A Humanização e a Formação Médica na Perspectiva dos Estudantes de Medicina da Universidade Federal do Rio Grande do Norte

The aim of this study is to understand the perception of medical students at the Federal University of Rio Grande do Norte (UFRN) about humanization in the context of their medical formation, using a qualitative approach. The focus group and participant observation techniques were used, involving a multidisciplinary team composed of professionals from the areas of anthropology and psychology, as well as professors from the medical course, who studied two groups of nine students in their final year. The data were analyzed using the categorical thematic content analysis technique, from which emerged three categories: student/patient relationship, teaching/learning and student/professor relationship. The first allows us to identify that student-patient contact is an essential experience for adopting a more humanized view of the disease process. The second category shows that unqualified professors in the pedagogic practices inherent to the teaching profession and the theory the practical dichotomy hinder the autonomous and holistic formation of knowledge. Similarly, the lack of practices outside the academic environment and the absence of multiprofessional stimulation interfere in the construction of an integral view of the individual. From the third category, the student/professor relationship, emerge two opposing subcategories (professor model and assymetric relationships), which reflect the importance of the professor`s ethical humanist position, as opposed to an authoritarian attitude, to form the professional attitude of the student. The results point important aspects of the medical formation that may open a discussion about humanization, in the context of new national curricular guidelines

Avaliação do conhecimento e de habilidades clínicas em saúde sexual e reprodutiva na graduação de medicina

No Brasil, a despeito das conquistas obtidas a partir da implantação do Sistema Único de Saúde e dos avanços legais e institucionais na atenção a diversos problemas relacionados ao gênero, a incorporação de temas relacionados aos direitos humanos, sexuais e reprodutivos no contexto da formação profissional em saúde permanece deficiente. Este trabalho teve como objetivos avaliar a inserção da temática saúde sexual e reprodutiva no currículo do curso de graduação em Medicina, por meio do emprego de avaliações de conteúdo cognitivo, procedimental e atitudinal. Trata-se de estudo de intervenção educacional envolvendo alunos do internato do curso de Medicina da UFRN. Foram utilizados os seguintes métodos avaliativos: prova escrita, exame clínico objetivo estruturado (OSCE) e Mini-CEX. Como variáveis explicativas foram consideradas o sexo, idade e participação prévia no componente curricular optativo Saúde Reprodutiva . A avaliação do processo constou da aplicação de questionários de satisfação e entrevistas acerca dos métodos avaliativos utilizados. Considerando os três métodos avaliativos empregados, 183 estudantes participaram do estudo, com média de idade de 24,5 ± 2,2 anos, sendo 52,5% do sexo masculino e 47,5% do sexo feminino. No contexto geral, observamos concordância entre os desempenhos dos estudantes nas avaliações de conteúdo cognitivo, procedimental e atitudinal. A participação dos estudantes no componente curricular eletivo Saúde Reprodutiva mostrou-se associada com melhor desempenho em algumas dimensões da avaliação cognitiva e na avaliação com o Mini-CEX, em relação às competências de anamnese, profissionalismo e qualidades humanísticas, relação médico paciente e desempenho global. A análise da fidedignidade entre os avaliadores na avaliação com o método OSCE mostrou-se adequada (alfa de Cronbach superior a 70%) em relação ao desempenho global e aos aspectos técnicos das competências avaliadas, observando-se baixa confiabilidade na avaliação da comunicação médico-paciente. O presente trabalho constitui-se numa experiência educacional inovadora e pioneira no âmbito da educação médica brasileira no que tange à inserção da temática de saúde sexual e reprodutiva na graduação, sugerindo-se um impacto positivo da iniciativa na formação do médico generalista na UFRN. A avaliação de conhecimentos, habilidades e atitudes em saúde sexual e reprodutiva na graduação de Medicina mostrou-se factível, com alta concordância entre os diferentes métodos empregados. Os métodos OSCE e Mini-CEX podem ser aplicados ao contexto da saúde sexual e reprodutiva, possibilitando a avaliação de competências clínicas relevantes para a formação do médico generalista e que habitualmente não são contempladas nas avaliações rotineiramente realizadas na graduação

ANÁLISE COMPARATIVA DO CONHECIMENTO, ATITUDES E PRECONCEITOS DE UNIVERSITÁRIOS DOS CURSOS DE PEDAGOGIA, EDUCAÇÃO FÍSICA E MEDICINA EM RELAÇÃO À EPILEPSIA

Epilepsy is a chronic disorder of the central nervous system, most frequently characterized by abnormal electrical impulses in the brain. It is the oldest recorded neurological disease and has been surrounded by myths, mistaken beliefs and preconceptions. Three professionals work with epileptic patients on a daily basis: teachers, physical educators and physicians . This study aimed to analyze and compare the level of knowledge, preconceptions and attitudes of undergraduate students in the courses of Pedagogy, Physical Education and Medicine, future professionals who will deal with epileptic patients. This descriptive observational study was conducted with 286 university undergraduates of both sexes (women 99/34.6% and men 187/65.4%) from the first to fourth year of Pedagogy, Physical Education and Medicine courses at the Universidade Estadual Rio Grande do Norte (UERN), with mean age of 23 years. A validated and adapted 17-question questionnaire, divided into nine knowledge-based questions, five related to preconceptions and three on attitudes, was applied. Results allowed elaboration of a manuscript entitled Comparative Analysis of Knowledge, Attitude and Preconceptions in University Undergraduates of Pedagogy, Physical Education and Medicine Courses in Relation to Epilepsy. The findings of this article show that knowledge of epilepsy in the three groups is very satisfactory. The low level of preconception indicates that educational or clarifying information is being transmitted, albeit by television, a layman s information vehicle, which has undoubtedly contributed to reducing the stigma of epilepsy through educational information. Results also suggest a lack of knowledge on how to act during a seizure, especially in education professionals. Although there are limitations in our sample, the relevance and contribution of this study is to call attention to the importance and need for these future professionals to be informed and learn correct attitudes with respect to epilepsy during their academic formation. This is essential at a time when the disease is being brought out of the shadows. This research was supported by the Office of the Dean of Teaching, and Deans of Pedagogy, Physical Education and Medicine at UERN. The research was made possible by the multidisciplinary interaction among a physical educator, child neurologist and statistician, all contributing to achieving the aims set out here

A reestruturação sócio-religiosa em Sergipe, no final do século XVIII

The issues surrounding the religious have been given greater importance in scientific discussions and the media. Discussions on religion and religiosity have become widespread as a means for construction of social representations, both as individual levels, in addition, in the collectivity. This work deals with the construction of the order of Jesus, missionaries and settlers of the projects that marked the presence of the Jesuit missionaries, from colonization to the religious restructuring imposed after the expulsion of the Jesuit Order in Sergipe. Expulsion is what happened in the midst of political and administrative changes made by the Portuguese government in the mid-eighteenth century, which had representation at the Marquis of Pombal its creator. Understanding the religious and social restructuring, designed here in the practices and representations of popular and official. This restructuring has had on the religious brotherhoods, religious orders and other representations, an important symbolic presence in the spaces sociorreligiosos linked to Catholic practices in Sergipe. Representation such that officially came into the vicars pasted their legal representatives, in the maintenance of religious practices in the boroughs and cities Sergipe

Cartas oficiais norte-riograndenses dos séculos XVIII, XIX e XX : constituição e caracterização de um corpus diacrônico

The diachronic studies marked the first decades of the 20th century in Brazilian linguistics, passing by an ostracism period after the 50s. Mainly from the 90s especially with the project, created in 1997, Para a história do português brasileiro (PHPB), which has systemized, in national ambit, the programme related to the area of diachrony the historical studies retake forces and have gradually increased since then. Our work is set in the new scene of Brazilian historical linguistics and it is associated to two research programmes: i) the constitution of a diachronic corpus; ii) the diachrony of text and discourse. As regards the first programme, we made effort to constitute a diachronic corpus of official letters about Rio Grande do Norte, we called cartas oficiais norte-rio-grandenses, written in 18th, 19th and 20th centuries. The chosen for bureaucrat letters occurred for they represent a textual category very productive in historical contexts, mostly 18th and 19th centuries, in which the command of writing was the least and also because they bring, almost always explicitly, the information of where, when, for whom and from whom, as remembers Fonseca (2003). The rules for constituting the corpus were based, although not strictly, on the orientation from PHPB. In respect to the second programme, we set up on the ideas of coserian base came from the studies on discourse traditions (TD) (Koch, 1997; Kabatek, 2006) amongst which that the texts are shaped so as to follow their own tradition (Coseriu, 2007), and we turned to Diplomatics (Belloto, 2002) in order to do the characterization of this corpus by the application of concepts from Diplomatics and TD as well as by the presentation of the structures that form those official letters: their textual genres, a kind of TD, with their macrostructures; and some of their formulaic expressions (microstructures), another sort of TD. This stage of characterizing will pay attention, as far as possible, to the dynamic between tradition and innovation that happen in the actualization of those textual structures along the centuries. This work intends to contribute with the researches connected to Historical Linguistics in Rio Grande do Norte, more specifically the ones related to the constitution of diachronic corpora and to TD; and with the study of official documents, textual category about which there are almost no studies (cf. Silveira, 2007)

Construções com tópico marcado em cartas pessoais brasileiras dos séculos XVIII, XIX E XX

This dissertation is a research on the marked topic construction (CT) in Brazilian personal letters from eighteenth, nineteenth and twentieth centuries. The goal of our research is to verify if CT are present in the writing of Brazilians born in the centuries in question. Our research focus is based on the assumptions of generative theory (CHOMSKY 1981; 1986), which states that grammar is internalized in the mind / brain of the writers, with the emphasis on studies of grammatical change, as pointed texts by Paixão de Sousa (2004), Carneiro (2005); Galves, Namiuti and Paixão de Sousa (2006) and Martins (2009). Our corpus was extracted from Projeto Para a História do Português Brasileiro (PHPB) and Cartas Brasileiras coletânea de fontes para o estudo do português. We selected forty-six correspondents who should be inserted into the two criteria set out in this research: to be Brazilian and be born in the centuries mentioned above, so that we could find legitimate topic constructions of PB. This work is based on researches by Pontes (1987), Mateus et al. (2003), Araujo (2006, 2009), Berlinck, Duarte and Oliveira (2009), which actively support us in the study of this linguistic phenomenon in Portuguese. The results show that the marked topic construction in our corpus appear on the writing of Brazilians since the second half of the eighteenth century, while the typical constructions in Brazilian Portuguese locative topic, subject topic and copy topic - are already reflected in the I-language of the writers born in the second half of the nineteenth century and the first of the twentieth century

Medicina filosófica: as relações entre medicina e filosofia na Grécia antiga e em Kant

This work deals with the relationship between medicine and philosophy, which has existed since Antiquity, and will also be discussed here from Kant s perspective. It presents the historical context formed by reciprocal influences of common notions regarding health/disease, balance/justice, and just measure, which are present in the medical discourse as much as in the philosophical one. It considers that Hippocratic medicine emerges from concerns about dietetics, thus creating the link between philosophy and medicine, which is important for our analysis on Kant s contributions to Hippocratic legacy. Taking into account these considerations, the work distinguishes between two aspects which are associated within the dietetics presented by Kant in his work The conflict of the faculties, studied here in the light of his Doctrine of virtue, particularly the duties to oneself in regard the care of one s body and the teleological conception. In this sense, the work indicates the role of Kantian thinking not only to enrich medical dietetics, by lending to it moral value, but also to enrich philosophy by highlighting its therapeutic effects

Teias de caridade e o lugar social dos expostos da Freguesia de Nª Srª da Apresentação: capitania do Rio Grande do Norte, século XVIII

The abandonment of newborn children is a reality nowadays. This reality enables us to discuss this issue in other temporalities, in all kinds of societies. Thus, this work aims to demonstrate how the population that lived at Freguesia de Nossa Senhora da Apresentação, a civil parish at a Rio Grande do Norte captaincy, socially placed the abandoned newborn during in the eighteenth century. These newborn were called exposed ones at the time and were inserted in a regional Exposed Circle. The research also discussed how the local Council assembly sheltered these newborn. For research development the following manuscript documents were used: baptism, wedding and demise documents at Freguesia de Nossa Senhora da Apresentação as well as the first Book of Records if the matrix church at this civil parish. The research also considered the terms of the Council assembly. Some printed documents were used such as Philippine Ordainments, the First Constitutions of the Archbishop in 1707 including the Lunario contents as well as texts from André João Antonil and Henry Koster. In the analysis reference work related to Social History was used. Thus, it is possible confirm that there was construction of socially accepted places for these exposed on behalf of the colonist at the region

Maus ares e malária: entre os pântanos de Natal e o feroz mosquito africano (1892-1932)

The development of epidemiological practices in the last years of the nineteenth and early twentieth century was characterized by both an influence of medical geography and the emergence of microbes and vectors of diseases. Both theories were used to explain outbreaks in Rio Grande do Norte specially in Natal. In this process were organized new institutions linked to public health, unhealthy spaces and prescribed hygiene measures. The redefinitions of the spaces were linked to updated elements of Hippocratic medicine such as aerism and emphasis on medical topography. How the physicians of the town were organized in the face of new meanings and fields of expertise in the demarcation of diseases and regulation of their own practices against the illegal medical practitioners? Likewise, the very occurrence of epidemics mobilized people, urban institutions and apparatuses. But how the Hippocratic legacy that leads to the idea of bad air originated by swamps from the eighteenth and nineteenth century has been linked to new microbial assumptions and disease vectors in the early twentieth century? How an invader from Africa, (the mosquito A. gambiae) mobilized transnational efforts to combat malaria and redefined the epidemiological practices? The aim of this work is to understand how epidemiological practices redefine the way we define spaces, practices and disease from both an approach influenced by a relational history of spaces and a theoretical synergy which includes topics in Science Studies, Post Structuralist Geography and some elements of Feminist Studies. Documentary research were surveyed in the reports of the provincial presidents, government posts to the Provincial Assembly, specialized medical articles and theses, and documents from the Rockefeller Foundation and national and international journals. In this regard shall be given to both material and discursive aspects of space-related practical epidemiological that Natal as much (in general) Rio Grande do Norte between bad air and malaria.

Liberdades possíveis em espaços periféricos: escravidão e alforria no termo da vila de Arez (séculos xviii e xix)

This paper discusses aspects of the slavery and emancipations in the village of Arez between the last quarter of the eighteenth century and the first decades of the nineteenth century. It seeks to identify the profile of the slaves and the emancipation possibilities in a peripheral region with few commercial activities, given that the most of the approaches about manumission consider towns and cities where the economic dynamics ware more pronounced, as places of higher possibilities of slaves working in diverse activities that allowed them to accumulate a reserve fund and thus buy their freedom. Therefore it was necessary to raise evidences of slavery in the case study, which was based on surveys of the eighteenth century, and the first decades of the nineteenth century and some population maps and civil records related to the early nineteenth century. The information about the manumission acts were analyzed based on writs of freedom registered in the village of Arez between 1774 and 1827 due to the absence of other documents about it. The registry books include all the documents of the Arez community; so, it was possible to observe what happened in rural localities, in the town, in the headquarters of the district and in the village of Goianinha. Based on information from the documents, it was possible to address some aspects of slavery like the predominant types of groups, the possible activities in which slaves were inserted and the profile of the freed slaves, the emancipation modes and, therefore, discuss the possible relations ship between the colonial space and manumissions and between masters and slaves

Avaliação do padrão do ciclo sono-vigília e a cognição em estudantes de medicina com diferentes esquemas de horários de aulas

The sleep patterns of students entering the university, is accompanied by many factors that can lead to changes in sleep habits, such as academic demands, new social opportunities, reduced parental care and irregular teaching schedules. The irregular pattern of sleep-wake cycle is usually accompanied by several daytime consequences, for example, reduced levels of motivation, performance, concentration, alertness and mood as well as increased fatigue and sleepiness.Thus, there are numerous reasons to support the fact that these students may suffer damage in their academic performance. The aim of this study was to evaluate the sleep-wake cycle (SWC) and cognition in medical students with different schemes teaching schedules. One group started classes at 08am, while the other started at 07am. We analyzed the data from 88 volunteers, 39 from each group. However, only those who participated in both stages of the study (n = 78) underwent cognitive testing. For subjective evaluation of the SWC was used questionnaires to check the quality of sleep, chronotype, daytime sleepiness and sleep habits. For objective evaluation was used actigraphy. For cognitive assessment was used the test MoCA (Montreal Cognitive Assessment). The results indicate that the group has class earlier had a greater irregularity of the SWC and a worse performance in cognitive testing. There was a difference between the schedules the week and weekend in the subjective variables, bedtime, wake up and sleep duration in both groups. The objective variables, time in bed showed difference between the schedules the week and weekend to the group started class at 08am and the variables bedtime, get up time, actual sleep time, time in bed and wake bouts in the class at 07am. In the cognitive test, there were differences between the groups in overall score and in the areas of executive function and memory recall. Thus, it is suggested that the class starting time may cause irregularity of the SWC and the irregularity may cause mild cognitive impairment. Moreover, cognitive testing MoCA was sensitive to detect differences among students, although the difference between the schedules is small

Relação entre o ciclo sono e vigília e a função cardiorrespiratória em estudantes de medicina

Students, normally, present an irregular sleep pattern characterized by delays in sleep onset and offset from weekdays to weekends, short sleep duration on weekdays and long sleep duration on weekends. The reduction of the necessary sleep and the irregularity in the sleep patterns provoke relevant short- and long-term impairments on performances, for example, in cardiorespiratory function. The cardiorespiratory performance represents, in addition to fitness, traces associated to health conditions and in several studies to pattern and/or individual s sleep quality. The aim of this study was to evaluate the pattern of the sleep-wake cycle and the cardiorespiratory function of medical students under different class schedules. The study was accomplished with two classes of medical students of UFRN, one had classes at 7 am (n = 47) and the second had classes at 8 am (n = 41) during the week. On the first stage of the study all volunteers filled out an anamnesis, the International Physical Activity questionnaire, the Pittsburgh index of sleep quality, the Portuguese version of the Horne and Östberg cronotype questionnaire, the Health and Sleep questionnaire and the Epworth Scale of Somnolence (ESS). On the second stage, 24 students (12 of each class) had their activity rhythm monitored by actimeters set to record activity at a 2-min interval for 14 days concomitant to the completion of the sleep diary. In this same stage, each volunteer performed the effort test (treadmill) only once in the morning period (between 9:00 and 11:00). The students showed an irregular pattern of the sleep-wake cycle and this irregularity is strongly influenced by the class schedules, in addition to the contribution of the academic demand, social activities and endogenous factors. The students who woke up earlier showed greater irregularity in the sleep-wake pattern. The earlier was the class schedule the worse was the sleep quality and the greater was the frequency of students with excessive diurnal somnolence. The classes schedules and the irregular pattern of the sleep-wake cycle did not show effect on the cardiorespiratory performance of the medical students. The performance on the test seems to be affected by other factors, which can be related to the pattern of the sleep-wake cycle or not. Therefore, it is suggested that the late start of classes provokes less irregularity on the pattern of the sleep-wake cycle. However, it was observed that this irregularity and the class schedule seem not to affect the cardiorespiratory performance directly