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Barros DSL, Silva DLMD, Leite SN. Clinical pharmaceutical services of primary health care of the Federal District: A discussion based on the SWOT matrix. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e18593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Cheng B, Ma Y, Wang H, Shen J, Zhang Y, Guo L, Guo Y, Li M. Particulate matter pollution and emergency room visits for respiratory diseases in a valley Basin city of Northwest China. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2021; 43:3457-3468. [PMID: 33559782 DOI: 10.1007/s10653-021-00837-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/23/2021] [Indexed: 05/25/2023]
Abstract
Epidemiological studies have suggested that particulate matter (PM) pollution seriously affects human health, particularly it is closely associated with respiratory diseases. The aim of this study is to quantitatively evaluate the effect of PMs (PM10 and PM2.5) on emergency room (ER) visits for respiratory diseases in Lanzhou, a valley basin city in northwest China. Based on the data of the ER visits, daily concentration of particulate matters and daily meteorological elements from January 1, 2013, to July 31, 2017, we used a generalized additive model (GAM) of time series to evaluate the exposure-response relationship between PMs and respiratory ER visits. Seasonal modified effects of PM2.5 and PM10 on different age and gender groups were also performed. Results showed that the highest incidence of respiratory diseases occurred in winter. Respiratory ER visits for the total were significantly associated with PM2.5 (at lag 0 day) and PM10 (at lag 3 days), with relative risks (RRs) of 1.042 (95%CI: 1.036 -1.047) and 1.013 (95%CI: 1.011-1.016), respectively. Effects of PM pollutants on respiratory diseases are different among different age and gender groups. Children under 15 years and the elders over 60 years were the most sensitive to PM pollution, and males were more sensitive than females. The results obtained in the current study would provide a scientific evidence for local government to make policy decision for prevention of respiratory diseases.
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Affiliation(s)
- Bowen Cheng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yuxia Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China.
| | - Hang Wang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Jiahui Shen
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yifan Zhang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Lingyun Guo
- The Second Hospital, Lanzhou University, Lanzhou, 730000, China
| | - Yongtao Guo
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Mingji Li
- Resource and Environment Department, Ningxia University, Yinchuan, 750021, China
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Machado M, Santos JM, Frere S, Chagnon P, Reisen VA, Bondon P, Ispány M, Mavroidis I, Reis NC. Deconstruction of annoyance due to air pollution by multiple correspondence analyses. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:47904-47920. [PMID: 33893918 DOI: 10.1007/s11356-021-13958-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 04/12/2021] [Indexed: 06/12/2023]
Abstract
Annoyance caused by air pollution is a matter of public health as it can cause stress and ill-health and affect quality of life, among other burdens. The aim of this study is to apply the multiple correspondence analyses (MCA) technique as a differential tooling to explore relationships between variables that can influence peoples' behaviour concerning annoyance caused by air pollution. Data were collected through a survey on air pollution, environmental issues and quality of life. Face-to-face survey studies were conducted in two industrialized urban areas (Vitoria in Brazil and Dunkirk in France). These two regions were chosen as their inhabitants often report feeling annoyed by air pollution, and both regions have similar industrial characteristics. The results showed a progressive correspondence between levels of annoyance and other active variables in the "air pollution" factor group: as the levels of annoyance increased, the levels of the other qualitative variables (importance of air quality, perceived exposure to industrial risk, assessment of air quality, perceived air pollution) also increased. Respondents who reported feeling annoyed by air pollution also thought that air quality was very important and were very concerned about exposure to industrial risks. Furthermore, they often assessed air quality as horrible, and they could frequently perceive air pollution by dust, odours and decreased visibility. The results also showed a statistically significant association between occurrence of allergies and high levels of annoyance.
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Affiliation(s)
- Milena Machado
- Instituto Federal de Ciência e Tecnologia do Espírito Santo, Guarapari, Brazil.
| | - Jane Meri Santos
- Department of Environmental Engineering, Universidade Federal do Espírito Santo, Vitoria, Brazil
| | - Severine Frere
- Université du Littoral Côte d'Opale, Maison de la Recherche em Science de l´Homme, Dunkerque, France
| | - Phillipe Chagnon
- Université du Littoral Côte d'Opale, Maison de la Recherche em Science de l´Homme, Dunkerque, France
| | | | - Pascal Bondon
- Laboratoire des Signaux et Systems, CNRS-Centrale Supélec-Université Paris-Sud, Gif sur Yvette, France
| | | | - Ilias Mavroidis
- School of Science and Technology, Hellenic Open University, Patra, Greece
| | - Neyval Costa Reis
- Department of Environmental Engineering, Universidade Federal do Espírito Santo, Vitoria, Brazil
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Attending a Blended In-Service Management Training in a Public Health System: Constraints and Opportunities for Pharmacists and Health Services. PHARMACY 2021; 9:pharmacy9010012. [PMID: 33466556 PMCID: PMC7838771 DOI: 10.3390/pharmacy9010012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/30/2020] [Accepted: 01/01/2021] [Indexed: 11/17/2022] Open
Abstract
Management and public health are important domains of competency for pharmacists. In about 90% of Brazilian health departments, pharmacists manage the selection and purchase of medicines. The Pharmaceutical Services and Access to Medicines Management Course (PSAMM) was offered to pharmacists working in the public health system. The aim of this study is to analyze the impacts of the course as perceived by the students (pharmacists). Two thousand five hundred pharmacists completed the course. It is a mixed-methods study, including subscribing forms (n = 2500), evaluation questionnaire (n = 1500), focus groups (n = 10), and semi-structured interviews (n = 31). Participants reported a high level of satisfaction with the course; they considered to have developed competencies related to leadership and management, competencies needed to enhance and sustain their practices in health services. Data analyses showed important barriers to complete the course: high course workload, poor quality of Internet access, lack of support from the health services. Participants highlighted crucial features of the course that helped them develop key competencies: practical in-service activities, useful and realistic contents, tutoring. These features helped participants overcome some important constraints described by them. The educational model described in this study was perceived as having a long-term impact on their behaviors and management practices in health services.
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Manzini F, Diehl EE, Farias MR, Dos Santos RI, Soares L, Rech N, Lorenzoni AA, Leite SN. Analysis of a Blended, In-Service, Continuing Education Course in a Public Health System: Lessons for Education Providers and Healthcare Managers. Front Public Health 2020; 8:561238. [PMID: 33324594 PMCID: PMC7725868 DOI: 10.3389/fpubh.2020.561238] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 11/03/2020] [Indexed: 11/29/2022] Open
Abstract
Introduction: To train pharmacists working in the public health system, the Brazilian Ministry of Health developed a specialization course called Pharmaceutical Service and Access to Medicine Management (PSAMM) between 2010 and 2016. The course was free of charge and used e-learning as its main approach. In the end, 2,500 pharmacists were trained. The purpose of this study was to identify and analyze the strengths, weaknesses, opportunities, and threats of an in-service and e-learning course for pharmacists working in a public health system. Materials and Methods: Three workshops involving 67 participants were conducted at the conclusion of the course to analyze the perspective of the PSAMM course's faculty (tutors, regional coordinators, professors, and management committee) and students (pharmacists). Strengths, weaknesses, opportunities, and threats analysis and qualitative analysis methods were used. Results and Discussion: The strength dimension had the greatest number of items. The qualitative analysis resulted in six categories: the category “E-learning in continuing education” had the most cited items. Internal elements such as in-service hands-on activities directly related to the professionals' roles, course contents, faculty, and the methods to offer the course (the mixed methods and materials) were positively assessed. Nonetheless, external elements were considered critical for the course's outcomes such as investments in the infrastructure of pharmaceutical services, access to the internet, local managers' support for continuing education and innovation implementation, practice of interprofessional collaboration, and political stability. The continuing education course in the public health system was affected by internal elements such as its project and structure as well as external elements such as the sociopolitical scenario. Continuing education investment must be accompanied by infrastructure investment and coordination of services.
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Affiliation(s)
- Fernanda Manzini
- Postgraduate Program in Pharmacy, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Eliana Elisabeth Diehl
- Department of Pharmacy Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Mareni Rocha Farias
- Postgraduate Program in Pharmacy, Federal University of Santa Catarina, Florianópolis, Brazil.,Department of Pharmacy Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | - Luciano Soares
- Department of Pharmacy Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Norberto Rech
- Postgraduate Program in Pharmacy, Federal University of Santa Catarina, Florianópolis, Brazil.,Department of Pharmacy Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | - Silvana Nair Leite
- Postgraduate Program in Pharmacy, Federal University of Santa Catarina, Florianópolis, Brazil.,Department of Pharmacy Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
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de Oliveira Fernandes MA, Andreão WL, Maciel FM, de Almeida Albuquerque TT. Avoiding hospital admissions for respiratory system diseases by complying to the final Brazilian air quality standard: an estimate for Brazilian southeast capitals. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:35889-35907. [PMID: 31993912 DOI: 10.1007/s11356-020-07772-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 01/17/2020] [Indexed: 06/10/2023]
Abstract
According to the World Health Organization (WHO), in 2016, 91% of the global population was living in places where guidelines on air quality were not met, which results in an estimated figure of seven million deaths annually. The new Brazilian air quality standards, CONAMA 491/2018, was the first revision in over two decades and has as final target the WHO guidelines for air quality, although no deadline has been established for implementation. The goal of this work was to quantify public health gains of this new policy based on hospitalizations due to respiratory diseases, the most studied outcome in Brazilian time series studies, in four Brazilian Southeast capitals: São Paulo (SP), Rio de Janeiro (RJ), Belo Horizonte (MG), and Vitória (ES) for PM10, PM2,5, SO2, CO, and O3. Population and hospitalizations data for all respiratory diseases for people under 5 years old, over 64 years old, most vulnerable populations, and all ages were analyzed. The air quality monitoring data was analyzed in two different periods: 2016 to 2018 for São Paulo and Vitória; and between 2015 and 2017 for Belo Horizonte and Rio de Janeiro, according to available monitoring data. A literature review was carried out to determine the appropriate relative risk to be used in the estimations, and the public health gains were calculated based on the selected relative risks for each city. The highest estimate was for São Paulo, with 3454 avoidable respiratory hospital admissions (all ages). In total, the four cities accounted for 4148 avoidable hospitalizations, which was associated to $1.1 million public health gains. Results considering the day of exposure (lag 0) were superior to those with the 5-day moving average (lag 5). The results highlighted the importance of adopting more restrictive standards and called for public policies, the necessity of expanding the air quality monitoring network, mapping emission sources, and improve the knowledge about the interaction between air pollution and health outcomes beyond respiratory disease for the region.
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Affiliation(s)
| | - Willian Lemker Andreão
- Dept. of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Belo Horizonte, 31270-010, Brazil
| | - Felipe Marinho Maciel
- Dept. of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Belo Horizonte, 31270-010, Brazil
- ArcelorMittal Brasil Sustainability Management, Belo Horizonte, 30130-915, Brazil
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Yamauti SM, Barreto JOM, Barberato-Filho S, Lopes LC. Strategies Implemented by Public Institutions to Approach the Judicialization of Health Care in Brazil: A Systematic Scoping Review. Front Pharmacol 2020; 11:1128. [PMID: 32848747 PMCID: PMC7406659 DOI: 10.3389/fphar.2020.01128] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 07/10/2020] [Indexed: 11/13/2022] Open
Abstract
Background The judicialization of health care is a social claim concerning the right to the access to health care. It usually occurs due to gaps in public policy or failures in its application. In Brazil, several public institutions have implemented strategies to approach this phenomenon. However, these strategies have not yet been systematized into functional categories. Objective To categorize and analyze the strategies implemented by public institutions in Brazil to approach the judicialization of health care. Method A systematic scoping review was developed following the method proposed by the Joanna Briggs Institute. The descriptor ‘judicialization of health’ was used to conduct the searches for studies in 18 electronic databases and other types of documents in the gray literature until March 2019. Documents containing the reports of strategies implemented in public institutions to approach the judicialization of health care in Brazil were included. Two independent reviewers assessed the eligibility of the documents and extracted the data. The strategies identified were categorized using definitions from the World Health Organization and existing Brazilian legislation. Results Seventy eight implemented strategies were identified and organized into nine categories: i. Technical support to the judiciary; ii. State health committees; iii. Organization of assistance; iv. Compliance with court orders, v. Computerized information systems; vi. Administrative proceeding; vii. Defense of the public authority; viii. Pharmacy and therapeutics committee; ix. Alternative dispute resolution. These categories are not mutually exclusive and often act in concert or complement each other’s activities. They represent services either existing or provided for in legal provisions by the public administration to meet various types of demands. Conclusions The categories proposed to approach the judicialization of health care represent some of the recommendations for qualifying public administration or are provided for in Brazilian legislation, or both. The existence of recommendations and legislation facilitate, but do not guarantee, the implementation of strategies by public institutions.
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Affiliation(s)
- Sueli Miyuki Yamauti
- Graduate Program in Pharmaceutical Science, University of Sorocaba, Sorocaba, Brazil
| | | | | | - Luciane Cruz Lopes
- Graduate Program in Pharmaceutical Science, University of Sorocaba, Sorocaba, Brazil
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Araújo LU, Santos DF, Bodevan EC, Cruz HLD, Souza JD, Silva-Barcellos NM. Patient safety in primary health care and polypharmacy: cross-sectional survey among patients with chronic diseases. Rev Lat Am Enfermagem 2019; 27:e3217. [PMID: 31826159 PMCID: PMC6896818 DOI: 10.1590/1518-8345.3123.3217] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 08/08/2019] [Indexed: 01/20/2023] Open
Abstract
Objective: to characterize and determine the polypharmacy prevalence in patients with chronic diseases and to identify the factors associated, in order to improvement of pharmaceutical care focused on patient safety. Methods: cross-sectional study included 558 patients, covered by primary health care, using a household and structured questionnaire. We analyzed the data on polypharmacy and its clinical and socioeconomic factors. Poisson regression analysis with robust variance was applied, with results expressed in prevalence ratio. Results: the results showed that polypharmacy (consumption of four or more drugs) was of 37.6%. The prevalence ratio analyses identified independent variables associated with polypharmacy: age (3.05), economic strata (0.33), way of medication acquisition through a combination of out-of-pocket and Brazilian public health system (1.44), diabetes and hypertension (2.11), comorbidities (coronary artery disease 2.26) and hospital admission (1.73). In the analyses, inappropriate medication use of the 278 patients (≥ 65 years) was associated with polypharmacy (prevalence ratio 4.04). Conclusion: polypharmacy study becomes an opportunity to guide the strategies for the patient safety to promote the medication without harm in chronic diseases.
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Affiliation(s)
- Lorena Ulhôa Araújo
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Departamento de Farmácia, Diamantina, Minas Gerais, Brazil
| | - Delba Fonseca Santos
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Departamento de Farmácia, Diamantina, Minas Gerais, Brazil
| | - Emerson Cotta Bodevan
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Departamento de Matemática e Estatística, Diamantina, Minas Gerais, Brazil
| | - Hellen Lilliane da Cruz
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Departamento de Farmácia, Diamantina, Minas Gerais, Brazil
| | - Jacqueline de Souza
- Universidade Federal de Ouro Preto, Escola de Farmácia, Ouro Preto, Minas Gerais, Brazil
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