Catering for the Needs of Diverse Patient Populations: Using ChatGPT to Design Case-Based Learning Scenarios.

Artificial intelligence (AI) represents an opportunity for medical education to enhance efficiency, interactivity, and realism in learning scenarios. This project uses it to identify angles we have not considered before, particularly in creating culturally sensitive educational cases that represent the needs of a diverse patient population. The implementation showed encouraging results, as the ChatGPT algorithm was successful in writing cases that are more culturally sensitive; however, iteration for refinement was needed. An evolution of these prompts and resulting cases are presented. AI-generated material is only as good as the prompts we use, and how we define the task depends on digital literacy and pedagogical intent.

Use of Novel Homochiral Thioureas Camphor Derived as Asymmetric Organocatalysts in the Stereoselective Formation of Glycosidic Bonds.

We synthesized six new camphor-derived homochiral thioureas 1-6, from commercially available (1R)-(-)-camphorquinone. These new compounds 1-6 were evaluated as asymmetric organocatalysts in the stereoselective formation of glycosidic bonds, with 2,3,4,6-tetra-O-benzyl-D-glucopyranosyl and 2,3,4,6-tetra-O-benzyl-D-galactopyranosyl trichloroacetimidates as donors, and several alcohols as glycosyl acceptors, such as methanol, ethanol, 1-propanol, 1-butanol, 1-octanol, iso-propanol, tert-butanol, cyclohexanol, phenol, 1-naphtol, and 2-naphtol. Optimization of the asymmetric glycosylation reaction was achieved by modifying reaction conditions such as solvent, additive, loading of catalyst, temperature, and time of reaction. The best result was obtained with 2,3,4,6-tetra-O-benzyl-D-galactopyranosyl trichloroacetimidates, using 15 mol% of organocatalyst 1, in the presence of 2 equiv of MeOH in solvent-free conditions at room temperature for 1.5 h, affording the glycosidic compound in a 99% yield and 1:73 α:ß stereoselectivity; under the same reaction conditions, without using a catalyst, the obtained stereoselectivity was 1:35 α:ß. Computational calculations prior to the formation of the products were modeled, using density functional theory, M06-2X/6-31G(d,p) and M06-2X/6-311++G(2d,2p) methods. We observed that the preference for ß glycoside formation, through a stereoselective inverted substitution, relies on steric effects and the formation of hydrogen bonds between thiourea 1 and methanol in the complex formed.

Well-being variations on students of health sciences related to their learning opportunities, resources, and daily activities in an online and on-crisis context: a survey-based study.

BACKGROUND: Universities' training process intensely relies on face-to-face education. The COVID-19 pandemic interrupted it and forced them to reinvent their process online. But this crisis seems not to be the last we will face, and we take it as a lesson to prepare for future crises. These critical contexts are especially challenging because they imply changing teaching strategies, and students may not have the technology access or the living conditions to connect as they need. They also lived through a pandemic where the virus and the life changes added stress to their learning process and threatened their well-being. So, this study aims to analyze how well-being variations reported by Health sciences students relate to their learning opportunities, access conditions, and daily activities. METHOD: We surveyed 910 Health sciences students from six different Chilean universities at the end of the first semester of 2020, the first in pandemic conditions. Respondents answered online questionnaires about 1) Remote teaching activities, 2) Learning resources availability, 3) Daily life activities, and 4) Well-being changes. We performed descriptive analysis and Structural Equation Modelling. RESULTS: Live videoconference classes were the most frequent teaching activity; only a third of the students had quiet spaces to study online, and most had to housekeep daily. More than two third reported some well-being deterioration. The structural equation model showed a good fit. CONCLUSION: Results show an online learning scenario that tries to emulate traditional learning focusing on expositive strategies. Most students reported that their well-being deteriorated during the semester, but tutorials, workplace availability, and social support were protective factors.

Results and effects of patients who have recovered from COVID-19: identifying the relationship with risk factors and comorbidities / Resultados e efeitos dos pacientes que se recuperaram da COVID-19: identificação da relação com fatores de risco e comorbilidades

Abstract The number of deaths from COVID-19 is closely associated with multimorbidities. This study aimed to review the clinical and functional conditions of patients who recovered from COVID-19. Additionally, identify the relationship with risk factors and comorbidities. Systemic arterial hypertension (SAH) was more frequently observed in patients with severe COVID-19. Diabetes mellitus (DM) is one of the comorbidities that has contributed the most to the increase in the number of hospitalizations due to complications and the number of deaths due to infection by COVID-19. Obesity has been shown to be a risk factor for hospitalization in patients with COVID-19 under 60 years of age. Most survivors of COVID-19 suffer primarily from muscle fatigue or weakness. In addition, patients who were more seriously ill during their hospital stay have greater impairment of functional capacity, pulmonary diffusion and fatigue symptoms, and are the main target population for long-term recovery interventions. To optimize the post-hospitalization rehabilitation of patients after discharge from COVID-19, the need for multidisciplinary work in rehabilitation, the reinforcement of public policies to ensure equity in access to the public health system and training should be considered of the health team in view of the new demands and realities generated by COVID-19.

Resumo O número de mortes por COVID-19 está intimamente associado a multimorbidades. O presente estudo teve como objetivo revisar as condições clínicas e funcionais de pacientes que se recuperaram da COVID-19. Adicionalmente, identificar a relação com fatores de risco e comorbidades. A hipertensão arterial sistêmica (HAS) foi observada com mais frequência em pacientes com COVID-19 grave. O diabetes mellitus (DM) é uma das comorbidades que mais tem contribuído para o aumento do número de internações por complicações e do número de óbitos por infecção por COVID-19. A obesidade demonstrou ser um fator de risco para hospitalização em pacientes com COVID-19 com menos de 60 anos. A maioria dos sobreviventes da COVID-19 sofre principalmente de fadiga ou fraqueza muscular. Além disso, os pacientes que estiveram mais gravemente enfermos durante sua internação hospitalar apresentam maior prejuízo da capacidade funcional, pior difusão pulmonar e sintomas de fadiga, sendo assim a população-alvo para intervenções de recuperação a longo prazo.. Para otimizar a reabilitação pós-hospitalização de pacientes após alta por COVID-19, deve-se considerar a necessidade de trabalho multiprofissional na reabilitação, o reforço das políticas públicas para garantir a equidade no acesso ao sistema público de saúde e o treinamento da equipe de saúde frente às novas demandas e realidades geradas pelo COVID-19.

The training of a new social-responsible generation of health professionals with a patient-centered vision / A formação de uma nova geração socialmente responsável de profissionais de saúde com uma visão centrada no paciente

Abstract The challenges that Latin America faces in health are deeply related to others, such as access to clean water, the right to education, and housing. Health professionals that work in an environment where the population faces constant barriers to accessing care in the public health system or has limited resources to pay for it in a private sector will face an ethical dilemma, the question of how to honor the call to care for patients when there is not enough support system or infrastructure to do so. Within the schools of medicine and health sciences, the question is how to train students to face or resolve these conflicts. The social responsibility approach is a proposal that allows the alignment of education for health professionals and health systems to contribute to the creation of an effective, equitable, and sustainable system. The present article aims to discuss this problem from the importance of training health professionals, ethical and committed to their communities, that have the skills and attitudes to implement a patient-centered vision. The involvement of universities and training institutions of the next generation of health professionals cannot be postponed.

Resumo Os desafios que a América Latina enfrenta em matéria de saúde estão profundamente relacionados a outros, como o acesso à água limpa, o direito à educação e à moradia. Os profissionais de saúde que trabalham em um ambiente onde a população enfrenta constantes barreiras ao acesso aos cuidados no sistema público de saúde ou tem recursos limitados para pagá-los em um setor privado enfrentarão um dilema ético, a questão de como honrar o chamado para cuidar dos pacientes quando não há sistema de apoio ou infraestrutura suficiente para fazê-lo. Dentro das escolas de medicina e ciências da saúde, a questão é como treinar os estudantes para enfrentar ou resolver estes conflitos. A abordagem da responsabilidade social é uma proposta que permite o alinhamento da educação dos profissionais de saúde e dos sistemas de saúde para contribuir para a criação de um sistema eficaz, equitativo e sustentável. O presente artigo visa discutir este problema a partir da importância de formar profissionais de saúde, éticos e comprometidos com suas comunidades, que tenham as habilidades e atitudes necessárias para implementar uma visão centrada no paciente. O envolvimento de universidades e instituições de treinamento da próxima geração de profissionais de saúde não pode ser adiado.

Healthy living behaviors in youth: a comparative study in Brazil, Colombia and Mexico / Comportamentos saudáveis de vida em jovens: um estudo comparado no Brasil, na Colômbia e no México

Abstract The physical, mental and social well being, refers to a new concept of health, far from a conceptualisations of absence of disease Additional challenges emerge as individuals face deep social inequities depending on their ethnicity, rural residence or low educational level, as these translate to poor access to health services and more difficulties to adhere to healthy living behaviors. The objective of this study was to assess the perception that adolescents and young adults in Latinamerica have of the importance of healthy living behaviors (HLB) in the physical, emotional and lifestyle spheres. The approach is considered quantitative and descriptive with a cross sectional design. The sampling consisted of 192 young adults in Brazil, Colombia and Mexico. The results show that participants prioritize higher emotional wellbeing. They state that the health crisis changed the perception, as now the value more the emotional side of health, and understand the status of a combination of the different aspects of wellness. The Latinamerican context poses a challenge in designing strategies with a holistic health perspective, with complexities in the economic and sociocultural domains.

Resumo O completo bem-estar físico, mental e social se refere a um novo conceito de saúde, muito além da ausência de doenças. Se os indivíduos são confrontados com profundas desigualdades sociais, em que fatores como etnia, moradia em zona rural ou baixo nível educacional se traduzem em um acesso menos adequado aos serviços de saúde, podendo ser um desafio adicional para aderir a comportamentos de vida saudável. O objetivo deste estudo foi avaliar a percepção de adolescentes e adultos jovens na América Latina sobre a importância dos comportamentos de vida saudável (CVS) nas esferas física, emocional e de estilo de vida. A abordagem é considerada quantitativa e descritiva, com desenho transversal. A estratégia de amostragem foi por conveniência. A amostra foi composta por 192 adultos jovens em três países da América Latina: Brasil, Colômbia e México. Os resultados mostram que os participantes priorizam um maior bem-estar emocional. Eles afirmam que a crise de saúde mudou a percepção, pois agora valorizam mais a saúde emocional e compreendem a importância da combinação dos diferentes aspectos do bem-estar. O contexto latino-americano desafia o desenho de estratégias com uma perspectiva holística da saúde, com complexidades nos domínios econômico e sociocultural.

Results and effects of patients who have recovered from COVID-19: identifying the relationship with risk factors and comorbidities.

The number of deaths from COVID-19 is closely associated with multimorbidities. This study aimed to review the clinical and functional conditions of patients who recovered from COVID-19. Additionally, identify the relationship with risk factors and comorbidities. Systemic arterial hypertension (SAH) was more frequently observed in patients with severe COVID-19. Diabetes mellitus (DM) is one of the comorbidities that has contributed the most to the increase in the number of hospitalizations due to complications and the number of deaths due to infection by COVID-19. Obesity has been shown to be a risk factor for hospitalization in patients with COVID-19 under 60 years of age. Most survivors of COVID-19 suffer primarily from muscle fatigue or weakness. In addition, patients who were more seriously ill during their hospital stay have greater impairment of functional capacity, pulmonary diffusion and fatigue symptoms, and are the main target population for long-term recovery interventions. To optimize the post-hospitalization rehabilitation of patients after discharge from COVID-19, the need for multidisciplinary work in rehabilitation, the reinforcement of public policies to ensure equity in access to the public health system and training should be considered of the health team in view of the new demands and realities generated by COVID-19.

Healthy living behaviors in youth: a comparative study in Brazil, Colombia and Mexico.

The physical, mental and social well being, refers to a new concept of health, far from a conceptualisations of absence of disease Additional challenges emerge as individuals face deep social inequities depending on their ethnicity, rural residence or low educational level, as these translate to poor access to health services and more difficulties to adhere to healthy living behaviors. The objective of this study was to assess the perception that adolescents and young adults in Latinamerica have of the importance of healthy living behaviors (HLB) in the physical, emotional and lifestyle spheres. The approach is considered quantitative and descriptive with a cross sectional design. The sampling consisted of 192 young adults in Brazil, Colombia and Mexico. The results show that participants prioritize higher emotional wellbeing. They state that the health crisis changed the perception, as now the value more the emotional side of health, and understand the status of a combination of the different aspects of wellness. The Latinamerican context poses a challenge in designing strategies with a holistic health perspective, with complexities in the economic and sociocultural domains.

The training of a new social-responsible generation of health professionals with a patient-centered vision.

The challenges that Latin America faces in health are deeply related to others, such as access to clean water, the right to education, and housing. Health professionals that work in an environment where the population faces constant barriers to accessing care in the public health system or has limited resources to pay for it in a private sector will face an ethical dilemma, the question of how to honor the call to care for patients when there is not enough support system or infrastructure to do so. Within the schools of medicine and health sciences, the question is how to train students to face or resolve these conflicts. The social responsibility approach is a proposal that allows the alignment of education for health professionals and health systems to contribute to the creation of an effective, equitable, and sustainable system. The present article aims to discuss this problem from the importance of training health professionals, ethical and committed to their communities, that have the skills and attitudes to implement a patient-centered vision. The involvement of universities and training institutions of the next generation of health professionals cannot be postponed.

Profesionalismo en tiempos de crisis: análisis de las principales controversias éticas durante la pandemia del COVID-19 / Professionalism in times of crisis: the analysis of the main ethical controversies during the COVID-19 pandemic

El cuidado del equipo interprofesional de salud es un factor indispensable para que el sistema sanitario funcione de manera estable y resi-liente, especialmente cuando la presión se vuelve extrema. La pandemia, además de poner a prueba los sistemas de salud y sus actores, ha dejado algunas dudas respecto a los alcances del profesionalismo, frente a las demandas y expectativas que la sociedad tiene. Para efectos de la presente revisión, el concepto de profesionalismo en tiempos de crisis incluye controversias y dilemas que surgen en la relación con la sociedad, ética profesional y responsabilidad sobre el autocuidado. El compromiso y la resiliencia para garantizar el cuidado del paciente son evidentes en el actuar de los profesionales de la salud; sin embargo, en ocasiones esto ha ido en detrimento de su propia integridad física y moral. La agenda de salud en México está en deuda con médicos, residentes y profesionales de enfermería, una vía para saldarla es a través del fortalecimiento de las instituciones, la definición de políticas y normativas institucionales que promuevan el autocuidado y, entre otras medidas, el establecimiento de sistemas que no obliguen a aquéllos a convertirse en héroes enfrentados a los riesgos de una crisis.

The care of the interprofessional health team is an indispensable factor for the health system to function in a stable and resilient manner, especially when the pressure becomes extreme. In addition to putting health systems and their actors to the test, the pandemic has left some doubts about the scope of professionalism in the face of society's demands and expectations. For this review, the concept of professionalism in times of crisis includes controversies and dilemmas that arise in the relationship with the community, professional ethics, and responsibility for self-care. Commitment and resilience to ensure patient care are evident in the actions of health professio-nals; however, at times, this has been to the detriment of their own physical and moral integrity. The health system in Mexico is indebted to physicians, residents, and nursing professionals, and a way to settle it is through the strengthening of institutions, the definition of institutional policies and regulations that promote self-care, and, among other measures, the establishment of systems that do not force them to become heroes facing the risks of a crisis.

Ageist No More: Interprofessional Training for Undergraduate Healthcare Students.

Ageism seeps deep into our society, whether in law, policies, or healthcare practices it segregates individuals based on their age. The aim of this work was to evaluate the impact of an educational strategy in ageist attitudes against older adults in healthcare undergraduate students. A five-week intervention: Healthy environments and self-care for the older adults was implemented. To assess the impact of this strategy in ageist attitudes in participants, a simulated consultation with an older adult was conducted. Participants' perspectives on the experience were collected using an online survey. One hundred and thirty-eight undergraduate students from health programs were included. They highlighted growth in the understanding of the normal aging process and the prejudices that surround aging. During the role-play activity, participants identified communication, empathy, and professionalism as the abilities developed with this strategy and the need to show empathy and avoid prejudice against older adults in their clinical interactions. Educational interventions are a great tool to promote cultural changes, diminish prejudices and misconceptions of ageism in future healthcare professionals.

Using a digital whiteboard for student engagement in distance education.

The COVID-19 pandemic transformed educational processes across different educational levels. As institutions and faculty members effort focused on guaranteeing academic continuity, the challenge was how to translate the learning methodologies applied in the classroom to virtual settings. A digital whiteboard was integrated to synchronous class sessions to complement the educational experience. During these sessions, students and teachers interacted to co-construct ideas and socialize learning. The objective of this study was to assess the impact of introducing a digital whiteboard in student engagement. The quantitative approach integrated student's perception through an online survey with 12 items. The results show that the students enjoyed the dynamic(4.56), students believe that the incorporation of digital whiteboard contributed to understanding abstract concepts(4.83), and perceived the resource contributed for class engagement(4.72). The design of educational projects that incorporate these resources translate to active learning dynamics which foster student engagement.

Estudio de la relación entre estrategias de aprendizaje y desempeño académico en estudiantes de medicina / Study of the relationship between learning strategies and academic performance in medical students

ntroducción: las estrategias de aprendizaje utilizadas por los estudiantes de medicina han evolucionado con el paso del tiempo, avanzando de modelos más tradicionales hacia la autodirección y autonomía del aprendizaje, propios de un aprendiz de por vida. El objetivo de este estudio fue evaluar la relación entre estas estrategias de aprendizaje y el desempeño académico de estudiantes de medicina. Materialesymétodos: el enfoque y diseño de la investigación es cuantitativo y correlacional. La muestra consistió en 144 estudiantes de una universidad privada del norte de México. Como instrumento se utilizó el cuestionario para la evaluación de las estrategias de aprendizaje de los estudiantes universitarios, y una pregunta donde los estudiantes reportaban su desempeño académico con el promedio acumulado. El análisis de datos considera el uso de estadística descriptiva a fin de explorar el desempeño académico y estrategia, y correlacional para entender la vinculación entre escalas. Como factor de interés para el análisis se integraron también las variables de género, edad, y grado de escolaridad del padre y madre. Resultados: los estudiantes muestran una media y desviación estándar (DE) de 9,22±0,41 en el desempeño académico (escala del 1 al 10). Las estrategias de aprendizaje con medias más altas fueron motivación intrínseca con una media de 4,69±0,56 y valor de la tarea con una media de 4,67±0,54. Las tendencias menos favorables fueron en atribuciones externas con media de 2,55±0,78 y repetición simple con una media de 2,82±1,12. La correlación entre las variables de desempeño académico y las subescalas de estrategias es débil, varían entre -0,01 con la subescala de componentes afectivos y 0,16 con la subescala de estrategias de control del contexto, interacción social y manejo de recursos. Discusión: los resultados del desempeño académico reportados por los estudiantes son congruentes con los altos parámetros de selección del programa de medicina. La falta de relación entre esta variable y las estrategias de aprendizaje contradicen la creencia de que la selección y activación de estas estrategias determina el desempeño. Es importante que al interior de los programas se estudien las estrategias utilizadas por los estudiantes, a fin de facilitar recursos para movilizarlos y potenciar su aprendizaje.

Introduction: The learning strategies used by medical students have evolved, moving from more traditional models to self-direction and autonomy of learning, part of life-long-learners. The objective of this study was to assess the relationship between learning strategies and the academic performance of medical students.Methods: The focus and design of the research are quantitative, correlational, and cross-sectional. The sample consisted of 144 students at a private university in northern Mexico. As an instrument, we used the Questionnaire to assess university students' learning strategies and a self-report of grades average on the program. The analysis of data analysis considers descriptive statistics to explore academic performance and each strategy and correlational to understand the link between the scales. As a factor of analysis, the variables of gender, age, and degree of schooling of the father and mother were used. Results: The results show a mean and standard deviation (SD) of 9.22±0,41 in academic performance (scale of 1 to 10). The strategies with the highest mean were intrinsic motivation with a mean of 4.69±0.56, and task valuation with a mean of 4.67±0.54. The lowest score were found on external attribution with a mean of 2.55±0.78 and simple repetition with a mean of 2.82±1.12. The analysis indicates that the correlation between academic performance and the strategies of the different subscales is weak, varying between -0.01 with the subscale of affective components and 0.16 with the subscale of context control strategies, social interaction, and resource management.

Current Activities Centered on Healthy Living and Recommendations for the Future: A Position Statement from the HL-PIVOT Network.

We continue to increase our cognizance and recognition of the importance of healthy living (HL) behaviors and HL medicine (HLM) to prevent and treat chronic disease. The continually unfolding events precipitated by the coronavirus disease 2019 (COVID-19) pandemic have further highlighted the importance of HL behaviors, as indicated by the characteristics of those who have been hospitalized and died from this viral infection. There has already been recognition that leading a healthy lifestyle, prior to the COVID-19 pandemic, may have a substantial protective effect in those who become infected with the virus. Now more than ever, HL behaviors and HLM are essential and must be promoted with a renewed vigor across the globe. In response to the rapidly evolving world since the beginning of the COVID-19 pandemic, and the clear need to change lifestyle behaviors to promote human resilience and quality of life, the HL for Pandemic Event Protection (HL-PIVOT) network was established. The 4 major areas of focus for the network are: (1) knowledge discovery and dissemination; (2) education; (3) policy; (4) implementation. This HL-PIVOT network position statement provides a current synopsis of the major focus areas of the network, including leading research in the field of HL behaviors and HLM, examples of best practices in education, policy, and implementation, and recommendations for the future.

Understanding the dimensions of a strong-professional identity: a study of faculty developers in medical education.

BACKGROUND: Faculty developers are regularly involved in training medical educators to enhance their teaching excellence through workshops and other formats. By exemplifying professional and institutional values, faculty developers may profoundly impact how other educators perceive their own professional identity. OBJECTIVE: The objective of this study was to understand how the professional identity of faculty developers is formed. DESIGN: A qualitative approach was used, with a semi-structured interview. The sample consisted of 10 medical educators. A deductive thematic analysis based on Bolivar et al. (2004a) model of professional identity formation for medical educators was carried out. RESULTS: Self-image was impacted favorably through social recognition from students and peers, and the belief of having demonstrated professional competence through job assignments and enrollment in different leadership positions. The social relations to the center or department in which the faculty developer participates were strongly related to job satisfaction. Expectations about the future of the profession included positive attitudes toward change brought by generational differences. Regarding the process of construction of professional identity, life stories and dissimilar professional careers converge in the same educational setting. Faculty developers regularly resort to self-reflection, with a desire to continue learning and developing. They are resilient and purposeful, even in negative experiences that they have faced as identity crises. They share an awareness in building a legacy for the patients, their families, and the community through nurturing new generations of health-care practitioners. CONCLUSIONS: The interviewed faculty developers have a strong-professional identity that is characterized by a stable sense of self, strong behavioral repertoire, and key associations with a community of practice.