Objective: To estimate the prevalence of accidents due to biological material exposure, the characteristics and post-accident conduct among professionals of pre-hospitalservices of the four municipalities of Minas Gerais, Brazil. Method: A cross-sectional study, using a structured questionnaire that was developed to enable the calculation of prevalence, descriptive analysis and analytical analysis using logistic regression. The study included 228 professionals; the prevalence of accidents due to biological material exposure was 29.4%, with 49.2% percutaneous, 10.4% mucousal, 6.0% non-intact skin, and 34.4% intact skin. Results: Among the professionals injured, those that stood out were nursing technicians (41.9%) and drivers (28.3%). Conclusion: Notification of the occurrence of the accident occurred in 29.8% of the cases. Percutaneous exposure was associated with time of work in the organization (OR=2.51, 95% CI: 1.18 to 5.35, p<0.017). Notification about accidents with biological material should be encouraged, along with professional evaluation / monitoring.
services according to an evidence-based approach, balancing and integrating elements of both community and hospitalservices. The integration of community and hospitalservices is regarded as a “balanced care model”, where most services are provided in community settings close to the populations served, with reduced hospital stays, usually at acute wards inside general hospitals. In LMICs that have the possibility to contemplate mental health in primary health care services, five categories of resources can be organized for the development of mental health care services: 1) outpatient clinics; 2) community mental health care teams; 3) acute inpatient services; 4) community-based residential care; and 5) work, occupational, and rehabilitation services. Community-oriented care should be characterized by the following assumptions: 1) focus on public health needs, i.e. priority to treat severe mental conditions; 2) development of local and accessible services; 3) engagement of users and their families in the planning and delivery of mental health care services; 4) promotion of self-help and empowerment for individuals and families; 5) provision of a setting for mutual assistance and/or peer support for service users; 6) development of stepped care options for referral to specialists and/or hospitalization if necessary; 7) provision of back-up supervision and support by specialized mental health services; 8) link with NGOs, particularly those involved in rehabilitation; and 9) arrangements for the system to work in a reference/counter-reference manner within a specific geographic area.
Abstract — Aims : To analyze factors associated with osteoporosis among outpatients of the Brazilian National Health System and to identify their association with hospital and labor economic outcomes. Methods: Cross-sectional study carried out in the city of Presidente Prudente / SP. The sample consisted of 542 adults of both sexes and aged ≥ 50 years old. The occurrence of osteoporosis, health-related productivity loss, use of hospitalservices and level of physical activity were assessed using questionnaires. Statistical analysis was composed of chi-square test, binary logistic regression and Mann-Whitney test. The signiicance level adopted was p-value <0.05. Results: The prevalence of osteoporosis was 14.4% (95% CI: 11.4% - 17.3%) and it was associated with female sex (p = 0.001), lower economic status (p-value = 0.036) and obesity (p-value = 0.003). Participants with osteoporosis showed a higher incidence of surgery in the last 12 months (OR = 2.13 [1.04 to 4.35]), productivity loss (OR = 1.91 [1.13 to 3.42]) and disability retirement (OR = 2.03 [1.20 to 3.43]). Over the past 12 months, the sum of direct and indirect economic loss was R$ 1,382,630.00. Conclusion: The female sex, lower economic status and obesity were associated with a higher occurrence of osteoporosis, and consequent higher use of hospitalservices and signiicant economic losses.
The type of distribution is mainly established according to the need and consumption of products, but also to the specific situations associated with the hospital service (ex: chemotherapy cycles in the Day Hospital and intensive care units). Hereupon, the use of the medicine, namely the prescription and the administration, is associated with different healthcare professionals of the hospital with whom the pharmacist must collaborate directly and therefore perform two main activities: attendance of the medical visit and visit the ward units (both topics discussed hereinafter). Despite the more valuable and useful information that arise from the medical visit, the presence in ward units is also important in order to establish a good interaction with the staff and mainly the head nurses, that can add more information to the pharmacist with the final objective of determine the best type of distribution. There is different distribution systems associated with the different hospitalservices, although the daily individual distribution in unit dose represents the main system distribution and constitutes a legal imperative since the publication in “Diário da República” of the joint order of the health minister assistant state secretaries and the health offices, of December 31 of 1991.   Several years of experience and reflection continue to demonstrate that this type of distribution remains the most effective and safe.
As for the mode of work, we sought teamwork with the paricipaion of nurses, psychiatrists, nutriionists, physical educaion teachers, lawyers and other profes- sionals. As opposed to the asylum model, there is no pro- tagonist (psychiatrist), nor is the hospital the typical insi- tuion. That is because we work away from the hospital, in the community, where through psychoeducaion we seek not only to suppress the symptoms but also to prevent re- lapses with a view to reducing hospital admissions, and, subsequently, achieve social reinserion.
All ten hospitals that provide internal medicine training in Guatemala were invited to participate in the study: six in Guatemala City, the other four in Antigua Guatemala, Cuilapa, Quetzaltenango, and Escuintla. The sample included ‘‘public’’ hospitals (operated by the MoH, that provide all services for free, with no insurance required) and ‘‘other’’ hospitals (the Guatema- lan Social Security Institute (IGSS), the Military Hospital, and two private hospitals with residency programs, all of them located in Guatemala City). House staff were classified as interns (last-year medical students), residents, and attending physicians. The latter included department directors and program directors, as they are required to provide patient care and have teaching responsibilities regardless of their administrative roles.
ABSTRACT This paper reports a qualitative research that aimed to analyze the Therapeutic Itinerary (TI) of 21 patients enrolled in a High Complexity Assistance Service for Individuals with Obesity provided by the University Hospital of the West of Paraná. In-depth interview was (State) applied as a means of data collection and, for data organization and analysis, it was adopted Kleinman’s (1978) referential, which advocates the interference of subsystems family, popular and professional in the TI path of those that seek to solve their health prob- lems. In family subsystem, the support of family and friends in the search for obesity clinical treatment was observed. Few patients adhered to alternative treatments, characteristic of the popular subsystem itself. Intervention and orientation of health professionals, inherent of the professional subsystem, proved to be crucial in the search for obesity specialized treatment. The TI study of the research subjects revealed that the family and professional core influ- ence is stronger than the popular one. Kleinman’s referential is limited as for the TI analysis of obese individuals, because it does not comprise important elements towards the obesity problem approach.
1 Division of Nutritional Sciences, Cornell University, Ithaca, New York , United States of America, 2 Ontario Institute for Cancer Research and Biostatistics Division, Dalla 3 Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands, 4 Netherlands Healthcare Inspectorate, The Hague, the Netherlands, 5 University of Leicester, Genetic Epidemiology Group, Department of Health Sciences, Leicester, United Kingdom, 6 National Institute for Health Research (NIHR) Leicester Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, United Kingdom, 7 Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, U.S. Department of Health and Human Services, Research Triangle Park, North Carolina, United States of America, 8 Division of Respiratory Medicine, University Hospital of Nottingham, Nottingham, United Kingdom, 9 Computational Medicine Core, Center for Lung Biology, Division of Pulmonary & Critical Care Medicine, Department of Medicine, University of Washington, Seattle, Washington, United States of America, 10 Icelandic Heart Association, Kopavogur, Iceland, 11 University of Iceland, Reykjavik, Iceland, 12 Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America, 13 Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America, 14 Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, United States of America, 15 Institute of Genetic Epidemiology, Helmholtz Zentrum Mu¨nchen - German Research Center for Environmental Health, Neuherberg, Germany, 16 Department of Thoracic Surgery and Division of Epidemiology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America, 17 Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh
RESUMO Este artigo relata pesquisa de natureza qualitativa que objetivou analisar o Itinerário Terapêutico (IT) de 21 pacientes cadastrados no Serviço de Assistência de Alta Complexidade ao Indivíduo com Obesidade do Hospital Universitário do Oeste do Paraná. Utilizou-se a en- trevista em profundidade para a obtenção dos dados e, para sua organização e análise, adotou- -se o referencial de Kleinman (1978), que defende a interferência dos subsistemas familiar, popular e profissional no IT percorrido pelas pessoas na busca de solução para problemas de saúde. No subsistema familiar, observou-se apoio da família e amigos na procura por tratamen- to clínico para a obesidade. Poucos pacientes aderiram a tratamentos alternativos, próprio do subsistema popular. A intervenção e orientação de profissionais da saúde, característica do subsistema profissional, mostrou-se decisiva na procura por tratamento especializado para a obesidade. O estudo do IT dos sujeitos da pesquisa revelou maior influência do núcleo familiar e profissional do que propriamente do núcleo popular. O referencial de Kleinman apresentou limites para a análise do IT de indivíduos obesos, não incluindo elementos importantes na abordagem do problema da obesidade.
In the late 1910s, Brazil inaugurated a sanitary reform process intended to expand the geographic radius of federal health services and integrate into its activities programs focused on previously neglected endemic diseases. The November 1919 establishment of the National Department of Public Health (Departamento Nacional de Saúde Pública, or DNSP) to replace the former General Directorship of Public Health was a landmark in this process. The new agency was nationwide in scope and included fields of activities not yet encompassed in the Brazilian public health sphere, like industrial and food hygiene. Two inspectorships were created to address the prevention of specific diseases, one to control tuberculosis (limited to what was then the Federal District) and the other concentrated on venereal diseases, leprosy, and cancer (Brasil, Dec. 31, 1923).
AIM: To assess the socio-cultural profile of HIV/AIDS patients attending the ICTC of a teaching hospital in Ongole, Andhra Pradesh for understanding the different dynamics associated with the disease which would be useful in designing the services for prevention of disease as well as care, support and treatment.
In terms of emotional response, in the acute situations when a patient’s mental health deteriorates so much that a hospital admission against their will is required, the burden of care for a family caregivers is extremely high and the feeling of relief once the help is in place is an understandable emotional consequence. However as this help (i.e. admission) is against their relative’s will, emotions of worry and guilt often accompany this sense of relief. In the constellation described above there is a risk of disempowerment of caregivers that in this study is illustrated by experiences that family caregivers’ opinion and their needs are not being valued in a decision making process, by lack of information and problems with confidentiality.
Referrals between general practitioners and mental health clinicians (psychiatric nurses and clinic psychologists) are mediated by telephone, and treatment planning for patients with co- morbid medical and psychiatric disorders, including inpatient management of patients at Bugesera hospital, is accomplished collaboratively between GPs and mental health professionals. With regard to informal MH carers and MH care deliverers, there is no formal referral strategy at the national level between traditional healers and health professionals, in BD there is no any specific data on these interactions. Most mental health professionals interviewed in this survey responded that traditional healers are sometimes used to help specific patients to reintegrate into their communities or to provide collateral information on background of patients.
The income obtained from selling the cooked food supplies and pastries are used to partially pay the administrative salaries. The institution`s partners, the Town Hall through its social canteen and 4 schools, are supporting the protected unit. Its services are promoted on the foundation`s website and through the direct communication with different companies and educational institutions. For the sustainability of the protected unit, the experts working in the foundation plan to identify new clients and to keep the existing ones, but also to develop new products.
To remain competitive, traditional industries in industrialized countries have adopted various strategies; for example, an efficient product development system to meet market demands, supplying high-quality products that satisfy customers, and reducing production costs that enable them to compete on price (Bikfalvi, Lay, Maloca, & Waser, 2013). Recent changes in the business environment, such as the increasing competitiveness of developing countries, globalization of markets, and new customer requirements, have made it more challenging to maintain these traditional strategies (Bikfalvi et al., 2013). In response to these new challenges, a growing number of industrial companies have sought to add value to their businesses by providing services (Bikfalvi et al., 2013; Vandermerwe & Rada, 1988) to achieve potential economic and competitive gains (Oliva & Kallenberg, 2003). This transition from a manufacturer of goods to a supplier of product-service solutions is called servitization (Vandermerwe & Rada, 1988).
Among 198 patients with a central vascular catheter inserted in the jugular vein (n=84) or a subclavia vein (n=114), 19 were withdrawn from the epidemiological analysis due non- recovery of catheter tips, removal to another unit, or hospital discharge, reducing the study to 179 patients. Four CR-BSIs caused by S. aureus were detected, another two were caused by MRSA. The CR-BSI rate caused by S. aureus was 4.9 episodes per 1,000 days/catheter and the CVCs colonization was 21.2%.
Maria Alice de França Rangel Rebello in her article “Quality evaluation of products/services of information: an experience of the University Hospital Library of the University of São Paulo”, aims at presenting the results of an investigation about satisfaction of users concerning services provided by the Library and Documentation Service of the University Hospital of USP. For this, it was used SERVQUAL scale in order to measure the level of quality perceived by users. The author also describes the methodology of implantation of the Quality Products and Services Evaluation Program of the Integrated Library System of USP.