Guia Para Categorização De Serviços De Alimentação Prático / Practical Food Service Categorization Guide

A proposta de Categorização dos serviços de alimentação foi baseada no Projeto Piloto da Copa do Mundo FIFA®2014 que por sua vez inspirou-se nas experiências bem-sucedidas de cidades como Los Angeles, Nova York e Londres (BRASIL, 2013). A Categorização é uma proposta para classificar os serviços de alimentação com base em um instrumento de avaliação, pontuado, segundo critérios de risco sanitário, com base na Resolução de Diretoria Colegiada (RDC) nº 216/2004 (BRASIL, 2004). A classificação ou Categorização do serviço de alimentação fica visível ao consumidor, dando a oportunidade de que este conheça a qualidade sanitária do local que utiliza. A metodologia preconiza o uso de uma lista de avaliação reduzida e com foco nos itens de maior risco sanitário para DTA. Além de melhorar a qualidade sanitária dos estabelecimentos, conscientiza o cidadão e compromete os responsáveis legais pela garantia do cumprimento das Boas Práticas de Manipulação (BPM). Este Guia é um documento não normativo, de caráter recomendatório, norteador para Categorização dos serviços de alimentação no estado do Rio de Janeiro e outros locais interessados. Tem como objetivo orientar as equipes e gestores das Visa estaduais e municipais na implantação da Categorização e nas inspeções sanitárias, bem como orientar os responsáveis legais dos serviços de alimentação na realização da autoavaliação, etapa fundamental da Categorização.

Planilha De Cálculo Do Risco Sanitário Manual Do Usuário Prático / Health Risk Calculation Worksheet Practical User Manual

Este documento traz o detalhamento sobre a utilização da planilha em Microsoft Excel®, Versão 2017, elaborada para facilitar o cálculo da pontuação de risco, da lista de avaliação para a Categorização dos serviços de alimentação.

Use of medication and associated factors in adults living in Rio Branco, Acre. Use of medication in adults

Abstract We analyzed use of medication and associated factors in adults aged 18-59 years living in Rio Branco, Acre. This is a cross-sectional and population-based study that used a probabilistic sample of the population from rural and urban areas of the city of Rio Branco, Acre. The Prevalence Ratio (PR) was calculated with 95% confidence intervals and associations were estimated by Poisson regression. This study found a 29.4% prevalence ratio of use of medication among individuals aged from 18 to 59 years (685 adults: 473 women and 212 men; producing estimates for 211,902 adults: 110,769 women and 101,133 men). After adjusted analysis, their use was associated with: age (50-59 years, PR: 2.36; 95%CI: 2.29-2.43); women (PR: 1.25; 95%CI: 1.23-1.27); up to elementary school (PR: 1.13; 95%CI: 1.11-1.15); and poor or very poor self-rated health (PR: 1.47; 95%CI: 1.43-1.51). The health conditions associated with use of medication were: number of comorbidities, hypertension, diabetes, insomnia, depression, number of health complaints and use of health services. The most frequently used drugs were those belonging to the following ATC categories: alimentary tract and metabolism, cardiovascular system, nervous system, and the musculoskeletal system.

A global call for talaromycosis to be recognised as a neglected tropical disease.

Talaromycosis (penicilliosis) is an invasive mycosis that is endemic in tropical and subtropical Asia. Talaromycosis primarily affects individuals with advanced HIV disease and other immunosuppressive conditions, and the disease disproportionally affects people in low-income and middle-income countries, particularly agricultural workers in rural areas during their most economically productive years. Approximately 17 300 talaromycosis cases and 4900 associated deaths occur annually. Talaromycosis is highly associated with the tropical monsoon season, when flooding and cyclones can exacerbate the poverty-inducing potential of the disease. Talaromycosis can present as localised or disseminated disease, the latter causing cutaneous lesions that are disfiguring and stigmatising. Despite up to a third of diagnosed cases resulting in death, talaromycosis has received little attention and investment from regional and global funders, policy makers, researchers, and industry. Diagnostic and treatment modalities remain extremely insufficient, however control of talaromycosis is feasible with known public health strategies. This Viewpoint is a global call for talaromycosis to be recognised as a neglected tropical disease to alleviate its impact on susceptible populations.

Defining and classifying public health systems: a critical interpretive synthesis.

BACKGROUND: The introduction of the determinants of health has caused a shift towards understanding health from a holistic perspective as well as increased recognition of public health's contributions to the health of the population. Several frameworks exist to conceptualise healthcare systems, highlighting the stark contrast of frameworks unique to public health systems. The objectives of this study were to define public health systems and assess differences between healthcare systems and public health systems within established health systems frameworks. METHODS: A critical interpretive synthesis was conducted. Databases searched included EBSCOhost, OVID, Scholars Portal, Web of Science, Cochrane Library and Health Systems Evidence. Data extraction, coding and analysis followed a best-fit framework analysis method. Initial codes were based on a current leading health systems and policy classification scheme - health systems arrangements (governance, financial and delivery arrangements). RESULTS: A total of 5933 unique documents were identified and 67 were included in the analysis. Definitions of public health and public health systems varied significantly as did their roles and functions across jurisdictions. Public health systems arrangements generally followed those of health systems, with the addition of partnerships (community and inter-sectoral) and communication playing a larger role in public health. A public health systems framework and conceptualisation of how public health currently fits within health systems are presented. CONCLUSIONS: Public health systems are unique and vital entities within health systems. In addition to examining how public health and public health systems have been defined within the literature, this review suggests that establishing the scope of public health is crucial to understanding its role within the larger health system and adds to the discourse around the relationship between public health, healthcare and population health. More broadly, this study addresses an important gap in understanding public health systems and provides conceptual and practical contributions as well as areas for future research.

3Ts of low cure rate: taxonomy, themes and theory of low cure rate in Pakistan's TB control programme and gathering a 360-degree perspective through qualitative, in-depth interviewing approach.

OBJECTIVE: WHO recommends cure of tuberculosis (TB) as the best prevention strategy; however, information about factors associated with low cure rate in patients with drug-susceptible TB is limited in Pakistan. Therefore, the purpose of this study was to explore the factors that account for low TB cure rate. METHODOLOGY: The present qualitative study recruited diverse informants through purposive sampling to explore low cure rate situation in Badin between March and June 2017. Data were collected from clinicians, paramedics, lab technicians, district field supervisors, patients and treatment supporters through indepth and face-to-face interviews. Interviews were conducted in local languages (Urdu and Sindhi) and transcribed into English. Coding structure was developed inductively and applied on textual data to draw output at the levels of taxonomy, themes and theory, as proposed by Bradley et al. FINDINGS: Thirty-seven individuals consented to participate in this study and provided detailed account of the subject under enquiry. Review of interview data collected from a variety of informants resulted in the identification of four broad factors (taxonomy) that contributed to the situation of low cure rate in one of the districts implementing the public-private mix intervention. These factors were (1) health-seeking behaviour, (2) technical capacity of the healthcare provider, (3) managerial capacity of the healthcare provider, and (4) access to healthcare facility and services. Each factor is deconstructed into key dimensions (themes) that emerged from the dialogue between the interviewer and the respondents. Moreover, dimensions were exemplified through underlying concepts that correspond to theories for low cure rate. CONCLUSION: Change in programme reporting requirement has demeaned the significance of having cure as treatment outcome. Therefore, returning the focus to achieving cure status for TB cases will be beneficial for assessing the effectiveness of TB control efforts. In parallel to the care delivery system, a mechanism for disseminating disease-related and treatment-related information should be introduced.

Feasibility of describing community strengths relative to Omaha system concepts.

OBJECTIVES: The purpose was to determine the feasibility of using a standardized language, the Omaha System, to describe community-level strengths. The objectives were: (a) to evaluate the feasibility of using the Omaha System at the community level to reflect community strengths and (b) to describe preliminary results of community strengths observations across international settings. DESIGN AND SAMPLE: A descriptive qualitative design was used. The sample was a data set of 284 windshield surveys by nursing students in 5 countries: Mexico, New Zealand, Norway, Turkey, and the United States. MEASURES: An online survey included a checklist and open-ended questions on community strengths for 11 concepts of the Omaha System Problem Classification Scheme: Income, Sanitation, Residence, Neighborhood/workplace safety, Communication with community resources, Social contact, Interpersonal relationship, Spirituality, Nutrition, Substance use, and Health care supervision. Themes were derived through content analysis of responses to the open-ended questions. RESULTS: Feasibility was demonstrated: Students were able to use the Omaha System terms and collect data on strengths. Common themes were described among the five countries. CONCLUSIONS: The Omaha System appears to be useful in documenting community-level strengths. Themes and exemplar quotes provide a first step in developing operational definitions of strengths at a more granular level.

Naming and the Public Health Roles of Physicians.

Resources from the American Medical Association (AMA) Archives facilitate historical consideration of how physicians' authority has been exercised in naming diseases, epidemics, and other health-related issues of national importance. Selected images emphasize physicians' roles in motivating public health initiatives through public service posters, advertisements, and minutes of the AMA House of Delegates meetings.

Feasibility of Describing Wellbeing and Strengths at the Community Level Utilizing the Omaha System.

Capturing strengths at the community level offers an emergent perspective to a strength-based approach for population health. The Omaha System standardized terminology has been found feasible to describe individual strengths in patient care planning. This study depicts results of using the Omaha System to capture strengths at the community level. Descriptive statistics and visualization were used to examine patterns of strengths and signs/symptoms by Omaha System Problem concept based on the secondary data analysis from 118 student-generated community assessments. Results suggest that it is feasible to use the Omaha System as a method classifying strengths and problems at the community level. The relationship between strengths and signs/symptoms is consistent with the pattern observed at the individual-level. Utilizing a strength-based model may provide robust information about community strengths leading to new approaches to population health management in support of community wellbeing.

[Same words, different meanings: How epidemiological terminology struggles with population health intervention research]. / À mêmes mots, sens différents--les difficultés de la terminologie épidémiologique avec la recherche en interventions en santé des populations.

Public health research differs from clinical epidemiological research in that its focus is primarily on the population level social and structural determinants of individual health and the interventions that might ameliorate them, rather than having a primary focus on individual-level risks. It is typically concerned with the proximal and distal causes of health problems, and their location within complex systems, more than with single exposures. Thus, epidemiological terms and concepts may have very different implications when used in the context of population health. This paper considers some key differences in relation to terms like 'population', 'baseline', 'control group' 'outcome' and 'adverse effects'. Even the concept of an 'intervention' often needs careful handling. The paper concludes that there is a need for an expanded, and more realistic use of these terms in the population health intervention research context.

[Development of valorization of physical activity: the role of HIV associations]. / La construction de la valorisation de l'activité physique : le rôle des associations VIH.

With the arrival of triple combination therapy in 1996-1997, HIV infection, considered up until then to be a life-threatening condition, changed statuses within the realm of public health actions Progressively likened to a "chronic illness", the discourse on HIV prevention targeting people living with HIV (PLHIV) began to evolve. A review of the scientific literature and the journals of four national HIV associations published between 1990 and 2010 shows that physical activities, previously discouraged because considered to be dangerous, have become increasingly presented as a means of improving quality of life and are increasingly recommended for PLHIV. This article studies this reconfiguration of the discourse on HIV prevention, as well as its effects on the discourse conveyed by HIV associations. The article shows how the new classification of HIV as a "chronic illness", on the basis of scientific expertise, has led to a modified discourse on prevention, including the recommendation of regular and controlled physical activity. This new orientation has contributed to the restructuring of HIV associations which relay this discourse and modify their organization and services, increasingly offering access to physical activities. However, this raises the question of the effects of this new representation of physical activities, as there has been little conside-ration of the difficulties encountered by PLHIV to respond to these repeated encouragements to modify their lifestyles in order to be "good" chronically ill patients. .

The Affordable Care Act's implications for a public health workforce agenda: taxonomy, enumeration, and the Standard Occupational Classification system.

The Affordable Care Act brings a renewed emphasis on the importance of public health services and those whose occupations are defined by performing the essential public health functions. The Affordable Care Act Prevention and Public Health Fund is a signal to the field that its work is important and critical to the health of the nation. Recent reports by the Institute of Medicine describe the changing dimensions of public health work in primary care integration and the need for enhanced financing of public health as investment. Gaining knowledge about the public health workforce, that is, how many workers there are and what they are doing, is of growing interest and concern for the field. Although enumeration of the public health workforce has been attempted several times by the federal government beginning as early as 1982, it was not until the year 2000 that a major effort was undertaken to obtain more complete information. Limitations that hampered Enumeration 2000 have persisted however. With implementation of the Affordable Care Act and other new ventures, key federal agencies are developing strategies to pursue a systemic and systematic enumeration and consistent taxonomy process. Included in these efforts is use of the Bureau of Labor Statistics, Standard Occupational Classification system. A clear and accurate understanding of the public health workforce and its characteristics is a major challenge. A well-constructed, systematic enumeration process can add to our understanding of the nature and functions of that workforce. In addition, discussion of enumeration must include the need for a consensus within the field that leads to a consistent taxonomy for the public health occupations. This article will provide a stage-setting brief of historical actions regarding enumeration, and it will examine selected enumeration activities taking place currently. It will discuss positive and negative implications facing public health and the potential for enhancing the existing Standard Occupational Classification system to aid enumeration studies.

Towards a unified taxonomy of health indicators: academic health centers and communities working together to improve population health.

The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public's health and reducing health disparities, the CTSA Consortium's Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators.The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy's application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health.

Search wide, dig deep: literature searching for qualitative research. An analysis of the publication formats and information sources used for four systematic reviews in public health.

BACKGROUND: When literature searching for systematic reviews, it is good practice to search widely across different information sources. Little is known about the contributions of different publication formats (e.g. journal article and book chapter) and sources, especially for studies of people's views. METHOD: Studies from four reviews spanning three public health areas (active transport, motherhood and obesity) were analysed in terms of publication formats and the information sources they were identified from. They comprised of 229 studies exploring people's perceptions, beliefs and experiences ('views studies') and were largely qualitative. RESULTS: Although most (61%) research studies were published within journals, nearly a third (29%) were published as research reports and 5% were published in books. The remainder consisted of theses, conference papers and raw datasets. Two-thirds of studies (66%) were located in a total of 19 bibliographic databases, and 15 databases provided studies that were not identified elsewhere. PubMed was a good source for all reviews. Supplementary information sources were important for identifying studies in all publication formats. CONCLUSIONS: Undertaking sensitive searches across a range of information sources is essential for locating views studies in all publication formats. We discuss some benefits and challenges of utilising different information sources.

Plantas medicinais no processo de cicatrização de feridas: uma revisão de literatura / Medicinal plants in the wound healing process: a literature review

Uma busca foi realizada na literatura, visando sumarizar as pesquisas realizadas e obter informações acerca da utilização de plantas medicinais no processo de cicatrização de feridas. Utilizaram-se os descritores: Plantas Medicinais e Cicatrização de Feridas e seus equivalentes em inglês e espanhol, com o operador booleano "AND" em três bases eletrônicas de dados (PubMed, LILACS e COCHRANE). Foram selecionados 57 artigos para compor a revisão. Os resultados apontam que um total de 52 plantas medicinais e um composto de ervas foram estudados experimentalmente ou clinicamente, quanto aos seus efeitos no auxílio do processo de cicatrização, sendo que a maioria (88,5%) apresentou eficácia. Com isso, verifica-se que a utilização de plantas medicinais trata de importante alternativa no tratamento de feridas, que começa a fazer parte da atenção à saúde brasileira, o que sugere novos estudos de comprovação clínica, custos, e benefícios e a constante atualização acerca das publicações realizadas.

It was done a literature search aiming to sumarize earlier conducted researches and in order to obtain information on the use of medicinal plants in wound healing process. The descriptors used were as follows: Medicinal Plants and Wound Healing and their equivalents in English and Spanish with the Boolean operator "AND" in three electronic databases (PubMed, LILACS and COCHRANE). Fifty seven articles were chosen to compose the review. The findings from a total of fifty two medicinal plants and one herbal compound that were experimentally or clinically studied in respect to their effects in wound healing process indicate that the majority of them (eighty eight point five per cent) showed efficacy. Thus, it can be seen that the use of medicinal plants is an important alternative in wounds treatment that becomes part of Brazilian health care, suggesting further studies of clinical evidence, costs and benefits and constantly updating on produced publications.

Key-phrase based classification of public health web pages.

This paper describes and evaluates the public health web pages classification model based on key phrase extraction and matching. Easily extendible both in terms of new classes as well as the new language this method proves to be a good solution for text classification faced with the total lack of training data. To evaluate the proposed solution we have used a small collection of public health related web pages created by a double blind manual classification. Our experiments have shown that by choosing the adequate threshold value the desired value for either precision or recall can be achieved.

Glossário temático: ciência e tecnologia em saúde / Thematic glossary: science and techonology in health

O conhecimento produzido pelas áreas técnicas do Ministérioda Saúde (MS) e por suas entidades vinculadas surge da convergênciados saberes de diversos domínios que se fundem à prática da gestãodo Sistema Único de Saúde (SUS). Em meio a essa pluralidade deinformações, o desenvolvimento dos produtos da terminologia insere--se no Plano de Gestão do Conhecimento do Ministério da Saúde.Instituído em 2010, este Plano objetiva dar visibilidade à gestão doconhecimento institucional, garantir a comunicação interna e externa,contribuir para a melhoria dos processos de tomada de decisão noâmbito da saúde pública e fortalecer a participação social.Identificar, relacionar, gerir e oferecer acesso a esse conhecimentoé um dos desafios atuais em que se discutem aspectos da democratizaçãoe do desenvolvimento de metodologias e tecnologiasque permitam a recuperação da informação, suplantando a lógica dasintaxe e atingindo a lógica da semântica. Em relação a este últimotópico, foram desenvolvidas ações relacionadas ao setor Saúde quegarantissem o tratamento terminológico das áreas do conhecimentoenvolvidas com a saúde.No que diz respeito à gestão da informação, o Projeto Terminologiada Saúde – uma iniciativa da Secretaria-Executiva realizada pormeio da Coordenação-Geral de Documentação e Informação (CGDI)– atua no desenvolvimento dos principais instrumentos que possibilitamo alinhamento da produção literária, documental e normativa daesfera federal do SUS com as premissas da Ciência da Informação.Os produtos idealizados para contribuir para o desenvolvimento e asocialização do conhecimento do setor Saúde são: o tesauro, o siglário,o banco de tradução e os glossários temáticos que constituem oGlossário do Ministério da Saúde...

Utilização de plantas medicinais com atividade antimicrobiana por usuários do serviço público de saúde em Campina Grande - Paraíba / Use of medicinal plants with antimicrobial activity by users of the Public Health System in Campina Grande - Paraíba, Brazil

O estudo avalia a utilização de plantas medicinais com atividade antimicrobiana pelos usuários do Sistema Único de Saúde do município de Campina Grande- PB, Brasil. Trata-se de um estudo descritivo, transversal, com abordagem quantitativa, cuja amostra constituiu-se de 220 usuários conduzido no período de Agosto de 2008 a Janeiro de 2009. A pesquisa foi realizada através de um roteiro de entrevistas não estruturada. Dentre os participantes do estudo, 65,0% utilizavam plantas medicinais, das quais Punica granatum L., Anacardium occidentale L., e Stryphnodendron adstringens foram as mais citadas. Observou-se que houve prevalência do gênero feminino na utilização. A maioria dos indivíduos obtém plantas medicinais no comércio local utilizando-as por indicação de familiares. Foi observado que 5,0% dos entrevistados afirmam já ter sofrido algum evento adverso decorrente do uso de plantas medicinais. Assim sugere-se que as informações sobre o uso da flora medicinal adquiridas nas comunidades locais, combinadas a estudos químicos/farmacológicos realizados em laboratórios especializados e a capacitação da equipe de saúde favorecerá a implementação da Portaria nº 971/2006, que tem como objetivo a garantia de acesso a plantas medicinais e fitoterápicos com segurança, eficácia e qualidade.

This study evaluates the use of medicinal plants with antimicrobial activity by users of the Unified Health System in Campina Grande Municipality, Paraíba, Brazil. This is a descriptive and transversal study with a quantitative approach, the sample of which consisted of 220 users, and was carried out from August 2008 to April 2009. The research was developed through an unstructured interview process. Among the study participants, 65.0% used medicinal plants, of which Punica granatum L., Anacardium occidentale L. and Stryphnodendron adstringens were most cited. There was prevalence of females. Most individuals obtain medicinal plants in the local market, using them as suggested by relatives. Results indicated that 5.0% of the interviewees stated to have suffered adverse event resulting from the use of medicinal plants. Thus, information about the use of medicinal plants, acquired in local communities, combined to chemical/pharmacological studies performed in specialized laboratories and the qualification of health professionals, will favor the implementation of Decree no. 971/2006, which aims to ensure access to medicinal plants and herbal medicines with safety, efficacy and quality.