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At least 1,279 records · Page 71Linked to original sources
PubMed2003

[Poverty, inequality, and equity in health: considerations based on a transversal gender perspective].

This article discusses the modernization of gender inequalities which has occurred in Brazil in the last 20 years under the hegemony of neo-liberal macro-economic policies. A concept of gender as transversal is applied to questions of reproductive health (contraception and abortion, prenatal care and birthing, adolescent pregnancy, maternal and reproductive mortality, STIs/AIDS, and violence, among others), permitting analysis by both gender and social class. The history of the PAISM (Program for Integral Health Care for Women), on the other hand, reveals the complex articulation of this national public health program which, although strongly influenced by the Brazilian women's movement, has been infiltrated by heterogeneous interests in the international context. PAISM serves as an example of the appropriation of proposals and principles that were generated by this social movement, but re-articulated to gloss over the process of deepening gender and class inequality.

Adolescent↗
PubMed1996

[Gynecology and obstetrics and the health system reform in Mexico].

Mexican Health System Reformation in Gynecology and Obstetrics is analyzed. The last 35 years, the specialty of Gynecology and Obstetrics has had dramatic advances which have forced the obstetrician/gynecologist to demand continuing medical education on doctrinaire aspects, skills development, epidemiology and sociology, as well as technological advances. In Mexico, social-medical field decrees a reproductive health program which points: priority to women's health, promotion in preventive actions, to consider economic facts and to integrate national programs. Finally, there is a reflection on the importance of having certified obstetrician/gynecologist.

Gynecology↗
PubMed1992

Malaria eradication and the selective approach to health care: some lessons from Ethiopia.

Analysis of the failure of the World Health Organization's global malaria campaign has contributed to the formulation of the primary health care concept as the basic international strategy for health improvement. The Primary Health Care Conference held in Alma-Ata in 1978 was to have ended the period of vertical disease control programs, such as the one against malaria, stressing instead the integration of these programs into horizontal community-based health systems. Malaria control programs, however, have not been integrated well--or in some cases at all--into primary health care networks. An analysis of the Ethiopian experience, as part of the worldwide malaria eradication program, illustrates the political and economic forces that have worked against the move from vertical to integrated malaria control activities, and from vertical to integrated health programs more generally.

Delivery of Health Care↗
PubMed2006

[Filariasis control: entry point for other helminthiasis control programs?].

Filariasis control programs are based on a decentralized drug distribution strategy known as "community-directed". This strategy could also be applied to the control of schistosomiasis and intestinal nematode infections. Integration of these control programs could be highly cost-effective. However, as a prerequisite for integration, it would be necessary to identify zones where these helminthic infections co-exist, specify the population categories that should receive each medication (ivermectin, albendazole, mebendazole, and praziquantel), check that combined administration of these drugs is safe and ensure that an integrated program would have no detrimental effect on the health care system and on the efficacy of ongoing programs.

Anthelmintics↗
PubMed1998

Intensive intervention for maltreated infants and toddlers in foster care.

We have described a program that integrates clinical approaches of infant mental health to infants and toddlers in foster care. The juxtaposition of a mental health program in a forensic setting creates a number of special features that we have highlighted. Unique from the clinical perspective, the team is explicitly relationship-focused, attempting to understand all of the young child's caregiving relationships as they affect development. We strive to enhance the quality of all of relationships in which infants participate, fostering healthy attachments and development. Also unique is the emphasis on system liaison, and making programmatic efforts to affect various systems involved in making custody determinations about infants and toddlers. Unique from the forensic perspective, we offer multidisciplinary expertise about an especially high-risk population, a comprehensive service delivery system in which we provide or coordinate and monitor all intervention efforts for a given family, a prevention orientation, and clinical follow-up with infants for as long as they are in care. The goals of the program include expediting permanency planning decisions, increasing continuity in high-quality foster care placements, increasing court satisfaction with mental health consultation, decreasing the number of court-ordered evaluations for adjudicated families, and increasing CPS satisfaction with available treatment and continuity of care. We believe that this approach integrates delivery of services to the youngest and most vulnerable victims of maltreatment and expedites permanency planning.

Caregivers↗
PubMed1988

Schools as agents for achieving the 1990 Health Objectives for the Nation.

This article clarifies the capacity of the nation's public schools to act as powerful and effective agents to facilitate attainment of the 1990 Health Objectives for the Nation. Of the health promotion and disease prevention objectives established by the Department of Health and Human Services in 1980, Iverson and Kolbe have identified 67 that can be achieved directly or indirectly through comprehensive school health programming. This process, however, can best be expedited by expanding the traditional definition of comprehensive school health from one that includes health instruction, health services, and a healthful school environment coordinated by a school/community health council to one that integrates additional programs and resources already in existence in most school and community environments: the physical education program, the school food service program, the school counseling program, and a school site health promotion initiative for faculty and staff. All eight of these areas can be utilized as highly valuable resources to facilitate the attainment of the health objectives for the nation. This schematic, first advanced by Kolbe, includes those diverse programs which have as their objectives the promotion of some aspect of health, either for students or staff, within the school setting. Specific suggestions for programming to attain those 1990 health objectives via an integrated school-based approach are discussed.

Environment↗
PubMedDate not supplied

Global priorities in the control of onchocerciasis.

Onchocerciasis is a major blinding disease. Appropriately, the World Health Organization, in cooperation with other United Nations agencies, supports two large-scale onchocerciasis programs. First, the Special Programme for Research and Training in Tropical Diseases has provided major support for much of the recent research on onchocerciasis. Second, the Onchocerciasis Control Programme is an ambitious, service-oriented effort to eliminate onchocerciasis as a public health problem in the Volta River basin area of West Africa. Initially, the latter program focused on vector control measures; recently, however, it has launched a major chemotherapy development initiative. Taken together, these two programs provide comprehensive support for the development of chemotherapy and vector control measures. However, in the absence of another integrated research program, there is a need to strengthen the available support for research into the immunologic aspects of onchocerciasis.

Filariasis↗
PubMed2001

Detecting and reducing hospital adverse events: outcomes of the Wimmera clinical risk management program.

OBJECTIVES: To determine if an integrated clinical risk management program that detects adverse patient events in a hospital, analyses their risk and takes action can alter the rate of adverse events. DESIGN: Longitudinal survey of adverse patient events over eight years of progressive implementation of the risk management program. PARTICIPANTS AND SETTING: 49,834 inpatients (July 1991 to September 1999) and 20,050 emergency department patients (October 1997 to September 1999) at a rural base hospital in the Wimmera region of Victoria. MAIN OUTCOME MEASURES: Rates of adverse events detected by medical record review and clinical incident and general practitioner reporting. RESULTS: The annual rate of inpatient adverse events decreased between the first and eighth years of the study from 1.35% of all patient discharges (69 events) to 0.74% (49 events) (P<0.001). Absolute risk reduction was 0.61% (95% CI, 0.23%-0.99%), and relative risk reduction was 44.9% (95% CI, 16.9%-72.9%). The quarterly rate of emergency department adverse events decreased between the first and eighth quarters of monitoring from 3.26% of all attendances (84 events) to 0.48% (12 events) (P< 0.001). Absolute risk reduction was 2.78% (95% CI, 2.04%-3.52%), and relative risk reduction was 85.3% (95% CI, 62.7%-100%). CONCLUSIONS: Adverse patient events can be detected, and their frequency reduced, using multiple detection methods and clinical improvement strategies as part of an integrated clinical risk management program.

Clinical Competence↗
PubMed1986

Sequential hemibody irradiation integrated into a chemotherapy-local radiotherapy program for limited disease small cell lung cancer.

Twenty-four patients with limited disease small cell lung cancer (SCLC) were treated with sequential hemibody irradiation (SHB) integrated into a conventional chemotherapy-local radiotherapy (LRT) program. Among 23 evaluable patients, 12 (52%) attained a complete response (CR) and 8 (35%) attained a partial response for an overall major response rate of 87%. The median time since study entry is 29 months. Durations of response are 9.9 months for all patients and 16.5 months for patients who achieved a CR. The primary site was the predominant area of recurrence. The median survival is 13.2 months for all patients and 23.2 months for the 12 patients who attained a CR. Myelosuppression, especially thrombocytopenia, was the major toxicity. Acute radiation toxicities and subacute pneumonitis previously associated with hemibody radiotherapy were well controlled or prevented using the current dose, premedication, and shielding techniques. This integrated program of systemic therapies with SHB and combination chemotherapy plus LRT is feasible for limited disease SCLC; it may prolong survival in patients who attain a CR but compared to similar programs without hemibody irradiation, there was no improvement in overall response rate, response duration, or survival.

Adult↗
PubMed2006

Bridge-it: a system for predicting implementation fidelity for school-based tobacco prevention programs.

Properly implemented school programs to prevent tobacco use and addiction can lower smoking prevalence up to 60%. However, numerous programs are not successful due to poor implementation. A system for estimating likelihood of future implementation fidelity of school-based prevention programs was tested using data collected at baseline and two year follow-up in 47 middle schools and high schools participating in the Texas Tobacco Prevention Initiative. The Bridge-It system includes an eight-factor, 36-item survey to analyze capacity for program implementation and a companion Bayesian model which provides estimations of likelihood of implementation fidelity several years after program initiation. The survey also asks about amount of implementing activity for each of the multiple components recommended in federal guidelines for school programs to prevent tobacco use. Criterion referenced cross-tabulations showed the system's forecast of implementation fidelity was correct in 74% of cases (p < .01). Model reliability was confirmed in regression analyses. Implementation fidelity at follow-up was predicted by the combination of the model's eight capacity factors at baseline. It includes program, implementation support, and non-program factors. Integration of the Bridge-It system, or comparable tools, into the dissemination and evaluation of school-based prevention programs can help to increase understanding of factors that influence implementation and provide guidance for capacity building. If administrators can identify at baseline schools likely to fall short of implementation goals, plans for resource allocation and provision of guidance, training, and technical assistance can be specifically tailored to identified needs.

Humans↗
PubMedDate not supplied

Quality management in home care: models for today's practice.

In less than a decade, home care providers have been a part of two major transitions in health care delivery. First, because of the advent of managed care and a shift from inpatient to community-based services, home care service delivery systems have experienced tremendous growth. Second, the principles and practices of total quality management and continuous quality improvement have permeated the organization, administration, and practice of home health care. Based on the work of Deming, Juran, and Crosby, the basic tenets of the new quality management philosophy involve a focus on the following five key areas: (1) systems and processes rather than individual performance; (2) involvement, collaboration, and empowerment; (3) internal and external "customers"; (4) data and measurement; and (5) standards, guidelines, and outcomes of care. Home care providers are among those in the forefront who are developing and implementing programs that integrate these foci into the delivery of quality home care services. This article provides a summary of current home care programs that address these five key areas of quality management philosophy and provide models for innovative quality management practice in home care. For further information about each program, readers are referred to the original reports in the home care and quality management journal literature, as cited herein.

Community Health Nursing↗
PubMedDate not supplied

Family welfare.

Explore the source record for details and available documents.

Asia↗
PubMedDate not supplied

Noncompliance among oral contraceptive acceptors in rural Bangladesh.

The levels of noncompliance among 175 oral contraceptive acceptors in a rural area of Bangladesh were monitored for three to four months. Unexpectedly high levels of noncompliance were observed, including both overconsumption and underconsumption of oral contraceptive pills. Although the study was designed to investigate only the levels of noncompliance and not the causes and consequences of noncompliance, some useful indications of the factors associated with noncompliance were obtained. The results indicate that noncompliance is a significant factor in family planning programs and, as such, warrants further in-depth investigation.

Bangladesh↗