176 results
Search Results
2. [Letter to the Editors on the paper by Cardoso et al.]
- Author
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Soares BC, Blasius KRB, Marcon CEM, and Marcelino LF
- Subjects
- Brazil, Female, Humans, Pregnancy, Abortion, Induced
- Published
- 2020
- Full Text
- View/download PDF
3. [Debate on the paper by Narvai et al].
- Author
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Portela MC and Vasconcellos MT
- Subjects
- Brazil, Data Collection methods, Data Collection standards, Databases, Factual, Humans, Sampling Studies, Data Interpretation, Statistical, Dental Health Surveys
- Published
- 2010
- Full Text
- View/download PDF
4. [Research in, about, and for health services: an international panorama and questions for health research in Brazil. Debate on the paper by Hillegonda Maria Dutilh Novaes].
- Author
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Almeida MF
- Subjects
- Brazil, Humans, Health Services Research, Information Dissemination methods, Information Services standards
- Published
- 2004
- Full Text
- View/download PDF
5. [Research in, about, and for health services: an international panorama and questions for health research in Brazil. Debate on the paper by Hillegonda Maria Dutilh Novaes].
- Author
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Camargo KR Jr
- Subjects
- Brazil, Humans, Bibliometrics, Databases, Bibliographic, Health Services Research statistics & numerical data
- Published
- 2004
- Full Text
- View/download PDF
6. [Research in, about, and for health services: an international panorama and questions for health research in Brazil. Debate on the paper by Hillegonda Maria Dutilh Novaes].
- Author
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Rozenfeld S
- Subjects
- Brazil, Humans, Databases, Bibliographic, Health Services Research statistics & numerical data
- Published
- 2004
- Full Text
- View/download PDF
7. [The determinative of the populations health conditions: which the paper of the health system?].
- Author
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Barreto ML
- Subjects
- Brazil, Humans, Health Services standards, Health Status
- Published
- 2004
- Full Text
- View/download PDF
8. [Research in, about, and for health services: an international panorama and questions for health research in Brazil. Debate on the paper by Hillegonda Maria Dutilh Novaes].
- Author
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Almeida C
- Subjects
- Brazil, Humans, Health Policy, Health Services Accessibility, Health Services Research, Quality of Health Care
- Published
- 2004
- Full Text
- View/download PDF
9. [Research in, about, and for health services: an international panorama and questions for health research in Brazil. Debate on the paper by Hillegonda Maria Dutilh Novaes].
- Author
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Conill EM
- Subjects
- Brazil, Humans, Diffusion of Innovation, Health Services Research
- Published
- 2004
- Full Text
- View/download PDF
10. [Research in, about, and for health services: an international panorama and questions for health research in Brazil. Debate on the paper by Hillegonda Maria Dutilh Novaes].
- Author
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Martins Mde A
- Subjects
- Brazil, Humans, Bibliometrics, Health Services Research statistics & numerical data
- Published
- 2004
- Full Text
- View/download PDF
11. [Challenges to intersectorality in the care of children with disabilities from the perspective of education professionals].
- Author
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Silva LND, Dias FS, Lenzi MF, and Costa IDS
- Subjects
- Aged, Brazil, Child, Humans, Disabled Children
- Abstract
This paper identifies and discusses factors that hinder interprofessional and intersectoral articulation, as well as evaluates the main regulations on the rights of children and persons with disabilities and scientific literature on intersectoriality A qualitative and applied research was conducted by means of a questionnaire applied online to education professionals who care for children with disabilities, in the municipality of Duque de Caxias, Rio de Janeiro State, Brazil. The open answers of the questionnaire were analyzed from a constructionist perspective, based on the production of polyphonic meanings. The norms contradict intersectoriality by reinforcing sectoriality, and their guidelines do not present the material dimension of the political processes, constituting a field of implications for inclusion practices. It identified three pillars that limit intersectoriality: individual and collective work overload; difficulty in engaging other actors in the network; limited knowledge to meet the demands received. The way these aspects were raised expresses barriers to access and operationalization of the Network of Care for Persons with Disabilities (RCPD) and reiterates contradictions produced by the normative guidelines that regulate work. e reduction of hospital stay, which is so impactful on the functional condition of the elderly.
- Published
- 2022
- Full Text
- View/download PDF
12. Advances and setbacks in the 20 years of the Brazilian National Food and Nutrition Policy.
- Author
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Santos SMCD, Ramos FP, Medeiros MAT, Mata MMD, and Vasconcelos FAG
- Subjects
- Brazil, Human Rights, Humans, Nutritional Status, Food Supply, Nutrition Policy
- Abstract
We sought to analyze the processes of formulation, updating and implementation of the Brazilian National Food and Nutrition Policy (PNAN), from 1999 to April 2020. This is a discussion paper, using institutional documentary sources, bibliographic search in national and international databases, as well as theses and dissertations. The theory of the cycle of public policies was adopted to systematize and present the set of information. PNAN was established in 1999 and updated ten years later, in a participatory process, based on an innovative approach centered on the paradigms of healthy food practices, the human right to food and nutritional security, aligned with the Brazilian Unified National. Regarding implementation, there are advances related to the publication of Food Guides with national guidelines; to the promotion of research in food and nutrition; to collective action to build the regulatory agenda, even if with disputes, and to the decentralization of financial resources for the execution of PNAN actions. The monitoring and evaluation focused on the food and nutritional situation; we found that there were insufficient mechanisms to feed back the policy. After 20 years, PNAN maintains the challenge of effectively fulfilling its historic commitment: the universal guarantee of the human right to adequate and healthy food.
- Published
- 2021
- Full Text
- View/download PDF
13. How heuristics and cognitive biases affect vaccination decisions.
- Author
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Luz PM, Nadanovsky P, and Leask J
- Subjects
- Bias, Brazil, Cognition, Humans, Vaccination, Decision Making, Heuristics
- Abstract
Immunization, the most successful public health intervention to date, can only be effective if eligible individuals or their legal representatives have access to vaccines and subsequently comply with their use. Under-vaccination stems from multiple causes: access, affordability, awareness, acceptance and activation. In this paper, we focus on acceptance and, specifically, on factors pertaining to individual or parental compliance, specifically the psychology of judgment and decision making. We describe how heuristics and cognitive biases - a facet of thoughts and feelings - affect vaccination decision making. Additionally, we address when and how social processes play a role and how attitudes towards vaccines might reflect a more general underlying attitude or ideology. The understanding of how decision making, with regards to vaccines occurs, and the role played by heuristics and cognitive biases can help inform more appropriate public health interventions.
- Published
- 2020
- Full Text
- View/download PDF
14. Health care seeking due to COVID-19 related symptoms and health care cancellations among older Brazilian adults: the ELSI-COVID-19 initiative.
- Author
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Macinko J, Woolley NO, Seixas BV, Andrade FB, and Lima-Costa MF
- Subjects
- Aged, Betacoronavirus, Brazil, COVID-19, Coronavirus Infections epidemiology, Female, Humans, Longitudinal Studies, Middle Aged, Office Visits trends, Pneumonia, Viral epidemiology, SARS-CoV-2, Socioeconomic Factors, Coronavirus Infections psychology, Office Visits statistics & numerical data, Pandemics, Patient Acceptance of Health Care, Pneumonia, Viral psychology
- Abstract
The continent of the Americas has the greatest number of people infected and deaths associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the world. Brazil occupies the 2nd position in numbers of infected cases and deaths, preceded only by the United States. Older adults and those with pre-existing chronic illnesses are more vulnerable to the consequences of the virus. The SARS-CoV-2 epidemic has serious consequences for health services. Therefore, an assessment of the pandemic's effect on the older Brazilian population is urgently needed. The study examines the prevalence of COVID-19 related symptoms, care-seeking, and cancellation of surgery or other scheduled medical care among a nationally representative sample of Brazilians aged 50 and over derived from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) and a telephone follow-up survey (the ELSI-COVID-19 initiative) between late May and early June 2020. About 10.4% of older adults reported any fever, dry cough or difficulty breathing in the 30 days prior to the interview, with the highest prevalence in the North region (50%). Among individuals with symptoms, only 33.6% sought care. Individuals living in the South or Southeast regions were significantly less likely to seek care for COVID-19 related symptoms. Nearly one in six participants had to cancel scheduled surgery or other medical care; this proportion was higher among women, those with more education, and people with multiple chronic conditions. This paper is among the first to investigate the effect of COVID-19 on health care use in Brazil among older adults. Results highlight the need to adapt health care delivery (such as through telemedicine) to ensure the continuity of care as well as the urgent need for wide dissemination of information to guide the population on disease prevention measures and how to obtain healthcare when needed.
- Published
- 2020
- Full Text
- View/download PDF
15. The experience with volunteer and collaborative work in mental health and psychosocial care during the COVID-19 pandemic.
- Author
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Kabad JF, Noal DDS, Passos MFD, Melo BD, Pereira DR, Serpeloni F, Souza MSE, Kadri MRE, Lima CC, Magrin NP, and Freitas CM
- Subjects
- Betacoronavirus, Brazil epidemiology, COVID-19, Coronavirus Infections epidemiology, Humans, Pneumonia, Viral epidemiology, Program Development, SARS-CoV-2, Cooperative Behavior, Coronavirus Infections psychology, Health Personnel psychology, Mental Health, Pandemics, Pneumonia, Viral psychology, Psychosocial Support Systems, Volunteers statistics & numerical data
- Abstract
Brazil is the country of the world with the second most COVID-19 cases and deaths, and the pandemic's impacts pose multiple challenges for mental health. This paper reports on experience with the emergency organization of the volunteer and collaborative Working Group (GT, in Portuguese) on mental health and psychosocial care aimed at producing rapid responses for health services in the context of COVID-19. The study involved the identification and systematization of current evidence in the scientific literature on mental health and psychosocial care in public health emergencies and pandemics, with the establishment of a network involving 117 researchers and 25 institutions, and the organization of themes for the elaboration of materials, referenced on the response phases in public health emergencies and pandemics. In less than 60 days, 18 technical documents were produced, ranging from services organization and management for different vulnerable groups. The materials became references in health institutions and services. A national course on mental health and psychosocial care in COVID-19 was also organized, with more than 60,000 people registered. The experience provides food for thought and a contribution for future experiences involving knowledge translation in the current pandemic and in future public health emergencies and pandemics, with the following: (1) combination of volunteer and collaborative work involving professionals with experience in the organization of services and care in past events; (2) reliance on institutional support and resources; (3) speed and credibility of work involving the establishment of networks of professionals and institutions; and (4) responses to the urgent needs with the capacity to shape paths for care in mental health and psychosocial care.
- Published
- 2020
- Full Text
- View/download PDF
16. Caring in the age of COVID-19: lessons from science and society.
- Author
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Souza CTV, Santana CS, Ferreira P, Nunes JA, Teixeira MLB, and Gouvêa MIFDS
- Subjects
- Access to Information, Brazil epidemiology, COVID-19, Community Participation methods, Coronavirus Infections epidemiology, Coronavirus Infections transmission, Humans, Pneumonia, Viral epidemiology, Pneumonia, Viral transmission, SARS-CoV-2, Social Isolation, Betacoronavirus, Coronavirus Infections prevention & control, Health Promotion methods, Information Dissemination methods, Pandemics prevention & control, Pneumonia, Viral prevention & control, Social Media, Vulnerable Populations
- Abstract
This paper focuses on our research and intervention in health promotion with patients and communities affected by various infectious diseases, in the project Knowledge-Sharing Platform. This project is developed at the National Institute of Infectious Diseases Evandro Chagas in the Oswaldo Cruz Foundation, Rio de Janeiro, Brazil, and promotes the continuing involvement of health researchers and professionals in the collaborative production of knowledge on health with patients and community groups and in their training as community health promoters. The new epidemic scenario created the demand for a space of dialogue and knowledge-sharing on the prevention of COVID-19 transmission. Due to the interruption of regular activities in the Knowledge-Sharing Platform, a strategy was launched to serve as a link between science and society and help overcome the social isolation imposed by the COVID-19 pandemic. The WhatsApp group allowed project members to participate by addressing questions (audio) on COVID-19 through mediation by community group leaders. The main questions by participants related to risk factors, transmission, immunity to the novel coronavirus, care related to prevention, symptoms, and treatment; and COVID-19 and influenza vaccine. The educational material Caring in the Age of COVID-19 was produced and shared with community leaders and distributed to the respective groups and was eventually shared in their communities as a response to a demand for knowledge that responds to the concerns of people already exposed to structural vulnerability.
- Published
- 2020
- Full Text
- View/download PDF
17. [Building a "Smiling Brazil"? Implementation of the Brazilian National Oral Health Policy in a health region in the State of São Paulo].
- Author
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Aquilante AG and Aciole GG
- Subjects
- Brazil, Delivery of Health Care, Esthetics, Dental, Health Policy, Humans, Oral Health, Program Evaluation, Comprehensive Dental Care, National Health Programs
- Abstract
This paper is a case study on the implementation of the Brazilian National Oral Health Policy (PNSB), known as "Smiling Brazil", in the cities of the Regional Health Department of Araraquara (DRS III) in São Paulo State. A structured questionnaire was given to the municipal oral health coordinators, an interview with oral health care professionals and managers was conducted, and the official data provided by the Brazilian Ministry of Health were coded to assess the policy's scope: (i) expansion and qualification of actions; (ii) work conditions; (iii) care; (iv) access; and (v) planning and management. The quantitative and qualitative analyses were linked by methods triangulation. In terms of PNSB implementation, the majority of the cities (52.6%) were classified as "good", with 42.1% classified as "bad". Approximately 10 years after launching the PNSB, despite strides in oral health care and access to different levels of care, the cities still experience difficulties in implementing the policy's principles.
- Published
- 2015
- Full Text
- View/download PDF
18. Sampling design for the Birth in Brazil: National Survey into Labor and Birth.
- Author
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Vasconcellos MT, Silva PL, Pereira AP, Schilithz AO, Souza Junior PR, and Szwarcwald CL
- Subjects
- Brazil epidemiology, Female, Humans, Models, Theoretical, Research Design, Sampling Studies, Birth Rate, Health Surveys, Live Birth epidemiology
- Abstract
This paper describes the sample design for the National Survey into Labor and Birth in Brazil. The hospitals with 500 or more live births in 2007 were stratified into: the five Brazilian regions; state capital or not; and type of governance. They were then selected with probability proportional to the number of live births in 2007. An inverse sampling method was used to select as many days (minimum of 7) as necessary to reach 90 interviews in the hospital. Postnatal women were sampled with equal probability from the set of eligible women, who had entered the hospital in the sampled days. Initial sample weights were computed as the reciprocals of the sample inclusion probabilities and were calibrated to ensure that total estimates of the number of live births from the survey matched the known figures obtained from the Brazilian System of Information on Live Births. For the two telephone follow-up waves (6 and 12 months later), the postnatal woman's response probability was modelled using baseline covariate information in order to adjust the sample weights for nonresponse in each follow-up wave.
- Published
- 2014
- Full Text
- View/download PDF
19. [Conceptual, item, semantic, and operational equivalence of a Brazilian version of the s-EMBU for measuring parental rearing practices in adolescents].
- Author
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Sampaio PF, Moraes CL, and Reichenheim M
- Subjects
- Adolescent, Brazil, Child, Cultural Characteristics, Female, Humans, Male, Parents education, Psychometrics, Reproducibility of Results, Semantics, Translations, Adolescent Behavior psychology, Child Rearing, Family Relations, Parents psychology, Surveys and Questionnaires
- Abstract
Parental upbringing of children and adolescents has received little attention in research on the promotion of children's health and wellbeing. This paper presents the initial cross-cultural adaptation process of a Brazilian version of the s-EMBU for adolescents, which intends to capture parental rearing practices. The study takes a universalistic approach to assess the four initial phases of cross-cultural adaptation: conceptual, item, semantic, and operational equivalence. The process thus included a literature review, discussion with experts, and translation and back-translation of items. A pretest was conducted with 10 adolescents in the waiting room of a public clinic. The adolescents did not understand some items as proposed in the original constructs. After some rewording, the items were properly understood as projected by the original instrument. The findings suggest that this Brazilian version of s-EMBU for adolescents is promising and that it provides room for future psychometric studies to complete the cross-cultural adaptation process.
- Published
- 2014
- Full Text
- View/download PDF
20. [Nobody gives orders here: the meanings of work and health for settlers from the Landless Rural Workers' Movement].
- Author
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Santos JC and Hennington EA
- Subjects
- Brazil, Ill-Housed Persons psychology, Humans, Motivation, Personal Autonomy, Qualitative Research, Rural Population, Social Conditions, Health Status, Ill-Housed Persons statistics & numerical data, Job Satisfaction, Labor Unions statistics & numerical data
- Abstract
This paper discusses the partial results of qualitative research on lifestyles and meanings attributed to health and work among settlers from the Landless Rural Workers' Movement (MST) and identifies strategies developed by workers to maintain and/or promote health. The study was conducted in a rural settlement affiliated with the MST in Campos dos Goytacazes, Rio de Janeiro State, Brazil. The ergological approach was the main theoretical and methodological reference for understanding work from the perspective of "human activity". The study techniques included document analysis, participant observation, semi-structured interviews, and focus groups, and the data were submitted to thematic content analysis. The landless rural workers attributed the meanings of freedom and satisfaction to their work, associated with self-management and autonomy, which they reported as key elements for health. Although rural work was considered tiring, the work and way of life in the settlement provided this community with possibilities for ensuring their health and resisting the hegemonic agribusiness model.
- Published
- 2013
- Full Text
- View/download PDF
21. [Guidelines for budget impact analysis of health technologies in Brazil].
- Author
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Ferreira-Da-Silva AL, Ribeiro RA, Santos VC, Elias FT, d'Oliveira AL, and Polanczyk CA
- Subjects
- Brazil, Budgets organization & administration, Cost-Benefit Analysis, Humans, Biomedical Technology economics, Budgets methods, Health Care Costs, Health Planning Guidelines
- Abstract
Budget impact analysis (BIA) provides operational financial forecasts to implement new technologies in healthcare systems. There were no previous specific recommendations to conduct such analyses in Brazil. This paper reviews BIA methods for health technologies and proposes BIA guidelines for the public and private Brazilian healthcare system. The following recommendations were made: adopt the budget administrator's perspective; use a timeframe of 1 to 5 years; compare reference and alternative scenarios; consider the technology's rate of incorporation; estimate the target population by either an epidemiological approach or measured demand; consider restrictions on technologies' indication or factors that increase the demand for them; consider direct and averted costs; do not adjust for inflation or discounts; preferably, integrate information on a spreadsheet; calculate the incremental budget impact between scenarios; and summarize information in a budget impact report.
- Published
- 2012
- Full Text
- View/download PDF
22. [Metropolitan and regional health planning: dilemmas of the Pact for Health in the Baixada Santista Metropolitan Area, São Paulo State, Brazil].
- Author
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Ianni AM, Monteiro PH, Alves OS, Morais Mde L, and Barboza R
- Subjects
- Brazil, Humans, National Health Programs organization & administration, Public Policy, Public Sector organization & administration, Urban Population, Regional Health Planning organization & administration
- Abstract
This paper focuses on the relationship between metropolitan and regional health planning based on the processes of regionalization and the Pact for Health in the Baixada Santista Metropolitan Area, São Paulo State, Brazil. The method used was a case study in two stages, namely during initial implementation of the Pact for Health (2007) and the Regional Administration Committees (CGR) and in 2010. Municipal and regional health systems managers and the director of the Metropolitan Agency were interviewed, and records were analyzed from ten years of meetings of the Regional Inter-Administration Committee and the Regional Development Council. Four issues emerged: financing and infrastructure; health services utilization; inefficiency of the Regional Health Administration's instruments and decision-making levels; and the relationship between different levels in the Administration. Metropolitan health management remained as an underlying issue, appearing only incidentally or tangentially to regional management. Despite some limitations, the CGR has been legitimized as a space for regional health management.
- Published
- 2012
- Full Text
- View/download PDF
23. [Effect of sampling plan on ordinal logistic models: an analysis of self-rated health status among Brazilian adults based on the National Household Sample Survey (PNAD 2008)].
- Author
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Moraes JR, Moreira JP, and Luiz RR
- Subjects
- Adult, Aged, Brazil, Female, Health Surveys methods, Humans, Male, Middle Aged, Odds Ratio, Rural Health, Self Report, Socioeconomic Factors, Urban Health, Young Adult, Diagnostic Self Evaluation, Health Status, Health Surveys statistics & numerical data, Logistic Models
- Abstract
Studies that draw on individual and environmental variables to explain differences in self-rated health status have increased gradually in Brazil, but are still limited in number. Due to time and cost issues, many studies use a complex sample design involving features (stratification, clustering, and different sample weights) that, when ignored, can influence odds ratios and standard errors in the statistical models. Using the National Household Sample Survey (PNAD 2008), this paper assesses the impact on these measurements when some or all of these features are not taken into account in fitting ordinal logistic models to establish associations between adults' self-rated health and various individual and environmental factors. According to this study, failure to take these three features into account simultaneously led to changes in the magnitude of the odds ratio between better self-rated health and most of the factors, besides important underestimation of standard errors.
- Published
- 2012
- Full Text
- View/download PDF
24. [The public healthcare system in the context of Brazil's demographic transition: current and future demands].
- Author
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Mendes Ada C, Sá DA, Miranda GM, Lyra TM, and Tavares RA
- Subjects
- Adolescent, Adult, Ambulatory Care organization & administration, Ambulatory Care trends, Brazil, Delivery of Health Care organization & administration, Health Planning trends, Health Services Needs and Demand organization & administration, Humans, Infant, Newborn, Middle Aged, National Health Programs, Population Growth, Young Adult, Delivery of Health Care trends, Health Services Needs and Demand trends, Hospitalization trends, Population Dynamics trends
- Abstract
This paper assesses inpatient and outpatient care and their capacity to respond to changing demands in the context of the demographic transition in Brazil. The data were obtained from studies by the Brazilian Institute of Geography and Statistics (IBGE) and databases in the National Health System (CNES, SIH, and SIA). The reduction in birth, fertility, and infant mortality rates and the increase in life expectancy at birth are still driving population growth, while decreasing the dependency rate, thereby providing the opportunity to make necessary adjustments. The population increased by more than 27.5 million from 1999 to 2009, with a 26.7% reduction in hospital beds and 947,000 hospitalizations, with distortions in the distribution by specialty, but with increases in high-complexity outpatient and inpatient care. The results show that Brazil is undergoing a transition in the healthcare model, requiring greater capacity for future planning of a more complex system and revising the model to prepare for a larger elderly population in the coming decades.
- Published
- 2012
- Full Text
- View/download PDF
25. [Labor market structure and access to private health insurance in Brazil].
- Author
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Machado AF, Andrade MV, and Maia AC
- Subjects
- Adult, Brazil, Educational Status, Female, Health Services Accessibility economics, Health Services Accessibility statistics & numerical data, Humans, Insurance, Health economics, Insurance, Health statistics & numerical data, Male, Middle Aged, Prepaid Health Plans economics, Work, Young Adult, Employment economics, Prepaid Health Plans statistics & numerical data
- Abstract
This paper aims to describe health insurance coverage among different types of workers in Brazil. Health insurance coverage and labor market insertion are used to define homogeneous groups of workers. The Grade of Membership method is used to build a typology of workers. The database was the Brazilian National Household Survey (PNAD) for 1998 and 2003, including a health survey. Five worker profiles were defined. The key variables were: health insurance coverage, schooling, and work status. The main findings show a positive association between health insurance coverage, income from work, and trade union membership.
- Published
- 2012
- Full Text
- View/download PDF
26. [Coverage by the Family Health Strategy and diagnosis of syphilis in pregnancy and congenital syphilis].
- Author
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Saraceni V and Miranda AE
- Subjects
- Brazil epidemiology, Disease Notification statistics & numerical data, Female, Humans, Information Systems, Live Birth, Pregnancy, Pregnancy Complications, Infectious, Prevalence, Stillbirth, Family Health statistics & numerical data, National Health Programs statistics & numerical data, Syphilis diagnosis, Syphilis epidemiology
- Abstract
This paper aimed to correlate syphilis in pregnancy and congenital syphilis with coverage of the Family Health Strategy (FHS), based on available data in the national health information systems. The syphilis notification estimates were calculated according to the Sentinel Childbirth Study for 2004 under the Ministry of Health and the data were obtained from the websites of the Health Surveillance Secretariat and Healthcare Secretariat, for the year 2008. The ratios between observed and estimated gestational syphilis and congenital syphilis were not statistically correlated with population coverage by the FHS (r = -0.28 and r = -0.40, respectively). The FHS is a privileged area for prenatal care and logically a source of compulsory notification of syphilis in pregnancy. By combining diagnosis with adequate treatment of syphilis in pregnant women and their partners, the FHS becomes a prime instrument for eliminating congenital syphilis in Brazil. Expanding the FHS coverage and quality of care are essential for achieving this goal.
- Published
- 2012
- Full Text
- View/download PDF
27. [Articulation between child and adolescent mental health services].
- Author
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Delfini PS and Reis AO
- Subjects
- Adolescent, Brazil, Child, Family Health, Female, Health Policy, Humans, Male, Mental Health, Qualitative Research, Referral and Consultation, Adolescent Health Services organization & administration, Child Health Services organization & administration, Mental Health Services organization & administration
- Abstract
The objective of this paper was to describe and analyze the articulation between children and adolescent mental health care interventions undertaken by teams working under the Family Health Strategy (FHS) and Psychosocial Care Centers for Children and Adolescents (CAPSI). In order to achieve these objectives, semi-structured interviews were conducted with five CAPSI and 13 FHS managers from five different regions of the city of São Paulo, Brazil. The 18 interviews were transcribed and analyzed froma hermeneutic perspective. It was found that interactions between the FHS and CAPSI occur mainly through referral of cases, matrix support or partnerships in cases concerning CAPSI. Obstacles, such as a lack of human resources, productivity goals and lack of training in mental health of FHS professionals were mentioned. The referral system and passing responsibility for mental health cases to specialized services and the hegemonic biomedical model and the fragmentation of care are common place in these services.
- Published
- 2012
- Full Text
- View/download PDF
28. [The school census as a search strategy for children and adolescents in epidemiological studies].
- Author
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Gonçalves-Silva RM, Sichieri R, Ferreira MG, Pereira RA, Muraro AP, Moreira NF, and Valente JG
- Subjects
- Adolescent, Age Distribution, Brazil epidemiology, Child, Female, Humans, Male, Censuses, Epidemiologic Studies, Information Systems, Population Surveillance methods
- Abstract
Low-cost alternatives that allow for the monitoring of population groups are important strategies in conducting cohort studies. This paper presents the procedures for the use of the National School Census as a search tool for children and adolescents in follow-up studies. The study was conducted among adolescent students who took vaccinations in clinics in Cuiabá, Mato Grosso State, Brazil in 1999. A total of 86.8% were identified in the census and 0.2% in the Mortality Information System. Of those identified, 1,716 were interviewed, representing a follow-up rate of 71.4%. In this study, the school census proved to be an effective method for finding students.
- Published
- 2012
- Full Text
- View/download PDF
29. [An evaluation model for oral health in primary care].
- Author
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Colussi CF and Calvo MC
- Subjects
- Brazil, Dental Health Services statistics & numerical data, Humans, Primary Health Care statistics & numerical data, Quality Assurance, Health Care methods, Quality Indicators, Health Care, Reproducibility of Results, Dental Health Services standards, Oral Health, Primary Health Care standards, Program Evaluation methods
- Abstract
This paper presents a model for assessing the quality of primary dental care and tests its applicability in municipalities in Santa Catarina State, Brazil. The model features two components: Management of Oral Health and Provision of Primary Oral Health Care. The first consists of the sub-components Inter-Sector Practice, Community Participation, Human Resources, and Infrastructure. The second includes the sub-components Promotion/Prevention and Diagnosis and Treatment throughout the life cycle (childhood, adolescence, adulthood, and old age). Forty indicators were developed in workshops with a group of experts. 207 municipalities participated in the evaluation, yielding a response rate of 70.6%. The model proved to be applicable and highly beneficial to municipalities of different sizes, allowing the identification of areas in which municipal managers need to improve their oral health practices. Another important contribution relates to managers' awareness of the need to improve data recording.
- Published
- 2011
- Full Text
- View/download PDF
30. [How does social position influence self-reported health status? A comparative analysis between 1998 and 2003].
- Author
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Rodrigues CG and Maia AG
- Subjects
- Brazil, Female, Health Status Disparities, Humans, Male, Occupations statistics & numerical data, Socioeconomic Factors, Health Status, Occupations classification, Self Concept, Social Class
- Abstract
The aim of this paper is to analyze how the social position of families affects self-reported health status, based on data from the 1998 and 2003 National Sample Household Survey of the Brazilian Institute of Geography and Statistics (PNAD-IBGE). The method was based on descriptive statistics and logistic regression to capture the conditional relationship between health status, social position, and other control variables, such as age, sex, race/color, income, education, and place of residence. The results show that the same hierarchy of the occupational classes is reproduced in self-reported health status. There was an increase in inequalities in the period, with a reduction in the prevalence of healthy workers in the lower social strata and an increase in the upper strata. Although there were more healthy individuals in non-agricultural classes, the probability of good self-reported health was higher among agricultural workers, after the other control variables were added to the regression models. The results emphasize the need to analyze health inequalities from the perspective of social stratification.
- Published
- 2010
- Full Text
- View/download PDF
31. [Evaluation model for human resource management in health].
- Author
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Scalco SV, Lacerda JT, and Calvo MC
- Subjects
- Brazil, Humans, National Health Programs, Evaluation Studies as Topic, Personnel Management methods, Personnel Management standards, Primary Health Care
- Abstract
This paper presents an assessment model for human resource management in health. This methodological research was structured through indicators tested in evaluative research. The Basic Operational Standard for Human Resources in the Unified National Health System (NOB/RH-SUS) was used as the baseline, and the following dimensions were analyzed: work management, workers' development, workers' health, and social control. The model was discussed and refined during a consensus workshop involving experts in human resources evaluation and management, by defining an assessment matrix with 12 indicators. The model was applied to 15 municipalities in Greater Metropolitan Florianópolis, Santa Catarina State, Brazil, and proved applicable to municipalities with different population sizes and administrative structures. Data were obtained from local information systems and official documents from the municipal health departments. The model's validity was demonstrated by the results of its application, consistent with data from the literature.
- Published
- 2010
- Full Text
- View/download PDF
32. [The demographic revolution among Brazilian indigenous peoples: the case of the Kayabí in the Xingu Indian Reservation, Mato Grosso State, Brazil, 1970-2007].
- Author
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Pagliaro H
- Subjects
- Adolescent, Adult, Brazil ethnology, Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Time Factors, Young Adult, Demography, Indians, South American statistics & numerical data
- Abstract
This paper analyzes the demographic dynamics of the Kayabí, a Tupi people in the Xingu Indian Reservation in Central Brazil, from 1970 to 2007. Data were gathered from vital statistics for the Xingu Indian Reservation at the Federal University in São Paulo. Contact with Brazilian national society from 1920 to 1950 in the Upper Teles Pires River Valley led to a population decrease due to clashes and epidemics. In 1952, part of the Kayabí group gradually began migrating to the Xingu, where they still live. In 1970 there were 204 Kayabí in Xingu villages, and by 2007 there were 1,162, representing a 4.8% annual growth rate. For 2000-2007 the crude birth rate was 51 per thousand inhabitants; total fertility rate 7.8 children per women; crude death crude 3.5 per thousand inhabitants; and infant mortality rate 17.5 per thousand live births. The majority of the population is under 15 years of age (55.9%). The results show a population recovery process, similar to that of some other indigenous group in Brazil.
- Published
- 2010
- Full Text
- View/download PDF
33. [Portuguese adaptation of the Cambridge Cognitive Examination-Revised in a public geriatric outpatient clinic].
- Author
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Paradela EM, Lopes Cde S, and Lourenço RA
- Subjects
- Aged, Aged, 80 and over, Ambulatory Care Facilities, Brazil, Cultural Characteristics, Female, Humans, Language, Male, Middle Aged, Neuropsychological Tests, Translations, Cognition Disorders diagnosis, Cross-Cultural Comparison, Geriatric Assessment, Health Services for the Aged, Surveys and Questionnaires
- Abstract
This paper presents the results of the first four steps (conceptual, item, semantic, and operational equivalences) of cross-cultural adaptation to Portuguese of the Cambridge Cognitive Examination-Revised (CAMCOG-R). The process was based on the theoretical model proposed by Herdman et al., which includes not only the four steps described above, but also measurement and functional equivalences, not evaluated in the current study. A panel of experts evaluated whether all dimensions that comprise the CAMCOG-R were present in Brazilian reality. Two translations and back-translations were performed, in addition to the 'focus group' technique. The Brazilian Portuguese version of the CAMCOG-R (Br-CAMCOG-R) was developed, maintaining the 69 items from the original instrument, with different levels of difficulty. It was then applied to 196 elders, with the test lasting an average of 43 +/- 9.4 minutes, and an average total score of 67 +/- 14.8 points. The Br-CAMCOG-R can be a useful tool for the cognitive evaluation of elders that tested positive during initial screening.
- Published
- 2009
- Full Text
- View/download PDF
34. [Review of data quality dimensions and applied methods in the evaluation of health information systems].
- Author
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Lima CR, Schramm JM, Coeli CM, and da Silva ME
- Subjects
- Brazil, Databases, Factual standards, Humans, Reproducibility of Results, Data Collection standards, Health Services Research standards, Information Systems standards
- Abstract
In Brazil, quality monitoring of data from the various health information systems does not follow a regular evaluation plan. This paper reviews quality evaluation initiatives related to the Brazilian information systems, identifying the selected quality dimensions and the method employed. The SciELO and LILACS databases were searched, as were the bibliographical references from articles identified in the search. 375 articles were initially identified, leaving a final total of 78 after exclusions. The four most frequent dimensions in articles totaled approximately 90% of the analyses. The studies prioritized certain quality dimensions: reliability, validity, coverage, and completeness. Half of the studies were limited to data from Rio de Janeiro and São Paulo. The limited number of studies on some systems and their unequal distribution between regions of the country hinder a comprehensive quality assessment of Brazil's health information systems. The importance of accurate information highlights the need to implement a data management policy for health information systems in Brazil.
- Published
- 2009
- Full Text
- View/download PDF
35. ['Judicialization' of public health policy for distribution of medicines].
- Author
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Chieffi AL and Barata RB
- Subjects
- Access to Information, Brazil, Federal Government, Humans, Patient Rights legislation & jurisprudence, Public Sector, Drugs, Essential supply & distribution, Health Policy legislation & jurisprudence, Judicial Role, National Health Programs legislation & jurisprudence, Social Justice legislation & jurisprudence
- Abstract
The supply of medicines in response to court orders or injunctions has become a common practice in the State of São Paulo, Brazil. This 'judicialization' of the health system clashes with basic principles of the Brazilian Unified National Health System (SUS), such as equal opportunity to access health services. The aim of this paper is to analyze the legal action used to obtain medicines through the São Paulo State Health Department, from two main angles: judicialization of public policies and breach of the equity principle. This is a descriptive study of legal action taken to obtain medicines through the São State Health Department, as listed in the Electronic Court Docket System for the year 2006. Most cases were filed through private attorneys; 47% of the patients had obtained their prescriptions through private care; and 73% of the cases involved patients from the three wealthiest areas in the city of São Paulo. The data demonstrate that such legal action violates key principles of the SUS such as equity, thereby privileging individuals with higher purchasing power and more access to information.
- Published
- 2009
- Full Text
- View/download PDF
36. [Complementary practices, medical rationalities, and health promotion: some overlooked contributions].
- Author
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Tesser CD
- Subjects
- Brazil, Humans, Public Policy, Complementary Therapies organization & administration, Delivery of Health Care, Health Promotion organization & administration, Professional Practice organization & administration
- Abstract
This article presents some key contributions to health promotion by complementary and alternative medicine (CAM). After contextualizing CAM, the article proposes a scheme for viewing the challenges and tensions in health promotion, organized along four thematic lines: (1) actions impacting the collective (social, collective 'empowerment') versus the individual; (2) inter-sector versus sectorial actions; (3) positive and expanded conception of health versus health as absence of disease; (4) directive versus dialogical pedagogy. The paper argues that the contributions of CAM to health promotion are oriented towards individuals and groups and to the sectorial pole of promotion; they are centered on positive conceptions of health, especially vitalist medical paradigms, including health-strengthening practices; and with 'empowering' pedagogical potential. The article highlights the relevance of these contributions, largely overlooked in the past, and the difficulties and guidelines for enabling them in Brazil, related to their non-scientific and poorly institutionalized configurations and their steady commodification.
- Published
- 2009
- Full Text
- View/download PDF
37. [Risk factors for respiratory morbidity at 12 to 36 months in very low birth weight premature infants previously admitted to a public neonatal intensive care unit].
- Author
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Chalfun G, Mello RR, Dutra MV, Andreozzi VL, and Silva KS
- Subjects
- Brazil epidemiology, Bronchopulmonary Dysplasia epidemiology, Child, Preschool, Ductus Arteriosus, Patent epidemiology, Female, Follow-Up Studies, Gestational Age, Humans, Infant, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases prevention & control, Infant, Very Low Birth Weight, Male, Morbidity, Pneumonia epidemiology, Respiratory Sounds, Respiratory Tract Diseases prevention & control, Risk Factors, Sex Factors, Socioeconomic Factors, Infant, Premature, Diseases epidemiology, Respiratory Tract Diseases epidemiology
- Abstract
The aim of this paper was to estimate respiratory morbidity and its determinants for premature infants aged 12 to 36 months. The population comprised 84 infants from a cohort of very low birth weight premature infants. The outcome was the respiratory morbidity incidence rate. The relationship between the independent variables and respiratory morbidity was estimated using a Poisson regression model. From 12 to 24 months of age, 56.3% of children had experienced at least one episode of respiratory disease. >From 24 to 36 months, 38.1% of children were affected. Variables significantly associated with respiratory morbidity were bronchopulmonary dysplasia (RR = 1.9; 95%CI: 1.2-2.9), abnormal lung compliance (RR = 1.6; 95%CI: 1.1-2.3), neonatal pneumonia (RR = 2.8; 95%CI: 1.9-4.0), patent ductus arteriosus (RR = 1.6; 95%CI: 1.1-2.5), and respiratory morbidity in the first year of life (RR = 1.7; 95%CI: 1.2-2.5). The incidence of respiratory morbidity remains high in this group of high-risk infants, which calls for regular follow-up and effective interventions to prevent respiratory disease and to improve the quality of life of these children and their families.
- Published
- 2009
- Full Text
- View/download PDF
38. [Ambulatory care sensitive hospitalizations: elaboration of Brazilian list as a tool for measuring health system performance (Project ICSAP--Brazil)].
- Author
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Alfradique ME, Bonolo Pde F, Dourado I, Lima-Costa MF, Macinko J, Mendonça CS, Oliveira VB, Sampaio LF, Simoni CD, and Turci MA
- Subjects
- Ambulatory Care, Brazil, Humans, Quality Indicators, Health Care, Waiting Lists, Health Services standards, Hospitalization statistics & numerical data, Primary Health Care standards, Quality of Health Care
- Abstract
Ambulatory care sensitive hospitalizations are a set of conditions for which access to effective primary care can reduce the likelihood of hospitalization. These hospitalizations have been used as an indicator of primary care performance in several countries and in three Brazilian states, but there is little consensus on which conditions should be included in this indicator. This paper presents a description of the steps undertaken to construct and validate a list for Brazil. The final list includes 20 groups of diagnostic conditions that represented 28.3% of a total of 2.8 million hospitalizations in the National Unified Health System in 2006. Gastroenteritis and complications, congestive heart failure, and asthma represented 44.1% of all ambulatory care sensitive hospitalizations. From 2000 to 2006, ambulatory care sensitive hospitalizations decreased by 15.8%, and this reduction was more significant than that observed in all other hospitalizations. The article concludes with potential applications and limitations of the proposed Brazilian list.
- Published
- 2009
- Full Text
- View/download PDF
39. [Abortion: 20 years of Brazilian research].
- Author
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Diniz D, Corrêa M, Squinca F, and Braga KS
- Subjects
- Brazil, Databases, Bibliographic, Female, Humans, Periodicals as Topic, Pregnancy, Abortion, Induced statistics & numerical data, Bibliometrics, Research statistics & numerical data
- Abstract
The aim of this paper is to discuss the main characteristics of the scientific literature on abortion in Brazil. Data were collected from 88 literature bases, and 2,109 documents from 1987 to 2008 were retrieved. Based on the findings, the field of abortion in Brazil is dominated by female researchers affiliated with public universities and nongovernmental organizations from the Southeast, with training in health sciences. There is no research on abortion in the North, while 14% of the studies were conducted in the Northeast and 4% in the Central-West. Abortion has been a constant theme in the scientific literature in Brazil, increasing in the mid-20th century.
- Published
- 2009
- Full Text
- View/download PDF
40. [Trends in the AIDS epidemic in groups at highest risk in Brazil, 1980-2004].
- Author
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Barbosa Júnior A, Szwarcwald CL, Pascom AR, and Souza Júnior PB
- Subjects
- Acquired Immunodeficiency Syndrome transmission, Adolescent, Adult, Brazil epidemiology, Disease Notification, Female, Humans, Incidence, Male, Middle Aged, Risk, Substance Abuse, Intravenous epidemiology, Young Adult, Acquired Immunodeficiency Syndrome epidemiology, Disease Outbreaks, Homosexuality, Male statistics & numerical data, Substance Abuse, Intravenous complications
- Abstract
The objective of this paper was to present the trends in the AIDS epidemic in the population groups at highest risk in Brazil. Discriminant analysis was used to reclassify cases with unknown risk into one of the three groups: IDU (injecting drug users), MSM (men who have sex with men), and heterosexuals. AIDS incidence rates by gender and exposure category were estimated for the period 1980-2004. In 1980-1988, 63.6% of AIDS cases were homosexual or bisexual males and 10% were females. Since 1988, there has been a decrease in the proportion of MSM and an increase in the other categories. Despite the incidence trends observed by exposure category, when the incidence rates were compared, the risk was much higher among MSM as compared to heterosexuals. Analysis of the AIDS epidemic dynamics in Brazil emphasizes the importance of MSM and male IDU as higher-risk groups.
- Published
- 2009
- Full Text
- View/download PDF
41. [Demographic profile of Boróro Indians from Mato Grosso State, Brazil, 1993-1996].
- Author
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Souza LG, Pagliaro H, and Santos RV
- Subjects
- Adolescent, Adult, Age Distribution, Aged, Brazil, Censuses, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Demography, Indians, South American statistics & numerical data, Vital Statistics
- Abstract
This paper analyzes the demographic profile of the Boróro Indians from Mato Grosso State, Brazil, from 1993 to 1996. Data came from annual collection and registration of vital statistics conducted by the health service in three villages (Garças, Meruri, and Morada dos Boróro). The average annual population growth rate was 2.4%. Nearly half (44%) of the population was younger than 15 years (median 16 years). The crude birth rate was 30.9 per 1,000 and the crude death rate 7.3 per 1,000 inhabitants. The infant mortality rate was high (58.8 per thousand live births), probably resulting from precarious health conditions in the villages. The results showed that women married younger than men and that there were numerous unmarried adult men (26.7%) and women (13.3%), as compared to data from other indigenous groups. The total fertility rate of Boróro women was 4.3, quite low compared to other indigenous communities in Brazil. The study emphasizes the importance of systematically collecting and analyzing demographic data on indigenous populations.
- Published
- 2009
- Full Text
- View/download PDF
42. [The cost of violence for the public health system in Brazil: available data and possibilities for estimation].
- Author
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Rodrigues RI, Cerqueira DR, Lobão WJ, and Carvalho AX
- Subjects
- Accidents, Traffic economics, Ambulatory Care Information Systems, Brazil, Budgets methods, Hospital Information Systems, Humans, Wounds and Injuries economics, Data Collection methods, Financing, Government economics, Health Care Costs statistics & numerical data, Violence economics
- Abstract
The Brazilian public budget for health was R$ 53 billion (approximately U$ 20 billion) in 2003. What share of this total was to treat victims of violence? It is impossible to estimate that proportion directly, due to limitations in the available data. This paper proposes a methodology to estimate the cost of violence for the public health system, using data from the Unified National Health System, the government budget, and the demand for public medical services (National Household Sample Survey). According to our estimates, in 2004 the costs of treatment for victims of external causes, aggressions, and traffic accidents were R$ 2.2 billion, R$ 119 million, and R$ 453 million, respectively. These findings were approximately four times higher than those observed in other studies.
- Published
- 2009
- Full Text
- View/download PDF
43. [Research on abortion in Brazil: gaps and challenges for the public health field].
- Author
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Menezes G and Aquino EM
- Subjects
- Abortion, Incomplete epidemiology, Abortion, Incomplete psychology, Abortion, Induced mortality, Abortion, Induced psychology, Adolescent, Adult, Brazil epidemiology, Female, Humans, Mental Health, Middle Aged, Pregnancy, Risk Factors, Young Adult, Abortion, Induced adverse effects, Delivery of Health Care standards
- Abstract
This paper provides a review of abortion studies produced in the field of public health in Brazil, highlighting current research gaps and challenges. Most studies focus on women admitted to public hospitals for treatment of incomplete abortion, so their scope is limited to abortions presenting complications. Women's profiles, abortion methods, motives, and immediate consequences for women's physical health are also included. However, there remains a need for studies on the following aspects: measuring abortion incidence; investigating cases of post-abortion complications and death; analyzing the relationship between abortion and contraception; investigating the impact of abortion on women's mental health; and incorporating men's perspectives. There is an urgent need for evaluative research on abortion care in public services. Research results should be disseminated widely, so as to help overcome any ideological bias in the current debate on abortion rights in the country.
- Published
- 2009
- Full Text
- View/download PDF
44. [Breaking silence and its barriers: a household survey on domestic violence against the elderly within the scope of a Family Health Program in Niterói, Rio de Janeiro State, Brazil].
- Author
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Moraes CL, Apratto Júnior PC, and Reichenheim ME
- Subjects
- Aged, Aged, 80 and over, Brazil epidemiology, Elder Abuse psychology, Family psychology, Female, Health Promotion, Humans, Male, Middle Aged, National Health Programs, Prevalence, Socioeconomic Factors, Elder Abuse statistics & numerical data, Family Health, Health Services for the Aged statistics & numerical data
- Abstract
The objective of this paper was to study the prevalence of domestic physical violence against the elderly in an area covered by the Family Health Program in Niterói, Rio de Janeiro State, Brazil. Using a household survey, 322 subjects 60 years or older were randomly selected from the census of seniors assigned to six health teams. Violence against seniors was detected by means of the Conflict Tactics Scales (CTS1). Physical violence in general was reported by 10.1% (95%CI: 6.7; 13.4) of interviewees, whereas 7.9% (95%CI: 4.9; 10.8) referred having been victims of severe physical violence in the preceding year. Violence was more frequent: against the "younger" elderly; in larger households; and against seniors with a history of diabetes and/or arthritis. The extent of violence against the elderly, even higher prevalence among those with other vulnerabilities, and its negative health consequences highlight the need for measures to deal with the problem within routine activities under the Family Health Program.
- Published
- 2008
- Full Text
- View/download PDF
45. [Antimicrobial prescription in family health units in Southern Brazil].
- Author
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Tavares NU, Bertoldi AD, and Muccillo-Baisch AL
- Subjects
- Adolescent, Adult, Aged, Anti-Infective Agents administration & dosage, Brazil, Child, Child, Preschool, Cross-Sectional Studies, Drug Prescriptions statistics & numerical data, Humans, Infant, Infant, Newborn, Middle Aged, Practice Patterns, Physicians', Seasons, Young Adult, Anti-Infective Agents therapeutic use, Family Health, Primary Health Care, Respiratory Tract Infections drug therapy
- Abstract
This paper describes antimicrobial prescription, clinical indications, and seasonal characteristics in primary health care. We performed a cross-sectional study in family health units in Bagé, Rio Grande do Sul State, Brazil, in July 2005 and January 2006. All medical prescriptions (n = 2,877) were analyzed, and the prevalence rates for antimicrobial prescription in winter and summer were 30.4% (95%CI: 28.5-32.4) and 21% (95%CI: 19.1-22.9), respectively. The most frequently prescribed antimicrobials were amoxicillin and sulfamethoxazole-trimethoprim. The main clinical indications for antimicrobial prescription were non-specific upper respiratory tract infections (22.5%), throat infections (20.8%), urinary tract infections (13.3%), otitis (8.5%), and sinusitis (7.5%). We observed differences between summer and winter in prescriptions for the same diseases. Seasonal differences between treatment profiles for the same diseases show the absence of a consistent antimicrobial prescription pattern in primary health care, contrary to World Health Organization guidelines, which advocate the establishment of protocols for antimicrobial use at all levels of care, as a strategy to prevent inadequate usage and the occurrence of strains that are resistant to available antimicrobials.
- Published
- 2008
- Full Text
- View/download PDF
46. [Schistosomiasis in an ecotourism area in Minas Gerais State, Brazil].
- Author
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Massara CL, Amaral GL, Caldeira RL, Drummond SC, Enk MJ, and Carvalho Odos S
- Subjects
- Animals, Biomphalaria parasitology, Brazil epidemiology, Feces parasitology, Humans, Schistosomiasis epidemiology, Schistosomiasis parasitology, Ecology, Schistosomiasis transmission, Travel
- Abstract
This paper discusses schistosomiasis transmission in São José da Serra, a village with a population of 500 in the county of Jaboticatubas, Minas Gerais State, Brazil. The area receives thousands of visitors a year for ecotourism. The study was motivated by a case of acute schistosomiasis involving a couple that spent the 2007 Carnival (Mardi Gras) holiday in the area. Stool tests from 268 local residents (53.6% of the population) showed that 35 (13%) were positive for the infection. A comparison with a previous survey (2005) in the same location showed an increase in the schistosomiasis-positive rate from 9.6% to 12.5%, among the 56 individuals who participated in both surveys. A malacological survey of 65 Biomphalaria glabrata snails showed one specimen (1.5%) eliminating cercariae. In a similar survey in 2005, no positive snail specimens were found. The study indicates that active schistosomiasis transmission is occurring in the area, and that integrated educational programs are needed for both the local community and tourists.
- Published
- 2008
- Full Text
- View/download PDF
47. [Association between social deprivation and causes of mortality among elderly residents in the city of Recife, Pernambuco State, Brazil].
- Author
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Silva Vde L, Leal MC, Marino JG, and Marques AP
- Subjects
- Accidents, Traffic mortality, Brazil epidemiology, Bronchial Neoplasms mortality, Diarrhea mortality, Female, Gastroenteritis mortality, Humans, Linear Models, Male, Middle Aged, Pneumonia mortality, Protein-Energy Malnutrition mortality, Reference Values, Residence Characteristics statistics & numerical data, Statistics, Nonparametric, Tuberculosis mortality, Vascular Diseases mortality, Cause of Death, Poverty classification
- Abstract
This paper aims to analyze mortality among elderly residents in the city of Recife, Pernambuco State, Brazil, and its association with social deprivation (hardship) in the year 2000. An ecological study was performed, and 94 neighborhoods and 5 social strata were analyzed. The independent variable consisted of a composite social deprivation indicator, obtained for each neighborhood and calculated through a scoring technique based on census variables: water supply, sewage, illiteracy, and head-of-household's years of schooling and income. The dependent variables were: mortality rate in individuals > 60 years of age and cause-specific mortality rates. The association was calculated by means of the Pearson correlation coefficient, linear regression, and mortality odds between social deprivation strata formed by grouping of neighborhoods according to the indicator's quintiles. The data show a statistically significant positive correlation between social deprivation and mortality in the elderly from pneumonia, protein-energy malnutrition, tuberculosis, diarrhea/gastroenteritis, and traffic accidents, and a negative correlation with deaths from bronchopulmonary and breast cancers.
- Published
- 2008
- Full Text
- View/download PDF
48. [Prevalence of hemoglobin S in the State of Paraná, Brazil, based on neonatal screening].
- Author
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Watanabe AM, Pianovski MA, Zanis Neto J, Lichtvan LC, Chautard-Freire-Maia EA, Domingos MT, and Wittig EO
- Subjects
- Anemia, Sickle Cell blood, Anemia, Sickle Cell ethnology, Brazil epidemiology, Cross-Sectional Studies, Heterozygote, Homozygote, Humans, Infant, Newborn, Neonatal Screening methods, Prevalence, Retrospective Studies, White People statistics & numerical data, beta-Thalassemia blood, beta-Thalassemia epidemiology, beta-Thalassemia ethnology, Anemia, Sickle Cell epidemiology
- Abstract
The Brazilian Ministry of Health created the National Neonatal Screening Program under ruling no. 822/2001, including neonatal screening for hemoglobinopathies. In the State of Paraná, neonatal screening is conducted by the Ecumenical Foundation for the Protection of the Handicapped. The prevalence rates were determined for homozygous and heterozygous hemoglobin S and Sbeta-thalassemia. Blood samples drawn on filter paper were examined by isoelectric focusing (IEF) and high-performance liquid chromatography (HPLC). From January 2002 to December 2004, 548,810 newborns were screened, with the detection of 21 with FS, two FSA/FS, and four FSA. After confirmatory tests at six months of age, 12 were defined as sickle-cell anemia, or a prevalence of 2.2:100,000 newborns; Sbeta-thalassemia was confirmed in 15 (2.7:100,000 newborns); and 8,321 newborns were diagnosed as heterozygous HbS (1,500:100,000 newborns). HbS prevalence in Paraná (in southern Brazil) is lower than in the Central-West, North, and Northeast of the country. Ethnic origin of the population, fetal deaths, and non-random procreation may contribute to the relatively low number of homozygous individuals in the State. Sbeta-thalassemia interaction suggests the presence of Euro-Mediterranean peoples in this population's miscegenation.
- Published
- 2008
- Full Text
- View/download PDF
49. [Home care and its relationship to the work environment in health].
- Author
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Kerber NP, Kirchhof AL, and Cezar-Vaz MR
- Subjects
- Brazil, Delivery of Health Care economics, Delivery of Health Care organization & administration, Humans, Delivery of Health Care methods, Home Care Services, Quality of Life
- Abstract
This paper discusses home care as a service that has expanded in the public and private health system, while arguing for the possibility that such care can leverage a significant impact on the population's quality of life and health. The article presents home care as a strategic possibility for reorganizing the health system, by means of integration between health workers and health institutions, and considers its possible political, economic, and technical impacts on the health system, health workers, and users of the service.
- Published
- 2008
- Full Text
- View/download PDF
50. [Physical activity in young adults and the elderly in areas covered by primary health care units in municipalities in the South and Northeast of Brazil].
- Author
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Siqueira FV, Facchini LA, Piccini RX, Tomasi E, Thumé E, Silveira DS, and Hallal PC
- Subjects
- Adult, Aged, Aged, 80 and over, Brazil epidemiology, Educational Status, Epidemiologic Methods, Female, Health Status, Humans, Male, Middle Aged, Primary Health Care statistics & numerical data, Community Health Centers statistics & numerical data, Exercise physiology, Health Behavior, Leisure Activities, Life Style, Motor Activity physiology
- Abstract
Shifts in Brazil's demographic structure have expanded the country's elderly population and consequently increased the rates of chronic diseases. This paper describes the prevalence of sedentary lifestyle and associated factors in a cross-sectional study, including 4,060 non-elderly and 4,003 elderly adults in 41 cities in seven States of the country. Prevalence of sedentary lifestyle was 31.8% (95%CI: 30.4-33.2) in non-elderly adults and 58.0% (95%CI: 56.4-59.5) in the elderly; sedentary lifestyle was more frequent in the Northeast and among males. Low family income was associated with higher prevalence of sedentary lifestyle in both non-elderly and elderly adults, while low schooling was only observed among the elderly. There was an inverse association between self-reported health status and sedentary lifestyle. Mean prevalence of sedentary lifestyle was higher in areas covered by pre-PROESF units in comparison to other health system models. We conclude that sedentary lifestyle is highly prevalent and that disadvantaged socioeconomic groups are more likely to be sedentary.
- Published
- 2008
- Full Text
- View/download PDF
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