Physician-Customized Strategies for Reducing Outpatient Waiting Time in South Korea Using Queueing Theory and Probabilistic Metamodels.

The time a patient spends waiting to be seen by a healthcare professional is an important determinant of patient satisfaction in outpatient care. Hence, it is crucial to identify parameters that affect the waiting time and optimize it accordingly. First, statistical analysis was used to validate the effective parameters. However, no parameters were found to have significant effects with respect to the entire outpatient department or to each department. Therefore, we studied the improvement of patient waiting times by analyzing and optimizing effective parameters for each physician. Queueing theory was used to calculate the probability that patients would wait for more than 30 min for a consultation session. Using this result, we built metamodels for each physician, formulated an effective method to optimize the problem, and found a solution to minimize waiting time using a non-dominated sorting genetic algorithm (NSGA-II). On average, we obtained a 30% decrease in the probability that patients would wait for a long period. This study shows the importance of customized improvement strategies for each physician.

Locating trauma centers considering patient safety.

Trauma continues to be the leading cause of death and disability in the U.S. for those under the age of 44, making it a prominent public health problem. Recent literature suggests that geographical maldistribution of Trauma Centers (TCs), and the resultant increase of the access time to the nearest TC, could impact patient safety and increase disability or mortality. To address this issue, we introduce the Trauma Center Location Problem (TCLP) that determines the optimal number and location of TCs in order to improve patient safety. We model patient safety through a surrogate measure of mistriages, which refers to a mismatch in the injury severity of a trauma patient and the destination hospital. Our proposed bi-objective optimization model directly accounts for the two types of mistriages, system-related under-triage (srUT) and over-triage (srOT), both of which are estimated using a notional tasking algorithm. We propose a heuristic based on the Particle Swarm Optimization framework to efficiently derive a near-optimal solution to the TCLP for realistic problem sizes. Based on 2012 data from the state of Ohio, we observe that the solutions are sensitive to the choice of weights for srUT and srOT, volume requirements at a TC, and the two thresholds used to mimic EMS decisions. Using our approach to optimize that network resulted in over 31.5% reduction in the objective with only 1 additional TC; redistribution of the existing 21 TCs led to 30.4% reduction.

Atenção integral à comunidade: autoavaliação das equipes de saúde da família / Full care for community: self-assessment of family health teams

Resumo Objetivo: analisar a autoavaliação das equipes de saúde da família quanto à atenção integral à saúde da comunidade. Método: pesquisa transversal analítica, em cidade polo do estado de Minas Gerais, Brasil. Todas as 75 equipes existentes na cidade, no período de coleta dos dados, estavam aderidas ao programa de avaliação. As equipes com ausência de informações nos 35 padrões de qualidade analisados foram excluídas. Analisaram-se 35 itens da subdimensão atenção integral, da Autoavaliação para Melhoria do Acesso e da Qualidade da Atenção Básica, instrumento validado pelo Ministério da Saúde brasileiro. Foram processadas análises estatísticas descritivas e bivariadas pelos testes Likelihood ratio, Anova e correlação de Pearson, para comparar a autoavaliação segundo localização (urbana e rural) e profissionais componentes das equipes. Resultados: entre as equipes, 38 (54,28 %) ficaram no nível satisfatório e sete (10 %) no insatisfatório. Houve melhor classificação para aquelas da área urbana (p = 0,010). As categorias profissionais técnico em enfermagem (p = 0,030), médico (p = 0,018), cirurgião-dentista (p = < 0,001) e auxiliar/ técnico em odontologia (p = 0,001) se correlacionaram positivamente com maior pontuação. Conclusões: evidenciou-se necessidade de aprimoramento da performance das equipes. Os achados trazem implicações para gestores e profissionais com impacto no cuidado e na atuação do enfermeiro.

Resumen Objetivo: analizar la autoevalua-ción de los equipos de salud de la familia en cuanto a la atención integral a la salud de la comunidad. Método: investigación transversal analítica en ciudad polo del estado de Minas Gerais, Brasil. Los 75 equipos de salud existentes en la ciudad durante el periodo de recopilación de datos se adhirieron al programa de evaluación. Se excluyeron los equipos sin información sobre los 35 estándares de calidad analizados. Se examinaron 35 ítems de la subdimensión atención integral de la Autoevaluación para la mejora del acceso y de la calidad de la atención básica, instrumento validado por el Ministerio de Salud brasileño. Se realizaron análisis estadísticos descriptivos y bivariados por las pruebas Likelihood ratio, Anova y correlación de Pearson. Se comparó autoevaluación por ubicación (urbana y rural) y los componentes del equipo profesional. Resultados: entre los equipos, 38 (54,28 %) quedaron en el nivel satisfactorio y siete (10 %) en el insatisfactorio. Se observó una mejor clasificación para área urbana (p = 0,010). Las categorías profesionales técnicas en enfermería (p = 0,030), médico (p = 0,018), cirujano-dentista (p = < 0,001) y auxiliar/técnico en odontología (p = 0,001) se correlacionaron positivamente con mayor puntuación. Conclusiones: se evidenció necesidad de perfeccionamiento del desempeño de los equipos. Los hallazgos traen implicaciones para gestores y profesionales, con impacto en el cuidado y en la actuación del enfermero.

Abstract Objective: to analyze the self-assessment of family health teams in terms of full care for community health. Method: analytical cross-sectional research in a city in the state of Minas Gerais, Brazil. The 75 health teams existing in the city during the data collection period joined the evaluation program. The teams without information about the 35 quality standards analyzed were excluded. 35 items of the sub-dimension full care of the self-assessment for the improvement of access and quality of basic care were examined, a validated instrument of the Brazilian Ministry of Health. Descriptive and bivariate statistical analyses were performed by the Likelihood ratio, Anova and Pearson correlation tests. Self-assessment was compared by location (urban and rural) and the components of the professional team. Results: among teams, thirty-eight (54.28 %) were at the satisfactory level and seven (10 %), in the unsatisfactory. A better classification was observed for urban area (p = 0.010). The nursing technical professional categories (p = 0.030), physician (p = 0.018), surgeon-dentist (p ≤ 0.001), and odontology assistant/ technician (p = 0.001) correlated positively with higher score. Conclusions: there was a need to improve the performance of the teams. The findings have implications for managers and professionals, with an impact on the care and action of the nurse.

Translation and validation of the Transition Readiness Assessment Questionnaire (TRAQ) / Tradução e validação do Questionário de Avaliação do Preparo para a Transição (TRAQ)

Abstract Objective: To translate and validate the Brazilian Portuguese version of the Transition Readiness Assessment Questionnaire in a population of adolescents and young adults with chronic rheumatologic disorders. This questionnaire evaluates the patient's readiness for making the transition from the pediatric health service to adult care. Methods: The four-phase methodology for the translation and validation of generic questionnaires was followed, including translation, back-translation, pilot testing and clinical validation of the final tool. The confirmatory factor analysis was used for clinical validation and the Cronbach's alpha coefficient was used to assess the overall internal consistency of the final tool. Results: A total of 150 patients with a mean age of 17.0 years (SD = 2.2 years, range 14-21 years) were enrolled for the final tool validation. Of those, 71 patients had juvenile systemic lupus erythematosus (47.3%), 64 had juvenile idiopathic arthritis (42.7%), and 15 had juvenile dermatomyositis (10%). During the confirmatory factor analysis, the dimension "Talking with providers" consisting of two questions, was considered as not fitting the translated questionnaire due to a very high ceiling effect and was therefore excluded. All other translated items favorably contributed to the overall consistency of the final tool; removing that dimension did not result in a substantial increase in Cronbach's alpha, which was 0.776. Conclusions: The Brazilian Portuguese version of the Transition Readiness Assessment Questionnaire was validated in a population of transitional patients with chronic rheumatologic disorders, after one dimension from the original questionnaire was excluded. It is a non-specific disease questionnaire; thus, it can be used to evaluate the transition readiness of Brazilian patients with other chronic diseases.

Resumo Objetivo: Traduzir para o português brasileiro e validar o Questionário de Avaliação do Preparo para a Transição em uma população de adolescentes e adultos jovens com doenças reumáticas crônicas. Este questionário avalia o preparo do paciente para realizar a transição do serviço de saúde pediátrico para a assistência ao adulto. Métodos: Seguimos a metodologia de quatro etapas para a tradução e validação de questionários genéricos que inclui tradução, retrotradução, teste piloto e validação clínica do instrumento final. Utilizamos Análise Fatorial Confirmatória e Coeficiente Alfa de Cronbach para testar a validade do instrumento e sua consistência interna. Resultados: Responderam ao questionário traduzido e adaptado 150 pacientes. A média de idade foi de 17,0 anos (DP = 2,2 anos, variação 14-21 anos). Tinham o diagnóstico de lúpus eritematoso sistêmico juvenil 71 pacientes (47,3%), 64 (42,7%) artrite idiopática juvenil e 15 (10%) dermatomiosite juvenil. Durante a análise fatorial confirmatória, a dimensão "Falando com a Equipe Médica" contendo duas questões teve que ser removida devido à presença de expressivo efeito teto. Todas as outras questões restantes contribuíram favoravelmente para aumentar a consistência interna do questionário, obteve-se um Coeficiente Alfa de Cronbach de 0,776. Conclusões: O Questionário de Avaliação do Preparo para a Transição na sua versão em português brasileiro pode ser validado em uma população de pacientes com doenças reumáticas crônicas em transição, com a exclusão de uma dimensão do questionário original. Por ser um questionário não específico para doenças reumáticas, poderá ser utilizado para avaliar o preparo para a transição de outros pacientes brasileiros com doenças crônicas.

Translation and validation of the Transition Readiness Assessment Questionnaire (TRAQ).

OBJECTIVE: To translate and validate the Brazilian Portuguese version of the Transition Readiness Assessment Questionnaire in a population of adolescents and young adults with chronic rheumatologic disorders. This questionnaire evaluates the patient's readiness for making the transition from the pediatric health service to adult care. METHODS: The four-phase methodology for the translation and validation of generic questionnaires was followed, including translation, back-translation, pilot testing and clinical validation of the final tool. The confirmatory factor analysis was used for clinical validation and the Cronbach's alpha coefficient was used to assess the overall internal consistency of the final tool. RESULTS: A total of 150 patients with a mean age of 17.0 years (SD=2.2 years, range 14-21 years) were enrolled for the final tool validation. Of those, 71 patients had juvenile systemic lupus erythematosus (47.3%), 64 had juvenile idiopathic arthritis (42.7%), and 15 had juvenile dermatomyositis (10%). During the confirmatory factor analysis, the dimension "Talking with providers" consisting of two questions, was considered as not fitting the translated questionnaire due to a very high ceiling effect and was therefore excluded. All other translated items favorably contributed to the overall consistency of the final tool; removing that dimension did not result in a substantial increase in Cronbach's alpha, which was 0.776. CONCLUSIONS: The Brazilian Portuguese version of the Transition Readiness Assessment Questionnaire was validated in a population of transitional patients with chronic rheumatologic disorders, after one dimension from the original questionnaire was excluded. It is a non-specific disease questionnaire; thus, it can be used to evaluate the transition readiness of Brazilian patients with other chronic diseases.

O processo de orientação de trabalhos de conclusão de cursos de especialização: a experiência da Escola de Saúde Pública da Bahia / The process of academic advising in specialization courses: the experience of the School of Public Health of Bahia / El proceso de orientación de trabajos de conclusión de cursos de especialización: la experiencia de la Escuela de Salud Pública de Bahía

A produção de novos conhecimentos fundamenta as práticas de ensino-aprendizagem, contribuindo para o fortalecimento das ações ofertadas e para a construção da identidade institucional. Em seus processos formativos, sobretudo as especializações lato sensu, a Escola de Saúde Pública da Bahia Professor Jorge Novis (ESPBA) prevê como produto final os trabalhos de conclusão de curso (TCC), concebidos como instrumentos impulsionadores para o desenvolvimento de pesquisas e intervenções nos serviços de saúde. Neste artigo buscou-se descrever e analisar o processo de orientação de TCC desenvolvido na escola, em seu percurso histórico, considerando as primeiras experiências e as transformações que se deram após a implantação de um conjunto de medidas voltadas para o aprimoramento dessa atividade. Para fins desta análise, foi realizado um estudo comparativo entre dois cursos de especialização promovidos pela escola. Os dados foram obtidos por meio de fichas de avaliação dos TCC, instrumento aplicado para avaliar e estabelecer nota aos produtos dos cursos. Dentre as modalidades de TCC disponíveis na ESPBA, o projeto de intervenção apresenta maior complexidade e tem maior relação com o processo de trabalho do servidor, tendo em vista que demanda uma clareza do contexto em que se quer intervir e a identificação de suas necessidades. Embora não tenha sido possível afirmar que houve uma influência direta das medidas implantadas para qualificar os TCC, pode-se inferir que as diferenças observadas no curso de Especialização em Gestão de Serviços de Saúde retratam a importância das discussões promovidas pela Comissão de Monitoramento e Avaliação da Escola com os discentes e orientadores.

The production of new knowledge grounds teaching-learning practices, contributing to the strengthening of the offered actions and the construction of institutional identity. In its formative processes, especially for lato sensu specializations, the ESPBA foresees as final product the final paper (TCC), designed as an impelling instrument for the development of research and interventions in health services. This article described and analyzed the TCC advising process developed in the school, throughout its historical course, considering the first experiences and transformations that occurred after the implementation of a set of measures to improve this activity. For the purposes of this analysis, a comparative study was carried out between two specialization courses promoted by the school. The data were obtained through evaluation cards of the TCC, an instrument used to evaluate and establish a grade to the products of the courses. Among the modalities of TCC available at ESPBA, the Intervention Project presents greater complexity and is more related to the educator's process, given it demands full understanding of the context to be intervened and the proper identification of needs. Despite no clear evidence of direct influence of the implemented measures in qualifying the TCC, it can be inferred that the differences observed in the specialization course of Health Services Management portrays the importance of discussions promoted by the Monitoring and Evaluation Commission of the school with students and counselors.

La producción de nuevos conocimientos fundamenta las prácticas de enseñanzaaprendizaje, contribuyendo al fortalecimiento de las acciones ofertadas y la construcción de la identidad institucional. En sus procesos formativos, sobre todo las especializaciones lato sensu, la Escuela de Salud Pública de Bahía Profesor Novis (ESPBA) prevé como producto final los Trabajos de Conclusión de Curso (TCC) concebidos como instrumentos impulsores para el desarrollo de investigaciones e intervenciones en los servicios de salud. En este artículo se buscó describir y analizar el proceso de orientación del TCC desarrollado en la escuela, en su recorrido histórico, considerando las primeras experiencias y las transformaciones que se dieron tras la implantación de un conjunto de medidas dirigidas al perfeccionamiento de esta actividad. En este análisis, se realizó un estudio comparativo entre dos cursos de especialización promovidos por la escuela. Los datos se recogieron de fichas de evaluación de los TCC, un instrumento que se aplica para evaluar y calificar a los productos de los cursos. Entre las modalidades de TCC disponibles en la ESPBA, el proyecto de intervención presenta mayor complejidad y tiene mayor relación con el proceso de trabajo del servidor, teniendo en vista que demanda una claridad del contexto que se quiere intervenir e identificar sus necesidades. Aunque no es posible afirmar que hubo una influencia directa de las medidas implantadas para calificar los TCC, se puede inferir que las diferencias observadas en el Curso de Especialización en Gestión de Servicios de Salud retratan la importancia de las discusiones promovidas por la Comisión de Monitoreo y Evaluación de la Escuela con los alumnos y orientadores.

Aspectos Pedagógicos do Aprender e Ensinar na Rede de Saúde: a Proposta Sombra / Pedagogical Aspects of Learning and Teaching in the Health Network: the Shadow Proposal

RESUMO A inclusão do mundo do trabalho na formação funda, no processo ensino-aprendizagem em saúde, uma ligação indissociável entre as unidades de saúde e as instituições de ensino superior. Formar profissionais o mais próximo da realidade dos usuários, com participação ativa nos problemas e necessidades que estão postos na vida, é o principal motor deste processo e convoca profissionais, usuários, alunos e docentes a vivenciar uma permanente tensão entre cuidar e ensinar. O encontro entre o trabalhador de saúde, o aluno e o usuário revela-se o principal foco de intercâmbio pedagógico, configurando-se como um cenário produtor de conhecimento e de questões para investigação, além do exercício do cuidado em saúde. Algo que remete ao desafio de construir estruturas pedagógicas capazes de produzir cuidado e conhecimento a partir do mundo do trabalho e considera a articulação de modos de agir e cuidar no campo da saúde. Trabalhar em busca de constituir formas de ensinar/aprender significa operar e agir sobre conceitos e sobre o campo de experiência que se coloca como um problema do experimentar na existência, pois estamos imersos no mundo do trabalho e do cotidiano dos serviços. Articular vínculo e responsabilidade dos sujeitos envolvidos com a produção do cuidado pode ser um meio de produzir maneiras de ensinar com outros sentidos e significados. Um arranjo em que a experiência no trabalho se torna capaz de produzir indícios para a construção de projetos terapêuticos e de ensinar produtores de sentido com respostas significativas às questões sobre cuidar e formar profissionais em saúde.

ABSTRACT Bringing the world of work into education forges, in the teaching/learning process in health, an inseparable link between health units and higher education institutions. The main driving force behind this process is to give professionals a training that is as close as possible to health users' reality, enabling them to actively participate in the problems and needs of users' lives. It invites professionals, users, students and teachers to experience the continual interplay between caring and teaching. The meeting between the health worker, the student and the user is the main focus of the pedagogical exchange, as a scenario that produces knowledge and questions for research, besides the practice of health care itself. In this scenario, the challenge is to construct pedagogical structures capable of producing care and knowledge, based on the world of work, and considering the articulation of ways of acting and caring in the field of health. Working to find ways of teaching and learning means engaging and acting on concepts, and on the field of experience that is posed as a problem for real-life experience, as we are immersed in the world of work and in the day-to-day service. Articulating the links, and responsibility of the subjects involved with the production of care may be a means of producing forms of teaching that has other meanings and significances. It is an arrangement in which work experience becomes capable of producing indications for the construction of therapeutic projects, and of teaching producers of meaning which provide answers to questions about caring and training health professionals.

La investigación en la formación de profesionales y en el profesorado de las ciencias médicas / Research in the formation of professionals and in the medical sciences faculty

Introducción: la educación médica superior en Cuba se fundamenta en los principios de excelencia, calidad y pertinencia. Es importante y necesaria la integración docente, asistencial, investigativa y gerencial. La excelencia universitaria se basa en el proceso docente educativo y el proceso de investigación científica. Objetivo: destacar la importancia de la investigación en las ciencias de la salud y la investigación pedagógica. Métodos: se realizó una búsqueda bibliográfica a través de los descriptores de las ciencias de la salud en diferentes fuentes de información y se seleccionaron las que se consideraron más importantes. Resultados: se resalta la importancia de la investigación científica en las ciencias de la salud, la pedagógica y la superación profesoral. Se analizan dificultades con respecto al número y calidad de las investigaciones, la aplicación de los resultados, el creciente movimiento estudiantil en su participación en eventos científicos, el ascenso favorable de las investigaciones en enfermería, la participación de los profesionales docentes y no docentes en las investigaciones y el valor de colaboración científica internacional. Conclusiones: la investigación científica en las ciencias de la salud constituye un pilar importante de desarrollo. Deben generalizarse y aplicarse los resultados. Las enfermedades crónicas no transmisibles, el cáncer y la emergencia y reemergencia de enfermedades infecciosas constituyen problemas prioritarios por su morbilidad y mortalidad. La investigación pedagógica y la superación profesoral son necesarias en la calidad de la enseñanza y en la obtención de un egresado de excelencia(AU)

Introduction: Higher medical education in Cuba is based on the principles of excellence, quality and relevance. It is important and necessary to integrate teaching, care, research and management. University excellence is based on the educational process and on the scientific research process. Objective: To highlight the importance of research in the health sciences and in pedagogical research. Methods: A bibliographic search was carried out using the descriptors of the health sciences in different sources of information and the ones considered most important were chosen. Results: The importance is highlighted of scientific research in the health sciences, pedagogy and teacher improvement. Difficulties are analyzed regarding the number and quality of the research, the application of the results, the growing student movement in their participation in scientific events, the favorable rise of research in nursing, the participation of the teaching and non-teaching professionals in the research and the value of international scientific collaboration. Conclusions: Scientific research in the health sciences constitutes a cornerstone for development. The results should be generalized and applied. Chronic noncommunicable diseases, cancer and the emergence and re-emergence of infectious diseases are priority problems due to their morbidity and mortality. Pedagogical research and teaching excellence are necessary in the quality of teaching and for obtaining a graduate of excellence(AU)

La investigación en la formación de profesionales y en el profesorado de las ciencias médicas / Research in the formation of professionals and in the medical sciences faculty

Introducción: la educación médica superior en Cuba se fundamenta en los principios de excelencia, calidad y pertinencia. Es importante y necesaria la integración docente, asistencial, investigativa y gerencial. La excelencia universitaria se basa en el proceso docente educativo y el proceso de investigación científica. Objetivo: destacar la importancia de la investigación en las ciencias de la salud y la investigación pedagógica. Métodos: se realizó una búsqueda bibliográfica a través de los descriptores de las ciencias de la salud en diferentes fuentes de información y se seleccionaron las que se consideraron más importantes. Resultados: se resalta la importancia de la investigación científica en las ciencias de la salud, la pedagógica y la superación profesoral. Se analizan dificultades con respecto al número y calidad de las investigaciones, la aplicación de los resultados, el creciente movimiento estudiantil en su participación en eventos científicos, el ascenso favorable de las investigaciones en enfermería, la participación de los profesionales docentes y no docentes en las investigaciones y el valor de colaboración científica internacional. Conclusiones: la investigación científica en las ciencias de la salud constituye un pilar importante de desarrollo. Deben generalizarse y aplicarse los resultados. Las enfermedades crónicas no transmisibles, el cáncer y la emergencia y reemergencia de enfermedades infecciosas constituyen problemas prioritarios por su morbilidad y mortalidad. La investigación pedagógica y la superación profesoral son necesarias en la calidad de la enseñanza y en la obtención de un egresado de excelencia(AU)

Introduction: Higher medical education in Cuba is based on the principles of excellence, quality and relevance. It is important and necessary to integrate teaching, care, research and management. University excellence is based on the educational process and on the scientific research process. Objective: To highlight the importance of research in the health sciences and in pedagogical research. Methods: A bibliographic search was carried out using the descriptors of the health sciences in different sources of information and the ones considered most important were chosen. Results: The importance is highlighted of scientific research in the health sciences, pedagogy and teacher improvement. Difficulties are analyzed regarding the number and quality of the research, the application of the results, the growing student movement in their participation in scientific events, the favorable rise of research in nursing, the participation of the teaching and non-teaching professionals in the research and the value of international scientific collaboration. Conclusions: Scientific research in the health sciences constitutes a cornerstone for development. The results should be generalized and applied. Chronic noncommunicable diseases, cancer and the emergence and re-emergence of infectious diseases are priority problems due to their morbidity and mortality. Pedagogical research and teaching excellence are necessary in the quality of teaching and for obtaining a graduate of excellence(AU)

Aspectos éticos de la investigación etnográfica en salud. El papel del comité de ética de la investigación / Ethical Aspects of Ethnographic Research in Health: The Role of the Research Ethics Committee / Aspectos éticos da pesquisa etnográfica em saúde. O papel do comitê de ética em pesquisa

Resumen La presencia e integración de la investigación cualitativa a los protocolos de investigación biomédica ha cobrado cada vez mayor relevancia, por la importancia de la antropología cultural. El caso particular de la etnografía adquiere aún más preeminencia en relación con la definición de riesgo para el sujeto de investigación. El presente artículo expone las principales características de la investigación etnográfica que deben ser evaluadas por un comité de ética de la investigación, y define una serie de recomendaciones para la evaluación del riesgo para los sujetos que se someten a este tipo de estudio. Los miembros de los comités de ética en investigación deben tener en cuenta la etnografía para realizar a cabalidad su función.

Abstract The presence and integration of qualitative research to the biomedical research protocols has become increasingly relevant, due to the importance of cultural anthropology. The particular case of ethnography acquires even more preeminence with regards to the definition of risk for the research subject. This paper presents the main characteristics of ethnographic research to be evaluated by a research ethics committee and defines a series of recommendations for risk assessment for subjects undergoing this type of study. The members of Research Ethics Committees must take ethnography into account in order to fully perform their duties.

Resumo A presença e integração da pesquisa qualitativa nos protocolos de pesquisa biomédica tem cobrado cada vez mais relevância por causa da importância da antropologia cultural. O caso particular da etnografia alcança ainda mais preeminência em relação à definição de risco para o sujeito da pesquisa. O presente artigo expõe as principais características da pesquisa etnográfica que devem ser avaliadas por um comitê de ética em pesquisa e define uma série de recomendações para a avaliação do risco para os sujeitos que se submetem a esse tipo de estudo. Os membros dos comitês de ética em pesquisa devem levar em consideração a etnografia para realizar plenamente sua função.

Algoritmo de trabajo para el paciente con bruxismo / Working algorithm for the patient with bruxism

Fundamento: el bruxismo es un problema médico a escala global que involucra el apretamiento y rechinamiento de los dientes, considerado una actividad masticatoria parafuncional. Objetivo: evaluar la utilidad de un algoritmo de trabajo para la atención primaria de pacientes bruxópatas. Métodos: se realizó una investigación en Sistema y Servicios de Salud en la consulta provincial de Oclusión de la provincia de Camagüey, de septiembre de 2015 a febrero de 2016. El universo de estudio lo formaron 425 pacientes y la muestra quedó constituida por 283 personas. La investigación se estructuró en cuatro momentos. Resultados: los desgaste dentarios representaron el 100 % de la muestra y en segundo lugar las interferencia dentarias y sobrecargas en el 99,29 % del total de examinados. Se observó predominio de una recuperación estética en el 100 % y libertad de los movimientos mandibulares en el 99,29 % de los pacientes. Consideraron útil el tratamiento 98,59 % de los encuestados y la principal razón expuesta por el 100 % de ellos fue la mejora estética. Conclusiones: los desgastes dentarios prevalecieron en la totalidad de los pacientes examinados, seguidos por la presencia de interferencias y sobrecargas. La mayoría de los pacientes mostraron funcionabilidad del sistema estomatognático una vez terminado el período de seguimiento con una evolución favorable en incremento. Casi todos los pacientes consideraron útil el tratamiento lo que superó las expectativas de los investigadores.

Background: bruxism is a medical problem worldwide that involves the clenching and grinding of the teeth, considered a parafunctional masticatory activity. Objective: to evaluate the use of a working algorithm for the primary assistance of bruxist patients. Methods: a research was performed in System and Health Services in the provincial occlusion consultation of Camagüey from September 2015 to February 2016. The universe for the study was composed of 425 patients and the sample was constituted by 283. The research was carried out in four stages. Results: the dental wears represented a 100 % of the sample and second the dental interference and overloading represented a 99,29 % of the examined patients. A 100 % of the prevalence of an aesthetic recovery and freedom of jaw movements in the 99,29 % of the patients were observed. A 98,59 % of the polled patients considered treatment very useful and the main reason exposed by a 100 % had to do with the aesthetic improvement. Conclusions: the dental wears prevailed in the total of the examined patients followed by the presence of interference and overloading. Most of the patients showed that the stomatognathic system was functional once the follow-up period was over with an increased favorable progress.Almost all patients considered the treatment useful which overcame the researchers' expectations.

Challenges in transitioning adolescents and young adults with rheumatologic diseases to adult Care in a Developing Country - the Brazilian experience.

BACKGROUND: Transition guidelines and recommendations for developing countries are limited and best transition practices in young patients with chronic medical conditions have been poorly examined. This study evaluates transition practices from pediatric to adult rheumatology care in Brazil. METHODS: Practicing pediatric rheumatologists registered in the Brazilian Society of Rheumatology were e-surveyed with SurveyMonkey® using the Chira et al. questionnaire that had been used previously to evaluate transition practices of pediatric rheumatologists from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) in the USA and Canada. The questionnaire was modified to better address specific issues pertaining to the Brazilian health care system. RESULTS: Seventy-six of 112 (68%) pediatric rheumatologists responded. Only 13% of the respondents reported that they had a well-established transition program and only 14% were satisfied with their current transition process. Eighty percent did not use any specific tools to assess transition readiness. While 43% of respondents considered 18 as the ideal transition age, only a third effectively transitioned their patients at that age while 48% did later. Major hurdles for a successful transition cited by the respondents included emotional attachment to the patients (95%) insufficient training in transition practice (87%), lack of devoted time for transition preparation and process (80%), lack of assistance by pediatric generalists, (77%), and lack of available adult subspecialists (75%). Sixty-seven percent of respondents stated that their program would need more tools/resources to facilitate transition and 59% believed that the development of specific guidelines would be useful to standardize and help with the transition process. CONCLUSIONS: Our study demonstrates that the identified challenges pertaining to transition in Brazilian patients are similar to those reported by pediatric rheumatologists in the United States and Canada. However, the current financial economic pressures affecting Brazil's health care system may force physicians to deprioritize non emergent care such as transition. A comprehensive understanding of transition issues specific to youth in developing countries and educating not only patients but also health care providers about the importance of a seamless transition process will support the development of transition guidelines and ensure better outcomes of pediatric subspecialty patients.

O método da pesquisa convergente assistencial e sua aplicação na prática de enfermagem / El método de la investigación convergente asistencial y su aplicación en la práctica de enfermería / The convergent care research method and its application in nursing practice

RESUMO Objetivo: refletir sobre a diligência de três estudos que seguiram o convencionado na Pesquisa Convergente Assistencial como referencial metodológico. Resultados: a Pesquisa Convergente Assistencial caracteriza-se pela realização de melhoramentos com introdução de inovações no contexto da prática assistencial de enfermagem e saúde. É orientada por seus próprios atributos: imersibilidade; simultaneidade; expansibilidade e dialogicidade. Foram analisadas três pesquisas que utilizaram o método da Pesquisa Convergente Assistencial. O estudo A consistiu na construção de material informativo (cartilha) como tecnologia a ser desenvolvida com base nos saberes e experiências dos participantes em relação ao exame de Tomografia Computadorizada. O estudo B se propôs a desenvolver práticas educativas com um grupo de mulheres catadoras de lixo no sentido de aliviar as cargas de trabalho e, desse modo, evitar acidentes de trabalho. O estudo C desenvolveu uma proposta de educação no trabalho com enfermeiras que atuam em cuidados paliativos com a construção de um instrumento sobre a avaliação da dor em pacientes com câncer. Conclusão: os três estudos mostraram que o método da Pesquisa Convergente Assistencial possibilita uma convergência entre ações de assistência e ações de pesquisa de modo a criar espaços de superposição dessas duas atividades, com a produção de um novo conhecimento e a mudança da prática assistencial. Esse método permite que tanto a pesquisa como a prática assistencial, possam ser desenvolvidas no mesmo espaço físico e temporal e, para isso, precisam ser desarticuladas ao operacionalizar análise específica de cada uma.

RESUMEN Objetivo: reflexionar sobre la diligencia de tres estudios que siguieron lo convenido en la Investigación Convergente Asistencial como referencial metodológico. Resultados: la Investigación Convergente Asistencial se caracteriza por la realización de mejoras con introducción de innovaciones en el contexto de la práctica asistencial de enfermería y salud. Es orientada por sus propios atributos: inmersibilidad; simultaneidad; expansibilidad y diálogo. Se analizaron tres investigaciones que utilizaron el método de la Investigación Convergente Asistencial. El estudio A consistió en la construcción de material informativo (cartilla) como tecnología a ser desarrollada con base en los saberes y experiencias de los participantes en relación al examen de Tomografía computarizada. El estudio B se propuso desarrollar prácticas educativas con un grupo de mujeres recolectoras de basura para aliviar las cargas de trabajo y, de este modo, evitar accidentes de trabajo. El estudio C desarrolló una propuesta de educación en el trabajo con enfermeras que actúan en cuidados paliativos con la construcción de un instrumento sobre la evaluación del dolor en pacientes con cáncer. Conclusión: los tres estudios mostraron que el método de la Investigación Convergente Asistencial posibilita una convergencia entre acciones de asistencia y acciones de investigación para crear espacios de superposición de esas dos actividades, con la producción de un nuevo conocimiento y el cambio de la práctica asistencial. Este método permite que tanto la investigación como la práctica asistencial, puedan ser desarrolladas en el mismo espacio físico y temporal y, para ello, necesitan ser desarticuladas al operacionalizar análisis específico de cada una.

ABSTRACT Objective: to reflect on the diligence of three studies that followed the convention of Convergent Care Research (Pesquisa Convergente Assistencial - PCA) as a methodological reference. Results: convergent Care Research is characterized by conducting improvements through introducing innovations in the context of nursing and health care practice. It is guided by its own attributes: immersibility; simultaneity; expandability and dialoging. Three studies using the Convergent Care Research method were analyzed: Study A consisted of constructing an informative material (booklet) as a technology to be developed based on the participants' knowledge and experiences regarding the computed Tomograpy scan; Study B proposed to develop educational practices with a group of female garbage/recyclable material collectors to alleviate their workload and thus prevent occupational accidents; Study C developed an education proposal for training nurses who work in palliative care by constructing an instrument regarding pain assessment in cancer patients. Conclusion: all three studies showed that the Convergent Care Research method allows for the convergence between care actions and research actions in order to create superposition spaces of these two activities, with the production of new knowledge and changes in care practice. This method allows both research and care practice to be developed in the same physical and temporal space, and therefore they need to be disarticulated by conducting a specific analysis for each one.

Exodontias no Sistema Único de Saúde em Minas Gerais: uma série temporal de 15 anos / Tooth extraction in the Brazilian Health System, Minas Gerais state: a 15-year time-series

Objetivo: Avaliar a tendência histórica de extrações dentárias no Estado de Minas Gerais entre os anos de 1998 e 2012. Métodos: Trata-se de um estudo de série temporal de exodontias de dentes permanentes no Estado de Minas Gerais, tendo sido os dados coletados no Sistema de Informações Ambulatoriais do Sistema Único de Saúde em 2013. Duas taxas de exodontias foram calculadas, ano a ano. A primeira refere-se à razão entre número total de exodontias de dentes permanentes dividida por todos os procedimentos preventivos, restauradores e cirúrgicos da atenção primária. A segunda foi a razão entre o número total de exodontias de dentes permanentes pelo número de habitantes. A análise estatística envolveu a construção de curvas de tendência histórica. Resultados: As duas taxas de exodontias comportaram-se de maneira errática no período avaliado. Houve uma ligeira tendência de aumento na taxa de exodontias por procedimentos da atenção primária e ligeira tendência de redução na taxa de exodontias pela população do Estado de Minas Gerais. Conclusão: As ligeiras tendências de aumento ou redução das taxas de exodontias revelam que as mesmas permaneceram constantes no período avaliado no Estado de Minas Gerais.(AU)

Aim: To evaluate the time-series of permanent tooth extraction in the state of Minas Gerais between the years 1998 and 2012. Methods: This is a timeseries study of permanent tooth extraction in the state of Minas Gerais. Data were collected in the Brazilian National Health Information System in 2013. Two annual rates of tooth extraction were calculated. The first was the ratio of the extractions of permanent teeth in relation to the total number of individual dental procedures in primary care. The second was the ratio of the number of extractions of permanent teeth divided by the total population. The statistical analysis of the time series was performed. Results: The two extractions rates behaved erratically during the study period. There was a slight tendency to increase in tooth extraction rate via primary care procedures and slight downward trend in tooth extraction rate in Minas Gerais state population. Conclusions: The slightly tendency in increase or decrease of the tooth extraction rates reveal that they remained constant in this period in the state of Minas Gerais.(AU)

Exploring psychological safety as a component of facilitation within the Promoting Action on Research Implementation in Health Services framework.

AIMS AND OBJECTIVES: To explore holistic facilitation as an approach to enable the healthcare team to critically analyse practice and enhance patient care. BACKGROUND: Globally, the challenge of changing healthcare practices for enhanced patient care is the focus of much attention. Facilitation is emerging as an important approach to assist healthcare teams to explore and improve their practice. Within the Promoting Action on Research Implementation in Health Services framework, which has been tested in an international arena, facilitation is a key element of operationalising collaborative changes in practice. This study uses the framework to explore holistic facilitation and the concept of psychological safety. DESIGN: An Emancipatory Action Research approach was used. METHODS: Facilitated critical reflection was undertaken with the healthcare team working in an abdominal surgical unit. In addition, the lead researcher maintained a reflexive journal. Data were analysed using thematic analysis. Eighty-five per cent (n = 48) of nursing staff and individual participants from other parts of the healthcare team (n = 3) participated in the two-year study. RESULTS: Data revealed 14 sub-themes that impacted upon the culture of the unit. These were as follows: support, leadership, oppressed behaviours, communication, interruptions, power imbalance, horizontal violence, threat, autonomy, distorted perceptions, vulnerability, value, trust and time. Psychological safety, leadership and oppressed behaviours emerged as three key themes in the practice context. CONCLUSIONS: There is a need to create psychologically safe spaces in environments where insufficient support, weak leadership and oppressed behaviours are apparent. Psychological safety enables individuals to feel safe to engage in difficult conversations and consider changes to practice. In a theoretical contribution to the area of facilitation, it is proposed that the additional element of psychological safety needs to be incorporated into facilitation models, in particular, the Promoting Action on Research Implementation in Health Services framework, to more accurately reflect the complexities of working with healthcare teams. RELEVANCE TO PRACTICE: The pressure on healthcare environments continues to increase. To achieve the necessary skills to lead and develop services requires more than simply highlighting what is wrong with practice. Creating psychologically safe spaces, using holistic facilitation, is essential to enabling healthcare teams to critically analyse practice and enhance patient care.

The occurrence of the care 'of us' in the movements and fluctuations of the interactive processes in the hospital environment / La occurencia del cuidado de "lo nosotros" en los movimientos y ondulaciones de los procesos interactivos en el ambiente hospitalario / Acontecendo o cuidado 'do nós' nos movimentos e ondulações dos processos interativos no ambiente hospitalar

This study's objective was to understand how nursing and health professionals experience and signify the relationships in the care "of us" process, using Grounded Theory as its method. A total of 25 nursing and health workers from a university hospital, distributed into four sample groups, participated in the study. Data were collected through semi-structured interviews in March-July 2011. The contextualization of the institution and management form the context. The movements of human relations/interactions and the professionals' health are causal conditions, while the advance of technology and decline of human care and social life are intervenient conditions. The processed human relations/interactions of care are the strategies that cause the care "of us" to take place in the procedural circularity of care and being-cared-for. The professionals construct the care "of us" in their practice, understood as relational and procedural, in the movements and fluctuations of processes of human interactions.

La finalidad fue comprender como los profesionales de enfermería y salud viven y significan las relaciones en el proceso de cuidado de "lo nosotros", utilizando la Teoría Fundamentada en los Datos como método. Participaron 25 profesionales de enfermería y salud de un hospital universitario, distribuidos en cuatro grupos de muestreo. Los datos fueron recolectados mediante entrevista semiestructurada, en el período de marzo a julio del 2011. La contextualización de la institución y gestión forma el contexto, los movimientos de las relaciones/interacciones humanas y la salud del profesional son condiciones causales, mientras el avance de la tecnología, el declive del cuidado humano y el vivir social son condiciones intervinientes. Las relaciones/interacciones humanas de cuidado procesadas son estrategias para que ocurra el cuidado de "lo nosotros" en la circularidad del proceso de cuidar y ser cuidado. En los movimientos y ondulaciones de los procesos de interacción humana, los profesionales construyen en su práctica el cuidado de "lo nosotros", entendido como relacional y procesual.

Objetivou-se compreender como os profissionais de enfermagem e de saúde experienciam e significam as relações no processo de cuidado 'do nós', utilizando a Teoria Fundamentada nos Dados como método. Participaram 25 profissionais de Enfermagem e de saúde de um hospital universitário, distribuídos em quatro grupos amostrais, cuja coleta dos dados foi realizada por entrevista semiestruturada, no período de março a julho de 2011. A contextualização da instituição e da gestão forma o contexto, os movimentos das relações/interações humanas e a saúde do profissional são condições causais, enquanto o avanço da tecnologia, o declínio do cuidado humano e o viver social são condições intervenientes. As relações/interações humanas de cuidado processadas são as estratégias para acontecer o cuidado 'do nós' na circularidade processual de cuidar e ser cuidado. Nos movimentos e ondulações dos processos de interação humana, os profissionais constroem na sua prática o cuidado 'do nós', entendido como relacional e processual.

A análise de implicação de pesquisadores em uma pesquisa-intervenção na Rede Cegonha: ferramenta da análise institucional / Analysis of researchers' implication in a research-intervention in the Stork Network: a tool for institutional analysis / El análisis de implicación de investigadores en una investigación-intervención en la Red Cegonha: herramienta de análisis institucional

Resumo: Estudo qualitativo baseado no referencial teórico metodológico da análise institucional, com o objetivo de analisar a implicação dos pesquisadores durante o processo de uma pesquisa-intervenção e as interferências que esta análise provocou. A pesquisa envolveu pesquisadores de duas universidades oriundos de cursos de medicina, enfermagem e odontologia, e trabalhadores de um Departamento Regional de Saúde no acompanhamento da implantação da Rede Cegonha no interior de São Paulo. Os pesquisadores trabalharam juntos na intervenção e em oficinas de análise. Contaram com um analista institucional externo, que auxiliou o grupo na análise de implicação. Duas instituições se destacaram na análise: a pesquisa, em cujo instituído predominam características de neutralidade, e a gestão, com características tayloristas. As diferenças entre os pesquisadores, as dificuldades em identificar ações próprias da gestão da rede e da pesquisa foram algumas das interferências identificadas. Conclui-se que a análise de implicação é uma ferramenta potente para pesquisas dessa natureza.

Abstract: This qualitative study is based on institutional analysis as the methodological theoretical reference with the objective of analyzing researchers' implication during a research-intervention and the interferences caused by this analysis. The study involved researchers from courses in medicine, nursing, and dentistry at two universities and workers from a Regional Health Department in follow-up on the implementation of the Stork Network in São Paulo State, Brazil. The researchers worked together in the intervention and in analysis workshops, supported by an external institutional analysis. Two institutions stood out in the analysis: the research, established mainly with characteristics of neutrality, and management, with Taylorist characteristics. Differences between researchers and difficulties in identifying actions proper to network management and research were some of the interferences that were identified. The study concludes that implication analysis is a powerful tool for such studies.

Resumen: Estudio cualitativo basado en el referencial teórico metodológico del análisis institucional, con el objetivo de analizar la implicación de los investigadores durante el proceso de una investigación-intervención y las interferencias que este análisis provocó. La pesquisa involucró a investigadores de dos universidades, procedentes de cursos de medicina, enfermería y odontología, y trabajadores de un Departamento Regional de Salud en el seguimiento de la implantación de la Red Cegonha en el interior de Sao Paulo. Los investigadores trabajaron juntos en la intervención y en oficinas de análisis. Contaron con un analista institucional externo, que auxilió al grupo en el análisis de implicación. Dos instituciones se destacaron en el análisis: la investigación, en cuya institución predominan características de neutralidad, y la gestión, con características tayloristas. Las diferencias entre los investigadores, las dificultades en identificar acciones propias de la gestión de la red y de la investigación fueron algunas de las interferencias identificadas. Se concluye que el análisis de implicación es una herramienta potente para investigaciones de esta naturaleza.

Ingresos por infarto agudo de miocardio en los cuatro años siguientes a la implementación de la prohibición de fumar en espacios cerrados / Admissions for acute myocardial infarction in the four years following the implementation of the prohibition of smoking in closed spaces

Fundamento y objetivos: los daños derivados del tabaco son múltiples, afectando tanto a quienes lo consumen como a quienes se hallan expuestos de forma pasiva al humo de segunda mano. Las políticas de control de tabaco en Uruguay han sido muy exitosas, en particular la prohibición de fumar en espacios cerrados de uso público. Diversas investigaciones comprobaron el amplio acatamiento de esta última, lo que se tradujo en reducción de los niveles de contaminación en el aire, tanto en la concentración de las partículas contaminantes del humo de tabaco como en los niveles de nicotina. Asimismo, en los dos años siguientes a la introducción de la normativa (implantada el 1º de marzo de 2006) hubo una reducción en los ingresos hospitalarios por infarto agudo de miocardio en todo el país. Método: para determinar el impacto de estas medidas luego de cuatro años de su entrada en vigor se recolectaron los ingresos por esta patología desde el 1º de marzo de 2004 hasta el 28 de febrero de 2010, y se analizó mediante regresión múltiple el número de ingresos por mes con el tiempo como variable independiente. Resultados: se comprobó una reducción de 17% en los ingresos por infarto de miocardio (riesgo relativo 0,83, IC 95% 0,74 a 0,92), el que fue uniforme a lo largo de los 48 meses analizados (p=0,250). Conclusiones: estos hallazgos muestran que la política de control de tabaco de nuestro país se tradujo en una mejora de la salud cardiovascular de la población durante los cuatro años siguientes a la misma.

Tobacco health harm is multiple and affects smokers and second-hand smokers. Tobacco control policies have been successful in Uruguay, particularly the prohibition of smoking in public closed spaces. Several investigations confirmed its wide acceptance, resulting in a reduction in air contamination levels, either in tobacco smoke contaminant particles as in nicotine levels. Also, in the two years following prohibition (March 1st, 2006) there was a reduction in hospital admissions for myocardial infarction in the country. To determine its impact after four years we collected data about admissions from March 1st, 2004 to February 28th, 2010 and analyzed, using multiple regression, the number of admissions by month using time as independent variable. We confirmed a 17% reduction in myocardial infarction admissions (relative risk 0,83, IC 95% 0,74-0,92), which was uniform through the 48 months analyzed (p 0.25). These findings showed that the control tobacco policy improved population cardiovascular health during the four years after that policy was introduced in our country.

Agotamiento profesional: concepciones e implicaciones en la salud pública / Burnout : concepts and implications affecting public health

El agotamiento profesional ( burnout ) se describió originalmente como una condición mental caracterizada por disminución del desempeño laboral, sensación de impotencia y frustración e incapacidad para alcanzar objetivos o metas laborales. Para algunos autores, el agotamiento profesional es un conjunto de signos y síntomas mal definido, en tanto que para otros es una enfermedad en sí misma y un problema potencial de salud pública. Se ha observado en todo el mundo que los profesionales y técnicos más afectados son aquellos que prestan servicios o asisten a otras personas, especialmente los dedicados a la atención en salud. Este ensayo se centra en la idea de que el agotamiento profesional debe ser asumido como una enfermedad más que como un síndrome; que sus referentes teóricos y metodológicos han variado a medida que han cambiado las definiciones de salud y enfermedad; que se detecta y se reporta cada vez más, y que sigue siendo una condición objeto de debate en diversos círculos científicos donde se esgrimen posturas radicalmente opuestas que son materia de análisis aquí. Tras exponer las diversas concepciones en torno a esta condición , el ensayo concluye con la exposición de las implicaciones y las opciones de estudio del agotamiento profesional como enfermedad en función de las condiciones y los entornos que favorecen su aparición entre los profesionales dedicados a la salud.

Burnout was originally described as a mental condition characterized by reduced work performance, impotence, frustration and lack of capability to reach objectives or goals while performing a job. For some authors, burnout is a poorly defined mixture of symptoms and signs, while other professionals think of it as a disease and a potential threat to public health. Worldwide, it has been observed that the most afflicted professionals and technicians are those who work providing services or assistance to other people, especially those dedicated to health care. This paper focuses on the idea that burnout should be considered a disease more than a syndrome. On the other hand, definitions of health and disease have changed with time, as well as theoretical and methodological references about burnout. In addition, burnout remains a condition that is being discussed in various scientific areas, with radically opposing positions; these approaches are discussed in this article. After presenting different conceptions regarding burnout, the essay concludes with an exploration of its implications and the identification of possible treatments, especially for health workers, among whom it is more common depending on their predisposing conditions and environments.

Conquistas e desafios dos Grupos de Pesquisa da Fundação Hospitalar do Estado de Minas Gerais / Achievements and challenges of the Hospital Foundation of Minas Gerais research groups

Introdução: A reunião de pesquisadores em torno de projetos tende a originar Grupos de Pesquisa liderados por um pesquisador mais experimentado. A área de pesquisa na Fundação Hospitalar do Estado de Minas Gerais (FHEMIG) tem caminhado em busca de maior qualidade em seus produtos e na formação de recursos humanos para a pesquisa.Objetivo: Descrever os Grupos de Pesquisa credenciados pela FHEMIG com ênfase na descrição do perfil dos líderes dos grupos. Métodos: Os dados sobre os Grupos de Pesquisa e seus líderes foram coletados no site do Conselho Nacional de Desenvolvimento Científico eTecnológico (CNPq), nos bancos de dados do Núcleo de Apoio ao Pesquisador da FHEMIG e nos relatórios da Comissão Interna do Programa de Bolsas de Iniciação Científica e Tecnológica (PIBIC). Resultados: A instituição possui 74 linhas de pesquisa em 29 Grupos de Pesquisa constituídos por 375 pessoas, dentre as quais 42 são líderes de grupos. Os Grupos de Pesquisa e os bolsistas do PIBIC concentram-se nos Hospitais de Ensino da Rede FHEMIG, porém os médicos residentes ainda não aderiram a esses grupos conforme o esperado. Metade dos grupos tinha o cadastro atualizado no sítio do CNPq. Conclusões: Desde a implantação dos Grupos de Pesquisa, houve crescimento e consolidação da atividade de pesquisa na Fundação, mas de maneira geral, ainda é necessário o desenvolvimento de estratégias de estímulo à atividade de pesquisa assim como de melhor estruturação dos grupos e de maior compromisso em manter as informações atualizadas.

Introduction: The reunion of investigators around specific projects tends to originate study groups led by a more experienced researcher. The Teaching and Research Department of the Hospital Foundation of Minas Gerais (FHEMIG) has developed in search of higher quality of its products and the training of human resources for research. Objective: Describe the research groups accredited by FHEMIG, with emphasis on the characterization of the profile of group leaders. Methods: Data on Research Groups and their leaders were collected at the National Council for Scientific and Technological Development (CNPq) website, in the databases of the FHEMIG's Teaching and Research Department, and in reports of the Internal Committee of the Fellowship Program for Scientific and Technological Initiation (PIBIC). Results: FHEMIG has 74 lines of research in 29 research groups, consisting of 375 investigators, with 42 group leaders. Research Groups and PIBIC fellows concentrated in theteaching hospitals, but medical residents have not yet acceded to these groups as expected. Currently, only half of the groups had its records updated on the CNPq website. Conclusions: Since the implementation of Research Groups, research activity at FHEMIG grew and consolidated, but there is a need for strategies to stimulate research activity, as well as to better structure the groups and assure greater commitment keeping its registries updated.