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Introduction. The COVID-19 infection drastically affected health care worldwide, creating challenges for primary care. In order to mitigate and manage infection, telemedicine has become an emerging and effective modality in several medical specialties, including head and neck surgery. Methods. Retrospective cross-sectional analysis of patients seen in virtual consultation over 18 months. Absolute and relative frequencies were estimated, univariate analysis was done with chi-square, and bivariate analysis with binary logistic regression. Variables such as primary diagnosis, the resolution power of the consultation, the need for an in-person appointment, the platform, and its difficulties were included. Results. 2485 patients from 11 departments were included. Thyroid pathology was the most frequent (62.9%), followed by aerodigestive tract pathology (10.8%). The consultation was efficient in 99% of cases, with a resolution capacity of 96.4%. 1.4% had difficulties on the platform and 8.3% of patients required an in-person. When there was difficulty in reviewing exams or an inadequate functional inspection, it was 30 times more likely to not be able to efficiently be resolved. Conclusion. Telemedicine provides an efficient alternative for care in head and neck surgery, especially in thyroid pathology controls, avoiding unnecessary travel. In the aerodigestive tract, where the physical examination is essential, its usefulness is limited to the possibility of performing a subsequent endoscopic examination that allows adequate staging and facilitates in-person assessment. [ABSTRACT FROM AUTHOR]

Background: The medical care paradigm is face-to-face; however, technological development has led to the digital modality. Objective: To determine cost-effectiveness of digital care and face-to-face care at the first level of care. Material and methods: Cost-effectiveness study. 2 groups were integrated: the digital service and the face-to-face service. The sample size was calculated with the percentage formula for 2 groups, and the result was 217 per group. The effectiveness was evaluated in 3 dimensions: the satisfaction of the patient, of the doctor and of the medical assistant. In all 3 cases the Visual analogue scale was used. The cost corresponded to the fixed unit cost estimated with the technique of times and movements adjusted for the duration of care. The statistical analysis included averages, percentages and costeffectiveness ratio. Results: The cost of digital attention is $343.83 and face-toface attention is $171.91 (all estimated in Mexican pesos). From the patient's perspective, the effectiveness in digital care is $9.47 and in face-to-face is $9.25. The cost to reach effectiveness of 10 in face-to-face care is $185.85 and in digital care $363.20. From the physician's perspective, the cost to achieve effectiveness of 10 is $419.13 in digital care and $184.52 in face-to-face care. From the perspective of the medical assistant, to achieve effectiveness of 10, the cost in digital care is $468.43 and in face-to-face $179.83. Conclusions: Currently, the best cost-effectiveness ratio corresponds to face-to-face care; however, digital care is an option that will have to evolve. [ABSTRACT FROM AUTHOR]

Expert knowledge is used in the development of wildlife habitat suitability models (HSMs) for management and conservation decisions. However, the consistency of such models has been questioned. Focusing on 1 method for elicitation, the analytic hierarchy process, we generated expert‐based HSMs for 4 felid species: 2 forest specialists (ocelot [Leopardus pardalis] and margay [Leopardus wiedii]) and 2 habitat generalist species (Pampas cat [Leopardus colocola] and puma [Puma concolor]). Using these HSMs, species detections from camera‐trap surveys, and generalized linear models, we assessed the effect of study species and expert attributes on the correspondence between expert models and camera‐trap detections. We also examined whether aggregation of participant responses and iterative feedback improved model performance. We ran 160 HSMs and found that models for specialist species showed higher correspondence with camera‐trap detections (AUC [area under the receiver operating characteristic curve] >0.7) than those for generalists (AUC < 0.7). Model correspondence increased as participant years of experience in the study area increased, but only for the understudied generalist species, Pampas cat (β = 0.024 [SE 0.007]). No other participant attribute was associated with model correspondence. Feedback and revision of models improved model correspondence, and aggregating judgments across multiple participants improved correspondence only for specialist species. The average correspondence of aggregated judgments increased as group size increased but leveled off after 5 experts for all species. Our results suggest that correspondence between expert models and empirical surveys increases as habitat specialization increases. We encourage inclusion of participants knowledgeable of the study area and model validation for expert‐based modeling of understudied and generalist species. [ABSTRACT FROM AUTHOR]

Introduction: Epilepsy is one of the most common chronic neurological diseases in pediatrics with variable clinical behavior and response to treatment, which requires frequent monitoring of the evolution. The pandemic caused by COVID-19 and social confinement limited in-person follow-up of in outpatient patients, which forced the use of alternatives; telemedicine was one of them. Objective: To present the benefits of telemedicine modalities for the follow-up of pediatric epileptic patients. Methods: A descriptive and prospective observational case series study was carried out with 52 epileptic patients between 0 and 18 years of age, from March 2020 to January 2022. Telemedicine modalities were used (conventional and mobile telephone, messaging SMS and voice, email, teleconsultations, home videos of the crises). A survey was also carried out on parents or guardians to find out their opinion on the usefulness of this method and the possibility of maintaining their use during the new normal. Results: The age group of 5-14 years (44.23%), male sex (57.69%), rural origin (57.69%) and focal onset seizures (51.92%) predominated. Only 13.46% of patients required admission. A hundred percent of parents considered the remote care modality useful during the pandemic and 73.07% considered that it could be maintained in the new normal. Conclusions: In the new normal, telemedicine could be an effective tool in combination with in-person consultations, especially for those patients with favorable clinical evolution, and also contribute to reducing costs for patients and families. [ABSTRACT FROM AUTHOR]

Objective: to unveil the value meanings of nurses in a human milk bank about nursing teleconsultation. Method: A phenomenological study based on Max Scheler's Theory of Values, with phenomenological interviews conducted in October and November 2022 with five nurses from a human milk bank in the second metropolitan region of Rio de Janeiro. The data collected was then subjected to Bardin's thematic analysis. Results: two categories emerged: Nursing teleconsultation and nurses' actions in the human milk donation process in times of Covid-19 - an expansion value; Nursing teleconsultation in the care of donors and infants assisted at the human milk bank - a useful health value. Conclusion: teleconsultation was understood as having values that expand and guarantee care, improving the representation of access for users, collaborating with the continuity of breastfeeding and the donation of human milk. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic caused face-to-face outpatient care in health establishments to be restricted, the government establishes actions to continue providing said health services. Objective of the study: To describe the usability of the virtual health care in the COVID-19 quarantine period at the National Institute of Child Health (INSN) of Peru. Material and methods: Cross-sectional study. 7,697 patients were admitted to the INSN for virtual outpatient consultation from May to July 2020. The sampling was simple random and there was a sample of 374 participants who met the selection criteria. The telehealth usability questionnaire (TUQ) was used. Parents of patients who received virtual consultation were interviewed by telephone. Results: The average age of the interviewees was 36.2 years, mostly women and from Lima. The average age of the patients treated is 6.7 years, being mostly male (51.3%). The Smartphone was the most used device (97.6%); medical services the most consulted (84.4%), most recurrent pathologies related to the respiratory system (10.4%). 55.2% and 57.4% of the participants totally agree on the usefulness and ease of use of virtual medical care, respectively. Conclusions: The use of telehealth in the INSN had a positive impact, it managed to connect patients with their doctor in order to continue with their treatments and provide an optimal medical care response in real time. [ABSTRACT FROM AUTHOR]

To report the implementation of service and care routine experienced by a resident nurse at DisqueSaúde SGA. This is an experience systematization. With connection and interpersonal communication changed due to Covid-19 pandemic, it was noticed that this occurred mainly through electronic means, needing to change health care. Thus begins, in May 2020, the teleorientation "DisqueSaúde-SGA", in the municipality of São Gonçalo do Amarante, Ceará. The service was well accepted by community, as users preferred contact via messages, seeking guidance on how to act in symptoms face, places for face-to-face care and testing, in addition to demands related to mental health. It is concluded that electronic means use for remote health care is coherent and well accepted, contributing to health promotion and social isolation. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has affected healthcare systems severely and has had a negative impact on healthcare. However, it has also been a catalyst for digital transformation in many healthcare centers and in the pharmaceutical industry. In this article, the experience of digital transformation during the pandemic is reviewed from the perspective of healthcare professionals and the pharmaceutical industry, with a focus on digital visits, on-line education, and the model of interaction between healthcare professionals and the industry. Also, some key points are given to facilitate a successful digital transformation. [ABSTRACT FROM AUTHOR]

The objective of this article is to present the experiences of telehealth in a hospital specialized in mental health in Lima, Peru during 2020. In accordance with the provisions such as the temporary closure of face-to-face care and mandatory confinement between the months of March As of December, care was progressively provided through telephone calls, video calls or digital platforms, with 57,398 teleconsultations and telemonitoring, 4411 mental health orientations, 295 teleinterconsultations in psychiatry, 42 teletraining activities and 29 educational sessions in mental health aimed at the general population. We conclude that the implementation of telehealth for the care of the users of the Hermilio Valdizán Hospital contributed to mental health care and reduces the gaps in access to specialized care in psychiatry due to the consequences of COVID-19. [ABSTRACT FROM AUTHOR]

The article addresses the obstacles to accessing telemedicine during the COVID-19 pandemic. It highlights the lack of internet access and digital devices, especially in rural areas and among older adults. Additionally, it mentions the lack of training in telemedicine due to the health emergency. The importance of addressing these barriers to ensure equitable healthcare is emphasized. The LivingLab Telehealth program at the University of Antioquia is mentioned as a successful example of telemedicine in Colombia. It is concluded that government interventions are required to improve access to telemedicine and reduce health inequities. [Extracted from the article]

Introduction: Teledermatology (store and forward) has been used to improve priority screening for hospital consultations and to respond, in a minority of cases, to simple situations. The Dermatology consultation request via Consulta Tempo e Horas must now be accompanied by clinical photo(s), according to Despacho 6280/2018 of 28 June 2018. We intend to evaluate the satisfaction of patients and family doctors regarding teledermatology consultation. Material and Methods: A survey was carried out on patients subjected to teledermatology consultation during the 1st quarter of 2018, with a retrospective analysis of the clinical record. An online survey was also carried out on family doctors belonging to the Agrupamentos de Centros de SaúdeACeS of the Centro Hospitalar Vila Nova de Gaia/Espinho reference area. Results: Of the 153 patients surveyed, response was obtained in 27.5% (n = 42). Pigmented lesions corresponded to 54.8% (n=23) of the total consultations. Treatment was proposed in 42.9% (n=18). Patients would prefer in-person consultation in 90.2% (n=38) of cases. Eighty-two responses were obtained from family doctors. Half of the responders agree with the mandatory attachment of clinical photos to the consultation request, even if this leads to an increase of 11.21 ± 8.84 minutes to the request time. When a teledermatology consultation is made, 47.6% (n=39) of family doctors report that the patient's problem is only partially treated. Conclusion: Teledermatology consultation (store and forward) only solves a minority of clinical situations. Furthermore, it is not considered a satisfactory solution for patients. [ABSTRACT FROM AUTHOR]

Introduction: in Brazil the COVID-19 pandemic, there was a recommended adoption of distance and social isolation measures, in addition to the implementation of actions for the vulnerability of groups at risk to contamination, such as heart disease. Objective: to reflect on the potential risk of heart disease and the role of nurses through health guidance in remote consultation. Method: reflection study, based on questions related to "why the COVID-19 pandemic in cardiac patients is a potential problem" and "what guidelines can be performed". To this end, it was used the identification and discussion of articles by the authors, from March 30 to April 30, 2020. Results: it was evidenced that the high risk potential of cardiac patients is in the association of high levels of the converting enzyme Angiotensin 2 (ECA-2). And that, during the remote consultation, there is the possibility of recommendations for cardiological treatment, care for the prevention of coronavirus infection, and suggestions for coping measures in isolation. Final Considerations: the Federal Council of Nursing in Brazil prior authorization, for the nurse to use teleconsultation, established professional support and great opportunity for an extended approach to Brazilians, especially those at risk. [ABSTRACT FROM AUTHOR]

Objective: Identify tele-monitoring strategies for patients with heart failure who collaborate for adherence when it comes to treatment. Material and Method: Integrative review of the literature carried out in the databases CINAHL, PubMed, Scielo and LILACS. The elaboration of the problem was guided by the PICO strategy that gave rise to the following question: "What are the tele-monitoring strategies for patients with heart failure that contribute to their adherence to treatment?". Results: Sixteen articles met the criteria defined by the study and, therefore, participated in the analysis of this review. Conclusion: Tele-monitoring allows the monitoring of a larger number of patients, contributing to the control of signs and symptoms of heart failure. Also, It favors the optimization of pharmacological and non-pharmacological treatments, reducing rates of rehospitalization and mortality. [ABSTRACT FROM AUTHOR]

Objective. Identify barriers to implementation of the teleconsultation process in order to develop strategies to improve the program's operation. Methods. A process evaluation strategy was used to study the implementation of the teleconsultation service. The program's operating manuals were compared with the qualitative and quantitative information compiled on the practical implementation of the teleconsultation process. Results. The factors reported as obstacles to the teleconsultation process were: slow Internet connection, the hours available to the public, the specialized services offered, and insufficient clinical history included in teleconsultation requests. It was determined that 60% of internal medicine patients received two or more teleconsultations in the study period, as did 44% of patients of the gynecology service. Four consulting medical units accounted for 75% of the teleconsultations and the rest were distributed among 12 medical units. Conclusions. The barriers identified in the teleconsultation process mainly affect consulting physicians; even so, productivity is on an upward trend. Despite the existing barriers, it was determined that some patients receive follow-up through the program, which favors access to care. It is necessary to standardize implementation and to conduct subsequent research on patients' health condition. [ABSTRACT FROM AUTHOR]

Objective: To systematically review the literature on the telehealth initiatives in telerehabilitation practices in children and adolescents from zero to 18 years old. Data sources: Randomized and controlled clinical trials published in the past ten years (January 2002 to February 2012) in Medline/PubMed, Medline/BVS, PEDro and Cochrane Library databases. The descriptors "telemedicine", "rehabilitation" and "telehealth" were used in three different languages (English, Portuguese and Spanish). Data synthesis: From the 20 studies found in the literature, nine were included in this review. Most of the studies showed that telerehabilitation is able to produce better results in the treatment when compared to the traditional methods, providing less frequency of symptoms, better disease control, better quality of life and greater adherence to treatment. Conclusions: Telerehabilitation is a viable and effective strategy in the treatment of common diseases in children and adolescents. However, there are few studies on the subject in this age group. Although telehealth is already consolidated worldwide, there are no studies in Brazil that used the telerehabilitation in children and adolescents, which reinforces the need for more research and investments. [ABSTRACT FROM AUTHOR]

OBJECTIVE: A second medical opinion can aid in the investigation of a health problem as well as in the definition of the therapeutic approach. The present study is aimed at demonstrating a process of second medical opinion by means of a web-based multispecialty system adapted for radiology. MATERIALS AND METHODS: The system was utilized by 49 residents at Universidade Federal de São Paulo, Brazil, who gave their medical opinion on 52 second opinion requests. Questionnaires were utilized as an evaluation tool. RESULTS: A total of 1704 medical second opinions were evaluated and 514 (29.1%) of them were defined as satisfactory. In 64.4% of cases, the answers of the questionnaires indicated that the images quality did not affect the diagnosis. On average, 6 minutes and 26 seconds was the time required to issue a remote second medical opinion. CONCLUSION: A process of second medical opinion by means of a web-based multispecialty system adapted for radiology has shown to be an excellent tool in the management of therapeutic approaches. [ABSTRACT FROM AUTHOR]

OBJECTIVE: A second medical opinion can aid in the investigation of a health problem as well as in the definition of the therapeutic approach. The present study is aimed at demonstrating a process of second medical opinion by means of a web-based multispecialty system adapted for radiology. MATERIALS AND METHODS: The system was utilized by 49 residents at Universidade Federal de São Paulo, Brazil, who gave their medical opinion on 52 second opinion requests. Questionnaires were utilized as an evaluation tool. RESULTS: A total of 1704 medical second opinions were evaluated and 514 (29.1%) of them were defined as satisfactory. In 64.4% of cases, the answers of the questionnaires indicated that the images quality did not affect the diagnosis. On average, 6 minutes and 26 seconds was the time required to issue a remote second medical opinion. CONCLUSION: A process of second medical opinion by means of a web-based multispecialty system adapted for radiology has shown to be an excellent tool in the management of therapeutic approaches. [ABSTRACT FROM AUTHOR]