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O "Plano estratégico de convivência e reflexão sobre o trabalho no Hospital Municipal Lourenço Jorge" foi elaborado, na perspectiva da Educação Permanente em Saúde (EPS), como proposta de estratégia de apoio à saúde mental de profissionais que atuam na emergência, tendo como referência o sofrimento psíquico gerado pela pandemia de covid-19. O plano estratégico tem por intuito: delinear uma ação capaz de proporcionar aos trabalhadores espaços de convivência e fala/escuta coletiva sobre o trabalho, ampliar a visibilidade e estimular o protagonismo, catalisando processos de reconhecimento horizontal e vertical e debater sobre o aprimoramento de processos e a construção de estratégias para enfrentamento dos desafios vivenciados no hospital que foram agravados pelo advento da pandemia. Trata-se de um produto de mestrado oriundo da dissertação intitulada: "Efeitos da pandemia na saúde mental de trabalhadores que atuam em uma emergência pública no município do Rio de Janeiro" de autoria da Enf. Me. Niquelli Therezinha Bom Eccard, sob orientação da Prof. Dr. Mônica Villela Gouvêa.

Repository associated with a manuscript on SARS-CoV-2 variants Lambda, Mu and Gamma phylogeographic spread in Latin America and Caribbean

The existence of large volumes of data has considerably alleviated concerns regarding the availability of sufficient data instances for machine learning experiments. Nevertheless, in certain contexts, addressing limited data availability may demand distinct strategies and efforts. The data modeling process used for epidemiologic analysis to predict the COVID-19 pandemic evolution at its beginning, emerged a question: how much data is needed to make reliable predictions? When does the volume of data provide a better understanding of the disease's evolution and, in turn, offer reliable forecasts? The asymptotic exponential curve fitting enabled the evaluation of the errors in different points, reflecting the increased available data over time. For a comprehensive understanding of the results at distinct stages of the time evolution, the average derivative of the curves and the equilibrium points were calculated, aimed to identify the convergence of the ARIMA models to a stable pattern. Due to its size, the dataset with the incidence of COVID-19 in the Brazilian States is available at: https://www.kaggle.com/datasets/leonardovianna/covid-19-data. This dataset was obtained from the COVID-19 panel of the Brazilian Ministry of Health. Images in the graphs folder can also be seen in the Jupyter notebooks.

Multivariate time series forecasting is essential in various fields, includ- ing healthcare and traffic management, but it is a challenging task due to the strong dynamics in both intra-channel relations (temporal patterns within individual variables) and inter-channel relations (the relationships between variables), which can evolve over time with abrupt changes. This paper proposes ERAN (Evolving Relational Attention Network), a framework for multivariate time series forecasting, that is capable to capture such dynamics of these relations. On the one hand, ERAN represents inter-channel relations with a graph which evolves over time, modeled using a recurrent neural network. On the other hand, ERAN represents the intra-channel relations using a temporal attentional convolution, which captures the local temporal dependencies adaptively with the input data. The elvoving graph structure and the temporal attentional convolution are intergrated in a unified model to capture both types of relations. The model is experimented on a large number of real-life datasets including traffic flows, energy consumption, and COVID-19 transmission data. The experimental results show a significant improvement over the state-of-the-art methods in multivariate time series forecasting particularly for non-stationary data.

A pandemia da COVID-19 trouxe expressivas mudanças no cenário social, econômico, de saúde e também educacional. No âmbito escolar, visando dar continuidade ao ensino e conter a propagação do vírus, as atividades foram ofertadas de maneira remota síncrona e/ou assíncrona, representando novos desafios a docentes e discentes. O objetivo desse trabalho é relatar a experiência da monitoria remota síncrona e assíncrona da disciplina do Programa de Integração Ensino Serviço Comunidade I do Curso de Medicina de uma Universidade Federal na região oeste do Paraná. Método: Estudo descritivo, do tipo relato de experiência, que versa sobre as atividades realizadas pelos discentes monitores, entre dezembro de 2021 e abril de 2022, através de ferramentas de interação social virtual. A priori, foi possível identificar os desafios enfrentados pelos próprios monitores, a saber: adaptação as ferramentas digitais, desenvolvimento de estratégias de ensino a serem utilizadas de modo remoto síncrono e elaboração de atividades problematizadoras na interface teórico-prática. Com o decorrer dos encontros, foi possível constatar aprimoramento de habilidades interpessoais, de comunicação e solução de problemas, ao lado, da construção de um espaço virtual de discussão coletiva do saber. Mesmo de modo incipiente, o uso de ferramentas tecnológicas foi adaptado à realidade vivida e se mostrou capaz de promover um aprendizado eficaz, validando as estratégias utilizadas. Ademais, cada encontro visava fomentar a construção de um saber científico capaz de subsidiar as futuras atividades práticas no contexto da Saúde Pública.

Stroke is a leading cause of disability and mortality worldwide, with more than 475,000 people currently living with lasting impairment in Australia including deconditioning and upper limb impairment. Neuroplasticity is considered a treatment target for stroke rehabilitation and recovery due to its association with improved prognosis and functional outcome. Exercise interventions may be utilised as a primer for motor rehabilitation post-stroke due to the potential to increase biomarkers of neuroplasticity such as Brain-Derived Neurotrophic Factor (BDNF). It is proposed that exercise interventions to increase BDNF concentration may be used as an adjuvant therapy to motor rehabilitation such as Constraint-Induced Movement Therapy (CIMT) to increase effectiveness. However, the optimal prescription and clinical application of exercise to increase BDNF concentrations have not been explored. The aim of this thesis was to explore exercise prescription and uptake post-stroke by 1) identifying optimal exercise training parameters, 2) investigating barriers and facilitators to the prescription and uptake of exercise in clinical practice, and 3) examining the relationship between commonly used outcome measures of neuroplasticity and upper limb function. This thesis consists of four individual studies. The first study is a systematic review and meta-analysis that explored parameters of exercise prescription and their relationship to BDNF concentration in people with stroke. Seven electronic databases were searched for experimental or observational studies measuring changes in BDNF concentration after exercise in people with stroke. Meta-analyses demonstrated significant increases in BDNF concentration following a single session, and program, of high intensity aerobic exercise (e.g., High Intensity Interval Training [HIIT]). This study was published in the journal ‘Stroke’. The second study was a mixed methods study that explored the barriers and facilitators to the use of HIIT post-stroke. People with stroke and health professionals who work in stroke rehabilitation were invited to complete an online questionnaire and semi-structured interview. Twenty-six people with stroke and 37 health professionals completed the questionnaire, while ten people with stroke and eight health professionals participated in an interview. People with stroke and health professionals who work with people with stroke consider HIIT to be a beneficial intervention following stroke, however its use in clinical practice is varied based upon client motivation and clinician expertise. People with stroke reported minimal support from people with stroke and health professionals, the lack of knowledge of the benefits of HIIT, and the use of the term ‘high intensity’ as the main barriers to participation. Access to health professionals, the provision of personalised education and individualisation of the protocol were reported by people with stroke as the main facilitators to participation in HIIT. Health professionals reported a lack of knowledge about how to prescribe HIIT, and participant motivation as the main barriers to the prescription of HIIT within the clinical environment. Increased education about the prescription and benefits of HIIT, obtaining medical clearance for HIIT, and comprehensive screening prior to commencing a HIIT program were the main facilitators to HIIT prescription reported by health professionals working with people with stroke. The third study investigated an alternative to BDNF, blood lactate, as a marker of brain plasticity given the challenges associated with measuring BDNF in clinical practice, such as cost, speciality training and equipment. Due to the Covid-19 pandemic recruiting people with stroke to participate in the study was not feasible, therefore, this study was completed in a healthy population of adults. Thirty-one healthy adults were tested for BDNF, and lactate concentrate before and after a submaximal graded exercise test. A poor correlation was observed between the two biomarkers at pre- (r = -0.256, p = 0.164) and post-exercise (r = 0.112, p = 0.549). The change in concentration from pre- to post-exercise (r = 0.019, p = 0.921) was also poorly correlated. Therefore, in healthy adults, there is little evidence to suggest a relationship between BDNF and lactate. The fourth study examined the correlation between two upper limb assessment tools to identify paretic upper limb use within an Australian clinical setting. The Motor Activity Log Amount of Use (MALAOU) and the Motor Activity Log Quality of Movement (MALQOM) 30-item scales are commonly used in clinical practice. The Rating of Everyday Arm-use in the Community and Home (REACH) scale similarly measures paretic upper limb use but is much less time intensive compared to the MALAOU and MALQOM. Ten people with stroke completed MALAOU, MALQOM and REACH assessments before and after a two-week intensive upper limb program. A moderate correlation between the MALQOM and REACH (rho = 0.717, p = 0.02) was observed at pre-intervention. No correlation was observed between any measure at any other timepoint, or when comparing the change in scores from pre- to post-intervention. The fifth study included in this thesis is a protocol for a randomised controlled trial as a future research recommendation based upon the learnings of the other studies. The randomised controlled trial was originally planned to be completed during candidature, however due to the Covid-19 pandemic this was not feasible. This protocol, to be completed after this program of research, will explore the efficacy of a combined HIIT and Modified-CIMT upper limb function.

In this thesis, I explore the significance of thinking with new materialism to re-conceptualise how teacher agency is becoming. Teacher agency is considered to be one of the most important factors in education reform, because teachers have the strongest influence on students, and their decision-making practices can determine whether they remain in the profession (Buchanan, 2015; Crandall, 2020; Datnow, 2012). The significance of teachers and their influence on students has been particularly salient during the COVID-19 pandemic and the post-pandemic period (Campbell, 2020; Ehren et al., 2021; OECD, 2023). The novelty of the spatial and temporal re-configurations caused by the pandemic has prompted new materialist discussions on developing novel ways of thinking, including a consideration of how nonhuman matter is also significant to the teaching profession (Heikkilä & Mankki, 2021). As such, I think with Karen Barad’s agential realism, a new materialist framework, to explore: how teacher agency is becoming through human-nonhuman intra-actions; the significance of the intertwined re-configuration of space, time, and matter when teacher agency is becoming; and implications for power dynamics in the teaching profession. In addition, I explain throughout the thesis how my doctoral journey has been becoming in a nonlinear manner, which was imperative to describe because thinking with new materialism entails acknowledging the nonrepresentational nature of research (Barad, 2007). I explore how teacher agency is becoming through three boundaries: 1. Exploring how teacher agency is becoming in public school; 2. Exploring how primary teacher agency is becoming; and 3. Exploring how primary teacher agency is becoming in Canada, Australia, and the United States (US). With respect to these bounded areas of inquiry, I employed a qualitative case study approach and generated semi-structured interviews and photo-elicitation data with 10 primary school teachers during the COVID-19 lockdowns in 2021. I identified each teacher participant as a case-entanglement which denotes that teachers are not predefined entities because they emerge through their relations with human-nonhuman phenomena. Next, I share the insights that emerged from the interview and photo-elicitation data including: how the COVID-19 pandemic significantly re-configured common temporal, spatial, and material aspects of teaching; how these re-configurations were produced by multicausal human-nonhuman intra-actions and elicited multidirectional effects; and how the research process itself is intra-acting in the entanglement where teacher agency is becoming. Next, I discuss that the interview and photo-elicitation data, along with insights from the rest of the thesis, illuminate how thinking with new materialism and the usage of teacher agency as a term are incommensurable. I address this incompatibility by re-conceptualising teacher agency into teacher agencies. Teacher agencies diverges from teacher agency, because this notion focuses on the causes AND effects on the outcome of whether possibilities emerge for teachers to shape their practice. Lastly, I explain how thinking with teacher agencies, as an apparatus and other material-discursive practices, has significant implications for understanding and addressing the power dynamics of the teaching profession, including in-justices teachers experience. I detail key implications for policy and practice in addressing such in-justices in the teaching profession including: emphasising relationality, not individuality; acknowledging the significance of space, time, and nonhuman matter; and re-configuring key elements of public school teaching such as teacher accountability practices and curriculum development. Through this thesis, I make significant theoretical, methodological, and empirical contributions to knowledge. Theoretically, I think with new materialism and agential realism, which is seldom done to explore teacher agency, and provide a novel re-conceptualisation of teacher agency through the notion of teacher agencies. Methodologically, I re-configure the process of doing research by sharing a nonrepresentational account of writing this thesis. Empirically, I provide novel insights on the temporal, spatial, and material aspects of teaching to re-work teacher policies, practices, and power dynamics.

A pandemia do COVID-19 ampliou a necessidade do uso de ferramentas digitais nas atividades de ensino, com o intuito de dar seguimento às atividades acadêmicas e oportunizar a interação entre docentes e discentes. Objetivo: Relatar a experiência da monitoria acadêmica do módulo do Programa de Integração Ensino, Serviço e Comunidade II (PIESC 2), do curso de Medicina, mediada por ferramentas digitais. Método: Estudo descritivo, com abordagem qualitativa e do tipo relato de experiência. Os encontros, remotos e síncronos para oferta da monitoria, eram realizados semanalmente. "Google Forms", "Canva". "Mentimeter" e "Classroom" foram utilizados como recursos interativos fundamentais para planejamento e aplicação das atividades. Resultados: Na perspectiva dos discentes-monitores, houve necessidade em adaptar-se à nova realidade imposta, sendo necessário a adequação das atividades para a modalidade remota. Por meio das ferramentas digitais, foi possível ministrar revisões, realizar questionários e tirar dúvidas de forma síncrona e eficiente. Os desafios decorrentes do período, possibilitaram o desenvolvimento de habilidades acadêmicas e profissionais. Sob o ponto de vista dos discentes a proposta foi cumprida com êxito, visto que possibilitou a consolidação do conhecimento teórico-prático proposto pelo módulo. Conclusão: A utilização de ferramentas digitais mostrou contribuições significativas, dado o cenário pandêmico, configurou-se como uma forma de enfrentamento e adaptação à nova realidade imposta, estreitando laços e agregando conhecimentos a todos os que contribuíram para o funcionamento ético e comprometido do programa e, ainda, consolida sua relevância no contexto da educação superior.

Os Transtornos Alimentares (TA) são uma variedade de transtornos psicológicos complexos que podem levar a prejuízos físicos e psicológicos significativos e estão associados a altas taxas de mortalidade e baixas taxas de detecção e intervenção. A pandemia do COVID-19 interrompeu a vida diária em escala global, impactando as rotinas das pessoas, os ambientes de vida e o bem-estar físico,mental e emocional. A pandemia impactou negativamente na vida de pessoas com transtornos alimentares, de modo que as taxas de incidência de anorexia nervosa (AN), transtorno da compulsão alimentar periódica (BED), bulimia nervosa (BN) e desordem alimentar(DE) aumentaram durante o confinamento relacionado ao COVID-19. O presente estudo objetivou uma revisão de literatura sobre a avaliação dos transtornos alimentares na pandemia do covid-19, nos últimos 4 anos, especificamente 2019 a 2022, na base de dados PubMed, em artigos de língua portuguesa,inglesa ou espanhola. Os resultados eliciaram 5 categorias: 1 - Implicações físicas/fisiológicas (25%); 2 – Implicações mentais/emocionais (33,3%); 3 – Implicações sociais (33,3%); 4 – Implicações na manutenção do tratamento (25%) e 5 – Implicações no agravamento, fatores predisponentes e reforço do transtorno alimentar (33,3%). Embora o número de artigos neste estudo seja relativamente pequeno ante as buscas iniciais na literatura, foram suficientes para retratar a realidade através de diversas dimensões possíveis, conforme as cinco categorias eliciadas. Mesmo que a amostra não permita uma generalização dos achados, mas proporcionaram uma concordância entre si quanto ao prejuízo da pandemia do COVID-19 aos portadores de Transtornos alimentares.

Spatial contagions, such as pandemics, opinion polarisation, infodemics, and civil unrest, exhibit nontrivial spatiotemporal patterns and dynamics driven by complex human behaviours and population mobility. Here we propose a concise generic framework to model different contagion types within a suitably defined contagion vulnerability space. This space comprises risk disposition, considered in terms of bounded risk aversion and adaptive responsiveness, and a generalised susceptibility acquisition. We show that resultant geospatial contagion configurations follow intricate Turing patterns observed in reaction-diffusion systems. Pattern formation is shown to be highly sensitive to changes in underlying vulnerability parameters. The identified critical regimes (tipping points) imply that slight changes in susceptibility acquisition and perceived local risks can significantly alter the population flow and resultant contagion patterns. We examine a case study of the COVID-19 pandemic in Australia, demonstrating that the observed geo-spatial pandemic spread generated Turing patterns in accordance with the proposed model. The paper describing the framework, model and results: Jamerlan, C. M. and Prokopenko M. 2024. Bounded risk disposition explains Turing patterns and tipping points during spatial contagions. R. Soc. Open Sci. 11: 240457. http://doi.org/10.1098/rsos.240457 Please cite this paper and references below when using the model.