Avaliação de serviços de assistência ambulatorial em aids, Brasil: estudo comparativo 2001/2007

OBJETIVO: Avaliar os serviços do Sistema Único de Saúde brasileiro de assistência ambulatorial a adultos vivendo com aids em 2007 e comparar com a avaliação de 2001. MÉTODOS: Os 636 serviços cadastrados no Ministério da Saúde em 2007 foram convidados a responder a um questionário previamente validado (Questionário Qualiaids) com 107 questões de múltipla escolha sobre a organização da assistência prestada. Analisaram-se as frequências das respostas de 2007 comparando-as com as obtidas em 2001 na forma de variação percentual (VP). RESULTADOS: Responderam o questionário 504 (79,2%) serviços. Cerca de 100,0% dos respondentes relataram ter pelo menos um médico, suprimento sem falhas de antirretrovirais e de exames CD4 e carga viral. Vários aspectos mostraram melhor desempenho em 2007 comparados a 2001: registro de número de faltas à consulta médica (de 18,3 para 27,0%, VP: 47,5%), agendamento de consulta em menos de 15 dias no início da terapia antirretroviral (de 55,3 para 66,2%, VP: 19,7%) e participação organizada do usuário (de 5,9 para 16,7%, VP: 183,1%). Houve manutenção de dificuldades: pequena variação na disponibilidade de exames especializados em até 15 dias, como endoscopia (31,9 para 34,5%, VP: 8,1%), e a piora de indicadores como tempo ideal de acesso a consultas especializadas (55,9 para 34,5% em cardiologia, VP negativa de 38,3%). O tempo médio despendido nas consultas médicas de seguimento manteve-se baixo: 15 minutos ou menos (52,5 para 49,5%, VP negativa de 5,8%). CONCLUSÕES: A avaliação de 2007 mostrou que os serviços contam com os recursos essenciais para a assistência ambulatorial. Houve melhoras em muitos aspectos em relação a 2001, mas persistem desafios. Pouco tempo dedicado à consulta médica pode estar vinculado ao número insuficiente de médicos e/ou à baixa capacidade de escuta e diálogo. A acessibilidade prejudicada a consultas especializadas mostra a dificuldade das infraestruturas locais do Sistema Único de Saúde.

Hallazgos de neuroimagen y desempeño ortográfi co de estudiantes con trastorno por défi cit de atención con hiperactividad según la semiología de los errores

Aim: To characterize, compare and classify the performance of students with attention deficit-hyperactivity disorder (ADHD) according to the semiology of errors and to describe the neuroimaging findings in these students. Methods: We evaluated 36 primary school boys and girls aged between 8 and 11 years old in the 3 rd to 5 th grades. The children were divided in two groups. Group I consisted of 18 students with an interdisciplinary diagnosis of ADHD (60% boys and 40% girls). Group II consisted of 18 children with good academic performance, paired by gender, age and grade with children in group I. The collective and individual versions of the Pro-ortografia spelling tests were applied. Results: Statistically significant differences were found in almost all the tests of the individual and collective versions of the spelling evaluation, with children with ADHD showing a higher average number of errors. Neuroimaging examinations indicated that 81% of the students in GI showed hypoperfusion in the frontal lobe, 7% had hypoperfusion of the thalamus and basal ganglia, 6% showed hypoperfusion in the basal ganglia only and 6% showed hypoperfusion in the left and right frontal lobes. Conclusions: Children with ADHD demonstrated poorer knowledge of the use of spelling rules in Brazilian Portuguese, which could be related to changes in blood flow in the frontal lobe, parietal lobe, thalamus and basal ganglia. These changes could cause a lack of attention, affecting phonological working memory and the planning of writing. © 2011 AELFA.

Evaluación del impacto de una intervención educativa en atención farmacéutica y farmacia clínica

Introduction: The World Health Organization considers pharmaceutical care (PC) of fundamental importance for the patient and the community. Its exercise requires knowledge and skills, which can be acquired in academic and/or continuing educations, credited for effectiveness and impact evaluation. However, few manuscripts in the literature have showed the contribution of the educational interventions on the knowledge, skill and attitude of students and professionals who participate in scientifi c events related to PC. Objective: To evaluate the impact of an educational intervention (EI), and its degree of satisfaction, to pharmacists and pharmacy students. Method: A quasi-experimental study was performed, through an extension course with 40 hours of lectures approaching issues related to PC and clinical pharmacy (CP). Participants answered a survey which was handed out before and after the EI. The statistic tests of Sinais and Mann-Whitney were applied to evaluate the EI signifi cance. Results: Participants (n= 49) were mostly (n= 34) students and performing activities related to PC and CP (n= 20). Statistics differences, before and after the EI, were found in the scores of knowledge, skill and attitude (p <0.001). The evaluated item which showed the most improvement was the last one. Most (n= 30) had exceeded or met their expectations (n= 19). Conclusions: The analysis of the data led us to conclude that an EI of 40 h/week about knowledge, skill and attitude in PC using traditional methods, improves knowledge and problem-solving skills of participants. ©2012 Ediciones Mayo, S.A. All rights reserved.

Atención farmacéutica como proceso pedagógico: Relato de un caso

The autonomy pedagogy allows the integration among theory, practice and reflection in the learning process. Applied to pharmaceutical care, the patient-centered process to achieve desired goals of therapy enables to build, rebuild and share knowledge and experiences with patients, in a critic and progressive way, inquiring and investigating. Therefore, it is possible to design a care plan according to patient experience, working together with the pharmaceutical care practitioner, to solve drugtherapy problems detected, with the patient as the center of the health care system. © 2012 Ediciones Mayo, S.A. Todos los derechos reservados.