RESUMO Objetivo: compreender o uso da ferramenta ultrassonográfica na consulta de enfermagem de pré-natal sob a perspectiva das enfermeiras obstétricas. Método: estudo descritivo, de abordagem qualitativa, realizado em uma maternidade de Belo Horizonte, Minas Gerais, Brasil, com dez enfermeiras(os) obstétricas(os) que utilizam a ultrassonografia obstétrica na consulta de enfermagem. Entrevista individual, semiestruturada, realizada entre 1º e 4 de dezembro de 2021. Utilizou-se o software Atlas.ti para o tratamento dos resultados por meio da análise de conteúdo temática de Bardin. Resultados: as enfermeiras obstétricas ampliaram o cuidado integral às gestantes, implementando a utilização da tecnologia ultrassonográfica durante a consulta de enfermagem obstétrica, inovando as práticas no Brasil. Entretanto, enfrentaram inúmeros desafios, que foram superados graças aos resultados positivos de qualificação do cuidado obstétrico e fetal. Conclusão: a utilização da tecnologia ultrassonográfica na consulta de enfermagem obstétrica significa um avanço na prática de enfermagem, pois possibilita acesso e qualificação ao cuidado em tempo oportuno, gratuitamente, pelo Sistema Único de Saúde. O apoio e o incentivo da gestão institucional fortaleceram a autonomia profissional das enfermeiras obstétricas, mediando a implementação da inovação. O foco do estudo soma-se ao desenvolvimento tecnológico empregado no cotidiano de trabalho da enfermagem brasileira, ampliando a resolubilidade da tomada de decisão aos agravos à saúde. Objetivo prénatal pré natal Método descritivo qualitativa Horizonte Gerais Brasil enfermeirasos os enfermeiras(os obstétricasos obstétricas(os individual semiestruturada º 2021 Utilizouse Utilizou se Atlasti Atlas ti Bardin Resultados gestantes Entretanto desafios fetal Conclusão oportuno gratuitamente Saúde inovação somase soma brasileira saúde 202 20 2

ABSTRACT Objective: to understand how ultrasound tools are used in prenatal Nursing consultations from the perspective of obstetric nurses. Method: a descriptive and qualitative study carried out with ten obstetric nurses that use obstetric ultrasound in their Nursing consultations at a maternity hospital in Belo Horizonte, Minas Gerais, Brazil. Individual, semi-structured interviews were conducted between December 1st and 4th, 2021. The Atlas.ti software was employed to process the results using Bardin's thematic content analysis. Results: the obstetric nurses expanded comprehensive care for pregnant women by implementing the use of ultrasound technology during Obstetric Nursing consultations, thus innovating the practices in Brazil. However, they faced countless challenges, which they overcame thanks to the positive results of improving obstetric and fetal care. Conclusion: using ultrasound technology in Obstetric Nursing consultations represents an advance in the Nursing practice, as it enables access and qualification to timely care, free of charge and through the Unified Health System. The support and encouragement of the institutional management strengthened obstetric nurses' professional autonomy, mediating the implementation of innovation. The study focus is added to the technological development employed in the everyday work of Brazilian Nursing, increasing resoluteness of decision-making in health problems. Objective Method Horizonte Gerais Brazil Individual semistructured semi structured st 4th th 2021 Atlasti Atlas ti Bardins Bardin s analysis Results However challenges Conclusion practice System autonomy innovation decisionmaking decision making problems 202 20 2

RESUMEN Objetivo: comprender cómo se utiliza la herramienta de ultrasonido en consultas de Enfermería prenatal, según la opinión de enfermeras especializadas en Obstetricia. Método: estudio descriptivo de enfoque cualitativo, realizado en una maternidad de Belo Horizonte, Minas Gerais, Brasil, con diez enfermeras(os) especializadas(os) en Obstetricia que utilizan ultrasonido obstétrico en consultas de Enfermería. Se llevaron a cabo entrevistas individuales y semiestructuradas entre el 1 y el 4 de diciembre de 2021. Se utilizó el programa de software Atlas.ti para procesar los resultados por medio de análisis temático de contenido según Bardin. Resultados: las enfermeras especializadas en Obstetricia ampliaron la atención integral provista a las embarazadas, implementando el uso de la tecnología de ultrasonido durante las consultas de Enfermería Obstétrica, innovando así las prácticas de la profesión en Brasil. No obstante, enfrentaron innumerables desafíos, que fueron superados gracias a los resultados positivos de calificación de la atención obstétrica y fetal. Conclusión: utilizar la tecnología de ultrasonido en consultas de Enfermería Obstétrica representa un avance en la práctica de Enfermería, puesto que permite acceder y calificar los cuidados en tiempo y forma, de manera gratuita y a través del Sistema Único de Salud. El apoyo e incentivo por parte de la gerencia institucional fortalecieron la autonomía profesional de las enfermeras especializadas en Obstetricia, mediando la implementación de la innovación. El punto central del estudio se suma al desarrollo tecnológico empleado en la rutina de trabajo de los profesionales de Enfermería en Brasil, expandiendo así la capacidad de resolución del proceso de toma de decisiones relacionado con problemas de salud. Objetivo prenatal Método cualitativo Horizonte Gerais Brasil enfermerasos os enfermeras(os especializadasos especializadas(os 2021 Atlasti Atlas ti Bardin Resultados embarazadas obstante desafíos fetal Conclusión forma Salud innovación salud 202 20 2

ABSTRACT Objective To determine the frequency of drug therapy problems among older adults in Primary Health Care, and to analyze the factors associated with their identification in the initial patient assessment, carried out by pharmacists offering medication therapy management services. Methods A cross-sectional study conducted with data from 758 older adults followed up in medication therapy management services in Primary Health Care in the cities of Belo Horizonte, Betim, and Lagoa Santa (MG, Brazil). Univariate and multivariate analyses were performed to evaluate the factors associated with identification of four or more drug therapy problems in the initial clinical assessment. Results A total of 1,683 drug therapy problems were identified, 73.6% of older patients had at least one problem. The most frequent problems were nonadherence (23.0%) and the need for additional drug therapy (18.0%). Polypharmacy, chronic obstructive pulmonary disease, hypertension, diabetes mellitus, heart failure, and aged 75 years or older remained positively and statistically associated with identification of four or more drug therapy problems (p<0.05). Conclusion There is a high frequency of problems related to medication use among older users of Primary Health Care, and the medication therapy management services should be prioritized to the older patients, who present with polypharmacy, chronic obstructive pulmonary disease, hypertension, diabetes mellitus, heart failure, and age ≥ 75 years, since they are more likely to have more drug therapy problems.

RESUMO Objetivo: Determinar os fatores associados à complexidade alta da farmacoterapia em pacientes com doença arterial coronariana. Métodos: Realizou-se um estudo transversal em um ambulatório multiprofissional de cardiologia na Atenção Secundária do Sistema Único de Saúde, de onde foram coletadas características sociodemográficas (idade, sexo e escolaridade), clínicas (número de condições de saúde, diagnósticos cardiovasculares e comorbidades) e farmacoterápicas (adesão, polifarmácia e polifarmácia cardiovascular). Essas características foram relacionadas com a complexidade da farmacoterapia, mensurada por meio do Índice de Complexidade da Farmacoterapia. A classificação em complexidade alta da farmacoterapia foi realizada empregando a normatização para idosos e a estratificação para pacientes adultos, sugeridas na literatura. Resultados: A complexidade da farmacoterapia total dos 148 pacientes apresentou mediana igual a 17,0 (amplitude interquartílica de 10,5). Na análise univariada, os fatores associados à complexidade alta foram insuficiência cardíaca, diabetes mellitus, hipertensão arterial, cinco ou mais doenças e não adesão. No modelo final, após regressão logística, houve associação estatisticamente significante (p<0,05) com as variáveis diabetes mellitus, hipertensão arterial e não adesão. Conclusão: A complexidade alta da farmacoterapia em pacientes com doença arterial coronariana foi associada à presença de diabetes mellitus, hipertensão arterial e relato de não adesão a medicamentos

ABSTRACT Objective: To determine the factors associated with the high complexity of medication regimen in patients with coronary artery disease. Methods: A cross-sectional study was carried out in a multiprofessional cardiology outpatient clinic, in the Secondary Care of the Unified Health System, where sociodemographic (age, sex, and education), clinical (number of health conditions, cardiovascular diagnoses, and comorbidities) and pharmacotherapeutic (adherence, polypharmacy, and cardiovascular polypharmacy) characteristics were collected. These were related to complexity of medication regimen, measured through the medication regimen complexity index. The classification of high complexity of medication regimen was carried out using standardization for the older adults and stratification for adult patients, as suggested in the literature. Results: The total complexity medication regimen of 148 patients had a median of 17.0 (interquartile range of 10.5). In the univariate analysis, the factors associated with high complexity were heart failure, diabetes mellitus, hypertension, five or more diseases, and non-adherence to treatment. In the final model, after logistic regression, there was a statistically significant association (p<0.05) with the variables diabetes mellitus, hypertension, and non-adherence. Conclusion: The high complexity of medication regimen in patients with coronary artery disease was associated with the presence of diabetes mellitus, hypertension, and reports of non-adherence to treatment.

RESUMO Objetivo Analisar, da perspectiva da farmacoterapia, os fatores associados à visita de idosos a departamentos de emergência em até 30 dias após a alta da internação índice. Métodos Foi realizado estudo transversal em hospital público geral, com idosos. Visita a departamento de emergência foi definido como a permanência do idoso nesse serviço por até 24 horas. A complexidade da farmacoterapia foi determinada usando o Medication Regimen Complexity Index. Os medicamentos potencialmente inapropriados para idosos foram classificados segundo os critérios American Geriatric Society/Beers , de 2015. O desfecho investigado foi a frequência de visita a departamento de emergência em 30 dias após a alta hospitalar. Regressão logística multivariada foi realizada para identificar os fatores associados à visita a departamento de emergência. Resultados No estudo, foram incluídos 255 idosos; 67 (26,3%) visitaram departamento emergência em 30 dias após a alta hospitalar. Polifarmácia e medicamentos potencialmente inapropriados para idosos não apresentaram associação estatística significante. O diagnóstico de insuficiência cardíaca e o índice da complexidade da farmacoterapia >16,5 apresentaram associação positiva com visita a departamento de emergência (RC=2,3; IC95%: 1,04-4,94; p=0,048; e RC=2,1; IC95%: 1,11-4,02; p=0,011), respectivamente. Ainda, o diagnóstico de diabetes mellitus e a doença renal crônica foram fatores de proteção para o desfecho (RC=0,4; IC95%: 0,20-0,73; p=0,004; e RC=0,3; IC95%: 0,13-0,86; p=0,023). Conclusão O diagnóstico de insuficiência cardíaca e o índice da complexidade da farmacoterapia >16,5 apresentaram associação positiva com ocorrência de visita a departamento de emergência dentro de 30 dias após a alta.

ABSTRACT Objective To analyze, from the pharmacotherapy perspective, the factors associated to visits of older adults to the emergency department within 30 days after discharge. Methods A cross-sectional study carried out in a general public hospital with older adults. Emergency department visit was defined as the stay of the older adult in this service for up to 24 hours. The complexity of drug therapy was determined using the Medication Regimen Complexity Index. Potentially inappropriate drugs for use in older adults were classified according to the American Geriatric Society/Beers criteria of 2015. The outcome investigated was the frequency of visits to the emergency department within 30 days of discharge. Multivariate logistic regression was performed to identify the factors associated with the emergency department visit. Results A total of 255 elderly in the study, and 67 (26.3%) visited emergency department within 30 days of discharge. Polypharmacy and potentially inappropriate medications for older adults did not present a statistically significant association. The diagnosis of heart failure and Medication Regimen Complexity Index >16.5 were positively associated with emergency department visits (OR=2.3; 95%CI: 1.04-4.94; p=0.048; and OR=2.1; 95%CI: 1.11-4.02; p=0.011), respectively. Furthermore, the diagnosis of diabetes mellitus and chronic kidney disease were protection factors for the outcome (OR=0.4; 95%CI: 0.20-0.73; p=0.004; and OR=0.3; 95%CI: 0.13-0.86; p=0.023). Conclusion The diagnosis of heart failure and Medication Regimen Complexity Index >16.5 were positively associated with the occurrence of an emergency department visit within 30 days of discharge.

ABSTRACT BACKGROUND: Older adults with a range of comorbidities are often prescribed multiple medications, which favors drug interactions. OBJECTIVES: To establish the frequency of potential drug interactions in prescriptions at hospital discharge among older adults and to identify the associated factors. DESIGN AND SETTING: Cross-sectional study conducted in a public hospital. METHODS: An initial face-to-face interview, data collection from the electronic medical records (covering sociodemographic, clinical, functional and drug therapy-related variables) and telephone follow-up after discharge were conducted to confirm the medication prescribed at discharge. Drug interactions were identified through the Micromedex DrugReax software, along with interactions that should be avoided among the elderly, as per the 2015 American Geriatric Society/Beers criteria. Multivariable logistic regression was performed. RESULTS: Potential for drug interactions was identified in the discharge drug therapy of 67.8% of the 255 older adults evaluated (n = 172), and 54.5% (n = 145) of the drug interactions were major. Among the drug interactions that should be avoided among older adults, those that increase the risk of falls were the most frequent. The drug interactions thus identified were independently associated with polypharmacy (odds ratio, OR = 12.62; 95% confidence interval, CI 6.25-25.50; P = 0.00), diabetes mellitus (OR = 2.16; 95% CI 1.05-4.44; P = 0.04), hypothyroidism (OR = 7.29; 95% CI 2.03-26.10; P = 0.00), chronic kidney disease (OR = 3.41; 95% CI 1.09-10.64; P = 0.03) and hospitalization in geriatric units (OR = 0.45; 95% CI 0.22-0.89; P = 0.02). CONCLUSION: The frequency of potential drug interactions in drug therapy prescribed at discharge for these older adults was high. Polypharmacy, diabetes mellitus, hypothyroidism and chronic kidney disease were positively associated with occurrences of drug interactions, while hospitalization in geriatric units showed an inverse association.

Abstract The interface between the fields of health and communication brings together a wide diversity of topics, perspectives and articulations between academic production (scientific content) and its dissemination to the public (health journalism). The development and convergence of communication technologies, the progressive mediatization of society and institutions, the new generation of readers and their ways of consuming health content are some of the examples of the various issues addressed in health communication. The aim of this article is to reflect on the relationship between media and health and its current importance in the production and dissemination of contents, in light of the new information and communication technologies, producing efficient and credible information, directed to different audiences.