Impact of a simulation-based interprofessional workshop (LINKS) on Portuguese healthcare students’ perception of roles and competencies: a quasi-experimental pilot study

Introduction There is a scarcity of simulation-based interprofessional (IP) programs in Portugal, with a notorious absence in undergraduate education. This paper describes the first step towards the development of an interprofessional education (IPE) undergraduate program, namely the implementation and preliminary assessment of the workshop LINKS – Lifting INterprofessional Knowledge through Simulation. The aim of this pilot study was to assess the educational effect of LINKS, in medical and nursing undergraduate students’ attitudes towards IP teamwork and collaborative practices, and their perception of roles and competencies within an IP team. Methods A total of 23 final-year students participated in the workshop. Teams of three or four elements (medical and nursing students) were exposed to two critical patient management simulation scenarios. To assess the impact of the workshop on students’ perception of IP collaborative practice, two surveys (ATTITUDES and IPEC) were applied before and after the workshop. Additionally, students’ opinion/satisfaction towards the workshop and its curricular integration was explored. Results Students’ awareness of the relevancy of IP learning and self-competency in IP practice improved. For all subdomains and overall scores, statistically significant differences were found when comparing the pre- and post-scores, for both medical and nursing students, in both surveys. All students agreed that the workshop added educational value to their training, and recommended its integration in the formal curriculum, with a first round in the penultimate year and repeated in the last year. Discussion Considering the pre–post test results and anecdotal comments shared during the session, we may infer that this single IPE event contributed to a clearer understanding of the team dynamic and individual role definition, increased the motivation to engage in collaborative practice between physicians and nurses and potentially challenged pre-existent stereotypes of each professional group. These findings corroborate the need for sustainable simulation-based IP programs, integrated in the undergraduate curricula, promoting early clinical interactions of different professional groups. We envision that the results of this study can help to inform future curriculum planning and provide useful insights that can be used within and between Portuguese institutions to develop a common IP undergraduate program.info:eu-repo/semantics/publishedVersio

Literacia científica e inclusão através da educação em ciências: Caso de uma criança portadora de TDAH

Neste trabalho apresentamos uma experiência pedagógica sobre o papel das atividades práticas/ experimentais na aprendizagem científica e inclusão de uma criança portadora de Transtorno do Déficit de Atenção com Hiperatividade (TDAH). Esta experiência pedagógica demonstrou que a educação em ciências proporciona um ensino personalizado na turma. Tivemos oportunidade de observar que numa criança com TDAH houve uma considerável melhoria no nível de literacia científica, no comportamento na sala de aula, bem como nas suas relações interpessoais. As atividades práticas/experimentais revelaramse, pois, um adequado recurso didático para a inclusão, para o desenvolvimento da autonomia e das aptidões escolares, nomeadamente as competências definidas no currículo para o “Estudo do Meio”, do 1º ano do ensino primário, bem como competências ao nível da escrita, da leitura e da expressão plástica

Parcerias entre faculdades de medicina no âmbito dos PALOP - Da elaboração à implementação de um programa estratégico de desenvolvimento

A cooperação no âmbito da Medicina, entre Portugal e os PALOP, deve ser a de capacitação das instituições parceiras. Desde 2005, tem a Faculdade de Medicina da Universidade do Porto (FMUP) implementado programas no âmbito da Educação Médica (EM) com a Faculdade de Medicina da Universidade Agostinho Neto (FMUAN), em Luanda, Angola. Em 2008, a extensão a Moçambique foi possível através do financiamento ao Projecto A NAME for Health – A Network Approach in Medical Education for the Pursuit of Quality of Higher Education Institutions and Health Systems (EDULINK). O reforço das redes de EM e de prestação de cuidados de saúde passou, desde aí, a desempenhar um papel central na cooperação com os PALOP

Destilador solar destinado a fornecer água potável para as famílias de agricultores de base familiar.

Com o objetivo de fornecer água potável aos agricultores do Semiárido do Nordeste Brasileiro, estudou-se a viabilidade técnica de um destilador solar no processo de dessalinização de água para consumo humano constituído de um coletor solar para aquecimento de água salina. Foram avalizados dois métodos de condução do fluxo de água do coletor solar para o tanque de evaporação. No Método 1 (M1) o fluxo de água foi constante (1L h-1), mantendo-se um lâmina de 10mm no interior da caixa de alvenaria. No Método 2 (M2) o fluxo de água, advindo do coletor solar, ocorria apenas às 15 horas quando o destilador/condensador era abastecido com água quente advinda do coletor solar, e após o abastecimento o fluxo de água era interrompido. Os volumes de água destilada produzida no sistema são suficientes para atender as necessidades de água destinada ao consumo direto de uma família na zona rural. Em termos médios a produção de água destilada por radiação solar incidente no sistema em M2 foi 46,87% maior que em M1

A relação entre o stress e os estilos de vida nos estudantes de medicina da Faculdade de Medicina do Porto

Different studies have demonstrated that there are significant changes in the health and habits/life-style of university students, and it seems that Medical students also reveal a significant vulnerability to the adoption of health risk behaviours. The present study aims to (1) characterize the main sources of academic stress of the Medical School students of the University of Porto as well as the intensity with which they are experienced, (2) investigate the variations in academic stress and psychosocial variables, due to gender, year of course and displacement from home and (3) contribute, for the first time, to the understanding of stress and life-style of medical students in Portugal. The empirical study included a sample of 251 students from all 6 years of the course (160 females and 91 males), evaluated by the following instruments: (1) The Inventory of Sources of Academic Stress in Medical Education (ISASME), and the Portuguese versions of (2) the Brief Personal Survey (BPS), (3) the General Health Questionnaire 12 (GHQ-12), and (4) the Interpersonal Behaviour Survey-Brief (ICI- Brief). In terms of overall levels of stress (GHQ-12), a prevalence of 58.2% of clinically significant stress symptoms was found, with the students from the basic cycle and those who are living away from home, presenting higher levels of stress. In terms of life-style, 47% of the students revealed health risk behaviours, with eating habits, physical exercise, alcohol and drug consumption, and body image being the main problem areas. Gender and year of course seem to have a significant influence on the variables studied, being the female students those who present higher levels of academic stress, stress responses (pressure/overload, physical distress, anxiety, anger/ frustration, inefficiency, depression and loss of control), and low levels of coping confidence; the students of the basic cycle reveal higher levels of stress in managing their life-style (academic stress), general stress symptoms and stress responses. This study calls attention for the need of preventive intervention with medical students in order to prevent negative consequences of stress and improve their life-style by promoting individual and social resources.Diferentes estudos têm vindo a demonstrar que há mudanças significativas ao nível dos hábitos/estilos de vida dos estudantes do ensino superior e, verifica-se que, os estudan- tes de Medicina também evidenciam uma significativa propensão para a adopção de estilos de vida de risco para a saúde. Neste sentido, o presente trabalho pretende (i) caracterizar as principais fontes de stress académico dos estudantes da Faculdade de Medicina do Porto (FMUP) e a intensidade com que são experienciadas, (ii) investigar as variações com o sexo, ciclo de formação e deslocação da residência de origem, no stress académico e variáveis psicossociais associadas e, (iii) contribuir, pela primeira vez, para o estudo aprofundado do stress e estilos de vida dos estudantes de Medicina em Portugal. O estudo empírico contou com uma amostra de 251 estudantes dos sextos anos do Plano de Estudos da Licenciatura em Medicina da FMUP (160 do sexo feminino e 91 do sexo masculino), avaliados através dos seguintes instrumentos: (a) o Inventário de Fontes de Stress Académico no curso de Medicina (IFSAM), o Inventário de Respostas e Recursos Pessoais (IRRP), (b) o Questionário de Hábitos de Saúde, (c) o General Health Questionnaire (GHQ-12) e (d) o Inventário de Comportamento Interpessoal-breve (ICI- breve). Verificou-se uma prevalência de 58,2% de sintomas clínicos de stress e 47% dos estudantes revelam comportamentos de risco para a saúde, sendo as áreas de maior preocupação os hábitos alimentares, a prática de exercício físico, o consumo de álcool e tabaco, e a imagem corporal. O sexo e o ciclo de formação revelam uma influência signifi- cativa nas variáveis estudadas, sendo as estudantes do sexo feminino as que apresentam maiores níveis de stress académico, respostas de stress e baixa confiança na sua capaci- dade de coping; já os estudantes do ciclo básico revelam maiores níveis de stress geral, stress na gestão dos estilos de vida e nas respostas de stress. Este estudo poderá contri- buir para alertar para a necessidade de intervir junto dos estudantes de Medicina, no sentido de prevenir as consequências negativas do stress académico e melhorar o bem- estar e estilo de vida dos estudantes de Medicina, promovendo recursos individuais e sociais importantes.info:eu-repo/semantics/publishedVersio

A Latin American, Portuguese and Spanish consensus on a core communication curriculum for undergraduate medical education

The autors would like to acknowledge the contributions of the participantsin the panel of experts. Their comments have helped us to reach moresuitable learning outcomes.They also want to thank the Universidad Francisco de Vitoria (Madrid, Spain)the financial support for the achievement of the projectTo present learning outcomes in clinical communication for a Core Curriculum for medical undergraduate students in Latin America, Portugal and Spain (LAPS-CCC) and to establish an expert network to support a transnational implementation. Through an iterative process, an international group of 15 experts developed an initial set of learning outcomes following a review and discussion of relevant international and local literature. A two-round Delphi survey involving 46 experts from 8 countries was performed. Quantative and qualitative analisis permited the definition of the final consensus. The initial proposal included 157 learning outcomes. The Delphi process generated 734 comments and involved the modification, deletion and addition of some outcomes. At the end of the process, a consensus was reached on 136 learning outcomes grouped under 6 competency domains with a high overall acceptance (95.1 %). The learning outcomes of this proposal provide a guide to introduce, support and develop communication curriculae for undergraduate medical studies in the countries involved or in other Spanish- or Portuguese-speaking countries. The online version of this article (doi:10.1186/s12909-016-0610-8) contains supplementary material, which is available to authorized users

Rhinitis associated with asthma is distinct from rhinitis alone: TARIA‐MeDALL hypothesis

Asthma, rhinitis, and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of “one-airway-one-disease,” coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases. With new data, it is time to reassess the concept. This article reviews (i) the clinical observations that led to Allergic Rhinitis and its Impact on Asthma (ARIA), (ii) new insights into polysensitization and multimorbidity, (iii) advances in mHealth for novel phenotype definitions, (iv) confirmation in canonical epidemiologic studies, (v) genomic findings, (vi) treatment approaches, and (vii) novel concepts on the onset of rhinitis and multimorbidity. One recent concept, bringing together upper- and lower-airway allergic diseases with skin, gut, and neuropsychiatric multimorbidities, is the “Epithelial Barrier Hypothesis.” This review determined that the “one-airway-one-disease” concept does not always hold true and that several phenotypes of disease can be defined. These phenotypes include an extreme “allergic” (asthma) phenotype combining asthma, rhinitis, and conjunctivitis.info:eu-repo/semantics/publishedVersio

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe