Ata da trecentésima quadragésima sexta reunião ordinária do Conselho Nacional de Saúde - CNS / Minutes of the three hundred and forty-sixth ordinary meeting of the national health council - CNS

Aos treze dias do mês de setembro de 2023, no Plenário do Conselho Nacional de Saúde "Omilton Visconde", Ministério da Saúde, Esplanada dos Ministérios, Bloco G, Anexo B, 1º andar, Brasília/DF, realizou-se a Tricentésima Quadragésima Sexta Reunião Ordinária do Conselho Nacional de Saúde ­ CNS. A 346ª Reunião Ordinária foi convocada para os dias 13 e 14 de setembro de 2023, contudo, a sessão foi suspensa na tarde do primeiro dia de reunião, por conta do falecimento abrupto da conselheira Marta Almeida durante o percurso entre Pernambuco e Brasília para participar da reunião.

Ata da trecentésima quadragésima quarta reunião ordinária do Conselho Nacional de Saúde - CNS / Minutes of the three hundred and forty-fourth ordinary meeting of the national health council - CNS

Aos dezenove e vinte dias do mês de julho de 2023, no Plenário do Conselho Nacional de Saúde "Omilton Visconde", Ministério da Saúde, Esplanada dos Ministérios, Bloco G, Anexo B, 1º andar, Brasília/DF, realizou-se a Tricentésima Quadragésima Quarta Reunião Ordinária do Conselho Nacional de Saúde ­ CNS. MESA DE ABERTURA ­ composição: conselheiro Fernando Zasso Pigatto, Presidente do CNS; e conselheira Heliana Neves Hemetério dos Santos, da Mesa Diretora do CNS. Às 9h15, o Presidente do CNS abriu a sessão saudando os presentes e os internautas que acompanhavam a reunião pela transmissão em tempo real. Manifestou sua satisfação com a realização de mais uma reunião do Conselho, espaço democrático de debate e de participação da sociedade. Conselheira Heliana Neves Hemetério dos Santos, da Mesa Diretora do CNS, também registrou seus cumprimentos a todas as pessoas presentes e as que acompanhavam a reunião de forma remota. A seguir, o Presidente do CNS apresentou os objetivos da reunião.

Ata da trecentésima quadragésima terceira reunião ordinária do Conselho Nacional de Saúde - CNS / Minutes of the three hundred and forty-third ordinary meeting of the national health council - CNS

Aos catorze e quinze dias do mês de junho de 2023, no Plenário do Conselho Nacional de Saúde "Omilton Visconde", Ministério da Saúde, Esplanada dos Ministérios, Bloco G, Anexo B, 1º andar - Brasília/DF, realizou-se a Tricentésima Quadragésima Terceira Reunião Ordinária do Conselho Nacional de Saúde ­ CNS. MESA DE ABERTURA ­ composição: Nísia Trindade, Ministra de Estado da Saúde; Swedenberger do Nascimento Barbosa, Secretário Executivo do Ministério da Saúde; conselheiro Fernando Zasso Pigatto, Presidente do CNS; e conselheira Ana Lúcia da Silva Marçal Paduello, da Mesa Diretora do CNS. Às 9h25, o Presidente do Conselho abriu os trabalhos com saudações às pessoas presentes e às que acompanhavam a reunião em tempo real. Agradeceu a presença da Ministra de Estado da Saúde e do Secretário Executivo e salientou que essa participação era um ato de valorização do controle social. Também destacou o trabalho conjunto do Conselho com o Ministério da Saúde, especialmente no processo preparatório da 17ª Conferência Nacional de Saúde. Conselheira Ana Lúcia da Silva Marçal Paduello, da Mesa Diretora do CNS, após saudar a mesa na pessoa da Ministra da Saúde e as demais pessoas participantes, apresentou os objetivos da reunião.

Ata da trecentésima trigésima sexta reunião ordinária do Conselho Nacional de Saúde - CNS / Minutes of the three hundred and thirty-sixth ordinary meeting of the national health council - CNS

Aos nove e dez dias de novembro de 2022 realizou-se a Tricentésima Trigésima Sexta Reunião Ordinária do Conselho Nacional de Saúde ­ CNS. O primeiro dia ocorreu no Brasília Imperial Hotel, Setor Hoteleiro Sul (SHS), Quadra 3, bloco H, Asa Sul, Brasília/DF e o segundo dia no Auditório Carlyle Guerra de Macedo, da Organização Pan-Americana da Saúde - OPAS/OMS, Lote 19, Avenida das Nações, SEN - Asa Norte, Brasília/DF. Estabelecido o quórum, às 9h10, foi composta a mesa de abertura pelo conselheiro Fernando Zasso Pigatto, Presidente do CNS e pela conselheira Maria da Conceição Silva, da Mesa Diretora do CNS. Após cumprimentar os presentes e os que acompanhavam a reunião em tempo real, o Presidente do Conselho apresentou os objetivos da 336ª Reunião Ordinária do CNS.

Ata da trecentésima trigésima quinta reunião ordinária do Conselho Nacional de Saúde - CNS / Minutes of the three hundred and thirty-fifth ordinary meeting of the national health council - CNS

Aos dezenove e vinte dias do mês de outubro de 2022, no Auditório Carlyle Guerra de Macedo, da Organização Pan-Americana da Saúde - OPAS/OMS, Lote 19, Avenida das Nações, Asa Norte, Brasília/DF, realizou-se a Tricentésima Trigésima Quinta Reunião Ordinária do Conselho Nacional de Saúde ­ CNS. Estabelecido o quórum, às 9h15, foi composta a mesa de abertura pelo conselheiro Fernando Zasso Pigatto, Presidente do CNS e pela conselheira Ana Lúcia da Silva Marçal Paduello, da Mesa Diretora do CNS. O Presidente do CNS iniciou os trabalhos, com saudações aos presentes e aos internautas que acompanhavam a transmissão em tempo real. Em seguida, apresentou os objetivos da 335ª Reunião Ordinária do CNS:

Ata da trecentésima trigésima reunião ordinária do Conselho Nacional de Saúde - CNS / Minutes of the three hundred and thirtieth ordinary meeting of the national health council - CNS

Aos vinte cinco e vinte e seis dias do mês de maio de 2022, no Manhattan Plaza Hotel, localizado 12 na Quadra 2, Bloco A, Setor Hoteleiro Norte, Asa Norte, Brasília, Distrito Federal, realizou-se a 13 Tricentésima Trigésima Reunião Ordinária do CNS. Estabelecido o quórum, às 9h15, foi 14 composta a mesa de abertura pelo conselheiro Fernando Zasso Pigatto, Presidente do CNS e 15 pela conselheira Madalena Margarida da Silva Teixeira, da Mesa Diretora do CNS. O 16 Presidente do CNS iniciou os trabalhos, com saudações aos presentes e aos internautas que 17 acompanhavam a transmissão. Em seguida, apresentou os objetivos da 330ª Reunião Ordinária 18 do CNS.

VARIABLES INVOLVED IN THE MANAGEMENT OF SCHOOL BULLYING: A BAYESIAN NETWORK ANALYSIS.

OBJECTIVE: To analyze the management of bullying by the managers of elementary schools. METHODS: Descriptive, exploratory research carried out through semi-structured interviews with 17 school counselors from a city in the South of Brazil, randomly selected from different geographical sectors. The interviews were recorded with participants' consent and, after transcription and checking, were discarded. The interviews covered the following subjects: sociodemographic characterization of subjects, school functioning, comprehension, recognition and management of bullying cases by counselors. Data analysis was performed using the Bayesian network associated with content analysis. RESULTS: The majority of subjects were females, between 30 and 50 years old. Fifteen subjects were graduated in pedagogy, and all had postgraduate degrees. Most of them worked as counselor for less than three years. Only two subjects, between 30 and 50 years old, understood the term bullying. Case recognition was lower in this age group. Having a degree influenced positively the recognition of bullying. The higher the number of students in the school, the lower the recognition of cases by managers. All subjects managed cases by addressing children, families, staff, and involving professionals and support groups. CONCLUSIONS: The understanding and recognition of bullying was given by a few interviewees. All managers reported similar management actions in the cases. Given the scarcity of studies on bullying management in schools, more studies in this area could improve the approach of cases and contribute to their reduction.

Embedding a genetic counselor into oncology clinics improves testing rates and timeliness for women with ovarian cancer.

OBJECTIVE: Germline genetic testing is crucial to the care of ovarian cancer patients, and as part of the guideline-based care for ovarian cancer patient's adherence to this recommendation has been low. We sought to determine whether embedding a genetic counselor (GC) within a medical and gynecologic oncology clinic would increase testing rates and improve the timeliness of testing. METHODS: Prospective cohort study of 358 ovarian cancer patients seen by medical and gynecologic oncologists between 2013 and 2015. Rates of referrals, completion of counseling, and genetic testing and timeliness of counseling were abstracted before and after a GC was embedded in the clinic in 2014. An additional year of data (2015) was collected to evaluate sustainability of the intervention. RESULTS: Between 2013 and 2015, 88-92% of women were referred for genetic testing, but in 2013 only 66% completed counseling and 61% were tested. After a GC was embedded in the clinic in 2014, more than 80% of referred women completed counseling and germline genetic testing. Time to genetic counseling also decreased from a median of 107 to 40 days, irrespective of age and cancer family history (p < 0.01). CONCLUSIONS: Embedding a GC into the workflow for ovarian cancer patients is an effective way of improving access to genetic counseling, testing rates, and the timeliness of testing.

Behavioral health home impact on transitional care and readmissions among adults with serious mental illness.

OBJECTIVE: To evaluate the impact of Maryland's behavioral health homes (BHHs) on receipt of follow-up care and readmissions following hospitalization among Medicaid enrollees with serious mental illness (SMI). DATA SOURCES: Maryland Medicaid administrative claims for 12 232 individuals. STUDY DESIGN: Weighted marginal structural models were estimated to account for time-varying exposure to BHH enrollment and time-varying confounders. These models compared changes over time in outcomes among BHH and comparison participants. Outcome measures included readmissions and follow-up care within 7 and 30 days following hospitalization. DATA COLLECTION/EXTRACTION METHODS: Eligibility criteria included continuous enrollment in Medicaid for the first two years of the study period; 21-64 years; and use of psychiatric rehabilitation services. PRINCIPAL FINDINGS: Over three years, BHH enrollment was associated with 3.8 percentage point (95% CI: 1.5, 6.1) increased probability of having a mental health follow-up service within 7 days of discharge from a mental illness-related hospitalization and 1.9 percentage point (95% CI: 0.0, 3.9) increased probability of having a general medical follow-up within 7 days of discharge from a somatic hospitalization. BHHs had no effect on probability of readmission. CONCLUSIONS: BHHs may improve follow-up care for Medicaid enrollees with SMI, but effects do not translate into reduced risk of readmission.

Variables involved in the management of school bullying: a bayesian network analysis / Variáveis envolvidas no gerenciamento de conflitos do tipo bullying em escolas: uma análise de rede bayesiana

ABSTRACT Objective: To analyze the management of bullying by the managers of elementary schools. Methods: Descriptive, exploratory research carried out through semi-structured interviews with 17 school counselors from a city in the South of Brazil, randomly selected from different geographical sectors. The interviews were recorded with participants' consent and, after transcription and checking, were discarded. The interviews covered the following subjects: sociodemographic characterization of subjects, school functioning, comprehension, recognition and management of bullying cases by counselors. Data analysis was performed using the Bayesian network associated with content analysis. Results: The majority of subjects were females, between 30 and 50 years old. Fifteen subjects were graduated in pedagogy, and all had postgraduate degrees. Most of them worked as counselor for less than three years. Only two subjects, between 30 and 50 years old, understood the term bullying. Case recognition was lower in this age group. Having a degree influenced positively the recognition of bullying. The higher the number of students in the school, the lower the recognition of cases by managers. All subjects managed cases by addressing children, families, staff, and involving professionals and support groups. Conclusions: The understanding and recognition of bullying was given by a few interviewees. All managers reported similar management actions in the cases. Given the scarcity of studies on bullying management in schools, more studies in this area could improve the approach of cases and contribute to their reduction.

RESUMO Objetivo: Analisar o gerenciamento de conflitos do tipo bullying pelos gestores de escolas de ensino fundamental. Métodos: Pesquisa descritiva e exploratória realizada por meio de entrevistas semiestruturadas com 17 orientadores de escolas escolhidas aleatoriamente de um município do Sul do Brasil, contemplando os diversos setores geográficos locais. As entrevistas foram gravadas mediante consentimento, e, após transcrição e conferência pelos sujeitos, descartadas. As entrevistas abordam: caracterização sociodemográfica dos sujeitos, funcionamento da escola e compreensão, reconhecimento e gerenciamento dos casos de bullying pelos orientadores. A análise dos dados foi feita com base na rede bayesiana associada à análise de conteúdo. Resultados: A maioria dos sujeitos era do sexo feminino e tinha entre 30 e 50 anos. Quinze sujeitos eram formados em pedagogia, e todos possuíam pós-graduação. A maioria atuava na função de orientador havia menos de três anos. A compreensão do termo bullying deu-se apenas por dois sujeitos, com idade entre 30 e 50 anos. Já o reconhecimento dos casos foi menor nessa faixa etária. Ter feito pós-graduação influenciou positivamente o reconhecimento de bullying. Quanto maior o número de alunos na escola, menor o reconhecimento dos casos pelos gestores. Todos os sujeitos gerenciaram os casos abordando as crianças, famílias e equipe e envolvendo profissionais e núcleos de apoio. Conclusões: A compreensão e o reconhecimento do bullying deram-se por poucos entrevistados. Todos os gestores relataram ações de gerenciamento semelhantes diante dos casos. Tendo em vista a escassez de estudos sobre gestão de bullying na escola, mais estudos nessa área poderiam melhorar a abordagem dos casos, contribuindo para sua redução.

"Real-world" effect of a peer counselor on breastfeeding outcomes in an urban prenatal clinic in the United States.

BACKGROUND: One approach for improving breastfeeding support and alleviating breastfeeding disparities is the implementation of a clinic-based peer counselor. Our objective was to assess the "real life" effects of an autonomous peer counselor who provides tailored support to low-income, minority women based on individual needs rather than a pre-determined research protocol. METHODS: This is a secondary analysis of a prospective cohort study of women receiving publicly funded prenatal care during the 6 months before and after introduction of a peer counselor in a single prenatal clinic. The peer counselor provided one-on-one antenatal and postpartum lactation support. Electronic medical record and survey data were collected. The primary outcome was breastfeeding continuation at 6 weeks postpartum. Secondary outcomes included breastfeeding comfort, confidence, and training satisfaction, any breastfeeding, and total breastfeeding duration. Bivariable and multivariable analyses were performed. RESULTS: Peer counselor exposure was not associated with the primary outcome of continued breastfeeding at 6 weeks (55.6% with peer counselor versus 49.1% without; aOR 1.26, 95% CI 0.69-2.31). However, women with peer counselor exposure were more likely to be satisfied with breastfeeding training at the time of delivery (98.2% vs. 83.6%, p = 0.006) and were more likely to have performed any breastfeeding (89.8% vs. 78.9%, p = 0.04), which remained significant on multivariable analysis (aOR 2.85, 95% CI 1.11-7.32). CONCLUSIONS: Peer counselor interventions are a promising approach to increase breastfeeding initiation. Further research is required to inform the most efficacious approach while also allowing peer counselors to operate independently and in line with the specific needs of their clients.

CNS no combate ao coronavírus / CNS in the fight against coronavirus

Desde os primeiros alertas, o Conselho Nacional de Saúde (CNS) tem dado a real importância frente ao cenário de emergência que o mundo enfrenta com o Novo Coronavírus. Com apoio de especialistas com responsabilidade sanitária e competência legal, conselheiros e conselheiras tomaram importantes decisões que visam atenuar a crise. Conheça algumas delas a seguir.

SIACS: Sistema de acompanhamento dos conselhos de saúde requer que municípios e Estados atualizem informações / SIACS: Monitoring system for health councils requires municipalities and states to update information

Com o objetivo de fortalecer a transparência e a participação do controle social no Sistema Único de saúde (SUS), o Conselho Nacional de Saúde (CNS) disponibiliza para os conselheiros estaduais, municipais e distrital o Sistema de Acompanhamento dos Conselhos Nacionais de Saúde (Siacs).

Conselho Nacional de Secretários de Saúde defende participação popular no SUS / National Council of Health Secretaries defends popular participation in the SUS

A nova diretoria do Conselho Nacional de Secretários de Saúde (Conass) foi empossada no dia 24/04, na sede da Organização Pan-Americana da Saúde (Opas), em Brasília.

Convocatória: CNS vai compor Comissões para o triênio 2019-2022 / Convocation: CNS will compose Commissions for the 2019-2022 triennium

As Comissões são organismos de acessória ao Plenário do Conselho Nacional de Saúde (CNS), que reiteram os princípios do Sistema Único de Saúde (SUS) e do controle social.

Bastidores da 16ª Conferência: saiba mais sobre alguns personagens dos bastidores e os números que construíram a 16ª Conferência Nacional de Saúde (8ª+8) / Backstage of the 16th Conference: learn more about some of the behind-the-scenes characters and the numbers that built the 16th National Health Conference (8th+8)

Fernanda Guedes percorreu os quase 2,5 mil quilômetros que separam Bagé, no interior do Rio Grande do Sul, de Brasília em duas etapas: primeiro de ônibus até a capital gaúcha e depois de avião. Dez horas de percurso a entregaram ao maior evento de participação social do Brasil. No fim da manhã de domingo (04/08), Fernanda iniciava sua primeira grande experiência como jornalista, integrando a equipe de comunicação colaborativa do evento. A jovem, de 22 anos, é uma das centenas de pessoas que tornaram possível a 16ª Conferência Nacional de Saúde (8ª+8): profissionais que trabalharam na comunicação, atendimento de urgência, práticas integrativas, alimentação, limpeza, segurança, pesquisa, credenciamento e relatoria.

Health products' and substance use among pregnant women visiting a tertiary hospital in Belgium: A cross-sectional study.

PURPOSE: To investigate the prevalence and type of health products used among pregnant women visiting a tertiary hospital in Belgium, as well as who advises these products, where women buy these products, which determinants are associated with medication and pregnancy vitamin intake, and preconception lifestyle changes such as folic acid intake and substance use. METHODS: A cross-sectional study was performed at the outpatient obstetrics clinics of the University Hospital Leuven, Belgium between November 2016 and March 2017. All pregnant women 18 years and older and understanding Dutch, French, or English were asked to participate in an online survey. RESULTS: In total, 379 pregnant women participated. Prevalence of medication use during the preceding week was 52%. Paracetamol (14%), levothyroxine (13%), and antacids (9%) were the most frequently used medicines. Pregnancy vitamins were used by 86% of women, and 97% had used a pregnancy vitamin somewhere during pregnancy. Only 56% initiated folic acid supplementation at least 1 month before pregnancy. Preconception use of folic acid among women following assisted reproductive technology was 73%. Inappropriate use of health products was observed among 3% of women. Prevalence of alcohol use and/or smoking during the preceding week was 6%. Alcohol and smoking cessation mainly occurred after pregnancy diagnosis. CONCLUSION: Pregnant women living in Belgium frequently use medicines, pregnancy vitamins, and other health products. Preconception lifestyle changes such as folic acid intake and alcohol and smoking cessation are poorly implemented. Public campaigns and interventions are needed to improve preconception care and counselling.

Novos titulares do Conselho Nacional de Saúde: novos nomes vão ter a missão de deliberar sobre e fiscalizar as políticas de saúde / New members of the National Health Council: new names will have the mission of deliberating on and overseeing health policies

O Conselho Nacional de Saúde finalizou, no final do ano passado, o processo eleitoral para definição dos responsáveis pela gestão 2018- 2021. Durante a cerimônia de posse, realizada em Brasília, o ex-presidente do CNS Ronald dos Santos, emocionado, declarou: "esse é um momento de celebração do nosso povo e da democracia".

Health Information Counselors: A New Profession for the Age of Big Data.

Health care is increasingly data driven. Concurrently, there are concerns that health professionals lack the time and training to guide patients through the growing medical "data jungle." In the age of big data, ever wider domains of people's lives are "datafied," which renders ever more information-at least in principle-usable for health care purposes. Turning data into meaningful information for clinical practice-and deciding what data or information should not be used for this purpose-requires a significant amount of time, resources, and skill. The authors argue that academic medicine should lead the way in navigating the use of complex, highly personal data in clinical practice. To make data actionable for both clinicians and patients, the authors propose that the best way to navigate the interface between patients and providers in the era of data-rich medicine would be the creation of a new profession entirely: health information counselors (HICs). HICs would have broad knowledge of various kinds of health data and data quality evaluation techniques, as well as analytic skills in statistics and data interpretation. Trained also in interpersonal communication, health management, insurance systems, and medico-legal aspects of data privacy, HICs would know enough about clinical medicine to advise on the relevance of any kind of data for prevention, diagnosis, and treatment. The creation of this new specialty would help patients and health care professionals to make more informed choices about how increasing amounts of health data and information can or should inform health care.

Ata da sexagésima terceira reunião extraordinária do Conselho Nacional de Saúde - CNS / Minutes of the sixty-third extraordinary meeting of the National Health Council - CNS

Aos catorze dias do mês de dezembro de dois mil e dezoito, no Plenário do Conselho Nacional de Saúde "Omilton Visconde", Ministério da Saúde, Esplanada dos Ministérios, Bloco G, Anexo B, 1º andar, Brasília-DF, realizou-se a Sexagésima Terceira Reunião Extraordinária do Conselho Nacional de Saúde ­ CNS, convocada para dar posse aos conselheiros e às conselheiras eleitas para o mandato do CNS 2018/2021 e realizar a eleição da Presidência e dos novos integrantes da Mesa Diretora do CNS para este mandato. Estabelecido o quórum, às 8h50, Sr. Ronald Ferreira dos Santos, ex-Presidente do CNS, procedeu à abertura dos trabalhos, cumprimentado os presentes e os internautas que acompanham a reunião em tempo real.