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1.
Rev Assoc Med Bras (1992) ; 70(5): e20231317, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38775504

RESUMEN

OBJECTIVE: The objective of this study was to investigate the newly graduated physicians' attitudes and perceptions regarding the medical relationship with the pharmaceutical industry and identify the sociodemographic patterns related to such thinking. METHODS: A structured questionnaire was administered to 4,601 participants selected from a pool of 16,323 physicians who were registered with one of the 27 Regional Medical Councils of Brazil in 2015. Answers were analyzed using two stratification variables: type of medical school (public vs. private) and the sex of the respondents. RESULTS: Out of the participants, 61.8% believed that industry funding could support medical conferences and education, and 48.4% felt that small gifts and conference travel funding were acceptable. Conversely, 64.7% disagreed with industry-sponsored social events. Views on whether pharmaceutical representatives' visits influenced prescriptions were divided. Statistically significant differences were observed between genders and medical school types, with men and private school graduates being more accepting of certain industry interactions. CONCLUSION: The study highlights the nuanced attitudes of new doctors toward industry relationships, indicating the need for clearer ethical guidelines and education in medical schools to align practice with evolving societal values.


Asunto(s)
Actitud del Personal de Salud , Industria Farmacéutica , Médicos , Humanos , Industria Farmacéutica/ética , Brasil , Masculino , Femenino , Encuestas y Cuestionarios , Médicos/psicología , Médicos/estadística & datos numéricos , Adulto , Percepción , Conflicto de Intereses , Estudios Transversales , Factores Socioeconómicos , Donaciones/ética , Facultades de Medicina , Persona de Mediana Edad , Factores Sexuales
2.
Rev. Assoc. Med. Bras. (1992, Impr.) ; Rev. Assoc. Med. Bras. (1992, Impr.);70(5): e20231317, 2024. tab
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1558936

RESUMEN

OBJECTIVE: The objective of this study was to investigate the newly graduated physicians' attitudes and perceptions regarding the medical relationship with the pharmaceutical industry and identify the sociodemographic patterns related to such thinking. METHODS: A structured questionnaire was administered to 4,601 participants selected from a pool of 16,323 physicians who were registered with one of the 27 Regional Medical Councils of Brazil in 2015. Answers were analyzed using two stratification variables: type of medical school (public vs. private) and the sex of the respondents. RESULTS: Out of the participants, 61.8% believed that industry funding could support medical conferences and education, and 48.4% felt that small gifts and conference travel funding were acceptable. Conversely, 64.7% disagreed with industry-sponsored social events. Views on whether pharmaceutical representatives' visits influenced prescriptions were divided. Statistically significant differences were observed between genders and medical school types, with men and private school graduates being more accepting of certain industry interactions. CONCLUSION: The study highlights the nuanced attitudes of new doctors toward industry relationships, indicating the need for clearer ethical guidelines and education in medical schools to align practice with evolving societal values.

3.
Rev Assoc Med Bras (1992) ; 69(6): e20230108, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37283362

RESUMEN

OBJECTIVE: The objective of this study was to evaluate fresh medical graduates' perceptions regarding the general aspects of ethics teaching in Brazilian medical schools. METHODS: A structured questionnaire was applied to 4,601 participants among the 16,323 physicians who registered in one of the 27 Regional Medical Councils of Brazil in 2015. Answers to four questions regarding general aspects of ethics education in medical school were analyzed. Sampling procedures involved two stratification variables: legal nature (public vs. private) of medical schools and monthly household income higher than 10 minimum wages. RESULTS: A large percentage of the participants had witnessed unethical behaviors during contact with patients (62.0%), toward coworkers (51.5%), and in relationships with patients' families (34.4%) over the course of their medical training. Even though most of the responders (72.0%) totally agreed that patient-physician relationship and humanities education were part of their medical school curriculum, important topics such as conflicts of interest and end-of-life education were not satisfactorily addressed in the participants' medical training. Statistically significant differences were found between the answers of public and private school graduates. CONCLUSION: Despite great efforts to improve medical ethics education, our findings suggest the persistence of deficits and inadequacies in the ethics training currently given in medical schools in Brazil. Further modifications in ethics training must be made to address the deficiencies shown in this study. This process should be accompanied by continuous evaluation.


Asunto(s)
Educación Médica , Médicos , Humanos , Facultades de Medicina , Brasil , Estudios Transversales , Curriculum , Ética Médica , Percepción
4.
Prev Vet Med ; 213: 105869, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36773375

RESUMEN

Dogs are thought to be highly exposed to environmental pathogenic leptospires, possibly acting as potential sources of infection for zoonotic transmission. Vaccination stands as the cornerstone strategy to prevent disease and urinary shedding in dogs, yet the success of vaccination is highly dependent on the correspondence of leptospires circulating locally with those used in vaccine compositions. To provide evidence for vaccine compatibility, and to assess whether there are regional differences on serogroup distribution, we conducted a systematic review with meta-analysis on serological data, characterization of leptospiral isolates and risk factors for seropositivity in dogs from Brazil. Studies reporting canine leptospirosis within the Brazilian territory were eligible for inclusion, and methodology was validated by PROSPERO under registration CRD42020204187. Six electronic databases were searched, and data regarding population, methods, and outcomes were extracted. Sixty-one studies were included to access serogroup distribution and risk factors, with a pooled positivity rate of 19.7% in dog population. Serological evidence indicates that Canicola, Icterohaemorrhagiae and Autumnalis are the most frequently found serogroups. Twenty-eight records were included to access leptospiral strains isolated in Brazil, with n = 56 strains characterized as serogroups Canicola, n = 37 as Icterohaemorrhagiae, n = 2 as Pomona, and n = 1 strain as Australis and Sejroe each. Risk factor analysis revealed that stray dogs, puppies or elderly dogs, male dogs and dogs kept by tutors with poor social and economic conditions are at high risk for infection. The present study revealed overall good compatibility of leptospiral strains circulating locally with those used in vaccines against canine leptospirosis in Brazil. The circulation of serovars Pomona and Grippotyphosa has not been consistently demonstrated, and the inclusion of these serovars in local vaccines cannot be supported by our results. The results also provided serological evidence for the circulation of Serogroup Autumnalis among the studied populations.


Asunto(s)
Enfermedades de los Perros , Leptospira , Leptospirosis , Animales , Perros , Masculino , Brasil/epidemiología , Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/prevención & control , Leptospirosis/epidemiología , Leptospirosis/prevención & control , Leptospirosis/veterinaria , Vacunas Bacterianas , Anticuerpos Antibacterianos
5.
Rev. Assoc. Med. Bras. (1992, Impr.) ; Rev. Assoc. Med. Bras. (1992, Impr.);69(6): e20230108, 2023. tab
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1440878

RESUMEN

SUMMARY OBJECTIVE: The objective of this study was to evaluate fresh medical graduates' perceptions regarding the general aspects of ethics teaching in Brazilian medical schools. METHODS: A structured questionnaire was applied to 4,601 participants among the 16,323 physicians who registered in one of the 27 Regional Medical Councils of Brazil in 2015. Answers to four questions regarding general aspects of ethics education in medical school were analyzed. Sampling procedures involved two stratification variables: legal nature (public vs. private) of medical schools and monthly household income higher than 10 minimum wages. RESULTS: A large percentage of the participants had witnessed unethical behaviors during contact with patients (62.0%), toward coworkers (51.5%), and in relationships with patients' families (34.4%) over the course of their medical training. Even though most of the responders (72.0%) totally agreed that patient-physician relationship and humanities education were part of their medical school curriculum, important topics such as conflicts of interest and end-of-life education were not satisfactorily addressed in the participants' medical training. Statistically significant differences were found between the answers of public and private school graduates. CONCLUSION: Despite great efforts to improve medical ethics education, our findings suggest the persistence of deficits and inadequacies in the ethics training currently given in medical schools in Brazil. Further modifications in ethics training must be made to address the deficiencies shown in this study. This process should be accompanied by continuous evaluation.

6.
Brasília; Conselho Federal de Medicina; 2020. 312 p. tab. il. 21x29,7 cm.
Monografía en Portugués | LILACS | ID: biblio-1436680

RESUMEN

A publicação Demografia Médica no Brasil 2020, com resultado da colaboração entre o Conselho Federal de Medicina (CFM) e a Universidade de São Paulo (USP), é uma produção científica que atualiza os conhecimentos acumulados na última década e traz novas informações detalhadas sobre a população de médicos e seu exercício profissional. Em 2020, o Brasil passou a contar com mais de 500 mil médicos. Esse marco vem acompanhado da persistência de desigualdades na distribuição dos profissionais, do aumento desenfreado de cursos e vagas de graduação e da ociosidade de vagas de Residência Médica. Da mesma forma, o crescimento dessa população ocorre com a exposição dos médicos ao aumento do número de vínculos e de jornadas de trabalho. Portanto, o número de médicos no país cresceu, nos últimos anos, na mesma proporção em que se impuseram novos desafios para a profissão médica e o funcionamento do sistema de saúde no país. Assim, a Demografia Médica 2020 do CFM se impõe no debate qualificado, baseado em dados e evidências, com a oferta de subsídios para a atuação das entidades e governantes comprometidos com a valorização da Medicina e as melhorias das condições de saúde da população.


Asunto(s)
Humanos , Especialización , Sistemas Locales de Salud , Personal de Salud/estadística & datos numéricos , Capacitación de Recursos Humanos en Salud , Brasil
7.
Clinics (Sao Paulo) ; 74: e1147, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31531569

RESUMEN

OBJECTIVE: To evaluate the impact of a complex-care-based medical school in the context of the Brazilian health care system on students' career choices. METHODS: This was a retrospective cross-sectional study based on medical regulatory organization records. It included records for 7,419 physicians who graduated from FMUSP. Geographic data were analyzed using Kernel maps, and the statistical analysis was performed with SPSS® version 24.0. A p-value less than 0.05 was considered significant. RESULTS: Of the 7,419 physicians, 68.6% (95% CI 67.5-69.7) were male, and 20.7% (95% CI 19.8%-21.7%) had no medical specialty, compared to 46.4% nationwide. Internal medicine and surgery-based specialties were more popular, accounting for 39.4% (95% CI 38.3%-40.5%) and 16.8% (95% CI 15.5%-17.6%) of our study group, compared to the Brazilian averages of 25.9% and 13.5%. Our graduates also had a higher probability of staying in São Paulo City, especially when born outside the city. CONCLUSION: We believe that FMUSP remains an interesting model for studying the impact of a highly specialized center on the education and career choices of medical students.


Asunto(s)
Medicina/estadística & datos numéricos , Médicos/estadística & datos numéricos , Facultades de Medicina/estadística & datos numéricos , Adulto , Distribución por Edad , Anciano , Brasil , Estudios Transversales , Femenino , Geografía , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Distribución por Sexo , Estudiantes de Medicina/estadística & datos numéricos
8.
BMC Med Educ ; 19(1): 136, 2019 May 08.
Artículo en Inglés | MEDLINE | ID: mdl-31068165

RESUMEN

BACKGROUND: Lack of providers in surgery, anesthesia, and obstetrics (SAO) is a primary driver of limited surgical capacity worldwide. We aimed to identify predictors of entry into Surgery, Anesthesia, and Obstetrics and Gynecology (SAO) fields and preference of working in the public sector in Brazil which may help in profiling medical students for recruitment into these needed areas. METHODS: A questionnaire was applied to all Brazilian medical graduates registered with a Board of Medicine from 2014 to 2015. Twenty-three characteristics were analyzed. Logistic regression was used to determine predictors' influence on outcome. RESULTS: There were 4601 (28.2%) responders to the survey, of which 40.5% (CI 34.7-46.5%) plan to enter SAO careers. Of the 23 characteristics analyzed, eight differed significantly between those who planned to work in SAO and those who did not. Of those eight characteristics, just three were significant predictors in the regression model: preference for working in the hospital setting, having spent more than 70% of their clinical years in practical activities, and valuing the substantial earning potential. These three factors explained only 6.3% of the variance in SAO preference. Within the graduates who preferred SAO careers, there were only two predictors for working in the public sector ("preparatory time before medical school" and valuing "prestige/status"). CONCLUSIONS: Factors affecting specialty and sector choice are multifaceted and difficult to predict. Future programs to fill provider gaps should identify methods other than medical student profiling to assure specialty and sector needs are met.


Asunto(s)
Anestesiología/educación , Educación de Postgrado en Medicina/estadística & datos numéricos , Cirugía General/educación , Fuerza Laboral en Salud/tendencias , Obstetricia/educación , Estudiantes de Medicina/estadística & datos numéricos , Adulto , Brasil , Selección de Profesión , Femenino , Investigación sobre Servicios de Salud , Humanos , Masculino , Especialización
9.
Clinics ; Clinics;74: e1147, 2019. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1039553

RESUMEN

OBJECTIVE: To evaluate the impact of a complex-care-based medical school in the context of the Brazilian health care system on students' career choices. METHODS: This was a retrospective cross-sectional study based on medical regulatory organization records. It included records for 7,419 physicians who graduated from FMUSP. Geographic data were analyzed using Kernel maps, and the statistical analysis was performed with SPSS® version 24.0. A p-value less than 0.05 was considered significant. RESULTS: Of the 7,419 physicians, 68.6% (95% CI 67.5-69.7) were male, and 20.7% (95% CI 19.8%-21.7%) had no medical specialty, compared to 46.4% nationwide. Internal medicine and surgery-based specialties were more popular, accounting for 39.4% (95% CI 38.3%-40.5%) and 16.8% (95% CI 15.5%-17.6%) of our study group, compared to the Brazilian averages of 25.9% and 13.5%. Our graduates also had a higher probability of staying in São Paulo City, especially when born outside the city. CONCLUSION: We believe that FMUSP remains an interesting model for studying the impact of a highly specialized center on the education and career choices of medical students.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Médicos/estadística & datos numéricos , Facultades de Medicina/estadística & datos numéricos , Medicina/estadística & datos numéricos , Estudiantes de Medicina/estadística & datos numéricos , Brasil , Estudios Transversales , Estudios Retrospectivos , Distribución por Sexo , Distribución por Edad , Geografía
10.
PLoS One ; 13(7): e0200384, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29995963

RESUMEN

Dogs are highly susceptible to the leptospiral infection, notably stray and sheltered dogs. Unsanitary conditions often observed in dog shelters may predispose the introduction and spread of leptospires among sheltered populations, potentially increasing the chances for the inadvertent adoption of asymptomatically infected animals. The present work describes a longitudinal study using a multidisciplinary approach for the identification of chronically infected dogs and the characterization of potentially pathogenic strains circulating among stray and sheltered dog populations in São Paulo, Brazil. A total of 123 dogs from three populations were included. The initial evaluation consisted of blood and urine quantitative PCR testing (qPCR), the detection of specific antibodies by microscopic agglutination test (MAT), physical examination and hematological and serum biochemistry analyses. The qPCR-positive dogs were prospectively examined, and reevaluations also included culture from urine samples. Positive qPCR samples were subjected to 16S rRNA and secY gene phylogenetic analysis. The recovered strains were characterized by Multilocus Sequence Typing, polyclonal serogroup identification and virulence determination. Leptospiruria was detected in all populations studied (13/123), and phylogenetic analysis revealed that 10 dogs had L. interrogans infection. Three dogs (3/13) had L. santarosai infection. The secY phylogenetic analysis revealed that the L. santarosai sequences clustered separately from those obtained from other hosts. Ten leptospiruric dogs were reevaluated, and three dogs presented persistent leptospiruria, allowing culturing from two dogs. The strains were characterized as L. interrogans serogroup Canicola (virulent) and L. santarosai serogroup Sejroe (not virulent). Serum samples were retested by MAT using the DU92 and DU114 strains as antigens, and no increased seroreactivity was detected. Asymptomatic L. santarosai infection was observed in all populations studied, suggesting a possible role of dogs in the chain of transmission of this leptospiral species. The results suggest a genetic distinction between lineages of Brazilian L. santarosai maintained by dogs and other animal hosts. Our findings revealed that dogs could act as maintenance hosts for distinct pathogenic Leptospira, highlighting also that asymptomatically infected dogs can be inadvertently admitted and adopted in dog shelters, potentially increasing the risks of zoonotic transmission.


Asunto(s)
Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/microbiología , Leptospirosis/veterinaria , Animales , Anticuerpos Antibacterianos/sangre , Proteínas Bacterianas/sangre , Proteínas Bacterianas/genética , Proteínas Bacterianas/orina , Brasil , Enfermedad Crónica , Ciudades , Perros , Femenino , Leptospira/genética , Leptospira/aislamiento & purificación , Leptospirosis/epidemiología , Leptospirosis/microbiología , Masculino , Filogenia , Estudios Prospectivos , ARN Ribosómico 16S/sangre , ARN Ribosómico 16S/orina
11.
BMC Vet Res ; 14(1): 222, 2018 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-30016949

RESUMEN

BACKGROUND: Dogs presenting with acute leptospirosis may present non-specific clinical and laboratory findings, and the definitive diagnosis may require additional confirmatory tests, including bacterial culture, for the direct or indirect identification of the pathogen. The present study describes the diagnosis of leptospirosis in suspected dogs based on the use of multiple diagnostic tests, including serological, molecular and bacteriological tests, along with the characterization of the recovered leptospiral strains. RESULTS: Urine, serum and blood samples were collected from 33 dogs with suspected clinical leptospirosis treated at the University of São Paulo Veterinary Hospital Service (Hovet FMVZ-USP) between 2013 and 2016. Only dogs with high blood urea nitrogen and creatinine levels in association with multiple clinical manifestations of the disease were included. Leptospiral culture, PCR and serology (Microscopic agglutination test - MAT) were performed in blood and urine samples taken from all suspected dogs at clinical presentation, and an additional prospective MAT titration was performed in seven dogs. Infection could be identified exclusively by PCR in 10 dogs (30.3%), exclusively by MAT in four dogs (12.1%) and by both tests in four dogs, totaling 18 dogs (54.5-95%CI: 37.6-71.5). Six out of eight MAT-confirmed cases presented with the highest titers against the Icterohaemorrhagiae serogroup. Leptospires were recovered from urine samples from two PCR-positive dogs, and both strains could be characterized by Multilocus Sequence Analysis and serogrouping as L. interrogans serogroup Icterohaemorrhagiae. Both isolates were shown to be pathogenic in the hamster model. CONCLUSIONS: The simultaneous use of MAT and PCR was able to increase the diagnosis of leptospirosis in clinically suspected cases. Despite the increasing incidence of new serovars affecting dogs being reported in different locations, our results suggest that leptospiral strains belonging to the Icterohaemorrhagiae serogroup are still a major causative agent of canine leptospirosis in São Paulo, Brazil.


Asunto(s)
Enfermedades de los Perros/diagnóstico , Leptospira , Leptospirosis/veterinaria , Enfermedad Aguda , Pruebas de Aglutinación/veterinaria , Animales , ADN Bacteriano/genética , Enfermedades de los Perros/microbiología , Perros , Leptospira/genética , Leptospira interrogans/genética , Leptospirosis/diagnóstico , Leptospirosis/microbiología , Tipificación de Secuencias Multilocus/veterinaria , Reacción en Cadena de la Polimerasa/veterinaria , ARN Ribosómico 16S/genética
12.
Hum Resour Health ; 16(1): 21, 2018 05 02.
Artículo en Inglés | MEDLINE | ID: mdl-29716607

RESUMEN

BACKGROUND: The internal migration of physicians from one place to another in the same country can unbalance the supply and distribution of these professionals in national health systems. In addition to economic, social and demographic issues, there are individual and professional factors associated with a physician's decision to migrate. In Brazil, there is an ongoing debate as to whether opening medicine programmes in the interior of the country can induce physicians to stay in these locations. This article examines the migration of physicians in Brazil based on the location of the medical schools from which they graduated. METHODS: A cross-sectional design based on secondary data of 275,801 physicians registered in the Regional Councils of Medicine (Conselhos Regionais de Medicina-CRMs) who graduated between 1980 and 2014. The evaluated outcome was migration, which was defined as moving away from the state where they completed the medicine programme to another state where they currently work or live. RESULTS: 57.3% of the physicians in the study migrated. The probability of migration ratio was greater in small grouped municipalities and lower in state capitals. 93.4% of the physicians who trained in schools located in cities with less than 100,000 inhabitants migrated. Fewer women (54.2%) migrated than men (60.0%). More than half of the physicians who graduated between 1980 and 2014 are in federative units different from the unit in which they graduated. Individual factors, such as age, gender, time of graduation and specialty, vary between the physicians who did or did not migrate. CONCLUSIONS: The probability of migration ratio was greater in small municipalities of the Southeast region and strong in the states of Tocantins, Acre and Santa Catarina. New studies are recommended to deepen understanding of the factors related to the internal migration and non-migration of physicians to improve human resource for health policies.


Asunto(s)
Fuerza Laboral en Salud , Médicos , Ubicación de la Práctica Profesional , Facultades de Medicina , Adulto , Anciano , Brasil , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Administración de Personal , Análisis Espacial
13.
BMC Health Serv Res ; 18(1): 299, 2018 04 23.
Artículo en Inglés | MEDLINE | ID: mdl-29688856

RESUMEN

BACKGROUND: The intertwined relation between public and private care in Brazil is reshaping the medical profession, possibly affecting the distribution and profile of the country's medical workforce. Physicians' simultaneous engagement in public and private services is a common and unregulated practice in Brazil, but the influence played by contextual factors and personal characteristics over dual practice engagement are still poorly understood. This study aimed at exploring the sociodemographic profile of Brazilian physicians to shed light on the links between their personal characteristics and their distribution across public and private services. METHODS: A nation-wide cross-sectional study using primary data was conducted in 2014. A representative sample size of 2400 physicians was calculated based  on the National Council of Medicine database registries; telephone interviews were conducted to explore physicians' sociodemographic characteristics and their engagement with public and private services. RESULTS: From the 2400 physicians included, 51.45% were currently working in both the public and private services, while 26.95% and 21.58% were working exclusively in the private and public sectors, respectively. Public sector physicians were found to be younger (PR 0.84 [0.68-0.89]; PR 0.47 [0.38-0.56]), less experienced (PR 0.78 [0.73-0.94]; PR 0.44 [0.36-0.53]) and predominantly female (PR 0.79 [0.71-0.88]; PR 0.68 [0.6-0.78]) when compared to dual and private practitioners; their income was substantially lower than those working exclusively for the private (PR 0.58 [0.48-0.69]) and mixed sectors (PR 0.31 [0.25-0.37]). Conversely, physicians from the private sector were found to be typically senior (PR 1.96 [1.58-2.43]), specialized (PR 1.29 [1.17-1.42]) and male (PR 1.35 [1.21-1.51]), often working less than 20 h per week (PR 2.04 [1.4-2.96]). Dual practitioners were mostly middle-aged (PR 1.3 [1.16-1.45]), male specialists with 10 to 30 years of medical practice (PR 1.23 [1.11-1.37]). CONCLUSION: The study shows that more than half of Brazilian physicians currently engage with dual practice, while only one fifth dedicate exclusively to public services, highlighting also substantial differences in socio-demographic and work-related characteristics between public, private and dual-practitioners. These results are consistent with the international literature suggesting that physicians' sociodemographic characteristics can help predict dual practice forms and prevalence in a country.


Asunto(s)
Médicos/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Adulto , Factores de Edad , Actitud Frente a la Salud , Brasil , Competencia Clínica/normas , Estudios Transversales , Atención a la Salud/estadística & datos numéricos , Femenino , Humanos , Renta/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Médicos/psicología , Práctica Privada/estadística & datos numéricos , Sector Privado/estadística & datos numéricos , Sector Público/estadística & datos numéricos , Factores Sexuales , Adulto Joven
14.
São Paulo; Conselho Regional de Medicina do Estado de São Paulo; 2018. 287 p. tab. il. 21x29,7 cm.
Monografía en Portugués | LILACS | ID: biblio-1436676

RESUMEN

A avaliação da disponibilidade, da distribuição e da capacidade da força de trabalho médico é essencial para o futuro de um sistema de saúde que precisa oferecer serviços qualificados à população. A quarta edição da Demografia Médica traz informações atualizadas e oferece novos dados que permitem melhor compreensão da realidade da prática médica no País. Desenvolvida com metodologia consistente, oferece condições para o dimensionamento do impacto das decisões de gestores (públicos e privados) nas esferas política, administrativa e no campo da assistência em saúde. No momento em que o Sistema Único de Saúde (SUS) completa 30 anos, em um cenário de crise causada por subfinanciamento e falta de infraestrutura, a Demografia Médica torna mais evidente a necessidade de estratégias que facilitem a distribuição de médicos qualificados no território nacional. Assim, estimula uma visão crítica sobre a autorização indiscriminada de abertura de escolas médicas no Brasil. Este trabalho contou com as participações da Universidade de São Paulo (USP) e do Conselho Regional de Medicina do Estado de São Paulo (Cremesp). Foram recebidos ainda subsídios da Associação Médica Brasileira (AMB) e da Comissão Nacional de Residência Médica (CNRM). Em síntese, esta publicação sinaliza o compromisso do CFM com a pesquisa científica de excelência e destinada à contribuição para um projeto de Nação mais justo, ético e solidário.


Asunto(s)
Humanos , Especialización , Sistemas Locales de Salud , Personal de Salud/estadística & datos numéricos , Capacitación de Recursos Humanos en Salud , Brasil
15.
Hum. resour. health ; Hum. resour. health;16(1)2018. tab
Artículo en Inglés | Coleciona SUS | ID: biblio-945115

RESUMEN

Background: The internal migration of physicians from one place to another in the same country can unbalance the supply and distribution of these professionals in national health systems. In addition to economic, social and demographic issues, there are individual and professional factors associated with a physician’s decision to migrate. In Brazil, there is an ongoing debate as to whether opening medicine programmes in the interior of the country can induce physicians to stay in these locations. This article examines the migration of physicians in Brazil based on the location of the medical schools from which they graduated. Methods: A cross-sectional design based on secondary data of 275,801 physicians registered in the Regional Councils of Medicine (Conselhos Regionais de Medicina-CRMs) who graduated between 1980 and 2014. The evaluated outcome was migration, which was defined as moving away from the state where they completed the medicine programme to another state where they currently work or live. Results: 57.3% of the physicians in the study migrated. The probability of migration ratio was greater in small grouped municipalities and lower in state capitals. 93.4% of the physicians who trained in schools located in cities with less than 100,000 inhabitants migrated. Fewer women (54.2%) migrated than men (60.0%). More than half of the physicians who graduated between 1980 and 2014 are in federative units different from the unit in which they graduated. Individual factors, such as age, gender, time of graduation and specialty, vary between the physicians who did or did not migrate. Conclusions: The probability of migration ratio was greater in small municipalities of the Southeast region and strong in the states of Tocantins, Acre and Santa Catarina. New studies are recommended to deepen understanding of the factors related to the internal migration and non-migration of physicians to improve human resource for health policies.


Asunto(s)
Fuerza Laboral en Salud , Migración Humana , Distribución de Médicos/estadística & datos numéricos , Facultades de Medicina , Brasil , Programas Nacionales de Salud
16.
Rev Assoc Med Bras (1992) ; 62(9): 853-861, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28001260

RESUMEN

OBJECTIVE: To evaluate the socio-demographic profile, path to medical school admission and factors affecting the choice of becoming a physician in Brazil. METHOD: Application of a structured questionnaire to 4,601 participants among the 16,323 physicians who graduated between 2014 and 2015 that subsequently registered with one of the 27 Regional Boards of Medicine (CRMs). RESULTS: The average age of participants is 27 years, 77.2% are white, 57% come from families with a monthly income greater than ten times the minimum wage, 65% have fathers who have completed higher education, 79.1% attended a private high school, and 63.5% selected the "will to make a difference in people's lives or do good" as their main reason for choosing medicine, with some differences between the sexes and matriculation at a public or private medical school. CONCLUSION: The recent politics for educational diversity and the opening of additional medical schools has not yet had an impact on the socio-demographic profile of graduates, who are mainly white, wealthy individuals.


Asunto(s)
Selección de Profesión , Educación de Pregrado en Medicina , Médicos/psicología , Encuestas y Cuestionarios , Adulto , Brasil , Femenino , Humanos , Masculino , Motivación , Médicos/estadística & datos numéricos , Facultades de Medicina , Factores Sexuales , Adulto Joven
17.
Rev. Assoc. Med. Bras. (1992, Impr.) ; Rev. Assoc. Med. Bras. (1992, Impr.);62(9): 853-861, Dec. 2016. tab, graf
Artículo en Inglés | LILACS | ID: biblio-829554

RESUMEN

SUMMARY Objective To evaluate the socio-demographic profile, path to medical school admission and factors affecting the choice of becoming a physician in Brazil. Method Application of a structured questionnaire to 4,601 participants among the 16,323 physicians who graduated between 2014 and 2015 that subsequently registered with one of the 27 Regional Boards of Medicine (CRMs). Results The average age of participants is 27 years, 77.2% are white, 57% come from families with a monthly income greater than ten times the minimum wage, 65% have fathers who have completed higher education, 79.1% attended a private high school, and 63.5% selected the “will to make a difference in people’s lives or do good” as their main reason for choosing medicine, with some differences between the sexes and matriculation at a public or private medical school. Conclusion The recent politics for educational diversity and the opening of additional medical schools has not yet had an impact on the socio-demographic profile of graduates, who are mainly white, wealthy individuals.


RESUMO Objetivo traçar o perfil sócio-demográfico de recémgraduados em medicina no Brasil, a forma de ingresso na graduação e os motivos de escolha da profissão médica. Método aplicação de questionário estruturado em 4.601 participantes, dentre 16.323 médicos formados entre 2014 e 2015, que se registraram em um dos 27 Conselhos Regionais de Medicina (CRM), considerados a populaçãoalvo do estudo. Resultados a idade média dos recém-graduados é de 27 anos, 77,2% são brancos, 57% vêm de famílias com renda mensal acima de dez salários mínimos, 65% têm pais com educação superior, 79,1% cursaram ensino médio em escola particular e 63,5% apontaram a “vontade de fazer diferença na vida das pessoas ou fazer o bem” como principal razão para a escolha da medicina, com diferenças entre sexo e natureza pública ou privada da escola de graduação. Conclusão as políticas no Brasil de inclusão educacional e de abertura de escolas médicas ainda não tiveram impacto no perfil dos recém-formados em medicina, em sua maioria indivíduos brancos e de maior nível socioeconômico.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Adulto Joven , Médicos/psicología , Selección de Profesión , Encuestas y Cuestionarios , Educación de Pregrado en Medicina , Médicos/estadística & datos numéricos , Facultades de Medicina , Brasil , Factores Sexuales , Motivación
18.
Acta Trop ; 162: 1-4, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-27282095

RESUMEN

Leptospirosis is a zoonotic disease of global importance caused by pathogenic Leptospira species. Dogs can become asymptomatically infected, acting like reservoir hosts for pathogenic Leptospira, notably Leptospira interrogans serovar Canicola. Identification of such individuals and characterization of leptospires involved in chronic infections may unravel the role of dogs in the epidemiology of particular leptospiral strains. The aim of the present work was to describe the first Leptospira santarosai strain isolated from a dog. The dog was kept in a public shelter in São Paulo city, Brazil, and presented asymptomatic urinary shedding detected by PCR. Prospective evaluation was performed to fully characterize its chronic carrier state. The dog did not present anti-Leptospira titles or clinical/laboratorial abnormalities during the evaluations; nevertheless long-term urinary shedding was confirmed by PCR and leptospires were recovered from two occasions. The isolated strain was molecularly characterized by partial 16S rRNA and secY gene sequencing and MLST analysis. Serogroup identification was performed using polyclonal antibodies. The strain was identified as Leptospira santarosai, serogroup Sejroe. This is the first evidence in the literature of the isolation of L. santarosai in dogs. Our findings show that dogs can persistently harbor leptospires other than L. interrogans.


Asunto(s)
Código de Barras del ADN Taxonómico , Reservorios de Enfermedades/microbiología , Perros/microbiología , Leptospira/clasificación , Leptospira/aislamiento & purificación , Leptospirosis/veterinaria , Animales , Brasil , Humanos , Leptospirosis/sangre , Tipificación de Secuencias Multilocus , Estudios Prospectivos , ARN Ribosómico 16S , Serogrupo
19.
Arq. Inst. Biol ; 83: e0842014, 2016. tab
Artículo en Portugués | LILACS, VETINDEX | ID: biblio-1005928

RESUMEN

O objetivo do trabalho foi determinar a prevalência de leptospirose e brucelose por Brucella canis e determinar os fatores de risco associados com a positividade em cães da Estância Turística de Ibiúna, estado de São Paulo, Brasil. Foram examinados 570 animais distribuídos em 4 regiões nos 48 bairros do município, no período de setembro de 2007 a março de 2008. O diagnóstico sorológico da leptospirose foi efetuado com o teste de soroaglutinação microscópica (SAM), e para o diagnóstico de brucelose foi realizado hemocultivo. Dos 570 animais examinados, 187 (32,8%; IC95% 28,9 - 36,8) foram soropositivos para leptospirose, com predomínio de reações para os sorovares Pyrogenes, Autumnalis e Canicola, e 6 (1,05%; IC95% 0,4 - 2,2) foram positivos para brucelose. A variável atividade sexual (OR = 1,73) foi identificada como fator de risco associado à positividade para leptospirose, e o manejo do tipo solto foi considerado fator de risco tanto para leptospirose (OR = 1,96) quanto para brucelose (OR = 10,85). Conclui-se que a leptospirose e a brucelose estão presentes em cães da Estância Turística de Ibiúna, São Paulo, e que a atividade sexual e o acesso irrestrito à rua são condições associadas com a prevalência das infecções.(AU)


The aim of this survey was to determine the prevalence of leptospirosis and brucellosis due to Brucella canis and to determine the risk factors associated with positivity in dogs of the Tourist Resort of Ibiúna, State of São Paulo, Brazil. A total of 570 blood samples were collected from dogs from 4 regions of 48 districts of the county of Ibiúna during the period of September 2007 to March 2008. Serological diagnosis of leptospirosis was performed with the microscopic agglutination test (MAT), and blood culture was used for the diagnosis of brucellosis. Of the 570 dogs used 187 (32.8%; 95%CI 28.9 - 36.8) were seropositive to leptospirosis, with predominance of reactions to serovars Pyrogenes, Autumnalis and Canicola, and 6 (1.05%; 95%CI 0.4 - 2.2) were positive to brucellosis. Variable sexual activity (OR = 1.73) was identified as risk factor associated with the positivity to leptospirosis, and free access to street was considered risk factor for both leptospirosis (OR = 1.96) and brucellosis (OR = 10.85). It is concluded that leptospirosis and brucellosis are present in dogs of the Tourist Resort of Ibiúna, State of São Paulo, and sexual activity and free access to street are conditions associated with the prevalence of infections.(AU)


Asunto(s)
Animales , Perros , Brucelosis , Brucella canis , Leptospirosis , Zoonosis
20.
Arq. Inst. Biol ; 83: 01-07, 2016. tab
Artículo en Portugués | VETINDEX | ID: biblio-1462418

RESUMEN

The aim of this survey was to determine the prevalence of leptospirosis and brucellosis due to Brucella canis and to determine the risk factors associated with positivity in dogs of the Tourist Resort of Ibiúna, State of São Paulo, Brazil. A total of 570 blood samples were collected from dogs from 4 regions of 48 districts of the county of Ibiúna during the period of September 2007 to March 2008. Serological diagnosis of leptospirosis was performed with the microscopic agglutination test (MAT), and blood culture was used for the diagnosis of brucellosis. Of the 570 dogs used 187 (32.8%; 95%CI 28.9 - 36.8) were seropositive to leptospirosis, with predominance of reactions to serovars Pyrogenes, Autumnalis and Canicola, and 6 (1.05%; 95%CI 0.4 - 2.2) were positive to brucellosis. Variable sexual activity (OR = 1.73) was identified as risk factor associated with the positivity to leptospirosis, and free access to street was considered risk factor for both leptospirosis (OR = 1.96) and brucellosis (OR = 10.85). It is concluded that leptospirosis and brucellosis are present in dogs of the Tourist Resort of Ibiúna, State of São Paulo, and sexual activity and free access to street are conditions associated with the prevalence of infections.


O objetivo do trabalho foi determinar a prevalência de leptospirose e brucelose por Brucella canis e determinar os fatores de risco associados com a positividade em cães da Estância Turística de Ibiúna, estado de São Paulo, Brasil. Foram examinados 570 animais distribuídos em 4 regiões nos 48 bairros do município, no período de setembro de 2007 a março de 2008. O diagnóstico sorológico da leptospirose foi efetuado com o teste de soroaglutinação microscópica (SAM), e para o diagnóstico de brucelose foi realizado hemocultivo. Dos 570 animais examinados, 187 (32,8%; IC95% 28,9 - 36,8) foram soropositivos para leptospirose, com predomínio de reações para os sorovares Pyrogenes, Autumnalis e Canicola, e 6 (1,05%; IC95% 0,4 - 2,2) foram positivos para brucelose. A variável atividade sexual (OR = 1,73) foi identificada como fator de risco associado à positividade para leptospirose, e o manejo do tipo solto foi considerado fator de risco tanto para leptospirose (OR = 1,96) quanto para brucelose (OR = 10,85). Conclui-se que a leptospirose e a brucelose estão presentes em cães da Estância Turística de Ibiúna, São Paulo, e que a atividade sexual e o acesso irrestrito à rua são condições associadas com a prevalência das infecções.


Asunto(s)
Animales , Perros , Brucella canis , Brucelosis , Leptospirosis , Zoonosis
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