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1.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-48575

RESUMEN

Foi sancionada, nesta terça-feira (4) a Lei nº 14.289, que obriga o sigilo sobre a condição de pessoas infectadas pelo vírus HIV e hepatites crônicas. A medida também abrange pessoas com hanseníase ou tuberculose. O sigilo é obrigatório no âmbito dos serviços de saúde, estabelecimentos de ensino, locais de trabalho, administração pública, segurança pública, processos judiciais e mídias escrita e audiovisual. O texto foi publicado no Diário Oficial da União.


Asunto(s)
VIH , Hepatitis , Tuberculosis , Lepra , Confidencialidad/normas
4.
Medwave ; 22(1): e8512, 2022 Jan 07.
Artículo en Español, Inglés | MEDLINE | ID: mdl-34995274

RESUMEN

The currently abundant bibliography on healthcare can make the search process an exhausting and frustrating experience. For this reason, it is essential to learn the basic concepts of research question formulation, information sources, and search strategies to make this process more efficient and user-friendly. The search strategy is an iterative process that allows the incorporation of tools and terms in the strategy design to optimize evidence retrieval. Each strategy varies according to the questions, the language used, the source of information accessed, and the available tools. This article is part of a methodological series of narrative reviews on biostatistics and clinical epidemiology. This narrative review describes the essential elements for developing a literature search strategy and identifying the relevant evidence concerning a clinical question through familiar and accessible sources (such as Google and Google Scholar), as well as search interfaces and technical-scientific databases focused on biomedical knowledge (PubMed and The Cochrane Library).


Asunto(s)
Personal de Salud , Almacenamiento y Recuperación de la Información , Bases de Datos Bibliográficas , Bases de Datos Factuales , Atención a la Salud , Humanos
5.
Artículo en Portugués | PAHO-IRIS | ID: phr-55572

RESUMEN

[RESUMO]. Objetivo. Identificar os fatores correlacionados à incidência e mortalidade por COVID-19 e verificar situações de sindemia em escala global. Métodos. Realizou-se um estudo ecológico de casos e óbitos confirmados de COVID-19 a partir de informações coletadas do European Center for Disease Prevention and Control em 2019 e 2020. Para a caracterização dos países, utilizaram-se indicadores do Banco Mundial e Worldometer Coronavirus. Foram realizadas análises descritivas e de correlação entre as variáveis independentes para posteriormente realizar o modelo de regressão linear múltipla, com o objetivo de identificar os fatores correlacionados à incidência e mortalidade por COVID-19. Resultados. Obtiveram-se dados de 185 países. A média da incidência dos casos foi de 16 482/mil habitantes, enquanto a média para mortalidade por COVID-19 foi de 291/mil habitantes, sendo América do Norte e Leste Asiático e Pacífico as regiões que apresentaram maiores e menores índices, respectivamente. Identificouse correlação positiva da taxa de incidência com proporção da população com idade de 15 a 64 anos, população urbana, desigualdade conforme Índice de Gini e com seis das sete regiões analisadas (exceto Leste Asiático e Pacífico). A taxa de mortalidade apresentou correlação negativa com a população de 0 a 14 anos e positiva com população urbana, desigualdade conforme índice de Gini e todas as regiões analisadas, exceto Leste Asiático e Pacífico. Conclusões. A morbimortalidade da COVID-19 esteve correlacionada à carga de condições crônicas, ao envelhecimento da população e à baixa capacidade dos serviços de saúde para testagem e oferta de leitos hospitalares, quadro agravado em países ou regiões com elevada desigualdade social, caracterizando uma situação de sindemia.


[ABSTRACT]. Objective. To identify factors correlated with the incidence and mortality from COVID-19 and investigate syndemic situations at the global level. Method. An ecologic study of confirmed COVID-19 cases and deaths was performed using information collected from the European Center for Disease Prevention and Control in 2019 and 2020. World Bank indicators and information obtained from Worldometer Coronavirus were used to characterize the countries. Descriptive analyses and correlations between independent variables were performed, followed by multiple linear regression analysis to identify factors correlated with COVID-19 incidence and mortality. Results. Data were obtained for 185 countries. Mean case incidence was 16 482/1,000 population, whereas mean COVID-19 mortality was 291/1,000 population, with the highest and lowest rates recorded in North America and East Asia and Pacific respectively. A positive correlation was identified between incidence rate and percent population aged 15 to 64 years, urban population, inequality measured by the Gini coefficient, and six out of the seven regions analyzed (except East Asia and Pacific). Mortality rate was negatively correlated with population aged 0 to 14 years and positively correlated with urban population, inequality measured by the Gini coefficient, and all regions analyzed except East Asia and Pacific. Conclusions. COVID-19 morbidity and mortality were correlated with the burden of chronic diseases, aging population, and low capacity of healthcare services for testing and providing hospital beds, a scenario complicated by social inequality in countries and regions, indicating a syndemic effect.


[RESUMEN]. Objetivo. Identificar los factores correlacionados con la incidencia de COVID-19 y la mortalidad por esa causa y verificar las situaciones de sindemia a escala mundial. Métodos. Se realizó un estudio ecológico de casos de COVID-19 y de defunciones confirmadas por esa causa a partir de la información obtenida del Centro Europeo para la Prevención y el Control de las Enfermedades en el 2019 y el 2020. Para caracterizar a los países, se utilizaron indicadores del Banco Mundial y del sitio web de referencia Worldometer Coronavirus. Se hicieron análisis descriptivos y de correlación entre las variables independientes para crear posteriormente un modelo de regresión lineal múltiple con el fin de identificar los factores correlacionados con la incidencia de COVID-19 y la mortalidad por esa causa. Resultados. Se obtuvieron datos de 185 países. La tasa media de incidencia de casos de COVID-19 fue de 16 482 por mil habitantes y la tasa media de mortalidad por esa causa fue de 291 por mil habitantes. Las regiones de América del Norte y de Asia oriental y el Pacífico presentaron los mayores y menores índices, respectivamente. Se observó una correlación positiva de la tasa de incidencia con la proporción del grupo de 15 a 64 años de edad, la población urbana, la desigualdad medida por el coeficiente de Gini y seis de las siete regiones analizadas (excepto Asia oriental y el Pacífico). La tasa de mortalidad presentó una correlación negativa con el grupo de 0 a 14 años de edad y positiva con la población urbana, la desigualdad medida por el coeficiente de Gini y todas las regiones analizadas, excepto Asia oriental y el Pacífico. Conclusiones. La morbimortalidad por COVID-19 guardó una correlación con la carga de problemas crónicos de salud, el envejecimiento de la población y la poca capacidad de realizar pruebas en los servicios de salud y de ofrecer camas de hospital, cuadro agravado en los países o regiones con una elevada tasa de desigualdad social y característico de una situación de sindemia.


Asunto(s)
COVID-19 , Atención a la Salud , Salud Pública , Sindémico , Epidemiología , Atención a la Salud , Salud Pública , Sindémico , Pandemias , Epidemiología , Atención a la Salud , Salud Pública , Sindémico , Pandemias , Epidemiología
6.
Washington, D.C.; OPS; 2022-01-04. (OPS/HSS/HS/21-0014).
No convencional en Español | PAHO-IRIS | ID: phr-55550

RESUMEN

La medición del gasto en salud y el seguimiento de recursos a través del sistema de cuentas de salud SHA2011 representan herramientas invaluables para la toma de decisiones y la adopción de políticas de salud. Conocer cuánto se gasta y cómo se gasta permite, por ejemplo, verificar si el gasto se vincula con las prioridades de política de un país; si los recursos del sistema se traducen en mayores y mejores prestaciones de salud; y si los recursos son asignados de acuerdo con las necesidades de salud específicas y alcanzan, por tanto, el máximo potencial de beneficios para la población. Esta información estratégica facilita el monitoreo del avance hacia los objetivos de acceso y cobertura universal del sistema desde el financiamiento, con eficiencia, equidad y sostenibilidad. Esta publicación describe los datos de una encuesta realizada a contadores de salud de la Región de las Américas con el objetivo de analizar los elementos clave para mejorar las estrategias de institucionalización de las cuentas de salud en los países. Así, se constató que la frecuencia en la rotación de personal y la insuficiencia de recursos representan obstáculos para la plena institucionalización. También se describen los antecedentes del establecimiento y la ampliación de las cuentas en América Latina y las prácticas de divulgación de los resultados más frecuentes. Concluye con reflexiones finales y recomendaciones.


Asunto(s)
Sistemas de Salud , Rendición de Cuentas Financieras en Salud , Políticas, Planificación y Administración en Salud , Política de Salud , Gastos en Salud , Política Pública , Salud Pública , Cobertura Universal de Salud , Estrategias para Cobertura Universal de Salud , Recursos en Salud , América Latina , Américas
7.
Washington, D.C.; OPS; 2022-01-03. (OPS/PHE/IMS/COVID-19/21-0015).
No convencional en Español | PAHO-IRIS | ID: phr-55544

RESUMEN

Esta publicación de la Organización Panamericana de la Salud (OPS) es una versión actualizada del documento de junio del 2020 titulado Consideraciones sobre la ejecución y el manejo del rastreo de contactos para la enfermedad por coronavirus del 2019 (COVID-19) en la Región de las Américas, cuyo propósito es complementar las orientaciones provisionales proporcionadas por la Organización Mundial de la Salud (OMS) sobre el rastreo de contactos en el contexto de la COVID-19. La presente publicación incluye orientación sobre el rastreo de contactos en los contactos vacunados y viajeros internacionales, así como en los entornos en los que hay transmisión comunitaria. También incluye las definiciones actualizadas de “caso”, “contacto” y “transmisión comunitaria” que ha publicado la OMS. El objetivo del presente documento es brindar orientación y recomendaciones operativas que permitan realizar el rastreo de contactos de COVID-19 en la Región de las Américas. El documento se actualizará conforme se disponga de información nueva sobre la COVID-19. Esta publicación está dirigida a las autoridades nacionales de salud, los profesionales de la salud pública y otros funcionarios que formulan y ejecutan políticas y procedimientos normalizados de trabajo relacionados con las operaciones de rastreo de contactos en la Región.


Asunto(s)
COVID-19 , Coronavirus , Betacoronavirus , Infecciones por Coronavirus , Trazado de Contacto , Vacunas contra la COVID-19 , Microscopía Electrónica de Transmisión de Rastreo , Transmisión de Enfermedad Infecciosa , Periodo de Transmisión , Vacunación , Vacunas , Enfermedades Prevenibles por Vacunación
8.
Washington, D.C.; OPS; 2022-01-03.
en Español | PAHO-IRIS | ID: phr-55125

RESUMEN

En la actualidad, las guías basadas en la evidencia constituyen una de las herramientas más útiles para mejorar la salud pública y la práctica clínica. Su finalidad es formular intervenciones con sólidas pruebas de eficacia, evitar riesgos innecesarios, utilizar los recursos de forma eficiente, disminuir la variabilidad clínica y, en esencia, mejorar la salud y garantizar una atención de calidad, razón de ser de los sistemas y servicios de salud. Las presentes directrices se elaboraron siguiendo la metodología GRADE con el apoyo de un panel de expertos clínicos de distintos países, todos ellos convocados por la Organización Panamericana de la Salud. Por medio de la respuesta a doce preguntas clave sobre el diagnóstico clínico y el tratamiento del dengue, el chikunguña y el zika, se formulan recomendaciones basadas en evidencia para pacientes pediátricos, jóvenes, adultos, personas mayores y embarazadas expuestos a estas enfermedades o con sospecha o diagnóstico confirmado de infección. La finalidad de las directrices es evitar la progresión a las formas graves y a los eventos mortales que puedan causar. Las recomendaciones están dirigidas a profesionales de la salud, incluidos el personal médico general, residente y especialista; y los profesionales de enfermería, así como a estudiantes de medicina y enfermería, quienes de una u otra forma participan en la atención de pacientes con sospecha de dengue, chikunguña o zika. También se dirige a los administradores de las unidades de salud y a los equipos directivos de los programas nacionales de prevención y control de enfermedades arbovirales, quienes tienen la responsabilidad de facilitar el proceso de aplicación de estas directrices. Esperamos que esta publicación beneficie no solo al personal de salud, que dispondrá de información científica actualizada y de la mejor calidad posible, sino a los menores, los adultos, las embarazadas, las personas mayores y la población en general, quienes recibirán una mejor atención de salud prestada por personal médico debidamente capacitado.


Asunto(s)
Virus Chikungunya , Virus del Dengue , Enfermedades Transmisibles , Diagnóstico Clínico , Dengue , Virus Zika , Arbovirus , Mujeres Embarazadas , Niño , Pediatría , Anciano , Control de Enfermedades Transmisibles
9.
Preprint en Portugués | SciELO Preprints | ID: pps-3458

RESUMEN

Objective: To analyze the performance of dental care procedures in the Unified Health System (SUS) in Brazil and regions, 2008 - 2018. Methods: Time series study with data obtained from the Outpatient Information System. Annual rates of dental procedures per 100,000 inhabitants, global and according to procedures and Brazilian regions were calculated from 2008 to 2018. Prais-Winsten regression was used to analyze time trends and annual percentage changes were calculated. Results: Decreasing trends were found in Brazil for Collective actions (-13.5% ­ 95%CI -21.1;-5.2), Individual preventive actions (-6.2% ­ 95%CI -7.7;-4.8), Restorations (-7.3% ­95%CI -10.5;-3.9) and Extractions (-6.9 ­ 95%IC -10.5;-3.1%). Endodontics and Periodontics showed stationary trends for most regions and Brazil. Prosthetic procedures showed an upward trend in all regions and Brazil (16.9% ­ 95%CI 9.1;25.2). Conclusion: Dental care procedures in SUS decreased between 2008 and 2018, except for prosthetic procedures whose production increased.


Objetivo: Analizar el desempeño de procedimientos dentales en el Sistema Único de Salud (SUS) en Brasil y regiones, 2008 - 2018. Métodos: Estudio de series temporales con datos del Sistema de Información Ambulatoria. Se calcularon tasas anuales de procedimientos dentales por 100 mil habitantes, globales y según categorías de procedimientos y regiones brasileñas de 2008 a 2018. Se utilizó la regresión de PraisWinsten para analizar tendencias temporales y se calcularon los cambios porcentuales anuales. Resultados: Hubo tendencia decreciente en Brasil para Acciones colectivas -13,5% ­ IC95% -21,1; -5,2), Acciones preventivas individuales (-6,2% ­ IC95% -7,7;-4,8), Restauraciones (-7,3% ­ IC95% -10,5;-3,9) y Extracciones (-6,9 ­ IC95% -10,5;-3,1%). Endodoncia y Periodoncia mostraron tendencias estacionarias para la mayoría de las regiones y Brasil. Procedimientos protésicos mostraron tendencia ascendente en todas las regiones y Brasil (16,9% ­ IC95% 9,1;25,2). Conclusión: La producción dental en el SUS disminuyó entre 2008 y 2018, a excepción de los procedimientos protésicos cuya producción aumentó.


Objetivo: Analisar a realização de procedimentos odontológicos pelo Sistema Único de Saúde (SUS), no Brasil e suas regiões geopolíticas, entre 2008 e 2018. Métodos: Estudo de série temporal, com dados do Sistema de Informações Ambulatoriais dos SUS. Foram calculadas taxas anuais de procedimentos odontológicos (por 100 mil habitantes), globais e por categorias de procedimentos e regiões. Utilizouse a regressão de Prais-Winsten para analisar as tendências temporais e calculou-se variações percentuais anuais (VPA). Resultados: Tendências decrescentes foram encontradas para o Brasil, em ações coletivas (VPA=-13,5% ­ IC95% -21,1;-5,2), ações preventivas individuais (VPA=-6,2% ­ IC95% -7,7;-4,8), restaurações (VPA=-7,3% ­IC95% -10,5;-3,9) e exodontias (VPA=-6,9 ­ IC95% -10,5;-3,1). Endodontia e periodontia apresentaram tendências estacionárias para a maioria das regiões e o Brasil. Procedimentos protéticos apresentaram tendência ascendente em todas as regiões e o Brasil (VPA=16,9% ­ IC95% 9,1;25,2). Conclusão: A produção odontológica no SUS apresentou decréscimo no período 2008-2018; à exceção de procedimentos protéticos,cuja produção aumentou.

10.
Preprint en Portugués | SciELO Preprints | ID: pps-3443

RESUMEN

Objective: To analyze the temporal trend of hospitalizations caused by abortion in Brazil between 2008-2018, according to Region and federal units (FU). Methods: Ecological study concerning hospitalizations due to abortion of women of childbearing age, from Hospital Information System data. The rates were calculated according the characteristics of women. The trend was assessed by Prais-Winsten generalized linear regression. Results: The 2,258,104 hospitalizations due to abortion 4 represent 5% of all hospitalizations in women of childbearing age. Hospitalizations for abortions in Brazil reduced 0.76 in the period; this trend occurred in 19 Brazilian FUs and all regions, except the South (stable). There was a significant reduction (p<0.001) in hospitalizations for spontaneous abortion and in admissions for abortion in women aged 20 to 39 years. Conclusion: A temporal trend of reduction in the hospitalizations due to abortion in Brazil was found, variating according to characteristics of the woman, FU and Region of residence.


Objetivo: Analizar la tendencia temporal de las hospitalizaciones por aborto en Brasil de 2008-2018, según región y unidad federativa. Métodos: Estudio ecológico con datos sobre hospitalizaciones por aborto de mujeres en edad fértil del Sistema de Información Hospitalaria. Las tasas se calcularon según las características de la mujer y la tendencia se evaluó mediante regresión lineal generalizada de Prais-Winsten. Resultados: Las 2.258.104 hospitalizaciones por aborto representan el 5% de todas las hospitalizaciones en mujeres en edad fértil. Hubo una reducción significativa de 0,76 puntos porcentuales por año; esta tendencia ocurrió en 19 UF brasileñas y en todas las regiones, excepto en el Sur (estable). Hubo una reducción significativa (p<0,001) en las hospitalizaciones por aborto espontáneo y en mujeres de 20 a 39 años. Conclusión: El estudio mostró una tendencia a reducir las hospitalizaciones por aborto en Brasil, con variaciones según características de la mujer, UF y Región de residencia


Objetivo: Analisar a tendência temporal das internações por aborto no Brasil, de 2008 a 2018, segundo região e Unidades da Federação (UF). Métodos: Estudo ecológico, com dados de internações por aborto de mulheres em idade fértil registrados no Sistema de Informações Hospitalares/Sistema Único de Saúde (SIH/SUS). As taxas foram calculadas segundo características da mulher; e a tendência, avaliada por regressão linear generalizada de Prais-Winsten.  Resultados: As 2.258.104 internações por aborto representaram 5% de todas as internações de mulheres em idade fértil. Houve redução significativa, de 0,76 pontos percentuais ao ano, no período. Essa tendência ocorreu em 19 UFs brasileiras e em todas as regiões, exceto a Sul (estável). Houve redução significativa (p-valor<0,001) nas internações por aborto espontâneo e nas internações de mulheres de 20 a 39 anos. Conclusão: Observou-se tendência de redução das internações por aborto no país, com variações segundo características da mulher, UF e região de residência.

12.
BMJ Open ; 12(1): e057127, 2022 01 03.
Artículo en Inglés | MEDLINE | ID: mdl-34980631

RESUMEN

OBJECTIVE: To examine SARS-CoV-2 vaccine confidence, attitudes and intentions in Australian adults as part of the iCARE Study. DESIGN AND SETTING: Cross-sectional online survey conducted when free COVID-19 vaccinations first became available in Australia in February 2021. PARTICIPANTS: Total of 1166 Australians from general population aged 18-90 years (mean 52, SD of 19). MAIN OUTCOME MEASURES: Primary outcome: responses to question 'If a vaccine for COVID-19 were available today, what is the likelihood that you would get vaccinated?'.Secondary outcome: analyses of putative drivers of uptake, including vaccine confidence, socioeconomic status and sources of trust, derived from multiple survey questions. RESULTS: Seventy-eight per cent reported being likely to receive a SARS-CoV-2 vaccine. Higher SARS-CoV-2 vaccine intentions were associated with: increasing age (OR: 2.01 (95% CI 1.77 to 2.77)), being male (1.37 (95% CI 1.08 to 1.72)), residing in least disadvantaged area quintile (2.27 (95% CI 1.53 to 3.37)) and a self-perceived high risk of getting COVID-19 (1.52 (95% CI 1.08 to 2.14)). However, 72% did not believe they were at a high risk of getting COVID-19. Findings regarding vaccines in general were similar except there were no sex differences. For both the SARS-CoV-2 vaccine and vaccines in general, there were no differences in intentions to vaccinate as a function of education level, perceived income level and rurality. Knowing that the vaccine is safe and effective and that getting vaccinated will protect others, trusting the company that made it and vaccination recommended by a doctor were reported to influence a large proportion of the study cohort to uptake the SARS-CoV-2 vaccine. Seventy-eight per cent reported the intent to continue engaging in virus-protecting behaviours (mask wearing, social distancing, etc) postvaccine. CONCLUSIONS: Most Australians are likely to receive a SARS-CoV-2 vaccine. Key influencing factors identified (eg, knowing vaccine is safe and effective, and doctor's recommendation to get vaccinated) can inform public health messaging to enhance vaccination rates.


Asunto(s)
COVID-19 , Comunicación en Salud , Vacunas , Adulto , Actitud , Australia , Vacunas contra la COVID-19 , Estudios Transversales , Humanos , Intención , Masculino , Salud Pública , SARS-CoV-2 , Vacunación
13.
PLoS One ; 17(1): e0262105, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34986171

RESUMEN

OBJECTIVE: To evaluate the use of a COVID-19 app containing relevant information for healthcare workers (HCWs) in hospitals and to determine user experience. METHODS: A smartphone app (Firstline) was adapted to exclusively contain local COVID-19 policy documents and treatment protocols. This COVID-19 app was offered to all HCWs of a 900-bed tertiary care hospital. App use was evaluated with user analytics and user experience in an online questionnaire. RESULTS: A total number of 1168 HCWs subscribed to the COVID-19 app which was used 3903 times with an average of 1 minute and 20 seconds per session during a three-month period. The number of active users peaked in April 2020 with 1017 users. Users included medical specialists (22.3%), residents (16.5%), nurses (22.2%), management (6.2%) and other (26.5%). Information for HCWs such as when to test for SARS-CoV-2 (1214), latest updates (1181), the COVID-19 telephone list (418) and the SARS-CoV-2 / COVID-19 guideline (280) were the most frequently accessed advice. Seventy-one users with a mean age of 46.1 years from 19 different departments completed the questionnaire. Respondents considered the COVID-19 app clear (54/59; 92%), easy-to-use (46/55; 84%), fast (46/52; 88%), useful (52/56; 93%), and had faith in the information (58/70; 83%). The COVID-19 app was used to quickly look up something (43/68; 63%), when no computer was available (15/68; 22%), look up / dial COVID-related phone numbers (15/68; 22%) or when walking from A to B (11/68; 16%). Few respondents felt app use cost time (5/68; 7%). CONCLUSIONS: Our COVID-19 app proved to be a relatively simple yet innovative tool that was used by HCWs from all disciplines involved in taking care of COVID-19 patients. The up-to-date app was used for different topics and had high user satisfaction amongst questionnaire respondents. An app with local hospital policy could be an invaluable tool during a pandemic.


Asunto(s)
COVID-19 , Personal de Salud , Hospitales , Aplicaciones Móviles , Política de Salud , Humanos , Difusión de la Información , SARS-CoV-2 , Teléfono Inteligente
14.
Sensors (Basel) ; 22(1)2022 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-35009881

RESUMEN

Blockchain ecosystems are rapidly maturing and meeting the needs of business environments (e.g., industry, manufacturing, and robotics). The decentralized approaches in industries enable novel business concepts, such as machine autonomy and servitization of manufacturing environments. Introducing the distributed ledger technology principles into the machine sharing and servitization economy faces several challenges, and the integration opens new interesting research questions. Our research focuses on data and event models and secure upgradeable smart contract platforms for machine servitization. Our research indicates that with the proposed approaches, we can efficiently separate on- and off-chain data and assure scalability of the DApp without compromising the trust. We demonstrate that the secure upgradeable smart contract platform, which was adapted for machine servitization, supports the business workflow and, at the same time, assures common identification and authorization of all the participants in the system, including people, devices, and legal entities. We present a hybrid decentralized application (DApp) for the servitization of 3D printing. The solution can be used for or easily adapted to other manufacturing domains. It comprises a modular, upgradeable smart contract platform and off-chain machine, customer and web management, and monitoring interfaces. We pay special attention to the data and event models during the design, which are fundamental for the hybrid data storage and DApp architecture and the responsiveness of off-chain interfaces. The smart contract platform uses a proxy contract to control the access of smart contracts and role-based access control in function calls for blockchain users. We deploy and evaluate the DApp in a consortium blockchain network for performance and privacy. All the actors in the solution, including the machines, are identified by their blockchain accounts and are compeers. Our solution thus facilitates integration with the traditional information-communication systems in terms of the hybrid architectures and security standards for smart contract design comparable to those in traditional software engineering.


Asunto(s)
Cadena de Bloques , Ecosistema , Humanos , Almacenamiento y Recuperación de la Información , Privacidad , Programas Informáticos
15.
Bull World Health Organ ; 100(1): 70-77, 2022 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-35017759

RESUMEN

The food system and climate are closely interconnected. Although most research has focused on the need to adopt a plant-based diet to help mitigate climate change, there is also an urgent need to examine the effects of climate change on food systems to adapt to climate change. A systems approach can help identify the pathways through which climate influences food systems, thereby ensuring that programmes combating malnutrition take climate into account. Although little is known about how climate considerations are currently incorporated into nutrition programming, climate information services have the potential to help target the delivery of interventions for at-risk populations and reduce climate-related disruption during their implementation. To ensure climate services provide timely information relevant to nutrition programmes, it is important to fill gaps in our knowledge about the influence of climate variability on food supply chains. A proposed roadmap for developing climate-sensitive nutrition programmes recommends: (i) research aimed at achieving a better understanding of the pathways through which climate influences diet and nutrition, including any time lags; (ii) the identification of entry points for climate information into the decision-making process for nutrition programme delivery; and (iii) capacity-building and training programmes to better equip public health practitioners with the knowledge, confidence and motivation to incorporate climate resilience into nutrition programmes. With sustained investment in capacity-building, data collection and analysis, climate information services can be developed to provide the data, analyses and forecasts needed to ensure nutrition programmes target their interventions where and when they are most needed.


Asunto(s)
Desnutrición , Política Nutricional , Dieta , Abastecimiento de Alimentos , Humanos , Desnutrición/prevención & control , Estado Nutricional
16.
Health Commun ; 37(1): 1-19, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34724838

RESUMEN

The COVID-19 pandemic has made it clear that effective public health messaging is an indispensable component of a robust pandemic response system. In this article, we review decades of research from the interdisciplinary field of communication science and provide evidence-based recommendations for COVID-19 public health messaging. We take a principled approach by systematically examining the communication process, focusing on decisions about what to say in a message (i.e., message content) and how to say it (i.e., message executions), and how these decisions impact message persuasiveness. Following a synthesis of each major line of literature, we discuss how science-based principles of message design can be used in COVID-19 public health messaging. Additionally, we identify emerging challenges for public health messaging during the COVID-19 pandemic and discuss possible remedies. We conclude that communication science offers promising public health messaging strategies for combatting COVID-19 and future pandemics.


Asunto(s)
COVID-19 , Pandemias , Comunicación , Humanos , Pandemias/prevención & control , Salud Pública , SARS-CoV-2
17.
J Nurs Care Qual ; 37(1): E15-E21, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34101696

RESUMEN

BACKGROUND: Nearly 10% of patients experience a harmful patient safety incident in the hospital setting. Current evidence focuses on incident reporting, whereas little is known about how incidents are managed within organizations. PURPOSE: The aim of this study was to explore processes, tools, and resources for incident management in Canadian health care organizations. METHODS: Qualitative focus groups were conducted with key stakeholders, representing clinicians, managers, executives, governors, patients, and families (n = 45). RESULTS: Qualitative data were thematically analyzed and presented as 3 themes: (1) variations in incident reporting and management; (2) simplification of the incident management process; and (3) need for leadership to support just culture and redefine harm. CONCLUSION: The study findings support and inform efforts to create a patient safety culture in Canadian and international health care organizations. There is a need to develop a standardized, accessible incident reporting and management system for use across health care sectors to promote continuous learning and improvement about patient safety.


Asunto(s)
Seguridad del Paciente , Gestión de Riesgos , Canadá , Atención a la Salud , Humanos , Administración de la Seguridad
18.
J Nurs Care Qual ; 37(1): 68-74, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34261088

RESUMEN

BACKGROUND: Mobility is a vital function of human life. Nurses have an essential role in preventing hospitalized patient complications through movement and ambulation. PURPOSE: This study examined the integration, accuracy, and precision of a paper-based mobility/ambulation tool into an electronic health record (EHR) to assess inpatient mobility/ambulation status. METHODS: This multisite mixed-methods study was a time-series correlational evaluation of a mobility/ambulation tool into the EHR. RESULTS: Sustainability data revealed strong correlations between nurse responses and EHR levels (r = 0.602; scores r = 0.624). Cronbach's α values were 0.737 and 0.761. Nurses' anecdotes supported the findings. CONCLUSION: Findings revealed that the EHR-Mobility Ambulation Tool is a valid, reliable, and stable tool. EHR-generated scores can assist in reducing charting burden, care planning, and inform the interdisciplinary health team at all patient care stages. Tool adoption could potentially assist nurses plan interventions suitable to maintain or increase hospitalized patients' mobility status and contribute to discharge planning.


Asunto(s)
Registros Electrónicos de Salud , Caminata , Atención a la Salud , Electrónica , Cuerpo Humano , Humanos
19.
Rev. bras. enferm ; 75(1): e20201217, 2022.
Artículo en Inglés | LILACS-Express | LILACS, BDENF - Enfermería | ID: biblio-1341041

RESUMEN

ABSTRACT Objective: to analyze the understanding of mothers about sickle cell disease and/or trait of the family from a diagnosed child. Methods: this is a qualitative study, using a semi-structured interview with 23 mothers, at a sickle cell disease outpatient clinic of a public institution, from October to December 2017. Analysis was thematic. Results: all participants had sickle cell trait as well as the parents of their children. Twenty children were diagnosed with sickle cell disease by Heel Prick Test, and three, after hospitalization due to the disease. Most did not know how to report the presence of the trait or disease in relatives other than nuclear. Final considerations: diagnosis cannot be restricted to the result of neonatal screening, requiring that preventive information on sickle cell crises be reinforced. It is recommended to search for other affected relatives to learn about their genetic condition, reflecting on their reproductive decisions.


RESUMEN Objetivo: analizar el entendimiento de las madres sobre células y/o anemia falciformes de la familia del niño diagnosticado. Métodos: se trata de un estudio cualitativo, mediante entrevista semiestructurada a 23 madres, en el ambulatorio de anemia falciforme de una institución pública, de octubre a diciembre de 2017. El análisis fue temático. Resultados: todos los participantes tenían células falciformes, así como los padres de sus hijos. Veinte niños fueron diagnosticados con anemia de células falciformes mediante la prueba de punción del talón y tres, después de la hospitalización debido a la enfermedad. La mayoría no sabía cómo informar la presencia de células o anemia en miembros de la familia distintos del nuclear. Consideraciones finales: el diagnóstico no puede restringirse al resultado del cribado neonatal, requiriendo que se refuerce la información preventiva sobre las crisis drepanocíticas. Se recomienda buscar a otros familiares afectados para conocer su condición genética, reflexionando sobre sus decisiones reproductivas.


RESUMO Objetivo: analisar o entendimento de mães acerca da condição do traço e/ou doença falciforme da família a partir da criança diagnosticada. Métodos: trata-se de um estudo qualitativo, sendo utilizada entrevista semiestruturada, com 23 mães, no ambulatório de doença falciforme de uma instituição pública, no período de outubro a dezembro de 2017. A análise foi temática. Resultados: todos os participantes tinham traço falciforme, bem como os pais dos seus filhos. Vinte crianças foram diagnosticadas com doença falciforme pelo teste do pezinho, e três, após hospitalização decorrente da doença. A maioria não sabia informar a presença do traço ou doença em outros membros da família que não a nuclear. Considerações finais: o diagnóstico não pode ficar restrito ao resultado da triagem neonatal, necessitando que as informações preventivas de crises falcêmicas sejam reforçadas. Recomenda-se a busca de outros membros da família afetados para conhecimento da sua condição genética, refletindo sobre suas decisões reprodutivas.

20.
Crit Care Nurs Q ; 45(1): 25-34, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34818295

RESUMEN

The topic of sepsis has been realized among the last 20 years. A majority of patients with sepsis enter the health system through the emergency department, and health professionals need to provide evidence-based care. Within the health system, interdepartmental teams were formed with the purpose to set a system-wide standard to meet the evidence-based practice standards for sepsis. Participants were recruited from every department that was involved with the care delivery of emergency department patients with sepsis. The team developed a team charter to state the group objectives. A gap analysis was completed to set group priorities. The first priority was to develop a system-wide sepsis alert process. The Operational Excellence coach conducted direct observations and interviews at each system facility and then a sepsis alert plan was developed. Two hospitals volunteered to pilot the sepsis alert within their emergency departments, and education was completed at each hospital. Informatics nurses developed electronic medical record workflow and outcome elements to help the team with the process. The pilot process showed an increase in compliance for core measures and laid the groundwork for each hospital to develop an individualized process.


Asunto(s)
Sepsis , Registros Electrónicos de Salud , Servicio de Urgencia en Hospital , Práctica Clínica Basada en la Evidencia , Hospitales , Humanos , Sepsis/diagnóstico , Sepsis/terapia
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