Deyla Moura Ramos Isoldi, Clélia Albino Simpson, Francisco Arnoldo Nunes de Miranda, Felismina Mendes, Antônia Lêda Oliveira Silva, Francisca Patrícia Barreto de Carvalho, Amélia Carolina Lopes Fernandes, Fábio Claudinei Da Costa Pereira
Objective: To communicate life stories of people who suffer from acquired immunodeficiency-syndrome with a higher vulnerability registered at the Municipal Secretary of Social Assistance and the diagnostic’s influence on their daily routine. Method: Descriptive and exploratory study based on oral life history. Thirteen people with AIDs took part in the study via a semi-structured interview. The narratives were analyzed using Bardin’s thematic content analysis. Results: Three thematic axes emerged from Bardin’s content analysis: prejudice and discrimination regarding the life routine with aids; Reaction when facing the diagnostic and the adhesion process for the antiretroviral treatment; Confrontation of religion and religiousness on people with aids. Conclusion: The people living with aids, a chronic and stigmatizing disease, need the support of multidisciplinary teams and an improvement in relation to the access, the coverage and the meaning assigned to the disease, besides a better quality of life and social assistance. We conclude that religion did not contribute to facing these people’s conditions. It brought blame, incorrect information that may impair the treatment and their follow-up. One infers that health education regarding HIV/AIDS needs to be remodeled on all of society’s segments.
{"title":"Prejudice, vulnerability, accession process, religiosity regarding the life routine with AIDS: life stories","authors":"Deyla Moura Ramos Isoldi, Clélia Albino Simpson, Francisco Arnoldo Nunes de Miranda, Felismina Mendes, Antônia Lêda Oliveira Silva, Francisca Patrícia Barreto de Carvalho, Amélia Carolina Lopes Fernandes, Fábio Claudinei Da Costa Pereira","doi":"10.3823/2612","DOIUrl":"https://doi.org/10.3823/2612","url":null,"abstract":"Objective: To communicate life stories of people who suffer from acquired immunodeficiency-syndrome with a higher vulnerability registered at the Municipal Secretary of Social Assistance and the diagnostic’s influence on their daily routine. \u0000Method: Descriptive and exploratory study based on oral life history. Thirteen people with AIDs took part in the study via a semi-structured interview. The narratives were analyzed using Bardin’s thematic content analysis. \u0000Results: Three thematic axes emerged from Bardin’s content analysis: prejudice and discrimination regarding the life routine with aids; Reaction when facing the diagnostic and the adhesion process for the antiretroviral treatment; Confrontation of religion and religiousness on people with aids. \u0000Conclusion: The people living with aids, a chronic and stigmatizing disease, need the support of multidisciplinary teams and an improvement in relation to the access, the coverage and the meaning assigned to the disease, besides a better quality of life and social assistance. We conclude that religion did not contribute to facing these people’s conditions. It brought blame, incorrect information that may impair the treatment and their follow-up. One infers that health education regarding HIV/AIDS needs to be remodeled on all of society’s segments.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49352758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ana Paula Santos Oliveira Brito, Edson Yuzur Yasojima, C. Mainardi, F. Rodrigues, Wescley Miguel Pereira Da Silva, M. V. Brito
Aims: To evaluate ethical and semiotechnique skills gain with intensive semiotechnique course to graduate medical students. Methods: Semiotics course was drawn up to 64 students of four medical courses of Belem, Para, Brazil. The course took place in two stages: the first for 32 students starting the third semester of the medical course, and the second for 32 students that started the internship. The course was taught intensively in two weekends, with didactic material prepared by the researchers. Pre-and post-training assessment was performed for verification of ethical skills needed in the doctor-patient relationship and the practical knowledge and skill in the technical implementation of the physical examination. Results: The students of 2nd year, in the eight proposed stations, have an average gain of 85.84%, reaching individually in some stations an improvement up to 120% as "Precordium” and “painful maneuvers of the abdomen" stations. The students of the 5th year initial notes average was 6.06, evolving to 9.21, with average percentage of 54.42% gain. For matters of ethical principles in dealing with the patient was observed initial average 5.05 that after the course has evolved to 9.36 to students of 2nd year and 6.16 to 9.60 in fifth year. In the evaluation of performance in implementing the semiotechnique maneuvers were observed initial notes of 4.76 and 5.95 to 8.51 and 8.82 respectively for students of 2nd and 5th year. Conclusion: The intensive course implemented proved to be effective in semiotechnique skills gain, both in improving ethical attitudes in dealing with the patient, as well as on the playing technique of physical examination.
{"title":"Ethical and Semiotechnique Skills Gain for Medical Students","authors":"Ana Paula Santos Oliveira Brito, Edson Yuzur Yasojima, C. Mainardi, F. Rodrigues, Wescley Miguel Pereira Da Silva, M. V. Brito","doi":"10.3823/2611","DOIUrl":"https://doi.org/10.3823/2611","url":null,"abstract":"Aims: To evaluate ethical and semiotechnique skills gain with intensive semiotechnique course to graduate medical students. \u0000Methods: Semiotics course was drawn up to 64 students of four medical courses of Belem, Para, Brazil. The course took place in two stages: the first for 32 students starting the third semester of the medical course, and the second for 32 students that started the internship. The course was taught intensively in two weekends, with didactic material prepared by the researchers. Pre-and post-training assessment was performed for verification of ethical skills needed in the doctor-patient relationship and the practical knowledge and skill in the technical implementation of the physical examination. \u0000Results: The students of 2nd year, in the eight proposed stations, have an average gain of 85.84%, reaching individually in some stations an improvement up to 120% as \"Precordium” and “painful maneuvers of the abdomen\" stations. The students of the 5th year initial notes average was 6.06, evolving to 9.21, with average percentage of 54.42% gain. For matters of ethical principles in dealing with the patient was observed initial average 5.05 that after the course has evolved to 9.36 to students of 2nd year and 6.16 to 9.60 in fifth year. In the evaluation of performance in implementing the semiotechnique maneuvers were observed initial notes of 4.76 and 5.95 to 8.51 and 8.82 respectively for students of 2nd and 5th year. \u0000Conclusion: The intensive course implemented proved to be effective in semiotechnique skills gain, both in improving ethical attitudes in dealing with the patient, as well as on the playing technique of physical examination.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44989779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Macovei, R. Magopet, L. Anghel, M. Balasanian, C. Răileanu, D. Marcu, C. Prisăcariu, C. Stătescu
A 41-year-old female was referred to our clinic with progressive dyspnea and a syncope, preceded by angina. On admission she was in cardiogenic shock. ECG showed diffuse repolarization changes and cardiac enzymes were elevated. The echocardiogram revealed severe left ventricular dysfunction with basal and medium walls hypokinesia. After stabilizing the patient, a coronary angiography was performed which revealed normal epicardial arteries. In the next days her clinical status was marked by severe hypertensive episodes with flash pulmonary edema and low responsiveness to therapy. Cardiovascular magnetic resonance showed myocardial edema and intramyocardial late gadolinium enhancement. An abdominal ultrasound raised suspicion of a pheochromocytoma due to an abnormal mass with cystic areas found on the right suprarenal gland. Elevated urinary free catecholamines and fractionated metanephrines confirmed the diagnosis. Further on, a CT scan better identified the heterogeneous tumor and the patient was referred for a right laparoscopic adrenalectomy. Follow-up at 1 month reported full recovery of the sistolic function. The particularity of the case is represented by the difficulty of diagnosis of adrenergic myocarditis, as well as the management of cardiogenic shock induced by it.
{"title":"Management of a rare case of adrenergic myocarditis complicated with cardiogenic shock","authors":"L. Macovei, R. Magopet, L. Anghel, M. Balasanian, C. Răileanu, D. Marcu, C. Prisăcariu, C. Stătescu","doi":"10.3823/2609","DOIUrl":"https://doi.org/10.3823/2609","url":null,"abstract":"A 41-year-old female was referred to our clinic with progressive dyspnea and a syncope, preceded by angina. On admission she was in cardiogenic shock. ECG showed diffuse repolarization changes and cardiac enzymes were elevated. The echocardiogram revealed severe left ventricular dysfunction with basal and medium walls hypokinesia. After stabilizing the patient, a coronary angiography was performed which revealed normal epicardial arteries. In the next days her clinical status was marked by severe hypertensive episodes with flash pulmonary edema and low responsiveness to therapy. Cardiovascular magnetic resonance showed myocardial edema and intramyocardial late gadolinium enhancement. An abdominal ultrasound raised suspicion of a pheochromocytoma due to an abnormal mass with cystic areas found on the right suprarenal gland. Elevated urinary free catecholamines and fractionated metanephrines confirmed the diagnosis. Further on, a CT scan better identified the heterogeneous tumor and the patient was referred for a right laparoscopic adrenalectomy. Follow-up at 1 month reported full recovery of the sistolic function. The particularity of the case is represented by the difficulty of diagnosis of adrenergic myocarditis, as well as the management of cardiogenic shock induced by it.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45401284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vania Novelli Domingues, M. Monteiro, José Antonio Cordero da Silva, G. Rêgo
Background This article aims to address questions related to the protection of rights of holders of compromised decisional competence, to make decisions, especially for its condition of vulnerability in relation to the other members of the human community to which they belong to, in access to the preservation of their dignity. Methods and Findings Although Bioethics has been increasingly evolving in plural and secular democratic societies, gaps and conflicts deserve a special reflection which can result in new paths and solutions for those with limitations in their abilities of understanding and determine according to this understanding, making decisions that may not translate a reflected decision about the health care they can undergo, as well as participation in scientific research and other issues involving their health and their bodies. Conclusions This work recommends a greater appreciation of patient autonomy, as well as embracing the Advance Directive of Will in the western world, with some limitations encountered, and some suggestions offered.
{"title":"Can Bioethics Protect the Holders of Compromised Decisional Competence?","authors":"Vania Novelli Domingues, M. Monteiro, José Antonio Cordero da Silva, G. Rêgo","doi":"10.3823/2610","DOIUrl":"https://doi.org/10.3823/2610","url":null,"abstract":"Background This article aims to address questions related to the protection of rights of holders of compromised decisional competence, to make decisions, especially for its condition of vulnerability in relation to the other members of the human community to which they belong to, in access to the preservation of their dignity. \u0000Methods and Findings Although Bioethics has been increasingly evolving in plural and secular democratic societies, gaps and conflicts deserve a special reflection which can result in new paths and solutions for those with limitations in their abilities of understanding and determine according to this understanding, making decisions that may not translate a reflected decision about the health care they can undergo, as well as participation in scientific research and other issues involving their health and their bodies. \u0000Conclusions This work recommends a greater appreciation of patient autonomy, as well as embracing the Advance Directive of Will in the western world, with some limitations encountered, and some suggestions offered.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48328427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Pires, M. Nascimento, Alyne Condurú dos Santos Cunha, Beatriz Hosana Biasi, Bianca Sousa de Almeida Neves, Cynthia Luciene Pereira Alves, D. Batista, J. Sobrinho, M. Xavier
Introduction: The hyperendemicity of leprosy in the northern region permeates regional aspects, including its large territorial extension and waterways, which make it difficult to access health and, consequently, control the disease. So that, the objective of this project is to describe the demographic and clinical profile of patients with leprosy and to evaluate their intradomiciliary contacts. Methods and findings: Observational, descriptive study, type of case series, through interview and complementary analysis of the medical records of patients undergoing specific treatment and / or treatment of leprosy reactions followed at the Dermatology outpatient clinic of the University of the State of Pará, in the city of Belém-PA, from January 2015 to December 2017. With convenience sampling, we interviewed 83 patients that met the inclusion criteria and collected socioeconomic and demographic variables, as well as clinical aspects based on the Madrid classification. Descriptive and inferential statistical methods were applied as: tables, graphs and statistical measures of position and Test G, with alpha significance = 0,05 and reliability of 95%. The predominance of males was observed (60.24%), the most affected age group was between 30 and 44 years old and the majority with incomplete secondary education. The predominant family income was up to 1 minimum wage. The most frequent clinical type was Virchowian (38 patients). Most of the patients did not present leprosy reaction and those who presented, the type 1 reaction was the most frequent and the nerve most affected was ulnar. Conclusion: Prevalence of multibacillary cases is a reflex of late diagnosis. It is important that there be intensification of actions and monitoring and active search for new cases.
{"title":"Leprosy: demographic and clinical characteristics of patients of endemic area in Amazon Region","authors":"C. Pires, M. Nascimento, Alyne Condurú dos Santos Cunha, Beatriz Hosana Biasi, Bianca Sousa de Almeida Neves, Cynthia Luciene Pereira Alves, D. Batista, J. Sobrinho, M. Xavier","doi":"10.3823/2608","DOIUrl":"https://doi.org/10.3823/2608","url":null,"abstract":"Introduction: The hyperendemicity of leprosy in the northern region permeates regional aspects, including its large territorial extension and waterways, which make it difficult to access health and, consequently, control the disease. So that, the objective of this project is to describe the demographic and clinical profile of patients with leprosy and to evaluate their intradomiciliary contacts. \u0000Methods and findings: Observational, descriptive study, type of case series, through interview and complementary analysis of the medical records of patients undergoing specific treatment and / or treatment of leprosy reactions followed at the Dermatology outpatient clinic of the University of the State of Pará, in the city of Belém-PA, from January 2015 to December 2017. With convenience sampling, we interviewed 83 patients that met the inclusion criteria and collected socioeconomic and demographic variables, as well as clinical aspects based on the Madrid classification. Descriptive and inferential statistical methods were applied as: tables, graphs and statistical measures of position and Test G, with alpha significance = 0,05 and reliability of 95%. The predominance of males was observed (60.24%), the most affected age group was between 30 and 44 years old and the majority with incomplete secondary education. The predominant family income was up to 1 minimum wage. The most frequent clinical type was Virchowian (38 patients). Most of the patients did not present leprosy reaction and those who presented, the type 1 reaction was the most frequent and the nerve most affected was ulnar. \u0000Conclusion: Prevalence of multibacillary cases is a reflex of late diagnosis. It is important that there be intensification of actions and monitoring and active search for new cases.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43831269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ching-Hsiang Wang, Jenq-Shyong Chan, Chung-Chi Yang, P. Hsiao
The typical clinical symptoms of hemothorax include a rapid development of chest pain or dyspnea, which may be life-threatening without immediate management. As we know, spontaneous hemothorax, a collection of blood within the pleural cavity without previous history of trauma or other cause, which usually onsets suddenly. The early and accurate diagnosis of spontaneous hemothorax is imperative in clinical practice. We reported a middle-age male undergoing regular hemodialysis was referred to our emergency department due to unknown cause of dyspnea and acute respiratory failure. Chest radiography revealed bilateral patchy infiltration of lung. Pleural tap analysis showed exudative pleural effusion with numerous red blood cells. Video-assisted thoracic surgery (VATS) were performed and confirmed the final diagnosis of spontaneous hemothorax. He was then successfully treated with the surgery of VATS combined chest tube thoracostomy.
{"title":"Unusual dyspnea in a hemodialysis patient: A case report","authors":"Ching-Hsiang Wang, Jenq-Shyong Chan, Chung-Chi Yang, P. Hsiao","doi":"10.3823/2607","DOIUrl":"https://doi.org/10.3823/2607","url":null,"abstract":"The typical clinical symptoms of hemothorax include a rapid development of chest pain or dyspnea, which may be life-threatening without immediate management. As we know, spontaneous hemothorax, a collection of blood within the pleural cavity without previous history of trauma or other cause, which usually onsets suddenly. The early and accurate diagnosis of spontaneous hemothorax is imperative in clinical practice. We reported a middle-age male undergoing regular hemodialysis was referred to our emergency department due to unknown cause of dyspnea and acute respiratory failure. Chest radiography revealed bilateral patchy infiltration of lung. Pleural tap analysis showed exudative pleural effusion with numerous red blood cells. Video-assisted thoracic surgery (VATS) were performed and confirmed the final diagnosis of spontaneous hemothorax. He was then successfully treated with the surgery of VATS combined chest tube thoracostomy.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42746411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lázaro Clarindo Celestino, Laura Andrian Leal, Fernanda Ludmilla Rossi Rocha, Silvia Helena Henriques
Background: To describe the working conditions of the nurses of the Family Health Strategy, characterizing the forms and modalities of work contract, types of bond, working hours, benefits, career plan and salaries. Method and Findings: Exploratory qualitative approach study. Participants were 18 nurses from the teams of the Family Health Strategy of a municipality in the countryside of Mina Gerais, Brazil. The data collection took place in July 2018 through interviews, using a script with closed questions. The Ethics Committee of the proposing Institution according to Official Letter 090/2018, CAAE 83419418.2.0000.5393, approved the study. Two forms of work contracts have been identified represented by the city hall and outsourced companies, the latter being the mode that offers the most benefits to workers. In addition, there was a lack of commensurate links, in addition to units with physical infrastructure that were compromised, lack of basic materials and supllies essential for the provision of care, absence of essential benefits for this category, insalubrity, commission for productivity, long journeys and overload of work, neglect and devaluation of the worker. Conclusions: This study should promote the managers' reflection on the working conditions offered to nurses in basic care, rethinking management models that help them cope with problems related to their work context, stimulating a healthy environment, mitigating possible occupational risks that could compromise physical or mental health of the worker.
{"title":"Working conditions of nurses in the Family Health Strategy","authors":"Lázaro Clarindo Celestino, Laura Andrian Leal, Fernanda Ludmilla Rossi Rocha, Silvia Helena Henriques","doi":"10.3823/2606","DOIUrl":"https://doi.org/10.3823/2606","url":null,"abstract":"Background: To describe the working conditions of the nurses of the Family Health Strategy, characterizing the forms and modalities of work contract, types of bond, working hours, benefits, career plan and salaries. \u0000Method and Findings: Exploratory qualitative approach study. Participants were 18 nurses from the teams of the Family Health Strategy of a municipality in the countryside of Mina Gerais, Brazil. The data collection took place in July 2018 through interviews, using a script with closed questions. The Ethics Committee of the proposing Institution according to Official Letter 090/2018, CAAE 83419418.2.0000.5393, approved the study. Two forms of work contracts have been identified represented by the city hall and outsourced companies, the latter being the mode that offers the most benefits to workers. In addition, there was a lack of commensurate links, in addition to units with physical infrastructure that were compromised, lack of basic materials and supllies essential for the provision of care, absence of essential benefits for this category, insalubrity, commission for productivity, long journeys and overload of work, neglect and devaluation of the worker. \u0000Conclusions: This study should promote the managers' reflection on the working conditions offered to nurses in basic care, rethinking management models that help them cope with problems related to their work context, stimulating a healthy environment, mitigating possible occupational risks that could compromise physical or mental health of the worker. \u0000 \u0000 ","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46667679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Coronary artery disease combined sepsis associated myocardial ischemia resulting in diffuse ST elevation on electrocardiogram has rarely been reported. We reported a rare case of diffuse ST elevation precipitated by septic shock and preexisting severe atherosclerosis heart disease. In clinical scenario, it is imperative for physicians to be aware of non-ischemic ST elevation etiologies and avoid inappropriate activation of the percutaneous coronary intervention (PCI) protocol, while not missing ST elevation myocardial infarction.
{"title":"An unusual case of diffuse ST elevation mimicking acute myocardial infarction: A challenge of emergent percutaneous coronary intervention?","authors":"Ching-Tsai Hsu, Ching-Han Liu, Chin-Sheng Lin, Wei-Shiang Lin, P. Hsiao, Jun-Ting Liou","doi":"10.3823/2605","DOIUrl":"https://doi.org/10.3823/2605","url":null,"abstract":"Coronary artery disease combined sepsis associated myocardial ischemia resulting in diffuse ST elevation on electrocardiogram has rarely been reported. We reported a rare case of diffuse ST elevation precipitated by septic shock and preexisting severe atherosclerosis heart disease. In clinical scenario, it is imperative for physicians to be aware of non-ischemic ST elevation etiologies and avoid inappropriate activation of the percutaneous coronary intervention (PCI) protocol, while not missing ST elevation myocardial infarction.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46984330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wendney Hudson de Alencar Fontes, Yohanna Karen do Santos Silva, Francisco Matheus Prado Luna, Raíssa Maria Rolim Bem de Morais, João Paulo Gomes Feitosa, F. B. D. Silva, Filipe Costa Lisboa, Maria do Socorro Vieira Gadelha, M. L. Neto
Background: Suicide is more common among people who follow a medical career. This occurs because undergraduation course subjects students to psychologically strained situations, which can reduce their mental health and predispose them to suicidal ideation. Objectives: To analyze the factors related to suicidal ideation among medical graduates, highlighting depression and personality traits. To check stigmas surrounding suicidal ideation. Methodology: An integrative review study was carried out using the Scopus database (Elsevier). We selected studies published between 2014 and 2019, using two descriptors: "medical students" and "suicidal ideation". Results and Findings: 139 scientific articles were selected, of which 10 met the eligibility criteria. Specific personality traits and depression predispose to suicide. Although the stigma of suicide and substance use is greater among men, female gender, poor financial status, and psychiatric disorders increase depression scores. Students close to graduation are more likely to cope with stress than others. Limitations: The articles included in this work were produced using different methodologies and different measurement instruments. The prevalence of depression and suicidal ideation among students may be greater, given that stigma may favor the occurrence of response bias. Conclusion: Rates of suicidal ideation are very prevalent in medical students. To solve this problem, medical schools should take steps to prevent adverse situations.
{"title":"Suicidal Ideation among Medical Students: An Integrative Review","authors":"Wendney Hudson de Alencar Fontes, Yohanna Karen do Santos Silva, Francisco Matheus Prado Luna, Raíssa Maria Rolim Bem de Morais, João Paulo Gomes Feitosa, F. B. D. Silva, Filipe Costa Lisboa, Maria do Socorro Vieira Gadelha, M. L. Neto","doi":"10.3823/2604","DOIUrl":"https://doi.org/10.3823/2604","url":null,"abstract":"Background: Suicide is more common among people who follow a medical career. This occurs because undergraduation course subjects students to psychologically strained situations, which can reduce their mental health and predispose them to suicidal ideation. \u0000Objectives: To analyze the factors related to suicidal ideation among medical graduates, highlighting depression and personality traits. To check stigmas surrounding suicidal ideation. \u0000Methodology: An integrative review study was carried out using the Scopus database (Elsevier). We selected studies published between 2014 and 2019, using two descriptors: \"medical students\" and \"suicidal ideation\". \u0000Results and Findings: 139 scientific articles were selected, of which 10 met the eligibility criteria. Specific personality traits and depression predispose to suicide. Although the stigma of suicide and substance use is greater among men, female gender, poor financial status, and psychiatric disorders increase depression scores. Students close to graduation are more likely to cope with stress than others. \u0000Limitations: The articles included in this work were produced using different methodologies and different measurement instruments. The prevalence of depression and suicidal ideation among students may be greater, given that stigma may favor the occurrence of response bias. \u0000Conclusion: Rates of suicidal ideation are very prevalent in medical students. To solve this problem, medical schools should take steps to prevent adverse situations. \u0000 ","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43470446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rosylane Rocha, Francisco Cortes Fernandes, J. C. Bezerra, Rui Nunes
Objective: The present study sought to assess whether any statistically significant differences exist between evaluations conducted by medical doctors and those by social workers within the National Social Security Institute (INSS), regarding identification of disability using the adapted Brazilian functionality index to grant retirement. Method To do this, an analytical investigation was done using the official INSS database for the period from October 2013 to January 2016, regarding evaluations to confirm disability among workers who were insured through the INSS. The analysis was conducted using the R software, version 3.4.1. A concordance index, significance analysis and the Pearson correlation test were applied. The sensitivity and specificity of the evaluations made by doctors, by social workers and by both were calculated. Arating index was obtained by dividing the result from the doctors’ evaluations by the result from the social workers’ evaluations. Results The correlation analysis using the R software showed that there was no statistical difference between the evaluations conducted by medical doctors and social workers. However, differences were observed in relation to calculation of the sensitivity of the evaluations, and in the analyses on the rating index and standard deviation between the doctors’ and social workers’ evaluations, especially in the domains of sensory function, domestic life and education, work and economic life. Conclusions This study demonstrated that there is a difference between evaluations conducted by medical experts and by social workers, which can be explained in terms of each professional’s interpretation of what is defined in the manual. The criteria used to define the rules for obtaining the benefit should be discussed. We highlight that the prerequisite for identifying a disability is that an impairment should be characterized by means of the International Classification of Diseases (ICD-10), which is a medical prerogative.
{"title":"Comparative Study on Evaluations Conducted by Medical Doctors and Social Workers in which the Adapted Brazilian Functionality Index for Granting Retirement to Persons with Disability was applied","authors":"Rosylane Rocha, Francisco Cortes Fernandes, J. C. Bezerra, Rui Nunes","doi":"10.3823/2602","DOIUrl":"https://doi.org/10.3823/2602","url":null,"abstract":"Objective: \u0000The present study sought to assess whether any statistically significant differences exist between evaluations conducted by medical doctors and those by social workers within the National Social Security Institute (INSS), regarding identification of disability using the adapted Brazilian functionality index to grant retirement. \u0000Method \u0000To do this, an analytical investigation was done using the official INSS database for the period from October 2013 to January 2016, regarding evaluations to confirm disability among workers who were insured through the INSS. The analysis was conducted using the R software, version 3.4.1. A concordance index, significance analysis and the Pearson correlation test were applied. The sensitivity and specificity of the evaluations made by doctors, by social workers and by both were calculated. Arating index was obtained by dividing the result from the doctors’ evaluations by the result from the social workers’ evaluations. \u0000Results \u0000The correlation analysis using the R software showed that there was no statistical difference between the evaluations conducted by medical doctors and social workers. However, differences were observed in relation to calculation of the sensitivity of the evaluations, and in the analyses on the rating index and standard deviation between the doctors’ and social workers’ evaluations, especially in the domains of sensory function, domestic life and education, work and economic life. \u0000Conclusions \u0000This study demonstrated that there is a difference between evaluations conducted by medical experts and by social workers, which can be explained in terms of each professional’s interpretation of what is defined in the manual. The criteria used to define the rules for obtaining the benefit should be discussed. We highlight that the prerequisite for identifying a disability is that an impairment should be characterized by means of the International Classification of Diseases (ICD-10), which is a medical prerogative.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41293322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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