Breaking bad news in neurology: assessing training, perceptions, and preparedness among residency programs in Brazil

ABSTRACT Objective We aimed to evaluate how breaking bad news training was implemented in neurology residency programs in Brazil and to assess the perception and preparedness of trainees and program directors. Methods We performed a cross-sectional descriptive study. Neurology trainees and program directors were recruited from the Brazilian Academy of Neurology registry through convenience sampling. Participants answered a survey evaluating the breaking bad news training at their institution and their preparedness and perception towards the topic. Results We collected 172 responses from 47 neurology institutions from all five socio-demographic regions of Brazil. More than 77% of trainees were dissatisfied with their breaking bad news training, and around 92% of program directors believed their programs required substantial improvement. Approximately 31% of neurology trainees reported never having a lecture about communicating bad news, 66% reported never having a simulated training, and nearly 61% never received feedback regarding their communication abilities. Moreover, 59% of program directors acknowledged that feedback was not a standard practice and nearly 32% reported the absence of any specific training. Conclusion This study suggested that the breaking bad news training in neurology residencies across Brazil is deficient and highlighted challenges to achieve this core competency. Program directors and trainees recognized the importance of the topic, and program directors acknowledged that many factors hinder the ability to implement formal training. Given the relevance of such a skill to patient care, every effort should be made to provide structured training opportunities during residency

O papel dos poluentes atmosféricos sobre o peso ao nascer em cidade de médio porte Paulista

Made available in DSpace on 2019-09-12T16:25:42Z (GMT). No. of bitstreams: 0 Previous issue date: 2014OBJETIVO: Verificar o efeito da poluição do ar sobre o peso ao nascer numa cidade de médio porte paulista.MÉTODOS: Estudo transversal, com dados relativos a todos os nascidos vivos de mães residentes no Município de São José dos Campos nos anos de 2005 a 2009. Foram obtidos dados do Departamento de Informações e Informática do Sistema Único de Saúde. Os dados dos poluentes do ar (PM10, SO2 e O3), as médias diárias de suas concentrações, foram fornecidos pela Companhia de Tecnologia de Saneamento Ambiental. Aplicou-se a regressão linear e a logística para a análise dos dados, realizadas nos programas Excel e STATA v.7.RESULTADOS: A exposição materna aos poluentes do ar não se associou ao nascimento de crianças com baixo peso, com exceção do SO2, no último mês de gestação (OR=1,25; IC95% 1,00-1,56). Além disso, a exposição materna ao PM10 e SO2 no último mês levou à diminuição do peso ao nascer (0,28g e 3,15g, respectivamente) para cada 1mcg/m3 de aumento da concentração desses poluentes, porém sem significância estatística.CONCLUSÕES: Este estudo não permitiu identificar associação estatística entre os níveis de concentração dos poluentes atmosféricos e o peso ao nascer, com exceção da exposição SO2, no último mês de gestação.OBJECTIVE: To investigate the effect of air pollution on birth weight in a medium-sized town in the State of São Paulo, Southeast Brazil.METHODS: Cross-sectional study using data from live births of mothers residing in São José dos Campos from 2005 to 2009. Data was obtained from the Department of Information and Computing of the Brazilian Unified Health System. Air pollutant data (PM10, SO2, and O3) and daily averages of their concentrations were obtained from the Environmental Sanitation & Technology Company. Statistical analysis was performed by linear and logistic regressions using the Excel and STATA v.7 software programs.RESULTS: Maternal exposure to air pollutants was not associated with low birth weight, with the exception of exposure to SO2 within the last month of pregnancy (OR=1.25; 95% CI=1.00-1.56). Maternal exposure to PM10 and SO2 during the last month of pregnancy led to lower weight at birth (0.28g and 3.15g, respectively) for each 1mg/m3 increase in the concentration of these pollutants, but without statistical significance.CONCLUSIONS: This study failed to identify a statistically significant association between the levels of air pollutants and birth weight, with the exception of exposure to SO2 within the last month of pregnancy.Universidade de Taubaté, Brazi

Association between maternal exposure to particulate matter and premature birth

The objective of this time-series study carried out in São José dos Campos, a southeastern Brazilian city, between 01.01.2005 and 31.12.2009, was to estimate the role of maternal exposure to air pollutants and preterm births. Preterm newborns of mothers aged between 18 and 34 years, with at least eight years of schooling, singleton pregnancies and whose delivery was vaginal were included in the study. Logistic regression was used to estimate the role of particulate matter, ozone and sulfur dioxide on preterm delivery with lags of zero up to 30 days. Exposure to particulate matter was associated significantly with preterm newborns in lags of 0, 1 and 3 days; but no association was found between cumulative maternal exposure in lags of 7, 15 and 30 days and the outcome. Maternal exposure to particulate matter therefore has an acute effect on preterm births in a medium-sized Brazilian town

Associação entre a exposição materna ao material particulado e parto prematuro

Made available in DSpace on 2019-09-12T16:26:08Z (GMT). No. of bitstreams: 0 Previous issue date: 2014O objetivo deste estudo de séries temporais desenvolvido em São José dos Campos, localizada sudeste do Brasil, entre 01.01.2005 e 31.12.2009, foi estimar o papel da exposição materna aos poluentes do ar e partos prematuros. Recém-nascidos prematuros de mães com idade entre 18 e 34 anos, com pelo menos oito anos de escolaridade, gestações únicas e cujo parto foi vaginal foram incluídos no estudo. A regressão logística foi utilizada para estimar o papel da exposição ao material particulado, ozônio e dióxido de enxofre em trabalho de parto prematuro com defasagens de zero até 30 dias. Exposição ao material particulado esteve associada significativamente com partos prematuros em lag 0, 1 e 3, mas não houve associação entre a exposição materna acumulada sete, 15 e 30 dias antes do parto e o desfecho. Assim, a exposição materna ao material particulado tem um efeito agudo em recém‑nascidos prematuros em uma cidade de brasileira de porte médio.The objective of this time-series study carried out in São José dos Campos, a southeastern Brazilian city, between 01.01.2005 and 31.12.2009, was to estimate the role of maternal exposure to air pollutants and preterm births. Preterm newborns of mothers aged between 18 and 34 years, with at least eight years of schooling, singleton pregnancies and whose delivery was vaginal were included in the study. Logistic regression was used to estimate the role of particulate matter, ozone and sulfur dioxide on preterm delivery with lags of zero up to 30 days. Exposure to particulate matter was associated significantly with preterm newborns in lags of 0, 1 and 3 days; but no association was found between cumulative maternal exposure in lags of 7, 15 and 30 days and the outcome. Maternal exposure to particulate matter therefore has an acute effect on preterm births in a medium-sized Brazilian town.[Lima, Thaiza Agostini Córdoba de; Nascimento, Luiz Fernando Costa; Medeiros, Andréa Paula Peneluppi de; Santos, Veridiana de Paula] Universidade de Taubaté, Brazi