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Background: Several lines of evidence indicate that medical schools have been failing to adequately nurture empathy and the ethical dimension in their graduates, the lack of which may play a central role in the genesis of medical errors, itself a major source of avoidable deaths, incapacity and wasted resources. It has been widely proposed that medical schools should adopt evaluation strategies as a means to promote a culture of respectful relationships. However, it is not clear if evaluation strategies in medical schools have addressed key domains related to that aim, such as ethics, through the perspective of their students. Hence, we conducted a national survey of instruments used by Brazilian medical schools to assess clerkship rotations from the perspective of students, with a main focus on the ethical domain. Methods: The authors invited 121 randomly selected institutions to participate in the study. Key informants answered a questionnaire about clerkship rotations and sent copies of any instrument used to assess the quality of clerkship rotations according to the students’ perspectives. Results: Twenty-six (53%) of 49 participating schools used an instrument to assess the quality of clerkship rotations according to the perspective of students. Just 13 (27%) schools had instruments containing at least one question encompassing the ethical domain. Only 2 (4%) schools asked students specifically about the occurrence of any negative experience concerning the ethical domain during rotations. Merely 1 (2%) school asked students about having witnessed patient mistreatment and none asked about mistreatment against students themselves. Conclusions: There are several missed opportunities in the way medical schools assess the quality of clerkship rotations regarding the ethical domain. Closing the gap between usual institutional discourses regarding ethics and how that dimension is assessed within clerkship rotations might represent an important step towards the improvement of medical education and healthcare systems. [ABSTRACT FROM AUTHOR]

Objective: To understand the predisposing factors that lead to the practice of self-medication and the factors associated with the use of medicines via self-medication in the adult population of Brazil. Methods: The analyzed data are part of the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM), a survey whose population consisted of individual residents permanently domiciled in urban areas in Brazil. In this work, the data references the 31 573 respondents aged 20 or higher (76.2% of the final PNAUM sample). Poisson regression models with robust variance were used for estimating the independent effect of each variable with medicine use via self-medication. Results: Of the interviewees, 73.6% stated they had used some medication without medical recommendation if they had previously used the same product; 73.8% stated they had used non-prescribed medicine when the medicine was already present at home; and 35.5% stated they had used some non-prescribed medication when they knew someone who had already taken the same medication. The prevalence of self-medication was 18.3%. The variables associated with the highest probability of using medicine via self-medication were: geographic region within Brazil, gender, age group, per capita income, self-assessment of health, self-reported use of previously used non-prescribed medication, and self-reported use of non-prescribed medication when that medication was already present at home. Conclusions: The use of medicines via self-medication in Brazil is relatively frequent and influenced by previous experience and familiarity with the medications, and is more common among women and individuals with low self-assessment of health. [ABSTRACT FROM AUTHOR]

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This paper reviews the literature on health and female homosexuality in Brazil and, along the way, outlines an alternative approach to reviewing academic literature. Rather than summarising the contents of previously published papers, we relate to these publications primarily as partakers in the creation of knowledge. Inspired by Actor-Network Theory (ANT), we apply ethnographic methods to understand the papers as study participants endowed with action. We also draw on the notions of inscription and intertextuality to trace the complex relationship between the findings in the articles and the realities outside of them. We claim that 'evidence' is the product of translational processes in which original events, such as experiments, blood tests and interviews, are changed into textual entities. In addition, text production is seen as an absorption of everything else surrounding its creation. When events are turned into articles, the text incorporates the political environment to which original events once belonged. We thus observe a political text inscribed into the written evidence of sexually transmitted infections, and the practice of publishing about scientific vulnerabilities emerges as political action. In contrast with traditional ways of reviewing literature in medical scholarship, this article offers a reminder that although there is a connection between textual evidence and the reality outside publications, these dimensions are not neutrally interchangeable., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)