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Objective: To evaluate the knowledge about physiological aspects, clinical management, and nutrition of primary care patients with type 2 diabetes mellitus by sociodemographic, economic, and clinical variables. Material and methods: We conducted an observational cross-sectional study in 22 Family Health Strategy units in the city of Montes Claros, Minas Gerais, in 2015 among 353 patients registered with type 2 diabetes mellitus. A structured questionnaire was used to assess sociodemographic and clinical characteristics. Knowledge was assessed using the diabetes knowledge scale questionnaire. Data were presented with absolute frequencies and percentages and analyzed using Poisson regression. Results: Most respondents demonstrated satisfactory knowledge in the field of physiology (60.30%) and unsatisfactory knowledge in clinical management (67.7%) and nutrition (61.5%). Schooling was associated with knowledge in the areas of physiology, clinical management and nutrition, and treatment associated with clinical management. Conclusion: Knowledge about type 2 diabetes mellitus was related to sociodemographic characteristics and treatment. The importance of health education for coping with this chronic condition is evident.
Objetivo: Evaluar los conocimientos sobre aspectos fisiológicos, manejo clínico y nutrición de usuarios con diabetes mellitus tipo 2 registrados en unidades de Atención Primaria y su análisis según variables sociodemográficas, económicas y clínicas. Métodos: Se trata de un estudio observacional y transversal realizado en 22 unidades de la Estrategia Salud de la Familia de la ciudad de Montes Claros, Minas Gerais, en 2015 con 353 pacientes registrados con diabetes mellitus tipo 2. Se utilizó un cuestionario estructurado para evaluar las características sociodemográficas y clínicas. El conocimiento se evaluó mediante el cuestionario de la escala de conocimiento de la diabetes. Los datos se presentaron en frecuencias absolutas y porcentajes. El análisis de datos utilizó la regresión de Poisson. Resultados: La mayoría de los encuestados demostró conocimientos satisfactorios en el campo de fisiología (60,30%) y conocimientos insatisfactorios en manejo clínico (67,7%) y nutrición (61,5%). La escolaridad se asoció con conocimientos en las áreas de Fisiología, Manejo Clínico y Nutrición e treatment con Manejo Clínico. Conclusión: El conocimiento sobre la diabetes mellitus tipo 2 está relacionado con las características sociodemográficas y el. tratamento. La importancia de la educación en salud para el enfrentamiento de esta condición crónica es evidente.
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Day surgery can effectively improve the utilization of medical resources. In October 2015, an obstetrics and gynecology hospital established a gynecological day surgery center to centrally manage gynecological day surgery and continuously optimize the management process. In July 2019, the hospital established an intelligent information platform for gynecological daytime surgery managemen. Based on this platform, the " evaluation-appointment-hospitalization-follow-up-chronic disease management" information management process was implemented, the " pre hospital-in hospital-post hospital" full process medical quality and safety monitoring was carried out to form a centralized closed-loop management mode for gynecological day surgery led by gynecologists. Under this management mode, the number of gynecological day surgeries in the hospital has increased from 2 866 cases in 2019 to 4 065 cases in 2021, providing convenient medical services and personalized chronic disease management services, and ensuring the quality and safety of gynecological day medical care, for reference for promoting the high-quality development of day surgeries in specialized hospitals.
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Pain is one of the most frightening and unbearable symptoms in cancer patients, approximately 80% of patients with advanced cancer have pain, and a systematic review shows that the prevalence of breakthrough cancer pain (BTcP) was 59.2%. Breakthrough pain often has a significant negative effect on quality of life of patients, which is related to a direct effect (suffering) and an indirect effect (interference with activities of daily living). Clinical management of BTcP is still not satisfactory despite the availability of various effective pain relief agents. The purpose of this review is to summarize the current situation of the management of BTcP at home and abroad, and to discuss the factors that hinder the management of BTcP.
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As one of the most common acute complications of diabetes, hypoglycemia can occur in any diabetic patients. Multiple risk factors can lead to the occurrence of hypoglycemia, but the risk of hypoglycemia is generally ignored in clinical practice. Therefore, attention should be paid to identifying high-risk population, strengthening blood glucose monitoring, and selecting reasonable diabetes treatment programs and health education. Hypoglycemia is associated with a variety of adverse outcomes, especially nervous system injury. In clinical practice, it is necessary to prevent and improve hypoglycemia complications and reduce glucose reperfusion brain injury. Continuous blood glucose monitoring technology and the new glucagon nasal spray powder have shown positive effects in the management of hypoglycemia, but there are still many challenges that need further research and exploration.
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Objective:Based on Web of Science database, this study aimed to explore the current status, research hotspots and development trends of countries regarding clinical management of osteoporotic fractures using bibliometrics and visualized analysis.Methods:We collected literatures in the field of clinical management of osteoporotic fractures included in Web of Science database, and applied bibliometrics to analyze the publication dates, countries, institutions, journals, authors, highly cited literatures and research hotspots. Visualization was drawn by VOSviewer software.Results:Analysis of the 2 508 articles revealed 3 types of data. (1) The analysis of basic information of the literature showed that: ①The country with the largest number of publications was the United States, which published 672 articles, followed by the United Kingdom and Canada, and China ranked fourth; ②The top three authors in the number of publications were Kanis JA, Cooper C and McCloskey EV respectively; ③The institution with the highest number of publications was the University of Sheffield, UK, followed by the University of Southampton, UK and the University of Toronto, Canada. (2) Network visualization of highly cited literatures showed that 118 highly cited literatures were mainly divided into 5 clusters, which were related to osteoporotic fracture diagnosis, treatment, medication adherence, management consensus and strategies of preventing refracture. (3) Temporal overlay visualization of research hotspots showed that early research mainly focused on traditional therapeutic drugs, and current research hotspots were mainly molecular targeted drugs, trabecular bone score and fracture liaison services.Conclusion:This study shows that the research activity of clinical management of osteoporotic fractures is increasing worldwide, and there is still a huge gap between China and Europe or the United States. Current research hotspots and development trends mainly focus on molecular targeted drugs, osteoporotic fracture treatment concepts, emerging fracture risk assessment tools, and fracture prevention and management models.
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The common adverse reactions caused by poly (ADP-ribose) polymerase (PARP) inhibitors include hematological toxicity, gastrointestinal toxicity and fatigue. The main prevention and treatment of hematological toxicity include: regular blood tests, referral to hematology department when routine treatment is ineffective, and being alert of myelodysplastic syndrome/acute myeloid leukemia. The key points to deal with gastrointestinal toxicity include: taking medicine at the right time, light diet, appropriate amount of drinking water, timely symptomatic treatment, prevention of expected nausea and vomiting, and so on. For fatigue, full assessment should be completed before treatment because the causes of fatigue are various; the management includes massage therapy, psychosocial interventions and drugs such as methylphenidate and Panax quinquefolius according to the severity. In addition, niraparib and fluzoparib can cause hypertension, hypertensive crisis and palpitation. Blood pressure and heart rate monitoring, timely symptomatic treatment, and multidisciplinary consultation should be taken if necessary. When cough and dyspnea occur, high resolution CT and bronchoscopy should be performed to exclude pneumonia. If necessary, PARP inhibitors should be stopped, and glucocorticoid and antimicrobial therapy should be given. Finally, more attention should be paid to drug interaction management, patient self-management and regular monitoring to minimize the risk and harm of adverse reactions of PARP inhibitors.
Subject(s)
Humans , Poly(ADP-ribose) Polymerase Inhibitors/adverse effects , Phthalazines/pharmacology , Poly(ADP-ribose) Polymerases , Fatigue/drug therapyABSTRACT
Medico-legal issues in orthopaedic practice are increasing day by day. With the tremendous metamorphosis in the healthcare sector, incidents of lawsuits against orthopaedic surgeons and hospitals, in the name of medical negligence is on the rise. With every consumer redress forum being more inclined in protecting the consumers, it is imperative for practising Doctors to be more informed on the Medico-legal aspects of their field of practice. Most orthopaedic cases that lead to medico-legal cases result from trauma. Besides, these cases are seen in the Emergency Room, thereby resulting in critical and uncertain decisions. Unlike in other fields where the patient has an existing relationship before any complications occur, rapport-building has to begin much after the treatment has begun. Technological advances in the orthopaedic field, availability of online information on platforms like Google, lack of communication, cutthroat competition among orthopaedic surgeons, awareness about the consumer protection act, mob psychology, interference by anti-social elements and local politicians etc have brought orthopaedic practice at this stage. Following ethical aspects, keeping good repo with patients and society, keeping our documentation perfect and precise, and doing transparent and honest practice can save orthopaedic surgeons in long run. Having empathy towards patients and society, keeping workload in our control, helping each other in crisis, and no medical jousting are also important measures to do safe medical practice in the present era. Keeping in mind the mantra of coming together, working together, and working in harmony is of utmost importance for an orthopaedic practice in recent times.
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Objective: To analyze clinical indicators of teledentistry management for the elderly population during the COVID-19 pandemic in Chile. Material and Methods:A pilot teledentistry project was developed for dental care of the elderly in 5 regions of Chile. The data obtained were recorded on the TEGO Platform to be subsequently selected and analyzed by the researchers in terms of clinical management indicators: degree of installed occupancy, degree of available occupation, degree of real occupation, interconsultation indicator per patient attended, urgencies according to reason for consultations, unpostponable prosthetic treatment according to reason for consultations, prevention in relation to granted benefits, prevention in relation to the patients cared for, and project absenteeism indicator. Results: The clinical management indicators obtained were as follows: The average degree of installed occupancy was 67%. The average degree of available occupancy was 78%, which accounts for the clinical time in which there are dental chairs and dentists willing to work. The average real occupancy degree was 86%. The average interconsultation indicator per patient observed was 25%. The indicator of urgencies according to the reason for the consultation was 95%, which indicates that the purpose of the study was fulfilled. The average unpostponable prosthetic treatment according to the reason for consultations was 5%. The prevention in relation to granted benefits reached 39%. Finally, the average indicator of absenteeism was 17%. Conclusion: The measurement of clinical management indicators contributes to meet the Chilean Ministry of Health Explicit Health Guarantees (GES), which are: Access, Timely Attention, Quality and Financial Protection.
Objetivo: Analizar indicadores clínicos del manejo de la teleodontología para la población de adultos mayores durante la pandemia de COVID-19 en Chile. Material y Métodos: Se desarrolló un proyecto piloto de teleodontología para la atención odontológica del adulto mayor en cinco regiones de Chile. Los datos obtenidos fueron registrados en la plataforma TEGO para ser posteriormente seleccionados y analizados por los investigadores en cuanto a indicadores de gestión clínica: grado de ocupación instalada, grado de ocupación disponible, grado de ocupación real, indicador de interconsulta por paciente atendido, urgencias según motivo por consultas, tratamiento protésico improrrogable según motivo de consultas, prevención en relación a las prestaciones otorgadas, prevención en relación a los pacientes atendidos e indicador de ausentismo del proyecto. Resultados: Los indicadores de gestión clínica obtenidos fueron los siguientes: El grado medio de ocupación instalada fue del 67%. El grado medio de ocupación disponible fue del 78%, lo que da cuenta del tiempo clínico en el que hay sillones dentales y odontólogos dispuestos a trabajar. El grado de ocupación real promedio fue del 86%. El indicador medio de interconsultas por paciente observado fue del 25%. El indicador de urgencias según el motivo de la consulta fue del 95%, lo que indica que se cumplió con el propósito del estudio. El promedio de tratamientos protésicos impostergables según el motivo de consulta fue del 5%. La prevención en relación a las prestaciones otorgadas alcanzó el 39%. Finalmente, el indicador promedio de ausentismo fue de 17%. Conclusión: La medición de indicadores de gestión clínica contribuye a cumplir con las Garantías Explícitas en Salud (GES) del Ministerio de Salud de Chile, que son: Acceso, Oportunidad, Calidad y Protección Financiera.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Dental Care/methods , Telemedicine/methods , Pandemics , Teledentistry , COVID-19 , Chile/epidemiologyABSTRACT
Resumen: Introducción: la pandemia por COVID-19 ha producido un fuerte impacto en la práctica quirúrgica mundial y luego de trascurridos 15 meses de diferir cirugías y seleccionar pacientes, aún no está bien establecida la magnitud del problema. Objetivo: conocer la evolución de la cirugía programada y su perfil de comportamiento en los servicios del Hospital Maciel (HM) durante el período de pandemia COVID-19. Método: se estudia la productividad quirúrgica del HM durante los períodos de prepandemia (2019) y pandemia (2020/2021), a partir del análisis de la oportunidad y especialidad de la cirugía realizada y la demanda de camas de Unidad de Cuidados Intensivos (UCI). Resultado: durante el período de pandemia (13/3/2020-30/6/2021) se operaron 5.302 pacientes; solo 132 (2,5%) se realizaron en pacientes COVID-19 positivos. La actividad quirúrgica global descendió 22,2% y en cirugías coordinadas 37,4%. Se mantuvo incambiado el volumen de cirugías de urgencias en relación al período prepandemia. Se constató un incremento exponencial de actividad en traumatología, (214%) y otorrinolaringología (57,4%); leve aumento en cirugías de tórax (12,7%), la cirugía vascular y la neurocirugía mantuvieron su actividad (0,3% y -7,8% respectivamente). Las clínicas de cirugía general descendieron su producción en forma importante: 63,5%. Conclusiones: se cumplió con la asistencia a pacientes oncológicos e impostergables, lo cual cambio el perfil de la cirugía, aumentando la actividad en las especialidades en detrimento marcado de la cirugía general y de las disciplinas que operan fundamentalmente patologías postergables y benignas de alta prevalencia.
Summary: Introduction: the COVID19 pandemic has caused a strong impact on surgical practices around the world, and after 15 months of differing surgeries and selecting patients, the actual magnitude of the problem has not been defined yet. Objective: to learn about the evolution of elective surgeries and behaviour profiles at the Maciel Hospital during the COVID19 pandemic. Method: the study analyses the delivery of elective surgeries at Maciel Hospital during the pre-pandemic (2019) and pandemic (2020/2021) periods by studying timing and area of specialization of the surgery performed and demand ICU beds. Results: during the pandemic period (13.3.2020-30.6.2021) 5302 patients were operated; and only 132 of them (2.5%) were COVID 19 positive. Global surgical services dropped 22.2% and 37.4% in elective surgeries. The number of emergency surgeries remained the same when compared to the pre-pandemic period. A huge growth was seen in traumatology (214%) and otorhinolaryngology (57.4%) services, a slight increase in thoracic consultations (12.7%) and no change was observed in vascular surgery consultations (0.3%). Consultations in other areas of specialization, such as urology, neurosurgery and general surgery significantly dropped, between 7.8% and 65.5%. Conclusions: health services were delivered to oncologic patients given their urgency, which, modfied the surgical profile, increasing activity in specializations and at the expense of general surgeries and the specialization areas the mainly operate bening conditions that may be delayed that are highly prevalent.
Resumo: Introdução: a pandemia COVID-19 teve um forte impacto na prática cirúrgica global e, após 15 meses de adiamento de cirurgias e seleção de pacientes, a magnitude do problema ainda não está bem estabelecida. Objetivo: conhecer a evolução da cirurgia programada e seu perfil de comportamento nos serviços do Hospital Maciel (HM) durante o período pandêmico de COVID-19. Método: estudou-se a produtividade cirúrgica programada do HM, nos períodos pré-pandêmico (2019) e pandêmico (2020/2021), a partir da análise da oportunidade e especialidade da cirurgia realizada e da demanda por leitos de UTI. Resultado: durante o período pandêmico (13/3/2020-30/6/2021), um total de 5.302 pacientes foram operados; Apenas 132 (2,5%) foram realizadas em pacientes COVID-19 positivos. A atividade cirúrgica global diminuiu 22,2% e 37,4% nas cirurgias coordenadas. Com relação ao período pré-pandêmico a quantidade de cirurgias de emergência permaneceu inalterada. Um aumento exponencial da atividade foi encontrado em trauma (214%) e otorrinolaringologia (57,4%); um pequeno aumento em tórax (12,7%); a cirurgia vascular manteve-se estável (0,3%), enquanto as demais disciplinas: urologia, neurocirurgia e ambas as clínicas de cirurgia geral diminuíram significativamente, entre 7,8% e 63,5%. Conclusões: foi cumprida a assistência aos doentes oncológicos e não postergáveis, o que alterou o perfil da cirurgia, aumentando a atividade nas especialidades, em acentuado detrimento da cirurgia geral e das disciplinas que operam sobretudo patologias postergáveis e benignas de alta prevalência.
Subject(s)
Surgery Department, Hospital/statistics & numerical data , Efficiency, Organizational , Pandemics , COVID-19ABSTRACT
Albinism is an inherited condition associated with significant depigmentation of the skin, hair and eyes. It occurs in every population with varying frequency, and narratives of people with albinism have been recorded since 200 BC. In southern Africa albinism is common, about 1 in 4000 people are affected, but it remains a poorly understood condition surrounded by myths and superstition. This article provides a historical background on oculocutaneous albinism (OCA) in southern Africa and presents relevant information from the literature regarding epidemiology, genetics and genetic counselling, health, psychosocial and cultural issues, and medical care. There are several recessively inherited types of OCA and a mutation, responsible for about 80%of South African variants, has been identified in OCA type 2. The physical characteristics associated with albinism, that is, sun-sensitive skin and low vision, can be managed. However, people with OCA in Africa also experience psychosocial issues, such as discrimination, because of the various superstitious beliefs and attitudes held in the community. Management should include medical care for health problems, appropriate adjustment of the schooling context and genetic counseling. In addition, widespread public awareness programs are required to increase the knowledge of the genetic causes of OCA and of the nature of genetic counselling, to address the negative attitudes in the community, to reduce the marginalization and stigmatization of people with albinism and to improve their quality of life.
Subject(s)
Psychology , Developmental Disabilities , Albinism , Health , Albinism, Oculocutaneous , Epidemiology , GeneticsABSTRACT
Albinism is an inherited condition associated with significant depigmentation of the skin, hair and eyes. It occurs in every population with varying frequency, and narratives of people with albinism have been recorded since 200 BC. In southern Africa albinism is common, about 1 in 4000 people are affected, but it remains a poorly understood condition surrounded by myths and superstition. This article provides a historical background on oculocutaneous albinism (OCA) in southern Africa and presents relevant information from the literature regarding epidemiology, genetics and genetic counselling, health, psychosocial and cultural issues, and medical care. There are several recessively inherited types of OCA and a mutation, responsible for about 80%of South African variants, has been identified in OCA type 2. The physical characteristics associated with albinism, that is, sun-sensitive skin and low vision, can be managed. However, people with OCA in Africa also experience psychosocial issues, such as discrimination, because of the various superstitious beliefs and attitudes held in the community. Management should include medical care for health problems, appropriate adjustment of the schooling context and genetic counseling. In addition, widespread public awareness programmes are required to increase the knowledge of the genetic causes of OCA and of the nature of genetic counselling, to address the negative attitudes in the community, to reduce the marginalisation and stigmatization of people with albinism and to improve their quality of life
Subject(s)
Developmental Disabilities , Epidemiology , Albinism, Oculocutaneous , Human Genetics , Psychology , HealthABSTRACT
Monkeypox outbreaks began in non-endemic countries in 2022, and the World Health Organization declared this outbreak a public health emergency of international concern.Although most cases present with mild symptoms, children are still a susceptible population.The expert consensus on the diagnosis, treatment and prevention of monkeypox in children of China was published on July 5, 2022.This article supplements with the latest Centers for Disease Control and Prevention recommendations on monkeypox in children.
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Monkeypox outbreaks began in non-endemic countries in 2022, and the World Health Organization declared this outbreak a public health emergency of international concern.Although most cases present with mild symptoms, children are still a susceptible population.The expert consensus on the diagnosis, treatment and prevention of monkeypox in children of China was published on July 5, 2022.This article supplements with the latest Centers for Disease Control and Prevention recommendations on monkeypox in children.
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ABSTRACT Objective to understand the best management practices in the health care provided to people living with HIV in Primary Health Care services from Florianópolis, Santa Catarina. Method a qualitative research study anchored in the Constructivist Grounded Theory. The study participants were nurses and managers involved with management practices in the care provided to people living with HIV in the municipality. The data were collected between July and September 2020 from intensive interviews with 12 nurses in four Basic Health Units and with five managers of the Municipal Health Department, Florianópolis, Santa Catarina, Brazil, totaling 17 participants. Data collection and analysis took place concomitantly, following the initial and focused coding phases. Results this resulted in the phenomenon entitled "Unveiling the best management practices in the care provided to people living with HIV related to decentralized, shared and evidence-based care", supported by three categories that point to decentralization of the clinical management of the HIV infection to Primary Health Care in Florianópolis, to instrumentalization and training of professionals to manage the infection through the use of scientific evidence, and to the care practices developed in the face of the COVID-19 pandemic. Conclusion decentralization of care for people living with HIV to Primary Health Care was presented as the foundation of the best practices, supported by teamwork and evidence-based clinical management.
RESUMEN Objetivo comprender las mejores prácticas de gestión de la atención médica provista a personas que viven con VIH en los servicios de Atención Primaria de la Salud de Florianópolis, Santa Catarina. Método investigación cualitativa, basada en la Teoría Fundamentada en los Datos constructivista. Los participantes del estudio fueron enfermeros y gerentes con participación en las prácticas de gestión de la atención provista a personas que viven con VIH en el municipio. Los datos se recolectaron entre julio y septiembre de 2020 a partir de entrevistas intensivas con 12 enfermeros en cuatro Unidades Básicas de Salud y con cinco gerentes de la Secretaría Municipal de Salud de Florianópolis, Santa Catarina, Brasil, totalizando 17 participantes. La recolección y el análisis de los datos tuvieron lugar simultáneamente, para luego desarrollar las fases de codificación inicial y focalizada. Resultados se arribó al fenómeno llamado "Revelando las mejores prácticas de gestión de la atención provista a personas que viven con VIH relacionadas con la asistencia descentralizada, compartida y basada en evidencias", sustentado por tres categorías que apuntan a la descentralización del manejo clínico de la infección por VIH al ámbito de la Atención Primaria de la Salud en Florianópolis, a la instrumentalización y capacitación de los profesionales para el manejo de la infección aplicando evidencias científicas, y a las prácticas de atención desarrolladas frente a la pandemia de COVID-19. Conclusión la descentralización de la atención provista a personas que viven con VIH al ámbito de la Atención Primaria de la Salud se presentó como la base de las mejores prácticas, sustentadas en el trabajo en equipo y el manejo clínico basado en evidencias.
RESUMO Objetivo compreender as melhores práticas de gestão no cuidado à saúde das pessoas que vivem com HIV em serviços de Atenção Primária à Saúde em Florianópolis, Santa Catarina. Método pesquisa qualitativa, ancorada na teoria fundamentada nos dados construtivista. Os participantes do estudo foram enfermeiros e gestores envolvidos com as práticas de gestão no cuidado às pessoas que vivem com HIV no município. Os dados foram coletados entre julho e setembro de 2020, a partir de entrevistas intensivas com 12 enfermeiros, em quatro Unidades Básicas de Saúde e cinco gestores da Secretaria Municipal de Saúde, de Florianópolis, Santa Catarina, Brasil, totalizando 17 participantes. A coleta e análise dos dados ocorreram de forma concomitante, seguindo as fases de codificação inicial e focalizada. Resultados chegou-se ao fenômeno intitulado "Desvelando as melhores práticas de gestão no cuidado às pessoas que vivem com HIV relacionadas com o cuidado descentralizado, compartilhado e baseado em evidências," sustentado por três categorias que apontam para a descentralização do manejo clínico da infecção por HIV para a Atenção Primária à Saúde em Florianópolis, a instrumentalização e treinamento dos profissionais para o manejo da infecção mediante o uso de evidências científicas e as práticas de cuidado desenvolvidas frente à pandemia de Covid-19. Conclusão a descentralização do cuidado às pessoas que vivem com HIV para a Atenção Primária à Saúde foi apresentada como alicerce das melhores práticas, amparadas no trabalho em equipe e manejo clínico baseado em evidências.
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Introducción: en Enfermería el reconocimiento de los patrones emancipatorio y sociopolítico en la práctica no es evidente. Esta identificación permite la cualificación del cuidado en áreas de gran complejidad como la oncológica, que afecta a población infantil y a sus familias. Objetivo: conocer el significado de los patrones de conocimiento sociopolítico y emancipatorio en los profesionales de Enfermería durante el cuidado de los niños con cáncer y sus familias. Metodología: estudio cualitativo etnográfico en el que se realizaron entrevistas semiestructuradas a diez enfermeros con experiencias entre los seis meses y diecisiete años trabajando con población oncológica pediátrica. Y observaciones no participantes en dos instituciones de salud, una privada y otra pública. Los datos se estudiaron bajo el procedimiento de análisis propuesto por Michael Angrosino, que consta de las fases: gestión de datos, lectura general y clasificación de temas. Resultados: como producto del análisis de la información se establecieron tres grandes temas: contexto de cuidado; cuidado de enfermería; y expresiones de los patrones sociopolítico y emancipatorio en el cuidado. En la discusión se articularon los resultados con la teoría de Sistemas de Imogene King. Conclusiones: a partir de la interacción de los enfermeros con los pacientes y sus familias se logró identificar que estrategias como la educación, el seguimiento, la gestión de casos y de trámites administrativos son formas de fortalecer la gobernanza compartida y la equidad social, los cuales son índices de credibilidad de los patrones sociopolítico y emancipatorio.
Introduction: In Nursing, the recognition of emancipatory and sociopolitical patterns in practice is not evident. This identification allows the qualification of care in areas of great complexity such as oncology, which affects children and their families. Objective: To know the meaning of sociopolitical and emancipatory knowledge patterns in nursing professionals during the care of children with cancer and their families. Methodology: Qualitative ethnographic study in which semi-structured interviews were conducted with ten nurses with experiences between six months and seventeen years working with pediatric oncology population. And non-participant observations in two health institutions, one private and one public. The data were studied under the analysis procedure proposed by Michael Angrosino, which consists of the following phases: data management, general reading and classification of themes. Results: As a result of the analysis of the information, three major themes were established: context of care; nursing care; and expressions of sociopolitical and emancipatory patterns in care. In the discussion, the results were articulated with Imogene King's Systems theory. Conclusions: Based on the interaction of nurses with patients and their families, it was possible to identify that strategies such as education, follow-up, case management and administrative procedures are ways of strengthening shared governance and social equity, which are indices of credibility of sociopolitical and emancipatory patterns.
Subject(s)
Humans , Nursing Care , Oncology Nursing , Clinical Governance , Cancer Survivors , Shared Governance, NursingABSTRACT
Resumo O estudo objetiva compreender o pensar e o agir dos profissionais de saúde sobre a coordenação entre níveis assistenciais. Pesquisa qualitativa oriunda de estudo multicêntrico internacional Equity-LA II. Reescutaram-se áudios de onze entrevistas de médicos/enfermeiras de dois níveis assistenciais no Recife, 2014. Realizou-se análise de conteúdo do referencial teórico da coordenação à luz da abordagem hermenêutica. A maioria dos profissionais conhecia as atribuições da coordenação, sem identificar sua execução. O médico da atenção primária não foi reconhecido como responsável clínico, nem quanto ao seu papel pelo médico da atenção especializada, enquanto o da atenção primária ressentia-se. Emergiram falhas no uso/preenchimento dos mecanismos de referência/contrarreferência e entraves organizacionais. A indisponibilidade para o "jogo da conversação" e "fusionalidade" evidenciou-se no não reconhecimento da autoridade no caráter autoritativo do médico da atenção primária pelo da especializada, sentimento de menos valia daquele e postura tecnicista e especializada na práxis de todos. A coordenação no olhar dos profissionais revelou a condição "aí-a-ser-compreendido" carecendo se lançar no "jogo da compreensão" para construir práticas dialógicas voltadas ao cuidado integral.
Abstract The study aims to understand the thinking and acting of health professionals about the coordination between levels of care. Qualitative research from an international multicenter study Equity-LA II. Audios were retrieved from eleven interviews of doctors/nurses of two levels of care in Recife, 2014. A content analysis of the theoretical framework of coordination was performed in the light of the hermeneutic approach. Most professionals knew the duties of coordination, without identifying its execution. The primary care physician was not recognized as responsible for the clinic, nor for his role by the specialist physician, while the primary care physician resented it. Failures in the use/completion of reference/counter-reference mechanisms and organizational barriers emerged. The unavailability for the "conversation game" and "fusionality" was evidenced in the lack of recognition of authority in the authoritative character of the primary care physician by that of the specialized, feeling of less value for that and technicist and specialized posture in everyone's practice. The coordination in on professionals' view revealed the "there-to-be-understood" condition that needs to be launched in the "game of comprehension" to build dialogical practices focused on integral care.
Subject(s)
Humans , Primary Health Care , Health Personnel , Attitude of Health Personnel , Communication , Delivery of Health Care , Qualitative ResearchABSTRACT
ABSTRACT: Fracture of an endodontic file inside a primary root canal is a rare but critical complication during the pulpectomy treatment, because the mechanical obstruction impedes the optimal cleaning and obturation of the pulp canal, compromising seriously the clinical outcome. This accidental event is mainly associated with over-use and excessive torque of intracanal files. Most clinicians opt to proceed with the extraction of the affected tooth followed by a space maintainer placement. Other practitioners attempt the non-surgical retrieval of the separated fragment through available proven techniques in permanent teeth; however, these methods may involve significant damage to the tooth and surround tissues. On the other hand, preservation of the metallic fragment might affect the treatment prognosis and interfere with the physiological root resorption.
RESUMEN: La fractura de una lima endodóntica dentro de un conducto radicular primario es una complicación rara aunque critica durante el tratamiento de pulpectomía, debido a que la obstrucción mecánica impide la limpieza y obturación óptimas del conducto pulpar, comprometiendo seriamente el resultado clínico. Este evento accidental está principalmente asociado con el sobreuso y torque excesivo de las limas dentro del conducto. La mayoría de los clínicos optan por realizar la extracción del diente afectado, seguido por la colocación de un mantenedor de espacio. Otros practicantes intentan la remoción no quirúrgica del fragmento separado a través de técnicas disponibles probadas en dientes permanentes; sin embargo, estos métodos pueden causar daños significativos al diente y tejidos circundantes. Por otra parte, la preservación del fragmento metálico puede afectar el pronóstico del tratamiento e interferir con el proceso de reabsorción radicular fisiológico.
Subject(s)
Periodontics/instrumentation , Root Canal Obturation , Dental Instruments , Pulp Capping and Pulpectomy AgentsABSTRACT
Resumo Como parte do estudo de avaliabilidade da avaliação da implementação do Prontuário Eletrônico do Paciente (PEP), o objetivo desta Revisão Sistemática (RS) foi identificar os domínios de avaliação a serem abordados. Esta RS, alinhada com o Cochrane Handbook for Systematic Reviews of Interventions e o Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) englobou artigos publicados de 2006 até 2019. Realizou-se a busca nas bases de dados eletrônicas SciELO, Oásis IBICT, BVS Regional e Scopus. A busca retornou 1.178 artigos, sendo 42 que atenderam aos critérios de inclusão. A maioria dos estudos utilizaram métodos qualitativos para análises. As publicações ocorreram entre 2006 e 2019, tendo sua concentração em 2017 com 9 (21%) artigos publicados. Não foram identificados estudos publicados em 2008 e 2009. Somente 10 estudos incluíam descrição, análises ou resultados relacionados aos domínios de implementação. Os principais domínios em que o PEP foi problematizado foram: subutilização; resistência dos profissionais ao seu uso; ênfase na usabilidade; e o PEP como repositório de informações. Apesar da inclusão de todos os estudos que contemplaram os princípios e diretrizes da Política Nacional de Humanização (PNH), eles ainda são incipientes.
Abstract As part of the evaluability study of the implementation of the Electronic Patient Record (EPR) evaluation, the aim of this Systematic Review (SR) was to identify the evaluation domains to be addressed. This SR, aligned with the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) encompassed articles published from 2006 to 2019. The search was carried out in the electronic databases SciELO, Oasis IBICT, BVS Regional and Scopus. The search resulted in 1,178 articles, 42 of which met the inclusion criteria. Most studies used qualitative methods for the analyses. The publications took place between 2006 and 2019, with a concentration in 2017 with 9 (21%) articles published in that year. No studies were published in 2008 and 2009. Only 10 studies included the description, analysis or results related to the domains of implementation. The main domains in which the EPR was problematized were: underutilization; professionals' resistance to its use; emphasis on usability; and EPR as an information source. Despite the inclusion of all studies that covered the principles and guidelines of the National Humanization Policy (NHP), they are still incipient.
Subject(s)
Humans , Primary Health Care , Humanization of Assistance , Electronic Health Records , Unified Health SystemABSTRACT
The World Health Organization (WHO) has set the goal of eliminating viral hepatitis as a threat to public health by 2030. Blocking mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is the key step for eliminating viral hepatitis, at the same time, it is the hotspot in the field of hepatitis B prevention and control as well. The China Foundation of Hepatitis Prevention and Control (CFHPC) organized a team of specialists to develop an algorithm for preventing MTCT of HBV, based on the most recent hepatitis B guidelines and the latest evidence. The algorithm covers 10 continuous steps from pregnant management to follow-up postpartum. Among the 10 steps, screening, antiviral therapy during pregnancy, and infant's immunization are the core components in the algorithm.
Subject(s)
Child , Female , Humans , Infant , Pregnancy , Algorithms , Antiviral Agents/therapeutic use , China , Hepatitis B/prevention & control , Hepatitis B Surface Antigens , Hepatitis B e Antigens , Hepatitis B virus , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy Complications, Infectious/prevention & controlABSTRACT
@#Contemporary endodontic microsurgery has emerged as a significant treatment modality in the retention of teeth with persistent apical periodontitis. This article proposes the concept of the full-cycle clinical management of endodontic microsurgery based on the condition of the patient and tooth, attempting to develop a comprehensive strategy for the examination, treatment and follow-up to save natural teeth. Full-cycle clinical management included preoperative consideration of the general condition and surgical site and selection of cases for endodontic microsurgery; intraoperative application of techniques such as lasers, "bone window" technique and targeted endodontic microsurgery to make the surgical approaches more varied and the operation minimally invasive; postoperative outcome assessment according to the history, clinical and radiographic examination; and analysis of the short- and long-term outcomes.