ABSTRACT
AIMS: The arrival of anti-vascular endothelial growth factor (anti-VEGF) therapies represented a treatment shift for several ophthalmological disorders and led to an increasing number of patients undergoing intravitreal injections. The aims of this observational study were to assess the expansion of anti-VEGF intravitreal injections in the Portuguese National Health System (NHS) and to identify factors correlated with geographical variations in episode rates. METHODS: Administrative database on discharge from Portuguese NHS hospitals was analysed for annual values and rates of intravitreal anti-VEGF injections at a national and regional level, between 2013 and 2018. RESULTS: The number of episodes of anti-VEGF treatment and patients treated increased 16% and 9% per year, respectively, between 2013 and 2018. During the study period around 72% of patients were treated in the Metropolitan areas of Lisbon and Porto and in the Central region. Intravitreal anti-VEGF treatment rates in 2018 were 560 per 100 000 population and presented high variability between municipalities. Higher anti-VEGF treatment rates at the municipality level were associated with shorter distances between their residence and the hospital. At the hospital level, higher ratio of ophthalmologists and higher organisational level were associated with higher anti-VEGF treatment rates. CONCLUSION: The number of episodes and patients treated with anti-VEGF injections has been growing in recent years. Proximity to healthcare, more access to ophthalmologists and hospitals with higher organisational levels are associated with higher anti-VEGF treatment rates. Improving access is crucial to reduce regional discrepancies and ensure optimal treatment frequency, which may improve health outcomes.
Subject(s)
Ranibizumab , Angiogenesis Inhibitors/therapeutic use , Bevacizumab , Humans , Intravitreal Injections , Portugal , Ranibizumab/therapeutic use , Retrospective Studies , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth FactorsABSTRACT
O desenvolvimento motor é uma sequência de etapas evolutivas que ocorre de acordo com a faixa etária, determinado por meio dos requisitos de interação da criança com a tarefa, individualidade biológica e condições do ambiente. O objetivo deste estudo é analisar o desempenho motor de escolares quilombolas entre 8 anos a 10 anos de idade. Trata-se de uma pesquisa quantitativa, do tipo transversal, com amostra constituída por 52 escolares. O instrumento de coleta de dados utilizado foi o protocolo de testes da Escala de Desenvolvimento Motor (EDM) de Rosa Neto. A seleção da amostra foi do tipo intencional. Apresentaram classificação normal médio as variáveis coordenação motora fina, com Quociente Motor (QM) (QM1 = 100,47), motricidade global (QM2 = 100,42) e equilíbrio (QM3 = 98,07). Já a variável esquema corporal teve a classificação normal baixo (QM4 = 82,06). As menores classificações foram nas áreas de organização espacial (QM5 = 73,3) com classificação inferior, e a organização temporal, muito inferior (QM6 = 69,0). Na classificação geral dos escolares, 94% (n = 49) obtiveram níveis de desenvolvimento motor normal (médio e baixo). Um percentual de 4% (n = 2) foi classificado como inferior e 2% (n = 1), muito inferior. Conclui-se que o desenvolvimento motor da maioria dos escolares quilombolas encontra-se dentro dos parâmetros da normalidade.
Motor development is a sequence of evolutionary steps that occurs according to age group, and it develops by means of requirements in the interaction of the child with the task, biological individuality, and environment conditions. This study analyzed the motor performance of Quilombola students between 8 to 10 years. This quantitative search with cross-type survey has a sample of 52 students. The data collection instrument used was the Rosa Neto's test protocol Motor Development Scale (MDS). The selection of the sample was of intentional type. The variables fine motor coordination, with quotient motor (QM) (QM1 = 100.47), global drive (QM2 = 100.42) and equilibrium (QM3 = 98.07) showed normal average classification. On the other hand, the variable body scheme had normal low rating (QM4 = 82.06). The smallest classifications were found in the areas of spatial organization (QM5 = 73.3), with lower classification, and temporal organization was much lower (QM6 = 69.0). In the general classification of the students, 94% (n = 49) achieved normal motor development levels (medium and low). A total of 4% (n = 2) was classified as lower and 2% (n = 1) much lower. The motor development of most Quilombola students is within normality parameters.
El desarrollo motor es una secuencia evolutiva que se produce según el grupo de edad, determinado por los requerimientos de la interacción del niño con la tarea, la individualidad biológica y las condiciones del medio ambiente. El objetivo de este estudio fue analizar el desempeño motor de los escolares quilombolas entre 8 y 10 años de edad. Es una investigación cuantitativa de tipo transversal, con una muestra formada por 52 escolares. El instrumento de recolección de datos utilizado fue el protocolo de prueba de la Escala de desarrollo motor de Rosa Neto (EDM). La selección de la muestra fue del tipo intencional. Se presentaron como clasificación normal media las variables la coordinación motriz fina, con el cociente motor (QM) (QM1 = 100,47), la motricidad global (QM2 = 100,42) y el equilibrio (QM3 = 98,07). La variable esquema del cuerpo tuvo la clasificación normal baja (QM4 = 82,06). Las menores clasificaciones estaban en las áreas de la organización espacial (QM5 = 73,3), con la clasificación inferior, y la organización temporal, mucho inferior (QM6 = 69,0). En la clasificación general de los escolares, el 94% (n = 49) obtuvieron niveles normales de desarrollo motor (medio y bajo). Un 4% (n = 2) se clasificó como inferior; y un 2% (n = 1), mucho inferior. Se concluye que el desarrollo motor de la mayoría de los escolares quilombolas se encuentra bajo los estándares de normalidad.
