RESUMO
BACKGROUND: Telementoring seems to be a promising strategy to deliver training and counselling to physicians in remote areas. In Peru, early graduated physicians must work for the Rural and Urban-Edge Health Service Program where they face important training needs. The aim of this study was to describe the usage of a one-on-one telementoring program for rural physicians and evaluate the aspects related to the perceptions of acceptability and usability. METHODS: Mixed methods study on recently graduated physicians who work in rural areas and participate in the telementoring program. The program used a mobile application to connect these young doctors with specialized mentors to answer queries about real-life problems raised by working in a rural area. We summarize administrative data to assess participant characteristics and their participation in the program. Additionally, we conducted in-depth interviews to explore the perceived usability, ease of use, and reason for non-use of the telementoring program. RESULTS: Of 74 physicians (mean age 25, 51.4% women) enrolled, 12 (16.2%) actively used the program and performed a total of 27 queries, which received response in an average time of 5.4 ± 6.3 h. In the interviews, the main reasons for non-use were connectivity issues, feelings of shame, and self-efficacy. For those who used the telementoring program they referred it was easy to use and solve their inquiries timely. CONCLUSIONS: The implementation of a telementoring program sought to provide guidance to recently graduated physicians working in rural areas. Low use rates show that administrative and process-related deficiencies in the program implementation need to be improved.
Assuntos
Médicos , Humanos , Feminino , Masculino , Peru , MentoresRESUMO
Objective: To evaluate the inclusion capacity and bactericidal efficiency of diallyl dimethyl ammonium chloride (PDADMAC) diluted in tetrahydrofuran (THF) upon inclusion in the medical grade silicone polymer structure. Material and Methods: It was diluted the PDADMAC in THF at the concentration of 4wt%. It was included in the silicon paste during its vulcanization process. The contact angle measurements were performed to evaluate whether the biocide inclusion into the silicon paste was successful. All samples were sterilized with gamma radiation at 25KGy-dosage prior to the microbiological tests. Microbiological testing strictly followed the Antibacterial products - Test for antibacterial activity and efficacy JIS Z 2801: 201010 and the used of specific bacteria, as Staphylococcus aureus ATCC 6538P and Escherichia coli ATCC 8739. Results: The results showed that PDADMAC, when dissolved in THF at 4wt%, displayed good incorporation in medical silicone and a broad-spectrum antibacterial response. The results of the tests using Escherichia coli ATCC 8739 and Staphylococcus aureus ATCC 6538P showed that the silicone with no biocide addition did not present antibacterial activity. In contrast, the experimental group plus 2 mL of PDADMAC would have an ideal antibacterial response. Conclusion: Medical grade silicone can be used as a material with antibacterial properties, since it has been able to keep PDADMAC compound attached to its structure, thus acquiring antimicrobial property.
Assuntos
Elastômeros de Silicone/análise , Técnicas In Vitro/métodos , Prótese Maxilofacial , Antibacterianos/análise , Elastômeros de Silicone , Brasil , Materiais Dentários , Metilenotetra-Hidrofolato Redutase (NADPH2)RESUMO
La aparición en los últimos años de bacterias grampositivas multirresistentes ha dificultado el tratamiento de ciertas infecciones intrahospitalarias y ha reducido las opciones terapéuticas. Esto es particularmente cierto para los Staphylococcus aureus resistentes a la meticilina (MRSA) y las recientemente aparecidas cepas de S. aureus de sensibilidad disminuida y resistentes a la vancomicina (VISA, VRSA) debido a la importancia de este antibiótico de uso hospitalario. Entre enero del 2000 y diciembre del 2001 se aislaron en nuestro laboratorio 609 cepas de Staphylococcus aureus, 74 por ciento de las cuales fueron resistentes a la meticilina. Altos niveles de resistencia a la eritromicina, clindamicina, cirpofloxacina, gentamicina, rifampicina, cloramfenicol, tetraciclina y cotrimoxasol fueron encontrados en las cepas MRSA responsables de infecciones intrahospitalarias. Las MRSA fueron principalmente responsables de infección de herida operatoria, neumonía e infecciones cutáneas superficiales. La detección de cepas VISA/VRSA es difícil y requiere tests de laboratorio especiales. En nuestro estudio no detectamos la presencia de ninguna cepa no sensible a la vancomicina. Sin una continua vigilancia, adecuadas medidas de bioseguridad y un uso racional de los antibióticos se seguirá encontrando altas tasas de prevalencia de MRSA.