Implementation and Evaluation of a Trainee Orientation Manual in an Intensive Care Unit Rotation.

Background: The intensive care unit (ICU) rotation places trainees in a fast-paced, high-intensity environment that requires complex patient care and multidisciplinary coordination. Trainees seek continuous medical knowledge acquisition while tasked with learning ICU-specific workflows, procedures, and policies. The unfamiliarity with rotation logistics and administrative roles and expectations could hinder the ICU rotation learning experience. A lack of standardization and material for trainee orientation to administrative ICU tasks and workflows could affect the trainee's rotation performance and overall learner satisfaction. Objective: We evaluated the implementation of an ICU trainee manual to provide trainees with a source of orientation for rotation logistics and nonclinical ICU tasks. We assessd its impact on content retention, learners' satisfaction with the manual, and overall ICU rotation experience. Methods: We designed an observational, prospective cohort study that included all trainees scheduled to rotate in the ICU during the 2020-2021 academic year. The ICU manual was delivered electronically and was available throughout the academic year. Trainees received a survey before their first ICU rotation (pretest) and 6 months after their first ICU rotation (retest) to assess content retention, trainees' perception of the ICU manual, and overall rotation satisfaction. Results: A total of 95 trainees completed the pretest survey, and 61 completed the retest survey. The target cohort response rate for each survey was 100%. Pretest scores were higher than the matched retest scores (41 of 48 [interquartile range, 37-44] vs. 38 of 48 [34-41]; P < 0.001). The median ICU manual satisfaction score was 32 of 40 (26-36.5). We found positive correlations between ICU manual trainee satisfaction score and the retest score (r[59] = 0.320; P = 0.01) and ICU rotation trainee satisfaction level (r[59] = 0.909; P < 0.001). Conclusion: Implementing an ICU manual to orient trainees to their ICU clinical rotation was well received and showed continued retention of orientation content. Higher ICU rotation trainee satisfaction levels were related to a positive perception of the ICU manual.

[The increase in domestic violence during the social isolation: what does it reveals?] / Isolamento social e o aumento da violência doméstica: o que isso nos revela?

The social isolation imposed by the COVID-19 pandemic brings out, in a empowered way, some worrying indicators about domestic violence and family violence against women. Organizations addressing domestic violence have already seen an increase in domestic violence due to forced coexistence, economic stress and fears about the Coronavirus. The article seeks to establish some relations between social isolation during the COVID-19 pandemic and the increase in violence against women, taking into account the context of a patriarchal society. Data, still incipient, published by the press of several countries were analyzed, as well as reports from international organizations and organizations focused on combating domestic violence. In parallel, a brief literature review with authors who discuss the social role of women in society.

O isolamento social imposto pela pandemia da COVID-19 traz à tona, de forma potencializada, alguns indicadores preocupantes sobre a violência doméstica e a violência familiar contra a mulher. As organizações voltadas ao enfrentamento da violência doméstica já observaram aumento da violência doméstica por causa da coexistência forçada, do estresse econômico e de temores sobre o coronavírus. O artigo busca estabelecer algumas relações entre o isolamento social durante a pandemia da COVID-19 e o aumento da violência contra as mulheres, levando em conta o contexto de uma sociedade patriarcal. Foram analisados dados, ainda incipientes, publicados pela imprensa de diversos países, bem como relatórios de organizações internacionais e organizações direcionadas ao enfrentamento da violência doméstica. Paralelamente, fez-se uma breve revisão de literatura com autores que discutem o papel social da mulher na sociedade.

Isolamento social e o aumento da violência doméstica: o que isso nos revela? / The increase in domestic violence during the social isolation: what does it reveals?

RESUMO: O isolamento social imposto pela pandemia da COVID-19 traz à tona, de forma potencializada, alguns indicadores preocupantes sobre a violência doméstica e a violência familiar contra a mulher. As organizações voltadas ao enfrentamento da violência doméstica já observaram aumento da violência doméstica por causa da coexistência forçada, do estresse econômico e de temores sobre o coronavírus. O artigo busca estabelecer algumas relações entre o isolamento social durante a pandemia da COVID-19 e o aumento da violência contra as mulheres, levando em conta o contexto de uma sociedade patriarcal. Foram analisados dados, ainda incipientes, publicados pela imprensa de diversos países, bem como relatórios de organizações internacionais e organizações direcionadas ao enfrentamento da violência doméstica. Paralelamente, fez-se uma breve revisão de literatura com autores que discutem o papel social da mulher na sociedade.

ABSTRACT: The social isolation imposed by the COVID-19 pandemic brings out, in a empowered way, some worrying indicators about domestic violence and family violence against women. Organizations addressing domestic violence have already seen an increase in domestic violence due to forced coexistence, economic stress and fears about the Coronavirus. The article seeks to establish some relations between social isolation during the COVID-19 pandemic and the increase in violence against women, taking into account the context of a patriarchal society. Data, still incipient, published by the press of several countries were analyzed, as well as reports from international organizations and organizations focused on combating domestic violence. In parallel, a brief literature review with authors who discuss the social role of women in society.

Prevalência do uso de psicotrópicos na atenção primária à saúde em um município do interior de Minas Gerais / Prevalence of psychotropic drugs use in primary health care in a city in the interior of Minas Gerais

Introdução. Desde sua introdução no suporte à saúde mental, o uso de psicotrópicos tem representado uma parcela significativa do total de fármacos prescritos na Atenção Básica à Saúde. Geralmente, a maioria dos usuários de tais drogas não é avaliada por um psiquiatra, indicando que muitos usam sem real necessidade. Objetivo. Verificar a prevalência de uso de psicotrópicos nas áreas de abrangências de Unidades Básicas de Saúde (UBS) de Barbacena. Métodos. Estudo transversal em que foi verificada a prevalência de uso de psicotrópicos entre pacientes atendidos em quatro UBS no município de Barbacena, Minas Gerais. Foram entrevistados 400 usuários, por meio de questionário elaborado pelos autores. Os testes de associações estatísticas utilizados incluíram o teste do qui-quadrado e o teste de Fischer para variáveis categóricas, além do teste t de Student para variáveis contínuas. A força da associação entre as variáveis explicativas e o desfecho estudado foi verificada por meio do cálculo do Odds Ratio. Resultados. O uso de psicotrópicos foi informado por 212 (53%) entrevistados. Entre as mulheres entrevistadas, 163 (59,0%) referiram consumo desses. Dentre os medicamentos, a classe dos benzodiazepínicos foi a mais utilizada ­ 130 (61,3%), principalmente entre aqueles com idade menor que 60 anos, sendo o clonazepam o mais prescrito desta. Conclusão. A prevalência do uso de psicotrópicos nas UBS pesquisadas foi elevada, indicando a necessidade de melhorar os cuidados na atenção à saúde mental desses pacientes. É provável que muitos desses indivíduos não apresentassem transtorno mental que justificasse o uso de medicamentos psiquiátricos. (AU)

Introduction. Since its introduction in mental health support, the use of psychotropic drugs has represented a significant portion of the total drugs prescribed, mainly at the Basic Health Unit (BHU). Most users of these drugs are not evaluated by a psychiatrist, indicating that many of them use it with no real necessity. Objective. To verify the prevalence of psychotropic drug use in areas covered by Basic Health Unit in Barbacena. Methods. Cross-sectional study in which the prevalence of psychotropic drug use was verified among patients treated at four BHUs in the city of Barbacena, Minas Gerais. 400 users were interviewed through a questionnaire prepared by the authors. The statistical association tests used included the chi-square test and the Fischer test for categorical variables, as well as the Student t-test for continuous variables. The strength of the association between the explanatory variables and the studied outcome was verified by calculating the Odds Ratio. Results. The use of psychotropic drugs was reported by 212 (53%) respondents. Among the women interviewed, 161 (76.2%) reported to consume it. Among the drugs, the benzodiazepine class was the most used - 130 (61.3%), especially those under 60 years old, being clonazepam the most prescribed one. Conclusion. The prevalence of psychotropic drug use in Barbacena's BHU coverage areas was high, indicating the need to improve care in mental health for these patients. Probably, many of these individuals did not have a mental disorder that justified the use of psychiatric medications. (AU)

Frecuencia de Toxocara sp. en los parques del distrito de Breña: Lima-Perú, 2010 / Frequency of in parks at Breña district: Lima-Peru, 2010

Toxocara Canis es un parásito cosmopolita del intestino delgado de caninos que afecta al hombre y es la causa principal del síndrome de larva migrans visceral. Existen estudios que evidencian el grado de contaminación por Toxocara sp. en parques públicos. Estudios en Lima también reportan su frecuencia en los parques según distritos. Objetivos: Determinar la frecuencia de huevos de en los parques del distrito de Breña. Métodos: Estudio de corte transversal. Se tomaron muestras de heces de canes de los parques del distrito de Breña, las cuales se analizaron por microscopía de luz y se determinó la presencia o ausencia de huevos de Toxocara Canis. Resultados: Se recolectaron 200 muestras de las cuales el 14% estuvieron contaminadas con huevos de Toxocara Canis. Del total de parques (25), se halló la presencia del parasito en el 48% (n=12). Conclusiones: Los parques del distrito de Breña muestran una frecuencia alta de huevos de este nemátodo. La frecuencia es similar a estudios previos realizados en el mismo distrito.

Toxocara Canis is a cosmopolitan parasite of canine small intestine that affects humans. It is the main cause of visceral larva migrans syndrome. Many studies show the degree of contamination by Toxocara spp. in public parks. Studies in Lima also reported its frequency in different parks by district. Aim: to determine the frequency of Toxocara canis eggs in parks at Breña district. Methods: observational, transversal study. Dog stool samples were collected from parks at Breña, and were analyzed by light microscopy to determine the presence of T. canis eggs. Results: Two hundred samples were collected, 14% of which were contaminated with Toxocara cannis eggs. Toxocara cannis was found in 48% (12/25) of Breña parks. Conclusions: parks at Breña show a high frequency of this nematode's eggs. The frequency is similar to that found by previous studies in the same district.