RESUMO

BACKGROUND: According to the Latin America Association for palliative care, Brazil offers only 0.48 palliative care services per 1 million inhabitants. In 2012, no accredited physicians were working in palliative care, while only 1.1% of medical schools included palliative care education in their undergraduate curricula. As a reflection of the current scenario, little research about end-of-life care has been published so that studies addressing this subject in the Brazilian setting are crucial. METHODS: A cross-sectional study study conducted with students applying for the medical residency of the Federal University of São Paulo were invited to voluntarily participate in an anonymous and self-administered questionnaire survey. The latter included demographic information, attitudes, prior training in end-of-life care, prior end-of-life care experience, the 20-item Palliative Care Knowledge Test (PCKT) and a consent term. RESULTS: Of the 3086 subjects applying for residency, 2349 (76%) answered the survey, 2225 were eligible for analysis while 124 were excluded due to incomplete data. Although the majority (99,2%) thought it was important to have palliative care education in the medical curriculum, less than half of them (46,2%) reported having received no education on palliative care. The overall performance in the PCKT was poor, with a mean score of 10,79 (± 3). While philosophical questions were correctly answered (81,8% of correct answers), most participants lacked knowledge in symptom control (50,7% for pain, 57,3% for dyspnea, 52,2% for psychiatric problems and 43,4% for gastrointestinal problems). Doctors that had already concluded a prior residency program and the ones that had prior experience with terminal patients performed better in the PCKT (p < 0,001). The high-performance group (more than 50% of correct answers) had received more training in end-of-life care, showed more interest in learning more about the subject, had a better sense of preparedness, as well as a higher percentage of experience in caring for terminal patients (p < 0,001). CONCLUSIONS: Our study showed that Brazilian physicians lack not only the knowledge, but also training in end-of-life medicine. Important factors to better knowledge in end-of-life care were prior training, previous contact with dying patients and prior medical residency. Corroborating the literature, for this group, training showed to be a key factor in overall in this area of knowledge. Therefore, Brazilian medical schools and residency programs should focus on improving palliative training, especially those involving contact with dying patients.

Assuntos

RESUMO

Background: Osteoporosis presents an increasing problem globally, primarily affecting older adults and postmenopausal women. Among important modifiable risk factors for osteoporosis, physical activity and calcium intake help reduce bone mineral loss and decrease the prevalence of osteoporosis. Although osteoporosis knowledge and health beliefs are associated with adopting preventive behavior and screening rates, few studies have evaluated them in Latin American populations. Materials and Methods: We conducted a cross-sectional study among female community leaders in a Peruvian periurban setting. A total of 60 women participated in the study, with a mean age of 43.7 ± 8.3 years, mean body mass index of 30.4 ± 5.3 kg/m2, 88% being overweight or obese, and 58.3% having completed high school education or beyond. Participants completed translated and culturally adapted Osteoporosis Knowledge Test and Osteoporosis Health Belief Scale via semistructured interviews. Results: Most participants reported high knowledge regarding osteoporosis, perceived benefits to exercise and calcium intake, and health motivation. The level of osteoporosis knowledge was highly associated with the level of education, and we found a trend for the association between level of knowledge and perceived benefits of exercise and barriers to calcium intake among participants. Conclusions: Female community leaders with high health motivation and community engagement can contribute enormously to osteoporosis prevention programs in local communities in the future.

RESUMO

Resumo O objetivo constituiu em avaliar o comportamento tático processual de crianças entre oito e 14 anos de idade em situação de jogo 3x3 com os pés, sem finalização. A amostra se compôs de 100 crianças (10,32 ± 1,45 anos de idade). O presente instrumento apresentou um total de 16 itens a serem observados, sendo quatro itens para cada situação tática ou dimensão (jogador no ataque sem bola - JSB, jogador no ataque com bola - JCB, marcação ao jogador no ataque sem bola - MJSB, marcação ao jogador no ataque com bola - MJCB). No Coeficiente de Validação de Conteúdo (CVC), obtiveram-se valores satisfatórios para as quatro dimensões avaliadas. Estabeleceu-se a fidedignidade do instrumento pelo cálculo do índice Kappa inter e intra-avaliadores, demonstrando concordância entre os avaliadores. O instrumento idealizado apresenta índices de validade para avaliar o conhecimento tático processual de crianças nos domínios propostos para modalidades que utilizam dos pés como forma de jogo.

Astract The objective was to evaluate the behavior of children tactical procedural between 8 and 14 years old in the game situation 3x3 with feet without finishing. The sample comprised 100 children (10.32 ± 1.45 years old). This instrument has a total of 16 items to be observed, with 4 items for each tactical situation or size (player without the ball on offense - JSB player with ball in attack - JCB, marking the player without the ball on offense - MJSB, marking the player with the ball in attack - MJCB). In Coefficient Content Validation (CVC), we obtained satisfactory values for the four situations evaluated. The reliability of the instrument was established by calculating the Kappa inter and intra-rater, showing consistency among raters. The instrument has idealized presents validity indexes to evaluate the procedural tactical knowledge of children in the areas proposed for modes that use the feet as a form of play.

Assuntos

RESUMO

Este estudo tem como objetivo apresentar um instrumento de 46 itens para avaliação de conhecimentos matemáticos para os primeiros quatro anos de escolaridade. Participaram no estudo 505 crianças portuguesas do 1º ao 4º ano do primeiro ciclo, com idades compreendidas entre os seis e os 12 anos. Uma análise fatorial de primeira e de segunda ordem revelou a existência de cinco fatores primários que se agrupam num único fator de segunda ordem relacionado com o conhecimento geral em matemática. Uma análise psicométrica com base no modelo de Rasch da Teoria de Resposta ao Item (TRI) permitiu depurar as propriedades psicométricas dos itens. A validade desenvolvimental do instrumento para os quatro anos de escolaridade abrangidos foi igualmente investigada e discutida. (AU)

This study presents a forty-six item instrument for the assessment of mathematical knowledge for first to fourth graders. Participants are 505 primary school Portuguese students from 1st to 4th grade, between six and 12 years old. A first and second order factor analysis of the items shows that there are five primary factors that are grouped in a single factor of second order related to general mathematical knowledge. A psychometric analysis based on Rasch's model of the Item Response Theory (IRT) was conducted in order to clear up the psychometric properties of the items. The developmental validity of the instrument for primary grades is also reported and discussed. (AU)

Assuntos