RESUMO
Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder. Worldwide, its prevalence is ~2% and its etiology is mostly unknown. Identifying biological factors contributing to OCD will elucidate underlying mechanisms and might contribute to improved treatment outcomes. Genomic studies of OCD are beginning to reveal long-sought risk loci, but >95% of the cases currently in analysis are of homogenous European ancestry. If not addressed, this Eurocentric bias will result in OCD genomic findings being more accurate for individuals of European ancestry than other ancestries, thereby contributing to health disparities in potential future applications of genomics. In this study protocol paper, we describe the Latin American Trans-ancestry INitiative for OCD genomics (LATINO, www.latinostudy.org). LATINO is a new network of investigators from across Latin America, the United States, and Canada who have begun to collect DNA and clinical data from 5,000 richly-phenotyped OCD cases of Latin American ancestry in a culturally sensitive and ethical manner. In this project, we will utilize trans-ancestry genomic analyses to accelerate the identification of OCD risk loci, fine-map putative causal variants, and improve the performance of polygenic risk scores in diverse populations. We will also capitalize on rich clinical data to examine the genetics of treatment response, biologically plausible OCD subtypes, and symptom dimensions. Additionally, LATINO will help elucidate the diversity of the clinical presentations of OCD across cultures through various trainings developed and offered in collaboration with Latin American investigators. We believe this study will advance the important goal of global mental health discovery and equity.
RESUMO
The teacher-student relationship in medicine is affected by incidents performed by teachers and perceived by students as morally incorrect. The objectives were to analyze these incidents perceived by third year medical students in 2009 and 2015, according to gender, position, career year, and instance, and to compare categories and motives. This is quantitative-qualitative research, based on a survey with closed and open items: to narrate incidents and motives. The relationship between variables was established with χ2 (p ≤ 0.05). The survey was administered to third year students: 218 in 2009 and 224 in 2015; mean age: 23.4 and 24.8 years old; feminine: 63.7% and 74.3%; and 199 and 209 incidents, respectively. In 2015 the incidents increased with: female students (p = 0.005), female teachers, classmates, first year, and oral tests. In 2009 most incidents were performed by teachers, followed by assistants, reversing in 2015 (p = 0.05). Psychological mistreatment was perceived greater in both years (+40%), followed by unfair evaluation (p = 0.001). The teacher's motives prevailed (+60%). Differences between the years could be due to: increasing female population among students and teachers, changes in the teaching positions, delegation of responsibilities of teachers, subjectivity in oral tests, and increase in social violence translated to the academic environment.