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Resumo Introdução O nível da literacia em saúde pode ser um fator que influencia os comportamentos e a saúde dos indivíduos. Objetivo Analisar a percepção de adultos e idosos sobre os seus comportamentos e sua condição de saúde bucal segundo o seu nível de literacia em saúde (LS). Método O presente estudo qualitativo foi realizado com adultos e idosos que que participaram da 'Coorte de Saúde Bucal de Adultos de Piracicaba', sendo classificados conforme os três perfis de perda dentária seguintes: 1) nunca ter perdido dentes; 2) incidência de perda dentária ≥ 4 dentes; 3) edêntulo total e com nível de literacia em saúde alta e baixa de acordo com a variável LS dicotomizada a partir da mediana. Para a coleta dos dados, foi feita uma nova entrevista domiciliar gravada com uso de roteiro-guia e após a transcrição foi realizada a análise de conteúdo. Resultados Independente do nível de LS, os indivíduos identificaram fatores de risco e proteção determinantes para o processo saúde-doença bucal. No entanto, os entrevistados com baixa LS apresentaram uma maior propensão aos comportamentos de risco. Os fatores individuais foram preponderantes para o entendimento de sua condição bucal, seja pelo sentimento de descuido ou de responsabilidade pela falta de acesso aos serviços odontológicos, seja pelo aspecto socioeconômico ou geográfico. Conclusão Os indivíduos com alta LS apresentaram uma capacidade argumentativa e um entendimento maiores sobre os comportamentos saudáveis, como higiene bucal e uso regular do serviço odontológico, independente do tipo de serviço utilizado.

Abstract Background The level of health literacy can be a factor that influences the behaviors and health of individuals. Objective To analyze the perception of adults and the elderly on their behaviors and their oral health conditions according to their level of health literacy (HL). Method The qualitative study was carried out with adults and the elderly who participated in the "Piracicaba Adult Oral Health Cohort" and had been classified into three tooth loss profiles: 1) never having lost teeth; 2) incidence of tooth loss ≥ 4 teeth; 3) total toothlessness and the level of health literacy dichotomized in the median at high and low HL. There was a new home interview recorded using a script, and after transcription, content analysis was performed. Results The individuals, regardless of the HL level, identified risk and protective factors that were decisive in the oral health-disease process. However, individuals with low HL were more adept at risky behavior. The individual factors were preponderant for the understanding of his oral condition, either by the feeling of carelessness or by the feeling of responsibility for the lack of access to dental services, either by the socioeconomic or geographical aspect. Conclusion Individuals with high HL showed greater argumentative capacity and understanding of healthy behaviors, such as oral hygiene and regular use of dental services, regardless of the type of service used.

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Resumo: Introdução: A transposição didática do processo de ensino-aprendizagem presencial-tradicional para o remoto-interativo com simulação em reanimação cardiopulmonar foi uma estratégia implementada por docentes para promover a educação cognitiva, psicomotora e reflexiva sobre aspectos éticos de estudantes de Medicina primeiranistas em tempos de pandemia. Relato de experiência: Trata-se de um relato de experiência de abordagem descritiva e reflexiva, resultado colaborativo multiprofissional e multidisciplinar de oito docentes, visando atingir objetivos educacionais. Ocorreu em 2021, na Faculdade de Medicina de Jundiaí (FMJ), nas disciplinas de Fundamentos Assistenciais e Noções de Primeiros Socorros, e Bioética e Humanidades Médicas. As atividades foram planejadas para serem realizadas com os 120 estudantes matriculados, por meio da plataforma Google Sala de Aula, vinculada à conta institucional, de maneira síncrona e assíncrona. Combinaram-se diferentes estratégias de ensino, materiais, mídias e linguagens com materiais didáticos on-line hipermidiáticos e off-line multimidiáticos, compostos por diferentes tipos/formatos. Discussão: A transposição foi singular e desafiadora para docentes e discentes. Fundamentou-se o trabalho colaborativo interprofissional docente na integração das duas disciplinas e na materialização da educação nas dimensões teóricas e práticas simuladas. Acredita-se que a abordagem utilizada, combinando alguns meios tecnológicos, simuladores artesanais, possibilitou, no contexto das restrições impostas pela pandemia em curso, o ensino e a aprendizagem em suporte básico de vida, na temática reanimação cardiopulmonar. Os estudantes tiveram a oportunidade de desenvolver competências cognitivas, técnicas e comportamentais, e avaliar o seu progresso, realizando e recebendo feedbacks imediatos, bem como por meio de avaliação formativa sem atribuição de nota. Conclusão: A transposição didática do processo de ensino e aprendizagem mediada por tecnologias possibilitou que os estudantes se aproximassem do conteúdo teórico e participassem de simulações clínicas em seus lares com segurança. Porém, não há um estudo comparativo que mostre que o desenvolvimento foi semelhante ao presencial. Consequentemente, será necessário que a assessoria pedagógica avalie as possíveis lacunas de aprendizagem e como poderão ser superadas ao longo do curso.

Abstract: Introduction: The didactic transposition of the traditional in-person teaching-learning process to the remote-interactive one with simulation in cardiopulmonary resuscitation was a strategy implemented by teachers to promote cognitive, psychomotor, and reflective education on the ethical aspects of first-year medical students in times of pandemic. Experience report: This is an experience report with a descriptive and reflective approach, which is a multiprofessional and multidisciplinary collaborative result of eight teachers, aiming to achieve educational goals. It took place in 2021, at the School of Medicine of Jundiaí (FMJ), in the disciplines of Basic Care and First Aid Notions and Bioethics and Medical Humanities. The activities were planned to be carried out with the 120 enrolled students, through the Google Classroom platform, linked to the institutional account, synchronously and asynchronously. Different teaching strategies, materials, media, and languages ​​were combined with online hypermedia and offline multimedia teaching materials, consisting of different types/formats. Discussion: The transposition was unique and challenging for teachers and students. The collaborative interprofessional teaching work was fundamental for the integration of the two disciplines and the materialization of education in the simulated theoretical and practical dimensions. It is believed that the approach used, combining some technological means, craft simulators, allowed the teaching and learning in basic life support in the cardiopulmonary resuscitation topic in the context of the restrictions imposed by the ongoing pandemic. The students had the opportunity to develop cognitive, technical, and behavioral skills, as well as assess their progress, performing and receiving immediate feedback, as well as through formative assessment without grade assignment. Conclusion: The didactic transposition of the teaching and learning process mediated by technologies allowed students to approach the theoretical content and safely participate in clinical simulations in their homes. However, there is no comparative study that shows that the development was similar to in-person teaching. Consequently, it will be necessary for the pedagogical advisory board to evaluate the possible learning gaps and how they can be overcome throughout the course.

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Objetivo: Caracterizar as perspectivas de graduandos da área de saúde sobre a temática minorias sexuais e de gênero na formação profissional. Métodos: Trata-se de um estudo descritivo com análise secundária dos dados qualitativos de 262 estudantes de graduação em saúde de duas Instituições de Ensino Superior no Estado de São Paulo (Brasil). Resultados: A maioria era solteiro (66%), do sexo feminino (83,4%), identidade de gênero feminina (81,2%) e heterosexual (90,6%). A maioria dos estudantes referiu não ter sofrido violência motivada pela identidade de gênero ou orientação sexual (95,4%), já ter tido essa temática durante a formação (61,7%), estar preparado profissionalmente frente a isso (88,4%) e para cuidar dessa população (77,5%). Dos discursos analisados frente à pergunta "Como você acha que a sua formação acadêmica poderia contribuir para lidar com as minorias sexuais?" emergiram duas categorias centrais: "saber lidar com as minorias sexuais e de gênero" e "tornar-se um profissional de saúde aberto à diversidade humana". Conclusão: Evidenciam-se áreas potenciais para a construção de competências sensíveis às minorias sexuais desde a graduação em saúde. (AU)

Objective: To characterize the perspectives of undergraduate students in the health field on the theme of sexual and gender minorities in professional training. Methods: This is a descriptive study with secondary analysis of the qualitative data of 262 undergraduate health students from two Higher Education Institutions in the State of São Paulo (Brazil). Results: Most was single (66%), female (83.4%), female gender identity (81.2%) and heterosexual (90.6%). Most students reported not having suffered violence motivated by gender identity or sexual orientation (95.4%), having already had this theme during training (61.7%), being professionally prepared for it (88.4%) and to care for the population (77.5%). From the speeches analyzed before the question "How do you think your academic training could contribute to dealing with sexual minorities?" two central categories emerged: "knowing how to deal with sexual and gender minorities" and "becoming a health professional open to human diversity". Conclusion: Potential areas for the construction of skills sensitive to the sexual minorities are evident since graduation in health. (AU)

Objetivo: Caracterizar las perspectivas de los estudiantes de pregrado en el campo de la salud sobre el tema de las minorías sexuales y de género en la formación profesional. Métodos: Se trata de un estudio descriptivo con análisis secundario de los datos cualitativos de 262 estudiantes del área de salud de dos Instituciones de Educación Superior en el Estado de São Paulo (Brasil). Resultados: La mayoría era soltero (66%), mujer (83,4%), identidad de género femenina (81,2%) y heterosexual (90,6%). La mayoría de los estudiantes refirió no haber sufrido violencia motivada por identidad de género u orientación sexual (95,4%), haber tenido ya esta temática durante la formación (61,7%), estar preparados profesionalmente para ello (88,4%) y atender a la población (77,5%). De los discursos analizados antes de la pregunta "¿Cómo crees que tu formación académica podría contribuir al trato con las minorías sexuales?" Surgieron dos categorías centrales: "saber lidiar con las minorías sexuales y de género" y "convertirse en un profesional de la salud abierto a la diversidad humana". Conclusión: Las áreas potenciales para la construcción de habilidades sensibles a las minorías sexuales son evidentes desde la graduación en salud. (AU)

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OBJECTIVE: To find out which was the opinion of residents in obstetrics and gynecology about the advantages and disadvantages of medical abortion as compared with surgical procedures. METHOD: Cross-sectional multicenter study among residents in obstetrics and gynecology from 21 maternity hospitals located in 4 different geographical regions of Brazil, using a self-responded questionnaire with 31 questions related to their opinion and experience on providing abortion services. RESULTS: Most residents agreed that "being less invasive" (94.7%), "does not require anesthesia" (89.7%), "can be accompanied during the process" (89.1%), "prevents physical trauma" (84.4%) were the main advantages of medical abortion. CONCLUSION: Residents perceived both clinical and personal issues as advantages of medical abortion.

OBJETIVO: Descobrir qual foi a opinião dos residentes em ginecologia e obstetrícia sobre as vantagens e desvantagens do aborto medicamentoso em relação aos procedimentos cirúrgicos. MéTODOS: Estudo multicêntrico transversal entre residentes de ginecologia e obstetrícia de 21 maternidades localizadas em 4 diferentes regiões geográficas do Brasil, utilizando um questionário autorrespondido com 31 questões relacionadas à sua opinião e experiência na prestação de serviços de aborto. RESULTADOS: A maioria dos residentes concordou que "ser menos invasivo" (94,7%), "não necessitar de anestesia" (89,7%), "poder ser acompanhado durante o processo" (89,1%), "prevenir trauma físico" (84,4%) foram as principais vantagens do aborto medicamentoso. CONCLUSãO: Os residentes perceberam tanto questões clínicas como pessoais como sendo vantagens do aborto medicamentoso.

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Abstract Objective To find out which was the opinion of residents in obstetrics and gynecology about the advantages and disadvantages of medical abortion as compared with surgical procedures. Method Cross-sectional multicenter study among residents in obstetrics and gynecology from 21 maternity hospitals located in 4 different geographical regions of Brazil, using a self-responded questionnaire with 31 questions related to their opinion and experience on providing abortion services. Results Most residents agreed that "being less invasive" (94.7%), "does not require anesthesia" (89.7%), "can be accompanied during the process" (89.1%), "prevents physical trauma" (84.4%) were the main advantages of medical abortion. Conclusion Residents perceived both clinical and personal issues as advantages of medical abortion.

Resumo Objetivo Descobrir qual foi a opinião dos residentes em ginecologia e obstetrícia sobre as vantagens e desvantagens do aborto medicamentoso em relação aos procedimentos cirúrgicos. Métodos Estudo multicêntrico transversal entre residentes de ginecologia e obstetrícia de 21 maternidades localizadas em 4 diferentes regiões geográficas do Brasil, utilizando um questionário autorrespondido com 31 questões relacionadas à sua opinião e experiência na prestação de serviços de aborto. Resultados A maioria dos residentes concordou que "ser menos invasivo" (94,7%), "não necessitar de anestesia" (89,7%), "poder ser acompanhado durante o processo" (89,1%), "prevenir trauma físico" (84,4%) foram as principais vantagens do aborto medicamentoso. Conclusão Os residentes perceberam tanto questões clínicas como pessoais como sendo vantagens do aborto medicamentoso.

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OBJECTIVE: To evaluate residents' knowledge about the evolution of abortion rates in countries where abortion has been legalized, and to assess whether such knowledge correlates with residents' sociodemographic characteristics and experience in abortion care. METHODS: A multicenter, cross-sectional study was conducted in 21 Brazilian hospitals with 404 medical residents in obstetrics and gynecology. Data collection occurred during February 2015 through January 2016. Data were collected through a self-administered, anonymous questionnaire. The χ2 test, Fisher exact test, and multiple logistic regression analysis were performed. RESULTS: Of residents, 60% believed that the abortion rate would increase after legalization; 82% had been involved in the care of women with incomplete abortion and 71% in the care of women admitted for legal abortion. Associations were found between knowledge of the evolution of the abortion rate after legalization and region of birth, region of medical school, and importance attached to religion. Multiple regression confirmed that studying medicine in the south/southeast of Brazil and attaching little importance to religion were associated with knowing that legalization does not lead to an increase in abortion rate. CONCLUSION: Information relating to abortion in medical schools and during residency is very limited and should be improved.

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Medical or drug-induced abortion has been proven as an effective means for termination of pregnancy. However, training of providers in the use of misoprostol has been limited. The current article aims to identify the degree of knowledge on medical abortion among Brazilian medical residents in Gynecology and Obstetrics. A multicenter cross-sectional study was performed with residents regularly enrolled in residency programs in Gynecology and Obstetrics in 21 teaching hospitals. A self-responded questionnaire was used. Correct responses to each of the alternatives were identified, and a binary response variable (≥ P70, < P70) was defined by the 70th percentile of the number of questions on misoprostol. Four hundred and seven medical residents returned the questionnaire, of which 404 were completed and three were blank. The majority (56.3%) of the residents were 27 years or younger, females (81.1%), and single or not living with a partner (70%). Two-thirds (68.2%) were in the first or second year of residency. Only 40.8% of the participants answered 70% or more of the questions correctly. In the multivariate analysis, enrollment in the third year of residency or greater (OR = 2.18; 95%CI: 1.350-3.535) and having participated in treatment of a woman with induced or probably induced abortion (OR = 4.12; 95%CI: 1.761-9.621) were associated with better knowledge on the subject. Among Brazilian medical residents in Gynecology and Obstetrics, knowledge on medical abortion is very limited and poses an obstacle to proper care in cases of legal termination of pregnancy.

O aborto medicamentoso ou farmacológico tem demonstrado ser um meio eficaz para a interrupção da gravidez. Entretanto, o treinamento de provedores no uso do misoprostol tem sido limitado. O presente artigo tem como objetivo identificar o grau de conhecimento dos médicos residentes em Ginecologia e Obstetrícia sobre aborto medicamentoso. Realizou-se um estudo transversal multicêntrico com residentes regularmente inscritos no programa de residência em Ginecologia e Obstetrícia de vinte e um hospitais de ensino. Foi utilizado um questionário de autorresposta. As respostas corretas a cada uma das alternativas foram identificadas e uma variável de resposta binária (≥ P70, < P70) foi definida pelo percentil 70 do número de perguntas sobre o misoprostol. Quatrocentos e sete médicos residentes devolveram o questionário, sendo que 404 estavam preenchidos e três em branco. A maioria (56,3%) dos residentes tinha até 27 anos de idade, era do sexo feminino (81,1%) e não vivia junto com um(a) companheiro(a) (70%). A maior proporção (68,2%) estava cursando o primeiro ou segundo ano da residência. Apenas 40,8% dos participantes acertaram 70% ou mais das afirmativas. Na análise múltipla, cursar o terceiro ano de residência ou superior (OR = 2,18; IC95%: 1,350-3,535) e ter participado do atendimento a uma mulher com abortamento induzido ou provavelmente induzido (OR = 4,12; IC95%: 1,761-9,621) mostraram-se associados a um maior conhecimento sobre o tema. Entre os médicos brasileiros residentes em Ginecologia e Obstetrícia, o conhecimento sobre o aborto medicamentoso é muito reduzido e constitui um obstáculo para o bom atendimento dos casos de interrupção legal da gestação.

El aborto con medicamentos o farmacológico ha demostrado ser un medio eficaz para la interrupción del embarazo. No obstante, la capacitación de los médicos en el uso del misoprostol ha sido limitada. El objetivo de este artículo es identificar el grado de conocimiento de los médicos residentes en Ginecología y Obstetricia sobre el aborto con medicamentos. Se realizó un estudio transversal multicéntrico con residentes regularmente inscritos en el programa de residencia en Ginecología y Obstetricia de veintiún hospitales de enseñanza. Se utilizó un cuestionario de autorrespuesta. Las respuestas correctas de cada una de las alternativas fueron identificadas y una variable de respuesta binaria (≥ P70, < P70) se definió por el percentil 70 del número de preguntas sobre el misoprostol. Cuatrocientos siete médicos residentes devolvieron el cuestionario, siendo que 404 estaban cumplimentados y tres en blanco. La mayoría (56,3%) de los residentes tenía hasta 27 años de edad, eran de sexo femenino (81,1%); no vivía junto a un(a) compañero(a) (70%). La mayor proporción (68,2%) estaba cursando el primero o segundo año de residencia. Solamente un 40,8% de los participantes acertaron un 70% o más de las afirmaciones. En el análisis múltiple, estar en el tercer año de residencia o superior (OR = 2,18; IC95%: 1,350-3,535) y haber estado implicado en la atención a una mujer con aborto inducido o probablemente inducido (OR = 4,12; IC95%: 1,761-9,621) se mostraron asociados a un mayor conocimiento sobre el tema. Entre los médicos brasileños residentes en Ginecología y Obstetricia, el conocimiento sobre aborto con medicamentos es muy reducido y constituye en obstáculo para una buena atención de los casos de interrupción legal de la gestación.

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O aborto medicamentoso ou farmacológico tem demonstrado ser um meio eficaz para a interrupção da gravidez. Entretanto, o treinamento de provedores no uso do misoprostol tem sido limitado. O presente artigo tem como objetivo identificar o grau de conhecimento dos médicos residentes em Ginecologia e Obstetrícia sobre aborto medicamentoso. Realizou-se um estudo transversal multicêntrico com residentes regularmente inscritos no programa de residência em Ginecologia e Obstetrícia de vinte e um hospitais de ensino. Foi utilizado um questionário de autorresposta. As respostas corretas a cada uma das alternativas foram identificadas e uma variável de resposta binária (≥ P70, < P70) foi definida pelo percentil 70 do número de perguntas sobre o misoprostol. Quatrocentos e sete médicos residentes devolveram o questionário, sendo que 404 estavam preenchidos e três em branco. A maioria (56,3%) dos residentes tinha até 27 anos de idade, era do sexo feminino (81,1%) e não vivia junto com um(a) companheiro(a) (70%). A maior proporção (68,2%) estava cursando o primeiro ou segundo ano da residência. Apenas 40,8% dos participantes acertaram 70% ou mais das afirmativas. Na análise múltipla, cursar o terceiro ano de residência ou superior (OR = 2,18; IC95%: 1,350-3,535) e ter participado do atendimento a uma mulher com abortamento induzido ou provavelmente induzido (OR = 4,12; IC95%: 1,761-9,621) mostraram-se associados a um maior conhecimento sobre o tema. Entre os médicos brasileiros residentes em Ginecologia e Obstetrícia, o conhecimento sobre o aborto medicamentoso é muito reduzido e constitui um obstáculo para o bom atendimento dos casos de interrupção legal da gestação.

El aborto con medicamentos o farmacológico ha demostrado ser un medio eficaz para la interrupción del embarazo. No obstante, la capacitación de los médicos en el uso del misoprostol ha sido limitada. El objetivo de este artículo es identificar el grado de conocimiento de los médicos residentes en Ginecología y Obstetricia sobre el aborto con medicamentos. Se realizó un estudio transversal multicéntrico con residentes regularmente inscritos en el programa de residencia en Ginecología y Obstetricia de veintiún hospitales de enseñanza. Se utilizó un cuestionario de autorrespuesta. Las respuestas correctas de cada una de las alternativas fueron identificadas y una variable de respuesta binaria (≥ P70, < P70) se definió por el percentil 70 del número de preguntas sobre el misoprostol. Cuatrocientos siete médicos residentes devolvieron el cuestionario, siendo que 404 estaban cumplimentados y tres en blanco. La mayoría (56,3%) de los residentes tenía hasta 27 años de edad, eran de sexo femenino (81,1%); no vivía junto a un(a) compañero(a) (70%). La mayor proporción (68,2%) estaba cursando el primero o segundo año de residencia. Solamente un 40,8% de los participantes acertaron un 70% o más de las afirmaciones. En el análisis múltiple, estar en el tercer año de residencia o superior (OR = 2,18; IC95%: 1,350-3,535) y haber estado implicado en la atención a una mujer con aborto inducido o probablemente inducido (OR = 4,12; IC95%: 1,761-9,621) se mostraron asociados a un mayor conocimiento sobre el tema. Entre los médicos brasileños residentes en Ginecología y Obstetricia, el conocimiento sobre aborto con medicamentos es muy reducido y constituye en obstáculo para una buena atención de los casos de interrupción legal de la gestación.

Medical or drug-induced abortion has been proven as an effective means for termination of pregnancy. However, training of providers in the use of misoprostol has been limited. The current article aims to identify the degree of knowledge on medical abortion among Brazilian medical residents in Gynecology and Obstetrics. A multicenter cross-sectional study was performed with residents regularly enrolled in residency programs in Gynecology and Obstetrics in 21 teaching hospitals. A self-responded questionnaire was used. Correct responses to each of the alternatives were identified, and a binary response variable (≥ P70, < P70) was defined by the 70th percentile of the number of questions on misoprostol. Four hundred and seven medical residents returned the questionnaire, of which 404 were completed and three were blank. The majority (56.3%) of the residents were 27 years or younger, females (81.1%), and single or not living with a partner (70%). Two-thirds (68.2%) were in the first or second year of residency. Only 40.8% of the participants answered 70% or more of the questions correctly. In the multivariate analysis, enrollment in the third year of residency or greater (OR = 2.18; 95%CI: 1.350-3.535) and having participated in treatment of a woman with induced or probably induced abortion (OR = 4.12; 95%CI: 1.761-9.621) were associated with better knowledge on the subject. Among Brazilian medical residents in Gynecology and Obstetrics, knowledge on medical abortion is very limited and poses an obstacle to proper care in cases of legal termination of pregnancy.

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OBJECTIVES: The aim of this study was to evaluate women's opinions about menopause and the sources of information they use to deepen their understanding of the topic. METHODS: Population-based study with 749 Brazilian women aged 45 to 60 years. The answers to the question "What is menopause?" were typed and coded, and categories that emerged from the interviewees' own speech were created. The answers to the question: "Where or from whom did you get information about menopause?" were also analyzed. RESULTS: The mean age of women was 52.5 (± 4.4) years. Of them, 68% were postmenopausal. According to 67.5% of the interviewees, the concept of menopause encompassed changes in the menstrual cycle and hormones. For 48%, menopause meant physical changes such as "hot flushes and vaginal dryness." For 22.7%, menopause represented psychological changes. The concept of menopause was associated with some change in sexuality for 7.6% of the interviewees. Approximately 18% could not explain what menopause meant. Regarding the sources of information, 44.5% of the women attributed this knowledge to friends and relatives. Doctors or health services were mentioned by 44.3% of women. Television or radio was cited by 22.0%; magazines, newspapers, or books were cited by 14.0%; and the Internet was cited by 6.8% of women. Fifty-two women (6.9%) reported having no source of information about menopause. CONCLUSIONS: Most of the interviewees relate the term "menopause" to physiological events. There seems to be a suppressed demand for information on the various aspects of the menopausal transition among middle-aged Brazilian women.

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RESUMO Este estudo visou conhecer a inserção dos estudantes na comunidade das escolas médicas brasileiras e como essas escolas estão realizando a integração curricular dos conteúdos básicos ao clínico por meio de casos clínicos vivenciados da atenção primária à saúde. Um questionário estruturado, com 26 itens, pré-testado, foi enviado inicialmente por e-mail aos coordenadores de 160 cursos de Medicina reconhecidos pelo Ministério da Educação (MEC), com pelo menos uma turma de egressos. As escolas e os coordenadores foram identificados com base na lista de escolas filiadas à Associação Brasileira de Educação Médica (Abem), no período de maio a outubro de 2013. O questionário foi respondido por 108 coordenadores das escolas médicas associadas. As respostas foram obtidas por e-mail, entrevista gravada por telefone (telepesquisa) e impressos (face a face), de maio a outubro de 2013, após assinado o Termo de Consentimento Livre e Esclarecido (TCLE). Os dados foram tabulados e analisados por meio de estatística descritiva, com distribuição percentual das variáveis categóricas, utilizando o programa estatístico Epi-InfoTM, versão 7.1.4.Para 88% dos coordenadores entrevistados, a escola prevê a integração curricular entre ciências básicas e clínicas; 58,3% apresentam integração curricular por meio da metodologia da problematização com casos clínicos da atenção primária à saúde;para 43,5% dos entrevistados, os conteúdos estão parcialmente integrados. Todas as escolas seguem as DCN 2001 e 38,9% delas receberam auxílio de políticas indutoras do governo federal. O currículo está norteado pelos agravos mais prevalentes para 63,9% das escolas, e 75,9% consideram os objetivos de aprendizagem relevantes para a população. Um total de86,1% prevê o trabalho com equipe multiprofissional, e 56,5% das escolas integram o médico de família com as demais especialidades. Para 71,3%, as atividades na comunidade aumentam a responsabilidade social dos egressos, e 37% acreditam que essas atividades possam auxiliar na melhor distribuição dos futuros profissionais. De acordo com os coordenadores, a maioria das escolas médicas apresenta integração de conteúdos básico-clínicos, e 67,6% opinaram que as estratégias utilizadas para integração em suas escolas são bem-sucedidas.

ABSTRACT This study aimed to assess community placement of studentsfrom Brazilian Medical Schools and the schools'integration of basic content intothe clinical curriculum through actual experience of clinical situations in primary health care. A structured questionnaire containing 26 pre-tested items was sent out initially by e-mail to the coordinators of160 medical courses recognized by the Ministry of Education (MEC) with at least one class of recent graduates. The selected schools and coordinators were identified from a list of ABEM (Brazilian Association of Medical Education) member institutions from May to October 2013. The questionnaires were answered by 108 coordinators in three different methods: by e-mail, by telephone interviewand in hard copy (face-to-face meetings) after signing the Informed Consent Form (TCLE). Data were tabulated and analyzed by descriptive statistics, with percentage distribution of the categorical variables, using thestatistical software packageEpi-InfoTM, version 7.1.4. 88% of thecoorindators reported that their school is striving to achieve curricular integration between basic, clinical and human sciences; 58.3% of them present integration through the problematization of clinical cases in primary care and 43.5% considerthe content to be partially integrated. All respondent schools follow the National Curriculum Guidelines of 2001 and 38.9% received inductive policy governmental aid. For 63.9% of the respondents,the curriculum is guided by the most prevalent health problems and 75.9% consider that the objectives are relevant to the population. A total of 86.1% foresee work withincross-functional teams and 56.5% of the schools integrate family physicians with other medical specialties. For 71.3%, activities in the local community increase social responsibility and 37% believe it may improve the distribution of future professionals. According to the coordinators, most medical schoolsare implementing basic and clinical curricular integration and 67.6% expressed the view that the strategies used for curricular integration at their medical schools are successful.

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AIMS AND OBJECTIVES: To describe the experiences of women who have suffered sexual violence and the impact and importance of that violence on their lives. BACKGROUND: Sexual violence against women is a serious problem worldwide. Studies need to investigate how women reorganise their lives after experiencing sexual violence. DESIGN: A qualitative design was used to explore women's experiences. METHODS: This study analysed semistructured interviews of 11 women who had experienced a sexual assault. The interviews were performed at a specialised walk-in clinic at a university hospital in the interior of São Paulo State, Brazil. A thematic analysis of the content led to the identification of the following themes: (1) impact and meaning of the violence; (2) feelings; (3) overcoming the violence and (4) expectations for the future. RESULTS: Sexual violence had a devastating impact on the lives of these women. The women's postviolence experiences caused feelings of guilt, impotence, fragility and immobility. These experiences also instilled a belief that they may have 'provoked' the violence. Nevertheless, the women showed resilience, investing all of their energy in returning their lives to pre-violence conditions. Family, friends and other important people, as well as the care that the women received from health services, were cited as factors that sustained this attitude of resilience. CONCLUSIONS: Providing appropriate care to female victims of sexual assault requires not only treating the physical damage caused by the violence but also evaluating the particularities of the experience's emotional impact on each woman and the psychosocial repercussions of the experience. RELEVANCE TO CLINICAL PRACTICE: Health professionals should follow up with women during their recovery period.

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Little is known about public perspectives of scientific and therapeutic uses of placentas. Gaps in knowledge potentiate ethical and clinical problems regarding collection and applications. As such, this study sought to assess the perspectives of placenta donation of a sample of women. Postpartum women's perspectives on placental donation were assessed at the State University of Campinas in the Centro de Atençäo Integral a Saúde da Mulher (CAISM) maternity hospital using a cross-sectional survey (n = 384) and semi-structured interviews (n = 12). Surveys were analyzed quantitatively and interviews were analyzed qualitatively using grounded coding; results were compared. The average age of respondents was 27. Fifty-six percent had more than one child, 45% were Caucasian, 38% were mixed-race, 74% identified with a Christian faith, 52% had high school education or higher, 13% regarded the placenta as spiritually important, 72% felt that knowing what happens to the placenta after birth was somewhat or very important, 78% supported the use of the placenta in research and medicine, 59% reported that consent to collect the placenta was very or somewhat important, 78% preferred their doctor to invite donation, and only 7% preferred the researcher to invite donation. Interviews suggested women appreciate being part of research and that receiving information about studies was important to them. Informed by these results, we argue that women support scientific and therapeutic uses of placentas, want to be included in decision making, and desire information about the placenta. Placentas should not be viewed as "throwaway" organs that are poised for collection without the involvement and permission of women. Women want to be meaningfully included in research processes.

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In Brazil, abortion is permitted by law in cases of rape-related pregnancy. This study reports on various aspects in the experience of women that have been sexually assaulted: diagnosis of the pregnancy, seeking legal abortion, and hospitalization in a university hospital. This was a qualitative study that interviewed ten women 18 to 38 years of age, with at least eight years of schooling, one to five years after legal abortion. The women had been previously unaware of their right to a legal abortion, were ashamed about the sexual assault, kept it secret, and had not sought immediate care. The diagnosis of pregnancy provoked anxiety and the wish to undergo an abortion. Women treated through private health plans received either insufficient orientation or none at all. Respectful treatment by the healthcare staff proved relevant for the women to cope with the abortion. The study highlights the need to publicize the right to abortion in cases of rape-related pregnancy and the healthcare services that perform legal abortion, in addition to training healthcare and law enforcement teams to handle such cases.

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OBJETIVO: Avaliar a proporção de serviços de saúde (SSs) que preenchem a notificação compulsória e quais os principais obstáculos para o preenchimento de tal documento. MÉTODOS: Realizou-se um estudo com abordagem mista. Para a abordagem quantitativa, foi realizado um estudo de corte transversal, com coleta de dados por telefone. Foram identificados 291 SSs no Estado de São Paulo que referiam dar atendimento a mulheres que sofrem violência sexual. A amostra foi composta por 172 serviços que referiram prestar atendimento de emergência às mulheres. Na abordagem qualitativa realizaram-se estudos de casos, com amostra intencional e de conveniência. Foram escolhidos seis municípios, nos quais foram entrevistados profissionais de dois SSs. Realizaram-se 45 entrevistas semiestruturadas. Para os dados quantitativos, realizou-se uma análise descritiva simples. Para os dados qualitativos, realizou-se análise temática do conteúdo das entrevistas. RESULTADOS: A proporção de serviços que referiram sempre preencher a ficha de notificação em casos de violência sexual foi de 79,1%. Mais da metade (53,5%) referiu dificuldades relativas às mulheres atendidas, um terço referiu motivos referentes à ficha e 29,7% reportaram dificuldades relacionadas aos profissionais. Na etapa qualitativa, as dificuldades mais referidas foram o tamanho da ficha, os problemas para se obter as informações da mulher e a dificuldade do profissional em obter essas informações. CONCLUSÃO: Embora a maior parte dos SSs tenha referido preencher a ficha de notificação compulsória, mencionou também várias dificuldades para fazê-lo, especialmente relacionadas à sobrecarga de trabalho dos profissionais e à incompreensão acerca da importância dessa notificação no contexto da atenção integral às mulheres que sofrem violência sexual. .

OBJECTIVE: To evaluate the proportion of health services that fill out the compulsory notification and what the main difficulties to fill it out are. METHODS: A study was carried out with two different approaches. For the quantitative approach, a cross sectional study was performed, with telephone data collection. In the state of São Paulo, 291 health services that had reported providing care to women who suffer from sexual violence were identified. The sample was composed of 172 services that reported providing emergency care to women. In the qualitative approach, case studies were conducted. Six cities were chosen by intention and convenience. For each of them, professionals from two health services were invited to participate. Forty-five semi-structured interviews were conducted. For quantitative data, a descriptive analysis was carried out. For qualitative data, a thematic analysis of content was performed. RESULTS: The proportion of health services which reported always filling out the notification in cases of sexual violence was 79.1%. More than half (53.5%) reported difficulties concerning the assisted women, one third reported reasons related to the form, and 29.7%, to the professionals. In the qualitative approach, the main difficulties were the size of the form, the problems to obtain the information about the woman and the difficulty for the professional to obtain this information. CONCLUSION: Although most health services claimed to fill out the compulsory notification, they also mentioned several difficulties to do so, especially with regard to the workload of professionals and the misunderstanding about the importance of the notification in the context of comprehensive care to women who suffer from sexual violence. .

OBJECTIVE: To evaluate the proportion of health services that fill out the compulsory notification and what the main difficulties to fill it out are. METHODS: A study was carried out with two different approaches. For the quantitative approach, a cross sectional study was performed, with telephone data collection. In the state of São Paulo, 291 health services that had reported providing care to women who suffer from sexual violence were identified. The sample was composed of 172 services that reported providing emergency care to women. In the qualitative approach, case studies were conducted. Six cities were chosen by intention and convenience. For each of them, professionals from two health services were invited to participate. Forty-five semi-structured interviews were conducted. For quantitative data, a descriptive analysis was carried out. For qualitative data, a thematic analysis of content was performed. RESULTS: The proportion of health services which reported always filling out the notification in cases of sexual violence was 79.1%. More than half (53.5%) reported difficulties concerning the assisted women, one third reported reasons related to the form, and 29.7%, to the professionals. In the qualitative approach, the main difficulties were the size of the form, the problems to obtain the information about the woman and the difficulty for the professional to obtain this information. CONCLUSION: Although most health services claimed to fill out the compulsory notification, they also mentioned several difficulties to do so, especially with regard to the workload of professionals and the misunderstanding about the importance of the notification in the context of comprehensive care to women who suffer from sexual violence. .

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OBJECTIVE: To evaluate the proportion of health services that fill out the compulsory notification and what the main difficulties to fill it out are. METHODS: A study was carried out with two different approaches. For the quantitative approach, a cross sectional study was performed, with telephone data collection. In the state of São Paulo, 291 health services that had reported providing care to women who suffer from sexual violence were identified. The sample was composed of 172 services that reported providing emergency care to women. In the qualitative approach, case studies were conducted. Six cities were chosen by intention and convenience. For each of them, professionals from two health services were invited to participate. Forty-five semi-structured interviews were conducted. For quantitative data, a descriptive analysis was carried out. For qualitative data, a thematic analysis of content was performed. RESULTS: The proportion of health services which reported always filling out the notification in cases of sexual violence was 79.1%. More than half (53.5%) reported difficulties concerning the assisted women, one third reported reasons related to the form, and 29.7%, to the professionals. In the qualitative approach, the main difficulties were the size of the form, the problems to obtain the information about the woman and the difficulty for the professional to obtain this information. CONCLUSION: Although most health services claimed to fill out the compulsory notification, they also mentioned several difficulties to do so, especially with regard to the workload of professionals and the misunderstanding about the importance of the notification in the context of comprehensive care to women who suffer from sexual violence. OBJECTIVE: To evaluate the proportion of health services that fill out the compulsory notification and what the main difficulties to fill it out are. METHODS: A study was carried out with two different approaches. For the quantitative approach, a cross sectional study was performed, with telephone data collection. In the state of São Paulo, 291 health services that had reported providing care to women who suffer from sexual violence were identified. The sample was composed of 172 services that reported providing emergency care to women. In the qualitative approach, case studies were conducted. Six cities were chosen by intention and convenience. For each of them, professionals from two health services were invited to participate. Forty-five semi-structured interviews were conducted. For quantitative data, a descriptive analysis was carried out. For qualitative data, a thematic analysis of content was performed. RESULTS: The proportion of health services which reported always filling out the notification in cases of sexual violence was 79.1%. More than half (53.5%) reported difficulties concerning the assisted women, one third reported reasons related to the form, and 29.7%, to the professionals. In the qualitative approach, the main difficulties were the size of the form, the problems to obtain the information about the woman and the difficulty for the professional to obtain this information. CONCLUSION: Although most health services claimed to fill out the compulsory notification, they also mentioned several difficulties to do so, especially with regard to the workload of professionals and the misunderstanding about the importance of the notification in the context of comprehensive care to women who suffer from sexual violence.

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No Brasil, a realização de interrupção legal de gestação consequente à violência sexual é permitida por lei. O objetivo deste estudo foi relatar vivências de mulheres após a violência sexual, no diagnóstico de gravidez, na busca pelo serviço de interrupção legal da gestação e durante a internação em um hospital universitário. Foi realizada pesquisa qualitativa com entrevistas semiestruturadas em dez mulheres de 18-38 anos e escolaridade ≥ 8 anos, após 1-5 anos da interrupção legal da gestação. As mulheres desconheciam o direito à interrupção legal da gestação, sentiram a violência sexual como experiência vergonhosa, mantiveram segredo e não procuraram qualquer atendimento imediato. O diagnóstico de gravidez provocou sentimentos de angústia e desejo de abortar. Para as mulheres que procuraram o setor de saúde suplementar as orientações foram precárias ou não aconteceram. O atendimento dos profissionais mostrou-se relevante para assimilação da experiência do aborto. É necessário divulgar o direito à interrupção legal da gestação e a existência de serviços que a realizam, e capacitar profissionais de saúde e segurança pública para atender esses casos.

In Brazil, abortion is permitted by law in cases of rape-related pregnancy. This study reports on various aspects in the experience of women that have been sexually assaulted: diagnosis of the pregnancy, seeking legal abortion, and hospitalization in a university hospital. This was a qualitative study that interviewed ten women 18 to 38 years of age, with at least eight years of schooling, one to five years after legal abortion. The women had been previously unaware of their right to a legal abortion, were ashamed about the sexual assault, kept it secret, and had not sought immediate care. The diagnosis of pregnancy provoked anxiety and the wish to undergo an abortion. Women treated through private health plans received either insufficient orientation or none at all. Respectful treatment by the healthcare staff proved relevant for the women to cope with the abortion. The study highlights the need to publicize the right to abortion in cases of rape-related pregnancy and the healthcare services that perform legal abortion, in addition to training healthcare and law enforcement teams to handle such cases.

En Brasil, la interrupción legal del embarazo, como consecuencia de actos de violencia sexual, está permitido por la ley. El objetivo de este trabajo es presentar la experiencia de mujeres tras actos de violencia sexual, el diagnóstico de su embarazo, su búsqueda del servicio de interrupción legal del embarazo y su internamiento en un hospital universitario. La investigación cualitativa se llevó a cabo mediante entrevistas semiestructuradas con 10 mujeres de 18-38 años, más de 8 años de escolaridad, tras 1-5 años de la interrupción legal del embarazo. Las mujeres no eran conscientes de su derecho a la interrupción legal del embarazo, sintieron la experiencia de sus violaciones como algo vergonzoso, las mantuvieron en secreto y no buscaron ninguna atención inmediata. El diagnóstico de embarazo les causó sentimientos de angustia y deseo de abortar. Para las mujeres que buscaron atención adicional de salud la información recibida era pobre o no se produjo. La asistencia de profesionales resultó relevante para asimilar la experiencia del aborto. Es necesario promover el derecho a la interrupción legal del embarazo y la existencia de servicios que lo realicen.

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Tradicionalmente a maternidade e a maternagem são vistas como decorrentes de relações biológicas e afetivas estabelecidas entre mãe e filho. Atualmente, com o avanço das tecnologias reprodutivas e as novas configurações familiares, observa-se o desenvolvimento de novas possibilidades de maternidade e maternagem que questionam os vínculos biológicos e os papéis de gênero nos cuidados ao filho. A reflexão sobre a construção social da maternidade e da maternagem ao longo do tempo pode favorecer a discussão sobre as demandas das novas configurações familiares. O objetivo deste artigo é realizar uma reflexão sobre os diferentes valores da maternidade e as diversas formas de maternagem desde a Idade Média até a atualidade, nas sociedades ocidentais...

Traditionally motherhood and mothering are seen as resulting from biological and affective relations between mother and son. Today, with the advancement of reproductive technologies and new family configurations observed the development of new sources of motherhood and maternal bonds questioning the biological and gender roles in the care of child. The reflection on the social construction of motherhood and mothering over time can encourage discussion about the demands of new family configurations. The purpose of this article is a reflection on the different values of motherhood and the various forms of mothering since the Middle Ages to the present, in western societies...

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Tradicionalmente a maternidade e a maternagem são vistas como decorrentes de relações biológicas e afetivas estabelecidas entre mãe e filho. Atualmente, com o avanço das tecnologias reprodutivas e as novas configurações familiares, observa-se o desenvolvimento de novas possibilidades de maternidade e maternagem que questionam os vínculos biológicos e os papéis de gênero nos cuidados ao filho. A reflexão sobre a construção social da maternidade e da maternagem ao longo do tempo pode favorecer a discussão sobre as demandas das novas configurações familiares. O objetivo deste artigo é realizar uma reflexão sobre os diferentes valores da maternidade e as diversas formas de maternagem desde a Idade Média até a atualidade, nas sociedades ocidentais.(AU)

Traditionally motherhood and mothering are seen as resulting from biological and affective relations between mother and son. Today, with the advancement of reproductive technologies and new family configurations observed the development of new sources of motherhood and maternal bonds questioning the biological and gender roles in the care of child. The reflection on the social construction of motherhood and mothering over time can encourage discussion about the demands of new family configurations. The purpose of this article is a reflection on the different values of motherhood and the various forms of mothering since the Middle Ages to the present, in western societies.(AU)

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OBJECTIVE: To investigate knowledge of HPV and HPV vaccines in men and women, users of the Brazilian Unified Health System, and the intention to get themselves and their teenage children vaccinated. METHODS: A descriptive, cross-sectional study with 286 women (18-49 years old) and 252 men (18-60 years old), users of five primary health units and two polyclinics in Campinas, SP, Southeastern Brazil, was carried out. Participants were interviewed in 2011 using a structured questionnaire. Bivariate and Poisson regression analysis were performed to identify variables associated with knowledge of HPV and HPV vaccines, and participants vaccination intentions. RESULTS: Almost 40.0% of the participants reported having heard of HPV and 28.9% mentioned adequate information. The main information source was the media (41.7%). Only 8.6% of the participants had heard of the HPV vaccines. Once the participants were informed of the existence of HPV vaccines about 94% of them said they would get vaccinated and/or vaccinate their teenage children, if the vaccines were available in the public health system. Schooling of over 8 years and being female were the variables independently associated with having heard of HPV, the vaccines and having adequate knowledge of the virus. Advanced age was associated with having heard of HPV vaccines. There were no variables associated with the vaccination intentions. CONCLUSIONS: These results reinforce the need for educational activities that provide the population with adequate information on HPV and preventive measures.

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BACKGROUND: The Brazilian Network for Surveillance of Severe Maternal Morbidity was established in 27 centers in different regions of Brazil to investigate the frequency of severe maternal morbidity (near-miss and potentially life-threatening conditions) and associated factors, and to create a collaborative network for studies on perinatal health. It also allowed interventions aimed at improving the quality of care in the participating institutions. The objective of this study was to evaluate the perception of the professionals involved regarding the effect of participating in such network on the quality of care provided to women. METHODS: A mixed quantitative and qualitative study interviewed coordinators, investigators and managers from all the 27 obstetric units that had participated in the network. Following verbal informed consent, data were collected six and twelve months after the surveillance period using structured and semi-structured interviews that were conducted by telephone and recorded. A descriptive analysis for the quantitative and categorical data, and a thematic content analysis for the answers to the open questions were performed. RESULTS: The vast majority (93%) of interviewees considered it was important to have participated in the network and 95% that their ability to identify cases of severe maternal morbidity had improved. They also considered that the study had a positive effect, leading to changes in how cases were identified, better organization/standardization of team activities, changes in routines/protocols, implementation of auditing for severe cases, dissemination of knowledge at local/regional level and a contribution to local and/or national identification of maternal morbidity. After 12 months, interviewees mentioned the need to improve prenatal care and the scientific importance of the results. Some believed that there had been little or no impact due to the poor dissemination of information and the resistance of professionals to change practice. In this second interview, a lack of systematic surveillance after the end of the study, difficulty in referring cases and changes in the leadership of the unit were mentioned. CONCLUSION: In the opinion of these professionals, participating in a network for the surveillance of severe maternal morbidity represented a good strategy for improving services, even in reference centers.

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