Objective: To provide a comprehensive picture of mental health problems (MHPs) in Brazilian medical students by documenting their prevalence and association with co-factors. Methods: We systematically searched the MEDLINE/PubMed, SciELO, LILACS, and PsycINFO databases for cross-sectional studies on the prevalence of MHPs among medical students in Brazil published before September 29, 2016. We pooled prevalences using a random-effects meta-analysis, and summarized factors associated with MHP. Results: We included 59 studies in the analysis. For meta-analyses, we identified the summary prevalence of different MHPs, including depression (25 studies, prevalence 30.6%), common mental disorders (13 studies, prevalence 31.5%), burnout (three studies, prevalence 13.1%), problematic alcohol use (three studies, prevalence 32.9%), stress (six studies, prevalence 49.9%), low sleep quality (four studies, prevalence 51.5%), excessive daytime sleepiness (four studies, prevalence 46.1%), and anxiety (six studies, prevalence 32.9%). Signs of lack of motivation, emotional support, and academic overload correlated with MHPs. Conclusion: Several MHPs are highly prevalent among future physicians in Brazil. Evidence-based interventions and psychosocial support are needed to promote mental health among Brazilian medical students.

Background and Objectives: Several factors can compromise patient safety, such as ineffective teamwork, failed organizational processes, and the physical and psychological overload of health professionals. Studies about associations between burn out and patient safety have shown different outcomes. Objective: To analyze the relationship between burnout and patient safety. Materials and Methods: A systematic review with a meta-analysis performed using PubMed and Web of Science databases during January 2018. Two searches were conducted with the following descriptors: (i) patient safety AND burnout professional safety AND organizational culture, and (ii) patient safety AND burnout professional safety AND safety management. Results: Twenty-one studies were analyzed, most of them demonstrating an association between the existence of burnout and the worsening of patient safety. High levels of burnout is more common among physicians and nurses, and it is associated with external factors such as: high workload, long journeys, and ineffective interpersonal relationships. Good patient safety practices are influenced by organized workflows that generate autonomy for health professionals. Through meta-analysis, we found a relationship between the development of burnout and patient safety actions with a probability of superiority of 66.4%. Conclusion: There is a relationship between high levels of burnout and worsening patient safety.

Introduction: The Corona virus (COVID-19) pandemic caused, among others, the need for colleges and universities managers around the world to reinvent new ways of providing education preserving its good quality at the same time. With the new ordinances of the Ministry of Education and Health, all courses can use remote methodologies for the continuity on the current school year. With new challenges and paradigms emerging from this methodological proposal: provide for the user the feeling of immersion, of being in the class room, from the navigation and interaction in this virtual environment, at the same time that the educator, respecting the educational principles and the pedagogical approach that he believes, does not transform this moment into a simple distance education. Objective: to describe the state of the art on nursing education and the challenges of using remote technologies in the time of Corona virus pandemic. Methods: this is a reflective study based on secondary sources of literature relevant to the theme, considering articles from national and international journals and recent productions on education, health training, remote technologies, COVId-19 and public health. Results: it is evident that experiencing the effects of the corona virus pandemic (COVID-19) in the health educational sector, especially in the field of nursing, goes beyond a structural reorganization of courses. It implies change attitude of managers, teachers and students to reformulate educational  practices (sometimes with traditional tools), with innovative practices preserving a  methodology that provides to the student criticality reflection, dialogue, bonding and interaction; elements that are part of a training aimed at transformation, empowerment and not just the transmission of knowledge. In this context, the COVID-19 pandemic caused paradigm shifts perhaps not yet overcome by  health science   institutions  , because when they perceived themselves within a reality that generated changes in the political, economic, cultural and social aspects at a global level, they had to reinvent and insert new ways of teaching in their work process; they had to discuss different educational approaches and, given the needs to readjust health teaching methods, they inserted remote technologies as essential tools to meet the real need for continuity of classes in non-face-to-face model. For many, it is a challenge, as it currently permeates a reflection on the attention of distance learning in the field of nursing and other courses in the health area. However, as it opened up to discussions about new ways of teaching mediated by innovation, it can be said that this will be one of the greatest impact of the pandemic in benefit the education: the contribution of new information and communication technologies in the teaching-learning process for training in health, as well as the reflection on distance education and its concepts, differentiating it from the concepts of remote methodology and the use of technologies. Conclusion: In nursing education, the discussion related to the use of remote technologies in the classroom has always been a point of debate. However, with the need to include these tools for the continuity of classes in the non-face-to-face model resulting from the social isolation strategy motivated by the pandemic of COVID-19, it can provide an opportunity to have a new look on the subject and perhaps there is an opportunity to expand the debate on the use of remote methodologies in health education, seeking a reflection on their interaction with the other teaching methods already implemented.

Introduction: in health promotion, practices are necessary to trigger mechanisms aimed at the creation or recreation of a new mode of enhancing health, in order to overcome the still-oriented actions of the biological approach. Prevailing actions oh health care, although important to the sector, do not advance toward a positive concept. Objective: to analyse the historical process of health as a concept and care models in the search for a new model of health promotion. Methods: This is a refl ective review designed to understand and appraise the international and national literature from Medline/PubMed, Lilacs and the Scientifi c Electronic Library (Scielo). For the organisation of data, articles were separated by themes, and the process of categorisation was conducted based on content analysis. Results: Despite having the knowledge that consistent actions with the assumptions of health promotion are of great importance to quality of life and equity in health, implementing them remains a challenge due to the predominance of curative practices and an individualistic approach. These practices, in turn, are revealed to be a refl ection of the concept of health that has passed from the absence of disease to a process related to social, political, economic and cultural factors. Conclusion:The concept of health has been transformed from historical ideas, refl ecting the emergence of new formulations about thinking and doing and, consequently, new proposals for changes in welfare models of health. Therefore, although the new model of healthcare has been structured from a health promotion perspective; there are still features of hegemonic models with the predominance of curative practices.

http: //dx.doi.org/10.17058/reci.v6i2.6427 Justificativa e Objetivos: A depressão é um problema de saúde pública que atinge cerca de 154 milhões de pessoas mundialmente, tendo sua incidência crescente nos últimos anos. Frente a esta problemática destaca-se o idoso neste contexto com um percentual de 15% de prevalência para algum sintoma depressivo, o que requer uma atenção especial e ações de prevenção e cuidado para tal população. Sendo assim, objetivou-se compreender acerca de depressão na terceira idade, o perfil e o processo de prevenção e tratamento dos sinais e sintomas, na literatura nacional e internacional. Método: Trata-se de uma revisão sistemática da literatura realizada nas bases de dados: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS); Medical Literature Analysis and Retrievial System Online (MEDLINE) e Scientific Electronic Library Online (SCIELO). Foram considerados os estudos do tipo artigos, dissertações e teses em português, inglês ou espanhol, entre os anos de 2010 a 2015, utilizando os descritores: depressão, idoso e geriatria. Para a coleta de dados utilizou-se o instrumento de Ursi, que inclui a avaliação do título do estudo, principais resultados e conclusões. Resultados:Após busca nas bases de dados, encontraram-se 261 estudos, sendo que após aplicação dos critérios de inclusão, selecionou-se 44, ao implementar o instrumento supracitado, finalizou-se com 17. Os resultados evidenciaram o perfil dos idosos acometidos pela depressão, formas de tratamentos, chegada ao serviço de saúde e comorbidades associadas. A pesquisa também mostrou a importância do estímulo ao autocuidado, ativação e engajamento deste público e familiares em atividades educativas, treinamento profissional de saú-de e ampliação do sistema como fatores importantes ao cuidado destes usuários. Conclusão: Os profissionais de saúde que lidam com o público idoso devem estar atentos aos sinais e sintomas da depressão, além de estarem constantemente capacitando-se para atender as demandas por meio de uma assistência eficaz e de qualidade, estimulando também métodos não farmacológicos de alívio dos sintomas, além de identificar o perfil destes idosos os quais as comorbidades associadas a depressão são mais comuns. Background and Objectives:Depression is a public health problem that affects approximately 154 million people worldwide and its incidence has increased in recent years. Regarding this problem, elderly individuals show a percentage of 15% prevalence for some depressive symptoms, which requires special attention and prevention and care actions for this population. Thus, this study aimed to understand about depression in the elderly, the profile and the process of prevention and treatment of signs and symptoms in national and international literature. Method: This is a systematic review of the literature carried out in the following databases:Latin American and Caribbean Health Sciences (LILACS); Medical Literature Analysis and Retrieval System Onli- RESUMO ABSTRACTRecebido em:

BackgroundConsidering the inequalities and the areas of low socioeconomic status in Brazil, access to health services is a challenge and the delay between diagnosis and treatment represents an important factor of worse prognosis in patients with breast cancer. Herein, we describe the clinical and epidemiological profiles of women with breast cancer and evaluate their access to health services, as well as treatment delays, at a reference centre of the Cariri region, Ceará, Brazil.MethodsThis is a retrospective study that included 473 women treated with breast cancer between 2009 and 2011 at the Oncology Centre of the Cariri.ResultsThe majority of these patients were aged between 40 and 69 years old (65.7%), without a completed high school degree (89.2%). They were married (62.9%) and were already diagnosed but had not yet been subjected to any previous treatment (77.8%). It was observed that 91.8% were referred from the public health service, and treatment was paid for by the public health service in 92.9% of the cases. The patients whose source of referral was the public system waited longer between diagnosis and the treatment initiation (p = 0.031; Mann–Whitney’s test), with a median waiting time of 71.5 days versus 39 days for those receiving referrals from private services. In addition, those with public referrals prior to diagnosis also experienced a longer waiting time between the first medical visit and treatment initiation (77 days vs. 37 days; p = 0.036; Mann–Whitney’s test), with the waiting time for the biopsy being an important factor in this delay.ConclusionsLate diagnosis was often the result of inefficiency of the prevention policies coupled with difficulty accessing the public health network. It was commonly observed that, even after diagnosis, the patients needed to wait too long before entering the Oncology Service because of long waiting queues in the public health system.

Introduction:Ageing is usually accompanied by deterioration of physical abilities, such as muscular strength, sensory sensitivity, and functional capacity, making chronic diseases, and the well-being of older adults new challenges to global public health.Objective:The purpose of this study was to evaluate whether a task practiced in a virtual environment could promote better performance and enable transfer to the same task in a real environment.Method:The study evaluated 65 older adults of both genders, aged 60 to 82 years (M = 69.6, SD = 6.3). A timing coincident task was applied to measure the perceptual-motor ability to perform a motor response. The participants were divided into 2 groups: started in a real interface and started in a virtual interface.Results:All subjects improved their performance during the practice, but improvement was not observed for the real interface, as the participants were near maximum performance from the beginning of the task. However, there was no transfer of performance from the virtual to real environment or vice versa.Conclusions:The virtual environment was shown to provide improvement of performance with a short-term motor learning protocol in a timing coincident task. This result suggests that the practice of tasks in a virtual environment seems to be a promising tool for the assessment and training of healthy older adults, even though there was no transfer of performance to a real environment.Trial registration:ISRCTN02960165. Registered 8 November 2016.

Introduction: Sudden Cardiac Arrest (SCA) is a serious public health problem and represents one of the leading causes of death in the world. In emergency situations the assessment of the victim and care must be effective, to reduce negative outcomes and to increase the survival rate. Objective: To analyze graduation students in the Health Sciences through objective testing on Basic Life Support (BLS). Methods: This is a descriptive, observational and cross sectional study, performed in the State of São Paulo, Brazil. The study population consisted of 664 graduation students in Medicine, Nursing, Physiotherapy, Pharmacy, Nutrition and Occupational Therapy. Data collection occurred through an instrument in the form of objective tests based on the guidelines for Basic Life Support from the American Heart Association. For analysis the Shapiro-Wilk, Chi-square, Mann-Whitney and Kruskal-Wallis tests were used. The adopted confidence level was 95%. The statistical program used was Stata 11.0. Result: There was found to be a prevalence of students who were female (82.23%), single (77.56%), on the physiotherapy course (53.16%), in the freshmen year (32.2%) with previous training (54.45%) and with a median age of 22 years old. When the association between the scores was analyzed according to sex, marital status, previous training, course and year of study, the relation between the number of correct answers and previous training, course and year of study showed statistically significant differences (p < 0.001). Conclusion: 99.9% of subjects had lower score than the minimum score of 84% of Americam Heart Association, which characterizes insufficient knowledge about the basic support of life theme. Thus, there is need for continued training of health sciences students on the subject, at the undergraduate level.