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1.
IEEE Pulse ; 11(5): 17-20, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33064639

RESUMO

Before the novel coronavirus (COVID-19) started sweeping across the United States, it began on the coasts. The first known case was reported in a county just outside of Seattle, WA, with other cases quickly cropping up in California and in the greater New York City region. As the virus lingered on the periphery of the country, doctors and physicians working in inland, rural communities worried about what might happen if the virus hit their homes.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Pandemias , Pneumonia Viral/terapia , Serviços de Saúde Rural , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Criatividade , Humanos , Colaboração Intersetorial , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Saúde da População Rural , Serviços de Saúde Rural/organização & administração , População Rural , Estados Unidos/epidemiologia , Universidades , Voluntários
4.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47839

RESUMO

Desde o início da pandemia, o Governo do Brasil, por meio do Ministério da Saúde, destinou aos 26 estados e o Distrito Federal R$ 83,6 bilhões. Desse total, R$ 58,1 bilhões foram para serviços de rotina do SUS, e os outros R$ 25,5 bilhões para o enfrentamento da Covid-19.


Assuntos
Infecções por Coronavirus , Pandemias/prevenção & controle , Colaboração Intersetorial
5.
Yakugaku Zasshi ; 140(9): 1151-1164, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32879247

RESUMO

Pharmacists working in collaboration with doctors are mainly involved in proposals and inquiries of prescription. At such times, belief conflicts are expected to deteriorate teamwork and induce stress. However, there is no strong evidence for this. To clarify factors resulting in belief conflicts, we conducted a survey among 594 pharmacists working at medical institutions in Gifu City and belonging to Gifu Pharmaceutical Association or Gifu Prefectural Society of Hospital Pharmacists between January 2019 and April 2019. The items of the survey were gender, place of employment, pharmacist working experience (years), awareness of "professional competencies for pharmacists" stated in Model Core Curriculum for Pharmacy Education -2015 version-, whether each item of "professional competencies for pharmacists" is applicable to himself/herself or not, whether teamwork deteriorates and stress occurs due to proposals and inquiries of prescription or not, and Assessment of Belief Conflict in Relationship-14 (ABCR-14). The recovery rate of the questionnaire was 50.3% and the valid response rate was 77.6%. Multiple logistic regression and Bayesian network analyses revealed that "I can empathize with a patient's feelings and emotions, but I experience difficulty with unfair criticism" commonly resulted in teamwork deterioration due to proposals of prescription. "Pharmacist working experience years (more than 10 years)" and "The other staff make unreasonable demands of me in the work" commonly resulted in stress. Thus, belief conflicts in therapeutic relationships result in teamwork deterioration and stress in prescription proposals.


Assuntos
Teorema de Bayes , Competência Clínica , Proposta de Concorrência , Colaboração Intersetorial , Análise Multivariada , Equipe de Assistência ao Paciente , Farmacêuticos/psicologia , Prescrições , Estresse Psicológico/etiologia , Currículo , Educação em Farmácia , Feminino , Humanos , Masculino , Inquéritos e Questionários
7.
Palmas; [Secretaria de Estado da Saúde]; 20200000. 22 p.
Monografia em Português | LILACS, Coleciona SUS, CONASS, SES-TO | ID: biblio-1120798

RESUMO

Regimento para estabelecer normas, competências e procedimentos da Comissão Permanente de Integração Ensino-Serviço do Estado do Tocantins - CIES Estadual/CIB-TO, que é uma instância intersetorial e interinstitucional permanente que participa da formulação, condução, monitoramento e avaliação da Política de Educação Permanente em Saúde ­ EPS e atende o disposto no artigo 14 da Lei 8.080/1990, regulamentada pelo Decreto Presidencial N°. 7.508, de 28 de junho de 2011, e a Norma Operacional Básica de Recursos Humanos em Saúde (NOB/RH-SUS).


Rules to establish rules, competences and procedures of the Permanent Commission for Teaching-Service Integration of the State of Tocantins - State CIES / CIB-TO, which is a permanent intersectoral and interinstitutional body that participates in the formulation, conduction, monitoring and evaluation of the Education Policy Permanent in Health - EPS and meets the provisions of article 14 of Law 8.080 / 1990, regulated by Presidential Decree N °. 7,508, of June 28, 2011, and the Basic Operational Standard for Human Resources in Health (NOB / RH-SUS).


Normas para establecer normas, competencias y procedimientos de la Comisión Permanente de Integración Docente-Servicio del Estado de Tocantins - Estatal CIES / CIB-TO, que es un órgano permanente intersectorial e interinstitucional que participa en la formulación, conducción, seguimiento y evaluación de la Política Educativa. Permanente en Salud - EPS y cumple con lo dispuesto en el artículo 14 de la Ley 8.080 / 1990, reglamentado por Decreto Presidencial N °. 7,508, del 28 de junio de 2011, y la Norma Básica Operativa de Recursos Humanos en Salud (NOB / RH-SUS).


Assuntos
Diretrizes para o Planejamento em Saúde , Organizações/normas , Colaboração Intersetorial , Guias como Assunto/normas , Regulamentação Governamental , Educação Continuada/organização & administração , Direção e Governança do Setor de Saúde/normas , Conselho Diretor/normas
8.
Emergencias (Sant Vicenç dels Horts) ; 32(4): 269-277, ago. 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-190943

RESUMO

La investigación es una de las labores inalienables al ejercicio de la profesión médica. En el ámbito de la medicina de urgencias y emergencias (MUE), durante las últimas décadas se ha producido un aumento progresivo de esta actividad, liderada por los propios profesionales que trabajan en servicios de urgencias hospitalarios (SUH) y en los sistemas médicos de emergencias. No obstante, su producción científica se ha fundamentado más en la actividad de grupos unicéntricos que en redes de colaboración entre centros. Los últimos años, no obstante, han aparecido líneas de investigación exclusivamente dedicadas a la MUE en diversos institutos de investigación sanitaria españoles, reconocidos por el Instituto de Salud Carlos III, y también grupos de investigación de procesos específicos con una producción mantenida en el tiempo, muchos de ellos vinculados a la Sociedad Española de Medicina de Urgencias y Emergencias (SEMES). En el contexto de la pandemia de COVID-19 generada por el SARS-CoV-2, ha surgido la necesidad de que estos elementos investigadores unan sus fuerzas para hacer frente a los principales retos investigadores que supone esta pandemia desde la perspectiva de los SUH. Ello ha conducido a la fundación de la red de investigación SIESTA (Spanish Investigators on Emergency Situacions TeAm), cuyo primer reto es la realización del macroproyecto UMC-19 (Unusual Manifestations of Covid-19) en el plazo de un mes. A continuación se describen los pasos seguidos y los principales hitos de esta experiencia primigenia


Research is an inalienable part of medicine. The last few decades have seen a steady increase in research relevant to emergency medicine, led by professionals working in hospital emergency departments and related medical services. Most of the work has been done by groups in individual rather than networked centers. However, several Spanish institutions recognized by the Carlos III Health Institute (ISCIII) have developed lines of research that focus exclusively on emergency medicine. In addition, stable research groups - many of them associated with the Spanish Society of Emergency Medicine (SEMES) - have been engaged in ongoing studies of processes specific to our field. The coronavirus disease 2019 (COVID-19) pandemic caused by the acute respiratory syndrome coronavirus 2 (SARSCoV-2) created a need to focus all our efforts on the main challenges facing emergency departments. In response, the SIESTA (Spanish Investigators in Emergency Situations TeAm) network was created. The network's first challenge has been to complete the UMC-19 (Unusual Manifestations of COVID-19) macroproject within a single month. This paper describes the steps SIESTA followed and the main goals of this pioneering experience


Assuntos
Humanos , Colaboração Intersetorial , Serviços Médicos de Emergência/organização & administração , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Serviços Médicos de Emergência/ética , Serviços Médicos de Emergência/métodos , Planos e Programas de Saúde/organização & administração , Formulação de Projetos , Espanha/epidemiologia
9.
Plast Reconstr Surg ; 146(2): 437-446, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32740603

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has confronted the U.S. health care system with unprecedented challenges amidst a tenuous economic environment. As inpatient hospitals across the country prepare for an overwhelming influx of highly contagious COVID-19 cases, many nonemergent procedures have been cancelled or indefinitely postponed without guidance regarding eventual safe accommodation of these procedures in the future. Given the potentially prolonged impact of the COVID-19 pandemic on health care use, it is imperative for plastic surgeons to collaborate with other medical and surgical specialties to develop surge capacity protocols that allow continuation of safe, high-quality, nonemergent procedures. The purpose of this article is to provide necessary and timely public health information relevant to plastic surgery and also share a conceptual framework to guide surge capacity protocols for nonemergent surgery.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Regionalização/organização & administração , Capacidade de Resposta ante Emergências/organização & administração , Cirurgia Plástica/organização & administração , Procedimentos Cirúrgicos Ambulatórios/normas , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Infecções por Coronavirus/transmissão , Procedimentos Cirúrgicos Eletivos/normas , Humanos , Controle de Infecções/normas , Colaboração Intersetorial , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Pneumonia Viral/transmissão , Guias de Prática Clínica como Assunto , Procedimentos Cirúrgicos Reconstrutivos/normas , Regionalização/normas , Cirurgia Plástica/normas , Centros Cirúrgicos/organização & administração , Centros Cirúrgicos/normas , Telemedicina/organização & administração , Telemedicina/normas , Estados Unidos
11.
J Am Acad Orthop Surg ; 28(15): e670-e678, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32732659

RESUMO

Outcomes research has historically been driven by single-center investigations. However, multicenter studies represent an opportunity to overcome challenges associated with single-center studies, including generalizability and adequate power. In hand surgery, most clinical trials are single-center studies, with few having randomized controls and blinding of both participants and assessors. This pervasive issue jeopardizes the integrity of evidence-based practice in the field. Because healthcare payers emphasize applying the best available evidence to justify medical services, multicenter research collaborations are increasingly recognized as an avenue for efficiently generating high-quality evidence. Although no study design is perfect, the potential advantages of multicenter trials include generalizability of the results, larger sample sizes, and a collaboration of experienced investigators poised to optimize protocol development and study conduct. As the era of single-center studies shifts toward investment in multicenter trials and clinical registries, investigators will inevitably be faced with the challenges of conducting or contributing to multicenter research collaborations. We present our experiences in conducting multicenter investigations to provide insight into this demanding and rewarding frontier of research.


Assuntos
Amputação , Artrite Reumatoide/cirurgia , Artroplastia/métodos , Medicina Baseada em Evidências , Dedos/cirurgia , Dedos/transplante , Mãos/cirurgia , Colaboração Intersetorial , Estudos Multicêntricos como Assunto , Satisfação Pessoal , Rádio (Anatomia)/lesões , Rádio (Anatomia)/cirurgia , Reimplante , Silicones , Nervo Ulnar/cirurgia , Traumatismos do Punho/cirurgia , Humanos , Resultado do Tratamento
12.
Lancet ; 396(10251): 612-622, 2020 08 29.
Artigo em Inglês | MEDLINE | ID: mdl-32861306

RESUMO

BACKGROUND: Traditional and faith healers (TFH) provide care to a large number of people with psychosis in many sub-Saharan African countries but they practise outside the formal mental health system. We aimed to assess the effectiveness and cost-effectiveness of a collaborative shared care model for psychosis delivered by TFH and primary health-care providers (PHCW). METHODS: In this cluster-randomised trial in Kumasi, Ghana and Ibadan, Nigeria, we randomly allocated clusters (a primary care clinic and neighbouring TFH facilities) 1:1, stratified by size and country, to an intervention group or enhanced care as usual. The intervention included a manualised collaborative shared care delivered by trained TFH and PHCW. Eligible participants were adults (aged ≥18 years) newly admitted to TFH facilities with active psychotic symptoms (positive and negative syndrome scale [PANSS] score ≥60). The primary outcome, by masked assessments at 6 months, was the difference in psychotic symptom improvement as measured with the PANSS in patients in follow-up at 3 and 6 months. Patients exposure to harmful treatment practices, such as shackling, were also assessed at 3 and 6 months. Care costs were assessed at baseline, 3-month and 6-month follow-up, and for the entire 6 months of follow-up. This trial was registered with the National Institutes of Health Clinical Trial registry, NCT02895269. FINDINGS: Between Sept 1, 2016, and May 3, 2017, 51 clusters were randomly allocated (26 intervention, 25 control) with 307 patients enrolled (166 [54%] in the intervention group and 141 [46%] in the control group). 190 (62%) of participants were men. Baseline mean PANSS score was 107·3 (SD 17·5) for the intervention group and 108·9 (18·3) for the control group. 286 (93%) completed the 6-month follow-up at which the mean total PANSS score for intervention group was 53·4 (19·9) compared with 67·6 (23·3) for the control group (adjusted mean difference -15·01 (95% CI -21·17 to -8·84; 0·0001). Harmful practices decreased from 94 (57%) of 166 patients at baseline to 13 (9%) of 152 at 6 months in the intervention group (-0·48 [-0·60 to -0·37] p<0·001) and from 59 (42%) of 141 patients to 13 (10%) of 134 in the control group (-0·33 [-0·45 to -0·21] p<0·001), with no significant difference between the two groups. Greater reductions in overall care costs were seen in the intervention group than in the control group. At the 6 month assessment, greater reductions in total health service and time costs were seen in the intervention group; however, cumulative costs over this period were higher (US $627 per patient vs $526 in the control group). Five patients in the intervention group had mild extrapyramidal side effects. INTERPRETATION: A collaborative shared care delivered by TFH and conventional health-care providers for people with psychosis was effective and cost-effective. The model of care offers the prospect of scaling up improved care to this vulnerable population in settings with low resources. FUNDING: US National Institute of Mental Health.


Assuntos
Cura pela Fé/organização & administração , Medicina Tradicional Africana , Atenção Primária à Saúde/organização & administração , Transtornos Psicóticos/terapia , Adulto , Análise por Conglomerados , Análise Custo-Benefício , Feminino , Gana , Humanos , Colaboração Intersetorial , Masculino , Pessoa de Meia-Idade , Nigéria , Resultado do Tratamento , Adulto Jovem
13.
Pediatrics ; 146(3)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32769199

RESUMO

OBJECTIVES: Multiple early childhood screenings are recommended, but gaps persist in implementation. Our aim for this project was to improve screening, discussion, referral, and follow-up of development, autism spectrum disorder (ASD), maternal depression, and social determinants of health (SDoH) to 90% by July 2018. METHODS: This 1-year national quality improvement collaborative involved 19 pediatric primary care practices. Supported by virtual and in-person learning opportunities, practice teams implemented changes to early childhood screening. Monthly chart reviews were used to assess screening, discussion, referral, and follow-up for development, ASD, maternal depression, and SDoH. Parent surveys were used to assess parent-reported screening and referral and/or resource provision. Practice self-ratings and team surveys were used to assess practice-level changes. RESULTS: Participating practices included independent, academic, hospital-affiliated, and multispecialty group practices and community health centers in 12 states. The collaborative met development and ASD screening goals of >90%. Largest increases in screening occurred for maternal depression (27% to 87%; +222%; P < .001) and SDoH (26% to 76%; +231%; P < .001). Statistically significant increases in discussion of results occurred for all screening areas. For referral, significant increases were seen for development (53% to 86%; P < .001) and maternal depression (23% to 100%; P = .008). Parents also reported increased screening and referral and/or resource provision. Practice-level changes included improved systems to support screening. CONCLUSIONS: Practices successfully implemented multiple screenings and demonstrated improvement in subsequent discussion, referral, and follow-up steps. Continued advocacy for adequate resources to support referral and follow-up is needed to translate increased screening into improved health outcomes.


Assuntos
Colaboração Intersetorial , Programas de Rastreamento/normas , Atenção Primária à Saúde/normas , Melhoria de Qualidade/normas , Inquéritos e Questionários , Pré-Escolar , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Atenção Primária à Saúde/métodos
14.
Public Health ; 186: 107-109, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32795769

RESUMO

OBJECTIVES: We aim to advance productive collaborations between public health and political science by highlighting key challenges to an effective partnership between these fields and examining the opportunities that exist to overcome them. STUDY DESIGN: This short communication takes a descriptive analytical approach. METHODS: We synthesize conceptual insights drawn from (1) a recent international workshop that brought together researchers at the intersection of public health and political science and (2) the emerging literature on 'public health political science.' RESULTS: Although public health and political science would appear to be natural partners, work typically occurs in parallel rather than in partnership, resulting in missed opportunities for productive collaboration. We identify three key challenges to an effective partnership between political science and public health. These include the need for a common language and shared understanding of key concepts; mutual recognition of the complexity and diversity within each field; and a deeper engagement with their conceptual and methodological complementarities and differences. We also identify the area of evidence-informed policymaking as particularly ripe for productive collaboration between public health and political science. CONCLUSIONS: As the roles of politics and scientific evidence in public health policy grow ever more contentious, public health and political science need to move beyond their disciplinary comfort zones and engage productively with the different perspectives and contributions that each field has to offer.


Assuntos
Colaboração Intersetorial , Política , Saúde Pública , Comunicação , Humanos , Formulação de Políticas , Política Pública
19.
Urologe A ; 59(8): 912-918, 2020 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-32638067

RESUMO

The request for increased outpatient care is currently widely discussed in healthcare debates. With that, the sectoral interface (outpatient/hospital) is receiving greater attention, which provides an incentive for better cooperation and coordination of all healthcare providers. This also marks an opportunity to establish new cross-sectoral structures-also for research. The definitions of cross-sectoral care and the research content need to be in a standardized and consolidated manner. The provision of treatment data along the entire patent's path remains essential for health services research. In this context, the cross-sectoral interface could be regarded as fragile in that it is particularly sensitive to disruptions. The current increasing digitalization can also be seen as an opportunity to minimize the loss of information through the further development of cross-sectoral structures and to improve patient care, while simultaneously making a contribution to research across sectoral borders.


Assuntos
Assistência à Saúde , Pesquisa sobre Serviços de Saúde , Colaboração Intersetorial , Assistência Ambulatorial , Humanos
20.
Urologe A ; 59(8): 931-940, 2020 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-32691108

RESUMO

BACKGROUND: The aim of the study is to compare the German specialization training in urology with other European concepts, to analyze regional differences and to evaluate the development of the personnel structure in urology in German hospitals and private practices for the last 5 years. In addition, possibilities for financial funding of residents in the outpatient sector will be analyzed. MATERIALS AND METHODS: After analyzing the changes in the new Urology Specialization Training Regulations (Musterweiterbildungsordnung), the current urology training situation in Germany was evaluated in a European comparison. A trend analysis of the personnel structure in urology has been performed for recent years. Additionally, a possible intersectoral rotation concept was developed. Financial funding possibilities for urological residents were evaluated in a standardized telephone survey. RESULTS: Compared to other European countries, the exceptional position of German urology with its enormous spectrum becomes evident. In some states, there are already possibilities of financial support provided by regional Associations of Statutory Health Insurance Physicians (Krankenversicherung) for the training of urological residents in private practices. CONCLUSIONS: While the organization of specialization training is commonly nation based in other European countries, there is heterogeneity in Germany due to the sovereignty of the states. Due to the shift of many specialization training contents towards the outpatient sector, alliances between clinics and practices in the sense of intersectoral training will become more important in the future. Therefore, the use of already existing funds and-as a long-term objective-a nationwide access to such funding is desirable.


Assuntos
Internato e Residência , Colaboração Intersetorial , Urologia/educação , Currículo , Europa (Continente) , Alemanha , Humanos , Especialização
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