Using hospital auxiliary worker and 24-h TB services as potential tools to overcome in-hospital TB delays: a quasi-experimental study.

BACKGROUND: In-hospital logistic management barriers (LMB) are considered to be important risk factors for delays in TB diagnosis and treatment initiation (TB-dt), which perpetuates TB transmission and the development of TB morbidity and mortality. We assessed the contribution of hospital auxiliary workers (HAWs) and 24-h TB laboratory services using Xpert (24h-Xpert) on the delays in TB-dt and TB mortality at Beira Central Hospital, Mozambique. METHODS: A quasi-experimental design was used. Implementation strategy-HAWs and laboratory technicians were selected and trained, accordingly. Interventions-having trained HAW and TB laboratory technicians as expediters of TB LMB issues and assurer of 24h-Xpert, respectively. Implementation outcomes-time from hospital admission to sputum examination results, time from hospital admission to treatment initiation, proportion of same-day TB cases diagnosed, initiated TB treatment, and TB patient with unfavorable outcome after hospitalization (hospital TB mortality). A nonparametric test was used to test the differences between groups and adjusted OR (95% CI) were computed using multivariate logistic regression. RESULTS: We recruited 522 TB patients. Median (IQR) age was 34 (16) years, and 52% were from intervention site, 58% males, 60% new case of TB, 12% MDR-TB, 72% TB/HIV co-infected, and 43% on HIV treatment at admission. In the intervention hospital, 93% of patients had same-day TB-dt in comparison with a median (IQR) time of 15 (2) days in the control hospital. TB mortality in the intervention hospital was lower than that in the control hospital (13% vs 49%). TB patients admitted to the intervention hospital were nine times more likely to obtain an early laboratory diagnosis of TB, six times more likely to reduce delays in TB treatment initiation, and eight times less likely to die, when compared to those who were admitted to the control hospital, adjusting for other factors. CONCLUSION: In-hospital delays in TB-dt and high TB mortality in Mozambique are common and probably due, in part, to LMB amenable to poor-quality TB care. Task shifting of TB logistic management services to HAWs and lower laboratory technicians, to ensure 24h-Xpert through "on-the-spot strategy," may contribute to timely TB detection, proper treatment, and reduction of TB mortality.

A profissionalização da gestão do voluntariado: um estudo de caso do departamento de voluntários do Hospital Israelita Albert Einstein / The professionalization of volunteer management: a case study of the Volunteers Department of the Hospital Israelita Albert Einstein

Resumo O trabalho voluntário passa de uma ação assistencialista para um processo que requer inovações de modo a alcançar eficiência em seus resultados, levando à profissionalização da gestão e obedecendo a critérios organizativos e estratégicos. Este estudo tem como objetivo compreender como é realizada a gestão do voluntariado a partir de um estudo de no Departamento de Voluntários do Hospital Israelita Albert Einstein. A pesquisa caracteriza-se como exploratória e qualitativa. Para coleta dos dados, foram utilizados documentos, observação e entrevistas. Foram entrevistados um coordenador e seis voluntários. Para análise dos dados, utilizou-se a análise de conteúdo e a técnica categorial. Os resultados apontam que o voluntariado não pode agir de maneira independente dentro do hospital, embora a autonomia seja necessária para poder implementar ações que tragam resultados. O voluntariado deve atuar de maneira a se adequar às regras do hospital. Todas as suas ações precisam estar de acordo com os princípios e objetivos da instituição. Acredita-se que a gestão do voluntariado vai muito além da gestão de pessoas, gestão participativa, resultados ou aspectos assistencialistas, envolvendo aspectos mais amplos e processos tradicionais de administração juntamente com as características do voluntariado. A profissionalização da gestão é fundamental para buscar o aperfeiçoamento, a inovação e instrumentos que permitam prestar contas e ainda administrar todas as dinâmicas que envolvem o voluntariado.

Abstract Voluntary work turns from a welfare action into a process that requires innovations in order to have efficient results, which leads to professional management, and follows organizational and strategic criteria. This study aims to understand how volunteer management is carried out by a case study performed in the Volunteer Department of Hospital Israelita Albert Einstein. This is an exploratory and qualitative research. Interviews, observations and documents were used on data collection. We interviewed one coordinator and six volunteers. We used data analysis and the categorical technique to analyze information. Results indicate that volunteering cannot be independent within the hospital, although autonomy is necessary to implement actions that bring results to the hospital. Volunteers should act in a manner that conforms to hospital rules, thus, all of their actions need to concur with the hospital's principles and goals. Volunteering management is more than people management, participatory management, results or assistance aspects; it involves broader elements and traditional management processes along with volunteering characteristics. Volunteering management professionalization is essential to improvement, innovation and instruments search, hence it can be accountable and still manage all volunteering dynamics.

O INCAvoluntário e suas histórias: a força da solidariedade / The INCAvoluntário and its stories: the strengrt of solidarity / El INCAvoluntário y sus historias: la fuerza de la solidaridad

No início do século XX, o Brasil vê nascerem as primeiras preocupações sociais com o câncer. Tal inquietação, relacionada à ampliação do conhecimento médico sobre a doença e à intensificação de pesquisas científicas e ações assistenciais para o seu controle na Europa e nos Estados Unidos, deu origem às primeiras iniciativas contra a doença no país. Essas tiveram como base ações filantrópicas e atividades pontuais no âmbito do Estado e deixariam como frutos as primeiras instituições direcionadas ao alívio dos que sofriam com a doença. O desenvolvimento institucional do INCA e a busca incessante de seus profissionais por diferentes formas de ampliar e humanizar o tratamento de seus pacientes possibilitam o grande aperfeiçoamento de um conjunto de atividades baseadas numa forma específica de filantropia: o trabalho voluntário. Tendo como base a doação humanitária do trabalho, o voluntariado hoje ocupa um papel central na instituição, em consonância com o crescimento desse novo modo de ação humanitária, que ocorre hoje em diversas sociedades ocidentais, como forma de apanágio do sofrimento.

[Determinants of risky sex practices among consultants of a Voluntary HIV counseling and testing Centre]. / Déterminants des pratiques sexuelles à risque chez les consultants d'un Centre de Conseils et de Dépistage Anonyme et Gratuit du VIH

BACKGROUND: Thirty years after the discovery of human immunodeficiency virus (HIV), knowledge and practices must be improved. AIM: Contribute to reducing the risk of virus transmission. METHODS: A study about the determinants of risky practices was conducted among the consultants of the Voluntary HIV Counseling and Testing Centre (VCTC) in Monastir University Hospital. RESULTS: We performed a cross sectional descriptive study with a total of 241 consultants who used the services of the VCTC during the period from January 1, 2008 to December 31, 2011. Data gathering was based on a self-administered questionnaire. Consultant's mean age was 27.4 ± 8 years with a male predominance. Three patients out of four were single and 65% have at least secondary-level education. Knowledge about the risk of HIV infection after an unprotected sex and drug use by injection were reported by 94.3% and 76.7% of the participants respectively. Risky sex practices were adopted by 89.3% of the subjects. At least secondary school level, knowledge of risk factors of contamination and fear of the virus transmission were identified as determinants of safe sexual practices (0,004 ≤ p ≤ 0,032). CONCLUSION: Improving knowledge of populations at risk for HIV is a privileged axis to lead to a reduction of infectious risk in our country.

La formación de las Damas Enfermeras de la Cruz Roja durante la Guerra Civil Española (1936-1939) / The formation of the Red Cross Nurses-Ladies during the Spanish Civil War (1936-1939)

Objetivo: explorar si existieron diferencias en la formación de las Damas Enfermeras Auxiliares Voluntarias de la Cruz Roja durante la Guerra Civil española (1936-1939) en las zonas dominadas por ambos contendientes. Método: investigación documental de corte histórico-pedagógico con revisión crítica de las publicaciones relacionadas con la formación de las Damas Enfermeras de la Cruz Roja de España durante la Guerra Civil española (1936-1939) localizadas en las bases de datos: Biblioteca Nacional de España, Centro Documental de la Memoria Histórica de España, GAZETA®, TESEO®, CISNE®, ENFISPO®, PUBLIMED®, CUIDEN®, DIALNET®, MEDLINE®, ISOC® e IME®. Conclusiones: hasta el año 1938 no se aprecian diferencias en la formación en ambos bandos, a partir de esta fecha el bloque sublevado aumenta la duración y contenidos teórico-prácticos de los estudios de las Damas Enfermeras de la Cruz Roja de España (AU)

Objetive: To explore whelther there were differences in the formation of the Red Cross Nurses-Ladies during the Spanish Civil War (1936-1939) in areas dominated by both parties. Method: Documentary research with critical review of publications related to the formation of the Spanish Red Cross Nurses-Ladies during the Spanish Civil War (1936-1939) located in the databases: National Library of Spain, Historical Memory Documentary Centre of Spain, GAZETA®, TESEO®, CISNE®, ENFISPO®, PUBLIMED®, CUIDEN®, DIALNET®, MEDLINE®, ISOC® e IME®. Conclusions: Until 1938, no differences were seen in the formation on both sides, from this date revolted block increases the duration and content of the theorical and practical studies of the Nurse-Ladies (AU)

[Collaboration between nurses and auxiliary staff: cognitive study on behaviour in a hospital environment]. / La collaborazione tra infermiere e operatore socio sanitario: indagine conoscitiva sui comportamenti in ambito ospedaliero.

The aim of this study was to analyze collaboration between nurses and auxiliary staff and it was implemented at the Santa Maria Nuova Hospital of Reggio Emilia. Although this topic is of great interest for the health structures, so far few studies dealing specifically with the interactions between these two categories have been published. The international scenario offers an extremely varied picture of the staff employed in such tasks : in fact, only Italy has a single national legislation which establishes that auxiliary staff are figures supporting the health professions in both a social and healty context. The study assessed the areas susceptible to improvement in terms of nursing-auxiliary staff collaboration , thus improving the quality of care, by promoting negotiation and confrontation between the two categories. In the literture the Jefferson Scale of Attitude Toward Physician Nurse Collaboration was used. Results identified that the priority areas of intervention regarded how the patient was received on hospital entry and during his stay and the safety of the patient throught hospitalization.

[Satisfaction perceived by outpatients and pharmacy auxiliaries in a Hospital Pharmacy Department, as a method of improving quality]. / Satisfacción percibida por los pacientes y por el personal auxiliar de farmacia del área de atención a pacientes externos como método de mejora de la calidad.

OBJECTIVES: To evaluate the satisfaction of pharmacy auxiliaries, and patients attending the Outpatient Pharmacy, after the restructuring of the physical space and the process of dispensing drugs. METHODS: Three months after the restructuring of the Area (January 2009), we gave satisfaction surveys (anonymously and voluntarily) over 2 weeks, to a sample of the 3,300 patients who came per month and another to pharmacy auxiliaries who had worked in the area. The surveys consisted of eight closed questions with a Likert-type format about the physical space and organization, dispensing process and overall satisfaction (primary endpoint). In addition, there was an open question to gather suggestions. RESULTS: A total of 265 patients received the questionnaire (response rate 94%). The most valued aspect was the confidentiality (4.2 ± 0.7) and the worst was the waiting area (3.2 ± 1). There was a 100% response rate from the 26 pharmacy auxiliaries who received the questionnaire. The highest score was obtained by the installation of the bar-code reader (3.9 ± 0.6) and the lowest for organization of the stores (3.1 ± 1.2). They added comments about the lack of personnel, computer systems, organization of space and the lack of clarity of the prescription. The overall patient satisfaction was 4.2 ± 0.6 and that of the auxiliaries was 3.7 ± 0.7. CONCLUSIONS: The results of patients and employees satisfaction surveys have been useful information to assess changes in the area and identify points for improvement. In most of the issues the satisfaction was greater in patients than employees. We believe it is necessary to carry out actions for improving physical space and organization.

Informe: actividades realizadas por los grupos de trabajo de voluntariado. Periodo 2008/2010 / No disponible

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Fundación Niño y Cáncer (FNC)

La Fundación Niño y Cáncer es una entidad sin fines de lucro que nació para ser un importante apoyo en el tratamiento integral de los niños con cáncer o leucemia del país (Plan AUGE y GES)

Hospital do Câncer - Instituto do Câncer Ceará (ICC)

O ICC é a maior estruturada instituição de combate e tratamento do câncer do Estado do Ceará, sendo referência nas regiões Norte e Nordeste.

Factores explicativos de la carencia de voluntariado en diversos hospitales españoles / Factors explaining the lack of volunteers in different Spanish hospitals

Con el objetivo de conocer los motivos por los que en un gran número de hospitales no existe colaboración voluntaria, se entrevistó a 55 hospitales y 76 asociaciones de voluntariado. Las principales razones planteadas giraban en torno a la especialización de las asociaciones en una población médica concreta, la ausencia de una figura responsable, y el desconocimiento de las tareas del voluntariado y de las vías de acceso al mismo. Estos datos llevan a concluir la importancia de fomentar acciones voluntarias que contemplen las necesidades globales del hospital, y la necesidad de difundir entre los hospitales información sobre las funciones del voluntariado y sobre las mejores vías para su incorporación (AU)

National Breast Cancer Coalition (NBCC)

The National Breast Cancer Coalition is a grassroots advocacy effort in the fight against breast cancer. Our Web site will help you join the fight against breast cancer. Here you'll find information about our history, goals, and accomplishments, how to become a member, our legislative agenda and political campaign, and our current programs, including Project LEAD® and our Clinical Trials Initiative.