Smoking is the leading cause of respiratory disease (RD). The harmful effects of smoking on the respiratory system begin in utero and influence immune responses throughout childhood and adult life. In comparison with “healthy” smokers, smokers with RD have peculiarities that can impede smoking cessation, such as a higher level of nicotine dependence; nicotine withdrawal; higher levels of exhaled carbon monoxide; low motivation and low self-efficacy; greater concern about weight gain; and a high prevalence of anxiety and depression. In addition, they require more intensive, prolonged treatment. It is always necessary to educate such individuals about the fact that quitting smoking is the only measure that will reduce the progression of RD and improve their quality of life, regardless of the duration and severity of the disease. Physicians should always offer smoking cessation treatment. Outpatient or inpatient smoking cessation treatment should be multidisciplinary, based on behavioral interventions and pharmacotherapy. It will thus be more effective and cost-effective, doubling the chances of success.

BACKGROUND: Educational practices involve essential principles for the learning segment in the most varied teaching strategies, with realistic simulation being an important strategy that can be used in the curriculum matrix, enriching the teaching-learning system and expanding the skills and competences of students. However, the use of new teaching strategies requires constant assessments as to their acceptance, applicability and effectiveness, both as a teacher and as a student. Objectives: Assess the student's perception of the ability of a strategy developed in a simulation scenario, being able to promote active learning; encourage collaborative work; offer different ways of learning and applying knowledge and conducting a reflection/evaluation on your learning. METHOD: Descriptive and cross-sectional study with 110 students of the 5th semester of the Medicine course at a Medical School in Salvador-Bahia between February and June 2019, in which simulations of patient care were performed in Clinical Medicine, in the Dementia scenario, with the use of actors, with whom the students could interact. A student was drawn, or a volunteer emerged, to participate directly in the simulated attendance, while the non-drawn ones observed and made considerations after the simulation. The selected student performed patient care individually depending on the scenario presented, performing anamnesis and communication. At the end of the simulation scenario, each student answered the instrument only once “Educational Practices Questionnaire (student version)”, which was developed by other researchers and validated in Portuguese to assess the best practices used in the simulation scenario, consisting of 16 items, with two subscales (one related to educational practices and the other the importance attributed to the item), being separated into four thematic blocks: active learning; collaboration; different ways of learning; and high expectations (both teacher and student must be motivated to teach and learn). The response model is a 5-point Likert type, with the option of “not applicable” when the statement does not concern the simulated practice performed. RESULTS: A total of 91 questionnaires out of the 110 answered were considered valid and analyzed. For each thematic block, a high percentage was observed for the Frequency of agreement, varying from 94.4% for the thematic block "High expectations" to 61.5% for "Collaboration"; the frequency of disagreement was relatively low, ranging from 20.1% for “Collaboration” to no frequency for “High expectations”. A high percentage was observed for the Frequency of Importance, ranging from 98.9% for the thematic blocks "High expectations" and "Different ways of learning" to 88.4% for "Collaboration"; the Frequency of Non-Importance was relatively low, varying from 2.1% for “Collaboration” to no frequency in “Active learning” and “High expectations”. CONCLUSION: This study showed that simulation becomes a viable possibility to assist the student's preparation, because they realize that the simulation is based on good educational practices and is also considered important for learning and teamwork.

INTRODUÇÃO: A simulação realística tem sido um método de aprendizagem amplamente utilizado no Brasil, sobretudo no ensino médico. Para reproduzir os cenários de atuação médica de forma mais fidedigna, o Design da simulação precisa ser bem planejado para levar o aluno ao maior nível de aproveitamento possível. OBJETIVOS: Descrever a avaliação da qualidade das características do desenho do cenário da simulação pelos dos alunos dos cursos de medicina. MÉTODOS: Estudo observacional, descritivo, de corte transversal realizado com estudantes do curso de medicina, no período de fevereiro de 2019. A amostra final foi de 90 estudantes. A Escala de Design da Simulação foi utilizada para a avaliação da estrutura do cenário da simulação. A partir da escala, as avaliações do Design da simulação pelos alunos foram tabuladas e comparadas através das médias e desvio padrão. RESULTADOS/DISCUSSÃO: Todos os itens analisados da Escala de Design da Simulação, obtiveram resultados positivos na avaliação, assim como a importância da elaboração adequada do Design. Aquele que obteve concordância predominante foi o domínio “Realismo” com média de 4,94 e desvio padrão de 0,20 e importância predominante foi o domínio “Feedback/reflexão”, com média de 4,95 e desvio padrão de 0,16. CONCLUSÃO: Os resultados deste estudo indicam percepções predominantemente positivas dos alunos do curso de medicina acerca do design construído para a simulação aplicada e da sua importância para o processo e aprendizagem. Além disso, pode-se de apontar os aspectos que precisam de melhor desenvolvimento e aprimoramento da simulação, assim como ressaltar os pontos positivos de destaque.

INTRODUCTION: Medical education is under many modifications, insertions and new perspectives on the learning teaching process, and the realistic simulation is one of these changes. It includes technical skills, but also attitudinal skills. The original idea of simulation is to integrate theoretical knowledge, skills and attitude.  OBJECTIVES: to tell the experience of building a simulation core in our institution, with faculty development and culture changes. METHODS: using the cartography, 04 teachers and 02 female actors told their narratives by memories and reflections about the path travelled and the knowledge built. RESULTS AND DISCUSSION: each one experience on the first simulation scenario in 2018.2. We reached the original objective (students’ participation and study), but also the depth of each one experience and reflection. There was a balance between technique and sensibility. The actor’s role to build and concretize the project was essential in this balance. CONCLUSIONS: the simulation strengthened the attitudinal competences, promoted the faculty development and showed the importance to put together art and technique on the health professional training.

INTRODUCTION: Death is the last act of the literary character, and it’s individual, but it doesn’t have to be lonely. We used the literary works  “A candle for Dario”, “A body without a name” and “The death of Ivan Ilyich” to show and discuss how death is portrayed in Literature. DEVELOPMENT: We essayed about how death can’t be shared, becoming an individual act. We also discussed how death is shown as lonely in Literature and how death denial and the death in hospital place make death a lonely act. Besides that, we presented about anomie (that we concepted as lack of name, identity and social connections) and how it is denounced in Literature, revealing the extreme loneliness in the death of the character. By the end, we considered how death can be more comfortable, when the person in this moment of life is in contact with empathic people and behavior, despite the difficulty of people being truly empathic when they deny their own death. CONCLUSION: The literary works we used show how denial, indifference, depersonalization and lack of empathy make death be more than individual, but lonely. Some empathic acts are shown in the literary works and they reveal that thinking, experiencing and living death can be more natural and empathic, when we refuse death denial.

Introdução: A dependência de nicotina predispõe a doenças, incapacidade funcional e alta morbimortalidade, resultando em impacto na qualidade de vida (QV) da população em geral. A QV é um tema importante e a constatação de sua associação com o nível de dependência de nicotina pode ser um caminho para sensibilizar os dependentes dessa substância a interromperem o consumo. Objetivo: correlacionar a qualidade de vida e o nível de dependência de nicotina em tabagistas. Materiais e Métodos: Estudo transversal, constituído por tabagistas admitidos no programa “Deixando de Fumar Sem Mistérios” EBMSP/ Unidade Brotas, ambos os sexos e idade≥18 anos. Excluídos tabagistas com dificuldade de compreensão dos questionários. Aplicados questionários validados: Tolerância de Fagerstrom e Whoqol-Bref. Resultados: As características sociodemográficas e clinicas dos 64 participantes estudados demonstraram predomínio do sexo feminino 48 (75%), idade média de 53,84±10,0anos, grau de escolaridade equivalente à 31(48,4%) com ensino médio e dois (3,1%) analfabetos. Em relação ao número de maços de cigarros consumidos por ano, a mediana de 34,37(21-49) maços/ano. E mediana igual a 2,0(2,0-4,0) na classificação da dependência de nicotina segundo a escala de Fagerstrom, traduzindo em uma baixa dependência. Na análise inferencial dos domínios do Whoqol-Bref e nível de dependência de nicotina revelou no domínio físico valor de p=0,10, psicológico p=0,79, social p=0,16, ambiental p=0,43, QV total p=0,14. Conclusão: O presente estudo não evidenciou uma correlação significativa da QV e o nível de dependência de nicotina, bem como da carga tabágica.

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