A Humaniza����o e a Forma����o M��dica 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

Avalia����o do conhecimento e de habilidades cl��nicas em sa��de sexual e reprodutiva na gradua����o de medicina

No Brasil, a despeito das conquistas obtidas a partir da implanta����o do Sistema ��nico de Sa��de e dos avan��os legais e institucionais na aten����o a diversos problemas relacionados ao g��nero, a incorpora����o de temas relacionados aos direitos humanos, sexuais e reprodutivos no contexto da forma����o profissional em sa��de permanece deficiente. Este trabalho teve como objetivos avaliar a inser����o da tem��tica sa��de sexual e reprodutiva no curr��culo do curso de gradua����o em Medicina, por meio do emprego de avalia����es de conte��do cognitivo, procedimental e atitudinal. Trata-se de estudo de interven����o educacional envolvendo alunos do internato do curso de Medicina da UFRN. Foram utilizados os seguintes m��todos avaliativos: prova escrita, exame cl��nico objetivo estruturado (OSCE) e Mini-CEX. Como vari��veis explicativas foram consideradas o sexo, idade e participa����o pr��via no componente curricular optativo Sa��de Reprodutiva . A avalia����o do processo constou da aplica����o de question��rios de satisfa����o e entrevistas acerca dos m��todos avaliativos utilizados. Considerando os tr��s m��todos avaliativos empregados, 183 estudantes participaram do estudo, com m��dia de idade de 24,5 �� 2,2 anos, sendo 52,5% do sexo masculino e 47,5% do sexo feminino. No contexto geral, observamos concord��ncia entre os desempenhos dos estudantes nas avalia����es de conte��do cognitivo, procedimental e atitudinal. A participa����o dos estudantes no componente curricular eletivo Sa��de Reprodutiva mostrou-se associada com melhor desempenho em algumas dimens��es da avalia����o cognitiva e na avalia����o com o Mini-CEX, em rela����o ��s compet��ncias de anamnese, profissionalismo e qualidades human��sticas, rela����o m��dico paciente e desempenho global. A an��lise da fidedignidade entre os avaliadores na avalia����o com o m��todo OSCE mostrou-se adequada (alfa de Cronbach superior a 70%) em rela����o ao desempenho global e aos aspectos t��cnicos das compet��ncias avaliadas, observando-se baixa confiabilidade na avalia����o da comunica����o m��dico-paciente. O presente trabalho constitui-se numa experi��ncia educacional inovadora e pioneira no ��mbito da educa����o m��dica brasileira no que tange �� inser����o da tem��tica de sa��de sexual e reprodutiva na gradua����o, sugerindo-se um impacto positivo da iniciativa na forma����o do m��dico generalista na UFRN. A avalia����o de conhecimentos, habilidades e atitudes em sa��de sexual e reprodutiva na gradua����o de Medicina mostrou-se fact��vel, com alta concord��ncia entre os diferentes m��todos empregados. Os m��todos OSCE e Mini-CEX podem ser aplicados ao contexto da sa��de sexual e reprodutiva, possibilitando a avalia����o de compet��ncias cl��nicas relevantes para a forma����o do m��dico generalista e que habitualmente n��o s��o contempladas nas avalia����es rotineiramente realizadas na gradua����o

AN��LISE COMPARATIVA DO CONHECIMENTO, ATITUDES E PRECONCEITOS DE UNIVERSIT��RIOS DOS CURSOS DE PEDAGOGIA, EDUCA����O F��SICA E MEDICINA EM RELA����O �� 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

Arche Tupi : uma leitura arquet��pica da mulher ��ndia em Casa-Grande & Senzala

This dissertation is a proposal for dialogue between Brazilian Social Thought, History of Portuguese America and the Analytical Psychology of C.G. Jung, highlighting the following archetypes: Anima, Animus, Shadow and Persona. Directing the study to the image of Indian women in this Brazilian interpretation of Casa-Grande & senzala by Gilberto Freyre, have largely centered on denial of the feminine image as a creative and positive in the minds of Brazilian culture, where a more specific analysis. We assume that your work has inspired several bridges over imaginary things in Brazil, including aspects relating to miscegenation, the study of foreign travelers, Jesuits and settlers / invaders of the sixteenth and seventeenth centuries the Portuguese disembarked in America and in this sense, the influence of his work as wasteful image through time and space of the Portuguese slave order. Above all, we intend to do a reading of Native women thought in his book

Frequ��ncia de retinopatia da prematuridade em rec��m-nascidos no Hospital das Cl��nicas da Faculdade de Medicina de Ribeir��o Preto da Universidade de S��o Paulo

OBJETIVOS: Determinar a frequ��ncia de retinopatia da prematuridade no Hospital das Cl��nicas da Faculdade de Medicina de Ribeir��o Preto (HCFMRP-USP) e verificar a associa����o da retinopatia da prematuridade com fatores de risco conhecidos. M��TODOS: Foi realizada an��lise prospectiva de 70 pacientes, nascidos no HCFMRP-USP, com peso inferior a 1.500 gramas, no per��odo de um ano. Os pacientes foram divididos em dois grupos (Retinopatia da prematuridade e Normal) para realiza����o de an��lise estat��stica com rela����o a fatores de risco conhecidos. Adotou-se n��vel de signific��ncia de 5%. RESULTADOS: A frequ��ncia de retinopatia da prematuridade foi de 35,71% entre os pr��-termos estudados. Os fatores pesquisados que apresentaram rela����o de risco para o desenvolvimento da doen��a foram: peso (p=0,001), idade gestacional (p=0,001), escore SNAPPE II (p=0,008), uso de oxigenoterapia por intuba����o (p=0,019) e por press��o positiva de vias a��reas (p=0,0017), m��ltiplas transfus��es sangu��neas (p=0,01) e uso de diur��ticos (p=0,01). CONCLUS��O: A frequ��ncia de retinopatia da prematuridade foi de 35,71% entre os pr��termos nascidos com menos de 1.500 g. V��rios fatores de risco foram identificados nos rec��m-nascidos do HCFMRP-USP, sendo constatado que crian��as mais pr��-termos apresentam formas mais graves de retinopatia da prematuridade.

Formas de preparo de figo-da-��ndia minimamente processado

The objective of this study was to evaluate the influence of methods of preparation in postharvest conservation of minimally processed products of cactus pear fruits. Ripe cactus pear fruits orange-fleshed, from a commercial orchard in the region of Valinhos, SP, Brazil, were used. After selection, the fruits were washed and the surface sanitized with a solution of dichloro s. triazinatriona sodium dihydrate (Sumaveg (R)) 200 mg 100g(-1) of free chlorine for 5 minutes. Fruits were then stored at 12 degrees C for 12 hours before processing. The first process was the removal of the shell and ends. Then, the fruits were cut longitudinally into two halves, peeled and sliced in 2 cm thick cross-sections. The whole fruit, halves and slices were packaged in polyethylene terephthalate containers (Neoforma (R) N-94). These units were stored at 3 degrees C for 16 days and analyses were performed every 4 days. The weight loss, the content of soluble solids (SS), the titratable acidity (TA), the ratio (SS / TA) and the ascorbic acid content were evaluated and the sensory analysis of products was performed. Whole fruits were preferred concerning the purchase intent and showed better results regarding the content of soluble solids, titratable acidity, soluble solids / titratable acidity and ascorbic acid content. The highest weight loss was observed in slices.

As origens da psican��lise de crian��as no Brasil: entre a educa����o e a medicina

O presente artigo tem por objetivo investigar a forma como as primeiras informa����es relativas �� psican��lise de crian��as foram introduzidas no Brasil, bem como delinear como estas id��ias foram apropriadas pelos te��ricos nacionais e incorporadas nas pr��ticas de assist��ncia �� crian��a desenvolvidas no Pa��s nas primeiras d��cadas do s��culo XX. Para isto foi desenvolvida uma pesquisa hist��rica de natureza qualitativa, mediante a realiza����o de um levantamento bibliogr��fico que buscou identificar a produ����o de autores nacionais sobre psican��lise de crian��as entre as d��cadas de 1920 a 1950. Os resultados indicam que a inser����o da psican��lise de crian��as no pa��s ocorreu por duas vias: primeiramente atrav��s da educa����o, mediante a utiliza����o deste referencial te��rico com o intuito de melhor gerir a educa����o das crian��as e solucionar seus problemas escolares; e, posteriormente, por interm��dio da medicina, mediante o desenvolvimento de uma pr��tica psicoter��pica destinada ao tratamento de crian��as com transtornos emocionais.

Medicina filos��fica: as rela����es entre medicina e filosofia na Gr��cia 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

Avalia����o do padr��o do ciclo sono-vig��lia e a cogni����o em estudantes de medicina com diferentes esquemas de hor��rios 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

Rela����o entre o ciclo sono e vig��lia e a fun����o cardiorrespirat��ria 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 ��stberg 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

Fenologia da figueira-da-��ndia em Selv��ria - MS

A figueira-da-��ndia �� uma cact��cea de origem mexicana, com grande potencial produtivo para as condi����es edafoclim��ticas do Brasil, por��m a falta de conhecimento faz com que a cultura seja pouco cultivada. Com o objetivo de avaliar a fenologia da figueira-da-��ndia, o presente trabalho foi realizado em plantas com 4 anos de idade, no espa��amento de 1,0 x 2,5 m, na ��rea experimental da Fazenda de Ensino, Pesquisa e Extens��o da Faculdade de Engenharia de Ilha Solteira - UNESP, localizada no munic��pio de Selv��ria - MS, de agosto de 2006 a janeiro de 2007. O delineamento experimental utilizado foi o inteiramente casualizado, com dez repeti����es, com uma planta por parcela experimental, ocasi��o em que foram avaliados a fenologia e o crescimento dos frutos. O per��odo de emiss��o das gemas concentrou-se nos meses de setembro e outubro. O florescimento, ocorreu 30 dias ap��s a emiss��o da gema flor��fera. Os frutos atingiram a maturidade fisiol��gica (ponto de colheita) aos 66 dias ap��s o florescimento e aos 72 dias apresentavam-se maduros, aptos para o consumo. O per��odo de desenvolvimento dos frutos, desde a emiss��o da gema flor��fera at�� a maturidade fisiol��gica, foi de 96 dias. A curva de crescimento dos frutos foi do tipo quadr��tica. A cultura da figueira-da-��ndia pode tornar-se uma alternativa principalmente para pequenos produtores, visto que n��o exige grandes investimentos para sua implanta����o e condu����o, al��m de se adaptar bem ��s condi����es ambientais de nosso Pa��s. Seus frutos possuem excelentes pre��os tanto no mercado nacional como no internacional, e o aproveitamento na forma de doces e geleias pode incrementar a renda dos produtores.

An��lise retrospectiva de fatores de risco e preditores de complica����es intraoperat��rias dos bloqueios do neuroeixo realizados na Faculdade de Medicina de Botucatu-UNESP

JUSTIFICATIVA E OBJETIVOS: As altera����es cardiovasculares associadas aos bloqueios do neuroeixo apresentam interesse pela frequ��ncia com que ocorrem e porque algumas delas podem ser consideradas efeitos fisiol��gicos desencadeados pelo bloqueio do sistema nervoso simp��tico. O objetivo desta pesquisa foi avaliar as complica����es cardiovasculares intraoperat��rias e os fatores preditores associados aos bloqueios do neuroeixo em pacientes com idades > 18 anos submetidos a procedimentos n��o obst��tricos, em um per��odo de 18 anos, em hospital universit��rio de atendimento terci��rio-HCFMB-UNESP. M��TODO: Foi realizada an��lise retrospectiva das seguintes complica����es: hipertens��o arterial, hipotens��o arterial, bradicardia sinusal e taquicardia sinusal. Tais complica����es foram correlacionadas com t��cnica anest��sica, estado f��sico (ASA), idade, sexo e comorbidades pr��-operat��rias. Para a an��lise estat��stica, foram utilizadas o teste de Tukey para compara����es entre propor����es e regress��o log��stica. RESULTADOS: Foram avaliados 32.554 pacientes submetidos a bloqueios do neuroeixo e houve 4.109 cita����es de hipotens��o arterial, 1.107 de bradicardia sinusal, 601 de taquicardia sinusal e 466 de hipertens��o arterial no per��odo intraoperat��rio. Hipotens��o foi mais frequente nos pacientes submetidos �� anestesia subaracnoidea cont��nua (29,4%, OR = 2,39), com idades > 61 anos e do sexo feminino (OR = 1,27). CONCLUS��ES: Hipotens��o e bradicardia intraoperat��rias foram complica����es mais frequentes, sendo que a hipotens��o arterial esteve relacionada �� t��cnica anest��sica (ASC), faixa et��ria elevada e sexo feminino. Taquicardia e hipertens��o arterial podem n��o ter sido diretamente relacionadas aos bloqueios do neuroeixo.

Clinical and pathological assessment of 82 patients with cardiovascular diseases undergoing autopsy at the Hospital das Cl��nicas of the Faculdade de Medicina de Botucatu from 1988 to 1993

OBJECTIVE: To evaluated the clinical diagnostic, efficiency for basic death causes in patients dying of circulatory disease and de relative frequency of those diseases. METHODS: Analysis of medical record data of 82 patients, ages from 16 to 84 years old (68 over 40 years old), whose died of circulatory disease and had undergone necropsy in the period from 1988 to 1993 years in the University Hospital of Medicine Faculty of Botucatu-UNESP, Br. RESULTS: The functional class of patients were III or IV, in 78%, and 81.7% needed urgent hospitalization. By the clinical judgment the death were by ischemic heart disease in 32 (21 acute myocardial infarction), Chagas'disease in 12, valvopathy in 11, cardiomyopathy in 7, heart failure with no specification of cardiopathy in 11 and other causes in 9. At the necropsy the death cause was ischemic heart disease in 34 patients, valvopathy in 10, Chagas'disease in 10, cardiomyopathy in 5, and heart failure with no specification of cardiopathy in 2.The concordance taxes were in thhe same order: 94,6%, 90,0%, 83.3%, 71.4% and 28.5%. CONCLUSION: There was a great efficiency of clinical diagnosis for death cause in a general university hospital. The ischemic heart disease were the main causes of death.

Qualidade de vida e sa��de f��sica e mental de m��dicos: uma autoavalia����o por egressos da Faculdade de Medicina de Botucatu - UNESP

OBJETIVO: O presente artigo teve como objetivo analisar resultados de autoavalia����es em termos de qualidade de vida (QV), sa��de f��sica (SF) e sa��de mental (SM) realizadas por ex-alunos do curso de medicina de uma universidade p��blica brasileira, associando-se tais indicadores a dados demogr��ficos e diversas dimens��es da atua����o profissional. M��TODOS: estudo de corte transversal que teve como popula����o-alvo todos os egressos da Faculdade de Medicina de Botucatu (UNESP) no per��odo de 1968 a 2005, utilizando-se um question��rio autoaplic��vel, respondido por correio ou internet. RESULTADOS: Dos 2.864 question��rios enviados, 1.224 (45%) foram respondidos. Tanto a QV como SF e SM foram avaliadas como boa ou muito boa por 67,8%, 78,8% e 84,5% dos participantes, respectivamente. Nos modelos finais de regress��o log��stica, associaram-se a avalia����o favor��vel de QV: ter boa SF e SM, frequentar congressos regulamente, ter tempo suficiente de lazer e estar satisfeito com a profiss��o. SF boa ou muito boa associou-se independentemente com QV e SM positivas, faixa de renda mais alta, pr��tica regular de atividades f��sicas e nunca ter fumado. SM favor��vel permaneceu associada com satisfa����o profissional, tempo para lazer, e boa avalia����o da QV e da SF. CONCLUS��ES: Entre os m��dicos egressos da UNESP, SF e SM foram aspectos indissoci��veis e tamb��m relacionados �� QV. Bons h��bitos, como praticar atividades f��sicas, ter tempo para lazer e n��o fumar foram associados �� melhor avalia����o da sa��de em geral e devem ser incentivados. A satisfa����o profissional teve um peso importante no bem-estar emocional relatado pelos participantes.