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Introduction: The elderly correspond to the most medicalized group in society. Therefore, studies related to the use of medicines are important to improve policies that guarantee comprehensive care. The objective of this study was to investigate the polypharmacy among elderly individuals attending an educational program in the Federal District of Brazil and estimate the prevalence and associated variables. Method: This is a cross-sectional study with 150 elderly individuals whose data were collected in the period from December 2022 to April 2023 by means of telephone calls. Results: The prevalence of polypharmacy was estimated in 18.7%. The variables showing a positive association with polypharmacy were the following: health self-perceived as bad or very bad (PR = 8.9; 95 % CI 4.78 – 16.70), smoking (PR = 2.50; 95 % CI 1.06 – 5.89), systemic arterial hypertension (PR = 3.55; 95 % CI 1.40 – 9.00), diabetes mellitus (PR = 3.46; 95 % CI 1.67 – 7.18), depression (PR = 3.32; 95 %CI 1.58 – 6.75), multi-morbidity (PR = 8.97; 95 % CI 1.26 – 64.10) and Charlson Comorbidity Index equal to or greater than 3 (PR = 7.21; 95 % CI 1.14 – 26.17). Conclusions: The prevalence of polypharmacy and associated variables are corroborated by other Brazilian studies. Therefore, it is pointed out that healthcare teams should pay attention to this aspect of geriatric pharmacotherapy to favour the responsible use of medications and yield positive clinical outcomes. [ABSTRACT FROM AUTHOR]

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Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of GeSec: Revista de Gestao e Secretariado is the property of Sindicato das Secretarias e Secretarios do Estado de Sao Paulo (SINSESP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study examines how public health issues were communicated during the 2020 US presidential campaign, particularly those concerning the global COVID‐19 pandemic. Using content analysis, we examined the available campaign speeches of the two major candidates, Donald Trump and Joseph R. Biden. We examined how the candidates discussed the COVID‐19 pandemic and vital areas of public health in those speeches. Analysis of these speeches found little discussion on healthcare in general and little to no discussion on the vital areas of public health. We also found that COVID‐19 statements were not as prevalent as we anticipated, given the unprecedented scope of the pandemic. Even during a pandemic, public health matters received very little attention during a Presidential campaign. Public health topics accounted for less than 1% of the content in candidates' official speeches. Given that elites help increase knowledge of public health concerns and influence policy, the lack of attention given to the pandemic in the 2020 general election cycle is surprising, if not alarming. Key points: The language used by US presidential candidates and other political elites can have an effect on health policy, health outcomes, and public health.During the 2020 US presidential election, Donald Trump and Joseph R. Biden paid little attention to public health issues in their campaign speeches.Political elites can help increase public awareness regarding health issues. The minimal discussion of health issues during the 2020 US presidential campaign is surprising and alarming for public health. [ABSTRACT FROM AUTHOR]

This research focused on the Indonesian Government's global pandemic policy mapping from 2000 to 2023 (n = 979). Indonesia has been affected by diseases such as H1N1, H5N1, SARS‐Cov‐1, and the current SARS‐CoV‐2 (COVID‐19). This research will focus on these outbreaks to see the readiness of Indonesian government policy mapping to emergencies. This research will measure Indonesian health policy mapping based on its capability to adapt to local contexts, construct a care delivery value chain, leverage shared delivery infrastructure, and improve health delivery and economic development. This study implemented feasibility analysis with a method scoring system for all the pillars above. Findings indicate that most health policies developed by the Indonesian Government are oriented toward responding to current conditions, not preparing for future health challenges. This research also provides patterns regarding the development of health policymaking to deal with emergency conditions. Key points: Most health policies instituted by the Indonesian government are oriented toward responding to the current condition, not preparing for future health challenges.There are minimum policies regarding the infrastructure for the prevention and readiness of Indonesian health challenges, especially regarding the Extraordinary Measure on Disease Outbreak (EMDO).This research finds a small number of policies addressing viruses and bacteria in Indonesia. [ABSTRACT FROM AUTHOR]

Copyright of Portuguese Journal of Mental Health Nursing / Revista Portuguesa de Enfermagem de Saúde Mental is the property of Portuguese Society of Mental Health Nursing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivo. Identificar y analizar el papel de los profesionales de enfermería en el desarrollo y la atención de la salud adolescente en Honduras, por medio del análisis de los contenidos de la formación de los estudiantes de enfermería y de las políticas relacionadas con la salud de los adolescentes. Métodos. Estudio de métodos mixtos, con enfoque explicativo secuencial, desarrollado de mayo a julio del 2023 por medio de encuesta con escuelas de enfermería, análisis de los documentos políticos, encuesta con profesionales de enfermería y grupo focal. Datos cuantitativos analizados mediante estadística descriptiva y datos cualitativos analizados mediante el marco teórico de Walt y Gilson. Resultados. Durante la investigación, se analizaron 18 documentos y participaron siete escuelas de enfermería, 141 enfermeras y 10 actores clave en posición de liderazgo. Los resultados apuntan a la necesidad de actualizar y difundir el marco normativo, garantizar recursos y estructura para implementar programas intersectoriales y sostenibles, y capacitar a los profesionales. La escuela representa un espacio importante para la implementación de acciones, contexto en el que la adopción de la enfermera escolar puede ser provechosa. Las enfermeras fueron identificadas como protagonistas en la aplicación de los programas y deben ser consideradas en el desarrollo de políticas dirigidas a este público. Conclusiones. Las enfermeras participan en diversas etapas del proceso de implementación de políticas y pueden hacer importantes contribuciones a la salud escolar en el primer nivel de salud. Para ello, es necesario aumentar la capacidad de las enfermeras y docentes de enfermería en temas actuales y relevantes en la atención a los adolescentes.

Suicide is a persistent social and public health problem; every year represents a global crisis that affects contemporary societies. A dominant psychopathological perspective summarizes current understanding. However, empirical evidence suggests that suicide is a complex, ambivalent and multidimensional phenomenon, involving social, economic, cultural and educational aspects. Every death by suicide is a failure of society and public policies. The purpose of this work is to offer some reasons to conceptualize suicide as a social problem.

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Objective. To analyse the recognition of the health rights of migrants in Chile in the health regulatory framework. Materials and methods. A sequential mixed methodology study. The qualitative phase included a documentary analysis of 37 instruments published up to the year 2021, on health actions aimed at the migrant population. Through content analysis, specific elements of the rights-based approach were identified. The quantitative phase included a descriptive analysis of hospital discharges, health insurance and health problems in the last three months. Data were obtained from publicly available databases. Results. Chile has progressively developed the implementation of the right to health for migrants. In turn, there is a reduction of gaps in the three indicators: no health insurance (15.8% 2017 vs. 10.9% 2020), hospital admissions without health insurance (25.5% 2014 vs. 6.6% 2020) and not having received medical care for a perceived health problem in the last three months (11.8% 2015 vs. 8.6% 2020). Conclusion. Although Chile is an example of progressive advance in the implementation of the right to health for migrants, there are still pending elements in terms of effective inclusion. [ABSTRACT FROM AUTHOR]

Resumen Este artículo pretende analizar los aportes de Mouffe y Laclau desde el posmarxismo, la democracia agonista y la lógica populista que innovaron sobre los modos de construir identidades colectivas y viabilidad política. Se indaga sobre la potencia de estas teorías para el desarrollo micropolítico de la gestión en salud. Las contribuciones teóricas ubican a las pasiones como la fuerza motora de la política; proponen sublimar los conflictos en acción por medio de canales institucionales; establecen a las prácticas hegemónicas como la capacidad de articular demandas heterogéneas; y explican la capacidad de configurar una identidad colectiva con un liderazgo contingente. Las particularidades del trabajo en salud, como la condición artesanal, los márgenes de autonomía, el ejercicio micropolítico para su desarrollo y la organización como una burocracia profesional, habilitan que las propuestas puedan ser llevadas a la práctica. Se señala que la experiencia de construir identidades al interior de la organización desde un lazo afectivo y la vehiculización de las demandas insatisfechas invitan a reducir el malestar en los servicios y a promover un posicionamiento de transformación.

Objective: This study aimed to design a survey that seeks to know the perception of the university community on the concepts of health, healthy university and constituent elements as a contribution to the formulation process of the construction of a healthy university policy. Methodology: Through a documentary analysis and guided by the review of experts and the referential framework of the Sustainable Development Goals (SDG), a survey was developed aimed at the university community. Results: A survey was built that can be applied online, which has four sections, the first on sociodemographic and institutional characterization, and the other three, each with a question focused on the key concepts of the study and 32 associated statements. The questions were of the "ranking" type, where potential respondents must compare affirmations with each other and sort them by preference. Conclusions: The construction process of this survey allows us to reflect the knowledge and interests of the community, identify priorities and meeting points between the diversity of positions that naturally inhabit a university. The concept of a healthy university and its transformation into a policy for the university requires a participatory process that accounts for collective action that shows the coordination and cooperation of key actors and the development of institutional capacities. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study is a review of the current state in relation to information on the COVID-19 pandemic, vaccines and treatments to fight this coronavirus. The period of analysis is focused on 2020, 2021 and 2022. Relevant international institutional sources made up of several countries have been selected, such as the World Health Organization (WHO) and its Regions of Europe and the Americas, as well as the European Union. The research analyzes reports, projects, resources and surveys of public and private organizations of the main health agencies and centers in the United States, México, Spain, and the United Kingdom. Methodology: A qualitative-documentary methodology, of a critical-interpretative nature, has been used to analyze the texts produced by the Institutions and Organisms, chosen in turn through a systematic selective sampling based on deliberate and intentional selection criterion due to their perceived importance in the field of health. Objectives: To obtain a panoramic vision of the main publications around the proposed object and advance in the knowledge of communication patterns to contribute with the necessary information in the field of public opinion during the vaccination campaign against COVID-19. Discussion and Conclusions: We consider that the joint work of journalists, researchers, health personnel and health Organizations and Institutions is more necessary than ever so that information on COVID-19 adequately reaches the population as a public health strategy achievement. Likewise, it is necessary to know the strengths and weaknesses of the health system to rethink actions and strategies with regard to other pandemics or health crises that will arrive in the coming decades. [ABSTRACT FROM AUTHOR]

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Ese artículo presenta la experiencia del diálogo político sanitario en enfermería desarrollado en Uruguay en el 2021, con base en la teoría del cambio. Se realizaron cuatro mesas de trabajo, con participación de 725 personas. Los puntos discutidos incluyeron: que existe un déficit de enfermeros licenciados para el desarrollo de los programas y para la cobertura de las funciones en todos los niveles de la atención a salud; la falta de visibilidad del impacto asistencial de las actividades desarrolladas; los recursos financieros insuficientes para la formación de grado y posgrado y la baja integración de los enfermeros en equipos de gestión y en espacios políticos de toma de decisiones en el país. Los participantes manifestaron la necesidad de implementar el plan nacional de desarrollo de la enfermería con los objetivos de que el país: disminuya el déficit de profesionales; invierta en la creación de cargos para satisfacer la demanda de cuidados profesionales; mejore las dotaciones de personal en los servicios en todos los niveles de atención; mejore las condiciones de trabajo; genere nuevos espacios de inserción de enfermeros ampliando su rol, mediante capacitación de posgrado y mejore continuamente la calidad de la formación. Los participantes hicierón hincapié en la necesidad de aumentar la coordinación intersectorial en los ámbitos de la gobernanza, la regulación y la gestión, y de acelerar los esfuerzos para aumentar la inversión en los profesionales de salud en Uruguay.

En Perú, la Región Amazonas enfrenta desafíos en el acceso a atención médica especializada y al tratamiento de enfermedades raras, incluyendo patologías congénitas. Estas patologías afectan la calidad de vida y requieren un enfoque integral y de responsabilidad social en la atención. Las personas con patologías congénitas en la Región Amazonas enfrentan barreras similares a nivel nacional e internacional, como limitado acceso a atención, altos costos y estigmatización. El propósito fue conocer las políticas públicas en salud en Perú y la visión de la responsabilidad social para la atención de patologías congénitas, utilizando la frecuencia de diagnóstico de malformaciones congénitas respecto de los diagnósticos entre 2012 y 2021 en la Región Amazonas, Perú. Para llevar a efectos la presente investigación se realizó una investigación es de nivel descriptivo, observacional, transversal, y retrospectivo. El rango de casos de malformación congénita en relación al total de atenciones oscila entre 0.04% a 0.18%, considerándose cifras insignificantes para la creación de políticas públicas en salud, considerándose una tasa de prevalencia de 1 caso por cada 1000 diagnósticos. La baja prevalencia de esta patología es la razón del desinterés del estado y la comunidad de salud para el desarrollo de políticas públicas que aborden estos problemas de salud. La implementación de programas de atención de patologías congénitas en poblaciones vulnerables, como la Región Amazonas, es esencial para garantizar acceso equitativo a servicios médicos que reflejen el compromiso de la sociedad con la salud de todos y que busquen abordar y disminuir las desigualdades existentes.

Resumo En este trabajo analizo las particularidades que adquiere la gestión cotidiana de política sanitaria en una ciudad de la Patagonia argentina, donde se evidencia una política focalizada y no explicitada sobre las mujeres migrantes provenientes de zonas rurales de Bolivia. A partir de una perspectiva de conocimiento etnográfica y la observación participante en diferentes espacios del sistema público de salud se evidencia el modo en que los equipos sanitarios identifican los factores de riesgo e instrumentan lógicas de seguimiento, intervención y control. En los encuentros entre las mujeres migrantes y las trabajadoras de salud se evidencian tensiones sobre las prácticas de salud en un contexto atravesado por múltiples formas de desigualdad. En algunas situaciones, las concepciones de riesgo emergen como una categoría dadora de derechos, en la que se evalúan prioridades para el acceso a la atención sanitaria según interpretación de las efectoras de salud. En este sentido analizo las estrategias de trabajadoras comunitarias en estos encuentros y en sus relaciones laborales, en las cuales deben responder con resultados evidenciables estadísticamente. Aquí las mujeres migrantes agencian modos de construir salud en contextos de desigualdad.

Scientific publications in research journals have adeptly investigated into topics of considerable interest, rendering nursing care more intricate in the face of increasingly thorough investigations into numerous phenomena. This ongoing exploration contributes significantly to the body of knowledge disseminated within the scientific community. Nevertheless, the advent of the global era has presented nursing with novel challenges that persist from the dawn of history parallel to a lingering shadow obscuring the true essence of the profession. An example is environmental nursing, often overlooked from the lens of social sustainability—a neglect that researchers, as minority groups in a relentless struggle, have sidelined. These challenges align with the dynamic demands imposed by society and the mandates of state and/or governmental parliaments.

Introducción: La salud adolescente transcurre por un grave deterioro en la actualidad. El objetivo de este trabajo fue identificar las prácticas de autocuidado de salud en adolescentes escolarizados entre 15 y 18 años que asisten a escuelas secundarias de cuatro departamentos del interior de la provincia de La Rioja, argentina. Metodología: estudio descriptivo transversal y analítico; datos relevados entre octubre y noviembre 2022 por muestreo no probabilístico por conveniencia, con análisis de frecuencias absolutas, relativas, análisis multivariado de regresión logística y Odds ratio con IC 95% significancia estadística de p= ˂0,05. Análisis factorial exploratorio (AFE) aplicando como extracción, el método de Componentes principales y como rotación el método Ortogonal Varimax. Software de análisis, SPSS versión 26. Resultados: Existen discordancias entre la auto-percepción del cuidado de salud y la práctica del cuidado. Se identifican disparidades del autocuidado según el género. Los factores que incrementan el autocuidado son el uso de aplicaciones digitales en salud, los controles médicos anuales o en menor tiempo, el mantener hábitos de pensamientos positivos. La principal preocupación de los adolescentes en relación al autocuidado de salud fue el consumo de bebidas con contenido etílico.

We know that deep scientization (DS)—the misrepresentation of political issues as technical/scientific ones best handled by experts—can unduly limit public deliberation and lead to policy misdesign. Yet, tools for investigating DS remain lacking. This article develops a new approach to diagnosing DS that works by identifying where experts have used their discretion to construct policy claims that contravene existing, shared epistemic standards. This approach's value is demonstrated through a case study of U.S. chronic fatigue syndrome (CFS) policy. The study shows that, whereas government experts originally developed CFS as a research construct, they have since used their discretionary power to recast CFS as a serious disease requiring new policy interventions. This epistemically unjustified transformation of CFS has limited public discussion of important value‐laden policy questions and arguably yielded poor policy outcomes. The approach developed here can also be used to uncover DS in other policy areas. Related Articles: Carlsson, Lars. 2017. "Policy Science at an Impasse: A Matter of Conceptual Stretching?" Politics & Policy 45(2): 148–68. https://doi.org/10.1111/polp.12196. Lemire, Sebastian, Laura R. Peck, and Allan Porowski. 2023. "The Evolution of Systematic Evidence Reviews: Past and Future Developments and Their Implications for Policy Analysis." Politics & Policy 51(3): 373–96. https://doi.org/10.1111/polp.12532. Luján, José Luis. 2023. "Evidence‐based Policies: Lessons from Regulatory Science." Politics & Policy 51(4). https://doi.org/10.1111/polp.12543. [ABSTRACT FROM AUTHOR]

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Copyright of Hospital a Domicilio is the property of Centro Internacional Virtual de Investigacion en Nutricion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Odontológica Colombiana is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective. To analyze the changes in the burden of HIV disease in the period 1990-2017, in contrast to the intervention policies and programs implemented for its prevention and control. Materials and methods. A timeline of policies and interventions in Mexico was developed and with JoinPoint regression models, we analyzed their possible relationship with significant changes in trends in the burden of HIV disease. Results. Changes in the burden of disease are related to the universalization of access to antiretroviral drugs (ARV), comprehensive care programs, and the fight against stigma and discrimination. In the period analyzed, there is a decrease in mortality related to universal and free access to ARVs. The magnitude of the changes tends to be greater in men than in women. Conclusions. The policies and programs implemented to treat people with HIV/AIDS in Mexico were integrated into increasingly cohesive and effective strategies. [ABSTRACT FROM AUTHOR]

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Management & Health / Revista Gestão & Saúde is the property of Revista Gestao e Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

El objetivo del artículo es describir cómo la gobernanza y la voluntad política han influido en la implementación de la Iniciativa HEARTS para la prevención y el control de la hipertensión arterial en el sistema de salud de Perú. Se describe el proceso de gobernanza y se realiza un análisis secundario de datos que compara los niveles basales al inicio de la fase 1 de HEARTS con los primeros seis meses de seguimiento en 34 establecimientos de salud. Se realizó la planificación y organización de la implementación de HEARTS desde el nivel nacional a través de la Dirección de Enfermedades No Transmisibles, contando con la voluntad política de la Alta dirección del Ministerio de Salud y el acompañamiento técnico de la Organización Panamericana de la Salud. La gobernanza se estructuró en 3 niveles: nacional, regional y local; la implementación se apoyó en actores claves de la academia, las sociedades científicas y las Direcciones Regionales de Salud y de las Redes Integrales. Los resultados encontrados tras los primeros meses de seguimiento evidenciaron un incremento de la cobertura y el control de la hipertensión arterial en la mayoría de los establecimientos intervenidos. El análisis de los factores claves relacionados con la voluntad política y la gobernanza en la implementación de la Iniciativa HEARTS para la prevención y el control de la hipertensión arterial demostró que las funciones de la Alta dirección, para alinear las políticas públicas y priorizar las enfermedades no trasmisibles, en coordinación estrecha y permanente entre los formuladores de política y el Ministro de Salud, tuvieron un efecto positivo en la implementación de la Iniciativa HEARTS en el Perú.

El cambio multidimensional que significó el proceso revolucionario cubano, permitió el desarrollo científicode la isla. El objetivo de este artículo es explicar la relación entre la política científica cubana y sus consecuentes fortalezas para el enfrentamiento ala pandemia de la COVID-19.Serevisaron variasinvestigaciones sobrela política científica cubana, la Biotecnología,los estudios actualizados sobre el enfrentamiento del mundo a la COVID-19, y la respuesta de Cuba. Se realizaronbúsquedas bibliográficas en sitios de internety libros impresos. Cuba,país en vías de desarrollo, históricamente se ha visto afectado porun sistema económico, comercial y político internacional desigual y excluyente.Aun así, cuenta con una política científica coherentey sistemática,que exhibe resultados no perfectos, pero respetables y honestos.A través de la ciencia y el Sistema de Salud,se puede decir que la respuesta cubanaanteestapandemia,ha sido,en lo fundamental, exitosa.

Objetivo. Estimar los beneficios económicos y en salud, por sexo y por quintil de ingreso, del incremento de los precios de los cigarros mediante impuestos en México. Métodos. Con un modelo de costo-efectividad extendido (ECEA, por su sigla en inglés) se estimaron los beneficios distributivos en mujeres y hombres con un escenario de incremento del precio de los cigarros de 44% (de 56,4 pesos mexicanos [MX$] a MX$81,2 por cajetilla), como resultado de triplicar el impuesto específico actual (de MX$0,49/cigarro a MX$1,49/cigarro). El modelo se calibró con fuentes oficiales de información nacional Resultados. Con el incremento del impuesto de un peso por cigarro, cerca de 1,5 millones de fumadores abandonarían el consumo (351 300 mujeres y 1,1 millón de hombres). Así, se evitarían aproximadamente 630 000 muertes prematuras atribuibles al tabaco. La reducción de la carga de enfermedad permitiría ahorros para el sector salud cercanos a MX$42 800 millones y evitaría que más de 250 000 personas (entre ellas, 50 200 mujeres fumadoras) cayeran en situación de pobreza. Además, se recaudarían MX$16 200 millones adicionales por año, de los cuales el quintil más bajo aportaría menos de 3% (1% en el caso de las mujeres de menores ingresos). Conclusiones. La epidemia de tabaquismo tiene patrones claramente diferenciados entre mujeres y hombres y reflejan un componente de género. Si bien los beneficios del impuesto al tabaco en México tendrían magnitudes relativas al estado actual de la epidemia en cada caso, estos podrían contribuir a un objetivo más amplio de justicia social mediante la reducción de las inequidades de género.

Copyright of European Policy Analysis is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Interventions that promote public health have the potential to transform lives, particularly for those who experience disability, where marked social and material inequalities occur across the life‐course. When evaluating such interventions, health‐related quality‐of‐life is regarded as a primary outcome and used to inform evidence‐based practice. Quality‐of‐life measures, however, are not straightforward heuristic devices but express technologies of epistemic power. By prioritizing methodological certainty over the credibility of personal testimonies, those experiencing disability can find themselves excluded from the evidence base on which public health interventions are based. Our study explores how disability is represented by tools informing evaluative public health research and establishes the possibility of alternate practices, including the potential for more appropriate measures better suited to representing experiences. We conclude by considering how discussions about "flourishing" can create more inclusive and empowering practices able to challenge inequalities and discrimination consistent with a commitment to social justice. Related Articles: Ewert, Benjamin. 2021. "Citizenship as a Form of Anticipatory Obedience? Implications of Preventive Health Policy in Germany." Politics & Policy 49(4): 891–912. https://doi.org/10.1111/polp.12421. Grijalva Maza, Luisa. 2012. "Deconstructing the Grand Narrative in Harry Potter: Inclusion/Exclusion and Discriminatory Policies in Fiction and Practice." Politics & Policy 40(3): 424–43. https://doi.org/10.1111/j.1747‐1346.2012.00358.x. Winburn, Jonathan, and Amanda Winburn. 2020. "The Role of Political Ideology in Public Opinion toward Enumerated Antibullying Policies in Public Schools." Politics & Policy 48(3): 442–63. https://doi.org/10.1111/polp.12355. [ABSTRACT FROM AUTHOR]

Objetivos. Sistematizar y analizar las acciones de respuesta relacionadas con los recursos humanos en salud durante la pandemia reportadas por 20 países de la Región de las Américas en la evaluación de medio término del Plan de acción sobre recursos humanos para el acceso universal a la salud y la cobertura universal de salud 2018-2023 (Organización Panamericana de la Salud, 2018), y valorar la trascendencia de las políticas y la gestión de los recursos humanos expresadas en la Estrategia y el Plan de recursos humanos durante emergencias sanitarias y en tiempos normales. Métodos. Se seleccionaron y sistematizaron reportes sobre las acciones contra la COVID-19 y los recursos humanos en salud de 20 países de la Región. Se clasificaron las acciones en acciones inmediatas de contingencia, acciones relacionadas con capacidades instaladas y acciones emergentes. Resultados. Las capacidades de planificar y gestionar los recursos humanos en salud en los países dependen de las estructuras y competencias instaladas y funcionales. La pandemia visibilizó la necesidad de disponer de nuevos perfiles laborales, mejorar las condiciones laborales y contractuales precarias, visibilizar la perspectiva de género y solucionar brechas numéricas en determinadas áreas y niveles de atención. Conclusiones. La vinculación de acciones contra la COVID-19 con el monitoreo del Plan demostró la importancia de la gobernanza, la gestión y las capacidades instaladas en recursos humanos de salud para dar respuestas en emergencias sanitarias y en tiempos normales. El análisis invita a la revisión de las políticas públicas existentes, los modelos de atención necesarios para orientar las necesidades actuales y futuras de recursos humanos de salud, los perfiles requeridos, las condiciones laborales y la cobertura de brechas numéricas existentes, entre otros temas. La pandemia permitió innovaciones en los países para responder a la demanda. La Estrategia y el Plan siguen vigentes para orientar y fortalecer el desempeño de los recursos humanos en salud.

Las enfermedades cardiovasculares son la principal causa de muerte en la Región de las Américas y la hipertensión es la causa de más del 50% de ellas. En la Región, más de una cuarta parte de las mujeres adultas y cuatro de cada diez hombres adultos tienen hipertensión y su diagnóstico, tratamiento y control son deficientes. En el 2021, la Organización Mundial de la Salud (OMS) publicó directrices actualizadas sobre el tratamiento farmacológico de la hipertensión en personas adultas. En este artículo se destaca el papel facilitador de la iniciativa mundial HEARTS de la OMS y la iniciativa HEARTS en las Américas para catalizar la implementación de estas directrices, a la vez que se proporciona asesoramiento específico sobre políticas para dicha implementación y se destaca la necesidad de adoptar un enfoque estratégico general para el control de la hipertensión. Los autores instan a quienes abogan por la salud y a los responsables de las políticas a priorizar la prevención y el control de la hipertensión para mejorar la salud y el bienestar de la población, y a reducir las disparidades de salud en relación con las enfermedades cardiovasculares dentro de la población y entre las poblaciones de la Región de las Américas.

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. A high-quality and timely medical forensic examination can potentially validate and address the crime to restore victims' rights, minimize the trauma they may experience, and promote healing. Aim. To evaluate compliance with the forensic criteria of the comprehensive health care protocol for victims of sexual assault according to resolution 0459 of 2012 in four hospitals in southwestern Colombia. Methods. Retrospective descriptive study, a checklist based on Resolution 0459 of 2012 was used to evaluate the process of care for victims of sexual assault in hospital institutions of low and medium complexity. Descriptive analysis of the data was performed. Categorical variables were presented as absolute and relative frequencies, a Z score test was used with a value of p < 0.05 as statistical significance. Results. 131 cases of sexual assault treated in the emergency services of low and medium complexity institutions were documented. 87% of the cases occurred in women and 50.4% in people under 14 years of age. In most cases, the standard of comprehensive care for victims of sexual violence was not met. Conclusion. The comprehensive care process with a forensic approach in Colombia is deficient; It violates the rights of victims, transgresses the gender equity policy and resolution 0459 of 2012. These situations could be having a significant impact on the administration of justice, the restitution of victims' rights and the impunity of the crime. [ABSTRACT FROM AUTHOR]

Objective. To assess how first experimenting with cigarettes or e-cigarettes is associated with current use in Guatemala, a middle-income country with weak tobacco control and no e-cigarette regulations. Materials and methods. We surveyed students from private schools in Guatemala City, limiting analyses to ever users (n=1 026). Multinomial logistic models regressed current product use on first product used, adjusting for sociodemographics and friends and family use. Results. The most common first product used was e-cigarettes (56%), followed by flavored cigarettes (24%) and regular cigarettes (20%). At the time of the survey, 4% were exclusive smokers, 37% were exclusive e-cigarette users, 18% dual users, and 40% had ever tried either but were not current users. Compared to those who first tried cigarettes, students who first tried e-cigarettes were less likely to be current smokers (RR=0.19 [CI: 0.11,0.31]) or dual users (RR=0.26 [CI: 0.14,0.49]) and students who first tried flavored cigarettes were more likely to be current smokers (RR=1.66 [CI=1.13,2.42]). Conclusions. In our sample, Guatemalan adolescents from private schools more frequently experiment and continue to use e-cigarettes than cigarettes. There is urgent need to implement e-cigarette restrictions in addition to tobacco control policy implementation. [ABSTRACT FROM AUTHOR]

Objective: to map mental health care for children and adolescents, its flows, lines and connections based on the articulation of the Psychosocial Care Centers for Children and Adolescents (Centros de Atenção Psicossocial Infantojuvenil, CAPSi) and Primary Health Care (PHC). Method: a qualitative and cartographic research study conducted between August and December 2017 in a municipality from Rio Grande do Sul. The study participants were CAPSi and PHC professionals. Results: the cartographic experience with the rhizomatic network made it possible to monitor CAPSi's articulation with PHC services; planning and sharing care according to workers' collective action, and also the "knots" and challenges of the child and youth mental health network. Insecurity to deal with the demand, lack of knowledge and the need for training as a support modality are challenges mentioned by PHC professionals for networked assistance. Conclusion: care-related arrangements can articulate/share the assistance provided, evoking a "rhizomatic network" of connections, flows and varied lines. [ABSTRACT FROM AUTHOR]

Implemented in 2003, the National Oral Health Policy currently faces a scenario of lack of funding and political prioritization. In this context, the identification of possible local and regional setbacks is fundamental. Thus, the dental care in the Northern macro-region of Paraná between 2013 and 2019 was evaluated through an exploratory study performed based on secondary data from the Unified Health System Outpatient Information System and the public reports of the e-Gestor platform. When analyzing the averages of basic individual dental procedures and collective oral health actions, the coverage of the first programmatic dental consultation, the total number of oral health teams by modality, the coverage of oral health teams and the traditional model, and the ratio between the population and the total number of oral health teams, we observed falls, especially from 2017, in all of these indicators. The results place the macro-region analyzed in a worrisome context and puts other localities on alert, as they show dismantling that inflicts risk to the historical achievements of confronting oral health inequities and overcoming a curative and mutilating dental care model. [ABSTRACT FROM AUTHOR]

Objective. To synthesize the evidence on the effectiveness of hospital transition care in the elderly to support decision-making. Method. This rapid systematic review followed the recommendations of the Cochrane Rapid Reviews Methods Group. Studies were selected from the PubMed, EMBASE, Cochrane Library, and Virtual Health Library (BVS) databases using the following criteria: focus on the elderly as population; provision of hospital transition care as intervention; care as usual (non-transition care) as comparator; and effectiveness of the presence vs. absence of transition care as the outcome, with effectiveness defined as improvement in any evaluated parameter. Systematic reviews published in Portuguese, English, or Spanish, with or without meta-analysis, that assessed hospital transition care in elderly individuals were included. Studies lacking a description of the intervention and target population were excluded. Results. Of the 207 identified reviews, 18 were included. The studies were conducted in 21 countries, with 10 studies conducted in Europe and one in Brazil. The effectiveness of care for the elderly was demonstrated through increased adherence to medication regimens, reduced adverse events and medication-related errors, improved functional status, reduced falls, and reduced healthcare costs. Conclusions. Despite the evidence indicating the effectiveness of hospital transition care, further research is needed to develop more robust indicators of clinical improvement and integration into healthcare systems. [ABSTRACT FROM AUTHOR]

Objective. To map the policies related to the prevention and control of antimicrobial resistance from a human health perspective in Brazil and systematize the historical course of these policies. Method. A scoping review was performed following Joana Briggs Institute and PRISMA guidelines. A literature search was performed in December 2020 in the LILACS, PubMed and EMBASE databases. The terms "antimicrobial resistance" AND "Brazil" as well as their synonyms were used. Using the same keywords, Brazilian government websites were searched for documents published until December 2021. Studies of all designs were included, with no language or date restrictions. Clinical documents, reviews and epidemiological studies that did not focus on antimicrobial resistance management policies in Brazil were excluded. Categories based on World Health Organization documents were used for data systematization and analysis. Results. In Brazil, policies related to antimicrobial resistance such as the National Immunization Program and hospital infection control programs can be traced back to before the creation of the Unified Health System. In the late 1990s and 2000s, the first specific policies on antimicrobial resistance (surveillance networks and programs) and education strategies were established; especially noteworthy is The National Action Plan for the Prevention and Control of Antimicrobial Resistance in the Single Health Scope (PAN-BR) of 2018. Conclusions. Despite the long history of policies related to antimicrobial resistance in Brazil, gaps were identified, particularly in monitoring the use of antimicrobials and surveillance of antimicrobial resistance. The PAN-BR, the first government document prepared from a One Health perspective, represents an important milestone. [ABSTRACT FROM AUTHOR]

Objective. To synthesize the evidence about the effects of telehealth interventions provided through smartphone apps and text messages on the behavior of adults regarding healthy food consumption. Method. A rapid systematic review of the literature was performed through searches in nine electronic databases to identify systematic reviews published in English, Portuguese, and Spanish that evaluated telehealth strategies compared to face-to-face interventions to improve dietary intake in the adult population (18 to 59 years old). Searches were performed in November 2020 and updated in April 2022. The included systematic reviews were assessed for methodological quality using the AMSTAR 2 tool. Results. Five systematic reviews were included. Methodological quality was moderate in one review and critically low in four. There was a dearth of studies comparing the use of telehealth strategies with face-to-face interventions for the promotion of healthy eating in adults. The most consistent results refer to an increase in the consumption of fruits and vegetables with the use of an app or text messages, in addition to improvement in the dietary habits of people with diabetes or glucose intolerance with the use of text messages. Conclusion. Positive effects were observed on healthy eating outcomes for most interventions using mobile apps or text messages; however, the findings refer to a few clinical trials with small samples that were analyzed in the systematic reviews covered in the present rapid review, most of which had low methodological quality. Thus, the current knowledge gap warrants the performance of further methodologically robust studies. [ABSTRACT FROM AUTHOR]

This article presents the experience of the health policy dialogue on nursing held in Uruguay in 2021, based on the theory of change. Four working groups were held, with the participation of 725 people. The points discussed included: the shortage of registered nurses to implement programs and cover functions at all levels of health care; the poor visibility of the healthcare impact of the activities carried out; insufficient financial resources for undergraduate and postgraduate training; and poor integration of nurses in management teams and policy decision-making spaces in the country. Participants expressed the need to implement the national nursing development plan so that the country can: reduce the shortage of professionals; invest in job creation to meet the demand for professional care; improve staffing of services at all levels of care; improve working conditions; create new spaces for nurses by expanding their role through postgraduate training, while continuously improving the quality of training. Participants emphasized the need to increase intersectoral coordination in the areas of governance, regulation, and management, and to step up efforts to increase investment in health professionals in Uruguay. [ABSTRACT FROM AUTHOR]

Objective. To assess the legislative frameworks concerning childhood vaccination in the English- and Dutch-speaking Caribbean and propose a model legislative framework for Caribbean countries. Methods. This study included a survey of 22 countries and territories in the Caribbean regarding legal vaccination mandates for school entry, budget allocations, sanctions, or exemptions. A legal consultant conducted a comprehensive search and analysis of legislation regarding vaccination among 13 Caribbean countries/ territories. A comparative analysis of the legislation under five themes--legislative structure, mandatory vaccination, national immunization schedule, sanctions, and exemptions--formed the basis for the proposed model legislation. Results. Among the 22 Caribbean countries/territories, 17 (77%) had legislation mandating vaccination, 16 (94%) mandated vaccination for school entry, 8 (47%) had a dedicated budget for immunization programs, and 13 (76%) had no legislated national schedules. The source of legislation includes six (35%) using the Education Act, eight (47%) the Public Health Act, and five (29%) a free-standing Vaccination Act. Three countries/ territories--Jamaica, Montserrat, and Saint Lucia--had immunization regulations. In 12 (71%) of the 17 countries with legislation, sanctions were included, and 10 (59%) permitted exemptions for medical or religious/ philosophical beliefs. Conclusions. Several countries in the Caribbean have made failure to vaccinate a child an offense. By summarizing the existing legislative frameworks and approaches to immunization in the Caribbean, the analysis guides policymakers in making effective changes to immunization legislation in their own countries. [ABSTRACT FROM AUTHOR]

This article aims to describe the activities conducted by the National Childhood Cancer Plan Working Group to support the development of national childhood cancer plans in Latin America and the Caribbean in the period 2019--2022, and to present the stage of plan development. The Working Group activities were supported by the Pan American Health Organization and St. Jude Children's Research Hospital, which is the World Health Organization (WHO) Collaborating Centre for Childhood Cancer. Year after year, the workshops and activities developed with the Working Group mobilized key stakeholders: pediatric oncologists, representatives of the Ministry of Health, foundations supporting childhood cancer initiatives, and hospital administrators. As of February 2023, one regional framework is in place, approved by the Council of Ministries of Health of Central America and the Dominican Republic, nine countries are currently implementing national plans or laws that include childhood cancer, and ten countries are writing new plans. The WHO three-step framework helped to guide the Working Group activities. All plans were supported by a situational analysis, which highlighted the importance of having systematized data for evidence-based policies. To increase implementation success, an accompanying budget and timeline help to ensure the adequate implementation of the interventions. More than anything, committed stakeholders remain the most fundamental element to successfully write and approve a national childhood cancer plan. This is an opportunity to share these countries' experience so the strategy can be adapted to support other countries developing a childhood cancer plan and extended to other public health areas. [ABSTRACT FROM AUTHOR]

Objective. To report the progress in Peru, since June 2019, in the implementation of the World Health Organization Global Initiative for Childhood Cancer using the CureAll framework, which can be replicated in low- and middle-income countries. Methods. A mixed method was used of participatory and documentary evaluation. The participatory evaluation included stakeholders from various government institutions, nonprofit organizations, and international partners. The documentary aspect consisted of a review of data on the regulatory environment, national projects, and interventions implemented. The Ministry of Health engaged more than 150 participants to form working committees, which have developed policy and regulatory documents to strengthen care services. Results. Achievements include a decrease in the national treatment abandonment rate from 18.6% to 8.5%, the approval of the Childhood Cancer Law, improvements in the management of patients with febrile neutropenia, and a reduction in rates of events of clinical deterioration and mortality of hospitalized patients. The Cure All implementation framework allows local teams to implement specific strategies and monitor early outcomes in pediatric oncology. Conclusions. The results obtained reflect the teamwork, the leadership of the authorities, the technical support of professionals, and the support of involved organizations. Further actions will be needed to guarantee sustainability, and monitoring tools are needed to assure success in the planned activities. [ABSTRACT FROM AUTHOR]

Objective. To describe the results of a national campaign aimed at the integrated control of neglected tropical diseases in Brazil in light of the World Health Organization (WHO) official documentation related to the integration of strategies for the prevention, control, and elimination or eradication of neglected tropical diseases. Methods. A document review that included official WHO documents published between 2007 and 2020 and campaign results extracted from the official technical report produced by the Brazilian Ministry of Health. Results. The integrated control of neglected tropical diseases was gradually incorporated in the WHO documentation over time. Preventive chemotherapy through mass drug administration, intensified case management, and integrated vector management were extensively recommended as strategies for integrated control. The Brazilian campaign was carried out in four iterations between 2013 and 2017. Children aged 5 to 14 years enrolled in municipal public schools nationwide were targeted. In summary, a total of 1 074 and 73 522 new cases of leprosy and trachoma, respectively, were detected. Nearly 18 million doses of preventive chemotherapy for soil-transmitted helminthiasis were administered. More than 700 cases of schistosomiasis were diagnosed and treated. Conclusions. The integrated strategies implemented in Brazil throughout the campaign generated results aligned with the WHO recommendations for the control of neglected tropical diseases, especially those regarding mass drug administration, active case detection, and intensified case management. Therefore, the continuity of the campaign with adequate evaluation tools must be encouraged as a constant public health policy in the Brazilian government agenda. [ABSTRACT FROM AUTHOR]