Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 12.282
Filtrar
1.
Recurso educacional aberto em Português | CVSP - Regional | ID: oer-3920

RESUMO

O que a equipe interprofissional deve saber sobre o COVID-19? Higiene das mãos Sinais e sintomas COVID-19 e atendimento odontológico no SUS Classificação de risco - COVID-19 Casos leves: isolamento domiciliar e manejo terapêutico Manejo de resíduos de serviços de saúde Fluxograma de manejo na atenção primária em Manejo clínico na APS/ESF Protocolo de manejo clínico do coronavírus (COVID-19) na atenção primária à saúde


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Betacoronavirus , Atenção Primária à Saúde/métodos , Guia de Prática Clínica
2.
Maturitas ; 142: 8-10, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33158491

RESUMO

Targeting older at-risk patients with decision-making algorithms is a priority at a time when hospitals are receiving an influx of Covid-19 patients that may exceed their capacity. Such screening could likely be extended to primary care settings in order to identify older community dwellers with Covid-19, but also those experiencing the adverse consequences of prolonged home confinement. The Centre of Excellence on Longevity of McGill University (Quebec, Canada) designed a short assessment for Montreal's housebound community-dwelling older adults. It acts as the first step in connecting older community dwellers who are housebound during the Covid-19 outbreak to telemedicine.


Assuntos
Infecções por Coronavirus , Avaliação Geriátrica , Pacientes Domiciliares , Pandemias , Pneumonia Viral , Atenção Primária à Saúde/métodos , Telemedicina , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Hospitais , Humanos , Quebeque
3.
Afr J Prim Health Care Fam Med ; 12(1): e1-e4, 2020 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-33181873

RESUMO

Cape Town is currently one of the hotspots for COVID-19 on the African continent. The Metropolitan Health Services have re-organised their primary health care (PHC) services to tackle the epidemic with a community-orientated primary care perspective. Two key goals have guided the re-organisation, the need to maintain social distancing and reduce risk to people using the services and the need to prepare for an influx of people with COVID-19. Facilities were re-organised to have 'screening and streaming' at the entrance and patients were separated into hot and cold streams. Both streams had 'see and treat' stations for the rapid treatment of minor ailments. Patients in separate streams were then managed further. If patients with chronic conditions were stable, they were provided with home delivery of medication by community health workers. Community health workers also engaged in community-based screening and testing. Initial evaluation of PHC preparedness was generally good. However, a number of key issues were identified. Additional infrastructure was required in some facilities to keep the streams separate with the onset of winter. Managers had to actively address the anxiety and fears of the primary care workforce. Attention also needed to be given to the prevention and treatment of non-COVID conditions as utilisation of these services decreased. The epidemic exposed intersectoral and intrasectoral fault lines, particularly access to social services at a time when they were most needed. Community screening and testing had to be refocused due to limited laboratory capacity and a lengthening turnaround time.


Assuntos
Serviços de Saúde Comunitária/métodos , Infecções por Coronavirus/terapia , Assistência à Saúde/métodos , Instalações de Saúde , Planejamento em Saúde , Pandemias , Pneumonia Viral/terapia , Atenção Primária à Saúde/métodos , Betacoronavirus , Doença Crônica , Cidades , Agentes Comunitários de Saúde , Coronavirus , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Epidemias , Pessoal de Saúde , Acesso aos Serviços de Saúde , Humanos , Programas de Rastreamento , Organizações , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Estações do Ano , África do Sul/epidemiologia , Triagem
6.
Br J Gen Pract ; 70(700): 528-529, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33122266
7.
BMJ Open ; 10(10): e043763, 2020 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-33020109

RESUMO

OBJECTIVES: We evaluated whether implementation of lockdown orders in South Africa affected ambulatory clinic visitation in rural Kwa-Zulu Natal (KZN). DESIGN: Observational cohort SETTING: Data were analysed from 11 primary healthcare clinics in northern KZN. PARTICIPANTS: A total of 46 523 individuals made 89 476 clinic visits during the observation period. EXPOSURE OF INTEREST: We conducted an interrupted time series analysis to estimate changes in clinic visitation with a focus on transitions from the prelockdown to the level 5, 4 and 3 lockdown periods. OUTCOME MEASURES: Daily clinic visitation at ambulatory clinics. In stratified analyses, we assessed visitation for the following subcategories: child health, perinatal care and family planning, HIV services, non-communicable diseases and by age and sex strata. RESULTS: We found no change in total clinic visits/clinic/day at the time of implementation of the level 5 lockdown (change from 90.3 to 84.6 mean visits/clinic/day, 95% CI -16.5 to 3.1), or at the transitions to less stringent level 4 and 3 lockdown levels. We did detect a >50% reduction in child healthcare visits at the start of the level 5 lockdown from 11.9 to 4.7 visits/day (-7.1 visits/clinic/day, 95% CI -8.9 to 5.3), both for children aged <1 year and 1-5 years, with a gradual return to prelockdown within 3 months after the first lockdown measure. In contrast, we found no drop in clinic visitation in adults at the start of the level 5 lockdown, or related to HIV care (from 37.5 to 45.6, 8.0 visits/clinic/day, 95% CI 2.1 to 13.8). CONCLUSIONS: In rural KZN, we identified a significant, although temporary, reduction in child healthcare visitation but general resilience of adult ambulatory care provision during the first 4 months of the lockdown. Future work should explore the impacts of the circulating epidemic on primary care provision and long-term impacts of reduced child visitation on outcomes in the region.


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Acesso aos Serviços de Saúde/estatística & dados numéricos , Acesso aos Serviços de Saúde/tendências , Pneumonia Viral/epidemiologia , Atenção Primária à Saúde , Saúde Pública , Adulto , Fatores Etários , Betacoronavirus , Serviços de Planejamento Familiar/estatística & dados numéricos , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Pandemias , Pediatria/estatística & dados numéricos , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/estatística & dados numéricos , Saúde Pública/métodos , Saúde Pública/estatística & dados numéricos , População Rural
8.
Aust J Gen Pract ; 49(10): 625-629, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33015676

RESUMO

BACKGROUND: The availability of a COVID-19 vaccine is being heralded as the solution to control the current COVID-19 pandemic, reduce the number of infections and deaths and facilitate resumption of our previous way of life. OBJECTIVE: The aim of this article is to provide a framework for primary care of what will be needed to optimise COVID-19 vaccine confidence and uptake in Australia once the vaccine prioritisation schedule and key target groups are known. DISCUSSION: While a number of vaccines are currently under development, with at least seven undergoing phase III trials (28 August 2020), it is hoped that an effective COVID-19 vaccine will become available to the public in 2021. Ensuring public confidence in vaccine safety and effectiveness will be crucial to facilitate uptake. General practitioners are at the forefront of public health, and one of the most trusted sources for patients. In this article, the authors discuss the expedited vaccine development process for COVID-19 vaccines; the likely vaccine prioritisation schedule and anticipated key target groups; the behavioural and social drivers of vaccination acceptance, including the work required to facilitate this; and the implications for general practice.


Assuntos
Infecções por Coronavirus , Clínicos Gerais/psicologia , Programas de Imunização/organização & administração , Pandemias , Pneumonia Viral , Saúde Pública/métodos , Vacinação , Vacinas Virais/farmacologia , Austrália , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Grupos Focais , Acesso aos Serviços de Saúde/organização & administração , Humanos , Pandemias/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Atenção Primária à Saúde/métodos , Autoimagem , Vacinação/métodos , Vacinação/psicologia
9.
PLoS One ; 15(10): e0239765, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33119636

RESUMO

BACKGROUND: Aboriginal and Torres Strait Islander people experience a greater burden of disease and die younger than non-Indigenous Australians, with Aboriginal people living in remote areas of the Northern Territory of Australia having the lowest life expectancy estimates. Despite a high burden of chronic disease among Aboriginal and Torres Strait Islander people, access to specialist health services remains low and models of care that increase engagement, may improve health outcomes. METHODS: We describe client and staff perspectives of a model of clinical genetics services provided by the MJD Foundation (MJDF) in geographically and culturally complex contexts within the Northern Territory of Australia. We seek to understand the MJDF model's success in supporting Aboriginal families with the familial, neurodegenerative condition Machado-Joseph disease and how it could be applied in the provision of other specialist services. Thematic analysis was undertaken on semi-structured interviews with primary health care staff (n = 2), Non-Aboriginal MJDF Staff (n = 7) and Aboriginal MJDF Clients / Community workers (n = 13). RESULTS: Four key themes regarding the MJDF model of service delivery were identified with the service being; 1) client led 2) accepting of various understandings of genetic disease causation 3) focused on relationships, continuity and trust between the service provider and the clients, and 4) committed to incorporating an inclusive whole-of-family practice. The MJDF model takes a community-based, person-and family-centred approach to successfully deliver effective specialist genetic health services in remote community settings. We propose that these approaches have broad application in the future design and delivery of specialist health services particularly in culturally complex settings.


Assuntos
Doença Crônica/epidemiologia , Acesso aos Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde , Serviços de Saúde do Indígena , Grupo com Ancestrais Oceânicos/genética , Adolescente , Competência Cultural , Feminino , Humanos , Masculino , Northern Territory/epidemiologia , Atenção Primária à Saúde/métodos , Relações Profissional-Paciente
10.
Comunidad (Barc., Internet) ; 22(2): 0-0, jul.-oct. 2020. graf
Artigo em Espanhol | IBECS | ID: ibc-193597

RESUMO

En 2006 nace una ONG en Boulembou (A 500 km de Dakar), fundada por cooperantes e inmigrantes del pueblo en nuestro país, donde se hicieron estudios para definir el entorno y asambleas y comités para priorizar intervenciones. OBJETIVOS: conocer el funcionamiento de un proyecto comunitario y formar parte de una ONG de codesarrollo, así como obtener y valorar los resultados de sus acciones a medio y largo plazo sobre la población. MÉTODOS: codesarrollo (las personas inmigrantes ayudan en realizar intervenciones en sus países de origen) y salud comunitaria (acciones para mejorar la salud de una comunidad más allá de la individual). RESULTADOS: el pueblo tiene agua potable, huertos, centro de salud (enfermero, comadrona y agentes de salud) y mejoras en la escuela. DISCUSIÓN: el enfoque y las líneas de trabajo realizadas desde un punto de vista comunitario y de codesarrollo han permitido que los proyectos se autogestionen y autofinancien para poder seguir evolucionando y progresando


An NGO was founded in 2006 in Boulembou (located 500 km from Dakar). It was founded by aid workers and immigrants from this town to our country. Studies were performed there to define the setting and to start meetings and committees to prioritize interventions. OBJECTIVES: To ascertain the operation of a community project and be part of a co-development NGO in addition to obtaining and evaluating the impact of its actions on the population in the medium and long term. METHODS: Co-development (immigrants assist with development in countries of origin) and community health (actions targeted at improving community health). RESULTS: The town now has drinking water from fountains, orchards and a healthcare centre (with a nurse, midwife and healthcare agents) in addition to school improvements. DISCUSSION: Projects were implemented from a community and co-development point of view and have facilitated self-management and self-financing to continue evolving and progressing by themselves


Assuntos
Humanos , Masculino , Feminino , Criança , Participação da Comunidade , Organizações , Atenção Primária à Saúde/métodos , Emigrantes e Imigrantes , Cooperação Internacional , Senegal , Saúde Pública , Avaliação de Programas e Projetos de Saúde
11.
Aust Health Rev ; 44(5): 733-736, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32878685

RESUMO

The COVID-19 pandemic has resulted in multiple changes in the delivery of general practice services. In response to the threat of the pandemic and in order to keep their businesses safe and viable, general practices have rapidly moved to new models of care, embraced Medicare-funded telehealth and responded to uncertain availability of personal protective equipment with innovation. These changes have shown the adaptability of general practice, helped keep patients and practice staff safe, and undoubtedly reduced community transmission and mortality. The pandemic, and the response to it, has emphasised the potential dangers of existing fragmentation within the Australian health system, and is affecting the viability of general practice. These impacts on primary care highlight the need for improved integration of health services, should inform future pandemic planning, and guide the development of Australia's long-term national health plan.


Assuntos
Infecções por Coronavirus/diagnóstico , Diagnóstico Precoce , Medicina Geral/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Atenção Primária à Saúde/organização & administração , Medicina Estatal/organização & administração , Telemedicina/organização & administração , Austrália , Betacoronavirus/patogenicidade , Medicina Geral/métodos , Medicina Geral/estatística & dados numéricos , Humanos , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/estatística & dados numéricos , Medicina Estatal/estatística & dados numéricos , Telemedicina/métodos
12.
J Am Board Fam Med ; 33(5): 645-649, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32989057

RESUMO

The COVID-19 outbreak is a stark reminder of the ongoing challenge of emerging and reemerging disease, the human cost of pandemics and the need for robust research.1 For primary care, the advent of COVID-19 has forced an unprecedented wave of practice change. In turn, Practice-Based Research Networks (PBRNs) must rapidly pivot to address the changing environment and the critical challenges faced by primary care. The pandemic has also impacted the ability of PBRNs to deploy traditional research methods such as face-to-face patient and provider interactions, practice facilitation, and stakeholder engagement. Providers need more relevant, patient-centered evidence and the skills to effect change. These skills will become more important than ever as primary care practices evolve in response to the current COVID-19 pandemic and the disparities in health outcomes highlighted by COVID-19 and the global Black Lives Matter social movement for justice. Throughout this issue, authors detail the work conducted by PBRNs that demonstrate many of these evolving concepts. Articles explore how PBRNs can evaluate COVID-19 in primary care, the role of PBRNs in quality improvement, stakeholder engagement, prevention and chronic care management, and patient safety in primary care.


Assuntos
Betacoronavirus , Redes Comunitárias/tendências , Infecções por Coronavirus , Pesquisa sobre Serviços de Saúde/tendências , Pandemias , Pneumonia Viral , Atenção Primária à Saúde/tendências , Redes Comunitárias/organização & administração , Pesquisa sobre Serviços de Saúde/métodos , Pesquisa sobre Serviços de Saúde/organização & administração , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Humanos , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/organização & administração , Projetos de Pesquisa , Participação dos Interessados , Estados Unidos
13.
J Am Board Fam Med ; 33(5): 774-778, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32989072

RESUMO

BACKGROUND: Primary care practice-based research networks (PBRNs) are critical laboratories for generating evidence from real-world settings, including studying natural experiments. Primary care's response to the novel coronavirus-19 (COVID-19) pandemic is arguably the most impactful natural experiment in our lifetime. EVALUATING THE IMPACT OF COVID-19: We briefly describe the OCHIN PBRN of community health centers (CHCs), its partnership with implementation scientists, and how we are leveraging this infrastructure and expertise to create a rapid research response evaluating how CHCs across the country responded to the COVID-19 pandemic. COVID-19 RESEARCH ROADMAP: Our research agenda focuses on asking: How has care delivery in CHCs changed due to COVID-19? What impact has COVID-19 had on the delivery of preventive services in CHCs? Which PBRN services (e.g., data surveillance, training, evidence synthesis) are most impactful to real-world practices? What decision-making strategies were used in the PBRN and its practices to make real-time changes in response to the pandemic? What critical factors in successfully and sustainably transforming primary care are illuminated by pandemic-driven changes? DISCUSSION AND CONCLUSIONS: PBRNs enable real-world evaluation of practice change and natural experiments, and thus are ideal laboratories for implementation science research. We present a real-time example of how a PBRN Implementation Laboratory activated a response to study a historic natural experiment, to help other PBRNs charting a course through this pandemic.


Assuntos
Betacoronavirus , Centros Comunitários de Saúde/tendências , Redes Comunitárias/tendências , Infecções por Coronavirus , Assistência à Saúde/tendências , Pesquisa sobre Serviços de Saúde/tendências , Pandemias , Pneumonia Viral , Atenção Primária à Saúde/tendências , Centros Comunitários de Saúde/organização & administração , Redes Comunitárias/organização & administração , Assistência à Saúde/métodos , Assistência à Saúde/organização & administração , Prática Clínica Baseada em Evidências , Pesquisa sobre Serviços de Saúde/métodos , Pesquisa sobre Serviços de Saúde/organização & administração , Humanos , Ciência da Implementação , Disseminação de Informação , Inovação Organizacional , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/organização & administração , Avaliação de Programas e Projetos de Saúde , Projetos de Pesquisa , Participação dos Interessados , Estados Unidos
15.
Epidemiol Psychiatr Sci ; 29: e164, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32883399

RESUMO

AIMS: To identify and categorise core components of effective stigma reduction interventions in the field of mental health in low- and middle-income countries (LMICs) and compare these components across cultural contexts and between intervention characteristics. METHODS: Seven databases were searched with a strategy including four categories of terms ('stigma', 'mental health', 'intervention' and 'low- and middle-income countries'). Additional methods included citation chaining of all papers identified for inclusion, consultation with experts and hand searching reference lists from other related reviews. Studies on interventions in LMICs aiming to reduce stigma related to mental health with a stigma-related outcome measure were included. All relevant intervention characteristics and components were extracted and a quality assessment was undertaken. A 'best fit' framework synthesis was used to organise data, followed by a narrative synthesis. RESULTS: Fifty-six studies were included in this review, of which four were ineffective and analysed separately. A framework was developed which presents a new categorisation of stigma intervention components based on the included studies. Most interventions utilised multiple methods and of the 52 effective studies educational methods were used most frequently (n = 83), and both social contact (n = 8) and therapeutic methods (n = 3) were used infrequently. Most interventions (n = 42) based their intervention on medical knowledge, but a variety of other themes were addressed. All regions with LMICs were represented, but every region was dominated by studies from one country. Components varied between regions for most categories indicating variation between cultures, but only a minority of studies were developed in the local setting or culturally adapted. CONCLUSIONS: Our study suggests effective mental health stigma reduction interventions in LMICs have increased in quantity and quality over the past five years, and a wide variety of components have been utilised successfully - from creative methods to emphasis on recovery and strength of people with mental illness. Yet there is minimal mention of social contact, despite existing strong evidence for it. There is also a lack of robust research designs, a high number of short-term interventions and follow-up, nominal use of local expertise and the research is limited to a small number of LMICs. More research is needed to address these issues. Some congruity exists in components between cultures, but generally they vary widely. The review gives an in-depth overview of mental health stigma reduction core components, providing researchers in varied resource-poor settings additional knowledge to help with planning mental health stigma reduction interventions.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Transtornos Mentais/psicologia , Atenção Primária à Saúde/métodos , Discriminação Social , Estigma Social , Estereotipagem , Humanos
16.
PLoS Med ; 17(9): e1003306, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32941435

RESUMO

BACKGROUND: The higher mortality rates in people with severe mental illness (SMI) may be partly due to inadequate integration of physical and mental healthcare. Accurate recording of SMI during hospital admissions has the potential to facilitate integrated care including tailoring of treatment to account for comorbidities. We therefore aimed to investigate the sensitivity of SMI recording within general hospitals, changes in diagnostic accuracy over time, and factors associated with accurate recording. METHODS AND FINDINGS: We undertook a cohort study of 13,786 adults with SMI diagnosed during 2006-2017, using data from a large secondary mental healthcare database as reference standard, linked to English national records for 45,706 emergency hospital admissions. We examined general hospital record sensitivity across patients' subsequent hospital records, for each subsequent emergency admission, and at different levels of diagnostic precision. We analyzed time trends during the study period and used logistic regression to examine sociodemographic and clinical factors associated with psychiatric recording accuracy, with multiple imputation for missing data. Sensitivity for recording of SMI as any mental health diagnosis was 76.7% (95% CI 76.0-77.4). Category-level sensitivity (e.g., proportion of individuals with schizophrenia spectrum disorders (F20-29) who received any F20-29 diagnosis in hospital records) was 56.4% (95% CI 55.4-57.4) for schizophrenia spectrum disorder and 49.7% (95% CI 48.1-51.3) for bipolar affective disorder. Sensitivity for SMI recording in emergency admissions increased from 47.8% (95% CI 43.1-52.5) in 2006 to 75.4% (95% CI 68.3-81.4) in 2017 (ptrend < 0.001). Minority ethnicity, being married, and having better mental and physical health were associated with less accurate diagnostic recording. The main limitation of our study is the potential for misclassification of diagnosis in the reference-standard mental healthcare data. CONCLUSIONS: Our findings suggest that there have been improvements in recording of SMI diagnoses, but concerning under-recording, especially in minority ethnic groups, persists. Training in culturally sensitive diagnosis, expansion of liaison psychiatry input in general hospitals, and improved data sharing between physical and mental health services may be required to reduce inequalities in diagnostic practice.


Assuntos
Hospitalização/tendências , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Comorbidade , Grupos Étnicos , Feminino , Hospitais Gerais , Humanos , Masculino , Transtornos Mentais/psicologia , Grupos Minoritários , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendências , Sistema de Registros , Fatores Socioeconômicos , Reino Unido/epidemiologia
17.
Eur J Gen Pract ; 26(1): 129-133, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32985278

RESUMO

The COVID-19 pandemic has modified organisation and processes of primary care. In this paper, we aim to summarise experiences of international primary care systems. We explored personal accounts and findings in reporting on the early experiences from primary care during the pandemic, through the online Global Forum on Universal Health Coverage and Primary Health Care. During the early stage of the pandemic, primary care continued as the first point of contact to the health system but was poorly informed by policy makers on how to fulfil its role and ill equipped to provide care while protecting staff and patients against further spread of the infection. In many countries, the creativity and initiatives of local health professionals led to the introduction or extension of the use of telephone, e-mail and virtual consulting, and introduced triaging to separate 'suspected' COVID-19 from non-COVID-19 care. There were substantial concerns of collateral damage to the health of the population due to abandoned or postponed routine care. The pandemic presents important lessons to strengthen health systems through better connection between public health, primary care, and secondary care to cope better with future waves of this and other pandemics.


Assuntos
Infecções por Coronavirus/epidemiologia , Comportamentos Relacionados com a Saúde , Médicos de Atenção Primária , Pneumonia Viral/epidemiologia , Atenção Primária à Saúde/métodos , Telemedicina , Triagem , Betacoronavirus , Assistência à Saúde , Humanos , Pandemias , Aceitação pelo Paciente de Cuidados de Saúde , Atenção Primária à Saúde/organização & administração , Pesquisa Qualitativa , Telefone
19.
Rev. cuba. estomatol ; 57(3): e1827, jul.-set. 2020.
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1126521

RESUMO

RESUMEN Introducción: El análisis de la situación de salud es un tema indispensable en la formación de profesionales que tienen a cargo la salud de una comunidad y que requieren de una útil herramienta para la identificación de problemas de salud en el primer nivel de atención. Objetivo: Describir una metodología para facilitar la ejecución de la fase analítica de la situación de salud bucal en una comunidad. Métodos: Se realizó una revisión bibliográfica, a través del buscador Google Académico y en las bases de datos bibliográficas PubMed, Lilacs, Cumed y SciELO Cuba. Se revisaron trabajos presentados en el Congreso Internacional de Estomatología 2015. Los descriptores empleados para la búsqueda fueron: estado de salud, salud bucal, salud poblacional, atención primaria de salud, educación en odontología, y sus homólogos en inglés. Luego de ser filtrados, de los resultados obtenidos, se seleccionaron, por su vinculación al tema y actualización, 49 publicaciones científicas. Discusión: El análisis de situación de salud sirve como instrumento científico metodológico para identificar, priorizar y solucionar problemas comunitarios. La fase analítica es la más compleja del estudio, y en la que surgen dificultades para procesarla ordenadamente, debe comenzar por la clasificación epidemiológica de la población estudiada y seguir un orden lógico en su realización. Conclusiones: S e presenta una metodología que facilita la identificación y priorización de los riesgos substanciales, durante la fase analítica de un análisis de salud bucal(AU)


ABSTRACT Introduction: Health status analysis is an indispensable topic in the training of professionals who will be in charge of health in a community and as such require a useful tool to identify health problems in primary care. Objective: Describe a methodology to facilitate oral health status analysis in a community. Methods: A bibliographic review was conducted in the search engine Google Scholar and the databases PubMed, Lilacs, Cumed and SciELO Cuba. The review also covered the papers presented at the International Dental Congress 2015. The search terms used were 'health status', 'oral health', 'population health', 'primary health care', 'dental education' and their counterparts in Spanish. After filtering the results obtained, 49 scientific publications were selected due to their relationship to the subject and their topicality. Discussion: Health status analysis serves as a scientific methodological tool to identify, prioritize and solve community problems. The analytical stage is the most complex in the study and the one in which difficulties arise related to its orderly processing. The starting point should be the epidemiological classification of the study population, and a logical order should be followed in its conduct. Conclusions: A methodology is presented which facilitates identification and prioritization of substantial risks during the analytical stage of an oral health status analysis(AU)


Assuntos
Humanos , Atenção Primária à Saúde/métodos , Avaliação em Saúde/métodos , Saúde Bucal/tendências , Educação em Odontologia/métodos , Literatura de Revisão como Assunto , Bases de Dados Bibliográficas
20.
Pharm. pract. (Granada, Internet) ; 18(3): 0-0, jul.-sept. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-194198

RESUMO

BACKGROUND: Potentially inappropriate prescribing is clearly associated with adverse health consequences among older people. Nevertheless, scarce evidence exists regarding the prevalence of potentially inappropriate prescriptions (PIP) in Albania, a Western Balkans country. OBJECTIVE: The aim of this study was to assess the prevalence of PIP among older Albanian patients in primary care and to determine the associated sociodemographic and medical factors, including the presence of mild cognitive impairment (MCI). METHODS: Cross-sectional study in two primary healthcare centers located in two different cities of Albania, a middle-income country in the Western Balkans. The Montreal Cognitive Assessment (MoCA) tool was applied to evaluate MCI. PIPs were assessed by two trained pharmacists using the Beers criteria 2019 update. Multivariate logistic regression analysis was conducted for possible risk factors predicting PIP in the study population. RESULTS: At least one PIP was identified among 40.23 % of the participants (174 older patients) and 10.35 % had more than one PIP. MCI was detected among 79.31 % of the patients. The most commonly represented drug groups in PIP were diuretics (24.71 %), benzodiazepines in the presence of MCI and antidepressants (both 8.62 %). The lack of electrolytes monitoring was the most common reason for PIP. According to the multivariate analysis, the only statistically significant association observed was between PIP and number of drugs prescribed [three to four drugs (OR 3.34; 95% CI 1.65:6.76), five or more than five drugs (OR 4.08; 95% CI 1.42:11.69)]. CONCLUSIONS: About four out of 10 older Albanian patients experience PIP in primary care. Further studies are needed for a comprehensive estimation of the prevalence and factors associated with PIP, particularly among elderly with mild cognitive impairment


No disponible


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Atenção Primária à Saúde/métodos , Prescrição Inadequada/prevenção & controle , Disfunção Cognitiva/tratamento farmacológico , Disfunção Cognitiva/epidemiologia , Antidepressivos , Benzodiazepinas , Fatores de Risco , Farmacêuticos/normas , Estudos Transversais , Análise Multivariada
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA