HEPATITIS B VACCINATION COVERAGE AND POSTVACCINATION SEROLOGIC TESTING AMONG MEDICAL STUDENTS AT A PUBLIC UNIVERSITY IN BRAZIL

The aim of this cross-sectional study was to determine the hepatitis B vaccination coverage among medical students at a public university in Rio de Janeiro, Brazil, and their compliance with the postvaccination serologic testing recommendations. Of the total of 858 students, 675 (78.7%) participated in the study. Among the participants, 48.9% (95% CI: 45.1% to 52.7%) were vaccinated against hepatitis B (received ≥ 3 doses of the vaccine), 31.6% were not (received 0, 1 or 2 doses), and 19.6% did not know their vaccination status. Hepatitis B vaccination coverage increased from 26.0% among first-year students to 70.6% among sixth-year students while the prevalence of unknown vaccination status decreased from 39.7% among first-year students to 2.4% among sixth-year students. The frequency of unvaccinated students ranged from 23.7% among fifth-year students to 34.4% among first-year students. Only 34.8% of the vaccinated students performed the anti-HBs testing after vaccination. Among these medical students, we found a low adherence to the hepatitis B vaccination and to the postvaccination serologic testing. A comprehensive hepatitis B immunization program should be offered to students at this medical school.

Mutilação Genital Feminina: o que Sabem os Profissionais de Saúde?

Portugal is considered by the World Health Organization (WHO) a risk country for the practice of Female Genital Mutilation (FGM). Objectives: To evaluate the knowledge that health professionals from Maternity Dr. Alfredo da Costa (MAC) have regarding FGM. Population and Methods: Analysis of surveys delivered to health professionals from MAC (a hospital dedicated to reproductive health), between April and June 2008, addressing issues related to the knowledge about FGM. Results: Authors collected 112 valid surveys involving 38 doctors, 48 nurses and 26 medical auxiliaries/administrative personnel. From the respondents, 106 (95%) had heard about FMG practice before, the media being the most reported source of information; 59 (53%) replied they could be able to recognize FGM cases in their clinical practice; however, only 31 (28%) claimed to know the FGM type classiication and 32 (29%) admitted to be prepared to recognize and manage these situations in their own clinical practice; 9 had been consulted explicitly by a FGM practice complication and 1 doctor had admitted having been asked to perform/execute FGM; 13 (12%) recognized that the Portuguese legislation its this practice. Regarding the practice of FGM, 100 (89%) of respondentes stated that it should not be maintained and 97 (87%) stated that it should not be tolerated. However, 42 (38%) considered that if these practices were a reality, then they should be medical assisted. Discussion: Health professionals can play an important role in eliminating the practice of FGM, not only by the proper clinical management of this situation, but also by preventing those communities at risk to resort to FGM. Most health professionals are not prepared to deal with FGM in their clinical practice. It is important to promote a better knowledge on the subject and to create protocols for proper clinical management.

Tecnologias Multimédia no Apoio ao Ensino da Assistência Pré-Hospitalar

Vivemos num mundo em constante mudança, onde a evolução tecnológica está cada vez mais presente no nosso quotidiano e as suas influências são inúmeras nas nossas vidas. Por outro lado, a vida humana é algo extremamente valioso e único pelo que a sociedade, também nessa área, tem procurado evoluir e dotar-se de novos meios e mecanismos de atuação, que possibilitem um socorro rápido e adequado em situações que possam em algum momento pôr em perigo a vida do ser humano. Pretendemos com o presente estudo, correlacionar estas duas vertentes, a do socorro á vítima para apoio á vida humana e a tecnologia no sentido de contribuir para uma formação mais distribuída mas ao mesmo tempo capaz de transmitir conhecimentos necessários á formação dos que socorrem. Para o efeito, planeamos o desenvolvimento de um Objeto de Aprendizagem (OA) denominado CiTAT (Curso Interativo de Tripulante de Ambulância de Transporte) que tem como objetivo acrescentar valor a todos os que são obrigados a frequentar o curso em regime presencial de Tripulante de Ambulância de Transporte (TAT). Após uma fase de análise do estado da arte relacionada com este tipo de formação, e após termos percebido como funciona e que tipos de recursos utilizam, analisámos temas relacionados com este tipo de formação como o “Sistema Integrado de Emergência Médica” o “Exame á Vítima”, o “Suporte Básico de Vida” e as “Emergências de Trauma”. Percebemos que a mudança de paradigma de formação das pessoas passou a ter novas formas de distribuir conhecimento em formato digital e que proporciona aos formandos um ensino distribuído em formatos de e-learning ou de b-learning. Os Objetos de Aprendizagem (OA) parecem assumir um relevo especial no ensino da área da saúde, abordando áreas temáticas e proporcionando aos seus utilizadores mecanismos de autoavaliação após a visualização dos conteúdos pedagógicos. Após o desenho do modelo concetual do CiTAT, avançamos para a produção de recursos necessários para a sua integração no OA. Após uma fase de testes e ajustes, avançamos para a sua avaliação final por parte dos utilizadores e preparamos um questionário para aferir o potencial de utilização deste tipo de soluções no ensino de TAT, atendendo ao facto de ser uma formação obrigatória e cuja recertificação é feita de três em três anos. O passo final foi a sua distribuição ao nível global, sendo o CiTAT catalogado com metadados e colocado no repositório MERLOT.

Psychiatric and Psychosocial Predictors of Medical Outcome After Liver Transplantation: a Prospective, Single-Center Study

OBJECTIVE: Recognizing the potential impact of psychiatric and psychosocial factors on liver transplant patient outcomes is essential to apply special follow-up for more vulnerable patients. The aim of this article was to investigate the psychiatric and psychosocial factors predicted medical outcomes of liver transplanted patients. METHODS: We studied 150 consecutive transplant candidates, attending our outpatient transplantation clinic, including 84 who had been grafted 11 of whom died and 3 retransplanted. RESULTS: We observed that active coping was an important predictor of length of stay after liver transplantation. Neuroticism and social support were important predictors of mortality after liver transplantation. CONCLUSION: It may be useful to identify patients with low scores for active coping and for social support and high scores for neuroticism to design special modes of follow-up to improve their medical outcomes.

Clustering medical tourism in Algarve: setting the first steps for the the health authority

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

Brain-computer interface (BCI): a methodological proposal to assess the impacts of medical applications in 2022

Based on the report for “Project IV” unit of the PhD programme on Technology Assessment (Doctoral Conference) at Universidade Nova de Lisboa (December 2011). This thesis research has the supervision of António Moniz (FCT-UNL and ITAS-KIT) and Armin Grunwald (Karlsruhe Institute of Technology-ITAS, Germany). Other members of the thesis committee are Mário Forjaz Secca (FCT-UNL) and Femke Nijboer (University of Twente, Netherlands).

While the crisis proceeds: A world redistribution of economic power?

The crisis has drawn attention to the fact that not only emerging powers but other regions of the world as well may be offering different development models and may constitute into alternative, in some dimensions more positive agents, in the conduct of the present stage of globalisation. Notwithstanding, the traditional western powers have not lost a large amount of control of the world economy. And the crisis proceeds, reallocating world power as in a Hobbesian anarchy. It is difficult to foresee smooth developments in the near future. On the contrary, multilateralism seems to be losing ground to unilateral action or bilateral arrangements. More or less disguised currency wars may lead to serious disequilibria, and turf wars may become more frequent, with motives ranging from securing captive markets to control of specific commodities and energy goods, or targeted regulatory frameworks. As economic policy becomes even more involved with defence and security affairs, the feedbacks from each side to the other seem likely to keep dissent and animosity high, rather than contributing to peaceful and constructive approaches. A more trouble-prone world may be easily expected.

Modeling and visualization of medical anesthesiology acts

Dissertação para obtenção do Grau de Mestre em Engenharia Informática

Improvisation in tightly controlled work environments: The case of medical practice

We present a qualitative analysis of organizational improvisation and provide a preliminary insight into the following question: how is improvisation present in tightly controlled work environments? We conducted in situ observations of, and interviews with, several emergency medical teams and complemented this information with statistical and media data. Using grounded theory, we developed four propositions that were arranged into a model that allowed the identification of two use levels of established routines: (1) the visible side that accommodates contextual requirements, and (2) the improvisational side that provides a response to activity characteristics. This dual process is related to the existence of pressures that operate at the institutional level with practical needs emerging from the operational domain. In contrast with most of the literature, this study reveals that the presence of a broad procedural organizational memory does not restrict improvisation but enables a bureaucratic system to produce flexible improvised performance.

Money for nothing?: The net costs of medical training

A Masters Thesis, presented as part of the requirements for the award of a Research Masters Degree in Economics from NOVA – School of Business and Economics