Suchergebnisse

AIM: To explore and synthesize the literature on factors related to mammography screening adherence among women in Brazil. DESIGN: A scoping review. METHODS: We searched 11 databases for studies published between 2006–January 2020. All identified articles were screened, and data were extracted from eligible studies. We used the UK Government Social Research Service weight of evidence appraisal tool to appraise the quality of the included study. RESULTS: From a total of 1,384 identified articles, 22 were retained. All included studies used quantitative, non‐experimental methods and all but two studies used cross‐sectional data. Quality of evidence varied across studies. We identified 41 factors that were investigated across the set of studies. Demographic and socio‐economic factors were the most commonly investigated, with older age, urban residence, living in the southeast of Brazil, higher level of education, higher income and private health insurance most consistently associated with mammography adherence.

Objective: To describe the main clinical, therapeutic and epidemiological characteristics of women diagnosed
with breast cancer in the Pérola Byington Hospital, between the years 2000 and 2006. Methods: This was a cross
sectional study and quantitative nature. Data collection was performed using a structured form. Results: Most
of the women were married, white, with low education, catholic and housewives. About 75% had at least one
pregnancy, and 33.1% breastfed. Just over 30% had hormone replacement. Smokers were 14.7% and 2.7% were
ex-smokers. The initial clinical staging of highest incidence are the II and III, representing together 66.5% of cases.
Before the first consultation, 91.3% of women had no diagnosis of breast cancer and no prior treatment. Conclusion:
Knowing the profile of women affected by breast cancer is essential for targeting of resources and decision-making.

OBJETIVO Avaliar a viabilidade de profissional especialista em comissões intra-hospitalares de doação de órgãos e tecidos para transplantes. MÉTODOS Estudo epidemiológico, retrospectivo e transversal (2003 a 2011 e 2008 a 2012), realizado com dados de doação de órgãos para transplantes no estado de São Paulo. Foram avaliados nove hospitais (hospitais 1 a 9). Foram avaliadas, por regressão logística, diferenças em número de notificações de morte encefálica e doadores efetivos (variáveis dependentes) após a entrada do profissional especialista (variável independente) na comissão intra-hospitalar de doação de órgãos e tecidos para transplantes. Para avaliação do faturamento hospitalar, foram calculados o salário-hora de médico e enfermeiro, conforme legislação da Consolidação das Leis do Trabalho, o retorno e o prazo do retorno do investimento. RESULTADOS Após a entrada de enfermeiro especialista na comissão, as notificações de morte encefálica e o número de doadores efetivos aumentaram no hospital 2 (4,17 e 1,52, respectivamente). No hospital 7, o número de doadores efetivos também aumentou de 0,005 para 1,54. E, após entrada de enfermeiro especialista, o faturamento hospitalar aumentou em 190,0% (variação de 40,0% a 1.955%). O custo mensal para 20 horas semanais do enfermeiro foi R$940,00 e, do médico, R$8.330,00. O retorno do investimento foi de 275%, em curto prazo (0,36 anos). CONCLUSÕES A inserção de profissional especialista nas comissões intra-hospitalares para captação de doação de órgãos e tecidos para transplantes mostra-se custo-efetiva. Novos estudos econômicos na área podem contribuir com uma política pública eficiente de implantação desse modelo de captação de órgãos e tecidos para transplantes. ; OBJECTIVE To evaluate the viability of a professional specialist in intra-hospital committees of organ and tissue donation for transplantation. METHODS Epidemiological, retrospective and cross-sectional study (2003-2011 and 2008-2012), which was performed using organ donation for transplants data in the state of Sao Paulo, Southeastern Brazil. Nine hospitals were evaluated (hospitals 1 to 9). Logistic regression was used to evaluate the differences in the number of brain death referrals and actual donors (dependent variables) after the professional specialist started work (independent variable) at the intra-hospital committee of organ and tissue donation for transplantation. To evaluate the hospital invoicing, the hourly wage of the doctor and registered nurse, according to the legislation of the Consolidation of Labor Laws, were calculated, as were the investment return and the time elapsed to do so. RESULTS Following the nursing specialist commencement on the committee, brain death referrals and the number of actual donors increased at hospital 2 (4.17 and 1.52, respectively). At hospital 7, the number of actual donors also increased from 0.005 to 1.54. In addition, after the nurse started working, hospital revenues increased by 190.0% (ranging 40.0% to 1.955%). The monthly cost for the nurse working 20 hours was US$397.97 while the doctor would cost US$3,526.67. The return on investment was 275% over the short term (0.36 years). CONCLUSIONS This paper showed that including a professional specialist in intra-hospital committees for organ and tissue donation for transplantation proved to be cost-effective. Further economic research in the area could contribute to the efficient public policy implementation of this organ and tissue harvesting model.

OBJECTIVE To evaluate the viability of a professional specialist in intra-hospital committees of organ and tissue donation for transplantation. METHODS Epidemiological, retrospective and cross-sectional study (2003-2011 and 2008-2012), which was performed using organ donation for transplants data in the state of Sao Paulo, Southeastern Brazil. Nine hospitals were evaluated (hospitals 1 to 9). Logistic regression was used to evaluate the differences in the number of brain death referrals and actual donors (dependent variables) after the professional specialist started work (independent variable) at the intra-hospital committee of organ and tissue donation for transplantation. To evaluate the hospital invoicing, the hourly wage of the doctor and registered nurse, according to the legislation of the Consolidation of Labor Laws, were calculated, as were the investment return and the time elapsed to do so. RESULTS Following the nursing specialist commencement on the committee, brain death referrals and the number of actual donors increased at hospital 2 (4.17 and 1.52, respectively). At hospital 7, the number of actual donors also increased from 0.005 to 1.54. In addition, after the nurse started working, hospital revenues increased by 190.0% (ranging 40.0% to 1.955%). The monthly cost for the nurse working 20 hours was US$397.97 while the doctor would cost US$3,526.67. The return on investment was 275% over the short term (0.36 years). CONCLUSIONS This paper showed that including a professional specialist in intra-hospital committees for organ and tissue donation for transplantation proved to be cost-effective. Further economic research in the area could contribute to the efficient public policy implementation of this organ and tissue harvesting model. ; OBJETIVO Avaliar a viabilidade de profissional especialista em comissões intra-hospitalares de doação de órgãos e tecidos para transplantes. MÉTODOS Estudo epidemiológico, retrospectivo e transversal (2003 a 2011 e 2008 a 2012), realizado com dados de doação de órgãos para transplantes no estado de São Paulo. Foram avaliados nove hospitais (hospitais 1 a 9). Foram avaliadas, por regressão logística, diferenças em número de notificações de morte encefálica e doadores efetivos (variáveis dependentes) após a entrada do profissional especialista (variável independente) na comissão intra-hospitalar de doação de órgãos e tecidos para transplantes. Para avaliação do faturamento hospitalar, foram calculados o salário-hora de médico e enfermeiro, conforme legislação da Consolidação das Leis do Trabalho, o retorno e o prazo do retorno do investimento. RESULTADOS Após a entrada de enfermeiro especialista na comissão, as notificações de morte encefálica e o número de doadores efetivos aumentaram no hospital 2 (4,17 e 1,52, respectivamente). No hospital 7, o número de doadores efetivos também aumentou de 0,005 para 1,54. E, após entrada de enfermeiro especialista, o faturamento hospitalar aumentou em 190,0% (variação de 40,0% a 1.955%). O custo mensal para 20 horas semanais do enfermeiro foi R$940,00 e, do médico, R$8.330,00. O retorno do investimento foi de 275%, em curto prazo (0,36 anos). CONCLUSÕES A inserção de profissional especialista nas comissões intra-hospitalares para captação de doação de órgãos e tecidos para transplantes mostra-se custo-efetiva. Novos estudos econômicos na área podem contribuir com uma política pública eficiente de implantação desse modelo de captação de órgãos e tecidos para transplantes.

BACKGROUND: Well-established performance measures for organ donation programs do not fully address the complexity and multifactorial nature of organ donation programs such as the influence of relationships and organizational attributes. OBJECTIVE: To synthesize the current evidence on key organizational attributes and processes of international organ donation programs associated with successful outcomes and to generate a framework to categorize those attributes. DESIGN: Scoping Review using a mixed methods approach for data extraction. SETTING: Databases included PubMed, CINAHL, Embase, LILACS, ABI Business ProQuest, Business Source Premier, and gray literature (organ donation association websites, Google Scholar—first 8 pages), and searches for gray literature were performed, and relevant websites were perused. SAMPLE: Organ donation programs or processes. METHODS: We systematically searched the literature to identify any research design, including text and opinion papers and unpublished material (research data, reports, institutional protocols, government documents, etc). Searches were completed on January 2018, updated it in May 2019, and lastly in March 2020. Title, abstracts, and full texts were screened independently by 2 reviewers with disagreements resolved by a third. Data extraction followed a mixed method approach in which we extracted specific details about study characteristics such as type of research, year of publication, origin/country of study, type of journal published, and key findings. Studies included considered definitions and descriptions of success in organ donation programs in any country by considering studies that described (1) attributes associated with success or effectiveness, (2) organ donation processes, (3) quality improvement initiatives, (4) definitions of organ donation program effectiveness, (5) evidence-based practices in organ donation, and (6) improvements or success in such programs. We tabulated the type and frequency of the presence or absence of reported improvement ...

Introduction: Biovigilance presents a new opportunity for growth and improvement of the donation-transplantation process. Biovigilance is defined as the monitoring and control of procedures involving human cells, tissues and organs, from donation to the clinical evolution of the recipient and the living donor, in order to obtain and provide information on risks and adverse events, and to prevent its occurrence or recurrence. Objective: Describe biovigilance and transplant models and initiatives in Brazil and worldwide. Method: Narrative review of national and international literature on biovigilance and transplantation models in Brazil and worldwide. Results: The risk is present in all stages involving the donation-transplantation process, and implies continuous surveillance. Bio-surveillance initiatives around the world involve institutions such as the World Health Organization and Italy's National Transplant Centre, which support the sharing of surveillance information published for teaching purposes and for greater public transparency and which, together with Member States of the European Union, aim to support the development and strengthening of the capacity to monitor and control quality, safety and effectiveness in this area. The Australian Government has an initiative that collects information on serious adverse events and reactions related to organ donation and transplantation, but it does not yet have an integrated surveillance system. Brazil, through its National Sanitary Vigilance Agency, has been monitoring the adverse events analysis, but that database needs to be integrated with that of the National Transplantation System. Conclusions: Having National efforts to address international initiatives with the World Health Organization is urgent, thus incorporating measures to implement a culture of quality and safety in the donor-transplant process, with innovative care modelling. It is also necessary to return back to society the high investments done in an efficient and effective manner. ; Introdução: A biovigilância apresenta nova oportunidade de melhoria e segurança do processo doação-transplante. A biovigilância é definida como o monitoramento e o controle durante os procedimentos que envolvem células, tecidos e órgãos humanos desde a doação até a evolução clínica do receptor e do doador vivo, com o objetivo de obter e disponibilizar informações sobre riscos e eventos adversos, a fim de prevenir sua ocorrência ou recorrência. Objetivo: Descrever acerca de modelos e iniciativas de biovigilância e transplante no Brasil e no mundo. Método: Revisão narrativa da literatura nacional e internacional. Resultados: O risco está presente em todas as etapas que envolvem a doação-transplante, e implica vigilância contínua. As iniciativas de biovigilância no mundo envolvem instituições como a Organização Mundial da Saúde e o Centro Nacional de Transplantes da Itália, que apoiam o compartilhamento de informações de vigilância publicadas para fins de ensino e para maior transparência pública e que, em conjunto com Estados-membros da União Europeia, têm o objetivo de apoiar o desenvolvimento e ofortalecimento da capacidade de monitorar e controlar a qualidade, a segurança e a eficácia nessa área. O governo australiano possui uma iniciativa que coleta informações sobre eventos adversos graves e reações relacionadas à doação e ao transplante de órgãos, mas ainda não possui um sistema de vigilância integrado. O Brasil, por meio da Agência Nacional de Vigilância Sanitária, possui acompanhamento da análise eventos adversos, mas os seus bancos de dados, precisam ser integrados àqueles do Sistema Nacional de Transplantes. Conclusões: É premente realizar esforço nacional para atender as inciativas internacionais com a Organização Mundial de Saúde e, assim, incorporar medidas para implementar uma cultura de qualidade e segurança no processo doação-transplante com uma modelagem assistencial inovadora, e devolver à sociedade o alto investimento realizado de modo eficiente e eficaz.