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Brazilian primary care

Marcos Augusto Bastos Dias, Rosa Maria Soares Madeira Domingues, Arthur Orlando Corrêa Schilithz, Marcos Nakamura-Pereira, Maria do Carmo Leal
BACKGROUND: The rate of cesarean delivery (CD) in Brazil has increased over the past 40 years. The CD rate in public services is three times above the World Health Organization recommended values. Among strategies to reduce CD, the most important is reduction of primary cesarean. This study aimed to describe factors associated with CD during labor in primiparous women with a single cephalic pregnancy assisted in the Brazilian Public Health System (SUS). METHODS: This study is part of the Birth in Brazil survey, a national hospital-based study of 23,894 postpartum women and their newborns...
October 17, 2016: Reproductive Health
Nilton Lavatori Correa, Lidia Vasconcellos de Sá, Rossana Corbo
: An increase in the incidence of second primary cancers (SPC) is the late effect of greatest concern that could occur in differentiated thyroid carcinoma (DTC) patients treated with radioactive iodine (RAI). The decision to treat a patient with RAI should therefore incorporate a careful risk-benefit analysis. The objective of this work is to adapt the risk estimation models developed by the Biological Effects of Ionizing Radiation Committee (BEIR VII) to local epidemiological characteristics, to assess the carcinogenesis risk from radiation in a population of Brazilian DTC patients treated with RAI...
October 20, 2016: Thyroid: Official Journal of the American Thyroid Association
Pedro Nazareth Aguiar, Gustavo Trautman Stock, Gilberto de Lima Lopes, Michelle Samora de Almeida, Hakaru Tadokoro, Bárbara de Souza Gutierres, Douglas Antônio Rodrigues
Objective: To assess aspects related to cancer in indigenous population. Methods: This is a retrospective study developed in a public university hospital. We included patients with 18 or more years of age, diagnosed with solid tumors, and followed between 2005 and 2015. Clinical features were assessed by descriptive statistics, and survival was evaluated by Kaplan-Meier curves and multivariate Cox regression. Results: Fifty patients were included...
July 2016: Einstein
Renata Castro Martins, Clarice Magalhães Rodrigues Dos Reis, Antonio Thomaz Gonzaga da Matta Machado, João Henrique Lara do Amaral, Marcos Azeredo Furquim Werneck, Mauro Henrique Nogueira Guimarães de Abreu
This cross-sectional study evaluated the relationship between primary and secondary oral health care in Brazil. For this purpose, data from the National Program for Improving Access and Quality of Primary Care were used. Dentists from 12,403 oral health teams (OHTs) answered a structured questionnaire in 2012. The data were analyzed descriptively and by cluster analysis. Of the 12,387 (99.9%) OHTs that answered all the questions, 62.2% reported the existence of Dental Specialties Centers (DSCs) to which they could refer patients...
2016: PloS One
Patricia Bartholomay, Daniele Maria Pelissari, Wildo Navegantes de Araujo, Zaida E Yadon, Einar Heldal
Objective To assess 1) the burden and socio-demographic and clinical characteristics of tuberculosis (TB) cases, and 2) the quality of TB care provided to patients who entered and remained within each health care service level (primary, secondary, or tertiary) and those who moved from one level to another, using process and results indicators. Methods This cross-sectional operational research study assessed new smear-positive pulmonary TB cases diagnosed in Brazilian state capitals in 2013 using TB program records and the TB surveillance system...
January 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
David S Younger
A network of family-based community-oriented primary health programs, or Programa Agentes Communita˙rios de Saúde, and family health programs, or Programa Saúde da Família, introduced almost 2 decades ago were the Brazilian government's health care models to restructure primary care under the Unified Health System, or Sistema Único de Saúde. The latter offers comprehensive coverage to all, although it is used by those of lower income, and despite achievement in the last quarter century, access to health services and gradients of health status continue to persist along income, educational background, racial, and religious lines...
November 2016: Neurologic Clinics
Luana Sicuro Correa, Yara Hahr Marques Hökerberg, Raquel de Vasconcellos Carvalhaes de Oliveira, Danielle Martins de Souza Barros, Helenara Abadia Ferreira Alexandria, Regina Paiva Daumas, Carlos Augusto Ferreira de Andrade, Sonia Regina Lambert Passos, Patrícia Brasil
OBJECTIVE: The aim of this study was to describe the use of dengue warning signs by pediatric healthcare staff in the Brazilian public health care system. METHODS: Cross-sectional study (2012) with physicians, nurses, and nurse technicians assisting children in five health care facilities. Participants reported the use and importance of dengue warning signs in pediatrics clinical practice through a structured questionnaire. Differences in the use of signs (chi-square test) and in the ranking assigned to each of them (Kruskal-Wallis) were assessed according to health care occupation and level of care (p<0...
2016: PloS One
Karen Athié, Alice Lopes do Amaral Menezes, Angela Machado da Silva, Monica Campos, Pedro Gabriel Delgado, Sandra Fortes, Christopher Dowrick
BACKGROUND: Community-based primary mental health care is recommended in low and middle-income countries. The Brazilian Health System has been restructuring primary care by expanding its Family Health Strategy. Due to mental health problems, psychosocial vulnerability and accessibility, Matrix Support teams are being set up to broaden the professional scope of primary care. This paper aims to analyse the perceptions of health professionals and managers about the integration of primary care and mental health...
September 30, 2016: BMC Health Services Research
Paulo César Brandão Veiga Jardim, Weimar Kunz Sebba Barroso de Souza, Renato Delascio Lopes, Andréa Araújo Brandão, Marcus V Bolívar Malachias, Marco Mota Gomes, Heitor Moreno Júnior, Eduardo Costa Duarte Barbosa, Rui Manoel Dos Santos Póvoa
BACKGROUND: A registry assessing the care of hypertensive patients in daily clinical practice in public and private centers in various Brazilian regions has not been conducted to date. Such analysis is important to elucidate the effectiveness of this care. OBJECTIVE: To document the current clinical practice for the treatment of hypertension with identification of the profile of requested tests, type of administered treatment, level of blood pressure (BP) control, and adherence to treatment...
August 2016: Arquivos Brasileiros de Cardiologia
Elaine Amaral de Paula, Mônica Barros Costa, Fernando Antonio Basile Colugnati, Rita Maria Rodrigues Bastos, Chislene Pereira Vanelli, Christiane Chaves Augusto Leite, Márcio Santos Caminhas, Rogério Baumgratz de Paula
OBJECTIVE: to assess the structure and results obtained by the "Chronic Renal Patients Care Program" in a Brazilian city. METHOD: epidemiological, cross-sectional study conducted in 14 PHC units and a secondary center from 2010 to 2013. The Donabedian Model was the methodological framework used. A total of 14 physicians, 13 supervisors, and 11 community health agents from primary healthcare were interviewed for the assessment of structure and process and 1,534 medical files from primary healthcare and 282 from secondary care were consulted to assess outcomes...
July 11, 2016: Revista Latino-americana de Enfermagem
Miguel Nasser Hissa
BACKGROUND: Diabetes mellitus (DM) is considered a global epidemic, and patient self-management education and support are critical in preventing and reducing the risk of complications. Self-monitoring of blood glucose (SMBG) is essential for care of individuals with DM, helping patients to achieve and maintain target blood glucose levels. The purpose of this study is to compare the satisfaction of insulinized DM patients on SMBG with use of investigational blood glucose meter (BGM) versus their routine device...
2016: Diabetology & Metabolic Syndrome
Jesús Montero-Marín, Jorge Gaete, Marcelo Demarzo, Baltasar Rodero, Luiz C Serrano Lopez, Javier García-Campayo
BACKGROUND: The use of the Self-Compassion Scale (SCS) as a single measure has been pointed out as problematic by many authors and its originally proposed structure has repeatedly been called into question. The negative facets of this construct are more strongly related to psychopathology than the positive indicators. The aim of this study was to evaluate and compare the different structures proposed for the SCS, including a new measure based only on the negative factors, and to assess the psychometric features of the more plausible solution...
2016: Frontiers in Psychology
Rosangela Barbiani, Carlise Rigon Dalla Nora, Rafaela Schaefer
OBJECTIVE: to identify and categorize the practices performed by nurses working in Primary Health Care and Family Health Strategy Units in light of responsibilities established by the profession's legal and programmatic frameworks and by the Brazilian Unified Health System. METHOD: a scoping review was conducted in the following databases: LILACS, IBECS, BDENF, CINAHL and MEDLINE, and the Cochrane and SciELO libraries. Original research papers written by nurses addressing nursing practices in the primary health care context were included...
2016: Revista Latino-americana de Enfermagem
Ana Luiza Vilela Borges, Geraldine Barrett, Osmara Alves Dos Santos, Natalia de Castro Nascimento, Fernanda Bigio Cavalhieri, Elizabeth Fujimori
BACKGROUND: Estimates of unplanned pregnancy worldwide are of concern, especially in low and middle-income countries, including Brazil. Although the contraceptive prevalence rate is high in Brazil, almost half of all pregnancies are reported as unintended. The only source of nationally representative data about pregnancy intention is the Demographic and Health Survey, as with many other countries. In more recent years, however, it has been realized that concept of unintended pregnancy is potentially more complex and requires more sophisticated measurement strategies, such as the London Measure of Unplanned Pregnancy (LMUP)...
2016: BMC Pregnancy and Childbirth
Mariana Charantola Silva, Marina Peduzzi, Carine Teles Sangaleti, Dirceu da Silva, Heloise Fernandes Agreli, Michael A West, Neil R Anderson
OBJECTIVE: To adapt and validate the Team Climate Inventory scale, of teamwork climate measurement, for the Portuguese language, in the context of primary health care in Brazil. METHODS: Methodological study with quantitative approach of cross-cultural adaptation (translation, back-translation, synthesis, expert committee, and pretest) and validation with 497 employees from 72 teams of the Family Health Strategy in the city of Campinas, SP, Southeastern Brazil. We verified reliability by the Cronbach's alpha, construct validity by the confirmatory factor analysis with SmartPLS software, and correlation by the job satisfaction scale...
June 10, 2016: Revista de Saúde Pública
Sonia Maria Martins, William Salibe-Filho, Luís Paulo Tonioli, Luís Eduardo Pfingesten, Patrícia Dias Braz, Juliet McDonnell, Siân Williams, Débora do Carmo, Jaime Correia de Sousa, Hilary Pinnock, Rafael Stelmach
Asthma and chronic obstructive pulmonary disease (COPD) are leading causes of hospitalisation and death in the city of Sao Bernardo do Campo. The municipality had difficulties in sustaining a pulmonology specialist team. Local policy has strengthened the knowledge of the primary care teams to improve the management of these diseases. Our aim is to pilot the implementation of an educational intervention based on collaborative care focused on reducing respiratory-related referrals. We implemented 'matrix support': a Brazilian collaborative educational intervention promoting specialist training and support for primary care physicians in three health territories with the highest number of referrals...
2016: NPJ Primary Care Respiratory Medicine
Felipe Machado Huguenin, Rejane Sobrino Pinheiro, Renan Moritz Varnier Rodrigues Almeida, Antonio Fernando Catelli Infantosi
INTRODUCTION: The global epidemiologic scenario indicates an increase in cardiovascular disease rates, with special emphasis on acute myocardial infarction (AMI), owing to its large magnitude and severity. In Brazil, coronary diseases now account for about 5% of hospital admission expenditures. OBJECTIVE: To characterize the admissions in the Brazilian Unified Health System of patients with AMI, by identifying clusters suggested by a traditional cluster analysis and by a multiple correspondence analysis (MCA)...
April 2016: Revista Brasileira de Epidemiologia, Brazilian Journal of Epidemiology
Luís Carlos Lopes-Júnior, Paulo Marcondes Carvalho Júnior, Victor Evangelista de Faria Ferraz, Lucila Castanheira Nascimento, Marcia Van Riper, Milena Flória-Santos
Recent advances in genomics and related technologies have the potential to improve health care throughout the world. In this cross-sectional study, we examine genetics education, knowledge, and genetics-related experiences among the nurses and physicians who provide primary care in a Brazilian city. Fifty-four healthcare professionals from family health units participated in the study (response rate: 90%). Data were collected using a structured 36-item questionnaire divided into five axes: sociodemographic data and academic background; genetics education; genetics knowledge; genetics-related experiences in family practice; and knowledge regarding the National Policy for Comprehensive Care in Clinical Genetics in the Unified Health System...
August 11, 2016: Nursing & Health Sciences
Ingrid Margareth Voth Lowen, Aida Maris Peres, Karla Crozeta, Elizabeth Bernardino, Carmem Lúcia Colomé Beck
OBJECTIVE: To relate the managerial competencies required of nurses with the process of change experienced in the expansion of the Family Health Strategy (FHS). METHOD: A qualitative research conducted in primary health care in a southern Brazilian city, through interviews with 32 managerial and clinical nurses. The interviews were processed by IRAMUTEQ software. The resulting classes were examined under five managerial competencies to promote change. RESULTS: The four classes obtained from data were: the Family Health Strategy expansion process; confrontations and potentialities; mobilization for the change; innovations in medical and nursing consultations...
December 2015: Revista da Escola de Enfermagem da U S P
Joanna d'Arc Lyra Batista, Mariana Vargas Furtado, Natan Katz, Milena Rodrigues Agostinho, Brasil Silva Neto, Erno Harzheim, Carisi Anne Polanczyk
BACKGROUND: Many Brazilian patients with complex diseases who are treated in tertiary referral clinics have been stable for long periods. The main needs of these patients involve monitoring of risk factors and review of drug prescriptions, which could be satisfactorily done in primary care facilities. The goal of this protocol is to evaluate the safety and effectiveness of telemedicine services to support the transition of patients with stable chronic coronary artery disease from the tertiary to the primary level of care...
2016: BMC Health Services Research
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