O SAGE aplica os princípios da medicina baseada em evidências e estabeleceu um processo metodológico completo para emitir ou atualizar recomendações. Especificamente para vacinas contra a COVID-19, uma descrição detalhada dos processos metodológicos pode ser encontrada no esquema de evidênc...ias do SAGE para vacinas contra a COVID-19. Esse esquema contém orientações sobre como levar em consideração os dados provenientes de ensaios clínicos em apoio à emissão de recomendações baseadas em evidências específicas para vacinas.
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La técnica diagnóstica ampliamente usada a nivel mundial corresponde a la Prueba de Tuberculina o test de Mantoux, la que a través de la inyección de antígenos de Micobacterium tuberculosis permite medir la reacción del individuo y estimar su probabilidad de infección. El presente manual tie...ne como objetivo describir la técnica para la realización del examen, además de ofrecer lineamientos para su uso programático en Chile.
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Este documento incluye los resultados de un proceso de elaboración rápida de guías. La información incluida en esta guía refleja la evidencia a la fecha publicada en el documento. Las recomendaciones se basaron en la evidencia disponible y su calidad (metodología GRADE) en el momento en que s...e publicó la guía. Sin embargo, reconociendo que hay numerosas investigaciones en curso, la Organización Panamericana de la Salud actualizará de forma periódica estas revisiones y las recomendaciones correspondientes.
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Las infecciones del sitio quirúrgico (ISQ) constituyen una de las Infecciones Asociadas al Cuidado de la Salud (IACS) más frecuentes que ponen en riesgo a los pacientes llevando muchas veces al fracaso del procedimiento quirúrgico. Con una incidencia mucho mayor en países de medianos y bajos ing...resos, representa un desafío de la práctica médica cotidiana que compromete la salud y la seguridad de los pacientes. La indicación de profilaxis primaria con antibióticos en relación a los procedimientos invasivos, tiene como objetivo disminuir la incidencia de infecciones con la consecuente disminución de la morbimortalidad debiendo utilizarse únicamente en aquellos procedimientos en los que hay evidencia de efectividad. Cabe destacar que la indicación inadecuada, tiene potenciales efectos adversos tales como infecciones por Clostridium difficile, emergencia de resistencia
bacteriana, reacciones adversas a drogas e incremento de los costos en salud.
La profilaxis antibiótica como complemento de una buena técnica quirúrgica, es una medida costo efectiva de prevención de las ISQ representando alrededor del 30% de la indicación de antibióticos entre los pacientes hospitalizados. Dado que en algunos estudios el uso inapropiado de antibióticos se ve reflejado en el 40 al
80% de las indicaciones médicas, desde la Comisión de Infecciones Asociadas al Cuidado de la Salud y Seguridad del Paciente de SADI hemos realizado una actualización de la evidencia disponible. Este documento es una acción complementaria al consenso “Prevención de Infección del Sitio Quirúrgico” realizado entre SADI y el Instituto Nacional de Epidemiología “J. Jara” durante el Congreso de SADI 2015.
La posibilidad de contar con una guía actualizada de profilaxis quirúrgica adaptada a nuestro medio, constituye una herramienta de uso cotidiano por parte de los profesionales del equipo quirúrgico que permite la optimización de la utilización de fármacos restringiendo así la emergencia y diseminación de la resistencia bacteriana. Sin duda esperamos que pueda ser de utilidad para el equipo de salud.
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The WHO estimates that 19 million children aged 15 years or younger are visually impaired. Of these, 1.4 million are irreversibly blind and need visual rehabilitation interventions for full psychological and personal development. The remainder have visual problems that could be prevented or treated.... Identifying children with visual problems early in life so that they can benefit from medical and optical interventions remains a key challenge for most child eye health programmes. Reports from various low-and middle-income countries indicate that the age of children undergoing operation for cataract is frequently too high to achieve maximum benefit.
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The World Health Organization (WHO) and the global community of countries, partners, donors, technical experts, scientists and field implementation teams continue to work towards the ultimate goal of a world free of the burden of neglected tropical diseases (NTDs).
Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a...sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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Trastornos externalizantes
Capítulo D.1.1
Edición: Matías Irarrázaval & Andres Martin
Traductores: Fernanda Prieto-Tagle & Carlos Gómez
This third regional report discusses gaps and challenges in reducing the harmful use of alcohol and how countries can reverse current trends in a cost-effective and expedited way.
L’un des principaux défis auxquels fait face le secteur de la santé au Togo est la mise à la disposition des décideurs, des partenaires et du public des données fiables, pertinentes et à temps opportun. Le présent annuaire des statistiques sanitaires a pour objectif, de contribuer à releve...r ce défi, en fournissant des informations de qualité sur le niveau de réalisation des plans d’action et des prestations de santé afin d’apprécier le niveau de performances de la mise en oeuvre des interventions à l’échelle du pays.
Cette publication retrace, sous forme de tableaux et de graphiques, les activités du département de la santé au Togo en 2016. Il s’agit : (i) des ressources en santé, (ii) de l’utilisation des services, (iii) des principales causes de morbidité et de mortalité, (iv) de la situation des maladies prioritaires et (v) des activités préventives et promotionnelles.
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Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to ...accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
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Vision 2030
Accessed: 17.11.2019
Medicina 2019, 55, 553; doi:10.3390/medicina55090553
Results: Twenty-one studies were analyzed, most of them demonstrating an association between the existence of burnout and the worsening of patient safety. High levels of burnout is more common among physicians and nurses, and it is associated wit...h external factors such as: high workload, long journeys, and ineffective interpersonal relationships. Good patient safety practices are influenced by organized workflows that generate autonomy for health professionals. Through meta-analysis, we found a relationship between the development of burnout and patient safety actions with a probability of superiority of 66.4%. Conclusion: There is a relationship between high levels of burnout and worsening patient safety.
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Blueprint for EECA countries, first edition