Prevention of Diseases, Promotion of Health and Reduction of Vulnerability: Historical Evolution of Concepts and Opportunities of Interprofessional Practices

International and national initiatives have as one of the objectives to reorient professional training, ensuring an integral approach to the health-disease process. The conceptual understanding, as well as the understanding of the historical and social roots that justify the emphasis on basic health care and strategies for health promotion and reduction of vulnerabilities, is pressing to support such a reorientation. – Present theoretical assumptions and practical implications in the historical emergency process and development of the concepts of Natural History of Disease / Levels of Prevention, Health Promotion and Vulnerability. – Reflect on the processes of historical transformation of conceptions and practices on the health-disease-care processes. – Reflect on the involvement and challenges for the interprofessional team in the provision of actions to prevent injuries, health promotion and reduction of vulnerability. Medical School (FM) São Paulo, Pinheiros campus The focus of the program is on the historical emergence of the concepts of multi-causality, Natural History of Diseases and Levels of Prevention. International and national benchmarks on health promotion. Discussion of the concept of vulnerability and network construction (intersectoriality). The role of health disciplines and professions in the three approaches (prevention, promotion and vulnerability), as well as the new pedagogical strategies applied to the field of health communication are examined. CLASSROOM SCHEDULE 1 1st part: Presentation of the students + presentation of the proposal of the discipline and the evaluation form – (registration for use of Dropbox) Profa Ana Claudia Germani Part 2: Visit to the museum of FMUSP + Lecture on Medicine and Historicity Prof. Andr_ Mota 2 1st part: History of medical practice and diseases Profo Andr_ Motta 2nd part: HND and levels of prevention. Prof. Jose Ricardo Ayres 3 General concepts of Health promotion in Brazil and in the world: opportunities for interprofessionality and intersectoriality. Profa Ana Claudia Germani 4 Vulnerability Profo Jose Ricardo Ayres 5 Communication on disease prevention and health promotion practices Profa Ricardo Teixeira 6 Course and student evaluation Andre Mota, Jose Ricardo de Carvalho Mesquita Ayres, Ana Claudia Camargo Gon_alves Germani 25 MPR5757 4 Frequency: Weight 1 Self assessment (performed individually on the last day of class, through interview of the student and responsible teachers): weight 1 Class Activities: Weight 2 Final evaluation – exercise: weight 6 http://www.fm.usp.br/en/portal/

Body in Perspective in Collective Health

The subject of the body is classic in the Human and Social Sciences with contributions from different disciplinary fields such as Anthropology, History and Sociology. In the country, the development of this area of __research and the consequent theoretical-conceptual consolidation gained momentum starting in the 1950s. Collective Health, as a field of knowledge and practices, has fostered the constitution of a growing and rich dialogue between the Health and humanities. In this sense, we present the proposal of a discipline on the body proposing the articulation of the disciplinary contributions of Anthropology, History and Sociology in the conformation of the thematic, at the same time, biological and cultural, related to the own social construction of the person and its relevance in the Processes conformed in the care, in the therapeutic practices, in the aesthetic interventions, in the suffering and the pain in face of the processes of illness and in the perception of the body in face of normative processes. The discipline has a theoretical and applied character, allowing to study the articulations of the subject under the referential of the disciplinary fields marked with its applications in the recent researches in the field of health, in addition to enabling, even if still basic, in the critical and reasoned reading of the Productions in the field of health that make use of the mentioned references. 1. Discuss the relationships between body, health, illness and care understood in their symbolic, social and historically constructed dimension; 2. Placing the studies on the body in the field of Human and Social Sciences, starting with the classic nature and culture dichotomy and inserting the contemporary critical debate of this tradition; 3. Contextualize the question of body and identity in the consumer society; 4. Present the concept of stigma and discuss its main repercussions in terms of prejudice, discrimination and exclusion for individuals and populations; 5. Present and discuss definitions about body, forms of care and curative or aesthetic interventions and their main repercussions in health studies; 6. Place the studies on sexuality and reproduction from the perspective of normative / therapeutic perspective on the subject, highlighting the contribution of gender studies in the understanding of the phenomenon that appears as a reference of articulation of the individual and the social, the subjective And the goal; 7. Analyze the relation body and work in contemporary society and its main repercussions in terms of needs of the productive system, training to the time of production, construction of subjectivities, illness and care. Medical School (FM) São Paulo, Pinheiros campus • Body as an object to think about the individual-society relationship in history; • Health-sickness and care in the socio-anthropological perspective; • Body, birth and death; • Corporalities and life cycles; • Body, reproduction and sexuality; • Biomedicine, medicalization and biopolitics of the body; • Work, body and subjectivity; • Body, pain and suffering; • Body, stigma, prejudice and rights. Andre Mota, Rosana Machin Barbosa, Maria Thereza Couto Falc_o 30 MPR5770 8 Participation and exercises in class. Written assessment _ individual test. http://www.fm.usp.br/en/portal/

Ethical and Methodological Principles in Clinical Research

Clinical research is a growing field and demands well prepared researchers from all _reas of health graduation courses. The complexity and variety of methods appied to clinical research, as well as the ethical issues brought by the proposition of protocols in this _rea require adequate training and background. Graduate students, both from master and PhD courses, need to enhance their knowledge and practice in the topics related to clinical research. To present and to discuss ethical basis and main methods of clinical research based on good practice principles. At the end of the discipline, graduate students will be able to write a research protocol, to analyze their project data and to elaborate a publication in their research field. Medical School (FM) São Paulo, Pinheiros campus 1. Ethical and bioethical principles 2. Research question 3. Clinical variables: biomarkers and surrogate endpoints 4. Statistical basis 5. Study design 6. Sampling, validity, bias, randomization and blinding 7. Advanced statistical methods 8. Sample size calculation 9. Assessment of adverse effects and medication adherence 10. Adaptative design and interim analyses 11. Propensity scores 12. Writing a protocol 13. Clinical research as a profession 14. Publishing Wu Tu Hsing Raymundo Soares de Azevedo Neto 30 MPT5795 15 Being an on-line discipline, presence is evaluated by student participation in the discussion forum at least once each week, and the quality of comments posted are graded. Week assignments and a final exam at the end of the discipline compose the final grade of the student. http://www.fm.usp.br/en/portal/

Scientific Method Applied to Clinical Research

The discipline is justified in the post-graduate context that aims at the production of high level scientific knowledge, which recognizes the importance of choosing a suitable research method in front of the research question previously formulated, be it of a basic or applied nature, with observational or experimental design, considering their bias and control powers, in the planning, execution and analysis phases. The course aims to provide a basic training on the nature of scientific knowledge, studying the fundamentals of methodology; Preparing students for the identification of problems, concepts and arguments that influence the theoretical, technical and operational strategies of health research with a special focus on those applied to clinical practice. Medical School (FM) São Paulo, Pinheiros campus Basic principles of the scientific method in health. Ethics in research. Planning and control of biases that promote the internal and external validity of the studies. Causal and statistical inference. Clinical relevance and statistical significance. Main types of designs for clinical studies, in view of clinical epidemiology. Descriptive measures of frequency and association between study variables. Common mistakes and biases in the development of research projects. Critical analysis of scientific articles. Application of basic statistical knowledge for the interpretation of association measures and random bias. Moacyr Roberto Cuce Nobre 61 MCP5884 2 The evaluation will be done through participation in lessons and seminars where research projects, literature papers and conceitual material are presented and discussed. http://www.fm.usp.br/en/portal/

Host-Bacterial Interactions in Women’s Health

Studies of the female genital tract in health and disease are being reported at a very rapid rate. New findings that enhance our understanding of the mechanisms leading to disorders in this area are published almost daily. Whereas previously the predominant focus in infections affecting women was on identification of the causative microorganism and finding the most effective drug for treatment, there is now a much greater appreciation of the role of host-microorganism interactions that promote well being or, conversely, that lead to disease. This has led to a concomitant increased understanding that all women are not identical nor will benefit from the same standard prevention or treatment protocol. There is a great need, currently not effectively met in a many cases, to appreciate genetic, immune, hormonal, microbiological and biochemical differences between women and to modify how we define disease and provide the most effective treatment on an individual basis. Development of increasingly sensitive methods to define the composition of the genital tract microbiome by gene amplification technology, coupled with a greater appreciation of host-microbe interactions, has led to a fundamental change in our understanding of the mechanisms that promote a healthy local environment. This is paralleled by a concomitant increase in our knowledge of how specific alterations promote genital tract pathology. The objective of this course is to provide the most up-to-date information on bacterial, immunological, genetic, and biochemical factors operative in the female genital tract and how their interactions influence health and disease. Medical School (FM) São Paulo, Pinheiros campus The course will focus on the following topics: 1. What is a normal vaginal microbiome? The latest findings on the composition of the vaginal microbiota in girls, adolescents and pre- and post-menopausal women will be presented. The role of individual components of the vaginal microbiota in maintaining a physiological environment also will be addressed. 2. How does the composition of the microbiome influences female reproductive tract health? Alterations in the microbiome in women with vulvovaginal candidiasis, bacterial vaginosis, trichomoniasis, chlamydial, human papillomavirus and human immunodeficiency virus infections and how they influence disease will be detailed. 3. How does a womans genetic make-up influence her likelihood to develop specific alterations leading to genital tract disease. Specifically, recent studies on the role of variations (polymorphisms) in genes involved in anti-microbial defense or in the magnitude and direction of immune responses will be discussed and their influence on susceptibility to various infectious and non-infectious disorders affecting women. 4. What is the contribution of epithelial cells in the female genital tract to local immunity? It is now apparent that vaginal and cervical epithelial cells contribute to immune defense by the spontaneous or induced release of many compounds that are toxic for different groups of microorganisms or that activate a productive immune response. The range of compounds released by epithelial cells, the specific conditions under which they are produced and how they contribute to genital tract health will be discussed. 5. What is the current state of knowledge of genetic, immune, microbiological and environmental factors that contribute to development of female genital tract malignancies  ovarian, fallopian tube, endometrial, cervical and vaginal cancer? Is it possible to predict the occurrence or relapse of these malignancies? 6. What is the current state of knowledge of the causes, diagnosis and treatment of endometriosis? 7. What is the current state of knowledge of the causes and treatment of polycystic ovarian syndrome? Is there any relationship with microbiome? 8. Metabolic syndrome and microbiome: what is the link? 9. What are heat shock proteins and how do they influence health or disease? What is their role in womens health? Classes 1) The human microbioma and the vaginal microbioma. 2) Microbioma and reproductive health infections. 3) Genetic polymorphism and womens health. 4) Autophagy. 5) Malignant genital neoplasias. 6) Endometriosis: the state of the art . 7) Polycistic ovarian syndrome: what is new? 8) Heat shock proteins . 9) Enviromental and sexual factors influencing HIV transmission . 10) Reproductive genital infections during pregnancy: mother and baby consequences. 11) Immunization: where are we today? 12) Society, women, heath and disease. 13) Metabolic syndrome and microbiome. Seminars 1) Gender and Immunity: hormonal influences on local and systemic immunity 2) Infection, immunity and cancer 3) The human microbiome in health and disease: does gender differences matter? 4) Women empowerment , immunity and reproductive health infections: where do we stand ? Iara Moreno Linhares, Edmund Chada Baracat, Jos_ Maria Soares J_nior 20 MGO5730 4 Minimum attendance of 75%, interest and participation in discussions at lectures and seminars. Monograph delivery and evaluation will be mandatory http://www.fm.usp.br/en/portal/

Evidence-Basead Medicine: Scientific Principles and Applicability in Research

The current discipline is organized in order to provide information for the researcher and the future professor for the establishment of the frontier of medical knowledge and substantiate questions, which if answered within the appropriate methodology, will motivate the scientific progress. With the easy access to the medical literature through the internet and the profusion of medical journals, update in medicine had become increasingly difficult, especially regarding the selection of the most reliable and papers with greatest impact in the clinical and surgical management of patients with gastroenterological conditions. Using epidemiology and the concepts of evidence-based medicine, it is possible to evaluate the methodological quality of the research, the cynical relevance, and the applicability of its conclusions in clinical-surgical practice. It is also possible to search for the research that provides the best answer(s) to the formulated question. On the other hand, applying “best evidence” in daily medical practice requires the comparison with the practical experience obtained over the years. Thus, the ideal is the development of concepts in evidence-based medicine in gastroenterology and the comparison with the clinical experience acquired in the Discipline of Digestive Surgery – FMUSP. To define evidence-based medicine, its functions and limitations. – To access the medical literature and how to look for the best evidence in the medical literature, in clinical and surgical gastroenterology. – To evaluate the impact of scientific research in the management of patients with gastroenterological conditions. – To evaluate the minimum prerequisites to develop a clinical research project in clinical and surgical gastroenterology. – To evaluate Meta-analyzes on clinical and surgical gastroenterology topics. Medical School (FM) São Paulo, Pinheiros campus What is and what is not Evidence Based Medicine, history, fundamentals, methods and objectives. • Critical analysis on the limits of the contribution of evidence-based medicine method. • Types of Epidemiological Studies • Basic Concepts in Biostatistics: Measures of Association: Odds Ratio, Relative Risk, Likelihood Ratio, etc … • Practical Application of Association Measures • Basic Concepts in Biostatistics: Confidence Interval. Type I error, Type II error. • Practical Application of Concepts: Confidence Interval, Type I error, Type II error. • How to access Medical Literature and How to look for the “best evidence” in Medical Literature • Systematic Reviews and Meta-Analysis • Main statistical tests used. How to select the test? What are the most common mistakes? • Use of Evidence Based Medicine in the adoption of new health technologies. The accreditation of new technologies in the public health system (SUS). Fauze Maluf Filho, Paulo Herman, Moacyr Roberto Cuce Nobre 34 MGT5736 4 The evaluation will be done by each professor´s criteria: participation grade and/or a written essay to evaluate the understanding of the content immediately after the end of each module. The average of these assessments will be the final mark awarded by the Discipline. Updated articles from the international medical literature will be provided. http://www.fm.usp.br/en/portal/

Cardiology Didactics

This course is justified by the main objective of the “Strito-Sensu” Graduate Program, which is to train teachers and researchers, responsible for promoting and developing scientific advances, but also know how to transmit them and carry the basic tools for a continuous learning. The didactics must be inserted within the principle of the integral formation of the students that will be trained in the current techniques of transmission of the knowledge. Therefore, didactics is a fundamental foundation in the training of these PG students. On the other hand, it can be observed that there is an intimate relationship between didactics and research, since its dissemination and communication to the scientific community and, even to the laity, must be clear, exact and follow ethical principles within established standards. ournals have specific, internationally established rules and, both publications and presentations, must adhere to the basic principles: ethics, accuracy, clarity, exemption, synthesis and conclusion with no other interests. For all these reasons the Discipline of Didactics in the formation of new PGs is justified. Provide postgraduate students with the basic principles of Didactics fundamentals and techniques, based on efficiency, propriety, precision and clarity in scientific expositions, whether oral or written. The form and content of the presentations are analyzed according to the theoretical bases and practical training. Medical School (FM) São Paulo, Pinheiros campus 1.Objectives and forms of scientific communication 2.Principles and methods of oral communication 3. How to prepare a lesson or scientific communication 4. Principles and methods of audio-visual scientific communication 5.Principles and methods of written scientific communication 6.Principles and methods of distance scientific communication 7.Use of projections: computation 8.Exhibition of themes in Poster 9. How to identify or highlight highlights in an oral presentation 10.Criteria for programming courses for: Undergraduate, Residency and Postgraduate Jose Antonio Franchini Ramires, Paulo Cury Rezende 16 MCP5823 3 1. Presentation of two seminars: 1) free themes with oral presentation and 2) data of the thesis project with presentation in the English language. 2. Elaboration of the program of a course for undergraduate students and / or specialization applying the acquired knowledge and evaluation of the discipline._ http://www.fm.usp.br/en/portal/

Seminars: Critical Analysis of Research Projects Developed in the Program – II

The concept of translational science has as principles the practical implementation of knowledge acquired through research for citizens and society. The student should understand, upon his admission into the graduate program, all stages of preparation of a project, from the formulation of the hypothesis, to structuring, raising of funds, achievement of the goals and practical application of knowledge. – We will encourage students to present their project structured as a paper in English. -The teachers will evaluate the content and form of presentation, developing an objective set of guidelines in partnership with students to guide the development of research. Contribute to the consolidation of the researchers’ training, improving their critical capacity to question the results of a study and its potential application; -To understand the concepts and implementation of the dissemination of knowledge; -Preparation of the paper, from the choice of the journal to the review of article; -Understand, discuss, analyze and develop research projects in various fields. Medical School (FM) São Paulo, Pinheiros campus Roberto Kalil Filho, Ludhmila Abrah_o Hajjar 45 MCP5868 4 Frequency, performance and participation during lectures and discussions (the responsible teachers are present in all classes). The course will be offered every semester. Students will present, in the form of a seminar structured as a paper, which will have a duration of 15 minutes. -There will be in-depth examination of the content and form of presentation of the project with the preparation of a plan that should contemplate the graduate program�fs period. http://www.fm.usp.br/en/portal/

Critical Analysis of Clinical Studies in Cardio-Oncology

In the last decades, the cancer treatment has advanced significantly and improved patients’ survival. As a result, cardiovascular complications related to chemotherapy have had a higher impact in their overall survival and quality of. Thus, understanding cardiotoxicity related to cancer treatment, the main medications involved, the potential for reversibility and the management of patients at risk of toxicity has become part of the daily practice of clinical cardiology. Additionally, the potential cardiotoxicity of newer cancer treatment drug is yet to be defined. The collaboration of the Cancer Institute of the State of S_o Paulo and the Heart Institute of the Hospital das Cl_nicas of the Medical School of the University of S_o Paulo, with extensive interaction between cardiologists and oncologists, provides a unique setting for the development of research in the field. The present course aims to bring the discussion on the development of the science related to the field to postgraduate students. Discipline aimed at postdoctoral physicians and other health professionals with scientific interest in the area of Cardio-Oncology. The main objective is to enable students to apply the key fundamental Cardio-oncology concepts in research and clinical practice. Medical School (FM) São Paulo, Pinheiros campus Topics to be addressed: 1. Critical analysis of the studies on cardiotoxicity by Anthracyclines, Trastuzumab and tyrosine kinase inhibitors; 2. Radiotherapy and cardiovascular system; 3. Effects of endocrine therapy for breast and prostate cancer and cardiovascular complications; 4. Peculiarities in the treatment of heart failure and coronary disease in cancer patients, evidence gaps and opportunities for research; 5. Pericardium diseases in cancer patients. Roberto Kalil Filho, Ludhmila Abrah_o Hajjar, M_rcio Sommer Bittencourt 42 MCP5872 2 Frequency, performance and participation during lectures and discussions (the responsible teachers are present in all classes) – On-line questionnaires http://www.fm.usp.br/en/portal/

Inovations on the Diagnosis and Treatment of Arrhythmias, Syncope and Prevention of Sudden Cardiac Death

The risk assessment and treatment of heart rhythm disorders have been modified and advanced substantially in recent years, as a consequence of the development of the technology and recognition of the anatomical and electrophysiological substrates, autonomic modulation and, more recently, molecular origins of cardiac arrhythmias. These instruments provided earlier and more accurate diagnoses, as well as deepened pathophysiological knowledge at the functional, macroscopic and even at the ultra structural level. In this context, there has been constant progresses and accelerated development of new therapeutic options, pharmacological and non-pharmacological, for patients suffering from heart rhythm disorders. Therefore, the understanding of the methods used for its investigation, as well as the development of adequate critical analysis in the decision making to treat them are fundamental for the improvement of researchers in this broad area of __cardiology. To update and motivate a critical analysis of the diagnosis approaches and management (both clinical and interventionists) of cardiac arrhythmias and syncope, as well as of prevention of sudden cardiac death. At the end, the student is expected to achieve a critical sense on the interpretation of the methods, recognizing its potentialities and limitations. Core Question How to diagnose and manage a patient with arrhythmia or syncope, recognizing the risk of sudden cardiac death and achieving the better therapeutic option, considering cost-effectiveness and the influence on the patient’s quality of life. Medical School (FM) São Paulo, Pinheiros campus The course will be divided into 4 modules. The teachers will give classes on the state of the art of the selected topics and the students will be requested to prepare specific seminars. At the end, there will be an evaluation based on their performance in the seminars (content and didactics) and their participation in the discussions. Denise Tessariol Hachul, Mauricio Ibrahim Scanavacca, Francisco Carlos da Costa Darrieux 12 MCP5875 2 Performance in the presentation and the content of seminars Assiduity Participation in discussions. http://www.fm.usp.br/en/portal/

Difficult to Control Asthma: Differential Diagnosis, Associated Co-Morbidities, Treatment Adhrence, Indoor and Outdoor Pollution

Rhinosinusitis, gastro-gastro esophageal reflux disease, vocal fold dyskinesia, anxiety / depression, obesity, sleep apnea, as well as, heart failure or presence of foreign body in the airways, among others, may aggravate or undermine asthma. The high percentage of these co-morbidities in asthmatics has led to an intense debate reflected in the literature on the cause-consequence relationship between both. However, even in relation to rhinitis – allergic disease present in 80% of asthmatics – the pathophysiological connection is inferred, due to the absence of conclusive evidence. The challenge of treating the uncontrolled asthmatic patient with associated morbidities, measuring the impact of the latter, and the need to address them determine the characterization of difficult-to-control asthma. Likewise, symptomatic patients treated as asthmatics and with a low response to treatment, not clinically controlled, may not have asthma. Or they may have adherence to treatment of less than 50%, as well as being exposed to environmental factors, also leading to difficult asthma control. At the request of the World Health Organization, a group of global experts has developed a classification that defines severe asthma in 3 types: 1) untreated or poorly treated asthma related to lack of adequate treatment due to lack of inputs or health infrastructure; 2) difficult to control asthma in patients who are poorly or partially controlled by the presence of comorbidities and / or continuous exposure to triggers and / or low adherence to treatment; and 3) severe asthma dependent on high doses of continuous corticosteroids with High risk of known adverse events or severe asthma refractory to treatment, even at high doses. This discipline aims to clarify the differences between these types of asthma, but focuses on the second type where the aforementioned factors confuse it with the other two types. To present and discuss the current concept of difficult-to-control asthma – called “problematic” – considering the particularities that classify it in some studies as severe asthma. The definition of asthma as morbidity characterized by symptoms such as dyspnea, dry cough and wheezing, commonly leads to the axiom “all that wheeze is asthma.” Morbidities from other systems are often present in asthmatics or mimic asthma. Similarly, low adherence to treatment and continuous exposure to triggers lead to uncontrolled asthma. To clarify the relationships between asthma and these morbidities, as well as to identify and treat these factors, it is essential to differentiate an uncontrolled asthma from severe (or both at the same time), including with regard to care and research outcomes. At the end of the course the student will master the concepts necessary for critical analysis of the evidences and plan research projects in the area of __physiopathology, management and treatment of difficult to control asthma Medical School (FM) São Paulo, Pinheiros campus Lecture 1: 1 hour – Definition of severe asthma vs. difficult to control asthma: is it possible to separate them? Lesson 2: 1 hour – How to measure control objectively and evaluate it after treatment of co-morbidities associated with difficult-to-control asthma. Seminars: 5 hours (presentation of articles by students, followed by group discussion) A) Is it asthma or not? Morbidities that mimic asthma B) Is severe asthmatic adherent to treatment? Causes and consequences C) Atopy, rhinitis, sinusitis and asthma control D) Obesity, gastro-esophageal reflux,sleep apnea and asthma control E) Anxiety, depression, vocal cord dyskinesia and asthma F) Asthma and COPD overlap Practical Class: 4 hours Pulmonology oupatient clinic Study Hours: 4 hours Alberto Cukier, Rafael Stelmach 13 MCP5881 2 This discipline has didactic continuity with the Discipline “Severe Asthma: Phenotypes and their Implications”. It is suggested the student be enrolled in both. Minimum number of students: 6 Maximum number of students: 12 Presence, participation in seminars and practical activities http://www.fm.usp.br/en/portal/

Time Series Analysis