1,746,343 research outputs found
Factors associated with time interval between the onset of symptoms and first medical visit in women with breast cancer
No full textWomen presenting with advanced breast cancer tumors are common in Brazil. Little is known about factors contributing to the delay in seeking care. The aim of this study was to identify factors associated with longer time intervals between the onset of breast cancer symptoms and the first medical visit in the Federal District, Brazil. The analysis included 444 symptomatic women with incident breast cancer, interviewed between September, 2012 and September, 2014, during their admission for breast cancer treatment in nine public hospitals in the Federal District. Patients with metastatic disease at diagnosis were not included in this study. The outcome was time interval between symptom onset and the first medical visit, whether > 90 (34% of patients) or 90 day interval was significantly associated with patients not performing mammography and/or breast ultrasound in the two years prior to breast cancer diagnosis (OR = 1.97; 95%CI: 1.26-3.08), and with more advanced stages (OR = 1.72. 95%CI: 1.10-272). Furthermore, there was a lower chance of delay in patients with higher levels of education (OR = 0.95; 95%CI: 0.91-0.99). A relatively high proportion of breast cancer patients in the Brazilian Federal District experienced delay to attend the first medical consultation after the symptoms onset. Increasing breast cancer awareness, especially among women with low educational levels and those not participating in mammography screening programs could contribute to reduce this delay.Higher Education School of Health Sciences (ESCS)Escola Super Ciencias Saude, SMHN Quadra 3,Conjunto A,Bloco 1,Edificio Fepecs, BR-70710907 Brasilia, DF, BrazilUniv Estadual Paulista, Programa Posgrad Saude Colet, Botucatu, SP, BrazilSecretaria Estado Saude Dist Fed, Brasilia, DF, BrazilCtr Univ Dist Fed, Brasilia, DF, BrazilUniv Estadual Paulista, Programa Posgrad Saude Colet, Botucatu, SP, Brazi
Clinical pathways of breast cancer patients treated in the Federal District, Brazil
No full textFundacao de Ensino e Pesquisa em Ciencias da Saude da Secretaria de Estado de Saude do Distrito FederalFundacao de Ensino e Pesquisa em Ciencias da Saude da Secretaria de Estado de Saude do Distrito Federal: 41Fundacao de Ensino e Pesquisa em Ciencias da Saude da Secretaria de Estado de Saude do Distrito Federal: 064.000.455/2013OBJECTIVE: To identify the clinical pathways of women with breast cancer treated in public hospitals, and to analyze the factors that influence the time interval between the first appointment and the start of therapy. METHODS: A cross-sectional study was conducted with 600 women with breast cancer treated in nine public hospitals in the Brazilian Federal District. Patients were interviewed between September 2012 and September 2014. Simple and multiple logistic regression models were adjusted to evaluate the variables associated with the time interval studied. The most frequent pathway was the one that started in primary care with following care in the therapy service (28.9%). In the multiple adjustment, factors associated to a longer time interval between the first appointment and therapy were: lower family income (OR = 1.89; 95% CI 1.32-2.68), the first appointment in public services (OR = 1.78; 95% CI 1.20-2.64), care in more than two health services in the clinical pathway (OR = 1.71; 95% CI 1.19-2.44); and obtaining the anatomopathological analysis of the biopsy in public services instead of private health services (OR = 1.87; 95% CI 1.29-2.71). Independently, the implementation of specialist appointment scheduling, with care regulation, was associated with a shorter time interval between first appointment and therapy (OR = 0.33; 95% CI 0.16-0.65). CONCLUSIONS: We observed that multiple pathways were covered by women with breast cancer treated in public services of the Federal District. Socioeconomic iniquities and several aspectos of the pathways covered were associated with a longer time interval between the first appointment and the start of breast cancer therapy
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Prenatal care in high-risk pregnancies and associated factors in the city of Sao Paulo, Brazil
No full textThis study assessed prenatal care in high-risk pregnancies and associated factors in the city of Sao Paulo, Brazil. This was an evaluative study of 689 pregnant women referred from primary care (PHC) to specialized care in 2016. The type of PHC model was used as the main independent variable: family health units (USE), bask health units (UBS), and UBS/mixed. Multiple logistic regression models with forward selection were used for the outcomes early initiation of prenatal care and shared follow-up between specialized care and PHC: Referral by a USF was associated with higher odds of early initiation of prenatal care and shared follow-up between specialized care and PHC. Independently of the type of PHC, there were associations between early initiation of prenatal care and white skin color, and between shared follow-up between specialized care and PHC and having received a home visit. The results demonstrate the importance of services organized according to the USF model, which conducts home visits and is attuned to the implicit vulnerabilities in pregnant women's individual characteristics.Univ Estadual Paulista, Fac Med, Botucatu, SP, BrazilSecretaria Estado Saude Sao Paulo, Inst Saude, Sao Paulo, SP, BrazilUniv Sao Paulo, Sao Paulo, SP, BrazilUniv Fed Mato Grosso do Sul, Campo Grande, MS, BrazilUniv Estadual Paulista, Fac Med, Botucatu, SP, Brazi
Brazilian Primary Health Care strategies during the COVID-19 pandemic: A scoping review
No full textPrimary Health Care is the gateway for users to access the Brazilian healthcare sys-tem and has been particularly affected by the COVID-19 pandemic demands. This review systematically identified and mapped evidence regarding novel or adapted strategies developed within PHC during the COVID-19 pandemic in Brazil. Our results are presented as a narrative synthesis following the JBI methodology. They were analyzed and discussed through the lens of the Health Work Process Theory, which al-lowed us to categorize the publications into two principal domains of strategies, managerial and clinical, encompassing strategies that were new, adapted, or maintained in healthcare services. Two hundred twenty-six interventions were iden-tified (130 managerial and 96 clinical) from 49 studies. The new strategies appeared more fre-quently in both domains, while the maintained ones were less prevalent. The array of interven-tions highlights different care models, sometimes aligned with a biomedical approach. In contrast, others focus on comprehensiveness and longitu-dinality based on a person-centered care, in the family, and the community. Thus, this review identified that the same pre-pandemic challenges persist.Secretaria Estado Saude Sao Paulo, Secretaria Estado da Saude Sao Paulo, R Santo Antonio 590, BR-01314000 Sao Paulo, SP, BrazilUniv Estadual Paulista, Fac Med Botucatu, Programa Posgrad Saude Colet, Botucatu, SP, BrazilUniv Estadual Paulista, Fac Med Botucatu, Programa Posgrad Saude Colet, Botucatu, SP, Brazi
Universal COVID-19 testing in the obstetric population: impacts on public health
No full textUniv Estadual Paulista, Fac Med Botucatu, Av Prof Mario Rubens Guimaraes Montenegro S-N, BR-18618687 Botucatu, SP, BrazilUniv Fed Sao Carlos, Ctr Ciancias Biol & Saude, Sao Carlos, BrazilFundacao Oswaldo Cruz, Inst Nacl Saude Mulher Crianca & Adolescente Fern, Rio De Janeiro, BrazilUniv Fed Santa Catarina, Dept Ginecol & Obstet, Florianopolis, SC, BrazilUniv Estadual Paulista, Fac Med Botucatu, Av Prof Mario Rubens Guimaraes Montenegro S-N, BR-18618687 Botucatu, SP, Brazi
Health is politics... There is a great disorder under heaven: the "communal" experience of the 15th Congresso Paulista de Saude Publica
Get PDFThis text aims to present a hrief account of the preparatory activities of the 15' Con9resso Paulista de Saude Publica, held in the second half of 2017. Within the material that was used, there are not taken during the preparatory meetings, excerpts from the exchanged messages and, fundamentally, the living record contained in the memory of the authors, as participants in the organization process. We present then the contours of the necessary health politicization and the trends that were mainly ohserved in the activities carried out in all the regional centers of the Associacao Paulista de Saude Publica It was also highlighted the particularity of the congress, which presented a very innovative program proposal it was a forward-looking propulsive congress, composed by nine events hosted in the regions in which are located the association centers. The10th event (a closing activity) took place in Sao Paulo as a theoretical-political celehration. At last, we highlight the strengthening of associative ties and the consolidation of the organization into nuclei.Este texto tem por finalidade apresentar um breve relato das atividades preparatórias do 15º Congresso Paulista de Saúde Pública, realizado no segundo semestre de 2017. No material utilizado, estavam inclusas notas tomadas durante as reuniões preparatórias, trechos de mensagens trocadas e, fundamentalmente, o registro vivo contido na memória dos autores, enquanto participantes do processo de organização. Apresentamos, então, os contornos da necessária politização da saúde e as principais tendências observadas nas atividades desenvolvidas em todos os núcleos regionais da Associação Paulista de Saúde Pública. É realçada, ademais, a particularidade do congresso, que mostrou forte inovação na proposta de programa; foi um congresso desconstruído, em movimento, que contou com a realização de nove eventos nas regiões que sediam núcleos da associação. O décimo evento, realizado como atividade de finalização, ocorreu em São Paulo na forma de celebração teórico-política. Ao final, destacamos o fortalecimento dos laços associativos e a consolidação da organização em núcleos.Univ Sao Paulo, Fac Saude Publ, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Dept Med Prevent, Sao Paulo, SP, BrazilUniv Sao Paulo, Fac Med, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Dept Med Prevent, Sao Paulo, SP, BrazilWeb of Scienc
An experience of collective construction of a self-evaluation instrument in the service of medical education grounded in the National Curricular Guidelines and based on the More Doctors Program
No full textThis article presents the experience of construction of a self-evaluation instrument focusing on the new National Curricular Guidelines (DCN) for Medicine programs, published in 2014, which ground the pedagogical projects of medical schools' courses created in the context of the More Doctors Program. The methodology of construction of this tool was based on collective work and interprofessionality and involved different perspectives and types of knowledge in its conception, in the definition of dimensions, and in the election of indicators. After many negotiation rounds, the instrument was validated and has been used in medicine courses of Brazilian federal universities in a formative perspective of evaluation, favoring the identification of strengths and weaknesses of the courses' pedagogical projects, emphasizing the requirements of an education in and for the Brazilian National Health System (SUS). The inductive strength of the evaluation contributed to the affirmation of ideas-forces that are strategic to the implementation of counter-hegemonic processes in medical education.Univ Estadual Campinas Unicamp, Dept Estudos & Prat Culturais, Fac Educ, 801 Cidade Univ Zeferino Vaz, BR-13083865 Campinas, SP, BrazilUniv Estadual Paulista, Dept Saude Publ, Fac Med Botucatu, Botucatu, SP, BrazilInst Cosmos Ensino Super Ltda, Fac Cosmos Manaus, Manaus, Amazonas, BrazilFundacao Estatal Saude Familia, Salvador, BA, BrazilUniv Estadual Paulista, Dept Saude Publ, Fac Med Botucatu, Botucatu, SP, Brazi
Pro-Ensino na Saude: research on teacher education and teaching and working processes in the Brazilian National Health System (SUS), with emphasis on the reorientation of professional education in the area of Health
No full textUniv Sao Paulo, Dept Ortodontia & Odontopediat, Fac Odontol, Avenida Lineu Prestes 2227, BR-05508000 Sao Paulo, SP, BrazilUniv Estadual Paulista, Fac Med Botucatu, Dept Saude Publ, Botucatu, SP, BrazilUniv Fed Sao Paulo, Dept Saude Educ & Soc, Santos, SP, BrazilUniv Estadual Paulista, Fac Med Botucatu, Dept Saude Publ, Botucatu, SP, Brazi
Knowledge, attitudes and practices of primary care professionals about the food guide for children up to 2 years old: a cross-sectional study, Botucatu, Sao Paulo, 2023
No full textObjective: To investigate the knowledge, attitudes, and practices of primary health care professionals regarding breastfeeding and complementary feeding, according to the recommendations of the dietary guide for Brazilian children under 2 years of age. Methods: This is a descriptive study carried out from October to December 2023, using a self-administered online questionnaire aimed at physicians, nurses, and community health agents working in primary health care in Botucatu, Sao Paulo. A descriptive analysis and association between professional categories and their knowledge, attitudes, and practices regarding the content of the guide were performed using Pearson's chi-square test. Results: A total of 74 professionals participated, including 37 community health agents, 19 nurses, and 18 physicians. Half of the professionals had low knowledge about the content of the guide, answering less than half of the questions correctly, with special emphasis on those related to complementary feeding, in which 57 professionals answered less than half of them correctly. Physicians and nurses were the professionals who believed they were more qualified to pass on information related to the content of the guide, when compared to community health agents (p-value <0.001). Regarding practices, 18 professionals claimed to sometimes provide guidance on breastfeeding, 24 claimed to never assess breastfeeding during consultations and home visits, and 22 of them provide guidance on the introduction of complementary feeding. Conclusion: The knowledge of physicians, nurses, and community health agents was deficient in relation to the content of the guide. Attitudes and practices regarding such content were also compromised.Univ Estadual Paulista, Fac Med Botucatu, Especializacao Redes Atencao Sistema Unico Saude, Botucatu, SP, BrazilUniv Estadual Paulista, Fac Med Botucatu, Programa Posgrad Saude Colet, Botucatu, SP, BrazilUniv Estadual Paulista, Fac Med Botucatu, Especializacao Redes Atencao Sistema Unico Saude, Botucatu, SP, BrazilUniv Estadual Paulista, Fac Med Botucatu, Programa Posgrad Saude Colet, Botucatu, SP, Brazi
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