[Transdisciplinary treatment of functional movement disorders: integration instead of dissociation]. / Die transdisziplinäre Behandlung funktioneller Bewegungsstörungen: Integration statt Dissoziation.

Successful treatment of patients with functional motor disorders is integrative in several ways: the primary treatment goal is the (re)integration of sensorimotor, cognitive and social functioning. The prerequisites for this are an integrated biopsychosocial model of everyone involved as well as close transdisciplinary cooperation. Instead of a simple addition of treatment components, all care providers and patients act in concert.

Sistematización del proceso de investigación y análisis de la administración y gestión de un proyecto de danza, movimiento humano y salud: Líneas de trabajo en salud y prevención primordial de Danza Universitaria / Systematization of the Research and Analysis Process of Administration and Management of a Dance, Human Movement and Health Project: Lines of Work in Health and Primary Prevention of Danza Universitaria / Sistematização do processo de investigação e análises da administração e gestão de um projeto de dança, movimento humano e saúde: formas de trabalho em saúde e prevenção primordial de Dança Universitária

Resumen: Introducción: En el contexto de una compañía profesional de danza, la pandemia ha generado cambios en las dinámicas de trabajo existentes tanto a nivel de áreas profesionales como de gestión. Propósito: Mostrar las acciones tomadas por una compañía profesional de danza en relación con la organización y la gestión para posicionar su quehacer al servicio de la sociedad a través del proyecto Líneas de trabajo en salud y prevención primordial de Danza Universitaria, surgido de la coyuntura de la COVID-19. Metodología: Sistematización de una experiencia de carácter exploratorio comprendida entre los meses de agosto del 2020 a octubre 2021, cuyos hallazgos reportados son el resultado de un proceso de recolección y organización de datos. Resultados: Se obtuvo información detallada y precisa sobre cada aspecto relacionado a la organización y administración del proyecto. Sistematización: Contextualización y análisis de la compañía Danza Universitaria, su recurso humano, visiones y prácticas dancísticas, al posicionar la danza como destreza de movimiento para la salud integral y abarcar el rol de profesionales de la danza para desembocar en los procesos administrativos y de gestión de la compañía. Conclusiones: Se esclarecen las dimensiones del proyecto como un sistema integrado en la comunidad y se visibiliza la capacidad de respuesta de este a las necesidades del entorno y al aporte de la danza y del movimiento para la salud integral. Recomendaciones: Valorar este proyecto como un espacio único que ha servido como objeto de estudio y parte de una experiencia académica que aporta al desarrollo y la gestión de las artes, el movimiento humano, la educación y la salud.

Abstract: Introduction: In the context of a professional dance company, the pandemic has generated changes in the existing work dynamics in its professional and managerial areas. Purpose: to show the organization and management actions taken by a professional dance company, aiming to position its work at the service of society through Lines of work in health and primary prevention of Danza Universitaria, a project that arises in response to the COVID-19 pandemic. Methodology: systematization of exploratory experience whose reported findings are the result of data collection and organization process between the months of August 2020 to October 2021. Results: detailed and precise information was obtained on each aspect related to the organization and project management. Systematization: the dance company, its human resources, visions and dance practices are contextualized and analyzed, positioning dance as a movement skill for integral health and encompassing the role of the dance professional to lead to the administrative and management processes of the company. Conclusions: the dimensions of the project as an integrated system in the community are clarified and its response capacity to the needs of the environment as well as the contribution of dance and movement for integral health is made visible. Recommendations: to value this project as a unique space that has served as an object of study and part of an academic experience that contributes to the development and management of the arts, human movement, education, and health.

Resumo: Introdução: No contexto de uma companhia profissional de dança a pandemia havia gerado mudanças nas dinâmicas de trabalho existentes tanto a nível das áreas profissionais como de gestão. Objetivo: Mostrar as ações tomadas por uma companhia profissional de dança com relação a organização e a gestão para posicionar o que fazer a serviços da sociedade através do projeto de Formas trabalho na saúde e prevenção primordial de Dança Universitária, surgido no período da COVID-19. Metodologia: sistematização de experiência de caráter investigativo no período compreendido nos meses de agosto 2020 a outubro 2021, cujos os traços encontrados no resultado do processo de apuração e organização dos datos. Resultado: obteve-se informações detalhada e precisa sobre cada aspecto relacionado a organização e administrativa do projeto. Sistematização: contextualização e análises da companhia de Dança Universitária, seu recurso humano, visões e prática dancísticas, a posicionar a dança como destreza de movimento para a saúde integral e abranger o rol do profissional de dança para terminar os processos administrativos e de gestão da companhia. Conclusões: deixa claro às dimensões do projeto como um sistema integrado entre a comunidade e se viabiliza a capacidade de resposta deste às necessidades de entorno e soporte da dança e o movimento para a saúde integral. Recomendações: valorizar este projeto como espaço único que serve como objeto de estudo e parte de uma experiência acadêmica que ajuda o desenvolvimento e gestão das artes, o movimento humano, a educação e a saúde.

Percepções de familiares sobre uma rede de cuidados de saúde mental infantojuvenil / Family perceptions about a children's mental health network / Percepciones familiares sobre una red de atención de salud mental infantojuvenil

Este artigo pretende conhecer como a rede de cuidados em saúde tem se operacionalizado a partir da percepção de familiares de crianças com demanda de cuidado em saúde mental (SM). Foram realizados dois grupos focais, um com familiares da Atenção Básica (AB) e outro com familiares do Centro de Atenção Psicossocial Infantojuvenil (CAPSij), totalizando 15 participantes. Seguiu-se com a análise lexical do tipo classificação hierárquica descendente, com o auxílio do software R Interface, a fim de análises multidimensionais de textos e questionários (IRaMuTeQ), resultando em cinco classes: A Pílula Mágica; Forças e Fraquezas dos serviços; Procurando por ajuda; Aceitando o diagnóstico da criança e Onde procurei ajuda. Os resultados apontam para dificuldades presentes na AB em identificar e manejar situações de Saúde Mental Infantojuvenil (SMIJ), por meio de uma lógica ainda medicalizante. Ressalta-se que a escola é apresentada como lugar de destaque na produção da demanda por cuidado e a família ainda é pouco convocada à construção das ações. Conclui-se, então, que avanços ainda são necessários para operacionalização de um cuidado pautado nas diretrizes da política de SMIJ.(AU)

This article aims to know how the healthcare network has been operationalized from the perception of family members of children with demand for mental health care (MH). Two focus groups were held, one with family members from Primary Care (PC) and the other with family members from the Child Psychosocial Care Center (CAPSij), totaling 15 participants. A lexical analysis of the descending hierarchical classification type was performed with the help of the software R Interface for multidimensional analyzes of texts and questionnaires (IRAMUTEQ), resulting in five classes: The Magic Pill; Strengths and Weaknesses of services; Looking for help; Accepting the child's diagnosis; and Where did I look for help. The results point to difficulties present in PC in identifying and managing situations of mental health in children and adolescents (MHCA), with a medicalization logic. Note that the school is presented as a prominent place in producing the demand for care, and the family is still not very much involved in the actions. It is, thus, concluded that advances are still needed for operationalization of care guided by MHCA policy guidelines.(AU)

Este artículo tuvo por objetivo conocer cómo opera una red asistencial a partir de la percepción de familiares de niños con demanda de atención en salud mental (SM). Se realizaron dos grupos focales, uno con familiares de Atención Primaria (AP) y otro con familiares del Centro de Atención Psicosocial Infantojuvenil (CAPSij), totalizando 15 participantes. Se realizó análisis léxico del tipo clasificación jerárquica descendente con la ayuda del software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ), lo que resultó en cinco clases: "La píldora mágica"; "Fortalezas y debilidades de los servicios"; "En busca de ayuda"; "Aceptar el diagnóstico del niño" y "¿Dónde busqué ayuda?". Los resultados apuntan las dificultades presentes en AP para identificar y manejar situaciones de salud mental infantojuvenil (SMIJ) mediante una lógica aún medicalizante. La escuela tiene un lugar destacado en la producción de la demanda de cuidados y la familia aún no está muy involucrada en la construcción de acciones. Se concluye que se necesitan avances para ofertar una atención guiada por lineamientos de la política del SMIJ.(AU)

Formação em psicologia escolar: implicações para a prática em equipe multiprofissional / The school psychology formation: implications for the practice in multidisciplinary team / Formación en psicología escolar: implicaciones para la práctica en equipo multiprofesional

O objetivo dessa pesquisa foi levantar o perfil sociodemográfico e formativo de psicólogos escolares, e discutir seu impacto nas práticas junto ao coletivo escolar e no trabalho em equipe. No município onde ocorreu a pesquisa, o psicólogo escolar é membro da equipe de especialistas em Educação. Participaram da pesquisa 62 psicólogos que atuam no Ensino Fundamental I, II, e na Educação de Jovens e Adultos. Os participantes responderam um questionário on-line com perguntas abertas e fechadas sobre dados sociodemográficos, de formação e atuação profissional. Realizou-se uma análise qualitativa a partir dos objetivos e itens do instrumento, quais sejam: caracterização do perfil sociodemográfico dos psicólogos escolares, formação acadêmica, atuação em psicologia escolar, atuação em outros campos/áreas da psicologia, e atuação em equipe de especialistas. A média de idade dos profissionais é de 47,46 anos, e apenas um é do sexo masculino. Possuem tempo de atuação de um a 36 anos, e a maioria não possui estágio supervisionado e pós-graduações no campo da psicologia escolar. Parte das equipes que trabalham nas escolas está incompleta, e há uma variabilidade nos dias e horários de reuniões. Reafirma-se que a formação de psicólogos escolares tem repercussões na atuação junto à equipe multidisciplinar, e a importância de intervenções pautadas na perspectiva crítica e psicossocial em Psicologia Escolar. Ademais, conhecer o perfil sociodemográfico e formativo destes profissionais possibilita obter um quadro atualizado sobre o grupo pesquisado e criar estratégias de intervenção que potencializem a atuação desses profissionais junto à equipe de especialistas e demais setores da escola.(AU)

The aim of this research is to identify the sociodemographic and training profile of school psychologists, and discuss their impact on practices within the school collective and the teamwork. In the city where the research took place, the school psychologist is a member of the council's expert team in Education. The research participants included 62 psychologists that work in elementary and intermediate school, and EJA. They answered an open and multiple choice online survey on sociodemographic, formation, and working data. A qualitative analysis was conducted considering its objectives and items, namely: sociodemographic profile, academic education, professional background on school psychology, other psychology fields/ areas, and participation on expert teams. The professionals are 47 and 46 years old, average, only one of them being male. They work in this position from one up to 36 years, and most of them do not have training experience and postgraduate studies in school psychology. Part of the teams working at schools are incomplete, and there is a variability concerning days and hours to team meetings. It is notable that the training profile of psychologists has repercussions in the performance with the multidisciplinary team, and in the importance of interventions based on critical and psychosocial perspectives in School Psychology. Moreover, knowing the sociodemographic and training profile of these professionals allowed us to have an updated chart about the researched group, as well as to create intervention strategies that enhance these professionals' performance within the expert team and other sectors of the school.(AU)

Esta investigación tuvo por objetivo levantar el perfil sociodemográfico y formativo de psicólogos escolares para discutir su impacto en las prácticas junto al colectivo escolar y al trabajo en equipo. En el municipio donde ocurrió la investigación, este profesional es miembro del equipo municipal de especialistas en Educación. Participaron 62 psicólogos que actúan en la educación primaria, secundaria y en la educación para jóvenes y adultos (EJA), y que respondieron a un cuestionario en línea con preguntas abiertas y de opción múltiple sobre datos sociodemográficos, de formación y de actuación profesional. Se realizó un análisis cualitativo según sus objetivos e ítems, o sea: perfil sociodemográfico, formación académica, actuación en Psicología Escolar, en otros campos/áreas de la Psicología o en equipo de especialistas. La edad mediana de los profesionales es de 46-47 años, y solo uno es del sexo masculino. El tiempo de actuación en el área varía entre 1 y 36 años, y la mayoría de los encuestados no tiene formación inicial y posgrado en el campo de la Psicología Escolar. Parte de los equipos que trabajan en las escuelas está incompleta, y existe una variabilidad en los días y horarios de reuniones. Se observó que la formación de los psicólogos escolares tiene repercusiones en la actuación con el equipo multidisciplinario y en la importancia de intervenciones basadas en la perspectiva crítica y psicosocial en Psicología Escolar. Además, conocer su perfil sociodemográfico y formativo posibilita obtener un cuadro actualizado sobre el grupo investigado, además de crear estrategias de intervención que potencialicen la actuación junto al equipo de especialistas y a los demás sectores de la escuela.(AU)

Plan estratégico nacional multisectorial de VIH e ITS 2022-2026 / National multisectoral strategic plan for HIV and STIs 2022-2026

El Plan Estratégico Nacional Multisectorial de VIH e ITS 2022-2026 (PENM 2022-2026) constituye la síntesis del esfuerzo nacional y multisectorial, el cual responde a las necesidades identificadas y expuestas por los diferentes sectores que trabajan la respuesta nacional al VIH, el presente plan permitirá afrontar la prevalencia e incidencia de casos por el Virus de Inmunodeficiencia humana (VIH) y de otras infecciones de transmisión sexual (ITS). El presente plan cuenta con mecanismos de respuesta en los diferentes momentos de la "Cascada del continuo de la atención": diagnóstico, confirmación, vinculación a una clínica de atención integral, retención en el Sistema Nacional Integrado de Salud, promoción de la adherencia al tratamiento en los servicios de salud y supresión viral. Su elaboración se ha basado en una posición consolidada de los compromisos gubernamentales con la respuesta al VIH, manifestada de diversas formas, tales como la sostenibilidad de la respuesta al VIH, posicionamiento político definido y acciones impulsoras de la participación de la sociedad civil y los diferentes actores de la vida social y económica del país

The National Multisectoral Strategic Plan for HIV and STIs 2022-2026 (PENM 2022-2026) constitutes the synthesis of the national and multisectoral effort, which responds to the needs identified and exposed by the different sectors that work the national response to HIV, the present The plan will make it possible to address the prevalence and incidence of cases of the Human Immunodeficiency Virus (HIV) and other sexually transmitted infections (STIs). This plan has response mechanisms at the different moments of the "Cascade of the continuum of care": diagnosis, confirmation, link to a comprehensive care clinic, retention in the National Integrated Health System, promotion of adherence to treatment in health services and viral suppression. Its preparation has been based on a consolidated position of government commitments to the response to HIV, manifested in various ways, such as the sustainability of the response to HIV, a defined political position and actions that promote the participation of civil society and the different actors of the social and economic life of the country

The collaborative development through multidisciplinary and advocate consensus of an accessible notice of rights for people with intellectual disabilities in police custody.

Background People with intellectual disabilities are over-represented in the criminal justice system. The United Nations' Convention on the Rights of Persons with Disabilities (UNCRPD) enshrines a right to equal access to justice for persons with disabilities (Article 13, UNCRPD). Accessible information is a key aspect of exercising this right. Yet, many jurisdictions, including Ireland, are yet to develop accessible information for disabled people who may be arrested. Aims This paper describes the collaborative development through multidisciplinary and advocate consensus of an accessible (Easy -to- Read) Notice of Rights (ERNR) for people with intellectual disabilities in police custody in Ireland. Methods Guidelines developed by Ireland's representative organisation for people with intellectual disabilities and examples of international practice were used to develop a draft ERNR by the primary researcher in partnership with an expert from a representative organisation for people with intellectual disabilities. The ERNR was developed thereafter through two focus groups with a view to achieving consensus with a focus on accessibility, accuracy and layout. This included a multidisciplinary focus group with participants from a representative organisation for people with intellectual disabilities, psychology, speech and language therapy, the police force, public health, forensic psychiatry, mental health, law and, subsequently, a focus group of people with lived experience of intellectual disability. Results Progressive development of the ERNR resulted in incremental improvements in textual accuracy as well as the inclusion of more accessible language and imagery. Originality/value This is the first attempt at developing an easy-to-read document relating to the legal rights of suspects in police custody in Ireland and, accordingly, this procedural innovation promises to assist, not just persons with intellectual disabilities, but also those with limited literacy at the point of arrest. The methodology used in the preparation of the document, employing a focus group to achieve consensus with participation from both multiple disciplines and persons with an intellectual disability, is in harmony with the ethos of the UNCPRD. This methodology may usefully be employed by other member states that have ratified the Convention but have yet to develop accessible version of the legal rights and entitlements that extend to arrested persons under their domestic law.

Towards an Integrated Healthcare System: Evolutionary Game Analysis on Competition and Cooperation Between Urban and Rural Medical Institutions in China.

Background: The game of interest is the root cause of the non-cooperative competition between urban and rural medical and health institutions. The study investigates competition and cooperation among urban and rural medical institutions using the evolutionary game analysis. Methods: With the evolutionary game model, analysis of the stable evolutionary strategies between the urban and rural medical and health facilities is carried out. A numerical simulation is performed to demonstrate the influence of various values. Results: The result shows that the cooperation mechanism between urban and rural medical Institutions is relevant to the efficiency of rural medical institutions, government supervision, reward, and punishment mechanism. Conclusions: Suggestions for utilizing the government's macro regulation and control capabilities, resolving conflicts of interest between urban and rural medical and health institutions is recommended. In addition, the study again advocates mobilizing the internal power of medical institutions' cooperation to promote collaboration between urban and rural medical and health institutions.

Cuidado e intersetorialidade nos estudos sobre a primeira infância: uma revisão integrativa / Care and intersectorality in early childhood studies: an integrative review

Estudos sobre os primeiros anos de vida, período que vem sendo denominado como primeira infância, são crescentes no Brasil, inclusive produzindo importantes discussões que culminaram na promulgação do Marco Legal para a Primeira Infância, em 2016. Constitucionalmente atribui-se a responsabilidade compartilhada da família, sociedade e o Estado no cuidado das crianças pequenas, no entanto, há uma lacuna de conhecimento sobre ações de cuidado e intersetoriais nessa fase da vida. Este trabalho, a partir de uma revisão integrativa da literatura, busca analisar as concepções abordadas na literatura nacional sobre intersetorialidade e o cuidado na Primeira Infância, a partir do Marco Legal da Primeira Infância. A busca bibliográfica foi realizada entre outubro e dezembro de 2021 e incluiu artigos científicos, documentos, teses e dissertações nacionais, com resumos disponíveis e indexados nas bases Portal BVS, Redalyc, Portal Capes e Scopus. O acervo encontrado foi composto por vinte e cinco (25) publicações lidas integralmente e organizadas em uma matriz de dados. Os dados foram organizados e três categorias analíticas foram discutidas numa síntese interpretativa. Os achados mostram a necessidade de reflexão do cuidado de maneira ampliada, integral e enquanto prática social para enfrentar as práticas hegemônicas, capitalistas, dicotômicas, hierárquicas e que provocam apagamentos no cuidado e inviabilizam práticas intersetoriais. Identificou se que, em prol da garantia e efetivação dos direitos das crianças, se faz necessário a ampliação do entendimento do cuidado, considerando sua polissemia, suas relações éticas e socioculturais a partir do cuidado integral, considerando os sujeitos como ativos nessa relação, produzindo alteridade, emergindo sentidos ausentes e possibilitando a pluralidade das vivências. A intersetorialidade apesar de se apresentar como estratégia fundamental para a garantia de cuidado integral das crianças, especialmente as mais vulneráveis, ainda se mantém ambígua e com poucos resultados enquanto práticas na relação saúde e educação infantil. Mais estudos precisam ser realizados considerando a relevância das ações de saúde e educação para o cuidado, valorizando o presente e favorecendo que de fato se estabeleça um cuidado mais democrático e equitativo em nossa sociedade.

The increasing studies in Brazil about the first years of life, called early childhood, promoted discussions which eventually led to the promulgation of the Early Childhood Legal Framework in 2016. Constitutionally, the responsibility for young children's caring is shared by the family, society and the State, however, a gap in the knowledge of caring and intersectoral actions for this phase of life exist. This article, part of an integrative review, attempts to analyze the concept addressed in the national literature about intersectoral and early childhood care stemming from the Early Childhood Legal Framework. The bibliographic search was carried out between October and December 2021 and included scientific articles, theses and national dissertations with abstracts available and indexed in the BVS, Redalyc, Capes and Scopus portals. The assemblage encountered consisted of 25 articles read in full and organized in a data matrix and three analytical categories were discussed in an interpretative synthesis. The findings reveal the necessity of reflecting about care in a broad, comprehensive manner and as social practice to deal with hegemonic, capitalist, dichotomic, hierarchic actions, provoking shutdowns in care and impeding intersectoral initiatives. For the benefit of warranting and materialization of children's rights, it is required to broaden the understanding of care, pondering its polysemy, its ethical and sociocultural relations arising from full care and making the individuals the protagonists of this relation, creating alterity, emerging previously absent meanings and favoring the plurality of life experiences. The intersectoral aspect, despite appearing as a key strategy to ensure full care to children, particularly the most vulnerable, is still ambiguous with scarce results as practices in the relation between health and childhood education. More studies are necessary considering the relevance of health and education actions for care, valuing the present and favoring the concept of an actual implementation of a more democratic and equalitarian care in our society.

Desafios da articulação intersetorial entre saúde e assistência social: uma revisão integrativa / Challenges of intersectoral articulation between health care and social support: an integrative review / Desafíos de la articulación intersectorial entre salud y asistencia social: una revisión integrativa

A organização do modelo de atenção à saúde vigente no Brasil a partir da implementação do Sistema Único de Saúde (SUS) incorporou a intersetorialidade como premissa essencial, definida como a pactuação de diferentes atores no contexto do planejamento e assistência a políticas e programas. Nesse âmbito, enfatiza-se a relevância da articulação entre os setores de saúde e assistência social, pretendendo maior resolutividade das demandas e integralidade da assistência. A partir disso, este estudo pretende analisar os desafios para a colaboração intersetorial entre saúde e assistência social assim como suas implicações para a gestão do cuidado. Para tanto, foi conduzida uma revisão integrativa da literatura disponível nas bases de dados SCIELO e LILACS entre o período 2010-2020. Entre a amostra selecionada para a revisão, é constatado um panorama amplo, heterogêneo e complexo das experiências entre os dois setores, marcadas por variabilidades e desafios institucionais, operacionais e de recursos, sendo unânime o entendimento de que essas experiências ainda se mostram isoladas e verticalizadas. Diversos são os entraves associados ao exercício da intersetorialidade enquanto eixo norteador da elaboração de políticas públicas robustas para a população, especialmente no que tange ao binômio saúde e assistência social, o que reitera a necessidade de revisitar os processos de trabalho, gestão, formação, organização e disposição da atenção à saúde no Brasil tendo em vista a proposição e alcance de resultados mais efetivos na busca pela redução das iniquidades em saúde e fortalecimento das estratégias de bem-estar social.

Following implementation of the Unified Health System (SUS), the current organization of Brazil's health care model incorporated intersectoriality, defined as the agreement of different actors in the context of planning and assisting programs and policies, as an essential premise. This emphasizes the importance of intersectoral articulation between health care and social support for greater resolution of demands and comprehensive care. Given this context, this integrative review analyzes the challenges of intersectoral collaboration between health and social support, and its implications for care management. Bibliographic research was conducted in the SciELO and LILACS databases for articles published between 2010 and 2020. The final sample was characterized by a broad, heterogeneous, and complex panorama of experiences between the two sectors, marked by institutional, operational, and resource challenges and variability, with the unanimous understanding that such experiences are still isolated and verticalized. Many obstacles are associated with the implementation of intersectoriality as a guiding principle for elaborating robust public policies, especially regarding the binomial health and social support, reiterating the need to revise work, management, training, organization and health care processes in Brazil, given the proposal and achievement of more effective results in the search for reducing health inequalities and strengthening social well-being strategies.

La organización del actual modelo de atención a la salud en Brasil a partir de la implementación del Sistema Único de Salud (SUS) incluyó como premisa esencial la intersectorialidad, definida como la concertación de diferentes actores en el contexto de la planificación y asistencia a programas y políticas. En este contexto, se destaca la importancia de la articulación entre los sectores de salud y asistencial, con miras a una mayor resolución de demandas y una atención integral. Ante lo anterior, este estudio pretende analizar los desafíos para la colaboración intersectorial entre salud y asistencia social, así como sus implicaciones para la gestión del cuidado. Para ello, se realizó una revisión integrativa de la literatura en las bases de datos SciELO y LILACS, en el período de 2010-2020. Entre la muestra seleccionada para la revisión, se verificó un panorama vasto, heterogéneo y complejo de las experiencias entre los dos sectores, marcadas por la variabilidad institucional, operativa y de recursos, y fue unánime el entendimiento de que estas experiencias aún son aisladas y verticalizadas. Son varios los obstáculos asociados al ejercicio de la intersectorialidad en tanto eje de la elaboración de sólidas políticas públicas a la población, especialmente en lo que se refiere al binomio salud-asistencia social, lo que plantea la necesidad de revisar los procesos de trabajo, la gestión, la formación, la organización y la atención a la salud en Brasil con miras a proponer y lograr resultados más efectivos en la búsqueda de la reducción de las inequidades en salud y el fortalecimiento de las estrategias de bienestar social.

Hospitals in Integrated Health Service Delivery Networks: Strategic Recommendations

In 2007, PAHO launched the Integrated Health Service Delivery Network (IHSDN) initiative to address the problems derived from the fragmentation of health services and to overcome the structural problems stemming from the widespread segmentation of health systems in the countries of the Region. In the IHSDN initiative, hospitals are an aggregate of specialized institutions that support a highly effective first level of care. Hospitals themselves are defragmented, which is theoretically correct, innovative, and even visionary. However, the IHSDN initiative does not seek to diminish the influence of hospitals in the health system or the importance of their role, but to integrate these institutions so that all their efforts are aligned with the needs of the people and communities they serve through the development of IHSDNs. It is obvious that without hospitals there can be no IHSDNs; however, it should also be recognized that without effective networks, hospitals cannot do their job. The IHSDN initiative presents a change in the role assigned to hospitals, in which they are no longer considered the apex of a pyramid in which the hierarchy is based on specialization to successfully treat disease. Instead, the hospital becomes a very important participant in a service organized as a network, performing specific tasks in a series of processes that cut repeatedly across the health service delivery network and include the participation of individuals and communities. The product of an intense debate and joint effort, this work contains a series of proposals in the six areas considered a priority for developing the new role of hospitals in IHSDNs: governance, resource allocation and incentives, the model of care, technology and infrastructure, human resources, and organization and management.

Child Psychiatrists and Psychologists: Enhanced Collaboration in Primary Care.

Psychiatry and psychology have a long history of competition that too often interferes with the collaboration that can characterize complementary contributions to our common missions. We hope this article will inspire our disciplines to expand on this collaboration, for the sake of our children and families, our communities, our colleagues, and honestly, ourselves. We are better together than apart. This text is a blueprint for the assumptions, attitudes, skills, and advocacy that can make this partnership healthy and successful.

Worldwide evidence about infant stunting from a public health perspective: A systematic review / Evidencia mundial sobre el retraso del crecimiento infantil desde una perspectiva de salud pública: revisión sistemática

Abstract Introduction: According to the World Health Organization (WHO) global estimates for 2017, 9.6% of children under 5 years old are stunted. Worldwide evidence shows that actions for preventing stunting and catching-up growth are relevant if addressed by all the sectors involved. Therefore, there is a need to identify 'intersectoral actions' to address the risk of stunting during pregnancy and the first 2 years of life. Objective: To identify and describe worldwide evidence for prevention, nutritional interventions, and 'intersectoral collaboration' efforts against stunting in infants. Materials and methods: We conducted a systematic review in 2019 (PROSPERO CRD42019134431). The search included PubMed, OVID, and Web of Science, as well as WHO and the Food and Agriculture Organization of the United Nations (FAO) official documents and expert recommendations. Results: We selected 231 studies: 86.1% described prevention-related factors, 30.7%, nutritional interventions, and 52.8% intersectoral collaboration efforts; 36.4% of the studies were conducted in multiple regions; 61% of the studies described the importance of interventions during pregnancy, 71.9% from birth up to 6 months old, and 84.8% from 6 months up to 2 years old. The most frequent variables described were antenatal care, nutritional counseling for the mother and the newborn, and counseling on micronutrient supplementation. Conclusions: Evidence-based understanding of actions geared towards monitoring the risk of stunting-associated factors from pregnancy up to 2 years old is critical.

Resumen Introducción. Según estimaciones mundiales de la Organización Mundial de la Salud (OMS) para el 2017, el 9,6 % de los niños menores de cinco años padecen retraso del crecimiento. La evidencia mundial ha demostrado que las acciones para prevenir el retardo del crecimiento o para tratarlo adquieren relevancia si las abordan todos los sectores involucrados. Por lo tanto, es necesario determinar las acciones intersectoriales para atender el riesgo de retraso del crecimiento durante el embarazo y los dos primeros años de vida. Objetivo. Rastrear y describir la evidencia mundial para la prevención, las intervenciones nutricionales y los esfuerzos de colaboración intersectorial contra el retraso del crecimiento en los lactantes. Materiales y métodos: Se hizo una revisión sistemática en el 2019 (PROSPERO CRD42019134431). La búsqueda incluyó PubMed, OVID y Web of Science, así como documentos oficiales de la OMS y la Organización para la Agricultura y la Alimentación de Naciones Unidas (FAO) y recomendaciones de expertos. Resultados. Se seleccionó un total de 231 estudios: 86,1 % describían factores relacionados con la prevención, 30,7 %, intervenciones nutricionales, y 52,8 %, esfuerzos de colaboración intersectorial; 36,4 % de ellos se llevaron a cabo en múltiples regiones. Del total, el 61 % de los estudios se enfocaba en la importancia de las intervenciones durante el embarazo, el 71,9 % desde el nacimiento hasta los seis meses y el 84,8 % desde los seis meses hasta los dos años. Las variables descritas con mayor frecuencia fueron la atención prenatal, el asesoramiento nutricional para la madre y el recién nacido, y el asesoramiento sobre la suplementación con micronutrientes. Conclusiones. La comprensión basada en la evidencia de las acciones orientadas a monitorear el riesgo de factores asociados al retraso del crecimiento desde el embarazo hasta los dos años, es fundamental.

Characteristics of systematic reviews evaluating treatments for COVID-19 registered in PROSPERO.

Characteristics and research collaboration of registered systematic reviews (SRs) on treatment modalities for coronavirus disease-2019 (COVID-19) remain unclear. This study analysed research collaboration, interventions and outcome measures in registered SRs on COVID-19 treatments and pointed out the relevant problems. PROSPERO (international prospective register of systematic reviews) was searched for SRs on COVID-19 treatments as of 2 June 2020. Excel 2016 was used for descriptive analyses of the extracted data. VOSviewer 1.6.14 software was used to generate network maps for collaborations between countries and institutions. A total of 189 SRs were included, which were registered by 301 institutions from 39 countries. China (69, 36.50%) exhibited the highest output. Cooperation between countries was not close enough. As an institution, the Chengdu University of Traditional Chinese Medicine (7, 3.70%) had the highest output. There was close cooperation between institutions. Interventions included antiviral therapy (81, 42.86%), respiratory support (16, 8.47%), circulatory support (11, 5.82%), plasma therapy for convalescent patients (11, 5.82%), immunotherapy (9, 4.76%), TCM (traditional Chinese medicine) treatment (9, 4.76%), rehabilitation treatment (5, 2.65%), anti-inflammatory treatment (16, 8.47%) and other treatments (31, 16.40%). Concerning antiviral therapy (81, 42.86%), the most commonly used antiviral agents were chloroquine/hydroxychloroquine (26, 13.76%), followed by remdesivir (12, 6.35%), lobinavir/ritonavir (11, 5.82%), favipiravir (5, 2.65%), ribavirin (5, 2.65%), interferon (5, 2.65%), abiron (4, 2.12%) and abidor (4, 2.12%). The most frequently used primary and secondary outcomes were the mortality rate (92, 48.68%) and hospital stay length (48, 25.40%), respectively. The expression of the outcomes was not standardised. Many COVID-19 SRs on treatment modalities have been registered, with a low completion rate. Although there was some collaboration between countries and institutions in the currently registered SRs on treatment modalities for COVID-19 on PROSPERO, cooperation between countries should be further enhanced. More attention should be directed towards identifying deficiencies of outcome measures, and the standardisation of results should be maximised.

A survey on Koreans' preferred type of collaboration between conventional medical and traditional Korean medicine doctors.

ABSTRACT: Although collaborative treatment by traditional Korean medicine doctors (KMDs) and medical doctors occurs, it is mainly done by referral. As no survey of the general public's preference for the type of collaboration has ever been conducted, we aimed to investigate Koreans' preferences for a collaborative treatment type.The responders were extracted by random digit dialing and then reextracted using the proportional quota sampling method by sex and age. From July to October 2017, telephone interviews were conducted and the participant responses regarding treatment history for spinal or joint diseases, experiences with collaborative treatment, and preferred type of collaborative treatment were recorded.Of the 1008 respondents, 44.64% reported a history of treatment for spinal or joint diseases at a medical institution. The concurrent collaborative treatment system, in which both KMDs and medical doctors are present in one location participating in the treatment concurrently, was the most preferred system among the respondents. Respondents who reported experience with traditional Korean medicine hospitals were more likely to prefer a one-stop treatment approach than those who did not have experience with traditional Korean medicine hospitals (adjusted odds ratio: 1.73; 95% confidence interval: 1.12-2.68). Respondents who were familiar with collaborative treatment but did not report any personal experience with it were more likely to prefer a one-stop treatment approach than those who were not familiar with collaborative treatment (adjusted odds ratio: 1.82; 95% confidence interval: 1.37-2.44).Koreans prefer a concurrent type of collaborative treatment system by KMDs and medical doctors. Therefore, efforts and support are needed to increase the application of the concurrent type of collaborative system.

Usage and promotion on Chinese medicine in Portuguese-speaking countries.

As the continuous opening-up and communication have been seen between China and other countries, traditional Chinese medical science and Chinese medicine now have gain popularity in China as well as the surrounding countries. As a window that China's opening-up through, Macau has been serving as a link between China and Portuguese language countries. The Forum for Economic and Trade Co-operation between China and Portuguese-speaking Countries (Macau), also known as Forum Macau, since it was established in 2003, has further enhanced the mutual exchange of commerce, culture and technologies. Promoting the industry of Chinese medical science among Portuguese-speaking countries has become one of the priorities of the Forum Macau. With multiple years of collaboration, among the Portuguese-speaking countries, Chinese medical science has gained promotion to some extent, as well as recognition from the government and people. The current study introduced the development of Chinese medical science among Portuguese-speaking countries from aspects such as legislation, cooperation and promotion, medical assistance, and clinical usage.

Land use-induced spillover: a call to action to safeguard environmental, animal, and human health.

The rapid global spread and human health impacts of SARS-CoV-2, the virus that causes COVID-19, show humanity's vulnerability to zoonotic disease pandemics. Although anthropogenic land use change is known to be the major driver of zoonotic pathogen spillover from wildlife to human populations, the scientific underpinnings of land use-induced zoonotic spillover have rarely been investigated from the landscape perspective. We call for interdisciplinary collaborations to advance knowledge on land use implications for zoonotic disease emergence with a view toward informing the decisions needed to protect human health. In particular, we urge a mechanistic focus on the zoonotic pathogen infect-shed-spill-spread cascade to enable protection of landscape immunity-the ecological conditions that reduce the risk of pathogen spillover from reservoir hosts-as a conservation and biosecurity priority. Results are urgently needed to formulate an integrated, holistic set of science-based policy and management measures that effectively and cost-efficiently minimise zoonotic disease risk. We consider opportunities to better institute the necessary scientific collaboration, address primary technical challenges, and advance policy and management issues that warrant particular attention to effectively address health security from local to global scales.

Partnering to Support Education for Midwives and Nurses in Liberia.

The midwifery and occupational health faculty of a U.S. university were approached by parish and health care leaders from Caldwell, Liberia, for assistance in addressing critical maternal health care needs in their community. Liberia has suffered setbacks in its efforts to improve health care for its people due to recent civil wars and the Ebola epidemic of 2014 to 2016. Initial discussions among international groups centered around realistic ways to help in the face of multiple compelling needs. Grant support for U.S. faculty to conduct exploratory meetings and educational workshops in Liberia was secured. Ethical principles and best practices in partnering across borders guided this partnership and include reciprocity, equity, and empowerment of health care workers, including nurses, midwives, community workers, and health center staff. Here, we describe the preparation for and implementation of these workshops, as well as plans for continuing collaborations that emerged from these workshops.

Community midwifery: a primary health care approach to care during pregnancy for Aboriginal and Torres Strait Islander women.

Comprehensive primary health care is integral to meaningful client-centred care, with nurses and midwives central to partnership approaches with individuals, families and communities. A primary health model of antenatal care is needed for Aboriginal and Torres Strait Islander women in rural and remote areas, where complex social determinants of health impact on pregnancy outcomes, early years and lifelong health. Staff experiences from a community midwifery-led antenatal program in a remote Western Australian setting were explored, with the aim of investigating program impacts from health service providers' perspectives. Interviews with 19 providers, including community midwives, child health nurses, program managers, a liaison officer, doctors and community agency staff, examined elements comprising a culturally safe community antenatal program for Aboriginal and Torres Strait Islander women, exploring program benefits and challenges. Thematic analysis derived five themes: Organisational and Accessibility Factors; Culturally Appropriate Support; Staff Availability and Competencies; Collaboration; and Sustainability. The ability of program staff to work in culturally safe partnerships with clients in collaboration with community agencies was essential to building meaningful and sustainable antenatal strategies. Midwifery primary health care competencies were viewed as a strong enabling factor, with potential to reduce health disparities in accordance with Australian Government and research recommendations.

Paving the way for successful twinning:: Using grounded theory to understand the contribution of twin pairs in twinning collaborations.

BACKGROUND: Twinning collaborations, where two groups - from educational institutions, hospitals or towns - work together cross-culturally on joint goals, are increasingly common worldwide. Pairing up individuals, so-called twin pairs, is thought to contribute to successful collaboration in twinning projects, but as yet, there is no empirical evidence or theory that offers insight into the value of the pair relationship for twinning. AIM: To explore the contribution of one-to-one relationships between twins to twinning projects, as exemplified in projects between Dutch and Moroccan, and Dutch and Sierra Leone midwives. METHODS: We conducted thirteen in-depth interviews with midwives from two twinning collaborations. Interviews were transcribed and analysed using an iterative, grounded theory process, yielding a theoretical understanding of one-to-one twinning relationships for twinning collaborations. FINDINGS: Participant comments fell into four substantive categories: 1) Being named a twin, 2) moving beyond culture to the personal level, 3) searching for common ground to engage, 4) going above and beyond the twinning collaboration. Their interplay demonstrates the value of twin pairs in paving the way for successful twinning. DISCUSSION: A complex combination of contextual inequities, personality, and cultural differences affect the twin relationship. Trusting relationships promote effective collaboration, however, as 'trust' cannot be mandated, it must be built by coaching twins in personal flexibility and (cultural) communication. CONCLUSION: By offering original insights into the ways twinning relationships are built, our research explores how twin pairs can enhance the success of twinning projects.