ABSTRACT
Human development rates in the Vale do Jequitinhonha, state of Minas Gerais, Brazil, called "Misery Valley," are among the lowest in the country, not to mention the often precarious psychosocial realities that daily contact with these families reveals. The history of neurosurgery at the Neurosurgical Reference Center at the Vale do Jequitinhonha e Mucuri dates from 2004, when the first neurosurgical procedures were performed in the recently organized Section of Neurosurgery. The historical surgical series shows the positive impact of the service. In 2007, the average was 3 neurosurgeries/month. In the last year, 2018, service growth boosted the record to 34.83 neurosurgeries/month. In addition to performing elective surgery, the neurosurgery team supports the emergency team by performing some neurosurgical procedures. The service number of patients operated since the development of the service is nearly 3,000. Neurosurgery at the Santa Casa de Caridade from Diamantina has been made comparable to the best national neurosurgery services.
Subject(s)
History, 21st Century , Brazil , Neurosurgical Procedures/instrumentation , Hospital Units/history , Neurosurgery/history , Neurosurgery/statistics & numerical dataABSTRACT
This article explores the controversial decision made by the Ministry of Health to restructure the perinatal emergency services in Portugal in 2006. Particular emphasis is given to the protests held across the country against, the actors involved, and the arguments put forward for and against the measure, in an attempt to understand the forms of knowledge and experiences brought to the discussion about the issues raised by the decision, and how different forms of knowledge are reconciled under a democratic process. In addition, this article explores the importance of citizen participation, including that which emerges from conflicting relations, in the formulation of health policies.
O artigo examina o processo de restruturação dos serviços de emergência perinatal implementado pelo Ministério da Saúde em Portugal em 2006 e tem como objetivo analisar essa decisão controversa. Especial ênfase é dada aos protestos desencadeados no país contra essa medida, os atores envolvidos e os argumentos contra e a favor, de forma a compreender os conhecimentos e as experiências trazidos para discussão dos problemas suscitados pela decisão tomada e como diferentes formas de conhecimento podem ser conciliadas no âmbito de procedimentos democráticos. Além disso, explora a relevância da participação cidadã na formulação de políticas de saúde, incluindo aquela que emerge de relações conflitantes.
Subject(s)
Humans , Female , Infant , History, 20th Century , History, 21st Century , Community Participation/history , Dissent and Disputes/history , Emergency Medical Services/history , Health Policy/history , Hospital Units/history , Maternal-Child Health Services/history , Perinatal Care/history , Emergency Medical Services/organization & administration , Infant Mortality/trends , Perinatal Care/organization & administration , Portugal/epidemiology , PregnancyABSTRACT
Por la heroica historia de Ignaz Semmelweis (1818-1865), los médicos hemos sido aconsejados a lavarnos las manos cada vez que examinamos un paciente. Deberíamos hacerlo antes y después, y estar seguros de que él nos viera Una manifiesta y justificada cruzada a favor de la limpieza de los estetoscopios y contra del uso de batas blancas. Corbatas y otras prendas de vestir, ha venido expresándose en ambientes médicos, primero en forma tímida y ahora con mayor fuerza, al aportarse pruebas convenientes acerca de la inconveniencia de llevarlas. La consigna es la eliminación de las corbatas durante la visita o revistas médicas al considerárselas como diseminadoras de infecciones adquiridas en el hospital. Las corbatas más que un probable reservorío de gérmenes son prendas innecesarias por lo que el médico debe reconocer su eventual riesgo. Las nuevas guías de la Brithish Medical Association incluyen un mayor énfasis en el lavado de las manos y de acuerdo a ella, es la intervención más importante en el control de las infecciones. Igualmente, se aboga por un mejor diseño de las salas de hospitalización, mejor provisión de lavamanos o geles antisépticos, políticas más inteligentes en la prescripción de antibióticos y eliminar el uso de ítems tales como corbatas, a veces usadas continuamente y por semanas y solo por raridad enviadas a la lavandería
Since the heroic history of Ignaz Semmelweis (1818´1865), we doctors have been advised to wash our hands every time we examine a patient. We should have to do it before and sfter, and be sure that the patients is seeing us An overt and warranted crusade in favor of cleaning stethoscopes and against the use of medical gowns, neckties and other clothing items has begun expressing itselfin medical spheres, first in timed form and now with greater force, thanks to convincing test regarding the inconvenience of their use. The main message is the alimination of neckties during examinations or medical rounds, considering that these are vehicles of infection acquired in the hospital. Neckties, more than probable reservoirs of germs, are unnecessary clothing items, reason why doctors must recognize their possible risk. The new guidelines of the Medical Brithish Association include a greater emphasis on the washing of hands and according to it, (it) is the most important intervention in the control of infections. Also, it pleads for a better design of hospital rooms, better provision of sink and/or antiseptic gels, more intelligent policies for antibiotic prescriptions and the elimination of the use of items such as neckties, sometimes used continuously and for weeks and only rarely washed