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2.
Indian J Tuberc ; 66(4): 549-554, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31813447

RESUMO

The targets of the WHO's End TB Strategy and the United Nations' (UN) Sustainable Development Goals (SDGs) have been expanded to"Find. Treat. All #EndTB" with universal access to TB diagnosis, treatment and care by 2022 in an effort to end the global TB epidemic. Trends to achieve the above targets in children have led to greater emphasis on the newer diagnostics paving way to microbiological confirmation and universal drug sensitivity in children.


Assuntos
Serviços de Saúde da Criança/tendências , Teste Tuberculínico , Tuberculose Pulmonar/prevenção & controle , Antituberculosos/farmacologia , Antituberculosos/uso terapêutico , Criança , Saúde Global , Humanos , Testes de Sensibilidade Microbiana , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/microbiologia
3.
Midwifery ; 78: 104-113, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31419781

RESUMO

BACKGROUND: Good quality midwifery care has the potential to reduce both maternal and newborn mortality and morbidity in high, low, and lower-middle income countries (LMIC) and needs to be underpinned by effective education. There is considerable variation in the quality of midwifery education provided globally. OBJECTIVE: To determine what are the most efficient and effective ways for LMICs to conduct pre-service and in-service education and training in order to adequately equip care providers to provide quality maternal and newborn care. DESIGN: Rapid Systematic Evidence Review METHODS: A systematic search of the following databases was conducted: Medline, CINAHL, LILACs, PsycInfo, ERIC, and MIDIRs. Studies that evaluated the effects of pre-service and in-service education that were specifically designed to train, educate or upskill care providers in order to provide quality maternal and newborn care were included. Data was extracted and presented narratively. FINDINGS: Nineteen studies were included in the review. Of these seven were evaluations of pre-service education programmes and 12 were evaluations of in-service education programmes. Whilst studies demonstrated positive effects on knowledge and skills, there was a lack of information on whether this translated into behaviour change and positive effects for women and babies. Moreover, the level of the evidence was low and studies often lacked an educational framework and theoretical basis. Mapping the skills taught in each of the programmes to the Quality Maternal and Newborn Care framework (Renfrew et al., 2014) identified that interventions focused on very specific or individual clinical skills and not on the broader scope of midwifery. KEY CONCLUSIONS: There is a very limited quantity and quality of peer reviewed published studies of the effectiveness of pre service and in service midwifery education in LMICs; this is at odds with the importance of the topic to survival, health and well-being. There is a preponderance of studies which focus on training for specific emergencies during labour and birth. None of the in-service programmes considered the education of midwives to international standards with the full scope of competencies needed. There is an urgent need for the development of theoretically informed pre-service and in-service midwifery education programmes, and well-conducted evaluations of such programmes. Upscaling quality midwifery care for all women and newborn infants is of critical importance to accelerate progress towards Sustainable Development Goal 3. Quality midwifery education is an essential pre-requisite for quality care. To deliver SDG 3, the startling underinvestment in midwifery education identified in this review must be reversed.


Assuntos
Serviços de Saúde da Criança/tendências , Educação/métodos , Pessoal de Saúde/educação , Serviços de Saúde Materna/tendências , Adulto , Assistência à Saúde , Países em Desenvolvimento , Educação/tendências , Feminino , Pessoal de Saúde/tendências , Humanos , Recém-Nascido , Masculino , Qualidade da Assistência à Saúde
4.
Pediatrics ; 143(6)2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31142579

RESUMO

For 25 years, the American Academy of Pediatrics (AAP) Community Access to Child Health (CATCH) program has supported pediatricians in collaborating within their communities to advance the health of all children. CATCH grants support pediatric residents and pediatricians in planning or implementing community-based child health initiatives. The CATCH program has provided almost 10 million dollars through 842 planning, 585 resident, and 305 implementation grants to >1700 pediatricians. Urban, rural, suburban, and tribal communities in every state as well as the District of Columbia and Puerto Rico have benefited from CATCH-funded projects. Collaborations with community partners such as schools, homeless shelters, and mental health centers have led to programs serving children and families, especially those living in poverty and in minority groups. The most recent program data reveal that 87.5% of the projects are operating 2 years after funding. Many CATCH projects have not only sustained themselves but have grown into larger programs with funding from other sources. CATCH has influenced pediatricians' careers by providing important skills, networking opportunities, career legitimacy, mentoring opportunities, and increased engagement with the AAP. More than 350 pediatricians have served the AAP as CATCH facilitators, the network of physicians that provides technical assistance to applicants and reviews grant applications. Responding to changing trends, CATCH leaders have looked at other funding models and recently launched the CATCH-On initiative. CATCH-On creates and provides templates from successful CATCH projects to busy pediatricians who can then implement the project in their communities with minimal funding.


Assuntos
Academias e Institutos/economia , Serviços de Saúde da Criança/economia , Serviços de Saúde Comunitária/economia , Acesso aos Serviços de Saúde/economia , Pediatria/economia , Academias e Institutos/tendências , Serviços de Saúde da Criança/tendências , Pré-Escolar , Serviços de Saúde Comunitária/tendências , Acesso aos Serviços de Saúde/tendências , Humanos , Pediatria/tendências , Fatores de Tempo , Estados Unidos/epidemiologia
6.
Emerg Med J ; 36(1): 39-46, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30389792

RESUMO

BACKGROUND: The number of EDs visit is on the increase, and the pressure on EDs is of significant concern worldwide. The usage of EDs by parents of children with minor illness is an important and still unresolved problem causing a burden to healthcare services. The aim of this study was to review the literature to summarise parental reasons for visiting ED for children with minor illness. METHOD: Seven electronic databases (Medline, Embase, PsycINFO, CINAHL, PubMed, Web of Science and Scopus) were comprehensively searched during a 2-week period in August 2016 and updated between 11 and 20 June 2018. The study selection process was undertaken independently by two authors. Qualitative and quantitative studies that focused on the reasons for parents of children with minor illness to attend an ED were included. Studies were assessed for quality and data were analysed by means of narrative synthesis. RESULTS: Twenty-four studies were included. Eleven studies employed quantitative methods, eleven studies used qualitative methods and two studies used mixed methods. Parental reasons for using ED included perceived urgency, ED advantages (eg, faster service, superior ED resources and efficiency), difficulties with getting a general practitioner appointment, lack of facilities in primary healthcare services, lack of health insurance, reassurance, convenience and access. CONCLUSION: This review identified some of the reasons why parents bring their children to the ED for minor illnesses highlighting the multifaceted nature of this problem. Understanding parental reasons behind their choice to use the ED may help us better design targeted interventions to reduce unnecessary ED visits and alleviate the burden on overstretched healthcare services. This review may help inform emergency care policy makers, researchers and healthcare staff to understand parents' reasons for visiting the ED, to better meet their healthcare needs.


Assuntos
Serviços de Saúde da Criança/tendências , Comportamento de Doença , Pais/psicologia , Aceitação pelo Paciente de Cuidados de Saúde , Criança , Pré-Escolar , Comportamento de Escolha , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/tendências , Humanos , Lactente
7.
Rev Bras Enferm ; 71(suppl 6): 2612-2619, 2018.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30540035

RESUMO

OBJECTIVE: To analyze the care coordination for the child and adolescent in chronic condition and users planning in the Health Care Network. METHOD: Qualitative study, conducted with 26 health professionals and managers through Focus Groups. Thematic content analysis was used. RESULTS: Care coordination is fragile, with lack of support from the management, and presence of high turnover of managers and professionals. The limits in the network planning are due to frequent changes in the careflow. Communication between levels of care and lack of counter-referral makes network care unfeasible. FINAL CONSIDERATIONS: There is a need for planning in the Health Care Network and establishment of careflow, as well as the construction of communication channels and tools of referral and counter-referral between professionals and services, for the constitution and integration of the network from the perspective of user-centered care.


Assuntos
Serviços de Saúde da Criança/normas , Doença Crônica/terapia , Continuidade da Assistência ao Paciente/normas , Pessoal de Saúde/psicologia , Adolescente , Adulto , Idoso , Criança , Serviços de Saúde da Criança/tendências , Doença Crônica/reabilitação , Feminino , Grupos Focais , Acesso aos Serviços de Saúde/normas , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Encaminhamento e Consulta/normas
8.
Artigo em Russo | MEDLINE | ID: mdl-30412149

RESUMO

BACKGROUND: The Moscow Health Department organized an efficient and comprehensive three-level system of medical rehabilitation for the children. Health resort-based treatment is normatively a component of the third stage of rehabilitation. AIM: The objective of the present study was to substantiate the necessity and validity of the health resort-based treatment as an integral part of the third stage of medical rehabilitation. MATERIAL AND METHODS: We have carried out the analysis of activities of 16 health resorts facilities during the period from 2016 to 2017 that included the evaluation in volume terms of the medical assistance, availability of the health resort-based treatment, and its clinical outcomes. The data thus obtained were systematized and processed with the use of the MS Office software package. RESULTS: The analysis of dynamics of the extent of the provided medical assistance expressed in terms of volume has demonstrated the increase in the overall number of people who had received health resort-based treatment in 2017 in comparison with that in 2016. The analysis of the structure of the pathological conditions in the patients admitted for the treatment in the health resort settings revealed correlation with the profiles of specialization of these facilities and with the structure of newly registered diseases. The analysis of the services rendered within the framework of the health resort-based treatment programs confirmed the effectiveness of medical assistance organized with the use of such approach. The study revealed challenges still facing the services responsible for the provision of the health resort-based treatment of the children in Moscow and the lines of activities in this field to be carried out in the near future. CONCLUSION: The experience gained by the Moscow public healthcare organizations gives evidence that the health resort facilities located directly in the region are necessary for rendering the comprehensive three-level medical rehabilitation as a very important component of its third (final).


Assuntos
Serviços de Saúde da Criança/organização & administração , Estâncias para Tratamento de Saúde , Reabilitação/organização & administração , Criança , Serviços de Saúde da Criança/tendências , Previsões , Humanos , Moscou , Reabilitação/tendências
9.
Orv Hetil ; 159(46): 1948-1956, 2018 11.
Artigo em Húngaro | MEDLINE | ID: mdl-30450931

RESUMO

Paediatric organ transplantation today is considered and accepted and widely available therapy in children with end-stage organ failure. It is important to know that in childhood, diseases leading to end-stage organ failure differ from those in adults. Beside this, in children there are different surgical and paediatric challenges before and after transplantation (size differences of the patient and donor organ, special and paediatric infections, different pharmacokinetics and pharmacodynamics of immunosuppressive drugs, noncompliance). However, paediatric organ transplantation in the last decades became a success story of the Hungarian health care owing to several working groups in Hungary and outside the country. Orv Hetil. 2018; 159(46): 1948-1956.


Assuntos
Serviços de Saúde da Criança/tendências , Bem-Estar da Criança/tendências , Transplante de Órgãos/tendências , Obtenção de Tecidos e Órgãos/organização & administração , Criança , Sobrevivência de Enxerto , Humanos , Hungria , Imunossupressores/uso terapêutico
10.
Buenos Aires; s.n; nov. 2018. 78 p. graf..
Não convencional em Espanhol | LILACS | ID: biblio-1009891

RESUMO

Ateneo de la Residencia de Psicopedagogía del CESAC Nº 15, del Área Programática del Hospital General de Agudos Cosme Argerich, de la Ciudad de Buenos Aires. A partir del Dispositivo de Crecimiento y Desarrollo, que funciona en el Centro de Salud desde hace más de veinte años, y trabaja con bebés de 0 a 18 meses, y sus madres, padres, o adultos referentes; se plantean distintas preguntas sobre el contexto de la infancia, y sobre estrategias de Atención Primaria en Salud. Se detalla la normativa y programas vigentes, para Nación y CABA; así como el tipo de intervención que se propone desde el Centro de Salud. En el último apartado se abordan diferentes aspectos constitutivos de la infancia, como el vínculo, el juego y el aprendizaje


Assuntos
Atenção Primária à Saúde , Serviços de Saúde da Criança/legislação & jurisprudência , Serviços de Saúde da Criança/provisão & distribução , Serviços de Saúde da Criança/tendências , Saúde da Criança , Centros Comunitários de Saúde , Atenção Integrada às Doenças Prevalentes na Infância , Internato não Médico
13.
Pediatr. aten. prim ; 20(79): e89-e104, jul.-sept. 2018. tab, mapas, graf
Artigo em Espanhol | IBECS | ID: ibc-180959

RESUMO

Introducción: la Asociación Española de Pediatría de Atención Primaria (AEPap) ha querido conocer el porcentaje de plazas de Pediatría de Atención Primaria (PAP) del sector público ocupadas por médicos no especialistas en Pediatría y sus Áreas Específicas (PAE), las condiciones laborales de las mismas y el número de profesionales que se encuentran próximos a la jubilación. Para ello, se ha realizado una encuesta entre los vocales de las asociaciones autonómicas que componen la asociación. Resultados: se han obtenido datos del 90% de las plazas de PAP. El porcentaje de plazas a nivel nacional no ocupadas por especialistas en PAE es del 25,1% (IC 95: 24,1-26,4%), habiendo mucha variabilidad entre comunidades autónomas y provincias, que va del 48,97% en las Islas Baleares al 0% en La Rioja. En relación con la edad de los profesionales, con datos obtenidos del 47,0% de las plazas, la cuarta parte tiene más de 60 años y un 40% supera los 55. En cuanto a los horarios de atención, con datos recogidos del 72,1% de las plazas, un 42,2% de los pediatras de AP trabajan exclusivamente de mañanas, un 29,9% cuatro mañanas y una tarde semanal y un 27,8% un mayor porcentaje de tardes o tardes exclusivas. Conclusiones: existe un déficit de pediatras de AP y una previsión de que este déficit aumente. Las autoridades sanitarias tienen que hacer un esfuerzo en la formación MIR y tienen que conseguir que las plazas de PAP sean más atractivas para los nuevos especialistas, favoreciendo la formación, investigación y disminuyendo el 30% de horarios de tarde exclusivas o predominantes


Introduction: the Spanish Association of Primary Care Pediatrics (AEPap) wants to know the percentage of primary care paediatrics (PAP) places in public health services occupied by non-specialists in Pediatrics and their Specific Areas (PSA), the working conditions of the same and the number of professionals who are next to retirement. For this, a survey has been carried out among the members of the autonomous associations that make up the association. Results: data of 90% of the PAP places have been obtained. The percentage of places at the national level not occupied by specialists in PSA is 25.1% (IC 95: 24,1 a 26,4%), there is a lot of variability among regions and provinces, ranging from 48.97% in the Balearic Islands to 0% in La Rioja. With data on the age obtained from 47% of the places, a quarter of the pediatricians are over 60 years old and 40% are more than 55. Regarding the hours of care, with data collected from 72,1% of the places, a 42,2% of the PAP works in the mornings, 29,9% in the morning and one evening per week and 27,8% in a higher percentage of evenings. Conclusions: there is a deficit of PAP and a forecast that this deficit will increase. The health authorities have to make an effort in the MIR training and they have to make PAP seats more attractive for new specialists, favoring training, research and decreasing 30% of exclusive or predominant evening schedules


Assuntos
Humanos , Atenção Primária à Saúde/tendências , Pessoal de Saúde/tendências , Serviços de Saúde da Criança/tendências , Enfermeiras Pediátricas/estatística & dados numéricos , Espanha , Especialização/tendências , Cobertura Efetiva de Serviços de Saúde/estatística & dados numéricos
19.
Hosp Pediatr ; 8(7): 394-403, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29871887

RESUMO

OBJECTIVES: Shared care plans play an essential role in coordinating care across health care providers and settings for children with medical complexity (CMC). However, existing care plans often lack shared ownership, are out-of-date, and lack universal accessibility. In this study, we aimed to establish requirements for shared care plans to meet the information needs of caregivers and providers and to mitigate current information barriers when caring for CMC. METHODS: We followed a user-centered design methodology and conducted in-depth semistructured interviews with caregivers and providers of CMC who receive care at a tertiary care children's hospital. We applied inductive, thematic analysis to identify salient themes. Analysis occurred concurrently with data collection; therefore, the interview guide was iteratively revised as new questions and themes emerged. RESULTS: Interviews were conducted with 17 caregivers and 22 providers. On the basis of participant perspectives, we identified 4 requirements for shared care plans that would help meet information needs and mitigate current information barriers when caring for CMC. These requirements included the following: (1) supporting the accessibility of care plans from multiple locations (eg, cloud-based) and from multiple devices, with alert and search features; (2) ensuring the organization is tailored to the specific user; (3) including collaborative functionality such as real-time, multiuser content management and secure messaging; and (4) storing care plans on a secure platform with caregiver-controlled permission settings. CONCLUSIONS: Although further studies are needed to understand the optimal design and implementation strategies, shared care plans that meet these specified requirements could mitigate perceived information barriers and improve care for CMC.


Assuntos
Cuidadores/psicologia , Serviços de Saúde da Criança , Doença Crônica , Computação em Nuvem , Crianças com Deficiência , Pessoal de Saúde/organização & administração , Adulto , Criança , Serviços de Saúde da Criança/organização & administração , Serviços de Saúde da Criança/tendências , Computação em Nuvem/tendências , Pessoal de Saúde/tendências , Humanos , Entrevistas como Assunto , Planejamento de Assistência ao Paciente , Percepção , Relações Profissional-Família , Pesquisa Qualitativa , Participação dos Interessados
20.
Cad Saude Publica ; 34(6): e00094417, 2018 06 21.
Artigo em Português | MEDLINE | ID: mdl-29947657

RESUMO

This article aims to identify changes in indicators for the organization of children's health services in primary care in the State of São Paulo, Brazil. An evaluative study was conducted with three series of cross-sectional evaluations with participation by 81 services, involving 32 municipalities (counties) in the central-west region of the state, who answered the Quali AB questionnaire in 2007, 2010, and 2014. The analysis used 74 children's health indicators and 7 services indicators. Comparison of the indicators evidenced changes in the organization of children's healthcare, with an improvement in the majority of the indicators in 2010 and maintenance or worsening in 2014, compared to 2007. In conclusion, children's health policy recommendations have not been fully realized in the organization of the supply of comprehensive care, although relevant issues such as childhood obesity and violence have been addressed by a few services.


Assuntos
Serviços de Saúde da Criança/organização & administração , Saúde da Criança , Atenção Primária à Saúde/organização & administração , Análise de Variância , Brasil , Criança , Saúde da Criança/estatística & dados numéricos , Saúde da Criança/tendências , Serviços de Saúde da Criança/estatística & dados numéricos , Serviços de Saúde da Criança/tendências , Cidades/estatística & dados numéricos , Estudos Transversais , Assistência à Saúde/estatística & dados numéricos , Assistência à Saúde/tendências , Promoção da Saúde/estatística & dados numéricos , Promoção da Saúde/tendências , Recursos em Saúde/estatística & dados numéricos , Recursos em Saúde/tendências , Pesquisa sobre Serviços de Saúde , Humanos , Atenção Primária à Saúde/estatística & dados numéricos , Atenção Primária à Saúde/tendências
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