Comparison of Two Methods of Capillary Sampling in Blood Pre-Donation Anemia Screening in Brazil.

BACKGROUND: The laboratory tests most used by blood banks to diagnose anemia are the hemoglobin (Hb) and microhematocrit (Hct) tests, measured from capillary samples. OBJECTIVE: To analyze the two capillary screening methods for pre-donation anemia by comparing their agreement in diagnosing anemia. METHOD: A cross-sectional study in a population of 15,521 blood donation candidates for whom information was available on Hb and Hct, performed from capillary blood samples. Hb was determined using the HemoCue® test and Hct by the centrifugation method. The Kappa coefficient was calculated to assess the agreement between the methods. Pearson's correlation tests and gender-adjusted linear regression were used to assess the change in the response variable (Hb) as a function of the explanatory variable (Hct). RESULTS: The majority of the study population were men (70.4%), aged between 18 and 44 years (72.1%), who declared themselves white or mixed skin color (85.6%), and had undergone at least 11 years of complete education (72.4%). The Kappa coefficient found was 92.7 and 99.2 for women and men, respectively. Pearson's correlation showed a correlation coefficient of 0.98 and the linear regression graph showed an adequate relationship between the tests with R2 = 0.97. CONCLUSIONS: Comparing the Hb and Hct capillary tests, it was found that Hct can be safely used to screen for anemia in pre-blood donation.

What is the association between social capital and diabetes mellitus? A systematic review.

Social capital has been included as an element that could influence the self-perception of health, mortality and mental diseases. We systematically reviewed papers that studied the influence of social capital in the control of diabetes mellitus (DM). We included studies published up to Feb. 16, 2017, without restriction of time or year of publication. Quantitative studies were included since they presented one well-defined parameter to evaluate DM and specifically measured social capital. We used the PRISMA and STROBE guidelines to perform this review and to evaluate the quality of papers. Only three papers met the inclusion criteria. All studies adopted cross-sectional design. The population, the instruments used to measure social capital, and the statistical analysis were different among the papers. In conclusion, although social capital seems to be related to DM, more studies are necessary to understand which dimensions are more important in this association, if the association is the same at the individual or neighborhood level, and what kind of population in terms of education, poverty and culture would be more influenced by social capital in DM control.

Effectiveness of individual strategies for the empowerment of patients with diabetes mellitus: A systematic review with meta-analysis.

AIMS: To identify and evaluate the effectiveness of individual empowerment strategies in patients with diabetes mellitus (DM). METHODS: A systematic review was performed in the PubMed, Scopus, Science Direct and BVS. For meta-analysis and evaluation of Cochrane Risk and Bias, Revman V 5.2 software was used. RESULTS: Eleven studies of 1073 publications met the inclusion criteria. The strategies used were individual consultations, phone calls, sessions via a website and use of a booklet. Glycemic Hemoglobin (HbA1c) was used to evaluate the effectiveness of the strategies, and 45.4% of the studies also used the Diabetes Empowerment Scale. Five studies (45.5%) showed significant improvements in HbA1c reduction, improvements in self-efficacy (18.2%), knowledge levels of DM (18.2%), quality of life (18.2%). However, after meta-analysis, no statistically significant improvement was found for HbA1c. CONCLUSION: This systematic review showed that individual strategies for DM empowerment were not effective in reducing HbA1c, despite contributing to improvements in psychosocial parameters. Therefore, individual strategies need to be reviewed so that they become effective in DM control.

Primary health care as assessed by health professionals: comparison of the traditional model versus the Family Health Strategy.

INTRODUCTION: The Family Health Strategy (FHS) should be first-contact care in the Brazilian Health System. However, Primary Health Care (PHC) still encompasses two models: the FHS and the traditional health care facilities. The expansion of the FHS has been slow and heterogeneous in many cities, rendering a comparative evaluation of key quality-related elements of PHC models crucial. OBJECTIVE: To compare the performance of PHC models as perceived by health professionals. METHODS: A cross-sectional study involving managers and health professionals from PHC of a medium-size city in South-eastern Brazil. Data were collected by applying the Primary Care Assessment Tool. The performance was estimated through primary health care indexes (general and partial PHCI by attributes). Univariate polytomous logistic regression was performed to compare care model performances according to their attributes. Strength of association was estimated by odds ratio with 95% confidence interval. RESULTS: Three managers and 81 health professionals participated in the study. The FHS had a better index rating than the traditional care model for general PHCI and for the attributes longitudinality, comprehensiveness, family focus and professional level. CONCLUSION: Although the FHS attained higher scores compared to the traditional model, it has not yet achieved the performance expected. This scenario points to the need for increased FHS cover and quality improvements at the existing units.

Primary health care as assessed by health professionals: comparison of the traditional model versus the Family Health Strategy / Avaliação da atenção primária à saúde por profissionais de saúde: comparação entre modelo tradicional versus Estratégia Saúde da Família

ABSTRACT: Introduction: The Family Health Strategy (FHS) should be first-contact care in the Brazilian Health System. However, Primary Health Care (PHC) still encompasses two models: the FHS and the traditional health care facilities. The expansion of the FHS has been slow and heterogeneous in many cities, rendering a comparative evaluation of key quality-related elements of PHC models crucial. Objective: To compare the performance of PHC models as perceived by health professionals. Methods: A cross-sectional study involving managers and health professionals from PHC of a medium-size city in South-eastern Brazil. Data were collected by applying the Primary Care Assessment Tool. The performance was estimated through primary health care indexes (general and partial PHCI by attributes). Univariate polytomous logistic regression was performed to compare care model performances according to their attributes. Strength of association was estimated by odds ratio with 95% confidence interval. Results: Three managers and 81 health professionals participated in the study. The FHS had a better index rating than the traditional care model for general PHCI and for the attributes longitudinality, comprehensiveness, family focus and professional level. Conclusion: Although the FHS attained higher scores compared to the traditional model, it has not yet achieved the performance expected. This scenario points to the need for increased FHS cover and quality improvements at the existing units.

RESUMO: Introdução: A Estratégia de Saúde da Família (ESF) deve ser o primeiro contato do Sistema Único de Saúde (SUS). Contudo dois modelos de atenção operam concomitantemente no âmbito da Atenção Primária à Saúde (APS): a ESF e o modelo tradicional. A expansão da ESF tem sido lenta e heterogênea em muitos municípios, tornando fundamental a condução de avaliações comparativas de atributos relacionados à qualidade dos modelos da APS. Objetivo: Comparar o desempenho dos modelos de atenção da APS de acordo com a percepção dos profissionais de saúde. Métodos: Estudo transversal com gestores e profissionais de saúde da APS do município de Divinópolis, Minas Gerais. Dados foram coletados por meio do Primary Care Assessment Tool. O desempenho dos modelos foi estimado por meio do Índice de Atenção Primária à Saúde (IAPS geral e específico). Regressão logística politômica univariada foi conduzida para comparação do desempenho dos modelos da APS de acordo com os atributos. A força da associação foi estimada por meio do odds ratio com intervalo de confiança de 95%. Resultados: Três gestores e 81 profissionais de saúde participaram do estudo. A ESF obteve melhor avaliação do que o modelo tradicional com relação ao IAPS geral e aos atributos vínculo, elenco de serviços, enfoque familiar e formação profissional. Conclusão: A ESF obteve escores superiores aos do modelo tradicional, entretanto ainda não atingiu o seu desempenho esperado. Esse cenário aponta para a necessidade de ampliação da cobertura da ESF e para a melhoria da qualidade das unidades de ESF existentes no Brasil.

As relações de poder no trabalho da Estratégia Saúde da Família / Power relations in the work of Family Health Strategy

Trata-se de pesquisa qualitativa que tem por objetivo analisar as relações de poder estabelecidas no trabalho da Estratégia Saúde da Família. Foram realizadas entrevistas semiestruturadas com dezenove profissionais integrantes de três equipes e utilizados registros efetuados a partir de observação participante. Os dados foram analisados segundo Bardin e categorizados em duas unidades analíticas. O estudo demonstrou que alguns paradigmas são difíceis de modificar, especialmente quando são vistos de forma natural pelos envolvidos. No entanto, avanços foram verificados a partir do posicionamento daqueles muitas vezes vistos como inferiores nas relações de poder desse serviço.

It is a qualitative study that aims to analyze the power relations established in the work of the Family Health Strategy. Semi-structured interviews with nineteen professional members of three teams were conducted and records obtained from participant observation were used. Data were analyzed according to Bardin and organized into two analytical categories. The study showed that some paradigms are difficult to modify, especially when they are seen as natural by the involved people. However, advances have been verified from the positioning of those often seen as inferiors on power relations in this service.

Situação vacinal dos estudantes da Universidade Federal De São João Del Rei, 2009 / Vaccination status for students at The Federal University Of São João Del Rey, 2009 / Estado de vacunación de estudiantes de La Universidad Federal De São João Del Rei, 2009

Neste estudo, buscou-se descrever a situação vacinal e os fatores associados à realização do esquema vacinal completo dos estudantes do primeiro período dos cursos de enfermagem, farmácia e medicina da UFSJ. A população do estudo foi constituída por 187 estudantes. Os dados foram coletados utilizando-se um questionário contendo as seguintes variáveis: sexo, idade, curso, apresentação do cartão vacinal e vacinação em dia. A digitação dos dados foi realizada no programa EpiData 3.1 e a análise no programa Epi Info 6.04. Encontrou-se uma cobertura vacinal de 92% contra a rubéola, seguida da dupla adulto e hepatite B com coberturas de 49% e 52%, respectivamente. A vacina contra a febre amarela foi a de menor cobertura, representando 37%. Além disso, 155 alunos apresentaram comprovante de vacinação. As variáveis sexo, idade e curso não estiveram associadas à vacinação em dia. Os resultados mostraram que esses estudantes não estão adequadamente vacinados, expondo-se às doenças imunopreveníveis no ato da prestação de serviço. É imperativo maior empenho das Instituições de ensino superior visando a uma adequada cobertura vacinal de seus graduandos.

This study aimed to describe vaccination status and to investigate the factors associated with immunization schedule of Nursing, Pharmacy and Medicine first period students at the Federal University of São João Del Rey.The study population consisted of 187 students. Data were collected through a questionnaire containing the following variables: sex, age, course year, presentation of immunization card, and being up-to-date with vaccination schedule. Data entry performed using EpiData 3.1 and EpiInfo 6.04. The study revealed a 92% of immunization coverage rate against measles, followed by 49% against tetanus, and 52% against diphtheria toxoid and hepatitis B. The vaccine against yellow fever presented the smallest coverage rate with 37%. Besides that, 155 students presented a proof of vaccination. The variables gender, age and course year were not associated with an up-to-date vaccination record. The results demonstrated that the students, being not properly immunized, were exposed to vaccine-preventable diseases. Higher educational institutions should make a greater effort to promote suitable vaccination coverage to their undergraduate students.

El presente estudio describe la situación de vacunación y los factores asociados a la realización del esquema de vacunación completo de los estudiantes de los cursos de enfermería, farmacia y medicina de la UFSJ. La población del estudio estuvo constituida por 187 estudiantes. Los datos fueron obtenidos a través de una encuesta con las variables sexo, edad, curso, presentación de cartilla de vacunación y vacunación en día. La digitación de los datos fue realizada en el programa EpiData 3.1 y el análisis en el programa Epi Info 6.04. Se encontró una cobertura de vacunación de 92% contra rubeola, seguida de la dupla adulto y hepatitis B con coberturas de 49% y 52%, respectivamente. La vacuna contra la fiebre amarilla fue la de menor cobertura, representando 37%. Además, 155 alumnos presentaron la cartilla de vacunación. Las variables sexo, edad y curso no estuvieron asociadas a la vacunación en día. Los resultados mostraron que dichos estudiantes, al no estar vacunados correctamente, estaban expuestos a enfermedades inmunoprevenibles. Es sumamente importante que las instituciones de enseñanza superior se empeñen en promover cobertura de vacunación adecuada para sus alumnos.