Soil contamination by eggs of soil-transmitted helminths with zoonotic potential in the town of Fernandópolis, State of São Paulo, Brazil, between 2007 and 2008

INTRODUÇÃO: A concentração de cães e gatos em áreas urbanas, associada a um número cada vez mais crescente da população errante desses animais, tem um papel epidemiológico importante na contaminação de solos de praças e parques públicos e na disseminação de infecções por variados gêneros de parasitas. O objetivo do presente estudo foi determinar a frequência de geo-helmintos com potencial zoonótico em solo de praças públicas e escolas municipais infantis da Cidade de Fernandópolis, Estado de São Paulo, Brasil, no período compreendido entre março de 2007 e fevereiro de 2008. MÉTODOS: Foram avaliadas todas as praças (32) e escolas (13) da cidade. As amostras foram testadas pelos métodos de Rugai adaptado, Willis e Caldwell e Caldwell. RESULTADOS: Foram avaliadas 225 amostras de solo com 30,2% (68) de positividade. Nas amostras provenientes de praças públicas, a positividade foi de 40% (64), ao passo que, nas escolas, foi de apenas 6,1% (6). Os ovos de parasitas encontrados foram Toxocara spp. 79,3% (47), Trichuris spp. 13,8% (8) e ancilostomídeos 6,9% (4). Variáveis relacionadas ao local, como o número de cães (OR 21,18 - IC95%: 10,81-41,51), de espécimes de fezes (OR 6,87 - IC95%: 3,51-13,47) e a utilização de cerca (OR 0,1 - IC95%: 0,05-0,20) tiveram impacto na contaminação do solo. CONCLUSÕES: Foram observados, nas amostras contaminadas, parasitas com potencial zoonótico, entre os quais estão os agentes etiológicos de doenças como a larva migrans visceral e cutânea, fato que representa risco a saúde da população que frequenta tais ambientes.INTRODUCTION: The concentration of dogs and cats in urban areas, associated with an ever-increasing wandering population of these animals, has an important epidemiological role in the soil contamination of public spaces and the spread of infections of several types of parasites. This study aimed to determine the frequency of soil-transmitted helminths with zoonotic potential in public squares and municipal primary schools in Fernandópolis, State of São Paulo, Brazil, conducted between 2007 and 2008. METHODS: All the squares (32) and schools (13) in the town were evaluated. Soil samples were tested using the Rugai method modified by Willis, Caldwell and Caldwell. RESULTS: A total of 225 soil samples were evaluated and 30.2% (68) were positive for helminths. In samples from public squares, 40% (64) contamination was observed; however, contamination in schools was only 6.1% (6). The parasites eggs identified were Toxocara spp. 79.3% (47), Trichuris spp. 13.8% (8) and Ancylostomatidae 6.9% (4). Variables related to the site, such as the number of dogs (OR 21.18, 10.81 - 41.51), fecal samples (OR 6.87, 3.51 - 13.47) and the use of fences (OR 0.1, 0.05 - 0.20), had an impact on soil contamination. CONCLUSIONS: In the contaminated samples, parasites with zoonotic potential were identified, including the etiologic agents of diseases like cutaneous and visceral larva migrans, a fact that poses a risk to health of the population that frequent such environments

Investigating the relation between self-assessment and patients' assessments of physicians-in-training empathy: a multicentric, observational, cross-sectional study in three teaching hospitals in Brazil

This study investigated the associations between self-assessed empathy levels by physicians in training and empathy levels as perceived by their patients after clinical encounters. The authors also examined whether patient assessments were valid and reliable tools to measure empathy in physicians in training. Objectives This study investigated the associations between self-assessed empathy levels by physicians in training and empathy levels as perceived by their patients after clinical encounters. The authors also examined whether patient assessments were valid and reliable tools to measure empathy in physicians in training. Design A multicentric, observational, cross-sectional study. Setting This study was conducted in three public teaching hospitals in Brazil. Participants From the 668 patients invited to participate in this research, 566 (84.7%) agreed. Of these, 238 (42%) were male and 328 (58%) were female. From the invited 112 physicians in training, 86 (76.8%) agreed. Of the 86 physicians in training, 35 (41%) were final-year medical students and 51 (59%) were residents from clinical and surgical specialties. The gender distribution was 39 (45%) males and 47 (51%) females. Primary and secondary outcome measures Physicians in training filled the Jefferson Scale of Physician Empathy (JSE) and the Interpersonal Reactivity Index. Patients answered the Jefferson Scale of Patient’s Perceptions of Physician Empathy (JSPPPE) and the Consultation and Relational Empathy Scale (CARE). Results This study found non-significant correlations between patient and physicians-in-training self-assessments, except for a weak correlation (0.241, p<0.01) between the JSPPPE score and the JSE compassionate care subscore. CARE and JSPPPE scales proved to be valid and reliable instruments. Conclusions Physicians-in-training self-assessments of empathy differ from patient assessments. Knowledge about empathy derived from self-assessment studies probably does not capture the perspective of the patients, who are key stakeholders in patient-centred care. Future research on the development of physician empathy or on outcomes of educational interventions to foster empathy should include patient perspectives.Fundação de Amparo à Pesquisa do Estado de São Paulo - FAPESP' (grant number: 2016/11908-1) and by the ’Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq' (grant number: 202319/2017-2

Are we preparing future doctors for assistance in situations of violence with a focus on gender and non-heterosexual sexualities? Report of a diagnostic educational “experience”

Abstract Medical schools must incorporate the teaching of professionalism into the curriculum to ensure that the next generations of physicians are prepared for a compassionate, humane, and ethical professional practice, suitable to the interests of society in a world with ever-increasing and ever-changing demands. This study’s greatest contribution is to highlight the interns’ poor performance in the legal and support aspects of the situations addressed. The data speak in favor of an institutionalized training policy as the first step toward getting the healthcare sector to prioritize competence in healthcare for victims of violence related to gender and non-heterosexual sexuality

Are we teaching patient safety to our academics? : The experience of a course in the countryside of São Paulo

Nowadays, one of the biggest concerns in the health care field is centered on patient safety with a primary focus on the errors of the medical team. In 2009, WHO created a guide for universities aimed at patient safety in which it suggests new ways of approaching patients, thus improving the quality of trained professionals and dramatically reducing adverse events. There is a consensus that there is a restructuring of a system that currently presents serious failures that result in permanent harm to the objective of the medical team, which is the well-being of the patient, as well as an efficient inspection of the Decree Number 529/13 in Brazilian universities. It is in this context that the present work proposes to highlight the gap currently existing in Brazilian universities, based on the sampling of one of them, located in the countryside of São Paulo. Prospective intervention study using a quantitative and qualitative methodology, carried out in two stages: analysis of teaching plans and application of the quantitative and qualitative perception instrument to professors. Was not found in the teaching plans of the modules of the medical course at Universidade Brasil the concept of patient safety. Semi-structured questionnaire was answered by 47 teachers, 11 (23.4%) of the basic cycle and 36 (76.6%) of the clinical cycle and internship. Professors at Universidade Brasil consider that the themes are extensivily addressed in their classes, although they are not described in most of the modules\u27 teaching plans. Medical education in Brazil needs a qualitative leap, and that leap is certainly in the area of patient safety.  In the context of implementation, the multiprofessional edition of the World Health Organization (WHO) patient safety curriculum guide can be used as guidance and a current and very promising development in relation to the acquisition and examination of the skills necessary for safe care for the patient is the establishment of interprofessional training wards. Considering that medical students are the future driving force of change in health care, it is necessary to encourage quality improvement and patient safety education to offer the patient-centered. The graduation, at any time and since day one, is the moment of formation, therefore favorable to the teaching of this topic for students in the health care field, and all teachers should be involved with these contents.

Perfil socioeconômico e difusão de tecnologia para o Programa Mulheres Rurais Produtivas/ Rio das Flores – RJ / Socioeconomic profile and technology diffusion for the Productive Rural Women Program / Rio das Flores – RJ

O CEFET, em parceria com a prefeitura municipal de Rio das Flores - RJ, conduziu o projeto “Programa Mulheres Rurais Produtivas do Abarracamento”, com objetivo de capacitar mulheres residentes em áreas rurais e de baixa renda do município, visando aumentar a qualidade de vida das participantes e o desenvolvimento econômico e social nessas localidades. Foram realizadas aulas práticas e teóricas sobre produção de doces e geleias, bem como aplicação de um questionário de caráter socioeconômico para as participantes. Além disso, confeccionou-se uma cartilha sobre técnicas simples e eficientes para a produção de doces artesanais com o intuito de complementar as informações sobre as aulas práticas. Os resultados mostraram que a maioria das mulheres recebe mensalmente menos de um salário mínimo; são negras; e, possuem o ensino fundamental incompleto. Ao final do trabalho, verificou-se a formação de uma Associação entre as participantes, tendo como resultado a produção e a venda de doces, contribuindo com a agregação de valor às frutas locais, bem como o aumento de renda das mulheres participantes do projeto

Blended Learning Methods in Specialization Graduate Courses Improve the Knowledge Gain Metric

Information and communication technologies (ICT) have been proven beneficial in teaching of health sciences courses. Combined e-learning strategies with face-to-face activities, among others, are defining characteristics of a new learning perspective called blended learning methods. The paucity of data to confirm the benefits of online forms of learning, in isolation or as a part of a blended learning method, indicates that more studies are still required to assess their influence on the teaching-learning process. This study measured knowledge gained using face-to-face (FtFA) and distance educational on virtual learning environments (DA-VLE) strategies in health sciences. For two consecutive years, FtFA and DA-VLE education strategies were used in a discipline of specialization graduate course, each discussing two topics. The knowledge gained using each strategy was assessed for each topic using a pre (PT) and post-test (PoT). The performance frequency (PF) of participants was categorized based on the number of correct answers in each assessed. The PF frequency increased between the PA and PoT in both strategies (FtFA and - DA-VLE), although higher scores were observed in DA-VLE strategies when compared to FtFA strategies. These data indicate that such strategies, within this context, are vital, and can bring benefits to the teaching-learning process in combination

Peer-Assisted Learning: A New Look at the Good Old Monitoring and Its Motivation from the Perspective of Student-Monitor

Peer-assisted learning (PAL), good old monitoring, has been used in medical schools and shown good results in professional development and in developing communication skills among students. This method provides mutual benefits for both monitors/near-peer teachers - NPT and monitored students; however, little is still known about the NPT’ perception about peer-assisted learning. To evaluate the real motivation of students to become NPT, and to investigate how NPT qualify their own teaching activities – such as productivity, performance and difficulties faced – seems to be a crucial step for implementing PAL in medical schools. The research instrument, a semi-structured questionnaire with 11 closed questions and 3 questions that allowed the answer “other” and further explanation, was answered by 26 medical students, NPT of basic disciplines. The results showed a positive effect of PAL on the teaching-learning process, and the real reasons of students to become NPT and the positive impacts of PAL on their academic life. The identification of these potential benefits should encourage medical schools to promote training so students can perform their role as NPT since PAL aids in the development of their clinical and pedagogical skills

Peer Assessment in the Context of Team-Based Learning in Undergraduate Education: How Far Can We Go?

In medical education, the team-based learning method (TBL) is a teaching strategy used to intensify interactive learning in small groups, in which the student is given the role of evaluating his/her peers - peer assessment (PA). To investigate the interference of the students' interpersonal relationships in awarding their peers grades (''halo effect''). A qualitative and quantitative retrospective study. The study participants were 78 first-year medical students, divided into 17 teams for the TBL. The final grade of the PA for each member was calculated by the average of the grades received from their peers. Results: The comparison between the average of the evaluations in the TBL method (MTBLs) and the PA showed that 17.64% of the teams showed a significant difference between the grades, thus having the “halo effect”. In the qualitative analysis, the “halo effect” was evidenced in only one of these teams. Although many studies corroborate the idea that using PA in the formative assessment is appropriate, advancing in the use of PA in the summative assessment is necessary, integrating it into the institution's evaluation system. Data presented here can help in continuing its use and in increasing its reliability

Cell biology and histology in medicine: perception on education and student performance

The subjects areas of Cellular Biology and Histology, which underpin the microscopic field of Morphology and are included in the first years of the curriculum in a Medical course, are the pillars of medical education  and for the clinical reasoning of future professionals. This study aimed to trace a teaching profile of Cellular Biology and Histology in the Medical courses which had participants in the selection process to fill vacancies by transfer, for the undergraduate course in the Medical School of São José do Rio Preto (FAMERP)  in 2017. This was a quantitative and qualitative cross-sectional study and 132 academics participated. The results showed that, in most Higher Education Institutions, these disciplines are taught theoretically and practically. In the comparison between the theoretical performance of the students of traditional and active teaching-learning methodology, a higher number of hits in Histology and a better final grade were observed in the traditional. The deficiency pointed out by the students was a lack of laboratory sessions with viewing histological glass slides with light microscopes. Also, the aspect of teachers’ pedagogical practice and dynamic classes was shown to be fundamental to the students' interest, as well as to better satisfaction’s index in learning these areas. Furthermore, integrating these disciplines with the clinical practice of Medicine has proved to be relevant for academics, who feel more instigated to knowledge. In the present study, it was detected a better use in relation to the Histology by the students of the courses of traditional methodology, compared to those of active methodology and in this way the analysis done can to collaborate for the enrichment and reaffirmation of the fruits of the comparison of teaching-learning methodologies