Sesión informativa COVID-19 en las Américas: 21 de julio - Español

Sesión informativa de la OPS sobre COVID-19

PAHO information session for the press on COVID-19 in the Americas: July 21, 2020

Ministro da Saúde interino, Eduardo Pazuello, mostra na Câmara Federal a nova plataforma COVID-19

O Ministério da Saúde está aprimorando a forma de divulgar os dados sobre a COVID-19. Com a nova plataforma, é possível saber casos e óbitos por estado e por região do país. O ministro da Saúde interino, Eduardo Pazuello, apresentou a nova ferramenta aos deputados federais e reafirmou o compromisso do Governo Federal com a transparência e verdade sobre o cenário da pandemia no país.

Coronavírus: o Governo adotou alguma medida para dar mais transparência para os dados da saúde?

Saiba mais em: www.saopaulo.sp.gov.br/coronavirus/planosp

The Preferences of Patients With Cancer Regarding Apps to Help Meet Their Illness-Related Information Needs: Qualitative Interview Study.

BACKGROUND: The shift from inpatient to outpatient and community cancer care means that more patients with cancer need to manage their condition at home, without the direct supervision of their clinician. Subsequently, research has reported that many patients with cancer have unmet information needs during their illness. Mobile devices, such as mobile phones and tablet computers, provide an opportunity to deliver information to patients remotely. Before designing an app intervention to help patients with cancer to meet their information needs, in-depth qualitative research is required to gain an understanding of the views of the target users. OBJECTIVE: We aimed to develop an app intervention to help patients meet their illness-related information needs in noninpatient settings. This study explored the information needs of patients with cancer and their preferences for an app and desired app features. Specifically, the perceived acceptability of an app, desired app features, and the potential benefits and disadvantages of, and barriers to, an app were explored. METHODS: Qualitative, one-on-one semistructured interviews were conducted with patients with urological, colorectal, breast, or gynecological cancers (N=23) across two hospitals in South Wales. Interviews were audio-taped, transcribed, and analyzed using a thematic analysis. RESULTS: Findings indicated that barriers to information exchange and understanding in consultations, and identification of reliable information sources between consultations, appeared to contribute to patients' unmet information needs. Consequently, app feature suggestions included a question prompt list, a glossary of cancer terms, a resources feature, and a contacts feature. Anticipated benefits of this type of app included a more informed patient, improved quality of life, decreased anxiety, and increased confidence to participate in their care. The anticipated barriers to app use are likely to be temporary or can be minimized with regard to these findings during app development and implementation. CONCLUSIONS: This study highlights the desire of patients with cancer for an app intervention to help them meet their information needs during and between consultations with their clinicians. This study also highlights the anticipated acceptability and benefits of this type of intervention; however, further research is warranted.

Avaliação da efetividade da intervenção com material educativo em pacientes cirúrgicos: revisão integrativa da literatura / Evaluation of the effectiveness of intervention with educational material in surgical patients: an integrative literature review / La evaluación de la efectividad de la intervención con material educacional en pacientes quirúrgicos: una revisión integradora de la literatura

Objetivo: Analisar a literatura científica produzida sobre métodos utilizados na avaliação da efetividade de tecnologias educativas impressas para o paciente submetido a cirurgia. Método: Revisão integrativa da literatura, tendo como questão norteadora "quais os métodos utilizados para avaliar a efetividade de tecnologias educativas impressas na educação do paciente cirúrgico?". O período de publicação dos estudos foi de 2000 a 2017, nos de dados: ISI Web of Science, Biblioteca Virtual em Saúde (BVS), PubMed, SCOPUS portais e/ou bases e Cochrane. Resultados: Foram inseridos dez artigos de ensaios clínicos randomizados, todos com a tecnologia educativa impressa (folheto), e o uso dessa contribuiu para uma diminuição tanto da ansiedade e depressão quanto dos níveis da dor. Conclusão: Apesar de avaliações positivas em relação à intervenção, ainda há dificuldades em mensurar a sua efetividade, e não foi possível estabelecer o melhor instante para a aplicação dos instrumentos de medida.

Objectives: To analyze the scientific literature on methods used in the evaluation of the effectiveness of printed educational materials designed for patients undergoing surgery. Method: This is an integrative literature review based on the following guiding question: "What methods are used to evaluate the effectiveness of printed educational materials in the education of surgical patients?" We considered studies published between 2000 and 2017 that appeared in ISI Web of Science, Virtual Health Library (VHL), PubMed, SCOPUS portals and/or databases and Cochrane. Results: We included 10 randomized clinical trials, all with printed educational materials (booklets). The studies revealed that the use of booklets contributed to a reduction not only in anxiety and depression levels, but also pain. Conclusion: Despite positive assessments regarding the intervention, there are still difficulties in measuring its effectiveness. Therefore, the best moment for the application of the assessment tool could not be established.

Objetivos: Analizar la literatura científica sobre los métodos utilizados en la evaluación de la efectividad de materiales educativos impresos creados para pacientes sometidos a cirurgía. Método: Esta es una revisión integradora de la literatura basada en la siguiente pregunta: "¿Cuáles son los métodos utilizados para evaluar la efectividad de los materiales educativos impresos en la educación de pacientes quirúrgicos?" Consideramos estudios publicados entre 2000 y 2007 encontrados en los portales y/o bases de datos de ISI Web Science, Virtual Health Library (VHL), PubMed, SCOPUS y Cochrane. Resultados: Se incluyeron 10 ensayos clínicos aleatorizados, todos con materiales educativos impresos (booklets). Los estudios revelaron que el uso de booklets contribuyó a una reducción no solo en los niveles de ansiedad y depresión, sino también en el dolor. Conclusión: Apesar de las evaluaciones positivas con respecto a la intervención, todavía aún hay dificultades para medir su efectividad. Por lo tanto, el mejor momento para conducir la herramienta de evaluación no pudo se establecer.

Acordo para permissão de residência, estudo e trabalho entre Brasil e Uruguai: efetividade em um locus identitário híbrido / Agreement for permission to reside, study and work between Brazil and Uruguay: effectiveness in a hybrid identity locus

O presente trabalho pretende estudar a integração do médico uruguaio, em razão de acordo entre a República Federativa do Brasil e a República Oriental do Uruguai para permissão de residência, estudo e trabalho a nacionais fronteiriços brasileiros e uruguaios. No intuito de alcançar esse desiderato, analisar-se-á, por intermédio de doutrina abalizada, a possibilidade de exercício da profissão na cidade gêmea de Aceguá-Brasil, em virtude das restrições estabelecidas pelo Conselho Federal de Medicina, verificando, assim, a eficácia imediata do já citado instrumento jurídico internacionalizado. Não obstante, enfatiza-se a crescente precarização da saúde pública nos pequenos municípios, especialmente em zonas de fronteira, contribuindo para o processo de subalternização das políticas públicas de saúde imposto pela universalidade epistêmica, coibindo a atuação de sujeitos e saberes historicamente subjugados. Sob essa conjuntura, importante se perfaz um ensaio crítico acerca da eficácia normativa do acordo em questão na cidade gêmea de Aceguá-Brasil, enfatizando o hibridismo identitário de um locus internacionalizado.

The present study intends to study the integration of the Uruguayan physician, due to an agreement between the Federative Republic of Brazil and the Eastern Republic of Uruguay for residence, study and work permits for Brazilian and Uruguayan border nationals. In order to achieve this goal, the possibility of exercising the profession in the twin city of Aceguá-Brasil, by virtue of the restrictions established by the Federal Council of Medicine, will be analyzed, through a qualified doctrine, thus verifying the effectiveness of the aforementioned internationalized legal instrument. Nevertheless, the growing precariousness of public health in small municipalities, especially in border areas, is emphasized, contributing to the process of subalternization of public health policies imposed by epistemic universality, curbing the performance of historically subjugated subjects and knowledge. Under this scenario, a critical essay about the normative effectiveness of the agreement in question in the twin city of Aceguá-Brasil, emphasizing the identity hybridism of an internationalized locus, is important.

Do interoperable national information systems enhance availability of data to assess the effect of scale-up of HIV services on health workforce deployment in resource-limited countries?

Sub-Saharan Africa (SSA) bears the heaviest burden of the HIV epidemic. Health workers play a critical role in the scale-up of HIV programs. SSA also has the weakest information and communication technology (ICT) infrastructure globally. Implementing interoperable national health information systems (HIS) is a challenge, even in developed countries. Countries in resource-limited settings have yet to demonstrate that interoperable systems can be achieved, and can improve quality of healthcare through enhanced data availability and use in the deployment of the health workforce. We established interoperable HIS integrating a Master Facility List (MFL), District Health Information Software (DHIS2), and Human Resources Information Systems (HRIS) through application programmers interfaces (API). We abstracted data on HIV care, health workers deployment, and health facilities geo-coordinates. Over 95% of data elements were exchanged between the MFL-DHIS and HRIS-DHIS. The correlation between the number of HIV-positive clients and nurses and clinical officers in 2013 was R2=0.251 and R2=0.261 respectively. Wrong MFL codes, data type mis-match and hyphens in legacy data were key causes of data transmission errors. Lack of information exchange standards for aggregate data made programming time-consuming.

Identifying optimal ways to collect, distill and provide efficient access to personal health information in emergency situations

We did not identify systematic reviews that addressed information-exchange systems. Of the 16 studies we identified that focused on approaches to supporting information exchange between sites and stakeholders, 13 specifically focused on health information exchange (HIE) systems that have been widely implemented in the United States.(2-14) In general, HIE is a process by which patient-level electronic health information is shared between stakeholders (e.g., clinicians, provider organizations, laboratories), and has been identified as a solution to the fragmentation and isolation of personal health information in healthcare settings.(14) The information shared may include test imaging results, discharge summaries and medication lists. These health records may be used in a variety of settings, including EDs to quickly obtain personal health information.(10) In addition to HIE systems, we identified three studies addressing other models of information exchange systems, including electronic patient care reports,(15;16) and electronic links between EDs and family physicians.

Making strides.

Texas' health information exchanges (HIEs) are closer to being able to connect to one another locally and across state lines.

Características evolutivas de la incapacidad temporal en un centro de salud / Evolutive characteristics of temporary disability in a health care center

Introducción. El objetivo es valorar la evolución de la incapacidad temporal (IT) en un centro de salud (CS) urbano durante 12 años (1993-2004) mediante un estudio observacional retrospectivo de prevalencia. Pacientes y métodos. Las variables evaluadas son: sexo, duración IT, diagnóstico (según CIE-9), año de la IT y causa de alta obtenidas de los partes de IT registrados en tres consultas de un CS. Resultados: Se registraron 3.924 procesos (58,4% varones). La duración media de la IT es de 46,3 ± 99,4 días para varones y 54,2 ± 103,9 para mujeres (intervalo de confianza de diferencia 1,5-14,4). Para valorar la evolución se han considerado tres periodos: 1993-1996 (1.141 procesos), 19972000 (1.128 procesos), 2001-2004 (1.655 procesos). Los diagnósticos más frecuentes son los osteomusculares (30,6%), infecciosos (23%), trastornos mentales (7,9%) y digestivos (7,2%). Evolutivamente el porcentaje de las causas osteomusculares y digestivas se han mantenido, mientras que las infecciosas han descendido del 27 al 18% y las mentales han aumentado del 6,6 al 10,1%, duplicándose el número de días perdidos por esta causa, pasando de 7.642 días en el primer periodo a 15.686 en el tercero. Las causas osteomusculares son las que más días perdidos originan (76.009 días) seguidas de las mentales (31.147 días). El porcentaje de IT por población activa ha pasado de 19,8% en 1993 a 30,5% en 2004. Conclusiones: Se ha producido un aumento progresivo del porcentaje de IT con respecto a la población activa atendida. En los últimos años las IT por trastornos mentales han aumentado considerablemente, duplicándose el número de días perdidos por esta causa (AU)

Introduction: This study has aimed to assess the evolution of work disablement (WD) for an urban Primary Care Center (PCC) over 12 years (1993-2004) by means of an observational, retrospective study on prevalence. Patients and methods; Variables: Gender, WD duration, diagnosis (according to ICD-9), year of the WD, reason for discharge obtained from WD reports recorded in three doctor’s offices in the PCC mentioned. Results: We recorded 3,924 conditions (58.4% males). Average duration of the WD was 46.3 ± 99.4 days for males and 54.2 ± 103.9 for women (Confidence Interval difference varies from 1.5-14.4). Three periods were used to assess evolution: 1993-1996 (1,141 conditions), 1997-2000 (1,128 conditions), 2001-2004 (1.655 conditions). The most frequent diagnoses were osteomuscular (30.6%), infectious (23%), mental disorders (7.9%) and digestive disorders (7.2%). In regards to evolution, percentages of osteomuscular and digestive causes were maintained whereas the infectious ones decreased from 27% to 18% and the mental ones increased from 6.6% to 10.1%, the number of days lost due to this being double, ranging from 7,642 days in the 1st period to 15,686 in the 3rd one. The most work days lost were due to osteomuscular causes (76,009 days) followed by mental ones (31,147 days). The percentage of WD for the active population has increased considerably, going from 19.8% in 1993 to 30.5% in 2004. Conclusions: There has been a progressive increase in the percentage of WD due to mental disorders in the working population in recent years. WD due to mental disorders has increased considerably in recent years, the number of workdays lost due to it doubling (AU)