BackgroundEarly Mobility (EM) has been recognized as a feasible and safe intervention that improves functional outcomes in hospitalized patients. The International Classification of Functioning, Disability and Health (ICF) supports understanding of functioning and disability in multidimensional concepts and efforts have been taken to apply ICF in a hospital environment. EM protocols might be linked with the ICF component of activity and participation. The correlations between ICF, EM, and functional scales might help the multidisciplinary team to conduct the best rehabilitation program, according to patients' functional demands.ObjectivesThe primary outcome is to analyze the activity level of neurological inpatients on admission and delivery after a Neurological Early Mobility Protocol (NEMP) at intermediate care settings in a public hospital in Brazil using Activity Level categories, HPMQ, and MBI scores. The secondary outcome is to analyze the ICF performance qualifier, specifically in the activity domain, transposing HPMQ and MBI scores to the corresponding ICF performance qualifiers.DesignAn international prospective study.MethodsNEMP was used to promote patients' mobility during a hospital stay in neurological ward settings. First, patients were categorized according to their Activity Levels (ALs) to determine the NEMP phase to initiate the EM protocol. ALs also were evaluated in the first and last sessions of NEMP. Thereafter, the Hospitalized Patient Mobility Questionnaire (HPMQ) was applied to identify whether patients needed assistance during the performance of hospital activities as well as the Modified Barthel Index (MBI). Both measures were applied in NEMP admission and discharge, and the Wilcoxon Signed Rank Test was used to compare data in these two time points. HPMQ and MBI scores were re-coded in the correspondent ICF performance qualifier.ResultsFifty-two patients were included with age of 55 ± 20 (mean ± SD) years and a length of hospital stay of 33 ± 21 days. Patients were classified along ALs categories at the admission/discharge as follows: AL 0 n = 6 (12%)/n = 5 (9%); AL 1 n = 12 (23%)/n = 6 (12%); AL 2 n = 13 (25%)/n = 8 (15%); AL 3 n = 10 (19%)/n = 13 (25%); AL 4 n = 11 (21%)/n = 20 (39%). HPMQ data revealed progressions for the activities of bathing (p < 0.001), feeding (p < 0.001), sitting at the edge of the bed (p < 0.001), sit to stand transition (p < 0.001), orthostatism (p < 0.001) and walking (p < 0.001). Transposing HPMQ activities into ICF performance qualifiers, improvements were shown in bathing (d510.3 to d510.1—severe problem to mild problem) and sitting at the edge of the bed (d4153.2 to d4153.1—moderate problem to mild problem). At MBI score were observed an average of 36 [IQR−35. (95% CI 31.5; 41.1)] on NEMP admission to 52 at discharge [IQR−50 (95% CI 43.2; 60.3)] (p < 0.001). Recoding MBI scores into ICF there were improvements from severe problem (3) to moderate problem (2).LimitationsThe delay in initiating NEMP compared to the period observed in the literature (24–72 h). The study was carried out at only one center.ConclusionsThis study suggests that neurological inpatients, in a public hospital in Brazil had low activity levels as could be seen by MBI and HPMQ scores and in the ICF performance qualifier. However, improvements in the evaluated measures and ICF activity domain were found after NEMP. The NEMP protocol has been initiated much longer than 72 h from hospital admission, a distinct window than seen in the literature. This enlargement period could be a new perspective for hospitals that are not able to apply mobility in the earliest 24–72 h.

Avaliação escolar é um instrumento bastante utilizado pelos professores durante o ano letivo. Podemos até mesmo afirmar que é um recurso indispensável no contexto educacional. Acreditamos que ela pode trazer contribuições ao processo de ensino e de aprendizagem, ao proporcionar ao discente, momentos de reflexão sobre os conteúdos apresentados em sala de aula, no sentido de buscar estabelecer relações entre as diferentes áreas do conhecimento para uma apropriação mais ampla dos temas estudados. Também da prática docente, visando buscar soluções para os problemas apontados pelos resultados das avaliações, se caracterizando, portanto, como uma ferramenta de “diagnóstico e reorientação” e de mudanças. Nesse sentido, investigamos como cinco licenciandos em Química da Universidade Federal de Juiz de Fora planejaram seus instrumentos avaliativos, no sentido de investigar que elementos eles mobilizaram durante a elaboração dos mesmos. Os licenciandos demonstraram reconhecer a importância da prática avaliativa, pois indicaram objetivos, para os recursos avaliativos que criaram, que se voltaram a aprendizagem dos alunos. Apesar de duas licenciandas persistirem no modelo tradicional, houve a preocupação de inserir situações que são do cotidiano dos estudantes da Educação Básica, a fim de facilitar a associação dos conceitos químicos aos fenômenos que acontecem diariamente a nossa volta. Entretanto, consideramos que ainda é preciso um tempo maior para discussão e realização de atividades voltadas à temática avaliação escolar durante o processo de formação inicial. Ainda são poucos os espaços que os licenciandos encontram para o estudo do tema.

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