O desafio teórico-prático da gestão dos serviços de saúde El desafío teórico práctico de la gestión de los servicios de salud Health services management challenges in theory and practice

Trata-se da temática da gestão de serviços e organizações de saúde, focando os saberes como recurso de ação que se revertem em fontes de autonomia, autoridade e poder dos sujeitos nos contextos de suas práticas. O movimento de consolidação do SUS coloca como desafio a "adequação" dos trabalhadores de saúde aos seus princípios e diretrizes, estabelecendo instrumentos como a gerência de serviços, para a reorganização do processo de trabalho em saúde. Na gestão hospitalar tomou-se o conceito de "ambiência" para compreender e reorganizar a funcionalidade do hospital dando destaque ao espaço físico e tecnológico, considerando que esses elementos não se conformam sem a mediância do social e do afetual.<br>Este artículo se trata de la temática de gestión de servicios y organizaciones de salud, enfocando los saberes como recursos de acción que revierten a fuentes de autonomía, autoridad y poder de los sujetos en los contextos de sus prácticas. El movimiento de consolidación del Sistema Único de Salud (SUS) pone como desafío la "adecuación" de los trabajadores de salud a sus principios y directrices, estableciendo instrumentos tales como la gerencia de servicios, con vistas a la reorganización del proceso de trabajo en salud. En la gestión hospitalaria, se tomó el concepto de "ambiencia" para comprender y reorganizar la funcionalidad del hospital, destacando el espacio físico y tecnológico y considerando que esos elementos no se conforman sin el intermedio del social y del afectual.<br>This article deals with the management of health services and organizations, focusing on knowledge as an action resource, which turns into a source of autonomy, authority and power for subjects in the context of their practices. The movement towards the consolidation of the Single Health System (SUS) gives rise to the challenge of "adapting" health workers to its principles and guidelines, establishing instruments such as service management with a view to the reorganization of the health work process. In hospital management, the concept of "ambience" was adopted to understand and reorganize hospital functionality, highlighting the physical and technological space, in view of the fact that these elements cannot be constituted without the intermedation of the social and affectual

A systematic review and meta-analysis of <it>Toxoplasma gondii</it> infection among the Mexican population

<p>Abstract</p> <p>Background</p> <p>Toxoplasmosis is a disease caused by <it>Toxoplasma gondii</it> and at least one-third of the world’s population has detectable <it>T. gondii</it> antibodies. The seroprevalence of <it>T.gondii</it> ranges from 15% to 50% among the Mexican general population. The aim of this work was to determine the mean prevalence and weighted mean prevalence of <it>T. gondii</it> infection, and to evaluate the epidemiological transition of infection in Mexico.</p> <p>Methods</p> <p>Pub Med, Lilacs, Medline, Latindex, Google Scholar data bases were searched to retrieve reports from 1951 up to 2012 regarding prevalence data, diagnostic tests and risk factors of infection among the adult population. Data collection and criteria eligibility was established in order to determine the crude prevalence (proportion of positive cases) of each study, together with weighted population prevalence according to individual research group categories to limit the bias that may impose the heterogeneous nature of the reports. A Forest Plot chart and linear regression analysis were performed by plotting the prevalence of infection reported from each study over a period of sixty years.</p> <p>Results</p> <p>A total of 132 studies were collected from 41 publications that included 70,123 individuals. The average mean prevalence was 27.97%, and weighted mean prevalence was 19.27%. Comparisons among different risk groups showed that the weighted prevalence was higher in women with miscarriages (36.03%), immunocompromised patients (28.54%), mentally-ill patients (38.52%) and other risk groups (35.13%). <it>Toxoplasma</it> infection among the Mexican population showed a downward trend of 0.1%/year over a period of sixty years that represents a 5.8% reduction in prevalence.</p> <p>Conclusions</p> <p>This analysis showed a downward trend of infection; however, there are individuals at high risk for infection such as immunocompromised patients, mentally-ill patients and pregnant women. Further research is required to provide better prevention strategies, effective diagnostic testing and medical management of patients. Educational efforts are required to avoid the transmission of infection in populations that cannot be controlled by drugs alone.</p