RESUMEN
Human Visceral Leishmaniasis is an endemic public health problem in the Amazon. This article analyzed the spatial distribution of this disease and its relationship with socioeconomic, environmental and public health policy variables in four mesoregions of the state of Pará, from 2011 to 2022. This ecological study used secondary data obtained from official Brazilian agencies. Spatial analysis was performed using the Flow, Kernel and Global Moran bivariate techniques expressed in thematic maps. In the mesoregions studied, 2685 cases of the disease were confirmed, with the highest number of cases in Southeast Pará state. The epidemiological profile followed the national pattern of occurrence of the disease, with a higher number of cases in children below school age. Spatial dependence was observed between the prevalence of the disease and socio-economic indicators. The most intense movement of patients was towards the Belém Metropolitan mesoregion. The disease showed an inhomogeneous pattern of distribution of cases, with a direct relationship between areas with cases and deforestation associated with different anthropic activities. There is a socio-environmental production of the disease that goes beyond the border limits of the mesoregions, and its establishment is related to the unsustainable development model implemented in the region.
RESUMEN
BACKGROUND: The COVID-19 pandemic highlighted the need for a new dynamic in the organization and practices of health services, as it required rapid restructuring to promote safe and harm-free assistance. OBJECTIVE: To assess the dimensions of the patient safety culture (PSC) from the perspective of the health team professionals in clinical-surgical ICU (G1) compared to a COVID-19 ICU (G2). METHODS: Cross-sectional, analytical, descriptive and inferential study, using the "Hospital Survey on Patient Safety Culture" questionnaire. RESULTS: The domain "Supervisor/Manager Expectations and Actions Promoting Patient Safety (PS)" was a potential weakness for G1 (p = 0.003). G2 was most positive on improving PS, being informed about errors, considering PS as a top priority to management, and that the units work together to provide the best care (p > 0.05). G1 was most negative about the work culture with staff from other units, exchange of information across units, and shift changes (p > 0.05). The highest PS grade was related to greater communication, and a smaller frequency of events was reported only for G2 (p > 0.05). CONCLUSION: There must be a balance in terms of attention focused on PS between different ICUs in times of crisis, especially regarding the supervisors/managers actions.
Asunto(s)
COVID-19 , Cultura Organizacional , Humanos , Estudios Transversales , Seguridad del Paciente , Brasil/epidemiología , Pandemias , COVID-19/epidemiología , Administración de la Seguridad , Unidades de Cuidados Intensivos , Encuestas y CuestionariosRESUMEN
Objective: To analyse the impact of screening actions on the incidence and mortality rates of cervical cancer (CC) in the city of Belém, Brazil. Methods: Based on the cancer registry data from 1998 to 2017, collected from the Belém Population-Based Cancer Registry, combined with local population data for the interval 1998-2017, CC incidence and mortality were calculated. The Segi world population 1960 was used for age-standardised incidence/mortality rates. Results: In the period analysed, there were 4,469 new cases and 1,660 deaths from CC. The median age at diagnosis of invasive cases was 51 years. The age-adjusted incidence rate decreased from 18.65/100,000 in 1998 to 11.79/100,000 in 2017, despite the increase observed in the first 5 years of the historical series, while there was stability in mortality rates in the same time lapse. Conclusion: CC is still one of the most common malignant tumours that threaten public health in northern Brazil. The trend of the disease depends on comprehensive prevention and control strategies regarding the local situation and age groups, with emphasis on the organisation of the screening programme and vaccination against human papillomavirus.