The fight against sexually transmitted infections cannot stop in the COVID-19 era: a brazilian experience in online training for sexually transmitted infections guidelines

Introduction: The Brazilian Ministry of Health had planned face-to-face workshops for professional training about the Clinical Protocols and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections for the year 2020. Due to the COVID-19 pandemic, the workshops were cancelled, and a new strategy was adopted: virtual meetings, called Webinars—Clinical Protocols and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections 2020. Objective: To report the experience at the Ministry of Health in online training about the clinical protocol and therapeutic guidelines for comprehensive care for people sexually transmitted infections for health professionals in 2020. Methods: The webinars were held in partnership with the Brazilian Society of Sexually Transmitted Diseases and the Pan American Health Organization. Each chapter of the Clinical Protocols and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections—2020 was converted into a webinar, with the participation of at least three experts, two speakers, and a moderator. Results: In total, 16 webinars were presented, covering topics such as sexually transmitted infections surveillance, prevention, diagnosis, treatment, public policies, and sexual violence. The initiative had more than 77,000 hits, with an average of 4,900 hits per webinar and the topic “syphilis” being the most accessed. The event reached all 27 federative units of Brazil, as well as 27 other countries. About 500 questions were received from the audience and answered during the sessions and/or through a document published later on by the Ministry of Health. Conclusion: Given the high number of hits and inquiries received, we can conclude that health professionals remained engaged in the topic of sexually transmitted infections during the pandemic. This experience shows the great potential of innovative methods for distance learning to promote continuing education, including a series of webinars aimed at strengthening the fight against sexually transmitted infections.

Desafios à ampliação do acesso na atenção primária à saúde

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Saúde Coletiva, Florianópolis, 2018.O Sistema Único de Saúde (SUS) posiciona a Atenção Primária a Saúde (APS) como ordenadora do sistema público de saúde brasileiro, por meio da Estratégia Saúde da Família (ESF), seu modelo organizativo preferencial. A APS tem como atributo essencial o acesso, pré-requisito para os outros atributos como integralidade e equidade: o bom acesso ou o acesso oportuno é aquele em que o usuário consegue o cuidado quando dele necessita. Essa pesquisa investigou a experiência de profissionais da ESF selecionados por terem participado de processos de ampliação do acesso nos seus centros de saúde (CS), focando nas facilidades e barreiras presentes nesse processo. Realizou-se um estudo qualitativo, através de entrevistas semiestruturadas com 20 profissionais e gestores da Secretaria Municipal de Saúde (SMS) de Florianópolis-SC, cuja rede de serviços de APS é formatada via ESF. Na análise temática das entrevistas, emergiram três polos temáticos: Papel dos Profissionais , Questões organizacionais e Papel da Gestão . O primeiro revelou a grande importância dos processos internos das equipes, mostrando que características dos profissionais e suas inter-relações apresentaram forte influência na ampliação do acesso. Os médicos(as) e enfermeiros(as) são figuras chaves, cujo protagonismo e parceria foram fundamentais para mudanças nos processos de trabalho e sua manutenção. A relação entre profissionais de diferentes equipes dentro de um CS também foi importante (como facilitadora ou obstáculos). A formação pós-graduada específica em APS teve grande relevância para motivação profissional em ampliar o acesso, principalmente a residência em Medicina de Família e Comunidade (MFC), assim como uma forte atuação clínica da enfermagem aumentou de forma consistente o acesso. Um fator dificultador da ampliação do acesso foi a heterogeneidade de entendimento dos profissionais e coordenadores sobre como deve ser o acesso e sua importância na APS. Quanto às Questões organizacionais , destacou-se a importância do vínculo com uma população definida, ligando acesso com longitudinalidade do cuidado; a importância do manejo do tempo, devido à necessidade de priorizar a agenda para a assistência e de aperfeiçoar a habilidade de realizar consultas mais eficientes; espaços protegidos para reuniões, para articular as mudanças nos processos de trabalho; as tecnologias de comunicação, para tornar mais ágil a comunicação entre os profissionais, aprimorar as formas de agendamento e melhorar o contato com os usuários (e-mail, telefone e aplicativos de bate-papo). No polo Papel da Gestão , os coordenadores locais demonstraram ter grande importância para auxiliar (ou ser um obstáculo) nos processos de ampliação de acesso. Quanto à gestão municipal, foi unânime a percepção de seu pouco apoio nos processos internos de mudanças das equipes e CS, e da falta de alguma recompensa ou cobrança institucional para ampliar o acesso, que poderia facilitar os processos locais. Em consonância com a literatura, dois fatores estruturais básicos foram identificados como limitadores da ampliação do acesso: adequação de recursos humanos (equipes completas) e dimensionamento populacional das equipes, dependentes da gestão municipal. Ambos influenciam a capacidade das equipes e comumente favorecem a sobrecarga dos profissionais que trabalham na APS.Abstract : The Unified Health System (SUS) places Primary Health Care as the provider of the brazilian public health system, through the Family Health Strategy (ESF), its preferred organizational model. The essential attribute of Primary Health Care is access, a prerequisite for other attributes such as integrality and equity: good access or timely access is one in which the user can obtain care when needed. This research investigated the experience of ESF professionals selected for having participated in processes of increasing access in their health centers (CS), focusing on the facilities and barriers present in this process. A qualitative study was carried out through semi-structured interviews with 20 professionals and managers of the Municipal Health Department (SMS) of Florianópolis-SC, whose network of Primary Health Care services is formatted via ESF. In the thematic analysis of the interviews, three thematic poles emerged: \"Role of Professionals\", \"Organizational Issues\" and \"Role of Management\". The first one revealed the great importance of the internal processes of the health teams, showing that the characteristics of the professionals and their interrelationships had a strong influence on the expansion of access. The doctors and nurses are key figures, whose role and partnerships were fundamental for changes in work processes and their maintenance. The relationship between professionals from different health teams within a CS was also important (as facilitator or obstacles). The specific post-graduate training in Primary Health Care had great relevance for professional motivation in increasing access, especially to the residency in Family and Community Medicine (MFC), as well as a strong clinical practice of nursing has consistently increased access. A factor that made access more difficult was the heterogeneity of the understanding of the professionals and coordinators about how access should be and its importance in Primary Health Care. Regarding the \"Organizational issues\", the importance of the bond with a defined population was highlighted, linking access with longitudinality of care; the importance of time management, due to the need to prioritize the agenda for assistance and to improve the ability to conduct more efficient consultations; protected spaces for meetings, to articulate changes in work processes; communication technologies, to streamline communication among professionals, improve scheduling and improve contact with users (email, phone, and chat applications). In the \"Role of Management\" area, the local coordinators have demonstrated great importance in helping (or being an obstacle) in the processes of access expansion. Regarding municipal management, there was a unanimous perception of their lack of support in the internal processes of team and CS changes, and the lack of any institutional reward or fee to expand access that could facilitate local processes. In agreement with the literature, two basic structural factors were identified as limiting the access expansion: adequacy of human resources (complete health teams) and population dimensioning of the health teams, dependent on municipal management. Both influence the capacity of teams and commonly favor the overload of professionals working in Primary Health Care

Effects of blood storage on ice in biochemical and arterial blood gas analysis of rats Efeitos da estocagem sanguínea em gelo na bioquímica e gasometria arterial de ratos

PURPOSE: To investigate the effects of blood storage in biochemical and arterial blood gas analysis of Wistar rats. METHODS: Ten adult male rats with weights between 300-350 g were used. The catheterization of the internal carotid artery were performed, followed by withdrawal of 3 ml of blood using 3 separate syringes each containing 1 ml. The syringes were fulfilled one after another and numerated according to the order of collection. Then, the following groups were devised: GT1 - samples that were firstly analyzed in 20 minutes and the second exam 65 minutes after the collection; GT2 - samples that were firstly analyzed in 35 minutes and the second exam 80 minutes after the collection; GT3 - samples that were firstly analyzed in 50 minutes and the second exam 95 minutes after the collection. The samples were stored in a container with a temperature between 0 Cº and 4 Cº. Upon analysis the values of pH, PaCO2, PaO2, HCO3-, SatO2, SBE, Na+ and K+ concentrations and glucose were compared. RESULTS: No statistically relevant difference (p<0.05) between the GT1, GT2 or GT3, when measuring pH, PaCO2, PaO2, HCO3-, SatO2, SBE or glucose, were found. However, Na+ concentration decreased and the K+ concentration increased (p<0.05) when comparing the first analysis (20 minutes) with the last one (95 minutes). CONCLUSION: The blood storage on ice does not interfere in the results of arterial blood gas analysis for the period of at least 95 minutes, except for the Na+ e K+ levels, which are practicable until 80 minutes after storage.<br>OBJETIVO: Analisar o efeito da estocagem sanguínea na bioquímica e na gasometria do sangue arterial de ratos Wistar. MÉTODOS: Foram utilizados 10 ratos adultos, machos, com peso compreendido entre 300 a 350 gramas. Cada animal foi submetido à cateterização da artéria carótida seguida de heparinização prévia do animal. Foram colhidos 3 ml de sangue total do rato, separados em três seringas contendo 1 ml cada. As seringas foram preenchidas uma após a outra e enumeradas respectivamente à ordem de coleta. De acordo com esta numeração as amostras foram distribuídas nos seguintes grupos: GT1 - amostras que tiveram primeira análise em 20 minutos e a segunda análise 65 minutos após a coleta; GT2 - amostras que tiveram primeira análise em 35 minutos e segunda análise 80 minutos após a coleta; GT3 - amostras que tiveram primeira análise em 50 minutos e 95 minutos após a coleta. As amostras foram estocadas em material isolante térmico, com temperatura entre 0 Cº e 4 Cº. Foram comparados os valores de pH, PaCO2, PaO2, HCO3-, SatO2, SBE, concentrações de Na+ e K+ e glicose. RESULTADOS: Não foram encontradas diferenças estatisticamente significantes (p<0.05) entre GT1, GT2 ou GT3 quando medidos pH, PaCO2, PaO2, HCO3-, SatO2, SBE ou glicose. Entretanto, a concentração de Na+ apresentou decréscimo enquanto que a concentração de K+ aumentou (p<0.05) quando comparados a primeira análise (20 minutos) e a última análise (95 minutos). CONCLUSÃO: A estocagem sanguínea em gelo não interfere nos resultados gasométricos arteriais no período mínimo de 95 minutos, à exceção dos níveis de Na+ e K+, viáveis até 80 minutos de análise pós-estocagem