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Digital technology coaches (DTCs) often support teachers with integrating technology into their classroom and instructional program, as well as provide ongoing staff development. To be effective, coaches tend to have specific characteristics for instructional coaching and competencies for educational coaching. We investigated if these characteristics and competencies applied to effective DTCs while we observed their proficiency with technology, their interactions with other educators, and the way they provide support for the teacher-professional learning (PL) process. Three DTCs led over 80 K-12 teachers from the same school district in classroom coaching sessions, collaborative planning meetings, PL sessions, and conference presentations. In keeping with generic qualitative methods, multiple data sources including fieldnotes, artifacts, and transcribed interviews were analyzed. Through examining data detailing their role and impact on the learning of their teacher colleagues, it was apparent that these DTCs possess the characteristics and competencies of effective instructional coaches. Importantly, this study adds to the literature on effective coaches by documenting the applicability of these characteristics and competencies to not only instructional coaches, but also DTCs, elucidating their role, and explaining their influence on teacher PL.

This project focused on how two technology coaches, a K-12 Technology Coach and a Science Technology Engineering Mathematics (STEM) Coach collaborated with their coach colleagues and tech-industry partners to offer teachers resources and embedded professional learning (PL). As part of a multiple-case study of coaching models of PL, over the course of two academic years, the researchers gathered observational data during classroom coaching sessions, small group professional learning sessions, and professional development workshops hosted by a tech-industry partner. Additionally, the coaches and a subset of middle school teachers participated in one-on-one interviews and the coaches had discussions in a focus group. Data analyses distilled two main themes: (1) coaches appeal to and collaborate with tech-industry partners; and (2) coaches solicit support and collaborate with school district administrators. Conclusions suggest that technology and STEM coaches serve an integral role in the implementation of technology across the district when collaborating with tech-industry partners. Recommendations include the need for technology coaches to be resourceful and initiate and foster tech-industry partnerships as well as dedicate time to collaborate with other coaches to enhance their own professional knowledge and skills.

Abstract Background During the pandemic period, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mutated, leading to changes in the disease’s severity and the therapeutic effect of drugs accordingly. This study aimed to present the actual use of therapeutics and clinical outcomes based on the prevalence of each variant using real-world data. Methods We analyzed the electronic medical records of adult patients admitted to Busan Medical Center after confirming coronavirus disease 2019 (COVID-19) from February 1, 2020, to June 30, 2022. Patients with mild-to-moderate COVID-19 who were at a high risk of disease progression were selected as study subjects, and the time period was classified according to the variants as ancestral strain, Delta variant, or Omicron variant. We compared drug use status and clinical outcomes by time period. Results Among all 3,091 patients, corticosteroids were the most commonly used therapy (56.0%), being used most frequently in the Delta variant (93.0%), followed by the Omicron variant (42.9%) and ancestral strain (21.2%). Regdanvimab accounted for the majority of therapeutic use in the Delta variant (82.9%) and ancestral strain (76.8%), whereas remdesivir was most frequently used during the Omicron variant period (68.9%). The composite outcomes of death or disease aggravation were ranked in the order of the Delta variant, Omicron variant, and ancestral strain (14.5, 11.9, and 6.0%, respectively, P

Introdução: Diversos suplementos têm surgido com a finalidade de complementar a dieta. Um dos suplementos que vem sendo o mais utilizado é o whey protein, principalmente para os praticantes de atividade física que buscam hipertrofia. Objetivo: Avaliar o consumo de whey protein por praticantes de atividade física da cidade de Antônio Prado-RS. Materiais e métodos: Trata-se de um estudo transversal descritivo, incluindo 90 indivíduos que frequentam academia e consomem o suplemento whey protein na cidade de Antônio Padro no Rio Grande do Sul. A coleta de dados foi realizada através de questionário autoaplicável, no período de dezembro de 2018 até março de 2019. Os questionários foram preenchidos pelos participantes nas entradas das academias, onde foram questionados sobre dados sociodemográficos, antropométricos, prática de atividade física sendo o tempo e a modalidade praticada, uso de suplementos nutricionais e quem indicou o uso do suplemento. Resultados: Foram incluídos 90 praticantes de academia usuários de whey protein. A maioria dos participantes foram adultos jovens do sexo masculino (63,3%), praticantes da modalidade de musculação (96,7%), em busca de hipertrofia (56,6%). Estes participantes ainda relataram que o macronutriente principal a ser consumido é a proteína (80%) e a maioria deles, não realiza acompanhamento com profissional nutricionista (48,9%). Conclusão: A maioria dos usuários de whey protein frequentadores de academias de Antônio Prado, eram adultos jovens do sexo masculino, sendo a maioria praticante de musculação, em busca de hipertrofia.

Este artigo se baseia em experiências no ensino superior para explorar o uso de metodologias artísticas na pesquisa educacional e na formação de professores, em consonância com as mudanças epistemológicas em curso na academia. O objetivo principal é refletir sobre os desafios e contribuições dessas abordagens para os processos de ensino, aprendizagem e pesquisa. Apoiados na perspectiva educativa da cultura visual (Hernández, 2011, 2013a; 2020) e na Investigação Baseada em Arte (Hernández, 2013b; Dias, 2013; Irwin, 2013), discutimos questões relacionadas à linguagem não verbal como um catalisador para explorar temas no ensino e na pesquisa. Concluímos que desviar da tradicional lógica acadêmica centrada no texto para a produção de narrativas visuais abre novas e múltiplas possibilidades de aprendizagem na contemporaneidade.

Purpose: This two-year study illuminates the experiences of technology coaches (digital learning coaches [DL] and science technology engineering and mathematics/literacy coaches [STEM/L]) as they engaged in their own professional learning (PL) facilitated by a faculty researcher. Design/methodology/approach: Technology coaches from different school districts and their respective colleagues participated in book studies as part of their PL. They reflected and debriefed individually and collaboratively with a researcher facilitator. Data were collected through interviews, field notes at meetings, observations, researchers' reflections and artefacts. Qualitative data analysis methods were employed. Findings: The findings offer a glimpse into (1) benefits of cross-district collaboration, (2) challenges finding resources for coaching, (3) career-long desire to learn and (4) time to build and sustain cross-collaborations. Practical implications: Conclusions suggest that DL and STEM/L coaches benefit from their own dedicated, differentiated programme of PL supported by each other (as from other districts) and a researcher facilitator. Educational implications are offered for researchers and other school district stakeholders for consideration for them to foster coaches' collaborative PL. Originality/value: Importantly, this project is an exemplar of how to support coaches' PL and growth through researcher facilitation of cross-district collaborative learning.

This survey-design study examined how 228 middle school preservice teachers perceived the implementation of digital and digital multimodal texts during course-required, mentored, tutoring sessions delivered in face-to-face and online settings prior to, during and toward the end of the COVID-19 pandemic. Tutors were able to recognize that texts could be used to elicit affective responses from their students, and had the potential to differentiate their lessons in accordance with learners' needs, but the technology challenges they faced seemed insurmountable to some. Given their lack of teaching experience, tutors struggled to determine the appropriateness of the resources and they held distinct perceptions of the accomplishments and challenges related to their tutoring sessions. Mentor responsiveness exhibited by honouring tutors' adaptive expertise can be seen as an important aspect of fostering tutors' confidence. Focusing on the role of the mentor in preservice teachers' tutoring field placements is a suggested area for future research.

Although small-group guided reading is traditionally an elementary school instructional practice, this study details how high school English teachers perceived its implementation in high school classrooms. As part of a larger, multiyear research project, this 2-year study examined a dual-level coaching professional learning program that included two school district literacy coaches, eight provincial literacy facilitators, and 21 high school teachers. Teachers were coached in the implementation of guided reading and small-group instruction to support students in Grades 9-10 who were struggling with reading. Qualitative methods were used to gather data including observations of the professional learning meetings and teachers' instruction; interviews with literacy coaches, professional literacy facilitators, and teachers; and artifact collection. Data were analyzed using the qualitative software program NVivo. The findings suggest that teacher coaching, modeling, co-planning, discussion, and reflection enhanced teachers' abilities to support students in their use of metacognitive skills and comprehension strategies during guided reading. Teachers noted some insightful instructional considerations for implementation of elementary instructional practices in their high school English classrooms. Overall, these results have practical implications for teachers seeking to help struggling high school readers.

Abstract Background Prolonged hemodialysis (HD) is performed from 6 to 12 h and can last up to 24 h. To prevent system clotting some studies suggest that Regional Citrate Anticoagulation (RCA) use reduces bleeding rates relative to systemic heparin. However, there may be difficulties in the patient’s clinical management and completing the prescribed HD with Genius system using RCA. Objective To analyze safety Quality Indicators (IQs) and follow up on prolonged HD with 4% sodium citrate solution in a Genius® hybrid system. Methods This is a retrospective cohort conducted in an intensive care unit. Results 53 random sessions of prolonged HD with 4% sodium citrate solution of critically ill patients with AKI assessed. Evaluated safety indicators were dysnatremia and metabolic alkalosis, observed in 15% and 9.4% of the sessions, respectively. Indicators of effectiveness were system clotting which occurred in 17.3%, and the minimum completion of the prescribed HD time, which was 75.5%. Conclusion The assessment of the indicators showed that the use of RCA with a 4% sodium citrate solution in prolonged HD with the Genius system in critically ill patients with AKI can be performed in a simple, safe, and effective way.

Using agricultural gypsum promotes nutrient descent and generates a less aggressive environment for roots, favoring their development and better use of water and nutrients. However, studies on apple trees are scarce, and there is no official recommendation for gypsum application in the soils of southern Brazil. This work aimed to evaluate the potential use of agricultural gypsum to increase soil fertility and apple tree productivity. The research was carried out in the municipality of Ipê, RS, in an apple orchard cv. Condessa planted fifteen years ago and with acidity in the soil layer of 20–40 cm. The design of the experiment was consisted of randomized blocks, containing five treatments and four replications, with 80 m2 each. The treatments consisted of five doses of agricultural gypsum, applied at the beginning of the productive cycle. The study evaluated soil chemical parameters at 0–20 cm and 20–40 cm, chlorophyll content, and crop productivity. The results showed an increase in the sulfur content up to the gypsum dose of 6.0 t∙ha−1 and a reduction in the magnesium content in the soil at both evaluated depths. Agricultural gypsum application did not significantly influence the other chemical parameters evaluated. Chlorophyll content in apple leaves was reduced, and there was an increase in productivity with the increase in the dose of agricultural gypsum. Therefore, gypsum can potentially improve soil fertility and increase apple tree productivity.

Background The Breakthrough Series model uses learning sessions (LS) to promote education, professional development and quality improvement (QI) in healthcare. Staff divergences regarding prior knowledge, previous experience, preferences and motivations make selecting which pedagogic strategies to use in LS a challenge.Aim We aimed to assess new active-learning strategies: two educational games, a card game and an escape room-type game, for training in healthcare-associated infection prevention.Methods This descriptive case study evaluated the performance of educational strategies during a Collaborative to reduce healthcare-associated infections in Brazilian intensive care units (ICUs). A post-intervention survey was voluntarily offered to all participants in LS activities.Results Seven regional 2-day LS were held between October and December 2022 (six for adult ICUs and one for paediatric/neonatal ICUs). Of 194 institutions participating in a nationwide QI initiative, 193 (99.4%) participated in these activities, totalling 850 healthcare professionals. From these, 641 participants responded to the survey (75.4%). The post-intervention survey showed that the participants responded positively to the educational activities.Conclusion The participants perceived the various pedagogical strategies positively, which shows the value of a broad and diverse educational approach, customised to local settings and including game-based activities, to enhance learning among healthcare professionals.

BackgroundOpioids have traditionally been used to manage acute or terminal pain. However, their prolonged use has the potential for abuse, misuse, and addiction. South Korea introduced a new health care IT system named the Narcotics Information Management System (NIMS) with the objective of managing all aspects of opioid use, including manufacturing, distribution, sales, disposal, etc. ObjectiveThis study aimed to assess the impact of NIMS on opioid use. MethodsWe conducted an analysis using national claims data from 45,582 patients diagnosed with musculoskeletal and connective tissue disorders between 2016 and 2020. Our approach included using an interrupted time-series analysis and constructing segmented regression models. Within these models, we considered the primary intervention to be the implementation of NIMS, while we treated the COVID-19 outbreak as the secondary event. To comprehensively assess inappropriate opioid use, we examined 4 key indicators, as established in previous studies: (1) the proportion of patients on high-dose opioid treatment, (2) the proportion of patients receiving opioid prescriptions from multiple providers, (3) the overlap rate of opioid prescriptions per patient, and (4) the naloxone use rate among opioid users. ResultsDuring the study period, there was a general trend of increasing opioid use. After the implementation of NIMS, significant increases were observed in the trend of the proportion of patients on high-dose opioid treatment (coefficient=0.0271; P=.01) and in the level of the proportion of patients receiving opioid prescriptions from multiple providers (coefficient=0.6252; P=.004). An abrupt decline was seen in the level of the naloxone use rate among opioid users (coefficient=–0.2968; P=.04). While these changes were statistically significant, their clinical significance appears to be minor. No significant changes were observed after both the implementation of NIMS and the COVID-19 outbreak. ConclusionsThis study suggests that, in its current form, the NIMS may not have brought significant improvements to the identified indicators of opioid overuse and misuse. Additionally, the COVID-19 outbreak exhibited no significant influence on opioid use patterns. The absence of real-time monitoring feature within the NIMS could be a key contributing factor. Further exploration and enhancements are needed to maximize the NIMS’ impact on curbing inappropriate opioid use.

Abstract Background One of the main challenges of microbiome analysis is its compositional nature that if ignored can lead to spurious results. Addressing the compositional structure of microbiome data is particularly critical in longitudinal studies where abundances measured at different times can correspond to different sub-compositions. Results We developed coda4microbiome, a new R package for analyzing microbiome data within the Compositional Data Analysis (CoDA) framework in both, cross-sectional and longitudinal studies. The aim of coda4microbiome is prediction, more specifically, the method is designed to identify a model (microbial signature) containing the minimum number of features with the maximum predictive power. The algorithm relies on the analysis of log-ratios between pairs of components and variable selection is addressed through penalized regression on the “all-pairs log-ratio model”, the model containing all possible pairwise log-ratios. For longitudinal data, the algorithm infers dynamic microbial signatures by performing penalized regression over the summary of the log-ratio trajectories (the area under these trajectories). In both, cross-sectional and longitudinal studies, the inferred microbial signature is expressed as the (weighted) balance between two groups of taxa, those that contribute positively to the microbial signature and those that contribute negatively. The package provides several graphical representations that facilitate the interpretation of the analysis and the identified microbial signatures. We illustrate the new method with data from a Crohn's disease study (cross-sectional data) and on the developing microbiome of infants (longitudinal data). Conclusions coda4microbiome is a new algorithm for identification of microbial signatures in both, cross-sectional and longitudinal studies. The algorithm is implemented as an R package that is available at CRAN ( https://cran.r-project.org/web/packages/coda4microbiome/ ) and is accompanied with a vignette with a detailed description of the functions. The website of the project contains several tutorials: https://malucalle.github.io/coda4microbiome/

Objetivo: Verificar a relação entre a circunferência do pescoço e indicadores antropométricos convencionais e não convencionais de risco cardiovascular e estado nutricional em idosos da comunidade. Materiais e Métodos: Estudo transversal com idosos da comunidade (≥ 60 anos de idade) atendidos na atenção básica do município de Doutor Ricardo-RS. A coleta de dados ocorreu de julho a novembro de 2019. Foram avaliadas as variáveis sociodemográficas; estilo de vida; doenças crônicas não transmissíveis; comorbidades; indicadores convencionais de risco cardiovascular (índice de massa corporal; percentual de gordura corporal e circunferência da cintura) e indicadores não convencionais de risco cardiovascular (circunferência do pescoço, razão cintura-estatura e índice de conicidade). Resultado: Participaram 44 idosos com idade média de 71,27±8,57 anos. As maiores médias da circunferência do pescoço foram associadas com sobrepeso (p=0,020); risco cardiovascular muito elevado (p=0,024), percentual de gordura (p=0,017), razão cintura-estatura (p=0,036) e índice de conicidade, respectivamente inadequados (p=0,003). A inadequação da circunferência do pescoço associou-se com a inadequação do estado nutricional (p=0,009); da circunferência da cintura (p=0,002) e razão cintura-estatura (p=0,036). Discussão: Maior circunferência do pescoço correlaciona-se positivamente com o aumento de risco cardiometabólico e sobrepeso em idosos. Conclusão: A circunferência do pescoço associou-se com os indicadores antropométricos convencionais e não convencionais para risco cardiovascular e com o estado nutricional.

Constatada a urgência ecológica de uma nova relação do ser humano com as outras criaturas, o artigo busca compreender a constituição de direitos e, na sua base, a categoria de dignidade. Para tanto, analisa a linguagem sobre a dignidade e um percurso histórico sobre a ampliação de reconhecimento de dignidade e direitos humanos. A partir dos animais, testa um reconhecimento alargado desses dois conceitos cada vez mais assimétricos. Dessa forma, a relação se transforma na gratuidade e na responsabilidade do Cuidado, assimétrico e interdependente, que configura, assim, um novo humanismo ecológico. Com Leonardo Boff e o Papa Francisco, o artigo sublinha as consequências dessa postura e os elementos teológico-pastorais de prática cristã do Cuidado. PALAVRAS-CHAVE: Direitos humanos. Humanismo. Ecologia. Cuidado.

Introdução: Praticantes de atividades físicas sem orientação nutricional tendem a acreditar que a proteína é o principal macronutriente da dieta. Objetivo: Avaliar o perfil dos usuários de academias, que utilizam suplementos alimentares, de acordo com o conhecimento sobre o macronutriente que mais deve ser consumido na alimentação. Materiais e métodos: Estudo transversal incluindo 219 indivíduos de usuários de suplementos nutricionais que frequentavam academias da cidade de Antônio Prado no Rio Grande do Sul no período de dezembro de 2018 até março de 2019. A coleta de dados foi realizada por meio de um questionário autoaplicável com perguntas sobre dados sociodemográficos, antropométricos, uso de suplementos nutricionais, prática de atividade física e questionamento sobre qual deve ser o principal macronutriente da dieta. Resultados e discussão: A amostra teve idade média de 33,83 ± 13,94 anos e foi constituída principalmente por mulheres (59,8%). Em relação ao conhecimento sobre o macronutriente mais consumido na alimentação, 79,5% da amostra acredita que é a proteína. Entre as mulheres, o valor foi 84,7% (p=0,030). Entre as pessoas que praticam atividade física por motivo de saúde, 83,6% creem que a proteína seja o principal macronutriente da dieta (p=0,005). A deficiência de conhecimento sobre alimentação saudável indica a necessidade de um nutricionista na assistência à praticantes de exercício físico, para garantir a qualidade alimentar e o alcance dos objetivos desejados. Conclusão: Entre usuários de suplementos nutricionais e frequentadores de academias, há elevada prevalência de indivíduos que acreditam que a proteína é o principal macronutriente a ser consumido na dieta.