Estructura de las comunidades de briófitos en los complejos de páramos de Boyacá-Colombia / Structure of bryophyte communities in the paramo complexes of Boyacá-Colombia

Introducción: Los páramos de Boyacá cubren el 18.3 % de la superficie de Colombia, y son diversos en flora y fauna, además, registran una alta variabilidad climática, topográfica y de hábitats, que permite que estos ecosistemas sean centros de diversidad en el Neotrópico, y por tanto albergan una alta diversidad de briófitos. Objetivo: Analizar la estructura y composición de las comunidades de briófitos de los complejos de páramos de Boyacá. Métodos: a partir de información de literatura, bases de datos y revisión de herbarios, se evaluó la composición florística y la completitud de muestreo para los complejos de páramos y sustratos. Resultados: Se encontraron 5 132 ejemplares, con 343 especies de musgos que fue el grupo más diverso, 256 hepáticas y dos antocerotes. El análisis de completitud de muestreo es representativo en un 98 %. Además, encontramos que la preferencia de sustratos es el terrícola con 409 especies y el cortícola con 341. La diversidad alfa del orden 0D mostró que Tota-Bijagual-Mamapacha (TBM) es el complejo más diverso con 368 especies, y Pisba (124) el menos diverso; el índice 1D mostró que el complejo (TBM) presentó 178 especies consideradas comunes, y la dominancia de especies (2D) fue mayor en el complejo Iguaque-Merchán con 119 taxa dominantes y en menor número Guantiva-La Rusia (105) y TBM (102). Conclusiones: El análisis de la diversidad beta mostró que el 62 % de la disimilitud en la composición de especies entre los complejos se debe al recambio de especies, igualmente sucede con la divergencia por sustratos que es del 51 %. Los briófitos en los páramos de Boyacá representan el 36.05 % de la diversidad colombiana, y el 2.96 % a nivel mundial.

Introduction: The Boyacá paramos cover 18.3 % of the Colombian surface, and are diverse in flora and fauna, moreover, have a high temperature, topography, and habitats, which allow these ecosystems to be centers of diversity in the Neotropics, and therefore they harbor a high diversity of bryophytes. Objectives: Analyze the structure and composition of the bryophyte communities of the paramos in the Boyacá complexes. Methods: Using literature, databases and herbariums records, the floristic composition, and the completeness of the sampling for the paramo and substrate complexes was evaluated. Results: We analyzed 5 132 specimens, with 343 species of mosses being the most diverse group, 256 liverworts and two hornworts. The sampling completeness analysis is 98 % representative. In addition, we found that the preference of substrates is terrestrial with 409 species and corticolous with 341. Alpha diversity of order 0D showed that Tota-Bijagual-Mamapacha (TBM) is the most diverse complex with 368 species, and Pisba (124) the least diverse; the 1D index showed that the complex (TBM) presented 178 species considered common, and the dominance of species (2D) was higher in the Iguaque-Merchán Complex with 119 dominant taxa and Guantiva-La Russia (105) and TBM (105) to a lesser number. (102). Conclusions: the analysis of beta diversity showed that 62 % of the dissimilarity in the composition of species between the complexes is due to the species turnover, the same happens with the divergence by substrates that is 51 %. Bryophytes in the Boyacá paramos represent 36.05 % of Colombian diversity, and 2.96 % worldwide.

Quality evaluation of infectious disease surveillance data in Lianyungang City in 2017 - 2021 / 公共卫生与预防医学

Objective To evaluate the quality of infectious disease surveillance data and provide scientific basis for improving data quality and health decision-making. Methods The comprehensive index of infectious disease monitoring system evaluation and the integrity, accuracy and reliability of infectious disease report data were used to evaluate the quality of infectious disease monitoring data in multiple dimensions. Results In 2021, The comprehensive evaluation index of infectious disease surveillance system was 98.40%. In terms of data integrity, 1 105 data were missing, and the incomplete rate was 1.46%; In terms of data accuracy, 1978 cases were not accurately, rate of accuracy was 26.72%; In terms of data reliability, the card reporting rate of tertiary medical institutions accounted for 67.05%, the diagnosis rate of confirmed cases was 27.74%, and the correction rate of report card was 28.48%. Conclusion The accuracy and reliability of infectious disease data are insufficient, and new methods for infectious disease monitoring data quality are expanded to make up for the lack of data quality evaluation of the current national epidemic system.

Completeness of information in electronic compared with paper-based patients’ records in a maternity setting in Dakar, Senegal

Background: Evaluate the consistency of information in paper-based records when registered in parallel with an electronic medical record.Methods: The study was performed at PMSHC in Dakar Senegal. From the end of year 2016, patients’ files were recorded on both paper-based and electronically. Additionally, previous records were electronically registered. To investigate the completeness of records before and after the electronic recording system has been implemented, information about some maternal and fetal/neonatal characteristics were assessed. When the variable was recorded, the system returned 1, unrecorded variables were coded as 0. We then calculated, for each variable, the unrecorded rate before 2017 and after that date. The study period extended from 2011 to June 2019, a nearly ten-year period. Data were extracted from E-perinatal to MS excel 2019 then SPSS 25 software. Frequencies of unrecorded variables were compared with chi-squared test at a level of significance of 5%.Results: A total of 48,270 unique patients’ records were identified during the eight-year period.  Among the study population, data for patients’ age, address and parity were available most of the time before and after 2017 (0.5% missing data versus 0.3% for age and 2.6% versus 1.3% for home address and from 0.3% to 0.0% for parity). However, phone number, maternal weight, maternal height, last menstrual period and blood group were found to be missing up to 96% before 2017. From 2017, these rates experienced a sudden decrease at a significant level: from 82.4% to 27.8% for phone number, from 96% to 56.3% for maternal weight and from 60.1% to 21.3% for blood group. Regarding newborns’ data, it was found that fetal height, head circumference and chest circumference were missing up to just under 25% before 2017. After that date, their completeness improved and flattened under 5%.Conclusions: Structured and computerized files reduce missing data. There is an urgent need the Ministry of health provides hospitals and health care providers with guidelines that describes the standardized information that should be gathered and shared in health and care records.

Diabetes registry and service in Nigerian suburban-based tertiary healthcare facility

Background: Diabetes register is a clinical tool necessary for patient management including follow-up and referral procedures. In the Bringing Research in Diabetes to Global Environments and Systems that is in progress in Delta State, Nigeria; part of focus is establishment of diabetes register at a tertiary health facility. This phase of the project aimed to establish a diabetes register and to assess the baseline data.Methods: This was a clinical observational descriptive study at Eku Baptist Government Hospital. The diabetes register developed as in previous report was adopted as a scale-up study. After due clearance from the hospital, patients’ hospital record files were screened for cases of diabetes and 70 files were identified. Data were analyzed descriptively using Microsoft Excel Data Analysis ToolPak 2010.Results: There was a 2/1 female/male ratio, while 6% were below 40 years. 90% of patients had blood glucose levels results that indicated poor diabetes control. There is problem of incomplete data collection, for instance <25% BMI data was available. Capability and opportunity for standard service, e.g. diabetic foot examination, lipid profile, renal and retinal assessment was available at the tertiary health facility to allow management and referral from other hospitals.Conclusions: This report highlights poor adherence to diabetes care practices by stakeholders. It underscores the need for motivation to improve the quality of clinical data collection vis-à-vis documentation that enables assessment of diabetes epidemiology, especially in a facility that has the capacity.

Diabetes registry and service in Nigerian suburban areas: experience at a secondary healthcare facility

Background: Disease registries help to provide quality healthcare, including chronic care. As part of ongoing bringing research in diabetes to global environments and systems 2 project in Delta State, Nigeria; a preliminary concern is completeness of clinical assessments and data collection that would enable patients’ follow-up. The aim of this piece of work is to investigate if data collected for local diabetes registry is complete and sufficient to provide better understanding of the disease epidemiology and treatment follow-up.Methods: This was a purposive medical records audit at public secondary level hospital that followed initial development of diabetes register at the Catholic Hospital, Abbi with 44 pieces of clinical and demographic information. At the public hospitals, 93 patients’ medical records were audited and the data were entered into the register and evaluated, descriptively.Results: The results show that about 52% of the 44 itemized information were collected, of which completeness of data/documentation was as low as 3% in some items. Blood pressure assessment was done on 70% of patients and 16% of patients had diabetes complications. Lifestyle regimen monitoring was not documented. Neither incidence nor morbidity and mortality rate could be definitively ascertained.Conclusions: Quality of clinical data documentation was poor. This study contributes a measure of community needs assessment for professional development training on diabetes.

Management of medical record in installation of inpatient regional public hospital Batara Guru Belopa

Background: This research is motivated by the high number of incompleteness of filling in the patient's medical record file in the inpatient installation, which is 30-35% in Regional Public Hospital Batara Guru Belopa.Methods: The research method is qualitative using the phenomenology approach. Determination of informants using purposive sampling method and obtained as many as eighteen informants. Data collection in the form of in-depth interviews, document review and observation. The validity of the data is done by triangulation and credibility test.Results: Management of medical records completeness seen from human resources who still need additional staffin the central part of the hospitalization by looking at the large number of patients and workload of the officers, doctors rarely fill in the full medical record sheets due to negligence of doctors due to other activities or in a hurry. Management of medical records completeness viewed from the procedure, there are still officers in the inpatient department who do not know the flow of exit and entry of the medical record file to the inpatient installation. The management of medical record completeness is seen from the information, implementation of hospital policy regarding the completeness of filling in medical record is not maximal because medical record file is slowly completed and returned to the medical record section.Conclusions: The hospital should be conducted a routine evaluation related to the completeness of the medical record and activated the hospital management information system (HMIS).

Evaluation of Surgical Completeness in Endoscopic Total Thyroidectomy with Central Neck Dissection via a Unilateral Axillo-Breast Approach Compared with Bilateral Axillo-Breast and Open Approach / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The aim of this study was to evaluate surgical completeness in endoscopic total thyroidectomy with central neck dissection via unilateral axillo-breast approach (UABA) compared with bilateral axillo-breast (BABA) and open approach (OA) by means of the radioactive iodine uptake (RAIU) ratio and thyroglobulin (Tg) of remnant thyroid. SUBJECTS AND METHOD: From July 2010 to March 2013, 82 patients who had underwent total thyroidectomy with central neck dissection and postoperative radioactive iodine (RAI) ablation for papillary thyroid carcinoma were enrolled. Of these patients, 27 patients underwent UABA, 24 patients BABA, and 31 patients OA. Clinicopathologic data, surgical outcome, stimulated Tg and RAIU ratio on the first postoperative RAI ablation scan were compared among 3 groups. RESULTS: Patients in the endoscopic surgery groups (UABA, BABA) were younger than those in the OA groups. Invasiveness such as operation time, postoperative pain, and drain amount in UABA was less than that in BABA and severer than that in OA. Other variables regarding clinicopathologic and surgical data were not significantly different. Stimulated Tg and RAIU ratio did not show significant differences among 3 groups (p=0.659 and p=0.664). CONCLUSION: The completeness of UABA was comparable with that of BABA and OA. The UABA may be a safe option for patients who need endoscopic thyroidectomy for papillary thyroid carcinoma.

Adherence towards Different Vaccines of Childhood Immunization of Under Five Year Old Children

Introduction: Adherence towards childhood immunization (completeness and timeliness), with consideration of age-dependent-seroconversion, is the basis for children protection. Despite high global and national immunization coverage, vaccine preventable diseases’ are rising. This study aimed to determine adherence (completeness and timeliness) towards different vaccines of childhood immunization and associated factors among mothers of under five children. Methods: Cross-sectional study design was conducted at a health clinic in Seremban. Total of 320 mothers of under five children attending child health clinic selected via systematic random sampling. Data collection was via validated self-administered questionnaires and proforma, analysed using SPSS version 22. Associations between categorical variables determined by chi-square tests. Results: Consented respondents were 314; resulting in response rate of 98.1%. Adherence (completeness) was 98.09% but only 56.5% - 97.1% of respondents adhered in terms of timeliness. Types of transportation was significantly associated with adherence (completeness), p=0.041. Employment status was significantly associated with adherence (timeliness) towards BCG (p=0.008), Hepatitis B dose one (p=0.018) and dose two (p=0.040) vaccines. Education level was significantly associated with adherence (timeliness) towards DTaP/IPV/HiB dose four (p=0.019). Maternal age and usage of government clinic were significantly associated with adherence (timeliness) of MMR dose one, p=0.030 and p=0.017 respectively. Conclusion: Adherence (completeness) was high but varying adherence towards vaccine timeliness. Transportation types associated with completeness. Employment status associated with BCG, first and second doses of Hepatitis B vaccines’ timeliness. Education level associated with fourth dose of DTaP/IPV/HiB. Maternal age and usage of government clinic associated with timeliness of first dose MMR.

Sobre fisioterapia e seus recursos terapêuticos: o grupo como estratégia complementar à reabilitação / On physical therapy and its therapeutic resources: the group as an additional strategy for rehabilitation / Sobre fisioteapia y sus recursos terapéuticos: el grupo como estrategia complementaria a la rehabilitación

Resumo O trabalho com grupos constitui uma estratégia privilegiada pelos profissionais de saúde que envolve um processo de subjetivação e estabelecimento de vínculos comunitários. Desenvolveu-se um grupo de mulheres em tratamento pós-operatório de ombro no ambulatório de fisioterapia de um hospital instalado na cidade de Curitiba, com o objetivo de potencializar os efeitos da fisioterapia convencional, oferecendo a essas mulheres condições para melhor lidar com suas dores e limitações funcionais. Realizou-se pesquisa qualitativa que possibilitou o estabelecimento de um processo descritivo em relação ao processo grupal e o contato direto e prolongado com os sujeitos da pesquisa por meio de seis oficinas realizadas no período de outubro de 2012 a março de 2013. O relato das mulheres apontou o grupo como um espaço acolhedor, onde partilharam experiências de vida, conquistaram amizades e aprenderam com o outro. Isso permitiu um repensar sobre seu comportamento e possibilidade de mudança de atitudes. Concluiu-se que, diante da necessidade de humanização do atendimento com vistas a uma atenção integral, a utilização de grupos como apoio no processo fisioterápico pode ser uma estratégia para uma prática menos reducionista e que reconheça a necessidade do outro.

Abstract Working with groups is a prime strategy for health professionals, and it involves a process of subjectivity and establishment of community ties. A group of women in post-operative shoulder treatment was formed at the physiotherapy clinic of a hospital installed in the city of Curitiba, capital of the state of Paraná, Brazil, aiming to enhance the effects of conventional therapy, giving these women conditions to better cope with their pain and functional limitations. Qualitative research was carried out, which enabled the establishment of a description of the group process, as well as direct and extended contact with the subjects during six workshops held from October 2012 to March 2013. The women reported that the group was a welcoming space, where they shared life experiences, made friends, and learned from each other. This allowed them to rethink their behavior and enabled possibilities for changing attitudes. It was concluded that, given the need for humanization in care with a view to comprehensive care, using groups to support the physiotherapy process can be a strategy for a less reductionist practice that recognizes other people's needs.

Resumen El trabajo con grupos constituye una estrategia privilegiada por los profesionales de la salud, que representa un proceso de subjetivación y de establecimiento de vínculos comunitarios. Se reunió un grupo de mujeres en tratamiento postoperatorio de hombro, en la clínica de fisioterapia de un hospital instalado en la ciudad de Curitiba, capital del estado de Paraná, Brasil. Este proceso tuvo como objetivo potencializar los efectos de la fisioterapia convencional, ofreciendo a estas mujeres condiciones para enfrentar mejor sus dolores y limitaciones funcionales. Se realizó una investigación cualitativa, que permitió establecer un proceso descriptivo en relación al proceso grupal y al contacto directo y prolongado con los sujetos de la investigación, por medio de seis talleres realizados en el período de octubre del 2012 a marzo del 2013. El relato de las mujeres señaló al grupo como un espacio acogedor, donde compartieron experiencias de vida, conquistaron amistades y aprendieron con el otro. Esto permitió replantear su comportamiento y las posibilidades de cambio de actitud. Se concluyó que, frente a la necesidad de humanización de la atención con miras a una atención integral, la utilización de grupos como apoyo en el proceso fisioterapéutico puede ser una estrategia para una práctica menos reduccionista y que reconozca las necesidades del otro.

A integralidade do SUS e a Judicialização por transplantes intestinais e multiviscerais / The integrality in the SUS and the judicialization by intestinal and multiple visceral transplants / La integridad del SUS y la legalización por los trasplantes intestinales y multiviscerales

A discussão sobre a judicialização da saúde no Brasil tem como tema central a questão do Sistema Único de Saúde - SUS não disponibilizar insumos e serviços de forma integral à população. Há demandas para transplantes de intestino e múltiplos órgãos, que em virtude do seu custo elevado, são combatidos pelos órgãos gestores do SUS, pelo custo elevado do procedimento. Tratou-se de um estudo de 4 casos ocorrido em 2014 sobre o tema para pacientes portadores de Síndrome de Berdon, Síndrome do Intestino Curto e a Doença de Inclusão Microvilositária. Concluiu-se pela pertinência da judicialização em vista da falta de recursos para os pacientes.

The discussion about the Health Judicialization has a main topic that is the public system does not offer integrally services and inputs to the population. There are judicial demands for intestine and multiple organs transplants, but they are very expensive. There was a case study about 4 cases in Ministry of Health with intestine and multiple visceral transplant in patients who carry Berdon Syndrome, Short-Gut Syndrome and the Microvillous Inclusion Disease. It concluded for the relevancy of the judicialization for these poor patients.

El debate sobre la judicialización de la salud en Brasil se centró en la cuestión de que el Sistema Único de Salud - SUS no está disponible en su totalidad al público. Hace demandas dirigidas a los trasplantes de intestino y de múltiples órganos, que, en virtud de su alto costo, son rechazadas por los órganos de gestión del SUS. Hizo un estudio de 4 casos teniendo como demandada el Ministerio de la Salud, sobre trasplantes de intestino y trasplantes multiviscerales para pacientes con Síndrome de Berdon, el Síndrome de intestino corto y la llamada Enfermedad de Inclusión Microvellosa. En este trabajo se analiza la cuestión de la integridad del Sistema Único de Salud, tratando de resolver el asunto que implica la prestación de cualquier tratamiento necesario a los pacientes del SUS.

Avaliação da assistência pré-natal na perspectiva da integralidade / Evaluación de la atención prenatal en términos de integralidad / Evaluation of prenatal care from the perspective of completeness

Evaluating prenatal care from the perspective of completeness. Method: this is an evaluative study whose purpose is the completeness of prenatal care focusing on the size of the organization of services, where two dimensions were analyzed. Professionals who work directly in prenatal care and health managers participated in the survey. Results: dimensions assurance resources and health surveillance model were analyzed and, from the respective notes, it was possible to obtain notes from management which respectively were considered regular notes (1st dimension 7,3, 2nd dimension 5,4, note of the 6,4 management). Conclusion: it is inferred for this municipality with respect to prenatal care interventions that are needed in this area to achieve a standard of quality founded on the completeness, municipal management must provide the necessary resources in order to have a more structured assistance...

Avaliar a assistência pré-natal na perspectiva da integralidade. Método: trata-se de um estudo avaliativo cujo objeto é a integralidade da assistência pré-natal com foco na dimensão da organização dos serviços, onde foram analisadas duas dimensões. Participaram da pesquisa, profissionais que atuavam diretamente na assistência pré-natal e os gestores de saúde nesse âmbito. Resultados: foram analisadas as dimensões garantia de recursos e modelo de vigilância em saúde e a partir das respectivas notas foi possível obter a nota da gestão onde, respectivamente, foram obtidas notas consideradas regulares (1° dimensão 7,3, 2° dimensão 5,4, nota da gestão 6,4). Conclusão: infere-se para este município, no que tange a assistência pré-natal, que são necessárias intervenções nesta área; para alcançar um padrão de qualidade pautado na integralidade, a gestão municipal precisa prover os recursos necessários para que se tenha uma assistência mais estruturada...

Evaluar la atención prenatal desde la perspectiva de la integralidad. Método: se trata de un estudio de evaluación cuya finalidad es la integridad de la atención prenatal, centrándose en el tamaño de la organización de los servicios, donde se analizaron dos dimensiones. Participaron de la encuesta, los profesionales que trabajan directamente como gestores de la atención y de salud prenatal en esta área. Resultados: los recursos de garantía de dimensiones y el modelo de vigilancia de la salud se analizaron y desde las respectivas notas fue posible obtener una nota de gestión que se obtuvieron notas regulares consideradas respectivamente (primera dimensión 7,3, segunda dimensión 5,4 nota de la gestión 6,4). Conclusión: se infiere de este municipio, con respecto a las intervenciones de atención prenatal, que se necesitan en esta área para lograr un estándar de calidad basada en la integralidad, la gestión municipal debe proporcionar los recursos necesarios con el fin de tener una ayuda más estructurada...

Enfermeira de ligação: estratégia de integração entre hospital e unidades da atenção primária / Liaison nurse: integration strategy between hospital and primary care units

Pesquisa de intervenção de caráter exploratório e de abordagem qualitativa. Os objetivos foram propor estratégia de contrarreferência do hospital para a atenção primária com a contribuição da "enfermeira de ligação"; avaliar o projeto piloto da "enfermeira de ligação" na perspectiva das enfermeiras das unidades de internação do hospital e da UPA que realizaram a contrarreferência; avaliar a proposta na perspectiva das enfermeiras da atenção primária e identificar o perfil dos usuários encaminhados das unidades de internação do hospital e da UPA para as unidades de saúde. Participaram deste estudo 53 enfermeiros: 12 enfermeiros do hospital: clínica médica masculina e feminina; cirurgia geral e do aparelho digestivo; ortopedia, urologia, neurologia clínica e centro de tratamento semi-intensivo, sete enfermeiros da UPA, 34 enfermeiros da atenção primária e 43 usuários totalizando 96 participantes. Para a realização da pesquisa foram considerados e respeitados todos os aspectos éticos conforme os preceitos da Resolução 466/12- CNS. Foi realizado um projeto piloto nas unidades de internação do hospital e da UPA e os enfermeiros participantes aceitaram assumir provisoriamente a função de "enfermeira de ligação". A implantação ocorreu em três etapas sequenciais: etapa I - planejamento da intervenção, etapa II - implantação do projeto piloto, etapa III - avaliação da intervenção - coleta de dados. Para análise das entrevistas dos enfermeiros participantes da pesquisa utilizou-se a técnica de análise de conteúdo proposta por Bardin, 2011 e para identificar o perfil dos usuários contrarreferenciados foi realizado avaliação das fichas de contrarreferências sendo analisadas pela mesma técnica. Entre os resultados verificou-se que a maioria dos enfermeiros participantes possui idade entre 31 a 40 anos com mais de dez anos de formação e com ao menos uma especialização. Em relação aos enfermeiros que realizaram a contrarreferência foi identificado quatro categorias: dificuldades relacionadas aos usuários, dificuldades relacionadas ao processo de trabalho, facilidades e sugestões. Em relação aos enfermeiros que receberam os usuários na atenção primária foram identificadas seis categorias: Opinião sobre o projeto, contato por telefone, informações recebidas sobre o usuário, recebimento da documentação de alta via e-mail, inclusão desta função no processo de trabalho do enfermeiro e sugestões. Em relação aos usuários foi identificado que a maioria possui mais de 60 anos de idade e a unidade de internação que mais contrarreferenciou usuários foi à unidade de neurologia clínica. Percebeu-se que todos os usuários contrarreferenciados eram portadores de mais de uma patologia prevalecendo à hipertensão arterial sistêmica e diabetes mellitus, sendo hospitalizados por diferentes motivos. Entre as necessidades de continuidade de cuidados apresentadas pelos usuários podemos citar cuidados com feridas complexas, cuidados com dispositivos, entre eles, sondas nasoenterais, nasogástricas, vesicais, colostomias, ileostomias e cateteres de hemodiálise. Entende-se que todos os enfermeiros consideraram importante a realização da contrarreferência e que este processo impactou diretamente na qualidade do atendimento, sendo possível ser implantado.

Exploratory intervention research and qualitative approach. The goals were to propose counter-reference strategy from the hospital to primary care with the contribution of the "liaison nurse", to evaluate the pilot project of the "liaison nurse" under the perspective of the nurses within the inpatient units and emergecy care units that conducted the counter-reference, to evaluate the proposal under the perspective of primary care nurses and identify the profile of the users sent from inpatient units within hospitals and emergency care units to care units. This study included 53 nurses: 12 hospital nurses - male and female medical clinics, general surgery and digestive tract, orthopedics, urology, clinical neurology and semi-intensive care unit - 7 emergency care unit nurses, 34 nurses in primary care and 43 users totaling 96 participants. For the research were considered and respected all ethical aspects as the provisions in Resolution 466 / 12- CNS. A pilot project was conducted inside hospital inpatient units and emergency care units, and the participating nurses accepted to provisionally assume the role of "liaison nurse." The implementation took place in three sequential steps: Step I - intervention planning, Step II - the pilot project implementation, Step III - evaluation of the intervention and data collection. For the analysis of the participant nurses interviews it was used the content analysis technique - proposed by Bardin, 2011 - and to identify the counter-reference users profile the counter-reference files were analyzed through the same technique. Among the results it was verified that most nurse participants aged 31 to 40 years old with more than ten years of training and at least one specialization. For nurses who performed the counter-reference, were identified four categories: problems related to users, difficulties related to the work process, facilities and suggestions. For nurses who received users in primary care, were identified six categories: Opinion about the project, contact by telephone, received information regarding the user, receiving the documentation regarding discharge through mail, inclusion of this function in the nurse work process, and suggestions. Regarding users, it was identified that most were 60 years or older and the hospitalization unit that did more counter-references was the clinical neurology. It was noticed that all counter-referenced users were carriers of more than one pathology, prevailing hypertension and diabetes mellitus, being hospitalized for different reasons. Among the requirements of continuous care presented by the users we can list complex wound care, care with devices, including, nasogastric tube, bladder, colostomy, ileostomy and hemodialysis catheters. It is understood that all nurses considered important to conduct the counter-reference and that this process directly impact the quality of care, being possible to be implemented.

O humor e o riso na promoção de saúde: uma experiência de inserção do palhaço na estratégia de saúde da família / Humor and laughter in health promotion: a clown insertion experience in the family health strategy

Resumo O trabalho com diferentes formas de expressão artístico-culturais tem sido considerado forma de intervenção na saúde que enriquece as possibilidades de compreensão e reflexão sobre necessidades dessa área. Um grupo de palhaços caracterizados de médicos realizou visitas domiciliares por oito meses em dez famílias em micro áreas de duas equipes de saúde da família. A prática visou ampliar a resolubilidade do cuidado a pessoas e a coletividade com intensa proximidade estabelecida pela arte da palhaçaria. A ideia foi fazer intervenções nos domicílios de famílias em situação de vulnerabilidade social indicadas pelas equipes de saúde da família e utilizar a alegria, o humor, o riso como formas de provocar reflexões sobre problemas cotidianos. A presença dos “médicos-palhaços” nas casas foi capaz de construir vínculos fortes e livres com as famílias e de potencializar o cuidado humanizado e integral no contexto da estratégia de saúde da família. Juntos, palhaços e famílias construíram, de modo singular, possíveis soluções para dificuldades enfrentadas no dia a dia. Os palhaços e palhaças foram capazes de agenciar novas construções subjetivas para cada família lidar com situações cotidianas.

Abstract Working with different forms of artistic and cultural expressions has been considered a form of health intervention to enhance the understanding and thinking about the needs in this field. A group of clown doctors conducted home visits for eight months to ten families located in micro areas of two family health teams. The practice aimed at expanding the solvability of the care given to people and to communities through the intense proximity established by the art of clownery. The idea consisted of making interventions in the homes of socially vulnerable families indicated by the family health teams using joy, humor, and laughter to stimulate reflections on the daily problems. The presence of “clown doctors” in the houses built strong and free bonds with the families and enhanced the humanized and comprehensive care within the context of family health strategy. Clowns and families found a special way to find possible solutions to the difficulties faced on a daily basis. Male and female clowns were able to manage new subjective constructions for each family to deal with everyday situations.

Educação permanente em saúde como prática avaliativa amistosa à integralidade em Teresópolis, Rio de Janeiro / Permanent education in health as an evaluative practice friendly to completeness in Teresópolis, Rio de Janeiro, Brazil / Educación permanente en salud como práctica evaluadora amigable a la integralidad en Teresópolis, Río de Janeiro, Brasil

ResumoO objetivo deste artigo é discutir o papel da educação permanente em saúde como prática avaliativa amistosa à integralidade no cotidiano dos serviços de saúde, além de sua influência na mudança do processo de trabalho das equipes de saúde da família, tomando como exemplo a experiência do município de Teresópolis, no Rio de Janeiro, em 2007 e 2008. Realizou-se uma pesquisa qualitativa de abordagem descritiva. A base teórica compôs-se de revisão bibliográfica, análise de documentos oficiais, atas das reuniões dos facilitadores com a coordenadora do grupo e atas da Comissão Intergestores Bipartite. O campo de observação consistiu de entrevista semiestruturada com o grupo de facilitadores. Para o estudo das entrevistas e atas, optou-se pela análise de conteúdo e efetuou-se o cotejamento das fontes como prova eficiente de validação. Percebeu-se que os profissionais ainda têm dificuldade em reconhecer como ferramentas de avaliação instrumentos que não os oficiais. No entanto, em Teresópolis, a prática de educação permanente foi capaz de promover mudanças no processo de trabalho, viabilizar formação crítica e reflexiva dos atuais e futuros profissionais de saúde, fortalecer a participação social e aproximar a gestão das questões locais de saúde, comprovando que pode ser considerada uma prática avaliativa amistosa à integralidade.

AbstractThe purpose of this article is to discuss the role continuing education in health plays as a friendly evaluative practice for completeness in the daily life of health services, as well as its influence in changing the family health teams'; working process. It is based on the experience of the municipality of Teresópolis, state of Rio de Janeiro, Brazil, in 2007 and 2008. A qualitative survey with a descriptive approach was conducted. The theoretical basis consisted of a review of the literature, of the analysis of official documents, minutes of the meetings of the facilitators with the coordinator of the group, and the minutes of the Bipartite Inter-Management Commission. The field of observation consisted of a semi-structured interview with the group of facilitators. To analyze the interviews and minutes, we opted for content analysis and compared the sources as an efficient proof of validation. It was noticed that professionals still find it hard to recognize instruments other than the official ones as assessment tools. However, in Teresópolis, the practice of continuing education was able to promote changes in the labor process, enabling critical and reflective training among current and future health professionals, strengthening social participation and bring management closer to the local health issues, thus proving that a friendly evaluative practice can be considered for completeness.

ResumenEl objetivo de este artículo es discutir el papel de la educación permanente en salud como práctica evaluadora amigable a la integralidad en el quehacer cotidiano de los servicios de salud, además de su influencia en el cambio del proceso de trabajo de los equipos de salud de la familia, tomando como ejemplo la experiencia del municipio de Teresópolis, en Río de Janeiro, Brasil, en 2007 y 2008. Se realizó una investigación cualitativa de enfoque descriptivo. La base teórica se compone de revisión bibliográfica, análisis de documentos oficiales, actas de las reuniones de los facilitadores con la coordinadora del grupo y actas de la Comisión Intergestores Bipartita. El campo de observación consistió en entrevista semiestructurada con el grupo de facilitadores. Para el estudio de las entrevistas y actas, se optó por el análisis de contenido y se efectuó el cotejo de las fuentes como prueba eficiente de validación. Se observó que los profesionales tienen además dificultades para reconocer como herramientas de evaluación instrumentos diferentes de los oficiales. No obstante, en Teresópolis, la práctica de educación permanente fue capaz de fomentar cambios en el proceso de trabajo, permitir la formación crítica y reflexiva de los actuales y futuros profesionales de la salud, fortalecer la participación social y aproximar la gestión de las cuestiones locales de salud, comprobando que puede ser considerada una práctica evaluadora amigable a la integralidad.

Changing physician behavior: interventions to improve prescription writing practices in a secondary level hospital in Delhi.

Background: According to a report by World Health Organization (WHO) in 2003, approximately 50% of all patients fail to take their medicine correctly. This is due to errors in prescription, underuse or misuse of medicines and ignorance of prescribers, dispensers, and patients. Methods: It is a hospital-based interventional-study carried out in a secondary level multispecialty hospital of Delhi. Investigators collected 536 prescriptions from the outpatient department of various departments and studied according to WHO core prescribing indicators for assessing drug prescription writing pattern. Interventions to improve the prescribing pattern included one continued medical education session and one workshop on prescription writing (providing essential drug list [EDL] etc.,), sharing the baseline data with the physicians and administrative approach. Evaluation of the prescribing pattern after 6 weeks of the intervention was done to find out the impact. Results: On an average 3.43 drug per encounter before intervention increased to 3.46 drugs per encounter. Inclusion of generic drugs and from EDL increased significantly from 54.8% to 73.4% and 76.9% to 88.4% respectively.. Prescribing antibiotics and injectables showed no significant reduction from baseline. The completeness of the prescriptions with respect to the various components improved significantly. Conclusion: Combining different intervention seems a noble approach to improve the prescription writing practices with respect to completeness and inclusion of generic drugs, drugs from EDL.

As contribuições do cuidado ao idoso no programa de HIPERDIA, para a formação profissional / The contributions of the elderly care at the hiperdia program, for vocational training

Este estudo objetiva relatar de forma descritiva a experiência vivenciada na unidade básica de saúde por acadêmicos, e descrever as práticas desenvolvidas ao idoso no programa HIPERDIA, contribuindo para a formação profissional desses acadêmicos. A elaboração deste estudo embasou-se na metodologia descritiva com abordagem qualitativa, desenvolvida na Unidade Básica de Saúde no município de Parnamirim (RN). Diante das experiências vivenciadas, podem ser verificados os cuidados com os idosos aqui envolvidos, portadores de doenças crônicas, possibilitando a formação de um profissional mais capacitado para elaboração de estratégias específicas de intervenções. O estudo permitiu constatar que, para a formação do acadêmico de enfermagem, o estágio curricular e extracurricular é de grande importância, pois possibilita a junção da teoria e prática, por meio das atividades que são realizadas durante esses estágios.

This study aims to report descriptively the lived experience in basic health unit by academics, and describe the practices in the elderly HIPERDIA program, contributing to the training of the academic. The preparation of this study embasou in the descriptive approach with a qualitative approach, developed at the Basic Health Unit in the Municipality of Parnamirim (RN). Given the experiences, one can understand the care with these elderly patients with chronic diseases, enabling the formation of a more qualified professional to draw up specific intervention strategies. The study finds that allowed for the formation of nursing academic, curricular and extracurricular internship is of great importance, since it enables the joining of theory and practice through activities that are held during stages.

A integralidade e as práticas em saúde da criança: uma revisão narrativa da produção científica brasileira. / The integralidade and practices in children health: a narrative review brazilian scientific production

Objetivo: buscou-se reunir um levantamento bibliográfico em forma de revisão narrativa sobre a produção atual de artigos científicos que adotam o conceito de integralidade para analisar as práticas de saúde da criança. Método: foram pesquisados artigos científicos produzidos entre os anos de 2009 e 2013. O critério de pesquisa foi a busca virtual em sites de produção acadêmica nos últimos cinco anos, tais como o Portal de Periódicos CAPES e bases de pesquisa de periódicos nacionais (Scielo, BVS – BIREME e PEPSIC). Resultados: evidenciou-se nos trabalhos estudados que apesar dos diversos sentidos dados ao conceito de integralidade, todos corroboram com o ideal de que as crianças têm o direito de serem atendidas, adequadamente, no conjunto de suas necessidades e no dever do Estado de oferecer serviços de saúde organizados para atender a essas necessidades. Considerações finais: essas devem ser atendidas em todos os níveis de assistência, por meio de ações de promoção, proteção, recuperação da saúde e reabilitação. Por isso, os desafios para implantar e implementar ações em favor da saúde da criança são inúmeros e complexos.

Objective: in this paper we sought to gather a literature review in narrative form on the production of scientific articles in the news that embrace the concept of completeness to analyze the practices of child health. Method: scientific articles produced between the years 2009 and 2013 were surveyed . The search was a virtual pursuit of academic production sites in the last five years , such as CAPES Portal Journals and Databases Search national journals (Scielo, BVS - BIREME and PEPSIC). Results: it was evident in the studies reviewed, which despite various meanings given to the concept of completeness , all corroborate the ideal that children have the right to be adequately met in the set of needs and the state’s duty to provide health services organized to meet these needs. Final considerations: these must be met at all levels of care through health promotion, protection, recovery and rehabilitation of health. So the challenges to deploy and implement actions in favor of children’s health are numerous and complex.

Completeness of pedigree and family cancer history for ovarian cancer patients / 부인종양

OBJECTIVE: To investigate the completeness of pedigree and of number of pedigree analysis to know the acceptable familial history in Korean women with ovarian cancer. METHODS: Interview was conducted in 50 ovarian cancer patients for obtaining familial history three times over the 6 weeks. The completeness of pedigree is estimated in terms of familial history of disease (cancer), health status (health living, disease and death), and onset age of disease and death. RESULTS: The completion of pedigree was 79.3, 85.1, and 85.6% at the 1st, 2nd, and 3rd time of interview and the time for pedigree analysis was 34.3, 10.8, and 3.1 minutes, respectively. The factors limiting pedigree analysis were as follows: out of contact with their relatives (38%), no living ancestors who know the family history (34%), dispersed family member because of the Korean War (16%), unknown cause of death (12%), reluctance to ask medical history of relatives (10%), and concealing their ovarian cancer (10%). The percentage of cancers revealed in 1st (2%) and 2nd degree (8%) relatives were increasing through surveys, especially colorectal cancer related with Lynch syndrome (4%). CONCLUSION: Analysis of pedigree at least two times is acceptable in Korean woman with ovarian cancer from the first study. The completion of pedigree is increasing, while time to take family history is decreasing during three time survey.

Avaliação da completude da variável raça/cor nos sistemas nacionais de informação em saúde para aferição da equidade étnico-racial em indicadores usados pelo Índice de Desempenho do Sistema Único de Saúde / Evaluation of the race/color variable completeness in the national health information systems for the measuring of ethnic-racial inequality in indicators used by the Performance Index of the Brazilian Unified Health System

Avaliou-se o preenchimento da variável raça/cor em oito sistemas/módulos nacionais de informação em saúde, bem como a viabilidade de cálculo e uso de indicadores segundo esse quesito na avalição do Sistema Único de Saúde. Somente três sistemas/módulos estavam adequados para validar três dos 24 indicadores usados pelo Índice de Desempenho do SUS. Apesar dos avanços nas estratégias para saúde de grupos étnico-raciais, o aprimoramento do preenchimento da variável permitirá melhor avaliação da situação de saúde da população negra. Recomenda-se monitoramento dessa variável por meio da qualificação da coleta e alimentação dos dados. É importante socializar o debate sobre equidade étnico-racial em saúde, utilizando-se o referido índice de desempenho para acompanhamento da atenção à saúde da população negra pelos governos e movimentos sociais.

The race/color variable was assessed in eight national systems/modules of health information. The calculation feasibility and use of indicators were also evaluated as for this same issue under the Unified Health System. Only three modules/systems could validate three out of the 24 indicators used by the SUS Performance Index. Despite advances towards health of ethnic and racial groups, the completeness of the variable is mandatory to allow for a better evaluation of the black population heath conditions. The monitoring of this variable is recommended by improving data collection and feed. It is important to broaden the debate on ethnic and racial equity in health by applying the mentioned performance index for monitoring the black population health care by Governments and social movements.

Study of completeness of prescriptions in paediatrics emergency section of a tertiary hospital in Lagos, Nigeria.

A prescription is the prescriber‘s written and signed formula instructing the pharmacist to supply the required drugs for a specific patient. It should be written legibly, accurately and completely in order to minimize errors in the dispensing and administration of medications. This study was to determine the level of occurrence of the essential elements in drug prescriptions in paediatric emergency section in LUTH. A total of 1158 prescriptions were studied and analysed for the essential elements. Also questionnaires were distributed to prescribers in the children emergency Unit of LUTH. Patient’s name was found to be the most occuring element (100%) while patient’s address was the least occuring element (11.5%). The other elements occurences were between 75 to 98% in the prescriptions studied. A similar trend was observed among the prescriber responses to rating of importance of basic elements in a prescription. The patient’s body weight was not included in the prescriptions studied. This is probably due to the fact that it is missing from the standard prescription form. Some of the prescriptions studied were deficient in some of the basic elements. It is being recommended that patient body weight should be included as an element in the standard prescription form for paediatric patients.