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Sample records for america embrace health

  1. Family health program user: knowledge and satisfaction about user embracement

    Directory of Open Access Journals (Sweden)

    Saulo Lacerda Borges de Sá

    2012-06-01

    Full Text Available Objective: To assess the knowledge and satisfaction of users of a Basic Health Unit about the strategy of embracement. Methods: Descriptive study with qualitative approach, carried out in a Basic Health Unit, Fortaleza, Brazil, where practical activities of the Education Program of Work for Health of the University of Fortaleza were performed. Fifty eight service users were involved, following inclusion criteria: being present during the data collection, age over 18, regardless of sex, and voluntary participation. Data collection occurred in December 2009, through semi-structured interview. The data associated with the identification of users were processed in Microsoft Office Excel 2007, being organizedstatistically in table. Data related to qualitative aspects were analyzed according to the technique of content analysis. Results: 56 (97% were women, with ages ranging between 21 and 40 years, 34 (59% were married and 53 (91% are literate. On family income, 55 (95%received less than two minimum salaries per month. In order to facilitate understanding the speech of users, these were evaluated from the perspective of two categories: knowledge about embracement and satisfaction with embracement. Conclusion: Users have a limited view of the significance and magnitude of the embracement to provide the care. Although satisfied with the service, respondents report as negative aspects: the shortage of professionals, the professional relationship with user impaired due to constant delays of the professional, and the dehumanization of care.

  2. [User embracement in the Family Health Strategy in Brazil: an integrative review].

    Science.gov (United States)

    Garuzi, Miriane; Achitti, Maria Cecília de Oliveira; Sato, Cintia Ayame; Rocha, Suelen Alves; Spagnuolo, Regina Stella

    2014-02-01

    To review the literature regarding the application of the notion of user embracement and to identify the contributions of this concept for primary health care practices in Brazil. We carried out an integrative review of the literature regarding primary health care. The following databases were searched: LILACS, SciELO, and MEDLINE, covering the period from 2006 to 2010. The following search terms were used in LILACS and SciELO: "acolhimento" and "programa saúde da família" and "saúde". For MEDLINE, the terms "user embracement" and "family health program" and "health" were used. The review was performed in November 2010. We identified 21 articles meeting the inclusion criteria, all of which described studies carried out in Brazil. The articles were divided into three empirical categories: integration and embracement; primary care work process; and evaluation of services. These are complementary categories that converge to two main views of embracement: the first sees embracement as a means of reorganizing the primary health care environment, and the second sees embracement as an attitude towards users. The review also shows that embracement may be a management tool that supports the Unified Health System and is associated with the principles of comprehensiveness and universality. Embracement is able to create a bond between health care workers and users. It promotes self-care, a better understanding of disease, as well as user co-responsibility for treatment. In addition, it facilitates universal access, strengthens multiprofessional and intersectoral work, qualifies care, humanizes practices, and encourages actions to combat prejudice. Nevertheless, the perspective of health care users regarding embracement deserves more attention and should be the focus of future studies.

  3. Health and health services in Central America.

    Science.gov (United States)

    Garfield, R M; Rodriguez, P F

    1985-08-16

    Despite rapid economic growth since World War II, health conditions improved only slowly in most of Central America. This is a result of poor medical, social, and economic infrastructure, income maldistribution, and the poor utilization of health investments. The economic crisis of the 1980s and civil strife have further endangered health in the region. Life expectancy has fallen among men in El Salvador and civil strife has become the most common cause of death in Guatemala, Nicaragua, and El Salvador. Large-scale US assistance has done little to improve conditions, and refugees continue to pour into North America. It is estimated that there are more than a million refugees within Central America, while a million have fled to the United States. Costa Rica and Nicaragua are partial exceptions to this dismal health picture. An effective approach to the many health problems in Central America will require joint planning and cooperation among all countries in the region.

  4. Public Health in the Americas

    Directory of Open Access Journals (Sweden)

    Ross Duncan

    2010-12-01

    Full Text Available

    In this special issue the four articles focus on population health in terms of primary care and preventive medicine. This critical area of health often receives less attention than health care issues (more so in the popular press but also in academic analyses.Upon reviewing these very interesting and illuminating articles it was striking that despite significant cultural, economic, geographic and historical differences there are many commonalities which exist throughout the Americas.

  5. Collaborating to embrace evidence-informed management practices within Canada's health system.

    Science.gov (United States)

    Strelioff, Wayne; Lavoie-Tremblay, Mélanie; Barton, Melissa

    2007-01-01

    In late 2005, 11 major national health organizations decided to work together to build healthier workplaces for healthcare providers. To do so, they created a pan-Canadian collaborative of 45 experts and asked them to develop an action strategy to improve healthcare workplaces. One of the first steps taken by members of the collaborative was to adopt the following shared belief statements to guide their thinking: "We believe it is unacceptable to fund, govern, manage, work in or receive care in an unhealthy health workplace," and, "A fundamental way to better healthcare is through healthier healthcare workplaces." This commentary provides an overview of the Quality Worklife-Quality Healthcare Collaborative action strategy. This strategy embraces the thinking set out by the lead papers (by Shamian and El-Jardali and by Clements, Dault and Priest) and brings to life evidence-informed management practices.

  6. [Health manpower in the Americas].

    Science.gov (United States)

    Nogueira, R P; Brito, P

    1986-01-01

    The article summarizes the country studies on the development of the health manpower situation published in this issue of Educación médica y Salud, Vol. 20, No. 3, 1986. The countries covered are Argentina, Brazil, Canada, Cuba, Colombia, Mexico, and the United States of America. In these studies, the concept of disequilibrium or lack of balance and proportion was used to describe and examine some specific situations. However, no study took this concept as an object of further theoretical development, and in some it was preferred to replace it explicitly with the term "problem." The following categories of health personnel are considered: physicians, nurses and "other professions" (the latter very briefly). Professional training, the labor market, the relationship between supply and demand and the relationship with the geographic distribution of members of the health professions in the country are discussed. The studies summarized show that the situations and trends are similar in most of the countries, but that specific variations exist owing to structural and situational aspects in each. The most notable differences are seen between the characteristics of the manpower in the developed and in the developing countries. The variations in the English-speaking countries of the Caribbean are also brought out. Finally, there is a discussion of the occupational pyramid of the human resources in the health field, which consists of three horizontal segments. At the vertex are the university-trained categories; the middle is occupied by the technicians and auxiliary personnel, and at the base are the occupations requiring a low educational level.

  7. Embracing risk

    Directory of Open Access Journals (Sweden)

    Ross Cagan

    2015-08-01

    Full Text Available I entered the science field because I imagined that scientists were society's “professional risk takers”, that they like surfing out on the edge. I understood that a lot of science – perhaps even most science – has to be a solid exploration of partly understood phenomena. But any science that confronts a difficult problem has to start with risk. Most people are at least a bit suspicious of risk, and scientists such as myself are no exception. Recently, risk-taking has been under attack financially, but this Editorial is not about that. I am writing about the long view and the messages we send to our trainees. I am Senior Associate Dean of the graduate school at Mount Sinai and have had the privilege to discuss these issues with the next generation of scientists, for whom I care very deeply. Are we preparing you to embrace risk?

  8. Forest health conditions in North America

    International Nuclear Information System (INIS)

    Tkacz, Borys; Moody, Ben; Castillo, Jaime Villa; Fenn, Mark E.

    2008-01-01

    Some of the greatest forest health impacts in North America are caused by invasive forest insects and pathogens (e.g., emerald ash borer and sudden oak death in the US), by severe outbreaks of native pests (e.g., mountain pine beetle in Canada), and fires exacerbated by changing climate. Ozone and N and S pollutants continue to impact the health of forests in several regions of North America. Long-term monitoring of forest health indicators has facilitated the assessment of forest health and sustainability in North America. By linking a nationwide network of forest health plots with the more extensive forest inventory, forest health experts in the US have evaluated current trends for major forest health indicators and developed assessments of future risks. Canada and Mexico currently lack nationwide networks of forest health plots. Development and expansion of these networks is critical to effective assessment of future forest health impacts. - The forests of North America continue to face many biotic and abiotic stressors including fragmentation, fires, native and invasive pests, and air pollution

  9. Is primary care ready to embrace e-health? A qualitative study of staff in a London primary care trust

    Directory of Open Access Journals (Sweden)

    Rishi Mannan

    2006-06-01

    Conclusions At the time of the study the systems that form part of NHS Connecting for Health, apart from the Quality Management and Analysis System (QMAS, were not implemented across the PCT. All the practices in the study acknowledged the benefits new technology would bring to the workplace, but there were also some common concerns, which suggest that staff working in primary care practices are not ready for e-health. Successful implementation of the NHS Connecting for Health programme rests on identifying, acknowledging and overcoming these concerns. A different approach might be required for those practices that have made very little progress in using email or moving towards an electronic patient record. This study suggests that a mistrust of technology and fears as to the heavy initial workload involved in becoming fully computerised have dissuaded some practices from embracing e-health. If NHS Connecting for Health is to be a success, implementation teams might need to focus initially on practices that have been reluctant to use technology to support both clinical care and the day-to-day work of the practice.

  10. Forest Health Status in North America

    Directory of Open Access Journals (Sweden)

    Borys Tkacz

    2007-01-01

    Full Text Available The forests of North America provide a variety of benefits including water, recreation, wildlife habitat, timber, and other forest products. However, they continue to face many biotic and abiotic stressors including fires, native and invasive pests, fragmentation, and air pollution. Forest health specialists have been monitoring the health of forests for many years. This paper highlights some of the most damaging forest stressors affecting North American forests in recent years and provides some projections of future risks.

  11. Occupational health in Central America.

    Science.gov (United States)

    Wesseling, Catharina; Aragón, Aurora; Morgado, Hugo; Elgstrand, Kaj; Hogstedt, Christer; Partanen, Timo

    2002-01-01

    The 12.4 million economically active population (EAP) of the seven Central American countries includes a large informal sector. Social security covers only 14-60%. No surveillance of occupational safety and health (OSH) hazards or accidents exists. Extrapolating the incidence of occupational accidents among insured Costa Rican workers to the Central American EAP yields two million accidents yearly, still a gross underestimate. Occupational diseases are underreported, misdiagnosed, and not recognized as such. A number of regional OSH programs aim at modernization of the labor administrations and address the formal sector, in particular textile maquila, in connection with free trade agreements. The weak role of the ministries of health is expected to strengthen under the Pan American Health Organization OSH program. Employers largely influence new policies. Workers' influence on OSH policies has been weak, with only about 10% unionization rate and scarce resources and OSH knowledge. Informal workers, however, are getting organized. OSH research is underdeveloped and not linked to policy making. Construction, agriculture, and general un/underemployment are considered priorities for intervention. The informal sector needs to be included in national and regional OSH policies. Regional collaboration and international development support are of strategic importance to achieve sustainable improvement in OSH.

  12. Epidemiology, epigenetics and the 'Gloomy Prospect': embracing randomness in population health research and practice.

    Science.gov (United States)

    Smith, George Davey

    2011-06-01

    Epidemiologists aim to identify modifiable causes of disease, this often being a prerequisite for the application of epidemiological findings in public health programmes, health service planning and clinical medicine. Despite successes in identifying causes, it is often claimed that there are missing additional causes for even reasonably well-understood conditions such as lung cancer and coronary heart disease. Several lines of evidence suggest that largely chance events, from the biographical down to the sub-cellular, contribute an important stochastic element to disease risk that is not epidemiologically tractable at the individual level. Epigenetic influences provide a fashionable contemporary explanation for such seemingly random processes. Chance events-such as a particular lifelong smoker living unharmed to 100 years-are averaged out at the group level. As a consequence population-level differences (for example, secular trends or differences between administrative areas) can be entirely explicable by causal factors that appear to account for only a small proportion of individual-level risk. In public health terms, a modifiable cause of the large majority of cases of a disease may have been identified, with a wild goose chase continuing in an attempt to discipline the random nature of the world with respect to which particular individuals will succumb. The quest for personalized medicine is a contemporary manifestation of this dream. An evolutionary explanation of why randomness exists in the development of organisms has long been articulated, in terms of offering a survival advantage in changing environments. Further, the basic notion that what is near-random at one level may be almost entirely predictable at a higher level is an emergent property of many systems, from particle physics to the social sciences. These considerations suggest that epidemiological approaches will remain fruitful as we enter the decade of the epigenome.

  13. Racism and Health in Rural America.

    Science.gov (United States)

    Kozhimannil, Katy B; Henning-Smith, Carrie

    2018-01-01

    This commentary responds to the recent article by Dr. James et al. on racial and ethnic health disparities in rural America, published in the November 16 issue of Morbidity and Mortality Weekly Report. We applaud Dr. James and colleagues for their important contribution uncovering intra-rural racial and ethnic disparities and build on their paper by discussing potential mechanisms, including structural racism. We also discuss several pragmatic steps that can be taken in research, policy, and practice to address racial and ethnic disparities in rural communities and to work toward health equity for all rural residents.

  14. Embrace the Chaos

    Science.gov (United States)

    Huwe, Terence K.

    2009-01-01

    "Embracing the chaos" is an ongoing challenge for librarians. Embracing the chaos means librarians must have a plan for responding to the flood of new products, widgets, web tools, and gizmos that students use daily. In this article, the author argues that library instruction and access services have been grappling with that chaos with…

  15. Addressing the Mental Health Needs of Black American Youth and Families: A Case Study from the EMBRace Intervention

    Directory of Open Access Journals (Sweden)

    Riana E. Anderson

    2018-05-01

    Full Text Available Black American youth are vulnerable to the consequences of repeated exposure to racial discrimination, particularly through hampered coping abilities and greater internalizing and externalizing problems. One way in which Black American parents have protected their children from these deleterious consequences is through racial socialization, or communication regarding aspects of racialized experiences and contexts. Less is known, however, about the potential therapeutic benefits of racial socialization via clinical intervention. The five-week Engaging, Managing, and Bonding through Race (EMBRace racial socialization intervention was developed to enhance coping strategies for parents and adolescents and reduce adolescent internalizing and externalizing problems. The purpose of this study is to describe a case study of one family through a mixed methods approach. Variables of interest included racial discrimination, racial socialization, coping, and psychological well-being. Quantitative and qualitative assessments were performed two weeks prior to and one week after the implementation of EMBRace, with qualitative data collected throughout the intervention. Results indicate a developing sense of coping for the adolescent and parent and reduced adolescent psychosocial problems despite increased racialized stress. Results will be used to further investigate the hypotheses proposed in the pilot with a powered sample, and future studies will explore how sociodemographic and biopsychosocial variables relate to policy recommendations, program implementation, and psychosocial outcomes.

  16. Health is primary: Family medicine for America's health.

    Science.gov (United States)

    Phillips, Robert L; Pugno, Perry A; Saultz, John W; Tuggy, Michael L; Borkan, Jeffrey M; Hoekzema, Grant S; DeVoe, Jennifer E; Weida, Jane A; Peterson, Lars E; Hughes, Lauren S; Kruse, Jerry E; Puffer, James C

    2014-10-01

    More than a decade ago the American Academy of Family Physicians, American Academy of Family Physicians Foundation, American Board of Family Medicine, Association of Departments of Family Medicine, Association of Family Practice Residency Directors, North American Primary Care Research Group, and Society of Teachers of Family Medicine came together in the Future of Family Medicine (FFM) to launch a series of strategic efforts to "renew the specialty to meet the needs of people and society," some of which bore important fruit. Family Medicine for America's Health was launched in 2013 to revisit the role of family medicine in view of these changes and to position family medicine with new strategic and communication plans to create better health, better health care, and lower cost for patients and communities (the Triple Aim). Family Medicine for America's Health was preceded and guided by the development of a family physician role definition. A consulting group facilitated systematic strategic plan development over 9 months that included key informant interviews, formal stakeholder surveys, future scenario testing, a retreat for family medicine organizations and stakeholder representatives to review strategy options, further strategy refinement, and finally a formal strategic plan with draft tactics and design for an implementation plan. A second communications consulting group surveyed diverse stakeholders in coordination with strategic planning to develop a communication plan. The American College of Osteopathic Family Physicians joined the effort, and students, residents, and young physicians were included. The core strategies identified include working to ensure broad access to sustained, primary care relationships; accountability for increasing primary care value in terms of cost and quality; a commitment to helping reduce health care disparities; moving to comprehensive payment and away from fee-for-service; transformation of training; technology to support

  17. Building equitable health systems in Latin America | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The region's segmented health systems make it difficult to provide equal access to ... to reorganize healthcare systems in Argentina, Brazil, Paraguay, and Uruguay. ... Involving urban communities in controlling dengue fever in Latin America.

  18. IAI Training in Climate and Health in the Americas

    Science.gov (United States)

    Aron, J. L.

    2007-05-01

    The Inter-American Institute for Global Change Research (IAI) has addressed training in climate and health in the Americas in two major ways. First, IAI supports students to engage in research training. A multi-country health activity funded by IAI was the collaborative research network (CRN) on Diagnostics and Prediction of Human Health Impacts in the Tropical Americas, which focused principally on the effect of El Nino/Southern Oscillation and other aspects of climate variability on mosquito-borne diseases malaria and dengue. The CRN involved students in Brazil, Mexico, Venezuela, Colombia and Jamaica. The CRN was also linked to other climate and health projects that used a similar approach. Second, IAI organizes training institutes to expand the network of global change research scientists and facilitate the transfer of global change research into practice. The IAI Training Institute on Climate and Health in the Americas was held on November 7 - 18, 2005 at the University of the West Indies in Kingston, Jamaica, engaging participants from the CRN and other programs in the Americas. The Training Institute's central objective was to help strengthen local and regional capacity to address the impacts of climate variability and climate change on human health in the populations of the Americas, particularly Latin America and the Caribbean. The Training Institute had three core components: Science; Applications; and Proposal Development for Seed Grants. Recommendations for future Training Institutes included incorporating new technologies and communicating with policy-makers to develop more proactive societal strategies to manage risks.

  19. Public health leadership education in North America

    OpenAIRE

    Uno, Hideo; Zakariasen,Kenneth

    2010-01-01

    Hideo Uno, Kenneth ZakariasenDepartment of Public Health Sciences, School of Public Health, University of Alberta, Edmonton, AB, CanadaAbstract: Public health leadership is one of the priority disciplines public health professionals need to learn well if they are to deal with demanding public health issues effectively and efficiently. This article looks at the trends in public health leadership education by reviewing the literature and using the Internet to explore the public health leadershi...

  20. Insuring America's health: principles and recommendations

    National Research Council Canada - National Science Library

    Committee on the Consequences of Uninsurance

    .... Being uninsured is associated with a range of adverse health, social, and economic consequences for individuals and their families, for the health care systems in their communities, and for the nation as a whole...

  1. United States of America: health system review.

    Science.gov (United States)

    Rice, Thomas; Rosenau, Pauline; Unruh, Lynn Y; Barnes, Andrew J; Saltman, Richard B; van Ginneken, Ewout

    2013-01-01

    This analysis of the United States health system reviews the developments in organization and governance, health financing, health-care provision, health reforms and health system performance. The US health system has both considerable strengths and notable weaknesses. It has a large and well-trained health workforce, a wide range of high-quality medical specialists as well as secondary and tertiary institutions, a robust health sector research program and, for selected services, among the best medical outcomes in the world. But it also suffers from incomplete coverage of its citizenry, health expenditure levels per person far exceeding all other countries, poor measures on many objective and subjective measures of quality and outcomes, an unequal distribution of resources and outcomes across the country and among different population groups, and lagging efforts to introduce health information technology. It is difficult to determine the extent to which deficiencies are health-system related, though it seems that at least some of the problems are a result of poor access to care. Because of the adoption of the Affordable Care Act in 2010, the United States is facing a period of enormous potential change. Improving coverage is a central aim, envisaged through subsidies for the uninsured to purchase private insurance, expanded eligibility for Medicaid (in some states) and greater protection for insured persons. Furthermore, primary care and public health receive increased funding, and quality and expenditures are addressed through a range of measures. Whether the ACA will indeed be effective in addressing the challenges identified above can only be determined over time. World Health Organization 2013 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  2. Social determinants of workers' health in Central America.

    Science.gov (United States)

    Aragón, Aurora; Partanen, Timo; Felknor, Sarah; Corriols, Marianela

    2011-01-01

    This communication summarizes the available data on work-related determinants of health in Central America. The Central American working population is young and moving from agriculture toward industry and services. Ethnicity, gender, migration, subemployment and precarious work, informality, rural conditions, low-level educational, poverty, ubiquitous worksite health hazards, insufficient occupational health services, low labor inspection density, and weak unions define the constellation of social determinants of workers' health in Central America. Data are, however, scanty both for hazards and work-related illnesses and injuries. Governments and industries have the responsibility of opening decent work opportunities, especially for those facing multiple inequalities in social determinants of health. A first step would be the ratification and implementation of the ILO Convention (187) on occupational safety and health by the seven national governments of the region.

  3. Embracing Uncertainty to Enable Transformation: The Process of Engaging in Trialogue for Mental Health Communities in Ireland

    Directory of Open Access Journals (Sweden)

    Simon Dunne

    2018-04-01

    Full Text Available Introduction: Community-based participatory approaches are valuable methods for improving outcomes and effectively integrating care among mental health communities. Trialogue is one such approach which uses Open Dialogue methods with groups of three or more people from different backgrounds who deal with mental health systems. Theory and Method: The current study employed a participatory action research design, which prospectively documented the processes and challenges of participating in Trialogue Meetings. Individuals from participating communities took part in interviews, focus groups or Open Dialogue discussions across three cycles of research. Results: Three prospective themes were identified from participants’ dialogue across the three cycles of research relating to the experience of participating in Trialogue, the development of Open Dialogue skills and the growth of individual Trialogue communities. Conclusions and Discussion: The findings demonstrate that, where desirable conditions are present, Trialogue Meetings are worthwhile and sustainable community-based participatory approaches which encourage disclosure and dialogue surrounding mental health, and may assist in improved integration of care between mental health stakeholders. In particular, Trialogue Meetings stimulate the development of Open Dialogue skills, provide a platform for “vital” and “transformative” self-expression with the potential for positive mental health outcomes and may facilitate the growth of communities surrounding mental health.

  4. Reshaping Health Care in Latin America

    International Development Research Centre (IDRC) Digital Library (Canada)

    Reform In Mexico — Silvia Tamez and Nancy Molina ... This book assesses the health care reforms of the past decade in Argentina, Brazil and Mexico. ...... prevention and control of pulmonary tuberculosis; prevention and control of high blood ...

  5. Containing health costs in the Americas.

    Science.gov (United States)

    Márquez, P

    1990-01-01

    In recent years, a series of policy measures affecting both demand and supply components of health care have been adopted in different Latin American and Caribbean countries, as well as in Canada and the United States. In applying these measures various objectives have been pursued, among them: to mobilize additional resources to increase operating budgets; to reduce unnecessary utilization of health services and consumption of pharmaceuticals; to control increasing production costs; and to contain the escalation of health care expenditures. In terms of demand management, some countries have established cost-recovery programmes in an attempt to offset declining revenues. These measures have the potential to generate additional operating income in public facilities, particularly if charges are levied on hospital care. However, only scant information is available on the effects of user charges on demand, utilization, or unit costs. In terms of supply management, corrective measures have concentrated on limiting the quantity and the relative prices of different inputs and outputs. Hiring freezes, salary caps, limitations on new construction and equipment, use of drug lists, bulk procurement of medicines and vaccines, and budget ceilings are among the measures utilized to control production costs in the health sector. To moderate health care expenditures, various approaches have been followed to subject providers to 'financial discipline'. Among them, new reimbursement modalities such as prospective payment systems offer an array of incentives to modify medical practice. Cost-containment efforts have also spawned innovations in the organization and delivery of health services. Group plans have been established on the basis of prepaid premiums to provide directly much or all health care needs of affiliates and their families. The issue of intrasectorial co-ordination, particularly between ministries of health and social security institutions, has much relevance for cost

  6. The Health of America's Aging Prison Population.

    Science.gov (United States)

    Skarupski, Kimberly A; Gross, Alden; Schrack, Jennifer A; Deal, Jennifer A; Eber, Gabriel B

    2018-03-23

    Older incarcerated individuals comprise the fastest growing demographic in the US prison system. Unhealthy lifestyles among incarcerated individuals and inadequate health care lead to earlier onset and more rapid progression of many chronic conditions that are prevalent among community-living older adults. There are limited peer-reviewed epidemiologic data in this area; however, there is growing interest in identifying strategies for housing aging incarcerated individuals, delivering appropriate health care in prisons, and coordinating after-release health care. In this systematic review, we summarize the epidemiologic evidence of the health challenges facing the aging US prison population. Our comprehensive literature search focused on health outcomes, including diseases, comorbid conditions, mental health, cognition, and mobility. From 12,486 articles identified from the literature search, we reviewed 21 studies published between 2007 and 2017. All the studies were observational and cross-sectional, and most (n = 17) were based on regional samples. Sample sizes varied widely, ranging from 25 to 14,499 incarcerated people (median, 258). In general, compared with their younger counterparts, older incarcerated individuals reported high rates of diabetes mellitus, cardiovascular conditions, and liver disease. Mental health problems were common, especially anxiety, fear of desire for death or suicide, and depression. Activities of daily living were challenging for up to one-fifth of the population. We found no empirical data on cognition among older incarcerated individuals. The findings of this review reveal few empirical data in this area and highlight the need for new data to drive policy and practice patterns that address critical health issues related to the aging prison population.

  7. [Governance and health: meaning and implications in Latin America].

    NARCIS (Netherlands)

    Rodriguez, C.; Lamothe, L.; Barten, F.J.M.H.; Haggerty, J.

    2010-01-01

    The term governance is used more and more often in the formulation, implementation, and evaluation of public policies. The purpose of this paper is twofold: to shed light on its meaning, and to study its applicability for the study of recent public health policies in Latin America. After discussing

  8. Adolescent Substance Use: America's #1 Public Health Problem

    Science.gov (United States)

    National Center on Addiction and Substance Abuse at Columbia University, 2011

    2011-01-01

    This report finds that adolescent smoking, drinking, misusing prescription drugs and using illegal drugs is, by any measure, a public health problem of epidemic proportion, presenting clear and present danger to millions of America's teenagers and severe and expensive long-range consequences for the entire population. This report is a wake-up call…

  9. Occupational Therapy embraces the National #Littlethings mental health and wellbeing campaign in Offaly via an Operation Transformation Programme

    Directory of Open Access Journals (Sweden)

    Deirdre Deegan

    2017-10-01

    Full Text Available Purpose - In early 2015, an Occupational Therapy led Operation Transformation healthy eating and exercise programme produced results suggestive of the value and need to promote and integrate physical activity interventions into mental health services. Design/methodology/approach - In all, 41 clients with various mental illness diagnoses participated in the eight-week Operation Transformation programme. The outcome measures involved weekly weigh-ins and an end of programme evaluation form. Findings - The quantifiable benefits – a total weight loss of nine stone ten and a half pounds – were mirrored in equally impressive qualitative impacts. Participants’ feedback via anonymous evaluation forms, echoed the findings of the articles appraised in the literature, including improvements in mood and energy levels, better sleep and increased motivation. Practical implications - The organisers will benefit from lessons learned in this first experience, including overcoming logistical and organisational difficulties experienced in enabling clients’ full participation. Originality/value - The evidence base points to the successful benefits of physical activity in promoting positive mental health. Occupational Therapists have a unique opportunity to drive forward the message of promoting physical activity via meaningful occupations.

  10. Review of Maritime Health research gab in latin America

    DEFF Research Database (Denmark)

    Jensen, Olaf Chresten

    for research in this part of the world. Materials and Methods PubMed, Google Scholar, SciELO - Scientific Electronic Library Online, Pan American Journal of Public Health, Medicina Maritima and other relevant journals in Latin America in the Spanish and English languages were searched. Results 57 peer......-reviewed articles on fishermen´s health and safety and none for the seafarers were included. Brazil counted for the main part n =39, while each of the other countries had 0-4 studies. The study objectives include occupational injuries, divers disease, skin diseases, hearing loss and other issues. The cross......Background So far the maritime health and safety research for seafarers and fishermen mainly comes from the industrial developed countries with sparse contributions from the developing countries. The aim was to give an overview of the peer reviewed research in Latin America to point out the needs...

  11. Embracing your emotions: affective state impacts lateralisation of human embraces.

    Science.gov (United States)

    Packheiser, Julian; Rook, Noemi; Dursun, Zeynep; Mesenhöller, Janne; Wenglorz, Alrescha; Güntürkün, Onur; Ocklenburg, Sebastian

    2018-01-18

    Humans are highly social animals that show a wide variety of verbal and non-verbal behaviours to communicate social intent. One of the most frequently used non-verbal social behaviours is embracing, commonly used as an expression of love and affection. However, it can also occur in a large variety of social situations entailing negative (fear or sadness) or neutral emotionality (formal greetings). Embracing is also experienced from birth onwards in mother-infant interactions and is thus accompanying human social interaction across the whole lifespan. Despite the importance of embraces for human social interactions, their underlying neurophysiology is unknown. Here, we demonstrated in a well-powered sample of more than 2500 adults that humans show a significant rightward bias during embracing. Additionally, we showed that this general motor preference is strongly modulated by emotional contexts: the induction of positive or negative affect shifted the rightward bias significantly to the left, indicating a stronger involvement of right-hemispheric neural networks during emotional embraces. In a second laboratory study, we were able to replicate both of these findings and furthermore demonstrated that the motor preferences during embracing correlate with handedness. Our studies therefore not only show that embracing is controlled by an interaction of motor and affective networks, they also demonstrate that emotional factors seem to activate right-hemispheric systems in valence-invariant ways.

  12. Sexual Health Competencies for Undergraduate Medical Education in North America.

    Science.gov (United States)

    Bayer, Carey Roth; Eckstrand, Kristen L; Knudson, Gail; Koehler, Jean; Leibowitz, Scott; Tsai, Perry; Feldman, Jamie L

    2017-04-01

    The number of hours spent teaching sexual health content and skills in medical education continues to decrease despite the increase in sexual health issues faced by patients across the lifespan. In 2012 and 2014, experts across sexuality disciplines convened for the Summits on Medical School Education and Sexual Health to strategize and recommend approaches to improve sexual health education in medical education systems and practice settings. One of the summit recommendations was to develop sexual health competencies that could be implemented in undergraduate medical education curricula. To discuss the process of developing sexual health competencies for undergraduate medical education in North America and present the resulting competencies. From 2014 to 2016, a summit multidisciplinary subcommittee met through face-to-face, phone conference, and email meetings to review prior competency-based guidelines and then draft and vet general sexual health competencies for integration into undergraduate medical school curricula. The process built off the Association of American Medical Colleges' competency development process for training medical students to care for lesbian, gay, bisexual, transgender, and gender non-conforming patients and individuals born with differences of sex development. This report presents the final 20 sexual health competencies and 34 qualifiers aligned with the 8 overall domains of competence. Development of a comprehensive set of sexual health competencies is a necessary first step in standardizing learning expectations for medical students upon completion of undergraduate training. It is hoped that these competencies will guide the development of sexual health curricula and assessment tools that can be shared across medical schools to ensure that all medical school graduates will be adequately trained and comfortable addressing the different sexual health concerns presented by patients across the lifespan. Bayer CR, Eckstrand KL, Knudson G, et

  13. Developing regional workplace health and hazard surveillance in the Americas

    Directory of Open Access Journals (Sweden)

    Choi Bernard C. K.

    2001-01-01

    Full Text Available An objective of the Workers' Health Program at the Pan American Health Organization (PAHO is to strengthen surveillance in workers' health in the Region of the Americas in order to implement prevention and control strategies. To date, four phases of projects have been organized to develop multinational workplace health and hazard surveillance in the Region. Phase 1 was a workshop held in 1999 in Washington, D.C., for the purpose of developing a methodology for identifying and prioritizing the top three occupational sentinel health events to be incorporated into the surveillance systems in the Region. Three surveillance protocols were developed, one each for fatal occupational injuries, pesticide poisoning,4 and low back pain, which were identified in the workshop as the most important occupational health problems. Phase 2 comprised projects to disseminate the findings and recommendations of the Washington Workshop, including publications, pilot projects, software development, electronic communication, and meetings. Phase 3 was a sub-regional meeting in 2000 in Rosario, Argentina, to follow up on the progress in carrying out the recommendations of the Washington workshop and to create a Virtual Regional Center for Latin America that could coordinate the efforts of member countries. Currently phase 4 includes a number of projects to achieve the objectives of this Center, such as pilot projects, capacity building, editing a compact disk, analyzing legal systems and intervention strategies, software training, and developing an internet course on surveillance. By documenting the joint efforts made to initiate and develop Regional multinational surveillance of occupational injuries and diseases in the Americas, this paper aims to provide experience and guidance for others wishing to initiate and develop regional multinational surveillance for other diseases or in other regions.

  14. One Health training, research, and outreach in North America

    Directory of Open Access Journals (Sweden)

    Cheryl Stroud

    2016-11-01

    Full Text Available Background: The One Health (OH concept, formerly referred to as ‘One Medicine’ in the later part of the 20th century, has gained exceptional popularity in the early 21st century, and numerous academic and non-academic institutions have developed One Health programs. Objectives: To summarize One Health training, research, and outreach activities originating in North America. Methods: We used data from extensive electronic records maintained by the One Health Commission (OHC (www.onehealthcommission.org/ and the One Health Initiative (www.onehealthinitiative.com/ and from web-based searches, combined with the corporate knowledge of the authors and their professional contacts. Finally, a call was released to members of the OHC's Global One Health Community listserv, asking that they populate a Google document with information on One Health training, research, and outreach activities in North American academic and non-academic institutions. Results: A current snapshot of North American One Health training, research, and outreach activities as of August 2016 has evolved. Conclusions: It is clear that the One Health concept has gained considerable recognition during the first decade of the 21st century, with numerous current training and research activities carried out among North American academic, non-academic, government, corporate, and non-profit entities.

  15. Commentary: improving the health of neglected populations in Latin America

    Directory of Open Access Journals (Sweden)

    Jones Danielle

    2007-01-01

    Full Text Available Abstract Neglected diseases encompass a group of pathologies that disproportionally affect resource-constrained areas of the world. In tropical and subtropical areas in Latin America, the vicious cycle of poverty, disease and underdevelopment is widespread. The burden of disease associated to neglected diseases in this region is mainly expressed through diseases such as malaria, dengue, intestinal parasitic infections, Chagas' disease, and many others. These maladies have burdened Latin America throughout centuries and have directly influenced their ability to develop and become competitive societies in the current climate of globalization. Therefore, the need for a new paradigm that integrates various public health policies, programs, and a strategy with the collaboration of all responsible sectors is long overdue. In this regard, innovative approaches are required to ensure the availability of low-cost, simple, sustainable, and locally acceptable strategies to improve the health of neglected populations to prevent, control, and potentially eliminate neglected diseases. Improving the health of these forgotten populations will place them in an environment more conducive to development and will likely contribute significantly to the achievement of the Millennium Development Goals in this area of the globe.

  16. [Health-Promoting Schools Regional Initiative of the Americas].

    Science.gov (United States)

    Ippolito-Shepherd, Josefa; Cerqueira, Maria Teresa; Ortega, Diana Patricia

    2005-01-01

    In Latin America, comprehensive health promotion programmes and activities are being implemented in the school setting, which take into account the conceptual framework of the Health-Promoting Schools Regional Initiative of the Pan American Health Organization, Regional office of the World Health Organization (PAHO/WHO). These programmes help to strengthen the working relationships between the health and education sectors. The Health-Promoting Schools Regional Initiative, officially launched by PAHO/WHO in 1995, aims to form future generations to have the knowledge, abilities, and skills necessary for promoting and caring for their health and that of their family and community, as well as to create and maintain healthy environments and communities. The Initiative focuses on three main components: comprehensive health education, the creation and maintenance of healthy physical and psychosocial environments, and the access to health and nutrition services, mental health, and active life. In 2001, PAHO conducted a survey in 19 Latin American countries to assess the status and trends of Health-Promoting Schools in the Region, for the appropriate regional, subregional, and national planning of pertinent health promotion and health education programmes and activities. The results of this survey provided information about policies and national plans, multisectoral coordination mechanisms for the support of health promotion in the school settings, the formation and participation in national and international networks of Health-Promoting Schools and about the level of dissemination of the strategy. For the successful development of Health-Promoting Schools is essential to involve the society as a whole, in order to mobilise human resources and materials necessary for implementing health promotion in the school settings. Thus, the constitution and consolidation of networks has been a facilitating mechanism for the exchange of ideas, resources and experiences to strengthen

  17. women in health and development: the view from the Americas.

    Science.gov (United States)

    1984-01-01

    This article highlights the central features of the 5-Year Regional Plan of Action on Women in Health and Development, adopted by the Pan American Health Organization (PAHO) in 1981. Although the Plan does not mandate specific actions, it encourages certain activities and establishes an annual reporting system concerning these activities. The Plan recognizes that women's health depends upon numerous factors outside of medicine, including women's employment, education, social status, and accepted roles, access to economic resources, and political power. The low status of women is reinforced by the sexual double standard that makes women responsible for the reproductive process yet denies them the right to control that process. The Plan advocates an incremental approach, in which projects 1st focus on priority areas and groups and then expand to provide more general benefits. Programs exclusively for women are not advocated; encouraged, instead, is the integration of women's health and development activities into the mainstream of general activities promoting health. Among the areas targeted for action are the collection of statistics on women's health, women's nutritional problems, environmental health, maternal-child health services, screening for breast and cervical cancer, and family planning . Community participation is proposed as a good vehicle for local action and an essential tool in the campaign for health for all. Efforts must be made to enlist women's support in identifying community needs, planning health actions, selecting appropriate resources and personnel, establishing and administering health services, and evaluating the results. Overall, the Plan provides a solid basis upon which health authorities of the Americas can build.

  18. The arts, health, and aging in america: 2005-2015.

    Science.gov (United States)

    Hanna, Gay Powell; Noelker, Linda S; Bienvenu, Beth

    2015-04-01

    In advance of the White House Conference on Aging (WHCoA) in 1981, 1995, and 2005, the arts and aging communities held mini-conferences to ensure that arts, culture, and livability were part of larger public policy discussions. This article takes a historical look at recommendations from the 2005 WHCoA Mini-Conference on Creativity and Aging in America, including arts in health care, lifelong learning, and livability through universal design. Overarching recommendations in 2005 requested investments in research, including cost-benefit analyses; identification of best practices and model programs; program dissemination to broaden the availability of arts programs. The "Arts" is a broad term encompassing all forms of arts including music, theater, dance, visual arts, literature, multimedia and design, folk, and traditional arts to engage the participation of all older Americans; promotion of innovative public and private partnerships to support arts program development, including workforce development (e.g., artists, social workers, and health care providers); and public awareness of the importance of arts participation to healthy aging. Through the leadership of the National Endowment for the Arts and U.S. Department of Health and Human Services, thinking about the arts and aging has broadened to include greater emphasis on a whole-person approach to the health and well-being of older adults. This approach engages older adults in arts participation not only as audience members, but as vital members of their community through creative expression focusing on life stories for intergenerational as well as interprofessional collaboration. This article reviews progress made to date and identifies critical gaps in services for future consideration at a 2015 Mini-Conference on Creativity and Aging related to the WCHoA area of emphasis on healthy aging. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights

  19. Quality assessment of published health economic analyses from South America.

    Science.gov (United States)

    Machado, Márcio; Iskedjian, Michael; Einarson, Thomas R

    2006-05-01

    Health economic analyses have become important to healthcare systems worldwide. No studies have previously examined South America's contribution in this area. To survey the literature with the purpose of reviewing, quantifying, and assessing the quality of published South American health economic analyses. A search of MEDLINE (1990-December 2004), EMBASE (1990-December 2004), International Pharmaceutical Abstracts (1990-December 2004), Literatura Latino-Americana e do Caribe em Ciências da Saúde (1982-December 2004), and Sistema de Informacion Esencial en Terapéutica y Salud (1980-December 2004) was completed using the key words cost-effectiveness analysis (CEA), cost-utility analysis (CUA), cost-minimization analysis (CMA), and cost-benefit analysis (CBA); abbreviations CEA, CUA, CMA, and CBA; and all South American country names. Papers were categorized by type and country by 2 independent reviewers. Quality was assessed using a 12 item checklist, characterizing scores as 4 (good), 3 (acceptable), 2 (poor), 1 (unable to judge), and 0 (unacceptable). To be included in our investigation, studies needed to have simultaneously examined costs and outcomes. We retrieved 25 articles; one duplicate article was rejected, leaving 24 (CEA = 15, CBA = 6, CMA = 3; Brazil = 9, Argentina = 5, Colombia = 3, Chile = 2, Ecuador = 2, 1 each from Peru, Uruguay, Venezuela). Variability between raters was less than 0.5 point on overall scores (OS) and less than 1 point on all individual items. Mean OS was 2.6 (SD 1.0, range 1.4-3.8). CBAs scored highest (OS 2.8, SD 0.8), CEAs next (OS 2.7, SD 0.7), and CMAs lowest (OS 2.0, SD 0.5). When scored by type of question, definition of study aim scored highest (OS 3.0, SD 0.8), while ethical issues scored lowest (OS 1.5, SD 0.9). By country, Peru scored highest (mean OS 3.8) and Uruguay had the lowest scores (mean OS 2.2). A nonsignificant time trend was noted for OS (R2 = 0.12; p = 0.104). Quality scores of health economic analyses

  20. O acolhimento e os processos de trabalho em saúde: o caso de Betim, Minas Gerais, Brasil "User embracement" and the working process in health: Betim's case, Minas Gerais, Brazil

    Directory of Open Access Journals (Sweden)

    Túlio Batista Franco

    1999-04-01

    Full Text Available Este trabalho relata experiência de inversão do modelo tecno-assistencial para a saúde, tendo como base a diretriz operacional do acolhimento. O acolhimento propõe que o serviço de saúde seja organizado, de forma usuário-centrada, partindo dos seguintes princípios: 1 atender a todas as pessoas que procuram os serviços de saúde, garantindo a acessibilidade universal; 2 reorganizar o processo de trabalho, a fim de que este desloque seu eixo central do médico para uma equipe multiprofissional ­ equipe de acolhimento ­, que se encarrega da escuta do usuário, comprometendo-se a resolver seu problema de saúde; e 3 qualificar a relação trabalhador-usuário, que deve dar-se por parâmetros humanitários, de solidariedade e cidadania. Por meio da investigação realizada, foi possível observar um aumento significativo do rendimento profissional, dos servidores não-médicos, que passaram a atuar na assistência; esse elevado rendimento profissional determinou, por conseqüência, maior oferta e aumento extraordinário da acessibilidade aos serviços de saúde.The subject of this paper is changes in health care when "user embracement" is used as a strategic aim. According to the "user embracement" concept, health care clients are the center of the health services' organization, including the following: 1 care for everyone seeking it, thus guaranteeing universal accessibility; 2 reorganization of the work process, such that its central thrust is shifted from the physician to the multiprofessional staff, or "user embracement team", in charge of "hearing" users and becoming involved in solving their health problems; and 3 solidarity, humanity, and citizenship as parameters for the relationship between health care users and providers. The research showed improvement of non-medical health care productivity and greater accessibility by users. After nine months, the "user embracement team" solved 50% of the health problems themselves. The above

  1. Suicide in Latin America: a growing public health issue.

    Science.gov (United States)

    Mascayano, Franco; Irrazabal, Matias; D Emilia, Wyatt; Vaner, Sidney Jane; Sapag, Jaime C; Alvarado, Ruben; Yang, Lawrence Hsin; Sinah, Binoy

    2015-01-01

    Suicide has become an international public mental health challenge, resulting in a need for interventions to address it as an individual, family, and community levels. The current scope review assesses trends regarding suicide within Latin America and the Caribbean: risk factors, protective factors, and mediators of suicidal ideation and behavior. Body: Our review is split into three sections, as a way of addressing the complex topic of suicide in an organized, comprehensive manner: (i) epidemiology of suicide in Latin America and Caribbean; (ii) factors associated to suicide ideation and attempts; and (iii) cultural factors as a predictors and mediators of suicide. Further, proper evidence about the association between suicide and cultural dimensions such as Familismo, Machismo/Marianismo, Religion and Acculturation is provided. Upon analyzing trends of and factors associated with suicide, we offer recommendations regarding future studies and intervention programs. We conclude that interventions and research should be based on and in response to cultural values and norms related to suicide within each community, in order to make more culturally-specific programs.

  2. Embracing the convenient care concept.

    Science.gov (United States)

    Ferris, Allison H; McAndrew, Thomas M; Shearer, Debra; Donnelly, Gloria F; Miller, Howard A

    2010-01-01

    The landscape of primary care medicine is rapidly changing. The decline in interest, both in primary care fields and students choosing these career paths, has left a vacuum in the health care system that must be filled. One of the recent developments has been the birth of "convenient care centers," also known as "retail clinics." This form of health care delivery has mostly been entrepreneurial and based in retail organizations, such as drug stores. These walk-in clinics provide basic medical care for minor common medical conditions, such as sore throat, urinary tract infection, the common cold, and ear infections. Much of this care is provided not by physicians, but by nurse practitioners or physician assistants. After seeing the success of the earliest of these clinics, MinuteClinic by CVS, many other businesses joined the venture, and retail clinics popped up in Wal-Mart, Target, and many local grocery stores. Gradually, hospital systems, physician groups, and managed care companies have also entered the market, sometimes partnering with retail outlets, such as the local grocery store or Wal-Mart, and less often, starting a stand-alone facility. Only 12% of retail clinics are owned by hospital systems or physician groups, while 73% are owned by CVS, Walgreens, or Target. There is even a national nonprofit organization called the Convenient Care Association, started in 2006, and based in Philadelphia, PA. This new trend in delivering health care has been mostly, if not totally, ignored by the medical school practice plans, with the exception of the Mayo Clinic in Minnesota, which has developed several "express care" clinics as stand-alone facilities. As a medical school practice plan and a division of general internal medicine, we could continue to keep a blind eye toward this new trend in primary care medicine or embrace the concept. We aim to develop a new convenient care model integrating our College of Medicine practice plan in partnership with our College of

  3. The EMBRACE web service collection.

    NARCIS (Netherlands)

    Pettifer, S.; Ison, J.; Kalas, M.; Thorne, D.; McDermott, P.; Jonassen, I.; Liaquat, A.; Fernandez, J.M.; Rodriguez, J.M.; Pisano, D.G.; Blanchet, C; Uludag, M.; Rice, P.; Bartaseviciute, E.; Rapacki, K.; Hekkelman, M.L.; Sand, O.; Stockinger, H.; Clegg, A.B.; Bongcam-Rudloff, E.; Salzemann, J.; Breton, V.; Attwood, T.K.; Cameron, G.; Vriend, G.

    2010-01-01

    The EMBRACE (European Model for Bioinformatics Research and Community Education) web service collection is the culmination of a 5-year project that set out to investigate issues involved in developing and deploying web services for use in the life sciences. The project concluded that in order for

  4. RedeAmericas: building research capacity in young leaders for sustainable growth in community mental health services in Latin America.

    Science.gov (United States)

    Yang, L; Pratt, C; Valencia, E; Conover, S; Fernández, R; Burrone, M S; Cavalcanti, M T; Lovisi, G; Rojas, G; Alvarado, R; Galea, S; Price, L N; Susser, E

    2017-01-01

    The purpose of this paper is to describe the development and initial accomplishments of a training program of young leaders in community mental health research as part of a Latin American initiative known as RedeAmericas. RedeAmericas was one of five regional 'Hubs' funded by the National Institute of Mental Health (NIMH) to improve community mental health care and build mental health research capacity in low- and middle-income countries. It included investigators in six Latin American cities - Santiago, Chile; Medellín, Colombia; Rio de Janeiro, Brazil; and Córdoba, Neuquén, and Buenos Aires in Argentina - working together with a team affiliated with the Global Mental Health program at Columbia University in New York City. One component of RedeAmericas was a capacity-building effort that included an Awardee program for early career researchers in the mental health field. We review the aims of this component, how it developed, and what was learned that would be useful for future capacity-building efforts, and also comment on future prospects for maintaining this type of effort.

  5. The First National Report Card on Quality of Health Care in America

    National Research Council Canada - National Science Library

    2004-01-01

    How good is the quality of health care in America? To answer this question Elizabeth McGlynn led a team of experts in the largest and most comprehensive examination ever conducted of health care quality in the United States...

  6. Health-Related Quality of Life in Locally Advanced Cervical Cancer Patients After Definitive Chemoradiation Therapy Including Image Guided Adaptive Brachytherapy: An Analysis From the EMBRACE Study

    DEFF Research Database (Denmark)

    Kirchheiner, Kathrin; Pötter, Richard; Tanderup, Kari

    2016-01-01

    Purpose This study analyzed functioning and symptom scores for longitudinal quality of life (QoL) from patients with locally advanced cervical cancer who underwent definitive chemoradiation therapy with image guided adaptive brachytherapy in the EMBRACE study. Methods and Materials In total, 744...... patients at a median follow-up of 21 months were included. QoL was prospectively assessed using European Organization for Research and Treatment of Cancer Quality of Life core module 30 (EORTC QLQ-C30) and EORTC cervical cancer module 24 (CX24) questionnaires at baseline, then every 3 months during...... at 6 months and then declined slightly at 3 and 4 years. The overall symptom experience was elevated at baseline and decreased to a level within the range of that of the reference population. Similarly, tumor-related symptoms (eg, pain, appetite loss, and constipation), which were present before...

  7. Current State of Child Health in Rural America: How Context Shapes Children's Health.

    Science.gov (United States)

    Probst, Janice C; Barker, Judith C; Enders, Alexandra; Gardiner, Paula

    2018-02-01

    Children's health is influenced by the context in which they live. We provide a descriptive essay on the status of children in rural America to highlight features of the rural environment that may affect health. We compiled information concerning components of the rural environment that may contribute to health outcomes. Areas addressed include the economic characteristics, provider availability, uniquely rural health risks, health services use, and health outcomes among rural children. Nearly 12 million children live in the rural United States. Rural counties are economically disadvantaged, leading to higher rates of poverty among rural versus urban children. Rural and urban children are approximately equally likely to be insured, but Medicaid insures a higher proportion of children in rural areas. While generally similar in health, rural children are more likely to be overweight or obese than urban children. Rural parents are less likely to report that their children received preventive medical or oral health visits than urban parents. Rural children are more likely to die than their urban peers, largely due to unintentional injury. Improving rural children's health will require both increased public health surveillance and research that creates solutions appropriate for rural environments, where health care professionals may be in short supply. Most importantly, solutions must be multisectoral, engaging education, economic development, and other community perspectives as well as health care. © 2016 National Rural Health Association.

  8. Health-system reform and universal health coverage in Latin America.

    Science.gov (United States)

    Atun, Rifat; de Andrade, Luiz Odorico Monteiro; Almeida, Gisele; Cotlear, Daniel; Dmytraczenko, T; Frenz, Patricia; Garcia, Patrícia; Gómez-Dantés, Octavio; Knaul, Felicia M; Muntaner, Carles; de Paula, Juliana Braga; Rígoli, Felix; Serrate, Pastor Castell-Florit; Wagstaff, Adam

    2015-03-28

    Starting in the late 1980s, many Latin American countries began social sector reforms to alleviate poverty, reduce socioeconomic inequalities, improve health outcomes, and provide financial risk protection. In particular, starting in the 1990s, reforms aimed at strengthening health systems to reduce inequalities in health access and outcomes focused on expansion of universal health coverage, especially for poor citizens. In Latin America, health-system reforms have produced a distinct approach to universal health coverage, underpinned by the principles of equity, solidarity, and collective action to overcome social inequalities. In most of the countries studied, government financing enabled the introduction of supply-side interventions to expand insurance coverage for uninsured citizens--with defined and enlarged benefits packages--and to scale up delivery of health services. Countries such as Brazil and Cuba introduced tax-financed universal health systems. These changes were combined with demand-side interventions aimed at alleviating poverty (targeting many social determinants of health) and improving access of the most disadvantaged populations. Hence, the distinguishing features of health-system strengthening for universal health coverage and lessons from the Latin American experience are relevant for countries advancing universal health coverage. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Embracing openness: the challenges of OER in Latin American education

    Directory of Open Access Journals (Sweden)

    Nadia Paola Mireles Torres

    2013-01-01

    Full Text Available The Open Educational Resources (OER movement and the Open Access began only over a decade ago. During this period, the progress of the Open Educational Resources movement took place in developed countries for the most part. Recently, new projects have begun to emerge with a strong emphasis on open education. Yet, the concept of openness in education is a very innovative one, and it has not been embraced by many. In some regions, such as Latin America, OER is still in its early stages and faces many challenges that need to be addressed. Some of these challenges include awareness raising and capacity development. But there is a bigger challenge to face: embracing openness as a core value and an institutional strategy. In this paper, we offer a brief overview of the meaning of the term “open” in education and we analyze the challenges facing the OER in Latin American countries.

  10. Health-Related Quality of Life in Locally Advanced Cervical Cancer Patients After Definitive Chemoradiation Therapy Including Image Guided Adaptive Brachytherapy: An Analysis From the EMBRACE Study

    Energy Technology Data Exchange (ETDEWEB)

    Kirchheiner, Kathrin, E-mail: kathrin.kirchheiner@meduniwien.ac.at [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna and General Hospital of Vienna, Vienna (Austria); Pötter, Richard [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna and General Hospital of Vienna, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna (Austria); Tanderup, Kari; Lindegaard, Jacob C. [Department of Oncology, Aarhus University Hospital, Aarhus (Denmark); Haie-Meder, Christine [Department of Radiotherapy, Gustave-Roussy, Villejuif (France); Petrič, Primož [Department of Radiotherapy, Institute of Oncology Ljubljana, Ljubljana (Slovenia); Department of Radiation Oncology, National Center for Cancer Care and Research, Doha (Qatar); Mahantshetty, Umesh [Department of Radiation Oncology, Tata Memorial Hospital, Mumbai (India); Jürgenliemk-Schulz, Ina M. [Department of Radiation Oncology, University Medical Centre Utrecht, Utrecht (Netherlands); Rai, Bhavana [Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh (India); Cooper, Rachel [Leeds Cancer Centre, St James' s University Hospital, Leeds (United Kingdom); Dörr, Wolfgang [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna and General Hospital of Vienna, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna (Austria); Nout, Remi A. [Department of Radiation Oncology, Leiden University Medical Center, Leiden (Netherlands); Lindegaard, Jacob; Tanderup, Kari; Fokdal, Lars; Van Der Steen Banasik, Elzbieta; Haie-Meder, Christine; Dumas, Isabelle; and others

    2016-04-01

    Purpose: This study analyzed functioning and symptom scores for longitudinal quality of life (QoL) from patients with locally advanced cervical cancer who underwent definitive chemoradiation therapy with image guided adaptive brachytherapy in the EMBRACE study. Methods and Materials: In total, 744 patients at a median follow-up of 21 months were included. QoL was prospectively assessed using European Organization for Research and Treatment of Cancer Quality of Life core module 30 (EORTC QLQ-C30) and EORTC cervical cancer module 24 (CX24) questionnaires at baseline, then every 3 months during the first year, every 6 months in the second and third years, and finally yearly thereafter in patients with no evidence of disease. Outcomes were evaluated over time and compared to those from an age-matched female reference population. Results: General QoL and emotional and social functioning were impaired at baseline but improved during the first 6 months after treatment, to reach a level comparable to that of the reference population, whereas cognitive functioning remained impaired. Both social and role functioning showed the lowest scores at baseline but which increased after treatment to reach a plateau at 6 months and then declined slightly at 3 and 4 years. The overall symptom experience was elevated at baseline and decreased to a level within the range of that of the reference population. Similarly, tumor-related symptoms (eg, pain, appetite loss, and constipation), which were present before treatment, decreased substantially at the first follow-up after treatment. Several treatment-related symptoms developed either immediately after and persisted over time (diarrhea, menopausal symptoms, peripheral neuropathy, and sexual functioning problems) or developed gradually after treatment (lymphedema and dyspnea). Conclusions: This longitudinal prospective QoL analysis showed that patients' general QoL and functioning were impaired before treatment compared to

  11. Health-Related Quality of Life in Locally Advanced Cervical Cancer Patients After Definitive Chemoradiation Therapy Including Image Guided Adaptive Brachytherapy: An Analysis From the EMBRACE Study

    International Nuclear Information System (INIS)

    Kirchheiner, Kathrin; Pötter, Richard; Tanderup, Kari; Lindegaard, Jacob C.; Haie-Meder, Christine; Petrič, Primož; Mahantshetty, Umesh; Jürgenliemk-Schulz, Ina M.; Rai, Bhavana; Cooper, Rachel; Dörr, Wolfgang; Nout, Remi A.; Lindegaard, Jacob; Tanderup, Kari; Fokdal, Lars; Van Der Steen Banasik, Elzbieta; Haie-Meder, Christine; Dumas, Isabelle

    2016-01-01

    Purpose: This study analyzed functioning and symptom scores for longitudinal quality of life (QoL) from patients with locally advanced cervical cancer who underwent definitive chemoradiation therapy with image guided adaptive brachytherapy in the EMBRACE study. Methods and Materials: In total, 744 patients at a median follow-up of 21 months were included. QoL was prospectively assessed using European Organization for Research and Treatment of Cancer Quality of Life core module 30 (EORTC QLQ-C30) and EORTC cervical cancer module 24 (CX24) questionnaires at baseline, then every 3 months during the first year, every 6 months in the second and third years, and finally yearly thereafter in patients with no evidence of disease. Outcomes were evaluated over time and compared to those from an age-matched female reference population. Results: General QoL and emotional and social functioning were impaired at baseline but improved during the first 6 months after treatment, to reach a level comparable to that of the reference population, whereas cognitive functioning remained impaired. Both social and role functioning showed the lowest scores at baseline but which increased after treatment to reach a plateau at 6 months and then declined slightly at 3 and 4 years. The overall symptom experience was elevated at baseline and decreased to a level within the range of that of the reference population. Similarly, tumor-related symptoms (eg, pain, appetite loss, and constipation), which were present before treatment, decreased substantially at the first follow-up after treatment. Several treatment-related symptoms developed either immediately after and persisted over time (diarrhea, menopausal symptoms, peripheral neuropathy, and sexual functioning problems) or developed gradually after treatment (lymphedema and dyspnea). Conclusions: This longitudinal prospective QoL analysis showed that patients' general QoL and functioning were impaired before treatment compared to those of

  12. The EMBRACE web service collection

    DEFF Research Database (Denmark)

    Pettifer, S.; Ison, J.; Kalas, M.

    2010-01-01

    The EMBRACE (European Model for Bioinformatics Research and Community Education) web service collection is the culmination of a 5-year project that set out to investigate issues involved in developing and deploying web services for use in the life sciences. The project concluded that in order...... for web services to achieve widespread adoption, standards must be defined for the choice of web service technology, for semantically annotating both service function and the data exchanged, and a mechanism for discovering services must be provided. Building on this, the project developed: EDAM......, an ontology for describing life science web services; BioXSD, a schema for exchanging data between services; and a centralized registry (http://www.embraceregistry.net) that collects together around 1000 services developed by the consortium partners. This article presents the current status of the collection...

  13. Embracing uncertainty in applied ecology.

    Science.gov (United States)

    Milner-Gulland, E J; Shea, K

    2017-12-01

    Applied ecologists often face uncertainty that hinders effective decision-making.Common traps that may catch the unwary are: ignoring uncertainty, acknowledging uncertainty but ploughing on, focussing on trivial uncertainties, believing your models, and unclear objectives.We integrate research insights and examples from a wide range of applied ecological fields to illustrate advances that are generally underused, but could facilitate ecologists' ability to plan and execute research to support management.Recommended approaches to avoid uncertainty traps are: embracing models, using decision theory, using models more effectively, thinking experimentally, and being realistic about uncertainty. Synthesis and applications . Applied ecologists can become more effective at informing management by using approaches that explicitly take account of uncertainty.

  14. Embracing Creativity in Occupational Therapy

    Directory of Open Access Journals (Sweden)

    Lydia Royeen, MOT, OTR/L

    2015-01-01

    Full Text Available Jen Gash, an occupational therapist and creativity coach living in the UK, provided the cover art for the winter 2015 issue of The Open Journal of Occupational Therapy. The picture is titled “Over the Exe.” Jen uses her inspiration of the Kawa River model in this painting. The painting is of her husband and daughter standing where the river meets the sea. This is a metaphoric representation of rejoining the greater collective. In addition, Jen has a passion for occupational therapists to encompass creativity. A core aspect of occupational therapy is the multi-dimensional concept of occupations; it allows for occupational therapists to incorporate creativity into daily practice. Jen’s goal is for occupational therapy to embrace its creative theoretical roots.

  15. Sandia National Laboratories embraces ISDN

    Energy Technology Data Exchange (ETDEWEB)

    Tolendino, L.F.; Eldridge, J.M.

    1994-08-01

    Sandia National Laboratories (Sandia), a multidisciplinary research and development laboratory located on Kirtland Air Force Base, has embraced Integrated Services Digital Network technology as an integral part of its communication network. Sandia and the Department of Energy`s Albuquerque Operations Office have recently completed the installation of a modernized and expanded telephone system based, on the AT&T 5ESS telephone switch. Sandia is committed to ISDN as an integral part of data communication services, and it views ISDN as one part of a continuum of services -- services that range from ISDN`s asynchronous and limited bandwidth Ethernet (250--1000 Kbps) through full bandwidth Ethernet, FDDI, and ATM at Sonet rates. Sandia has demonstrated this commitment through its use of ISDN data features to support critical progmmmatic services such as access to corporate data base systems. In the future, ISDN will provide enhanced voice, data communication, and video services.

  16. Globalizing the history of disease, medicine, and public health in Latin America.

    Science.gov (United States)

    Espinosa, Mariola

    2013-12-01

    The history of Latin America, the history of disease, medicine, and public health, and global history are deeply intertwined, but the intersection of these three fields has not yet attracted sustained attention from historians. Recent developments in the historiography of disease, medicine, and public health in Latin America suggest, however, that a distinctive, global approach to the topic is beginning to emerge. This essay identifies the distinguishing characteristic of this approach as an attentiveness to transfers of contagions, cures, and medical knowledge from Latin America to the rest of the world and then summarizes a few episodes that demonstrate its promise. While national as well as colonial and neocolonial histories of Latin America have made important contributions to our understanding, works taking the global approach have the potential to contribute more directly to the decentering of the global history of disease, medicine, and public health.

  17. Changing patterns of migration in Latin America: how can research develop intelligence for public health?

    Directory of Open Access Journals (Sweden)

    Baltica Cabieses

    Full Text Available Migration patterns in Latin America have changed significantly in recent decades, particularly since the onset of global recession in 2007. These recent economic changes have highlighted and exacerbated the weakness of evidence from Latin America regarding migration-a crucial determinant of health. Migration patterns are constantly evolving in Latin America, but research on migration has not developed at the same speed. This article focuses on the need for better understanding of the living conditions and health of migrant populations in Latin America within the context of the recent global recession. The authors explain how new data on migrant well-being could be obtained through improved evidence from censuses and ongoing research surveys to 1 better inform policy-makers about the needs of migrant populations in Latin America and 2 help determine better ways of reaching undocumented immigrants. Longitudinal studies on immigrants in Latin America are essential for generating a better representation of migrant living conditions and health needs during the initial stages of immigration and over time. To help meet this need, the authors support the promotion of sustainable sources of data and evidence on the complex relationship between migration and health.

  18. [Power and health in South America: international sanitary conferences, 1870-1889].

    Science.gov (United States)

    Chaves, Cleide de Lima

    2013-06-01

    This article analyzes the international sanitary conferences that were held in South America in 1873 and 1887, involving the Brazilian Empire and the Republics of Argentina and Uruguay, as an integral part of a series of similar events that took place in Europe and North America starting in the second half of the nineteenth century. The interests of the countries involved, namely trade relations and immigration from Europe - both directly affected by the epidemics - are discussed, and the repercussions of these sanitary agreements on the other countries in the Americas are indicated. The American health conventions in the late nineteenth century represented the first initiatives in the Americas to solve international public health problems.

  19. Recent Activities on the Embrace Space Weather Regional Warning Center: the New Space Weather Data Center

    Science.gov (United States)

    Denardini, Clezio Marcos; Dal Lago, Alisson; Mendes, Odim; Batista, Inez S.; SantAnna, Nilson; Gatto, Rubens; Takahashi, Hisao; Costa, D. Joaquim; Banik Padua, Marcelo; Campos Velho, Haroldo

    2016-07-01

    the ionospheric profiles in two equatorial sites and in two low latitude sites; (b) several solar radio telescopes to monitor solar activity (under development); (c) the matrix of the GNSS TEC map over South America; (d) the Embrace Airglow All-sky Imagers Network (Embrace GlowNet); and (d) the Embrace Magnetometer Network (Embrace Magnet), all of them in South America. Also, the system allows subscription to space weather alerts and reports. Contacting Author: C. M. Denardini (clezio.denardin@inpe.br)

  20. Should we embrace nuclear energy?

    International Nuclear Information System (INIS)

    Nolch, Guy

    2006-01-01

    During his recent tour of North America, Australian Prime Minister John Howard called for a 'full-blooded debate' about the place of nuclear power in the nation's energy mix. 'I have a very open mind on the development of nuclear energy in my own country,' he said. Treasurer Peter Costello said that only economic arguments precluded Australia's move to nuclear energy. 'If it becomes commercial, we should have it,' he said on 23 May. But in reality the 'debate' had already been adjudicated. Three days later the Australian Nuclear Science and Technology Organisation (ANSTO) presented Science Minister Julie Bishop with a report that delivered Costello's economic justification for nuclear power

  1. Natural disasters and communicable diseases in the Americas: contribution of veterinary public health.

    Science.gov (United States)

    Schneider, Maria Cristina; Tirado, Maria Cristina; Rereddy, Shruthi; Dugas, Raymond; Borda, Maria Isabel; Peralta, Eduardo Alvarez; Aldighieri, Sylvain; Cosivi, Ottorino

    2012-01-01

    The consequences of natural disasters on the people living in the Americas are often amplified by socio-economic conditions. This risk may be increased by climate-related changes. The public health consequences of natural disasters include fatalities as well as an increased risk of communicable diseases. Many of these diseases are zoonotic and foodborne diseases. The aim of this article is to provide an overview of the importance of natural disasters for the Americas and to emphasise the contribution of veterinary public health (VPH) to the management of zoonotic and foodborne disease risks. An analysis was conducted of natural disasters that occurred in the Americas between 2004 and 2008. Five cases studies illustrating the contributions of VPH in situations of disaster are presented. The data shows that natural disasters, particularly storms and floods, can create very important public health problems. Central America and the Caribbean, particularly Haiti, presented a higher risk than the other areas of the Americas. Two priority areas of technical cooperation are recommended for this region, namely: reducing the risk of leptospirosis and other vector-borne disease outbreaks related to floods and hurricanes and improving food safety. The contribution of different disciplines and sectors in disaster preparedness and response is of paramount importance to minimise morbidity and mortality.

  2. International trends in health science librarianship. Part 5 Latin America and the Caribbean.

    Science.gov (United States)

    Berry, Beverley; Rodrííguez-Jiménez, Teresa M

    2013-03-01

    This is the 5th in a series of articles exploring international trends in health science librarianship in Latin America and the Caribbean in the first decade of the 21st century. The invited authors are from Argentina, Bermuda and Mexico. Future issues will track trends in Central Europe and the Middle East. JM. © 2013 The authors. Health Information and Libraries Journal © 2013 Health Libraries Group.

  3. Reshaping Health Care in Latin America: A Comparative Analysis of ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    In many countries of the world, including Canada, arguments are made for a private–public mix in the financing and provision of health services. Proponents claim that such a mix would improve both access and quality of health care. Opponents counter that it would create a two-tiered system, narrowing the range of options ...

  4. Intersectoral Municipal Leadership for Health in Latin America ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This mosquito is responsible for transmitting two viral diseases: dengue fever and ... Both diseases are responsible for rapidly growing health and economic ... Addressing Africa's unmet need for family planning by intensifying sexual and ...

  5. FINANCING HEALTH IN LATIN AMERICA • Volume 1

    International Development Research Centre (IDRC) Digital Library (Canada)

    © arte i diseño 2012

    Health Sector Reform Project at the World Bank. He was a national ...... Guerrero R, Gallego AI, Becerril-Montekio V, Vásquez J. (2011). Sistema de ..... unemployed members of the household (Sauerborn, Adams, & Hien, 1996). Pradhan and ...

  6. Health Financing, Equity and Poverty in Latin America | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Health financing has been a key entry point of reform initiatives in Chile, ... Call for proposals: Innovations for the economic inclusion of marginalized youth ... Findings from an IDRC-supported program figure prominently at the annual ...

  7. Mental health in adolescence: is America's youth flourishing?

    Science.gov (United States)

    Keyes, Corey L M

    2006-07-01

    A continuous assessment and a categorical diagnosis of the presence of mental health, described as flourishing, and the absence of mental health, characterized as languishing, are proposed and applied to data from the second wave of the Child Development Supplement (CDS-II) of the Panel Study of Income Dynamics (PSID), in which a comprehensive set of subjective well-being items were administered to a sample of 1,234 youth ages 12-18. Flourishing was the most prevalent diagnosis among youth ages 12-14; moderate mental health was the most prevalent diagnosis among youth ages 15-18. Depressive symptoms decreased as mental health increased. Prevalence of conduct problems (arrested, skipped school, alcohol use, cigarette smoking, and marijuana use) also decreased and measures of psychosocial functioning (global self-concept, self-determination, closeness to others, and school integration) increased as mental health increased. Findings suggest the importance of positive mental health in future research on adolescent development. 2006 APA, all rights reserved

  8. Interdisciplinary Collaboration in Gerontology and Geriatrics in Latin America: Conceptual Approaches and Health Care Teams

    Science.gov (United States)

    Gomez, Fernando; Curcio, Carmen Lucia

    2013-01-01

    The underlying rationale to support interdisciplinary collaboration in geriatrics and gerontology is based on the complexity of elderly care. The most important characteristic about interdisciplinary health care teams for older people in Latin America is their subjective-basis framework. In other regions, teams are organized according to a…

  9. [Interventions to improve access to health services by indigenous peoples in the Americas].

    Science.gov (United States)

    Araujo, Miguel; Moraga, Cecilia; Chapman, Evelina; Barreto, Jorge; Illanes, Eduardo

    2016-11-01

    Synthesize evidence on effectiveness of interventions designed to improve access to health services by indigenous populations. Review of systematic reviews published as of July 2015, selecting and analyzing only studies in the Region of the Americas. The bibliographic search encompassed MEDLINE, Lilacs, SciELO, EMBASE, DARE, HTA, The Cochrane Library, and organization websites. Two independent reviewers selected studies and analyzed their methodological quality. A narrative summary of the results was produced. Twenty-two reviews met the inclusion criteria. All selected studies were conducted in Canada and the United States of America. The majority of the interventions were preventive, to surmount geographical barriers, increase use of effective measures, develop human resources, and improve people's skills or willingness to seek care. Topics included pregnancy, cardiovascular risk factors, diabetes, substance abuse, child development, cancer, mental health, oral health, and injuries. Some interventions showed effectiveness with moderate or high quality studies: educational strategies to prevent depression, interventions to prevent childhood caries, and multicomponent programs to promote use of child safety seats. In general, results for chronic non-communicable diseases were negative or inconsistent. Interventions do exist that have potential for producing positive effects on access to health services by indigenous populations in the Americas, but available studies are limited to Canada and the U.S. There is a significant research gap on the topic in Latin America and the Caribbean.

  10. Building equitable health systems in Latin America | CRDI - Centre ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    One publication was “Notes for studying primary care within the context of segmented health systems” (article in Spanish with English abstract), which was published in 2010 in Revista de Salud Pública. The paper identifies trends and compares the implementation and performance of PHC in each Southern Cone country, ...

  11. America's health care safety net: intact but endangered

    National Research Council Canada - National Science Library

    Lewin, Marion Ein; Altman, Stuart H

    2000-01-01

    ... of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. Support for this project was provided by the Health Resources and Services Administration (Contract No. 240-97-0030). The views presented in this report are those of the Institute of Medicine Committee on the Changing Market, Managed Ca...

  12. Children?s Health in Latin America: The Influence of Environmental Exposures

    OpenAIRE

    Laborde, Amalia; Tomasina, Fernando; Bianchi, Fabrizio; Brun?, Marie-Noel; Buka, Irena; Comba, Pietro; Corra, Lilian; Cori, Liliana; Duffert, Christin Maria; Harari, Raul; Iavarone, Ivano; McDiarmid, Melissa A.; Gray, Kimberly A.; Sly, Peter D.; Soares, Agnes

    2014-01-01

    Background Chronic diseases are increasing among children in Latin America. Objective and Methods To examine environmental risk factors for chronic disease in Latin American children and to develop a strategic initiative for control of these exposures, the World Health Organization (WHO) including the Pan American Health Organization (PAHO), the Collegium Ramazzini, and Latin American scientists reviewed regional and relevant global data. Results Industrial development and urbanization are pr...

  13. Methods and challenges for the health impact assessment of vaccination programs in Latin America

    Directory of Open Access Journals (Sweden)

    Ana Marli Christovam Sartori

    2015-01-01

    Full Text Available ABSTRACT OBJECTIVE To describe methods and challenges faced in the health impact assessment of vaccination programs, focusing on the pneumococcal conjugate and rotavirus vaccines in Latin America and the Caribbean. METHODS For this narrative review, we searched for the terms "rotavirus", "pneumococcal", "conjugate vaccine", "vaccination", "program", and "impact" in the databases Medline and LILACS. The search was extended to the grey literature in Google Scholar. No limits were defined for publication year. Original articles on the health impact assessment of pneumococcal and rotavirus vaccination programs in Latin America and the Caribbean in English, Spanish or Portuguese were included. RESULTS We identified 207 articles. After removing duplicates and assessing eligibility, we reviewed 33 studies, 25 focusing on rotavirus and eight on pneumococcal vaccination programs. The most frequent studies were ecological, with time series analysis or comparing pre- and post-vaccination periods. The main data sources were: health information systems; population-, sentinel- or laboratory-based surveillance systems; statistics reports; and medical records from one or few health care services. Few studies used primary data. Hospitalization and death were the main outcomes assessed. CONCLUSIONS Over the last years, a significant number of health impact assessments of pneumococcal and rotavirus vaccination programs have been conducted in Latin America and the Caribbean. These studies were carried out few years after the programs were implemented, meet the basic methodological requirements and suggest positive health impact. Future assessments should consider methodological issues and challenges arisen in these first studies conducted in the region.

  14. [Trends and perspectives in health personnel research in the Americas].

    Science.gov (United States)

    Nogueira, R P

    1985-01-01

    It is paradoxical that the lion's share (60 to 80%) of the health budgets of the countries is invested in meeting the personnel costs of the system, and yet few studies have been done to assess the production of that personnel. The importance of personnel as a basic constituent of the sector and its presence at all levels of medical care (from physicians to auxiliaries) makes it vitally important to know how it has evolved over time so that trends can be anticipated and policies guided accordingly. This work seeks to fill, at least partly, the information gap on this subject. The method by which the author has chosen to make this evaluation is to examine the published literature on health personnel, inasmuch as the situation is reflected in articles and documents on the subject. He therefore examined the general trends observed in the following specific areas: increase of personnel and medical schools, the upsurge in the international migration of physicians, changes in the pace of personnel production, emphasis on the integration of services and education, etc. After a detailed analysis of the articles in Educación médica y salud and the Index Medicus Latinoamericano classified by subjects, the author concludes that, although much has been written on health personnel, little in-depth research has been done in primary data sources, and what is done is predominantly surveys. Besides, this research is concerned essentially with the curriculum and organization of university instruction, and betrays a great concern with coverage extension and primary care and with the training and use of auxiliary personnel, planning, and continuing education.

  15. Gaps of maritime health research in Latin America – a literature review

    DEFF Research Database (Denmark)

    Jensen, Olaf Chresten; Andrioti, Despena; Canals, M. Luisa

    for research in this part of the world. Materials and Methods PubMed, Google Scholar, SciELO - Scientific Electronic Library Online, Pan American Journal of Public Health, Medicina Maritima and other relevant journals in Latin America in the Spanish and English languages were searched. Results 57 peer......-reviewed articles on fishermen´s health and safety and none for the seafarers were included. Brazil counted for the main part n =39, while each of the other countries had 0-4 studies. The study objectives include occupational injuries, divers disease, skin diseases, hearing loss and other issues. The cross......Background So far the maritime health and safety research for seafarers and fishermen mainly comes from the industrial developed countries with sparse contributions from the developing countries. The aim was to give an overview of the peer reviewed research in Latin America to point out the needs...

  16. Rakhaine community embraces family planning.

    Science.gov (United States)

    Chowdhury, S M

    1994-01-01

    The Rakhaines are a small, tightly knit community of 15,000 people who occupy parts of the coastal and hilly districts of southern Bangladesh. It is a closed community with different ethnic origins and religion from other Bangladeshis. As such, they have been largely unreached by government health and family planning services. In response to the need to bring services to these people, contact was established between the Family Planning Association of Bangladesh (FPAB) and the Rakhaine in 1987 in the interest of improving family health and well-being among the Rakhaine people through the introduction of maternal and child health care and family planning. The Family Planning Services for the Rakhaine Community project of the FPAB began in Cox's Bazar and Harbang in late 1987, and spread gradually over the hilly terrain inhabited by the Rakhaine to now serve 2000 couples. Although family planning was the focal point, the project also incorporated schemes for income generation, maternal and child health care, and sanitation. At baseline, less than 25% of reproductive age couples were using contraception, but this proportion grew to 69% by 1993, higher than the national contraceptive prevalence rate of approximately 40%. Used by 41% of married women of reproductive age, the pill is the most preferred contraceptive method, followed by sterilization among 10% of women. The efforts of fieldworkers were crucial to program success. The author notes that current users have been using contraception on average for just over two years. Moreover, the level of tetanus toxoid immunization rose to 60% of pregnant women, while 75% of children are now immunized against major life-threatening diseases. Some costs are recovered, but not enough to finance the project.

  17. The burden of unscheduled health care for asthma in Latin America.

    Science.gov (United States)

    Neffen, H; Gonzalez, S N; Fritscher, C C; Dovali, C; Williams, A E

    2010-01-01

    To determine the level and cost of unscheduled health care resource use in adults and children across all asthma symptom severities in Latin America. The level and cost of health care resource use were analysed for 2074 patients with asthma included in the Asthma Insights and Reality in Latin America (AIRLA) survey from 10 Latin American countries. Health care resource use was multiplied by country-specific unit costs to estimate average per-patient annual costs. Patients were classified as adults (> or = 16 years) or children (asthma symptoms were experienced by 53.1% of patients (50.1% of children and 54.6% of adults). In the year preceding the survey, 57.1% of patients required unscheduled health care resource use and 45.1% reported at least 1 emergency hospital contact. The percentage of patients reporting unscheduled health care resource use was greatest amongst those with severe persistent symptoms (71.9%) but it was also high in those with mild intermittent symptoms (45.7%). An average of 73.2% of annual costs of asthma-related health care for the 10 countries was due to unscheduled health care. Expenditure on unscheduled care was greatest amongst both adults and children with severe persistent asthma symptoms (US $558 and US $769, respectively). Adults and children with mild intermittent symptoms also incurred considerable unscheduled costs (US $204 and US $215, respectively). Poorly controlled asthma imposes a considerable cost burden driven by unscheduled health care resource use in Latin America. Treatments to control asthma and reduce the need for unscheduled health care could reduce this cost in both adults and children.

  18. Implementation strategy for advanced practice nursing in primary health care in Latin America and the Caribbean.

    Science.gov (United States)

    Oldenburger, David; De Bortoli Cassiani, Silvia Helena; Bryant-Lukosius, Denise; Valaitis, Ruta Kristina; Baumann, Andrea; Pulcini, Joyce; Martin-Misener, Ruth

    2017-06-08

    SYNOPSIS Advanced practice nursing (APN) is a term used to describe a variety of possible nursing roles operating at an advanced level of practice. Historically, APN roles haves evolved informally, out of the need to improve access to health care services for at-risk and disadvantaged populations and for those living in underserved rural and remote communities. To address health needs, especially ones related to primary health care, nurses acquired additional skills through practice experience, and over time they developed an expanded scope of practice. More recently, APN roles have been developed more formally through the establishment of graduate education programs to meet agreed-upon competencies and standards for practice. The introduction of APN roles is expected to advance primary health care throughout Latin America and the Caribbean, where few such roles exist. The purpose of the paper is to outline an implementation strategy to guide and support the introduction of primary health care APN roles in Latin America and the Caribbean. The strategy includes the adaptation of an existing framework, utilization of recent research evidence, and application of knowledge from experts on APN and primary health care. The strategy consists of nine steps. Each step includes a national perspective that focuses on direct country involvement in health workforce planning and development and on implementation. In addition, each step incorporates an international perspective on encouraging countries that have established APN programs and positions to collaborate in health workforce development with nations without advanced practice nursing.

  19. Critical medical humanities: embracing entanglement, taking risks.

    Science.gov (United States)

    Viney, William; Callard, Felicity; Woods, Angela

    2015-06-01

    What can the medical humanities achieve? This paper does not seek to define what is meant by the medical humanities, nor to adjudicate the exact disciplinary or interdisciplinary knowledges it should offer, but rather to consider what it might be capable of doing. Exploring the many valences of the word 'critical', we argue here for a critical medical humanities characterised by: (i) a widening of the sites and scales of 'the medical' beyond the primal scene of the clinical encounter; (ii) greater attention not simply to the context and experience of health and illness, but to their constitution at multiple levels; (iii) closer engagement with critical theory, queer and disability studies, activist politics and other allied fields; (iv) recognition that the arts, humanities and social sciences are best viewed not as in service or in opposition to the clinical and life sciences, but as productively entangled with a 'biomedical culture'; and, following on from this, (v) robust commitment to new forms of interdisciplinary and cross-sector collaboration. We go on to introduce the five other articles published in this special issue of the journal, reflecting on the ways in which collaboration and critique are articulated in their analyses of immunology, critical neuroscience, toxicity, global clinical labour, and psychological coercion and workfare. As these articles demonstrate, embracing the complex role of critical collaborator--one based on notions of entanglement, rather than servility or antagonism--will, we suggest, develop the imaginative and creative heterodox qualities and practices which have long been recognised as core strengths of the medical humanities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Ethical issues in genetics and public health in Latin America with a focus on Argentina.

    Science.gov (United States)

    Penchaszadeh, Victor B

    2015-07-01

    This paper reviews the health situation and developments in medical genetics and bioethics in Latin America, with a focus on Argentina. The region is the most inequitable in the world, with an average Gini Index of 52.5 and 25 % of the population living in poverty. Health expenditures are low and health systems are fragmented and privatised, with curtailed governmental responsibility and regulation. Health-care decision making is mostly in the hands of private insurance corporations and the medical-industrial complex, so that what is (or is not) covered by health plans is arbitrary and determined by the market and not by population health needs. This inequity and the lack of meaningful governmental intervention in the provision of health care, including genetic services, are at the heart of the bioethical dilemmas in Latin America. It is not surprising, therefore, that bioethics in the region has developed an approach grounded in social justice, equity and human rights as guiding principles, in contrast to the individualism espoused by Anglo-Saxon bioethics. The main ethical issues identified in genetics in Latin America are (1) inequity in access to genetic services, particularly in prenatal diagnosis, (2) genetic discrimination and (3) the lack of adherence to internationally accepted requisites of clinical validity and utility for diagnostic and predictive genetic testing. In this context, there is a risk that the impressive advances in genetics/genomics occurring in developed countries may fail to improve the public's health and deepen inequity, with the implementation of expensive genetic technologies of unproven validity.

  1. The implications of trade liberalization for diet and health: a case study from Central America.

    Science.gov (United States)

    Thow, Anne Marie; Hawkes, Corinna

    2009-07-28

    Central America has undergone extensive trade liberalization over the past two decades, and has recently signed a Free Trade Agreement with the United States. The region is also experiencing a dual burden of malnutrition with the growth of dietary patterns associated with the global 'nutrition transition'. This study describes the relationship between trade liberalization policies and food imports and availability, and draws implications for diet and health, using Central America as a case study region. Changes in tariff and non-tariff barriers for each country were documented, and compared with time-series graphs of import, production and availability data to show the outcome of changes in trade policy in relation to food imports and food availability. Changes in trade policy in Central America have directly affected food imports and availability via three avenues. First, the lowering of trade barriers has promoted availability by facilitating higher imports of a wide range of foods. Second, trade liberalization has affected food availability through promoting domestic meat production. Third, reductions in barriers to investment appear to be critical in expansion of processed food markets. This suggests that changes in trade policies have facilitated rising availability and consumption of meat, dairy products, processed foods and temperate (imported fruits) in Central America. This study indicates that the policies of trade liberalization in Central American countries over the past two decades, particularly in relation to the United States, have implications for health in the region. Specifically, they have been a factor in facilitating the "nutrition transition", which is associated with rising rates of obesity and chronic diseases such as cardiovascular disease and cancer. Given the significant cost of chronic disease for the health care system, individuals and the wider community, it is critical that preventive health measures address such upstream determinants

  2. The implications of trade liberalization for diet and health: a case study from Central America

    Directory of Open Access Journals (Sweden)

    Hawkes Corinna

    2009-07-01

    Full Text Available Abstract Background Central America has undergone extensive trade liberalization over the past two decades, and has recently signed a Free Trade Agreement with the United States. The region is also experiencing a dual burden of malnutrition with the growth of dietary patterns associated with the global 'nutrition transition'. This study describes the relationship between trade liberalization policies and food imports and availability, and draws implications for diet and health, using Central America as a case study region. Methods Changes in tariff and non-tariff barriers for each country were documented, and compared with time-series graphs of import, production and availability data to show the outcome of changes in trade policy in relation to food imports and food availability. Results Changes in trade policy in Central America have directly affected food imports and availability via three avenues. First, the lowering of trade barriers has promoted availability by facilitating higher imports of a wide range of foods. Second, trade liberalization has affected food availability through promoting domestic meat production. Third, reductions in barriers to investment appear to be critical in expansion of processed food markets. This suggests that changes in trade policies have facilitated rising availability and consumption of meat, dairy products, processed foods and temperate (imported fruits in Central America. Conclusion This study indicates that the policies of trade liberalization in Central American countries over the past two decades, particularly in relation to the United States, have implications for health in the region. Specifically, they have been a factor in facilitating the "nutrition transition", which is associated with rising rates of obesity and chronic diseases such as cardiovascular disease and cancer. Given the significant cost of chronic disease for the health care system, individuals and the wider community, it is critical

  3. SALTRA: a regional program for workers' health and sustainable development in Central America.

    Science.gov (United States)

    Wesseling, Catharina; Aragón, Aurora; Elgstrand, Kaj; Flores, Reinaldo; Hogstedt, Christer; Partanen, Timo

    2011-01-01

    In 2003, the university-based Program on Work and Health in Central America, SALTRA, was launched to build national and regional capacities in occupational safety and health with the goal of preventing and reducing poverty in Central America. SALTRA has implemented 20 projects including action projects in priority sectors (e.g., construction, sugarcane, hospitals, migrant coffee workers); strengthening of surveillance (occupational health profiles, carcinogenic exposures, fatal injuries and pesticides); a participatory model for training and risk monitoring by workers; building occupational health capacity for professionals, employers, and workers, with collaborating networks between the countries; strengthening of universities in work, environment, and health; studies of serious occupational and environmental situations; communication channels; and continued efforts to raise political awareness. SALTRA has placed issues of workers' health on political, business, and academic agendas throughout the region and has laid the foundations for achieving substantial future improvements in health conditions of all workers in the region. External evaluators envisioned SALTRA as an innovative development model.

  4. Disabling health care? Medicaid managed care and people with disabilities in America

    DEFF Research Database (Denmark)

    Hiranandani, Vanmala Sunder

    2011-01-01

    Medicaid, America's largest government-funded health insurance program, plays a pivotal role in providing health services to eight million adults with disabilities. Since the mid-1990s, many Medicaid programs have aggressively introduced managed care, which reconfigures service delivery using...... business principles. Most states have insufficient experience in developing managed care plans for Medicaid beneficiaries with disabilities. Middle-aged adults with physical disabilities present their own constellation of health care issues that is not readily appreciated in health and social services....... The purpose of the study was to understand their experiences in accessing physical health care services and to ascertain the effects of managed care on their health and well-being. This study found beneficiaries encounter numerous barriers in accessing preventative, treatment, and acute care services. Overall...

  5. Redesigning Higher Education: Embracing a New Paradigm

    Science.gov (United States)

    Watson, William R.; Watson, Sunnie Lee

    2014-01-01

    Higher education is under enormous pressure to transform itself and embrace a new paradigm. Operating under an outdated model that no longer aligns with the realities of modern society, institutions of higher education are recognizing the need to drastically remake themselves or possibly cease to exist. This article explores the current landscape…

  6. Sharing regulatory data as tools for strengthening health systems in the Region of the Americas

    Directory of Open Access Journals (Sweden)

    Varley Dias Sousa

    Full Text Available ABSTRACT Regulatory transparency is an imperative characteristic of a reliable National Regulatory Authority. In the region of the Americas, the process of building an open government is still fragile and fragmented across various Health Regulatory Agencies (HRAs and Regional Reference Authorities (RRAs. This study assessed the transparency status of RRAs, focusing on various medicine life-cycle documents (the Medicine Dossier, Clinical Trial Report, and Inspection Report as tools for strengthening health systems. Based on a narrative (nonsystematic review of RRA regulatory transparency, transparency status was classified as one of two types: public disclosure of information (intra-agency data and data- and work-sharing (inter-agency data. The risks/benefits of public disclosure of medicine-related information were assessed, taking into account 1 the involvement and roles of multiple stakeholders (health care professionals, regulators, industry, community, and academics and 2 the protection of commercial and personal confidential data. Inter-agency data- and work-sharing was evaluated in the context of harmonization and cooperation projects that focus on regulatory convergence. Technical and practical steps for establishing an openness directive for the pharmaceutical regulatory environment are proposed to improve and strengthen health systems in the Americas. Addressing these challenges requires leadership from entities such as the Pan American Health Organization to steer and support collaborative regional alliances that advance the development and establishment of a trustworthy regulatory environment and a sustainable public health system in the Americas, using international successful initiatives as reference and taking into account the domestic characteristics and experiences of each individual country.

  7. Sharing regulatory data as tools for strengthening health systems in the Region of the Americas.

    Science.gov (United States)

    Sousa, Varley Dias; Ramalho, Pedro I; Silveira, Dâmaris

    2016-05-01

    Regulatory transparency is an imperative characteristic of a reliable National Regulatory Authority. In the region of the Americas, the process of building an open government is still fragile and fragmented across various Health Regulatory Agencies (HRAs) and Regional Reference Authorities (RRAs). This study assessed the transparency status of RRAs, focusing on various medicine life-cycle documents (the Medicine Dossier, Clinical Trial Report, and Inspection Report) as tools for strengthening health systems. Based on a narrative (nonsystematic) review of RRA regulatory transparency, transparency status was classified as one of two types: public disclosure of information (intra-agency data) and data- and work-sharing (inter-agency data). The risks/benefits of public disclosure of medicine-related information were assessed, taking into account 1) the involvement and roles of multiple stakeholders (health care professionals, regulators, industry, community, and academics) and 2) the protection of commercial and personal confidential data. Inter-agency data- and work-sharing was evaluated in the context of harmonization and cooperation projects that focus on regulatory convergence. Technical and practical steps for establishing an openness directive for the pharmaceutical regulatory environment are proposed to improve and strengthen health systems in the Americas. Addressing these challenges requires leadership from entities such as the Pan American Health Organization to steer and support collaborative regional alliances that advance the development and establishment of a trustworthy regulatory environment and a sustainable public health system in the Americas, using international successful initiatives as reference and taking into account the domestic characteristics and experiences of each individual country.

  8. A systematic review of nursing research priorities on health system and services in the Americas.

    Science.gov (United States)

    Garcia, Alessandra Bassalobre; Cassiani, Silvia Helena De Bortoli; Reveiz, Ludovic

    2015-03-01

    To systematically review literature on priorities in nursing research on health systems and services in the Region of the Americas as a step toward developing a nursing research agenda that will advance the Regional Strategy for Universal Access to Health and Universal Health Coverage. This was a systematic review of the literature available from the following databases: Web of Science, PubMed, LILACS, and Google. Documents considered were published in 2008-2014; in English, Spanish, or Portuguese; and addressed the topic in the Region of the Americas. The documents selected had their priority-setting process evaluated according to the "nine common themes for good practice in health research priorities." A content analysis collected all study questions and topics, and sorted them by category and subcategory. Of 185 full-text articles/documents that were assessed for eligibility, 23 were selected: 12 were from peer-reviewed journals; 6 from nursing publications; 4 from Ministries of Health; and 1 from an international organization. Journal publications had stronger methodological rigor; the majority did not present a clear implementation or evaluation plan. After compiling the 444 documents' study questions and topics, the content analysis resulted in a document with 5 categories and 16 subcategories regarding nursing research priorities on health systems and services. Research priority-setting is a highly important process for health services improvement and resources optimization, but implementation and evaluation plans are rarely included. The resulting document will serve as basis for the development of a new nursing research agenda focused on health systems and services, and shaped to advance universal health coverage and universal access to health.

  9. Bibliometric analysis of regional Latin America's scientific output in Public Health through SCImago Journal & Country Rank

    Science.gov (United States)

    2014-01-01

    Background In the greater framework of the essential functions of Public Health, our focus is on a systematic, objective, external evaluation of Latin American scientific output, to compare its publications in the area of Public Health with those of other major geographic zones. We aim to describe the regional distribution of output in Public Health, and the level of visibility and specialization, for Latin America; it can then be characterized and compared in the international context. Methods The primary source of information was the Scopus database, using the category “Public Health, Environmental and Occupational Health”, in the period 1996–2011. Data were obtained through the portal of SCImago Journal and Country Rank. Using a set of qualitative (citation-based), quantitative (document recount) and collaborative (authors from more than one country) indicators, we derived complementary data. The methodology serves as an analytical tool for researchers and scientific policy-makers. Results The contribution of Latin America to the arsenal of world science lies more or less midway on the international scale in terms of its output and visibility. Revealed as its greatest strengths are the high level of specialization in Public Health and the sustained growth of output. The main limitations identified were a relative decrease in collaboration and low visibility. Conclusions Collaboration is a key factor behind the development of scientific activity in Latin America. Although this finding can be useful for formulating research policy in Latin American countries, it also underlines the need for further research into patterns of scientific communication in this region, to arrive at more specific recommendations. PMID:24950735

  10. Health outcomes among HIV-positive Latinos initiating antiretroviral therapy in North America versus Central and South America

    Science.gov (United States)

    Cesar, Carina; Koethe, John R; Giganti, Mark J; Rebeiro, Peter; Althoff, Keri N; Napravnik, Sonia; Mayor, Angel; Grinsztejn, Beatriz; Wolff, Marcelo; Padgett, Denis; Sierra-Madero, Juan; Gotuzzo, Eduardo; Sterling, Timothy R; Willig, James; Levison, Julie; Kitahata, Mari; Rodriguez-Barradas, Maria C; Moore, Richard D; McGowan, Catherine; Shepherd, Bryan E; Cahn, Pedro

    2016-01-01

    Introduction Latinos living with HIV in the Americas share a common ethnic and cultural heritage. In North America, Latinos have a relatively high rate of new HIV infections but lower rates of engagement at all stages of the care continuum, whereas in Latin America antiretroviral therapy (ART) services continue to expand to meet treatment needs. In this analysis, we compare HIV treatment outcomes between Latinos receiving ART in North America versus Latin America. Methods HIV-positive adults initiating ART at Caribbean, Central and South America Network for HIV (CCASAnet) sites were compared to Latino patients (based on country of origin or ethnic identity) starting treatment at North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) sites in the United States and Canada between 2000 and 2011. Cox proportional hazards models compared mortality, treatment interruption, antiretroviral regimen change, virologic failure and loss to follow-up between cohorts. Results The study included 8400 CCASAnet and 2786 NA-ACCORD patients initiating ART. CCASAnet patients were younger (median 35 vs. 37 years), more likely to be female (27% vs. 20%) and had lower nadir CD4 count (median 148 vs. 195 cells/µL, p<0.001 for all). In multivariable analyses, CCASAnet patients had a higher risk of mortality after ART initiation (adjusted hazard ratio (AHR) 1.61; 95% confidence interval (CI): 1.32 to 1.96), particularly during the first year, but a lower hazard of treatment interruption (AHR: 0.46; 95% CI: 0.42 to 0.50), change to second-line ART (AHR: 0.56; 95% CI: 0.51 to 0.62) and virologic failure (AHR: 0.52; 95% CI: 0.48 to 0.57). Conclusions HIV-positive Latinos initiating ART in Latin America have greater continuity of treatment but are at higher risk of death than Latinos in North America. Factors underlying these differences, such as HIV testing, linkage and access to care, warrant further investigation. PMID:26996992

  11. Worker health and safety and climate change in the Americas: issues and research needs

    Directory of Open Access Journals (Sweden)

    Max Kiefer

    Full Text Available SYNOPSIS This report summarizes and discusses current knowledge on the impact that climate change can have on occupational safety and health (OSH, with a particular focus on the Americas. Worker safety and health issues are presented on topics related to specific stressors (e.g., temperature extremes, climate associated impacts (e.g., ice melt in the Arctic, and a health condition associated with climate change (chronic kidney disease of non-traditional etiology. The article discusses research needs, including hazards, surveillance, and risk assessment activities to better characterize and understand how OSH may be associated with climate change events. Also discussed are the actions that OSH professionals can take to ensure worker health and safety in the face of climate change.

  12. Qualitative Description of Global Health Nursing Competencies by Nursing Faculty in Africa and the Americas

    Science.gov (United States)

    Wilson, Lynda; Moran, Laura; Zarate, Rosa; Warren, Nicole; Ventura, Carla Aparecida Arena; Tamí-Maury, Irene; Mendes, Isabel Amélia Costa

    2016-01-01

    Abstract Objective: to analyze qualitative comments from four surveys asking nursing faculty to rate the importance of 30 global health competencies for undergraduate nursing programs. Method: qualitative descriptive study that included 591 individuals who responded to the survey in English (49 from Africa and 542 from the Americas), 163 who responded to the survey in Spanish (all from Latin America), and 222 Brazilian faculty who responded to the survey in Portuguese. Qualitative comments were recorded at the end of the surveys by 175 respondents to the English survey, 75 to the Spanish survey, and 70 to the Portuguese survey. Qualitative description and a committee approach guided data analysis. Results: ten new categories of global health competencies emerged from the analysis. Faculty also demonstrated concern about how and when these competencies could be integrated into nursing curricula. Conclusion: the additional categories should be considered for addition to the previously identified global health competencies. These, in addition to the guidance about integration into existing curricula, can be used to guide refinement of the original list of global health competencies. Further research is needed to seek consensus about these competencies and to develop recommendations and standards to guide nursing curriculum development. PMID:27276020

  13. All-Embracing Manufacturing Roadmap System

    CERN Document Server

    Halevi, Gideon

    2012-01-01

    All-embracing manufacturing is a system that aims to dissolve the complexity of the manufacturing process and restore the inherent simplicity. It claims that production is very simple and flexible by nature. However, the complexity is a result of the production system approach which makes it rigid and therefore complex. All-embracing manufacturing introduces flexibility to production planning, it eliminates constraints, bottlenecks, and disruptions automatically while it restores the simplicity. No decision is made ahead of time, but only at the time of execution. It introduces technology as dominant part of manufacturing. It is a computer oriented system that imitates human behavior i.e. practically as any of us behave in daily personal life.

  14. Interdisciplinary collaboration in gerontology and geriatrics in Latin America: conceptual approaches and health care teams.

    Science.gov (United States)

    Gomez, Fernando; Curcio, Carmen Lucia

    2013-01-01

    The underlying rationale to support interdisciplinary collaboration in geriatrics and gerontology is based on the complexity of elderly care. The most important characteristic about interdisciplinary health care teams for older people in Latin America is their subjective-basis framework. In other regions, teams are organized according to a theoretical knowledge basis with well-justified priorities, functions, and long-term goals, in Latin America teams are arranged according to subjective interests on solving their problems. Three distinct approaches of interdisciplinary collaboration in gerontology are proposed. The first approach is grounded in the scientific rationalism of European origin. Denominated "logical-rational approach," its core is to identify the significance of knowledge. The second approach is grounded in pragmatism and is more associated with a North American tradition. The core of this approach consists in enhancing the skills and competences of each participant; denominated "logical-instrumental approach." The third approach denominated "logical-subjective approach" has a Latin America origin. Its core consists in taking into account the internal and emotional dimensions of the team. These conceptual frameworks based in geographical contexts will permit establishing the differences and shared characteristics of interdisciplinary collaboration in geriatrics and gerontology to look for operational answers to solve the "complex problems" of older adults.

  15. Linking evidence to action on social determinants of health using Urban HEART in the Americas.

    Science.gov (United States)

    Prasad, Amit; Groot, Ana Maria Mahecha; Monteiro, Teofilo; Murphy, Kelly; O'Campo, Patricia; Broide, Emilia Estivalet; Kano, Megumi

    2013-12-01

    To evaluate the experience of select cities in the Americas using the Urban Health Equity Assessment and Response Tool (Urban HEART) launched by the World Health Organization in 2010 and to determine its utility in supporting government efforts to improve health equity using the social determinants of health (SDH) approach. The Urban HEART experience was evaluated in four cities from 2010-2013: Guarulhos (Brazil), Toronto (Canada), and Bogotá and Medellín (Colombia). Reports were submitted by Urban HEART teams in each city and supplemented by first-hand accounts of key informants. The analysis considered each city's networks and the resources it used to implement Urban HEART; the process by which each city identified equity gaps and prioritized interventions; and finally, the facilitators and barriers encountered, along with next steps. In three cities, local governments spearheaded the process, while in the fourth (Toronto), academia initiated and led the process. All cities used Urban HEART as a platform to engage multiple stakeholders. Urban HEART's Matrix and Monitor were used to identify equity gaps within cities. While Bogotá and Medellín prioritized among existing interventions, Guarulhos adopted new interventions focused on deprived districts. Actions were taken on intermediate determinants, e.g., health systems access, and structural SDH, e.g., unemployment and human rights. Urban HEART provides local governments with a simple and systematic method for assessing and responding to health inequity. Through the SDH approach, the tool has provided a platform for intersectoral action and community involvement. While some areas of guidance could be strengthened, Urban HEART is a useful tool for directing local action on health inequities, and should be scaled up within the Region of the Americas, building upon current experience.

  16. Linking evidence to action on social determinants of health using Urban HEART in the Americas

    Directory of Open Access Journals (Sweden)

    Amit Prasad

    2013-12-01

    Full Text Available OBJECTIVE: To evaluate the experience of select cities in the Americas using the Urban Health Equity Assessment and Response Tool (Urban HEART launched by the World Health Organization in 2010 and to determine its utility in supporting government efforts to improve health equity using the social determinants of health (SDH approach METHODS: The Urban HEART experience was evaluated in four cities from 2010-2013: Guarulhos (Brazil, Toronto (Canada, and Bogotá and Medellín (Colombia. Reports were submitted by Urban HEART teams in each city and supplemented by first-hand accounts of key informants. The analysis considered each city's networks and the resources it used to implement Urban HEART; the process by which each city identified equity gaps and prioritized interventions; and finally, the facilitators and barriers encountered, along with next steps RESULTS: In three cities, local governments spearheaded the process, while in the fourth (Toronto, academia initiated and led the process. All cities used Urban HEART as a platform to engage multiple stakeholders. Urban HEART's Matrix and Monitor were used to identify equity gaps within cities. While Bogotá and Medellín prioritized among existing interventions, Guarulhos adopted new interventions focused on deprived districts. Actions were taken on intermediate determinants, e.g., health systems access, and structural SDH, e.g., unemployment and human rights CONCLUSIONS: Urban HEART provides local governments with a simple and systematic method for assessing and responding to health inequity. Through the SDH approach, the tool has provided a platform for intersectoral action and community involvement. While some areas of guidance could be strengthened, Urban HEART is a useful tool for directing local action on health inequities, and should be scaled up within the Region of the Americas, building upon current experience.

  17. Theoretical underpinnings of state institutionalisation of inclusion and struggles in collective health in Latin America.

    Science.gov (United States)

    Mahmood, Qamar; Muntaner, Carles

    2018-03-28

    Community participation as a strategy in health aims to increase the role of citizens in health decision-making which are contextualised within the institutions of democracy. Electoral representation as the dominant model of democracy globally is based on the elite theory of democracy that sees political decision-making a prerogative of political elites. Such political elitism is counter to the idea of democratic participation. Neoliberalism together with elitism in political sphere have worsened social inequities by undermining working class interests. Latin America has seen adverse consequences of these social inequities. In response, social movements representing collective struggles of organised citizens arose in the region. This paper explores the theoretical underpinnings of democratic participation in contemporary Latin American context at the nexus of emerging social movement activism and policy responses. The paper will use empirical examples to highlight how such democratic practices at the societal level evolved while demanding political inclusion. These societal democratic practices in Latin America are redefining democracy, which continues to be seen in the political sphere only. Health reforms promoting participatory democracy in several Latin American countries have demonstrated that establishing institutions and mechanisms of democratic participation facilitate collective participation by the organised citizenry in state affairs.

  18. Will electronic personal health records benefit providers and patients in rural America?

    Science.gov (United States)

    Hargreaves, John S

    2010-03-01

    The objective of this study was to educate stakeholders (e.g., providers, patients, insurers, government) in the healthcare industry about electronic personal health records (PHRs) and their potential application in rural America. Extensive research was performed on PHRs through standard literature search, product demonstrations, educational webinars, and fact finding via news releases. Various stakeholders are eager to transform the healthcare industry into the digital age like other industries (i.e., banking, retail). Despite low adoption of PHRs in 2008 (2.7% of U.S. adults), patients are interested in secure messaging and eVisits with their physicians, online appointment scheduling and reminders, and online access to their laboratory and radiology results. Federal agencies (e.g., Health and Human Services, Department of Defense, Veterans Affairs [VA]), popular information technology (IT) vendors (e.g., Google, Microsoft), and large insurers (e.g., Aetna) have energized the industry through pilot programs and new product announcements. It remains to be seen if barriers to adoption, including privacy concerns, lack of interoperability standards and funding, and provider resistance, can be overcome to enable PHRs to become a critical tool in the creation of a more efficient and less costly U.S. healthcare industry. Electronic PHRs hold great promise to enhance access and improve the quality of care provided to patients in rural America. Government, vendors, and insurers should create incentives for providers and patients to implement PHRs. Likewise, patients need to become more aware of PHRs and their ability to improve health outcomes.

  19. [Health, globalization and interculturalism: an anthropological approach to the situation of indigenous peoples in South America].

    Science.gov (United States)

    Hita, Susana Ramírez

    2014-10-01

    This article reflects upon the impact of globalization and interculturalism on the living conditions of indigenous peoples in South America. Through two examples - Bolivia and Argentina - it is seen how health interculturalism has transformed into a discourse and a practice that both global organizations and most Latin American countries have used to assimilate and attract indigenous communities. Traditional medicine is respected and valued without proposing changes to improve the living conditions of these population groups. This is especially true in those areas where land is being expropriated or contaminated with the extraction of gas, oil, minerals and the construction of dams, along with indiscriminate deforestation of the rainforest. Health/illness cannot be separated from the territorial conditions of these peoples since environmental health is critical for their survival.

  20. SHARES OF HEALTH PROMOTION FOR THE ELDERLY IN BRAZIL AND LATIN AMERICA: AN INTEGRATIVE LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Mariana dos Santos Ribeiro

    2013-09-01

    Full Text Available Introduction: Health promotion in the elderly is approaching the concept of active aging, in which the individual preserves capabilities and development potential. Objective: Identify the Brazilian literature and Latin American studies which reflect actions and practices to promote health among older adults. Method: This is an integrative literature review, the main question was: 'what are the issues addressed in the literature on the promotion of health among the elderly in Brazil and Latin America? ". The searches were done in LILACS and MEDLINE in English, Portuguese and Spanish, the descriptors used were controlled "health promotion" and "elderly". Results: The sample included 16 articles that were categorized into topics that addressed actions to promote health among older adults as group work, educational, artistic and alternative strategies, awareness and empowerment of the elderly, programs for disease prevention and oral health. Conclusion: The implementation of health promotion practices can facilitate the process of empowerment of elderly and increase social control and improve their health in order to make the reach full physical wellbeing, mental and social

  1. Prioritization of strategies to approach the judicialization of health in Latin America and the Caribbean

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Pinzón-Flórez

    2016-01-01

    Full Text Available ABSTRACT OBJECTIVE To describe strategies that contribute to the comprehensive approach to the judicialization of health in countries of Latin America and the Caribbean. METHODS A search was structured to identify articles presenting strategies to approach the judicialization of health. A survey was designed, which included actors of the health system and judiciary sector. We prioritized the strategies qualified by more than the 50.0% of the participants as “very relevant”. Strategies were categorized according to: governance, provision of services, human resources, information systems, financing, and medical products. RESULTS We included 64 studies, which identified 50 strategies, related to the sub-functions and components of health systems. Of the 165 people who answered the survey, 80.0% were aged 35-64 years. The distribution of men and women was homogeneous. Half of the respondents were from Colombia (20.0%, Uruguay (16.9%, and Argentina (12.7%. We prioritized strategies that addressed aspects of generation of useful scientific evidence for decision making according to the health needs of the population, empowerment for the society, and creating spaces for discussion of measures of inclusion or exclusion of health technologies. The executive and judiciary decision makers prioritized questions that dealt with strategies that would ensure accountability. CONCLUSIONS The results of this study contribute to the identification of effective strategies to approach the phenomenon of judicialization of health, guaranteeing the right to health.

  2. Prioritizing Zoonotic Diseases: Differences in Perspectives Between Human and Animal Health Professionals in North America.

    Science.gov (United States)

    Ng, V; Sargeant, J M

    2016-05-01

    Zoonoses pose a significant burden of illness in North America. Zoonoses represent an additional threat to public health because the natural reservoirs are often animals, particularly wildlife, thus eluding control efforts such as quarantine, vaccination and social distancing. As there are limited resources available, it is necessary to prioritize diseases in order to allocate resources to those posing the greatest public health threat. Many studies have attempted to prioritize zoonoses, but challenges exist. This study uses a quantitative approach, conjoint analysis (CA), to overcome some limitations of traditional disease prioritization exercises. We used CA to conduct a zoonoses prioritization study involving a range of human and animal health professionals across North America; these included epidemiologists, public health practitioners, research scientists, physicians, veterinarians, laboratory technicians and nurses. A total of 699 human health professionals (HHP) and 585 animal health professionals (AHP) participated in this study. We used CA to prioritize 62 zoonotic diseases using 21 criteria. Our findings suggest CA can be used to produce reasonable criteria scores for disease prioritization. The fitted models were satisfactory for both groups with a slightly better fit for AHP compared to HHP (84.4% certainty fit versus 83.6%). Human-related criteria were more influential for HHP in their decision to prioritize zoonoses, while animal-related criteria were more influential for AHP resulting in different disease priority lists. While the differences were not statistically significant, a difference of one or two ranks could be considered important for some individuals. A potential solution to address the varying opinions is discussed. The scientific framework for disease prioritization presented can be revised on a regular basis by updating disease criteria to reflect diseases as they evolve over time; such a framework is of value allowing diseases of

  3. Maternal health research outputs and gaps in Latin America: reflections from the mapping study.

    Science.gov (United States)

    Vargas-Riaño, Emily; Becerril-Montekio, Víctor; Becerra-Posada, Francisco; Tristán, Mario

    2017-09-18

    As part of the MASCOT/WOTRO multinational team conducting the maternal health literature mapping, four Latin American researchers were particularly interested in analysing information specific to their region. The mapping started with 45,959 papers uploaded from MEDLINE, CINAHL, Embase, LILACAS, PopLINE, PsycINFO and Web of Knowledge. From these, 4175 full texts were reviewed and 2295 papers were subsequently included. Latin America experienced an average maternal mortality decline of 40% between 1990 and 2013. Nevertheless, the region's performance was below the global average and short of the 75% reduction set in Millennium Development Goal 5 for 2015. The main outcomes show that research on maternal health in the countries where the most impoverished populations of the world are living is not always aligned with their compelling needs. From another perspective, the review made it possible to recognize that research funding as well as the amount of scientific literature produced concentrate on issues that are not necessarily among the main causes of maternal deaths. Even though research on maternal health in Latin America has grown from an average of 92.5 publications per year in 2000-2003 to 236.7 between 2008 and 2012, it's not satisfactorily keeping pace with other regions. In conclusion, it is critical to effectively orient research funding and production to respond to the health needs of the population. At the same time, there is a need for innovative mechanisms to strengthen the production and uptake of scientific evidence that can properly inform public health decision making.

  4. A road map for leptospirosis research and health policies based on country needs in Latin America.

    Science.gov (United States)

    Pereira, Martha Maria; Schneider, Maria Cristina; Munoz-Zanzi, Claudia; Costa, Federico; Benschop, Jackie; Hartskeerl, Rudy; Martinez, Julio; Jancloes, Michel; Bertherat, Eric

    2018-02-19

    This report summarizes the presentations, discussions and the recommendations coming from the Oswaldo Cruz Institute/FIOCRUZ International Workshop for Leptospirosis Research Based on Country Needs and the 5th Global Leptospirosis Environmental Action Network meeting, which was held in the city of Rio de Janeiro, Brazil, 10-12 November 2015. The event focused on health policy and worked to develop a road map as a consensus document to help guide decision-making by policymakers, funding bodies, and health care professionals. The direction that leptospirosis research should take in the coming years was emphasized, taking into account the needs of countries of Latin America, as well as experiences from other world regions, as provided by international experts. The operational concepts of "One Health" and translational research underlaid the discussions and the resulting recommendations. Despite the wide geographic distribution of leptospirosis and its impact in terms of incidence, morbidity, and mortality, leptospirosis is not yet considered a "tool-ready" disease for global initiatives. Surveillance programs need new tools and strategies for early detection, prevention, and follow-up. The major recommendations developed at the Rio meeting cover both health policy and research. The health policy recommendations should be taken into account by decisionmakers, government officials, and the Pan American Health Organization. The priorities for research, technological development, and innovation should be considered by research institutions, universities, and stakeholders.

  5. Qualitative analysis of governance trends after health system reforms in Latin America: lessons from Mexico.

    Science.gov (United States)

    Arredondo, A; Orozco, E; Recaman, A L

    2018-03-01

    Health policies in Latin America are centered on the democratization of health. Since 2003, during the last generation of reforms, health systems in this region have promoted governance strategies for better agreements between governments, institutions, and civil society. In this context, we develop an evaluative research to identify trends and evidence of governance after health care reforms in six regions of Mexico. Evaluative research was developed with a retrospective design based on qualitative analysis. Primary data were obtained from 189 semi-structured interviews with purposively selected health care professionals and key informants. Secondary data were extracted from a selection of 95 official documents on results of the reform project at the national level, national health policies, and lines of action for good governance. Data processing and analysis were performed using ATLAS.ti and PolicyMaker. A list of main strengths and weaknesses is presented as evidence of health system governance. Accountability at the federal level remains prescriptive; in the regions, a system of accountability and transparency in the allocation of resources and in terms of health democratization strategies is still absent. Social protection and decentralization schemes are strategies that have allowed for improvements with a proactive role of users and civil society. Regarding challenges, there are still low levels of governance and difficulties in the effective conduct of programs and reform strategies together with a lack of precision in the rules and roles of the different actors of the health system. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  6. Multinational corporations and infectious disease: Embracing human rights management techniques.

    Science.gov (United States)

    Salcito, Kendyl; Singer, Burton H; Weiss, Mitchell G; Winkler, Mirko S; Krieger, Gary R; Wielga, Mark; Utzinger, Jürg

    2014-01-01

    Global health institutions have called for governments, international organisations and health practitioners to employ a human rights-based approach to infectious diseases. The motivation for a human rights approach is clear: poverty and inequality create conditions for infectious diseases to thrive, and the diseases, in turn, interact with social-ecological systems to promulgate poverty, inequity and indignity. Governments and intergovernmental organisations should be concerned with the control and elimination of these diseases, as widespread infections delay economic growth and contribute to higher healthcare costs and slower processes for realising universal human rights. These social determinants and economic outcomes associated with infectious diseases should interest multinational companies, partly because they have bearing on corporate productivity and, increasingly, because new global norms impose on companies a responsibility to respect human rights, including the right to health. We reviewed historical and recent developments at the interface of infectious diseases, human rights and multinational corporations. Our investigation was supplemented with field-level insights at corporate capital projects that were developed in areas of high endemicity of infectious diseases, which embraced rights-based disease control strategies. Experience and literature provide a longstanding business case and an emerging social responsibility case for corporations to apply a human rights approach to health programmes at global operations. Indeed, in an increasingly globalised and interconnected world, multinational corporations have an interest, and an important role to play, in advancing rights-based control strategies for infectious diseases. There are new opportunities for governments and international health agencies to enlist corporate business actors in disease control and elimination strategies. Guidance offered by the United Nations in 2011 that is widely embraced

  7. Postneoliberal Public Health Care Reforms: Neoliberalism, Social Medicine, and Persistent Health Inequalities in Latin America.

    Science.gov (United States)

    Hartmann, Christopher

    2016-12-01

    Several Latin American countries are implementing a suite of so-called "postneoliberal" social and political economic policies to counter neoliberal models that emerged in the 1980s. This article considers the influence of postneoliberalism on public health discourses, policies, institutions, and practices in Bolivia, Ecuador, and Venezuela. Social medicine and neoliberal public health models are antecedents of postneoliberal public health care models. Postneoliberal public health governance models neither fully incorporate social medicine nor completely reject neoliberal models. Postneoliberal reforms may provide an alternative means of reducing health inequalities and improving population health.

  8. Viral hepatitis in Latin America and the Caribbean: a public health challenge

    Directory of Open Access Journals (Sweden)

    Núria Díez-Padrisa

    2013-10-01

    Full Text Available Viral hepatitis (VH is an emergent concern in public health agendas worldwide. More than one million people die annually from hepatitis and 57% and 78% of global cirrhosis and hepatocellular carcinoma cases, respectively, are caused by VH. The burden of disease caused by hepatitis in Latin America and the Caribbean (LAC is high. Data on hepatitis has been collected in several countries, but more accurate and comparable studies are needed. Hepatitis B vaccination and screening of donated blood are routine practices in the region. However, integrated policies covering prevention and control of disease caused by all types of hepatitis viruses are scarce. Existing preventive measures need to be reinforced. Attention must be paid to at-risk populations, awareness campaigns, and water and food safety. Affordable access to diagnosis and treatment, population screening, referral to health services and monitoring of positive cases are among the main challenges currently posed by VH in LAC. The World Health Organization framework and Pan American Health Organization regional strategy, defined in response to resolution WHA63.18 of the World Health Assembly, may help to overcome these difficulties. Successful experiences in the fight against hepatitis in some LAC countries may also provide very interesting solutions for the region.

  9. [Core competencies in public health: a regional framework for the Americas].

    Science.gov (United States)

    Conejero, Juana Suárez; Godue, Charles; Gutiérrez, José Francisco García; Valladares, Laura Magaña; Rabionet, Silvia; Concha, José; Valdés, Manuel Vázquez; Gómez, Rubén Darío; Mujica, Oscar J; Cabezas, César; Lucano, Lindaura Liendo; Castellanos, Jorge

    2013-07-01

    The response is described to the 2010 call from the Pan American Health Organization to develop a Regional Framework on Core Competencies in Public Health, with a view to supporting the efforts of the countries in the Americas to build public health systems capacity as a strategy for optimal performance of the Essential Public Health Functions. The methodological process for the response was divided into four phases. In the first, a team of experts was convened who defined the methodology to be used during a workshop at the National Institute of Public Health of Mexico in 2010. The second phase involved formation of the working groups, using two criteria: experience and multidisciplinary membership, which resulted in a regional team with 225 members from 12 countries. This team prepared an initial proposal with 88 competencies. In the third phase, the competencies were cross-validated and their number reduced to 64. During the fourth phase, which included two workshops, in March 2011 (Medellín, Colombia) and June 2011 (Lima, Peru), discussions centered on analyzing the association between the results and the methodology.

  10. [Toward a model of communications in public health in Latin America and the Caribbean].

    Science.gov (United States)

    Macías-Chapula, César A

    2005-12-01

    So far, there have been no bibliometric or scientometric studies that make it possible to examine, with quantitative, retrospective, and comprehensive criteria, the scientific output on public health in Latin America and the Caribbean (LAC). Further, the weakness of the existing information systems makes it impossible to examine the relevance, quality, and impact of this scientific output, with a view to evaluating it in terms of societal needs and existing patterns of scientific communication. This article presents the results of a bibliographic analysis of the scientific output in the area of public health in Latin America and the Caribbean. The ultimate goal of the analysis is to build a model of scientific communication in this field, to help researchers, managers, and others working in the area of public health to make decisions and choose actions to take. We conducted a literature review in order to identify the distribution of publications on public health that were produced by LAC researchers and published in each of the LAC countries from 1980 through 2002. The review used the Literatura Latino-Americana e do Caribe em Saúde Pública (LILACS-SP) (Latin American and Caribbean Literature on Public Health) bibliographic database. That database is operated by the Latin American and Caribbean Center on Health Sciences Information (BIREME), which is in São Paulo, Brazil. We processed the LILACS-SP data using two software packages, Microsoft Excel and Bibexcel, to obtain indicators of the scientific output, the type of document, the language, the number of authors for each publication, the thematic content, and the participating institutions. For the 1980-2002 period, there were 97,605 publications registered, from a total of 37 LAC countries. For the analysis presented in this article, we limited the sample to the 8 countries in Latin America and the Caribbean that had at least 3,000 documents each registered in the LILACS-SP database over the 1980-2002 study

  11. Effects of economic crises on population health outcomes in Latin America, 1981-2010: an ecological study.

    Science.gov (United States)

    Williams, Callum; Gilbert, Barnabas James; Zeltner, Thomas; Watkins, Johnathan; Atun, Rifat; Maruthappu, Mahiben

    2016-01-06

    The relative health effects of changes in unemployment, inflation and gross domestic product (GDP) per capita on population health have not been assessed. We aimed to determine the effect of changes in these economic measures on mortality metrics across Latin America. Ecological study. Latin America (21 countries), 1981-2010. Uses multivariate regression analysis to assess the effects of changes in unemployment, inflation and GDP per capita on 5 mortality indicators across 21 countries in Latin America, 1981-2010. Country-specific differences in healthcare infrastructure, population structure and population size were controlled for. Between 1981 and 2010, a 1% rise in unemployment was associated with statistically significant deteriorations (peconomics, policymakers should prioritise amelioration of unemployment if population health outcomes are to be optimised. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. WHO Global Survey on Maternal and Perinatal Health in Latin America: classifying caesarean sections

    Directory of Open Access Journals (Sweden)

    Faúndes Anibal

    2009-10-01

    Full Text Available Abstract Background Caesarean section rates continue to increase worldwide with uncertain medical consequences. Auditing and analysing caesarean section rates and other perinatal outcomes in a reliable and continuous manner is critical for understanding reasons caesarean section changes over time. Methods We analyzed data on 97,095 women delivering in 120 facilities in 8 countries, collected as part of the 2004-2005 Global Survey on Maternal and Perinatal Health in Latin America. The objective of this analysis was to test if the "10-group" or "Robson" classification could help identify which groups of women are contributing most to the high caesarean section rates in Latin America, and if it could provide information useful for health care providers in monitoring and planning effective actions to reduce these rates. Results The overall rate of caesarean section was 35.4%. Women with single cephalic pregnancy at term without previous caesarean section who entered into labour spontaneously (groups 1 and 3 represented 60% of the total obstetric population. Although women with a term singleton cephalic pregnancy with a previous caesarean section (group 5 represented only 11.4% of the obstetric population, this group was the largest contributor to the overall caesarean section rate (26.7% of all the caesarean sections. The second and third largest contributors to the overall caesarean section rate were nulliparous women with single cephalic pregnancy at term either in spontaneous labour (group 1 or induced or delivered by caesarean section before labour (group 2, which were responsible for 18.3% and 15.3% of all caesarean deliveries, respectively. Conclusion The 10-group classification could be easily applied to a multicountry dataset without problems of inconsistencies or misclassification. Specific groups of women were clearly identified as the main contributors to the overall caesarean section rate. This classification could help health care

  13. Meeting health and family planning needs in Latin America and the Caribbean.

    Science.gov (United States)

    1995-06-01

    The operations research and technical assistance (OR/TA) project in The Population Council has concentrated on fertility and infant mortality issues in Latin American and the Caribbean for more than a decade through INOPAL. INOPAL is an acronym for Investigacion Operacional en Planificacion Familiar y Atencion Materno-Infantil para America Latina y el Caribe (Operations Research in Family Planning and Maternal-Child Health in Latin America and the Caribbean). In March 1995, the project entered its third phase, INOPAL III, with the renewal of its contract from the United States Agency for International Development (USAID). To facilitate communication between INOPAL, collaborating agencies, and USAID, INOPAL Director James Foreit moved from Peru to a Council office in Washington, D.C. INOPAL has six objectives: 1) to test the integration of family planning and reproductive health services; 2) to increase access to family planning; 3) to develop strategies to reach special populations; 4) to improve the sustainability of family planning programs; 5) to improve service quality; and 6) to institutionalize operations research capability in the region. INOPAL II conducted 61 subprojects in 12 countries in collaboration with 24 USAID cooperating agencies and other international organizations. The project established new services for postpartum women, adolescents, and rural women; improved program quality and financial sustainability; increased vasectomy promotion and the range of available contraceptives; and developed new modes of service delivery. A key finding of INOPAL II operations research was the importance of increasing cost-effectiveness to ensure program sustainability. INOPAL III will work toward all six objectives, with an emphasis on integrating reproductive health and family planning services. Operations research and technical assistance (OR/TA) subprojects will focus on the prevention and treatment of sexually transmitted diseases, perinatal and postpartum

  14. HEALTH TECHNOLOGY ASSESSMENT FOR DECISION MAKING IN LATIN AMERICA: GOOD PRACTICE PRINCIPLES.

    Science.gov (United States)

    Pichon-Riviere, Andrés; Soto, Natalie C; Augustovski, Federico Ariel; García Martí, Sebastián; Sampietro-Colom, Laura

    2018-06-11

    The aim of this study was to identify good practice principles for health technology assessment (HTA) that are the most relevant and of highest priority for application in Latin America and to identify potential barriers to their implementation in the region. HTA good practice principles proposed at the international level were identified and then explored during a deliberative process in a forum of assessors, funders, and product manufacturers. Forty-two representatives from ten Latin American countries participated. Good practice principles proposed at the international level were considered valid and potentially relevant to Latin America. Five principles were identified as priority and with the greatest potential to be strengthened at this time: transparency in the production of HTA, involvement of relevant stakeholders in the HTA process, mechanisms to appeal decisions, clear priority-setting processes in HTA, and a clear link between HTA and decision making. The main challenge identified was to find a balance between the application of these principles and the available resources in a way that would not detract from the production of reports and adaptation to the needs of decision makers. The main recommendation was to progress gradually in strengthening HTA and its link to decision making by developing appropriate processes for each country, without trying to impose, in the short-term, standards taken from examples at the international level without adequate adaptation of these to local contexts.

  15. [Health technology assessment for decision-making in Latin America: good practice principles].

    Science.gov (United States)

    Pichon-Riviere, Andrés; Soto, Natalie C; Augustovski, Federico Ariel; García Martí, Sebastián; Sampietro-Colom, Laura

    2018-02-19

    Identify the most relevant, applicable, and priority good practice principles in health technology assessment (HTA) in Latin America, and potential barriers to implementing them in the region. HTA good practice principles postulated worldwide were identified and then explored through a deliberative process in a forum of evaluators, funders, and technology producers. Forty-two representatives from ten Latin American countries participated in the forum. The good practice principles postulated at the international level were considered valid and potentially applicable in Latin America. Five principles were identified as priorities and as having greater potential to be expanded at this time: transparency in carrying out HTA; involvement of stakeholders in the HTA process; existence of mechanisms to appeal decisions; existence of clear mechanisms for HTA priority-setting; and existence of a clear link between assessment and decision-making. The main challenge identified was to find a balance between application of these principles and available resources, to prevent the planned improvements from jeopardizing report production times and failing to meet decision-makers' needs. The main recommendation was to gradually advance in improving HTA and its link to decision-making by developing appropriate processes for each country, without attempting to impose, in the short term, standards taken from examples at the international level without adequate adaptation to the local context.

  16. Asian Indians in America: The influence of values and culture on mental health.

    Science.gov (United States)

    Chandra, Rohit M; Arora, Lily; Mehta, Urvakhsh M; Asnaani, Anu; Radhakrishnan, Rajiv

    2016-08-01

    Asian Indians represent a significant portion of the largest growing race of Asians in the past decade in the United States. This selective review examines major cultural themes related to first- and second-generation Asian Indians living in the United States as they impact psychological and psychiatric dysfunction in this population. Specifically, we review the impact of Asian Indian culture on mental health, discuss the impact of acculturation and ethnic identity development on the mental health of Indian-Americans, and focus on typical mental health problems of Asian Indian adolescents, women and elderly in America. Finally, we provide a brief overview of empirically-supported treatment approaches and cultural considerations for additional treatments relevant to this population. This review is intended to provide an important foundation for more systematic empirically-driven investigation into better understanding how Asian Indian cultural themes impact mental health for Indian-Americans, and how to develop effective treatments for these issues in this cultural group. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. [The Telehealth Network of the Americas and its role in primary health care].

    Science.gov (United States)

    Bill, Guillermo; Crisci, Carlos D; Canet, Tomislav

    2014-01-01

    The need to guarantee equitable access to health regardless of geographic, economic, or technological barriers motivated the Member States of the Organization of American States to create the Telehealth Network of the Americas, coordinated by the Inter-American Telecommunication Committee. The Network focuses on the use of new information and communications technology applied to health, based on the values of respect, equity, and solidarity and mandated by the philosophy of primary health. Its members include government agencies, nongovernmental organizations, university forums, hospital federations, and telecommunications companies, and it has already extended its reach to other continents and to different fields in which telemedicine is being used. Among its first achievements, it has implemented an innovative tool to be used in cases of disaster or limited geographic access. This mobile telemedicine station is housed in a portable case that includes a computer, various digital devices (otoscope, ophthalmoscope, microscope, dermatoscope), a high-resolution digital camera, an X-ray film viewer, and a satellite antenna. With this tool, it is possible to provide specialized support for rural physicians and primary health care workers located far from large urban centers.

  18. Impact of bullying victimization on suicide and negative health behaviors among adolescents in Latin America.

    Science.gov (United States)

    Romo, Matthew L; Kelvin, Elizabeth A

    2016-11-01

    To compare the prevalence of bullying victimization, suicidal ideation, suicidal attempts, and negative health behaviors (current tobacco use, recent heavy alcohol use, truancy, involvement in physical fighting, and unprotected sexual intercourse) in five different Latin American countries and determine the association of bullying victimization with these outcomes, exploring both bullying type and frequency. Study data were from Global School-based Student Health Surveys from Bolivia, Costa Rica, Honduras, Peru, and Uruguay, which covered nationally representative samples of school-going adolescents. The surveys used a two-stage clustered sample design, sampling schools and then classrooms. Logistic regression models were run to determine the statistical significance of associations with bullying. Among the 14 560 school-going adolescents included in this study, the prevalence of any bullying victimization in the past 30 days was 37.8%. Bullying victimization was associated with greater odds of suicidal ideation with planning (adjusted odds ratio (AOR): 3.12; P bullying victimization on suicide outcomes was also observed. Bullying victimization was associated with higher odds of current tobacco use (AOR: 2.14; P bullying victimization varied by country, its association with suicidal ideation and behavior and negative health behaviors remained relatively consistent. Addressing bullying needs to be made a priority in Latin America, and an integrated approach that also includes mental and physical health promotion is needed.

  19. Multinational corporations and health care in the United States and Latin America: strategies, actions, and effects.

    Science.gov (United States)

    Jasso-Aguilar, Rebeca; Waitzkin, Howard; Landwehr, Angela

    2004-01-01

    In this article we analyze the corporate dominance of health care in the United States and the dynamics that have motivated the international expansion of multinational health care corporations, especially to Latin America. We identify the strategies, actions, and effects of multinational corporations in health care delivery and public health policies. Our methods have included systematic bibliographical research and in-depth interviews in the United States, Mexico, and Brazil. Influenced by public policy makers in the United States, such organizations as the World Bank, International Monetary Fund, and World Trade Organization have advocated policies that encourage reduction and privatization of health care and public health services previously provided in the public sector. Multinational managed care organizations have entered managed care markets in several Latin American countries at the same time as they were withdrawing from managed care activities in Medicaid and Medicare within the United States. Corporate strategies have culminated in a marked expansion of corporations' access to social security and related public sector funds for the support of privatized health services. International financial institutions and multinational corporations have influenced reforms that, while favorable to corporate interests, have worsened access to needed services and have strained the remaining public sector institutions. A theoretical approach to these problems emphasizes the falling rate of profit as an economic motivation of corporate actions, silent reform, and the subordination of polity to economy. Praxis to address these problems involves opposition to policies that enhance corporate interests while reducing public sector services, as well as alternative models that emphasize a strengthened public sector

  20. Breaking Health Insurance Knowledge Barriers Through Games: Pilot Test of Health Care America

    Science.gov (United States)

    James, Juli

    2017-01-01

    Background Having health insurance is associated with a number of beneficial health outcomes. However, previous research suggests that patients tend to avoid health insurance information and often misunderstand or lack knowledge about many health insurance terms. Health insurance knowledge is particularly low among young adults. Objective The purpose of this study was to design and test an interactive newsgame (newsgames are games that apply journalistic principles in their creation, for example, gathering stories to immerse the player in narratives) about health insurance. This game included entry-level information through scenarios and was designed through the collation of national news stories, local personal accounts, and health insurance company information. Methods A total of 72 (N=72) participants completed in-person, individual gaming sessions. Participants completed a survey before and after game play. Results Participants indicated a greater self-reported understanding of how to use health insurance from pre- (mean=3.38, SD=0.98) to postgame play (mean=3.76, SD=0.76); t71=−3.56, P=.001. For all health insurance terms, participants self-reported a greater understanding following game play. Finally, participants provided a greater number of correct definitions for terms after playing the game, (mean=3.91, SD=2.15) than they did before game play (mean=2.59, SD=1.68); t31=−3.61, P=.001. Significant differences from pre- to postgame play differed by health insurance term. Conclusions A game is a practical solution to a difficult health issue—the game can be played anywhere, including on a mobile device, is interactive and will thus engage an apathetic audience, and is cost-efficient in its execution. PMID:29146564

  1. Respiratory health in Latin America: number of specialists and human resources training.

    Science.gov (United States)

    Vázquez-García, Juan-Carlos; Salas-Hernández, Jorge; Pérez Padilla, Rogelio; Montes de Oca, María

    2014-01-01

    Latin America is made up of a number of developing countries. Demographic changes are occurring in the close to 600 million inhabitants, in whom a significant growth in population is combined with the progressive ageing of the population. This part of the world poses great challenges for general and respiratory health. Most of the countries have significant, or even greater, rates of chronic respiratory diseases or exposure to risk. Human resources in healthcare are not readily available, particularly in the area of respiratory disease specialists. Academic training centers are few and even non-existent in the majority of the countries. The detailed analysis of these conditions provides a basis for reflection on the main challenges and proposals for the management and training of better human resources in this specialist area. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  2. Personal Strengths and Health Related Quality of Life in Dementia Caregivers from Latin America

    Directory of Open Access Journals (Sweden)

    Stephen K. Trapp

    2015-01-01

    Full Text Available The research literature has begun to demonstrate associations between personal strengths and enhanced psychosocial functioning of dementia caregivers, but these relationships have not been examined in the context of dementia caregivers in Latin America. The present study examined whether personal strengths, including resilience, optimism, and sense of coherence, were associated with mental and physical health related quality of life (HRQOL in 130 dementia caregivers in Mexico and Argentina. Structural equation modeling found that the personal strengths collectively accounted for 58.4% of the variance in caregiver mental HRQOL, and resilience, sense of coherence, and optimism each had unique effects. In comparison, the personal strengths together accounted for 8.9% of the variance in caregiver physical HRQOL, and only sense of coherence yielded a unique effect. These results underscore the need to construct and disseminate empirically supported interventions based in part on important personal strengths, particularly sense of coherence, for this underrepresented group.

  3. Personal Strengths and Health Related Quality of Life in Dementia Caregivers from Latin America

    Science.gov (United States)

    Trapp, Stephen K.; Perrin, Paul B.; Aggarwal, Richa; Peralta, Silvina Victoria; Stolfi, Miriam E.; Morelli, Eliana; Peña Obeso, Leticia Aracely; Arango-Lasprilla, Juan Carlos

    2015-01-01

    The research literature has begun to demonstrate associations between personal strengths and enhanced psychosocial functioning of dementia caregivers, but these relationships have not been examined in the context of dementia caregivers in Latin America. The present study examined whether personal strengths, including resilience, optimism, and sense of coherence, were associated with mental and physical health related quality of life (HRQOL) in 130 dementia caregivers in Mexico and Argentina. Structural equation modeling found that the personal strengths collectively accounted for 58.4% of the variance in caregiver mental HRQOL, and resilience, sense of coherence, and optimism each had unique effects. In comparison, the personal strengths together accounted for 8.9% of the variance in caregiver physical HRQOL, and only sense of coherence yielded a unique effect. These results underscore the need to construct and disseminate empirically supported interventions based in part on important personal strengths, particularly sense of coherence, for this underrepresented group. PMID:26160998

  4. Progress in reducing inequalities in reproductive, maternal, newborn,' and child health in Latin America and the Caribbean: an unfinished agenda

    OpenAIRE

    María Clara Restrepo-Méndez; Aluísio J. D. Barros; Jennifer Requejo; Pablo Durán; Luis Andrés de Francisco Serpa; Giovanny V. A. França; Fernando C. Wehrmeister; Cesar G. Victora

    2015-01-01

    OBJECTIVE: To expand the "Countdown to 2015" analyses of health inequalities beyond the 75 countries being monitored worldwide to include all countries in Latin America and the Caribbean (LAC) that have adequate data available. METHODS: Demographic and Health Surveys and Multiple Indicator Cluster Surveys were used to monitor progress in health intervention coverage and inequalities in 13 LAC countries, five of which are included in the Countdown (Bolivia, Brazil, Guatemala, Haiti, and Peru) ...

  5. Modern Earthworks and Their Cosmic Embrace

    Science.gov (United States)

    Hatch, J. G.

    2011-06-01

    This paper examines the use of sky imagery in a number of modern Earthworks. They range from Robert Smithson's Spiral Jetty (1970), Robert Morris' Observatory (1971), Nancy Holt's Sun Tunnels (1973-76), to ongoing manifestations like Charles Ross' Star Axis (1971-present) and James Turrell's Roden Crater Project (1974-present). My interest in discussing these various works is to look at why so many of them have focused on the firmament, what factors contributed to this interest, their specific meaning, what the various sites of these works have offered, and last but not least, their possible relationship to past Earth projects, like Stonehenge and Machu Picchu, for example, that have also embraced the sky as their subject.

  6. Nighttime Insomnia Symptoms and Perceived Health in the America Insomnia Survey (AIS)

    Science.gov (United States)

    Walsh, James K.; Coulouvrat, Catherine; Hajak, Goeran; Lakoma, Matthew D.; Petukhova, Maria; Roth, Thomas; Sampson, Nancy A.; Shahly, Victoria; Shillington, Alicia; Stephenson, Judith J.; Kessler, Ronald C.

    2011-01-01

    ; Stephenson JJ; Kessler RC. Nighttime insomnia symptoms and perceived health in the America Insomnia Survey (AIS). SLEEP 2011;34(8):997-1011. PMID:21804662

  7. The Roots of North America's First Comprehensive Public Health Insurance System

    Directory of Open Access Journals (Sweden)

    Ostry, Aleck

    2001-06-01

    Full Text Available The Canadian province of Saskatchewan in 1944 it inherited a long tradition of "socialized" medicine in many rural regions. However, urban medicine was based on fee-for-service payment of physicians and no private health insurance. In crafting North America's first public health insurance system, the government built on the rural medical infrastructure already in place by expanding a rural salaried system of physician payment and successfully promoted a regional comprehensive insurance system piloted in a southern region of the province. However, major demographic shifts from countryside to city during the 1950s, burgeoning physician supply, increased immigration of physicians into the provinces' cities, and aggressive expansion of urban-based private insurance for physician services into rural regions, shifted the balance of medical power away from rural towards urban centers in the province. The increasing resistance, by the medical profession, to health-care reform in Saskatchewan in the 1950s must be considered within a geographic framework as rural regions of the province became the major battleground between government and insurance third party payers. While historical comparisons should not be overstated, re-visiting this struggle may be useful in the current era in which the pressure for privatization of the medical system in Canada appear to be growing.

  8. Social capital, income inequality and the social gradient in self-rated health in Latin America: A fixed effects analysis.

    Science.gov (United States)

    Vincens, Natalia; Emmelin, Maria; Stafström, Martin

    2018-01-01

    Latin America is the most unequal region in the world. The current sustainable development agenda increased attention to health inequity and its determinants in the region. Our aim is to investigate the social gradient in health in Latin America and assess the effects of social capital and income inequality on it. We used cross-sectional data from the World Values Survey and the World Bank. Our sample included 10,426 respondents in eight Latin American countries. Self-rated health was used as the outcome. Education level was the socioeconomic position indicator. We measured social capital by associational membership, civic participation, generalized trust, and neighborhood trust indicators at both individual and country levels. Income inequality was operationalized using the Gini index at country-level. We employed fixed effects logistic regressions and cross-level interactions to assess the impact of social capital and income inequality on the heath gradient, controlling for country heterogeneity. Education level was independently associated with self-rated health, representing a clear social gradient in health, favoring individuals in higher socioeconomic positions. Generalized and neighborhood trust at country-level moderated the effect on the association between socioeconomic position and health, yet favoring individuals in lower socioeconomic positions, especially in lower inequality countries, despite their lower individual social capital. Our findings suggest that collective rather than individual social capital can impact the social gradient in health in Latin America, explaining health inequalities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Improving adolescent sexual and reproductive health in Latin America: reflections from an International Congress.

    Science.gov (United States)

    Córdova Pozo, Kathya; Chandra-Mouli, Venkatraman; Decat, Peter; Nelson, Erica; De Meyer, Sara; Jaruseviciene, Lina; Vega, Bernardo; Segura, Zoyla; Auquilla, Nancy; Hagens, Arnold; Van Braeckel, Dirk; Michielsen, Kristien

    2015-01-24

    In February 2014, an international congress on Promoting Adolescent Sexual and Reproductive Health (ASRH) took place in Cuenca, Ecuador. Its objective was to share evidence on effective ASRH intervention projects and programs in Latin America, and to link this evidence to ASRH policy and program development. Over 800 people participated in the three-day event and sixty-six presentations were presented.This paper summarizes the key points of the Congress and of the Community Embedded Reproductive Health Care for Adolescents (CERCA) project. It aims at guiding future ASRH research and policy in Latin America. 1. Context matters. Individual behaviors are strongly influenced by the social context in which they occur, through determinants at the individual, relational, family, community and societal levels. Gender norms/attitudes and ease of communication are two key determinants. 2. Innovative action. There is limited and patchy evidence of effective approaches to reach adolescents with the health interventions they need at scale. Yet, there exist several promising and innovative examples of providing comprehensive sexuality education through conventional approaches and using new media, improving access to health services, and reaching adolescents as well as families and community members using community-based interventions were presented at the Congress. 3. Better measurement. Evaluation designs and indicators chosen to measure the effect and impact of interventions are not always sensitive to subtle and incremental changes. This can create a gap between measured effectiveness and the impact perceived by the targeted populations. Thus, one conclusion is that we need more evidence to better determine the factors impeding progress in ASRH in Latin American, to innovate and respond flexibly to changing social dynamics and cultural practices, and to better measure the impact of existing intervention strategies. Yet, this Congress offered a starting point from which to

  10. Pediatric SCI/D caregiver mental health and family dynamics in Colombia, South America.

    Science.gov (United States)

    Doyle, Sarah T; Perrin, Paul B; Nicholls, Elizabeth; Olivera, Silvia Leonor; Quintero, Lorena Medina; Otálvaro, Nadezda Yulieth Méndez; Arango-Lasprilla, Juan Carlos

    2016-01-01

    This study examined the connections between family dynamics and the mental health of caregivers of youth with spinal cord injuries/disorders (SCI/D) caregivers from Colombia, South America. It was hypothesized that lower family functioning would be associated with poorer caregiver mental health. A cross-sectional study of self-report data collected from caregivers through the Hospital Universatario Hernando Moncaleano Perdomo in Neiva, Colombia. Thirty caregivers of children with SCI/D from Nevia, Colombia who were a primary caregiver for ≥3 months, providing care for an individual who was ≥6 months post-injury/diagnosis, familiar with the patient's history, and without neurological or psychiatric conditions. Caregivers' average age was 41.30 years (SD = 10.98), and 90% were female. Caregivers completed Spanish versions of instruments assessing their own mental health and family dynamics. Family dynamics explained 43.2% of the variance in caregiver burden and 50.1% of the variance in satisfaction with life, although family dynamics were not significantly associated with caregiver depression in the overall analysis. Family satisfaction was the only family dynamics variable to yield a significant unique association with any index of caregiver mental health (satisfaction with life). If similar findings emerge in future intervention research, interventions for pediatric SCI/D caregivers in Colombia and other similar global regions could benefit from including techniques to improve family dynamics, especially family satisfaction, given the strong potentially reciprocal connection between these dynamics and caregiver mental health. The degree of disability resulting from SCI/D can vary greatly depending on the severity and level of the lesion, though permanent impairment is often present that profoundly impacts both physical and psychological functioning. Very little is known about the impact of pediatric SCI/D in developing countries, despite the high rates of

  11. Family Planning in the Context of Latin America's Universal Health Coverage Agenda.

    Science.gov (United States)

    Fagan, Thomas; Dutta, Arin; Rosen, James; Olivetti, Agathe; Klein, Kate

    2017-09-27

    Countries in Latin America and the Caribbean (LAC) have substantially improved access to family planning over the past 50 years. Many have also recently adopted explicit declarations of universal rights to health and universal health coverage (UHC) and have begun implementing UHC-oriented health financing schemes. These schemes will have important implications for the sustainability and further growth of family planning programs throughout the region. We examined the status of contraceptive methods in major health delivery and financing schemes in 9 LAC countries. Using a set of 37 indicators on family planning coverage, family planning financing, health financing, and family planning inclusion in UHC-oriented schemes, we conducted a desk review of secondary sources, including population surveys, health financing assessments, insurance enrollment reports, and unit cost estimates, and interviewed in-country experts. Findings: Although the modern contraceptive prevalence rate (mCPR) has continued to increase in the majority of LAC countries, substantial disparities in access for marginalized groups remain. On average, mCPR is 20% lower among indigenous women than the general population, 5% lower among uninsured women than insured, and 7% lower among the poorest women than the wealthiest. Among the poorest quintile of women, insured women had an mCPR 16.5 percentage points higher than that of uninsured women, suggesting that expansion of insurance coverage is associated with increased family planning access and use. In the high- and upper-middle-income countries we reviewed, all modern contraceptive methods are typically available through the social health insurance schemes that cover a majority of the population. However, in low- and lower-middle-income countries, despite free provision of most family planning services in public health facilities, stock-outs and implicit rationing present substantial barriers that prevent clients from accessing their preferred method

  12. [Conditions for universal access to health in Latin America: social rights, social protection and financial and political constraints].

    Science.gov (United States)

    Sojo, Ana

    2011-06-01

    After a brief review of the concept of health equity and its social and sectoral determinants, some macroeconomic aspects of health expenditure in Latin America are considered. Given the significant contemporary tensions with regard to social rights and the definition of health benefits, three emblematic experiences are analyzed in very different health systems, namely those of Chile, Colombia and Mexico. They cover different aspects, such as the guarantee of health benefits, the reduction of forms of implicit rationing and/or barriers to admission, and also aspects related to the quality of services.

  13. Protecting America's economy, environment, health, and security against invasive species requires a strong federal program in systematic biology

    Science.gov (United States)

    Hilda Diaz-Soltero; Amy Y. Rossman

    2011-01-01

    Systematics is the science that identifies and groups organisms by understanding their origins, relationships, and distributions. It is fundamental to understanding life on earth, our crops, wildlife, and diseases, and it provides the scientific foundation to recognize and manage invasive species. Protecting America's economy, environment, health, and security...

  14. Flavonoids and heart health: Proceedings of the ILSI North America Flavonoids Workshop may 31-june 1, 2005, Washington DC

    NARCIS (Netherlands)

    Erdman, J.W.; Balentine, D.; Arab, L.; Beecher, G.; Dwyer, J.T.; Folts, J.; Harnly, J.; Hollman, P.C.H.; Keen, C.L.; Mazza, G.; Messina, M.; Scalbert, A.; Vita, J.; Williamson, G.; Burrows, J.

    2007-01-01

    This article provides an overview of current research on flavonoids as presented during a workshop entitled, "Flavonoids and Heart Health," held by the ILSI North America Project Committee on Flavonoids in Washington, DC, May 31 and June 1, 2005. Because a thorough knowledge and understanding about

  15. Community embedded reproductive health interventions for adolescents in Latin America: development and evaluation of a complex multi-centre intervention

    NARCIS (Netherlands)

    Decat, P.; Nelson, E.; de Meyer, S.; Jaruseviciene, L.; Orozco, M.; Segura, Z.; Gorter, A.; Vega, B.; Cordova, K.; Maes, L.; Temmerman, M.; Leye, E.; Degomme, O.

    2013-01-01

    Background Adolescents in Latin America are at high risk for unwanted and unplanned pregnancies, which often result in unsafe abortions or poor maternal health outcomes. Both young men and women in the region face an increased risk of sexually transmitted infections due to inadequate sexual and

  16. "A Fair Chance for the Girls": Discourse on Women's Health and Higher Education in Late Nineteenth Century America

    Science.gov (United States)

    Tsang, Tiffany Lee

    2015-01-01

    Histories of education in America often discuss how concerns over women's health influenced public opinion on women's participation in higher education in the late nineteenth century. However, these histories almost exclusively focus on literature produced by the medical community--literature claiming that rigorous academic study was detrimental…

  17. Distancing, not embracing, the Distancing-Embracing model of art reception.

    Science.gov (United States)

    Davies, Stephen

    2017-01-01

    Despite denials in the target article, the Distancing-Embracing model appeals to compensatory ideas in explaining the appeal of artworks that elicit negative affect. The model also appeals to the deflationary effects of psychological distancing. Having pointed to the famous rejection in the 1960s of the view that aesthetic experience involves psychological distancing, I suggest that "distance" functions here as a weak metaphor that cannot sustain the explanatory burden the theory demands of it.

  18. The forsaken mental health of the Indigenous Peoples - a moral case of outrageous exclusion in Latin America.

    Science.gov (United States)

    Incayawar, Mario; Maldonado-Bouchard, Sioui

    2009-10-29

    Mental health is neglected in most parts of the world. For the Indigenous Peoples of Latin America, the plight is even more severe as there are no specific mental health services designed for them altogether. Given the high importance of mental health for general health, the status quo is unacceptable. Lack of research on the subject of Indigenous Peoples' mental health means that statistics are virtually unavailable. To illustrate their mental health status, one can nonetheless point to the high rates of poverty and extreme poverty in their communities, overcrowded housing, illiteracy, and lack of basic sanitary services such as water, electricity and sewage. At the dawn of the XXI century, they remain poor, powerless, and voiceless. They remain severely excluded from mainstream society despite being the first inhabitants of this continent and being an estimated of 48 million people. This paper comments, specifically, on the limited impact of the Pan American Health Organization's mental health initiative on the Indigenous Peoples of Latin America. The Pan American Health Organization's sponsored workshop "Programas y Servicios de Salud Mental en Communidades Indígenas" [Mental Health Programs and Services for the Indigenous Communities] in the city of Santa Cruz, Bolivia on July16 - 18, 1998, appeared promising. However, eleven years later, no specific mental health program has been designed nor developed for the Indigenous Peoples in Latin America. This paper makes four specific recommendations for improvements in the approach of the Pan American Health Organization: (1) focus activities on what can be done; (2) build partnerships with the Indigenous Peoples; (3) consider traditional healers as essential partners in any mental health effort; and (4) conduct basic research on the mental health status of the Indigenous Peoples prior to the programming of any mental health service. The persistent neglect of the Indigenous Peoples' mental health in Latin America

  19. The forsaken mental health of the Indigenous Peoples - a moral case of outrageous exclusion in Latin America

    Directory of Open Access Journals (Sweden)

    Maldonado-Bouchard Sioui

    2009-10-01

    Full Text Available Abstract Background Mental health is neglected in most parts of the world. For the Indigenous Peoples of Latin America, the plight is even more severe as there are no specific mental health services designed for them altogether. Given the high importance of mental health for general health, the status quo is unacceptable. Lack of research on the subject of Indigenous Peoples' mental health means that statistics are virtually unavailable. To illustrate their mental health status, one can nonetheless point to the high rates of poverty and extreme poverty in their communities, overcrowded housing, illiteracy, and lack of basic sanitary services such as water, electricity and sewage. At the dawn of the XXI century, they remain poor, powerless, and voiceless. They remain severely excluded from mainstream society despite being the first inhabitants of this continent and being an estimated of 48 million people. This paper comments, specifically, on the limited impact of the Pan American Health Organization's mental health initiative on the Indigenous Peoples of Latin America. Discussion The Pan American Health Organization's sponsored workshop "Programas y Servicios de Salud Mental en Communidades Indígenas" [Mental Health Programs and Services for the Indigenous Communities] in the city of Santa Cruz, Bolivia on July16 - 18, 1998, appeared promising. However, eleven years later, no specific mental health program has been designed nor developed for the Indigenous Peoples in Latin America. This paper makes four specific recommendations for improvements in the approach of the Pan American Health Organization: (1 focus activities on what can be done; (2 build partnerships with the Indigenous Peoples; (3 consider traditional healers as essential partners in any mental health effort; and (4 conduct basic research on the mental health status of the Indigenous Peoples prior to the programming of any mental health service. Summary The persistent neglect of

  20. Embracing Racism: Understanding Its Pervasiveness & Persistence

    Science.gov (United States)

    Williams, Gary L.

    2012-01-01

    The legacy of slavery and racism in America and the history of what John C. Calhoun and other Southern leaders of the 1800s called "our peculiar institution" has not gone unnoticed. Neither has the psychological damage that remains as baggage carried by the descendents of both the slave and the slave owner (Berry & Blassingame, 1982;…

  1. Impact of bullying victimization on suicide and negative health behaviors among adolescents in Latin America

    Directory of Open Access Journals (Sweden)

    Matthew L. Romo

    Full Text Available ABSTRACT Objective To compare the prevalence of bullying victimization, suicidal ideation, suicidal attempts, and negative health behaviors (current tobacco use, recent heavy alcohol use, truancy, involvement in physical fighting, and unprotected sexual intercourse in five different Latin American countries and determine the association of bullying victimization with these outcomes, exploring both bullying type and frequency. Methods Study data were from Global School–based Student Health Surveys from Bolivia, Costa Rica, Honduras, Peru, and Uruguay, which covered nationally representative samples of school-going adolescents. The surveys used a two-stage clustered sample design, sampling schools and then classrooms. Logistic regression models were run to determine the statistical significance of associations with bullying. Results Among the 14 560 school-going adolescents included in this study, the prevalence of any bullying victimization in the past 30 days was 37.8%. Bullying victimization was associated with greater odds of suicidal ideation with planning (adjusted odds ratio (AOR: 3.12; P < 0.0001 and at least one suicide attempt (AOR: 3.07; P < 0.0001. An increasing exposure–response effect of increasing days of bullying victimization on suicide outcomes was also observed. Bullying victimization was associated with higher odds of current tobacco use (AOR: 2.14; P < 0.0001; truancy (AOR: 1.76; P < 0.0001; physical fighting (AOR: 2.40; P < 0.0001; and unprotected sexual intercourse (AOR: 1.77; P < 0.0001. Conclusions Although the prevalence of bullying victimization varied by country, its association with suicidal ideation and behavior and negative health behaviors remained relatively consistent. Addressing bullying needs to be made a priority in Latin America, and an integrated approach that also includes mental and physical health promotion is needed.

  2. Effects of economic crises on population health outcomes in Latin America, 1981–2010: an ecological study

    Science.gov (United States)

    Williams, Callum; Gilbert, Barnabas James; Zeltner, Thomas; Watkins, Johnathan; Atun, Rifat; Maruthappu, Mahiben

    2016-01-01

    Objectives The relative health effects of changes in unemployment, inflation and gross domestic product (GDP) per capita on population health have not been assessed. We aimed to determine the effect of changes in these economic measures on mortality metrics across Latin America. Design Ecological study. Setting Latin America (21 countries), 1981–2010. Outcome measures Uses multivariate regression analysis to assess the effects of changes in unemployment, inflation and GDP per capita on 5 mortality indicators across 21 countries in Latin America, 1981–2010. Country-specific differences in healthcare infrastructure, population structure and population size were controlled for. Results Between 1981 and 2010, a 1% rise in unemployment was associated with statistically significant deteriorations (pinflation rate was associated with significant deteriorations (pinflation, significant deteriorations (pinflation. Conclusions Rises in unemployment and inflation are associated with long-lasting deteriorations in several population health outcomes. Unemployment exerted much larger effects on health than inflation. In contrast, changes in GDP per capita had almost no association with the explored health outcomes. Contrary to neoclassical development economics, policymakers should prioritise amelioration of unemployment if population health outcomes are to be optimised. PMID:26739715

  3. Embracing the complexity of educational programmes

    Directory of Open Access Journals (Sweden)

    Elly Govers

    2016-12-01

    Full Text Available Systems of monitoring and control have left many educators and organisations in the field of post-compulsory education struggling to find ways to meet the needs of an increasingly diverse society. Education is complex. Many educators would agree that it is influenced by many, often contradictory, voices and power structures. Based on the findings of a case study involving multiple programmes in a post-compulsory education institution in Aotearoa/New Zealand, this paper aims to unravel this complexity for the case of educational programmes. It describes how programmes can be seen as complex systems, created by people and directed by discourses in society, some of which are more influential than others. If programmes are seen as complex systems, the experience of struggle as referred to above can be understood as a consequence of the attempt to control the complexity rather than work with it. This control limits the possibilities for development and innovation. Alternatively, as this paper will explain, acknowledging and embracing the complexity of programmes helps open up spaces for innovation that would otherwise remain hidden. It is argued that the ultimate space for change is educators’ personal and collective responsibility for the discourses in society they choose to follow.

  4. [International financing for cooperation to develop health in Latin America and the Caribbean].

    Science.gov (United States)

    De Los Ríos, Rebecca; Arósquipa, Carlos; Vigil-Oliver, William

    2011-08-01

    The purpose of this study is (a) to examine the ways in which Latin America and the Caribbean (LAC) have benefited from increases in international development assistance for health (DAH) at the global level and whether the trend observed after the Millennium Summit has also applied to the Region; (b) to determine whether there are differences in the distribution of this assistance, based on the gross per capita income of each country; (c) to identify the possible effects of the 2008 international financial crisis on official bilateral assistance; and (d) to compare trends in public health expenditure in relation to DAH before and after the Millennium Summit. The study has found that DAH in LAC follows a very different pattern than in other regions of the world. The period from 1997 to 2008 was one of fluctuating stagnation, with average annual disbursements of US$ 1 200 million. Multilateral financial institutions accounted for 79% of the average disbursements in the upper-middle income countries between 2002 and 2008, while official bilateral assistance held the greatest share (61%) in the low- and lower-middle income countries. Bilateral assistance grew at an annual rate of 13% during this period, but in the year after the crisis, disbursements fell to US$ 20 million. Sixty-four percent of bilateral assistance came from the United States, Spain, and Canada, with 29% of it being directed to HIV/AIDS and sexually transmitted diseases. After the Millennium Summit DAH channeled to governments decreased 30% in the period 2001-2006, and its share of public health expenditure in the region was 0.3% for the same period, with an equally marginal proportion in relation to total health expenditure for 2008 (0.37%; US$ 2 per capita). The study concludes that after the Millennium Summit, DAH in LAC did not grow nor did it equal the trends prior to 2000, and public health expenditure followed its historical growth trend, without further increases in relation to the regional

  5. International programs and veterinary public health in the Americas--success, challenges, and possibilities.

    Science.gov (United States)

    Arambulo, Primo

    2008-09-15

    The veterinary public health (VPH) program at the Pan American Health Organization (PAHO) began in 1949 when an arrangement with the newly founded World Health Organization made PAHO its Regional Office for the Americas to serve as the specialized health agency both for the Organization of American States and the United Nations. It started as a Section of Veterinary Medicine to help eradicate rabies on both sides of the US-Mexico border, and PAHO grew to be the biggest VPH program in the world. By providing a political and technical base, PAHO assisted its member states to organize and develop their national VPH programs and activities, and it provides technical cooperation and works with their national counterparts to solve national and local problems. In the 1980s and 1990s, PAHO concentrated that cooperation on several, specific needs: the elimination of dog-transmitted human rabies, hemispheric eradication of foot-and-mouth disease (FMD), regional action planning for food safety, control/eradication of bovine tuberculosis and brucellosis, and surveillance and prevention of emerging zoonoses and food-borne diseases. The Pan American centers developed a number of diagnostic antigens and a continental system for the surveillance of FMD and vesicular diseases, using geographic quadrant technology to augment sensitivity, analyze data, and make decisions. Another visible accomplishment is the elimination of hydatidosis in the endemic countries and regions of the southern cone. In addition, the VPH program of PAHO pioneered the mobilization of the private sector to participate in official programs. Nevertheless, privatization of animal and human health services has had a negative effect on human resources and infrastructure by weakening essential epidemiological functions in some countries. Today, there is a need for closer coordination between veterinary medicine and medical services. Practically all potential bioterrorism agents are zoonoses, and it is cost

  6. [The report of the Commission on Macroeconomics and Health: its relevance to the countries of Latin America and the Caribbean].

    Science.gov (United States)

    2002-09-01

    The Commission on Macroeconomics and Health (CMH) was established by the Director-General of the World Health Organization (WHO) to evaluate the role of health in economic development. On 20 December 2001 the CMH submitted its report to the WHO Director-General. Entitled Macroeconomics and Health: Investing in Health for Economic Development, the CMH report affirms that in order to reduce poverty; and achieve economic development, it is essential to improve the health of the poor; to accomplish this, it is necessary to expand the access that the poor have to essential health services. The Commission believes that more financial resources are needed, that the health expenditures of less-developed and low-income countries are insufficient for the challenges that these countries face, and that high-income countries must increase their financial assistance in order to help solve the main health problems of less-developed and low-income countries. This piece summarizes a report that was prepared by the Program on Public Policy and Health of the Division of Health and Human Development of the Pan American Health Organization (PAHO). The PAHO document analyzes the importance of the CMH report for the countries of Latin America and the Caribbean, focusing on some of the central arguments put forth in the CMH report as they relate to achieving better health conditions in the Americas. These arguments have been organized around three major themes in the CMH report: a) the relationships between health and economic growth, b) the principal health problems that affect the poor in low-income and low-middle-income#10; countries, and c) the gap between the funding needed to address the principal problems that affect these countries and the actual spending levels. #10;

  7. Toward a Culturally Responsive Model of Mental Health Literacy: Facilitating Help-Seeking Among East Asian Immigrants to North America.

    Science.gov (United States)

    Na, Sumin; Ryder, Andrew G; Kirmayer, Laurence J

    2016-09-01

    Studies have consistently found that East Asian immigrants in North America are less likely to use mental health services even when they experience levels of distress comparable to Euro-Americans. Although cultural factors that may prevent East Asian immigrants from seeking mental health care have been identified, few studies have explored ways to foster appropriate help-seeking and use of mental health services. Recent work on mental health literacy provides a potential framework for strategies to increase appropriate help-seeking and use of services. This paper reviews the literature on help-seeking for mental health problems among East Asian immigrants living in Western countries to critically assess the relevance of the mental health literacy approach as a framework for interventions to improve appropriate use of services. Modifications needed to develop a culturally responsive framework for mental health literacy are identified. © Society for Community Research and Action 2016.

  8. Public health foodborne illness case study during a Special Operations Forces deployment to South America.

    Science.gov (United States)

    McCown, Michael; Grzeszak, Benjamin

    2010-01-01

    Although many public health articles have been published detailing foodborne illness outbreaks, a medical literature search revealed no articles that detail a case study or a specific response of a deployed U.S. military unit to a potential foodborne illness. This article describes a recent public health case study of a U.S. Special Operations Forces (SOF) team sickened while deployed to South America. It highlights public health factors which may affect U.S. personnel deployed or serving overseas and may serve as a guide for a deployed SOF medic to reference in response to a potential food- or waterborne illness outbreak. Eight food samples and five water samples were collected. The food samples were obtained from the host nation kitchen that provided food to the SOF team. The water samples were collected from the kitchen as well as from multiple sites on the host nation base. These samples were packaged in sterile containers, stored at appropriate temperatures, and submitted to a U.S. Army diagnostic laboratory for analysis. Laboratory results confirmed the presence of elevated aerobic plate counts (APCs) in the food prepared by the host nation and consumed by the SOF team. High APCs in food are the primary indicator of improper sanitation of food preparation surfaces and utensils. This case study concluded that poor kitchen sanitation, improper food storage, preparation, and/or holding were the probable conditions that led to the team?s symptoms. These results emphasize the importance of ensuring safe food and water for U.S. personnel serving overseas, especially in a deployment or combat setting. Contaminated food and/or water will negatively impact the health and availability of forces, which may lead to mission failure. The SOF medic must respond to potential outbreaks and be able to (1) critically inspect food preparation areas and accurately advise commanders in order to correct deficiencies and (2) perform food/water surveillance testing consistently

  9. The quest for equity in Latin America: a comparative analysis of the health care reforms in Brazil and Colombia

    Science.gov (United States)

    2012-01-01

    Introduction Brazil and Colombia have pursued extensive reforms of their health care systems in the last couple of decades. The purported goals of such reforms were to improve access, increase efficiency and reduce health inequities. Notwithstanding their common goals, each country sought a very different pathway to achieve them. While Brazil attempted to reestablish a greater level of State control through a public national health system, Colombia embraced market competition under an employer-based social insurance scheme. This work thus aims to shed some light onto why they pursued divergent strategies and what that has meant in terms of health outcomes. Methods A critical review of the literature concerning equity frameworks, as well as the health care reforms in Brazil and Colombia was conducted. Then, the shortfall inequality values of crude mortality rate, infant mortality rate, under-five mortality rate, and life expectancy for the period 1960-2005 were calculated for both countries. Subsequently, bivariate and multivariate linear regression analyses were performed and controlled for possibly confounding factors. Results When controlling for the underlying historical time trend, both countries appear to have experienced a deceleration of the pace of improvements in the years following the reforms, for all the variables analyzed. In the case of Colombia, some of the previous gains in under-five mortality rate and crude mortality rate were, in fact, reversed. Conclusions Neither reform seems to have had a decisive positive impact on the health outcomes analyzed for the defined time period of this research. This, in turn, may be a consequence of both internal characteristics of the respective reforms and external factors beyond the direct control of health reformers. Among the internal characteristics: underfunding, unbridled decentralization and inequitable access to care seem to have been the main constraints. Conversely, international economic adversities

  10. Prioritization of strategies to approach the judicialization of health in Latin America and the Caribbean.

    Science.gov (United States)

    Pinzón-Flórez, Carlos Eduardo; Chapman, Evelina; Cubillos, Leonardo; Reveiz, Ludovic

    2016-09-01

    To describe strategies that contribute to the comprehensive approach to the judicialization of health in countries of Latin America and the Caribbean. A search was structured to identify articles presenting strategies to approach the judicialization of health. A survey was designed, which included actors of the health system and judiciary sector. We prioritized the strategies qualified by more than the 50.0% of the participants as "very relevant". Strategies were categorized according to: governance, provision of services, human resources, information systems, financing, and medical products. We included 64 studies, which identified 50 strategies, related to the sub-functions and components of health systems. Of the 165 people who answered the survey, 80.0% were aged 35-64 years. The distribution of men and women was homogeneous. Half of the respondents were from Colombia (20.0%), Uruguay (16.9%), and Argentina (12.7%). We prioritized strategies that addressed aspects of generation of useful scientific evidence for decision making according to the health needs of the population, empowerment for the society, and creating spaces for discussion of measures of inclusion or exclusion of health technologies. The executive and judiciary decision makers prioritized questions that dealt with strategies that would ensure accountability. The results of this study contribute to the identification of effective strategies to approach the phenomenon of judicialization of health, guaranteeing the right to health. Describir estrategias que contribuyan al abordaje integral de la judicialización de la salud en países de América Latina y El Caribe. Se estructuró una búsqueda para identificar artículos que presentaran estrategias para el abordaje de la judicialización en salud. Se diseñó una encuesta, en donde se incluyeron actores del sistema de salud y del sector judicial. Se priorizaron las estrategias calificadas por más del 50,0% de los participantes como "muy relevantes

  11. Examining gender equity in health policies in a low- (Peru), middle- (Colombia), and high- (Canada) income country in the Americas.

    Science.gov (United States)

    Stewart, Donna E; Dorado, Linda M; Diaz-Granados, Natalia; Rondon, Marta; Saavedra, Javier; Posada-Villa, Jose; Torres, Yolanda

    2009-12-01

    Gender inequities in health prevail in most countries despite ongoing attempts to eliminate them. Assessment of gender-sensitive health policies can be used to identify country specific progress as well as gaps and issues that need to be addressed to meet health equity goals. This study selected and measured the existence of gender-sensitive health policies in a low- (Peru), middle- (Colombia), and high (Canada)-income country in the Americas. Investigators selected 10 of 20 gender-sensitive health policy indicators and found eight to be feasible to measure in all three countries, although the wording and scope varied. The results from this study inform policy makers and program planners who aim to develop, improve, implement, and monitor national gender-sensitive health policies. Future studies should assess the implementation of policy indicators within countries and assess their performance in increasing gender equity.

  12. A Pan American Health Organization strategy for cervical cancer prevention and control in Latin America and the Caribbean.

    Science.gov (United States)

    Luciani, Silvana; Andrus, Jon Kim

    2008-11-01

    Cervical cancer is the leading cause of cancer deaths among women in Latin America and the Caribbean, and disproportionately affects poorer women. Mortality rates in the region are seven times greater than in North America. In light of the significant public health burden, the Pan American Health Organization has drafted a Regional Strategy for Cervical Cancer Prevention and Control. The Strategy calls for increased action to strengthen programmes through an integrated package of services: health information and education; screening and pre-cancer treatment; invasive cervical cancer treatment and palliative care; and evidence-based policy decisions on whether and how to introduce human papillomavirus (HPV) vaccines. It calls for a seven-point plan of action: conduct a situation analysis; intensify information, education and counselling; scale up screening and link to pre-cancer treatment; strengthen information systems and cancer registries; improve access to and quality of cancer treatment and palliative care; generate evidence to facilitate decision-making regarding HPV vaccine introduction; and advocate for equitable access and affordable HPV vaccines. This proposed strategy, approved by the PAHO Directing Council on 1 October 2008, has the possibility of stimulating and accelerating the introduction of new screening technology and HPV vaccines into programmes throughout Latin America and the Caribbean.

  13. The situation of nursing education in Latin America and the Caribbean towards universal health.

    Science.gov (United States)

    Cassiani, Silvia Helena De Bortoli; Wilson, Lynda Law; Mikael, Sabrina de Souza Elias; Peña, Laura Morán; Grajales, Rosa Amarilis Zarate; McCreary, Linda L; Theus, Lisa; Agudelo, Maria Del Carmen Gutierrez; Felix, Adriana da Silva; Uriza, Jacqueline Molina de; Gutierrez, Nathaly Rozo

    2017-05-11

    to assess the situation of nursing education and to analyze the extent to which baccalaureate level nursing education programs in Latin America and the Caribbean are preparing graduates to contribute to the achievement of Universal Health. quantitative, descriptive/exploratory, cross-sectional study carried out in 25 countries. a total of 246 nursing schools participated in the study. Faculty with doctoral level degrees totaled 31.3%, without Brazil this is reduced to 8.3%. The ratio of clinical experiences in primary health care services to hospital-based services was 0.63, indicating that students receive more clinical experiences in hospital settings. The results suggested a need for improvement in internet access; information technology; accessibility for the disabled; program, faculty and student evaluation; and teaching/learning methods. there is heterogeneity in nursing education in Latin America and the Caribbean. The nursing curricula generally includes the principles and values of Universal Health and primary health care, as well as those principles underpinning transformative education modalities such as critical and complex thinking development, problem-solving, evidence-based clinical decision-making, and lifelong learning. However, there is a need to promote a paradigm shift in nursing education to include more training in primary health care. avaliar a situação da educação em enfermagem e analisar o quanto os programas de educação em enfermagem, no nível de Bacharelado na América Latina e no Caribe, estão preparando graduados a contribuir para o alcance da Saúde Universal. estudo quantitativo, descritivo/exploratório, transversal, realizado em 25 países. um total de 246 escolas de enfermagem participaram do estudo. O corpo docente com nível de Doutorado totalizou 31,3%; sem o Brasil o número fica reduzido a 8,3%. A razão entre experiências clínicas nos serviços de atenção primária à saúde e nos serviços hospitalares foi de 0

  14. Ubiquitous wireless ECG recording: a powerful tool physicians should embrace.

    Science.gov (United States)

    Saxon, Leslie A

    2013-04-01

    The use of smart phones has increased dramatically and there are nearly a billion users on 3G and 4G networks worldwide. Nearly 60% of the U.S. population uses smart phones to access the internet, and smart phone sales now surpass those of desktop and laptop computers. The speed of wireless communication technology on 3G and 4G networks and the widespread adoption and use of iOS equipped smart phones (Apple Inc., Cupertino, CA, USA) provide infrastructure for the transmission of wireless biomedical data, including ECG data. These technologies provide an unprecedented opportunity for physicians to continually access data that can be used to detect issues before symptoms occur or to have definitive data when symptoms are present. The technology also greatly empowers and enables the possibility for unprecedented patient participation in their own medical education and health status as well as that of their social network. As patient advocates, physicians and particularly cardiac electrophysiologists should embrace the future and promise of wireless ECG recording, a technology solution that can truly scale across the global population. © 2013 Wiley Periodicals, Inc.

  15. Qualitative Description of Global Health Nursing Competencies by Nursing Faculty in Africa and the Americas.

    Science.gov (United States)

    Wilson, Lynda; Moran, Laura; Zarate, Rosa; Warren, Nicole; Ventura, Carla Aparecida Arena; Tamí-Maury, Irene; Mendes, Isabel Amélia Costa

    2016-06-07

    to analyze qualitative comments from four surveys asking nursing faculty to rate the importance of 30 global health competencies for undergraduate nursing programs. qualitative descriptive study that included 591 individuals who responded to the survey in English (49 from Africa and 542 from the Americas), 163 who responded to the survey in Spanish (all from Latin America), and 222 Brazilian faculty who responded to the survey in Portuguese. Qualitative comments were recorded at the end of the surveys by 175 respondents to the English survey, 75 to the Spanish survey, and 70 to the Portuguese survey. Qualitative description and a committee approach guided data analysis. ten new categories of global health competencies emerged from the analysis. Faculty also demonstrated concern about how and when these competencies could be integrated into nursing curricula. the additional categories should be considered for addition to the previously identified global health competencies. These, in addition to the guidance about integration into existing curricula, can be used to guide refinement of the original list of global health competencies. Further research is needed to seek consensus about these competencies and to develop recommendations and standards to guide nursing curriculum development. analisar os dados qualitativos obtidos em quatro surveys realizados com docentes de enfermagem que avaliaram a importância de 30 competências em saúde global para cursos de graduação em enfermagem. pesquisa qualitativa-descritiva com 591 indivíduos que responderam ao survey em inglês (49 da África e 542 das Américas), 163 que responderam ao survey em espanhol (todos da América Latina), e 222 docentes brasileiros que responderam ao survey em português. Os comentários qualitativos foram registrados ao final dos surveys por 175 respondentes na língua inglesa, 75 na espanhola e 70 na portuguesa. A análise dos dados foi dirigida por uma descrição qualitativa e desenvolvido

  16. Examining the relationship between health-related quality of life in individuals with spinal cord injury and the mental health of their caregivers in Colombia, South America.

    Science.gov (United States)

    Coleman, Jennifer A; Harper, Leia A; Perrin, Paul B; Olivera, Silvia L; Perdomo, Jose L; Arango, Jose A; Arango-Lasprilla, Juan C

    2013-12-01

    Although considerable research has been carried out on family caregivers of individuals with various types of disabilities, spinal cord injury (SCI) caregivers have received considerably less attention in terms of research, especially in regions such as Latin America. This study examined the relationship between health-related quality of life (HRQOL) in individuals with SCI and their family caregiver's mental health in Neiva, Colombia. Thirty-four individuals with SCI and their primary caregivers (34 dyads; n=68) from the Foundation for the Integral Development of People with Disabilities in Neiva, Colombia, were included in this study. Individuals with SCI completed eight subscales of the SF-36 that assessed HRQOL. Five aspects of caregiver mental health were assessed, including burden (Zarit Burden Interview), satisfaction with life (Satisfaction with Life Scale), depression (Patient Health Questionnaire-9), self-esteem (Rosenberg Self-Esteem Scale), and anxiety (State Trait Anxiety Inventory). A series of multiple regressions uncovered strong associations among the HRQOL of individuals with SCI and various aspects of caregiver mental health. In these regressions, patient physical functioning and pain were independently related to caregiver burden; patient pain and general health were independently related to caregiver satisfaction with life; and patient pain was independently related to caregiver anxiety. HRQOL in individuals with SCI was robustly related to their caregiver's mental health, suggesting that the two sets of variables are closely linked. These findings suggest that caregiver mental health should be a central part of SCI rehabilitation interventions, especially in Latin America.

  17. The Infectious Diseases Society of America emerging infections network: bridging the gap between clinical infectious diseases and public health.

    Science.gov (United States)

    Pillai, Satish K; Beekmann, Susan E; Santibanez, Scott; Polgreen, Philip M

    2014-04-01

    In 1995, the Centers for Disease Control and Prevention granted a Cooperative Agreement Program award to the Infectious Diseases Society of America to develop a provider-based emerging infections sentinel network, the Emerging Infections Network (EIN). Over the past 17 years, the EIN has evolved into a flexible, nationwide network with membership representing a broad cross-section of infectious disease physicians. The EIN has an active electronic mail conference (listserv) that facilitates communication among infectious disease providers and the public health community, and also sends members periodic queries (short surveys on infectious disease topics) that have addressed numerous topics relevant to both clinical infectious diseases and public health practice. The article reviews how the various functions of EIN contribute to clinical care and public health, identifies opportunities to further link clinical medicine and public health, and describes future directions for the EIN.

  18. [Health, human development, and governance in Latin America and the Caribbean at the beginning of the 21st century].

    Science.gov (United States)

    Casas-Zamora, Juan Antonio

    2002-01-01

    The issue of the reciprocal relationship between health and development has recently taken on greater importance in Latin America and the Caribbean (LAC), given the persistence of extreme poverty and the political and social difficulties due to macroeconomic imbalances and crises of governance. This piece reviews concepts of sustainable human development, social determinants of health in general and of health inequities in particular (gender, ethnic group, income level), and the relationship between health and economic growth in the medium term and the long term. An analysis is made of how persistent poverty in countries of LAC relates to disparities in health conditions, access to health services, and health care financing, as well as to such health determinants as nutrition and environmental sanitation. Health inequities most strongly affect the most excluded and vulnerable sectors of the population. In the face of this situation, the author stresses that putting a priority on health inequities is vital to safeguarding the governability and the social and political stability of countries in LAC in the next decade.

  19. Health inequalities by gradients of access to water and sanitation between countries in the Americas, 1990 and 2010.

    Science.gov (United States)

    Mújica, Oscar J; Haeberer, Mariana; Teague, Jordan; Santos-Burgoa, Carlos; Galvão, Luiz Augusto Cassanha

    2015-11-01

    To explore distributional inequality of key health outcomes as determined by access coverage to water and sanitation (WS) between countries in the Region of the Americas. An ecological study was designed to explore the magnitude and change-over-time of standard gap and gradient metrics of environmental inequalities in health at the country level in 1990 and 2010 among the 35 countries of the Americas. Access to drinking water and access to improved sanitation facilities were selected as equity stratifiers. Five dependent variables were: total and healthy life expectancies at birth, and infant, under-5, and maternal mortality. Access to WS correlated with survival and mortality, and strong gradients were seen in both 1990 and 2010. Higher WS access corresponded to higher life expectancy and healthy life expectancy and lower infant, under-5, and maternal mortality risks. Burden of life lost was unequally distributed, steadily concentrated among the most environmentally disadvantaged, who carried up to twice the burden than they would if WS were fairly distributed. Population averages in life expectancy and specific mortality improved, but whereas absolute inequalities decreased, relative inequalities remained mostly invariant. Even with the Region on track to meet MDG 7 on water and sanitation, large environmental gradients and health inequities among countries remain hidden by Regional averages. As the post-2015 development agenda unfolds, policies and actions focused on health equity-mainly on the most socially and environmentally deprived-will be needed in order to secure the right for universal access to water and sanitation.

  20. Comparison of national health research priority-setting methods and characteristics in Latin America and the Caribbean, 2002-2012.

    Science.gov (United States)

    Reveiz, Ludovic; Elias, Vanessa; Terry, Robert F; Alger, Jackeline; Becerra-Posada, Francisco

    2013-07-01

    To compare health research priority-setting methods and characteristics among countries in Latin America and the Caribbean during 2002 - 2012. This was a systematic review that identified national health research policies and priority agendas through a search of ministry and government databases related to health care institutions. PubMed, LILACS, the Health Research Web, and others were searched for the period from January 2002 - February 2012. The study excluded research organized by governmental institutions and specific national strategies on particular disease areas. Priority-setting methods were compared to the "nine common themes for good practice in health research priorities." National health research priorities were compared to those of the World Health Organization's Millennium Development Goals (MDG). Of the 18 Latin American countries assessed, 13 had documents that established national health research priorities; plus the Caribbean Health Research Council had a research agenda for its 19 constituents. These 14 total reports varied widely in terms of objectives, content, dissemination, and implementation; most provided a list of strategic areas, suggestions, and/or sub-priorities for each country; however, few proposed specific research topics and questions. Future reports could be improved by including more details on the comprehensive approach employed to identify priorities, on the information gathering process, and on practices to be undertaken after priorities are set. There is a need for improving the quality of the methodologies utilized and coordinating Regional efforts as countries strive to meet the MDG.

  1. Comparison of national health research priority-setting methods and characteristics in Latin America and the Caribbean, 2002 - 2012

    Directory of Open Access Journals (Sweden)

    Ludovic Reveiz

    2013-07-01

    Full Text Available OBJECTIVE: To compare health research priority-setting methods and characteristics among countries in Latin America and the Caribbean during 2002 - 2012. METHODS: This was a systematic review that identified national health research policies and priority agendas through a search of ministry and government databases related to health care institutions. PubMed, LILACS, the Health Research Web, and others were searched for the period from January 2002 - February 2012. The study excluded research organized by governmental institutions and specific national strategies on particular disease areas. Priority-setting methods were compared to the "nine common themes for good practice in health research priorities." National health research priorities were compared to those of the World Health Organization's Millennium Development Goals (MDG. RESULTS: Of the 18 Latin American countries assessed, 13 had documents that established national health research priorities; plus the Caribbean Health Research Council had a research agenda for its 19 constituents. These 14 total reports varied widely in terms of objectives, content, dissemination, and implementation; most provided a list of strategic areas, suggestions, and/or sub-priorities for each country; however, few proposed specific research topics and questions. CONCLUSIONS: Future reports could be improved by including more details on the comprehensive approach employed to identify priorities, on the information gathering process, and on practices to be undertaken after priorities are set. There is a need for improving the quality of the methodologies utilized and coordinating Regional efforts as countries strive to meet the MDG.

  2. [Self-reported general health in older adults in Latin America and the Caribbean: usefulness of the indicator].

    Science.gov (United States)

    Wong, Rebeca; Peláez, Martha; Palloni, Alberto

    2005-01-01

    To evaluate self-reported general health (SRGH) as a health indicator and to analyze its covariates in people 60 years old or older living in private homes in seven cities of Latin America and the Caribbean. This cross-sectional descriptive study was based on data from the Health, Well-Being, and Aging survey (Salud, Bienestar y Envejecimiento, or "SABE survey"), which was carried out in 1999 and 2000 in Bridgetown, Barbados; Buenos Aires, Argentina; Havana, Cuba; Mexico City, Mexico; Montevideo, Uruguay; Santiago, Chile; and São Paulo, Brazil. The survey looked at the demographic and socioeconomic characteristics of the participants, several health indicators (self-reported chronic diseases, depression, and cognitive features), the social and family support network, the use of health services, reported and observed functionality, the respondent's income, and the durable consumer goods in the household. In probit regression models, self-reported fair or poor health was used as the dependent variable. The marginal effect of each categorical explanatory variable was used to indicate the difference between the probability of reporting poor health by persons who did or did not have a given characteristic. In all the cities studied the self-reporting of "excellent" health was very low (6% or less). The results of the multivariate analysis of the relationships between SRGH and covariates showed: (1) the relative importance of several health indicators as covariates of SRGH, (2) the association between sociodemographic characteristics and SRGH, and (3) the differences or similarities found among the seven cities with respect to the relationships studied. The level of self-rated good health was highest in Buenos Aires and Montevideo (60%), followed by Bridgetown and São Paulo (around 50%) and Havana, Santiago, and Mexico City (between 30% and 40%). The respondents' evaluation of their memory was the factor that was most strongly related to SRGH, followed by satisfaction

  3. Exploration of a rare population of Chinese chestnut in North America: stand dynamics, health and genetic relationships.

    Science.gov (United States)

    Miller, Amy C; Woeste, Keith E; Anagnostakis, Sandra L; Jacobs, Douglass F

    2014-10-20

    With the transport of plants around the globe, exotic species can readily spread disease to their native relatives; however, they can also provide genetic resistance to those relatives through hybrid breeding programmes. American chestnut (Castanea dentata) was an abundant tree species in North America until its decimation by introduced chestnut blight. To restore chestnut in North America, efforts are ongoing to test putative blight-resistant hybrids of Castanea dentata and Chinese chestnut (Castanea mollissima), but little is known about the ecology of C. mollissima. In a forest in northeastern USA in which C. mollissima has become established, we explored questions of stand dynamics, health and genetic relationships of C. mollissima offspring to an adjacent parent orchard. We found that C. mollissima was adapted and randomly distributed among native species in this relatively young forest. The genetics of the C. mollissima population compared with its parents indicated little effect of selection pressure as each of the parent trees contributed at least one offspring. The ease with which this exotic species proliferated calls to question why C. mollissima is rare elsewhere in forests of North America. It is likely that a time window of low animal predation allowed seedlings to establish, and the shallow soil at this site limited the maximum forest canopy height, permitting the characteristically short-statured C. mollissima to avoid suppression. Our results indicate that because C. mollissima exhibited pioneer species characteristics, hybrids between C. mollissima and C. dentata have the potential to be successful pioneer species of future forests in North America, and we challenge the paradigm that exotic tree species are wholly detrimental to native biodiversity. We contend that exotic tree species should be assessed not only by their level of threat to native species, but also by their potential positive impacts on ecosystems via hybrid breeding programmes

  4. Sleepiness and health in midlife women: results of the National Sleep Foundation's 2007 Sleep in America poll.

    Science.gov (United States)

    Chasens, Eileen R; Twerski, Sarah R; Yang, Kyeongra; Umlauf, Mary Grace

    2010-01-01

    The 2007 Sleep in America poll, a random-sample telephone survey, provided data for this study of sleep in community-dwelling women aged 40 to 60 years. The majority of the respondents were post- or perimenopausal, overweight, married or living with someone, and reported good health. A subsample (20%) reported sleepiness that consistently interfered with daily life; the sleepy subsample reported more symptoms of insomnia, restless legs syndrome, obstructive sleep apnea, depression and anxiety, as well as more problems with health-promoting behaviors, drowsy driving, job performance, household duties, and personal relationships. Hierarchical regression showed that sleepiness along with depressive symptoms, medical comorbidities, obesity, and lower education were associated with poor self-rated health, whereas menopause status (pre-, peri- or post-) was not. These results suggest that sleep disruptions and daytime sleepiness negatively affect the daily life of midlife women.

  5. Embracing autism in Canadian rural communities.

    Science.gov (United States)

    Hoogsteen, Lindsey; Woodgate, Roberta L

    2013-06-01

    The purpose of this study was to explore the lived experience of Canadian parents living in rural areas who were parenting a child with autism. A phenomenological design described by van Manen was applied to guide this study. This study took place in rural communities of Western Canada. Purposive sampling was used to recruit 26 families parenting a child with autism in rural communities. Participants ranged in age from 26 to 50 years old and lived an average of 197 kilometres away from an urban city. Parents of children with autism took part in audio-taped, in-depth interviews. A total of 26 open-ended interviews were completed over four months with an average of 83 minutes per interview. All interviews and field notes were transcribed verbatim and analyzed using van Manen's selective highlighting approach. When describing the characteristics of living rurally while parenting a child with autism, parents reported that the rural community had (i) less of everything, (ii) safety and familiarity, and (iii) a family of support. Parents believed that although there were disadvantages to living in a rural community, parents felt isolated in terms of services but not in terms of the support received by the community. The results of this study add to our knowledge of parenting experiences with attention to the rural experience and furthermore, recommendations for nurses and health care professionals were provided. © 2013 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  6. [Musculoskeletal pain in Central American workers: results of the First Survey on Working Conditions and Health in Central America].

    Science.gov (United States)

    Rojas, Marianela; Gimeno, David; Vargas-Prada, Sergio; Benavides, Fernando G

    2015-08-01

    Examine the prevalence of musculoskeletal pain (MSP) in the six Spanish-speaking countries of Central America using a single standardized instrument, the First Survey on Working Conditions and Health in Central America in workers from all manual and non-manual labor sectors, using social security coverage as an indicator of formal versus informal employment. The workers (n = 12 024) were surveyed in their homes. The age-adjusted prevalence of MSP during the previous month was calculated for pain in the back (upper, or cervical; middle, or thoracic; and lower, or lumbar) and arm joints (shoulder, elbow, and wrist). Prevalence was estimated by sex, occupation (manual or non-manual), economic sector (agriculture, industry, or services), and social security coverage. Poisson regression models were used to calculate the prevalence rates and 95% confidence intervals, with stratification by country and anatomical site. By sites, the age-adjusted prevalence of cervical-dorsal MSP was the highest, especially in El Salvador (47.8%) and Nicaragua (45.9%), and lumbar MSP was less prevalent, especially in Panama (12.8%) and Guatemala (14.8%). After additional adjustments, the prevalence of MSP was higher in women and manual workers for all the sites and in all the countries. There were no differences in MSP in terms of social security coverage or sector of economic activity. The high prevalence of MSP in Central America, regardless of sector of activity or social security coverage, indicates that the prevention of MSP should be a priority in occupational health programs in low- and middle-income countries, especially for women and manual workers.

  7. Progress of implementation of the World Health Organization strategy for HIV drug resistance control in Latin America and the Caribbean.

    Science.gov (United States)

    Ravasi, Giovanni; Jack, Noreen; Alonso Gonzalez, Mónica; Sued, Omar; Pérez-Rosales, María Dolores; Gomez, Bertha; Vila, Marcelo; Riego, Amalia del; Ghidinelli, Massimo

    2011-12-01

    By the end of 2010, Latin America and the Caribbean (LAC) achieved 63% antiretroviral treatment (ART) coverage. Measures to control HIV drug resistance (HIVDR) at the country level are recommended to maximize the efficacy and sustainability of ART programs. Since 2006, the Pan American Health Organization has supported implementation of the World Health Organization (WHO) strategy for HIVDR prevention and assessment through regional capacity-building activities and direct technical cooperation in 30 LAC countries. By 2010, 85 sites in 19 countries reported early warning indicators, providing information about the extent of potential drivers of drug resistance at the ART site. In 2009, 41.9% of sites did not achieve the WHO target of 100% appropriate first-line prescriptions; 6.3% still experienced high rates (> 20%) of loss to follow-up, and 16.2% had low retention of patients (< 70%) on first-line prescriptions in the first year of treatment. Stock-outs of antiretroviral drugs occurred at 22.7% of sites. Haiti, Guyana, and the Mesoamerican region are planning and implementing WHO HIVDR monitoring surveys or threshold surveys. New HIVDR surveillance tools for concentrated epidemics would promote further scale-up. Extending the WHO HIVDR lab network in Latin America is key to strengthening regional lab capacity to support quality assured HIVDR surveillance. The WHO HIVDR control strategy is feasible and can be rolled out in LAC. Integrating HIVDR activities in national HIV care and treatment plans is key to ensuring the sustainability of this strategy.

  8. Epidemiological and financial indicators of hypertension in older adults in Mexico: challenges for health planning and management in Latin America.

    Science.gov (United States)

    Arredondo, Armando; Duarte, Maria Beatriz; Cuadra, Silvia Magali

    2017-04-01

    This study estimated the epidemiological and financial indicators of hypertension in order to identify challenges in strategic planning and management for health systems in Latin America. This is a longitudinal study with a population base of 187 326 reported cases of older adults with hypertension, diagnosed at public health institutions in Mexico. The cost-evaluation method that was used was based on the instrumentation and consensus techniques. To estimate the epidemiological changes and financial consequences for 2015-2017, time series analyses and probabilistic models were constructed according to the Box-Jenkins technique. Regarding epidemiological changes for 2015 versus 2017, an increase of 8-12% is expected (p financial requirements. The total amount estimated for hypertension in 2015 (in US dollars) was $1 575 671 330. It included $747 527 259 as direct costs and $829 144 071 as indirect costs. If the risk factors and the different healthcare services for older adults remain as they are currently, the financial consequences of epidemiological changes in older adults will have a major impact on the users' pockets, following in order of importance, on social security providers and on public assistance providers. The challenges and implications of our findings in the context of universal coverage reforms in Latin America reinforce the urgent need to develop more and better strategic planning for the prevention of chronic diseases. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  9. Latin America and the Caribbean: Assessment of the Advances in Public Health for the Achievement of the Millennium Development Goals

    Directory of Open Access Journals (Sweden)

    Amal K. Mitra

    2010-05-01

    Full Text Available To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs, that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1 eradicating extreme poverty and hunger; (2 achieving universal primary education; (3 promoting gender equality; (4 reducing child mortality; (5 improving maternal health; (6 combating HIV/AIDS, malaria and other diseases; (7 ensuring environmental sustainability; and (8 developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN Secretary-General urges countries to engage constructively to review progress towards the MDGs. This paper aims to evaluate advances in public health, with special reference to gender inequalities in health, health sector reform, global burden of disease, neglected tropical diseases, vaccination, antibiotic use, sanitation and safe water, nutrition, tobacco and alcohol use, indicators of health, and disease prevention in Latin America and the Caribbean region (LAC. The paper also identifies areas of deficits for the achievement of MDGs in LAC.

  10. Latin America and the Caribbean: assessment of the advances in public health for the achievement of the Millennium Development Goals.

    Science.gov (United States)

    Mitra, Amal K; Rodriguez-Fernandez, Gisela

    2010-05-01

    To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs), that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1) eradicating extreme poverty and hunger; (2) achieving universal primary education; (3) promoting gender equality; (4) reducing child mortality; (5) improving maternal health; (6) combating HIV/AIDS, malaria and other diseases; (7) ensuring environmental sustainability; and (8) developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN Secretary-General urges countries to engage constructively to review progress towards the MDGs. This paper aims to evaluate advances in public health, with special reference to gender inequalities in health, health sector reform, global burden of disease, neglected tropical diseases, vaccination, antibiotic use, sanitation and safe water, nutrition, tobacco and alcohol use, indicators of health, and disease prevention in Latin America and the Caribbean region (LAC). The paper also identifies areas of deficits for the achievement of MDGs in LAC.

  11. Meeting report: development of environmental health indicators in Brazil and other countries in the americas.

    Science.gov (United States)

    Carneiro, Fernando F; Oliveira, Mara Lúcia C; Netto, Guilherme F; Galvão, Luis A C; Cancio, Jacira A; Bonini, Estela M; Corvalan, Carlos F

    2006-09-01

    This report summarizes the Brazilian experience on the design and implementation of environmental health, with contributions from Argentina, Canada, and Cuba, presented at the International Symposium on the Development of Indicators for Environmental Health Integrated Management, held in Recife, Pernambuco, Brazil, on 17-18 June 2004. The methodology for the development of environmental health indicators has been used as a reference in the implementation of environmental health surveillance in Brazil. This methodology has provided tools and processes to facilitate the understanding and to measure the determinants of risks to environmental health, to help decision makers control those risks. Key words: environmental health indicators, environmental health surveillance, integrated management.

  12. Health care providers and human trafficking: What do they know, what do they need to know? Findings from the middle East, the Caribbean, and Central America

    NARCIS (Netherlands)

    Viergever, R.F.; West, H.; Borland, R.; Zimmerman, C.

    2015-01-01

    BACKGROUND: Human trafficking is a crime that commonly results in acute and chronic physical and psychological harm. To foster more informed health sector responses to human trafficking, training sessions for health care providers were developed and pilot-tested in the Middle East, Central America,

  13. Medical Simulation: Utilize, Inspire, Embrace , Verify

    Directory of Open Access Journals (Sweden)

    Frederic McKENZIE

    2014-06-01

    Full Text Available (ExtractI too have experienced the enthusiasm of an individual seeking to learn a new task. More years ago than I care to elaborate and before the proliferation of health care simulators, I visited the ER with a painful ache and had an interesting training experience with a youthful ER nurse. She looked around possibly to see if anyone could help or oversee her and noting that everyone else was busy and my veins were attractively prominent, she promptly asked if I would mind if she practiced drawing blood. Under duress due to pain perhaps, I agreed. I am not sure if the art and science of phlebotomy includes the part of chasing the vein with the needle under the epidermis or whether it is at the 3rd or 4th stick that phlebotomy starts to become something akin to torture but thankfully after the 4th stick, I received an apology and a surrender from the novice nurse and we waited for a more experienced practitioner.  That day I wished for a better way and hoped that no one else would need to endure the painful or even perilous results of such inexperience.... 

  14. Health inequalities by gradients of access to water and sanitation between countries in the Americas, 1990 and 2010

    Directory of Open Access Journals (Sweden)

    Oscar J. Mújica

    Full Text Available OBJECTIVE: To explore distributional inequality of key health outcomes as determined by access coverage to water and sanitation (WS between countries in the Region of the Americas. METHODS: An ecological study was designed to explore the magnitude and change-over-time of standard gap and gradient metrics of environmental inequalities in health at the country level in 1990 and 2010 among the 35 countries of the Americas. Access to drinking water and access to improved sanitation facilities were selected as equity stratifiers. Five dependent variables were: total and healthy life expectancies at birth, and infant, under-5, and maternal mortality. RESULTS: Access to WS correlated with survival and mortality, and strong gradients were seen in both 1990 and 2010. Higher WS access corresponded to higher life expectancy and healthy life expectancy and lower infant, under-5, and maternal mortality risks. Burden of life lost was unequally distributed, steadily concentrated among the most environmentally disadvantaged, who carried up to twice the burden than they would if WS were fairly distributed. Population averages in life expectancy and specific mortality improved, but whereas absolute inequalities decreased, relative inequalities remained mostly invariant. CONCLUSIONS: Even with the Region on track to meet MDG 7 on water and sanitation, large environmental gradients and health inequities among countries remain hidden by Regional averages. As the post-2015 development agenda unfolds, policies and actions focused on health equity-mainly on the most socially and environmentally deprived-will be needed in order to secure the right for universal access to water and sanitation.

  15. Gesture, Landscape and Embrace: A Phenomenological Analysis of ...

    African Journals Online (AJOL)

    The 'radical reflection' on the 'flesh of the world' to which this analysis aspires in turn bears upon the general field of gestural reciprocities and connections, providing the insight that intimate gestures of the flesh, such as the embrace, are primordial attunements, motions of rhythm and reciprocity, that emanate from the world ...

  16. The Bear and Dragon Embrace: Russian-Chinese Security Cooperation

    Science.gov (United States)

    2017-04-21

    embrace with the Soviet Union, cemented by the Sino-Soviet Treaty of Friendship, Alliance, and Mutual Assistance, signed in...historically a festering sore—especially for China—would remain an area of tension. For the Chinese, the boundary was the physical symbol of its failure to...partnership, Russia still engages in balancing behavior toward China. 6 Christina Yeung and

  17. Districts Embrace the Community to Benefit All Students

    Science.gov (United States)

    Weinzapfel, Patricia

    2018-01-01

    Moving from a traditional school district to one that embraces a community schools model requires fundamental shifts in organizational structure and practices. Evansville Vanderburgh School Corporation in southern Indiana and Vancouver Public Schools in Vancouver, Wash., are two districts that have navigated this change. Leaders from those…

  18. How many schools adopt interviews during the student admission process across the health professions in the United States of America?

    Science.gov (United States)

    Glazer, Greer; Startsman, Laura F; Bankston, Karen; Michaels, Julia; Danek, Jennifer C; Fair, Malika

    2016-01-01

    Health profession schools use interviews during the admissions process to identify certain non-cognitive skills that are needed for success in diverse, inter-professional settings. This study aimed to assess the use of interviews during the student admissions process across health disciplines at schools in the United States of America in 2014. The type and frequency of non-cognitive skills assessed were also evaluated. Descriptive methods were used to analyze a sample of interview rubrics collected as part of a national survey on admissions in the health professions, which surveyed 228 schools of medicine, dentistry, pharmacy, nursing, and public health. Of the 228 schools, 130 used interviews. The most desirable non-cognitive skills from 34 schools were identified as follows: communication skills (30), motivation (22), readiness for the profession (17), service (12), and problem-solving (12). Ten schools reported using the multiple mini-interview format, which may indicate potential for expanding this practice. Disparities in the use of interviewing across health professions should be verified to help schools adopt interviews during student admissions processes.

  19. Management training in global health education: a Health Innovation Fellowship training program to bring healthcare to low-income communities in Central America.

    Science.gov (United States)

    Prado, Andrea M; Pearson, Andy A; Bertelsen, Nathan S

    2018-01-01

    Interprofessional education is increasingly recognized as essential for health education worldwide. Although effective management, innovation, and entrepreneurship are necessary to improve health systems, business schools have been underrepresented in global health education. Central America needs more health professionals trained in health management and innovation to respond to health disparities, especially in rural communities. This paper explores the impact of the Health Innovation Fellowship (HIF), a new training program for practicing health professionals offered jointly by the Central American Healthcare Initiative and INCAE Business School, Costa Rica. Launched in 2014, HIF's goal is to create a network of highly trained interdisciplinary health professionals in competencies to improve health of Central American communities through better health management. The program's fellows carried out innovative healthcare projects in their local regions. The first three annual cohorts (total of 43 fellows) represented all health-related professions and sectors (private, public, and civil society) from six Central American countries. All fellows attended four 1-week, on-site modular training sessions, received ongoing mentorship, and stayed connected through formal and informal networks and webinars through which they exchange knowledge and support each other. CAHI stakeholders supported HIF financially. Impact evaluation of the three-year pilot training program is positive: fellows improved their health management skills and more than 50% of the projects found either financial or political support for their implementation. HIF's strengths include that both program leaders and trainees come from the Global South, and that HIF offers a platform to collaborate with partners in the Global North. By focusing on promoting innovation and management at a top business school in the region, HIF constitutes a novel capacity-building effort within global health education. HIF

  20. [The Caribbean origins of the National Public Health System in the USA: a global approach to the history of medicine and public health in Latin America].

    Science.gov (United States)

    Espinosa, Mariola

    2015-01-01

    This article defines global history in relation to the history of medicine and public health. It argues that a global approach to history opens up a space for examining the reverberations transmitted from the geographic periphery towards western regions, which have traditionally dominated modern historiography. It analyzes two medical interventions in the Caribbean in the late nineteenth and early twentieth century, showing how these events had profound consequences in the USA. The successes achieved in the Caribbean in terms of yellow fever and ancylostoma control, as well as providing a model for health campaigns in the southern USA, inspired the centralization of public health in North America under the centralizing control of the federal government.

  1. The rise of health biotechnology research in Latin America: A scientometric analysis of health biotechnology production and impact in Argentina, Brazil, Chile, Colombia, Cuba and Mexico

    Science.gov (United States)

    2018-01-01

    This paper analyzes the patterns of health biotechnology publications in six Latin American countries from 2001 to 2015. The countries studied were Argentina, Brazil, Chile, Colombia, Cuba and Mexico. Before our study, there were no data available on HBT development in half of the Latin-American countries we studied, i.e., Argentina, Colombia and Chile. To include these countries in a scientometric analysis of HBT provides fuller coverage of HBT development in Latin America. The scientometric study used the Web of Science database to identify health biotechnology publications. The total amount of health biotechnology production in the world during the period studied was about 400,000 papers. A total of 1.2% of these papers, were authored by the six Latin American countries in this study. The results show a significant growth in health biotechnology publications in Latin America despite some of the countries having social and political instability, fluctuations in their gross domestic expenditure in research and development or a trade embargo that limits opportunities for scientific development. The growth in the field of some of the Latin American countries studied was larger than the growth of most industrialized nations. Still, the visibility of the Latin American research (measured in the number of citations) did not reach the world average, with the exception of Colombia. The main producers of health biotechnology papers in Latin America were universities, except in Cuba were governmental institutions were the most frequent producers. The countries studied were active in international research collaboration with Colombia being the most active (64% of papers co-authored internationally), whereas Brazil was the least active (35% of papers). Still, the domestic collaboration was even more prevalent, with Chile being the most active in such collaboration (85% of papers co-authored domestically) and Argentina the least active (49% of papers). We conclude that the

  2. The rise of health biotechnology research in Latin America: A scientometric analysis of health biotechnology production and impact in Argentina, Brazil, Chile, Colombia, Cuba and Mexico.

    Science.gov (United States)

    León-de la O, Dante Israel; Thorsteinsdóttir, Halla; Calderón-Salinas, José Víctor

    2018-01-01

    This paper analyzes the patterns of health biotechnology publications in six Latin American countries from 2001 to 2015. The countries studied were Argentina, Brazil, Chile, Colombia, Cuba and Mexico. Before our study, there were no data available on HBT development in half of the Latin-American countries we studied, i.e., Argentina, Colombia and Chile. To include these countries in a scientometric analysis of HBT provides fuller coverage of HBT development in Latin America. The scientometric study used the Web of Science database to identify health biotechnology publications. The total amount of health biotechnology production in the world during the period studied was about 400,000 papers. A total of 1.2% of these papers, were authored by the six Latin American countries in this study. The results show a significant growth in health biotechnology publications in Latin America despite some of the countries having social and political instability, fluctuations in their gross domestic expenditure in research and development or a trade embargo that limits opportunities for scientific development. The growth in the field of some of the Latin American countries studied was larger than the growth of most industrialized nations. Still, the visibility of the Latin American research (measured in the number of citations) did not reach the world average, with the exception of Colombia. The main producers of health biotechnology papers in Latin America were universities, except in Cuba were governmental institutions were the most frequent producers. The countries studied were active in international research collaboration with Colombia being the most active (64% of papers co-authored internationally), whereas Brazil was the least active (35% of papers). Still, the domestic collaboration was even more prevalent, with Chile being the most active in such collaboration (85% of papers co-authored domestically) and Argentina the least active (49% of papers). We conclude that the

  3. Arthritis in America

    Science.gov (United States)

    ... Digital Press Kit Read the MMWR Science Clips Arthritis in America Time to Take Action! Language: English ( ... by about 40% by being physically active. Problem Arthritis is common and a growing health threat. Arthritis ...

  4. Regular-Fat Dairy and Human Health: A Synopsis of Symposia Presented in Europe and North America (2014-2015).

    Science.gov (United States)

    Astrup, Arne; Rice Bradley, Beth H; Brenna, J Thomas; Delplanque, Bernadette; Ferry, Monique; Torres-Gonzalez, Moises

    2016-07-29

    In recent history, some dietary recommendations have treated dairy fat as an unnecessary source of calories and saturated fat in the human diet. These assumptions, however, have recently been brought into question by current research on regular fat dairy products and human health. In an effort to disseminate, explore and discuss the state of the science on the relationship between regular fat dairy products and health, symposia were programmed by dairy industry organizations in Europe and North America at The Eurofed Lipids Congress (2014) in France, The Dairy Nutrition Annual Symposium (2014) in Canada, The American Society for Nutrition Annual Meeting held in conjunction with Experimental Biology (2015) in the United States, and The Federation of European Nutrition Societies (2015) in Germany. This synopsis of these symposia describes the complexity of dairy fat and the effects regular-fat dairy foods have on human health. The emerging scientific evidence indicates that the consumption of regular fat dairy foods is not associated with an increased risk of cardiovascular disease and inversely associated with weight gain and the risk of obesity. Dairy foods, including regular-fat milk, cheese and yogurt, can be important components of an overall healthy dietary pattern. Systematic examination of the effects of dietary patterns that include regular-fat milk, cheese and yogurt on human health is warranted.

  5. Children's health and the environment in North America : a first report on available indicators and measures : executive summary

    International Nuclear Information System (INIS)

    2006-01-01

    This report represents North America's contribution to the global initiative to promote environmental and child health protection. It indicates that despite improvements in many areas, children remain at risk from environmental threats. The report focuses on the following 3 priority areas: asthma and respiratory disease; lead and other chemicals, including pesticides and waterborne diseases. This document is the first integrated, regional report providing indicators for a series of children's health and environment issues. It is intended to increase awareness of the relationship between environmental risks and children's health and to provide a means of measuring and promoting change. An introduction to the participating countries was included along with population data, birth rates, child mortality, immunization rates and socioeconomic determinants of health. The affect of outdoor and indoor air pollution on asthma and respiratory disease in Canada, Mexico and the United States was discussed along with blood lead levels and the affect of lead in the home, as well as industrial releases of lead, chemicals and pesticides. Drinking water and sanitation issues were also discussed with reference to the link with waterborne diseases. It was concluded that more effort in trilateral collaboration is needed to improve the quality of future reports. Some observations and opportunities for improvement were noted. figs

  6. Successes, challenges and needs regarding rural health medical education in continental Central America: a literature review and narrative synthesis.

    Science.gov (United States)

    Colon-Gonzalez, Maria C; El Rayess, Fadya; Guevara, Sara; Anandarajah, Gowri

    2015-01-01

    Central American countries, like many others, face a shortage of rural health physicians. Most medical schools in this region are located in urban areas and focus on tertiary care training rather than on community health or primary care, which are better suited for rural practice. However, many countries require young physicians to do community service in rural communities to address healthcare provider shortages. This study aimed to: (a) synthesize what is known about the current state of medical education preparing physicians for rural practice in this region, and (b) identify common needs, challenges and opportunities for improving medical education in this area. A comprehensive literature review was conducted between December 2013 and May 2014. The stepwise, reproducible search process included English and Spanish language resources from both data-based web search engines (PubMed, Web of Science/Web of Knowledge, ERIC and Google Scholar) and the grey literature. Search criteria included MeSH terms: 'medical education', 'rural health', 'primary care', 'community medicine', 'social service', in conjunction with 'Central America', 'Latin America', 'Mexico', 'Guatemala', 'Belize', 'El Salvador', 'Nicaragua', 'Honduras', 'Costa Rica' and 'Panama'. Articles were included in the review if they (1) were published after 1984; (2) focused on medical education for rural health, primary care, community health; and (3) involved the countries of interest. A narrative synthesis of the content of resources meeting inclusion criteria was done using qualitative research methods to identify common themes pertaining to the study goals. The search revealed 20 resources that met inclusion criteria. Only four of the 20 were research articles; therefore, information about this subject was primarily derived from expert opinion. Thematic analysis revealed the historical existence of several innovative programs that directly address rural medicine training needs, suggesting that

  7. Is wealthier always healthier? The impact of national income level, inequality, and poverty on public health in Latin America.

    Science.gov (United States)

    Biggs, Brian; King, Lawrence; Basu, Sanjay; Stuckler, David

    2010-07-01

    Despite findings indicating that both national income level and income inequality are each determinants of public health, few have studied how national income level, poverty and inequality interact with each other to influence public health outcomes. We analyzed the relationship between gross domestic product (GDP) per capita in purchasing power parity, extreme poverty rates, the gini coefficient for personal income and three common measures of public health: life expectancy, infant mortality rates, and tuberculosis (TB) mortality rates. Introducing poverty and inequality as modifying factors, we then assessed whether the relationship between GDP and health differed during times of increasing, decreasing, and decreasing or constant poverty and inequality. Data were taken from twenty-two Latin American countries from 1960 to 2007 from the December 2008 World Bank World Development Indicators, World Health Organization Global Tuberculosis Database 2008, and the Socio-Economic Database for Latin America and the Caribbean. Consistent with previous studies, we found increases in GDP have a sizable positive impact on population health. However, the strength of the relationship is powerfully influenced by changing levels of poverty and inequality. When poverty was increasing, greater GDP had no significant effect on life expectancy or TB mortality, and only led to a small reduction in infant mortality rates. When inequality was rising, greater GDP had only a modest effect on life expectancy and infant mortality rates, and no effect on TB mortality rates. In sharp contrast, during times of decreasing or constant poverty and inequality, there was a very strong relationship between increasing GDP and higher life expectancy and lower TB and infant mortality rates. Finally, inequality and poverty were found to exert independent, substantial effects on the relationship between national income level and health. Wealthier is indeed healthier, but how much healthier depends on how

  8. Public health programs as surrogates for social action in Suriname, South America.

    Science.gov (United States)

    Peplow, Daniel; Augustine, Sarah

    2015-01-01

    This paper addresses the merits of public health activism that advocates for social change in which health is the outcome of interest. We acknowledge that while efforts at the individual level are important, social network models consider the underlying mechanisms that lie outside the public health sector. This paper considers the inequitable health of Indigenous people who bear a disproportionate share of the negative health consequences due to economic development programs that follow an assimilation model. This paper discusses a combination of theoretical constructs to understand and solve the problems at hand. It concludes that while the attention paid to technological and behavioral solutions at the individual level yields important health outcomes, attention should also be paid to structural causes that address social, political and economic barriers to prevent disease, disability and premature death. © The Author(s) 2014.

  9. [Mental health and stress by acculturation in immigrants from South America in northern Chile].

    Science.gov (United States)

    Urzúa M, Alfonso; Heredia B, Osvaldo; Caqueo-Urízar, Alejandra

    2016-05-01

    Coping with changes brought about by immigration and social circumstances that often characterize this process may cause mental health problems. To analyze the relationship between acculturation stress and mental health symptoms in South American immigrants residing in Antofagasta, Chile. The OQ questionnaire, which assesses mental health and the acculturation stress questionnaire from Ruiz, were answered by 431 immigrants (53.8% Colombian and 46.2% Peruvian) aged between 18 and 65 years old. The major source of acculturation stress was distance from origin, followed by difficulties in social relationships and perceived discrimination and rejection. About 50% of respondents had elevated levels of discomfort in their life, with mental health problems derived from their adjustment to social roles and relationships. There was a high correlation between acculturation stress levels and severity of mental health symptoms. Immigrants are exposed to high levels of stress resulting in a negative impact on their mental health.

  10. Understanding the Health Literacy of America Results of the National Assessment of Adult Literacy

    OpenAIRE

    Cutilli, Carolyn Crane; Bennett, Ian M.

    2009-01-01

    Health literacy refers to an individual’s ability to understand healthcare information to make appropriate decisions (S. C Ratzen & R. M. Parker, 2000). Healthcare professionals are obligated to make sure that patients understand information to maximize the benefits of healthcare. The National Assessment of Adult Literacy (NAAL) provides information on the literacy/health literacy levels of the U.S. adult population. The NAAL is the only large-scale survey of health literacy. The results of t...

  11. Perspectives on Strengthening Cancer Research and Control in Latin America Through Partnerships and Diplomacy: Experience of the National Cancer Institute’s Center for Global Health

    Directory of Open Access Journals (Sweden)

    Silvina Frech

    2018-02-01

    Full Text Available According to the Pan American Health Organization, noncommunicable diseases, including cancer, are the leading causes of preventable and premature death in the Americas. Governments and health care systems in Latin America face numerous challenges as a result of increasing morbidity and mortality from cancer. Multiple international organizations have recognized the need for collaborative action on and technical support for cancer research and control in Latin America. The Center for Global Health at the US National Cancer Institute (NCI-CGH is one entity among many that are working in the region and has sought to develop a strategy for working in Latin America that draws on and expands the collaborative potential of engaged, skilled, and diverse partners. NCI-CGH has worked toward developing and implementing initiatives in collaboration with global partners that share the common objectives of building a global cancer research community and translating research results into evidence-informed policy and practice. Both objectives are complementary and synergistic and are additionally supported by an overarching strategic framework that is focused on partnerships and science diplomacy. This work highlights the overall strategy for NCI-CGH engagement in Latin America through partnerships and diplomacy, and highlights selected collaborative efforts that are aimed at improving cancer outcomes in the region.

  12. [National health research systems in Latin America: a 14-country review].

    Science.gov (United States)

    Alger, Jackeline; Becerra-Posada, Francisco; Kennedy, Andrew; Martinelli, Elena; Cuervo, Luis Gabriel

    2009-11-01

    This article discusses the main features of the national health research systems (NHRS) of Argentina, Bolivia, Brazil, Chile, Costa Rica, Cuba, Ecuador, El Salvador, Honduras, Panama, Paraguay, Peru, Uruguay, and Venezuela, based on documents prepared by their country experts who participated in the First Latin American Conference on Research and Innovation for Health held in April 2008, in Rio de Janeiro, Brazil. The review also includes sources cited in the reports, published scientific papers, and expert opinion, as well as regional secondary sources. Six countries reported having formal entities for health research governance and management: Brazil and Costa Rica's entities are led by their ministries of health; while Argentina, Cuba, Ecuador, and Venezuela have entities shared by their ministries of health and ministries of science and technology. Brazil and Ecuador each reported having a comprehensive national policy devoted specifically to health science, technology, and innovation. Argentina, Brazil, Costa Rica, Cuba, Ecuador, Panama, Paraguay, Peru, and Venezuela reported having established health research priorities. In conclusion, encouraging progress has been made, despite the structural and functional heterogeneity of the study countries' NHRS and their disparate levels of development. Instituting good NHRS governance/management is of utmost importance to how efficiently ministries of health, other government players, and society-at-large can tackle health research.

  13. Choosing fatherhood: how teens in the justice system embrace or reject a father identity.

    Science.gov (United States)

    Shade, Kate; Kools, Susan; Pinderhughes, Howard; Weiss, Sandra J

    2012-01-01

    The purpose of this qualitative study was to further the understanding of father identity and role development among adolescents involved in the justice system. Youth who were expecting a child or parenting an infant and who were incarcerated, arrested, or had admitted to criminal behavior participated in interviews and observations in a juvenile detention center and in the community. Data analysis revealed 4 patterns of fathering intentions: (a) embracing fatherhood, (b) being barred from fatherhood, (c) being ambivalent about fatherhood, or (d) rejecting fatherhood. Community health nurses can use this information to assess father identity status and address factors that interfere with father engagement. Copyright © Taylor & Francis Group, LLC

  14. e-Health Research and Capacity Building in Latin America and the ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This project will therefore investigate a range of locally relevant, affordable and ... awareness of free and open source software (FOSS) in health informatics, with a ... for decision-makers, practitioners and developers of health information systems. ... IWRA/IDRC webinar on climate change and adaptive water management.

  15. Training in reproductive health and sexuality: the case of a regional program in Latin America.

    Science.gov (United States)

    Ramos, S; Gogna, M

    1997-01-01

    Beginning in July 1993, a 5-year program has sought to provide social research, training, and technical assistance in reproductive health and sexuality in Argentina, Chile, Peru, and Colombia by 1) building research capacity and promoting an interdisciplinary approach to reproductive health and sexuality and 2) promoting a gender perspective to these issues. The target groups are women's nongovernmental organizations (NGOs); family planning, reproductive health, and women's health providers; and social scientists conducting health-related research. Training activities include regional workshops, a Regional Resident Fellowship Program to support graduate-level education, and provision of technical assistance. The first 3 years of the program have revealed that the basic training needs in these areas include 1) helping women's NGOs improve their record-keeping capacity, evaluation processes, theoretical and methodological background, and institutional-building ability; 2) sensitizing women's health providers to sociocultural dimension of health-illness issues and to a gender and human rights perspective; and 3) training social scientist researchers to apply their skills in applied research, develop their theoretical background, and improve research quality control procedures. The main challenges for training activities in the field of reproductive health and sexuality are posed by the complexity of the issues and their interdisciplinary nature.

  16. ACEH IN HISTORY: Preserving Traditions and Embracing Modernity

    Directory of Open Access Journals (Sweden)

    Amirul Hadi

    2013-12-01

    Full Text Available This paper attempts to critically discuss on how the Acehnese in history, while trying to embrace the modern world, have made every effort at preserving their traditions. As an ethnic group which has a glorious past, Aceh has strongly been connected to “identity”; and this is expressed in various means, including “social memory.” For this very reason, “traditions”, including those of the past, are explored and preserved. Yet, the challenges of modernity are also apparent. It is in this context that the Acehnese are trapped at the crossroad. On the one hand, they tend to preserve their traditions, yet, on the other, they need to embrace modern lives. The Acehnese seem to have encountered considerable obstacles on this issue, for they tend to focus more on historical “romanticism” (nostalgia rather than historical “awareness” (consciousness. Eventually, the “spirit” of the past cannot be brought into light.

  17. Improving the quality of cancer care in America through health information technology.

    Science.gov (United States)

    Feeley, Thomas W; Sledge, George W; Levit, Laura; Ganz, Patricia A

    2014-01-01

    A recent report from the Institute of Medicine titled Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis, identifies improvement in information technology (IT) as essential to improving the quality of cancer care in America. The report calls for implementation of a learning healthcare IT system: a system that supports patient-clinician interactions by providing patients and clinicians with the information and tools necessary to make well informed medical decisions and to support quality measurement and improvement. While some elements needed for a learning healthcare system are already in place for cancer, they are incompletely implemented, have functional deficiencies, and are not integrated in a way that creates a true learning healthcare system. To achieve the goal of a learning cancer care delivery system, clinicians, professional organizations, government, and the IT industry will have to partner, develop, and incentivize participation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. Animal health economics: an aid to decisionmaking on animal health interventions - case studies in the United States of America.

    Science.gov (United States)

    Marsh, T L; Pendell, D; Knippenberg, R

    2017-04-01

    For animal disease events the outcomes and consequences often remain unclear or uncertain, including the expected changes in benefits (e.g. profit to firms, prices to consumers) and in costs (e.g. response, clean-up). Moreover, the measurement of changes in benefits and costs across alternative interventions used to control animal disease events may be inexact. For instance, the economic consequences of alternative vaccination strategies to mitigate a disease can vary in magnitude due to trade embargoes and other factors. The authors discuss the economic measurement of animal disease outbreaks and interventions and how measurement is used in private and public decision-making. Two illustrative case studies in the United States of America are provided: a hypothetical outbreak of foot and mouth disease in cattle, and the 2014-2015 outbreak of highly pathogenic avian influenza in poultry.

  19. A call to the Church: Embrace children with disabilities

    Directory of Open Access Journals (Sweden)

    Natalie Ann Flickner

    2015-01-01

    Full Text Available Children with Disabilities are one of the groups of children most in need globally. The author uses her personal story of growing up as a child with mild cerebral palsy to express her solidarity and highlight the multiple needs of children with disabilities around the world. These children should no longer be stigmatized by the world wide church but instead be embraced and ministered to in the name of Jesus.

  20. Countering war or embracing peace? Dialogues between regionalism and multilateralism in Latin America (1945-1954

    Directory of Open Access Journals (Sweden)

    Moreli Rocha, Alexandre L.

    2015-06-01

    Full Text Available Still an open debate, definitions about the beginning of the Cold War were even more ambiguous to actors at the time concerned with development and exit strategies for the Second World War. That was precisely the scenario to several Latin American leaders who, far from the Iron Curtain, were debating the rise of the UN system and of parliamentary diplomacy. Focusing on a multilateral strategy of action for the post-war international order, our work tries to put together the Pan-Latin, Pan-American and UN policies of Latin Americans since the Chapultepec Conference of February 1945 until the 1954 Conferences of Caracas, which fashioned the Organization of American States’ Cold War status, and of Madrid, which failed to consolidate the Latin Union.Todavía un debate en abierto en la historiografía, la definición sobre los marcos del principio de la Guerra Fría fue aún más ambigua para los actores involucrados en el conflicto bélico precedente y preocupados con el desarrollo y las salidas estratégicas posibles de la Segunda Guerra Mundial. Esta fue la realidad para varios líderes latinoamericanos que, lejos de la Cortina de Hierro, quedaban mucho más preocupados con el surgimiento del sistema de las Naciones Unidas y la diplomacia parlamentaria. Centrándose sobre las estrategias multilaterales para la orden internacional de la posguerra, nuestro trabajo pretende analizar las políticas Pan-Latinas, Pan Americanas y para las Naciones Unidas de la América Latina desde la Conferencia de Chapultepec, en febrero de 1945, hasta las Conferencias de 1954 de Caracas, que consolidó la Organización de los Estados Americanos en un contexto de Guerra Fría, y de Madrid, que no logró consolidar la Unión Latina.

  1. Best practices in intercultural health: five case studies in Latin America

    Science.gov (United States)

    Mignone, Javier; Bartlett, Judith; O'Neil, John; Orchard, Treena

    2007-01-01

    The practice of integrating western and traditional indigenous medicine is fast becoming an accepted and more widely used approach in health care systems throughout the world. However, debates about intercultural health approaches have raised significant concerns. This paper reports findings of five case studies on intercultural health in Chile, Colombia, Ecuador, Guatemala, and Suriname. It presents summary information on each case study, comparatively analyzes the initiatives following four main analytical themes, and examines the case studies against a series of the best practice criteria. PMID:17803820

  2. Corporate America and community health: exploring the business case for investment.

    Science.gov (United States)

    Pronk, Nicolaas P; Baase, Catherine; Noyce, Jerry; Stevens, Denise E

    2015-05-01

    The principal aim of this project was to learn from corporate executives about the most important components of a business case for employer leadership in improving community health. We used dialogue sessions to gain insight into this issue. The strongest elements included metrics and measurement, return on investment, communications, shared values, shared vision, shared definitions, and leadership. Important barriers included lack of understanding, lack of clear strategy, complexity of the problem, trust, lack of resources and leadership, policies and regulations, and leadership philosophy. Substantial variability was observed in the degree of understanding of the relationship between corporate health and community health. The business case for intentional and strategic corporate investment in community health occurs along a continuum has a set of clearly defined elements that address why investment may make sense, but also asks questions about the "what-to-do" and the "how-to-do-it."

  3. Your money or your life: strong medicine for America's health care system

    National Research Council Canada - National Science Library

    Cutler, David M

    2004-01-01

    ...; doctors who are frustrated by in­ surance restrictions; more than 40 million people without health in­ surance. "Medical care is in crisis," we are repeatedly told, and so it is. Barely one in five Americans thinks the medical system works well. 1 For all the talk about crisis, however, health reform has proven painfully difficult. President Bill Cl...

  4. Realization of the international human right to health in an economically integrated North America.

    Science.gov (United States)

    Kinney, Eleanor D

    2009-01-01

    With the North American Free Trade Agreement (NAFTA), the health care sectors of the United States, Canada, and Mexico are becoming more economically integrated. NAFTA poses major challenges to the realization of the international human right. These include: (1) Cross Border Trade in Medical Products, (2) Cross Border Trade in Medical Services, and the attendant investment protections, (3) Portability and Comparability of Health Insurance Coverage, and (4) Protection of Public Health Insurance Programs. The United States, Mexico, and Canada all provide public health insurance programs either to the entire population as in Canada or to vulnerable groups as in the United States. In none of these countries have private, for-profit providers and insurers been able to provide universal and affordable health coverage and care in a truly free market. Private insurers and for-profit providers should not profit from the care of the healthy and wealthy in ways that compromise the public programs that serve the poor and seriously ill. Nor should they be allowed to use NAFTA processes to compromise public programs. Policy makers must consider implications of NAFTA and move toward assuring access to affordable health care for all people on the North American continent.

  5. Progress in reducing inequalities in reproductive, maternal, newborn,' and child health in Latin America and the Caribbean: an unfinished agenda

    Directory of Open Access Journals (Sweden)

    María Clara Restrepo-Méndez

    2015-07-01

    Full Text Available OBJECTIVE: To expand the "Countdown to 2015" analyses of health inequalities beyond the 75 countries being monitored worldwide to include all countries in Latin America and the Caribbean (LAC that have adequate data available. METHODS: Demographic and Health Surveys and Multiple Indicator Cluster Surveys were used to monitor progress in health intervention coverage and inequalities in 13 LAC countries, five of which are included in the Countdown (Bolivia, Brazil, Guatemala, Haiti, and Peru and eight that are not (Belize, Colombia, Costa Rica, Dominican Republic, Guyana, Honduras, Nicaragua, and Suriname. The outcomes included neonatal and under-5 year mortality rates, child stunting prevalence, and the composite coverage index-a weighted average of eight indicators of coverage in reproductive, maternal, newborn, and child health. The slope index of inequality and concentration index were used to assess absolute and relative inequalities. RESULTS: The composite coverage index showed monotonic patterns over wealth quintiles, with lowest levels in the poorest quintile. Under-5 and neonatal mortality as well as stunting prevalence were highest among the poor. In most countries, intervention coverage increased, while under-5 mortality and stunting prevalence fell most rapidly among the poor, so that inequalities were reduced over time. However, Bolivia, Guatemala, Haiti, Nicaragua, and Peru still show marked inequalities. Brazil has practically eliminated inequalities in stunting. CONCLUSIONS: LAC countries presented substantial progress in terms of reducing inequalities in reproductive, maternal, newborn, and child health interventions, child mortality, and nutrition. However, the poorest 20% of the population in most countries is still lagging behind, and renewed actions are needed to improve equity.

  6. Progress in reducing inequalities in reproductive, maternal, newborn,' and child health in Latin America and the Caribbean: an unfinished agenda.

    Science.gov (United States)

    Restrepo-Méndez, María Clara; Barros, Aluísio J D; Requejo, Jennifer; Durán, Pablo; Serpa, Luis Andrés de Francisco; França, Giovanny V A; Wehrmeister, Fernando C; Victora, Cesar G

    2015-07-01

    To expand the "Countdown to 2015" analyses of health inequalities beyond the 75 countries being monitored worldwide to include all countries in Latin America and the Caribbean (LAC) that have adequate data available. Demographic and Health Surveys and Multiple Indicator Cluster Surveys were used to monitor progress in health intervention coverage and inequalities in 13 LAC countries, five of which are included in the Countdown (Bolivia, Brazil, Guatemala, Haiti, and Peru) and eight that are not (Belize, Colombia, Costa Rica, Dominican Republic, Guyana, Honduras, Nicaragua, and Suriname). The outcomes included neonatal and under-5 year mortality rates, child stunting prevalence, and the composite coverage index-a weighted average of eight indicators of coverage in reproductive, maternal, newborn, and child health. The slope index of inequality and concentration index were used to assess absolute and relative inequalities. The composite coverage index showed monotonic patterns over wealth quintiles, with lowest levels in the poorest quintile. Under-5 and neonatal mortality as well as stunting prevalence were highest among the poor. In most countries, intervention coverage increased, while under-5 mortality and stunting prevalence fell most rapidly among the poor, so that inequalities were reduced over time. However, Bolivia, Guatemala, Haiti, Nicaragua, and Peru still show marked inequalities. Brazil has practically eliminated inequalities in stunting. LAC countries presented substantial progress in terms of reducing inequalities in reproductive, maternal, newborn, and child health interventions, child mortality, and nutrition. However, the poorest 20% of the population in most countries is still lagging behind, and renewed actions are needed to improve equity.

  7. [The "culture of survival" and international public health in Latin America: the Cold War and the eradication of diseases in the mid-twentieth century].

    Science.gov (United States)

    Cueto, Marcos

    2015-01-01

    This article analyzes the main campaigns run by international agencies and national health bodies to eradicate infectious diseases in rural Latin America in the 1940s and 1950s. The political dimensions of the period have been studied but there has been little attention as yet to the health dimensions. This article proposes the concept of a "culture of survival" to explain the official public health problems of states with limited social policies that did not allow the exercise of citizenship. Public health, as part of this culture of survival, sought a temporary solution without confronting the social problems that led to infections and left a public health legacy in the region.

  8. Climate change and health in the United States of America: impacts, adaptations, and research

    International Nuclear Information System (INIS)

    Jouan, R.; Magaud, M.

    2009-11-01

    After a description of the various impacts of climate change on human health, this report describes and comments the impacts of climate change on health in the USA: impacts of heat waves, of air quality degradation, of extreme climate events, of climate change on infectious diseases and allergies, regional impacts of climate change. In a second part, it describes the strategies of adaptation to the 'climate change and health' issue in the USA: mitigation and adaptation to climate change, adaptation challenges, insufficiently prepared public health system, adaptation to heat waves, adaptation to air quality degradation, adaptation to extreme climate events, adaptation to food- and water-based diseases and to vector-based diseases, examples of proactive adaptation. The last part describes the organisation of research on 'climate change and health' in the USA: nowadays and in the future, role of federal agencies, priority research axes. The 'United States Global Change Research Program' is presented in appendix, as well as the most important research centres (mostly in universities)

  9. Water and Forest Health: Drought Stress as a Core Driver of Forest Disturbances and Tree Mortality in Western North America

    Science.gov (United States)

    Allen, C. D.; Williams, P.

    2012-12-01

    Increasing warmth and dry climate conditions have affected large portions of western North America in recent years, causing elevated levels of both chronic and acute forest drought stress. In turn, increases in drought stress amplify the incidence and severity of the most significant forest disturbances in this region, including wildfire, drought-induced tree mortality, and outbreaks of damaging insects and diseases. Regional patterns of drought stress and various forest disturbances are reviewed, including interactions among climate and the various disturbance processes; similar global-scale patterns and trends of drought-amplified forest die-off and high-severity wildfire also are addressed. New research is presented that derives a tree-ring-based Forest Drought Stress Index (FDSI) for the three most widespread conifer species (Pinus edulis, Pinus ponderosa, and Pseudotsuga menziesii) in the southwestern US (Arizona, New Mexico), demonstrating nonlinear escalation of FDSI to levels unprecedented in the past 1000 years, in response to both drought and especially recent warming. This new work further highlights strong correlations between drought stress and amplified forest disturbances (fire, bark beetle outbreaks), and projects that by ca. 2050 anticipated regional warming will cause mean FDSI levels to reach extreme levels that may exceed thresholds for the survival of current tree species in large portions of their current range. Given recent trends of forest disturbance and projections for substantially warmer temperatures and greater drought stress for much of western North America in coming years, the growing risks to western forest health are becoming clear. This emerging understanding suggests an urgent need to determine potentials and methods for managing water on-site to maintain the vigor and resilience of western forests in the face of increasing levels of climate-induced water stress.

  10. A mapping of information security in health Information Systems in Latin America and Brazil.

    Science.gov (United States)

    Pereira, Samáris Ramiro; Fernandes, João Carlos Lopes; Labrada, Luis; Bandiera-Paiva, Paulo

    2013-01-01

    In health, Information Systems are patient records, hospital administration or other, have advantages such as cost, availability and integration. However, for these benefits to be fully met, it is necessary to guarantee the security of information maintained and provided by the systems. The lack of security can lead to serious consequences such as lawsuits and induction to medical errors. The management of information security is complex and is used in various fields of knowledge. Often, it is left in the background for not being the ultimate goal of a computer system, causing huge financial losses to corporations. This paper by systematic review methodologies, presented a mapping in the literature, in order to identify the most relevant aspects that are addressed by security researchers of health information, as to the development of computerized systems. They conclude through the results, some important aspects, for which the managers of computerized health systems should remain alert.

  11. Building alliances for improving newborn health in Latin America and the Caribbean

    Directory of Open Access Journals (Sweden)

    Molly K. Miller-Petrie

    2014-07-01

    Full Text Available The regional Latin American and Caribbean (LAC Neonatal Alliance and national neonatal alliances in Bolivia, El Salvador, and Peru were studied through in-depth interviews and a review of publications. Findings were analyzed to distill successful strategies, structures, and tools for improving neonatal health by working through alliances that can be replicated at the regional or national level. The studies found the following factors were the most critical for successful outcomes from alliance work: inclusion of the Ministry of Health as a leader or primary stakeholder; a committed, diverse, technically expert, and horizontal membership; the presence of champions for neonatal health at the national level; development of a shared work plan based on feasible objectives; the use of shared financing mechanisms; the use of informal and dynamic organizational structures; and a commitment to scientific evidence-based programming. The relationship between the regional and national alliances was found to be mutually beneficial.

  12. Islam, medicine, and Arab-Muslim refugee health in America after 9/11.

    Science.gov (United States)

    Inhorn, Marcia C; Serour, Gamal I

    2011-09-03

    Islam is the world's second largest religion, representing nearly a quarter of the global population. Here, we assess how Islam as a religious system shapes medical practice, and how Muslims view and experience medical care. Islam has generally encouraged the use of science and biomedicine for the alleviation of suffering, with Islamic authorities having a crucial supportive role. Muslim patients are encouraged to seek medical solutions to their health problems. For example, Muslim couples who are infertile throughout the world are permitted to use assisted reproductive technologies. We focus on the USA, assessing how Islamic attitudes toward medicine influence Muslims' engagement with the US health-care system. Nowadays, the Arab-Muslim population is one of the fastest growing ethnic-minority populations in the USA. However, since Sept 11, 2001, Arab-Muslim patients--and particularly the growing Iraqi refugee population--face huge challenges in seeking and receiving medical care, including care that is judged to be religiously appropriate. We assess some of the barriers to care--ie, poverty, language, and discrimination. Arab-Muslim patients' religious concerns also suggest the need for cultural competence and sensitivity on the part of health-care practitioners. Here, we emphasise how Islamic conventions might affect clinical care, and make recommendations to improve health-care access and services for Arab-Muslim refugees and immigrants, and Muslim patients in general. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. La Salud Pública en América Latina y El Caribe Public Health in Latin America and the Caribbean

    Directory of Open Access Journals (Sweden)

    Oscar García-Roco Pérez

    2002-08-01

    Full Text Available Se consideran a través de la situación de salud, las características de la Salud Pública en América Latina y el Caribe, su evolución y los hechos que justifican los procesos de reforma del sector, sus fuentes teóricas, la forma en que se desarrollan, y los problemas que enfrentan. Se describen las características esenciales de Colombia, Chile, México, Venezuela y se particulariza en el modelo cubano. Se realiza una reflexión final respecto a la contradictoria situación prevaleciente y se analiza su contexto políticoThe characteristics of Public Health in Latin America and the Caribbean through the present health state of the region is considered. The evolution of these characteristics and the facts that justify the processes of reformation of the sector, as well as their theoretical sources ; the form in which they are developed, and the problems they face are also regarded. The essential characteristics of Colombia, Chile, Mexico, Venezuela and particularly those of the Cuban model are described. A final reflection regarding the contradictory prevalent situation and its political context is made

  14. Introduction to U.S. health policy: the organization, financing, and delivery of health care in America

    National Research Council Canada - National Science Library

    Barr, Donald A

    2011-01-01

    ... A. Barr reviews the current structure of the American health care system, describing the historical and political contexts in which it developed and the core policy issues that continue to confront us today...

  15. Introduction to U.S. health policy: the organization, financing, and delivery of health care in America

    National Research Council Canada - National Science Library

    Barr, Donald A

    2011-01-01

    Health care reform has dominated public discourse over the past several years, and the recent passage of the Affordable Care Act, rather than quell the rhetoric, has sparked even more debate. Donald...

  16. 'Disease is unrhythmical': jazz, health, and disability in 1920s America.

    Science.gov (United States)

    Johnson, Russell L

    2011-01-01

    The 1920s in the United States are commonly remembered as the Jazz Age. Although historians have focused on the African American origins of the music, another theme was also prominent in the public discourse surrounding jazz: disability. Critics saw jazz and its associated dances as defective, causing both mental and physical impairments in their devotees. In other words, jazz music and dance were disabled and disabling. Proponents of jazz responded in kind, asserting that jazz did not cause impairments, it cured them; similarly, jazz was not defective music or dance, but a revitalisation of the art forms. On the one hand, these reactions might have been expected, given the long history of belief in a relationship between music and health. However, the importance of health issues such as eugenics and rehabilitation in the 1920s also clearly influenced the responses of opinion leaders, politicians, academics, music professionals, and others to jazz music and dance.

  17. US Health Care Reform and Rural America: Results From the ACA's Medicaid Expansions.

    Science.gov (United States)

    Benitez, Joseph A; Seiber, Eric E

    2018-03-01

    Medicaid expansions, prompted by the Affordable Care Act, generated generally positive effects on coverage and alleviated much of the financial burden associated with seeking health care. We do not know if these shifts also extend to the nation's rural populations. Using 2011-2015 Behavioral Risk Factor Surveillance System data, this study compares trend changes for coverage, access to care, and health care utilization in response to Medicaid expansion among urban and rural residents using a difference-in-differences regression approach. Following Medicaid expansion, low-income rural and urban residents both experienced reductions in uninsurance; however, the coverage uptake in rural settings (8.5 percentage points [pp], P .10). In spite of larger uptakes in coverage among rural residents, reductions in cost-related barriers to medical care were slightly larger among urban residents, and access to a regular source of medical care (5.2 pp, P rural residents than urban residents; however, it appears there remain opportunities to improve access to care among potentially vulnerable rural residents. © 2017 National Rural Health Association.

  18. Multi-pollutant surface objective analyses and mapping of air quality health index over North America.

    Science.gov (United States)

    Robichaud, Alain; Ménard, Richard; Zaïtseva, Yulia; Anselmo, David

    2016-01-01

    Air quality, like weather, can affect everyone, but responses differ depending on the sensitivity and health condition of a given individual. To help protect exposed populations, many countries have put in place real-time air quality nowcasting and forecasting capabilities. We present in this paper an optimal combination of air quality measurements and model outputs and show that it leads to significant improvements in the spatial representativeness of air quality. The product is referred to as multi-pollutant surface objective analyses (MPSOAs). Moreover, based on MPSOA, a geographical mapping of the Canadian Air Quality Health Index (AQHI) is also presented which provides users (policy makers, public, air quality forecasters, and epidemiologists) with a more accurate picture of the health risk anytime and anywhere in Canada and the USA. Since pollutants can also behave as passive atmospheric tracers, they provide information about transport and dispersion and, hence, reveal synoptic and regional meteorological phenomena. MPSOA could also be used to build air pollution climatology, compute local and national trends in air quality, and detect systematic biases in numerical air quality (AQ) models. Finally, initializing AQ models at regular time intervals with MPSOA can produce more accurate air quality forecasts. It is for these reasons that the Canadian Meteorological Centre (CMC) in collaboration with the Air Quality Research Division (AQRD) of Environment Canada has recently implemented MPSOA in their daily operations.

  19. STAKEHOLDER INVOLVEMENT IN THE HEALTH TECHNOLOGY ASSESSMENT PROCESS IN LATIN AMERICA.

    Science.gov (United States)

    Pichon-Riviere, Andres; Soto, Natalie; Augustovski, Federico; Sampietro-Colom, Laura

    2018-06-11

    Latin American countries are taking important steps to expand and strengthen universal health coverage, and health technology assessment (HTA) has an increasingly prominent role in this process. Participation of all relevant stakeholders has become a priority in this effort. Key issues in this area were discussed during the 2017 Latin American Health Technology Assessment International (HTAi) Policy Forum. The Forum included forty-one participants from Latin American HTA agencies; public, social security, and private insurance sectors; and the pharmaceutical and medical device industry. A background paper and presentations by invited experts and Forum members supported discussions. This study presents a summary of these discussions. Stakeholder involvement in HTA remains inconsistently implemented in the region and few countries have established formal processes. Participants agreed that stakeholder involvement is key to improve the HTA process, but the form and timing of such improvements must be adapted to local contexts. The legitimization of both HTA and decision-making processes was identified as one of the main reasons to promote stakeholder involvement; but to be successful, the entire system of assessment and decision making must be properly staffed and organized, and certain basic conditions must be met, including transparency in the HTA process and a clear link between HTA and decision making. Participants suggested a need for establishing clear rules of participation in HTA that would protect HTA producers and decision makers from potentially distorting external influences. Such rules and mechanisms could help foster trust and credibility among stakeholders, supporting actual involvement in HTA processes.

  20. Use of the internet as a resource for consumer health information: results of the second osteopathic survey of health care in America (OSTEOSURV-II).

    Science.gov (United States)

    Licciardone, J C; Smith-Barbaro, P; Coleridge, S T

    2001-01-01

    The Internet offers consumers unparalleled opportunities to acquire health information. The emergence of the Internet, rather than more-traditional sources, for obtaining health information is worthy of ongoing surveillance, including identification of the factors associated with using the Internet for this purpose. To measure the prevalence of Internet use as a mechanism for obtaining health information in the United States; to compare such Internet use with newspapers or magazines, radio, and television; and to identify sociodemographic factors associated with using the Internet for acquiring health information. Data were acquired from the Second Osteopathic Survey of Health Care in America (OSTEOSURV-II), a national telephone survey using random-digit dialing within the United States during 2000. The target population consisted of adult, noninstitutionalized, household members. As part of the survey, data were collected on: facility with the Internet, sources of health information, and sociodemographic characteristics. Multivariate analysis was used to identify factors associated with acquiring health information on the Internet. A total of 499 (64% response rate) respondents participated in the survey. With the exception of an overrepresentation of women (66%), respondents were generally similar to national referents. Fifty percent of respondents either strongly agreed or agreed that they felt comfortable using the Internet as a health information resource. The prevalence rates of using the health information sources were: newspapers or magazines, 69%; radio, 30%; television, 56%; and the Internet, 32%. After adjusting for potential confounders, older respondents were more likely than younger respondents to use newspapers or magazines and television to acquire health information, but less likely to use the Internet. Higher education was associated with greater use of newspapers or magazines and the Internet as health information sources. Internet use was lower

  1. A multistakeholder platform to promote health and prevent noncommunicable diseases in the region of the Americas: the Pan American Health Organization partners forum for action.

    Science.gov (United States)

    Hospedales, C James; Jané-Llopis, Eva

    2011-08-01

    Noncommunicable diseases (NCDs) and obesity are the most serious health problem facing the countries of the Americas in terms of avoidable deaths as well as costs to governments, families, and business. The main causes are ageing of the population, and widespread risks such as tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol, linked to major changes in the way we live and work, to public policies, cultural norms, and private sector forces. Underlying determinants are globalization, urbanization, poverty, education, gender, ethnicity, and access to health services. Yet, approximately 80% of cardiovascular disease and diabetes, and 40% of cancer, are preventable through a range of cost-effective population and individual measures for those at high risk of living with NCDs. However, the multisectoral nature of NCDs requires a cross-sector response to succeed. Several governments have commenced intersectoral efforts, and civil society and private sector also have many initiatives, but the responses are fragmented and skewed. The Partners Forum is being launched by the Pan American Health Organization in collaboration with the World Economic Forum and a set of partners including member states, partners in civil society, and partners in the private sector, as a multisector platform to catalyze, recognize, and scale up collaborative action to promote health and prevent and control NCDs at regional, subregional, and country level. The principles of partnership and lessons learned from other partnership experiences are being used in its design.

  2. Embracing "Soft Skill" Diversity in the Workplace (Invited)

    Science.gov (United States)

    Thomas, T.

    2010-12-01

    Embracing "Soft Skill" Diversity in the Workplace Terri Thomas, Sr. Director Global Customer Support ShoreTel INRODUCTION Truly successful diversity programs go beyond gender, age, ethnicity, race, sexual orientation and spiritual practice. They include diversity of thought, style, leadership and communication styles, the so called “soft skills”. The increasing need for global workforces is stronger than ever and high performance teams have fully embraced, successfully harnessed and put into practice robust diversity programs than include a “soft skill” focus. Managing diversity presents significant organizational challenges, and is not an easy task, particularly in organizations that are heavily weighted with highly technical professionals such as engineers, accountants etc.. The focus of this presentation is on leveraging the “Soft Skills” diversity in technical work environments to create high performance and highly productive teams. WHY DIVERSITY and WHY NOW? Due to increasing changes in the U.S. population, in order to stay competitive, companies need to focus on diversity and look for ways to become inclusive organizations because diversity has the potential of yielding greater productivity and competitive advantages . Managing and valuing diversity is a key component of effective people management, which can improve workplace productivity (Black Enterprise, 2001). Changing demographics, from organizational restructuring, women in the workplace, equal opportunity legislation and other legal issues, are forcing organizations to become more aggressive in implementing robust diversity practices. However, YOU do not need to wait for your organization to introduce a formal “Diversity” program. There are steps you can take to introduce diversity into your own workgroups. There is no “one single answer” to solve this issue, however this discussion will provide thought provoking ideas, examples of success and failure and a starting point for you

  3. Electronic Health Record in Bolivia and ICT: A Perspective for Latin America

    Directory of Open Access Journals (Sweden)

    Eugenio Gil

    2017-08-01

    Full Text Available The emergence of new technologies in society through its application to many areas and very diverse realities is a clear element in the time in which we live. The health sector has been unable to escape this reality and has been renovated many of its traditional structures with new options brought by the application of information technology and communication (ICT in areas such as management and hospital administration. This paper focuses on analyzing from the point of view of medical diagnosis the importance of electronic medical records as a unifying element of the information essential for this type of diagnosis, and the use of artificial intelligence techniques in this field. To this end the current situation of electronic medical records is analyzed in a country like Bolivia exhaustively analyzing three of the most important health centers. Is used for this unstructured interview experts on the subject reflect the current status of electronic medical records from the point of view of protection of the right to privacy of individuals and will serve as a model for development, not only in Bolivia but also in other Latin American countries.

  4. [Priority research agendas: a strategic resource for health in Latin America].

    Science.gov (United States)

    Becerra-Posada, Francisco; de Snyder, Nelly Salgado; Cuervo, Luis Gabriel; Montorzi, Gabriela

    2014-12-01

    Understand and analyze procedures used to create national integrated research agendas from 2007 to 2011 in Argentina, Guatemala, Mexico, Panama, and Paraguay. Descriptive, cross-sectional study using an online survey of agenda preparation processes; specifically, development, integration, implementation, and use and dissemination of the agenda. The 45 respondents reported following specific methodologies for agenda construction and had a good opinion of organizational aspects with regard to prior information provided and balance among disciplines and stakeholders. Some 60% considered the coordinators impartial, although 25% mentioned biases favoring some subject; 42% received technical support from consultants, reading matter, and methodological guidelines; 40% engaged in subject-matter priority-setting; and 55% confirmed dissemination and communication of the agenda. However, only 22% reported inclusion of agenda topics in national calls for research proposals. In the countries studied, development of the health research agenda was characterized by prior planning and appropriate organization to achieve - consensus-based outcomes. Nevertheless, the agendas were not used in national calls for research proposals, reflecting lack of coordination in national health research systems and lack of connection between funders and researchers. It is recommended that stakeholders strengthen integration and advocacy efforts to modify processes and structures of agenda-based calls for research proposals.

  5. The impact of health-management training programs in Latin America on job performance

    Directory of Open Access Journals (Sweden)

    Díaz-Monsalve Sonia Janeth

    2004-01-01

    Full Text Available A study was undertaken in Mexico, Colombia, and El Salvador to determine the impact of a management training program on health managers' job performance. A quasi-experimental design was used where in the baseline study an intervention group of 85 district health managers in the three countries was compared with a control group of 71 managers who did not receive the training program. After the implementation of an 18-month training program (which included 5-day training workshops and a series of tasks to be carried out between the workshops, the outcome in terms of improved job performance (i.e. use of predefined management techniques was measured through twelve management performance indicators. The data collection tools were two questionnaires, participant observation in managers' workplaces, focus group discussions, staff interviews, and document analysis. In Mexico, the control group showed 8.3 times weaker management performance compared to the intervention group; in Colombia the value was 3.6 and in El Salvador 2.4. Factors associated with a successful training outcome were: (a training techniques, (b strengthening of enabling factors, and (c reinforcement mechanisms.

  6. Hispanic Latin America, Spain and the Spanish-speaking Caribbean: a rich source of reference material for public health, epidemiology and tropical medicine.

    Science.gov (United States)

    Williams, John R; Bórquez, Annick; Basáñez, María-Gloria

    2008-09-30

    There is a multiplicity of journals originating in Spain and the Spanish-speaking countries of Latin America and the Caribbean (SSLAC) in the health sciences of relevance to the fields of epidemiology and public health. While the subject matter of epidemiology in Spain shares many features with its neighbours in Western Europe, many aspects of epidemiology in Latin America are particular to that region. There are also distinctive theoretical and philosophical approaches to the study of epidemiology and public health arising from traditions such as the Latin American social medicine movement, of which there may be limited awareness. A number of online bibliographic databases are available which focus primarily on health sciences literature arising in Spain and Latin America, the most prominent being Literatura Latinoamericana en Ciencias de la Salud (LILACS) and LATINDEX. Some such as LILACS also extensively index grey literature. As well as in Spanish, interfaces are provided in English and Portuguese. Abstracts of articles may also be provided in English with an increasing number of journals beginning to publish entire articles written in English. Free full text articles are becoming accessible, one of the most comprehensive sources being the Scientific Electronic Library Online (SciELO). There is thus an extensive range of literature originating in Spain and SSLAC freely identifiable and often accessible online, and with the potential to provide useful inputs to the study of epidemiology and public health provided that any reluctance to explore these resources can be overcome. In this article we provide an introduction to such resources.

  7. Crossing boundaries to improve mental health in the Americas: international collaborative authorship.

    Science.gov (United States)

    Killion, Chery M

    2007-01-01

    A nurse anthropologist with a background in international collaborations attended Project LEAD for two years, which enabled her to continue to serve as an advocate for the mentally ill in Belize. The anthropologist collaborated with a psychiatrist from Belize to develop a cross-cultural, cross-discipline publication, "Mental Health in Belize: A National Priority, " which highlights the work of psychiatric nurse practitioners in the country. The researcher learned to collaborate with her peer in Belize through face to face discussions and e-mail and overcame technological difficulties and cultural barriers to produce an international publication. Project LEAD gave the author a sense of self-discovery and self-knowledge, reinforced core values, and developed a frame of reference for leadership. The author also benefited from discussions by local, national, and international leaders on leadership in terms of its key components, contexts, challenges, triumphs, and styles.

  8. Clase social y salud en América Latina Social class and health in Latin America

    Directory of Open Access Journals (Sweden)

    Carles Muntaner

    2012-02-01

    Full Text Available Se repasan los principales conceptos de clase social, ocupación y estratificación social, y su contribución al análisis de los determinantes sociales de la salud (DSS, y se revisan los estudios empíricos desarrollados en América Latina que utilicen las relaciones de empleo como DSS. La revisión se ha enfocado en los estudios sobre la relación entre salud y clase social basados en las perspectivas neoweberiana o neomarxista. La búsqueda en la Biblioteca Virtual en Salud de BIREME y en la base de datos SciELO permitió localizar 28 artículos de esas características. Esta relativa escasez contrasta con la abundancia de trabajos con tales enfoques realizados en Europa y en los Estados Unidos, con una larga tradición en el análisis de los DSS. En tal sentido, las implicaciones políticas y programáticas de la investigación sobre clase social y relaciones de empleo son diferentes y complementarias de los estudios de gradientes de salud asociados a los ingresos y la educación. La globalización en las relaciones de empleo exige nuevos conceptos para explicar y medir los mecanismos de acción de los DSS trascendiendo lo estrictamente laboral; en particular, la relevancia en la realidad latinoamericana actual del impacto del trabajo informal sobre la salud.This paper reviews the principal concepts of social class, occupation, and social stratification, and their contribution to the analysis of the social determinants of health (SDH, and reviews empirical studies conducted in Latin America that use employment relations as an SDH. The review focuses on studies of the relationship between health and social class based on neo-Weberian or neo-Marxist perspectives. A search of the BIREME Virtual Health Library and the SciELO database found 28 articles meeting these characteristics. This relative dearth contrasts with the profusion of papers that use these approaches written in Europe and in the United States, with a long tradition in the

  9. Research plan to reduce health disparities in the United States of America

    Directory of Open Access Journals (Sweden)

    2001-01-01

    Full Text Available La salud de los habitantes de los Estados Unidos de América (EE.UU. ha mejorado en las últimas décadas, pero, a pesar de ello, sigue habiendo diferencias notables entre la carga de enfermedad y la mortalidad de la mayoría de la población del país y de minorías tales como los afroamericanos, los hispanos, los indios norteamericanos, los indígenas de Alaska, los asiáticos o los oriundos de las islas del Pacífico. Estas minorías raciales y étnicas, que en la actualidad representan cerca del 28% de la población de los EE.UU., tienen menor esperanza de vida y presentan mayores tasas de enfermedad cardiovascular, cáncer, mortalidad infantil, malformaciones congénitas, asma, diabetes, accidentes vasculares cerebrales, enfermedades de transmisión sexual y enfermedades mentales. Entre los organismos gubernamentales de los EE.UU. que están trabajando para reducir estas disparidades de salud se encuentran los Institutos Nacionales de la Salud (National Institutes of Health: NIH. Basándose en sus propios esfuerzos anteriores, los NIH han publicado recientemente un borrador de un plan quinquenal denominado "Plan estratégico de investigación del NIH para reducir y eliminar las disparidades de salud". El documento describe las tres áreas principales en las que los NIH centrarán sus esfuerzos para reducir dichas disparidades: investigación, infraestructura de investigación, e información pública y expansión de los servicios a la comunidad.

  10. Characterization of fruit development and potential health benefits of arrayan (Luma apiculata), a native berry of South America.

    Science.gov (United States)

    Fuentes, Lida; Valdenegro, Mónika; Gómez, María-Graciela; Ayala-Raso, Aníbal; Quiroga, Evelyn; Martínez, Juan-Pablo; Vinet, Raúl; Caballero, Eduardo; Figueroa, Carlos R

    2016-04-01

    The arrayan berry (Luma apiculata) is a native fruit from South America that belongs to the Myrtaceae family. To elucidate and characterize the developmental process and the potential health benefits of this edible fruit, quality and physiological parameters, along with antioxidant capacity, were evaluated during four clearly defined developmental stages of the fruit in two seasons. Fruit firmness slowly decreases during fruit development, whereas the solid soluble content/titratable acidity ratio (SSC/TA) increases significantly in the final stages of development. The measurement of low respiration rates and low ethylene production during growth and ripening suggested that the arrayan berry should be classified as a non-climacteric fruit. Arrayan berries show a significant increase in their antioxidant capacity from small green to black ripe fruit. FRAP and TEAC assays showed high correlations with total polyphenolic content (TPC) during ripening and high antioxidant capacity at all fruit stages, showing greater values in ripe fruit (FRAP: 24 ± 2 and 28 ± 3 μM FeSO4/gFW; TEAC: 18 ± 2 and 20 ± 1 Eq. Trolox/gFW for each season, respectively) than those observed in the blueberry (FRAP: 10 ± 2 and 19 ± 3 μM FeSO4/gFW; TEAC: 10 ± 2 and 17 ± 3). In addition, bioactive assays using ripe fruit extracts show presence of flavonol and anthocyanins, a high ORAC value (62,500 ± 7000 μmol/gDW) and a concentration-dependent vascular protection under high glucose conditions. The results obtained show that these endemic berry fruits have a promising potential as functional food. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Building America

    Energy Technology Data Exchange (ETDEWEB)

    Brad Oberg

    2010-12-31

    IBACOS researched the constructability and viability issues of using high performance windows as one component of a larger approach to building houses that achieve the Building America 70% energy savings target.

  12. Violence and Abuse in Rural America

    Science.gov (United States)

    ... Guide Rural Health Topics & States Topics View more Violence and Abuse in Rural America Violence and abuse ... of harassment, stalking, and bullying? How prevalent is violence and abuse in rural America? According to the ...

  13. [Financial impact of smoking on health systems in Latin America: A study of seven countries and extrapolation to the regional level].

    Science.gov (United States)

    Pichon-Riviere, Andrés; Bardach, Ariel; Augustovski, Federico; Alcaraz, Andrea; Reynales-Shigematsu, Luz Myriam; Pinto, Márcia Teixeira; Castillo-Riquelme, Marianela; Torres, Esperanza Peña; Osorio, Diana Isabel; Huayanay, Leandro; Munarriz, César Loza; de Miera-Juárez, Belén Sáenz; Gallegos-Rivero, Verónica; Puente, Catherine De La; Navia-Bueno, María Del Pilar; Caporale, Joaquín

    2016-10-01

    Estimate smoking-attributable direct medical costs in Latin American health systems. A microsimulation model was used to quantify financial impact of cardiovascular and cerebrovascular disease, chronic obstructive pulmonary disease (COPD), pneumonia, lung cancer, and nine other neoplasms. A systematic search for epidemiological data and event costs was carried out. The model was calibrated and validated for Argentina, Bolivia, Brazil, Chile, Colombia, Mexico, and Peru, countries that account for 78% of Latin America's population; the results were then extrapolated to the regional level. Every year, smoking is responsible for 33 576 billion dollars in direct costs to health systems. This amounts to 0.7% of the region's gross domestic product (GDP) and 8.3% of its health budget. Cardiovascular disease, COPD, and cancer were responsible for 30.3%, 26.9%, and 23.7% of these expenditures, respectively. Smoking-attributable costs ranged from 0.4% (Mexico and Peru) to 0.9% (Chile) of GDP and from 5.2% (Brazil) to 12.7% (Bolivia) of health expenditures. In the region, tax revenues from cigarette sales barely cover 37% of smoking-attributable health expenditures (8.1% in Bolivia and 67.3% in Argentina). Smoking is responsible for a significant proportion of health spending in Latin America, and tax revenues from cigarette sales are far from covering it. The region's countries should seriously consider stronger measures, such as an increase in tobacco taxes.

  14. An assessment of public health surveillance of Zika virus infection and potentially associated outcomes in Latin America.

    Science.gov (United States)

    Bautista, Leonelo E; Herrera, Víctor M

    2018-05-24

    We evaluated whether outbreaks of Zika virus (ZIKV) infection, newborn microcephaly, and Guillain-Barré syndrome (GBS) in Latin America may be detected through current surveillance systems, and how cases detected through surveillance may increase health care burden. We estimated the sensitivity and specificity of surveillance case definitions using published data. We assumed a 10% ZIKV infection risk during a non-outbreak period and hypothetical increases in risk during an outbreak period. We used sensitivity and specificity estimates to correct for non-differential misclassification, and calculated a misclassification-corrected relative risk comparing both periods. To identify the smallest hypothetical increase in risk resulting in a detectable outbreak we compared the misclassification-corrected relative risk to the relative risk corresponding to the upper limit of the endemic channel (mean + 2 SD). We also estimated the proportion of false positive cases detected during the outbreak. We followed the same approach for microcephaly and GBS, but assumed the risk of ZIKV infection doubled during the outbreak, and ZIKV infection increased the risk of both diseases. ZIKV infection outbreaks were not detectable through non-serological surveillance. Outbreaks were detectable through serologic surveillance if infection risk increased by at least 10%, but more than 50% of all cases were false positive. Outbreaks of severe microcephaly were detected if ZIKV infection increased prevalence of this condition by at least 24.0 times. When ZIKV infection did not increase the prevalence of severe microcephaly, 34.7 to 82.5% of all cases were false positive, depending on diagnostic accuracy. GBS outbreaks were detected if ZIKV infection increased the GBS risk by at least seven times. For optimal GBS diagnosis accuracy, the proportion of false positive cases ranged from 29 to 54% and from 45 to 56% depending on the incidence of GBS mimics. Current surveillance systems have a

  15. Hispanic Latin America, Spain and the Spanish-speaking Caribbean: A rich source of reference material for public health, epidemiology and tropical medicine

    Directory of Open Access Journals (Sweden)

    Basáñez María-Gloria

    2008-09-01

    Full Text Available Abstract There is a multiplicity of journals originating in Spain and the Spanish-speaking countries of Latin America and the Caribbean (SSLAC in the health sciences of relevance to the fields of epidemiology and public health. While the subject matter of epidemiology in Spain shares many features with its neighbours in Western Europe, many aspects of epidemiology in Latin America are particular to that region. There are also distinctive theoretical and philosophical approaches to the study of epidemiology and public health arising from traditions such as the Latin American social medicine movement, of which there may be limited awareness. A number of online bibliographic databases are available which focus primarily on health sciences literature arising in Spain and Latin America, the most prominent being Literatura Latinoamericana en Ciencias de la Salud (LILACS and LATINDEX. Some such as LILACS also extensively index grey literature. As well as in Spanish, interfaces are provided in English and Portuguese. Abstracts of articles may also be provided in English with an increasing number of journals beginning to publish entire articles written in English. Free full text articles are becoming accessible, one of the most comprehensive sources being the Scientific Electronic Library Online (SciELO. There is thus an extensive range of literature originating in Spain and SSLAC freely identifiable and often accessible online, and with the potential to provide useful inputs to the study of epidemiology and public health provided that any reluctance to explore these resources can be overcome. In this article we provide an introduction to such resources.

  16. Hispanic Latin America, Spain and the Spanish-speaking Caribbean: A rich source of reference material for public health, epidemiology and tropical medicine

    Science.gov (United States)

    Williams, John R; Bórquez, Annick; Basáñez, María-Gloria

    2008-01-01

    There is a multiplicity of journals originating in Spain and the Spanish-speaking countries of Latin America and the Caribbean (SSLAC) in the health sciences of relevance to the fields of epidemiology and public health. While the subject matter of epidemiology in Spain shares many features with its neighbours in Western Europe, many aspects of epidemiology in Latin America are particular to that region. There are also distinctive theoretical and philosophical approaches to the study of epidemiology and public health arising from traditions such as the Latin American social medicine movement, of which there may be limited awareness. A number of online bibliographic databases are available which focus primarily on health sciences literature arising in Spain and Latin America, the most prominent being Literatura Latinoamericana en Ciencias de la Salud (LILACS) and LATINDEX. Some such as LILACS also extensively index grey literature. As well as in Spanish, interfaces are provided in English and Portuguese. Abstracts of articles may also be provided in English with an increasing number of journals beginning to publish entire articles written in English. Free full text articles are becoming accessible, one of the most comprehensive sources being the Scientific Electronic Library Online (SciELO). There is thus an extensive range of literature originating in Spain and SSLAC freely identifiable and often accessible online, and with the potential to provide useful inputs to the study of epidemiology and public health provided that any reluctance to explore these resources can be overcome. In this article we provide an introduction to such resources. PMID:19243576

  17. Role of PAHO/WHO in eHealth Capacity Building in the Americas: Analysis of the 2011–2015 period

    Directory of Open Access Journals (Sweden)

    David Novillo-Ortiz

    Full Text Available Political will and adoption of measures toward the use of eHealth have been steadily increasing, facilitating mobilization of resources necessary to adopt and implement digital services that will make it possible to improve access, expand coverage, and increase financial efficiency of health care systems. Adoption of the Strategy and Plan of Action on eHealth of the Pan American Health Organization (PAHO in 2011 by all Member States in the Region of the Americas has led the Region to major progress in this regard, including the following: creation of knowledge networks and development of information sources, establishment of eHealth sustainability models, support for development of electronic health records, promotion of standards on health data and related technologies that ensure exchange of information, use of mobile devices to improve health, and improvement in quality of care through telemedicine. This article details the main actions carried out by PAHO with regard to eHealth, specifically by the office of Knowledge Management, Bioethics, and Research in the 2011-2015 period (first period of implementation of the PAHO eHealth strategy and plan of action, which include research and capacity-building activities, development of technical guidelines, and formation of knowledge networks.

  18. Escaping National Tags and Embracing Diversity: Third Culture Kid Songwriters

    Directory of Open Access Journals (Sweden)

    Sanfilippo-Schulz Jessica

    2018-04-01

    Full Text Available Nowadays, more and more writers cannot be classified according to one single nation. Whereas in Imagined Communities Anderson describes the development of nations and national belongings, in Third Culture Kid (TCK discourse a central theme is the concept of not belonging to one specific nation or culture (“NatioNILism”. TCKs are individuals who were raised moving from one country to the next due to their parents’ career choices. Not having had a fixed home while growing up, rather than accepting classifications according to nations and cultures, many TCKs prefer to embrace diversity. Antje Rauwerda argues that the fiction of adult TCKs comprises typical features that reflect the consequences of a displaced international childhood and accordingly coins the new literary classification Third Culture Literature. Whereas Rauwerda exclusively analyses novels written by TCKs, this article examines whether the effects of hypermobile international childhoods can be detected in the works of TCK songwriters. By analysing not only the song lyrics of contemporary musicians such as Haikaa, Sinkane and Tanita Tikaram but also the artists’ views regarding issues such as belonging, identity and transience, it will be shown that in the scholarly realm the TCK lens can be expanded to song texts too.

  19. Textbook America.

    Science.gov (United States)

    Karp, Walter

    1980-01-01

    Focuses on how political attitudes have been influenced by American history textbooks at various times throughout history. Excerpts from traditional and revisionist textbooks are presented, with emphasis on "America Revised" by Frances FitzGerald. Journal available from Harper's Magazine Co., 2 Park Ave., New York, NY 10016. (DB)

  20. Rapid Spread of Zika Virus in The Americas--Implications for Public Health Preparedness for Mass Gatherings at the 2016 Brazil Olympic Games.

    Science.gov (United States)

    Petersen, Eskild; Wilson, Mary E; Touch, Sok; McCloskey, Brian; Mwaba, Peter; Bates, Matthew; Dar, Osman; Mattes, Frank; Kidd, Mike; Ippolito, Giuseppe; Azhar, Esam I; Zumla, Alimuddin

    2016-03-01

    Mass gatherings at major international sporting events put millions of international travelers and local host-country residents at risk of acquiring infectious diseases, including locally endemic infectious diseases. The mosquito-borne Zika virus (ZIKV) has recently aroused global attention due to its rapid spread since its first detection in May 2015 in Brazil to 22 other countries and other territories in the Americas. The ZIKV outbreak in Brazil, has also been associated with a significant rise in the number of babies born with microcephaly and neurological disorders, and has been declared a 'Global Emergency by the World Health Organization. This explosive spread of ZIKV in Brazil poses challenges for public health preparedness and surveillance for the Olympics and Paralympics which are due to be held in Rio De Janeiro in August, 2016. We review the epidemiology and clinical features of the current ZIKV outbreak in Brazil, highlight knowledge gaps, and review the public health implications of the current ZIKV outbreak in the Americas. We highlight the urgent need for a coordinated collaborative response for prevention and spread of infectious diseases with epidemic potential at mass gatherings events. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Health and Ethical Consequences of Outsourcing Pivotal Clinical Trials to Latin America: A Cross-Sectional, Descriptive Study.

    Science.gov (United States)

    Homedes, Núria; Ugalde, Antonio

    2016-01-01

    The implications of conducting clinical trials in low and middle income countries on the financial accessibility and safety of the pharmaceutical products available in those markets have not been studied. Regulatory practices and ethical declarations lead to the commercialization of the new products, referred to as New Molecular Entities (NMEs), in the countries where tested as soon as they are approved in high surveillance countries. Patients and patients' associations use the Latin American courts to access new and expensive treatments, regardless of their safety profile and therapeutic value. Cross-sectional, descriptive study. To determine the therapeutic value and safety profile of the NMEs approved by the Food and Drug Administration (FDA) in 2011 and 2012 that had been tested in Latin America, and the implications of their market approval for the pharmaceutical budgets in the countries where tested. Latin America. To assess the therapeutic value and safety of the NMEs commercialized in the different countries we used f independent drug bulletins. The prices of the NMEs for the consumers were obtained from the pharmaceutical price observatories of the countries were the medicines had been tested. If the price was not available in the observatories, it was obtained from pharmaceutical distributors. We used the countries' minimum wage and per capita income to calculate the financial accessibility of a course of treatment with the NMEs. We found that 33 NMEs approved by the FDA in 2011 and 2012 have been tested in Latin America. Of these, 26 had been evaluated by independent drug bulletins and only five were found to add some value to a subset of patients and had significant side-effects. The pharmaceutical prices were very high, varied widely across countries and were unrelated to the countries' income per capita or minimum wage. The implementation of clinical trials in Latin America results in the commercialization of medicines with questionable safety

  2. Bolivia. America = Las Americas [Series].

    Science.gov (United States)

    Toro, Leonor; Avery, Robert S.

    Written for teachers to use with migrant children in elementary grades and to highlight the many Americas, this bilingual English/Spanish social studies resource booklet provides historical and cultural information on Bolivia. A table of contents indicates the language--Spanish or English--in which the topics are written. The quarterly provides an…

  3. Capital social y promoción de la salud en América Latina Social capital and health promotion in Latin America

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    Jaime C Sapag

    2007-02-01

    Full Text Available América Latina enfrenta problemáticas de desarrollo y salud comunes. La equidad y la superación de la pobreza son cruciales en la búsqueda de soluciones integrales y de alto impacto. El artículo analiza el concepto de capital social, su relación con salud, sus limitaciones y potencialidades, desde una perspectiva de desarrollo comunitario y promoción de salud en América Latina. También, se identifican desafíos prioritarios, como la medición y fortalecimiento del capital social. Se discute cómo y por qué el capital social pudiera ser crítico en una estrategia global de promoción de la salud, donde el empoderamiento y la participación comunitaria, el trabajo interdisciplinario e intersectorial permitirían avanzar en los objetivos de salud pública y en la concreción de un cambio social sustentable. Igualmente, se identifican algunas de las potenciales limitaciones del concepto de capital social en el contexto de promoción de la salud en América Latina.Latin America faces common development and health problems and equity and overcoming poverty are crucial in the search for comprehensive and high impact solutions. The article analyzes the definition of social capital, its relationship with health, its limitations and potentialities from a perspective of community development and health promotion in Latin America. High-priority challenges are also identified as well as possible ways to better measure and to strengthen social capital. Particularly, it is discussed how and why social capital may be critical in a global health promotion strategy, where empowerment and community participation, interdisciplinary and intersectorial work would help to achieve Public Health aims and a sustainable positive change for the global development. Also, some potential limitations of the social capital concept in the context of health promotion in Latin America are identified.

  4. Scream-embrace displays in wild black-horned capuchin monkeys.

    Science.gov (United States)

    Lynch Alfaro, Jessica

    2008-06-01

    Reintroduction of capuchin monkeys (Cebus apella) into their social group in captivity can elicit sirena screams and embraces. Captive scream-embrace displays are male biased, and females never perform sirena screams. One hypothesis is that scream-embrace displays serve a tension-reduction or reconciliatory function between males with conflicting interests. Alternatively, these displays may function to maintain strong affiliative bonds between friendly male dyads. Scream and/or embrace displays in wild Brazilian black-horned capuchins were analyzed for social and ecological contexts, behavioral components, and individuals involved. Seventy-two displays were observed during the 199-day study period. Among the 66 displays for which both members could be identified by sex, there were 42 occurrences of male-male dyads, 17 of male-female dyads, and seven of female-female dyads. Scream-embrace dyads were male-male pairs significantly more often than expected from group membership, and the alpha male was the only male to engage in scream-embrace displays with females. Female-female pairs did embrace, but never emitted sirena screams. Displays most commonly occurred in "reunion" contexts, primarily the reuniting of subgroups after hours or days out of contact, but also after intergroup encounters, and across groups in "intergroup" displays. Displays were rare, but socially contagious, and subgroup reunions could elicit multiple displays in rapid succession. Although the occurrence of screams and embraces was positively correlated, both behaviors also occurred independently, and their functions may be different. Male sirena screams may be honest advertisements of united alliances, directed toward a third party, whereas the embrace may be a risky affiliative signal, directed primarily within the dyad. Copyright 2008 Wiley-Liss, Inc.

  5. Calidad de los datos de salud ocupacional en América Latina y el Caribe The quality of occupational health data in Latin America and the Caribbean

    Directory of Open Access Journals (Sweden)

    1999-01-01

    Full Text Available Work-related accidents and illnesses cause significant economic and social losses in Latin America and the Caribbean. However, the lack of reliable and systematized data on that situation makes it harder for health authorities and business operators to make decisions and for workers and the general public to take steps to improve working conditions, reduce risks, and prevent those accidents and illnesses. To address that concern, the Program on Workers' Health of the Pan American Health Organization (PAHO coordinated the Project on Systematizing Basic Data on Workers' Health in the Countries of the Americas. A report on the project issued in August 1998 contains results, conclusions, and recommendations based on data collected from 10 countries of the Region: Barbados, Brazil, Chile, Colombia, Costa Rica, Jamaica, Mexico, Panama, Peru, and Venezuela. The data were systematized and presented in 42 tables that allowed comparisons among the countries and evaluations of the situation in any one of the countries. Data from countries with adequate record keeping made it clear that many persons work in sectors with high rates of accidents and chronic disease. The research also found it is often hard to analyze trends and changes in labor mortality and morbidity and the conditions that increase the frequency of accidents and occupational diseases. That is because countries and institutions use a variety of approaches to classify, diagnose, and report diseases and occupational injuries, and also frequently modify their criteria. As a follow-up to this research, PAHO is working to compile more specific information on occupational health in the countries of the Region, through an approach that would improve the quality of the information and make it easier to compare the data that is collected.

  6. Health and Ethical Consequences of Outsourcing Pivotal Clinical Trials to Latin America: A Cross-Sectional, Descriptive Study

    Science.gov (United States)

    Homedes, Núria; Ugalde, Antonio

    2016-01-01

    Introduction The implications of conducting clinical trials in low and middle income countries on the financial accessibility and safety of the pharmaceutical products available in those markets have not been studied. Regulatory practices and ethical declarations lead to the commercialization of the new products, referred to as New Molecular Entities (NMEs), in the countries where tested as soon as they are approved in high surveillance countries. Patients and patients’ associations use the Latin American courts to access new and expensive treatments, regardless of their safety profile and therapeutic value. Design and Objectives Cross-sectional, descriptive study. To determine the therapeutic value and safety profile of the NMEs approved by the Food and Drug Administration (FDA) in 2011 and 2012 that had been tested in Latin America, and the implications of their market approval for the pharmaceutical budgets in the countries where tested. Setting Latin America. Measures To assess the therapeutic value and safety of the NMEs commercialized in the different countries we used f independent drug bulletins. The prices of the NMEs for the consumers were obtained from the pharmaceutical price observatories of the countries were the medicines had been tested. If the price was not available in the observatories, it was obtained from pharmaceutical distributors. We used the countries’ minimum wage and per capita income to calculate the financial accessibility of a course of treatment with the NMEs. Results We found that 33 NMEs approved by the FDA in 2011 and 2012 have been tested in Latin America. Of these, 26 had been evaluated by independent drug bulletins and only five were found to add some value to a subset of patients and had significant side-effects. The pharmaceutical prices were very high, varied widely across countries and were unrelated to the countries’ income per capita or minimum wage. Conclusion The implementation of clinical trials in Latin America

  7. Status and progress of family health in Latin America and the Caribbean: the Ibero-American Confederation of Family Medicine (ICPM perspective

    Directory of Open Access Journals (Sweden)

    María Inez Padula Anderson

    2013-01-01

    Full Text Available In the XXI century, much of humanity does not have access to comprehensive health care, or even basic equitable health care. If studies show that countries with organized health systems based on a qualified and inclusive model of Primary Health Care (PHC and family physicians as permanent staff are achieving unquestionable results, why a large part of the countries with lower socio-economic development have not committed strongly to implement an efficient reform of their health systems based on PHC and family medicine (FM? These issues are at the core of the Latin American Confederation of Family Medicine’s concerns, an international non-profit organization composed of national associations of countries of FM from Latin America, Spain and Portugal. Its primary mission is to drive the implementation of a proper PHC system in all countries of the region and to ensure that family medicine, as a specialty, is considered critical to health systems, thereby transforming it into a public policy.

  8. The Pan American Health Organization’s role and perspectives on the mapping and modeling of the neglected tropical diseases in Latin America and the Caribbean: an overview

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    Steven K. Ault

    2012-09-01

    Full Text Available The Pan American Health Organization (PAHO, which functions as the regional office for the Americas of the World Health Organization, is committed to provide technical cooperation to countries to update the epidemiological information available for mapping and modelling of the neglected tropical diseases (NTDs, a set of diseases mainly caused by parasites affecting people living in low socioeconomic and favourable environmental conditions. This communication discusses PAHO’s role and perspectives in the use of mapping and modelling of these diseases with a view to promote its use in the development and implementation of integrated, inter-programmatic and inter-sectoral plans for the prevention, control or elimination of the NTDs and other infectious diseases related to poverty.

  9. The Pan American Health Organization's role and perspectives on the mapping and modeling of the neglected tropical diseases in Latin America and the Caribbean: an overview.

    Science.gov (United States)

    Ault, Steven K; Nicholls, Ruben Santiago; Saboya, Martha IdaIí

    2012-09-01

    The Pan American Health Organization (PAHO), which functions as the regional office for the Americas of the World Health Organization, is committed to provide technical cooperation to countries to update the epidemiological information available for mapping and modelling of the neglected tropical diseases (NTDs), a set of diseases mainly caused by parasites affecting people living in low socioeconomic and favourable environmental conditions. This communication discusses PAHO's role and perspectives in the use of mapping and modelling of these diseases with a view to promote its use in the development and implementation of integrated, inter-programmatic and inter-sectoral plans for the prevention, control or elimination of the NTDs and other infectious diseases related to poverty.

  10. Health Care Reform: America's Dilemma. Report on the National Meeting (Boston, Massachusetts, November 28-29, 1990).

    Science.gov (United States)

    Labor/Higher Education Council, Washington, DC.

    Health care reform's direct effect on higher education and labor is the subject of this conference report. Individual, panel, and interactive work group presentations addressing the values and options on health care issues are included. Following an introduction, three papers discuss the U.S. health care system: (1) "National Health Care…

  11. Assessing service use for mental health by Indigenous populations in Australia, Canada, New Zealand and the United States of America: a rapid review of population surveys.

    Science.gov (United States)

    McIntyre, Cecily; Harris, Meredith G; Baxter, Amanda J; Leske, Stuart; Diminic, Sandra; Gone, Joseph P; Hunter, Ernest; Whiteford, Harvey

    2017-08-04

    Indigenous people in Australia, Canada, New Zealand and the United States of America experience disproportionately poor mental health compared to their non-Indigenous counterparts. To optimally allocate resources, health planners require information about the services Indigenous people use for mental health, their unmet treatment needs and the barriers to care. We reviewed population surveys of Indigenous people to determine whether the information needed to guide service development is being collected. We sought national- or state-level epidemiological surveys of Indigenous populations conducted in each of the four selected countries since 1990 that asked about service use for mental health. Surveys were identified from literature reviews and web searches. We developed a framework for categorising the content of each survey. Using this framework, we compared the service use content of the surveys of Indigenous people to each other and to general population mental health surveys. We focused on identifying gaps in information coverage and topics that may require Indigenous-specific questions or response options. Nine surveys met our inclusion criteria. More than half of these included questions about health professionals consulted, barriers to care, perceived need for care, medications taken, number, duration, location and payment of health professional visits or use of support services or self-management. Less than half included questions about interventions received, hospital admissions or treatment dropout. Indigenous-specific content was most common in questions regarding use of support services or self-management, types of health professionals consulted, barriers to care and interventions received. Epidemiological surveys measuring service use for mental health among Indigenous populations have been less comprehensive and less standardised than surveys of the general population, despite having assessed similar content. To better understand the gaps in mental

  12. Health care providers and human trafficking: what do they know, what do they need to know? Findings from the middle East, the Caribbean, and central america.

    Science.gov (United States)

    Viergever, Roderik F; West, Haley; Borland, Rosilyne; Zimmerman, Cathy

    2015-01-01

    Human trafficking is a crime that commonly results in acute and chronic physical and psychological harm. To foster more informed health sector responses to human trafficking, training sessions for health care providers were developed and pilot-tested in the Middle East, Central America, and the Caribbean. This study presents the results of an investigation into what health care providers knew and needed to know about human trafficking as part of that training program. Participants attended one of seven two-day training courses in Antigua and Barbuda, Belize, Costa Rica, Egypt, El Salvador, Guyana, and Jordan. We assessed participants' knowledge about human trafficking and opinions about appropriate responses in trafficking cases via questionnaires pre-training, and considered participant feedback about the training post-training. 178 participants attended the trainings. Pre-training questionnaires were completed by 165 participants (93%) and post-training questionnaires by 156 participants (88%). Pre-training knowledge about health and human trafficking appeared generally high for topics such as the international nature of trafficking and the likelihood of poor mental health outcomes among survivors. However, many participants had misconceptions about the characteristics of trafficked persons and a provider's role in responding to cases of trafficking. The most valued training components included the "Role of the Health Provider," "Basic Definitions and Concepts," and "Health Consequences of Trafficking." Training health care providers on caring for trafficked persons has the potential to improve practitioners' knowledge about human trafficking and its health consequences, and to increase safe practices when responding in cases of trafficking. This study provides lessons for the design of training programs on human trafficking that aim to help health care providers identify and refer victims, and provide care for survivors.

  13. Health care providers and human trafficking: what do they know, what do they need to know? Findings from the Middle East, the Caribbean and Central America.

    Directory of Open Access Journals (Sweden)

    Roderik F Viergever

    2015-01-01

    Full Text Available BackgroundHuman trafficking is a crime that commonly results in acute and chronic physical and psychological harm. To foster more informed health sector responses to human trafficking, training sessions for health care providers were developed and pilot-tested in the Middle East, Central America and the Caribbean. This study presents the results of an investigation into what health care providers knew and needed to know about human trafficking as part of that training program.MethodsParticipants attended one of seven two-day training courses in Antigua and Barbuda, Belize, Costa Rica, Egypt, El Salvador, Guyana and Jordan. We assessed participants’ knowledge about human trafficking and opinions about appropriate responses in trafficking cases via questionnaires pre-training, and considered participant feedback about the training post-training. Results178 participants attended the trainings. Pre-training questionnaires were completed by 165 participants (93% and post-training questionnaires by 156 participants (88%. Pre-training knowledge about health and human trafficking appeared generally high for topics such as the international nature of trafficking and the likelihood of poor mental health outcomes among survivors. However, many participants had misconceptions about the characteristics of trafficked persons and a provider’s role in responding to cases of trafficking. The most valued training components included the Role of the Health Provider, Basic Definitions and Concepts and Health Consequences of Trafficking. DiscussionTraining health care providers on caring for trafficked persons has the potential to improve practitioners’ knowledge about human trafficking and its health consequences, and to increase safe practices when responding in cases of trafficking. This study provides lessons for the design of training programs on human trafficking that aim to help health care providers identify and refer victims, and provide care for

  14. Genero y politicas de salud de la mujer en america latina: caso Perú (Parte I Gender and woman's health politics in Latino America: the case of the Peru

    Directory of Open Access Journals (Sweden)

    Marina Violeta Estrada Pérez de Martos

    1996-04-01

    Full Text Available En este estudio se hace una presentación y análisis de la problemática de la mujer, considerando su condición social, de acuerdo a la ideologia androcentrista en la sociedad. Se hace una breve evolución histórica de la mujer bajo el recorte analítico de género. De otro lado, se analiza las políticas públicas y de salud de la mujer en América Latina, especialmente en el Perú, desde el Incanato, explicando las, razones de la formulación e implantación del Programa de Planificación Familiar y del Programa de Atención Materno Infantil.This study includes a presentation and analysis about the woman's problematic. It considers the woman social condition concording to the androgynors ideology of the society. Briefly it presents a historical evolution of the woman in accord with the gender analysis. On the other hand, it presents too, an analysis of the health and the public politics in relation to the woman in Latin America, mainly in Peru, since the Incanato period, justifying the motives of the formulation and implementation of the Family Planning Program, the Responsable Paternity Program and Child and Mother Atention Program.

  15. Psychology of the Embrace: How Body Rhythms Communicate the Need to Indulge or Separate.

    Science.gov (United States)

    Koch, Sabine C; Rautner, Helena

    2017-11-29

    In the context of embodiment research, there has been a growing interest in phenomena of interpersonal resonance. Given that haptic communication is particularly under-researched, we focused on the phenomenon of embracing. When we embrace a dear friend to say good-bye at the end of a great evening, we typically first employ smooth and yielding movements with round transitions between muscular tensing and relaxing ( smooth , indulging rhythms ), and when the embrace is getting too long, we start to use slight patting ( sharp , fighting rhythms with sharp transitions) on the back or the shoulders of the partner in order to indicate that we now want to end the embrace. On the ground of interpersonal resonance, most persons (per-sonare, latin = to sound through) understand these implicit nonverbal signals, expressed in haptic tension-flow changes, and will react accordingly. To experimentally test the hypothesis that smooth, indulgent rhythms signal the wish to continue, and sharp, fighting rhythms signal the wish to separate from an embrace, we randomly assigned 64 participants, all students at the University of Heidelberg, to two differently sequenced embrace conditions: (a) with the fighting rhythm at the end of the sequence of two indulgent rhythms (Sequence A: smooth-smooth-sharp); and (b) with the fighting rhythm between two indulgent rhythms (Sequence B: smooth-sharp-smooth). Participants were embraced for 30 s by a female confe-derate with their eyes blindfolded to focus on haptic and kinesthetic cues without being distracted by visual cues. They were instructed to let go of a handkerchief that they held between the fingers of their dominant hand during the embrace, when they felt that the embracer signaled the wish to finish the embrace. Participants significantly more often dropped the handkerchief in the phase of the fighting rhythm, no matter in which location it occurred in the embrace sequence. We assume that we learn such rhythmic behaviors and their

  16. Psychology of the Embrace: How Body Rhythms Communicate the Need to Indulge or Separate

    Directory of Open Access Journals (Sweden)

    Sabine C. Koch

    2017-11-01

    Full Text Available In the context of embodiment research, there has been a growing interest in phenomena of interpersonal resonance. Given that haptic communication is particularly under-researched, we focused on the phenomenon of embracing. When we embrace a dear friend to say good-bye at the end of a great evening, we typically first employ smooth and yielding movements with round transitions between muscular tensing and relaxing (smooth, indulging rhythms, and when the embrace is getting too long, we start to use slight patting (sharp, fighting rhythms with sharp transitions on the back or the shoulders of the partner in order to indicate that we now want to end the embrace. On the ground of interpersonal resonance, most persons (per-sonare, latin = to sound through understand these implicit nonverbal signals, expressed in haptic tension-flow changes, and will react accordingly. To experimentally test the hypothesis that smooth, indulgent rhythms signal the wish to continue, and sharp, fighting rhythms signal the wish to separate from an embrace, we randomly assigned 64 participants, all students at the University of Heidelberg, to two differently sequenced embrace conditions: (a with the fighting rhythm at the end of the sequence of two indulgent rhythms (Sequence A: smooth-smooth-sharp; and (b with the fighting rhythm between two indulgent rhythms (Sequence B: smooth-sharp-smooth. Participants were embraced for 30 s by a female confe­derate with their eyes blindfolded to focus on haptic and kinesthetic cues without being distracted by visual cues. They were instructed to let go of a handkerchief that they held between the fingers of their dominant hand during the embrace, when they felt that the embracer signaled the wish to finish the embrace. Participants significantly more often dropped the handkerchief in the phase of the fighting rhythm, no matter in which location it occurred in the embrace sequence. We assume that we learn such rhythmic behaviors and

  17. Genero y politicas de salud de la mujer en America Latina: caso Perú (parte II Gender and woman's health politics in Latino America: the case of the Peru

    Directory of Open Access Journals (Sweden)

    Marina Violeta Estrada Pérez de Martos

    1996-08-01

    Full Text Available En este estudio se hace una presentación y análisis de la problemática de la mujer, considerando su condición social, de acuerdo a la ideologia androcentrista en la sociedad. Se hace una breve evolución histórica de la mujer bafo el recorte analítico de género. Se analiza las políticas públicas y de salud de la mujer en América Latina, especialmente en el Perú, desde el Incanato, explicando las razones de la formulación e implantación del Programa de Planificación Familiar y del Programa de Atención Materno Infantil.Finalmente, se resalta la importancia de considerar proyectos, programas y políticas de salud que no sean excluyentes y que no se refieran solamente al aspecto reproductivo biológico de la mujer.This study includes a presentation and analysis about the woman's problematic. It considers the woman social condition concording to the androgynors ideology of the society. Briefly it presents a historical evolution of the woman in accord with the gender analysis. It presents too, an analysis of the health and the public politics in relation to the woman in Latin America, mainly in Peru, since the Incanato period, justifying the motives of the formulation and implementation of the Family Planning Program, the Responsable Paternity Program and Child and Mother Atention Program. Finally, this study considers the importance of integral projects, programs and health politics and not only considering the women's reproduction.

  18. Providers’ perspectives on inbound medical tourism in Central America and the Caribbean: factors driving and inhibiting sector development and their health equity implications

    Science.gov (United States)

    Johnston, Rory; Crooks, Valorie A.; Cerón, Alejandro; Labonté, Ronald; Snyder, Jeremy; Núñez, Emanuel O.; Flores, Walter G.

    2016-01-01

    Background Many governments and health care providers worldwide are enthusiastic to develop medical tourism as a service export. Despite the popularity of this policy uptake, there is relatively little known about the specific local factors prospectively motivating and informing development of this sector. Objective To identify common social, economic, and health system factors shaping the development of medical tourism in three Central American and Caribbean countries and their health equity implications. Design In-depth, semi-structured interviews were conducted in Mexico, Guatemala, and Barbados with 150 health system stakeholders. Participants were recruited from private and public sectors working in various fields: trade and economic development, health services delivery, training and administration, and civil society. Transcribed interviews were coded using qualitative data management software, and thematic analysis was used to identify cross-cutting issues regarding the drivers and inhibitors of medical tourism development. Results Four common drivers of medical tourism development were identified: 1) unused capacity in existing private hospitals, 2) international portability of health insurance, vis-a-vis international hospital accreditation, 3) internationally trained physicians as both marketable assets and industry entrepreneurs, and 4) promotion of medical tourism by public export development corporations. Three common inhibitors for the development of the sector were also identified: 1) the high expense of market entry, 2) poor sector-wide planning, and 3) structural socio-economic issues such as insecurity or relatively high business costs and financial risks. Conclusion There are shared factors shaping the development of medical tourism in Central America and the Caribbean that help explain why it is being pursued by many hospitals and governments in the region. Development of the sector is primarily being driven by public investment promotion

  19. Providers’ perspectives on inbound medical tourism in Central America and the Caribbean: factors driving and inhibiting sector development and their health equity implications

    Directory of Open Access Journals (Sweden)

    Rory Johnston

    2016-11-01

    Full Text Available Background: Many governments and health care providers worldwide are enthusiastic to develop medical tourism as a service export. Despite the popularity of this policy uptake, there is relatively little known about the specific local factors prospectively motivating and informing development of this sector. Objective: To identify common social, economic, and health system factors shaping the development of medical tourism in three Central American and Caribbean countries and their health equity implications. Design: In-depth, semi-structured interviews were conducted in Mexico, Guatemala, and Barbados with 150 health system stakeholders. Participants were recruited from private and public sectors working in various fields: trade and economic development, health services delivery, training and administration, and civil society. Transcribed interviews were coded using qualitative data management software, and thematic analysis was used to identify cross-cutting issues regarding the drivers and inhibitors of medical tourism development. Results: Four common drivers of medical tourism development were identified: 1 unused capacity in existing private hospitals, 2 international portability of health insurance, vis-a-vis international hospital accreditation, 3 internationally trained physicians as both marketable assets and industry entrepreneurs, and 4 promotion of medical tourism by public export development corporations. Three common inhibitors for the development of the sector were also identified: 1 the high expense of market entry, 2 poor sector-wide planning, and 3 structural socio-economic issues such as insecurity or relatively high business costs and financial risks. Conclusion: There are shared factors shaping the development of medical tourism in Central America and the Caribbean that help explain why it is being pursued by many hospitals and governments in the region. Development of the sector is primarily being driven by public

  20. Providers' perspectives on inbound medical tourism in Central America and the Caribbean: factors driving and inhibiting sector development and their health equity implications.

    Science.gov (United States)

    Johnston, Rory; Crooks, Valorie A; Cerón, Alejandro; Labonté, Ronald; Snyder, Jeremy; Núñez, Emanuel O; Flores, Walter G

    2016-01-01

    Many governments and health care providers worldwide are enthusiastic to develop medical tourism as a service export. Despite the popularity of this policy uptake, there is relatively little known about the specific local factors prospectively motivating and informing development of this sector. To identify common social, economic, and health system factors shaping the development of medical tourism in three Central American and Caribbean countries and their health equity implications. In-depth, semi-structured interviews were conducted in Mexico, Guatemala, and Barbados with 150 health system stakeholders. Participants were recruited from private and public sectors working in various fields: trade and economic development, health services delivery, training and administration, and civil society. Transcribed interviews were coded using qualitative data management software, and thematic analysis was used to identify cross-cutting issues regarding the drivers and inhibitors of medical tourism development. Four common drivers of medical tourism development were identified: 1) unused capacity in existing private hospitals, 2) international portability of health insurance, vis-a-vis international hospital accreditation, 3) internationally trained physicians as both marketable assets and industry entrepreneurs, and 4) promotion of medical tourism by public export development corporations. Three common inhibitors for the development of the sector were also identified: 1) the high expense of market entry, 2) poor sector-wide planning, and 3) structural socio-economic issues such as insecurity or relatively high business costs and financial risks. There are shared factors shaping the development of medical tourism in Central America and the Caribbean that help explain why it is being pursued by many hospitals and governments in the region. Development of the sector is primarily being driven by public investment promotion agencies and the private health sector seeking

  1. Stories From the Field: The Use of Information and Communication Technologies to Address the Health Needs of Underserved Populations in Latin America and the Caribbean.

    Science.gov (United States)

    Farach, Nasim; Faba, Gladys; Julian, Soroya; Mejía, Felipe; Cabieses, Báltica; D'Agostino, Marcelo; Cortinois, Andrea A

    2015-01-01

    As their availability grew exponentially in the last 20 years, the use of information and communication technologies (ICT) in health has been widely espoused, with many emphasizing their potential to decrease health inequities. Nonetheless, there is scarce availability of information regarding ICT as tools to further equity in health, specifically in Latin American and Caribbean settings. Our aim was to identify initiatives that used ICT to address the health needs of underserved populations in Latin America and Caribbean. Among these projects, explore the rationale behind the selection of ICT as a key component, probe perceptions regarding contributions to health equity, and describe the challenges faced during implementation. We conducted an exploratory qualitative study. Interviews were completed via Skype or face-to-face meetings using a semistructured interview guide. Following participant consent, interviews were audio recorded and verbatim transcriptions were developed. All transcriptions were coded using ATLASti7 software. The text was analyzed for patterns, shared themes, and diverging opinions. Emerging findings were reviewed by all interviewers and shared with participants for feedback. We interviewed representatives from eight organizations in six Latin American and Caribbean countries that prominently employed ICT in health communication, advocacy, or surveillance projects. ICT expanded project's geographic coverage, increased their reach into marginalized or hard-to-reach groups, and allowed real-time data collection. Perceptions of contributions to health equity resided mainly in the provision of health information and linkage to health services to members of groups experiencing greater morbidity because of poverty, remote place of residence, lack of relevant public programs, and/or stigma and discrimination, and in more timely responses by authorities to the health needs of these groups as a result of the increased availability of strategic

  2. Information and communication technology (ICT) and eHealth policy in Latin America and the Caribbean: a review of national policies and assessment of socioeconomic context.

    Science.gov (United States)

    Jimenez-Marroquin, Maria Carolina; Deber, Raisa; Jadad, Alejandro R

    2014-01-01

    To examine the availability of national information and communication technology (ICT) or eHealth policies produced by countries in Latin America and the Caribbean (LAC), and to determine the influence of a country's socioeconomic context on the existence of these policies. Documents describing a national ICT or eHealth policy in any of the 33 countries belonging to the LAC region as listed by the United Nations were identified from three data sources: academic databases; the Google search engine; and government agencies and representatives. The relationship between the existence of a policy and national socioeconomic indicators was also investigated. There has been some progress in the establishment of ICT and eHealth policies in the LAC region. The most useful methods for identifying the policies were 1) use of the Google search engine and 2) contact with Pan American Health Organization (PAHO) country representatives. The countries that have developed a national ICT policy seem to be more likely to have a national eHealth policy in place. There was no statistical significant association between the existence of a policy and a country's socioeconomic context. Governments need to make stronger efforts to raise awareness about existing and planned ICT and eHealth policies, not only to facilitate ease of use and communication with their stakeholders, but also to promote collaborative international efforts. In addition, a better understanding of the effect of economic variables on the role that ICTs play in health sector reform efforts will help shape the vision of what can be achieved.

  3. Assessment of Jordanian Patient's Colorectal Cancer Awareness and Preferences towards CRC Screening: Are Jordanians Ready to Embrace CRC Screening?

    Science.gov (United States)

    Omran, Suha; Barakat, Husam; Muliira, Joshua Kanaabi; Bashaireh, Ibrahim; Batiha, Abdul-Moni'm

    2015-01-01

    Colorectal cancer (CRC is increasingly becoming a major cause of cancer morbidity and mortality in Jordan. However the population's level of awareness about CRC, CRC screening test preferences and willingness to embrace screening are not known. The aim of this study was to assess the level of CRC awareness and screening preferences among Jordanian patients. A survey assessing the CRC knowledge levels was distributed among patients attending outpatient gastroenterology clinics in public hospitals throughout Jordan. A total of 800 surveys were distributed and of these 713 (89.1%) were returned. Only 22% of the participants correctly judged CRC among the choices provided as the commonest cause of cancer related deaths. The majority of participants (68.3%) underestimated their risk for CRC. Only 26.8% correctly judged their life time risk while 5% overestimated their risk. Two thirds of participants (66%) were willing to pay 500 Jordanian Dinars (equivalent to 706 US$) in order to get a prompt colonoscopy if recommended by their physician, while 25.5% reported that they would rather wait for 6 months in order to get a free colonoscopy. Although the participants tended to underestimate their risk for CRC, they were mostly aware of CRC as a major cause of mortality and were willing to embrace the concept of CRC screening and bear the related financial costs. These findings about CRC awareness and propensity for screening provide a good foundation as the Jordanian health system moves forward with initiatives to promote CRC screening and prevention.

  4. Comparison of dental education and professional development between mainland China and North America.

    Science.gov (United States)

    Wu, Z Y; Zhang, Z Y; Jiang, X Q; Guo, L

    2010-05-01

    Different educational and professional developments within the dental field create different sets of missions, norms, and practices regarding dental diseases and their appropriate treatment. This review has addressed differences in dental education and professional development between mainland China and North America. Many factors influence the choice of model and it is very difficult to predict which model will become predominant. However, there is growing sentiment that the independent faculty model in North America is logical and superior to the model, which 'integrates' dental and medical education in mainland China. Many North America dental schools place a high priority on preclinical and clinical training in the curriculum in order to expose students to patient oral health needs and systemic dental problems much earlier than in mainland China. North America dental schools promote and embrace students self-learning skills by the use of PBL, CRL, and TRAD education methodologies and new e-based technologies and approaches whereby students learn rather than are taught. In mainland China, the traditional lecture-based format is still employed in the majority of dental schools; however, strategies to enhance students self-learning skills is increasingly utilised in most well-known Chinese dental schools. The Chinese dental education model, which treats dentistry as a sub-specialty of medicine, has brought about fundamental differences, with the dentist functioning essentially as a stomatologist. For example, China has built up a large oral and maxillofacial surgery society, and craniofacial surgery is performed to a much broader extent by Chinese dentists than by most North American counterparts. In North America, dentists engage in full-time work, attend continuing training/education programmes, belong to an association, gain legal status, and construct a code of ethics emphasising the quality of care delivered to the public. Currently, continuing dental

  5. Effects of the Boy Scouts of America Personal Fitness Merit Badge on Cardio-Metabolic Risk, Health Related Fitness and Physical Activity in Adolescent Boys.

    Science.gov (United States)

    Maxwell, Justin; Burns, Ryan D; Brusseau, Timothy A

    2017-01-01

    A growing number of adolescents are more sedentary and have fewer formal opportunities to participate in physical activity. With the mounting evidence that sedentary time has a negative impact on cardiometabolic profiles, health related fitness and physical activity, there is a pressing need to find an affordable adolescent physical activity intervention. One possible intervention that has been overlooked in the past is Boy Scouts of America. There are nearly 900,000 adolescent boys who participate in Boy Scouts in the United States. The purpose of this research study was to evaluate the effect of the Personal Fitness merit badge system on physical activity, health-related fitness, and cardio-metabolic blood profiles in Boy Scouts 11-17 years of age. Participants were fourteen (N = 14) Boy Scouts from the Great Salt Lake Council of the Boy Scouts of America who earned their Personal Fitness merit badge. Classes were held in the Spring of 2016 where boys received the information needed to obtain the merit badge and data were collected. Results from the related-samples Wilcoxon signed rank test showed that the median of differences between VO 2 peak pre-test and post-test scores were statistically significant ( p = 0.004). However, it also showed that the differences between the Pre-MetS (metabolic syndrome) and Post-MetS scores (p = 0.917), average steps taken per day ( p = 0.317), and BMI ( p = 0.419) were not statistically significant. In conclusion, the merit badge program had a positive impact on cardiovascular endurance, suggesting this program has potential to improve cardiovascular fitness and should be considered for boys participating in Boy Scouts.

  6. Cholera in the Americas.

    Science.gov (United States)

    1991-01-01

    The cholera epidemic 1st hit South America in January 1991 in the coastal town of Chancay, Peru. In 2 weeks, it spread over 2000 km of the Pacific coast. By the end of the 1st month, it had already reached the mountains and tropical forests. By August 1991, cholera cases were reported in order of appearances in Ecuador, Colombia, Chile, Brazil, the US, Mexico, Guatemala, Bolivia, and El Salvador. Health authorities still do not know how it was introduced into South America. The case fatality rate has remained at a low of 1%, probably due to the prompt actions of health authorities in informing the public of the epidemic and what preventive cautions should be taken. This epidemic is part of the 7th pandemic which originated in Celebes, Indonesia in 1961. Cholera can spread relatively unchecked in Latin America because sewage in urban areas is not treated even though they do have sewage collection systems. The untreated wastewater enters rivers and the ocean. Consumption of raw seafood is not unusual and has been responsible for cholera infection in some cases. In fact, many countries placed import restrictions on marine products from Peru following the outbreak at a loss of $US10-$US40 million. Municipal sewage treatment facilities, especially stabilization ponds, would prevent the spread of cholera and other pathogens. In rural areas, pit latrines located away from wells can effectively dispose of human wastes. Most water supplies in Latin America are not disinfected. Disinfection drinking water with adequate levels of chlorine would effectively destroy V. cholera. If this is not possible, boiling the water for 2-3 minutes would destroy the pathogen. Any cases of cholera must be reported to PAHO. PAHO has responded to the outbreak by forming a Cholera Task Force and arranged transport of oral rehydration salts, intravenous fluids, antibiotics, and other essential medical supplies.

  7. Embracing international children's rights: from principles to practice.

    Science.gov (United States)

    Oberg, Charles N

    2012-07-01

    As clinicians, pediatricians need to be cognizant of the how the principles of equity, social justice, and children's rights help to inform and guide us as we strive for the health and well being of all children. Children of the world are frequently the most vulnerable global citizens facing poverty, displacement, and lack of life's basic necessities. An awareness of international children's rights can serve as a catalyst for working toward the ultimate dream that all children have the right to be raised in a warm and loving family as part of the global community where health and well-being is realized. To that end, the American Academy of Pediatrics has a number of valuable resources designed to promote a better understanding of international children's rights. These include the Community Pediatric Section's Children's Rights Curriculum dedicated to increasing awareness of the UN Convention on the Rights of the Children and the relationship between public policy, advocacy, and children's health. In addition, the American Academy of Pediatrics' Section on International Child Health is committed to improving the health and well-being of the world's children through education, advocacy, research, and the delivery of health services and the creation of effective global partnerships.

  8. Risk Prioritization Tool to Identify the Public Health Risks of Wildlife Trade: The Case of Rodents from Latin America.

    Science.gov (United States)

    Bueno, I; Smith, K M; Sampedro, F; Machalaba, C C; Karesh, W B; Travis, D A

    2016-06-01

    Wildlife trade (both formal and informal) is a potential driver of disease introduction and emergence. Legislative proposals aim to prevent these risks by banning wildlife imports, and creating 'white lists' of species that are cleared for importation. These approaches pose economic harm to the pet industry, and place substantial burden on importers and/or federal agencies to provide proof of low risk for importation of individual species. As a feasibility study, a risk prioritization tool was developed to rank the pathogens found in rodent species imported from Latin America into the United States with the highest risk of zoonotic consequence in the United States. Four formally traded species and 16 zoonotic pathogens were identified. Risk scores were based on the likelihood of pathogen release and human exposure, and the severity of the disease (consequences). Based on the methodology applied, three pathogens (Mycobacterium microti, Giardia spp. and Francisella tularensis) in one species (Cavia porcellus) were ranked as highest concern. The goal of this study was to present a methodological approach by which preliminary management resources can be allocated to the identified high-concern pathogen-species combinations when warranted. This tool can be expanded to other taxa and geographic locations to inform policy surrounding the wildlife trade. © 2015 Blackwell Verlag GmbH.

  9. Health problems awareness during travel among faculty members of a large university in Latin America: preliminary report

    Directory of Open Access Journals (Sweden)

    Ana Cristina Nakamura Tome

    2013-02-01

    Full Text Available Health safety during trips is based on previous counseling, vaccination and prevention of infections, previous diseases or specific problems related to the destination. Our aim was to assess two aspects, incidence of health problems related to travel and the traveler's awareness of health safety. To this end we phone-interviewed faculty members of a large public University, randomly selected from humanities, engineering and health schools. Out of 520 attempts, we were able to contact 67 (12.9% and 46 (68.6% agreed to participate in the study. There was a large male proportion (37/44, 84.1%, mature adults mostly in their forties and fifties (32/44, 72.7%, all of them with higher education, as you would expect of faculty members. Most described themselves as being sedentary or as taking occasional exercise, with only 15.9% (7/44 taking regular exercise. Preexisting diseases were reported by 15 travelers. Most trips lasted usually one week or less. Duration of the travel was related to the destination, with (12h or longer trips being taken by 68.2% (30/44 of travelers, and the others taking shorter (3h domestic trips. Most travelling was made by air (41/44 and only 31.8% (14/44 of the trips were motivated by leisure. Field research trips were not reported. Specific health counseling previous to travel was reported only by two (4.5%. Twenty seven of them (61.4% reported updated immunization, but 11/30 reported unchecked immunizations. 30% (9/30 reported travel without any health insurance coverage. As a whole group, 6 (13.6% travelers reported at least one health problem attributed to the trip. All of them were males travelling abroad. Five presented respiratory infections, such as influenza and common cold, one neurological, one orthopedic, one social and one hypertension. There were no gender differences regarding age groups, destination, type of transport, previous health counseling, leisure travel motivation or pre-existing diseases

  10. Health problems awareness during travel among faculty members of a large university in Latin America: preliminary report.

    Science.gov (United States)

    Tome, Ana Cristina Nakamura; Canello, Thaís Brandi; Luna, Expedito José de Albuquerque; Andrade Junior, Heitor Franco de

    2013-01-01

    Health safety during trips is based on previous counseling, vaccination and prevention of infections, previous diseases or specific problems related to the destination. Our aim was to assess two aspects, incidence of health problems related to travel and the traveler's awareness of health safety. To this end we phone-interviewed faculty members of a large public University, randomly selected from humanities, engineering and health schools. Out of 520 attempts, we were able to contact 67 (12.9%) and 46 (68.6%) agreed to participate in the study. There was a large male proportion (37/44, 84.1%), mature adults mostly in their forties and fifties (32/44, 72.7%), all of them with higher education, as you would expect of faculty members. Most described themselves as being sedentary or as taking occasional exercise, with only 15.9% (7/44) taking regular exercise. Preexisting diseases were reported by 15 travelers. Most trips lasted usually one week or less. Duration of the travel was related to the destination, with (12h) or longer trips being taken by 68.2% (30/44) of travelers, and the others taking shorter (3h) domestic trips. Most travelling was made by air (41/44) and only 31.8% (14/44) of the trips were motivated by leisure. Field research trips were not reported. Specific health counseling previous to travel was reported only by two (4.5%). Twenty seven of them (61.4%) reported updated immunization, but 11/30 reported unchecked immunizations. 30% (9/30) reported travel without any health insurance coverage. As a whole group, 6 (13.6%) travelers reported at least one health problem attributed to the trip. All of them were males travelling abroad. Five presented respiratory infections, such as influenza and common cold, one neurological, one orthopedic, one social and one hypertension. There were no gender differences regarding age groups, destination, type of transport, previous health counseling, leisure travel motivation or pre-existing diseases. Interestingly

  11. Where to next with animal health in Latin America? The transition from endemic to disease-free status.

    Science.gov (United States)

    Rojas, H; Romero, J R

    2017-04-01

    The Latin American and Caribbean region (LAC) is a leading global producer and exporter of animal products. Its livestock production systems are diverse, ranging from large-scale commercial enterprises to family farms. Countries in this region have sought to improve their animal health status through both public and private efforts. Despite significant advances in eradicating such diseases as foot and mouth disease and classical swine fever, other animal health challenges remain; constraining exports, causing negative economic impacts and threatening food security. Obtaining certification of disease-free status is only the first step towards gaining benefits from improvements in animal health. Increasing international trade means that countries must manage the sustainability of their disease-free status in conjunction with trade partners and must comply with additional food safety and animal welfare standards. This paper comments on the challenges created by this new scenario in relation to the epidemiology and economics of animal health, when seeking to improve decisionmaking for animal health management. The authors characterise the current LAC livestock landscape and animal health situation, describing transitions in disease control and the use of economics in improving animal health. They conclude with remarks on the challenges presented by decision-making, economic rationality, sources of benefits, distribution and incentives.

  12. Health-care decision-making processes in Latin America: problems and prospects for the use of economic evaluation.

    Science.gov (United States)

    Iglesias, Cynthia P; Drummond, Michael F; Rovira, Joan

    2005-01-01

    The use of economic evaluation studies (EE) in the decision-making process within the health-care system of nine Latin American (LA) and three European countries was investigated. The aim was to identify the opportunities, obstacles, and changes needed to facilitate the introduction of EE as a formal tool in health-care decision-making processes in LA. A comparative study was conducted based on existing literature and information provided through a questionnaire applied to decision makers in Argentina, Brazil, Colombia, Cuba, Mexico, Nicaragua, Peru, Portugal Spain, United Kingdom, Uruguay, and Venezuela. Systematic electronic searches of HEED, NHS EED, and LILACS were conducted to identify published economic evaluation studies in LA from 1982 onward. There is relatively little evidence of the conduct and use of EE within the health care systems in LA. Electronic searches retrieved 554 records; however, only 93 were EE. In the nine LA participating countries, broad allocation of health-care resources is primarily based on political criteria, historical records, geographical areas, and specific groups of patients and diseases. Public-health provision and inclusion of services in health-insurance package are responsibilities of the Ministry of Health. Decisions regarding the purchase of medicines are primarily made through public tenders, and mainly based on differences in clinical efficacy and the price of health technologies of interest. To expedite the process of incorporating EE as a formal tool to inform decision-making processes within the health-care systems in LA countries, two main conditions need to be fulfilled. First, adequate resources and skills need to be available to conduct EE of good quality. Second, decision-making procedures need to be modified to accommodate "evidence-based" approaches such as EE.

  13. Association of sociodemographic, lifestyle, and health factors with sleep quality and daytime sleepiness in women: findings from the 2007 National Sleep Foundation "Sleep in America Poll".

    Science.gov (United States)

    Baker, Fiona C; Wolfson, Amy R; Lee, Kathryn A

    2009-06-01

    To investigate factors associated with poor sleep quality and daytime sleepiness in women living in the United States. Data are presented from the National Sleep Foundation's 2007 Sleep in America Poll that included 959 women (18-64 years of age) surveyed by telephone about their sleep quality, daytime sleepiness, and sociodemographic, health, and lifestyle factors. Poor sleep quality was reported by 27% and daytime sleepiness was reported by 21% of respondents. Logistic multivariate regression analyses revealed that poor sleep quality and daytime sleepiness were both independently associated with poor health, having a sleep disorder, and psychological distress. Also, multivariate analyses showed that women who consumed more caffeinated beverages and those who had more than one job were more likely to report poor sleep quality but not daytime sleepiness. Daytime sleepiness, on the other hand, was independently associated with being black/African American, younger, disabled, having less education, and daytime napping. Poor sleep quality and daytime sleepiness are common in American women and are associated with health-related, as well as sociodemographic, factors. Addressing sleep-related complaints in women is important to improve their daytime functioning and quality of life.

  14. Embracing a Full Spectrum Definition of Art Therapy

    Science.gov (United States)

    Spooner, Heather

    2016-01-01

    In this viewpoint the author makes a case for developing a clear and concise definition of art therapy that can easily be adopted by art therapists working across a spectrum of theoretical frameworks. The reader is asked to widen the lens through which art therapy is defined by considering its influence on society, the mind, health, and behavior.…

  15. Dissemination of public health information: key tools utilised by the NECOBELAC network in Europe and Latin America.

    Science.gov (United States)

    De Castro, Paola; Marsili, Daniela; Poltronieri, Elisabetta; Calderón, Carlos Agudelo

    2012-06-01

     Open Access (OA) to scientific information is an important step forward in communication patterns, yet we still need to reinforce OA principles to promote a cultural change of traditional publishing practices. The advantages of free access to scientific information are even more evident in public health where knowledge is directly associated with human wellbeing.  An OA 'consolidation' initiative in public health is presented to show how the involvement of people and institutions is fundamental to create awareness on OA and promote a cultural change. This initiative is developed within the project NEtwork of COllaboration Between Europe and Latin American Caribbean countries (NECOBELAC), financed by the European Commission.  Three actions are envisaged: Capacity building through a flexible and sustainable training programme on scientific writing and OA publishing; creation of training tools based on semantic web technologies; development of a network of supporting institutions.  In 2010-2011, 23 training initiatives were performed involving 856 participants from 15 countries; topic maps on scientific publication and OA were produced; 195 institutions are included in the network.  Cultural change in scientific dissemination practices is a long process requiring a flexible approach and strong commitment by all stakeholders. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group Health Information and Libraries Journal.

  16. Moving on from NAFTA to the FTAA?: the impact of trade agreements on social and health conditions in the Americas

    Directory of Open Access Journals (Sweden)

    Miguel San Sebastián

    2004-10-01

    Full Text Available Gracias a los tratados comerciales internacionales, el comercio mundial y la inversión extranjera se han incrementado vertiginosamente en los últimos 25 años. Es preciso, entonces, examinar las pruebas acumuladas de que el comercio tiene un efecto sobre la salud e incorporarlas en el proceso de formulación de políticas. Uno de los acuerdos en actual proceso de negociación es el Área de Libre Comercio de las Américas (Free Trade Agreement of the Americas,o ALCA. Con el fin de ayudar a evaluar las posibles consecuencias sanitarias de este acuerdo en el Hemisferio Occidental, este artículo examina los 10 años de experiencia que han tenido Canadá, México y los Estados Unidos de América con el Tratado de Libre Comercio de América del Norte (North American Free Trade Agreement,o TLCAN. Aunque los tres países han visto una expansión macroeconómica, las ganancias prometidas en lo referente a mayores fuentes de empleo, mayores ingresos y menos desigualdad y pobreza no se han producido. El TLCAN también ha tenido un gran impacto en la agricultura, los servicios públicos y el grado de soberanía ejercido por los tres gobiernos en lo que respecta a la adopción de políticas en pro de los intereses del público. Se espera que el ALCA sea el régimen de comercio e inversión más completo del mundo. Representa un mayor peligro que el TLCAN debido a la vulnerabilidad de la mayoría de los países de las Américas y a la propuesta de que se incorporen al ALCA nuevos reglamentos muy estrictos encaminados a extender la injerencia del tratado hacia nuevos sectores que el TLCAN no abarca. Las organizaciones de salud pública deben participar en la polémica en torno al ALCA y los gobiernos de los países de las Américas deben darle mayor prioridad a la salud que al comercio si se han de evitar riesgos innecesarios para la salud de los pueblos americanos.

  17. La comunicación para la salud como disciplina en las universidades estadounidenses Health communication as a field of study in universities in the United States of America

    Directory of Open Access Journals (Sweden)

    Rina Alcalay

    1999-03-01

    Full Text Available This article analyzes the state of development of communications related to health in universities of the United States of America. This specialty is essential for people's well-being, and it involves interpersonal, organizational, and mass communications. In the United States, communications for health promotion is an area of applied communications with social relevance and generally performed in interdisciplinary settings. A number of universities in the United States offer communications master's degree programs with an emphasis on health. However, so far, the only program with a formal graduate degree in health and communications is one jointly offered by the Emerson University Department of Communications and the Tufts School of Medicine. Developing and including this specialization in the schools of communications in Latin America is crucial to improving the quality of life of the peoples of the continent.

  18. Forest Health in North America: Some Perspectives on Actual and Potential Roles of Climate and Air Pollution

    Science.gov (United States)

    S. McLaughlin; K. Percy

    1999-01-01

    The perceived health of forest ecosystems over large temporal and spatial scales can be strongly influenced by the frames of reference chosen to evaluate both forest condition and the functional integrity of sustaining forest processes. North American forests are diverse in range, species composition, past disturbance history, and current management practices....

  19. Human rights and the right to health in Latin America: the Two Faces of One Powerful Idea

    Directory of Open Access Journals (Sweden)

    Alicia Ines Stolkiner

    2010-04-01

    Full Text Available During the past decade the discussion of human rights has reappeared in the field of health, replacing the technocratic approaches of the previous period which had centered on cost-effectiveness. The focus on rights in public policies, with its emphasis on international norms for social rights, has influenced primary health care (PHC strategy and fostered the return of PHC to its original role as guarantor of the right to health.3 As human rights became increasingly global, they once again occupied a central place in World Health Organization (WHO documents and in government attitudes. The revival of human rights discourse occurred at a time when neoliberalism was being discredited intellectually. It coincided with the appearance of governments critical of the hegemonic model of the 1990s, the restructuring of geopolitical alliances, and a crisis of world capitalism affecting its central core. Various trends have co-existed within this process; the attempt to establish more just societies runs parallel to the search for a new way to legitimize power, given the loss of consensus over the neoliberal model. This dual aspect of the inclusion of human rights in the political arena demands a careful analysis of the various discourses and the proposals with which they are associated.

  20. Working conditions and health in Central America: a survey of 12,024 workers in six countries.

    Science.gov (United States)

    Benavides, Fernando G; Wesseling, Catharina; Delclos, George L; Felknor, Sarah; Pinilla, Javier; Rodrigo, Fernando

    2014-07-01

    To describe the survey methodology and initial general findings of the first Central American Survey of Working Conditions and Health. A representative sample of 12,024 workers was interviewed at home in Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua and Panama. Questionnaire items addressed worker demographics, employment conditions, occupational risk factors and self-perceived health. Overall, self-employment (37%) is the most frequent type of employment, 8% of employees lack a work contract and 74% of the workforce is not covered by social security. These percentages are higher in Guatemala, Honduras and El Salvador, and lower in Costa Rica, Panama and Nicaragua. A third of the workforce works more than 48 h per week, regardless of gender; this is similar across countries. Women and men report frequent or usual exposures to high ambient temperature (16% and 25%, respectively), dangerous tools and machinery (10%, 24%), work on slippery surfaces (10%, 23%), breathing chemicals (12.1%, 18%), handling toxic substances (5%, 12.1%), heavy loads (6%, 20%) and repetitive movements (43%, 49%). Two-thirds of the workforce perceive their health as being good or very good, and slightly more than half reports having good mental health. The survey offers, for the first time, comparable data on the work and health status of workers in the formal and informal economy in the six Spanish-speaking Central American countries, based on representative national samples. This provides a benchmark for future monitoring of employment and working conditions across countries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. Embracing service user involvement in radiotherapy education: A discussion paper

    International Nuclear Information System (INIS)

    Hill, Gareth; Thompson, Gillian; Willis, Susan; Hodgson, Denyse

    2014-01-01

    Aim: There is currently a drive within cancer services to incorporate user involvement in delivery and education, as such the aim of this article is to investigate the potential role of service users in pre-registration education and how this could impact on radiotherapy programmes. Method: Key databases were searched for terms: patient participation, service user involvement, health care education, student assessment, patient involvement, pre-registration education and training. Suitable literature was reviewed and references within all articles and documents were investigated to ensure as broad and an inclusive search possible. Results: There is little published literature indicating user involvement in radiotherapy education but many studies in nursing, medicine and other allied health professions indicate a rationale for user involvement. Discussion: There are benefits of involving service users, i.e. gaining insight from patients and carers perspectives, challenges stereotypes and assumptions. Disadvantages include the quality of the feedback from users in assessment, resources required, and the ethical considerations. Conclusion: Inclusion of service users in radiotherapy education is recommended in line with cancer care policy, they provide a unique perspective to learning and involvement should be encouraged

  2. "This is How We Live, This is How We Die:" Social Stratification, Aging, and Health in Urban America

    OpenAIRE

    Abramson, Corey Michael

    2012-01-01

    From our first breath in the hospital to the day we die, we live in a society characterized by unequal opportunities for maintaining health and taking care of ourselves when ill. These disparities reflect persistent racial, socio-economic, and gender-based inequalities and contribute to their persistence over time. Social scientists have established that gaps in access to information, uneven material resources, unequal treatment in medical institutions, and differences in interpersonal networ...

  3. Rupture, resilience, and risk: relationships between mental health and migration among gay-identified men in North America.

    Science.gov (United States)

    Lewis, Nathaniel M

    2014-05-01

    An established body of research in psychology, psychiatry and epidemiology links social stigma and stress with poor mental and sexual health outcomes among gay-identified men. Less work considers how these linkages are mediated by place and almost none considers the role of movement across places. This qualitative study, based on the migration narratives of 48 gay-identified men living in Ottawa, Ontario, Canada, and Washington, D.C., U.S.A. gives more careful consideration to the ways in which mental and emotional health issues (e.g., anxiety, depression, substance use) in this population both precipitate migration and stem from migration. The narratives show that decisions to migrate often emerge from men׳s experiences of place-based minority stress and associated health outcomes. At the same time, moving to urban gay communities, when coupled with other life circumstances, can create or reinforce physical and emotional insecurities that lead to low self-esteem, substance use and sexual risk-taking. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Reframing political violence and mental health outcomes: outlining a research and action agenda for Latin America and the Caribbean region

    Directory of Open Access Journals (Sweden)

    Duncan Pedersen

    Full Text Available In recent decades, the number of people exposed to traumatic events has significantly increased as various forms of violence, including war and political upheaval, engulf civilian populations worldwide. In spite of widespread armed conflict, guerrilla warfare and political violence in the Latin American and Caribbean region, insufficient attention had been paid in assessing the medium and long-term psychological impact and additional burden of disease, death, and disability caused by violence and wars amongst civilian populations. Following a review of the literature, a few central questions are raised: What is the short, medium and long-term health impact of extreme and sustained forms of violence in a given population? How political violence is linked to poor mental health outcomes at the individual and collective levels? Are trauma-related disorders, universal outcomes of extreme and sustained violence? These questions lead us to reframe the analysis of political violence and mental health outcomes, and reexamine the notions of trauma, after which a research and action agenda for the region is outlined. In the concluding sections, some basic principles that may prove useful when designing psychosocial interventions in post-conflict situations are reviewed.

  5. Embracing a world of subtlety and nuance on coral reefs

    Science.gov (United States)

    Mumby, Peter J.

    2017-09-01

    Climate change will homogenise the environment and generate a preponderance of mediocre reefs. Managing seascapes of mediocrity will be challenging because our science is ill prepared to deal with the `shades of grey' of reef health; we tend to study natural processes in the healthiest reefs available. Yet much can be gained by examining the drivers and implications of even subtle changes in reef state. Where strong ecological interactions are discovered, even small changes in abundance can have profound impacts on coral resilience. Indeed, if we are to develop effective early warnings of critical losses of resilience, then monitoring must place greater emphasis on measuring and interpreting changes in reef recovery rates. In terms of mechanism, a more nuanced approach is needed to explore the generality of what might be considered `dogma'. A more nuanced approach to science will serve managers needs well and help minimise the rise of mediocrity in coral reef ecosystems.

  6. Changing tides: increasing evidence to embrace a patient classification system.

    Science.gov (United States)

    Malloch, Kathy

    2012-01-01

    The effective use of a patient classification system (PCS) in a way that provides value to all health care organizations has yet to be realized given the challenging developmental pathway of these systems. As the science and technology of workforce management emerges along with evidence to support the relationships between nurse work and patient care needs, it is no longer appropriate to rely on systems that provide aggregated and minimal data to address the need for safer patient care and retention of nurses. Specificity about patient care needs in a valid and reliable PCS is essential on our pathway to improved resource utilization, improved decision making, integration of nurse cognitive and knowledge work, and management of variances from planned resource use. Advancements with technology, the ability to create and monitor equitable nurse-patient assignments, conceptual clarity, evidence, regulatory requirements, and professional role development point to a new receptiveness for PCSs.

  7. Embracing First-Person Perspectives in Soma-Based Design

    Directory of Open Access Journals (Sweden)

    Kristina Höök

    2018-02-01

    Full Text Available A set of prominent designers embarked on a research journey to explore aesthetics in movement-based design. Here we unpack one of the design sensitivities unique to our practice: a strong first person perspective—where the movements, somatics and aesthetic sensibilities of the designer, design researcher and user are at the forefront. We present an annotated portfolio of design exemplars and a brief introduction to some of the design methods and theory we use, together substantiating and explaining the first-person perspective. At the same time, we show how this felt dimension, despite its subjective nature, is what provides rigor and structure to our design research. Our aim is to assist researchers in soma-based design and designers wanting to consider the multiple facets when designing for the aesthetics of movement. The applications span a large field of designs, including slow introspective, contemplative interactions, arts, dance, health applications, games, work applications and many others.

  8. A novel educational strategy targeting health care workers in underserved communities in Central America to integrate HIV into primary medical care.

    Science.gov (United States)

    Flys, Tamara; González, Rosalba; Sued, Omar; Suarez Conejero, Juana; Kestler, Edgar; Sosa, Nestor; McKenzie-White, Jane; Monzón, Irma Irene; Torres, Carmen-Rosa; Page, Kathleen

    2012-01-01

    Current educational strategies to integrate HIV care into primary medical care in Central America have traditionally targeted managers or higher-level officials, rather than local health care workers (HCWs). We developed a complementary online and on-site interactive training program to reach local HCWs at the primary care level in underserved communities. The training program targeted physicians, nurses, and community HCWs with limited access to traditional onsite training in Panama, Nicaragua, Dominican Republic, and Guatemala. The curriculum focused on principles of HIV care and health systems using a tutor-supported blended educational approach of an 8-week online component, a weeklong on-site problem-solving workshop, and individualized project-based interventions. Of 258 initially active participants, 225 (225/258=87.2%) successfully completed the online component and the top 200 were invited to the on-site workshop. Of those, 170 (170/200=85%) attended the on-site workshop. In total, 142 completed all three components, including the project phase. Quantitative and qualitative evaluation instruments included knowledge assessments, reflexive essays, and acceptability surveys. The mean pre and post-essay scores demonstrating understanding of social determinants, health system organization, and integration of HIV services were 70% and 87.5%, respectively, with an increase in knowledge of 17.2% (pstructure, and effectiveness in improving their HIV-related knowledge and skills. This innovative curriculum utilized technology to target HCWs with limited access to educational resources. Participants benefited from technical skills acquired through the process, and could continue working within their underserved communities while participating in the online component and then implement interventions that successfully converted theoretical knowledge to action to improve integration of HIV care into primary care.

  9. Reasons for embracing a religion: The case of Brazilian women

    Directory of Open Access Journals (Sweden)

    Guilherme Irffi

    2017-05-01

    Full Text Available The Economics of Religion is based on the model proposed by Azzi and Ehrenberg in 1975, which aimed to assess the religious frequency. Therefore, this article proposes to estimate the determinants of religious frequency of Brazilian women. To achieve this goal, information from the National Survey of Demography and Health of Children and Women as of 2006 (PNDS-2006 is employed and from an ordered logistic regression model, socioeconomic determinants, demographic, cultural and behavioral factors that may interfere in such demand are estimeted. According to the results, it can be inferred that religious frequency of Brazilian women receive interposition of their demographic characteristics, in particular rises with age. In relation to income, it was not observed any correlation pattern, while higher level of education reduces the likelihood of the woman never go to church. Thus, we found no evidence that the level of occupation, marital status and death of children affect significantly the frequency to religious services of women surveyed. And finally, the main feature of women impacting the demand for religious activities and services stems from the inspiration that the woman had, that is, if she was raised in a religion, especially Catholic or evangelical.

  10. American Congress of Rehabilitation Medicine in 2006: embracing the future.

    Science.gov (United States)

    Rosenthal, Mitchell

    2007-04-01

    The American Congress of Rehabilitation Medicine (ACRM) modified its mission and structure in 1997 to become an organization focused on medical rehabilitation research. Initially, this transformation accelerated an already diminishing membership, a weakened financial condition, and some level of dysfunction within the organizational structure. In recent years, with the advent of evidence-based practice and the expectation that empirical research is critical to the survival of clinical specialties such as rehabilitation medicine, ACRM has become re-energized. New initiatives have been spawned that have led to stabilization and an influx of new members, a measurable improvement in the quality of scientific presentations at, and participation in, the annual meetings, efforts directed toward increasing the visibility and involvement of ACRM on an international level, programming directed toward early career scientists, strong public policy advocacy, and renewed and expanded inter-organizational partnerships. In addition, the financial position of ACRM has improved markedly and prospects toward long-term fiscal health and growth are "the new reality." ACRM has now moved significantly beyond the "survival" step of the Maslow hierarchy toward the goal of self-actualization.

  11. "How Can You Live without Your Kids?": Distancing from and Embracing the Stigma of "Incarcerated Mother."

    Science.gov (United States)

    Aiello, Brittnie; McQueeny, Krista

    2016-01-01

    This article examines how incarcerated mothers constructed moral identities in the face of stigma. Analyzing data from participant observation and 83 in-depth interviews with incarcerated mothers, we show that mothers claimed moral identities by distancing from the stigma of incarceration and/or embracing the identity of incarcerated mothers.…

  12. Literacy Learning in a Digitally Rich Humanities Classroom: Embracing Multiple, Collaborative, and Simultaneous Texts

    Science.gov (United States)

    Buckley-Marudas, Mary Frances

    2016-01-01

    Understanding what happens when teachers embrace digital media for literacy learning is critical to realizing the potential of learning in the digital era. This article examines some of the ways that a high school teacher and his students leverage digital technologies for literacy learning in their humanities classrooms. The author introduces the…

  13. Embracing Complexity: Rethinking the Relation between Play and Learning--Comment on Lillard et al. (2013)

    Science.gov (United States)

    Weisberg, Deena Skolnick; Hirsh-Pasek, Kathy; Golinkoff, Roberta Michnick

    2013-01-01

    Lillard et al. (2013) concluded that pretend play is not causally related to child outcomes and charged that the field is subject to a "play ethos", whereby research is tainted by a bias to find positive effects of play on child development. In this commentary, we embrace their call for a more solidly scientific approach to questions in this…

  14. Individual differences in embracing negatively valenced art: The roles of openness and sensation seeking.

    Science.gov (United States)

    Fayn, Kirill; Kuppens, Peter

    2017-01-01

    We elaborate on the role of individual differences in the processing mechanisms outlined by the Distancing-Embracing model. The role of openness is apparent in appreciating meaning-making art that elicits interest, feeling moved, and mixed emotions. The influence of sensation seeking is likely to manifest in thrill-chasing art that draws on the arousing interplay of positive and negative emotions.

  15. Investigation Effects of Narrowing Rotor Pole Embrace to Efficiency and Cogging Torque at PM BLDC Motor

    Directory of Open Access Journals (Sweden)

    Cemil Ocak

    2016-02-01

    Full Text Available Engineers think that pole embrace size of a PM BLDC motor affects directly the efficiency and the torque. Dealing with theexperimental research, in the studywe have investigated the effects of narrowing rotor pole embrace step by step by changing sizes parametrically. By doing so, high efficiency and low cogging torque would have been obtained for a 20 W PM BLDC motor. In order to do this,pole arc to pole pitch ratio of magnets at the rotor poles has been changed parametrically (0.5 to 1 by genetic algorithm methodfirst. Then the electromagnetic field dispersions, output parameters of the motor, new rotor constructions have been obtained; and new pole embrace has been derived from the variation of pole arc to pole pitch ratio. We have also calculatedthe magnetic flux distribution, output power, torque, cogging torque and efficiency values analytically and the effects of new pole embrace to motor efficiency and torque have been simulated. The developed 18 slots, 6 poles, surface mounted inner runner configuration rotor machine is proposed as to be used insmall dentistry apparatus.

  16. Embracing the Future: Embedding Digital Repositories in Higher Education Institutions. Research Brief

    Science.gov (United States)

    Hoorens, Stijn; van Dijk, Lidia Villalba; van Stolk, Christian

    2009-01-01

    This briefing paper captures the key findings and recommendations of a study commissioned by the Joint Information Systems Committee on aspects of the strategic commitment of institutions to repository sustainability. This project, labelled EMBRACE (EMBedding Repositories And Consortial Enhancement), is aimed at enhancing the functionality,…

  17. The Changing Context of Rural America: A Call to Examine the Impact of Social Change on Mental Health and Mental Health Care.

    Science.gov (United States)

    Carpenter-Song, Elizabeth; Snell-Rood, Claire

    2017-05-01

    Recent social changes and rising social inequality in the rural United States have affected the experience and meaning of mental illness and treatment seeking within rural communities. Rural Americans face serious mental health disparities, including higher rates of suicide and depression compared with residents of urban areas, and substance abuse rates in rural areas now equal those in urban areas. Despite these increased risks, people living in rural areas are less likely than their urban counterparts to seek or receive mental health services. This Open Forum calls for a research agenda supported by anthropological theory and methods to investigate the significance of this changed rural social context for mental health.

  18. Role of PAHO/WHO in eHealth Capacity Building in the Americas: Analysis of the 2011-2015 period.

    Science.gov (United States)

    Novillo-Ortiz, David; D'Agostino, Marcelo; Becerra-Posada, Francisco

    2016-08-01

    Political will and adoption of measures toward the use of eHealth have been steadily increasing, facilitating mobilization of resources necessary to adopt and implement digital services that will make it possible to improve access, expand coverage, and increase financial efficiency of health care systems. Adoption of the Strategy and Plan of Action on eHealth of the Pan American Health Organization (PAHO) in 2011 by all Member States in the Region of the Americas has led the Region to major progress in this regard, including the following: creation of knowledge networks and development of information sources, establishment of eHealth sustainability models, support for development of electronic health records, promotion of standards on health data and related technologies that ensure exchange of information, use of mobile devices to improve health, and improvement in quality of care through telemedicine. This article details the main actions carried out by PAHO with regard to eHealth, specifically by the office of Knowledge Management, Bioethics, and Research in the 2011-2015 period (first period of implementation of the PAHO eHealth strategy and plan of action), which include research and capacity-building activities, development of technical guidelines, and formation of knowledge networks. RESUMEN La voluntad política y la adopción de medidas en relación con el uso de la eSalud han ido en aumento de forma constante, favoreciendo la movilización de los recursos necesarios a fin de adoptar y poner en marcha servicios digitales que permitan mejorar el acceso, ampliar la cobertura y aumentar la eficiencia financiera de los sistemas de atención de salud. Con la aprobación de la Estrategia y Plan de Acción de eSalud de la Organización Panamericana de la Salud (OPS) en 2011 por todos los Estados Miembros de la Región de las Américas, se han realizado importantes avances a este respecto en la Región, entre los que se destacan: la creación de redes de

  19. Is increasing industrialization affecting remote ecosystem health in the South Americas? Insights from ocean surface water measurements of As, Sb and Pb from a GEOTRACES transect

    Science.gov (United States)

    Weiss, Dominik; Salaun, Pascal; Van den Berg, Stan; Bi, Zaoshun

    2014-05-01

    Continued industrial development of the South Americas with increasing atmospheric emission of toxic trace metals has lead to a growing concern about possible effects on pristine ecosystem health. Concentration measurements of trace metals in ocean surface waters in the North Atlantic have successfully revealed the global extent of atmospheric pollution in the Northern Hemisphere during economical growth in the USA and Europe, suggesting a similar approach can be applied to the Southern Hemisphere. To this end, we determined concentrations of lead (Pb), antimony (Sb) and arsenic (As) using voltammetry in surface water samples of the South Atlantic Ocean collected during the third leg of the GEOTRACES West Atlantic Cruise. These elements are volatile and therefore most likely suitable tracer elements of industrial emissions from South America. The samples were not filtered and the solutions were acidified and UV digested. Total concentrations of Pb were detected. Detected As levels correspond to the sum of inorganic species (AsIII + AsV) plus the mono methyl arsenic acid (MMA) while the dimethyl arsenic acid (DMA) is not detected in such conditions. For Sb, detected levels correspond at least to the sum of inorganic fractions (SbIII + SbV). The measured concentrations for Pb varied from 6 to 23 pM. Concentrations were highest at -35° latitude and lowest at -40° and -50° latitude. We found a decreasing trend from about -35° latitude southwards. The average concentrations of As was 20 nM and of Sb 1.2 nM. Arsenic showed a more significant north to south trend than Sb. Arsenic concentration was highest at -23 ° latitude (21 nM) and the lowest at -43 ° latitude (17.7 nM). Antimony concentration was highest at -31 ° latitude (1.5 nM) and lowest at -35 ° latitude (1.0 nM). Our preliminary data suggests that the major industrial centres in Brazil (i.e., Sao Paolo, Rio de Janeiro) and Argentina (i.e., Buenos Aires) affect atmospheric metal fluxes to remote

  20. Beneficial association between active travel and metabolic syndrome in Latin-America: A cross-sectional analysis from the Chilean National Health Survey 2009-2010.

    Science.gov (United States)

    Sadarangani, Kabir P; Von Oetinger, Astrid; Cristi-Montero, Carlos; Cortínez-O'Ryan, Andrea; Aguilar-Farías, Nicolás; Martínez-Gómez, David

    2018-02-01

    There is limited evidence on potential health benefits of active travel, independently of leisure-time physical activity (PA), with metabolic syndrome (MetS) in Latin-America. To investigate the relationship between active travel and metabolic syndrome (MetS) and its components in a national representative sample of Chilean adults. Cross-sectional study of 2864 randomly selected adults' participants enrolled in the 2009-2010 Chilean National Health Survey (CNHS). Self-reported PA was obtained with the validated Global PA Questionnaire and classifying participants into insufficiently active (travel PA with MetS and its components at a regional level, adjusted for socio-demographic characteristics and other types of PA. 46.2% of the sample engaged in 150min/week of active travel and the prevalence of MetS was 33.7%. Mets was significantly lower among active travel participants. Active travel was associated with lower odds of MetS (OR 0.72; 95%CI 0.61-0.86), triglycerides (OR 0.77; 95%CI 0.64-0.92) and abdominal obesity (OR 0.82; 95%CI 0.69-0.97) after controlling for socio-demographics and other types of PA. Active travel was negatively associated with MetS, triglycerides and abdominal obesity. Efforts to increase regional active travel should be addressed as a measure to prevent and reduce the prevalence of MetS and disease burden in middle income countries. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Freedom of conscience and health care in the United States of america: the conflict between public health and religious liberty in the patient protection and affordable care act.

    Science.gov (United States)

    West-Oram, Peter

    2013-09-01

    The recent confirmation of the constitutionality of the Obama administration's Patient Protection and Affordable Care Act (PPACA) by the US Supreme Court has brought to the fore long-standing debates over individual liberty and religious freedom. Advocates of personal liberty are often critical, particularly in the USA, of public health measures which they deem to be overly restrictive of personal choice. In addition to the alleged restrictions of individual freedom of choice when it comes to the question of whether or not to purchase health insurance, opponents to the PPACA also argue that certain requirements of the Act violate the right to freedom of conscience by mandating support for services deemed immoral by religious groups. These issues continue the long running debate surrounding the demands of religious groups for special consideration in the realm of health care provision. In this paper I examine the requirements of the PPACA, and the impacts that religious, and other ideological, exemptions can have on public health, and argue that the exemptions provided for by the PPACA do not in fact impose unreasonable restrictions on religious freedom, but rather concede too much and in so doing endanger public health and some important individual liberties.

  2. Little People of America

    Science.gov (United States)

    ... information. World Dwarf Games 2017 Welcome to Little People of America Little People of America (LPA) is a nonprofit organization that provides support and information to people of short stature and their families. LPA is ...

  3. A novel educational strategy targeting health care workers in underserved communities in Central America to integrate HIV into primary medical care.

    Directory of Open Access Journals (Sweden)

    Tamara Flys

    Full Text Available BACKGROUND: Current educational strategies to integrate HIV care into primary medical care in Central America have traditionally targeted managers or higher-level officials, rather than local health care workers (HCWs. We developed a complementary online and on-site interactive training program to reach local HCWs at the primary care level in underserved communities. METHODS: The training program targeted physicians, nurses, and community HCWs with limited access to traditional onsite training in Panama, Nicaragua, Dominican Republic, and Guatemala. The curriculum focused on principles of HIV care and health systems using a tutor-supported blended educational approach of an 8-week online component, a weeklong on-site problem-solving workshop, and individualized project-based interventions. RESULTS: Of 258 initially active participants, 225 (225/258=87.2% successfully completed the online component and the top 200 were invited to the on-site workshop. Of those, 170 (170/200=85% attended the on-site workshop. In total, 142 completed all three components, including the project phase. Quantitative and qualitative evaluation instruments included knowledge assessments, reflexive essays, and acceptability surveys. The mean pre and post-essay scores demonstrating understanding of social determinants, health system organization, and integration of HIV services were 70% and 87.5%, respectively, with an increase in knowledge of 17.2% (p<0.001. The mean pre- and post-test scores evaluating clinical knowledge were 70.9% and 90.3%, respectively, with an increase in knowledge of 19.4% (p<0.001. A survey of Likert scale and open-ended questions demonstrated overwhelming participant satisfaction with course content, structure, and effectiveness in improving their HIV-related knowledge and skills. CONCLUSION: This innovative curriculum utilized technology to target HCWs with limited access to educational resources. Participants benefited from technical skills

  4. Alcohol, diabetes, and public health in the Americas Alcohol, diabetes y salud pública en las Américas

    Directory of Open Access Journals (Sweden)

    Thomas Babor

    2012-08-01

    Full Text Available This article describes epidemiological evidence on the association between alcohol use and diabetes, and the implications for clinical management and public health policies in the Americas. Heavy alcohol use is a risk factor for both diabetes and poor treatment adherence, despite evidence that moderate drinking can protect against type 2 diabetes under some circumstances. The burden of disease from diabetes associated with excessive alcohol consumption warrants both clinical and public health measures. On the clinical level, research on early interventions to prevent hazardous drinking shows that new screening, brief intervention, and referral techniques are effective ways to manage hazardous drinking in primary care settings. On the population level, restrictions on alcohol marketing and other alcohol control policies reduce the frequency and intensity of alcohol consumption in at-risk populations. These policy actions are recommended within the context of the World Health Organization's global strategy to reduce the harmful use of alcohol.Este artículo describe las pruebas epidemiológicas de la asociación entre el consumo de alcohol y la diabetes, así como sus implicaciones para el manejo clínico y las políticas de salud pública en las Américas. Aunque existe evidencia de que, en determinadas circunstancias, el consumo moderado de alcohol puede proteger contra la diabetes de tipo 2, su consumo excesivo es un factor de riesgo tanto para la diabetes como para la adherencia terapéutica deficiente. La carga de morbilidad de la diabetes asociada con el consumo excesivo de alcohol requiere la adopción de medidas tanto clínicas como de salud pública. En el ámbito clínico, la investigación sobre intervenciones tempranas para prevenir el consumo de riesgo muestra que las nuevas técnicas de tamizaje, intervención breve y remisión son formas eficaces de abordar el consumo de riesgo en atención primaria. En el ámbito poblacional, las

  5. Embracing Change

    Science.gov (United States)

    Lehmusto, Kirsti

    2012-01-01

    Most universities face similar challenges, so it is with good reason that universities often look to peer institutions to benchmark their branding efforts. Whether across town or around the world, other institutions' brands can inspire ideas. But why not go further? What could universities learn about branding from companies and brands such as…

  6. Togetherness in the Americas.

    Science.gov (United States)

    Black, Jan Knippers

    1984-01-01

    There is a growing unacknowledged reality to the oneness of America. Latin America is increasingly sharing not only the blessings of U.S.-style modernization, but its demons as well. Also, many problems that have long plagued Latin America, e.g., indebtedness and militarism, are becoming more apparent in the United States. (RM)

  7. Mapping the use of research to support strategies tackling maternal and child health inequities: evidence from six countries in Africa and Latin America.

    Science.gov (United States)

    Vargas, Emily; Becerril-Montekio, Victor; Gonzalez-Block, Miguel Ángel; Akweongo, Patricia; Hazel, Cynthia N A; Cuembelo, Maria de Fatima; Limbani, Felix; Bernardo, Wanderley; Muñoz, Fernando

    2016-01-07

    Striving to foster collaboration among countries suffering from maternal and child health (MCH) inequities, the MASCOT project mapped and analyzed the use of research in strategies tackling them in 11 low- and middle-income countries. This article aims to present the way in which research influenced MCH policies and programs in six of these countries - three in Africa and three in Latin America. Qualitative research using a thematic synthesis narrative process was used to identify and describe who is producing what kind of research, how research is funded, how inequities are approached by research and policies, the countries' research capacities, and the type of evidence base that MCH policies and programs use. Four tools were designed for these purposes: an online survey for researchers, a semi-structured interview with decision makers, and two content analysis guides: one for policy and programs documents and one for scientific articles. Three modalities of research utilization were observed in the strategies tackling MCH inequities in the six included countries - instrumental, conceptual and symbolic. Instrumental utilization directly relates the formulation and contents of the strategies with research results, and is the least used within the analyzed policies and programs. Even though research is considered as an important input to support decision making and most of the analyzed countries count five or six relevant MCH research initiatives, in most cases, the actual impact of research is not clearly identifiable. While MCH research is increasing in low- and middle-income countries, the impact of its outcomes on policy formulation is low. We did not identify a direct relationship between the nature of the financial support organizations and the kind of evidence utilization within the policy process. There is still a visible gap between researchers and policymakers regarding their different intentions to link evidence and decision making processes.

  8. Embracing Ebooks : Acquisition and Collection Development Landscape in Philippine Academic Libraries

    OpenAIRE

    Janice D.C. Peñaflor; Justina Garcia

    2017-01-01

    In the recent years, libraries are evidently expanding their embrace in adoption of ebooks. This may be attributed to the real and perceived advantages demonstrated by ebooks in terms of accessibility, functionality and cost effectiveness. Increasingly, ebooks form a growing part of the collections in academic libraries as a viable format to support the information needs of their patrons. Some libraries have adopted ebooks on a large scale while others are still tentative in their acquisition...

  9. Status of the implementation of the World Health Organization multimodal hand hygiene strategy in United States of America health care facilities.

    Science.gov (United States)

    Allegranzi, Benedetta; Conway, Laurie; Larson, Elaine; Pittet, Didier

    2014-03-01

    The World Health Organization (WHO) launched a multimodal strategy and campaign in 2009 to improve hand hygiene practices worldwide. Our objective was to evaluate the implementation of the strategy in United States health care facilities. From July through December 2011, US facilities participating in the WHO global campaign were invited to complete the Hand Hygiene Self-Assessment Framework online, a validated tool based on the WHO multimodal strategy. Of 2,238 invited facilities, 168 participated in the survey (7.5%). A detailed analysis of 129, mainly nonteaching public facilities (80.6%), showed that most had an advanced or intermediate level of hand hygiene implementation progress (48.9% and 45.0%, respectively). The total Hand Hygiene Self-Assessment Framework score was 36 points higher for facilities with staffing levels of infection preventionists > 0.75/100 beds than for those with lower ratios (P = .01) and 41 points higher for facilities participating in hand hygiene campaigns (P = .002). Despite the low response rate, the survey results are unique and allow interesting reflections. Whereas the level of progress of most participating facilities was encouraging, this may reflect reporting bias, ie, better hospitals more likely to report. However, even in respondents, further improvement can be achieved, in particular by embedding hand hygiene in a stronger institutional safety climate and optimizing staffing levels dedicated to infection prevention. These results should encourage the launch of a coordinated national campaign and higher participation in the WHO global campaign. Copyright © 2014 World Health Organization. Published by Mosby, Inc. All rights reserved.

  10. Practising chaordic beauty: On embracing strangers in one inner city faith community

    Directory of Open Access Journals (Sweden)

    Stephan de Beer

    2016-11-01

    Full Text Available In this article I read one inner city faith community – the Tshwane Leadership Foundation (TLF – through the lenses of literature that reflects on chaordic organisations and chaordic leadership. I explore whether an emphasis on the management of diversity, which is widespread in organisational and ecclesial practices and languages, should not be replaced with a spirituality of vulnerable embrace, as I discover it in this specific faith community. It is a spirituality that combines an invitation and radical embrace of diversity, and a dance with chaos, with a posture of vulnerability and a vision of justice. I bring the reflections of community members in TLF on difference and diversity in their organisation, in conversation with scholars contemplating chaordic organisations and chaordic leadership. I then wonder whether their emphasis on embrace instead of management does not open up the possibility of retrieving and affirming the hidden beauties and potentialities mediated by diversity, which is, I suggest, to practise ‘chaordic beauty’.

  11. Honeybee health in South America

    OpenAIRE

    Maggi , Matías; Antúnez , Karina; Invernizzi , Ciro; Aldea , Patricia; Vargas , Marisol; Negri , Pedro; Brasesco , Constanza; De Jong , David; Message , Dejair; Teixeira , Erica Weinstein; Principal , Judith; Barrios , Carlos; Ruffinengo , Sergio; Da Silva , Rafael Rodríguez; Eguaras , Martín

    2016-01-01

    International audience; AbstractHoneybees are essential components to modern agriculture and economy. However, a continuous increase in cases of colony losses and colony depopulation are being reported worldwide. This critical situation has put the fragile equilibrium between bees and plants on the edge. As a consequence, several scientists have begun to focus their lines of research on this issue. Most researchers agree that there is no single explanation for the observed colony losses. Inst...

  12. Quality assurance in MR image guided adaptive brachytherapy for cervical cancer: Final results of the EMBRACE study dummy run

    DEFF Research Database (Denmark)

    Kirisits, Christian; Federico, Mario; Nkiwane, Karen

    2015-01-01

    and BT. Centers with experience in IGABT (>30 cases) had better performance as compared to centers with limited experience. CONCLUSION: The comprehensive dummy run designed for the EMBRACE trial has been a feasible tool for QA in IGABT of cervix cancer. It should be considered for future IGABT trials...... aspects of image guided adaptive brachytherapy (IGABT). METHODS AND MATERIALS: EMBRACE is a prospective multicenter trial aiming to assess the impact of (MRI)-based IGABT in locally advanced cervical cancer. An EMBRACE dummy run was designed to identify sources and magnitude of uncertainties and errors...

  13. Elia Kazan's America America: A Message for America.

    Science.gov (United States)

    Molofsky, Merle

    2018-06-01

    Elia Kazan's 1963 film, America America is a tribute to the immigrant experience of his own forebears, and has relevance to the refugee crisis of today. In stark black and white cinematography, the film provides insight into the refugee-immigrant experience, personified in Stavros, a young man longing for freedom, obsessed with an idealized America. His hope and innocence cannot safeguard him. His memories of his happy childhood and loving family create idealizing transferences to a world of others who manipulate and betray him as he undertakes his quest. Eventually he too learns to manipulate and betray, unconsciously identifying with the aggressor. History will offer ethical challenges, the black and white cinematography mirroring the black and white perception of good and bad, the shades of grey evoking a maturation of understanding.

  14. Working Together in Urban Schools: How a University Teacher Education Program and Teach for America Partner to Support Alternatively Certified Teachers

    Science.gov (United States)

    Heineke, Amy J.; Carter, Heather; Desimone, Melissa; Cameron, Quanna

    2010-01-01

    The College of Teacher Education and Leadership (CTEL) at Arizona State University (ASU) embraced the opportunity to partner with Teach For America (TFA) to tailor existing teacher preparation programs to meet the unique needs of alternatively certified teachers in urban schools. Rather than harp on the distinctions between ideologies and…

  15. Heart Failure in North America

    OpenAIRE

    Blair, John E. A; Huffman, Mark; Shah, Sanjiv J

    2013-01-01

    Heart failure is a major health problem that affects patients and healthcare systems worldwide. Within the continent of North America, differences in economic development, genetic susceptibility, cultural practices, and trends in risk factors and treatment all contribute to both inter-continental and within-continent differences in heart failure. The United States and Canada represent industrialized countries with similar culture, geography, and advanced economies and infrastructure. During t...

  16. Las reformas neoliberales del sector de la salud: déficit gerencial y alienación del recurso humano en América Latina Neoliberal health sector reforms in Latin America: unprepared managers and unhappy workers

    Directory of Open Access Journals (Sweden)

    Antonio Ugalde

    2005-03-01

    Full Text Available This work analyzes the neoliberal health sector reforms that have taken place in Latin America, the preparation of health care workers for the reforms, the reforms' impacts on the workers, and the consequences that the reforms have had on efficiency and quality in the health sector. The piece also looks at the process of formulating and implementing the reforms. The piece utilizes secondary sources and in-depth interviews with health sector managers in Bolivia, Colombia, Costa Rica, the Dominican Republic, Ecuador, El Salvador, and Mexico. Neoliberal reforms have not solved the human resources problems that health sector evaluations and academic studies had identified as the leading causes of health system inefficiency and low-quality services that existed before the reforms. The reforms worsened the situation by putting new pressures on health personnel, in terms of both the lack of necessary training to face the challenges that came with the reforms and efforts to take away from workers the rights and benefits that they had gained during years of struggles by unions, and to replace them with temporary contracts, reduced job security, and lower benefits. The secrecy with which the reforms were developed and applied made workers even more unified. In response, unions opposed the reforms, and in some countries they were able to delay the reforms. The neoliberal reforms have not improved the efficiency or quality of health systems in Latin America despite the resources that have been invested. Nor have the neoliberal reforms supported specific changes that have been applied in the public sector and that have demonstrated their ability to solve important health problems. These specific changes have produced better results than the neoliberal reforms, and at a lower cost.

  17. Central America's shrinking forests.

    Science.gov (United States)

    1992-01-01

    This news brief reports that 66% of deforestation in Central America has happened in the past 40 years, based on World Conservation Union (WCU) data. Deforestation is expected to continue. The population of Central America and Mexico grew by 28% between 1977 and 1987. Growth is decreasing but remains high at 2.5% in all countries of the region except Panama. 29 million was the regional population in 1990; the projection is for 63 million by 2025. Population is migrating to urban centers. Forests declined by 13% and croplands increased from 4% to 13% of total land area and pasture land from 2% to 37%. There was an increase in unproductive land from 145 to 24%, i.e., 50% of El Salvador's land had soil degradation as does 30% of Guatemala's. In addition to deforestation and soil degradation, there has been soil erosion leading to sedimentation buildup near dam sites and in rivers, which diminishes hydroelectric power capability. Silting also affects groundwater resources, which impact on a safe drinking water supply. Population growth results in increased demand for fuelwood, urban land, and agricultural land. New techniques practiced widely are needed in order to meet the region's needs or demands. Slowing population growth buys time for adjusting to the necessary changes needed for sustaining the region's population. WCU urges conservation organizations to raise awareness about the role population plays in environmental degradation, and to support efforts to reduce birth rates. Women's status needs to be improved through income-generating projects, for instance, and cooperation is needed between conservation groups and organizations involved with improving maternal and child health.

  18. Pesquisa em saúde, política de saúde e eqüidade na América Latina Health research, health policy and equity in Latin America

    Directory of Open Access Journals (Sweden)

    Alberto Pellegrini Filho

    2004-06-01

    Full Text Available O autor analisa as relações entre pesquisa de saúde, políticas de saúde e eqüidade na América Latina. Descreve novas tendências no modo de produção do conhecimento, que permitem maior integração entre as necessidades sociais e a pesquisa, facilitando o vínculo entre esta e o processo de definição de políticas. Analisa as manifestações das novas tendências na América Latina e finaliza com a descrição de algumas iniciativas promovidas pela OPAS no sentido de aproveitar as oportunidades abertas pelas novas tendências para a melhoria das condições de saúde na região. Busca defender a tese de que a informação e o conhecimento são bens públicos essenciais e que as iniqüidades de acesso a esses bens são importantes determinantes das iniqüidades em saúde. Para que as políticas de saúde e as políticas de pesquisa em saúde se integrem e se consolidem como políticas públicas voltadas a atender ao interesse público e à promoção da eqüidade, é necessário o fortalecimento do processo democrático de definição das mesmas, multiplicando os atores envolvidos, os espaços e oportunidades de interação entre eles e instrumentando sua participação com o acesso eqüitativo a informações e conhecimentos científicos pertinentes que permitam a defesa fundamentada de seus interesses.The author analyzes the relationships between health research, health policies and equity in Latin America. He describes new trends in the mode of knowledge production that enhance the integration between social needs and research, facilitating the ties between research and the policy making process. The author also analyzes the manifestations of these new trends in Latin America, and describes some initiatives promoted by the PAHO aimed to take advantage of the opportunities opened by these trends to improve health conditions in the region. Throughout the article the author defends the thesis that information and knowledge are

  19. Texas passes first law for safe patient handling in America: landmark legislation protects health-care workers and patients from injury related to manual patient lifting.

    Science.gov (United States)

    Hudson, Mary Anne

    2005-01-01

    On June 17,2005, Texas Governor Rick Perry (R) signed into law Senate Bill 1525, making Texas the first state in the nation to require hospitals and nursing homes to implement safe patient handling and movement programs. Governor Perry is to be commended for this heroic first stand for safe patient handling in America. The landmark legislation will take effect January 1, 2006, requiring the establishment of policy to identify, assess, and develop methods of controlling the risk of injury to patients and nurses associated with lifting, transferring, repositioning, and movement of patients; evaluation of alternative methods from manual lifting to reduce the risk of injury from patient lifting, including equipment and patient care environment; restricting, to the extent feasible with existing equipment, manual handling of all or most of a patient's weight to emergency, life-threatening, or exceptional circumstances; and provision for refusal to perform patient handling tasks believed to involve unacceptable risks of injury to a patient or nurse. Manually lifting patients has been called deplorable, inefficient, dangerous to nurses, and painful and brutal to patients; manual lifting can cause needless suffering and injury to patients, with dangers including pain, bruising, skin tears, abrasions, tube dislodgement, dislocations, fractures, and being dropped by nursing staff during attempts to manually lift. Use of safe, secure, mechanical lift equipment and gentle friction-reducing devices for patient maneuvering tasks could eliminate such needless brutality. Research has proven that manual patient lifting is extremely hazardous to health-care workers, creating substantial risk of low-back injury, whether with one or two patient handlers. Studies on the use of mechanical patient lift equipment, by either nursing staff or lift teams, have proven repeatedly that most nursing staff back injury is preventable, leading to substantial savings to employers on medical and

  20. Embracing uncertainty, managing complexity: applying complexity thinking principles to transformation efforts in healthcare systems.

    Science.gov (United States)

    Khan, Sobia; Vandermorris, Ashley; Shepherd, John; Begun, James W; Lanham, Holly Jordan; Uhl-Bien, Mary; Berta, Whitney

    2018-03-21

    Complexity thinking is increasingly being embraced in healthcare, which is often described as a complex adaptive system (CAS). Applying CAS to healthcare as an explanatory model for understanding the nature of the system, and to stimulate changes and transformations within the system, is valuable. A seminar series on systems and complexity thinking hosted at the University of Toronto in 2016 offered a number of insights on applications of CAS perspectives to healthcare that we explore here. We synthesized topics from this series into a set of six insights on how complexity thinking fosters a deeper understanding of accepted ideas in healthcare, applications of CAS to actors within the system, and paradoxes in applications of complexity thinking that may require further debate: 1) a complexity lens helps us better understand the nebulous term "context"; 2) concepts of CAS may be applied differently when actors are cognizant of the system in which they operate; 3) actor responses to uncertainty within a CAS is a mechanism for emergent and intentional adaptation; 4) acknowledging complexity supports patient-centred intersectional approaches to patient care; 5) complexity perspectives can support ways that leaders manage change (and transformation) in healthcare; and 6) complexity demands different ways of implementing ideas and assessing the system. To enhance our exploration of key insights, we augmented the knowledge gleaned from the series with key articles on complexity in the literature. Ultimately, complexity thinking acknowledges the "messiness" that we seek to control in healthcare and encourages us to embrace it. This means seeing challenges as opportunities for adaptation, stimulating innovative solutions to ensure positive adaptation, leveraging the social system to enable ideas to emerge and spread across the system, and even more important, acknowledging that these adaptive actions are part of system behaviour just as much as periods of stability are. By

  1. Embracing a broad spirituality in end of life discussions and advance care planning.

    Science.gov (United States)

    Churchill, Larry R

    2015-04-01

    Advance care planning for end of life typically focuses on the mechanics of completing living wills and durable power of attorney documents. Even when spiritual aspects of end of life care are discussed, the dominant assumptions are those of traditional religious systems. A broad view of spirituality is needed, one that may involve traditional religious beliefs but also includes personal understandings of what is holy or sacred. Embracing this broad practice of spirituality will help both familial and professional caregivers honor an essential aspect of end of life discussions and promote greater discernment of the deep meaning in advance care documents.

  2. The Readiness of the European Union to Embrace the Fourth Industrial Revolution

    Directory of Open Access Journals (Sweden)

    Eva Kuruczleki

    2016-12-01

    Full Text Available Knowledge has become a crucial factor of production in the developed economies and, as humans are the carriers and utilisers of knowledge, skilled human resource is gaining similarly large relevance. These advancements are elements of the substantial changes that characterise the fourth industrial revolution – a phenomenon worth studying in detail. The European Union has been explicitly concerned about the shift to the knowledge economy since the Lisbon Summit of 2000. More than one and a half decades later the eu’s readiness to embrace the knowledge-driven fourth industrial revolution can be examined. We undertake that by creating an index based on various related data.

  3. Rabies in the Americas

    Science.gov (United States)

    Rabies in the Americas Search this site Welcome Previous Meetings Steering Committee Contact Sitemap Welcome The Rabies in the Americas (RITA) meeting is an annual event that has been held since 1990 managers of rabies programs, wildlife biologists, laboratory personnel and other people interested in

  4. World review: Latin America

    International Nuclear Information System (INIS)

    Anon.

    2000-01-01

    The article gives information on contracts announced (and to whom) throughout Latin America in all aspects of the petroleum, natural gas and petrochemicals industries. Countries specifically mentioned are Argentina, Brazil, Chile, Mexico, Trinidad and Venezuela. The future for the oil industry in Latin America is viewed as 'highly prospective'

  5. The Distancing-Embracing model of the enjoyment of negative emotions in art reception.

    Science.gov (United States)

    Menninghaus, Winfried; Wagner, Valentin; Hanich, Julian; Wassiliwizky, Eugen; Jacobsen, Thomas; Koelsch, Stefan

    2017-01-01

    Why are negative emotions so central in art reception far beyond tragedy? Revisiting classical aesthetics in the light of recent psychological research, we present a novel model to explain this much discussed (apparent) paradox. We argue that negative emotions are an important resource for the arts in general, rather than a special license for exceptional art forms only. The underlying rationale is that negative emotions have been shown to be particularly powerful in securing attention, intense emotional involvement, and high memorability, and hence is precisely what artworks strive for. Two groups of processing mechanisms are identified that conjointly adopt the particular powers of negative emotions for art's purposes. The first group consists of psychological distancing mechanisms that are activated along with the cognitive schemata of art, representation, and fiction. These schemata imply personal safety and control over continuing or discontinuing exposure to artworks, thereby preventing negative emotions from becoming outright incompatible with expectations of enjoyment. This distancing sets the stage for a second group of processing components that allow art recipients to positively embrace the experiencing of negative emotions, thereby rendering art reception more intense, more interesting, more emotionally moving, more profound, and occasionally even more beautiful. These components include compositional interplays of positive and negative emotions, the effects of aesthetic virtues of using the media of (re)presentation (musical sound, words/language, color, shapes) on emotion perception, and meaning-making efforts. Moreover, our Distancing-Embracing model proposes that concomitant mixed emotions often help integrate negative emotions into altogether pleasurable trajectories.

  6. America in the Eyes of America Watchers:

    DEFF Research Database (Denmark)

    Feng, Huiyun; He, Kai

    2015-01-01

    Based on an original survey conducted in the summer of 2012 in Beijing, we examine how China's America watchers—IR scholars who work on US-China relations—have viewed China's power status in the international system, US-China relations and some specific US policies in Asia. Our survey shows that ...

  7. America's Children and the Environment

    Science.gov (United States)

    ... Labs and Research Centers America's Children and the Environment (ACE) Contact Us Share ACE presents key information ... of updates to ACE . America's Children and the Environment (ACE) America's Children and the Environment (ACE) is ...

  8. A comparative analysis of the changes in nursing practice related to health sector reform in five countries of the Americas Análisis comparativo de los cambios en la práctica de la enfermería relacionados con la reforma del sector de la salud en cinco países americanos

    OpenAIRE

    Edilma B. Guevara; Elnora P. Mendias

    2002-01-01

    Objective. To identify changes in nursing practice and the nursing-practice environment that have occurred with implementation of health sector reform in five countries in the Americas. Methods. An exploratory study of selected settings in Argentina, Brazil, Colombia, Mexico, and the United States of America was conducted between 1997 and 1999 to collect narrative data from 125 professional nurses about their perceptions of nursing practice and changes in work environments. Descriptions of ch...

  9. Tourette Association of America

    Science.gov (United States)

    ... outcomes Find a Doctor Find information for Select Audience Parents Adults with Tourette Kids Teens Educators Professionals ... About Tourette Tourette Association of America Welcomes NFL Marketing Executive Julie Haddon to Its Board of Directors ...

  10. Rediscovering South America

    National Research Council Canada - National Science Library

    Ray, Charles; Shearer, Thomas D; Staszak, Michael

    1997-01-01

    In presenting the U.S. National Security Strategy of Engagement and Enlargement the Clinton Administration states that, "The unprecedented triumph of democracy and market economies throughout the (Latin America...

  11. Paralyzed Veterans of America

    Science.gov (United States)

    ... Connected Twitter @PVA1946 Facebook @Paralyzed Veterans of America Instagram @PVA1946 National Veterans Wheelchair Games App Download Now ... 838-7782 CONNECT WITH US Facebook Twitter YouTube Instagram Flickr STAY INFORMED WITH NEWS & UPDATES Enter your ...

  12. Sister outsider: an enduring vision embracing myself, my sister and the 'other'.

    Science.gov (United States)

    Rivera-Fuentes, Consuela

    2007-01-01

    This piece reflects on and reacts to Audre Lorde's critique of racism within Lesbian communities. One purpose of the article is to honor and rescue Lorde's wonderful insight into the power of words when uttered and shared by women, as well as her ideas about differences and connections that exist between Black and white feminisms. Lorde's insistence on a 'sisterhood,' which embraces the 'other' and ourselves at the same time, is a recurrent thought throughout this paper. The article is also firmly grounded in the author's own experience of alienation and racism in the European context of Women's Studies. The second purpose of this position piece is to offer practical suggestions for how to keep Lesbian Studies alive.

  13. EMBRACE@Nançay: an ultra wide field of view prototype for the SKA

    International Nuclear Information System (INIS)

    Torchinsky, S.A.; Censier, B.; Serylak, M.; Renaud, P.; Taffoureau, C.; Olofsson, A.O.H.; Karastergiou, A.

    2015-01-01

    A revolution in radio receiving technology is underway with the development of densely packed phased arrays for radio astronomy. This technology can provide an exceptionally large field of view, while at the same time sampling the sky with high angular resolution. Such an instrument, with a field of view of over 100 square degrees, is ideal for performing fast, all-sky, surveys, such as the ''intensity mapping'' experiment to measure the signature of Baryonic Acoustic Oscillations in the HI mass distribution at cosmological redshifts. The SKA, built with this technology, will be able to do a billion galaxy survey. I will present a very brief introduction to radio interferometry, as well as an overview of the Square Kilometre Array project. This will be followed by a description of the EMBRACE prototype and a discussion of results and future plans

  14. Embrace, Embed and Enliven: Advancing Social Responsibilities at the University of Northampton, England

    Directory of Open Access Journals (Sweden)

    Emel Thomas

    2017-04-01

    Full Text Available As the United Kingdom's (UK first Ashoka U Changemaker Campus, the University of Northampton (UoN has embarked on a strategy that embraces social enterprises. Social enterprise, innovation and entrepreneurship are key competences that have been used by the university to address social inequalities. This paper will account for the social engagement challenges that are influential in the UK's higher educational environment. International perspectives will be highlighted to demonstrate that significant advantages can be obtained by borrowing and adapting policies and practice strategies. Our primary aims are: to showcase the fundamental activities of social responsibility as demonstrated by UoN and provide examples of stakeholder demands during periods of significant change. We argue that it is essential for higher education institutions (HEI to develop a more nuanced and innovative examination of community based initiatives and networks in order to sustain engagement and access.

  15. A Channel For Gay America? A Cultural Criticism Of The Logo Channel's Commercial Success On American Cable Television

    OpenAIRE

    Johnson Jr., Michael

    2008-01-01

    Logo currently holds a self-described monopoly as the “Gay Channel for America.” Logo stands alone as the single most concentrated national-level vehicle of LGBT (Lesbian, Gay, Bisexual and Transgendered) visibility in the post millennial television era. The Logo Channel has reaped financial rewards from its strategy as a business entity, as LGBT American television viewers embraced its presence as a signifier to America that gays and lesbians have finally “made it”. First, any claim to a mon...

  16. Hacia la búsqueda de efectividad en promoción de la salud en América Latina Searching evidence of health promotion effectiveness in Latin America

    Directory of Open Access Journals (Sweden)

    Ligia de Salazar

    2004-09-01

    Full Text Available La promoción de la salud en América Latina ha sido expresada no solo como una meta sino como una voluntad política de gobiernos, instituciones de salud y centros educativos. La implementación de sus principios y componentes se convierte en un reto, en una región donde las condiciones para ser saludable y las capacidades de controlar determinantes de salud están lejos de las expectativas. Desde esta perspectiva ha sido ampliamente reconocida la necesidad de evaluar los logros y efectos de la promoción de la salud, en términos de las capacidades para lograr cambios en el estado de salud y sus determinantes. Esta tarea se está afrontado a través del proyecto de Evidencias de Efectividad en Promoción de Salud en América Latina, promovido por la UIPES. Concientización, formación, investigación evaluativa, diseminación de información y abogacía son las estrategias principales y actividades del proyecto, con el fin de fortalecer la capacidad regional para desarrollar, publicar y usar resultados de las evaluaciones para influir en decisiones relacionadas con promoción de salud.Health promotion in the Latin America region has been expressed not only as a goal but as a political will of governments, health institutions and educative centers. The implementation of its principles and components is in itself a challenge in a region where health determinants and therefore the conditions to be healthy are far from the expected, demanding intersectoral actions and sometimes complex interventions that goes beyond the health sector and individual actions. It has been recognized the need to evaluate its achievements and effects in both, people capacity to deal with health problems and its determinants and changes in health status and conditions to be healthy. This task constitutes not only an ethical imperative but a methodological and political challenge which has been faced through the project Evidences of Effectiveness in Health Promotion in

  17. Nuclear medicine in the countries of Latin America

    International Nuclear Information System (INIS)

    Touya, Eh.

    1987-01-01

    The role of nuclear medicine in protection of health in Latin America states is shown. Nuclear medicine methods are applied in Latin America countries for diagnosis of coronary disease, cancer, malfunctioning of separate organs and transplants, kidney transplants in particular. The present situation in protection of health in the region is evaluated. It is emphasized that nuclear medicine should play its role in the course of public health improvement in those countries

  18. Tarnished Gold: Classical Music in America

    Science.gov (United States)

    Asia, Daniel

    2010-01-01

    A few articles have appeared recently regarding the subject of the health of classical music (or more broadly, the fine arts) in America. These include "Classical Music's New Golden Age," by Heather Mac Donald, in the "City Journal" and "The Decline of the Audience," by Terry Teachout, in "Commentary." These articles appeared around the time of…

  19. Adolescent Pregnancy in America: Causes and Responses

    Science.gov (United States)

    Domenico, Desirae M.; Jones, Karen H.

    2007-01-01

    Adolescent pregnancy has occurred throughout America's history. Only in recent years has it been deemed an urgent crisis, as more young adolescent mothers give birth outside of marriage. At-risk circumstances associated with adolescent pregnancy include medical and health complications, less schooling and higher dropout rates, lower career…

  20. America's Children 1976: A Bicentennial Assessment.

    Science.gov (United States)

    Fleming, Virginia; And Others

    This factbook presents 87 pages of pictures, graphs, diagrams, quotations, statistics, and text aimed at portraying the current status of children in America. The major areas examined include: (1) children in poverty; (2) child health; (3) family changes and day care; and (4) special child care needs for handicapped, abused, or neglected children.…

  1. Integrating Ecohealth Assessment in the Americas | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    However, very few impact assessment laws are adequately implemented in Latin ... Integrated eco-health assessment law in the Americas : a hemispheric research ... IWRA/IDRC webinar on climate change and adaptive water management. International Water Resources Association, in close collaboration with IDRC, ...

  2. Precursors to Language Development in Typically and Atypically Developing Infants and Toddlers: The Importance of Embracing Complexity

    Science.gov (United States)

    D'Souza, Dean; D'Souza, Hana; Karmiloff-Smith, Annette

    2017-01-01

    In order to understand how language abilities emerge in typically and atypically developing infants and toddlers, it is important to embrace complexity in development. In this paper, we describe evidence that early language development is an experience-dependent process, shaped by diverse, interconnected, interdependent developmental mechanisms,…

  3. Integrated Care for Older Adults Improves Perceived Quality of Care : Results of a Randomized Controlled Trial of Embrace

    NARCIS (Netherlands)

    Uittenbroek, Ronald J; Kremer, Hubertus P H; Spoorenberg, Sophie L W; Reijneveld, Sijmen A; Wynia, Klaske

    BACKGROUND: All community-living older adults might benefit from integrated care, but evidence is lacking on the effectiveness of such services for perceived quality of care. To examine the impact of Embrace, a community-based integrated primary care service, on perceived quality of care. Stratified

  4. T.R. Reid, The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care, New York, The Penguin Press, 2009, 277p

    Directory of Open Access Journals (Sweden)

    Eveline Thévenard

    2010-02-01

    Full Text Available The U.S. Interstate Highway System was inspired by Germany’s. Sushi and pizza have become some of America’s favorite foods. So why not borrow from foreign models to reform the most expensive and inequitable health care system in the developed world? U.S. researchers’ interest in cross-national comparative studies has increased in recent years, and scholarly journals such as Health Affairs and the Journal of Health Politics Policy and Law regularly devote space to analyses of health care fina...

  5. Neosporosis in South America.

    Science.gov (United States)

    Moore, D P

    2005-01-20

    This work gathers reports about Neospora-infections in South America. Neospora-infections have been reported from Argentina, Brazil, Chile, Paraguay, Peru and Uruguay. Evidence of exposure to N. caninum was mentioned in cattle, goats, sheep, dogs, cats, water buffaloes, alpacas, llamas, South American opossums, wolves and other wild canids. No antibodies were found in horses. Interesting epidemiological and pathological data were described. Two isolations were performed from dogs, one from cattle, and recently five from water buffaloes. Since the cattle industry is important in South America and reproductive losses caused by Neospora-infection have been identified, more investigations are needed in order to understand its epidemiology and control the disease.

  6. Barriers to Clinical Research in Latin America

    OpenAIRE

    Chomsky-Higgins, Kathryn; Miclau, Theodore A.; Mackechnie, Madeline C.; Aguilar, Dino; Avila, Jorge Rubio; dos Reis, Fernando Baldy; Balmaseda, Roberto; Barquet, Antonio; Ceballos, Alfredo; Contreras, Fernando; Escalante, Igor; Elias, Nelson; Vincenti, Sergio Iriarte; Lozano, Christian; Medina, Fryda

    2017-01-01

    Enhancing health research capacity in developing countries is a global health priority. Understanding the orthopedic burden of disease in Latin America will require close partnership between more-developed and less-developed countries. To this end, the Osteosynthesis and Trauma Care Foundation assembled a research consortium of Latin-American orthopedic leaders. Prior to the meeting, we surveyed attendees on perceived barriers to conducting research at their institutions. During the event, wo...

  7. Notes on health care planning in Latin America and the Caribbean Notas sobre planejamento de assistência médica na América Latina e no Caribe

    Directory of Open Access Journals (Sweden)

    José Maria Pacheco de Souza

    1977-06-01

    Full Text Available Attention is called to the fact that the efforts to improve health of populations in Latin America have generally failed. The inequality in the distribution of ill-health is great. The authors accept the fact that the lack of resources available to the health sector may be a restriction towards the improvement of the situation, but they argue that a much more important issue is the misuse of such resources and their maldistribution within the health sector. The lack of integration and coordination between the health services, the conflict of public and private health systems, the under-utilization of existing services and the gap between planning and real implementation are discussed.Chama-se a atenção para o fato de que os esforços para a melhoria da saúde das populações da América Latina, geralmente têm falhado. A desigualdade na distribuição de saúde é grande. Aceita-se o fato de que a falta de recursos disponíveis para o setor saúde pode ser empecilho para a melhoria da situação, mas argumenta-se que um fator muito mais importante é o uso indevido de tais recursos e sua má distribuição dentro do setor saúde. São discutidas as faltas de integração e coordenação dos serviços de saúde, o conflito entre sistemas público e privado de saúde, a sub-utilização dos serviços existentes, o distanciamento entre o planejamento e a sua real implementação.

  8. Embracing interactions in ocean acidification research: confronting multiple stressor scenarios and context dependence.

    Science.gov (United States)

    Kroeker, Kristy J; Kordas, Rebecca L; Harley, Christopher D G

    2017-03-01

    Changes in the Earth's environment are now sufficiently complex that our ability to forecast the emergent ecological consequences of ocean acidification (OA) is limited. Such projections are challenging because the effects of OA may be enhanced, reduced or even reversed by other environmental stressors or interactions among species. Despite an increasing emphasis on multifactor and multispecies studies in global change biology, our ability to forecast outcomes at higher levels of organization remains low. Much of our failure lies in a poor mechanistic understanding of nonlinear responses, a lack of specificity regarding the levels of organization at which interactions can arise, and an incomplete appreciation for linkages across these levels. To move forward, we need to fully embrace interactions. Mechanistic studies on physiological processes and individual performance in response to OA must be complemented by work on population and community dynamics. We must also increase our understanding of how linkages and feedback among multiple environmental stressors and levels of organization can generate nonlinear responses to OA. This will not be a simple undertaking, but advances are of the utmost importance as we attempt to mitigate the effects of ongoing global change. © 2017 The Authors.

  9. Embracing Ebooks : Acquisition and Collection Development Landscape in Philippine Academic Libraries

    Directory of Open Access Journals (Sweden)

    Janice D.C. Peñaflor

    2017-07-01

    Full Text Available In the recent years, libraries are evidently expanding their embrace in adoption of ebooks. This may be attributed to the real and perceived advantages demonstrated by ebooks in terms of accessibility, functionality and cost effectiveness. Increasingly, ebooks form a growing part of the collections in academic libraries as a viable format to support the information needs of their patrons. Some libraries have adopted ebooks on a large scale while others are still tentative in their acquisitions. This study aims to examine the current status of collection build-up of ebooks in different academic libraries in Metro Manila. Specifically, it will look at the extent by which they collect and acquire ebooks as well as the issues being faced by the libraries in their efforts to build their ebook collection. This paper employs a survey method to determine the collection size, selection models, methods of acquisition, budget allocation, collection development policy and other related items. The results of the study will provide an overview of the extent of ebook adoption among the academic libraries in the Philippines. It will also serve as a basis for proposing possible solutions to common issues that confronts the libraries of today concerning integrating ebooks in the collection. Lastly, the findings may also serve as a benchmark for best practices for other libraries.

  10. Embracing the Importance of FAIR Research Products - Findable, Accessible, Interoperable, and Reusable

    Science.gov (United States)

    Stall, S.

    2017-12-01

    Integrity and transparency within research is solidified by a complete set of research products that are findable, accessible, interoperable, and reusable. In other words, they follow the FAIR Guidelines developed by FORCE11.org. Your datasets, images, video, software, scripts, models, physical samples, and other tools and technology are an integral part of the narrative you tell about your research. These research products increasingly are being captured through workflow tools and preserved and connected through persistent identifiers across multiple repositories that keep them safe. They help secure, with your publications, the supporting evidence and integrity of the scientific record. This is the direction that Earth and space science as well as other disciplines is moving. Within our community, some science domains are further along, and others are taking more measured steps. AGU as a publisher is working to support the full scientific record with peer reviewed publications. Working with our community and all the Earth and space science journals, AGU is developing new policies to encourage researchers to plan for proper data preservation and provide data citations along with their research submission and to encourage adoption of best practices throughout the research workflow and data life cycle. Providing incentives, community standards, and easy-to-use tools are some important factors for helping researchers embrace the FAIR Guidelines and support transparency and integrity.

  11. Conceptualizing community resilience to natural hazards – the emBRACE framework

    Directory of Open Access Journals (Sweden)

    S. Kruse

    2017-12-01

    Full Text Available The level of community is considered to be vital for building disaster resilience. Yet, community resilience as a scientific concept often remains vaguely defined and lacks the guiding characteristics necessary for analysing and enhancing resilience on the ground. The emBRACE framework of community resilience presented in this paper provides a heuristic analytical tool for understanding, explaining and measuring community resilience to natural hazards. It was developed in an iterative process building on existing scholarly debates, on empirical case study work in five countries and on participatory consultation with community stakeholders where the framework was applied and ground-tested in different contexts and for different hazard types. The framework conceptualizes resilience across three core domains: (i resources and capacities, (ii actions and (iii learning. These three domains are conceptualized as intrinsically conjoined within a whole. Community resilience is influenced by these integral elements as well as by extra-community forces comprising disaster risk governance and thus laws, policies and responsibilities on the one hand and on the other, the general societal context, natural and human-made disturbances and system change over time. The framework is a graphically rendered heuristic, which through application can assist in guiding the assessment of community resilience in a systematic way and identifying key drivers and barriers of resilience that affect any particular hazard-exposed community.

  12. Conceptualizing community resilience to natural hazards - the emBRACE framework

    Science.gov (United States)

    Kruse, Sylvia; Abeling, Thomas; Deeming, Hugh; Fordham, Maureen; Forrester, John; Jülich, Sebastian; Nuray Karanci, A.; Kuhlicke, Christian; Pelling, Mark; Pedoth, Lydia; Schneiderbauer, Stefan

    2017-12-01

    The level of community is considered to be vital for building disaster resilience. Yet, community resilience as a scientific concept often remains vaguely defined and lacks the guiding characteristics necessary for analysing and enhancing resilience on the ground. The emBRACE framework of community resilience presented in this paper provides a heuristic analytical tool for understanding, explaining and measuring community resilience to natural hazards. It was developed in an iterative process building on existing scholarly debates, on empirical case study work in five countries and on participatory consultation with community stakeholders where the framework was applied and ground-tested in different contexts and for different hazard types. The framework conceptualizes resilience across three core domains: (i) resources and capacities, (ii) actions and (iii) learning. These three domains are conceptualized as intrinsically conjoined within a whole. Community resilience is influenced by these integral elements as well as by extra-community forces comprising disaster risk governance and thus laws, policies and responsibilities on the one hand and on the other, the general societal context, natural and human-made disturbances and system change over time. The framework is a graphically rendered heuristic, which through application can assist in guiding the assessment of community resilience in a systematic way and identifying key drivers and barriers of resilience that affect any particular hazard-exposed community.

  13. Targeted harassment, subcultural identity and the embrace of difference: a case study.

    Science.gov (United States)

    Hodkinson, Paul; Garland, Jon

    2016-09-01

    This paper examines the significance of experiences and understandings of targeted harassment to the identities of youth subcultural participants, through case study research on goths. It does so against a context of considerable recent public discussion about the victimization of alternative subcultures and a surprising scarcity of academic research on the subject. The analysis presented indicates that, although individual direct experiences are diverse, the spectre of harassment can form an ever-present accompaniment to subcultural life, even for those who have never been seriously targeted. As such, it forms part of what it is to be a subcultural participant and comprises significant common ground with other members. Drawing upon classic and more recent understandings of how subcultural groups respond to broader forms of outside hostility, we show how the shared experience of feeling targeted for harassment tied in with a broader subcultural discourse of being stigmatized by a perceived 'normal' society. The role of harassment as part of this, we argue, contributed to the strength with which subcultural identities were felt and to a positive embrace of otherness. © London School of Economics and Political Science 2016.

  14. Delayed Reaction: The Tardy Embrace of Physical Organic Chemistry by the German Chemical Community.

    Science.gov (United States)

    Weininger, Stephen J

    2018-02-01

    The emergence of physical organic chemistry, which focuses on the mechanisms and structures of organic reactions and molecules using the tools of physical chemistry, was a major development in twentieth-century chemistry. It first flourished in the interwar period, in the UK and then in the US. Germany, by contrast, did not embrace the field until almost a half century later. The great success of classical organic chemistry, especially in synthesis, encouraged indifference to the new field among German chemists, as did their inductivist research philosophy, as enunciated by Walter Hückel's ground-breaking textbook (1931). This author also resisted new concepts and representations, especially those of the American theoretician, Linus Pauling. The arrival of the Nazi regime reinforced such resistance. Postwar conditions initiated a reaction against this conservative, nationalistic attitude, especially in the American Occupation Zone. Exposure to American textbooks and visiting lecturers influenced attitudes of younger chemists. The accompanying shift towards a more explanatory, less hierarchical mode of pedagogy was consonant with larger social and political developments.

  15. Canada-Latin America and Caribbean Zika Virus Research Program ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-05-10

    May 10, 2016 ... ... in the hardest hit countries in Latin America and the Caribbean. The Canadian Institutes for Health Research and the International Development ... understand the causes and effects of the the virus, and ultimately prevent its ...

  16. Black Writers' Views of America.

    Science.gov (United States)

    Hairston, Loyle

    1979-01-01

    This article argues that the stagnation, pessimism, and self-pity evident in recent Black writing results in part from the alienation of Black writers from the mainstream of Black life, and in part from the illusions that they share with other Blacks who have embraced the American value system. (Author/EB)

  17. The sexual and reproductive health of young people in Latin America: evidence from WHO case studies La salud sexual y reproductiva de los jóvenes en América Latina: evidencia derivada de estudios de la OMS

    Directory of Open Access Journals (Sweden)

    Kate Kostrzewa

    2008-02-01

    Full Text Available This original article addresses the sexual and reproductive health needs of young people aged 15 to 24 in Latin America. It introduces five articles from original research projects in three countries: Argentina, Brazil, and Peru. These projects were funded by the World Health Organization. This article explains the importance of studies that address the sexual and reproductive health of young people in developing countries. It provides an overview of sexual and reproductive health issues in Latin America and a discussion these issues in the three study countries. The five articles deal with difficult and challenging issues, including: knowledge of STIs and HIV/AIDS; pregnancy related practices; quality of care; the role of young men in couple formation, pregnancy and adoption of contraceptive practice; and, the role of obstetricians and gynecologists in public policy debate about family planning and abortion. The four articles in this special section help to improve our understanding of the factors that contribute to risky sexual behavior and negative reproductive health outcomes among youth in Latin America. The findings are useful to help inform and improve health care interventions in various contexts.Este artículo original trata de las necesidades de salud sexual y reproductiva de jóvenes entre 15 y 24 años de edad en América Latina. Se presentan cuatro artículos derivados de investigaciones originales en tres países: Argentina, Brasil y Perú. Estos proyectos fueron patrocinados por la Organización Mundial de la Salud. Este artículo elucida la importancia de los estudios que tratan de la salud sexual y reproductiva de jóvenes en países en desarollo. Se ilustra el panorama general en cuestiones de salud sexual y reproductiva en América Latina y una discusión de estas cuestiones en los tres países de donde provienen los estudios. Los cinco artículos discuten cuestiones difíciles y controversiales, como los conocimientos sobre

  18. Violence against children in Latin America and Caribbean countries: a comprehensive review of national health sector efforts in prevention and response

    Directory of Open Access Journals (Sweden)

    Andrea L. Wirtz

    2016-09-01

    Full Text Available Abstract Background Violence against children (VAC remains a global problem. The health sector has an opportunity and responsibility to be part of the multi-sector collaboration to prevent and respond to VAC. This review aimed to assess the health sector’s response to VAC among Latin American & Caribbean (LAC countries, particularly as it relates to physical violence, sexual violence, and neglect. Method National protocols for the identification and provision of health care to child survivors of violence, abuse and neglect were solicited in partnership with UNICEF and PAHO/WHO country offices within the LAC region. A parallel systematic review was undertaken in January 2015 to review studies published in the last 10 years that describe the regional health sector response to VAC. Results We obtained health sectors guidelines/protocols related to VAC from 22 of 43 (51 % countries and reviewed 97 published articles/reports that met the review inclusion criteria. Country protocols were presented in Spanish (n = 12, Portuguese (n = 1, and English (n = 9. Thematic areas of country protocols included: 1 identifying signs and symptoms of VAC, 2 providing patient-centered care to the victim, and 3 immediate treatment of injuries related to VAC. The systematic review revealed that health professionals are often unaware of national protocols and lack training, resources, and support to respond to cases of VAC. Further, there is limited coordination between health and social protection services. Conclusions VAC remains an international, public health priority. Health professionals are well-positioned to identify, treat and refer cases of VAC to appropriate institutions and community-based partners. However, poor protocol dissemination and training, limited infrastructure, and inadequate human resources challenge adherence to VAC guidelines.

  19. America, Linearly Cyclical

    Science.gov (United States)

    2013-05-10

    AND VICTIM- ~ vAP BLAMING 4. AMERICA, LINEARLY CYCUCAL AF IMT 1768, 19840901, V5 PREVIOUS EDITION WILL BE USED. C2C Jessica Adams Dr. Brissett...his desires, his failings, and his aspirations follow the same general trend throughout history and throughout cultures. The founding fathers sought

  20. Preserve America News

    Science.gov (United States)

    Hillary Clinton, and Mrs. Laura Bush on stage at the Sewall-Belmont House. Mrs. Bush was joined by Secretary of the Interior Dirk Kempthorne and Senators Hillary Clinton (NY) and Pete Domenici (NM), who Save America's Treasures established by the Clinton Administration. Secretary Dirk Kempthorne, Senator

  1. Ecodesign in Central America

    NARCIS (Netherlands)

    Crul, M.R.M.

    2003-01-01

    This PhD thesis describes and analyses the change process started by the Ecodesign project in Central America, executed between 1998 and 2002. The project started using the concept and praxis developed in Europe. Nine ecodesign projects were performed in industry, and ecodesign was introduced to

  2. America's Success Syndrome

    Science.gov (United States)

    Duplisea, Eric A.

    1974-01-01

    America's earliest schools taught career awareness and job skills, but for 200 years it was a speciality curriculum--cultivating a classical heritage predominated. Recently the hard sell message is that schooling and credentialism ensure entry into the "successful life". Vocational educators must become leaders, explode this myth, and redefine…

  3. Language in America.

    Science.gov (United States)

    Postman, Neil, Ed.; And Others

    The essays published in this collection were written in response to the basic question, "To what extent is the language of politics/advertising/psychotherapy/education/bureaucracy/etc. facilitating or impeding our chances of survival?" The general topic here is the contemporary use of language and the semantic environment in America, especially in…

  4. Only "In America"

    Science.gov (United States)

    Miranda, Maria Eugenia

    2011-01-01

    As the daughter of an interracial couple growing up in a middle-class town on Long Island in the 1970s, Soledad O'Brien learned not to let inappropriate or racist comments throw her. Now as the anchorwoman of CNN's "In America" documentary unit, she says she asks those uncomfortable questions about race all the time. She shines spotlight…

  5. Still Teaching for America

    Science.gov (United States)

    Kronholz, June

    2013-01-01

    In this article, June Kronholz talks to co-chief executives of Teach For America (TFA), Elisa Villanueva Beard and Matt Kramer about how TFA has managed to keep its forward momentum for almost 24 years. Four primary reasons are discussed: (1) Common Vision, Regional Innovation; (2) Data-Driven Improvement; (3) Global Reach; and (4) Stoking the…

  6. GEONETCast Americas - Architecture

    Science.gov (United States)

    , Component Identification and Selection Discussion Version 2.2.0: June 11, 2014, provides". . . an overview of a GEONETCast Americas ground station, its components, and helpful discussion to relating the also available in Spanish, English. GNC-A Ground Station Simplified Component Diagram GEONETCast

  7. Literacy in South America.

    Science.gov (United States)

    Hornberger, Nancy H.

    1991-01-01

    Literacy in South America must be understood in terms of the linguistic diversity there, where only 2 of 14 nations and territories are monolingual. Oral traditions, standardization of indigenous languages, nonstandard varieties of colonial languages, bilingual education and mother tongue literacy, literacy teaching, and politics are discussed.…

  8. Allergen extracts for immunotherapy in Latin America

    Directory of Open Access Journals (Sweden)

    Ricardo Cardona-Villa

    2018-04-01

    Full Text Available Background: The Latin American Society of Allergy, Asthma, and Immunology (SLAAI presents a document about the use of immunotherapy (IT in Latin America, where administration patterns, indications and contraindications, effects on health, adverse events and socioeconomic impact are reviewed. Objective: To review publications analyzing the use of IT in Latin America. Methods: A literature review was carried out in order to identify works addressing IT in Latin America. This review was focused on practical scientific information available on IT in the region, and a parallel comparison was made with practices observed in the United States and European countries. Results: Of the 21 Latin American countries included, only 9 had original articles meeting the selection criteria; a total of 82 articles were selected, most of them from Brazil and Mexico. Most widely used allergenic extracts in Latin America tropical and subtropical regions were those of mites and pollen. Conclusion: Although it is true that there are huge challenges for the future of IT in Latin America, studies on subcutaneous IT and sublingual IT are increasing, but most of them are retrospective and some have design bias, and more prospective studies are therefore required, using internationally validated scales for clinical evaluation.

  9. Un marco de evaluación de la atención primaria de salud en América Latina A framework for evaluating primary health care in Latin America

    Directory of Open Access Journals (Sweden)

    Jeannie L. Haggerty

    2009-11-01

    Full Text Available OBJETIVOS: Determinar la pertinencia de aplicar la estrategia canadiense de evaluación de la atención primaria de salud (APS en América Latina y proponer las modificaciones necesarias para llegar a un consenso latinoamericano. MÉTODOS: Se utilizó el método Delphi para llegar a un consenso entre 29 expertos comprometidos con el desarrollo o la evaluación de la APS en América Latina. Se realizaron cuatro rondas virtuales y un encuentro presencial para discutir el modelo lógico de evaluación de la APS, los siete objetivos y los seis factores condicionantes que forman parte de la estrategia canadiense, con sus interrogantes de evaluación e indicadores. Se calificaron la relevancia y la pertinencia de cada concepto desde el punto de vista de los países de América Latina. RESULTADOS: Los expertos consideraron los objetivos y los factores condicionantes de la estrategia canadiense altamente pertinentes para evaluar la APS en América Latina, aunque reconocieron la necesidad de modificarlos para aumentar su pertinencia. Los principales cambios fueron la formulación de una visión y una misión de la APS, la inclusión de nuevos objetivos y factores condicionantes y la reformulación de los originales. Los objetivos de coordinación y atención integral e integrada no lograron un alto nivel de consenso debido a ambigüedades en los enunciados originales y la coexistencia de distintas interpretaciones sobre el significado de ciertas dimensiones de evaluación referidas en los enunciados. CONCLUSIONES: Se lograron avances significativos en el camino hacia la construcción de un marco de evaluación para la APS en la Región de las Américas. Es necesario desarrollar indicadores e instrumentos de recolección de información adecuados y factibles de ser aplicados en distintos contextos.OBJECTIVES: To determine the relevancy of applying the Canadian primary health care (PHC assessment strategy to Latin America and to propose any modifications

  10. Gastroenterology training in Latin America

    Science.gov (United States)

    Cohen, Henry; Saenz, Roque; de Almeida Troncon, Luiz E; Lizarzabal, Maribel; Olano, Carolina

    2011-01-01

    Latin America is characterized by ethnic, geographical, cultural, and economic diversity; therefore, training in gastroenterology in the region must be considered in this context. The continent’s medical education is characterized by a lack of standards and the volume of research continues to be relatively small. There is a multiplicity of events in general gastroenterology and in sub-disciplines, both at regional and local levels, which ensure that many colleagues have access to information. Medical education programs must be based on a clinical vision and be considered in close contact with the patients. The programs should be properly supervised, appropriately defined, and evaluated on a regular basis. The disparity between the patients’ needs, the scarce resources available, and the pressures exerted by the health systems on doctors are frequent cited by those complaining of poor professionalism. Teaching development can play a critical role in ensuring the quality of teaching and learning in universities. Continuing professional development programs activities must be planned on the basis of the doctors’ needs, with clearly defined objectives and using proper learning methodologies designed for adults. They must be evaluated and accredited by a competent body, so that they may become the basis of a professional regulatory system. The specialty has made progress in the last decades, offering doctors various possibilities for professional development. The world gastroenterology organization has contributed to the speciality through three distinctive, but closely inter-related, programs: Training Centers, Train-the-Trainers, and Global Guidelines, in which Latin America is deeply involved. PMID:21633594

  11. Heart Failure Society of America

    Science.gov (United States)

    ... MACRA Resource Portal The Heart Failure Society of America, Inc. (HFSA) represents the first organized effort by heart failure experts from the Americas to provide a forum for all those interested ...

  12. Economic integration in the Americas

    OpenAIRE

    Uitdewilligen, G.

    1997-01-01

    This pioneering study shows that economic integration in the Americas is not simply a matter of removing trade barriers. Economic Integration in the Americas addresses the pervasive effects of economic integration on the economy as a whole.

  13. The health and economic impact of dengue in Latin America El impacto sanitario y económico del dengue en Latinoamérica

    Directory of Open Access Journals (Sweden)

    Jaime R. Torres

    2007-01-01

    Full Text Available In the last two decades, all countries in the tropical regions of Latin America have experienced marked increases in the incidence of both classic dengue and dengue hemorrhagic fever. Major risk factors for the occurrence of dengue in the region, as well as some regional peculiarities in its clinical expression, such as the extensive involvement of older age groups, have been defined. While little information exists on the economic impact of dengue in the region in terms of disease burden, the estimated loss associated with the disease is on the same order of magnitude as tuberculosis, sexually transmitted diseases (excluding HIV/AIDS, Chagas disease, leishmaniasis, or intestinal helminths. Therefore, similar priority should be given in the allocation of resources for dengue research and control. Data on cost-efficacy and cost-benefit analysis of dengue control programs in Latin America are scarce; however, the cost per DALY averted by control programs during endemic periods appears low, as compared to other mosquito-borne diseases like yellow fever, leishmaniasis, or malaria. Additionally, the cost-benefit ratio of the control programs has proven to be positive.En las últimas dos décadas, todos los países de las regiones tropicales de Latinoamérica han registrado un fuerte aumento en la incidencia de dengue clásica y dengue hemorrágica. Ya fueron identificados los principales factores de riesgo para la ocurrencia de dengue en la región, así como algunas peculiaridades regionales en su expresión clínica, como el comprometimiento frecuente de grupos de la tercera edad. Pese a la falta de información sobre el impacto económico del dengue en la región en términos de gastos por la enfermedad, las pérdidas estimadas asociadas con la misma son del mismo orden de magnitud que los de la tuberculosis, enfermedades sexualmente transmisibles (excluyendo VIH/SIDA, enfermedad de Chagas, leishmaniasis o parasitosis intestinales. Por tanto, la

  14. Climate change and health in the United States of America: impacts, adaptations, and research; Changement climatique et santeaux Etats-Unis: impacts, adaptations et recherche

    Energy Technology Data Exchange (ETDEWEB)

    Jouan, R.; Magaud, M

    2009-11-15

    After a description of the various impacts of climate change on human health, this report describes and comments the impacts of climate change on health in the USA: impacts of heat waves, of air quality degradation, of extreme climate events, of climate change on infectious diseases and allergies, regional impacts of climate change. In a second part, it describes the strategies of adaptation to the 'climate change and health' issue in the USA: mitigation and adaptation to climate change, adaptation challenges, insufficiently prepared public health system, adaptation to heat waves, adaptation to air quality degradation, adaptation to extreme climate events, adaptation to food- and water-based diseases and to vector-based diseases, examples of proactive adaptation. The last part describes the organisation of research on 'climate change and health' in the USA: nowadays and in the future, role of federal agencies, priority research axes. The 'United States Global Change Research Program' is presented in appendix, as well as the most important research centres (mostly in universities)

  15. Payers' experiences with confidential pharmaceutical price discounts: A survey of public and statutory health systems in North America, Europe, and Australasia.

    Science.gov (United States)

    Morgan, Steven G; Vogler, Sabine; Wagner, Anita K

    2017-04-01

    Institutional payers for pharmaceuticals worldwide appear to be increasingly negotiating confidential discounts off of the official list price of pharmaceuticals purchased in the community setting. We conducted an anonymous survey about experiences with and attitudes toward confidential discounts on patented pharmaceuticals in a sample of high-income countries. Confidential price discounts are now common among the ten health systems that participated in our study, though some had only recently begun to use these pricing arrangements on a routine basis. Several health systems had used a wide variety of discounting schemes in the past two years. The most frequent discount received by participating health systems was between 20% and 29% of official list prices; however, six participants reported their health system received one or more discount over the past two years that was valued at 60% or more of the list prices. On average, participants reported that confidential discounts were more common, complex, and significant for specialty pharmaceuticals than for primary care pharmaceuticals. Participants had a more favorable view of the impact of confidential discount schemes on their health systems than on the global marketplace. Overall, the frequency, complexity, and scale of confidential discounts being routinely negotiated suggest that the list prices for medicines bear limited resemblance to what many institutional payers actually pay. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  16. Development of a Faith-Based Mental Health Literacy Program to Improve Treatment Engagement Among Caribbean Latinos in the Northeastern United States of America.

    Science.gov (United States)

    Caplan, Susan; Cordero, Carolyn

    2015-01-01

    Depression is one of the leading causes of years lived with disability (YLDs) worldwide. Although depression can be successfully treated, 75% of Americans do not receive care. Treatment rates among Latinos immigrants are significantly lower than non-immigrant Latinos and non-Hispanic Whites. Known factors for mental health-care disparities such as poverty, insurance coverage, language barriers, and access to specialty mental health services in Latino neighborhoods do not fully explain the differences in treatment rates. Significant, but poorly understood factors influencing depression treatment among Latinos in the United States are lack of culturally congruent care, low mental health literacy, and stigma. Even though churches are a major source of health information, social and spiritual support for Latinos, the conceptualization of culturally congruent care rarely addresses religious beliefs. Therefore, one strategy to reduce disparities in depression treatment is to partner with churches to address faith-based stigma. Community-based participatory research is recognized as a methodology particularly well suited for creating successful culturally targeted interventions. The purpose of this article is to describe the process of creating a faith-based mental health literacy intervention in the Caribbean Latino community using the principles of community-based participatory research. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  17. Field Evaluations of Topical Arthropod Repellents in North, Central, and South America

    Science.gov (United States)

    2014-09-01

    De La Rocque et al. 2011) and their spread into higher elevations of Africa, Latin America , and Asia (Epstein 2001). Dengue fever and...denguehemorrhagic fever have resurgeddramatically in Latin America (Zell 2004). In North America ,West Nile virus has impacted signiÞcantly the health and welfare of...VECTOR CONTROL, PEST MANAGEMENT, RESISTANCE, REPELLENTS Field Evaluations of Topical Arthropod Repellents in North, Central , and South America KENDRA

  18. Healthy Municipios in Latin America.

    Science.gov (United States)

    Restrepo, H E; Llanos, G; Contreras, A; Rocabado, F; Gross, S; Suárez, J; González, J

    1995-09-01

    This article describes the Healthy Municipios movement in Latin America and gives examples of some PAHO projects that could become demonstration projects. The Healthy Municipios movement was established in the early 1990s. The movement aims to promote healthy municipalities according to objectives set forth in the 1987 Ottawa Charter on Health Promotion, the 1992 Declaration of Bogota, and the 1993 Caribbean Health Promotion Charter. The movement is a joint effort of government, the health sector, and the community in promoting health locally. Key features of the movement are its creativity, variety, political strength, and adaptation to local conditions. Technical cooperation serves the purpose of facilitating information exchange and promotes the use of modern techniques of analysis and scientific and technical information. All projects shared the following common features: initiation by the local community with strong political commitment, intersectoral organizational structure, widespread community mobilization and participation, problem solving activities, and a recognizable leader. Pioneering projects include the Comprehensive Project for Cienfuegos, Cuba; the Health Manizales, Colombia; the Network in Mexico; Baruta and El Hatillo, Venezuela; Valdivia, Chile; and San Carlos Canton, Costa Rica. It is concluded that these projects and most others aim to assure equity. These efforts are important for placing health on the political agenda and implementing healthy policies. The Valdivia project, for example, serves a population of about 120,000 in the urban city of Valdivia, the semi-urban area, and rural areas. The project was officially sanctioned by the President of Chile on World Health Day in 1993. Progress was reported in mass communication and school-based programs. Attention was directed also to prevention of risk factors for noncommunicable diseases and to the problem of traffic accidents.

  19. Antifungal pharmacodynamics: Latin America's perspective

    Directory of Open Access Journals (Sweden)

    Javier M. Gonzalez

    2017-01-01

    Full Text Available The current increment of invasive fungal infections and the availability of new broad-spectrum antifungal agents has increased the use of these agents by non-expert practitioners, without an impact on mortality. To improve efficacy while minimizing prescription errors and to reduce the high monetary cost to the health systems, the principles of pharmacokinetics (PK and pharmacodynamics (PD are necessary. A systematic review of the PD of antifungals agents was performed aiming at the practicing physician without expertise in this field. The initial section of this review focuses on the general concepts of antimicrobial PD. In vitro studies, fungal susceptibility and antifungal serum concentrations are related with different doses and dosing schedules, determining the PD indices and the magnitude required to obtain a specific outcome. Herein the PD of the most used antifungal drug classes in Latin America (polyenes, azoles, and echinocandins is discussed.

  20. Neurotrauma Research in Latin America

    Directory of Open Access Journals (Sweden)

    Andrés Rubiano

    2014-10-01

    It is time to think about how consortium studies related to neurotrauma in Latin America are needed, in order to integrate robust databases that reveal the true variability in the comprehensive care of these patients, including aspects of pre-hospital care, emergency care, surgical and intensive care management, without neglecting fundamental aspects like integral rehabilitation. It is time to develop a Latin American traumatic coma data bank. This initiative should be led by research groups from the region, trying to understand and integrate data analysis in a better fashion, trying to reduce the potential of bias as a result of misunderstanding the dynamic of health systems with limited resources, low capabilities for urgent inter-hospital referral and lack subspecialty training that is still in the process of development.

  1. Review of health research on indigenous populations in Latin America, 1995-2004 Revisión de la investigación en salud en poblaciones indígenas de Latinoamérica, 1995-2004

    Directory of Open Access Journals (Sweden)

    Miguel San Sebastián

    2007-08-01

    Full Text Available OBJECTIVE: To review health research conducted among indigenous populations in Latin America during the period 1995-2004. Material and methods. The search strategy was purposely broad to ensure the identification of all relevant studies indexed in the PubMed and Lilacs databases. RESULTS: Six-hundred ninety citations were included. One hundred fifty-nine (23.0% papers dealt with indigenous populations in Central America and 509 (73.8% papers with South American populations. Three hundred two (43.8% of the studies were quantitative, 39 (5.7% qualitative, 259 (37.5% mainly based on laboratory work and 24 (3.5% dealt with policy analyses. The most common researched theme was human biology with 200 (29.0 % papers, followed by communicable diseases (150 papers, 21.7 %. CONCLUSIONS: There is a special need for policy studies in the field of indigenous health. An increased commitment to resources and capacity building will be the real challenge for indigenous health research in the nearest future.OBJETIVO: Revisar la investigación en salud realizada en poblaciones indígenas de Latinoamérica, de 1995 a 2004. MATERIAL Y MÉTODOS: La estrategia de búsqueda fue amplia para asegurar la identificación de todos aquellos estudios relevantes catalogados en las bases de datos PubMed y Lilacs. RESULTADOS: Se incluyeron 690 citaciones; de ellas, 509 (73.8% artículos trataron sobre poblaciones indígenas sudamericanas y 159 (23.0% sobre poblaciones indígenas de Centroamérica. Trescientos dos (43.8% de los estudios fueron cuantitativos, 39 (5.7% cualitativos, 259 (37.5% basados principalmente en trabajo de laboratorio y 24 (3.5% trataron sobre análisis de políticas de salud. El tema de investigación más estudiado fue el de biología humana con 200 artículos (29.0%, seguido de enfermedades transmisibles (150 artículos, 21.7%. CONCLUSIONES: Existe una necesidad especial de estudios de políticas de salud en el campo de la salud indígena. Un mayor

  2. Global transport of Fukushima-derived radionuclides from Japan to Asia, North America and Europe. Estimated doses and expected health effects

    Science.gov (United States)

    Evangeliou, Nikolaos; Stohl, Andreas; Balkanski, Yves

    2017-04-01

    The earthquake and the subsequent tsunami that occurred offshore of Japan resulted in a serious accident at the nuclear facility of Fukushima. A large number of fission products were released and transported worldwide. We estimate that around 23% of the released 137Cs remained into Japan, while 76% deposited in the oceans. Around 163 TBq deposited over North America, among which 95 TBq over USA, 40 TBq over Canada and 5 TBq over Greenland). About 14 TBq deposited over Europe (mostly in the European part of Russia, Sweden and Norway) and 47 TBq over Asia (mostly in the Asian part of Russia, Philippines and South Korea), while traces were observed over Africa, Oceania and Antarctica. Since the radioactive plume followed a northward direction before its arrival to USA and then to Europe, a significant amount of about 69 TBq deposited in the Arctic, as well. An attempt to assess exposure of the population and the environment showed that the effective dose from gamma irradiation during the first 3 months was estimated between 1-5 mSv in Fukushima and the neighbouring prefectures. In the rest of Japan, the respective doses were found to be less than 0.5 mSv, whereas in the rest of the world it was less than 0.1 mSv. Such doses are equivalent with the obtained dose from a simple X-ray; for the highly contaminated regions, they are close to the dose limit for exposure due to radon inhalation (10 mSv). The calculated dose rates from radiocesium exposure on reference organisms ranged from 0.03 to 0.18 μGy h-1, which are 2 orders of magnitude below the screening dose limit (10 μGy h-1) that could result in obvious effects on the population. However, monitoring data have shown that much higher dose rates were committed to organisms raising ecological risk for small mammals and reptiles in terms of cytogenetic damage and reproduction.

  3. Evaluaciones económicas de tecnologías sanitarias: una perspectiva global para su aplicación en América Latina Economic evaluations of health technologies: a global perspective for their implementation in Latin America

    Directory of Open Access Journals (Sweden)

    Manuel Espinoza

    2011-09-01

    Full Text Available Fenómenos como el aumento progresivo del gasto en salud y el envejecimiento poblacional han obligado a los distintos países a considerar metodologías económicas que permitan obtener un mayor beneficio sanitario dentro de un contexto de recursos limitados. El presente artículo describe los componentes básicos a considerar en una evaluación de tecnología sanitaria, analiza el proceso de toma de decisión en un análisis de costo efectividad y reporta como dicha metodología ha sido implementada en América Latina y en el resto de mundo.Phenomena as the progressive increase of health expenditure and the population aging have lead many countries to consider economic methodologies in order to obtain bigger sanitary benefits in contexts of limited resources. This article describes the basic components to consider in a health technology assessment , it analyses the process of decision making with cost-effectiveness analysis and reports how this methodology has been widely implemented in Latin America and the rest of the world.

  4. Commerce in health services in North America within the context of the North American Free Trade Agreement El comercio de servicios de salud en América del Norte en el contexto del Tratado de Libre Comercio

    Directory of Open Access Journals (Sweden)

    Octavio Gómez-Dantés

    1997-06-01

    Full Text Available This article discusses the future of commercial trade in personal health services in North America within the context of the North American Free Trade Agreement (NAFTA and the latter's potential influence on health care for the Mexican people. It begins by defining concepts related to international trade of services, particularly health services, and then proceeds to analyze elements of NAFTA that affect the delivery, regulation, and financing of such services, as well as their future trade within the NAFTA area. It concludes with some recommendations directed at helping Mexico's national health care system confront the risks posed while taking advantage of the opportunities offered by the Mexican economy's entry into a broader market.El presente artículo discute el futuro del intercambio comercial de servicios personales de salud en América del Norte en el contexto del Tratado de Libre Comercio (TLC y la posible influencia de este último sobre la atención de salud de la población mexicana. En la primera parte se definen conceptos relacionados con el intercambio internacional de servicios en general y de servicios de salud en particular y se analizan los componentes del TLC que afectan a la prestación, regulación y financiamiento de estos servicios, así como a su futuro intercambio en la zona del TLC. Al final del artículo se hacen recomendaciones dirigidas a ayudar al sistema nacional de salud de México a enfrentar los riesgos y aprovechar las oportunidades que brinda la incorporación de la economía mexicana a un mercado más amplio.

  5. Latin America Report.

    Science.gov (United States)

    1986-11-17

    yesterday, the reserved market throughout the country for in- formatics has also been extended to computer software programs. The DIARIO OFICIAL ...Pemex Northern States Price Cuts 97 PARAGUAY Journalists Union Denounces Arrest of Members (EL DIARIO , 25 Oct 86) .....; .. 98 Police...topple the elected government in Man- • agua — including US$200 000 to the anti-San- dinista "Friends of the Democratic Centre in Central America". I

  6. Microtensile Bond Strength of Embrace Wetbond Hydrophilic Sealant in Different Moisture Contamination: An In-Vitro Study.

    Science.gov (United States)

    Panigrahi, Antarmayee; Srilatha, K T; Panigrahi, Rajat G; Mohanty, Susant; Bhuyan, Sanat K; Bardhan, Debojyoti

    2015-07-01

    Contamination of etched enamel with saliva has been shown to result in sealant failure. Recently, a hydrophilic sealant has been introduced. In absence of documented literature, this in vitro study was undertaken to ascertain the efficacy of Embrace Wet Bond without reduction of microtensile bond strength in the different moisture contamination. A 5mm block of sealant were built over prepared occlusal surface of 40 non-carious therapeutically extracted third molars which were sectioned into 1mm thick stick and tested using Zwick micro tensile tester. Obtained data were subjected to descriptive analysis, one-way ANOVA and Scheffe's post-hoc tests. Mean microtensile bond strength of Embrace sealant was not significantly lowered in different moisture contamination groups except Group 3 (air drying), which showed very highly significant (p<0.001) decrease in μTBS as compared to Group 1 (non-contaminated). Mean μTBS of Embrace sealant remains largely unchanged even in presence of moisture. Owing to its hydrophilic property, this sealant can be a great help in cases where maintaining isolation is difficult.

  7. Quality assurance in MR image guided adaptive brachytherapy for cervical cancer: Final results of the EMBRACE study dummy run.

    Science.gov (United States)

    Kirisits, Christian; Federico, Mario; Nkiwane, Karen; Fidarova, Elena; Jürgenliemk-Schulz, Ina; de Leeuw, Astrid; Lindegaard, Jacob; Pötter, Richard; Tanderup, Kari

    2015-12-01

    Upfront quality assurance (QA) is considered essential when starting a multicenter clinical trial in radiotherapy. Despite the long experience gained for external beam radiotherapy (EBRT) trials, there are only limited audit QA methods for brachytherapy (BT) and none include the specific aspects of image guided adaptive brachytherapy (IGABT). EMBRACE is a prospective multicenter trial aiming to assess the impact of (MRI)-based IGABT in locally advanced cervical cancer. An EMBRACE dummy run was designed to identify sources and magnitude of uncertainties and errors considered important for the evaluation of clinical, and dosimetric parameters and their relation to outcome. Contouring, treatment planning and dose reporting was evaluated and scored with a categorical scale of 1-10. Active feedback to centers was provided to improve protocol compliance and reporting. A second dummy run was required in case of major deviations (score 30 cases) had better performance as compared to centers with limited experience. The comprehensive dummy run designed for the EMBRACE trial has been a feasible tool for QA in IGABT of cervix cancer. It should be considered for future IGABT trials and could serve as the basis for continuous quality checks for brachytherapy centers. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Los trastornos mentales en América Latina y el Caribe: asunto prioritario para la salud pública Mental disorders in Latin America and the Caribbean: a public health priority

    Directory of Open Access Journals (Sweden)

    Robert Kohn

    2005-11-01

    los trastornos mentales en América Latina y el Caribe sigue siendo abrumadora. Además, las tasas actuales probablemente subestiman el número de personas sin atención. La transición epidemiológica y los cambios en la composición poblacional acentuarán aun más la brecha en la atención en América Latina y el Caribe, a no ser que se formulen nuevas políticas de salud mental o que se actualicen las existentes, procurando incluir en ellas la extensión de los programas y servicios.OBJECTIVE: The growing burden of mental disorders in Latin America and the Caribbean has become too large to ignore. There is a need to know more about the prevalence of mental disorders and the gap between the number of individuals with psychiatric disorders and the number of those persons who remain untreated even though effective treatments exist. Having that knowledge would make it possible to improve advocacy, adopt better policies, formulate innovative intervention programs, and apportion resources commensurate with needs. METHODS: Data were extracted from community-based psychiatric epidemiological studies published in Latin America and the Caribbean from 1980 through 2004 that used structured diagnostic instruments and provided prevalence rates. Estimates of the crude rates in Latin America and the Caribbean for the various disorders were determined by calculating the mean and median rates across the studies, by gender. In addition, data on service utilization were reviewed in order to calculate the treatment gap for specific disorders. RESULTS: Nonaffective psychosis (including schizophrenia had an estimated mean one-year prevalence rate of 1.0%; major depression, 4.9%; and alcohol use abuse or dependence, 5.7%. Over one-third of individuals with nonaffective psychosis, over half of those with an anxiety disorder, and some three-fourths of those with alcohol use abuse or dependence did not receive mental health care from either specialized or general health services

  9. A comparative analysis of chiropractic and general practitioner patients in North America: Findings from the joint Canada/United States survey of health, 2002–03

    Directory of Open Access Journals (Sweden)

    Chiang Lu-May

    2006-04-01

    Full Text Available Abstract Background Scientifically rigorous general population-based studies comparing chiropractic with primary-care medical patients within and between countries have not been published. The objective of this study is to compare care seekers of doctors of chiropractic (DCs and general practitioners (GPs in the United States and Canada on a comprehensive set of sociodemographic, quality of life, and health-related variables. Methods Data are from the Joint Canada/U.S. Survey of Health (JCUSH, 2002–03, a random sample of adults in Canada (N = 3505 and the U.S. (N = 5183. Respondents were categorized according to their pattern of health-care use in the past year. Distributions, percentages, and estimates (adjusted odds ratios weighted to reflect the complex survey design were produced. Results Nearly 80% of respondents sought care from GPs; 12% sought DC care. Compared with GP only patients, DC patients in both countries tend to be under 65 and white, with arthritis and disabling back or neck pain. U.S. DC patients are more likely than GP only patients to be obese and to lack a regular doctor; Canadian DC patients are more likely than GP only patients to be college educated, to have higher incomes, and dissatisfied with MD care. Compared with seekers of both GP and DC care, DC only patients in both countries have fewer chronic conditions, take fewer drugs, and have no regular doctor. U.S. DC only patients are more likely than GP+DC patients to be uninsured and dissatisfied with health care; Canadian DC only patients are more likely than GP+DC patients to be under 45, male, less educated, smokers, and not obese, without disabling back or neck pain, on fewer drugs, and lacking a regular doctor. Conclusion Chiropractic and GP patients are dissimilar in both Canada and the U.S., with key differences between countries and between DC patients who do and do not seek care from GPs. Such variation has broad and potentially far-reaching health policy and

  10. Building America Industrialized Housing Partnership (BAIHP)

    Energy Technology Data Exchange (ETDEWEB)

    McIlvaine, Janet; Chandra, Subrato; Barkaszi, Stephen; Beal, David; Chasar, David; Colon, Carlos; Fonorow, Ken; Gordon, Andrew; Hoak, David; Hutchinson, Stephanie; Lubliner, Mike; Martin, Eric; McCluney, Ross; McGinley, Mark; McSorley, Mike; Moyer, Neil; Mullens, Mike; Parker, Danny; Sherwin, John; Vieira, Rob; Wichers, Susan

    2006-06-30

    This final report summarizes the work conducted by the Building America Industrialized Housing Partnership (www.baihp.org) for the period 9/1/99-6/30/06. BAIHP is led by the Florida Solar Energy Center of the University of Central Florida and focuses on factory built housing. In partnership with over 50 factory and site builders, work was performed in two main areas--research and technical assistance. In the research area--through site visits in over 75 problem homes, we discovered the prime causes of moisture problems in some manufactured homes and our industry partners adopted our solutions to nearly eliminate this vexing problem. Through testing conducted in over two dozen housing factories of six factory builders we documented the value of leak free duct design and construction which was embraced by our industry partners and implemented in all the thousands of homes they built. Through laboratory test facilities and measurements in real homes we documented the merits of 'cool roof' technologies and developed an innovative night sky radiative cooling concept currently being tested. We patented an energy efficient condenser fan design, documented energy efficient home retrofit strategies after hurricane damage, developed improved specifications for federal procurement for future temporary housing, compared the Building America benchmark to HERS Index and IECC 2006, developed a toolkit for improving the accuracy and speed of benchmark calculations, monitored the field performance of over a dozen prototype homes and initiated research on the effectiveness of occupancy feedback in reducing household energy use. In the technical assistance area we provided systems engineering analysis, conducted training, testing and commissioning that have resulted in over 128,000 factory built and over 5,000 site built homes which are saving their owners over $17,000,000 annually in energy bills. These include homes built by Palm Harbor Homes, Fleetwood, Southern Energy

  11. The Journey toward Voluntary Public Health Accreditation Readiness in Local Health Departments: Leadership and Followership Theories in Action.

    Science.gov (United States)

    Carman, Angela L

    2015-01-01

    Local health department directors' intent on getting their organizations ready for accreditation must embrace the blurring of leader/follower lines and create an accreditation readiness team fueled not by traditional leader or follower roles but by teamship.

  12. The Journey toward Voluntary Public Health Accreditation Readiness in Local Health Departments: Leadership and Followership Theories in Action

    OpenAIRE

    Carman, Angela L.

    2015-01-01

    Local health department directors’ intent on getting their organizations ready for accreditation must embrace the blurring of leader/follower lines and create an accreditation readiness team fueled not by traditional leader or follower roles but by teamship.

  13. Autoinforme de salud general en adultos mayores de América Latina y el Caribe: su utilidad como indicador Self-reported general health in older adults in Latin America and the Caribbean: usefulness of the indicator

    Directory of Open Access Journals (Sweden)

    Rebeca Wong

    2005-06-01

    , Santiago y México, D.F. (entre 30 y 40%. La evaluación de la propia memoria fue el factor más fuertemente asociado con el resultado del ASG, seguido de la satisfacción con el estado nutricional y con la vida. CONCLUSIONES: El ASG captó múltiples facetas de la salud de los adultos mayores, como el padecimiento de enfermedades crónicas, su grado de satisfacción con el nivel de nutrición y con la vida, su percepción del estado de la propia memoria y los problemas de funcionalidad que sufrían. Se deben emprender estudios más detallados que permitan establecer el papel que desempeña la salud emocional en la demanda de atención sanitaria de los adultos mayores en América Latina y el Caribe y determinar si existe alguna asociación entre el ASG y el uso de los servicios de salud.OBJECTIVES: To evaluate self-reported general health (SRGH as a health indicator and to analyze its covariates in people 60 years old or older living in private homes in seven cities of Latin America and the Caribbean. METHODS: This cross-sectional descriptive study was based on data from the Health, Well-Being, and Aging survey (Salud, Bienestar y Envejecimiento, or "SABE survey", which was carried out in 1999 and 2000 in Bridgetown, Barbados; Buenos Aires, Argentina; Havana, Cuba; Mexico City, Mexico; Montevideo, Uruguay; Santiago, Chile; and São Paulo, Brazil. The survey looked at the demographic and socioeconomic characteristics of the participants, several health indicators (self-reported chronic diseases, depression, and cognitive features, the social and family support network, the use of health services, reported and observed functionality, the respondent's income, and the durable consumer goods in the household. In probit regression models, self-reported fair or poor health was used as the dependent variable. The marginal effect of each categorical explanatory variable was used to indicate the difference between the probability of reporting poor health by persons who did or did

  14. Managing America`s solid waste

    Energy Technology Data Exchange (ETDEWEB)

    1998-03-02

    This report presents an historical overview of the federal role in municipal solid waste management from 1965 to approximately 1995. Attention is focuses on the federal role in safeguarding public health, protecting the environment, and wisely using material and energy resources. It is hoped that this report will provide important background for future municipal solid waste research and development initiatives.

  15. North America: Chapter 5

    Science.gov (United States)

    Schwartz, Mark D.; Beaubien, Elisabeth G.; Crimmins, Theresa M.; Weltzin, Jake F.; Edited by Schwartz, Mark D.

    2013-01-01

    Plant phenological observations and networks in North America have been largely local and regional in extent until recent decades. In the USA, cloned plant monitoring networks were the exception to this pattern, with data collection spanning the late 1950s until approximately the early 1990s. Animal observation networks, especially for birds have been more extensive. The USA National Phenology Network (USA-NPN), established in the mid-2000s is a recent effort to operate a comprehensive national-scale network in the United States. In Canada, PlantWatch, as part of Nature Watch, is the current national-scale plant phenology program.

  16. Timekeeping in the Americas

    Science.gov (United States)

    López, J. M.; Lombardi, M. A.

    2015-10-01

    Time and its measurement belong to the most fundamental core of physics, and many scientific and technological advances are directly or indirectly related to time measurements. Timekeeping is essential to everyday life, and thus is the most measured physical quantity in modern societies. Time can also be measured with less uncertainty and more resolution than any other physical quantity. The measurement of time is of the utmost importance for many applications, including: global navigation satellite systems, communications networks, electric power generation, astronomy, electronic commerce, and national defense and security. This paper discusses how time is kept, coordinated, and disseminated in the Americas.

  17. Knight Capital Americas LLC

    DEFF Research Database (Denmark)

    Austin, Robert D.; Meister, Darren

    2015-01-01

    It took 19 years to build Knight Capital Americas LLC into the largest market maker on the New York Stock Exchange, but on August 1, 2012, it took only 45 minutes for the firm to be wiped out by an information technology (IT) problem: a change in the company's software caused it to lose more than...... $450 million dollars in less than an hour. Although it was ultimately saved from bankruptcy when it was acquired two days later, the terms of acquisition were very unfavourable to the company's shareholders. How did this happen? Could it have been prevented? What should the staff, the chief executive...

  18. TIMEKEEPING IN THE AMERICAS.

    Science.gov (United States)

    López, J M; Lombardi, M A

    Time and its measurement belong to the most fundamental core of physics, and many scientific and technological advances are directly or indirectly related to time measurements. Timekeeping is essential to everyday life, and thus is the most measured physical quantity in modern societies. Time can also be measured with less uncertainty and more resolution than any other physical quantity. The measurement of time is of the utmost importance for many applications, including: global navigation satellite systems, communications networks, electric power generation, astronomy, electronic commerce, and national defense and security. This paper discusses how time is kept, coordinated, and disseminated in the Americas.

  19. North America pipeline map

    International Nuclear Information System (INIS)

    Anon.

    2005-01-01

    This map presents details of pipelines currently in place throughout North America. Fifty-nine natural gas pipelines are presented, as well as 16 oil pipelines. The map also identifies six proposed natural gas pipelines. Major cities, roads and highways are included as well as state and provincial boundaries. The National Petroleum Reserve is identified, as well as the Arctic National Wildlife Refuge. The following companies placed advertisements on the map with details of the services they provide relating to pipeline management and construction: Ferus Gas Industries Trust; Proline; SulfaTreat Direct Oxidation; and TransGas. 1 map

  20. Has the implementation of the TRIPS Agreement in Latin America and the Caribbean produced intellectual property legislation that favours public health?

    Science.gov (United States)

    Oliveira, Maria Auxiliadora; Bermudez, Jorge Antonio Zepeda; Chaves, Gabriela Costa; Velásquez, Germán

    2004-11-01

    The World Trade Organization's Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement establishes minimum standards for intellectual property rights, including patent protection for pharmaceuticals; therefore, it may make it difficult for developing countries to gain access to medicines, especially those countries that are the least developed. This study aims to determine whether implementation of the TRIPS Agreement in Latin American and Caribbean countries has generated patent legislation that is sensitive to public health needs. Legislation in 11 Latin American and Caribbean countries was analysed. The variables considered in the analysis were: the term of patents issued, patentable subject matter, transition periods (that is, time until legislation was enacted), reversal of the burden of proof of patent infringement, exhaustion of rights, compulsory licensing and the early working exception (which allows a country to complete all procedures necessary to register a generic product before the original patent expires). By 2000, all of the countries studied had reformed their legislation to conform to the agreement. Brazil and Argentina used the transition period until 2005 to grant patents in the pharmaceutical industry. All countries, except Panama, made use of the safeguards and flexibilities available through the agreement by including mechanisms for compulsory licensing in their legislation. Argentina; Bolivia, Colombia, Ecuador, Peru and Venezuela (countries that represented the Andean community); the Dominican Republic; and Panama included mechanisms to allow parallel importation. Mexico did not. Brazil only permits parallel importation after a compulsory licence has been issued. The early working exception is included in legislation in Brazil and the Dominican Republic. The countries in this study did not incorporate all of the mechanisms allowed for by the Agreement and are not adequately using the provisions that enable World Trade

  1. Has the implementation of the TRIPS Agreement in Latin America and the Caribbean produced intellectual property legislation that favours public health?

    Science.gov (United States)

    Oliveira, Maria Auxiliadora; Bermudez, Jorge Antonio Zepeda; Chaves, Gabriela Costa; Velásquez, Germán

    2004-01-01

    OBJECTIVE: The World Trade Organization's Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement establishes minimum standards for intellectual property rights, including patent protection for pharmaceuticals; therefore, it may make it difficult for developing countries to gain access to medicines, especially those countries that are the least developed. This study aims to determine whether implementation of the TRIPS Agreement in Latin American and Caribbean countries has generated patent legislation that is sensitive to public health needs. METHODS: Legislation in 11 Latin American and Caribbean countries was analysed. The variables considered in the analysis were: the term of patents issued, patentable subject matter, transition periods (that is, time until legislation was enacted), reversal of the burden of proof of patent infringement, exhaustion of rights, compulsory licensing and the early working exception (which allows a country to complete all procedures necessary to register a generic product before the original patent expires). FINDINGS: By 2000, all of the countries studied had reformed their legislation to conform to the agreement. Brazil and Argentina used the transition period until 2005 to grant patents in the pharmaceutical industry. All countries, except Panama, made use of the safeguards and flexibilities available through the agreement by including mechanisms for compulsory licensing in their legislation. Argentina; Bolivia, Colombia, Ecuador, Peru and Venezuela (countries that represented the Andean community); the Dominican Republic; and Panama included mechanisms to allow parallel importation. Mexico did not. Brazil only permits parallel importation after a compulsory licence has been issued. The early working exception is included in legislation in Brazil and the Dominican Republic. CONCLUSION: The countries in this study did not incorporate all of the mechanisms allowed for by the Agreement and are not adequately using the

  2. Prevalence and Social Determinants of Smoking in 15 Countries from North Africa, Central and Western Asia, Latin America and Caribbean: Secondary Data Analyses of Demographic and Health Surveys.

    Science.gov (United States)

    Sreeramareddy, Chandrashekhar T; Pradhan, Pranil Man Singh

    2015-01-01

    Article 20 of the World Health Organisation Framework Convention on Tobacco Control calls for a cross-country surveillance of tobacco use through population-based surveys. We aimed to provide country-level prevalence estimates for current smoking and current smokeless tobacco use and to assess social determinants of smoking. Data from Demographic and Health Surveys done between 2005 and 2012, among men and women from nine North African, Central and West Asian countries and six Latin American and Caribbean countries were analyzed. Weighted country-level prevalence rates were estimated for 'current smoking' and 'current use of smokeless tobacco (SLT) products' among men and women. In each country, social determinants of smoking among men and women were assessed by binary logistic regression analyses by including men's and women's sampling weights to account for the complex survey design. Prevalence of smoking among men was higher than 40% in Armenia (63.1%), Moldova (51.1%), Ukraine (52%), Azerbaijan (49.8 %), Kyrgyz Republic (44.3 %) and Albania (42.52%) but the prevalence of smoking among women was less than 10% in most countries except Ukraine (14.81%) and Jordan (17.96%). The prevalence of smokeless tobacco use among men and women was less than 5% in all countries except among men in the Kyrgyz Republic (10.6 %). Smoking was associated with older age, lower education and poverty among men and higher education and higher wealth among women. Smoking among both men and women was associated with unskilled work, living in urban areas and being single. Smoking among men was very high in Central and West Asian countries. Social pattern of smoking among women that was different from men in education and wealth should be considered while formulating tobacco control policies in some Central and West Asian countries.

  3. Prevalence and Social Determinants of Smoking in 15 Countries from North Africa, Central and Western Asia, Latin America and Caribbean: Secondary Data Analyses of Demographic and Health Surveys.

    Directory of Open Access Journals (Sweden)

    Chandrashekhar T Sreeramareddy

    Full Text Available Article 20 of the World Health Organisation Framework Convention on Tobacco Control calls for a cross-country surveillance of tobacco use through population-based surveys. We aimed to provide country-level prevalence estimates for current smoking and current smokeless tobacco use and to assess social determinants of smoking.Data from Demographic and Health Surveys done between 2005 and 2012, among men and women from nine North African, Central and West Asian countries and six Latin American and Caribbean countries were analyzed. Weighted country-level prevalence rates were estimated for 'current smoking' and 'current use of smokeless tobacco (SLT products' among men and women. In each country, social determinants of smoking among men and women were assessed by binary logistic regression analyses by including men's and women's sampling weights to account for the complex survey design.Prevalence of smoking among men was higher than 40% in Armenia (63.1%, Moldova (51.1%, Ukraine (52%, Azerbaijan (49.8 %, Kyrgyz Republic (44.3 % and Albania (42.52% but the prevalence of smoking among women was less than 10% in most countries except Ukraine (14.81% and Jordan (17.96%. The prevalence of smokeless tobacco use among men and women was less than 5% in all countries except among men in the Kyrgyz Republic (10.6 %. Smoking was associated with older age, lower education and poverty among men and higher education and higher wealth among women. Smoking among both men and women was associated with unskilled work, living in urban areas and being single.Smoking among men was very high in Central and West Asian countries. Social pattern of smoking among women that was different from men in education and wealth should be considered while formulating tobacco control policies in some Central and West Asian countries.

  4. Descentralización del sector salud en América Latina Descentralization of the health sector in Latin America

    Directory of Open Access Journals (Sweden)

    A. Ugalde

    2002-02-01

    Full Text Available Este trabajo analiza la experiencia latinoamericana con la descentralización de servicios de salud. Los autores examinan el significado de la descentralización: geográfica, institucional y de funciones. Se identifican los objetivos que según los promotores de la descentralización la justifican y se documenta que, en general, no se han conseguido. Una revisión de la bibliografía y los estudios llevados a cabo por los autores sugieren que con frecuencia la descentralización ha producido resultados opuestos a los buscados, es decir, ha incrementado la inequidad, ha disminuido la eficiencia y calidad de los servicios, y ha aumentado los costes. Se señala que la información existente no permite determinar con seguridad si el fracaso de la descentralización se debe a la selección de políticas inadecuadas o a fallos en el proceso de implementación. Se reconoce que la descentralización es un proceso político complejo que no se puede diseñar ni imponer desde fuera y que antes de tomar la decisión de descentralizar es necesario identificar cuál de las muchas modalidades de descentralización se quiere implementar, estimar los costes, anticipar los problemas que se pueden presentar en su proceso de implementación y buscar soluciones a los mismos. Los autores concluyen sugiriendo que los bancos multilaterales han errado al forzar a los países a descentralizar de una manera improvisada sin tener en cuenta los diferentes contextos históricos, políticos y socioeconómicos.This paper analyzes the Latin American experience of decentralizing health services within the context of health reform. We examine the meaning of the term decentralization and discuss the various modalities of this concept: geographical, institutional and functional. The objectives that, in general, these objectives have not been achieved. After reviewing the literature and drawing on our own fieldwork, we conclude that in many instances the Latin American

  5. Determinants of physical activity in America: a first characterization of physical activity profile using the National Health and Nutrition Examination Survey (NHANES).

    Science.gov (United States)

    Kao, Ming-Chih Jeffrey; Jarosz, Renata; Goldin, Michael; Patel, Amy; Smuck, Matthew

    2014-10-01

    To develop and implement methodologies for characterizing accelerometry-derived patterns of physical activity (PA) in the United States in relation to demographics, anthropometrics, behaviors, and comorbidities using the National Health and Nutrition Examination Survey (NHANES) dataset. Retrospective analysis of nationally representative database. Computer-generated modeling in silico. A total of 6329 adults in the United States from the NHANES 2003-2004 database. To discover subtle multivariate signal in the dynamic and noisy accelerometry data, we developed a novel approach, termed discretized multiple adaptive regression and implemented the algorithm in SAS 9.2 (SAS Institute, Cary, NC). Demographic, anthropometric, comorbidity, and behavioral variables. The intensity of PA decreased with both increased age and increased body mass index. Both greater education and greater income correlate with increased activity over short durations and reduced activity intensity over long durations. Numerous predictors demonstrated effects within activity ranges that may be masked by use of the standard activity intensity intervals. These include age, one of the most robust variables, where we discovered decreasing activities inside the moderate activity range. It also includes gender, where women compared with men have increased proportions of active times up to the center of light activity range, and income greater than $45,000, where a complex effect is seen with little correspondence to existing cut-points. The results presented in this study suggest that the method of multiple regression and heat map visualization can generate insights otherwise hidden in large datasets such as NHANES. A review of the provided heat maps reveals the trends discussed previously involving demographic, anthropometric, comorbidity, and behavioral variables. It also demonstrates the power of accelerometry to expose alterations in PA. Ultimately, this study provides a US population-based norm to

  6. Capital social y salud en América Latina y el Caribe: una revisión sistemática Social capital and health in Latin America and the Caribbean: a systematic review

    Directory of Open Access Journals (Sweden)

    Cristóbal E. Kripper

    2009-02-01

    Full Text Available OBJETIVO: Identificar la información validada disponible sobre la relación entre el capital so cial (CS y la salud en América Latina y el Caribe (ALC. MÉTODOS: Se realizó una búsqueda sistemática de los trabajos publicados entre enero de 1990 y junio de 2007 en las bases de datos Medline, SciELO, LILACS y The Cochrane Library. Se analizaron todos los artículos de investigación y revisión publicados en revistas científicas, que evaluaran el CS y su relación con la salud en ALC. RESULTADOS: Se encontraron 15 artículos (11 de investigación original y 4 de revisión. Las áreas de salud exploradas por las investigaciones originales fueron: a mortalidad y esperanza de vida, b salud mental, c traumas, d estado nutricional y e vacunación. Se analiza detalla damente la validez de estos trabajos, sus resultados y principales conclusiones. CONCLUSIONES: A pesar de las limitaciones propias del concepto de CS y de los estudios iden tificados, se puede afirmar que existe evidencia científica incipiente de la posible relación entre el CS y la salud en ALC. El CS podría desempeñar un papel protector en ciertas áreas sanita rias, como la prevención de traumas y la salud mental; no obstante, la relación entre el CS y la salud podría variar según los subtipos de CS y los contextos socioeconómicos y culturales es pecíficos. Resulta fundamental continuar desarrollando investigaciones en el ámbito de la epi demiología social, en las que se analice en profundidad la relación entre los determinantes so ciales y los aspectos específicos de la salud en el contexto de ALC.OBJECTIVE: To identify validated information available on the relationship between social capital (SC and health in Latin America and the Caribbean (LAC. METHODS: A systematic search for papers published from January 1990-June 2007 was conducted on the Medline, SciELO, LILACS, and the Cochrane Library databases. All of the research and review articles published by

  7. Building America FY 2016 Annual Report: Building America Is Driving Real Solutions in the Race to Zero Energy Homes

    Energy Technology Data Exchange (ETDEWEB)

    Sara Farrar, Stacey Rothgeb, Ben Polly, Lieko Earle, and Tim Merrigan

    2016-12-01

    The U.S. Department of Energy (DOE) Building America Program enables the transformation of the U.S. housing industry to achieve energy savings through energy-efficient, high-performance homes with improved durability, comfort, and health for occupants. Building America bridges the gap between the development of emerging technologies and the adoption of codes and standards by engaging industry partners in applied research, development, and demonstration of high-performance solutions.

  8. Anaglyph, South America

    Science.gov (United States)

    2003-01-01

    This anaglyph (stereoscopic view) of South America was generated with data from the Shuttle Radar Topography Mission (SRTM). It is best viewed at or near full resolution with anaglyph glasses. For this broad view the resolution of the data was first reduced to 30 arcseconds (about 928 meters north-south but variable east-west), matching the best previously existing global digital topographic data set called GTOPO30. The data were then resampled to a Mercator projection with approximately square pixels (about one kilometer, or 0.6 miles, on each side). Even at this decreased resolution the variety of landforms comprising the South American continent is readily apparent.Topographic relief in South America is dominated by the Andes Mountains, which extend all along the Pacific Coast. These mountains are created primarily by the convergence of the Nazca and South American tectonic plates. The Nazca Plate, which underlies the eastern Pacific Ocean, slides under western South America resulting in crustal thickening, uplift, and volcanism. Another zone of plate convergence occurs along the northwestern coast of South America where the Caribbean Plate also slides under the South American Plate and forms the northeastern extension of the Andes Mountains.East of the Andes, much of northern South America drains into the Amazon River, the world's largest river in terms of both watershed area and flow volume. Topographic relief is very low in much of the Amazon Basin but SRTM data provide an excellent detailed look at the basin's three-dimensional drainage pattern, including the geologic structural trough (syncline) that hosts the eastern river channel.North of the Amazon, the Guiana Highlands commonly stand in sharp contrast to the surrounding lowlands, indeed hosting the world's tallest waterfall, Angel Falls (979 meters or 3212 feet). Folded and fractured bedrock structures are distinctive in the topographic pattern.South of the Amazon, the Brazilian Highlands show a mix of

  9. "How can you live without your kids?": Distancing from and embracing the stigma of “incarcerated mother"

    Directory of Open Access Journals (Sweden)

    Brittnie Aiello

    2016-05-01

    Full Text Available This article examines how incarcerated mothers constructed moral identities in the face of stigma. Analyzing data from participant observation and 83 in-depth interviews with incarcerated mothers, we show that mothers claimed moral identities by distancing from the stigma of incarceration and/or embracing the identity of incarcerated mothers. Utilizing these strategies, women challenged the stigma of convicted felon/bad mother and reinforced the assumptions that motherhood is compulsory and should be reserved for women with enough money and standing to give their children advantages. The implications for understanding motherhood as a mechanism of moral identity and social control are discussed.

  10. Fermilab and Latin America

    International Nuclear Information System (INIS)

    Lederman, Leon M.

    2006-01-01

    As Director of Fermilab, starting in 1979, I began a series of meetings with scientists in Latin America. The motivation was to stir collaboration in the field of high energy particle physics, the central focus of Fermilab. In the next 13 years, these Pan American Symposia stirred much discussion of the use of modern physics, created several groups to do collaborative research at Fermilab, and often centralized facilities and, today, still provides the possibility for much more productive North-South collaboration in research and education. In 1992, I handed these activities over to the AAAS, as President. This would, I hoped, broaden areas of collaboration. Such collaboration is unfortunately very sensitive to political events. In a rational world, it would be the rewards, cultural and economic, of collaboration that would modulate political relations. We are not there yet

  11. Water privatization and public health in Latin America La privatización del abastecimiento de agua y la salud pública en América Latina

    Directory of Open Access Journals (Sweden)

    John P. Mulreany

    2006-01-01

    Full Text Available OBJECTIVES: This study had two objectives: (1 to determine what the public health and development literature has found regarding the public health outcomes of water privatization in Latin America and (2 to evaluate whether the benefits of water privatization, if any, outweigh the equity and justice concerns that privatization raises. METHODS: Using a standard set of terms to search several databases, the authors identified and reviewed articles and other materials from public health and development sources that were published between 1995 and 2005 and that evaluated the public health effects of water privatizations in Latin America from 1989 to 2000, based on (1 access to water by the poor and/or (2 improvements in public health. Next, the authors examined the experiences of three cities in Bolivia (Cochabamba, El Alto, and La Paz in order to illuminate further the challenges of water privatization. Finally, the authors considered the equity and justice issues raised by the privatization of water. RESULTS: The literature review raised persistent concerns regarding access to water by the poor under privatization. The review also suggested that the public sector could deliver public health outcomes comparable to those of the private sector, as measured by access rates and decreasing child mortality rates. In terms of social equity and justice, privatization marked a troubling shift away from the conception of water as a "social good" and toward the conception of water-and water management services-as commodities. CONCLUSIONS: Our results indicated there is no compelling case for privatizing existing public water utilities based on public health grounds. From the perspective of equity and justice, water privatization may encourage a minimalist conception of social responsibility for public health that may hinder the development of public health capacities in the long run.OBJETIVOS: Este estudio tuvo dos objetivos: 1 determinar lo que dicen las

  12. Dynamics of Race, Culture and Key Indicators of Health In the Nations 100 Largest Cities and Their Suburbs. The Social and Health Landscape of Urban and Suburban America Report Series.

    Science.gov (United States)

    Andrulis, Dennis P.; Duchon, Lisa M.; Reidj, Hailey M.

    This report profiles the 2000 status of and changes (since 1990) in rates of health and health-related measures for racially and culturally diverse populations living in the 100 largest U.S. cities and their suburbs. Data came from the U.S. Census Bureau and Centers for Disease Control and Prevention to identify patterns in race/ethnicity, foreign…

  13. La atención gerenciada en América Latina. Transnacionalización del sector salud en el contexto de la reforma Managed care in Latin America: transnationalization of the health sector in a context of reform

    Directory of Open Access Journals (Sweden)

    Celia Iriart

    2000-01-01

    Full Text Available Este artículo presenta resultados de la investigación comparativa "Atención Gerenciada en América Latina: Su Papel en la Reforma de los Sistemas de Salud", realizada por equipos de Argentina, Brasil, Chile, Ecuador y Estados Unidos. El objetivo del estudio fue analizar el proceso de exportación de la atención gerenciada, especialmente desde Estado Unidos, y su incorporación en los países latinoamericanos. Los métodos utilizados incluyeron técnicas cualitativas y cuantitativas. La adopción de la atención gerenciada muestra el proceso de transnacionalización del sector salud. Nuestros hallazgos demuestran el ingreso de los principales capitales financieros multinacionales en el sector privado de seguros y de prestadores de salud, y su intencionalidad de participar en la administración de las instituciones estatales y de los fondos de la seguridad social médica. Concluimos que este proceso de cambio sustancial, que implica la paulatina adopción de la atención gerenciada, es facilitado por las transformaciones operadas a nivel ideológico.This article presents the results of the comparative research project "Managed Care in Latin America: Its Role in Health Reform". The project was conducted by teams in Argentina, Brazil, Chile, Ecuador, and the United States. The study's objective was to analyze the process by which managed care is exported, especially from the United States, and how managed care is adopted in Latin American countries. Our research methods included qualitative and quantitative techniques. Adoption of managed care reflects transnationalization of the health sector. Our findings demonstrate the entrance of large multinational financial capital into the private insurance and health services sectors and their intention of participating in the administration of government institutions and medical/social security funds. We conclude that this basic change involving the slow adoption of managed care is facilitated by

  14. Population aging, health and urban environment in Latin America. Challenges of gerontological Urbanism / Envejecimiento de la población, salud y ambiente urbano en América Latina. Retos del Urbanismo gerontológico

    Directory of Open Access Journals (Sweden)

    Sarai Merari Salas-Cardenas

    2014-09-01

    Full Text Available El estudio reflexiona sobre los desafíos del envejecimiento de la población en las zonas urbanas de América Latina, destacando la importancia de la planificación gerontológica del entorno físico y social en la salud y calidad de vida de las personas mayores. La metodología consistió en una revisión de la literatura científica, principalmente revistas indexadas a Scopus y Thomson-Reuters. Los resultados indican que en la región el crecimiento urbano agrava las condiciones ambientales y los problemas de salud de la población de edad avanzada, una situación que se ve afectada por el contexto de vulnerabilidad social (pobreza, problemas de acceso a los servicios de salud. También, algunas de las claves se discuten en la comprensión de los desafíos de la planificación gerontológica de las ciudades de América Latina, y la participación activa de las personas mayores en el diseño de entornos construidos dinámicos y estimulantes, en especial, hogares y espacios públicos. Además, en la región el avance del envejecimiento de la población urbana va a generar una fuerte demanda de los gerontólogos ambientales, especialmente arquitectos, urbanistas y profesionales de la salud ambiental, con formación gerontológica en la sensibilidad de diseños favorables para envejecer en el lugar. The study reflects on the challenges of aging populations in urban Latin America, highlighting the importance of the gerontological planning of physical and social environment on the health and quality of life of older people. The methodology consisted of a review of the scientific literature, mainly journals indexed to Scopus and Thomson-Reuters index. The results indicate that, in the region the urban growth exacerbates environmental conditions and health problems of the elderly population, a situation that is exacerbated by the context of social vulnerability (poverty, problems of access to health services.

  15. [Prenatal care in Latin America].

    Science.gov (United States)

    Buekens, P; Hernández, P; Infante, C

    1990-01-01

    Available data on the coverage of prenatal care in Latin America were reviewed. In recent years, only Bolivia had a coverage of prenatal care of less than 50 per cent. More than 90 per cent of pregnant women received prenatal care in Chile, Cuba, the Dominican Republic, and Puerto Rico. Prenatal care increased between the 1970 and 1980 in the Dominican Republic, Ecuador, Guatemala, Honduras, Mexico, and Peru. The coverage of prenatal care decreased in Bolivia and Colombia. The mean number of visits increased in Cuba and Puerto Rico. The increase of prenatal care in Guatemala and Honduras is due to increased care by traditional birth attendants, compared to the role of health care institutions. We compared the more recent data on tetanus immunization of pregnant women to the more recent data on prenatal care. The rates of tetanus immunization are always lower than the rates of prenatal care attendance, except in Costa Rica. The rates of tetanus immunization was less than half as compared to the rates of prenatal care in Bolivia, Guatemala, and Peru. To improve the content of prenatal care should be an objective complementary to the increase of the number of attending women.

  16. Sustainable cities in Latin America

    International Nuclear Information System (INIS)

    Rodriguez Tejerina, Miguel

    2015-11-01

    In the present day, Latin America is the most urbanised region - and also the most inequitable - on the planet, which means that its urban areas amass both huge wealth and huge poverty. Within this context, dealing with climate change is also a chance to increase citizens' well-being. Better public transport and more efficient energy and waste management are, besides being effective measures to reduce emissions, ultimately actions with a strong social component and work towards improving transportation and public health care and generate savings for citizens. Equally, actions geared towards boosting urban resilience represent measures that go beyond adaptation responses to climate change and primarily benefit those that are most vulnerable in the population. In the context of the future new global climate agreement, cities are taking a more prominent role in this new urban era, and gained in importance in the Sustainable Development Goals, LAC has a lot to give in the lessons learned from urbanisation. Rapidly urbanising regions like Asia and Africa, where population growth will be concentrated in cities in the present and near future, could learn a lot from the urbanisation process that has occurred, and continues to occur, in LAC. From the transport industry to energy and water, successful cases are numerous and varied, as are the setbacks, from which valuable lessons can be drawn for the purposes of more effectively facing up to this new global urban reality

  17. Embracing a competency-based specialty curriculum for community-based nursing roles.

    Science.gov (United States)

    Levin, Pamela F; Swider, Susan M; Breakwell, Susan; Cowell, Julia M; Reising, Virginia

    2013-01-01

    The Quad Council competencies for public health nursing (PHN) provide guidance in developing curricula at both the generalist and specialist level. However, these competencies are based on nursing roles in traditional public health agencies and community/public health is defined more broadly than official agency practice. The question arises as to whether community-based specialties require largely the same knowledge and skill set as PHN. The purpose of the competency cross-mapping project reported here was to (a) assess the intersection of the Quad Council competencies with four community-based specialties and (b) ensure the appropriateness of a Quad Council-based curriculum to prepare graduates across these four specialties (home health, occupational health, environmental health, and school nursing). This article details the multistep cross-mapping process, including validation with practice leaders. Results indicate strong alignment of community-based specialty competencies with Quad Council competencies. Community-based specialty-specific content that did not align well is identified, along with examples of didactic and clinical strategies to address gaps. This work indicates that a Quad Council-based curriculum is appropriate to prepare graduates in community-based specialties when attention to the specialty-specific competencies in the clinical setting is included. This work guides the development of a doctorate of nursing practice curriculum in PHN, encompassing the four additional community-based specialties. © 2013 Wiley Periodicals, Inc.

  18. Association between dietary protein intake and grip strength among adults aged 51 years and over: What We Eat in America, National Health and Nutrition Examination Survey 2011-2014.

    Science.gov (United States)

    Mishra, Suruchi; Goldman, Joseph D; Sahyoun, Nadine R; Moshfegh, Alanna J

    2018-01-01

    Distributing daily protein intake evenly across meals (∼25-30g/meal) has been suggested to improve muscle mass. The aim of this research is to examine the association between grip strength, total protein intake and its distribution across day's meals in older adults. Nationally representative dietary intake data of adults aged 51 years and older (n = 4,123) who participated in What We Eat in America, NHANES 2011-2014 were analyzed. Protein intake per day and per eating occasion (breakfast, lunch, dinner, and snack) were determined. Combined grip strength was calculated and expressed in kilograms. Grip strength of individuals consuming ≥25g protein at 1 eating occasion was compared with those consuming same level of protein at 2 and 3 or more eating occasions. Grip strength of individuals in quartile 1 of daily protein intake was compared to those in the other quartiles. All associations were examined without and with adjustment for age, race/ethnicity, physical activity, health status, and smoking status. The comparison involving eating occasions and protein intake quartiles were further adjusted for daily protein intake and energy intake, respectively. Only 33% of men and 19% of women had protein intake of ≥25g at 2 or more eating occasions. These individuals also had higher grip strength and daily protein intake. Grip strength was positively associated with consumption of ≥25g protein at 2 eating occasions as compared to consumption of same level of protein at 1 eating occasion (peating occasions was not associated with grip strength. However, higher daily protein intake was positively associated with grip strength in women.

  19. Rogue America: Benevolent Hegemon or Occupying Tyrant?

    National Research Council Canada - National Science Library

    Samuels, Richard P

    2008-01-01

    .... Based on this working definition, America?s foreign policy history does not support characterization as a rogue state, though its dominant military and some imperialist history are exploited in rogue-America rhetoric...

  20. A luta pelo banimento do amianto nas Américas: uma questão de saúde pública The struggle to ban asbestos in the Americas: an issue of public health

    Directory of Open Access Journals (Sweden)

    Hermano Castro

    2003-01-01

    Full Text Available Este artigo tem como objetivo resgatar a luta pelo banimento do amianto ou asbesto nas Américas. Destacando-se a importância do amianto como um problema de Saúde Pública, pelo seu potencial carcinogênico reconhecido para os seres humanos, perpassando pela constituição de redes como contrapoderes em prol do banimento dessa fibra nociva, ressaltando a participação social nessa luta. O problema do amianto nas discussões das políticas públicas de saúde, trabalho e meio ambiente ainda permanece pouco claro no campo da Saúde do Trabalhador. Ao restringir a apenas um único campo de atuação, reduz-se a atuação das vigilâncias, como se estivesse apenas limitado ao ambiente de trabalho. É necessária então a discussão nos campos da Saúde Ambiental e da Saúde Publica. A ausência de políticas públicas contribui para a invisibilidade dos problemas relacionados ao amianto no Brasil. Hoje, as vítimas do amianto não têm suas doenças reconhecidas, e seus direitos são negados em várias instâncias do poder público. Conclui-se que a luta pelo fim da utilização dessa fibra e a redução das doenças provocadas pela mesma configuram-se um movimento político comprometido com a transformação social na busca por uma sociedade mais justa, igualitária e saudável.This article has the aim of rescuing the fight for the banishment of asbestos in Americas. The authors emphasize the importance of the asbestos as a problem of Public Health, due to its carcinogenic potential to human health, passing through the constitution of nets of counterpower on behalf of the banishment of the fiber, pointing out the importance of social participation in this fight. The asbestos public policy of health, work and environment is pointed out as a central problem. There are some misconceptions in the field of Worker's Health on facing the risks and damages caused by asbestos/amiantos and it is very important not to restrict the surveillance only to

  1. Treatment of methicillin-resistant Staphylococcus aureus in Latin America

    Directory of Open Access Journals (Sweden)

    Carlos M Luna

    Full Text Available The global spread of methicillin-resistant Staphylococcus aureus (MRSA means it is now a pathogen of worldwide public health concern. Within Latin America, MRSA is highly prevalent, with the proportion of S. aureus isolates that are methicillin-resistant on the rise, yet resources for managing the infection are limited. While several guidelines exist for the treatment of MRSA infections, many are written for the North American or European setting and need adaptation for use in Latin America. In this article, we aim to emphasize the importance of appropriate treatment of MRSA in the healthcare and community settings of Latin America. We present a summary of the available guidelines and antibiotics, and discuss particular considerations for clinicians treating MRSA in Latin America

  2. Technical assistance in Latin America

    International Nuclear Information System (INIS)

    Oteiza-Quirno, A.

    1976-01-01

    As in the other regions, nuclear technology development in Latin America reflects mainly the degree of technological development already existing in each country. It is quite significant that in nearly all countries in Latin America the medical profession has been the first to show interest in using nuclear techniques. As a result, a country such as Uruguay has become a source of recruitment for technical assistance experts in nuclear medicine to other developing countries, while at the same time it continues to receive assistance for new sophisticated techniques from the IAEA. Part of this assistance, in turn, comes from the neighbouring countries, Argentina and Brazil. For example, an expert from Uruguay is currently assigned under an Agency programme to Costa Rica, El Salvador and Guatemala, and experts from Argentina and Brazil have been sent to Uruguay. This is an example of 'horizontal' development, meaning mutual assistance between developing countries under programmes supported by the United Nations Agencies, which is now being emphasized by the United Nations Development Programme (UNDP). Still in the field of nuclear medicine, another significant model is provided by Bolivia. With assistance from the IAEA, and thanks to the availability of a good professional infrastructure in that country, a net of nuclear medicine services has been started, consisting of a well-developed nuclear medicine centre in La Paz and regional centres in Cochabamba, Sucre and Santa Cruz. Because of its great variations in altitude, Bolivia is in the position of being able to conduct research on the adaptation of man to diverse environmental conditions. The Agency has contributed, and continues to do so, to these programmes by sending experts, providing for training abroad of Bolivian doctors under its fellowship programmes, and providing basic equipment for all four centres. Independently of the cases described above, the IAEA has implemented or is implementing a considerable

  3. Access to health care in America

    National Research Council Canada - National Science Library

    Millman, Michael L

    1993-01-01

    ... Millman, Ph.D., Editor NATIONAL ACADEMY PRESS Washington, D.C. 1993 Copyrightoriginal retained, the be not from cannot book, paper original however, for version formatting, authoritative the typesetting-specific created from the as publication files other XML and from this of recomposed styles, version heading print the breaks, use been...

  4. Global Health Observatory (GHO)

    Science.gov (United States)

    ... global health estimates Health Equity Monitor 3.1 Maternal mortality Maternal health 3.2 Newborn and child mortality Child ... Programmes) Quick links Contact us Frequently asked questions Employment Feedback Privacy Email scams Regions Africa Americas South- ...

  5. User embracement in practices care in psychosocial care centers the perspective of local managers

    Directory of Open Access Journals (Sweden)

    Andreza Kelly Cardoso da Silva Soares

    2017-03-01

    Full Text Available Introduction: Psychosocial care centres (CAPS, strategic IN articulation of psychosocial care network and health system gateway, propose to the reorganization of health practices, by adopting a new ethic of care, based on respect to the singularity of the subjects and in the reception to the health needs of the users. Reception is a device for transforming practices and humanizing health care.  Objective: To analyse the operation of the host users of CAPS from the perspective of local coordinators in Fortaleza, Ceará, Brazil.  Method: Qualitative research with case study design, performed with CAPS coordinators of the city of Fortaleza, Ceará, Brazil. Data were collected through semi-structured interviews and observation, being submitted to the analysis of thematic content.  Results: The host constituted innovative device in mental health practices, as triggered the construction of new ways of dealing with the subject in psychological distress, by incorporating technologies such as qualified listening, building autonomy, with attention focused on the user. Provided a reorientation of work and service processes, requesting the articulation for network care. In addition, it was configured as a strategy for humanization in the CAPS. Was presented, however, operational difficulties related to the environment and to the effectiveness of the network of attention.  Final considerations: The host device configured for reorienting health practices, enhancing the consolidation of psychosocial care model, with humanization and increased solvability. However, challenges remain to be overcome, related to the environment and to the effectiveness of the network of care.

  6. Políticas públicas vigentes de salud mental en Suramérica: un estado del arte / Current public policies on mental health in South America: a state of the art

    Directory of Open Access Journals (Sweden)

    Silvia Henao

    2016-05-01

    Full Text Available Resumen Objetivo: presentar un Estado del Arte sobre el contenido de las políticas públicas de salud mental vigentes en Suramérica, con el propósito de establecer un panorama de los alcances y limitaciones de la normatividad sobre el tema en la región. Metodología: Estudio documental de enfoque hermenéutico mediante el cual se interpretó y explicó las relaciones entre los contenidos de las políticas públicas de salud mental y el contexto de los países suramericanos. Para el análisis se incluyeron documentos normativos de los países, tales como Acuerdos, Resoluciones y Leyes. Igualmente, se utilizaron publicaciones académicas en el periodo comprendido entre 2003 a 2013, que posibilitaron la descripción y el análisis del tema de investigación. Resultados: países como Colombia, Argentina, Paraguay, Brasil, Perú, Ecuador y Uruguay cuentan con disposiciones normativas vigentes (acuerdos, resoluciones y leyes que sustentan el contenido de las políticas públicas en materia de salud mental. Por otra parte, Chile, Bolivia y Venezuela fundamentan sus políticas en mecanismos administrativos (programas, planes y proyectos sin apelar a la norma de obligatorio cumplimiento. Conclusión: la noción de salud mental que subyace a cada Política Nacional hace énfasis en la promoción de la salud y la prevención de la enfermedad, desde una concepción positiva del bienestar que resalta el papel activo de los sujetos y poblaciones, las capacidades y libertades disponibles; sin embargo, los recursos, estrategias, acciones y metas están orientados sobre la base de un modelo biomédico que prioriza el diagnóstico y el tratamiento de trastornos mentales. / Abstract Objective: to present the state of the art regarding the content of the public mental health policies currently in force in South America in order to establish an overview of the scope and limitations of the regulations on the subject in the region. Methodology: a documentary study

  7. Wind Powering America

    Energy Technology Data Exchange (ETDEWEB)

    Flowers, L. (NREL); Dougherty, P. J. (DOE)

    2001-07-07

    At the June 1999 Windpower Conference, the Secretary of Energy launched the Office of Energy Efficiency and Renewable Energy's Wind Powering America (WPA) initiative. The goals of the initiative are to meet 5% of the nation's energy needs with wind energy by 2020 (i.e., 80,000 megawatts installed), to double the number of states that have more than 20 megawatts (MW) of wind capacity to 16 by 2005 and triple it to 24 by 2010, and to increase wind's contribution to Federal electricity use to 5% by 2010. To achieve the Federal government's goal, DOE would take the leadership position and work with its Federal partners. Subsequently, the Secretary accelerated the DOE 5% commitment to 2005. Achieving the 80,000 MW goal would result in approximately $60 billion investment and $1.5 billion of economic development in our rural areas (where the wind resources are the greatest). The purpose of this paper is to provide an update on DOE's strategy for achieving its goals and the activities it has undertaken since the initiative was announced.

  8. Mexico and Central America.

    Science.gov (United States)

    Bronfman, M

    1998-01-01

    This article reviews the literature on migration and HIV/AIDS in Mexico and Central America, including Belize, Costa Rica, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, and Panama. Most migrants travel to the US through Mexico. US-Mexico trade agreements created opportunities for increased risk of HIV transmission. The research literature focuses on Mexico. Most countries, with the exception of Belize and Costa Rica, are sending countries. Human rights of migrants are violated in transit and at destination. Migration policies determine migration processes. The Mexican-born population in the US is about 3% of US population and 8% of Mexico's population. About 22% arrived during 1992-97, and about 500,000 are naturalized US citizens. An additional 11 million have a Mexican ethnic background. Mexican migrants are usually economically active men who had jobs before leaving and were urban people who settled in California, Texas, Illinois, and Arizona. Most Mexican migrants enter illegally. Many return to Mexico. The main paths of HIV transmission are homosexual, heterosexual, and IV-drug-injecting persons. Latino migrants frequently use prostitutes, adopt new sexual practices including anal penetration among men, greater diversity of sexual partners, and use of injectable drugs.

  9. Geoparks in Latin America

    International Nuclear Information System (INIS)

    Mantesso-Neto, V.; Mansur, K.; López, R.; Schilling, M.; Ramos, V.

    2010-01-01

    A Geopark is a territory delimited part of a holistic concept of protection, education and sustainable development, based on geological sites of particular importance, rarity or aesthetic geological sites. A Geopark achieves its goals through three main areas: geoconservation, education and geotourism. The first network of Geoparks born in Europe in 2000, and from 2004 UNESCO is promoting the creation of a Global Geoparks Network (Global Geoparks Network, GGN ). Currently, there are 64 Global Geoparks in 19 countries, and the movement is in full development. In Latin America there is hardly Araripe Geopark in Brazil. Presented in this work, projects and studies related to the development of Geoparks in Argentina, Brazil, Chile, Costa Rica, Peru and Venezuela. We understand that Colombia, Cuba, Ecuador, Mexico and Nicaragua have projects in this line, but the details are not yet readily available. The authors invite geoscientists and professionals in related fields to join a movement for the creation of the Latin American Network of Geoparks, intended as a framework for the conservation, sustainable use and disclosure of our national geological heritage

  10. Wind Powering America

    International Nuclear Information System (INIS)

    Flowers, L.; Dougherty, P. J.

    2001-01-01

    At the June 1999 Windpower Conference, the Secretary of Energy launched the Office of Energy Efficiency and Renewable Energy's Wind Powering America (WPA) initiative. The goals of the initiative are to meet 5% of the nation's energy needs with wind energy by 2020 (i.e., 80,000 megawatts installed), to double the number of states that have more than 20 megawatts (MW) of wind capacity to 16 by 2005 and triple it to 24 by 2010, and to increase wind's contribution to Federal electricity use to 5% by 2010. To achieve the Federal government's goal, DOE would take the leadership position and work with its Federal partners. Subsequently, the Secretary accelerated the DOE 5% commitment to 2005. Achieving the 80,000 MW goal would result in approximately$60 billion investment and$1.5 billion of economic development in our rural areas (where the wind resources are the greatest). The purpose of this paper is to provide an update on DOE's strategy for achieving its goals and the activities it has undertaken since the initiative was announced

  11. Nuclear options in Latin America

    International Nuclear Information System (INIS)

    1983-11-01

    An account is given of the Treaty of Tlatelolco, 1967, providing for the designation of Latin America as a Nuclear Weapon-Free Zone (NWFZ); additional protocols attached to the Treaty are available for signature by States outside the region. The Treaty is administered by the Organisation for the Prohibition of Nuclear Weapons in Latin America (OPANAL). Reference is made to its latest meeting, held in May 1983. The present paper also discusses the following: Non-Proliferation Treaty (with references to safeguards agreements concluded between each State and the IAEA); nuclear suppliers' group; peaceful nuclear explosions; nuclear energy programmes in Latin America. (U.K.)

  12. Promoting Individual Health Using Information Technology: Trends in the US Health System

    Science.gov (United States)

    Nimkar, Swateja

    2016-01-01

    Objectives: Advances in electronics, the Internet and telecommunication have pushed the field of health care to embrace information technology (IT). However, the purposeful use of technology is relatively new to the field of health promotion. The primary objective of this paper is to review various applications of health IT, with a focus on its…

  13. Cobertura efectiva de las intervenciones en salud de América Latina y el Caribe: métrica para evaluar los sistemas de salud Effective coverage of health interventions in Latin America and the Caribbean: metrics for the assessment of health systems performance

    Directory of Open Access Journals (Sweden)

    Sandra Martínez

    2011-01-01

    Full Text Available OBJETIVO: Medir la cobertura efectiva para once intervenciones de salud en nueve países de América Latina utilizando las encuestas de demografía y salud o registros administrativos que abarcan la salud infantil, de la mujer y el adulto. MATERIAL Y MÉTODOS: Se seleccionaron las intervenciones y se armonizaron definiciones y métodos de cálculo de acuerdo con la información disponible para lograr la comparabilidad entre países. RESULTADOS: Chile es el país con mejores indicadores de coberturas crudas y efectivas, seguido por México y Colombia, y existen brechas importantes entre regiones, departamentos o estados. CONCLUSIONES: La métrica de cobertura efectiva es un indicador sensible que relaciona la necesidad de las intervenciones en salud, su utilización y calidad, lo que permite valorar los programas de salud al aportar datos precisos de dónde y a quién deben dirigirse los recursos y esfuerzos nacionales para que los países alcancen los propósitos y metas planteados.OBJECTIVE: To measure effective coverage for ll health interventions in Latin America including the children's, women's and adult health, as part of program evaluation. MATERIAL AND METHODS: Interventions were selected; the definitions and calculation methods were harmonized according to the information available to ensure comparability between countries. RESULTS: Chile has better indicators of crude and effective coverage followed by Mexico and Colombia.There are significant gaps between regions, counties or states. CONCLUSIONS: The health metric on effective coverage is a sensitive indicator that links three important aspects: Coverage of health interventions, use of health services, and access to such services. Effective coverage is a good tool to evaluate health programs performance, and also provides data of where and to whom the system should address national efforts and resources to achieve the purposes and goals set.

  14. Hacia un modelo de comunicación en salud pública en América Latina y el Caribe Toward a model of communications in public health in Latin America and the Caribbean

    Directory of Open Access Journals (Sweden)

    César A. Macías-Chapula

    2005-12-01

    área de salud pública, caracterizado principalmente por los elementos señalados a continuación. Treinta y siete países participaron con 97 605 documentos en el período de 1980-2002. La mayor parte de los registros aportados por esas ocho naciones correspondió a artículos publicados en revistas científicas (67,73% y a monografías (29,46%. La proporción de trabajos firmados por dos o más autores fue relativamente alta, de 56,48% entre los registros analizados. La producción correspondiente a artículos científicos (56 253 se distribuyó entre 929 diferentes títulos de revistas. Las revistas con mayor producción, en orden descendente, fueron: Revista de Saúde Pública; Cadernos de Saúde Pública, Revista Médica de Chile, Archivos Latinoamericanos de Nutrición y Salud Pública de México. La clasificación temática de las revistas participantes se distribuyó en 29 diferentes especialidades, principalmente de las áreas de medicina general y pediatría. La producción consiste principalmente en estudios en seres humanos en general y, en orden descendente, de sexos femenino y masculino y de edad adulta; en menor proporción, en embarazadas y personas de edad mediana o ancianos. En el ámbito regional, el contenido de la producción coincide en aspectos como factores de riesgo, políticas de salud y atención primaria de la salud. Se identifica una preponderancia de ciertas áreas temáticas entre los países participantes, como el de los médicos de familia en Cuba. CONCLUSIONES: Se obtuvo un modelo preliminar de comunicación en salud pública en América Latina y el Caribe que se espera ayude a sentar las bases para una mayor investigación orientada hacia el desarrollo de un modelo de comunicación científica en el área.OBJECTIVE: So far, there have been no bibliometric or scientometric studies that make it possible to examine, with quantitative, retrospective, and comprehensive criteria, the scientific output on public health in Latin America

  15. Patterns of demographic change in the Americas.

    Science.gov (United States)

    Ubelaker, D H

    1992-06-01

    Considerable scholarly debate has focused on the nature of demographic change in the Americas before and after 1492. Recent research on human skeletal samples and related archeological materials suggests that morbidity and mortality were increasing throughout much of the Western Hemisphere before 1492 in response to increased population density, increased sedentism, and changing subsistence. The evidence suggests that after 1492 population reduction was caused not by continental pandemics but by localized or regional epidemics augmented by social and economic disruption. The twentieth century has witnessed remarkable Native American population recovery, fueled both by improvements in health care and changing definitions of "being Indian."

  16. ScaleUp America Communities

    Data.gov (United States)

    Small Business Administration — SBA’s new ScaleUp America Initiative is designed to help small firms with high potential “scale up” and grow their businesses so that they will provide more jobs and...

  17. Federal Support for Preserve America

    Science.gov (United States)

    Mississippi's Heritage Tourism Industry Post Hurricane Katrina also received a $150,000 Preserve America Grant Arkansas Delta, one for music, one for African-American history, and one for agriculture. The project will

  18. Environmental Governance in Latin America

    NARCIS (Netherlands)

    de Castro, F.; Hogenboom, B.; Baud, M.

    2016-01-01

    The multiple purposes of nature - livelihood for communities, revenues for states, commodities for companies, and biodiversity for conservationists - have turned environmental governance in Latin America into a highly contested arena. In such a recourse-rich region, unequal power relations,

  19. African Ethnobotany in the Americas

    Directory of Open Access Journals (Sweden)

    Egleé L. Zent

    2013-10-01

    Full Text Available Review of African Ethnobotany in the Americas. Edited by Robert Voeks and John Rashford. 2013. Springer. Pp. 429, 105 illustrations, 69 color illustrations. $49.95 (paperback. ISBN 978‐1461408352.

  20. Counseling African-American women with the Sistas Embracing Empowerment (SEE) model

    OpenAIRE

    Stepney, Chantal

    2008-01-01

    Research from the last two decades indicates that African-American women have faced extreme mental health challenges in overcoming experiences of isolation, depression and somatization. Unfortunately, the sources of these stressors are largely attributed to racial and gender discrimination and societal expectations and norms associated with African-American women. Additionally, minimal research has been conducted to determine the most effective counseling approaches to aid this population. A ...

  1. Should Latin America Fear China?

    OpenAIRE

    Eduardo Lora

    2005-01-01

    This paper compares growth conditions in China and Latin America to assess fears that China will displace Latin America in the coming decades. China`s strengths include the size of the economy, macroeconomic stability, abundant low-cost labor, the rapid expansion of physical infrastructure, and the ability to innovate. China`s weaknesses, stemming from insufficient separation between market and state, include poor corporate governance, a fragile financial system and misallocation of savings. ...

  2. Health Effects of Environmental Pollution.

    Science.gov (United States)

    Environmental Protection Agency, Washington, DC.

    This booklet notes that for a long time the American people were willing to pay any price for progress. Now may refuse to accept an environment that menaces their health and lowers their enjoyment of life. They are embracing a new environmental consciousness, a broader vision of reality, a more profound sense of their place in nature. Among the…

  3. Urban violence and public health in Latin America: a sociological explanatory framework Violencia urbana y salud pública en Latinoamérica: un marco sociológico explicativo

    Directory of Open Access Journals (Sweden)

    Roberto Briceño-León

    2005-12-01

    Full Text Available Interpersonal violence has become one of the main public health issues in Latin American cities. This article presents a framework for sociological interpretation that operates on three levels, expressed in the factors that originate, foment, or facilitate violence. Macro-social factors include: social inequality due to the increase in wealth versus poverty; the paradox of more schooling with fewer employment opportunities; increasing expectations and the impossibility of meeting them; changes in family structure; and loss of importance of religion in daily life. At the meso-social level the analysis highlights: increased density in poor areas and urban segregation; masculinity cult; and changes in the local drug market. The micro-social level includes: an increase in the number of firearms; alcohol consumption; and difficulties in verbal expression of feelings. The article concludes with an analysis of how violence is leading to the breakdown not only of urban life but also of citizenship as a whole in Latin America.La violencia interpersonal se ha convertido en uno de los principales problemas de salud pública de las ciudades de América Latina. El artículo presenta una interpretación sociológica de la violencia en tres niveles: (a macro-sociales ­ la desigualdad social debida al incremento de la riqueza y la pobreza; la paradoja del mayor nivel educativo de las personas, pero las menores oportunidades de empleo, el incremento de las expectativas y de la imposibilidad de satisfacerlas; los cambios en la familia y la pérdida de importancia de la religión en la vida cotidiana de las personas; (b meso-sociales ­ el incremento de la densidad en las zonas pobres y la segregación urbana, la cultura de la masculinidad y los cambios en el mercado local de la droga; (c micro-sociales ­ el incremento de las armas de fuego, el consumo de alcohol y las dificultades de expresión verbal de los sentimientos por las personas. El artículo concluye

  4. Association between dietary protein intake and grip strength among adults aged 51 years and over: What We Eat in America, National Health and Nutrition Examination Survey 2011-2014.

    Directory of Open Access Journals (Sweden)

    Suruchi Mishra

    Full Text Available Distributing daily protein intake evenly across meals (∼25-30g/meal has been suggested to improve muscle mass. The aim of this research is to examine the association between grip strength, total protein intake and its distribution across day's meals in older adults.Nationally representative dietary intake data of adults aged 51 years and older (n = 4,123 who participated in What We Eat in America, NHANES 2011-2014 were analyzed. Protein intake per day and per eating occasion (breakfast, lunch, dinner, and snack were determined. Combined grip strength was calculated and expressed in kilograms. Grip strength of individuals consuming ≥25g protein at 1 eating occasion was compared with those consuming same level of protein at 2 and 3 or more eating occasions. Grip strength of individuals in quartile 1 of daily protein intake was compared to those in the other quartiles. All associations were examined without and with adjustment for age, race/ethnicity, physical activity, health status, and smoking status. The comparison involving eating occasions and protein intake quartiles were further adjusted for daily protein intake and energy intake, respectively.Only 33% of men and 19% of women had protein intake of ≥25g at 2 or more eating occasions. These individuals also had higher grip strength and daily protein intake. Grip strength was positively associated with consumption of ≥25g protein at 2 eating occasions as compared to consumption of same level of protein at 1 eating occasion (p<0.05 in unadjusted model, but not when adjusted. Grip strength was positively associated with daily protein intake among women in quartiles 3 and 4 (p<0.05 of protein intake in both unadjusted and adjusted models compared to lowest protein intake. Among men, grip strength was associated with daily protein intake in quartiles 3 and 4 (p<0.05 in the unadjusted model, but not when adjusted.In a nationally representative sample of older adults, consuming ≥25g

  5. Spondylitis Association of America

    Science.gov (United States)

    ... unknown. MS (400,000) Rheumatoid Arthritis (1.3million) Autism (1.5million) Spondyloarthritis (2.7million) 75% 54% 1 in 4 patients have seen five or more health professionals in search of a diagnosis The typical age of onset is between 17 ...

  6. Embracing life-the Bethlehem Schools' Project, an "icebreaker" and "a foot in the door".

    Science.gov (United States)

    Hocking, Mary

    2018-01-01

    This workshop details a Partnership involving a High school, a Hospital (Calvary Health Care Bethlehem), La Trobe University and Palliative Care Victoria which seeks to support Community Capacity and resilience in dealing with Life-Limiting illness, death, dying and Loss. This alliance has produced an educational resource which may be used, not only as a tool to normalize death, but also as a means of exploring 'keys to well-being' at any stage of life, through any loss or challenge. This workshop features a template which has been trialled, adapted and evaluated in High School, workshop and Hospital induction settings within Australia. Responses thus far have been "overwhelmingly positive". Translating evidence of positive outcomes into Education & Health Care Systems, is a challenge-this workshop offers a means of approaching both. The conclusion of the workshop provides a number of insights: (I) engaging communities in discussions about well-being and harnessing the insights of youth is a palatable means of discussing well-being at end-of-life; (II) what we know, as a community about supporting people with life-limiting illness is applicable across the span of life-not just at the end; (III) just as it takes a village to raise a child-it takes a village to ensure a quality end-of life experience. What began as a one-off hospital immersion for Secondary School students has grown to become a sustainable educational resource, applicable across a number of domains-with the capacity to become an evidence-based means of increasing community EOL capacity. This workshop details the evolution of a community partnership, which produced an evaluated, sustainable, educational resource encouraging conversations about death and loss whilst emphasizing the essentials of well-being. It is a potential "foot in the door" of the education system and an "ice-breaker" for new staff/students to Palliative care.

  7. Tuberculosis control in the Americas: current approaches.

    Science.gov (United States)

    Pio, A; Western, K

    1976-01-01

    Tuberculosi remains a serious public health problem in the Americas, and it has not declined as rapidly or as much as experts projected it would in the 1940's. Scientific advances in control of the disease over the last three decades have produced effective chemotherapeutic agents, established the immunizing capacity of BCG vaccine, and demonstrated the superior value of bacteriologic diagnosis in symptomatic individuals over mass community x-ray surveys, which are both inefficient and costly. They have also shown that most cases can be treated on an ambulatory basis, obviating the need for the lengthy hospital stays which have heretofore weighed so heavily on budgets. By standardization of control methods, both for diagnosis and for chemotherapy, these tasks can be taken on by polyvalent staff in the general health services, whose wide coverage places them in a position to reach a much larger segment of the population than that attended by the traditional vertical system. To a greater or lesser degree, all the countries in the Americas are beginning to orient their strategies in this direction, and some of them already have considerable progress to report.

  8. [The cholera epidemic in Latin America].

    Science.gov (United States)

    Olsvik, O

    1992-05-30

    An outbreak of cholera started in Peru in January 1991 and spread through most Latin American countries within a year. This was the first known epidemic of cholera in America for more than a century. In 1991, 321,334 persons were reported to have cholera in Peru, 119,063 were hospitalized, and 2,906 died. Other countries like Ecuador, Colombia, Guatemala, Brazil, Mexico, Bolivia, Chile, El Salvador, Venezuela and Honduras were also affected, but these countries combined accounted for only 20% of the cases registered in Peru. In April 1992, all Latin American countries except Uruguay, Paraguay and French Guyana have reported cholera. The mortality rate for the epidemic in Latin America was only 1%, mainly owing to good oral rehydration treatment provided by Local health services and the Pan American Health Organization. The causative organism was Vibrio cholerae, serogroup O1, serotype Inaba (and Ogawa) of the El Tor biotype. Genetic characterization shows this strain to be unique, and the designation is reserved for the Latin American strain, distinguishing it from the other El Tor isolates from the 7th pandemic.

  9. US-LA CRN Clinical Cancer Research in Latin America

    Science.gov (United States)

    The United States – Latin America Cancer Research Network (US-LA CRN) convened its Annual Meeting, in coordination with the Ministry of Health of Chile to discuss the Network’s first multilateral clinical research study: Molecular Profiling of Breast Cancer (MPBC).

  10. Latin America Report

    Science.gov (United States)

    1985-10-22

    Hungarian Medicines 56 Milk Production Project 57 New Ambassador to Switzerland 58 French Cameraman Reports Confiscation Mirage Loses Missile in...months ago has unfairly tarnished the state’s prestige. Chihuahua has been tainted by marihuana . No one wants to succeed Ornelas," said a labor...Aug 85 P 8] 9907- HUNGARIAN MEDICINES — The vice minister for technical provisions from MINSA [Ministry of Health], Pablo Coca, received a

  11. El financiamiento internacional para la cooperación al desarrollo de la salud de América Latina y el Caribe International financing for cooperation to develop health in Latin America and the Caribbean

    Directory of Open Access Journals (Sweden)

    Rebecca De Los Ríos

    2011-08-01

    úblico en salud siguió su tendencia de crecimiento histórico, sin mayores incrementos con respecto al producto interno bruto regional. Frente a este panorama y por ser ALC la región más desigual pero no la más pobre del mundo, resulta imperativo replantearse las formas de pensar, conducir y entregar la cooperación para el desarrollo de la salud con enfoques innovadores y mecanismos alternativos de financiamiento que respondan más y mejor a las realidades de la región.The purpose of this study is (a to examine the ways in which Latin America and the Caribbean (LAC have benefited from increases in international development assistance for health (DAH at the global level and whether the trend observed after the Millennium Summit has also applied to the Region; (b to determine whether there are differences in the distribution of this assistance, based on the gross per capita income of each country; (c to identify the possible effects of the 2008 international financial crisis on official bilateral assistance; and (d to compare trends in public health expenditure in relation to DAH before and after the Millennium Summit. The study has found that DAH in LAC follows a very different pattern than in other regions of the world. The period from 1997 to 2008 was one of fluctuating stagnation, with average annual disbursements of US$ 1 200 million. Multilateral financial institutions accounted for 79% of the average disbursements in the upper-middle income countries between 2002 and 2008, while official bilateral assistance held the greatest share (61% in the low- and lower-middle income countries. Bilateral assistance grew at an annual rate of 13% during this period, but in the year after the crisis, disbursements fell to US$ 20 million. Sixty-four percent of bilateral assistance came from the United States, Spain, and Canada, with 29% of it being directed to HIV/AIDS and sexually transmitted diseases. After the Millennium Summit DAH channeled to governments decreased 30% in

  12. Canadian Organ Replacement Register (CORR: Reflecting the Past and Embracing the Future

    Directory of Open Access Journals (Sweden)

    Louise M Moist

    2014-10-01

    Full Text Available Introduction: The Canadian Organ Replacement Register (CORR is the only Canadian information system on kidney and extra-kidney organ failure and transplantation in Canada. CORR's mandate is to record and analyze the level of activity and outcomes of vital organ transplantation and treatment of end stage kidney disease using dialysis, either hemodialysis or peritoneal dialysis, activities across Canada. The Canadian Organ Replacement Register was officially launched in 1987, and it included transplantation of extra-renal vital organs (liver, heart, lung, pancreas, bowel, in addition to renal transplantation and replacement therapy, with new financial support from the provinces. Objective: This manuscript describes the process of data acquisition and reporting, focusing on the patients with end stage kidney disease on dialysis, with data reported from the 2014 CORR Annual Data Report and the Center-Specific Reports on Clinical Measures. Methods: CORR is currently housed in the Canadian Institute for Health Information and collects data from hospital dialysis programs, regional transplant programs, organ procurement organizations and kidney dialysis services offered at independent health facilities. Data on patients is collected by completion of survey forms for each patient at the start of dialysis or receiving a transplant, using the Initial Registration form, and yearly follow up forms, which collects data on the status of the patient as of October 31 st . Results: The incident rate per million population (RPMP has remained stable with the exception of the 65+ age group with has experience a modest decrease since 2001. However, there has been an increasing prevalence of ESKD diagnoses, with the highest rate per million population (RPMP amongst the age group 65+ years. This is likely attributed to gradual improving patient survival. Between 2003 and 2012, nearly 90% of dialysis patients younger than < 18 and 26% of patients 75+ years survived for

  13. Food choice motives and bread liking of consumers embracing hedonistic and traditional values.

    Science.gov (United States)

    Pohjanheimo, Terhi; Paasovaara, Rami; Luomala, Harri; Sandell, Mari

    2010-02-01

    This study addresses the effect of personal values on consumers' food choice motives and on the liking of bread. A total of 224 consumers participated in the study in three groups: traditional and hedonistic consumers, who presented opposite value types according to the Schwartz value theory, and a control group. Three different rye breads were evaluated for liking and their sensory profiles were determined. The consumer groups' values, food choice motives measured with the Food Choice Questionnaire and a Concern scale, and liking of the breads differed significantly according to the analysis of variance and a partial least squares regression analysis. For hedonistic consumers, rye bread characterized by a soft and porous texture influenced liking positively, and food choice motives "mood" and "price" correlated positively with their values. Traditional consumers were more positive toward different types of rye bread, and food choice motives "natural content", "familiarity" and "health concern" were more important to them than to hedonists. Overall, this study demonstrated that values are connected to food choice motives and, to some extent liking and, thus, values can be utilized both in product development and in advertising. 2009 Elsevier Ltd. All rights reserved.

  14. Embracing the gut microbiota: the new frontier for inflammatory and infectious diseases

    Science.gov (United States)

    van den Elsen, Lieke WJ; Poyntz, Hazel C; Weyrich, Laura S; Young, Wayne; Forbes-Blom, Elizabeth E

    2017-01-01

    The gut microbiota provides essential signals for the development and appropriate function of the immune system. Through this critical contribution to immune fitness, the gut microbiota has a key role in health and disease. Recent advances in the technological applications to study microbial communities and their functions have contributed to a rapid increase in host–microbiota research. Although it still remains difficult to define a so-called ‘normal' or ‘healthy' microbial composition, alterations in the gut microbiota have been shown to influence the susceptibility of the host to different diseases. Current translational research combined with recent technological and computational advances have enabled in-depth study of the link between microbial composition and immune function, addressing the interplay between the gut microbiota and immune responses. As such, beneficial modulation of the gut microbiota is a promising clinical target for many prevalent diseases including inflammatory bowel disease, metabolic abnormalities such as obesity, reduced insulin sensitivity and low-grade inflammation, allergy and protective immunity against infections. PMID:28197336

  15. Embracing value co-creation in primary care services research: a framework for success.

    Science.gov (United States)

    Janamian, Tina; Crossland, Lisa; Jackson, Claire L

    2016-04-18

    Value co-creation redresses a key criticism of researcher-driven approaches to research - that researchers may lack insight into the end users' needs and values across the research journey. Value co-creation creates, in a step-wise way, value with, and for, multiple stakeholders through regular, ongoing interactions leading to innovation, increased productivity and co-created outcomes of value to all parties - thus creating a "win more-win more" environment. The Centre of Research Excellence (CRE) in Building Primary Care Quality, Performance and Sustainability has co-created outcomes of value that have included robust and enduring partnerships, research findings that have value to end users (such as the Primary Care Practice Improvement Tool and the best-practice governance framework), an International Implementation Research Network in Primary Care and the International Primary Health Reform Conference. Key lessons learned in applying the strategies of value co-creation have included the recognition that partnership development requires an investment of time and effort to ensure meaningful interactions and enriched end user experiences, that research management systems including governance, leadership and communication also need to be "co-creative", and that openness and understanding is needed to work across different sectors and cultures with flexibility, fairness and transparency being essential to the value co-creation process.

  16. Supporting transvisibility and gender diversity in nursing practice and education: embracing cultural safety.

    Science.gov (United States)

    Kellett, Peter; Fitton, Chantelle

    2017-01-01

    Many nursing education programs deserve a failing grade with respect to supporting gender diversity in their interactions with their students and in terms of the curricular content directed toward engaging in the safe and supportive nursing care of transgender clients. This situation contributes to transinvisibility in the nursing profession and lays a foundation for nursing practice that does not recognize the role that gender identity plays in the health and well-being of trans-clients and trans-nurses. This article seeks to raise readers' awareness about the problems inherent to transinvisibility and to propose several curricular and structural-level interventions that may serve to gradually increase the recognition of gender diversity in the planning and delivery of nursing education and practice. Contextualized in gender and intersectionality theory, cultural safety is presented as a viable and appropriate framework for engaging in these upstream approaches to addressing gender diversity in nursing education and practice. Among the structural interventions proposed are as follows: inclusive information systems, creation of gender neutral and safe spaces, lobbying for inclusion of competencies that address care of trans-persons in accreditation standards and licensure examinations and engaging in nursing research in this area. © 2016 John Wiley & Sons Ltd.

  17. Wave functions and low-order density matrices for a class of two-electron 'artificial atoms' embracing Hookean and Moshinsky models

    International Nuclear Information System (INIS)

    Holas, A.; Howard, I.A.; March, N.H.

    2003-01-01

    A class of model two-electron 'artificial atoms' is proposed which embraces both Hookean and Moshinsky models. Particle densities and spinless first-order density matrices are obtained for this class of models. These quantities and the interacting system kinetic energy can be calculated using the ground-state solution of an explicit single-particle radial Schroedinger equation

  18. Creating a Global Consciousness by Embracing a World of Women: A Pedagogical Strategy Dedicated to Regaining the Momentum for Women's Rights

    Science.gov (United States)

    Edmonds, Regina M.

    2007-01-01

    If we are to regain some of the energy which characterized the Women's Movement during its earliest years and again during the 1960's and 1970's, we must endeavor to raise awareness among young people about the work for social justice that remains undone and we must find ways to inspire them to re-embrace activism and to develop, what Smyser…

  19. Bowel morbidity following radiochemotherapy and image-guided adaptive brachytherapy for cervical cancer: Physician- and patient reported outcome from the EMBRACE study

    DEFF Research Database (Denmark)

    Jensen, Nina Boje Kibsgaard; Pötter, Richard; Kirchheiner, Kathrin

    2018-01-01

    BACKGROUND/PURPOSE: This study describes late bowel morbidity prospectively assessed in the multi-institutional EMBRACE study on MRI-guided adaptive brachytherapy in locally advanced cervical cancer (LACC). MATERIALS/METHODS: A total of 1176 patients were analyzed. Physician reported morbidity (C...

  20. The Extent to Which Universities Have Embraced Technology in Service Delivery: A Comparative Study of NUST (Zimbabwe) and University of Venda (RSA)

    Science.gov (United States)

    Khumalo, Njabulo Bruce; Baloyi, Charity

    2018-01-01

    Information Communication Technologies have greatly impacted the education sector over the years leading to electronic service delivery. Universities all over the world are embracing Information Communication Technologies especially the internet, creating websites, making use of web 2.0 applications, that is, social networks and moving their…

  1. Fatigue, insomnia and hot flashes after definitive radiochemotherapy and image-guided adaptive brachytherapy for locally advanced cervical cancer: An analysis from the EMBRACE study

    DEFF Research Database (Denmark)

    Smet, Stéphanie; Pötter, Richard; Haie-Meder, Christine

    2018-01-01

    OBJECTIVE: To evaluate the pattern of manifestation of fatigue, insomnia and hot flashes within the prospective, observational, multi-center EMBRACE study. METHODS: Morbidity was prospectively assessed according to CTCAE v.3 and patient-reported outcome with EORTC QLQ-C30/CX24 at baseline and reg...

  2. User embracement and maternal characteristics associated with liquid offer to infants.

    Science.gov (United States)

    Niquini, Roberta Pereira; Bittencourt, Sonia Azevedo; Lacerda, Elisa Maria de Aquino; Couto de Oliveira, Maria Inês; Leal, Maria do Carmo

    2010-08-01

    To identify the maternal characteristics and welcoming actions towards mothers of infants aged less than six months associated with early liquid offer. Cross-sectional study performed in 2007, with a representative sample of mothers of infants aged less than six months (n=1,057), users of Primary Health Care (PHC) Units, in the city of Rio de Janeiro, Southeastern Brazil. A multivariate logistic regression model was used to estimate the association between explanatory variables and liquid offer, with weighing and design effect and controlled for infant age. Of all mothers, 32% did not receive the welcoming card in the maternity hospital, 47% did not receive guidance on breastfeeding at their first visit to the PHC unit after childbirth and 55% reported they had offered liquids to their infants. Women without at least six months of previous breastfeeding experience were more likely to offer liquids than those with such experience (OR=1.57; 95% CI: 1.16;2.13). Mothers who had not received guidance on breastfeeding at their first visit to the UBS after childbirth were 58% more likely to offer liquids than those who had received it. Liquid offer was positively associated with adolescence among women with a partner (OR=2.17; 95% CI: 1.10;4.30) and negatively associated with adolescence among those without a partner (OR=0.31; 95% CI: 0.11;0.85). Among women with less than eight years of education, those who had not received guidance on breastfeeding after childbirth were 1.8 times more likely to offer liquids than others who had received it. Age, marital status and previous breastfeeding experience are maternal characteristics associated with liquid offer to infants aged less than six months. Receiving early guidance on breastfeeding could reduce liquid offer to infants.

  3. Where does human plague still persist in Latin America?

    OpenAIRE

    Maria Cristina Schneider; Patricia Najera; Sylvain Aldighieri; Deise I Galan; Eric Bertherat; Alfonso Ruiz; Elsy Dumit; Jean Marc Gabastou; Marcos A Espinal

    2014-01-01

    Background Plague is an epidemic-prone disease with a potential impact on public health, international trade, and tourism. It may emerge and re-emerge after decades of epidemiological silence. Today, in Latin America, human cases and foci are present in Bolivia, Brazil, Ecuador, and Peru. Aims The objective of this study is to identify where cases of human plague still persist in Latin America and map areas that may be at risk for emergence or re-emergence. This analysis will provide evidence...

  4. Fuglene. Audubon: Birds of America

    DEFF Research Database (Denmark)

    Schlichtkrull, Torsten

    2010-01-01

    The Royal Library owns one of the most exceptional works in book history, an original edition of John James Audubon Birds of America. This edition, in a format called “double elephant folio” was published from 1827 to 1838. On basis of existing literature, this article briefly describes the work...... the Royal Library and the University Library, joined the library cooperation of the 1800’s on an equal standing with the other two libraries. The Classen’s Library and the library’s founder, industrialist JF Classen are described briefly in this article. Due to two library mergers the Birds of America...

  5. Health by Stealth--Exploring the Sociocultural Dimensions of Salutogenesis for Sport, Health and Physical Education Research

    Science.gov (United States)

    McCuaig, Louise; Quennerstedt, Mikael

    2018-01-01

    Sport, health and physical education (SHPE) researchers have increasingly embraced the salutogenic model of health devised by Aaron Antonvosky, to re-understand and problematise the relation between movement, physical activity or physical education on one hand, and health on the other. However, contemporary research employing Antonovsky's theories…

  6. Onchocerciasis in the Americas: from arrival to (near) elimination.

    Science.gov (United States)

    Gustavsen, Ken; Hopkins, Adrian; Sauerbrey, Mauricio

    2011-10-25

    Onchocerciasis (river blindness) is a blinding parasitic disease that threatens the health of approximately 120 million people worldwide. While 99% of the population at-risk for infection from onchocerciasis live in Africa, some 500,000 people in the Americas are also threatened by infection. A relatively recent arrival to the western hemisphere, onchocerciasis was brought to the New World through the slave trade and spread through migration. The centuries since its arrival have seen advances in diagnosing, mapping and treating the disease. Once endemic to six countries in the Americas (Brazil, Colombia, Ecuador, Guatemala, Mexico and Venezuela), onchocerciasis is on track for interruption of transmission in the Americas by 2012, in line with Pan American Health Organization resolution CD48.R12. The success of this public health program is due to a robust public-private partnership involving national governments, local communities, donor organizations, intergovernmental bodies, academic institutions, non-profit organizations and the pharmaceutical industry. The lessons learned through the efforts in the Americas are in turn informing the program to control and eliminate onchocerciasis in Africa. However, continued support and investment are needed for program implementation and post-treatment surveillance to protect the gains to-date and ensure complete elimination is achieved and treatment can be safely stopped within all 13 regional foci.

  7. Onchocerciasis in the Americas: from arrival to (near elimination

    Directory of Open Access Journals (Sweden)

    Sauerbrey Mauricio

    2011-10-01

    Full Text Available Abstract Onchocerciasis (river blindness is a blinding parasitic disease that threatens the health of approximately 120 million people worldwide. While 99% of the population at-risk for infection from onchocerciasis live in Africa, some 500,000 people in the Americas are also threatened by infection. A relatively recent arrival to the western hemisphere, onchocerciasis was brought to the New World through the slave trade and spread through migration. The centuries since its arrival have seen advances in diagnosing, mapping and treating the disease. Once endemic to six countries in the Americas (Brazil, Colombia, Ecuador, Guatemala, Mexico and Venezuela, onchocerciasis is on track for interruption of transmission in the Americas by 2012, in line with Pan American Health Organization resolution CD48.R12. The success of this public health program is due to a robust public-private partnership involving national governments, local communities, donor organizations, intergovernmental bodies, academic institutions, non-profit organizations and the pharmaceutical industry. The lessons learned through the efforts in the Americas are in turn informing the program to control and eliminate onchocerciasis in Africa. However, continued support and investment are needed for program implementation and post-treatment surveillance to protect the gains to-date and ensure complete elimination is achieved and treatment can be safely stopped within all 13 regional foci.

  8. Overview of social inequalities in health in the Region of the Americas, using various methodological approaches Visión general de las desigualdades de salud en la Región de las Américas, usando diversos enfoques metodológicos

    Directory of Open Access Journals (Sweden)

    George A.O. Alleyne

    2002-12-01

    Full Text Available Over the past decade, according to several important indicators, health conditions have improved in the Region of the Americas. However, inequalities persist among the countries of the Region. This article has two primary objectives: 1 to provide some unbiased evidence on health inequalities among countries of the Region of the Americas and 2 to illustrate the application of some of the more frequently used methods for measuring inequalities, including effect measurements, population attributable risk, the slope index of inequality, the relative index of inequality, and the concentration index. Analyses have shown that there are great health disparities in the Region of the Americas. For example, residents of the poorest countries of the Region live nearly 10 years less, on average, than do residents of the richest countries. If the other countries of the Americas had the same incidence of tuberculosis as does the subregion of North America (Bermuda, Canada, and the United States of America, there would be 76% fewer cases of this disease in the Region. In the Americas, nearly 35% of deaths of infants under 1 year old are concentrated in the 20% of live births that occur in the group with the lowest income. As for maternal mortality in the Americas, fewer than 2% of maternal deaths occur in association with the 20% of live births in the group with the highest income. The analyses of health inequalities based on the use of various methods highlight the existence of important disparities among subregions and countries of the Americas that are not readily seen when using only the more-traditional methods for analyzing mortality and morbidity. There is also a need to incorporate the concepts of distribution and socioeconomic dimensions of health when interpreting a given situation. Using this approach will allow decisionmakers to target areas and populations that are in less-favorable conditions. A considerable body of aggregate data at the Regional

  9. Systematic review on embracing cultural diversity for developing and sustaining a healthy work environment in healthcare.

    Science.gov (United States)

    Pearson, Alan; Srivastava, Rani; Craig, Dianna; Tucker, Donna; Grinspun, Doris; Bajnok, Irmajean; Griffin, Pat; Long, Leslye; Porritt, Kylie; Han, Thuzar; Gi, Aye A

    2007-03-01

    quality  Methodological quality was independently established by two reviewers, using standardised techniques from the Joanna Briggs Institute (JBI) System for the Unified Management, Assessment and Review of Information (SUMARI) package. Discussion with a third reviewer was initiated where a low level of agreement was identified for a particular paper. Following inclusion, data extraction was conducted using standardised data extraction tools from the JBI SUMARI suite for quantitative and qualitative research. Data synthesis was performed using the JBI Qualitative Assessment and Review Instrument and JBI Narrative, Opinion and Text Assessment and Review Instrument software to aggregate findings by identifying commonalities across texts. Quantitative data were presented in narrative summary, as statistical pooling was not appropriate with the included studies. Results  Of the 659 identified papers, 45 were selected for full paper retrieval, and 19 were considered to meet the inclusion criteria for this review. The results identified a number of processes that would contribute to the development of a culturally competent workforce. Appropriate and competent linguistic services, and intercultural staff training and education, were identified as key findings in this review. Conclusions  The review recommends that health provider agencies establish links with organisations that can address needs of culturally diverse groups of patients, include cultural competence in decision support systems and staff education as well as embed them in patient brochures and educational materials. The review also concluded that staff in-service programs consider the skills needed to foster a culturally competent workforce, and recruitment strategies that also explicitly address this need.

  10. Health-related behaviors and overweight: a study of Latino adolescents in the United States of America Conductas relacionadas con la salud y sobrepeso: estudio en adolescentes latinoamericanos residentes en los Estados Unidos de América

    Directory of Open Access Journals (Sweden)

    Jorge Delva

    2007-01-01

    Full Text Available OBJECTIVES: This study examined, by gender, differences in being overweight among adolescents of Mexican, Puerto Rican, and other Latin American heritage who live in the United States of America, and investigated the relationships between these differences and socioeconomic status, health-related behaviors, and family characteristics. METHODS: This cross-sectional survey study obtained and analyzed data from nationally representative samples of Latino 8th and 10th graders in the Monitoring the Future study from 1991 to 2004 (N = 11 265. RESULTS: A higher proportion of Mexican-American girls were overweight than other Latin American girls, both before and after adjusting for many confounders. For both genders, being overweight was inversely associated with socioeconomic status and frequency of vigorous exercise, and positively associated with the amount of television viewing. No family characteristic variable examined was associated with overweight. CONCLUSIONS: Time spent exercising and time spent watching television are two potentially modifiable risk factors that, if targeted, may result in important reductions in overweight. The findings indicate the need to identify gender- and culturally-appropriate interventions that can increase physical activity and reduce sedentary activities among Latino adolescents, particularly in families of low socioeconomic status.OBJETIVOS: Analizar las diferencias, según el sexo, en el sobrepeso de adolescentes de origen mexicano, puertorriqueño y de otros países latinoamericanos que viven en los Estados Unidos de América e investigar la relación entre esas diferencias y el estatus socioeconómico, las conductas relacionadas con la salud y las características familiares. MÉTODOS: En este estudio transversal por encuesta se obtuvieron y analizaron los datos de muestras representativas para el país de estudiantes latinoamericanos del 8.° y 10.° grados del estudio Monitoring the Future de 1991 a 2004 (N

  11. Embracing Complexity of Crop Phytobiomes with a Multidisciplinary Roadmap for Phytobiomes Research and an Industry-Academic Research Alliance

    Science.gov (United States)

    Eversole, K.

    2016-12-01

    To meet the demands of a global human population expected to exceed 9.6 billion by 2055, crop productivity in sustainable agricultural systems must improve considerably in the face of a steadily changing climate and increased biotic and abiotic stressors. Traditional agricultural sciences have relied mostly on research within individual disciplines and linear, reductionist approaches for crop improvement. While significant advancements have been made in developing and characterizing genetic and genomic resources for crops, we still have a very limited understanding of genotype by environment x management (GxExM) interactions that determine productivity, sustainability, quality, and the ability to withstand biotic and abiotic stressors. Embracing complexity and the non-linear organization and regulation of biological systems would enable a paradigm shift in breeding and crop production by allowing us to move towards a holistic, systems level approach that integrates a wide range of disciplines (e.g., geophysics, biology, agronomy, physiology, genomics, genetics, breeding, physics, pattern recognition, feedback loops, modeling, and engineering) and knowledge about crop phytobiomes (i.e., plants, their associated macro- and micro-organisms, and the geophysical environment of distinct geographical sites). By focusing on the phytobiome, we will be able to elucidate, quantify, model, predict, act, manipulate, and prevent and ultimately prescribe the cropping systems, methods, and management practices most suited for a particular farm, grassland, or forest. The recently released, multidisciplinary roadmap entitled Phytobiomes: A Roadmap for Research and Translation and the new International Alliance for Phytobiomes Research, an industry-academic consortium, will be presented.

  12. Holistic Health Care for the Medically Uninsured: The Church Health Center of Memphis

    OpenAIRE

    Morris, G. Scott

    2015-01-01

    The Church Health Center (CHC) in Memphis was founded in 1987 to provide quality, affordable health care for working, uninsured people and their families. With numerous, dedicated financial supporters and health care volunteers, CHC has become the largest faith-based health care organization of its type nationally, serving >61,000 patients. CHC embraces a holistic approach to health by promoting wellness in every dimension of life. It offers on-site services including medical care, dentistry,...

  13. Allan Bloom, America, and Education.

    Science.gov (United States)

    West, Thomas

    2000-01-01

    Refutes the claims of Allan Bloom that the source of the problem with today's universities is modern philosophy, that the writings and ideas of Hobbes and Locke planted the seeds of relativism in American culture, and that the cure is Great Books education. Suggests instead that America's founding principles are the only solution to the failure of…

  14. Brain Injury Association of America

    Science.gov (United States)

    ... Only) 1-800-444-6443 Welcome to the Brain Injury Association of America (BIAA) Brain injury is not an event or an outcome. ... misunderstood, under-funded neurological disease. People who sustain brain injuries must have timely access to expert trauma ...

  15. Clitopilus argentinus in North America

    NARCIS (Netherlands)

    Baroni, Timothy J.

    1992-01-01

    Clitopilus argentinus is reported for the first time from North America. A full description and illustrations of the basidiomata and microscopic structures are provided. An X-ray elemental analysis of the diagnostic ‘hyaline’ incrustations of the pileus surface shows these extracellular structures

  16. Rural Poverty in Latin America

    OpenAIRE

    Keith Griffin

    1999-01-01

    The fact that most poor people in Latin America live in urban areas had implied that poverty in the region is regarded as largely an urban phenomenon. However, this document exposes what available data suggest: that rural poverty still is significant in many Latin American countries.

  17. Going Digital in Rural America.

    Science.gov (United States)

    Malecki, Edward J.

    This paper examines the extent to which rural America is digital--has access to the Internet and to newer technologies such as wireless broadband--and discusses rural supply and demand for "going digital." Supply aspects include issues of both infrastructure and public policy. Demand aspects include entrepreneurs (business users) and…

  18. Fire management in central America

    Science.gov (United States)

    Andrea L. Koonce; Armando González-Cabán

    1992-01-01

    Information on fire management operations in Central America is scant. To evaluate the known level of fire occurrence in seven countries in that area, fire management officers were asked to provide information on their fire control organizations and on any available fire statistics. The seven countries surveyed were Guatemala, Belize, Honduras, El Salvador, Nicaragua,...

  19. Can Marxism Explain America's Racism?

    Science.gov (United States)

    Willhelm, Sidney M.

    1980-01-01

    The Marxist interpretation of the Black experience in America has always had difficulty explaining various noneconomic aspects of racism. A perspective is needed that can blend racism as a variable in relationship with economic variables. To reach this perspective, the labor process within capitalism must be more fully understood. (Author/GC)

  20. The Second Discovery of America

    Science.gov (United States)

    Lewis, Richard S.

    1973-01-01

    Summarizes the major areas of concern considered at the first international conference on Science and Man in the Americas. Topics emphasized include: natural resources of the oceans, movements of the earth's crust, volcanology, energy resources, and food production as it relates to the world population problem. (JR)

  1. Tuning History in Latin America

    Science.gov (United States)

    Velázquez Albo, Marco

    2017-01-01

    This article analyses the development and achievements of the area of History in the Tuning-Latin America Project from its launch in 2004 to its completion in 2013. Through two phases and nine general meetings, academics from Argentina, Brazil, Chile, Colombia, Costa Rica, Cuba, Guatemala, Mexico and Peru, along with academics from Spain, Portugal…

  2. Tenure and America's Community Colleges

    Science.gov (United States)

    DiMaria, Frank

    2012-01-01

    America's colleges and universities have been moving slowly but steadily away from tenure over the past decade. The American Federation of Teachers reports that community colleges have seen a 22% increase in the number of instructional staff between 1997 and 2007. During that time, the percentage of community college faculty that were full-time…

  3. Demographic tensions in Central America.

    Science.gov (United States)

    1986-08-01

    This discussion of Central America focuses on the rapid growth of its population, its stagnating economy, and those countries that are socioeconomically advanced. Between 1950-85 the population of Central America tripled, from 9.1 million to 26. 4 million, due to marked mortality declines and the absence of off-setting fertility declines. The distribution of Central Americas's growing populations sets its population growth apart from that of other developing regions. Currently, almost half of all Central Americans live in cities. Although the average growth rate for Central American countries has fallen and is expected to drop further, the decline does not counterbalance the effect of the absolute rise in population numbers. The average annual growth rate of more than 3% annually in the 1960s fell to about 2.6% in recent years, but this decline is due primarily to socioeconomically advanced Costa Rica and Panama. Central America's age structure further complicates the population crisis. About 43% of Central Americans are under the age of 15. When the increasingly larger young population group enters it reproductive years, the potential for future growth (albeit the falling rate of population increase) is unparalleled. UN population projections show the region's population at 40 million by the year 2000. The 1973 oil crisis began a downward spiral for the buoyant post World War II Central American economy. Between 1950-79, real per capita income growth in Central America doubled, with Central American economies growing an average of 5.3% annually. By the early 1980s, overseas markets of the trade-dependent countries of Central America had dried up due to protectionism abroad and slumping basic commodity prices. These and other factors plunged Central America into its current economic malaise of falling real per capita income, rising unemployment, curtailed export led economic growth, and a rising cost of living. In general, economic growth in Central America

  4. BAT-BORNE RABIES IN LATIN AMERICA

    Directory of Open Access Journals (Sweden)

    Luis E. Escobar

    2015-02-01

    Full Text Available The situation of rabies in America is complex: rabies in dogs has decreased dramatically, but bats are increasingly recognized as natural reservoirs of other rabies variants. Here, bat species known to be rabies-positive with different antigenic variants, are summarized in relation to bat conservation status across Latin America. Rabies virus is widespread in Latin American bat species, 22.5%75 of bat species have been confirmed as rabies-positive. Most bat species found rabies positive are classified by the International Union for Conservation of Nature as “Least Concern”. According to diet type, insectivorous bats had the most species known as rabies reservoirs, while in proportion hematophagous bats were the most important. Research at coarse spatial scales must strive to understand rabies ecology; basic information on distribution and population dynamics of many Latin American and Caribbean bat species is needed; and detailed information on effects of landscape change in driving bat-borne rabies outbreaks remains unassessed. Finally, integrated approaches including public health, ecology, and conservation biology are needed to understand and prevent emergent diseases in bats.

  5. Toxocariasis in North America: a systematic review.

    Directory of Open Access Journals (Sweden)

    Rachel M Lee

    2014-08-01

    Full Text Available Toxocariasis is an important neglected tropical disease that can manifest as visceral or ocular larva migrans, or covert toxocariasis. All three forms pose a public health problem and cause significant morbidity in areas of high prevalence. To determine the burden of toxocariasis in North America, we conducted a systematic review of the literature following PRISMA guidelines. We found 18 articles with original prevalence, incidence, or case data for toxocariasis. Prevalence estimates ranged from 0.6% in a Canadian Inuit community to 30.8% in Mexican children with asthma. Commonly cited risk factors included: African-American race, poverty, male sex, and pet ownership or environmental contamination by animal feces. Increased prevalence of Toxocara spp. infection was linked in a group of case control studies conducted in Mexico to several high risk groups including waste pickers, asthmatic children, and inpatient psychiatry patients. Further research is needed to determine the true current burden of toxocariasis in North America; however the prevalence estimates gathered in this review suggest that the burden of disease is significant.

  6. Desigualdades sociais em saúde e na utilização dos serviços de saúde entre os idosos na América Latina Social inequality in health and the utilization of health services among the elderly in Latin America

    Directory of Open Access Journals (Sweden)

    Kenya Valéria Micaela de Souza Noronha

    2005-06-01

    íses que apresentam os piores indicadores sociais (elevada desigualdade de renda e baixo índice de desenvolvimento humano tenderam a apresentar as maiores desigualdades em saúde e na utilização dos serviços de saúde.OBJECTIVE: To learn if there is social inequality in health and in the utilization of health services among the elderly in six cities of Latin America: Buenos Aires, Argentina; São Paulo, Brazil; Santiago, Chile; Havana, Cuba; Mexico City, Mexico; and Montevideo, Uruguay. METHODS: This study used data from a project called Health, Well-being, and Aging in Latin America and the Caribbean (known as the "SABE project". To investigate the presence of social inequality in health an ordinal probit model was used, with health status indicated by the following dependent variables: activities of daily living, instrumental activities of daily living, physical mobility, and self-rated health. To measure social inequality in the utilization of health services two characteristics were assessed: one for outpatient medical services (whether or not individuals received outpatient care, and how many times, and one for hospital admissions (whether or not individuals were hospitalized. For outpatient services, we estimated a negative binomial hurdle model, and for hospital admissions, a logit model was constructed. RESULTS: Our main results suggest the presence of social inequality in health in all the cities, with better-off socioeconomic groups having better health. The difference in health was less marked in Havana, Buenos Aires, and Montevideo, and it was more pronounced in São Paulo and Mexico City. With respect to the utilization of health services we found inequalities in the use of outpatient services in Santiago, Mexico City, and São Paulo. In Santiago and Mexico City, more schooling was associated with a higher number of expected outpatient medical visits; however, the opposite was found in São Paulo. For hospital admissions, inequality was found only in S

  7. America's nuclear waste backlog

    International Nuclear Information System (INIS)

    Benenson, R.

    1981-01-01

    This report discusses three topics: concern and controversy relating to nuclear waste; high-level waste storage and politics of waste disposal. The most pressing waste disposal problem concerns spent fuel assemblies from commercial nuclear power plants. It was expected that commercial spent fuel would be sent to commercial reprocessing plants. The feasibility of commercial reprocessing in the United States is contingent on the expansion of the nuclear power industry. The current high-level liquid waste inventory is about 77 million gallons. These are stored at Richland, Washington; Aiken, South Carolina; and Idaho Falls, Idaho. The only commercial high-level wastes ever produced are stored at the defunct reprocessing facility at West Valley, New York. A high-level waste repository must be capable of isolating wastes that will remain dangerous for thousands of years. Salt has long been considered the most suitable medium for high-level and transuranic waste disposal. The timetable for opening a deep geological repository is one of the issues that will have to be dealt with by Congress. The 97th Congress appears ready to act on high-level nuclear waste legislation. Even opponents of nuclear expansion admit the necessity of legislation. Even if Congress gets its act together, it does not mean that the nuclear waste issue is gone. There are still unknowns - future of reprocessing, the needs and demands of the military; the health of the nuclear power industry; the objections of residents in potential site areas; the possibility of a state veto, and the unsolved technological problems in geologic site selection

  8. Cooperação e integração regional em saúde na América do Sul: a contribuição da Unasul-Saúde Regional cooperation and integration in health in South America: the contribution of Unasur-Health

    Directory of Open Access Journals (Sweden)

    Paulo Marchiori Buss

    2011-06-01

    Full Text Available O objetivo deste artigo é discutir o processo de integração da América do Sul na área da saúde, desde a constituição da União de Nações Sul-Americanas (Unasul, em maio de 2008, até o surgimento do Conselho de Saúde da Unasul, em 2009, e seu ulterior desenvolvimento no último ano (2009-2010. Este estudo é de caráter descritivo e o meio de investigação foi o estudo de caso. Apresentam-se os principais elementos constitutivos da Agenda de Saúde Sul-Americana, com especial destaque para a área de desenvolvimento e gestão de recursos humanos em saúde, que esteve sob a coordenação do Brasil no último ano. Os autores concluem que esse intercâmbio contribuirá para minimizar as assimetrias entre os países, colaborando para a melhoria das condições de vida e saúde da região.The scope of this study is to discuss the process of integration of South America in the domain of health, from the constitution of the Union of South American Nations (Unasur, in May 2008, through to the emergence of the Unasur Council of Health, in 2009, and its ongoing development in the past year (2009-2010. This study is descriptive in nature and the medium of investigation was the case study. The authors present the main constituent elements of the South-American Health Agenda, with particular emphasis on the area of development and management of human resources in health, which was coordinated by Brazil in the past year. The authors conclude that this interchange will contribute to minimization of the asymmetries amongst the countries, collaborating to improve the quality of life and health conditions in the region.

  9. 75 FR 18095 - America's Marine Highway Program

    Science.gov (United States)

    2010-04-09

    ... Marine Highway Transportation. Authority: Energy Independence and Security Act of 2007, Sections 1121...] RIN 2133-AB70 America's Marine Highway Program AGENCY: Maritime Administration, Department of... interim final rule that established America's Marine Highway Program, under which the Secretary will...

  10. Eye Care: MedlinePlus Health Topic

    Science.gov (United States)

    ... Battery Safety Facts (Prevent Blindness America) - PDF Eye Health in Sports and Recreation (American Academy of Ophthalmology) Also in Spanish Eye Safety at Work (Prevent Blindness America) Four Fantastic Foods to Keep ...

  11. Acesso ao serviço de fonoaudiologia: a implantação do acolhimento no município de Toledo - PR Access to service of speech therapy: implementing the embracement practice in Toledo City - PR

    Directory of Open Access Journals (Sweden)

    Juliana Cunha da Costa

    2012-10-01

    Full Text Available TEMA: para inserir o acolhimento nos serviços de saúde, é preciso desenvolver formas de receber a população; respeitando os diferentes modos de como o usuário procura ajuda. Desta forma, o presente trabalho é um relato de experiência, que teve por objetivo agilizar o acesso ao serviço de Fonoaudiologia, bem com escutar e dar respostas mais adequadas aos usuários. PROCEDIMENTOS: como forma de estruturar o acesso foi realizada a implantação das práticas de acolhimento na porta de entrada ao serviço de Fonoaudiologia do município de Toledo, no Paraná. Para a realização do acolhimento foram estabelecidos dois momentos. O primeiro referiu-se a lista de espera de usuários que necessitava ser conhecida e no momento posterior, os novos usuários escolheram entre dias e horários fixos, como forma de entrada no serviço de Fonoaudiologia. Em alguns encontros houve também a participação de enfermeiro, psicólogo e assistente social. RESULTADOS: ofereceu-se aos usuários melhor acesso ao atendimento fonoaudiológico, proporcionou o enriquecimento da relação profissional/usuário, à adequação dos procedimentos terapêuticos e esclarecimentos quanto ao funcionamento do serviço. CONCLUSÃO: a implantação do acolhimento na porta de entrada ao serviço de Fonoaudiologia agilizou o acesso da população, assim como escutar implica em respeitar as demandas do usuário.BACKGROUND: for the embracement practice in health services to occur it is necessary to develop ways to receive the population, respecting the different modes of how the users seek help. In this way, this assignment is an experience report that had as objective to expedite the access to service of speech therapy, as well as to listen and to give more appropriate answers to the users. PRODUCERS: as a way to structure the access, one accomplished the implementation of embracement´s practice in the incoming door at the services of speech therapy at Toledo´s city in

  12. Reaching remote areas in Latin America.

    Science.gov (United States)

    Jaimes, R

    1994-01-01

    Poor communities in remote and inaccessible areas tend to not only be cut off from family planning education and services, but they are also deprived of basic primary health care services. Efforts to bring family planning to such communities and populations should therefore be linked with other services. The author presents three examples of programs to bring effective family planning services to remote communities in Central and South America. Outside of the municipal center in the Tuxtlas region of Mexico, education and health levels are low and people live according to ancient customs. Ten years ago with the help of MEXFAM, the IPPF affiliate in Mexico, two social promoters established themselves in the town of Catemaco to develop a community program of family planning and health care offering education and prevention to improve the quality of people's lives. Through their health brigades taking health services to towns without an established health center, the program has influenced an estimated 100,000 people in 50 villages and towns. The program also has a clinic. In Guatemala, the Family Welfare Association (APROFAM) gave bicycles to 240 volunteer health care workers to facilitate their outreach work in rural areas. APROFAM since 1988 has operated an integrated program to treat intestinal parasites and promote family planning in San Lucas de Toliman, an Indian town close to Lake Atitlan. Providing health care to more than 10,000 people, the volunteer staff has covered the entire department of Solola, reaching each family in the area. Field educators travel on motorcycles through the rural areas of Guatemala coordinating with the health volunteers the distribution of contraceptives at the community level. The Integrated Project's Clinic was founded in 1992 and currently carries out pregnancy and Pap tests, as well as general lab tests. Finally, Puna is an island in the middle of the Gulf of Guayaquil, Ecuador. Women on the island typically have 10

  13. ACHP | Summary of the Preserve America Initiative

    Science.gov (United States)

    Initiative Preserve America: Explore and Enjoy Our Heritage (logo) Summary of the Preserve America Initiative Preserve America is a White House initiative that encourages and supports community efforts to preserve and enjoy our priceless cultural and natural heritage. The goals of the initiative include a greater shared

  14. Embracing early literacy indicators

    DEFF Research Database (Denmark)

    Broström, Stig; Hansen, Ole Henrik; Jensen, Anders Skriver

    2010-01-01

    Abstract til paper om early literacy indikatorer. Det paper abstractet er knyttet til var en del af et inviteret, selvorganiseret symposium som afrapporterede EASE-projektet (www.ease-eu.com) på OMEP's 26. verdenskongres.......Abstract til paper om early literacy indikatorer. Det paper abstractet er knyttet til var en del af et inviteret, selvorganiseret symposium som afrapporterede EASE-projektet (www.ease-eu.com) på OMEP's 26. verdenskongres....

  15. Embracing early literacy indicators

    DEFF Research Database (Denmark)

    Broström, Stig; Hansen, Ole Henrik; Jensen, Anders Skriver

    2010-01-01

    Om hvordan læringshistorie-metoden blev modificeret til at blive målrettet skriftsprogstilegnelse (EASE-projektet), og hvordan såkaldte skriftsprogstilegnelses-indikatorer er potentielt indsnævrende for den pædagogiske praksis....

  16. Embracing the network

    DEFF Research Database (Denmark)

    Boysen, Mikkel Snorre Wilms

    2017-01-01

    In society and education, creativity is considered a key priority. Yet, the notion of creativity is challenged by an increased focus on the distributed aspects of human action. This change of perspective is particularly problematic to handle in a school context, because teachers are obliged...... indicates that the concept of distributed creativity can be implemented productively in a school setting. However, the study also demonstrates that traditional understandings of creative processes is only partly compatible with the notion of distributed creativity. In the end, suggestions are made in order...

  17. Embracing the future

    International Nuclear Information System (INIS)

    Beasley, S.C.

    1998-01-01

    An overview of the Tennessee Gas Pipeline System/Project is presented. The system spans much of the central, eastern and southwestern United States, extending into the northeastern states to hook up with the Portland Natural Gas and the Maritimes and Northeast pipelines. It was stated that nearly all of the local distributing companies' load is undergoing retail restructuring, suggesting that by the time the restructuring is completed as much as 40 per cent of natural gas will be distributed by independent marketers. In effect, different customers, different rules, (e.g. the FERC policy initiatives) different services and different use of the assets will add up to a different natural gas business. The new natural gas business will be characterized by new services, strategic expansions, improved reliability and efficiency, customer choice and improved customer relations

  18. Embracing the Dragon

    DEFF Research Database (Denmark)

    Munyi, Elijah Nyaga

    Notwithstanding extensive analysis on the pros and cons of Chinese-African involvement, there has not been much in development of a collective African policy framework for economic engagement with China. This paper seeks to shift focus from the debate on the pros and cons of Chinese – Africa rela...

  19. Embracing the Dragon

    DEFF Research Database (Denmark)

    Munyi, Elijah Nyaga

    2012-01-01

    Notwithstanding extensive analysis on the pros and cons of Chinese-African involvement, there has not been much in development of a collective African policy framework for economic engagement with China. This paper seeks to shift focus from the debate on the pros and cons of Chinese – Africa rela...

  20. Embracing the network

    DEFF Research Database (Denmark)

    Boysen, Mikkel Snorre Wilms

    2017-01-01

    In society and education, creativity is considered a key priority. Yet, the notion of creativity is challenged by an increased focus on the distributed aspects of human action. This change of perspective is particularly problematic to handle in a school context, because teachers are obliged to ex...