Geografia E Saúde: O Lugar Como Premissa Da Atividade Informacional Da Atenção Básica Do Sistema único De Saúde

The aim of this article is to warn the necessity of considering the place as an important variable of the information activity in the Brazilian Primary Care. Informational activity, as a standardized process, based on the State centralism and on a constrained view on health, undermines new opportunities to understand the places of the country in an emancipatory, autonomous way, in which voice is given to the upward forces that inhabit everyday life. Thus, we need to understand health’s relationship with places, as well as their influence on all the processes of social life. A new informational activity must be able to capture local realities and their geographies, being, therefore, more likely to ensure health and life for everyone. © 2016, UNIV SAOPAULO. All rights reserved.25372173

A Multi-State Model Approach

Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland.This paper introduces a methodology for estimating transition intensities in a multi-state model for disability and long-term care insurance. We propose a novel framework that integrates observable risk factors, such as demographic (age and sex), lifestyle (smoking and exercise habits) and health-related variables (body mass index), into the estimation and graduation of transition intensities, using a parametric approach based on the Gompertz–Makeham law and generalised linear models. The model features four states—autonomous, dead, and two intermediate states representing varying disability levels—providing a detailed view of disability/lack of autonomy progression. To illustrate the proposed framework, we simulate a dataset with individual risk profiles and model trajectories, mirroring Portugal’s demographic composition. This allows us to derive a functional form (as a function of age) for the transition intensities, stratified by relevant risk factors, thus enabling precise risk differentiation. The results offer a robust basis for developing tailored pricing structures in the Portuguese market, with broader applications in actuarial science and insurance. By combining granular disability modelling with risk factor integration, our approach enhances accuracy in pricing structure and risk assessment.publishersversionpublishe

Assessments of Opportunities to Improve Antibiotic Prescribing in an Emergency Department: A Period Prevalence Survey

Introduction Approximately 30% of all outpatient antimicrobials are inappropriately prescribed. Currently, antimicrobial prescribing patterns in emergency departments (ED) are not well described. Determining inappropriate antimicrobial prescribing patterns and opportunities for interventions by antimicrobial stewardship programs (ASP) are needed. Methods A retrospective chart review was performed among a random sample of non-admitted, adult patients who received an antimicrobial prescription in the ED from January 1 to December 31, 2015. Appropriateness was measured using the Medication Appropriateness Index, and was based on provider adherence to local guidelines. Additional information collected included patient characteristics, initial diagnoses, and other chronic medication use. Results Of 1579 ED antibiotic prescriptions in 2015, we reviewed a total of 159 (10.1%) prescription records. The most frequently prescribed antimicrobial classes included penicillins (22.6%), macrolides (20.8%), cephalosporins (17.6%), and fluoroquinolones (17.0%). The most common indications for antibiotics were bronchitis or upper respiratory tract infection (URTI) (35.1%), followed by skin and soft tissue infection (SSTI) (25.0%), both of which were the most common reason for unnecessary prescribing (28.9% of bronchitis/URTIs, 25.6% of SSTIs). Of the antimicrobial prescriptions reviewed, 39% met criteria for inappropriateness. Among 78 prescriptions with a consensus on appropriate indications, 13.8% had inappropriate dosing, duration, or expense. Conclusion Consistent with national outpatient prescribing, inappropriate antibiotic prescribing in the ED occurred in 39% of cases with the highest rates observed among patients with bronchitis, URTI, and SSTI. Antimicrobial stewardship programs may benefit by focusing on initiatives for these conditions among ED patients. Moreover, creation of local guideline pocketbooks for these and other conditions may serve to improve prescribing practices and meet the Core Elements of Outpatient Stewardship recommended by the Centers for Disease Control and Prevention

Geografia e saúde: o lugar como premissa da atividade informacional da Atenção Básica do Sistema Único de Saúde

Resumo O presente artigo visa chamar a atenção para a necessidade de se considerar o lugar como uma variável importante da atividade de informação em saúde na Atenção Básica do Brasil. Enquanto processo normatizado e fundamentado no centralismo do Estado e numa metodologia restrita de se enxergar a saúde, a atividade informacional, como é concebida hoje, acaba por minar novas possibilidades de compreender os lugares do país de uma maneira emancipatória, autônoma e que dê voz às forças ascendentes que habitam o cotidiano. Nesse sentido, alertamos para a necessidade de se compreender a saúde na sua relação com os lugares e da influência destes em todos os processos da vida social. Uma nova atividade informacional deve, entretanto, ser capaz de capturar as realidades locais e suas geografias, sendo assim mais susceptível de sucesso, no que diz respeito a garantir a saúde e a vida de todos

Strategies for Aspiring Biomedical Researchers in Resource-Limited Environments

Strategies for Aspiring Biomedical Researchers in Resource-Limited Environment

The Peru approach against the COVID-19 infodemic: Insights and strategies

The COVID-19 epidemic has spawned an "infodemic,"with excessive and unfounded information that hinders an appropriate public health response. This perspective describes a selection of COVID-19 fake news that originated in Peru and the government's response to this information. Unlike other countries, Peru was relatively successful in controlling the infodemic possibly because of the implementation of prison sentences for persons who created and shared fake news. We believe that similar actions by other countries in collaboration with social media companies may offer a solution to the infodemic problem.Revisión por pare

Evaluation of a joint Bioinformatics and Medical Informatics international course in Peru

Background: New technologies that emerge at the interface of computational and biomedical science could drive new advances in global health, therefore more training in technology is needed among health care workers. To assess the potential for informatics training using an approach designed to foster interaction at this interface, the University of Washington and the Universidad Peruana Cayetano Heredia developed and assessed a one-week course that included a new Bioinformatics (BIO) track along with an established Medical/Public Health Informatics track (MI) for participants in Peru. Methods: We assessed the background of the participants, and measured the knowledge gained by track-specific (MI or BIO) 30-minute pre- and post-tests. Participants' attitudes were evaluated both by daily evaluations and by an end-course evaluation. Results: Forty-three participants enrolled in the course - 20 in the MI track and 23 in the BIO track. Of 20 questions, the mean % score for the MI track increased from 49.7 pre-test (standard deviation or SD = 17.0) to 59.7 (SD = 15.2) for the post-test (P = 0.002, n = 18). The BIO track mean score increased from 33.6 pre-test to 51.2 post-test (P less than 0.001, n = 21). Most comments (76%) about any aspect of the course were positive. The main perceived strength of the course was the quality of the speakers, and the main perceived weakness was the short duration of the course. Overall, the course acceptability was very good to excellent with a rating of 4.1 (scale 1-5), and the usefulness of the course was rated as very good. Most participants (62.9%) expressed a positive opinion about having had the BIO and MI tracks come together for some of the lectures. Conclusion: Pre- and post-test results and the positive evaluations by the participants indicate that this first joint Bioinformatics and Medical/Public Health Informatics (MI and BIO) course was a success.The University of Washington AMAUTA Global Training in Health Informatics, a Fogarty International Center/NIH funded grant (5D43TW007551), and the AMAUTA Research Practica Program, a Puget Sound Partners for Global Health-funded grant

Handheld computers for self-administered sensitive data collection: A comparative study in Peru

<p>Abstract</p> <p>Background</p> <p>Low-cost handheld computers (PDA) potentially represent an efficient tool for collecting sensitive data in surveys. The goal of this study is to evaluate the quality of sexual behavior data collected with handheld computers in comparison with paper-based questionnaires.</p> <p>Methods</p> <p>A PDA-based program for data collection was developed using Open-Source tools. In two cross-sectional studies, we compared data concerning sexual behavior collected with paper forms to data collected with PDA-based forms in Ancon (Lima).</p> <p>Results</p> <p>The first study enrolled 200 participants (18–29 years). General agreement between data collected with paper format and handheld computers was 86%. Categorical variables agreement was between 70.5% and 98.5% (Kappa: 0.43–0.86) while numeric variables agreement was between 57.1% and 79.8% (Spearman: 0.76–0.95). Agreement and correlation were higher in those who had completed at least high school than those with less education. The second study enrolled 198 participants. Rates of responses to sensitive questions were similar between both kinds of questionnaires. However, the number of inconsistencies (p = 0.0001) and missing values (p = 0.001) were significantly higher in paper questionnaires.</p> <p>Conclusion</p> <p>This study showed the value of the use of handheld computers for collecting sensitive data, since a high level of agreement between paper and PDA responses was reached. In addition, a lower number of inconsistencies and missing values were found with the PDA-based system. This study has demonstrated that it is feasible to develop a low-cost application for handheld computers, and that PDAs are feasible alternatives for collecting field data in a developing country.</p

Latent Class Analysis of Sexual Risk Patterns Among Esquineros (Street Corner Men) a Group of Heterosexually Identified, Socially Marginalized Men in Urban Coastal Peru

We explored patterns of sexual risk behavior among esquineros, heterosexually-identified, socially-marginalized Peruvian men using latent class analysis. We used data from the Peru site of the National Institute of Mental Health (NIMH) Collaborative HIV/STD Prevention Trial which included n = 2,109 heterosexually-identified men. The latent class analysis used seven risk behaviors to group esquineros into risk classes. We identified four latent classes, of which two classes had lower probabilities and two classes had higher probabilities of these risk behaviors. Comparing the two lower risk classes to the two higher risk classes yielded significantly more unprotected sex acts (Chi square P value < 0.001). The risk behaviors in two of the latent classes identified were primarily related to alcohol and drug use. Future HIV/STI prevention interventions may benefit from this information by tailoring messages to fit the observed risk patterns and should focus on drug and alcohol use