Implicações das atividades práticas no Laboratório de Habilidades e Simulação relacionado a motivação e sentimentos dos alunos

Objetivo: verificar as implicações das atividades práticas no Laboratório de Habilidade e Simulação relacionado à motivação e os sentimentos expressos pelos estudantes universitários quando regressam às atividades presenciais após o isolamento social causado pela pandemia da COVID-19. Método: estudo quase-experimental, com um único grupo, do tipo pré e pós-teste, realizado por meio de uma intervenção educacional baseada no treino de habilidades de administração de medicamentos e punção venosa, com estudantes de medicina de uma universidade pública brasileira. A amostra foi composta por 47 estudantes. Para a coleta de dados, foram utilizados os instrumentos de caracterização dos sujeitos e sentimentos autopercebidos pelos estudantes e a Escala de Motivação Situacional. Resultados: na amostra, 98% referiram falta de atividades práticas durante a pandemia. O sentimento mais frequentemente descrito foi a ansiedade. Após a realização da atividade, observou-se uma mudança na frequência dos sentimentos expressos, embora não se tenha verificado uma mudança significativa nos níveis motivacionais. A Regulação Externa (5,1 – 5,6), a Regulação (6,1 – 6,4) e a Motivação Intrínseca (5,6 – 6,0) apresentaram resultados elevados, demostrando semelhança com os sentimentos relatados pelos alunos. Conclusão: a motivação é essencial para uma aprendizagem eficaz e a utilização de metodologias ativas reforça as habilidades construídas de uma forma efetiva nos estudantes frente ao processo de aprendizagem.

Perception of training and job perspectives among final-year residents in the specialty of Endocrinology and Nutrition.

INTRODUCTION: The medical specialisation model in Spain is carried out in the context of specialised health training, through the residency programme. The aim of the study is to analyse, by an anonymous survey, the opinion on three aspects among final-year residents in Endocrinology and Nutrition (E&N): self-assessment of the knowledge acquired, working prospects, care and training consequences arising from the pandemic COVID-19. MATERIALS AND METHODS: Cross-sectional observational study using a voluntary and anonymous online survey, shared among final-year national interns in the last year of the E&N programme, carried out between June-July 2021. RESULTS: 51 responses were obtained, 66% of the fourth-year residents. Overall perception of their knowledge was 7.8 out of 10. Most external rotations were in thyroid and nutrition areas. A total of 96.1% residents, carried out some activity associated with COVID-19, with a training deterioration of 6.9 out of 10. 88.2% cancelled their rotations and 74.5% extended their working schedule. The average negative emotional impact was 7.3 out of 10. 80.4% would like to continue in their training hospital, remaining 45.1%. 56.7% have an employment contract of less than 6 months, most of them practising Endocrinology. CONCLUSION: The perception of the knowledge acquired during the training period is a "B". Residents consider that the pandemic has led to a worsening of their training, generating a negative emotional impact. Employment outlook after completing the residency can be summarised as: temporality, practice of Endocrinology and interhospital mobility.

Virtual assistant: a tool for health co-production in coping with covid-19 / Asistente virtual: una herramienta para co-producción en salud con el fin de hacer frente al covid-19 / Assistente virtual: ferramenta para coprodução em saúde no enfrentamento à covid-19

ABSTRACT Objective: to describe the development of a virtual assistant as a potential tool for health co-production in coping with COVID-19. Method: this is an applied technological production research study developed in March and April 2020 in five stages: 1) literature review, 2) content definition, 3) elaboration of the dialog, 4) test of the prototype, and 5) integration with the social media page. Results: the literature review gathered diverse scientific evidence about the disease based on the Brazilian Ministry of Health publications and by consulting scientific articles. The content was built from the questions most asked by the population, in March 2020, evidenced by Google Trends, in which the following topics emerged: concept of the disease, prevention means, transmission of the disease, main symptoms, treatment modalities, and doubts. Elaboration of the dialog was based on Natural Language Processing, intentions, entities and dialog structure. The prototype was tested in a laboratory with a small number of user computers on a local network to verify the functionality of the set of apps, technical and visual errors in the dialog, and whether the answers provided were in accordance with the user's question, answering the questions correctly and integrated into Facebook. Conclusion: the virtual assistant proved to be a health education tool with potential to combat "Fake News". It also represents a patient-centered form of health communication that favors the strengthening of the bond and interaction between health professionals and patients, promoting co-production in health.

RESUMEN Objetivo: describir el desarrollo de un asistente virtual como posible herramienta para la co-producción en salud a fin de hacer frente al COVID-19. Método: trabajo de investigación aplicado de producción tecnológica, desarrollado en marzo y abril de 2020 en cinco etapas: 1) revisión de la literatura, 2) definición del contenido, 3) elaboración del diálogo, 4) prueba del prototipo y 5) integración con la página web del medio social. Resultados: en la revisión de la literatura se reunieron evidencias científicas sobre la enfermedad a partir de las publicaciones del Ministerio de Salud de Brasil, al igual que sobre la base de consultas en artículos científicos. El contenido se elaboró a partir de las preguntas más frecuentes de la población, en marzo de 2020, puestas en evidencia por medio de Google Trends, donde surgieron los siguientes temas: concepto de la enfermedad, formas de prevención, transmisión de la enfermedad, principales síntomas, modalidades de tratamiento y dudas. La elaboración del diálogo se basó en el Procesamiento de Lenguaje Natural, en intenciones, en entidades y en la estructura del diálogo. El prototipo se puso a prueba en un laboratorio con una cantidad reducida de computadoras usuario en una red local para verificar la funcionalidad del conjunto de aplicaciones, errores técnicos y visuales acerca del diálogo, y si las respuestas proporcionadas estaban de acuerdo con la pregunta del usuario, respondiendo correctamente los interrogantes e integrado a Facebook. Conclusión: el asistente virtual demostró ser una herramienta de educación en salud con potencial para combatir Fake News. También representa una forma de comunicación en salud centrada en el paciente que favorece el fortalecimiento del vínculo y la interacción entre profesionales de la salud y pacientes, promoviendo así la coproducción en salud.

RESUMO Objetivo: descrever o desenvolvimento de um assistente virtual como ferramenta potencial para a coprodução em saúde no enfrentamento à COVID-19. Método: trata-se de uma pesquisa aplicada de produção tecnológica, desenvolvida nos meses de março e abril de 2020 em cinco etapas: 1) revisão de literatura, 2) definição de conteúdo, 3) construção do diálogo, 4) teste do protótipo e 5) integração com página de mídia social. Resultados: a revisão de literatura reuniu evidências científicas sobre a doença a partir das publicações do Ministério da Saúde, no Brasil, e de consultas em artigos científicos. O conteúdo foi construído a partir das perguntas mais realizadas pela população, em março de 2020, evidenciadas por meio do Google Trends, em que emergiram os seguintes temas: conceito da doença, formas de prevenção, transmissão da doença, principais sintomas, formas de tratamento e dúvidas. A construção do diálogo foi baseada em Processamento de Linguagem Natural, intenções, entidades e estrutura de diálogo. O protótipo foi testado em laboratório com um número reduzido de computadores usuários em uma rede local para verificar a funcionalidade do conjunto de aplicações, erros técnicos e visuais acerca do diálogo e se as respostas fornecidas estavam de acordo com a pergunta do usuário, respondendo de forma correta os questionamentos e integrado ao Facebook. Conclusão: o assistente virtual mostrou-se uma ferramenta de educação em saúde e com potencial para combater fake news. Também representa uma forma de comunicação em saúde centrada no paciente, que favorece o fortalecimento de vínculo e interação entre profissionais de saúde e pacientes, promovendo a coprodução em saúde.

Nanomedicine and Drug Delivery Systems: Roles, Advantages and Disadvantages

Nanotechnology is a new and rapidly evolving subject in the pharmacological and therapeutic professions. Nanoparticles have many advantages as medication delivery systems, including increased efficacy and fewer adverse drug reactions. This study investigated the roles of nanomedicine and drug delivery systems in the pharmaceutical industry, as well as the advantages and disadvantages of nanotechnology. The study used a qualitative research technique, with online survey questionnaires sent to medical professionals and experts in the field of nanomedicine. These surveys comprised open-ended questions that enabled respondents to record their responses in whatever way they deemed fit. The ten respondents were from a variety of medical and health institutes, as well as medical consulting firms. In terms of results, the research established that nanomedicine had been used in medical care for therapy and diagnostic purposes. They are being explored in clinical trials for several reasons. Nanoparticles are used to treat renal disease, Tuberculosis, skin problems, Alzheimer's disease, and various types of cancer and to create COVID-19 vaccines. Further information about the study findings may be found in the results and discussion chapter.Copyright © 2022 Dr. Yashwant Research Labs Pvt. Ltd.. All rights reserved.

Virtual meetings on morbidity and mortality in Colombia: An exploratory study / Reuniones virtuales de morbilidad y mortalidad en Colombia: un estudio exploratorio

Resumen Introducción: la pandemia por la Covid-19 modificó la educación médica con estrategias apoyadas en plataformas virtuales y en escenarios no convencionales. Un ejemplo de ello son las reuniones de morbilidad y mortalidad (M y M). El objetivo de este estudio es describir las características de las M y M virtuales en las instituciones de práctica de los residentes de cirugía general en Colombia; así como la percepción de los participantes sobre su funcionamiento, comparado con las M y M presenciales o tradicionales. Método: estudio observacional y descriptivo realizado en 21 instituciones hospitalarias de práctica, de 17 programas de cirugía general de Colombia en donde operan M y M virtuales. Se obtuvo información sobre sus objetivos, características operativas y alcances. Con encuestas autodiligenciadas se investigó, además, la percepción de los participantes acerca de su utilidad y funcionamiento, producto del cambio a la virtualidad. Participaron 82 residentes y 65 docentes de diferentes programas de posgrado de cirugía general del país. Resultados: las M y M virtuales se ejecutan en el 53 % de los sitios de práctica de los residentes de Colombia, con el predominio en las instituciones privadas. Si bien hay diferencias en su organización, persiste el modelo tradicional de M y M: objetivos, estructura y alcances. Hay una duración mayor de las reuniones, se realizan en horarios no convencionales, con una percepción de un menor nivel académico. Se respira un menor ambiente de hostilidad con el uso de la virtualidad. Conclusión: las reuniones de morbilidad y mortalidad se realizan en un escenario de virtualidad. Su funcionamiento es similar a las reuniones presenciales y su ejecución ofrece oportunidades de mejora en términos de forma y fondo.

Summary Introduction: The Covid-19 pandemic changed medical education, with strategies supported by virtual platforms and non-conventional scenarios. An example of this is the morbidity and mortality meetings (M&M). The objective of this study is to find the characteristics of virtual M&M meetings in different institutions focused on general surgery resident´s students in Colombia, and how medical residents and professors feel about them compared to the traditional face-to-face meetings. Methodology: This is an observational, and descriptive study in 21 hospital practice institutions of 17 General Surgery programs in Colombia, where virtual M&M operate. Information was obtained on their objectives, operational characteristics and scope. Additionally, in self-completion surveys, the participants' perception about the usefulness and operation was investigated, this, because of the shift to virtuality. There was participation of 82 residents and 65 professors from different postgraduate programs in General Surgery in the country. Results: Virtual M&Ms continue in 53 % of the practice sites, with a predominance in private institutions. There are differences in their organization, although the traditional M&M model persists: objectives, structure, and scope. There is a longer duration of meetings, unconventional schedules and the perception of a reduced academic level. There is an improvement in the hostile environment, within the virtuality. Conclusion: M&Ms have a place in a virtual scenario. Its operation is like face-to-face meetings, and its execution offers opportunities for improvement in terms of form and content.

Chilblain: a brief history of cold comfort remedies

Chilblain, also known as pernio, has gained publicity in recent years as a result of its association with 'COVID toes' during the COVID-19 pandemic. Long before this, chilblain had left its mark throughout history and literature. The word 'chilblain' has Anglo-Saxon roots. 'Chil' comes from Old English ciele meaning 'chill' or 'frost', while 'blain' comes from the Old English blegen meaning 'inflammatory swelling' or 'sore'. The two words were brought together in the 1540s. The choice of words somehow acknowledges that cold is the aetiological factor that brings on this painful swelling. The Victorian novel Jane Erye, written by Charlotte Bronte in 1847, described the physical hardships that children had to struggle with through the winter at Lowood, the charity school for poor and orphaned girls. Her work masterfully sculptured the essence of chilblain and its effects on the children. Multiple notable figures proposed various remedies to treat the bothersome symptoms of chilblains. Pedanius Dioscorides was a Greek physician and botanist whose monumental work De Materia Medica in the first century AD compiled a list of topical remedies for chilblains, including quince oil, fenugreek oil, frankincense gum, burnt figs in wax, a mixture of gentian, crab ashes and honey, burnt ass hooves, bear grease and decoction of turnip as a warm pack. To cure chilblains, Nicholas Culpeper, an English herbalist, advised grating horseradish and applying it as a mustard plaster. We now know grated horseradish root produces a powerful mustard oil that acts as a rubefacient, which irritates the skin and increases its blood flow. Dr Lewis Johns was a recognized medical officer in the field of medical electricity in charge of the Electrical Department of St Bartholomew's Hospital. He noted a reduced incidence of chilblains in children with poliomyelitis who were treated with a warm electric footbath in 1899. The beneficial effects most likely originated from the warm bath rather than the electricity itself. Sir Thomas Lewis, a British cardiologist, investigated skin responses to injury and vascular reactions of the skin to cold exposure. His careful observations and descriptions of chilblains published in the British Medical Journal in 1941 remain true to this day. Practices such as praying to the statue of St Benignus of Dijon with chilblains, wearing electric patent socks (invented in 1882) and using an electrical vacuum tube in 1922 had also made their way into the lives of sufferers as a potential cure. Despite the epidemiological study of chilblain in over 3000 servicewomen, carried out by the Auxiliary Territorial Service in the winter of 1942, no specific remedy was found. When it comes to chilblain, prevention is better than cure by keeping the hands and feet warm and dry and staying active, and chilblains usually resolve spontaneously within a few weeks.

Operative autonomy and supervision of the surgical resident: A look at the COVID-19 pandemic / Autonomía y supervisión operatorias del residente de cirugía: Una mirada en la pandemia por COVID-19

Introducción. Al declararse la pandemia por SARS-CoV-2, se establecieron múltiples cambios en los sistemas de salud y en las instituciones hospitalarias, influyendo en la actividad quirúrgica global. El objetivo de este estudio fue evaluar el impacto de la pandemia en los niveles de autonomía y supervisión operatorias de los residentes de cirugía. Métodos. Estudio analítico cuasi-experimental, que incluyó los procedimientos quirúrgicos registrados por residentes de cirugía general de la Universidad de La Sabana, de febrero de 2019 a agosto de 2021. Se analizaron la autonomía y la supervisión mediante la escala Zwisch en los periodos prepandemia y pandemia. Resultados. Se recolectaron datos de 10.618 procedimientos en el periodo establecido, la mayoría realizados con abordaje abierto (57,4 %) y en rotaciones tronculares de cirugía general (65 %). Los procedimientos realizados más frecuentes fueron apendicectomía (18,6 %), colecistectomía (18,4 %) y herniorrafías (8,6 %). Se encontró una disminución estadísticamente significativa en los niveles globales de autonomía y supervisión entre los periodos analizados de 2, 4/4, 0 a 2, 2/4, 0 (p<0,001). Discusión. La disminución en la autonomía percibida por los residentes podría corresponder al impacto negativo en la motivación intrínseca de los individuos, en la disminución objetiva en el logro de las competencias esperadas en su proceso de formación quirúrgica y a la pérdida del relacionamiento colectivo propiciado por los aislamientos y limitaciones vividos. Conclusión. La pandemia por COVID-19 impactó negativamente en la autonomía y supervisión operatoria de los residentes de cirugía general de la Universidad de La Sabana, Chía, Colombia.

Introduction. Changes in health systems and hospital institutions due to the coronavirus pandemic influenced global surgical activity. The objective of this study was to evaluate the impact of the pandemic on the levels of autonomy and supervision in general surgery residents. Methods. Quasi-experimental analytical study. It included the surgical procedures recorded by general surgery residents of the University of La Sabana from February 2019 to August 2021. Autonomy and supervision were analyzed using the Zwisch scale in the pre-pandemic and pandemic periods. Results. 10,618 procedures were collected in the established period. Most surgeries were performed with an open approach (57,4%), in rotations of general surgery (65%). The most frequent procedures performed were appendectomy (18,6%), and cholecystectomy (18,4%), and herniorrhaphy (8,6%). There was a decrease in levels of autonomy and supervision compared between the analyzed periods from 2, 4/4, 0 to 2, 2/4, 0 (p<0.001). Discussion. The decrease in the autonomy perceived by the residents could correspond to the negative impact on the intrinsic motivation of the individuals, a decrease in the achievement of the competencies expected in their surgical training process, and the loss of the collective relationship produced by the isolation and limitations experienced. Conclusion. The COVID-19 pandemic had a negative impact on autonomy and supervision in general surgery residents of the University of La Sabana, Chia, Colombia

Home medical care for patients with covid-19 / Atención médica a domicilio en pacientes con covid-19

La atención de salud en domicilio es un servicio que brindan los profesionales sanitarios en los hogares de los pacientes en tiempos de pandemia por Covid-19; este servicio sufrió alteraciones en su proceso desde la planificación hasta la atención. Objetivo: Describir el proceso de atención medica a domicilio en pacientes con covid-19. Materiales y Método: Con el objetivo de describir el proceso de atención médica en domicilio a pacientes con Covid-19, se realiza el presente artículo elaborado como una revisión bibliográfica; de un nivel de investigación tipo descriptivo en donde se realizó un análisis sistemático de los documentos encontrados en la web. Resultados: Se encontraron estudios relacionados, donde indican que las visitas domiciliarias a personas con Covid-19 y se priorizó la identificación temprana de los signos de peligro. Conclusión: A pesar del riesgo de contagio de los profesionales de salud, continuaron realizando las visitas domiciliarias brindando una atención médica adecuada(AU)

Home health care is a service provided by health professionals in patients' homes in times of the Covid-19 pandemic; This service suffered changes in its process from planning to care. Objective: To describe the process of home health care in patients with covid-19Materials and Method: With the aim of describing the process of medical care at home for patients with Covid-19, this article is prepared as a bibliographic review; of a descriptive type research level where a systematic analysis of the documents found on the web was carried out. Results: Related studies were found, indicating that home visits to people with Covid-19 and early identification of danger signs were prioritized. Conclusion: Despite the risk of infection of health professionals, they continued to make home visits providing adequate medical care(AU)

Contexts of vulnerabilities and the production of care as themes in medical education / Os contextos de vulnerabilidades e a produção de cuidado como temas na formação médica

Resumo Este artigo analisa a oferta de um componente curricular na graduação de medicina da Universidade Federal da Paraíba. O módulo em questão foi ofertado como componente optativo, para estudantes do quarto período do curso, durante o ensino remoto emergencial imposto pela covid-19, em 2020. Seu objetivo era problematizar, por meio de rodas de conversa virtuais e outras estratégias pedagógicas participativas, os processos de vulnerabilidade e a produção do cuidado em saúde de diferentes grupos sociais. Para isso, foi utilizada uma triangulação de métodos (quanti-qualitativa) por meio da aplicação de um questionário eletrônico e entrevistas em profundidade com os discentes do módulo. Os dados do questionário passaram por uma análise descritiva, enquanto as entrevistas passaram por uma análise temática através do software IRAMUTEQ. A análise dos dados permitiu perceber os efeitos do módulo como uma forma contra-hegemônica ao modelo de formação biomédica, proporcionando um (re)posicionamento dos estudantes no âmbito acadêmico, social e médico. Percebe-se que a formação médica ainda é pautada em sistemas de opressão como o racismo, a corponormatividade e o patriarcado, porém o módulo permitiu a transgressão desse modelo biomédico ao proporcionar um processo formativo que abrange os cuidados às populações em situação de vulnerabilidade.

Abstract This article analyzes the offer of a curricular component in the undergraduate course Federal University of Paraiba. The module in question was offered as an optional component for students in the fourth period of the course, during the emergency remote teaching imposed by the COVID-19 in 2020. It aimed to problematize via virtual conversation circles and other participatory pedagogical strategies and address the processes of vulnerability and production of health care in different social groups. For this, a triangulation of methods (quanti-qualitative) was used by applying an electronic questionnaire and in-depth interviews with the students in the module. Questionnaire data underwent descriptive analysis, whereas the interviews, thematic analysis via IRAMUTEQ. Data analysis enabled us to perceive the effects of the module as a counter-hegemonic form to the biomedical training model, providing the academic, social, and medical (re)positioning of students. We observed that medical training still follows systems of oppression such as racism, corponormativity, and patriarchy but the module enabled students to transgress this biomedical model by providing a training process which encompasses care for vulnerable populations.

Academic supervision of doctors in indigenous areas during the Covid-19 pandemic / Supervisão acadêmica de médicos em áreas indígenas durante a pandemia de Covid-19 / Supervisión académica de médicos en áreas indígenas durante la pandemia de Covid-19

Trata-se de estudo qualitativo sobre o papel da supervisão acadêmica do Grupo Especial de Supervisão do Projeto Mais Médicos para o Brasil de Roraima (GES-RR) durante a pandemia de Covid-19. Foi realizada uma cartografia, com entrevistas e uma roda de conversa. Durante a pandemia, a Atenção à Saúde Indígena passou por rearranjos e a supervisão acadêmica do GES-RR exerceu-se remotamente, o que reduziu seu potencial, mas manteve sua relevância. O acolhimento dos médicos pelos supervisores potencializou a capacidade transformadora da assistência e diminuiu a sensação de isolamento e abandono. O GES-RR foi importante para a mediação de conflitos com a gestão, para a qualificação do trabalho médico, para a reflexão sobre as relações e condições de trabalho e como espaço privilegiado de Educação Permanente em Saúde. O estudo mostrou a importância dos papéis exercidos e da retomada presencial em momento oportuno.(AU)

We conducted a qualitative study to investigate the academic supervision role of the Special Supervision Group for the More Doctors Project for Brazil in Roraima (GES-RR) during the Covid-19 pandemic. We constructed a map based on interviews and conversation circles. During the pandemic, indigenous health care underwent reshaping and academic supervision was performed by the GES-PR remotely, reducing its potential but maintaining its relevance. The support provided to the doctors by the supervisors enhanced the transformative capacity of care and reduced the sensation of isolation and abandonment. The GES-RR played an important role in mediating conflicts with management, improving the quality of medical work, and stimulating reflection on working relations and conditions, and is uniquely positioned to provide permanent health education. The findings highlight the importance of the roles and of returning to face-to-face working at the appropriate time.(AU)

Se trata de un estudio cualitativo sobre el papel de la supervisión académica del Grupo Especial de Supervisión del Proyecto Más Médicos para Brasil de Roraima (GES-RR) durante la pandemia de Covid-19. Se realizó una cartografía, con entrevistas y una ronda de conversaciones. Durante la pandemia, la Atención de la Salud Indígena pasó por reorganizaciones y la supervisión académica del GES-RR se ejerció remotamente, pero mantuvo su relevancia. La acogida a los médicos por parte de los supervisores potencializó la capacidad transformadora de la asistencia y disminuyó la sensación de aislamiento y abandono. El GES-RR fue importante en la mediación de conflictos con la gestión, calificación del trabajo médico, para la reflexión sobre las relaciones y condiciones de trabajo y como espacio privilegiado de Educación Permanente de Salud. El estudio mostró la importancia de los papeles ejercidos y de la retomada presencial en momento oportuno.(AU)

Limitaciones de los estudiantes en el curso de cirugía de pregrado durante la pandemia de COVID-19.

OBJECTIVE: To know the limitations that the students encountered during the undergraduate surgery course during COVID-19 pandemic. METHOD: Through an online questionnaire, students were asked about the evaluation of the undergraduate surgery course, the limitations encountered during the course, both those perceived by themselves, and the limitations they perceived in teachers. Questions were asked about the total evaluation of the surgery course and the clinical part of the course. RESULTS: 63 students of the subject of surgery were included. The most mentioned limitations of the students were the availability of schedule and teaching material. The most mentioned limitation in relation to the teachers was the lack of technical knowledge. A relationship was found between the evaluation of the course and the interaction between the teacher and the student. CONCLUSIONS: The medical education have undergone great changes, especially the clinical part. There are several limitations in this process that can be improved by teachers and students and the perception of the quality of the course is related to the degree of interaction that teachers had with the students.

OBJETIVO: Conocer las limitaciones que los estudiantes encontraron durante el curso de pregrado de cirugía durante la pandemia de COVID-19. MÉTODO: Mediante un cuestionario en línea, se interrogó a los estudiantes acerca de la evaluación del curso de cirugía de pregrado y las limitaciones encontradas durante el curso, tanto las percibidas por ellos mismos como las que percibieron en sus maestros. Se preguntó acerca de la evaluación total del curso de cirugía y de la parte clínica del curso. RESULTADOS: Se incluyeron 63 estudiantes de la materia de cirugía. Las limitaciones de los estudiantes más mencionadas fueron la disponibilidad de horario y de material didáctico. La limitación más mencionada en relación a los maestros fue la falta de conocimientos técnicos. Se encontró relación entre la evaluación del curso y la interacción que se tuvo entre el maestro y el estudiante. CONCLUSIONES: La educación en medicina ha sufrido grandes cambios, sobre todo la parte clínica. Existen diversas limitaciones en este proceso que pueden mejorarse por parte de maestros y estudiantes, y la percepción de la calidad del curso está relacionada con el grado de interacción que los maestros tuvieron con los estudiantes.

Imagen de las secuelas pulmonares víricas en pandemias

El conocimiento de las secuelas de afectación pulmonar tras la enfermedad por coronavirus 2019 (COVID-19) es todavía limitado dado el poco tiempo de seguimiento. En este trabajo se revisan las publicaciones con seguimiento radiológico una vez superada la infección causada por otros virus descritos con anterioridad, que tienen al pulmón como órgano diana y que ocasionan un daño probablemente similar: los coronavirus causantes del Síndrome Respiratorio Agudo Severo (SARS-CoV) y del Síndrome respiratorio de oriente medio (MERS-CoV), y el virus influenza A-subtipo H1N1. El daño pulmonar ocasionado por estos virus deriva en una afectación intersticial de lenta resolución, con una probable correlación con las pruebas funcionales respiratorias. La mayor extensión de las secuelas se ha asociado a una mayor edad y una mayor gravedad del cuadro clínico infeccioso. Sin embargo, todavía se desconocen los hallazgos pulmonares observados en la imagen y su repercusión funcional a largo plazo.Alternate : Knowledge of lung sequelae after coronavirus disease 2019 (COVID-19) is still limited given the short follow-up time. In this work, publications with a follow-up of radiological findings once the infection caused by other previously described viruses that have the lung as their target organ and that cause probably similar changes are reviewed, including the coronaviruses that cause Severe Acute Respiratory Syndrome (SARS-CoV) and Middle East respiratory syndrome (MERS-CoV), and influenza A-subtype H1N1 virus. Lung damage caused by these viruses leads to slow-resolution interstitial disease, with variable correlation with respiratory function tests. The greater extension of the sequelae has been associated with an older age and a greater severity of the infectious clinical picture. However, the pulmonary imaging findings and their long-term functional impact are still unknown.

Digital educational resources as support tools for teaching general pathology in undergraduate health courses / Recursos educativos digitales como herramientas de apoyo para la enseñanza de patología general en cursos de pregrado del área de la salud

Los recursos educativos digitales se han transformado en un importante material de apoyo al proceso de enseñanza- aprendizaje, especialmente durante la pandemia por COVID-19. Estos corresponden a recursos de autoaprendizaje, generalmente en línea y de dominio público cuya disponibilidad inmediata a todo tipo de dispositivos electrónicos permite una rápida interacción del estudiante con materiales didácticos programados. El objetivo de este estudio fue evaluar el grado de satisfacción de cinco recursos educativos digitales, desarrollados como herramientas de apoyo para la enseñanza de la patología general, en estudiantes de carreras de pregrado del área de la salud de la Universidad Austral de Chile. Estudio descriptivo y exploratorio. Se desarrollaron cinco recursos educativos digitales donde se visualizan imágenes microscópicas correspondientes a procesos patológicos ocurridos en diferentes tejidos. Estos recursos fueron alojados en repositorios de la universidad y se encuentran actualmente disponibles en el canal de YouTube. Para conocer el grado de satisfacción, en sus aspectos pedagógicos y técnicos, se realizó una encuesta digital, anónima y voluntaria a estudiantes que cursaron asignaturas de patología, la que contempló cuatro dominios con sus respectivas preguntas: forma; control de usuario; contenido educativo y valoración global. El 94 % de los estudiantes calificaron el recurso de excelente o muy bueno y todos los dominios obtuvieron sobre el 80 % de satisfacción. Los contenidos representan lo que el recurso dice ofrecer, ayuda a resolver dudas y facilita la comprensión de la materia. El tamaño y color del texto es el adecuado y las imágenes presentan una excelente calidad y resolución. Los recursos cumplen con una alta calidad técnica y pedagógica, que asegura un gran potencial de uso para la enseñanza de la patología general, guiar el trabajo autónomo del estudiante y las actividades prácticas con el microscopio.

SUMMARY: Digital educational resources have become an important material to support the teaching-learning process, especially during the COVID-19 pandemic. These correspond to self-learning resources, generally online and the public domain, whose immediate availability to all types of electronic devices allows for rapid learner interaction with programmed didactic materials. The public domain and its immediate availability to all types of electronic devices allows a quick interaction of the student with self-explanatory didactic materials. The objective of this study was to evaluate the degree of satisfaction of five digital educational resources, developed as support tools for the teaching of general pathology, in undergraduate students of the health area of the Universidad Austral de Chile. Descriptive and exploratory study. Five digital educational resources have been developed where microscopic images corresponding to pathological processes occurring in different tissues are visualized these resources were hosted in university repositories and uploaded to the YouTube channel. To determine the degree of satisfaction, in their pedagogical and technical aspects, an anonymous and voluntary digital survey was carried out among students taking pathology courses, which included four domains with their respective questions: form; user control; educational content and overall assessment. The 94 % of the students evaluated the resource as excellent or very good and all domains obtained over 80 % satisfaction. The contents represent what the resource says it offers, helps to resolve doubts and facilitates the understanding of the subject. The size and color of the text is adequate, and the images present excellent quality and resolution. The resources developed offer a high technical and pedagogical quality, which guarantees a great potential for use in the teaching of general pathology, guiding the student's autonomous work and practical activities with the microscope.

A study on the utilization of Ayushman Bharat arogya scheme among patients admitted to a tertiary care hospital during Covid pandemic

Introduction and Aim: In India, most of the households face financial hardships due to catastrophic health care expenses. In response to covid-19 pandemic, the government launched the Ayushman Bharat Arogya Karnataka program, which offered health insurance for the coverage of covid-19 treatment costs and prevent families from undergoing financial hardships and incurring healthcare costs. The purpose of this study was to investigate and compare the utilization of the Ayushman Bharat insurance scheme among covid-19 positive and non-covid patients admitted to a tertiary care hospital in the Karnataka district of Dakshina Kannada. Methodology: Data was collected from medical records of a tertiary care hospital in the Dakshina Kannada District of Karnataka for this cross-sectional study. The data collected was analyzed using the Microsoft Excel program, and the results subjected to statistical analysis using IBM SPSS software ver.20. Result(s): The study found that there was a significant association between utilization of ABArK among patients (Covid and non-Covid) admitted to the hospital. While the utilization of ABArK among covid patients was found to be 51.3%, the utilization among non-covid patients was only 14.1% (chi2= 1242.32, p value <0.001). Conclusion(s): To improve the utilization of this scheme, public awareness activities must be conducted. As a result, less out-of-pocket expenditure would be incurred and access to healthcare facilities made easier. Copyright © 2022, Indian Association of Biomedical Scientists. All rights reserved.

EvaPharMed - Development and evaluation of an interprofessional education project for pharmacy and medical students: A pilot study

Introduction: Interprofessional education projects with pharmacy and medical students (PS and MS) are rare in Germany (Institut fuer Medizinische und Pharmazeutische Pruefungsfragen, 2019). However, for a future trustful collaboration personal contacts and mutual understanding are vital (Weisenborn et al., 2019). Care by an interprofessional team is beneficial for patients. According to the fifth Action Plan 2021 - 2024 to improve medication safety of the Federal Ministry of Health (2021), interprofessional collaboration is an important key element. Objective(s): The authors developed and implemented an interprofessional education project for PS and MS. The pilot study was conducted to understand the students' perceptions and to evaluate whether students were satisfied with their learning progress and would recommend this project. Method(s): The project, developed by an interprofessional team, consisted of three parts: (1) an interprofessional online seminar, (2) practical training at the Medication Management Center (MMC) and (3) a one-day internship in a general practitioner's (GP's) office. In all three parts, PS and MS performed patient-oriented casework and medication reviews together. The project was evaluated using anonymous pre- and post-questionnaires, containing the German version of the Student Perceptions of Physician-Pharmacist Interprofessional Clinical Education instrument (SPICE-2D) and open-ended questions to further evaluate the students' perceptions (Pudritz et al., 2020). The post-questionnaire asked for feedback as well as a recommendation of this project for other students, using a five-point Likert scale. Furthermore, the students' satisfaction with their learning progress was assessed. Result(s): Due to the SARS-CoV-2 pandemic, only the seminar (part 1) was performed in each term. The other parts of the project were implemented progressively. The third execution in the winter term 2021/22 was eventually able to contain all three parts. Through all executions, 105 students (46 PS, 59 MS) attended the interprofessional seminar, 64 (29 PS, 35 MS) the practical training at the MMC and nine joined the internship in a GP's office. For the seminar, 41 of 53 participants were satisfied with their learning progress and 64 of 67 students would recommend it to others. Regarding the practical training at the MMC, 37 of 46 students were satisfied with their learning progress and 45 of 47 would recommend it to others. Finally, the internship in a GP's office was mostly rated positive. Conclusion(s): Despite the pandemic, the interprofessional education project was successfully implemented. The insights gained from the evaluation will be used to adapt the project and its evaluation, eventually. Moreover, the development of further interprofessional education projects will benefit from the gained understanding. The focus of the evaluation of the main study will shift to the students' perceptions towards patient-oriented casework and medication reviews. In addition to the questionnaires, guided individual interviews will be used.

Antidepressant and Antipsychotic Prescribing Following Icu Admission Due to Covid-19

INTRODUCTION: Patients with post-intensive care syndrome (PICS) suffer from a constellation of cognitive, mental, and physical effects. Previous studies have demonstrated increased antidepressant prescribing in patients with PICS. The purpose of this study was to examine the rates of antidepressant and antipsychotic use in patients with PICS following critical illness due to COVID-19. METHOD(S): This was a retrospective chart review of adult patients (>18 years old) with PICS following critical illness due to COVID-19 who had at least 1 visit to the ICU survivor clinic at IU Health between September 2020 and July 2022. Patients were excluded if they were never admitted to the ICU, were admitted to a non IU Health ICU, or if they had incomplete medical records. The primary endpoint was the rate of combined antidepressant and antipsychotic use before ICU admission compared to their last clinic visit. The chi-square test was used to compare nominal data. RESULT(S): A total of 117 patients presented to the survivor clinic during the study time period. 35 patients were included in the analysis. Patients had a mean (+/- SD) age 53 (+/- 17) years and tended to be Caucasian 23 (66%) with low rates of having a college degree 6 (17%). During their ICU stays patients there were high rates of mechanical ventilation 24 (69%). While use of ECMO 9 (26%) and documented delirium 10 (28%) were less frequent. Underlying conditions identified at the initial clinic visit included cognitive impairment 20 (57%), depression 11 (31%), anxiety 8 (23%), and PTSD 4 (11%). Antidepressant and antipsychotic use was higher at the last clinic visit when compared to prior to ICU admission [16 (46%) vs. 5 (14%);p=0.0041]. At the time of the last clinic visit none of the 16 patients were receiving an antipsychotic while all were receiving an antidepressant. CONCLUSION(S): Patients with PICS following critical illness due to COVID-19 have an increased rate of antidepressant prescribing use compared to pre-illness. Further research is needed regarding the management and outcomes of these patients following critical illness due to COVID-19.

Risk Factors Associated with Hospitalization among 0 to 21 Years Old Patients with Active Asthma/Active Airway Disease: Preliminary Findings from Multi-Center Study Across United States

Background. More data are needed to understand the risk for COVID-19 severity among pediatric asthma patients. We present findings from a national registry characterizing COVID-19 hospitalizations among pediatric asthma patients. Methods. Data were obtained from the Pediatric COVID-19 US Registry, which included medical records of COVID-19 cases < 21 years old between March 2020 and May 2021. Those with asthma were eligible while immunocompromised and transplant cases were excluded. Descriptive statistics and chi-square tests were performed. Results. Of the 1089 eligible asthma cases, half were 12 to 17 years old [Figure 1], the majority were male [Figure 2], a third Black African American [Figure 3], and most were Non-Hispanic/Latino 825 (76%). 242 (22%) reported a history of smoking. A fourth of cases (257 (23.6%) were hospitalized for COVID-19. More than half (54%) reported asthma as their only pre-existing condition. The majority (n=71, 28%) were taking regular inhaled corticosteroids. Almost half (n=120, 47%) had abnormal chest radiographic findings, 20 (7.8%) had abnormal CT findings, and 24 (9%) progressed to lower respiratory infection. About 10% (n=25) needed mechanical ventilation. A third (n=88, 34%) required ICU care with 33% of those receiving inhaled corticosteroids. A quarter needed mechanical ventilation [Figure 5]. Compared to asthma patients not hospitalized for COVID-19, those hospitalized were significantly (P< 0.05) more likely to be non-Hispanic, have multiple pre-existing conditions, and be obese [Figure 6]. Compared to those not admitted to ICU, ICU cases were significantly more likely to be obese and be diagnosed with MIS-C [Figure 7]. Demographics Conclusion. This is one of the first national studies examining COVID-19 among pediatric cases with asthma. Our data suggest that children with asthma who have multiple pre-existing conditions and/or are obese have a higher risk for hospitalization. These early data may aid clinicians in developing future prospective studies to understand COVID-19 risk among this vulnerable population. (Figure Presented).

Tele-Emergency Care May Improve Access to Emergency Care Resources While Reducing Need for In-Person Emergency Department Evaluation

Study Objectives: Access to timely emergency medical care is essential to the US health care system but can be particularly challenging for individuals in rural communities and those with physical impediments, strained economic resources, and increased susceptibility to nosocomial COVID-19 infection. Emergency care access is further impacted by emergency department (ED) crowding and limited resources. Telemedicine presents an innovative solution towards improving this access. We aim to evaluate the final disposition of patients utilizing the Veterans Health Administration Desert Pacific Veterans Integrated Service Network's (VISN 22) novel Tele-Emergency Care program (TEC) to describe the efficacy of this innovative option in increasing Veterans' access to care and conserving ED resource utilization. Method(s): Veterans who called the VA Clinical Contact Center (CCC) Monday through Friday, 7a to 7p PST, were triaged via a Triage Expert Dual Purpose protocol. If patients were triaged to a recommended follow-up interval (RFI) of needing medical care in either a 0-2-hour or a 2-8-hour time window, consenting patients were routed to the VISN 22 TEC program. TEC clinicians consisted of emergency physicians and experienced advanced practice providers. After evaluation, TEC clinicians recorded their final dispositions as: (1) Resolved (completing the care encounter virtually);(2) Referred to ED;(3) Referred to Urgent Care (UC);or (4) e911 Activated by Tele-ED Clinician (activating emergency medical transport). Care resolution included ordering of outpatient laboratory and/or imaging studies, outpatient prescription medications, or scheduled outpatient referral to Primary or Specialty Care for further evaluation. Veterans initially triaged to a virtual evaluation but who later declined seeing a clinician were labeled as "Patient Self-Cancelled". Result(s): From March 2021 through April 2022, 7140 patients were referred to the 0-2-hour RFI and 9928 to the 2-8-hour RFI. Among those triaged to a 0-2-hour RFI, 3706 (51.9%) had their care resolved, 2697 (37.8%) were referred to an ED, 468 (6.6%) were referred to UC, 217 (3.0%) were cancelled by the patient, and 52 (0.7%) required e911 activation. Among those triaged to a 2-8-hour RFI, 6716 (67.6%) had their care resolved, 1949 (19.6%) were referred to an ED, 832 (8.4%) were referred to UC, 412 (4.1%) were cancelled by the patient, and 19 (0.2%) required e911 activation. Conclusion(s): Prior to VISN 22 Tele-Emergency Care implementation, Veterans who called the CCC and were triaged to a 0-2-hour or a 2-8-hour RFI would be referred to the nearest ED or UC. TEC provided eligible Veterans with a virtual expert consultation option to address their acute care needs. After implementation, more than half of Veterans triaged to either a 0-2-hour or a 2-8-hour RFI had their care resolved virtually, potentially reducing low-value and low-acuity ED visits and preserving resources for higher acuity and critical patients. Further research is needed to assess which presenting complaints were most amenable to telehealth evaluation, the economic impact to the VA health care system, and the rate of short-term unanticipated ED or UC visits despite TEC case resolution. No, authors do not have interests to disclose Copyright © 2022

Covid-19: knowledge, risk perception, trust and vaccination readiness among German medical students

Introduction: The Covid-19 pandemic has highlighted the urgency for innovative vaccine strategies since the best of vaccines cannot be useful if people do not accept vaccinations. The current situation suggests that vaccinology has been ignored in the medical curriculum and needs more representation in teaching. Objective(s): What, where and how vaccinology is taught during medical studies in Heidelberg and development of an interdisciplinary revised syllabus and practice-oriented teaching methods. Method(s): Curricular mapping of courses on the topic of "vaccination", defining new learning objectives for designing innovative teaching units in consultation with teachers and students, redevelopment and updating of teaching materials. Result(s): In preliminary work, an OSCE has been created by students. Initial findings on the status of teaching on vaccinations and related communication skills in medical schools of Germany with respect to student needs and the national guidelines on learning goals for future physicians are submitted in journal 'Vaccine'. In collaboration with the elective track Digital Medicine, two tele- OSCEs, an online knowledge quiz on vaccination education and a corresponding evaluation tool will be developed in WS 2021/22. Students will learn how to create modern teaching methods and evaluate them scientifically, using a concrete and relevant topic as an example, and will gain an insight into teaching. Conclusion(s): The findings will be integrated into the Heidelberg medical school curriculum (HeiCuMed) on a long-term basis by developing a comprehensive interdisciplinary module 'Vaccination and Vaccines', which can either be integrated into various existing courses (e.g. virology, medical Communication, global health, etc) or as a separate elective interprofessional course.

Online training in radiology during the COVID-19 pandemic.

The COVID-19 pandemic has changed the methods used for teaching radiology in medical schools, residency programs, and continuing medical education. The need to continue training in radiology in a situation requiring physical distancing has led to the massive use of online methods, and this is where internet has provided a solution to mitigate the problem. This paper aims to present a series of useful, freely accessible resources that share the #FOAMRad philosophy for online training in radiology during the COVID-19 pandemic.