Identification of factors associated with resilience in medical students through a cross-sectional census.

OBJECTIVES: Research on resilience has been gaining momentum, and it has already been shown that increased resilience creates positive changes at the individual and collective levels. Understanding of the factors associated with resilience may guide specific actions directed towards different populations. The objective of this study was to investigate these associated factors within a population of medical students. DESIGN: Cross-sectional census. SETTING: A public medical school in the state of Rio de Janeiro, Brazil. PARTICIPANTS: Out of a total of 551 medical students, five students were excluded due to inactive registrations, and four transferred students were also excluded, resulting in a total of 542 remaining participants. MEASURES: Adopting an anonymous questionnaire that included the Resilience Scale, in addition to questions related to sociodemographic, behavioural health-related and academic variables, the association between these variables and resilience was investigated. RESULTS: The high rate of answers to each item constitutes a indication of students' interest in participating, whereas the lowest percentile was 97.1%. The mean resilience score obtained was considered moderate. Factors such as gender, race, previous schools attended, financial independence, living situation, parents' education level, religion, quota-based admission, smoking, alcohol abuse and use of illegal drugs were not associated with resilience. In a multivariate analysis using ordinal logistic regression, associations were maintained only between the highest resilience score and the non-use of habit-forming prescription drugs (OR: 0.58; 95% CI 0.41 to 0.80), having a better perception of one's own health (OR: 0.57; 95% CI 0.41 to 0.81) and being older (OR: 1.37; 95% CI 1.12 to 1.67). CONCLUSION: The census performed with the medical students showed, with the multivariate analysis, that besides age, the variables most closely tied with resilience were health and medicalisation, and the variables connected with income and religion showed no association.

Academic leagues: a Brazilian way to teach about cancer in medical universities.

BACKGROUND: Performance of qualified professionals committed to cancer care on a global scale is critical. Nevertheless there is a deficit in Cancer Education in Brazilian medical schools (MS). Projects called Academic Leagues (AL) have been gaining attention. However, there are few studies on this subject. AL arise from student initiative, arranged into different areas, on focus in general knowledge, universal to any medical field. They are not obligatory and students are responsible for the organizing and planning processes of AL, so participation highlights the motivation to active pursuit of knowledge. The objective of this study was to explore the relevance of AL, especially on the development of important skills and attitudes for medical students. METHODS: A survey was undertaken in order to assess the number of AL Brazilian MS. After nominal list, a grey literature review was conducted to identify those with AL and those with Oncology AL. RESULTS: One hundred eighty of the 234 MS were included. Only 4 MS selected held no information about AL and 74.4 % of them had AL in Oncology. The majority had records in digital media. The number of AL was proportional to the distribution of MS across the country, which was related to the number of inhabitants. CONCLUSIONS: The real impact and the potential of these projects can be truly understand by a qualitative analysis. AL are able to develop skills and competencies that are rarely stimulated whilst studying in traditional curriculum. This has positive effects on professional training, community approach through prevention strategies, and development on a personal level permitting a dynamic, versatile and attentive outlook to their social role. Besides stimulating fundamental roles to medical practice, students that participate in AL acquire knowledge and develop important skills such as management and leadership, entrepreneurship, innovation, health education, construction of citizenship. Oncology AL encourage more skilled care to patients and more effective policies for cancer control.

Medicalização da saúde da mulher: mulheres esterilizadas em maior risco de histerectomia / Medicalization of women's health: sterilezed women at higher risk of histerectomy

Na maioria dos estudos as mulheres 'submetidas à ligadura tubária (LT) apresentam, mais freqüentemente, histerectomia (HT) subseqüente, mas a presença de um mecanismo causal biológico tem sido questionada. Com o objetivo de investigar a presença dessa associação e identificar possíveis determinantes, foram analisados dados seccionais relativos a 1.945 mulheres participantes da Fase I (ano de 1999) do Estudo Pró-Saúde. Essa população de estudo incluiu somente indicações de HT não relacionadas ao parto ou por causa benigna. As variáveis analisadas representam três dimensões: posição socioeconômica, acesso/utilização dos serviços de saúde e estilo de vida. A análise de correspondência e a análise multinomial viabilizaram comparações que evidenciaram perfis distintos. Para realização da LT encontrou-se, como fator de risco, uma maior paridade e baixa escolaridade. Para realização de histerectomia observou-se a maior idade e a menor renda e, para realização de ambos os procedimentos, a utilização de serviços de saúde passou a ser relevante. Na regressão logística simples, observou-se associação entre ligadura tubária e histerectomia (OR= 1,9; IC95 por cento: 1 ,4-2,6). Entretanto, quando controlada por potenciais confundi dores essa associação perde a significância estatística (OR=1,2; IC95 por cento:O,9-l,7), levando a supor que essa associação pode ser justificada por mecanismos distais macrossociais e não por mecanismos biológicos

[Correspondence analysis for the evaluation of women's profile during post-menopause and hormone replacement therapy]. / Análise de correspondência para avaliação do perfil de mulheres na pós-menopausa e o uso da terapia de reposição hormonal.

This study illustrates the use of correspondence analysis to identify distinct profiles characterizing hormone replacement therapy (HRT) users and non-users, allowing the visualization of concurrent characteristics associated with this self-selection process. We analyzed cross-sectional information provided by 195 women reporting natural menopause, among 2,240 participants in the Pro-Saude Study (Rio de Janeiro, Brazil). Non-users had an unfavorable profile, including greater weight gain during adult life, older age, later menopause, and less schooling. This analytic tool should be used more extensively in public health research, in exploratory analyses of the relations among a large number of variables in key populations.

Análise de correspondência para avaliação do perfil de mulheres na pós-menopausa e o uso da terapia de reposição hormonal / Correspondence analysis for the evaluation of women's profile during post-menopause and hormone replacement therapy

Neste estudo ilustra-se a utilização da técnica de análise de correspondência na caracterização do perfil das usuárias e das não-usuárias da Terapia de Reposição Hormonal (TRH). Analisou-se dados seccionais de 195 mulheres com relato de menopausa natural, entre 2.240 participantes do Estudo Pró-Saúde (Rio de Janeiro). As mulheres não-usuárias da TRH apresentaram perfil mais desfavorável em relação às usuárias dessa terapia, por exemplo, ganho ponderal mais acentuado na vida adulta, idade mais avançada, menopausa mais tardia e menor nível de escolaridade. O uso desta ferramenta analítica deveria ser estimulada na área da saúde, em análises exploratórias das inter-relações entre um grande número de variáveis em populações de interesse.