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  1 / 6410 MEDLINE  
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[PMID]:29346351
[Au] Autor:Watson H; Moss R
[Ad] Endereço:National Clinical Lead for the AYA Cancer Network Aotearoa.
[Ti] Título:Adolescents and young adults with cancer in New Zealand-understudied and underserved.
[So] Source:N Z Med J;131(1468):8-11, 2018 01 19.
[Is] ISSN:1175-8716
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Mh] Termos MeSH primário: Assistência à Saúde/métodos
Necessidades e Demandas de Serviços de Saúde
Neoplasias/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Seres Humanos
Área Carente de Assistência Médica
Neoplasias/mortalidade
Nova Zelândia/epidemiologia
Taxa de Sobrevida
Adulto Jovem
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180119
[St] Status:MEDLINE


  2 / 6410 MEDLINE  
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[PMID]:29369857
[Au] Autor:Sofer D
[Ad] Endereço:Dalia Sofer.
[Ti] Título:Nurse-Led Health Clinics Show Positive Outcomes.
[So] Source:Am J Nurs;118(2):12, 2018 02.
[Is] ISSN:1538-7488
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:But political and fiscal challenges remain.
[Mh] Termos MeSH primário: Prática Avançada de Enfermagem
Instituições de Assistência Ambulatorial
[Mh] Termos MeSH secundário: Acesso aos Serviços de Saúde
Seres Humanos
Área Carente de Assistência Médica
Satisfação do Paciente
Estados Unidos
[Pt] Tipo de publicação:NEWS
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1097/01.NAJ.0000530229.30533.ce


  3 / 6410 MEDLINE  
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[PMID]:28448769
[Au] Autor:Yang YT; Chen B; Wanchek T
[Ad] Endereço:1 Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA.
[Ti] Título:Dental Therapists: A Solution to a Shortage of Dentists in Underserved Communities?
[So] Source:Public Health Rep;132(3):285-288, 2017 May/Jun.
[Is] ISSN:1468-2877
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Auxiliares de Odontologia/organização & administração
Assistência Odontológica/organização & administração
Acesso aos Serviços de Saúde/organização & administração
Área Carente de Assistência Médica
[Mh] Termos MeSH secundário: Auxiliares de Odontologia/legislação & jurisprudência
Seres Humanos
Reembolso de Seguro de Saúde
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1177/0033354917698114


  4 / 6410 MEDLINE  
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[PMID]:29292322
[Au] Autor:Mays KA; Maguire M
[Ad] Endereço:Dr. Mays is Associate Professor and Associate Dean of Academic Affairs, University of Minnesota School of Dentistry; Ms. Maguire is Assistant Director, Outreach Division, Department of Primary Dental Care, University of Minnesota. kmays@umn.edu.
[Ti] Título:Care Provided by Students in Community-Based Dental Education: Helping Meet Oral Health Needs in Underserved Communities.
[So] Source:J Dent Educ;82(1):20-28, 2018 Jan.
[Is] ISSN:1930-7837
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Since 2000, reports have documented the challenges faced by many Americans in receiving oral health care and the consequences of inadequate care such as high levels of dental caries among many U.S. children. To help address this problem, many dental schools now include community-based dental education (CBDE) in their curricula, placing students in extramural clinics where they provide care in underserved communities. CBDE is intended to both broaden the education of future oral health professionals and expand care for patients in community clinics. The aim of this study was to develop a three-year profile of the patients seen and the care provided by students at extramural clinics associated with one U.S. dental school. Three student cohorts participated in the rotations: final-year students in the Doctor of Dental Surgery, Bachelor of Science in Dental Hygiene, and Master of Dental Therapy programs. The study was a retrospective analysis of data retrieved from the school's database for three consecutive academic years. The data included patients' demographics and special health care needs status (based on information collected by students from their patients) and procedures students performed while on rotations. For the three-year period, the results showed a total of 43,128 patients were treated by 418 student providers. Approximately 25% of all encounters were with pediatric patients. Students completed 5,908 child prophylaxis, 5,386 topical fluoride varnish, and 7,678 sealant procedures on pediatric patients. Annually, 7% of the total patients treated had special health care needs. The results show that these students in CBDE rotations provided a substantial amount of oral health care at extramural sites and gained additional experience in caring for a diverse population of patients and performing a wide range of procedures.
[Mh] Termos MeSH primário: Odontologia Comunitária/educação
Serviços de Saúde Comunitária
Serviços de Saúde Bucal
Educação em Odontologia
Necessidades e Demandas de Serviços de Saúde
Área Carente de Assistência Médica
Estudantes de Odontologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Criança
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Estados Unidos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180112
[Lr] Data última revisão:
180112
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE
[do] DOI:10.21815/JDE.018.003


  5 / 6410 MEDLINE  
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[PMID]:29292321
[Au] Autor:Simon L; Shroff D; Barrow J; Park SE
[Ad] Endereço:Dr. Simon is a Fellow in Oral Health and Medicine Integration, Harvard School of Dental Medicine and an MD student, Harvard Medical School; Deepti Shroff is a DMD student, Harvard School of Dental Medicine; Ms. Barrow is Associate Dean, Office of Global and Community Health, Harvard School of Dental
[Ti] Título:A Reflection Curriculum for Longitudinal Community-Based Clinical Experiences: Impact on Student Perceptions of the Safety Net.
[So] Source:J Dent Educ;82(1):12-19, 2018 Jan.
[Is] ISSN:1930-7837
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Community-based dental education (CBDE) allows dental students to be immersed in community settings and provide care to populations that are underserved. Exposure to those groups during training may impact provider attitudes, which may be strengthened by supporting students' reflection and exploration of their own attitudes. The aim of this study was to describe the implementation and preliminary results of a pilot longitudinal reflection curriculum integrated into a community-based clinical experience (CBCE) for senior dental students at one U.S. dental school and to report the impact of the reflection curriculum and CBCE on student experiences with populations that are underserved. In academic year 2015-16, all 35 senior dental students at one U.S. dental school were invited to complete an 11-item survey before and after completing a 12-week CBCE with integrated, longitudinal online reflections. Students received feedback from a faculty member after each reflection. All 35 students completed the survey, for a 100% response rate. After the CBCE, the students reported improved clinical efficiency and increased confidence in treatment planning and in treating dental emergencies and dentally anxious patients. They also reported improved understanding of the structure and relevance of community health centers, the role of different health care team members, and the impact of health policy. There was no significant difference in future plans to work with groups that are underserved. These results suggest that the CBCE and reflection curriculum had a positive impact on the students' clinical confidence as well as expanding their understanding of the broader oral health care delivery system. To address persistent oral health disparities, dental schools should continue to adopt CBDE programming that will prepare providers to effectively care for populations that are underserved.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Odontologia Comunitária/educação
Serviços de Saúde Comunitária
Educação em Odontologia
Provedores de Redes de Segurança
Estudantes de Odontologia/psicologia
[Mh] Termos MeSH secundário: Boston
Currículo
Área Carente de Assistência Médica
Autorrelato
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180112
[Lr] Data última revisão:
180112
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE
[do] DOI:10.21815/JDE.018.004


  6 / 6410 MEDLINE  
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[PMID]:29065129
[Au] Autor:Qian Y; Gao J; Zhou Z; Yan J; Xu Y; Yang X; Li Y
[Ad] Endereço:School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.
[Ti] Título:An equity analysis of health examination service utilization by women from underdeveloped areas in western China.
[So] Source:PLoS One;12(10):e0186837, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: This study sought to examine the sources of inequity in health examination service utilization by women from underdeveloped areas in western China. METHODS: Based on data from the 5th National Health Service Survey in Shaanxi province, women's utilization of health examination services was examined according to gynecological, cervical smear, and breast examination rates. The equity of health examination service utilization by 15- to 64-year-old women and the factors contributing to inequity were determined using the health concentration index, decomposition of the concentration index, and the horizontal inequity index. RESULTS: The examination rates for gynecological, cervical smear, and breast exams for 15- to 64-year-old women in Shaanxi province were 40.61%, 27.08%, and 24.59%, respectively. The horizontal inequity indices of gynecological, cervical smear, and breast examination rates were 0.0480, 0.0423, and 0.0764, respectively, and each examination rate was higher for wealthy individuals. The contribution rates of economic status to the inequalities in gynecological, cervical smear, and breast examination rates were 65.80%, 74.31%, and 56.49%, respectively. The contribution rates of educational status to the inequalities in gynecological, cervical smear, and breast examination rates were 21.01%, 14.83% and 30.00%, respectively. The contribution rates of age to the inequalities in gynecological, cervical smear, and breast examination rates were 25.77%, 26.55%, and 18.40%, respectively. CONCLUSIONS: Women's health examination rates differed between populations with different socio-demographic characteristics. There is pro-wealth inequality in each examination rate. This study found that financial status, age, and education level were the main reasons for the unequal utilization of health examination services.
[Mh] Termos MeSH primário: Área Carente de Assistência Médica
Exame Físico
Serviços de Saúde da Mulher/utilização
[Mh] Termos MeSH secundário: Adolescente
Adulto
China
Feminino
Disparidades em Assistência à Saúde
Seres Humanos
Meia-Idade
Teste de Papanicolaou
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171025
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0186837


  7 / 6410 MEDLINE  
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[PMID]:28931037
[Au] Autor:Deckert A; Neuhann F; Klose C; Bruckner T; Beiersmann C; Haloka J; Nsofwa M; Banda G; Brune M; Reutter H; Rothenbacher D; Zeier M
[Ad] Endereço:Institute of Public Health, Heidelberg University Hospital, Heidelberg, Germany.
[Ti] Título:Assessment of renal function in routine care of people living with HIV on ART in a resource-limited setting in urban Zambia.
[So] Source:PLoS One;12(9):e0184766, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Data on renal impairment in sub-Saharan Africa (SSA) remains scarce, determination of renal function is not part of routine assessments. We evaluated renal function and blood pressure in a cohort of people living with HIV (PLWH) on antiretroviral treatment (ART) in the Renal Care Zambia project (ReCaZa). METHODS: Using routine data from an HIV outpatient clinic from 2011-2013, we retrospectively estimated the glomerular filtration rate (eGFR, CKD-Epi formula) of PLWH on ART in Lusaka, Zambia. Data were included if adults had had at least one serum creatinine recorded and had been on ART for a minimum of three months. We investigated the differences in eGFR between ART subgroups with and without tenofovir disproxil fumarate (TDF), and applied multivariable linear models to associate ART and eGFR, adjusted for eGFR before ART initiation. RESULTS AND DISCUSSION: Among 1118 PLWH (63,3% female, mean age 41.8 years, 83% ever on TDF; median duration 1461 [range 98 to 4342] days) on ART, 28.3% had an eGFR <90 ml/min, and 5.5% <60 ml/min at their last measurement. Information on other conditions associated with renal impairment was not systematically documented. Fourteen per cent of the PLWH who later switched to TDF-free ART had an initial eGFR lower 60ml/min. Nineteen percent had first-time hypertensive readings at their last visit. The multivariable models suggest that physicians acted according to guidelines and replaced TDF-containing ART if patients developed moderate/severe renal impairment. CONCLUSIONS: Assessment of renal function in SSA remains a challenge. The vast majority of PLWH benefit from long-term ART, including improved renal function. However, approximately 5% of PLWH on ART may have clinically relevant decreased eGFR, and 27% hypertension. While a routine renal assessment might not be feasible, strategies to identify patients at risk are warranted. Targeted monitoring prior and during ART is recommended, however, should not delay ART access.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/efeitos adversos
Taxa de Filtração Glomerular/efeitos dos fármacos
Infecções por HIV/tratamento farmacológico
HIV-1/isolamento & purificação
Área Carente de Assistência Médica
Testes Imediatos
Insuficiência Renal/induzido quimicamente
[Mh] Termos MeSH secundário: Adulto
Países em Desenvolvimento
Feminino
Infecções por HIV/virologia
HIV-1/efeitos dos fármacos
Seres Humanos
Testes de Função Renal
Masculino
Meia-Idade
Insuficiência Renal/epidemiologia
Estudos Retrospectivos
Zâmbia/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-HIV Agents)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171017
[Lr] Data última revisão:
171017
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170921
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184766


  8 / 6410 MEDLINE  
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[PMID]:28899245
[Au] Autor:Tallier PC; Reineke PR; Frederickson K
[Ad] Endereço:1 Director/Associate Professor, Nursing, Mercy College, Dobbs Ferry, NY, USA.
[Ti] Título:Evaluation of Healthy Living Wellness Program With Minority Underserved Economically Disadvantaged Older Adults.
[So] Source:Nurs Sci Q;30(2):143-151, 2017 Apr.
[Is] ISSN:1552-7409
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The purpose of this Roy adaptation model-guided study was to test the effectiveness of a student registered nurse intern-led nursing intervention entitled the Healthy Living Wellness Program. A one-group pretest/posttest preexperimental design was used. The intervention was imparted to minority, underserved, economically disadvantaged older adults ( N = 30). Significant findings pre- and postintervention were reported for body mass index, waist circumference, self-reported blood glucose, and weight. The findings supported the effectiveness of the nursing intervention, the Healthy Living Wellness Program, guided by the Roy adaptation model.
[Mh] Termos MeSH primário: Comportamentos Relacionados com a Saúde
Promoção da Saúde/métodos
Área Carente de Assistência Médica
Grupos Minoritários/psicologia
[Mh] Termos MeSH secundário: Idoso
Índice de Massa Corporal
Feminino
Seres Humanos
Masculino
Estudantes de Enfermagem
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170914
[St] Status:MEDLINE
[do] DOI:10.1177/0894318417693285


  9 / 6410 MEDLINE  
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[PMID]:28885419
[Au] Autor:Chen CCG; Dougherty A; Whetstone S; Mama ST; Larkins-Pettigrew M; Raine SP; Autry AM; Association of Professors of Gynecology and Obstetrics Committee on Global Health
[Ad] Endereço:Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland; the Department of Obstetrics, Gynecology and Reproductive Sciences, Larner College of Medicine at the University of Vermont, Burlington, Vermont; the Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California; the Department of Obstetrics/Gynecology, Cooper Medical School of Rowan University, Camden, New Jersey; the Department of Obstetrics/Gynecology and Reproductive Biology, Case Western School of Medicine, Cleveland, Ohio; and the Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
[Ti] Título:Competency-Based Objectives in Global Underserved Women's Health for Medical Trainees.
[So] Source:Obstet Gynecol;130(4):836-842, 2017 Oct.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The Association of Professors of Gynecology and Obstetrics Committee on Global Health developed an inclusive definition of global women's health and competency-based objectives that reflected work internationally, as well as with U.S. vulnerable and underserved populations, such as refugee and immigrant populations or those who would otherwise have compromised access to health care. The knowledge, skill, and attitude-based competencies required to fulfill each learning objective were mapped to the Accreditation Council for Graduate Medical Education Outcomes Project's educational domains and the Consortium of Universities for Global Health competency domains. The proposed global women's health definition and competency-based learning objective framework is a first step in ensuring quality standards for educating trainees to address global women's health needs. By proposing these objectives, we hope to guide future program development and spark a broader conversation that will improve health for vulnerable women and shape educational, ethical, and equitable global health experiences for medical trainees.
[Mh] Termos MeSH primário: Estágio Clínico
Educação Baseada em Competências/normas
Educação de Graduação em Medicina/normas
Área Carente de Assistência Médica
[Mh] Termos MeSH secundário: Benchmarking
Feminino
Saúde Global
Ginecologia/educação
Seres Humanos
Serviços de Saúde Materno-Infantil
Obstetrícia/educação
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170909
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002197


  10 / 6410 MEDLINE  
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[PMID]:28704570
[Au] Autor:Bellizzi S; Sobel HL; Ali MM
[Ad] Endereço:UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
[Ti] Título:Signs of eclampsia during singleton deliveries and early neonatal mortality in low- and middle-income countries from three WHO regions.
[So] Source:Int J Gynaecol Obstet;139(1):50-54, 2017 Oct.
[Is] ISSN:1879-3479
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine the prevalence of eclampsia symptoms and to explore associations between eclampsia and early neonatal mortality. METHODS: The present secondary analysis included Demographic and Health Surveys data from 2005 to 2012; details of signs related to severe obstetric adverse events of singleton deliveries during interviewees' most recent delivery in the preceding 5 years were included. Data and delivery history were merged for pooled analyses. Convulsions-used as an indicator for having experienced eclampsia-and early neonatal mortality rates were compared, and a generalized random effect model, adjusted for heterogeneity between and within countries, was used to investigate the impact of presumed eclampsia on early neonatal mortality. RESULTS: The merged dataset included data from six surveys and 55 384 live deliveries that occurred in Colombia, Bangladesh, Indonesia, Mali, Niger, and Peru. Indications of eclampsia were recorded for 1.2% (95% confidence interval [CI] 1.0-1.3), 1.7% (95% CI 1.5-2.1), and 1.7% (95% CI 1.5-2.1) of deliveries reported from the American, South East Asian, and African regions, respectively. Pooled analyses demonstrated that eclampsia was associated with increased risk of early neonatal mortality (adjusted risk ratio 2.1 95% CI 1.4-3.2). CONCLUSION: Increased risk of early neonatal mortality indicates a need for strategies targeting the early detection of eclampsia and early interventions.
[Mh] Termos MeSH primário: Eclampsia/epidemiologia
Cuidado Pré-Natal/normas
[Mh] Termos MeSH secundário: Adolescente
Adulto
Estudos Transversais
Países em Desenvolvimento
Eclampsia/etiologia
Eclampsia/mortalidade
Feminino
Necessidades e Demandas de Serviços de Saúde
Inquéritos Epidemiológicos
Seres Humanos
Lactente
Mortalidade Infantil
Recém-Nascido
Serviços de Saúde Materno-Infantil
Área Carente de Assistência Médica
Meia-Idade
Gravidez
Resultado da Gravidez
Fatores Socioeconômicos
Organização Mundial da Saúde
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170714
[St] Status:MEDLINE
[do] DOI:10.1002/ijgo.12262



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