Mental health support services for medical students: a systematic review / Serviços de apoio à saúde mental do estudante de Medicina: uma revisão sistemática

Abstract: Introduction: Considering the high prevalence of mental health problems among medical students, medical schools should be ethically committed to promote student's mental health, offering health services and prevention strategies. Objective: The objective of this systematic review is to identify scientific publications on mental health services offered by Brazilian universities to medical students, as well as the professionals involved and the types of interventions most often offered. Method: Systematic literature review, following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). The Scielo, PubMed/Medline, Lilacs, ERIC, The Cochrane Library and CAPES databases were searched for studies published until August 2020, as well as theses and dissertations. The studies were screened, selected, analyzed and relevant data were extracted by two independent reviewers. Results: 16 studies were included. The identified mental health services resort to different strategies towards a common goal of promoting medical students' mental health. The interventions most frequently found in these services are brief psychotherapy, psychiatric care, psychological-educational guidance and mentoring programs. Most services were created to attend medical students and some of these have been extended to other undergraduate students. In the analyzed services, there is a predominance of multidisciplinary teams, which differ regarding the number and categories of professionals involved. Conclusion: Mental health support services for medical students in Brazil differ both in terms of how they work within the institutions and in terms of the involved professionals. It was observed that publications on these services are scarce when compared to the number of institutions that offer the undergraduate medical course in Brazil. Aiming to expand and consolidate actions aimed at promoting medical students' mental health in Brazilian higher education institutions, further research on this topic is required.

Resumo: Introdução: Considerando a alta prevalência de problemas de saúde mental entre estudantes de Medicina, as instituições que formam profissionais médicos têm o compromisso ético de se preocupar com a promoção da saúde mental de seu corpo discente, oferecendo serviços de apoio e desenvolvendo estratégias de prevenção. Objetivo: Esta revisão tem como objetivo identificar publicações científicas sobre serviços de assistência oferecidos aos estudantes de Medicina nas instituições de ensino superior do Brasil, bem como informações sobre os profissionais que os compõem, o público-alvo atendido e os tipos de intervenção mais utilizados. Método: Trata-se de revisão sistemática de literatura, orientada pelas diretrizes do Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Foi realizada busca por estudos nas bases de dados SciELO, PubMed/Medline, Lilacs, ERIC, The Cochrane Library e Catálogo de Teses e Dissertações da Capes, sem delimitação de tempo, publicados até agosto de 2020. Em seguida, duas revisoras, de forma independente, selecionaram os estudos e extraíram os dados pertinentes para a construção desta revisão. Resultado: Foram incluídos 16 estudos. Os serviços de apoio identificados atuam por meio de estratégias diversas com o objetivo comum de promoção da saúde mental do estudante. As intervenções mais encontradas nesses serviços são atendimento psicoterápico breve, atendimento psiquiátrico, orientação psicopedagógica e programas de mentoring. A maioria dos serviços foi implementada para atender estudantes de Medicina, e alguns ampliaram seu alcance a discentes de outros cursos de graduação. Em relação aos profissionais que compõem esses serviços, encontramos equipes multiprofissionais que variam em número e categorias profissionais envolvidas. Conclusão: Os serviços de apoio destinados ao estudante de Medicina no Brasil apresentam diferenças tanto quanto à forma de atuação dentro das instituições como quanto aos profissionais envolvidos. Verificou-se que as publicações sobre esses serviços são escassas quando comparadas ao número de instituições que oferecem o curso de graduação em Medicina no Brasil. A fim de ampliar e consolidar ações voltadas para a promoção da saúde mental do estudante de Medicina dentro das instituições de ensino superior brasileiras, mais pesquisas sobre essa temática são necessárias.

Longitudinal study: lifestyle and cardiovascular health in health science students / Estudio longitudinal: estilos de vida y salud cardiovascular de estudiantes de ciencias de la salud

Background: Changing lifestyle habits is considered the principal measure for the control of blood pressure and obesity. The aim of this study was to characterize the eating habits, anthropometric characteristics, physical fitness and blood pressure of students of health science degrees during the first three academic years and to explore the relation between the aforementioned parameters. Methods: This was a longitudinal study conducted over three years on the eating habits and physical fitness of health science students (n=366) and the influence of these factors on blood pressure and obesity. Results: The mean food group intakes of both female and male participants corresponded to a high consumption of lean and fatty meat, sweets and pastries and a low consumption of cereals, fruits, vegetables, olive oil, fish, nuts and vegetables. Blood pressure and obesity-related parameters were within normal ranges and did not change over the study period. Aerobic capacity values increased in men from the beginning to the end of the study, while V02 max decreased in women between the first and second years. Conclusion: We note that, in both women and men, blood pressure values were lower when diet was high in vegetables, legumes, nuts, fish and olive oil. In both sexes, we found a negative correlation between aerobic capacity and systolic and diastolic blood pressure and a positive correlation between obesity and blood pressure. The pattern of the eating habits and changes therein were different in young women and men, the former being focused on improving their diet and the latter on improving their physical fitness (AU)

Objetivo: Cambiar los hábitos de vida se considera la principal medida para el control de la presión arterial y la obesidad. El objetivo de este estudio fue caracterizar los hábitos alimentarios, características antropométricas, condición física y la presión arterial de los estudiantes de grados de ciencias de la salud durante los tres primeros años académicos y analizar la relación entre los parámetros antes mencionados. Métodos: El estudio fue un estudio longitudinal llevado a cabo durante los tres primeros años de universidad, donde se midieron los hábitos alimenticios y la condición física de los estudiantes de grados de ciencias de la salud (n = 366) y la influencia de estos factores sobre la presión arterial y la obesidad. Resultados: El consumo de alimentos tanto de mujeres como de hombres, se correspondió con un consumo excesivo de carne magra y grasa, dulces y pasteles; y un bajo consumo de cereales, frutas, verduras, aceite de oliva, pescado, frutos secos y legumbres. Los parámetros de la presión arterial y de la obesidad se sitúan dentro de la normalidad y no varían a lo largo del periodo de estudio. Los valores de la capacidad aeróbica aumentaron en los hombres desde el principio hasta el final del estudio, mientras que V02 max disminuyó en las mujeres entre el primer y segundo año. Conclusiones: Observamos que tanto en las mujeres como en los hombres, los valores de presión arterial fueron más bajos cuando la dieta era rica en verduras, legumbres, frutos secos, pescados y aceite de oliva. En ambos sexos, se encontró una correlación negativa entre la capacidad aeróbica y la presión arterial sistólica y diastólica y una correlación positiva entre la obesidad y la presión arterial. El patrón de los hábitos alimentarios y los cambios a lo largo de los tres años, fueron diferentes en las mujeres y los hombres. Las mujeres se centran más en la mejora de su dieta y los hombres en la mejora de su condición física (AU)

Fee-paying systems and service patterns in a Hong Kong dental clinic.

OBJECTIVE: This study aimed to describe and compare patients' consumption of dental services and dentists' productivity in a university campus clinic before and after changing from a time-based to an item-based fee-paying system. METHOD: Data were collected from the University of Hong Kong dental clinic which serves all university students and staff. A time-based fee-paying system had been in use up to February 1999 when it was switched to an item-based system. Computerised records of all patients in two 1-year periods starting from February 1996 and February 1999 were analysed. RESULTS: The percentages of eligible users who attended the University dental clinic were similar in the two study periods (30% in 96/97 vs 29% in 99/00). However, on average, patients consumed more dental service items in a year after the switch in fee-paying system (3.2 vs 4.1). There was also an increase in the mean number of dental service items provided by a dentist per working week after the change in fee-paying system (71.5 vs 99.4). CONCLUSION: On switching from a time-based to an item-based fee-paying system, dentists in the UHS dental clinic became more productive and the consumption of dental services per patient also increased.

Prevalencia de molestias premenstruales en una población universitaria de Quito

Las molestias premensuales son un trastorno coún de consulta diaria, cuyo concepto, etiología, fisiología y tratamiento aún no están bien definidos, aunque su investigación ha alcanzado grandes adelantos en muchos casos son incapacitantes y afectan a gran cantidad de mujeres, se presentan en la segunda fase del ciclo menstrual y cesan al iniciarse la menstruación. En este trabajo se realizó la investigación de 60 mujeres estudiantes comprendidas entre los 18 y 25 años de edad, de las cuales el 86 por ciento (n=48), presentaron molestias premenstruales; de estas, en el 88 poor ciento (n=42) las molestias afectaron en grado leve a moderado las actividades diarias, y en el 6 por ciento la afección fue grave con ausentismo estudiantil y laboral. Las molestias que más frecuentemente se encontgraron fueron acné (79por ciento), irritabilidad, cambios de humos (75 por ciento), depresión (72 por ciento), hinchazón del abdomen (72 por ciento), cansancio (65 por ciento) mastalgia (58 por ciento), ansiedad (47 por ciento) resultados que coinciden con estudios publicados en otros países...