SUMMARY OBJECTIVE: We sought to understand the landscape of published articles regarding medical schools’ learning environments (LE) worldwide, with an explicit focus on potentially harmful aspects of the LE as an effort to identify areas specifically in need of remediation or intervention that could prevent future unprofessional behaviors, burnout, violence and mistreatment among students and physicians. METHODS: A bibliometric analysis was conducted in six electronic databases (PubMed/Medline, Web of Science, Cochrane Library, SCOPUS, ERIC-ProQuest, and PsycINFO) up to December 31, 2016, including 12 themes: learning environment – general, hidden curriculum (harmful), unethical behaviors, bullying/hazing, violence, sexual discrimination, homophobia, racism, social discrimination, minorities discrimination, professional misconduct, and other negative aspects. RESULTS: Of the 9,338 articles found, 710 met the inclusion criteria. The most common themes were general LE (233 articles), unprofessional behaviors (91 articles), and sexual discrimination (80 articles). Approximately 80% of articles were published in the 21st century. CONCLUSION: There is a definite increase in scientific articles on negative aspects of the medical school LE in high-quality journals, especially in the 21st century. However, more studies are needed to investigate negative LE aspects with greater attention to experimental, longitudinal, and cross-cultural study designs.
SUMMARY Objective: We sought to understand the landscape of published articles regarding medical schools’ learning environments (LE) worldwide, with an explicit focus on potentially negative aspects of the LE as an effort to identify areas specifically in need of remediation or intervention that could prevent future unprofessional behaviours, burnout, violence and mistreatment among students and physicians. Methods: A bibliometric analysis was conducted in six electronic databases (PubMed/Medline, Web of Science, Cochrane Library, SCOPUS, ERIC-ProQuest and PsycINFO) through December 31, 2016, including 12 themes: learning environment - general, hidden curriculum (negative), unethical behaviours, bullying/hazing, violence, sexual discrimination, homophobia, racism, social discrimination, minorities’ discrimination, professional misconduct, and "other" negative aspects. Results: Of 9,338 articles found, 710 met the inclusion criteria. The most common themes were general LE (233 articles), unprofessional behaviours (91 articles), and sexual discrimination (80 articles). Approximately 80% of articles were published in the 21st century. Conclusion: There is a clear increase in scientific articles on negative aspects of the medical school LE in high-quality journals, especially in the 21st century. However, more studies are needed to investigate negative LE aspects with greater attention paid to experimental, longitudinal, and cross-cultural study designs.
Resumo A telemedicina na atenção primária à saúde por meio do Programa Nacional Telessaúde Brasil Redes surge como uma ferramenta tecnológica de apoio a profissionais de saúde no seguimento de pacientes do Sistema Único de Saúde. Neste trabalho relata-se a experiência sobre o uso do programa na atenção primária e discutem-se as implicações éticas e bioéticas envolvidas na adesão obrigatória do programa ao sistema de regulação local para diminuir filas de encaminhamentos e organizar o acesso aos serviços especializados. Identificaram-se dificuldades de acesso do usuário à assistência em saúde especializada, limitações à autonomia médica e conflitos na relação médico-paciente. O uso da telemedicina na atenção primária apresenta diferentes nuances éticas e bioéticas, que necessitam ser analisadas, e carece de legislação própria e normas, de modo a assegurar os direitos dos pacientes e valorizar a relação médico-paciente, assim como o trabalho do profissional médico que atua na porta de entrada do Sistema Único de Saúde.
IntroductionThe International Federation of Medical Students’ Associations of Brazil (IFMSA Brazil) is a nonprofit, nonpartisan and non-governmental organisation representative of Brazilian medical students. IFMSA Brazil was founded in 1991 and it is currently present in 95 medical schools around the country, at 26 Brazilian states. IFMSA Brazil envisions promoting a positive impact in society by allowing medical students to become leaders in health advocate, to find and to develop their potential. IFMSA Brazil acts through priority areas, defined by Standing Committees, developing projects and programs that may impact on society aiming health promotion and education. The Standing Committee on Sexual and Reproductive Health including HIV/AIDS (SCORA) brings the subject to discussion and engages Brazilian medical students to advocate on this specific field. MethodsWe analysed IFMSA Brazil’s Online System of Activities and Reports (SOLAR), which archives all projects and activities held by the Federation in its 95 Local Committees. We considered all the post-projects submitted to the platform of SCORA in 2016. ResultsWe received 108 activities submissions related to HIV, HPV and syphilis. The main activities developed were Candlelight Memorial Day, Health Care Blitzes, ”Adolescer” - a Comprehensive Sexual Education Project for Teenagers, Campaigns of Act Against AIDS, Sexual Education Projects directed to elderly and sex workers and general events related to sexual and reproductive health in medical education. ConclusionDeveloping new strategies of health promotion and education in sexual and reproductive theme may help different communities and improve education of Brazilian medical students. IFMSA Brazil is acting in a volunteering work to raise medical students’ voice and engage advocacy in health, allowing the health care attention to neglected populations and preventing the increase of sexually transmitted infections and other diseases.
IntroductionHIV and AIDS represent one of the greatest concerns in global health in the last three decades. In Brazil, the percentage of people living with HIV and dying with AIDS increases every year. The number of cases in the south of Brazil is bigger than in the rest of the country, particularly in Rio Grande do Sul and Santa Catarina as the second and third states with the largest numbers. Medical students from the International Federation of Medical Students Association of Brazil (IFMSA Brazil) in the south of the country conducted this study to better comprehension of Brazilian citizens’ understanding about the subject. MethodsThis study investigated the profile of general population in three Brazilian cities (Curitiba, Londrina and Tubarão), identifying the sociodemographic aspects and knowledge level related to HIV and AIDS, in a descriptive and quantitative analysis. Data was collected through a questionnaire with nine questions, in November 2016. Results343 individuals, 57% female and the majority of them between 21 and 30 years old. The answers showed an alarming situation in the south region of Brazil. Almost half of them (49.6%) did not know about their serology for HIV, meanwhile 60.6% revealed already being worried about that. Regarding HIV and AIDS definition, 71.7% did not know the difference between the virus and the syndrome. When asked about a method of prevention for HIV and other STIs, more than 90% knew how to prevent themselves and most of them mentioned condoms as the method used. Only 41.4% reported using condoms regularly. When asked about social interaction with people living with HIV, 74.6% would not have sexual relations and 16.9% would not be friends with someone living with the virus. ConclusionOne of the reasons for the massive numbers of HIV cases in the south of Brazil is the lack of knowledge of the population. Knowing the social determinants and population profile allows integrative practices, as the development of new action strategies to improve health promotion and health education regarding HIV and AIDS.
Objetivo: este estudo avaliou os níveis de ansiedade de universitários brasileiros durante a pandemia de COVID-19. Metodologia: a escala de Transtorno de Ansiedade Generalizada de 7 itens foi usada para medir os níveis de ansiedade de 1.837 respondentes a um questionário de pesquisa online. Resultados: os participantes foram em sua maioria mulheres de 18 a 27 anos, matriculados em programas de pós-graduação em universidades públicas, morando com pessoas consideradas de risco para COVID-19, e com renda familiar de 1 a 3 salários mínimos. Mais de 75% dos participantes relataram algum nível de ansiedade, com 23,08% relatando níveis graves, enquanto apenas 24,93% apresentaram níveis normais de ansiedade. A regressão logística ordinal identificou que ser mulher jovem de baixa renda pode afetar o nível de ansiedade. Além disso, estudantes da área de humanidades, estudantes bem informados e aqueles em risco de COVID-19 eram significativamente mais propensos a sentir ansiedade. Conclusão: a saúde mental dos universitários brasileiros, particularmente de determinados grupos, foi afetada pela pandemia de COVID-19 e requer atenção e cuidados específicos.
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