Evaluation of massive education in prison health: a perspective of health care for the person deprived of freedom in Brazil.

Education, with an emphasis on prison health, has acted as a policy inducing changes in work processes, which the Brazilian National Health System (SUS) has used, and which is present in permanent health education, which promotes health care for people deprived of liberty. This article aims to present an analysis of the impacts of the strategy of massive education on prison health in Brazil from the perspective of health professionals and other actors operating in the Brazilian prison system. The data used in the study come from a questionnaire consisting of 37 questions applied nationwide between March and June 2022. Responses were collected from students who completed the course "Health Care for People Deprived of Freedom" of the learning pathway "Prison System", available in the Virtual Learning Environment of the Brazilian Health System (AVASUS). This course was offered nationally, whose adhesion (enrollment) occurred spontaneously, i.e., the course was not a mandatory. The data collected allowed us to analyze the impacts of massive education on prison health. The study also shows that the search for the course is made by several areas of knowledge, with a higher incidence in the health area, but also in other areas, such as humanities, which also work directly with the guarantee of the rights of people deprived of liberty, which are professionals in the areas of social work, psychology, and education. The analysis based on the data suggests that the massive education mediated by technology through the courses of the learning pathway, besides disseminating knowledge-following the action plan of the 2030 Agenda of the United Nations Educational, Scientific and Cultural Organization (UNESCO)-, are an effective tool to promote resilience in response to prison health and care demands of people deprived of liberty.

Massive health education through technological mediation: Analyses and impacts on the syphilis epidemic in Brazil.

With syphilis cases on the rise, Brazil declared an epidemic in 2016. To address the consequent public health crisis, the Ministry of Health laid out a rapid response plan, namely, the "Syphilis No!" Project (SNP), a national instrument to fight the disease which encompasses four dimensions: (a) management and governance, (b) surveillance, (c) comprehensive care, and (d) strengthening of educommunication. In the dimension of education, the SNP developed the learning pathway "Syphilis and other Sexually Transmitted Infections (STIs)" to strengthen and promote Health Education. This pathway features 54 Massive Open Online Courses (MOOCs), delivered through the Virtual Learning Environment of the Brazilian Health System (AVASUS). This paper analyzes the impacts of the learning pathway "Syphilis and other STIs" on the response to the epidemic in Brazil, highlighting the educational process of the learning pathway and its social implications from the perspective of the United Nations' 2030 Agenda and its Sustainable Development Goals. Three distinct databases were used to organize the educational data: the learning pathway "Syphilis and other STIs" from AVASUS, the National Registry of HealthCare Facilities from the Brazilian Ministry of Health (MoH), and the Brazilian Occupation Classification, from the Ministry of Labor. The analysis provides a comprehensive description of the 54 courses of the learning pathway, which has 177,732 enrollments and 93,617 participants from all Brazilian regions, especially the Southeast, which accounts for the highest number of enrollees. Additionally, it is worth noting that students living abroad also enrolled in the courses. Data characterization provided a demographic study focused on the course participants' profession and level of care practiced, revealing that the majority (85%) worked in primary and secondary healthcare. These practitioners are the target audience of the learning pathway and, accordingly, are part of the personnel directly engaged in healthcare services that fight the syphilis epidemic in Brazil.

The relevancy of massive health education in the Brazilian prison system: The course "health care for people deprived of freedom" and its impacts.

Introduction: Brazil has one of the largest prison populations globally, with over 682,000 imprisoned people. Prison health is a public health emergency as it presents increasingly aggravating disease rates, mainly sexually transmitted infections (STI). And this problem already affects both developed and developing nations. Therefore, when thinking about intervention strategies to improve this scenario in Brazil, the course "Health Care for People Deprived of Freedom" (ASPPL), aimed at prison health, was developed. This course was implemented in the Virtual Learning Environment of the Brazilian Health System (AVASUS). Given this context, this study analyzed the aspects associated with massive training through technological mediation and its impacts on prison health. Methods: This cross-sectional study analyzed data from 8,118 ASPPL course participants. The data analyzed were collected from six sources, namely: (i) AVASUS, (ii) National Registry of Health Care Facilities (CNES), (iii) Brazilian Occupational Classification (CBO), (iv) National Prison Department (DEPEN); (v) Brazilian Institute of Geography and Statistics (IBGE); and the (iv) Brazilian Ministry of Health (MoH), through the Outpatient Information System of the Brazilian National Health System (SIA/SUS). A data processing pipeline was conducted using Python 3.8.9. Results: The ASPPL course had 8,118 participants distributed across the five Brazilian regions. The analysis of course evaluation by participants who completed it shows that 5,190 (63.93%) reported a significant level of satisfaction (arithmetic mean = 4.9, median = 5, and standard deviation = 0.35). The analysis revealed that 3,272 participants (40.31%) are health workers operating in distinct levels of care. The prison system epidemiological data shows an increase in syphilis diagnosis in correctional facilities. Conclusions: The course enabled the development of a massive training model for various health professionals at all care levels and regions of Brazil. This is particularly important in a country with a continental size and a large health workforce like Brazil. As a result, social and prison health impacts were observed.

Evaluation of a protocol for rapid diagnosis of enterovirus associated with acute flaccid paralysis cases.

BACKGROUND: The virological surveillance of acute flaccid paralysis (AFP) is a critical component of the initiative of the World Health Organization (WHO) to eradicate poliomyelitis worldwide. Furthermore rapid methods are needed either to detect or rule out the presence of polioviruses during the late stages of eradication, especially in polio-free areas. OBJECTIVES: The aim of this study was to evaluate a fast protocol combining one passage (5 days) in cell culture followed by RT-PCR and molecular typing in order to detect and type poliovirus (PV) and other enteroviruses associated with AFP cases. STUDY DESIGN: A total of 216 fecal suspensions from AFP suspected cases were tested by using this approach and compared with the WHO gold standard. RESULTS: Using the WHO protocol enterovirus was detected in 12 out of the 216 AFP samples (5.55%) while with the proposed protocol enterovirus was detected in 15 out of the 216 AFP samples (6.94%). The additional positive samples detected by the proposed method were classified as non-polio enteroviruses (NPEV). CONCLUSIONS: The proposed protocol showed higher sensitivity than the WHO gold standard, reducing the entire process of identification and typing of the isolates from the typically 14-21 days to only approximately 6-8 days.

Effects of a tomato (Solanum lycopersicum) extract on the labeling of blood constituents with technetium-99m / Efeitos de um extrato de tomate (Solanum lycopersicum) na marcação de constituintes sangüíneos com tecnécio-99m

O tomate (Solanum lycopersicum) é o segundo vegetal mais produzido e consumido no mundo, tendo sido indicado para prevenção e tratamento de câncer, asma e arteriosclerose. Constituintes sangüíneos marcados com radionuclídeos têm sido usados em procedimentos na medicina nuclear. Dados têm mostrado que alimentos e drogas podem alterar a marcação de constituintes sangüíneos com tecnécio-99m (99mTc). Este estudo avaliou a influência de um extrato de tomate neste procedimento de radiomarcação. Sangue heparinizado (Wistar rats) foi incubado in vitro com diferentes concentrações de um extrato de tomate e a marcação com 99mTc foi realizada. Plasma (P) e células sangüíneas (CS) foram separadas permitindo o isolamento das frações solúvel (SF-P/SF-CS) e insolúvel (IF-P/IF-CS) por precipitação e centrifugação. A radioatividade nos constituintes sangüíneos (P, CS, IF-P, SF-P, IF-CS e SF-CS) foi determinada e a porcentagem de radioatividade ( por centoATI), calculada. O extrato de tomate usado, nas maiores concentrações (2,00 e 4,00g/mL), reduziu significativamente (p < 0,05) a por centoATI na IF-P, embora este extrato não tenha modificado a radiomarcação da CS e fixação da radioatividade na IF-CS. Em conclusão, nossos dados sugerem que os compostos químicos presentes no extrato aquoso de tomate teriam algumas propriedades capazes de alterar a fixação do 99mTc nas proteínas plasmáticas.

Tomato (Solanum lycopersicum) is the second most produced and consumed vegetable in the world. It has been indicated in the prevention and treatment of cancer, asthma and atherosclerosis. Blood constituents labeled with radionuclides have been used in procedures in nuclear medicine. Data have shown that food and drugs can alter the labeling of blood constituents with technetium-99m (99mTc). This study evaluated the influence of a tomato extract on this radiolabeling procedure. Heparinized blood (Wistar rats) was incubated in vitro with different concentrations of a tomato extract and 99mTc-labeling was performed. Plasma (P) and blood cells (BC) were separated following soluble (SF-P/SF-BC) and insoluble (IF-P/IF-BC) fractions isolation by precipitation and centrifugation. The radioactivities on blood constituents (P, BC, IF-P, SF-P, IF-BC and SF-BC) were determined and the percentage of radioactivity ( percentATI) was calculated. The tomato extract used at the highest concentrations (2.00 and 4.00g/mL), reduced significantly (p < 0.05) the percentATI in IF-P, although this extract did not modify the radiolabeling on BC, neither the radioactivity fixation on IF-BC. In conclusion, our data suggest that the chemical compounds present in the aqueous tomato extract could have some properties capable of change the fixation of 99mTc on plasma proteins.

Effect of barbatimão [Stryphnodendron adstringens (Mart. ) Coville] infusion on the labling of blood elements with technetium-99m

The Barbatimão is a tree which bark is rich in tannin. It is used on popular medicine as a wound healing agent, in the treatment of gastric lesions, as anti-leishmanial agent and as anti-inflammatory. Red blood cells (RBC) are labeled with technetium-99m (Tc-99m) and are utilized in many procedures in nuclear medicine. Some authors have reported that drugs (natural and synthetic) can alter the labeling of RBC with Tc-99m. This study evaluates the effect of barbatimão infusion on the labeling of red blood cells (RBC) and plasma (P) proteins with Tc-99m. Heparinized blood from Wistar rats was incubated with NaCl 0.9 percent as control and different concentrations of barbatimão infusion. Following the addition of stannous chloride (SnCl2), as reducing agent, and Tc-99m, as sodium pertechnetate, the blood samples were centrifuged. P and RBC were separated and were also precipitated with trichloroacetic acid 5 percent. Insoluble (IF-P and IF-RBC) fractions were isolated. The percentage of radioactivity in all the samples was determined. All the barbatimão infusion concentrations decreased the labeling of RBC, IF-P and IF-RBC. We can speculate that the barbatimão infusion interfered on the labeling of RBC due to the redox properties and/or it can also act as a chelator of the stannous ion.