Barriers to Modern Contraceptive Use by Female Workers in Indonesia's Urban Areas.

Background: Female workers in Indonesia are vulnerable, because they must work to earn a living while still being responsible for domestic problems. This study analyzes the barriers to the use of modern contraceptives by female workers in Indonesia's urban areas. Methods: This cross-sectional survey looked at 21,696 female workers. We used modern contraceptive use as a dependent variable, and age, education, wealth, known modern contraceptives, number of live births, ideal number of children, and insurance ownership as independent variables. In the final test, we employed binary logistic regression. Results: The results showed that women at all age categories were more likely than those aged 15-19 years not to use modern contraceptives, except those aged 35-39 years, who showed no difference. All other marital types were more likely to use modern contraceptives than married individuals. Rich female workers were 1.139 times more likely than poor workers not to use modern contraceptives (adjusted odds ratio [AOR], 1.139; 95% confidence interval [CI], 1.026-1.264). Female workers who did not know about modern contraceptives were 4.549 times more likely than those who did not to use modern contraceptives (AOR, 4.549; 95% CI, 1.037-19.953). Female workers with more than two children were 9.996 times more likely than those with two or fewer children not to use modern contraceptives (AOR, 9.996; 95% CI, 9.1890-10.875). Conclusion: This study identified five factors associated with the non-use of modern contraceptives by female workers in Indonesia's urban areas: young, unmarried, rich, did not know about modern contraceptives, and had more than two children.

Factores sociodemográficos y ambientales relacionados con el uso de mascarillas en la población durante la pandemia por la COVID-19 / Sociodemographic and environmental factors associated with mask use during the COVID-19 pandemic

Fundamentos: Durante la pandemia de la COVID-19 se implementaron medidas de prevención con el propósito de reducir su transmisión comunitaria. El grado de cumplimiento con estas medidas estuvo influenciado por diversos factores sociodemográficos y ambientales. Sin embargo, existe escasa literatura científica que aborde el cumplimiento de las medidas preventivas en la población general. El objetivo de este estudio fue analizar la asociación entre factores sociodemográficos y ambientales, así como la adhesión al uso de mascarillas en contactos estrechos. Métodos: Se realizó un estudio transversal con 1.778 individuos, identificados mediante el rastreo de contactos estrechos de personas con SARS-CoV-2 por la Central de Coordinación de la COVID-19 de Mallorca, entre febrero y junio de 2021. Se realizó un análisis descriptivo y se utilizó un modelo de regresión logística para determinar los factores asociados al incumplimiento del uso de mascarillas.Resultados: La edad media de los participantes fue de 42,8±17,4 años (53,6% de mujeres). El 60,8% (IC 95%: 57,8-62,3) de los contactos estrechos no utilizó mascarilla durante su contacto. No se observaron diferencias estadísticamente significativas en función del sexo o grupo etario (p=0,497 y p=0,536, respectivamente). Las situaciones de mayor incumplimiento con el uso de mascarillas se dieron en el entorno domiciliario, espacios cerrados sin ventilación y al mantener distancias cortas (p<0,001). Conclusiones: Nuestros hallazgos indican una menor adhesión al uso de mascarillas en escenarios de mayor riesgo. Frente a futuras situaciones de crisis sanitaria, se deberían diseñar intervenciones que realcen la conciencia sobre los riesgos y que promuevan una mayor adhesión a medidas de prevención y control.(AU)

Background: During COVID-19 pandemic, prevention measures were implemented to mitigate the community transmission of SARS-CoV-2. Compliance with these measures was influenced by several sociodemographic and environmental factors. However, literature addressing compliance with these prevention measures among the general population remains limited. The study aimed to assess the association of sociodemographic and environmental factors and mask usage during close contact situations. Methods: A cross-sectional study was conducted with a sample of 1,778 individuals identified through close contact tracing of indivi-duals diagnosed with SARS-CoV-2 by the COVID-19 Coordination Center of Mallorca, from February to June 2021. A descriptive analysis was conducted, and a logistic regression model was utilized to evaluate factors associated with mask non-compliance. Results: The mean age of the participants was 42.8±17.4 years, with 53.6% being female. Among close contacts, 60.8% (95% CI: 57.8-62.3) did not use masks during their contact. No significant differences were observed between genders or across age groups (p=0.497 and p=0.536, respectively). Factors linked to mask non-compliance included the home setting, indoor spaces without venti-lation, and closer physical distances (p<0.001). Conclusions: Our findings indicate that mask adherence was notably lower among close contacts exposed to higher risk. In future public health crises, interventions should be developed to raise awareness about risks and promote adherence to preventive and control measures.(AU)

Predictors of Health Literacy Levels in Patients Attending Anesthesia Outpatient Clinics for Preoperative Evaluation.

INTRODUCTION: Health literacy significantly impacts healthcare outcomes, particularly in preoperative settings where patients' understanding of medical procedures, adherence to instructions, and surgical outcomes are influenced. Despite accessibility to medical information, challenges persist in comprehending healthcare details, affecting active patient participation in care. This study aims to assess health literacy among patients attending anesthesia outpatient clinics for preoperative evaluation and analyze associated factors. METHODS: A sample size of 240 patients was determined using power analysis. The inclusion criteria encompassed informed, consenting patients with adequate mental capacity and primary education, aged 18-65 years, according to the American Society of Anesthesiologists (ASA I-II). Data were collected through a descriptive characteristics form and the Health Literacy Scale (HLS). RESULTS: The mean health literacy score was 29.37±6.22, indicating a moderate level. Marital status, education level, employment status, book reading preference, comorbidities, and reason for clinic visits significantly influenced health literacy (p<0.001). Regression analysis revealed marital status (ß=-1.915, p=0.047), employment (ß=1.187, p=0.039), and book reading preference (ß=3.76, p<0.001) as independent predictors of health literacy. DISCUSSION: Health literacy levels were associated with various socio-demographic and health-related factors. Notably, being single or divorced, employed, and enjoying reading predicted higher health literacy. This underscores the impact of social support, occupation, and reading habits on health literacy. However, longitudinal studies with objective measures are warranted to further explore these associations. CONCLUSION: This study underscores the importance of addressing health literacy levels in anesthesia outpatient clinics, highlighting key predictors such as marital status, education, and employment. While contributing to our understanding of preoperative health literacy, further research using longitudinal designs and objective measures is essential. Bridging the health literacy gap is crucial for empowering patients, refining decision-making, and elevating the quality of overall surgical experiences.

Strengths and weaknesses in the high-risk baby care network / Fortalezas y debilidades en la red de atención al bebé de alto riesgo / Potencialidades e fragilidades na rede de cuidados do bebê de alto risco

ABSTRACT Objective: To characterize the Stork Network in health care for high-risk babies, pointing out its main challenges. Method: questionnaires were applied with those responsible for the babies and with network health professionals. Data were analyzed quantitatively. Results: statistically relevant variables were: link with the Basic Health Unit; individuals' awareness of Family Health Support Center team; awareness of Family Health teams regarding the diagnosis of high-risk pregnancy and compliance with prenatal care; means of communication of individuals' birth; awareness of the need for hospitalization as well as its duration; awareness of follow-up in Secondary Health Care; and its outcome, pointing to a difficulty in the axis of coordination and longitudinality of the services provided in the network. Conclusion: the greatest challenges lie in covering the territory by Family Health strategy teams, expanding teams and solidifying partnerships with Higher Education Institutions, guaranteeing a differentiated professional training.

RESUMEN Objetivo: caracterizar la Red Cigüeña en la atención a la salud de los bebés de alto riesgo, señalando sus principales desafíos. Método: se aplicaron cuestionarios con los responsables de los bebés y con los profesionales de salud de la red. Los datos se analizaron cuantitativamente. Resultados: las variables estadísticamente relevantes fueron: vinculación con la Unidad Básica de Salud; conocimiento de las personas sobre el equipo de los Centros de Apoyo a la Salud de la Familia; sensibilización de los equipos de Salud de la Familia sobre el diagnóstico del embarazo de alto riesgo y la adherencia al control prenatal; medio de comunicación del nacimiento de las personas; conciencia de la necesidad de hospitalización, así como de su duración; conocimientos sobre seguimiento en Atención Secundaria de Salud; y su resultado, apuntando a una dificultad en el eje de coordinación y longitudinalidad de los servicios prestados en la red. Conclusión: los mayores desafíos están en la cobertura del territorio por los equipos de la estrategia de Salud de la Familia, en la ampliación de los equipos y en la consolidación de alianzas con Instituciones de Educación Superior, garantizando una formación profesional diferenciada.

RESUMO Objetivo: caracterizar a Rede Cegonha na atenção à saúde ao bebê de alto risco, apontando seus principais desafios. Método: questionários foram aplicados com os responsáveis pelos bebês e com os profissionais de saúde da rede. Os dados foram analisados quantitativamente. Resultados: as variáveis estatisticamente relevantes foram: vínculo com a Unidade Básica de Saúde; conhecimento dos indivíduos sobre a equipe Núcleos de Apoio à Saúde da Família; ciência das equipes de Saúde da Família quanto ao diagnóstico de gravidez de risco e adesão ao pré-natal; via de comunicação do nascimento dos indivíduos; ciência quanto à necessidade de internação hospitalar, bem como sua duração; conhecimento sobre acompanhamento na Atenção Secundária à Saúde; e o desfecho do mesmo, apontando para uma dificuldade no eixo da coordenação e longitudinalidade dos serviços prestados na rede. Conclusão os maiores desafios estão na cobertura do território pelas equipes de estratégia de Saúde da Família, na ampliação de equipes e na solidificação das parcerias com as Instituições de Ensino Superior, garantindo uma formação profissional diferenciada.

Ethel Parsons' biographical characteristics: leadership in American and Brazilian nursing / Rasgos biográficos de Ethel Parsons: liderazgo en la enfermería americana y brasileña / Traços biográficos de Ethel Parsons: uma liderança na enfermagem norte-americana e brasileira

ABSTRACT Objective: to reconstruct Ethel Parsons' biographical aspects in the centenary of the technical cooperation mission for nursing development in Brazil. Method: biographical research, carried out using the historical sources analysis method, which consists of reading and interpreting the collected documents. Results: from a renowned family, Ethel Parsons was head of public health services and worked for the American Red Cross before being appointed to coordinate the Rockefeller Foundation mission in Brazil, where she inaugurated the Anglo-American model of nursing. For ten years, Parsons dedicated herself to leading such a mission, which resulted in implementation and dissemination, by decree, of the Anglo-American model of nursing. In 1931, she returned to her country, where she died in 1953. Conclusion: Ethel Parsons stood out in the 20th century as a woman and a nurse, leading public health care services in the USA and Brazil. Her biography demonstrates an ideal of professionalization and science to be conquered by nursing in the care and educational scenario, which influenced the design of a collective identity for Brazilian nursing.

RESUMEN Objetivo: reconstruir aspectos biográficos de Ethel Parsons en el centenario de la misión de cooperación técnica para el desarrollo de la enfermería en Brasil. Método: investigación biográfica, realizada mediante el método de análisis de fuentes históricas, que consiste en la lectura e interpretación de los documentos recopilados. Resultados: de una familia renombrada, Ethel Parsons fue jefa de servicios de salud pública y trabajó para la Cruz Roja Americana antes de ser designada para coordinar la misión de la Fundación Rockefeller en Brasil, donde inauguró el modelo angloamericano de enfermería. Durante diez años, Parsons se dedicó a liderar tal misión, que resultó en la implementación y difusión, por decreto, del modelo angloamericano de enfermería. En 1931 regresó a su país, donde falleció en 1953. Conclusión: Ethel Parsons se destacó en el siglo XX como mujer y enfermera, al frente de los servicios públicos de salud en EUA y Brasil. Su biografía demuestra un ideal de profesionalización y ciencia a ser conquistado por la enfermería en el escenario asistencial y educativo, lo que influyó en el diseño de una identidad colectiva para la enfermería brasileña.

RESUMO Objetivo: reconstruir aspectos biográficos de Ethel Parsons no centenário da missão de cooperação técnica para o desenvolvimento da enfermagem no Brasil. Método: pesquisa biográfica, realizada pelo método de análise de fontes históricas, que consiste em leitura e interpretação dos documentos coletados. Resultados: de família renomada, Ethel Parsons ocupou chefias de serviços de saúde pública e atuou na Cruz Vermelha Americana antes de ser indicada para coordenar a missão da Fundação Rockefeller no Brasil, onde inaugurou o modelo anglo-americano de enfermagem. Por dez anos, Parsons se dedicou a liderar tal missão, que resultou na implantação e difusão, por força de decreto, do modelo anglo-americano de enfermagem. Em 1931, retornou a seu país, onde faleceu em 1953. Conclusão: Ethel Parsons se destacou no século XX como mulher e enfermeira, liderando serviços assistenciais de saúde pública nos EUA e no Brasil. Sua biografia demonstra um ideal de profissionalização e ciência a ser conquistado pela enfermagem no cenário assistencial e educacional, que influenciou no delineamento de uma identidade coletiva da enfermagem brasileira.

Programa mais médicos: a regulamentação das atividades e os fundamentos legais / More medical program: regulation of activities and legal grounds

O presente artigo versa sobre a legalidade das atividades laborais exercidas pelos médicos participantes do Programa Mais Médicos, política pública adotada no Brasil pela Lei nº 12.871, de outubro de 2013. A revisão de literatura acerca da temática possibilitou esclarecer melhor o porquê da criação desse programa, ressaltando políticas anteriores a sua implementação e o número de médicos em alguns estados brasileiros em 2012. O estudo destaca ainda, os três eixos de atuação do programa, sendo um deles o emergencial, o qual busca aumentar a quantidade de profissionais de saúde em localidades, sobretudo, isoladas. Com relação aos outros eixos, há o de infraestrutura, que é responsável pela construção de hospitais e modernização dos existentes e o de educação superior que visa a formar médicos para atender às gerações futuras. Além disso, enfatiza-se, a partir da análise tanto das leis brasileiras quanto da doutrina, que o Mais Médicos cumpre os fundamentos legais. Em virtude disso, fica nítido que as práticas de curandeirismo e charlatanismo, estudadas por um ramo da Medicina Legal, não estão relacionadas a essa política. Por último, conclui-se que o Mais Médicos está contribuindo para a melhoria do serviço de saúde oferecido à população no Brasil, tal fato reconhecido pela Organização das Nações Unidas (ONU).

This article discusses about the legality of work activities practiced by doctors participating in the Programa Mais Médicos, public policy adopted in Brazil by Law number 12.871, October 2014. The literature review on the theme enabled to clarify the creation of this program, underscoring previous policy implementation and the number of doctors in some Brazilian states in 2012. The study also highlights the program’s three performance axes, one of the emergency, which seeks to increase the number of health professionals in locations, mostly isolated ones. As for the other axes, there is the infrastructure, which is responsible for building hospitals and upgrading of existing and the higher education that aims to train physicians to meet future generations. Besides that, it is emphasized, from the analysis of both the Brazilian law as the doctrine, that the Mais Médicos meets the legal fundamentals. Thus, it gets clear that the practices of faith healing and quackery, studied by a branch of Legal Medicine, are not related to this policy. Finally, it was concluded that more doctors are contributing to the improvement of health services offered to the population in Brazil, this fact is recognized by the Organização das Nações Unidas (United Nations Organizations).