A percepção dos médicos de família sobre a distribuição da despesa em medicamentos, meios complementares de diagnóstico e de terapêutica na sua consulta itself.

Os autores desenvolveram um processo Delphi em duas voltas para recolher a percepção dos médicos de família do Centro de Saúde de Cascais sobre os valores que eles atribuem à despesa com medicamentos, meios complementares de diagnóstico e meios complementares de terapêutica nos atendimentos de planeamento familiar, saúde materna, saúde infantil, saúde de adultos, atendimento complementar e atendimento domiciliário. Assumiu-se que a média dos valores percentuais obtidos na segunda volta do painel, constitui o consenso do grupo e serão aplicados na elaboração do orçamento-programa do Centro de Saúde de Cascais

Modelo DPSEEA e Vigilância em Saúde Ambiental em Portugal: Doenças Oncológicas

In Portugal cancer is the main cause of premature death and the second main cause of death for all age groups. It is estimated that, globally, the proportion of cases of cancer due to modifiable risk factors exceeds one third of the total number of cases.Through an applied, descriptive and documental research, an indicators dashboard was prepared based on the DPSEEA model, optimizing the use of available information for obtaining a snapshot of the situation and evolution of environmental health in Portugal having an impact on oncological diseases.41 websites belonging to public bodies were consulted, resulting in the selection of 81 potential indicators. The most adequate indicators–3 for each dimension of the model–was selected by a panel of 21 experts. These indicators were classified in terms of validity, solidity, relevance, sensitivity and statistical quality.The differences observed in the scores for the different indicators in all dimensions are of statistical significance, and the chosen set of 3 indicators for each dimension is likewise relevant in 95 % thereof (p < 0.05).The country’s performance was evaluated on a 0-100 scale by calculating 3 index numbers: performance, dimension, and overall.Portugal has action programmes for current environmental domains that are in need of a review so as to optimize them and carry out an effective intersectoral intervention on environmental health from which a decrease in the exposure to oncologically determinant environmental aspects results.En Portugal, el cáncer es la principal causa de muerte prematura y la segunda causa de muerte en todas las edades. Se estima que, a escala mundial, la proporción de casos de cáncer atribuibles a factores de riesgo modificables supera un tercio del total de casos de cáncer.A través de una investigación aplicada, descriptiva y documental se elaboró un cuadro de indicadores basado en el modelo DPSEEA, optimizando la utilización de la información disponible para realizar un análisis de situación/evolución de la salud ambiental en Portugal con impacto en las enfermedades oncológicas.Fueron consultados los sitios de 41 organismos públicos y se seleccionaron 81 indicadores potenciales. La selección de los indicadores más adecuados se realizó con la colaboración de un grupo de expertos, organizados por grupos de forma aleatoria y estratificada por áreas de formación. Los indicadores se clasificaron cuanto a la validez, fiabilidad, pertinencia, sensibilidad y calidad estadística.Las diferencias observadas en las puntuaciones para los indicadores en todas las dimensiones fueron estadísticamente significativas y el conjunto de 3 indicadores seleccionados para cada dimensión es igualmente relevante en el 95 % de ellos (p<0,05).El resultado del país se obtuvo con una clasificación de 0-100 mediante el cálculo de tres números índice: rendimiento, dimensión y global.Portugal cuenta con programas de acción para las áreas ambientales de especial atención que es importante revisar buscando su optimización y una intervención intersectorial efectiva en salud ambiental de la que resulte una disminución de la exposición a determinantes ambientales oncológicos.Em Portugal o cancro é a principal causa de morte prematura e a segunda causa de morte em todas as idades. Estima-se que mundialmente a proporção de casos de cancro atribuível a fatores de risco modificáveis exceda um terço dos mesmos.Através de uma pesquisa aplicada, descritiva e documental elaborou-se um quadro de indicadores alicerçado no modelo DPSEEA, otimizando a utilização da informação disponível para uma leitura da situação e evolução da saúde ambiental em Portugal com impacto na área das doenças oncológicas.Foram consultados os sites de 41 entidades públicas e selecionados 81 potenciais indicadores. A seleção dos indicadores mais adequados foi efetuada com a colaboração de um painel de peritos, organizados por grupos de forma aleatória e estratificada por áreas de formação. Os indicadores foram classificados numa escala de Likert quanto à validez, solidez, relevância, sensibilidade e qualidade estatística.Estatisticamente as diferenças nas pontuações observadas para os diferentes indicadores em todas as dimensões são significativas e o conjunto de 3 indicadores escolhidos para cada dimensão é igualmente relevante em 95 % dos mesmos (p<0,05). O desempenho do país foi obtido pela classificação de 0-100 obtida pelo cálculo de três números índice: desempenho,dimensão e global. O índice desempenho é um índice relativo que considera os resultados dos países da Europa dos 15.Portugal detém programas de ação para os domínios ambientais presentes que importa revisar procurando a sua otimização e uma efetiva intervenção intersectorial em saúde ambiental da qual resulte a diminuição da exposição a determinantes ambientais oncológicos

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Crisis and response of the biomedical model of health promotion: editorial

info:eu-repo/semantics/publishedVersio

Burnout syndrome and its relationship with the job satisfaction of nursing staff in the emergency service of a public hospital in Lima 2023

Objetivo: Analizar la relación del Síndrome de Burnout con la satisfacción laboral del personal de enfermería del Servicio de Emergencia de un Hospital Público de Lima 2023. Metodología: Se desarrolló enfoque de estudio cuantitativo, aplicado, no experimental, correlacional, de corte transversal; la población es conformada por el personal de enfermería (60 personas) del servicio de emergencia del Hospital de Lima. No se halló muestra, debido a que se trabajó con toda la población. Resultados. La dimensión agotamiento emocional del síndrome de burnout con la satisfacción laboral, es alto agotamiento emocional con baja satisfacción laboral en 31.7%, relacionándose en 49%. La dimensión despersonalización del síndrome de burnout con la satisfacción laboral, hay alta despersonalización con baja satisfacción laboral en 28.3%, relacionándose en 55%. La dimensión realización personal del síndrome de burnout con la satisfacción laboral, hay media realización personal con baja satisfacción laboral en 28.3% y una alta realización personal con media satisfacción laboral en 28.3%, relacionándose en 51%. En el objetivo general, hay alto síndrome de burnout con baja satisfacción laboral en 30%, se relacionan en 70

Panel of Environmental Health Indicators for Oncological Diseases

In Portugal, cancer is the leading cause of premature death and the second leading cause of death in all ages. Worldwide, the proportion of cases of cancer attributable to modifiable risk factors exceeds one-third. These cases are avoidable. The organization model of environmental health indicators DPSEEA: Driving Force-Pressure-Situation-ExposureEffect-Action simplifies the description and analysis of the relationships between development, environment and health, with an aim to better decision-making. Through an applied, descriptive and documental research process, a table of 18 indicators based on the DPSEEA model was developed, aimed at reading the current state and evolution of environmental health in Portugal with impact on the area of oncological diseases. The public websites of 41 entities were consulted and 81 indicators were identified. The selection of the 18 most appropriate indicators, three for each dimension of the model, was made with a panel of 21 experts, randomly organized and stratified by training areas. The indicators were classified on a Likert scale for validity, solidity, relevance, sensitivity and statistical quality. The differences in the scores observed for the different indicators in all dimensions were statistically significant, and the set of three indicators chosen for each dimension was equally relevant in 95% of comparisons (p <0.05)

CBiOS Science Sessions - 2017 -

Indoor air quality in baby's room: a study about VOC levels Qualidade do ar interior em quartos de bebés: estudo das concentrações de compostos orgânicos voláteis (COV), Raquel Rodrigues dos Santos; Ana S. Fernandes; Liliana Castanheira; DPSEEA Model and Surveillance in Environmental Health in Portugal: Oncological Diseases; Modelo DPSEEA e Vigilância em Saúde Ambiental em Portugal: Doenças Oncológicas Rogério Nunes; Margarida Estudante, Cipriano Justo; Eggs and chicken embryos as potential sentinels for flock and hatchery; Ovos e embriões de frango como potenciais sentinelas para incubação; Rute Noiv