Sample records for brazilian public health

  1. Governance in managing public health resources in Brazilian municipalities. (United States)

    Avelino, George; Barberia, Lorena G; Biderman, Ciro


    This study contributes to the health governance discussion by presenting a new data set that allows for comparisons of the management of health resources among Brazilian municipalities. Research on Brazil is particularly important as the provision of health services was decentralized in 1988 and since then municipalities have been given greater responsibilities for the management of fiscal resources for public health service provision. Based on detailed information on corruption practices (such as over-invoicing, illegal procurement and fake receipts) from audit reports of health programmes in 980 randomly selected Brazilian municipalities, this study deepens understanding of the relationship between health governance institutions and the incidence of corruption at the local level by exploring the extent to which horizontal and vertical accountabilities contribute to reducing the propensity of municipal government officials to divert public health resources for private gain. The results of our multiple regression analysis suggest that the experience of health municipal councils is correlated with reductions in the incidence of corruption in public health programmes. This impact is significant over time, with each additional year of health council experience reducing corruption incidence levels by 2.1% from baseline values. The findings reported in this study do not rely on the subjectivity of corruption measures which usually conflate the actual incidence of corruption with its perception by informants. Based on our results, we provide recommendations that can assist policy makers to reduce corruption.

  2. Clinical investigations for SUS, the Brazilian public health system


    Ana Patrícia Paula; Silvana Pereira Giozza; Michelle Zanon Pereira; Patrícia Souza Boaventura; Leonor Maria Pacheco Santos; Camile Giaretta Sachetti; César Omar Carranza Tamayo; Clarissa Campos Guaragna Kowalski; Flavia Tavares Silva Elias; Suzanne Jacob Serruya; Reinaldo Guimarães


    CONTEXT AND OBJECTIVE: Scientific and technological development is crucial for advancing the Brazilian health system and for promoting quality of life. The way in which the Brazilian Ministry of Health has supported clinical research to provide autonomy, self-sufficiency, competitiveness and innovation for the healthcare industrial production complex, in accordance with the National Policy on Science, Technology and Innovation in Healthcare, was analyzed. DESIGN AND SETTING: Descriptive inves...

  3. Clinical investigations for SUS, the Brazilian public health system

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    Ana Patrícia de Paula

    Full Text Available CONTEXT AND OBJECTIVE: Scientific and technological development is crucial for advancing the Brazilian health system and for promoting quality of life. The way in which the Brazilian Ministry of Health has supported clinical research to provide autonomy, self-sufficiency, competitiveness and innovation for the healthcare industrial production complex, in accordance with the National Policy on Science, Technology and Innovation in Healthcare, was analyzed. DESIGN AND SETTING: Descriptive investigation, based on secondary data, conducted at the Department of Science and Technology, Ministry of Health. METHODS: The Ministry of Health's research management database, PesquisaSaúde, was analyzed from 2002 to 2009, using the key word "clinical research" in the fields "primary sub-agenda" or "secondary sub-agenda". The 368 projects retrieved were sorted into six categories: basic biomedical research, preclinical studies, expanded clinical research, clinical trials, infrastructure support and health technology assessment. From a structured review on "clinical research funding", results from selected countries are presented and discussed. RESULTS: The amount invested was R$ 140 million. The largest number of projects supported "basic biomedical research", while the highest amounts invested were in "clinical trials" and "infrastructure support". The southeastern region had the greatest proportion of projects and financial resources. In some respects, Brazil is ahead of other BRICS countries (Russia, India, China and South Africa, especially with regard to establishing a National Clinical Research Network. CONCLUSION: The Ministry of Health ensured investments to encourage clinical research in Brazil and contributed towards promoting cohesion between investigators, health policies and the healthcare industrial production complex.

  4. [Brazilian bibliographical output on public oral health in public health and dentistry journals]. (United States)

    Celeste, Roger Keller; Warmling, Cristine Maria


    The scope of this paper is to describe characteristics of the scientific output in the area of public oral health in journals on public health and dentistry nationwide. The Scopus database of abstracts and quotations was used and eight journals in public health, as well as ten in dentistry, dating from 1947 to 2011 were selected. A research strategy using key words regarding oral health in public health and key words about public health in dentistry was used to locate articles. The themes selected were based on the frequency of key words. Of the total number of articles, 4.7% (n = 642) were found in oral health journals and 6.8% (n = 245) in public health journals. Among the authors who published most, only 12% published in both fields. There was a percentile growth of public oral health publications in dentistry journals, though not in public health journals. In dentistry, only studies indexed as being on the topic of epidemiology showed an increase. In the area of public health, planning was predominant in all the phases studied. Research to evaluate the impact of research and postgraduate policies in scientific production is required.

  5. Oral Care during Pregnancy: Attitudes of Brazilian Public Health Professionals

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    Saul Martins Paiva


    Full Text Available There is little information about health professionals’ behavior regarding oral health care during pregnancy. We evaluated attitudes of obstetricians/gynecologists, nurses, and dentists working at a public community service towards pregnant women’s oral health. Health professionals responded to a self-applied questionnaire. Cluster analysis identified two clusters of respondents; Chi-square, Student’s t test, and logistic regression were used to compare the two clusters in terms of the independent variables. Respondents were categorized into cluster 1 ‘less favorable’ (n = 159 and cluster 2 ‘more favorable’ (n = 124 attitudes. Professionals that had attended a residency or specialization program (OR = 2.08, 95% CI = 1.15–3.77, p = 0.016 and worked exclusively at the public service (OR = 2.15, 95% CI = 1.10–4.20, p = 0.025 presented more favorable attitudes. Obstetricians/gynecologists (OR = 0.22, 95% CI = 0.09–0.54, p = 0.001 and nurses (OR = 0.50, 95% CI = 0.29–0.86, p = 0.013 showed less favorable attitudes than dentists. Health care providers’ attitudes regarding pregnant women’s oral health were related to their occupation, qualification, and dedication to the public service.

  6. Work conditions and occupational health of dentists in Brazilian Public Health System

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    Suzely Adas Saliba Moimaz


    Full Text Available Introduction: work healthy conditions are essential for a great professional performance. Objective: To verify the perception of dentists regarding structural and healthy conditions of dental offices in the Brazilian Public Health System (SUS and their satisfaction with work and public job. Material and Method: In this cross-sectional study, type inquiry, 24 Brazilian dentists were interviewed. The follow variables were asked: cleaning and asepsis; maintenance and time of use of dental equipment; satisfaction with work and public job. Results: The professionals were "satisfied" or "very satisfied" with cleaning and asepsis (66.67%; Dental equipment (54.17%, reflectors (54.17% and the dental chairs (54.17% had more than 24 years of use; 20% of all professionals said that the equipment had maintenance but only to fix them. Of total, 58.33% had already given no attendance for patients and broken equipment was the most frequent cause (92.86%. It was observed satisfaction with work (79.1% and public job (95.83%. It was concluded that dentists who worked in SUS were satisfied with public job, although they had said the need for improvement on structural and healthy work conditions.

  7. Making tenofovir accessible in the brazilian public health system: patent conflicts and generic production. (United States)

    Veras, Juliana


    In May 2011, the Brazilian Ministry of Health announced the distribution of the first batch of locally produced generic tenofovir disoproxil fumarate (TDF) to support its program of universal and free access for the treatment of HIV/AIDS. The inclusion of TDF in the public health program illustrates what has been considered the 'Brazilian model' of HIV/AIDS response, as it illustrates the current phase of the Brazilian pharmaceutical economy. Brazil is known for having managed to control the expansion of HIV/AIDS through a unique initiative combining the public health and the industrial production of generics. But, if at first local manufacturers could freely copy ARVs and produce cheaper generic versions that were delivered to the Ministry of Health, since the country started to grant patents on drugs in 1996, the sustainability of this policy has been challenged by the high cost of patented second-line HIV/AIDS treatments. In order to assure continuity of the local production of ARVs, and keep the program of public health alive, Brazilians are now forced to deal with conflicts of drugs' intellectual property rights in order to open the path to generic production. This article aims to describe the experiences surrounding TDF in Brazil and the unprecedented conflicts and challenges it has brought for our different interviewees. Blurring the frontier between the public and the private, the TDF case was driven at the same time by an ethic of drug access and regulation of drug quality, which has inspired Brazilians to intervene and transform the world they live in.

  8. Attitudes and Perceptions of the Brazilian Public Health System by Transgender Individuals

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    Kátia Bones Rocha


    Full Text Available This study aims to describe how transgender people perceive services offered by the Brazilian Public Health System (SUS. This qualitative study, using the phenomenological technique, is based on eight semi-structured interviews conducted with individuals whose gender identity and/or gender expression differs from the sex they were assigned at birth. Each interview was evaluated by two interviewers and a content analysis performed by all members of the research group. The analysis identified the following categories as having high relevance to the participants’ experiences: homophobia, receptiveness, and humanization, access to health care, and suggestions to improve the SUS. Information shared by participants emphasized their belief that health care professionals are not adequately prepared to assist transgendered individuals and that health care providers should use a more sensitive approach towards them. A recurrent theme was the need to use appropriate and socially acceptable terminology when providing health care services in order to facilitate transgendered individuals' inclusive treatment. Despite the effort of Brazilian authorities, there is a need for significant improvement in health care practices in order to comply with SUS quality standards. This study highlights the importance of qualitative investigations to improve planning and to help define public health policies with the goal of including the most vulnerable and marginalized groups of the population. URN: urn:nbn:de:0114-fqs0902281

  9. [Market and public policy network failures: challenges and possibilities for the Brazilian Unified Health System]. (United States)

    Pinheiro Filho, Francisco Percival; Sarti, Flávia Mori


    The principles and guidelines of the Brazilian Unified Health System (SUS) impose a healthcare service structure based on public policy networks which, combined with the financing model adopted, leads to market failings. This imposes barriers to the management of the public health system and the enactment of SUS objectives. The institutional characteristics and the heterogeneity of players, allied to the existence of different healthcare approaches, generate analytical complexity in the study of the global dynamics of the SUS network. There are limitations in the use of quantitative methods based on static analysis of retrospective SUS data. Thus, an approach taking SUS as a complex system using innovative quantitative methodology based on computational simulation is proposed. This paper sought to analyze challenges and possibilities of the combined application of cellular automata modeling and agent-based modeling for simulation of the evolution of the SUS healthcare service network. This approach should permit better understanding of the organization, heterogeneity and structural dynamics of the SUS service network and a minimization of the effects of market failings on the Brazilian health system.

  10. Indirect and direct costs of treating patients with ankylosing spondylitis in the Brazilian public health system

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    Valderilio Feijó Azevedo


    Full Text Available ABSTRACT Introduction: Patients with Ankylosing Spondylitis (AS require a team approach from multiple professionals, various treatment modalities for continuous periods of time, and can lead to the loss of labour capacity in a young population. So, it is necessary to measure its socio-economic impact. Objectives: To describe the use of public resources to treat AS in a tertiary hospital after the use of biological medications was approved for treating spondyloarthritis in the Health Public System, establishing approximate values for the direct and indirect costs of treating this illness in Brazil. Material and methods: 93 patients selected from the ambulatory spondyloarthritis clinic at the Hospital de Clínicas of the Federal University of Paraná between September 2011 and September 2012 had their direct costs indirect treatment costs estimation. Results: 70 patients (75.28% were male and 23 (24.72% female. The mean age was 43.95 years. The disease duration was calculated based on the age of diagnosis and the mean was 8.92 years (standard deviation: 7.32; 63.44% were using anti-TNF drugs. Comparing male and female patients the mean BASDAI was 4.64 and 5.49 while the mean BASFI was 5.03 and 6.35 respectively. Conclusions: The Brazilian public health system's spending related to ankylosing spondylitis has increased in recent years. An important part of these costs is due to the introduction of new, more expensive health technologies, as in the case of nuclear magnetic resonance and, mainly, the incorporation of anti-TNF therapy into the therapeutic arsenal. The mean annual direct and indirect cost to the Brazilian public health system to treat a patient with ankylosing spondylitis, according to our findings, is US$ 23,183.56.

  11. Accessibility to Specialized Public Oral Health Services from the Perspective of Brazilian Users. (United States)

    de Castro, Ricardo Dias; Rangel, Marianne de Lucena; da Silva, Marcos André Azevedo; de Lucena, Brunna Thaís Lucwu; Cavalcanti, Alessandro Leite; Bonan, Paulo Rogério Ferreti; Oliveira, Julyana de Araújo


    The Specialized Dental Clinics (SDCs) represent the first government initiative in Latin America aimed at providing specialized oral health services. This study sought to evaluate the organizational accessibility to specialized oral health care services in Brazil and to understand the factors that may be associated with accessibility from the user's perspective. This epidemiological, cross-sectional and quantitative study was conducted by means of interviews with individuals who sought specialized public oral health services in the city of João Pessoa, Paraíba, Brazil, and consisted of a sample of 590 individuals. Users expressed a favorable view of the classification and resolutive nature of specialized services offered by Brazilian public health. The binary logistic regression analysis revealed weak points highlighting the difficulty involved in obtaining such treatments leading to unfavorable evaluations. In the resolutive nature item, difficulty in accessing the location, queues and lack of materials and equipment were highlighted as statistically significant unfavorable aspects. While many of the users considered the service to be resolutive, weaknesses were mentioned that need to be detected to promote improvements and to prevent other health models adopted worldwide from reproducing the same flaws.

  12. Accessibility to Specialized Public Oral Health Services from the Perspective of Brazilian Users (United States)

    de Castro, Ricardo Dias; Rangel, Marianne de Lucena; da Silva, Marcos André Azevedo; de Lucena, Brunna Thaís Lucwu; Cavalcanti, Alessandro Leite; Bonan, Paulo Rogério Ferreti; Oliveira, Julyana de Araújo


    The Specialized Dental Clinics (SDCs) represent the first government initiative in Latin America aimed at providing specialized oral health services. This study sought to evaluate the organizational accessibility to specialized oral health care services in Brazil and to understand the factors that may be associated with accessibility from the user’s perspective. This epidemiological, cross-sectional and quantitative study was conducted by means of interviews with individuals who sought specialized public oral health services in the city of João Pessoa, Paraíba, Brazil, and consisted of a sample of 590 individuals. Users expressed a favorable view of the classification and resolutive nature of specialized services offered by Brazilian public health. The binary logistic regression analysis revealed weak points highlighting the difficulty involved in obtaining such treatments leading to unfavorable evaluations. In the resolutive nature item, difficulty in accessing the location, queues and lack of materials and equipment were highlighted as statistically significant unfavorable aspects. While many of the users considered the service to be resolutive, weaknesses were mentioned that need to be detected to promote improvements and to prevent other health models adopted worldwide from reproducing the same flaws. PMID:27775584

  13. Need for orthodontic treatment among Brazilian adolescents: evaluation based on public health

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    Carolina Vieira de Freitas


    Full Text Available OBJECTIVE: To identify the prevalence and the severity of malocclusions and to analyze factors associated with the need for orthodontic treatment of Brazilian adolescents. METHODS: This exploratory, cross-sectional study was carried out based on secondary data from the national epidemiological survey on oral health in Brazil (2002-2003. Socio-demographic conditions, self-perception, and the existence and degree of malocclusion, using the Dental Aesthetic Index, were evaluated in 16,833 adolescent Brazilians selected by probabilistic sample by conglomerates. The dependent variable need orthodontic treatment was estimated from the severity of malocclusion. The magnitude and direction of the association in bivariate and multivariate analyzes from a Robust Poisson regression was estimated. RESULTS: The majority of the adolescents needed orthodontic treatment (53.2%. In the multivariate analysis, the prevalence of the need for orthodontic treatment was larger among females, non-whites, those that perceived a need for treatment, and those that perceived their appearance as normal, bad, or very bad. The need for orthodontic treatment was smaller among those that lived in the Northeast and Central West macro-regions compared to those living in Southeast Brazil and it was also smaller among those that perceived their chewing to be normal or their oral health to be bad or very bad. CONCLUSIONS: There was a high prevalence of orthodontic treatment need among adolescents in Brazil and this need was associated with demographic and subjective issues. The high prevalence of orthodontic needs in adolescents is a challenge to the goals of Brazil's universal public health system.

  14. Ambivalent implications of health care information systems: a study in the Brazilian public health care system

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    João Porto de Albuquerque


    Full Text Available This article evaluates social implications of the "SIGA" Health Care Information System (HIS in a public health care organization in the city of São Paulo. The evaluation was performed by means of an in-depth case study with patients and staff of a public health care organization, using qualitative and quantitative data. On the one hand, the system had consequences perceived as positive such as improved convenience and democratization of specialized treatment for patients and improvements in work organization. On the other hand, negative outcomes were reported, like difficulties faced by employees due to little familiarity with IT and an increase in the time needed to schedule appointments. Results show the ambiguity of the implications of HIS in developing countries, emphasizing the need for a more nuanced view of the evaluation of failures and successes and the importance of social contextual factors.

  15. [Epidemiology and Public Health: tendencies of the Brazilian epidemiology production regarding volume, indexation and investigation areas - 2001 to 2006]. (United States)

    Turci, Silvana Rubano Barretto; Guilam, Maria Cristina Rodrigues; Câmara, Maria Clara Coelho


    This article examines and interprets the trends of epidemiological production in Brazil in the Public Health context. CAPES indicators from 2001 to 2006 were used as database. We analyzed 26 programs and select the 10 major ones to analyze their bibliographic production in indexed journals. It was observed that the total production of epidemiological articles accounted for 40% of production in Public Health and 55% of the production was published in international journals, especially Cadernos de Saúde Pública, Revista de Saúde Pública and Ciência & Saúde Coletiva. The most prevalent themes were public health nutrition, maternal and infant health and, infectious diseases, particularly AIDS. Environmental e worker's heath, oral health, violence and health of the elderly have been ratified as objects of study for the discipline, while meta-analysis and geoprocessing appear as a useful tool for health services. We conclude that the epidemiological production tends to increase in indexed publications, covering various topics and a wide spectrum of relevant issues to Brazilian health policy.

  16. The American Nurses of the Special Public Health Service and the Formation of Human Resources in Brazilian Nursing. (United States)

    Bonini, Bárbara Barrionuevo; Freitas, Genival Fernandes de; Fairman, Julie; Mecone, Márcia Cristina da Cruz


    Objective To historicize the changes in training human resources in nursing in Brazil during the period from 1942 to 1961 based on the presence of 35 American nurses assigned to work in cooperation with Special Public Health Service. Method The sources used for the study were reports written by American nurses who described their impressions, suggestions, and the activities they carried out in the country. These were analyzed based on the discourse analysis of Michel Foucault. Results The period mentioned was marked by an American presence in nursing projects developed by the Special Public Health Service. The discourses indicated that the period was marked by many changes in Brazilian nursing, particularly with respect to attracting and training human resources for the profession. Conclusion The results indicate that the American nurses, through what they said and their influence, were central to the consolidation of a new paradigm in the training of nursing professionals in Brazil.

  17. Development policy for the Brazilian health industry and qualification of national public laboratories. (United States)

    Viana, Ana Luiza d'Ávila; Silva, Hudson Pacifico da; Ibañez, Nelson; Iozzi, Fabíola Lana


    Technological innovations play a decisive role in societies' development by contributing to economic growth and the population's welfare. The state has a key role in this process by inducing innovative behavior, strategies, and decisions. This study addresses Brazil's current policy for development of the health industry and its effects on qualification of national public laboratories by contextualizing different cycles of interaction between health policy and the industrial base, discussing the government's development strategy and the transfer and absorption of health technology (through Industrial Development Partnerships), and presenting two current partnerships involving public laboratories in the production of medicines and vaccines. Resumo: As inovações tecnológicas jogam papel decisivo no processo de desenvolvimento das sociedades, visto que contribuem para gerar crescimento econômico e bem-estar da população. O Estado possui grande importância e centralidade nesse processo, pois pode induzir fortemente o comportamento, as estratégias e as decisões relativas à inovação. O presente artigo tem por objetivo investigar a atual política de desenvolvimento produtivo em saúde no Brasil e seus reflexos sobre a capacitação dos laboratórios públicos nacionais. Para essa finalidade, contextualiza os diferentes ciclos de interação entre a política de saúde e a sua base produtiva, discute a estratégia do governo brasileiro para o desenvolvimento, a transferência e a absorção de tecnologia na área da saúde (as parcerias para o desenvolvimento produtivo) e apresenta duas parcerias vigentes envolvendo laboratórios públicos para a produção de medicamentos e vacinas.

  18. [Productivity and academic assessment in the Brazilian public health field: challenges for Human and Social Sciences research]. (United States)

    Bosi, Maria Lúcia Magalhães


    This article analyzes some challenges for knowledge output in the human and social sciences in the public health field, under the current academic assessment model in Brazil. The article focuses on the qualitative research approach in human and social sciences, analyzing its status in comparison to the other traditions vying for hegemony in the public health field, conjugating the dialogue with the literature, especially the propositions pertaining to the social fields present in the work of Pierre Bourdieu, with elements concerning the field's dynamics, including some empirical data. Challenges identified in the article include hurdles to interdisciplinary dialogue and equity in the production of knowledge, based on recognition of the founding place of human and social sciences in the public health field. The article discusses strategies to reshape the current correlation of forces among centers of knowledge in public health, especially those capable of impacting the committees and agendas that define the accumulation of symbolic and economic capital in the field.

  19. Hypertension control in brazilian publications

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    Pinho, Natália de Alencar; Pierin, Angela Maria Geraldo, E-mail: [Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP (Brazil)


    Hypertension is a major public health problem due to its high prevalence and cardiovascular complications. Its treatment is aimed at reducing cardiovascular morbidity and mortality, its goal being to maintain blood pressure levels below 140/90 mm Hg. Hypertension control in Brazil is low, and nationwide rates are unknown. The objective of this review was to provide an overview on hypertension control in Brazil from publications in a database. We identified 45 publications. In population-based studies, the highest control rate (57.6%) was reported in a multicenter study in 100 municipalities and the city of São José do Rio Preto, São Paulo state (52.4%), while the lowest rates (around 10%) were identified in microregions of the Rio Grande do Sul state and in the city of Tubarão, Santa Catarina state. In conclusion, the studies assessed showed a wide variation in hypertension control rates. It is worth noting that the comparison between studies was a major limiting factor, because of the different methods used.

  20. Evaluating genotoxic risks in Brazilian public health agents occupationally exposed to pesticides: a multi-biomarker approach. (United States)

    Franco, Fernanda Craveiro; Alves, Alessandro Arruda; Godoy, Fernanda Ribeiro; Avelar, Juliana Boaventura; Rodrigues, Douglas Dantas; Pedroso, Thays Millena Alves; da Cruz, Aparecido Divino; Nomura, Fausto; de Melo E Silva, Daniela


    This is the first study demonstrating genotoxic effects and whole transcriptome analysis on community health agents (CHAs) occupationally exposed to pesticides in Central Brazil. For the transcriptome analysis, we found some genes related to Alzheimer's disease (LRP1), an insulin-like growth factor receptor (IGF2R), immunity genes (IGL family and IGJ), two genes related to inflammatory reaction (CXCL5 and CCL3), one gene related to maintenance of cellular morphology (NHS), one gene considered to be a strong apoptosis inductor (LGALS14), and several transcripts of the neuroblastoma breakpoint family (NBPF). Related to comet assay, we demonstrated a significant increase in DNA damage, measured by the olive tail moment (OTM), in the exposed group compared to the control group. Moreover, we also observed a statistically significant difference in OTM values depending on GSTM1 genotypes. Therefore, Brazilian epidemiological surveillance, an organization responsible for the assessment and management of health risks associated to pesticide exposure to CHA, needs to be more proactive and considers the implications of pesticide exposure for CHA procedures and processes.

  1. Public health

    NARCIS (Netherlands)

    Berg, van den A.E.


    Agnes van den Berg wrote an essay about human health and nature, establishing that subject as an important policy argument in developing (urban) nature in the Netherlands. She studied the public balance of fear and fascination for nature, summarising benefits on human health. In this chapter, she ad

  2. Brazilian physical activity guidelines as a strategy for health promotion. (United States)

    Sebastião, Emerson; Schwingel, Andiara; Chodzko-Zajko, Wojtek


    Public health actions endorsed by the federal government, for instance, health promotion initiatives, usually have greater impact at population level compared to other types of initiatives. This commentary aims to instigate debate on the importance and necessity of producing federally endorsed brazilian physical activity guidelines as a strategy for health promotion.

  3. Profile of patients with rheumatic diseases undergoing treatment with anti-TNF agents in the Brazilian Public Health System (SUS, Belo Horizonte - MG

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    Haliton Alves de Oliveira Junior


    Full Text Available The aim of this study was to describe the baseline demographic and clinical characteristics as well as the functional status of a prospective cohort of patients with rheumatic diseases assisted by the Brazilian Public Health System (SUS. Data for 302 patients receiving tumor necrosis factor α inhibitors (anti-TNF agents was collected through a standard form. Among patients, 229 (75.8% were female and 155 (51.3% were Caucasian; the mean age was 50.3 ± 12.8 years, and the mean disease duration was 9.9 ± 8.7 years. Among them 214 patients (70.9% received adalimumab, 72 (23.8% etanercept, and 16 (5.3% infliximab. Mean Health Assessment Questionnaire-Disability Index (HAQ-DI was 1.37 ± 0.67 for all participants. Poor functional response was associated with female gender, married patients and with a score of < 0.6 on the EuroQoL-5 dimensions (EQ-5D. Significant correlation was found between the HAQ-DI values, disease activity and quality of life (QOL. The results obtained in this study contribute to a better understanding of the clinical and demographic characteristics of patients with rheumatic diseases at the beginning of anti-TNF-agent treatment by SUS. Furthermore, our findings are consistent with another Brazilian and foreign cross-sectional investigations. This knowledge can be of great importance for further studies evaluating the effectiveness of biological agents, as well as, to contribute to improve the well-being of the patients with rheumatic diseases.

  4. Are more resources always the answer? A supply and demand analysis for public health services in Brazilian municipalities

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    Fabiana Rocha


    Full Text Available The aim of this paper is to determine whether it is necessary to increase available resources to local governments or if better use of these funds is sufficient. The paper contributes to the literature by looking both at the supply and demand for public health services. If the demand is estimated correctly, one can compare its expected value to actual health expenditures. Even if actual expenditures are lower than the estimated demand, it is not certain that additional spending is necessary. If the efficiency scores (supply side indicate that local governments can simply “save” resources to make up for the difference, then it is possible to reduce (or bring to zero new resources only by requiring local governments to efficiently manage their expenditures. Since municipalities in Brazil are very heterogeneous, we estimate their efficiency using the metafrontier approach (O’Donnell et al., 2008, while we estimate the demand through an equation derived from the median voter theorem model. Using 2010 data, we find evidence that efficient management of spending is sufficient to meet excess demand for goods and services in the health sector.

  5. Discourses and polarities concerning health promotion in the Brazilian health system. (United States)

    Luciana, Kind; Ferreira-Neto, João Leite


    This paper presents theoretical reflections on health promotion in the Brazilian public health context. Some characteristics and problems of the international debate are highlighted, but our focus is the position of health promotion as it is discussed in the Brazilian health system. We follow the foucauldian perspective of biopower and resistence to discuss the selected texts and documents related to health promotion that were considered relevant for the purpose of this investigation. Health promotion is discussed as a field of discourses, practices, knowledge production and power. We concentrate our analysis on the debate proposed by collective health researchers on the repercussions of the Lalonde Report in the international Health Promotion Charts, and on the connexion between health promotion and the Brazilian health system. The discussion demonstrates that health promotion work requires constant attention and significant effort from managers, technicians, and health system users, and that each step forward reveals new challenges and calls for new actions.

  6. Institutionalising of public health. (United States)

    Karkee, R


    Though public health situation in Nepal is under-developed, the public health education and workforce has not been prioritised. Nepal should institutionalise public health education by means of accrediting public health courses, registration of public health graduates in a data bank and increasing job opportunities for public health graduates in various institutions at government sector.

  7. Factors associated with cesarean delivery during labor in primiparous women assisted in the Brazilian Public Health System: data from a National Survey

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    Marcos Augusto Bastos Dias


    Full Text Available Abstract Background The rate of cesarean delivery (CD in Brazil has increased over the past 40 years. The CD rate in public services is three times above the World Health Organization recommended values. Among strategies to reduce CD, the most important is reduction of primary cesarean. This study aimed to describe factors associated with CD during labor in primiparous women with a single cephalic pregnancy assisted in the Brazilian Public Health System (SUS. Methods This study is part of the Birth in Brazil survey, a national hospital-based study of 23,894 postpartum women and their newborns. The rate of CD in primiparous women was estimated. Univariate and multivariable logistic regression was performed to analyze factors associated with CD during labor in primiparous women with a single cephalic pregnancy, including estimation of crude and adjusted odds ratios and their respective 95 % confidence intervals. Results The analyzed data are related to the 2814 eligible primiparous women who had vaginal birth or CD during labor in SUS hospitals. In adjusted analyses, residing in the Southeast region was associated with lower CD during labor. Occurrence of clinical and obstetric conditions potentially related to obstetric emergencies before delivery, early admission with < 4 cm of dilatation, a decision late in pregnancy for CD, and the use of analgesia were associated with a greater risk for CD. Favorable advice for vaginal birth during antenatal care, induction of labor, and the use of any good practices during labor were protective factors for CD. The type of professional who attended birth was not significant in the final analyses, but bivariate analysis showed a higher use of good practices and a smaller proportion of epidural analgesia in women cared for by at least one nurse midwife. Conclusions The CD rate in primiparous women in SUS in Brazil is extremely high and can compromise the health of these women and their newborns

  8. Revision of giftedness on brazilian periodic publication

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    Tatiana de Cássia Nakano


    Full Text Available The definition of giftedness is related to the existence of high abilities in several and different fields and involves the study of process as intelligence, motivation, creativity and leadership. Due to the lack of research in this area, the present study aimed to review researches about giftedness on Brazilian periodic publications, in two databases: Scielo and Pepsic. The results pointed to the existence of 19 theorical and empiric articles, published between 2002 and 2009, that approached distinct dimensions of giftedness: conceptual definitions, models and forms of identification, models of attendance, Brazilian laws to guide the performance, researches with teachers, family and school environment, studies of cognitive, social and emotional dimension, finally behaviors and emotional disorders related to the giftedness. The articles analysis allowed concluding the recent interest for the theme, it was observed divergences in the definition of the concept, the lack of specific tests, with validity and standards, beyond the recognition of the importance of the school environment and the psychologis

  9. Análise econômica da interação entre a infraestrutura da saúde pública e privada no Brasil Economic analysis of the Brazilian public and private health infrastructure

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    Marislei Nishijima


    Full Text Available Este artigo analisa de que forma a interação entre o setor público e privado de saúde da economia brasileira, avaliando como a sua estrutura produtiva, aliada ao aparato legal referente ao período anterior à regulação da Agência Nacional de Saúde Suplementar, pode ter causado um impacto negativo sobre o acesso dos brasileiros de baixa renda aos bens públicos de saúde. Para dar suporte aos argumentos apresentados, foram utilizados os microdados do suplemento saúde da PNAD de 1998, analisados por meio de modelos logit e probit tendo em vista o caráter qualitativo da variável dependente. Os resultados sugerem evidências favoráveis à hipótese proposta.This article analyses how the last Brazilian Constitution - which regulates the universal rights of public health care - has negatively impacted the distribution of health care in terms of the access that Brazilians with lower incomes have to public health care. The specific way that the public and private sectors of health care functions has caused this to happen. This phenomenon was indirectly tested using supplementary health economics survey data, together with a traditional household survey, the "Pesquisa Nacional de Amostra por Domicílio" (PNAD, from 1998. Logit and probit models were used to analyze the data, and the results supported the proposed hypothesis.

  10. Demography, vulnerabilities and right to health to Brazilian prison population. (United States)

    Soares, Marden Marques; Bueno, Paula Michele Martins Gomes


    This study investigates the latest research on the profile of the Brazilian prison population, its demography and current laws and regulations. It aims in the direction of ensuring the human right to health. Brazilian prison system is a complex universe in which state and federal criminal contexts keep more than 607,000 people in custody. This population is composed of 75% of young and black people, 67% poorly educated and 41% are pre-trial detainees, living in overcrowded prisons and architecturally vandalized, with population growth of around 575% in 24 years, making this environment a major focus of production of diseases. The prison becomes the object of differentiated intervention by public bodies linked to the executive and the judiciary - it is worth remarking that the data show the high level of inequalities and health vulnerabilities among the prison population, whose needs involve a set of cross-sector of transverse public policies actions towards penal execution.

  11. Twitter and public health. (United States)

    Bartlett, Catherine; Wurtz, Rebecca


    Twitter can serve as a powerful communication modality to both "push" and "pull" public health data; each user is a potential public health sensor and actor. However, in 2012, only 8% of local health departments had Twitter accounts. We outline how Twitter works, describe how to access public tweets for public health surveillance purposes, review the literature on Twitter's current and potential role supporting public health's essential services, summarize Twitter's limitations, and make recommendations for health department use.

  12. [Adolescence and mental health: a review of the Brazilian literature]. (United States)

    Benetti, Sílvia Pereira da Cruz; Ramires, Vera Regina Röhnelt; Schneider, Ana Cláudia; Rodrigues, Ana Paula Guzinski; Tremarin, Daniela


    The objective of this work was to review the Brazilian scientific literature from 1995 to 2005 on mental health in adolescence, considering the priorities identified by the World Health Organization (depression, anxiety, substance abuse, behavioral disorders, eating disorders, psychosis, child abuse, and violence). 971 abstracts were identified in the LILACS, MEDLINE, INDEXPsi, and SciELO databases, using descriptors associated with the themes. After selection according to specified criteria, 267 abstracts were analyzed by year, focus, methodological design, and principal conclusions. A qualitative analysis was performed on the main findings. Brazilian publications in this area have increased in the last five years. The majority of the articles aimed to identify the problem, while a smaller proportion dealt with the development of intervention and prevention strategies.

  13. Georges Canguilhem and the development of Brazilian Public Heatlh field

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    José Ricardo de Carvalho Mesquita Ayres


    Full Text Available Historical epistemology has played an important role in the development of modern Brazilian Public Health or “Saúde Coletiva” (Collective Health. Born as an academic search for new conceptual foundations of a social committed field of scientific knowledge, as well as a social political movement against civil-military dictatorship implanted in Brazil in 1964, the so called Brazilian Sanitary Reform Movement found in the French historical epistemology, particularly in the works of Georges Canguilhem, a powerful ally. This paper aims to revisit the main features of this relationship, focusing in particular the inaugural works of Sergio Arouca and Cecília Donnangelo and the Health Work Process Theory as developed in the Department of Preventive Medicine of the Medical School of the University of São Paulo. The discussion is centered in the way Canguilhem’s philosophical concepts, such as the normative character of life and of its knowledge, the qualitative discontinuity between normal and pathological phenomena and the value oriented definition of health on one hand, and on the other hand, Canguilhem’s historiographical method, focused on the rational development of concepts as the core subject of the historical-epistemological research, the acknowledge of “external” influences over scientific developments, such as social and technological conditions, and the positive role attributed to obstacles, failures and accidents in the progress of a scientific discipline were all crucial to promote the intertwining of the political and academic goals of the Movement and still remain a challenging element for the development of the philosophical and historical reflections of the field of “Saúde Coletiva”.

  14. Cost-Effectiveness of High, Moderate and Low-Dose Statins in the Prevention of Vascular Events in the Brazilian Public Health System

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    Ribeiro, Rodrigo Antonini, E-mail: [Programa de Pós-Graduação em Epidemiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS (Brazil); Duncan, Bruce Bartholow [Programa de Pós-Graduação em Epidemiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS (Brazil); Programa de Pós-Graduação em Cardiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Ziegelmann, Patricia Klarmann [Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS (Brazil); Departamento de Estatística da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Stella, Steffan Frosi [Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS (Brazil); Programa de Pós-Graduação em Cardiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Vieira, Jose Luiz da Costa [Instituto de Cardiologia / Fundação Universitária de Cardiologia, Porto Alegre, RS (Brazil); Restelatto, Luciane Maria Fabian [Serviço de Medicina Interna do Hospital de Clínicas de Porto Alegre, Porto Alegre, RS (Brazil); Polanczyk, Carisi Anne [Programa de Pós-Graduação em Epidemiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS (Brazil); Programa de Pós-Graduação em Cardiologia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil)


    Statins have proven efficacy in the reduction of cardiovascular events, but the financial impact of its widespread use can be substantial. To conduct a cost-effectiveness analysis of three statin dosing schemes in the Brazilian Unified National Health System (SUS) perspective. We developed a Markov model to evaluate the incremental cost-effectiveness ratios (ICERs) of low, intermediate and high intensity dose regimens in secondary and four primary scenarios (5%, 10%, 15% and 20% ten-year risk) of prevention of cardiovascular events. Regimens with expected low-density lipoprotein cholesterol reduction below 30% (e.g. simvastatin 10mg) were considered as low dose; between 30-40%, (atorvastatin 10mg, simvastatin 40mg), intermediate dose; and above 40% (atorvastatin 20-80mg, rosuvastatin 20mg), high-dose statins. Effectiveness data were obtained from a systematic review with 136,000 patients. National data were used to estimate utilities and costs (expressed as International Dollars - Int$). A willingness-to-pay (WTP) threshold equal to the Brazilian gross domestic product per capita (circa Int$11,770) was applied. Low dose was dominated by extension in the primary prevention scenarios. In the five scenarios, the ICER of intermediate dose was below Int$10,000 per QALY. The ICER of the high versus intermediate dose comparison was above Int$27,000 per QALY in all scenarios. In the cost-effectiveness acceptability curves, intermediate dose had a probability above 50% of being cost-effective with ICERs between Int$ 9,000-20,000 per QALY in all scenarios. Considering a reasonable WTP threshold, intermediate dose statin therapy is economically attractive, and should be a priority intervention in prevention of cardiovascular events in Brazil.

  15. Cost-Effectiveness of High, Moderate and Low-Dose Statins in the Prevention of Vascular Events in the Brazilian Public Health System

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    Rodrigo Antonini Ribeiro


    Full Text Available Background: Statins have proven efficacy in the reduction of cardiovascular events, but the financial impact of its widespread use can be substantial. Objective: To conduct a cost-effectiveness analysis of three statin dosing schemes in the Brazilian Unified National Health System (SUS perspective. Methods: We developed a Markov model to evaluate the incremental cost-effectiveness ratios (ICERs of low, intermediate and high intensity dose regimens in secondary and four primary scenarios (5%, 10%, 15% and 20% ten-year risk of prevention of cardiovascular events. Regimens with expected low-density lipoprotein cholesterol reduction below 30% (e.g. simvastatin 10mg were considered as low dose; between 30-40%, (atorvastatin 10mg, simvastatin 40mg, intermediate dose; and above 40% (atorvastatin 20-80mg, rosuvastatin 20mg, high-dose statins. Effectiveness data were obtained from a systematic review with 136,000 patients. National data were used to estimate utilities and costs (expressed as International Dollars - Int$. A willingness-to-pay (WTP threshold equal to the Brazilian gross domestic product per capita (circa Int$11,770 was applied. Results: Low dose was dominated by extension in the primary prevention scenarios. In the five scenarios, the ICER of intermediate dose was below Int$10,000 per QALY. The ICER of the high versus intermediate dose comparison was above Int$27,000 per QALY in all scenarios. In the cost-effectiveness acceptability curves, intermediate dose had a probability above 50% of being cost-effective with ICERs between Int$ 9,000-20,000 per QALY in all scenarios. Conclusions: Considering a reasonable WTP threshold, intermediate dose statin therapy is economically attractive, and should be a priority intervention in prevention of cardiovascular events in Brazil.

  16. [Work as subsistence in Brazilian public hospitals]. (United States)

    Vaghetti, Helena Heidtmann; Padilha, Maria Itayra; da Silva, Rosimeri Carvalho; de Almeida Simões, Jorge Manuel Trigo


    That was a review study that aimed to analyze the interpretations that authors of dissertations and thesis about the meanings expressed by health workers, about the relations of subsistence with the job, in the organizational culture of public hospitals in Brazil. Data were extracted from from dissertations and theses in the period from 2002 to 2006. The theoretical methodological reference laid in the interpretive anthropology by Clifford Geertz. The results point that the subsistence relations conduct to alienation from work. The payment generates economic non satisfaction that pry the need to have other jobs. The work stability feeds the disengagement and actions that stimulates the transgression of standards and help the own governs in public hospitals in Brazil.

  17. Training Public Health Advisors. (United States)

    Meyer, Pamela A; Brusuelas, Kristin M; Baden, Daniel J; Duncan, Heather L


    Federal public health advisors provide guidance and assistance to health departments to improve public health program work. The Centers for Disease Control and Prevention (CDC) prepares them with specialized training in administering public health programs. This article describes the evolving training and is based on internal CDC documents and interviews. The first federal public health advisors worked in health departments to assist with controlling syphilis after World War II. Over time, more CDC prevention programs hired them. To meet emerging needs, 3 major changes occurred: the Public Health Prevention Service, a fellowship program, in 1999; the Public Health Associate Program in 2007; and integration of those programs. Key components of the updated training are competency-based training, field experience, supervision, recruitment and retention, and stakeholder support. The enduring strength of the training has been the experience in a public health agency developing practical skills for program implementation and management.

  18. Discover: What Is Public Health? (United States)

    ... Series Undergraduate Network Membership Contact Discover What is Public Health? Public health protects and improves the health of individuals, families, communities, and populations, locally and globally. Public health is personal. Public health professionals focus on preventing ...

  19. American Public Health Association (United States)

    ... Published Books Fact Sheets Reports and Issue Briefs Advertising Public Health Buyers Guide Publications Contacts Professional Development ... Steps Challenge doubles its goal Apr 11 2017 Facebook Is your organization an APHA member? As an ...

  20. Brazilian union actions for workers' health protection

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    Rodolpho Repullo Junior

    Full Text Available CONTEXT: Many authors have emphasized the importance of worker strength through unionized organizations, in relation to the improvement of working procedures, and have reported on the decisiveness of labor movement actions in achieving modifications within the field of work and health. OBJECTIVE: To describe the ways in which Brazilian unions have tried to intervene in health-illness and work processes, identifying the existence of commonality in union actions in this field. TYPE OF STUDY: Qualitative study. SETTING: Postgraduate Program, Environmental Health Department, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil. METHODS: Union health advisers and directors were interviewed. Documents relating to union action towards protecting workers' health were collected and analyzed. RESULTS: Unions articulate actions regarding workers' health of a technical and political nature that involve many aspects and high complexity. These have been divided into thematic categories for better analysis. DISCUSSION: Union actions regarding workers' health in Brazil are restricted to some unions, located mainly in the southern, southeastern and northeastern regions of the country. Nonetheless, the unions undertaking such actions represent many professions of great economic and political importance. CONCLUSIONS: The recent changes in health and safety at work regulations, recognition of professional diseases, creation of workers' health services and programs within the unified health system, and operational improvements in companies' specialized safety and occupational medicine services, all basically result from union action. There is commonality of union action in this field in its seeking of technical and political strengthening for all workers and their general and local representation. This has the objective of benefiting collective bargaining between employers and workers. Inter-institutional action on behalf of workers' rights

  1. Patentes farmacêuticas e saúde pública: desafios à política brasileira de acesso ao tratamento anti-retroviral Pharmaceutical patents and public health: challenges for the Brazilian antiretroviral treatment policy

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    Constance Marie Milward de Azevedo Meiners


    Full Text Available O preço elevado de medicamentos patenteados tem intensificado o debate em torno do impacto do regime da propriedade intelectual sobre o acesso a tratamentos de saúde, merecendo destaque o caso do HIV/AIDS. A política brasileira de tratamento anti-retroviral, parte de um programa nacional que integra medidas de prevenção e promoção da saúde, permitiu o alcance de uma ampla cobertura com qualidade, tendo sido apontada como modelo para outros países. Não obstante, conforme amadurece o Programa Nacional de DST e AIDS, os gastos com a incorporação de anti-retrovirais patenteados ao esquema terapêutico para pacientes em tratamento atinge um peso, cada vez maior, em seu orçamento. O presente artigo toma em conta os desafios apresentados pelas patentes farmacêuticas à saúde pública e discute possíveis caminhos para a sustentação da política de acesso universal e gratuito ao tratamento contra HIV/AIDS no Brasil.The high prices of patented drugs have fueled the debate regarding the impact of the intellectual property system on access to treatment, with a special focus on HIV/AIDS. The Brazilian policy for antiretroviral treatment, part of a comprehensive program that includes both disease prevention and health promotion activities, has allowed the country to meet goals for coverage and quality and has been considered a model for other countries. However, as the Brazilian STD/AIDS Program reaches maturity, the increasing incorporation of patented drugs into the AIDS treatment regimen imposes an increasing burden on the country's health budget. This article discusses the public health challenges raised by pharmaceutical patents and discusses possible ways to sustain the national policy for free, universal access to HIV/AIDS treatment.

  2. Copagamentos no Sistema Público Brasileiro: anomalia ou tendência? Joint payment in the Brazilian Public Health System: anomaly or tendency?

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    Maria de Fatima Siliansky de Andreazzi


    Full Text Available O copagamento como complemento ao financiamento de unidades públicas de saúde é uma recomendação específica do Banco Mundial para reformar sistemas de saúde e tem sido amplamente utilizado no contexto internacional. O Brasil é uma exceção. O objetivo do trabalho foi analisar a situação do copagamento no Sistema Único de Saúde diante da constatação de sua ocorrência em dois municípios de uma microrregião de Minas Gerais. A questão principal a ser respondida foi: trata-se de um caso anômalo, isolado, ou uma prática não privilegiada pelas análises da implementação da política de saúde no Brasil na atualidade, uma tendência a ser monitorada?Joint payment as a complement to finance public health unities is a specific recommendation by the World Bank in order to rearrange health systems, and it has been widely used throughout the world. Brazil is an exception. The aim of the article is to analyze the situation of joint payment in Sistema Único de Saúde - SUS - (Unique Health System in two cities of a micro-region in Minas Gerais State. The main question to be answered was if we were facing an anomalous isolated case or if it was a practice non-privileged by the analyses of implementation of public health currently in Brazil, a tendency to be monitored.

  3. Public health workforce taxonomy. (United States)

    Boulton, Matthew L; Beck, Angela J; Coronado, Fátima; Merrill, Jacqueline A; Friedman, Charles P; Stamas, George D; Tyus, Nadra; Sellers, Katie; Moore, Jean; Tilson, Hugh H; Leep, Carolyn J


    Thoroughly characterizing and continuously monitoring the public health workforce is necessary for ensuring capacity to deliver public health services. A prerequisite for this is to develop a standardized methodology for classifying public health workers, permitting valid comparisons across agencies and over time, which does not exist for the public health workforce. An expert working group, all of whom are authors on this paper, was convened during 2012-2014 to develop a public health workforce taxonomy. The purpose of the taxonomy is to facilitate the systematic characterization of all public health workers while delineating a set of minimum data elements to be used in workforce surveys. The taxonomy will improve the comparability across surveys, assist with estimating duplicate counting of workers, provide a framework for describing the size and composition of the workforce, and address other challenges to workforce enumeration. The taxonomy consists of 12 axes, with each axis describing a key characteristic of public health workers. Within each axis are multiple categories, and sometimes subcategories, that further define that worker characteristic. The workforce taxonomy axes are occupation, workplace setting, employer, education, licensure, certification, job tasks, program area, public health specialization area, funding source, condition of employment, and demographics. The taxonomy is not intended to serve as a replacement for occupational classifications but rather is a tool for systematically categorizing worker characteristics. The taxonomy will continue to evolve as organizations implement it and recommend ways to improve this tool for more accurate workforce data collection.

  4. The territorial logic in brazilian health policy

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    Eliane Cristina Lopes Brevilheri


    Full Text Available This article aims to reflect on the territorial dimension has been addressed in the current Brazilian health policy. Provides an initial approximation of the theoretical discussion about the category territory and its implications for social policy. Then we analyze how this category was included in the principles and guidelines of the National Health System, deployed in key programs and normative instruments of health policy from 1990. It is concluded that: the territorial dimension was present from conception through SUS guideline regionalization of activities and services. In the main programs implemented in the 1990s, the territorial dimension had a character cutouts geographical and normative instruments gave centrality to the process of decentralization. However, from the 2000s, the regionalization strategy, pointing to the territorial perspective, gains greater significance. However, we still need to overcome the logic purely political-administrative and act so as to identify the real needs of the people, their potential, diversity and particularities, towards "used territory" referred to Milton Santos.

  5. Exploring professionalization among Brazilian oral health technicians

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    Sanglard-Oliveira Carla


    Full Text Available Abstract Professional dental auxiliaries emerged in the early 20th century in the United States of America and quickly spread to Europe and other regions of the world. In Brazil, however, oral health technicians (OHTs, who occupy a similar role as dental hygienists, had a long journey before the occupation achieved legal recognition: Brazilian Law 11.889, which regulates this occupation in the country, was only enacted in 2008. The aim of this paper is to review the literature on the professionalization of OHTs, highlighting the triggering, limiting and conflicting aspects that exerted an influence on the historical progress of these professionals in Brazil. We have tested Abbott’s and Larson’s theory on professionalization, against the history of OHTs. A number of different dental corporative interests exerted an influence over professionalization, especially in discussions regarding the permissible activities of these professionals in the oral cavity of patients. With primary health care advances in Brazil, the importance of these professionals has once again come to the forefront. This seems to be a key point in the consolidation of OHTs in the area of human resources for health in Brazil.

  6. [The organizational culture of a Brazilian public hospital]. (United States)

    Rocha, Fernanda Ludmilla Rossi; Marziale, Maria Helena Palucci; de Carvalho, Michele Cristina; Cardeal Id, Samira de Fátima; de Campos, Monica Chiodi Toscano


    The objective of this research was to analyze the organizational culture of a Brazilian public hospital. It is a descriptive study with quantitative approach of data, developed in a public hospital of São Paulo State, Brazil. The sample was composed by 52 nurses and 146 nursing technicians and auxiliaries. Data were collected from January to June 2011 using the Brazilian Instrument for Assessing Organizational Culture - IBACO. The analysis of the organizational values showed the existence of hierarchical rigidity and centralization of power within the institution, as well as individualism and competition, which hinders teamwork. The values concerning workers' well-being, satisfaction and motivation were not highly valued. In regard to organizational practices, the promotion of interpersonal relationship, continuous education, and rewarding practices were not valued either. It becomes apparent that traditional models of work organization support work practices and determine the organizational culture of the hospital.

  7. The organizational culture of a Brazilian public hospital

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    Fernanda Ludmilla Rossi Rocha


    Full Text Available The objective of this research was to analyze the organizational culture of a Brazilian public hospital. It is a descriptive study with quantitative approach of data, developed in a public hospital of São Paulo State, Brazil. The sample was composed by 52 nurses and 146 nursing technicians and auxiliaries. Data were collected from January to June 2011 using the Brazilian Instrument for Assessing Organizational Culture – IBACO. The analysis of the organizational values showed the existence of hierarchical rigidity and centralization of power within the institution, as well as individualism and competition, which hinders teamwork. The values concerning workers’ well-being, satisfaction and motivation were not highly valued. In regard to organizational practices, the promotion of interpersonal relationship, continuous education, and rewarding practices were not valued either. It becomes apparent that traditional models of work organization support work practices and determine the organizational culture of the hospital.

  8. [Cost analysis of18F-FDG PET-CT from the perspective of the Brazilian Unified National Health System as healthcare provider: a study in a public healthcare center in Rio de Janeiro, Brazil]. (United States)

    Caetano, Rosângela; Schluckebier, Luciene Fontes; Bastos, Cláudia Regina Garcia; Silva, Rondineli Mendes da; Carneiro, Michel Pontes; Silva, Jorge Wagner Esteves da; Biz, Aline Navega


    Positron emission tomography (PET) has been introduced recently in Brazil and requires costs analysis to support economic evaluation studies on its use. The current study analyzed the use of 18 F-FDG PET-CT and estimated its costs from the perspective of a public healthcare provider. The micro-costing technique was used, identifying, quantifying, and valuing all the inputs used to perform the procedure. Cost estimates considered 85 tests performed at the Brazilian National Cancer Institute from March to June 2012. Reference cases were defined as adult cancer patients, output of five tests per day, and one dose of 18 F-FDG per patient. Unit cost for the procedure was BRL 3,150.30 based on career wages under the Ministry of Science and Technology and BRL 2,927.19 based on Ministry of Health career wages. The factor with the heaviest cost impact was daily output of tests. Other factors that could impact the test's cost in public healthcare institutions were also examined.

  9. Analysis of undergraduate cell biology contents in Brazilian public universities. (United States)

    Mermelstein, Claudia; Costa, Manoel Luis


    The enormous amount of information available in cell biology has created a challenge in selecting the core concepts we should be teaching our undergraduates. One way to define a set of essential core ideas in cell biology is to analyze what a specific cell biology community is teaching their students. Our main objective was to analyze the cell biology content currently being taught in Brazilian universities. We collected the syllabi of cell biology courses from public universities in Brazil and analyzed the frequency of cell biology topics in each course. We also compared the Brazilian data with the contents of a major cell biology textbook. Our analysis showed that while some cell biology topics such as plasma membrane and cytoskeleton was present in ∼100% of the Brazilian curricula analyzed others such as cell signaling and cell differentiation were present in only ∼35%. The average cell biology content taught in the Brazilian universities is quite different from what is presented in the textbook. We discuss several possible explanations for these observations. We also suggest a list with essential cell biology topics for any biological or biomedical undergraduate course. The comparative discussion of cell biology topics presented here could be valuable in other educational contexts.

  10. Ideal cardiovascular health prevalence in the Brazilian population - National Health Survey (2013). (United States)

    Velasquez-Melendez, Gustavo; Felisbino-Mendes, Mariana Santos; Matozinhos, Fernanda Penido; Claro, Rafael; Gomes, Crizian Saar; Malta, Deborah Carvalho


    Primordial prevention is defined as the initial prevention of risk factors, through the adoption of healthier behaviors. Within this concept, the American Heart Association (AHA) has defined seven metrics, based on evidence, to achieve ideal cardiovascular health. The aim of this study was to evaluate the prevalence of cardiovascular health in the Brazilian population, according to sex, age, and region of residence, using data from the latest National Health Survey (2013). We assessed the risk factors, as recommended by the AHA, combined (number of factors) and individually: four behavioral (smoking, physical activity, body mass index and diet) and three biological factors (blood pressure, blood glucose and cholesterol levels). The Brazilian population has reached very low prevalence (1%), for the sum of 7 factors in ideal level. Individually, 3.2% of the population consumed ideal diet, followed by physical activity (23.6%) and body mass index (43.7%). The subjects aged between 18 and 35 years showed higher prevalence of metrics combined at the optimal levels (0.5%), which was also reached by the population of the Northern region. These results indicate that greater efforts are urgent by public policies at the level of primordial prevention in order to achieve appropriate targets of cardiovascular health in the Brazilian population.

  11. Public Health Nutrition Education

    DEFF Research Database (Denmark)

    Torheim, Liv Elin; Birgisdottir, Bryndis Eva; Robertson, Aileen


    Public Health Nutrition Education Liv Elin Torheim* 1, Bryndis Eva Birgisdottir2, 3, Inga Thorsdottir2, 3, Aileen Robertson4, Runa Midtvåge4, Chalida Mae Svastisalee4, Hanne Gillett4, Agneta Yngve5, Arja Erkkilä6 1Department of Nursing and Health Promotion, Oslo and Akershus University College......, Oslo, Norway, 2Unit for Nutrition Research, Landspitali University Hospital , 3Department of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland, 4Global Nutrition and Health, Metropolitan University College, Copenhagen, Denmark, 5School of Hospitality, culinary arts and meal science......, Örebro University, Örebro, Sweden, 6Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland Abstract text: Most Nordic health policy priorities are diet related, including reduction of social health inequalities, prevention of non-communicable diseases (NCDs...

  12. Entre a saúde coletiva e a saúde mental: um instrumental metodológico para avaliação da rede de Centros de Atenção Psicossocial (CAPS do Sistema Único de Saúde Public health and mental health: methodological tools to evaluate the Brazilian Network of Referral Centers for Psycho-Social Care (CAPS in the Brazilian Unified Health System

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    Rosana Teresa Onocko-Campos


    Full Text Available Trata-se de discussão preliminar sobre possível instrumental metodológico para pesquisa avaliativa da rede de Centros de Atenção Psicossocial (CAPS do SUS. Problematiza-se a relevância que a área da saúde mental deveria ter para a saúde coletiva, considerando a alta prevalência de transtornos psíquicos e relativa carência de estudos da interface dessas áreas. Destacam-se as características dos CAPS para demonstrar que são serviços particularmente complexos. Considera-se imprescindível a aproximação das duas áreas para a constituição de um campo interdisciplinar de saberes e práticas, e aponta-se a necessidade dessa convergência para o desenvolvimento de um processo avaliativo sistemático dos CAPS. Levando-se em conta a complexidade do objeto e visando gerar subsídios para a Reforma Psiquiátrica Brasileira, com base em instrumentos da pesquisa avaliativa, propõe-se: a importância de se resgatar a participação de diversos atores no processo avaliativo, a necessidade de coletar e sistematizar diversos estudos desenvolvidos na academia sobre o tema, e a importância de promover um novo território de pesquisa no âmbito das políticas públicas de saúde, que possa subsidiar formuladores, gestores e equipes na reformulação de suas práticas.This article presents a preliminary discussion of potential methodological tools for qualitative research on the Network of Referral Centers for Psycho-Social Care (CAPS in the Brazilian Unified Health System (SUS. The relevance of mental health within the field of public health is examined. The study focuses on the high prevalence of mental disorders and the disproportionate lack of studies on the interface between mental health and public health. The establishment of an interdisciplinary field between public health and mental health is proposed to meet common needs by achieving similar perspectives in knowledge and practice. A particular group of tools is proposed, emphasizing

  13. Age at the diagnosis and in the beginning of intervention from hearing impaired children, in a public Brazilian hearing health service

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    Pinto, Meliane Melina


    Full Text Available Introduction: The earlier the diagnosis and the intervention from the hearing impairment less will be the impact for the development of cognitive abilities, hearing and of speech from the child. Objective: Characterize the age in the diagnosis and the beginning of intervention of the hearing loss and the accompaniment of the assisted children in a public Brazillian hearing health service - Espaço Reouvir from the Clinicas Hospital from the Medical School from the University of São Paulo. Method: Retrospective study with information from 166 medical records from children regarding the: gender; etiology, type, degree and laterality of the hearing impairment; age in the diagnosis and adaptation of the Hearing aids (HA and accompaniment in the service. Results: The sample was composed by 56% men and 44% women. The prevailing etiology was from multifactorial origin. The hearing loss from the neurosensory type occurred in 88,6% of the cases. The degree of moderate hearing loss was the most frequent (30,7%, symmetry in both ears was found in 69,9% of the cases and unilateral hearing loss in 2,4%. The average age in the diagnosis was of 5,46 years and in the intervention was of 6,86 years. A total of 96,98% of children had already completed the process of adaptation and 78,32% still remained in the accompaniment. Conclusion: The program Reouvir-HCFMUSP still receives children, both for diagnosis and or intervention in a late manner. However, still is possible the realization of the accompaniment of a significant number of users of the hearing aids, enabling a process of adaptation more effective.


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    Teresa Rodriguez Cao


    Full Text Available This paper investigates changes in long-term operational and financial performance for a sample of Brazilian companies made initial public offerings (IPO's shares, in the period 2002-2008. This period showed a historically high number of IPOs, a heavily discontinued phenomenon with the international financial crisis of 2008. As performance measures were chosen six financial indicators usually adopted in the literature in periods of three years pre-IPO, year of listing and three years post-IPO. The indicators evaluated were size, growth rate, profitability, financial leverage, investment level and investment rate. The results show evidence that, on average, there were statistically significant improvements in size, profitability, investment level and investment rate. But there was no evidence statistically significant changes in the growth rate and financial leverage after the IPO of Brazilian firms.

  15. The Supply of Trade Credit by Brazilian Publicly Traded Firms

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    Rafael Felipe Schiozer


    Full Text Available This paper investigates the determinants of trade credit supply by Brazilian publicly traded companies between the years of 2005 and 2008. International literature (both theoretical and empirical documents that the main determinants of trade credit supply are the size of the firm and the size of its debt. Both indicate that the availability of resources to the firm is an important factor for the supply of trade credit. In addition, the literature confirms strategic uses of trade credit such as those for price discrimination purposes. The results obtained using a sample of 157 Brazilian companies do not support that size and indebtedness are relevant determinants for trade credit supply, but they confirm the supply of trade credit as a strategic tool for the firms. Additionally we observed a significant decrease in trade credit supply in 2008, the year in which a severe international financial crisis took place.

  16. The role of Public Private Partnership: the Brazilian experience of modernizing hospitals in the São Paulo Prefecture Health Secretariat. (United States)

    Vicente, Roser; Castillejo, Joan


    Within the health sector, the aim of the PPP model is to improve management efficiency and innovation in health care services while it also helps to accelerate the modernization of national health systems. Gesaworld's experience in Brazil, including the modernization of the hospital network of the São Paulo Prefecture, has contributed to improvements in the health of the population by offering better health care facilities. The scope of the project, which is based on the legal model of an administrative concession contract, includes sustainability criteria as part of the project.

  17. Zoonosis of public health interest in slaughtered Brazilian equidaeZoonoses de interesse em saúde pública em equídeos brasileiros abatidos

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    Roberta Lemos Freire


    Full Text Available The objective of this study was to investigate the presence of Trichinella spp. in the musculature and anti-Toxoplasma gondii and anti-Leptospira spp. antibodies in the serum of equidae slaughtered at two abattoir-cold storage facilities licensed by the brazilian Federal Inspection Service. Masseter muscle and blood samples were collected from 398 animals of both sexes and different ages originating from six different Brazilian states. The serum samples were subjected to the Indirect Fluorescence Antibody Test for T. gondii (IFAT ³ 64 obtaining 46 (11.6% samples reagent. For Leptospira spp. Antibody quantification, the serum samples were tested by microscopic seroagglutination test (MAT ³ 100, and 123 (30.9% reagent results were obtained. It was possible to identify the most likely infecting serovar in 95 samples (77.2%: Hardjo (26.3% and Autumnalis (12.6% were the ones most prevalent. None of the 398 masseter muscle samples analyzed revealed any presence of Trichinella spp. larvae. The slaughtered equidae that were investigated were probably exposed to the etiologic agents of toxoplasmosis and leptospirosis, but they did not present Trichinella infection.O objetivo deste estudo foi investigar a presença de Trichinella spp. na musculatura e anticorpos anti-Toxoplasma gondii e anti-Leptospira spp. em soro de equídeos abatidos em dois matadourosfrigoríficos com serviço de Inspeção Federal. Amostras de músculo masséter e sangue foram coletados de 398 animais de ambos os sexos e várias idades, provenientes de seis diferentes estados brasileiros. As amostras de soro foram submetidas à Reação de Imunofluorescência Indireta para T. gondii (IFI ³ 64 obtendo 46 (11,6% amostras reagentes. Para Leptospira spp. as amostras de soro foram testadas pelo teste de soroaglutinação microscópica (MAT ³ 100 e 123 (30,9% amostras foram reagentes. Foi possível identificar o sorovar mais provável em 95 amostras (77,2% sendo Hardjo (26,3% e

  18. Belisário Penna, combatente: um capítulo da história da saúde pública brasileira Belisário Penna, a champion in the history of Brazilian public health

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    Luiz Antonio de Castro-Santos


    Full Text Available A contribuição do médico sanitarista Belisário Penna (1868-1939 à história da saúde pública no Brasil constitui o tema central do texto. Belisário Penna é retratado aqui a partir de sua militância, dos combates que travou em defesa do saneamento rural e pela melhoria das condições de saúde de toda a população brasileira. O propósito também é situá-lo em meio aos debates de sua época, esclarecendo, por exemplo, como as ideias de Belisário - tão bem apresentadas em suas eloquentes palestras - primavam por se contrapor ao pensamento racista dominante entre as elites do País. Belisário argumentava que os obstáculos ao progresso nacional residiam na precariedade tanto da saúde quanto da instrução pública. Nessa medida, os problemas referidos à questão da eugenia no País eram interpretados sob um prisma otimista: no lugar de determinismos raciais intangíveis, a presença do Estado, por meio de programas de higiene e educação cívica, traria o progresso desejado. O "otimismo sanitário" do combatente mineiro não consistiu em um atributo só dele, mas era compartilhado por outros médicos e intelectuais em torno de movimentos como a Liga Pró-Saneamento, cujas bandeiras acenavam a necessidade de mudanças sociais e alcançaram significativa ressonância popular.The contribution of the sanitarian Belisário Penna (1868-1939 to the history of public health in Brazil constitutes the central topic of this text. The intellectual, professional, and political profile of Belisário Penna is here reconsidered, in the light of his entrenched defense of rural sanitation, his militancy in favor of the improvement of living conditions in the backlands of Brazil, and his criticism of oligarchical power. The intention is also to point out how he opposed, through a series of speeches of great eloquence, the climate of opinion in Brazil's early Republic. He took in the preoccupations of Brazilian elite with "eugenics," discussing

  19. Earning management: analysis of publications in brazilian accounting journals

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    Débora Gomes Machado


    Full Text Available The goal of this study is to identify characteristics, from the perspective of social networks, of the scientific literature on earning management in Brazilian accounting journals. Specifically, were identified: a authors and their social networks of scientific production; b researched topics, models for accruals detection, authors’ networks and the period studied; c methodological procedures used. A bibliometric survey, with a quantitative approach was performed through the analysis of 17 Brazilian accounting journals, since their first edition until the year 2010. Out of them, 10 published articles having the theme earning management in the title, abstract or keywords. The 32 identified articles were submitted to content analysis and then the data were presented from the perspective of social networks. The survey results show that: the authors and their social networks of production originates mostly from Universidade de São Paulo (USP; the most researched theme was the methods or means to conduct earnings management, and accruals measurement models, with emphasis on Kang and Sivaramakrishnan Model; the descriptive research, based on document and quantitative approach were the most commonly used forms in the articles researched. It is noteworthy that structural gaps are the topics, such as compensation plans, political costs and earnings management in different contractual environments. The research results can contribute to academia to highlight some features of the earnings management theme and its researchers, in the field of publications in Brazilian accounting journals.

  20. O mix público-privado no Sistema de Saúde Brasileiro: financiamento, oferta e utilização de serviços de saúde The public-private mix in the Brazilian Health System: financing, delivery and utilization of health services

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    Isabela Soares Santos


    Full Text Available O artigo analisa o mix público-privado do sistema de saúde brasileiro a partir da oferta, utilização e financiamento dos serviços de saúde. Contempla os subsídios públicos para o setor privado. Trata-se de um estudo quantitativo, baseado em dados secundários provenientes de bases de dados oficiais. Mostra que existem desigualdades na oferta e na utilização de serviços em prol da população com plano de saúde, em decorrência da peculiar inserção do setor suplementar, que oferece cobertura suplementar e duplicada ao sistema público (SUS, sem desconsiderar que outros fatores podem determinar o uso de serviços de saúde e aumentar as desigualdades. A análise é feita com base na tipologia de mix público-privado desenvolvida pela OECD em 2004, que auxilia a compreensão das desigualdades que ocorrem em cada tipo de mix, e mostra que as que ocorrem no sistema de saúde brasileiro se dão pelo fato de a cobertura de serviços ofertados pelo segmento de seguro privado ser duplicada à cobertura de serviços do SUS. Ainda, as desigualdades verificadas no sistema de saúde brasileiro ocorrem num sistema de saúde em que o financiamento público ao SUS é minoritário e existem grandes subsídios públicos para o setor privado.This paper analyzes the public-private mix in the Brazilian Health System from the perspective of health care delivery, utilization and financing. Moreover, this quantitative study based on secondary data from official databases contemplates the subsidies granted by the government to the private sector. It shows the existence of some inequalities favoring the population having private health plans, a result of the peculiar participation of the private sector in the Brazilian Health System not only offering supplementary care but duplicating the coverage offered by the public system (called SUS. The analysis is made on the basis of the classification of public-private mix in Health Systems developed by the OECD in

  1. Music and Public Health

    DEFF Research Database (Denmark)

    Bonde, Lars Ole; Juel, Knud; Ekholm, Ola


    Background: ‘Music and public health’ is a new field of study. Few scientific studies with small samples have documented health implications of musical participation. Research questions in this epidemiological study were: 1) Is there an association between self-rated health and active use of music...... in daily life? 2) What associations can be observed between musical background, uses and understanding of music as a health factor, and self-reported health? Method: Data came from the Danish Health and Morbidity Survey 2013, based on a simple random sample of 25.000 adult Danes (16+ years). Response rate......: 57%. Multiple logistic regression analyses were performed to investigate associations between musical background/activities and health-related indicators. Discussion: The study documents that a majority of informants use music to regulate physical and psychological states...

  2. Globalisation and public health. (United States)

    Bettcher, D; Lee, K


    At the dawn of the 21st century, globalisation is a word that has become a part of everyday communication in all corners of the world. It is a concept that for some holds the promise of a new and brighter future, while for others it represents a threat that needs to be confronted and counteracted. In the area of public health, a wide range of claims have been made about the various impacts, both positive and negative, that can be attributed to globalisation. In the ever expanding literature on globalisation and health, it has become apparent that considerable confusion is emerging in both the ways that terminology is applied and concepts are defined. The determinants of health are increasingly multisectoral, and in tackling these challenges it is necessary to take a multidisciplinary approach that includes policy analyses in such areas as trade, environment, defence/security, foreign policy, and international law. In assembling the terms for this glossary, we have attempted to demonstrate the richness of the globalisation and public health debate, and in so doing have selected some of the core terms that require definition. We hope that this glossary will help to clarify this interesting and challenging area, and will also serve as a useful entry point to this new debate in public health.

  3. Public health law research: exploring law in public health systems. (United States)

    Ibrahim, Jennifer K; Burris, Scott; Hays, Scott


    The importance of law in the organization and operation of public health systems has long been a matter of interest to public health lawyers and practitioners, but empirical research on law as a factor in health system performance has been limited in quantity and sophistication. The emergence of Public Health Law Research and Public Health Systems and Services Research within a coordinated effort to strengthen public health research and practice has dramatically changed matters. This article introduces Public Health Law Research as an integral part of Public Health Systems and Services Research, discusses the challenges of integrating the 2 fields, and highlights 2 examples of current research that demonstrate the benefits of an integrated approach to improve the use of law in public health practice.

  4. Insights in Public Health (United States)

    Hayes, Donald K; Calhoun, Candice R; Joseph, Lin; Farnsworth, JoAnn Y; Arakaki, Kimberly B


    The Hawai‘i Maternal and Infant Health Collaborative, founded in 2013, is a public-private partnership committed to improving birth outcomes and reducing infant mortality. The Collaborative was developed in partnership with the Executive Office on Early Learning Action Strategy with help from the Department of Health and National Governor's Association. The Action Strategy provides Hawai‘i with a roadmap for an integrated and comprehensive early childhood system, spanning preconception to third grade. The Collaborative helps advance goals within the Action Strategy by focusing on ensuring that children have the best start in life by being healthy and welcomed. The Collaborative has completed a strategic plan and accompanying Logic Model, The First 1,000 Days, aimed at achieving the outcomes of 8% reduction in preterm births and 4% reduction in infant mortality. To date over 120 people across Hawai‘i have been involved in the Collaborative. These members include physicians and clinicians, public health planners and providers, insurance providers and health care administrators. The work is divided into three primary areas and coordinated by a cross sector leadership team. Work is specific, outcome driven, informed by data and primarily accomplished in small work groups. PMID:27738566

  5. Green supply chain management: analysis of brazilian academic publications

    Directory of Open Access Journals (Sweden)

    José Carlos Barbieri


    Full Text Available This paper deals with environmental issues from the perspective of Supply Chain Management. With the incorporation of environmental concerns in a systematic manner the concept of Green Supply Chain Management (GSCM has emerged. The subject GSCM interests not only to academics but also to professional audience especially with regard to new legal obligations, and social pressures of various types of stakeholders, as well as issues related to the competitiveness of enterprises and their supply chains. However, the way in which this knowledge is being produced in Brazil is not clear, hence the need for a mapping which areas and sub-areas of GSCM has been studied most frequently. Thus, this work can be characterized as a desk research that aims to analyze the Brazilian academic publications on green supply chain management. In order to delimit the scope of the research, we collected articles published from 2006 to 2010 in specific Brazilian congresses of Management and Production Engineering, as EnANPAD, SIMPOI and SIMPEP. 110 papers were collected and analyzed.The area of Green Operations represents 81% of published articles and 45% of these focus on Reverse Logistics. 70% of total papers are empirical and 77% use a qualitative approach, while 57% of the total are case studies

  6. External control of the public water supply in 29 Brazilian cities

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    Suzely Adas Saliba Moimaz


    Full Text Available The fluoridation of public water supplies is considered the most efficient public health measure for dental caries prevention. However, fluoride levels in the public water supply must be kept constant and adequate for the population to gain preventive benefit. The aim of this study was to analyze fluoride levels in the public water supply of 29 Brazilian municipalities during a 48-month period from November 2004 to October 2008. Three collection sites were defined for each source of municipal public water supply. Water samples were collected monthly and analyzed at the Research Laboratory of the Nucleus for Public Health (NEPESCO, Public Health Postgraduate Program, Araçatuba Dental School (UNESP. Of the 6862 samples analyzed, the fluoride levels of 53.5% (n = 3671 were within the recommended parameters, those of 30.4% (n = 2084 were below these parameters, and those of 16.1% (n = 1107 were above recommended values. Samples from the same collection site showed temporal variability in fluoride levels. Variation was also observed among samples from collection sites with different sources within the same municipality. Although 53.5% of the samples contained the recommended fluoride levels, these findings reinforce the importance of monitoring to minimize the risk of dental fluorosis and to achieve the maximum benefit in the prevention of dental caries.

  7. Perfil socioeconômico, nutricional e de saúde de adolescentes recém-ingressos em uma universidade pública brasileira Socioeconomic, nutritional and health profile of adolescents recently admitted to a Brazilian public university

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    Valéria Cristina Ribeiro VIEIRA


    Full Text Available Objetivou-se delinear o perfil socioeconômico, nutricional e de saúde de adolescentes recém-ingressos em uma universidade pública brasileira. As variáveis comportamentais foram obtidas por meio de questionário, o percentual de gordura corporal (%GC pelo somatório das dobras cutâneas e o estado nutricional pelo Índice de Massa Corporal. A maioria dos adolescentes era do sexo feminino (57,3%, não residia com familiares (89,8%, consumia bebida alcoólica (73,5%, omitia alguma refeição principal (57,3% e rejeitava um ou mais alimentos do grupo das hortaliças (79,5%. Cerca de 57,0% não realizavam atividade física e 7,0% fumavam. Em torno de 72,0% e 25,0%, respectivamente, consumiam hortaliça e fruta cinco ou mais vezes na semana. Os eutróficos predominavam, mas 58,7% destes apresentavam %GC elevado. Concluiu-se que considerável parcela dos indivíduos estudados residia sem os familiares e apresentava, além de inadequação da composição corporal e do comportamento alimentar, outros fatores de risco à saúde, como o consumo de álcool e a inatividade física.The objective of this work was to describe the socioeconomic, nutritional and health profile of adolescents recently admitted to a Brazilian public university. The behavioral variables were obtained by interview, the body fat percentage (BF% by the sum of the four skinfold thicknesses and the nutritional status by body mass index. Most of the students were female (57.3%, lived away from their families (89.8%, drank alcohol (73.5%, skipped a main meal (57.3% and rejected one or more types of vegetables (79.5%. About 57.0% did not practice any physical activity and 7.0% smoked. About 72.0% and 25.0%, respectively, consumed vegetable and fruit five times or over during the week. The eutrophic subjects predominated, but 58.7% of them presented a high BF%. The results showed that a considerable number of the subjects lived away from their families and had inadequate body

  8. Public health, public trust and lobbying. (United States)

    Wynia, Matthew K


    Each year, infection with Human Papillomavirus (HPV) leads to millions of abnormal Pap smears and thousands of cases of cervical cancer in the US. Throughout the developing world, where Pap smears are less common, HPV is a leading cause of cancer death among women. So when the international pharmaceutical giant Merck developed a vaccine that could prevent infection with several key strains of HPV, the public health community was anxious to celebrate a major advance. But then marketing and lobbying got in the way. Merck chose to pursue an aggressive lobbying campaign, trying to make its new vaccine mandatory for young girls. The campaign stoked public mistrust about how vaccines come to be mandated, and now it's not just Merck's public image that has taken a hit. The public health community has also been affected. What is the lesson to be learned from this story? Public health communication relies on public trust.

  9. [Phonoaudiology in public health]. (United States)

    Freire, R M


    An undestanding of the activities and functions of a speech therapist within the specific context of the Basic Health Units (Unidades Básicas de Saúde) is sought. Difficulties relating to the introduction of a new service on the basis of one of the health professions that has not hitherto belonged to the group of categories which are traditionally incorporated in these same Basic Units. When the statistical data on the demand for speech therapy services by the population who attend health centres were considered, it was discovered that 32% were of schooling age and had been referred by schools, allegedly due to "learning problems". Closer contact with these children, through speech therapy, has brought a different aspect to light i.e. that one cannot consider as disturbance/deviation/problem/pathology written signs which constitute indications of the shock between the process of literacy and that of learning how to read and write. To understand the problem from the point of view of public health, a programme of teacher counselling is proposed, with the purpose of helping the school to clarify its role as co-constructor of the child's literacy process and of returning to the teacher the responsibility for the success and/or failure of teaching how to read and write. A similar programme is proposed for creches where coincidently, a greater proportion (44%) of the younger children (2 to 5 years of age) are seen to have difficulties in oral language development.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Teaching at primary healthcare services within the Brazilian national health system (SUS in Brazilian healthcare professionals' training

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    Ramona Fernanda Ceriotti Toassi


    Full Text Available The aim of this study was to analyze the role of teaching at primary healthcare services within the Brazilian National Health System (SUS in dentists' training, at a public university in the south of Brazil. A qualitative methodological approach (case study was used. Interviews were conducted with 12 dentistry students, six dentists who were preceptors working in public primary healthcare services and three teachers connected with this curricular training. Our findings showed that the curricular training in SUS primary healthcare services had an impact on the dentists' education through establishment of bonds, autonomy in problem-solving and multiprofessional teamwork. It was seen that they learned about how healthcare services function, about healthcare and about development of cultural competence. There is a need to maintain constant questioning regarding these practices, and to ensure the presence of infrastructure and qualified professionals for teaching at these services.

  11. Health research networks on the web: an analysis of the Brazilian presence

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    Pamela Barreto Lang


    Full Text Available In order to map Brazilian institutions’ web presence in an international network of health research institutions, a study was conducted in 2009, including 190 institutions from 42 countries. The sample was based on WHO (World Health Organization collaborating centers, and the methodology used webometric analyses and techniques, especially interlinks, and social network analysis. The results showed the presence of five Brazilian institutions, featuring the Oswaldo Cruz Foundation (Fiocruz, showing links to 20 countries and 42 institutions. Through the interface between the health field and the web, the study aims to contribute to future analyses and a plan for strategic repositioning of these institutions in the virtual world, as well as to the elaboration of public policies and recognition of webometrics as an area to be explored and applied to various other fields of knowledge.

  12. Health research networks on the web: an analysis of the Brazilian presence. (United States)

    Lang, Pamela Barreto; Gouveia, Fábio Castro; Leta, Jacqueline


    In order to map Brazilian institutions' web presence in an international network of health research institutions, a study was conducted in 2009, including 190 institutions from 42 countries. The sample was based on WHO (World Health Organization) collaborating centers, and the methodology used webometric analyses and techniques, especially interlinks, and social network analysis. The results showed the presence of five Brazilian institutions, featuring the Oswaldo Cruz Foundation (Fiocruz), showing links to 20 countries and 42 institutions. Through the interface between the health field and the web, the study aims to contribute to future analyses and a plan for strategic repositioning of these institutions in the virtual world, as well as to the elaboration of public policies and recognition of webometrics as an area to be explored and applied to various other fields of knowledge.

  13. Towards a public health profession

    DEFF Research Database (Denmark)

    Foldspang, Anders


    of a unified and authorised profession thus should have high priority among public health workers and their societies, academies and associations—for example, EUPHA—and the WHO, as it is for the Association of Schools of Public Health in the European Region, ASPHER, whose institutional members are responsible...... in the theoretical as well as the practical potential of the public health professional. Thus, he and she must be able to perform, what WHO Europe has developed as Essential Public Health Operations (EPHOs).3 This, in turn, implies that the public health professional possesses the set of intellectual (knowledge......) as well as practical (skills) competences stated in ASPHER’s comprehensive list of public health core competences.4 The lists have, since 2006, been developed with the participation of public health researchers, practitioners and decision makers and in conferences and workshops. In 2012, they were...

  14. Demandas judiciais e assistência terapêutica no Sistema Único de Saúde Judicial demands and therapeutic assistance in the Brazilian Public Health System

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    Fabiola Sulpino Vieira


    Full Text Available OBJETIVO: Analisar a cobertura qualitativa das políticas terapêuticas no Sistema Único de Saúde (SUS, no âmbito federal, para doenças referidas em ações judiciais. MÉTODOS: Realizou-se pesquisa exploratória com base em uma amostra de doenças referidas em ações judiciais impetradas contra a Secretaria Municipal da Saúde de São Paulo em 2005. Efetuou-se uma busca das normas que estabelecem políticas terapêuticas nas páginas eletrônicas do Ministério da Saúde e sobre os recursos terapêuticos recomendados (medicamentos e procedimentos cirúrgicos na base de dados Diseasedex, integrante do sistema Micromedex. Elaborou-se quadro-resumo, analisando-se para cada doença a cobertura por política terapêutica federal vigente, em função da inclusão de medicamentos ou procedimentos recomendados nesta política como primeira linha de tratamento. RESULTADOS: O atendimento terapêutico está contemplado para a maioria das doenças (n = 26, seja por meio de política da atenção básica, seja por meio de política para doenças raras e/ou de alto custo, o que representa 96% das doenças da amostra estudada (n = 27. Observou-se que das 27 doenças, três delas estão contempladas por política terapêutica limitada, ou seja, a política não oferece as abordagens de primeira escolha em sua totalidade, o que corresponde a 11% da amostra. A única doença que não está contemplada por política terapêutica é o transtorno do déficit de atenção e hiperatividade. CONCLUSÃO: Existem limitações em termos de cobertura qualitativa para o tratamento de algumas doenças da amostra estudada, em âmbito federal, o que compromete a integralidade da assistência terapêutica e da atenção à saúde em alguns casos.OBJECTIVE: To analyze the qualitative coverage of therapeutic policies at federal level in the Brazilian Public Health System (SUS for diseases that were the subject of lawsuits. METHODS: An exploratory research was performed

  15. Health approaches in a widely adopted Brazilian high school biology textbook

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    Liziane Martins


    Full Text Available Considering the long tradition of discussing health in the Brazilian school curriculum, it is important to investigate how this topic is addressed by the textbooks, the main resource used by most schools in the country. In particular, it is relevant to verify if this content is presented in a manner that contributes to the development of the students as active and critical members of the society. We analyze how health is treated in the textbook Biology, by Laurence (2005, which has been the high school Biology textbook most chosen by public school teachers among those certified by the National Program for High School Textbooks (PNLEM/2007, sponsored by the Brazilian Ministry of Education (MEC. We used categorical content analysis techniques, involving the decomposition of the texts into units of analysis, the categories, which were built in this work through analogical regroupings, by using semantic criteria. In order to investigate the treatment given to health, we applied an analytical table to the units of recording, which consist of sentences, paragraphs, and sections of the textbook that discuss contents related to health and disease. This table systematizes eight health indicators, seeking to identify three health approaches: biomedical, behavioral, and socioecological. We found 267 units of recording in the textbook and, based on their analysis, it was possible to categorize the textbook as one in which the biomedical approach prevails. Our findings are consistent with other works that indicate the prevalence of this approach in Brazilian education, and Brazilian and international textbooks. Another important finding of the work is that the behavioral approach does not hold, at least for the analyzed textbook, as a view of health different from the biomedical and socioecological approaches. After all, when the book mentions behaviors and habits of life associated with health, it generally emphasizes biological dimensions, aligning with a

  16. The contagion effect of public debt on monetary policy: the Brazilian experience

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    Fernando de Holanda Barbosa


    Full Text Available This paper attempts to explain why the Brazilian inter-bank interest rate is so high compared with rates practiced by other emerging economies. The interplay between the markets for bank reserves and government securities feeds into the inter-bank rate the risk premium of the Brazilian public debt.

  17. Doping and Public Health

    DEFF Research Database (Denmark)

    Christiansen, Ask Vest INHDR - International Network for Humanistisc Doping Research, med den virtuella adressen , höll sin andra konferens den 15-16 augusti på Aarhus Universitet, med dess Center for Idræt som värdinstitution. En...... rad av världens främsta idrottsvetare och dopningsexperter hade mött upp för att presentera papers till en intresserad och engagerad publik. Temat för konferensen var "Doping and Public Health", och den aspekten behandlades också; dock tolkade flera presentatörer temat på sina egna vis, och hela...


    Directory of Open Access Journals (Sweden)

    Mihir K. R.


    Full Text Available Tuberculosis is a major public health problem world o ver and it is India’s worst scourge. In the words of Charles Dickens “it is the disease medicine never cured, wealth warded off, or poverty could boast exemption from.... Which sometimes moves in giant strides & sometimes at tardy sluggish pace, but slow or quick... is never sur e and certain”. India bears 28.4% of the entire world’s burden of Tuberculosis. Every year 2 2 lakh persons contract Tuberculosis, but only half of them seek medical care. One Indian die s of Tuberculosis every 3 minutes! Tuberculosis is not only a medical malady but an ec onomic disaster too it perpetuates poverty and poverty begets Tuberculosis. In view of the enor mity of the problem let us leaf through the pages of history

  19. Public health and media advocacy. (United States)

    Dorfman, Lori; Krasnow, Ingrid Daffner


    Media advocacy blends communications, science, politics, and advocacy to advance public health goals. In this article, we explain how media advocacy supports the social justice grounding of public health while addressing public health's "wicked problems" in the context of American politics. We outline media advocacy's theoretical foundations in agenda setting and framing and describe its practical application, from the layers of strategy to storytelling, which can illuminate public health solutions for journalists, policy makers, and the general public. Finally, we describe the challenges in evaluating media advocacy campaigns.

  20. [Health work in MERCOSUR: a Brazilian approach]. (United States)

    Machado, Maria Helena; Paula, Aïda El-Khoury de; Aguiar Filho, Wilson


    MERCOSUR Member Countries (Brazil, Argentina, Paraguay, Uruguay, and Venezuela) have viewed the regional integration process and management of work and education in health as a concern for government, considering the health sector's specificities. Key issues are professional accreditation and harmonization of current legislation. This article discusses initiatives in the Permanent MERCOSUR Forum related to work in the health field. The Forum serves as a space for dialogue between various actors: Ministry of Health, health workers, and professional boards, with the aim of supporting the work by the Sub-Commission on Professional Development and Practice, under MERCOSUR Working Sub-Group 11, Health, aiding in the formulation of health management and education policies. The current challenge involves the creation of mechanisms for implementing joint actions to solve problems in the regulation of professional practice, especially in municipalities along the borders between MERCOSUR countries.

  1. Health for all: a public health vision. (United States)

    McBeath, W H


    The approach of a millennial passage invites public health to a review of past performance and a preview of future prospects toward assuring a healthy public. Since the 1974 Canadian Lalonde report, the best national plans for health progress have emphasized disease prevention and health promotion. WHO's multinational Health for All by the Year 2000 promotes basic health services essential to leading a socially and economically productive life. Healthy People 2000, the latest US guide, establishes three goals: increase healthy life span, reduce health disparities, and achieve universal access to preventive services. Its objectives can be used to excite public understanding, equip program development, evaluate progress, and encourage public accountability for health initiatives. Needed is federal leadership in defining requisite action and securing necessary resources. Elsewhere a "new public health" emphasizes community life-style and multisectoral "healthy public policy." In the United States, a national health program is needed to achieve equity in access to personal health care. Even more essential is equitable sharing in basic health determinants in society--nutritious food, basic education, safe water, decent housing, secure employment, adequate income, and peace. Vital to such a future is able and active leadership now from governments and public health professionals.

  2. Resource mobilization for health advocacy: Afro-Brazilian religious organizations and HIV prevention and control. (United States)

    Garcia, Jonathan; Parker, Richard G


    Brazil's national response to AIDS has been tied to the ability to mobilize resources from the World Bank, the World Health Organization, and a variety of donor agencies. The combination of favorable political economic opportunities and the bottom-up demands from civil society make Brazil a particularly interesting case. Despite the stabilization of the AIDS epidemic within the general Brazilian population, it continues to grow in pockets of poverty, especially among women and blacks. We use resource mobilization theories to examine the role of Afro-Brazilian religious organizations in reaching these marginalized populations. From December 2006 through November 2008, we conducted ethnographic research, including participant observation and oral histories with religious leaders (N = 18), officials from the National AIDS Program (N = 12), public health workers from Rio de Janeiro (N = 5), and non-governmental organization (NGO) activists who have worked with Afro-Brazilian religions (N = 5). The mobilization of resources from international donors, political opportunities (i.e., decentralization of the National AIDS Program), and cultural framings enabled local Afro-Brazilian religious groups to forge a national network. On the micro-level, in Rio de Janeiro, we observed how macro-level structures led to the proliferation of capacity-building and peer educator projects among these religious groups. We found that beyond funding assistance, the interrelation of religious ideologies, leadership, and networks linked to HIV can affect mobilization.

  3. Leprosy: International Public Health Policies and Public Health Eras

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    Niyi Awofeso


    Full Text Available Public health policies continue to play important roles in national and international health reforms. However, the influence and legacies of the public health eras during which such policies are formulated remain largely underappreciated. The limited appreciation of this relationship may hinder consistent adoption of public health policies by nation-states, and encumber disinvestment from ineffective or anachronistic policies. This article reviews seven public health eras and highlights how each era has influenced international policy formulation for leprosy control—“the fertile soil for policy learning”. The author reiterates the role of health leadership and health activism in facilitating consistency in international health policy formulation and implementation for leprosy control.

  4. Public relations effectiveness in public health institutions. (United States)

    Springston, Jeffrey K; Weaver Lariscy, Ruth Ann


    This article explores public relations effectiveness in public health institutions. First, the two major elements that comprise public relations effectiveness are discussed: reputation management and stakeholder relations. The factors that define effective reputation management are examined, as are the roles of issues and crisis management in building and maintaining reputation. The article also examines the major facets of stakeholder relations, including an inventory of stakeholder linkages and key audiences, such as the media. Finally, methods of evaluating public relations effectiveness at both the program level and the institutional level are explored.

  5. [Terrorism, public health and health services]. (United States)

    Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge


    Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.

  6. Migrant Health: a value for Public Health

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    Patrizia Laurenti


    Full Text Available The health matters associated with migration are crucial public health challenges faced by both governments and societies. According to United Nations estimates, 120 million of the approximately 175 million migrants worldwide are migrant workers with their families (1. Legal and illegal workers have a different status and, therefore, varying levels of access to social and health services. The collective health needs and implications of this sizeable population are considerable, and different health determinants and levels of vulnerability could impact on their health (2. The main public health goal is to avoid disparities in health status and access to health services between migrants and the host population (3. The second, closely associated principle, is to ensure migrants’ health rights, as stated during the 4th Conference on Migrant and Ethnic Minority Health in Europe which took place from 21st to 23rd June 2012 in Milan, where Migrants and ethnic minorities were confirmed as a benefit to the society (4.


    Directory of Open Access Journals (Sweden)

    Samantha Alflen Banin


    Full Text Available This article discusses the view of man as a gender category in public policies and national laws, especially those focused on violence against women. With this objective, it contextualizes the studies of feminisms and masculinities as theories and epistemology that guide the analysis of 17 official Brazilian documents selected for this study. This analysis seeks to clarify how the gendered man has been understood in various documents over the years. It discusses how the formulation of laws can provide a new accountability approach beyond the punishment of these men. It also investigates the regulation of some of the existing groups of men who have used violence against women in the country. It finalizes claiming the importance of these reflections for the debate on gender and masculinities in pursuit of a more effective system of prevention and eradication of violence against women. It discusses and argues in favor of both changing the way this category is addressed in official documents, and formalizing spaces for reflection for men who have used violence against women.

  8. Zoning should promote public health. (United States)

    Hirschhorn, Joel S


    Legally, governments use their police powers to protect public health, safety, and welfare through zoning. This paper presents a case for revisiting zoning on the basis of increasing evidence that certain types of community design promote public health, as opposed to the dominant pattern of sprawl development, which does not. Zoning, and the land use planning linked to it, that prohibits or disfavors health-promoting community designs contradicts the inherent public policy goal on which it is based. If there is a paradigm shift underway, from traditional sprawl to health-promoting community designs, then health professionals and others should understand why zoning must be reassessed.

  9. Liberalism and Public Health Ethics. (United States)

    Rajczi, Alex


    Many public health dilemmas involve a tension between the promotion of health and the rights of individuals. This article suggests that we should resolve the tension using our familiar liberal principles of government. The article considers the common objections that (i) liberalism is incompatible with standard public health interventions such as anti-smoking measures or intervention in food markets; (2) there are special reasons for hard paternalism in public health; and (3) liberalism is incompatible with proper protection of the community good. The article argues that we should examine these critiques in a larger methodological framework by first acknowledging that the right theory of public health ethics is the one we arrive at in reflective equilibrium. Once we examine the arguments for and against liberalism in that light, we can see the weaknesses in the objections and the strength of the case for liberalism in public health.

  10. Periodontal health and global public health. (United States)

    Petersen, Poul E; Baehni, Pierre C


    Chronic diseases are a growing burden to people, to health-care systems and to societies across the world. The rapid increase in the burden of chronic diseases is particularly prevalent in the developing countries. Periodontal disease is one of the two most important oral diseases contributing to the global burden of chronic disease. In addition to social determinants, periodontal health status is related to several proximal factors. Modifiable risk factors, such as tobacco use, excessive alcohol consumption, poor diet and nutrition, obesity, psychological stress and insufficient personal/oral hygiene, are important and these principal risk factors for periodontal disease are shared by other chronic diseases. The present monograph is devoted to the existing evidence on the practice of public health related to periodontal health. Public health is defined as the process of mobilizing and engaging local, national and international resources to assure that people can be healthy. Social determinants of health, environmental hazards and unhealthy lifestyles are prioritized in modern public health-care. Disease prevention and health promotion are cornerstones in actions for public health. This volume of Periodontology 2000 is entitled ‘Periodontal health and global public health’; the 12 articles of this volume discuss different aspects of this statement. It covers a range of subjects from public health issues to patient care. This monograph intends to stimulate community action research in the field of periodontology in order to help the development of appropriate public health intervention and relevant surveillance programs. It also expects to stimulate health authorities and professional organizations to initiate and support actions to promote periodontal health in their respective countries.

  11. Development of health literacy scale among Brazilian mothers in Japan. (United States)

    Hashimoto, Hidemi; Yanagisawa, Satoko


    Japanese-Brazilians were the third largest immigrant group in Japan in 2011. Their health issues have caused concern, as their limited language made them vulnerable by hindering access to health services. Upon considering child health, mothers' health literacy (HL) is very important. This study aimed to develop a health literacy scale among Brazilian mothers (HLSBM) in Japan. Questionnaires in Portuguese were distributed to 1474 mothers from December 2011 to March 2012. Among 698 collected, 558 questionnaires were analyzed. We prepared 29 candidate items for HLSBM based on Nutbeam's concept of functional, interactive and critical literacy. The dimensional structure was determined statistically using confirmatory factor analysis. Validity was also analyzed by Pearson's correlation with Ishikawa's scale and Kendall's coefficient of concordance among researchers. Cronbach's α coefficients were calculated to examine internal consistency. The confirmatory factor analysis revealed a two-factor model (five items for basic literacy and five items for critical literacy) with sufficient goodness of fit (GFI 969, AGFI 945, NFI 959, CFI 972, RMSEA 060). The internal consistency values of the total score, basic and critical literacy sub-scales were 0.819, 0.889 and 0.667, respectively. Kendall's coefficient of concordance showed good agreement of researchers (p literacy and 0.472 for critical literacy. The HLSBM consisting of two factors was confirmed to be valid and reliable. The HLSBM must be useful for understanding this vulnerable group's health literacy and its associated factors.

  12. Working together for public health. (United States)

    Martelli, Pompeo


    Italy's recent economic growth and strategic position in the Mediterranean Sea have made it a prime destination for immigrants and asylum seekers in Europe. Despite its well-developed health care system, statistics on foreign citizens' health are worrisome. In 1998 public health services were extended to illegal immigrants, giving them the right to necessary urgent and non-urgent medical assistance, even for a prolonged period. This paper examines a two-year joint intervention project between Centre for the Study and Research of Public Health (Mental Health), Local Health Agency ROMA E (LHA RME) and the non-governmental organization Médecins Sans Frontières (MSF) in Rome.

  13. Public Health Events and International Health Regulations

    Centers for Disease Control (CDC) Podcasts


    Dr. Katrin Kohl, a medical officer at the CDC, discusses the World Health Organization’s International Health Regulations for assessing and reporting on public health events across the world.  Created: 6/21/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 6/21/2012.

  14. Constructing public oral health policies in Brazil: issues for reflection

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    Catharina Leite Matos Soares


    Full Text Available This paper addresses the construction of public oral health policies in Brazil by reviewing the available literature. It includes a discussion of the social responses given by the Brazilian State to oral health policies and the relationship of these responses with the ideological oral health movements that have developed globally, and that have specifically influenced oral health policies in Brazil. The influence of these movements has affected a series of hegemonic practices originating from both Market Dentistry and Preventive and Social Dentistry in Brazil. Among the state activities that have been set into motion, the following stand out: the drafting of a law to regulate the fluoridation of the public water supply, and the fluoridation of commercial toothpaste in Brazil; epidemiological surveys to analyze the status of the Brazilian population's oral health; the inclusion of oral health in the Family Health Strategy (Estratégia de Saúde da Família - ESF; the drawing up of the National Oral Health Policy, Smiling Brazil (Brasil Sorridente. From the literature consulted, the progressive expansion of state intervention in oral health policies is observed. However, there remains a preponderance of hegemonic "dental" practices reproduced in the Unified Public Health Service (Sistema Único de Saúde - SUS and the Family Health Strategy.

  15. Courts and health care rationing: the case of the Brazilian Federal Supreme Court. (United States)

    Wang, Daniel W L


    The recognition that access to health care is a constitutional right in Brazil has resulted in a situation in which citizens denied treatments by the public health care system have brought lawsuits against health authorities, claiming that their right to health was violated. This litigation forces the courts to decide between a patient-centred and a population-centred approach to public health - a choice that forces the courts to assess health care rationing decisions. This article analyses the judgments of the Brazilian Federal Supreme Court in right to health cases, arguing that the Court's recent decisions have been contrary to their long-standing stance against rationing. In 2009, the Court organized a public hearing to discuss this topic with civil society and established criteria to determine when rationing would be legal. However, I argue that these criteria for health care rationing do not adequately address the most difficult health care distribution dilemmas. They force the health care system to keep their rationing criteria implicit and make population-centred concerns secondary to individual-centred ones.

  16. Can mothers rely on the Brazilian health system for their deliveries? An assessment of use of the public system and out-of-pocket expenditure in the 2004 Pelotas Birth Cohort Study, Brazil

    Directory of Open Access Journals (Sweden)

    Bertoldi Andréa D


    Full Text Available Abstract Background In a country where comprehensive free health care is provided via a public health system (SUS, an unexpected high frequency of catastrophic out-of-pocket expenditure has been described. We studied how deliveries were financed among mothers of a birth cohort and whether they were an important source of household out-of-pocket expenditure. Methods All deliveries occurring in the city of Pelotas, Brazil, during 2004, were recruited for a birth cohort study. All mothers were interviewed just after birth and three months later. Comprehensive data on the pregnancy, delivery, birth conditions and newborn health were collected, along with detailed information on expenses related to the delivery. Results The majority of the deliveries (81% were financed by the public health system, a proportion that increased to more than 95% among the 40% poorest mothers. Less than 1% of these mothers reported some out-of-pocket expenditure. Even among those mothers covered by a private health plan, nearly 50% of births were financed by the SUS. Among the 20% richest, a third of the deliveries were paid by the SUS, 50% by private health plans and 17% by direct payment. Conclusion The public health system offered services in quantity and quality enough to attract even beneficiaries of private health plans and spared mothers from the poorest strata of the population of practically any expense.

  17. Chiropractic care and public health

    DEFF Research Database (Denmark)

    Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre


    through the lifespan, and effective participation in community health issues. The questions that are addressed include: Is spinal manipulative therapy for neck and low-back pain a public health problem? What is the role of chiropractic care in prevention or reduction of musculoskeletal injuries...... in children? What ways can doctors of chiropractic stay updated on evidence-based information about vaccines and immunization throughout the lifespan? Can smoking cessation be a prevention strategy for back pain? Does chiropractic have relevance within the VA Health Care System for chronic pain and comorbid...... to public health? What public health roles can chiropractic interns perform for underserved communities in a collaborative environment? Can the chiropractic profession contribute to community health? What opportunities do doctors of chiropractic have to be involved in health care reform in the areas...

  18. Remote hearing aid fitting: Tele-audiology in the context of Brazilian Public Policy (United States)

    Penteado, Silvio Pires; Ramos, Sueli de Lima; Battistella, Linamara Rizzo; Marone, Silvio Antonio Monteiro; Bento, Ricardo Ferreira


    Summary Introduction: Currently, the Brazilian government has certificated nearly 140 specialized centers in hearing aid fittings through the Brazilian National Health System (SUS). Remote fitting through the Internet can allow a broader and more efficient coverage with a higher likelihood of success for patients covered by the SUS, as they can receive fittings from their own homes instead of going to the few and distant specialized centers. Aim: To describe a case of remote fitting between 2 cities, with revision of the literature. Method: Computer gears, a universal interface, and hearing aids were used. Case study: An audiologist located in a specialized center introduced a new hearing aid and its fitting procedure to a remote center (200 km away). The specialized center helped the remote center in fitting a hearing aid in 2 patients, and performed fitting in one of its own patients. The whole process was done through the Internet with audio and video in real time. Results: Three patients were fitted remotely. Three audiologists were remotely trained on how to fit the hearing aids. Conclusions: Remote fitting of hearing aids is possible through the Internet, as well as further supplying technical training to a remote center about the fitting procedures. Such a technological approach can help the government advance public policies on hearing rehabilitation, as patients can be motivated about maintaining their use of hearing aids with the option to ask for help in the comfort of their own homes. PMID:25991960

  19. The right to public health. (United States)

    Wilson, James


    Much work in public health ethics is shaped by an 'autonomy first' view, which takes it to be axiomatic that it is difficult to justify state interference in the lives of competent adults unless the behaviours interfered with are compromised in terms of their autonomy, or would wrongfully infringe on the autonomy of others. However, such an approach is difficult to square with much of traditional public heath practice. Recent years have seen running battles between those who assume that an 'autonomy first' approach is basically sound (and so much the worse for public health practice) and those who assume that public health practice is basically sound (and so much the worse for the 'autonomy first' approach). This paper aims to reconcile in a normatively satisfying way what is best about the 'autonomy first' approach with what is best about a standard public health approach. It develops a positive case for state action to promote and protect health as a duty that is owed to each individual. According to this view, the state violates individuals' rights if it fails to take cost-effective and proportionate measures to remove health threats from the environment. It is thus a mistake to approach public health in the way that 'autonomy first' accounts do, as primarily a matter of individual entitlements versus the common good. Too little state intervention in the cause of improving population health can violate individuals' rights, just as too much can.

  20. [Anomie and public mental health]. (United States)

    Parales-Quenza, Carlos J


    This article uses the concept of anomie for understanding public mental-health issues and constructing strategies aimed at promoting health and preventing disease. Studying anomie involves many definitions and approaches; this article conceptualises anomie as dérréglement or derangement and as a total social fact as its effects and consequences are pervasive across all areas of human experience. The article suggests the pertinence of the concept to public health based on several authors' observations depicting Latin-America as being a set of anomic societies and Colombia as the extreme case. Current definitions of mental health in positive terms (not just as being the absence of mental illness) validate the need for considering anomie as an indicator of public mental health. The article proposes that if anomie expresses itself through rules as basic social structure components, then such rules should also be considered as the point of intervention in promoting mental health.

  1. Fulfillment of the Brazilian Agenda of Priorities in Health Research

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    Guimarães Reinaldo


    Full Text Available Abstract This commentary describes how the Brazilian Ministry of Health's (MoH research support policy fulfilled the National Agenda of Priorities in Health Research (NAPHR. In 2003, the MoH started a democratic process in order to establish a priority agenda in health research involving investigators, health managers and community leaders. The Agenda was launched in 2004 and is guiding budget allocations in an attempt to reduce the gap between scientific knowledge and health practice and activities, aiming to contribute to improving Brazilian quality of life. Many strategies were developed, for instance: Cooperation Agreements between the Ministry of Health and the Ministry of Science and Technology; the decentralization of research support at state levels with the participation of local Health Secretariats and Science and Technology Institutions; Health Technology Assessment; innovation in neglected diseases; research networks and multicenter studies in adult, women's and children's health; cardiovascular risk in adolescents; clinical research and stem cell therapy. The budget allocated by the Ministry of Health and partners was expressive: US$419 million to support almost 3,600 projects. The three sub-agenda with the higher proportion of resources were "industrial health complex", "clinical research" and "communicable diseases", which are considered strategic for innovation and national development. The Southeast region conducted 40.5% of all projects and detained 59.7% of the resources, attributable to the concentration of the most traditional health research institutes and universities in the states of São Paulo and Rio de Janeiro. The second most granted region was the Northeast, which reflects the result of a governmental policy to integrate and modernize this densely populated area and the poorest region in the country. Although Brazil began the design and implementation of the NAPHR in 2003, it has done so in accordance with the 'good

  2. Profiling alumni of a Brazilian public dental school

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    Nunes Maria F


    Full Text Available Abstract Background Follow-up studies of former students are an efficient way to organize the entire process of professional training and curriculum evaluation. The aim of this study was to identify professional profile subgroups based on job-related variables in a sample of former students of a Brazilian public dental school. Methods A web-based password-protected questionnaire was sent to 633 registered dentists who graduated from the Federal University of Goias between 1988 and 2007. Job-related information was retrieved from 14 closed questions, on subjects such as gender, occupational routine, training, profits, income status, and self-perception of professional career, generating an automatic database for analysis. The two-step cluster method was used for dividing dentists into groups on the basis of minimal within-group and maximal between-group variation, using job-related variables to represent attributes upon which the clustering was based. Results There were 322 respondents (50.9%, predominantly female (64.9% and the mean age was 34 years (SD = 6.0. The automatic selection of an optimal number of clusters included 289 cases (89.8% in 3 natural clusters. Clusters 1, 2 and 3 included 52.2%, 30.8% and 17.0% of the sample respectively. Interpretation of within-group rank of variable importance for cluster segmentation resulted in the following characterization of clusters: Cluster 1 - specialist dentists with higher profits and positive views of the profession; Cluster 2 - general dental practitioners in small cities; Cluster 3 - underpaid and less motivated dentists with negative views of the profession. Male dentists were predominant in cluster 1 and females in cluster 3. One-way Anova showed that age and time since graduation were significantly lower in Cluster 2 (P Conclusions Cluster analysis was a valuable method for identifying natural grouping with relatively homogeneous cases, providing potentially meaningful information for

  3. Periodontal health and global public health

    DEFF Research Database (Denmark)

    Petersen, Poul E; Baehni, Pierre C


    local, national and international resources to assure that people can be healthy. Social determinants of health, environmental hazards and unhealthy lifestyles are prioritized in modern public health-care. Disease prevention and health promotion are cornerstones in actions for public health. This volume......Chronic diseases are a growing burden to people, to health-care systems and to societies across the world. The rapid increase in the burden of chronic diseases is particularly prevalent in the developing countries. Periodontal disease is one of the two most important oral diseases contributing...... to the global burden of chronic disease. In addition to social determinants, periodontal health status is related to several proximal factors. Modifiable risk factors, such as tobacco use, excessive alcohol consumption, poor diet and nutrition, obesity, psychological stress and insufficient personal...

  4. Public Health Genetics : Challenging "Public Health at the Crossroads"

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    Angela Brand


    Full Text Available

    Dear public health professionals, Honestly, isn’t it time to ask whether or not we are doing “the right things”in public health? Are our present public health strategies evidence-based? The public health agenda demands a vision that reaches beyond research to the application of public health and the determination of it’s impact. In this scenario what is the role of genomics? In the past twenty years, advances in genome research have revolutionised what is known about the role of inheritance in health and disease.[1]

    Nowadays,we know that our DNA determines not only the cause of single-gene disorders, but also determines our predisposition to common diseases.Whereas medicine is currently undergoing extraordinary developments from its morphological and phenotype orientation to a molecular and genotype orientation, promoting the importance of prognosis and prediction, public health practice has to date concerned itself with environmental determinants of health and disease and has paid scant attention to genetic variations within the population.

     The advances brought about by genomics is changing these perceptions.[2,3] Many predict, that this knowledge will enable health promotion messages and disease prevention programmes to be specifically directed at susceptible individuals or at subgroups of the population, based on their genetic profile.[4,5]

    The new technologies will allow researchers to examine genetic mutations at the functional genomic unit level, and to better understand the significance of environmental factors such as noxious agents, nutrition and personal behaviour in relation to the causation of diseases such as cardiovascular diseases, psychiatric disorders and infectious diseases.

  5. Personalism for public health ethics

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    Carlo Petrini


    Full Text Available In public health ethics, as in bioethics, utilitarian approaches usually prevail, followed by Kantian and communitarian foundations. If one considers the nature and core functions of public health, which are focused on a population perspective, utilitarianism seems still more applicable to public health ethics. Nevertheless, faulting additional protections towards the human person, utilitarianism doesn't offer appropriate solutions when conflicts among values do arise. Further criteria must be applied to protect the fundamental principles of respect for human life. Personalism offers similar advantages to utilitarianism but warrants more protection to the human person. We suggest a possible adaptation of personalism in the specific field of public health by means of four principles: absolute respect for life or principle of inviolability; subsidiarity and the "minimum" mandatory principle; solidarity; justice and non discrimination.

  6. Socioeconomic inequalities and changes in oral health behaviors among Brazilian adolescents from 2009 to 2012 (United States)

    Freire, Maria do Carmo Matias; Jordão, Lidia Moraes Ribeiro; Malta, Deborah Carvalho; Andrade, Silvânia Suely Caribé de Araújo; Peres, Marco Aurelio


    OBJECTIVE To analyze oral health behaviors changes over time in Brazilian adolescents concerning maternal educational inequalities. METHODS Data from the Pesquisa Nacional de Saúde do Escolar (Brazilian National School Health Survey) were analyzed. The sample was composed of 60,973 and 61,145 students from 26 Brazilian state capitals and the Federal District in 2009 and 2012, respectively. The analyzed factors were oral health behaviors (toothbrushing frequency, sweets consumption, soft drink consumption, and cigarette experimentation) and sociodemographics (age, sex, race, type of school and maternal schooling). Oral health behaviors and sociodemographic factors in the two years were compared (Rao-Scott test) and relative and absolute measures of socioeconomic inequalities in health were estimated (slope index of inequality and relative concentration index), using maternal education as a socioeconomic indicator, expressed in number of years of study (> 11; 9-11; ≤ 8). RESULTS Results from 2012, when compared with those from 2009, for all maternal education categories, showed that the proportion of people with low toothbrushing frequency increased, and that consumption of sweets and soft drinks and cigarette experimentation decreased. In private schools, positive slope index of inequality and relative concentration index indicated higher soft drink consumption in 2012 and higher cigarette experimentation in both years among students who reported greater maternal schooling, with no significant change in inequalities. In public schools, negative slope index of inequality and relative concentration index indicated higher soft drink consumption among students who reported lower maternal schooling in both years, with no significant change overtime. The positive relative concentration index indicated inequality in 2009 for cigarette experimentation, with a higher prevalence among students who reported greater maternal schooling. There were no inequalities for

  7. Socioeconomic inequalities and changes in oral health behaviors among Brazilian adolescents from 2009 to 2012

    Directory of Open Access Journals (Sweden)

    Maria do Carmo Matias Freire


    Full Text Available OBJECTIVE To analyze oral health behaviors changes over time in Brazilian adolescents concerning maternal educational inequalities.METHODS Data from the Pesquisa Nacional de Saúde do Escolar(Brazilian National School Health Survey were analyzed. The sample was composed of 60,973 and 61,145 students from 26 Brazilian state capitals and the Federal District in 2009 and 2012, respectively. The analyzed factors were oral health behaviors (toothbrushing frequency, sweets consumption, soft drink consumption, and cigarette experimentation and sociodemographics (age, sex, race, type of school and maternal schooling. Oral health behaviors and sociodemographic factors in the two years were compared (Rao-Scott test and relative and absolute measures of socioeconomic inequalities in health were estimated (slope index of inequality and relative concentration index, using maternal education as a socioeconomic indicator, expressed in number of years of study (> 11; 9-11; ≤ 8.RESULTS Results from 2012, when compared with those from 2009, for all maternal education categories, showed that the proportion of people with low toothbrushing frequency increased, and that consumption of sweets and soft drinks and cigarette experimentation decreased. In private schools, positive slope index of inequality and relative concentration index indicated higher soft drink consumption in 2012 and higher cigarette experimentation in both years among students who reported greater maternal schooling, with no significant change in inequalities. In public schools, negative slope index of inequality and relative concentration index indicated higher soft drink consumption among students who reported lower maternal schooling in both years, with no significant change overtime. The positive relative concentration index indicated inequality in 2009 for cigarette experimentation, with a higher prevalence among students who reported greater maternal schooling. There were no inequalities

  8. Citations of Brazilian physical therapy journals in national publications (United States)

    Teixeira, Renan K. C.; Yamaki, Vitor N.; Botelho, Nara M.; Teixeira, Renato C.


    Background Quotations in Brazilian journals are mainly obtained from national articles (articles from Brazilian journals); thus, it is essential to determine how frequently these articles reference Brazilian journals. Objective This study sought to verify how frequently national papers are cited in the references of three Brazilian physical therapy journals. Method All references for articles published in Fisioterapia em Movimento, Fisioterapia e Pesquisa and Revista Brasileira de Fisioterapia between 2010 and 2012 were evaluated. In particular, the numbers of national articles and international articles (articles from international journals) cited in these references were determined. Results A total of 13,009 references cited by 456 articles were analyzed, and 2,924 (22.47%) of the cited works were national articles. There were no significant differences among the three examined years. A total of 36 (7.89%) articles did not cite national articles, whereas 65 (13.25%) articles cited more national articles than international articles. Conclusion On average, 22.47% of the works cited by the evaluated articles were national articles. No significant differences were detected among the three analyzed years. PMID:24675917

  9. Insights in Public Health (United States)

    Tong, Michelle; Sentell, Tetine


    Chinese Americans constitute the largest percentage of Asian Americans. In Hawai‘i, Chinese Americans make up approximately 4.7% of the total state population. Accurately assessing health disparities across specific Asian American subgroups is critically important to health research and policy, as there is often substantial variability in risk and outcomes. However, even for Chinese Americans, the largest of the Asian American subgroups, such analyses can present challenges in population-based surveys. This article considers these challenges generally and then specifically in terms of the issue of health literacy and heart disease in Chinese Americans using existing population-based survey data sets in the United States, California, and Hawai‘i.

  10. American Public Health Association (United States)

    ... Infectious Diseases has a new Spanish language website!… RT @CDCgov: Know when you need ... Together we can fight antibiotic resistance. Be #AntibioticSmart. https://t.… RT @AMJPublicHealth: Whiteness of the #opioidepidemic is ...

  11. Health Reforms and Public Health in Georgia

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    Raminashvili, D.


    Full Text Available BACKGROUND: Starting from 90‘th, the Government of Georgia (GoG made several attempts to transform Georgian health care system into one with improved efficiency, accessibility, and quality services. Mandatory social health insurance which was introduced in the 1990s was abolished and private health insurance has been promoted as its replacement. The main principle of health care reform since 2006 was the transition towards complete marketization of the health care sector: private provision, private purchasing, liberal regulation, and minimum supervision.This paper aims to analyze an impact of ongoing reforms on public health and population health status.MATERIALS AND METHODS: A systematic review of the available literature was conducted through national and international organization reports; key informant interviews were conducted with major stakeholders. RESULTS: The country has attained critical achievements in relation to improved maternal and child health, national responses to HIV, TB and Malaria. Life expectancy has increased from 70.3 years in 1995 to 75.1 years in 2010. Under-5 mortality indicator has improved from 45.3 to 16.4 per 1000 live birth in 2005-2010 meaning a 64% decrease. However, Georgia is still facing a number of critical challenges securing better health for the population. Cardiovascular diseases are by far the largest cause of mortality, respiratory diseases are the leading cause of morbidity and have doubled during last decade. Georgia has one of the highest rates of male smoking in the world (over 50%.CONCLUSION: Governmental efforts in health promotion and disease prevention can have significant impact on health status by preventing chronic diseases and detecting health problems at a treatable stage. Government should consider increasing funding for public health and prevention programmes with the focus on prevention of the main risk factors affecting the population’s health: tobacco and drug use and unsafe

  12. Citizen Science for public health. (United States)

    Den Broeder, Lea; Devilee, Jeroen; Van Oers, Hans; Schuit, A Jantine; Wagemakers, Annemarie


    Community engagement in public health policy is easier said than done. One reason is that public health policy is produced in a complex process resulting in policies that may appear not to link up to citizen perspectives. We therefore address the central question as to whether citizen engagement in knowledge production could enable inclusive health policy making. Building on non-health work fields, we describe different types of citizen engagement in scientific research, or 'Citizen Science'. We describe the challenges that Citizen Science poses for public health, and how these could be addressed. Despite these challenges, we expect that Citizen Science or similar approaches such as participatory action research and 'popular epidemiology' may yield better knowledge, empowered communities, and improved community health. We provide a draft framework to enable evaluation of Citizen Science in practice, consisting of a descriptive typology of different kinds of Citizen Science and a causal framework that shows how Citizen Science in public health might benefit both the knowledge produced as well as the 'Citizen Scientists' as active participants.

  13. Insights in Public Health (United States)

    Choy, Lehua B; Smith, Heidi Hansen; Espiritu, Justine; Higa, Earl; Lee, Thomas; Maddock, Jay


    Abstract In 2011, a small pilot bike share program was established in the town core of Kailua, Hawai‘i, with funding from the Hawai‘i State Department of Health. The Kailua system consisted of two stations with 12 bicycles, and the goal was to secure additional funding to expand the station network in the future. Community feedback consistently indicated support for the bike share program. However, system metrics showed low levels of usage, averaging 41.5 rides per month (2011–2014). From observational data, users were primarily tourists. With minimal local staff, the bike share program had limited resources for promotion and education, which may have hindered potential use by local residents. Management of station operations and bike maintenance were additional, ongoing barriers to success. Despite the challenges, the pilot bike share program was valuable in several ways. It introduced the bike share concept to Hawai‘i, thereby helping to build awareness and connect an initial network of stakeholders. Furthermore, the pilot bike share program informed the development of a larger bike share program for urban Honolulu. As limited information exists in the literature about the experiences of smaller bike share programs and their unique considerations, this article shares lessons learned for other communities interested in starting similar bike share programs. PMID:26535166

  14. Planejamento estadual no SUS: o caso da Secretaria da Saúde do Estado da Bahia Planning in Brazilian Public Health System: the case of the Health Secretariat of State of Bahia

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    Washington Luiz Abreu de Jesus


    Full Text Available Este artigo toma como objeto o processo de planejamento da Secretaria da Saúde do Estado da Bahia no período compreendido entre janeiro de 2007 e julho de 2009. Busca-se descrever e analisar esse processo, discutindo-se algumas dificuldades e avanços no aperfeiçoamento da prática de planejamento em saúde, por meio de uma análise de documentos desenvolvidos no período pela instituição e de registros sistemáticos dos autores sobre a experiência vivenciada. O processo se desenvolve numa tentativa de aproximar a teoria à prática, com a articulação do enfoque estratégico-situacional à perspectiva do agir comunicativo, tendo como princípio fundamental a participação social. A análise demonstra um conjunto de movimentos dialógicos, articulados por meio dos momentos explicativo, normativo, estratégico e tático-operacional, que culminam com a formulação do Plano Estadual de Saúde. Revela também a potência do planejamento diante da pluralidade e multiplicidade de abordagens utilizadas para construir coletivamente uma visão de futuro em instituições que adotam "planos" como sendo apostas à qualificação das ações de governo.The object of this article is the planning process of the Health Secretariat of State of Bahia from January 2007 to July 2009. It describes and analyses this process, discussing the difficulties and the advances to build the planning practice in this institution. It was used documental analyses and systematic registers of lived experience by the authors to do it. The process points for an approach between theory and practice articulating the Strategic-situational focus and the Communicative Action, including the principle of the Social Participation. The analyses explain that the process occurs in a pool of dialogic movements enlaced by the explicative, normative, strategic and tactic-operative moments that finished with the construction of the Health Secretariat of State of Bahia. There is a

  15. Micropolitics of the work in the Brazilian Family Health Program: do caretakers also need care?

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    Francisco Senna de Oliveira Neto


    Full Text Available The space of work micropolitics in the Brazilian Family Health Strategy is a scenario where the protagonism of workers and users of health services takes place. The objective of this article was to recognize and study the diverse, creative, and dynamic potential of how the activities in the Brazilian Family Health Strategy are organized and, mainly, to see the other face of the health care technology: the health of the health workers. This is a qualiquantitative exploratory study, developed by the application of instruments for the evaluation of life quality and occupational history, supported by the observation and evaluation of the daily work in a Brazilian Family Health Strategy unit in the town of Jerônimo Monteiro, state of Espírito Santo, in Brazil. The results show that, when targeting his/her own health, the health worker is more concerned about health problems and disorders already installed, neglecting the preventive aspects. Signs of organic and psychic suffering were considered as caused by work overload and by precariousness of links and work conditions. The study also showed that reflections on occupational health in the Brazilian Family Health Strategy also need to be carried out and that health prevention and promotion need to be explored by health workers. It is also important to review the path of the Brazilian Family Health Strategy under the perspective of health workers, aiming at the construction of a humanized work environment. 

  16. Strengthening public health research for improved health

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    Enrique Gea-Izquierdo


    Full Text Available Research in public health is a range that includes from fundamental research to research in clinical practice, including novel advances, evaluation of results and their spreading. Actually, public health research is considered multidisciplinary incorporating numerous factors in its development. Establishing as a mainstay the scientific method, deepens in basic research, clinical epidemiological research and health services. The premise of quality and relevance is reflected in international scientific research, and in the daily work and good biomedical practices that should be included in the research as a common task. Therefore, the research must take a proactive stance of inquiry, integrating a concern planned and ongoing development of knowledge. This requires improve international coordination, seeking a balance between basic and applied research as well as science and technology. Thus research cannot be considered without innovation, weighing up the people and society needs. Acting on knowledge of scientific production processes requires greater procedures thoroughness and the effective expression of the results. It is noted as essential to establish explicit principles in review and evaluation of the adjustments of actions, always within the standards of scientific conduct and fairness of the research process. In the biomedical scientific lines it have to be consider general assessments that occur related to the impact and quality of health research, mostly leading efforts to areas that require further attention. However, other subject areas that may be deficient or with lower incidence in the population should not be overlook. Health research as a source of new applications and development provides knowledge, improving well-being. However, it is understandable without considering the needs and social demands. Therefore, in public health research and to improve the health of the population, we must refine and optimize the prevention and

  17. From Non-Cultural to Intercultural Principles: A Proposal for English Classes in Brazilian Public Schools (United States)

    Mota Pereira, Fernanda


    This article focuses on English language teaching in Brazilian public schools, based on experiences in primary and secondary education, as well as in Teaching Practicum courses at a university. Through these experiences, the article critiques the overemphasis on grammar and the lack of an intercultural approach. The author engages the reader with…

  18. [The internationalization of health: contextual elements and institutional frameworks of Brazilian cooperation]. (United States)

    Pires-Alves, Fernando A; Paiva, Carlos Henrique Assunção; de Santana, José Paranaguá


    The article contextualizes the emergence of an international policy for the Brazilian Unified Health System as the common agenda of the Pan American Health Organization (PAHO) and the Brazilian Ministry of Health. For this purpose, two contextual axes were explored throughout the work. The first discusses the explicit relationship between the development-cooperation-health triad from an international perspective. The second examines the recent evolution of Brazilian foreign policy, particularly with respect to the role it is playing in South-South cooperation on health matters. The contextual framework that defines Brazilian international cooperation with PAHO is emphasized, above all with regard to the implementation of a specific cooperation agreement. The article concludes that this agreement, within the framework of South-South cooperation, is one of the principal institutional mechanisms established to bring about technical cooperation in health in the current setting.

  19. Dietary patterns of Brazilian adolescents: results of the Brazilian National School-Based Health Survey (PeNSE

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    Letícia Ferreira Tavares


    Full Text Available The objectives of this study were to identify dietary patterns in Brazilian adolescents, describe their distributions in Brazil's State capitals and Federal District, and analyze the correlations with the Municipal Human Development Index (HDI-M. The study analyzed a sample of 60,954 ninth-graders from public and private schools who participated in the National School-Based Health Survey (PeNSE in 2009. Cluster analysis was used to characterize dietary patterns. Three patterns were identified: healthy (27.7%, unhealthy (34.6%, and mixed (37.7%. Adolescents in the country's Southeast, South, and Central West regions showed a higher proportion of the healthy eating pattern. HDI-M showed a positive correlation with the healthy pattern and a negative correlation with the mixed pattern. The identification of different dietary patterns within and between regions and according to HDI-M highlights the need for better knowledge of each local context in terms of both the magnitude of events and the examination of determinants within these different realities.

  20. Dietary patterns of Brazilian adolescents: results of the Brazilian National School-Based Health Survey (PeNSE). (United States)

    Tavares, Letícia Ferreira; Castro, Inês Rugani Ribeiro de; Levy, Renata Bertazzi; Cardoso, Letícia de Oliveira; Claro, Rafael Moreira


    The objectives of this study were to identify dietary patterns in Brazilian adolescents, describe their distributions in Brazil's State capitals and Federal District, and analyze the correlations with the Municipal Human Development Index (HDI-M). The study analyzed a sample of 60,954 ninth-graders from public and private schools who participated in the National School-Based Health Survey (PeNSE) in 2009. Cluster analysis was used to characterize dietary patterns. Three patterns were identified: healthy (27.7%), unhealthy (34.6%), and mixed (37.7%). Adolescents in the country's Southeast, South, and Central West regions showed a higher proportion of the healthy eating pattern. HDI-M showed a positive correlation with the healthy pattern and a negative correlation with the mixed pattern. The identification of different dietary patterns within and between regions and according to HDI-M highlights the need for better knowledge of each local context in terms of both the magnitude of events and the examination of determinants within these different realities.

  1. The Incorporation of Entrepreneurship in the Public Sector: reflections based on brazilian context

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    Josiel Valadares


    Full Text Available This essay aims seeks to broaden the debate on the incorporation of the theme Entrepreneurship in the Public Sector (EPS through the literature review on the reflective character to be taken to transpose concepts from the private sector to the public sector. It was understood that needs a critical discussion on the process of appropriating that theme in Brazil. It was observed that the Brazilian Public Administration is marked by a hybrid model of administration, in which patrimonial practices, bureaucratic and managerial coexist, making the complex adaptation of entrepreneurship. Therefore, we must be wary of exaggerated expectations regarding this theme in Brazilian Public Administration, as have several limitations that meet the sustainability of democratic governments.

  2. Law and public health at CDC. (United States)

    Goodman, Richard A; Moulton, A; Matthews, G; Shaw, F; Kocher, P; Mensah, G; Zaza, S; Besser, R


    Public health law is an emerging field in U.S. public health practice. The 20th century proved the indispensability of law to public health, as demonstrated by the contribution of law to each of the century's 10 great public health achievements. Former CDC Director Dr. William Foege has suggested that law, along with epidemiology, is an essential tool in public health practice. Public health laws are any laws that have important consequences for the health of defined populations. They derive from federal and state constitutions; statutes, and other legislative enactments; agency rules and regulations; judicial rulings and case law; and policies of public bodies. Government agencies that apply public health laws include agencies officially designated as "public health agencies," as well as health-care, environmental protection, education, and law enforcement agencies, among others.

  3. Integrating Brazilian health information systems in order to support the building of data warehouses

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    Sergio Miranda Freire

    Full Text Available AbstractIntroductionThis paper's aim is to develop a data warehouse from the integration of the files of three Brazilian health information systems concerned with the production of ambulatory and hospital procedures for cancer care, and cancer mortality. These systems do not have a unique patient identification, which makes their integration difficult even within a single system.MethodsData from the Brazilian Public Hospital Information System (SIH-SUS, the Oncology Module for the Outpatient Information System (APAC-ONCO and the Mortality Information System (SIM for the State of Rio de Janeiro, in the period from January 2000 to December 2004 were used. Each of the systems has the monthly data production compiled in dbase files (dbf. All the files pertaining to the same system were then read into a corresponding table in a MySQL Server 5.1. The SIH-SUS and APAC-ONCO tables were linked internally and with one another through record linkage methods. The APAC-ONCO table was linked to the SIM table. Afterwards a data warehouse was built using Pentaho and the MySQL database management system.ResultsThe sensitivities and specificities of the linkage processes were above 95% and close to 100% respectively. The data warehouse provided several analytical views that are accessed through the Pentaho Schema Workbench.ConclusionThis study presented a proposal for the integration of Brazilian Health Systems to support the building of data warehouses and provide information beyond those currently available with the individual systems.

  4. [Youth and health: discourse analysis on supply and access to public facilities]. (United States)

    Souza, Cinoélia Leal; Souzas, Raquel


    From the standpoint of sociodemographic, teens today represent an important portion of the Brazilian population. In 2005 the Brazilian government published the National Youth Policy. Despite of this, many teens still find difficulties in accessing public services, especially the ones involving health. This study aimed to analyze young students' speeches about the conditions of access to public services and health through qualitative research. The students inquired live in rural and urban areas of the city of Vitória da Conquista - Bahia. The method used was the content analysis proposed by Bardin (1979) and Minayo (2006), and the technique of discussion groups for youth proposed by Weller (2006).

  5. Drought impacts on children's respiratory health in the Brazilian Amazon. (United States)

    Smith, Lauren T; Aragão, Luiz E O C; Sabel, Clive E; Nakaya, Tomoki


    Drought conditions in Amazonia are associated with increased fire incidence, enhancing aerosol emissions with degradation in air quality. Quantifying the synergic influence of climate and human-driven environmental changes on human health is, therefore, critical for identifying climate change adaptation pathways for this vulnerable region. Here we show a significant increase (1.2%-267%) in hospitalisations for respiratory diseases in children under-five in municipalities highly exposed to drought. Aerosol was the primary driver of hospitalisations in drought affected municipalities during 2005, while human development conditions mitigated the impacts in 2010. Our results demonstrated that drought events deteriorated children's respiratory health particularly during 2005 when the drought was more geographically concentrated. This indicates that if governments act on curbing fire usage and effectively plan public health provision, as a climate change adaptation procedure, health quality would improve and public expenditure for treatment would decrease in the region during future drought events.

  6. [Use of health technology assessment in decision-making processes by the Brazilian Ministry of Health on the incorporation of technologies in the Brazilian Unified National Health System]. (United States)

    Novaes, Hillegonda Maria Dutilh; Elias, Flávia Tavares Silva


    Policies for scientific development and knowledge production in health have increased in recent decades. In Brazil, incentives for research, development, and innovation have been part of the National Health Act since 1990, and science and technology policies for health, including health technology assessment (HTA), have been implemented since 1994, as in many other countries. The emphasis is now on impact evaluation of HTA policies in the incorporation of technologies by health services and systems. The article presents a case study of HTA utilization in decision-making processes in the Brazilian Ministry of Health, analyzing participation by the Department of Science and Technology (DECIT), responsible for the production of assessments used in the Commission on Technology Incorporation (CITEC) of the Ministry of Health from 2008 to 2010. CITEC used 103 assessments in its decisions during this period, of which DECIT produced 80%. Nearly all were literature reviews on therapeutic technologies. An increase in knowledge production was observed. A methodological and political learning process appears to have occurred in the use of HTA, but its impact on Brazilian Unified National Health System remains unclear.

  7. Padrões e mudanças no financiamento e regulação do Sistema de Saúde Brasileiro: impactos sobre as relações entre o público e privado Patterns and changes in the financing and regulation of Brazilian Health System: impacts on public and private relationships

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    Ligia Bahia


    Full Text Available O trabalho sistematiza as matrizes interpretativas envolvidas no debate sobre o sistema de saúde brasileiro e avança hipóteses sobre as extensas e dinâmicas fronteiras de interseção público-privadas que o caracterizam. Considerando que o hiato entre as concepções sobre o sistema de saúde baseadas em modelos puros e a realidade brasileira, na qual predominam as formas híbridas de prestação e organização de redes de serviços, constitui, per se, um foco permanente de tensões, o estudo destaca e dimensiona: a utilização de fontes públicas de financiamento à demanda e a oferta dos planos de saúde; o afluxo de clientes de planos a uma capacidade instalada de recursos físicos e humanos constituída e reproduzida com recursos públicos; a inserção público-privada de profissionais de saúde e as franquias para dirigentes de empresas privadas assumirem cargos públicos e vice-versa. Os reflexos da estrutura e formas de articulação entre o público e o privado nas agendas dos mais importantes fóruns de debate e formulação de diretrizes para o sistema de saúde, as Conferências de Saúde (previstas pela Lei 8142-90 como instâncias de avaliação e elaboração de diretrizes para a saúde nas três esferas de governo, e das instituições governamentais relacionadas diretamente com o SUS são analisados. Conclui-se que as tensões, conflitos e proposições, sobre o considerado componente público do sistema de saúde, estão direcionadas a arenas específicas de debate. Paralelamente renovaram-se e constituíram-se outros fóruns de negociação sobre o componente privado. Portanto, a segmentação das demandas reflete-se, de maneira quase automática, no âmbito setorial, na definição de "pautas especializadas" - ou no público ou no privado.This article systematizes the interpretative matrixes used in the debate about the Brazilian Unified Health System and formulates hypothesis about the extensive and dynamic frontiers

  8. [Social marketing and public health]. (United States)

    Arcaro, P; Mannocci, A; Saulle, R; Miccoli, S; Marzuillo, C; La Torre, G


    Social marketing uses the principles and techniques of commercial marketing by applying them to the complex social context in order to promote changes (cognitive; of action; behavioral; of values) among the target population in the public interest. The advent of Internet has radically modified the communication process, and this transformation also involved medical-scientific communication. Medical journals, health organizations, scientific societies and patient groups are increasing the use of the web and of many social networks (Twitter, Facebook, Google, YouTube) as channels to release scientific information to doctors and patients quickly. In recent years, even Healthcare in Italy reported a considerable application of the methods and techniques of social marketing, above all for health prevention and promotion. Recently the association for health promotion "Social marketing and health communication" has been established to promote an active dialogue between professionals of social marketing and public health communication, as well as among professionals in the field of communication of the companies involved in the "health sector". In the field of prevention and health promotion it is necessary to underline the theme of the growing distrust in vaccination practices. Despite the irrefutable evidence of the efficacy and safety of vaccines, the social-cultural transformation together with the overcoming of compulsory vaccination and the use of noninstitutional information sources, have generated confusion among citizens that tend to perceive compulsory vaccinations as needed and safe, whereas recommended vaccinations as less important. Moreover, citizens scarcely perceive the risk of disease related to the effectiveness of vaccines. Implementing communication strategies, argumentative and persuasive, borrowed from social marketing, also for the promotion of vaccines is a priority of the health system. A typical example of the application of social marketing, as

  9. Ethics in Public Health Research (United States)

    Curtis, Valerie A.; Garbrah-Aidoo, Nana; Scott, Beth


    Skill in marketing is a scarce resource in public health, especially in developing countries. The Global Public–Private Partnership for Handwashing with Soap set out to tap the consumer marketing skills of industry for national handwashing programs. Lessons learned from commercial marketers included how to (1) understand consumer motivation, (2) employ 1 single unifying idea, (3) plan for effective reach, and (4) ensure effectiveness before national launch. After the first marketing program, 71% of Ghanaian mothers knew the television ad and the reported rates of handwashing with soap increased. Conditions for the expansion of such partnerships include a wider appreciation of what consumer marketing is, what it can do for public health, and the potential benefits to industry. Although there are practical and philosophical difficulties, there are many opportunities for such partnerships. PMID:17329646

  10. Public health aspects of tobacco control revisited

    NARCIS (Netherlands)

    Gallagher, Jennifer E.; Alajbeg, Ivan; Buechler, Silvia; Carrassi, Antonio; Hovius, Marjolijn; Jacobs, Annelies; Jenner, Maryan; Kinnunen, Taru; Ulbricht, Sabina; Zoitopoulos, Liana


    The tobacco epidemic presents a major public health challenge, globally, and within Europe. The aim of the Public Health Work Stream at the 2nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals was to review the public health aspects of tobacco control and make

  11. Public health interventions: evaluating the economic evaluations

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    Martin Forster


    Full Text Available Recent years have witnessed much progress in the incorporation of economic considerations into the evaluation of public health interventions. In England, the Centre for Public Health Excellence within the National Institute for Health and Care Excellence works to develop guidance for preventing illness and assessing which public health interventions are most effective and provide best value for money...

  12. [The needed Brazilian Health System and the possible Brazilian Health System: management strategies. An experience-based reflection]. (United States)

    de Souza, Luis Eugenio Portela Fernandes


    The present text presents a reflection about the author's experience as head of a Health Department of a big city during two and a half years. It presents a systematization of the strategic projects, the political and technical activities and the managerial routine, in which he was involved. It identifies three levels (macro, meso and micro) and four dimensions of management (social-political, institutional, technical-sanitary and administrative in the strict sense). In each dimension, on the three levels, it discusses management strategies designed to contribute to the construction of a universal and equitable Brazilian Health System (SUS). Although it may be premature to evaluate the degree of implantation and the effects of the proposed strategies, their analysis and discussion can be useful for being strongly based on empirical elements. The paper concludes that, even though the consolidation of the SUS is a political struggle that surpasses the management arena, managers are important agents who need to know how to develop strategies able to foster the principles of universality and equity.


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    Guilherme Luz Tortorella


    Full Text Available During the last decade, there has been a demand for public services to enhance management practices and attain results comparable to those experienced in the private sector. The need for achieving higher quality standards in public services has highlighted the importance of exploring new management techniques to account for the obsolescence in those organizations’ administrative models, with particular emphasis on healthcare services. This paper reports the application of one such new management technique, named Value Stream Mapping (VSM, in the sterilized unit of a public healthcare organization. We present here the benefits of analyzing healthcare processes using VSM, contributing to the existing body of knowledge on Lean management by examining the validity of applying its principles and practices in contexts other than manufacturing.

  14. [Social medicine, public health and governance for health]. (United States)

    Holčík, Jan


    Social medicine, public health and governance for health have a long tradition in the Czech Republic but some problems persist. Possible solutions are reliable information, research, education and training. Action plans for Health 2020 implementation are appreciated as well as a valuable help of the WHO Country Office, Czech Republic.Key words: social medicine, public health, health, health governance, governance for health, Health 2020, World Health Organization.

  15. Enhancing public health law communication linkages. (United States)

    Silverman, Ross D


    Although interest in the field of public health law has dramatically increased over the past two decades, there remain significant challenges in communicating and sharing public health law-related knowledge. Access to quality information, which may assist in a public health department's efforts to protect the public's health, welfare, and safety, varies widely from jurisdiction to jurisdiction, and interjurisdictional communication remains at best a patchwork quilt with many holes. What follows is an analysis of several approaches the Public Health Law Association or other public health law-related organizations might undertake to serve as a conduit for the identification, gathering, and dissemination of extant public health law information, as well as the development of new public health law-related content, with a particular focus on the use of electronic means for such efforts.

  16. Insufficient Sleep Is a Public Health Epidemic (United States)

    ... this? Submit Button Past Emails CDC Features Insufficient Sleep Is a Public Health Problem Language: English Español ( ... insufficient sleep is an important public health concern. Sleep-Related Unhealthy Behaviors The Behavioral Risk Factor Surveillance ...

  17. [Congressional amendments to the Brazilian Federal health budget]. (United States)

    Baptista, Tatiana Wargas de Faria; Machado, Cristiani Vieira; Lima, Luciana Dias de; Garcia, Marcia; Andrade, Carla Lourenço Tavares de; Gerassi, Camila Duarte


    The public budget in Brazil has undergone significant changes since enactment of the 1988 Federal Constitution. Mechanisms for integration of planning activities and budget execution have been created, and Legislative participation in budgeting has increased. Congressional amendments appeared in this context. The article discusses the participation of Congressional amendments in the Federal health budget from 1997 to 2006, combining elements for discussion of funding mechanisms and health planning. Such amendments played a significant role in the budget process, accounting for over half of health funds in some years. The North was the region of Brazil that received most resources resulting from Congressional amendments, suggesting the need for further studies on the relationship between the amendments' enforcement and political party coalitions. The article concludes that the amendments cannot be understood solely as a funding mechanism, but mainly as a political instrument, and that they are not necessarily subject to health planning logic.

  18. Brave new world: mental health experiences of Puerto Ricans, immigrant Latinos, and Brazilians in Massachusetts. (United States)

    Sánchez, Mónica; Cardemil, Esteban; Adams, Sara Trillo; Calista, Joanne L; Connell, Joy; Depalo, Alexandra; Ferreira, Juliana; Gould, Diane; Handler, Jeffrey S; Kaminow, Paula; Melo, Tatiana; Parks, Allison; Rice, Eric; Rivera, Ismael


    Depression and anxiety are of the most commonly occurring mental health disorders in the United States. Despite a variety of efficacious interventions for depression and anxiety, it is clear that ethnic minorities experience mental health care disparities in their access to mental health services and the quality of treatment they receive. Research indicates that Latino heterogeneity impacts access to depression and anxiety treatment. In addition, Brazilians are becoming an increasingly visible minority within the United States and are often depicted as Latinos. The current study sought to understand the role of acculturation and stigma in mental health symptom endorsement and treatment seeking among Puerto Ricans, immigrant Latinos, and Brazilians. A total of 250 self-identified Latinos and Brazilians were interviewed about their mental health symptom and treatment experience, acculturation, and stigma toward mental illness. Results indicated considerable variability across the three groups, with Puerto Ricans endorsing higher rates of depression and anxiety, as well as higher rates of treatment seeking, than either the immigrant Latinos or the Brazilians. Acculturation played a differential role in the endorsement of anxiety treatment seeking for Brazilians. Finally, although the three groups differed in the extent to which they experienced stigma about mental health issues, stigma did not predict symptom endorsement or treatment-seeking behavior for any of the three groups. These findings underscore the importance of attending to both between-groups and within-group differences in the mental health and mental health treatment experiences of different ethnic groups.

  19. Applications of health information exchange information to public health practice

    DEFF Research Database (Denmark)

    Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R.


    Health information exchange (HIE) can support several aspects of public health practice by increasing the availability, timeliness, and comprehensiveness individual-level patient information. The potential benefits to disease monitoring, disaster response, and other public health activities served...... qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. We derived the codes for the template analysis through a literature review. HIE supported public health activities consistent with expectations in the literature...

  20. The prevalence of developmental dyscalculia in Brazilian public school system. (United States)

    Bastos, José Alexandre; Cecato, Angela Maria Traldi; Martins, Marielza Regina Ismael; Grecca, Kelly Regina Risso; Pierini, Rafael


    The goal of the study was to assess public school children at the end of the first stage of elementary school. We used a protocol applied concurrently with a writing test in the form of an unexpected activity in 28 public schools; 2,893 children assessed, 687 exhibited performance below 58 points, 184 were excluded due to change of address or lack of consent; 503 children subjected to a test of intellectual capacity and reading assessment and 71 considered intellectually disabled were excluded. 226 (7.8%) children, who could read, write, and had normal intellectual level, met the criteria of developmental dyscalculia (DD), 98 female and 128 male. The most influential factors in the prevalence were socioeconomic levels of the schools neighborhood, education level of parents, and being male, as demonstrated by the odds ratio and multiple logistic regression analysis. Further studies should be done so that educational policies are taken.

  1. The prevalence of developmental dyscalculia in Brazilian public school system

    Directory of Open Access Journals (Sweden)

    José Alexandre Bastos


    Full Text Available ABSTRACT The goal of the study was to assess public school children at the end of the first stage of elementary school. We used a protocol applied concurrently with a writing test in the form of an unexpected activity in 28 public schools; 2,893 children assessed, 687 exhibited performance below 58 points, 184 were excluded due to change of address or lack of consent; 503 children subjected to a test of intellectual capacity and reading assessment and 71 considered intellectually disabled were excluded. 226 (7.8% children, who could read, write, and had normal intellectual level, met the criteria of developmental dyscalculia (DD, 98 female and 128 male. The most influential factors in the prevalence were socioeconomic levels of the schools neighborhood, education level of parents, and being male, as demonstrated by the odds ratio and multiple logistic regression analysis. Further studies should be done so that educational policies are taken.

  2. Public Health Interventions for School Nursing Practice (United States)

    Schaffer, Marjorie A.; Anderson, Linda J. W.; Rising, Shannon


    School nurses (SNs) use public health nursing knowledge and skills to provide nursing services to school populations. The Public Health Intervention Wheel is a practice framework that can be used to explain and guide public health nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic…

  3. 42 CFR 90.9 - Public health advisory. (United States)


    ... 42 Public Health 1 2010-10-01 2010-10-01 false Public health advisory. 90.9 Section 90.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH... PROCEDURES § 90.9 Public health advisory. ATSDR may issue a public health advisory based on......

  4. Public Health Challenges and Priorities for Kazakhstan

    Directory of Open Access Journals (Sweden)

    Altyn Aringazina


    Full Text Available The Republic of Kazakhstan is one of the largest and fastest growing post-Soviet economies in Central Asia. Despite recent improvements in health care in response to Kazakhstan 2030 and other state-mandated policy reforms, Kazakhstan still lags behind other members of the Commonwealth of Independent States of the European Region on key indicators of health and economic development. Although cardiovascular diseases are the leading cause of mortality among adults, HIV/AIDS, tuberculosis, and blood-borne infectious diseases are of increasing public health concern. Recent data suggest that while Kazakhstan has improved on some measures of population health status, many environmental and public health challenges remain. These include the need to improve public health infrastructure, address the social determinants of health, and implement better health impact assessments to inform health policies and public health practice. In addition, more than three decades after the Declaration of Alma-Ata, which was adopted at the International Conference on Primary Health Care convened in Kazakhstan in 1978, facilitating population-wide lifestyle and behavioral change to reduce risk factors for chronic and communicable diseases, as well as injuries, remains a high priority for emerging health care reforms and the new public health. This paper reviews the current public health challenges in Kazakhstan and describes five priorities for building public health capacity that are now being developed and undertaken at the Kazakhstan School of Public Health to strengthen population health in the country and the Central Asian Region.

  5. Public Health Disease Surveillance Networks. (United States)

    Morse, Stephen S


    Zoonotic infections are important sources of human disease; most known emerging infections are zoonotic (e.g., HIV, Ebola virus, severe acute respiratory syndrome, Nipah virus, and enteropathogenic Escherichia coli) and originated as natural infections of other species that acquired opportunities to come in contact with humans. There are also serious infectious diseases classically considered zoonotic, such as influenza, rabies, bubonic plague, brucellosis, and leptospirosis. More recently, it has been recognized that wildlife constitutes a particularly important source of novel zoonoses. With all this microbial movement, surveillance is considered the first line of public health defense. The zoonotic origin of many human and livestock infections argues strongly for the synergistic value of a One Health approach, which provides the capability to identify pathogens crossing into new species and could provide earlier warning of potential epidemics. This article discusses public health surveillance and major recent surveillance initiatives and reviews progress toward implementing a One Health surveillance framework. Networks discussed include global intergovernmental organizations and recent combined efforts of these organizations; Web-based nongovernmental systems (e.g., ProMED, the Program for Monitoring Emerging Diseases); and networks of bilateral or multilateral government programs (e.g., the CDC's Global Disease Detection [GDD] platform; the U.S. Department of Defense's Global Emerging Infections Surveillance and Response System [GEIS]; regional and subregional networks; and the U.S. Agency for International Development's Emerging Pandemic Threats [EPT] program and its surveillance component, PREDICT). Syndromic surveillance also has potential to complement existing systems. New technologies are enabling revolutionary capabilities for global surveillance, but in addition to serious technical needs, both sustainability and data-sharing mechanisms remain

  6. Physical Education's Role in Public Health. (United States)

    Sallis, James F.; McKenzie, Thomas L.


    Analyzes contributions physical education makes to child and adult health. Topics discussed are current levels of U.S. children's physical activity; status of elementary physical education programs; health-related physical activity interventions; public health analysis of elementary physical education; and public health role and goal for physical…

  7. Public health workforce: challenges and policy issues

    Directory of Open Access Journals (Sweden)

    Beaglehole Robert


    Full Text Available Abstract This paper reviews the challenges facing the public health workforce in developing countries and the main policy issues that must be addressed in order to strengthen the public health workforce. The public health workforce is diverse and includes all those whose prime responsibility is the provision of core public health activities, irrespective of their organizational base. Although the public health workforce is central to the performance of health systems, very little is known about its composition, training or performance. The key policy question is: Should governments invest more in building and supporting the public health workforce and infrastructure to ensure the more effective functioning of health systems? Other questions concern: the nature of the public health workforce, including its size, composition, skills, training needs, current functions and performance; the appropriate roles of the workforce; and how the workforce can be strengthened to support new approaches to priority health problems. The available evidence to shed light on these policy issues is limited. The World Health Organization is supporting the development of evidence to inform discussion on the best approaches to strengthening public health capacity in developing countries. WHO's priorities are to build an evidence base on the size and structure of the public health workforce, beginning with ongoing data collection activities, and to map the current public health training programmes in developing countries and in Central and Eastern Europe. Other steps will include developing a consensus on the desired functions and activities of the public health workforce and developing a framework and methods for assisting countries to assess and enhance the performance of public health training institutions and of the public health workforce.

  8. Shaping and authorising a public health profession

    Directory of Open Access Journals (Sweden)

    Katarzyna Czabanowska


    doctors, nurses, lawyers, and architects can enjoy the benefits of the 2005/36/EC Directive amended by 2013/55/EU Directive on the recognition of professional qualifications, public health professionals are left out from these influential (elite professions. Firstly, we use the profession traits theory as a framework in arguing whether public health can be a legitimate profession in itself; secondly, we explain who public health professionals are and what usually is required for shaping the public health profession; and thirdly, we attempt to sketch the road to the authorisation or licensing of public health professionals. Finally, we propose some recommendations.

  9. Health Insurance Marketplace Public Use Files (United States)

    U.S. Department of Health & Human Services — A set of seven (7) public use files containing information on health insurance issuers participating in the Health Insurance Marketplace and certified qualified...

  10. Undergraduate Public Health Majors: Why They Choose Public Health or Medicine? (United States)

    Hilton, Warren


    This mixed methods study examined the relationship between the motivations for attending college of undergraduate students with a focus on students with a public health major, and their desire to pursue graduate training in public health and subsequently, public health careers. The study highlighted the current public health workforce shortage and…

  11. Políticas públicas brasileñas para las personas mayores Brazilian public policies for elderly patients

    Directory of Open Access Journals (Sweden)

    Marcia Regina Martins Alvarenga


    Full Text Available Diferentes estudios recientes demuestran que el envejecimiento de la población brasileña es irreversible. Evaluar las necesidades de salud de este segmento poblacional para gestionar los recursos disponibles es imprescindible para los profesionales de la salud. Ese artículo tiene como objetivo presentar el Sistema único de Salud en Brasil y las políticas públicas para las personas mayores. El país brasileño no dispone de una red de servicios articulados y dedicados a la asistencia de las necesidades específicas de las personas mayores, a pesar de que la legislación brasileña está avanzando en cuanto a la promoción y la protección de la salud de estas personas.Recent different studies show that Brazilian population aging is irreversible. Evaluation of the elderly health care needs by health professionals is essential to the management of the available resources. The aim of this article is to describe the Brazilian Unified Health Care System and the public policies for elderly. In spite of the lack of an integrated health care network to provide health care to meet the needs of the elderly population, Brazilian legislation is improving, foreseeing the health promotion and protection of older people.

  12. Enhancing crisis leadership in public health emergencies. (United States)

    Deitchman, Scott


    Reviews of public health emergency responses have identified a need for crisis leadership skills in health leaders, but these skills are not routinely taught in public health curricula. To develop criteria for crisis leadership in public health, published sources were reviewed to identify attributes of successful crisis leadership in aviation, public safety, military operations, and mining. These sources were abstracted to identify crisis leadership attributes associated with those disciplines and compare those attributes with crisis leadership challenges in public health. Based on this review, the following attributes are proposed for crisis leadership in public health: competence in public health science; decisiveness with flexibility; ability to maintain situational awareness and provide situational assessment; ability to coordinate diverse participants across very different disciplines; communication skills; and the ability to inspire trust. Of these attributes, only competence in public health science is currently a goal of public health education. Strategies to teach the other proposed attributes of crisis leadership will better prepare public health leaders to meet the challenges of public health crises.

  13. 42 CFR 93.220 - Public Health Service or PHS. (United States)


    ... RESEARCH MISCONDUCT Definitions § 93.220 Public Health Service or PHS. Public Health Service or PHS means... 42 Public Health 1 2010-10-01 2010-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS...

  14. The mental health care gap among children and adolescents: data from an epidemiological survey from four Brazilian regions.

    Directory of Open Access Journals (Sweden)

    Cristiane S Paula

    Full Text Available INTRODUCTION: Worldwide, a minority of disordered children/adolescents receives mental health assistance. In order to improve service access, it is important to investigate factors that influence the process leading to receiving care. Data on frequency and barriers for mental health service use (MHSU among Brazilian children/adolescents are extremely scarce and are needed to guide public policy. OBJECTIVES: To establish the frequency of MHSU among 6-to-16-year-old with psychiatric disorders from four Brazilian regions; and to identify structural/psychosocial/demographic barriers associated with child/adolescent MHSU. METHODS: Multicenter cross-sectional-study involving four towns from four out of five Brazilian regions. In each town, a representative sample of elementary public school students was randomly selected (sample: 1,721. Child/adolescent MHSU was defined as being seen by a psychologist/psychiatrist/neurologist in the previous 12 months. Standardized instruments measured: (1 children/adolescent characteristics [(1.1 Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-PL-psychiatric disorders; (1.2 Ten Questions Screen-neurodevelopment problems; (1.3 two subtests of WISC-III-estimated IQ; (1.4 Academic Performance Test-school performance], (2 factors related to mothers/main caregivers (Self-Reporting Questionnaire-anxiety/depression, (3 family (Brazilian Research-Companies-Association's Questionnaire-SES. RESULTS: Only 19.8% of children/adolescents with psychiatric disorder have used mental health services in the previous 12 months. Multiple logistic regression modeling identified five factors associated with lower rates of MHSU (female gender, adequate school performance, mother/main caregiver living with a partner, lower SES, residing in deprived Brazilian regions regardless of the presence of any psychiatric disorders/neurodevelopmental problems. CONCLUSIONS: Only a small proportion of children

  15. Linking public health agencies and hospitals for improved emergency preparedness: North Carolina's public health epidemiologist program

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    Markiewicz Milissa


    Full Text Available Abstract Background In 2003, 11 public health epidemiologists were placed in North Carolina's largest hospitals to enhance communication between public health agencies and healthcare systems for improved emergency preparedness. We describe the specific services public health epidemiologists provide to local health departments, the North Carolina Division of Public Health, and the hospitals in which they are based, and assess the value of these services to stakeholders. Methods We surveyed and/or interviewed public health epidemiologists, communicable disease nurses based at local health departments, North Carolina Division of Public Health staff, and public health epidemiologists' hospital supervisors to 1 elicit the services provided by public health epidemiologists in daily practice and during emergencies and 2 examine the value of these services. Interviews were transcribed and imported into ATLAS.ti for coding and analysis. Descriptive analyses were performed on quantitative survey data. Results Public health epidemiologists conduct syndromic surveillance of community-acquired infections and potential bioterrorism events, assist local health departments and the North Carolina Division of Public Health with public health investigations, educate clinicians on diseases of public health importance, and enhance communication between hospitals and public health agencies. Stakeholders place on a high value on the unique services provided by public health epidemiologists. Conclusions Public health epidemiologists effectively link public health agencies and hospitals to enhance syndromic surveillance, communicable disease management, and public health emergency preparedness and response. This comprehensive description of the program and its value to stakeholders, both in routine daily practice and in responding to a major public health emergency, can inform other states that may wish to establish a similar program as part of their larger public

  16. The scientific production in health and biological sciences of the top 20 Brazilian universities

    Directory of Open Access Journals (Sweden)

    R. Zorzetto


    Full Text Available Brazilian scientific output exhibited a 4-fold increase in the last two decades because of the stability of the investment in research and development activities and of changes in the policies of the main funding agencies. Most of this production is concentrated in public universities and research institutes located in the richest part of the country. Among all areas of knowledge, the most productive are Health and Biological Sciences. During the 1998-2002 period these areas presented heterogeneous growth ranging from 4.5% (Pharmacology to 191% (Psychiatry, with a median growth rate of 47.2%. In order to identify and rank the 20 most prolific institutions in these areas, searches were made in three databases (DataCAPES, ISI and MEDLINE which permitted the identification of 109,507 original articles produced by the 592 Graduate Programs in Health and Biological Sciences offered by 118 public universities and research institutes. The 20 most productive centers, ranked according to the total number of ISI-indexed articles published during the 1998-2003 period, produced 78.7% of the papers in these areas and are strongly concentrated in the Southern part of the country, mainly in São Paulo State.

  17. Determining factors for the adoption of stock option plans in brazilian publicly traded companies

    Directory of Open Access Journals (Sweden)

    Geovanne Dias de Moura


    Full Text Available The objective was to identify the determining factors for the adoption of stock option plans in Brazilian publicly traded companies. Therefore, a descriptive research was developed by means of document analysis and a quantitative approach, using logistic regression. The sample consists of 158 companies, using data for the period from 2009 till 2012. The results evidenced an increase in the number of companies with stock option plans during the period. Among the factors company size, liquidity constraint, stock concentration, horizon problem, stockholder participation of CEO, dual function of CEO and chairman of the board, described in the literature as influences for the use of stock option plans, three were confirmed in the sample analyzed. The factors “current liquidity” between 2010 and 2012; “horizon problem” between 2009 and 2012; and “stockholder participation” in 2012, further evidence positive relations in the Brazilian context.

  18. PERCC Tools: Public Health Preparedness for Clinicians

    Centers for Disease Control (CDC) Podcasts


    CDC’s Office of Public Health Preparedness and Response funds Preparedness and Emergency Response Research Centers (PERRCs) to examine components of the public health system. This podcast is an overview of mental and behavioral health tools developed by the Johns Hopkins PERRC.  Created: 8/29/2011 by Emergency Risk Communication Branch (ERCB)/Joint Information Center (JIC); Office of Public Health Preparedness and Response (OPHPR).   Date Released: 8/30/2011.

  19. Nuclear education in public health and nursing

    Energy Technology Data Exchange (ETDEWEB)

    Winder, A.E.; Stanitis, M.A.


    Twenty-three public health schools and 492 university schools of nursing were surveyed to gather specific information on educational programs related to nuclear war. Twenty public health schools and 240 nursing schools responded. Nuclear war-related content was most likely to appear in disaster nursing and in environmental health courses. Three schools of public health report that they currently offer elective courses on nuclear war. Innovative curricula included political action projects for nuclear war prevention.

  20. The Economic Crisis and Public Health

    Directory of Open Access Journals (Sweden)

    Victor Sidel


    Full Text Available The current global economic crisis seriously threatens the health of the public. Challenges include increases in malnutrition; homelessness and inadequate housing; unemployment; substance abuse, depression, and other mental health problems; mortality; child health problems; violence; environmental and occupational health problems; and social injustice and violation of human rights; as well as decreased availability, accessibility, and affordability of quality medical and dental care. Health professionals can respond by promoting surveillance and documentation of human needs, reassessing public health priorities, educating the public and policymakers about health problems worsened by the economic crisis, advocating for sound policies and programs to address these problems, and directly providing necessary programs and services.

  1. Public health reform and health promotion in Canada. (United States)

    Kirk, Megan; Tomm-Bonde, Laura; Schreiber, Rita


    More than 25 years have passed since the release of the Ottawa Charter for Health Promotion. This document represented a substantial contribution to public health in its emphasis on the economic, legal, political and cultural factors that influence health. With public health renewal underway across Canada, and despite overwhelming support in the public health community for the Ottawa Charter, how much its principles will be included in the renewal process remains unclear. In this paper, we present the historical understanding of health promotion in Canada, namely highlighting the contributions from the Lalonde Report, Alma Ata Declaration, the Ottawa Charter for Health Promotion and the more recent population health movement. We discuss public health renewal, using the province of British Columbia in Canada as an example. We identify the potential threats to health promotion in public health renewal as it unfolds.

  2. (Public) Health and Human Rights in Practice. (United States)

    Annas, George J; Mariner, Wendy K


    Public health's reliance on law to define and carry out public activities makes it impossible to define a set of ethical principles unique to public health. Public health ethics must be encompassed within--and consistent with--a broader set of principles that define the power and limits of governmental institutions. These include human rights, health law, and even medical ethics. The human right to health requires governments not only to respect individual human rights and personal freedoms, but also, importantly, to protect people from harm from external sources and third parties, and to fulfill the health needs of the population. Even if human rights are the natural language for public health, not all public health professionals are comfortable with the language of human rights. Some argue that individual human rights--such as autonomy and privacy--unfairly limit the permissible means to achieve the goal of health protection. We argue that public health should welcome and promote the human rights framework. In almost every instance, this will make public health more effective in the long run, because the goals of public health and human rights are the same: to promote human flourishing.

  3. An analysis of equity in Brazilian health system financing. (United States)

    Ugá, Maria Alicia Domínguez; Santos, Isabela Soares


    Health care in Brazil is financed from many sources--taxes on income, real property, sales of goods and services, and financial transactions; private insurance purchased by households and firms; and out-of-pocket payments by households. Data on household budgets and tax revenues allow the burden of each source except firms' insurance purchases for their employees to be allocated across deciles of adjusted per capita household income, indicating the progressivity or regressivity of each kind of payment. Overall, financing is approximately neutral, with progressive public finance offsetting regressive payments. This last form of finance pushes some households into poverty.

  4. Lean diesel technology and human health: a case study in six Brazilian metropolitan regions

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    Paulo Afonso de André


    Full Text Available OBJECTIVE: Due to their toxicity, diesel emissions have been submitted to progressively more restrictive regulations in developed countries. However, in Brazil, the implementation of the Cleaner Diesel Technologies policy (Euro IV standards for vehicles produced in 2009 and low-sulfur diesel with 50 ppm of sulfur was postponed until 2012 without a comprehensive analysis of the effect of this delay on public health parameters. We aimed to evaluate the impact of the delay in implementing the Cleaner Diesel Technologies policy on health indicators and monetary health costs in Brazil. METHODS: The primary estimator of exposure to air pollution was the concentration of ambient fine particulate matter (particles with aerodynamic diameters <2.5 μm, [PM2.5]. This parameter was measured daily in six Brazilian metropolitan areas during 2007-2008. We calculated 1 the projected reduction in the PM2.5 that would have been achieved if the Euro IV standards had been implemented in 2009 and 2 the expected reduction after implementation in 2012. The difference between these two time curves was transformed into health outcomes using previous dose-response curves. The economic valuation was performed based on the DALY (disability-adjusted life years method. RESULTS: The delay in implementing the Cleaner Diesel Technologies policy will result in an estimated excess of 13,984 deaths up to 2040. Health expenditures are projected to be increased by nearly US$ 11.5 billion for the same period. CONCLUSIONS: The present results indicate that a significant health burden will occur because of the postponement in implementing the Cleaner Diesel Technologies policy. These results also reinforce the concept that health effects must be considered when revising fuel and emission policies.

  5. Public health nursing, ethics and human rights. (United States)

    Ivanov, Luba L; Oden, Tami L


    Public health nursing has a code of ethics that guides practice. This includes the American Nurses Association Code of Ethics for Nurses, Principles of the Ethical Practice of Public Health, and the Scope and Standards of Public Health Nursing. Human rights and Rights-based care in public health nursing practice are relatively new. They reflect human rights principles as outlined in the Universal Declaration of Human Rights and applied to public health practice. As our health care system is restructured and there are new advances in technology and genetics, a focus on providing care that is ethical and respects human rights is needed. Public health nurses can be in the forefront of providing care that reflects an ethical base and a rights-based approach to practice with populations.

  6. Public Health and Midwifery in Indonesia. (United States)


    JPRS: ^472 21 March 1961 PUBLIC HEALTH AND MIDWIFERY IN INDONESIA 3y M. Joedono DISTRIBUTION STATEMENT A Approved for Public Release...established to service the translation and research needs of the various government departments. ,-^’ JPRS: J^72 CSO: 1335-S/d PUBLIC HEALTH AND MIDWIFERY

  7. Injury prevention and public health

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    David A. Sleet


    Full Text Available Injuries are one of the most under-recognized public health problems facing the world today. With more than 5 million deaths every year, violence and injuries account for 9% of global mortality, as many deaths as from HIV, Malaria and Tuberculosis combined. Eight of the 15 leading causes of death for people ages 15 to 29 years are injury-related: road traffic injuries, suicides, homicides, drowning, burns, war injuries, poisonings and falls. For every death due to war, there are three deaths due to homicide and five deaths due to suicide. However, most violence happens to people behind closed doors and results not in death, but often in years of physical and emotional suffering [1]. Injuries can be classified by intent: unintentional or intentional. Traffic injuries, fire-related injuries, falls, drowning, and poisonings are most often classified as unintentional injuries; injuries due to assault, selfinflicted violence such as suicide, and war are classified as intentional injuries, or violence. Worldwide, governments and public and private partners are increasingly aware of the strains that unintentional injuries and violence place on societies. In response they are strengthening data collection systems, improving services for victims and survivors, and increasing prevention efforts [1].

  8. Evaluation of physical activity in the health promotion for brazilian teenagers: a systematic review

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    Alvaro Adolfo Duarte Alberto


    Full Text Available Objective: To analyze the methodological designs of national studies that assessed the level of physical activity for promoting adolescent health. Methods: a systematic literature review of original researches and publications of MEDLINE, LILACS, SCOPUS and ADOLEC electronic databases. It focused on determinant aspects of physical activity for health promotion using the following keywords: physical activity, physical fitness, physical activity, physical exercise, motor activity, sedentary and sedentariness, adolescent, adolescence, young, youth, teenager, and teenage, Brazil, Brazilian, South America, Low-middle income and country(ies. Data analysis covered the period from 2005 to 2011. First, 449 studies were identified. After analyzing the titles of the manuscripts, 130 articles were eligible for abstract evaluation and subsequent full text analysis. In the end, 31 articles met all inclusion criteria. Results: A total of 93.6% (n=29 of the evaluated studies used cross-sectional design, with samples ranging from 92 to 5028 subjects, and all of them used questionnaires for measuring physical activity. The main analysis of the studies was based on the association between physical activity, biodemographic data (age, gender and socioeconomic data (income, social class and parental education. Conclusion: The national studies assessing the level of physical activity for promoting adolescent health appear with great methodological variability since there is no standardization in the methodological design, instrument and definition of variables, highlighting the need for longitudinal studies in this area. doi:10.5020/18061230.2013.p426

  9. Cuidado nutricional em hospitais públicos de quatro estados brasileiros: contribuições da avaliação em saúde à vigilância sanitária de serviços Nutritional care in public hospitals of four Brazilian states: contributions of health evaluation to health surveillance services

    Directory of Open Access Journals (Sweden)

    Marismary Horsth De Seta


    Full Text Available Considerando a importância do cuidado nutricional para a qualidade da atenção prestada ao paciente internado, a pesquisa objetivou avaliar esse cuidado em oito hospitais públicos que receberam aportes do QualiSUS em quatro estados do país. Realizaram-se entrevistas semiestruturadas com nutricionistas, observação direta e revisão de 219 prontuários de pacientes internados nas clínicas médicas. Os achados sugerem fragilidades no cuidado nutricional hospitalar; deficiente integração entre produção de refeições e assistência nutricional nos hospitais pesquisados, além de deficiências estruturais. Ressaltam-se problemas relacionados ao processo de cuidado nutricional, inclusive na sua documentação. Em 93% dos prontuários não havia registros do estado nutricional na admissão, nem de avaliação nutricional dos pacientes em terapia nutricional. Aponta-se que a avaliação realizada pela vigilância sanitária em inspeções de rotina, centrada na verificação do cumprimento de normas e nos aspectos estruturais, não contempla a detecção de um possível risco nutricional para o paciente. Sugere-se a inclusão de outros critérios e estratégias pela vigilância sanitária, dentre eles a revisão de prontuários abertos.Considering the importance of nutritional care for the quality of care provided to hospitalized patients, the study aims to assess health care in eight public hospitals that have received support from QualiSUS in four Brazilian states. There were semi-structured interviews with nutritionists, direct observation and review of 219 records of patients admitted to the medical clinics. The findings suggest weaknesses in the hospital nutritional care, poor integration between the production of food and nutritional care in the surveyed hospitals, in addition to structural deficiencies. We highlight problems related to the nutritional care process, including its documentation. In 93% of the records there were no

  10. Global public health today: connecting the dots

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    Marta Lomazzi


    Full Text Available Background: Global public health today faces new challenges and is impacted by a range of actors from within and outside state boundaries. The diversity of the actors involved has created challenges and a complex environment that requires a new context-tailored global approach. The World Federation of Public Health Associations has embarked on a collaborative consultation with the World Health Organization to encourage a debate on how to adapt public health to its future role in global health. Design: A qualitative study was undertaken. High-level stakeholders from leading universities, multilateral organizations, and other institutions worldwide participated in the study. Inductive content analyses were performed. Results: Stakeholders underscored that global public health today should tackle the political, commercial, economic, social, and environmental determinants of health and social inequalities. A multisectoral and holistic approach should be guaranteed, engaging public health in broad dialogues and a concerted decision-making process. The connection between neoliberal ideology and public health reforms should be taken into account. The WHO must show leadership and play a supervising and technical role. More and better data are required across many programmatic areas of public health. Resources should be allocated in a sustainable and accountable way. Public health professionals need new skills that should be provided by a collaborative global education system. A common framework context-tailored to influence governments has been evaluated as useful. Conclusions: The study highlighted some of the main public health challenges currently under debate in the global arena, providing interesting ideas. A more inclusive integrated vision of global health in its complexity, shared and advocated for by all stakeholders involved in decision-making processes, is crucial. This vision represents the first step in innovating public health at the

  11. Conflicts of Interest: Manipulating Public Health (United States)

    Stein, Richard; Davis, Devra Lee


    Evaluating the potential health impacts of chemical, physical, and biological environmental factors represents a challenging task with profound medical, public health, and historical implications. The history of public health is replete with instances, ranging from tobacco to lead and asbestos, where the ability to obtain evidence on potential…

  12. Constructing violence as a public health problem. (United States)

    Winett, L B


    Once viewed primarily as a criminal justice problem, violence and its prevention are now often claimed by public health professionals as being within their purview. The author reviewed 282 articles published in public health and medical journals from 1985 through 1995 that discussed violence as a public health problem. She found that while authors tended to identify social and structural causes for violence, they suggested interventions that targeted individuals' attitudes or behaviors and improved public health practice. Her study illuminates the tension between public health professionals' vision of the social precursors of violence and their attempts to apply a traditional set of remedies. In targeting individuals to rid the nation of violence, the public health community is deemphasizing societal causes.

  13. The linkage of Baltimore's mental health and public health systems. (United States)

    Collier, M T; Lambropoulos, A S; Williams-Glasser, G; Baron, S T; Birkmeyer, J


    The Institute of Medicine's The Future of Public Health calls for a strengthening of linkages between public health and mental health, with a view to integrating the functions at the service delivery level. This paper details the history of the mental health/public health interface in Baltimore, Maryland. In 1977, mental health and addiction services were merged into the Department of Health. More recently, in 1988 adult mental health services were split off into a quasi-public corporation. Children's mental health, however, was retained as a distinct service within the Department of Health in order to enhance coordination with other health services for children. Replication of such coordinated-care models is certainly feasible.

  14. The public communication of science in public health graduate programs in Brazil: From the coordinators' perspective (United States)

    Teixeira, C. A.; Gallo, P. R.


    Introduction - The elaboration process of public policies for science and technology in knowledge societies should include not only experts, but all society members. There are studies on lay people's perception of science and technology. However, what is the scientists' perspective on public communication of science? Objectives - To describe and characterize the concepts that coordinators of Brazilian public health graduate programs have about public communication of science. Methods - This is an analytical and descriptive report of an exploratory research (doctoral study). The answers of fifty-one coordinators to two questionnaires were submitted for content analysis. The categories were transformed into variables that allowed the data processing by the Hiérarchique Classificatoire et Cohésitive (CHIC®) software. Results - Similarity analysis strongly suggested (0,99) that coordinators understand public communication as a communication directed to academic peers and students, also as a form of participation in scientific events and communication by scientific papers. Likewise, the implication analysis suggested a strong implication (0,98) between scientific communication understood as public communication. Conclusion - The notion of public communication of science as a social right and as a commitment and responsibility of researchers and research centers is not explicitly present in the narrative of the coordinators, although in general the coordinators conceive it as a relevant activity. This study thus contributes to a reflection on the role of scientists, researchers and research centers in public communication of science and technology.

  15. The State Public Health Laboratory System


    Inhorn, Stanley L.; Astles, J. Rex; Gradus, Stephen; Malmberg, Veronica; Snippes, Paula M.; Wilcke, Burton W.; White, Vanessa A.


    This article describes the development since 2000 of the State Public Health Laboratory System in the United States. These state systems collectively are related to several other recent public health laboratory (PHL) initiatives. The first is the Core Functions and Capabilities of State Public Health Laboratories, a white paper that defined the basic responsibilities of the state PHL. Another is the Centers for Disease Control and Prevention National Laboratory System (NLS) initiative, the go...

  16. How Health Reform is Recasting Public Psychiatry. (United States)

    Shaner, Roderick; Thompson, Kenneth S; Braslow, Joel; Ragins, Mark; Parks, Joseph John; Vaccaro, Jerome V


    This article reviews the fiscal, programmatic, clinical, and cultural forces of health care reform that are transforming the work of public psychiatrists. Areas of rapid change and issues of concern are discussed. A proposed health care reform agenda for public psychiatric leadership emphasizes (1) access to quality mental health care, (2) promotion of recovery practices in primary care, (3) promotion of public psychiatry values within general psychiatry, (4) engagement in national policy formulation and implementation, and (5) further development of psychiatric leadership focused on public and community mental health.

  17. Toxoplasmose: soroprevalência em puérperas atendidas pelo Sistema Único de Saúde Toxoplasmosis: seroprevalence in postpartum women attended by SUS (Brazilian Public Health System

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Dutra Leão


    postpartum women, attended in two hospitals of the Public Health System (SUS in Cuiabá, and its correlation with age, previous abortion and women's knowledge of the disease. METHODS: a cross-sectional study including 205 women with ages from 14 to 43 (mean 22.4 years old, attended in these hospitals for two months, in the first or second days postpartum. Each woman answered a short questionnaire and had peripheral blood sample collected. Blood samples were stored at 20°C until assay. The seroprevalence was determined by quantitative detection of specific IgG antibody against Toxoplasma gondii, using a microparticle enzyme immunoassay. All samples were assayed at the same time. RESULTS: The average number of pregnancies in the women included in this study was 2.2, and the majority of them was pregnant for the first time. The seroprevalence found was 70.7% (165 of 205 women. No statistical correlation was found between seroprevalence and age (p = 0.967 or previous abortion (p = 0.82. Most of the women in this study (78% did not know about toxoplasmosis and no statistical correlation was found between this condition and seroprevalence (p = 0.49. CONCLUSION: the high seroprevalence found in the present study is in accordance with surveys previously reported in our country and other developing countries. Among the women included in this study, an expressive number (29.3% is still under risk of contamination. The lack of statistical correlation between seroprevalence and women's age, lack of knowledge about the disease and report of previous abortion is in accordance with some previous studies and in disagreement with others.

  18. Systematic review of public health branding. (United States)

    Evans, W Douglas; Blitstein, Jonathan; Hersey, James C; Renaud, Jeanette; Yaroch, Amy L


    Brands build relationships between consumers and products, services, or lifestyles by providing beneficial exchanges and adding value to their objects. Brands can be measured through associations that consumers hold for products and services. Public health brands are the associations that individuals hold for health behaviors, or lifestyles that embody multiple health behaviors. We systematically reviewed the literature on public health brands; developed a methodology for describing branded health messages and campaigns; and examined specific branding strategies across a range of topic areas, campaigns, and global settings. We searched the literature for published studies on public health branding available through all relevant, major online publication databases. Public health branding was operationalized as any manuscripts in the health, social science, and business literature on branding or brands in health promotion marketing. We developed formalized decision rules and applied them in identifying articles for review. We initially identified 154 articles and reviewed a final set of 37, 10 from Africa, Australia, and Europe. Branded health campaigns spanned most of the major domains of public health and numerous communication strategies and evaluation methodologies. Most studies provided clear information on planning, development, and evaluation of the branding effort, while some provided minimal information. Branded health messages typically are theory based, and there is a body of evidence on their behavior change effectiveness, especially in nutrition, tobacco control, and HIV/AIDS. More rigorous research is needed, however, on how branded health messages impact specific populations and behaviors.

  19. Applications of health information exchange information to public health practice. (United States)

    Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R


    Increased information availability, timeliness, and comprehensiveness through health information exchange (HIE) can support public health practice. The potential benefits to disease monitoring, disaster response, and other public health activities served as an important justification for the US' investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local public health practitioners participating in five different exchanges. Using qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. HIE supported public health activities consistent with expectations in the literature. However, no single department realized all the potential benefits of HIE identified. These findings suggest ways to improve HIE usage in public health.

  20. Public Health Nutrition as a Profession

    DEFF Research Database (Denmark)

    Robertson, Aileen


    and cardiovascular diseases. There exists enormous potential to promote health and prevent diseases through targeting unhealthy life style, and it is crucial to develop a qualified public health nutrition workforce to reduce the NCD burden. Professionals with broad capacity within the field of public health...... nutrition are necessary to identify and respond to the current health challenges. However, public health nutrition has not been recognized as a profession in all countries. Public health nutrition (PHN) is an evolving profession within nutrition science that focuses on solving nutritional problems affecting...... population groups rather than those of individuals. Central elements of the profession are to assess the impact of various aspects of the food systems on the nutritional status, health and health inequalities of population groups, and to develop, recommend and implement evidence-based measures to improve...

  1. [Public health ethics and reproduction]. (United States)

    Alexandrova-Yankulovska, S; Bozhinov, P; Bojinova, S


    Medical progress has enabled achievements that were not even thinkable earlier but at the same time society and public health have had to face new challenges. What are we ready to accept in the area of human reproduction? This paper aims at ethical analysis of Bulgarian laws on reproduction. The abortion debate nowadays has got new dimiension focusing not that much on its moral acceptability but rather on the acceptable indications for its performance. Is it ethical to perform abortion in case of undesired gender of the embryo or genetic malformations? Lots of moral issues mark the area of assisted reproduction which is due to the separation of the reproductive functions (ova, sperm and embryo donation, surrogacy), fragmentation of motherhood and fatherhood, differentiation of biological and social parenthood. Defining limits of acceptable interference or non-interference in human reproduction will never be easy, but dynamics of moral judgment shouldn't bother us. The rigidity of moral norms is what should be alarming because it threatens procreative autonomy.

  2. Public health insurance under a nonbenevolent state. (United States)

    Lemieux, Pierre


    This paper explores the consequences of the oft ignored fact that public health insurance must actually be supplied by the state. Depending how the state is modeled, different health insurance outcomes are expected. The benevolent model of the state does not account for many actual features of public health insurance systems. One alternative is to use a standard public choice model, where state action is determined by interaction between self-interested actors. Another alternative--related to a strand in public choice theory--is to model the state as Leviathan. Interestingly, some proponents of public health insurance use an implicit Leviathan model, but not consistently. The Leviathan model of the state explains many features of public health insurance: its uncontrolled growth, its tendency toward monopoly, its capacity to buy trust and loyalty from the common people, its surveillance ability, its controlling nature, and even the persistence of its inefficiencies and waiting lines.

  3. Health self-assessment by hemodialysis patients in the Brazilian Unified Health System

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    Tiago Ricardo Moreira


    Full Text Available ABSTRACT OBJECTIVE To examine whether the level of complexity of the services structure and sociodemographic and clinical characteristics of patients in hemodialysis are associated with the prevalence of poor health self-assessment. METHODS In this cross-sectional study, we evaluated 1,621 patients with chronic terminal kidney disease on hemodialysis accompanied in 81 dialysis services in the Brazilian Unified Health System in 2007. Sampling was performed by conglomerate in two stages and a structured questionnaire was applied to participants. Multilevel multiple logistic regression was used for data analysis. RESULTS The prevalence of poor health self-assessment was of 54.5%, and in multivariable analysis it was associated with the following variables: increasing age (OR = 1.02; 95%CI 1.01–1.02, separated or divorced marital status (OR = 0.62; 95%CI 0.34–0.88, having 12 years or more of study (OR = 0.51; 95%CI 0.37–0.71, spending more than 60 minutes in commuting between home and the dialysis service (OR = 1.80; 95%CI 1.29–2.51, having three or more self-referred diseases (OR = 2.20; 95%CI 1.33–3.62, and reporting some (OR = 2.17; 95%CI 1.66–2.84 or a lot of (OR = 2.74; 95%CI 2.04–3.68 trouble falling asleep. Individuals in treatment in dialysis services with the highest level of complexity in the structure presented less chance of performing a self-assessment of their health as bad (OR = 0.59; 95%CI 0.42–0.84. CONCLUSIONS We showed poor health self-assessment is associated with age, years of formal education, marital status, home commuting time to the dialysis service, number of self-referred diseases, report of trouble sleeping, and also with the level of complexity of the structure of health services. Acknowledging these factors can contribute to the development of strategies to improve the health of patients in hemodialysis in the Brazilian Unified Health System.

  4. The role of public health informatics in enhancing public health surveillance. (United States)

    Savel, Thomas G; Foldy, Seth


    Public health surveillance has benefitted from, and has often pioneered, informatics analyses and solutions. However, the field of informatics also serves other facets of public health including emergency response, environmental health, nursing, and administration. Public health informatics has been defined as the systematic application of information and computer science and technology to public health practice, research, and learning. It is an interdisciplinary profession that applies mathematics, engineering, information science, and related social sciences (e.g., decision analysis) to important public health problems and processes. Public health informatics is a subdomain of the larger field known as biomedical or health informatics. Health informatics is not synonymous with the term health information technology (IT). Although the concept of health IT encompasses the use of technology in the field of health care, one can think of health informatics as defining the science, the how and why, behind health IT. For example, health IT professionals should be able to resolve infrastructure problems with a network connection, whereas trained public health informaticians should be able to support public health decisions by facilitating the availability of timely, relevant, and high-quality information. In other words, they should always be able to provide advice on methods for achieving a public health goal faster, better, or at a lower cost by leveraging computer science, information science, or technology.

  5. Group work in the public health context: A proposal for training in psychology. (United States)

    Rasera, Emerson F; Pegoraro, Renata F; Pereira, Eliane R


    The entry of psychologists into the public health sector in Brazil is usually connected to a traditional clinical model, and, thus, marked by a lack of training for group work. A reflection on the training of psychologists for group work is essential. Aiming at contributing to this theme, the objective of this article is to discuss the training for group work in the public health sector. In particular, we aim to introduce a proposal for training in psychology in a Brazilian public university, covering a theoretical-practical module, as well as basic and professionalizing internship programmes.

  6. Redistributive effects in public health care financing. (United States)

    Honekamp, Ivonne; Possenriede, Daniel


    This article focuses on the redistributive effects of different measures to finance public health insurance. We analyse the implications of different financing options for public health insurance on the redistribution of income from good to bad health risks and from high-income to low-income individuals. The financing options considered are either income-related (namely income taxes, payroll taxes, and indirect taxes), health-related (co-insurance, deductibles, and no-claim), or neither (flat fee). We show that governments who treat access to health care as a basic right for everyone should consider redistributive effects when reforming health care financing.

  7. Bullying Prevention for Public Health Practitioners

    Centers for Disease Control (CDC) Podcasts


    This podcast discusses bullying as a public health problem, and provides information and resources for public health practitioners.  Created: 1/19/2012 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 1/19/2012.

  8. Law as a tool of public health. (United States)

    Akintola, S O


    The preservation of the public's health is one of the most important goals of government. The enactment and enforcement of law is the primary means by which government can encourage as well as compel conditions for healthier and safer lifestyles. The Law creates and assigns functions for public health authorities. In this regard, law is a fundamental element of effective public health policy and practice. It has played a crucial role in many of public health's greatest achievements. In spite of its contribution to effective Public Health practice, the potential for the application of law to chronic disease prevention and control is yet to be fully recognized. The development and implementation of legal frameworks could broaden the range of effective public health strategies and provide valuable tools for the public health workforce. In order to expand the range of effective public health interventions, the government should use the law as a tool to achieve the goal of preventing chronic diseases and ameliorate the growing epidemic of obesity, heart disease, stroke, cancer and other chronic diseases and their risk factors.

  9. Physical Activity, Public Health, and Elementary Schools (United States)

    McKenzie, Thomas L.; Kahan, David


    Physical inactivity is a serious public health problem that is associated with numerous preventable diseases. Public health concerns, particularly those related to the increased prevalence of overweight, obesity, and diabetes, call for schools to become proactive in the promotion of healthy, physically active lifestyles. This article begins by…

  10. Public Health Ethics Related Training for Public Health Workforce: An Emerging Need in the United States

    Directory of Open Access Journals (Sweden)

    A Kanekar


    Full Text Available Background: Ethics is a discipline, which primarily deals with what is moral and immoral behavior. Public Health Ethics is translation of ethical theories and concepts into practice to address complex multidimensional public health problems. The primary purpose of this paper was to conduct a narrative literature review-addressing role of ethics in developing curriculum in programs and schools of public health, ethics-related instruction in schools and programs of public health and the role of ethics in developing a competent public health workforce. Methods: An open search of various health databases including Google scholar and Ebscohost yielded 15 articles related to use of ethics in public health practice or public health training and the salient features were reported.  Results: Results indicated a variable amount of ethics' related training in schools and programs of public health along with public health practitioner training across the nation. Bioethics, medical ethics and public health ethics were found to be subspecialties' needing separate ethical frameworks to guide decision making.Conclusions: Ethics based curricular and non-curricular training for emerging public health professionals from schools and programs of public health in the United States is extremely essential.  In the current age of public health challenges faced in the United States and globally, to have an ethically untrained public health force is arguably, immoral and unethical and jeopardizes population health.  There is an urgent need to develop innovative ethic based curriculums in academia as well as finding effective means to translate these curricular competencies into public health practice.

  11. Evaluation models and Brazilian health reform: a qualitative-participatory approach. (United States)

    Bosi, Maria Lúcia Magalhães; Mercado-Martinez, Francisco Javier


    Throughout the last years, there has been a growing interest in ongoing assessment proposals in Latin America, which are more far-reaching and not traditional. The aim of this study was to analyze the potential of qualitative-participatory evaluation in view of the challenge of strengthening health reforms in the region, particularly those considered progressive, such as the Brazilian case. There is the need to assess health reforms in a rigorous and permanent way, especially the incongruity when using normative models to evaluate health systems based on principles of universality, comprehensiveness, humanization and democratic management. In addition to the demand for assessment instruments and strategies, the Brazilian health reform requires the adoption of evaluation proposals and practices that are founded on other paradigms, distinct from the hegemonic one, in the sphere of health assessment. It is recommended that emerging evaluative models be used, such as those with a qualitative-participatory approach.

  12. The effects of public debt management on macroeconomic equilibrium: An analysis of the Brazilian economy

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    Cleomar Gomes da Silva


    Full Text Available The aim of this paper is to study the effects of public debt management on yield curve spreads in Brazil, in order to see possible impacts on the country's economic activity. State space models, together with Kalman Filter estimators, are used for the period ranging from June 2002 to February 2012. The results indicate that increases in the issuance of fixed rate linked bonds lead to increases on yield spreads and the longer the maturity, the longer the effect. The opposite occurs when there is an increased issuance of floating rate linked bonds. Therefore, a change in the structure of the Brazilian public debt is not neutral on the yield curve, with possible impacts on the country's macroeconomic balance.

  13. The PedsQL™ Oral Health Scale: feasibility, reliability and validity of the Brazilian Portuguese version

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    Bendo Cristiane B


    Full Text Available Abstract Background Oral and orofacial problems may cause a profound impact on children’s oral health-related quality of life (OHRQoL because of symptoms associated with these conditions that may influence the physical, psychological and social aspects of their daily life. The OHRQoL questionnaires found in the literature are very specific and are not able to measure the impact of oral health on general health domains. Consequently, the objective of this study was to evaluate the psychometric properties of the Portuguese version for Brazilian translation of the Pediatric Quality of Life Inventory™ (PedsQL™ Oral Health Scale in combination with the PedsQL™ 4.0 Generic Core Scales. Methods The PedsQL™ Oral Health Scale was forward-backward translated and cross-culturally adapted for the Brazilian Portuguese language. In order to assess the feasibility, reliability and validity of the Brazilian version of the instrument, a study was carried out in Belo Horizonte with 208 children and adolescents between 2 and 18 years-of-age and their parents. Clinical evaluation of dental caries, socioeconomic information and the Brazilian versions of the PedsQL™ Oral Health Scale, PedsQL™ 4.0 Generic Core Scales, Child Perceptions Questionnaire (CPQ11-14 and CPQ8-10 and Parental-Caregiver Perception Questionnaire (P-CPQ were administered. Statistical analysis included feasibility (missing values, confirmatory factor analysis (CFA, internal consistency reliability, and test-retest intraclass correlation coefficients (ICC of the PedsQL™ Oral Health Scale. Results There were no missing data for both child self-report and parent proxy-report on the Brazilian version of the PedsQL™ Oral Health Scale. The CFA showed that the five items of child self-report and parent proxy-report loaded on a single construct. The Cronbach's alpha coefficients for child/adolescent and parent oral health instruments were 0.65 and 0.59, respectively. The test

  14. Budget impact analysis of the percutaneous septal occluder for treatment of ostium secundum atrial septal defects in the Brazilian Unified National Health System

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    Kátia Marie Simões e Senna


    Full Text Available The aim of this study was to perform a budget impact analysis on the adoption of percutaneous occlusion of ostium secundum atrial septal defects in the Brazilian Unified National Health System. Costs were collected using micro-costing technique from medical records for each treatment technique (conventional surgery versus percutaneous septal occluder at a public federal hospital specialized in high-complexity cardiology. The analysis showed that expenditures associated with percutaneous occlusion were lower than with conventional surgery, and sensitivity analysis confirmed the cost reduction in several scenarios, showing a significant budget impact with a 30% adoption rate for the percutaneous occluder (savings of approximately 1.5 million dollars per year. The study indicates that the adoption of the percutaneous septal occluder would mean cost savings of approximately 3.5 million dollars for the Brazilian public health system.

  15. Public health nursing education in Russia. (United States)

    Ivanov, L Louise; Paganpegara, Galina


    The collapse of the Soviet Union in 1990 brought many changes to Russia, including changes in nursing education. However, the changes did not include content in public health nursing. Most health care in Russia is provided at the tertiary level in hospitals. Health promotion and health education are new concepts in Russia and are not well understood. When health education does occur, it is at the individual level, taught by physicians, and in response to new diagnoses. Health promotion at the primary level and with aggregates is not often practiced. Russia currently is in a demographic crisis where health indicators continue to decline. Russian nurses trained in public health principles, such as health promotion, health education, and providing primary and secondary prevention services at the population and aggregate level, can positively affect the current demographic crisis.

  16. Mobile Technologies and Public Health

    Centers for Disease Control (CDC) Podcasts


    In this podcast, Erin Edgerton, CDC, and Eric Holman, President of SmartReply, discuss why mobile technologies are an important communications tool for disseminating health messages.  Created: 9/5/2008 by National Center for Health Marketing (NCHM), Division of eHealth Marketing (DeHM).   Date Released: 1/12/2009.

  17. [Empowerment in the public health practice]. (United States)

    Chia, Shu-Li


    Public health personnel are the first-line workers of preventive care and medical services. In the face of rapid social and demographic changes, empowerment and on-job training have become important approaches to enhance the function of nurses. Health centers act like the "peripheral nerves" of the government healthcare system, as they must both reflect the needs of community residents and fully implement government mandated services. While widely distributed, health centers face manpower shortages and disorderly information collection and distribution systems. Empowerment and on-job training programs can enhance public heath staff knowledge in order to cope with heavy workloads and shift toward multi-dimensional development. This paper examines the experience of the New Taipei City Public Health Bureau in conducting health center empowerment programs from four perspectives, including personal cultivation and organizational cultivation. It was found that public health staff self-recognition of professional values can also be further strengthened through alliances within the community, and that establishing personal relationships with patients by "treating patients as relatives" was effective in realizing health center objectives. This paper also reminds agency supervisors that staff training is a critical management task. Health authorities should thus introduce in a timely manner organizational management, on-job training, service reengineering, and other related corporate philosophies; facilitate staff empowerment; consolidate core professional knowledge; and construct intellectual and social capital that meets health unit needs in order to enhance health center competitiveness and public health staff knowledge.

  18. Região Centro-Oeste se destaca na apreensão de medicamentos injetáveis encaminhados ao INCQS/FIOCRUZ Efficiency of public health enforcement actions in the Brazilian Middle-West region

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    Claudia Ribeiro Souto


    Full Text Available INTRODUÇÃO: Um estudo conduzido no INCQS com medicamentos injetáveis encaminhados para análise fiscal identificou um percentual de perdas (análise não realizada considerado excessivo. Uma tentativa então foi feita para identificar fatores associados a estas perdas. MÉTODOS: A existência de irregularidades na apreensão do medicamento (variável dependente foi investigada com relação à região de origem, motivo da apreensão e classificação ATC do medicamento (variáveis independentes. RESULTADOS: A região Norte contribuiu com apenas 2,2% do total de medicamentos encaminhados, 50% dos quais não puderam ser analisados. Apenas 1,4% dos medicamentos encaminhados pela região Centro-Oeste apresentaram irregularidades na apreensão. CONCLUSÃO: A eficiência da implementação de um programa de qualidade na Vigilância Sanitária do estado de Goiás foi detectada na etapa analítica, permitindo ao laboratório completar o ciclo de fiscalização.INTRODUCTION: A study conducted in the National Institute of Health Quality Control for the fiscal analysis of injectable drugs identified an excessive percentage of losses (analysis not performed. An attempt to identify factors associated with these losses was performed. METHODS: The presence of irregularities at the time of the apprehension of the drug (dependent variable was investigated in relation to the region where the drug came from, the reason for drug apprehension and the drug ATC classification (independent variables. RESULTS: The North region contributed with only 2.2% of all drugs sent to analysis, 50% of which could not be conducted. Only 1.4% of the drugs sent by the Middle-West region had problems in the apprehension process. CONCLUSION: An efficient implementation of a quality program in Health Surveillance in the state of Goiás was detected in the analytical phase, allowing the laboratory to complete the inspection cycle.

  19. Public health, GIS, and the internet. (United States)

    Croner, Charles M


    Internet access and use of georeferenced public health information for GIS application will be an important and exciting development for the nation's Department of Health and Human Services and other health agencies in this new millennium. Technological progress toward public health geospatial data integration, analysis, and visualization of space-time events using the Web portends eventual robust use of GIS by public health and other sectors of the economy. Increasing Web resources from distributed spatial data portals and global geospatial libraries, and a growing suite of Web integration tools, will provide new opportunities to advance disease surveillance, control, and prevention, and insure public access and community empowerment in public health decision making. Emerging supercomputing, data mining, compression, and transmission technologies will play increasingly critical roles in national emergency, catastrophic planning and response, and risk management. Web-enabled public health GIS will be guided by Federal Geographic Data Committee spatial metadata, OpenGIS Web interoperability, and GML/XML geospatial Web content standards. Public health will become a responsive and integral part of the National Spatial Data Infrastructure.

  20. Applications of health information exchange information to public health practice

    DEFF Research Database (Denmark)

    Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R.


    as an important justification for the US’ investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local public health practitioners participating in five different exchanges. Using......Health information exchange (HIE) can support several aspects of public health practice by increasing the availability, timeliness, and comprehensiveness individual-level patient information. The potential benefits to disease monitoring, disaster response, and other public health activities served...... qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. We derived the codes for the template analysis through a literature review. HIE supported public health activities consistent with expectations in the literature...

  1. Bridging radiology and public health: the emerging field of radiologic public health informatics. (United States)

    Mollura, Daniel J; Carrino, John A; Matuszak, Diane L; Mnatsakanyan, Zaruhi R; Eng, John; Cutchis, Protagoras; Babin, Steven M; Sniegoski, Carol; Lombardo, Joseph S


    Radiology and public health have an emerging opportunity to collaborate, in which radiology's vast supply of imaging data can be integrated into public health information systems for epidemiologic assessments and responses to population health problems. Fueling the linkage of radiology and public health include (i) the transition from analog film to digital formats, enabling flexible use of radiologic data; (ii) radiology's role in imaging across nearly all medical and surgical subspecialties, which establishes a foundation for a consolidated and uniform database of images and reports for public health use; and (iii) the use of radiologic data to characterize disease patterns in a population occupying a geographic area at one time and to characterize disease progression over time via follow-up examinations. The backbone for this integration is through informatics projects such as Systematized Nomenclature of Medicine Clinical Terms and RadLex constructing terminology libraries and ontologies, as well as algorithms integrating data from the electronic health record and Digital Imaging and Communications in Medicine Structured Reporting. Radiology's role in public health is being tested in disease surveillance systems for outbreak detection and bioterrorism, such as the Electronic Surveillance System for the Early Notification of Community-based Epidemics. Challenges for radiologic public health informatics include refining the systems and user interfaces, adhering to privacy regulations, and strengthening collaborative relations among stakeholders, including radiologists and public health officials. Linking radiology with public health, radiologic public health informatics is a promising avenue through which radiology can contribute to public health decision making and health policy.

  2. Human resources for health and decentralization policy in the Brazilian health system

    Directory of Open Access Journals (Sweden)

    Pierantoni Celia


    Full Text Available Abstract Background The Brazilian health reform process, following the establishment of the Unified Health System (SUS, has had a strong emphasis on decentralization, with a special focus on financing, management and inter-managerial agreements. Brazil is a federal country and the Ministry of Health (MoH, through the Secretary of Labour Management and Health Education, is responsible for establishing national policy guidelines for health labour management, and also for implementing strategies for the decentralization of management of labour and education in the federal states. This paper assesses whether the process of decentralizing human resources for health (HRH management and organization to the level of the state and municipal health departments has involved investments in technical, political and financial resources at the national level. Methods The research methods used comprise a survey of HRH managers of states and major municipalities (including capitals and focus groups with these HRH managers - all by geographic region. The results were obtained by combining survey and focus group data, and also through triangulation with the results of previous research. Results The results of this evaluation showed the evolution policy, previously restricted to the field of 'personnel administration', now expanded to a conceptual model for health labour management and education-- identifying progress, setbacks, critical issues and challenges for the consolidation of the decentralized model for HRH management. The results showed that 76.3% of the health departments have an HRH unit. It was observed that 63.2% have an HRH information system. However, in most health departments, the HRH unit uses only the payroll and administrative records as data sources. Concerning education in health, 67.6% of the HRH managers mentioned existing cooperation with educational and teaching institutions for training and/or specialization of health workers. Among them

  3. Light and shadow in the Brazilian graduate studies system in health

    Directory of Open Access Journals (Sweden)

    Reinaldo Guimarães


    Full Text Available The author discusses the challenges faced by the Brazilian graduate studies system with an emphasis on the human health sector. He identifies imbalances in the supply side of knowledge, a prime territory for graduate programs, while highlighting that a proper conceptualization of such imbalances is incomplete if it fails to incorporate the demands for scientific and technological knowledge coming from healthcare services, industry, and society. He draws on concepts from technology economics involved in the innovation systems approach. The article highlights the historical and current role of Brazilian Graduate Studies Coordinating Board (Capes, particularly its evaluation system, as an essential device for overcoming the existing challenges in Brazilian graduate studies. The author concludes by suggesting some conceptual adjustments in the agency’s work.

  4. Blogging, Mobile Phones, and Public Health

    Centers for Disease Control (CDC) Podcasts


    In this podcast, Erin Edgerton, CDC, and Craig Lefebvre, George Washington University discuss social media, blogs, and mobile technologies and how they can be used for public health.  Created: 5/15/2009 by National Center for Health Marketing (NCHM), Division of eHealth Marketing (DeHM).   Date Released: 6/30/2009.

  5. Political Science Theory for Public Health Practice (United States)

    Watson, Tyler


    Community health educators are well versed in the behavior sciences, including intervention theories. However, most public health professionals are not familiar with the policy theories related to political advocacy. Because health educators are engaging in policy advocacy more frequently, and as a result of the profession including policy…

  6. SUS, política pública de Estado: seu desenvolvimento instituído e instituinte e a busca de saídas The Brazilian Unified Health System (SUS, State Public Policy: Its institutionalized and future development and the search for solutions

    Directory of Open Access Journals (Sweden)

    Nelson Rodrigues dos Santos


    Full Text Available O texto resgata significados do movimento da reforma sanitária e do movimento municipal de saúde no contexto dos anos 70 e 80, sua força social, política e inovadora na reconstrução democrática na época. A seguir constata que a implementação das diretrizes constitucionais, regulamentadas em 1.990 pelas Leis 8080/90 e 8142/90, vem sendo marcada nos últimos 22 anos por quatro pesados e crescentes obstáculos impostos pela política de Estado a todos os governos: subfinanciamento federal, subsídios federais ao mercado de planos privados de saúde, resistência à reforma da estrutura gerencial estatal da prestação de serviços e, entrega do gerenciamento de estabelecimentos públicos a entes privados. O SUS incluiu no sistema público de saúde metade da população antes excluída, mas estes obstáculos mantêm a cobertura da atenção básica focalizada abaixo da linha de pobreza e com baixa resolutividade. Conclui que a real política de Estado para a saúde nesses 22 anos vem priorizando a criação e a expansão do mercado dos planos privados de saúde para os direitos do consumidor, e secundarizando a efetivação das diretrizes constitucionais para os direitos humanos de cidadania.This paper redeems the significance of the health reform movement and the municipal healthcare movement in the context of the 1970s and 1980s, and its social, politic and innovative power in the democratic reconstruction of the day. It then notes that the implementation of the constitutional guidelines, regulated in 1990 by Laws 8080/90 and 8142/90, has been characterized in the last 22 years by four major and mounting obstacles imposed by State policy on all governments: federal underfunding; federal subsidies to the private health plan market; resistance to reform of the State management structure of service provision; and the handing over of administration of public facilities to private entities. The Brazilian Unified Health System (SUS included

  7. Financiamento, gasto público e gestão dos recursos em saúde: o cenário de um estado brasileiro Funding, public spending and management of health resources: the current situation in a Brazilian State

    Directory of Open Access Journals (Sweden)

    Valéria Rodrigues Leite


    Full Text Available O artigo aborda a temática do financiamento e o processo de descentralização tendo como objetivo examinar a composição, a direção e a gestão dos recursos na área da saúde. A amostra investigada foi constituída por 14 municípios do Estado do Rio Grande do Norte. A pesquisa envolveu coleta de dados referente às transferências, recursos próprios municipais e gastos com atenção básica. Na análise da gestão foi realizado um levantamento junto aos dirigentes locais e conselheiros. Observa-se que o financiamento do Sistema Único de Saúde se faz às expensas das transferências federais e receitas municipais, com pequena participação dos recursos estaduais. A direção dos gastos tem privilegiado a atenção básica. No processo de gestão, verifica-se centralização das ações nas prefeituras. As secretarias municipais e os conselhos cumprem em parte a legislação e apresentam dificuldades na autonomia e o controle social. Os resultados mostram que os instrumentos de planejamento e gestão são limitados em função das contradições presentes no contexto institucional, político e cultural no âmbito regional.This article investigates the issue of funding and the decentralization process in order to examine the composition, application and management of resources in the healthcare area. The sample surveyed involved 14 municipalities in the state of Rio Grande do Norte, Brazil. The research involved data gathering of financial transfers, the municipality's own resources and primary healthcare expenses. Management analysis included a survey of local managers and counselors. It was seen that the Unified Health System is funded mainly by federal transfers and municipal revenues and to a far lesser extent by state resources. Funds have been applied predominantly in primary healthcare. The management process saw centralization of actions in the city governments. Municipal secretarial offices and councils comply partially with

  8. The Forum for Defence of the Brazilian Unified Health System (Sistema Único de Saúde) and its role in building community participation in the fight against the privatization of health. (United States)

    de Lara, Lutiane; Guareschi, Neuza Maria de Fátima


    Based on a Foucauldian framework, this article discusses the involvement of the Forum for Defence of the Sistema Único de Saúde in the fight against health care privatization. Community participation is a locus of experience that produces subjects implicated in the production of public health care. The locus of experience in this instance derives from the rejection of private elements that historically have been part of Brazilian public policies. It is an experience that produces workers and service users as agents able to defend the public system and endowed with instituting power.

  9. The Double-entry Bookkeeping Committee of 1914 and the Brazilian Public Accounting System

    Directory of Open Access Journals (Sweden)

    Tiago Villac Adde


    Full Text Available The history of Brazilian accounting has not been explored at length. Through a historical survey, this article presents the history of the Double-entry Bookkeeping Committee of 1914. After the Proclamation of the Republic was announced in 1889, the government started to expand its administrative bodies, necessitating the introduction of a bureaucracy able to perform new functions. In the same period, Brazil experienced a strong economic development with the development of its coffee industry. In 1905, under the leadership of Carlos de Carvalho, São Paulo State Treasury bookkeeping tasks were introduced under a double-entry bookkeeping system and through accrual and financial accounting. Double-entry bookkeeping practices in the federal public accounting system, although enshrined in law since 1808, were only fully realized after the creation of the Double-entry Bookkeeping Committee in 1914. In that same year, due to the negotiation of a second funding loan, English creditor bank auditors requested a balance of the National Treasury from the Minister of Finance Rivadávia Corrêa. Because the balance had not been prepared in eight years, the Double-entry Bookkeeping Committee was established in June of 1914, and this body completed a technical audit of Revenues and Expenditures. The committee also conducted the state administration's first Asset and Liability audit since the colonial era. The Double-entry Bookkeeping Committee of 1914 spearheaded changes to the Brazilian public accounting system, including the creation of the Public Accounting Code in 1922 and the approval of Central Accounting Office of the Republic regulation in 1924, strengthening and ascribing perpetuity to practices adopted after 1914.

  10. Innovative statistical methods for public health data

    CERN Document Server

    Wilson, Jeffrey


    The book brings together experts working in public health and multi-disciplinary areas to present recent issues in statistical methodological development and their applications. This timely book will impact model development and data analyses of public health research across a wide spectrum of analysis. Data and software used in the studies are available for the reader to replicate the models and outcomes. The fifteen chapters range in focus from techniques for dealing with missing data with Bayesian estimation, health surveillance and population definition and implications in applied latent class analysis, to multiple comparison and meta-analysis in public health data. Researchers in biomedical and public health research will find this book to be a useful reference, and it can be used in graduate level classes.

  11. The stigmatization dilemma in public health policy

    DEFF Research Database (Denmark)

    Ploug, Thomas; Holm, Søren; Gjerris, Mickey


    Background Multi-resistant bacteria pose an increasing and significant public health risk. As awareness of the severity of the problem grows, it is likely that it will become the target for a range of public health interventions. Some of these can intentionally or unintentionally lead...... to stigmatization of groups of citizens. Discussion The article describes the phenomenon of stigmatization within the health care area by discussing the concept in relation to AIDS and psychiatric diagnosis. It unfolds the ethical aspects of using stigmatization as a public health instrument to affect unwanted...... behaviours e.g. smoking. Moreover it discusses stigmatization as an unintended albeit expected side effect of public health instruments potentially used to counter the challenge of multi-resistant bacteria with particular reference to the Danish case of the growing problems with Methicillin...

  12. Impact of public health research in Greenland

    DEFF Research Database (Denmark)

    Bjerregaard, Peter; Curtis, Tine


    research. Two health surveys have been carried out in Greenland by the National Institute of Public Health, and a follow-up is being planned together with the Directorate of Health. The results have been widely used by politicians, administrators, and health care professionals.......In 1992, the Greenland Home Rule Government took over the responsibility for health care. There has since been a growing cooperation between the Directorate of Health and researchers in Denmark and Greenland, for instance by the Directorate supporting workshops and funding a chair in health...

  13. Applications of health information exchange information to public health practice

    DEFF Research Database (Denmark)

    Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R.


    qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. We derived the codes for the template analysis through a literature review. HIE supported public health activities consistent with expectations in the literature...

  14. Advancing Public Health through Continuing Education of Health Care Professionals (United States)

    Hudmon, Karen Suchanek; Addleton, Robert L.; Vitale, Frank M.; Christiansen, Bruce A.; Mejicano, George C.


    This article describes how the CS2day (Cease Smoking Today) initiative positioned continuing education (CE) in the intersection between medicine and public health. The authors suggest that most CE activities address the medical challenges that clinicians confront, often to the neglect of the public health issues that are key risk factors for the…

  15. Public health emergencies and the public health/managed care challenge. (United States)

    Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra


    The relationship between insurance and public health is an enduring topic in public health policy and practice. Insurers share certain attributes with public health. But public health agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and public health become particularly evident during periods of public health emergency, when a public health agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, public health agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the public health system. Critical issues of state and federal policy arise in the context of the public health/insurance relations during public health emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of public health emergency response.

  16. Global health competencies according to nursing faculty from Brazilian higher education institutions

    Directory of Open Access Journals (Sweden)

    Carla Aparecida Arena Ventura


    Full Text Available OBJECTIVES: to identify the agreement of faculty affiliated with Brazilian higher education institutions about the global health competencies needed for undergraduate nursing students' education and whether these competencies were covered in the curriculum offered at the institution where they were teaching.METHOD: exploratory-descriptive study, involving 222 faculty members who answered the Brazilian version of the "Questionnaire on Core Competencies in Global Health", made available electronically on the website Survey Monkey.RESULTS: participants predominantly held a Ph.D. (75.8%, were women (91.9% and were between 40 and 59 years of age (69.3%. The mean and standard deviation of all competencies questioned ranged between 3.04 (0.61 and 3.88 (0.32, with scores for each competency ranging from 1 "strongly disagree" to 4 "strongly agree". The results demonstrated the respondents' satisfactory level of agreement with the global health competencies.CONCLUSIONS: the study demonstrated a high mean agreement level of the nursing faculty from Brazilian HEI with the global health competencies in the questionnaire. The curricula of the HEI where they teach partially address some of these. The competencies in the domain "Globalization of health and health care" are the least addressed.


    Directory of Open Access Journals (Sweden)

    Milton de Abreu Campanario


    Full Text Available The text is the part of public policy of a larger research project on Brazilian Outward ForeignDirect Investment - OFDI. The text analyses the viability to adopt policies to enhance FDI,particularly outward. Based on statistical data and on literature review, the policy agenda framesthe underling questions surrounding the theme. There is not yet a theoretical framework to dealwith emergent countries’ FDI and related policies. There exist strong evidences that capital flowsthrough FDI generate externalities in the following domains: macroeconomics, microeconomicsand foreign relations particularly in areas related to industrial organization and innovation. Thetheoretical proposition is that international capital flows are compatible to monetary stability,commercial openness, investment promotion and industrial innovation policies. A betterpositioning of national enterprises internationally may result in growing partnership within theforeign environment. Brazil has not a set of policies to deal with inward and outward BrazilianFDI flows. These policies do not necessarily jeopardize macroeconomic policy and the relatedmonetary and currency stabilization goals. It contends that FDI stimulus by means of publicpolicies may contribute not just to a better competitiveness and innovation of Brazilianenterprises, but also assure a balanced growing and economic structural change.

  18. Global public health and the information superhighway. (United States)

    LaPorte, R E


    Applications of networking to health care have focused on the potential of networking to transmit data and to reduce the cost of health care. In the early 198Os networks began forming among academic institutions; one of them was Bitnet. During the 1980s Internet evolved, which joined diverse networks, including those of governments and industry. The first step is to connect public health organizations such as ministries of health, the World Health Organization, the Pan-American Health Organization, and the United Nations. Computer-based telecommunication will vastly increase effective transmission of information. Networking public health workers in local health departments, academia, governments, industry, and private agencies, will bring great benefits. One is global disease telemonitoring: with new epidemiological techniques such as capture-recapture, accurate estimates of incidences of important communicable and non-communicable diseases can now be obtained. Currently all countries in the Americas except Haiti are connected through Internet. No systematic integration of telecommunication and public health systems across countries has occurred yet. On-line vital statistics could be usable almost instantaneously to facilitate monitoring and forecasting of population growth and the health needs of mothers and children. Linking global disease telemonitoring (morbidity data for non-communicable diseases) with environmental data systems would considerably improve understanding of the environmental determinants of disease. Internet is already linked to the National Library of Medicine through Bitnis. Computer based distance education is rapidly improving through E-mail searches. Reading materials, video, pictures, and sound could be transmitted across huge distances for low costs. Hundreds of schools are already networked together. On-line electronic journals and books have the potential for instantaneous dissemination of free information through gopher servers. Global

  19. Emerging arboviruses and public health challenges in Brazil (United States)

    Lima-Camara, Tamara Nunes


    ABSTRACT Environmental modification by anthropogenic actions, disordered urban growth, globalization of international exchange and climate change are some factors that help the emergence and dissemination of human infectious diseases transmitted by vectors. This review discusses the recent entry of three arboviruses in Brazil: Chikungunya, West Nile, and Zika virus, focusing on the challenges for the Country’s public health. The Brazilian population is exposed to infections caused by these three arboviruses widely distributed on the national territory and associated with humans. Without effective vaccine and specific treatment, the maintainance and integration of a continuos entomological and epidemiological surveillance are important so we can set methods to control and prevent these arboviruses in the Country. PMID:27355468

  20. Emerging arboviruses and public health challenges in Brazil

    Directory of Open Access Journals (Sweden)

    Tamara Nunes Lima-Camara


    Full Text Available ABSTRACT Environmental modification by anthropogenic actions, disordered urban growth, globalization of international exchange and climate change are some factors that help the emergence and dissemination of human infectious diseases transmitted by vectors. This review discusses the recent entry of three arboviruses in Brazil: Chikungunya, West Nile, and Zika virus, focusing on the challenges for the Country’s public health. The Brazilian population is exposed to infections caused by these three arboviruses widely distributed on the national territory and associated with humans. Without effective vaccine and specific treatment, the maintainance and integration of a continuos entomological and epidemiological surveillance are important so we can set methods to control and prevent these arboviruses in the Country.

  1. Integrating Advanced Molecular Technologies into Public Health. (United States)

    Gwinn, Marta; MacCannell, Duncan R; Khabbaz, Rima F


    Advances in laboratory and information technologies are transforming public health microbiology. High-throughput genome sequencing and bioinformatics are enhancing our ability to investigate and control outbreaks, detect emerging infectious diseases, develop vaccines, and combat antimicrobial resistance, all with increased accuracy, timeliness, and efficiency. The Advanced Molecular Detection (AMD) initiative has allowed the Centers for Disease Control and Prevention (CDC) to provide leadership and coordination in integrating new technologies into routine practice throughout the U.S. public health laboratory system. Collaboration and partnerships are the key to navigating this transition and to leveraging the next generation of methods and tools most effectively for public health.

  2. Health, nutrition, and public policy

    NARCIS (Netherlands)

    Frenk, J.; Coutre, le J.; Bladeren, van P.J.; Blum, S.


    The relationship between health and the economy is complex and hardly a matter of unidirectional cause and consequence. With health increasingly being understood as a stimulus for the economy, nutrition directly assumes the status of an economic identifier. This paper discusses the growing complexit

  3. Qualitative research and dental public health

    Directory of Open Access Journals (Sweden)

    Roslind Preethi George


    Full Text Available The use of Qualitative Research (QR methods are now getting common in various aspects of health and healthcare research and they can be used to interpret, explore, or obtain a deeper understanding of certain aspects of human beliefs, attitudes, or behavior through personal experiences and perspectives. The potential scope of QR in the field of dental public health is immense, but unfortunately, it has remained underutilized. However, there are a number of studies which have used this type of research to probe into some unanswered questions in the field of public health dentistry ranging from workforce issues to attitudes of patients. In recent health research, evidence gathered through QR methods provide understanding to the social, cultural, and economic factors affecting the health status and healthcare of an individual and the population as a whole. This study will provide an overview of what QR is and discuss its contributions to dental public health research.

  4. Elderly health and implementation of the Brazilian National Health Policy for Elderly Persons on the performed actions in basic healthcare

    Directory of Open Access Journals (Sweden)



    Full Text Available The Brazilian National Health Policy for Elderly Persons (PNSPI – in Portuguese was formulated by the Ministry of Health through Ordinance No. 2.528/2006 in line with the 1988 Brazilian Constitution. The study investigated whether municipalities from the South region of the State of Santa Catarina had knowledge and applied the PNSPI, on the performed actions in basic healthcare, especially on the Units of Family Healthcare Services based on what the Constitution and the Statute of the Elderly comprise. A deductive method with a qualitative approach and a descriptive research were used. As a result, some difficulties experienced by the research subjects related to two important points of policies and strategies of PNSPI were identified: the lack of a planned policy and of a continuous health education for the elderly; and the lack of a stimulating exercise of social control, whether in the health sector, or in the Municipal Council of Elderly People.


    Directory of Open Access Journals (Sweden)

    Marcella Costa RADAEL


    Full Text Available Reproduction is a fundamental part of life being and studies related to fish reproduction have been much accessed. The aim of this study was to perform a bibliometric analysis in intend to identify trends in this kind of publication. During June 2013, were performed searches on Scopus Database, using the term “fish reproduction”, being compiled and presented information related to the number of publications per year, number of publications by country, publications by author, by journal, by institution and most used keywords. Based on the study, it was possible to obtain the following results: Brazil occupies a highlight position in number of papers, being that the Brazilian participation compared to worldwide publishing production is having an exponential increase; in Brazil, there is a high concentration of articles when concerning the top 10 authors and institutions. The present study allows verifying that the term “fish reproduction” has been focused by many scientific papers, being that in Brazil there is a special research effort related to this subject, especially in the last few years. The main contribution concerns to the use of bibliometric methods to describe the growth and concentration of researches in the area of fishfarm and reproduction.

  6. Comparison of neuropsychological performance between students from public and private Brazilian schools. (United States)

    Casarin, Fabíola Schwengber; Wong, Cristina Elizabeth Izábal; Parente, Maria Alice de Mattos Pimenta; de Salles, Jerusa Fumagalli; Fonseca, Rochele Paz


    Neuropsychological assessment reveals that certain cognitive changes that take place during the neural development process may be associated with biopsychosocial issues. A substantial body of research has focused on cognitive development in children and adults, but few such studies have been carried out on adolescents. Therefore, research into the processing of neuropsychological functions in adolescents, taking into account the role of major socio-cultural factors such as school type (public vs. private), is highly relevant. The present study sought to assess whether differences in neuropsychological development exist between adolescent students of public (government-funded) and private schools. A total of 373 grade-matched students between the ages of 12 and 18, 190 from public schools and 183 from private schools, took part in the study. All subjects had no self-reported neurologic or psychiatric conditions and sensory disorders. The NEUPSILIN Brazilian Brief Neuropsychological Assessment Battery was administered to this sample. Comparison of mean scores (one-way ANCOVA with socioeconomic score and age as covariates) showed that adolescents attending private schools generally outperformed their public-school peers in tasks involving sustained attention, memory (working and visual), dictated writing, and constructional and reflective abilities. We conclude that school type should be taken into account during standardization of neuropsychological assessment instruments for adolescent and, probably, child populations.

  7. Defining and Developing Global Public Health Course for Public Health Graduates

    Directory of Open Access Journals (Sweden)

    Rajendra eKarkee


    Full Text Available Global Public Health is increasingly being seen as a speciality field within the university education of Public Health. However, the exact meaning of Global Public Health is still unclear resulting in varied curricula and teaching units among universities. The contextual differences between high and low and middle income countries, and the process of globalisation need to be taken into account while developing any global public health course.Global Public Health and Public Health are not separable and Global Public Health often appears as an extension of Public Health in the era of globalisation and interdependence. Though Global Public Health is readily understood as health of global population, it is mainly practised as health problems and their solutions set within low and middle income countries. Additional specialist competencies relevant to the context of low and middle income countries are needed to work in this field. Although there can be a long list of competencies relevant to this broad topic, available literature suggests that knowledge and skills related with ethics and vulnerable groups/issues; globalisation and its impact on health; disease burden; culture, society and politics; and management are important.

  8. World Health Organization and disease surveillance: Jeopardizing global public health? (United States)

    Blouin Genest, Gabriel


    Health issues now evolve in a global context. Real-time global surveillance, global disease mapping and global risk management characterize what have been termed 'global public health'. It has generated many programmes and policies, notably through the work of the World Health Organization. This globalized form of public health raises, however, some important issues left unchallenged, including its effectiveness, objectivity and legitimacy. The general objective of this article is to underline the impacts of WHO disease surveillance on the practice and theorization of global public health. By using the surveillance structure established by the World Health Organization and reinforced by the 2005 International Health Regulations as a case study, we argue that the policing of 'circulating risks' emerged as a dramatic paradox for global public health policy. This situation severely affects the rationale of health interventions as well as the lives of millions around the world, while travestying the meaning of health, disease and risks. To do so, we use health surveillance data collected by the WHO Disease Outbreak News System in order to map the impacts of global health surveillance on health policy rationale and theory.

  9. Integrating child health information systems in public health agencies. (United States)

    Bara, Debra; McPhillips-Tangum, Carol; Wild, Ellen L; Mann, Marie Y


    Public health agencies at state and local levels are integrating information systems to improve health outcomes for children. An assessment was conducted to describe the extent to which public health agencies are currently integrating child health information systems (CHIS). Using online technology information was collected, to assess completed and planned activities related to integration of CHIS, maturity of these systems, and factors that influence decisions by public health agencies to pursue integration activities. Of the 39 public health agencies that participated, 18 (46%) reported already integrating some or all of their CHIS, and 13 (33%) reported to be planning to integrate during the next 3 years. Information systems most commonly integrated include Early Hearing Detection and Intervention (EHDI), immunization, vital records, and Newborn Dried Bloodspot Screening (NDBS). Given the high priority that has been placed on using technology to improve health status in the United States, the emphasis on expanding the capability for the electronic exchange of health information, and federal support for electronic health records by 2014, public health agencies should be encouraged and supported in their efforts to develop, implement, and maintain integrated CHIS to facilitate the electronic exchange of health information with the clinical healthcare sector.

  10. [Thinking health under the perspective of Brazilian immigrants living in Portugal]. (United States)

    Paredes Moreira, Maria Adelaide Silva; Silva, Antonia Oliveira; Feitosa Alves, Maria do Socorro Costa; Jesuino, Jorge Correia; Tura, Luiz Fernando Rangel


    This study aimed at determining the social representations on health and immigrants constructed by Brazilians. Samples consisted of one hundred Brazilian male and female immigrants living in Lisbon, Portugal. The technique of free evocation, which uses as inductive words "health "and "immigrant", were used for data collection. Data were submitted to analyses using the software EVOC (Ensemble de Programmes Permettant L'analyse des Evocations). We detected the presence of the psycho-affective and social-interaction dimensions as to health, whereas as to "immigrant", individuals related it to a difficult experience that generates pain, prejudice, and homesickness, where the love for the family are the reason to immigrate to obtain better life conditions.

  11. Electromagnetic Fields and Public Health: Mobile Phones (United States)

    ... sheets Fact files Questions & answers Features Multimedia Contacts Electromagnetic fields and public health: mobile phones Fact sheet N° ... an estimated 6.9 billion subscriptions globally. The electromagnetic fields produced by mobile phones are classified by the ...

  12. Public health nutrition in Latin America. (United States)

    Solomons, Noel W


    An inquiry into options for Masters-level training and into attitudes and perceptions among a convenience sample of nutrition students and professionals from 11 countries suggests that the term, "Public Health Nutrition", as such, is poorly represented and poorly understood in the Latin American region. At least six countries (Brazil, Chile, Cuba, Mexico, Peru, Puerto Rico) at seven sites have Masters programs to provide training for nutrition in a public health context or public health with an emphasis in nutrition. Exploring alliances from the Americas with the formal PHN discipline emerging in Europe should enrich the mutual perspective on curriculum design. However, the form and context of postgraduate training in Latin America must consider first and foremost its own job-markets, diverse public health needs, and resource allocations in building or transforming training programs.

  13. VT - Environmental Public Health Tracking Data Explorer (United States)

    Vermont Center for Geographic Information — What is Environmental Public Health Tracking?Tracking is an ongoing national effort to better understand how environmental hazards can contribute to certain...

  14. [Drug use in the public health debate]. (United States)

    Tirado-Otálvaro, Andrés Felipe


    This article addresses illegal drug use within the current debate in traditional public health and in proposals from Latin America, while emphasizing the need to approach the issue from an alternative public health perspective centered on individual users, groups, and social movements as protagonists. This counterhegemonic approach thus aims to orient the discussion on the need for inclusive and democratic public policies. Illegal drug use has been addressed from various perspectives: clinical medicine, viewing it as a problem that generates mental disorders and infectious diseases, both through risky sexual practices and/or use of injecting paraphernalia; from a legal perspective, as a problem related to delinquency; and according to traditional public health, as a problem that generates school dropout and work absenteeism and increases the demand on health services, in addition to increasing violence and death. However, not all forms of drug consumption involve problematic use, nor do they all trigger disorders related to substance use.

  15. Celebrating Leadership in Public Health and Medicine (United States)

    ... Navigation Bar Home Current Issue Past Issues Celebrating Leadership in Public Health and Medicine Friends of the ... a Distinguished Medical Science Award for his global leadership in cancer research and the development of combination ...

  16. Conceptualizing ORGANIZATIONAL HEALTH - Public health management and leadership perspectives

    DEFF Research Database (Denmark)

    Orvik, Arne

    The thesis introduces a new conceptual model of organizational health and discusses its implications for public health management and leadership. It is developed with reference to organizational theories and ideologies, including New Public Management, the use of which has coincided with increasing...... workplace health problems in health care organizations. The model is based on empirical research and theories in the fields of public health, health care organization and management, and institutional theory. It includes five dimensions and defines organizational health in terms of how an organization...... is able to cope with the tensions associated with diverse values and competing institutional logics. This definition calls for an understanding of the tensions between values associated with quality, efficiency and integrity, and a dialectical perspective when attempting to assess the integration as well...

  17. Assessment of Public Health Infrastructure to Determine Public Health Preparedness (United States)


    62 Confirmed Positive 39 92 42 Residences Abated 40 92 43 Rabies and Zoonosis Control 2 Animal Bite Investigation3 1,280 … … Pets...Shops Inspected 9 9 100 Notes: 1 LHER: Local Health Evaluation Report 2 Zoonosis : Diseases transmitted from animals to humans 3 Number of...5,984 5,984 Childhood Lead Poisoning Risk assessments 2 466 932 Residences abated 8 40 320 Rabies and Zoonosis Control 2 Animal

  18. Corporate philanthropy, lobbying, and public health policy. (United States)

    Tesler, Laura E; Malone, Ruth E


    To counter negative publicity about the tobacco industry, Philip Morris has widely publicized its philanthropy initiatives. Although corporate philanthropy is primarily a public relations tool, contributions may be viewed as offsetting the harms caused by corporate products and practices. That such donations themselves have harmful consequences has been little considered. Drawing on internal company documents, we explored the philanthropy undertaken as part of Philip Morris's PM21 image makeover. Philip Morris explicitly linked philanthropy to government affairs and used contributions as a lobbying tool against public health policies. Through advertising, covertly solicited media coverage, and contributions to legislators' pet causes, Philip Morris improved its image among key voter constituencies, influenced public officials, and divided the public health field as grantees were converted to stakeholders.



    Bianchi, Márcia; Lemmertz, Caroline; Raimundini, Simone Leticia; Vendruscolo, Maria Ivanice


    Derivative minimize the risks of companies operating with foreign currencies and future sales. The use of these financial instruments is increasing through many Brazilian companies that don´t evidence for the lack of effective regulation. The publicly traded companies must show in the notes the risks involved in the operations, the market value and the criteria and assumptions to determine this value of financial instruments and the policies of operation and control of operations. Therefore, ...

  20. Dental public health in India: An insight (United States)

    Gambhir, Ramandeep Singh; Kaur, Amanpreet; Singh, Arshdeep; Sandhu, Anmol Rattan Singh; Dhaliwal, Angad Prakash Singh


    Oral diseases are a major public health problem, and their burden is on increase in many low- and middle-income countries. Dental public health (DPH) aims to improve the oral health of the population through preventive and curative services. However, its achievements in India are being questioned probably because of lack of proficiency and skill among DPH personnel. The literature search for the present study was conducted utilizing various search engines and electronic databases such as PubMed and MEDLINE. Documents related to the Central and State Governments of India were also considered. Finally, 26 articles were selected for the present study from which relevant information can be extracted. The present study focuses on some of the important aspects relating to DPH in India such as priority for oral health, DPH workforce and curriculum, utilization of DPH personnel in providing primary oral health care, role of mobile dental vans, and research in DPH. It was concluded that more attention should be given toward preventive oral health care by employing more number of public health dentists in public sector, strengthening DPH education and research, and combining oral health programs with general health-care programs.

  1. Development of Systematic Knowledge Management for Public Health: A Public Health Law Ontology (United States)

    Keeling, Jonathan


    The Institute of Medicine has stated that legal structures and the authority vested in health agencies and other partners within the public health system are essential to improving the public's health. Variation between the laws of different jurisdictions within the United States allows for natural experimentation and research into their…

  2. Law, liability, and public health emergencies. (United States)

    Hoffman, Sharona; Goodman, Richard A; Stier, Daniel D


    According to many experts, a public health emergency arising from an influenza pandemic, bioterrorism attack, or natural disaster is likely to develop in the next few years. Meeting the public health and medical response needs created by such an emergency will likely involve volunteers, health care professionals, public and private hospitals and clinics, vaccine manufacturers, governmental authorities, and many others. Conducting response activities in emergency circumstances may give rise to numerous issues of liability, and medical professionals and other potential responders have expressed concern about liability exposure. Providers may face inadequate resources, an insufficient number of qualified personnel, overwhelming demand for services, and other barriers to providing optimal treatment, which could lead to injury or even death in some cases. This article describes the different theories of liability that may be used by plaintiffs and the sources of immunity that are available to public health emergency responders in the public sector, private sector, and as volunteers. It synthesizes the existing immunity landscape and analyzes its gaps. Finally, the authors suggest consideration of the option of a comprehensive immunity provision that addresses liability protection for all health care providers during public health emergencies and that, consequently, assists in improving community emergency response efforts.

  3. Globalization of public health law and ethics. (United States)

    Sohn, Myongsei


    The Constitution of the World Health Organization (1946) states that the "enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social position." The international legal framework for this right was laid by the Universal Declaration of Human Rights (1948) and reaffirmed in the International Covenant on Economic, Social, and Cultural Rights (1966) and the Declaration of Alma-Ata (1978). In recent years, the framework has been developed on 10 key elements: national and international human rights, laws, norms, and standards; resource constraints and progressive realization; obligations of immediate effect; freedoms and entitlements; available, accessible, acceptable, and good quality; respect, protect, and fulfill; non-discrimination, equality, and vulnerability; active and informed participation; international assistance and cooperation; and monitoring and accountability. Whereas public health law plays an essential role in the protection and promotion of the right to health, the emergence of SARS (2003) highlighted the urgent need to reform national public health laws and international obligations relating to public health in order to meet the new realities of a globalized world, leading to the WHO Framework Convention on Tobacco Control (2003) and the revision of the WHO International Health Regulations (2005). The Asian Institute for Bioethics and Health Law, in conjunction with the Republic of Korea's Ministry of Health and Welfare and the WHO International Digest of Health Legislation, conducted a comparative legal analysis of national public health laws in various countries through a project entitled Domestic Profiles of Public/Population Health Legislation (2006), which underscored the importance of recognizing the political and social contexts of distinct legal cultures, including Western, Asian, Islamic, and African.

  4. Pharmaceutical lobbying in Brazil: a missing topic in the public health research agenda. (United States)

    Paumgartten, Francisco José Roma


    In the US, where registration of lobbyists is mandatory, the pharmaceutical industry and private health-care providers spend huge amounts of money seeking to influence health policies and government decisions. In Brazil, where lobbying lacks transparency, there is virtually no data on drug industry expenditure to persuade legislators and government officials of their viewpoints and to influence decision-making according to commercial interests. Since 1990, however, the Associação da Indústria Farmacêutica de Pesquisa (Interfarma - Pharmaceutical Research Industry Association), Brazilian counterpart of the Pharmaceutical Research and Manufacturers of America (PhRMA), main lobbying organization of the US pharmaceutical industry, has played a major role in the advocacy of interests of major drug companies. The main goals of Interfarma lobbying activities are: shortening the average time taken by the Brazilian regulatory agency (ANVISA) to approve marketing authorization for a new drug; making the criteria for incorporation of new drugs into SUS (Brazilian Unified Health System) more flexible and speeding up technology incorporation; changing the Country's ethical clearance system and the ethical requirements for clinical trials to meet the need of the innovative drug industry, and establishing a National Policy for Rare Diseases that allows a prompt incorporation of orphan drugs into SUS. Although lobbying affects community health and well-being, this topic is not in the public health research agenda. The impacts of pharmaceutical lobbying on health policies and health-care costs are of great importance for SUS and deserve to be investigated.

  5. Internal Communication in the Public Management: The Case of a Brazilian Federal Public Authority

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    Priscila Reinaldo Marson


    Full Text Available The intention of this article is to present a case study on the adoption and use of new channels of internal communication in a federal public autarchy. The study was conducted at the National Institute of Social Security, in São Paulo, between July 2008 and July 2009, and aimed to monitor the period in which a new internal communication plan was developed and implemented in its initial phase. The research methodology used was the case study, consisting of documentary analysis, field research and in-depth interviews conducted with the institution’s public employees. As a result, it was possible to observe the internal resistance and the difficulties encountered in the management of the new plan. Among its conclusions, the study highlights the need for a previous study on the conditions of relationships and practices developed in a public service unit at the adoption of new communication tools. It also highlights the importance of planning and management actions in the implementation of the intended communication actions, including internal marketing efforts to sensitize users about the meaning and importance of internal communication in promoting greater agility and efficiency in the workplace, in order to offer best public services to users.

  6. Functional health literacy and healthy eating: Understanding the brazilian food guide recommendations

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    Maria Auristela Magalhães Coelho


    Full Text Available Objective: To assess the relationship between the functional health literacy of Unified Heath System users and the understanding of food servings in the pocket version of the Brazilian Food Guide. Methods: Functional health literacy was assessed by the Brief Test of functional health literacy. Two dialogue rounds were conducted with patients with adequate functional health literacy (Group 1 and inadequate functional health literacy (Group 2. The dialogues were recorded and analyzed according to the discourse of the collective subject. Results: Most (58.0% users had inadequate functional health literacy. Five core areas were identified: understands serving sizes; does not understand serving sizes; serving sizes are confusing; unfamiliar/uncommon foods; small letters. Group 2 had more trouble understanding. Conclusion: Difficulty understanding hinders health promotion. Individuals need to have access to educational materials that are easier to understand and developed taking their functional health literacy into account.

  7. Noise exposure and public health

    NARCIS (Netherlands)

    Passchier-Vermeer, W.; Passchier, W.F.


    Exposure to noise constitutes a health risk. There is sufficient scientific evidence that noise exposure can induce hearing impairment, hypertension and ischemic heart disease, annoyance, sleep disturbance, and decreased school performance. For other effects such as changes in the immune system and

  8. Political Economy of Public Health

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    Judith W. Leavitt


    Full Text Available Review of: Launching Global Health: The Caribbean Odyssey of the Rockefeller Foundation. Steven Palmer. Ann Arbor: University of Michigan Press, 2010. xi + 301 pp. (Cloth US$ 70.00 Partner to the Poor: A Paul Farmer Reader. Paul Farmer, edited by Haun Saussy. Berkeley: University of California Press, 2010. xii + 660 pp. (Paper US$ 27.50

  9. Public Spending on Health as Political Instrument?

    DEFF Research Database (Denmark)

    Fielding, David; Freytag, Andreas; Münch, Angela


    The paper argues that the type of the political regime does not only drive public spending on health, but that dependent on the type of regime inequality in health status within its population is fostered by applying selective strategies. An empirical analysis is conducted for 132 low- and middle...

  10. Public health aspects of physical activity

    NARCIS (Netherlands)

    Wendel-Vos, G.C.W.


    In this thesis different public health aspects of physical activity in the Netherlands were addressed, taking into account its broad scope. Research was carried out on physical activity methodology, determinants of physical activity and the relationship between physical activity and different health

  11. Public health 101 nanocourse: a condensed educational tool for non-public health professionals. (United States)

    Ramirez, Cherie L; Gajdos, Zofia K Z; Kreatsoulas, Catherine; Afeiche, Myriam C; Asgarzadeh, Morteza; Nelson, Candace C; Kanjee, Usheer; Caban-Martinez, Alberto J


    Graduate students and postdoctoral fellows-including those at the Harvard School of Public Health (HSPH)-have somewhat limited opportunities outside of traditional coursework to learn holistically about public health. Because this lack of familiarity could be a barrier to fruitful collaboration across disciplines, HSPH postdocs sought to address this challenge. In response, the Public Health 101 Nanocourse was developed to provide an overview of five core areas of public health (biostatistics, environmental health sciences, epidemiology, health policy and management, and social and behavioral sciences) in a two half-day course format. We present our experiences with developing and launching this novel approach to acquainting wider multidisciplinary audiences with the field of public health.

  12. Remote Sensing, Air Quality, and Public Health (United States)

    Quattrochi, Dale A.; Rickman, Douglas; Mohammad, Al-Hamdan; Crosson, William; Estes, Maurice, Jr.; Limaye, Ashutosh; Qualters, Judith


    HELIX-Atlanta was developed to support current and future state and local EPHT programs to implement data linking demonstratio'n projects which could be part of the EPHT Network. HELIX-Atlanta is a pilot linking project in Atlanta for CDC to learn about the challenges the states will encounter. NASA/MSFC and the CDC are partners in linking environmental and health data to enhance public health surveillance. The use of NASA technology creates value - added geospatial products from existing environmental data sources to facilitate public health linkages. Proving the feasibility of the approach is the main objective

  13. Public engagement on global health challenges

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    Minhas Gunjeet S


    Full Text Available Abstract Background Experience with public engagement activities regarding the risks and benefits of science and technology (S&T is growing, especially in the industrialized world. However, public engagement in the developing world regarding S&T risks and benefits to explore health issues has not been widely explored. Methods This paper gives an overview about public engagement and related concepts, with a particular focus on challenges and benefits in the developing world. We then describe an Internet-based platform, which seeks to both inform and engage youth and the broader public on global water issues and their health impacts. Finally, we outline a possible course for future action to scale up this and similar online public engagement platforms. Results The benefits of public engagement include creating an informed citizenry, generating new ideas from the public, increasing the chances of research being adopted, increasing public trust, and answering ethical research questions. Public engagement also fosters global communication, enables shared experiences and methodology, standardizes strategy, and generates global viewpoints. This is especially pertinent to the developing world, as it encourages previously marginalized populations to participate on a global stage. One of the core issues at stake in public engagement is global governance of science and technology. Also, beyond benefiting society at large, public engagement in science offers benefits to the scientific enterprise itself. Conclusion Successful public engagement with developing world stakeholders will be a critical part of implementing new services and technologies. Interactive engagement platforms, such as the Internet, have the potential to unite people globally around relevant health issues.

  14. Patterns in PARTNERing across Public Health Collaboratives

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    Christine A. Bevc


    Full Text Available Inter-organizational networks represent one of the most promising practice-based approaches in public health as a way to attain resources, share knowledge, and, in turn, improve population health outcomes. However, the interdependencies and effectiveness related to the structure, management, and costs of these networks represents a critical item to be addressed. The objective of this research is to identify and determine the extent to which potential partnering patterns influence the structure of collaborative networks. This study examines data collected by PARTNER, specifically public health networks (n = 162, to better understand the structured relationships and interactions among public health organizations and their partners, in relation to collaborative activities. Combined with descriptive analysis, we focus on the composition of public health collaboratives in a series of Exponential Random Graph (ERG models to examine the partnerships between different organization types to identify the attribute-based effects promoting the formation of network ties within and across collaboratives. We found high variation within and between these collaboratives including composition, diversity, and interactions. The findings of this research suggest common and frequent types of partnerships, as well as opportunities to develop new collaborations. The result of this analysis offer additional evidence to inform and strengthen public health practice partnerships.

  15. Conceptual model of communications in public health

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    Марія Андріївна Знаменська


    Full Text Available Actuality. The role of communications in effective reform of public health in the country is discovered in scientific literature last time. But there are no works that fully present the system of communications in public health; this fact defined actuality of the given research.Methods. The next scientific methods are used in this work: structural and logical analysis, conceptual modeling. The systematic approach became a base of research. Results. There was elaborated conceptual model of the system of communications in public health its node idea is a consistent solution of the priority problem of supply the population of the country in whole and the separate task groups of communicative impact with complex objective information in the system of public health. At constructing of the model there were separated the next groups of problems: structural construction of the system of communication; supply of the system with resources; methods and means of communication; monitoring and assessment of efficiency of communication.Conclusions. The use of this model allows at optimal costs to eliminate the organizational and administrative defects and increase an awareness of the people in organization of public health, in maintenance and improvement of personal health

  16. Public health and health education in faith communities. (United States)

    Chatters, L M; Levin, J S; Ellison, C G


    This special issue of Health Education & Behavior is devoted to broadly examining the interconnections among public health, health education, and faith-based communities. In addition to a focus on questions related to the practice of public health and health education within religious settings (e.g., program development, implementation, and evaluation), the articles in this issue examine a broad range of both substantive and methodological questions and concerns. These articles include contributions that address (1) various theoretical and conceptual issues and frameworks explaining the relationships between religious involvement and health; (2) substantive reviews of current research in the area; (3) individual empirical studies exploring the associations between religious involvement and health attitudes, beliefs, and behaviors; (4) evaluations of health education programs in faith communities; and (5) religious institutions and their contributions to the development of health policy. The articles comprising the issue are selective in their coverage of the field and provide different and complementary perspectives on the connections between religious involvement and health. It is hoped that this approach will appeal to a broad audience of researchers, practitioners, policy makers, and others from health education, public health, and related social and behavioral science disciplines.

  17. Parks, recreation, and public health collaborative. (United States)

    Kruger, Judy


    The primary goal of many park and recreation agencies is to provide resources and programs that improve quality of life for the community. Increasing physical activity is one aspect of this agenda. Promoting physical activity is a public health goal; however, increasing population-level physical activity will require access to places for physical activity (e.g. parks). Practitioners and policy makers need more information to document the roles that parks and recreation facilities play to promote physical activity and contribute to public health. A working group of approximately 20 professionals experienced in data collection came together to discuss the needs for better surveillance and measurement instruments in the fields of parks, recreation, and public health. The working group made two major recommendations: (1) the need for collaborative research and data sharing, and (2) the need for surveillance measures to demonstrate the amount of health-related physical activity acquired in the park setting.

  18. [History of the scientific field of Food and Nutrition in Public Health in Brazil]. (United States)

    de Assis Guedes de Vasconcelos, Francisco; Batista Filho, Malaquias


    This paper aims to trace the history of the scientific field of Food and Nutrition in Public Health in Brazil (FNPH), trying to describe the contexts that allowed the construction, consolidation and redefinition of the field, to identify the Brazilian scientists who contributed to this process and address the scientific concepts or paradigms that guided the actions of these scientists. As methodological criteria of analysis three cross sections corresponding to contexts of history in this field were established: the first one covers the period from 1930 to 1963, the second one between 1964 and 1984 and the third one considers the period from 1985 to 2010. We conclude that the field of FNPH assumed the current configuration from the mid-1970's, within the so-called Brazilian health movement, whose main ideas were the achievement of health reform and the construction of the Unified Health System. We reaffirm the importance of multidisciplinary character and the premise of the important role of the field of FNPH in ensuring the human right to healthy food, a component of the set of conditions necessary for health promotion, disease prevention, surveillance and health recovery and improvement of quality of life for all Brazilians.

  19. Public Health (AFSC 43HX) (United States)


    D238 Write training reports 1.41 3 D234 Score tests .65 16 0014 3. Occupational Health E252 Maintain Environmental Protection Agency (EPA) reference...hazard reports 2.22 9 E252 Maintain Environmental Protection Agency (EPA) reference files 1.59 6 0024 3j. Industrial Case files B B 131 Update shop...0048 3bb. Indoor Air Quality B E252 Maintain Environmental Protection Agency (EPA) reference files 1.59 6 0050 4a. Food Inspection Program B E242

  20. The invisibilization of health promotion in Australian public health initiatives. (United States)

    O'Hara, Lily; Taylor, Jane; Barnes, Margaret


    The field of health promotion has arguably shifted over the past thirty years from being socially proactive to biomedically defensive. In many countries this has been accompanied by a gradual decline, or in some cases the almost complete removal of health promotion designated positions within Government health departments. The language or discourse used to describe the practice and discipline of health promotion is reflective of such changes. In this study, critical discourse analysis was used to determine the representation of health promotion as a practice and a discipline within 10 Australian Government weight-related public health initiatives. The analysis revealed the invisibilization of critical health promotion in favour of an agenda described as 'preventive health'. This was achieved primarily through the textual practices of overlexicalization and lexical suppression. Excluding document titles, there were 437 uses of the terms health promotion, illness prevention, disease prevention, preventive health, preventative health in the documents analysed. The term 'health promotion' was used sparingly (16% of total terms), and in many instances was coupled with the term 'illness prevention'. Conversely, the terms 'preventive health' and 'preventative health' were used extensively, and primarily used alone. The progressive invisibilization of critical health promotion has implications for the perceptions and practice of those identifying as health promotion professionals and for people with whom we work to address the social and structural determinants of health and wellbeing. Language matters, and the language and intent of critical health promotion will struggle to survive if its speakers are professionally unidentifiable or invisible.

  1. Soils and public health: the vital nexus (United States)

    Pachepsky, Yakov


    Soils sustain life. They affect human health via quantity, quality, and safety of available food and water, and via direct exposure of individuals to soils. Throughout the history of civilization, soil-health relationships have inspired spiritual movements, philosophical systems, cultural exchanges, and interdisciplinary interactions, and provided medicinal substances of paramount impact. Given the climate, resource, and population pressures, understanding and managing the soil-health interactions becomes a modern imperative. We are witnessing a paradigm shift from recognizing and yet disregarding the 'soil-health' nexus complexity to parameterizing this complexity and identifying reliable controls. This becomes possible with the advent of modern research tools as a source of 'big data' on multivariate nonlinear soil systems and the multiplicity of health metrics. The phenomenon of suppression of human pathogens in soils and plants presents a recent example of these developments. Evidence is growing about the dependence of pathogen suppression on the soil microbial community structure which, in turn, is affected by the soil-plant system management. Soil eutrophication appears to create favorable conditions for pathogen survival. Another example of promising information-rich research considers links and feedbacks between the soil microbial community structure and structure of soil physical pore space. The two structures are intertwined and involved in the intricate self-organization that controls soil services to public health. This, in particular, affects functioning of soils as a powerful water filter and the capacity of this filter with respect to emerging contaminants in both 'green' and 'blue' waters. To evaluate effects of soil services to public health, upscaling procedures are needed for relating the fine-scale mechanistic knowledge to available coarse-scale information on soil properties and management. More needs to be learned about health effects of soils

  2. A Decision Support System for Land Allocation under Multiple Objectives in Public Production Forests in the Brazilian Amazon

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    Marco W. Lentini


    Full Text Available Logging in natural forests is a vital economic activity in the Brazilian Amazon. However, illegal and unplanned logging is exhausting forests rapidly. In 2006, a new forestry law in Brazil (Lei 11,284/2006 established the legal framework to develop state and national public forests for multiple uses. To support public forest planning efforts, we combine spatially explicit data on logging profits, biodiversity, and potential for community use for use within a forest planning optimization model. While generating optimal land use configurations, the model enables an assessment of the market and nonmarket tradeoffs associated with different land use priorities. We demonstrate the model's use for Faro State Forest, a 636,000 ha forest embedded within a large mosaic of conservation units recently established in the state of Pará. The datasets used span the entire Brazilian Amazon, implying that the analysis can be repeated for any public forest planning effort within the region.

  3. Building the national health information infrastructure for personal health, health care services, public health, and research

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    Detmer Don E


    Full Text Available Abstract Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries. The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin

  4. Professional and community satisfaction with the Brazilian family health strategy

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    Lilian G Perez


    Full Text Available OBJECTIVE: To analyze the strengths and limitations of the Family Health Strategy from the perspective of health care professionals and the community. METHODS: Between June-August 2009, in the city of Vespasiano, Minas Gerais State, Southeastern Brazil, a questionnaire was used to evaluate the Family Health Strategy (ESF with 77 healthcare professionals and 293 caregivers of children under five. Health care professional training, community access to health care, communication with patients and delivery of health education and pediatric care were the main points of interest in the evaluation. Logistic regression analysis was used to obtain odds ratios and 95% confidence intervals as well as to assess the statistical significance of the variables studied. RESULTS: The majority of health care professionals reported their program training was insufficient in quantity, content and method of delivery. Caregivers and professionals identified similar weaknesses (services not accessible to the community, lack of healthcare professionals, poor training for professionals and strengths (community health worker-patient communications, provision of educational information, and pediatric care. Recommendations for improvement included: more doctors and specialists, more and better training, and scheduling improvements. Caregiver satisfaction with the ESF was found to be related to perceived benefits such as community health agent household visits (OR 5.8, 95%CI 2.8;12.1, good professional-patient relationships (OR 4.8, 95%CI 2.5;9.3, and family-focused health (OR 4.1, 95%CI 1.6;10.2; and perceived problems such as lack of personnel (OR 0.3, 95%CI 0.2;0.6, difficulty with access (OR 0.2, 95%CI 0.1;0.4, and poor quality of care (OR 0.3, 95%CI 0.1;0.6. Overall, 62% of caregivers reported being generally satisfied with the ESF services. CONCLUSIONS: Identifying the limitations and strengths of the Family Health Strategy from the healthcare professional and

  5. Association of Schools and Programs of Public Health (United States)

    ... Search Find an Academic Program Discover Discover Overview Public health protects and improves the health of individuals, families, ... Services and Natural Disasters Health Disparities Profiles in Public Health Study Study Overview Graduates of CEPH-accredited schools ...

  6. Mapping the health indicators of Chhattisgarh: A public health perspective

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    Abhiruchi Galhotra


    Full Text Available Introduction: The state of Chhattisgarh today faces several challenges in improving the health status of its people. The on-going problems of maternal and child mortality, communicable diseases, and HIV/AIDS pandemic still need greater interventions/support from the already overburdened health systems. In addition, the public health challenges include the escalating burden of chronic noncommunicable diseases. Keeping all these things in mind a study was carried out to have an overview of the public health scenario of Chhattisgarh. Aim: This paper aims to review the different public health indicators of Chhattisgarh. Materials and Methods: This study comprised of reviewing different health indicators of Chhattisgarh adopting three different methods during the period March-April 2013. The methods were: (i extensive online search, (ii reviewing the related literatures from different journals and other authentic printed materials, and (iii information collected from public health experts through e-mail, telephone, or direct interaction. Results: Out of 2.55 crore populations in the state (as per Census 2011, 78% lives in rural areas and 37% of the population is tribal. The sex ratio is 968 and the literacy rate is 65.5% in population above 7 years of age. There is a shortage of trained health care providers in Chhattisgarh. The crude birth rate is 23.5 per 1000 (population Annual Health Survey [AHS] 2011-2012. The infant mortality rate is 48 per 1000 live births (SRS 2012. Malnutrition, anemia, sickle cell hemoglobinopathy, Beta thalassemia trait, and G6 PD enzyme deficiency are very high among the tribes of Chhattisgarh. Malaria has been a major health problem. Chhattisgarh is one of the states with annual parasite index >5 (MRC report. The other states are Rajasthan, Gujarat, Karnataka, Goa, Southern Madhya Pradesh, Jharkhand, Odisha, and Northeastern states. Conclusion: From a public health point of view, most of the health indicators are below

  7. Edentulism and shortened dental arch in Brazilian elderly from the National Survey of Oral Health 2003

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    Marco Túlio Freitas Ribeiro


    Full Text Available OBJECTIVE: To describe the distribution of edentulism and estimate the prevalence of functional dentition and shortened dental arch among elderly population. METHODS: A population-based epidemiological study was carried out with a sample of 5,349 respondents aged 65 to 74 years obtained from the 2002 and 2003 Brazilian Ministry of Health/Division of Oral Health survey database. The following variables were studied: gender; macroregion of residence; missing teeth; percentage that met the World Health Organization goal for oral health in the age group 65 to 74 years (50% having at least 20 natural teeth; presence of shortened dental arch; number of posterior occluding pairs of teeth. The Chi-square test assessed the association between categorical variables. The Kruskal-Wallis and Mann-Whitney tests were used to assess differences of mean between number of posterior occluding pairs teeth, macro-region and gender. RESULTS: The elderly population had an average of 5.49 teeth (SD: 7.93 with a median of 0. The proportion of completely edentulous respondents was 54.7%. Complete edentulism was 18.2% in the upper arch and 1.9% in the lower arch. The World Health Organization goal was achieved in 10% of all respondents studied. However, only 2.7% had acceptable masticatory function and aesthetics (having at least shortened dental arch and a mean number of posterior occluding pairs of 6.94 (SD=2.97. There were significant differences of the percentage of respondents that met the World Health Organization goal and presence of shortened dental arch between men and women. There were differences in shortened dental arch between macroregions. CONCLUSIONS: The Brazilian epidemiological oral health survey showed high rate of edentulism and low rate of shortened dental arch in the elderly population studied, thus suggesting significant functional and aesthetic impairment in all Brazilian macroregions especially among women.

  8. Bullying in Brazilian school children: analysis of the National Adolescent School-based Health Survey (PeNSE 2012

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    Deborah Carvalho Malta


    Full Text Available OBJECTIVE: To describe the victimization and bullying practice in Brazilian school children, according to data from the National Adolescent School-based Health Survey and to compare the surveys from 2009 and 2012. METHODS: This is a cross-sectional study with univariate and multivariate analyzes of the following variables: to have been treated badly by colleagues, to have been bullied and to have bullied other children. The following independent variables were analyzed: age, sex, race/color, type of school, maternal education. Prevalence rates were compared between the editions of 2009 and 2012 of the survey. RESULTS: Of all the adolescents analyzed, 27.5% have not been treated well by peers at school, with greater frequency among boys (OR = 1.50, at the age of 15 years (OR = 1.29 and 16 (OR = 1.41, public school students (OR = 2.08, black (OR = 1.18 and whose mothers had less education; 7.2% reported having been bullied, with a greater chance in younger students (13 years old, male (OR = 1.26, black (OR = 1.15 and indigenous (OR = 1.16 and whose mothers had less education; 20.8% reported to have bullied other children, with a greater chance for older students, at the age of 14 (OR = 1.08 and 15 years (OR = 1.18, male (OR = 1.87, black (OR = 1.14 and yellow (OR = 1.15, children of mothers with higher education, private school students. There was an increase of bullying in the Brazilian capitals, from 5.4 to 6.8%, between 2009 and 2012. DISCUSSION: The occurrence of bullying reveals that the Brazilian school context is also becoming a space of reproduction of violence, in which it is crucial to act intersectorally and to articulate social protection networks, aiming to face this issue.

  9. Realising social justice in public health law. (United States)

    Fox, Marie; Thomson, Michael


    Law has played an important, but largely constitutive, role in the development of the public health enterprise. Thus, law has been central to setting up the institutions and offices of public health. The moral agenda has, however, been shaped to a much greater extent by bioethics. While social justice has been placed at the heart of this agenda, we argue that there has been little place within dominant conceptions of social justice for gender equity and women's interests which we see as crucial to a fully realised vision of social justice. We argue that, aside from particular interventions in the field of reproduction, public health practice tends to marginalise women-a claim we support by critically examining strategies to combat the HIV pandemic in sub-Saharan Africa. To counter the marginalisation of women's interests, this article argues that Amartya Sen's capabilities approach has much to contribute to the framing of public health law and policy. Sen's approach provides an evaluative and normative framework which recognises the importance of both gender and health equity to achieving social justice. We suggest that domestic law and international human rights provisions, in particular the emerging human right to health, offer mechanisms to promote capabilities, and foster a robust and inclusive conception of social justice.

  10. Self-perceived health and clinical characteristics in young adult students from the brazilian northeast

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    Thereza Maria Magalhães Moreira


    Full Text Available Objective To analyze the association between socioeconomic situation, clinical characteristics referred and the family history of cardiovascular disease, with the Self-perceived health of young adults education and their implications for clinical characteristics observed. Method Analytical study conducted with 501 young adults who are students in countryside city in the Brazilian Northeast. We used binary logistic regression. Results The final model explained 83.3% of the self-perceived positive health, confirming the association of Self-perceived health with male, residence in the community, have excellent/very good lifestyle and does not have or do not know that there are cases of stroke in the family. Conclusion Health perception was often optimistic, being important to identify devices to be worked closer to their perception of their actual health condition, increasing the effectiveness of health promotion activities undertaken by professionals.

  11. Social marketing: its place in public health. (United States)

    Ling, J C; Franklin, B A; Lindsteadt, J F; Gearon, S A


    This review of the public health role of social marketing begins by tracing the history of social marketing and noting that social marketing adopts the traditional marketing framework of product, price, place, and promotion and embraces several methods of commercial marketing as well as consumer research. However, no universally acknowledged definition exists. A review of the literature is divided into three time periods representing early theoretical development, the evaluation of experiences, and increasing acceptance. Concerns about social marketing are discussed in terms of ethics, disempowerment, and the commercialization of health information. Examples of social marketing are then provided from developing countries and are analyzed in groupings defined as tangible products, sustained health practices, and service utilization. Practitioners' views and concerns are also reviewed. The strengths of social marketing include knowledge of the audience, systematic use of qualitative methods, use of incentives, closer monitoring, strategic use of the mass media, realistic expectations, aspiring to high standards, and recognition of price. Weaknesses of social marketing include its time, money, and human requirements; the fact that marketing elements are missing (public health lacks the flexibility to adjust products and services to clients' interests and preferences); and the potential serious impact on the future of Public Service Announcements, which may die out because social marketers pay for air time. After placing social marketing in context with other practices designed to achieve social change, the review ends with the prediction that the public health role of social marketing is likely to increase. The World Health Organization's recent call for health promotion and the UN Children's Fund's social mobilization actions are provided as examples of this increased role. It is noted, however, that social marketing alone cannot solve public health problems.

  12. Expert consensus (SBC/SBHCI) on the use of drug-eluting stents: recommendations of the Brazilian society of interventional cardiology/ Brazilian society of cardiology for the Brazilian public single healthcare system. (United States)

    Lima, Valter C; Mattos, Luiz Alberto P; Caramori, Paulo R A; Perin, Marco A; Mangione, José A; Machado, Bruno M; Coelho, Wilson M C; Bueno, Ronaldo R L


    National Health Surveillance Agency (ANVISA). During this stage the interested company submits to the regulatory agency, results from clinical studies that demonstrate the efficacy and safety of the new device or pharmaceutical product. Frequently, in addition to clinical studies, approval records for clinical use from the regulatory agencies of other countries, mainly the United States of America and the European Community are also submitted. The successful completion of this stage means that the medication or device may be prescribed or used by the physicians in Brazil. The second stage in the incorporation of new healthcare technology involves the reimbursement or financing of the treatment that was approved in the previous stage based on its efficacy and safety. This stage can be more complex than the first one since the new technology, whether a substitution for established treatment methods or the introduction of a new treatment concept, are usually more expensive. The incorporation of new technology requires a cost-effectiveness analysis so that fund administrators can make decisions based on the universal scenario of limited resources to finance healthcare with treatments that are more and more burdensome. The difficulties of funding management are aggravated by medical and social ethical implications that arise when a treatment is approved based on its efficacy and safety but is not made available to patients who could benefit greatly from it. In Brazil, assessment methods for the incorporation of new technology based on reimbursement or financing have not been fully developed for either the private healthcare plans or the Brazilian Public Healthcare System (SUS). The implementation of new technology in both healthcare systems is a slow process and frequently the implementation is a result of the requirements of patients or the organizations that represent them and at times is the result of legal proceedings or political pressure imposed by physicians and their

  13. Health Security Intelligence: Assessing the Nascent Public Health Capability (United States)


    Information Sharing System MOU Memorandum of Understanding NBIC National Biosurveillance Integration Center NCMI National Center for...definition, have come to the fore in the literature, biosurveillance and health security. Biosurveillance , as a term, is too limited to provide the...purposes. The Government Accountability Office (GAO) in a 2006 report on public health infrastructure described biosurveillance as, “…automated

  14. [Drugs legalization and public health]. (United States)

    Laranjeira, Ronaldo


    The objective of this article is to: (1) evaluate the rationality and opportunity of this debate; (2) try to establish links with legal drugs; (3) evaluate the available data on the effect of legalization of a drug; and (4) propose an alternative drug police based on clear objectives to be reached; (5) describe how Sweden is dealing with the theme of drugs restriction as a social care. Methodologically the text constitutes in a summary of readings and elaborations of the author, placed to incite a discussion. It is concluded that four aspects need to be taken into consideration when a drug police of a country is analyzed, they are: (1) external factors influence the police: international agreements, health and social assistance police, individual rights, authority and autonomy of physicians and other professionals; (2) the objective established influence formal polices and its implementation; (3) the symbolic influence that excels the implementation. Influent people make declarations that strongly reach the legitimacy and adhesion to actions; (4) formal polices and their implementation receive direct influence to socially perceived damages by the drugs use, which could be independent of the real level of its use in a determined society.

  15. Public Health needs modified strategy

    Directory of Open Access Journals (Sweden)

    Suresh Rathi MBBS, M.Sc Epidemiology, Assistant Professor, Department Of Community Medicine, S. B. K. S. Medical Institute and Research Centre, Piparia, Vadodara - 391760, Gujarat, Email


    Full Text Available is a fast changing field. In fact, the whole concept of diagnosing and treating a patient is modifying rapidly. Benchmarks of the medical progress are continually changing: infectious/communicable diseases ravaged mankind for centuries but the dramatic decline in infectious/communicable diseases, during mid 19th century due to improvements in sanitation, nutrition and general living conditions among affluent countries has changed the picture. But due to re-emergence of certain infectious/communicable diseases the World Health Report 1996 declared that infectious/communicable diseases have not only become the world's leading cause of premature death, but they also threaten to cripple social and economic development in developing countries1. And here we are living in the twenty-first century still bewildered and confused by infectious/communicable diseases despite the availability of vaccination, latest diagnostic facilities, chemotherapy and above all well-trained medical professionals. What makes the scenario particularly tragic is that most infectious/communicable diseases are easily treatable; the failure is operational one. .........

  16. Individual and Contextual Determinants of Periodontal Health in 12-Year-Old Schoolchildren in a Brazilian Capital City

    Directory of Open Access Journals (Sweden)

    Lidia Moraes Ribeiro Jordão


    Full Text Available The study aimed to describe periodontal health status and its association with individual and contextual factors among 12-year-old schoolchildren in a midwest Brazilian capital city. This cross-sectional study included data from an oral health survey carried out in 2010 in the city of Goiania, Brazil and secondary data obtained from the local health authority. Data were collected through oral clinical examinations and interviews. For assessment of periodontal status two components of the community periodontal index (CPI were used: calculus and bleeding after probing. Dependent variable was presence of any periodontal condition. Independent individual variables were the children’s sex and color/race, and their mother’s level of schooling. Contextual variables were related to the schools (type and existence of toothbrushing program and its geographic location in the health districts. Rao-Scott test and multilevel Poisson analysis were performed. The prevalence of calculus and/or bleeding was 7%. Brown color, public schools, and those located in health district with intermediate socioeconomic indicators were associated to a higher prevalence of this condition. The prevalence of adverse periodontal condition was low and the inequalities in its distribution were determined by individual as well as contextual factors related to the schools and the geographic area.

  17. Chernobyl: the effects on public health?

    Energy Technology Data Exchange (ETDEWEB)

    Aurengo, A. [Hopital Pitie-Salpetriere, Dept. Nucleaire Medecine, 75 - Paris (France)


    Because of its public health, ecological and industrial consequences, the Chernobyl accident has become a myth which serves as the focus of many fears, justified or not. no one can question the seriousness of the event, but after fifteen years there is still no agreement about the effect it has had or will have on public health. For example, the total number of deaths attributed to Chernobyl varies from less than a hundred to several millions and congenital malformations from negligible to cataclysmic. Effects on public health may be calculated from data on contamination, from the dose received and from the risk, all three of which are likely to be very roughly known; or they may be evaluated on the spot, either by epidemiological studies or by examining medical registers. This report makes an inventory of the different risks and takes stock on them. (N.C.)

  18. Existing public health surveillance systems for mental health in China. (United States)

    Zhou, Wei; Xiao, Shuiyuan


    Mental health is a challenging public health issue worldwide and surveillance is crucial for it. However, mental health surveillance has not been developed until recently in certain developed countries; many other countries, especially developing countries, have poor or even no health information systems. This paper presents surveillance related to mental health in China, a developing country with a large population of patients with mental disorders. Detailed information of seven relevant surveillance systems is introduced respectively. From the perspective of utilization, problems including accessibility, comprehensiveness and data quality are discussed. Suggestions for future development are proposed.

  19. Opportunities for Palliative Care in Public Health. (United States)

    De Lima, Liliana; Pastrana, Tania


    In May 2014, the World Health Assembly, of the World Health Organization (WHO), unanimously adopted a palliative care (PC) resolution, which outlines clear recommendations to the United Nations member states, such as including PC in national health policies and in the undergraduate curricula for health care professionals, and highlights the critical need for countries to ensure that there is an adequate supply of essential PC medicines, especially those needed to alleviate pain. This resolution also carries great challenges: Every year over 20 million patients (of which 6% are children) need PC at the end of life (EOL). However, in 2011, approximately three million patients received PC, and only one in ten people in need is currently receiving it. We describe this public health situation and systems failure, the history and evolution of PC, and the components of the WHO public health model. We propose a role for public health for PC integration in community settings to advance PC and relieve suffering in the world.

  20. A saúde da mulher em situação de violência: representações e decisões de gestores/as municipais do Sistema Único de Saúde Women's health in violent situations: municipal administrative roles and decision-making in the Brazilian public health system

    Directory of Open Access Journals (Sweden)

    Madge Porto


    , such as the problem of public health and quality of living, or more technically, the cost-benefit issue, did appear as key arguments.

  1. Intervenção coronariana percutânea no Brasil: resultados do Sistema Único de Saúde Intervención coronaria percutánea en el Brasil: Resultados del Sistema Único de Salud Percutaneous coronary intervention in Brazil: results from the Brazilian Public Health System

    Directory of Open Access Journals (Sweden)

    Leopoldo Soares Piegas


    Full Text Available FUNDAMENTO: O Sistema Único de Saúde (SUS realiza aproximadamente 80% das intervenções coronarianas percutâneas (ICP no Brasil. O conhecimento desses dados permitirá planejar adequadamente o tratamento da doença arterial coronariana (DAC. OBJETIVO: Analisar e discutir os resultados das ICP realizadas pelo SUS. MÉTODOS: Foram avaliados os dados do SIH/DATASUS disponibilizados para consulta pública. RESULTADOS: Entre os anos de 2005 a 2008 foram realizados 166.514 procedimentos em 180 hospitais. A mortalidade hospitalar média foi de 2,33%, variando de 0% a 11,35%, sendo mais baixa no Sudeste, 2,03% e mais alta na região Norte, 3,64% (p 0,05. A mortalidade foi maior no gênero feminino (p 65 a (p FUNDAMENTO: El Sistema Único de Salud (SUS realiza aproximadamente 80% de las intervenciones coronarias percutáneas (ICP en el Brasil. El conocimiento de esos datos permitirá planear adecuadamente el tratamiento de la enfermedad arterial coronaria (EAC. OBJETIVO: Analizar y discutir los resultados de las ICP realizadas por el SUS. MÉTODOS:Fueron evaluados los datos del SIH/DATASUS disponibles para la consulta pública. RESULTADOS: Entre los años 2005 a 2008 fueron realizados 166.514 procedimientos en 180 hospitales. La mortalidad hospitalaria media fue de 2,33%, variando de 0% a 11,35%, siendo más baja en el Sudeste, 2,03% y más alta en la región Norte, 3,64% (p 0,05. La mortalidad fue mayor en el género femenino (p 65 a (p BACKGROUND: The Brazilian Public Health System (SUS holds approximately 80% of percutaneous coronary interventions (PCI in Brazil. Being aware of these data will enable to design a proper plan for the treatment of coronary artery disease (CAD. OBJECTIVE: To review and discuss the results of PCIs performed by the SUS. METHODS: We reviewed data from SIH/DATASUS available for public consultation. RESULTS: From 2005 to 2008, 166,514 procedures were performed in 180 hospitals. Average hospital mortality was 2.33%, ranging

  2. Introductory Disciplines of Astronomy in Undergraduation Geography in Brazilian Public Universities (United States)

    Henrique Azevedo Sobreira, Paulo


    There are some previous works about introductory disciplines of Astronomy in higher education in various undergraduation at Brazilian universities, but this is a specific research for Geography courses in public universities. Some undergraduate courses in Geography in Brazil offer introductory disciplines of Astronomy, since the second half of the twentieth century. This work presents an updated survey on the topic, and it proposes an effort at the national level, for the benefit of the increase in introductory disciplines of Astronomy in undergraduation in Geography. The data collected from public universities were obtained from the consultation of the websites of state universities, federal and county in 2012, 2013 and 2015, for information on the Geography courses and, among them, those with disciplines of Astronomy. The results show that there are 94 undergraduation in Geography courses in public universities, 12 of them had introductory disciplines of Astronomy until 2012 and 2013. In 2015 three of these disciplines were canceled which reduced to 9 universities. There were 23 undergraduation in Geography courses in 10 bachelor degrees and 14 education degrees with Astronomy disciplines. At 2015 it decreased to 20 in 5 bachelors and 8 education degrees. There are two undergraduation Geography courses with two introductory disciplines of Astronomy, while the other 18 offer only one discipline. The inclusion of introductory disciplines of Astronomy depends on the actions of professors' groups who works in undergraduation Geography courses, and of the astronomers initiative to offering them. The ideal is that the astronomers who actuate like professors in universities, normally in Math, Physics, Technologies, Enginnering and Science courses, they would can help and offer introductory disciplines in Astronomy for undergraduation in Geography courses.

  3. Public Health, Ethics, and Autonomous Vehicles. (United States)

    Fleetwood, Janet


    With the potential to save nearly 30 000 lives per year in the United States, autonomous vehicles portend the most significant advance in auto safety history by shifting the focus from minimization of postcrash injury to collision prevention. I have delineated the important public health implications of autonomous vehicles and provided a brief analysis of a critically important ethical issue inherent in autonomous vehicle design. The broad expertise, ethical principles, and values of public health should be brought to bear on a wide range of issues pertaining to autonomous vehicles.

  4. Religion and health: public health research and practice. (United States)

    Chatters, L M


    Research examining the relationships between religion and the health of individuals and populations has become increasingly visible in the social, behavioral, and health sciences. Systematic programs of research investigate religious phenomena within the context of coherent theoretical and conceptual frameworks that describe the causes and consequences of religious involvement for health outcomes. Recent research has validated the multidimensional aspects of religious involvement and investigated how religious factors operate through various biobehavioral and psychosocial constructs to affect health status through proposed mechanisms that link religion and health. Methodological and analytical advances in the field permit the development of more complex models of religion's effects, in keeping with proposed theoretical explanations. Investigations of religion and health have ethical and practical implications that should be addressed by the lay public, health professionals, the research community, and the clergy. Future research directions point to promising new areas of investigation that could bridge the constructs of religion and health.

  5. Drought impacts on children's respiratory health in the Brazilian Amazon


    Smith, Lauren T.; Aragão, Luiz E. O. C.; Sabel, Clive E.; Nakaya, Tomoki


    Drought conditions in Amazonia are associated with increased fire incidence, enhancing aerosol emissions with degradation in air quality. Quantifying the synergic influence of climate and human-driven environmental changes on human health is, therefore, critical for identifying climate change adaptation pathways for this vulnerable region. Here we show a significant increase (1.2%-267%) in hospitalisations for respiratory diseases in children under-five in municipalities highly exposed to dro...

  6. [Health, work and environment at the Brazilian rural]. (United States)

    Peres, Frederico


    This manuscript discusses the implications of the productive paradigm changes in health and environment of rural area of Brazil. It analyzes production, economy and demography data, facing social and structural determinants with health and environmental reflexes, revealing a serious panorama that includes: a) environmental impacts associated to large productive chains, such as corn, soy-bean, cotton and sugar cane; b) chemical contamination of diverse environment compartments due to pesticides and fertilizers used in agriculture; c) the use of natural land in the expansion of agriculture and cattle farming activities; and d) the reflexes of these actions on individuals, workers or not, that are more and more forced to deal with extreme vulnerability situations because of the risk of rural work processes. Thus, the present article points that macro-determinants (or driven-forces) tends to configure the health status of Rural Brazil inhabitants which, day after day, face a series of challenges in order to guarantee dignity in their work and quality of life.

  7. Developing an academia-based public health observatory: the new global public health observatory with emphasis on urban health at Johns Hopkins Bloomberg School of Public Health. (United States)

    Castillo-Salgado, Carlos


    Health observatories may differ according to their mission, institutional setting, topical emphasis or geographic coverage. This paper discusses the development of a new urban-focused health observatory, and its operational research and training infrastructure under the academic umbrella of the Department of Epidemiology and the Institute of Urban Health at the Johns Hopkins Bloomberg School of Public Health (BSPH) in Baltimore, USA. Recognizing the higher education mission of the BSPH, the development of a new professional training in public health was an important first step for the development of this observatory. This new academia-based observatory is an innovative public health research and training platform offering faculty, investigators, professional epidemiology students and research partners a physical and methodological infrastructure for their operational research and training activities with both a local urban focus and a global reach. The concept of a public health observatory and its role in addressing social health inequalities in local urban settings is discussed.

  8. [Legislation on primary care in Brazilian Unified National Health System: document analysis]. (United States)

    Domingos, Carolina Milena; Nunes, Elisabete de Fátima Polo de Almeida; Carvalho, Brígida Gimenez; Mendonça, Fernanda de Freitas


    A reflection on Brazil's legislation for primary care helps understand the way health policy is implemented in the country. This study focuses on the legal provisions aimed at strengthening primary care, drawing on an analysis of documents from the Ministry of Health's priority actions, programs, and strategies. A total of 224 provisions were identified, in two groups of documents, so-called instituting provisions and complementary provisions. The former include the principles and guidelines of the Brazilian Unified National Health System (SUS) and also involve the expansion of actions. Financing was a quantitatively central theme, especially in the complementary provisions. The analysis led to reflection on the extent to which these strategies can induce linkage between health system managers and civil society in building a political project resulting in improvements and meeting the population's health needs.

  9. Risk communication, risk perception, and public health. (United States)

    Aakko, Eric


    Risk communication is about building trust while deploying an interactive and ongoing communication process in which audience members are active participants. This interactive participation may not solve a public health crisis, but it will help reduce unwarranted fear, anxiety and distrust. Consequently, if a government agency fails to understand how to effectively communicate about health risks, their trustworthiness and credibility may suffer, and a crisis event may go from bad to worse.

  10. Screening and overdiagnosis : public health implications



    Overdiagnosis is the diagnosis of an abnormality that bears no substantial health hazard and no benefit for patients to be aware of. Resulting mainly from the use of increasingly sensitive screening and diagnostic tests, as well as broadened definitions of conditions requiring an intervention, overdiagnosis is a growing but still largely misunderstood public health issue. Fear of missing a diagnosis or of litigation, financial incentives or patient's need of reassurance are further causes ...

  11. [nutritional Education In Public Health Services].


    Boog, M.C.


    The purpose of this study was to discuss the implementation of nutritional education in public health services from the perspective of health professionals (physicians and nurses) working in them. The study was conducted in the Municipality of Campinas, São Paulo State, Brazil, from October 1993 to July 1995, using action-based research methodology. The results describe the construction of nutritional knowledge in training and professional institutions; behavior towards food-related problems ...

  12. Carrying guns in public: legal and public health implications. (United States)

    Vernick, Jon S


    In District of Columbia v. Heller, the U.S. Supreme Court ruled that the Second Amendment protects an individual's right to own handguns in the home for protection, invalidating a Washington, D.C. law banning most handgun possession. The Heller decision, however, provided lower courts with little guidance regarding how to judge the constitutionality of gun laws other than handgun bans. Nevertheless, lower courts have upheld the vast majority of federal, state, and local gun laws challenged since Heller. One area in which some lower courts have disagreed has been the constitutionality of laws regulating the ability to carry firearms in public. This issue may be the next to be addressed by the Supreme Court under its evolving Second Amendment jurisprudence. Courts should carefully consider the negative public health and safety implications of gun carrying in public as they weigh the constitutionality of these laws.


    Directory of Open Access Journals (Sweden)

    Geyse SANTOS


    Full Text Available In recent years, increasing concerns about toxicity residues in agricultural products have stimulated an increased interest in new agricultural strategies. While considering new strategies, the question arises if homeopathic preparations could be of use in plants. Homeopathy was born as an experimental discipline, and, generally, plants are able to react to homeopathic substances. In this paper, we conduct an up-to-date review of the existing in literature on Brazilian basic research in homeopathy applied in plants and agroecosystems to raise the profiles of Brazilian publications, according QUALIS methods and H index of Journals. The results of this research are useful not only for those who are interested in the homeopathy itself, but also to analyze the expanding that through experiments attending mainly agroecological production, aimed at improving on the level of publications.

  14. Climate services to improve public health. (United States)

    Jancloes, Michel; Thomson, Madeleine; Costa, María Mánez; Hewitt, Chris; Corvalan, Carlos; Dinku, Tufa; Lowe, Rachel; Hayden, Mary


    A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4-6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers.

  15. 41 CFR 101-5.307 - Public Health Service. (United States)


    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the...

  16. Surveillance, health promotion and control of Chagas disease in the Amazon Region - Medical attention in the Brazilian Amazon Region: a proposal (United States)

    Coura, José Rodrigues; Junqueira, Angela CV


    We refer to Oswaldo Cruz's reports dating from 1913 about the necessities of a healthcare system for the Brazilian Amazon Region and about the journey of Carlos Chagas to 27 locations in this region and the measures that would need to be adopted. We discuss the risks of endemicity of Chagas disease in the Amazon Region. We recommend that epidemiological surveillance of Chagas disease in the Brazilian Amazon Region and Pan-Amazon region should be implemented through continuous monitoring of the human population that lives in the area, their housing, the environment and the presence of triatomines. The monitoring should be performed with periodic seroepidemiological surveys, semi-annual visits to homes by health agents and the training of malaria microscopists and healthcare technicians to identify Trypanosoma cruzi from patients' samples and T. cruzi infection rates among the triatomines caught. We recommend health promotion and control of Chagas disease through public health policies, especially through sanitary education regarding the risk factors for Chagas disease. Finally, we propose a healthcare system through base hospitals, intermediate-level units in the areas of the Brazilian Amazon Region and air transportation, considering the distances to be covered for medical care. PMID:26560976

  17. Surveillance, health promotion and control of Chagas disease in the Amazon Region--Medical attention in the Brazilian Amazon Region: a proposal. (United States)

    Coura, José Rodrigues; Junqueira, Angela C V


    We refer to Oswaldo Cruz's reports dating from 1913 about the necessities of a healthcare system for the Brazilian Amazon Region and about the journey of Carlos Chagas to 27 locations in this region and the measures that would need to be adopted. We discuss the risks of endemicity of Chagas disease in the Amazon Region. We recommend that epidemiological surveillance of Chagas disease in the Brazilian Amazon Region and Pan-Amazon region should be implemented through continuous monitoring of the human population that lives in the area, their housing, the environment and the presence of triatomines. The monitoring should be performed with periodic seroepidemiological surveys, semi-annual visits to homes by health agents and the training of malaria microscopists and healthcare technicians to identify Trypanosoma cruzi from patients' samples and T. cruzi infection rates among the triatomines caught. We recommend health promotion and control of Chagas disease through public health policies, especially through sanitary education regarding the risk factors for Chagas disease. Finally, we propose a healthcare system through base hospitals, intermediate-level units in the areas of the Brazilian Amazon Region and air transportation, considering the distances to be covered for medical care.

  18. Intercultural Competency in Public Health: A Call for Action to Incorporate Training into Public Health Education. (United States)

    Fleckman, Julia M; Dal Corso, Mark; Ramirez, Shokufeh; Begalieva, Maya; Johnson, Carolyn C


    Due to increasing national diversity, programs addressing cultural competence have multiplied in U.S. medical training institutions. Although these programs share common goals for improving clinical care for patients and reducing health disparities, there is little standardization across programs. Furthermore, little progress has been made to translate cultural competency training from the clinical setting into the public health setting where the focus is on population-based health, preventative programming, and epidemiological and behavioral research. The need for culturally relevant public health programming and culturally sensitive public health research is more critical than ever. Awareness of differing cultures needs to be included in all processes of planning, implementation and evaluation. By focusing on community-based health program planning and research, cultural competence implies that it is possible for public health professionals to completely know another culture, whereas intercultural competence implies it is a dual-sided process. Public health professionals need a commitment toward intercultural competence and skills that demonstrate flexibility, openness, and self-reflection so that cultural learning is possible. In this article, the authors recommend a number of elements to develop, adapt, and strengthen intercultural competence education in public health educational institutions.

  19. Public health and business: a partnership that makes cents. (United States)

    Simon, Paul A; Fielding, Jonathan E


    Historically, public health agencies have had relatively few formal partnerships with private business. However, both groups share an interest in ensuring a healthy population. Businesses have a financial interest in supporting organized public health efforts; in turn, business partnerships can increase the reach and effectiveness of public health. This paper makes the case for the business sector's participation in the broad public health system and its support of governmental public health agencies. Examples of past and current partnerships exemplify how public health efforts benefit business and suggest opportunities for future collaboration to improve the public's health.

  20. [Suggestions for the upcoming public health law in Spain]. (United States)

    Urbanos, Rosa


    The upcoming public health law must serve as the basis for public health reform. The text of the law should allow public health structures to be modernized and adapted to the country's new needs. A broader concept of public health and a redefinition of its functions and basic services are required. Some of the main suggestions for the upcoming law are the establishment of a Spanish Agency for Public Health and a Public Health Council, the design of a Spanish Strategy of Public Health, and reform of professional training.

  1. Low Health System Performance, Indigenous Status and Antivenom Underdosage Correlate with Spider Envenoming Severity in the Remote Brazilian Amazon


    Vanderson Souza Sampaio; André Alexandre Gomes; Iran Mendonça Silva; Jacqueline Sachett; Luiz Carlos de Lima Ferreira; Sâmella Oliveira; Meritxell Sabidò; Hipócrates Chalkidis; Maria Graças Vale Barbosa Guerra; Jorge Luis Salinas; Fan Hui Wen; Marcus Vinícius Guimarães de Lacerda; Wuelton Marcelo Monteiro


    Background A better knowledge of the burden and risk factors associated with severity due to spider bites would lead to improved management with a reduction of sequelae usually seen for this neglected health problem, and would ensure proper use of antivenoms in remote localities in the Brazilian Amazon. The aim of this study was to analyze the profile of spider bites reported in the state of Amazonas in the Western Brazilian Amazon, and to investigate potential risk factors associated with se...

  2. Health care quality improvement publication trends. (United States)

    Sun, Gordon H; MacEachern, Mark P; Perla, Rocco J; Gaines, Jean M; Davis, Matthew M; Shrank, William H


    To analyze the extent of academic interest in quality improvement (QI) initiatives in medical practice, annual publication trends for the most well-known QI methodologies being used in health care settings were analyzed. A total of 10 key medical- and business-oriented library databases were examined: PubMed, Ovid MEDLINE, EMBASE, CINAHL, PsycINFO, ISI Web of Science, Scopus, the Cochrane Central Register of Controlled Trials, ABI/INFORM, and Business Source Complete. A total of 13 057 articles were identified that discuss at least 1 of 10 well-known QI concepts used in health care contexts, 8645 (66.2%) of which were classified as original research. "Total quality management" was the only methodology to demonstrate a significant decline in publication over time. "Continuous quality improvement" was the most common topic of study across all publication years, whereas articles discussing Lean methodology demonstrated the largest growth in publication volume over the past 2 decades. Health care QI publication volume increased substantially beginning in 1991.

  3. Media, racism and public health psychology. (United States)

    Nairn, Raymond; Pega, Frank; McCreanor, Tim; Rankine, Jenny; Barnes, Angela


    International literature has established that racism contributes to ill-health of migrants, ethnic minorities and indigenous peoples. Racism generally negates wellbeing, adversely affecting physical and psychological health. Numerous studies have shown that media contribute marginalizing particular ethnic and cultural groups depicting them primarily as problems for and threats to the dominant. This articles frames media representations of, and their effect on, the indigenous Maori of Aotearoa, New Zealand within the ongoing processes of colonization. We argue that reflects the media contribution to maintenance and naturalisation of colonial relationships and seek to include critical media scholarship in a critical public health psychology.

  4. Remote sensing and urban public health (United States)

    Rush, M.; Vernon, S.


    The applicability of remote sensing in the form of aerial photography to urban public health problems is examined. Environmental characteristics are analyzed to determine if health differences among areas could be predicted from the visual expression of remote sensing data. The analysis is carried out on a socioeconomic cross-sectional sample of census block groups. Six morbidity and mortality rates are the independent variables while environmental measures from aerial photographs and from the census constitute the two independent variable sets. It is found that environmental data collected by remote sensing are as good as census data in evaluating rates of health outcomes.

  5. Public health - threats, concerns and key actions

    DEFF Research Database (Denmark)

    Czeskleba-Dupont, Rolf

    Public health is discussed departing from priorities related to the precautionary principle with special reference to air pollution from wood burning in individual stoves and the susceptibility of vulnerable groups, i.a. people with genetic predispositions for a lack of detoxifying capacity....

  6. Multilevel modelling and public health policy

    NARCIS (Netherlands)

    Leyland, Alastair H.; Groenewegen, Peter P.


    Background: Multilevel modelling is a statistical technique that extends ordinary regression analysis to the situation where the data are hierarchical. Such data form an increasingly common evidence base for public health policy, and as such it is important that policy makers should be aware of this

  7. Multilevel modelling and public health policy.

    NARCIS (Netherlands)

    Leyland, A.H.; Groenewegen, P.P.


    BACKGROUND: Multilevel modelling is a statistical technique that extends ordinary regression analysis to the situation where the data are hierarchical. Such data form an increasingly common evidence base for public health policy, and as such it is important that policy makers should be aware of this

  8. Public trust in Dutch health care

    NARCIS (Netherlands)

    Straten, G.F.M.; Friele, R.D.; Groenewegen, P.P.


    This article describes the development of a valid and reliable instrument to measure different dimensions of public trust in health care in the Netherlands. This instrument is needed because the concept was not well developed,or operationalized in earlier research. The new instrument will be used in

  9. Public trust in Dutch health care.

    NARCIS (Netherlands)

    Straten, G.F.M.; Friele, R.D.; Groenewegen, P.P.


    This article describes the development of a valid and reliable instrument to measure different dimensions of public trust in health care in the Netherlands. This instrument is needed because the concept was not well developed, or operationalized in earlier research. The new instrument will be used i

  10. Commercial Pesticides Applicator Manual: Public Health. (United States)

    Fitzwater, William D.; Reed, Leonard G., Jr.

    This training manual provides information needed to meet the minimum EPA standards for certification as a commercial applicator of pesticides in the public health pest control category. The text discusses pests such as roaches, bedbugs, bees, mosquitoes, gnats, flies, and rodents with possible control measures provided. (CS)

  11. Five Critical Challenges for Public Health (United States)

    Kumanyika, Shiriki K.


    This article presents comments and observations given by Dr. Shiriki K. Kumanyika as the Lautenberg Award Lecture at the commencement of the University of Medicine and Dentistry of New Jersey-Rutgers School of Public Health, May 20, 2013. The award is named after Senator Frank Lautenberg, who served as a U.S. Senator from New Jersey during 1982 to…

  12. Geometric Abstract Art and Public Health Data

    Centers for Disease Control (CDC) Podcasts


    Dr. Salaam Semaan, a CDC behavioral scientist, discusses the similarities between geometric abstract art and public health data analysis.  Created: 10/18/2016 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 10/18/2016.

  13. The public health impact of obesity

    NARCIS (Netherlands)

    Visscher, T.L.S.


    The prevalence of obesity (severe overweight) has been increasing in western societies during the last decades. Epidemiological studies to the public health impact of obesity are therefore warranted. This thesis aimed at describing the long-term and recent time trends of obesity in the Netherlands,

  14. Social capital and health: implications for public health and epidemiology. (United States)

    Lomas, J


    Public health and its "basic science", epidemiology, have become colonised by the individualistic ethic of medicine and economics. Despite a history in public health dating back to John Snow that underlined the importance of social systems for health, an imbalance has developed in the attention given to generating "social capital" compared to such things as modification of individual's risk factors. In an illustrative analysis comparing the potential of six progressively less individualised and more community-focused interventions to prevent deaths from heart disease, social support and measures to increase social cohesion faired well against more individual medical care approaches. In the face of such evidence public health professionals and epidemiologists have an ethical and strategic decision concerning the relative effort they give to increasing social cohesion in communities vs expanding access for individuals to traditional public health programs. Practitioners' relative efforts will be influenced by the kind of research that is being produced by epidemiologists and by the political climate of acceptability for voluntary individual "treatment" approaches vs universal policies to build "social capital". For epidemiologists to further our emerging understanding of the link between social capital and health they must confront issues in measurement, study design and analysis. For public health advocates to sensitise the political environment to the potential dividend from building social capital, they must confront the values that focus on individual-level causal models rather than models of social structure (dis)integration. The evolution of explanations for inequalities in health is used to illustrate the nature of the change in values.

  15. [International Classification of Public Health Nursing Practices - CIPESC®: a pedagogical tool for epidemiological studies]. (United States)

    Nichiata, Lúcia Yasuko Izumi; Padoveze, Maria Clara; Ciosak, Suely Itsuko; Gryschek, Anna Luiza de Fátima Pinho Lins; Costa, Angela Aparecida; Takahashi, Renata Ferreira; Bertolozzi, Maria Rita; de Araújo, Núbia Virgínia D'Ávila Limeira; Pereira, Erica Gomes; Dias, Vânia Ferreira Gomes; Cubas, Marcia Regina


    The CIPESC® is a tool that informs the work of nurses in Public Health and assists in prioritizing their care in practice, management and research. It is also a powerful pedagogical instrument for the qualification of nurses within the Brazilian healthcare system. In the teaching of infectious diseases, using the CIPESC® assists in analyzing the interventions by encouraging clinical and epidemiological thinking regarding the health-illness process. With the purpose in mind of developing resources for teaching undergraduate nursing students and encouraging reflection regarding the process of nursing work, this article presents an experimental application of CIPESC®, using meningococcal meningitis as an example.

  16. Radiation protection policies to protect public health

    Energy Technology Data Exchange (ETDEWEB)

    Muckerheide, J. [Commonwealth Massachusetts, Needham, MA (United States)


    Scientific data from plant, animal, and human populations more strongly find radiation essential to life, i.e., suppressing background radiation is debilitating and that moderately enhanced radiation doses have positive effects, than that low-moderate radiation dose has adverse effects. {close_quote} Federal radiation protection policy will be in the public interest and save hundreds of billions of dollars at no public health cost when known dose effects to exposed populations are applied to ensure no adverse health effects, with safety margins, and when appropriate research is funded (and public benefits from new radiation and nuclear science and technology applications are enabled) at the sole cost of reduced federal power and influence.

  17. Public-Private Partnerships In Health

    Directory of Open Access Journals (Sweden)

    khalid BOUTI


    Full Text Available Extract:The current importance of public debt requires governments to increasingly shift towards Public-Private Partnerships (PPPs. They are long-term contracts of private financing method providing or contributing to public service. The payment is made by the public partner and/or users of the service.The World Health Organization (WHO defines this type of partnership as ‘‘a means to bring together a set of actors for the common goal of improving the health of populations based on mutually agreed roles and principles.’’Historically, the principle of PPP was established by the Private Finance Initiative (PFI, launched by the conservative government of John Major in 1992. It was from this moment that this model quickly spread to the rest of the world. In the mid-90s and from Australia, PPP agreement began to become part of the language of governments. In 1997, Labour with Tony Blair leading, strongly developed this management method, first and particularly in hospitals and then, in the entire public sector and spreading to the Royal Navy. Today, 10-15% of British public investments are made using PFI method....

  18. Developing public sociology through health impact assessment. (United States)

    Elliott, Eva; Williams, Gareth


    The renewed interest in 'public sociology' has sparked debate and discussion about forms of sociological work and their relationship to the State and civil society. Medical sociologists are accustomed to engaging with a range of publics and audiences inside and outside universities and are in a position to make an informed contribution to this debate. This paper describes how some of the debates about sociological work are played out through a 'health impact assessment' of a proposed housing renewal in a former coal mining community. We explore the dynamics of the health impact assessment process and relate it to wider debates, current in the social sciences, on the 'new knowledge spaces' within which contentious public issues are now being discussed, and the nature of different forms of expertise. The role of the 'public sociologist' in mediating the relationships between the accounts and interpretations of lay participants and the published 'evidence' is described as a process of mutual learning between publics, professionals and social scientists. It is argued that the continued existence and development of any meaningful 'professional sociology' requires an openness to a 'public sociology' which recognises and responds to new spaces of knowledge production.

  19. Study of digoxin use in a public health unit

    Directory of Open Access Journals (Sweden)

    Felipe C. Souza


    Full Text Available Digoxin is used for heart failure associated to systolic dysfunction and high ventricular rate. It has a narrow therapeutic range and intoxication may occur due to drug interactions or comorbidities. The aim of this work was to study digoxin use in a public health unit delineating the profile of patients susceptible to digitalis intoxication. Medical records belonging to patients admitted to the cardiomyopathy ward of the health unit (2009-2010 and in use of digoxin were analyzed. Among 647 patients admitted, 185 individuals using digoxin and possessed records available. The registration of plasma digoxin concentration was found in 80 records and it was out of the therapeutic range in 42 patients (52.5%. This group of individuals was constituted mainly by males patients (79%, functional class III of heart failure (65%, exhibiting renal failure (33%. The evaluated sample reflects the epidemiology of heart failure in Brazil and, although pharmacotherapy had been according to Brazilian Guidelines, apparently the monitoring was not performed as recommended. This work highlighs the necessity of plasma digoxin constant monitoring during pharmacotherapy and the development of protocols that enable a safer use, especially in male patients, functional class III and with renal dysfunction.

  20. Public Health Offices, Public Health Agencies - county, name, address, contact info, email, website, Published in 2007, Iowa Dept. of Public Health. (United States)

    NSGIC GIS Inventory (aka Ramona) — This Public Health Offices dataset, was produced all or in part from Published Reports/Deeds information as of 2007. It is described as 'Public Health Agencies -...

  1. Smoking, Mental Illness, and Public Health. (United States)

    Prochaska, Judith J; Das, Smita; Young-Wolff, Kelly C


    Tobacco remains the leading preventable cause of death worldwide. In particular, people with mental illness are disproportionately affected with high smoking prevalence; they account for more than 200,000 of the 520,000 tobacco-attributable deaths in the United States annually and die on average 25 years prematurely. Our review aims to provide an update on smoking in the mentally ill. We review the determinants of tobacco use among smokers with mental illness, presented with regard to the public health HAVE framework of "the host" (e.g., tobacco user characteristics), the "agent" (e.g., nicotine product characteristics), the "vector" (e.g., tobacco industry), and the "environment" (e.g., smoking policies). Furthermore, we identify the significant health harms incurred and opportunities for prevention and intervention within a health care systems and larger health policy perspective. A comprehensive effort is warranted to achieve equity toward the 2025 Healthy People goal of reducing US adult tobacco use to 12%, with attention to all subgroups, including smokers with mental illness. Expected final online publication date for the Annual Review of Public Health Volume 38 is March 20, 2017. Please see for revised estimates.

  2. Genetics in public health: Rarely explored

    Directory of Open Access Journals (Sweden)

    Aswini Y


    Full Text Available The availability and the integration of genetic information into our understanding of normal and abnormal growth and development are driving important changes in health care. These changes have fostered the hope that the availability of genetic information will promote a better understanding of disease etiology and permit early, even pre-symptomatic diagnosis and preventive intervention to avoid disease onset. Hence, our aim was to review and provide the insight into the role of genetics in public health and its scope as well as barriers. The use of genetics along with their goals and essential public health functions are discussed. From the era of eugenics to the present era, this area has seen many turns in which geneticists have put through their effort to tie together the strings of both molecular genetics and public health. Though still the dark clouds of eugenics, the predictive power of genes, genetic reductionism, non-modifiable risk factors, individuals or populations, resource allocation, commercial imperative, discrimination and understanding and education are hanging above. The technological and scientific advances that have fundamentally changed our perception of human diseases fuel the expectations for this proactive health.

  3. Intercultural competency in public health: a call for action to incorporate training into public health education

    Directory of Open Access Journals (Sweden)

    Julia eFleckman


    Full Text Available Due to increasing national diversity, programs addressing cultural competence have multiplied in U.S. medical training institutions. Little progress has been made to translate cultural competency training from the clinical setting into the public health setting where the focus is on population-based health, preventative programming, and epidemiological and behavioral research. The need for culturally relevant public health programming and culturally sensitive public health research is more critical than ever. Awareness of differing cultural roles needs to be included in all processes of planning, implementation and evaluation. In focusing on community-based health program planning and research, cultural competence implies that it is possible for public health professionals to completely know another culture, whereas intercultural competence implies it is a dual-sided process. Public health professionals need a commitment toward intercultural competence and skills that demonstrate flexibility, openness and self-reflection so that cultural learning is possible. In this article, the authors recommend a number of elements to develop, adapt and strengthen intercultural competence education in public health educational institutions.


    Program Area: Environmental HealthTopic Area: Linking Public Health Data into ActionTitle of Presentation: Linking Public Health and Air Quality Data for AccountabilityBackground and Significance Tracking environmental exposures to air pollutan...

  5. Public Health Campaign Cut Consumption of Sugary Drinks (United States)

    ... page: Public Health Campaign Cut Consumption of Sugary Drinks Soda sales ... 2016 THURSDAY, Nov. 17, 2016 (HealthDay News) -- A public health campaign to reduce sugary drink consumption led to ...

  6. Cost of diseases related to alcohol consumption in the Brazilian Unified Health System (United States)

    Coutinho, Evandro Silva Freire; Bahia, Luciana; Barufaldi, Laura Augusta; Abreu, Gabriela de Azevedo; Malhão, Thainá Alves; Pepe, Camila Ribeiro; Araujo, Denizar Vianna


    ABSTRACT OBJECTIVE To estimate the direct costs associated to outpatient and hospital care of diseases related to alcohol consumption in the Brazilian Unified Health System. METHODS Attributable populational risks were estimated for the selected diseases related to the use of 25 g/day or more of ethanol (risk consumption), considering a relative risk (RR) ≥ 1.20. The RR estimates were obtained from three meta-analysis. The risk consumption rates of the Brazilian population ≥ 18 years old were obtained by a national survey. Data from the Hospital Information System of SUS (HIS-SUS) were used to estimate the annual costs of the health system with the diseases included in the analysis. RESULTS The total estimated costs for a year regarding diseases related to risk consumption were U$8,262,762 (US$4,413,670 and US$3,849,092, for outpatient and hospital care, respectively). CONCLUSIONS Risk consumption of alcohol is an important economic and health problem, impacting significantly the health system and society. PMID:27305403

  7. Brazilian Cinema: A Comparative Study between Fundraising Through Mechanisms of Public Incentive versus the Selling Revenue on the Brazilian Box Offices

    Directory of Open Access Journals (Sweden)

    Inácio Alaiola Nogueira Dos Santos Júnior


    Full Text Available Responsible for maintaining active the actual cinematographic production, the politics of incentive to cinema do not guarantee an equal state of recourse capture for all the movies produced in the country as well as provoke discussion which relate production quality to volume capture, in which has taken to the creation of the common sense that says that movies which present elevated recourse fund must present best-selling results. Therefore, this study has the objective of analyzing the relation between the recourse volume captured from the mechanisms of public incentive and the selling volume on the Brazilian box offices. Due to that, descriptive research was made, with documentary character and quantitative approach. The data used in this study is related to information towards fundraising and income about the box office of 666 brazilian movies released between 1995 and 2012, while the statistical analysis used was the 'Spearman correlation' coefficient. The results showed that there is a strong positive correlation between the two variablesanalyzed, revealing a trend of movies with high fundraising are the ones that register the highest grossing box office. Data analysis also revealed that there is a concentration of both incentive funds (61% as income at the box office (75% in films with volume greater uptake of R $ 3 million.

  8. Comparing public-health research priorities in Europe

    Directory of Open Access Journals (Sweden)

    la Torre Giuseppe


    Full Text Available Abstract Background Despite improving trends, countries in Europe continue to face public-health challenges. This study investigated the priorities of stakeholders for research to meet these challenges. Methods Public-health research includes population-level and health-system research, but not clinical or biomedical research. The study drew on data from three surveys undertaken through collaboration in SPHERE (Strengthening Public Health Research in Europe. There was participation of ministries in 18 of 28 (64% response European countries, from 22 of 39 (56% response member national associations of the European Public Health Association, and from 80 civil society health organisations (53% of members of the European Public Health Alliance Results Public-health research fields included disease control, health promotion and health services. Ministries of health, rather than ministries of science or education, mostly took responsibility for public-health research: they reported varied but well-defined areas for research in relation to national health plans and programmes. National public health associations reported research priorities across most fields of public health, although with some European regional differences. Civil society health organisations prioritised health promotion research nationally, but also health services research internationally. There was less research reported on methods, such as modelling and economic analysis, wider determinants of health, and public-health interventions. Conclusion Systematic collaboration between stakeholders across European countries would enhance knowledge and promote innovation to address contemporary public-health challenges.

  9. Acne as a public health problem

    Directory of Open Access Journals (Sweden)

    Leda Semyonov


    Full Text Available Although acne is the most common skin disorder, epidemiological data on this condition are scarce. The social and economic effects of acne are mostly related to the high prevalence of this pathology, so much so that we can consider acne as a public health problem. Our proposal is to realize a computerized case sheet for each acne sufferer based on a minimum data set. This should include: patient’s age, sex, clinical form of acne and grade of severity. This information should then be introduced into a database management system. Examining the data collected we hope to contribute to the efficient use of health care resources and to improve management of public health problems highlighted in prior epidemiological investigations.

  10. Harmful Algal Blooms and Public Health (United States)

    Grattan, Lynn M.; Holobaugh, Sailor; Morris, J. Glenn


    The five most commonly recognized Harmful Algal Bloom related illnesses include Ciguatera poisoning, Paralytic Shellfish poisoning, Neurotoxin Shellfish poisoning, Diarrheic Shellfish Poisoning and Amnesic Shellfish poisoning. Although they are each the product of different toxins, toxin assemblages or HAB precursors these clinical syndromes have much in common. Exposure occurs through the consumption of fish or shellfish; routine clinical tests are not available for diagnosis; there is no known antidote for exposure; and the risk of these illnesses can negatively impact local fishing and tourism industries. Thus, illness prevention is of paramount importance to minimize human and public health risks. To accomplish this, close communication and collaboration is needed among HAB scientists, public health researchers and local, state and tribal health departments at academic, community outreach, and policy levels. PMID:27616971

  11. Big Social Data in Public Health

    DEFF Research Database (Denmark)

    Hansen, Kjeld S.; Mukkamala, Raghava Rao; Hussain, Abid


    We introduce the notion of “Socially Shared Health Information” (SSHI) referring to the phenomena of users and health organizations explicitly sharing health related information on social media platforms such as Facebook and Twitter. In order to investigate the phenomena of SSHI, in this paper, we...... present a multi-method case study of the organizational strategies for and user engagement with the Facebook page of the official portal for the public Danish Healthcare Services ( We analysed qualitative data in the form of a semi-structured interview with the social media editor of and netnographic observations, and quantitative data from the full historic fetch of the official Facebook wall. Our results show a good alignment between the organizational and social media strategies of the public Danish Healthcare Services but point out the lack of domain-specific metrics to measure its...

  12. Harmful Algal Blooms and Public Health. (United States)

    Grattan, Lynn M; Holobaugh, Sailor; Morris, J Glenn


    The five most commonly recognized Harmful Algal Bloom related illnesses include Ciguatera poisoning, Paralytic Shellfish poisoning, Neurotoxin Shellfish poisoning, Diarrheic Shellfish Poisoning and Amnesic Shellfish poisoning. Although they are each the product of different toxins, toxin assemblages or HAB precursors these clinical syndromes have much in common. Exposure occurs through the consumption of fish or shellfish; routine clinical tests are not available for diagnosis; there is no known antidote for exposure; and the risk of these illnesses can negatively impact local fishing and tourism industries. Thus, illness prevention is of paramount importance to minimize human and public health risks. To accomplish this, close communication and collaboration is needed among HAB scientists, public health researchers and local, state and tribal health departments at academic, community outreach, and policy levels.


    Directory of Open Access Journals (Sweden)

    Fábio Solon Tajra


    Full Text Available The Health Pact presented a new proposal for strategic advancement and formalization in healthcare. In this moment, there was the necessity of signing the commitment management which gathered some of the commitments made by managers as auditing in health. The aim of this study is to analyze the performance of management responsibilities about audit in SUS in reference to the document among brazilian states. Documentary research was carried out from the data source available in the site of the Participatory Strategic Support / Ministry of Health. We observed satisfactory levels (80.77% in meeting these responsibilities. However, it is necessary to greater commitment of management, once the audit has taken over the process of health reform, significant policy making in ensuring the principles of effectiveness, efficiency, effectiveness and economy.

  14. Globalisation and global health governance: implications for public health. (United States)

    Kruk, Margaret E


    Globalisation is a defining economic and social trend of the past several decades. Globalisation affects health directly and indirectly and creates economic and health disparities within and across countries. The political response to address these disparities, exemplified by the Millennium Development Goals, has put pressure on the global community to redress massive inequities in health and other determinants of human capability across countries. This, in turn, has accelerated a transformation in the architecture of global health governance. The entrance of new actors, such as private foundations and multi-stakeholder initiatives, contributed to a doubling of funds for global health between 2000 and 2010. Today the governance of public health is in flux, with diminished leadership from multilateral institutions, such as the WHO, and poor coherence in policy and programming that undermines the potential for sustainable health gains. These trends pose new challenges and opportunities for global public health, which is centrally concerned with identifying and addressing threats to the health of vulnerable populations worldwide.

  15. Gambling and the Health of the Public: Adopting a Public Health Perspective. (United States)

    Korn, David A.; Shaffer, Howard J.


    During the last decade there has been an unprecedented expansion of legalized gambling throughout North America. Three primary forces appear to be motivating this growth: (1) the desire of governments to identify new sources of revenue without invoking new or higher taxes; (2) tourism entrepreneurs developing new destinations for entertainment and leisure; and (3) the rise of new technologies and forms of gambling (e.g., video lottery terminals, powerball mega-lotteries, and computer offshore gambling). Associated with this phenomenon, there has been an increase in the prevalence of problem and pathological gambling among the general adult population, as well as a sustained high level of gambling-related problems among youth. To date there has been little dialogue within the public health sector in particular, or among health care practitioners in general, about the potential health impact of gambling or gambling-related problems. This article encourages the adoption of a public health perspective towards gambling. More specifically, this discussion has four primary objectives:1. Create awareness among health professionals about gambling, its rapid expansion and its relationship with the health care system;2. Place gambling within a public health framework by examining it from several perspectives, including population health, human ecology and addictive behaviors;3. Outline the major public health issues about how gambling can affect individuals, families and communities;4. Propose an agenda for strengthening policy, prevention and treatment practices through greater public health involvement, using the framework of The Ottawa Charter for Health Promotion as a guide.By understanding gambling and its potential impacts on the public's health, policy makers and health practitioners can minimize gambling's negative impacts and appreciate its potential benefits.

  16. Distributed data processing for public health surveillance

    Directory of Open Access Journals (Sweden)

    Yih Katherine


    Full Text Available Abstract Background Many systems for routine public health surveillance rely on centralized collection of potentially identifiable, individual, identifiable personal health information (PHI records. Although individual, identifiable patient records are essential for conditions for which there is mandated reporting, such as tuberculosis or sexually transmitted diseases, they are not routinely required for effective syndromic surveillance. Public concern about the routine collection of large quantities of PHI to support non-traditional public health functions may make alternative surveillance methods that do not rely on centralized identifiable PHI databases increasingly desirable. Methods The National Bioterrorism Syndromic Surveillance Demonstration Program (NDP is an example of one alternative model. All PHI in this system is initially processed within the secured infrastructure of the health care provider that collects and holds the data, using uniform software distributed and supported by the NDP. Only highly aggregated count data is transferred to the datacenter for statistical processing and display. Results Detailed, patient level information is readily available to the health care provider to elucidate signals observed in the aggregated data, or for ad hoc queries. We briefly describe the benefits and disadvantages associated with this distributed processing model for routine automated syndromic surveillance. Conclusion For well-defined surveillance requirements, the model can be successfully deployed with very low risk of inadvertent disclosure of PHI – a feature that may make participation in surveillance systems more feasible for organizations and more appealing to the individuals whose PHI they hold. It is possible to design and implement distributed systems to support non-routine public health needs if required.

  17. [Undergraduate on Public Health: limits and possibilities as a professional education strategy]. (United States)

    Bosi, Maria Lúcia Magalhães; Paim, Jairnilson Silva


    This article aims to call into question Public Health as a field for professionalization by systematizing theoretical, social and ethical-political bases for undergraduate education. We also attempt to record the trajectory in formulating undergraduate courses in that field and, more recently, the emergence of these projects in Brazilian Universities. In Brazil, the current projects are a result of institutional experience gained in Public Health teaching in different undergraduate courses in the field of health. Additionally, there is also a teaching tradition in non-degree and master's and PhD graduate courses. International experiences from similar courses, as well as orientation from international agencies represent important information for such initiatives. Furthermore, policies targeting social inclusion and the expansion in the number of student places in higher education have been propelling the movement. There is also the realization that the Brazilian Public Health System demands new actors able to provide answers which are both different and complementary to those offered by traditional undergraduate courses. While several institutions are in the stage of offering this education to society, this article presents a set of elements which are derived from reflection in the epistemological, sociological and political-sanitary spheres.

  18. Chronic Kidney Disease: A Public Health Problem That Needs a Public Health Action Plan

    Directory of Open Access Journals (Sweden)

    Anton C. Schoolwerth, MD, MSHA


    Full Text Available For a health problem or condition to be considered a public health issue, four criteria must be met: 1 the health condition must place a large burden on society, a burden that is getting larger despite existing control efforts; 2 the burden must be distributed unfairly (i.e., certain segments of the population are unequally affected; 3 there must be evidence that upstream preventive strategies could substantially reduce the burden of the condition; and 4 such preventive strategies are not yet in place. Chronic kidney disease meets these criteria for a public health issue. Therefore, as a complement to clinical approaches to controlling it, a broad and coordinated public health approach will be necessary to meet the burgeoning health, economic, and societal challenges of chronic kidney disease.

  19. PPACA and public health: creating a framework to focus on prevention and wellness and improve the public's health. (United States)

    Majette, Gwendolyn Roberts


    PPACA epitomizes comprehensive health care reform legislation. Public health, disease prevention, and wellness were integral considerations in its development. This article reveals the author's personal experiences while working on the framework for health care reform in the United States Senate and reviews activity in the United States House of Representatives. This insider's perspective delineates PPACA's positive effect on public health by examining the infrastructure Congress designed to focus on prevention, wellness, and public health, with a particular focus on the National Prevention, Health Promotion and Public Health Council; the National Prevention, Health Promotion, Public Health, and Integrative Health Care Strategy; and the Prevention and Public Health Fund. The Council, strategy, and fund are especially important because they reflect compliance with some of the Institute of Medicine's recommendations to improve public health in the United States, as well as international health and human rights norms that protect the right to health.

  20. Public health nutrition and food policy. (United States)

    Caraher, Martin; Coveney, John


    Food in its many manifestations allows us to explore the global control of health and to examine the ways in which food choice is moulded by many interests. The global food market is controlled by a small number of companies who operate a system that delivers 'cheap' food to the countries of the developed world. This 'cheap' food comes at a price, which externalises costs to the nation state in terms of health consequences (diabetes, coronary heart disease and other food-related diseases) and to the environment in terms of pollution and the associated clean-up strategies. Food policy has not to any great extent dealt with these issues, opting instead for an approach based on nutrition, food choice and biomedical health. Ignoring wider elements of the food system including issues of ecology and sustainability constrains a broader understanding within public health nutrition. Here we argue that public health nutrition, through the medium of health promotion, needs to address these wider issues of who controls the food supply, and thus the influences on the food chain and the food choices of the individual and communities. Such an upstream approach to food policy (one that has been learned from work on tobacco) is necessary if we are seriously to influence food choice.

  1. [Association between coverage by oral health teams in the family health and the increase in dental care output in Brazilian municipalities, 1999 and 2011]. (United States)

    Corrêa, Gabriel Trevizan; Celeste, Roger Keller


    The aim of this study was to analyze the association between population coverage by oral health teams under the Family Health Strategy (FHS) and the difference in 1999 and 2011 in rates of use of public dental services in Brazilian municipalities. The sample included all 5,507 municipalities in both years. Data were used from government information systems to perform logistic regression for modeling the increase in procedure rates. By 2011, 85% of Brazil's municipalities had oral health teams under the FHS and there had been an increase in infrastructure, human and financial resources. Dental care output increased 49.5% from 1999 to 2011. Municipalities that incorporated more than 3 oral health teams per 10,000 inhabitants showed higher odds of increasing their rates of community procedures (OR = 1.61, 95%CI: 1.23-2.11), prophylactic procedures (OR = 2.05, CI95%: 1.56-2.69), restorations (OR = 2.07, 95%CI: 1.58-2.71), and extractions (OR = 1.53, 95%CI: 1.19-1.97) after adjusting for socio-demographic factors and variations in physical, human and financial resources. The incorporation of oral health teams into the FHS appears more effective for increasing indicators of the use of dental services.

  2. Public Health in Europe : 10 years EUPHA

    Directory of Open Access Journals (Sweden)

    Wilhelm Kirch


    Full Text Available

    What is Public Health (PH? What are the links between Public Health research and policy in Europe? Where is PH coming from in the 20th century and where is it directed to?

    These are some of the questions addressed by Public Health in Europe – 10 years EUPHA, the volume, edited by Prof.W. Kirch and published by Springer in 2004, that presents a selection of the manuscripts from the 10th Annual Congress of EUPHA, held in Dresden in 2002.

    Gunnar Tellness, the President of EUPHA, reminds us what PH is, or what it should be: the science devoted to reduce in the population the amount of disease, premature death and disease-related discomfort, sickness and disability.

    In addressing these themes,Tellness suggests to improve PH by employing healthpromoting and cultural activities, in order to establish strong collaborations between public agencies, private business, organisations and pioneers.


    Directory of Open Access Journals (Sweden)

    Acosta Orlando


    Full Text Available The progress made in plant biotechnology has provided an opportunity to new food crops being developed having desirable traits for improving crop yield, reducing the use of agrochemicals and adding nutritional properties to staple crops. However, genetically modified (GM crops have become a subject of intense debate in which opponents argue that GM crops represent a threat to individual freedom, the environment, public health and traditional economies. Despite the advances in food crop agriculture, the current world situation is still characterised by massive hunger and chronic malnutrition, representing a major public health problem. Biofortified GM crops have been considered an important and complementary strategy for delivering naturally-fortified staple foods to malnourished populations. Expert advice and public concern have led to designing strategies for assessing the potential risks involved in cultivating and consuming GM crops. The present critical review was aimed at expressing some conflicting points of view about the potential risks of GM crops for public health. It was concluded that GM food crops are no more risky than those genetically modified by conventional methods and that these GM crops might contribute towards reducing the amount of malnourished people around the world. However, all this needs to be complemented by effective political action aimed at increasing the income of people living below the poverty-line.

  4. Poverty & health: criticality of public financing. (United States)

    Duggal, Ravi


    Countries with universal or near universal access to healthcare have health financing mechanisms which are single-payer systems in which either a single autonomous public agency or a few coordinated agencies pool resources to finance healthcare. This contributes to both equity in healthcare as well as to low levels of poverty in these countries. It is only in countries like India and a number of developing countries, which still rely mostly on out-of-pocket payments, where universal access to healthcare is elusive. In such countries those who have the capacity to buy healthcare from the market most often get healthcare without having to pay for it directly because they are either covered by social insurance or buy private insurance. In contrast, a large majority of the population, who suffers a hand-to-mouth existence, is forced to make direct payments, often with a heavy burden of debt, to access healthcare from the market because public provision is grossly inadequate or non existent. Thus, the absence of adequate public health investment not only results in poor health outcomes but it also leads to escalation of poverty. This article critically reviews the linkages of poverty with healthcare financing using evidence from national surveys and concludes that public financing is critical to good access to healthcare for the poor and its inadequacy is closely associated with poverty levels in the country.

  5. Translating science into action: periodontal health through public health approaches. (United States)

    Jürgensen, Nanna; Petersen, Poul E; Ogawa, Hiroshi; Matsumoto, Sayaka


    Clinical and public health research data have shown that a number of individual, professional and community health measures may be valuable in preventing the major oral diseases. The fundamental gap in knowledge, however, is not confined to 'what to do' but rather 'how' to translate the scientific findings into effective and sustainable programs for groups and populations. The advances in oral health science have not yet benefitted the poor and disadvantaged population groups around the world to the fullest extent possible and this has led to inequalities in periodontal health as well as in other chronic diseases. Research on the causative role of tobacco use in periodontal disease is strong because of the fact that tobacco-induced disease ultimately may lead to the loss of teeth. Studies also indicate that wound healing may be negatively affected by the use of tobacco. Likewise, research has shown that extreme use of alcohol, poor diet and nutrition, and psychological stress all have negative effects on periodontal health. Research on sociobehavioral risk factors has great implication to prevent periodontal disease. The case for tobacco is illustrated in this report. The global exposure to tobacco use in adults and adolescents is outlined. Because of the global Framework Convention for Tobacco Control (2003), the solid research on the harmful effect of tobacco is now being widely used for public health. The importance of tobacco prevention within the context of health-promoting schools is emphasized. Research on other population-directed strategies and their implications on public health would be instrumental to integrated prevention of chronic disease and periodontal disease. Community interventions and delivery of preventive oral care by oral health services may have positive outcomes for periodontal health but periodontal research needs to be further strengthened by the provision of sound evidence. It is somewhat remarkable that research on true population

  6. Vaccinations: A public health triumph and a public relations tragedy. (United States)

    Jacobson, Robert M


    Routine vaccination has been hailed as one of the top public health achievements of the last century. However, despite the reduced number of cases of and deaths from vaccine-preventable diseases such as pertussis and measles, outbreaks continue to occur as more parents fail to adequately vaccinate their children because of misinformation about immunizations. This article describes the challenges of making sure all children in the United States are fully immunized and what physicians need to know to effectively work with parents who may be hesitant to vaccinate their children.

  7. Multisectoral studies in Public Health in Ukraine

    Directory of Open Access Journals (Sweden)

    Andreeva, Tatiana


    Full Text Available The second issue of the TCPHEE contains materials presented at the conference ‘Economics, sociology, theory and practice of public health’ conducted in Kiev on April 12-15, 2011. Conference participants were the faculty, doctoral and master students of the School of Public Health (SPH at the National University of Kyiv-Mohyla Academy (NaUKMA. Reports were first discussed during the conference and then submitted as conference abstracts for the editorial review. The revised versions were then peer-reviewed and were subject to editorial approval again.

  8. [Nutritional challenges in the Brazilian Unified National Health System for building the interface between health and food and nutritional security]. (United States)

    Rigon, Silvia do Amaral; Schmidt, Suely Teresinha; Bógus, Cláudia Maria


    This article discusses the establishment of inter-sector action between health and food and nutritional security in Brazil from 2003 to 2010, when this issue was launched as a priority on the government's agenda. A qualitative study was developed according to constructivist epistemology, using key-informant interviews in the field's nationwide social oversight body. Advances and challenges in this process are addressed as analytical categories. The National Food and Nutrition Policy (PNAN) was mentioned as the link between the two fields, decentralized through a network with activity in the states and municipalities. However, the study found political, institutional, and operational obstacles to the effective implementation of the PNAN in the Brazilian Unified National Health System and consequently to a contribution to the advancement of Health and Food and Nutritional Security in the country. The predominance of the biomedical, curative, and high-complexity model was cited as the principal impediment, while health promotion policies like the PNAN were assigned secondary priority.

  9. Poison Center Data for Public Health Surveillance: Poison Center and Public Health Perspectives (United States)

    Law, Royal K.; Schier, Josh; Schauben, Jay; Wheeler, Katherine; Mulay, Prakash


    Objective To describe the use of poison center data for public health surveillance from the poison center, local, state, and federal public health perspectives and to generate meaningful discussion on how to address the challenges to collaboration. Introduction Since 2008, poisoning has become the leading cause of injury-related death in the United States (US); since 1980, the poisoning-related fatality rate in the US has almost tripled.1 Many poison-related injuries and deaths are reported to regional poison centers (PCs) which receive about 2.4 million reports of human chemical and poison exposures annually.2 Federal, state, and local public health (PH) agencies often collaborate with poison centers and use PC data for public health surveillance of poisoning-related health issues. Many state and local PH agencies have partnerships with regional PCs for direct access to local PC data which help them perform this function. At the national level, CDC conducts public health surveillance for exposures and illnesses of public health significance using the National Poison Data System (NPDS), the national PC reporting database. Though most PC and PH officials agree that PC data play an important role in PH practice and surveillance, collaboration between PH agencies and PCs has been hindered by numerous challenges. To address these challenges and bolster collaboration, the Poison Center and Public Health Collaborations Community of Practice (CoP) was created in 2010 by CDC as a means to share experiences, identify best practices, and facilitate relationships among federal, state and local public health agencies and PCs. To date, the Poison Center and Public Health Collaborations CoP includes over 200 members from state and local public health, regional PCs, CDC, the American Association of Poison Control Centers (AAPCC), and the Environmental Protection Agency (EPA). A leadership team was created with representatives of the many stakeholders of the community to drive its

  10. Public health system - current status and world experience

    Directory of Open Access Journals (Sweden)

    Andreyeva І.А.


    Full Text Available In the review, the evolution of Public Health and global development tendencies of Public Health system have been discussed. Stages of formation of the updated concept, principles of Public Health organization and the role of various organizations have been shown in the connection with development of the global concept of "Health for All". A well-functioning public health system is primarily the result of multisectoral cooperation. The aim of modern Public Health is to provide conditions of access to appropriate and cost-effective health care for all population groups, including health promotion and disease prevention.

  11. Legal aspects of public health: difficulties in controlling vector-borne and zoonotic diseases in Brazil. (United States)

    Mendes, Marcílio S; de Moraes, Josué


    In recent years, vector-borne and zoonotic diseases have become a major challenge for public health. Dengue fever and leptospirosis are the most important communicable diseases in Brazil based on their prevalence and the healthy life years lost from disability. The primary strategy for preventing human exposure to these diseases is effective insect and rodent control in and around the home. However, health authorities have difficulties in controlling vector-borne and zoonotic diseases because residents often refuse access to their homes. This study discusses aspects related to the activities performed by Brazilian health authorities to combat vector-borne and zoonotic diseases, particularly difficulties in relation to the legal aspect, which often impede the quick and effective actions of these professionals. How might it be possible to reconcile the need to preserve public health and the rule on the inviolability of the home, especially in the case of abandoned properties or illegal residents and the refusal of residents to allow the health authority access? Do residents have the right to hinder the performance of health workers even in the face of a significant and visible focus of disease transmission? This paper argues that a comprehensive legal plan aimed at the control of invasive vector-borne and zoonotic diseases including synanthropic animals of public health importance should be considered. In addition, this paper aims to bridge the gap between lawyers and public health professionals and to facilitate communication between them.

  12. Public school teachers’ perceptions about mental health (United States)

    Soares, Amanda Gonçalves Simões; Estanislau, Gustavo; Brietzke, Elisa; Lefèvre, Fernando; Bressan, Rodrigo Affonseca


    OBJECTIVE To examine public school teachers’ perceptions about general health and mental health, and the way in which they obtained this information. METHODS Qualitative research was conducted with 31 primary and secondary school teachers at a state school in the municipality of Sao Paulo, SP, Southeastern Brazil, in 2010. The teachers responded to a questionnaire containing open-ended questions about mental health and general health. The following aspects were evaluated: Teachers’ understanding of the terms “health and “mental health,” the relevance of the need for information on the subject, the method preferred for obtaining information, their experience with different media regarding such matters, and perceptions about the extent to which this available information is sufficient to support their practice. The data were processed using the Qualiquantisoft software and analyzed according to the Discourse of the Collective Subject technique. RESULTS From the teachers’ perspective, general health is defined as the proper physiological functioning of the body and mental health is related to the balance between mind and body, as a requirement for happiness. Most of the teachers (80.6%) showed great interest in acquiring knowledge about mental health and receiving educational materials on the subject. For these teachers, the lack of information creates insecurity and complicates the management of everyday situations involving mental disorders. For 61.3% of the teachers, television is the medium that provides the most information on the topic. CONCLUSIONS The data indicate that there is little information available on mental health for teachers, showing that strategies need to be developed to promote mental health in schools. PMID:26039397

  13. Urban planning and public health at CDC. (United States)

    Kochtitzky, Chris S; Frumkin, H; Rodriguez, R; Dannenberg, A L; Rayman, J; Rose, K; Gillig, R; Kanter, T


    Urban planning, also called city and regional planning, is a multidisciplinary field in which professionals work to improve the welfare of persons and communities by creating more convenient, equitable, healthful, efficient, and attractive places now and for the future. The centerpiece of urban planning activities is a "master plan," which can take many forms, including comprehensive plans, neighborhood plans, community action plans, regulatory and incentive strategies, economic development plans, and disaster preparedness plans. Traditionally, these plans include assessing and planning for community needs in some or all of the following areas: transportation, housing, commercial/office buildings, natural resource utilization, environmental protection, and health-care infrastructure. Urban planning and public health share common missions and perspectives. Both aim to improve human well-being, emphasize needs assessment and service delivery, manage complex social systems, focus at the population level, and rely on community-based participatory methods. Both fields focus on the needs of vulnerable populations. Throughout their development, both fields have broadened their perspectives. Initially, public health most often used a biomedical model (examining normal/abnormal functioning of the human organism), and urban planning often relied on a geographic model (analysis of human needs or interactions in a spatial context). However, both fields have expanded their tools and perspectives, in part because of the influence of the other. Urban planning and public health have been intertwined for most of their histories. In 1854, British physician John Snow used geographic mapping of an outbreak of cholera in London to identify a public water pump as the outbreak's source. Geographic analysis is a key planning tool shared by urban planning and public health. In the mid-1800s, planners such as Frederick Law Olmsted bridged the gap between the fields by advancing the concept

  14. Transitions in state public health law: comparative analysis of state public health law reform following the Turning Point Model State Public Health Act. (United States)

    Meier, Benjamin Mason; Hodge, James G; Gebbie, Kristine M


    Given the public health importance of law modernization, we undertook a comparative analysis of policy efforts in 4 states (Alaska, South Carolina, Wisconsin, and Nebraska) that have considered public health law reform based on the Turning Point Model State Public Health Act. Through national legislative tracking and state case studies, we investigated how the Turning Point Act's model legal language has been considered for incorporation into state law and analyzed key facilitating and inhibiting factors for public health law reform. Our findings provide the practice community with a research base to facilitate further law reform and inform future scholarship on the role of law as a determinant of the public's health.

  15. [The ALANAM statement on public health policy]. (United States)

    Goic, Alejando; Armas, Rodolfo


    The ALANAM (Association of Latin American National Academies of Medicine) statement on public health policy, issued following its 19th Congress, held October 28–30, 2010, in Santiago, Chile, declares that cardiovascular diseases, cancer, accidents and violence are the leading causes of death in the region, while in several of its member nations, emergent and re-emergent infectious diseases, malnutrition, and mother-child illnesses remain prevalent. The statement calls attention to the lack of functioning water supply and sewage systems in many villages and rural areas. After describing the social causes of the present state of public health in Latin America (poverty levels reaching upwards of 44% of the total population, or some 110 million people), it calls on governments, first, to spare no efforts in the task of eradicating extreme poverty in the short-term, and poverty in the long-term. Second, considering that about 15 million 3-to-6 year-olds have no access to education, it recommends extending educational services to these children, and to improve the quality of existing pre-school and primary education. Third, the statement calls for universal health care coverage and for equal access to good quality medical care for everyone, and for programs aimed at promoting healthy personal habits and self-care. In this regard, it also recommends that disease prevention programs be sustained over time, that national sanitary objectives be defined, and that its results be periodically reviewed. Fourth, it recommends that primary health care be extended to everyone, and that it be enhanced by improving coverage and coordination with secondary and tertiary level health care institutions. The statement lays special stress on the need for adopting public health policies aimed at lowering the cost of medicines; to this end, it calls for the creation of an official list of generic drugs. The statement ends by calling on governments to support public health research as a

  16. Zika Virus: Implications for Public Health. (United States)

    Focosi, Daniele; Maggi, Fabrizio; Pistello, Mauro


    The World Health Organization has declared the current Zika virus (ZIKV) epidemic a public health emergency of international concern. Lack of vaccines and reliable diagnostic tests, broad geographical distribution of mosquito species that can transmit the virus, and absence of population immunity in newly affected countries are causes for concern. Although most infected persons are asymptomatic, ZIKV has been associated with a rise in cases of neurological complications and fetal central nervous system malformations. This defines such an arbovirus as something whose transmission should be prevented. This review summarizes the current understanding of ZIKV biology and epidemiology, as well as possible interventions to prevent contagion and transmission.

  17. Tackling poor parenting: a public health issue. (United States)

    Poole, Judith


    The adverse consequences associated with poor parenting persist down the generations and are a problem for society as well as individuals. The author cites evidence suggesting that in many cases poor parenting is associated with socioeconomic deprivation, including health inequalities. She argues that most parents (especially mothers, as the main child carers) are motivated to do their best for their children but that many families struggle against poverty. Poor parenting skills may be a product of poverty and social exclusion rather than the fault of individual parents. A public health approach, based on partnership with parents to meet their expressed needs in appropriate ways, could offer a constructive way forward.

  18. Florence Nightingale: nurse and public health pioneer. (United States)

    Ellis, Harold


    August 2010 marks the centenary of the death of Florence Nightingale, who must be, without doubt, the most famous name in nursing. Most people, even those in the health professions, think of her as 'The Lady with the Lamp'; the heroine of the Crimean War, who tended the sick and wounded soldiers at Scutari. Important though this was, her main contribution, which continued long after Crimea, was in the organization of nursing training, in hospital planning, public and military health, and in effective collection of medical statistics.

  19. The expansion of "the feminine" within the Brazilian public sphere: telenovelas of the 1970s and 1980s

    Directory of Open Access Journals (Sweden)

    Esther Império Hamburger

    Full Text Available This paper revisits the wide range of critical literature that, from a variety of theoretical perspectives and with an emphasis on different historical periods and countries, deals with the relationships between mass media and representations of gender relations. This review of the literature focuses on works that are particularly suggestive for our ensuing discussion on the major conventions of Brazilian telenovela, a television genre that blends elements of documentary and fiction and treats the nation in melodramatic terms. Analysis of relevant programs that were exhibited during the 70s and the 80s suggests that these soaps constructed the Brazilian public space in terms that expanded what the industry had conventionally defined as "woman's domain".

  20. Mentoring in epidemiology and public health training. (United States)

    Davis, Faith G


    In the past, mentoring was the job of one senior researcher in which the mentor molded the mentee in his/her own image. With public health being a very multidisciplinary field, mentoring may need to evolve to facilitate the needs of emerging scientists-including epidemiologists. The mentoring relationship can begin at many education stages, including high school. Involving students at all education levels acts as a way to recruit and nurture interest in public health. On the basis of the experience in the medical sciences, mentoring programs also can be used to recruit and retain high-quality professionals in our discipline. Mentoring functions nurture a young mentee with the bonus of greater workplace satisfaction for the mentor. Nevertheless, more understanding of what constitutes successful mentoring and how to develop programs that create great mentors is needed.

  1. Peak oil, food systems, and public health. (United States)

    Neff, Roni A; Parker, Cindy L; Kirschenmann, Frederick L; Tinch, Jennifer; Lawrence, Robert S


    Peak oil is the phenomenon whereby global oil supplies will peak, then decline, with extraction growing increasingly costly. Today's globalized industrial food system depends on oil for fueling farm machinery, producing pesticides, and transporting goods. Biofuels production links oil prices to food prices. We examined food system vulnerability to rising oil prices and the public health consequences. In the short term, high food prices harm food security and equity. Over time, high prices will force the entire food system to adapt. Strong preparation and advance investment may mitigate the extent of dislocation and hunger. Certain social and policy changes could smooth adaptation; public health has an essential role in promoting a proactive, smart, and equitable transition that increases resilience and enables adequate food for all.

  2. Massive open online courses in public health. (United States)

    Gooding, Ira; Klaas, Brian; Yager, James D; Kanchanaraksa, Sukon


    Massive open online courses (MOOCs) represent a new and potentially transformative model for providing educational opportunities to learners not enrolled in a formal educational program. The authors describe the experience of developing and offering eight MOOCs on a variety of public health topics. Existing institutional infrastructure and experience with both for-credit online education and open educational resources mitigated the institutional risk and resource requirements. Although learners are able to enroll easily and freely and do so in large numbers, there is considerable variety in the level of participation and engagement among enrollees. As a result, comprehensive and accurate assessment of meaningful learning progress remains a major challenge for evaluating the effectiveness of MOOCs for providing public health education.

  3. Parasitic zoonoses; public health and veterinary perspectives. (United States)

    Graczyk, Tadeusz K; Tamang, Leena; Doocy, Shannon C


    The importance of parasitic zoonoses continues to increase on both local and global scales as interactions between people and animals become more frequent through global travel, intensification of agriculture, habitat devastation, and changes in world trade patterns. A current and real threat is the potential for a deliberate introduction of a zoonotic disease through the prospect of bioterrorism. Parasitic zoonoses represent significant problems in public health, animal agriculture and conservation, and the meat industry. There is an urgent need for integration of medical and veterinary services, continuous disease surveillance in both humans and animals, the teaching of zoonoses to medical doctors, and intensified research on zoonotic agents and diseases. The convergence of both public health and veterinary services currently represents a real challenge for managing zoonotic diseases.

  4. Reporting on health-related research in two prestigious Brazilian newspapers

    Directory of Open Access Journals (Sweden)

    Ricardo Afonso Teixeira


    Full Text Available OBJECTIVES: The dissemination of health-related news through newspapers can influence the behavior of patients and of health care providers. We conducted a study to analyze the characteristics of health-related research published by two leading Brazilian newspapers. METHOD: We retrospectively evaluated health-related news published in the electronic versions of the newspapers Folha de São Paulo and O Estado de São Paulo over a period of three months (July through September, 2009. Only articles mentioning medical research were included. The articles were categorized according to topic, source, study location and the nature of the headline. We also analyzed the presence of background information on the topic, citations of medical periodicals, national contextualization and references to products or companies. RESULTS: Scientific research articles corresponded to 57% and 20% of health-related articles published by Folha de São Paulo and O Estado de São Paulo, respectively. Folha de São Paulo published significantly more articles about national studies, and most articles were written by its own staff. In contrast, most articles in O Estado de São Paulo came from news agencies. Folha de São Paulo also better contextualized its reports for Brazilian society. O Estado de São Paulo tended to cite the name of the periodical in which the study was published more frequently, but their articles lacked national contextualization. CONCLUSION: The results showed a significant difference in the way in which the studied newspapers report on health-related research. Folha de São Paulo tends to write its own articles and more frequently publishes the results of national research, whereas O Estado de São Paulo publishes articles that originate in news agencies, most of which have little national contextualization.

  5. Reporting on health-related research in two prestigious Brazilian newspapers (United States)

    Teixeira, Ricardo Afonso; Carlini, Marcela; de Carvalho Jatobá e Sousa, Arthur; Fernandes, Paula Teixeira; Camargo, Vera Regina Toledo; Vogt, Carlos; Li, Li Min


    OBJECTIVES: The dissemination of health-related news through newspapers can influence the behavior of patients and of health care providers. We conducted a study to analyze the characteristics of health-related research published by two leading Brazilian newspapers. METHOD: We retrospectively evaluated health-related news published in the electronic versions of the newspapers Folha de São Paulo and O Estado de São Paulo over a period of three months (July through September, 2009). Only articles mentioning medical research were included. The articles were categorized according to topic, source, study location and the nature of the headline. We also analyzed the presence of background information on the topic, citations of medical periodicals, national contextualization and references to products or companies. RESULTS: Scientific research articles corresponded to 57% and 20% of health-related articles published by Folha de São Paulo and O Estado de São Paulo, respectively. Folha de São Paulo published significantly more articles about national studies, and most articles were written by its own staff. In contrast, most articles in O Estado de São Paulo came from news agencies. Folha de São Paulo also better contextualized its reports for Brazilian society. O Estado de São Paulo tended to cite the name of the periodical in which the study was published more frequently, but their articles lacked national contextualization. CONCLUSION: The results showed a significant difference in the way in which the studied newspapers report on health-related research. Folha de São Paulo tends to write its own articles and more frequently publishes the results of national research, whereas O Estado de São Paulo publishes articles that originate in news agencies, most of which have little national contextualization. PMID:22473408

  6. The public health workforce: An assessment in the Netherlands

    NARCIS (Netherlands)

    Jambroes, M.


    The public health workforce is a key resource of population health. How many people work in public health in the Netherlands, what are their characteristics and who does what? Remarkably, such information about the size and composition of the public health workforce in the Netherlands is lacking. A

  7. Interorganizational collaboration in public health data sharing. (United States)

    Casey, Colleen; Li, Jianling; Berry, Michele


    Purpose The purpose of this paper is to analyze the institutional and social forces that influence collaborative data sharing practices in cross-sector interorganizational networks. The analysis focusses on the data sharing practices between professionals in the transportation and public health sectors, areas prioritized for collaborative action to improve public health. Design/methodology/approach A mixed methods design is utilized. Electronic surveys were sent to 57 public health and 157 transportation professionals in a large major metropolitan area in the USA (response rate 39.7 percent). Focus groups were held with 12 organizational leaders representing professionals in both sectors. Findings The application of the institutional-social capital framework suggests that professional specialization and organizational forces make it challenging for professionals to develop the cross-sector relationships necessary for cross-sector collaborative data sharing. Research limitations/implications The findings suggest that developing the social relationships necessary for cross-sector collaboration may be resource intensive. Investments are necessary at the organizational level to overcome the professional divides that limit the development of cross-sector relationships critical for collaborative data sharing. The results are limited to the data sharing practices of professionals in one metropolitan area. Originality/value Despite mandates and calls for increased cross-sector collaboration to improve public health, such efforts often fail to produce true collaboration. The study's value is that it adds to the theoretical conceptualization of collaboration and provides a deeper understanding as to why collaborative action remains difficult to achieve. Future study of collaboration must consider the interaction between professional specialization and the social relationships necessary for success.

  8. Social Media Image Analysis for Public Health



    Several projects have shown the feasibility to use textual social media data to track public health concerns, such as temporal influenza patterns or geographical obesity patterns. In this paper, we look at whether geo-tagged images from Instagram also provide a viable data source. Especially for "lifestyle" diseases, such as obesity, drinking or smoking, images of social gatherings could provide information that is not necessarily shared in, say, tweets. In this study, we explore whether (i) ...

  9. Syndromic surveillance: A necessary public health tool



    Of late much has been said about emerging infectious diseases and the threat of bioterrorism. The focus has been on continuous public health surveillance for early detection of outbreaks and potential threats. Preparedness is the way forward and relevant institutions and organizations need to make the necessary investments early. Familiarity, good coordination, active participation and a change of mindset amongst personnel is crucial to make the system work. We also share a general approach t...

  10. Urban Public Health: Is There a Pyramid?


    Meirong Su; Bin Chen; Zhifeng Yang; Yanpeng Cai; Jiao Wang


    Early ecologists identified a pyramidal trophic structure in terms of number, biomass and energy transfer. In 1943, the psychologist Maslow put forward a pyramid model to describe layers of human needs. It is indicated that the pyramid principle is universally applicable in natural, humanistic and social disciplines. Here, we report that a pyramid structure also exists in urban public health (UPH). Based on 18 indicators, the UPH states of four cities (Beijing, Tokyo, New York, and London) ar...

  11. [Ethical and political diversity in the right to health care in Brazilian municipalities along the MERCOSUR border]. (United States)

    Nogueira, Vera Maria Ribeiro; Dal Prá, Keli Regina; Fermiano, Sabrina


    This article presents the results of a study in Brazilian municipalities along the border with the other Southern Cone Common Market (MERCOSUR) countries, identifying health care patterns and showing ethical and political diversity in the guarantee and use of the right to health care, characterizing demands on (and responses by) local health systems. The main variable was whether non-Brazilians had access to Brazilian health services. Data were collected using forms in municipalities with more than 10 thousand inhabitants, field diaries, meetings, and interviews. The definition of the right to health care varied greatly, indicating lack of common ethical and political principles and weak institutionality, with incapacity to absorb the demand by non-Brazilian patients. Agreements between the respective Federal governments of MERCOSUR countries had failed to reach the local level and were ignored by local health services managers and professionals. The foreign population remains uncertain about receiving care. In Brazil, the lack of uniform standards of care lead to ad hoc personal decisions by health services managers and professionals, thus hindering integrated action.

  12. Public health implications of wireless technologies. (United States)

    Sage, Cindy; Carpenter, David O


    Global exposures to emerging wireless technologies from applications including mobile phones, cordless phones, DECT phones, WI-FI, WLAN, WiMAX, wireless internet, baby monitors, and others may present serious public health consequences. Evidence supporting a public health risk is documented in the BioInitiative Report. New, biologically based public exposure standards for chronic exposure to low-intensity exposures are warranted. Existing safety standards are obsolete because they are based solely on thermal effects from acute exposures. The rapidly expanding development of new wireless technologies and the long latency for the development of such serious diseases as brain cancers means that failure to take immediate action to reduce risks may result in an epidemic of potentially fatal diseases in the future. Regardless of whether or not the associations are causal, the strengths of the associations are sufficiently strong that in the opinion of the authors, taking action to reduce exposures is imperative, especially for the fetus and children. Such action is fully compatible with the precautionary principle, as enunciated by the Rio Declaration, the European Constitution Principle on Health (Section 3.1) and the European Union Treaties Article 174.

  13. Impact of leishmaniasis on public health

    Directory of Open Access Journals (Sweden)

    L. B Camargo


    Full Text Available Leishmaniasis is a parasitic zoonosis caused by protozoans of the genus Leishmania transmitted by insects known as phlebotomines, which are found in wild or urban environments. It affects domestic and wild animals and transmission to man happens by accident. The disease occurs in tropical and sub-tropical areas, mainly in Asia, Europe, Africa, and the Americas. There are two forms that affect man: American cutaneous leishmaniasis (ACL and American visceral leishmaniasis (AVL. The latter is caused by three species of Leishmania: Leishmania (Leishmania donovani, Leishmania (Leishmania infantum, and Leishmania (Leishmania chagasi, which are grouped in the Leishmania (Leishmania donovani complex. Wild reservoir hosts of L. chagasi known so far are foxes and marsupials. In domestic environment, dogs are the most important reservoir hosts and sources of infection to the vectors Lutzomyia longipalpis. Leishmaniasis is difficult to control, causing epidemic outbreaks, thus being an important public health problem. Due to lesions caused by the mucocutaneous type and the severity of those caused by the visceral type in humans, visceral leishmaniasis is one of the main public health concerns. This paper is part of the monograph presented at the end of the residency program in the field of Zoonosis and Public Health at the School of Veterinary Sciences and Animal Husbandry, São Paulo State University, UNESP, Botucatu, São Paulo State, Brazil, in 2005.

  14. A public health physician named Walter Leser. (United States)

    Mello, Guilherme Arantes; Bonfim, José Ruben de Alcântara


    A brief review of the career of the public health physician Walter Sidney Pereira Leser, who died in 2004 aged 94. Self-taught, from his 1933 doctoral thesis he became a country reference in the field of statistics and epidemiology, with dozens of studies and supervisions. In the clinical field he is one of the founders of Fleury Laboratory, and participates in the creation of CREMESP. As an academic, Leser was a professor at the Escola de Sociologia e Política de São Paulo, Escola Paulista de Medicina e Faculdade de Farmácia e Odontologia da USP. Also, Leser introduced objective tests in the college entrance examination, and led the creation of CESCEM and Carlos Chagas Foundation. In the Escola Paulista de Medicina he created the first Preventive Medicine Department of the country. As a public official, he was secretary of the State Department of Health of São Paulo between 1967 and 1971 and between 1975 and 1979, responsible for extensive reforms and innovations. Among the most remembered, the creation of sanitary medical career. Throughout this legacy, he lent his name to the "Medal of Honor and Merit Public Health Management" of the State of São Paulo.

  15. [Intensify the development of public policy has the health: approaches strategic for the authorities of health public]. (United States)

    Guyon, Ak'ingabe


    Health promotion is one of the essential functions of public health authorities. The first pillar of health promotion is the elaboration of healthy public policy. Using the theoretical foundations of the healthy public policy concept, it can be demonstrated that public health authorities are able to develop, at their own scale, healthy public policies. Three strategic approaches are proposed in order to support public health authorities in strengthening their healthy public policy actions. First, better understand the tools or policy instruments (economic, regulation, information and persuasion) at their disposal. Second, take stock of the many types of legitimacy (theoretical, legislative, administrative and scientific) available to public health authorities as they develop healthy public policy. Third, consider the potential scientific roles that can be adopted while using the various policy instruments. These approaches can represent a pragmatic and structuring support for public health authorities wanting to strengthen their healthy public policy actions.

  16. 77 FR 28883 - Draft Public Health Action Plan-A National Public Health Action Plan for the Detection... (United States)


    ... HUMAN SERVICES Centers for Disease Control and Prevention Draft Public Health Action Plan--A National Public Health Action Plan for the Detection, Prevention, and Management of Infertility AGENCY: Centers... requesting public comment on the draft National Public Health Action Plan for the Detection, Prevention,...

  17. 77 FR 38296 - Draft Public Health Action Plan-A National Public Health Action Plan for the Detection... (United States)


    ... HUMAN SERVICES Centers for Disease Control and Prevention Draft Public Health Action Plan--A National Public Health Action Plan for the Detection, Prevention, and Management of Infertility AGENCY: Centers... Federal Register requesting public comment on the draft National Public Health Action Plan for...

  18. Using public relations to promote health: a framing analysis of public relations strategies among health associations. (United States)

    Park, Hyojung; Reber, Bryan H


    This study explored health organizations' public relations efforts to frame health issues through their press releases. Content analysis of 316 press releases from three health organizations-the American Heart Association, the American Cancer Society, and the American Diabetes Association-revealed that they used the medical research frame most frequently and emphasized societal responsibility for health issues. There were differences, however, among the organizations regarding the main frames and health issues: the American Diabetes Association was more likely to focus on the issues related to social support and education, while the American Heart Association and the American Cancer Society were more likely to address medical research and scientific news. To demonstrate their initiatives for public health, all the organizations employed the social support/educational frame most frequently. Researchers and medical doctors frequently were quoted as trusted sources in the releases.

  19. Lexicon, definitions, and conceptual framework for public health surveillance. (United States)

    Hall, H Irene; Correa, Adolfo; Yoon, Paula W; Braden, Christopher R


    Public health surveillance is essential to the practice of public health and to guide prevention and control activities and evaluate outcomes of such activities. With advances in information sciences and technology, changes in methodology, data availability and data synthesis, and expanded health information needs, the question arises whether redefining public health surveillance is needed for the 21st century. The current definition is "Public health surveillance is the ongoing, systematic collection, analysis, and interpretation of health data, essential to the planning, implementation and evaluation of public health practice, closely integrated with the dissemination of these data to those who need to know and linked to prevention and control."

  20. The Quad Council practice competencies for public health nursing. (United States)

    Swider, Susan M; Krothe, Joyce; Reyes, David; Cravetz, Michelle


    This article describes the most recent efforts by the Quad Council of Public Health Nursing organizations to review and revise the competencies for PHN practice, and highlights the implications of these competencies for practice, education, and research. The Quad Council is a coalition of four nursing organizations with a focus on public health nursing and includes the Association of Community Health Nursing Educators; the Association of Public Health Nursing (known prior to July 1, 2012 as the Association of State and Territorial Directors of Nursing); the Public Health Nursing section of the American Public Health Association; and the Council on Economics and Practice of the American Nurses' Association. The Quad Council competencies are based on the Council on Linkages competencies for public health professionals and were designed to ensure that public health nursing fits in the domain of public health science and practice.

  1. Influence of the Toothpaste with Brazilian Ethanol Extract Propolis on the Oral Cavity Health

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    Dariusz Skaba


    Full Text Available Propolis-based therapeutic agents represent this potential for the development of new drugs in dental care. The aim of a clinical-cohort study was to determine the influence of application of toothpaste enriched with Brazilian extract of propolis (EEP on health status of oral cavity. Laboratory analysis was conducted in order to assess the chemical composition of EEP including total phenolic compounds, the DPPH (1,1-diphenyl-2-picrylhydrazyl radical scavenging activity, ABTS radical cation scavenging activity, and FRAP assay. Clinical research involved two groups of subjects comprising 32 adult patients, with assessment based on the preliminary evaluation of the state of their marginal periodontium. The investigation of oral health indices API, OHI, and SBI and microbiological examination of oral microflora were also carried out. Results obtained indicated time-dependent microbial action of EEP at 50 mg/L concentration, with antimicrobial activity against Gram-positive bacteria. The total decrease of API, OHI, and SBI mean values was observed. Hygienic preparations with 3% content of Brazilian ethanol extract of green propolis (EEP efficiently support removal of dental plaque and improve the state of marginal periodontium.

  2. Public health aspects of food irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Kaferstein, F. [Director, Programme of Food Safety and Food Aid, WHO, CH-1211, Geneva 27, (Switzerland)


    Post-harvest losses due to sprouting, insect infestation and spoilage by microorganisms is a serious problem in many countries and commonly aggravates the problem of food shortages. In addition, many developing countries also depend largely on agricultural produce, such as grain, tuber and tropical fruit, as major export crops to earn foreign exchange. The use of ionizing radiation as an effective means of disinfecting and/or prolonging the self-life of several food products has been well documented in a number of developing countries. The World health organization (WHO) encourages its Member States to consider all measures to eliminate or reduce food borne pathogens in food and improve their supplies of safe and nutritious food. In regard to its contribution to food safety, food irradiation may be one of the most significant contributions to public health to be made by food science and technology since the introduction of pasteurization. Because the promotion of a safe, nutritious and adequate food supply is an essential component of its primary health care strategy, WHO is concerned that the unwarranted rejection or limitation of this process may endanger public health and deprive consumers of the choice of foods processed for safety. (Author)

  3. Clinical toxicology: clinical science to public health. (United States)

    Bateman, D N


    1. The aims of the present paper are to: (i) review progress in clinical toxicology over the past 40 years and to place it in the context of modern health care by describing its development; and (ii) illustrate the use of clinical toxicology data from Scotland, in particular, as a tool for informing clinical care and public health policy with respect to drugs. 2. A historical literature review was conducted with amalgamation and comparison of a series of published and unpublished clinical toxicology datasets from NPIS Edinburgh and other sources. 3. Clinical databases within poisons treatment centres offer an important method of collecting data on the clinical effects of drugs in overdose. These data can be used to increase knowledge on drug toxicity mechanisms that inform licensing decisions, contribute to evidence-based care and clinical management. Combination of this material with national morbidity datasets provides another valuable approach that can inform public health prevention strategies. 4. In conclusion, clinical toxicology datasets offer clinical pharmacologists a new study area. Clinical toxicology treatment units and poisons information services offer an important health resource.

  4. Public health and the knowledge industry. (United States)

    Camargo, Kenneth Rochel de


    Knowledge plays an important role in health care. The production and diffusion of health-related knowledge are increasingly under the control of private commercial interests, which are characterized by conflicts of interests that result in abuses of power. Considerable research has been done on the medical-industrial complex and its role in the production of power imbalances and the consequent abuses, but little attention has been dedicated to the role played by the publishing industry, which can be subject to the same problems. The widely diffused idea that 'frequent and major changes' occur in medicine, albeit unsupported by clearcut evidence, is an effective marketing tool for both the pharmaceutical and publishing industries, who feed and thrive on physicians' insecurities. The production and distribution of knowledge should be addressed as a strategic component of public health.

  5. Developing the midwife's role in public health. (United States)

    Byrom, Sheena; Symon, Andrew


    There is widespread acceptance that health can be shaped by factors occurring as far back as infancy, and even before birth. In September 2010 the document Midwifery 2020: Delivering Expectations was launched in Edinburgh. The aim of the report was to establish the future direction for midwifery in the UK, and included specific reference to the midwife's public health role. The report notes that experiences from in utero development until eight years of age lay critical foundations for the entire life course. The report reiterates previous debate on the important contribution maternity services have in addressing health inequalities, and emphasises the importance of midwives striving to address the needs of the most vulnerable communities they serve.

  6. Public health and Web 2.0. (United States)

    Hardey, Michael


    This article examines the nature and role of Web 2.0 resources and their impact on health information made available though the Internet. The transition of the Web from version one to Web 2.0 is described and the main features of the new Web examined. Two characteristic Web 2.0 resources are explored and the implications for the public and practitioners examined. First, what are known as 'user reviews' or 'user testimonials', which allow people to comment on the health services delivered to them, are described. Second, new mapping applications that take advantage of the interactive potential of Web 2.0 and provide tools to visualize complex data are examined. Following a discussion of the potential of Web 2.0, it is concluded that it offers considerable opportunities for disseminating health information and creating new sources of data, as well as generating new questions and dilemmas.

  7. Public perception of mental health in Iraq

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    Al-Hasoon Saad


    Full Text Available Abstract Background People who suffer from mental illness, the professionals who treat them, and indeed the actual concept of mental illness are all stigmatised in public perception and often receive very negative publicity. This paper looks at Iraq, which has a population of 30 million who are mainly Moslem. Mental health services and professionals have historically been sparse in Iraq with 1 psychiatrist per 300,000 before 2003 falling to 1 per million until recently and 1 primary care centre (40 Healthcare Workers including 4 General Practitioners to 35,000 population, compared with 1 GP per 1700 population in the UK. Methods We aimed to assess public attitudes and perceptions to mental illness. Participants were asked to complete a questionnaire (additional file 1, which was designed specifically for Iraqi contexts and was made available in 2 languages. The survey was carried out in 500 participants' homes across 2 districts of Baghdad. Additional file 1 Public Perception of Mental Illness Questionnaire. Click here for file Results The response rate of the survey was 86.4%. The paper shows respondents views on the aetiology of mental illness, perceptions of people with mental illness and attitudes towards care and treatment of people with mental illness. Conclusions This survey of public attitudes towards mental illness in Iraq has shown that community opinion about the aetiology of mental illness is broadly compatible with scientific evidence, but understanding of the nature of mental illness, its implications for social participation and management remains negative in general.

  8. Public health equity in refugee situations

    Directory of Open Access Journals (Sweden)

    Crisp Jeff


    Full Text Available Abstract Addressing increasing concerns about public health equity in the context of violent conflict and the consequent forced displacement of populations is complex. Important operational questions now faced by humanitarian agencies can to some extent be clarified by reference to relevant ethical theory. Priorities of service delivery, the allocation choices, and the processes by which they are arrived at are now coming under renewed scrutiny in the light of the estimated two million refugees who fled from Iraq since 2003. Operational questions that need to be addressed include health as a relative priority, allocations between and within different populations, and transition and exit strategies. Public health equity issues faced by the humanitarian community can be framed as issues of resource allocation and issues of decision-making. The ethical approach to resource allocation in health requires taking adequate steps to reduce suffering and promote wellbeing, with the upper bound being to avoid harming those at the lower end of the welfare continuum. Deliberations in the realm of international justice have not provided a legal or implementation platform for reducing health disparities across the world, although norms and expectations, including within the humanitarian community, may be moving in that direction. Despite the limitations of applying ethical theory in the fluid, complex and highly political environment of refugee settings, this article explores how this theory could be used in these contexts and provides practical examples. The intent is to encourage professionals in the field, such as aid workers, health care providers, policy makers, and academics, to consider these ethical principles when making decisions.

  9. Oral health in the agenda of priorities in public health (United States)

    Antunes, José Leopoldo Ferreira; Toporcov, Tatiana Natasha; Bastos, João Luiz; Frazão, Paulo; Narvai, Paulo Capel; Peres, Marco Aurélio


    ABSTRACT This study describes the scientific production on oral health diffused in Revista de Saúde Pública, in the 50 years of its publication. A narrative review study was carried out using PubMed, as it is the search database that indexes all issues of the journal. From 1967 to 2015, 162 manuscripts specifically focused on oral health themes were published. This theme was present in all volumes of the journal, with increasing participation over the years. Dental caries was the most studied theme, constantly present in the journal since its first issue. Periodontal disease, fluorosis, malocclusions, and other themes emerged even before the decline of dental caries indicators. Oral health policy is the most recurring theme in the last two decades. Revista de Saúde Pública has been an important vehicle for dissemination, communication, and reflection on oral health, contributing in a relevant way to the technical-scientific interaction between professionals in this field. PMID:27598787

  10. Oral health in the agenda of priorities in public health

    Directory of Open Access Journals (Sweden)

    José Leopoldo Ferreira Antunes


    Full Text Available ABSTRACT This study describes the scientific production on oral health diffused in Revista de Saúde Pública, in the 50 years of its publication. A narrative review study was carried out using PubMed, as it is the search database that indexes all issues of the journal. From 1967 to 2015, 162 manuscripts specifically focused on oral health themes were published. This theme was present in all volumes of the journal, with increasing participation over the years. Dental caries was the most studied theme, constantly present in the journal since its first issue. Periodontal disease, fluorosis, malocclusions, and other themes emerged even before the decline of dental caries indicators. Oral health policy is the most recurring theme in the last two decades. Revista de Saúde Pública has been an important vehicle for dissemination, communication, and reflection on oral health, contributing in a relevant way to the technical-scientific interaction between professionals in this field.

  11. Prevalência de fatores de risco cardiovascular em idosos usuários do Sistema Único de Saúde de Goiânia Prevalence of cardiovascular risk factors in elderly individuals treated in the Brazilian Public Health System in Goiânia

    Directory of Open Access Journals (Sweden)

    Carla Cristina da Conceição Ferreira


    question is still unknown by the elderly treated in the Brazilian Public Health System (SUS. OBJECTIVE: To investigate the prevalence of CVRF among the elderly treated by SUS in the city of Goiânia, state of Goiás, Brazil. METHODS: Cross-sectional study using a multiple-stage sampling method, carried out through a home-based interview with 418 elderly individuals aged > 60 years treated by SUS in the city of Goiânia, state of Goiás, Brazil. Socioeconomic and demographic data, as well as data on lifestyle, weight, height, waist circumference, blood pressure and medications used were collected. The studied CVRF were: arterial hypertension, diabetes mellitus, total obesity, central obesity, dyslipidemias, smoking, sedentary lifestyle and alcohol consumption. The Chi-square test was used for the analyses of the associations, with significance being set at 5%. RESULTS: The prevalences of the CVRF were: 80.4% of arterial hypertension; 83.3% of central obesity; 59.8% of sedentary lifestyle; 32.2% of total obesity; 23.4% of dyslipidemias; 19.1% of diabetes mellitus; 10.0% of smoking and 5.9% of alcohol consumption. As for the simultaneity, 2.4% of the elderly did not present CVRF. The simultaneity of two or more CVRF occurred in 87.3% of the elderly and was more frequent among women. CONCLUSION: The CVRF occur simultaneously in more than half of the elderly individuals, and the most prevalent ones were: arterial hypertension, central obesity and sedentary lifestyle. It is necessary to foster the strategies of health promotion and prevention of cardiovascular injury in elderly individuals treated by SUS in the city of Goiânia, especially among those with simultaneous CVRF.

  12. [The impact of conditional cash transfers on health status: the Brazilian Bolsa Familia Programme]. (United States)

    Rivera Castiñeira, Berta; Currais Nunes, Luis; Rungo, Paolo


    Conditional cash transfers are becoming the standard approach to reducing poverty levels; the Brazilian Bolsa Familia Program, in particular, is the largest program of this kind, and the evaluation of its impact allows for drawing some interesting conclusions, which may apply to other countries. In this paper, the lack of positive results in terms of both health status and modification of unhealthy habits is underlined. Among different causes, which are discussed here, the existence of barriers on the supply side appears as the most important limitation for obtaining better results. The positive impact of this program on both education and poverty reduction however, allows for predicting improvements in health status in the long run.

  13. A literatura em saúde pública: o ensino de um "novo olhar" sobre o processo saúde-doença Literatura en salud pública: enseñanza de una nueva visión sobre el proceso salud-enfermedad The brazilian literature in public health: the teaching of a "new look" about the health-illness process

    Directory of Open Access Journals (Sweden)

    Lenilde Duarte de Sá


    Full Text Available Este "paper" apresenta a utilização de obras da Literatura Brasileira em disciplinas vinculadas à área de Enfermagem em Saúde Pública, na Escola de Enfermagem de Ribeirão Preto, da Universidade de São Paulo-EERP/USP. Tem como objetivo o relato preliminar de uma experiência que visa sensibilizar o aluno do Curso da Graduação em Enfermagem, no que concerne a ampliação do "olhar" sobre a realidade, na qual se estabelecem as relações entre os homens e o processo saúde-doença, dentro da concepção de complexidade e singularidade do viver-adoecer humano considerando espaço e tempo. Em fase primária de execução, essa experiência vem se baseando metodologicamente nas concepções da Nova História (École des Analles no paradigma da da complexidade (MORIN, no conceito de circularidade e do paradigma indiciário (GINZBURG.Este artículo presenta el uso da Literatura Brasileña en las disciplinas del área de Enfermería en Salud Pública, en la Escuela de Enfermería de Ribeirão Preto de la Universidad de São Paulo-EERP/USP. Su objetivo es relatar en forma preliminar, una experiencia que sensibiliza el aluno de curso de pregrado de Enfermería con respecto a ampliar su visión de la realidad, en donde se establecen las relaciones entre las personas y el proceso salud-enfermedad, dentro de una concepción de complexidad y singularidad del vivir y enfermar del ser human, cosiderando espacio y tiempo. En su fase primaria de ejecución, esta experiencia se basó, metodológicamente en las concepciones de la nueva historia (Écolle des Annales, en el paradigma de la complejidad (MORIN, en el concepto de circularidad y el paradigma indiciário (GINZBURG.This paper presents the use of Brazilian literature in public health nursing courses at the University of São Paulo at Ribeirão Preto College of Nursing.The goal is a preliminary report about experiences that intend to keep the students in touch in order to wide their view of reality

  14. Sustainable Health Development Becoming Agenda for Public Health Academia

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    Amirhossein TAKIAN


    Full Text Available Background: Sustainable Development Goals (SDGs aim to transform our world, and each goal has specific targets to be achieved by 2030. For the goals to be achieved, everyone needs to do their part: governments, academia, the private sector and all people. This paper summarizes the main evidence-based recommendations made by excellent academics and scholars who discussed their experiences and views during the conference to respond to the challenges of sustainable health development.Methods: To contribute to exploring to the academia's role in reaching SDGs, the 1st International Conference on Sustainable Health Development was held at Tehran University of Medical Sciences, on 24-25 April 2016, in Tehran, Iran. Results: In line with Goal 3 of SDGs: "ensure healthy lives and promote well-being for all at all ages", the conference discussed various aspects of Universal Health Coverage (UHC, as well as Global Action Plans for prevention and control of Non-Communicable Diseases (NCDs, and explained the special role of academic public health institutes in education, research and service provision in the two above-mentioned areas. Conclusion: To fulfill the requirements of SDGs, modern approaches to funding, education, teaching, research priority setting and advocacy, which in turn need novel strategies in collaboration and constructive partnerships among academic public health institutes from low, middle and high-income countries, are essential. Keywords: Sustainable development goals (SDGs, Academia, UHC, NCD

  15. Sustainable Health Development Becoming Agenda for Public Health Academia (United States)

    TAKIAN, Amirhossein; AKBARI-SARI, Ali


    Background: Sustainable Development Goals (SDGs) aim to transform our world, and each goal has specific targets to be achieved by 2030. For the goals to be achieved, everyone needs to do their part: governments, academia, the private sector and all people. This paper summarizes the main evidence-based recommendations made by excellent academics and scholars who discussed their experiences and views during the conference to respond to the challenges of sustainable health development. Methods: To contribute to exploring to the academia’s role in reaching SDGs, the 1st International Conference on Sustainable Health Development was held at Tehran University of Medical Sciences, on 24–25 April 2016, in Tehran, Iran. Results: In line with Goal 3 of SDGs: “ensure healthy lives and promote well-being for all at all ages”, the conference discussed various aspects of Universal Health Coverage (UHC), as well as Global Action Plans for prevention and control of Non-Communicable Diseases (NCDs), and explained the special role of academic public health institutes in education, research and service provision in the two above-mentioned areas. Conclusion: To fulfill the requirements of SDGs, modern approaches to funding, education, teaching, research priority setting and advocacy, which in turn need novel strategies in collaboration and constructive partnerships among academic public health institutes from low, middle and high-income countries, are essential. PMID:28028502

  16. Public Health Intelligence: Learning From the Ebola Crisis. (United States)

    Carney, Timothy Jay; Weber, David Jay


    Today's public health crises, as exemplified by the Ebola outbreak, lead to dramatic calls to action that typically include improved electronic monitoring systems to better prepare for, and respond to, similar occurrences in the future. Even a preliminary public health informatics evaluation of the current Ebola crisis exposes the need for enhanced coordination and sharing of trustworthy public health intelligence. We call for a consumer-centric model of public health intelligence and the formation of a national center to guide public health intelligence gathering and synthesis. Sharing accurate and actionable information with government agencies, health care practitioners, policymakers, and, critically, the general public, will mark a shift from doing public health surveillance on people to doing public health surveillance for people.

  17. Legionella is an emerging Public Health problem

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    Paola Borella


    Full Text Available

    The issue of Legionnaires’ disease has emerged as a major public health problem, interesting not only researchers, but also managers of public and private organisations, those responsible for public health, the general population and occasionally magistrates.

    The cases of legionellosis are increasing as a result of improved etiological diagnostic methods, population lifestyles and characteristics which favour the presence of the responsible organism in the environment which leads to the frequent exposure and transmission of the disease to at-risk groups whose relative numbers are growing.

    Legionella spp is an opportunistic waterborne pathogen that finds its ideal habitat in warm-humid environments, it is able to survive in conditions unfavourable to other germs (elevated temperatures, presence of biocides, etc. and multiply in particular ecological niches (amoebas and other protozoa, biofilm.

    Because of this, it frequently colonises the hot water systems of houses, hotels, campsites, sports centres, hospitals, tertiary care centres, etc., as well as air-conditioning cooling towers, evaporative condensers and places where water stagnates at temperatures of at least 20°C. From our experience,the disease is frequently contracted by inhaling aerosols from the contaminated water systems of houses or work places, but it has also been contracted during stays in holiday accommodation, from using baths/showers in sports and recreation centres and finally during hospital stays.

  18. Implementation of public policy on alcohol and other drugs in Brazilian municipalities: comparative studies. (United States)

    Mota, Daniela Belchior; Ronzani, Telmo Mota


    One of the challenges with respect to public health and the abuse of alcohol and other drugs is to implement policies in support of greater co-ordination among various levels of government. In Brazil, policies are formulated by the Secretaria Nacional de Políticas sobre Drogas (SENAD - State Department for Policies on Drugs) and the Ministério da Saúde (MS - Ministry of Health). This study aims to compare implementation of policies adopted by SENAD and MS at the municipal level. Three municipalities were intentionally selected: Juiz de Fora having a larger network of treatment services for alcohol and drug users; Lima Duarte, a small municipality, which promotes the political participation of local actors (COMAD - Municipal Council on Alcohol and Drugs); and São João Nepomuceno, also a small municipality, chosen because it has neither public services specialised to assist alcohol and other drugs users, nor COMAD. Data collection was conducted through interviews with key informants (n = 19) and a review of key documents concerned with municipal policies. Data analysis was performed using content analysis. In Juiz de Fora, there are obstacles regarding the integration of the service network for alcohol and other drug users and also the articulation of local actors, who are predominant in the mental health sector. In Lima Duarte, while there is a link between local actors through COMAD, their actions within the local service network have not been effective. In São João Nepomuceno, there were no public actions in the area of alcohol and drugs, and consequently insufficient local debate. However, some voluntary, non-governmental work has been undertaken. There were weaknesses in the implementation of national-level policies by SENAD and the MS, due to the limited supply of available treatment, assistance and the lack of integration among local actors.

  19. The occupational therapist in Primary Health Care: representation in journals and Brazilian congresses

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    Bianca Gonçalves de Carrasco Bassi


    Full Text Available In the 2000’s, supported by governmental investments in the Family Health Strategy, reflections onthe subject of Primary Health Care (PHC began to arise, which in Brazil was called Basic Health Care. As partof the research in the Primary Health Care matter, an analysis on the occupational therapy work in this contextwas carried out. This article seeks to present a discussion map of the category about its intervention in the areabased in two national Journals of Occupational Therapy and the main local forum of discussion, the Brazilian Congress of Occupational Therapy. Articles with this thematic published between 2000 and 2011, as well as thescientific knowledge presented in the last seven congresses (1999-2011 were searched. Twenty-one full articleson this theme published in specialized Periodicals during this period were selected. The investigation showed thatmost articles related to the assistance of the occupational therapist to disabled people in Primary Health Care,mainly results of research and education studies carried out by universities from the State of Sao Paulo. Withrespect to the papers presented in the congresses, from a total of 3755, 191 (5% scientific congress presentationsconcerned Primary Health Care. Results showed an increase in the discussions on this theme during the studyperiod. It was possible to conclude that more importance has been given to this theme and more comprehensiveresearches are needed to support knowledge improvement in this field.

  20. Environment and public health; Environnement et sante publique

    Energy Technology Data Exchange (ETDEWEB)

    Escande, J.P. [Hopital Cochin, 75 - Paris (France); Cicolella, A. [Institut National de l' Environnement Industriel et des Risques, 60 - Verneuil en Halatte (INERIS) (France); Hemon, D. [Institut National de la Sante et de la Recherche Medicale (INSERM), 75 - Paris (France)] [and others


    These fourteen presentations on the public health effects of the pollution, showed the environment and life style modifications effects on the public health but also the difficulty to evaluate the risk assessment. This analysis brings information and opinion on the environment, the public health, the scientific representation, the evaluation paradigm, the press amplification, the public health policy choices and the risks of too severe regulations. (A.L.B.)

  1. How federalism shapes public health financing, policy, and program options. (United States)

    Ogden, Lydia L


    In the United States, fiscal and functional federalism strongly shape public health policy and programs. Federalism has implications for public health practice: it molds financing and disbursement options, including funding formulas, which affect allocations and program goals, and shapes how funding decisions are operationalized in a political context. This article explores how American federalism, both fiscal and functional, structures public health funding, policy, and program options, investigating the effects of intergovernmental transfers on public health finance and programs.

  2. Public health in a rapidly changing world

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    Tatiana I. Andreeva


    Full Text Available Several months in 2013 and 2014 have been a hardly predictable time in Ukraine, and the situation is still far from being stable. This made the editorial team of TCPHEE based in Ukraine postpone publishing consecutive issues. However, while the situation still requires practical steps, many aspects including those related to public health require analysis and debate. Thus we invite opinion pieces and studies addressing all different spheres of how public health should function under changing social circumstances. There might be a wide range of such related topics. The most obvious ones are those linked to changing living conditions. Many studies have been undertaken and published with regard to health threats to refugees, people involved in natural or technical disasters (Noji, 2005. Along with environmental health threats, there might be mental health disturbances (World Health Organization, 1992 resulting from long-term strain, losses et cetera. Another important focus is related to changes in health services provision. Crimea, which is a former Ukrainian territory now occupied by the Russian Federation, was among those in Ukraine highly affected with HIV (Dehne, Khodakevich, Hamers, & Schwartlander, 1999. This was responded by several NGOs actively providing harm reduction services to high-risk groups along with methadone substitution therapy to opiate users and antiretroviral medicines to those HIV-infected (Curtis, 2010. However, there are news reports that Russia is going to stop provision of methadone (, 2014. As opiate substitution programs have been shown an effective approach towards preventing HIV transmission among people who inject drugs (MacArthur et al., 2012, such change in public health policies might affect not only most at risk populations but their partners and population as a whole as well resulting in a rapid spread of HIV. Yet another related topic is that of how health services can be organized at times of

  3. Public trust in health care : Exploring the mechanisms

    NARCIS (Netherlands)

    van der Schee, E.


    The aim of this thesis is to investigate how public trust in health care is formed, by studying the mechanisms behind it, addressing the following research question: ‘Which mechanisms explain differences in public trust in health care?’. Public trust in health care is important. Low levels of trust

  4. Collaboration, Competencies and the Classroom: A Public Health Approach (United States)

    Waller, Lauren E.; Papadopoulos, Andrew


    The University of Guelph Master of Public Health program is a professional degree program that seeks to prepare graduates to meet complex public health needs by developing their proficiency in the 36 public health core competencies. Provision of experiential learning opportunities, such as a semester-long practicum, is part of student development.…

  5. 19 CFR 4.70 - Public Health Service requirements. (United States)


    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Public Health Service requirements. 4.70 Section 4... THE TREASURY VESSELS IN FOREIGN AND DOMESTIC TRADES Foreign Clearances § 4.70 Public Health Service... Public Health Service....

  6. 38 CFR 3.753 - Public Health Service. (United States)


    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Public Health Service. 3... Pension, Compensation, and Dependency and Indemnity Compensation Retirement § 3.753 Public Health Service... of the Public Health Service, who was receiving disability compensation on December 31, 1956,...

  7. 21 CFR 25.16 - Public health and safety emergencies. (United States)


    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Public health and safety emergencies. 25.16... ENVIRONMENTAL IMPACT CONSIDERATIONS Agency Actions Requiring Environmental Consideration § 25.16 Public health... importance to the public health or safety, may make full adherence to the procedural provisions of NEPA...

  8. Elite Sport, Doping and Public Health

    DEFF Research Database (Denmark)

    The issue of doping in sport was once of interest only to aficionados of elite sports.  Nowadays, it is a matter of intense public scrutiny thatspans the worlds of health, medicine, sports, politics, technology, andbeyond.  In keeping with this territorial expansion, the aim of this book is toill......The issue of doping in sport was once of interest only to aficionados of elite sports.  Nowadays, it is a matter of intense public scrutiny thatspans the worlds of health, medicine, sports, politics, technology, andbeyond.  In keeping with this territorial expansion, the...... aim of this book is toillustrate how the issue of doping has evolved beyond the world of elite sport into an arena of public health.  In so doing, the book drawsupon multi-disciplinary perspectives from applied and professionalethics, biomedical science, history, philosophy, policy studies, andsociology.  The essays, written by a...... group of leading international experts, is theproduct of a colloquium of the International Network of HumanisticDoping Research held at Aarhus University in Denmark.  Their scoperanges from conceptual analysis, case studies to policy critique.  Eachof these disciplinary perspectives, it is argued, is necessary to understand the problem of doping “in...

  9. Public health research systems in the European union

    Directory of Open Access Journals (Sweden)

    McCarthy Mark


    Full Text Available Abstract Background Strengthening health research is an important objective for international health organisations, but there has been less attention to support for health research in Europe. We describe the public-health (population and organisational level research systems in the 27 European Union countries. Methods We developed a typology for describing health research structures based on funding streams and strategies. We drew data from internet sources and asked country informants to review these for consistency and completeness. The structures were described as organograms and narratives in country profiles for each of the 27 EU member states. National public-health research structures included public and independent funding organisations, 'mixed' institutions (which receive funds, and both use and allocate them and provider institutions. Results Most health research is funded through ministries of science or science councils (and sometimes foundations, while parliaments and regions may also contribute. National institutes of public health are usually funded by ministries of health. Many national research organisations both determine research programmes and undertake health research, but there is a move towards public-health sciences within the universities, and a transition from internal grants to competitive funding. Of 27 national research strategies, 17 referred to health and 11 to public health themes. Although all countries had strategies for public health itself, we found little coherence in public-health research programmes. The European Commission has country contact points for both EU research and health programmes, but they do not coordinate with national health-research programmes. Conclusions Public-health research is broadly distributed across programmes in EU countries. Better understanding of research structures, programmes and results would improve recognition for public health in Europe, and contribute to practice. EU

  10. Syndromic surveillance: A necessary public health tool

    Directory of Open Access Journals (Sweden)

    Fatimah Lateef


    Full Text Available Of late much has been said about emerging infectious diseases and the threat of bioterrorism. The focus has been on continuous public health surveillance for early detection of outbreaks and potential threats. Preparedness is the way forward and relevant institutions and organizations need to make the necessary investments early. Familiarity, good coordination, active participation and a change of mindset amongst personnel is crucial to make the system work. We also share a general approach to using electronic Emergency Department data for syndromic surveillance.

  11. Obesity and adolescence. A public health concern. (United States)

    Merrick, Joav; Birnbaum, Liora; Kandel, Isack; Morad, Mohammed


    Obesity in adolescence has increased significantly over the past 30-40 years and a recent international comparison study (13 European countries, Israel and the US) showed that the highest prevalence in adolescents was found in the US (12.6% in 13 year old boys, 10.8% in girls; 13.9% in 15 year old boys and 15.1% in 15 year old girls) and the lowest in Lithuania. This increase in adolescence is a public health concern, because most obese adolescents continue their obesity into adulthood with serious risk for chronic disease. Focus should therefore be on prevention programs that increase healthier patterns of lifestyle and physical activity.

  12. Public access computing in health science libraries. (United States)

    Kehm, S


    Public access computing in health science libraries began with online computer-assisted instruction. Library-based collections and services have expanded with advances in microcomputing hardware and software. This growth presents problems: copyright, quality, instability in the publishing industry, and uncertainty about collection scope; librarians managing the new services require new skills to support their collections. Many find the cooperative efforts of several organizational units are required. Current trends in technology for the purpose of information management indicate that these services will continue to be a significant focus for libraries.

  13. Primary health care and public health: foundations of universal health systems. (United States)

    White, Franklin


    The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable.

  14. [Health on the borders: access to and demands on the Brazilian National Health System by foreigners and non-resident Brazilians in cities along the border with MERCOSUR countries from the perspective of municipal health secretaries]. (United States)

    Giovanella, Ligia; Guimarães, Luisa; Nogueira, Vera Maria Ribeiro; Lobato, Lenaura de Vasconcelos Costa; Damacena, Giseli Nogueira


    In the context of forming common markets, border areas require special attention, since they anticipate the effects of integration processes. Along borders, different political, monetary, security, and social systems coexist; the intensification of flows resulting from integration raises challenges for the health systems, requiring specific policies focused on guaranteeing the right to health. This article presents the results of a study on the conditions for access to (and demands for) health services in the MERCOSUR border cities. A survey was performed with municipal health secretaries in the 69 Brazilian cities in the States of Rio Grande do Sul, Santa Catarina, Paraná, and Mato Grosso do Sul that border on the other MERCOSUR countries. The study attempted to identify the services demanded by the border population, mechanisms used for access, flows between services and systems, response strategies, and local agreements. Initiatives for cooperation between Brazilian and foreign local administrators were identified in nearly half of the municipalities and can orient the formulation of guidelines for border situations, allowing improvement in comprehensive access to health care.

  15. ELT in Brazilian Public Schools: History, Challenges, New Experiences and Perspectives (United States)

    Teixeira de Almeida, Ricardo Luiz


    Historically speaking, the teaching of English was never a part of Brazilian primary schools programmes. Foreign language teaching as an obligatory school subject appears only in the sixth year of basic education, and its goal is more connected to the development of critical citizens, rather than to the promotion of proficient speakers of the…

  16. Uma nova disciplina: o direito sanitário A new (Brazilian academic discipline: health law

    Directory of Open Access Journals (Sweden)

    Sueli Gandolfi Dallari


    Full Text Available A reivindicação da saúde como direito tem levado o Estado a assumir responsabilidades crescentes pela promoção, proteção e recuperação da saúde do povo. A atuação do Estado contemporâneo - de Direito - é orientada por normas jurídicas. O conhecimento das normas que regulam a ação estatal no campo da saúde é indispensável ao sanitarista, profissional designado pela sociedade para trabalhar especificamente pela elevação de seu nível de saúde. Nessa linha, foram analisadas experiências estrangeiras com o ensino do direito sanitário, juntamente com as recomendações dos organismos internacionais de saúde. Conclui-se que a implementação do ensino do direito sanitário, no Brasil, é urgente.The demand for health seen as the citizen's right, has led the State to accept increasing responsabilities regarding the health of the people, as evidenced by policies of health promotion, protection and recovery. The activity of a modern State ("State of law" is exercised according to juridical principles. It is highly advisable, therefail, that health workers-those professionals that society has appointed to work on its behalf for the raising of its health levels should have knowledge of the rules which guide the State's performance in the health area. Thus, foreign experiences in teaching health law as well as the recommendations of International Health Agencies, analysed in this paper, lead us to conclude that the teaching of health law is a must among the Brazilian academic priorities.

  17. [Food and nutrition in the Family Health Strategy in five Brazilian cities]. (United States)

    Pimentel, Viviane Rangel de Muros; de Sousa, Maria Fátima; Hamann, Edgar Merchán; Mendonça, Ana Valéria Machado


    This work is part of a national study seeking to understand the difficulties and the potential for overcoming the challenges faced in the quest to improve food and nutrition campaigns developed under the aegis of the Family Health Strategy. It is examined from the standpoint of professional teams of the Family Health Strategy and Family Health Support Centers of five major Brazilian cities. A qualitative approach was used to design a multiple case approach and the technique of focus groups was conducted to collect data. The instrument used was a semi-structured pre-tested and validated script with two leading questions. The Collective Subject Discourse technique was used for data analysis, based on which the synthesized discourses were created using the Qualiquantisoft program. Sixty health professionals from various training areas were interviewed, including dietitians, nurses and physicians. The results showed that the difficulties encountered for the provision of food and nutrition campaigns and the lack of professionals in this area have hampered compliance with the principles of comprehensiveness, universality and resolubility of health care.

  18. [Burnout : concepts and implications affecting public health]. (United States)

    Segura, Omar


    Burnout was originally described as a mental condition characterized by reduced work performance, impotence, frustration and lack of capability to reach objectives or goals while performing a job. For some authors, burnout is a poorly defined mixture of symptoms and signs, while other professionals think of it as a disease and a potential threat to public health. Worldwide, it has been observed that the most afflicted professionals and technicians are those who work providing services or assistance to other people, especially those dedicated to health care. This paper focuses on the idea that burnout should be considered a disease more than a syndrome. On the other hand, definitions of health and disease have changed with time, as well as theoretical and methodological references about burnout. In addition, burnout remains a condition that is being discussed in various scientific areas, with radically opposing positions; these approaches are discussed in this article. After presenting different conceptions regarding burnout, the essay concludes with an exploration of its implications and the identification of possible treatments, especially for health workers, among whom it is more common depending on their predisposing conditions and environments.

  19. Advances in Mycotoxin Research: Public Health Perspectives. (United States)

    Lee, Hyun Jung; Ryu, Dojin


    Aflatoxins, ochratoxins, fumonisins, deoxynivalenol, and zearalenone are of significant public health concern as they can cause serious adverse effects in different organs including the liver, kidney, and immune system in humans. These toxic secondary metabolites are produced by filamentous fungi mainly in the genus Aspergillus, Penicillium, and Fusarium. It is challenging to control the formation of mycotoxins due to the worldwide occurrence of these fungi in food and the environment. In addition to raw agricultural commodities, mycotoxins tend to remain in finished food products as they may not be destroyed by conventional processing techniques. Hence, much of our concern is directed to chronic health effects through long-term exposure to one or multiple mycotoxins from contaminated foods. Ideally risk assessment requires a comprehensive data, including toxicological and epidemiological studies as well as surveillance and exposure assessment. Setting of regulatory limits for mycotoxins is considered necessary to protect human health from mycotoxin exposure. Although advances in analytical techniques provide basic yet critical tool in regulation as well as all aspects of scientific research, it has been acknowledged that different forms of mycotoxins such as analogs and conjugated mycotoxins may constitute a significant source of dietary exposure. Further studies should be warranted to correlate mycotoxin exposure and human health possibly via identification and validation of suitable biomarkers.

  20. Alumni survey of Masters of Public Health (MPH training at the Hanoi School of Public Health

    Directory of Open Access Journals (Sweden)

    Nguyen Ha


    Full Text Available Abstract Background 1 To elicit the opinions of the Public Health alumni of the MPH program; 2 To assess the applicability of the knowledge and skills acquired; 3 To identify the frequency of the public health competencies that the alumni performed. Methods We requested 187 graduates to complete a self-administered questionnaire and conducted in-depth interviews with 8 alumni as well as a focus group discussion with 14 alumni. Results In total 79.1% (148 of the MPH graduates completed and returned the questionnaire. Most alumni (91% agreed that the MPH curriculum corresponded with the working requirements of public health professionals; and nearly all were satisfied with what they have learnt (96%. Most respondents said that the MPH program enabled them to develop relevant professional skills (95% and that they were satisfied with the curriculum (90%. Notably fewer respondents (73% felt that the MPH program structure was balanced and well designed. Most alumni (64.3% were satisfied with Hanoi School of Public Health (HSPH full-time lecturers; but even more (83% were satisfied with visiting lecturers. The most commonly selected of the 34 pre-identified public health competencies were: applying computer skills (66.4%, planning and managing health programs (47.9%, communicating with the community and/or mobilizing the community to participate in health care (43.2%. Overall, the MPH alumni felt that HSPH emphasized research methods at the expense of some management and operational competencies. The most important challenges at work identified by the alumni were insufficient skills in: data analysis, decision making, inter-sectoral cooperation development, English language and training. Conclusion The training program should be reviewed and revised to meet the needs of its graduates who enter diverse situations and positions. English language skills were identified as top priority for further emphasis. The training program should comply with a more

  1. Costs of genetic testing: Supporting Brazilian Public Policies for the incorporating of molecular diagnostic technologies

    Directory of Open Access Journals (Sweden)

    Rosane Paixão Schlatter


    Full Text Available This study identifies and describes the operating costs associated with the molecular diagnosis of diseases, such as hereditary cancer. To approximate the costs associated with these tests, data informed by Standard Operating Procedures for various techniques was collected from hospital software and a survey of market prices. Costs were established for four scenarios of capacity utilization to represent the possibility of suboptimal use in research laboratories. Cost description was based on a single site. The results show that only one technique was not impacted by rising costs due to underutilized capacity. Several common techniques were considerably more expensive at 30% capacity, including polymerase chain reaction (180%, microsatellite instability analysis (181%, gene rearrangement analysis by multiplex ligation probe amplification (412%, non-labeled sequencing (173%, and quantitation of nucleic acids (169%. These findings should be relevant for the definition of public policies and suggest that investment of public funds in the establishment of centralized diagnostic research centers would reduce costs to the Public Health System.

  2. The Perceived and Real Value of Health Information Exchange in Public Health Surveillance (United States)

    Dixon, Brian Edward


    Public health agencies protect the health and safety of populations. A key function of public health agencies is surveillance or the ongoing, systematic collection, analysis, interpretation, and dissemination of data about health-related events. Recent public health events, such as the H1N1 outbreak, have triggered increased funding for and…

  3. Hypertension – a public health problem

    Directory of Open Access Journals (Sweden)

    Zélia Maria de Sousa Araújo Santos


    Full Text Available Hypertension is considered an important public health problem in Brazil,which is aggravated by its high prevalence and late detection. In addition, it is oneof the major risk factor for cardiovascular and cerebrovascular diseases.Hypertension, considered a “silent murder”, is the largest social problem indeveloped countries and in a large number of developing countries. Despite of knownefficacy and affectivity of various preventive and control measures, including thepharmacological ones, hypertension will continue, for decades, representing oneof the largest health challenges and high cost disease for individuals and society. Ifcontrol of existed cases, as well as control and prevention of risks factors for thisdisease are not implemented, this problematic will affect a large proportion of thepopulation in our country, which, in 2020, will have had increase significantly over60 years of age.Hypertension is a multifactor, multisystem syndrome. It can be cause bymultiple causes, being related to inadequate life style, constitutional factors, suchas: sex, age, race/color and family history; as well as environmental issues, suchas: sedentary lifestyle, stress, smoking, alcoholism, inadequate diet and obesity.Due to its silent course, a person can be surprised by its complications, beingnecessary learn to live with its chronic nature on an every day basis. Nevertheless,this type of problem is influenced by a series of determinants, including personalitycharacteristics, forms to face the disease, self-concept, self-image, experience withthe disease and health care professionals attitudes.One of the difficulties found in the treatment of persons with hypertensionis the lack of adhesion to the treatment, as 50% of the known patients withhypertension don’t treat themselves, and among those who do, few have controlledblood pressure. Between 30 and 50% of persons with hypertension stop treatmentwithin the first year of treatment, and 75% after five

  4. Public trust in health care : a performance indicator?

    NARCIS (Netherlands)

    Schee, Evelien van der; Groenewegen, Peter P.; Friele, Ronald D.


    Purpose – If public trust in health care is to be used as a performance indicator for health care systems, its measurement has to be sensitive to changes in the health care system. For this purpose, this study has monitored public trust in health care in The Netherlands over an eight-year period, fr

  5. Synthetic cathinones: a new public health problem. (United States)

    Karila, Laurent; Megarbane, Bruno; Cottencin, Olivier; Lejoyeux, Michel


    New psychoactive substances (NPS) have completely modified the drug scene and the current landscape of addiction. Synthetic substances, such as substituted or synthetic cathinones, also known as « legal highs », are often produced and used to mimic the effects of controlled drugs such as cocaine, methylenedioxymethamphetamine (MDMA, ecstasy), and methamphetamine. The overwhelming majority of synthetic cathinones are produced in China and South East Asian countries. The Internet has emerged as the new marketplace for NPS, playing a major role in providing information on acquisition, synthesis, extraction, identification, and substance use. All these compounds are intentionally mislabeled and sold on-line under slang terms such as bath salts, plant food, plant feeders and research chemicals. They are sometimes labeled « not for human use » or « not tested for hazards or toxicity ». The rapid spread of NPS forces member countries of the European Union to adapt their response to the potential new dangers that may cause. To date, not only health actors but also the general public need to be clearly informed and aware of dangers resulting from NPS spread and use. Here, we review the major clinical effects of synthetic cathinones to highlight their impact on public health. A literature search was conducted from 2009 to 2014 based on PubMed, Google Scholar, Erowid, and governmental websites, using the following keywords alone or in combination: "new psychoactive substances", "synthetic cathinones", "substituted cathinones", "mephedrone", "methylone", "MDPV", "4-MEC", "addiction", and "substance use disorder".

  6. Biosecurity through Public Health System Design.

    Energy Technology Data Exchange (ETDEWEB)

    Beyeler, Walter E. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Finley, Patrick D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Arndt, William [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Walser, Alex Christian [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Mitchell, Michael David [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)


    We applied modeling and simulation to examine the real-world tradeoffs between developingcountry public-health improvement and the need to improve the identification, tracking, and security of agents with bio-weapons potential. Traditionally, the international community has applied facility-focused strategies for improving biosecurity and biosafety. This work examines how system-level assessments and improvements can foster biosecurity and biosafety. We modeled medical laboratory resources and capabilities to identify scenarios where biosurveillance goals are transparently aligned with public health needs, and resource are distributed in a way that maximizes their ability to serve patients while minimizing security a nd safety risks. Our modeling platform simulates key processes involved in healthcare system operation, such as sample collection, transport, and analysis at medical laboratories. The research reported here extends the prior art by provided two key compone nts for comparative performance assessment: a model of patient interaction dynamics, and the capability to perform uncertainty quantification. In addition, we have outlined a process for incorporating quantitative biosecurity and biosafety risk measures. Two test problems were used to exercise these research products examine (a) Systemic effects of technological innovation and (b) Right -sizing of laboratory networks.


    Directory of Open Access Journals (Sweden)

    Russel J REITER; Fatih GULTEKIN; Luis J FLORES; Ma Pilar TERRON; Dun-Xian TAN


    Full Text Available This review summarizes the beneficial actions of melatonin in various experimental conditions/diseases and identifies where the use of melatonin may be helpful in improving public health. The nightly use of melatonin supplements by humans often improves their sleep and helps correct the circadian dyssynchronization associated with “jet lag”. Additionally, melatonin has been found effective in curtailing the growth of a variety of experimental cancers. Mechanistically, this is achieved by melatonin’s ability to limit fatty acid uptake, especially linoleic acid, by tumor cells. Fatty acids are growth factors for many tumors. Additionally, melatonin inhibits the elevated telomerase activity of tumor cells thus making them more fragile and vulnerable to chemotherapies. Melatonin also may inhibit angiogenesis in tumors by suppressing endothelin-1 production and the indole interferes with the stimulatory action of steroids on hormone-responsive tumors. As an ubiquitously-acting antioxidant, melatonin reduces cardiac damage during ischemia/reperfusion (I/R injury (heart attack and during I/R to the brain (stroke. Melatonin also limits the toxicity of amyloid  peptide and of neurofibrillary tangles, two of the cardinal signs of Alzheimer’s disease. Collectively, these data suggest supplementation with melatonin, whose endogenous levels decrease with age, may improve the quality of life in the aged and, as a consequence, be beneficial for public health generally. [TAF Prev Med Bull 2006; 5(2.000: 131-158

  8. CDC National Environmental Public Health Tracking Network (Tracking Network) (United States)

    U.S. Department of Health & Human Services — The National Environmental Public Health Tracking Network is a system of integrated health, exposure, and hazard information and data from a variety of national,...

  9. Value Relevance vis-à-vis Disclosure on Business Combinations and Goodwill Recognized by Publicly Traded Brazilian Companies

    Directory of Open Access Journals (Sweden)

    Maíra Melo de Souza

    Full Text Available Abstract The objective of this study is to examine the value relevance of the level of disclosure on business combinations and goodwill recognized by publicly traded Brazilian companies. The research sample is composed of publicly traded Brazilian companies that carried out any type of business combination, as the acquiring entity, between 2010 and 2013, yielding a total sample of 202 observations. To measure the disclosure level of each, a metric was created based on CPC-15 R1 (2011 to examine certain disclosure items in order to render a greater level of detail. Data collection was carried out using the footnotes to the annual consolidated standardized financial statements (DFPs available from the São Paulo Stock Exchange (BM&FBOVESPA website. The results revealed that disclosure levels for business combinations are positively and significantly associated with the stock price of the companies analyzed. As to the recognition of goodwill during business combinations, despite the fact that it represents a significant share of the value of the transactions, no statistical significance explaining stock price behavior was found. It also bears mentioning that the average level of disclosure identified in the explanatory notes in the sample was very low, indicating that companies need to improve when it comes to transparency of information.


    Directory of Open Access Journals (Sweden)

    Carla Estefania Albert


    Full Text Available This article presents a literature review of the literature on evaluation of mental health services from BVS ECO, without limited timeline. Design and Methods: A systematic review of texts in Spanish, Portuguese and English. It used certain preliminary criteria for inclusion and exclusion to identify relevant studies, using descriptors: evaluation, mental health evaluation/ assessment. Results: There were 48 articles of which 21 were excluded. The main theme of the publications was the verification of costs versus service complexity, and among the most recent publications, based on the type of treatment of psychological disorders. Conclusions: As a facilitator of research in Health Economics, BVS ECO should allow access to the full text and it is urgently to review the classification and inclusion of publications in the Base about evaluations inquiries. In terms of production, there is a tendency of articles over time, with detailing methodologies and objectives of border between health assessment and health economic evaluation.

  11. Recent Developments in Public Health Nursing in the Americas

    Directory of Open Access Journals (Sweden)

    Jose Arturo Ruiz-Larios


    Full Text Available This study presents an assessment of the participation and training of nurses in public health areas in the Americas. Information was gathered through a literature review and interviews with key informants from Mexico, Colombia, and Paraguay. Results demonstrate that there is significant variation in definitions of public health nursing across the region and current systematized data about the workforce profile of public health nursing personnel is not available for many countries in the Americas. There are significant regional differences in the levels and types of training of nurses working in public health areas and an increasing number of nurses are pursuing training in public health at the master’s and doctoral levels. Many nurses carry out some or all of the essential functions of public health, but are not considered to be public health nurses. Generally, auxiliary and technical nurses have a broader presence in public health areas than professional nurses. In the future, regional health systems reforms should support increased recruitment and training of public health nurses, as well as stronger roles in public health research and health care at the individual, community, and population levels.

  12. Transparency during public health emergencies: from rhetoric to reality



    Effective management of public health emergencies demands open and transparent public communication. The rationale for transparency has public health, strategic and ethical dimensions. Despite this, government authorities often fail to demonstrate transparency. A key step in bridging the gap between the rhetoric and reality is to define and codify transparency to put in place practical mechanisms to encourage open public health communication for emergencies. The authors demonstrate this appro...

  13. Periodontal health through public health - the case for oral health promotion

    DEFF Research Database (Denmark)

    Watt, Richard G; Petersen, Poul E


    world clinical care and chairside prevention are both unaffordable and inappropriate for the control of periodontal diseases. A paradigm shift away from the individualized treatment approach to a population public health model is needed to promote periodontal health and, in particular to address social......Periodontal diseases are highly prevalent, particularly amongst socially disadvantaged populations, impact on quality of life and are costly to treat. Clinical treatments and chairside preventive approaches alone will never adequately address this problem. Indeed in many parts of the developing...... health policies acting at local, regional, national and international levels need to be implemented to achieve sustainable improvements in oral health. To be effective these policies need to link across the broader public health agenda and require public engagement and support. Clinicians, public health...

  14. Translational physiology: from molecules to public health. (United States)

    Seals, Douglas R


    The term 'translational research' was coined 20 years ago and has become a guiding influence in biomedical research. It refers to a process by which the findings of basic research are extended to the clinical research setting (bench to bedside) and then to clinical practice and eventually health policy (bedside to community). It is a dynamic, multidisciplinary research approach. The concept of translational physiology applies the translational research model to the physiological sciences. It differs from the traditional areas of integrative and clinical physiology by its broad investigative scope of basic research to community health. Translational physiology offers exciting opportunities, but presently is under-developed and -utilized. A key challenge will be to expand physiological research by extending investigations to communities of patients and healthy (or at risk) individuals. This will allow bidirectional physiological investigation throughout the translational continuum: basic research observations can be studied up to the population level, and mechanisms can be assessed by 'reverse translation' in clinical research settings and preclinical models based on initial observations made in populations. Examples of translational physiology questions, experimental approaches, roadblocks and strategies for promotion are discussed. Translational physiology provides a novel framework for physiology programs and an investigational platform for physiologists to study function from molecular events to public health. It holds promise for enhancing the completeness and societal impact of our work, while further solidifying the critical role of physiology in the biomedical research enterprise.

  15. Introduction to the Special Issue: Public Health Genetics and Genomics. (United States)

    McWalter, Kirsty; Gaviglio, Amy


    This special issue of the Journal of Genetic Counseling is dedicated to public health genetics and genomics. The seventeen papers featured in this issue span such topics as genetic counselors in public health roles, newborn screening, population screening, ethics, and health beliefs and behaviors. In this introduction to the special issue, we review some history of public health genetics and genomics, present the Centers for Disease Control and Prevention's "10 Essential Public Health Services" with associated genetics specific recommendations and priorities, and briefly overview how each article ties into the world of public health genetics and genomics. We hope this issue encourages genetic counselors to visualize their ever expanding and important roles in public health genetics and genomics, as well as their contributions to improving population health.

  16. [Building a "Smiling Brazil"? Implementation of the Brazilian National Oral Health Policy in a health region in the State of São Paulo]. (United States)

    Aquilante, Aline Guerra; Aciole, Geovani Gurgel


    This paper is a case study on the implementation of the Brazilian National Oral Health Policy (PNSB), known as "Smiling Brazil", in the cities of the Regional Health Department of Araraquara (DRS III) in São Paulo State. A structured questionnaire was given to the municipal oral health coordinators, an interview with oral health care professionals and managers was conducted, and the official data provided by the Brazilian Ministry of Health were coded to assess the policy's scope: (i) expansion and qualification of actions; (ii) work conditions; (iii) care; (iv) access; and (v) planning and management. The quantitative and qualitative analyses were linked by methods triangulation. In terms of PNSB implementation, the majority of the cities (52.6%) were classified as "good", with 42.1% classified as "bad". Approximately 10 years after launching the PNSB, despite strides in oral health care and access to different levels of care, the cities still experience difficulties in implementing the policy's principles.

  17. Ethics in public health research: masters of marketing: bringing private sector skills to public health partnerships. (United States)

    Curtis, Valerie A; Garbrah-Aidoo, Nana; Scott, Beth


    Skill in marketing is a scarce resource in public health, especially in developing countries. The Global Public-Private Partnership for Handwashing with Soap set out to tap the consumer marketing skills of industry for national handwashing programs. Lessons learned from commercial marketers included how to (1) understand consumer motivation, (2) employ 1 single unifying idea, (3) plan for effective reach, and (4) ensure effectiveness before national launch. After the first marketing program, 71% of Ghanaian mothers knew the television ad and the reported rates of handwashing with soap increased. Conditions for the expansion of such partnerships include a wider appreciation of what consumer marketing is, what it can do for public health, and the potential benefits to industry. Although there are practical and philosophical difficulties, there are many opportunities for such partnerships.

  18. Partnership work between Public Health and Health Psychology: introduction to a novel training programme

    Directory of Open Access Journals (Sweden)

    Robinson Clare


    Full Text Available Abstract Background Public health services implement individual, community and population level interventions to change health behaviours, improve healthy life expectancy and reduce health inequalities. Understanding and changing health behaviour is complex. Integrating behaviour change theory and evidence into interventions has the potential to improve services. Methods Health Psychologists apply evidence and theories aimed at understanding and changing health behaviour. A Scottish programme is piloting the training of Health Psychologists within NHS contexts to address prominent public health challenges. Results This article outlines the details of this novel programme. Two projects are examined to illustrate the potential of partnership working between public health and health psychology. Conclusion In order to develop and improve behaviour change interventions and services, public health planners may want to consider developing and using the knowledge and skills of Health Psychologists. Supporting such training within public health contexts is a promising avenue to build critical NHS internal mass to tackle the major public health challenges ahead.

  19. Prisoner reentry: a public health or public safety issue for social work practice? (United States)

    Patterson, George T


    A significant literature identifies the policy, economic, health, and social challenges that confront released prisoners. This literature also describes the public health and public safety risks associated with prisoner reentry, provides recommendations for improving the reentry process, and describes the effectiveness of prison-based programs on recidivism rates. Public health and public safety risks are particularly significant in communities where large numbers of prisoners are released and few evidence-based services exist. The purpose of this article is to describe the public health and public safety risks that released prisoners experience when they reenter communities, and to discuss the social justice issues relevant for social work practice.

  20. Competency Guidelines for Public Health Laboratory Professionals: CDC and the Association of Public Health Laboratories. (United States)

    Ned-Sykes, Renée; Johnson, Catherine; Ridderhof, John C; Perlman, Eva; Pollock, Anne; DeBoy, John M


    These competency guidelines outline the knowledge, skills, and abilities necessary for public health laboratory (PHL) professionals to deliver the core services of PHLs efficiently and effectively. As part of a 2-year workforce project sponsored in 2012 by CDC and the Association of Public Health Laboratories (APHL), competencies for 15 domain areas were developed by experts representing state and local PHLs, clinical laboratories, academic institutions, laboratory professional organizations, CDC, and APHL. The competencies were developed and reviewed by approximately 170 subject matter experts with diverse backgrounds and experiences in laboratory science and public health. The guidelines comprise general, cross-cutting, and specialized domain areas and are divided into four levels of proficiency: beginner, competent, proficient, and expert. The 15 domain areas are 1) Quality Management System, 2) Ethics, 3) Management and Leadership, 4) Communication, 5) Security, 6) Emergency Management and Response, 7) Workforce Training, 8) General Laboratory Practice, 9) Safety, 10) Surveillance, 11) Informatics, 12) Microbiology, 13) Chemistry, 14) Bioinformatics, and 15) Research. These competency guidelines are targeted to scientists working in PHLs, defined as governmental public health, environmental, and agricultural laboratories that provide analytic biological and/or chemical testing and testing-related services that protect human populations against infectious diseases, foodborne and waterborne diseases, environmental hazards, treatable hereditary disorders, and natural and human-made public health emergencies. The competencies support certain PHL workforce needs such as identifying job responsibilities, assessing individual performance, and providing a guiding framework for producing education and training programs. Although these competencies were developed specifically for the PHL community, this does not preclude their broader application to other professionals

  1. Care for health. The 2006 Dutch Public Health Status and Forecasts Report


    de Hollander AEM; Hoeymans N; Melse JM; van Oers JAM; Polder JJ; VTV


    As in the past a large amount of information on health, prevention and health care in the Netherlands has been collected for this edition of the VTV public health forecast. Public health in the Netherlands is improving, but can still be better. Overweight and unhealthy behaviour, especially among young people, are becoming a source of concern for public health in the future. Furthermore, there are many differences in health and health risks cited among regions and neighbourhoods. Backlogs in ...

  2. Climate change and human health: impacts, vulnerability and public health. (United States)

    Haines, A; Kovats, R S; Campbell-Lendrum, D; Corvalan, C


    It is now widely accepted that climate change is occurring as a result of the accumulation of greenhouse gases in the atmosphere arising from the combustion of fossil fuels. Climate change may affect health through a range of pathways, for example as a result of increased frequency and intensity of heat waves, reduction in cold related deaths, increased floods and droughts, changes in the distribution of vector-borne diseases and effects on the risk of disasters and malnutrition. The overall balance of effects on health is likely to be negative and populations in low-income countries are likely to be particularly vulnerable to the adverse effects. The experience of the 2003 heat wave in Europe shows that high-income countries may also be adversely affected. Adaptation to climate change requires public health strategies and improved surveillance. Mitigation of climate change by reducing the use of fossil fuels and increasing a number of uses of the renewable energy technologies should improve health in the near-term by reducing exposure to air pollution.

  3. Public Health and International Drug Policy (United States)

    Csete, Joanne; Kamarulzaman, Adeeba; Kazatchkine, Michel; Altice, Frederick; Balicki, Marek; Buxton, Julia; Cepeda, Javier; Comfort, Megan; Goosby, Eric; Goulão, João; Hart, Carl; Horton, Richard; Kerr, Thomas; Lajous, Alejandro Madrazo; Lewis, Stephen; Martin, Natasha; Mejía, Daniel; Mathiesson, David; Obot, Isidore; Ogunrombi, Adeolu; Sherman, Susan; Stone, Jack; Vallath, Nandini; Vickerman, Peter; Zábranský, Tomáš; Beyrer, Chris


    Executive summary In September 2015, the member states of the United Nations endorsed sustainable development goals (SDG) for 2030 that aspire to human rights-centered approaches to ensuring the health and well-being of all people. The SDGs embody both the UN Charter values of rights and justice for all and the responsibility of states to rely on the best scientific evidence as they seek to better humankind. In April 2016, these same states will consider control of illicit drugs, an area of social policy that has been fraught with controversy, seen as inconsistent with human rights norms, and for which scientific evidence and public health approaches have arguably played too limited a role. The previous UN General Assembly Special Session (UNGASS) on drugs in 1998 – convened under the theme “a drug-free world, we can do it!” – endorsed drug control policies based on the goal of prohibiting all use, possession, production, and trafficking of illicit drugs. This goal is enshrined in national law in many countries. In pronouncing drugs a “grave threat to the health and well-being of all mankind,” the 1998 UNGASS echoed the foundational 1961 convention of the international drug control regime, which justified eliminating the “evil” of drugs in the name of “the health and welfare of mankind.” But neither of these international agreements refers to the ways in which pursuing drug prohibition itself might affect public health. The “war on drugs” and “zero-tolerance” policies that grew out of the prohibitionist consensus are now being challenged on multiple fronts, including their health, human rights, and development impact. The Johns Hopkins – Lancet Commission on Drug Policy and Health has sought to examine the emerging scientific evidence on public health issues arising from drug control policy and to inform and encourage a central focus on public health evidence and outcomes in drug policy debates, such as the important deliberations of

  4. New Developments in Undergraduate Education in Public Health: Implications for Health Education and Health Promotion (United States)

    Barnes, Michael D.; Wykoff, Randy; King, Laura Rasar; Petersen, Donna J.


    The article provides an overview of efforts to improve public health and health education training and on the potential use of Critical Component Elements (CCEs) for undergraduate health education programs toward more consistent quality assurance across programs. Considered in the context of the Galway Consensus Conference, the authors discuss the…

  5. Public mental health. II: The psychological dimension. (United States)

    Curle, A


    Alienation, which is the source of much violence, is widespread throughout the world, deriving from and connected with adverse social and economic conditions. It is a state of estrangement from society often associated with bitterness and resentment; these exacerbate conflict and lead to war and other types of violence. Alienation is the antithesis of compassion and other feelings on which the good society is based. It is partially maintained by a web of psychological falsehoods, knots, relating to: awareness, happiness, identity, permanence, separateness, guilt and inferiority, and violence. These knots foster confused thinking that makes us more vulnerable to alienation. Unravelling the knots and cutting through the web of psychological falsehoods helps to release the human potential for positive, peaceful and non-violent action. Medicine can best contribute to weakening wide-spread alienation through the development of public mental health, working at the interface with the social, economic and cultural actors in the development of civil society.

  6. Caffeinated alcohol beverages: a public health concern. (United States)

    Attwood, Angela S


    Consumption of alcohol mixed with caffeinated energy drinks is becoming popular, and the number of pre-mixed caffeinated alcohol products on the worldwide market is increasing. There is public health concern and even occasional legal restriction relating to these drinks, due to associations with increased intoxication and harms. The precise nature and degree of the pharmacological relationship between caffeine and alcohol is not yet elucidated, but it is proposed that caffeine attenuates the sedative effects of alcohol intoxication while leaving motor and cognitive impairment unaffected. This creates a potentially precarious scenario for users who may underestimate their level of intoxication and impairment. While legislation in some countries has restricted production or marketing of pre-mixed products, many individuals mix their own energy drink-alcohol 'cocktails'. Wider dissemination of the risks might help balance marketing strategies that over-emphasize putative positive effects.

  7. Economics and public health at CDC. (United States)

    Messonnier, Mark L


    Economics is the study of decisions--the incentives that lead to them and the consequences that result from them--as they relate to present and future production, distribution, and consumption of goods and services when resources are limited and have alternative uses. At CDC, economics is used to systematically identify, measure, value, and compare the costs and consequences of alternative prevention strategies. Costs and consequences in public health can be measured in various ways, including incidence or prevalence of disease; numbers of adverse events; utility measures, such as quality-adjusted life years; and monetary values. Because it deals with behavior, economics is not really about money at all. Money is just a convenient way to measure incentives and consequences.

  8. Status Epilepticus: Epidemiology and Public Health Needs (United States)

    Sánchez, Sebastián; Rincon, Fred


    Status epilepticus (SE) is defined as a continuous clinical and/or electrographic seizure activity lasting five minutes or more or recurrent seizure activity without return to baseline. There is a paucity of epidemiological studies of SE, as most research is derived from small population studies. The overall incidence of SE is 9.9 to 41 per 100,000/year, with peaks in children and the elderly and with febrile seizures and strokes as its main etiologies. The etiology is the major determinant of mortality. Governments and the academic community should predominantly focus on the primary prevention of etiologies linked to SE, as these are the most important risk factors for its development. This review describes the incidence, prevalence, etiology, risk factors, outcomes and costs of SE and aims to identify future research and public health needs. PMID:27537921

  9. The Brazilian unified national health system as an observatory for universal rights: a reflection based on the social sciences¹

    Directory of Open Access Journals (Sweden)

    Paulo Roberto do Nascimento


    Full Text Available The bibliography on the crisis of modernity is wide-ranging. One particular school of thought takes the view that various pillars of modern social life are under threat: among them the achievements represented by universal rights. The public health literature also points out that the Brazilian Unified National Health System (SUS is a development going against the worldwide movement towards flexibilization of these rights. The principles of universality and comprehensiveness not only constitute an institutional, financial, political and social challenge, but also express society's decision to implement universal rights. We have used Souza Santos's theoretical instrument to characterize SUS as an observatory regarding effective application of these rights. Institutional remodeling and democratic deliberations for establishing a social contract emerge again as matters of importance.

  10. Transparency during public health emergencies: from rhetoric to reality. (United States)

    O'Malley, P; Rainford, J; Thompson, A


    Effective management of public health emergencies demands open and transparent public communication. The rationale for transparency has public health, strategic and ethical dimensions. Despite this, government authorities often fail to demonstrate transparency. A key step in bridging the gap between the rhetoric and reality is to define and codify transparency to put in place practical mechanisms to encourage open public health communication for emergencies. The authors demonstrate this approach using the example of the development and implementation process of a public health emergency information policy.

  11. Healthy public policy--is health impact assessment the cornerstone? (United States)

    Metcalfe, O; Higgins, C


    The 8th International Health Impact Assessment Conference, entitled 'Healthy public policy--is health impact assessment the cornerstone?', was hosted by the Institute of Public Health in Ireland (IPH). At the event, IPH sponsored a keynote speech to set the context of the conference and outline the importance of healthy public policy. This article presents an overview of healthy public policy and the barriers to its adoption in policy-making. Health impact assessment is one such tool to overcome the barriers, and the authors recommend the methodology as the cornerstone to healthy public policy.

  12. [Food and Nutrition in Public Health: constitution, contours and scientific status]. (United States)

    Bosi, Maria Lúcia Magalhães; Prado, Shirley Donizete


    This paper aims to examine the route on which Food and Nutrition in Public Health was build in the Brazilian context, from its fields of origin, identifying tensions and convergences, seeking to demarcate its boundaries and to characterize its status within the scientific field. We seek to evince the existence of a movement marked by the fruitful encounter between the field of "Public Health" and a portion of the field of "Food and Nutrition", or more precisely, one of their cores, starring actors oriented by knowledge distinguished from other nuclei in this field. Such phenomena, that we postulate as outcomes of the contact nuclei of knowledge that identify the Public Health with the field of "Food and Nutrition", led to a specific core of distinct knowledge and praxis in this context corresponds to what we call "Food and Nutrition in Public Health". This is a process marked from the outset by tensions between the biological and social paradigms, becoming the one hand, as a major challenge to be faced, and secondly, as a promising way for the approach between different fields of science, both the more practical, such as those targeted to conceptual reflection.

  13. Which public and why deliberate?--A scoping review of public deliberation in public health and health policy research. (United States)

    Degeling, Chris; Carter, Stacy M; Rychetnik, Lucie


    Deliberative methods are of increasing interest to public health researchers and policymakers. We systematically searched the peer-reviewed literature to identify public health and health policy research involving deliberative methods and report how deliberative methods have been used. We applied a taxonomy developed with reference to health policy and science and technology studies literatures to distinguish how deliberative methods engage different publics: citizens (ordinary people who are unfamiliar with the issues), consumers (those with relevant personal experience e.g. of illness) and advocates (those with technical expertise or partisan interests). We searched four databases for empirical studies in English published 1996-2013. This identified 78 articles reporting on 62 distinct events from the UK, USA, Canada, Australasia, Europe, Israel, Asia and Africa. Ten different types of deliberative techniques were used to represent and capture the interests and preferences of different types of public. Citizens were typically directed to consider community interests and were treated as a resource to increase democratic legitimacy. Citizens were preferred in methodological studies (those focused on understanding the techniques). Consumers were directed to focus on personal preferences; thus convened not as a source of policy decisions, but of knowledge about what those affected by the issue would accept. Advocates-who are most commonly used as expert witnesses in juries-were sometimes engaged to deliberate with consumers or citizens. This almost always occurred in projects directly linked to policy processes. This suggests health policymakers may value deliberative methods as a way of understanding disagreement between perspectives. Overall however, the 'type' of public sought was often not explicit, and their role not specified. This review provides new insight into the heterogeneity and rising popularity of deliberative methods, and indicates a need for greater

  14. Public health department accreditation: setting the research agenda. (United States)

    Riley, William J; Lownik, Elizabeth M; Scutchfield, F Douglas; Mays, Glen P; Corso, Liza C; Beitsch, Les M


    Health department accreditation is one of the most important initiatives in the field of public health today. The Public Health Accreditation Board (PHAB) is establishing a voluntary accreditation system for more than 3000 state, tribal, territorial, and local health departments using domains, standards, and measures with which to evaluate public health department performance. In addition, public health department accreditation has a focus on continuous quality improvement to enhance capacity and performance of health departments in order to advance the health of the population. In the accreditation effort, a practice-based research agenda is essential to build the scientific base and advance public health department accreditation as well as health department effectiveness. This paper provides an overview of public health accreditation and identifies the research questions raised by this accreditation initiative, including how the research agenda will contribute to better understanding of processes underlying the delivery of services by public health departments and how voluntary accreditation may help improve performance of public health departments.

  15. A review of low-level air pollution and adverse effects on human health: implications for epidemiological studies and public policy

    Directory of Open Access Journals (Sweden)

    Neide Regina Simoes Olmo


    Full Text Available The aim of this study was to review original scientific articles describing the relationship between atmospheric pollution and damage to human health. We also aimed to determine which of these studies mentioned public policy issues. Original articles relating to atmospheric pollution and human health published between 1995 and 2009 were retrieved from the PubMed database and analyzed. This study included only articles dealing with atmospheric pollutants resulting primarily from vehicle emissions. Three researchers were involved in the final selection of the studies, and the chosen articles were approved by at least two of the three researchers. Of the 84 non-Brazilian studies analyzed, 80 showed an association between atmospheric pollution and adverse effects on human health. Moreover, 66 showed evidence of adverse effects on human health, even at levels below the permitted emission standards. Three studies mentioned public policies aimed at changing emission standards. Similarly, the 29 selected Brazilian studies reported adverse associations with human health, and 27 showed evidence of adverse effects even at levels below the legally permitted emission standards. Of these studies, 16 mentioned public policies aimed at changing emission standards. Based on the Brazilian and non-Brazilian scientific studies that have been conducted, it can be concluded that, even under conditions that are compliant with Brazilian air quality standards, the concentration of atmospheric pollutants in Brazil can negatively affect human health. However, as little discussion of this topic has been generated, this finding demonstrates the need to incorporate epidemiological evidence into decisions regarding legal regulations and to discuss the public policy implications in epidemiological studies.

  16. Shaping public policy and population health in the United States: why is the public health community missing in action? (United States)

    Raphael, Dennis


    Renewed international interest in the structural determinants of health manifests itself in a focus on the social determinants of health and the public policy antecedents that shape their quality. This increased international interest in public policy in support of the structural determinants of health has had little traction in the United States. This should be surprising since the United States presents one of the worst population health profiles and public policy environments in support of health among wealthy developed nations. The U.S. position as a health status and policy outlier results from long-term institutional changes that are shaped by political, economic, and social forces. U.S. public health researchers' and workers' neglect of these structural and public policy issues conforms to the dominant ideological discourses that serve to justify these changes. The author presents some means by which public health researchers and workers can challenge these dominant discourses.

  17. Public Health Law and Institutional Vaccine Skepticism. (United States)

    Parasidis, Efthimios


    Vaccine-hesitant parents are often portrayed as misinformed dilettantes clinging to unscientific Internet chatter and a debunked study that linked vaccines and autism. While this depiction may be an accurate portrayal of a small (but vocal) subset, scholars have unearthed a more complex picture that casts vaccine hesitancy in the context of broader notions of lack of trust in government and industry. At the same time, commentators have highlighted limitations of the vaccine injury compensation program and US Supreme Court Justices Sonia Sotomayor and Ruth Bader Ginsburg have argued that preemption laws that provide vaccine manufacturers with broad legal immunities create "a regulatory vacuum in which no one ensures that vaccine manufacturers adequately take account of scientific and technological advancements when designing or distributing their products." In short, the discussions surrounding vaccine hesitancy that dominate public discourse detract from serious debate as to whether amendments to vaccine-related laws can address the limitations of the existing framework governing immunizations. This commentary examines these issues through a public health law lens.

  18. History and evolution of surveillance in public health

    Directory of Open Access Journals (Sweden)

    Varun Kumar


    Full Text Available The modern concept of surveillance has evolved over the centuries. Public health surveillance provides the scientific database essential for decision making and appropriate public health action. It is considered as the best public health tool to prevent the occurrence of epidemics and is the backbone of public health programs and provides information so that effective action can be taken in controlling and preventing diseases of public health importance. This article reviews the history of evolution of public health surveillance from historical perspective: from Hippocrates, Black Death and quarantine, recording of vital events for the first time, first field investigation, legislations that were developed over time and modern concepts in public health surveillance. Eradication of small pox is an important achievement in public health surveillance but the recent Severe Acute Respiratory Syndrome (SARS and Influenza pandemics suggest still there is a room for improvement. Recently new global disease surveillance networks like FluNet and DengueNet were developed as internet sites for monitoring influenza and dengue information. In spite of these developments, global public health surveillance still remains unevenly distributed. There is a need for increased international cooperation to address the global needs of public health surveillance.

  19. AIDS, empire, and public health behaviorism. (United States)

    Basu, Sanjay


    Much of the current health approach to designing HIV/AIDS interventions in resource-poor settings involves behavior-change initiatives, particularly those adopting education-based and "culturally competent" frameworks for the reduction of HIV-associated "risk behaviors." This article reviews the evidence and social assumptions behind this approach to preventing HIV transmission, and argues that these approaches are often inadequate or misguided, particularly in their conflation of the concept of "culture" with social circumstances. By analyzing the socioeconomic circumstances that constrain individual agency, and by combining data from prevention literature with analyses of international trade agreements and the controversies over antiretroviral drug distribution, the author argues that the movement of capital and the maintenance of inequality are central to the problems associated with behavior-change initiatives and must be addressed through new paradigms in order to respond appropriately to the global AIDS pandemic. Hardt and Negri's paradigm of "Empire"--that is, examining the system through which social inequalities are maintained not only between countries but also within them--offers prospects for the design of new interventions and targets for public health workers and social movements.

  20. Aflatoxins, hepatocellular carcinoma and public health. (United States)

    Magnussen, Arvin; Parsi, Mansour A


    Hepatocellular carcinoma (HCC) is one of the leading causes of cancer deaths worldwide, primarily affecting populations in the developing countries. Aflatoxin, a food contaminant produced by the fungi Aspergillus flavus and Aspergillus parasiticus, is a known human carcinogen that has been shown to be a causative agent in the pathogenesis of HCC. Aflatoxin can affect a wide range of food commodities including corns, oilseeds, spices, and tree nuts as well as milk, meat, and dried fruit. Many factors affect the growth of Aspergillus fungi and the level of aflatoxin contamination in food. Drought stress is one of the factors that increase susceptibility of plants to Aspergillus and thus aflatoxin contamination. A recent drought is thought to be responsible for finding of trace amounts of aflatoxin in some of the corn harvested in the United States. Although it's too soon to know whether aflatoxin will be a significant problem, since United States is the world's largest corn producer and exporter, this has raised alarm bells. Strict regulations and testing of finished foods and feeds in the United States should prevent a major health scare, and prevent human exposure to deleterious levels of aflatoxin. Unfortunately, such regulations and testing are not in place in many countries. The purpose of this editorial is to summarize the current knowledge on association of aflatoxin and HCC, encourage future research and draw attention to this global public health issue.

  1. Social marketing and public health intervention. (United States)

    Lefebvre, R C; Flora, J A


    The rapid proliferation of community-based health education programs has out-paced the knowledge base of behavior change strategies that are appropriate and effective for public health interventions. However, experiences from a variety of large-scale studies suggest that principles and techniques of social marketing may help bridge this gap. This article discusses eight essential aspects of the social marketing process: the use of a consumer orientation to develop and market intervention techniques, exchange theory as a model from which to conceptualize service delivery and program participation, audience analysis and segmentation strategies, the use of formative research in program design and pretesting of intervention materials, channel analysis for devising distribution systems and promotional campaigns, employment of the "marketing mix" concept in intervention planning and implementation, development of a process tracking system, and a management process of problem analysis, planning, implementation, feedback and control functions. Attention to such variables could result in more cost-effective programs that reach larger numbers of the target audience.

  2. Discretionary Fortification—A Public Health Perspective

    Directory of Open Access Journals (Sweden)

    Tarasuk Valerie


    Full Text Available ‘Discretionary fortification’ refers to the addition of vitamins and minerals to foods at the discretion of manufacturers for marketing purposes, but not as part of a planned public health intervention. While the nutrients added may correspond to needs in the population, an examination of novel beverages sold in Toronto supermarkets revealed added nutrients for which there is little or no evidence of inadequacy in the population. This is consistent with the variable effects of manufacturer-driven fortification on nutrient adequacy observed in the US. Nutrient intakes in excess of Tolerable Upper Intake Levels are now observed in the context of supplement use and high levels of consumption of fortified foods. Expanding discretionary fortification can only increase nutrient exposures, but any health risks associated with chronically high nutrient loads from fortification and supplementation remain to be discovered. Regulatory bodies are focused on the establishment of safe levels of nutrient addition, but their estimation procedures are fraught with untested assumptions and data limitations. The task of determining the benefits of discretionary fortification is being left to consumers, but the nutrition information available to them is insufficient to allow for differentiation of potentially beneficial fortification from gratuitous nutrient additions.

  3. Urban public health: is there a pyramid? (United States)

    Su, Meirong; Chen, Bin; Yang, Zhifeng; Cai, Yanpeng; Wang, Jiao


    Early ecologists identified a pyramidal trophic structure in terms of number, biomass and energy transfer. In 1943, the psychologist Maslow put forward a pyramid model to describe layers of human needs. It is indicated that the pyramid principle is universally applicable in natural, humanistic and social disciplines. Here, we report that a pyramid structure also exists in urban public health (UPH). Based on 18 indicators, the UPH states of four cities (Beijing, Tokyo, New York, and London) are compared from the point of view of five aspects, namely physical health, living conditions, social security, environmental quality, and education and culture. A pyramid structure was found in each city when focusing on 2000-2009 data. The pyramid of Beijing is relatively similar to that of Tokyo, and the pyramids of New York and London are similar to each other. A general development trend in UPH is proposed and represented by different pyramid modes. As a basic conjecture, the UPH pyramid model can be verified and developed with data of more cities over a longer period, and be used to promote healthy urban development.

  4. Urban Public Health: Is There a Pyramid?

    Directory of Open Access Journals (Sweden)

    Meirong Su


    Full Text Available Early ecologists identified a pyramidal trophic structure in terms of number, biomass and energy transfer. In 1943, the psychologist Maslow put forward a pyramid model to describe layers of human needs. It is indicated that the pyramid principle is universally applicable in natural, humanistic and social disciplines. Here, we report that a pyramid structure also exists in urban public health (UPH. Based on 18 indicators, the UPH states of four cities (Beijing, Tokyo, New York, and London are compared from the point of view of five aspects, namely physical health, living conditions, social security, environmental quality, and education and culture. A pyramid structure was found in each city when focusing on 2000–2009 data. The pyramid of Beijing is relatively similar to that of Tokyo, and the pyramids of New York and London are similar to each other. A general development trend in UPH is proposed and represented by different pyramid modes. As a basic conjecture, the UPH pyramid model can be verified and developed with data of more cities over a longer period, and be used to promote healthy urban development.

  5. Public Health Indicators for Europe: Context, Selection, Definition

    NARCIS (Netherlands)

    Kramers PGN; ECHI (European Community Health Indicators); ECHI team; VTV


    This ECHI-2 report (ECHI = European Community Health Indicators) presents a list of indicators in the field of public health. The indicators range from health status (e.g. cancer incidence) through health determinants (e.g. nutrition, air pollution) to preventive actions and health care systems. The

  6. Unraveling Brazilian Indian population prostate good health: clinical, anthropometric and genetic features

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    Mario M. de Lima Junior


    Full Text Available Purpose To compare dietary, lifestyle, clinical, anthropometric, genetic and prostatic features of Brazilian Indians and non-Indians (Amazon. Methods 315 men, 228 Indians and 89 non-Indians, ≥40 years old were submitted to digital rectal examination, serum prostate specific antigen (PSA, testosterone, TP53 and GSTP1 genotyping, anthropometric, lifestyle, dietary, personal and familial medical history. Prostatic symptoms were evaluated with the International Prostate Symptom Score (IPSS. Results Macuxis and Yanomamis represented 43.6% and 14.5% of Indians respectively who spontaneously referred no prostate symptoms. Mean IPSS was 7, range 3-19, with only 15% of moderate symptoms (score 8-19; Mean age was 54.7 years, waist circumference 86.6 cm, BMI 23.9 kg/m2. Yanomamis presented both lower BMI (21.4 versus 24.8 and 23.3, p=0,001 and prostate volume than Macuxis and “other ethnic groups” (15 versus 20, p=0.001. Testosterone (414 versus 502 and 512, p=0.207 and PSA (0.48 versus 0.6 and 0.41, p=0.349 were similar with progressive PSA increase with aging. Val/Val correlated with lower PSA (p=0.0361. Indians compared to control population presented: - TP53 super representation of Arg/Arg haplotype, 74.5% versus 42.5%, p<0.0001. -GSTP1 Ile/Ile 35.3% versus 60.9%; Ile/Val 45.9% versus 28.7%; Val/Val 18.8% versus 10.3%; p=0.0003. Conclusions Observed specific dietary, lifestyle, anthropometric and genetic profile for TP53 and GSTP1 may contribute to Brazilian Indian population prostate good health.

  7. Improving Coordination of Addiction Health Services Organizations with Mental Health and Public Health Services. (United States)

    Guerrero, Erick G; Andrews, Christina; Harris, Lesley; Padwa, Howard; Kong, Yinfei; M S W, Karissa Fenwick


    In this mixed-method study, we examined coordination of mental health and public health services in addiction health services (AHS) in low-income racial and ethnic minority communities in 2011 and 2013. Data from surveys and semistructured interviews were used to evaluate the extent to which environmental and organizational characteristics influenced the likelihood of high coordination with mental health and public health providers among outpatient AHS programs. Coordination was defined and measured as the frequency of interorganizational contact among AHS programs and mental health and public health providers. The analytic sample consisted of 112 programs at time 1 (T1) and 122 programs at time 2 (T2), with 61 programs included in both periods of data collection. Forty-three percent of AHS programs reported high frequency of coordination with mental health providers at T1 compared to 66% at T2. Thirty-one percent of programs reported high frequency of coordination with public health services at T1 compared with 54% at T2. Programs with culturally responsive resources and community linkages were more likely to report high coordination with both services. Qualitative analysis highlighted the role of leadership in leveraging funding and developing creative solutions to deliver coordinated care. Overall, our findings suggest that AHS program funding, leadership, and cultural competence may be important drivers of program capacity to improve coordination with health service providers to serve minorities in an era of health care reform.

  8. Comparison of the epidemiologic features and patterns of initial care for prostate cancer between public and private institutions: a survey by the Brazilian Society of Urology

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    Aguinaldo Cesar Nardi


    Full Text Available OBJECTIVE: To describe the epidemiological features and patterns of initial care for prostate cancer at public and private institutions in the State of Sao Paulo, Brazil. MATERIALS AND METHODS: A total of 1,082 physicians affiliated to the Sao Paulo Section of the Brazilian Society of Urology were invited to participate in this cross-sectional, web-based survey. Between September 2004 and September 2005, participating urologists entered data on demographic, clinical and pathological characteristics of patients diagnosed with prostate cancer in their practice. Data on patients attended at public institutions were analyzed and compared with those patients attended at private practice. RESULTS: One hundred and ten society members contributed with data from 1915 patients, 1026 (53.6% of whom from public institutions. When compared with patients attended at private institutions, those attended at public institutions were older and more likely to be black, had higher serum prostate specific antigen (PSA levels, had a higher probability of being diagnosed with metastatic disease, but were less likely to undergo prostatectomy (all P < 0.001. In multivariate analysis, age, biopsy Gleason score, and being attended at a public institution were independently associated with metastatic disease upon diagnosis. The significant predictors of nonsurgical treatment were age, black race, and higher serum levels of PSA. CONCLUSIONS: A statewide registry provides valuable information regarding patient demographics, clinical features, and patterns of care. The results of this study suggest that significant disparities exist for patients with prostate cancer attended at different health-care systems. The relative contribution of biological versus socioeconomic features remains uncertain.

  9. Oral health technicians in Brazilian primary health care: potentials and constraints. (United States)

    Aguiar, Dulce Maria Lucena de; Tomita, Nilce Emy; Machado, Maria de Fátima Antero Sousa; Martins, Cleide Lavieri; Frazão, Paulo


    Different perspectives on the role of mid-level workers in health care might represent a constraint to health policies. This study aimed to investigate how different agents view the participation of oral health technicians in direct activities of oral healthcare with the goal of understanding the related symbolic dispositions. Theoretical assumptions related to inter-professional collaboration and conflicts in the field of healthcare were used for this analysis. A researcher conducted 24 in-depth interviews with general dental practitioners, oral health technicians and local managers. The concepts of Pierre Bourdieu supported the data interpretation. The results indicated inter-professional relations marked by collaboration and conflict that reflect an action space related to different perspectives of primary care delivery. They also unveiled the symbolic devices related to the participation of oral health technicians that represent a constraint to the implementation of oral health policy, thus reducing the potential of primary health care in Brazil.

  10. Full-Range Public Health Leadership, Part 1: Quantitative Analysis

    Directory of Open Access Journals (Sweden)

    Erik L. Carlton


    Full Text Available Background. Workforce and leadership development are central to the future of public health. However, public health has been slow to translate and apply leadership models from other professions and to incorporate local perspectives in understanding public health leadership. Purpose. This study utilized the full-range leadership model in order to examine public health leadership. Specifically, it sought to measure leadership styles among local health department directors and to understand the context of leadership local health departments.Methods. Leadership styles among local health department directors (n=13 were examined using survey methodology. Quantitative analysis methods included descriptive statistics, boxplots, and Pearson bivariate correlations using SPSS v18.0. Findings. Self-reported leadership styles were highly correlated to leadership outcomes at the organizational level. However, they were not related to county health rankings. Results suggest the preeminence of leader behaviors and providing individual consideration to staff as compared to idealized attributes of leaders, intellectual stimulation, or inspirational motivation. Implications. Holistic leadership assessment instruments, such as the Multifactor Leadership Questionnaire (MLQ can be useful in assessing public health leaders approaches and outcomes. Comprehensive, 360-degree reviews may be especially helpful. Further research is needed to examine the effectiveness of public health leadership development models, as well as the extent that public health leadership impacts public health outcomes.

  11. [The modern international public health and globalization challenges]. (United States)


    The article deals with the issues of impact of globalization on population health and public health. The positive and negative aspects of this process are analyzed. The role of international organizations (UN, WHO, UNESCO, ILO, UNISEF) is demonstrated in the area of management of globalization impact on public health of different countries, Russia included.

  12. Understanding Evaluation Training in Schools and Programs of Public Health (United States)

    Fierro, Leslie A.; Christie, Christina A.


    This study provides an understanding of how the coursework required for attaining a Masters of Public Health (MPH) degree in epidemiology or health education from accredited schools or programs of public health prepares students to evaluate programs or interventions. Study data were generated using a content analysis of required coursework…

  13. Bed Bug Epidemic: A Challenge to Public Health (United States)

    Ratnapradipa, Dhitinut; Ritzel, Dale O.; Haramis, Linn D.; Bliss, Kadi R.


    In recent years, reported cases of bed bug infestations in the U.S. and throughout the world have escalated dramatically, posing a global public health problem. Although bed bugs are not known to transmit disease to humans, they pose both direct and indirect public health challenges in terms of health effects, treatment, cost, and resource…

  14. 75 FR 27348 - Public Health Services Act; Delegation of Authority (United States)


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Public Health Services Act; Delegation of Authority Notice is hereby given that I have delegated to the Director, Office of Public Health...

  15. The Public Health Journey: The Meaning and the Moment (United States)

    Koh, Howard K.


    The public health journey is a remarkable one, filled with twists and turns as well as risks and rewards. Because promoting the health of others represents a mission brimming with meaning, our professional work is also profoundly personal. At this extraordinary moment in our nation's public health history, I reflect on the purpose of the…

  16. Building public health law capacity at the local level. (United States)

    Hoffmann, Diane E; Rowthorn, Virginia


    Local health officials are called upon every day to implement the programs, enforce the regulations, and take the actions that protect the health of the citizens in their districts. These responsibilities and duties are created and regulated by a complex interplay of federal, state, and local law. Not only is an understanding of these laws necessary to carry out public health activities on a daily basis, but many public health scholars and practitioners also believe that the law can be used as a tool to take proactive steps to improve public health. Unfortunately, many local public health officials do not have access to the legal assistance they need to address the various legal questions that confront them. This deficit makes it harder for them to meet their day-to-day responsibilities and makes it much more difficult for them to use the law proactively as a method to improve public health in their communities. In addition, many of the attorneys who provide legal support to public health departments do not have the time or resources to develop a thorough and up-to-date understanding of public health law. This paper examines the experience of a number of local health offices in obtaining legal advice and of attorneys who provide legal advice and assistance to local health departments and assesses different models for organizing and financing the provision of legal services to local public health officials.

  17. Arsenic in North Carolina: public health implications. (United States)

    Sanders, Alison P; Messier, Kyle P; Shehee, Mina; Rudo, Kenneth; Serre, Marc L; Fry, Rebecca C


    Arsenic is a known human carcinogen and relevant environmental contaminant in drinking water systems. We set out to comprehensively examine statewide arsenic trends and identify areas of public health concern. Specifically, arsenic trends in North Carolina private wells were evaluated over an eleven-year period using the North Carolina Department of Health and Human Services database for private domestic well waters. We geocoded over 63,000 domestic well measurements by applying a novel geocoding algorithm and error validation scheme. Arsenic measurements and geographical coordinates for database entries were mapped using Geographic Information System techniques. Furthermore, we employed a Bayesian Maximum Entropy (BME) geostatistical framework, which accounts for geocoding error to better estimate arsenic values across the state and identify trends for unmonitored locations. Of the approximately 63,000 monitored wells, 7712 showed detectable arsenic concentrations that ranged between 1 and 806μg/L. Additionally, 1436 well samples exceeded the EPA drinking water standard. We reveal counties of concern and demonstrate a historical pattern of elevated arsenic in some counties, particularly those located along the Carolina terrane (Carolina slate belt). We analyzed these data in the context of populations using private well water and identify counties for targeted monitoring, such as Stanly and Union Counties. By spatiotemporally mapping these data, our BME estimate revealed arsenic trends at unmonitored locations within counties and better predicted well concentrations when compared to the classical kriging method. This study reveals relevant information on the location of arsenic-contaminated private domestic wells in North Carolina and indicates potential areas at increased risk for adverse health outcomes.

  18. Zika Virus: An Emerging Public Health Challenge

    Directory of Open Access Journals (Sweden)

    Sumeena Basundra


    Full Text Available Emerging infectious diseases comprise a substantial proportion of global morbidity and mortality. The world has been hit by Zika virus (ZIKV after it was able to surmount an effective public health response for its control. ZIKV disease is an emerging mosquitoborne disease which occurred as large outbreaks in Yap since 2007, Polynesia in 2013 and Brazil in 2015. ZIKV infection in pregnant women has been observed to be associated with congenital microcephaly with neurological and autoimmune sequelae in general population of Brazil. The incubation period of ZIKV varies from few days to weeks. Only 20% of infected cases have symptoms like any other arboviral illness. ZIKV is diagnosed using RT-PCR (reverse transcriptase-polymerase chain reaction and virus isolation from blood samples. The treatment comprises of relief of symptoms by conservative management with no specific vaccine being available. The prevention and control of ZIKV is based on reduction of vector density by Integrated Vector Management and personal protection measures. As per Indian scenario, Ministry of Health had issued guidelines based on effective surveillance, risk communication, laboratory and travel regulations. Approaches to such a potential global health security threat should be consistent, proactive, and should involve coordinated, multi-pronged, multilateral collaborative efforts since the concern is at the highest and immediate because of Global epidemic, Rio de Janeiro Olympic Games starting from Aug 5-21, 2016 and strong association with microcephaly. Most importantly the need of the hour is the development of vaccine for protection especially the young women who are in the reproductive age groups. The research for which is ongoing as far as the current situation of global epidemic response is concerned.

  19. [One hundred years' history of public health activities in Korea]. (United States)

    Meng, K H


    In a dictionary of epidemiology, recently edited by John Last, public health was defined as one of the efforts organized by society to protest, promote, and restore the peoples' health. It is the combination of sciences, skills, and beliefs that is directed to the maintenance and improvement of the health of all the people through collective or social action. In most countries, the efforts to protect, promote, and restore the peoples' health are mostly organized by the government, and therefore, the history of public health in the respective countries is closely related to the state of government and its administrative structures. In this article, the history of public health activities in Korea during the last 100 years has been reviewed in four consecutive time periods from the end of Li Dynasty till now. The public health during the first some 50 years from 1897 when the Dae Han Empire began to 1945 when the Japanese colonial period ended can be characterized by enforcement of personal and environmental hygiene by the police. In those days, communicable disease control was the main purpose of such public health measures. Second phase of Korean public health from 1945 to the time of military coup in 1961 is characterized by enactment of various public health laws and the related public health practices. Major health related laws are communicable disease control law, environmental hygiene act, industrial safety and health law, and so on. Important public health practice in this time period was family planning. Third phase of public health history from 1962 to 1992 can be recorded as the time when the actual public health practices were fully developed. Because of well established health center activities throughout the country, basic public health services were provided together with primary medical care services to the people in rural areas. Since 1993, two civilian governments have been trying to change the concept of their health administration from providing

  20. Produtivismo e avaliação acadêmica na Saúde Coletiva brasileira: desafios para a pesquisa em Ciências Humanas e Sociais Productivity and academic assessment in the Brazilian public health field: challenges for human and social sciences research

    Directory of Open Access Journals (Sweden)

    Maria Lúcia Magalhães Bosi


    Full Text Available Este artigo problematiza alguns desafios que se impõem à produção do conhecimento nas Ciências Humanas e Sociais, no campo da Saúde Coletiva, sob o atual modelo que norteia as avaliações acadêmicas no Brasil. Para tanto, o artigo focaliza o enfoque qualitativo de pesquisa em Ciências Humanas e Sociais, analisando o seu estatuto ante outras tradições que com ele disputam hegemonia no campo da Saúde Coletiva, conjugando o diálogo com a literatura, notadamente proposições relativas aos campos sociais presentes na obra de Pierre Bourdieu, com elementos concernentes à dinâmica do campo, incluindo incursões a dados empíricos. Dentre os desafios assinalados, destacam-se aqueles referentes ao impedimento de diálogos interdisciplinares e obstáculos à equidade na produção do conhecimento, baseada no reconhecimento da natureza e do lugar fundante das Ciências Humanas e Sociais no campo Saúde Coletiva. Discutem-se estratégias visando a reconfigurar a atual correlação de forças entre os núcleos de saberes da Saúde Coletiva, notadamente aquelas capazes de impactar comitês e agendas que definem a acumulação do capital simbólico e econômico no âmbito analisado.This article analyzes some challenges for knowledge output in the human and social sciences in the public health field, under the current academic assessment model in Brazil. The article focuses on the qualitative research approach in human and social sciences, analyzing its status in comparison to the other traditions vying for hegemony in the public health field, conjugating the dialogue with the literature, especially the propositions pertaining to the social fields present in the work of Pierre Bourdieu, with elements concerning the field's dynamics, including some empirical data. Challenges identified in the article include hurdles to interdisciplinary dialogue and equity in the production of knowledge, based on recognition of the founding place of human and

  1. Adapting online learning for Canada's Northern public health workforce

    Directory of Open Access Journals (Sweden)

    Marnie Bell


    Full Text Available Background . Canada's North is a diverse, sparsely populated land, where inequalities and public health issues are evident, particularly for Aboriginal people. The Northern public health workforce is a unique mix of professional and paraprofessional workers. Few have formal public health education. From 2009 to 2012, the Public Health Agency of Canada (PHAC collaborated with a Northern Advisory Group to develop and implement a strategy to strengthen public health capacity in Canada's 3 northern territories. Access to relevant, effective continuing education was identified as a key issue. Challenges include diverse educational and cultural backgrounds of public health workers, geographical isolation and variable technological infrastructure across the north. Methods . PHAC's Skills Online program offers Internet-based continuing education modules for public health professionals. In partnership with the Northern Advisory Group, PHAC conducted 3 pilots between 2008 and 2012 to assess the appropriateness of the Skills Online program for Northern/Aboriginal public health workers. Module content and delivery modalities were adapted for the pilots. Adaptations included adding Inuit and Northern public health examples and using video and teleconference discussions to augment the online self-study component. Results . Findings from the pilots were informative and similar to those from previous Skills Online pilots with learners in developing countries. Online learning is effective in bridging the geographical barriers in remote locations. Incorporating content on Northern and Aboriginal health issues facilitates engagement in learning. Employer support facilitates the recruitment and retention of learners in an online program. Facilitator assets included experience as a public health professional from the north, and flexibility to use modified approaches to support and measure knowledge acquisition and application, especially for First Nations, Inuit and

  2. Relationship between Sense of Coherence and oral health in adults and elderly Brazilians

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    Rosane Silvia DAVOGLIO


    Full Text Available Abstract The purpose of this study was to investigate the relationship between Sense of Coherence (SOC and oral health clinical variables (number of teeth present and absence of need for dental prostheses. The sample consisted of 720 adults and elderly Brazilians. The data were collected at home using the SOC-13 scale – a form of clinical examination for the evaluation of oral conditions – and a questionnaire evaluating socioeconomic aspects and the use of dental services. Statistical analysis, both univariate and multivariate, was performed by Poisson regression with robust variance adjustment. The average age of the participants was 60.2 years, and they were predominantly female (57.8%. Among the participants who had a strong SOC, the absence of the need for dental prostheses was 34% higher than among those with a weak SOC, demonstrating a significant difference between the groups (PR = 1.34, 95%CI = 1.06–1.70; p = 0.015. Individuals who had a strong SOC had a 5% higher prevalence of 14 or more existing teeth than those with a weak SOC, which was statistically significant after adjustment for co-factors (PR = 1.05, 95%CI = 1.01–1.11, p = 0.033. A strong personal Sense of Coherence has a beneficial influence on the oral health of adults and older people in Brazil.

  3. Public Health and Terrorism Preparedness: Cross-Border Issues


    Olson, Debra; Leitheiser, Aggie; Atchison, Christopher; Larson, Susan; Homzik, Cassandra


    On December 15, 2003, the Centers for Public Health Preparedness at the University of Minnesota and the University of Iowa convened the “Public Health and Terrorism Preparedness: Cross-Border Issues Roundtable.” The purpose of the roundtable was to gather public health professionals and government agency representatives at the state, provincial, and local levels to identify unmet cross-border emergency preparedness and response needs and develop strategies for addressing these needs. Represen...

  4. [Participation in health: systematization of the articles published in Brazilian journals--1988/2005]. (United States)

    Cavalcanti, Maria de Lourdes Tavares; Cabral, Marta Henriques de Pina; Antunes, Ludmila Rodrigues


    This is a study involving the revision of 107 papers on participation in health, published in 25 Public Health journals, with a view to systematize its main focus points and identify the options for the participation of society in the health system. Bibliographic research was conducted using key words, and the reading of abstracts of articles published in national public health journals linked to the CAPES portal between 1988 and 2005. The articles selected were read and categorized according to methodological and thematic aspects. Three dimensions were identified: the main dimension emphasizes participation as a strategy for the enhancing of citizenship and recognition of the right to health; the second refers to participation as a strategy for democratization of the State and strengthening of the health system, including participation in political, managerial and inspection decisions; in the third dimension of community participation, individuals, families and the community share the responsibility for health with the State. In the works examined the participation in the health system is still in progress and highlights its importance as an incentive for social capital; however, some authors point to difficulties for effective participation in accordance with legal propositions.

  5. Public health nurses' primary health care practice: strategies for fostering citizen participation. (United States)

    Aston, Megan; Meagher-Stewart, Donna; Edwards, Nancy; Young, Linda M


    Citizen participation is heralded as a critical element of community health programs that emphasize empowerment and health promotion strategies. Although there is a growing body of research on public health nurses' primary health care practice, few studies have described how public health nurses foster citizen participation. This article presents findings from an interpretive qualitative study of public health nurses' perceptions of their role in fostering citizen participation in an eastern Canadian province at a time of significant health care restructuring. The findings from this study clearly profile public health nurses as integral to the practice of fostering citizen participation.

  6. Health for all: a fundamental goal of public health in our region. (United States)

    Binns, Colin; Lee, Mi Kyung


    Since its foundation 30 years ago, the mission of the Asia-Pacific Academic Consortium for Public Health has been promoting "health for all" through public health. "Health for all" became the theme of Walter Patrick's public health career and inspired his contribution to APACPH. However, the universality of health care is now under threat, more from economists and politicians than public health workers. Health for all remains a continuing challenge for all public health workers in our region. Progress is being made toward this goal as life expectancy in the Western Pacific has increased from 64 to 78 in the past 3 decades. Prof Walter Patrick was strong public health advocate, and this review was written as a tribute to good friend and inspiring colleague who believed in, and worked for "health for all."

  7. Internationality of Publications, Co-Authorship, References and Citations in Brazilian Evolutionary Biology

    Directory of Open Access Journals (Sweden)

    Dirce Maria Santin


    Full Text Available The international dimensions of contemporary science have significantly impacted production and use patterns of scientific knowledge, which, in turn, requires new insights of librarians, publishers and academic institutions. Despite the recognized importance of internationality in science, studies on the internationalization of scientific output are still limited and dedicated exclusively to analyzing of its diffusion and international collaboration. This study analyzes the national/international character of articles, international collaboration, references and citations of Brazilian scientific output in Evolutionary Biology in order to understand the contribution to the internationalization of science in Brazil. Analyses are based on data from the Science Citation Index of Web of Science and include 1450 articles, 60,454 references and 18,059 citing documents. Results reveal similar internationality patterns, with 99.6% of articles published in foreign journals, 90.5% international references, and 88.5% international citations. Despite recording the lowest value among the indicators (51.9%, international collaboration surpasses the national and international average and is an important characteristic in the field in Brazil, contributing to increasing the number of references and the impact of articles. Evolutionary Biology is considered a predominantly international field, whose internationality patterns increase the audience for the studies and provide greater visibility for Brazilian science.

  8. National Center for Disaster Medicine and Public Health (United States)

    Federal Laboratory Consortium — The National Center for Disaster Medicine and Public Health (NCDMPH) is an academic center tasked with leading federal, and coordinating national, efforts to develop...

  9. Managing complex systems: performance management in public health. (United States)

    Landrum, Laura B; Baker, Stacy L


    The complexity of mobilizing and managing systems-wide public health responses has prompted Turning Point's Performance Management National Excellence Collaborative, funded by the Robert Wood Johnson Foundation, to develop a conceptual framework for performance management in public health. The framework has four integrated parts: (1) performance standards, (2) performance measures, (3) reporting of progress, and (4) a quality improvement process. The Collaborative based its framework on evidence gathered through a survey of current state performance management practices, a literature review, and its investigation of current practice models. This balanced and cohesive management model can be constructively used by public health programs, organizations, and community and state public health systems.

  10. [Interdisciplinary efforts in public health: an area under construction]. (United States)

    Gomes, R; Deslandes, S F


    This article, based on a literature review, aims to discuss the interdisciplinarity on Public Health (its needs, barriers for implementation and possibilities). Therefore, initially, the authors present a discuss on conceptual and historical terms, that explains the subject. In this part, it is discussed the process of inclusion and exclusion of interdisciplinarity on Public Health, as well as the different dimension of it. Subsequently it is related an interdisciplinary experience on Public Health. Finally, the authors concluded that the interdisciplinary is extremely necessary to Public Health due to the complexity of its object of study.

  11. Psychometric properties of the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS

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    Pordeus Isabela A


    Full Text Available Abstract Background Oral disorders can have a negative impact on the functional, social and psychological wellbeing of young children and their families and cause pain/discomfort for the child. Oral health-related quality of life (OHRQoL has emerged as an important health outcome in clinical trials and healthcare research. The Early Childhood Oral Health Impact Scale (ECOHIS is a proxy measure of children's OHRQoL designed to assess the negative impact of oral disorders on the quality of life of preschool children. The objective of this study was to evaluate the psychometric properties of the Brazilian version of the ECOHIS (B-ECOHIS. Methods This investigation was carried out in preliminary and field studies. The preliminary study comprised a cross-sectional study carried out in the city of Petropolis, Brazil. A sample of 150 children from two to five years of age was recruited at a public hospital. In the field study, an epidemiological survey was carried out in public and private preschools of Belo Horizonte, Brazil. The B-ECOHIS was answered by 1643 parents/caregivers of five-year-old male and female preschool children. In both phases, oral examinations were performed by a single previously calibrated dentist. Reliability was determined through test-retest reliability and internal consistency. Validity was determined through convergent and discriminant validities. The correlation between the scores obtained on the child and family impact sections was assessed. Results In the preliminary (P and field (F study, test-retest reliability correlation values were 0.98 and 0.99 for the child impact section and 0.97 and 0.99 for the family impact section, respectively. The B-ECOHIS demonstrated internal consistency: child impact section (P: α = 0.74; F: α = 0.80 and family impact section (P: α = 0.59; F: α = 0.76. The correlation between the scores obtained on the child and family impact sections was statistically significant (P: rs = 0.54; F: rs

  12. TB in Correctional Facilities Is a Public Health Concern (United States)

    ... this? Submit Button Past Emails CDC Features TB in Correctional Facilities is a Public Health Concern Recommend ... health concern. Figure 1 (larger view). TB Control in Correctional Facilities Diagnosing and treating TB in correctional ...

  13. [The public health legislation in conditions of globalization]. (United States)

    Yefremov, D V; Jyliyaeva, E P


    The article demonstrates the impact of globalization on development of public health legislation at the international level and in particular countries. The legislation is considered as a tool to decrease the globalization health risks for population

  14. Manifestations of integrated public health policy in Dutch municipalities

    NARCIS (Netherlands)

    Peters, D.; Harting, J.; van Oers, H.; Schuit, J.; de Vries, N.; Stronks, K.


    Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a contin

  15. Manifestations of integrated public health policy in Dutch municipalities

    NARCIS (Netherlands)

    Peters, D.; Harting, J.; van Oers, J.A.M.; Schuit, J.; Stronks, K.


    Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a contin

  16. Importance of public health informatics: a survey of public health schools and graduate programs in the United States. (United States)

    Richards, Janise


    This paper examines the importance of data, information, and informatics to public health practice. Forty public health academicians from 40 schools and graduate programs of public health were interviewed. All agreed that informatics was important to public health practice. A qualitative analysis of their comments revealed their beliefs on the importance of informatics skills and knowledge to the practice of public health. The resulting comment groups varied from "some skills are more important than others" to "need all the skills." Eight "importance" comment groups were formed: 1) skills for all professionals; 2) some skills more than others; 3) yes, they need all the skills; 4) skills to become better practitioners; 5) usefulness to practitioners; 6) communication with public; 7) they're [the public] are depending on us; and 8) the future.

  17. A model for training public health workers in health policy: the Nebraska Health Policy Academy. (United States)

    Brandert, Kathleen; McCarthy, Claudine; Grimm, Brandon; Svoboda, Colleen; Palm, David; Stimpson, Jim P


    There is growing recognition that health goals are more likely to be achieved and sustained if programs are complemented by appropriate changes in the policies, systems, and environments that shape their communities. However, the knowledge, skills, and abilities needed to create and implement policy are among the major needs identified by practitioners at both the state and local levels. This article describes the structure and content of the Nebraska Health Policy Academy (the Academy), a 9-month program developed to meet the demand for this training. The Academy is a competency-based training program that aims to increase the capacity of Nebraska's state and local public health staff and their community partners to use public health policy and law as a public health tool. Our initiative allows for participation across a large, sparsely populated state; is grounded in adult learning theory; introduces the key principles and practices of policy, systems, and environmental change; and is offered free of charge to the state's public health workforce. Challenges and lessons learned when offering workforce development on public health policy efforts are discussed.

  18. Public health campaigns and obesity - a critique

    Directory of Open Access Journals (Sweden)

    Proietto Joseph


    Full Text Available Abstract Background Controlling obesity has become one of the highest priorities for public health practitioners in developed countries. In the absence of safe, effective and widely accessible high-risk approaches (e.g. drugs and surgery attention has focussed on community-based approaches and social marketing campaigns as the most appropriate form of intervention. However there is limited evidence in support of substantial effectiveness of such interventions. Discussion To date there is little evidence that community-based interventions and social marketing campaigns specifically targeting obesity provide substantial or lasting benefit. Concerns have been raised about potential negative effects created by a focus of these interventions on body shape and size, and of the associated media targeting of obesity. Summary A more appropriate strategy would be to enact high-level policy and legislative changes to alter the obesogenic environments in which we live by providing incentives for healthy eating and increased levels of physical activity. Research is also needed to improve treatments available for individuals already obese.

  19. Public health practice course using Google Plus. (United States)

    Wu, Ting-Ting; Sung, Tien-Wen


    In recent years, mobile device-assisted clinical education has become popular among nursing school students. The introduction of mobile devices saves manpower and reduces errors while enhancing nursing students' professional knowledge and skills. To respond to the demands of various learning strategies and to maintain existing systems of education, the concept of Cloud Learning is gradually being introduced to instructional environments. Cloud computing facilitates learning that is personalized, diverse, and virtual. This study involved assessing the advantages of mobile devices and Cloud Learning in a public health practice course, in which Google+ was used as the learning platform, integrating various application tools. Users could save and access data by using any wireless Internet device. The platform was student centered and based on resource sharing and collaborative learning. With the assistance of highly flexible and convenient technology, certain obstacles in traditional practice training can be resolved. Our findings showed that the students who adopted Google+ were learned more effectively compared with those who were limited to traditional learning systems. Most students and the nurse educator expressed a positive attitude toward and were satisfied with the innovative learning method.

  20. Medical marijuana: a public health perspective

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    Ushang Desai


    Full Text Available Over the few years medical marijuana is growing in the United States. Because of the medical marijuana legislators able to legalized recreational marijuana in the two states in the US. Marijuana has several potential benefits that help in certain disease. The delivery of marijuana is also important because smoking marijuana has severe side effects. Physicians also play important role in medical marijuana, physicians also divided on the use of medical marijuana. Their attitude towards medical marijuana important for the treatment of disease is important for the community. Marijuana is the most commonly used illegal drug in the US and all over world, several risks associated with it. Major concern is medical marijuana increased the use of marijuana and will create the public health problem in the society. There are several medical benefits from the marijuana but require more research to establish the marijuana as a medicine. Control of medical marijuana is also major issue for the law enforcement agencies and challenge for policymakers also in the United States. [Int J Basic Clin Pharmacol 2013; 2(2.000: 136-143