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1.
Einstein (Sao Paulo) ; 18: eGS4442, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31576910

RESUMO

OBJECTIVE: To analyze the legal demands of tiotropium bromide to treat chronic obstructive pulmonary disease. METHODS: We included secondary data from the pharmaceutical care management systems made available by the Paraná State Drug Center. RESULTS: Public interest civil action and ordinary procedures, among others, were the most common used by the patients to obtain the medicine. Two Health Centers in Paraná (Londrina and Umuarama) concentrated more than 50% of the actions. The most common specialty of physicians who prescribed (33.8%) was pulmonology. There is a small financial impact of tiotropium bromide on general costs with medicines of the Paraná State Drug Center. However, a significant individual financial impact was observed because one unit of the medicine represents 38% of the Brazilian minimum wage. CONCLUSION: Our study highlights the need of incorporating this medicine in the class of long-acting anticholinergic bronchodilator in the Brazilian public health system.


Assuntos
Broncodilatadores/economia , Medicamentos Essenciais/provisão & distribução , Necessidades e Demandas de Serviços de Saúde/legislação & jurisprudência , Função Jurisdicional , Doença Pulmonar Obstrutiva Crônica/economia , Brometo de Tiotrópio/economia , Brasil , Medicamentos Essenciais/economia , Acesso aos Serviços de Saúde/economia , Acesso aos Serviços de Saúde/legislação & jurisprudência , Acesso aos Serviços de Saúde/tendências , Necessidades e Demandas de Serviços de Saúde/economia , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Programas Nacionais de Saúde , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Estudos Retrospectivos , Estatísticas não Paramétricas , Fatores de Tempo
4.
Rev Assoc Med Bras (1992) ; 65(6): 796-800, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31340307

RESUMO

OBJECTIVE: To estimate the human resources and services needed to meet the demand of the Brazilian population who would benefit from palliative care, based on the population growth projection for 2040. METHODS: Population and mortality estimates and projections were obtained from the Brazilian Institute of Geography and Statistics. Service needs were estimated based on literature data. RESULTS: The expected increase in the Brazilian population for 2000-2040 is 31.5%. The minimum estimate of patients with palliative care needs was 662,065 in 2000 and 1,166,279 in 2040. The staff required for each hundred thousand inhabitants would increase from 1,734 to 2,282, the number of doctors needed would increase from 4,470 to 6,274, and the number of nurses from 8,586 to 11,294, for the same period. CONCLUSION: The definition of a national strategy predicting the increasing palliative care needs of the population is necessary. The expansion of the support network for chronic and non-transmissible diseases is necessary, but the training of existing human resources at all levels of attention to perform palliative actions can be a feasible alternative to minimize the suffering of the population.


Assuntos
Necessidades e Demandas de Serviços de Saúde/tendências , Mão de Obra em Saúde/tendências , Cuidados Paliativos/tendências , Brasil , Feminino , Previsões , Acesso aos Serviços de Saúde/estatística & dados numéricos , Acesso aos Serviços de Saúde/tendências , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Mão de Obra em Saúde/estatística & dados numéricos , Humanos , Masculino , Cuidados Paliativos/estatística & dados numéricos , Fatores de Tempo
5.
Work ; 63(1): 39-47, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31127743

RESUMO

BACKGROUND: Previous studies indicate a variety of health challenges among musicians. Despite this, less is known concerning the roles of work-related and personal factors associated with the musicians' mental health. OBJECTIVE: We wanted to investigate personal and work-related demands and resources associated with psychological distress in professional musicians. METHODS: Based on a sample of 1,607 of professional Norwegian musicians, we conducted a hierarchical multiple regression analysis. RESULTS: We found that personal factors such as level of neuroticism and sense of mastery had the strongest association with PD. Extraversion, openness to experience, conscientiousness, job demands and social support did also contribute to distress in our final statistical model, but to a lesser degree. Somewhat surprisingly, work-family conflict, effort-reward imbalance and job control were not associated with PD in our final model. CONCLUSIONS: Our results show that both work-related factors (job demands and social support) and personal resources (personality and sense of mastery) are associated with PD among musicians in this cross-sectional study. Prospective research is needed in order to investigate these associations further. Meanwhile, we suggest to emphasize early development of sense of mastery and social support in music education and industry.


Assuntos
Necessidades e Demandas de Serviços de Saúde/tendências , Serviços de Saúde Mental/estatística & dados numéricos , Música/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Noruega , Psicometria/instrumentação , Psicometria/métodos , Análise de Regressão , Apoio Social , Inquéritos e Questionários , Carga de Trabalho/psicologia
7.
PLoS Med ; 16(3): e1002751, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30822339

RESUMO

BACKGROUND: The prevalence of diabetes is increasing rapidly in low- and middle-income countries (LMICs), urgently requiring detailed evidence to guide the response of health systems to this epidemic. In an effort to understand at what step in the diabetes care continuum individuals are lost to care, and how this varies between countries and population groups, this study examined health system performance for diabetes among adults in 28 LMICs using a cascade of care approach. METHODS AND FINDINGS: We pooled individual participant data from nationally representative surveys done between 2008 and 2016 in 28 LMICs. Diabetes was defined as fasting plasma glucose ≥ 7.0 mmol/l (126 mg/dl), random plasma glucose ≥ 11.1 mmol/l (200 mg/dl), HbA1c ≥ 6.5%, or reporting to be taking medication for diabetes. Stages of the care cascade were as follows: tested, diagnosed, lifestyle advice and/or medication given ("treated"), and controlled (HbA1c < 8.0% or equivalent). We stratified cascades of care by country, geographic region, World Bank income group, and individual-level characteristics (age, sex, educational attainment, household wealth quintile, and body mass index [BMI]). We then used logistic regression models with country-level fixed effects to evaluate predictors of (1) testing, (2) treatment, and (3) control. The final sample included 847,413 adults in 28 LMICs (8 low income, 9 lower-middle income, 11 upper-middle income). Survey sample size ranged from 824 in Guyana to 750,451 in India. The prevalence of diabetes was 8.8% (95% CI: 8.2%-9.5%), and the prevalence of undiagnosed diabetes was 4.8% (95% CI: 4.5%-5.2%). Health system performance for management of diabetes showed large losses to care at the stage of being tested, and low rates of diabetes control. Total unmet need for diabetes care (defined as the sum of those not tested, tested but undiagnosed, diagnosed but untreated, and treated but with diabetes not controlled) was 77.0% (95% CI: 74.9%-78.9%). Performance along the care cascade was significantly better in upper-middle income countries, but across all World Bank income groups, only half of participants with diabetes who were tested achieved diabetes control. Greater age, educational attainment, and BMI were associated with higher odds of being tested, being treated, and achieving control. The limitations of this study included the use of a single glucose measurement to assess diabetes, differences in the approach to wealth measurement across surveys, and variation in the date of the surveys. CONCLUSIONS: The study uncovered poor management of diabetes along the care cascade, indicating large unmet need for diabetes care across 28 LMICs. Performance across the care cascade varied by World Bank income group and individual-level characteristics, particularly age, educational attainment, and BMI. This policy-relevant analysis can inform country-specific interventions and offers a baseline by which future progress can be measured.


Assuntos
Assistência à Saúde/economia , Diabetes Mellitus/economia , Diabetes Mellitus/epidemiologia , Necessidades e Demandas de Serviços de Saúde/economia , Inquéritos Epidemiológicos/economia , Pobreza/economia , Adolescente , Adulto , Estudos Transversais , Assistência à Saúde/tendências , Diabetes Mellitus/terapia , Feminino , Necessidades e Demandas de Serviços de Saúde/tendências , Inquéritos Epidemiológicos/tendências , Humanos , Renda/tendências , Masculino , Pessoa de Meia-Idade , Pobreza/tendências , Adulto Jovem
8.
World J Gastroenterol ; 25(2): 163-177, 2019 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-30670907

RESUMO

Non-alcoholic fatty liver disease (NAFLD) is a major chronic liver disease that can lead to liver cirrhosis, liver cancer, and ultimately death. NAFLD is pathologically classified as non-alcoholic fatty liver (NAFL) or non-alcoholic steatohepatitis (NASH) based on the existence of ballooned hepatocytes, although the states have been known to transform into each other. Moreover, since the detection of ballooned hepatocytes may be difficult with limited biopsied specimens, its clinical significance needs reconsideration. Repeated liver biopsy to assess histological NAFLD activity for therapeutic response is also impractical, creating the need for body fluid biomarkers and less invasive imaging modalities. Recent longitudinal observational studies have emphasized the importance of advanced fibrosis as a determinant of NAFLD outcome. Thus, identifying predictors of fibrosis progression and developing better screening methods will enable clinicians to isolate high-risk NAFLD patients requiring early intensive intervention. Despite the considerable heterogeneity of NAFLD with regard to underlying disease, patient age, and fibrosis stage, several clinical trials are underway to develop a first-in-class drug. In this review, we summarize the present status and future direction of NAFLD/NASH research towards solving unmet medical needs.


Assuntos
Pesquisa Biomédica/tendências , Hepatócitos/patologia , Pesquisa Interdisciplinar/tendências , Fígado/patologia , Hepatopatia Gordurosa não Alcoólica/patologia , Biomarcadores/análise , Pesquisa Biomédica/métodos , Biópsia/métodos , Progressão da Doença , Desenvolvimento de Medicamentos/métodos , Desenvolvimento de Medicamentos/tendências , Fibrose , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Pesquisa Interdisciplinar/métodos , Fígado/citologia , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/tratamento farmacológico , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Seleção de Pacientes , Prevalência , Índice de Gravidade de Doença
9.
Acta Derm Venereol ; 99(4): 370-374, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30666336

RESUMO

Understanding of the epidemiology and healthcare service utilization related to atopic dermatitis is necessary to inform the use of new treatments. This cross-sectional study was based on a group of patients with atopic dermatitis and a matched control group comprised of age- and sex- matched enrolees without atopic dermatitis from a large medical database. Healthcare service utilization usage data were extracted and compared between groups. The study included 116,816 patients with atopic dermatitis and 116,812 controls. Atopic dermatitis was associated with an increased burden of healthcare utilization across the entire spectrum of healthcare services compared with controls. For patients severely affected by atopic dermatitis, the increased burden correlated with disease severity: a high-er frequency of emergency room visits (odd ratio (OR) 1.7; 95% confidence interval (CI) 1.6-1.9), dermatology wards hospitalizations (OR 315; 95% CI 0-7,342), and overall hospitalizations (OR 3.6; 95% CI 3.3-3.9). In conclusion, this study demonstrates an increased burden of healthcare utilization in atopic dermatitis.


Assuntos
Dermatite Atópica/terapia , Fármacos Dermatológicos/uso terapêutico , Serviço Hospitalar de Emergência/tendências , Recursos em Saúde/tendências , Hospitalização/tendências , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Bases de Dados Factuais , Dermatite Atópica/diagnóstico , Dermatite Atópica/etiologia , Feminino , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Lactente , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde/tendências , Prevalência , Sistema de Registros , Estudos Retrospectivos , Índice de Gravidade de Doença , Fatores de Tempo , Adulto Jovem
10.
Hepatobiliary Pancreat Dis Int ; 18(1): 79-86, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30583855

RESUMO

BACKGROUND: Currently, surgical resection represents the only curative treatment for pancreatic cancer (PC), however, the majority of tumors are no longer resectable by the time of diagnosis. The aim of this study was to describe time trends and distribution of pancreaticoduodenectomies (PDs) performed for treating PC in Brazil in recent years. METHODS: Data were retrospectively obtained from Brazilian Health Public System (namely DATASUS) regarding hospitalizations for PC and PD in Brazil from January 2008 to December 2015. PC and PD rates and their mortalities were estimated from DATASUS hospitalizations and analyzed for age, gender and demographic characteristics. RESULTS: A total of 2364 PDs were retrieved. Albeit PC incidence more than doubled, the number of PDs increased only 37%. Most PDs were performed in men (52.2%) and patients between 50 and 69 years old (59.5%). Patients not surgically treated and those 70 years or older had the highest in-hospital mortality rates. The most developed regions (Southeast and South) as well as large metropolitan integrated municipalities registered 76.2% and 54.8% of the procedures, respectively. LMIM PD mortality fluctuated, ranging from 13.6% in 2008 to 11.8% in 2015. CONCLUSIONS: This study suggests a trend towards regionalization and volume-outcome relationships for PD due to PC, as large metropolitan integrated municipalities registered most of the PDs and more stable mortality rates. The substantial differences between PD and PC increasing rates reveals a limiting step on the health system resoluteness. Reduction in the number of hospital beds and late access to hospitalization, despite improvement in diagnostic methods, could at least in part explain these findings.


Assuntos
Neoplasias Pancreáticas/epidemiologia , Neoplasias Pancreáticas/cirurgia , Pancreaticoduodenectomia/tendências , Padrões de Prática Médica/tendências , Cirurgiões/tendências , Distribuição por Idade , Idoso , Brasil/epidemiologia , Feminino , Necessidades e Demandas de Serviços de Saúde/tendências , Mortalidade Hospitalar/tendências , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde/tendências , Neoplasias Pancreáticas/mortalidade , Pancreaticoduodenectomia/efeitos adversos , Pancreaticoduodenectomia/mortalidade , Sistema de Registros , Estudos Retrospectivos , Distribuição por Sexo , Fatores de Tempo , Resultado do Tratamento
11.
Support Care Cancer ; 27(1): 287-295, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29951714

RESUMO

PURPOSE: To investigate the unmet supportive care needs (SCNs) of Chinese cancer survivors and to identify factors associated with the unmet SCNs of cancer survivors. METHODS: A cross-sectional survey of Chinese cancer survivors was conducted using validated scales of the Cancer Survivors Unmet Needs scale (CaSUN), physical symptom concerns (Cancer Survivors Survey of Needs-CSSN subscale), and a single-item measure of global quality of life (QoL) perception. RESULTS: There were 330 participants, with a mean score of 7.1 (0-10) in overall QoL. The reported rate of the 19 symptom concerns ranged from 19.4 to 72.2%. The level of unmet SCNs (moderate and strong need) ranged from 12.1 to 59.1%. The top five unmet needs included concerns about the cancer re-occurring (59.1%), accessing the best medical care (52.7%), accessing complementary therapy services (51.5%), changes to beliefs (48.2%), and survivor expectations (47.6%). The strength of unmet SCNs was negatively correlated with participant age (P < 0.05), average time since diagnosis (P < 0.05), and overall QoL (P < 0.01) and positively correlated with all symptom concerns (all P < 0.001). CONCLUSIONS: Study findings call attention to cancer survivors' unmet SCNs and related factors. Underscored areas in developing survivorship care included paying special attention to existential survivorship, empowering survivor management of chronic symptoms, particularly for younger survivors, as well as for survivors with poor QoL, and those with a shorter time since diagnosis. This tailored survivorship care should be developed and delivered by a multidisciplinary team to support cancer services, with a greater capacity to deliver individualized, unmet SCN-driven care to survivors.


Assuntos
Sobreviventes de Câncer/psicologia , Necessidades e Demandas de Serviços de Saúde/tendências , Neoplasias/terapia , Qualidade de Vida/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/patologia , Adulto Jovem
12.
J Autism Dev Disord ; 49(4): 1652-1664, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30552540

RESUMO

Utilizing the 2016 National Survey of Children's Health, this study illustrates that children with ASD have nearly 4 times higher odds of unmet health care needs compared to children without disabilities, whereas children with other disabilities had nearly 2 times higher odds of unmet health care needs compared to children without disabilities. Applying Andersen's Behavioral Model of health care utilization, this study estimates that enabling factors (e.g., access to health insurance, quality of health insurance, access to family-centered care, family-level stress, exposure to adverse childhood experiences, and parental employment) improved prediction of regression model for unmet health care needs by 150%. Policy and program implications are discussed and a new framework for responding to observed disparities is discussed.


Assuntos
Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Saúde da Criança/tendências , Necessidades e Demandas de Serviços de Saúde/tendências , Disparidades em Assistência à Saúde/tendências , Inquéritos e Questionários , Adolescente , Experiências Adversas da Infância , Transtorno do Espectro Autista/terapia , Criança , Serviços de Saúde da Criança/estatística & dados numéricos , Pré-Escolar , Feminino , Acesso aos Serviços de Saúde/tendências , Humanos , Seguro Saúde , Masculino , Pais/psicologia , Fatores Socioeconômicos , Estados Unidos/epidemiologia
13.
J Manag Care Spec Pharm ; 24(12-a Suppl): S3-S16, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30582825

RESUMO

BACKGROUND: Spinal muscular atrophy (SMA) is an autosomal recessive neurodegenerative disease that, in most cases, involves homozygous deletion of the SMN1 gene. This causes a deficiency in survival motor neuron (SMN) protein, which plays a critical role in motor neuron development. SMA has a range of phenotype expression resulting in variable age of symptom onset, maximum motor strength achieved, and survival. Without intervention, infants with a more severe form of the disease (type 1 SMA) die before 2 years of age. Although it is rare, SMA is the most common fatal inherited disease of infancy, and until recently, treatment was primarily supportive. In 2016, a new agent, nusinersen, was approved by the FDA. Other treatments are in development, including a gene therapy, AVXS-101. These treatments are not only improving the lives of patients with SMA and their families, they are changing the disease phenotype. They have the greatest benefit when given early in the disease course. OBJECTIVES: To discuss current knowledge about SMA, provide clinical evidence for available and emerging treatment options, and present approaches for adding new therapies to hospital/health system formularies to ensure timely access to newly approved therapies for SMA. SUMMARY: Advances in clinical care have significantly extended the lives of individuals with SMA, and research into the genetic mechanisms leading to disease have revealed strategies for intervention that target the underlying cause of SMA. Nusinersen is now on the market, and other treatment options, such as AVXS-101, may soon be approved. This article provides an overview of SMA and the genetic mechanisms leading to SMN deficiency, then describes how new and emerging treatments work to overcome this deficiency and prevent associated nerve damage and disability. In addition, we discuss steps for incorporating AVXS-101 into hospital/health system formularies, along with barriers and concerns that may delay access, based in part on lessons learned with nusinersen.


Assuntos
Terapia Genética/métodos , Atrofia Muscular Espinal/terapia , Oligonucleotídeos/uso terapêutico , Proteína 1 de Sobrevivência do Neurônio Motor/genética , Ensaios Clínicos como Assunto , Dependovirus/genética , Aprovação de Drogas , Éxons/efeitos dos fármacos , Éxons/genética , Deleção de Genes , Terapia Genética/economia , Terapia Genética/legislação & jurisprudência , Terapia Genética/tendências , Vetores Genéticos/genética , Vetores Genéticos/uso terapêutico , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Atrofia Muscular Espinal/diagnóstico , Atrofia Muscular Espinal/genética , Atrofia Muscular Espinal/mortalidade , Oligonucleotídeos/economia , Oligonucleotídeos/farmacologia , Sarcômeros/efeitos dos fármacos , Proteína 2 de Sobrevivência do Neurônio Motor/genética , Estados Unidos , United States Food and Drug Administration
14.
Psychiatry Res ; 270: 792-800, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30551327

RESUMO

The study aims to report the number of newspaper articles including the word "schizo" in the period 2001 - 2015 and to identify possible predictors reinforcing negative stereotypes about people with schizophrenia. The electronic archives of the Italian newspaper "La Stampa" have been searched for the term "schizo". Selected articles were grouped in articles related to mental health (rMH) or article not related to mental health (nrMH). 946 articles were identified. Schizophrenia-related terms were used in 356 (36.03%) article rMH, which mainly reinforce negative stereotypes regarding mental illness both in rMH and nrMH groups. Over time, only in the rMH group a significant reduction of articles reinforcing negative stereotypes was found. Several factors have been identified as predictors of article reinforcing negative stereotypes: unnecessarily dramatic or sensational headline or content; inaccurate or not in the correct context use of medical terminology; emphasis to the illness rather than to the person; mental disorders are the same; disclosure of particular individual has a mental illness. Although there has been a significant reduction in stigmatizing articles, in the rMH group one article out of three reinforces negative stereotypes.


Assuntos
Educação em Saúde/tendências , Saúde Mental/educação , Jornais como Assunto/tendências , Esquizofrenia , Estereotipagem , Feminino , Previsões , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Itália , Masculino , Saúde Mental/tendências , Serviços de Saúde Mental/tendências , Privacidade , Encaminhamento e Consulta/tendências , Esquizofrenia/terapia
15.
Orthod Fr ; 89(4): 355-363, 2018 12.
Artigo em Francês | MEDLINE | ID: mdl-30565554

RESUMO

INTRODUCTION: The diagnosis of scoliosis during orthodontic treatment is often attributed to orthodontic treatment, which may be a simple confounding factor. Do scoliotic patients require increased orthodontic treatment? Is the extent of their need for orthodontic treatment correlated with the severity of their scoliosis? MATERIAL AND METHOD: The authors conducted a comparative multicenter epidemiological study between a group of patients with a proven diagnosis of scoliosis objectified by the Cobb angle and a control group recruited from the general population. The endpoint was the Index Of Orthodontic Treatment Need (IOTN). The calculation of the number of subjects was made a priori. A statistical significance threshold of 5% was used for the statistical analysis. RESULTS: In this study, 104 patients were included: 36 patients (10 boys, 26 girls) with an average age of 12.1 years (+/-2.3 years) in the scoliosis group (mean Cobb angle = 21°) versus 69 patients (20 boys, 49 girls) with an average age of 12 years (+/-2.7 years) in the control group. Patients with scoliosis have a significantly higher need for orthodontic treatment than the general population. The study did not correlate the severity of scoliosis with the increased need for orthodontic treatment. DISCUSSION: Thus, the diagnosis of scoliosis during orthodontic treatment should not systematically result in the removal of the orthodontic appliance over-hastily held responsible for the scoliotic condition.


Assuntos
Necessidades e Demandas de Serviços de Saúde , Ortodontia , Escoliose/epidemiologia , Escoliose/terapia , Adolescente , Estudos de Casos e Controles , Criança , Feminino , França/epidemiologia , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Masculino , Ortodontia/métodos , Ortodontia/estatística & dados numéricos , Ortodontia/tendências
16.
Gac. sanit. (Barc., Ed. impr.) ; 32(5): 466-472, sept.-oct. 2018. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-174195

RESUMO

Objetivo: Este artículo describe la estrategia de incorporación de artistas en los equipos de profesionales de salud comunitaria en la ciudad de Madrid, en concreto en los Centros Madrid Salud. Método: El colectivo artístico Batas Nómadas, formado por tres artistas expertos en artes plásticas y visuales, ha utilizado la performance y dinámicas participativas para explicar la incorporación del arte y los artistas en estos equipos de profesionales de Madrid Salud. Resultados: El colectivo Batas Nómadas ha intervenido en 14 equipos de trabajo de los Centros Madrid Salud (CMS) y recogido datos de forma creativa, de los y las 179 profesionales participantes. Conclusiones: Se han visualizado necesidades de intervención en salud comunitaria, y reflexionado acerca de la utilidad del arte para favorecer el trabajo participativo de los equipos Madrid Salud


Objetive: This article describes the strategy of incorporating artists into the teams of community health in the city of Madrid, specifically in the Madrid Salud Centers. Method: The artistic colletive, Batas Nómadas, formed by three artists expertized in visual arts, has developed performances and participatory aproach to explain the incorporation of art and artists in these teams of professionals of Madrid Salud. Results: Batas Nómadas has carried out sessions in 14 work teams of the Madrid Salud Centers and has collected data in a creative way from the 179 professionals that have participated in these sessions. Conclusions: These actions have shown some needs in community health, and have noticed a meaningful reflection on the usefulness of the art to develop participative strategies into the Madrid Salud teams


Assuntos
Humanos , Terapia pela Arte/organização & administração , Centros Comunitários de Saúde/organização & administração , Necessidades e Demandas de Serviços de Saúde/tendências , Pessoal de Saúde/tendências , Avaliação de Eficácia-Efetividade de Intervenções , Promoção da Saúde/tendências , Criatividade
17.
Recurso educacional aberto em Espanhol | ID: oer-3790

RESUMO

Programa de Monitoreo sobre Enfermedades Crónicas No Transmisibles Es un curso para Fortalecer el sistema de atención de pacientes con enfermedades crónicas no Transmisibles, dado por el Equipo de la Secretaría de Salud Pública y Ambiente de la Facultad de Ciencias Médicas de la UNC. y Equipo de la Red integrada de salud del Hospital Italiano de Córdoba. Estos nuevos objetivos presentan la singularidad de instar a todos los países, ya sean ricos, pobres o de ingresos medianos, a adoptar medidas para promover la prosperidad al tiempo que protegen el planeta. Reconocen que las iniciativas para acabar con la pobreza deben ir de la mano de estrategias que favorezcan el crecimiento económico y aborden una serie de necesidades sociales, entre las que cabe señalar la educación, la salud, la protección social y las oportunidades de empleo, a la vez que luchan contra el cambio climático y promueven la protección del medio ambiente.


Assuntos
Prática Avançada de Enfermagem/22060 , Avaliação de Resultados (Cuidados de Saúde) , Prática Avançada de Enfermagem , Necessidades e Demandas de Serviços de Saúde/tendências
18.
Ther Umsch ; 75(2): 127-134, 2018 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-30022721

RESUMO

Give the due value to the end of life: the systematic underfunding of specialised palliative care in the Swiss DRG system Abstract. Palliative care is an integral part of modern medicine, improving quality of life, treatment satisfaction, and reducing the costs of care in severe disease. Patients' access should be early, regardless of age, diagnosis and setting, when incurable or advanced disease has been diagnosed. The public expenditure for specialised palliative care units in hospitals can be seen as yardstick for an appropriate palliative care supply, but in Switzerland only a mere fraction of revenues is dedicated to the palliative care units. Every year, 66'000 patients die in Switzerland, 38 % of them in a hospital. Health care costs for the last year of life account for 1.9 billion Swiss francs, but palliative care units receive only estimated 51 million Swiss francs per year. Reasons are a too little number of palliative care units, a systemic underfunding of their services and a fragmentary supply chain for severely ill or dying patients. This leads to ethically conflicting situations for clinicians. They have to deal with shortage of supply and, due to economic reasons, are forced to transfer severely ill or dying patients into inadequate settings. Based on international recommendations, Switzerland is in need of further 500 beds for specialised palliative care (actually 335), and at least 11'000 patients per year need access to a specialised palliative care service (actually about 3'500). Under the actual tariffing system, units for palliative care in hospitals are endangered in their existence. Corrections of the remuneration system are urgently warranted. On the long run, a national legal basis should be elaborated to safeguard adequate palliative care supply for all patients in need and as a base for monitoring, formation and research in palliative care.


Assuntos
Grupos Diagnósticos Relacionados/economia , Financiamento Governamental/economia , Necessidades e Demandas de Serviços de Saúde/economia , Programas Nacionais de Saúde/economia , Cuidados Paliativos/economia , Assistência Terminal/economia , Idoso , Idoso de 80 Anos ou mais , Doença Crônica/economia , Doença Crônica/terapia , Financiamento Governamental/tendências , Previsões , Gastos em Saúde/estatística & dados numéricos , Gastos em Saúde/tendências , Acesso aos Serviços de Saúde/economia , Acesso aos Serviços de Saúde/tendências , Necessidades e Demandas de Serviços de Saúde/tendências , Número de Leitos em Hospital/economia , Unidades Hospitalares/economia , Humanos , Programas Nacionais de Saúde/tendências , Cuidados Paliativos/tendências , Dinâmica Populacional , Suíça , Assistência Terminal/tendências
19.
Ther Umsch ; 75(2): 105-111, 2018 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-30022725

RESUMO

Dementia from a palliative care perspective: why a disease-specific advance care planning is necessary Abstract. Palliative Care has to transform profoundly in the context of population aging in many countries around the globe. It has to collaborate increasingly with geriatric medicine and incorporate geriatric expertise. One of the pivotal challenges of geriatric palliative care is ethically appropriate decision making for patients who have lost decision-making capacity. While the traditional approach to advance directives (living wills) has demonstrably proven ineffective, the new approach that is currently being embraced, including in German-speaking countries, is the systemic process of advance care planning (ACP). In this article, ACP is first presented with its general aims, elements and effects. Second, it is shown why we need an adapted ACP program for people with dementia and what such a dementia-specific ACP must entail.


Assuntos
Planejamento Antecipado de Cuidados , Diretivas Antecipadas , Demência/terapia , Cuidados Paliativos/métodos , Planejamento Antecipado de Cuidados/ética , Planejamento Antecipado de Cuidados/tendências , Diretivas Antecipadas/ética , Diretivas Antecipadas/tendências , Idoso , Idoso de 80 Anos ou mais , Tomada de Decisões , Demência/diagnóstico , Demência/epidemiologia , Previsões , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Cuidados Paliativos/ética , Cuidados Paliativos/tendências , Suíça
20.
Ther Umsch ; 75(2): 101-104, 2018 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-30022726

RESUMO

Paediatric Palliative Care: What is different in children compared to adults? Abstract. The number of children and adolescents (0 - 18 years) with life-limiting conditions and needs for paediatric palliative care (PPC) is rising. In Switzerland, the awareness for these needs lags largely behind other developed countries. In the United Kingdom, the prevalence for children with life-limiting conditions and PPC needs was estimated at 32 children per 10'000 population (0 - 19 years). In Switzerland, this would correspond to an absolute number of 5'000 children living with a life-limiting condition and potentially in need of PPC. In contrast, the number of deaths accounts for around 500 children (0 - 18 years) every year. Most common causes of death are perinatal conditions, contributing to nearly 50 % of all deaths in childhood, followed by accidents and complex chronic conditions such as genetic / congenital disorders, neurological and cardiac conditions and cancer. Compared to adults with palliative care needs, the group of children is significantly smaller but at the same time highly heterogenic. Heterogeneity relates to: the whole age continuum from neonates, infants and children to adolescents; a broad spectrum of diseases including rare diseases; a variety of needs due to age, development and the illness, e. g. needs for specialist care or technical support; various in- and outpatient settings. Paediatric care always encompasses the whole family and their particular needs. Internationally, hospital-based programmes have been developed and implemented to meet these particular needs of children and their families.


Assuntos
Cuidados Paliativos/métodos , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Doença Crônica/epidemiologia , Doença Crônica/terapia , Estudos Transversais , Previsões , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Lactente , Recém-Nascido , Comunicação Interdisciplinar , Colaboração Intersetorial , Cuidados Paliativos/estatística & dados numéricos , Pediatria , Suíça
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