segunda-feira, 31 de outubro de 2016

Banco de Leite do HU



Banco de Leite completa 20 anos de serviços prestados 











 
O Banco de Leite Humano (BLH) do Hospital da Universidade Estadual de Maringá (UEM) está completando 20 anos. Implantado em 30 de outubro de 1996 no Hospital Universitário, na época como um projeto de extensão, hoje ele é o segundo maior Banco de Leite do Paraná em volume de doação. 
O Hospital Universitário dispõe de veículo próprio para coletar, quatro vezes por semana, as doações em Maringá e na microrregião. Todo o leite doado é pasteurizado e passa por rigoroso controle de qualidade físico-químico antes de ser encaminhado aos lactantes, como exames de acidez Dornic e de composição nutricional. Orientações práticas sobre amamentação, sobre ordenha manual e sobre a própria doação de leite são fornecidas diária e pessoalmente às mães que agendam horário no banco ou também por telefone.

A equipe profissional do serviço é interdisciplinar e formada por sete pessoas, entre enfermeiro, técnicos de enfermagem, nutricionista e pessoal de apoio.

Padrão Ouro - Em 2014, o Banco de Leite Humano recebeu a certificação Padrão Ouro em Excelência pela Rede Brasileira de Bancos de Leite Humano (RedeBLH), devido ao seu desempenho. Anualmente, os bancos de leite humano são avaliados e certificados de acordo com os critérios de excelência preconizados pela RedeBLH nas categorias Ouro, Prata e Bronze.
 

Banco de Leite do HU recebeu o certificado pelo terceiro ano consecutivo, mas em 2014 foi a primeira vez que ele subiu ao pódio. No ano passado, o hospital manteve o Padrão Ouro.
A enfermeira Beatriz Genovez enumera a renovação dos equipamentos e o aumento do número de coletas e visitas domiciliares – possível graças ao veículo adquirido pelo hospital– como os principais fatores que contribuíram com o bom resultado obtido e a consequente conquista da categoria máxima da certificação.

20 anos – Os 20 anos do Banco de Leite foram comemorados durante o 1º Simpósio Multidisciplinar em Neonatologia: fases do cuidado neonatal, realizado nesta sexta-feira, dentro da programação do 4º Encontro Brasil Canadá: 2º Congresso Internacional de Tratamento da Obesidade e doenças crônicas não transmissíveis.
 

Além da palestra a Importância das doadoras nos 20 anos do Banco de Leite Humano do Hospital Universitário de Maringá, ministrada pela professora Márcia Maria Benevenuto de Oliveira, da Universidade Estadual de Londrina, o Simpósio também prestou uma série de homenagens.

Serviço - Contatos com a equipe do BLH podem ser feitos pelo telefone 55.44.3011-9174 

quarta-feira, 26 de outubro de 2016

Atividades de graduação



UEM suspende calendário acadêmico e vestibular


 

Por decisão do Conselho de Ensino, Pesquisa e Extensão (CEP), a Universidade Estadual de Maringá (UEM) decidiu suspender o Calendário Acadêmico para os cursos de graduação. A suspensão está relacionada ao período de greve na Instituição, sendo retroativa a 14 de outubro. Também por decisão do CEP, serão mantidas as atividades para as  5ª e 6ª séries do curso de  Medicina, que funcionam em regime de internato no Hospital Universitário e obedece período letivo próprio, já previsto no Calendário. Outra exceção é o curso de Odontologia, especificamente nas 4ª e 5ª séries, que do mesmo modo segue período letivo próprio.

Reunido nesta quarta-feira, dia 26, o CEP ainda decidiu pela suspensão das provas do PAS (Processo de Avaliação Seriada), do Vestibular EAD e do Vestibular de Verão. Importante destacar que se a greve terminar até 3 de novembro, as provas do PAS e do Vestibular EAD serão realizadas normalmente no dia 27 de novembro. Com relação ao Vestibular de Verão, a data limite é 11 de novembro. Ou seja, se até essa data a greve terminar, o concurso será realizado como previsto no período de 11 a 13 de dezembro.

Para o reitor Mauro Baesso a suspensão do Calendário é uma medida necessária e garante que a carga horária dos cursos seja cumprida integralmente, sem prejuízo aos acadêmicos. A previsão, segundo Baesso, é de que o período letivo avance até fevereiro, considerando o quadro hoje. Pelo último Calendário aprovado pelo CEP as aulas iriam até 18 de janeiro.

Com relação aos concursos vestibulares, a decisão do CEP é uma questão de cautela, considerando que a realização dos concursos exige uma grande logística para a organização e aplicação das provas. “As datas limites estabelecidas garantem o tempo necessário para que a Comissão Central do Vestibular Unificado organize, com segurança, os concursos”, diz o reitor, reforçando que as provas só serão adiadas se a paralisação se estender além dessas datas.   

segunda-feira, 24 de outubro de 2016

Teamwork



ABCs for Managers who Lead – T is for Teamwork

Photo credit: Warren Zelman


Team means Together Everyone Achieves More! – Author Unknown

If you want to go fast, go alone. If you want to go far, go together. – African proverb

From earliest times, family groups, tribes, and communities resulted in the survival of the human race. With the development and increasing sophistication of the brain, our ancestors learned that these groups gave them the benefits of strength against their enemies and successful strategies in hunting their food. Whether members of the group were highly skilled with spears, had the gift of healing or bore the children, each member’s contribution to the group contributed to survival.

Although many of us still live and work in communities, our sense of self has grown. What was a unique contribution to a tribe or group in prehistoric times has turned into individualism and self-reliance. Except in sports and maybe in our families, we have lost much of the sense of working with and for the benefit of a group – teamwork.

Teamwork is the quintessential contradiction of a society grounded in individual achievement.- Marvin R. Weisbord, international consultant.

However, teams and groups have benefits even today, some of them can even be categorized as survival benefits. Here are some examples of the modern day benefits of teamwork:
  1. Teams allow us to complete large complex tasks for the benefit of our societies. Whether these tasks are providing medical care, developing policies to care for the poor and sick, innovating new technologies to make communications easier and faster, or building new bridges or cities, they are all complex and require the skills and dedication of many people working together.
  2. Teams, not individuals, get lasting results. Collaboration yields ownership and ownership yields enthusiasm and sustainability.
  3. Teams create and innovate. With many people, there are many ideas to be shared and new ideas to be generated and used.
  4. Teams support their members and provide guidance to members who are struggling or just learning. In fact, one of the stated or unstated role of teams is to help the members succeed in their individual jobs as well as success as a group.

One piece of log creates a small fire, adequate to warm you up, add just a few more pieces to blast an immense bonfire, large enough to warm up your entire circle of friends; needless to say that individuality counts but team work dynamites. ~Jin Kwon, martial arts master

 

Teaming well

Strong and effective teams have the following characteristics(1):
  • Built on a strong foundation of trust. Building and maintaining trust in teams requires good communications, demonstrations of competency by the team members, willingness to be vulnerable to the group, and an assumption of positive intent on the part of all team members.
  • Able to manage conflict. In fact, strong and effective teams encourage and thrive on respectful conflict and regular feedback because this means that they are generating a diversity of ideas and are fully engaged in the creative process. Artificial harmony creates stagnation and may result in the team taking actions that are not fully supported by all of the team members or just not optimal.
  • Committed to the task and the other members of the team. Team members are inspired to go above and beyond in their dedication to team results and to each other. With this commitment, the team is more important than any individual team member and team members are inspired to work for the common good.
  • Hold each other accountable. The best teams have clearly defined high standards and expect team members to live up to them. Team members bring their skills and capabilities and are accountable to each other for using them for the benefit of the team and achieving team results.
  • Pay attention to results. We say that “results speak for themselves.” If teams obtain the results they seek, they are effective. If they don’t, there is something going on below the surface (e.g. unexpressed or resolved conflicts, fear, investment in the status quo, hidden agendas, etc.).

Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the only thing that ever has. ~Margaret Meade


domingo, 23 de outubro de 2016

Medical practice



How my forever moments have shaped me as a doctor


APStock
Each of us collects what I call forever moments, whether we’re aware of them or not. These emotionally charged personal and professional moments become strongly embedded into our long-term memories and can indefinitely affect our behaviors, values, and perspectives.

My first forever moment came at age 13, when my 11-year-old brother and I survived a house fire that killed our parents. It wasn’t actually a single event but a series of powerful moments that created an enduring impression: my abrupt awakening to thick, grey smoke in my bedroom; the crash of splintered wood on my outstretched hand as my neighbor kicked in our front door; the unimaginable words from my uncle as he told my brother and me that our parents had died during the fire; and the comforting blanket placed over my shoulders by the emergency medical technician in the back of the ambulance on my way to the hospital. I’ve had other forever moments since then — as a parent, a patient, and a physician — that have shaped my life and my work as a physician.

Health care is filled with forever moments for patients and their family members, who often feel vulnerable and isolated during these stressful experiences. One of the many important jobs of health care providers is to help patients and families through these times by being sensitive to and supportive of what they are going through.

Some forever moments are easy to spot. Others aren’t. Complicating matters further is that time with patients is often dominated by digital distractions and measured productivity pressures. These can get in the way of the personal connection that is so essential to seeing another individual’s forever moment. One way to more easily connect with patients and family members is by tapping into your own moments. I often rely on three of them, from different times in my life.

Parent. My wife and I had our first child during the end of our residency training in Philadelphia. Our daughter was born prematurely and needed urgent support of her breathing. While in the neonatal intensive care unit, an air pocket formed around one of her lungs, making it difficult to breathe. To allow her lung to expand, a small chest tube was placed between her ribs to drain air out of this pocket for a few days.

After the first tube was removed, a second pocket immediately formed and she needed another chest tube. It was a struggle for my wife and me to remain positive each day when our daughter seemed to improve one day and then worsen the next. Seventeen days after she was born, we were finally able to take our daughter home with us. She appears blissfully unaffected by the experience, her only reminder the small scars from her chest tubes. Our daughter’s hospital stay did, however, create forever moments for her parents. Remembering them helps me better connect with how family members feel during prolonged, invariably stressful hospitalizations of their loved ones.
Patient. In the middle of my second year of residency, I developed a progressive, unrelenting headache. A CT scan showed that a small cyst in the center of my brain had suddenly blocked the circulation of fluid inside my head. I needed urgent brain surgery to remove the cyst and relieve the pressure.

My surgeon’s personalized approach toward both me and my wife inspired us to trust him implicitly before an intimidating surgery. Although I’m sure he discussed the potential risks of the surgery, what I remember today are hearing the risks of not doing the surgery, including death. I recall telling my wife that everything would be okay as I was wheeled down the hallway toward the operating room.

As an obstetrics resident who had done many surgeries, my wife was understandably worried about the unpredictable events that can occur during any operation. Mine was successful, with no long term effects other than a scar. That forever moment as a patient motivates me to do everything I can to develop trust with each of my patients.

Physician. As an internal medicine resident in the intensive care unit, I worked with a newlywed couple the same age as my wife and I were at the time. She was extremely sick with an aggressive cancer. I stood with her grieving 25-year-old husband, talking about end-of-life choices for his wife as tears slowly rolled down his face.

I tried to envision how I would feel if my wife were this sick at such a young age, but I couldn’t fully imagine how painful this moment was for him. I carefully put my hand on his shoulder and said, “I am so sorry.” Afterward, I sat in a nearby nursing station and put my head in my hands, desperately wanting to do more to help the man and his wife. This was a deeply personal experience for me because I directly related to his perspective as a new husband. That moment clearly shaped my belief in the durable impact of forever moments on providers.
When these moments were happening, I didn’t realize their importance or their longevity. But when I turned 40 last year — an age neither of my parents reached — I finally recognized the potential lifelong impact of a moment.

Health care providers have an enormous responsibility, and an incredible opportunity, to positively contribute to forever moments, which can potentially affect patients and their family members forever. We should rely on our own experiences as family members, patients, and providers to better understand and connect with patients and families as they adapt to intimidating and often frightening medical information and begin forming these moments.

With the continued push in health care to optimize measured value and statistical outcomes, it is increasingly important and inherently valuable to make it possible for health care providers to be present, focused, and connected in a personal way to each patient and family as they encounter their forever moments.

* Nathan Merriman, MD, is director of endoscopy and co-chief of gastroenterology at the Christiana Care Health System in Delaware.

sábado, 22 de outubro de 2016

Patient-centered Care





Atenção centrada no paciente na prática interprofissional colaborativa

AGRELI, Heloise Fernandes; PEDUZZI, Marina  e  SILVA, Mariana Charantola. Interface (Botucatu) [online]. 2016, vol.20, n.59, pp.905-916.  Epub 13-Maio-2016. ISSN 1807-5762.  http://dx.doi.org/10.1590/1807-57622015.0511.

Este estudo foi realizado com o objetivo de descrever os elementos-chave da atenção centrada no paciente e sua relação com a prática interprofissional colaborativa na atenção primária à saúde, no contexto do Sistema Único de Saúde, apoiado em revisão de literatura nacional e internacional. Os resultados mostram que, à medida que os profissionais centram atenção no paciente e suas necessidades de saúde, operam simultaneamente um deslocamento de foco para um horizonte mais amplo e além de sua própria atuação profissional. Esse deslocamento é reconhecido como componente de mudança do modelo de atenção à saúde na perspectiva da integralidade, com potencial de impacto na qualidade da atenção.

Clique aqui para ler o artigo na íntegra, em Português  ou em Inglês

sexta-feira, 21 de outubro de 2016

Large classes



Decrease Class Size, Increase Learning

Regardless of the genetic makeup of any given class, too many students is a recipe for disaster and yet many districts keep student caps excessively high and wonder why student achievement isn't improving.

It is physically impossible for one teacher to meet with 34 students in a high school classroom individually every day, if we want that time to be meaningfully spent. Every child deserves to feel like the teacher is available to help with particular needs and struggles, but if the teacher slows down enough to address any one child, there is a chance many others will lose out.

How can we solve this never ending problem?

It's simple, reduce the class sizes or put more teachers in classes that must remain larger.

Setting up routines and rituals that allow students to take ownership of their learning takes time and if we want to do it so it works, and lessens the burden on the teacher, then we need to at least teach students these expectations across school settings in smaller classes like advisory and there must be a level of consistency kept.

Large classes can often be unwieldy to even the most successful and accomplished teachers and rather than spending time watching students flourish, teachers spend time managing behavior. 

We can all agree, that this is not what school should look like, yet in many places this is what happens. 

All or many of the following challenges can occur when there are too many kids in one room:
  • increased probability of distraction or distractable behavior
  • less time spent on instruction
  • group work can be impeded 
  • students don't get the close attention and feedback they require to succeed
  • higher likelihood of incidents that can escalate
  • less freedom to let students lead the lessons because there isn't much space to move around
  • creativity can be stifled because the pace can be stop and go
  • attendance can also be an issue in larger classes which also leads to other challenges
  • loss of personal touch 
  • difficulty building rapport and relationships with all students

In addition to the impact of having too many kids in a classroom, the additional workload for teachers outside of school assessing work and differentiating lessons appropriately can lead to accelerated teacher burn out. Let's face it working with more kids at once is more exhausting. We expend more energy to try to get them where they need to be.

If class sizes aren't going to be addressed because of bottom lines, either because of a lack of teacher resources or school funding, then we are going to have to find a way to function better inside of these undesirable situations.

domingo, 9 de outubro de 2016

E-learning





The Evolution of Multiple Choice E-learning




Move over rote learning: there’s a new development in multiple choice e-learning that facilitates and deepens the application of the learning and not just short-term memory. This is good news for companies who wish to develop the skills of their employees and prompt them to act on their learning, instead of simply testing their ability to remember.(Five principles for effective training design that leads to change)

Peer Instruction

This new generation of multiple choice includes peer instruction. It makes it possible to combine summative and formative assessment in e-learning, a benefit which does not occur during the one-way communication that characterizes multiple choice as we know it today. This is a huge step forward for e-learning because it creates a change-oriented experience that will take corporate e-learning to a whole new level.

"A change-oriented approach will take corporate e-learning to a whole new level"

Involving E-learners

“Tell me and I forget, teach me and I may remember, involve me and I learn.”– Benjamin Franklin

The brilliance of introducing peer instruction in multiple choice e-learning is that, for the first time, students are provided with an opportunity to involve themselves in the process, observe what their peers are doing, reflect on and then adjust their answer. This is important from a learning theory perspective. According to neuro-pedagogical research, if we want to facilitate a learning experience that leads to change, rather than as a means to test memory, involvement and reflection is key. (Illeris, 2013. Lieberoth, 2013. Mezirow, 2001).

"Reflection is the key to facilitate a learning experience that leads to change"

The Importance of Reflection

According to Bjarne Walgreen a Scandinavian professor who researches workplace competencies, it is through reflection that we learn how to act in a certain situation in order to achieve a certain goal (Walgreen, 2008). It is through reflection that we get to know more about how and why we should act when we use newly acquired knowledge in practice. But until now, it has not been technically possible to use multiple choice to create a formative assessment learning experience other than rote memory. Multiple choice e-learning has been limited to information dumping and cannot be seen as a complete learning experience (Suen, 2014).  Filling the heads of learners with facts without taking their motivation and engagement into consideration and only testing their recall of said facts makes for an empty learning outcome.

"Multiple choice e-learning has been limited to information dumping and cannot be seen as a complete learning experience"

Making Multiple Choice Matter for Participants

Peer instruction is finally breaking off its relationship with the old pedagogical approach to e-learning in use today. Adding a social element to e-learning makes it possible for participants to do more than choose a multiple choice answer: they get to explain and share their reflections about their choices and to learn from each other.

How Peer Instruction Works in Practice

Peer instruction has been developed by edX.org (today’s most valuable LMS developed by Harvard & MIT, worth more than $500 billion and accessible as open source at openedx.org), with an aim to take e-learning to a higher level. The way peer instruction works in practice is as follows (edX, 2016):

          Step 1. Explain Your Choice
          Step 2. Review Other Initial Responses
          Step 3. Revise Your Response
          Step 4. Review the Correct Answer
          Step 5. Compare Answers


Step 1: Explain your Choice

The learner is prompted to write an explanation for the answer chosen through multiple choice.

This step is their opportunity to provide a persuasive argument about why the answer is the correct one. The answer might include references to a course video, or a practical experience, or describing how the learner arrived at the choice he/she made.

Together, the answer that the learner chose and this explanation comprise his/her initial response. When the learner selects Next, his/her initial response is added to the collection of initial responses by all of the other course participants.



Step 2: Review Other Initial Responses

The learner then reviews the initial responses submitted by other course participants. The course team decides how many other responses the learner will see: they might see one response for each of the possible answer choices, or a set that is chosen completely at random.

This step gives the participant a chance to learn from the explanations that other learners submitted, and to reassess their own understanding of the topic.



Step 3. Revise Your Response

The learner can now decide whether he/she want to change the initial response by selecting a different answer choice, revising their explanation, or both.

This is an optional step. The learner can submit a final response that is the same as their initial response, or change it completely. When they move on to the next step, they learn the correct answer.



Step 4. Review the Correct Answer

The learner can now review the correct answer choice and the explanation provided by the course team.




Step 5. Compare Answers

Graphs that reveal the percentage of learners who selected each answer are shared to further help reinforce the learning. The first graph, below, shows the percentage of learners who selected each answer initially, and the second graph shows the percentage of learners who selected each answer after they had the opportunity to review the explanations that other learners provided. The learners can compare their own choices, and the correct one, to the answers from their peers. (The graphs appear after ten learners submit their final responses.)

This step can be just as thought provoking as the others. 



Successful Learning is Change

To me, a successful learning experience is about change. It’s about being able to use new knowledge in practice, to develop skills and competencies and to be able to do something better than before. This is the kind of learning that leads to more skilled employees. The development of peer instruction into multiple-choice e-learning is going to change the learning landscape, for better.   

Resources:
Illeris, K. (2013). Transformativ læring og identitet. Samfundslitteratur.
Lieberoth, A. (2013). Hukommelsessystemer og oplevelseslæring: Hvordan forvandler hjernen episoder til semantisk viden?. Cursiv11, 59-82.
Wahlgren, B. Høyrup, S. Pedersen, K. Rattleff, P. (2002). Refleksion og læring Kompetenceudvikling i arbejdslivet. Frederiksberg: Samfundslitteratur
Mezirow, J. (1991). Transformative dimensions of adult learning. Jossey-Bass, 350 Sansome Street, San Francisco, CA 94104-1310.
Suen, H. K. (2014). Peer assessment for massive open online courses (MOOCs). The International Review of Research in Open and Distributed Learning, 15(3), 312-327