[Translated article] Digital health for promoting adherence to antiretroviral treatment in patients with HIV/AIDS: A meta-review.

INTRODUCTION: Digital health or "e-health" is a set of applications based on information and communication technologies (ICTs) that can be used to promote self-care and medication adherence in patients with chronic diseases. The aim of this study was to carry out a review of systematic reviews (meta-review) on efficacy studies of e-health interventions to promote adherence to antiretroviral therapy (ART) in people living with HIV/AIDS. METHODOLOGY: A review of systematic reviews ("meta-review") was performed using the Medline-PubMed database on efficacy studies of e-health components to promote adherence to ART, in patients with HIV/AIDS, proposing a structured search strategy (PICO question). A selection process for systematic reviews was conducted based on inclusion and exclusion criteria. Subsequently, the corresponding data were extracted, and the analysis was accomplished in descriptive tables. RESULTS: A total of 29 systematic reviews were identified, from which 11 were selected. These reviews comprised 55 RCTs with different e-health interventions and enrolled a total of 15,311 HIV/AIDS patients. Studies included a total of 66 comparisons (experimental group vs. control group) in indirect adherence measurements based on different measurement techniques (36 statistically significant); 21 comparisons of viral load (VL) measurements (10 statistically significant); and 8 comparisons of CD4+ cell count measurements (3 statistically significant). m-Health was the most studied component followed by the telephone call and e-learning. CONCLUSION: Evidence was found that supports that some e-health interventions are effective in promoting adherence to ART and improving health outcomes in patients with HIV/AIDS, although it is identified that more studies are needed for more robust evidence.

Mapping Strategies for Strengthening Safety Culture: A Scoping Review.

BACKGROUND: Twenty years after the "To Err Is Human" report, one in ten patients still suffer harm in hospitals in high-income countries, highlighting the need to strengthen the culture of safety in healthcare. This scoping review aims to map patient safety culture strengthening strategies described in the literature. METHOD: This scoping review follows the JBI methodology. It adhered to all scoping review checklist items (PRISMA-ScR) with searches in the Lilacs, MedLine, IBECS, and PubMed databases and on the official websites of Brazilian and North American patient safety organizations. The research took place during the year 2023. RESULTS: In total, 58 studies comprising 52 articles and 6 documents from health organizations were included. Various strategies were identified and grouped into seven categories based on similarity, highlighting the need for a comprehensive organizational approach to improve patient care. The most described strategies were communication (69%), followed by teamwork (58.6%) and active leadership (56.9%). CONCLUSION: The identified strategies can promote the development of a culture in which an organization can achieve patient safety, involving practices and attitudes that reduce risks and errors in healthcare. However, the identification of strategies is limited because it is restricted to certain databases and websites of international organizations and does not cover a broader spectrum of sources. Furthermore, the effectiveness of these strategies in improving patient safety culture has not yet been evaluated.

Public Health Strategies in the Face of Crisis: A Comprehensive Review of the Zika Outbreak in India.

This review provides a comprehensive analysis of the public health strategies employed during the Zika outbreak in India, focusing on the identification, surveillance, and containment efforts. The multifaceted approach, including vector control measures, healthcare infrastructure enhancement, and public communication strategies, played a pivotal role in mitigating the impact of the virus. Government policies and international collaborations emerged as influential factors, underscoring the significance of a coordinated response to infectious disease crises. The study emphasizes the importance of ongoing vigilance and preparedness in public health systems, acknowledging the dynamic nature of emerging infectious diseases. The Zika outbreak in India serves as a valuable case study, offering insights into the strengths and weaknesses of crisis management responses. As the global community faces ongoing health challenges, the lessons learned from this review contribute to refining strategies, improving coordination, and fostering a proactive and resilient approach to safeguarding public health.

Active Case-Finding: An Effective Solution for Tuberculosis Detection in Vulnerable Groups - The Romanian Experience.

Introduction: Tuberculosis (TB) remains a global health challenge, requiring enhanced active case finding (ACF) through screening strategies. This study assesses the effectiveness of such an approach in locating TB cases among vulnerable groups, such as homeless persons, injecting drug users, those detained in prison, and people living in rural areas. Methods: The study focuses on socio-economic characteristics and TB detection rates across Romanian counties using modern techniques including computer-aided detection of lesions on chest X-ray and GeneXpert tests. Results: The results highlight the disproportionate burden of TB in vulnerable groups, by revealing significant differences in TB detection rates between regions. Notably, the TB detection rates among these vulnerable groups (250.85 per 100,000 population) are five times higher than the national incidence rate (46.1). Discussion: These findings underscore the imperative integration of ACF into National TB Program to provide customized and efficient solutions for diverse vulnerable groups, thereby informing crucial public health initiatives and interventions.

Epidemiological patterns and spatiotemporal analysis of cardiovascular disease mortality in Iran: Development of public health strategies and policies.

BACKGROUND: Cardiovascular diseases (CVD) stand out as the leading cause of mortality, and the mortality rate attributed to this disease is notably elevated in Iran. Consequently, dedicated studies on CVD become imperative. METHODS: This cross-sectional study utilized data from the death registration system of the Ministry of Health, Treatment and Medical Education of Iran. In this study, the statistical population of all people who died due to CVD in Iran were18,146, 21,945, and 24,352 individuals in the years 2017, 2018, and 2019, respectively. The primary objective is to conduct a spatiotemporal analysis of CVD mortality spatiotemporally using GIS-based methodologies. To achieve this, CVD mortality data at the township level for the years 2017, 2018, and 2019 in Iran are subjected to spatial statistical tests, including Anselin Local Moran's I and Hot Spot Analysis (Getis-Ord Gi*), as well as analytical techniques such as Mean Center (MC), (SD), and (GIS). RESULTS: The study identified a rising trend in cardiovascular disease-related deaths in Iran, reaching (46.36% females and 53.64 males), (45.39% females and 54.61% males) and (45.67% females and 54.33% males) individuals in the years 2017, 2018, and 2019, respectively. Throughout this period, the mortality rate was higher among men, with the elderly showing the highest mortality. Notably, distinct hotspots of cardiovascular disease mortality emerged in the western, southern, and eastern regions of Iran. These findings emphasize the importance of targeted interventions and further investigation into the contributing factors in these specific geographic areas. CONCLUSION: Geographic factors are identified as significant contributors to an elevated risk of cardiovascular disease mortality. Our study, shedding light on the spatial dynamics of the disease, offers valuable insights for decision-makers. The findings can contribute to the formulation of effective strategies and policies, aligning with a Holistic Cardiovascular Health Strategy, Gender-Based Healthcare Policies, and Spatial Planning and Environmental Policies.

Analysis of the fight against the COVID-19 pandemic in long-term care facilities in the pre-vaccination period.

INTRODUCTION: The COVID-19 pandemic has disproportionately affected individuals residing in Long-Term Care Facilities (LTCFs), necessitating tailored strategies to manage outbreaks. This study examines the outcomes of the ILPI BH project, a collaborative effort between the Municipal Health Department and the Hospital das Clínicas of the Federal University of Minas Gerais, designed to mitigate COVID-19 spread within LTCFs. METHODS: Prospective cohort of secondary data: 1,794 old residents in 99 long-term care facilities of Belo Horizonte, Brazil, were followed from May 2020 to January 2021. The study analyzed the prevention strategies, residents' clinical data, and the characteristics of the long-term care facilities, correlating these variables with the number of infections, hospitalizations, and deaths from COVID-19. It checked absolute numbers and rates of incidence, hospitalization, mortality, and lethality. RESULTS: There have been 58 COVID-19 outbreaks in long-term care facilities. There were 399 cases among residents, 96 hospitalizations for COVID-19 and 48 deaths from COVID-19 (2.7 % of the cohort), with a case fatality rate of 12 %. After multivariate analysis, the intrinsic variables to residents associated with higher mortality risk were higher degree of frailty (OR=1.08; p = 0.004) and the fact of living in a long-term care facility with a considerable proportion of residents' coverage by health plans (OR = 1.01; p = 0.028). Early geriatric follow-up showed an association with a reduction in the number of hospitalizations due to COVID-19. CONCLUSION: The correct classification of the degree of frailty of institutionalized older people seems to have been relevant for predicting mortality from COVID-19. The extensive assistance by private health plans, contrary to what is supposed, did not result in better health protection. Early geriatric follow-up was beneficial and may be an attractive strategy in the face of health emergencies that affect long-term care facilities to reduce hospital admissions.

Self-management eHealth solutions for menopause - a systematic scoping review.

OBJECTIVE: The purpose of this scoping review was to highlight the current scientific evidence on eHealth-based information tools for menopause in terms of quality, requirements and previous intervention outcomes. METHODS: We systematically searched electronic databases (Embase, CINAHL, Cochrane Library, Global Health Database [Ovid], Web of Science, ClinicalTrials.gov [NLM], LIVIVO Search Portal [ZB MED] and Google Scholar) from 1974 to March 2022 for relevant records. RESULTS: Our search yielded 1773 records, of which 28 met our inclusion criteria. Thirteen of 28 selected studies were cross-sectional with qualitative content analysis of websites about menopause; 9 studies were cohort studies examining the impact of an eHealth intervention; two studies were randomized controlled trials comparing eHealth tools with conventional ones; and four studies were non-systematic literature reviews. CONCLUSION: This scoping review highlights the potential of eHealth-based information tools for the management of menopause and shows that most eHealth-based information tools are inadequate in terms of readability and the balanced view on information. Providers of eHealth-based information tools should pay attention to a participatory design, readability, balance of content and the use of multimedia tools for information delivery to improve understanding.

Digital health to promote adherence to antiretroviral treatment in patients with HIV/AIDS: Meta review. / Salud digital para promover la adherencia al tratamiento antirretroviral en pacientes con VIH/sida: metarevisión.

INTRODUCTION: Digital health or "e-Health" is a set of applications based on Information and Communication Technologies that can be used to promote self-care and medication adherence in patients with chronic diseases. The aim of this study was to carry out a review of systematic reviews (meta-review) on efficacy studies of e-Health interventions to promote adherence to antiretroviral therapy in people living with HIV/AIDS. METHOD: A review of systematic reviews ("meta-review") was performed using the Medline-PubMed database on efficacy studies of e-Health components to promote adherence to antirretroviral therapy, in patients with HIV/AIDS, proposing a structured search strategy (PICO question). A selection process for systematic reviews was conducted based on inclusion and exclusion criteria. Subsequently, the corresponding data were extracted, and the analysis was accomplished in descriptive tables. RESULTS: A total of 29 systematic reviews were identified, from which 11 were selected. These reviews comprised 55 randomized controlled therapies with different e-Health interventions and enrolled a total of 15,311 HIV/AIDS patients. Studies included a total of 66 comparisons (experimental group vs. control group) in indirect adherence measurements based on different measurement techniques (36 statistically significant); 21 comparisons of viral load measurements (10 statistically significant); and 8 comparisons of CD4+ cell count measurements (3 statistically significant). m-Health was the most studied component followed by the telephone call and e-Learning. CONCLUSIONS: Evidence was found that supports that some e-Health interventions are effective in promoting adherence to antirretroviral therapy and improving health outcomes in patients with HIV/AIDS, although it is identified that more studies are needed for more robust evidence.

Tanzania's and Germany's Digital Health Strategies and Their Consistency With the World Health Organization's Global Strategy on Digital Health 2020-2025: Comparative Policy Analysis.

BACKGROUND: In recent years, the fast-paced adoption of digital health (DH) technologies has transformed health care delivery. However, this rapid evolution has also led to challenges such as uncoordinated development and information silos, impeding effective health care integration. Recognizing these challenges, nations have developed digital health strategies (DHSs), aligning with their national health priorities and guidance from global frameworks. The World Health Organization (WHO)'s Global Strategy on Digital Health 2020-2025 (GSDH) guides national DHSs. OBJECTIVE: This study analyzes the DHSs of Tanzania and Germany as case studies and assesses their alignment with the GSDH and identifies strengths, shortcomings, and areas for improvement. METHODS: A comparative policy analysis was conducted, focusing on the DHSs of Tanzania and Germany as case studies, selected for their contrasting health care systems and cooperative history. The analysis involved a three-step process: (1) assessing consistency with the GSDH, (2) comparing similarities and differences, and (3) evaluating the incorporation of emergent technologies. Primary data sources included national eHealth policy documents and related legislation. RESULTS: Both Germany's and Tanzania's DHSs align significantly with the WHO's GSDH, incorporating most of its 35 elements, but each missing 5 distinct elements. Specifically, Tanzania's DHS lacks in areas such as knowledge management and capacity building for leaders, while Germany's strategy falls short in engaging health care service providers and beneficiaries in development phases and promoting health equity. Both countries, however, excel in other aspects like collaboration, knowledge transfer, and advancing national DHSs, reflecting their commitment to enhancing DH infrastructures. The high ratings of both countries on the Global Digital Health Monitor underscore their substantial progress in DH, although challenges persist in adopting the rapidly advancing technologies and in the need for more inclusive and comprehensive strategies. CONCLUSIONS: This study reveals that both Tanzania and Germany have made significant strides in aligning their DHSs with the WHO's GSDH. However, the rapid evolution of technologies like artificial intelligence and machine learning presents challenges in keeping strategies up-to-date. This study recommends the development of more comprehensive, inclusive strategies and regular revisions to align with emerging technologies and needs. The research underscores the importance of context-specific adaptations in DHSs and highlights the need for broader, strategic guidelines to direct the future development of the DH ecosystem. The WHO's GSDH serves as a crucial blueprint for national DHSs. This comparative analysis demonstrates the value and challenges of aligning national strategies with global guidelines. Both Tanzania and Germany offer valuable insights into developing and implementing effective DHSs, highlighting the importance of continuous adaptation and context-specific considerations. Future policy assessments require in-depth knowledge of the country's health care needs and structure, supplemented by stakeholder input for a comprehensive evaluation.

Investigação do aleitamento materno com foco sobre a exclusividade dessa prática no primeiro semestre de vida da criança, em um município do norte de Minas Gerais / Investigation of breastfeeding focusing on the exclusivity of this practice in the first semester of the child's life, in a municipality in the north of Minas Gerais

Objetivo: investigar o aleitamento materno com foco sobre a exclusividade dessa prática no primeiro semestre de vida da criança, em um município do norte de Minas Gerais. Métodos: trata-se de um estudo descritivo, qualitativo realizado com 13 mães com idade entre 24 e 39 anos. Os dados foram coletados entre agosto e setembro de 2023, por meio de uma entrevista semiestruturada, e analisados mediante análise temática. Resultados: as mulheres indicaram ter enfrentado dificuldades na prática do aleitamento materno exclusivo, especialmente nos primeiros dias de vida da criança, devido a ingurgitamento, mastite, fissuras mamárias, pressão social e pessoal de leite fraco. Identificou-se como benefícios do aleitamento materno exclusivo a proteção imunológica, o estreitamento de vínculo, a prevenção de doenças e de desnutrição na criança, assim como a aceleração da involução uterina e a prevenção de cânceres na mulher. O apoio da família, do parceiro e da equipe de saúde foi apontado como fatores facilitadores do aleitamento materno, porém indicaram receber poucas orientações dos profissionais sobre amamentação. Conclusão: destaca-se a importância de a equipe de saúde atuar com um olhar zeloso perante esse público, intensificando as orientações sobre aleitamento materno exclusivo a fim de reduzir as dúvidas e dificuldades para elevar as taxas de duração e exclusividade do aleitamento materno.

Objective: to investigate breastfeeding with a focus on the exclusivity of this practice in the first semester of a child's life in a municipality in the north of Minas Gerais. Methods: this is a descriptive, qualitative study carried out with 13 mothers aged between 24 and 39 years old. Data were collected between August and September 2023 from a semi-structured interview and analyzed using Thematic Analysis. Results: women indicated that they faced difficulties in practicing exclusive breastfeeding, especially in the first days of the child's life, due to engorgement, mastitis, breast fissures, and social and personal pressure of weak milk. The benefits of exclusive breastfeeding were identified as immunological protection, strengthening bonds, preventing diseases and malnutrition in children, as well as accelerating uterine involution, and preventing cancer in women. Support from family, partner, and healthcare team was identified as factors that facilitate breastfeeding, but they indicated that they received little guidance from professionals about breastfeeding. Conclusion: the importance of the health team acting with a zealous eye towards the public is highlighted, intensifying guidance on exclusive breastfeeding in order to reduce doubts and difficulties in increasing the duration and exclusivity of breastfeeding.

Does education influence COVID-19 vaccination? A global view.

After the recent hard attempts felt on a global scale, notably in the health sector, the steady efforts of scientists have been materialized in maybe one of the most expected findings of the last decades, i.e. the launching of the COVID-19 vaccines. Although it is not our goal to plead for vaccination, as the decision in this regard is a matter of individual choice, we believe it is necessary and enlightening to analyze how one's educational status interferes with COVID-19 vaccination. There are discrepancies between world states vis-à-vis their well-being and their feedback to crises, and from the collection of features that can segregate the states in handling vaccination, in this paper, the spotlight is on education. We are referring to this topic because, generally, researches converge rather on the linkage between economic issues and COVID-19 vaccination, while education levels are less tackled in relation to this. To notice the weight of each type of education (primary, secondary, tertiary) in this process, we employ an assortment of statistical methods, for three clusters: 45 low-income countries (LICs), 72 middle-income countries (MICs) and 53 high-income countries (HICs). The estimates suggest that education counts in the COVID-19 vaccination, the tertiary one having the greatest meaning in accepting it. It is also illustrated that the imprint of education on vaccination fluctuates across the country groups scrutinized, with HICs recording the upper rates. The heterogeneity of COVID-19 vaccination-related behaviors should determine health authorities to treat this subject differently. To expand the COVID-19 vaccines uptake, they should be in an ongoing dialogue with all population categories and, remarkably, with those belonging to vulnerable communities, originated mostly in LICs. Education is imperative for vaccination, and it would ought to be on the schedule of any state, for being assimilated into health strategies and policies.

Text analysis of Macao's COVID-19 prevention and control policies: discussion on strategy evolution and public health capabilities.

Background: The global impact of the coronavirus disease 2019 (COVID-19) pandemic has been profound. Macao Special Administrative Region (SAR), renowned as an international hub for tourism and entertainment, has actively responded to the crisis. However, a comprehensive analysis detailing the evolution of Macao SAR's policies throughout this period is currently lacking. Methods: This study aims to comprehensively understand the decision-making processes, policy formulation, and implementation strategies of the Macao SAR government amidst the pandemic through the analysis of speeches and inquiries made by legislative council members and other relevant documents. Employing both quantitative and qualitative analytical methods, including word frequency analysis and word vector models, we identify key themes and patterns. Additionally, we conducted a comparative analysis of keyword frequencies during the two waves of the pandemic using radar charts. Results: The results indicate a heightened focus by the Macao SAR government on pandemic control measures and economic impacts. In response, the government formulated and implemented policies, provided support initiatives, and managed port clearance, all while focusing on enhancing healthcare infrastructure and community services. Conclusions: The government persistently amends its policies in response to the evolving challenges posed by the pandemic. The evolution of the dynamic Zero-COVID strategy highlights the government's adaptability and comprehensive consideration, ensuring public health and societal stability.

Exploring COVID-19 Vaccination Willingness in Italy: A Focus on Resident Foreigners and Italians Using Data from PASSI and PASSI d'Argento Surveillance Systems.

(1) The COVID-19 pandemic exacerbated health disparities, both between foreign and autochthonous populations. Italy was one of the European countries that was the most affected by the COVID-19 pandemic; however, only limited data are available on vaccine willingness. This study aims to assess the propensity of foreign and autochthonous populations residing in Italy to be vaccinated and the relative associated factors. (2) Data were collected and analysed from the two Italian surveillance systems, PASSI and PASSI d'Argento, in the period of August 2020-December 2021. The data include those of the Italian resident adult population over 18 years old. A multinomial logistic regression model, stratified by citizenship, was used to assess the associations of sociodemographic, health, and COVID-19 experience variables with vaccination attitudes. (3) This study encompassed 19,681 eligible subjects. Considering the willingness to be vaccinated, foreign residents were significantly less certain to get vaccinated (49.4% vs. 60.7% among Italians). Sociodemographic characteristics, economic difficulties, and trust in local health units emerged as factors that were significantly associated with vaccine acceptance. Having received the seasonal flu vaccine was identified as a predictor of COVID-19 vaccine acceptance among foreign and Italian residents. (4) This study underscores the significance of tailoring interventions to address vaccine hesitancy based on the diverse characteristics of foreign and Italian residents. This research offers practical insights for public health strategies, highlighting the importance of tailored educational campaigns, improved communication, and nuanced interventions to enhance vaccine acceptance and uptake within both populations.

Perfil e práticas dos médicos da atenção primária na pandemia de covid-19 em Salvador, Bahia, Brasil / The profile and practices of primary care physicians during the covid-19 pandemic in Salvador, Bahia, Brazil / Perfil y prácticas de los médicos de atención primaria en la pandemia de la covid-19 en Salvador, Bahía, Brasil

Em 2020, a atenção à saúde sofreu o impacto da pandemia de covid-19, e a Atenção Primária não foi exceção. Para melhor compreender a reorganização desse setor no município de Salvador, Bahia, esta pesquisa descreve o perfil dos médicos e as práticas de saúde realizadas por eles na Atenção Primária no contexto da pandemia. Trata-se de um estudo de corte transversal descritivo, que se utiliza de um questionário online autoaplicável distribuído aos médicos participantes que atuam nas unidades básicas de saúde que compõem a Atenção Primária do município. Para análise dos dados, foi utilizada estatística descritiva simples. Com um total de 43 questionários respondidos, foram descritos aspectos referentes a: perfil, formação e atuação dos médicos; mudanças estruturais ocorridas e adoção de novas ferramentas de trabalho; manutenção dos cuidados primários de rotina; ações de vigilância em saúde; suporte social a grupos vulneráveis; e atuação clínica em pacientes com covid-19. Com uma maioria de médicas jovens, recém-formadas e em um período curto de atuação nas equipes onde estavam inseridas, observou-se pouco envolvimento em vigilância e suporte a grupos vulneráveis e um abrangente uso de telemedicina e reestruturação do funcionamento das unidades. Contudo, alguns cuidados primários, como acompanhamento de doenças crônicas e puericultura, resultaram em limitações no acesso e, consequentemente, menor atenção ao cuidado longitudinal.

In 2020, health care suffered the impact of the COVID-19 pandemic and primary care was no exception. To better understand the reorganization of this segment in the municipality of Salvador, Bahia, this research describes the profile of physicians and health practices performed by them in primary care in the pandemic context. This is a cross-sectional descriptive study using an online self-administered questionnaire distributed to participating physicians who work in the basic health units that are a part of primary care in the municipality. For data analysis, simple descriptive statistics was used. With a total of 43 questionnaires answered, the following aspects were described: profile, training, and performance of physicians; structural changes and adoption of new work tools; maintenance of routine primary care; health surveillance actions; social support to vulnerable groups; and clinical performance with COVID-19 patients. With mostly young females, recently graduated, and with a short period of service in the teams where they were located; little involvement in surveillance and support to vulnerable groups is observed, as well as an extensive use of telemedicine and restructuring of the operation of the units. However, some primary care, such as chronic disease follow-up and childcare, resulted in limitations in access and, consequently, less attention to longitudinal care.

En 2020, la atención sanitaria sufrió el impacto de la pandemia de la covid-19 y la atención primaria no fue la excepción. Para comprender mejor la reorganización de este sector en el municipio de Salvador, en Bahía (Brasil), esta investigación describe el perfil de los médicos y las prácticas de salud realizadas por ellos en la atención primaria en el contexto de la pandemia. Se trata de un estudio descriptivo transversal que utilizó un cuestionario autoadministrado en línea distribuido a los médicos participantes que trabajan en las Unidades Básicas de Salud que componen la atención primaria del municipio. Para el análisis de los datos, se utilizó estadística descriptiva simple. Con un total de 43 preguntas respondidas, se describieron aspectos referentes al perfil, formación y capacitación de los médicos; a los cambios estructurales ocurridos y adopción de nuevas herramientas de trabajo; al mantenimiento de los cuidados primarios de rutina; a las acciones de vigilancia en salud; al apoyo social a grupos vulnerables; y a la capacitación clínica en pacientes con covid-19. La mayoría de las médicas eran jóvenes, recién licenciadas y tenían un corto período de actuación en los equipos con los cuales trabajaban, se observó una escasa implicación en la vigilancia y apoyo a colectivos vulnerables, así como un amplio uso de la telemedicina y la reestructuración del funcionamiento de las unidades. Sin embargo, algunas atenciones primarias, como el seguimiento de enfermedades crónicas y la atención a la infancia, se tradujeron en limitaciones en el acceso y, en consecuencia, en menos atención al cuidado longitudinal.

Estratégias de enfrentamento da covid-19 pela enfermagem no âmbito hospitalar: uma revisão integrativa / Strategies for coping with covid-19 through nursing in a hospital setting: an integrative review / Estrategias de afrontamiento de la covid-19 por la enfermería en el ámbito hospitalario: una revisión integradora

Com o surgimento da pandemia causada pelo vírus da severe acute respiratory syndrome (SARS-CoV-2), necessitou-se implementar medidas de controle hospitalar, a fim de evitar a propagação e reinfecção dos pacientes acometidos. Assim, objetivou-se identificar as estratégias adotadas pela enfermagem no enfrentamento da covid-19, mediante revisão integrativa da literatura nas bases de dados: SciELO, LILACS e BVS, de 2019 a 2022. Selecionou-se palavras-chave seguindo os Descritores de Ciências da Saúde (DeCS) e operadores booleanos. A transmissão do novo coronavírus ocorre de pessoa para pessoa, por inalação ou contato com gotículas respiratórias do indivíduo infectado com incubação de dois a 14 dias. Os sintomas variam entre febre, tosse, dor de garganta, dificuldade respiratória, e outros. A alta transmissibilidade do vírus alastrou-se de forma rápida e frequente, sendo necessário se atentar à segurança dos profissionais de saúde e dos pacientes, por meio da correta utilização dos equipamentos de proteção individual (EPI) e da sistematização da assistência de enfermagem, na qual o enfermeiro direciona e coordena, de forma individualizada, a prestação da assistência ao paciente na unidade de saúde, observando os sinais e sintomas para determinar a gravidade do quadro clínico e prestar todos os cuidados necessários. Este trabalho proporcionou uma visão ampla das estratégias adotadas pelos profissionais de enfermagem, destacando a atuação corajosa, ativa e contínua deles na linha de frente do enfrentamento da pandemia, com prestação da assistência integral de qualidade aos pacientes.

The emergence of the pandemic caused by the severe acute respiratory syndrome virus (SARS-CoV-2) required implementing hospital control measures to prevent the spread and reinfection of affected patients. Thus, this study analyzes practices used by nurses to combat COVID-19 by means of an integrative literature review. Bibliographic search was conducted in the SciELO, LILACS and BVS databases from 2019 to 2022 using DeCS descriptors and Boolean operators. COVID-19 transmission occurs from person to person through inhalation or contact with respiratory droplets from infected individuals with incubation of 2 to 14 days. Symptoms range from fever, cough, sore throat, difficulty breathing to more severe reactions. Its high transmissibility lead to a quick and frequent spread, demanding better attention to professional and patient safety through the correct use of PPEs and the systematization of nursing care, in which nurses direct and coordinate the provision of individualized care to patients the health unit, observing signs and symptoms to determine clinical severity and provide all necessary care. The present work gave a broad view of the strategies adopted by nursing professionals, highlighting their courageous, active and continuous actions on the front line to combat the pandemic, providing comprehensive quality care to patients.

La pandemia provocada por el virus del síndrome respiratorio agudo severo (SARS-CoV-2) requirió la implementación de medidas de control hospitalario para evitar la propagación y reinfección de los pacientes afectados. En este contexto, se pretende identificar las estrategias de afrontamiento de la covid-19 utilizadas por la enfermería; para ello, se realizó una revisión integradora de la literatura en las bases de datos SciELO, LILACS y BVS en el período de 2019 a 2022. Las palabras clave se seleccionaron siguiendo los Descriptores de las Ciencias de la Salud (DeSC) y los operadores booleanos. El nuevo coronavirus se propaga de persona a persona mediante la inhalación o contacto con gotículas respiratorias de la persona infectada en un período de incubación de 2 días a 14 días. Los síntomas van desde fiebre, tos, dolor de garganta, dificultad para respirar, entre otros. La propagación del virus se dio de manera rápida y frecuente, por lo que se requirió prestar atención a la seguridad de los profesionales de la salud y de los pacientes, mediante el uso correcto de los equipos de protección individual (EPI) y la sistematización de los cuidados de enfermería, en que el enfermero dirige y coordina, de manera individualizada, la atención al paciente en la unidad de salud, observando sus signos y síntomas para determinar la gravedad del cuadro clínico y brindarle los cuidados necesarios. Este trabajo proporciona una visión amplia de las estrategias adoptadas por los profesionales de enfermería, con su acción valiente, activa y continua en primera línea en el afrontamiento a la pandemia, brindando una atención integral de calidad a los pacientes.

Práticas Avançadas de Enfermagem ­ PAE / Advanced Nursing Practices ­ ANP

Trata de nota técnica sobre Práticas Avançadas de Enfermagem (PAE) no Brasil, elaborada por comissão e submetida à aprovação do plenário do Conselho Federal de Enfermagem (Cofen). O documento aborda conceitos, ações, implementação e regulação das práticas avançadas de Enfermagem, expandindo os limites do escopo da atuação do enfermeiro e reforçando a sua prática clínica. (AU)

This is a technical note on Advanced Nursing Practices (ANP) in Brazil, prepared by a committee and submitted for approval by the plenary of the Federal Nursing Council (Cofen). The document addresses concepts, actions, implementation and regulation of advanced nursing practices, expanding the limits of the scope of nurses' work and reinforcing their clinical practice. (AU)

Esta es una nota técnica sobre las Prácticas Avanzadas de Enfermería (PAE) en Brasil, elaborada por un comité y sometida a la aprobación del plenario del Consejo Federal de Enfermería (Cofen). El documento aborda los conceptos, acciones, implementación y reglamentación de las prácticas avanzadas de enfermería, ampliando los límites del ámbito de actuación de las enfermeras y reforzando su práctica clínica. (AU)

Evaluation of the Impact of Oral Health on the Daily Activities of Users of the National Health System.

BACKGROUND: the integration of dentistry services in the Unified Health System in Brazil (SUS) is essential in primary care assistance. OBJECTIVE: we aimed to develop a tool for improving demand flowby evaluating the impact of oral health on the daily activities of users of the Family Health Unitusing the Oral Impacts of Daily Performance (OIDP)tool. METHODS: In Barretos, Brazil, a cross-sectional study was conducted at a Family Health Unit (FHU)including patients over 12 years old. Oral health impact was assessed using the Oral Impacts of Daily Performance (OIDP) tool, and family risk was measured with the Coelho-Savassi scale. RESULTS: 430 participants, including 411 adults and 19 young people, were recruited. Of the adults, 31% had an average OIDP score of 16.61. For young people, 53% reported an impact (average OIDP score: 28.61). Family risk (R1) was prevalent in 57.9% of young people and 53.3% of adults. Among adults, different activities were affected by risk: smiling without embarrassment (risk level 2), enjoying contact with people (risk level 3), and performing one's job or social role (risk level 1). Emotional state (R3) had the lowest OIDP score (p = 0.029). CONCLUSION: implementation of the OIDP scale in clinical practice enhances healthcare planning and ensures better-quality and equitable services, thus emphasizing comprehensive oral healthcare within the SUS.

[Primary prevention of gender-based violence]. / Prevención primaria de la violencia de género.

Gender-based violence is a serious public health problem and a violation of human rights. The vast scale of the problem indicates that it is necessary to advance in its primary prevention. The health sector has an important role to play, especially Primary Health Care, based on its community orientation and with the involvement of all members of the team. The intervention framework defined by the acronym "RESPECT", promoted by the World Health Organization, shows the 7 strategies that are currently promising to lead to reductions in gender-based violence, based on the best scientific evidence available to date. Using a participatory, life-cycle approach, promoting coordination and partnership across sectors, and implementing combined interventions are some of the guiding principles from which to work today.

Atenção à pessoa com anemia falciforme no contexto da Estratégia Saúde da Família: a ótica dos profissionais / Caring the patient with falciform anemia in the context of the Family Health Strategy: the views of professionals

Resumo Introdução: Na atenção à pessoa com anemia falciforme, é imprescindível um cuidado compartilhado e coordenado pela Atenção Primária à Saúde. Os profissionais de saúde da família devem se comprometer com a assistência, sendo necessária uma articulada rede de atenção à saúde. Este estudo teve por objetivo compreender as visões de profissionais de saúde da família acerca da atenção à saúde da pessoa com anemia falciforme. Método: Pesquisa qualitativa, realizada em Diamantina, estado de Minas Gerais, Brasil, com enfermeiros e médicos da Estratégia Saúde da Família (ESF). Conduziram-se entrevistas semiestruturadas com 15 profissionais — sendo, depois, submetidas à análise temática de conteúdo. Resultados: Emergiram duas categorias temáticas: "assistência à pessoa com anemia falciforme: fragilidades no contexto da Estratégia Saúde da Família" e "referência e contrarreferência na atenção: uma rede fragmentada". Revelaram-se desafios a serem superados: o acompanhamento sistemático mostrou-se incipiente, atribuiu-se a responsabilidade pelo cuidado principalmente ao serviço do hemocentro e o sistema de referência e contrarreferência apresentou fragmentação. Conclusões: No cenário da ESF, a assistência requer avanços para que seja de melhor qualidade, com efetiva atuação da equipe e rede de atenção bem estruturada.

Abstract Background: While caring the patients with sickle cell anemia, shared care coordinated by Primary Health Care is essential. Family health professionals must commit to care, and an articulated healthcare network is necessary. This study aimed to understand the visions of family health professionals about health care for patients with sickle cell anemia. Method: Qualitative research was carried out in Diamantina, state of Minas Gerais, Brazil, with nurses and physicians of the Family Health Strategy (ESF). Semi-structured interviews were conducted with 15 professionals and the results were submitted to content thematic analysis. Results: Two thematic categories emerged: "assistance to the person with sickle cell anemia: fragilities in the context of the Family Health Strategy" and "reference and counterreference in care: a fragmented network." Challenges to overcome were revealed: systematic follow-up was incipient; responsibility for care was attributed mainly to the blood center service; and the reference and counter-reference system presented fragmentation. Conclusions: In the ESF scenario, care requires advances to be of better quality, with effective team performance and a well-structured care network.