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Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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PubMed1991

General theory of paradigms in health.

In Costa Rica, three sequential health paradigms have been identified over the last 50 years. The first began to develop during the 40's and has been called that of the deficiency diseases, since with a diachronic approach it placed excessive emphasis on malnutrition. The second began in 1970 and it is known as that of the infectious diseases, since through a holistic or synchronic approach, it underlined the importance of infections in high rates of morbidity and mortality. The third and last is the paradigm of the chronic diseases, it appeared in the 80's and is presently in process, doing battle with the chronic ailments, life styles, and environment, and it also utilizes a holistic approach. The recognition of these three paradigms has permitted Costa Rica a rapid advance in improving the health of its population, to the point that with a per capita outlay of $130 (US dollars), it has indices similar to those of the industrialized nations. This particular experience could be useful for other less-developed countries that are still applying the paradigm of the deficiency diseases.

Adult↗
PubMed1991

AIDS: a right to be informed.

Individuals have to assume some responsibility for their own health. Governments do, however, have a duty to ensure that their citizens are armed with the necessary information and education. At present there appears to be a serious degree of ignorance about sexually transmitted disease in general and AIDS in particular. The importance of disseminating information on this topic is discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Alma Ata and health for all by the year 2000. The roles of academic institutions.

The title of this article raises a complex set of questions. To begin, what happened at Alma Ata and the goal that emanated from it-Health for All by the Year 2000--are themselves controversial matters. At least there are some who are strongly critical of those events and ideas. Even without linking academic institutions with Alma Ata and HFA/2000, a controversy is spawned when one asks about the roles of such institutions in dealing with societal problems--which problems should a university address, and how deeply does a university become engaged in them, particularly if it carries the university out of the cloister into the trenches of societal conflict? Linking academic institutions with Alma Ata and HFA/2000 deepens the controversy but also provides a framework for examining the basic principles on which each is based, and for testing those principles against the realities of real world problems of health development. This article draws on recent critical assessments of both sides of the equation: a recent Consultative Committee to the Director General of WHO that analyzes the successes and failures of PHC development to date, and lays out conditions for greater effectiveness in the future; and the Technical Discussions of WHO on the Roles of Universities in the Strategy for Health for All that review traditional and progressive arguments about the roles of universities in their societies, and how HFA can be seen as fitting into that debate. The thinking contained in these documents provides ample opportunity to examine whether or not academic institutions should have a role that relates to Alma Ata and Health for All, and, in the end, takes the position that, indeed, this is an appropriate role for those universities prepared to make the commitment. The point is also made that such involvement cannot be effective if the scale of the institutional commitment is marginal--it must be substantial and institution-wide. An example is given of the Aga Khan University in Karachi, Pakistan, an institution avowedly committed to a community orientation and to health services development. The Network of Community-Oriented Educational Institutions for Health Sciences can be considered a movement of educational institutions in this direction. It is functioning with considerable creative initiative in addressing issues having to do with problem-based teaching methods, community orientation, and partnerships with governmental health services.(ABSTRACT TRUNCATED AT 400 WORDS)

Academic Medical Centers↗
PubMed1991

Adolescent sexuality and public policy.

In recent decades, various attempts have been made to determine the level of sexual activity among adolescents. This information has been used in the planning and evaluation of sex-related programs. However, there is a flaw in using only the initial estimates of the behavior--that a sexually active person is defined as one who has had sexual intercourse. This narrow definition distorts the perception of adolescent sexual behavior. Sexual activity can more accurately be designated by focusing on the actual frequency with which teenagers have sex. In this research report, adolescents were considered sexually active if they had had sex within the last four weeks. Using this definition, adolescents were found to be substantially less sexually active than has been previously reported. This finding was then used to look at various policy decisions in the areas of sex education, family planning, and sexually transmitted disease prevention.

Adolescent↗
PubMedDate not supplied

Fundamental elements of the quality of care: a simple framework.

This article argues for attention to a neglected dimension of family planning services--their quality. A framework for assessing quality from the client's perspective is offered, consisting of six parts (choice of methods, information given to clients, technical competence, interpersonal relations, follow-up and continuity mechanisms, and the appropriate constellation of services). The literature is reviewed regarding evidence that improvements in these various dimensions of care result in gains at the individual level; an even scarcer body of literature is reviewed for evidence of gains at the level of program efficiency and impact. A concluding section discusses how to make practical use of the framework and distinguishes three vantage points from which to view quality: the structure of the program, the service-giving process itself, and the outcome of care, particularly with respect to individual knowledge, behavior, and satisfaction with services.

Contraception↗
PubMed1990

Health in strip cartoons.

Strip cartoons are among the most vivid means of communication at our disposal, and they are particularly popular with the young. Medical matters have featured in many stories, though usually in a peripheral role. Could more be done to use this powerful medium, or would deliberate exploitation destroy it?

Cartoons as Topic↗
PubMedDate not supplied

Toward consistency in breastfeeding definitions.

On 28 April 1988, the Interagency Group for Action on Breastfeeding met to develop and agree upon a set of definitions that could be used as standardized terminology for the collection and description of cross-sectional information on breastfeeding behavior. The schema and potential framework suggested at the meeting were reviewed extensively by breastfeeding researchers and program personnel, revised at subsequent meetings by a variety of organizations, and compared against published research on patterns of breastfeeding and their effects on infant nutrition, health, and fertility. This schema and framework: (1) acknowledge that the term "breastfeeding" alone is insufficient to describe the numerous types of breastfeeding behavior, (2) distinguish full from partial breastfeeding, (3) subdivide full breastfeeding into categories of exclusive and almost exclusive breastfeeding, (4) differentiate among levels of partial breastfeeding, and (5) recognize that there can be token breastfeeding with little to no nutritional impact. The schema and framework should assist researchers and agencies in their efforts to accurately describe and interpret breastfeeding practices.

Breast Feeding↗