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Objective: Low back pain is a common complaint among pregnant women. It is estimated that about 50% of pregnant women complain of some form of back pain at some point in pregnancy or during the postpartum period. The aim of this study was to evaluate the frequency of low back pain during pregnancy and its characteristics. Methods: Cross-sectional study with low-risk pregnant women. After approval by the Human Research Ethics Committee and receiving written informed consent, we included pregnant women over 18 years of age and excluded those with psychiatric disorders, previous lumbar pathologies, and receiving treatment for low back pain. Results: We interviewed 97 pregnant women. The frequency of low back pain was 68%. The mean age was 26.2 years and the median gestational age was 30 weeks. Fifty-eight pregnant women declared themselves as brown (58%). Most (88.6%) were married or living in common-law marriage, 56 (57.7%) worked outside the home, and 71 (73.2%) had completed high school. Low back pain was more frequent during the second trimester of pregnancy (43.9%), referred to as a “burning” sensation in 37.8% of patients, with intermittent frequency in 96.9% of the women. The symptoms got worse at night (71.2%). Resting reduced low back pain in 43.9% of pregnant women, while the standing position for a long time worsened it in 27.2% of patients. Conclusion: Low back pain is common in pregnant women, has specific characteristics, and is more frequent in the second trimester of pregnancy. This indicates the need for prevention strategies that enable better quality of life for pregnant women. Resumo: Objetivo: A lombalgia é uma queixa comum entre grávidas. Estima-se que cerca de 50% das gestantes queixam-se de algum tipo de dor lombar em algum momento da gravidez ou durante o puerpério. O objetivo deste estudo foi avaliar a frequência da lombalgia na gestação e suas características. Método: Estudo de corte transversal com gestantes de baixo risco. Após a aprovação pelo Comitê de Ética em Pesquisa em Seres Humanos e a assinatura do termo de consentimento livre e esclarecido, foram incluídas maiores de 18 anos e alfabetizadas e excluídas gestantes com distúrbios psiquiátricos, com patologias lombares prévias e em tratamento para dor lombar. Resultados: Foram entrevistadas 97 gestantes. A frequência de dor lombar foi 68%. A média de idade foi 26,2 anos e a mediana da idade gestacional de 30 semanas; 58 consideraram-se pardas (58%). A maioria (88,6%) era casada ou vivia em união estável, 56 (57,7%) trabalhavam fora e 71 (73,2%) tinham o ensino médio completo. A lombalgia foi mais frequente durante o segundo trimestre gestacional (43,9%), referida como “em queimação” por 37,8% das pacientes e com frequência intermitente em 96,9%. Os sintomas pioravam no período noturno (71,2%). O repouso reduzia a dor lombar em 43,9%, enquanto a posição ortostática por longo tempo agravava em 27,2%. Conclusão: A lombalgia é comum em gestantes, apresenta características específicas e é mais frequente no segundo trimestre. Isso alerta para a necessidade de serem instituídas estratégias de prevenção que possibilitem melhor qualidade de vida para a gestante. Keywords: Low back pain, Frequency and characteristics of low back pain, Pregnant women, Palavras-chave: Lombalgia, Frequência e características da lombalgia, Gestantes

In pregnant women subjected to spinal anesthesia for a Cesarean section, episodes of nausea and vomiting are common both during and following surgery. Acupuncture for the prophylaxis and treatment of these complications has been gaining in popularity due to its low cost, simplicity, absence of side effects and confirmed efficacy. This study investigated the efficacy of stimulating the P6 acupoint in conjunction with the use of dexamethasone as prophylaxis for nausea and vomiting in pregnant women submitted to spinal anesthesia for a Cesarean section. The patients (n = 100) were randomly distributed into two groups. In the first group (n = 50), a site located one centimeter laterally from P6 was stimulated. This is not a true acupuncture point (sham acupuncture). In the second group (n = 50), P6 was stimulated. In both groups, 4 mg of dexamethasone were administered intravenously. A questionnaire was used to obtain information on the occurrence of nausea and vomiting during surgery and in the first 12 hours postpartum. The chi-square test and Fisher’s exact test were used to assess differences between the groups. Age and physical status were similar in both groups. The incidence of nausea during surgery was 32% (n = 16) in the control group and 22% (n = 11) in the P6 group (p > 0.05). In the first 12 hours following surgery, nausea occurred in 16% of the women in the control group (n = 6) and in 4% in the P6 group (n = 4) (p = 0.045). The incidence of vomiting in the control group was 12% (n = 6) during surgery and 10% (n = 5) in the postoperative period compared to 8% (n = 4) and 4% (n = 2), respectively, in the P6 group (p > 0.05). Although these differences were not statistically significant with the exception of the incidence of nausea in the first 12 hours postpartum, a reduction occurred in the incidence of all the outcomes evaluated in the P6 group.

Brain death (BD) alters the pathophysiology of patients and may damage the kidneys, the lungs, the heart and the liver. To obtain better quality transplant organs, intensive care physicians in charge of the maintenance of deceased donors should attentively monitor these organs. Careful hemodynamic, ventilatory and bronchial clearance management minimizes the loss of kidneys and lungs. The evaluation of cardiac function and morphology supports the transplant viability assessment of the heart. The monitoring of liver function, the management of the patient's metabolic status and the evaluation of viral serology are fundamental for organ selection by the transplant teams and for the care of the transplant recipient.

Introduction The organ shortage for transplantation, the principal factor that increases waiting lists, has become a serious public health problem. In this scenario, the intensivist occupies a prominent position as one of the professionals that first has a chance to identify brain death and to be responsible for the maintenance of the potential deceased donor. Objective This report attempts to establish guidelines for care and maintenance of adult deceased donor organs guiding and standardizing care provided to patients with brain death. Method These guidelines were composed by intensivists, transplant coordinators, professionals from various transplant teams, and used transplant center. The formulated questions were forwarded to all members and recommendations were constructed after an extensive literature review selecting articles with the highest degree of evidence. Results Guidelines were developed in the form of questions reflecting frequent experiences in clinical intensive care practices. The main questions were: Is there an optimal interval for keeping organs of deceased donors viable? What actions are considered essential for maintaining deceased donors in this period? What are the limits of body temperature? How should the patient be warmed? Which laboratory tests should be performed? What is the collection interval? What are the limits in the laboratory and the capture scenario? What are the limits of blood pressure? When and how should one use catecholamines? Conclusions This pioneer project involved a multidisciplinary team working in organ transplantation seeking to provide treatment guidance to increase the number of viable organs from deceased adult donors.

A morte encefálica induz várias alterações fisiopatológicas que podem causar lesões em rins, pulmões, coração e fígado. Portanto, a atuação do intensivista durante a manutenção do potencial doador falecido exige cuidados específicos com estes órgãos visando sua maior viabilidade para transplantes. O manejo hemodinâmico cuidadoso, os cuidados ventilatórios e de higiene brônquica minimizam a perda de rins e pulmões para o transplante. A avaliação da condição morfológica e funcional do coração auxilia na avaliação do potencial transplantável deste órgão. Por fim, a avaliação da função hepática, assim como o controle metabólico e a realização de sorologias virais são fundamentais para a orientação das equipes transplantadoras na seleção do órgão a ser doado e no cuidado com o receptor. Brain death (BD) alters the pathophysiology of patients and may damage the kidneys, the lungs, the heart and the liver. To obtain better quality transplant organs, intensive care physicians in charge of the maintenance of deceased donors should attentively monitor these organs. Careful hemodynamic, ventilatory and bronchial clearance management minimizes the loss of kidneys and lungs. The evaluation of cardiac function and morphology supports the transplant viability assessment of the heart. The monitoring of liver function, the management of the patient's metabolic status and the evaluation of viral serology are fundamental for organ selection by the transplant teams and for the care of the transplant recipient

A atuacao do intensivista durante a manutencao do potencial doador falecido na busca da reducao de perdas de doadores e do aumento da efetivacao de transplantes nao se restringe aos aspectos hemodinâmicos. O adequado controle endocrino-metabolico e essencial para a manutencao do aporte energetico aos tecidos e do controle hidro-eletrolitico, favorecendo inclusive a estabilidade hemodinâmica. A abordagem das alteracoes hematologicas e igualmente importante considerando as implicacoes da pratica transfusional inapropriada. Ressalta-se ainda o papel da ventilacao protetora na modulacao inflamatoria e consequente aumento do aproveitamento de pulmoes para transplante. Por fim, assinala-se a relevância da avaliacao criteriosa das evidencias de atividade infecciosa e da antibioticoterapia na busca do maior utilizacao de orgaos de potenciais doadores falecidos

A desproporção entre a grande demanda por transplantes de órgãos e a baixa realização de transplantes é um grave problema de saúde pública. O reconhecimento da morte encefálica, a adequada abordagem da família e a manutenção clínica do doador falecido são fundamentais para a diminuição desta desproporção. Neste cenário, o intensivista tem importância central e a aplicação do conjunto de informações disponíveis para manutenção do potencial doador falecido está claramente associada à redução de perdas de doadores e ao aumento da qualidade e da efetivação de transplantes There is a relative shortage of appropriate organs available for transplantation. The appropriate diagnosis of brain death, a suitable family approach and the maintenance of the deceased donor are fundamental in addressing this issue. The intensive care physician plays a key role in the maintenance of the deceased donor, thereby reducing losses and increasing the number of successful transplants

There is a relative shortage of appropriate organs available for transplantation. The appropriate diagnosis of brain death, a suitable family approach and the maintenance of the deceased donor are fundamental in addressing this issue. The intensive care physician plays a key role in the maintenance of the deceased donor, thereby reducing losses and increasing the number of successful transplants.

Mestrado em Gestão Curricular No Ensino Secundário pretende-se que os alunos desenvolvam uma literacia científica que contribua para os tornar cidadãos informados, activos e capazes de não só discutir mas também encontrar as soluções para os problemas com que se deparam no mundo em que vivem. Ora, a proposta de abordagem curricular centrada na Aprendizagem Baseada na Resolução de Problemas consiste na aprendizagem de novos conhecimentos a partir da confrontação dos alunos com contextos problemáticos. Assim, os objectivos deste estudo consistiram em conceptualizar, organizar, implementar e avaliar materiais curriculares numa perspectiva de ensino orientada para a Aprendizagem Baseada na Resolução de Problemas, inserida nas unidades temáticas “Movimentos na Terra e no Espaço” (componente de Física) e “ Da Atmosfera ao Oceano: soluções na Terra e para a Terra” (componente de Química) e em diagnosticar dificuldades sentidas quer pelos alunos quer pela professora na sua implementação. Esta abordagem foi aplicada numa turma do 11º ano de escolaridade do Curso de Ciências e Tecnologias, em duas fases. A primeira, aplicada à componente de Física, visava essencialmente avaliar os documentos quanto à sua conceptualização, aplicabilidade, relevância de informação e estratégia de ensino e aprendizagem aplicada. Na segunda fase, aplicada à componente de Química, todo o processo foi repetido, permitindo assim o exercício de um cruzamento confirmatório e ou infirmatório. Os dados de natureza distinta, foram recolhidos de formas diversas: numa primeira fase, através de um teste de conhecimentos e um teste de aferição de desempenho dos alunos na resolução de situações problemáticas, usados num contexto de pré-teste e pós-teste; de um questionário de opinião sobre a eficácia e adesão da abordagem de ensino e aprendizagem implementada. Numa segunda, através de um teste de aferição do desempenho dos alunos na resolução de situações problemáticas e de uma entrevista, “Focus Group”. A técnica de observação foi também utilizada, baseando-se em notas de campo e relatórios de dificuldades sentidas quer pelos alunos, quer pela professora. Da análise dos resultados, poder-se-á concluir que os alunos evoluíram de uma forma muito positiva, na aprendizagem conceptual de Física e Química e mostraram ter desenvolvido competências na resolução de situações problemáticas. Não obstante as limitações inerentes ao estudo aqui apresentado como por exemplo a dimensão da amostra e os instrumentos utilizados, os resultados obtidos parecem apontar no sentido da vantagem do ensino orientado para a Aprendizagem Baseada na Resolução de Problemas sobre o ensino do tipo usualmente praticado nas nossas escolas. Assim, sugere-se a realização de mais estudos centrados na aprendizagem destes e outros temas utilizando esta metodologia, pois permite que os alunos dos diferentes níveis de ensino desenvolvam capacidades de resolver problemas sócio-científicos. ABSTRACT: In High School it is expected that students acquire and develop a scientific literacy which can make them knowledgeable and active citizens, capable of not only discussing but also contributing to finding solutions to problems they are faced with in the world they live in. Therefore, Learning Based on Problem-solving consists in acquiring more knowledge by solving problems that come up when the student is faced with a problematic issue. Consequently, the objectives of this study were based upon the conception, organization, implementation and evaluation of teaching materials in a perspective of teaching towards learning based on problemsolving, within such themes as “Movements in Space and on Earth” (a Physics component) and “From the Environment to the Ocean: Solutions on Earth for our Earth”, (a Chemistry component) and on the diagnosis of the difficulties faced by both students and teachers in implementing the aforementioned. This type of teaching and learning was carried out in two phases in an 11th grade class from the Science and Technology course. The first phase, implemented in the subject of Physics, was essentially directed to evaluating the documents as to their applicability, legibility, relevance in terms of the applied teaching and learning information and strategy. During the second phase, implemented in Chemistry, the whole process was equally repeated, thus allowing for a crosscheck exercise, so as to confirm and or inform. Data was collected under several forms: during the first phase, through two tests, one assessing knowledge and the other evaluating the students’ performance in solving problematic situations, both used before and after the implementation of the new strategy. The students also answered an opinion questionnaire on the efficiency and acceptance of this teaching and learning method. During the second phase, data collection was done through a test on the ability of students in solving problematic issues and a group interview called “Focus Group”. Data was also collected based on observation and note-taking in the field and on the reports regarding the difficulties felt both by students and the teacher. Upon analyzing the results, we may conclude that the students evolved in a very positive way in the conceptual learning of Physics and revealed having developed competence in solving problematic issues. Despite the limitations inherent in the study presented herein, the results which were obtained seem to point to an advantage in teaching focused on Learning Based upon Problem-solving, compared to the traditional teaching method in practice in our schools. Thus, we suggest that more studies should be done regarding this teaching method and others, and the capacity of students, within different school levels, in solving social-scientific issues.