Ethically conflictive situations for discussion with medical students: a professor's view

The ethical and humanistic training of medical students has been both valued and questioned in recent years. Discussion of the ethical conflicts that arise during future medical practice is one of the strategies with the greatest impact for developing students' moral skills. With the aim of identifying and analyzing the most relevant conflictive situations for discussion with future physicians, we asked faculty members working with medical students at the UNIFESP-EPM School of Medicine to list three important situations for discussion. The sample included 237 participants. The answers were recorded as items and categorized thematically, and were compared to the topics covered in formal ethics courses in Brazilian medical schools, analyzed in relation to the specialized literature. The themes that emerged in this study can be explored through different teaching-learning strategies. It is up to medical schools to encourage the different disciplines and rotations to provide formal spaces for discussions and to promote awareness raising of faculty members for this task.A formação ética e humanística dos estudantes de Medicina vem sendo bastante valorizada e questionada na atualidade. A discussão dos conflitos éticos que surgem durante o exercício da medicina é uma das estratégias de maior impacto para o desenvolvimento da competência moral dos estudantes. Com o objetivo de conhecer e analisar as situações de conflito consideradas mais relevantes para a discussão com os futuros médicos, pedimos a profissionais que exercem atividades de ensino com estudantes de Medicina na UNIFESP-EPM que mencionassem até três situações importantes para discussão. Participaram da pesquisa 237 sujeitos. As respostas, registradas por itens e categorizadas por temas, foram comparadas aos assuntos abordados em cursos formais de ética das escolas médicas brasileiras e analisadas à luz da literatura especializada. Os temas que emergiram desta pesquisa podem ser explorados por diferentes estratégias de ensino-aprendizagem. Cabe às escolas médicas estimular as diversas disciplinas a abrir espaços formais para as discussões e investir na conscientização e no preparo docente para esta tarefa.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Effect of maternal calcium intake during pregnancy on children's blood pressure: A systematic review of the literature

<p>Abstract</p> <p>Background</p> <p>Calcium supplementation during pregnancy has been shown to reduce the incidence of hypertension in the mother, but the effects on the offspring are uncertain. Assessing the impact on the offspring is very important given the now large body of evidence indicating that blood pressure levels in childhood and young adulthood can be influenced by factors operating during fetal life. We conducted a systematic review of the literature to summarize the evidence supporting an association between maternal dietary calcium intake during pregnancy and blood pressure in the offspring.</p> <p>Methods</p> <p>A systematic review was performed to identify randomized, quasi-randomized and cohort studies reporting the relationship between offspring blood pressure or incidence of hypertension and levels of maternal dietary calcium intake during pregnancy, either from supplements (i.e. pills) or food. MEDLINE, EMBASE and the Cochrane Library Registry were searched for relevant trials.</p> <p>Results</p> <p>Two randomized trial and three observational studies were identified and included in this review. In 4 of the 5 studies, loss to follow-up was a serious concern. There was heterogeneity between the studies, particularly those conducted on children below 12 month of age. Results were more consistent among the studies including older children (1 to 9 years) where a higher maternal calcium intake was associated with a reduction of -1.92 mm Hg (95% CI -3.14 to -0.71) in offspring systolic blood pressure. One large randomized trial found a clinically and statistically significant reduction in the incidence of hypertension in 7-year-old children (RR = 0.59, 95% CI 0.39 to 0.90).</p> <p>Conclusion</p> <p>There is evidence in the literature to support an association between maternal calcium intake during pregnancy and offspring blood pressure. However, more research is needed to confirm these finding given the small sample sizes and the methodological problems in many of the studies conducted so far. More studies on populations with calcium deficit are also needed. If confirmed, these findings could have important public health implications. Calcium supplementation during pregnancy is simple and inexpensive and may be a way to reduce the risk of hypertension and its sequels in the next generation.</p

A Lightweight Regression Method to Infer Psycholinguistic Properties for Brazilian Portuguese

Psycholinguistic properties of words have been used in various approaches to Natural Language Processing tasks, such as text simplification and readability assessment. Most of these properties are subjective, involving costly and time-consuming surveys to be gathered. Recent approaches use the limited datasets of psycholinguistic properties to extend them automatically to large lexicons. However, some of the resources used by such approaches are not available to most languages. This study presents a method to infer psycholinguistic properties for Brazilian Portuguese (BP) using regressors built with a light set of features usually available for less resourced languages: word length, frequency lists, lexical databases composed of school dictionaries and word embedding models. The correlations between the properties inferred are close to those obtained by related works. The resulting resource contains 26,874 words in BP annotated with concreteness, age of acquisition, imageability and subjective frequency.Comment: Paper accepted for TSD201

Revisitando o Principialismo: aplicações e insuficiências na abordagem dos problemas bioéticos nacionais

This article present the most often criticisms in Brazilian bioethics teories, face on the importation of foreign theories, especially against the “Principialist Paradigm”. Try to show the Principlism not as a paradigm of bioethics, but as an educational tool; and analyze advantages e shortcomings of its application. Discuse the Principlism is neither a paradigm, nor a general moral theory; it simply provides a framework for identification and discussion of moral problems. Principlism’s difficulties to deal with public health problems come from the complexity for the specification of the principle of Justice and from the treatment, more political than ethical, that those problems demand. Comments that the principlist tool employs concepts whose apprehension is relatively simple. It is appropriate for the discussion of real cases, especially if leaded by non-specialists.O artigo apresenta as mais freqüentes críticas articuladas nas teorias bioéticas brasileiras contra a importação de teorias estrangeiras, quase sempre dirigidas ao “Paradigma Principialista”. Busca mostrar o Principialismo não como paradigma da Bioética, mas descrevê-lo como ferramenta educativa, analisando aspectos positivos e negativos de sua utilização. Discute o Principialismo, apontando que não é um paradigma, nem sequer uma teoria moral geral, mas uma ferramenta que fornece estrutura para identificar e refletir sobre problemas morais. Aponta que dificuldade do Principialismo com os problemas de saúde pública advém da complexidade na especificação do princípio da Justiça e da abordagem, antes política que ética, que o enfrentamento de tais problemas exige. Considera que a ferramenta principialista utiliza conceitos cuja apreensão é relativamente simples, sendo apropriada para a discussão de casos reais, especialmente quando conduzida por não especialistas