Questões de Vestibular Comentadas sobre inglês
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Making family medicine a more attractive specialty: strategies to address the shortage of primary care specialists in Brazil
Primary Health Care (PHC) is often the first level of the health system and is responsible for the coordination of medical and interdisciplinary care. As the preferred entry point to the Brazilian Unified Health System (SUS), PHC is of fundamental importance and is present in all regions of the country. It aims to enable access to health care and ensures the coordination and completeness of care. This structure can treat approximately 80% of the overall need related to diseases presented in the Basic Health Units.
Despite its importance, the valorization of PHC and Family Medicine (FM) as a discipline and a public policy has not been prioritized in most Brazilian educational institutions. According to the study on medical demography carried out by the Regional Medical Council of São Paulo (CREMESP), Brazil had 500,000 physicians in 2020, but with unequal distribution among the nation’s five regions, and a concentration of professionals in the capital cities compared to the countryside.
This issue is faced by many countries. In the United States (US) of 8,116 primary care postgraduate training positions (which includes pediatrics, internal medicine, and family doctors), 42 percent were filled by graduates of U.S. medical schools and the American Association of Medical Colleges (AAMC) projects a shortage of 21,100 to 55,200 primary care physicians (PCP) by 2034. In Europe, where PCP was traditionally respected and recognized, the lack of General Practitioners (GP) is also increasing and is a matter of concern. Workload and a lack of perceived prestige associated with the PCP track can make primary care less attractive. These sorts of misconceptions, along with lower salaries, burnout, and difficult career advancement makes primary care a difficult specialty to attract and retain doctors.
For Feuerwerker, vacancies in Brazilian institutions are the result of several elements: the encouragement of distinctive specialties and institutions, the historical misunderstanding and importance of the practice, and the increased incentive of specialization in medical education. The lack of investments in supplies and infrastructure in primary care, career development concerns, and low salaries, and the valorization of the formation of FM doctors in the work of the EFS also contribute to difficulty in retaining these positions in Brazil.
With the aim to reduce the vacancy rate in the medical residency programs for FM, some Brazilian health departments introduced reforms and additional financing for FM training. In 2020, the region of Campinas, where we work, introduced a program called “More Doctors for the City of Campinas” (PMMC), which established a partnership between public and private higher education institutions, hospitals, and Urgency/Emergency Units with a novel post-graduation proposal for FM. It created a program to support the training of specialists in family medicine, stimulate research, and expand care in Basic Health Units, and has since resulted in a 50% decrease in vacancies.
One of the successful elements of the Campinas program, together with quality of medical training, is that it helps bring medical classroom training closer to the community and everyday social reality. PMMC-trained physicians are aware of how their work impacts the local community and its particular health needs. The program has resulted in care that is more responsive to community needs, especially from the perspective of adopting a care model that prioritizes health promotion, disease prevention, diagnosis, and treatment in an integrated manner. However, for the EFS to continue to innovate and improve its response capacity to contemporary health problems, it must invest heavily in professional training, the rational incorporation of information and communication technologies, and the creation of appropriate working conditions for multidisciplinary teams.
Disponível em: https://speakingofmedicine.plos.org/2023/01/13/. Acesso em: 4 mar. 2024. [Adaptado].
(www.aljazeera.com, 28.11.2023. Adaptado.)
According to the information presented, a suitable title for the text is:
Text 2
White Blood
Doctors in Germany faced something they had never seen before. A 39-year-old patient’s blood was so pale and thick that it looked like milk. The medical condition was not a mystery. The (1) nearly comatose patient suffered from extreme hypertriglyceridemia. It is caused by too much fat in the blood.
Siphoning off the offending triglyceride molecules and returning the cleaned plasma to the body usually solves the problem. However, when staff tried the normal route, his viscous blood clogged the hospital’s filtering equipment. Not once, but twice. The problem was a record amount of triglycerides. Around 500 mg/dL is considered “high.” The man’s count read (2) an astonishing 18,000 mg/dL.
Desperate to save his life, doctors (3) resorted to an ancient remedy abandoned by modern medicinebloodletting. A good amount of the white gunk was drained and replaced with red blood cell concentrates and saline solution. It worked. (4) Although the cause of the severity is unknown, the patient’s genes, obesity, and irregular consumption of his diabetes medication might have combined to cause the mother of all hypertriglyceridemia cases.
(Source: 10 Fascinating Facts And Stories Involving Body Parts - Listverse - Adapted. Retrieved on 23rd Sep, 2024)
Select the option that provides the CORRECT sequence to replace the underlined words in Text 2, while maintaining the original meaning as closely as possible.
I. The person to .......... you spoke yesterday is my neighbour. (whom - which)
II. The car, ............. is parked outside, needs a wash. (which - that)
III. The boy .............. bike was stolen reported it to the police. (which - whose)
IV. The house ............. we bought last year needs some repairs. (that - whom)
V. He is the teacher ......... inspired me to study science. (who - which)
VI. He’s the author of the book about ........ everyone is talking. (who - whom)
Mark the alternative that corresponds to the CORRECT sequence from I to VI, respectively, to complete the sentences.
Binge-watching television, watching YouTube videos for hours, or scrolling on your phone every morning may seem (I) ____________, but research shows that too much screen time may be (II) ____________ to your health. [...] Too much (III) ____________ can impact our health in a myriad of ways, (IV) ____________ eye strain and neck pain (V)________social isolation and mental health issues, and in some cases, it may cause harm (VI) ____________ our brains.
(Source: Adapted from What Excessive Screen Time Does to the Adult Brain | Cognitive Enhancement (stanford.edu), retrieved on 23rd Sep, 2024)
Select the option that contains the CORRECT sequence of words to accurately complete the excerpt.
Text 1
Monkeypox is nothing new, and the virus is endemic in several countries. But when cases started appearing beyond the expected places—and among people who didn’t travel to those endemic regions—researchers paid attention. [...] We’ve been aware of monkeypox for decades, and we have been interested in it mostly because it’s a cousin of smallpox. It is a related orthopoxvirus. The symptoms, although somewhat less severe, are quite similar to smallpox. In most cases, it causes relatively mild illness, meaning most people don’t end up in the hospital with it. [...] It spreads through large respiratory droplets and bodily fluids, so mostly it spreads through close or intimate contact with other people. It’s not highly contagious— nothing like COVID, for example. [...] The Monkeypox virus does tend to be a very stable virus. Unlike COVID, or flu that’s mutating constantly, the orthopoxviruses tend to be quite stable. I think the expectation is that the vaccines would still be effective.
(Source: Adapted from What You Need to Know About Monkeypox | Johns Hopkins | Bloomberg School of Public Health (jhu.edu), retrieved on 23rd Sep, 2024)
According to Text 1, analyse whether the statements that follow are true (T) or false (F).
I ( ) Monkeypox is a recently discovered virus that has drawn researchers' attention.
II ( ) Monkeypox and smallpox are caused by viruses that belong to the same family.
III ( ) Usually, the symptoms of smallpox do not result in severe manifestations or health problems and are generally not serious, unlike those of the monkeypox.
IV ( ) The monkeypox virus mutates constantly. Covid and the flu viruses are likely to be quite stable.
V ( ) It's expected that the vaccines for monkeypox, smallpox, Covid, and the flu are effective because these viruses are relatively stable.
VI ( ) Some regions of the world experience ongoing levels of monkeypox rather than occasional outbreaks.
The statements I to VI are respectively:
Text 1
Most animals can regenerate some parts of their bodies, such as skin. But when a three-banded panther worm is cut into three pieces, each piece grows into a new worm. Researchers are investigating this feat partly to learn more about humans’ comparatively limited abilities to regenerate, and they’re making exciting progress. An especially promising discovery is that both humans and panther worms have a gene for early growth response (EGR) linked to regeneration.
Text 2
When Mansi Srivastava and her team reported that panther worms, like humans, possess a gene for EGR, it caused excitement. However, as the team pointed out, the gene likely functions very differently in humans than it does in panther worms. Srivastava has likened EGR to a switch that activates other genes involved in regeneration in panther worms, but how this switch operates in humans remains unclear.
Disponível em: http://satsuite.collegeboard.org. Acesso em: 10 Jan. 2024.
After you have read both texts, it is possible to state that
By Tara Haelle
Microplastics are everywhere in the environment—and in our bodies. The build-up of these tiny plastic particles in blood vessels is linked to a greater risk of heart attack, stroke, and death, according to a new study. When plaque builds up in arteries—a disease called atherosclerosis—the thicker vessel walls reduce blood flow to parts of the body, raising the risk of strokes, angina, and heart attack. The plaques are typically a mixture of cholesterol, fatty substances, waste from cells, calcium, and a blood clotting protein called fibrin. The new study now focuses on some 300 people with atherosclerosis, some of whom also had tiny plastic particles—microplastics and nanoplastics—embedded in plaques in their carotid artery, a major blood vessel in the neck that provides blood to the brain. The people with plastic-containing plaques were more than four times more likely to have a heart attack or stroke or to die from any cause over the next three years, according to the research published on March 7 in the New England Journal of Medicine.
Disponível em: https://www.nationalgeographic.com/. Acesso em: 11 Abr. 2024.
According to the text, what can be said about microplastic particles?
Disponível em: https://www.discovery.com/. Acesso em: 18 Fev. 2024.
Considering this text on robots and bioengineering, it is INCORRECT to state that
Disponível em: http://www.theguardian.com/. Acesso em: 4 Fev. 2024.
Tome como base o texto acima e analise as asserções abaixo.
I. Terremotos são sempre seguidos de tremores secundários de menor impacto.
II. Cientistas acreditam que até hoje são sentidos efeitos do terremoto de Quebec de 1663.
III. Abalos sísmicos secundários podem ocorrer até mesmo séculos depois do principal.
IV. Em áreas sísmicas, fica difícil distinguir abalos secundários de simples tremores comuns.
V. É pouco provável que terremotos perto de Charleston estejam relacionados com o de 1886.
Assinale a alternativa que apresenta apenas asserções corretas.
INSTRUCTION: Read the following text to answer question.
Brachytherapy: A Tool for Fighting Cancer
Imagine you are camping at night, and you are sitting inside a tent. You want to read a book, but it is too dark. If someone outside the tent shines a flashlight at the book, that might help – you might be able to do some reading, especially if the person with the flashlight is not too far away. If the person with the flashlight gets very close to the tent, it will probably be easier to read your book. If you have a flashlight with you inside the tent and you hold your flashlight right up next to the pages of the book, then you are really in business! Brachytherapy is a little like this flashlight, because doctors deliver a dose of radiation right up close to tumor cells instead of treating them from farther away.
There are several ways to treat cancer using radiation. [...] When healthcare providers use beams of radiation from outside the patient, like with the linear accelerator, that is a little like shining the flashlight from outside of the tent. This is a great option, especially if doctors can aim the beam very carefully at the target. Another way to treat cancer with radiation is by using little pieces of radioactive metal. If doctors put the radioactive source right into the tumor that they are trying to treat, the cancer cells will get a high dose of radiation. This is what is done in brachytherapy.
Radiation Seeds and Extra Special Robots
There are several ways healthcare providers can deliver brachytherapy treatments. The first one that we will talk about is to use lots of little capsules, called seeds. Even though they are called seeds, these are a lot different than the kind of seeds you use in your garden! These seeds are pretty small – they are each about the size of a grain of rice. A doctor can surgically implant these seeds directly inside a tumor. The seeds stay in place inside and, because they are radioactive, they release radiation right where the cancer is.
In another type of brachytherapy, healthcare providers can use a robot called an afterloader that controls where the radioactive source is placed in the patient. This robot can move the source through special tubes into the inside of a patient. When the treatment is over, the robot removes the source from the patient. When the radiation source is not being used for treatment, it sits inside a container inside the robot. That container is made of lead so that it blocks radiation. The afterloader can be controlled from outside the treatment room, so the doctor and other members of the healthcare team can be outside of the room while the source is outside of its special container and is being used to treat the patient. This makes delivering radiation safer for the medical team, because they are not exposed to radiation each time they treat a patient.
Available at: https://kids.frontiersin.org/articles/10.3389/ frym.2024.1378550. Accessed on: July 27, 2024.
INSTRUCTION: Read the following text to answer question.
Brachytherapy: A Tool for Fighting Cancer
Imagine you are camping at night, and you are sitting inside a tent. You want to read a book, but it is too dark. If someone outside the tent shines a flashlight at the book, that might help – you might be able to do some reading, especially if the person with the flashlight is not too far away. If the person with the flashlight gets very close to the tent, it will probably be easier to read your book. If you have a flashlight with you inside the tent and you hold your flashlight right up next to the pages of the book, then you are really in business! Brachytherapy is a little like this flashlight, because doctors deliver a dose of radiation right up close to tumor cells instead of treating them from farther away.
There are several ways to treat cancer using radiation. [...] When healthcare providers use beams of radiation from outside the patient, like with the linear accelerator, that is a little like shining the flashlight from outside of the tent. This is a great option, especially if doctors can aim the beam very carefully at the target. Another way to treat cancer with radiation is by using little pieces of radioactive metal. If doctors put the radioactive source right into the tumor that they are trying to treat, the cancer cells will get a high dose of radiation. This is what is done in brachytherapy.
Radiation Seeds and Extra Special Robots
There are several ways healthcare providers can deliver brachytherapy treatments. The first one that we will talk about is to use lots of little capsules, called seeds. Even though they are called seeds, these are a lot different than the kind of seeds you use in your garden! These seeds are pretty small – they are each about the size of a grain of rice. A doctor can surgically implant these seeds directly inside a tumor. The seeds stay in place inside and, because they are radioactive, they release radiation right where the cancer is.
In another type of brachytherapy, healthcare providers can use a robot called an afterloader that controls where the radioactive source is placed in the patient. This robot can move the source through special tubes into the inside of a patient. When the treatment is over, the robot removes the source from the patient. When the radiation source is not being used for treatment, it sits inside a container inside the robot. That container is made of lead so that it blocks radiation. The afterloader can be controlled from outside the treatment room, so the doctor and other members of the healthcare team can be outside of the room while the source is outside of its special container and is being used to treat the patient. This makes delivering radiation safer for the medical team, because they are not exposed to radiation each time they treat a patient.
Available at: https://kids.frontiersin.org/articles/10.3389/ frym.2024.1378550. Accessed on: July 27, 2024.
INSTRUCTION: Read the following text to answer question
Bringing Physics Into The Doctor’s Office?
Particle physics is a scientific discipline that tries to understand the tiniest building blocks of the universe. These particles are so small that we cannot see them with our eyes or even with advanced microscopes. To study them, particle physicists use huge, powerful machines called particle accelerators, which get particles moving at very high speeds and then smash them into each other. Examining what comes out of these collisions, using giant detectors, can teach scientists a lot about the tiny particles that make up atoms, like electrons and quarks, and even the famous Higgs boson. Nuclear physicists can also use and study radioactive isotopes – atoms that give off a kind of energy called radiation – in their experiments.
On the surface, particle physics and medicine might seem as different as plumbing and carpentry. But some particle physicists have the same goal as doctors – they would ultimately like to see their research improve human lives. Working together, doctors and particle physicists can combine tools and ideas from these two separate disciplines to improve the way diseases, like cancer for instance, are diagnosed and treated. When particle physicists collaborate with doctors, the sky(scraper) is the limit!
Available at: https://kids.frontiersin.org/articles/10.3389/
frym.2024.1302457. Accessed on: July 17, 2024.
Read the following article abstract.
Abstract
In this article, we explore the importance of cooperation in science. Just as various construction trades must work together to build a skyscraper, scientists from separate fields can cooperate to tackle complex scientific challenges. This is called interdisciplinary collaboration, and it is a great way to do science. By bringing together knowledge and tools from multiple fields, scientists can uncover creative solutions and make meaningful connections that they might not have reached on their own. We give an example of how collaboration between particle physics and medicine – two fields that seem very different from one another – come together to improve healthcare. Using the tools of particle physics, scientists are enhancing cancer diagnosis and treatment. Interdisciplinary collaboration is the best way to address many of the complex issues we face today, like controlling climate change or fighting cancer, and it can help scientists and doctors make a lasting impact on human lives and the health of our planet.
Available at: https://kids.frontiersin.org/articles/10.3389/
frym.2024.1302457. Accessed on: July 17, 2024.
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