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Impact of the Health Gym Program on hospital admissions for stroke in the state of Pernambuco, Brazil
This study aimed to evaluate the impact of the Health Gym Program (HGP) on hospital admissions for stroke in the state of Pernambuco, Brazil. This policy impact evaluation used a quasi-experimental approach consisting of a difference-in-differences estimator, weighted by propensity score matching to deal with potential confounding variables. The study comprised socioeconomic, demographic, and epidemiological data from official Brazilian databases from 2010 to 2019. The treatment group was composed of the 134 municipalities that implemented the HGP since 2011. The 51 municipalities that did not were allocated to the comparison group. The nearest neighbor algorithm (N5) was used to pair treatment and comparison group municipalities and create the weights to evaluate the average treatment effect on the treated (ATT) in the difference-in-differences estimator. In 2010, 2,771 people were hospitalized for stroke (0.51% of all hospitalizations) and in 2019, 11,542 (2%). Municipalities that implemented the HGP had 18.37% fewer hospitalizations than their counterparts in the comparison group. The program’s impact in reducing hospitalization rates was incrementally greater among men (ATT: -0.1932) and those aged 71 to 80 years (ATT: -0.1911). All results were statistically significant at the 5% level. The HGP reduced hospitalization for stroke in several population groups, but primarily in those whose underlying prevalence of stroke is highest, reinforcing the importance of public investments in health promotion policies designed to encourage lifestyle changes.Resumo: O estudo teve como objetivo avaliar o impacto do Programa Academia da Saúde (PAS) nas internações hospitalares por acidente vascular cerebral (AVC) no Estado de Pernambuco, Brasil. Esta avaliação
de impacto das políticas utilizou uma abordagem quase-experimental que consiste em um estimador de diferença-em-diferenças, ponderado
pelo pareamento por escore de propensão para lidar com possíveis fatores de confusão. O estudo foi composto por dados socioeconômicos, demográficos e epidemiológicos de bases de dados oficiais brasileiras entre os anos de 2010 e 2019. O grupo de tratamento foi composto pelos 134 municípios que implantaram o PAS a partir de 2011, e os 51
municípios que não implantaram foram alocados no grupo de comparação. O algoritmo do vizinho mais próximo (N5) foi utilizado para emparelhar
os municípios tratados e comparar aos municípios do grupo controle, criando os pesos que foram utilizados para avaliar o efeito médio do tratamento sobre o tratado (ATT) no estimador de diferença-
-em-diferenças. Houve 2.771 internações por AVC em 2010 (0,51% de todas as internações) e 11.542 (2%) em 2019. Os municípios que implementaram o PAS tiveram 18,37% menos internações em comparação
com seus homólogos no grupo de comparação. O impacto do programa na redução das taxas de internação foi maior entre os homens (ATT: -0,1932) e naqueles com idade entre 71 e 80 anos (ATT: -0,1911). Todos os resultados foram estatisticamente significativos em um nível de 5%. O
PAS reduziu a hospitalização por AVC em vários grupos populacionais, mas principalmente naqueles em que a prevalência subjacente de AVC é mais alta, reforçando a importância dos investimentos públicos em políticas de promoção da saúde destinadas a estimular mudanças nos estilos de vida.
Avaliação de Programas e Projetos de Saúde;
Doença Crônica; Promoção da Saúde; Pontuação
de Propensão; Acidente Vascular CerebralResumen: El objetivo de este trabajo es evaluar el impacto del Programa Academia de la Salud (PAS) en los ingresos hospitalarios por accidente cerebrovascular (ACV) en el estado de Pernambuco, Brasil. Esta evaluación del impacto de la política utilizó un enfoque cuasi-experimental que consiste en un estimador de diferencias en diferencias, ponderado por el emparejamiento de puntuación de propensión para hacer frente a posibles factores de confusión. El estudio incluyó datos socioeconómicos, demográficos y epidemiológicos de bases de datos oficiales brasileñas de 2010 a 2019. El grupo de tratamiento se compuso de los 134 municipios que implementaron el PAS a partir de 2011 y los 51 municipios que no lo hicieron se asignaron al grupo de comparación. Se utilizó el algoritmo del vecino más próximo (N5) para emparejar los municipios tratados y los del grupo de comparación y crear las ponderaciones que se emplearon para evaluar el efecto medio del tratamiento sobre los tratados (ATT) en el estimador de diferencias en diferencias. Hubo 2.771 hospitalizaciones por ACV en 2010 (0,51% de todas las hospitalizaciones) y 11.542 (2%) en 2019. Los municipios que aplicaron el PAS tuvieron un 18,37% menos de hospitalizaciones en comparación con sus homólogos del grupo de comparación. El impacto del programa en la reducción de las tasas de hospitalización fue gradualmente mayor entre los hombres (ATT: -0,1932) y entre las personas de 71 a 80 años (ATT: -0,1911). Todos los resultados fueron estadísticamente significativos al nivel del 5%. El PAS redujo la hospitalización por ACV en varios grupos de población, pero principalmente en aquellos en los que la prevalencia subyacente de ACV es mayor, lo que refuerza la importancia de las inversiones públicas en políticas de promoción de la salud diseñadas para impulsar cambios en los estilos de vida.
Evaluación de Programas y Proyectos de Salud;
Enfermedad Crónica; Promoción de la Salud;
Puntaje de Propensión; Accidente CerebrovascularPernambuco State Foundation for the Support of Science and Technology (FACEPE), and the Brazilian National Research Council (CNPq)
2 nd Brazilian Consensus on Chagas Disease, 2015
Abstract Chagas disease is a neglected chronic condition with a high burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. It is hoped that this document will strengthen the development of integrated actions against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research
O perfil das readmissões de idosos num hospital geral de Marília/SP El perfil de los reingresos de ancianos en un hospital general del municipio de Marília, SP The profile of elderly patients' readmissions in a general hospital located in Marília/SP
Estudo descritivo sobre readmissões de idosos em hospital geral, no município de Marília-SP, em 1996/1997. OBJETIVOS: Caracterizar o perfil das readmissões, quanto às variáveis sexo, idade, estado civil, naturalidade, profissão, diagnósticos principal e secundário, tempo de permanência hospitalar, tipo de saída, fonte de financiamento, tipo de procedimento e intervalo de tempo entre as admissões; analisar registros da enfermagem, nos prontuários, sobre as condições à admissão e alta. Construído banco de dados sobre admissões, adotando o "software" Epi-Info 6. Pesquisados 262 idosos (53,8% mulheres) que apresentaram 502 readmissões; 32,8% destes foram readmitidos uma vez e 55,9% retornaram à instituição em menos de 60 dias. Média de idade 73,2 anos e de permanência hospitalar 5,49 dias. Predominaram as doenças crônicas respiratórias e 55,8% das readmissões apresentaram diagnóstico secundário. Análise do conteúdo dos registros permitiu identificar a rotina da enfermagem, revelando apenas alguns aspectos da condição dos idosos à recepção e saída.<br>Estudio descriptivo sobre el reingreso del anciano en un hospital general en el municipio de Marília-SP, en 1996/1997. OBJETIVOS: caracterizar el perfil de los reingresos en relación con las variables sexo, edad, estado civil, naturalidad, profesión, diagnósticos principal y secundario, tiempo de permanencia hospitalaria, tipo de salida, fuente de financiación, tipo de procedimiento e intervalo de tiempo entre los reingresos; analizar registros de enfermería en las historias clínicas de los ancianos, sobre sus condiciones de admisión y alta. Se construyó un banco de datos sobre admisiones, adoptando el "software" Epi-Info 6. Se investigaron 262 ancianos (53,8% mujeres) que presentaron 502 reingresos; 32,8% de estos reingresaron una vez y 55,9% retornaron a la institución en menos de 60 días. El promedio de edad fue de 73,2 años y la estancia hospitalaria de 5,49 días. Predominaron las enfermedades crónicas del sistema respiratorio y 55,8% de los reingresos presentaron diagnóstico secundario. El análisis de contenido de las notas de enfermería identificó rutina en la práctica de enfermería revelando solamente algunos aspectos de la situación de los ancianos a la recepción y la salida.<br>This is a descriptive study about the readmissions of elderly patients in a general hospital located in the city of Marília, São Paulo, Brazil, in 1996 and 1997. OBJECTIVES: characterizing the readmission profile with respect to the following variables: gender, age, marital status, origin, profession, main and secondary diagnoses, time of hospitalization, type of discharge, financing source, type of procedure and interval between hospitalizations; analyzing the nursing notes in the patients' records about health conditions at the time of admission and discharge. A database about admissions was compiled by using the Epi-Info 6 software. The research population consisted of two hundred sixty-two elderly patients (53.8% of whom were female), who presented 502 readmissions; 32.8% of these occurred once and 55.9% took place in less than 60 days. The patients' mean age was 73.2 years and the average time of hospitalization was 5.49 days. Chronic respiratory diseases predominated and 55.8% of the readmitted patients presented a secondary diagnosis. The content analysis of the notes identified the nursing routine and revealed only some of the aspects concerning the elderly persons' conditions at the time of admission and discharge
Recombinant NAD-dependent SIR-2 Protein of Leishmania donovani: Immunobiochemical Characterization as a Potential Vaccine against Visceral Leishmaniasis
Development of Novel Prime-Boost Strategies Based on a Tri-Gene Fusion Recombinant L. tarentolae Vaccine against Experimental Murine Visceral Leishmaniasis
Functionalization of polymers and nanomaterials for water treatment, food packaging, textile and biomedical applications: a review
A New Boson with a Mass of 125 GeV Observed with the CMS Experiment at the Large Hadron Collider
The Higgs boson was postulated nearly five decades ago within the framework of the standard model of particle physics and has been the subject of numerous searches at accelerators around the world. Its discovery would verify the existence of a complex scalar field thought to give mass to three of the carriers of the electroweak force-the W+, W-, and Z 0 bosons-as well as to the fundamental quarks and leptons. The CMS Collaboration has observed, with a statistical significance of five standard deviations, a new particle produced in proton-proton collisions at the Large Hadron Collider at CERN. The evidence is strongest in the diphoton and four-lepton (electrons and/or muons) final states, which provide the best mass resolution in the CMS detector. The probability of the observed signal being due to a random fluctuation of the background is about 1 in 3 x 106. The new particle is a boson with spin not equal to 1 and has a mass of about 1.25 giga-electron volts. Although its measured properties are, within the uncertainties of the present data, consistent with those expected of the Higgs boson, more data are needed to elucidate the precise nature of the new particle