Interaction Between Macrophages and Cryptococcus neoformans: Distinguishing Phagocytosed Versus External Fungi.

The interaction between macrophages and Cryptococcus neoformans is crucial in the pathogenesis of cryptococcosis. These phagocytes are important immune effectors, but also a niche in which facultative intracellular parasites, such as C. neoformans, thrive. Consequently, phagocytosis of cryptococcal cells and its outcomes are very frequently studied. One major issue with several of the tests used for this, however, is that macrophage-C. neoformans interaction does not always result in phagocytosis, as fungi may be attached to the external surface of the phagocyte. The most used methodologies to study phagocytosis of cryptococcal cells have varying degrees of precision in separating fungi that are truly internalized from those that are outside macrophages. Here we describe two assays to measure phagocytosis that can differentiate internal from external C. neoformans cells.

Aplicativos de apoio à educação sobre a segurança do paciente hospitalizado: uma prospecção tecnológica / Educational apps to support patient safety in hospitals: a technology perspective

OBJETIVO: Investigar os aplicativos móveis que foram desenvolvidos com a finalidade de orientar os profissionais, os pacientes e seus acompanhantes quanto às ações de segurança do paciente no contexto de hospitalização. MÉTODO: Prospecção tecnológica realizada nas lojas virtuais App Store e Google Play e na ferramenta de busca da Google, cujo critério de inclusão foi aplicativos voltados para segurança do paciente no contexto hospitalar sem limitação de recorte temporal. RESULTADOS: Foram incluídos e analisados no estudo 25 aplicativos. A maioria dos aplicativos eram móveis, desenvolvido em inglês, com ênfase para os profissionais de saúde. Ademais, tiveram como limitação, fragilidades relacionadas ao design e características lúdicas. CONCLUSÃO: O estudo pode contribuir para desenvolvimento de novos aplicativos para educação sobre a segurança do paciente, promovendo o aumento do engajamento nas ações de prevenção de erros.

OBJECTIVE: To examine mobile applications developed to guide healthcare professionals, patients, and their caregivers regarding patient safety interventions in the context of hospitalization. METHODS: A technological prospection was conducted in the virtual stores App Store and Google Play and through the Google search tool. Inclusion criteria included applications focused on patient safety in the context of hospitalization without temporal limitations. RESULTS: 25 applications were included in the study and analyzed. The Most applications were mobile, developed in English, and focused on healthcare professionals. In addition, they had limitations and weaknesses related to design and playful features. CONCLUSIONS: The study may contribute to developing of new patient safety education applications that promote increased engagement in error prevention interventions.

Psidium guajava L. phenolic compound-reinforced lamellar scaffold for tracheal tissue engineering.

The aim of this work was to develop a dense lamellar scaffold, as a biomimetic material with potential applications in the regeneration of tracheal tissue after surgical tumor resection. The scaffolds were produced by plastic compression technique, exploiting the use of total phenolic compounds (TPC) from Psidium guajava Linn as a potential cross-linking agent in a polymeric mixture based on collagen (COL), silk fibroin (SF), and polyethylene glycol 400 (PEG 400). Fourier transform infrared spectroscopy (FTIR) and differential scanning calorimetry (DSC) confirmed the chemical interactions between the polymers and the cross-linking of TPC between COL and SF. Morphological analyses showed scaffolds with porosity, interconnectivity, and a porous surface structure with a gyroid-like geometry. The analysis of the anisotropic degree resulted in anisotropic structures (0.1% TFC and 0.3% TFC) and an isotropic structure (0.5% TFC). In the mechanical properties, it was evidenced greater resistance for the 0.3% TFC formulation. The addition of TPC percentages did not result in a significant difference (p > 0.05) in swelling capacity and disintegration rate. The results confirmed that TPC were able to modulate the morphological, morphometric, and mechanical properties of scaffolds. Thus, this study describes a potential new material to improve the regeneration of major tracheal structures after surgical tumor removal.

Training to Analyze Functional Parameters with Fiberoptic Endoscopic Evaluation of Swallowing: A Scoping Review.

Analyzing fiberoptic endoscopic evaluation of swallowing (FEES) is challenging and requires training to ensure the proficiency of health professionals and improve reliability. This scoping review aims to identify and map the available evidence on training health professionals to analyze FEES functional parameters. The method proposed by the Joanna Briggs Institute and the PRISMA-ScR guidelines were followed. The search was performed in MEDLINE, Cochrane Library, Embase, Web of Science, Scopus, CINAHL databases, and in the gray literature. Two blinded independent reviewers screened articles by title and abstract. Then, they read the full text of the included reports, considering the eligibility criteria. Data were extracted using a standardized form. Six studies met the established eligibility criteria, published between 2009 and 2022, with few participants. All these studies addressed training as part of the process to validate a rating scale. No standardized criteria were observed regarding the selection of experts and participants, training structure, and outcome measures to assess participants' competence. The reviewed literature indicates that training must be developed to equip students and health professionals who treat dysphagia, enabling them to analyze the functional parameters of the FEES, considering variables that may influence the participants' performance.

Iron and aluminum ore mining pollution induce oxidative and tissue damage on fruit-eating bats from the Atlantic Forest.

Mining, a vital industry for economic growth, poses significant environmental pollution challenges. Failures in tailings dam containment have caused environmental contamination and raised concerns about preserving the globally significant biodiversity in the Atlantic Forest, which is under severe threat. Fruit-eating bats are key for forest regeneration as essential seed dispersers and pollinators. This study focuses on two keystone species, Artibeus lituratus and Sturnira lilium, exploring the effects of iron ore mining area (FEOA) and aluminum ore mining area (ALOA) on these bats, respectively, and comparing to individuals from a preserved Atlantic Forest fragment (FFA). Bats from FEOA showed higher Aluminum (Al), Calcium (Ca), Iron (Fe) and Barium (Ba) liver accumulation, as well as Ca and Fe muscle accumulation. These animals also showed higher liver and kidney oxidative damage associated with liver fibrosis and kidney inflammation. Brain and muscle also showed oxidative stress. Bats from ALOA showed higher Ca and Ba liver accumulation and Ca, Zinc (Zn), and Ba muscle accumulation, along with higher brain oxidative stress, liver fibrosis, and kidney inflammation. Our findings indicate that iron and aluminum ore mining activities cause adverse effects on bat tissues, posing a potential threat to biodiversity maintenance in the Atlantic Forest.

Technology for the treatment promotion of adults living with HIV: Positive o Cuidado (Positive the Care).

OBJECTIVES: to develop a responsive website focused on treatment adherence for adult users living with HIV. METHODS: technological study conducted between August and October 2020, in the light of Pierre Lévy's theoretical-philosophical framework, using the Double Diamond Process methodology associated with the five stages of The Elements of User Experience framework. RESULTS: it was developed the responsive website Positive Care (Positive o Cuidado), composed of an initial presentation screen and 13 other screens named: Family Health and You; Undetectable = Untransmissible; Antiretroviral Drugs; Routine Tests; Vaccination; Antiretroviral Delivery; Drug Interactions; Combined Prevention; Support Services; Healthy Life; Family and Reproductive Planning; Covid 19; and Questions, Curiosities, and Myths. FINAL CONSIDERATIONS: the responsive website was developed based on the software design and programming process and has requirements/functionalities with the potential to strengthen the collective intelligence about HIV and, consequently, to promote treatment adherence by its users.

Avaliação e intervenção responsiva e integrativa na criança com distúrbio alimentar pediátrico com Trissomia do 21: Relato de caso / Responsive and integrative assessment and intervention in children with pediatric feeding disorder with Trisomy 21: A case report / Evaluación e intervención receptiva e integradora en un niño con trastorno alimentario pediátrico con Trisomía 21: Reporte de caso

Na criança com Trissomia do 21 a dificuldade alimentar pode estar presente. Alguns sinais são as alterações na habilidade motora-oral, no processamento sensorial, tempo elevado das refeições, recusa alimentar prolongada e falta de autonomia. Ainda pouco se discute sobre as dificuldades alimentares e seu processo terapêutico nesta população. O objetivo deste estudo foi descrever a avaliação e intervenção fonoaudiológica e da terapia ocupacional na dificuldade alimentar de uma criança com Trissomia do 21 com o uso de estratégias de alimentação responsiva e integrativa. Criança 3 anos e 2 meses, sexo masculino. Avaliação fonoaudiológica demonstrou criança com distúrbio alimentar pediátrico, caracterizado por atraso na habilidade motora-oral, baixa percepção intraoral e comportamento alimentar altamente seletivo. Na avaliação da terapia ocupacional verificou-se perfil sensorial alterado. Na fonoterapia foram trabalhados aspectos como a percepção do alimento, ritmo e o tempo de alimentação. Na terapia ocupacional, o objetivo foi adequar nível de alerta, favorecer a independência e o desenvolvimento psicomotor. Após a intervenção, a reavaliação fonoaudiológica demonstrou que houve ampliação do cardápio, melhora da percepção, da habilidade motora intraoral, aceitação de diferentes utensílios e modos de apresentação do alimento, autonomia e prazer nas refeições. A reavaliação da terapia ocupacional mostrou um nível de alerta e atenção mais adequado, uso das mãos e dedos de maneira mais funcional para se alimentar. Foram observadas evoluções positivas em relação à intervenção fonoaudiológica e da terapia ocupacional na dificuldade alimentar de uma criança com Trissomia do 21 com o uso de estratégias de alimentação responsiva e integrativa. (AU)

In children with Trisomy 21 feeding difficulty can be observed, such as changes in oral motor skills, sensory processing, longer mealtimes, food refusal, lack of autonomy and others. However, there is little discussion about feeding difficulties and rehabilitation process in this population. This study aimed to describe speech-language and occupational therapy assessment and intervention in feeding difficulties in a 3-year and 2-month-old male child with a diagnosis of Trisomy 21. Speech-language pathology assessment found that the child had feeding difficulties, delay in oral motor skills, low intraoral perception and acceptance, while the occupational therapy assessment showed an altered sensory profile. The speech-language pathology sessions included aspects such as food perception, rhythm and feeding time. In turn, occupational therapy sessions aimed to adjust the alertness level, promote independence and psychomotor development. After the intervention, the speech-language pathology reassessment showed that there was an expansion of the menu for the ingestion, improvement in perception and intraoral motor skills, acceptance of different utensils and food presentation modes, autonomy and pleasure in meals. The reassessment of occupational therapy showed a better level of alertness and attention, more functional use of hands and fingers to eat. Therefore, a positive progress was observed in the feeding difficulty of a child with Trisomy 21 after a speech-language pathology and occupational therapy intervention with the use of responsive and integrative feeding strategies. (AU)

Niños con Trisomía 21, pueden presentar dificultades de alimentación. Algunos signos son cambios en las habilidades motrices orales, procesamiento sensorial, tiempos prolongados de comida, rechazo prolongado de alimentos y falta de autonomía. Hay poca discusión sobre las dificultades de alimentación y su proceso terapéutico en esta población. El objetivo deste estudio fue describir la evaluación e intervención fonoaudiológica y de terapia ocupacional en la dificultad de alimentación de un niño con Trisomía 21 utilizando estrategias de alimentación receptiva e integradora. Niño de 3 años y 2 meses. La evaluación fonoaudiológica mostró un trastorno alimentario pediátrico, caracterizado por un retraso en las habilidades motoras orales, percepción intraoral baja y comportamiento alimentario altamente selectivo. En la evaluación de terapia ocupacional se observó un perfil sensorial alterado. En fonoaudiología se trabajaron aspectos como la percepción de alimentos, ritmo y tiempo de alimentación. En terapia ocupacional, el objetivo fue ajustar el nivel de alerta, favoreciendo la independencia y desarrollo psicomotor. Después de la intervención, la reevaluación fonoaudiológica se evidenció una ampliación del menú, mejoras en percepción, motricidad intraoral, aceptación de diferentes utensilios y formas de presentar alimentos, autonomía y placer en las comidas. La reevaluación de terapia ocupacional mostró un nivel de alerta y atención más adecuado, uso de manos y dedos de forma más funcional para alimentarse. Fueron observadas evoluciones positivas con relación a la intervención fonoaudiológica y de terapia ocupacional en la dificultad de alimentación de un niño con Trisomía 21 con el uso de estrategias de alimentación receptiva e integradora. (AU)

The use of agitated saline as contrast agent in a contrast-enhanced cystosonography for detection of urinary bladder rupture in animal cadavers.

OBJECTIVE: To determine the value of microbubble contrast cystosonography in the diagnosis of bladder rupture in animals. DESIGN: Prospective, method comparison study from November 2019 to October 2020. SETTING: University teaching hospital. ANIMALS: Thirty-four ethically sourced cadavers of dogs, rats, and rabbits. INTERVENTIONS: In a prospective and blinded study, the cadavers were divided into 2 randomized groups: with bladder rupture (CR), and without bladder rupture (SR). Urinary catheterization was performed in all cadavers. Through the urethral catheter, bladders in CR group were ruptured using a rigid stainless steel guide wire. Microbubble contrast was infused into the bladder through the urethral catheter, while a single, blinded observer sonographically assessed the bladder. The time to diagnosis and the number of attempts needed for diagnosis were recorded. MEASUREMENTS AND MAIN RESULTS: The study included cadavers of 16 female Wistar rats, 6 female dogs, 11 male dogs, and 1 male rabbit. Time to diagnosis in dogs (2.25 ± 0.91 min) was statistically higher when compared to rats (1.15 ± 0.75 min; P = 0.03). Of the 34 cases, incorrect diagnosis of bladder rupture was made in only 2 dogs (6%), indicating a diagnostic sensitivity of 88.88%, specificity of 100%, and an accuracy of 94%. The positive predictive value was 1 and the negative predictive value was 0.9. CONCLUSIONS: Our study showed that the described method is accurate, sensitive, and specific for the detection of bladder rupture in animal cadavers of different species, size, and sex.

A randomized controlled trial to test the effectiveness of two technology-enhanced diabetes prevention programs in primary care: The DiaBEAT-it study.

Objective: To evaluate the effectiveness of two technology-enhanced interventions for diabetes prevention among adults at risk for developing diabetes in a primary care setting. Methods: The DiaBEAT-it study employed a hybrid 2-group preference (Choice) and 3-group randomized controlled (RCT) design. This paper presents weight related primary outcomes of the RCT arm. Patients from Southwest Virginia were identified through the Carilion Clinic electronic health records. Eligible participants (18 and older, BMI ≥ 25, no Type 2 Diabetes) were randomized to either Choice (n = 264) or RCT (n = 334). RCT individuals were further randomized to one of three groups: (1) a 2-h small group class to help patients develop a personal action plan to prevent diabetes (SC, n = 117); (2) a 2-h small group class plus automated telephone calls using an interactive voice response system (IVR) to help participants initiate weight loss through a healthful diet and regular physical activity (Class/IVR, n = 110); or (3) a DVD with same content as the class plus the same IVR calls over a period of 12 months (DVD/IVR, n = 107). Results: Of the 334 participants that were randomized, 232 (69%) had study measured weights at 6 months, 221 (66%) at 12 months, and 208 (62%) at 18 months. Class/IVR participants were less likely to complete weight measures than SC or DVD/IVR. Intention to treat analyses, controlling for gender, race, age and baseline BMI, showed that DVD/IVR and Class/IVR led to reductions in BMI at 6 (DVD/IVR -0.94, p < 0.001; Class/IVR -0.70, p < 0.01), 12 (DVD/IVR -0.88, p < 0.001; Class/IVR-0.82, p < 0.001) and 18 (DVD/IVR -0.78, p < 0.001; Class/IVR -0.58, p < 0.01) months. All three groups showed a significant number of participants losing at least 5% of their body weight at 12 months (DVD/IVR 26.87%; Class/IVR 21.62%; SC 16.85%). When comparing groups, DVD/IVR were significantly more likely to decrease BMI at 6 months (p < 0.05) and maintain the reduction at 18 months (p < 0.05) when compared to SC. There were no differences between the other groups. Conclusions: The DiaBEAT-it interventions show promise in responding to the need for scalable, effective methods to manage obesity and prevent diabetes in primary care settings that do not over burden primary care clinics and providers. Registration: https://clinicaltrials.gov/ct2/show/NCT02162901, identifier: NCT02162901.

Radiographic dental age estimation applying and comparing Demirjian's seven (1973) and four (1976) teeth methods.

To apply Demirjian's seven (1973, D7) and four (1976, D4) teeth methods in a sample of Brazilian children and compare their performances for age estimation. Panoramic radiographs of 1200 children (600 females and 600 males) were collected from Southeast Brazil. The children were equally distributed (n = 60 females and 60 males) between age intervals of 1 year between 6 and 15.9 (mean age = 10.9; standard deviation [SD]: 2.9) years. D7 and D4 dental age estimation methods were applied by two observers and were compared based on their error rates (error = estimated age-chronological age). Both methods overestimated the chronological age (p < 0.0001). D7 led to overestimations of 0.71 (p < 0.0001) in females and 0.83 (p < 0.0001) in males, while the overestimations with D4 were 0.14 (p = 0.0067) and 0.73 (p < 0.0001) for females and males, respectively. The mean age estimated by D7 was 11.7 (SD: 3.1) years, while for D4, it was 11.3 (SD: 3.3) years. Intra- and interobserver agreement was ≥ 0.98. D4 optimized the performance of radiographic dental age estimation compared to D7. Improvements were reflected in the total sample and separately for female and male children from Southeast Brazil.

Technology for the treatment promotion of adults living with HIV: Positive o Cuidado (Positive the Care) / Tecnología para la promoción del tratamiento de usuario adulto viviendo con VIH: Positiva el Cuidado / Tecnologia para a promoção do tratamento de usuário adulto vivendo com HIV: Positive o Cuidado

ABSTRACT Objectives: to develop a responsive website focused on treatment adherence for adult users living with HIV. Methods: technological study conducted between August and October 2020, in the light of Pierre Lévy's theoretical-philosophical framework, using the Double Diamond Process methodology associated with the five stages of The Elements of User Experience framework. Results: it was developed the responsive website Positive Care (Positive o Cuidado), composed of an initial presentation screen and 13 other screens named: Family Health and You; Undetectable = Untransmissible; Antiretroviral Drugs; Routine Tests; Vaccination; Antiretroviral Delivery; Drug Interactions; Combined Prevention; Support Services; Healthy Life; Family and Reproductive Planning; Covid 19; and Questions, Curiosities, and Myths. Final Considerations: the responsive website was developed based on the software design and programming process and has requirements/functionalities with the potential to strengthen the collective intelligence about HIV and, consequently, to promote treatment adherence by its users.

RESUMEN Objetivo: desarrollar sitio responsivo con enfoque en la adhesión al tratamiento de usuarios adultos viviendo con VIH. Métodos: estudio tecnológico realizado entre agosto y octubre de 2020, basado en el referencial teórico-filosófico de Pierre Lévy, usando la metodología Double Diamond Process relacionada a los cinco planes del framework The Elements of User Experience. Resultados: fue desarrollado el sitio responsivo "Positiva el Cuidado", compuesto por pantalla inicial de presentación y miás 13 pantallas denominadas: Salud de la familia y tú; Indétectable = Intransmisible; Medicaciones antirretrovirales; Exámenes de rutina; Vacunación; Entrega de antirretrovirales; Interacciones medicamentosas; Prevención combinada; Servicios de apoyo; Vida saludable; Planeamiento familiar y reproductivo; Covid-19; y Dudas, Curiosidad y Mitos. Consideraciones Finales: el sitio responsivo fue desarrollado basado en el proceso de diseño y programación del software y posee requisitos/funcionalidades con potencial de fortalecer la inteligencia colectiva acerca del VIH y, consecuentemente, promover la adhesión al tratamiento por sus usuarios.

RESUMO Objetivos: desenvolver site responsivo com foco na adesão ao tratamento de usuários adultos vivendo com HIV. Métodos: estudo tecnológico realizado entre agosto e outubro de 2020, à luz do referencial teórico-filosófico de Pierre Lévy, usando a metodologia Double Diamond Process associada aos cinco planos do framework The Elements of User Experience. Resultados: foi desenvolvido o site responsivo "Positive o Cuidado", composto por tela inicial de apresentação e mais 13 telas denominadas: Saúde da família e você; Indetectável = Intransmissível; Medicações antirretrovirais; Exames de rotina; Vacinação; Entrega de antirretrovirais; Interações medicamentosas; Prevenção combinada; Serviços de apoio; Vida saudável; Planejamento familiar e reprodutivo; Covid-19; e Dúvidas, Curiosidade e Mitos. Considerações Finais: o site responsivo foi desenvolvido com base no processo de design e programação do software e possui requisitos/funcionalidades com potencial de fortalecer a inteligência coletiva acerca do HIV e, consequentemente, promover a adesão ao tratamento por seus usuários.

Aplicativos móveis voltados ao preparo para procedimentos cirúrgicos: uma prospecção tecnológica / Mobile applications aimed at preparation for surgical procedures: a technological prospecting / Aplicaciones móviles para la preparación de procedimientos quirúrgicos: una prospección tecnológica

Objetivo: analisar as principais características dos aplicativos móveis, disponíveis em lojas virtuais, que tratam sobre a temática da realização de procedimentos cirúrgicos. Método: prospecção tecnológica, de abordagem qualitativa do tipo exploratória, realizada por busca de aplicativos nas lojas virtuais Apple Store ® e Google Play ®, utilizando as palavras-chave: Centro Cirúrgico, Cirurgia, Simulador de cirurgia e Jogos de cirurgia, em português, inglês e espanhol. Realizou-se análise temática categorial dos achados. Resultados: 67 ocorrências foram classificadas em quatro categorias: 'Aplicativos destinados à orientação para procedimento cirúrgico', 'Aplicativos sobre o trabalho em centro cirúrgico', 'Aplicativos voltados à equipe de saúde', e 'Aplicativos relacionados a jogos de entretenimento'. Conclusões: os aplicativos voltam-se tanto para indivíduos que buscam orientações sobre procedimentos, quanto a profissionais da área da saúde. No entanto, há uma lacuna referente à orientações pré-operatórias específicas para pediatria, onde nenhuma ocorrência foi registrada

Objective: to analyze the main characteristics of mobile applications available in virtual stores, which deal with performing surgical procedures. Method: technological prospection, with a qualitative exploratory approach, carried out by searching for applications in the Apple Store® and Google Play® virtual stores, using the keywords: Surgical Center, Surgery, Surgery Simulator, and Surgery Games, in Portuguese, English, and Spanish. We performed a categorical thematic analysis of the findings. Results: 67 occurrences were classified into four categories: 'Applications intended to guide the surgical procedure,' 'Applications about working in the operating room,' 'Applications aimed at the health team,' and 'Applications related to entertainment games. Conclusions: the applications are aimed both at individuals seeking procedure guidance and healthcare professionals. However, there is a gap regarding specific preoperative guidelines for pediatrics, where no occurrence was recorded

Objetivo: analizar las principales características de las aplicaciones móviles, disponibles en las tiendas virtuales, que tratan el tema de la realización de procedimientos quirúrgicos. Método: prospección tecnológica, con enfoque exploratorio cualitativo, realizada mediante la búsqueda de aplicaciones en las tiendas virtuales Apple Store® y Google Play®, utilizando las palabras clave: Centro Quirúrgico, Cirugía, Simulador de Cirugía y Juegos de Cirugía, en portugués, inglés y español. Se realizó un análisis temático categórico de los hallazgos. Resultados: 67 ocurrencias fueron clasificadas en cuatro categorías: 'Aplicaciones destinadas a orientar el procedimiento quirúrgico', 'Aplicaciones sobre el trabajo en quirófano', 'Aplicaciones dirigidas al equipo de salud' y 'Aplicaciones relacionadas con juegos de entretenimiento'. Conclusiones: las aplicaciones están dirigidas tanto a personas que buscan orientación sobre procedimientos como a profesionales de la salud. Sin embargo, existe un vacío con respecto a las pautas preoperatorias específicas para pediatría, donde no se registró ninguna ocurrencia

Nanotechnology-Based Dressings for Wound Management.

Wound healing is known to be a complicated and intricate process and commonly classified as chronic or acute. Patients with chronic wounds are of public health concern, and require more attention onto skin lesions, including atopic dermatitis. Despite being a natural process, healing can be impaired by existing chronic de diseases such as diabetes, for example. Recently, wound dressings based in nanotechnology systems have emerged as a viable option to improve the healing process. Current advances in nanotechnology-based systems to release growth factors and bioactive agents represent a great opportunity to develop new therapies for wound treatments. It is essential that healthcare professionals understand the key processes involved in the healing cascade, to maximize care with these patients and minimize the undesirable outcomes of non-healing wounds. Therefore, this review aims to summarize the healing process phases and provide a general overview of dressings based in nanotechnology using biomaterials for the release of active agents in wound site.

Students' perspective of the teaching-learning process of oral radiology before and during the COVID-19 pandemic.

The SARS-Cov-2 (COVID-19) pandemic changed the educational structure of dentistry courses and highlighted the importance of online tools. Understanding students' perception regarding these changes is essential to establishing future teaching-learning strategies to accommodate students' needs in higher education. The aim of this study was to assess students' perceptions of the Oral Radiology teachinglearning process before and during the COVID-19 pandemic. The sample consisted of students (n = 111) of the 2nd, 4th and 6th semesters of the dentistry course, who answered a questionnaire with 21 items: A) Students' demographic data (5 questions); B) Students' teaching-learning experiences during the pre-pandemic period (8 questions); and C) Students' teaching-learning experiences during the post-pandemic period (8 questions). Stuart-Maxwell tests revealed statistically significant differences between students' opinions before and during the pandemic when they were asked about the structure of the Oral Radiology module (p = 0.008); their previous experience with e-learning and teaching (p < 0.001); their thoughts about the importance of e-learning in Oral Radiology (p < 0.05); and the time they spent online for academic purposes (p < 0.05). Students seem to prefer on-campus activities (before COVID-19), but the pandemic increased their awareness of the importance of e-learning, the time they spent on online studies, and their knowledge of online educational tools.

A pandemia de SARS-Cov-2 (COVID-19) mudou a estrutura educacional dos cursos de odontologia e destacou a importância das ferramentas online. Compreender a percepção dos alunos sobre as mudanças vivenciadas é essencial para estabelecer futuras estratégias de ensino-aprendizagem e acomodar as necessidades dos alunos no ensino superior. Este estudo teve como objetivo avaliar a percepção dos alunos sobre o processo de ensino-aprendizagem de Radiologia Odontológica antes e durante a pandemia de COVID-19. A amostra foi composta por alunos (n = 111) do 2º, 4º e 6º semestres do curso de odontologia que responderam a um questionário com 21 itens: A) Dados demográficos dos alunos (5 questões); B) Experiências de ensino-aprendizagem dos alunos no período pré-pandemia (8 questões); e C) Experiências de ensino-aprendizagem dos alunos no período pós-pandemia (8 questões). Os testes de Stuart-Maxwell revelaram diferenças estatisticamente significativas entre as opiniões dos alunos antes e durante as pandemias quando questionados sobre a estrutura do módulo de Radiologia Odontológica (p = 0,008); sua experiência anterior com ensino a distância (p < 0,001); seus pensamentos relacionados à importância da Radiologia Odontológica via e-learning (p < 0,05); e o tempo gasto online para fins acadêmicos (p < 0,05). Os alunos parecem preferir atividades no campus (antes do COVID-19), mas as pandemias aumentaram sua conscientização sobre a importância do e-learning, seu tempo dedicado aos estudos online e sua familiarização com ferramentas educacionais online.

Students' perspective of the teaching-learning process of oral radiology before and during the COVID-19 pandemic / Perspectiva dos alunos sobre o processo de ensinoaprendizagem em radiologia odontológica antes e durante a pandemia de COVID-19

ABSTRACT The SARS-Cov-2 (COVID-19) pandemic changed the educational structure of dentistry courses and highlighted the importance of online tools. Understanding students' perception regarding these changes is essential to establishing future teaching-learning strategies to accommodate students' needs in higher education. The aim of this study was to assess students' perceptions of the Oral Radiology teachinglearning process before and during the COVID-19 pandemic. The sample consisted of students (n = 111) of the 2nd, 4th and 6th semesters of the dentistry course, who answered a questionnaire with 21 items: A) Students' demographic data (5 questions); B) Students' teaching-learning experiences during the pre-pandemic period (8 questions); and C) Students' teaching-learning experiences during the post-pandemic period (8 questions). Stuart-Maxwell tests revealed statistically significant differences between students' opinions before and during the pandemic when they were asked about the structure of the Oral Radiology module (p = 0.008); their previous experience with e-learning and teaching (p < 0.001); their thoughts about the importance of e-learning in Oral Radiology (p < 0.05); and the time they spent online for academic purposes (p < 0.05). Students seem to prefer on-campus activities (before COVID-19), but the pandemic increased their awareness of the importance of e-learning, the time they spent on online studies, and their knowledge of online educational tools.

RESUMO A pandemia de SARS-Cov-2 (COVID-19) mudou a estrutura educacional dos cursos de odontologia e destacou a importância das ferramentas online. Compreender a percepção dos alunos sobre as mudanças vivenciadas é essencial para estabelecer futuras estratégias de ensino-aprendizagem e acomodar as necessidades dos alunos no ensino superior. Este estudo teve como objetivo avaliar a percepção dos alunos sobre o processo de ensino-aprendizagem de Radiologia Odontológica antes e durante a pandemia de COVID-19. A amostra foi composta por alunos (n = 111) do 2º, 4º e 6º semestres do curso de odontologia que responderam a um questionário com 21 itens: A) Dados demográficos dos alunos (5 questões); B) Experiências de ensino-aprendizagem dos alunos no período pré-pandemia (8 questões); e C) Experiências de ensino-aprendizagem dos alunos no período pós-pandemia (8 questões). Os testes de Stuart-Maxwell revelaram diferenças estatisticamente significativas entre as opiniões dos alunos antes e durante as pandemias quando questionados sobre a estrutura do módulo de Radiologia Odontológica (p = 0,008); sua experiência anterior com ensino a distância (p < 0,001); seus pensamentos relacionados à importância da Radiologia Odontológica via e-learning (p < 0,05); e o tempo gasto online para fins acadêmicos (p < 0,05). Os alunos parecem preferir atividades no campus (antes do COVID-19), mas as pandemias aumentaram sua conscientização sobre a importância do e-learning, seu tempo dedicado aos estudos online e sua familiarização com ferramentas educacionais online.

Procedimentos que envolvem a cirurgia de crianças no período perioperatório: Revisão de escopo / Procedimientos que involucran la cirugía infantil en el periodo peroperatorio: Scope review / Procedures involving child surgery in the peroperative period: Scoping review

Objetivo: identificar os componentes necessários ao entendimento da criança quanto aos procedimentos e etapas que irá se deparar durante o período perioperatório. Método: revisão sistemática do tipo Revisão de Escopo. A busca foi realizada nas bases de dados: Sistema Latino-Americano e do Caribe de Informação em Ciências da Saúde (LILAC's), Scientific Eletronic Online (SciELO), SCOPUS, WEB OF SCIENCE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Base de Dados de Enfermagem (BDENF), com recorte temporal de 10 anos (2010 ­ 2019). Resultados: foram selecionados 16 estudos que descreviam as etapas da cirurgia, divididos em três: pré-operatório, intraoperatório e pós-operatório. Os estudos descreviam as etapas, os procedimentos e os materiais utilizados no centro cirúrgico, que poderiam ser percebidos pela criança. Conclusões: o objetivo foi alcançado e essas informações poderão ser exploradas para construção de materiais educativos voltados à orientação de crianças para o procedimento cirúrgico ou guiar profissionais e familiares. (AU)

Objective: To identify the components necessary for the child's understanding of the procedures and steps that will be encountered during the perioperative period. Method: systematic review of the Scoping Review. The search was performed on the databases: Latin American and Caribbean Health Sciences Information System (LILAC's), Scientific Electronic Online (SciELO), SCOPUS, WEB OF SCIENCE, Cumulative Index for Nursing and Allied Health Literature (CINAHL), Nursing Database (BDENF), with a 10-year time frame (2010 - 2019). Results: 16 studies were selected that described the stages of surgery, divided into three: preoperative, intraoperative and postoperative. The studies described the steps, procedures and materials used in the operating room, which could be perceived by the child Conclusions: the objective was achieved and this information can be used to build educational materials aimed at guiding children for the surgical procedure or guiding professionals and family members.(AU)

Objetivo: identificar los componentes necesarios para la comprensión del niño de los procedimientos y pasos que se encontrarán durante el período perioperatorio. Método: revisión sistemática del tipo Scoping Review. La búsqueda se realizó en las siguientes bases de datos: Sistema de Información de Ciencias de la Salud de América Latina y el Caribe (LILAC's), Scientific Electronic Online (SciELO), SCOPUS, WEB OF SCIENCE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Base de Datos de Enfermería ( BDENF), con un horizonte temporal de 10 años (2010 ­ 2019). Resultados: Se seleccionaron 16 estudios que describían las etapas de la cirugía, divididos en tres: preoperatorio, intraoperatorio y posoperatorio. Los estudios describieron los pasos, procedimientos y materiales utilizados en el quirófano, que podrían ser percibidos por el niño. Conclusiones: el objetivo fue alcanzado y esa información puede ser utilizada para la construcción de materiales educativos destinados a orientar a los niños para el procedimiento quirúrgico o orientar a los profesionales y familiares(AU)

Barreiras no acesso aos serviços de saúde por residentes de comunidades rurais: Revisão integrativa / Barreras en el acceso a los servicios de salud por parte de los residentes de comunidades rurales: Revisión integrativa / Barriers in access to health services by residents of rural communities: Integrative review

Objetivo: compreender as barreiras no acesso aos serviços de saúde por residentes de comunidades rurais. Método: Trata-se de uma revisão integrativa da literatura, realizada no período de agosto a novembro de 2021, nas bases de dados Scientific Eletronic Library Online, Medical Literature Analysis and Retrieval System Online e ScienceDirect. Resultados: A busca nas bases de dados resultou em um total de 44 artigos selecionados. Aplicados os critérios de inclusão e exclusão, foi elencado para análise, o total de 21 artigos os quais foram lidos na íntegra. Destes, 3 foram excluídos, pois não contemplaram o objeto abordado e 18 artigos foram selecionados para integrar este estudo. Conclusão: Foi possível compreender a estrutura de acesso aos serviços de saúde primários pela população residente de comunidades rurais, identificando as barreiras e dificuldades enfrentadas, permite prover e pensar em estratégias que minimizem os impactos sobre a saúde desta população(AU)

Objective: to understand the barriers in accessing health services by residents of rural communities. Method: This is an integrative literature review, carried out from August to November 2021, in the Scientific Electronic Library Online, Medical Literature Analysis and Retrieval System Online and ScienceDirect databases. Results: The search in the databases resulted in a total of 44 selected articles. After applying the inclusion and exclusion criteria, a total of 21 articles were listed for analysis, which were read in full. Of these, 3 were excluded, as they did not contemplate the object addressed and 18 articles were selected to integrate this study. Conclusion: It was possible to understand the structure of access to primary health services by the population residing in rural communities, identifying the barriers and difficulties faced, allowing to provide and think of strategies that minimize the impacts on the health of this population(AU)

Objetivo: comprender las barreras en el acceso a los servicios de salud por parte de los habitantes de las comunidades rurales. Método: Se trata de una revisión integrativa de la literatura, realizada de agosto a noviembre de 2021, en las bases de datos Scientific Electronic Library Online, Medical Literature Analysis and Retrieval System Online y ScienceDirect. Resultados: La búsqueda en las bases de datos arrojó un total de 44 artículos seleccionados. Después de aplicar los criterios de inclusión y exclusión, se listaron para su análisis un total de 21 artículos, los cuales fueron leídos en su totalidad. De estos, 3 fueron excluidos, por no contemplar el objeto abordado y 18 artículos fueron seleccionados para integrar este estudio. Conclusión: Fue posible comprender la estructura de acceso a los servicios primarios de salud por parte de la población residente en las comunidades rurales, identificando las barreras y dificultades enfrentadas, permitiendo brindar y pensar estrategias que minimicen los impactos en la salud de esta población(AU)

Formação de gestores públicos escolares à luz da reflexividade prática / Formación de gestores de escuelas públicas a la luz de la reflexividad práctica / Training of public-school managers in the light of practical reflexivity

Resumo O objetivo deste estudo é buscar a interpretação de experiências e dos significados atribuídos pelos gestores escolares durante seu processo de capacitação no contexto da formação continuada oferecida pelo Governo do Estado da Paraíba. Com base na participação num dos módulos de formação continuada de gestores escolares com 35 diretores e carga horária de 24 horas, utilizamos os elementos constituintes do diálogo reflexivo para compreender a formação de gestores escolares. Os resultados apontam para uma dissonância entre o conteúdo da formação em relação à realidade e demandas dos gestores escolares, criando um binômio teoria x prática. É possível também identificar os problemas políticos que envolvem a escolha dos diretores escolares e as consequências na prática de fazer gestão. A formação de gestores públicos, ancorada na reflexividade prática, pode ser considerada um mecanismo de contribuição para a gestão democrática.

Resumen El objetivo de este estudio es buscar una interpretación de las experiencias y significados atribuidos por los administradores escolares durante su formación en el contexto de educación permanente ofrecida por el Gobierno del Estado de Paraíba. Con base en la participación en uno de los módulos de formación continua para administradores escolares con 35 directores y una carga de trabajo de 24 horas, utilizamos los elementos constitutivos del diálogo reflexivo para comprender la formación de administradores escolares. Los resultados apuntan a una disonancia entre los contenidos formativos en relación con la realidad y demandas de los directivos, creando un binomio teoría-práctica. También es posible identificar los problemas políticos en torno a la elección de directores escolares y las consecuencias en la práctica del hacer. La formación de gestores públicos, anclada en la reflexividad práctica, puede ser considerada un mecanismo para contribuir a la gestión democrática.

Abstract This study seeks to interpret school managers' experiences and meanings during their training in a continuing education program offered by the government of the Brazilian state of Paraíba. The study used the constituent elements of reflexive dialogue to understand school managers' training, obtained through participant observation during a module of a continuing education program for school managers with 35 school principals and a workload of 24 hours. The results point to a dissonance between training content and the managers' demands and reality, creating a binomial theory vs. practice. It is also possible to identify the political problems around hiring school principals and the consequences of such a process in school management. The research concludes that the training of public managers anchored in practical reflexivity can be a mechanism to contribute to democratic management.

Anteromedial meniscofemoral ligament-A rare finding.

We report a case of a 49-year-old patient presenting an anteromedial meniscofemoral ligament (AMMFL) on both knees with a tear of this ligament in the left knee associated to a normal anterior cruciate ligament (ACL). The AMMFL is a relatively rare anatomic structure that may correspond to a variant of the ACL type anterior root insertion of the medial meniscus. The findings reported in the literature were in most part results of incidental situations. AMMFL can be visualized through magnetic resonance imaging (MRI) and arthroscopy.

Regulation and Use of Health Information Systems in Brazil and Abroad: Integrative Review.

There is increasing debate about the importance of using information and communication technologies to strengthen health systems. Information systems are one of the most widespread technologies for this end in different healthcare contexts. The primary objective of this study was to highlight and discuss the main characteristics of the regulation and use of health information systems in Brazil and abroad. As a secondary objective, the main characteristics identified in Brazil were compared with the findings for other countries. A robust search strategy incorporated five electronic databases. The research question was defined using the SPIDER strategy, and thematic content analysis was applied. Fourteen articles composed the final sample, and three analytic categories were identified: "Use in the Context of Health Systems"; "Implications for Health Management"; and "Communication and Interoperability." The regulation and use of health information systems in different countries was directly related to their socioeconomic context. In Latin America and Africa, policy strengthening and implementation possibilities for health management were discussed. In the United States, Europe, and Asia, the discussions on interoperability between different services was emphasized. The complexity of the Brazilian health system leads to similarities in the data analysis with several countries from different regions and with distinct political configurations.