RESUMO

BACKGROUND: The growing discussion on teacher development focuses on diversified educational skills that promote knowledge and innovation in the teaching, learning and assessment process. With the Covid-19 scenario, this picture of necessary changes has become more evident, demonstrating the need for professional preparation to work in teacher development. The aim of the study was to analyze the effectiveness of teacher development programs for the training of university teachers in the health area, through a systematic review and meta-analysis. METHODS: The systematic review and meta-analysis were carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and involved searching five databases - PubMed-Medline, Education Resource Information Center (ERIC), SCOPUS, Embase and Web of Science. The review included randomized clinical trials and cohort studies that addressed the effectiveness of teaching professionalization in the health area for university professors. The quality of the selected studies was assessed based on the evaluation criteria of the Joanna Briggs Institute tool. The random effects meta-analysis method was used to explain the distribution of effects between the studies, using Stata® software (version 11.0) and publication bias was examined by visual inspection of the graphs and Egger's test. RESULTS: We included 12 studies in the systematic review and 8 in the meta-analysis. These studies were published between 1984 and 2022 in 14 countries. Significant changes were reported in teachers' behavior to stimulate and encourage students, improvement in the quality of teaching and teaching staff, as well as improvement in skills such as leadership and self-evaluation. Furthermore, the result of the meta-analysis showed that there is evidence of the effectiveness of the positive effects of teacher development programs after their implementation, with this effect being 1.70% and an increase of 4.75 in the effect of these teacher development programs. CONCLUSION: Our study shows that development programs have been implemented in different countries and contexts, all of which have proven to be effective in the short, medium and long term. We recommend that future research focus specifically on the different competencies that have been acquired following the implementation of these programs.

Assuntos

RESUMO

Objetivo: compreender os fatores que influenciam o comportamento de pessoas com diabetes desvio-positivas na perspectiva de profissionais de saúde. Material e Métodos: pesquisa qualitativa, realizada em um centro de referência secundário do interior de Minas Gerais. Participaram da pesquisa 10 profissionais de saúde da equipe multidisciplinar. A coleta de dados deu-se por entrevista guiada por roteiro com perguntas abertas, analisadas pela técnica de Análise de Conteúdo. Resultados: a primeira categoria evidenciou que a adesão está relacionada a questões socioeconômicas, ao apoio da equipe de saúde e família. A segunda atribuiu a avaliação da adesão aos dados objetivos, como exames laboratoriais e medidas antropométricas, e aos dados subjetivos, como motivação do paciente para o tratamento. Conclusões: destaca-se a importância da criação e manutenção de uma rede de apoio ao doente crônico junto à família e ao sistema de saúde, incentivando o protagonismo e autocuidado.

Objective: to understand the factors that influence to the behavior of people with deviant-positive diabetes from the perspective of health professionals. Material and Methods: qualitative research, carried out in a secondary reference center in the interior of Minas Gerais. Ten health professionals from the multidisciplinary team participated in the research. Data collection took place through an interview guided by a script with open questions, analyzed by the Content Analysis technique. Results: the first category showed that adherence is related to socioeconomic issues, to the support of the health and family team. The second attributed the assessment of adherence to objective data, such as laboratory tests and anthropometric measures, and to subjective data, such as patient motivation for treatment. Conclusions: it signals the importance of creating and maintaining a support network for the chronically ill with the family and the health system, encouraging protagonism and self-care.

RESUMO

CONTEXT: Arterial Hypertension (AH) and Diabetes Mellitus (DM) are diseases that are getting worse all over the world. Linked to this advance, is the growing digital health market with numerous mobile health applications, which aim to help patients and professionals in the proper management of chronic diseases. The aim of this study was to analyze, through a systematic review and meta-analysis, the effectiveness of using mobile health applications in monitoring AH and/or DM in the adult and elderly population. METHODS: The systematic review and meta-analysis was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Metanalyses guidelines and involved searching five databases - Medline/PubMed, Embase, CINAHL, Virtual Library in Health and Cochrane Library. The review included randomized and cohort clinical trials testing the effects of the intervention on changing biochemical parameters and clinical efficacy in people treated for AH and/or DM. The quality of the selected studies was assessed based on the evaluation criteria of the Joanna Briggs Institute tool. The random effects meta-analysis method was used to explain effect distribution between studies, by Stata® software (version 11.0) and publication bias was examined by visual inspection of graphs and Egger test. RESULTS: We included 26 studies in the systematic review and 17 in the meta-analysis. These studies were published between 2014 to 2022 in 14 countries. Were reported improvement in knowledge and self-management of AH and DM, social motivation with treatment and behavioral change, reduction in glycated hemoglobin values, fasting glucose and blood pressure, improvement in adherence to drug treatment, among others. The result of the meta-analysis showed that there is evidence that the use of mobile applications can help reduce glycated hemoglobin by 0.39% compared to the usual care group. CONCLUSIONS: Monitoring and self-monitoring of behaviors and health care related to AH and DM in adults and the elderly through mobile applications, has clinically significant effectiveness in reducing glycated hemoglobin levels. Future studies should provide more evidence and recommendations for best practices and development of digital health interventions. TRIAL REGISTRATION: PROSPERO. International Prospective Registry of Systematic Reviews. CRD42022361928.

Assuntos

RESUMO

BACKGROUND: The COVID-19 pandemic received widespread media coverage due to its novelty, an early lack of data, and the rapid rise in deaths and cases. This excessive coverage created a secondary "infodemic" that was considered to be a serious public and mental health problem by the World Health Organization and the international scientific community. The infodemic particularly affected older individuals, specifically those who are vulnerable to misinformation due to political positions, low interpretive and critical analysis capacity, and limited technical-scientific knowledge. Thus, it is important to understand older people's reaction to COVID-19 information disseminated by the media and the effect on their lives and mental health. OBJECTIVE: We aimed to describe the profile of exposure to COVID-19 information among older Brazilian individuals and the impact on their mental health, perceived stress, and the presence of generalized anxiety disorder (GAD). METHODS: This cross-sectional, exploratory study surveyed 3307 older Brazilians via the web, social networks, and email between July 2020 and March 2021. Descriptive analysis and bivariate analysis were performed to estimate associations of interest. RESULTS: Major proportions of the 3307 participants were aged 60 to 64 years (n=1285, 38.9%), female (n=2250, 68.4%), and married (n=1835, 55.5%) and self-identified as White (n=2364, 71.5%). Only 295 (8.9%) had never started or completed a basic education. COVID-19 information was mainly accessed on television (n=2680, 81.1%) and social networks (n=1943, 58.8%). Television exposure was ≥3 hours in 1301 (39.3%) participants, social network use was 2 to 5 hours in 1084 (32.8%) participants, and radio exposure was ≥1 hour in 1223 (37%) participants. Frequency of exposure to social networks was significantly associated with perceived stress (P=.04) and GAD (P=.01). A Bonferroni post hoc test revealed significantly different perceived stress in participants who were exposed to social networks for 1 hour (P=.04) and those who had no exposure (P=.04). A crude linear regression showed that "some" social media use (P=.02) and 1 hour of exposure to social media (P<.001) were associated with perceived stress. Adjusting for sociodemographic variables revealed no associations with this outcome variable. In a crude logistic regression, some social media use (P<.001) and 2 to 5 hours of exposure to social media (P=.03) were associated with GAD. Adjusting for the indicated variables showed that some social network use (P<.001) and 1 hour (P=.04) and 2 to 5 hours (P=.03) of exposure to social media were associated with GAD. CONCLUSIONS: Older people, especially women, were often exposed to COVID-19-related information through television and social networks; this affected their mental health, specifically GAD and stress. Thus, the impact of the infodemic should be considered during anamnesis for older people, so that they can share their feelings about it and receive appropriate psychosocial care.

RESUMO

As Diretrizes Curriculares Nacionais para o Curso de Graduação em Odontologia orientam para uma formação humanista, crítica, reflexiva, e pautada em princípios éticos/bioéticos. Considerando que os coordenadores dos cursos de graduação são fundamentais no processo de formação, foi realizada uma pesquisa nacional, objetivando analisar o perfil acadêmico desses atores. Trata-se de pesquisa transversal, documental, exploratória e analítica. A coleta de dados ocorreu entre junho e julho de 2020, a partir da consulta aos currículos na Plataforma Lattes. Realizaram-se análises descritivas e univariada. Foram analisados os currículos dos coordenadores dos 446 cursos de Odontologia em atividade no Brasil. Destes, 53,0% eram do sexo masculino; 94,2% formados em Odontologia; 81,2% possuíam pelo menos uma especialização, 89,5% mestrado e 52,0% doutorado; 0,4% possuíam especialização em bioética e 0,7% em odontologia legal; 0,7% possuíam mestrado em odontologia legal; 11,7% já haviam lecionado disciplinas nas áreas de ética (deontológica e bioética); 3,8% participavam de projetos de pesquisa e 2,0% de projetos de extensão relacionados à ética; e 6,1% tinham publicações relacionadas à deontologia, ética e/ou bioética. Conclui-se que a maioria dos coordenadores possui cursos de especialização e mestrado, e pouco mais da metade possui doutorado. No entanto, poucos têm alguma formação nas áreas de ética e/ou bioética, ou apresentam projetos de extensão e pesquisa nesses campos do conhecimento (AU).

Las Directrices Curriculares Nacionales para los Cursos de Pregrado en Odontología prevén una formación humanística, crítica, y reflexiva basada en principios éticos/bioéticos. Considerando que los coordinadores de los cursos de pregrado son fundamentales en el proceso de formación, se realizó una pesquisa nacional para analizar el perfil académico de esos profesionales. Se trata de una investigación transversal, documental, exploratoria, y analítica. La colecta de datos se realizó entre junio y julio de 2020, a partir de la consulta de planes de estudio en la Plataforma Lattes. Se realizaron análisis descriptivos y univariados. Fueron analizados los currículos de los coordinadores de los 446 cursos de Odontología activos en Brasil. De los mismos, 53,0% eranhombres; 94,2% eran graduados en Odontología; 81,2% tenían por lo menos una especialización, 89,5% maestría y 52,0% doctorado; 0,4% tenían especialización en Bioética, y 0,7% en Odontología Legal; 11,7% ya había impartido asignaturas en las áreas de ética(deontológica y bioética); 3,8% participaba en proyectos de investigación, y 2,0% en proyectos de extensión relacionados con la ética; 6,1% tenía publicaciones relacionadas con la deontología, la ética y/o la bioética. Se concluye que la mayoría de los coordinadores tienen títulos de especialización y maestría, y poco más de la mitad tienen un doctorado. No obstante, pocos tienen formación en las áreas de ética y/o bioética, o presentan proyectos de extensión e investigación en estos campos del conocimiento (AU).

The National Curriculum Guidelines for the Undergraduate Course in Dentistry guide towards for humanistic, critical, and reflective education, with activities based on ethical/bioethical principles. Considering that undergraduate course coordinators are essential in conducting the education process, a nationwide study was carried out with the objective of evaluating the academic profile of these actors. This is a cross-sectional, documentary, exploratory, and analytical study. The data collection was carried out between June and July 2020, from the consultation of curricula on the Lattes Platform. Descriptive and univariate analyses were performed. The curricula of the coordinators from 446 Dentistry courses in activity in Brazil were analyzed. Of these, 53.0% were male; 94.2% graduated in Dentistry; 81.2% had at least one specialization, 89.5% had a master's degree, and 52.0% had a doctorate; 0.4% had a specialization in bioethics and 0.7% in legal dentistry; 11.7% had already lectured subjects in ethics (deontology and bioethics); 3.8% had participated in research projects, and 2.0% in extension projects related to ethics; while 6.1% had publications related to deontology, ethics, and/or bioethics. It is concluded that most coordinators have specialization and master's degrees, and just over half have a doctorate. However, few have some training in the areas of ethics and/or bioethics, or have extension and research projects in these fields of knowledge (AU).

Assuntos

RESUMO

The objective was to estimate the prevalence of excessive iodine intake in pregnant women and to investigate the consequences for maternal-fetal health. The systematic review was based on PRISMA. The search was conducted in September 2021 in LILACS, PubMed/MEDLINE, Science Direct, and SCOPUS databases. Observational studies that assessed excessive nutritional iodine status in pregnancy diagnosed by urinary iodine concentration and associated it with biomarkers of thyroid health function were included. Study selection, data extraction, and risk of biased evaluation were performed independently. Meta-analysis was calculated using a fixed and random effect model, and heterogeneity was assessed by the chi-square test. Meta-regressions were performed to identify the causes of heterogeneity using the Knapp and Hartung test. Nine studies were included in the systematic review, and eight in the meta-analysis. The prevalence of excessive iodine intake in 10,736 pregnant women in different regions of the world was 52%. The main implications for pregnant women were hypothyroxinemia, hypothyroidism, and hyperthyroidism. For the newborn, macrosomia and thyroid dysfunction. In addition, drinking water with high iodine intake contributed to excessive iodine intake. Therefore, the prevalence of iodine excess was 52%, with high heterogeneity among studies, explained by trimester of gestation and FT4 level; therefore, the farther the trimester of gestation and the lower the FT4, the higher the prevalence of iodine excess. PROSPERO Registration: CRD420206467 ( https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=206467 ).

Assuntos

RESUMO

Resumo Este artigo analisa a importância que coordenadores dos cursos de odontologia brasileiros atribuem ao ensino da bioética e sua opinião sobre o perfil desejável para egressos desse curso. Trata-se de estudo exploratório, descritivo e transversal realizado com 130 coordenadores de cursos de odontologia brasileiros no qual foram realizadas análises descritivas e análise de conteúdo de Bardin. A grande maioria dos participantes atribui importância à bioética em diferentes situações e 23,8% deles consideram um perfil adequado o profissional com postura ética e humanizada, reflexivo e com competência técnica. A bioética está sendo inserida na matriz curricular dos cursos de odontologia, e a maioria dos coordenadores a considera importante em diferentes situações, mas nem todos os gestores entendem o que ela contempla.

Abstract This article analyzes the importance dentistry course coordinators attribute to bioethics teaching and their opinion on the expected graduate profile. An exploratory, descriptive cross-sectional study was conducted with 130 coordinators of Brazilian dentistry courses. Data underwent descriptive analysis and Bardin's content analysis. Most participants attribute importance to bioethics teaching in different situations and 23.8% considered a professional with an ethical and humanized attitude, who is reflective and technically competent as a suitable profile. Dentistry courses are increasingly including bioethics in their curricula, and although most coordinators consider it important, not all understand its principles.

Resumen Este artículo analiza la importancia que los coordinadores de las carreras de Odontología en Brasil atribuyen a la enseñanza de la bioética y su opinión sobre el perfil deseable para los graduados de esta carrera. Se trata de un estudio exploratorio, descriptivo y transversal, realizado con 130 coordinadores de las carreras de Odontología de Brasil en el que se llevaron a cabo análisis descriptivos y análisis de contenido de Bardin. La mayoría de los participantes considera que la bioética es importante en diferentes situaciones, y el 23,8% de ellos estiman que un profesional con actitud ética y humanizada, reflexivo y técnicamente competente es un perfil adecuado. La bioética se está incluyendo en el plan de estudios de las carreras de Odontología, y la mayoría de los coordinadores la consideran importante en diferentes situaciones, pero no todos los directores entienden su alcance.

RESUMO

Objective: Evaluate the burden of family caregivers of cancer patients in a Brazilian oncology hospital. Method: Quantitative, descriptive, and cross-sectional research conducted in a Brazilian oncology hospital, located in Minas Gerais. Data collection occurred through the application of a questionnaire containing sociodemographic questions, and the Zarit scale, which assesses the degree of burden of caregivers, was used. Inclusion criteria were family car-egivers over 18, whose family member had a diagnosis of cancer, and who was involved in caregiving. The association between burden and the explanatory variables was performed from the multiple linear regression model. The program SPSS version 20 was used to perform the analyses. Results: Among the 125 individuals interviewed, the majority were under 38 years old, 66.4% were female, 45.6% were children, and 22.4% were spouses. The time of care varied from six months (39.2%) to two years (21.6%), and 80% of the interviewed individuals acted directly in the care of the ill person; 97.6% did not present overload. Conclusions: The caregivers, in general, did not present overload; however, it was verified reduction in the quality of life of these caregivers when the questions of the Zarit scale referring to the psychological and social relations domains, separately, were analyzed. (AU)

Objetivo: Avaliar a sobrecarga dos familiares cuidadores de pacientes com câncer num hospital oncológico brasileiro. Método: Pesquisa quantitativa, descritiva e transversal, realizada em um hospital oncológico brasileiro, localizado em Minas Gerais. A coleta de dados ocorreu por meio da aplicação de um questionário contendo perguntas socio-demográficas e foi utilizada a escala de Zarit, que avalia o grau de sobrecarga dos cuidadores. Os critérios de inclusão foram familiares cuidadores acima de 18 anos, cujo membro da família tivesse o diagnóstico de câncer 2https://www.revistas.usp.br/rmrpAssessment of the burden of family caregiverse que estivesse envolvido no cuidado. A associação entre sobrecarga e as variáveis explicativas foi realizada a par-tir do modelo de regressão linear múltipla. O programa SPSS versão 20 foi utilizado para a realização das análises. Resultados: Dentre os 125 indivíduos entrevistados, a maioria possuía menos de 38 anos, 66,4% eram do sexo feminino, 45,6% eram filhos e 22,4% cônjuges. O tempo de prestação de cuidados variou de seis meses (39,2%) a dois anos (21,6%) e 80% dos entrevistados atuavam diretamente nos cuidados, 80% atuavam diretamente nos cuidados do ente adoecido, 97,6% não apresentaram sobrecarga. Conclusões: Os cuidadores, de uma forma geral, não apresentaram sobrecarga, porém, constatou-se uma redução na qualidade de vida destes cuidadores, quando analisadas as questões da escala Zarit referentes aos domínios psicológico e de relações sociais, isoladamente. (AU)

Objetivo: Evaluar la carga de los cuidadores familiares de pacientes con cáncer en un hospital oncológico brasileño. Método: Investigación cuantitativa, descriptiva y transversal, realizada en un hospital oncológico brasileño, ubicado en Minas Gerais. La recogida de datos se realizó mediante la aplicación de un cuestionario con preguntas sociodemográficas y se utilizó la escala de Zarit, que evalúa el grado de carga de los cuidadores. Los criterios de inclusión fueron los cuidadores familiares mayores de 18 años, cuyo miembro de la familia había sido diagnosticado de cáncer y estaba involucrado en el cuidado. La asociación entre la carga y las variables explicativas se realizó a partir del modelo de regresión lineal múltiple. Se utilizó el programa SPSS versión 20 para realizar los análisis. Resultados: Entre las 125 personas entrevistadas, la mayoría tenía menos de 38 años, el 66,4% eran mujeres, el 45,6% eran hijos y el 22,4% cónyuges. El tiempo de atención varió de seis meses (39,2%) a dos años (21,6%) y el 80% de los entrevistados actuó directamente en el cuidado del enfermo, el 97,6% no presentó sobrecarga. Conclusiones: Los cuidadores, en general, no presentaron sobrecarga, sin embargo, se verificó una reducción en la calidad de vida de estos cuidadores cuando se analizaron las preguntas de la escala de Zarit referidas a los dominios psicológico y de relaciones sociales, por separado. (AU)

Assuntos

RESUMO

OBJECTIVE: To evaluate the presence of LGA and the relationship with the 10-year risk of a cardiovascular event in hypertensive and diabetic patients in Primary Health Care. STUDY DESIGN: The study design used is cross-sectional. METHODS: This study was based on the application of questionnaires, anthropometric measurements, and laboratory tests carried out from August 2017 to April 2018. Logistic regression was used to evaluate the odds ratio of the explanatory variables in relation to the highest tercile of LGA. The Framingham risk score was used to assess the 10-year risk of cardiovascular event. The comparison of this score with the LGA terciles was analyzed using ANOVA. RESULTS: An increase in the 10-year risk of cardiovascular event score was observed with an increasing LGA tercile, and this pattern prevailed after adjusting for confounding variables. CONCLUSION: An association between LGA and the 10-year risk of cardiovascular event was observed in a representative sample of hypertensive and diabetic patients.

Assuntos

RESUMO

OBJECTIVE: the study evaluated the effect of using the safe surgery checklist (CL) on the incidence of adverse events (AE). METHODS: cross-sectional and retrospective research with 851 patients undergoing surgical procedures in 2012 (n=428) and 2015 (n=423), representing the periods before and after CL implantation. The AE incidences for each year were estimated and compared. The association between the occurrence of AE and the presence of CL in the medical record was analyzed. RESULTS: a reduction in the point estimate of AE was observed from 13.6% (before using the CL) to 11.8% (with the use of the CL). The difference between the proportions of AE in the periods before and after the use of CL was not significant (p=0.213). The occurrence of AE showed association with the following characteristics: anesthetic risk of the patient, length of stay, surgery time and classification of the procedure according to the potential for contamination. Considering the proportion of deaths, there was a significant reduction in deaths (p=0.007) in patients whose CL was used when compared to those without the use of the instrument. There was no significant association between the presence of CL and the occurrence of AE. It was concluded that the presence of CL in the medical record did not guarantee an expected reduction in the incidence of AE. CONCLUSION: however, it is believed that the use of the instrument integrated with other patient safety strategies can improve the safety/quality of surgical care in the long term.

Assuntos