A avaliação das aprendizagens na prática da simulação em Enfermagem como feedback de ensino

O presente trabalho é um estudo teórico e reflexivo que emergiu como um recorte de um estudo de caso com caráter qualitativo, descritivo e participante, referente ao projeto de pesquisa intitulado "Estudo da avaliação no disparador de aprendizagem Simulação" do Laboratório Morfofuncional da Faculdade de Enfermagem (FEn) da Universidade Federal de Pelotas (UFPel). O objetivo é demonstrar a importância da avaliação das aprendizagens da prática da Simulação como retroalimentação (feedback) ao processo de aperfeiçoamento do planejamento de ensino. A simulação é uma tentativa de reproduzir os aspectos essenciais de um cenário clínico real. Identifica-se a avaliação da aprendizagem como um espaço curricular potencial para a reavaliação do processo ensino-aprendizagem e do planejamento do ensino. A interdisciplinaridade das questões de saúde precisam ser reportadas para o pensar, o sentir e o fazer pedagógico da formação em Enfermagem com a finalidade de direcioná-lo à integralidade, à universalidade em saúde e à formação crítica, reflexiva e autodirigida.Este trabajo es una reflexión y es un recorte de un estudio de caso con cualitativa y descriptiva, y los participantes, haciendo referencia al proyecto de investigación titulado "Estudio sobre la evaluación del aprendizaje de activación de simulación" del Laboratorio Morfofuncional de la Escuela de Enfermería de la Universidad Federal de Pelotas, Rio Grande do Sul, Brasil. El objetivo es demostrar la importancia de la evaluación del aprendizaje de la práctica de la simulación como retroalimentación del proceso para mejorar la planificación de la educación. La simulación es un intento de reproducir las características esenciales de un ambiente clínico real. Identifica la evaluación del aprendizaje como un potencial espacio curricular para la valorización del proceso de enseñanza-aprendizaje y la planificación de la educación. El carácter interdisciplinario deben ser reportados a la forma de pensar, sentir y hacer de formación educativa en enfermería con el fin de dirigir a la integralidad, universalidad en la salud y la formación crítica, reflexiva y auto-dirigido.This paper is a theoretical and reflective that emerged as a cutting from a case study with qualitative and descriptive and participant, referring to the research project entitled "Study on the evaluation of trigger learning Simulation" of Morphofunctional Laboratory of College of Nursing of Federal University of Pelotas (UFPel). The goal is to demonstrate the importance of assessment of learning the practice of simulation as feedback the process for improving the planning of education. Simulation is an attempt to reproduce the essential features of a real clinical setting. Identifies the assessment of learning as a curricular space potential for the revaluation of the teaching-learning process and planning of education. The interdisciplinary nature of health issues need to be reported to the thinking, feeling and doing educational training in nursing in order to direct you to the completeness, universality in health and training critical, reflective and self-directed

Neocortical Axon Arbors Trade-off Material and Conduction Delay Conservation

The brain contains a complex network of axons rapidly communicating information between billions of synaptically connected neurons. The morphology of individual axons, therefore, defines the course of information flow within the brain. More than a century ago, Ramón y Cajal proposed that conservation laws to save material (wire) length and limit conduction delay regulate the design of individual axon arbors in cerebral cortex. Yet the spatial and temporal communication costs of single neocortical axons remain undefined. Here, using reconstructions of in vivo labelled excitatory spiny cell and inhibitory basket cell intracortical axons combined with a variety of graph optimization algorithms, we empirically investigated Cajal's conservation laws in cerebral cortex for whole three-dimensional (3D) axon arbors, to our knowledge the first study of its kind. We found intracortical axons were significantly longer than optimal. The temporal cost of cortical axons was also suboptimal though far superior to wire-minimized arbors. We discovered that cortical axon branching appears to promote a low temporal dispersion of axonal latencies and a tight relationship between cortical distance and axonal latency. In addition, inhibitory basket cell axonal latencies may occur within a much narrower temporal window than excitatory spiny cell axons, which may help boost signal detection. Thus, to optimize neuronal network communication we find that a modest excess of axonal wire is traded-off to enhance arbor temporal economy and precision. Our results offer insight into the principles of brain organization and communication in and development of grey matter, where temporal precision is a crucial prerequisite for coincidence detection, synchronization and rapid network oscillations

Where should patients with or at risk of delirium be treated in an acute care system? Comparing the rates of delirium in patients receiving usual care versus alternative care : a systematic review and meta‐analysis

Background: Delirium is an acute condition that occurs in hospitalised patients and leads to poor patient outcomes that can last long term. Therefore, the importance of prevention is undeniable and adopting new models of care for at risk patients should be prioritised. Objectives: This systematic review and meta‐analysis will assess the effectiveness of different interventions designed to prevent or manage delirium in acutely unwell hospitalised patients. Methods: MEDLINE, EMBASE, PsychINFO, OpenGrey, Web of Science and reference lists of journals were searched. Eligible studies reported on incidence or duration of delirium, used a validated delirium diagnostic tool, and compared an intervention to either a control or another intervention group. Meta‐analyses were conducted, and GRADE pro software was used to assess the certainty of evidence. This review is registered on PROSPERO. Results: A total of 59 studies were included and 33 were eligible for meta‐analysis. Delirium incidence was most significantly reduced by non‐pharmacological multicomponent interventions compared to usual care, with pooled risk ratios of 0.57 (95% CI: 0.44 to 0.73, ten randomised controlled trials) and 0.47 (95% CI: 0.35 to 0.64, six observational studies). Single component interventions did not significantly reduce delirium incidence compared to usual care in seven randomised trials (risk ratio= 0.92, 95% CI: 0.81 to 1.04). The most effective single component intervention in reducing delirium incidence, was a hospital‐at‐home intervention (risk ratio = 0.29, 95% CI: 0.09 to 0.87). Conclusions: Non‐pharmacological multicomponent interventions are effective in preventing delirium, however the same cannot be said for other interventions due to uncertain results. There is some evidence that providing multicomponent interventions in patients’ homes is more effective than a hospital setting. Therefore, researching the benefits of hospital‐at‐home interventions in delirium prevention is recommended

Functional iron deficiency markers are absent during pregnancy despite evidence of low iron stores

Introduction Functional iron deficiency parameters predict iron-restricted erythropoiesis more precisely than ferritin. Ferritin and erythropoiesis can be affected by inflammation and hormonal alterations. We hypothesize that the association between low ferritin concentrations and iron-restricted erythropoiesis is not comparable between pregnant and non-pregnant women. Materials and methods Pregnant women ( n = 926) were included at week 12 of gestation. Ferritin concentrations, %hypochromic erythrocytes (%HYPO), %microcytic erythrocytes (%MICRO), reticulocyte haemoglobin content (MCHr), mean cell volume (MCV) and mean cell haemoglobin (MCH) were analysed. Data were compared with non-pregnant women ( n = 1302). Results Functional iron deficiency parameters (%HYPO, %MICRO, MCHr) were present in, respectively, 3.9%, 14.3% and 2.3% off all pregnant women. Univariate analysis of low ferritin (&lt;20 μg/L) showed significant differences between non-pregnant versus pregnant women; %HYPO (10.92% vs. 0.92%), increased %MICRO (4.33% vs. 1.00%) and decreased MCHr (24.9 pg vs. 29.5 pg), respectively. In the logistic regression analysis, MCHr, %MICRO and MCV were independently associated with low ferritin concentrations in pregnant women, while %HYPO and %MICRO were independently associated variables in non-pregnant women with low ferritin concentrations. Discussion Functional iron deficiency is significantly less frequent in pregnant women compared with iron-deficient non-pregnant women. During pregnancy, iron metabolism might be differentially regulated for optimal fetal growth and development despite low maternal iron stores. </jats:sec