Factors associated with risk of COVID-19 contagion for endoscopy healthcare workers: A survey from the Italian society of digestive endoscopy.

BACKGROUND AND AIMS: The present study was aimed to assess the risk of SARS-CoV-2 infection and associated factors among HCWs in endoscopy centers in Italy. METHODS: All members of the Italian Society of Digestive Endoscopy (SIED) were invited to participate to a questionnaire-based survey during the first months of the COVID-19 outbreak in Italy. RESULTS: 314/1306 (24%) SIED members accounting for 201/502 (40%) endoscopic centers completed the survey. Personal Protection Equipment (PPE) were available in most centers, but filtering face-piece masks (FFP2 or FFP3) and negative pressure room were not in 10.9 and 75.1%. Training courses on PPE use were provided in 57.2% of centers only; there was at least one positive HCW in 17.4% of centers globally, 107/3308 (3.2%) HCWs were diagnosed with COVID-19 with similar rates of physicians (2.9%), nurses (3.5%) and other health operators (3.5%). Involvement in a COVID-19 care team (OR: 4.96) and the lack of training courses for PPE, (OR: 2.65) were associated with increased risk. CONCLUSIONS: The risk of COVID-19 among endoscopy HCWs was not negligible and was associated with work in a COVID-19 care team and lack of education on proper PPE use. These data deserve attention during the subsequent waves.

Práticas Integrativas e Complementares na Atenção Primária à Saúde brasileira / Traditional and Complementary Medicine in Primary Health Care in Brazil

RESUMO Apresenta-se a situação das Práticas Integrativas e Complementares (PIC) na Atenção Primária à Saúde (APS) brasileira, seus problemas e estratégias de enfrentamento. Foram analisados bancos de dados, legislação, normas e relatórios governamentais, confrontados com pesquisas, sobretudo o primeiro inquérito nacional independente sobre PIC. Em 2017 e 2018, 29 modalidades de PIC foram institucionalizadas no Sistema Único de Sáude (SUS). Segundo dados oficiais, elas se expandiram e foram ofertadas por 20% das equipes de APS em 2016, em 56% dos municípios, mas o inquérito encontrou oferta só em 8% deles. Tal discrepância deve-se provavelmente ao registro/divulgação dos dados: um profissional, ao registrar uma vez o exercício de uma PIC, converte seu município em ofertante nas estatísticas governamentais. Quase 80% das PIC ocorrem na APS, sendo mais comuns: práticas corporais, plantas medicinais, acupuntura e homeopatia. Há pouca regulamentação nacional da formação e prática em PIC. A maioria dos praticantes é profissional convencional da APS, por iniciativa própria, desempenhando papel de destaque na (pouca) expansão. A inserção do tema no ensino é incipiente, e há pesquisas na área, porém poucas publicações. Estratégias de institucionalização das PIC na APS envolvem estímulo federal aos municípios, via profissionais competentes, matriciamento, educação permanente e ação governamental para sua inserção na formação profissional.(AU)

ABSTRACT We present the situation of Traditional and Complementary Medicine (T&CM) in Brazilian Primary Health Care (PHC), its problems and coping strategies. Databases, legislation, regulations and government reports were analyzed, in particular, the first national survey on T&CM. In 2017-2018, 29 T&CM modalities were institutionalized in the Unified Health System (SUS). According to official data, they expanded and were offered by 20% of the PHC teams in 2016, in 56% of the municipalities, but the survey found offer in only 8% of them. Such discrepancy is probably due to the registration / disclosure of data: a professional, once having recorded the exercise of a T&CM converts his / her municipality into a bidder in government statistics. Almost 80% of T&CM occur in PHC, being more common: body practices, medicinal plants, acupuncture, and homeopathy. There is little national training and practice regulation in T&CM. Most professionals are conventional PHC practitioners, on their own initiative, playing an important role in the (small) expansion. The insertion of the theme in education is incipient and there are researches in the area, but few publications. T&CM institutionalization strategies in PHC involve federal stimulus to municipalities, through competent professionals, matrixing, permanent education in service, and governmental action for their insertion in the professional training.(AU)

Faculty development in family medicine. A reassessment.

The 16 Canadian departments of family medicine were surveyed to ascertain the availability and content of faculty development activities. The results suggest numerous changes since 1985 and a strong commitment to faculty development. With the consolidation of many faculty development activities to date, departments should now consider other methods of faculty development, broaden their activities beyond the current emphasis on "teaching skills," examine the possibility of integrating faculty development with faculty evaluation, and conduct more systematic program evaluations.

Frecuencia de satisfacción con la atención médica en familiares de pacientes pediátricos hospitalizados / Frequency of satisfaction among relatives with medical care of hospitalized pediatric patients

Objetivos. 1. Identificar la frecuencia de satisfacción global con la atención médica en familiares de pacientes pediátricos hospitalizados, 2. Identificar la frecuencia de satisfacción con cada uno de los grupos de personal que participan en la atención de los pacientes y 3. Identificar los aspectos específicos de la atención en los que se presenta la mayor frecuencia de satisfacción e insatisfacción. Diseño de la investigación. Se realizó una encuesta comparativa prolectiva en un hospital pediátrico de tercer nivel de atención que incluyó a 600 familiares. Mediciones principales. Se utilizó un cuestionario autoaplicable, con 51 preguntas con formato de respuestas cerradas, el cual exploraba la satisfacción de los familiares respecto a los médicos tratantes, a los auxiliares clínicos, personal de trabajo social, servicio de foráneos y personal de apoyo. La satisfacción global se identificó de dos formas. En la primera se preguntó a los familiares directamente acerca de su satisfacción y en la segunda, se construyó un índice en el cual se consideró como satisfacción, cuando el paciente manifestaba su conformidad con más del 75 por ciento de los aspectos evaluados. Resultados. La frecuencia de satisfacción global manifestada explícitamente por el familiar ocurrió en el 99 por ciento de los casos (IC 95 por ciento = 98.7 por ciento - 99.99 por ciento, n=589). De manera similar, la frecuencia de familiares satisfechos globalmente de acuerdo al índice fue de 92 por ciento (IC 95 por ciento = 90.1 por ciento - 94.4 por ciento n=553). La frecuencia de satisfacción de los familiares con el grupo médico ocurrió en 87 por ciento de los casos, con el personal de apoyo en 84 por ciento con el servicio de foráneos en 81 por ciento, con los auxiliares clínicos en 79 por ciento y con el personal de trabajo social en 67 por ciento (P=0.00000001). Los aspectos específicos de la atención en los que se identificó una mayor frecuencia de insatisfacción fueron: la no explicación de los procedimientos por parte del personal de laboratorio (41 por ciento), el no conocer a la dietista (37 por ciento). Conclusiones. La frecuencia de satisfacción global por parte de los familiares de pacientes pediátricos hospitalizados fue alta. El personal médico fue el grupo hacia el que se expresó una mayor frecuencia de satisfacción. Los aspectos específicos de la atención relacionados con los auxiliares clínicos, fueron en los que se identificó la mayor frecuencia de insatisfacción por parte de los familiares de los pacientes