Medical curricula on intimate partner violence in Mozambique

Introduction: The aim of the study described in this paper is to screen medical curricula in relation to the attention paid to intimate partner violence, by applying a framework derived from the international literature. Material and Methods: We screened curricula of five Mozambican medical schools based on a state-of-the-art intimate partner violence curriculum framework. The latter framework was based on a review of the literature. Results: Few medical schools of Mozambique could be identified addressing intimate partner violence in their curriculum. When tackled, intimate partner violence content is mostly dealt within the context of Obstetrics and Gynaecology, Community Health and Forensic Medicine rotations. Intimate partner violence contents are integrated as stand-alone modules in some specific subjects. In none of the schools, specific teachers teaching intimate partner violence could be identified. No time allocation was specified to address the topic; no teaching and learning strategies could be identified invoking awareness or supporting basic knowledge acquisition; additionally, hardly any information about related assessment methods was found. Only in one medical school was the subject part of the formal curriculum. Discussion: Intimate partner violence content is hardly and inconsistently addressed. The limited intimate partner violence content tracked in the Mozambican medical schools’ curricula, mainly addresses violence in general, for instance as identified in Orthopaedics or Surgery contexts and sexual violence in Obstetrics and Gynaecology. The inclusion of elements of intimate partner violence in the curriculum remains restricted, questioning the impact of medical education of future practitioners’ competencies. Conclusion: Critical changes are needed in medical curricula to match the current epidemiology of intimate partner violence in Mozambique

Gaps in medical students' competencies to deal with intimate partner violence in key Mozambican medical schools

Purpose: The researchers aimed to identify the gaps in competencies designed to help medical students to deal with Intimate Partner Violence (IPV) in key Mozambican medical schools curricula. Method: A survey was administered to 3rd and 6th-year medical students (N387), enrolled in five medical schools in Mozambique. The instrument focused on mapping students' perceived mastery of their knowledge, skills, and attitudes related to IPV. Results: In total, 387 medical students (RR 66%) participated in the survey. The overall mean perceived mastery of IPV competence was 36.18 (SD = 24.52) for knowledge, 32.01 (SD = 27.37) for skills, and 43.47 (SD = 27.58) for attitudes. Though 6th-year students reported a significantly higher mastery level, it is still below a mastery-learning benchmark of 80%. Conclusions: Medical students report critically low levels in their mastery of IPV- related competencies. This implies a need for a more comprehensive approach to developing knowledge, skills, and attitudes to deal with the victims of IPV

O DEBATE PARA A PAZ TORNA-SE UTOPIA NA SOCIEDADE? Reflexão em torno das desigualdades sociais

A Paz desde muito considerou-se como a ausência de guerra, por sua vez passou a servir como ausência de todas as hostilidades e passa numa reflexão de cultura de Paz. Com Kant, no Sec. XVIII, começa a reflexão sobre a possibilidade da Paz ser eterna, Kant elaborou tal como uma necessidade de toda a sociedade, assim sendo na actualidade social, encontramos diversas classes e que as tais classes originam as desigualdades sociais, tendo-me questionado, será possível termos a Paz Perpetua no mundo das desigualdades? há necessidade da revisão da origem das desigualdades e assim Rousseau destaca o privado e a definição do primeiro ocupante como a causa das guerras, Galvão destaca que a queda ou  a crise moral; é a causa da exclusão social e tal exclusão social traz as desigualdades pois alimentada pelo neo-liberalismo. Em quanto as sociedades encontrarem-se estruturadas de forma vertical; entre as classes põe em causa a Paz Perpétua e caso o egoísmo saia e haja um novo ordenamento das classes sociais sendo horizontais há possibilidade de existir um entendimento eterno e evitar as violências sociais. Para que a paz perpetua seja uma realidade hoje, é necessário que as classes sociais sejam minimizadas e que haja uma sociedade ordenada em que as necessidades básicas fundamentem a justiça social.  Palavras-Chave: Paz Perpetua; sociedade; Classes Sociais; desigualdade

Prozone in malaria rapid diagnostics tests: how many cases are missed?

<p>Abstract</p> <p>Background</p> <p>Prozone means false-negative or false-low results in antigen-antibody reactions, due to an excess of either antigen or antibody. The present study prospectively assessed its frequency for malaria rapid diagnostic tests (RDTs) and <it>Plasmodium falciparum </it>samples in an endemic field setting.</p> <p>Methods</p> <p>From January to April 2010, blood samples with <it>P. falciparum </it>high parasitaemia (≥ 4% red blood cells infected) were obtained from patients presenting at the Provincial Hospital of Tete (Mozambique). Samples were tested undiluted and 10-fold diluted in saline with a panel of RDTs and results were scored for line intensity (no line visible, faint, weak, medium and strong). Prozone was defined as a sample which showed no visible test line or a faint or weak test line when tested undiluted, and a visible test line of higher intensity when tested 10-fold diluted, as observed by two blinded observers and upon duplicate testing.</p> <p>Results</p> <p>A total of 873/7,543 (11.6%) samples showed <it>P. falciparum</it>, 92 (10.5%) had high parasitaemia and 76 were available for prozone testing. None of the two Pf-pLDH RDTs, but all six HRP-2 RDTs showed prozone, at frequencies between 6.7% and 38.2%. Negative and faint HRP-2 lines accounted for four (3.8%) and 15 (14.4%) of the 104 prozone results in two RDT brands. For the most affected brand, the proportions of prozone with no visible or faint HRP-2 lines were 10.9% (CI: 5.34-19.08), 1.2% (CI: 0.55-2.10) and 0.1% (CI: 0.06-0.24) among samples with high parasitaemia, all positive samples and all submitted samples respectively. Prozone occurred mainly, but not exclusively, among young children.</p> <p>Conclusion</p> <p>Prozone occurs at different frequency and intensity in HRP-2 RDTs and may decrease diagnostic accuracy in the most affected RDTs.</p

Anais do II Encontro de Escritores de Língua Portuguesa

Literatura e Lusofonia, colectânea dos textos apresentados ao II Encontro de Escritores de Língua Portuguesa, realizado na cidade de Natal, de 23 a 25 de novembro de 2011, é finalmente publicado, em 2013, ultrapassados que foram obstáculos de vária ordem que surgiram ao longo da sua preparação. Registamos com satisfação que a atual Prefeitura de Natal decidiu dar continuidade aos Encontros de Escritores de Língua Portuguesa, com a sua IV edição a decorrer em novembro de 2013, no âmbito do Festival Literário de Natal. As instituições promotoras deste livro gostariam de ressalvar que o conteúdo dos textos incluídos em Literatura e Lusofonia é da responsabilidade exclusiva dos seus autores. A presente edição segue a grafia do Acordo Ortográfico.Câmara Municipal de Natal e Câmara Municipal de Lisboainfo:eu-repo/semantics/publishedVersio

A country-wide malaria survey in Mozambique. II. Malaria attributable proportion of fever and establishment of malaria case definition in children across different epidemiological settings

Abstract Background Protection against clinical malaria episodes is acquired slowly after frequent exposure to malaria parasites. This is reflected by a decrease with increasing age in both parasite density and incidence of clinical episodes. In many settings of stable malaria transmission, the presence of asymptomatic malaria parasite carriers is common and the definition of clinical malaria remains uncertain. Methods Between February 2002 and April 2003, a country-wide malaria survey was conducted in 24 districts of Mozambique, aiming to characterize the malaria transmission intensities and to estimate the proportion of fever cases attributable to malaria infections in order to establish the malaria case definition. A total of 8,816 children less than ten years of age were selected for the study. Axillary temperature was measured in all participating subjects and finger prick blood collections were taken to prepare thick and thin films for identification of parasite species and determination of parasite density. The proportion of fever cases attributable to malaria infection was estimated using a logistic regression of the fever on a monotonic function of the parasite density and, using bootstrap facilities, bootstrapped estimated confidence intervals, as well as the sensitivity and specificity for different parasite density cut-offs were produced. Results Overall, the prevalence of Plasmodium falciparum was 52.4% (4,616/8,816). The prevalence of fever (axillary temperature ≥ 37.5°C) was 9.4% (766/8,816). Fever episodes peaked among children below 12 months of life [15.1% (206/1,517)]. The lowest fever prevalence of 5.9% (67/1,224) was recorded amongst children between five and seven years of age. Among 4,098 parasitized children, 498/4,098 (13.02%) had fever. The prevalence of malaria infections associated with fever peaked among children in the less than twelve months age group and thereafter decreased rapidly with increasing age (p The proportion of fever attributed to malaria was 37.8% (95% CI 32.9% – 42.7%). An age-specific pattern was observed with significant variations across different regions in the country. In general, among children less than 12 months of life, the proportion of fever attributed to malaria infection was 43.5% (95% CI 25.8% – 61.2%), in children aged between 12 and 59 months of age was 39.6% (95% CI 30.3% – 48.9%), and among children aged between 5 and 10 years old was 21.5% (95% CI 11.6% – 31.4%). Conclusion This study confirms that malaria remains a major cause of febrile illness during childhood. It also defines the relation between parasite density and fever and how this varies with age and region. This may help guide case definition for clinical trials of preventive tools, as well as provide definitions that may improve the precision of measurement of the burden of disease.</p