Evaluation of implementation of geotechnologies applied to health : a methodological proposal

Este artigo tem como objetivo propor um modelo metodológico de avaliação somativa, do uso das ferramentas de geoprocessamento no serviços e ações do Sistema Único de Saúde (SUS), contemplando dois, eficácia e eficiência, dos sete pilares do método de avaliação. A avaliação é composta pelas seguintes etapas: entendimento do papel e da missão do serviço no sistema de saúde, estabelecimento dos objetivos da avaliação, escolha dos aspectos ou dimensões a serem avaliadas, construção de critérios, padrões e indicadores; desenho do estudo de avaliação; processo de avaliação; identificação dos problemas e falhas, propostas de mudança; execução das ações de correção e reavaliação, os quais são apresentados em modelo lógico. O proposto consiste de informações por dimensões de estrutura, processo e resultado necessários para medir o nível de qualidade alcançado comparando e análise das informações a serem obtidas, a partir dos critérios previamente estabelecidos na matriz de análise e julgamento. Como resultado obteve-se um modelo logico, a matriz de relevância da avaliação, a de análise e de julgamento, um questionário estruturado com 17 perguntas, indicadores para medir acesso, a qualidade e o desempenho. Como recomendação para avaliação de outras ferramentas utilizadas no SUS com interface com o geoprocessamento.This article aims to propose a methodological model of summative evaluation, for use of geoprocessing tools in the services and actions of the Unified National Health System (SUS), considering two: effectiveness and efficiency of the seven pillars of the evaluation method. The evaluation consists of the following steps: understanding the role and mission of the service in the health system, establishing the objectives of the evaluation, choosing the aspects or dimensions to be evaluated, building criteria, standards and indicators; design of the evaluation study; evaluation process; identification of problems and failures, proposals for change; implementation of the correction and revaluation actions, which are presented in a logical model. And the proposed one consists of information by structure, process and result dimensions needed to measure the level of quality achieved by comparing and analysis of the information to be obtained, from the criteria previously established in the matrix of analysis and judgment. As a result, we obtained a logistic model, the relevance matrix of the evaluation, the analysis and judgment matrix, a structured questionnaire with 17 questions, indicators to measure access, quality and performance. As a recommendation for the evaluation of other Geoprocessing tools used in the SUS, allowing the comparison of effectiveness and efficiency

Maus-tratos na infância: o papel do pediatra no reconhecimento precoce

Objetivos: Este artigo teve como objetivo elaborar uma revisão de literatura acerca da temática dos maus-tratos em crianças e adolescentes dentro da perspectiva da Pediatria, apresentar um breve histórico dos maus-tratos infantis, apontando as principais diferenças entre os seus tipos e buscar compreender e reconhecer os principais sinais precoces apresentados por estes pacientes. Metodologia: Foram analisadas, através de revisão de literatura, publicações de periódicos científicos em base de dados, especialmente, MedLine e Scielo, bem como fontes oficiais do Ministério da Saúde, legislação e literatura médica vigente. Resultados: De fato, a violência contra a criança representa uma das expressões de maus-tratos mais comuns e que mais estão sujeitas à possibilidade de prevenção. Classicamente, são definidos como abusos psicológicos, físicos e sexuais; negligência ou abandono e Síndrome de Munchausen por procuração. É fundamental que o pediatra identifique e compreenda os principais fatores ambientais envolvidos e reconheça precocemente através da anamnese e exame físico os sinais sugestivos dessas agressões. Conclusão: O Pediatra exerce uma função basilar uma vez que se encontra como um dos pontos chave no atendimento à criança vítima de maus-tratos. Inicialmente é esse profissional quem irá acolher o menor, e, por isso, deverá reconhecer os sinais de alarme que determinarão os próximos passos na propedêutica da atenção a este paciente

SARS-CoV-2 in children with cancer in Brazil : results of a multicenter national registry

Background: Strategies to mitigate the impact of COVID-19 in special populations are complex and challenging. Few studies have addressed the impact of COVID-19 on pediatric patients with cancer in low- and middle-income countries. Methods: Multicenter observational cohort study with prospective records and retrospective analyses starting in April 2020 in 21 pediatric oncology centers distributed throughout Brazil. Participants: Patients under 18 years of age who are infected by the SARS-CoV-2 virus (confirmed diagnosis through reverse transcriptase-polymerase chain reaction [RT-PCR]) while under treatment at pediatric oncology centers. The variables of interest included clinical symptoms, diagnostic and therapeutic measures. The repercussions of SARS-CoV-2 infection on cancer treatment and general prognosis were monitored. Results: One hundred seventy-nine patients were included (median age 6 [4–13] years, 58% male). Of these, 55.9% had acute leukemia and 34.1% had solid tumors. The presence of SARS-CoV-2 was diagnosed by RT-PCR. Various laboratory markers were analyzed, but showed no correlation with outcome. Children with low or high BMI for age had lower overall survival (71.4% and 82.6%, respectively) than those with ageappropriate BMI (92.7%) (p = .007). The severity of presentation at diagnosis was significantly associated with outcome (p < .001). Overall mortality in the presence of infection was 12.3% (n = 22). Conclusion: In children with cancer and COVID-19, lower BMI was associated with worse prognosis. The mortality in this group of patients (12.3%) was significantly higher than that described in the pediatric population overall (~1%)

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora