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[PMID]:28460606
[Au] Autor:Hughes BO; Moshabela M; Owen J; Gaede B
[Ad] Endereço:a Centre for Rural Health , University of KwaZulu-Natal , Durban , South Africa.
[Ti] Título:The relevance and role of homestays in medical education: a scoping study.
[So] Source:Med Educ Online;22(1):1320185, 2017.
[Is] ISSN:1087-2981
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The community-based medical education curriculum is growing in popularity as a strategy to bring universal health coverage to underserved communities by providing medical students with hands-on training in primary health care. Accommodation and immersion of medical students within the community will become increasingly important to the success of community-based curricula. In the context of tourism, homestays, where local families host guests, have shown to provide an immersive accommodation experience. OBJECTIVE: By exploring homestays in the educational context, this scoping study investigates their role in providing an immersive pedagogical experience for medical students. DESIGN: A scoping review was performed using the online databases ScienceDirect and the Duke University Library Database, which searches Academic Search Complete, JSTOR, LexisNexis Academic, Web of Science, Proquest, PubMed and WorldCat. Using the inclusion term 'homestays' and excluding the term 'tourism', 181 results were returned. AClose assessment using inclusion criteria narrowed this to 14 relevant articles. RESULTS: There is very little published research specific to the experience of medical students in community homestays, indicating a gap in the literature. However, the existing educational outcomes suggest homestays may have the potential to serve a significant role in medical education, especially as a component of decentralised or community-based programmes. The literature reveals that educational homestays influence language learning, cultural immersion, and the development of professional skills for health science careers. These outcomes relate to the level of engagement between students and hosts, including the catalytic role of community liaisons. CONCLUSIONS: Homestays offer a unique depth of experience that has the potential to enrich the education of participating students, and require further research, particularly in the context of distributed and decentralised training platforms for medical and health sciences students. Future studies should explore the potential for homestays as a pedagogical component of community-based medical curriculum. ABBREVIATIONS: CBME: Community-based medical education.
[Mh] Termos MeSH primário: Serviços de Saúde Comunitária/métodos
Assistência à Saúde/métodos
Educação de Graduação em Medicina/métodos
Atenção Primária à Saúde/métodos
Distribuição Espacial da População
Estudantes de Medicina
[Mh] Termos MeSH secundário: Currículo
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1080/10872981.2017.1320185


  2 / 29209 MEDLINE  
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[PMID]:29220562
[Au] Autor:Perreault D
[Ti] Título:Comment dénicher des ressources communautaires pour nos patients..
[So] Source:Perspect Infirm;14(3):48-50, 2017 May-Jun.
[Is] ISSN:1708-1890
[Cp] País de publicação:Canada
[La] Idioma:fre
[Mh] Termos MeSH primário: Serviços de Saúde Comunitária
[Mh] Termos MeSH secundário: Seres Humanos
Quebeque
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE


  3 / 29209 MEDLINE  
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[PMID]:29489647
[Au] Autor:Lin S; Xian Y; Liu Y; Cai W; Song J; Zhang X
[Ad] Endereço:Department of Clinical Teaching and Research, School of Nursing, Xinjiang Medical University.
[Ti] Título:Risk factors and community intervention for nonalcoholic fatty liver disease in community residents of Urumqi, China.
[So] Source:Medicine (Baltimore);97(9):e0021, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study is to investigate the prevalence and risk factors of nonalcoholic fatty liver disease (NAFLD) and to analyze the effect of comprehensive community intervention on NAFLD in community residents in Urumqi, China.Cluster sampling method with street community as a unit was adopted in this study. Questionnaire survey, body measurement, blood biochemistry (including liver function, fasting blood glucose [FPG], and uric acid [UA]) examination as well as liver B ultrasound were performed. Then, comprehensive intervention was conducted in NAFLD patients.A total of 1000 people were enrolled, including 344 men and 656 women, with an average age of 51.79 ±â€Š4.28 years. Of them, 660 were Han Chinese, 327 were Uygur, and 13 were Hui. The overall prevalence rate of NAFLD was 54.3%. The prevalence rate of NAFLD is higher in middle-aged population and is higher in ethnic minority than that in Han. NAFLD was associated with the past medical history of metabolic diseases. The factors of body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), waist circumference, hip circumference, neck circumference, subcutaneous fat thickness, FPG, alanine aminotransferase, and aspartate aminotransferase were identified as risk factors for NFALD. Neck circumference predicts the occurrence of NAFLD in female better, whereas subcutaneous fat predicts the occurrence of NAFLD in male better. After 8 months of community intervention in NAFLD patients, the changes of BMI, SBP, DBP, waist circumference, neck circumference, subcutaneous fat thickness, and UA were statistically significant (P < .05).The prevalence rate of NAFLD is high in Urumqi, China. Community intervention is effective in reducing the degree of NAFLD and promoting the overall health of NAFLD patients.
[Mh] Termos MeSH primário: Serviços de Saúde Comunitária
Educação em Saúde
Hepatopatia Gordurosa não Alcoólica/epidemiologia
Hepatopatia Gordurosa não Alcoólica/prevenção & controle
[Mh] Termos MeSH secundário: China/epidemiologia
Estudos Transversais
Feminino
Seres Humanos
Masculino
Meia-Idade
Hepatopatia Gordurosa não Alcoólica/diagnóstico
Prevalência
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000010021


  4 / 29209 MEDLINE  
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[PMID]:29465559
[Au] Autor:Zhang Y; Cao H; Jiang P; Tang H
[Ad] Endereço:Department of Geriatrics Cardiology.
[Ti] Título:Cardiac rehabilitation in acute myocardial infarction patients after percutaneous coronary intervention: A community-based study.
[So] Source:Medicine (Baltimore);97(8):e9785, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Acute myocardial infarction (AMI) is one of the leading causes of death and physical disability worldwide. However, the development of community- based cardiac rehabilitation (CR) in AMI patients is hysteretic. Here, we aimed to evaluate the safety and efficacy of CR applied in the community in AMI patients who underwent percutaneous coronary intervention (PCI). METHODS: A total of 130 ST-segment elevated myocardial infarction (STEMI) patients after PCI were randomly divided into 2 groups in the community, rehabilitation group (n = 65) and control group (n = 65). Cardiac function, a 6-minute walk distance, exercise time and steps, cardiovascular risk factors were monitored respectively and compared before and after the intervention of 2 groups. The software of EpiData 3.1 was used to input research data and SPSS16.0 was used for statistical analysis. RESULTS: After a planned rehabilitation intervention, the rehabilitation group showed better results than the control group. The rehabilitation group had a significant improvement in recurrence angina and readmission (P < .01). Left ventricular ejection fraction (LVEF) of rehabilitation group showed improvement in phase II (t = 4.963, P < .01) and phase III (t = 11.802, P < .01), and the New York Heart Association (NYHA) classification was recovered within class II. There was a significant difference compared with before (Z = 7.238, P < .01). Six minutes walking distance, aerobic exercise time, and steps all achieved rehabilitation requirements in rehabilitation group in phase II and III, there existed distinct variation between 2 phases. Rehabilitation group had a better result in cardiovascular risk factors than control group (P < .05). CONCLUSION: Community-based CR after PCI through simple but safe exercise methods can improve the AMI patient's living quality, which includes increasing cardiac ejection fraction, exercise tolerance, and physical status. It must be emphasized that the good result should be established by the foundation of close cooperation between cardiologists and general practitioners, also the importance of cooperation of patients and their families should not be ignored. The rehabilitation program we used is feasible, safe, and effective.
[Mh] Termos MeSH primário: Reabilitação Cardíaca/métodos
Serviços de Saúde Comunitária/métodos
Terapia por Exercício/métodos
Infarto do Miocárdio/reabilitação
Intervenção Coronária Percutânea/reabilitação
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Tolerância ao Exercício
Feminino
Seres Humanos
Masculino
Meia-Idade
Infarto do Miocárdio/fisiopatologia
Infarto do Miocárdio/cirurgia
Volume Sistólico
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009785


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[PMID]:28459925
[Au] Autor:Carrasquillo O; Lebron C; Alonzo Y; Li H; Chang A; Kenya S
[Ad] Endereço:Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida2Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida.
[Ti] Título:Effect of a Community Health Worker Intervention Among Latinos With Poorly Controlled Type 2 Diabetes: The Miami Healthy Heart Initiative Randomized Clinical Trial.
[So] Source:JAMA Intern Med;177(7):948-954, 2017 Jul 01.
[Is] ISSN:2168-6114
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Community health worker (CHW) intervention is a promising approach to address type 2 diabetes among Latinos. However, evidence from randomized clinical studies is limited. Objective: To compare a CHW intervention with enhanced usual care. Design, Setting, and Participants: This 52-week, single-blind, randomized clinical trial included 300 Latino adults aged 18 to 65 years who were treated in 2 public hospital outpatient clinics in Miami-Dade County, Florida, from July 1, 2010, through October 31, 2013. Eligible participants had a hemoglobin A1c (HbA1c) level of 8.0 or greater. Follow-up was completed January 31, 2015, and data were analyzed from March 10, 2015, to June 6, 2016. Interventions: A 1-year CHW intervention consisted of home visits, telephone calls, and group-level activities. Main Outcomes and Measures: Primary outcomes included systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDLC) levels, and HbA1c levels. Secondary outcomes included body mass index, medication regimen intensification, and self-reported measures of diet, physical activity, and medication regimen adherence. Results: Of the 300 participants randomized (135 men [45%] and 165 women [55%]; mean [SD] age, 55.2 [7.0] years), we obtained follow-up data on 215 (71.7%). Participants in the CHW group received a median of 4 home visits and 20 telephone calls. After adjusting for baseline values and covariates, participants in the CHW group had an HbA1c level that was 0.51% lower (95% CI, -0.94% to -0.08%) than that of participants in the enhanced usual care group. The reduction in SBP of 4.62 mm Hg (95% CI, -9.01 to -0.24 mm Hg) did not meet the preplanned target of 8 mm Hg and was not statistically significant in unadjusted models. No significant differences in LDLC levels (mean difference, -8.2 mg/dL; 95% CI, -18.8 to 2.3 mg/dL) or any of the preplanned secondary outcomes were observed. Post hoc analyses suggest that the intervention may be more beneficial among those with worse control of their type 2 diabetes at baseline. Conclusions and Relevance: Among Latinos with poorly controlled type 2 diabetes, a 12-month CHW intervention lowered HbA1c levels by 0.51%. The intervention did not lead to improvements in LDLC levels, and the findings with respect to SBP were variable and half of what was targeted. Future studies should examine whether CHW interventions affect other measures, such as access to health care or social determinants of health. Trial Registration: clinicaltrials.gov Identifier: NCT01152957.
[Mh] Termos MeSH primário: Serviços de Saúde Comunitária
Agentes Comunitários de Saúde
Diabetes Mellitus Tipo 2
Cooperação do Paciente/etnologia
[Mh] Termos MeSH secundário: Adulto
Atitude do Pessoal de Saúde
Glicemia/análise
Serviços de Saúde Comunitária/métodos
Serviços de Saúde Comunitária/organização & administração
Agentes Comunitários de Saúde/organização & administração
Agentes Comunitários de Saúde/psicologia
Diabetes Mellitus Tipo 2/diagnóstico
Diabetes Mellitus Tipo 2/etnologia
Diabetes Mellitus Tipo 2/psicologia
Diabetes Mellitus Tipo 2/terapia
Comportamento Alimentar/etnologia
Comportamento Alimentar/fisiologia
Feminino
Florida/epidemiologia
Hemoglobina A Glicada/análise
Hispano-Americanos/estatística & dados numéricos
Seres Humanos
Masculino
Meia-Idade
Avaliação de Processos e Resultados (Cuidados de Saúde)
Autocuidado/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Blood Glucose); 0 (Glycated Hemoglobin A)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170502
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1001/jamainternmed.2017.0926


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[PMID]:29277901
[Au] Autor:Redeker NS; Ordway MR; Banasiak N; Caldwell B; Canapari C; Crowley A; Fenick A; Jeon S; O'Connell M; Sude L; Sadler LS
[Ad] Endereço:Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut.
[Ti] Título:Community partnership for healthy sleep: Research protocol.
[So] Source:Res Nurs Health;41(1):19-29, 2018 02.
[Is] ISSN:1098-240X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Beginning early in life, sleep health, including adequate quality, quantity, and consistent sleep routines, is critical to growth and development, behavior, and mental and physical health. Children who live in economically stressed urban environments are at particular risk for sleep deficiency and its negative consequences. Although efficacious sleep health interventions are available, few address the context of economically stressed urban environments. The purpose of this paper is to describe a two-phase protocol for an ongoing NIH/NINR-funded community-engaged study designed to understand the perspectives of parents, community child care and pediatric health care providers about sleep habits, factors that contribute to sleep and sleep habits, sleep difficulty, and potentially useful sleep promotion strategies among children living in economically stressed urban environments. The social-ecological model guides this study. Phase I employs a convergent mixed-methods design, in which we are conducting semi-structured interviews with parents, childcare providers, and primary health care providers. We are collecting 9 days of objective sleep data (wrist actigraphy) from children who are 6-18 months (n = 15) and 19-36 months of age (n = 15) and parent reports of sleep and sleep-related factors using standard questionnaires. In Phase I, we will use a qualitative descriptive approach to analyze the interview data, and descriptive statistics to analyze the survey and actigraph data. In Phase II, we will use the information to develop a contextually relevant program to promote sleep health. Our long-term goal is to improve sleep health and sleep-related outcomes in these children.
[Mh] Termos MeSH primário: Serviços de Saúde da Criança/organização & administração
Serviços de Saúde Comunitária/organização & administração
Promoção da Saúde/métodos
Pesquisa em Enfermagem
Atenção Primária à Saúde/organização & administração
Transtornos do Sono-Vigília/terapia
População Urbana/estatística & dados numéricos
[Mh] Termos MeSH secundário: Pré-Escolar
Connecticut
Feminino
Seres Humanos
Lactente
Masculino
Inquéritos e Questionários
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:171227
[St] Status:MEDLINE
[do] DOI:10.1002/nur.21840


  7 / 29209 MEDLINE  
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[PMID]:29361656
[Au] Autor:Mortenson LC; Thomson Reuters Accelus.
[Ti] Título:Medicaid Waivers.
[So] Source:Issue Brief Health Policy Track Serv;2017:1-39, 2017 Dec 26.
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Medicaid/organização & administração
[Mh] Termos MeSH secundário: Serviços de Saúde Comunitária
Serviços de Saúde Bucal
Definição da Elegibilidade
Emprego
Reforma dos Serviços de Saúde
Serviços de Assistência Domiciliar
Seres Humanos
Índios Norte-Americanos
Cobertura do Seguro
Pessoas sem Cobertura de Seguro de Saúde
Serviços de Saúde Mental
Patient Protection and Affordable Care Act
Governo Estadual
Detecção do Abuso de Substâncias
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE


  8 / 29209 MEDLINE  
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[PMID]:29361655
[Au] Autor:Raduege TJ; Thomson Reuters Accelus.
[Ti] Título:Medicaid Restructuring.
[So] Source:Issue Brief Health Policy Track Serv;2017:1-72, 2017 Dec 26.
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Medicaid/organização & administração
[Mh] Termos MeSH secundário: Organizações de Assistência Responsáveis
Orçamentos
Serviços de Saúde Comunitária
Elegibilidade Dupla ao MEDICAID e MEDICARE
Definição da Elegibilidade
Governo Federal
Reforma dos Serviços de Saúde
Serviços de Assistência Domiciliar
Seres Humanos
Programas de Assistência Gerenciada
Serviços de Saúde Mental
Patient Protection and Affordable Care Act
Assistência Centrada no Paciente
Governo Estadual
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE


  9 / 29209 MEDLINE  
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[PMID]:29361654
[Au] Autor:Berry MD; Thomson Reuters Accelus.
[Ti] Título:Medicaid Reimbursement.
[So] Source:Issue Brief Health Policy Track Serv;2017:1-25, 2017 Dec 26.
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Reembolso de Seguro de Saúde/legislação & jurisprudência
Medicaid/economia
Medicaid/organização & administração
[Mh] Termos MeSH secundário: Serviços de Saúde Comunitária
Governo Federal
Fraude/prevenção & controle
Serviços de Assistência Domiciliar
Seres Humanos
Seguro Odontológico
Seguro de Serviços Farmacêuticos
Federação Internacional de Planejamento Familiar
Assistência de Longa Duração
Atenção Primária à Saúde
Diálise Renal
Governo Estadual
Telemedicina
Transporte de Pacientes
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE


  10 / 29209 MEDLINE  
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[PMID]:29360335
[Au] Autor:Raduege TJ; Thomson Reuters Accelus.
[Ti] Título:Federal Medicaid Policy.
[So] Source:Issue Brief Health Policy Track Serv;2017:1-64, 2017 Dec 26.
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Medicaid/organização & administração
[Mh] Termos MeSH secundário: Serviços de Saúde Comunitária
Segurança Computacional
Elegibilidade Dupla ao MEDICAID e MEDICARE
Registros Eletrônicos de Saúde
Governo Federal
Acesso aos Serviços de Saúde
Serviços de Assistência Domiciliar
Seres Humanos
Seguro de Serviços Farmacêuticos
Programas de Assistência Gerenciada
Uso Significativo
Patient Protection and Affordable Care Act
Segurança do Paciente
Satisfação do Paciente
Projetos Piloto
Atenção Primária à Saúde
Governo Estadual
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE



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