Ciencia & saude coletiva最新文献_第6页

New paths for specialized care in the Municipality of Rio de Janeiro, Brazil: results from the Super Centro Carioca de Saúde. 巴西里约热内卢市专科护理的新途径：来自Saúde里约热内卢超级中心的结果。

IF 1.2 4区医学

Ciencia & saude coletiva Pub Date : 2025-07-01 Epub Date: 2025-01-31 DOI: 10.1590/1413-81232025307.18782024

Fernanda Adães Britto, André Luis Paes Ramos, Paula Bortolon, Thiago Costa Virgilio, Alexandre Modesto, Iandara de Moura Silva, Rodrigo Schwartz Pegado, José Carlos Prado Junior

{"title":"New paths for specialized care in the Municipality of Rio de Janeiro, Brazil: results from the Super Centro Carioca de Saúde.","authors":"Fernanda Adães Britto, André Luis Paes Ramos, Paula Bortolon, Thiago Costa Virgilio, Alexandre Modesto, Iandara de Moura Silva, Rodrigo Schwartz Pegado, José Carlos Prado Junior","doi":"10.1590/1413-81232025307.18782024","DOIUrl":"10.1590/1413-81232025307.18782024","url":null,"abstract":"The Outpatient Regulation System in the Municipality of Rio de Janeiro (MRJ) faced a significant increase in demand for doctor´s appointments, exams, and surgeries between 2020 and 2024. The creation of the Carioca Super Health Center (Super Centro Carioca de Saúde - SCCS) in 2023 aimed to improve access to specialized procedures and reduce waiting times. A descriptive cross-sectional study was conducted based on data available at the Transparency Portal to evaluate the frequency of requests, available slots, authorizations, and waiting times between 2020 and 2024. There was a 3.7-fold increase in requests and a 4-fold increase in authorizations between 2020 and 2024. The SCCS contributed 19% of the total available slots in 2023, especially for imaging and ophthalmology procedures. The mean waiting list decreased by 4% over the period, with a 44% reduction in exam waiting lists and a 39% reduction in average waiting time. However, waiting lists for doctors' appointments increased by 38%. The expansion of service capacity and the establishment of specialized units like the SCCS were effective in reducing waiting times for exams and surgeries. Nevertheless, the continuous increase in demand, especially for doctor´s appointments, suggests the need for ongoing planning and effective policies for waiting list management and service prioritization.","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 7","pages":"e18782024"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preparedness, Surveillance, and Response to Public Health Emergencies in the City of Rio de Janeiro, Brazil, from 2021 to 2024. 2021年至2024年巴西里约热内卢市突发公共卫生事件的准备、监测和应对

IF 1.2 4区医学

Ciencia & saude coletiva Pub Date : 2025-07-01 Epub Date: 2025-02-13 DOI: 10.1590/1413-81232025307.18832024

Gislani Mateus Oliveira Aguilar, Luciana Freire de Carvalho, Caio Luiz Pereira Ribeiro, João Roberto Cavalcante, Raquel Proença, Gerson Oliveira Penna, Márcio Henrique de Oliveira Garcia, Daniel Soranz

{"title":"Preparedness, Surveillance, and Response to Public Health Emergencies in the City of Rio de Janeiro, Brazil, from 2021 to 2024.","authors":"Gislani Mateus Oliveira Aguilar, Luciana Freire de Carvalho, Caio Luiz Pereira Ribeiro, João Roberto Cavalcante, Raquel Proença, Gerson Oliveira Penna, Márcio Henrique de Oliveira Garcia, Daniel Soranz","doi":"10.1590/1413-81232025307.18832024","DOIUrl":"10.1590/1413-81232025307.18832024","url":null,"abstract":"This article describes the trajectory of the city of Rio de Janeiro in facing public health emergencies between 2021 and 2024, based on three axes of action proposed by the World Health Organization (WHO): preparedness, surveillance, and response. Innovation in timely data analysis from non-conventional information sources has enabled an early detection of events, promoting reorientation in health surveillance practices. The construction of a strong institutional identity, as well as the coordination of response actions in Emergency Operations Centers, contributed to the consolidation of a culture of rapid response and networking. The integration of primary health care (PHC) and surveillance networks guaranteed a continuity of care and coordinated risk management, highlighting the importance of a decentralized health system that seeks intersectorality in responding to emergencies. The advances observed in combating the COVID-19 and dengue epidemics during this period in the city were driven by adequate investments in structure and human resources, emphasizing the importance of continuous financing and strategic planning aimed at this model of care.","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 7","pages":"e18832024"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Public health expenditures in Vitória/ES: priority for primary care. 在Vitória/ES中的公共卫生支出：优先考虑初级保健。

IF 1.2 4区医学

Ciencia & saude coletiva Pub Date : 2025-07-01 Epub Date: 2024-06-16 DOI: 10.1590/1413-81232025307.17062023

Marilene Gonçalves França, Adriana Ilha da Silva, Robson Zuccolotto

{"title":"Public health expenditures in Vitória/ES: priority for primary care.","authors":"Marilene Gonçalves França, Adriana Ilha da Silva, Robson Zuccolotto","doi":"10.1590/1413-81232025307.17062023","DOIUrl":"10.1590/1413-81232025307.17062023","url":null,"abstract":"This study analyzed public spending on health actions and services, especially on primary care, in the municipality of Vitória/ES from 2009 to 2019. It is a quantitative and documentary study that analyzed health expenditure data, based on indicators from the Public Health Budget Information System. The average total expenditure per capita in Vitória corresponded to R$ 1,091.84 per inhabitant per year, with a reduction of 7.83%, caused by the decrease in available revenue. The per capita expenditure on own resources corresponded to an average of R$ 811.02 per inhabitant per year, which represented 74.28% of the total per capita expenditure and was the main source of financing of the system. In terms of the direction of expenditure, there was a predominance of current expenditure to the detriment of capital expenditure. In terms of spending per level of health care, basic care suffered a drastic lowering in per capita spending per year (43.47%), representing 8.52% of total per capita health spending. This scenario is linked to the fiscal austerity policy of the Union, characterized by a reduction in resources for primary care and the lack of priority given to this sub-function by the municipal management.","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 7","pages":"e17062023"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[The importance of integrating epidemiological surveillance into primary health care to mitigate hospitalizations for congenital syphilis]. [将流行病学监测纳入初级卫生保健以减少先天性梅毒住院的重要性]。

IF 1.2 4区医学

Ciencia & saude coletiva Pub Date : 2025-07-01 Epub Date: 2025-03-08 DOI: 10.1590/1413-81232025307.00142025

Guilherme Almeida Elidio, Janaina Sallas, Dirce Bellezi Guilhem

引用次数: 0

Development of Clinical and Health Governance: Primary Health Care in the Lisbon and Tagus Valley Region. 临床和卫生治理的发展：里斯本和塔古斯河谷地区的初级卫生保健。

IF 1.2 4区医学

Ciencia & saude coletiva Pub Date : 2025-07-01 Epub Date: 2025-02-26 DOI: 10.1590/1413-81232025307.21562024

Eunice Isabel do Nascimento Carrapiço, Ana Rita Semedo Correia, Baltazar Ricardo Monteiro

{"title":"Development of Clinical and Health Governance: Primary Health Care in the Lisbon and Tagus Valley Region.","authors":"Eunice Isabel do Nascimento Carrapiço, Ana Rita Semedo Correia, Baltazar Ricardo Monteiro","doi":"10.1590/1413-81232025307.21562024","DOIUrl":"10.1590/1413-81232025307.21562024","url":null,"abstract":"The Clinical and Health Councils (Conselhos Clínicos e de Saúde - CCS) became responsible for implementing Clinical and Health Governance (Governação Clínica e de Saúde - GCS) in primary health care (PHC) in Portugal. However, this project suffered political abandonment, although there are cases of continuity due to the dedication of CCS professionals. Considering the lack of evidence on the impact of GCS concerning the horizontal integration of the Functional Units of Health Center Groups (Agrupamentos de Centros de Saúde - ACES), the present study sought to identify micropolitical elements that could enhance this horizontal integration. The modified Delphi technique (Policy Delphi) was used as a methodology involving a group of ten experts with experience in academia, in administrative structures, and in the CCS, who shared their experiences to answer the research questions. The results revealed, on the one hand, a general tendency, on the part of the experts to accept that the CCS fulfilled the competences that were assigned. On the other hand, they identified economic and social limitations in the development of the project, as well as the fragmentation of care and tensions generated by disparities between the Functional Units. This study also made it possible to suggest a set of micropolicies capable of promoting the integration of GCS in PHC.","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 7","pages":"e21562024"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Energy-adjusted antioxidant micronutrient intake is correlated with HOMA-IR and anthropometric variables. 能量调节抗氧化微量营养素摄入与HOMA-IR和人体测量变量相关。

IF 1.2 4区医学

Ciencia & saude coletiva Pub Date : 2025-07-01 Epub Date: 2024-06-27 DOI: 10.1590/1413-81232025307.09362023

Maria Izabel Siqueira de Andrade, Berilany Dos Santos Sena, Juliana Souza Oliveira, Vanessa Sá Leal, Poliana Coelho Cabral, Pedro Israel Cabral de Lira

{"title":"Energy-adjusted antioxidant micronutrient intake is correlated with HOMA-IR and anthropometric variables.","authors":"Maria Izabel Siqueira de Andrade, Berilany Dos Santos Sena, Juliana Souza Oliveira, Vanessa Sá Leal, Poliana Coelho Cabral, Pedro Israel Cabral de Lira","doi":"10.1590/1413-81232025307.09362023","DOIUrl":"10.1590/1413-81232025307.09362023","url":null,"abstract":"Evidence suggests that the consumption of foods rich in antioxidant nutrients is capable of modulating oxidative stress and assisting in the prevention of chronic diseases. The aim of the present study was to estimate the dietary intake of antioxidant nutrients among Brazilian adolescents and investigate correlations with anthropometric variables and the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). It is hypothesized that the dietary intake of antioxidant micronutrients among Brazilian adolescents is inversely associated with insulin resistance. A cross-sectional study was conducted with data from 37,023 adolescents who participated in the Study of Cardiovascular Risk in Adolescents (ERICA/Brazil). Spearman's correlation test was used to analyse the relation between HOMA-IR and energy-adjusted vitamins A, C, and E, zinc and selenium. Crude and adjusted analyzes were performed using linear regression. An inverse correlation was found between antioxidant vitamin and mineral intake and HOMA-IR among boys and girls with overweight and obesity in the different age groups (p < 0.05). In addition, low intake of the antioxidant micronutrients selenium and vitamin C were significantly associated with insulin resistance.","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 7","pages":"e09362023"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rio 460 years: Five million Rio residents have access to primary health care services. 460岁：500万bbb居民获得初级卫生保健服务。

IF 1.2 4区医学

Ciencia & saude coletiva Pub Date : 2025-07-01 DOI: 10.1590/1413-81232025307.04092025

Luiz Felipe Pinto, Gerson Oliveira Penna, José Agenor Alvares da Silva, Luis Augusto Pisco

引用次数: 0

Factors Associated with the Occurrence of Severe Acute Respiratory Syndrome (SARS) among COVID-19 Cases. COVID-19病例中发生严重急性呼吸系统综合征（SARS）的相关因素

IF 1.2 4区医学

Ciencia & saude coletiva Pub Date : 2025-07-01 Epub Date: 2025-02-13 DOI: 10.1590/1413-81232025307.19502024

Mellina Marques Vieira Izecksohn, Iuri da Costa Leite, Regina Paiva Daumas, Rosane Esteves Siqueira Rodrigues

{"title":"Factors Associated with the Occurrence of Severe Acute Respiratory Syndrome (SARS) among COVID-19 Cases.","authors":"Mellina Marques Vieira Izecksohn, Iuri da Costa Leite, Regina Paiva Daumas, Rosane Esteves Siqueira Rodrigues","doi":"10.1590/1413-81232025307.19502024","DOIUrl":"10.1590/1413-81232025307.19502024","url":null,"abstract":"This retrospective cohort study investigated factors associated with Severe Acute Respiratory Syndrome (SARS) or death among confirmed COVID-19 cases treated at a Primary Health Care (PHC) unit in Rio de Janeiro from August 2020 to January 2022. The occurrence of SARS or death was identified in the Influenza Epidemiological Surveillance Information System and in the Mortality Information System, respectively. Individual characteristics, symptoms, and predominant viral variant were the explanatory variables tested in logistic regression models. Of 1,708 COVID-19 episodes, 72 (4.2%) resulted in SARS, of which 17 (1.0%) were fatal. Among the risk factors for SARS, obesity, pregnancy, chronic heart disease, diabetes, dyspnea, fever, and illness during the predominance of the Gamma variant were highlighted. There were no cases of worsening during the predominance of the Omicron variant. In conclusion, the risk of COVID-19 worsening depends on individual patient characteristics as well as the circulating viral variants, underscoring the essential role of continuous surveillance in detecting changes in the epidemiological landscape and in guiding prevention and care strategies.","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 7","pages":"e19502024"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Geographical distribution and factors associated with physicians' and nurses' productivity in Brazilian primary healthcare. 巴西初级卫生保健中与医生和护士生产力相关的地理分布和因素。

IF 1.2 4区医学

Ciencia & saude coletiva Pub Date : 2025-07-01 Epub Date: 2025-02-20 DOI: 10.1590/1413-81232025307.11452024

Rafael Damasceno de Barros, Jorge Augusto Silva Valente de Andrade, Hugo de Cerqueira Melo, Aiara Nascimento Amaral Bomfim

{"title":"Geographical distribution and factors associated with physicians' and nurses' productivity in Brazilian primary healthcare.","authors":"Rafael Damasceno de Barros, Jorge Augusto Silva Valente de Andrade, Hugo de Cerqueira Melo, Aiara Nascimento Amaral Bomfim","doi":"10.1590/1413-81232025307.11452024","DOIUrl":"10.1590/1413-81232025307.11452024","url":null,"abstract":"The aim of this study was to analyze the geographical distribution and factors associated with productivity in Brazilian primary health care (PHC) for the year 2023. Productivity was defined as the number of individual consultations conducted by physicians and nurses per PHC team. The average productivity in Brazil was 247.1 and 138.8 consultations per month for physicians and nurses, respectively. The Southern region (357.7), states such as Santa Catarina (411.2), Rio Grande do Sul (353.6), and Mato Grosso (339.2), and capital cities like Curitiba (413.2), Porto Alegre (377.4), and Palmas (353.8) exhibited the highest physician productivity. Positive associations with physician and nurse productivity were found for APS coverage, registered users per team, number of nursing technicians and assistants per team, and electronic health records. Municipalities with lower social vulnerability and smaller population size demonstrated higher physician productivity. Additionally, per capita APS expenditure was positively associated with physician productivity and negatively associated with nurse productivity. Collective activities such as team meetings, health education, and group consultations were positively correlated with physician and nurse productivity.","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 7","pages":"e11452024"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The 7-step consultation: what we learned and how to improve it? 7步咨询：我们学到了什么？如何改进？

IF 1.2 4区医学

Ciencia & saude coletiva Pub Date : 2025-07-01 DOI: 10.1590/1413-81232025307.21842024

Victor Manuel Borges Ramos, Eunice Isabel do Nascimento Carrapiço

{"title":"The 7-step consultation: what we learned and how to improve it?","authors":"Victor Manuel Borges Ramos, Eunice Isabel do Nascimento Carrapiço","doi":"10.1590/1413-81232025307.21842024","DOIUrl":"10.1590/1413-81232025307.21842024","url":null,"abstract":"In 2008, the book, \"A Consulta em 7 passos\" (Consultation in 7 steps), was published in Portugal. This work proposes, for training and learning purposes, the structuring of medical consultations into three stages and seven steps: preparation; first minutes; exploration; evaluation; plan; closure; and final reflection. This article aims to briefly assess \"what we have learned and what we believe can be improved\". Over the years, the authors have gathered new ideas, criticisms, and suggestions on the application of the method in dozens of meetings and training sessions with interns and residents. The most important points include: the method should be applied with flexibly; the consultation should be considered to be only one piece of the broader and more complex mosaic that is health care for each person; it is important to emphasize the perspective of the meeting of people, agendas, and objectives; the existence of a personal, unified, and integrative clinical record; the optimal use of information and communication technologies; the need to develop a \"personal/individual care plan\" and the concept of \"personal self-management of health\"; the inclusion of the person-centered clinical method in a more comprehensive systemic model; and the development of collaborative intelligence and action in multidisciplinary teams dedicated to caring for each person and family.","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 7","pages":"e21842024"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0