A experiência de profissionais da saúde de um Centro de Saúde Escola do estado de São Paulo na pandemia da Covid-19 / The experience of health professionals from the Centro de Saúde Escola in the state of São Paulo during the Covid-19 pandemic

Em 2020, a Atenção Primária à Saúde do Sistema Único de Saúde cumpriu função de protagonista no combate à Covid-19 como primeiro acesso aos serviços de saúde, que foi considerada Emergência de Saúde Pública e doença pandêmica, exigindo desses serviços e dos profissionais uma reorganização, com fortalecimento do trabalho em equipe para garantir cuidado integral e de qualidade à população. Objetivo: compreender a experiência de profissionais da saúde da Atenção Primária na pandemia. Métodos: estudo qualitativo na abordagem compreensiva, decorrente de projeto maior e aprovado com o Parecer Consubstanciado. Coleta de dados: entre agosto de 2021 e fevereiro de 2022, por entrevistas individuais, síncronas, pela plataforma Google Meet; gravadas pela própria plataforma, transcritas e analisadas segundo referencial metodológico de Bardin, vertente temática. Das unidades de significação originaram categorias e temas propostos. Resultados: cinco categorias: reorganização do processo de trabalho da unidade de saúde; sentimentos demonstrados por profissionais e população; conflito população-profissionais da saúde na adesão à vacinação influenciada pela mídia; indicadores do processo de trabalho durante a pandemia; e (des)conhecimento. Três temas foram identificados: Processo de trabalho da equipe multidisciplinar da unidade de saúde durante a pandemia de 2020 e 2021; Enfrentamento/sentimento dos profissionais e pacientes; Mídia influenciando comportamento da população. Considerações finais: as contribuições do estudo corroboram para desenvolver alternativas para melhorar o cuidado ao paciente; proporcionar condições de apoio aos profissionais, tornando-se necessário que a unidade de saúde forneça suporte psicológico aos profissionais e que os gestores considerem as vivências dos trabalhadores para fortalecer o trabalho em equipe.

In 2020, Primary Health Care (PHC) of the Sistema Único de Saúde (SUS) played a leading role in the fight against Covid-19 as the first access to health services. Covid-19 was considered a Public Health Emergency and a pandemic disease, which required all services and health professionals to reorganize and strengthen teamwork to ensure comprehensive and quality care for the population. Objective: to understand the experience of health professionals working in Primary Care in the Covid-19 pandemic. Methods: qualitative study with a comprehensive approach, resulting from a larger project approved with Embodied Opinion number 4,731,629. Data collection: took place from August 2021 to February 2022, through individual interviews, synchronous, through the Google Meet platform. These were recorded by the platform itself, transcribed and analyzed according to Bardin's Content Analysis methodological framework, thematic approach. From the units of meaning originated the proposed categories and themes. Results: five categories: reorganization of the health unit's work process; feelings shown by professionals and population; conflict population-health professionals in adherence to vaccination influenced by the media; Indicators of the work process during the pandemic and (lack of) knowledge. Three themes were identified: The work process of the health unit's multidisciplinary team during the 2020 and 2021 pandemic; The coping/feeling of professionals and patients; Media influencing population behavior. The study's contributions support the development of alternatives to improve patient care; provide support conditions for professionals. Final considerations: the study's contributions support the development of alternatives to improve patient care; provide support conditions for professionals, making it necessary for the health unit to provide psychological support to professionals and for managers to consider the experiences of workers to strengthen teamwork.

Atención primaria de salud en adultos mayores del Centro de Salud Belén, Loja (Ecuador) / Primary health care in older adults of the Belén Health Center, Loja (Ecuador)

La calidad de atención primaria de salud parte desde la perspectiva individual del servicio recibido en cualquiera de los niveles de atención de salud. La presente investigación tuvo como finalidad identificar el tipo de experiencia de los adultos mayores que acuden al primer nivel de atención primaria del Centro de Salud Belén en el periodo junio - diciembre 2022. Con un enfoque cuantitativo en una población de 91 adultos mayores, a quienes se aplicó el Cuestionario Herramientas de Evaluación de Atención Primaria (PCAT ­ usuarios adultos) donde la experiencia ata en la calidad de atención dentro de la calificación general (≥ 6,6; < 6,6), obtuvo predominio en el sexo femenino 52,75% (n=48) con respecto al 47,25% (n=43) del sexo masculino. La confiabilidad del cuestionario empleado se midió utilizando la prueba estadística de alfa de Cronbach con un valor de 0.79, considerado aceptable. Con los resultados obtenidos se evidencian que la calificación global de la calidad de atención fue alta sin embargo, existen deficiencias en los atributos de la atención primaria dentro del centro, además de un predominio en la consulta de la población femenina con todos los grupos etarios acude con mayor frecuencia con respecto a la masculina (AU)

The quality of primary health care starts from the individual perspective of the service received at any of the levels of health care. The purpose of this research was to identify the type of experience of older adults who attend the first level of primary care at the Belén Health Center in the period June - December 2022. With a quantitative approach in a population of 91 older adults, whom The Primary Care Assessment Tools Questionnaire (PCAT ­ adult users) was applied where experience ties in the quality of care within the general rating (≥ 6.6; < 6.6), obtaining a predominance in the female sex 52,75% (n=48) compared to 47.25% (n=43) of the male sex . The reliability of the questionnaire used was measured using the Cronbach's alpha statistical test with a value of 0.79, considered acceptable. The results obtained showed that the overall rating of the quality of care was high, however, there are deficiencies in the attributes of primary care within the Belén Health Center, in addition to a predominance in the consultation of the female population with all the age groups attend more frequently compared to men (AU)

Analysis of the Bond of Users from Different Basic Health Units with Possible Diagnosis of Non-Communicable Chronic Diseases during the Covid-19 Pandemic in a city in southern Brazil

Non-communicable chronic diseases (NCDs) are considered one of the leading causes of death worldwide. During the COVID-19 pandemic, these diseases have been neglected due to the Brazilian Unified National Health System (BHUS) overload. In this context, this study aimed to analyze the bond between patients with NCDs and primary care during the COVID-19 pandemic while also seeking to identify the population's level of knowledge about health parameters and their relationship with the healthcare system. A cross-sectional and observational study was conducted, in which an online questionnaire was administered to collect socioeconomic information from patients and their bond with BHUS in the metropolitan region of Maringa, Parana, Brazil, encompassing individuals over 18 years of age. The survey was promoted on social media, and interested participants responded to the questionnaire, which addressed topics such as identification, medication use, disease information, knowledge about NCDs, and general data related to COVID-19. The obtained and analyzed responses revealed a low bond level between this population and primary care and a lack of knowledge about NCDs and their health during the pandemic. There was a notable decrease in seeking healthcare services during this period, which may be explained by the fear of contracting the novel coronavirus. This study is essential to understand patients' responses to public health challenges during the pandemic. It can become a valuable ally in dealing with future pandemics and endemic crises, enabling improvements in care and raising awareness among the population about NCDs and the healthcare system.

Las enfermedades crónicas no transmisibles (ENT) son consideradas una de las principales causas de muerte a nivel mundial. Durante la pandemia de COVID-19, estas enfermedades han sido desatendidas debido a la sobrecarga de las Unidades Básicas de Salud (UBS). En ese contexto, el objetivo de este estudio es analizar el vínculo entre los pacientes con enfermedades crónicas no transmisibles (ECNT) y la atención primaria durante la pandemia de COVID-19, buscando identificar el nivel de conocimiento de la población sobre los parámetros de salud y la relación con el sistema de salud. Se realizó un estudio transversal y observacional, en el que se aplicó un cuestionario en línea para recolectar información socioeconómica de los pacientes y su vínculo con las BHU en la región metropolitana de Maringá/PR, abarcando personas mayores de 18 años. La divulgación se realizó en las redes sociales y los interesados respondieron el cuestionario que abordó temas como identificación, uso de medicamentos, información sobre enfermedades, conocimientos sobre ECNT y datos generales relacionados con el COVID-19. Las respuestas obtenidas y analizadas revelaron un bajo nivel de vinculación de esta población con la atención primaria, así como un desconocimiento sobre las ECNT y su propia salud durante la pandemia. Hubo una notable reducción en la demanda de servicios de salud durante este período, lo que puede explicarse por el temor a la contaminación por el nuevo coronavirus. Este estudio se presenta como una herramienta importante para comprender la respuesta de los pacientes a los desafíos de salud pública durante la pandemia. Puede convertirse en un valioso aliado para enfrentar futuras pandemias y crisis endémicas, posibilitando mejoras en la atención y concientización de la población sobre las ECNT y el sistema de salud.

As doenças crônicas não transmissíveis (DCNTs) são consideradas uma das principais causas de morte em todo o mundo. Durante a pandemia da COVID-19, essas doenças têm sido negligenciadas devido à sobrecarga das Unidades Básicas de Saúde (BHU). Neste contexto, o objetivo deste estudo é analisar o vínculo dos pacientes com DCNTs com a atenção primária durante a pandemia da COVID-19, ao mesmo tempo em que busca identificar o nível de conhecimento da população sobre os parâmetros de saúde e o relacionamento com o sistema de saúde. Realizou-se um estudo transversal e observacional, no qual foi aplicado um questionário online para coletar informações socioeconômicas dos pacientes e seu vínculo com as BHUs na região metropolitana de Maringá/PR, abrangendo indivíduos maiores de 18 anos. A divulgação foi realizada em mídias sociais e os interessados responderam ao questionário que abordou tópicos como identificação, uso de medicações, informações sobre doenças, conhecimento acerca das DCNTs e dados gerais relacionados à COVID-19. As respostas obtidas e analisadas revelaram um baixo nível de vínculo dessa população com a atenção primária, assim como uma falta de conhecimento sobre as DCNTs e a própria saúde durante a pandemia. Observou-se uma notável redução na procura por serviços de saúde durante esse período, o que pode ser explicado pelo receio da contaminação pelo novo coronavírus. Este estudo se apresenta como uma ferramenta importante para compreender a resposta dos pacientes frente aos desafios da saúde pública durante a pandemia. Ele pode se tornar um aliado valioso para lidar com futuras pandemias e crises endêmicas, possibilitando melhorias nos cuidados e na conscientização da população sobre as DCNTs e o sistema de saúde.

Factores de riesgo cardiovascular en pacientes geriátricos atendidos en el centro de salud INNFA / Cardiovascular risk factors in geriatric patients attended at the INNFA health center / Factores de risco cardiovascular em doentes geriátricos atendidos no centro de saúde do INNFA

Los llamados factores de riesgo cardiovascular conductuales, como la dieta inadecuada, sedentarismo, el consumo excesivo de alcohol y el tabaquismo, aumentan la probabilidad de ataque cardíaco y accidente cerebrovascular, incluso cuando coexisten en personas sin padecimientos previos. Objetivo fue identificar los factores de riesgo cardiovascular en pacientes geriátricos del Centro de salud INNFA, en Macas, Ecuador. Metodología: Investigación con enfoque cuantitativo, diseño no experimental, alcance descriptivo, de corte transversal, empleó una muestra de 40 pacientes geriátricos atendidos en el Centro de Salud referido, la técnica para la recolección de datos fue la encuesta y el instrumento un cuestionario de riesgos cardiovasculares. La muestra de estudio se caracterizó por el predominio del sexo femenino y edades entre 60 y 69 años en los pacientes, condiciones socio-económicas que pueden incrementar el riesgo cardiovascular como como nivel educativo básico y la remuneración menor a un salario básico unificado. Conclusión: La mayoría de los pacientes presentaban dos o más factores de riesgo y entre estos predominaron la hipertensión arterial, hipercolesterolemia, sobrepeso, consumo excesivo de bebidas alcohólicas y la diabetes mellitus.

The so-called behavioral cardiovascular risk factors, such as inadequate diet, sedentary lifestyle, excessive alcohol consumption, and smoking, increase the probability of heart attack and stroke, even when they coexist in persons with no previous conditions. The objective was to identify cardiovascular risk factors in geriatric patients at the INNFA health center in Macas, Ecuador. Methodology: Research with a quantitative approach, non-experimental design, descriptive scope, cross-sectional, used a sample of 40 geriatric patients attended at the referred health center, the technique for data collection was the survey and the instrument was a cardiovascular risk questionnaire. The study sample was characterized by the predominance of female sex and age between 60 and 69 years in patients, socio-economic conditions that may increase cardiovascular risk such as basic education level and remuneration lower than a unified basic salary. Conclusion: Most of the patients had two or more risk factors and among these, arterial hypertension, hypercholesterolemia, overweight, excessive consumption of alcoholic beverages and diabetes mellitus predominated.

Os chamados factores de risco cardiovascular comportamentais, como a alimentação inadequada, o sedentarismo, o consumo excessivo de álcool e o tabagismo, aumentam a probabilidade de enfarte do miocárdio e de acidente vascular cerebral, mesmo quando coexistem em pessoas sem patologias prévias. O objetivo foi identificar os factores de risco cardiovascular em pacientes geriátricos do centro de saúde INNFA em Macas, Equador. Metodologia: Investigação com abordagem quantitativa, desenho não experimental, âmbito descritivo, transversal, com uma amostra de 40 pacientes geriátricos atendidos no referido centro de saúde, a técnica de recolha de dados foi um inquérito e o instrumento foi um questionário de risco cardiovascular. A amostra do estudo caracterizou-se pelo predomínio do sexo feminino e idade entre 60 e 69 anos, condições socioeconómicas que podem aumentar o risco cardiovascular como o nível de escolaridade básico e remuneração inferior a um salário base unificado. Conclusão: A maioria dos pacientes apresentava dois ou mais fatores de risco e, dentre estes, predominaram a hipertensão arterial, a hipercolesterolemia, o excesso de peso, o consumo excessivo de bebidas alcoólicas e o diabetes mellitus.

Vivenciando o cuidado em saúde bucal para pessoas idosas em acompanhamento em saúde mental: relato de experiência / Experiencing oral health care aimed at older people undergoing mental health care: an experience report

A interlocução entre saúde mental, pessoas idosas e saúde bucal é um assunto que precisa ser abordado na formação em Odontologia. Mesmo que em um curto período dentro dos 5 anos de formação, um momento em que estes temas se encontram em um estágio extramuros mostra-se interessante e enriquecedor. O objetivo do presente artigo é apresentar um relato de experiência de estudantes de Odontologia na promoção da saúde dentro do escopo da Odontologia em uma instituição de longa permanência em um município do Rio Grande do Sul. Metodologicamente, o presente relato de experiência foi estruturado de acordo com o referencial teórico para Sistematização de Experiências, seguindo os seguintes passos: descrição do ponto de partida, elaboração de perguntas iniciais, reflexão sobre o processo vivido e descrição e apresentação dos pontos finais da experiência. As 7 estudantes de graduação envolvidas nesta experiência planejaram e desenvolveram, com professores-tutores e supervisores locais, ações de cuidado e educação em saúde bucal para 32 pessoas institucionalizadas. As atividades desenvolvidas geraram engajamento mútuo, tanto das estagiárias quanto dos residentes e trabalhadores da instituição. Neste contexto, este texto apresenta experiências em uma narrativa permeada pelas dificuldades, potencialidades e motivações para o aprendizado da Odontologia (AU).

El diálogo entre salud mental, personas mayores y salud bucal es un tema que es necesario abordar en la formación de Odontología. Aunque sea en un corto período dentro de los 5 años de formación, un momento en el que estos temas se encuentran en una etapa extramuros resulta interesante y enriquecedor. El objetivo de este artículo es presentar un relato de experiencia de estudiantes de Odontología en la promoción de la salud en el ámbito de la Odontología en una institución de larga duración en una ciudad de Rio Grande do Sul. Metodológicamente, este relato de experiencia se estructuró de acuerdo con el marco teórico para Sistematización de Experiencias, siguiendo los siguientes pasos: descripción del punto de partida, elaboración de preguntas iniciales, reflexión sobre el proceso vivido y descripción y presentación de los puntos finales de la experiencia. Las 7 estudiantes de pregrado involucradas en esta experiencia planificaron y desarrollaron, con profesores-tutores y supervisores locales, acciones de educación y atención en salud bucal para 32 personas institucionalizadas. Las actividades desarrolladas generaron un compromiso mutuo, tanto entre los pasantes como entre los residentes y trabajadores de la institución. En este contexto, este texto presenta experiencias en una narrativa permeada por las dificultades, potencialidades y motivaciones para aprender Odontología (AU).

The dialogue between mental health, older people and oral health is a topic that must be addressed in Dentistry training. Even if in a short period within the 5 years of training, the moment when these themes come together in an internship program outside the college walls proves to be interesting and enriching. The objective of this article is to present an experience report of Dentistry students aimed at promoting healthwithin the scope of Dentistry in a long-term institution located in a municipality in the state of Rio Grande do Sul. Methodologically, this experience report was structured according to the theoretical framework for Systematization of Experiences and followed these steps: description of the starting point, formulation of the initial questions, reflection about the process experienced and, finally, description and presentation of the end points of the experience. The 7 undergraduate students participating in this experience, together with tutor-professors and local supervisors, planned and developed care and educational actions focused on oral health for 32 institutionalized individuals. The activities developed generated mutual engagement between the interns and the institution's residents and workers. In this context, this article presents experiences that followed a narrative permeated by the difficulties, potentialities, and motivations encountered in the Dentistry learning process (AU).

Status quo of Chinese educational research in community bases for general practice standardized residency training: a bibliometric study / 中华全科医师杂志

Objective:To investigate the status quo of educational and teaching research in community bases for general practice standardized residency training in China.Methods:The studies related to education research in community bases for general practice standardized residency training were searched from Chinese Journal Full Text Database (CNKI), Wanfang Database and China Science and Technology Journal Database (VIP) from inception to November 30, 2023. The keywords of "standardized training of general practitioner residents" or "general practice standardized training" or "general practitioner standardized training" or "general practice training" and "community-based teaching " or "community training" "community base" or "community teaching" were used for search, and affiliations of authors should contain"community health service center". The literature was read and summarized using Endnote and Excel software.Results:A total of 171 articles were retrieved that met the criteria, and 130 articles were finally selected for analysis according to the quality review criteria of the literature. The authors of articles were distributed in 78 institutions of 17 provinces or regions, with 9 provinces or regions having a total of 123 articles (94.6%) with 2 published articles or more, of which the highest number was found in Beijing and Shanghai. Seventeen institutions published 2 or more articles with a total of 69 articles (53.1%), including 67 articles (51.5%) were co-authored by 2 units. The ranking top ten institutions in terms of the number of articles published were 5 community health service centers in Beijing, 4 in Shanghai (co-authored with Shanghai Zhongshan Hospital). There were 46 articles (35.4%) published in core journals and 55 articles (42.3%) with fund-supported projects. The studies presented teaching methods, teaching and training contents, teaching evaluation and effects, teacher training, teaching base construction and information technology application.Conclusion:The educational and teaching research in community bases for general practice standardized training in China has gradually received attention, the researches were mainly carried out by community medical institutions, but the overall quality of research needs to be further improved.

Health status and needs of occupational population in an industrial park in Shanghai, China / 中华全科医师杂志

Objective:To investigate the health status and needs of the occupational population in an industrial park in Shanghai, and to explore the causes.Methods:The study was a mixed method study. First, a list of health needs of the occupational population was developed through literature review. Then, a questionnaire was prepared on the basis of the list of health needs of the occupational population, which consisted of 4 parts: basic personal information, health status, medical care, and health needs. From September 16 to October 9, 2022, 3 enterprises of representative size and industry in Shanghai Xinzhuang Industrial Park were selected by convenience sampling method, and the target sample size was allocated in equal proportions according to the total number of employees, and the Quick Response code of the electronic questionnaire was distributed (Questionnaire Star). Finally, an interview outline was created based on the results of the questionnaire survey to gain a deeper understanding of the connotations and reasons for the health needs of employees, etc. The interviews were conducted from October 15 to 22, 2022.Results:A total of 819 enterprise employees were surveyed, of whom 580 (70.82%) were male, and their age was mainly concentrated in the 19-44 age group (621(75.82%)). Among them, 348 (42.49%) were overweight or obese, 388 (47.37%) had regular medical check-ups, and only 224 (27.35%) had active health interventions. The top 5 health needs of the surveyed population were relief of visual fatigue (365(44.57%)), improvement of sleep (355(43.35%)), relief of physical fatigue (343(41.88%)), oral health (333(40.66%)), and immunity enhancement (332(40.54%)). The interviewees were from 2 large enterprises, totaling 12 people. The results of the interviews showed that excessive use of mobile phones, high stress, interpersonal and social confusion, retaliatory late nights, sedentary lifestyles, and socializing were the main causes of health problems.Conclusions:The health status of the occupational population in Shanghai Xinzhuang Industrial Parks is not optimistic, and their health needs are obvious. Their health problems and needs are related to the characteristics of their work patterns.

Maternal and perinatal outcomes of minimally invasive fetal surgeries: experience from two reference centers in Rio de Janeiro, Brazil

ABSTRACT BACKGROUND: Concerns regarding high open surgery-related maternal morbidity have led to improvements in minimally invasive fetal surgeries. OBJECTIVE: To analyze the perinatal and maternal outcomes of minimally invasive fetal surgery performed in Rio de Janeiro, Brazil. DESIGN AND SETTING: Retrospective cohort study conducted in two tertiary reference centers. METHODS: This retrospective descriptive study was conducted using medical records from 2011 to 2019. The outcomes included maternal and pregnancy complications, neonatal morbidity, and mortality from the intrauterine period to hospital discharge. RESULTS: Fifty mothers and 70 fetuses were included in this study. The pathologies included twin-twin transfusion syndrome, congenital diaphragmatic hernia, myelomeningocele, lower urinary tract obstruction, pleural effusion, congenital upper airway obstruction syndrome, and amniotic band syndrome. Regarding maternal complications, 8% had anesthetic complications, 12% had infectious complications, and 6% required blood transfusions. The mean gestational age at surgery was 25 weeks, the mean gestational age at delivery was 33 weeks, 83% of fetuses undergoing surgery were born alive, and 69% were discharged from the neonatal intensive care unit. CONCLUSION: Despite the small sample size, we demonstrated that minimally invasive fetal surgeries are safe for pregnant women. Perinatal mortality and prematurity rates in this study were comparable to those previously. Prematurity remains the most significant problem associated with fetal surgery.

Ultra-processed food consumption during pregnancy and newborn weight / Consumo de alimentos ultraprocessados durante a gestação e peso ao nascer do recém-nascido

Abstract Objectives: to assess the association between pregnant women's consumption of ultra-processed foods and newborn body weight. Methods: prospective study with pregnant women (n=214) selected from all Basic Health Units in the city of Pinhais, Paraná. Socioeconomic, demographic, and health data were collected. Food consumption data were assessed using a 24-hour dietary recall and tabulated with GloboDiet software. Daily relative energy intake of ultra-processed food was estimated and logistic regression analysis was utilized. The infuence of covariates on the association analysis was also explored (e.g., income and education). Results: ultra-processed foods contributed to 26.9% of pregnant women's total energy intake. About 5.7% of newborns were classifed as small-for-gestational-age and 10.7% as large-for-gestational-age. A borderline statistically signifcant association was observed between large-for-gestational-age newborn weight and maternal consumption of ultra-processed foods (OR= 1.027; p=0.048). Additionally, family income was associated with the consumption of ultra-processed foods (OR= 0.144; p=0.008). With each additional 1% consumption of ultra-processed foods, mothers' likelihood of having large-for-gestational-age babies increased by about 2.7%. Conclusions: the study reveals a trend of positive association between the weight of large-for-gestational-age newborns and the consumption of ultra-processed foods by pregnant women, but not for small-for-gestational-age children.

Resumo Objetivos: avaliar a associação entre o consumo de alimentos ultraprocessados por gestantes e o peso de recém-nascidos. Métodos: estudo prospectivo com gestantes (n=214) selecionadas em Unidades Básicas de Saúde em Pinhais, Paraná. Dados socioeconômicos, demográfcos e de saúde foram coletados. Dados de consumo alimentar foram coletados por recordatório de 24-horas físico e entrados no software GloboDiet. O consumo diário relativo de energia proveniente de alimentos ultraprocessados foi estimado e a análise de regressão logística foi utilizada, considerando covariáveis como renda familiar e escolaridade. Resultados: o consumo de alimentos ultraprocessados pelas gestantes representou 26,9% da energia total. Cerca de 5,7% de recém-nascidos foram classifcados como pequenos para idade gestacional (PIG) e 10,7% como grandes para idade gestacional (GIG). Foi observada uma associação estatisticamente signifcativa limítrofe entre o peso dos recém-nascidos GIG e o consumo materno de alimentos ultraprocessados (OR= 1,027; p=0,048). Além disso, a renda familiar esteve associada com o consumo de alimentos ultraprocessados (OR=0,144; p=0,008). A cada 1% adicional de consumo de alimentos ultraprocessados, a probabilidade de as mães terem recém-nascidos GIG aumentou cerca de 2,7%. Conclusões: o estudo revela uma tendência de associação positiva entre o peso de recém-nascidos GIG e o consumo de alimentos ultraprocessados por mulheres grávidas, mas não para crianças PIG.

Evolution of the availability of Information and Communication Technologies in primary health care in Brazil, 2012 to 2018 / Evolução da disponibilidade de Tecnologias de Informação e Comunicação na Atenção Primária à Saúde do Brasil, 2012 a 2018

ABSTRACT Objective: To verify the evolution of the availability of information and communication technology equipment and inputs in primary health care services that participated in the external evaluation of the Access and Quality Improvement Program in Primary Care and its distribution according to context characteristics social and geographic. Methods: Cross-sectional study, analyzed the distribution of information and communication technology equipment in basic health units in Brazil, during the three cycles (2012 to 2018) of the Program for Improving Access and Quality in Primary Care. The variables were examined at the municipal level and stratified by geopolitical region. Univariate analysis was performed, using the chi-square test and testing the distributions of exposures among themselves and between the outcome and exposures. Results: The availability of information and communication technology equipment increased from 9.4% (2012) to 17.5% (2018), with emphasis on the Southeast and South regions, in municipalities with a population size of up to 10,000 inhabitants², with greater family health coverage and high/very high HDI-M. Over the period from 2012 to 2018, basic units joined the program and increased availability of information and communication technologies, such as Internet access, which ranged from 45.2% (n=6,249) to 74.0% (n=21,423), with emphasis on the Northeast region, which increased from 19.1% (n=970) to 58.8% (n=7,087). Conclusion: Investment in technologies and constant evaluation of primary care in the country is necessary, contributing to its strengthening.

RESUMO Objetivo: Verificar a evolução da disponibilidade de equipamentos e insumos de tecnologia de informação e comunicação nos serviços de Atenção Primária à Saúde que participaram da avaliação externa do Programa de Melhoria do Acesso e da Qualidade na Atenção Básica e sua distribuição de acordo com características do contexto social e geográfico. Métodos: Estudo transversal, que analisou a distribuição de equipamentos de tecnologia de informação e comunicação nas unidades básicas de saúde do Brasil, durante os três ciclos (2012 a 2018) do Programa de Melhoria do Acesso e da Qualidade na Atenção Básica. As variáveis foram examinadas no nível dos municípios e estratificadas por região geopolítica. Realizou-se análise univariada, com o uso do teste χ2 e teste das distribuições das exposições entre si e entre o desfecho e as exposições. Resultados: A disponibilidade do conjunto de equipamentos de tecnologias de informação e comunicação evoluiu de 9,4% (2012) para 17,5% (2018), com destaque às Regiões Sudeste e Sul, em municípios com porte populacional de até 10 mil hab.², com maior cobertura de saúde da família e índice de desenvolvimento humano municipal — IDH-M alto/muito alto. Ao longo do período de 2012 a 2018, houve adesão de unidades básicas ao programa e aumento na disponibilidade de tecnologias de informação e comunicação, como o acesso à internet, que foi de 45,2% (n=6.249) a 74,0% (n=21.423), com destaque para a Região Nordeste com aumento de 19,1% (n=970) a 58,8% (n=7.087). Conclusão: São necessários o investimento em tecnologias e a constante avaliação da atenção primária no país, contribuindo para seu fortalecimento.

The reality of epilepsy in primary care in Rio de Janeiro: the importance of educational projects for better patient care / A realidade da epilepsia na atenção primária no Rio de Janeiro: a importância de projetos educacionais para o melhor cuidado ao paciente

Abstract Background The Basic Health Unit (Unidade Básica de Saúde - UBS, in Portuguese) is the first point of contact in the public healthcare system for people with epilepsy. Primary care professionals need to appropriately diagnose, treat, and refer, if necessary, to tertiary services. Objective To evaluate the knowledge of UBS professionals on the management of patients with epilepsy in Rio de Janeiro. Methods Online questionnaires were performed on the topic of epilepsy before and after exposure to classes taught by epileptologists. Results A total of 66 doctors participated, 54.5% of whom were residents or trained in family medicine. The majority had from 1 to 3 years of practice. Insecurity prevailed in the management of pregnant women and the elderly. Around 59.1% of the participants referred patients with seizures without examinations. A total of 78% of the participants did not correctly classify seizure types, and 2/3 did not define drug-resistant epilepsy. Induction and broad-spectrum drugs were common. The therapeutic decision depended on availability in the basic health unit (UBS) (81.8%), dosage (60.6%), side effects (34.8%), and age (36.4%). Comorbidities and sex influenced 1/4 of the sample. For 23% of the participants, the type of crisis did not affect the choice. Regarding typical non-pharmacological options, 75% of the participants were aware of cannabidiol, 40.9% of surgery, 22.7% of ketogenic diet, and 22.8% of deep brain stimulation/vagus nerve stimulation (DBS/VNS). A total of 90.2% indicated the need for training. Conclusion There are deficits in the knowledge of UBS professionals in the management of epilepsy. Specialized training is imperative to optimize the care offered within SUS.

Resumo Antecedentes A Unidade Básica de Saúde (UBS) é o primeiro contato no sistema público de saúde para pessoas com epilepsia. Profissionais de atenção primária precisam diagnosticar, tratar e encaminhar adequadamente, se necessário, a serviços terciários. Objetivo Avaliar o conhecimento dos profissionais das UBSs sobre o manejo de pacientes com epilepsia no Rio de Janeiro. Métodos Foram realizados questionários online sobre o tema da epilepsia pré e pós exposição a aulas ministradas por epileptólogos. Resultados Participaram 66 médicos, sendo 54,5% residentes ou formados em medicina da família. A maioria tinha de 1 a 3 anos de prática. A insegurança prevaleceu no manejo de gestantes e idosos. Cerca de 59,1% dos participantes encaminhavam pacientes com crises sem exames. Um total de 78% dos participantes não classificou corretamente tipos de crises, e 2/3 não definiram epilepsia farmacorresistente. Fármacos indutores e de amplo espectro foram comuns. A decisão terapêutica dependeu da disponibilidade na Unidade Básica de Saúde (UBS) (81,8%), posologia (60,6%), efeitos colaterais (34,8%) e idade (36,4%). Comorbidades e sexo influenciaram 1/4 da amostra. Para 23% dos participantes, o tipo de crise não afetou a escolha. Quanto a opções não farmacológicas típicas, 75% conheciam o canabidiol, 40,9% a cirurgia, 22,7% a dieta cetogênica, 22,8% a estimulação cerebral profunda/estimulação do nervo vago (ECP/ENV). Um total de 90,2% dos participantes indicou necessidade de treinamento. Conclusão Há déficits no conhecimento dos profissionais das UBSs no manejo da epilepsia. O treinamento especializado é imperativo para otimizar o cuidado oferecido no âmbito do SUS.

Juegos y prácticas como micropolíticas en las instituciones sociales del Estado / Plays and practices as micropolitics in State social institutions

RESUMEN El objetivo de este ensayo es analizar el juego como un elemento central en las prácticas que construyen micropolíticas en las instituciones sociales del Estado. Los principales conceptos que se trabajan son: juego, prácticas y micropolíticas. El análisis se recorta a las instituciones de los campos sociales haciendo énfasis en el tamaño material. La hipótesis es que el tamaño de la organización es inversamente proporcional al desarrollo del juego en las instituciones. Esta discusión se da en un contexto marcado por un fuerte desapego a lo público y a lo estatal, lo cual no hace más que agravar las profundas desigualdades sociales, el nihilismo y la aporofobia, con una crisis de legitimidad de las instituciones públicas frente al avance de ideas no democráticas en gobiernos elegidos democráticamente en varios países de América Latina y de otros continentes.

ABSTRACT The aim of this essay is to analyze plays as a central element in the practices that construct micropolitics within the social institutions of the State. The main concepts addressed are: plays, practices, and micropolitics. The analysis focuses on institutions within social fields, emphasizing material size. The hypothesis posits that the size of the organization is inversely proportional to the development of plays within the institutions. This discussion takes place in a context marked by a strong detachment from the public and the state, exacerbating profound social inequalities, nihilism, and aporophobia, alongside a crisis of legitimacy of public institutions in the face of the advance of non-democratic ideas in democratically elected governments in several countries in Latin America and other continents.

Sistematização da assistência de enfermagem: percepção de uma equipe multiprofissional na atenção primária à saúde / Sistematización de la atención de enfermería: la percepción de un equipo multiprofesional en atención primaria de la salud / Systematization of nursing care: the perception of a multiprofessional team within the primary health care scope

Objetivo: analisar a percepção da equipe multiprofissional acerca da sistematização da assistência de enfermagem na atenção primária à saúde. Método: estudo de análise temática reflexiva, com abordagem qualitativa, fundamentado no estudo de caso único, realizado no ano de 2021. O cenário constituiu-se de unidade básica de saúde, onde participaram 14 colaboradores da equipe multiprofissional. A coleta de dados foi realizada por meio de entrevistas semiestruturadas, utilizando gravadores digitais, seguindo a análise de dados indutiva. O estudo foi aprovado eticamente. Resultados: foram extraídas duas categorias empíricas referindo-se ao conhecimento da equipe face as atribuições do enfermeiro na atenção primária, bem como as facilidades e as dificuldades enfrentadas pelo enfermeiro no cotidiano de trabalho na implementação da sistematização da assistência de enfermagem. Considerações finais: a sistematização da assistência de enfermagem ainda apresenta incipiente para a equipe multiprofissional, tornando inviável a aplicação desta ferramenta pelo enfermeiro no seu processo de trabalho.

Objetivo: analizar la percepción del equipo multiprofesional acerca de la Sistematización de la Atención de Enfermería en Atención Primaria de la Salud. Método: estudio de análisis temático reflexivo con enfoque cualitativo, fundamentado en el estudio de un único caso y realizado en el año 2021. El escenario de la investigación fue una unidad básica de salud en la que participaron 14 trabajadores del equipo multiprofesional. Los datos se recolectaron por medio de entrevistas semiestructuradas, utilizando grabadoras digitales y siguiendo la técnica de análisis inductivo de datos. El estudio contó con la debida aprobación ética. Resultados: se extrajeron dos categorías empíricas referidas al conocimiento del equipe frente a los deberes de los enfermeros en Atención Primaria, al igual que las facilidades y dificultades enfrentadas por los enfermeros en la rutina de trabajo al implementar la Sistematización de la Atención de Enfermería. Consideraciones finales: la Sistematización de la Atención de Enfermería sigue siendo incipiente para el equipo multiprofesional, lo que impide que los enfermeros apliquen esta herramienta en su proceso de trabajo.

Objective: to analyze the multiprofessional team perception regarding the Systematization of Nursing Care in Primary Health Care. Method: a reflective thematic analysis study with a qualitative approach based on a single case study carried out in 2021. The scenario consisted of a basic health unit and the participants were 14 staff members from its multiprofessional team. Data collection was carried out through semi-structured interviews using digital recorders and following an inductive data analysis. The study was ethically approved. Results: two empirical categories were extracted, one referring to the team's knowledge about nurses' duties in Primary Health Care and the other related to the facilitating factors and difficulties faced by nurses in their daily effort to implement the Systematization of Nursing Care. Final considerations: the Systematization of Nursing Care still proved to be incipient for the multiprofessional team, making it unfeasible for nurses to apply this tool in their work process.

El cuidado de niños y adolescentes negros con problemas de salud mental en la interseccionalidad entre género y raza / The care provided to black-skinned children and adolescents with mental health problems in the intersection between gender and race / O cuidado de crianças e adolescentes negros com problemas de saúde mental na interseccionalidade entre gênero e raça

Objetivo: caracterizar el perfil sociofamiliar de niños y adolescentes negros con problemas de salud mental y describir desde un enfoque interseccional quién es responsable de su cuidado. Método: estudio exploratorio descriptivo de enfoque cualitativo, llevado a cabo en un Centro de Atención Psicosocial Infantil y Juvenil de la región norte del municipio de São Paulo. La recolección de datos se realizó con 47 familiares de niños y adolescentes negros, con el soporte de un guion con variables predefinidas, sometidas a análisis estadístico. Resultados: se realizaron 49 entrevistas, 95,5% con mujeres, con edad promedio de 39 años, 88,6% madres, 85,7% negras. La renta familiar procede del salario para el 100% de los cuidadores hombres y el 59% de las mujeres. Entre las cuidadoras negras, 25% tienen casa propia y, entre las pardas, 46,2%. Del total de cuidadores, el 10% vive en casas ocupadas, el 20% vive en viviendas cedidas, el 35% tiene casa propia y el 35% alquila. La red de contención social es mayor entre los blancos (16,7%), seguidos por los pardos (3,8%) y está ausente entre los negros (0%). Conclusión: las responsables por el cuidado de niños y e adolescentes negros atendidos en el CAPSij, son, casi en su totalidad mujeres, "madres o abuelas" negras (o mulatas), con acceso desigual a educación, trabajo y vivienda, derechos sociales constitucionales en Brasil.

Objective: to characterize the sociofamily profile of black-skinned children and adolescents with mental health problems and to intersectionally describe who assumes responsibility for their care. Method: a descriptive and exploratory study with a quantitative approach, developed in the Psychosocial Care Center for Children and Adolescents from the North region of the municipality of São Paulo. The data were collected from 47 family members of black-skinned children and adolescents, using a script with predefined variables submitted to statistical analysis. Results: a total of 49 interviews were conducted: 95.5% women with a mean age of 39 years old, 88.6% mothers and 85.7% black-skinned. Family income comes from wages for all the male caregivers and for 59% of the women. Among the black-skinned female caregivers, 25% live in their own house, whereas this percentage is 46.2% among the brown-skinned ones. Of all the caregivers, 10% have a job, 20% live in transferred properties, 35% in houses of their own and 35% in rented places. The social support network is larger among white-skinned people (16.7%), followed by brown-skinned (3.8%), and absent among black-skinned individuals (0%). Conclusion: those responsible for the care of black-skinned children and adolescents monitored by the CAPS-IJ are almost entirely women, black-skinned (black or brown) "mothers or grandmothers", with unequal access to education, work and housing, constitutional social rights in Brazil.

Objetivo: caracterizar o perfil sociofamiliar de crianças e adolescentes negros com problemas de saúde mental e descrever interseccionalmente quem se responsabiliza por seus cuidados. Método: estudo descritivo exploratório de abordagem quantitativa, desenvolvido em um Centro de Atenção Psicossocial Infantojuvenil da região norte do município de São Paulo. Os dados foram coletados com 47 familiares de crianças e adolescentes negros, utilizando um roteiro com variáveis pré-definidas, submetidas à análise estatística. Resultados: foram realizadas 49 entrevistas, sendo 95,5% com mulheres, média de idade de 39 anos, 88,6% mães, 85,7% negras. A renda familiar é proveniente de salário, para 100% dos cuidadores homens e para 59% das mulheres. Dentre as cuidadoras pretas, 25% possuem casa própria, sendo que, dentre as pardas, 46,2%. Do total de cuidadores, 10% vivem em condições de ocupação, 20% habitam moradias cedidas, 35% casas próprias e 35% alugadas. A rede social de suporte é maior entre os brancos (16,7%), seguido pelos pardos (3,8%) e ausente entre os pretos (0%). Conclusão: as responsáveis pelo cuidado de crianças e adolescentes negros acompanhados pelo CAPSij, são na quase totalidade mulheres, "mães ou avós" negras (pretas ou pardas), com acesso desigual à educação, trabalho e moradia, direitos sociais constitucionais no Brasil.

Prevalência de insônia, comorbidades associadas e uso de benzodiazepínicos por profissionais da Atenção Primária à Saúde / Prevalence of chronic insomnia, associated comorbidities and use of benzodiazepines by Primary Health care professionals

Introdução: A insônia é capaz de modificar o padrão do sono e afetar a saúde e a funcionalidade das atividades desempenhadas pelo indivíduo. Os profissionais da área da saúde se apresentam como uma população em risco para a insônia, devido às características de seu trabalho. Objetivos: Este estudo analisou a prevalência de insônia e a presença de comorbidades entre esses profissionais. Métodos: Foi realizado um estudo observacional, transversal, em agentes comunitários de saúde (ACS), enfermeiros (ENF), médicos (MED) etécnicos de enfermagem (TEC) que atuam nas Unidades Básicas de Saúde (UBS) de um município do sul de Santa Catarina (SC), no período de maio até outubro de 2021. Os dados foram coletados por meio da aplicação de um questionário on-line auto administrado, via Google Docs. Os questionários foram aplicados em 168 profissionais de saúde, os quais foram alocados em dois grupos: ACS (93) e TEC (22), totalizando 115 participantes; ENF (24) e MED (29), com 53 participantes. As variáveis analisadas foram: perfil sociodemográfico e estilo de vida dos profissionais; presença de ansiedade, depressão, dor crônica e utilização de benzodiazepínico (BZD); presença de insônia; gravidade da insônia e bem-estar mental atual. Resultados: 53% dos ACS/TEC apresentam insônia (59%insônia leve, 32,8% insônia moderada, 8,2% insônia grave), 54,8% ansiedade, 33% depressão, 31,3% dor crônica e 23,5% utilizam benzodiazepínicos (BZD). Entre os ENF e MED, a prevalência de insônia foi de 34% (61,1% insônia leve e 38,9% insônia moderada), 35,8% ansiedade, 13,2% depressão, 5,7% crônica e 5,7% utilizam BZD. Conclusão: Foi possível constatar maior prevalência de insônia, ansiedade, depressão, dor crônica e utilização de benzodiazepínicos entre os profissionais de saúde quando comparados com a população geral, especialmente entre os ACS e TEC.

Introduction: Insomnia is able to modify the sleep pattern and affect the health and functionality of the activities performed by the individual. Health professionals are a population at risk for insomnia, due to the characteristics of their work. Objectives: This study analyzed the prevalence of insomnia and the presence of comorbidities among these professionals. Methods: An observational, cross-sectional study was carried out with community health agents (ACS), nurses (ENF), physicians (MED) and nursing technicians (TEC) who work in Basic Health Units (UBS) in a municipality in the south of Brazil. of Santa Catarina (SC), from May to October 2021. Data were collected through the application of a self-administered online questionnaire, via Google Docs. The questionnaires were applied to 168 health professionals, who were divided into two groups: ACS (93) and TEC (22), totaling 115 participants; ENF (24) and MED (29), with 53 participants. The variables analyzed were: sociodemographic profile and lifestyle of professionals; presence of anxiety, depression, chronic pain and use of benzodiazepines (BZD); presence of insomnia; severity of insomnia and current mental well-being. Results: 53% of the ACS/TEC have insomnia (59% mild insomnia, 32.8% moderate insomnia, 8.2% severe insomnia), 54.8% anxiety, 33% depression, 31.3% chronic pain and 23, 5% use benzodiazepines (BZD). Among ENF and MED, the prevalence of insomnia was 34% (61.1% mild insomnia and 38.9% moderate insomnia), 35.8% anxiety, 13.2% depression, 5.7% chronic and 5. 7% use BZD. Conclusion: It was possible to observe a higher prevalence of insomnia, anxiety, depression, chronic pain and use of benzodiazepines among health professionals when compared to the general population, especially among CHA and TEC.

Implementación del plan de estudio de enfermería a distancia durante la pandemia de COVID-19 / The Implementation of a Nursing Distance Curriculum during the COVID-19 Pandemic

Introducción: La pandemia de COVID-19 ha ocasionado que las universidades deban transitar de un plan de estudios presencial a la educación a distancia de emergencia. Para la Escuela de Enfermería de la Universidad de Chile, se adiciona la imposibilidad de asistir a centros de salud con estudiantes, por la crisis sanitaria que golpea a nivel nacional; mas, junto con los desafíos, se presentan oportunidades de innovación, creatividad y colaboración. Objetivo: Exponer la experiencia de la implementación de un plan de estudio de enfermería a distancia durante la pandemia COVID-19 sobre la base del modelo de Kern. Métodos: Se analizó la implementación de un plan de educación online desde el modelo de Kern, que planteaba una propuesta centrada en el estudiantado, con el fin de elaborar un marco curricular orientado a resolver las demandas formativas. Se consideraron los intereses, las necesidades, los recursos y la articulación de aprendizajes, a partir de los actores que intervienen en el proceso educativo. Resultados: Las problemáticas y los desafíos se presentaron de manera transversal para estudiantes y docentes, y en todos los niveles organizacionales. Estas se relacionaron principalmente con brechas sociales, imposibilidad de realizar actividades presenciales y factores emocionales. La flexibilidad, la adaptación, el trabajo colaborativo y el manejo de la incertidumbre fueron habilidades primordiales en este proceso. Conclusiones: La virtualización en la educación ha sido una alternativa de emergencia que ha permitido enfrentar los desafíos de la pandemia de COVID-19. Reflexionar sobre la experiencia de manera crítica ha posibilitado identificar aquellas prácticas educativas efectivas e innovadoras, así como las oportunidades(AU)

Introduction: The COVID-19 pandemic has caused universities to undergo a transition from a face-to-face curriculum to emergency distance education. For the Nursing school of the University of Chile, the impossibility of attending health centers with students is added, due to the health crisis affecting the country; however, along with the challenges, opportunities emerge for innovation, creativity and collaboration. Objective: To present the experience concerning the implementation of a distance learning Nursing curriculum during the COVID-19 pandemic based on the Kern model. Methods: The implementation of an online education plan was analyzed following the Kern's model, which proposed a student-centered proposal, in order to elaborate a curricular framework oriented to solve the training demands. Interests, needs, resources and learning articulation were considered, with an initial focus on the actors involved in the educational process. Results: The problem situations and challenges appeared in a cross-sectional manner for students and teachers, as well as at all organizational levels. These are mainly related to social gaps, the impossibility of carrying out face-to-face activities, and emotional factors. Flexibility, adaptation, collaborative work and uncertainty management were paramount skills in this process. Conclusions: Virtualization in education has been an emergency alternative that has permitted to face the challenges of the COVID-19 pandemic. Reflecting on the experience in a critical manner has allowed to identify effective and innovative educational practices, as well as opportunities(AU)

Saúde mental de idosos: uma análise da série Unidade Básica (2016) / Mental health of older adults: an analysis of the series Unidade Básica(2016) / Salud mental del las personas mayores: un análisis de la serie Unidade Básica (2016)

Este artigo tem o objetivo de analisar dois episódios da primeira temporada da Unidade Básica (2016), a fim de identificar sentidos sobre a saúde mental de idosos. Esta série televisiva foi divulgada pela Universal Channel e escrita por Helena Petta, Newton Cannito e Ana Petta. Apenas dois episódios compõem o corpus desta pesquisa; os outros foram desconsiderados por não abordarem o tema. O primeiro trata de Vilma, uma idosa que abandonou o autocuidado por causa da depressão, e o quarto fala sobre Eraldo, um idoso que ficou depressivo em razão de problemas financeiros, amorosos e alcoólicos. A análise de narrativas será utilizada como metodologia, possibilitando a identificação e a interpretação crítica dos sentidos sobre idosos e saúde mental. De forma geral, os resultados revelaram que os episódios não seguem uma visão holística, desconsiderando, portanto, a necessidade de cuidar da saúde física e mental das pessoas idosas para lhes proporcionar bem-estar.

This article aims to analyze two episodes of the first season of Unidade Básica (2016) in order to identify meanings about the mental health of older adults. This series was broadcast by Universal Channel and written by Helena Petta, Newton Cannito and Ana Petta. Only two episodes compose the corpus of this research; the others were disregarded because they do not deal with the theme. The first episode narrated the story of Vilma, an older woman who was depressed and then abandoned self-care. The fourth episode was about Eraldo, an older man who became depressed due to his financial, love and alcoholic problems. The narrative analysis was used as a methodology, enabling the identification and critical interpretation of meanings about older people and mental health. In general, the results reveal that the episodes do not follow a holistic view, disregarding the need to take care of physical and mental health to provide the well-being of them.

Este artículo tiene como objetivo analizar dos episodios de la primera temporada de Unidade Básica(2016) con el fin de identificar significados sobre la salud mental de los adultos mayores. Esta serie fue transmitida por Universal Channel y escrita por Helena Petta, Newton Cannito y Ana Petta. Sólo dos episodios constituyen el corpus de esta investigación; los demás fueron descartados por no retratar el tema. El primer episodio narra la historia de Vilma, una mujer la tercera edad que abandonó el autocuidado a causa de su estado de depresión. El cuarto episodio fue sobre Eraldo, un hombre también de la tercera edad, que se deprimió por problemas económicos, amorosos y alcohólicos. Se utilizó como metodología el análisis narrativo, que permitió la identificación e interpretación crítica de significados sobre las personas mayores y la salud mental. En general, los resultados revelan que los dos episodios no siguen una visión holística, desconociendo la necesidad de cuidar de la salud física y mental para proporcionar bienestar a las personas mayores.

Impacto y consecuencias de la violencia ginecológica en la vida de las mujeres / Impact and consequences of gynecological violence in the lives of women

Objetivo: El objetivo fue analizar un conjunto de resultados sobre violencia ginecológica y relacionarlos con su impacto en la percepción del cuerpo, la sexualidad, la autoimagen y autoestima. Métodos: Se realizó un estudio descriptivo de tipo transversal. Se analizaron 812 relatos de mujeres de diversas regiones de Chile. Resultados: Se detectaron tres clases de consecuencias de la violencia: adopción de medidas de protección y resguardo, impacto en la experiencia de sí mismas y sus cuerpos y secuelas físicas y emocionales de la violencia en sus vidas. Adicionalmente, se presentan algunas experiencias de recuperación de autonomía en el cuidado de la salud ginecológica. Conclusión: La violencia ginecológica es parte de la experiencia común de las mujeres y puede constituir un grave problema de salud pública y erigirse en una barrera en el acceso de las mujeres a servicios de salud(AU)

Objective: The objective was to analyze a set of results on gynecological violence and relate them to their impact on the perception of the body, sexuality, self-image and self-esteem. Methods: A descriptive cross-sectional study was carried out. 812 stories of women from different regions of Chile were analyzed. Results: Three kinds of consequences of violence were detected: adoption of protection and shelter measures, impact on the experience of themselves and their bodies, and physical and emotional consequences of violence in their lives. Additionally, some experiences of autonomy recovery in gynecological health care are presented. Conclusion: Gynecological violence is part of the common experience of women and can constitute a serious public health problem and become a barrier to women's access to health services(AU)

Establishment of basic tests and extended tests list for clinical laboratories in Shanghai community health service centers / 中华全科医师杂志

Objective:To develop a list of basic and expanded medical laboratory tests in community health service centers in Shanghai.Methods:The status quo of human and equipment resource allocation, the test items and quality control currently performed, the perspectives of various stakeholders, the capacity building of community clinical laboratory in community health service centers in Shanghai were investigated by quantitative survey and qualitative interview; and the rating scores of each test item were assessed by expert consultation using Delphi method. The expert focus discussion was conducted, and each test item was rated and classified. Finally a list of the basic tests and expanded tests in clinical laboratories of community health service center was developed.Results:A total of 247 questionnaires were distributed and 192 (77.7%) were answered. A list of 94 laboratory test items was screened out based on the questionnaire survey of the laboratories of the community health centers. Thirty one experts in the relevant areas were invited to rate the test items, the average authority coefficient of experts was 0.90, with which the weighted average of the expert ratings was made. There were 45 (47.9%) items scored 7 or higher, 38 (40.4%) scored between 5 and 7, and 11 (11.7%) scored less than 5. Based on the results of the expert focus discussion, 48 items were recommended as the basic tests and 46 items as the extended tests.Conclusion:In this study a list of tests recommended to clinical laboratories in Shanghai community health service centers has been developed, which contains 48 basic tests and 46 extended tests.

Application of a tiered progressive training model in standardized residency training of general practice / 中华全科医师杂志

Objective:To investigate the effectiveness of a tiered progressive training model in the standardized residency training of general practice in primary care institutions.Methods:A tiered progression teaching plan was applied for 26 general practice residents who attended the rotation of general practice residency training in Beijing Fangzhuang Community Hearlth Service Center from June 2022 to May 2023. The plan defined the teaching objectives and requirements for different stages, and the Leicester Assessment Package (LAP) and narrative medicine were included in the teaching methods. The effectiveness of the tiered progression training was evaluated through a questionnaire survey on the post competency of general practice residents.Results:There were 12 primary stage residents, 9 intermediate stage residents and 5 advanced stage residents. The post-training scores of general practice residents in all three stages of residents were significantly higher than the pre-training scores ( t=-3.627,-2.073,-5.277,all P<0.05). The scores of basic medical and health services, basic public health services, information utilization ability and management ability, medical knowledge and lifelong learning, interpersonal communication and teamwork, professional quality after six post competency training were significantly higher than those before training in all three stages of residents. The scores of basic medical and health services, basic public health services, medical knowledge and lifelong learning, in primary residents were significantly improved compared with those before training ( t=-3.457,-3.428,-3.063, all P<0.05);the scores of basic public health services, interpersonal communication and teamwork, and professional quality in intermediate residents were significantly higher than those before training ( t=-2.328,-2.100,-1.997, all P<0.05); the scores of basic medical and health services, basic public health services, information utilization ability and management ability, medical knowledge and lifelong learning, interpersonal communication and teamwork, and professional quality in senior residents were significantly higher than those before training ( t=-5.707,-4.542,-2.952,-1.753,-2.705,-2.805, all P<0.05). Conclusion:The application of tiered and progressive training model in the standardized residency training is helpful to improve the post competency of general practice residents.