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Background: The environments in which doctors in training operate have been distinguished by being rigid, hostile and routine. There is scientific evidence that people who are victims of workplace violence are more likely to suffer from depression, a disorder that has been associated with suicidal ideation. Objective: To predict suicidal ideation as a function of depressive symptoms and workplace violence in undergraduate internal physicians. Material and methods: The quantitative method was used through a non-experimental, cross-sectional, explanatory design with non-probabilistic convenience sampling. 117 medical students who were doing their internship in health centers in Sonora, Mexico participated. Participants responded to the Workplace Violence Scale (Mobbing), the Beck Depression Inventory, and the Beck Suicidal Ideation Scale. Results: A high perception of workplace violence, moderate levels of depression and low levels of suicidal ideation were identified; Workplace violence was positively and significantly associated with depression and suicidal behavior. Furthermore, it was found that violence provides more explanation for suicidal behavior compared to depression. Conclusions: The predictive role of workplace violence in the suicidal behavior of undergraduate internal physicians is confirmed. Highlights the importance of developing prevention and intervention programs to reduce workplace violence in medical training environments. [ABSTRACT FROM AUTHOR]

Copyright of GeSec: Revista de Gestao e Secretariado is the property of Sindicato das Secretarias e Secretarios do Estado de Sao Paulo (SINSESP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: In Peru, there have been more than 2 million international migrants from 1990 to 2021, including 12.6 % of healthcare professionals. This migration has resulted in a lack of human resources and work overload. Consequently, at the national level, there is a need to identify the factors associated with the intention to migrate among professionals in healthcare facilities. At the international level, it has been found that one of the main motivations is job dissatisfaction. Therefore, the main objective of this study is to estimate the association between job satisfaction and the intention to migrate among Peruvian physicians and nurses. Materials and methods: An observational analytical study of secondary databases using responses from physicians and nurses from the 2016 Encuesta Nacional de Satisfacción de Usuarios en Salud (Ensusalud - National Survey of User Satisfaction in Health). The independent variable was job satisfaction among healthcare personnel, while the dependent variable was their intention to migrate. A comparison of weighted rates of the intention to migrate between job satisfaction categories and other covariates was performed using the chi-square test with second-order Rao-Scott correction. Subsequently, log-binomial models were used to estimate adjusted prevalence ratios (aPR). Results: The sample included 5,098 professionals. Among them, 25 % had the intention to migrate. However, such intention was not associated with job satisfaction (aPR: 1.10; 95 % CI: 0.72-1.68). Furthermore, we found that participants aged between 20 and 40 years, those who did not have a professional specialty, had an intermediate command of other languages and perceived a decline in their health due to work had an increase in the intention to migrate of 250 %, 27 %, 34 % and 61 %, respectively. Conclusion: We did not find an association between job satisfaction and the intention to migrate among Peruvian physicians and nurses. [ABSTRACT FROM AUTHOR]

La aplicación de la informática a la medicina ha traído consigo importantes avances en el diagnóstico, tratamiento y seguimiento de enfermedades. Sin embargo, también ha generado preocupaciones éticas en relación a la privacidad y confidencialidad de la información de los pacientes, así como sobre el uso adecuado y responsable de la tecnología. En el contexto actual, la información médica de los pacientes se almacena en bases de datos y sistemas informáticos, permitiendo un acceso rápido y fácil para los profesionales de la salud. Sin embargo, esto también puede comprometer la privacidad y confidencialidad de los pacientes, si no se implementan medidas adecuadas de seguridad y protección de datos. Otra preocupación ética es el uso de la inteligencia artificial y algoritmos en la toma de decisiones clínicas. Si bien estos sistemas pueden brindar diagnósticos más precisos y rápidos, también plantean interrogantes sobre la responsabilidad y autonomía del médico, así como sobre el sesgo y la discriminación que podrían surgir de la programación de estos algoritmos. La pregunta investigada en este tema es: ¿cuáles son los aspectos éticos a considerar en la aplicación de la informática a la medicina? El objetivo es investigar y analizar los principales dilemas éticos que se plantean con el uso de la tecnología en el ámbito médico, así como proponer recomendaciones para asegurar una aplicación ética y responsable. Los principales hallazgos en la investigación muestran que es fundamental garantizar la privacidad y confidencialidad de los datos de los pacientes, implementando medidas de seguridad informática robustas y educando a los profesionales de la salud sobre la importancia de la protección de datos. Asimismo, se destaca la necesidad de una regulación clara y ética en el desarrollo y uso de la inteligencia artificial en medicina, asegurando que se sigan principios como la transparencia, equidad y justicia. En conclusión, la aplicación de la informática a la medicina presenta grandes beneficios, pero también desafíos éticos. Es necesario encontrar un equilibrio entre la utilización de la tecnología para mejorar la atención médica y el respeto por los derechos y dignidad de los pacientes. La ética debe ser una parte integral de la aplicación de la informática en la medicina, garantizando el uso responsable y ético de la tecnología en beneficio de la salud de las personas.

Introducción. Las enfermedades cardiovasculares son la principal causa de muerte a nivel mundial. Dentro de los múltiples factores de riesgo se encuentran el sedentarismo, la obesidad, la dislipidemia, hipertensión arterial, el tabaquismo, entre otros. Objetivo. Determinar la frecuencia de factores de riesgo cardiovascular en médicos residentes del Hospital Nacional de Itauguá. Materiales y método. Estudio observacional descriptivo transversal en el que se incluyeron médicos residentes del Hospital Nacional de Itauguá en el año 2024. Se midieron las variables sociodemográficas, las medidas antropométricas y los factores de riesgo cardiovascular. Resultados. Participaron en el estudio, 113 residentes con edad promedio de 26,9 ± 2,2 años, el 62,8% del sexo femenino, 92,9% de estado civil soltero, 36,3% del primer año de la residencia y 24,8% de la especialidad de medicina interna. El factor de riesgo cardiovascular más frecuente fue el antecedente familiar de enfermedad cardiovascular (78,8%), seguido por la inactividad física (67,3%), el sobrepeso/obesidad (47,8%), el tabaquismo (23,0%), la dislipidemia (7,1%) y la hipertensión arterial (0,9%). Conclusión. Los médicos residentes presentan una alta prevalencia de factores de riesgo cardiovascular, especialmente antecedentes familiares e inactividad física. El sobrepeso y la obesidad también fueron frecuentes, sin embargo, la hipertensión arterial y la dislipidemia fueron menos frecuentes.

Este artículo cruza la Historia política de las elites y del poder con la Historia de las profesiones para analizar en una perspectiva comparada (España, Francia y Reino Unido) la cuestión del estatus social de los médicos en la Europa liberal decimonónica. Se trata de demostrar que el prestigio social alcanzado por los médicos les valía una consideración suficiente para estar contado dentro de las elites de las sociedades liberales. Pero esta condición de elite era marginal, esencialmente local y muy por debajo de lo que el conjunto de la profesión esperaba. Mientras los regímenes liberales fueron censitarios, con una participación política fundada en la propiedad o la condición de funcionario, los únicos médicos que obtuvieron títulos nobiliarios u otras recompensas honorificas fueron médicos integrados a la administración pública o médicos de Corte.

Illustrious names distinguish the work of many historians from Santiago de Cuba, some of them coming from other sciences or simply from their self-taught work. In recent years, it is remarkable the work of three doctors who are recognized for their performance in their medical specialties: DSc: Wilkie Delgado Correa, (dentistry), Dr. Carlos Rafael Fleitas Salazar, (anesthesiology) and DSc. Ricardo Hodelín Tablada, (neurosurgery), but at the same time, they are unbeatable historians. This work goes some way towards a rapprochement to them, who keep a scientific curiosity within the bounds of the culture from Santiago de Cuba. In the same way, their evaluations about how they manage to carry out simultaneously both professions with great contributions are presented and the apparent contradictions between the methodology of history and medical science are taken into account. Finally, the answers to the projective question are presented: Medicine or history? [ABSTRACT FROM AUTHOR]

Copyright of Economic History Research / Investigaciones de Historia Económica is the property of Asociacion Espanola de Historia Economica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The new wave of medical pedagogy has shifted its focus from developing clinical skills to over-reliance on technologies, impairing the clinical ability of new physicians. The correct identification, adequate application and exhaustive disclosure of clinical signs contributes to economic and time savings, as the case of the wide variety in aortic insufficiency. However, the new approach of the educational system of medicine has relegated clinical skills to the background and by virtue of the above, new strategies in medical pedagogy have been proposed to give priority once again to the perfection of clinical skills of doctors in training. [ABSTRACT FROM AUTHOR]

Copyright of Pasado y Memoria. Revista de Historia Contemporánea is the property of Pasado y Memoria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A presente pesquisa buscou investigar a trajetória da Policlínica de Botafogo (P.B.), instituição de assistência fundada em 1900, pelo médico Luiz Pedro Barbosa, evidenciando o seu modelo de organização inspirada nos dispensários europeus e norte-americanos, papel na prestação da assistência à saúde aos pobres urbanos e funcionamento como espaço para o desenvolvimento do ensino médico. O objetivo do trabalho foi reconstruir a trajetória da PB, entre 1900 e 1939, evidenciando a importância do seu papel médico e social, investigando a implantação, organização, manutenção e evolução da assistência à saúde, analisando os dados estatísticos relacionados a doações, ao número de consultas e ao quadro médico, e trazendo para o debate as transformações sociais e urbanas que possibilitaram o desenvolvimento da instituição. O estudo acerca da origem desta instituição não apenas trouxeram à luz questões relacionadas com a assistência à saúde em meio a transformações sociais, políticas, econômicas e culturais entre o final do século XIX e o início do século XX no Brasil e contribuição ao conhecimento para a historiografia das ciências e da saúde do país.

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciencias de la Salud is the property of Colegio Mayor de Nuestra Senora del Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Médicas UIS is the property of Universidad Industrial de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of the Argentine Society of Dermatology / Revista de la Journal Sociedad Argentina de Dermatología is the property of Editorial Biotecnologica S.R.L and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The current scientific literature reflects a variability in the knowledge of dentists and physicians regarding the interactions between periodontal disease and systemic conditions. Objectives: To compare the level of knowledge about periodontal disease and its relationship with systemic alterations in dentists and physicians in the Peruvian army. Material y methods: A cross-sectional study was carried out on 188 participants (104 physicians and 84 dentists) selected by non-probabilistic sampling. The instrument consisted of two sections: a first part with the sociodemographic characteristics of the participants and a second part corresponding to the questionnaire to evaluate the level of knowledge. Results: When comparing the level of knowledge about periodontal disease and systemic alterations in dentists and physicians, no relationship was found between the level of knowledge and the profession at the general level (p = 0.208), by dimensions (p = 0.266 for diabetes mellitus, p = 0.195 for gestation and p = 0.09 for cardiovascular diseases), or according to sociodemographic data (p > 0.05). Conclusion: It was concluded that there is no difference between the level of knowledge of periodontal disease and systemic disorders in dentists and doctors of the Peruvian Army; furthermore, no significant associations were found between sociodemographic characteristics and the level of knowledge in dentists or physicians. [ABSTRACT FROM AUTHOR]

Objective: To determine the association between psychosocial work factors and symptoms of anxiety or depression among healthcare personnel in the Intensive Care Unit (ICU) at Hospital Regional Eleazar Guzmán Barrón in Nuevo Chimbote. Materials and methods: An observational, cross-sectional study was conducted, using both crude and adjusted models, to determine the association between burnout syndrome (BS), evaluated through the Maslach Burnout Inventory (MBI), and job satisfaction (JS), assessed via the Job Satisfaction Questionnaire S20/23. The associations were expressed as prevalence ratios (PR) with their respective 95 % confidence intervals (95 % CI). Results: Out of the 70 doctors engaged in the SERUMS program, 77.14 % were aged between 18 and 33 years, 52.86 % were males, 51.43 % had less than one year work experience and 88.57 % worked at a health center of the Ministry of Health. The prevalence of BS was 45.71 %. The prevalence of JS was as follows: dissatisfaction 30 %, satisfaction 32.86 % and indifference 37.14 %. In the crude analysis, a statistically significant association between BS and JS was found (PR = 13.5; 95 % CI: 3.08 - 59.24) and in the analysis adjusted for sex, marital status and length of work experience, the association between BS and JS remained statistically significant (PR = 14.15; 95 % CI: 3.02 - 66.32). Conclusions: BS is negatively associated with JS, with one in two doctors experiencing BS. Moreover, there appears to be a higher likelihood of job dissatisfaction among personnel with BS. This suggests that BS could serve as an indicator in different management areas and be considered in health management decision-making. Solving these issues could contribute to improving current working conditions and, therefore, the healthcare system. [ABSTRACT FROM AUTHOR]

Copyright of Cuadernos Médico Sociales is the property of Colegio Medico de Chile (A.G.) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: El síndrome de burnout ha ganado relevancia en los ámbitos laboral y de la salud, aunque persisten desafíos en su definición y diagnóstico. Objetivos: Indagar las experiencias de los médicos colombianos en relación con el diagnóstico y tratamiento del síndrome de burnout. Métodos: Se realizaron entrevistas semiestructuradas a siete médicos, utilizando el análisis de contenido para identificar categorías relacionadas con la formación médica y el burnout como entidad nosológica. Resultados: Los participantes reconocieron el síndrome y sus dimensiones, pero enfrentan dificultades en el diagnóstico debido a la falta de formación formal y criterios claros. El burnout se asocia tanto con factores intralaborales como extralaborales, lo que afecta el proceso diagnóstico. El tratamiento varía según el rol profesional, enfocándose en modificar factores laborales o abordar síntomas con intervenciones farmacológicas o psicosociales. La participación de profesionales en salud mental fue crucial en el proceso de tratamiento y seguimiento. El diagnóstico es complejo por falta de criterios y herramientas específicas, lo que conlleva a establecer más bien sospechas que un diagnóstico definitivo. Conclusiones: Se destaca la importancia de abordar el burnout desde una perspectiva de salud pública, considerando el impacto del entorno de trabajo en la salud. Mientras los expertos en salud mental se centran en diagnósticos y tratamiento individuales, los médicos laborales se enfocan en corregir condiciones de trabajo. Se necesitan investigaciones integrales que contemplen las implicaciones sociales y legales asociadas al síndrome de burnout.

Objetivo: determinar la influencia del estrés laboral en la calidad de atención de los médicos del Programa de Atención Domiciliaria de EsSalud de Lima, 2023. Método: estudio cuantitativo descriptivo, correlacional, diseño no experimental, transversal, la población estuvo conformada por 170 médicos del servicio de Programa de Atención Domiciliaria (Padomi), la muestra es censal; se emplearon dos cuestionarios, para estrés el de Maslach y para calidad de atención el de Parasuraman, ambos debidamente validados. Resultados: coeficiente de correlación Rho de Spearman de -0.424 indica que existe relación negativa entre las variables además se encuentra en el nivel de correlación moderada y siendo el nivel de significancia bilateral p

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Despite the relevance of the pharmaceutical industry in Mexico, physicians working in this market, such as the Adjacent Pharmacy Clinics (caf) and the authorized third parties, are usually employed under flexible and precarious characteristics that tend to deprofessionalize them. With the support of the qualitative approach, a case study was developed, interviews were applied to physicians who worked in a third party authorized clinic located in Guadalajara; through testimonies, the activities and working conditions of the company were evidenced. It was identified that the physicians who worked in the clinic accepted flexible and precarious working conditions in exchange for practicing their profession and acquiring work experience while they found a job with better working conditions or while they were preparing to continue with their specialty studies. [ABSTRACT FROM AUTHOR]

Resumo: Este estudo objetivou analisar as percepções de obstetras e residentes de ginecologia-obstetrícia, atuantes numa maternidade escola federal, sobre o aborto legal em casos de gravidez decorrente de violência sexual, desvelando suas motivações, resistências e sentimentos, e identificando suas experiências com o tema. A primeira etapa correspondeu ao preenchimento de um questionário autoaplicável. Os critérios de seleção foram: obstetras vinculados ao centro obstétrico; diretor da divisão médica; e residentes do programa de ginecologia-obstetrícia da instituição. Obtiveram-se 36 questionários respondidos. A segunda etapa correspondeu à realização de uma entrevista, tendo sido utilizado o critério de amostragem por saturação e foram entrevistados seis médicos. As entrevistas foram analisadas pelo método de análise de conteúdo, na modalidade temática. Os questionários retrataram que todos os participantes já haviam prestado assistência a mulheres em situação de violência sexual e que a maioria já havia participado da realização de um aborto legal. As entrevistas evidenciaram os dilemas enfrentados pelos profissionais na assistência a esses casos e a escassez da formação profissional em relação à temática. A palavra da mulher foi tida ora como objeto de suspeição em relação à veracidade do estupro, ora como capaz de suscitar afetação das profissionais em suas escutas, o que possibilitou que essas se aproximassem das vítimas e ofertassem uma assistência mais humanizada. Os resultados apontaram para a importância da temática ser abordada nos campos da saúde e da formação para além do enfoque técnico-científico, visando produzir novas estratégias de cuidado.

Introducción: La empatía es uno de los componentes de la estructura de la humanización en la atención de los pacientes. Los médicos especialistas deben tener altos niveles de empatía. Objetivo. El objetivo del presente trabajo es describir los niveles de empatía en médicos que trabajan en un hospital de alta complejidad y explorar diferencias entre las especialidades estudiadas. Métodos: Muestra por conveniencia de 237 médicos que representa el 53,55 % del total poblacional (N=443). La empatía fue medida mediante la Escala de Empatía para Profesionales de la Salud. Se realizó análisis factorial confirmatorio y análisis multigrupo para examinar la invarianza del modelo entre los sexos y análisis de confiabilidad (α de Cronbach, coeficiente de correlación intraclase y ω de McDonald). Resultados: La especialidad de pediatría tuvo los niveles más altos en la empatía general y en las dimensiones Cuidado con compasión y “Caminando en los zapatos del paciente”, no así en la dimensión Toma de perspectiva donde presenta niveles semejantes a las especialidades de anestesiología, medicina crítica y terapia intensiva, y ginecología. Conclusión: Los valores de la empatía y los valores en las subescalas Cuidado con compasión y “Caminando en los zapatos del paciente” fueron (en valores absolutos, pero no estadísticos) mayores en la especialidad de Pediatría. En la subescala Toma de perspectiva, las especialidades de Pediatría, Anestesiología, Cirugía y Clínica se observaron puntuaciones prácticamente iguales. Se requieren otros estudios que permita arribar a una explicación que permita entender por qué algunas especialidades tienen valores de empatía mayores que otras.

N/a.

Objetivo: Evaluar la asociación entre el síndrome de burnout (SB) y la satisfacción laboral (SL) en los médicos serumistas de Ayacucho en el contexto de la pandemia por la COVID-19. Materiales y métodos: Estudio observacional, transversal, que usó un modelo crudo y ajustado para evaluar la asociación entre el SB, valorado por medio del cuestionario Maslach Burnout Inventory (MBI), y la SL, por medio del cuestionario de satisfacción S20/23. Las asociaciones se presentaron como razón de prevalencia (RP) con sus respectivos intervalos de confianza al 95 % (IC al 95 %). Resultados: De los 70 médicos serumistas, se encontró que el 77,14 % tenía entre 18-33 años, el 52,86 % eran hombres, el 51,43 % tenía menos de un año de experiencia laboral y el 88,57 % laboró en un centro de salud del Ministerio de Salud (Minsa). La prevalencia del SB fue de 45,71 %. La prevalencia del SB con insatisfacción fue del 30 %; con satisfacción, 32,86 %, y los indiferentes, 37,14 %. En el análisis crudo encontramos significancia estadística entre el SB y la SL (RP = 13,5; IC del 95 %:3,08-59,24), y en el análisis ajustado por sexo, estado civil y tiempo de experiencia laboral, la asociación entre el SB y la SL permaneció estadísticamente significativa (RP = 14,15; IC del 95 %: 3,02-66,32). Conclusiones: El SB se asocia a la SL de manera negativa, encontrando uno de cada dos médicos con SB. Además, se sugiere que existe mayor probabilidad de insatisfacción laboral en el personal con SB. Ello da a entender que podría usarse como indicador en diferentes áreas de la gestión y ser un punto a evaluar en la toma de decisiones en las directivas de salud. La solución de estos problemas contribuiría a mejorar las condiciones laborales actuales y, por ende, el sistema de salud.

RESUMO O estudo objetivou conhecer a concepção dos médicos que atuam na Estratégia da Saúde da Família de Juazeiro do Norte (CE) sobre a atenção à saúde do idoso. Para tanto, foi realizado estudo qualitativo através de entrevistas com dez médicos. A abordagem do serviço de saúde centrado na doença e na consulta ambulatorial, privilegiando as doenças crônicas, a não participação em ações com outros profissionais da saúde, a não utilização de avaliação global do idoso e uma visão negativa da velhice foram os principais aspectos evidenciados no estudo. Os resultados encontrados reforçam a necessidade de melhorias na capacitação dos médicos da Atenção Primária para o cuidado com idosos.

The article analyzes the subversive work assigned by the Biden administration to the United States Agency for International Development, to attack Cuban medical brigades abroad. Specifically, it analyzes the new program called Combating forced labor in Cuban medical missions, and at the same time, corroborates the existence of a strategy to boycott medical cooperation and the export of health services, especially aimed at the latter modality, with the in order to cut off economic income. The background to this new program is a similar one funded by the Trump government in 2019, although it has an additional one million dollars. Since the main line of message used against international Cuban medical agreements is that they violate human rights by promoting slave labor, they prioritize the search for testimonies to support said campaign. The program has elements of covert actions and requires those elected to carry out actions within Cuba and in Latin American countries. The latter is consistent with the health strategy that Biden implements to regain his influence in the region, in addition to reducing Cuba's prominence. Finally, it is shown that, although Biden imposes his imprint on the strategy, he is a follower of Donald Trump.

Introduction: The rational use of health resources has awakened us to the importance of including this theme in the curriculum of medical schools. This research aims to compare the perception of cost-conscious attitudes of medical students before and after the implementation of the CW campaign and after 1 year of medical practice. Material and methods: Longitudinal study conducted with students and physicians, who answered a questionnaire on cost-conscious perception at 3 moments: before the implementation of the CW campaign during the undergraduate phase; immediately after the campaign; and after 1 year of medical practice. In order to make the comparison among the different moments, the T-test for paired samples was used. Results: In the first 2 moments, 98 students participated, of which 80 also participated in the third moment, already as physicians. Most students disagreed that physicians should not think about cost when making therapeutic decisions, with a change after the educational actions (P = .001). There was agreement by the students on the items that refer to the physicians’ posture regarding science and responsibility to contain costs and discuss treatment options with patients. Comparing the answers after the campaign and at 1 year of practice, it was observed that the perception of cost-conscious attitudes was maintained. Conclusions: Students showed high perception of cost-consciousness, even before the implementation of the campaign. Nevertheless, after the educational actions, an increase in this perception was observed; and, after 1 year of medical practice, this perception was maintained. Resumen: Introducción: el uso racional de los recursos de salud nos ha despertado la importancia de incluir este tema en el currículo de las facultades de Medicina. Esta pesquisa pretende comparar la percepción de las actitudes conscientes de los costos de los estudiantes de Medicina antes y después de la implementación de la campaña CW y después de un año de práctica médica. Materiales y métodos: estudio longitudinal realizado con estudiantes y médicos, quienes respondieron un cuestionario de percepción de conciencia de los costos en 3 momentos: antes de la implementación de la campaña CW durante la etapa de pregrado, inmediatamente después de la campaña y después de un año de práctica médica. Para realizar la comparación entre los diferentes momentos se utilizó la prueba T para muestras apareadas. Resultados: en los 2 primeros momentos participaron 98 estudiantes, de los cuales 80 también participaron en el tercer momento, ya como médicos. La mayoría de los estudiantes no estuvo de acuerdo en que los médicos no deben pensar en el costo al tomar decisiones terapéuticas, con un cambio después de las acciones educativas (p = 0,001). Hubo acuerdo de los estudiantes en los ítems que se refieren a la postura de los médicos frente a la ciencia y la responsabilidad de contener costos y discutir opciones de tratamiento con los pacientes. Comparando las respuestas después de la campaña y al año de práctica, se observó que se mantuvo la percepción de actitudes conscientes de los costos. Conclusiones: los estudiantes mostraron alta percepción de conciencia de los costos, incluso antes de la implementación de la campaña. Sin embargo, luego de las acciones educativas, se observó un aumento en esta percepción, y después de un año de práctica médica, esta percepción se mantuvo.

Resumo A organização e o processo de trabalho são espaços privilegiados para reconhecer as forças que levam ao sofrimento psíquico. Este artigo pretende analisar as percepções de médicos(as) da atenção primária à saúde, que atuam no Programa Mais Médicos, sobre as relações entre sofrimento psíquico e processo de trabalho, no contexto da pandemia do coronavirus. Esta pesquisa foi realizada por meio de um estudo de caso, utilizando métodos e técnicas qualitativas para a coleta, descrição e análise dos dados. Foi selecionada uma amostra intencional em conformidade com a técnica de saturação teórica. A coleta de informações foi realizada com ajuda de entrevistas semiestruturadas, seguindo um roteiro construído para atender aos objetivos desta pesquisa. A análise do discurso dos entrevistados articulou categorias de análise extraidas de cinco eixos temáticos que têm pontos de articulação entre si, com consensos e contradições que dão sentido às visões e posições dos atores no campo da saúde. Os resultados evidenciaram a pandemia como catástrofe sanitária e traumática, redimensionando o processo de trabalho e contribuindo para a sobrecarga, conflitos, medo, sentimento de desamparo e sofrimento psíquico. Inúmeras carências, problemas de infraestrutura, burocracia, interferências políticas, descompasso entre a formação e a prática também contribuiram para esse sofrimento.

Objective: To evaluate the incidence and factors associated with suicidal ideation in a sample of resident physicians from two institutions. Materials and methods: A descriptive, observational, prospective and cross-sectional study was carried out to estimate the suicidal ideation and associated factors with the Plutchik Suicide Risk Scale among resident physicians from two hospitals between September and October 2022. Descriptive statistics were used with measures of central tendency and dispersion, as well as relative and absolute frequencies. In addition, Pearson's chi-square goodness of fit test and Kruskal-Wallis H test were used to examine the differences between specialties, and Tukey's Honest Significant Difference test to determine which specialty was different. Results: A total of 225 surveys were answered, out of which 20 were eliminated due to inadequate completion, leaving 205 complete surveys for analysis. The average age was 28.66 years (SD ± 2.360) and 71.2 % were females. Concerning the specialties, pediatrics was found in 28.8 % of the respondents and anesthesiology in 20.5 %. A significant association between specialties with a value of p = 0.0000 and academic degrees with p = 0.003 (p ≤ 0.05) was evidenced. Differences regarding suicidal ideation were found by specialty: Kruskal-Wallis H test showed a value of p = 0.000 and Tukey's Honest Significant Difference test revealed that the specialty of gynecology was the different one. Conclusions: According to the results of the study sample, approximately one fourth of the resident physicians had suicidal ideation. Its prevalence in this sample showed no significant difference with respect to its incidence in Latin America. An association between suicidal ideation, medical specialties and academic degree was found. As for the comparison between specialties, gynecology was the one with the highest suicidal ideation rate. This work had some limitations; for example, the groups were very heterogeneous, a probabilistic selection technique was not used, and the statistical tests were nonparametric. [ABSTRACT FROM AUTHOR]

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Introdução: As consultas informais são atos médicos caracterizados pela autorreferenciação a um médico, sem registo clínico ou seguimento adequado. Apesar de controversa, esta prática assume-se como parte integrante da cultura médica. Este caso clínico mostra a importância de compreender as consequências das consultas informais e as vantagens de uma atitude preventiva em relação à saúde do próprio. Descrição do caso: Profissional de saúde do sexo feminino, de 28 anos, com lombalgia com dois meses de evolução recorre a uma consulta informal, na qual foram discutidos um diagnóstico presuntivo e um plano de tratamento a ser implementado. Devido ao agravamento sintomatológico recorreu a uma consulta formal de ortotraumatologia, na qual se estabeleceu um diagnóstico definitivo de hérnia lombar e foi discutido e implementado um plano de tratamento de forma partilhada, que teve bons resultados. Comentário: Este caso revela a complexidade da relação clínica e contexto psicossocial das consultas informais. Os profissionais de saúde estão particularmente suscetíveis à trivialização dos sinais e sintomas, recorrendo a consultas informais para uma rápida resolução da condição clínica, de forma a conseguirem manter-se a trabalhar, mas sem aprofundar a etiologia e causa do problema.

Objetivo: este estudio evaluó síntomas de Burnout entre médicos y enfermeros antes, durante y después de la atención provista a pacientes con la enfermedad COVID-19. Método: estudio comparativo y transversal realizado en la unidad de Atención Respiratoria de un hospital público de nivel terciario. Se empleó el Inventario de Burnout Maslach. Resultados: se distribuyeron 280 encuestas entre los tres períodos: antes (n=80), durante (n=105) y después (n=95) de la atención a pacientes con COVID-19; se obtuvieron 172 encuestas respondidas. Las tasas de respuesta fueron 57,5%, 64,8% y 61,1%, respectivamente. Los valores de prevalencia de Burnout grave fueron 30,4%, 63,2% y 34,5% antes, durante y después de la atención a pacientes por la enfermedad del coronavirus 2019 (p

Objetivo: Evaluar la incidencia y factores asociados al pensamiento suicida en una muestra de médicos residentes de dos instituciones. Materiales y métodos: Se realizó un estudio de tipo descriptivo, observacional, prospectivo y transversal, entre los meses de septiembre a octubre del 2022, para estimar el pensamiento suicida en los médicos residentes de dos hospitales con la escala de Plutchik, además de buscar factores asociados. Se aplicó la estadística descriptiva con medidas de tendencia central y de dispersión, frecuencias relativas y absolutas; las pruebas ji al cuadrado de Pearson y de bondad de ajuste, así como la prueba de Kruskal-Wallis se emplearon para examinar las diferencias entre especialidades, y la prueba post-hoc de Tukey para evaluar la especialidad diferente. Resultados: Se respondió un total de 225 encuestas, de las cuales se eliminaron 20 por inadecuado diligenciamiento, y quedaron 205. El promedio de edad fue de 28,66 años (DS ± 2,360) y el 71,2 % correspondió al sexo femenino. En cuanto a las especialidades, se encontró a pediatría con el 28,8 % y a anestesiología con el 20,5 %. Se evidenció asociación significativa entre especialidades, con un valor de p = 0,0000, y grado académico de p = 0,003 (p ≤ 0,05). Según la especialidad, se encontraron diferencias en cuanto al pensamiento suicida; la prueba de Kruskal-Wallis mostró un valor de p = 0,000 y la prueba post-hoc de Tukey reveló que la especialidad de ginecología fue la diferente. Conclusiones: De acuerdo con los resultados de la muestra, alrededor de una cuarta parte de los médicos residentes manifiesta pensamiento suicida. La prevalencia en dicha muestra no presenta diferencia significativa con respecto a la incidencia a nivel latinoamericano. Se encontró una asociación entre ideas suicidas, especialidades médicas y grado académico. En cuanto a comparación entre las especialidades, ginecología fue la que mostró mayor ideación suicida. Este trabajo presenta algunas limitaciones, por ejemplo, existe una gran heterogeneidad de grupos, no se empleó una técnica de selección probabilística y las pruebas estadísticas empleadas fueron no paramétricas.

Objetivo: evaluar los niveles de estrés y satisfacción laboral en el personal de salud durante la pandemia COVID-19. Método: se aplicó una encuesta electrónica a médicos y enfermeras que laboraron en áreas COVID. Para medir el estrés y la satisfacción laboral se usaron los cuestionarios MBI-HSS y SL-SCP, respectivamente. Se emplearon estadísticas descriptivas, de correlación y modelos de regresión lineal para analizar los datos; se incluyeron 258 personas; 123 médicos (52.3 %) y 135 enfermeras (47.7 %). Resultados: el estrés laboral estuvo presente en el 67.4 %, siendo severo en el 33.7 % y ausente en un 32.6 %. Los factores que se asociaron a estrés fueron la cantidad de horas de trabajo y turnos nocturnos, haber dado positivo en la prueba de SARS-CoV-2, insuficiente acceso a equipos de protección personal y el área de trabajo, existiendo mayores puntuaciones en sala de operaciones y UCI. En cuanto a la satisfacción laboral, se vio que un 76.7 % presentó una satisfacción regular, 21.7 % insatisfacción y un 1.6 % estuvo satisfecho. Las variables que mejor predijeron satisfacción fueron la edad, la ausencia de estrés laboral, los incentivos financieros, el tipo de contrato y el área de trabajo, viéndose mejores puntuaciones en áreas no críticas. Conclusión: la pandemia COVID-19 provocó niveles elevados de burnout, aunque se mantuvieron niveles regulares de satisfacción laboral. Objective: to evaluate the levels of stress and job satisfaction in healthcare professionals during the COVID-19 pandemic. Method: an electronic survey was applied to physicians and nurses who worked in COVID-19 areas. To measure occupational stress and job satisfaction, the MBI-HSS and SL-SCP questionnaires were used, respectively. Descriptive statistics, of correlation and linear regression models were applied to analyze the data; a total of 258 people were included; 123 physicians (52.3 %) and 135 nurses (47.7 %). Results: occupational stress was present in 67.4 %, being severe in 33.7 % and absent in 32.6 %. The factors associated with stress were the greater number of working hours and night shifts, having positive tested for SARS-CoV-2, insufficient access to personal protective equipment and the working area, with higher scores in the operating room and ICU. Regarding job satisfaction, it was seen that 76.7 % presented regular satisfaction, 21.7 % dissatisfaction and 1.6 % satisfaction. The factors that best predicted satisfaction were age, absence of occupational stress, financial incentives, type of job contract and the working area, with better scores in non-critical areas. Conclusion: the COVID-19 pandemic caused high levels of occupational stress, although regular levels of job satisfaction were maintained. [ABSTRACT FROM AUTHOR]

The training of medical specialists in Mexico has had an arduous path during the development of medical residencies; from its beginnings in tutorial and empirical forms, both the difficulties of professors and institutions in the implementation of postgraduate courses, up to the obtaining of a formal and systematized residency acknowledged by higher education institutions have come to the fore. During this stage, there have been resident physicians' movements aimed to safeguard their rights and responsibilities, based on the duality of being, on one hand, a postgraduate student and, on the other one, a temporary worker. In this essay, it will be done a briefly review of the most relevant legal aspects which involve both, resident physicians, as well as medical specialization courses in Mexico. [ABSTRACT FROM AUTHOR]

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Introduction: Acute diarrheal disease (Add) produces high morbidity and mortality in pediatric age. Although guidelines for appropriate management are available, these are not always followed. Objective: to investigate the outpatient management of Add in children under 5 years of age by venezuelan pediatric care personnel. methods: observational, analytical, cross-sectional study. A survey was carried out with an online application. the following data were registered: age, sex, workplace, time since the last update in management of diarrhea, indication for pharmacological treatments and prevention/hygiene measures. the association between pharmacological prescriptions and characteristics of the respondents was evaluated. Results: A total of 221 doctors responded the survey: 43.0% pediatricians, average age 41.9 ± 14.15; 70.1% female; mixed workplace (public and private) 42.1%; time since the last update 83.3 %, less than 5 years. 59.2% consulted consensus or guideliness. 81.4% prescribed oral rehydration salts (ors), human milk 78.7%, early refeeding 43.8%, zinc 23.9%, probiotics 52.9%, antiemetics 65.6%, hand washing 93.2%. being >40 years old was associated with prescribing antiemetics and working in private practice, (or= 2.4; 1.4-4.3 and or= 0.5; 0.3-0.9), antacids and gastric secretion inhibitors (or= 2.6; 1.3-4.9 and or= 0.4; 0.2-0.7; respectively), while probiotics (or=1.4: 0. 7-2.9) and zinc (or= 1.8; 1.0-3.0) with night shifts in public institutions (or= 1.9; 95%: 1.0-3.4). Conclusion: our study supports the need for further evaluation and implementation strategies of the esPghAn/fIsPghAn/svPP guidelines. [ABSTRACT FROM AUTHOR]

Based on the intense demands of caring for others, present in the context of hospital urgency and emergency, this paper explores the work practice of care that physicians perform in this situation. The reflection has the ethics of care in Psychoanalysis as a guiding axis, which matches up with the goal of humanizing care, currently in force in the National Policy for Humanization. It presents the narratives of four resident physicians as witnesses of the undeniable subjective effects undergone in these professional experiences. It concludes that it is essential to implement public policies and institutional actions that take into account the effective caring for the caregiver, thus establishing the validity of another logic not restricted to technical performance. [ABSTRACT FROM AUTHOR]

Objective: To determine the association between burnout syndrome (BS) and job satisfaction (JS) among doctors from Ayacucho engaged in the SERUMS program in the context of the COVID-19 pandemic. Materials and methods: An observational cross-sectional study which used a crude and adjusted model to determine the association between BS, assessed through the Maslach Burnout Inventory (MBI), and JS, assessed through the Job Satisfaction Questionnaire S20/23. The associations were expressed as prevalence ratio (PR) with their respective 95 % confidence intervals (95 % CI). Results: Out of the 70 doctors engaged in the SERUMS program, 77.14 % were between 18 and 33 years old, 52.86 % were men, 51.43 % had less than one year work experience and 88.57 % worked at a health center of the Ministry of Health. The prevalence of BS was 45.71 %. The prevalence of JS was as follows: dissatisfaction 30 %, satisfaction 32.86 % and indifference 37.14 %. In the crude analysis, we found statistical significance between BS and JS (PR = 13.5; 95 % CI: 3.08-59.24) and in the analysis adjusted for sex, marital status and time of work experience, the association between BS and JS remained statistically significant (PR = 14.15; 95 % CI: 3.02-66.32). Conclusions: BS is negatively associated with JS, finding one out of two doctors with BS. In addition, it is suggested that there is a greater probability of job dissatisfaction in personnel with BS. This implies that it could be used as an indicator in different management areas and be an aspect to assess in health management decision-making. The solution to these problems would help to improve working conditions and, therefore, the health system. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To estimate the opinion of the internal doctors of Specialties Hospital no. 2 Lic. Luis Donaldo Colosio Murrieta, Ciudad Obregon, Sonora, Mexico, about respect for their right to education and decent work. MATERIALS AND METHODS: Descriptive, observational, prospective, cross-sectional study done in September 2022 to evaluate the opinion of undergraduate doctors regarding their rights to education and decent work. We included demographic variables, as well as the results of the survey. Descriptive statistics were applied, we used χ² of goodness of fit to contrast our proportions in the perception of events favorable to education and decent work. RESULTS: There were included 53 surveys; 27 women and 26 men; mean age was 24.32 ± 1.848 years; 35 were in second grade. Out of the 53 participants, 31 perceived their rights to education favorable at a high to very high level and 22 perceived favorable work as high and very high. The analysis with χ² of goodness of fit in the contrast of proportions of perception of favorable events on the right to education found differences p = 0.00008 (p ≤ 0.05) but not in the proportion of decent work with a value of pn= 0.466 (p ≤ 0.05) CONCLUSIONS: Nearly three-fifths of our undergraduate physicians rate their favorable education rights as high to very high, while two-fifths rate them as moderate to very low. [ABSTRACT FROM AUTHOR]

It is recognized that practicing physicians have little training in communication skills with the patient; although this problem is related to the clinical area, it is reasonable to think that the deficiency of these skills also extends to teaching activities. On the other hand, university teaching in the undergraduate and postgraduate study plans is not fully professionalized. Usually, to develop teaching functions, it is only required that the doctor has covered the degree's academic credits, without a prior requirement of training or teaching experience; this can have an unfavorable impact on the teacher-student relationship and negatively affect the academic preparation of students. Communication has a central role in strengthening teaching skills, relationships, respect, and empathy towards medical students, given their role in the success of teaching. This article analyzes aspects related to this process in teacherstudent binomial. [ABSTRACT FROM AUTHOR]

The scarce attention paid in the historiography of Chiapas to the pandemic known as "Spanish influenza", does not prevent us from recognizing its impact on human lives in the southeastern Mexican state, specifically at the end of 1918 and beginning of 1919. Given the lack of knowledge of the virus that caused the rapid deaths, at the time, the remedies known from previous influenza epidemics were used, as well as the knowledge of the few physicians who lived in Chiapas. In this sense, this article offers the extensive response of Dr. Gustavo Gómez Azcárate to the request of the state government to establish preventive measures and antidotes to face the disease. A response that is historically contextualized to understand the difficulties in dealing with a health emergency, such as the one caused by the influenza pandemic, due to the material and scientific shortcomings of the time. [ABSTRACT FROM AUTHOR]

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Reseña del libro Diego Armus (director). Sanadores, parteras, curanderas y médicas. Las artes de curar en la argentina moderna. Buenos Aires, Fondo de Cultura Económica, 2022.]