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This study aimed to estimate reductions in travel-related carbon dioxide (CO2) emissions, travel time and distance resulting from a telemedicine service for patients with chronic conditions, and to assess its potential to contribute to more equitable access to specialised care in Northeast Brazil.
Cross-sectional study.
Primary healthcare units in the Northeast region of Brazil.
Patients between birth and 104 years of age with chronic conditions who received video-based teleconsultations between June 2022 and November 2023.
The primary outcome was the reduction in travel-related carbon emissions due to avoided in-person referrals. Secondary outcomes included travel time and travel distance savings. Round-trip distances between primary healthcare units and referral centres were estimated using geolocation data. CO2 emissions were calculated using the Greenhouse Gas (GHG) Protocol adapted to Brazil (Brazilian GHG Protocol Programme), focusing on Scope 3 emissions from patient travel.
A total of 4642 teleconsultations were conducted with 4106 patients. Of these, 4021 (86.6%) avoided in-person referrals, resulting in estimated savings of 226 900 miles in travel distance and 488 584 min in travel time. The estimated CO2 emissions avoided totalled 21 593 kg (21 930 kg CO2 equivalent), with a mean of 5.37 kg (SD±5.5) per teleconsultation (5.4 kg CO2 equivalent ; SD±5.5). Greater travel distance savings were observed among patients living in municipalities with lower Municipal Human Development Index (mean 92.3±104.2 miles vs 17.3±8.4 miles; p
Telemedicine use in Northeast Brazil significantly reduced patient travel, leading to substantial savings in CO2 emissions. These savings were more pronounced for patients in smaller, less developed municipalities. By reducing the need for travel, telemedicine can improve access to healthcare for remote or underserved populations, while also supporting environmental sustainability.
To map interventions in the sexuality of men with stomas.
Scoping review, following JBI and PRISMA-ScR guidelines to report results.
Databases consulted were PubMed, via National Library of Medicine, Latin American and Caribbean Health Sciences Literature, Web of Science, Scopus, Embase, Scientific Electronic Library Online, Brazilian Electronic Library of Thesis and Dissertations, CAPES Catalogue of Thesis and Dissertations and Open Access Scientific Repository of Portugal. Texts were read by independent reviewers, with no time or language restrictions.
The final sample included 10 studies. Data were synthesised and grouped for its similarity to approach models, preoperative orientations, self-care promotion, collecting pouch hygiene and safety, sexual health discussion and education, construction of bonds and sexual function evaluation.
Interventions in the sexuality of men with stomas included adherence to models for approaching sexuality, focusing on the permission and coparticipation of the patient, open conversations on the topic, self-care promotion, collecting pouch hygiene and safety, encouragement to the creation of bonds, sexual function evaluation in pre- and postoperative periods and individual and/or collective sexual health education.
This study contributes to the sexuality of men with stomas. It identified recommendations to approach and conduct the topic at hand, addressing the rehabilitation process since the surgery to place the stoma is considered.
This study addressed scientific literature on the sexuality of men with stomas. Most were from Europe and results demonstrated a gap in knowledge. This research will impact the stoma therapy research, affecting teams involved in the care to men with stomas, encouraging reflections on the sexuality of these patients.
This study complies with the PRISMA-ScR.
There was no patient or public contribution.
The protocol of this scoping review was registered in the Open Science Framework, registered under DOI 10.17605/OSF.IO/X9DSC. It can be accessed through the following link: https://osf.io/x9dsc/?view_only=a9c62ef6c11f44499f7b2bfe1fe379f9.
Objetivo: identificar las necesidades humanas básicas de las embarazadas de alto riesgo hospitalizadas con base en la Teoría de Wanda Horta. Método: investigación asistencial realizada con dieciséis gestantes de alto riesgo hospitalizadas en una maternidad de referencia en Ceará entre septiembre y noviembre de 2019. Se recolectó información a través de diario de campo y ficha de caracterización de las gestantes y registros de necesidades humanas básicas. Los resultados se analizaron mediante estadística descriptiva simple y un enfoque integral a la luz del marco de Wanda Horta. Resultados: las gestantes presentaron necesidades psicobiológicas, psicosociales y psicoespirituales, siendo prevalentes: ausencia de actividades de ocio, inseguridad emocional, escaso conocimiento, sueño y descanso perjudicados, y actividades físicas restringidas por indicación de descanso. Consideraciones finales: se cree que el razonamiento crítico y el juicio clínico de los enfermeros se centraron en la individualidad de las gestantes, identificando necesidades en los tres niveles propuestos por la teoría, apuntando caminos para cualificar el cuidado de enfermería a las gestantes de alto riesgo.
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