Several countries maintain universal health coverage, which implies responsibility to organize delivery formats of healthcare services and products for citizens. In Brazil, the health system has a principle of universal access for more than 30 years, but many deficiencies remain and the country observes a day practice for those seeking judicial decisions to determine provision of healthcare.
IntroductionThe Brazilian health system has not been able to enforce the constitutional Right to Health for the entire population, leaving litigation as the last alternative for the fulfillment of the right. In order to harmonize and underpin the decision making of federal judges, an Academic Detailing (AD) program with concepts of evidence-based medicine and health policies for federal judges will be conducted nationwide in Brazil. AD is a strategy to provide information, combining an interactive outreach approach with the best evidence. This study reports the method used to define key messages to be used during visits.MethodsGovernment, federal judges and academy representatives were invited to a workshop on health litigation in Brazil. They were divided into six groups to discuss five hypothetical scenarios. In each scenario, groups listed two possible key messages to disseminate during AD, addressing the legal, scientific, economic or ethical dimensions. After the definition, a vote was taken, according to the importance that each participant attributed to them (1 to 10), and then a score was generated.ResultsOf the thirty-one participants, five were from the judiciary, three prosecutors, one health insurance representative, nine managers and thirteen from the academy. From the case study presented, fifty-five key messages were suggested. After removing duplicates, twenty-five were selected to assign importance values by each participant. The key messages were sorted from highest to lowest score, the most important being “Explain what evidence-based medicine means and what scientific evidence means”.ConclusionsKnowledge of theoretical concepts of evidence-based medicine, health policies and the technology incorporation process seem to be of fundamental importance to federal judges. This information will serve as a basis for decision making regarding litigious proceedings involving the constitutional Right to Health in Brazil. From the selected key messages, bulletins to the academic detailing program to federal judges shall be produced.
A oferta de disciplinas on-line cresce vertiginosamente nas Instituições de Ensino Superior (IES) e osprofessores cada vez mais, se veem desafiado a modificar sua prática pedagógica para acompanharem a tendênciavigente à modalidade de ensino não presencial. Diante desse problema, o objetivo deste trabalho – de natureza aplicadae exploratória e de abordagem qualitativa – é registrar as concepções de docentes universitários, atuantes emcursos de Pedagogia à Distância. Toma como foco compreender, sob a ótica desses docentes, o que é docência online,visando registrar e discutir as características necessárias para essa prática. Quanto aos resultados da pesquisa,verificou-se que as principais características podem ser agrupadas como sendo aquelas que: são capazes de entendero momento em que o aluno se encontra na relação ensino-aprendizagem fazendo as adaptações necessárias à comunicaçãocom ele; que sabem distinguir os limites entre o ensino presencial e os do ambiente on-line; são conhecedoresdas ferramentas no Ambiente Virtual de Aprendizagem (AVA), bem como sabem planejar e mediá-las de acordocom a variação de estudantes e conteúdos; apresentam sempre um feedback sobre as atividades e solicitações dosaprendizes e, por fim, pensam os processos avaliativos específicos e têm abertura para o trabalho em equipe, ouseja, com outros profissionais envolvidos com o processo, que vão desde os produtores dos conteúdos até os tutores.Palavras-chave: Docência Universitária On-Line. Tecnologias da Informação e Comunicação (TIC). AmbientesVirtuais de Aprendizagem (AVA). ONLINE TEACHING AT HIGHER EDUCATION: conceptions for a new style of pedagogyAbstract: The offer of online courses soars on Higher Education Institutions (HEI) and teachers find themselveschallenged, increasingly, to modify their pedagogical practice to follow up the trend towards online teaching modality.Faced with of this problem, the aim of this study - from applied and exploratory nature and qualitative approach - isto register the conceptions of university teachers in Pedagogy courses at Distance Learning. It takes as its focus theunderstanding, in the vision of these teachers, what is online teaching, aiming at record and discuss the necessaryfeatures for this practice. Regarding the results of the survey, it has been found that the main features can be groupedas being those that: are able to understand the moment of the student in the teaching-learning process making therequired adjustments to the communication with him; Student knows how to distinguish the limits between classroomlearning and the online environment; are knowledgeable in tools on Virtual Learning Environment (VLE) as well as toplan and mediate them, according to the variance of students and content; always submit feedback about activitiesand requests of apprentices and ultimately think particular evaluative processes and have opening for teamwork, ie, toother professionals involved with the process ranging from content producers to tutors.Keywords: University teaching online. Information and Communication Technologies (ICT). Virtual Learning Environments(VLE). ENSEÑANZA UNIVERSITARIA EN LÍNEA: conceptos para un nuevo estilo de lapedagogía Resumen: La oferta de cursos en línea crece dramáticamente en las Instituciones de Educación Superior (IES) y losmaestros se ven desafiados, cada vez más, a modificar su práctica pedagógica para dar seguimiento a la tendenciaa la modalidad de enseñanza en línea. Frente a este problema, el objetivo de este estudio - de naturaleza aplicaday exploratoria y abordaje cualitativo - es registrar las concepciones de los profesores universitarios en los cursos dePedagogía en Educación a Distancia. Toma como foco entender, bajo la óptica de estos maestros, lo que es la enseñanzaen línea, con el objetivo de registrar y analizar las características necesarias para esta práctica. Con respectoa los resultados de la encuesta, se ha encontrado que las principales características se pueden agrupar como aquellasque: son capaces de entender el momento del estudiante en el proceso de enseñanza-aprendizaje haciendo losajustes necesarios en la comunicación con él; saber distinguir los límites entre el aprendizaje en el aula y el ambienteen línea; son conocedores de las herramientas en Entorno Virtual de Aprendizaje (EVA), así como para planificar ymediar en ellos de acuerdo a la variación de estudiantes y contenidos; siempre envían comentarios sobre las actividadesy solicitudes de aprendices y en última instancia piensan particulares procesos evaluativos y tienen aperturapara el trabajo en equipo, es decir, a otros profesionales que intervienen en el proceso que van desde productores decontenido a los tutores.Palabras clave: La enseñanza universitaria en línea. Tecnologías de la información y comunicación (TIC). Entornosde aprendizaje virtual (EAV).
Burosumab for treatment of patients with hypophosphatamic rickets Introduction: X-linked hypophosphatemia (HLX), which is a rare, permanent, chronically disabling and deforming bone disease, with profound impact on the patient's daily activities and quality of life. XLH patients have mutations that inactivate the PHEX gene and cause high concentrations of fibroblast growth factor 23 (FGF23) in the blood, altering the phosphate detection control system, leading to excessive urinary phosphate excretion and subsequent hypophosphatemia, resulting in defects in bone mineralization and impacts on other tissues such as muscles. Burosumab acts by inhibiting excess activity of FGF23, normalizing renal phosphate excretion and increasing serum active vitamin D concentration. The aim of this study was to evaluate the efficacy and safety of burosumab in the treatment of XLH. Method: A systematic review was performed in the PUBMED and Cochrane Library databases, using the descriptors "hypophosphatemia" AND "burosumab". Results: A phase III clinical trial evaluating the safety and efficacy of burosumab compared to conventional therapy (phosphate solution and active vitamin D) was recovered. The primary outcome assessed was change in severity of rickets at week 40, as assessed by the Global Radiographic Change Impression (RGI-C) score. At week 40, patients in the burosumab group had significantly greater improvement in the RGI-C score than patients in the conventional therapy group. Treatment emergent adverse events occurred more frequently with burosumab. Serious adverse events were considered unrelated to treatment. Conclusion: The published phase III clinical trial has some advantage in the use of burosumab compared to conventional treatment with phosphate solutions and active forms of vitamin D.
RESUMO: Esta pesquisa teve como objetivo descrever e analisar a proposta de trabalho do Atendimento Educacional Especializado (AEE) das escolas municipais do município de Uberlândia-MG. Para tanto, foi realizada uma pesquisa qualitativa de caráter descritivo e analítico, como definem Lüdke e André (1986), por ser um espaço singular de análise de uma situação do cotidiano, em que lançamos mão do referencial teórico, da prática e da reflexão. Por meio da construção dos dados foi possível fazer a correlação de todos os aspectos apresentados pelos atores da pesquisa, o que culminou em quatro categorias: a história da Educação Especial no município; a visão dos professores do AEE e da sala/classe comum sobre o AEE e o NADH; Sala de Recurso Multifuncional (SRM) e acessibilidade arquitetônica e pedagógica; e a formação de professores. A pesquisa explicitou a necessidade da interlocução entre professores do AEE e da sala/classe comum, bem como uma formação continuada dos professores. Constatamos que as escolas da rede municipal têm se articulado para a oferta do AEE, mas muito ainda precisa ser realizado para esse intento.
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