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Ortodoncia ; 83(166): 8-13, jul.-dic. 2019. ilus
Artigo em Espanhol | LILACS | ID: biblio-1102094


La indicación de extracciones en aquellos casos en preparación para cirugía ortognática representa un compromiso, ya que la mayoría de las veces dichas extracciones sirven para exponer las desarmonías del contenido dental en relación con el continente óseo, lo que causa un empeoramiento estético que solo se reparará en ocasión de la cirugía. Es por eso que las opciones de "cirugía primero" se solicitan con mayor frecuencia en los últimos años.(AU)

Prescription of extractions in those cases in preparation for orthognathic surgery represents a compromise, since most times those extractions serve to show disharmonies of dental content in relation to the bone continent, which causes an aesthetical worsening that will only be repaired on occasion of surgery. That is why the 'surgery first' options are most frequently requested in recent years.(AU)

Ortodontia , Cirurgia Ortognática , Extração Dentária , Preparativos para Desastre , Prescrições , Má Oclusão de Angle Classe II , Má Oclusão de Angle Classe III
Geneva; PAHO; 2016-10.
em Inglês | PAHO-IRIS | ID: phr-31292


[Executive Summary]. From 15-17 March 2016, the World Health Organization (WHO) and the Pan American Health Organization (WHO/Region of the Americas) held a regional meeting on influenza vaccination in Santiago, Chile. The meeting combined the Third WHO meeting on seasonal influenza vaccine composition and the Third meeting of the REVELAC-i network (Network for evaluating influenza vaccine effectiveness in Latin America and the Caribbean). It aimed to support countries of Latin America and the Caribbean (LAC) in using information from influenza surveillance and influenza vaccination programs to make evidence-based decisions and further develop the recommendations for seasonal influenza vaccination. Participants from 21 countries, two WHO Collaborating Centers for Reference and Research on Influenza (Center for Disease Prevention and Control, USA (US-CDC), and Victorian Infectious Diseases Reference Laboratory, Australia) and eight collaborating institutions/partners, and multidisciplinary teams from the ministries of health across the Americas (professionals engaged in epidemiological and virological influenza surveillance and immunization programs managers) attended the meeting. Influenza vaccination is particularly challenging compared to other vaccines included in EPI schedules, due to the need for annual, optimally timed vaccination, the wide spectrum of target groups that comprises the entire life course (over six months of age), a relatively lower vaccine effectiveness compared to childhood EPI vaccines, and the limitations of the availability of vaccines. In recent years, the LAC countries have continued their efforts to sustain or increase seasonal influenza vaccine uptake among high risk groups, especially among pregnant women. These countries have also continued strengthening influenza surveillance, immunization platforms and information systems, indirectly improving preparedness for future pandemics. Challenges, however, persist in the estimation of vaccination coverage, especially for pregnant women and persons with chronic conditions. Since 2013, LAC countries through their influenza vaccine effectiveness evaluation network (REVELAC-i for its acronym in Spanis Red para la Evaluación de Vacunas En Latino América y el Caribe–influenza) have successfully estimated influenza vaccine effectiveness against severe influenza illness among children aged 6 months-5 years and adults ≥60 years targeted for vaccination. Regarding influenza seasonality in countries of the American Tropics, the analysis of recent epidemiological evidence suggested no evidence of year round circulation (except in Colombia and Venezuela) but rather the occurrence of one to two annual epidemic peaks of influenza illnesses and most of them (except Mexico, Jamaica and Guatemala) corresponding to southern hemisphere circulation. WHO/PAHO emphasized the importance of continuing intensive/mass vaccination before the primary influenza epidemic peak, reaching high vaccination coverages among high risk groups. Any adjustments to national influenza vaccination guidelines should be guided by the local epidemiology of influenza, as demonstrated by some countries (five from Central America and one from the Caribbean, since 2007) that changed their vaccination timing to April-May using the Southern Hemisphere formulation. Considerations for a prolonged supply of influenza vaccines in tropical countries were also discussed during the meeting following an update from global and regional influenza vaccine manufacturers. The meeting participants agreed on a short term research agenda addressing influenza vaccine effectiveness and impact among all target groups, knowledge, attitudes and practices related to vaccination among pregnant women and healthcare workers, documenting the experience of influenza vaccination as recommended by the SAGE and exploring the cost-effectiveness of quadrivalent influenza vaccines for which there is no official WHO nor PAHO TAG recommendation to date.

Vacinação , Vacinas contra Influenza , América , Emergências , Preparativos para Desastre , Pandemias , Organização Mundial da Saúde
Rev Panam Salud Publica ; 40(3),sept. 2016
Artigo em Inglês | PAHO-IRIS | ID: phr-31233


Extreme weather events have revealed the vulnerability of health care facilities and the extent of devastation to the community when they fail. With climate change anticipated to increase extreme weather and its impacts worldwide—severe droughts, floods, heat waves, and related vector-borne diseases—health care officials need to understand and address the vulnerabilities of their health care systems and take action to improve resiliency in ways that also meet sustainability goals. Generally, the health sector is among a country’s largest consumers of energy and a significant source of greenhouse gas emissions. Now it has the opportunity lead climate mitigation, while reducing energy, water, and other costs. This Special Report summarizes several initiatives and compares three toolkits for implementing sustainability and resiliency measures for health care facilities: the Canadian Health Care Facility Climate Change Resiliency Toolkit, the U.S. Sustainable and Climate Resilient Health Care Facilities Toolkit, and the PAHO SMART Hospitals Toolkit of the World Health Organization/Pan American Health Organization. These tools and the lessons learned can provide a critical starting point for any health system in the Americas.

Los sucesos climáticos extremos han puesto de manifiesto la vulnerabilidad de las instalaciones de atención sanitaria y el grado de devastación infligido a la comunidad cuando estas fallan. Ante un cambio climático que preanuncia un aumento de los sucesos climáticos extremos y sus respectivos impactos en todo el mundo (sequías, inundaciones y olas de calor intensas, así como enfermedades relacionadas transmitidas por vectores) los profesionales sanitarios deben comprender y hacer frente a las vulnerabilidades de sus sistemas de atención de salud, y emprender acciones que apunten a mejorar su resistencia de manera sostenible. Por lo general, el sector salud es uno de los mayores consumidores de energía de un país y una fuente significativa de emisión de gases de efecto invernadero. En la actualidad tiene la oportunidad de liderar las acciones de mitigación frente al cambio climático, y a la vez de reducir los costos de energía y agua, entre otros. En este informe especial se resumen varias iniciativas y se comparan tres recursos dirigidos a implementar medidas de sostenibilidad y resistencia para instalaciones de atención sanitaria: la Herramienta de Resistencia ante el Cambio Climático para Instalaciones de Atención Sanitaria (Canadá), la Herramienta de Resistencia ante el Cambio Climático para Instalaciones de Atención Sanitaria (Estados Unidos) y la Herramienta Hospitales Inteligentes de la Organización Panamericana de la Salud/ Organización Mundial de la Salud. Estas herramientas y las lecciones aprendidas a través de ellas proporcionan un punto de partida crucial para todos los sistemas de salud de la Región de las Américas.

Efeitos do Clima , Mudança Climática , Desenvolvimento Sustentável , Preparativos para Desastre , América , Mudança Climática , Efeitos do Clima , Prevenção e Mitigação , Planejamento em Desastres , Instalações de Saúde , Desenvolvimento Sustentável , Prevenção e Mitigação , Instituições de Saúde, Recursos Humanos e Serviços
Washington, D.C; PAHO; 2016-09.
em Inglês | PAHO-IRIS | ID: phr-31207


[Foreword]. Faced with the complex situation caused by dengue in the Americas and around the world, in 2003 the Pan American Health Organization/World Health Organization (PAHO/WHO) developed the Integrated Management Strategy for Dengue Prevention and Control in the Americas (IMS-Dengue) in collaboration with its member countries in order to tackle the disease through these six components: laboratory, social communication, epidemiology, integrated vector management, environmental, and patient care. The Organization considers patient care to be a vital component and has made it a priority. The first edition of Dengue: guidelines for the care of patients in the Region of the Americas was published (in Spanish) in 2010, based on a WHO document published for the same purpose in 2009. Implementation of the first edition in the Americas was followed by extensive training of health care workers, specifically on timely diagnosis, classification, and case management, with an emphasis on primary care. Recent advances in diagnostic procedures and clinical management make it necessary to update the information on the care of patients with dengue. This second edition of Dengue: guidelines for patient care in the Region of the Americas includes information on the clinical manifestations of the disease, care and treatment, epidemiological surveillance, and laboratory diagnosis. It also includes new information on the reorganization of health services during outbreaks and epidemics, which will be very useful to health unit managers. The guidelines consider this continent’s experiences and are evidence-based at the highest scientific level. PAHO/WHO presents this second edition to countries and territories of the Americas at a time when other arboviral diseases (chikungunya and Zika) have been introduced into the Region. Therefore, it is essential to ensure accurate and timely diagnosis of dengue cases, as well as adequate clinical monitoring. These guidelines—an essential tool for health care workers to correctly manage the dengue cases that appear daily in our countries––seek to prevent the progression to the severe forms of dengue and deaths caused by the disease.

Dengue , Dengue Grave , Laboratórios , Surtos de Doenças , Preparativos para Desastre , América , Assistência à Saúde
In. Caribbean Public Health Agency. Caribbean Public Health Agency: 60th Annual Scientific Meeting. Kingston, The University of the West Indies. Faculty of Medical Sciences, 2015. p.[1-75]. (West Indian Medical Journal Supplement).
Monografia em Inglês | MedCarib | ID: med-18068


OBJECTIVE: To review basic, critical elements of emergency preparedness and response capacity in the healthcare system of Trinidad and Tobago. DESIGN AND METHODS: A descriptive study involving one major hospital and one randomly selected health centre in each Regional Health Authority (RHA). Responders were chosen by purposive sampling and structured face-to-face interviews were carried out. Data collection was undertaken using modified versions of two previously validated data collection tools. RESULTS: All 5 hospitals in each RHA and 4 of 5 health centres participated. Emergency response plans existed in all healthcare facilities reviewed; however plans were not regularly tested. An investigation team can be assembled in 24 hours and a patient referral system was in place in all hospitals. There appeared to be access to stockpiles in all facilities. There was a gap in ongoing infection control measures including the absence of regular personal protective equipment (PPE) training for staff. CONCLUSIONS: There was an urgent need for systematic rather than ad hoc measures for testing existing plans and staff training in their roles and responsibilities during an acute public health event should one occur. For infectious diseases with high case fatality rates such as avian influenza and Ebola, it is critical for front line staff to be aware of infection control measures including how to properly use PPE. Governments should take the opportunity of the Ebola outbreak in West Africa to utilize public health capacity to catalyse the systematic strengthening of core capacities for alert and response to meet their International Health Regulations (IHR) 2005 obligations.

Preparativos para Desastre , Setor de Assistência à Saúde , Serviços Médicos de Emergência , Serviço Hospitalar de Emergência , Avaliação da Capacidade de Trabalho , Trinidad e Tobago
In. Caribbean Public Health Agency. Caribbean Public Health Agency: 60th Annual Scientific Meeting. Kingston, The University of the West Indies. Faculty of Medical Sciences, 2015. p.[1-75]. (West Indian Medical Journal Supplement).
Monografia em Inglês | MedCarib | ID: med-18070


OBJECTIVES: (i). The establishment of a baseline of Trinidad & Tobago’s Health Information System (HIS) status; (ii). The promotion of a common and comprehensive understanding of the HIS among all stakeholders; (iii). The identification of existing strengths and weaknesses of the HIS; and (iv). The identification of priority areas for improvement. DESIGN AND METHODS: Using the Version 4.0 of the WHO’s Health Metrics Network Assessment Tool three (3) Regional Health Authorities (RHAs) were evaluated. The scoring scheme was based on a system of “0” to “3”. “0” meaning “not prepared at all” and “3” meaning “fully prepared”. Interviews were conducted with County Medical Officers of Health, Medical Chiefs of Staff, Executive Medical Directors, Information and Communications Technology (ICT) Managers and Public Health Observatory Heads. RESULTS AND FINDINGS: The results indicated that the lowest scores were assigned to data management (48%) and resources (49%), both classified as present but not adequate. Dissemination and use (53%), information products (58%) and data sources (61%) were found to be adequate. HIS indicators were found to be highly adequate (76%). CONCLUSION: The main areas of weakness in Trinidad and Tobago’s current HIS readiness were Data Management and Resources, while Indicator status was its greatest attribute.

Sistemas de Informação , Sistemas de Informação Hospitalar , Preparativos para Desastre , Trinidad e Tobago
Edumecentro ; 5(3): 95-107, sep.-dic. 2013. ilus
Artigo em Espanhol | LILACS | ID: lil-685254


Introducción: el trabajo investigativo en la educación superior debe estar encaminado a la solución teórico práctica de sus problemas, partiendo de esta premisa los autores se proponen como objetivo caracterizar el nivel de preparación de los docentes para dirigir el proceso de enseñanza aprendizaje utilizando los niveles de asimilación. Métodos: se realizó una investigación descriptiva y transversal en la Filial Universitaria de Ciencias Médicas del municipio Manicaragua durante el curso académico 2011-2012, para la cual fueron abordados los fundamentos teóricos y metodológicos en torno a los niveles de asimilación, concepto, tipos e importancia de su utilización en la clase. De un universo de 65 docentes categorizados se seleccionó una muestra intencional de 10 con más de cinco años de experiencia, que imparten docencia en el primer y segundo años de la carrera de Medicina, y se asumieron una gama de métodos y técnicas investigativas desde el nivel empírico hasta el estadístico para lograr el objetivo propuesto. Resultados: todos los encuestados consideran necesaria la preparación metodológica para la dirección del proceso enseñanza aprendizaje, conocen los niveles de asimilación pero no saben cómo aplicarlos. Conclusiones: los docentes desconocen cómo orientar actividades dentro de sus clases teniendo en cuenta los niveles de asimilación, el método que seleccionan no siempre les permite transitar por estos, lo que evidencia una insuficiente preparación para dirigir el proceso de enseñanza aprendizaje mediante su uso.

Introduction: research work in higher education should be aimed at the practical-theoretical solution of its problems. Based on this premise, the authors' objective is to determine the qualifications of teachers to lead the teaching-learning process using the levels of assimilation. Methods: a cross-sectional descriptive study was conducted at the Medical University Branch in Manicaragua during the academic year 2011-2012. The theoretical and methodological foundations concerning the levels of assimilation, its concept, types and importance of their classroom use were included. Of a universe of 65 professors, an intentional sample formed by 10 professors was selected. They had more than five years of experience and taught first and second years of medical undergraduate studies. A range of methods and investigative techniques, from empirical to statistical levels, were used to achieve the objective. Results: all respondents consider that methodological training is needed to lead the teaching-learning process. They know assimilation levels but do not know how to apply them. Conclusions: teachers do not know how to guide activities within their classes taking into account the levels of assimilation. The method they chose does not always allow them to go through these levels. It demonstrates insufficient preparation to lead the teaching-learning process with their use.

Ensino , Preparativos para Desastre , Docentes , Aprendizagem