Página 16 dos resultados de 287434 itens digitais encontrados em 0.134 segundos

‣ Scientific output trends in oral health in Brazil

DIAS, Aldo Angelim; NARVAI, Paulo Capel; REGO, Delane Maria
Fonte: PAN AMER HEALTH ORGANIZATION Publicador: PAN AMER HEALTH ORGANIZATION
Tipo: Artigo de Revista Científica
Português
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Objective. To describe dental research trends in Brazil (especially population-based oral health) in the early Twenty-first Century. Methods. The abstracts of studies presented at meetings of the Brazilian Society for Dental Medicine Research (Sociedade Brasileira de Pesquisa Odontologica) from 2001-2006 were assessed in terms of methodological design (aggregate or population-based and individual-based studies, observational and intervention studies, cross-sectional and longitudinal studies); general type (literature review, studies with human subjects, and laboratory studies); and classification into one of the 19 specialty categories recognized by the Brazilian Federal Dentistry Council. Of the 10 406 abstracts presented in this period, 5 203 (50%) were reviewed. Results. Concerning methodological design, 87.5% of the abstracts referred to individual-based studies, whereas 12.5% were of aggregate studies. Concerning the general category, 41.7% referred to studies with human subjects. The remaining abstracts (58.3%) described in vitro (31.1%) or in vivo (23.6%) laboratory research and literature reviews (3.6%). Concerning the Council`s specialty categories, only five had a frequency higher than 10.0%: esthetic dentistry, periodontics...

‣ Tracking Pediatric Asthma:The Massachusetts Experience Using School Health Records

Knorr, Robert S.; Condon, Suzanne K.; Dwyer, Frances M.; Hoffman, Danielle F.
Fonte: National Institue of Environmental Health Sciences Publicador: National Institue of Environmental Health Sciences
Tipo: Artigo de Revista Científica
Português
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The Massachusetts Department of Public Health, in collaboration with the U.S. Centers for Disease Control and Prevention Environmental Public Health Tracking Program, initiated a 3-year statewide project for the routine surveillance of asthma in children using school health records as the primary data source. School district nurse leaders received electronic data reporting forms requesting the number of children with asthma by grade and gender for schools serving grades kindergarten (K) through 8. Verification efforts from an earlier community-level study comparing a select number of school health records with primary care provider records demonstrated a high level of agreement (i.e., > 95%). First-year surveillance targeted approximately one-half (n = 958 schools) of all Massachusetts’s K–8 schools. About 78% of targeted school districts participated, and 70% of the targeted schools submitted complete asthma data. School nurse–reported asthma prevalence was as high as 30.8% for schools, with a mean of 9.2%. School-based asthma surveillance has been demonstrated to be a reliable and cost-effective method of tracking disease through use of an existing and enhanced reporting structure.

‣ Strengthening the Legal Foundation for Public Health Practice: A Framework for Action

Moulton, Anthony D.; Matthews, Gene W.
Fonte: © American Journal of Public Health 2001 Publicador: © American Journal of Public Health 2001
Tipo: Artigo de Revista Científica
Publicado em /09/2001 Português
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Growing concern that public health laws may be inadequate to the challenges that confront public health practitioners has led to adoption of a Healthy People 2010 objective for improved laws and policies. It has also led to concerted efforts to strengthen the legal foundation for public health practice. In this editorial, the authors present a framework for collaborative research, analysis, and development to strengthen public health laws, skill in applying laws, and law-related information resources.

‣ An Ethics Framework for Public Health

Kass, Nancy E.
Fonte: © American Journal of Public Health 2001 Publicador: © American Journal of Public Health 2001
Tipo: Artigo de Revista Científica
Publicado em /11/2001 Português
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More than 100 years ago, public health began as an organized discipline, its purpose being to improve the health of populations rather than of individuals. Given its population-based focus, however, public health perennially faces dilemmas concerning the appropriate extent of its reach and whether its activities infringe on individual liberties in ethically troublesome ways. In this article a framework for ethics analysis of public health programs is proposed.

‣ Ethical Oversight of Public Health Research: Can Rules and IRBs Make a Difference in Developing Countries?

London, Leslie;
Fonte: © American Journal of Public Health 2002 Publicador: © American Journal of Public Health 2002
Tipo: Artigo de Revista Científica
Publicado em /07/2002 Português
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Controversies in the conduct of international research continue to pose challenges for the system of ethical review, particularly for developing countries. Although the concept of vulnerability is key to addressing these challenges, ethical review has typically ignored the agency of vulnerable participants and groups in determining what kind of review process is needed. Concurrent with developments shaping the new public health that seek to operationalize empowerment of communities by placing them as initiators and organizers of their own health, ethical review of public health research must find ways to recognize the agency of vulnerable individuals, groups, and communities in the review process if it is to address effectively the ethical dilemmas currently evident in collaborative international research. (Am J Public Health. 2002;92:1079–1084)

‣ Universal Coverage and Public Health: New State Studies

Shaffer, Ellen R.
Fonte: © American Journal of Public Health 2003 Publicador: © American Journal of Public Health 2003
Tipo: Artigo de Revista Científica
Publicado em /01/2003 Português
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Recent evaluations of the California Health Service Plan (CHSP) confirmed that financing health care through a single government payer can provide universal coverage—while saving significantly on health care spending—to a degree unparalleled by alternative approaches. Public ownership of the delivery system can further provide authority and accountability for critical reforms that improve the population’s health and quality of care, including coordination of the delivery system.

‣ Population Health in Canada: A Brief Critique

Coburn, David; Denny, Keith; Mykhalovskiy, Eric; McDonough, Peggy; Robertson, Ann; Love, Rhonda
Fonte: © American Journal of Public Health 2003 Publicador: © American Journal of Public Health 2003
Tipo: Artigo de Revista Científica
Publicado em /03/2003 Português
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An internationally influential model of population health was developed in Canada in the 1990s, shifting the research agenda beyond health care to the social and economic determinants of health. While agreeing that health has important social determinants, the authors believe that this model has serious shortcomings; they critique the model by focusing on its hidden assumptions.

‣ Health, Morality, and Housing: The “Tenement Problem” in Chicago

Garb, Margaret
Fonte: © American Journal of Public Health 2003 Publicador: © American Journal of Public Health 2003
Tipo: Artigo de Revista Científica
Publicado em /09/2003 Português
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In this article, I trace the history of Chicago’s Health Department, exploring when and how housing conditions came to be considered a serious social problem requiring municipal regulation. Although journalists and labor leaders were among the first Chicagoans to link tenement housing to the spread of contagious disease, Health Department officials quickly began regulating the city’s housing stock under their own authority. I argue that in attempting to eliminate the dangers of contagious disease, a long-standing public health threat, health officials drew new attention to the dangers of multifamily dwellings and set a precedent for government regulation of living conditions in tenement dwellings.

‣ The contribution of reproductive ill-health to the overall burden of perceived illness among women in southern India

Bhatia,Jagdish; Cleland,John
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2001 Português
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OBJECTIVE: To investigate women's perceptions of the overall burden of illness among a sample of women in southern India. METHODS: A community-based sample of 421 young married women in a subdistrict about 70 kilometres from Bangalore, Karnataka State, India, were interviewed monthly for one year. At each visit, information on the symptoms of all forms of illness they had experienced was elicited with the aid of a checklist. Details were obtained on the durations of episodes of illness and on health-seeking behaviour and costs. The symptoms were subsequently coded in accordance with the International Classification of Diseases (ICD-10). FINDINGS: Reproductive ill-health accounted for half of all illness-days and for 31% of total curative health expenditure. The 1990 Global Burden of Disease study estimated that 27.4% of disability-adjusted life years (DALYs) lost in Indian women aged 15-44 years were attributable to reproductive ill-health. CONCLUSIONS: Our study indicates that this dimension of morbidity, when measured in terms of women's subjective experiences, makes a larger contribution to the burden of illness than that suggested by the DALY approach. This lends justification to the high priority attached to reproductive ill-health in India.

‣ Reduction of catastrophic health care expenditures by a community-based health insurance scheme in Gujarat, India: current experiences and challenges

Ranson,Michael Kent
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2002 Português
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OBJECTIVE: To assess the Self Employed Women's Association's Medical Insurance Fund in Gujarat in terms of insurance coverage according to income groups, protection of claimants from costs of hospitalization, time between discharge and reimbursement, and frequency of use. METHODS: One thousand nine hundred and thirty claims submitted over six years were analysed. FINDINGS: Two hundred and fifteen (11%) of 1927 claims were rejected. The mean household income of claimants was significantly lower than that of the general population. The percentage of households below the poverty line was similar for claimants and the general population. One thousand seven hundred and twelve (1712) claims were reimbursed: 805 (47%) fully and 907 (53%) at a mean reimbursement rate of 55.6%. Reimbursement more than halved the percentage of catastrophic hospitalizations (>10% of annual household income) and hospitalizations resulting in impoverishment. The average time between discharge and reimbursement was four months. The frequency of submission of claims was low (18.0/1000 members per year: 22-37% of the estimated frequency of hospitalization). CONCLUSIONS: The findings have implications for community-based health insurance schemes in India and elsewhere. Such schemes can protect poor households against the uncertain risk of medical expenses. They can be implemented in areas where institutional capacity is too weak to organize nationwide risk-pooling. Such schemes can cover poor people...

‣ Protecting human health in a changing world: the role of social and economic development

Woodward,Alistair; Hales,Simon; Litidamu,Navitalai; Phillips,David; Martin,John
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2000 Português
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The biological and physical environment of the planet is changing at an unprecedented rate as a result of human activity, and these changes may have an enormous impact on human health. One of the goals of human development is to protect health in the face of rapid environmental change, but we often fail to do this. The aim in this paper is to distinguish between socioeconomic aspects of development that are likely to be protective and those that are likely to increase vulnerability (the capacity for loss resulting from environmental change). Examples include climate change in the Pacific. We conclude that protecting human health in a changing world requires us to take steps to minimize harmful change wherever possible, and at the same time to be prepared for surprises. The goals of mitigation (reducing or preventing change) and adaptation (response to change) are not mutually exclusive. In fact, steps to make populations more resilient in the face of change are often similar to those that are needed to lighten the load on the environment. We need social policies that convert economic growth into human development. Wider application of sustainable development concepts is part of the solution. In particular, there is a need to promote health as an essential asset of poor and vulnerable populations. It is their key to productivity and to surviving shocks; it is also the key to achieving broader development goals such as universal education. For these reasons it is in the interests of all sectors - economic...

‣ A new face for private providers in developing countries: what implications for public health?

Palmer,Natasha; Mills,Anne; Wadee,Haroon; Gilson,Lucy; Schneider,Helen
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2003 Português
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The use of private health care providers in low- and middle-income countries (LMICs) is widespread and is the subject of considerable debate. We review here a new model of private primary care provision emerging in South Africa, in which commercial companies provide standardized primary care services at relatively low cost. The structure and operation of one such company is described, and features of service delivery are compared with the most probable alternatives: a private general practitioner or a public sector clinic. In a case study of cost and quality of services, the clinics were popular with service users and run at a cost per visit comparable to public sector primary care clinics. However, their current role in tackling important public health problems was limited. The implications for public health policy of the emergence of this new model of private provider are discussed. It is argued that encouraging the use of such clinics by those who can afford to pay for them might not help to improve care available for the poorest population groups, which are an important priority for the government. Encouraging such providers to compete for government funding could, however, be desirable if the range of services presently offered...

‣ Health information technology in primary health care in developing countries: a literature review

Tomasi,Elaine; Facchini,Luiz Augusto; Maia,Maria de Fatima Santos
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2004 Português
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This paper explores the debate and initiatives concerning the use of information technology (IT) in primary health care in developing countries. The literature from 1992-2002 was identified from searches of the MEDLINE, Latin American and Caribbean Health Science Literature Database (LILACS), Cochrane Library and Web of Science databases. The search identified 884 references, 350 of which were classified according to the scheme described by the Pan American Health Organization (PAHO). For the analysis of advantages, problems and perspectives of IT applications and systems, 52 articles were selected according to their potential contribution to the primary health-care processes in non-developed countries. These included: 10 on electronic patient registries (EPR), 22 on process and programmatic action evaluation and management systems (PPAEM) and 20 on clinical decision-support systems (CDS). The main advantages, limitations and perspectives are discussed.

‣ Health in south-eastern Europe: a troubled past, an uncertain future

Rechel,Bernd; Schwalbe,Nina; McKee,Martin
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/07/2004 Português
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The political and economic turmoil that occurred in south-eastern Europe in the last decade of the twentieth century left a legacy of physical damage. This aspect of the conflict has received considerable coverage in the media. However, surprisingly less has been reported about the effects of that turmoil on the health of the people living in the region. In an attempt to identify and synthesize data on these effects, we carried out a systematic review and used the results to put together a searchable online database of documents, reports, and published material, the majority of which have not previously been easily accessible (http://www.lshtm.ac.uk/ecohost/see/index.php). The database covers the period from the early 1990s to 2003 and will be of considerable interest to policy-makers. It contains 762 items, many of them annotated and available for downloading. This paper synthesizes the main findings obtained from the material in the database and emphasizes the need for concerted action to improve the health of people in south-eastern Europe. Furthermore, we also recommend that agencies working in post-conflict situations should invest in developing and maintaining online databases that would be useful to others working in the area.

‣ The determinants of self-reported health-related quality of life in a culturally and socially diverse South African community

Jelsma,Jennifer; Ferguson,Gillian
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2004 Português
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OBJECTIVE: To determine factors predictive of the score on the visual analogue scale (VAS) of the EQ-5D questionnaire. METHODS: The responses of 1159 residents of a socially and ethnically diverse suburb of Cape Town, South Africa, to the EQ-5D questionnaire were analysed using forward stepwise multiple regression. The variables entered included ethnic group, religious affiliation (Christian or Muslim), income level, unemployment, recent illness or disability and each level of the five EQ-5D domains. FINDINGS: The model developed accounted for an adjusted r² of 0.234 and included 11 variables. In addition to the EQ-5D domains, the presence of a disability, an income of less than US$ 420 per month, unemployment and age in years were significant predictors of VAS score. CONCLUSION: The substantial contribution of health state to the VAS indicates that it is a valid measure of health-related quality of life (HRQoL) across population groups. However, the subjects with lower social status reported a worse HRQoL than their health state alone warranted and this variable might need to be taken into account if the VAS is to be used to compare health states across populations. This paper provides empirical evidence of how HRQoL is perceived by different socioeconomic...

‣ Health services under the General Agreement on Trade in Services

Adlung,Rudolf; Carzaniga,Antonia
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2001 Português
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The potential for trade in health services has expanded rapidly in recent decades. More efficient communication systems have helped to reduce distance-related barriers to trade; rising incomes and enhanced information have increased the mobility of patients; and internal cost pressures have led various governments to consider possibilities for increased private participation. As yet, however, health services have played only a modest role in the General Agreement on Trade in Services (GATS). It is possible that Members of the World Trade Organization have been discouraged from undertaking access commitments by the novelty of the Agreement, coordination problems between relevant agencies, widespread inexperience in concepts of services trade, a traditionally strong degree of government involvement in the health sector, and concerns about basic quality and social objectives. However, more than five years have passed since GATS entered into force, allowing hesitant administrations to familiarize themselves with its main elements and its operation in practice. The present paper is intended to contribute to this process. It provides an overview of the basic structure of GATS and of the patterns of current commitments in health services and of limitations frequently used in this context. The concluding section discusses possibilities of pursuing basic policy objectives in a more open environment and indicates issues that may have to be dealt with in current negotiations on services.

‣ Cost-effectiveness of community health workers in tuberculosis control in Bangladesh

Islam,Md. Akramul; Wakai,Susumu; Ishikawa,Nobukatsu; Chowdhury,A.M.R.; Vaughan,J. Patrick
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2002 Português
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OBJECTIVE: To compare the cost-effectiveness of the tuberculosis (TB) programme run by the Bangladesh Rural Advancement Committee (BRAC), which uses community health workers (CHWs), with that of the government TB programme which does not use CHWs. METHODS: TB control statistics and cost data for July 1996 - June 1997 were collected from both government and BRAC thanas (subdistricts) in rural Bangladesh. To measure the cost per patient cured, total costs were divided by the total number of patients cured. FINDINGS: In the BRAC and government areas, respectively, a total of 186 and 185 TB patients were identified over one year, with cure rates among sputum-positive patients of 84% and 82%. However, the cost per patient cured was US$ 64 in the BRAC area compared to US$ 96 in the government area. CONCLUSION: The government programme was 50% more expensive for similar outcomes. Although both the BRAC and government TB control programmes appeared to achieve satisfactory cure rates using DOTS (a five-point strategy), the involvement of CHWs was found to be more cost-effective in rural Bangladesh. With the same budget, the BRAC programme could cure three TB patients for every two in the government programme.

‣ The research agenda for improving health policy, systems performance, and service delivery for tuberculosis control: a WHO perspective

Nunn,Paul; Harries,Anthony; Godfrey-Faussett,Peter; Gupta,Raj; Maher,Dermot; Raviglione,Mario
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2002 Português
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The development of WHO's DOTS strategy for the control of tuberculosis (TB) in 1995 led to the expansion, adaptation and improvement of operational research in this area. From being a patchwork of small-scale studies concerned with aspects of service delivery, TB operational research shifted to larger-scale, often multicountry projects that were also concerned with health policy and the needs of health systems. The results are now being put into practice by national TB control programmes. In 1998 an ad hoc committee identified the chief factors inhibiting the expansion of DOTS: lack of political will and commitment, poor financial support for TB control, poor organization and management of health services, inadequate human resources, irregular drug supplies, the HIV epidemic, and the rise of multidrug resistance. An analysis of current operational research on TB is presented on the basis of these constraints, and examples of successful projects are outlined in the article. We discuss the prerequisites for success, the shortcomings of this WHO- supported programme, and future challenges and needs.

‣ Use of existing data for public health planning: a study of the prevalence of hepatitis B surface antigen and core antibody in Al Ain Medical District, United Arab Emirates

Al-Owais,A.; Al-Suwaidi,K.; Amiri,N.; Carter,A.O.; Hossain,M.M; Sheek-Hussein,M.M.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2000 Português
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INTRODUCTION: Hepatitis B is of major public health importance. Accurate information on its occurrence, with particular reference to the prevalence of immunity and chronic infection (marked by the presence of hepatitis B core antibody and surface antigen, respectively, in serum), is essential for planning public health programmes for the control of the disease. The generation of marker prevalence data through serological surveys is costly and time-consuming. The present study in Al Ain Medical District, United Arab Emirates, investigated the possibility of obtaining sufficiently accurate marker prevalence estimates from existing data to plan public health programmes. METHODS: Two antenatal screening databases, one student serological survey database, one immunization programme database and one pre-marriage screening database containing information on marker prevalence were identified. Epidemiological data were abstracted from these databases and analysed. RESULTS: The data showed that the prevalence of hepatitis B surface antigen and the prevalence of core antibody in young citizens in 1998 were approximately 2% and 14% respectively, that any immunization campaign aimed at citizens of the United Arab Emirates should target teenagers as they had the highest risk of acquiring the disease...

‣ Health information system reform in South Africa: developing an essential data set

Shaw,Vincent
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2005 Português
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Health services are increasingly under pressure to develop information systems that are responsive to changing health needs and appropriate to service objectives. Developing an essential data set provides managers with a clearly defined set of indicators for monitoring and evaluating services. This article describes a process that resulted in the creation of an essential data set at district level. This had a significant impact on neighbouring districts and resulted in the development of a regional essential data set, which in turn helped to influence the creation of a provincial and then national essential data set. Four key lessons may be drawn from the process. The development of an essential data set both requires and can contribute to a process that allows the reporting requirements to be adjusted over time in response to changing circumstances. In addition, it contributes to (and requires) the integration of programme reporting requirements into a coherent information system. While the case study describes a bottom-up approach, a top-down consultative process is advocated because it establishes a framework within which information needs can be reviewed. Lastly, the use of surveys can aid efforts to keep the essential elements to a minimum. In conclusion...