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1.
Lima; Perú. Ministerio de Salud; 20190900. 24 p. tab.
Monografia em Espanhol | LILACS, LIPECS | ID: biblio-1016369

RESUMO

Desarrollar un procedimiento estandarizado de respuesta inmediata frente a un foco de rabia urbana.


Assuntos
Vírus da Raiva , Pesquisa , Guias como Assunto
2.
Pan Afr Med J ; 33(Suppl 2): 2, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31402963

RESUMO

Introduction: Liberia remains at high risk of poliovirus outbreaks due to importation. The country maintained certification level acute flaccid paralysis (AFP) surveillance indicators each year until 2014 due to Ebola outbreak. During this time, there was a significant drop in non-polio AFP rate to (1.2/100,000 population under 15 years) in 2015 from 2.9/100, 000 population in 2013, due to a variety of reasons including suspension on shipment of acute flaccid paralysis stool specimen to the polio regional lab in Abidjan, refocusing of surveillance officers attention solely on Ebola virus disease (EVD) surveillance, inactivation of national polio expert committee (NPEC) and National Certification Committee (NCC). The Ministry of Health (MOH) supported by partners worked to restore AFP surveillance post EVD outbreak and ensure that Liberia maintains its polio free certification. Methods: We conducted a desk review to summarize key activities conducted to restore acute flaccid paralysis (AFP) surveillance based on World Health Organization (WHO) AFP surveillance guidelines for Africa region. We also reviewed AFP surveillance indicators and introduction of new technologies. Data sources were from program reports, scientific and gray literature, AFP database, auto visual AFP detection and reporting (AVADAR) and ONA Servers. Data analysis was done using Microsoft excel and access spread sheets, ONA software and Geographic Information System (Arc GIS). Results: AFP surveillance indicators improved with a rebound of non-polio AFP rate (NPAFP) rate from 1.2/100, 000 population under 15 years in 2015 to 4.3 in 2017. The stool adequacy rate at the national level also improved from 79% in 2016 to 82% in 2017, meeting the global target. The percentage of counties meeting the two critical AFP surveillance indicators NPAFP rate and stool adequacy improved from 47% in 2016 to 67% in 2017.The Last polio case reported in Liberia was in late 2010. Conclusion: There was significant improvement in the key AFP surveillance indicators such as NPAFP rate and stool adequacy with a 3.5 fold increase in NPAFP from 2014 to 2017. By 2017, the stool adequacy rate was up to target levels compared to 2016, which was below target level of 80%. The number of counties meeting target for the two critical AFP surveillance indicators also increased by 20% points between 2016 and 2017. Similarly there was approximately two-fold increase in the oral polio vaccines (OPV) coverage for the reported AFP cases between 2015 and 2017. Strategies employed to address gaps in AFP surveillance included enhanced active case search for AFP, re-instatement of laboratory testing, supportive supervision in addition to facilitating enhanced community engagement in surveillance activities. New technologies such as AVADAR Pilot, electronic integrated supportive supervision (ISS) and electronic surveillance (eSurv) tools were introduced to improve real time AFP case reporting. However, there remain residual gaps in AFP surveillance in the country especially at the sub-national level. Similarly, the newly introduced technologies will require continued funding and capacity building for MOH staff to ensure sustainability of the initiatives.


Assuntos
Surtos de Doenças/prevenção & controle , Doença pelo Vírus Ebola/epidemiologia , Poliomielite/epidemiologia , Vigilância da População/métodos , Doença Aguda , Adolescente , Criança , Pré-Escolar , Fezes/virologia , Feminino , Sistemas de Informação Geográfica , Guias como Assunto , Humanos , Lactente , Recém-Nascido , Libéria/epidemiologia , Masculino , Paralisia/epidemiologia , Paralisia/prevenção & controle , Paralisia/virologia , Poliomielite/prevenção & controle , Vacina Antipólio Oral/administração & dosagem
3.
Arq Gastroenterol ; 56(2): 213-231, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31460590

RESUMO

Liver and biliary tract diseases are common causes of morbidity and mortality worldwide. Invasive procedures are usually performed in those patients with hepatobiliary diseases for both diagnostic and therapeutic purposes. Defining proper indications and restraints of commonly used techniques is crucial for proper patient selection, maximizing positive results and limiting complications. In 2018, the Brazilian Society of Hepato-logy (SBH) in cooperation with the Brazilian Society of Interventional Radiology and Endovascular surgery (SOBRICE) and the Brazilian Society of Digestive Endoscopy (SOBED) sponsored a joint single-topic meeting on invasive procedures in patients with hepatobiliary diseases. This paper summarizes the proceedings of the aforementioned meeting. It is intended to guide clinicians, gastroenterologists, hepatologists, radiologists, and endoscopists for the proper use of invasive procedures for management of patients with hepatobiliary diseases.


Assuntos
Doenças Biliares/cirurgia , Hepatopatias/cirurgia , Brasil , Gerenciamento Clínico , Guias como Assunto , Humanos , Sociedades Médicas
4.
Biochem Med (Zagreb) ; 29(3): 030704, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31379462

RESUMO

Introduction: The aim of the study is to assess the degree of adherence of medical laboratories to Kidney Disease Improving Global Outcomes (KDIGO) 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease (CKD) in laboratory practice in Czechia and Slovakia. Materials and methods: An electronic questionnaire on adherence to KDIGO 2012 guideline was designed by an external quality assessment (EQA) provider SEKK spol. s.r.o. The questionnaire was placed and distributed through website to all medical biochemistry laboratories in Czechia and Slovakia (N = 396). Results: A total of 212 out of 396 laboratories responded to the questions, though some laboratories only answered some questions, those applicable to their practice. A total of 48 out of 212 laboratories adopted the KDIGO 2012 guideline in full extent. The metrological traceability of creatinine measurement to standard reference material of SRM 967 was declared by 180 out of 210 laboratories (two of the responding laboratories did not measure creatinine). Thirty laboratories are not well educated on traceability of creatinine measurement and seven laboratories do not calculate estimated glomerular filtration rate (eGFR). Both urinary albumin concentration and albumin to creatinine ratio are reported by 144 out of 175 laboratories (37 of the responding laboratories did not measure urinary albumin). Conclusion: Majority of laboratories in Czechia and Slovakia adopted some parts of the KDIGO 2012 guideline in their practice, but only 23% of the laboratories apply them completely. Thus, further education and action should be conducted to improve its implementation.


Assuntos
Laboratórios Hospitalares/normas , Insuficiência Renal Crônica/diagnóstico , Creatinina/urina , República Tcheca , Taxa de Filtração Glomerular , Guias como Assunto , Humanos , Insuficiência Renal Crônica/patologia , Eslováquia , Inquéritos e Questionários
5.
Implement Sci ; 14(1): 80, 2019 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412887

RESUMO

BACKGROUND: Designing implementation research can be a complex and daunting task, especially for applied health researchers who have not received specialist training in implementation science. We developed the Implementation Science Research Development (ImpRes) tool and supplementary guide to address this challenge and provide researchers with a systematic approach to designing implementation research. METHODS: A multi-method and multi-stage approach was employed. An international, multidisciplinary expert panel engaged in an iterative brainstorming and consensus-building process to generate core domains of the ImpRes tool, representing core implementation science principles and concepts that researchers should consider when designing implementation research. Simultaneously, an iterative process of reviewing the literature and expert input informed the development and content of the tool. Once consensus had been reached, specialist expert input was sought on involving and engaging patients/service users; and economic evaluation. ImpRes was then applied to 15 implementation and improvement science projects across the National Institute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South London, a research organisation in London, UK. Researchers who applied the ImpRes tool completed an 11-item questionnaire evaluating its structure, content and usefulness. RESULTS: Consensus was reached on ten implementation science domains to be considered when designing implementation research. These include implementation theories, frameworks and models, determinants of implementation, implementation strategies, implementation outcomes and unintended consequences. Researchers who used the ImpRes tool found it useful for identifying project areas where implementation science is lacking (median 5/5, IQR 4-5) and for improving the quality of implementation research (median 4/5, IQR 4-5) and agreed that it contained the key components that should be considered when designing implementation research (median 4/5, IQR 4-4). Qualitative feedback from researchers who applied the ImpRes tool indicated that a supplementary guide was needed to facilitate use of the tool. CONCLUSIONS: We have developed a feasible and acceptable tool, and supplementary guide, to facilitate consideration and incorporation of core principles and concepts of implementation science in applied health implementation research. Future research is needed to establish whether application of the tool and guide has an effect on the quality of implementation research.


Assuntos
Ciência da Implementação , Projetos de Pesquisa , Guias como Assunto , Humanos
6.
Implement Sci ; 14(1): 81, 2019 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412894

RESUMO

BACKGROUND: The National Diabetes Prevention Program (National DPP) is rapidly expanding in an effort to help those at high risk of type 2 diabetes prevent or delay the disease. In 2012, the Centers for Disease Control and Prevention funded six national organizations to scale and sustain multistate delivery of the National DPP lifestyle change intervention (LCI). This study aims to describe reach, adoption, and maintenance during the 4-year funding period and to assess associations between site-level factors and program effectiveness regarding participant attendance and participation duration. METHODS: The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to guide the evaluation from October 2012 to September 2016. Multilevel linear regressions were used to examine associations between participant-level demographics and site-level strategies and number of sessions attended, attendance in months 7-12, and duration of participation. RESULTS: The six funded national organizations increased the number of participating sites from 68 in 2012 to 164 by 2016 across 38 states and enrolled 14,876 eligible participants. By September 2016, coverage for the National DPP LCI was secured for 42 private insurers and 7 public payers. Nearly 200 employers were recruited to offer the LCI on site to their employees. Site-level strategies significantly associated with higher overall attendance, attendance in months 7-12, and longer participation duration included using self-referral or word of mouth as a recruitment strategy, providing non-monetary incentives for participation, and using cultural adaptations to address participants' needs. Sites receiving referrals from healthcare providers or health systems also had higher attendance in months 7-12 and longer participation duration. At the participant level, better outcomes were achieved among those aged 65+ (vs. 18-44 or 45-64), those who were overweight (vs. obesity), those who were non-Hispanic white (vs. non-Hispanic black or multiracial/other races), and those eligible based on a blood test or history of gestational diabetes mellitus (vs. screening positive on a risk test). CONCLUSIONS: In a time of rapid dissemination of the National DPP LCI the findings of this evaluation can be used to enhance program implementation and translate lessons learned to similar organizations and settings.


Assuntos
Diabetes Mellitus Tipo 2/prevenção & controle , Promoção da Saúde/organização & administração , Centers for Disease Control and Prevention (U.S.) , Guias como Assunto , Promoção da Saúde/economia , Humanos , Ciência da Implementação , Estilo de Vida , Avaliação de Programas e Projetos de Saúde , Estados Unidos
7.
Stud Health Technol Inform ; 264: 734-738, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438021

RESUMO

Clinical practice guidelines (CPGs) are indispensable in the practice of evidence-based medicine. However, the cost of effective CPG dissemination strategies is prohibitive and not cost-effective. Therefore, scalable strategies using available technology are needed. We describe a formal model-driven approach to design a gamified e-learning system for clinical guidelines. We employ gamification to increase user motivation and engagement in the training of guideline content. Our approach involves the use of models for different aspects of the system, an entity model for the clinical domain, a workflow model for the clinical processes and a game model to manage the training sessions. A game engine instantiates a training session by coupling the workflow and entity models to automatically generate questions based on the data in the model instances. Our approach is flexible and adaptive as it allows for easy updates of the guidelines, integration with different device interfaces and representation of any guideline.


Assuntos
Instrução por Computador , Assistência à Saúde , Medicina Baseada em Evidências , Guias como Assunto , Aprendizagem , Motivação
10.
J Assoc Physicians India ; 67(4): 30-34, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31299835

RESUMO

Introduction: Dengue fever management is guided by WHO guideline, the recent one being 2009; however, compliance to the guideline is difficult to assess and in India there is no data on it. The present study, a longitudinal pre-post interventional quality improvement study, was done to determine the compliance to the guideline on dengue patients before and after resident physicians' training during two peak seasons and their impact on survival. Methods: This study was conducted in a tertiary health care centre in North India over 18 months. Data of hospitalized patients who admitted with dengue fever diagnosis in a peak season was collected in the form of quality indicators as described by the WHO-2009 guideline on dengue. Resident physicians were then given appropriate training about the guideline during the off season. Data of new dengue patients in next peak season after resident training was collected and compared with the baseline by standard statistical tests. Results: The post-intervention compliances of all components increased (total mean score by giving one point to each of the quality indicators reached 7.9 from 6.4). The compliance to individual indicator also increased: the admission criteria (baseline, 44% to post-intervention, 52%, p = 0.37), classification criteria (91.7% to 96%, p = 0.33), correct staging/triage (42.9% to 86%, p <0.001), vitals monitoring (85.7% to 92%, p = 0.28), correct usage of bolus fluids (34.3% to 69.5%, p <0.001), crystalloid as choice of fluid (100% in both groups), proper fluid titration (26.2% to 56%, p <0.001), hematocrit monitoring (95.2% to 98%, p = 0.42), platelet transfusion when indicated (65.5% to 58%, p = 0.39), antibiotic use when required (61.5% to 80%, p = 0.03), and discharge criteria (100% in both groups). The mortality decreased from 7.1% (baseline) to zero (post-intervention). The median duration of hospital stay also reduced by 1 day. Conclusion: The study affirms that the compliance to WHO guideline on dengue management in India can be further improved by regular physician training on the guideline. Simultaneously, this educational intervention not only improves patient outcomes but also direct proper resource utilization especially platelet transfusion and antibiotic use. Furthermore, every hospital/institute should have an internal quality improvement program like this to improve the management of dengue patients. Future studies are needed to understand various barriers to 100% implementation of the guideline.


Assuntos
Dengue/terapia , Cooperação do Paciente , Melhoria de Qualidade , Fidelidade a Diretrizes , Guias como Assunto , Hospitais , Humanos , Índia , Organização Mundial da Saúde
12.
Clin Biochem ; 71: 74-76, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31287996

RESUMO

OBJECTIVE: During the last decade, guidelines published by the American College of Obstetricians and Gynecologists (ACOG) and Society for Maternal Fetal Medicine (SMFM) have emphasized an increasingly limited role for fetal lung maturity (FLM) testing. As a reference laboratory for FLM testing, we were therefore interested in determining the impact of changing guidelines on our test volumes. METHODS: We retrospectively reviewed FLM test volume data from 2006 to 2016 for the following FLM assays: lecithin/sphingomyelin ratio, phosphatidylglycerol, disaturated lecithin, and lamellar body count. RESULTS: We found that there was a precipitous decline in test volumes from 2006 to 2016; our analysis led us to discontinue providing reference laboratory FLM testing in 2016 given the very low volumes. CONCLUSIONS: The 2019 ACOG guidelines now state that FLM testing no longer has clinical utility. Therefore, clinical laboratory directors should meet with obstetrics providers to discuss discontinuation of FLM testing at their institutions.


Assuntos
Guias como Assunto , Pulmão/embriologia , Maturidade dos Órgãos Fetais , Humanos , Estudos Retrospectivos
13.
J Clin Pathol ; 72(9): 573-578, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31300532

RESUMO

The International Collaboration on Cancer Reporting (ICCR) has developed a suite of detailed datasets for international implementation. These datasets are based on the reporting protocols developed by the Royal College of Pathologists (UK), The Royal College of Pathologists of Australasia and the College of American Pathologists, with modifications undertaken by international expert groups appointed according to ICCR protocols. The dataset for the reporting of renal biopsy for tumour is designed to provide a structured reporting template containing minimum data recording key elements suitable for international use. In formulating the dataset, the ICCR panel incorporated recommendations from the 2012 Vancouver Consensus Conference of the International Society of Urological Pathology (ISUP) and the 2016 edition of the WHO Bluebook on tumours of the urinary and male genital systems. Reporting elements were divided into Required (Core) and Recommended (Non-core) components of the report. Required elements are as follows: specimen laterality, histological tumour type, WHO/ISUP histological tumour grade, sarcomatoid morphology, rhabdoid morphology, necrosis, lymphovascular invasion and coexisting pathology in non-neoplastic kidney. Recommended reporting elements are as follows: operative procedure, tumour site(s), histological tumour subtype and details of ancillary studies. In particular, it is noted that fluorescence in situ hybridisation studies may assist in diagnosing translocation renal cell carcinoma (RCC) and in distinguishing oncocytoma and eosinophilic chromophobe RCC. It is anticipated that the implementation of this dataset into routine clinical practice will facilitate uniformity of pathology reporting worldwide. This, in turn, should have a positive impact on patient treatment and the quality of demographic information held by cancer registries.


Assuntos
Biópsia/normas , Confiabilidade dos Dados , Bases de Dados Factuais/normas , Conjuntos de Dados como Assunto/normas , Cooperação Internacional , Neoplasias Renais/patologia , Consenso , Comportamento Cooperativo , Guias como Assunto/normas , Humanos , Neoplasias Renais/epidemiologia , Neoplasias Renais/cirurgia , Gradação de Tumores/normas , Nefrectomia/normas , Valor Preditivo dos Testes
14.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 41(3): 396-401, 2019 Jun 30.
Artigo em Chinês | MEDLINE | ID: mdl-31282336

RESUMO

Human genetic resources are valuable for life science research and pharmaceutical industry.Competitions for human genetic resources and the relevant techniques and industries have increasingly become intense among countries with the the implementation of precision medicine strategy and the maturity of gene editing technology.In the context of scientific progress and efficiency,the Organisation for Economic Co-operation and Development,the most important international economic organization,has proposed solutions to technological development and research paradigm changes from the perspective of national and global public interests.The United States,Japan,the United Kingdom,and some other developed countries have also released their policies and guidelines on the sharing of genetic resource data.In this article we analyzed these policies and guidelines,with an attempt to further improve the administration of human genetic resource sharing in China and promote the legal sharing and effective use of these resources.


Assuntos
Genética Humana , Disseminação de Informação , China , Guias como Assunto , Humanos
16.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46603

RESUMO

Os Protocolos Clínicos e Diretrizes Terapêuticas (PCDT) são documentos que estabelecem critérios para o diagnóstico da doença ou do agravo à saúde; o tratamento preconizado, com os medicamentos e demais produtos apropriados, quando couber; as posologias recomendadas; os mecanismos de controle clínico; e o acompanhamento e a verificação dos resultados terapêuticos, a serem seguidos pelos gestores do SUS. Devem ser baseados em evidência científica e considerar critérios de eficácia, segurança, efetividade e custo-efetividade das tecnologias recomendadas.


Assuntos
Protocolos Clínicos , Guias como Assunto , Guias de Prática Clínica como Assunto
17.
Zhonghua Gan Zang Bing Za Zhi ; 27(5): 343-346, 2019 May 20.
Artigo em Chinês | MEDLINE | ID: mdl-31177657

RESUMO

Oral nucleos(t)ide analogues (NAs) is one of the main and efficient way for the treatment of chronic hepatitis B (CHB). Considering the antiviral potency and drug resistance of domestic and foreign guidelines, NAs are divided into first-line and non-first-line drugs. "An Expert Consensus for the Adjustment of Treatment Strategies in Patients with Chronic Hepatitis B Treated with Non-first-line Nucleos(t)ide Analogues," is mainly aimed at those patients who are currently using non-first-line NAs drugs. In addition, how to standardize the adjustment to first-line NAs drugs of choice, which can strengthen the effectiveness of initial antiviral treatment to obtain better antiviral efficacy, and improve patient compliance, coinciding with the avoidance of occurrence of serious drug adverse reactions in patients with CHB is presented.


Assuntos
Antivirais/uso terapêutico , Guias como Assunto/normas , Hepatite B Crônica/tratamento farmacológico , Nucleosídeos/uso terapêutico , Avaliação de Resultados (Cuidados de Saúde)/métodos , Guias de Prática Clínica como Assunto , Consenso , Vírus da Hepatite B , Humanos , Resultado do Tratamento
18.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(5): 601-604, 2019 May 10.
Artigo em Chinês | MEDLINE | ID: mdl-31177746

RESUMO

Discordance, such as overlap, repetition and inconsistent, of standards is one of the major problems in current standardization affair in China. Therefore, improving the unity and authority of standards through reduction of overlap, repetition and inconsistency has become the main goal of deepening standardization reform in China. This paper summarizes the discordance in public health standards in China, analyzes the major reasons and provides specific strategic suggestions through case analysis of public health standards in the ways of comparisons of same kind standards of other deparments and standards in administration documents and guidelines or technical specifications of academic associations or societies.


Assuntos
Prática de Saúde Pública/normas , Saúde Pública/normas , China , Guias como Assunto , Humanos
20.
Lima; Perú. Ministerio de Salud; 20190600. 42 p. tab, graf.
Monografia em Espanhol | LILACS, LIPECS | ID: biblio-1005684

RESUMO

La presente Directiva Sanitaria es de aplicación obligatoria en todos los establecimientos de Salud del Ministerio de Salud, y de los Gobiernos Regionales y Locales. Puede servir de referencia para los otros prestadores de salud: Essalud, Sanidad de las Fuerzas Armadas, Policía Nacional del Perú, Municipalidades, Clínicas y otros.


Assuntos
Prevenção de Doenças , Neoplasias , Guias como Assunto
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