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1.
Washington, D.C.; PAHO; 2021-02-03. (PAHO/FPL/CLP/20-0017).
em Inglês | PAHO-IRIS | ID: phr-53245

RESUMO

In this abridged version of the Evidence-based Clinical Practice Guidelines for the Follow-Up of at-risk neonates, we provide recommendations for the care of newborns up to 2 years of age, corresponding to the first phase of their follow-up. The recommendations are intended for all health sector staff responsible for the primary care of these neonates: general practitioners, family practitioners, pediatricians, neonatologists, pediatric ophthalmologists, pediatric otolaryngologists, nursing professionals, specialists in other fields, and multidisciplinary staff involved in the care process. The purpose of these guidelines is to facilitate policy implementation processes carried out by decision-makers and members of government bodies, and will also be useful for parents, mothers, and caregivers. The main topics covered by this document include the hospital discharge criteria, including screening tests; information and support for parents, mothers, and caregivers; screening at the follow-up visit, and the frequency of follow-ups until the infant is 2 years of age. These guidelines do not address matters related to nursing or comorbidities.


Assuntos
Recém-Nascido , Diretrizes para o Planejamento em Saúde , Terapia Intensiva Neonatal , Mortalidade Infantil , Recém-Nascido Prematuro , Fatores de Risco , Família , Promoção da Saúde
2.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47979

RESUMO

Até 5 milhões de mortes por ano poderiam ser evitadas se a população em todo o mundo fosse mais ativa. Em um momento em que muitas pessoas encontram-se em casa devido à COVID-19, a Organização Mundial da Saúde (OMS) lançou nesta quinta-feira (26) novas diretrizes sobre atividade física e comportamento sedentário, que enfatizam que todas as pessoas, de todas as idades e habilidades, podem ser fisicamente ativas e que todo tipo de movimento conta.


Assuntos
Atividade Motora , Comportamento Sedentário , Diretrizes para o Planejamento em Saúde
3.
Rev. chil. fonoaudiol. (En línea) ; 19: 1-10, nov. 2020. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1148403

RESUMO

A nivel internacional se propone un mínimo de un profesional fonoaudiólogo por cada diez camas críticas o más, dependiendo de la complejidad de cada institución. En Chile no existen lineamientos similares, no obstante, el Ministerio de Salud ha generado recomendaciones para el cálculo de la brecha profesional según número y complejidad de las camas hospitalarias. El objetivo de este estudio es estimar el número de fonoaudiólogos y horas de contratación teóricas requeridas para la atención de pacientes adultos hospitalizados en instituciones públicas de alta complejidad en Chile. Para ello se realizó un estudio descriptivo, observacional, transversal. Se incluyeron todos los hospitales públicos de alta complejidad del país, excluyendo aquellos pediátricos y psiquiátricos. Como instrumentos se utilizaron el documento "Modelo de Gestión Red de Rehabilitación" del Ministerio de Salud, la base de datos actualizada del total de camas de la red hospitalaria y el software Microsoft Excel. El estudio fue aprobado por Comité Ético Científico del Hospital San Juan de Dios. En total 59 de 188 hospitales existentes en Chile fueron incluidos. De acuerdo con el análisis realizado basado en el número de camas en Chile, se requieren aproximadamente 269 fonoaudiólogos contratados 44 horas semanales para la atención de pacientes adultos en hospitales de alta complejidad. De ellos 104 se ubican en la Región Metropolitana; alrededor de 31 en la Región del BíoBío y cerca de 24 en la Región de Valparaíso. Se sugiere la revisión de las orientaciones ministeriales y la realización de un segundo estudio sobre la brecha profesional existente en Chile con los datos obtenidos.


International institutions have suggested one Speech and Language Therapist per ten critical beds, and possibly even more forhigh-complexity institutions. However, there are no similar recommendations in Chile, although the Ministry of Health has developed recommendations to calculate the number of professionals required according to the number and type of clinical bed. The aim of this study is to describe the number of Speech and Language Therapists along with the number of theorical working hours per week required for the attention of hospitalised adult patients in high-complexity hospitals in Chile, for which a descriptive, observational and transversal study was performed. High-complexity hospitals were included, excluding psychiatric and paediatric institutions. Microsoft Excel, the "Modelo de Gestión Red de Rehabilitación" guideline from the Ministry of Health, and the updated database of the clinical network beds were also used. This study was previously approved by a Research Ethics Committee from Hospital San Juan de Dios, and a total of 59 out of 188 hospitals were included. According to the analysis based on features of the clinical beds, 269 Speech and Language Therapists are required for 44 hours per week to attend adult patients in high-complexity hospitals across the country. Of the 269 professionals, 104 are needed in the Metropolitan region, approximately 31 in the Bío-Bío region and circa 24 in the Valparaíso region. According to these results, it is suggested the Ministry review its guidelines and undertake a further project in order to identify the current professional gap in Chile.


Assuntos
Humanos , Patologia da Fala e Linguagem/estatística & dados numéricos , Atenção à Saúde , Fonoaudiologia/estatística & dados numéricos , Mão de Obra em Saúde/organização & administração , Planejamento Hospitalar , Chile , Estudos Transversais , Planejamento Sanitário , Instalações de Saúde , Mão de Obra em Saúde/estatística & dados numéricos , Diretrizes para o Planejamento em Saúde , Administração Hospitalar , Hospitais/estatística & dados numéricos
5.
Circ J ; 84(11): 2023-2026, 2020 10 23.
Artigo em Inglês | MEDLINE | ID: mdl-32981908

RESUMO

BACKGROUND: The Japanese Circulation Society proposes recommendations for all healthcare professionals involved in cardiovascular medicine to protect them from infection and ensure that seriously ill patients requiring urgent care receive proper treatment.Methods and Results:Patients are divided into "Positive or suspected coronavirus disease 2019 (COVID-19)" and "All others". Furthermore, tests and treatments are divided into emergency or standby. For each category, we propose recommendations. CONCLUSIONS: To maintain the cardiovascular care system, The Japanese Circulation Society recommends completely preventing nosocomial COVID-19 infections, ensuring adequate PPE necessary for healthcare personnel, and learning and implementing standard precautions.


Assuntos
Betacoronavirus/genética , Doenças Cardiovasculares/terapia , Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/prevenção & controle , Diretrizes para o Planejamento em Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/virologia , Infecção Hospitalar/virologia , Pessoal de Saúde , Humanos , Controle de Infecções/métodos , Intubação Intratraqueal , Japão , Equipamento de Proteção Individual , Pneumonia Viral/fisiopatologia , Pneumonia Viral/virologia , Reação em Cadeia da Polimerase , Sociedades Médicas
6.
Sensors (Basel) ; 20(17)2020 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-32887338

RESUMO

COVID-19 has shown a relatively low case fatality rate in young healthy individuals, with the majority of this group being asymptomatic or having mild symptoms. However, the severity of the disease among the elderly as well as in individuals with underlying health conditions has caused significant mortality rates worldwide. Understanding this variance amongst different sectors of society and modelling this will enable the different levels of risk to be determined to enable strategies to be applied to different groups. Long-established compartmental epidemiological models like SIR and SEIR do not account for the variability encountered in the severity of the SARS-CoV-2 disease across different population groups. The objective of this study is to investigate how a reduction in the exposure of vulnerable individuals to COVID-19 can minimise the number of deaths caused by the disease, using the UK as a case study. To overcome the limitation of long-established compartmental epidemiological models, it is proposed that a modified model, namely SEIR-v, through which the population is separated into two groups regarding their vulnerability to SARS-CoV-2 is applied. This enables the analysis of the spread of the epidemic when different contention measures are applied to different groups in society regarding their vulnerability to the disease. A Monte Carlo simulation (100,000 runs) along the proposed SEIR-v model is used to study the number of deaths which could be avoided as a function of the decrease in the exposure of vulnerable individuals to the disease. The results indicate a large number of deaths could be avoided by a slight realistic decrease in the exposure of vulnerable groups to the disease. The mean values across the simulations indicate 3681 and 7460 lives could be saved when such exposure is reduced by 10% and 20% respectively. From the encouraging results of the modelling a number of mechanisms are proposed to limit the exposure of vulnerable individuals to the disease. One option could be the provision of a wristband to vulnerable people and those without a smartphone and contact-tracing app, filling the gap created by systems relying on smartphone apps only. By combining very dense contact tracing data from smartphone apps and wristband signals with information about infection status and symptoms, vulnerable people can be protected and kept safer.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Transmissão de Doença Infecciosa/estatística & dados numéricos , Modelos Teóricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Saúde Pública/métodos , Quarentena/organização & administração , Populações Vulneráveis , Busca de Comunicante/métodos , Infecções por Coronavirus/epidemiologia , Surtos de Doenças/prevenção & controle , Diretrizes para o Planejamento em Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Controle de Infecções/estatística & dados numéricos , Invenções/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/organização & administração , Serviços Preventivos de Saúde/normas , Saúde Pública/estatística & dados numéricos , Administração em Saúde Pública/métodos , Quarentena/métodos , Quarentena/estatística & dados numéricos , Reino Unido/epidemiologia , Populações Vulneráveis/estatística & dados numéricos
7.
Palmas; [Secretaria de Estado da Saúde]; 25 set. 2020. 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.
Medicine (Baltimore) ; 99(34): e21926, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846861

RESUMO

BACKGROUND: Intensive care unit-acquired weakness (ICU-AW) is an acquired neuromuscular lesion and a common occurrence in patients who are critically ill. There are already systematic reviews on ICU-AW. Therefore, we provide a protocol for an overview of systematic reviews to improve the effectiveness of the construction of an evidence-based practice for prevention of ICU-AW. METHODS: We will search the PubMed, CINAHL, EMBASE, and the Cochrane Library for the relevant systematic review or meta-analyses about ICU-AW. Study selection, data extraction, and the quality assessment of the included studies will be performed independently by 2 reviewers. And the methodological quality, report quality and evidence quality will be evaluated by Assessment of Multiple Systematic Reviews-2 tool, Preferred Reporting Items for Systematic Reviews and Meta Analyses Statement checklist and Grading of Recommendations Assessment, Development and Evaluation system, respectively. RESULTS: This overview of systematic reviews and meta-analysis will collect the evidence published about the ICU-AW. CONCLUSION: We hope that our research will contribute to clinicians and public decision making about the ICU-AW. REGISTRATION NUMBER: INPLASY202070067.


Assuntos
Unidades de Terapia Intensiva/estatística & dados numéricos , Debilidade Muscular/etiologia , Debilidade Muscular/prevenção & controle , Estado Terminal/enfermagem , Tomada de Decisões , Estudos de Avaliação como Assunto , Prática Clínica Baseada em Evidências/métodos , Feminino , Diretrizes para o Planejamento em Saúde , Humanos , Masculino , Debilidade Muscular/epidemiologia , Prevalência , Fatores de Risco
11.
Jpn J Clin Oncol ; 50(8): 852-858, 2020 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-32419014

RESUMO

OBJECTIVE: Watson for Oncology (WFO), an artificial intelligence from IBM Corporation, can provide a treatment plan by analyzing patient's disease characteristics. The present study was performed to examine the concordance between treatment recommendations proposed by WFO and the multidisciplinary tumor board at our center. The aim was to explore the feasibility of using WFO for breast cancer cases in China and to ascertain the ways to make WFO more suitable for Chinese patients with breast cancer. METHODS: Data from 302 breast cancer patients treated at the Second Affiliated Hospital of Xi'an Jiaotong University between October 2016 and February 2018 was retrieved and retrospectively analyzed by WFO. The recommendations were divided into 'recommended', 'considered' and 'not recommended' groups. Results were considered concordant when oncologists' recommendations were categorized as 'recommended' or 'for consideration' by WFO. RESULTS: The concordance rate of 200 subjects with postoperative adjuvant therapy was 77%. However, the rate was 27.5% in the remaining 102 cases with metastatic disease receiving either first-line or no treatment. Further analysis demonstrated that inconsistencies were mainly due to different choices of chemotherapy regimens. Subgroup study indicates that tumor stage, receptor status and age also had influences at the concordance rate. CONCLUSION: The results of this study suggest that WFO is a promising artificial intelligence system for the treatment of breast cancer. These findings can also serve as a reference framework for the inclusion of artificial intelligence in the ongoing medical reform in China.


Assuntos
Inteligência Artificial , Neoplasias da Mama/terapia , Diretrizes para o Planejamento em Saúde , Pesquisa Interdisciplinar , Oncologia , Adulto , Idoso , Neoplasias da Mama/patologia , China , Terapia Combinada , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Metástase Neoplásica , Estudos Retrospectivos
12.
Am J Trop Med Hyg ; 103(1_Suppl): 125-134, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32400345

RESUMO

Herein, we summarize what we consider are major contributions resulting from the Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) program, including its key findings and key messages from those findings. Briefly, SCORE's key findings are as follows: i) biennial mass drug administration (MDA) with praziquantel can control schistosomiasis to moderate levels of prevalence; ii) MDA alone will not achieve elimination; iii) to attain and sustain control throughout endemic areas, persistent hotspots need to be identified following a minimal number of years of annual MDA and controlled through adaptive strategies; iv) annual MDA is more effective than biennial MDA in high-prevalence areas; v) the current World Health Organization thresholds for decision-making based on the prevalence of heavy infections should be redefined; and vi) point-of-care circulating cathodic antigen urine assays are useful for Schistosoma mansoni mapping in low-to-moderate prevalence areas. The data and specimens collected and curated through SCORE efforts will continue to be critical resource for future research. Besides providing useful information for program managers and revision of guidelines for schistosomiasis control and elimination, SCORE research and outcomes have identified additional questions that need to be answered as the schistosomiasis community continues to implement effective, evidence-based programs. An overarching contribution of SCORE has been increased cohesiveness within the schistosomiasis field-oriented community, thereby fostering new and productive collaborations. Based on SCORE's findings and experiences, we propose new approaches, thresholds, targets, and goals for control and elimination of schistosomiasis, and recommend research and evaluation activities to achieve these targets and goals.


Assuntos
Diretrizes para o Planejamento em Saúde , Schistosoma mansoni/efeitos dos fármacos , Esquistossomose/prevenção & controle , África/epidemiologia , Animais , Anti-Helmínticos/uso terapêutico , Antígenos de Helmintos/imunologia , Biomarcadores/sangue , Criança , Fezes/parasitologia , Glicoproteínas/imunologia , Proteínas de Helminto/imunologia , Humanos , Masculino , Administração Massiva de Medicamentos , Doenças Negligenciadas/tratamento farmacológico , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/prevenção & controle , Contagem de Ovos de Parasitas , Praziquantel/uso terapêutico , Prevalência , Saúde Pública , Esquistossomose/diagnóstico , Esquistossomose/tratamento farmacológico , Esquistossomose/epidemiologia , Esquistossomose mansoni/diagnóstico , Esquistossomose mansoni/tratamento farmacológico , Esquistossomose mansoni/epidemiologia , Esquistossomose mansoni/prevenção & controle
13.
Am J Trop Med Hyg ; 103(1_Suppl): 92-96, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32400346

RESUMO

The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) was established in late 2008 to conduct operational research to inform global health practices related to the control and elimination of schistosomiasis. The greatest part of the SCORE investment has been in multiyear, long-term efforts, including cluster-randomized trials of gaining and sustaining control of schistosomiasis, trials on elimination of schistosomiasis, and diagnostic test development and evaluation. In the course of planning and conducting SCORE studies, critical questions were raised that could be answered relatively quickly by collecting, collating, and synthesizing existing data. Through its Rapid Answers Project (RAP), the SCORE conducted seven systematic reviews, including four associated meta-analyses, on issues related to screening for schistosomiasis, enhancing mass drug administration, treatment impacts, and the efficacy of snail control for prevention of human schistosomiasis. This article summarizes the findings of the seven RAP reports and provides links to the studies and their supporting information.


Assuntos
Diretrizes para o Planejamento em Saúde , Esquistossomose , Animais , Anti-Helmínticos/uso terapêutico , Análise de Dados , Saúde Global , Fidelidade a Diretrizes , Humanos , Administração Massiva de Medicamentos , Moluscocidas , Esquistossomose/diagnóstico , Esquistossomose/epidemiologia , Esquistossomose/prevenção & controle , Caramujos/parasitologia , Resultado do Tratamento
14.
Am J Trop Med Hyg ; 103(1_Suppl): 114-124, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32400350

RESUMO

For the past 10 years, the Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), funded by the Bill & Melinda Gates Foundation, has been supporting operational research to provide a stronger evidence base for controlling and moving toward elimination of schistosomiasis. The SCORE portfolio was developed and implemented with engagement from many stakeholders and sectors. Particular efforts were made to include endemic country neglected tropical disease program managers. Examples of the challenges we encountered include the need to balance rigor (e.g., conducting large cluster-randomized trials) with ensuring relevance to real-world settings, allowing for local contexts while standardizing key study aspects, adjusting to evolving technologies, and incorporating changing technologies into multiyear studies. The Schistosomiasis Consortium for Operational Research and Evaluation's findings and data and the collected specimens will continue to be useful in the years to come. Our experiences and lessons learned can benefit both program managers and researchers conducting similar work in the future.


Assuntos
Diretrizes para o Planejamento em Saúde , Esquistossomose/prevenção & controle , África/epidemiologia , Anti-Helmínticos/uso terapêutico , Análise de Dados , Humanos , Administração Massiva de Medicamentos , Doenças Negligenciadas/tratamento farmacológico , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/prevenção & controle , Prevalência , Saúde Pública , Esquistossomose/tratamento farmacológico , Esquistossomose/epidemiologia , Resultado do Tratamento , Medicina Tropical/estatística & dados numéricos
15.
J Am Geriatr Soc ; 68(6): 1136-1142, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32374440

RESUMO

Coronavirus disease 2019 (COVID-19) continues to impact older adults disproportionately, from severe illness and hospitalization to increased mortality risk. Concurrently, concerns about potential shortages of healthcare professionals and health supplies to address these needs have focused attention on how resources are ultimately allocated and used. Some strategies misguidedly use age as an arbitrary criterion, inappropriately disfavoring older adults. This statement represents the official policy position of the American Geriatrics Society (AGS). It is intended to inform stakeholders including hospitals, health systems, and policymakers about ethical considerations to consider when developing strategies for allocating scarce resources during an emergency involving older adults. Members of the AGS Ethics Committee collaborated with interprofessional experts in ethics, law, nursing, and medicine (including geriatrics, palliative care, emergency medicine, and pulmonology/critical care) to conduct a structured literature review and examine relevant reports. The resulting recommendations defend a particular view of distributive justice that maximizes relevant clinical factors and deemphasizes or eliminates factors placing arbitrary, disproportionate weight on advanced age. The AGS positions include (1) avoiding age per se as a means for excluding anyone from care; (2) assessing comorbidities and considering the disparate impact of social determinants of health; (3) encouraging decision makers to focus primarily on potential short-term (not long-term) outcomes; (4) avoiding ancillary criteria such as "life-years saved" and "long-term predicted life expectancy" that might disadvantage older people; (5) forming and staffing triage committees tasked with allocating scarce resources; (6) developing institutional resource allocation strategies that are transparent and applied uniformly; and (7) facilitating appropriate advance care planning. The statement includes recommendations that should be immediately implemented to address resource allocation strategies during COVID-19, aligning with AGS positions. The statement also includes recommendations for post-pandemic review. Such review would support revised strategies to ensure that governments and institutions have equitable emergency resource allocation strategies, avoid future discriminatory language and practice, and have appropriate guidance to develop national frameworks for emergent resource allocation decisions. J Am Geriatr Soc 68:1136-1142, 2020.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Geriatria/normas , Alocação de Recursos para a Atenção à Saúde/normas , Diretrizes para o Planejamento em Saúde , Pandemias , Pneumonia Viral , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Estados Unidos/epidemiologia
16.
J Gynecol Oncol ; 31(4): e68, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32458596

RESUMO

The outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 has rapidly spread globally. Cancer patients are at a higher risk of being infected with the coronavirus and are more likely to develop severe complications, as compared to the general population. The increasing spread of COVID-19 presents challenges for the clinical care of patients with gynecological malignancies. Concerted efforts should be put into managing gynecological malignancies in an orderly manner by strictly implementing the measures that are specifically developed for controlling the spread of COVID-19. We have drafted Recommendations on Management of Gynecological Malignancies during the COVID-19 Pandemic based on our experience on controlling COVID-19 pandemic in China. We recommend that patients with gynecological malignancies should be managed in hierarchical and individualized manners in combination with local conditions related to COVID-19. Medical care decision should be balanced between controlling COVID-19 pandemic spread and timely diagnosis and treatment for gynecologic oncology patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Neoplasias dos Genitais Femininos/epidemiologia , Pneumonia Viral/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Feminino , Guias como Assunto , Ginecologia/normas , Diretrizes para o Planejamento em Saúde , Humanos , Oncologistas/normas , Pandemias
17.
Respir Med ; 168: 105949, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32469706

RESUMO

BACKGROUND: Cough is a common yet distressing symptom that results in significant health care costs from outpatient visits and related consultations. OBJECTIVE: The understanding of the pathobiology of cough in recent times has undergone an evolution with Cough hypersensitivity syndrome (CHS) being suggested in most cases of dry cough. However, in the case of productive cough, ancillary mechanisms including impaired Mucociliary clearance, in addition to hypermucosecretory bronchospastic conditions of Smoker's cough, asthma-COPD overlap, bronchiectasis, and allergic bronchopulmonary aspergillosis, need to be critically addressed while optimizing patient care with symptomatic therapy in outpatient settings of India. METHODS: In this review, evidence-based graded recommendations on use of antitussives - & protussives as a Position Paper were developed based on the Level and Quality of Scientific evidence as per Agency for Health Care and Quality (AHRQ) criteria listing and Expert opinions offered by a multidisciplinary EMA panel in India. RESULTS: Management of acute or chronic cough involves addressing common issues of environmental exposures and patient concerns before instituting supportive therapy with antitussives or bronchodilatory cough formulations containing mucoactives, anti-inflammatory, or short-acting beta-2 agonist agents. CONCLUSION: The analyses provides a real world approach to the management of acute or chronic cough in various clinical conditions with pro- or antitussive agents while avoiding their misuse in empirical settings.


Assuntos
Antitussígenos/uso terapêutico , Tosse/tratamento farmacológico , Tosse/etiologia , Aspergilose Broncopulmonar Alérgica/complicações , Asma/complicações , Bronquiectasia/complicações , Broncodilatadores/uso terapêutico , Tosse/diagnóstico , Tosse/economia , Medicina Baseada em Evidências , Expectorantes/uso terapêutico , Diretrizes para o Planejamento em Saúde , Humanos , Índia , Erros de Medicação/prevenção & controle , Depuração Mucociliar , Doença Pulmonar Obstrutiva Crônica/complicações , Fumar/efeitos adversos
19.
J Am Geriatr Soc ; 68(6): 1131-1135, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32342998

RESUMO

This policy brief sets forth the American Geriatrics Society's (AGS's) recommendations to guide federal, state, and local governments when making decisions about care for older adults in assisted living facilities (ALFs) during the coronavirus disease 2019 (COVID-19) pandemic. It focuses on the need for personal protective equipment, access to testing, public health support for infection control, and workforce training. The AGS continues to review guidance set forth in peer-reviewed articles, as well as ongoing and updated guidance from the US Department of Health and Human Services, the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention, and other key agencies. This brief is based on the situation and any federal guidance or actions as of April 15, 2020. Joining a separate AGS policy brief on COVID-19 in nursing homes (DOI: 10.1111/jgs.16477), this brief is focused on ALFs, given that varied structure and staffing can impact their response to COVID-19. J Am Geriatr Soc 68:1131-1135, 2020.


Assuntos
Moradias Assistidas/normas , Infecções por Coronavirus/prevenção & controle , Geriatria/normas , Diretrizes para o Planejamento em Saúde , Instituição de Longa Permanência para Idosos/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Idoso , Betacoronavirus , Infecções por Coronavirus/virologia , Feminino , Humanos , Controle de Infecções/normas , Masculino , Pneumonia Viral/virologia , Sociedades Médicas , Estados Unidos/epidemiologia
20.
PLoS One ; 15(4): e0231260, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32275695

RESUMO

BACKGROUND: Specialist sexual assault services, which collect forensic evidence and offer holistic healthcare to people following sexual assault, have been established internationally. In England, these services are called sexual assault referral centres (SARCs). Mental health and substance misuse problems are common among SARC attendees, but little is known about how SARCs should address these needs. This review aims to seek and synthesise evidence regarding approaches to identification and support for mental health and substance misuse problems in SARCs and corresponding services internationally; empirical evidence regarding effective service models; and stakeholders' views and policy recommendations about optimal SARC practice. METHODS: A systematic review was undertaken. PsycINFO, MEDLINE, IBSS and CINAHL were searched from 1975 to August 2018. A web-based search up to December 2018 was also conducted to identify government and expert guidelines on SARCs. Quality assessment and narrative synthesis were conducted. RESULTS: We included 107 papers. We found that identification based on clinical judgement, supportive counselling and referral to other services without active follow-up were the most common approaches. Evaluations of interventions for post-rape psychopathology in attendees of sexual assault services provided mixed evidence of moderate quality. Very little evidence was found regarding interventions or support for substance misuse. Stakeholders emphasised the importance of accessibility, flexibility, continuity of care, in-house psychological support, staff trained in mental health as well as specialist support for LGBT groups and people with learning difficulties. Guidelines suggested that SARCs should assess for mental health and substance misuse and provide in-house emotional support, but the extent and nature of support were not clarified. Both stakeholders and guidelines recommended close partnership between sexual assault services and local counselling services. CONCLUSIONS: This review suggests that there is big variation in the mental health and substance misuse provision both across and within different sexual assault service models. We found no robust evidence about how sexual assault services can achieve good mental health and substance misuse outcomes for service users. Clearer guidance for service planners and commissioners, informed by robust evidence about optimal service organisations and pathways, is required. PROSPERO registration number: CRD42018119706.


Assuntos
Saúde Mental , Delitos Sexuais/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Feminino , Governo , Guias como Assunto , Diretrizes para o Planejamento em Saúde , Recursos em Saúde , Humanos , Masculino , Reino Unido
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