Pap Smear Cancer Coverage in Brazilian Capitals including the Pandemic Period Caused by the SARS-CoV-2 Virus: Ecological Study.

INTRODUCTION: Cervical cancer develops slowly and may not manifest signs and symptoms at an early stage. It is worth mentioning the factors that can influence the onset of cervical cancer: smoking, early sexual life, multiple sexual partners, use of oral contraceptives, multiparity, low socioeconomic status, among others. An important risk factor for the onset of this disease is HPV infection, a virus associated with most cases of precursor lesions of this type of cancer. It is essential to understand the comprehensiveness of the scope and adherence to the recommended guidelines throughout the national territory. Therefore, health indicators are important management tools that make it possible to evaluate the services offered, measuring the reach of the target population, the supply and access to preventive exams. OBJECTIVE: To analyze the trend of progress in cervical cancer coverage actions in Brazilian capitals from 2016 to 2021. METHOD: This is an ecological study with temporal analysis that used secondary data referring to process indicators for cervical cancer control actions in women aged between 25 and 64 years living in Brazilian capitals between 2016 and 2021. Aspects related to the quality of care in the cervical cancer prevention program were evaluated using databases of the Cancer Information System (SISCAN), available in DATASUS. The indicators used to monitor and evaluate cervical cancer control actions were (i) cervical coverage, (ii) reason for cervical surgery, and (iii) proportion of cervical cancer every 3 years. RESULTS: In 2016, 410,000 tests were performed and notified in the SISCAN system in all Brazilian capitals, with emphasis on Curitiba, with 65,715 tests performed, and Porto Velho, with 174. In 2020, there was a reduction in exams compared to the previous year in all capitals, with the exception of Palmas, which went from 7655 exams to 9604. It was observed that all the capitals studied showed an increase in the annual percentage variation of Pap smear coverage, with the exception of Brasília, Manaus, Porto Alegre and Porto Velho, which did not show a statistically significant increase (APC = 3.01, 2.746, 3.987, 3.69, respectively). When analyzing the performance of oncotic cytology exams in the capitals according to the years 2019 and 2020, it was observed that only Manaus registered an increase in the number of procedures performed, reaching a difference of 56.5% from one year to the next. CONCLUSION: The ecological analysis revealed a worrying drop in the number of tests performed in 2020, reflecting a sharp drop in coverage actions in Brazilian capitals during the pandemic caused by the SARS-CoV-2 virus. The pandemic has exacerbated existing inequalities and highlighted the need for adaptive strategies to maintain essential screening services in times of crisis.

Normal isn't normal: On the medicalization of health.

BACKGROUND: This study investigated the proportion of the U.S. population classified as healthy based on 10 common indicators, examined in two ways: (1) above or below (in the healthy direction) the sample median (termed "normal"), and (2) below diagnostic cut-off points for clinical caseness or high risk (termed "ideal"). METHODS: Data are from the 2017-March 2020 round of the National Health and Nutrition Examination Survey (NHANES). Sample sizes ranged from 3,956 to 8,961 for respective health indicators, with a total of 3,102 respondents for two weighted multi-item measures described below. Measures included the Alameda 5 health behaviors (smoking, drinking exercising, sleeping, and body mass index) and five standard biomarkers (systolic and diastolic blood pressure, resting heart rate, fasting glucose, and total cholesterol). Besides point prevalences for the normal and ideal categories for each indicator, we also calculated the proportion healthy for all 10 indicators, again calculated both ways, termed "meta-normal" and "meta-ideal." RESULTS: The prevalence of meta-normality was 1.05%, suggesting that hardly any adult Americans are completely healthy according to population norms. Findings for meta-ideality showed that while most Americans are not clinical cases for any respective indicator, only 5.55% met the official criteria for being healthy according to all 10 indicators. CONCLUSION: Most Americans appear healthy according to nearly all key health indicators and biomarkers, according to "normal" or "ideal" criteria. However, the proportion healthy according to all measures is extremely small. Relatively few U.S. adults are completely healthy according to clinical criteria (meta-ideal), and even fewer are completely healthy according to population norms (meta-normal). Results are interpreted through sociological writing on medicalization.

The Impact of Continuity of Care on Health Indicators in Patients With Type 2 Diabetes Mellitus in Family Medicine Clinics in Riyadh.

BACKGROUND: Diabetes Mellitus Type 2 (DM2) is highly prevalent in Saudi Arabia, with many experiencing complications due to the disease. Family medicine physicians are usually the primary care providers responsible for the medical management of type 2 diabetes mellitus patients. Microvascular and macrovascular complications can occur if type 2 diabetes mellitus is poorly managed. Effective management of health indicators in patients with DM2 relating to glycated hemoglobin (HbA1c), low density lipoprotein cholesterol, blood pressure, and tobacco use is an essential part of medical care to prevent complications. Due to the projected increase in the number of patients with DM2, there is huge concern surrounding the management of this chronic illness that requires review. This study aims to evaluate the impact of continuity of care on health indicators among family medicine patients diagnosed with diabetes mellitus type 2 and to analyze the effect of continuity of care regarding the completion of age-appropriate preventive health screenings. METHODS:  This is a retrospective cohort study. Data collected from electronic medical records of patients 40-75 years of age that received care at the Family Medicine clinics that were diagnosed with type 2 diabetes mellitus with ≥4 clinic visits from January 1, 2017, to June 30, 2020, at King Faisal Specialist Hospital & Research Centre in Riyadh, Saudi Arabia. Data collected included demographic data, body mass index, smoking status, blood pressure, past medical history, preventive health screening completed, and laboratory results, including HbA1c and lipid profile. The continuity of care index and usual provider continuity score indices were calculated for the analysis to measure continuity of care. RESULTS:  Three hundred and fifty-two patients were included in the study. Most of the patients were Saudi (74.15%), female (51.99%), and married (82.67%). In addition, 90.34% accounted for a high usual provider continuity of care score (UPCS), and 64.20% of the patients had a high continuity of care index (COCi). Younger age groups were significantly more prevalent in the high UPCS group (p=0.037). Additionally, patients of non-Saudi nationalities constituted a significantly larger proportion of the high UPCS group. Single patients showed high UPCS. Comorbidities were not different between the groups, except inflammatory joint disease, which was more common in the low COCi group. Preventative screening measures were also not different between the groups; however, the type of colon cancer screening differed, where patients with high COCi more frequently underwent colonoscopies (13.3% vs. 4.4%, p=0.015) instead of fecal occult blood tests. CONCLUSION:  For the first time, we report the implications of the continuity of care for DM2 patients in Saudi Arabia and the Middle East. Continuity of care did not result in the improvement of health indicators or in the completion of preventive health screenings in diabetic patients. Further studies are needed in the region to confirm our findings and assess the association between continuity of care and patient health indicators impact.

Analysis of the implementation of an AIDS mortality committee through municipal health indicators / Análise da implantação de um comitê de mortalidade por AIDS mediante indicadores de saúde municipais / Análisis de la implantación de un comité de mortalidad por SIDA a través de indicadores municipales de salud

Background and objective: the acquired immunodeficiency syndrome (AIDS) has high rates of detection and death in the state of Rio Grande do Sul. In order to better understand such deaths, in December 2017, the Uruguaiana Municipal Department of Health implemented the AIDS Mortality Committee (CMaids). This study aimed to analyze the impact of an CMaids implementation in Uruguaiana through municipal health indicators. Methods: an ecological time-series study that used secondary data from the official platforms of the Ministry of Health from 2008 to 2020. Results: a reduction in the indicators number of deaths (from 28 in 2008 to 9 in 2020), mortality rate (from 22.0 in 2008 to 7.1 deaths/100,000 inhabitants in 2020), and fatality rate (from 46.74 in 2008 to 9.61 deaths/1,000 inhabitants in 2020) was observed. Moreover, trend lines were verified between 2017-2020 through the logarithmic regression model with join points. A relevant Annual Percent Change in mortality and fatality indicators was verified, with a reduction of 59.1% and 73.4%, respectively, in 2020, when comparing the observed and expected values. Conclusion: the findings enable us to conjecture that CMaids contributed to health indicator improvement, evidencing this as a relevant strategy to handle HIV/AIDS endemic at the local level.(AU)

Justificativa e objetivo: a síndrome da imunodeficiência adquirida (aids) apresenta elevadas taxas de detecção e óbito no estado do Rio Grande do Sul. A fim de compreender melhor tais óbitos, em dezembro de 2017, a Secretaria Municipal de Saúde de Uruguaiana implementou o Comitê de Mortalidade por aids (CMaids). O objetivo deste estudo é analisar o impacto da implantação do CMaids de Uruguaiana por meio de indicadores de saúde municipais. Métodos: estudo ecológico de série temporal, utilizando dados secundários das plataformas oficiais do Ministério da Saúde entre o período de 2008 a 2020. Resultados: observou-se redução dos indicadores número de óbitos (de 28 em 2008 para 9 em 2020), taxa de mortalidade (de 22,0 em 2008 para 7,1 óbitos/100.000 habitantes em 2020) e taxa de letalidade (de 46,74 em 2008 para 9,61 óbitos/1.000 habitantes em 2020). Ainda, verificaram-se linhas de tendência entre 2017-2020 por meio do modelo de regressão logarítmica com pontos de junção. Averiguou-se relevante mudança percentual anual nos indicadores de mortalidade e letalidade, com redução de 59,1% e 73,4%, respectivamente, em 2020, ao comparar-se o valor observado e o esperado. Conclusão: os achados permitem conjecturar que o CMaids contribuiu para melhorias dos indicadores de saúde, evidenciando essa como uma estratégia relevante para o enfrentamento do HIV/aids em nível local.(AU)

Justificación y objetivo: el síndrome de inmunodeficiencia adquirida (sida) presenta altas tasas de detección y muerte en el estado de Rio Grande do Sul. Para entender mejor esas muertes, en diciembre de 2017, la Secretaría Municipal de Salud de Uruguaiana implementó el Comité de Mortalidad por SIDA (CMaids). El objetivo de este estudio es analizar el impacto de la implementación del CMaids de Uruguaiana a través de los indicadores de salud municipales. Métodos: estudio ecológico de series temporales, utilizando datos secundarios de las plataformas oficiales del Ministerio de Salud desde 2008 hasta 2020. Resultados: se observó la reducción de los indicadores de número de óbitos (de 28 en 2008 a 9 en 2020), tasa de mortalidad (de 22,0 en 2008 a 7,1 muertes/100.000 habitantes en 2020) y tasa de letalidad (de 46,74 en 2008 a 9,61 muertes/1.000 habitantes en 2020). Además, se verificaron líneas de tendencia entre 2017-2020 a través del modelo de regresión logarítmica con puntos de unión. Se verificó un cambio porcentual anual relevante en los indicadores de mortalidad y letalidad, con una reducción de 59,1% y 73,4%, respectivamente, en 2020, al comparar los valores observados y esperados. Conclusión: los resultados permiten conjeturar que el CMaids contribuye a mejorar los indicadores de salud, evidenciando que es una estrategia relevante para la lucha contra el VIH/SIDA a nivel local.(AU)

Incorporación a las estadísticas oficiales del Municipio de Pila de indicadores positivos de salud infantil: proyecto CREDEPILA / Incorporation of positive child health indicators to the official statistics of the Municipality of Pila: CREDEPILA project

RESUMEN INTRODUCCIÓN: El municipio bonaerense de Pila carecía de indicadores adecuados para monitorear la salud infantil de su población. El objetivo fue incorporar indicadores positivos de crecimiento físico y desarrollo psicomotor en niños de 0 a 5,99 años. MÉTODOS: Se convocó a toda la población objetivo (con consentimiento parental) a los jardines y centros de atención primaria. Personal capacitado midió peso, estaturalongitud corporal y administró 13 pautas de desarrollo de la Referencia Nacional (RN). Las medianas de datos antropométricos se obtuvieron con el método LMS; la edad de cumplimiento de pautas se estimó con regresión logística y el ajuste, con el test de Hosmer-Lemeshow. El índice de desarrollo (ID) se calculó con una regresión lineal entre las diferencias entre las edades de cumplimiento de los niños con las de la RN, y las edades de la RN. RESULTADOS: De un total de 321 niños, se evaluó a 307 (95,6% del total; 169 niñas). Las curvas de estatura fueron similares a las de la Organización Mundial de la Salud y a las argentinas actualizadas (los puntajes "z" no difirieron significativamente de cero); las de peso e índice de masa corporal mostraron un moderado sobrepeso: z= 0,38±0,07 de desvío estándar. No hubo diferencias significativas entre sexos. Con las 6 pautas que mostraron un ajuste adecuado, el ID fue 89. DISCUSIÓN: El método se implementó con éxito. Pila cuenta ahora con una línea de base para el monitoreo anual de la salud infantil.

ABSTRACT INTRODUCTION: The Buenos Aires municipality of Pila lacked adequate indicators to monitor child health in the population. The objective was to incorporate positive indicators based on physical growth and psychomotor development in children aged 0 to 5.99 years. METHODS: The entire target population was summoned to kindergartens and primary care centers (with parental consent). Trained health personnel measured weight, supine length/height and administered 13 developmental items taken from the National Reference (NR). Medians of anthropometric data were obtained with LMS method; the age of attainment of items was estimated with logistic regression and the fit was assessed with the Hosmer-Lemeshow test. Developmental index (DI) was calculated with linear regression of differences between children's attainment ages and those of the NR, and the ages of the NR. RESULTS: Of 321 children, 307 (95.6% of the total; 169 girls) were evaluated. Height curves were similar to those of the World Health Organization and updated Argentine curves (z-scores did not significantly differ from zero); weight and body mass index curves showed moderate overweight: z = 0.38±0.07 standard deviation. No significant sex differences were found. Based on the 6 items that showed a good fit, the DI was 89. DISCUSSION: The method was successfully implemented. Pila has now a baseline for annual monitoring of children's health.

Indicadores do Programa Nacional de Imunizações em menores de um ano: tendência temporal no Maranhão, Brasil, 2010 a 2021 / Indicators of the National Immunization Program for children under one year old: time trend in Maranhão, Brazil, 2010 to 2021

Resumo Objetivou-se analisar a tendência dos indicadores do Programa Nacional de Imunizações (PNI) em menores de um ano e classificar os municípios quanto ao risco de transmissão de doenças imunopreveníveis (RTDIp) no Maranhão de 2010 a 2021. Estudo ecológico de série temporal, baseado em dados secundários de cobertura vacinal (CV), homogeneidade de cobertura vacinal (HCV), proporção de abandono (PA) e RTDIp, com abrangência estadual, para vacinas do calendário nacional infantil. Regressão de Prais-Winstein estimou tendência (α = 5%) e variação percentual anual (VPA) dos indicadores. Houve CV flutuantes e discrepantes entre as vacinas, com tendência decrescente (p < 0,01), exceto contra hepatite B (p = 0,709) e rotavírus (p = 0,143). As quedas mais acentuadas foram para as vacinas contra febre amarela e BCG. Todas as taxas de HCV estavam abaixo do esperado, com a diminuição a partir de 2014 e VPA de 5,75% a 14,02%. Houve tendência crescente da PA para pentavalente e poliomielite. No período de 2015 e 2021 houve incremento de 52,54% na proporção dos municípios maranhenses com RTDIp muito alto (p = 0,025) e alto (p = 0,028). Ao longo de 12 anos, houve piora dos indicadores do PNI em menores de um ano, reafirmando a suscetibilidade para o surgimento de doenças imunopreveníveis.

Abstract We aimed to analyze the trend of indicators of the National Immunization Program (acronym in Portuguese. PNI) in children under one-year-old and classify municipalities regarding the risk of transmission of vaccine-preventable diseases (RTVPD) in Maranhão from 2010 to 2021. This ecological time series study was based on secondary data on vaccination coverage (VC). vaccination coverage homogeneity (VCH). proportion of abandonment (PA). and RTVPD. with state coverage for vaccines in the national children's calendar. Prais-Winsten regression estimated trends (α=5%) and the indicators' annual percentage change (APC). We identified fluctuating and discrepant VC between vaccines. with a decreasing trend (p < 0.01). except those against Hepatitis B (p = 0.709) and oral human rotavirus (p = 0.143). The sharpest falls were for Yellow Fever (APC = 12.24%) and BCG (APC = 12.25%) vaccines. All VCH rates were lower than expected. with a drop from 2014 and APC between 5.75% (Pneumococcal 10; p = 0.033) and 14.02% (Poliomyelitis; p < 0.01). We observed an increasing trend in PA for Pentavalent (APC = 4.91%; p < 0.01) and Poliomyelitis (APC = 3.55%; p < 0.01). We identified an increase of 52.54% in the proportion of municipalities in Maranhão from 2015 to 2021. with extremely high (p = 0.025) and high (p = 0.028) RTVPD. The PNI indicators deteriorated. reaffirming the susceptibility to the emergence of vaccine-preventable diseases.

Qualidade da assistência de enfermagem ao idoso na atenção primária à saúde no interior de minas gerais

Objetivos: Avaliar a confiabilidade, viabilidade, usabilidade e a utilidade dos indicadores de qualidade da assistência ao idoso na Atenção Primária à Saúde e descrever a qualidade da assistência de enfermagem ao idoso nesse nível de atenção. Material e Métodos: Estudo transversal, com abordagem quantitativa, desenvolvido em uma Estratégia de Saúde da Família de um município no interior de Minas Gerais. A população do estudo foi composta pelos profissionais de enfermagem (indicadores coletados por meio de entrevista), prontuários de idosos (indicadores coletados por meio de supervisão), gestores municipais da secretaria de saúde (avaliação da utilidade e usabilidade) e avaliador de campo (avaliação da confiabilidade e viabilidade/disponibilidade). Utilizaram-se 22 indicadores (5 gerenciais e 17 relacionados ao cuidado de enfermagem), disponíveis on-line no Harvard Dataverse. Foram utilizadas análise descritiva por meio de frequências absolutas e percentuais. A confiabilidade dos dados foi mensurada por análise de concordância entre as coletas por meio do índice Kappa. A viabilidade de coleta dos dados foi dada em escala de um a nove, quanto maior melhor a viabilidade; para utilidade e usabilidade foi utilizada escala variando de 1 ponto (não recomendado), a 9 pontos (altamente recomendado). Resultados: A confiabilidade dos indicadores mensurados por meio de entrevistas e análise dos prontuários obteve 100% de respostas concordantes, sendo considerada substancial. Sobre a viabilidade sete indicadores não estavam disponíveis e dentre estes dois foram considerados inviáveis; a utilidade e usabilidade obtiveram avaliação positiva; observou-se baixo percentual de cumprimento dos indicadores, demonstrando baixa qualidade da assistência de enfermagem prestada ao idoso. Conclusões: Os resultados apontaram confiabilidade substancial na coleta, viabilidade na maioria dos indicadores, utilidade e usabilidade com avaliação positiva e baixo percentual de cumprimento dos indicadores.

Objectives: To evaluate the reliability, feasibility, usability and usefulness of the indicators of quality of care for the elderly in primary health care, and to describe the quality of nursing care for the elderly. Materials and Methods: Cross-sectional study with a quantitative approach, developed in the context of the Family Health Strategy program in a municipality of the State of Minas Gerais. The study population consisted of nursing professionals (indicators collected through interviews), elderly medical records (indicators collected through supervision), managers of municipal health departments (assessment of usefulness and usability) and field evaluators (assessment reliability and feasibility/availability). 22 indicators (5 managerial and 17 related to nursing care), available online at the Harvard Dataverse repository, were used. Descriptive analysis was used through absolute and percentage frequencies. Reliability was measured by concordance analysis between the collected data using the Kappa index. Feasibility was measured on a scale of one to nine: the higher the better the feasibility; for usefulness and usability a scale ranging from 1 point (not recommended) to 9 points (highly recommended) was used. Results: The reliability of the indicators, measured through interviews and analysis of medical records, showed 100% of concordant responses, so that it was considered relevant. Seven indicators were not available and, among these, two were considered unfeasible: usefulness and usability had a positive evaluation; there was a low percentage of compliance with the indicators, which shows low quality of nursing care provided to the elderly. Conclusions: The results showed substantial reliability in the collection, feasibility in most of the indicators, usefulness and usability with positive evaluation and low percentage of compliance with the indicators.

Objetivos: Evaluar la confiabilidad, factibilidad, usabilidad y utilidad de los indicadores de calidad del cuidado a la persona mayor en la Atención Primaria de Salud y describir la calidad del cuidado de enfermería a la persona mayor en este nivel de atención. Material y Método: Estudio transversal con enfoque cuantitativo, desarrollado en una Estrategia de Salud de la Familia de un municipio del interior de Minas Gerais, Brasil. La población de estudio estuvo compuesta por profesionales de enfermería (indicadores recolectados a través de entrevistas), prontuarios de personas mayores (indicadores recolectados a través de la supervisión), gestores de departamentos de salud municipales (evaluación de utilidad y usabilidad) y evaluadores de campo (evaluación de confiabilidad y factibilidad/disponibilidad). Se utilizaron 22 indicadores (5 gerenciales y 17 relacionados con el cuidado de enfermería), disponibles en línea en Harvard Dataverse. Se utilizó análisis descriptivo a través de frecuencias absolutas y porcentuales. La fiabilidad se midió mediante el análisis de concordancia entre colecciones utilizando el índice Kappa. La factibilidad se dio en una escala de uno a nueve, cuanto más alta, mejor factibilidad; para la utilidad y usabilidad se utilizó una escala que va desde 1 punto (no recomendado) hasta 9 puntos (muy recomendable). Resultados: La confiabilidad de los indicadores, medidos a través de entrevistas y análisis de historias clínicas, obtuvo el 100% de repuestas concordantes, considerándose sustancial. Siete indicadores no estaban disponibles y, entre estos, dos se consideraron inviables; la utilidad y usabilidad tuvo evaluación positiva; hubo bajo porcentaje de cumplimiento de los indicadores, lo que demuestra baja calidad de la atención de enfermería brindada a las personas mayores. Conclusiones: Los resultados mostraron una fiabilidad sustancial en la recogida, viabilidad en la mayoría de los indicadores, utilidad y usabilidad con evaluación positiva y bajo porcentaje de cumplimiento de los indicadores.

Education, health indicators and fertility outcomes: a longitudinal analysis of couples in Britain.

Previous studies have shown that highly educated women are more likely to realise their fertility aspirations, or experience a faster progression to a higher order birth, compared to lower educated women. This is often explained by improved economic or social resources among the higher educated. However, it is unclear whether educational differences in health behaviours may also contribute to these differential fertility outcomes. In this study, we use data from Waves 1-7 of the UK Longitudinal Household Study, combined with data from the Nurse Health Assessment from Wave 2 to estimate couples' likelihood of experiencing additional childbirth within six years. A discrete-time event history model is employed to analyse the transition to a higher order birth, while accounting for both partners' level of education as well as smoking patterns and body mass index. We find that couples in which the female partner is highly educated are more likely to experience childbirth within six years compared to others. In addition, female smoking is negatively associated with the likelihood of childbirth, while no significant effect has been found for male health factors. Female health indicators explain some of the variation in fertility outcomes for women with lower secondary education compared to degree-educated women. However, education remains a significant predictor of the transition to higher order births, also after accounting for male and female health indicators. It is therefore important to consider both socio-economic and health factors in order to understand variations in fertility outcomes.

Indicadores de acesso nos serviços de reabilitação física das desordens musculoesqueléticas em Belo Horizonte (MG) / Indicadores de acceso en servicios de rehabilitación física para trastornos musculoesqueléticas en Belo Horizonte (MG) / Access indicators in physical rehabilitation services for musculoskeletal disorders in Belo Horizonte (MG)

RESUMO A crescente demanda por atendimento nos serviços de reabilitação física do Sistema Único de Saúde (SUS) excede a oferta, o que resulta em longas filas de espera. Neste estudo, realizou-se uma pesquisa quantitativa de cunho exploratório que teve por objetivo a apresentação de indicadores para facilitar o acesso aos serviços de reabilitação física no que tange às desordens musculoesqueléticas. Os dados foram colhidos dos prontuários de usuários residentes nas regiões noroeste e oeste de Belo Horizonte (MG), com mais de 18 anos de idade, submetidos a acolhimento no Centro Especializado em Reabilitação IV no ano de 2019. Obtiveram-se os seguintes indicadores: absenteísmo no momento da avaliação; tempo médio para início do tratamento de acordo com a prioridade; tempo médio de tratamento; e média de usuários atendidos ao mês. A análise deste estudo foi pautada em 362 prontuários. O tempo médio para início de tratamento foi de aproximadamente 69 dias e o período médio de tratamento, de 94 dias. O serviço absorveu cerca de 30 novos usuários ao mês e apresentou índice de absenteísmo de 16,8%. Acredita-se que os indicadores apresentados possivelmente favorecerão a gestão e o controle das filas de espera dos serviços de reabilitação do SUS.

RESUMEN La creciente demanda de atención en los servicios de rehabilitación física del Sistema Único de Salud (SUS) supera la oferta, lo que se traduce en largas colas de espera. Este estudio es una investigación cuantitativa exploratoria, que tuvo como objetivo presentar indicadores para facilitar el acceso a los servicios de rehabilitación física con respecto a los trastornos musculoesqueléticos. Se recolectaron datos de las historias clínicas de los usuarios residentes en las regiones noroeste y oeste de Belo Horizonte (en Mina Gerais, Brasil), mayores de 18 años de edad y que ingresaron al Centro Especializado en Rehabilitación IV en 2019. Se obtuvieron los siguientes indicadores: Absentismo al momento de la evaluación; tiempo medio para iniciar el tratamiento según la prioridad; tiempo medio de tratamiento y número medio de usuarios atendidos por mes. El análisis de este estudio se basó en 362 historias clínicas. El tiempo medio para iniciar el tratamiento fue de aproximadamente 69 días y el período medio de tratamiento, 94 días. El servicio recibió cas 30 nuevos usuarios al mes y presentó una tasa de absentismo del 16,8%. Los indicadores presentados pueden favorecer la gestión y control de las listas de espera de los servicios de rehabilitación del SUS.

ABSTRACT The growing demand for care in the physical rehabilitation services of the Unified Health System (SUS) exceeds the supply, resulting in long waiting lines. This study is an exploratory quantitative research, which aims to present indicators to ease the access to physical rehabilitation services related to musculoskeletal disorders. Data were collected from the medical records of users residing in the northwest and west regions of Belo Horizonte (MG), who were over 18 years old and underwent treatment at the Specialized Rehabilitation Center IV (CER-IV) in 2019. The following indicators were obtained: absenteeism at the time of assessment; average time to start treatment according to priority; mean treatment time; and average number of users served per month. The analysis was based on 362 medical records. The mean time to start treatment was approximately 69 days and the mean treatment period was 94 days. The service absorbed around 30 new users per month and presented an absenteeism rate of 16.8%. It is believed that the indicators presented will possibly favor the management and control of the SUS rehabilitation services waiting lines.

Higiene de las manos basada en indicadores de rendimiento / Hand Hygiene Based on Performance Indicators

Introducción: Las manos de los profesionales son el vehículo más común para la transmisión de microorganismos de un paciente a otro. En ese contexto, la higiene de las manos se considera una medida primaria muy relevante para controlar las infecciones asociadas a la atención sanitaria. Objetivo: Verificar la adherencia a las prácticas de higiene de las manos entre los profesionales de la salud en la Unidad de Cuidados Intensivos de un Hospital Universitario. Métodos: Estudio descriptivo de corte transversal con abordaje cuantitativo, realizado en la Unidad de Cuidados Intensivos de un Hospital Universitario Brasileiro en el año 2020. La población del estudio estuvo formada por 121 profesionales de la salud. La recogida de datos se produjo mediante la consulta de la base de datos puesta a disposición por el Comité de Control de Infecciones Hospitalarias del hospital. El análisis estadístico se procesó en el Statistical Package for the Social Sciences-SPSS versión 22, a través de estadísticas descriptivas simples. Resultados: La tasa de adherencia al saneamiento fue superior a 78,04 por ciento. Los residentes de enfermedades tuvieron la tasa de depresión más alta, 96,72 por ciento. Por otro lado, los médicos tuvieron solo 57,29 por ciento de su atención con higiene. Estos eventos indican que los profesionales de la salud de la Unidad de Cuidados Intensivos pueden estar preocupados por el riesgo de que se realicen los procedimientos, debido a la exposición a fluidos corporales y regiones contaminadas. Conclusiones: Se encontró adherencia insatisfactoria al saneamiento para todas las categorías profesionales durante el período de demostración de la investigación(AU)

Introduction: The hands of professionals are the most common vehicle for the transmission of microorganisms from one patient to another. In this setting, hand hygiene is considered a very relevant primary measure for controlling healthcare-associated infections. Objective: To verify adherence to hand hygiene practices among healthcare professionals in the intensive care unit of a university hospital. Methods: Descriptive and cross-sectional study, with a quantitative approach, carried out in 2020 in the intensive care unit of a Brazilian university hospital. The study population consisted of 121 health professionals. Data collection was done by consulting the database available under the committee for hospital infection control at the institutional level. The statistical analysis was done with the Statistical Package for the Social Sciences (SPSS), version 22, using simple descriptive statistics. Results: The sanitation adherence rate was over 78.04 percent. Internal Medicine residents had the highest depression rate, accounting for 96.72 percent. On the other hand, physicians had only 57.29 percent of their care with sanitation. These events indicate that healthcare professionals in the intensive care unit may be concerned about the risk of procedures being performed due to exposure to body fluids and contaminated areas. Conclusions: Unsatisfactory adherence to sanitation was found in all professional categories during the research demonstration period(AU)

Health Indicators as Measures of Individual Health Status and Their Public Perspectives: Cross-sectional Survey Study.

BACKGROUND: Disease status (eg, cancer stage) has been used in routine clinical practice to determine more accurate treatment plans. Health-related indicators, such as mortality, morbidity, and population group life expectancy, have also been used. However, few studies have specifically focused on the comprehensive and objective measures of individual health status. OBJECTIVE: The aim of this study was to analyze the perspectives of the public toward 29 health indicators obtained from a literature review to provide evidence for further prioritization of the indicators. The difference between health status and disease status should be considered. METHODS: This study used a cross-sectional design. Online surveys were administered through Ohio University, ResearchMatch, and Clemson University, resulting in three samples. Participants aged 18 years or older rated the importance of the 29 health indicators. The rating results were aggregated and analyzed as follows (in each case, the dependent variables were the individual survey responses): (1) to determine the agreement among the three samples regarding the importance of each indicator, where the independent variables (IVs) were the three samples; (2) to examine the mean differences between the retained indicators with agreement across the three samples, where the IVs were the identified indicators; and (3) to rank the groups of indicators into various levels after grouping the indicators with no mean differences, where the IVs were the groups of indicators. RESULTS: In total, 1153 valid responses were analyzed. Descriptive statistics revealed that the top five-rated indicators were drug or substance abuse, smoking or tobacco use, alcohol abuse, major depression, and diet and nutrition. Among the 29 health indicators, the three samples agreed upon the importance of 13 indicators. Inferential statistical analysis indicated that some of the 13 indicators held equal importance. Therefore, the 13 indicators were categorized by rank into seven levels: level 1 included blood sugar level and immunization and vaccination; level 2 included LDL cholesterol; level 3 included HDL cholesterol, blood triglycerides, cancer screening detection, and total cholesterol; level 4 included health literacy rate; level 5 included personal care needs and air quality index greater than 100; level 6 included self-rated health status and HIV testing; and level 7 included the supply of dentists. Levels 1 to 3 were rated significantly higher than levels 4 to 7. CONCLUSIONS: This study provides a baseline for prioritizing 29 health indicators, which can be used by electronic health record or personal health record system designers or developers to determine what can be included in the systems to capture an individual's health status. Currently, self-rated health status is the predominantly used health indicator. Additionally, this study provides a foundation for tracking and measuring preventive health care services more accurately and for developing an individual health status index.

Ruta integral de atención en salud para personas con amputaciones de miembro inferior, para mejorar el funcionamiento y la calidad de vida / Integral pathway of health care for people with lower limb amputations, to improve the functioning and quality of life / Rota abrangente de cuidados de saúde de pessoas com amputações de membros inferiores, para melhorar o funcionamento e qualidade de vida

Resumen Objetivo: Presentar el estudio mediante el cual se construyó una ruta integral de atención en salud (RIAS) para la atención del paciente amputado de miembro inferior por causas traumática, vascular o diabetes mellitus, cuyo fin es implementar las recomendaciones de la Guía de práctica clínica del paciente amputado y garantizar la atención integral en salud de esta población en Colombia. Con la ruta se pretende orientar a los actores involucrados en la ejecución de intervenciones individuales para el diagnóstico, el tratamiento y la rehabilitación, e impactar en los desenlaces en salud y equidad de esta población. Metodología: Este estudio responde a una estrategia de mejoramiento de la atención en salud. Para esto, se revisó el Manual metodológico para la elaboración e implementación de las RIAS; se creó el grupo desarrollador de la ruta; se priorizaron y describieron las intervenciones en función del proceso continuo de atención en salud; se evaluó la práctica asistencial actual con grupos focales de pacientes y profesionales; se formularon los resultados esperados en el proceso de gestión y atención en salud (hitos), y se elaboró el diagrama de la ruta. Resultados: A partir de la Guía de práctica clínica se elaboraron 25 intervenciones individuales priorizadas y caracterizadas según el actor responsable, la población objetivo y el entorno. Para cada una de las intervenciones se presentan resultados esperados en salud, calidad de prestación de servicios, aspectos relacionados con la equidad, y la perspectiva de pacientes y actores involucrados con la atención. Se construyeron los indicadores para el seguimiento e implementación de la ruta. Conclusión: Se construyó la primera ruta integral de atención en salud del paciente con amputación de miembro inferior, de acuerdo con los lineamientos del manual del Ministerio de Salud y de la Protección Social.

Abstract Objective: Build an Integral Health Care Pathway for the care of patients with lower limb amputation due to traumatic, vascular or diabetes mellitus causes, in order to implement the recommendations of the cpg for amputee patients and guarantee comprehensive health care for this population in Colombia. Methodology: This study is a strategy to improve health care. Carried out by a review of the Methodological Manual for the Development and Implementation of Comprehensive Health Care Pathway, then the development group was created. A process of prioritization and description of required individual interventions was developed based on health care. Evaluation of current care practice with focus groups, formulation of milestones and development of the intervention diagram. Results: 25 individual interventions were prioritized and characterized according to the responsible actor, target population and environment. Expected results in health, quality of service delivery, issues related to equity, as well as the perspective of patients and actors involved with care are shown. Indicators were built for monitoring and implementation of the pathway. Conclusion: With the previous results, the first Integral Health Care Pathway for the Lower Limb Amputee Patient was developed. It intends to guide the actors involved, when executing individual interventions for the diagnosis, treatment and rehabilitation, to impact outcomes in health and equity of this group .

Resumo Objetivo: Construir uma Rota de Atenção Integral à Saúde do Paciente Amputado do Membro Inferior por causas traumáticas, vasculares ou diabetes mellitus, com a finalização de implementar as recomendações do gpc do paciente amputado e garantir a atenção integral na saúde desta población em Colômbia. Metodologia: Este estudo responde a uma estratégia para melhorar os cuidados de saúde. Foi realizada uma revisão do Manual Metodológico para o Desenvolvimento e Implementação de Rotas Integrais de Atenção à Saúde, criação do grupo de desenvolvimento da rota. Um processo de priorização e descrição das intervenções individuais necessárias foi desenvolvido com base na continuidade dos cuidados de saúde. Avaliação da prática assistencial atual com grupos focais, formulação de marcos e desenvolvimento do diagrama de intervenção. Resultados: 25 intervenções individuais foram priorizadas e caracterizadas de acordo com o ator responsável, população-alvo e ambiente. Determinação dos resultados esperados em saúde, qualidade da prestação de serviços, questões relacionadas a equidade, bem como a perspectiva de pacientes e atores envolvidos no atendimento. Foram construídos indicadores para o monitoramento e implementação da rota. Conclusão: Com os resultados anteriores, foi construída a primeira Rota de Atenção Integral à Saúde do paciente com amputação de membros inferiores por causas traumáticas e neurovasculares, com sua implementação, visando orientar os atores envolvidos na execução de intervenções individuais para a diagnóstico, tratamento e reabilitação, impactar os resultados em saúde e eqüidade dessa população.

Aporte de la solidaridad médica cubana a la salud de la población de Timor-Leste / Contribution of Cuban medical solidarity to the health of Timor-Leste´s population

Introducción: La solidaridad médica cubana llega a Timor-Leste cuando no habían transcurrido dos años de su independencia, con una infraestructura de salud muy dañada y prácticamente sin médicos disponibles para garantizar los servicios básicos de salud. Objetivo: Analizar el aporte de la solidaridad médica cubana en la mejora del estado de salud de la población de Timor-Leste en el periodo 2004-2019. Métodos: Se realizó una investigación cualitativa, que se apoyó en el estudio descriptivo y retrospectivo y se aplicó el método etnográfico. El periodo de estudio abarcó 15 años, desde 2004 hasta 2019. Conclusiones: La solidaridad médica cubana en la salud de Timor-Leste, durante estos 15 años, ha contribuido a modificar el cuadro sanitario que tenía ese país cuando logró su independencia en el año 2002, convirtiéndose en uno de los países con mejores indicadores en la Región de Oceanía. La asistencia médica y la formación de estudiantes en Cuba y en el propio Timor-Leste son elementos decisivos de la cooperación de Cuba en la trasformación y fortalecimiento del sistema sanitario timorense, factores esenciales para alcanzar la cobertura universal de salud(AU)

Introduction: Cuban medical solidarity arrives in Timor-Leste two years after its independence, with a badly damaged health infrastructure and practically no doctors available to guarantee basic health services. Objective: Analyze the contribution of Cuban medical solidarity in improving the health status of Timor-Leste´s population in the period 2004-2019. Methods: A qualitative research was carried out, which was based on the descriptive and retrospective study and the ethnographic method was applied. The study period spanned 15 years, from 2004 to 2019. Conclusions: Cuban medical solidarity in Timor-Leste, during these 15 years, has contributed to modify the health picture that the country had when it achieved its independence in 2002, becoming one of the countries with the best indicators in the Oceania Region. Medical assistance and the training of students in Cuba and in Timor-Leste itself are decisive elements of Cuba's cooperation in the transformation and strengthening of the Timorese health system, which are essential factors in achieving universal health coverage(AU)

Physiotherapist on the move: where babies at risk are referred for follow-up after hospital discharge / Fisioterapeuta em movimento: para onde os bebês de risco são encaminhados para acompanhamento após a alta hospitalar

Abstract Introduction Two facts may influence a newborn's development. One is to be a newborn at risk and the other is to be hospitalized in Intensive Care Unit. Objective To examine where at-risk infants are being referred for longitudinal follow-up after hospital discharge, and to carry out an analysis of the epidemiological and care profile of these babies. Methods Documentary, descriptive and retrospective study, comprising the medical records of 479 newborns (NBs) hospitalized Hospital Materno Infantil Presidente Vargas from January 2019 to May 2020. The variables studied were: gender, baby's race/color, type of delivery, prenatal consultations, classification according to gestational age, weight, Apgar of the 1st, 5th, 10th minute, hospitalization diagnosis, main diagnosis, outcomes, length of stay, multidisciplinary follow-up during hospitalization, post-discharge referrals (specialized and non-specialized). Social and environmental data were: maternal age and race/color, maternal and paternal education. Results Higher prevalence of full-term male babies born by cesarean delivery, declared as white, with high Apgar scores, with varied diagnoses, with prematurity prevailing. Maternal mean was 26.2 years, (SD ± 7.3), the most reported race/color was also white, the mean of mothers' studies was 8.1 years (SD ± 2.4). Only 14% (n = 67) performed motor physical therapy at the hospital and 2.1% (n = 10) were referred for evaluation and early intervention for post-discharge physical therapy. The specialized service with the highest referral was the hospital's neuropediatrics graduates' outpatient clinic (17.3%, n = 83) and, for the non-specialized, it was the Basic Health Unit/BHU (39.7%, n = 190). Conclusion Most NBs are referred to the specific medical team or post-discharge BHU. The physiotherapist was the professional little remembered for monitoring this public in the hospital and after discharge.

Resumo Introdução Dois fatos podem influenciar o desenvolvimento do recém-nascido. Um é ser um recém-nascido de risco e o outro é ser internado em Unidade de Terapia Intensiva. Objetivo Examinar para onde os bebês de risco estão sendo encaminhados para acompanhamento longitudinal após a alta hospitalar e realizar uma análise do perfil epidemiológico e assistencial desses bebês. Métodos Estudo documental, descritivo e retrospectivo, composto pelos prontuários de 479 recém-nascidos (RNs) internados no Hospital Materno Infantil Presidente Vargas no período de janeiro de 2019 a maio de 2020. As variáveis estudadas foram: sexo, raça/cor do bebê, tipo de parto, consultas de pré-natal, classificação de acordo com a idade gestacional idade, peso, Apgar do 1º, 5º, 10º minuto, diagnóstico de internação, diagnóstico principal, desfechos, tempo de internação, acompanhamento multidisciplinar durante a internação, encaminhamentos pós-alta (especializados e não especializados). Os dados socioambientais foram: idade materna e raça/cor, escolaridade materna e paterna. Resultados Maior prevalência de bebês a termo do sexo masculino, nascidos de parto cesáreo, declarados como brancos, com escores de Apgar elevados, com diagnósticos variados, prevalecendo a pre-maturidade. A média materna foi de 26,2 anos (DP ± 7,3), a raça/cor mais relatada foi branca, a média de estudos das mães foi de 8,1 anos (DP ± 2,4). Apenas 14% (n = 67) realizaram fisioterapia motora no hospital e 2,1% (n = 10) foram encaminhados para avaliação e intervenção precoce para fisioterapia pós-alta. O serviço especializado de maior referência foi o ambulatório de egressos de neuropediatria do hospital (17,3%, n = 83) e, para os não especializados, foi a Unidade Básica de Saúde/UBS (39,7%, n = 190). Conclusão A maioria dos RNs são encaminhados para equipe médica específica ou UBS pós-alta. O fisioterapeuta foi o profissional pouco lembrado pelo acompanhamento desse público no hospital e após a alta.

Potencialidades e desafios do monitoramento da saúde na Agenda 2030 no Brasil / Potential and challenges of health monitoring in the 2030 Agenda in Brazil

Resumo O presente artigo tem dois objetivos integrados: (i) identificar a representação da saúde na Agenda 2030, a partir dos indicadores relacionados à saúde operacionalizados por instituições internacionais e nacionais; e (ii) comparar as potencialidades das plataformas para o monitoramento dos compromissos de saúde brasileiros nos ODS. Argumenta-se que ainda existem controvérsias importantes trazidas pela maior complexidade da Agenda 2030, em particular na operacionalização dos indicadores relacionados à saúde, cujos determinantes perpassam muitos outros objetivos e metas. O monitoramento e avaliação mais efetivos dos compromissos brasileiros nos ODS requer melhoria, com maior desagregação e estratificação dos indicadores na população, ainda que o retrato do país hoje disponibilizado nas diversas plataformas nacionais e internacionais já seja amplo.

Abstract This article has two integrated objectives: (i) to identify the representation of health in the 2030 Agenda from health-related indicators implemented by international and national institutions; and (ii) to compare the potential of platforms for monitoring Brazilian health commitments in the SDGs. It is argued that there are still important controversies brought about by the greater complexity of the 2030 Agenda, particularly in the operationalization of health-related indicators, whose determinants permeate many other objectives and goals. Finally, even though the picture of the country currently available on national and international platforms is already broad, improvements are required for more effective monitoring and evaluation of Brazilian commitments in the SDGs, with greater disaggregation and stratification of indicators in the population.

Cross-cultural adaptation, validation and reliability of the Medication Safety Thermometer tool for use in Brazil / Adaptación transcultural, validez y confiabilidad de la herramienta Medication Safety Thermometer para uso en Brasil / Adaptação transcultural, validação e confiabilidade da ferramenta Medication Safety Thermometer para uso no Brasil

ABSTRACT Objectives: to perform cross-cultural adaptation, face and content validation and reliability analysis of the Medication Safety Thermometer tool for use in Brazil. Methods: the process of cross-cultural adaptation and validation followed the stages of translation, synthesis of translations, back-translation, content validation performed by experts, and face validation through pre-testing. Reliability was determined by calculating the Kappa coefficient. Results: the two translated versions were synthesized into a single version, which was back-translated and showed no divergences. The expert committee judged the adapted tool as equivalent, reaching a Content Validity Index higher than 0.8. The mean global understanding was 1.82, demonstrating face validity. The assessed items had Kappa coefficient greater than 0.61, showing agreement between observers. Conclusions: the cross-cultural adaptation of the tool was performed following an established methodology. The adapted tool showed inter-rater reliability and validity for use in Brazil.

RESUMEN Objetivos: realizar adaptación transcultural, validez facial y contenido y análisis de confiabilidad de la herramienta Medication Safety Thermometer para uso en Brasil. Métodos: el proceso de adaptación transcultural y validez siguió las etapas de traducción, síntesis de las traducciones, retro-traducción, validez de contenido realizada por especialistas y validez facial mediante el pretest. La confiabilidad fue determinada por el cálculo del coeficiente de Kappa. Resultados: las dos versiones traducidas fueron sintetizadas en una única versión, que fue retro-traducida y no demostró divergencias. El comité de expertos juzgó la herramienta adaptada como equivalente, alcanzando Índice de Validez de Contenido mayor que 0,8. La mediana de comprensión global fue de 1,82, demostrando validez facial. Los ítems evaluados presentaron coeficiente de Kappa mayor que 0,61, evidenciando concordancia entre observadores. Conclusiones: la adaptación transcultural de la herramienta fue realizada siguiendo metodología establecida. La herramienta adaptada mostró confiabilidad entre observadores y validez para utilización en Brasil.

RESUMO Objetivos: realizar adaptação transcultural, validação de face e conteúdo e análise da confiabilidade da ferramenta Medication Safety Thermometer para uso no Brasil. Métodos: o processo de adaptação transcultural e validação seguiu as etapas de tradução, síntese das traduções, retrotradução, validação de conteúdo realizada por especialistas e validação de face mediante o pré teste. A confiabilidade foi determinada pelo cálculo do coeficiente de Kappa. Resultados: as duas versões traduzidas foram sintetizadas em uma única versão, que foi retrotraduzida e não demonstrou divergências. O comitê de experts julgou a ferramenta adaptada como equivalente, alcançando Índice de Validade de Conteúdo maior que 0,8. A média de compreensão global foi de 1,82, demonstrando validade de face. Os itens avaliados apresentaram coeficiente de Kappa maior que 0,61, evidenciando concordância entre observadores. Conclusões: a adaptação transcultural da ferramenta foi realizada seguindo metodologia estabelecida. A ferramenta adaptada mostrou confiabilidade entre observadores e validade para utilização no Brasil.

Potential years of life lost to cancer in Mato Grosso, stratified by sex: 2000 to 2019 / Anos potenciais de vida perdidos por câncer em Mato Grosso, estratificados por sexo: 2000 a 2019

ABSTRACT: Objective: To estimate the potential years of life lost (PYLL) to cancer in the State of Mato Grosso, from 2000 to 2019, stratified by sex, according to age groups and cancer types. Methods: It is a quantitative study with an ecological approach developed from secondary data, using the PYLL and its derivatives. Results: In the period analyzed, deaths from cancer in Mato Grosso resulted in 680,338 PYLL before the age of 80, with a variation of 82.5%. Of this total, 52.7% were assigned to males. The rate of the PYLL for cancer before the age of 60 was 70.9% in males, and 80.1% among women. The rates of PYLL increased in the period and showed slightly higher values in males. In the analysis according to age group, the rates of PYLL were also higher in males, except between the ages of 30 and 49. Lung cancers and lymphomas/leukemias resulted in greater losses of PYLL among men and female specific cancers (breast, cervical and uterine, and ovarian cancer) accounted for 36.26% of the PYLL among women, with variability per age groups. Conclusion: In Mato Grosso, the PYLL indicator for cancer presented unfavorable evolution between 2000 and 2019, with greater damage for males and for the younger population. Leukemias, lymphomas, and lung and breast cancers were the main causes for the PYLL.

RESUMO: Objetivo: Estimar os anos potenciais de vida perdidos por câncer no estado de Mato Grosso, no período de 2000 a 2019, estratificando os dados por sexo, segundo faixas etárias e tipos de câncer. Métodos: Trata-se de um estudo quantitativo, com abordagem ecológica a partir de dados secundários, utilizando-se o indicador anos potenciais de vida perdidos e seus derivados. Resultados: No período analisado, as mortes por câncer em Mato Grosso resultaram em 680.338 anos potenciais de vida perdidos antes dos 80 anos, com variação de 82,5%. Desse total, 52,7% foram atribuídos ao sexo masculino. O peso dos anos potenciais de vida perdidos por câncer antes dos 60 anos foi de 70,9% no sexo masculino e 80,1% entre as mulheres. As taxas de anos potenciais de vida perdidos aumentaram no período estudado e apresentaram valores ligeiramente mais elevados entre os homens. Na análise segundo faixas etárias, as taxas de anos potenciais de vida perdidos também foram maiores entre os homens, exceto entre 30 e 49 anos. Os cânceres de pulmão e linfomas/leucemias resultaram em maiores perdas de anos potenciais de vida entre os homens, e os cânceres de especificidade feminina (mama, colo e corpo do útero e ovário) responderam por 36,26% dos anos potenciais de vida perdidos entre as mulheres, com variabilidade por faixas etárias. Conclusão: Em Mato Grosso, o indicador anos potenciais de vida perdidos por câncer apresentou evolução desfavorável entre 2000 e 2019, com maior prejuízo para o sexo masculino e para a população mais jovem. As leucemias, linfomas e cânceres de pulmão e mama foram os principais responsáveis pelos anos potenciais de vida perdidos.

Taxa de mortalidade por câncer de colo de útero na 16ª região de saúde da Paraíba, 2005-2015 / Mortality rate from cervical cancer in the 16th health region of Paraíba, 2005-2015 / Tasa de mortalidad por cáncer del cuello uterino en la 16ª región de salud de Paraíba, 2005-2015

O câncer do colo do útero (CCU) é um problema de saúde pública no Brasil, responsável por altos índices de morbimortalidade entre as mulheres de acordo com os indicadores de saúde. O objetivo deste estudo foi analisar e discutir o comportamento da taxa de mortalidade por CCU na 16ª Região de Saúde entre 2010 e 2015. Este é um estudo transversal retrospectivo, com base em dados retirados do Sistema de Informações sobre Mortalidade (SIM)-Datasus no período de 2005 a 2015. No cenário de mortalidade por CCU na Paraíba, em relação aos respectivos números de óbitos entre os anos de 2005 e 2015 na 16ª Região de Saúde, os municípios de pequeno porte tiveram suas taxas mantidas, porém Campina Grande, região de médio porte, apresentou aumento exponencial a partir de 2012, evidenciando, assim, aumento em todo o estado, além de representar um ponto fora da curva que elevou o índice. Foi possível perceber pouco êxito das políticas de saúde na 16ª Região de Saúde a partir do ano de 2012, pois o número de óbitos triplicou em relação ao ano anterior, mantendo-se crescente até o fim do período estudado, o que demonstrou possível falta de eficácia na gestão e coordenação do cuidado em saúde.

Responsible for high morbidity and mortality rates among women according to health indicators, cervical cancer (CCU) constitutes a public health issue in Brazil. Hence, this retrospective, cross-sectional study analyzes and discusses the CCU mortality rate in the 16th Health Region of Paraíba, Brazil, between 2005 and 2015. Data was collected from the Mortality Information System (SIM)- DATASUS for the 2005-2015 period. Regarding the respective number of deaths between 2005 and 2015, in the scenario of CCU mortality, small municipalities maintained their rates, but Campina Grande, a medium-sized city, showed an exponential increase from 2012, thus evidencing a statewide increase, as well as representing a point outside the curve that raised the index. Health policies were shown to be ineffective in the 16th Health Region from 2012, since the number of deaths tripled in relation to the previous year, and kept increasing until the end of the studied period, demonstrating possible inefficient health care management and coordination.

El cáncer del cuello uterino (CCU) es un problema de salud pública que, en Brasil, presenta altas tasas de morbimortalidad entre las mujeres con respecto a los indicadores de salud. El objetivo de este estudio fue analizar y discutir el comportamiento de la tasa de mortalidad por CCU en la 16ª Región de Salud entre 2010 y 2015. Se trata de un estudio transversal retrospectivo, basado en los datos obtenidos del Sistema de Información de Mortalidad (SIM)-DATASUS en el periodo entre 2005 y 2015. En el escenario de mortalidad por CCU, con respecto al período 2005 y 2015 en la 16ª Región de Salud, los municipios menores mantuvieron sus índices, pero Campina Grande, región de mediano porte, tuvo un aumento exponencial de los casos a partir de 2012, lo que evidencia una alza en todo el estado y representa una excepción que elevó el índice. Se destaca que las políticas de salud en la 16ª Región de Salud tuvieron poco éxito a partir del año 2012, ya que el número de óbitos se triplicó con relación al año anterior y se mantuvo en alza hasta el final del período estudiado, demostrando una posible falta de eficacia en la gestión y coordinación del cuidado en salud.

Effect of short-term consumption of pork supplemented by organic selenium on selenium concentration, antioxidant status, and lipid parameters of consumers.

The aim of the research was to evaluate the impact of consumption of pork enriched with selenium on selenium concentration, antioxidant status and lipid parameters of consumers. The research involved 59 probands in four experiments from the general population of Slovakia. The probands consumed 200 g of enriched meat with organic selenium from pork fed with selenized yeast three times a week during one month. Probands of exp.1 consumed freshly prepared lunch and probands of exp. 2-4 consumed sterilized meat. During the experiment, three blood collections were carried out. After short-term consumption of enriched pork with selenium, concentration of selenium in the blood serum of probands increased significantly in exp. 1 and 4 (P < 0.05). TAS increased significantly after 28 days in exp. 2, 3 and 4 (P < 0.05 and P < 0.001). The level of T-C and TG significantly decreased in exp. 2 and 4 (P < 0.05). HDL-C levels non-significantly increased (P > 0.05) in exp. 1, 3, and 4. The levels of LDL-C significantly decreased in exp. 2 (P < 0.05). These results demonstrated that pork appears to be a suitable component for increase the selenium intake of consumers.