A study establishing sensitivity and accuracy of smartphone photography in ophthalmologic community outreach programs: Review of a smart eye camera

Purpose: Diseases affecting the cornea are a major cause of corneal blindness globally. The pressing issue we are facing today is the lack of diagnostic devices in rural areas to diagnose these conditions. The aim of the study is to establish sensitivity and accuracy of smartphone photography using a smart eye camera (SEC) in ophthalmologic community outreach programs. Methods: In this pilot study, a prospective non?randomized comparative analysis of inter?observer variability of anterior segment imaging recorded using an SEC was performed. Consecutive 100 patients with corneal pathologies, who visited the cornea specialty outpatient clinic, were enrolled. They were examined with a conventional non?portable slit lamp by a cornea consultant, and the diagnoses were recorded. This was compared with the diagnoses made by two other consultants based on SEC videos of the anterior segment of the same 100 patients. The accuracy of SEC was accessed using sensitivity, specificity, PPV, and NPV. Kappa statistics was used to find the agreement between two consultants by using STATA 17.0 (Texas, USA). Results: There was agreement between the two consultants to diagnosing by using SEC. Above 90% agreements were found in all the diagnoses, which were statistically significant (P?value < 0.001). More than 90% sensitivity and a negative predictive value were found. Conclusion: SEC can be used successfully in the community outreach programs like field visits, eye camps, teleophthalmology, and community centers, where either a clinical setup is lacking or ophthalmologists are not available.

Desafios do Brincar com Idosos: Narrativas de Estudantes de Medicina do Programa Amigos do Sorriso / Challenges of Playing with the Elderly: Medicine Students Narratives of the Amigos do Sorriso Program

Resumo: Introdução: O programa de extensão Amigos do Sorriso foi construído a partir da compreensão da extensão universitária como integrante da formação dos estudantes, ao proporcionar vivências e trocas na aproximação entre a academia e a sociedade em geral. Os participantes são estudantes da área da saúde e desenvolvem atividades lúdicas com foco no processo de humanização, na educação em saúde e nos seus efeitos multiplicadores. Desde 2010, o programa realiza atividades quinzenais numa instituição de longa permanência para idosos (Ilpi), com o objetivo de oportunizar momentos lúdicos, com estratégias criativas e comunicativas, no sentido de ressignificar a velhice por meio do brincar. Este artigo tem como objetivos descrever as vivências e compreender quais foram os aprendizados desenvolvidos pelos estudantes de Medicina nesse âmbito. Método: Trata-se de uma pesquisa qualitativa, desenvolvida a partir de 13 narrativas redigidas entre 2018 e 2019 por estudantes de Medicina que participaram das atividades lúdicas na Ilpi. Realizou-se análise temática de conteúdo dos materiais em diálogo com os referenciais teóricos e a literatura relacionada. Resultados: As três categorias temáticas foram: o brincar com o idoso, construção artesanal da comunicação e partilha entre gerações sobre o envelhecer. Os extensionistas discutiram as diversas formas do brincar, sua relação com a promoção da saúde e as especificidades de desenvolver atividades lúdicas com o idoso. Utilizaram diversas formas de comunicação para interação com os idosos, conversando, ouvindo e contando histórias e respeitando os silêncios, o que provocou encontros e desencontros, todos disparados pelo brincar. Discutiram sobre o processo de envelhecimento, a saúde do idoso, a velhice asilar e o próprio encontro de gerações por meio do qual puderam refletir sobre si mesmos. Conclusões: As atividades na Ilpi proporcionaram aos estudantes a percepção da potência das estratégias lúdicas, promotoras da autonomia e saúde, sem infantilização dos idosos. Possibilitaram o reconhecimento de estratégias para aproximação e vínculo, respeitando limites individuais e coletivos, ao compartilharem histórias e sentimentos de forma empática. Dessa forma, destaca-se o desenvolvimento de competências para o futuro médico, tanto gerais como para o cuidado com as pessoas idosas, no reconhecimento de que todos estão envolvidos no universo do florescer do envelhecimento.

Abstract: Introduction: The community outreach program Amigos do Sorriso (Friends of Smiling) is based on the understanding that community outreach programs are part of academic training because they provide experiences that result in exchanges between the students and the society. The participants are undergraduate students from the healthcare field, who develop ludic activities focusing on humanization, health education and the resulting multiplying effects. Since 2010, fortnightly activities have been conducted at an old people's home with the aim of offering playful experiences involving creative and communicative strategies, in order to give new meaning to old age through playing. The objective of this article is to describe these experiences and understand what the medicine students have learned from them. Methods: this article presents a qualitative study, based on 13 narratives written between 2018 and 2019 by undergraduate medicine students who were involved in activities at the old people's home. The content was analyzed from a thematic perspective and correlated to the theoretical framework. Results: Three thematic categories were identified: playing with the elderly, handcrafted construction of communication and sharing between generations about aging. The participants discussed the different forms of play, its relations with health promotion and the specific characteristics of developing Ludic activities with the elderly. Through play they were also able to explore various forms of communication: talking, listening, sharing stories, and respecting the moments of silence, that led to agreement and disagreement. Finally, they discussed the aging process, elderly heath, elderly people in care and the contact itself between generations, allowing the students to reflect on themselves. Conclusions: The activities in the old people's home enabled the students to appreciate the potential that strategies of play offer in terms of promoting autonomy and health, without infantilizing the elderly. It allowed them to identify strategies to form closer relationships and ties with the elderly subjects, respecting individual and collective boundaries when sharing stories and feelings with empathy. Hence the highlight of the program was the development of skills, both general and specific for elderly care, among future medics, recognizing that the aging is a process that involves us all.

Curricularização da Extensão Universitária no Ensino Médico: o Encontro das Gerações para Humanização da Formação / Curricularisation of University Community Outreach in Medical Education: Meeting of Generations for a Humanized Training

RESUMO Este trabalho relata uma experiência de curricularização da extensão universitária no curso médico que teve como objetivos conduzir ações de extensão com vistas ao bem-estar de idosas de uma Instituição de Longa Permanência (ILP), bem como desenvolver habilidades do médico honesto, íntegro, cuidadoso, altruísta e empático consigo, com os "idosos" e com os pares envolvidos nas ações. O modelo usado para organização das atividades combinou métodos de aprendizagem de habilidades por meio da experiência, reflexão crítica sobre as experiências, ambiente de pequeno grupo para suporte e validação e programa longitudinal coeso para desenvolvimento total. As atividades foram vivenciadas em grupos de 12 integrantes, supervisionados por um professor com visitas semanais à ILP de agosto a dezembro de 2018. O modelo utilizado mostrou-se útil para o desenvolvimento de características humanísticas almejadas nos indivíduos em formação. O envolvimento em todas as etapas do processo e o comprometimento com o bem-estar da população selecionada indicam que a curricularização cumpriu seu papel de proporcionar aos estudantes o desenvolvimento de consciência cidadã em paralelo à formação técnica. A instituição de ensino superior deve oferecer continuamente ações para que os estudantes desenvolvam plenamente seu lado humano e preservem as características observadas no contato com a população idosa.

ABSTRACT This work describes the experience of including community outreach activities of a university into the medical course curriculum, with the objectives of developing outreach actions directed at the well-being of the elderly from a Long Stay Institution (ILP). At the same time the work promoted the development of honest, caring, selfless professionals empathetic toward the "elderly" and peers involved in the actions. The model used to organize the activities combined methods of learning skills through experience, critical reflection on experiences, small group environment for support and validation, and a cohesive longitudinal program for total development. The activities were experienced in groups of 12 supervised by a teacher with weekly visits to the ILP from August to December of 2018. The model used proved to be useful for the development of humanistic characteristics. Involvement in all stages of the process and commitment to the well-being of the selected population indicate that the curricularisation fulfilled its role of providing students with the development of citizen awareness and technical training. The institution must continually offer actions for students to fully develop their human side and preserve the characteristics observed in their contact with the elderly population.

Estágios curriculares no SUS: experiências da Faculdade de Odontologia da UFRGS / Curriculum internships in SUS: experiences of the School of Dentistry of UFRGS

Um dos objetivos principais das propostas de mudança de paradigma no ensino odontológico do país tem sido o de conformar o perfil profissional do cirurgião-dentista de modo a torná-lo mais ajustado às exigências ditadas pelo Sistema Único de Saúde. Mas esse é um modelo de formação incipiente e que ainda carece de consensos em torno do modo como formar esses profissionais. O objetivo deste artigo é descrever e avaliar processos pedagógicos, técnicos e políticos produzidos no percurso de implantação dos estágios curriculares de odontologia da Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul, apontando aspectos envolvidos nas experiências de reorientação da formação do cirurgião-dentista para sua atuação no Sistema Único de Saúde. Foram analisadas produções escritas e depoimentos de docentes, documentos e relatórios institucionais e pesquisas escolares. As redes de atenção e ensino em saúde bucal encontram-se em processo de estruturação, desafios precisam ser superados: expansão limitada da atenção primária à saúde e, consequentemente, dos campos de estágios; necessidade de avanços nas discussões sobre o papel, atribuições e institucionalizações do preceptor/trabalhador e do tutor/docente; as incompreensões, ainda persistentes, a respeito dos estágios, tanto na instituição de ensino superior como na gestão e nos serviços do SUS; questões de financiamento; discurso hegemônico da clínica liberal-privatista e seus reflexos no embate constante entre tutores/preceptores e discentes; limites impostos pelo desenho fragmentado da rede de atenção em saúde (AU).

One of the main objectives of the proposed paradigmatic shift in dental education in the country has been to shape the professional profile of the dentist in order to make it more suited to the needs dictated by the Brazilian Public Health System (SUS). However, this dental education model is still being shaped and there is no consensus in respect to how these professionals should be trained. The aim of this article was to describe and evaluate the pedagogical, technical and policy processes created over the course of implementing the new curricular dental internships at the School of Dentistry of the Federal University of Rio Grande do Sul. The paper also discusses the aspects involved in  redirecting dental professional training towards SUS operations. Written and oral works  of the teaching staff, documents and institutional reports, as well as school research were all analyzed. Professional education / health service integration is the fundamental axis of the changes in the processes taking place both in higher education and public health service actions. However, in order for such processes to take place in effect, it is necessary to analyze and disseminate how these experiences have developed, examining the struggles and the achievements encountered along the way (AU).

An eight-year experience of implementing a pro-active approach to early detection of breast cancer in a community

OBJECTIVES: The objectives of this study were to determine the demographic as well as clinical profile of patients participating in the breast cancer community outreach program and determine if the Breast Cancer Community Outreach Program can successfully find breast cancer cases in the community.METHODS: In 2001, a breast cancer community outreach program was organized by the Vicente Sotto Memorial Center - Breast Center. The program components included breast cancer lay forum, breast self-examination (BSE) classes and breast clinic. Twenty seven breast cancer community outreach program were conducted in a span of 8 years.RESULTS: There were 1719 participants with a mean age of 32.5 years. The most common reason for consultation was breast check-up (79.6%), majority had normal breast examination findings (75.9%) and breast cancer was also identified in only 19 out of 1719 (1.1%). Most of these were early breast cancer.CONCLUSION: The Breast Cancer Community Outreach Program was not only vital in providing an-site breast cancer cases among women consulting at the community breast clinic.