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1.
Biomed Res Int ; 2021: 8871287, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33855086

RESUMO

Background: Facility-based death review committee (DRC) of neonatal deaths and stillbirths can encourage stakeholders to enhance the quality of care during the antenatal period and labour to improve birth outcomes. To understand the benefits and impact of the DRCs, this study was aimed at exploring the DRC members' perception about the role and benefits of the newly developed facility-based DRCs in five pilot hospitals in Jordan, to assess women empowerment, decision-making process, power dynamics, culture and genderism as contributing factors for deaths, and impact of COVID-19 lockdown on births. Methods: A descriptive study of a qualitative design-using focus group discussions-was conducted after one year of establishing DRCs in 5 pilot large hospitals. The number of participants in each focus group ranged from 8 to10, and the total number of participants was 45 HCPs (nurses and doctors). Questions were consecutively asked in each focus group. The moderator asked the main questions from the guide and then used probing as needed. A second researcher observed the conversation and took field notes. Results: Overall, there was an agreement among the majority of DRC members across all hospitals that the DRC was successful in identifying the exact cause of neonatal deaths and stillbirths as well as associated modifiable factors. There was also a consensus that the DRC contributed to an improvement in health services provided for pregnant women and newborns as well as protecting human rights and enabling women to be more interdependent in taking decisions related to family planning. Moreover, the DRC agreed that a proportion of the neonatal deaths and stillbirths occurring in the hospitals could have been prevented if adequate antenatal care was provided and some traditional harmful practices were avoided. Conclusions: Facility-based neonatal death review audit is practical and can be used to identify exact causes of maternal and neonatal deaths and is a valuable tool for hospital quality indicators. It can also change the perception and practice of health care providers, which may be reflected in improving the quality of provided healthcare services.


Assuntos
Comitês Consultivos , Atitude Frente a Saúde , Morte Perinatal , Natimorto , Comitês Consultivos/organização & administração , Tomada de Decisões , Feminino , Grupos Focais , Pessoal de Saúde , Hospitais , Direitos Humanos , Humanos , Recém-Nascido , Controle de Infecções/métodos , Unidades de Terapia Intensiva Neonatal , Jordânia , Morte Perinatal/prevenção & controle , Gravidez , Gestantes , Cuidado Pré-Natal
2.
Lancet Glob Health ; 9(4): e489-e551, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33607016
3.
Lancet Respir Med ; 9(4): 430-434, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33450202

RESUMO

The COVID-19 pandemic strained health-care systems throughout the world. For some, available medical resources could not meet the increased demand and rationing was ultimately required. Hospitals and governments often sought to establish triage committees to assist with allocation decisions. However, for institutions operating under crisis standards of care (during times when standards of care must be substantially lowered in the setting of crisis), relying on these committees for rationing decisions was impractical-circumstances were changing too rapidly, occurring in too many diverse locations within hospitals, and the available information for decision making was notably scarce. Furthermore, a utilitarian approach to decision making based on an analysis of outcomes is problematic due to uncertainty regarding outcomes of different therapeutic options. We propose that triage committees could be involved in providing policies and guidance for clinicians to help ensure equity in the application of rationing under crisis standards of care. An approach guided by egalitarian principles, integrated with utilitarian principles, can support physicians at the bedside when they must ration scarce resources.


Assuntos
/terapia , Cuidados Críticos/organização & administração , Alocação de Recursos para a Atenção à Saúde/organização & administração , Pandemias/prevenção & controle , Triagem/organização & administração , Comitês Consultivos/organização & administração , Comitês Consultivos/normas , Cuidados Críticos/economia , Cuidados Críticos/normas , Cuidados Críticos/estatística & dados numéricos , Tomada de Decisões Gerenciais , Saúde Global/economia , Saúde Global/normas , Alocação de Recursos para a Atenção à Saúde/economia , Alocação de Recursos para a Atenção à Saúde/normas , Política de Saúde , Humanos , Colaboração Intersetorial , Pandemias/economia , Guias de Prática Clínica como Assunto , Padrão de Cuidado/economia , Triagem/normas
6.
Eur Respir Rev ; 29(157)2020 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-33020069

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome-coronavirus-2. Consensus suggestions can standardise care, thereby improving outcomes and facilitating future research. METHODS: An International Task Force was composed and agreement regarding courses of action was measured using the Convergence of Opinion on Recommendations and Evidence (CORE) process. 70% agreement was necessary to make a consensus suggestion. RESULTS: The Task Force made consensus suggestions to treat patients with acute COVID-19 pneumonia with remdesivir and dexamethasone but suggested against hydroxychloroquine except in the context of a clinical trial; these are revisions of prior suggestions resulting from the interim publication of several randomised trials. It also suggested that COVID-19 patients with a venous thromboembolic event be treated with therapeutic anticoagulant therapy for 3 months. The Task Force was unable to reach sufficient agreement to yield consensus suggestions for the post-hospital care of COVID-19 survivors. The Task Force fell one vote shy of suggesting routine screening for depression, anxiety and post-traumatic stress disorder. CONCLUSIONS: The Task Force addressed questions related to pharmacotherapy in patients with COVID-19 and the post-hospital care of survivors, yielding several consensus suggestions. Management options for which there is insufficient agreement to formulate a suggestion represent research priorities.


Assuntos
Comitês Consultivos/organização & administração , Betacoronavirus , Consenso , Infecções por Coronavirus/epidemiologia , Cooperação Internacional , Pneumonia Viral/epidemiologia , Pneumologia/normas , Sociedades Médicas , Europa (Continente) , Humanos , Pandemias , Estados Unidos
16.
BMC Health Serv Res ; 20(1): 392, 2020 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-32384886

RESUMO

BACKGROUND: Community advisory groups (CAGs) have been shown to be catalysts who bridge the gap between communities and primary health care facilities by sustaining good working relationships through community engagement to improve the quality of the health care services. This study aimed to explore the establishment, operation, and accomplishments of a CAG towards building a strong partnership between the health facilities and local communities in support of the Partner Defined Quality (PDQ) process, to improve the delivery of quality maternal and neonatal care in a peri-urban setting in the province of KwaZulu-Natal, South Africa. METHODS: The study used a qualitative exploratory research design. Recruitment followed a purposive sampling approach. The study targeted leadership representatives from the community, potential beneficiaries, and health care providers in the selected catchment areas. Participants were identified during community mobilization events that took place during the preparatory stage to ensure key stakeholder support. A participatory research approach was used to discuss membership, composition, the selection criteria, including formulation, and agreement on terms of reference of the CAG membership, roles and responsibilities. A rapid assessment method was used for data collection and analysis of establishment of the CAG, its activities and accomplishments. RESULTS: The community nominated 24 CAG members during the consultative meetings and the organogram provides clear terms of reference, roles and responsibilities. Immediately after inception, the CAG used four indicators (weaknesses, threats and risks, strengths, and opportunities) to review the community and primary health care challenges that affect their communities. These CAG activities were linked with the phases of the PDQ process. The CAG committed itself going forward to continue to create an enabling environment for all stakeholders working to improve the well-being of the community, especially the PDQ teams working on improving the care of pregnant mothers and their babies pre- and post-delivery. CONCLUSION: This work shows that developing community relationships and infrastructure are critical initial stages before embarking on PDQ planning and implementation. Empowerment, local ownership, funding, technical resources and ongoing support are critical elements for sustainability of CAG activities.


Assuntos
Comitês Consultivos/organização & administração , Relações Comunidade-Instituição , Serviços de Saúde Materna/organização & administração , Atenção Primária à Saúde/organização & administração , Melhoria de Qualidade/organização & administração , Serviços Urbanos de Saúde/organização & administração , Feminino , Humanos , Recém-Nascido , Gravidez , África do Sul
19.
Rev Esp Salud Publica ; 942020 Mar 11.
Artigo em Espanhol | MEDLINE | ID: mdl-32158014

RESUMO

The Committee for Immunization Programme and Registry (Ponencia de Programa y Registro de Vacunaciones) was created in 1991 to advise the Interterritorial Council of the National Health System on the situation of vaccine preventable diseases and the establishment and evaluation of measures for their prevention and control. Among other functions, this Committee evaluates the immunization programmes taking into account the scientific evidence and the epidemiological situation. In this way the Committee advises decision makers on the Public Health Commission of the Interterritorial Council. Any change in the National Immunization Programme, since the first one published in 1996 by the Interterritorial Council to the current Immunization Programme throughout life, has been advised from the technical and scientific point of view by this Committee. Taking into account both the work developed and the methodology used for developing the technical advice, the Committee for Immunization Programme and Registry is considered the National Immunization Technical Advisory Group for Spain. This paper reviews the functions and work developed by the Committee for Immunization Programme and Registry, the changes conducted in the National Immunization Programme under its advice and the current challenges.


Assuntos
Comitês Consultivos/organização & administração , Política de Saúde , Programas de Imunização/organização & administração , Humanos , Sistema de Registros , Espanha
20.
Pediatrics ; 145(4)2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32193211

RESUMO

Asthma is a significant public health issue, impacting quality of life, morbidity, and health care costs nationally. Stock asthma rescue medication policies authorize school districts to maintain unassigned albuterol and enable trained staff members to administer the medication in response to asthma symptoms, exercise premedication, and asthma emergencies. Stock asthma rescue (or reliever) medication laws serve as an important fail-safe measure. Such laws provide districts with the ability to respond if a student has an asthma emergency at school but either lacks a diagnosis or does not have access to their own medication. As of September 2019, 13 states have enacted either a law or regulation authorizing the stocking of asthma rescue medication in schools: Arizona, Colorado, Georgia, Illinois, Missouri, New Hampshire, New Jersey, New Mexico, Oklahoma, Ohio, Texas, Utah, and West Virginia. Three additional states provide stock albuterol asthma guidelines but do not have legislation: Indiana, New York, and Nebraska. Some states have found that these policies reduce the need for 911 calls and emergency medical services transports as a result of asthma exacerbations. Initial data also demonstrate that these policies reach populations in need and improve health outcomes. This case study will describe the current state of asthma in Illinois, an innovative policy solution to address asthma emergencies in schools, and the steps taken to advocate for stock asthma rescue medication in Illinois. Legislation for stock albuterol in Illinois was signed into law in August 2018.


Assuntos
Albuterol/uso terapêutico , Antiasmáticos/uso terapêutico , Asma/tratamento farmacológico , Emergências , Instituições Acadêmicas/legislação & jurisprudência , Comitês Consultivos/organização & administração , Criança , Armazenamento de Medicamentos/legislação & jurisprudência , Regulamentação Governamental , Acesso aos Serviços de Saúde/legislação & jurisprudência , Humanos , Illinois , Legislação de Medicamentos , Estoque Estratégico/legislação & jurisprudência , Estados Unidos
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