Educação e saúde nos territórios de Pontão-RS: resgatando memórias e compartilhando saberes / Education and health in the territories of Pontão-RS: rescuing memories and sharing knowledge

Esta obra trata da sistematização de algumas das experiências desenvolvidas no município de Pontão-RS através do Programa de Extensão "Círculos de cultura: diálogos em saúde na escola e na comunidade" da Universidade Federal da Fronteira Sul (UFFS) Campus Passo Fundo, em parceria com as Secretarias de Educação, Saúde e Assistência Social de Pontão-RS. Evidencia a sistematização de parte dos processos desenvolvidos através de ações intersetoriais de formação de professores (as), de apoio aos processos pedagógicos nas escolas e de experiências de interação entre estudantes e professoras do curso de graduação em Medicina da UFFS, com profissionais da Secretaria da Saúde e de Assistência Social junto às escolas, grupos e comunidades. Resultado também de um esforço coletivo de todas as escolas e professores (as) do município de Pontão sobre trajetórias e dinâmicas de cada território e comunidade onde as escolas estão inseridas, trazendo as principais marcas do processo pedagógico de cada escola. Uma obra construída por muitas mãos e que apresenta inovações produzidas como dispositivo de implementação de políticas públicas intersetoriais e de base territorial.

Escola sem partido e conservadorismo moral: instrumentalização da religião, sexualidade e gênero / School without party and moral conservatism: the instrumentalization of religion, sexuality and gender / Escuela sin partido y conservadurismo moral: la instrumentalización de la religión, sexualidad y género

Este artigo tem por objetivo identificar e discutir alguns estratagemas psicológicos utilizados por movimentos conservadores e autoritários recentemente difundidos no Brasil - em especial, pelo Movimento Escola sem Partido -, em relação a temas como sexualidade e gênero, que atualmente foram incluídos como essenciais à formação escolar. Com esse propósito, empenhamo-nos em compreender a perspectiva cultural em que se apoiam e o modo como a articulam, ideologicamente, para inviabilizar o debate sobre eles. A partir da análise dos Projetos de Lei 246/2019 e 1859/2015, identificamos estratégias conservadoras que, autoritariamente, deslegitimam sua inclusão na formação escolar. Dentre elas, pareceu-nos urgente investigar a instrumentalização da religião, pois favorece a subordinação da crença religiosa, sobretudo associada ao conservadorismo moral imbricado na tradição cristã brasileira, ao discurso político autoritário. Assim como os movimentos fascistas que, nos Estados Unidos da década de 1930, reivindicavam um ordenamento autoritário e opressor da sociedade por meio do apelo a conteúdos religiosos instrumentalizados para esse fim, atualmente, o discurso religioso também é utilizado como forma de suscitar adesão ao conservadorismo social e político e de justificar preconceitos arraigados. Constatamos que a instrumentalização da religião é uma forma de justificar a permanência de valores conservadores na escola e na sociedade, bem como de reiterar o modelo de família heterossexual monogâmica e a ordem patriarcal. Por meio de estratagemas como esses, os movimentos conservadores e autoritários, articulados em função da negação da diversidade sexual e de gênero, impedem que a escola se constitua como espaço democrático e diverso.(AU)

This paper identifies and discusses the psychological ploys employed by recent conservative and authoritarian movements in Brazil, particularly the School without Party movement, against topics like sexuality and gender, which are currently included as essential to school education. To do so, we sought to understand their cultural basis and how they are ideologically articulated to prevent school debate around these topics. By analyzing Bills 246/2019 and 1859/2015, we identified some conservative strategies that authoritatively delegitimize their inclusion in school education. Chief among them is the instrumentalization of religion, since it favors subordinating religious belief, mainly associated with traditional Christian moral conservatism, to authoritarian political discourse. Similar to the fascist movements in the 1930s United States that claimed an authoritarian and oppressive ordering of society by appealing to religious content, religious speech is currently instrumentalized to encourage social and political conservatism adherence and to justify deep-seated prejudices. Religion instrumentalization is used to justify upholding conservative values at school and in society, as well as to reiterate the monogamous heterosexual family model and patriarchy. Through such ploys, authoritarian and conservative movements, articulated around denying sexual and gender diversity, prevent the school from becoming a democratic and diverse environment.(AU)

Este artículo tiene por objetivo identificar y discutir algunas de las estratagemas psicológicas que utilizan los movimientos conservadores y autoritarios, difundidas recientemente en Brasil, en particular por el Movimiento Escuela sin Partido, con relación a temas como sexualidad y género, que actualmente se incluyeron en la formación escolar. Con este propósito, se pretende comprender la base cultural en la que se han apoyado y cómo la articulan ideológicamente para hacer inviable el debate sobre ellas. A partir de análisis de los Proyectos de Ley 246/2019 y 1859/2015, se identificaron estrategias conservadoras que, autoritariamente, deslegitiman la inclusión de estos temas en la formación escolar. Entre ellas, parece urgente analizar la instrumentalización de la religión, porque favorece la subordinación de la creencia religiosa al discurso político autoritario, sobre todo asociada al conservadurismo moral presente en las vertientes del cristianismo brasileño. Al igual que los movimientos fascistas en los Estados Unidos en los años 1930 que reivindicaban una planificación autoritaria de la sociedad mediante un llamado a contenidos religiosos instrumentalizados, actualmente se utiliza el discurso religioso como forma de promover la adhesión al conservadurismo social y político y de justificar los prejuicios. Se constata que la instrumentalización de la religión es un modo de justificar la permanencia de valores conservadores en la escuela, así como de confirmar el modelo de familia heterosexual monógama y el orden patriarcal. Estos estratagemas que son utilizados por los movimientos conservadores y autoritarios, articulados en función de la negación de la diversidad sexual y de género, impiden que la escuela sea democrática y diversa.(AU)

Educação permanente no sistema único de saúde: concepções de profissionais da gestão e dos serviços / Continuing permanent education in the brazilian national health system: conceptions from management and care professionals / Educación continua en el sistema único de salud brasileño: concepciones de los profesionales de gestión y servicios

Este artigo pretende compreender as concepções de profissionais da gestão e dos serviços do Sistema Único de Saúde (SUS) sobre Educação Permanente em Saúde (EPS), bem como seus desafios e potencialidades. Utilizou-se de grupo focal para coleta, seguido de análise lexical do tipo classificação hierárquica descendente com auxílio do software Iramuteq. Os resultados delinearam quatro classes: a) EPS - entendimentos e expectativas; b) entraves à EPS; c) ETSUS e EPS por meio de cursos e capacitações; e d) dispositivos de EPS: potencialidades e desafios. Os participantes apontaram equívocos de entendimentos acerca da EPS ao equipará-la à Educação Continuada (EC) voltada à transferência de conteúdo, com repercussões negativas na prática de EPS. Discute-se o risco em centralizar o responsável pela concretização dessa proposta, que deveria ser coletiva e compartilhada entre diferentes atores. Reivindica-se, portanto, uma produção colaborativa, que possa circular entre os envolvidos, de modo que cada um experimente esse lugar e se aproprie da complexidade de interações propiciadas pela Educação Permanente em Saúde.(AU)

This article aims to understand the conceptions of professionals from the management and services of the Unified Health System (SUS) on Permanent Education in Health (EPS), as well as its challenges and potential. A focus group was used for data collection, followed by a lexical analysis of the descending hierarchical classification type using the Iramuteq software. The results delineated four classes: a) EPS - understandings and expectations; b) obstacles to EPS; c) ETSUS and EPS by courses and training; and d) EPS devices: potentialities and challenges. Participants pointed out misunderstandings about EPS, when equating it with Continuing Education (CE) focused on content transfer, with negative repercussions on EPS practice. The risk of centralizing the person responsible for implementing this proposal, which should be collective and shared among different actors, is discussed. Therefore, a collaborative production is claimed for, which can circulate among those involved, so that each one experiences this place and appropriates the complexity of interactions provided by Permanent Education in Health.(AU)

Este artículo tiene por objetivo comprender las concepciones de los profesionales de la gestión y servicios del Sistema Único de Salud (SUS) sobre Educación Continua en Salud (EPS), así como sus desafíos y potencialidades. Se utilizó un grupo focal para la recolección de datos, seguido por un análisis léxico del tipo clasificación jerárquica descendente con la ayuda del software Iramuteq. Los resultados delinearon cuatro clases: a) EPS: entendimientos y expectativas, b) Barreras para EPS, c) ETSUS y EPS a través de cursos y capacitación, y d) Dispositivos EPS: potencialidades y desafíos. Los participantes informaron que existen malentendidos sobre EPS al equipararla a Educación Continua, con repercusiones negativas en la práctica de EPS, orientada a la transferencia de contenidos. Se discute el riesgo de elegir a un solo organismo como responsable de implementar esta propuesta colectiva, que debería ser colectiva y compartida entre los diferentes actores. Se aboga por un liderazgo colaborativo, que pueda circular entre los involucrados, para que cada uno experimente este lugar y se apropie de la complejidad de interacciones que brinda la Educación Continua en Salud.(AU)

A relação com o saber nas atividades lúdicas escolares / The relationship with knowledge in school recreational activities / La relación con el saber en las actividades lúdicas escolares

O brincar é uma atividade importante para o desenvolvimento infantil, porque melhora aspectos cognitivos, emocionais e físicos. Além disso, jogos e brincadeiras podem ser explorados como recurso educacional. Partindo do entendimento da ludicidade enquanto um processo subjetivo, este trabalho investigou a relação com o saber estabelecida durante as brincadeiras, buscando compreendê-las em suas dimensões epistêmica, social e identitária. Dezesseis estudantes do 5º ano do ensino fundamental foram entrevistados a partir de um roteiro baseado no instrumento "balanço do saber", proposto por Bernard Charlot. As questões foram adaptadas para possibilitar apreender o que as crianças dizem aprender durante as brincadeiras em que participam, com ênfase naquelas realizadas em sala de aula. Os resultados da análise de conteúdo realizada mostraram que, apesar de existirem conflitos sobre como se estabelecem as funções lúdica e educativa, quando a brincadeira infantil é utilizada como recurso pedagógico, os sujeitos podem identificar benefícios no processo de aprendizagem por meio dela. Aponta-se, também, a necessidade de considerar a condição social da criança no ambiente escolar para o sucesso ao utilizar essas atividades como práticas pedagógicas.(AU)

Child's play is an important activity for child development since it improves cognition, emotional, and physical aspects. Games can also be explored as an educational resource. Starting from the understanding that playfulness is a subjective process, this work has investigated the relationship to the knowledge stablished during games, aiming to understand it in its epistemic, social, and identitary dimensions. A group of 16 5th grade students were interviewed from a script based on the instrument "balance of knowledge," as proposed by Bernard Charlot. The questions were adapted to enable the apprehension of what children say they learn on the games they play, emphasizing those which are played in classrooms. The results of the content analysis performed have showed that, despite the conflicts on how both playful and educative functions are stablished when child's play is used as a pedagogic resource, the subjects can identify benefits on the process of learning with it. The need to consider the child's social condition in the school environment to reach success when using these activities as pedagogical practices is also pointed out.(AU)

Jugar es una actividad importante para el desarrollo de los niños, porque mejora aspectos cognitivos, emocionales y físicos. Por tanto, los juegos son explorados como recurso educativo. Partiendo de la comprensión de que lo lúdico es un proceso subjetivo, este trabajo analizó la relación con el saber que se establece durante el juego, con el objetivo de comprenderlo en sus dimensiones epistémica, social e identitaria. Se entrevistó a dieciséis estudiantes de quinto grado a partir de un guion basado en el instrumento "balance del saber" propuesto por Bernard Charlot. Las preguntas fueron adaptadas para permitir la aprehensión de lo que los niños dicen que aprenden en sus juegos, enfatizando los que se juegan en las aulas. Los resultados del análisis de contenido realizado mostraron que, a pesar de que existen conflictos sobre cómo se establecen ambas funciones lúdica y educativa cuando se utiliza el juego infantil como recurso pedagógico, los niños pueden identificar beneficios en el proceso de aprendizaje a través del juego. Se señala la necesidad de considerar la condición social del niño en el entorno escolar para alcanzar el éxito al utilizar estas actividades como prácticas pedagógicas.(AU)

The role of collaborative learning in resilience in healthcare-a thematic qualitative meta-synthesis of resilience narratives.

BACKGROUND: To provide high quality services in increasingly complex, constantly changing circumstances, healthcare organizations worldwide need a high level of resilience, to adapt and respond to challenges and changes at all system levels. For healthcare organizations to strengthen their resilience, a significant level of continuous learning is required. Given the interdependence required amongst healthcare professionals and stakeholders when providing healthcare, this learning needs to be collaborative, as a prerequisite to operationalizing resilience in healthcare. As particular elements of collaborative working, and learning are likely to promote resilience, there is a need to explore the underlying collaborative learning mechanisms and how and why collaborations occur during adaptations and responses. The aim of this study is to describe collaborative learning processes in relation to resilient healthcare based on an investigation of narratives developed from studies representing diverse healthcare contexts and levels. METHODS: The method used to develop understanding of collaborative learning across diverse healthcare contexts and levels was to first conduct a narrative inquiry of a comprehensive dataset of published health services research studies. This resulted in 14 narratives (70 pages), synthesised from a total of 40 published articles and 6 PhD synopses. The narratives where then analysed using a thematic meta-synthesis approach. RESULTS: The results show that, across levels and contexts, healthcare professionals collaborate to respond and adapt to change, maintain processes and functions, and improve quality and safety. This collaboration comprises activities and interactions such as exchanging information, coordinating, negotiating, and aligning needs and developing buffers. The learning activities embedded in these collaborations are both activities of daily work, such as discussions, prioritizing and delegation of tasks, and intentional educational activities such as seminars or simulation activities. CONCLUSIONS: Based on these findings, we propose that the enactment of resilience in healthcare is dependent on these collaborations and learning processes, across different levels and contexts. A systems perspective of resilience demands collaboration and learning within and across all system levels. Creating space for reflection and awareness through activities of everyday work, could support individual, team and organizational learning.

Do diagnóstico institucional ao apoio interdisciplinar: a psicologia hospitalar durante a Covid-19 / From institutional diagnosis to interdisciplinary support: hospital psychology during the Covid-19 / Del diagnóstico institucional al apoyo interdisciplinario: la psicología hospitalaria frente a Covid-19

The crisis generated by the coronavirus disease 2019 (Covid-19) pandemic changed health care routines and the dynamics of hospitals and impacted health professionals. This experience report presents an interdisciplinary institutional support intervention, led by the psychology service of a pediatric hospital. Based on the hospital management's demand for the care of the employees' mental health, an institutional diagnosis was made and an interdisciplinary action of guidance, support and reception to employees was structured, which collected and organized into 11 categories concerns and obstacles to the functioning of the hospital during the pandemic. Hence, it was possible to realign care flows and offer psychological support to professionals, highlighting the interdisciplinary quality of mental health care. We verified emotional rebalancing, strengthening of professional identity, and better occupational performance. The transformation process that was fostered helped to overcome difficulties and promote an environment of resilience and better coping with the situation, indicating the need to maintain the attention that the crisis demanded.

A pandemia provocada pela Covid-19 alterou as rotinas assistenciais hospitalares e impactou os profissionais de saúde. Este relato de experiência apresenta uma intervenção interdisciplinar de apoio institucional, liderada pelo Serviço de Psicologia de um hospital pediátrico, e a constatação da possibilidade de encontrar soluções inovadoras, sistematizadas e fundamentadas para novos problemas. A partir da demanda da direção da instituição de cuidado destinado à saúde mental dos colaboradores, realizou-se um diagnóstico institucional e estruturou-se a ação interdisciplinar de orientação, apoio e acolhimento aos colaboradores, revelando preocupações e entraves do hospital durante a pandemia. A partir daí, foi possível realinhar a ação, ressaltando a qualidade interdisciplinar do cuidado com a saúde mental. Constataram-se reequilíbrio emocional, fortalecimento da identidade profissional e melhor desempenho ocupacional. Esse resgate fomentou um processo de transformação que consistiu em colaborar para a superação de dificuldades, promover um ambiente de resiliência e melhor enfrentamento da situação, e indicar a necessidade de manutenção da atenção que a crise oportunizou.

La crisis generada por la pandemia de la coronavirus disease 2019 (Covid-19) cambió las rutinas de atención médica y la dinámica de los hospitales y impactó los profesionales de la salud. Presenta-se una intervención interdisciplinaria de apoyo institucional, dirigida por el servicio de psicología de un hospital pediátrico. Con base en las demandas de la administración del hospital para el cuidado de la salud de los empleados, se realizó un diagnóstico institucional y se estructuró una acción interdisciplinaria de orientación, apoyo y acogida a los empleados que recopiló y organizó en 11 categorías inquietudes y obstáculos para el funcionamiento del hospital durante la pandemia. Los flujos de atención han sido reordenados, destacando la calidad interdisciplinaria de la atención en salud mental. Verificamos reequilibrio emocional, fortalecimiento de la identidad profesional y mejor desempeño ocupacional. El proceso de transformación que se impulsó ayudó a superar las dificultades y promover un ambiente de resiliencia y mejor enfrentamiento a la situación, indicando la necesidad de mantener la atención que demandaba la crisis.

Collaborative Learning to Advance Knowledge and Implementation of Strategic Health Purchasing in Sub-Saharan Africa.

Strategic purchasing means deliberately directing health funds to priority populations, interventions, and services. This is done by actively creating incentives so funding is used equitably and efficiently and is aligned with population health needs. Strategic purchasing is a complex policy area fraught with challenging technical, institutional, and political issues. Policy makers and practitioners are an important source of tacit knowledge-experiential knowledge that is context specific and gained over time. Collaborative learning, through which a group of peers jointly problem-solves and generates lessons and solutions that can be adapted to different country contexts, is an important way to advance collective understanding of how to make progress on strategic purchasing within the unique health financing systems of sub-Saharan Africa. The Strategic Purchasing Africa Resource Center (SPARC), a resource hub hosted by AMREF Health Africa with technical support from Results for Development, is facilitating a collaborative learning agenda among 11 technical partners in 10 countries. SPARC and the technical partners are generating new insights and practical lessons to inform country policy and regional discourse on how to better use strategic purchasing to advance progress toward universal health coverage (UHC). This paper summarizes lessons and best practices from SPARC's collaborative learning approach that can benefit others who are seeking to apply a similar approach to share tacit learning on strategic purchasing and UHC.

Collaborative case-based learning with programmatic team-based assessment: a novel methodology for developing advanced skills in early-years medical students.

BACKGROUND: Imperial College London launched a new, spiral undergraduate medical curriculum in September 2019. Clinical & Scientific Integrative cases (CSI) is an innovative, flagship module, which uses pioneering methodology to provide early-years learning that [1] is patient-centred, [2] integrates clinical and scientific curriculum content, [3] develops advanced team-work skills and [4] provides engaging, student-driven learning. These aims are designed to produce medical graduates equipped to excel in a modern healthcare environment. METHODS: CSI has adopted a novel educational approach which utilises contemporary digital resources to deliver a collaborative case-based learning (CBL) component, paired with a team-based learning (TBL) component that incorporates both learning and programmatic assessment. This paper serves to explore how first-year students experienced CSI in relation to its key aims, drawing upon quantitative and qualitative data from feedback surveys from CSI's inaugural year. It provides a description and analysis of the module's design, delivery, successes and challenges. RESULTS: Our findings indicate that CSI has been extremely well-received and that the majority of students agree that it met its aims. Survey outputs indicate success in integrating multiple elements of the curriculum, developing an early holistic approach towards patients, expediting the development of important team-working skills, and delivering authentic and challenging clinical problems, which our students found highly relevant. Challenges have included supporting students to adapt to a student-driven, deep learning approach. CONCLUSIONS: First-year students appear to have adopted a patient-centred outlook, the ability to integrate knowledge from across the curriculum, an appreciation for other team members and the self-efficacy to collaboratively tackle challenging, authentic clinical problems. Ultimately, CSI's innovative design is attractive and pertinent to the needs of modern medical students and ultimately, future doctors.

Atención primaria social en Colombia: una mirada desde una experiencia exitosa / Social primary care in Colombia: A look from a successful experience

Resumen Introducción: La estrategia de Atención Primaria Social ha sido valorada por la Organización Panamericana de la Salud como una experiencia exitosa. Objetivo: Analizar la experiencia de Atención Primaria Social en el departamento de Caldas en el marco de un proceso de sistematización. Materiales y métodos: Estudio de sistematización de experiencias, las unidades de análisis y de trabajo fueron documentos municipales y departamentales, información del Observatorio Social de Caldas y relatos de diferentes actores. Técnicas: 71 entrevistas a profundidad a informantes claves, 27 grupos focales, 11 diarios de campo y revisión documental. La información fue recolectada en 6 fases y luego analizada en el software ATLAS.ti 8.0. Resultados: La estrategia tuvo un recorrido histórico bajo lineamientos nacionales e internacionales desde los años 80 hasta la actualidad, fue modificada en 2013 al articular actores y sectores público-privados para convertirla en "Atención Primaria Social". El modelo operativo se cimienta en la transectorialidad y educación interdisciplinar, bienestar y salud familiar, y participación social y comunitaria, cuyo eje central son los actores, familias y comunidades. Se destacan actividades como caracterización familiar, intervenciones a familias priorizadas y unidades de análisis para apoyo, monitoreo y seguimiento. Conclusiones: Han participado diferentes actores en la comprensión de la mirada y el abordaje de la salud desde lo "social", un actor relevante ha sido la comunidad, acompañada de sus líderes y la academia. La voluntad política del gobierno nacional, departamental y municipal es relevante para el éxito de la estrategia. Los indicadores en salud han sido impactados por el avance en la implementación de la estrategia de Atención Primaria Social.

Abstract Introduction: The Social Primary Care strategy has been evaluated by the Pan American Health Organization as a successful experience. Objective: To analyze the experience of Primary Social Care in the department of Caldas within the framework of a systematization process. Methods: Systematization study of experiences, the units of analysis and work were municipal and departmental documents, information from the Social Observatory of Caldas and accounts of different actors. Techniques: 71 in-depth interviews with key informants, 27 focus groups, 11 field diaries and documentary review, the information was collected in 6 phases and then analyzed in ATLAS. ti 8.0 software. Results: The strategy had a historical trajectory under national and international guidelines from the 1980s to the present, it was modified in 2013 by articulating actors and public-private sectors to turn it into "Social Primary Care". The operational model is based on trans-sectoriality and interdisciplinary education, family wellbeing and health, and social and community participation, whose central axis are the actors, families, and communities. Activities include family characterization, interventions for prioritized families and units of analysis for support, monitoring and follow-up. Conclusions: Different actors have participated in the understanding of the "social" approach to health, a relevant actor has been the community accompanied by its leaders and academia. The political will of the national, departmental and municipal governments is relevant for the success of the strategy. Health indicators have been impacted by the progress in the implementation of the Social Primary Health Care strategy.

Percepções de educadores e profissionais de saúde sobre interdisciplinaridade no contexto do Programa Saúde na Escola / Percepciones de educadores y profesionales de la salud sobre la interdisciplinaridad en el contexto del Programa Salud en la Escuela / Perceptions of educators and health professionals about interdisciplinarity in the School Health Program context

Este estudo teve por objetivo analisar as percepções de profissionais da saúde e da educação para a interdisciplinaridade no trabalho de promoção de saúde na escola, antes e depois da formação sobre autorregulação para o autocuidado e a promoção da saúde. Foi realizado um estudo exploratório e descritivo, de caráter qualitativo, no qual participaram 26 profissionais da saúde e da educação, distribuídos em dois grupos focais antes e dois depois da formação. Para a interpretação dos dados foi utilizada a análise temática. Os participantes perceberam que as ações de saúde nas escolas devem ser realizadas continuamente e de maneira interdisciplinar. Esta investigação destaca que a educação continuada é importante para a sensibilização dos profissionais para a interdisciplinaridade. (AU)

El objetivo de este estudio fue analizar las percepciones de profesionales de la salud y educación para la interdisciplinariedad en el trabajo de promoción de la salud en la escuela, antes y después de la formación en la autorregulación para el autocuidado y la promoción de la salud. Se realizó un estudio exploratorio y descriptivo de carácter cualitativo, en el cual 26 profesionales de salud y educación participaron, distribuidos en dos grupos de enfoque antes y dos después de la formación. Para interpretación de datos se utilizó el análisis temático. Los participantes se dieron cuenta de que las acciones de salud en las escuelas deben realizarse continuamente y de forma interdisciplinaria. Esta investigación destaca que la formación continua es importante para la sensibilización de los profesionales en la interdisciplinariedad. (AU)

This study aimed at analyzing the perceptions of health and education professionals about interdisciplinarity in health promotion at school before and after a continuing education program on self-regulation for self-care and health promotion. An exploratory and descriptive qualitative study was conducted with 26 health and education professionals, who participated in two focus groups before the program and two after it. Thematic analysis was used to interpret the data. The participants realized that school health actions must be carried out continuously and in an interdisciplinary manner. This study highlights that continuing education is important for raising awareness of interdisciplinarity among professionals. (AU)

Now Is Our Time to Act: Why Academic Medicine Must Embrace Community Collaboration as Its Fourth Mission.

In his Leadership Plenary at the Association of American Medical Colleges (AAMC) annual meeting, "Learn Serve Lead 2020: The Virtual Experience," president and CEO David Skorton emphasized that the traditional tripartite mission of academic medicine-medical education, clinical care, and research-is no longer enough to achieve health justice for all. Today, collaborating with diverse communities deserves equal weight among academic medicine's missions. This means going beyond "delivering care" to establishing and expanding ongoing, two-way community dialogues that push the envelope of what is possible in service to what is needed. It means appreciating community assets and creating ongoing pathways for listening to and learning from the needs, lived experiences, perspectives, and wisdom of patients, families, and communities. It means working with community-based organizations in true partnership to identify and address needs, and jointly develop, test, and implement solutions. This requires bringing medical care and public/population health concepts together and addressing upstream fundamental causes of health inequities. The authors call on academic medical institutions to do more to build a strong network of collaborators across public and population health, government, community groups, and the private sector. We in academic medicine must hold ourselves accountable for weaving community collaborations consistently throughout research, medical education, and clinical care. The authors recognize the AAMC can do better to support its member institutions in doing so and discuss new initiatives that signify a shift in emphasis through the association's new strategic plan and AAMC Center for Health Justice. The authors believe every area of academic medicine could grow and better serve communities by listening and engaging more and bringing medical care, public health, and other sectors closer together.

Addressing Equity in Global Medical Education During the COVID-19 Pandemic: The Global Medical Education Collaborative.

PROBLEM: The COVID-19 pandemic has presented a unique set of challenges to medical education globally. Low- and middle-income countries (LMICs) have faced unique barriers in transitioning to virtual modalities, and many medical students in LMICs experienced dramatically reduced educational time. The authors created the Global Medical Education Collaborative (GMEC) to address this problem by providing free, online, case-based tutorials to medical students in LMICs during the pandemic. APPROACH: The authors developed a needs assessment to gauge students' educational requirements, which informed GMEC's 2 primary goals: to provide free access to interactive online tutorials for students in LMICs and to bridge the physical distance between educators and learners via an online platform. A pilot program in Nigeria (April 26-May 26, 2020) helped inform the current strategy and logistics. Tutors and students were recruited via social media and medical education networks at the authors' home institutions. OUTCOMES: Within the first 2 months (April 26-June 26, 2020), 324 students representing 12 countries and 20+ medical schools joined GMEC. Additionally, 95 physicians and trainees joined as tutors and, collectively, delivered 52 tutorials. Students responded to a needs assessment querying confidence in various clinical domains, interest in covering clinical topics, barriers to virtual learning, and the effect of the pandemic on their education. Tutors held 1-hour, interactive tutorials over Zoom covering a variety of clinical topics. According to surveys, 91% of students (71 of 78) felt more confident in the material related to the tutorial's topic after participating. NEXT STEPS: GMEC will continue to engage students, tutors, and collaborators to facilitate the delivery of innovative, high-quality tutorials to students affected by COVID-19 in LMICs. To ensure that the platform is sustainable and aligned with GMEC's mission to promote equity in global medical education, the collaborative will need to be agile and responsive.

Atenção, Educação e Gestão: produções da rede Profsaúde ­ Volume 3 / Attention, Education and Management: productions of the Profsaúde network ­ Volume 3

O envelhecimento da população é um fenômeno mundial. A Organização Mundial da Saúde (OMS) estima que em 2025 existirão dois bilhões de pessoas com mais de 60 anos, com maior taxa de crescimento entre idosos com 80 ou mais anos. Esse processo destaca-se nos países em desenvolvimento, onde aumentos de até 300% da população idosa são esperados, especialmente na América Latina (OMS, 2015). No Brasil, o aumento da população idosa vem ocorrendo de forma muito rápida, sem a correspondente modificação nas condições de vida (LeiteCavalcanti, Rodrigues-Gonçalves, Rios-Aciutti & Leite-Cavalcanti, 2009). Em 2060, o percentual da população com 65 anos ou mais de idade deverá alcançar 25,5% (Instituto Brasileiro de Geografia e Estatística, 2018). Santos, Andrade e Bueno (2009) afirmam que "o envelhecimento não é um processo unitário, não acontece de modo simultâneo em todo o organismo nem está associado à existência de uma doença". Diante do envolvimento de vários fatores, este processo precisa ser entendido e planejado tendo em vista uma abordagem multidisciplinar. As diferenças na morbidade, invalidez e morte mudaram ao longo dos últimos anos. Idosos têm uma prevalência de 17% a 30% de transtornos mentais, sendo grande a associação com transtornos físicos (Garrido & Menezes, 2002; Pimenta et al, 2013). Idosos brasileiros são, em sua maioria, portadores de, no mínimo, uma doença crônica e fazem uso de medicamentos regularmente (Lima-Costa & Veras, 2003). Entre as doenças crônicas não transmissíveis (DCNT), a demência tem papel relevante, podendo o idoso apresentar sinais de declínio cognitivo

Interdisciplinarity and interprofessionality in teamwork: perceptions of multiprofessional residents in Hospital Care

Multiprofessional Health Residency Programs were created to further align health training with the needs of the population and, through an emphasis on teamwork, have been contributing to the consolidation of the Brazilian Unified Health System. The present study sought to understand the perceptions of a group of multiprofessional residents in Hospital Care about interdisciplinarity and interprofessionality within the scope of teamwork. This is a qualitative study that had the participation of 29 multiprofessional residents in the 'Hospital Care' area of concentration, all female (six psychologists, six social workers, six nurses, six physiotherapists and five nutritionists). Data were collected by means of a semi-structured interview script. The corpuswas subjected to thematic content analysis. Most of the participants: (1) reported that their first contact with the notion of interdisciplinarity occurred when they were in college, which led to them assimilating it as a synonym for joint action, and (2) claimed to have no knowledge of the notion of interprofessionality, but valued the horizontalization of relations between health professionals. Additionally, important conditions concerning both interdisciplinarity and interprofessionality were not emphasized by the participants. Further studies on the subject are needed, due to its importance for public health.

Atenção, Educação e Gestão: Produções da Rede Profsaúde ­ volume 2 Atenção, Educação e Gestão: Produções da Rede Profsaúde ­ volume 2 / Attention, Education and Management: Profsaúde Network Productions ­ volume 2

Esta obra é constituída por trabalhos produzidos no âmbito do Mestrado Profissional em Saúde da Família (PROFSAÚDE), proposta de formação que ocorre em uma rede nacional composta por 22 instituições de Ensino Superior das cinco regiões do país, coordenada pela FIOCRUZ. Trata-se do segundo volume de manuscritos organizados nos três eixos temáticos ­ Atenção, Educação e Gestão ­ alinhados à proposta pedagógica do curso. A obra tem como objetivo fortalecer a divulgação do conhecimento produzido pela Rede PROFSAÚDE e contribuir para mudanças nas práticas profissionais e de gestão da Atenção Primária à Saúde no SUS. Esperamos que a divulgação dessas experiências de pesquisa e intervenção possa inspirar outros profissionais e pesquisadores comprometidos com a defesa da Atenção Primária à Saúde pública, universal e comprometida com os preceitos democráticos do SUS.

Development of an Operative Trauma Course in Uganda-A Report of a Three-Year Experience.

BACKGROUND: Trauma is a leading cause of morbidity and mortality in low-income countries. Improved health care systems and training are potential avenues to combat this burden. We detail a collaborative and context-specific operative trauma course taught to postgraduate surgical trainees practicing in a low-resource setting and examine its effect on resident practice. METHOD: Three classes of second year surgical residents participated in trainings from 2017 to 2019. The course was developed and taught in conjunction with local faculty. The most recent cohort logged cases before and after the course to assess resources used during initial patient evaluation and operative techniques used if the patient was taken to theater. RESULTS: Over the study period, 52 residents participated in the course. Eighteen participated in the case log study and logged 117 cases. There was no statistically significant difference in patient demographics or injury severity precourse and postcourse. Postcourse, penetrating injuries were reported less frequently (40 to 21% P < 0.05) and road traffic crashes were reported more frequently (39 to 60%, P < 0.05). There was no change in the use of bedside interventions or diagnostic imaging, besides head CT. Of patients taken for a laparotomy, there was a nonstatistically significant increase in the use of four-quadrant packing 3.4 to 21.7%) and a decrease in liver repair (20.7 to 4.3%). CONCLUSIONS: The course did not change resource utilization; however, it did influence clinical decision-making and operative techniques used during laparotomy. Additional research is indicated to evaluate sustained changes in practice patterns and clinical outcomes after operative skills training.