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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. 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.

  4. The Affordable Care Act and community benefit: a mandate Catholic health care can (partly) embrace.

    Science.gov (United States)

    McCruden, Patrick

    2013-09-01

    The 2010 Patient Protection and Affordable Care Act (ACA) requires not-for-profit hospitals, including Catholic hospitals, to engage in meaningful community assessment and collaboration efforts in order to maintain their tax-exempt status. Now that the ACA has been upheld by the U.S. Supreme Court, this paper argues that the requirements related to a more robust community engagement process should be embraced by Catholic not-for-profit hospitals and health systems. Apart from the legal requirements under ACA, an equally persuasive moral mandate to engage in community-level assessment and action exists in the ethical tradition of Catholic health care, particularly in the notions of the common good, preferential option for the poor, and subsidiarity. This paper examines the compelling nature of these moral norms in light of the dual goals of improving overall community health and reducing health disparities among vulnerable populations. It concludes with the examination of one model of community collaboration: Mobilizing for Action through Planning and Partnerships (MAPP).

  5. Family health program user: knowledge and satisfaction about user embracement - doi: 10.5020/18061230.2012.s96

    Directory of Open Access Journals (Sweden)

    Saulo Lacerda Borges de Sá

    2012-11-01

    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 organized statistically 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.

  6. 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?

  7. 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

  8. Embracing change.

    Science.gov (United States)

    Orr, Patty; Davenport, Doris

    2015-03-01

    This article challenges the way nurses have thought about the business of nursing practice and education, while exposing emerging innovations that are calling nurses to action. Several quality measurement programs and the Affordable Care Act are discussed in relation to changes in nursing practice that will be required to meet the challenges of an evolving health care system. Using a change theory as the framework to guide both transformational and incremental planned change will increase the chance of success. Selected change theories are considered and one theory is used to illustrate usefulness in facilitating change in nursing practice. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. The opportunity for health plans to improve quality and reduce costs by embracing primary care medical homes.

    Science.gov (United States)

    Collins, Sarah; Piper, Kevin B Kip; Owens, Gary

    2013-01-01

    The large and growing costs of healthcare will continue to burden all payers in the nation's healthcare system-not only the states that are struggling to meet Medicaid costs and the federal government, but also the private health plans that serve commercial, Medicare Advantage, and Medicaid beneficiaries. Cost will increasingly become a concern as millions more people become newly insured as a result of the Patient Protection and Affordable Care Act (ACA). Primary care delivery through patient-centered medical homes (PCMHs) and other coordinated-care models have improved care and reduced costs. Health plans have a strategic opportunity to promote better care at a lower cost by embracing medical homes and encouraging their growth. Health plans can play an important role in transforming the US healthcare system, as well as better position themselves for long-term corporate success. To discuss several examples of organizations that serve a variety of beneficiaries and have been successful in promoting medical homes and coordinated primary care, and to suggest steps that health plans can take to improve the quality of care and reduce costs. The models discussed in this article take a number of different approaches to create incentives for high-quality, cost-effective, coordinated primary care. Several health plans and groups use enhanced fee-for-service or per-member per-month payment models for primary care physician (PCP) practices that reach a specified level of medical home or electronic health record certification. Most of the examples addressed in this article also include an additional payment to encourage care management and coordination. The results showed a significant decline in costs and in the use of expensive medical services. One Medicaid coordinated-care program we reviewed saved almost $1 billion in reduced spending over 4 years, and achieves savings of approximately 15% within 6 months of the beneficiaries' enrollment into their program. Another PCMH

  10. 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.

  11. Increasing the cost-effectiveness of telemedicine by embracing e-health.

    Science.gov (United States)

    Mitchell, J

    2000-01-01

    In 1999 a national study of telemedicine in Australia led to the promotion of the concept of 'e-health', the health sector's equivalent of 'e-commerce'. A new study explored the view that, with the convergence of technologies and the consequent increase in ability to perform multiple functions with those technologies, it is unwise to promote telemedicine in isolation from other uses of technologies in health-care. The major sources of information for the study were the presentations and discussions at five national workshops held to discuss the findings of the original report on telemedicine. Nineteen case studies were identified. The case studies showed that with the convergence of technologies telehealth is becoming part of e-health. The cost-effectiveness of both telehealth and telemedicine improves considerably when they are part of an integrated use of telecommunications and information technology in the health sector.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. Health system reforms in South America: an opportunity for UNASUR

    OpenAIRE

    Gomes-Temporão, José; Instituto Suramericano de Gobierno Salud (ISAGS/UNASUR). Rio de Janeiro, Brasil.; Faria, Mariana; Instituto Suramericano de Gobierno Salud (ISAGS/UNASUR). Rio de Janeiro, Brasil.

    2014-01-01

    Health systems in South America still support segmentation, privatization and fragmentation. Health reforms of the structural adjustment programs in the 1980s and 1990s in South America followed different purposes and strategies ranging from privatization, commodification and state intervention for the implementation of a national public health service with universal access as a right of the citizens. Since the 2000s, many countries have expanded social policies, reduced poverty and social in...

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

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

    Private funding - including out-of-pocket expenditure - is a considerable source of health financing in Latin America, where families can face economic ruin from catastrophic health expenses. Health system reforms have occurred at different times in various Latin American countries over the past few decades. Health ...

  18. Embracing the Dragon

    DEFF Research Database (Denmark)

    Munyi, Elijah Nyaga

    relations to arguing that time is auspicious for Africa to develop common policy measures to manage China and making provisional policy proposals on how to do that. The paper‟s argument is twofold; first, an incipient African disenchantment over China [as outlined in the post-FOCAC 2009 AU report] provides...... proposes pragmatic policies for embracing China – beyond praise or criticism....

  19. 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.

  20. [Social capital and health promotion in Latin America].

    Science.gov (United States)

    Sapag, Jaime C; Kawachi, Ichiro

    2007-02-01

    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.

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

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

    The book sheds light on important issues pertaining to accessibility and equity and, in its approach, sets precedents and provides guidelines for further comparative work on health care reform. Reshaping Health Care in Latin America will appeal to academics, scholars, researchers, and students in health sciences, policy ...

  2. Embracing the Dragon

    DEFF Research Database (Denmark)

    Munyi, Elijah Nyaga

    2012-01-01

    relations to arguing that time is just ripe for Africa to develop unified policy measures to manage China and making provisional policy proposals on how to do that. The paper’s hypothesis is twofold; first, an incipient African disenchantment over china [as outlined in the post-FOCAC 2009 AU report....... This paper proposes pragmatic policies for embracing china – beyond praise or criticism...

  3. Embracing Physical Literacy

    Science.gov (United States)

    Roetert, E. Paul; Jefferies, Stephen C.

    2014-01-01

    At the most recent SHAPE America National Convention held in St. Louis, MO, an international perspective of the term "physical literacy" was introduced. Experts representing North America, Europe, and Asia provided insight into the increased acceptance and implementation of the term. Since the terms "physical education" and…

  4. Insuring America's health: principles and recommendations

    National Research Council Canada - National Science Library

    Committee on the Consequences of Uninsurance; Board on Health Care Services; Institute of Medicine; National Academy of Sciences

    .... 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...

  5. 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......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...

  6. 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.

  7. 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

  8. [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

  9. 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…

  10. [Advancing public mental health research in Latin America].

    Science.gov (United States)

    Susser, Ezra

    2015-01-01

    This special issue on Mental Health of the Journal of the School of Medicine, represents a significant contribution to the advance of public mental health research and training in Latin America. The editors (as well as the authors) deserve much credit for having conceived and implemented the joint publication of these papers. In this brief introduction, I draw attention to four ways in which their effort is likely to accelerate progress in this field.

  11. [Geography and health: themes and perspectives in Latin America].

    Science.gov (United States)

    Iñiguez Rojas, L

    1998-01-01

    Relations between geography and health have been recognized since ancient times. Investigation of such relations has been characterized by isolated and scant efforts. This article aims to explore potential links between geography's theoretical and methodological frame of reference and knowledge and interpretation of the population's health. It approaches the antecedents of medical or health-related geography and the use of the theoretical and methodological framework of geographic space, as well as identifying alternatives for its implementation. Finally, it raises several points relating to current development in the relations between geography and health in Latin America, as well as alternatives for such development.

  12. [A framework for evaluating primary health care in Latin America].

    Science.gov (United States)

    Haggerty, Jeannie L; Yavich, Natalia; Báscolo, Ernesto Pablo

    2009-11-01

    To determine the relevancy of applying the Canadian primary health care (PHC) assessment strategy to Latin America and to propose any modifications that might be needed for reaching a consensus in Latin America. The Delphi method was used to reach a consensus among 29 experts engaged in PHC development or evaluation in Latin America. Four virtual sessions and a face-to-face meeting were held to discuss the PHC evaluation logic model and the seven goals and six conditioning factors that make up the Canadian strategy, as well as any questions regarding the evaluation and indicators. The relevance of each concept was ranked according to the perspective of the Latin American countries. The experts considered the Canadian strategy's objectives and conditioning factors to be highly relevant to assessing PHC in Latin America, though they acknowledged that additional modification would increase relevance. The chief suggestions were to create a PHC vision and mission, to include additional objectives and conditioning factors, and to rework the original set. The objectives that concerned coordination and integrated comprehensive care did not achieve a high degree of consensus because of ambiguities in the original text and multiple interpretations of statements regarding certain aspects of the evaluation. Considerable progress was made on the road to building a PHC evaluation framework for the Region of the Americas. Indicators and information-gathering tools, which can be appropriately and practically applied in diverse contexts, need to be developed.

  13. Children's health in Latin America: the influence of environmental exposures.

    Science.gov (United States)

    Laborde, Amalia; Tomasina, Fernando; Bianchi, Fabrizio; Bruné, 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; Suk, William A; Landrigan, Philip J

    2015-03-01

    Chronic diseases are increasing among children in Latin America. 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. Industrial development and urbanization are proceeding rapidly in Latin America, and environmental pollution has become widespread. Environmental threats to children's health include traditional hazards such as indoor air pollution and drinking-water contamination; the newer hazards of urban air pollution; toxic chemicals such as lead, asbestos, mercury, arsenic, and pesticides; hazardous and electronic waste; and climate change. The mix of traditional and modern hazards varies greatly across and within countries reflecting industrialization, urbanization, and socioeconomic forces. To control environmental threats to children's health in Latin America, WHO, including PAHO, will focus on the most highly prevalent and serious hazards-indoor and outdoor air pollution, water pollution, and toxic chemicals. Strategies for controlling these hazards include developing tracking data on regional trends in children's environmental health (CEH), building a network of Collaborating Centres, promoting biomedical research in CEH, building regional capacity, supporting development of evidence-based prevention policies, studying the economic costs of chronic diseases in children, and developing platforms for dialogue with relevant stakeholders.

  14. 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.

  15. Overcoming social segregation in health care in Latin America.

    Science.gov (United States)

    Cotlear, Daniel; Gómez-Dantés, Octavio; Knaul, Felicia; Atun, Rifat; Barreto, Ivana C H C; Cetrángolo, Oscar; Cueto, Marcos; Francke, Pedro; Frenz, Patricia; Guerrero, Ramiro; Lozano, Rafael; Marten, Robert; Sáenz, Rocío

    2015-03-28

    Latin America continues to segregate different social groups into separate health-system segments, including two separate public sector blocks: a well resourced social security for salaried workers and their families and a Ministry of Health serving poor and vulnerable people with low standards of quality and needing a frequently impoverishing payment at point of service. This segregation shows Latin America's longstanding economic and social inequality, cemented by an economic framework that predicted that economic growth would lead to rapid formalisation of the economy. Today, the institutional setup that organises the social segregation in health care is perceived, despite improved life expectancy and other advances, as a barrier to fulfilling the right to health, embodied in the legislation of many Latin American countries. This Series paper outlines four phases in the history of Latin American countries that explain the roots of segmentation in health care and describe three paths taken by countries seeking to overcome it: unification of the funds used to finance both social security and Ministry of Health services (one public payer); free choice of provider or insurer; and expansion of services to poor people and the non-salaried population by making explicit the health-care benefits to which all citizens are entitled. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. 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

  17. 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.

  18. 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.

  19. The meanings of universal health care in Latin America.

    Science.gov (United States)

    Clark, Mary A

    2015-02-01

    In Latin America, competing definitions of universal health care are found. Variants include traditional universalism, basic universalism, and minimal or residual universalism. These definitions are informed by European traditions, a renewed emphasis on equity among Latin American social policy experts, and World Bank strategy. This essay explores these definitions as well as areas of overlap and points of difference between and among them using examples from several Latin American countries. The most important difference concerns the preventive and curative services not covered by the benefits packages of minimal universal programs, a gap expected to grow increasingly costly for patients. Copyright © 2015 by Duke University Press.

  20. Child psychiatry and mental health in Latin America.

    Science.gov (United States)

    Oschilewsky, Rodrigo Chamorro; Gómez, Cristóbal Martínez; Belfort, Edgard

    2010-01-01

    The review of epidemiological studies of psychiatric disorders in children and teenagers in Latin America, is validated and updated in this article. The present article incorporates variants that are contributed from the neurosciences, which allow us to see difficulties as opportunities, across such mechanisms as the plasticity neuronal, trying to change paradigms, frequently pessimistic in this type of review, and we call for the active participation of all the scientific societies of our countries in the development of public policies, based on prevention, for the vulnerability of the rights of our children and teenagers suggesting a multidisciplinary boarding in mental health.

  1. 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.

  2. 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

  3. 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

  4. 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

  5. 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...... and its associated recommendations and standards definitions....

  6. 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.

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

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

    Influencing pro-poor telecommunications policy in Latin America. A research network on telecommunications policy is playing a significant role in influencing pro-poor ICT policies in Latin America. View moreInfluencing pro-poor telecommunications policy in Latin America ...

  8. 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...... 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...... 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...

  9. 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.

  10. Dengue: an escalating public health problem in Latin America.

    Science.gov (United States)

    Tapia-Conyer, Roberto; Betancourt-Cravioto, Miguel; Méndez-Galván, Jorge

    2012-05-01

    Dengue infection is a significant and escalating public health problem in Latin America. Its re-emergence and subsequent rise in the region over the past 50 years has largely been caused by a combination of a lack of political will, the radical growth of urban populations, migration flow and insufficient financial resources. Its increased incidence has been compounded by climate change, poor sanitation and extreme poverty, which lead to more breeding sites of the mosquito vector Aedes aegypti. In order to control dengue effectively, an integrated approach incorporating vector management and environmental and social solutions is required. To achieve success, these programmes require commitment and responses at both national and community level. The development of a vaccine is a vital tool in the fight against dengue. For successful introduction, those implementing vaccination need to be educated on the value of such a strategy. Effective political leadership, innovative financial mechanisms and co-operation across all disciplines, sectors and national borders are essential to eradication of the disease.

  11. 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.

  12. 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.

  13. 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

  14. 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

  15. Public e-Health Innovation and Equity in Latin America and the ...

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

    Providing equitable public health services in low-resource contexts requires locally relevant information. This is particularly true in Latin America and the Caribbean, where there is wide disparity in health services access and delivery. Electronic health has already demonstrated its usefulness in electronic health records and ...

  16. 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.

  17. Work and health in Latin America: results from the working conditions surveys of Colombia, Argentina, Chile, Central America and Uruguay.

    Science.gov (United States)

    Merino-Salazar, Pamela; Artazcoz, Lucía; Cornelio, Cecilia; Iñiguez, María José Itatí; Rojas, Marianela; Martínez-Iñigo, David; Vives, Alejandra; Funcasta, Lorena; Benavides, Fernando G

    2017-06-01

    To describe working and employment conditions, and health status between non-agricultural employees with a written contract from Colombia, Argentina, Chile, Central America and Uruguay. We compared data from the first working condition surveys (WCS) of Colombia, Argentina, Chile, Central America and Uruguay. For comparative purposes, we selected a subsample of 15 241 non-agricultural employees aged 18-64 years and working with a written contract. We calculated prevalences and 95% CIs for the selected variables on working and employment conditions, and health status, separated by sex. Across all countries, at least 40% of women and 58% of men worked >40 hours a week. The most prevalent exposures were repetitive movements, followed by noise and manual handling, especially among men. Psychosocial exposures were very common among both sexes. Workers in Chile (33.4% of women and 16.6% of men) and Central America (24.3% of women and 19.1% of men) were more likely to report poor self-perceived health and were least likely to do so in Colombia (5.5% of women and 4.2% of men). The percentage of workers reporting occupational injuries was work and health in different Latin American countries, based on the national WCSs available. This allows for a better understanding of occupational health and could serve as a baseline for future research and surveillance of work and health in the Region. However, greater efforts are needed to improve WCSs comparability. 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/.

  18. 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.

  19. The EMBRACE web service collection.

    Science.gov (United States)

    Pettifer, Steve; Ison, Jon; Kalas, Matús; Thorne, Dave; McDermott, Philip; Jonassen, Inge; Liaquat, Ali; Fernández, José M; Rodriguez, Jose M; Pisano, David G; Blanchet, Christophe; Uludag, Mahmut; Rice, Peter; Bartaseviciute, Edita; Rapacki, Kristoffer; Hekkelman, Maarten; Sand, Olivier; Stockinger, Heinz; Clegg, Andrew B; Bongcam-Rudloff, Erik; Salzemann, Jean; Breton, Vincent; Attwood, Teresa K; Cameron, Graham; Vriend, Gert

    2010-07-01

    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 and its associated recommendations and standards definitions.

  20. 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.

  1. Reforming America's health system through innovation and entrepreneurship.

    Science.gov (United States)

    Reece, Richard L

    2005-01-01

    America's attempts for healthcare reform are gridlocked. Healthcare special interests are reluctant to abandon profitable activities, and American culture-distrust of centralized federal power, belief in self-improvement, desire for choice, and belief in equal access to medical technologies-is slow to change. Physician entrepreneurship and innovation, coupled with consumer-driven healthcare and public-private partnerships, may break the present gridlock.

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

    Science.gov (United States)

    Cabieses, Baltica; Tunstall, Helena; Pickett, Kate E; Gideon, Jasmine

    2013-07-01

    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.

  3. 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.

  4. 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)

  5. [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.

  6. Providing primary health care through integrated microfinance and health services in Latin America.

    Science.gov (United States)

    Geissler, Kimberley H; Leatherman, Sheila

    2015-05-01

    The simultaneous burdens of communicable and chronic non-communicable diseases cause significant morbidity and mortality in middle-income countries. The poor are at particular risk, with lower access to health care and higher rates of avoidable mortality. Integrating health-related services with microfinance has been shown to improve health knowledge, behaviors, and access to appropriate health care. However, limited evidence is available on effects of fully integrating clinical health service delivery alongside microfinance services through large scale and sustained long-term programs. Using a conceptual model of health services access, we examine supply- and demand-side factors in a microfinance client population receiving integrated services. We conduct a case study using data from 2010 to 2012 of the design of a universal screening program and primary care services provided in conjunction with microfinance loans by Pro Mujer, a women's development organization in Latin America. The program operates in Argentina, Bolivia, Mexico, Nicaragua, and Peru. We analyze descriptive reports and administrative data for measures related to improving access to primary health services and management of chronic diseases. We find provision of preventive care is substantial, with an average of 13% of Pro Mujer clients being screened for cervical cancer each year, 21% receiving breast exams, 16% having a blood glucose measurement, 39% receiving a blood pressure measurement, and 46% having their body mass index calculated. This population, with more than half of those screened being overweight or obese and 9% of those screened having elevated glucose measures, has major risk factors for diabetes, high blood pressure, and cardiovascular disease without intervention. The components of the Pro Mujer health program address four dimensions of healthcare access: geographic accessibility, availability, affordability, and acceptability. Significant progress has been made to meet basic

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

    DEFF Research Database (Denmark)

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

    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......-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...... to the tropic areas. More studies are needed on seafaring and fishing for the prevention of health risks among fishermen and seafarers in Latin America. Key words Maritime Health, Accidents, Latin America, Fishing, Seafaring...

  8. [Comprehensive primary care and segmented health systems in South America].

    Science.gov (United States)

    Giovanella, Ligia; Almeida, Patty Fidelis de

    2017-10-02

    The article analyzes recent reforms in primary health care in the South American countries, discussing the scope and challenges for establishing comprehensive primary health care in the region's health systems. The data sources were case studies conducted in 12 countries, and the analytical lines were the strategic components in the design and implementation of primary health care: national policy approaches, characteristics of financing, organization and provision, and the workforce in primary health care. The crosscutting analysis from a comparative perspective provides an overview of primary health care in the region's countries and highlights convergences and asymmetries. A common trait is the recovery of the expanded definition of primary health care with family and community components, a territorial base, multidisciplinary team, incorporation of community health workers, and social participation. Implementation revealed heterogeneities in the advances and contradictions in the models. Insufficient supply of physicians, difficulties in provision and physician retention in remote and peripheral areas, as well as in primary health care itself, precarious employment relations, and absence of career plans are common problems, and there have been recent initiatives in government intervention to direct the workforce to the public system. Segmentation of the supply of primary health care converges with the segmentation of social protection in the various countries, through maintenance of social insurance or selective and targeted insurance or coverage by private health insurance, and persistent exclusion of populations from the right to health. The article argues that implementation of comprehensive primary health care is conditioned by the prevailing modalities of social protection in health.

  9. 400 Navels: The Future of School Health in America.

    Science.gov (United States)

    Cronin, Godfrey E.; Young, William M.

    This book tells the story of how one school system in a medically underserved community near Chicago conceived and implemented primary care health facilities in two of its schools to serve all the children of the school district. The key to the preventive health care plan is the use of specially trained school nurse practitioners and health aides…

  10. 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.

  11. 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.

  12. Central America Field Epidemiology Training Program (CA FETP): a pathway to sustainable public health capacity development

    OpenAIRE

    L?pez, Augusto; C?ceres, Victor M

    2008-01-01

    Abstract The Central America Field Epidemiology Training Program (CA FETP) is a public health capacity-building training programme aimed at developing high-caliber field epidemiologists at various levels of the public health system. It began in 2000 as part of the effort to rebuild public health infrastructure in six Central American and Caribbean countries following the devastation of Hurricanes Mitch and Georges in late 1998. Since then, the CA FETP has evolved from one regional training pr...

  13. The bottom quartile for health indices in America vs Europe.

    Science.gov (United States)

    Shandera, Wayne Xavier

    2014-01-01

    The inequities in health outcomes in different parts of the developed world merit further analysis. An index comprising mortality and morbidity factors was composed for American states and European nations. Multiple factors and bottom quartile status were analyzed by regression methodology. The 51 American states (and District of Columbia) showed a "Health Index" value based on life expectancy at birth and morbidity determined by rates of cardiac disease and cancer that ranged from 63 (Mississippi and West Virginia) to 94 (Utah). The 48 of 51 European states with assessable data showed a Health Index based on life expectancy at birth and quality adjusted life years that ranged from 53 (Russia) to 98 (San Marino). American states with the lowest quartile values were clustered in the American South and Appalachian areas. European states ranking in the bottom quartile were typically from Eastern Europe and showed a history of a Communism and recognized governmental corruption. Because American poor health rankings are the result of controllable factors (smoking, adult onset diabetes, obesity), Americans can improve their bottom quartile status more readily than Europeans whose ranking status is a function of history (Communism, civil conflicts) and poverty (Southeastern and Eastern nations). Copyright © 2014 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

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

    NARCIS (Netherlands)

    Córdova Pozo, K.; Chandra-Mouli, V.; Decat, P.; Nelson, E.; de Meyer, S.; Jaruseviciene, L.; Vega, B.; Segura, Z.; Auquilla, N.; Hagens, A.; van Braeckel, D.; Michielsen, K.

    2015-01-01

    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

  15. 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…

  16. 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, ...

  17. Financing health in Latin America : Household Spending and ...

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

    25 févr. 2013 ... Ecohealth Chair on Urban Air Pollution and Non-Communicable Respiratory Diseases (West Africa). Urban air pollution, indoors and outdoors, is a major worldwide health and environmental problem, particularly in Africa, where it is associated with economic activity, transportation, and the use.

  18. Sick Schools 2009: America's Continuing Environmental Health Crisis for Children

    Science.gov (United States)

    Healthy Schools Network, Inc., 2010

    2010-01-01

    Everybody knows that healthy school buildings contribute to student learning, reduce health and operating costs, and ultimately, increase school quality and competitiveness. However, 55 million of the nation's children attend public and private K-12 schools where poor air quality, hazardous chemicals and other unhealthy conditions make students…

  19. Health Consequences of Alcohol Use in Rural America.

    Science.gov (United States)

    Brody, Gene H.; Neubaum, Eileen; Boyd, Gayle M.; Dufour, Mary

    Results of three national surveys suggest that the prevalence of drinking was lower in nonmetropolitan areas than in metropolitan areas. However, nonmetro and metro areas were similar in the presence of risk for heavy, dependent, and problem drinking. Therefore, they probably share similar risks for health consequences of such levels of…

  20. 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...

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

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

    In the study's second step, researchers will pilot test an inter-sector approach. The aim is to promote municipal regulatory incentives for food and health systems, and community and workplace environments. Researchers will use a participatory methodology that involves multi-sector municipal committees, together with ...

  2. FINANCING HEALTH IN LATIN AMERICA • Volume 1

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

    © arte i diseño 2012

    reviewer who may quote brief passages in a review. Suggested citation: Knaul FM, Wong R, Arreola-Ornelas H. Household Spending and ...... rest of the volume by providing basic definitions and the general motivation for the study of financial protection in health in the region. From a practical point of view, financial ...

  3. Health care technology transfer in Latin America and the Caribbean

    NARCIS (Netherlands)

    Coe, G.A.; Banta, H.D.

    1992-01-01

    The greatest problem concerning health care technology for developing countries is that they are dependent upon the industrialized world for technology. The only short-term solution to this problem is to improve the choices that are available to them. This goal will require changes in the structure

  4. [Economic evaluations of health technologies: a global perspective for their implementation in Latin America].

    Science.gov (United States)

    Espinoza, Manuel; Castillo-Riquelme, Marianela; Zarate, Victor

    2011-01-01

    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.

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

    Science.gov (United States)

    Sartori, Ana Marli Christovam; Nascimento, Andréia de Fátima; Yuba, Tânia Yuka; Soárez, Patrícia Coelho de; Novaes, Hillegonda Maria Dutilh

    2015-01-01

    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. 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. 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. 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.

  6. 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.

  7. Descrição e análise do acolhimento: uma contribuição para o Programa de Saúde da Família Descripción y analisis del acogimiento: una contribuición para el Programa de Salud de la Familia Description and analysis of embracement: a contribution to Family Health Program

    Directory of Open Access Journals (Sweden)

    Lislaine Aparecida Fracolli

    2004-06-01

    Full Text Available O Programa de Saúde da Família prevê ações de saúde humanizadas, tecnicamente competentes e intersetorialmente articuladas, tornando fundamental "acolher". Este estudo objetivou identificar como se processa o "acolhimento" em Unidades de Saúde da Família, em São Paulo. Os sujeitos foram profissionais de saúde que realizavam "acolhimento" e os dados foram coletados através de observações e entrevistas. Os resultados apontaram que o "acolhimento" realiza uma escuta clínica, focalizada na queixa, com uma intervenção pontual, pouco resolutiva e não construtora de vínculo. É necessário repensar o "acolhimento", nos seus aspectos teóricos e práticos, para que este possa efetivamente se constituir em uma prática capaz de instaurar um modelo de saúde de "porta aberta" consoante com as diretrizes do SUS.El Programa de Salud de la Familia requiere atención humanizada y técnicamente competente, lo que hace fundamental "acoger". Este estudio tuvo como objetivo identificar el proceso de "acogimiento" en Unidades de Salud de la Familia en São Paulo, SP, Brasil. Los sujetos fueron profesionales que hacen el "acogimiento" y los datos fueron recolectados por medio de observaciones y entrevistas. Los resultados mostraron que el "acogimiento" realiza escucha clínica enfocada en la queja, con intervención limitada, poco resolutiva y que no construye vínculos. Es necesario repensar el "acogimiento", en sus aspectos teóricos y prácticos, para viabilizar el modelo de "puertas abiertas" como proponen las directrices del Sistema Único de Salud.The humanist and efficient healthcare required by the Family Health Program makes the "embracement" essential. This study aimed to identify how the "embracement" was developed at Family Healthcare Services in Sao Paulo, SP. Brazil. The authors observed several "embracement" links and interviewed healthcare professionals. The results pointed out the clinical and biological focuses of the

  8. Should the chiropractic profession embrace the doctrine of informed consent?

    Science.gov (United States)

    Lehman, James J.; Conwell, Timothy D.; Sherman, Paul R.

    2008-01-01

    Abstract This commentary provides a narrative review of the literature focusing on the use of a health care informed consent process in the United States. This article reviews the current positions of the World Medical Association, American Medical Association, American Chiropractic Association, Wisconsin and New Jersey State Courts, US Federal Government Office of Health Policy and Clinical Outcomes, and 1 college of chiropractic regarding the doctrine of informed consent. The authors recommend that the chiropractic profession embrace the doctrine of informed consent and promulgate it as a standard of care. The implementation of this doctrine by chiropractic physicians promotes and improves the safety of chiropractic interventions. PMID:19646372

  9. 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…

  10. Chikungunya in the region of the Americas. A challenge for rheumatologists and health care systems.

    Science.gov (United States)

    Pineda, Carlos; Muñoz-Louis, Roberto; Caballero-Uribe, Carlo V; Viasus, Diego

    2016-10-01

    At the end of 2013, the Pan American Health Organization issued an epidemiological alert due to the detection of the first local cases of Chikungunya in the Americas. By August 2015, autochthonous transmissions were detected in 33 countries and territories of the Americas. Latin America has reported nearly one million cases; only Colombia has issued a report of >200,000 cases during the first 4 months of 2015. In some Latin American and Caribbean countries, Chikungunya becomes a major public health problem. The disease commonly exhibits a self-limited course of arthritis, usually lasting for a few days or that may be prolonged to weeks; however, in 10-60 % of cases, joint pain may become chronic and persist for up to 3-5 years. Human-caused environmental changes, such as climate change, the globalization of international exchange, and disordered urban growth, are some factors that aid in its emergence and dissemination. Outbreaks of Chikungunya comprise a challenge for health care systems and rheumatologists because of the high attack rate on the population and the anticipated development of post-Chikungunya chronic rheumatism. This review emphasizes the rheumatologic clinical manifestations reported in the American continent and highlights the challenges that health care systems face in the absence of an effective vaccine and specific treatment to fight Chikungunya.

  11. 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.

  12. Connecting health-related quality of life and mental health in dementia caregivers from Colombia, South America.

    Science.gov (United States)

    Perrin, Paul B; Morgan, Matthew; Aretouli, Eleni; Sutter, Megan; Snipes, Daniel J; Hoyos, Guillermo Ramirez; Buraye, Jacqueline Arabia; Arango-Lasprilla, Juan Carlos

    2014-01-01

    Research in Caucasian populations has begun to examine the broad associations between physical and mental health in dementia caregivers. However, the examination of this relationship in Latin America is largely absent from the literature despite the fact that the region will see a major increase in dementia cases over the next 20 years. The current study examined the associations between health-related quality of life (HRQOL) and mental health in 90 dementia caregivers from Colombia, South America. A canonical correlation found that higher caregiver HRQOL was related to better mental health, as expected. Caregivers with high vitality and low role limitations due to physical problems tended to have low depression and high satisfaction with life. Follow-up multiple regressions found that caregiver role limitations due to physical problems was uniquely associated with satisfaction with life, whereas vitality, role limitations due to physical problems, and pain were uniquely associated with burden (although the pain effect was likely error due to a suppressor effect). Additionally, vitality and social functioning were uniquely negatively related to depression. Because of the extremely high overlap between these two sets of variables, dementia interventions are needed in Latin America that target both caregiver mental and physical health, as both likely operate in unison and influence each other.

  13. 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

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

    Science.gov (United States)

    Thow, Anne Marie; Hawkes, Corinna

    2009-01-01

    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 that preventive health

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

    OpenAIRE

    Sartori, Ana Marli Christovam; Nascimento, Andr?ia de F?tima; Yuba, T?nia Yuka; de So?rez, Patr?cia Coelho; Novaes, Hillegonda Maria Dutilh

    2015-01-01

    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 pu...

  16. 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.

  17. Some considerations on women's mental health in Latin America and the Caribbean.

    Science.gov (United States)

    Gaviria, Silvia L; Rondon, Marta B

    2010-01-01

    The mental health status of women in Latin America depends on several social determinants: unequal access to education and work and its benefits, as well as exposure to violence and lack of proper reproductive health impinge on women's psychological well-being. A review of the epidemiological studies on mental health in the region shows a paucity of gender disaggregated data which hinders analyses. However, depression and anxiety are twice as prevalent in women, post traumatic stress disorder is common in the regions that have been exposed to political violence, suicide is an important cause of death in the reproductive years and alcohol and drug use are increasing among younger women. Given the current risks for mental health for girls and women in the region, it is important that research in this area be fostered and it is even more important that gender as it relates to health be included in the curricula of health professionals.

  18. Sociocultural factors affecting reproductive health in latin america and the Caribbean.

    Science.gov (United States)

    Rice, M

    1991-01-01

    This article provides an overview of the socio-economic, health and fertility conditions in the countries of the Americas. Among those considered are GNP and annual growth and inflation rates, fertility rates, increasing urbanization, life expectancy at birth, infant and child mortality, and maternal mortality particularly due to complication from pregnancy and childbirth. Barriers for women and men on contraception use are discussed. Among the most important influencing factors are ethical and moral considerations, lack of access to information and supplies, women holding a lower status than men throughout Latin America and some parts of the Caribbean resulting in women's unregulated fertility, poor quality health services being available, and lower educational opportunities and levels than men. Additionally, the extremely poor quality of the interface women have with the health care system sends many of them away. Although a major proportion of pregnancies occur in adolescent women, no special provisions are made to provide education or services to this population. The article ends by proposing some alternative actions to improve options for contraceptive choices in the populations of Latin America and the Caribbean.

  19. 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.

  20. 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.

  1. 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.

  2. 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; de Uriza, Jacqueline Molina; Gutierrez, Nathaly Rozo

    2017-01-01

    Objective: 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. Method: quantitative, descriptive/exploratory, cross-sectional study carried out in 25 countries. Results: 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. Conclusion: 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. PMID:28513769

  3. Future challenges for parasitology: vector control and one health in the Americas.

    Science.gov (United States)

    Little, Susan E

    2013-08-01

    "One Health" is a term that encapsulates and underscores the inherent interrelatedness of the health of people, animals, and the environment. Vector-borne infections are central in one health. Many arthropod vectors readily feed on humans and other animals, serving as an ideal conduit to move pathogens between a wide spectrum of potential hosts. As ecological niches flux, opportunities arise for vectors to interact with novel species, allowing infectious agents to broaden both geographic and host ranges. Habitat change has been linked to the emergence of novel human and veterinary disease agents, and can dramatically facilitate expansion opportunities by allowing existing vector populations to flourish and by supporting the establishment of new pathogen maintenance systems. At the same time, control efforts can be hindered by the development of parasiticide and pesticide resistance, foiling efforts to meet these challenges. Using examples drawn from representative diseases important in one health in the Americas, including rickettsial infections, Lyme borreliosis, Chagas disease, and West Nile virus, this paper reviews key aspects of vector-borne disease maintenance cycles that present challenges for one health in the Americas, including emergence of vector-borne disease agents, the impact of habitat change on vector-borne disease transmission, and the complexities faced in developing effective control programs. Novel strategies will be required to effectively combat these infections in the future if we are to succeed in the goal of fostering an environment which supports healthy animals and healthy people. Copyright © 2013 Elsevier B.V. All rights reserved.

  4. 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

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

    OpenAIRE

    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 ...

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

    Science.gov (United States)

    Kiefer, Max; Rodríguez-Guzmán, Julietta; Watson, Joanna; van Wendel de Joode, Berna; Mergler, Donna; da Silva, Agnes Soares

    2016-09-01

    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.

  7. Capacity building in human resources for health: The experience of the region of the Americas.

    Science.gov (United States)

    Godue, Charles; Cameron, Rick; Borrell, Rosa Maria

    2016-12-27

    Since the year 2003, most countries of the Region of the Americas have experienced sustained economic growth and inclusive development policies. In the health sector, achieving universal access became the overarching goal. However, the structural limitations of the health workforce represented a formidable obstacle to change. National Health Authorities were confronted with the challenge of developing critical capacities to redress entrenched inequalities in access to qualified health personnel. Under the auspices of the Pan American Health Organization, the Ministers of Health of the Region adopted, in September 2007, twenty regional goals for Human Resources for Health 2007-2015, aligned with the renewed strategy of Primary Health Care. Subsequently, a set of indicators and a methodology were developed to assess the goals and to monitor progress at the country level. Fifteen countries carried out a baseline assessment in 2009 or 2010 and conducted a second assessment in 2013. Although differences were noted across goals and between countries, the results suggested improvements in all twenty goals overall. The goals linked to the distribution of personnel, the management of migration, and the cooperation with education institutions appeared to be more resilient to change. The twenty Regional Goals for Human Resources for Health provided a common vision for action and a framework for cooperation within and among countries, and was a catalyst for change. Faced with evolving challenges, the countries should consider adopting a new shared agenda that builds on progress made and further supports intergovernmental policy alignment and capacity building in health workforce development, governance and management.

  8. 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

  9. Collaborative mental health services in primary care systems in Latin America: contextualized evaluation needs and opportunities.

    Science.gov (United States)

    Sapag, Jaime C; Rush, Brian; Ferris, Lorraine E

    2016-02-01

    This study examined Latin American evaluation needs regarding the development of a collaborative mental health care (CMHC) evaluation framework as seen by local key health-care leaders and professionals. Potential implementation challenges and opportunities were also identified. This multisite research study used an embedded mixed methods approach in three public health networks in Mexico, Nicaragua and Chile. Local stakeholders participated: decision-makers in key informant interviews, front-line clinicians in focus groups and other stakeholders through a survey. The analysis was conducted within site and then across sites. A total of 22 semi-structured interviews, three focus groups and 27 questionnaires (52% response rate) were conducted. Participants recognized a strong need to evaluate different areas of CMHC in Latin America, including access, types and quality of services, human resources and outcomes related to mental disorders, including addiction. A priority was to evaluate collaboration within the health system, including the referral system. Issues of feasibility, including the weaknesses of information systems, were also identified. Local stakeholders strongly supported the development of a comprehensive evaluation framework for CMHC in Latin America and cited several dimensions and contextual factors critical for inclusion. Implementation must allow flexibility and adaptation to the local context. © 2015 John Wiley & Sons Ltd.

  10. Bioeconomy in Latin America.

    Science.gov (United States)

    Sasson, Albert; Malpica, Carlos

    2018-01-25

    This article provides the authors' view on how Latin America has embraced bioeconomy principles in the last two decades with different levels of socio-economic impact. Examples of biodiversity resource valorization in medicine, eco-intensification of agriculture, biotechnology applications in mature sectors such as mining, food and beverage production, bio-refineries and ecosystem services are provided. The importance of participatory and social innovation initiatives is highlighted. Copyright © 2017. Published by Elsevier B.V.

  11. 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.

  12. 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.

  13. 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.

  14. Urban air pollution in Latin America and the Caribbean: health perspectives.

    Science.gov (United States)

    Romieu, I; Weitzenfeld, H; Finkelman, J

    1990-01-01

    In the last few years, air pollution has become a major issue in some countries of Latin America and the Caribbean because of urban development and growing industrialization. In addition to industrial processes often concentrated in the cities, vehicle emission and stationary-source fuel combustion are the primary sources of air pollution. Although air-quality standards have been established in some Latin American countries, these are frequently exceeded. Adverse health effects of air pollution have been mainly associated with the following pollutants: sulfur dioxide and particulate matter, photochemical oxidants, nitrogen dioxide and carbon monoxide, and lead. Short-term as well as long-term effects can be expected at levels exceeding WHO guidelines. The Latin American urban areas most affected by anthropogenic pollutant emissions are: the area of São Paulo (Brazil), the city of Santiago (Chile) and the metropolitan area of Mexico City. However, situations similar to those prevailing in these cities could well occur in other cities of Latin America and the Caribbean. The population exposed to air-pollutant levels exceeding WHO guidelines can be estimated to 81 million or 26.5% of the total urban population of Latin America and 19% of its total population. These estimates correspond to 30 million children (0-14), 47 million adults (15-59) and 4 million elderly people (60+). To date a very limited number of epidemiological studies have been carried out to determine the potential health effects of air pollutants in Latin America. To obtain a rough estimate, a scenario was hypothesized in which subjects living in cities would be exposed to a given level of air pollutant, using data from the international literature to extrapolate the expected number of events in different strata of the hypothetical population. The estimated health effects are considerable and warrant priority control intervention. This is true although epidemiological studies are needed to evaluate

  15. [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.

  16. 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

  17. Gender, acculturative stress and Caribbean immigrants' health in the United States of America: an exploratory study.

    Science.gov (United States)

    Livingston, I L; Neita, M; Riviere, L; Livingston, S L

    2007-06-01

    Given that the health of many immigrants declines after increasing years in their host countries and that there may be gender differences in these experiences, this exploratory study's main objective was twofold: a) assess the relationship between acculturative stress and negative health (ie both mental and physical) and b) determine if there were any gender differences in these stress-health relationships. Gender-stratified analyses were conducted on a sample of 418 (males = 158, females = 260) English-speaking immigrants (the majority of whom were Jamaicans--males = 81%, females = 86%) that lived in the District of Columbia, Virginia, and Maryland (DC Metropolitan Area, United States of America (USA). Mail-order surveys were used to collect the data over a six-month period in 2002. Data for the main independent variable, acculturative stress, were collected using five indices (ie personal problems, group affiliations, adjustment to life in the USA, lonely feelings and feeling socially satisfied). Data for the major dependent variable, health, were collected using four indices (ie symptoms of depression, physical health conditions, the rating of one's health and the feeling of control one had over one's health). After controlling for selected covariates, both males (r = 0.42, p loneliness (r = .26, p < 0.05) had less symptoms of depression. These exploratory results suggest the potential importance of selected variables (eg personal problems and depression) in efforts at improving the health of Caribbean immigrants.

  18. 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.

  19. 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

  20. 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

  1. Effects of Stigma and Discrimination Reduction Trainings Conducted Under the California Mental Health Services Authority: An Evaluation of Disability Rights California and Mental Health America of California Trainings

    OpenAIRE

    Cerully, Jennifer L.; Collins, Rebecca L.; Wong, Eunice C.; Roth, Elizabeth; Marks, Joyce; Yu, Jennifer

    2016-01-01

    Describes the methods and results of a RAND evaluation of stigma and discrimination reduction trainings delivered by two program partners, Disability Rights California and Mental Health America of California.

  2. Evaluation dimensions for collaborative mental health services in primary care systems in latin america: results of a Delphi group.

    Science.gov (United States)

    Sapag, Jaime C; Rush, Brian; Barnsley, Jan

    2015-05-01

    This article presents the results of a Delphi group to identify the dimensions of an evaluation framework for collaborative mental health care (CMHC) in Latin America. A three-round Delphi process was implemented with 26 experts from Latin America and Canada to identify main areas of consensus, as well as disagreements, about the importance and feasibility of potential evaluation dimensions previously identified in Mexico, Nicaragua and Chile. Participants validated 40 evaluation dimensions. They strongly endorsed a comprehensive evaluation framework for CMHC in Latin America. This study represents a solid foundation for developing an evaluation framework for CMHC.

  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. Mental health services development in Latin America and the Caribbean: achievements, barriers and facilitating factors.

    Science.gov (United States)

    Caldas de Almeida, J M

    2013-03-01

    Mental health services reforms in Latin America and the Caribbean in the last 20 years have led to a significant improvement of mental health services. They also contributed to the development of new evidence that may help the implementation of future reforms. These advances, however, were clearly insufficient to respond to the huge challenges countries of Latin American and the Caribbean face to improve mental health services. Insufficient funding, one of the most important barriers to mental health services development found in most countries, was related to the absence of a strong consensus among all stakeholders and the weakness of user and family associations. Other barriers were the lack of technical capacity of the coordination unit responsible for development of services in the ministries of health, resistance from professionals towards changing to new models of care and lack of human resources. Transition to democracy in some countries and natural disasters proved to be windows of opportunity for mental health services reform. Facilitating factors included alliance with the human rights defence movement, development of research capacity in Latin American and the Caribbean countries, and international cooperation.

  5. Update on disparities in oral health and access to dental care for America's children.

    Science.gov (United States)

    Edelstein, Burton L; Chinn, Courtney H

    2009-01-01

    This contribution updates federal survey findings on children's oral health and dental care since release of Oral Health in America: A Report of the Surgeon General in 2000. Dental caries experience continued at high levels, impacting 40% of all children aged 2 to 11 years, with greater disease and untreated disease burden borne by poor and low-income children and racial/ethnic minorities. Caries rates increased for young children (to 28% of 2- to 5-year-olds in the period 1999-2004) and remained flat for most other ages. The total volume of caries and untreated caries increased as the numbers of children increased. The proportion of US children with a dental visit increased modestly (from 42% to 45% between 1996 and 2004), with the greatest increases occurring among children newly covered by the State Children's Health Insurance Program (SCHIP). Disparities in dental visits continued to be evidenced by age, family income, race/ethnicity, and caregiver education. Parental reports of children's oral health and dental care parallel these findings and also reveal higher unmet dental needs among children with special health care needs. Racial- and income-based disparities in both oral health and dental care continue into adolescence and young adulthood. These disparities can, as in the past, be expected to exacerbate under the forces of growing income disparities and demographic trends.

  6. 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.

  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. The Need to Promote Sexual Health in America: A New Vision for Public Health Action.

    Science.gov (United States)

    Ford, Jessie V; Ivankovich, Megan B; Douglas, John M; Hook, Edward W; Barclay, Lynn; Elders, Joycelyn; Satcher, David; Coleman, Eli

    2017-10-01

    Sexual health is considered to be a state of wellness with physical, emotional, mental, and social dimensions. Sexual health can contribute to our overall well-being in each of these dimensions. However, despite the intrinsic importance and positive aspects of sexuality in our lives, the United States presently faces significant challenges related to the sexual health of its citizens, including human immunodeficiency virus, other sexually transmitted infections, viral hepatitis, unintended pregnancies, sexual violence, sexual dysfunction, and cancers in reproductive tracts with serious disparities among the populations affected. In particular, high rates of poverty, income inequality, low educational attainment, stigma, racism, sexism, and homophobia can make it more difficult for some individuals and communities to protect their sexual health. Given that many pressing public health issues in the United States are related to sexual health and that sexual health has been increasingly recognized as an important national health priority, now is the time to energize and focus our efforts toward optimal sexual health of the population. In this paper, we outline the rationale for addressing sexual health as a means to better promote overall health and address sexuality related morbidities. In addition, we present a logic model outlining an approach for advancing sexual health in the United States, as well as a range of action steps for consideration by public health practitioners, researchers, and policymakers.

  9. Central America Field Epidemiology Training Program (CA FETP): a pathway to sustainable public health capacity development.

    Science.gov (United States)

    López, Augusto; Cáceres, Victor M

    2008-12-16

    The Central America Field Epidemiology Training Program (CA FETP) is a public health capacity-building training programme aimed at developing high-caliber field epidemiologists at various levels of the public health system. It began in 2000 as part of the effort to rebuild public health infrastructure in six Central American and Caribbean countries following the devastation of Hurricanes Mitch and Georges in late 1998. Since then, the CA FETP has evolved from one regional training programme managed by CDC to several national FETPs with each country assuming ownership of its domestic programme. The curriculum is competency-based, and is divided into a three-tiered training pyramid that corresponds to the needs at the local, district and central levels of the health system. Trainees at each tier spend about 20% of their time in the classroom and 80% in the field implementing what they have learned while being mentored by graduates of the programme. FETP trainees have responded to multiple natural disasters and conducted hundreds of investigations including surveillance evaluations, outbreak responses and planned studies. Also graduates of the CA FETP are assuming influential positions in their respective ministries. As countries meet the challenge of institutionalizing their programmes, the CA FETP concept will increasingly be recognized as a model for sustainable public health capacity development.

  10. Central America Field Epidemiology Training Program (CA FETP: a pathway to sustainable public health capacity development

    Directory of Open Access Journals (Sweden)

    Cáceres Victor M

    2008-12-01

    Full Text Available Abstract The Central America Field Epidemiology Training Program (CA FETP is a public health capacity-building training programme aimed at developing high-caliber field epidemiologists at various levels of the public health system. It began in 2000 as part of the effort to rebuild public health infrastructure in six Central American and Caribbean countries following the devastation of Hurricanes Mitch and Georges in late 1998. Since then, the CA FETP has evolved from one regional training programme managed by CDC to several national FETPs with each country assuming ownership of its domestic programme. The curriculum is competency-based, and is divided into a three-tiered training pyramid that corresponds to the needs at the local, district and central levels of the health system. Trainees at each tier spend about 20% of their time in the classroom and 80% in the field implementing what they have learned while being mentored by graduates of the programme. FETP trainees have responded to multiple natural disasters and conducted hundreds of investigations including surveillance evaluations, outbreak responses and planned studies. Also graduates of the CA FETP are assuming influential positions in their respective ministries. As countries meet the challenge of institutionalizing their programmes, the CA FETP concept will increasingly be recognized as a model for sustainable public health capacity development.

  11. Escherichia coli diseases in Latin America-a 'One Health' multidisciplinary approach.

    Science.gov (United States)

    Torres, Alfredo G

    2017-03-01

    The emergence and evolution of pathogenic Escherichia coli strains associated with animal and human infections continues being a topic of active investigation in recent years. Latin America has responded to this thread establishing the Latin American Coalition for Escherichia coli Research (LACER), a multidisciplinary group of scientists applying principles of the One Health initiative. LACER is integrating animal, human and environmental health for the mutual benefit of all, while reducing the impact of human disease. Here, I depict the usefulness of this approach by providing three examples from several priority areas in E. coli research and comparing them to the activities performed by LACER, which are enhancing collaborative efforts in biomedical research and providing a translational platform to connect with epidemiological studies and public health policy makers. The manuscript concludes with a brief historical description regarding the establishment of LACER, emphasizing the importance of collaboration between health professionals of different international organizations and not only across one specific country, to effectively combat current and future E. coli infections. The benefits of utilizing 'One Health' concepts in the establishment of LACER should encourage other professionals studying zoonotic or environmentally acquired human infections to implement effective international collaborations to combat common problems. © FEMS 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. 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.

  13. [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

  14. 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

  15. 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

  16. 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.

  17. [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.

  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. 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.

  20. [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.

  1. 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

    2010-01-01

    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. PMID:15779471

  2. 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

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

    Science.gov (United States)

    Champlin, Sara; James, Juli

    2017-11-16

    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. 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. A total of 72 (N=72) participants completed in-person, individual gaming sessions. Participants completed a survey before and after game play. 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); t 71 =-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); t 31 =-3.61, P=.001. Significant differences from pre- to postgame play differed by health insurance term. 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. ©Sara Champlin, Juli James. Originally published in JMIR Serious Games (http://games.jmir.org), 16.11.2017.

  4. [Animal production and animal health and their relationship with veterinary public health in Latin America and the Caribbean].

    Science.gov (United States)

    Casas Olascoaga, R; Rosenberg, F J; Astudillo, V M

    1991-12-01

    The authors analyse the relationships which exist, in terms of programmes, sectors and institutions, between animal health, animal production and veterinary public health on the one hand, and between each of these three sectors and public health in general on the other. The most important common factor is food safety. Undernutrition, which affects some 60 million inhabitants of Latin America and the Caribbean, is still the most important public health problem in this part of the world. While it is known that the major cause of undernutrition is the low gross domestic product and uneven distribution of wealth, increased animal production and productivity would provide the key to an improvement in the situation. The concept of animal health, in its broadest sense, implies optimum animal production in a given region and during a specified period of time. Veterinary public health has functions and objectives which are crucial for food safety: protection and hygiene of foods, and control of the use in animal production of substances toxic to human beings (such as heavy metals, hormones and insecticides). Within the area of transmissible diseases, the authors discuss control measures for zoonoses. Besides the specific subject of interdisciplinary relationships in regard to zoonoses, the authors stress the importance of joint work conducted in the research, development and implementation of laboratory diagnostic activities and the production and quality control of antigens and vaccines. The production of laboratory animals is another sphere of common activity and research, and it cannot be said that such work is specific to any one of the three disciplines. Moreover, the fields of health, animal health and veterinary public health share the same methods and strategies, and reciprocal benefits could be more significant than the objectives of individual programmes. Reference is made to the organisation of state services and their adaptation to administrative de

  5. The Mental Health of Rural America: The Rural Programs of the National Institute of Mental Health.

    Science.gov (United States)

    Yahraes, Herbert; And Others

    Prepared by the National Institute of Mental Health staff and grantees, this report gives not only the quantitative research data, but also demonstrations of community mental health efforts that serve as excellent models for other communities to follow. Chapter I presents An Introduction: The Setting and an Overview; Chapter II, Studies of Rural…

  6. 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.

  7. 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) ...

  8. 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

  9. Embracing the family member the person in psychic suffering in nursing studies

    Directory of Open Access Journals (Sweden)

    Cristiene Barbosa Lima

    2014-09-01

    Full Text Available Objective: To evidence knowledge published in the field of nursing care on the embracement to family members of people in psychic suffering in health services. Methods: Integrative review, accomplished in June and July 2012, in LILACS, BDENF, IBECS, MEDLINE and SciELO databases, using the keywords: “mental health”, “user embracement” and “family”. The inclusion criteria were met by 14 texts, written by professionals and nursing students, in Portuguese language, published between 2007 and 2011. The data was resumed in four tables and a figure, and analyzed under the framework of the user embracement by the National Humanization Policy. Results: No trends related to studies on user embracement can be stated. Most publications adopt a qualitative approach and content analysis, with evidence being type III. There is a predominance of research having health professionals as subjects. However, the family and other actors are starting to get involved. Taking similar care of the family and the person in suffering is highlighted in all of the studies analyzed. It was evidenced need for interaction between the health services and the specialized mental health network and for training the team in order to minimize to the difficulties faced by the family. Conclusion: Family embracement was often pointed as a device that facilitates the rehabilitation. There is much to be done toward its embracement in health services, so that the family is allowed to realize that their living is not necessarily the continuity of the trouble faced by the other person. doi:http://dx.doi.org/10.5020/18061230.2013.p571

  10. National Bone Health Alliance: an innovative public-private partnership improving America's bone health.

    Science.gov (United States)

    Lee, David B; Lowden, Mia Rochelle; Patmintra, Valerie; Stevenson, Katie

    2013-12-01

    The U.S. National Bone Health Alliance (NBHA) is a public-private partnership launched in 2010 that brings together its 56 partners from the government, nonprofit, and for-profit sectors to collectively promote bone health and prevent disease; improve bone disease diagnosis and treatment; and enhance bone research, surveillance, and evaluation. NBHA is driven to achieve its 20/20 vision to reduce fractures 20 % by the year 2020 through projects including 2Million2Many, an osteoporosis awareness campaign; Fracture Prevention CENTRAL, an online resource center providing support to sites interested in launching a secondary fracture prevention program; bone turnover marker standardization project; and working groups in rare bone disease and the clinical diagnosis of osteoporosis. NBHA provides a platform to coordinate messaging among individuals and organizations on subjects important to bone health; pool funding and efforts around shared priorities; and work together towards the goals and recommendations of the National Action Plan on Bone Health.

  11. Housing, urban development and health in Latin America: contrasts, inequalities and challenges.

    Science.gov (United States)

    Comarú, Francisco de Assis; Westphal, Marcia Faria

    2004-01-01

    Since the outset of the 20th century, growing urbanization and its contingent waxing populations in Latin America, including Brazil, have come to have alarming effects on the conditions of life, especially in the areas of housing and healthcare for such populations. In this paper, we present data describing and qualifying the process of urbanization and its consequences for Latin American countries and certain Brazilian cities. Arguments are presented about the effects of the urbanization process and the development of low-income human settlements (slums known as favelas and squatting in tenement housing) on health conditions, diseases, and the death rate. The first part of the paper is based on secondary and quantitative data about urbanization, housing, and health in Brazilian and other Latin American cities. Governmental and nongovernmental data are used to structure the problematic landscape of the Latin American region. In the second part of the paper, we focus on a case study of a Brazilian coast city that has registered an intense population growth. This study demonstrates that urban policy (housing, environmental, sanitation, and urban transportation) requires an integration of health and environmental public policy and demonstrates the importance of the role of popular participation in urban public policy-making, and the potential importance of the Bertiioga Healthy City Project from the perspective of a better integration of actions, policies, and programs.

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

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    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.

  13. Environment, health, and gender in Latin America: trends and research issues.

    Science.gov (United States)

    Wasserman, E

    1999-04-01

    Over the past several decades, Latin America underwent rapid urbanization, a demographic shift led by women. Women now make up almost half of the economically active population and the feminization of urban poverty is being reported as well. The majority of men and women now work in unregulated, unorganized "informal" and nontraditional industries and services lacking occupational and environmental regulations. There is a marked paucity of health studies examining possible hazardous exposures, especially where gender-based social etiologies are concerned. This is true even in concentrated industries such as manufacturing assembly plants and in potentially hazardous occupations in mining and nontraditional agricultural exports, for which data from other disciplines are available and raise serious concerns. The need to ensure enough jobs at sufficient levels of income to alleviate poverty will remain a major challenge at the turn of the century and the environmental health implications of doing so could be far-reaching. What data are available and, more strikingly, the paucity of published epidemiologic studies warrant deep concern and support calls for urgent, multidisciplinary research into the health effects of the combined, multiple assaults of hazardous industrial waste, inadequate water and sewage treatment, and occupational exposures. Given the complex and varied work roles of women, the information reviewed also points to the need to conduct such research in the region within a social-etiologic framework of gender analysis. Copyright 1999 Academic Press.

  14. 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;…

  15. 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.

  16. 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

  17. 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

  18. 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...

  19. 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

  20. 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

  1. "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…

  2. Embracing changes: adaptation by adolescents with cancer.

    Science.gov (United States)

    Ramini, Sasha Kareema; Brown, Richard; Buckner, Ellen B

    2008-01-01

    The purpose of this study was to use the Roy Adaptation Model (RAM) to examine adaptive strategies of adolescents with cancer. This theory-based, descriptive study was conducted through a children's hematology/oncology clinic. Investigator-designed open-ended interview questions were generated based on the four adaptive modes--physiological, self-concept, role function, and interdependence. Respondents included adolescents and young adults who had experienced cancer as adolescents. Adolescents and young adults reported evidences of positive adaptation. Experiences congruent with the adaptive modes included responding to uncontrolled nausea, embracing changes, wanting to feel normal, having the support and protection of family, and feeling increased psychosocial maturation. Respondents reported creatively managing bodily changes, keeping positive attitudes, and demonstrating psychosocial maturation. Practice implications highlight the imperative for nurses to listen to patients in the evaluation of care. In addition, establishing survivor clinics, structuring peer support, and encouraging involvement in activities such as cancer camps can facilitate adaptation. Through the crisis of cancer, the adolescent's voice can shape the direction for nursing care.

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

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    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

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

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    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.

  6. 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 (pinflation rate was associated with significant deteriorations (pinflation, significant deteriorations (pinflation. 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. 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/

  7. Stigma towards mental illness and substance use issues in primary health care: Challenges and opportunities for Latin America.

    Science.gov (United States)

    Sapag, Jaime C; Sena, Brena F; Bustamante, Inés V; Bobbili, Sireesha J; Velasco, Paola R; Mascayano, Franco; Alvarado, Rubén; Khenti, Akwatu

    2017-08-02

    Stigma towards mental illness and addictive disorders is a global problem and one of the main obstacles in tackling this issue remains the effective integration of mental health services into primary health care (PHC). In Latin America, information has significantly increased on the existence of stigma; however, little is known about effective interventions to prevent stigma and promote recovery-oriented practices in PHC. The aim of this study is to understand the existing evidence regarding mental health stigma in PHC with a special focus on the Latin American region. A scoping review of the literature related to mental health stigma in PHC was conducted. Two hundred and seventeen articles were evaluated; 74 met inclusion criteria and 14 additional articles were selected from references of search results. Results were subdivided into five different perspectives: users, family members and significant others, health professionals, contextual factors, and potential effective interventions. Only nine studies were based in Latin America, and only one described an intervention to reduce stigma in mental health services, not specifically in PHC. We found an urgent need to develop interventions to understand and reduce stigma in PHC settings, especially in Latin America.

  8. 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

  9. Color studio in crisis: embracing change

    Science.gov (United States)

    Smith, Dianne

    2002-06-01

    Teaching color to students of architecture and design within the higher education sector is becoming more of a luxury than of core business. With increasing financial demands, reduced resources, and increasing student numbers, educators are required to think laterally to cater for change without sacrificing learning objectives. This paper raises some of the issues involved in the educative climate within one Australian university setting. Using a reflective narrative, educational objectives are defined, the implementation of new modes of 'teaching' as a means of coping with higher student numbers and reduced staffing and technical resources are described, and the outcomes in terms of student learning over an eight year period are critiqued. Institutional management policy is forcing the educator to re-evaluate the value of the traditional studio, and the intensive 'hands- on' interactive approach that traditionally is integral to such an approach. As curriculum development involves not only theory and project work, the classroom culture, the physical environment and the University and School context need to be addressed. Generic skills, in association with professional knowledge and skills, should be addressed, and therefore, opportunities for teaching a traditionally studio-based subject on-line as a computer based unit would appear to be limited. This discussion aims to pose questions, as well as reflecting upon successes and failures in this area of education within the University context. There is a need to embrace the contextual demands while ensuring that the student knowledge of color , and the joy of discovering its characteristics in practice, are not sacrificed but enhanced.

  10. Towards the construction of health workforce metrics for Latin America and the Caribbean

    Directory of Open Access Journals (Sweden)

    Carrasco Victor V

    2011-10-01

    Full Text Available Abstract Introduction One of the components of the Health Observatory for Latin American and the Caribbean (HO-LAC is the design and implementation of metrics for human resources for health. Under the HO-LAC initiative, researchers from nine countries in the region formed the Collaborative Community on Human Resources for Health in Latin America and the Caribbean to identify common metrics applicable to the field of human resources for health (HRH. Case description The case description comprises three stages: a the origins of an initiative in which a non-governmental organization brings together researchers involved in HRH policy in LAC, b a literature search to identify initiatives to develop methods and metrics to assess the HRH field in the region, and c subsequent discussions held by the group of researchers regarding the possibilities of identifying an appropriate set of metrics and indicators to assess HRH throughout the region. Discussion and evaluation A total of 101 documents produced between 1985 and 2008 in the LAC region were identified. Thirty-three of the papers included a variety of measurements comprising counts, percentages, proportions, indicators, averages and metrics, but only 13 were able to fully describe the methods used to identify these metrics and indicators. Of the 33 articles with measurements, 47% addressed labor market issues, 25% were about working conditions, 23% were on HRH training and 5% addressed regulations. Based on these results, through iterative discussions, metrics were defined into three broad categories (training, labor market and working conditions and available sources of information for their estimation were proposed. While only three of the countries have data on working conditions, all countries have sufficient data to measure at least one aspect of HRH training and the HRH labor market. Conclusions Information gleaned from HRH metrics makes it possible to carry out comparisons on a determined

  11. Towards the construction of health workforce metrics for Latin America and the Caribbean.

    Science.gov (United States)

    Nigenda, Gustavo G; Machado, Maria H; Ruiz, Fernando F; Carrasco, Victor V; Moliné, Patricia P; Girardi, Sabado S

    2011-10-14

    One of the components of the Health Observatory for Latin American and the Caribbean (HO-LAC) is the design and implementation of metrics for human resources for health. Under the HO-LAC initiative, researchers from nine countries in the region formed the Collaborative Community on Human Resources for Health in Latin America and the Caribbean to identify common metrics applicable to the field of human resources for health (HRH). The case description comprises three stages: a) the origins of an initiative in which a non-governmental organization brings together researchers involved in HRH policy in LAC, b) a literature search to identify initiatives to develop methods and metrics to assess the HRH field in the region, and c) subsequent discussions held by the group of researchers regarding the possibilities of identifying an appropriate set of metrics and indicators to assess HRH throughout the region. A total of 101 documents produced between 1985 and 2008 in the LAC region were identified. Thirty-three of the papers included a variety of measurements comprising counts, percentages, proportions, indicators, averages and metrics, but only 13 were able to fully describe the methods used to identify these metrics and indicators. Of the 33 articles with measurements, 47% addressed labor market issues, 25% were about working conditions, 23% were on HRH training and 5% addressed regulations. Based on these results, through iterative discussions, metrics were defined into three broad categories (training, labor market and working conditions) and available sources of information for their estimation were proposed. While only three of the countries have data on working conditions, all countries have sufficient data to measure at least one aspect of HRH training and the HRH labor market. Information gleaned from HRH metrics makes it possible to carry out comparisons on a determined experience in space and time, in a given country and/or region. The results should then

  12. [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

  13. 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

  14. Potential intussusception risk versus health benefits from rotavirus vaccination in Latin America.

    Science.gov (United States)

    Desai, Rishi; Parashar, Umesh D; Lopman, Benjamin; de Oliveira, Lucia Helena; Clark, Andrew D; Sanderson, Colin F B; Tate, Jacqueline E; Matus, Cuahtemoc Ruiz; Andrus, Jon K; Patel, Manish M

    2012-05-01

    With the recent postlicensure identification of an increased risk of intussusception with rotavirus vaccine, the 14 Latin American countries currently using rotavirus vaccine must now weigh the health benefits versus risks to assess whether to continue vaccination. To inform policy considerations, we estimated excess intussusception cases and mortality potentially caused by rotavirus vaccine for each of the 14 countries and compared these estimates to hospitalizations and deaths expected to be averted through vaccination. We used regional rotavirus disease burden and rotavirus vaccine efficacy data, global natural intussusception and regional rotavirus vaccine-related risk estimates, and country-specific diphtheria, tetanus, and pertussus vaccination coverage rates to estimate rotavirus vaccine coverage rates. We performed a probabilistic sensitivity analysis to account for uncertainty in these parameters. For an aggregate hypothetical birth cohort of 9.5 million infants in these 14 countries, rotavirus vaccine would annually prevent 144 746 (90% confidence interval [CI], 128 821-156 707) hospitalizations and 4124 deaths (90% CI, 3740-4239) due to rotavirus in their first 5 years of life but could cause an additional 172 hospitalizations (90% CI, 126-293) and 10 deaths (90% CI, 6-17) due to intussusception, yielding benefit-risk ratios for hospitalization and death of 841:1 (90% CI, 479:1 to 1142:1) and 395:1 (90% CI, 207:1 to 526:1), respectively. In an uncertainty analysis using 10 000 simulations of our probabilistic parameters, in comparing rotavirus disease averted to intussusception events caused, the hospitalization ratio was never below 100:1, and our death ratio fell below 100:1 only once. The health benefits of vaccination far outweigh the short-term risks and support continued rotavirus vaccination in Latin America.

  15. [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;

  16. 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

  17. 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.

  18. 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.

  19. Public health impact and economic benefits of quadrivalent influenza vaccine in Latin America.

    Science.gov (United States)

    Jamotte, Aurélien; Clay, Emilie; Macabeo, Bérengère; Caicedo, Andrès; Lopez, Juan Guillermo; Bricks, Lucia; Romero Prada, Martín; Marrugo, Rubén; Alfonso, Pamela; Moreno Arévalo, Brechla; Franco, Danilo; Garcia Diaz, Lourdes; Isaza de Molto, Yadira

    2017-04-03

    Annual trivalent influenza vaccines (TIV) containing 2 A strains and one B lineage have been recommended for the prevention of influenza in most of Latin American countries. However, the circulation of 2 B lineages (Victoria and Yamagata) and difficulties in predicting the predominating lineage have led to the development of quadrivalent influenza vaccines (QIV), including both B lineages. Thus, the objective was to estimate the public health impact and influenza-related costs if QIV would have been used instead of TIV in 3 Latin American countries. We used a static model over the seasons 2010-2014 in Brazil, 2007-2014 in Colombia and 2006-2014 in Panama, focusing on population groups targeted by local vaccination recommendations: young children, adults with risk factors and the elderly. In Brazil, between 2010 and 2014, using QIV instead of TIV would have avoided US$ 6,200 per 100,000 person-years in societal costs, based on 168 influenza cases, 89 consultations, 3.2 hospitalizations and 0.38 deaths per 100,000 person-years. In Colombia and Panama, these would have ranged from US$ 1,000 to 12,700 (based on 34 cases, 13-25 consultations, 0.6-8.9 hospitalizations and 0.04-1.74 deaths) and from US$ 3,000 to 33,700 (based on 113 cases, 55-82 consultations, 0.5-27.8 hospitalizations and 0.08-6.87 deaths) per 100,000 person-years, respectively. Overall, the broader protection offered by QIV would have reduced the influenza humanistic and economic burden in the 3 countries. Despite the lack of local data leading to several extrapolations, this study is the first to give quantitative estimates of the potential benefits of QIV in Latin America.

  20. Public health impact and economic benefits of quadrivalent influenza vaccine in Latin America

    Science.gov (United States)

    Jamotte, Aurélien; Clay, Emilie; Macabeo, Bérengère; Caicedo, Andrès; Lopez, Juan Guillermo; Bricks, Lucia; Romero Prada, Martín; Marrugo, Rubén; Alfonso, Pamela; Moreno Arévalo, Brechla; Franco, Danilo; Garcia Diaz, Lourdes; Isaza de Molto, Yadira

    2017-01-01

    ABSTRACT Annual trivalent influenza vaccines (TIV) containing 2 A strains and one B lineage have been recommended for the prevention of influenza in most of Latin American countries. However, the circulation of 2 B lineages (Victoria and Yamagata) and difficulties in predicting the predominating lineage have led to the development of quadrivalent influenza vaccines (QIV), including both B lineages. Thus, the objective was to estimate the public health impact and influenza-related costs if QIV would have been used instead of TIV in 3 Latin American countries. We used a static model over the seasons 2010–2014 in Brazil, 2007–2014 in Colombia and 2006–2014 in Panama, focusing on population groups targeted by local vaccination recommendations: young children, adults with risk factors and the elderly. In Brazil, between 2010 and 2014, using QIV instead of TIV would have avoided US$ 6,200 per 100,000 person-years in societal costs, based on 168 influenza cases, 89 consultations, 3.2 hospitalizations and 0.38 deaths per 100,000 person-years. In Colombia and Panama, these would have ranged from US$ 1,000 to 12,700 (based on 34 cases, 13–25 consultations, 0.6–8.9 hospitalizations and 0.04–1.74 deaths) and from US$ 3,000 to 33,700 (based on 113 cases, 55–82 consultations, 0.5–27.8 hospitalizations and 0.08–6.87 deaths) per 100,000 person-years, respectively. Overall, the broader protection offered by QIV would have reduced the influenza humanistic and economic burden in the 3 countries. Despite the lack of local data leading to several extrapolations, this study is the first to give quantitative estimates of the potential benefits of QIV in Latin America. PMID:28118092

  1. 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

  2. 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

  3. Cardiovascular health in the Americas: facts, priorities and the UN high-level meeting on non-communicable diseases.

    Science.gov (United States)

    Ordúñez, Pedro

    2011-10-01

    Population aging, smoking, unhealthy diet and physical inactivity, in the context of globalization and unregulated urbanization, explain the high prevalences of hypertension, hypercholesterolemia and diabetes in the Americas, making cardiovascular diseases the main cause of death. Moreover, cardiovascular diseases and their risk factors disproportionately affect the poorest people, obstructing antipoverty efforts and further deepening health and other inequities. The global crisis of chronic non-communicable diseases has reached such proportions that the UN General Assembly called a high-level meeting in September 2011 to address the issue as one of human development, aiming to stimulate political commitment to a concerted global effort to stem the pandemic. In reference to the Americas, this article reviews the burden of cardiovascular diseases and describes priorities for strategies and action in the region and their relation to the results of the UN meeting.

  4. Inequalities in health in Latin America and the Caribbean: descriptive and exploratory results for self-reported health problems and health care in twelve countries

    Directory of Open Access Journals (Sweden)

    J. Norberto W. Dachs

    2002-06-01

    Full Text Available Objective. To explore and describe inequalities in health and use of health care as revealed by self-report in 12 countries of Latin America and the Caribbean. Methods. A descriptive and exploratory study was performed based on the responses to questions on health and health care utilization that were included in general purpose household surveys. Inequalities are described by quintile of household expenditures (or income per capita, sex, age group (children, adults, and older adults, and place of residence (urban vs. rural area. For those who sought health care, median polishing was performed by economic status and sex, for the three age groups. Results. Although the study is exploratory and descriptive, its findings show large economic gradients in health care utilization in these countries, with generally small differences between males and females and higher percentages of women seeking health care than men, although there were some exceptions among the lower economic strata in urban areas. Conclusions. Inequalities in self-reported health problems among the different economic strata were small, and such problems were usually more common among women than men. The presence of small inequalities may be due to cultural and social differences in the perception of health. However, in most countries included in the study, large inequalities were found in the use of health care for the self-reported health problems. It is important to develop regional projects aimed at improving the questions on self-reported health in household interview surveys so that the determinants of the inequalities in health can be studied in depth. The authors conclude that due to the different patterns of economic gradients among different age groups and among males and females, the practice of standardization used in constructing concentration curves and in computing concentration indices should be avoided. At the end is a set of recommendations on how to improve these

  5. 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.

  6. [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.

  7. Charting the Course to Universal Health in the Americas: Cristian Morales PhD, PAHO/WHO Representative in Cuba.

    Science.gov (United States)

    Reed, Gail

    2016-07-01

    After leaving Chile during the Pinochet era, Dr Morales studied economics, health administration and international health at the University of Montreal. But his baptism in the field came in Haiti, where he was first PAHO advisor to the health ministry, and then for five years was responsible for human resources and health economics in the PAHO offices in the capital of Port-au-Prince. He was at his post during the flooding in Gonaïves, five hurricanes, the 2010 earthquake and the ensuing cholera epidemic-doubtless the most dramatic and complex times for the country's health in recent history. Before becoming the PAHO/WHO Representative in Cuba in 2015, he was Regional Advisor in Financing and Health Economics based in Washington, DC. In that role, he plunged into the often thorny debates about just how far governments of the Americas were willing to go towards achieving universal health-universal coverage plus universal access. The result was a historic resolution passed in late 2014 by PAHO's Directing Council (CD53.R14 Strategy for Universal Access to Health and Universal Health Coverage). Dr Morales talks about the process, the outcomes… and the road ahead.

  8. 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.

  9. [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

  10. Surveillance for leptospirosis in the Americas, 1996-2005: a review of data from ministries of health.

    Science.gov (United States)

    Costa, Federico; Martinez-Silveira, Martha Silvia; Hagan, José E; Hartskeerl, Rudy A; Dos Reis, Mitermayer Galvão; Ko, Albert Icksang

    2012-09-01

    To characterize current leptospirosis reporting practices in the Americas. Information was collected from the official websites of national ministries of health from the Americas region and two international organizations; personal communications; and three international morbidity databases. For all sources other than the morbidity databases, the review was limited to official reports citing clinically suspected and laboratory confirmed leptospirosis cases or deaths during the period 1996-2005. A total of 73 out of 1 644 reports met the selection criteria and were included in the analysis. Published leptospirosis data were available from half of the countries/sovereign territories (24 out of 48), and 18 of them had mandatory notification policies for leptospirosis. The sum of the median number of leptospirosis cases notified annually by the 24 countries/territories was 4 713.5, but just three countries (Brazil, Costa Rica, and Cuba) accounted for 83.1% (3 9cas20 es) of the notifications. Eight (16.7%) countries reported deaths due to leptospirosis. The sum of the median number of deaths reported annually for the eight countries was 380, but 349 (91.8%) were reported by Brazil. Notification practices in the Americas for leptospirosis are limited. Therefore, the numbers of cases and deaths reported are not representative for the region. The lack of leptospirosis data for many countries/territories may reflect weaknesses in certain aspects of national surveillance systems, including mandatory reporting policies, clinical laboratory infrastructure for performing case confirmation, and capacity to collect reported cases. Improved surveillance of leptospirosis cases and deaths in the Americas is needed to allow monitoring of regional epidemiological patterns and to estimate the burden of this important disease.

  11. Surveillance for leptospirosis in the Americas, 1996–2005: a review of data from ministries of health

    Science.gov (United States)

    Costa, Federico; Martinez-Silveira, Martha Silvia; Hagan, José E.; Hartskeerl, Rudy A.; dos Reis, Mitermayer Galvão; Ko, Albert Icksang

    2014-01-01

    Objective To characterize current leptospirosis reporting practices in the Americas. Methods Information was collected from the official websites of national ministries of health from the Americas region and two international organizations; personal communications; and three international morbidity databases. For all sources other than the morbidity databases, the review was limited to official reports citing clinically suspected and laboratory confirmed leptospirosis cases or deaths during the period 1996–2005. Results A total of 73 out of 1 644 reports met the selection criteria and were included in the analysis. Published leptospirosis data were available from half of the countries/sovereign territories (24 out of 48), and 18 of them had mandatory notification policies for leptospirosis. The sum of the median number of leptospirosis cases notified annually by the 24 countries/territories was 4 713.5, but just three countries (Brazil, Costa Rica, and Cuba) accounted for 83.1% (3 920 cases) of the notifications. Eight (16.7%) countries reported deaths due to leptospirosis. The sum of the median number of deaths reported annually for the eight countries was 380, but 349 (91.8%) were reported by Brazil. Conclusions Notification practices in the Americas for leptospirosis are limited. Therefore, the numbers of cases and deaths reported are not representative for the region. The lack of leptospirosis data for many countries/territories may reflect weaknesses in certain aspects of national surveillance systems, including mandatory reporting policies, clinical laboratory infrastructure for performing case confirmation, and capacity to collect reported cases. Improved surveillance of leptospirosis cases and deaths in the Americas is needed to allow monitoring of regional epidemiological patterns and to estimate the burden of this important disease. PMID:23183556

  12. Can nursing epistemology embrace p-values?

    Science.gov (United States)

    Ou, Christine H K; Hall, Wendy A; Thorne, Sally E

    2017-10-01

    The use of correlational probability values (p-values) as a means of evaluating evidence in nursing and health care has largely been accepted uncritically. There are reasons to be concerned about an uncritical adherence to the use of significance testing, which has been located in the natural science paradigm. p-values have served in hypothesis and statistical testing, such as in randomized controlled trials and meta-analyses to support what has been portrayed as the highest levels of evidence in the framework of evidence-based practice. Nursing has been minimally involved in the rich debate about the controversies of treating significance testing as evidentiary in the health and social sciences. In this paper, we join the dialogue by examining how and why this statistical mechanism has become entrenched as the gold standard for determining what constitutes legitimate scientific knowledge in the postpositivistic paradigm. We argue that nursing needs to critically reflect on the limitations associated with this tool of the evidence-based movement, given the complexities and contextual factors that are inherent to nursing epistemology. Such reflection will inform our thinking about what constitutes substantive knowledge for the nursing discipline. © 2017 John Wiley & Sons Ltd.

  13. Embracing Excellence: A Positive Approach to Ethical Decision Making

    Science.gov (United States)

    Hinz, Lisa D.

    2011-01-01

    Ethics courses may provoke fear and uncertainty in art therapy students and practitioners if taught from a risk management perspective, which focuses on reducing therapist exposure to risk and avoiding harm to clients. In contrast, a positive ethical approach fosters empowerment, embraces limits, and enhances trust between art therapists and their…

  14. 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…

  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. 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.... 

  17. [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.

  18. 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.

  19. 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.

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

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

    There is growing recognition that access to timely, accurate and appropriate information can help improve health outcomes. This has led to increased interest in the use of information and communication technologies (ICTs) in health systems, often referred to as eHealth or Health Information Systems (HIS). History has ...

  1. 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.

  2. 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

    2010-01-01

    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. PMID:20623022

  3. 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.

  4. Structural Vulnerability Among Migrating Women and Children Fleeing Central America and Mexico: The Public Health Impact of "Humanitarian Parole".

    Science.gov (United States)

    Valdez, Elizabeth Salerno; Valdez, Luis A; Sabo, Samantha

    2015-01-01

    Since October 2013, US Customs and Border Patrol has apprehended 15,979 families on the Southwest Border of the US. Daily, migrating women and children from Mexico and Central America that qualify for humanitarian parole are released from immigration detention to a humanitarian aid organization in Southern Arizona. After several days in detention facilities, these families arrive tired, hungry, dehydrated, and with minimal direction regarding their final destination, and adherence to the parameters of their parole. Project helping hands (PHHs) utilizes a network of volunteers to provide the women and children with food, water, clothing, hygiene products, hospitality, and legal orientation. The aim of this assessment was to document the experiences of families granted humanitarian parole through the lens of structural vulnerability. Here, we apply qualitative methods to elicit PHH lead volunteer perspectives regarding the migration experience of migrating families. Using inductive analysis, we found six major themes emerged from the qualitative data: reasons for leaving, experience on the journey, dehumanization in detention, family separation, vulnerability, and resiliency. These findings elucidate the different physical and psychological distresses that migrating families from Mexico and Central America experience before, during and after their arrival at the US-Mexico border. We posit that these distresses are a result of, or exacerbated by, structural vulnerability. Structural vulnerability has life-long health implications for a sub-population of young mothers and their children. The number of migrating families who have experienced traumatic events before and during their migration experience continues to expand and thus warrants consideration of mental health surveillance and intervention efforts for these families. More public health research is needed to better understand and combat the health challenges of this growing population.

  5. Structural Vulnerability among Migrating Women and Children Fleeing Central America and Mexico:The Public Health Impact of Humanitarian Parole

    Directory of Open Access Journals (Sweden)

    Elizabeth Salerno Valdez

    2015-06-01

    Full Text Available Since October 2013, US Customs and Border Patrol (USCBP has apprehended 15,979 families on the Southwest Border of the United States. Daily, migrating women and children from Mexico and Central America that qualify for humanitarian parole are released from immigration detention to a humanitarian aid organization in Southern Arizona. After several days in detention facilities, these families arrive tired, hungry, dehydrated, and with minimal direction regarding their final destination, and adherence to the parameters of their parole. Project Helping Hands (PHH utilizes a network of volunteers to provide the women and children with food, water, clothing, hygiene products, hospitality, and legal orientation. The aim of this assessment was to document the experiences of families granted humanitarian parole through the lens of structural vulnerability. Here we apply qualitative methods to elicit PHH lead volunteer perspectives regarding the migration experience of migrating families. Using inductive analysis, we found six major themes emerged from the qualitative data: reasons for leaving, experience on the journey, dehumanization in detention, family separation, vulnerability, and resiliency.These findings elucidate the different physical and psychological distresses that migrating families from Mexico and Central America experience before, during and after their arrival at the US-Mexico border. We posit that these distresses are a result of, or exacerbated by, structural vulnerability. Structural vulnerability has life-long health implications for a sub-population of young mothers and their children. The number of migrating families who have experienced traumatic events before, and during their migration experience continues to expand and thus warrants consideration of mental health surveillance and intervention efforts for these families. More public health research is needed to better understand and combat the health challenges of this growing

  6. 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,

  7. 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.

  8. 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

  9. Binational public policies: health social marketing event in migration Mexico and United States of America

    OpenAIRE

    García González, Janet

    2013-01-01

    The aim is to reflect on the differences and points of agreement arising from the comparative analysis of US strategies for Mexican migrant health and social marketing, by researchers at the Department of Public Health Services of California, the Binational Health Office Border / University of California and the Autonomous University of Puebla. Material and Methods: The design is qualitative, the collection technique applied structured interviews to 21 key informants, officials of health inst...

  10. 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

  11. Health Communications in Rural America: Lessons Learned from an Arthritis Campaign in Rural Arkansas

    Science.gov (United States)

    Balamurugan, Appathurai; Rivera, Mark; Sutphin, Kim; Campbell, Debbie

    2007-01-01

    Context: Lack of awareness about diseases and associated risk factors could partially account for some rural health disparities. Health communications campaigns can be an effective means of increasing awareness in these areas. Purpose: To review findings and lessons learned from a rural health communications campaign. Methods: The health…

  12. Health-hazard evaluation report HETA-86-445-1831, Aluminum Company of America, Lafayette, Indiana

    Energy Technology Data Exchange (ETDEWEB)

    Hartle, R.W.

    1987-09-01

    In response to a request from employees at the Aluminum Company of America, an evaluation was made of potential exposure to polychlorinated biphenyls (PCBs) during the extrusion-press operation. Hydraulic fluids used in the running of these presses contained PCBs. The hydraulic and coolant lines and pumps required maintenance both internally and below the presses where there was a series of catacombs containing the equipment. These areas were typically soaked with the hydraulic and coolant fluids. While some of these concentration levels exceeded the NIOSH recommended exposure limit (1 microgram/cubic meter), serum PCB levels (nondetectable to 15.9 nanograms/milliliter) were not above those of the normal nonoccupationally exposed population. The author concludes that the levels of PCBs presents a potential hazard. The author recommends the use of personal protective clothing and decontamination of the area.

  13. Current epidemiological trends for Chagas disease in Latin America and future challenges in epidemiology, surveillance and health policy

    Directory of Open Access Journals (Sweden)

    Álvaro Moncayo

    2009-07-01

    Full Text Available Chagas disease, named after Carlos Chagas, who first described it in 1909, exists only on the American Continent. It is caused by a parasite, Trypanosoma cruzi, which is transmitted to humans by blood-sucking triatomine bugs and via blood transfusion. Chagas disease has two successive phases: acute and chronic. The acute phase lasts six-eight weeks. Several years after entering the chronic phase, 20-35% of infected individuals, depending on the geographical area, will develop irreversible lesions of the autonomous nervous system in the heart, oesophagus and colon, and of the peripheral nervous system. Data on the prevalence and distribution of Chagas disease improved in quality during the 1980s as a result of the demographically representative cross-sectional studies in countries where accurate information was not previously available. A group of experts met in Brasilia in 1979 and devised standard protocols to carry out countrywide prevalence studies on human T. cruzi infection and triatomine house infestation. Thanks to a coordinated multi-country programme in the Southern Cone countries, the transmission of Chagas disease by vectors and via blood transfusion was interrupted in Uruguay in 1997, in Chile in 1999 and in Brazil in 2006; thus, the incidence of new infections by T. cruzi across the South American continent has decreased by 70%. Similar multi-country initiatives have been launched in the Andean countries and in Central America and rapid progress has been reported towards the goal of interrupting the transmission of Chagas disease, as requested by a 1998 Resolution of the World Health Assembly. The cost-benefit analysis of investment in the vector control programme in Brazil indicates that there are savings of US$17 in medical care and disabilities for each dollar spent on prevention, showing that the programme is a health investment with very high return. Many well-known research institutions in Latin America were key elements of a

  14. Current epidemiological trends for Chagas disease in Latin America and future challenges in epidemiology, surveillance and health policy.

    Science.gov (United States)

    Moncayo, Alvaro; Silveira, Antonio Carlos

    2009-07-01

    Chagas disease, named after Carlos Chagas, who first described it in 1909, exists only on the American Continent. It is caused by a parasite, Trypanosoma cruzi, which is transmitted to humans by blood-sucking triatomine bugs and via blood transfusion. Chagas disease has two successive phases: acute and chronic. The acute phase lasts six-eight weeks. Several years after entering the chronic phase, 20-35% of infected individuals, depending on the geographical area, will develop irreversible lesions of the autonomous nervous system in the heart, oesophagus and colon, and of the peripheral nervous system. Data on the prevalence and distribution of Chagas disease improved in quality during the 1980s as a result of the demographically representative cross-sectional studies in countries where accurate information was not previously available. A group of experts met in Brasilia in 1979 and devised standard protocols to carry out countrywide prevalence studies on human T. cruzi infection and triatomine house infestation. Thanks to a coordinated multi-country programme in the Southern Cone countries, the transmission of Chagas disease by vectors and via blood transfusion was interrupted in Uruguay in 1997, in Chile in 1999 and in Brazil in 2006; thus, the incidence of new infections by T. cruzi across the South American continent has decreased by 70%. Similar multi-country initiatives have been launched in the Andean countries and in Central America and rapid progress has been reported towards the goal of interrupting the transmission of Chagas disease, as requested by a 1998 Resolution of the World Health Assembly. The cost-benefit analysis of investment in the vector control programme in Brazil indicates that there are savings of US$17 in medical care and disabilities for each dollar spent on prevention, showing that the programme is a health investment with very high return. Many well-known research institutions in Latin America were key elements of a worldwide network of

  15. 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.

  16. 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

  17. 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

  18. 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.

  19. 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

  20. 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.

  1. 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.

  2. 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

  3. 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...

  4. Causes of mortality and development: Evidence from large health shocks in 20th century America

    DEFF Research Database (Denmark)

    Worm Hansen, Casper

    Exploiting pre-intervention variation in flu/pneumonia, tuberculosis and maternal mortality, together with time variation arising from medical breakthroughs starting in the late 1930s, this paper studies the aggregate impact of large health shocks across US states. The analysis demonstrates that ......, the decline in maternal mortality has a fragile, but positive relationship with income per capita. Because these specific health shocks affected mortality across the life cycle differently, the evidence here underscores the general tenet of regarding health as multifaceted....

  5. 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.

  6. 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.

  7. Values and Subjective Mental Health in America: A Social Adaptation Approach.

    Science.gov (United States)

    Kahle, Lynn R.; And Others

    Although surveys of mental health involve some controversy, a significant relationship between values and mental health appears to exist. To study the adaption of individuals with alternative values to their psychological worlds, over 2,000 adults identified their most important values. Alcohol abuse, drug abuse, dizziness, anxiety, and general…

  8. 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.

  9. 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.

  10. 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

  11. Health care costs and financial consequences of epidemiological changes in chronic diseases in Latin America: evidence from Mexico.

    Science.gov (United States)

    Arredondo, A; Zúñiga, A; Parada, I

    2005-08-01

    To determine the costs of health services and the financial consequences of changes in the epidemiological profile of chronic diseases in Latin America. We conducted longitudinal analyses of costs and of the economic impact of the epidemiological transition in healthcare services for diabetes and hypertension in the Mexican health system. The study population included both the insured and uninsured populations. The cost-evaluation method was based on the instrumentation and consensus techniques. To estimate the epidemiological changes and financial consequences for 2004-2006, six models were constructed according to the Box-Jenkins technique, using confidence intervals of 95% and the Box-Pierce test. Costs ranged from US$613 to US$887 for diabetes, and from US$485 to US$622 for hypertension. Regarding epidemiological changes for 2004 compared with 2006, an increase is expected in both cases, although results predict a greater increase for diabetes, 10-15% in all three institutions (Phealth services required by insured and uninsured populations, the greater increase (17%) will be for the insured population (Psystem will be particularly strong. Another relevant financial factor is the appearance of internal competition in the use and allocation of financial resources among the main providers in the health services; this factor becomes even more complicated within each provider. In effect, within each institution, hypertension and diabetes programmes must compete for resources with other programmes for chronic and infectious diseases.

  12. 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."

  13. 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...

  14. 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.

  15. 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.

  16. 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.

  17. [Social thinking in health in Latin America: revisiting Juan César García].

    Science.gov (United States)

    Nunes, Everardo Duarte

    2013-09-01

    The article reconstitutes the social thinking in health by Argentine physician and sociologist Juan César García (1932-1984), analyzing the main publications approaching his work and activities. The article situates his thinking in the two fields that marked his production: social medicine and the social sciences from the 1960s to the late 1980s. The article highlights his work with the Pan American Health Organization and his perspective of analyzing social medicine and the social sciences by relating them not only to the Latin American historical, social, economic, and political context, but also to historical materialism: linking medicine to the social structure; the influence of the social structure on the production and distribution of diseases; internal analysis of the production of medical services; and the relationship between training of health personnel and the medical field. As demonstrated, even today his work can be a reference for the discussion of such themes as medical education, health personnel training, the role of science and technology, the social sciences in medical education, and historical aspects of public health.

  18. Health differences between populations of the United States of America and the European Union.

    Science.gov (United States)

    Ginter, Emil; Simko, Vladimir

    2010-12-01

    This review documents health care outcome in relation to health expenditure in the US and in the European Union (EU) and it attempts to interpret the root cause of observed differences. In comparison with the US where the per capita expenditure for health care is close to 8,000 international dollars, health expenditure in the Western European Countries (WEC) (France, Germany, Britain, Italy) is approximately only half of that in the US. In the Central and Eastern European Countries (CEEC) it is 20 per cent or less of the US health care budget. Infant mortality in the US is much higher than in the WEC and some CEEC (Czech Republic, Poland, Hungary and Slovakia) countries are even better off in infant mortality than the US. Concerning the male life expectancy, Caucasian Americans rank the lowest of the WEC, representing a statistical boundary between the WEC and the CEEC. Like the American caucasian males, the American Caucasian females rank at the lowest range of the WEC. Afro-American females have values substantially worse, almost along the lowest ranking CEEC. European societies have been established for centuries, cherishing strong social values. The US is a much younger rapidly developing multi-ethnic community that derived its progress from adhering to traditions and principles of free choice. Witness to the rate at which the US society can resolve difficult social problems is the enormous progress in eliminating racial discrimination during the past fifty years.

  19. 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)

  20. [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.

  1. 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.

  2. Unaccompanied Children Migrating from Central America: Public Health Implications for Violence Prevention and Intervention.

    Science.gov (United States)

    Estefan, Lianne Fuino; Ports, Katie A; Hipp, Tracy

    2017-04-01

    Unaccompanied children (UC) migrating to the USA from the Central American countries of El Salvador, Guatemala, and Honduras are an underserved population at high risk for health, academic, and social problems. These children experience trauma, violence, and other risk factors that are shared among several types of interpersonal violence. The trauma and violence experienced by many unaccompanied children, and the subsequent implications for their healthy development into adulthood, indicate the critical need for a public health approach to prevention and intervention. This paper provides an overview of the violence experienced by unaccompanied children along their migration journey, the implications of violence and trauma for the health and well-being of the children across their lifespan, prevention and intervention approaches for UC resettled in the USA, and suggestions for adapted interventions to best address the unique needs of this vulnerable population.

  3. 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.

  4. Burden of disease, health indicators and challenges for epidemiology in North America.

    Science.gov (United States)

    Toporowski, Amy; Harper, Sam; Fuhrer, Rebecca; Buffler, Patricia A; Detels, Roger; Krieger, Nancy; Franco, Eduardo L

    2012-04-01

    Commissioned by the International Epidemiological Association, this article is part of a series on burden of disease, health indicators and the challenges faced by epidemiologists in bringing their discoveries to provide equitable benefit to the populations in their regions and globally. This report covers the health status and epidemiological capacity in the North American region (USA and Canada). We assessed data from country-specific sources to identify health priorities and areas of greatest need for modifiable risk factors. We examined inequalities in health as a function of social deprivation. We also reviewed information on epidemiological capacity building and scientific contributions by epidemiologists in the region. The USA and Canada enjoy technologically advanced healthcare systems that, in principle, prioritize preventive services. Both countries experience a life expectancy at birth that is higher than the global mean. Health indicator measures are consistently worse in the USA than in Canada for many outcomes, although typically by only marginal amounts. Socio-economic and racial/ethnic disparities in indicators exist for many diseases and risk factors in the USA. To a lesser extent, these social inequalities also exist in Canada, particularly among the Aboriginal populations. Epidemiology is a well-established discipline in the region, with many degree-granting schools, societies and job opportunities in the public and private sectors. North American epidemiologists have made important contributions in disease control and prevention and provide nearly a third of the global scientific output via published papers. Critical challenges for North American epidemiologists include social determinants of disease distribution and the underlying inequalities in access to and benefit from preventive services and healthcare, particularly in the USA. The gains in life expectancy also underscore the need for research on health promotion and prevention of disease

  5. 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

  6. Towards Healthy Schools 2015: Progress on America's Environmental Health Crisis for Children

    Science.gov (United States)

    Healthy Schools Network, Inc., 2013

    2013-01-01

    States compel children to attend school; in fact, 98% of all school-age children attend schools--irrespective of conditions. Yet the environmental conditions of decayed facilities or facilities close to hazards can damage children's health and ability to learn. At the same time, it is well documented that healthy school facilities can help…

  7. Farming for Health. Green-care farming across Europe and the United States of America

    NARCIS (Netherlands)

    Hassink, J.; Dijk, van M.

    2006-01-01

    The utilization of agricultural farms as a base for promoting human mental and physical health and social well-being is a new promising development. On farms, the animals, the plants, the garden, the forest and the landscape are used in recreational or work-related activities for psychiatric

  8. 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.

  9. The men's health center: Disparities in gender specific health services among the top 50 "best hospitals" in America.

    Science.gov (United States)

    Choy, Jeremy; Kashanian, James A; Sharma, Vidit; Masson, Puneet; Dupree, James; Le, Brian; Brannigan, Robert E

    2015-07-01

    Gender-specific integrated health services have long existed in the arena of women's health care, but men's health centers (MHCs) have only recently emerged as a novel practice model. Here, we seek to evaluate the prevalence and format of MHCs found in the leading academic medical centers in the United States. The US News & World Report's Top 50 Ranked Hospitals for Urology was used as our cohort. Data were gathered on the presence of MHCs and types of providers and conditions treated. An equivalent search was performed for women's health centers (WHCs). Sixteen of 50 (32%) promoted some type of MHC, compared to 49 of 50 (98%) offering a WHC. Eight of the top 15 ranked institutions (53%) had an MHC compared to eight of 35 (23%) remaining programs. Six of 16 MHCs incorporated providers from a variety of medical disciplines, including urologists, internists, endocrinologists, cardiologists, and psychologists, while another six of 16 MHCs were staffed solely by urologists. Eight of 16 provided services for exclusively urologic issues, four of 16 offered additional services in treatment of other medical conditions, and four of 16 did not specify. A considerable disparity exists between the prevalence of gender-specific health services, with WHCs being much more numerous than MHCs. All but one leading institution had WHCs compared to less than one-third having MHCs. Our findings also highlight the heterogeneous nature of men's health programs, as they exhibit great variability in program type and focus, yet are all being marketed under the "Men's Health" banner.

  10. KEYNOTE ADDRESS OF THE SEVENTH INTERNATIONAL CONFERENCE ON THE HEALTH OF CHINESE IN NORTH AMERICA: Health Status of Chinese Americans: Challenges and Opportunities.

    Science.gov (United States)

    Chen, Moon S.

    1995-01-01

    PURPOSE. This paper is based on the author's keynote address given at the Seventh International Conference on the Health Problems of Chinese in North America. METHODS. The author/speaker reviewed the literature related to Chinese American health problems within the context of the broader demographic and aggregated health data reported on Asian Americans and Pacific Islanders. FINDINGS. In addition to background demographic statistics provided on Chinese Americans, the author/speaker focused on two categories of diseases: (1) communicable diseases; and (2) chronic diseases because of the greater availability of data on these categories. Communicable diseases from which Chinese Americans appear to suffer disproportionally are tuberculosis and hepatitis B. Infection with the hepatitis B virus also makes Chinese Americans much more susceptible to chronic liver diseases including cancer. Chinese also suffer disproportionally more from nasopharyngeal cancer; because of higher than average adult male smoking rates, these men can be expected to suffer disproportionally from a future epidemic of lung cancer cases. Unhealthy acculturation patterns in food consumption point towards changing profiles of cardiovascular morbidity and mortality as well as higher rates of dietary related cancers. OBSERVATIONS. Rather than conclusions, observations of the current health status of Chinese Americans were offered. Four measures that organizations such as the Chinese medical societies and Chinese American health professionals can pursue to advance the health status of Chinese Americans, particularly in the area of heaslth policy, are: (1) voting; (2) collecting data on health status; (3) writing for professional journals; and (4) being active in policy development. KEY WORDS. Chinese Americans; health status; tuberculosis; hepatits B; cancer; diet; acculturation; smoking

  11. [A methodology to implement preventive actions against harmful drug use in the context of primary health care in Latin America].

    Science.gov (United States)

    Costa, Pedro Henrique Antunes da; Mota, Daniela Cristina Belchior; Cruvinel, Erica; Paiva, Fernando Santana de; Ronzani, Telmo Mota

    2013-05-01

    To develop a methodology to implement practices of prevention against the use of alcohol and other drugs in the context of primary health care (PHC) that will contribute to the debate about policies and actions in Latin American countries. This intervention research project was carried out in a small/medium-sized Brazilian city. The development process was assessed through participant observation with the aim of adapting the methodology to local needs and identifying existing weaknesses and strengths with impact on implementation. A model was developed with six stages: initial contact and planning, diagnosis and mapping, sensitization, training, follow-up, and communication of results to participants. The following weaknesses were identified: limitation of resources (human, financial, infrastructural), limitations in the coverage and comprehensiveness of the assistance network, poor participation from physicians, training based on medicalized care, insufficient participation of health care management, insufficient involvement and participation of civil society, and few opportunities for participation of the population in the planning and execution of public policies. Strengths included the participation of community health agents and nurses in applying, organizing, and planning initiatives, in addition to the organization of educative and preventive actions in schools and communities by health care teams, suggesting that it is possible to implement screening, brief intervention, and referral to treatment (SBIRT) initiatives in the context of PHC in Latin America. The methodology developed in this study can be useful for Latin American countries if local needs are taken into consideration. It should be noted, however, that results will only be observed in the mid- to long term, rather than strictly in the short term.

  12. 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

  13. 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...

  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

    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...

  15. The men's health center: Disparities in gender specific health services among the top 50 “best hospitals” in America

    Directory of Open Access Journals (Sweden)

    Jeremy Choy

    2015-07-01

    Conclusion: A considerable disparity exists between the prevalence of gender-specific health services, with WHCs being much more numerous than MHCs. All but one leading institution had WHCs compared to less than one-third having MHCs. Our findings also highlight the heterogeneous nature of men's health programs, as they exhibit great variability in program type and focus, yet are all being marketed under the “Men's Health” banner.

  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. 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.

  18. 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.

  19. Lessons for the health care industry from America's experience with public utilities.

    Science.gov (United States)

    Colton, R; Frisof, K B; King, E R

    1997-01-01

    In the United States, the traditional public utilities, power and telecommunications, along with health care, are being deregulated and becoming increasingly competitive, especially on price. Regulation of the public utilities has occurred for the past century not simply because they have been monopolies, but, more importantly, because they are "industries affected with the public interest," that is industries which: 1. provide an essential service, 2. benefit from public prequisites, and 3. would cause great public harm if mismanaged. Consequently, the presence of competition in these industries does not negate the need for regulation. Regulation of these industries is best understood as being along the three sides of a "triangle of public interests"--quality, public accountability, and universal service. Examples are provided of these types of regulation in power and telecommunications, even in current "deregulatory" legislation. Health care reform activists in the United States have lately paid attention mostly to the first two legs of the triangle; they are encouraged to focus creatively on the third leg--universal health care.

  20. Health and traditional medicine cultures in Latin America and the Caribbean.

    Science.gov (United States)

    Pedersen, D; Baruffati, V

    1985-01-01

    In this article, the authors summarise the origins and development of traditional medicine cultures in the Latin American and Caribbean regions, beginning with an overview of terminology and definitions related to 'medicine' and 'medical systems'. A short look is taken at original medicine cultures and at how they syncretised with colonial European medicine to give birth to a mosaic of lay and traditional medicine practices still in evidence in the New World today. A review is then made of the latest and main bibliographic sources in traditional medicine for the region, which are then analysed briefly. The main body of the paper deals with the different research approaches to traditional medicine cultures of which seven are discussed here. The authors conclude by stressing the need for closing the gap between the social and medical sciences in order to reach a better understanding of the health needs of the population. Biology and culture are at the centre of the discussion between medicine and anthropology where two trends dominate, viz. the socio-cultural and the biomedical models. The main task for ethnomedical researchers in the Latin American region is to work towards the creation of a bio-sociocultural model in an attempt to enrich systems qualitatively in the development of more humane and efficient interventions, both in the clinical field as in the field of health policies and strategies.

  1. 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.

  2. 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.

  3. Special diets in modern America: Analysis of the 2012 National Health Interview Survey data.

    Science.gov (United States)

    Leung, Brenda; Lauche, Romy; Leach, Matthew; Zhang, Yan; Cramer, Holger; Sibbritt, David

    2017-01-01

    Special diets are frequently used by the public but reasons for use and characteristics of users remain unclear. To determine prevalence of the use of special diets, the individual characteristics associated with their use and reasons for use. The secondary analysis used data from the 2012 National Health Interview Survey (NHIS), a cross-sectional household interview survey of a nationally representative sample of non-hospitalized US adult populations ( n = 34,525). The dependent variables in this secondary analysis were the use of a special diet (vegetarian, macrobiotic, Atkins, Pritikin, and Ornish) ever and during the past 12 months. Independent variables included sociodemographic, clinical and behavioral variables. Prevalence of special diet use and reasons for use were analyzed descriptively. Associations between independent and dependent variables were analyzed using Chi-square tests and logistic regression. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Lifetime and 12-month prevalence of using special diets were 7.5% (weighted n = 17.7 million) and 2.9% (weighted n = 6.9 million), respectively. Individuals using special diets in the past 12 months were more likely female (OR = 1.45; 95% CI = 1.21-1.74), not married (OR = 0.76; 95% CI = 0.63-0.91), college-educated (OR = 1.98; 95% CI = 1.25-3.11) and depressed (OR = 1.50; 95% CI = 1.14-1.98). They more likely also used herbal products (OR = 2.35; 95%CI = 1.84-2.99), non-vitamin (OR = 1.82; 95% CI = 1.45-2.27) and vitamin supplements (OR = 1.57; 95% CI = 1.24-1.99). Diets were mainly used to improve overall health (76.7%) or for general wellness/prevention (70.4%). Special diets are mainly used for unspecific health reasons by those who are females, have a college degree or with depression, and commonly used in conjunction with herbs and dietary supplements.

  4. 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.

  5. Interaction of Flavivirus with their mosquito vectors and their impact on the human health in the Americas.

    Science.gov (United States)

    Valderrama, Anayansi; Díaz, Yamilka; López-Vergès, Sandra

    2017-10-28

    Some of the major arboviruses with public health importance, such as dengue, yellow fever, Zika and West Nile virus are mosquito-borne or mosquito-transmitted Flavivirus. Their principal vectors are from the family Culicidae, Aedes aegypti and Aedes albopictus being responsible of the urban cycles of dengue, Zika and yellow fever virus. These vectors are highly competent for transmission of many arboviruses. The genetic variability of the vectors, the environment and the viral diversity modulate the vector competence, in this context, it is important to determine which vector species is responsible of an outbreak in areas where many vectors coexist. As some vectors can transmit several flaviviruses and some flaviviruses can be transmitted by different species of vectors, through this review we expose importance of yellow fever, dengue and Zika virus in the world and the Americas, as well as the updated knowledge about these flaviviruses in their interaction with their mosquito vectors, guiding us on what is probably the beginning of a new stage in which the simultaneity of outbreaks will occur more frequently. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Backsliding on a key health investment in Latin America and the Caribbean: the case of breastfeeding promotion.

    Science.gov (United States)

    Lutter, Chessa K; Chaparro, Camila M; Grummer-Strawn, Laurence; Victora, Cesar G

    2011-11-01

    We examined trends in breastfeeding promotion investments, breastfeeding promotion activities, and breastfeeding duration in Latin America and the Caribbean from the 1980s to the 2000s. We obtained financial data from the United States Agency for International Development and the International Code Documentation Center, and we obtained breastfeeding promotion data from surveys of breastfeeding coordinators with ministries of health and with the International Baby Food Action Network. We obtained breastfeeding data from nationally representative surveys conducted between 1986 and 2008. Investment in breastfeeding promotion declined in the 2000s relative to earlier years. For all countries, breastfeeding duration increased between the first and last survey. Of the 12 countries represented in the interval when investment in breastfeeding promotion was high, breastfeeding duration decreased in 1 country. Of the 12 countries represented in the interval when investment was low, breastfeeding duration decreased in 3 countries. Nonetheless, the average annual change in breastfeeding duration for the 2 intervals was positive and similar (0.16 months and 0.21 months). Breastfeeding promotion likely resulted in large improvements in breastfeeding. Investments in breastfeeding promotion have declined, but this does not appear to have adversely affected breastfeeding duration.

  7. Lead exposure in Latin America and the Caribbean. Lead Research Group of the Pan-American Health Organization.

    Science.gov (United States)

    Romieu, I; Lacasana, M; McConnell, R

    1997-04-01

    As a result of the rapid industrialization of Latin America and the Caribbean during the second half of this century, exposure to lead has become an increasingly important problem. To obtain an estimate of the magnitude of lead exposure in the region, we carried out a survey and a literature search on potential sources of lead exposure and on blood lead concentrations. Sixteen out of 18 Latin American and 2 out of 10 Caribbean countries responded to the survey. Lead in gasoline remains a major problem, although the lead content has decreased in many countries in the last few years. The impact of leaded fuel is more important in urban settings, given their high vehicular density. Seventy-five percent of the population of the region lives in urban areas, and children younger than 15 years of age, the most susceptible group, comprise 30% of the population. Other sources of lead exposure identified in the region included industrial emissions, battery recycling, paint and varnishes, and contaminated food and water. Lead is recognized as a priority problem by national authorities in 72% of the countries that responded to the survey, and in 50% of the countries some legislation exists to regulate the lead content in certain products. However, compliance is low. There is an urgent need for a broad-based coalition between policy makers, industry, workers, unions, health care providers, and the community to take actions to reduce environmental and occupational lead exposures in all the Latin American and Caribbean countries.

  8. 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.

  9. Reproducible preclinical research-Is embracing variability the answer?

    Science.gov (United States)

    Karp, Natasha A

    2018-03-01

    Translational failures and replication issues of published research are undermining preclinical research and, if the outcomes are questionable, raise ethical implications over the continued use of animals. Standardization of procedures, environmental conditions, and genetic background has traditionally been proposed as the gold standard approach, as it reduces variability, thereby enhancing sensitivity and supporting reproducibility when the environment is defined precisely. An alternative view is that standardization can identify idiosyncratic effects and hence decrease reproducibility. In support of this alternative view, Voelkl and colleagues present evidence from resampling a large quantity of research data exploring a variety of treatments. They demonstrate that by implementing multi-laboratory experiments with as few as two sites, we can increase reproducibility by embracing variation without increasing the sample size.

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

    OpenAIRE

    Sabine C. Koch; Helena Rautner

    2017-01-01

    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 ...

  11. United States of America Department of Health and Human Services support for advancing influenza vaccine manufacturing in the developing world.

    Science.gov (United States)

    Perdue, Michael L; Bright, Rick A

    2011-07-01

    Since 2005, the Government of the United States of America has provided more than US$ 50 million to advance influenza vaccine development in low-resourced countries. This programme has provided a unique opportunity for the US Government to develop a comprehensive view of, and to understand better the challenges and future needs for influenza vaccines in the developing world. The funding for this programme has been primarily through a cooperative agreement with the World Health Organization (WHO) to support directly its capacity-building grants to government-owned or -supported vaccine manufacturers in developing countries. A second cooperative agreement with the Program for Appropriate Technologies in Health (PATH) was initiated to accelerate the completion of a current Good Manufacturing Practice cGMP production facility, along with supporting facilities to obtain a reliable source of eggs, and to conduct clinical trials of influenza vaccine manufactured in Vietnam. This mechanism of utilizing cooperative agreements to support capacity-building for vaccine development in low-resourced settings has been novel and unique and has yielded fruitful returns on minimal investment. The information derived from this programme helps to clarify not only the development challenges for influenza vaccines and how the United States may assist in meeting those challenges, but also other vaccine development issues common to manufacturers in developing countries. While building the initial capacity to produce influenza vaccines can be a straightforward exercise, the sustainability of the enterprise and expansion of subsequent markets will be the key to future usefulness. There is hope for expansion of the global influenza vaccine market. Ongoing burden of disease studies are elucidating the impact of influenza infections, particularly in children, and more countries will take note and respond accordingly, since respiratory diseases are now the number one killer of children under

  12. [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.

  13. 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.

  14. Breast health global initiative (BHGI) outline for program development in Latin America Breast health global initiative (BHGI) planeamiento para el desarrollo de programas en América latina

    OpenAIRE

    Benjamin O. Anderson; Eduardo Cazap

    2009-01-01

    The Breast Health Global Initiative (BHGI) applied an evidence-based consensus review process to develop guidelines for breast cancer early detection, diagnosis, and treatment in low- and middle-income countries (LMCs) including those in Latin America. Breast cancer outcomes correlate with the degree to which 1) cancers are detected early, 2) cancers can be diagnosed correctly, and 3) proper multimodality treatment can be provided in a timely fashion. Cancer prevention through health behavior...

  15. 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

  16. America's challenge.

    Science.gov (United States)

    Lindsay, G N

    1968-01-01

    As government increasingly recognizes its own obligations to support and provide family planning as a health and social measure, serious questions are raised as to the proper role for Planned Parenthood World Federation as a private organization. Federal programs both at home and abroad tend to make private fundraising more difficult, whatever the role of this organization may be. Contrary to common impression, experience thus far indicates that the existence of governmental programs does not decrease demands on Planned Parenthood as a private agency. A wide gap also exists between public acceptance, which has been realized, and public conviction, which still has not been accepted. Only those who feel distress at the vision of an all-encompassing megalopolis, only those with concern for the qualify of life in the crowd, and only those who see finite limits of resources recognize that the US must someday plan a halt to population growth. As the gap between the developed and the underdeveloped world widens, economists point out that the US, with less than 6% of the world's population, already consumes some 50% of the world's available raw materials. Business and government leaders are beginning to understand the rate at which an industrial and affluent society consumes the world's substance and threatens the environment. If the assumption is correct that the population explosion constitutes a major threat to life on earth, then America's own attitudes and actions at home, as well as abroad and in the developing countries, are vital. In the next few years Planned Parenthood faces the task of converting the tide of public acceptance into one of conviction and effective action on a giant scale both at home and abroad. In its effort, Planned Parenthood has continued to expand its own service functions. It now has 157 local affiliates with an additional 30 in the organizational stage. In 1967 Planned Parenthood affiliates operated 470 family planning centers, 71 more than

  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. Acknowledging conservation trade-offs and embracing complexity.

    Science.gov (United States)

    Hirsch, Paul D; Adams, William M; Brosius, J Peter; Zia, Asim; Bariola, Nino; Dammert, Juan Luis

    2011-04-01

    There is a growing recognition that conservation often entails trade-offs. A focus on trade-offs can open the way to more complete consideration of the variety of positive and negative effects associated with conservation initiatives. In analyzing and working through conservation trade-offs, however, it is important to embrace the complexities inherent in the social context of conservation. In particular, it is important to recognize that the consequences of conservation activities are experienced, perceived, and understood differently from different perspectives, and that these perspectives are embedded in social systems and preexisting power relations. We illustrate the role of trade-offs in conservation and the complexities involved in understanding them with recent debates surrounding REDD (Reducing Emissions from Deforestation and Degradation), a global conservation policy designed to create incentives to reduce tropical deforestation. Often portrayed in terms of the multiple benefits it may provide: poverty alleviation, biodiversity conservation, and climate-change mitigation; REDD may involve substantial trade-offs. The gains of REDD may be associated with a reduction in incentives for industrialized countries to decrease carbon emissions; relocation of deforestation to places unaffected by REDD; increased inequality in places where people who make their livelihood from forests have insecure land tenure; loss of biological and cultural diversity that does not directly align with REDD measurement schemes; and erosion of community-based means of protecting forests. We believe it is important to acknowledge the potential trade-offs involved in conservation initiatives such as REDD and to examine these trade-offs in an open and integrative way that includes a variety of tools, methods, and points of view. ©2010 Society for Conservation Biology.

  19. Iniciativa Regional de Reforma del Sector de la Salud en América Latina y el Caribe The Latin America and Caribbean Regional Health Sector Reform Initiative

    Directory of Open Access Journals (Sweden)

    Pedro Crocco

    2000-08-01

    Full Text Available Muchos países de América Latina y el Caribe están introduciendo reformas que pueden influir profundamente en la forma como se prestan los servicios de salud y en quienes los reciben. Tanto en la Cumbre de las Américas de 1994 como en la "Reunión Especial sobre Reforma del Sector de la Salud" de 1995, organizada por la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS, el Banco Interamericano de Desarrollo, el Banco Mundial y otros organismos multilaterales y bilaterales, los gobiernos de la Región decidieron apoyar la generación de capacidad de análisis y la capacitación en lo relativo a las reformas del sector de la salud. En consecuencia, en 1997, la OPS y la Agencia de los Estados Unidos para el Desarrollo Internacional lanzaron la "Iniciativa Regional de Reforma del Sector de la Salud en América Latina y el Caribe". Esta iniciativa tiene un financiamiento de aproximadamente US$ 10 millones hasta el año 2002 para apoyar actividades en Bolivia, Brasil, Ecuador, El Salvador, Guatemala, Haití, Honduras, Jamaica, México, Nicaragua, Paraguay, Perú y República Dominicana, busca promover una prestación más equitativa y eficaz de los servicios básicos de salud sustentando actividades regionales, y se encuentra ya en su tercer año de implementación.Many countries throughout Latin America and the Caribbean are introducing reforms that can profoundly influence how health services are provided and who receives them. Governments in the region identified the need for a network to support health reform by building capacity in analysis and training, both at the Summit of the Americas in 1994 and at the Special Meeting on Health Sector Reform, which was convened in 1995 by an interagency committee of the Pan American Health Organization/World Health Organization, the Inter-American Development Bank, the World Bank, and other multilateral and bilateral agencies. In response, in 1997 the Pan American Health

  20. Brain Injury Association of America

    Science.gov (United States)

    ... com/Godspeed-Story-Pag.. Read More... BIAA Applauds Trump Administration's Opioid Emergency Declaration; Calls for More Resources ... The Brain Injury Association of America salutes the Trump Administration for directing the Department of Health and ...

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    Eskild Petersen

    2016-03-01

    Full Text Available 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.

  3. Latin America.

    Science.gov (United States)

    Soni, P. Sarita, Ed.

    1993-01-01

    This serial issue features 6 members of the Indiana University System faculty who have focused their research on Latin America, past and present. The first article, "A Literature of Their Own," highlights Darlene Sadlier's research on Brazilian women's fiction and poetry that has led to an interest in the interplay of Brazilian and…

  4. Latin America.

    Science.gov (United States)

    Greenfield, Gerald Michael

    1986-01-01

    Notes the problematical elements of diversity within Latin America, establishes priorities for the social studies curriculum, and reviews what should be taught about its geography, resources, people, religion, customs, economics, politics, history, and international relationships. Lists Latin American Studies programs and published instructional…

  5. Illiterate America.

    Science.gov (United States)

    Kozol, Jonathan

    Intended for those involved in American social service and educational communities, this book addresses the widespread problem of illiteracy in the United States and the social consequences of this problem. Following an introduction, the chapters in the first section of the book discuss the growing crisis of illiterate America, specifically, the…

  6. 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)

  7. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  9. 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.

  10. Should we stop looking for common grounds and start embracing our differences?

    DEFF Research Database (Denmark)

    Thomassen, Mette Lindahl

    2015-01-01

    Should we stop looking for common grounds and start embracing our differences? - Entrepreneurship education in an Engineering context Questions we care about: The paper is centered around the question “Should we stop looking for common grounds and start embracing our differences? “. It is fundame......Should we stop looking for common grounds and start embracing our differences? - Entrepreneurship education in an Engineering context Questions we care about: The paper is centered around the question “Should we stop looking for common grounds and start embracing our differences...... and target groups call for diverse methodologies and training of different sets of skills and competences?”. The question “Why entrepreneurship education?” is answered from tree different angles. If we raise the question:” What is effective entrepreneurship education in a specific discipline...

  11. 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

  12. 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

  13. 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…

  14. 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.

  15. The reality of the management of mental health services in Latin America, reflexions from the perspective of a vision of strategic planning.

    Science.gov (United States)

    Robles, Enrique Camarena; Belfort, Edgard G

    2010-01-01

    The history of mental health services in Latin America, has been influenced by public policies derived from governments in turn, in each one of the countries of the region. As much in the definition of these public policies, as in the resource allocation, the rule has been inconsistency and indifference. The few results have been dependent on the decision of one or just a few people who were able to make decisions in local and regional Latin American governments. A brief analysis regarding the role and transformation of psychiatric hospitals can be found in this article, also of the workers attitudes and ideology, as well as the importance of developing better mental health professionals with knowledge of public administration and particularly in well-known strategies such as strategic planning.

  16. 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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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.

  18. 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

  19. 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

  20. 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.

  1. Structural Vulnerability Among Migrating Women and Children Fleeing Central America and Mexico: The Public Health Impact of “Humanitarian Parole”

    Science.gov (United States)

    Valdez, Elizabeth Salerno; Valdez, Luis A.; Sabo, Samantha

    2015-01-01

    Since October 2013, US Customs and Border Patrol has apprehended 15,979 families on the Southwest Border of the US. Daily, migrating women and children from Mexico and Central America that qualify for humanitarian parole are released from immigration detention to a humanitarian aid organization in Southern Arizona. After several days in detention facilities, these families arrive tired, hungry, dehydrated, and with minimal direction regarding their final destination, and adherence to the parameters of their parole. Project helping hands (PHHs) utilizes a network of volunteers to provide the women and children with food, water, clothing, hygiene products, hospitality, and legal orientation. The aim of this assessment was to document the experiences of families granted humanitarian parole through the lens of structural vulnerability. Here, we apply qualitative methods to elicit PHH lead volunteer perspectives regarding the migration experience of migrating families. Using inductive analysis, we found six major themes emerged from the qualitative data: reasons for leaving, experience on the journey, dehumanization in detention, family separation, vulnerability, and resiliency. These findings elucidate the different physical and psychological distresses that migrating families from Mexico and Central America experience before, during and after their arrival at the US–Mexico border. We posit that these distresses are a result of, or exacerbated by, structural vulnerability. Structural vulnerability has life-long health implications for a sub-population of young mothers and their children. The number of migrating families who have experienced traumatic events before and during their migration experience continues to expand and thus warrants consideration of mental health surveillance and intervention efforts for these families. More public health research is needed to better understand and combat the health challenges of this growing population. PMID:26157791

  2. 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

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    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.

  3. Ecosystem approaches and health in Latin America Enfoques ecossistêmicos e saúde: vertentes e aplicações na América Latina

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    Carlos Machado de Freitas

    2007-02-01

    Full Text Available Important environmental changes that have become increasingly pronounced in the last two centuries and that are seriously affecting human health require the development of integrated and participatory scientific approaches that can result in proposals for institutional and public policy changes. The purpose of this article is to offer some elements that can contribute to a line of reflection based on studies with ecosystem approaches in the Latin America context. The authors begin with a brief description of current scientific literature in public health that links ecosystems and human health in Latin America; next, they describe and compare the two prevailing trends that form the basis for the theoretical and methodological debates on ecosystem approaches; they also review the empirical research in Latin America or concerning Latin American countries in which an ecosystem approach has been adopted. The results point to limited scientific output on the interface between ecosystems and human health; aspects involving public participation and implementation of institutional changes and public policies are still in a rather incipient stage.As grandes mudanças ambientais que vêm se acentuando nos últimos dois séculos e que afetam a saúde humana exigem o desenvolvimento de abordagens científicas integradas, participativas e que resultem em proposições de mudanças institucionais e nas políticas públicas. O objetivo deste artigo é oferecer elementos para uma reflexão sobre uma linha destas abordagens integradas, os enfoques (ecosistêmicos, na realidade latino-americana. Para alcançar este objetivo, realizamos breve descrição do quadro atual de produção científica no âmbito da Saúde Pública sobre ecossistemas e saúde humana na América Latina; descrevemos e comparamos as duas vertentes que se encontram na base do debate teórico e metodológico sobre os enfoques ecossistêmicos; analisamos os trabalhos empíricos que adotaram

  4. Child health in Latin America: historiographic perspectives and challenges Saúde infantil na América Latina: perspectivas historiográficas e desafios

    Directory of Open Access Journals (Sweden)

    Anne-Emanuelle Birn

    2007-09-01

    Full Text Available Patterns of child health and well-being in Latin America's past - have been assumed to be delayed and derivative of European and North Americanexperiences. Through an examination of recent historiography, this essay traces a more complex reality: interest in infant and child health in Latin America arose from a range of domestic and regional prerogatives. This attention was rooted in preColumbian cultures, then relegated to the private sphere during the colonial period, except for young public wards. Starting in the 19th century, professionals, reformers, and policy-makers throughout the region regarded child health as a matter central to building modern societies. Burgeoning initiatives were also linked to international priorities and developments, not through one-way diffusion but via ongoing interaction of ideas and experts. Despite pioneering approaches to children's rights and health in Latin America, commitment to child well-being has remained uneven, constrained in many settings by problematic political and economic conditions uch.Modelos de saúde e bem-estar infantis do passado na América Latina têm sido considerados como subprodutos defasados de experiências européias e norte-americanas. Com base em análise da historiografia recente, este artigo apresenta uma realidade mais complexa: o interesse pela criança e a saúde infantil na América Latina origina-se de um conjunto de condições domésticas e regionais. Com raízes em culturas pré-colombianas, foi relegado à esfera privada no período colonial, exceto quanto à custódia pública de jovens. A partir do século XIX, profissionais, reformadores e políticos de toda a região passaram a considerar a saúde infantil fundamental para a construção das sociedades modernas. As iniciativas que emergiram desde então guardam relação também com prioridades e programas internacionais, não por difusão unidirecional mas sim pela interação de idéias e especialistas. Apesar

  5. 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.

  6. Public purchasers contracting external primary care providers in Central America for better responsiveness, efficiency of health care and public governance: issues and challenges.

    Science.gov (United States)

    Macq, Jean; Martiny, Patrick; Villalobos, Luis Bernardo; Solis, Alejandro; Miranda, Jose; Mendez, Hilda Cecilia; Collins, Charles

    2008-09-01

    Several national health systems in Latin America initiated health reforms to counter widespread criticisms of low equity and efficiency. For public purchasing agencies, these reforms often consisted in contracting external providers for primary care provision. This paper intends to clarify both the complex and intertwined issues characterizing such contracting as well as health system performances within the context of four Central American countries. It results from a European Commission financed project lead between 2002 and 2005, involving participants from Costa Rica, Guatemala, Nicaragua, Salvador, United Kingdom, Netherlands and Belgium, whose aim was to promote exchanges between these participants. The findings presented in this paper are the results of a two stage process: (a) the design of an initial analytical framework, built upon findings from the literature, interlinking characteristics of contractual relation with health systems performances criteria and (b) the use of that framework in four case studies to identify cross-cutting issues. This paper reinforces two pivotal findings: (a) contracting requires not only technical, but also political choices and (b) it cannot be considered as a mechanical process. The unpredictability of its evolution requires a flexible and reactive approach. This should be better assimilated by national and international organizations involved in health services provision, so as to progressively come out of dogmatic approaches in deciding to initiate contractual relation with external providers for primary care provision.

  7. Not Safe at Home: How America's Housing Crisis Threatens the Health of Its Children. A Research Report.

    Science.gov (United States)

    Sharfstein, Joshua; Sandel, Megan

    Through an Internet campaign, the Doc4Kids Project gathered stories from pediatric caregivers about children whose health has been compromised by poor housing and whose health has been improved by housing assistance. The medical literature was also reviewed to estimate the total impact of inadequate housing on child health in the United States.…

  8. 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

  9. 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

  10. 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

  11. 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)

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

    2015-01-01

    Background 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. Objective 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. Methods 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. Results 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

  12. [The intercontinental schizophrenia outpatient health outcomes study (IC-SOHO): initial 6 month findings of the sample in Latin America].

    Science.gov (United States)

    Brunner, E; Gargoloff, P; Caro, O; González, C; Landa, E; González, C H; Barahona, A; Soria, D; Tamayo, J; Rovner, J; Adrianzen, C; Silva, H; Hodge, A; O'Halloran, R; Assunção, S S M

    2006-01-01

    The IC-SOHO study was designed to supply information on antipsychotic treatments in the real clinical practice by assessment of a large and diverse sample population with schizophrenia. This document describes the findings of the first 6 months of IC-SOHO in Latin America. To date, this is the largest observational study of its type in this region. In this observational and prospective study, those out-patients with schizophrenia, who require a change or initiation of antipsychotic medication are hospitalized. Effectiveness was evaluated using the Clinical Global Impression-Seriousness (CGI-S) grading scale. Tolerability was assessed by questionnaires on adverse events and weight measurements. Herein, the comparisons between olanzapine (monotherapy), risperidone (monotherapy) and conventional antipsychotics (monotherapy and combined therapy) are presented. As a whole, 7,658 patients participated in the ICSOHO; n=2,671 from 11 countries of Latin America that were included in this report. At 6 months, the proportion of patients who responded to olanzapine was significantly greater than those who responded to risperidone or conventional antipsychotics (p<0.001). Patients from the olanzapine group had greater improvements in all the symptom domains, including general, positive, negative, depressive and cognitive symptoms in comparison with risperidone (p<0.05) or conventional antipsychotics (p < 0.001). Extrapyramidal symptoms (EPS) and tardive dyskinesia (TD) decreased from baseline in the groups treated with olanzapine and risperidone, but increased in the conventional group. The adverse events related with the sexual function were more prominent in the conventional group. Weight gain was observed in each treatment group, although the patients from the olanzapine group had greater weight grain followed by those of risperidone and then by those of conventional antipsychotics. Our findings in this population of the Latin American sample emulate the results of other

  13. Prevention, control, and elimination of neglected diseases in the Americas: Pathways to integrated, inter-programmatic, inter-sectoral action for health and development

    Directory of Open Access Journals (Sweden)

    Genovese Miguel A

    2007-01-01

    Full Text Available Abstract Background In the Latin America and Caribbean region over 210 million people live below the poverty line. These impoverished and marginalized populations are heavily burdened with neglected communicable diseases. These diseases continue to enact a toll, not only on families and communities, but on the economically constrained countries themselves. Discussion As national public health priorities, neglected communicable diseases typically maintain a low profile and are often left out when public health agendas are formulated. While many of the neglected diseases do not directly cause high rates of mortality, they contribute to an enormous rate of morbidity and a drastic reduction in income for the most poverty-stricken families and communities. The persistence of this "vicious cycle" between poverty and poor health demonstrates the importance of linking the activities of the health sector with those of other sectors such as education, housing, water and sanitation, labor, public works, transportation, agriculture, industry, and economic development. Summary The purpose of this paper is three fold. First, it focuses on a need for integrated "pro-poor" approaches and policies to be developed in order to more adequately address the multi-faceted nature of neglected diseases. This represents a move away from traditional disease-centered approaches to a holistic approach that looks at the overarching causes and mechanisms that influence the health and well being of communities. The second objective of the paper outlines the need for a specific strategy for addressing these diseases and offers several programmatic entry points in the context of broad public health measures involving multiple sectors. Finally, the paper presents several current Pan American Health Organization and other institutional initiatives that already document the importance of integrated, inter-programmatic, and inter-sectoral approaches. They provide the framework for a

  14. Prevention, control, and elimination of neglected diseases in the Americas: Pathways to integrated, inter-programmatic, inter-sectoral action for health and development

    Science.gov (United States)

    Holveck, John C; Ehrenberg, John P; Ault, Steven K; Rojas, Rocio; Vasquez, Javier; Cerqueira, Maria Teresa; Ippolito-Shepherd, Josefa; Genovese, Miguel A; Periago, Mirta Roses

    2007-01-01

    Background In the Latin America and Caribbean region over 210 million people live below the poverty line. These impoverished and marginalized populations are heavily burdened with neglected communicable diseases. These diseases continue to enact a toll, not only on families and communities, but on the economically constrained countries themselves. Discussion As national public health priorities, neglected communicable diseases typically maintain a low profile and are often left out when public health agendas are formulated. While many of the neglected diseases do not directly cause high rates of mortality, they contribute to an enormous rate of morbidity and a drastic reduction in income for the most poverty-stricken families and communities. The persistence of this "vicious cycle" between poverty and poor health demonstrates the importance of linking the activities of the health sector with those of other sectors such as education, housing, water and sanitation, labor, public works, transportation, agriculture, industry, and economic development. Summary The purpose of this paper is three fold. First, it focuses on a need for integrated "pro-poor" approaches and policies to be developed in order to more adequately address the multi-faceted nature of neglected diseases. This represents a move away from traditional disease-centered approaches to a holistic approach that looks at the overarching causes and mechanisms that influence the health and well being of communities. The second objective of the paper outlines the need for a specific strategy for addressing these diseases and offers several programmatic entry points in the context of broad public health measures involving multiple sectors. Finally, the paper presents several current Pan American Health Organization and other institutional initiatives that already document the importance of integrated, inter-programmatic, and inter-sectoral approaches. They provide the framework for a renewed effort toward the

  15. 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.

  16. 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

  17. 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.

  18. 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.…

  19. 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

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. Las enfermedades emergentes y reemergentes: un problema de salud en las Américas Emerging and reemerging diseases: a health problem in the Americas

    Directory of Open Access Journals (Sweden)

    Guillermo Mesa Ridel

    2004-04-01

    Full Text Available In the Region of the Americas the emerging and reemerging infectious diseases that had the greatest impact on health, in terms of their incidence and the number of deaths that they caused during the five-year period of 1999­2003, were: malaria, yellow fever, dengue hemorrhagic fever, AIDS, anthrax, and SARS, as well as infection by hantavirus and by West Nile virus. The appearance of epidemics of emerging and reemerging diseases is related to biological, social, and economic factors. Growth in international trade, the movement of large numbers of people across national borders, the variability and genetic adaptability of the causative microorganisms, and inefficiencies in public health systems help to spread infections and epidemics. To avoid or reduce the serious effects of these epidemics, countries should give priority in their national agendas to surveillance of emerging and reemerging diseases and should implement a set of measures to combat the diseases. The most important of these measures is to develop a strategy that is based on early warning and rapid response mechanisms, with personnel and laboratories as well as communications networks that link laboratories with health service providers. This strategy should be backed by priority funding and adequate policies.

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

    OpenAIRE

    Mitra, Amal K.; Rodriguez-Fernandez, Gisela

    2010-01-01

    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/...

  6. 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.

  7. Comparing the Course of Mental Health Over the First Year After Stroke With Healthy Controls in Colombia, South America.

    Science.gov (United States)

    Sutter, Megan; Olabarrieta Landa, Laiene; Calderón Chagualá, Amilkar; Chacón Peralta, Helmer; Vergara Torres, Gina; Perrin, Paul B; Arango-Lasprilla, Juan Carlos

    2017-01-01

    Stroke is a primary cause of death and disability in upper-middle-income countries such as Colombia. Given the lack of comprehensive rehabilitation for stroke patients in Colombia, there is a need to assess longitudinal mental health problems poststroke in this region. To compare the course of mental health in stroke patients to healthy controls over the first year poststroke in Ibague, Colombia. Cross-sectional study. The Psychological Attention Center of Antonio Nariño University in Ibague, Colombia. Stroke patients (n = 50) and age- and gender-matched healthy controls (n = 50). Patients and controls completed self-report Spanish versions of demographic information, injury-related characteristics, and mental health questionnaires MAIN OUTCOME MEASUREMENTS: Outcomes assessed included mental health (depression, anxiety, and stress) at 3, 6, and 12 months poststroke. Hierarchical linear models suggested that stroke patients had worse depression and anxiety over time than controls (P Colombia. Despite the improvements in anxiety and depression over the first year poststroke, patient anxiety and depression were still worse in comparison to those in healthy controls. The current findings indicate a need for rehabilitation services in Colombia, especially targeting mental health issues. I. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. Good Health, Strong Families, and Positive Early Learning Experiences: Promoting Better Public Policies for America's Infants and Toddlers

    Science.gov (United States)

    Lally, J. Ronald; Lurie-Hurvitz, Erica; Cohen, Julie

    2006-01-01

    The ZERO TO THREE Policy Center has three areas of focus: good health, strong families, and positive early learning experiences. Effective policies must promote healthy functioning in all domains, including cognitive, physical, and social and emotional development. Comprehensive services are essential to meeting the needs of very young children…

  13. Costs and health effects of breast cancer interventions in epidemiologically different regions of Africa, North America, and Asia.

    NARCIS (Netherlands)

    Groot, M.T.; Baltussen, R.M.P.M.; Groot, C.A. de; Anderson, B.O.; Hortobagyi, G.N.

    2006-01-01

    We estimated the costs and health effects of treating stage I, II, III, and IV breast cancer individually, of treating all stages, and of introducing an extensive cancer control program (treating all stages plus early stage diagnosis) in three epidemiologically different world regions--Africa, North

  14. 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....

  15. Postdoctoral Education in Dentistry: Preparing Dental Practitioners To Meet the Oral Health Needs of America in the 21st Century.

    Science.gov (United States)

    Glassman, Paul; Meyerowitz, Cyril

    1999-01-01

    Reviews the history of postdoctoral programs in dentistry and medicine, focusing on postdoctoral general dentistry education, and describes the changing health-care environment in which future dental professionals will practice, relating the dental postdoctoral experience to that in medicine. A strategy is presented to prepare dental practitioners…

  16. 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.

  17. 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.

  18. 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.

  19. "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.…

  20. 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,…

  1. 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.

  2. 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…

  3. 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.

  4. 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.

  5. An Emergency Medicine-Primary Care Partnership to Improve Rural Population Health: Expanding the Role of Emergency Medicine.

    Science.gov (United States)

    Greenwood-Ericksen, Margaret B; Tipirneni, Renuka; Abir, Mahshid

    2017-11-01

    The health of rural America is failing and our traditional approaches have proved ineffective at improving health in rural communities. Rural populations are now a health disparity population, facing higher mortality rates for the 5 leading causes of death compared with their urban counterparts. We must generate novel, rural-specific approaches to solve this challenge-and there is a clear role for the field of emergency medicine. Building on emergency departments' (EDs') expanding role in health care delivery and emergency medicine's increasing involvement in population health, we propose a new health care delivery model for rural population health based on partnership between emergency medicine and primary care that embraces the important role that EDs play in rural areas. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  6. Analysis of the enablers of capacities to produce primary health care-based reforms in Latin America: a multiple case study.

    Science.gov (United States)

    Báscolo, Ernesto Pablo; Yavich, Natalia; Denis, Jean-Louis

    2016-06-01

    Primary health care (PHC)-based reforms have had different results in Latin America. Little attention has been paid to the enablers of collective action capacities required to produce a comprehensive PHC approach. To analyse the enablers of collective action capacities to transform health systems towards a comprehensive PHC approach in Latin American PHC-based reforms. We conducted a longitudinal, retrospective case study of three municipal PHC-based reforms in Bolivia and Argentina. We used multiple data sources and methodologies: document review; interviews with policymakers, managers and practitioners; and household and services surveys. We used temporal bracketing to analyse how the dynamic of interaction between the institutional reform process and the collective action characteristics enabled or hindered the enablers of collective action capacities required to produce the envisioned changes. The institutional structuring dynamics and collective action capacities were different in each case. In Cochabamba, there was an 'interrupted' structuring process that achieved the establishment of a primary level with a selective PHC approach. In Vicente López, there was a 'path-dependency' structuring process that permitted the consolidation of a 'primary care' approach, but with limited influence in hospitals. In Rosario, there was a 'dialectic' structuring process that favoured the development of the capacities needed to consolidate a comprehensive PHC approach that permeates the entire system. The institutional change processes achieved the development of a primary health care level with different degrees of consolidation and system-wide influence given how the characteristics of each collective action enabled or hindered the 'structuring' processes. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. The EMBRACE II study: The outcome and prospect of two decades of evolution within the GEC-ESTRO GYN working group and the EMBRACE studies

    Directory of Open Access Journals (Sweden)

    Richard Pötter

    2018-02-01

    The EMBRACE II study is an interventional and observational multicentre study which aims to benchmark a high level of local, nodal and systemic control while limiting morbidity, using state of the art treatment including an advanced target volume selection and contouring protocol for EBRT and brachytherapy, a multi-parametric brachytherapy dose prescription protocol (clinical validation of dose constraints, and use of advanced EBRT (IMRT and IGRT and brachytherapy (IC/IS techniques (clinical validation. The study also incorporates translational research including imaging and tissue biomarkers.

  8. 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

  9. Epidemiological changes and financial consequences of hypertension in Latin America: implications for the health system and patients in Mexico.

    Science.gov (United States)

    Arredondo, Armando; Zuñiga, Alexis

    2012-03-01

    The aim of this study was to assess the costs and financial consequences of epidemiological changes in hypertension in Mexico. The cost evaluation method to estimate costs was based on instrumentation techniques. To estimate the epidemiological changes and expected cases of hypertension in 2010-2012, three probabilistic models were constructed according to the Box-Jenkins technique. Comparing the economic impact, from 2010 to 2012 there will be a 24% increase in financial requirements (p < 0.05). The total cost of hypertension in 2011 will be US$ 5,733,350,291, including US$ 2,718,280,941 in direct costs and US$ 3,015,069,350 in indirect costs. If the risk factors and various healthcare models remain unaltered in the institutions analyzed here, the financial consequences will have a major impact on users' pockets, followed by social security providers and public healthcare providers. The authors suggest a revision in the planning, organization, and allocation of resources, particularly programs for health promotion and prevention of hypertension.

  10. 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.

  11. 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.

  12. 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…

  13. Embracing Diversity

    NARCIS (Netherlands)

    S. Puntoni (Stefano)

    2015-01-01

    markdownabstract__Abstract__ Societies are vastly more diverse today than they used to be and, in many industries, developing theories and approaches that recognize and capitalize on this greater consumer diversity is crucial. In business schools, diversity tends to be discussed only in relation

  14. 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’.

  15. Criminality and Violence in Latin America: a Comparative ...

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

    Canada-Latin America and Caribbean Zika Virus Research Program. A new funding opportunity on Zika virus is responding to the virus outbreak and the health threat it represents for the affected populations in the hardest hit countries in Latin America and the... View moreCanada-Latin America and Caribbean Zika Virus ...

  16. 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

    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 acquired

  17. 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

  18. 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

  19. 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.

  20. 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)

  1. The limits of the Buddhist embrace of science. Commentary on "Compassion, ethics, and neuroscience: neuroethics through Buddhist eyes".

    Science.gov (United States)

    Cho, Francisca

    2012-09-01

    The readiness of Buddhists to dialogue with and embrace modern science has caused some to worry that this encounter will deform Buddhist traditions for the sake of acceptance by the West. But their strong tradition of epistemological skepticism and intellectual pluralism makes it unlikely that Buddhists will embrace scientific positivism. Given the tensions between religion and science in contemporary western society, it is perhaps this feature of Buddhism that can make the most fruitful contribution in its dialogue with science.

  2. [User embracement and social (de)medicalization: a challenge for the family health teams].

    Science.gov (United States)

    Tesser, Charles Dalcanale; Poli Neto, Paulo; Campos, Gastão Wagner de Sousa

    2010-11-01

    This article discusses the relation between sheltering practice and social medicalization in the primary care. It begins with a revision about social medicalization and mentions some influences concerning the organization of the Brazilian primary care. It also indicates that the ground of receptivity proposal was provided by those influences. It argues the potentiality to accomplish the sheltering with a demedicalization and interdisciplinary action and its reverse effect, when restricted simply to emergency medic care. There are hereby suggested changes in the management and organization of routines, agendas as well as collective and individuals activities of the professionals with the intention to reduce medicalization. The conclusion favors the expansion of experimentation on sheltering as a strategy in dealing with unexpected events and with primary care spontaneous demand, always watching out for its medicalization potential.

  3. Inequalities in health in Latin America and the Caribbean: descriptive and exploratory results for self-reported health problems and health care in twelve countries Desigualdades de salud en América Latina y el Caribe: resultados descriptivos y exploratorios basados en la autonotificación de problemas de salud y atención de salud en doce países

    OpenAIRE

    J. Norberto W. Dachs; Marcela Ferrer; Carmen Elisa Florez; Aluisio J. D. Barros; Rory Narváez; Martín Valdivia

    2002-01-01

    Objective. To explore and describe inequalities in health and use of health care as revealed by self-report in 12 countries of Latin America and the Caribbean. Methods. A descriptive and exploratory study was performed based on the responses to questions on health and health care utilization that were included in general purpose household surveys. Inequalities are described by quintile of household expenditures (or income) per capita, sex, age group (children, adults, and older adults), and p...

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

    Science.gov (United States)

    Molofsky, Merle

    2018-03-26

    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.

  5. A AUTORREGULAMENTAÇÃO DA PUBLICIDADE DE MEDICAMENTOS E PRODUTOS DE SAÚDE NA AMÉRICA LATINA: UMA ANÁLISE DOS CÓDIGOS DEONTOLÓGICOS DO SETOR PUBLICITÁRIO NA AMÉRICA LATINA | THE SELF-REGULATION OF MEDICINES AND HEALTH PRODUCTS ADVERTISING IN LATIN AMERICA: AN ANALYSIS OF THE ADVERTISING SECTOR CODES OF ETHICS IN LATIN AMERICA

    Directory of Open Access Journals (Sweden)

    Dhione Oliveira Santana

    2016-08-01

    Full Text Available This paper aims to investigate the advertising self-regulation of medicines and health products (Products and Services have the same meaning in this research present in the ethical codes of the advertising industry in Latin America. To do so, it was seek through content analysis, identify, classify and categorize the standards present in the advertising industry codes governing the publicity of medicines and health products. Ethical codes are present in nine countries in Latin America with seven of them are referred to medicines and health products, and only five have specific rules for the sector. In summary, the analyzed codes present in its generality, lenient rules to the sector, bringing instructions mainly to the content of the messages and it must therefore, national and professionals in the health sector codes and/or the pharmaceutical industry rules, act with stiffness in control advertising of medicines and health products.

  6. 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

  7. 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.

  8. 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...

  9. 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.

  10. 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

  11. 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.

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

    Science.gov (United States)

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

    2017-05-01

    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 randomized controlled trial. Integrated care and support according to the "Embrace" model was provided by 15 general practitioners in the Netherlands. Based on self-reported levels of case complexity and frailty, a total of 1456 community-living older adults were stratified into non-disease-specific risk profiles ("Robust," "Frail," and "Complex care needs"), and randomized to Embrace or control groups. Embrace provides integrated, person-centered primary care and support to all older adults living in the community, with intensity of care dependent on risk profile. Primary outcome was quality of care as reported by older adults on the Patient Assessment of Integrated Elderly Care (PAIEC). Effects were assessed using mixed model techniques for the total sample and per risk profile. Professionals' perceived level of implementation of integrated care was evaluated within the Embrace condition using the Assessment of Integrated Elderly Care. Older adults in the Embrace group reported a higher level of perceived quality of care than those in the control group (B = 0.33, 95 % CI = 0.15-0.51, ES d = 0.19). The advantages of Embrace were most evident in the "Frail" and "Complex care needs" risk profiles. We found no significant advantages for the "Robust" risk profile. Participating professionals reported a significant increase in the perceived level of implementation of integrated care (ES r = 0.71). This study shows that providing a population-based integrated care service to community-living older adults improved the quality of care as perceived by older adults and participating professionals.

  13. 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.

  14. Estimating prevalence of chronic obstructive pulmonary disease in the Southern Cone of Latin America: how different spirometric criteria may affect disease burden and health policies.

    Science.gov (United States)

    Sobrino, Edgardo; Irazola, Vilma E; Gutierrez, Laura; Chen, Chung-Shiuan; Lanas, Fernando; Calandrelli, Matías; Ponzo, Jacqueline; Mores, Nora; Serón, Pamela; Lee, Allison; He, Jiang; Rubinstein, Adolfo L

    2017-12-11

    Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death worldwide. The study aimed to determine and compare the prevalence of COPD in the general population aged 45-74 years old according to fixed ratio and lower limit of normal (LLN) thresholds in four cities in the Southern Cone of Latin America. The Pulmonary Risk in South America (PRISA) study used a 4-stage stratified sampling method to select 5814 participants from 4 cities in the Southern Cone of Latin America (Bariloche and Marcos Paz, Argentina; Temuco, Chile; and Pando-Barros Blancos, Uruguay). Data on demographic information, medical history, risk factors, pre-bronchodilator and post-bronchodilator spirometry were obtained using a standard protocol. According to GOLD, COPD was defined as a post-bronchodilator ratio of forced expiratory volume in one second (FEV1) over forced vital capacity (FVC) less than 70%. The LLN threshold was defined as the lower fifth percentile for predicted FEV1/FVC, and was evaluated as an alternative COPD definition. Overall COPD prevalence was 9.3% (95% CI 8.4, 10.2%), and men had a higher prevalence [11.8% (95% CI 10.3, 13.3%)] than women [7.3% (95% CI 6.2, 8.3%)] with the fixed ratio. Overall COPD prevalence using LLN was 4.7% (95% CI 4.1, 5.3%), higher in men: 5.8% (95% CI 4.7, 6.8%) than women: 3.9% (95% CI 3.1, 4.7%). COPD prevalence was significantly higher among those who were older, had Latin America.

  15. 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'

  16. 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 ...

  17. 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.

  18. 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.

  19. America's Children and the Environment

    Science.gov (United States)

    ... Protection Agency Search Search 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 ...

  20. Health Literacy and the Patient With Heart Failure-Implications for Patient Care and Research: A Consensus Statement of the Heart Failure Society of America

    OpenAIRE

    Evangelista, LS; Rasmusson, KD; Laramee, AS; Barr, J; Ammon, SE; Dunbar, S; Ziesche, S; Patterson, JH; Yancy, CW

    2010-01-01

    Background: Low health literacy compromises patient safety, quality health care, and desired health outcomes. Specifically, low health literacy is associated with decreased knowledge of one's medical condition, poor medication recall, nonadherence to treatment plans, poor self-care behaviors, compromised physical and mental health, greater risk of hospitalization, and increased mortality. Methods: The health literacy literature was reviewed for: definitions, scope, risk factors, assessment, i...

  1. 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...

  2. 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 ...

  3. Prevent Child Abuse America

    Science.gov (United States)

    ... call the police . Crisis and support contacts For Child Abuse Reporting Numbers in your State please visit: Child ... suspected child abuse and neglect. Parent Resources Prevent Child Abuse America (800) CHILDREN A resource for tips, referrals, ...

  4. 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

  5. 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

  6. 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

  7. Freud's antipathy to America.

    Science.gov (United States)

    Warner, S L

    1991-01-01

    Freud first saw this in America's attitude toward the use of cocaine. It was freely and legally used and even promoted by American physicians as beneficial in many medical conditions. Freud was first swept along by America's prococaine enthusiasm. He narrowly missed destroying his own medical reputation by his continuing close connection and advocacy of cocaine. Freud made his only visit to America in 1909. Despite the success of his visit and the congeniality of Americans toward him, he was already programmed toward a negative response. He allowed minor everyday inconveniences and cultural differences to spoil the trip for him. The chronic intestinal distress that had bothered him previously now was labelled as his "American dyspepsia." He developed additional reasons for disliking America. They accepted his three key dissenters, Adler, Jung, and Rank. He even believed that these three men achieved greater notoriety and popularity in America than he did. In fact, the Freudian psychoanalytic movement became much larger and more powerful in America than did the followings of any or all of his defectors. Freud did not like the shortcuts and lack of mastery of the basics of psychoanalysis that he believed happened in America. Some of this was true, but it was mainly exaggerated in Freud's mind. The gold of psychoanalysis was never transformed into a practical but deficient psychoanalytic alloy as Freud feared it might. There was a genuine disagreement about whether a psychoanalyst should have to become a medical doctor or not. It was a complicated issue in America because of laws that said that doing psychoanalysis was practicing medicine. Freud viewed the American stand against recognizing lay analysts as more evidence of American's being a rebellious son. Economic factors also played a significant factor in Freud's dislike of America. Freud was initially enthusiastic about President Wilson and his plans for peace. He found after World War I that all of his savings

  8. Growing pains in South America.

    Science.gov (United States)

    Joyce, S

    1997-08-01

    This article describes some negative effects from modernization and urban growth in South America, including disease, pesticides, occupational hazards, poor environmental controls of water and garbage, sanitation, and environmental degradation. South America is following the global trend toward urbanization and the problems that accompany it. Agricultural expansion led to an expanded market for pesticides that includes the deadly DDT, paraquat, and heptachlor. Brazil and Colombia are the largest consumers. Latin American officials justify use of DDT, which is banned in the US and many European countries, as an effective means of combating mosquitos that carry malaria. Exposure occurs during harvesting, transporting, forestry, livestock farming, and vector control activities. Methyl bromide, which is used post-harvest and as a soil fumigant, is dangerous enough to be banned in the US in 2001, and in developing countries in 2002. Exposure to toxic chemicals can severely inhibit enzyme action that is necessary for neurological functioning. A hot climate, which prevents protective clothing, lack of education on proper application, and absence of water to wash exposed skin, make pesticide protection very difficult. Over 40 million agricultural workers are at risk of pesticide poisoning. Habitat destruction has contributed to increased mosquito infestations. Children in the workplace are at even greater risk of noise pollution and chemical poisoning. South America pollutes almost 11 times more fresh water per capita than Europe. About 70% of domestic garbage is collected, and about 30% is disposed of correctly. Only 10% of urban wastewater is treated before discharge into waterways. The loss of coastal wetlands reduces the ability of waterways to filter and absorb nutrients. Environmental health problems suggest an interlinkage between environmental sustainability, human health, and economic growth.

  9. Policy Influence and Urban Slums in Latin America : Ecohealth ...

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

    Policy Influence and Urban Slums in Latin America : Ecohealth International Workshop. IDRC's Ecosystem Approaches to Human Health (Ecohealth) program initiative has been active in Latin America and the Caribbean for the past eight years. Ecohealth recognizes that it is now imperative to systematize the lessons ...

  10. Latin America and the Caribbean | IDRC - International ...

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

    Long-term sustainability of development in Latin America and the Caribbean through economic growth, equitable access to health and social services, sustainable natural resources, and civil security. And we are ... Honduras. With our partners, IDRC-funded research in Honduras is building robust local leadership capacity.

  11. 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…

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

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

    Countries of the Americas are proceeding with economic negotiations that could either support or inhibit sustainable development. Impact assessment can help mitigate serious health and environmental risks arising from new trade and economic development policies, and open space for greater public participation.

  13. The State of America's Children: 1992.

    Science.gov (United States)

    Children's Defense Fund, Washington, DC.

    This report on the state of children in the United States begins with a call to action that points out the destructive effects of poverty, violence, and drug use on America's children while outlining 10 needed steps that should be followed to help alleviate these problems. The greater part of the report focuses on: (1) health; (2) child care; (3)…

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. Learning from Past Infrastructure to Embrace Friction and Create the Research Data Alliance

    Science.gov (United States)

    Parsons, M. A.

    2014-12-01

    In creating international organizations, we are often seeking to create new scientific infrastructure. Yet infrastructure is never truly planned or designed up front. It evolves through a staged process that can involve complex dynamics, unanticipated consequences, and significant friction between individuals, organizations, and systems. Collaborators may agree on general directions or principles, but they do not necessarily have common goals. Coalition style politics emerge that can both ameliorate and exacerbate the friction, but it is through this multifaceted perspective that we achieve greater understanding. The Research Data Alliance embraces this complex dynamic. It has no overarching plan or architecture, but it provides core principles and a "neutral place" that provide enough alignment to move forward while still recognizing the value of friction. The focus is on building and implementing bridges or gateways that connect disparate systems, organizations, and processes in order to create more interconnection and increase data sharing. This presentation will describe this approach adopted by RDA and the initial products created--both technical and social. More importantly, it will illustrate how these products have been adopted at multiple scales and suggest ways forward toward a rapid evolution of a data-sharing infrastructure.

  20. 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...

  1. Breast health global initiative (BHGI outline for program development in Latin America Breast health global initiative (BHGI planeamiento para el desarrollo de programas en América latina

    Directory of Open Access Journals (Sweden)

    Benjamin O. Anderson

    2009-01-01

    Full Text Available The Breast Health Global Initiative (BHGI applied an evidence-based consensus review process to develop guidelines for breast cancer early detection, diagnosis, and treatment in low- and middle-income countries (LMCs including those in Latin America. Breast cancer outcomes correlate with the degree to which 1 cancers are detected early, 2 cancers can be diagnosed correctly, and 3 proper multimodality treatment can be provided in a timely fashion. Cancer prevention through health behavior modification may influence breast cancer incidence in LMCs. Diagnosing breast cancer at earlier stages will reduce breast cancer mortality. Programs to promote breast self-awareness and clinical breast examination and resource-adapted mammographic screening are important early detection steps. Screening mammography has been shown to reduce breast cancer mortality, but is cost prohibitive in some settings. Breast imaging, initially with ultrasound and, at higher resource levels with diagnostic mammography, improves preoperative diagnostic assessment and permits image-guided needle sampling. Multimodality therapy includes surgery, radiation, and systemic therapies.La Iniciativa Global para la Salud de la Mama (BGHI ha aplicado un proceso de revisión de consenso, basado en la evidencia, a fin de desarrollar guías para la detección precoz del cáncer de mama, diagnóstico y tratamiento, en países de bajos y medianos ingresos (PBMI incluyendo aquellos en América latina. La evolución del cáncer de mama se correlaciona con el grado al cual 1 los cánceres son detectados tempranamente 2los cánceres pueden ser diagnosticados correctamente, y 3el adecuado tratamiento multimodal suministrado a tiempo. La prevención del cáncer a través de modificaciones de las conductas de salud puede modificar la incidencia del cáncer de mama en PBMI. El diagnóstico del cáncer de mama en estadios iniciales reduce la mortalidad por cáncer de mama. Los programas que promueven

  2. 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...

  3. 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)

  4. 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.

  5. Explaining health differences between men and women in later life: a cross-city comparison in Latin America and the Caribbean.

    Science.gov (United States)

    Zunzunegui, Maria-Victoria; Alvarado, Beatriz-Eugenia; Béland, François; Vissandjee, Bilkis

    2009-01-01

    This paper describes differences in health and functional status among older men and women and attempts to anchor the explanations for these differences within a lifecourse perspective. Seven health outcomes for men and women 60 years and older from seven Latin American and Caribbean cities are examined, using data from the 2000 SABE survey (Salud, Bienestar y Envejecimiento-n=10,587). Age-adjusted as well as city- and sex-specific prevalence was estimated for poor self-rated health, comorbidity, mobility limitations, cognitive impairment, depressive symptoms and disability in basic and instrumental activities of daily living. Logistic regressions were fitted to determine if the differences between men and women in each outcome could be explained by differential exposures in childhood (hunger, poverty), adulthood (education, occupation) and old age (income) and/or by differential vulnerability of men and women to these exposures. Sao Paulo, Santiago and Mexico, cities in countries with a high level of income inequalities, presented the highest prevalence of disability, functional limitations and poor physical health for both women and men. Women showed poorer health outcomes as compared with men for all health indicators and in all cities. Controlling for lifecourse exposures in childhood, adulthood and old age did not attenuate these differences. Women's unadjusted and adjusted odds of reporting poor self-rated health, cognitive impairment and basic activities of daily living disability were approximately 50% higher than for men, twice as high for number of comorbidities, depressive symptoms and instrumental activities of daily living disability, and almost three times as high for mobility limitations. Higher vulnerability to lifecourse exposures in women as compared with men was not found, meaning that lifecourse exposures have similar odds of poor health outcomes for men and women. A more integrated understanding of how sex and gender act together to influence

  6. 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

  7. 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

  8. EPA Efforts in Latin America and the Caribbean

    Science.gov (United States)

    The Latin America and Caribbean (LAC) program provides environmental tools and information to build the capacity of LAC governments and civil society organizations to reduce environmental degradation and its impacts on public health.

  9. 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

    2017-05-01

    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, processes, and abilities (e.g. statistical learning, sampling, functional specialization, visual attention, social interaction, motor ability). We also present evidence from our studies on neurodevelopmental disorders (e.g. Down syndrome, fragile X syndrome, Williams syndrome) that variations in these factors significantly contribute to language delay. Finally, we discuss how embracing complexity, which involves integrating data from different domains and levels of description across developmental time, may lead to a better understanding of language development and, critically, lead to more effective interventions for cases when language develops atypically.

  10. Public Opinion in America.

    Science.gov (United States)

    Monroe, Alan D.

    The purposes of this book are to summarize and analyze the nature of public opinion in contemporary America and to examine the implications of that nature for the possibility of a functioning democracy. Material in the four sections covers the following topics: "The Study of Public Opinion: Political Theory and Methodology"--opinions and…

  11. America's "Private" Public Schools

    Science.gov (United States)

    Petrilli, Michael J.; Scull, Janie

    2010-01-01

    In this report, the authors identify public schools whose doors are effectively closed to poor children. These institutions--generally found in wealthy urban enclaves or well-heeled suburbs--educate many of the children of America's elite while proudly waving the "public school" flag. But they hardly embody the "common school" ideal. In fact, by…

  12. Western Europe's America Problem

    Science.gov (United States)

    Markovits, Andrei S.

    2007-01-01

    In this article, the author discusses Europe's anti-Americanism stance. He observes that Europe's aversion to America has become greater, louder, and more determined, and that it has unified Western Europeans more than any other political emotion (with the exception of a common hostility toward Israel). The author contends that the many disastrous…

  13. 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...

  14. 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…

  15. North America [Chapter 5

    Science.gov (United States)

    Ronald L. Trosper; Fred Clark; Patrica Gerez-Fernandez; Frank Lake; Deborah McGregor; Charles M. Peters; Silvia Purata; Teresa Ryan; Alan Thomson; Alan E. Watson; Stephen Wyatt

    2012-01-01

    The colonial history of North America presents a contrast between Mexico and the two predominantly English-speaking countries, the United States and Canada. In Mexico, indigenous and other local communities own considerable forested lands, a consequence of the Mexican Revolution of the early twentieth century. In the United States, forest land is now primarily in...

  16. 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

  17. Eye Care: MedlinePlus Health Topic

    Science.gov (United States)

    ... America) Recommended Sports Eye Protectors (Prevent Blindness America) Smoking and Eye Health (American Academy of Ophthalmology) Also in Spanish Tips for Buying Sports Eye Protectors (Prevent Blindness America) Journal Articles References and abstracts from MEDLINE/PubMed (National ...

  18. 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.

  19. 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)

  20. 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.

  1. Latin America: the next region for haematopoietic transplant progress.

    Science.gov (United States)

    Jaimovich, G; Martinez Rolon, J; Baldomero, H; Rivas, M; Hanesman, I; Bouzas, L; Bonfim, C; Palma, J; Kardus-Urueta, A; Ubidia, D; Bujan-Boza, W; Gonzalez-Ramella, O; Ruiz-Argüelles, G; Gomez-Almaguer, D; Espino, G; Fanilla, E; Gonzalez, D; Carrasco, A; Galeano, S; Borelli, G; Hernandez-Gimenez, M; Pasquini, M; Kodera, Y; Gratwohl, A; Gratwohl, M; Nuñez, J; Szer, J; Gale, R P; Niederwieser, D; Seber, A

    2017-05-01

    Haematopoietic cell transplant activity in the 28 countries comprising Latin America is poorly defined. We conducted a voluntary survey of members of the Latin American Bone Marrow Transplantation Group regarding transplant activity 2009-2012. Collated responses were compared with data of transplant rates from the Worldwide Network for Blood and Marrow Transplantation for other geographic regions. Several socio-economic variables were analysed to determine correlations with transplant rates. In total, 94 teams from 12 countries reported 11 519 transplants including 7033 autotransplants and 4486 allotransplants. Annual activity increased from 2517 transplants in 2009 to 3263 in 2012, a 30% increase. Median transplants rate (transplant per million inhabitants) in 2012 was 64 (autotransplants, median 40; allotransplants, median 24). This rate is substantially lower than that in North America and European regions (482 and 378) but higher than that in the Eastern Mediterranean and Asia Pacific regions (30 and 45). However, the Latin America transplant rate is 5-8-fold lower than that in America and Europe, suggesting a need to increase transplant availability. Transplant team density in Latin America (teams per million population; 1.8) is 3-4-fold lower than that in North America (6.2) or Europe (7.6). Within Latin America, there is substantial diversity in transplant rates by country partially explained by diverse socio-economic variables including per capita gross national income, health expenditure and physician density. These data should help inform future health-care policy in Latin America.

  2. 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

  3. 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.

  4. Can a comprehensive voucher programme prompt changes in doctors' knowledge, attitudes and practices related to sexual and reproductive health care for adolescents? A case study from Latin America.

    NARCIS (Netherlands)

    Meuwissen, L.E.; Gorter, A.C.; Kester, A.D.M.; Knottnerus, J.A.

    2006-01-01

    OBJECTIVES: To evaluate whether participation in a competitive voucher programme designed to improve access to and quality of sexual and reproductive health care (SRH-care), prompted changes in doctors' knowledge, attitudes and practices. METHODS: The voucher programme provided free access to

  5. 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.

  6. 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.

  7. Antifungal pharmacodynamics: Latin America's perspective.

    Science.gov (United States)

    Gonzalez, Javier M; Rodriguez, Carlos A; Agudelo, Maria; Zuluaga, Andres F; Vesga, Omar

    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. Copyright © 2016 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.

  8. 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.

  9. A Systematic Review of Changes in Marine Mammal Health in North America, 1972-2012: The Need for a Novel Integrated Approach.

    Directory of Open Access Journals (Sweden)

    Claire A Simeone

    Full Text Available Marine mammals are often cited as "sentinels of ocean health" yet accessible, synthesized data on their health changes that could effectively warn of ocean health changes are rare. The objectives of this study were to 1 perform a systematic review of published cases of marine mammal disease to determine spatial and temporal trends in disease from 1972-2012, including changes in regions and taxa affected and specific causes; and 2 compare numbers of published cases of neoplasia with known, hospital-based neoplasia records to explore the causes of discrepancy between numbers of published cases and true disease trends. Peer-reviewed literature was compiled, and data were collected from The Marine Mammal Center database in Sausalito, California for comparison of numbers of neoplasia cases. Toxicoses from harmful algal blooms appear to be increasing. Viral epidemics are most common along the Atlantic U.S. coastline, while bacterial epidemics, especially leptospirosis, are most common along the Pacific coast. Certain protozoal and fungal zoonoses appear to be emerging, such as Toxoplasma gondii in southern sea otters in California, and Cryptococcus gattii in cetaceans in the Pacific Northwest. Disease reports were most common from California where pinniped populations are large, but increased effort also occurs. Anthropogenic trauma remains a large threat to marine mammal health, through direct mortality and indirect chronic disease. Neoplasia cases were under-reported from 2003-2012 when compared to true number of cases, and over-reported in several years due to case duplication. Peer-reviewed literature greatly underestimates the true magnitude of disease in marine mammals as it focuses on novel findings, fails to reflect etiology of multifactorial diseases, rarely reports prevalence rather than simple numbers of cases, and is typically presented years after a disease first occurs. Thus literature cannot guide management actions adequately, nor

  10. 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

  11. Mosquitoes of Middle America.

    Science.gov (United States)

    1976-09-30

    adeloupe, 1964-1966. S Cova Garcia, Pablo, Division de Endemias Rurales, Ministerio de Sanidad y Asistencia Social , Mara- cay, Venezuela...Central America. Diaz Najerra , Alfonso, Laboratorio de En tomologia, Instituto de Salubridad y Enfermedades Trop- icales.— Mosquitoes of Mexico , loan of...Saneamiento Ambiental. Minister io de Sanidad y Asistencia Social , Caracas , Venezuela. — Organization of topotypic survey of mosquitoes in Vene zuela

  12. 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

  13. Western North America dynamics

    Science.gov (United States)

    Ghosh, A.; Becker, T. W.; Humphreys, G.; Gérault, M.

    2009-12-01

    Basal shear tractions, as generated by mantle convection, are likely to affect the stress field over western North America, and hence, influence the deformation of the North American lithosphere. Earlier studies (Humphreys & Coblentz (2007)) have argued for the importance of shear tractions beneath the continent, but at a reduced amplitude from those predicted by Becker & O'Connell (2001). However, these tractions did not take into account the existence of lateral viscosity variations (LVVs) beneath North America, resulting from strong cratonic root and weak plate margin. We evaluate the tractions and the resulting stresses over North America by incorporating LVVs in a global, high resolution, finite element convection code, CitcomS. Since our ultimate goal is to match observables, such as plate motions and geoid, in addition to stresses, we perform a global inversion for both radial and lateral viscosity variations and choose the viscosity structures that yield a good fit simultaneously to both the global geoid and plate motions. We evaluate the tractions and corresponding stress field from those models. We also attempt to incorporate the effects of gravitational potential energy (GPE) in our convection model. The combined stress field from GPE and tractions are compared to stress observations, such as the World Stress Map.

  14. 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

  15. America's top model. As the health information exchange market heats up--with vendors jockeying for position and funds being allocated--one state is paving the way.

    Science.gov (United States)

    Gamble, Kate Huvane

    2010-07-01

    As states move forward in establishing health information exchanges (HIEs), many are looking to New York State for guidance. New York, which got an early start in building a data exchange program, has been successful in securing private investments to supplement its public funds. It has also established a credible infrastructure, governance and policy framework for a statewide HIE network. However, significant hurdles to successful HIE implementation remain. One industry report cautions that policy, security, patient consent, lack of data standards and physician acceptance still need to be addressed.

  16. El embarazo no deseado: impacto sobre la salud y la sociedad en América Latina y el Caribe Unwanted pregnancy: impact on health and society in Latin America and the Caribbean

    Directory of Open Access Journals (Sweden)

    Ana Langer

    2002-03-01

    Full Text Available Engaging in sexuality and reproduction should always be something that is wanted and planned. Unfortunately, when that is not the case, one result can be unwanted pregnancy. Unwanted pregnancies have consequences for women, their families, and their countries. This document reviews the causes and results of unwanted pregnancy, emphasizing the impact that this problem has on Latin America and the Caribbean (LAC. Four reasons why unwanted pregnancy is a continuing problem in LAC are: 1 people's growing desire to have smaller families, 2 the unmet need for family planning, 3 the fact that contraceptive methods are not 100% effective, and 4 unwanted sexual relations. Unwanted pregnancies especially affect adolescent women, single women, and women over 40 years of age. Given their desperate situation with an unwanted pregnancy, some women opt for an unsafe abortion, which can lead to their death. Other women can go so far as to commit suicide, or be murdered by a family member or other person who is unhappy that the pregnancy has occurred. It has been found that women who decide to continue with the pregnancy have higher risks of suffering an illness, and the same is true for the child. Reducing unwanted pregnancies and treating post-abortion complications are key to lowering maternal mortality and morbidity. This necessitates developing mass communication programs that address gender issues, education programs for girls, and sex education programs. It is also vital to make available to all persons reproductive health services that include family planning methods. In the countries of LAC with laws that specify grounds for legally ending a pregnancy, it is necessary that health care be organized to actually provide this service, and that health care programs obtain the safest, most effective technologies now available for ending a pregnancy.

  17. National Rural Health Association

    Science.gov (United States)

    ... Membership Membership NRHA brings together those dedicated to improving health care in rural America. JOIN TODAY > icon-advocacy Advocate ... Rural Health Fellows Rural Health Students Rural Primary Care NRHA ... Oral Health Initiative ADVOCACY Fighting for Rural Medicare Cuts ...

  18. 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

  19. Eqüidade e reforma setorial na América Latina: um debate necessário Equity and health sector reform in Latin America: a necessary debate

    Directory of Open Access Journals (Sweden)

    Celia Almeida

    2002-01-01

    Full Text Available Reforma e eqüidade são termos que têm freqüentado os discursos políticos, documentos técnicos e discussões conceituais nas últimas décadas em distintas propostas com diferentes referenciais ideológicos. Entender a importância e centralidade desses temas no debate contemporâneo na América Latina pressupõe aprofundar a reflexão sobre a política de saúde no âmbito das políticas sociais, qualificar de que reformas estamos falando e o lugar que a eqüidade ocupa nessa discussão. Na primeira parte deste ensaio, discutem-se os conceitos de reforma e eqüidade; a seguir, faz-se um repasse sobre política de saúde como política social; e por fim, são discutidos os elementos centrais da agenda de reforma de sistemas de saúde na região. Conclui-se que a situação é dramática, as reformas recentes exacerbaram as desigualdades e criaram novos problemas, ao substituir valores de solidariedade e igualdade de oportunidade pelos de um "individualismo utilitarista radical"; e o princípio de "necessidades de saúde" pelo de "risco", monetarizado e definido segundo a posição social e econômica do indivíduo. Faz-se necessário retomar a discussão das políticas sociais e de saúde como a matriz de princípios que justificam o ordenamento de quaisquer outras políticas.Reform and equity are terms that have frequented political discourse, technical documents, and conceptual discussions in recent decades in different proposals with different ideological references. To understand the importance and centrality of these themes in the contemporary debate in Latin America implies a more in-depth reflection on health policy in the sphere of social policies and to define which reforms were are discussing and the place equity occupies in this discussion. The first part of this essay discusses the concepts of reform and equity, followed by a review of health policy as a social policy. The article ends by discussing the central elements on the

  20. 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.

  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. 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

  3. 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.

  4. "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.

  5. 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.

  6. 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

  7. Mosques in North America

    Directory of Open Access Journals (Sweden)

    Omar Khalidi

    2008-12-01

    Full Text Available The following article derived from an exhibit catalogue put together by Public Affairs Germany in the U.S. Embassy in Berlin and the U.S. Consulates in Frankfurt and Düsseldorf and accompanied Dr. Omar Khalidi’s photo exhibit “Mosques in America.” There are over 2,000 mosques in the United States, mostly housed in buildings originally built for other purposes. American mosques built in the last few decades, however, in the period in which Islam has begun to feel at home in the United States, are almost universally architect-designed.

  8. 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.

  9. The University of the National Football League: How Technology, Injury Surveillance, and Health Care Have Improved the Safety of America's Game.

    Science.gov (United States)

    Matava, Matthew J; Görtz, Simon

    2016-07-01

    American football has become one of the most popular sports in the United States. Despite the millions of players at all levels of competition who gain the physical, social, and psychological rewards that football provides, many interested stakeholders continue to ask, "Is football safe?" Although there are only approximately 1,700 players on National Football League (NFL) rosters, the injuries they sustain have garnered the most attention-and criticism-from the national media. Increased public awareness of the injury potential football possesses has led to an open debate and a major shift in public sentiment over the past 5 years. Although no sport is perfectly safe, the question is whether it can be made relatively safe and if the long-term consequences are worth the risk. This article reviews the methods by which one sports league-the NFL-has used advances in medical technology and injury surveillance to improve the health and safety of its players. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  10. Meta-analysis of the effects of laidlomycin propionate, fed alone or in combination with chlortetracycline, compared with monensin sodium, fed alone or in combination with tylosin, on growth performance, health, and carcass outcomes in finishing steers in North America.

    Science.gov (United States)

    Cernicchiaro, N; Corbin, M; Quinn, M; Prouty, F; Branine, M; Renter, D G

    2016-04-01

    The objective of this research was to use data from multiple studies to comprehensively quantify the effects of feeding 1) laidlomycin propionate (LP), alone and/or in combination with chlortetracycline, compared with 2) monensin sodium (MS), alone and/or in combination with tylosin, at commercially approved dosages, on ADG, DMI, feed efficiency (FE), mortality, and carcass characteristics (HCW and liver abscesses). A secondary objective was to explore potential sources of heterogeneity among the comparative effectiveness studies. A systematic review of peer-reviewed literature and industry reports was used to identify studies that included direct comparisons of these treatments in finishing steers in North America. Random-effects meta-analysis models of performance, carcass, and health-related outcomes were fitted with extracted data, consisting of a total of 17 data sets comprising a total of 135 pens and 13,603 steers. Results showed that pens of steers fed LP had increased ADG (live and carcass adjusted), DMI, and HCW compared with those fed monensin ( 0.05) were identified for FE or for health-related outcomes (overall and cause-specific mortality). There was a substantial amount of heterogeneity in outcomes among studies, and when pen size and type of production setting were included in mixed-effects meta-regression models, they accounted for only a small proportion of the between-study heterogeneity found in the meta-analysis models. Therefore, caution should be exercised when interpreting summary estimates in the presence of substantial heterogeneity. However, these results provide comprehensive information on the comparative effects of different ionophores across multiple studies and multiple years, states, and production settings. These unique results can enable quantitative and informed decisions by potential end users of these feed additives that are widely used in the U.S. beef industry for reducing the costs of beef production through enhanced cattle

  11. El informe de la Comisión sobre Macroeconomía y Salud: su relevancia para los países de América Latina y el Caribe The report of the Commission on Macroeconomics and Health: its relevance to the countries of Latin America and the Caribbean

    Directory of Open Access Journals (Sweden)

    2002-09-01

    Full Text Available 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 countries, and c the gap between the funding needed to address the principal problems that affect these countries and the actual spending levels.

  12. 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

  13. 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

  14. [Campylobacter and campylobacteriosis: a view from South America].

    Science.gov (United States)

    Fernández, Heriberto

    2011-03-01

    The thermotolerant species of Campylobacter have become very important in public health, especially as agents of infectious diarrhea in human beings. In this brief revision we present part of the available information generated in South America about epidemiological, clinical and bacteriological aspects of campylobacteriosis and we identify some differences between the observed and documented campylobacteriosis in South America compared to those described in industrialized countries.

  15. Building America FY 2016 Annual Report: Building America Is Driving Real Solutions in the Race to Zero Energy Homes

    Energy Technology Data Exchange (ETDEWEB)

    Farrar, Sara; Rothgeb, Stacey; Polly, Ben; Earle, Lieko; Merrigan, Tim

    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.

  16. 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

  17. 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

  18. Foreign Medical Students in the Americas: 1971-72.

    Science.gov (United States)

    Health Resources Administration (DHEW/PHS), Bethesda, MD. Div. of Manpower Intelligence.

    In order to accumulate data on foreign medical students in the Americas, medical schools of the member countries of the Pan American Health Organization region of the World Health Organization were surveyed to acquire data on their student enrollments by country of origin, sex, and year of study for the 1971-72 academic year. A tabular…

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

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

    2016-05-10

    May 10, 2016 ... A new funding opportunity on Zika virus is responding to the virus outbreak and the health threat it represents for the affected populations in the hardest hit countries in Latin America and the Caribbean. The Canadian Institutes for Health Research and the International Development Research Centre, ...

  20. 76 FR 52670 - 2011 Technology Transfer Summit North America Conference

    Science.gov (United States)

    2011-08-23

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health 2011 Technology Transfer...: Notice of Conference. SUMMARY: The NIH Office of Technology Transfer extends invitations to attend the 2011 Technology Transfer Summit North America Conference. DATES: October 3-4, 2011. ADDRESSES: NIH...

  1. Alliances for Chagas elimination in Central America | IDRC ...

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

    Public Health Implications of Alcohol Industry Corporate Social Responsibility Programs (Latin America). Researchers are raising growing concerns over the impact of corporate social responsibility (CSR) programs in the alcohol industry. View morePublic Health Implications of Alcohol Industry Corporate Social ...

  2. 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

  3. 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

  4. 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.

  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. 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…

  7. 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

  8. Ending child homelessness in America.

    Science.gov (United States)

    Bassuk, Ellen L

    2010-10-01

    Approximately 1.5 million children experience homelessness in America each year. The current economic recession and staggering numbers of housing foreclosures have caused the numbers of homeless families to increase dramatically. The impact of homelessness on families and children is devastating. Without a place to call home, children are severely challenged by unpredictability, dislocation, and chaos. Homelessness and exposure to traumatic stresses place them at high risk for poor mental health outcomes. Despite the pressing needs of these children, federal policy during the last decade has focused primarily on chronically homeless adult individuals-to the exclusion of the families. In 2010, however, the U.S. Interagency Council on Homelessness issued a comprehensive plan to eradicate homelessness for all people through interagency collaboration and aligning mainstream services. A key goal is to prevent and end homelessness for families, youth, and children within 10 years. This policy-focused article describes several tools that can be used to help achieve this goal, including: general principles of care for serving homeless families and children; BSAFE-a promising practice that helps families access community-based services and supports; and the Campaign to End Child Homelessness aimed at action on behalf of homeless families and children at the national, state, and local levels. © 2010 American Orthopsychiatric Association.

  9. 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

  10. Mobilizing Black America

    Science.gov (United States)

    1993-04-01

    and financially for childbirth or parenting. - Adolescent Pregnancy Black female teenagers 15 to 19 years old were 140 percent more likely to have a...on adolescent pregnancy teenage sexual activity, and federally funded programs prevention. NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT...communities? o Access to Health Care: Does everyone have equal access? o Poverty o Racism o Health Insurance o Black Physicians o Summary o Infant Mortality

  11. Reference librarians' perceptions of the issues they face as academic health information professionals

    OpenAIRE

    Scherrer, Carol S.

    2004-01-01

    Background: Leaders in the profession encourage academic health sciences librarians to assume new roles as part of the growth process for remaining vital professionals. Have librarians embraced these new roles?

  12. Empowering Workers to Rebuild America's Economy and Longer-Term Competitiveness: Green Skills Training for Workers. Hearing of the Committee on Health, Education, Labor, and Pensions, United States Senate, One Hundred Eleventh Congress, First Session on Examining Empowering Workers to Rebuild America's Economy and Longer-Term Competitiveness, Focusing on Green Skills Training for Workers (April 21, 2009). Senate Hearing 111-813

    Science.gov (United States)

    US Senate, 2011

    2011-01-01

    Among the topics discussed in this hearing were: what constitutes green energy, how workers can best be provided the skills to thrive in green industries, and the future of America's energy and environmental policies. Statements were presented by: Honorable Patty Murray, a U.S. Senator from the State of Washington, opening statement; Honorable…

  13. 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...

  14. Reshaping Health Care in Latin America

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

    Only the high-income groups benefited in Mexico, while all income groups benefited in Chile, Colombia, and Uruguay. In Venezuela ...... The economic model adopted in the country from the 1950s on had initially been very dynamic, especially in the industrial sector, and indicated a strong capacity for growth. However, this ...

  15. 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...

  16. 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

  17. [An overview of telehealth initiatives in Latin America].

    Science.gov (United States)

    dos Santos, Alaneir de Fátima; D'Agostino, Marcelo; Bouskela, Maurício Simon; Fernandéz, Andrés; Messina, Luiz Ary; Alves, Humberto José

    2014-01-01

    This article aimed to systematize the views on telehealth in Latin America and to present the experience of building an instrument for monitoring the development of telehealth initiatives based on the reality of this region. A group was structured to coordinate telehealth efforts in Latin America, with members appointed by the ministries of health of 16 countries. Five thematic groups were also set up. Based on international experiences and focusing on the reality of telehealth in the continent, an instrument was created to monitor the development of telehealth in Latin America. Several countries have national telehealth projects: Brazil, Colombia, Ecuador, Mexico, Panama. Others are in the process of development and early deployment: Bolivia, Costa Rica, Cuba, El Salvador, Guatemala, Peru, Venezuela. The instrument described in the article, which is still being tested, proposes a characterization of countries according to their telehealth development stage: nonexistent, nascent, intermediate, advanced, and exemplary. Currently, important telehealth initiatives are already underway in Latin America.

  18. Getting messier with TIDieR: embracing context and complexity in intervention reporting.

    Science.gov (United States)

    Cotterill, Sarah; Knowles, Sarah; Martindale, Anne-Marie; Elvey, Rebecca; Howard, Susan; Coupe, Nia; Wilson, Paul; Spence, Michael

    2018-01-18

    The Template for Intervention Description and Replication (TIDieR) checklist and guide was developed by an international team of experts to promote full and accurate description of trial interventions. It is now widely used in health research. The aim of this paper is to describe the experience of using TIDieR outside of trials, in a range of applied health research contexts, and make recommendations on its usefulness in such settings. We used the TIDieR template for intervention description in six applied health research projects. The six cases comprise a diverse sample in terms of clinical problems, population, settings, stage of intervention development and whether the intervention was led by researchers or the service deliverers. There was also variation in how the TIDieR description was produced in terms of contributors and time point in the project. Researchers involved in the six cases met in two workshops to identify issues and themes arising from their experience of using TIDieR. We identified four themes which capture the difficulties or complexities of using TIDieR in applied health research: (i) fidelity and adaptation: all aspects of an intervention can change over time; (ii) voice: the importance of clarity on whose voice the TIDieR description represents; (iii) communication beyond the immediate context: the usefulness of TIDieR for wider dissemination and sharing; (iv) the use of TIDieR as a research tool. We found TIDieR to be a useful tool for applied research outside the context of clinical trials and we suggest four revisions or additions to the original TIDieR which would enable it to better capture these complexities in applied health research: An additional item, 'voice' conveys who was involved in preparing the TIDieR template, such as researchers, service users or service deliverers. An additional item, 'stage of implementation' conveys what stage the intervention has reached, using a continuum of implementation research suggested by the

  19. Getting messier with TIDieR: embracing context and complexity in intervention reporting

    Directory of Open Access Journals (Sweden)

    Sarah Cotterill

    2018-01-01

    Full Text Available Abstract Background The Template for Intervention Description and Replication (TIDieR checklist and guide was developed by an international team of experts to promote full and accurate description of trial interventions. It is now widely used in health research. The aim of this paper is to describe the experience of using TIDieR outside of trials, in a range of applied health research contexts, and make recommendations on its usefulness in such settings. Main body We used the TIDieR template for intervention description in six applied health research projects. The six cases comprise a diverse sample in terms of clinical problems, population, settings, stage of intervention development and whether the intervention was led by researchers or the service deliverers. There was also variation in how the TIDieR description was produced in terms of contributors and time point in the project. Researchers involved in the six cases met in two workshops to identify issues and themes arising from their experience of using TIDieR. We identified four themes which capture the difficulties or complexities of using TIDieR in applied health research: (i fidelity and adaptation: all aspects of an intervention can change over time; (ii voice: the importance of clarity on whose voice the TIDieR description represents; (iii communication beyond the immediate context: the usefulness of TIDieR for wider dissemination and sharing; (iv the use of TIDieR as a research tool. Conclusion We found TIDieR to be a useful tool for applied research outside the context of clinical trials and we suggest four revisions or additions to the original TIDieR which would enable it to better capture these complexities in applied health research: An additional item, ‘voice’ conveys who was involved in preparing the TIDieR template, such as researchers, service users or service deliverers. An additional item, ‘stage of implementation’ conveys what stage the intervention has reached

  20. 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

  1. 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

  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. Relationship education for stepcouples reporting relationship instability--evaluation of the Smart Steps: Embrace the Journey curriculum.

    Science.gov (United States)

    Lucier-Greer, Mallory; Adler-Baeder, Francesca; Harcourt, Kate Taylor; Gregson, Kimberly D

    2014-10-01

    Smart Steps: Embrace the Journey is a research-based educational curriculum for stepfamily couples ("stepcouples"). The curriculum is designed to build couple strengths while addressing the unique challenges of repartnering with a child or children from a previous relationship. This study evaluated the effectiveness of this curriculum with 151 individuals in relationally less stable stepcouple relationships who either engaged in the Smart Steps curriculum (n = 97) or were part of the comparison group (n = 54). This study represents methodological and conceptual advances in the study of stepfamily programs with the use of a comparison group, a racially and economically diverse sample, and a relationally at-risk population. Results indicated that those who participated in Smart Steps reported significant increases in individual empowerment, couple quality, family harmony, and parenting efficacy while these measures were unchanged for those who did not receive the program. Implications for future research and for practitioners are provided. © 2014 American Association for Marriage and Family Therapy.

  4. Protrusive push versus enveloping embrace: computational model of phagocytosis predicts key regulatory role of cytoskeletal membrane anchors.

    Directory of Open Access Journals (Sweden)

    Marc Herant

    2011-01-01

    Full Text Available Encounters between human neutrophils and zymosan elicit an initially protrusive cell response that is distinct from the thin lamella embracing antibody-coated targets. Recent experiments have led us to hypothesize that this behavior has its mechanistic roots in the modulation of interactions between membrane and cytoskeleton. To test and refine this hypothesis, we confront our experimental results with predictions of a computer model of leukocyte mechanical behavior, and establish the minimum set of mechanistic variations of this computational framework that reproduces the differences between zymosan and antibody phagocytosis. We confirm that the structural linkages between the cytoskeleton and the membrane patch adherent to a target form the "switchboard" that controls the target specificity of a neutrophil's mechanical response. These linkages are presumably actin-binding protein complexes associating with the cytoplasmic domains of cell-surface receptors that are engaged in adhesion to zymosan and Fc-domains.

  5. Alternativas de financiamiento de la atención médica en América Latina y el Caribe Alternatives for the financing of health care in Latin America and the Caribbean

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Coelho Campino

    1995-06-01

    Full Text Available Dada la magnitud del problema de salud en los paises de America Latina y el Caribe, el déficit de recursos financieros necesarios para proveer atención médica no se puede cubrir a través de aumentos en los precios, o adoptando medidas como pago por servicio o cobro por los costos de los servicios. Es necesario recurrir a la política fiscal. Se demuestra que es posible aumentar los recursos disponibles para la atención médica, tanto por el aumento en la recaudación de impuestos, como por la toma de decisión política de aumentar los ingresos del gobierno destinados a financiar la atención médica. Se revisa la experiencia de los Fondos de Emergencia Social y de las operaciones de cambio de deuda por salud como importantes fuentes adicionales de recursos especialmente para financiar la inversión.Dada a magnitude do problema de saúde nos países da América Latina e do Caribe, não é possível cobrir o déficit de recursos financeiros necessários para prover assistência médica através de aumentos nos preços, ou com a adoção de medidas como o pagamento por serviços ou a cobrança do custo dos serviços. Faz-se necessário recorrer à política fiscal. Foi mostrado que é possível aumentar os recursos disponíveis para assistência médica, tanto por meio do aumento na arrecadação de impostos, quanto pela tomada da decisão política de aumentar a parcela da receita do Governo, destinada a financiar a assistência médica. Foi revista a experiência dos Fundos de Emergência Social e das operações de troca de dívida por projetos na área de saúde como importantes fontes adicionais de recursos, especialmente para financiar o investimento.Latin America and the Caribbean (LAC countries are experiencing both an economic crisis and a crisis in the public sector. As a result it is impossible to increase the amount of resources available to the health sector, unless there is a drastic restructuring of the way in which financing

  6. 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.

  7. 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

  8. 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

  9. Peritonitis in Latin America.

    Science.gov (United States)

    Barretti, Pasqual; Bastos, Kleyton A; Dominguez, Jorge; Caramori, Jacqueline C T

    2007-01-01

    Peritoneal dialysis has a high acceptance rate in Latin America, thus the knowledge concerning complication patterns is of great relevance. This work reviews Latin American data on peritonitis, the most serious complication of peritoneal dialysis. The incidence of peritonitis has been reduced over time, concomitantly with the incorporation of safer exchange systems and the use of prophylactic measurements. Today, rates lower than 1 episode per 24 patient-months are commonly reported. Furthermore, changes in causative organisms have been observed, with predominance of Staphylococcus aureus up through the mid-1990s, as well as increases in coagulase-negative staphylococcus and participation of gram negatives. However, the prevalence of S. aureus is still high, due possibly to climatic conditions and the elevated prevalence of carriers. Resolution rate varies from 55% to 78%, transfer to hemodialysis from 10.9% to 15.4%, and death in 3% to 9.9% of cases. Outcome is worse in S. aureus episodes compared to those with coagulase-negative staphylococcus, despite the higher percentage of oxacillin-resistant strains among the former. In general, despite socioeconomic or climatic conditions, our results are similar to those in developed countries, perhaps as a consequence of technological improvements and/or center expertise.

  10. 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.

  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. O neoliberalismo na America Latina

    Directory of Open Access Journals (Sweden)

    David Ibarra

    2011-06-01

    Full Text Available Neoliberalism in Latin America. Neoliberalism and globalization had decisive influence in shaping public policies both internal and foreign in Latin America. Less state, trade and market freedoms, social goals subordinated to economic criteria, are part and parcel of the neoliberal utopia. Price stability was erected as the main social objective; import substitution resulted replaced by exports as the main source of growth. The neoliberal net results as applied to Latin America are: less growth, deindustrialization, income concentration and precarious employments. Therefore, countries public policies should try to gain autonomy to use jointly markets and public intervention in a constructive and innovative fashion.

  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 mejo