Medical faculty profile is an important determinant of student profile and future practice expectations of medical students in Angola

Funding Information: Rosa Ferrinho for assistance with data processing and literature search. COSEP for data collection. Funda??o para a Ci?ncia e Tecnologia for funds to GHTM UID/04413/2020. This study was part of a broader consultation for the Government of Angola. Authorization for publishing this study was obtained from the Ministry of Health of Angola. Funding Information: The study was sponsored by the Government of Angola. Publisher Copyright: © 2021, The Author(s).Background: Angola is among one of the most deprived countries in the world in terms of medical professionals. In the past decade, the Angolan Government has invested in the expansion of faculties of medicine in the country. We analysed the profiles of medical students in Angola according to four clusters of medical schools: older faculty in the country, private faculties, Cuban sponsored faculties and military faculty; under the assumption that the organizational culture of the different faculties might influence the expectations and decisions towards future professional life of medical students regarding where they want to work (community versus hospital) and in which sector (exclusively public versus not exclusively public). Methods: Observational cross-sectional study. Piloted, standardized questionnaire to final year medical students or higher year of training in the first four-month of 2014 (N = 402). Data were entered into a SPSS v.20 database and descriptive statistics computed. Statistical significance for categorical variables was tested by Pearson chi-square, Fisher exact or likelihood ratio tests as appropriate. Comparison of means was tested with Anova. Backward elimination binary logistic regression was used to test the hypothesis that type of faculty of medicine is an important determinant of future professional practice, i.e., level (hospital vs. community) or sector of practice (exclusive public sector vs. private or private and public), while controlling for confounders. Results: After controlling for age, sex, marital status, place of birth and place of primary and secondary education, type of family and family influence, students were more likely to choose community over hospital practice and to prefer exclusive public practice if attending a Cuba supported faculty of medicine. Conclusions: Medical education cannot be isolated from planning of the medical workforce. Some important and impactful careers choices, like choosing rural over urban practice, public over private sector practice, have deep influences in the medical professionals’ labour market. Some of these decisions are shaped even before the end of the medical training. As such, the monitoring of future professional intentions in medical schools should be done regularly to accommodate both the health system needs and the hopes and dreams of medical trainees.publishersversionpublishe

comparação dos perfis dos alunos de diferentes cursos (medicina, enfermagem e TDT), em diferentes níveis de ensino (básico, médio e superior)

Introdução: Descrevemos a evolução da formação de técnicos de saúde (TdS) em Angola e verificamos que o Plano de Desenvolvimento de Recursos Humanos (PDRH) 1997-2007 teve um profundo impacto no desenvolvimento da formação da força de trabalho em saúde em Angola. Este artigo relata um estudo feito no âmbito da elaboração do segundo PDRH 2013-2025 tendo por objetivo obter dados comparáveis sobre o perfil dos estudantes que frequentavam os diferentes cursos de ciências da saúde em Angola. Métodos: A metodologia foi baseada na utlizada em estudos semelhantes noutros países lusófonos e em Angola em 2007. O estudo decorreu no primeiro quadrimestre de 2014 subcontratado a uma empresa especializada. Os dados foram inseridos em SPSS v.20 em 2014 e estatísticas descritivas (contagem, frequência relativa, média e desvio padrão e medianas) foram calculadas com SPSS v 25 durante 2020. Resultados: Os resultados do estudo revelam uma mensagem positiva. Os alunos foram recrutados com uma ampla base geográfica; estavam satisfeitos com a escolha da formação e o seu desempenho era, em geral, satisfatório, embora a percentagem de estudantes de técnicas de diagnóstico e terapêutica (TDT) com disciplinas em atraso mereça atenção. Após a formação pretendiam estabelecer-se em Angola, de preferência numa prática hospitalar, de preferência na rede pública. Como o setor público não tem capacidade para absorver todos os alunos, é gratificante constatar que muitos estavam abertos à prática no setor privado, principalmente nas capitais provinciais ou nacionais, preferencialmente em acumulação com trabalhos do setor público. Discussão e conclusões: Em fim de ciclo do Plano Nacional de Formação de Quadros 2013-2020, este estudo destaca algumas das questões que terão de ser abordadas pelas instituições de formação a fim de contribuir para uma força de trabalho de saúde equilibrada em Angola, com TdS em quantidade com a qualidade e distribuição necessárias para dar reposta às necessidades do sistema de saúde e da população. Introduction: We describe the evolution of the training of health technicians (HT) in Angola and find that the Human Resources Development Plan (HRDP) 1997-2007 had a profound impact on the development of the training of the health workforce in Angola. This article reports on a study carried out within the scope of the preparation of the second HRDP 2013-2025 with the objective of obtaining comparable data on the profile of students who attended the different health sciences courses in Angola. Methods: The methodology was based on that used in similar studies in other Portuguese-speaking countries and in Angola in 2007. The study took place in the first four months of 2014, subcontracted to a specialized company. Data were entered in SPSS v.20 in 2014 and descriptive statistics (count, relative frequency, mean and standard deviation and medians) were calculated with SPSS v 25 during 2020. Results: The study results reveal a positive message. The students were recruited with a wide geographic base; they were satisfied with the choice of training and their performance was, in general, satisfactory, although the percentage of students in the Allied Health Sciences (AHS) with over-due subjects deserves attention. After training, they intended to settle in Angola, preferably in a hospital practice, preferably in the public network. As the public sector does not have the capacity to absorb all students, it is gratifying to note that many were open to practice in the private sector, mainly in provincial or national capitals, preferably in accumulation with public sector work. Discussion and conclusions: At the end of the cycle of the National Staff Training Plan 2013-2020, this study highlights some of the issues that will have to be addressed by training institutions in order to contribute to a balanced health workforce in Angola, with HT in quantity with the quality and distribution needed to respond to the needs of the health system and the populationpublishersversionpublishe

Masticatory efficiency, bite force and electrical activity of the masseter and temporalis muscles in bodybuilders

This study aimed to compare the masticatory efficiency, the maximum voluntary occlusal bite force (MVOBF) and the electrical activity (EMG) of masticatory muscles of practitioners of upper limb bodybuilding before and after physical activity. Twenty he

Dynamic UCLA for single tilted implant in an aesthetic region

AbstractIntroductionThe aim of this paper was to present a rehabilitation of a patient with a dynamic universal castable long abutment (UCLA) for a single tilted implant in the anterior maxillary area.Presentation of caseA 57-year-old male patient attended the dentistry college clinic complaining of a vertical fracture of a residual root of the dental element 22. The tooth extraction was indicated for the implant installation. Due to the socket buccal wall thickness, the implant was installed with an inclination to the palate. It was done in a two-stage surgical protocol, and an external hexagon implant (3.75×11.5mm) was placed. After a six-month healing period to correct the implant position, a dynamic UCLA was set in place, rectifying the implant emergence profile at 20°. The ceramic structure fitting was performed and, after the patient’s consent, the prosthesis was finalized and installed.DiscussionAfter a follow-up period of twenty months, no complications were observed.ConclusionThe installation of tilted implants with a dynamic UCLA may be a viable option, faster and less invasive than bone grafts

Rendas têxteis artesanais nos ambientes de memória: a inclusão digital multiplicadora da informação

Esse artigo propõe apresentar e debater as possibilidades de comunicação das coleções têxteis, e de modo especial, dos acervos de rendas artesanais e suas rendilheiras nos espaços expositivos como a casa-museu, os centros de memória e memoriais contextualizando o patrimônio cultural e considerando as categorias de lugar. Nessa perspetiva, pretende-se ampliar a discussão sobre a inclusão digital como impulsionadora dos processos de reconhecimento, gestão e salvaguarda do património imaterial. O estudo é desenvolvido pela análise de projetos expositivos que se valem de abordagens híbridas incorporando as tecnologias digitais como multiplicadoras da abrangência, continuidade e (re)uso da informação. A abordagem conceitual inclui o debate sobre a curadoria contextualizada da produção artesanal no amplo espectro dos Objetivos do Desenvolvimento Sustentável. Portanto, os contextos de produção do bem cultural, com ênfase na capacidade de transmissão a partir dos processos tradicionais de formação, bem como os modos de organização social do trabalho artesanal, revelam-se norteadores do discurso adotado para apresentação dos acervos nos ambientes físicos e digitais

OCCULT AND SEMI-OCCULT CONSTIPATION IN CHILDREN WITH MONOSYMPTOMATIC OR NON MONOSYMPTOMATIC ENURESIS

ABSTRACT Background: Functional constipation and enuresis frequently coexist. Constipation treatment often results in resolution or improvement of the enuresis. However, besides the classical presentation, patients can present with occult constipation (OC) diagnosed in complementary evaluation; in addition, semi-occult constipation (SOC) can be detected by means of a detailed questionnaire. Objective: To quantify OC and SOC frequency in children with monosymptomatic or non monosymptomatic enuresis (MNE or NMNE). Methods: Otherwise healthy children/adolescents, with enuresis refractory to behavioral therapy and denying constipation after simple questions, answered a structured bowel habit questionnaire and were submitted to a plain abdominal radiological exam. Constipation was classified considering the Boston diagnostic criteria (to allow diagnosis at initial stages), and fecal loading in the X-ray quantified ≥10 by the Barr score. Children with constipation received a standardized treatment (except 26 “pilot” children). Results: Out of 81 children, 80 aged 9.34±2.07 years, 52.5% male, were diagnosed with constipation: 30 OC, 50 SOC; 63.75% had MNE, 36.25% NMNE (six NMNE without behavioral therapy). Demographic data and the Barr score were similar for OC and SOC, but SOC children experienced significantly more constipation complications (retentive fecal incontinence and/or recurrent abdominal pain). Not showing the Bristol Stool Scale (BSS) to 24 “pilot” children, or absence of constipation symptoms accompanying BSS predominantly type 3, in 13 children, did not significantly impact the detection of constipation by the Barr score. Children identifying BSS 3 or ≤2 had similar results. Twenty-eight children, with adequate follow-up after treatment, improved or recovered from constipation at 44 of their 52 follow-up visits. Conclusion: In patients with MNE or NMNE refractory to behavioral therapy, and who initially denied constipation after simple questions, a detailed questionnaire based on the Boston diagnostic criteria detected SOC in 61.7%, and the radiological Barr score revealed fecal loading (OC) in 37.0% of them

Occupational therapy's theoretical-practical overview in cardiovascular health care for adults and older adults: an integrative review

Introdução: As evidências científicas acerca das especificidades da atuação do terapeuta ocupacional nas doenças cardiovasculares são insuficientes. Objetivos: Conhecer o panorama teórico-prático da terapia ocupacional na atenção à saúde cardiovascular ao adulto e ao idoso. Método: Revisão bibliográfica integrativa da literatura indexada nas bases de dados PSYcInfo; Cochrane; Web of Science; PUBMED; SCOPUS; EMBASE; LILACS; SciELO; CINAHL; Rehabilitation & Sports Medicine Source; Academic Searcher Premier, com recorte temporal de 1917 a 2020. Resultados: Identificou-se que diferentes aspectos são abordados nas intervenções, tais como: educação em saúde, conservação de energia, aumento da autopercepção da saúde, otimização da capacidade funcional residual e retorno ao máximo possível da condição anterior ao evento cardíaco, engajamento em atividades significativas, apoio emocional e estímulo à mobilidade, ao gerenciamento do estresse, à participação comunitária. Conclusão: Identificou-se atuação da Terapia Ocupacional na atenção à saúde cardiovascular, em especial no contexto hospitalar em equipes de reabilitação cardíaca, o que mostra a necessidade de outros estudos que evidenciem sua relevância em contextos territoriais.: Introduction: Scientific evidence about the occupational therapist's practice in cardiovascular diseases is insufficient. Objective: Comprehend occupational therapy's theoretical-practical overview in cardiovascular care for adults and older adults. Method: An integrative bibliographic review was conducted with the indexed literature in the following databases: PsycInfo; Cochrane; Web of Science; PUBMED; SCOPUS; EMBASE; LILACS; SciELO; CINAHL; Rehabilitation & Sports Medicine Source; Academic Searcher Premier, from 1917 to 2020. Results: It was identified that the interventions comprehended different aspects such as: health education, energy conservation, increasing self-perception of health, optimization of residual functional capacity, the resumption as much as possible of the prior condition before the cardiac event, engaging in meaningful activities, providing emotional support and encouraging mobility, stress management, and community participation. Conclusion: It addressed the practice of occupational therapy in cardiovascular health, especially in hospital care with cardiac rehabilitation teams, which highlights the need for further research that evidences its relevance in territorial contexts

A retrospective study

Funding Information: The authors thank technicians, Clinicians, and staff members from the Instituto Nacional de Investigação em Saúde (INIS), Direcção Nacional de Saúde Pública (DNSP), World Health Organization (WHO), and Médecins Sans Frontières for their technical support and assistance. Orçamento Geral de Estado (State General Budget) 2022 was allocated to the National Institute for Health Research (INIS) through the Ministry of Health, Angola. The funding agency was not involved in the design of the study, the gathering, analysis, and interpretation of the data, the writing of the manuscript, or the decision to submit the manuscript for publication. Publisher Copyright: © 2024 The Authors. Health Science Reports published by Wiley Periodicals LLC.Background and Aims: The acute tropical infectious disease known as yellow fever (YF) is caused by an arbovirus and is characterized by fever, jaundice, hemorrhage, headache, muscle pain, nausea, vomiting, and fatigue. Angola experienced a yellow fever virus (YFV) outbreak that was documented in December 2015. However, little is known about the outcome of this outbreak. We aimed to demonstrate epidemic features and lessons learned during the YF epidemic in Angola. Methods: A total of 4618 blood samples from suspected YF cases were sent to the Instituto Nacional de Investigação em Saúde (INIS), a national referral and public health laboratory, between December 5, 2015, and December 23, 2016. Sample analyses were conducted using enzyme-linked immunosorbent assay (ELISA) and reverse transcription polymerase chain reaction (RT-PCR) assays. Blood samples were sent from 16 out of the 18 provinces of Angola. Results: We detected 884 (19.1%) cases that were positive for ELISA, which were confirmed by RT-PCR assay. Considering the positive cases, the incidence among male patients was around three times higher (n = 223; 10.9%) than in female patients (n = 59; 2.6%) in the 20–29 age group, followed by the age group 10–19 with n = 211 (6.8%) in males versus n = 108 (3.3%) in females; and the age group 30–39 had n = 68 (4.8%) in males versus n = 28 (1.8%) in females. The other groups had an incidence below 3.0%. The case fatality ratio for YF was in young adults in the age group 20–29 with n = 39 cases, followed by the age group 10–19 with n = 16 cases, and finally the age group 0–9 with n = 13 cases. The other age groups had several deaths by YF below 10 cases. Conclusions: This study demonstrates features of the YF epidemic that occurred in Angola. Also, it demonstrates that YF causes deaths in young people but is preventable by high vaccine coverage. Thus, public health laboratory surveillance must be strengthened to reduce the possibility of emerging and re-emerging human infections.publishersversionpublishe