Top PDF Abstract This article discusses the processes of de-

Abstract This article discusses the processes of de-

Abstract This article discusses the processes of de-

Abstract This article discusses the processes of de- centralization and regionalization of health policy in Brazil and Spain between 1980 and 2015. The study was developed with contributions of the his- torical institutionalism and of the historical-com- parative method, by means of three dimensions of analysis: State context; trajectory and institution- ality of the decentralization and regionalization of health; and constraints. The study showed that, in both countries, the more general context of re- democratization and decentralization of the State conditioned the reforms of health systems and their political-administrative organization. In addition, historical, institutional and political factors have had a specific impact in each case, influencing the regional organization of services, the balance of power and the division of responsibilities between the governmental spheres in the management, financing and coordination of health policy. The study suggests that the way these factors interre- lated over time is important for understanding the decentralization and regionalization of health sys- tems in different contexts.
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Abstract This article analyses the main charac-

Abstract This article analyses the main charac-

Abstract This article analyses the main charac- teristics of federalism in Brazil and its institution- al relations with health policy. It discusses feder- alism from a classical perspective highlighting the essentially centralized nature of Brazil’s system and the prevalence of decentralizing health pol- icies underpinned by the principles enshrined by the 1988 Constitution.We used primary data obtained from an electronic questionnaire re- sponded by secretaries of health sitting on the governing bodies of the country’s health region and secondary data Ministry of Health databases covering the current health regions. The findings show that significant progress has been made in the implementation of regional governing bodies, yet without any significant impact on the reduc- tion of deep regional inequalities in primary and hospital care. It concludes by suggesting that the persistence of inequalities is down to weak cen- tral coordination capacity and an inappropriate trade-off between a centralized federal system and competition between entities, thus undermining cooperative regionalization of the public health system as envisaged by the 1988 Constitution. Key words Federalism, Regional inequalities, Unified Health System
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Abstract This article provides an overview of the

Abstract This article provides an overview of the

in turn was shaped by the relative timing of de- mocratization and economic and social policy reforms. The cases of Chile and Brazil illustrate these differences clearly. Chile’s extreme ortho- dox reforms were in part possible because they were carried out under a dictatorship. Pinochet strengthened private providers at the expense of the public sector in in both the health and pen- sion systems. He fully privatized the pension system and created a system of private health in- surance and health care providers, the ISAPRES, to which employees could direct their compulso- ry health care contributions. In contrast, union pressures and lack of party discipline in Congress hindered Brazil’s democratic presidents from en- acting the wide reforms in social policy that the IFIs preferred. Pension reform was very slow and partial – in fact, it fell short of not only neoliber- al designs but also of progressive aspirations for curtailment of high benefits for privileged sec- tors 15 . Countries that suffered drastic neoliberal
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Abstract This article analyses the process of con-

Abstract This article analyses the process of con-

lished the main guidelines for the construction of the National System of Epidemiological Surveil- lance in the SUS, which was intended to be de- centralized and comprehensive, i.e. not limited to communicable diseases, whilst at the same time not devaluing this component of traditional pub- lic health. The suggested strategy was to establish links with the National Council of State Secretar- ies of Health (Conass) and the National Council of Municipal Health Secretaries (Conasems) to construct an intergovernmental strategy involv- ing the three SUS management spheres in order to rapidly decentralize the prevention and control of diseases already existent in Brazil, ensuring that there was no interruption in actions or pos- sible damage to the health of the population, as well as expanding the scope of HS activities. The idea was to reduce the fragmentation of surveil- lance activities, which were largely organized in the form of special programs in the SES and the regional directorates of Funasa, and to construct a new surveillance. It was also proposed to inte- grate the health care network, particularly prima- ry health care, in order to provide greater connec- tivity and better quality for the system.
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Abstract This article presents an overview of

Abstract This article presents an overview of

In spite of the achieved progress, the relation- ship with the state and municipal managers suf- fers from the centralizing stance of Anvisa, which does little to help decentralization take effect. It does not recognize, in regulations, technical and legal attributions of these levels in certain work processes. To date, there has been no political decision to consolidate the SNVS in the environ- ment of the SUS. If, on the one hand, this system has been laid out in terms of rules, on the other, it suffers what might be called incomplete restruc- turing, because only the federal component has been structurally reformed 19 .
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Abstract This article briefly analyses the central

Abstract This article briefly analyses the central

Abstract This article briefly analyses the central points of the World Bank’s agenda for the reform of national states in Latin America, between 1980 and 2017. The text is based on World Bank doc- uments and specialized literature. Initially some relevant aspects of the history of the World Bank and its configuration as a multilateral organiza- tion are presented. Next, it discusses the role of the institution in the encouragement of structural adjustment programs for the economies of the re- gion during the 1980s, based on a hyper-market oriented agenda. Afterwards, the process of the renewal and expansion process of the Bank’s po- litical agenda from the end of the 1990s is looked at, which was based on the maintenance of the macroeconomic adjustment, the encouragement of institutional reforms, and combatting extreme poverty. Finally, the principal lines in the Bank’s social policy reform agenda are discussed, includ- ing health.
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Abstract This article briefly analyses the central

Abstract This article briefly analyses the central

means that the relationship of the Bank with the state also involves and implies social classes and groups, since it is the dispute and agreements of power between them which creates state policy. From this results the second aspect, related to the fact that the relationship of the Bank with states is not limited to state agencies, but also involves civil society organizations and private corpora- tions. In third place, it is necessary to take into account that states have very asymmetrical con- ditions of negotiation, depending on the size of their economies and their level of external de- pendency. For example, highly indebted poor countries avidly depend on external funding and have bargaining conditions that are absolutely distinct from countries such as China and Brazil, which count on large international reserves and national development banks with much larger portfolios than the World Bank. Finally, it should not be forgotten that the Bank is a social actor in the middle of an extensive network of relations of public, private, non-governmental, philan- thropic, business, and financial agents which dis- pute the directions, means, and the meanings of development at a national and global scale. Even differing profoundly from each other in relation to the resources of power which they possess, these agents interact with the Bank in the sense of adapting, negotiating, and spreading the ideas and prescriptions of the institutions, translating them in accordance with their own interests and priorities. In this sense, governments frequently use the Bank’s recommendations or the condi- tions it imposes to support the implementation of unpopular reforms. The same occurs with the various national rankings that the Bank estab- lishes about the ‘quality of the institutional en- vironment’ or the ‘facility to do business,’ which function as certificates of the good or bad be- haviour of governments and institutions in gen- eral. Furthermore, since the action of the Bank is multiscale, the emphasis of its operations can oscillate between the Union, states, and munic- ipalities, according to the political orientation and the priorities of those in government. For this reason, the effectiveness of the Bank’s actions needs a combination of coercion with persuasion, through which are constructed, outside and inside the national spaces, visions of the world, and the mutual interests, both in civil society and in the state apparatus.
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Abstract This article aims to estimate the specific

Abstract This article aims to estimate the specific

used in this study due to incomplete data. Deaths and causes of death were identified via the Mortality Information System (Sistema de Informaçoes sobre Mortalidade - SIM) of Espírito Santo state from 2000 to 2012. Penile cancer was defined as the cause of death for cases registered with diagnostic code ICD C60, accord- ing to the 10th edition of the International Clas- sification of Diseases (ICD), approved in 1989 and updated in 2008, must appear as the basic cause of death to be considered as death-specific for penile cancer.
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Abstract This article analyses the main charac-

Abstract This article analyses the main charac-

Abstract This article analyses the main charac- teristics of federalism in Brazil and its institution- al relations with health policy. It discusses feder- alism from a classical perspective highlighting the essentially centralized nature of Brazil’s system and the prevalence of decentralizing health pol- icies underpinned by the principles enshrined by the 1988 Constitution.We used primary data obtained from an electronic questionnaire re- sponded by secretaries of health sitting on the governing bodies of the country’s health region and secondary data Ministry of Health databases covering the current health regions. The findings show that significant progress has been made in the implementation of regional governing bodies, yet without any significant impact on the reduc- tion of deep regional inequalities in primary and hospital care. It concludes by suggesting that the persistence of inequalities is down to weak cen- tral coordination capacity and an inappropriate trade-off between a centralized federal system and competition between entities, thus undermining cooperative regionalization of the public health system as envisaged by the 1988 Constitution. Key words Federalism, Regional inequalities, Unified Health System
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Abstract Abstract This article examines phar-

Abstract Abstract This article examines phar-

The progress made by these initiatives in- volves controversies. With respect to drug mar- keting and advertising, during the time of the public hearing which resulted in the regulatory instrument, a large group of researchers, pro- fessionals, and activists made an emphatic pro- nouncement criticizing the document, partic- ularly the failure to adopt prior inspection. The group argued that in the case of subsequent de- tection of an infringement, the small size of the fine does not act as a deterrent because risks are more than compensated by the sales during the period in which marketing piece are broadcast. Indeed, studies have shown a low level of com- pliance with the legislation governing marketing pieces directed at both professionals and us- ers 58,59 .
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Abstract This article discusses the influence of

Abstract This article discusses the influence of

Abstract This article discusses the influence of environmental conditions on the prevalence of systemic hypertension in two riverine commu- nities in the Sustainable Development Reserve of Tupé, Manaus, Amazonas, Brazil, through an ecological study of multiple groups and contextu- al analysis carried out with the local inhabitants. To identify the environmental etiology describing the risk of disease development, the study com- pares demographics, incidence rates and common daily practices in these communities, using data collected in the field, between 2012 and 2014, as well as values provided by IBGE, originally from National Health Survey, 2013. The results suggest that social and environmental determinants, such as general living conditions, occupation and ac- cess to protective health care, in the investigated communities, are relevant factors in explaining the observed variability in systemic arterial hy- pertension (SAH) incidence rates. The study con- cludes by pointing out the importance and need to consider socio-environmental vulnerability in the elaboration of public health policies and in the management of environmentally protected areas. Key words Society, Environment, Systemic ar- terial hypertension, Health vulnerability, Health management
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Abstract This article aimed to assess the prev-

Abstract This article aimed to assess the prev-

Abstract This article aimed to assess the prev- alence of dyslipidemia and associated factors in children aged from 4 to 7 years old. It is a cross-sectional study conducted with 402 chil- dren aged from 4 to 7 years old, accompanied by a Lactation Support Program in the first six months of life. We measured total cholesterol, tri- glycerides and high-density lipoprotein (HDL) and low-density lipoprotein (LDL). We selected the variables that could be associated with the lipid profile, such as the family history of dyslipid- emia, nutritional status and food consumption of children. We performed Poisson regression analy- sis with robust variance. The level of significance adopted was p<0.05. We observed increased LDL values in 46.8% (188), total cholesterol in 37.6% (151), triglycerides in 10.4% (42) and below-de- sirable HDL in 33.8% (136) of the children. There was a statistically significant association between the family history of dyslipidemia with total cho- lesterol, LDL and triglycerides (p<0.05 and p < 0.001, respectively); Early weaning with LDL (p < 0.05); Sedentarism with LDL and triglycerides (p < 0.05 and p < 0.001, respectively); as well as HDL with candy consumption (p < 0.05). There was a significant prevalence of changes in the lipid profile of the children. Nutrition education activi- ties and programs aimed at this group are needed. Key words Dyslipidemias, Children, Child’s nu- trition
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Abstract The scope of this article is to analyze

Abstract The scope of this article is to analyze

Resumo O objetivo deste artigo é avaliar a quali- dade de vida no trabalho de fisioterapeutas docen- tes de cursos de fisioterapia no município de Goiâ- nia-GO. Trata-se de um estudo transversal com 65 docentes. Foram incluídos fisioterapeutas docentes do curso de fisioterapia no município de Goiânia. Foram excluídos aqueles que estavam afastados, com menos de seis meses de atividade e que res- ponderam os questionários de forma incompleta. Utilizou-se um questionário sociodemográfico e o Total Quality of Work Life (TQWL-42) para avaliação da qualidade de vida no trabalho. Veri- ficou-se que os docentes que atuavam em pós-gra- duação, ou exerciam cargo de chefia apresentaram médias significativamente melhores que aqueles que atuavam apenas na graduação. A satisfação com a renda e com a atividade docente também apresentou resultados significativos, influencian- do a qualidade de vida no trabalho dos partici- pantes. A atuação em cargos e locais que permitem maior autonomia, posição social e remuneração, assim como a avaliação subjetiva da satisfação com a renda e com a atuação na docência, in- fluenciaram a qualidade de vida no trabalho dos fisioterapeutas docentes.
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Abstract The scope of this article is to analyze

Abstract The scope of this article is to analyze

Os softwares Office Excel® 2013 e RecLink III, versão 3.1.6â foram utilizados na etapa de padronização das VI. O excesso ou déficit da po- pulação masculina como percentual do total da população foi calculado como sendo a diferença entre os sexos dividido pelo total da população e, em seguido, multiplicado por 100. O IW e IM foram calculados em planilha eletrônica do Of- fice Excel®. Para ambos os índices foram calcu- ladas as taxas de variação anual média (TVAM). A TVAM proporciona informação sobre as varia- ções anuais acumuladas, em termos médio, en- tre as distintas variações de cada ano do período estudado. Matematicamente, a TVAM é definida como TVAM (%) = ( – 1) x 100 em que “n” representa o número de anos estudados e VI e VF representam o valor inicial e o valor final do período, respectivamente. O teste U de Mann-Whitney foi utilizado para comparar as distribuições da idade, segundo o sexo. O teste baseado na estatística qui-quadrado de Pearson foi utilizado para comparação de proporções por sexo. O nível de 5% de significância estatística foi utilizado nas análises. O estudo foi aprovado pelo comitê de ética em pesquisa do Hospital de Clí- nicas de Porto Alegre da Universidade Federal do Rio Grande do Sul.
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ABSTRACT This article aims at presenting the concept of

ABSTRACT This article aims at presenting the concept of

Mas, para unir Walter Benjamin e Louis Althusser sob o possível conceito de “interpelação fantasmagórica”, seria útil romper esse significativo impasse no.. qual o pensamento pós-estrut[r]

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Abstract This article presents a historical anal-

Abstract This article presents a historical anal-

tution, which states that health, and therefore health workers, are public goods. Major positive changes in policy culminated in the creation of the Department of Management of Work and Education in Healthcare (Secretaria de Gestão do Trabalho e da Educação na Saúde – SGTES) with- in the Ministry of Health in 2003. During this period a framework for the planning and devel- opment of the SUS workforce was developed en- compassing the following policies and measures: the National Policy for Continuing Education in Healthcare; Aprender SUS (learn SUS); Projeto Vivências e Estágios na Realidade do SUS- VER- SUS(the experiences and internships in the real- ity of the SUS project); Pró-Saúde (pro health); PET Saúde; Telessaúde; UNASUS; reactivation of the National Negotiating Table; Programa de Desprecarização do Trabalho no SUS (the “dep- recarisation” of work in the SUS program); the Chamber of Labor Regulation; the National Pol- icy for the Promotion of SUS Workers’ Health; Programa de Qualificação e Estruturação da Gestão do Trabalho e da Educação no SUS– Pro- geSUS (program for enhancing and structuring the management of work and education in the SUS);and the Mercosur Permanent Health Work Forum. More recently, in 2013, the Programa Mais Médicos (more doctors program) was cre- ated, providing doctors for remote and isolated areas across the country, thus improving access to health services in these areas.
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Abstract This article discusses the issue of social

Abstract This article discusses the issue of social

This article aims to problematize the advanc- es and limits of the Brazilian social protection system against the social demands arising from the treatment of children and adolescents that go beyond the specific limits of health care. The need for this reflection was imposed in the con- text of the first author’s experience in a pediatric ward of a public reference hospital in oncology in the city of Rio de Janeiro, which accompanies children and adolescents with cancer and their families, which resulted in the study on the sub- ject in the scope of a Post-graduation in Public Health in the same city. This part of the recog- nition of the complexity of this disease charac- terized by severe clinical demands and several repercussions in family daily life and social life. The article deals with the social rights of this part of the population.
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Abstract This article discusses the influence of

Abstract This article discusses the influence of

through the application of a semi-structured questionnaire, highlighting the sociodemograph- ic variables of age, gender, education, occupation and monthly income. The sampling plan was de- lineated from the spatial distribution of the res- idences located in the Agrovila and Livramento communities. In a census survey, buildings were identified by their geographic coordinates. In the sequence, sets of addresses were randomized, considering the proportionality of the spatial concentration of the residences, 95% confidence interval and sample error of 5%. The residents selected for the interviews were those who main- tained a fixed residence at the addresses selected and agreed to provide the required information. Prospective participants were excluded if they were temporary residents and/or lived at another address. Those who, after two attempts, were not present and those who refused to cooperate were also excluded from the survey.
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Abstract This article presents the findings of a

Abstract This article presents the findings of a

Abstract This article presents the findings of a study of the coverage of health, science and tech- nology during 2012 by the Jornal Nacional, a national television news program in Brazil pro- duced by the Rede Globo de Televisão. A total of 246 news stories addressing health-related topics were analyzed, half of which addressed scientific research, technological innovation and hospital care, and were shown to represent a doctor-cen- tered discourse. The findings also show that 82% of the news stories concerning science and technol- ogy advertise products that are about to be intro- duced onto the market, illustrating the commer- cial nature of this research. The article discusses two aspects portrayed by these news stories that characterize the biological body as an artifact: the construction of a virtual and fragmented body through the diffusion of images of the inside of the body; and the importance of biotechnological issues, which leaves life processes open to molecu- lar manipulation and alteration. The study also questions the nature-culture hybridization pres- ent in biotechnological objects.
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Abstract The scope of this article is to assess low

Abstract The scope of this article is to assess low

Resumo O objetivo deste artigo é avaliar a pre- valência e os fatores associados à dor lombar nos últimos 12 meses entre adolescentes de um mu- nicípio do sul do estado do Piauí, Brasil. Estudo transversal com 1112 adolescentes de 13-19 anos do município de Caracol. Investigaram-se ca- racterísticas demográficas, socioeconômicas, nu- tricionais, comportamentais e comorbidades. O desfecho foi a ocorrência de dor lombar (DL) nos últimos 12 meses. Foi calculada a prevalência do desfecho de acordo com as variáveis independen- tes. Entre os adolescentes com DL no último ano, foi calculada a proporção de indivíduos com dor lombar crônica. Para análise dos fatores associa- dos, foi utilizada a regressão de Poisson bruta e ajustada para cálculo das razões de prevalência. A prevalência de dor lombar nos últimos 12 meses foi de 32,9%. De acordo com a análise ajustada, sexo feminino (RP = 1,75; IC95%:1,45-2,10), idade entre 18-19 anos (RP = 1,27; IC95%:1,01-1,62), maior renda (RP = 1,33; IC95%:1,06-1,67), estar trabalhando (RP 1,25 IC95%:1,02-1,53) e apre- sentar distúrbios psiquiátricos menores (RP 1,51 IC95%: 1,25-1,82) permaneceram associados à DL nos últimos 12 meses. Este estudo encontrou elevada prevalência de DL entre adolescentes de um município pequeno do semiárido nordestino. Palavras-chave Dor lombar, Dor Lombar Crôni- ca, Adolescência, Epidemiologia, Prevalência Abstract The scope of this article is to assess low
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