Disposición de profesionales de la salud chilenos hacia la consejería breve anti-tabaco en pacientes hospitalizados de una institución privada / Readiness of chilean healthcare professionals towards brief tobacco cessation counseling in hospitalized smoking patients of a private institution

OBJETIVO: Evaluar la disposición pre y post intervención de profesionales de la salud de una consejería breve antitabaco (CBA) para pacientes fumadores hospitalizados. MATERIAL Y MÉTODO: Estudio cuantitativo, descriptivo correlacional de corte transversal, con 65 sujetos participantes. RESULTADOS: El 84,6% de los participantes son mujeres, con edad promedio de 33.8 años (DS±9,1). El 52,3% se desempeñaba como técnico en enfermería, seguidos por los enfermeros(as) (18,5%). El 34,9% de los sujetos eran fumadores, de ellos el 21,6% fumaba entre 1 y 5 cigarrillos diarios. Se observó mayor disposición y aceptabilidad hacia la CBA en los proveedores de salud que no fuman versus los fumadores en la medición basal. Post intervención hay diferencias significativas n el grupo de profesionales fumadores, mejorando su disposición y aceptabilidad hacia la CBA. CONCLUSIONES: A mayor consumo de tabaco en los proveedores de salud, menor es la disposición, la aceptabilidad y la conducta habitual de realizar la CBA a los pacientes adultos hospitalizados. Una intervención de CBA dirigida a personal fumador ha demostrado ser efectiva en mejorar su disposición. Si bien el ser fumador constituye una barrera de implementación, es algo que se puede mejorar con capacitación, por lo que se invita a tomar en considerar el nivel de consumo de tabaco de los funcionarios en futuras intervenciones de CBA en pacientes hospitalizados.

OBJECTIVE: To assess readiness among healthcare providers in pre- and post- brief tobacco cessation counseling (BTCC) intervention for hospitalized smoking patients. MATERIAL AND METHOD: Quantitative, descriptive, cross-sectional correlational study, with 65 participants. RESULTS: 84,6% of the participants are women, with an average age of 33,8 years (DS9,1). 52,3% work as nursing technicians, followed by nurses (18,5%). 34,9% of the participants are smokers, of which 21,6% smoke between 1 and 5 cigarettes a day. Greater readiness and acceptability towards BTCC are observed in non-smoking healthcare providers. Significant differences are found in the post BTCC intervention group of smoking healthcare providers, improving their readiness and acceptability towards BTCC. CONCLUSIONS: The greater the tobacco consumption of healthcare providers, the lower readiness, acceptability, and common practice of performing BTCC on hospitalized adult patients. A BTCC intervention aimed at smoking healthcare providers has been shown to be effective in improving their readiness. Although being a smoking healthcare provider has shown to be a barrier to BTCC implementation, it is something that can be overcome with intervention, which is why it is important to consider the level of tobacco consumption of healthcare providers in future implementation of BTCC in hospitalized patients.

Influencia de la sensibilidad, la calidad y la empatía en la satisfacción de proveedores de servicios de Internet

Este trabajo proporciona elementos para el desarrollo de un modelo conceptual del efecto que presentan la sensibilidad y la empatía sobre la percepción de calidad y la satisfacción, al momento de contratar a proveedores de servicios de internet en el sur del Estado de Quintana Roo, México. El objetivo del estudio es comprender cómo afecta la sensibilidad, la empatía y la calidad sobre la satisfacción de los clientes de los proveedores de servicios de Internet. Se utilizó la técnica de muestreo no probabilístico "bola de nieve" para integrar una muestra de 384 usuarios que proporcionaron información mediante la técnica de encuesta. Se desarrolló un modelo probado empíricamente utilizando el modelo de ecuaciones estructurales para analizar el impacto de las variables en la satisfacción. Los resultados muestran que la calidad del proveedor de internet se encuentra altamente influenciada por la empatía del personal y por la sensibilidad, todos estos factores inciden de manera directa y positiva en la satisfacción del cliente, siendo más importante el valor percibido de la empatía que puede afectar en la opinión del usuario, lo que es relevante porque ayuda a comprender por qué los clientes se quedan con un proveedor de servicios en particular. CLASIFICACIÓN JEL M31, L86

This research provides elements for the development of a conceptual model of the effect that sensitivity and empathy have on the perception of quality and satisfaction, when hiring internet service providers in the south of the State of Quintana Roo, Mexico. The objective of the study is to understand how sensitivity empathy and quality affect the satisfaction of customers of Internet service providers. The non-probabilistic "snowball" sampling technique was used to integrate a sample of 384 users who provided information through the survey technique. An empirically tested model was developed using the structural equation model to analyze the impact of variables on satisfaction. The results show that the quality of the Internet provider is highly influenced by the empathy of the staff and by the sensitivity all these factors directly and positively affect customer satisfaction, being more important the perceived value of empathy that can affect the opinion of the user which is relevant because it helps to understand why customers stay with a particular service provider. JEL CLASSIFICATION M3I, L86

Este artigo fornece elementos para o desenvolvimento de um modelo conceitual do efeito da sensibilidade e da empatia na percepção da qualidade e da satisfação ao contratar provedores de serviços de Internet no sul do estado de Quintana Roo, México. O objetivo do estudo é entender como a sensibilidade, a empatia e a qualidade afetam a satisfação do cliente com os provedores de serviços de Internet. A técnica de amostragem não probabilística "bola de neve" foi usada para integrar uma amostra de 384 usuários que forneceram informações por meio da técnica de pesquisa. Um modelo testado empiricamente foi desenvolvido usando modelagem de equação estrutural para analisar o impacto das variáveis na satisfação. Os resultados mostram que a qualidade do provedor de Internet é altamente influenciada pela empatia e pela capacidade de resposta da equipe, todas com impacto direto e positivo na satisfação do cliente, sendo que o valor percebido da empatia é mais importante e pode afetar a opinião do usuário, o que é relevante porque ajuda a entender por que os clientes permanecem com um determinado provedor de serviços. CLASSIFICAÇÃO JEL M31, L86

Early Identification of Autism Spectrum Disorder (ASD): Strategies for Use in Local Communities

Early diagnosis of autism spectrum disorder (ASD) is essential for improved outcomes. There is a paucity of data on the prevalence of ASD in low- and middle-income countries (LMIC), but early identifcation may be further delayed in those communities. In this paper, recent studies on strategies for the early detection of ASD, and the prevalence of ASD in LMIC are reviewed. The limitations that can arise in the early identifcation of ASD in LMIC communities are discussed, and screening tools and strategies that can be helpful are identifed. The goal is to recommend models that are culturally appropriate and scientifcally valid, easily integrated within community settings while strengthening community systems and reducing disparities in the early identifcation of ASD. Starting locally by simplifying and demystifying the ASD identifcation process and building community connections will inform global researchers and policymakers while making a diference in the lives of the children and families afected by ASD.

Professional Quality of Life (ProQOL) of Health Care Providers in Manipur, India

Introduction: Professional Quality of Life (ProQOL) relates to comfort and satisfaction in a profession. Health care providers are exposed to great level of stress and traumatic events in their job. This study aimed at de-termining the ProQOL of health care providers in Bishnupur district. Methodology: A cross sectional study was conducted among health care providers of Bishnupur district, Ma-nipur during 24 January- 24 February 2021. The participants were 153 healthcare providers from district hospital, CHCs and PHCs using a convenience method. The instrument for collecting data consisted of “Profes-sional Quality of Life Measure version 5(ProQOL-5)” questionnaire. Chi square test and Pearson’s r correlation was used for analysis. Results: Mean age of the participants was 37.54 + 9.1 years. The mean values for the domain compassion sat-isfaction (CS), secondary traumatic stress (STS), burnout (BO) was 36.7 + 5.2, 23.2+ 4.5 and 23.3 + 5.6 respec-tively. BO and STS were positively correlated. There was no significant association between other domains. Participants who had night shifts had more BO level compared to others. Conclusion: Majority of the participants had moderate CS and STS. Those having prolonged duty hours expe-rienced more burnout compared to others.

Evaluating a wellness intervention including micro-practices for healthcare professionals before and during COVID-19 / Evaluando una intervención de bienestar con micro prácticas para profesionalesde la salud antes y durante el COVID-19

Abstract Objective: To describe, with a mixed design study, healthcare professionals' pre-post descriptive measures of quality of life (subjective wellness) and prolonged fatigue, as well as an improvement in overall wellness and satisfaction regarding micro-practices as a result of participation in a wellness intervention before and during COVID-19. Material and Methods: This study had a mixed design involving two independent groups of healthcare professionals participating in a wellness intervention with micro-practices before and during COVID-19. The intervention contained multimodal presentations with animated cartoon stories, comics, storytelling, readings, breathing, mindfulness and visualization exercises, adapted from second-order factors in the Indivisible Self model. Pre-post descriptive measures of quality of life (subjective wellness), prolonged fatigue, as well as improvement in overall wellness and satisfaction regarding micro-practices were collected. Results: Attending to either wellness interventions before or during COVID-19 had a positive and, in some cases significant, effect on important indicators of quality-of-life and prolonged fatigue among healthcare professionals. A qualitative analysis indicated a subjective improvement in overall wellness and satisfaction regarding the use of micropractices included in the wellness interventions, regardless of whether these were presented in person or virtually. Most participants subjectively indicated that they improved in the targeted indicators, especially achievement of better wellness. Conclusions: During ordinary and extraordinary circumstances, healthcare professionals require specific interventions that act primarily to provide them with strategies that can improve physical, emotional, and spiritual health. Use of micro-practices in multimodal workshops to improve healthcare practitioner wellness is a successful tool for learning or remembering the importance of pausing during daily clinical activities and refocusing their energy.

Resumen Objetivo: Describir, con un estudio de diseño mixto, la medición descriptiva pre-post sobre la calidad de vida (bienestar subjetivo) y la fatiga prolongada entre profesionales de salud, así como su mejora en el bienestar general y satisfacción respecto al uso de micro-prácticas como resultado de participar en una intervención de bienestar antes y durante COVID-19. Material y métodos: Este estudio tuvo un diseño mixto en el que participaron dos grupos independientes de profesionales del sector salud en una intervención de bienestar con micro-prácticas antes y durante el COVID-19. La intervención consistió en presentaciones multimodales con historias con dibujos animados, cómics, narración de cuentos, lecturas, ejercicios de respiración, mindfulness y visualización, adaptados a partir de los factores de segundo orden del modelo del Yo Indivisible. Se recolectaron medidas descriptivas pre-post de calidad de vida (bienestar subjetivo), fatiga prolongada, así como su mejora en el bienestar general y la satisfacción con respecto a las micro-prácticas. Resultados: La asistencia a cualquiera de las intervenciones para el bienestar antes o durante la COVID-19 tuvo un efecto positivo y, en algunos casos, significativo, sobre importantes indicadores de calidad de vida y fatiga prolongada entre los profesionales del ámbito de la salud. El análisis cualitativo indicó una mejoría subjetiva en cuanto a su bienestar general y satisfacción con respecto al uso de las micro-prácticas incluidas en las intervenciones de bienestar, independientemente de si éstas se presentaron en persona o virtualmente. La mayoría de los participantes indicaron subjetivamente que habían mejorado en los indicadores enfocados, especialmente el logro de un mayor bienestar. Conclusiones: Durante circunstancias ordinarias y extraordinarias, los profesionales de la salud requieren intervenciones específicas que actúen principalmente para proporcionarles estrategias que puedan mejorar la salud física, emocional y espiritual. El uso de microprácticas en talleres multimodales para mejorar el bienestar de los profesionales es una herramienta exitosa para aprender o recordar la importancia que tiene hacer una pausa durante las actividades clínicas diarias y reenfocar su energía.

Perceptions and factors contributing to medication errors amongst the health-care providers in a tertiary care hospital

Background: The use of drugs in the medical field (health care) to reduce the illness process and suffering in the patients is very common. The drugs used should not harm or introduce a new ailment in the patients, which will indirectly increase the burden to the patient, relatives, and also to the society in many ways. Aims and Objectives: The primary objective of the study is to assess the awareness about medication errors among various healthcare professionals – doctors, nurses, and pharmacist, also to spread the awareness on avoiding these medication error and suggest remedies to minimize these errors after analyzing the data. Materials and Methods: This is a descriptive study undertaken after ethical committee approval and conducted by self-reported questionnaires in health-care providers. The participants are grouped into three groups as: Group A: Postgraduates of clinical departments; Group B: Nurses in intensive care unit, casualty and OT; and Group C: Pharmacists. The responses are analyzed using SPSS 17 software. Results: The study shows all the three groups that are equally involved in the mediation errors in different levels of health administration starting from selection of drugs, prescription writing, dispensing of medicine, and also administration of drugs to the patients. Conclusion: Many issues are involved in medication errors done by the health-care providers in different levels of care giving which should be corrected and minimized using latest technologies, reducing the overworking, conducting the lectures, seminars regularly will reduce the occurrence of the incidence, and suffering in such patients.

Comparison of Multimodal Strategies to Enhance Recognition of Child Development Milestones among Childcare Providers during a Virtual or In-person Conference / Comparación de estrategias multimodales para mejorar el reconocimiento de los hitos del desarrollo infantil entre los proveedores de servicios de guardería durante una conferencia virtual o presencial / Comparação de estratégias multimodais para melhorar o reconhecimento de indicadores de desenvolvimento infantil entre o pessoal encargado do cuidado das crianças durante conferência virtual ou presencial

Introduction: Evaluations of knowledge obtained during conferences, whether in person or virtually, are rarely documented, in part because of the complexity of including an assessment, the pretesting involved, confidentiality concerns, and differences among attendees in terms of their education, language, and willingness to be evaluated. Objective: During a conference in the United States, we compared the recognition of developmental milestones using two different multimodal communication strategies (video vs. oral presentation) among three groups of childcare providers. Methods: Cross-sectional study with repeated measures. One hour before the conference completion, two groups (one virtual and one in-person) received an 8-minute multimodal presentation on child developmental milestones at 4 months (cartoon video); a control group, during the face-to-face conference, received an 8-minute multimedia presentation (oral via PowerPoint) on child developmental milestones at 4 months. The three groups responded twice to a scale to measure their recognition of developmental milestones before the lecture began and fifteen minutes before the end of the 2 ½ hours lecture. Results: Attendees, both in person and via the virtual modality, had significantly better recognition of developmental milestones at 4 months of age compared to the control group adjusted for age and education levels. Conclusion: These results suggest the advantages of a multimodal presentation using video versus an oral presentation during lectures to increase recognition of children's developmental milestones, which are complex and varied. Similarly, such a strategy may be effective regardless of the different characteristics related to the educational level or age of the set of participants attending a conference.

Introducción: las evaluaciones de los conocimientos obtenidos durante conferencias, tanto en persona como de forma virtual, rara vez se documentan, en parte debido a la complejidad de incluir una evaluación, las pruebas previas que conlleva, las preocupaciones sobre la confidencialidad y las diferencias entre los asistentes en cuanto a su nivel educativo, lenguaje y disposición a ser evaluados. Objetivo: se comparó el reconocimiento de los indicadores del desarrollo infantil durante una conferencia en los Estados Unidos utilizando dos estrategias de comunicación multimodal diferentes (presentación de vídeo vs. presentación oral) entre tres grupos de personal a cargo del cuidado de los niños. Métodos: estudio transversal con medidas repetidas. Una hora antes de finalizar la conferencia, dos grupos (uno virtual y otro presencial) recibieron una presentación multimodal de 8 minutos sobre los indicadores del desarrollo infantil a los 4 meses (en vídeo con dibujos animados); un grupo de control, durante la conferencia presencial, recibió una presentación multimedia de 8 minutos (oral mediante PowerPoint) sobre los indicadores del desarrollo infantil a los 4 meses. Resultados: los tres grupos respondieron dos veces a una escala para medir el reconocimiento de los indicadores del desarrollo infantil antes de que empezara la conferencia y quince minutos antes de que terminara la conferencia de 2½ horas. Los asistentes, tanto en persona como a través de la modalidad virtual, tuvieron un reconocimiento significativamente mayor de los indicadores del desarrollo infantil a los 4 meses de edad en comparación con el grupo de control, ajustado por edad y niveles de educación. Conclusión: estos resultados sugieren las ventajas de una presentación multimodal con vídeo en comparación con una presentación oral durante las conferencias para aumentar el reconocimiento de los indicadores del desarrollo infantil, que son complejos y variados. Asimismo, dicha estrategia puede ser eficaz independientemente de las diferentes características relacionadas con el nivel educativo o la edad del grupo de participantes que asisten a una conferencia.

ntrodução: as avaliações de conhecimentos obtidos durante conferências, tanto pessoalmente quanto de forma virtual, rara vez são documentadas, em parte, devido à complexidade de incluir uma avaliação, o pré-teste envolvido, questões de confidencialidade e diferenças entre os participantes em termos de nível educacional, linguagem e vontade de ser avaliado. Objetivo: foi comparado o reconhecimento dos indicadores de desenvolvimento infantil durante uma conferencia nos Estados Unidos usando duas estratégias de comunicação multimodal diferentes (apresentação de vídeo versus apresentação oral) em três grupos de pessoal a cargo do cuidado de crianças. Métodos: estudo transversal com medidas repetidas. Uma hora antes de finalizar a conferência, dois grupos (um virtual e outro presencial) receberam apresentação multimodal de 8 minutos sobre os indicadores de desenvolvimento infantil aos 4 meses (em vídeo com quadrinhos animados); um grupo de controle, durante a conferencia presencial, recebeu uma apresentação multimídia de 8 minutos (oral mediante PowerPoint) sobre os indicadores de desenvolvimento infantil aos 4 meses. Resultados: os três grupos responderam duas vezes a uma escala para medir o reconhecimento dos indicadores de desenvolvimento infantil antes de começar a conferencia e quinze minutos antes de terminar a conferencia de 2½ horas. Os assistentes, tanto em pessoa quanto em modalidade virtual, tiveram um reconhecimento significativamente maior dos indicadores de desenvolvimento infantil a 4 meses de idade em comparação com o grupo de controle, ajustado por idade e níveis de educação. Conclusão: estes resultados sugerem as vantagens de uma apresentação multimodal com vídeo em comparação com uma apresentação oral durante as conferencias para aumentar o reconhecimento dos indicadores de desenvolvimento infantil, que são complexos e variados. Mesmo assim, tal estratégia pode ser eficaz independentemente das diferentes caraterísticas relacionadas com o nível educativo ou a idade do grupo de participantes que assistem a uma conferencia.

Care-recipient perspectives on the responsiveness of Orthopedic surgical services in a tertiary center in Nigeria

Responsiveness optimisesthe system-based approach to meeting legitimate demands by healthcare recipients. This study assessed the responsiveness of orthopaedic services at the University of Port Harcourt Teaching Hospital (UPTH) from the perspectives of the care recipients. Methods:Descriptive cross-sectional study among 442 consecutively recruited recipients of orthopaedic services at UPTH from March to June 2020. Close-ended questionnaire with responsiveness conceptualised by five constructs: dignity, autonomy, confidentiality, quality of basic amenities and choice of care provider, each measured along 4-point response scale. The internal consistency reliability of the responsiveness scale was determined by the Cronbach's alpha coefficient. Descriptive (frequency, percentages, bar charts) and inferential (ordinal logistic regression) statistics were conducted and p-values ≤ 0.05 were considered statistically significant. Results: Response rate was 97.3% and the Cronbach's alpha coefficient for the responsiveness scale was 0.83. Participants' mean age was 38.5±14.8years with more being males (55.8%), privately employed (34.9%) and completed secondary education (82.5%). Proportion of respondents who gave excellent ratings across responsiveness domains were dignity (32.8%), autonomy (34.2%), confidentiality (26.3%), amenities (25.8%) and no excellent rating for choice of provider. Marital, employment and visit status were the most consistent factors associated with feedback on autonomy, choice of providers, confidentiality domains.Conclusion: More orthopaedic patients were pleased with the level of autonomy and dignity than choice of providers and quality of basic amenities. There is the need for enhanced responsiveness of orthopedic services to meeting the unique needs of patients and achieving improved quality of care and patient outcomes

Healthcare providers' satisfaction with participation in private health insurance scheme in a city in the southern Nigeria

Health insurance coverage in Nigeria is still very low as over 70% of health care expenditure is financed by out-of-pocket payment. Health care providers are critical participants in the private health insurance scheme, therefore, their perception and satisfaction with the scheme is fundamental in ensuring sustainability. This study assessed health providers' satisfaction with private health insurance scheme in Port Harcourt Rivers State.Method: A descriptive cross-sectional study which engaged a two-stage sampling method to recruit 60 participating health facilities and 180 responding health personnel by simple random sampling at each stage. A structured, pretested interviewer-administered questionnaire was used to collect data on the levels of satisfaction with the four major domains of satisfaction viz; billing rate, payment models, HMO administrative processes and claims management. Data was analysedusing of SPSS, version 26. Characteristics of the responding facilities were tabulated and compared. Level of satisfaction was deduced by Likert Scale according to the domains of satisfaction. Regression analysis with p-value was set at less than or equal to 0.05 was used to determine the predictors of satisfaction with participation in health insurance. The level of satisfaction with negotiated billing rates, payment models, HMO administrative processes and claims management were analyseddescriptively, and results were presented as means, standard deviation, frequencies and percentages, in tables, pie and bar charts

The role of librarians in healthcare interprofessional collaboration: a literature review

Background: As the delivery of healthcare evolves to become more interconnected, coordinating care between nurses, pharmacists, physicians, social workers as well as medical librarians and other disciplines has become increasingly important. Librarians are more deeply involved in ward rounds routine exercise, provision of instruction in health information literacy, medical informatic, evidence-based research skills, and problembased learning. This article introduces key concepts relating to the interprofessional collaborative teamwork among health professionals and its impact on medical librarians. Methods: Data for this paper was collected through the literature review and it was done using various online searching tools with relevant information including, PubMed, LibHub, Science Direct and Google Scholar. Results: The results show that the emerging and changed roles have resulted in a shift in professional identity with the health sciences librarians moving toward a collaborative, consultative practice that is more closely aligned to user's needs and approaching patient care from a team-based perspective. Conclusion and Recommendation: The paper concludes among others that there is a need for library science educators and health sciences librarians to seek and identify skills needed for evolving library practice and formal documentation of new roles within clinical settings. It is recommended that they should add technology, collaborative, consultative, instructional design, and teaching skills to their professional toolbox

A study of knowledge, attitude and practices regarding biomedical waste management among health care providers in a tertiary care Institute in Punjab

The biomedical waste, if not properly managed, can harm the surrounding environment, cause various infections and injuries to the healthcare workers, patients, their attendants. Methods: This cross-sectional study was conducted to assess the knowledge, attitude and practices among different cadres of health care providers in a tertiary care institute. Expecting that 50% of the study population had precise knowledge about the rules and legislation of biomedical waste management, with an allowable error of 10%, at 95% confidence interval, and accounting for the finite population correction for 1700 participants, a minimum sample size of 426 was taken. Data analysis was done by using Microsoft excel and SPSS. Results: Out of 426 subjects, 138 (32.4%) were nurses, 35 (8.2%) were lab technicians and 253 (59.4%) were housekeeping staff. Knowledge, attitude and practices regarding biomedical waste management and handling were significantly (p<0.05) higher among the nurses as compared to other health care providers. Conclusions: Knowledge, attitude and practices regarding the collection, segregation, rules, and disposal of biomedical waste management was more among nursing staff compared to other health care workers. Hence, emphasis on adequate training is required among other health care workers for the safe handling and disposal of biomedical waste management.

SNORE (Sleep Deprivation Among Night Shift Health Staff on Rotation Evaluation) Study Protocol

Background: SNORE (Sleep deprivation among Night shift health staff On Rotation-Evaluation) study is conceptualized to study the effects of sleep deprivation on healthcare professionals working night shifts on rotation. Materials and Methods: A comparative cross-sectional study is devised including health-care profes-sionals working night shifts on rotation at a tertiary level health-care facility, using a semi-structured questionnaire which can test sleep deprivation, cognitive ability, and quality of life. The process is to ap-proach 309 probable study participants based on stratified random sampling, after exclusion of health-care professionals with other factors which may interfere with sleep deprivation testing. Discussion: The study protocol was set in such a way as to randomly include participants from all cadres of healthcare providers as per population proportion. By measuring the effects on cognitive effect and quality of life necessary steps can be taken to provide better quality of life and to decrease cognitive im-pairment, especially among health care professionals working night shifts.

Percepção de determinantes de saúde e doença em um território: relato de experiência / Perception of health and disease determinants in a territory: experience report / Percepción de los determinantes de la salud y enfermedad en un territorio: reporte de experiencia

O processo saúde-doença compreende amplas variáveis que envolvem o indivíduo e o meio em que vive. Diante da pandemia causada pelo novo coronavírus, da síndrome respiratória aguda grave e das necessidades de saúde da população no contexto do território, este estudo teve como objetivo conhecer a percepção de usuários do Sistema Único de Saúde (SUS) sobre os determinantes de saúde e doença, aliado à perspectiva do controle social e dos direitos e deveres dos usuários. Trata-se de um relato de experiência elaborado no contexto de atuação da equipe de residentes multiprofissionais em Atenção Básica/Saúde da Família e Comunidade da Prefeitura Municipal de Mossoró. Foram realizadas três etapas, constituídas por planejamento e pesquisa bibliográfica acerca do controle social e participação da comunidade no SUS; encontro com agentes comunitários de saúde para o (re)conhecimento ampliado do território; e encontro com membros da comunidade para discussão dos determinantes de saúde e doença no território. Os usuários participantes manifestaram uma visão ampliada do conceito de saúde, com menção a problemas ambientais e sociais que impactam as condições da saúde em sua comunidade. Pela experiência da ação, pode-se observar que a população sente a necessidade de momentos em que possa ser ouvida e, com os profissionais de saúde, debater os problemas e possíveis soluções para a comunidade, compreendendo sua corresponsabilização no processo de promoção da saúde nos âmbitos individual e coletivo, estabelecendo vínculos construtivos.

The health-disease process comprises broad variables that involve the individual and the environment in which they live. Given the pandemic caused by the new coronavirus, the severe acute respiratory syndrome, and the health needs of the population within a territory, this study sought to know the perception of Unified Health System (SUS) users about health and disease determinants, combined with the perspective of social control, and the rights and duties of users. This experience report was elaborated amidst a multidisciplinary team of residents in Primary Care/Family and Community Health of the Municipality of Mossoró. The research consisted of three stages: planning and bibliographical research about social control and community participation in the SUS; meeting with community health agents for a broader knowledge of the territory; and meeting with community members to discuss health and disease determinants in the territory. Participants expressed an expanded view of the concept of health, mentioning environmental and social issues that affect health conditions in their community. This experience showed that the population feels the need to be heard and discuss, together with health professionals, the problems and possible solutions for the community, understanding their co-responsibility in individual and collective health promotion actions, establishing constructive bonds.

El proceso salud-enfermedad tiene amplias variables que involucran al individuo y al medio en que se vive. Ante la pandemia provocada por el nuevo coronavirus, el síndrome respiratorio agudo severo y las necesidades de salud de la población en el contexto del territorio, este estudio tuvo como objetivo conocer la percepción de los usuarios del Sistema Único de Salud (SUS) sobre los determinantes de la salud y la enfermedad, combinados con la perspectiva del control social y los derechos y deberes de los usuarios. Este es un reporte de experiencia, elaborado en el contexto del trabajo del equipo multidisciplinario de residentes en Atención Básica/Salud Familiar y Comunitaria del Municipio de Mossoró (Brasil). Se realizaron tres momentos, consistentes en la planificación y búsqueda bibliográfica sobre control social y participación comunitaria en el SUS; encuentro con agentes comunitarios de salud para el (re)conocimiento ampliado del territorio; y reunión con miembros de la comunidad para discutir los determinantes de la salud y la enfermedad en el territorio. Los usuarios participantes expresaron una visión ampliada del concepto de salud, mencionando problemas ambientales y sociales que repercuten en las condiciones de salud de su comunidad. Se puede observar, a partir de la experiencia de la acción, que la población siente la necesidad de momentos en los que se pueda escucharla para, junto a los profesionales de la salud, discutir los problemas y posibles soluciones a la comunidad, que llevan en consideración su corresponsabilidad en la promoción de la salud a nivel individual y colectivo, y establecen vínculos constructivos.

Informal Healthcare Providers of Abortion Services among Three Scheduled Tribes of Jharkhand

Background: There is a dominant role of informal healthcare providers (IHPs) in the current cultural and sociological context of tribal communities. They outnumber formal health‑care providers, thus bridging the gap between existing and nonexisting public health facilities despite not having formal training or accreditation. Objectives: The study examines the role, relevance, and extent of abortion services provided by IHPs‑ in Jharkhand among three Scheduled Tribe groups. Materials and Methods: Based on in‑depth interviews with 15 IHPs and 42 married women among three Scheduled Tribe groups in three districts of Jharkhand, a qualitative study was conducted. Interview guidelines addressed reasons for preferring IHP services, their scope of practice, dissemination, and quality of services. Results: The majority of women seeking abortions used traditional contraceptives, which often resulted in unwanted pregnancies. The economic, cultural, social, access to services, and confidence factors encouraged women to seek abortion services from IHPs. There were differences in the nature of access to abortion services among tribal groups. The Chero and Korwa tribes continued to rely heavily on simpler life technologies that shaped their beliefs and practices regarding reproduction. The Ho tribe, however, preferred to use the formal health‑care system since they were close to a more complex society. Conclusion: IHP plays a significant role in the social structure of Tribes, demonstrating their marginalization in access to formal health‑care services. Eventually, they replaced traditional healers with their function as physicians.

Mental Health of Doctors Who Treat Patients with covid-19 in Mexico City: An Anthropological Investigation / La salud mental de los médicos que atienden covid-19 en la Ciudad de México: una investigación antropológica / A saúde mental dos médicos que tratam a covid-19 na Cidade do México: uma investigação antropológica

Introduction: The objective of this article was to explore, from an anthropological perspective, the social representations that doctors who treat covid-19 in specialized hospitals in Mexico City have, regarding the relationship between their professional performance and the deterioration of their mental health; as well as their social representations of the existing institutional resources to provide them mental health attention and their care-seeking and self-care strategies. Materials and Methods: For this, a quali-tative investigation was carried out with semi-structured interviews with 35 doctors who treat covid-19. Results: From the points of view of the doctors, various sociocultural and structural causes of mental illness related to their professional performance are documented and analyzed, as well as their repre-sentations about the inadequacy and/or ineffectiveness of the institution, group, or individual resources to provide them mental health attention; and some allopathic and non-biomedical forms of care-seeking and self-care. Conclusions: Recommendations are made to address the etiologies of the disease analyzed in a culturally and structurally appropriate way to the context of the pandemic.

Introducción: el objetivo de este artículo es explorar, desde una perspectiva antropológica, las representaciones sociales de los médicos que atienden covid-19 en hospitales especializados de la Ciudad de México, respecto a la relación entre su desempeño profesional y el deterioro de su salud mental, así como de los recursos institucionales existentes para atenderla y sus estrategias de búsqueda de atención y de autoatención. Materiales y métodos: para ello, se realizó una investigación cualitativa con entrevistas semiestructuradas a 35 médicos que atienden covid-19. Resultados: a partir de sus puntos de vista se documentan y analizan diversas causas socioculturales y estructurales del padecimiento mental relacionado con su desempeño profesional, así como sus representaciones sobre la inadecuación o ineficacia de los recursos institucionales, grupales o individuales, para atenderlo y algunas modalidades de búsqueda de atención y autoatención alopáticas y no biomédicas. Conclusiones: se realizan recomendaciones para abordar institucionalmente las etiologías del padecimiento reportadas por los entrevistados de una forma cultural y estructuralmente adecuada al contexto de la pandemia.

Introdução: O objetivo deste artigo é explorar, a partir de uma perspectiva antropológica, as represen-tações sociais que os médicos que tratam a covid-19 em hospitais especializados na Cidade do México, têm sobre a relação entre seu desempenho profissional e a deterioração de sua saúde mental; bem como os recursos institucionais existentes para cuidar da saúde mental e as estratégias de busca de cuidado e autocuidado. Materiais e métodos: Para isso, foi realizada uma pesquisa qualitativa com entrevistas semiestruturadas com 35 médicos que tratam da covid-19. Resultados: Do ponto de vista dos médicos, são documentadas e analisadas diversas causas socioculturais e estruturais do adoecimento mental relacio-nadas à sua atuação profissional, bem como suas representações sobre a inadequação e/ou ineficiência dos recursos institucionais, grupais ou individuais, disponíveis para atendê-los e algumas modalidades de busca de cuidado e autocuidado alopáticos e não biomédicos. Conclusões: São feitas recomendações para abordar institucionalmente as etiologias da doença relatadas pelos entrevistados de forma cultural e estruturalmente adequada no contexto da pandemia.

Barreras para la atención de las conductas suicidas en Ciudad de México: experiencias del personal de salud en el primer nivel de atención / Barriers to Care of Suicidal Behavior in Mexico City: Health Personnel Experiences at the First Level of Care / Barreiras para a atenção das condutas suicidas na Cidade do México: experiências dos profissionais de saúde na atenção básica

Resumen Objetivo: Identificar las barreras que existen para la atención de las conductas suicidas, desde la perspectiva de las/los profesionales de la salud mental del primer nivel de atención de la Ciudad de México. Metodología: Estudio cualitativo exploratorio, basado en 35 entrevistas semiestructuradas, dirigidas a personal de salud de dos unidades de salud mental de referencia nacional. El análisis de la información se hizo mediante el Framework Analysis. Resultados: Las/los participantes consideraron que las conductas suicidas no han sido definidas como una prioridad dentro de los trastornos de salud mental. La ausencia de políticas públicas, la sobrecarga de trabajo, la falta de seguimiento a las/los pacientes, entre otras, fueron identificadas como barreras para una atención adecuada y oportuna. Conclusiones: Los programas de prevención de las conductas suicidas deben tomar en cuenta el contexto socioeconómico de la población y las características de los servicios de salud, así como las necesidades de las personas prestadoras de servicios de salud. Se requiere ampliar el entrenamiento profesional y mejorar el sistema de referencia y contrarreferencia entre los distintos niveles de atención.

Abstract Objective: To identify the existing barriers to the care of suicidal behavior from the perspective of mental health professionals at the first level of care in Mexico City. Methodology: Qualitative exploratory study based on 35 semi-structured interviews conducted on health personnel from two national reference mental health facilities. The data were analyzed with Framework Analysis. Results: The participants considered that suicidal behavior has not been prioritized among mental health disorders. The absence of public policies, work overload, lack of patient follow-up, among others, were identified as barriers to adequate and timely care. Conclusions: Suicidal behavior prevention programs should consider the socioeconomic context of the population, the characteristics of health services, and the needs of health care providers. Professional training should be enhanced, and the referral and counter-referral system across levels of care should be improved.

Resumo Objetivo: Identificar as barreiras existentes para a atenção das condutas suicidas, desde a perspectiva dos profissionais de saúde mental de atenção básica da Cidade do México. Metodologia: Estudo qualitativo exploratório, baseado em 35 entrevistas semiestruturadas, dirigidas a profissionais de saúde de duas unidades de saúde mental de referência nacional. A análise da informação foi feita através do Framework Analysis. Resultados: Os participantes consideraram que as condutas suicidas não têm sido definidas como uma prioridade dentro dos transtornos de saúde mental. A ausência de políticas públicas, a sobrecarga de trabalho, a falta de seguimento aos pacientes, entre outras, foram identificadas como barreiras para uma atenção adequada e oportuna. Conclusões: Os programas de prevenção das condutas suicidas devem considerar o contexto socioeconômico da população e as características dos serviços de saúde, além das necessidades dos profissionais de saúde. É necessário ampliar o treinamento profissional e melhorar o sistema de referência e contrarreferência entre os diferentes níveis de atenção.

Exploring the knowledge and perception towards generic medicines among undergraduate medical and nursing students – A questionnaire-based comparative study

Background: Healthcare providers are still hesitant in prescribing generic medicines due to several misconceptions about bioequivalence, efficacy, quality, and safety of generic medicines as compared to their branded counterparts. Proper teaching and training help in positive changes in perception as well as the prescribing and dispensing practices of healthcare providers. Aim and Objectives: The aims of this study were to study the knowledge and perception about the generic medicine among 2nd year MBBS and nursing students and to find out the differences between the student’s responses. Materials and Methods: An observational cross-sectional study was conducted involving 83 2nd year MBBS students and 60 2nd year nursing students in Bundelkhand Medical College, Sagar (M.P.), India. Assessment of knowledge and perception about generic medicines using the normal 5-point Likert scale and calculation using the independent-samples Mann–Whitney U-Test and P < 0.05 was considered statistically significant for differences observed among the two groups. Results: Only 33% of MBBS students and 17% of nursing students were select correct answer for bioequivalence limits. Almost 82% of MBBS and 53% of nursing students were agreed toward generic medicines are less expensive than brand name medicines (P = 0.00). Only 45% of MBBS students and 15% of nursing students were disagreed toward generic medicines are of inferior quality to branded drugs (P = 0.001). About 37% of MBBS students and 20% of nursing students were disagreed toward generic medicines are less effective and less safe than brand name medicines (P = 0.01) and only 12% of MBBS students and 7% of nursing students were disagreed toward brand name medicine which are required to meet higher safety standards than generic medicines (P = 0.09). Conclusion: In our study, we found that significant knowledge gap with regard to the regulatory bioequivalence limits for generic medicines and misconceptions about generic drugs is also quite prevalent. Educational interventions are most important tool to improve knowledge and change in perceptions among healthcare students about generic medicines and eventually promote practice of prescribing cost-effective generic drugs.

Direct Benefit Transfer Scheme for Tuberculosis Patients – Performance Challenges observed by the Providers and Patients

Introduction: Government of India launched an Aadhar-linked Direct Benefit Transfer (DBT) scheme from 1st April, 2018. Under this scheme, all notified TB patients would receive Rs 500 per month (~US$7) throughout the course of their treatment for nutritional support. Aim and Objectives: To determine the challenges faced by the health providers and patients in the implementation of Direct Benefit Transfer scheme. Methods: This was a mixed method cross-sectional study conducted on all public and private TB patients notified during the year 2019 under RNTCP (now NTEP) in district Amritsar, Punjab. Quantitative data about the availability and validation of bank accounts was obtained from the Nikshay portal after having permission from the District TB Officer. Qualitative data was obtained from the focus group discussion and in-depth interviews with the involved staff members (17) and patients (20) registered in Tuberculin units of Amritsar. Results: From the Nikshay reports, it was observed that there was significant difference between the public and private sector and between rural and urban areas. Focus group discussion was done with the TB Health Visitor (TBHV) and Senior TB supervisors (STS) and asked about the hurdles they faced. Items were identified and tabulated. In-depth interviews were conducted on 20 patients, 10 each from public and private sector respectively. Data collected was transcribed and arranged as per the themes or questions and then the information was recorded under those sub-headings. Conclusion: The major challenges observed by the providers were lack of support from the private sector, lack of awareness among people, technical issues and more work burden. Patients mostly mentioned about confidentiality issues, lack of awareness, social stigma of the disease, less amount and long and complex process.

A reforma psiquiátrica em relatos de cuidadores de residências terapêuticas / Psychiatry reform in reports of therapeutic residence care providers

Resumo A Reforma Psiquiátrica brasileira criou uma série de dispositivos para substituir o sistema asilar, entre eles o Serviço Residencial Terapêutico (SRT). Com o objetivo de ampliar as reflexões sobre os desafios enfrentados pela proposta reformista, este estudo analisa os discursos construídos pelos cuidadores das residências terapêuticas de Campina Grande (PB), visando detectar estratégias argumentativas favoráveis ou contrárias à Reforma, identificar as identidades que constroem para si próprios, para os demais profissionais da rede de saúde mental e para os usuários do serviço, além de analisar como nomeiam e descrevem o sofrimento psíquico. A pesquisa, de cunho qualitativo, baseou-se na perspectiva teórico-metodológica da psicologia social discursiva. Obtiveram-se 18 depoimentos orais que foram submetidos à análise de discurso. Apesar dos cuidadores se posicionarem a favor da reforma psiquiátrica, apresentam relatos que reforçam a necessidade dos hospitais psiquiátricos, sobretudo, nos momentos de crise dos usuários. Ademais, os profissionais dos hospitais são posicionados, em alguns relatos, como mais capacitados do que os da rede substitutiva. Esses relatos ainda associam o sofrimento psíquico à doença, à periculosidade e à alienação, e caracterizam os usuários como agressivos, perigosos e instáveis. De modo geral, os entrevistados justificam algumas práticas hospitalocêntricas, valorizam o saber médico e reproduzem discursos asilares.

Abstract The Brazilian Psychiatry Reform has created a number of alternatives to substitute the asylum internment system, among them, the Therapeutic Residential Service (SRT). Aiming at deepening the reflections over the challenges the reformist proposal faces, this study analyzes the discourses constructed by care providers of therapeutic residences in Campina Grande (state of Paraíba), to identify argumentative strategies either in favor or against the Reform, identify the identities they build for themselves and for other mental health network professionals and for the service users, in addition to analyzing how they name and describe psychic suffering. The research has a qualitative character, based on the theoretical-methodological perspective of discursive social psychology. A total of 18 oral reports were obtained and submitted to discourse analysis. Although the care providers revealed their approval of the psychiatric reform, their reports stress the need for psychiatric hospitals, mainly for those users undergoing crises. Besides, hospital professionals are seen, in some of those reports, as more capable than those in the substitutive network. Moreover, these reports associate psychiatric suffering to disease, to dangerousness, and to alienation and characterize the users as aggressive, dangerous, and unstable. On the whole, those interviewed justify some practices typical of hospitals, value medical knowledge and reproduce asylum discourses.

Study on knowledge, attitudes and practices of pulse oximetry among pediatric healthcare providers in China and their influencing factors / 中华实用儿科临床杂志

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.