL-6 and COX-2. CcL (0.1, 1 or 10 mg/kg) inhibited dextran, and CcL (1 mg/kg) inhibited histamine-induced rat paw edema. Both effects were reversed by mucin inhibition. CcL (1 mg/kg) was ineffective for the treatment of serotonin- and bradykinin-induced rat paw edema. When injected via the i.pl. route, CcL (10 mg/kg) elicited rat paw edema involving a wide range of mediators. CONCLUSIONS: The anti-inflammatory action of CcL involves the inhibition of IL-1ß, TNF-α, IL-6 and COX-2 expression and histamine H1 receptors. When locally administered, CcL exerts pro-inflammatory actions.

Mechanisms involved in the anti-inflammatory action of a polysulfated fraction from Gracilaria cornea in rats.

The anti-inflammatory mechanisms of the sulfated polysaccharidic fraction obtained from red marine alga Gracilaria cornea (Gc-FI) were investigated using a paw edema model induced in rats by different inflammatory agents (carrageenan, dextran, serotonin, bradykinin, compound 48/80 or L-arginine). Gc-FI at the doses of 3, 9 or 27 mg/kg, subcutaneously--s.c., significantly inhibited rat paw edema induced by carrageenan and dextran, as confirmed by myeloperoxidase and Evans' blue assessments, respectively. Gc-FI (9 mg/kg, s.c.) inhibited rat paw edema induced by histamine, compound 48/80 and L-arginine. Additionally, Gc-FI (9 mg/kg, s.c.) inhibited Cg-induced edema in animals with intact mast cells but did not inhibit that with degranulated mast cells by compound 48/80, revealing a protective role on mast cell membranes. Gc-FI down-regulated the IL-1ß, TNF-α and COX-2 mRNA and protein levels compared with those of the carrageenan group, based on qRT-PCR and immunohistochemistry analyses. After inhibition with ZnPP IX, a specific heme oxygenase-1 (HO-1) inhibitor, the anti-inflammatory effect of Gc-FI was not observed in Cg-induced paw edema, suggesting that the anti-inflammatory effect of Gc-FI is, in part, dependent on the integrity of the HO-1 pathway. Gc-FI can target a combination of multiple points involved in inflammatory phenomena.

Complicações obstétricas em adolescentes de uma maternidade / Obstetric complications in teens of a maternity

Objetivo: identificar as complicações obstétricas em adolescentes atendidas em uma maternidade. Método:trata-se de estudo documental, retrospectivo, realizado a partir da coleta de 45 prontuários do serviço dearquivo médico e estatístico (Same) do Hospital Regional de Cajazeiras, em março e abril de 2011. Os dadosforam analisados com enfoque no método quantitativo, o qual tende a enfatizar o raciocínio dedutivo, asregras da lógica e atributos mensuráveis de experiência humana. A pesquisa foi aprovada pelo Comitê de Éticaem Pesquisa da Faculdade Santa Maria (FSM), sob o CAAE n. 43102/2010. Resultados: 31,1% das adolescentesapresentaram bebês com baixo peso ao nascer; 22,2% com pré-eclampsia; 20% com prematuridade; 13,3% comruptura do colo do útero; e 8,8% com infecções urogenitais e eclampsia. Conclusão: diante dos achados, fazsenecessária uma melhor atuação dos profissionais e gestores de saúde, pois a adolescência é um desafiopara pais, educadores e profissionais da saúde e demanda, assim, apoio, compreensão, participação e diálogo.

[Educating a nurse for basic health care]. / A formação do enfermeiro para o cuidado na atenção básica à saúde.

This work aims at describing the experience of the 1st grade class in the Nursing Course at the Faculty of Medicine of Marilia (FAMEMA) in 2002. In 1998, a new Political-Pedagogical Project (PPP) was started aiming at educating a critical and reflexive professional, capable of teamwork, by promoting nursing care in a humane way. An integrated curriculum and the problematisation methodology were adopted as strategies to implement the PPP, tailoring education to the job market. Among the competencies to be developed toward basic health care, they employed a strategy to integrate 1st and 2nd grade classes in a microarea by applying the MAPP technique.

A formação do enfermeiro para o cuidado na atenção básica à saúde / Educating a nurse for basic health care / La formación del enfermero para el cuidado en la atención básica a la salud

O presente trabalho pretende relatar a experiência desenvolvida durante o ano de 2002, na 1ª série do Curso de Enfermagem da Faculdade de Medicina de Marília (FAMEMA). A partir de 1998 iniciou-se um novo Projeto Político-Pedagógico (PPP) que tem como objetivo formar um profissional generalista, crítico e reflexivo, capaz de trabalhar em equipe, promovendo cuidados de enfermagem de forma humanizada. Adotou-se como estratégias para implementação do PPP o currículo integrado e a Metodologia da Problematização, articulando a formação ao mundo do trabalho. Dentre as competências a serem desenvolvidas para atuarem na atenção básica à saúde, utilizou-se como estratégia a integração entre 1ª e 2ª séries em uma micro-área, aplicando a técnica do MAPP.

This work aims at describing the experience of the 1st grade class in the Nursing Course at the Faculty of Medicine of Marília (FAMEMA) in 2002. In 1998, a new Political-Pedagogical Project (PPP) was started aiming at educating a critical and reflexive professional, capable of teamwork, by promoting nursing care in a humane way. An integrated curriculum and the problematisation methodology were adopted as strategies to implement the PPP, tailoring education to the job market. Among the competencies to be developed toward basic health care, they employed a strategy to integrate 1st and 2nd grade classes in a microarea by applying the MAPP technique.

El presente trabajo pretende relatar la experiencia desarrollada durante el 2002, en la 1ª serie del Curso de Enfermería de la Facultad de Medicina de Marília. En 1998 empezó un nuevo Proyecto Político-Pedagógico (PPP) que tiene como objetivo formar un profesional generalista, crítico y reflexivo, capaz de trabajar en equipo y promover cuidados de enfermería de forma humanizada. Se adoptó como estrategia para implementar el PPP el currículo integrado y la Metodología de la Problematización, articulando la formación al mundo del trabajo. Entre las competencias que se deben desarrollar para que el enfermero actúe en la atención básica a la salud, se utilizó hacer una integración entre la 1ª y la 2ª series en una micro área, aplicando la técnica del MAPP.

Desenvolvimento e aprendizagem da crianca

Os autores abordam diferentes concepcao metateoricas e teorias sobre o processo de desenvolvimento e aprendizagem da crianca e fazem uma reflexao sobre suas repercussoes na pratica pedagogica. Demarcam, ainda, o modelo e a teoria que parecem mais adequados ao estabelecimento de uma proposta pedagogica promotora do processo de desenvolvimento e aprendizagem. Enfatizam, tambem, que as propostas voltadas para a crianca pre-escolar no Brasil, tem sido assistematicas, desiguais e insuficientes para demarcar o carater educativo (ditado pela Constituicao), contribuindo para um crescente processo de reproducao da seletividade social. Faz-se necessario, portanto, que os debates entre o Estado e a sociedade civil continuem cada vez mais presentes.