Prior knowledge of students: essential aspects that a nursing expert professor identifies, interprets, and organizes to foster learning.

Objective: To analyze the essential aspects that the nursing expert professor identifies, interprets, and organizes during classroom dialogic processes with students to foster their learning. Methods: Qualitative study, part of a multicenter study, which used ethnography of communication specifically from a micro-ethnographic approach. An expert professor from the Faculty of Nursing at a public university in Medellín, Colombia, was selected for the study. The fieldwork was done in three stages: 1:non-participant observations in two in-person classes of the Morphophysiology course recorded on video from two different perspectives (one focusing on the professor and another on the students); 2:think-aloud interviews with the professor and five students (three from the first class and two from the second) who spontaneously started more than two communicative interactions with the professor during the classes; and 3:parallel transcriptions, organized in didactic sequences (videos). The analysis was supported by the unit Student-Professor (identification-evaluation-answer) Student [S-P(i-e-a)S'], and by continuous comparisons of the data. Results: Four categories were identified: 1: Identification of essential aspects: importance of prior knowledge, 2: Interpretation: connection between essential aspects and students' mental processes, 3: Organization of the answer: connection between prior knowledge and new knowledge, and: 4: Synchronization with the learning needs of the students, which were grouped in a meta-category: Prior knowledge of the students: essential aspects for learning. Conclusion: Students' experiential prior knowledge constitutes the essential aspects identified, interpreted, and organized by the expert professor to achieve significant learning.

Prior knowledge of students: essential aspects that a nursing expert professor identifies, interprets, and organizes to foster learning / Saberes previos de los estudiantes: aspectos esenciales que un docente experto en enfermería identifica, interpreta y organiza para favorecer el aprendizaje / Conhecimento prévio dos alunos: aspectos essenciais que um professor especialista em enfermagem identifica, interpreta e organiza para promover a aprendizagem

Objective. To analyze the essential aspects that the nursing expert professor identifies, interprets, and organizes during classroom dialogic processes with students to foster their learning. Methods. Qualitative study, part of a multicenter study, which used ethnography of communication specifically from a micro-ethnographic approach. An expert professor from the Faculty of Nursing at a public university in Medellín, Colombia, was selected for the study. The fieldwork was done in three stages: 1)non-participant observations in two in-person classes of the Morphophysiology course recorded on video from two different perspectives (one focusing on the professor and another on the students); 2)think-aloud interviews with the professor and five students (three from the first class and two from the second) who spontaneously started more than two communicative interactions with the professor during the classes; and 3)parallel transcriptions, organized in didactic sequences (videos). The analysis was supported by the unit Student-Professor (identification-evaluation-answer) Student [S-P(i-e-a)S ́], and by continuous comparisons of the data. Results. Four categories were identified: 1) Identification of essential aspects: importance of prior knowledge, 2) Interpretation: connection between essential aspects and students' mental processes, 3) Organization of the answer: connection between prior knowledge and new knowledge, and: 4) Synchronization with the learning needs of the students, which were grouped in a meta-category: Prior knowledge of the students: essential aspects for learning. Conclusion. Students' experiential prior knowledge constitutes the essential aspects identified, interpreted, and organized by the expert professor to achieve significant learning.

Objetivo. Analizar los aspectos esenciales que el docente experto en enfermería identifica, interpreta y organiza durante los procesos dialógicos con los estudiantes en el aula para favorecer su aprendizaje. Métodos. Estudio cualitativo, parte de un estudio multicéntrico, que utilizó la etnografía de la comunicación desde un abordaje micro-etnográfico. Se seleccionó un docente experto de una Facultad de Enfermería de una universidad pública de Medellín, Colombia. El trabajo de campo se desarrolló en tres momentos: 1) observaciones no participantes en dos clases presenciales del curso de morfofisiología grabadas en video en dos planos (uno enfocando al profesor, y el otro, a los estudiantes); 2) entrevistas Think-Aloud Protocol (método de pensamiento en voz alta) al docente y a cinco estudiantes (tres de la primera clase y dos de la segunda) que iniciaron espontáneamente más de dos interacciones con el docente durante las clases; y 3) transcripciones paralelas, organizadas en secuencias didácticas (videos). El análisis se apoyó en la unidad [E-P(i-e-r)E ́] (Estudiante-Profesor (identificación-evaluación-respuesta) Estudiante ́) y en comparaciones constantes de los datos. Resultados. Emergieron cuatro categorías: 1) Identificación de aspectos esenciales: importancia de los saberes previos, 2) Interpretación: articulación de los aspectos esenciales y los procesos mentales del estudiantado, 3) Organización de la respuesta: conexión entre saberes previos y el nuevo conocimiento, y: 4) Sintonización con las necesidades de aprendizaje del estudiantado; las que fueron agrupadas en una meta-categoría: Saberes previos del estudiante: aspectos esenciales para el aprendizaje. Conclusión.Los saberes previos experienciales de los estudiantes se constituyen en los aspectos esenciales identificados, interpretados y organizados por el profesor experto, para el logro de aprendizajes significativos.

Objetivo. Analisar os aspectos essenciais que o professor especialista em enfermagem identifica, interpreta e organiza durante os processos dialógicos com os alunos em sala de aula para promover sua aprendizagem. Métodos. Estudo qualitativo, parte de um estudo multicêntrico, que utilizou a etnografia da comunicação a partir de uma abordagem microetnográfica. Foi selecionada uma professora especialista da Faculdade de Enfermagem de uma universidade pública de Medellín, Colômbia. O trabalho de campo foi desenvolvido em três momentos: 1) observações não participantes em duas aulas presenciais do curso de morfofisiologia gravadas em vídeo em dois planos (um focado no professor, e outro, nos alunos); 2) Entrevistas do Protocolo Think-Aloud com a professora e cinco alunos (três da primeira turma e dois da segunda) que iniciaram espontaneamente mais de duas interações com a professora durante as aulas; e 3) transcrições paralelas, organizadas em sequências didáticas (vídeos). A análise baseou-se na unidade [E-P(i-e-r)E ́] (Aluno-Professor (identificação-avaliação-resposta) Aluno ́) e em comparações constantes dos dados. Resultados. Emergiram quatro categorias: 1) Identificação dos aspectos essenciais: importância do conhecimento prévio, 2) Interpretação: articulação dos aspectos essenciais e dos processos mentais do aluno, 3) Organização da resposta: conexão entre conhecimentos prévios e novos conhecimentos, e: 4) Sintonia com as necessidades de aprendizagem do corpo discente; que foram agrupados em uma metacategoria: Conhecimentos prévios do aluno: aspectos essenciais para a aprendizagem. Conclusão. O conhecimento experiencial prévio dos alunos constitui os aspectos essenciais identificados, interpretados e organizados pelo professor especialista, para a obtenção de uma aprendizagem significativa.

Safety and Pharmacokinetics of a Combined Antioxidant Therapy against Myocardial Reperfusion Injury: A Phase 1 Randomized Clinical Trial in Healthy Humans.

Myocardial reperfusion injury (MRI) accounts for up to 50% of the final size in acute myocardial infarction and other conditions associated with ischemia-reperfusion. Currently, there is still no therapy to prevent MRI, but it is well known that oxidative stress has a key role in its mechanism. We previously reduced MRI in rats through a combined antioxidant therapy (CAT) of ascorbic acid, N-acetylcysteine, and deferoxamine. This study determines the safety and pharmacokinetics of CAT in a Phase I clinical trial. Healthy subjects (n = 18) were randomized 2:1 to CAT or placebo (NaCl 0.9% i.v.). Two different doses/infusion rates of CATs were tested in a single 90-minute intravenous infusion. Blood samples were collected at specific times for 180 minutes to measure plasma drug concentrations (ascorbic acid, N-acetylcysteine, and deferoxamine) and oxidative stress biomarkers. Adverse events were registered during infusion and followed for 30 days. Both CAT1 and CAT2 significantly increased the CAT drug concentrations compared to placebo (P < .05). Most of the pharmacokinetic parameters were similar between CAT1 and CAT2. In total, 6 adverse events were reported, all nonserious and observed in CAT1. The ferric-reducing ability of plasma (an antioxidant biomarker) increased in both CAT groups compared to placebo (P < .001). The CAT is safe in humans and a potential treatment for patients with acute myocardial infarction undergoing reperfusion therapy.

Integrated approach to reducing polypharmacy in older people: exploring the role of oxidative stress and antioxidant potential therapy.

Increased life expectancy, attributed to improved access to healthcare and drug development, has led to an increase in multimorbidity, a key contributor to polypharmacy. Polypharmacy is characterised by its association with a variety of adverse events in the older persons. The mechanisms involved in the development of age-related chronic diseases are largely unknown; however, altered redox homeostasis due to ageing is one of the main theories. In this context, the present review explores the development and interaction between different age-related diseases, mainly linked by oxidative stress. In addition, drug interactions in the treatment of various diseases are described, emphasising that the holistic management of older people and their pathologies should prevail over the individual treatment of each condition.

Reducción, reutilización y reciclaje: Una revisión crítica del conocimiento científico sobre las pérdidas y desperdicios de alimentos en Chile

Reducir, reutilizar y reciclar, "regla de las tres R", son estrategias que promueven una actitud responsable hacia el medioambiente y contribuyen al desarrollo sostenible. El objetivo de esta revisión fue analizar las publicaciones científicas generadas en Chile en el área de las pérdidas y desperdicios de alimentos (PDA), con enfoque en su cuantificación y basadas en "la regla de las tres R". Se realizó una búsqueda de literatura en tres bases de datos: Web of Science, Pubmed y Scopus. Los artículos originales seleccionados se clasificaron según tipo de acción, etapa de la cadena de suministro de alimentos, grupo de alimentos, cuantificación de PDA y tipo de estrategia (reducción, reutilización o reciclaje). Se encontraron 5 artículos de revisión y 31 artículos originales. La revalorización de subproductos agroindustriales fue la principal acción involucrada en los estudios de PDA (n= 22). El tipo de subproducto también fue analizado, y se encontró que los compuestos fenólicos provenientes de frutales son los más estudiados. Solo el 32% (12/31) de los artículos reportaron información sobre cuantificación de PDA. La revalorización de subproductos sumada a la recuperación de alimentos para producción de energía (n= 4) y de compostaje (n= 2) hacen que el reciclaje sea la estrategia más investigada. Estos antecedentes evidencian la necesidad de complementar la investigación nacional a nivel de acciones que apunten más hacia la reducción y reutilización de PDA y su cuantificación. Este conocimiento permitirá establecer líneas base y planes de monitoreo que contribuyan al cumplimiento de los Objetivos de Desarrollo Sostenible en Chile.

Reduce, reuse, and recycle "the 3Rs rule" are strategies that promote a responsible attitude towards the environment and contribute to sustainable development. The objective of this review was to analyze the scientific publications generated in Chile in the area of food loss and waste (FLW), with a focus on its quantification and based on "the 3Rs rule". A literature search was carried out in three databases: Web of Science, Pubmed, and Scopus. The selected original articles were classified according to the type of action, stage of the food supply chain, food group, FLW quantification, and type of strategy (reduction, reuse, or recycling). Five review articles and 31 original articles were found. The revalorization of agro-industrial by-products was the main initiative involved in the FLW studies (n= 22). The type of by-product was also analyzed, and it was found that the phenolic compounds from fruits are the most studied. Only 32% (12/31) of the articles reported information on FLW quantification. The revalorization of by-products added to food recovery for energy production (n= 4) and composting (n= 2) make recycling the most researched strategy. These antecedents show the need to complement the national research at the level of actions that point more towards reducing and reusing of FLW and its quantification. This knowledge will allow the establishment of baselines and monitoring plans that contribute to the fulfillment of the Sustainable Development Goals in Chile.

Endostatin and Cancer Therapy: A Novel Potential Alternative to Anti-VEGF Monoclonal Antibodies.

Angiogenesis is a physiological process that consists of the formation of new blood vessels from preexisting ones. Angiogenesis helps in growth, development, and wound healing through the formation of granulation tissue. However, this physiological process has also been linked to tumor growth and metastasis formation. Indeed, angiogenesis has to be considered as a fundamental step to the evolution of benign tumors into malignant neoplasms. The main mediator of angiogenesis is vascular endothelial growth factor (VEGF), which is overexpressed in certain cancers. Thus, there are anti-VEGF monoclonal antibodies, such as bevacizumab, used as anti-cancer therapies. However, bevacizumab has shown adverse events, such as hypertension and proteinuria, which in the most severe cases can lead to cessation of therapy, thus contributing to worsening patients' prognosis. On the other hand, endostatin is an endogenous protein that strongly inhibits VEGF expression and angiogenesis and shows a better safety profile. Moreover, endostatin has already given promising results on small scale clinical studies. Hence, in this review, we present data supporting the use of endostatin as a replacement for anti-VEGF monoclonal antibodies.

Antioxidant Protection against Trastuzumab Cardiotoxicity in Breast Cancer Therapy.

Breast cancer is the most frequent malignant neoplastic disease in women, with an estimated 2.3 million cases in 2020 worldwide. Its treatment depends on characteristics of the patient and the tumor. In the latter, characteristics include cell type and morphology, anatomical location, and immunophenotype. Concerning this latter aspect, the overexpression of the HER2 receptor, expressed in 15-25% of tumors, is associated with greater aggressiveness and worse prognosis. In recent times some monoclonal antibodies have been developed in order to target HER2 receptor overexpression. Trastuzumab is part of the monoclonal antibodies used as targeted therapy against HER2 receptor, whose major problem is its cardiac safety profile, where it has been associated with cardiotoxicity. The appearance of cardiotoxicity is an indication to stop therapy. Although the pathophysiological mechanism is poorly known, evidence indicates that oxidative stress plays a fundamental role causing DNA damage, increased cytosolic and mitochondrial ROS production, changes in mitochondrial membrane potential, intracellular calcium dysregulation, and the consequent cell death through different pathways. The aim of this review was to explore the use of antioxidants as adjuvant therapy to trastuzumab to prevent its cardiac toxicity, thus leading to ameliorate its safety profile in its administration.

Spanish version of the readiness for interprofessional learning scale (RIPLS) in an undergraduate health sciences student context.

The Readiness for Interprofessional Learning Scale (RIPLS) has been widely used to measure students' and professionals' attitudes toward interprofessional learning. However, inconsistencies have been reported concerning its validity and reliability. This study aimed to translate, adapt, and validate the RIPLS questionnaire to be applied to Spanish-speaking health sciences students in Chile. Content and construct validity evidence of the newly created Spanish version of the RIPLS scale were analyzed. An exploratory (EFA) and confirmatory (CFA) analysis were conducted, determining goodness-of-fit indexes. Reliability was evaluated through Cronbach's Alpha Coefficient. We assessed sensitivity to change of the RIPLS scale by comparing pre- and post-interprofessional education workshop scores. The EFA showed that there were three factors. In the CFA, most of the standardized factor loadings were higher than 0.3. Regarding internal consistency, Cronbach's Alpha was 0.86. The differences between the total RIPLS scores before and after the workshops were statistically significant. The Spanish version of RIPLS showed evidence of validity and reliability for use amongst health sciences students. The construct was adequately measured and was shown that it could be used to assess the impact of interprofessional education workshops.

¡De repente, profesor! Caminos que recorren los enfermeros en busca de formación docente / Suddenly, teacher! Paths taken by nurses searching for teacher training / De repente, professor! Caminhos percorridos pelos enfermeiros em busca da formação docente

ABSTRACT Objective: to know the paths taken by the nurse-teachers of the Nursing technical course in search of their training for the teaching career. Method: a qualitative and cross-sectional research study, carried out with nurses who teach at the Nursing technical course of a Technical School of the Unified Health System in Ceará. The data were collected through a focus group in October 2019, and analyzed according to Bardin's thematic content analysis, with the aid of the Qualitative Data Analysis Software. Results: the paths for nurses' teacher training permeate their motivation to enter the teaching career, whose reasons are related to the difficulty finding a job in the assistance area, invitation to teach, job opportunity or existence of some need; initial performance in teaching, which emphasizes mid-level; and by training itself, which had its need confirmed and, from the participants' perspective, met through participation in institutional qualifications and personal search for specialization courses. Conclusion: the paths taken by nurse-teachers in search of their training for the teaching career are related to the reasons why they enter teaching, with their initial performance in teaching and with teacher training itself, regarding verification of their need and ways accessed for such qualification. The nurse's prior training for the teaching practice ultimately points to professional excellence and appreciation and commitment to the Unified Health System. Thus, it becomes imperative to (re)formulate policies that consider the complexity and professionality of teaching, with a view to expert teaching training and performance.

RESUMEN Objetivo: conocer los caminos que recorren los profesores de enfermería en el curso técnico de Enfermería en busca de su formación docente. Método: investigación cualitativa, transversal, realizada con enfermeros profesores del curso técnico de Enfermería en una Escuela Técnica del Sistema Único de Salud en Ceará. Los datos se recopilaron a través de un grupo focal, en octubre de 2019, y se analizaron de acuerdo con el análisis de contenido temático de Bardin, con el soporte del Qualitative Data Analysis Software. Resultados: los caminos para la formación del docente de enfermería pasan por su motivación para la inserción en la docencia, cuyas razones se relacionan con la dificultad de ser empleado en tareas asistenciales, invitación a enseñar, oportunidad laboral o existencia de alguna necesidad; desempeño inicial en la docencia, que enfatiza la educación secundaria; y por la formación propiamente dicha, cuya necesidad fue corroborada y, a juicio de los participantes, suplida a través de la participación en las cualificaciones institucionales y la búsqueda personal de cursos de especialización. Conclusión: los caminos que recorren los profesores de enfermería en busca de su formación docente están relacionados con las razones por las que ingresan a la docencia, con el desempeño inicial en la docencia y con la propia formación docente, en cuanto a la constatación de su necesidad y las vías de acceso para dicha cualificación. La formación previa del enfermero para la práctica docente apunta, en última instancia, a la excelencia y la valoración profesional y al compromiso con el Sistema Único de Salud, por lo que es imperativo (re) formular políticas que consideren la complejidad y profesionalidad de la docencia, con miras a la obtención de formación y actuación docente especializada.

RESUMO Objetivo: conhecer os caminhos percorridos pelos enfermeiros docentes do curso técnico de Enfermagem em busca da sua formação para a docência. Método: pesquisa qualitativa, transversal, realizada com enfermeiros professores do curso técnico de Enfermagem de uma Escola Técnica do Sistema Único de Saúde do Ceará. Os dados foram coletados através de grupo focal, em outubro de 2019, e analisados segundo análise de conteúdo temática de Bardin, com apoio do Qualitative Data Analysis Software. Resultados: os caminhos para a formação docente do enfermeiro perpassam pela sua motivação para inserção na docência, cujos motivos relacionam-se com a dificuldade de empregar-se na assistência, convite para lecionar, oportunidade de trabalho ou existência de alguma necessidade; atuação inicial no ensino, a qual confere ênfase ao nível médio; e pela formação propriamente, que teve sua necessidade constatada e, na visão dos participantes, suprida mediante a participação em qualificações institucionais e busca pessoal por cursos de especialização. Conclusão: os caminhos percorridos pelos enfermeiros docentes em busca da sua formação para a docência guardam relação com os motivos pelos quais ingressam no ensino, com a atuação inicial no magistério e com a própria formação docente, referente à constatação da sua necessidade e vias acessadas para tal qualificação. A formação prévia do enfermeiro para o exercício docente aponta, em última análise, para a excelência e valorização profissional e compromisso com o Sistema Único de Saúde. Assim, torna-se imperativa a (re)formulação de políticas que considerem a complexidade e profissionalidade do ensino, com vistas a uma formação e atuação docente experta.

Joint Cardioprotective Effect of Vitamin C and Other Antioxidants against Reperfusion Injury in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention.

Percutaneous coronary intervention (PCI) has long remained the gold standard therapy to restore coronary blood flow after acute myocardial infarction (AMI). However, this procedure leads to the development of increased production of reactive oxygen species (ROS) that can exacerbate the damage caused by AMI, particularly during the reperfusion phase. Numerous attempts based on antioxidant treatments, aimed to reduce the oxidative injury of cardiac tissue, have failed in achieving an effective therapy for these patients. Among these studies, results derived from the use of vitamin C (Vit C) have been inconclusive so far, likely due to suboptimal study designs, misinterpretations, and the erroneous conclusions of clinical trials. Nevertheless, recent clinical trials have shown that the intravenous infusion of Vit C prior to PCI-reduced cardiac injury biomarkers, as well as inflammatory biomarkers and ROS production. In addition, improvements of functional parameters, such as left ventricular ejection fraction (LVEF) and telediastolic left ventricular volume, showed a trend but had an inconclusive association with Vit C. Therefore, it seems reasonable that these beneficial effects could be further enhanced by the association with other antioxidant agents. Indeed, the complexity and the multifactorial nature of the mechanism of injury occurring in AMI demands multitarget agents to reach an enhancement of the expected cardioprotection, a paradigm needing to be demonstrated. The present review provides data supporting the view that an intravenous infusion containing combined safe antioxidants could be a suitable strategy to reduce cardiac injury, thus improving the clinical outcome, life quality, and life expectancy of patients subjected to PCI following AMI.

Targeting Ferroptosis against Ischemia/Reperfusion Cardiac Injury.

Ischemic heart disease is a leading cause of death worldwide. Primarily, ischemia causes decreased oxygen supply, resulting in damage of the cardiac tissue. Naturally, reoxygenation has been recognized as the treatment of choice to recover blood flow through primary percutaneous coronary intervention. This treatment is the gold standard therapy to restore blood flow, but paradoxically it can also induce tissue injury. A number of different studies in animal models of acute myocardial infarction (AMI) suggest that ischemia-reperfusion injury (IRI) accounts for up to 50% of the final myocardial infarct size. Oxidative stress plays a critical role in the pathological process. Iron is an essential mineral required for a variety of vital biological functions but also has potentially toxic effects. A detrimental process induced by free iron is ferroptosis, a non-apoptotic type of programmed cell death. Accordingly, efforts to prevent ferroptosis in pathological settings have focused on the use of radical trapping antioxidants (RTAs), such as liproxstatin-1 (Lip-1). Hence, it is necessary to develop novel strategies to prevent cardiac IRI, thus improving the clinical outcome in patients with ischemic heart disease. The present review analyses the role of ferroptosis inhibition to prevent heart IRI, with special reference to Lip-1 as a promising drug in this clinicopathological context.

Aprendizaje interprofesional en los internados de las carreras de la salud del Hospital Josefina Martínez / Interprofessional learning of interns at Josefina Martínez Hospital

Introducción: las dinámicas de atención en salud requieren que los profesionales que componen el equipo de salud trabajen en for-ma colaborativa. Sin embargo, durante su formación, las oportunidades de aprendizaje con otras disciplinas son escasas. Se reportan los resultados del primer proyecto para promover el aprendizaje interprofesional en los internos que rotan por el Hospital Josefina Martínez. Método: de marzo a julio 2018, se realizó un taller constituido por dos sesiones, en cada rotación de internado. Participaron internos de cinco carreras en forma conjunta (kinesiología, odontología, nutrición, fonoaudiología y terapia ocupacional). Se adaptó la encuesta de disposición al aprendizaje interprofesional, para ser aplicada antes y después de cada taller. Se calcularon las medianas, rangos intercuartílicos (Q1; Q3y se compararon los puntajes mediante test de Wilcoxon. Resultados: hubo una disposición positiva inicial al aprendizaje interprofesional, con mejoría significativa después de los talleres en todas las dimensiones de la encuesta: Trabajo en equipo y colaboración (<0,001), trabajo centrado en el paciente (<0,001), y sentido de identidad profesional (<0,05). La diferencia del puntaje global de la encuesta también fue significativa (<0,001). Conclusiones: se demostró un cambio favorable y significativo en las respuestas de los internos después de los talleres, en todas las dimensiones de la encuesta. En los comentarios, destacaron la relevancia de aprender con estudiantes de otras carreras, describiendo que aumentó su conocimiento sobre éstas y reforzando el impacto que dicha integración tiene en mejorar la atención y resolución de problemas en salud.

Background: The dynamics of health care require that the health professionals work collaboratively; however, during their training, learning opportunities with other disciplines are infrequent. The results of the first project to promote interprofessional learning in the clinical internship at Hospital Josefina Martínez are reported. Methods: From March to July 2018, two workshops for each internship rotation were carried. Students from fivecareers participated together (Kinesiology, Dentistry, Nutrition, Speech Therapy, and Occupa-tional Therapy). The readiness to interprofessional scale survey was adapted, to be applied before and after each workshop. Medians, interquartile range (Q1; Q3) were calculated, and the Wilcoxon test was used to compare the results. Results: There was an initial po-sitive readiness for interprofessional learning, with a significant improvement in all the dimensions of the survey, after the workshops: Teamwork and collaboration (<.001), patient-centered care (<.001), and sense of professional identity (<.05). The differences from the overall survey were also significant (<0.001). Conclusions: A favorable change was demonstrated in the responses of the students after the workshops, overalland in all the dimensions of the survey. In the comments, the students highlighted the relevance of learning with students from other careers, describing that it increased their knowledge about different professions and strengthening the impact that this integration has in improving attention and resolving health problems.

Desinfección de las impresiones dentales, soluciones desinfectantes y métodos de desinfección. Revisión de literatura / Disinfection of dental impressions, disinfectant solutions and disinfection methods. Literature review

La toma de impresiones en Odontología es un procedimiento frecuentemente realizado y su contaminación por microorganismos presentes en la flora bucal exige que sea some-tida a un procedimiento de desinfección después de ser retirada de boca, para reducir al máximo los riesgos de infección cruzada tanto en la clínica como en el laboratorio. Las impresiones pueden ser fuente de transmisión de infecciones entre el odontólogo y el laboratorio debido al contacto con saliva y sangre del paciente, que luego infectan de forma cruzada los moldes de yeso. Se han descrito varios métodos de desinfección de impresiones en la literatura que tienen sus propias ventajas, desventajas y efectos sobre el material de impresión. Con el fin de mejorar el conocimiento y el comportamiento de los trabajadores de la salud dental con respecto a la desinfección de impresiones, en la presen-te revisión se sintetizan las técnicas de desinfección actuales así como sus efectos sobre la estabilidad dimensional y reproducción de detalles de los materiales de impresión. El uso de un desinfectante de nivel medio es recomendado por la Asociación Dental Americana, siendo los agentes químicos más accesibles que los agentes físicos por su fácil aplicación y menor costo. El desinfectante más recomendado es el hipoclorito de sodio al 5,25%, debido a sus mínimas interacciones, su bajo precio y, aunque la solución es poco estable, su renovación es fácil y económica.

Impression taking in dentistry is a frequent performed procedure and its contamination by microorganisms present in the oral flora requires that it be subjected to a disinfection procedure after being removed from the mouth, to minimize the risks of cross infection both in the clinic as in the laboratory. Impressions can be a source of infections trans-mission between the dentist and the laboratory due to the contact with saliva and blood of the patient, which then cross-infect the plaster casts. Several methods of impressions disinfection had been described in the literature that has their own advantages, disad-vantages and effects on the impression material. In order to improve the knowledge and behavior of dental health workers regarding the disinfection of impressions, the present review summarizes current disinfection techniques as well as their effects on dimensional stability and reproduction of details of impression materials: The use of a mid-level dis-infectant is recommended by the American Dental Association, chemical agents being more accessible than physical agents because of their easy application and lower cost. The most recommended disinfectant is 5.25% sodium hypochlorite, due to the minimal interactions with impression materials, although the solution is not very stable, it is economical and easy to obtain.

Health systems strengthening for noncommunicable disease control and healthy aging: integrated actions in Aruba and Curaçao.

Caribbean countries are experiencing social, epidemiological, and demographic transitions shaped by the growing elderly population and the rise of noncommunicable diseases (NCDs)-now responsible for 78% of all deaths. These circumstances demand rethinking the model of care to improve health outcomes and build more sustainable health systems with new orientations in policy, service delivery, organization, training, technology, and financing. Policy must be aimed towards healthy living, leveraging interventions that ensure healthy aging. The health system must proactively structure interventions to reduce the incidence of new NCD cases and to prevent related complications. Interventions should be focused on optimizing the individual's capacity, functional ability, and autonomy within adapted environments, as well as with the necessary preventive, long-term care, self-care, community care, and health system support.

Los países del Caribe están experimentando transiciones sociales, epidemiológicas y demográficas como resultado del envejecimiento de la población y el aumento de la prevalencia de las enfermedades no transmisibles (ENT), que en la actualidad causan el 78% de todas las defunciones. Estas circunstancias exigen replantear el modelo de atención para mejorar los resultados de salud y establecer sistemas de salud más sostenibles mediante nuevos enfoques en políticas, prestación de servicios, organización, capacitación, tecnología y financiamiento. Las políticas deben tener como propósito procurar una vida saludable, aprovechando las intervenciones que garanticen el envejecimiento saludable. El sistema de salud debe ser proactivo, estructurando las intervenciones para reducir la incidencia de nuevos casos de ENT y para prevenir las complicaciones relacionadas. Las intervenciones deben centrarse en optimizar la capacidad funcional, la autonomía y el desenvolvimiento general de la persona dentro de un entorno adaptado y con el apoyo necesario del sistema de salud en materia de atención preventiva, cuidados a largo plazo, de autocuidado y de atención en la comunidad.

Os países do Caribe estão passando por transições sociais, epidemiológicas e demográficas configuradas pela população de idosos cada vez maior e a ascensão das doenças não transmissíveis (DNTs), já responsáveis por 78% de todas as mortes. Essas circunstâncias exigem repensar o modelo de atenção para melhorar os desfechos de saúde e construir sistemas de saúde mais sustentáveis, com novas orientações de política, prestação de serviços, organização, treinamento, tecnologia e financiamento. As políticas devem ser orientadas para a vida saudável, alavancando intervenções que asseguram o envelhecimento saudável. O sistema de saúde deve estruturar proativamente intervenções para reduzir a incidência de novos casos de DNT e a prevenir as complicações relacionadas. As intervenções devem se concentrar na otimização da capacidade do indivíduo, das habilidades funcionais e da autonomia dentro de ambientes adaptados, e também nas ações preventivas a para assistência de longa duração, no autocuidado, na atenção na comunidade e no apoio pelos sistemas de saúde.

Health systems strengthening for noncommunicable disease control and healthy aging: integrated actions in Aruba and Curaçao

[ABSTRACT]. Caribbean countries are experiencing social, epidemiological, and demographic transitions shaped by the growing elderly population and the rise of noncommunicable diseases (NCDs)—now responsible for 78% of all deaths. These circumstances demand rethinking the model of care to improve health outcomes and build more sustainable health systems with new orientations in policy, service delivery, organization, training, technology, and financing. Policy must be aimed towards healthy living, leveraging interventions that ensure healthy aging. The health system must proactively structure interventions to reduce the incidence of new NCD cases and to prevent related complications. Interventions should be focused on optimizing the individual’s capacity, functional ability, and autonomy within adapted environments, as well as with the necessary preventive, long-term care, self-care, community care, and health system support.

[RESUMEN]. Los países del Caribe están experimentando transiciones sociales, epidemiológicas y demográficas como resultado del envejecimiento de la población y el aumento de la prevalencia de las enfermedades no transmisibles (ENT), que en la actualidad causan el 78% de todas las defunciones. Estas circunstancias exigen replantear el modelo de atención para mejorar los resultados de salud y establecer sistemas de salud más sostenibles mediante nuevos enfoques en políticas, prestación de servicios, organización, capacitación, tecnología y financiamiento. Las políticas deben tener como propósito procurar una vida saludable, aprovechando las intervenciones que garanticen el envejecimiento saludable. El sistema de salud debe ser proactivo, estructurando las intervenciones para reducir la incidencia de nuevos casos de ENT y para prevenir las complicaciones relacionadas. Las intervenciones deben centrarse en optimizar la capacidad funcional, la autonomía y el desenvolvimiento general de la persona dentro de un entorno adaptado y con el apoyo necesario del sistema de salud en materia de atención preventiva, cuidados a largo plazo, de autocuidado y de atención en la comunidad.

[RESUMO]. Os países do Caribe estão passando por transições sociais, epidemiológicas e demográficas configuradas pela população de idosos cada vez maior e a ascensão das doenças não transmissíveis (DNTs), já responsáveis por 78% de todas as mortes. Essas circunstâncias exigem repensar o modelo de atenção para melhorar os desfechos de saúde e construir sistemas de saúde mais sustentáveis, com novas orientações de política, prestação de serviços, organização, treinamento, tecnologia e financiamento. As políticas devem ser orientadas para a vida saudável, alavancando intervenções que asseguram o envelhecimento saudável. O sistema de saúde deve estruturar proativamente intervenções para reduzir a incidência de novos casos de DNT e a prevenir as complicações relacionadas. As intervenções devem se concentrar na otimização da capacidade do indivíduo, das habilidades funcionais e da autonomia dentro de ambientes adaptados, e também nas ações preventivas a para assistência de longa duração, no autocuidado, na atenção na comunidade e no apoio pelos sistemas de saúde.

Skills for generalist and specialist nurses working in the prevention and control of infections in Brazil. / Competências para enfermeiros generalistas e especialistas atuarem na prevenção e controle de infecções no Brasil.

OBJECTIVE: to define the competencies for the prevention and control of healthcare-related infections that should be developed by the generalist nurse and the specialist nurse in infection control in Brazil. METHOD: the Delphi technique, developed in four rounds, was used. Thirty-one nurses and eight physicians participated in the study, with expertise in infection prevention and control. Data were collected using open-ended questionnaires, whose answers were treated using the content analysis technique. Structured instruments were used to evaluate the importance of each competency using a Likert scale. Data were analyzed and presented in a descriptive way, use of median and coefficient of variation. RESULTS: the competences were organized in 4 core, 14 generic and 17 specific, with name and description of each competency. CONCLUSION: the definition of competencies for the prevention and control of healthcare-related infections is the first step to begin the rethinking of the teaching and learning process in the initial training of nurses. The data found in the present study may help to restructure education and support permanent education programs in health.

La promoción de salud en la escuela como estrategia para el abordaje de la cronicidad en España / Health promotion in schools as a strategy for addressing chronic disease in Spain / A promoção da saúde na escola como estratégia para controlar a cronicidade em Espanha / La promotion de la santé à l'école comme stratégie pour faire face á la chronicité en Espagne

Resumen Objetivo: Este artículo aborda los temas que sirvieron de referencia teórica de una disertación de tesis doctoral. Se pretende analizar las principales conductas y factores de patologías crónicas que avalan la necesidad del enfoque promocional de salud en la escuela y a lo del todo el curso de vida, así como su impacto en la mejora de la salud global de la población y la reducción del gasto público en España. Material y métodos: Se ha utilizado una perspectiva crítica desde la que se hace una revisión reflexiva sobre dichos factores en el contexto español, estudiando la necesidad de abordaje temprano. Los factores analizados han estado relacionados con la alimentación y actividad física, salud bucodental, consumo de sustancias tóxicas, seguridad vial, sexualidad y bienestar emocional. Resultados: Se observa un descenso de actividad física en la etapa escolar. Tres de cada diez niños/as tienen sobrepeso u obesidad. La prevalencia de afecciones bucodentales ronda el 40% a los 6 años. El cannabis es la tercera droga más consumidas por los escolares de 14-18 años, después del tabaco y el alcohol. Más de la mitad de los fallecimientos por accidente de tráfico entre los jóvenes (18-24 años) fue durante la noche y fin de semana. España se consolida como tercer país de la Unión Europea con mayor número de abortos. Las infecciones de transmisión sexual afectan de forma desproporcionada a las adolescentes. Los trastornos de salud mental están entre los cuatro problemas más prevalentes de los niños/as menores de 15 años Conclusiones: Se concluye que las acciones educativas realizadas en la escuela desde las edades más tempranas sobre los factores y conductas pueden reducir considerablemente los costes individuales, económicos y sociales que acarrean las enfermedades crónicas, convirtiéndose en una necesidad estratégica para el abordaje de la cronicidad, que es uno de los mayores retos a los que se enfrenta el sistema sanitario español.

Abstract Object: This article focuses on the topics that served as theoretical reference of a doctoral dissertation. The aim is to analyze the main behaviors and factors of chronic pathologies that support the need of the promotional approach of health in the school and the whole life course, as well as its impact in the improvement of the global health of the population and the reduction of the public spending in Spain. Materials and methods: A critical perspective has been used from which a reflexive review of these factors in the Spanish context has been carried out, studying the need of an early approach. Factors related to diet and physical activity, oral health, toxic substance use, road safety, sexuality and emotional well-being have been analyzed. Results: There was a decrease in physical activity in the school stage. Three out of ten children are overweight or obese. The prevalence of oral diseases is around 40% at 6 years. Cannabis is the third most consumed drug by schoolchildren aged 14-18, after tobacco and alcohol. More than half of the deaths due to traffic accidents among young people (18-24 years old) occurred during the night and weekend. Spain is consolidated as the third country in the European Union with the highest number of abortions. Sexually transmitted infections disproportionately affect teenagers. Mental health disorders are among the four most prevalent problems of children under 15 years of age. Conclusions: It is concluded that educational actions carried out in schools from the earliest ages on behavioral risk factors can considerably reduce the individual, economic and social costs of chronic diseases, becoming a strategic necessity for dealing with chronic diseases, which is one of the greatest challenges facing the Spanish health system.

Resumo Objetivo: Este artigo aborda os temas que foram usados como referência teórica numa tese de doutoramento. Pretendeu-se analisar os principais comportamentos e fatores relacionados com as patologias crónicas que suportam a necessidade de uma abordagem de promoção de saúde na escola e em todo o ciclo de vida, bem como o seu impacto na melhoria da saúde global da população e na redução das despesas públicas em Espanha. Materiais e métodos: Utilizou-se uma perspectiva crítica a partir de uma revisão reflexiva sobre esses fatores no contexto espanhol, estudando a necessidade de intervenção precoce. Os fatores analisados foram relacionados com a alimentação, a atividade física, a saúde bucal, o consumo de substâncias tóxicas, a segurança rodoviária, a sexualidade e o bem-estar emocional Resultados: Observou-se uma diminuição da atividade física em crianças de idade escolar. Três em cada dez crianças sofrem excesso de peso ou obesidade. A prevalencia de doenjas bucais é de cerca de 40% aos 6 anos. A Cannabis é a terceira droga mais consumida por alunos dos 14 a 18 anos, depois do consumo de tabaco e álcool. Mais da metade das mortes por acidentes rodoviários dos jovens entre os 18 e 24 anos ocorreram durante a noite e no fim-de-semana. A Espanha é o terceiro país da Uniao Europeia com mais número de abortos. As infecções sexualmente transmissíveis afetam desproporcionalmente as adolescentes. Os transtornos mentais estao entre os quatro problemas mais prevalentes em crianças menores de 15 anos de idade. Conclusões: Conclui-se que as ações educativas realizadas na escola, em idades precoces, sobre os fatores de risco comportamentais, podem reduzir consideravelmente os custos individuais, económicos e sociais que as doenjas crónicas acarretam, transformando-se numa necessidade estratégica para a abordagem da cronicidade, que é um dos maiores desafios que o sistema de saúde espanhol enfrenta.

Résumé Objectif: Cet article se centre sur les sujets qui ont servi de référence théorique pour une thése de doctorat. L'objectif est d'analyser les principaux comportements et facteurs de pathologies chroniques qui supportent le besoin de l'approche promotionnelle de la santé á l'école et tout au long de la vie, ainsi que son impact sur l'amélioration de la santé globale de la population et la réduction du dépenses publiques en Espagne. Matériaux et méthodes: Une perspective critique a été utilisée á partir de laquelle une revue réflexive est faite sur ces facteurs dans le contexte espagnol, en étudiant la nécessité d'une approche précoce. Les facteurs analysés ont été liés á l'alimentation et á l'activité physique, á la santé bucco-dentaire, á la consommation de substances toxiques, á la sécurité routiére, á la sexualité et au bien-etre émotionnel. Résultats: Il y a une diminution de l'activité physique au stade scolaire. Trois enfants sur dix sont en surpoids ou obéses. La prévalence des maladies buccales est d'environ 40% á 6 ans. Le cannabis est la troisiéme drogue la plus consommé par les écoliers agés de 14 á 18 ans, aprés le tabac et l'alcool. Plus de la moitié des décés dus aux accidents de la circulation chez les jeunes (18-24 ans) ont eu lieu pendant la nuit et le week-end. L'Espagne est consolidée comme le troisiéme pays de l'Union européenne avec le plus grand nombre d'avortements. Les infections sexuellement transmissibles touchent de maniére disproportionnée les adolescentes. Les troubles de santé mentale sont parmi les quatre problémes les plus courantes chez les enfants de moins de 15 ans. Conclusion: Les actions éducatives menées á l'école dés le plus jeune age sur les facteurs et les comportements peuvent réduire considérablement les coúts individuels, économiques et sociaux qu'apportent les maladies chroniques, devenant une nécessité stratégique pour l'approche de la chronicité, qui est l'un des plus grands défis du systéme de santé espagnol.

Condições sociais, escolarização e hábitos de estudo no desempenho acadêmico de concluintes da área da saúde / Social conditions, schooling and study habits in the academic performance of finalists in the field of health / Condiciones sociales, escolarización y hábitos de estudio en el desempeño académico de graduados del área de la salud

Resumo Vários fatores contribuem para a dificuldade no acesso e permanência na Educação Superior no Brasil. O objetivo deste estudo foi identificar a diferença de desempenho dos estudantes por condições socioeconômicas, escolarização e hábitos de estudo. Foi realizado estudo transversal analítico com base nos dados do Exame Nacional de Desempenho dos Estudantes, em amostra de 196.856 alunos dos cursos de saúde em 2013. A nítida barreira que estudantes de classes sociais menos favorecidas apresentam para ingresso e permanência na Educação Superior requer uma permanente busca de maior justiça social. Enquanto se mantiver a atual situação, é papel do governo proporcionar estratégias que viabilizem o acesso à Educação Superior por meio de políticas afirmativas e recursos para viabilizar que pessoas com piores condições socioeconômicas possam investir em sua formação. A bolsa-permanência apresentou-se como essencial na busca da equidade, assim como a bolsa acadêmica permitiu melhor desempenho, em especial, pelo maior vínculo com a Instituição de Educação Superior.

Abstract Many factors contribute to the difficulty in accessing and remaining in Higher Education in Brazil. The objective of the present study was to identify the difference in the performance of the students due to socioeconomic conditions, schooling and study habits. We conducted an analytical cross-sectional study based on the data of the National Student Performance Exam (Exame Nacional de Desempenho dos Estudantes, in Portuguese), with a sample of 196,856 students from health courses in 2013. The clear obstacle faced by the students from underprivileged social classes to their admission and permanence in Higher Education requires a constant struggle for greater social justice. While the current situation remains unchanged, it is the role of the government to provide strategies to make viable the access to Higher Education through affirmative policies and resources to make it possible for the underprivileged to invest in their education. The permanence scholarship presented itself as crucial in the struggle for equity, and it enabled a better performance on the part of the students, especially due to their stronger ties with the Higher Education Institution.

Resumen Varios factores contribuyen a la dificultad en el acceso y permanencia en la Educación Superior en Brasil. El objetivo de este estudio fue identificar la diferencia de desempeño de los estudiantes por condiciones socioeconómicas, escolarización y hábitos de estudio. Fue realizado un estudio transversal analítico con base en los datos del Examen Nacional de Desempeño de los Estudiantes, en alrededor de 196.856 alumnos de los cursos de salud en 2013. La nítida barrera que estudiantes de clases sociales menos favorecidas presentan para ingreso y permanencia en la Educación Superior requiere una permanente búsqueda de mayor justicia social. Mientras se mantenga la actual situación, es papel del gobierno proporcionar estrategias que viabilicen el acceso a Educación Superior por medio de políticas afirmativas y recursos para viabilizar que personas con peores condiciones socioeconómicas puedan invertir en su formación. La beca-permanencia se presentó como esencial en la búsqueda de equidad, así como la beca académica permitió mejor desempeño, en especial, por mayor vínculo con la Institución de Educación Superior.

Autoscopia no processo de formação de docentes reflexivos / Autoscopy in the process of training reflective professors

Objetivo compreender como a autoscopia, apoiada no Modelo de Ação e Raciocínio Pedagógico, contribui para formação de docentes reflexivos. Métodos estudo qualitativo e descritivo, realizado com uma docente de Enfermagem, do Curso Técnico em Enfermagem. Para os dados coletados, por meio de entrevistas, observação não participante e autoscopia, foi utilizada análise de conteúdo, com os resultados interpretados à luz do referencial teórico de Shulman. Resultados as percepções relatadas pela docente antes da autoscopia diferem das conclusões pós-autoscopia, demonstrando avanços na nova compreensão. A estrutura da autoscopia, seguindo o Modelo de Ação e Raciocínio Pedagógico de Shulman, possibilitou o exercício reflexivo docente. Conclusão a inclusão da autoscopia nos processos de formação docente pode estimular postura reflexiva, permitindo avanços nas práticas de ensino.

Objective to understand how autoscopy, supported by the Model of Action and Pedagogical Reasoning, contributes to the formation of reflective professors. Methods a qualitative and descriptive study, carried out with a Nursing professor, of the Nursing Technical Course. For the collected data, through interviews, non-participant observation and autoscopy, content analysis was used, with the results interpreted in the light of the referential theorist of Shulman. Results the perceptions reported by the professor before autoscopy differ from the post-autoscopy findings, demonstrating advances in the new comprehension. The structure of autoscopy, following Shulman's Model of Action and Pedagogical Reasoning, made possible reflective professor exercise. Conclusion the inclusion of autoscopy in teacher training processes can stimulate reflective posture, allowing for advances in teaching practices.