Information and communication technologies in health care: enabling projects and applications in Chile

Includes bibliography

Surveys on time use and unpaid work in Latin America and the Caribbean: Experience to date and challenges for the future

Incluye bibliografía.

Occurrence of pathogenic environmental mycobacteria on surfaces in health institutions

The presence of environmental mycobacteria on surfaces in two public health institutions, namely a health center and a hospital in upstate São Paulo (Brazil), was identified by polymerase chain reaction-restriction enzyme analysis (PRA). The possible sources of contamination by these microorganisms were evaluated, contributing to epidemiology studies. Methods: From June 2005 to June 2006, a total of 632 samples were collected from exposed surfaces, such as washbasins, drinking fountains, and other accessible sites, and the mycobacteria present in the samples were isolated and cultured. Results: Sixty-five mycobacteria were isolated from the 632 samples; 47 of which were detected in samples from the health center and 18 in samples collected from the hospital. The isolates were identified by DNA restriction patterns obtained by PRA, and potentially pathogenic species were found to be prevalent among the identified mycobacteria. This study shows that the PRA technique can be employed as a fast and easy method for identification of nontuberculous mycobacteria in public areas. Conclusions: The isolation of environmental mycobacteria from the two health institutions demonstrates that these surfaces are reservoirs of potentially pathogenic mycobacteria and indicates the need for continuous maintenance and monitoring. These data will add to the study of the epidemiology of these microorganisms.

The role of the state in health public policies: an overview of the debate on the concept of State and the Brazilian case

This article is the result of a narrative literature review. The objective is to show the development of an overview on the ideological debate on the design of state health policies. We argue that the role of the state in the development of health policy, even under the pressure of the global market, may create alternatives to promote and drive economic and social development, meaning they are not subject to economic constraints imposed by the liberal ideal of market. Here is a part of a theoretical discussion about the construction and presence of the State in Latin America, particularly in Brazil. We take the approaches of the Marxist tradition and liberal to the issue as reference. This discussion allows us to understand the historical role of the state in the maintenance of social policies, specifically health, is an alternative to public control eases the intense capital mobility promoted by economic globalization. In this sense, the theme makes the Brazilian health an important issue of social sciences, why is the historicity of the construction of the Brazilian health system, as a public policy that can mirror the actual reconstruction of the institutional framework of the Brazilian state with the establishment instances of negotiation between the various spheres of power that strengthen the state in this process of democratization of Brazilian society.

School activities in health education and their impact on parents

There is little empirical evidence establishing the value of schoolhouse education of children and the repercussions on their families; a quantitative analysis of instructional intervention in health and its reflection on the family permits quantification of its effectiveness outside of the school setting. To this end, we utilized instruction on head lice in schoolchildren was conducted. A randomized sample of those responsible for students enrolled from the third to fifth grade, from two public schools who had taken an instructional module on pediculosis, were invited to respond to a questionnaire that aimed to ascertain their opinions on the instruction and what its impact was on their family. The variables were assessed by univariat analysis. Of 155 total respondents, 89.9% were the parents of the students. The students that had infestation, in turn, had greater capacity to influence the family on measures against lice. The majority of those responsible supported the instruction and reported being satisfied with the school for having addressed the theme. When the subject pertains to the reality of the students, the school-family link is strengthened. Instruction on pediculosis in school helps bridge the gap between the theoretical and the practical, a harmonization required in health education.

A METHODOLOGY TO EVALUATE OBSOLETE INVENTORY IN HEALTH CARE

Many organizations are currently facing inventory management problems such as distributing inventory on-time and maintain the correct inventory levels to satisfy the customer or end users. Organizations understand the need for maintaining the accurate inventory levels but sometimes fall short leading a wide performance gap in maintaining inventory accurately. The inventory inaccuracy can consume much of the investment on purchasing inventory and many times leads to excessive inventory. The research objective of thesis is to provide a decision making criteria to the management for closing or maintaining the warehouse based on basic purchasing and holding cost information. The specific objectives provide information regarding the impact of inventory carrying cost, obsolete inventory, inventory turns. The methodology section explains about the carrying cost ratio that would help inventory managers to adopt best practices to avoid obsolete inventory and also reduce excessive inventory levels. The research model was helpful in providing a decision making criteria based on the performance metric developed. This research model and performance metric had been validated by analysis of warehouse data and results indicated a shift from two-echelon inventory supply chain to a one-echelon or Just In Time (JIT) based inventory supply chain. The recommendations from the case study were used by a health care organization to reorganize the supply chain resulting in the reduction of excessive inventory.

LEISURE AND MENTAL HEALTH IN PEOPLE WITH HYPERTENSION: CONVERGENCE IN HEALTH EDUCATION

People with hypertension constantly deal with issues related to mental health due to the psychosocial determinants of this illness, and leisure is an important control strategy. The objective of this study was to promote health education to a group of hypertensive patients, through research-action, based on critical-social pedagogy, and taking into consideration the participants' perception of leisure. Educational activities were conducted and, following, an evaluation was performed regarding the subjects' opinion about the impact of leisure on their lives and mental health. The group perceived leisure as a coping strategy for loneliness and also as a late development of independence; it was also regarded as a means of socialization and as a promotion of mental health. These perceptions revealed two themes: aging, leisure, and chronic disease; and knowledge and leisure experiences. Educational actions, such as group dynamics and discussions, were planned considering these themes with the purpose of providing the necessary conditions for socializing and exchanging experiences.

Equity in health: tuberculosis in the Bolivian immigrant community of Sao Paulo, Brazil

Objectives To analyse the profile of tuberculosis (TB) among Bolivian immigrants, investigate the impact that this population has on the trends of TB and assess equity in access to TB treatment, in the city of Sao Paulo, Brazil. Methods Descriptive study of the epidemiological profile of TB in four city districts with large Bolivian populations, comparing cases among Brazilians and Bolivians, during the 19982008 period was carried out. We used logistic regression to adjust the treatment outcome for potential confounders. Results We identified 2056 new TB cases: 65.7% in Brazilians, 32.1% in Bolivians and 2.2% among other nationalities. Although TB incidence remained stable (high) over the study period, the annual proportion of cases among Bolivians increased from 15.0% to 53.0%. In comparison with the Brazilians, the Bolivians were younger (median age, 24 vs. 40 years; P < 0.0001) and presented a lower unemployment rate (3.1%vs. 11.6%; P < 0.0001), a lower rate of HIV co-infection (1.5%vs. 28.5%; P < 0.001), a higher proportion of individuals receiving supervised treatment (81.5%vs. 62.0%; P < 0.0001) and a higher proportion of cures (71.6%vs. 63.2%; P < 0.0001). After having been adjusted for potential confounder, cure after treatment was not associated with nationality. Conclusions Bolivian immigrants influenced the incidence but not the trends of TB among Brazilians in the study area. We found no significant differences between Bolivians and Brazilians regarding healthcare access or treatment outcome. Guaranteed universal health care access for all, including undocumented individuals, contributes to health equity. Specific intervention strategies are warranted for immigrants with tuberculosis.

Epidemiological intelligence as a model of organization in health

The concept of epidemiological intelligence, as a construction of information societies, goes beyond monitoring a list of diseases and the ability to elicit rapid responses. The concept should consider the complexity of the definition of epidemiology in the identification of this object of study without being limited to a set of actions in a single government sector. The activities of epidemiological intelligence include risk assessment, strategies for prevention and protection, subsystems of information, crisis management rooms, geographical analysis, etc. This concept contributes to the understanding of policies in health, in multisectorial and geopolitical dimensions, as regards the organization of services around public health emergencies, primary healthcare, as well as disasters. The activities of epidemiological intelligence should not be restricted to scientific research, but the researchers must beware of threats to public health. Lalonde's model enabled consideration of epidemiological intelligence as a way to restructure policies and share resources by creating communities of intelligence, whose purpose is primarily to deal with public health emergencies and disasters.

NURSES AND THE ASSESSMENT IN HEALTH SYSTEM MANAGEMENT

The objective of this study was to undertake a critical reflection regarding assessment as a managerial tool that promotes the inclusion of nurses in the health system management process. Nurses, because of their education and training, which encompasses knowledge in both the clinical and managerial fields and is centered on care, have the potential to assume a differentiated attitude in management, making decisions and proposing health policies. Nevertheless, it is necessary to first create and consolidate an expressive inclusion in decisive levels of management. Assessment is a component of management, the results of which may contribute to making decisions that are more objective and allow for improving healthcare interventions and reorganizing health practice within a political, economic, social and professional context; it is also an area for the application of knowledge that has the potential to change the current panorama of including nurses in management.

Social Mobilization in Health and Sanitation in an Action Research Process in an Indigenous Community in Northwestern Amazon

The living conditions of the inhabitants of Iauarete, an indigenous area in the municipality of Sao Gabriel da Cachoeira, State of Amazonas (Northern Brazil), have been negatively affected by population density, poor sanitation and maintenance of sanitation practices that are incompatible with that reality. To improve the population's quality of life, sanitation systems that are adequate to the local socio-cultural characteristics should be implemented, as well as educational processes with emphasis on social mobilization and community empowerment. The aim of this paper is to report and discuss a training course on health and sanitation using action research, directed to the mobilization of the Iauarete indigenous people, with the objective of assisting other studies of this nature. In the meetings, issues related to environmental health were discussed, a Community Newspaper was constructed, the course participants made interviews and drew up claims documents. This experience has enhanced the participants' understanding of local problems and of the importance of social mobilization for the dialogue with governmental institutions that are responsible for providing sanitation services and for seeking better living conditions. The researchers and teachers of the training course benefitted from the construction of collective knowledge resulting from interaction with subjects of the investigated situation and from the recognition and redefinition of their representations, fulfilling the fundamental premise of action research.

Professional competences of nurse to work in Intensive Care Units: an integrative review

This study aimed to identify and analyze nurses' competences to work at Intensive Care Units-ICU. An integrative review method was used, and data were collected in LILACS, SciELO and BDENF, from August to October 2010. Ten articles were identified, published in the last 12 years. Data grouping permitted the construction of thematic units related to nurses' competences: nursing care management, high-complexity nursing care delivery, decision making, leadership, communication, continuing/permanent education, human resource management, material resource management. The professional competences identified can support the outline of guidelines to constitute the profile of nursing working in intensive care units and drive/mobilize the improvement of nursing care practices.

Mitochondrial translation in health and disease

Mitochondrial disorders have become the most common cause of inborn errors of metabolism. Impairments in mitochondrial protein synthesis are one of the causes of these diseases, which are clinically and genetically heterogeneous. The mitochondrial translation machinery decodes 13 polypeptides essential for the oxidative phosphorylation process. Mitochondria protein synthesis depends on the integrity of mitochondrial rRNAs and tRNAs genes, and at least one hundred of nuclear encoded products. Diseases caused by mutations in mitochondrial genes as well as in ribosomal proteins, translational factors, RNA modifying enzymes, and all other constituents of the translational machinery have been described in patients with combine respiratory chain deficiency, and are the object of this review.