Mapeamento da produção científica sobre o Programa Mais Médicos

O Programa Mais Médicos (PMM) foi instituído pela Lei nº 12.871, de 22 de outubro de 2013, com a finalidade de reduzir as desigualdades regionais na área da saúde e garantir acesso igualitário e integral aos serviços de saúde. A implantação desse programa tem gerado interesse nos pesquisadores da área de política, planejamento e gestão em saúde, interessados em analisar seu processo de formulação e implementação, bem com os resultados alcançados até o momento. O objetivo deste trabalho é efetuar uma revisão integrativa da literatura sobre o PMM em diferentes bases de dados – Biblioteca Virtual em Saúde, portal de periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes) e plataforma de pesquisa do Programa Mais Médicos –, visando identificar seus principais temas de investigação, os pesquisadores e os resultados de estudos. Foram identificados 137 trabalhos, publicados entre os anos de 2013 a 2016, classificados segundo o ano de publicação, o tipo de trabalho, o idioma, a área do conhecimento, temas e subtemas abordados, a procedência institucional dos autores e os resultados apresentados. A maioria dos estudos procede da área centro-sul do Brasil, sendo pesquisas empíricas que analisam ou avaliam o programa e apontam que o PMM tem reduzido a escassez de médicos em determinadas regiões do país, melhorado a relação médico/paciente, estimulado práticas interdisciplinares e fortalecido a atenção primária no Sistema Único de Saúde (SUS). Indicam, também, alguns limites do PMM, notadamente a inadequação do perfil dos profissionais que dele participam, o que demanda o fortalecimento das iniciativas de formação e educação permanente do pessoal inserido no programa.The Mais Médicos Program (MMP) was established by Law no. 12,871 of October, 22nd 2013 with the purpose of reducing regional inequalities in health and ensuring full and egalitarian access to health services. The implementation of this program has generated interest in health policy, planning, and management researchers, who intend to analyze its formulation and implementation process, as well as the results achieved until now. The objective of this article is to perform an integrative literature review concerning the MMP in different databases – Biblioteca Virtual em Saúde, journal platform from Higher Education Improvement Coordination (Capes) and research platform from Mais Médicos Program –, to identify the main themes of investigation, researchers, and study results. We identified 137 articles published between 2013 and 2016, which were classified according to the year of publication, type of publication, language, field of knowledge, themes and subthemes approached, author’s affiliation, and results. Most studies were published on Brazil’s central south region, and were empirical studies evaluating or analyzing the program, pointing that MMP has reduced the shortage of physicians in some regions of the country, improved the doctor-patient relationship, stimulated interdisciplinary practices and consolidated primary care in the Brazilian National Health System (SUS). They also indicate some of the program’s limitations, especially the inadequacy of the profile of the professionals who integrate it, which demand the strengthening of the permanent educational initiatives for the personnel inserted in the program

Teleatendimento em tempos da Covid-19: uma estratégia de cuidado longitudinal a grupos prioritários atendidos na Atenção Primária à Saúde, no município de Salvador, BA

The Covid-19 pandemic triggered a range of changes in the functioning of health facilities. In the specific case of Primary Care, there is a remodeling of work processes, of the interactions between health professionals and people in accessing services. This article aims to present a tell-service proposal for people with arterial hypertension and diabetes at the Family Health Unit Sabino Silva, in Salvador-Bahia, which could be replicated in other contexts. Elaborated in a dialogical way by residents of Family and Community Medicine, this proposal can provide numerous benefits: greater integration among the members of the health team; guarantee of monitoring of people registered in the unit; maintenance of longitudinality of care; reducing people's exposure to Covid-19; reordering access to health services; greater participation of professionals in remote work.A pandemia da Covid-19 desencadeou uma gama de alterações no funcionamento das unidades de saúde. No caso específico da atenção primária observa-se um remodelamento dos processos de trabalho, das interações entre profissionais de saúde e usuários no acesso aos serviços. O presente artigo objetiva apresentar uma proposta de teleatendimento para pessoas portadores de hipertensão arterial e diabetes na Unidade de Saúde da Família Prof. Sabino Silva, em Salvador-Bahia, que poderá ser replicada em outros contextos. Elaborada de forma dialógica por residentes de Medicina de Família e Comunidade, a referida proposta poderá propiciar inúmeros benefícios: maior integração entre os membros da equipe de saúde; garantia de monitoramento das pessoas adscritas na unidade; manutenção da longitudinalidade do cuidado; redução da exposição das pessoas à Covid-19; reordenamento do acesso ao serviço de saúde; maior participação dos profissionais em trabalho remoto

Permanecer SUS: a (re)formação em saúde sob a perspectiva do acolhimento e da humanização

Aim: to analyze the perception of students members of Permanecer SUS program of the Health Secretariat in Bahia, from the National Policy of Humanization. Method: qualitative study of field research with Institutional Ethnography approach. Participant observation and semi-structured interviews were conducted with 10 academics in the health field. Results: the data shows that the program has a positive influence for the participant’s academic education. One of the biggest benefits appointed is that there is greater awareness about the principles user embracement and humanization, and consequently a better understanding of the public health system in Brazil. Conclusion: according to the subjects’ speech, aspects on the importance of the program for professional formation and recognition of the vulnerability of an integral and humanized care in health services emergedObjetivo: analizar las percepciones de los estudiantes del programa Permanecer SUS de la Secretaría de Salud del Estado de Bahía, de la Política Nacional de Humanización. Método: estudio cualitativo e investigativo con enfoque de Etnografía Institucional. Entrevistas de observación participante y semi-estructuradas con 10 académicas de la salud. Resultados: los datos analizados muestran que el programa tiene una influencia positiva para la educación universitaria de los participantes. Uno de los mayores beneficios es la mayor conciencia acerca de los principios de acogimiento y humanización, y por lo tanto una mejor comprensión del sistema de salud pública en Brasil. Conclusión: mediante el discurso de los temas surgieron aspectos como la importancia del programa para la formación profesional y el reconocimiento de la vulnerabilidad de una atención integral y humanizada en los servicios de salud.http://dx.doi.org/10.5902/2179769213593Objetivo: analisar a percepção dos estudantes integrantes do programa Permanecer SUS da Secretaria de Saúde do Estado da Bahia, a partir da Política Nacional de Humanização. Método: estudo qualitativo do tipo pesquisa de campo com abordagem da Etnografia Institucional. Foram realizadas observações participantes e entrevistas semiestruturadas com 10 acadêmicos da área da saúde. Resultados: os dados analisados mostram que o programa apresenta influências positivas para a formação universitária dos participantes. Um dos maiores benefícios apontados é de que há maior sensibilização acerca dos princípios do acolhimento e humanização, e consequentemente uma melhor compreensão acerca do sistema de saúde pública do Brasil. Conclusão: por meio do discurso dos sujeitos emergiram aspectos da importância do programa para a formação profissional e o reconhecimento da vulnerabilidade de uma assistência integral e humanizada nos serviços de saúde

Study of Bc+B_c^+ decays to the K+K−π+K^+K^-\pi^+ final state and evidence for the decay Bc+→χc0π+B_c^+\to\chi_{c0}\pi^+

A study of $B_c^+\to K^+K^-\pi^+$ decays is performed for the first time using data corresponding to an integrated luminosity of 3.0 $\mathrm{fb}^{-1}$ collected by the LHCb experiment in $pp$ collisions at centre-of-mass energies of $7$ and $8$ TeV. Evidence for the decay $B_c^+\to\chi_{c0}(\to K^+K^-)\pi^+$ is reported with a significance of 4.0 standard deviations, resulting in the measurement of $\frac{\sigma(B_c^+)}{\sigma(B^+)}\times\mathcal{B}(B_c^+\to\chi_{c0}\pi^+)$ to be $(9.8^{+3.4}_{-3.0}(\mathrm{stat})\pm 0.8(\mathrm{syst}))\times 10^{-6}$. Here $\mathcal{B}$ denotes a branching fraction while $\sigma(B_c^+)$ and $\sigma(B^+)$ are the production cross-sections for $B_c^+$ and $B^+$ mesons. An indication of $\bar b c$ weak annihilation is found for the region $m(K^-\pi^+)<1.834\mathrm{\,Ge\kern -0.1em V\!/}c^2$, with a significance of 2.4 standard deviations.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://lhcbproject.web.cern.ch/lhcbproject/Publications/LHCbProjectPublic/LHCb-PAPER-2016-022.html, link to supplemental material inserted in the reference

Study of J /ψ production in Jets

The production of J/ψ mesons in jets is studied in the forward region of proton-proton collisions using data collected with the LHCb detector at a center-of-mass energy of 13 TeV. The fraction of the jet transverse momentum carried by the J/ψ meson, z(J/ψ)≡pT(J/ψ)/pT(jet), is measured using jets with pT(jet)>20 GeV in the pseudorapidity range 2.5<η(jet)<4.0. The observed z(J/ψ)distribution for J/ψ mesons produced in b-hadron decays is consistent with expectations. However, the results for prompt J/ψ production do not agree with predictions based on fixed-order nonrelativistic QCD. This is the first measurement of the pT fraction carried by prompt J/ψ mesons in jets at any experiment

Compressed representation of a partially defined integer function over multiple arguments

In OLAP (OnLine Analitical Processing) data are analysed in an n-dimensional cube. The cube may be represented as a partially defined function over n arguments. Considering that often the function is not defined everywhere, we ask: is there a known way of representing the function or the points in which it is defined, in a more compact manner than the trivial one

Performance of CMS muon reconstruction in pp collision events at sqrt(s) = 7 TeV

The performance of muon reconstruction, identification, and triggering in CMS has been studied using 40 inverse picobarns of data collected in pp collisions at sqrt(s) = 7 TeV at the LHC in 2010. A few benchmark sets of selection criteria covering a wide range of physics analysis needs have been examined. For all considered selections, the efficiency to reconstruct and identify a muon with a transverse momentum pT larger than a few GeV is above 95% over the whole region of pseudorapidity covered by the CMS muon system, abs(eta) < 2.4, while the probability to misidentify a hadron as a muon is well below 1%. The efficiency to trigger on single muons with pT above a few GeV is higher than 90% over the full eta range, and typically substantially better. The overall momentum scale is measured to a precision of 0.2% with muons from Z decays. The transverse momentum resolution varies from 1% to 6% depending on pseudorapidity for muons with pT below 100 GeV and, using cosmic rays, it is shown to be better than 10% in the central region up to pT = 1 TeV. Observed distributions of all quantities are well reproduced by the Monte Carlo simulation.Comment: Replaced with published version. Added journal reference and DO

X-ray emission from the Sombrero galaxy: discrete sources

We present a study of discrete X-ray sources in and around the bulge-dominated, massive Sa galaxy, Sombrero (M104), based on new and archival Chandra observations with a total exposure of ~200 ks. With a detection limit of L_X = 1E37 erg/s and a field of view covering a galactocentric radius of ~30 kpc (11.5 arcminute), 383 sources are detected. Cross-correlation with Spitler et al.'s catalogue of Sombrero globular clusters (GCs) identified from HST/ACS observations reveals 41 X-rays sources in GCs, presumably low-mass X-ray binaries (LMXBs). We quantify the differential luminosity functions (LFs) for both the detected GC and field LMXBs, whose power-low indices (~1.1 for the GC-LF and ~1.6 for field-LF) are consistent with previous studies for elliptical galaxies. With precise sky positions of the GCs without a detected X-ray source, we further quantify, through a fluctuation analysis, the GC LF at fainter luminosities down to 1E35 erg/s. The derived index rules out a faint-end slope flatter than 1.1 at a 2 sigma significance, contrary to recent findings in several elliptical galaxies and the bulge of M31. On the other hand, the 2-6 keV unresolved emission places a tight constraint on the field LF, implying a flattened index of ~1.0 below 1E37 erg/s. We also detect 101 sources in the halo of Sombrero. The presence of these sources cannot be interpreted as galactic LMXBs whose spatial distribution empirically follows the starlight. Their number is also higher than the expected number of cosmic AGNs (52+/-11 [1 sigma]) whose surface density is constrained by deep X-ray surveys. We suggest that either the cosmic X-ray background is unusually high in the direction of Sombrero, or a distinct population of X-ray sources is present in the halo of Sombrero.Comment: 11 figures, 5 tables, ApJ in pres

Performance of CMS muon reconstruction in pp collision events at sqrt(s) = 7 TeV

The performance of muon reconstruction, identification, and triggering in CMS has been studied using 40 inverse picobarns of data collected in pp collisions at sqrt(s) = 7 TeV at the LHC in 2010. A few benchmark sets of selection criteria covering a wide range of physics analysis needs have been examined. For all considered selections, the efficiency to reconstruct and identify a muon with a transverse momentum pT larger than a few GeV is above 95% over the whole region of pseudorapidity covered by the CMS muon system, abs(eta) < 2.4, while the probability to misidentify a hadron as a muon is well below 1%. The efficiency to trigger on single muons with pT above a few GeV is higher than 90% over the full eta range, and typically substantially better. The overall momentum scale is measured to a precision of 0.2% with muons from Z decays. The transverse momentum resolution varies from 1% to 6% depending on pseudorapidity for muons with pT below 100 GeV and, using cosmic rays, it is shown to be better than 10% in the central region up to pT = 1 TeV. Observed distributions of all quantities are well reproduced by the Monte Carlo simulation.Comment: Replaced with published version. Added journal reference and DO

Azimuthal anisotropy of charged particles at high transverse momenta in PbPb collisions at sqrt(s[NN]) = 2.76 TeV

The azimuthal anisotropy of charged particles in PbPb collisions at nucleon-nucleon center-of-mass energy of 2.76 TeV is measured with the CMS detector at the LHC over an extended transverse momentum (pt) range up to approximately 60 GeV. The data cover both the low-pt region associated with hydrodynamic flow phenomena and the high-pt region where the anisotropies may reflect the path-length dependence of parton energy loss in the created medium. The anisotropy parameter (v2) of the particles is extracted by correlating charged tracks with respect to the event-plane reconstructed by using the energy deposited in forward-angle calorimeters. For the six bins of collision centrality studied, spanning the range of 0-60% most-central events, the observed v2 values are found to first increase with pt, reaching a maximum around pt = 3 GeV, and then to gradually decrease to almost zero, with the decline persisting up to at least pt = 40 GeV over the full centrality range measured.Comment: Replaced with published version. Added journal reference and DO