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Percepções de mulheres que sobreviveram ao espectro da placenta acreta sobre a cesárea: o que dizem aquelas que optaram pela cesárea a pedido?
(Universidade Federal de São Carlos, 2024-12-02) Begalli, Bruna Molina; Avó, Lucimar Retto da Silva de; https://lattes.cnpq.br/5353180921178881; https://orcid.org/0000-0001-7282-420X
INTRODUCTION: The global increase in cesarean section rates has raised concerns about maternal morbidity and mortality associated with the procedure. Pregnant women's choice of method of delivery is influenced by personal and external factors, such as social, family and medical influences and pressures. Satisfaction with cesarean section, however, is often envied by studies that tend to present detailed opinions, making the results difficult to interpret. The growing preference for cesarean sections without medical indication raises doubts about the basis of these choices and the ability of women to critically evaluate medical recommendations, especially after serious complications. OBJECTIVE: The objective of this study was to evaluate the perceptions regarding cesarean section of women who, after having a cesarean section "on request", faced complications of the placental accreta spectrum (PAS). The responses of these women were compared to those of those who did not have this option. METHOD: This observational, retrospective and cross-sectional study was extended in a reference university hospital over 18 years (2005-2023). Included exposed women with PAS and undergoing postpartum hysterectomy. Data were collected via a structured questionnaire, complemented by information from medical records, covering demographics, perceptions about the first cesarean section and reflections after complications. Participants were divided into two groups: those with a cesarean section "on request" and those with a cesarean section on "other requests." The study was approved by the ethics committee. RESULTS: The study revealed that of the 66.7% participants who had three or more pregnancies, 36.4% were in the "on request" group and that 81.8% of these had private health insurance. Furthermore, 36.6% of women had little or no knowledge about the risks of cesarean section before the first surgery, and 85.4% were unaware of the PAS. More than half (53.7%) stated that they would make different decisions with current knowledge, and 78% believe that the public knows little about the topic. Finally, 19.6% disagree with the cesarean section law, and 31.7% were still unaware of the relationship between PAS and cesarean sections, even after a near miss. CONCLUSION: Cesarean section on request reflects a choice of a combination of several factors, influenced by beliefs and fears about vaginal birth, which is still seen as a convenient solution. Thus, the lack of knowledge about its risks and changes in opinion after serious complications reinforce that such choices are not based on scientific reflection. Therefore, for women's autonomy to be fully guaranteed, correct information and the deconstruction of deeply rooted myths among the population must be promoted.
O planejamento urbano do território rural: as “chácaras de recreio” e o jogo da ilegalidade no município de São Carlos (SP)
(Universidade Federal de São Carlos, 2024-12-02) Rasera, Denise; Peres, Renata Bovo; https://lattes.cnpq.br/6045407453925020; https://lattes.cnpq.br/0574486745919669; https://orcid.org/0000-0002-3469-0391
In the municipalities of the interior of the State of São Paulo, Brazil, many rural and peri-urban areas are occupied by "recreational farms", which are often characterized by their illegal nature. Initially sought primarily for leisure purposes, these areas are increasingly being absorbed by the "city," either through their incorporation as residential housing or the replication of residential developments in surrounding urban expansion areas. This study aims to analyze urban expansion through the lens of "recreational farm" developments, considering urban planning perspectives and the historical context of their establishment in a case study municipality. The discussion focuses on the advances and contradictions within federal and municipal land-use legislation related to "recreational farms." For this purpose, a case study was conducted in the municipality of São Carlos (SP), using various temporal frameworks according to the research objectives. The methods included bibliographic research, document analysis, semi-structured interviews, and the creation of visualization maps. The results highlight the persistence of illegal occupation processes in environmentally protected areas or areas with fragile soils, as well as the existence of contradictions in the regulation of rural territories.
A visão de um estudante sobre o processo avaliativo de um curso de medicina baseado em metodologias ativas de ensino e aprendizagem, em uma universidade federal no interior do estado de São Paulo, entre os anos de 2019 e 2024
(Universidade Federal de São Carlos, 2024-12-02) Bispo, João Paulo Borges; Adler, Ubiratan Cardinalli; https://lattes.cnpq.br/7366046180927920; https://orcid.org/0000-0003-3236-8347
The evolution of medical education reflects the pressing need to adapt to the complexities of modern society, which demands that future physicians develop not only robust knowledge but also essential skills and attitudes. Traditionally, assessments have prioritized categorization, focusing primarily on measuring the adequacy of outcomes. However, contemporary approaches advocate for the adoption of active learning methodologies and integrated evaluation processes, aiming to create a more holistic educational experience. This study seeks to examine the alignment between the assessment practices of the medical program at the Federal University of São Carlos (UFSCar), contemporary standards in medical education, and their impact on academic training after 19 years of the program's implementation. Particular emphasis is placed on the students’ critical and reflective experiences, offering insights into how these practices shape their educational journey. This study adopts a basic research design with a qualitative approach, combining bibliographic and documentary analysis with a critical-reflective narrative to conduct an exploratory examination of the subject. The research involved a literature review on assessment processes in medical education, an analysis of the political-pedagogical project of UFSCar's medical program, and an in-depth examination of the critical-reflective portfolio of a medical student at UFSCar between 2019 and 2024. Student assessment is a cornerstone of medical education, serving not only to evaluate academic performance but also to cultivate the essential competencies required for professional practice. The evolution of educational paradigms has introduced approaches that prioritize continuous learning, integrating the evaluation of knowledge, skills, and attitudes. Effective assessment must balance formative, summative, and informative functions: tracking learning progress, guiding student development, and evaluating the quality of educational delivery. In this context, programmatic assessment emerges as an innovative and integrative approach, leveraging a variety of evaluation methods to offer a holistic and longitudinal view of student learning. This discussion explores the author’s experiences within the medical program at UFSCar, which introduced an innovative curriculum centered on competency-based education and programmatic assessment. Initially, the shift from a traditional, outcome-focused model to one emphasizing active learning and continuous assessment proved challenging. Adapting to active methodologies and programmatic evaluations required significant effort, reflecting the inherent complexities of such a transition. The author observed an initial alignment with the program's pedagogical goals; however, inconsistencies. This divergence highlighted the need for greater cohesion in implementing innovative practices. Despite the evident benefits of the system, the author identified areas for improvement. Participation in the Evaluation Committee (NAv) was particularly impactful, offering a transformative experience that enhanced understanding of the assessment framework and enabled active contributions to its refinement. In conclusion, while the program lays a robust foundation for medical education, there remains significant potential for refinement. In the UFSCar medical program, the curriculum is structured around competencies and active methodologies, adopting a constructivist approach with continuous assessment. While this framework aligns with contemporary assessment guidelines in theory, practical challenges remain. These include the need for a clearer understanding of assessment processes, as well as greater diversity and transparency in the criteria and tools employed. Programmatic assessment emerges as a promising solution. This approach has the potential to make learning more meaningful and impactful. However, achieving a true transformation of assessment systems requires a cultural shift in the teaching process. True renewal of assessment systems requires cultural change and continuous education among all education stakeholders. Thus, assessment can effectively become a moment of learning and for learning.
Entre estetoscópios e corações: o encontro da ciência e da sensibilidade ao longo da minha jornada acadêmica
(Universidade Federal de São Carlos, 2024-12-02) Silva, Renata Postel; Adler, Ubiratan Cardinalli; https://lattes.cnpq.br/7366046180927920; https://orcid.org/0000-0003-3236-8347
This paper, presented as part of the medicine graduation course at the Federal University of São Carlos (UFSCar), focuses on a reflective narrative of the experiences, challenges, and lessons learned throughout the student's academic journey. The narrative also emphasizes the significant role of extracurricular activities in the student's personal and professional development, broadening her perspective and providing a more comprehensive view of medicine. Throughout her undergraduate studies, the student had the opportunity to engage in practical experiences across various healthcare environments, participating in extension programs and internships that exposed her to diverse realities within the healthcare system. These experiences contributed to the enhancement of both clinical skills and the ability to manage complex situations. Particularly, the extension activities offered by UFSCar, known as ACIEPEs, were instrumental in strengthening her commitment to ethics, empathy, holistic care, active listening and humanized patient care – key aspects in shaping a medical professional capable of addressing the contemporary challenges of the medical profession.
Narrativa crítico-reflexiva sobre minhas vivências no curso de medicina da universidade federal de são carlos visão sobre o curso, a universidade e a cidade de são carlos na perspectiva de um homem preto
(Universidade Federal de São Carlos, 2024-12-02) Silva, Guilherme dos Santos; Avó, Lucimar Retto da Silva de; https://lattes.cnpq.br/5353180921178881; https://orcid.org/0000-0001-7282-420X
This work is a critical-reflexive narrative that explores the experience of a black student on the medical course at the Federal University of São Carlos. The author addresses challenges and personal experiences that involve insertion in a predominantly white and elite academic environment, contrasting moments of welcome with episodes of discrimination and violence, both experienced and observed. The narrative allows analysis these experiences through the theoretical perspective of relevant authors in the field of anti-racist resistance. Based on these experiences, the author reflects on the impact of these years of graduation in the construction of their identity and in their formation as future health professional. In conclusion, he highlights how this
Minha trajetória na medicina UFSCAR: uma narrativa reflexiva
(Universidade Federal de São Carlos, 2024-12-02) Silva, Daniel Souza da; Adler, Ubiratan Cardinalli; https://lattes.cnpq.br/7366046180927920; https://orcid.org/0000-0003-3236-8347
The medical course at UFSCar adopts active learning as its guiding principle. In active learning, the traditional roles of students and teachers are redefined within a bilateral participatory dynamic, although with a student-centered focus. Students are responsible for actively engaging with problem situations, articulating their conceptions and understandings, and formulating questions that help build bridges between their prior knowledge and the new skills needed to face proposed challenges. The Final Graduation Project (TCC) is a synthesis of the development of the student’s professional practice, constructed from their records and experiences throughout the course. This work aims to present the author’s journey over the six years of the medical program, highlighting the development of competencies, acquired skills, and challenges faced, especially the impact of studying medicine during a global pandemic.