Effects of a Physical Exercise Program on Quality of Life and Physical Fitness of Breast Cancer Survivors: the MAMA_MOVE Gaia After Treatment Trial.

To assess the effects of a group class physical exercise program on health-related quality of life (HRQOL), physical fitness and activity, and safety in early breast cancer women after treatment, a double-phase trial [16-week control phase (CP) followed by a 16-week intervention phase (IP)] was designed. Outcomes were evaluated at baseline (T1), 8 (T2) and 16 (T3) weeks (CP), and 24 (T4) and 32 (T5) weeks (IP). The primary endpoint was global health status. Out of 82 enrolled patients, 37 completed the IP. Global health status decreased (-10,1; 95% CI -19.8 to -0.4; p = 0.040) during the CP and stabilized during the IP. Physical and sexual functioning increased during the IP (p = 0.008; p = 0.017), while cardiorespiratory fitness increased in the CP (p = 0.004). Upper limb strength and lower limb functionality increased during both phases [CP: p < 0.0001, p = 0.001 (surgical and nonsurgical arm), p = 0.028; IP: p < 0.0001, p = 0.002, p = 0.009]. Body mass index decreased in the IP (p = 0.026). Waist circumference increased in the CP (p = 0.001) and decreased in the IP (p = 0.010); sedentary behaviours and moderate and vigorous physical activity did not change. Adherence to 70% of the sessions was reported in 54% of patients. No serious adverse events related to the intervention were reported. In conclusion, the physical exercise program was able to prevent the decline in global health status and to improve other domains of HRQOL and physical fitness. As physical exercise is not the standard of care in many countries, the implementation of group class programs might be an option.

O Ideal Profissional na Formação Médica / The Professional Ideal in Medical Formation

Resumo Introdução: No curso de Medicina, os estudantes recebem não somente conhecimento e habilidades técnicas em sala de aula e nos campos de prática, mas também aprendem valores, atitudes e comportamentos profissionais. Nesse processo, ocorre a construção social do médico, em que será desenvolvido o ideal profissional. Esta pesquisa teve como objetivo compreender o processo de formação da identidade profissional a partir dos seguintes aspectos: a identificação dos ideais de profissão e de profissionais sobre as qualidades pessoais e profissionais dos docentes do curso médico, a imagem de profissional e os fatores contribuintes para o ingresso na profissão. Métodos: Para isso, utilizou-se uma metodologia qualitativa de caráter exploratório, realizada por meio de entrevista semiestruturada com 20 discentes do primeiro ao sétimo semestre do curso de Medicina de uma escola médica de João Pessoa. As informações coletadas foram estudadas com base na análise do discurso. As categorias utilizadas para análise foram: o "bom médico", o "bom professor" e a idealização do profissional "bem-sucedido". Resultados: Os sujeitos da pesquisa tinham em média 22,2 anos de idade e 13 eram do sexo feminino e sete do sexo masculino. Mais da metade dos alunos se autodeclarou de cor branca e 45% informaram renda familiar maior que 20 salários mínimos. Quando se exploraram as categorias, percebeu-se que a imagem profissional mescla a ideia de status, por meio do reconhecimento da sociedade e da estabilidade financeira, e a de intenção de cuidar das pessoas. Conclusão: Observou-se que o "bom médico" deve ser um profissional "humano"; "estudioso", "atualizado" e "resolutivo"; "profissional comprometido" e "responsável". Além disso, os estudantes esperam desenvolver esses aspectos durante a graduação, mas muitas vezes se deparam com o que "não querem ser". Outro elemento importante foi a percepção do conflito entre as ideias de "técnico competente" e "médico humano". Essas características são transferidas para o "bom professor", sendo reconhecido o educador que detém mais características do ideal profissional.

Abstract Introduction: In medical school, students receive not only technical knowledge and skills in the classroom and fields of practice, but also learn values, attitudes, and professional behaviors. In this process, the social construction of the physician takes place, in which the professional ideal will be developed. The aim of this research was to understand the process of professional identity formation based on: the identification of the ideals of the profession and professionals on the personal and professional qualities of the medical course teachers; professional image; and the factors contributing to the entry into the profession. Methods: For this purpose, a qualitative exploratory methodology was used through a semi-structured interview with 20 students from the first to the seventh semesters of the medical course of a medical school in João Pessoa. The collected information was studied from the discourse analysis. The categories used for analysis were: the "good doctor"; the "good teacher"; and the idealization of the "successful" professional. Results: The subjects were 22.2 years of age; 13 were females and 7 were males. More than half of the students self-declared their ethnicity as white and 45% reported a family income greater than twenty minimum wages. Exploring the categories, it was observed that the professional image merges the idea of status, through the recognition of society and financial stability, and the intention to take care of people. Conclusion: It was observed that the "good doctor" must be a "humane" professional; "studious," "updated," and "resolutive"; "committed professional" and "responsible". In addition, the students expect to develop these aspects during their undergraduate education, but often encounter what they "do not want to be." Another important element was the perception of the conflict between the ideas of a "competent technician" and a "humane doctor". These characteristics are transferred to the "good teacher", thus recognizing the educator that holds the most characteristics of the professional ideal.