Teoria das Filas: avanços, aplicações e reavaliações dos processos de gestão de serviços de saúde - uma análise bibliométrica

Este artigo analisa as contribuições e aplicações da Teoria das Filas (TF) no campo dos problemas de gerenciamento de serviços de saúde, apresentando um sistema de classificação cronológica dos cuidados de saúde examinados com o auxílio de modelos de filas. O objetivo é descrever as principais tendências na aplicação da TF para os tomadores de decisão em serviços de saúde e fornecer informações para melhorar este processo. Foi realizada revisão bibliográfica a fim de investigar as áreas de saúde suportadas por modelos de filas, além de buscas por artigos que descrevessem modelos de problemas e seus tópicos. O presente trabalho analisou 314 artigos que abordam as aplicações da TF em Gerenciamento de Cuidados em Saúde (GCS), no período de 2014 e 2020, e concluiu-se que esta revisão demonstra que TF pode contribuir para a melhoria dos serviços de saúde e proporciona aos gestores recursos para as alcançarem

O impacto do método HFMEA nas instituições de saúde: uma ferramenta para redução de risco / The impact of the HFMEA method in healthcare institutions: a tool for risk reduction

Objetivo:  O Modo de Falha em Saúde e Análise de Efeitos (HFMEA) ou FMEA na saúde é uma ferramenta prospectiva para análise de riscos na gestão da saúde. A utilização deste método está espalhada na literatura causando um entendimento local sobre o assunto. Sendo assim, este artigo tem como objetivo fornecer uma visão ampliada e sistematizada sobre o método HFMEA apresentando o que é, como elaborar e quais foram os impactos causados por esta ferramenta nas instituições de saúde. Projeto/metodologia/abordagem: Foi efetuada uma revisão bibliográfica na literatura em 56 artigos. A seleção dos documentos foi através de um processo de triagem aplicado aos registros identificados através da busca por artigos com a palavra-chave “HFMEA”. Constatações: Os estudos analisados indicam que 5 dos 8 principais erros e eventos adversos mais comuns na assistência de saúde utilizaram o HFMEA como ferramenta de mitigação dos erros e riscos vigentes. Além disso, foi apresentado uma análise dos impactos da HFMEA, classificando-os quanto as principais áreas de aplicação.  Logo, os notáveis efeitos da adoção da HFMEA são aumento da segurança do paciente e melhoria da gestão. Originalidade: Este estudo deseja servir de estímulo para o desenvolvimento de pesquisas futuras em gestão de risco por meio do método HFMEA para eliminação e/ou redução de erros, como a principal lacuna a ser preenchida como também a propagação deste método às organizações de prestação a saúde

Evaluating Lean Healthcare implementation with data mining: opportunities and improvements in emergency services

The waiting time for care in emergency services impacts overcrowding. The Fast Track method contributes to reducing this waiting time. The objective of this study was to evaluate the problems identified and improvements made in emergency services through the execution of the Lean Healthcare project. With the qualitative research approach, data mining allowed reaching results that demonstrated similar problems in emergency services in eight federative units. The improvements implemented contributed to the reduction of patient waiting time. Data mining allowed evaluating groups with similar characteristics, which showed the correlation between the problems encountered and the improvements made in the emergency services

High-fat diets rich in soy or fish oil distinctly alter hypothalamic insulin signaling in rats

Hypothalamic insulin inhibits food intake, preventing obesity. High-fat feeding with polyunsaturated fats may be obesogenic, but their effect on insulin action has not been elucidated. the present study evaluated insulin hypophagia and hypothalamic signaling after central injection in rats fed either control diet (15% energy from fat) or high-fat diets (50% energy from fat) enriched with either soy or fish oil. Soy rats had increased fat pad weight and serum leptin with normal body weight, serum lipid profile and peripheral insulin sensitivity. Fish rats had decreased body and fat pad weight, low leptin and corticosterone levels, and improved serum lipid profile. A 20-mU dose of intracerebroventricular (ICV) insulin inhibited food intake in control and fish groups, but failed to do so in the soy group. Hypothalamic protein levels of IR. IRS-1, IRS-2, Akt, mTOR, p70S6K and AMPK were similar among groups. ICV insulin stimulated IR tyrosine phosphorylation in control (68%), soy (36%) and fish (34%) groups. Tyrosine phosphorylation of the pp185 band was significantly stimulated in control (78%) and soy (53%) rats, but not in fish rats. IRS-1 phosphorylation was stimulated only in control rats (94%). Akt serine phosphorylation was significantly stimulated only in control (90%) and fish (78%) rats. the results showed that, rather than the energy density, the fat type was a relevant aspect of high-fat feeding, since blockade of hypothalamic insulin signal transmission and insulin hypophagia was promoted only by the high-fat soy diet, while they were preserved in the rats fed with the high-fat fish diet. (C) 2012 Elsevier Inc. All rights reserved.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Universidade Federal de São Paulo, Dept Fisiol, Disciplina Fisiol Nutr, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Fisiol, Disciplina Fisiol Nutr, BR-04023062 São Paulo, BrazilWeb of Scienc

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data