Profissão médica

 
Vale a pena ser Médico

( Homenagem que presto a este grande ser humano que foi Rubem Alves )





1933 - 2014

Clique aqui para ler um pouco sobre este grande brasileiro

Traditional Medicine

Aldeia Indígena de Piaçaguera, em Peruíbe - litoral paulista, lança Cartilha que visa Resgatar a Medicina Tradicional Tupi Guarani

                                                                                     Dra. Elizabeth Cristina Garcia de Carvalho 

                                                                                                                             
Assim como brancos e negros, os índios também estão perdendo o conhecimento dos mais velhos em relação as plantas medicinais, mas felizmente ainda tem iniciativas que estão resgatando estes conhecimentos. No dia 11 de junho em Peruíbe, no litoral paulista, foi lançado na aldeia indígena  Piaçaguera, uma cartilha: “Folhas e Raízes - Resgatando a Medicina Tradicional Tupi Guarani".

A ideia surgiu quando uma criança teve dor de barriga na escola indígena e eles não tinham remédios para aliviar a dor.  Os professores, a princípio, ficaram sem saber o que fazer, mas depois lembraram que a planta "nhimbogwé regwá" (macelinha), era usada antigamente para este fim, então fizeram um chá e a criança melhorou. A partir deste fato, os professores Luan Elisio Apyka e Dhevan Pacheco tiveram a iniciativa de procurar os Anciãos da tribo e o Pajé, para que eles ensinassem as crianças e os professores sobre o uso das plantas da medicina tradicional indígena.

Os alunos se sentiram muito valorizados com a presença dos Anciãos na escola transmitindo seus conhecimentos e logo perceberam a profunda importância daquilo tudo que estava acontecendo, além disso, se deram conta de como é importante que eles próprios, futuramente, possam dar continuidade à transmissão desta sabedoria para as futuras gerações. A partir de então, Anciãos, professores e crianças foram juntos para a mata, em busca de conhecer o habitat destas plantas, aprendendo no próprio local a reconhecer, como colher e como  utilizar cada uma delas.

Com a ajuda da Comissão Pro-Índio de São Paulo e apoio das Secretarias de Educação do município e do estado, parte este trabalho foi concretizado numa cartilha, que será distribuída a todas as aldeias da região e outras.

Na ocasião do lançamento, compôs-se uma mesa com os professores e representantes de várias entidades, e os alunos da escola deram início a uma apresentação de cânticos e danças ritmados por instrumentos tradicionais como a flauta, o chocalho, tambores e violões, transformando tudo em algo muito além de uma simples apresentação, mas num verdadeiro ritual de agradecimento. Em seguida, presenciamos diversas manifestações feitas pelos representantes das Secretarias de Educação do Estado e Município, da Comissão Pró-Índio, FUNAI, dos próprios Anciãos, bem como da diretora e professores da escola, culminado num delicioso almoço tradicional, seguindo tarde adentro com cânticos e danças circulares, que encantou a todos com uma alegria revigorante!

Através do site  www.cpisp.org.br, os interessados podem adquirir esta cartilha escrita em português e em Tupi Guarani, promovendo também um estímulo ao resgate da língua.

*Drª Elizabeth Cristina Garcia de Carvalho, é Homeopata e Fitoterapeuta. Ao longo dos anos, como médica do Programa Saúde da Família, vem se dedicando ao desenvolvimento e incentivo de projetos voltados para o cultivo, manejo e utilização de plantas medicinais junto a comunidades, em diversos municípios nos estados do Rio de Janeiro, Minas e São Paulo.

 

EcoMedicina

Educational games

Game-based Social Skills Assessments: Making the Play for Better Emotional Health

Gamification and Social Skills Development can Work Hand in Hand to Improve Emotional Well Being and Outcomes

by Melissa DeRosier

 

Educators and parents are now seeing that games—long thought to be a waste of kids’ time—can be powerful learning tools.

Games show promise in improving students’ problem solving skills, learning motivation and engagement, and their test scores. They are also well-suited for assessments, as demonstrated in the 2010 National Education Technology Plan where U.S. Secretary of Education Arne Duncan called for more research about how “assessment technologies, such as simulations, collaborative environments, virtual worlds, games, and cognitive tutors, can be used to engage and motivate learners while assessing complex skills.”

Although games have been used mainly for learning and assessment in the core academic subjects, they hold significant promise for other areas, such as social skills.

Long-Term Effects of Positive Peer Relationships

Social skills assessments (SSA) identify children’s social skills strengths and deficits, enabling teachers, counselors, and other providers to address areas of weakness through social skills training. Through social skills training, children can learn to build positive relationships with their peers, which helps increase children’s grades, test scores, and self-esteem, as well as improve their physical and mental health.

In contrast, the effects of poor social skills are staggering. Children with poor social skills are more likely to:

• Bully others or be bullied
• Perform poorly academically
• Have more absences from school
• Drop out of school
• Have lifelong mental and physical health issues
• Become sexually promiscuous
• Engage in criminal behavior
• Commit suicide
• Have unstable relationships

Limitations of Traditional Social Skills Assessments

Effective SSA do three things:

1. Identify children who have social skill deficits and would benefit from social skills training.
2. Monitor their progress throughout the training and decide if any changes should be made to better address the child’s needs.
3. Determine if the child’s social skills improved at the end of the training, and if not, what the next steps should be.

Assessments during and after the training are important, since it may take months or longer for positive changes in children’s social skills to translate into improvements in peer relations, mental health, and academics.

SSA are only as good as the data they collect, and no traditional data collection method exists that provides high quality data and is time- and cost-effective.

For example, behavioral rating scales, the most popular data collection method, rely on self-report by children and observations by teachers. Behavioral rating scales are quick and cheap to administer and have low training requirements, which is beneficial for time-pressed teachers and money-strapped schools.

However, the data they provide is limited. The scales are not engaging to children, so children have low motivation to provide thoughtful, honest responses or to respond at all, which would affect the quality and accuracy of the data. Children may pick the answer that is most socially appropriate regardless if it reflects the child’s true behavior. Observer bias also plays a role as teachers may let their opinion of the child influence how they assess the child’s behavior, and children may behave differently when teachers are around compared to when they are with their peers, so the teacher would not be able to assess the child’s social skills accurately.

The Promise of Game-based Social Skills Assessments

This is where game-based SSA come in. Game-based SSA allow data collection that is time- and cost-efficient because teachers need minimal training to administer the assessments, and it can be administered to many children at once. And because games are capable of tracking changes in a child’s behavior over time, they can be used for progress monitoring and evaluation.

Game-based SSA are engaging to children, which helps make the data more reliable and accurate. They can also simulate common social situations, allowing a teacher to see how a child will react in a specific situation that the teacher may not have observed the child in, such as witnessing bullying or dealing with a peer who is upset.

Moreover, game-based SSA can incorporate “stealth assessment”—that is, the game collects data without the child realizing it. Children don’t change their behavior when they’re unaware they’re being assessed, making the data more accurate, and the child is focused on the situation, which provides a better approximation of how he or she would behave in a similar real-world situation.

Stealth assessment also uses information about children’s actual behaviors to manipulate facets of the game to assess children at different levels, responding to each child’s unique strengths and weaknesses and getting a better picture of the child’s social skills. Examples of stealth assessment include the number of times a particular object or character is clicked on, amount of time before a specific action is taken, and the order of actions during problem solving.

Game-based Social Skills Assessments Considerations and Best Practices

From our own research developing a game-based SSA, Zoo U, we’ve unlocked some important considerations and best practices in creating an effective game-based SSA.

First, it’s important to consult relevant research to decide which social skills to target and how to define them. A well-designed game-based SSA should rely heavily on subject matter experts—experts in child social development, education, child mental and behavioral health—to develop the content and scoring procedures that form the foundation of the virtual SSA environment.

Setting is important when designing a game-based SSA. We chose a virtual school-like world where children learn to be zookeepers. We selected this setting because it’s similar, but not identical, to a real school, so it allowed us to present virtual social situations analogous to common elementary school experiences. A setting too similar to real school life may have been boring for children, and some children may have actually experienced the social situations in real life, which would bias how they interacted with the software in ways we couldn’t know.

In SSA, skills are measured based on the child’s in-game choices and responses. Even though a section of the game may target specific social skills, each section should incorporate multiple skills, because in real life social interactions are complex and social skills are used concurrently. Response options should make the right answer difficult to figure out. For example, the game could present several options with all responses being more or less correct, with differing levels of appropriateness.

Game-based SSA should provide scenarios similar to real-life situations that children encounter, and like the real world, the choices that the child makes should influence how others in the scene respond and what subsequent options are available. Games can score the sequence itself, in addition to each individual menu choice.

The game should generate assessment reports based on the child’s choices, which tell the teacher how the child compares to his or her peers in the classroom and the country. A well-designed report can also inform teachers when a child may be gaming the system or not trying his or her best as indicated by clicking through dialogue without listening to it, clicking around too much, and picking answers at random.

While encouraged in popular entertainment games, these behaviors produce inaccurate data for assessing social skills. Game-based SSA should include accuracy checks to catch this behavior, generate warnings when this happens, and provide teachers with recommendations on how to proceed with the child. It is critical to design a game-based SSA so that the assessment and gameplay are not at odds with each other.

Choosing a Game for Assessment

Make sure that any game you employ for a SSA is based in solid research that demonstrates its validity and reliability. You must hold games to the same accuracy standards as any other SSA approach or you’ll be collecting data that undermines your social skills training goals. A cheaper or flashier game without this research base may look good, but if it results in a failed social skills training, you’ll have to implement another training to make up for it. You will then be spending more time and money than if you had opted for a research-based game from the start.

* Melissa DeRosier, Ph.D., is the founder and CEO of 3C Institute, a research and development company that develops social-emotional learning products for children, adolescents, and parents for use in schools, clinics, and community agencies, and partners with outside organizations to develop customized web-based applications for their programs and research. The company’s products, including the recently-released book, Social Skills Assessment through Games: The New Best Practice, can be found at 3C Marketplace.

3D-Models for Anatomy

Australian University 3D-prints body parts for med schools

One of the body parts in Monash University's "3D Printed Anatomy Series" Monash University

By Barry Levine

The zombie apocalypse isn’t the only factor driving up the demand for dead bodies. More medical students + people living longer = fewer cadavers for scientific research and medical education.

But Monash University in Australia has a solution: 3D-print the body parts.

Earlier this week, the university announced the availability of the first commercially available kit with 3D-printed anatomical body parts for medical education and training. The 3D Printed Anatomy Series, for which the school is seeking commercial partners, has no human tissue, but does feature such popular human components as limbs, chest, abdomen, head and neck.

“Many medical schools report either a shortage of cadavers, or find their handling and storage too expensive as a result of strict regulations governing where cadavers can be dissected,” said Professor Paul McMenamin in a statement. He’s Director of the University’s Centre for Human Anatomy Education, and the related research has been published in the journal Anatomical Sciences Education.

Any venture capitalist reading this will recognize that cadavers are an aging market solution, so to speak, that is dying for a shakeup. They are not only hard to find, but they’re expensive and smell funny because of embalming.

“Some people don’t feel that comfortable working with them,” McMenamin said.

The Anatomy Series’ value prop also includes the laudable fact that people don’t have to die so that medical students can learn. “Our 3D printed series can be produced quickly and easily,” he noted — plus they don’t deteriorate.

[Creepy goth editor's note: Real cadavers are still needed for forensics research, i.e., figuring out how long bodies take to decompose in all kinds of scenarios (underwater, in a forest, etc.) to determine approximate time of death in criminal cases.]

But the Monash body parts still need to start with an actual, you know, body.

First, real body parts are scanned with a CT or surface laser scanner to get the 3D model. Then the part is recreated layer by layer, in color, using a plaster-like power or a plastic.

However, if the same venture capitalist is still reading this, be aware that, as with the do-it-yourself kit provided by Mother Nature, giving birth to human anatomy by 3D means is a skill that can easily be replicated.

The Thingiverse 3D marketplace, for instance, is already showcasing a collection of 3D models of body parts, including a human hand skeleton, an ear, and what someone accurately describes as “my customized ass.”

This means that, at some point, any competent medical school may be able to simply print the body parts it needs. So much for Monash’s first-mover advantage.

The other drawback to the Monash solution is that the use cases for discrete body parts, provided without body tissue, do not include dissection.

But that’s only a bump in the road toward body-ordering. A year ago, for instance, Popular Science featured body parts — with tissue — that scientists can already 3D print with human cells, including ears, kidneys, blood vessels, and skin grafts.

A full body reproduced with 3D printing for dissection would be a monumental undertaking. Until that day arrives, one assumes virtual/augmented reality could help fill in the missing pieces.

The seller’s market for dead bodies is, at last, coming to an end.

Metaphors in Medicine

The Whimsical Way Medical Students Learn About The Body

By Anna Almendrala

We already knew doctors have strong stomachs. We just didn't know how strong. 

It turns out that medical education has a long and rich history of using food metaphors to describe body parts, diseases, symptoms, and everything else that students have to memorize. For instance, pus from a liver abscess looks a lot like anchovy sauce, and a particularly aggressive form of lung cancer is called "oat cell carcinoma" for its appearance under the microscope. 

Dr. Ritu Lakhtakia, M.D., Ph.D., head of the Department of Pathology at the College of Medicine at Sultan Qaboos University, compiled these medical-foodie terms in a recently published article for the journal Medical Humanities in an effort to preserve a dying tradition. Because she herself was once a med student, toiling away to memorize facts and pictures, Lakhtakia has fond memories about how culinary imagery made study time a bit more fun.

"They make memorization of difficult facts child's play," said Lakhtakia about food metaphors in an email to the Huffington Post. "They also introduce medical graduates across the world to cuisines they are unfamiliar with."

For instance, one of the tell-tale symptoms of von Recklinghausen’s disease are cafe au lait marks on the skin. Certain fungal skin infections produce skin scrapes that look like spaghetti and meatballs under a microscope. 

Unfortunately, said Lakhtakia, the tradition is dying away in favor of what she called "more direct (and less picturesque)" language. The metaphors are also becoming unnecessary because of technological advancement. Take, for example, the task of estimating tumor size. 

"Long before scale measurements came into vogue, a three-dimensional estimate of the size of tumors could be easily documented by being compared with peanuts or walnuts (if larger, lemons or oranges come in handy for sizing!)," Lakhtakia wrote in the article. 

Lakhtakia is not sure why food metaphors are so prevalent in medicine, but she guesses that the universality of food gave teachers a common base with students from which to explain difficult medical concepts. And of course, there is another reason: doctors and researchers eat while working.

"A part of this curious tradition may owe its origins to practising physicians and researchers catching up on their meals in clinical side rooms or operating theatre offices, or with an inevitably cold platter eaten with eyes glued to a microscope," she wrote in her article. "It is a wonder that, in the midst of the smells and sights of human affliction, a physician has the stomach to think of food at all!"

A wonder indeed. In honor of this quirky, stomach-churning medical tradition, Huffington Post's own Alissa Scheller whimsically illustrated just a few of the metaphors Lakhtakia included in her articles. Be warned: links to the real thing are included in each caption, so click or tap at your own peril!

"An apple shape versus a pear shape contrasts the habitus depending on the predominant fat distribution on the body." - Dr. Ritu Lakhtakia, Medical Humanities.

"The biconcavity of the red blood cell easily evokes craving for a doughnut." - Dr. Ritu Lakhtakia, Medical Humanities.

"Rather dramatic and visible reddish-purple birthmarks (vascular anomalies) on the skin are colloquially called port wine stain." - Dr. Ritu Lakhtakia, Medical Humanities.

"The delightful high that a bar of chocolate promises is negated by its likeness to chocolate cyst of the ovary, an endometriotic cyst containing dark-brown fluid from repeated cycles of endometrial proliferation and shedding with haemorrhage." - Dr. Ritu Lakhtakia, Medical Humanities.

"The pout displayed by the rheumatic mitral valve, with its narrowed opening, thickened lips and commissural fusion is mirrored in a fish mouth." - Dr. Ritu Lakhtakia, Medical Humanities.

 

"First-year medical students are inevitably taught that the kidney is bean shaped (lovers of red meat may conversely call the bean kidney-shaped)" - Dr. Ritu Lakhtakia, Medical Humanities.

Diretrizes curriculares

CFM contesta novas diretrizes curriculares de medicina

Pelas regras, as escolas de medicina terão até dezembro de 2018 para implementar as mudanças

 

O Conselho Federal de Medicina (CFM) contesta as mudanças e a maneira como foram determinadas as novas diretrizes curriculares em medicina. Mauro Luiz de Britto Ribeiro, conselheiro ​representante do Mato Grosso do Sul no CFM, chama atenção que as diretrizes de 2001 foram discutidas durante ​10 anos e que as novas mudanças foram elaboradas ao longo de seis meses. “Foi uma discussão feita às pressas e sem debate com profundidade necessária com as entidades médicas, academias e a sociedade. É preciso entender que a má formação dos médicos na atualidade decorre da abertura indiscriminada de escolas, muitas delas sem a menor condição de funcionamento. Não é com novas diretrizes que estes problemas e deficiências serão solucionados”.
​ ​
As novas diretrizes curriculares nacionais dos cursos de medicina entraram em vigor nesta semana (23/06), com a publicação da Resolução 3/2014 no Diário Oficial da União (DOU). ​Pelas regras, as escolas de medicina terão até dezembro de 2018 para implementar as mudanças. No entanto, nas turmas abertas a partir de então, o novo currículo terá um ano para ser implementado.
​ ​
Para o conselheiro não existe estrutura física hospitalar e de preceptora para criação de 12 mil novas vagas de graduação e, por consequência, de residência médica no Brasil. “Observamos que faltam critérios para que essas escolas funcionem. O que já encontramos são estruturas limitadas, sem laboratórios, hospitais de ensino e professores capacitados (especialistas, mestres e doutores)”​, disse​.

Diretrizes - Entre as principais mudanças está o estágio obrigatório no Sistema Único de Saúde (SUS), na atenção básica e no serviço de urgência e emergência. Pela resolução, o internato deve ter a duração mínima de dois anos, com 30% da carga horária cumprida no SUS.

A resolução ainda garante que os estudantes serão avaliados pelo governo a cada dois anos. A avaliação será obrigatória e o resultado será contado como parte do processo de classificação para os exames dos programas de residência médica. A prova será elaborada pelo Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira (Inep), responsável por avaliações como o Exame Nacional do Ensino Médio (Enem). O Inep tem dois anos para começar a aplicar a avaliação.​
​
​Nos últimos 24 anos, o número de escolas médicas passou de 83 para 234 (aumento de 282%). Desde 2011, passaram a funcionar 57 deles (51% privados). Este quadro ​coloca o Brasil em segundo lugar no ranking mundial, atrás apenas da Índia, país com população seis vezes maior e​ que tem​ 381 escolas.

Fonte: CFM
​

Teaching

The Hard Part

Getty Images/Score RF

By Peter Greene

They never tell you in teacher school, and it's rarely discussed elsewhere. It is never, ever portrayed in movies and tv shows about teaching. Teachers rarely bring it up around non-teachers for fear it will make us look weak or inadequate.

Valerie Strauss in the Washington Post once put together a series of quotes to answer the question "How hard is teaching?" and asked for more in the comments section. My rant didn't entirely fit there, so I'm putting it here, because it is on the list of Top Ten Things They Never Tell You in Teacher School.

The hard part of teaching is coming to grips with this:

There is never enough.

There is never enough time. 

There are never enough resources.

There is never enough you.

As a teacher, you can see what a perfect job in your classroom would look like. You know all the assignments you should be giving. You know all the feedback you should be providing your students. You know all the individual crafting that should provide for each individual's instruction. You know all the material you should be covering. You know all the ways in which, when the teachable moment emerges (unannounced as always), you can greet it with a smile and drop everything to make it grow and blossom.

You know all this, but you can also do the math. 110 papers about the view of death in American Romantic writing times 15 minutes to respond with thoughtful written comments equals -- wait! what?! That CAN'T be right! Plus quizzes to assess where we are in the grammar unit in order to design a new remedial unit before we craft the final test on that unit (five minutes each to grade). And that was before Chris made that comment about Poe that offered us a perfect chance to talk about the gothic influences, and then Alex and Pat started a great discussion of gothic influences today. And I know that if my students are really going to get good at writing, they should be composing something at least once a week. And if I am going to prepare my students for life in the real world, I need to have one of my own to be credible.

If you are going to take any control of your professional life, you have to make some hard, conscious decisions. What is it that I know I should be doing that I am not going to do?

Every year you get better. You get faster, you learn tricks, you learn which corners can more safely be cut, you get better at predicting where the student-based bumps in the road will appear. A good administrative team can provide a great deal of help.

But every day is still educational triage. You will pick and choose your battles, and you will always be at best bothered, at worst haunted, by the things you know you should have done but didn't. Show me a teacher who thinks she's got everything all under control and doesn't need to fix a thing for next year, and I will show you a lousy teacher. The best teachers I've ever known can give you a list of exactly what they don't do well enough yet.

Not everybody can deal with this. I had a colleague years ago who was a great classroom teacher. But she gave every assignment that she knew she should, and so once a grading period, she took a personal day to sit at home and grade papers for 18 hours straight. She was awesome, but she left teaching, because doing triage broke her heart.

So if you show up at my door saying, "Here's a box from Pearson. Open it up, hand out the materials, read the script, and stick to the daily schedule. Do that, and your classroom will work perfectly," I will look you in your beady eyes and ask, "Are you high? Are you stupid?" Because you have to be one of those. Maybe both.

Here's your metaphor for the day.

Teaching is like painting a huge Victorian mansion. And you don't actually have enough paint. And when you get to some sections of the house it turns out the wood is a little rotten or not ready for the paint. And about every hour some supervisor comes around and asks you to get down off the ladder and explain why you aren't making faster progress. And some days the weather is terrible. So it takes all your art and skill and experience to do a job where the house still ends up looking good.

Where are school reformy folks in this metaphor? They're the ones who show up and tell you that having a ladder is making you lazy, and you should work without. They're the ones who take a cup of your paint every day to paint test strips on scrap wood, just to make sure the paint is okay (but now you have less of it). They're the ones who show up after the work is done and tell passersby, "See that one good-looking part? That turned out good because the painters followed my instructions." And they're most especially the ones who turn up after the job is complete to say, "Hey, you missed a spot right there on that one board under the eaves."

There isn't much discussion of the not-enough problem. Movie and tv teachers never have it (high school teachers on television only ever teach one class a day). And teachers hate to bring it up because we know it just sounds like whiny complaining.

But all the other hard parts of teaching -- the technical issues of instruction and planning and individualization and being our own "administrative assistants" and acquiring materials and designing unit plans and assessment -- all of those issues rest solidly on the foundation of Not Enough.

Trust us. We will suck it up. We will make do. We will Find A Way. We will even do that when the state and federal people tasked with helping us do all that instead try to make it harder. Even though we can't get to perfect, we can steer toward it. But if you ask me what the hard part of teaching is, hands down, this wins.

There's not enough.

Originally posted at Curmudgucation

Saúde Pública

Fomento a pesquisas em Saúde Pública

A OPAS, em parceria com a Aliança de Investigação em Sistemas e Políticas de Saúde da Organização Mundial de Saúde (OMS), está com as inscrições abertas para profissionais de saúde de instituições públicas que desejam obter subsídios financeiros para realização de pesquisas que visam melhorar a implementação de programas de saúde pública nos países das Américas. O apoio financeiro é de US$ 30.000 e US$ 35.000, e as propostas podem ser inscritas até o próximo dia 31 de julho.

O objetivo é facilitar a implementação de programas de saúde dos países das Américas por meio do uso de evidências e pesquisas. Estas bolsas estão destinadas para profissionais de programas de saúde diversos temas, desde gerentes e agentes de saúde locais, que procuram executar projetos de forma mais eficaz. Os recursos podem ser usados para os custos relacionados com as atividades de pesquisadores para investigação ou para recompilação das informações, mas não para o pagamento de pessoal adicional dentro do programa.

Aqueles que obter esse suporte também receberão treinamento da OPAS/OMS e AHPSR para desenvolvimento de protocolos e realização de pesquisas, coleta e monitoramento de dados e análise. Este projeto é gerenciado pelo Departamento de Gestão do Conhecimento, Bioética e Pesquisa da OPAS/OMS.

Para mais informações sobre os critérios de elegibilidade, digite o seguinte link: 

http://www.paho.org/Hq/index.php?option=com_content&view=article&id=9684:grants&Itemid=41015&lang=es

Subsidios para mejorar la ejecución de programas
Traducción del conocimiento para acción

Presentación de solicitudes hasta el 31 de julio de 2014 inclusive

La Organización Panamericana de la Salud (OPS) y la Alianza para la Investigación en Políticas y Sistemas de Salud (AHPSR), de la Organización Mundial de la Salud (OMS), están elaborando un programa de enfoque centrado en los países para apoyar la ejecución de proyectos de cooperación técnica en la región. La iniciativa tiene por objeto facilitar la realización de mejoras en la ejecución de programas a través de investigaciones acerca de dicha ejecución integradas en los procesos existentes en América Latina y el Caribe. Se trata de propuestas centradas en los países, no de 'estudios de investigación' convencionales. Los fondos correspondientes podrán utilizarse para sufragar los costos relativos al tiempo de trabajo o las actividades de recopilación de datos de algunos investigadores, pero no para el pago de personal adicional en el marco del programa.

 Fonte – OPAS

Estratégia de Saúde da Família

Estratégia saudável

Saúde da Família trouxe avanços, mas precisa de investimentos para melhorar 

Luiz Augusto Facchini

Apesar dos problemas diariamente destacados, o SUS, implantado em 1988, acumula sucessos na universalização do direito constitucional à saúde. As ações ofertadas gratuitamente pelo sistema estão entre as mais abrangentes dentre os países com sistemas públicos, incluindo de vacinas a transplantes. E são favorecidas pela Estratégia de Saúde da Família.

Implantada em 1994, a Saúde da Família oferta ações de promoção da saúde, exames preventivos e cuidados básicos, principalmente em áreas onde reside a população mais pobre. Em julho de 2013, totalizou 34.185 equipes distribuídas em 5.309 (95%) municípios, desde as pequenas localidades do interior até as grandes cidades, atingindo e 108.096.363 pessoas (56% da população brasileira).

A iniciativa tem sido bastante avaliada e os resultados sinalizam uma tendência de melhoria do desempenho do SUS, em praticamente todos os portes de município, à medida que aumenta a cobertura. Além disso, a proporção do gasto municipal não aumentou com o incremento da cobertura, sugerindo a eficiência da estratégia.

Os indicadores e serviços melhoraram significativamente nos últimos 20 anos no Brasil, acompanhando a expansão do SUS e da cobertura de Saúde da Família. Entre 1990 e 2012, a taxa de mortalidade infantil caiu 75%, enquanto a taxa de mortalidade de menores de 5 anos foi reduzida em 77%. Nos últimos cinco anos, as internações hospitalares por diabetes diminuíram 25% e a proporção de crianças menores de 5 anos abaixo do peso caiu 67%. O crescimento da cobertura da Saúde da Família está associado à redução da mortalidade infantil e de internações por condições sensíveis à atenção primária, ao maior acesso a consultas gratuitas e ao atendimento domiciliar, especialmente em populações mais pobres.

Várias ações foram praticamente universalizadas. Mais de 95% das mulheres recebem cuidados pré-natais e a cobertura de vacinas contra difteria, tétano e coqueluche em crianças menores de um 1 ano é superior a 95% na maioria dos municípios. Os cuidados de hipertensão e diabetes e o acesso a medicamentos para essas condições alcançam a grande maioria das pessoas com os agravos.

Ainda assim, persistem problemas de estrutura (prédios, equipamentos, registro eletrônico e acesso a internet) e de organização (coordenação do cuidado multiprofissional, especialmente de problemas crônicos) na Saúde da Família e a qualidade dos cuidados deixa a desejar. Apenas 30% das pessoas com diabetes tiveram seus pés examinados, 46% dos pacientes com pressão alta realizaram eletrocardiograma e 60% das puérperas fizeram revisão pós-parto. Investimentos em infraestrutura, coordenação e qualificação dos cuidados integrais vão ser fundamentais para melhorar não apenas a efetividade, mas também a equidade em saúde, dada sua maior presença em municípios e áreas mais pobres.


* Luiz Augusto Facchini é epidemiologista e conselheiro da Associação Brasileira de Saúde Coletiva

http://oglobo.globo.com/opiniao/estrategia-saudavel-13084802#ixzz36R9UMlZK

Revalida 2014

Exame de revalidação recebe mais de dois mil inscritos

Prova simplifica o processo de reconhecimento de diplomas de medicina emitidos por instituições de ensino estrangeiras

por Portal Brasil 

A edição 2014 do Exame Nacional de Revalidação de Diplomas Médicos Expedidos por Instituições de Educação Superior Estrangeiras recebeu 2.152 inscrições. Os países que apresentaram o maior número de inscritos foram Brasil (1.111), Bolívia (523), Colômbia (124), Peru (120) e Argentina (66).

Quanto à origem do diploma, a Bolívia lidera, com 1.144 inscritos de diferentes nacionalidades. Em seguida, vêm Cuba (291), Paraguai (157) e Argentina (151).

O exame compreende duas etapas. A primeira, formada pela avaliação escrita (objetiva e discursiva); a segunda, pela avaliação de habilidades clínicas. As provas escritas ocorrem no dia 20 próximo; a de habilidades clínicas, em 27 e 28 de setembro.

Sobre o exame

O exame de revalidação foi criado para simplificar o processo de reconhecimento de diplomas de medicina emitidos por instituições de ensino estrangeiras. Para atuar como médico no Brasil, o estudante formado no exterior precisa revalidar o diploma. 

A prova é orientada pela matriz de correspondência curricular para fins de revalidação de diplomas médicos expedidos por instituições estrangeiras. Na matriz foram definidos conteúdos, competências e habilidades das cinco grandes áreas de exercício profissional — cirurgia, medicina de família e comunidade, pediatria, ginecologia-obstetrícia e clínica médica.

Fonte:  Ministério da Educação