Telecardiology on the diagnostic support of chest pain in twenty-two Emergency Care Units (UPA 24h) in the State of Rio de Janeiro / Telecardiology on the diagnostic support of chest pain in twenty-two Emergency Care Units (UPA 24h) in the State of Rio de Janeiro

Background: Telecardiology may be a useful support in diagnosis and management of chest pain. Objective: Evaluate the application of telecardiology to support the differential diagnosis of chest pain in patients admitted to Emergency Care Units. Method: Observational, retrospective and documental study of 5,816 patients admitted with supposedly cardiological chest pain in twenty two Emergency Care Units in the state of Rio de Janeiro. Data were tabulated and analyzed by Excel® software, using simple descriptive statistics, from the database of the Cardiology Consultancy Nucleus. Results: Diagnostic disagreement was found in 1,593 (27.39%) cases. Of these, 1,477 (92.72%) were diagnosed locally as non-ST-elevation myocardial infarction (non-STEMI), 74 (4.64%) as acute myocardial infarction with ST-segment elevation (STEMI), 40 (2.52%) as acute pulmonary edema (APE) and 2 (0.12%) as tachyarrhythmia. Intensive care referral was requested to 100% of these patients. After telecardiology, the diagnoses were: 385 (24.17%) unstable angina, 289 (18.14%) congestive heart failure, 212 (13.31%) APE, 174 (10.92%) STEMI, 152 (9.54%) hypertensive emergency, 113 (7.09%) acute chronic renal failure, 89 (5.59%) non-STEMI, 89 (5.59%) pneumonia, 39 (2.45%) sepsis, 26 (1.63 %) myopericarditis, 20 (1.26%) tachyarrhythmia and 5 (0.31%) orovalvar disease. The outcome after telecardiology was 1,178 discharges (73.94%), 338 (21.21%) referrals, 62 (3.90%) deaths and 15 (0.95%) unknown. Conclusion: Telecardiology was effective in chest pain diagnosis and management, optimizing hospital admission in the public health system

Perspectivas metodológicas de la investigación en salud pública, breve mirada / Methodological perspectives of public health research. A brief look

RESUMEN La investigación permite el fortalecimiento de las disciplinas, particularmente aquellas que se nutren de información de varias especialidades, como la salud pública. El objetivo de este informe es proporcionar de forma consolidada perspectivas metodológicas viables para enriquecer a la salud pública como ciencia. De la revisión destacan tres elementos claves: el tipo de abordaje investigativo, los enfoques de evidencia y competencia en el contexto metodológico de la indagación en la salud colectiva. Se concluye que el conocimiento sistemático, específico, integrado al contexto y obtenido en atención a las circunstancias de la investigación, el objeto de estudio y la ubicación institucional, contribuyen con el fortalecimiento de la salud pública como ciencia multidisciplinaria, directamente implicada, por su competencia y base en la evidencia, en la toma de decisiones en materia de salud por parte del Estado en áreas tan importantes como las necesidades, los servicios y los sistemas de salud.

ABSTRACT Research allows for the strengthening of disciplines, particularly those that draw on information from various specialties, such as public health. The objective of this report is to provide consolidated methodological perspectives to enrich public health as a science. The review highlights three key elements: the type of investigative approach, the evidence and competence approaches in the methodological context of the inquiry into collective health. It is concluded that the systematic, specific knowledge, integrated to the context and obtained in attention to the circumstances of the investigation, the object of study and the institutional location, contribute with the strengthening of public health as a multidisciplinary science, directly involved, for its competence and based on the evidence, in the decision making in matters of health by the State in areas as important as needs, services and health systems.

Desarrollo de habilidades investigativas en el campo de la Salud Pública / The development of research skills in the field of public health

Introducción: el desarrollo de habilidades investigativas a través de programas docentes se adquieren a medida que se va ejecutando en su vinculación con el proceso de investigación en diferentes momentos. Objetivo identificar los contenidos que permiten a los estudiantes la construcción de conocimientos, la creación y desarrollo de habilidades investigativas en el campo de la salud pública. Método: se realizó un estudio descriptivo, donde fueron revisados los programas de estudio del doctorado curricular, las maestrías, los diplomados, especialidades y otras formas organizativas de la educación de posgrado que se imparten en la Escuela Nacional de Salud Pública en el curso académico 2013-2014. Resultados: se revisaron un total de 13 programas docentes, de ellos 6 (46,2 por ciento) fueron programas de maestría, 4 (30,8 por ciento) programas de diplomados, 2 (15,4 por ciento) programas de especialidad y un programa de doctorado para un 7,7 por ciento. Conclusiones: en los programas de estudios de la Escuela Nacional de Salud Pública la investigación constituye un eje central de las habilidades que el estudiante debe adquirir, por tanto, esto fortalece el desarrollo de las líneas de investigación en la institución, las que se responden a los principales problemas de salud identificados(AU)

Introduction: The research skills developed through teaching programs are acquired as they are implemented linking them with the research process at different times. Objective: To identify contents that allow the students to build knowledge, as well as create and develop research skills in the field of public health. Method: A descriptive study was carried out, for which we reviewed the programs of study of the doctorates, masters, degrees, specialties, and other organizational forms of postgraduate education at the National School of Public Health in the academic year 2013-2014. Results: We reviewed a total of 13 teaching programs, out of which 6 (46.2 percent) were master's programs, 4 (30.8 percent) diploma courses programs, 2 (15.4 percent) specialty programs, and a doctoral program (7.7 percent). Conclusions: In the programs of study at the National School of Public Health research is a central axis of the skills the student must acquire; therefore, this strengthens the development of the institution's research lines, which respond to the main health problems that were identified(AU)