Uso da prescrição eletrônica como estratégia de segurança do paciente

Introdução: O erro de medicação pode trazer graves consequências. A cada ano nos Estados Unidos ocorre em média 1,5 milhões de eventos adversos evitáveis, além do gasto de 3,5 bilhões de dólares em todo o país. De acordo com os dados do Sistema de Notificações em Vigilância Sanitária (NOTIVISA) entre junho de 2019 e maio de 2020 foram notificados 151.442 incidentes associados à assistência de saúde, sendo que os erros na terapia medicamentosa representam uma grande parcela dessas ocorrências. Objetivo: Analisar o uso da prescrição eletrônica como estratégia de segurança do paciente. Metodologia: Trata-se de uma revisão integrativa da literatura realizada na biblioteca virtual SCIELO e nas seguintes bases de dados: MEDLINE, LILACS e BDENF, utilizando os seguintes descritores presentes no Descritores em Ciências da Saúde (DECS): “prescrição eletrônica”, “erro de medicação” e “segurança do paciente”, cruzando com o operador booleano AND. Foram incluídos artigos em português, completos, de livre acesso, publicados entre 2016 e 2022, e excluídos artigos duplicados, que não respondessem à questão de pesquisa, teses e carta ao leitor. Resultados e Discussão: Conforme os critérios de inclusão e exclusão foram selecionados 10 artigos para compor a pesquisa.  Foi encontrado nos estudos dentre os vários benefícios da PE, a melhora na legibilidade e disponibilidade da prescrição, cuidado continuado de maneira mais adequado, o que reduz erros de medicação. Apesar dos inúmeros benefícios a prescrição eletrônica, ela não deve ser encarada como garantia de que não haverá erros, pois se não for usada corretamente não irá atingir o objetivo proposto.  Considerações Finais: Os estudos evidenciaram que a prescrição eletrônica tem inúmeros benefícios, porém, não pode ser usada como uma ferramenta que irá por fim e solucionar todos os erros relacionados à prescrição de medicamentos

Tendência de suicídio em adolescentes brasileiros entre 1997-2016

Objective: to analyze the suicide mortality trend in Brazilian adolescents from 1997 to 2016. Method: ecological study of time series; Prais-Winsten regression was used. Results: 14,852 suicide deaths were recorded, with mortality rates per 100,000 inhabitants of 1.95 in 1997, 2.65 in 2016 and average of 2.14 in the period 1997-2016; deaths predominated in males (67.59%), due to intentional self-harm (84.19%) and occurring at home (52,69%); the Midwest region had the highest rate in the period (3.71 / 100,000 inhabitants), with emphasis on Mato Grosso do Sul (8.3 / 100,000 inhabitants); there was a tendency towards an increase by 1.35% per year in suicide in the general adolescent population (CI95%: 0.56; 2.15), 1.63% in males (CI95%: 0.56 ; 2.29), 3.11% in the North (CI95%: 2.25; 3.98) and 4.19% in the Northeast (CI95%: 2.58; 5.84). Conclusion: suicide mortality in Brazilian adolescents showed an upward trend in the period studied.Objetivo: analisar a tendência da mortalidade por suicídio em adolescentes brasileiros no período de 1997 a 2016. Método: estudo ecológico de séries temporais; empregou-se regressão de Prais-Winsten. Resultados: foram registrados 14.852 óbitos por suicídio, com taxas de mortalidade por 100.000 habitantes de 1,95 em 1997, 2,65 em 2016 e média de 2,14 no período 1997-2016; predominaram óbitos no sexo masculino (67,59%), por lesões autoprovocadas intencionalmente (84,19%) e ocorridos no domicílio (52,69%); a região Centro-Oeste apresentou a maior taxa no período (3,71/100.000 hab.), com destaque para Mato Grosso do Sul (8,3/100.000 hab.); observou-se tendência de aumento de 1,35% ao ano na mortalidade por suicídio na população geral de adolescentes (IC95% 0,56; 2,15), 1,63% no sexo masculino (IC95% 0,56; 2,29), 3,11% na região Norte (IC95% 2,25; 3,98) e 4,19% no Nordeste (IC95% 2,58; 5,84). Conclusão: a mortalidade por suicídio em adolescentes brasileiros mostrou tendência ascendente no período estudado

Conhecimentos dos clientes de uma loja de suplementos alimentares sobre a alimentação saúdavel e fatores associados

Objective: To evaluate the knowledge of customers of a food supplement store about healthy eating and associated factors. Materials and Methods: This is an analytical, cross-sectional study with a quantitative approach. This study was carried out in a shop that markets food supplements in the city of Montes Claros-MG. Participants were selected by convenience and intentionally selected clients, who accepted to respond to the questionnaires, which were over 18 years of age. Questionnaires were used to evaluate socio-demographic and economic characteristics, life habits, physical activity level, smoking, alcohol consumption, weight loss treatment and Body Mass Index. To assess knowledge about healthy eating and the use of dietary supplements, subjects responded to a questionnaire adapted from Zamin and Schimanoski (2010). Results: With regard to knowledge about healthy eating, 91.8% of respondents stated that they had very good/sufficient knowledge about this practice and 60.7% believe that healthy eating is indispensable in the practice of physical activity. There was a significant association between knowledge about healthy eating with the variables: schooling (p=0.023), number of daily meals (p=0.020), knowledge about dietary supplements (p=0.003) and physical activity practice (p=0.028). Conclusion: It is concluded that people have increasingly sought knowledge about healthy eating to meet their food needs and that factors such as level of schooling, number of daily meals, knowledge about dietary supplements and physical activity are factors that are associated with knowledge about healthy eating in this population.Objetivo: Avaliar conhecimento dos clientes de uma loja de suplementos alimentares sobre alimentação saudável e fatores associados. Materiais e Métodos: Trata-se de um estudo do tipo analítico, transversal, com abordagem quantitativa. Este estudo foi realizado em uma loja que comercializa suplementos alimentares na cidade Montes Claros-MG. Participaram 61 clientes selecionados por conveniência e de forma intencional, que aceitaram responder aos questionários, que apresentaram idade superior a 18 anos. Foram aplicados questionários que avaliavam as características sociodemográficas e econômicas, hábitos de vida, nível de atividade física, tabagismo, etilismo, tratamento para perder peso e Ãndice de Massa Corporal. Para avaliar o conhecimento acerca da alimentação saudável e o uso de suplementos alimentares, os indivíduos responderam a um questionário adaptado de Zamin e Schimanoski (2010). Resultados: Com relação ao conhecimento sobre alimentação saudável, 91,8% dos entrevistados afirmaram ter conhecimento muito bom/suficiente sobre esta prática e 60,7% acreditam que a alimentação saudável é indispensável na prática de atividade física. Houve associação significativa entre o conhecimento sobre alimentação saudável com as variáveis: escolaridade (p=0,023), número de refeições diárias (p=0,020), conhecimento sobre suplementos alimentares (p=0,003) e prática de atividade física (p= 0,028). Conclusão: Conclui-se que pessoas tem buscado cada vez mais conhecimento sobre a alimentação saudável para suprir suas necessidades alimentares e que fatores como nível de escolaridade, número de refeições diárias, conhecimento sobre o sobre suplementos alimentares e prática de atividade física, são fatores que se associam ao conhecimento sobre alimentação saudável dessa população

Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM2.5 air pollution, 1990-2019 : an analysis of data from the Global Burden of Disease Study 2019

Background Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2.5 originating from ambient and household air pollution.Methods We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2.5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure-response curve from the extracted relative risk estimates using the MR-BRT (meta-regression-Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2.5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2.5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals.Findings In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2.5 exposure, with an estimated 3.78 (95% uncertainty interval 2.68-4.83) deaths per 100 000 population and 167 (117-223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13.4% (9.49-17.5) of deaths and 13.6% (9.73-17.9) of DALYs due to type 2 diabetes were contributed by ambient PM2.5, and 6.50% (4.22-9.53) of deaths and 5.92% (3.81-8.64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2.5.Interpretation Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2.5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.Peer reviewe

Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM2.5 air pollution, 1990-2019 : An analysis of data from the Global Burden of Disease Study 2019

Background Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2·5 originating from ambient and household air pollution. Methods We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2·5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure–response curve from the extracted relative risk estimates using the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2·5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2·5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals. Findings In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2·5 exposure, with an estimated 3·78 (95% uncertainty interval 2·68–4·83) deaths per 100 000 population and 167 (117–223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13·4% (9·49–17·5) of deaths and 13·6% (9·73–17·9) of DALYs due to type 2 diabetes were contributed by ambient PM2·5, and 6·50% (4·22–9·53) of deaths and 5·92% (3·81–8·64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2·5. Interpretation Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2·5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

A experiência de se elaborar uma tecnologia cuidativo-educacional à luz da Teoria das Transições

Objective: to report the experience of the first phase of the development of a care-educational technology for the promotion of children’s mental health. Method: this is an experience report about the first phase of the elaboration of a manual in the light of Meleis’ Transitions Theory and Goleman’s Emotional Intelligence Model. Results: the manual should be prepared considering childhood as a period of a developmental nature, having as facilitators the school and the child’s positive emotional characteristics, which may be inhibited by factors related to the negative social context. Regarding the pattern of response, it was expected that the manual would seek a pattern of positive emotional response from the child, through the promotion of mental health, from the strengthening of children’s emotional skills. Conclusion: the choice of Theory promotes effective communication and the use of Goleman's Emotional Intelligence Model enables the manual to obtain understanding, multiplication and execution.Objetivo: reportar la experiencia de la primera fase de la preparación de una tecnología educativa sobre el cuidado para la promoción de la salud mental infantil. Método: se trata de un relato de experiencia sobre la primera fase de la elaboración de un manual a la luz de la Teoría de las Transiciones de Meleis y del Modelo de Inteligencia Emocional de Goleman. Resultados: el guía debe ser preparado considerando la infancia como un período de carácter de desarrollo, teniendo como facilitadores la escuela y las características emocionales positivas del niño, que pueden ser inhibidas por factores relacionados con el contexto social negativo. En cuanto al patrón de respuesta, se esperaba que el guía buscara un patrón de respuesta emocional positiva del niño, mediante la promoción de la salud mental, a partir del fortalecimiento de las habilidades emocionales de los niños. Conclusión: la elección de la Teoría promueve la comunicación efectiva y el uso del Modelo de Inteligencia Emocional de Goleman posibilita que el TBI obtenga comprensión, multiplicación y ejecución.Objective: to report the experience of the first phase of the development of a care-educational technology for the promotion of children’s mental health. Method: this is an experience report about the first phase of the elaboration of a manual in the light of Meleis’ Transitions Theory and Goleman’s Emotional Intelligence Model. Results: the manual should be prepared considering childhood as a period of a developmental nature, having as facilitators the school and the child’s positive emotional characteristics, which may be inhibited by factors related to the negative social context. Regarding the pattern of response, it was expected that the manual would seek a pattern of positive emotional response from the child, through the promotion of mental health, from the strengthening of children’s emotional skills. Conclusion: the choice of Theory promotes effective communication and the use of Goleman's Emotional Intelligence Model enables the manual to obtain understanding, multiplication and execution

Perfil de medicamentos descartados pelos usuários do sistema único de saúde no município de Divinópolis-MG

O objetivo do estudo foi orientar profissionais e usuários do Sistema Único de Saúde (SUS) sobre o descarte e armazenamento de medicamentos, além de identificar o perfil de medicamentos descartados, em Divinópolis, Minas Gerais. As quatro etapas do estudo foram desenvolvidas de Março a Dezembro de 2014, a saber: 1) a escolha de doze Unidades de Saúde (Unidade Básica de Saúde ou Estratégia de Saúde da Família); 2)contato com a unidade de saúde para agendamento da palestra educativa; 3) realização da palestra e coleta dos medicamentos descartados; 4) Análise do perfil dos medicamentos coletados. Foram recolhidas 11.518 unidades de medicamentos, sendo 9.729 vencidos (84,5%). A forma farmacêutica mais encontrada foi o comprimido (95,2%). As classes farmacológicas mais coletadas foram os anti-hipertensivos (22,0%), hipoglicemiante oral (10,7%) e antiagregante plaquetário (10,6%). Observou-se elevada frequência de medicamentos vencidos, o que evidencia a necessidade de estratégias educativas para pacientes e equipe de saúde

Armazenamento e descarte de medicamentos:: Estratégia educativa e perfil de medicamentos descartados

The objective of study was guide health professionals and users of Brazilian Public Health System (Sistema Único de Saúde -SUS) about the disposal and storage of drugs, besides to identify the discarded drug profile, in Divinópolis city, Minas Gerais. The four stages of the study were developed from March to December 2014: 1) 12 health care centers selected (Primary health care units); 2) contact with health care centers for scheduling the educational lecture; 3) educational lecture and drugs collection were done; 4) Analysis of the drugs profile. It were collected 11,518 unit of drugs, 9,729 (84.5%) was expired. The most frequent pharmaceutical form was tablets (95.2%). The most collected pharmacological classes were anti-hypertensive (22.0%), oral hypoglycemic agents (10.7%) and antiplatelet (10.6%). There was a high frequency of expired drugs, which highlights the need for educational strategies for patients and health professionalsO objetivo do estudo foi orientar profissionais e usuários do Sistema Único de Saúde (SUS) sobre o descarte e armazenamento de medicamentos, além de identificar o perfil de medicamentos descartados, em Divinópolis, Minas Gerais. As quatro etapas do estudo foram desenvolvidas de Março a Dezembro de 2014, a saber: 1) a escolha de doze Unidades de Saúde (Unidade Básica de Saúde ou Estratégia de Saúde da Família); 2)contato com a unidade de saúde para agendamento da palestra educativa; 3) realização da palestra e coleta dos medicamentos descartados; 4) Análise do perfil dos medicamentos coletados. Foram recolhidas 11.518 unidades de medicamentos, sendo 9.729 vencidos (84,5%). A forma farmacêutica mais encontrada foi o comprimido (95,2%). As classes farmacológicas mais coletadas foram os antihipertensivos (22,0%), hipoglicemiante oral (10,7%) e antiagregante plaquetário (10,6%). Observou-se elevada frequência de medicamentos vencidos, o que evidencia a necessidade de estratégias educativas para pacientes e equipe de saúde.El objetivo fue orientar a los profesionales y usuarios del Sistema Único de Salud (SUS) sobre la eliminación y el almacenamiento de los medicamentos e identificar el perfil de medicamentos eliminados, en Divinópolis, Minas Gerais. Las cuatro etapas del estudio se han desarrollado de marzo a diciembre de 2014:1) la elección de doce Unidades de Salud (atención primaria de salud); 2) en contacto con la unidad de salud para la programación; 3) la realización de la charla y la recogida de los medicamentos eliminados; 4) el análisis del perfil de los medicamentos recogidos. Fueron recogidos 11.518 unidades de medicamentos, sendo 9.729 se encontraban fuera del período de validez (84,5%). La forma farmacêutica mas encontrada fue el comprimido (95,2%). Las clases farmacológicas mas encontradas fueron antihipertensivos (22,0%), hipoglucemiantes orales (10,7%) y antiagregantes (10,6%). Se notó alta frecuencia de productos caducados, que pudo envidenciar la necesidad de estrategias educativa