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[PMID]:29064359
[Au] Autor:Fitter DL; Delson DB; Guillaume FD; Schaad AW; Moffett DB; Poncelet JL; Lowrance D; Gelting R
[Ad] Endereço:Centers for Disease Control and Prevention, Port-au-Prince, Haiti.
[Ti] Título:Applying a New Framework for Public Health Systems Recovery following Emergencies and Disasters: The Example of Haiti following a Major Earthquake and Cholera Outbreak.
[So] Source:Am J Trop Med Hyg;97(4_Suppl):4-11, 2017 Oct.
[Is] ISSN:1476-1645
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Emergencies can often directly impact health systems of an affected region or country, especially in resource-constrained areas. Health system recovery following an emergency is a complex and dynamic process. Health system recovery efforts have often been structured around the World Health Organization's health systems building blocks as demonstrated by the Post-Disaster Needs Assessment. Although this structure is valuable and well known, it can overlook the intricacies of public health systems. We retrospectively examine public health systems recovery, a subset of the larger health system, following the 2010 Haiti earthquake and cholera outbreak, through the lens of the 10 essential public health services. This framework illustrates the comprehensive nature of and helps categorize the activities necessary for a well-functioning public health system and can complement other assessments. Outlining the features of a public health system for recovery in structured manner can also help lay the foundation for sustainable long-term development leading to a more robust and resilient health system.
[Mh] Termos MeSH primário: Cólera
Assistência à Saúde/organização & administração
Desastres
Surtos de Doenças
Terremotos
Emergências
Saúde Pública
[Mh] Termos MeSH secundário: Cólera/epidemiologia
Planejamento em Desastres
Haiti/epidemiologia
Seres Humanos
Pesquisa em Sistemas de Saúde Pública
Estudos Retrospectivos
Organização Mundial da Saúde
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171025
[St] Status:MEDLINE
[do] DOI:10.4269/ajtmh.16-0862


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[PMID]:28234969
[Au] Autor:Kimaro GD; Mfinanga S; Simms V; Kivuyo S; Bottomley C; Hawkins N; Harrison TS; Jaffar S; Guinness L; REMSTART trial team
[Ad] Endereço:Muhimbili Medical Research Centre, National Institute for Medical Research, Dar es Salaam, Tanzania.
[Ti] Título:The costs of providing antiretroviral therapy services to HIV-infected individuals presenting with advanced HIV disease at public health centres in Dar es Salaam, Tanzania: Findings from a randomised trial evaluating different health care strategies.
[So] Source:PLoS One;12(2):e0171917, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Understanding the costs associated with health care delivery strategies is essential for planning. There are few data on health service resources used by patients and their associated costs within antiretroviral (ART) programmes in Africa. MATERIAL AND METHODS: The study was nested within a large trial, which evaluated screening for cryptococcal meningitis and tuberculosis and a short initial period of home-based adherence support for patients initiating ART with advanced HIV disease in Tanzania and Zambia. The economic evaluation was done in Tanzania alone. We estimated costs of providing routine ART services from the health service provider's perspective using a micro-costing approach. Incremental costs for the different novel components of service delivery were also estimated. All costs were converted into US dollars (US$) and based on 2012 prices. RESULTS: Of 870 individuals enrolled in Tanzania, 434 were enrolled in the intervention arm and 436 in the standard care/control arm. Overall, the median (IQR) age and CD4 cell count at enrolment were 38 [31, 44] years and 52 [20, 89] cells/mm3, respectively. The mean per patient costs over the first three months and over a one year period of follow up following ART initiation in the standard care arm were US$ 107 (95%CI 101-112) and US$ 265 (95%CI 254-275) respectively. ART drugs, clinic visits and hospital admission constituted 50%, 19%, and 19% of the total cost per patient year, while diagnostic tests and non-ART drugs (co-trimoxazole) accounted for 10% and 2% of total per patient year costs. The incremental costs of the intervention to the health service over the first three months was US$ 59 (p<0.001; 95%CI 52-67) and over a one year period was US$ 67(p<0.001; 95%CI 50-83). This is equivalent to an increase of 55% (95%CI 51%-59%) in the mean cost of care over the first three months, and 25% (95%CI 20%-30%) increase over one year of follow up.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/economia
Terapia Antirretroviral de Alta Atividade/economia
Assistência à Saúde/economia
Infecções por HIV/economia
Custos de Cuidados de Saúde/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Fármacos Anti-HIV/uso terapêutico
Contagem de Linfócito CD4
Assistência à Saúde/estatística & dados numéricos
Progressão da Doença
Feminino
Infecções por HIV/diagnóstico
Infecções por HIV/tratamento farmacológico
Infecções por HIV/virologia
Recursos em Saúde
Seres Humanos
Masculino
Meningite Criptocócica/diagnóstico
Meningite Criptocócica/tratamento farmacológico
Meningite Criptocócica/economia
Meningite Criptocócica/microbiologia
Pesquisa em Sistemas de Saúde Pública
Tanzânia
Combinação Trimetoprima e Sulfametoxazol/economia
Combinação Trimetoprima e Sulfametoxazol/uso terapêutico
Tuberculose Pulmonar/diagnóstico
Tuberculose Pulmonar/tratamento farmacológico
Tuberculose Pulmonar/economia
Tuberculose Pulmonar/microbiologia
Zâmbia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-HIV Agents); 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170225
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0171917


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[PMID]:27924765
[Au] Autor:Sheikh K; Kumar S; Ved R; Kumar S; Raman VR; Ghaffar A; Tran N; Reddy S; Swaminathan S
[Ad] Endereço:Public Health Foundation of India, Institutional Area Gurgaon 122002, India. Electronic address: kabir.sheikh@phfi.org.
[Ti] Título:India's new health systems knowledge platform-making research matter.
[So] Source:Lancet;388(10061):2724-2725, 2016 12 03.
[Is] ISSN:1474-547X
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Gestão do Conhecimento
Pesquisa em Sistemas de Saúde Pública
Pesquisa
[Mh] Termos MeSH secundário: Tomada de Decisões
Programas Governamentais
Seres Humanos
Índia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170627
[Lr] Data última revisão:
170627
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161208
[St] Status:MEDLINE


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[PMID]:27514515
[Au] Autor:Shiferaw F; Letebo M; Bane A
[Ad] Endereço:World Health Organization-Ethiopia, Non_communicable Diseases, Addis Ababa, Ethiopia. et_fassil@hotmail.com.
[Ti] Título:Chronic viral hepatitis: policy, regulation, and strategies for its control and elimination in Ethiopia.
[So] Source:BMC Public Health;16(1):769, 2016 Aug 11.
[Is] ISSN:1471-2458
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hepatitis B and C are silent killers not yet recognized as major public health challenges in many developing countries with huge disease burden. In Ethiopia, Hepatitis B is endemic with an average prevalence of 10.8 %, and the prevalence of Hepatitis C is 2 %. The prevalence of both infections, however, is likely to be underreported due to the lack of diagnostic facilities and appropriate surveillance systems. Ethiopia is also among the many Sub-Sahara African countries lacking a coordinated and systematic national response to chronic viral hepatitis. The objective of this study is to examine the current level of response to viral Hepatitis B & C in Ethiopia with the aim to bring identified gaps to the attention of relevant stakeholders and policy makers. METHODS: This cross-sectional qualitative study was based on semi-structured in-depth interviews with 21 key informants from health facilities, health offices, pharmaceutical companies, regulatory bodies, professional association and blood bank units. Participants were selected purposively based on their role in the national hepatitis response. The investigators also reviewed available policy and strategy documents, standards of practice and surveys, and paid visits to pharmaceutical premises to check the availability of antiviral drugs. Thematic analysis was employed to make sense of the data. During the data analysis process, all the authors critically read the materials, and data was triangulated by source, interpreter view and thematic perspective to ensure accurate representation and comprehensiveness, and validation of the interviewees' responses. Once each investigator reviewed the data independently, the team reached a common understanding of the scope and contexts of the information attained. Data were subsequently reduced to key concepts, and case stories were taken with successive revisions. The key concepts were later coded into most basic meaningful categories. The World Health Organization (WHO) global hepatitis response framework was used to organize the analysis. RESULTS: Ethiopia is in the process of preparing strategic plan and guidelines for viral hepatitis. However, the country still lacks the required partnerships, and resource mobilization as a national health response is limited. Community awareness on the disease transmission and its sequel is poor. Viral hepatitis screening services are not widely available except for the occasional mandatory medical checkups for work or travel purposes. Healthcare providers often take no further action after diagnosing patients with viral hepatitis due to lack of treatment guidelines and strategic frameworks for screening, diagnosis, and treatment. Besides, drugs that are effective in the treatment of viral hepatitis are not available, mainly due to regulatory challenges. CONCLUSIONS: Viral hepatitis and its disease burden are getting little attention in Ethiopia and many low-income countries. The levels of technical guidance and financial support from the international community are low. To date, the response to the infections in Ethiopia is patchy. Thus, the country needs to formulate policy and strategies in the areas of disease surveillance, risk group identification and screening, use of the birth dose of hepatitis B vaccine, and care and treatment. Improving availability of data on viral hepatitis, access to low-cost generic drugs and developing and dissemination of treatment guidelines are also critical. Leveraging the successful Health Extension Program for a hepatitis response, and exploring ways to learn from and integrate into the HIV/AIDS program should also be considered.
[Mh] Termos MeSH primário: Recursos em Saúde/estatística & dados numéricos
Acesso aos Serviços de Saúde/estatística & dados numéricos
Hepatite B Crônica
Hepatite C Crônica
Saúde Pública/estatística & dados numéricos
[Mh] Termos MeSH secundário: Estudos Transversais
Etiópia
Instalações de Saúde/estatística & dados numéricos
Pessoal de Saúde/estatística & dados numéricos
Política de Saúde
Acesso aos Serviços de Saúde/legislação & jurisprudência
Seres Humanos
Programas de Rastreamento/estatística & dados numéricos
Prevalência
Saúde Pública/legislação & jurisprudência
Pesquisa em Sistemas de Saúde Pública
Pesquisa Qualitativa
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170726
[Lr] Data última revisão:
170726
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160813
[St] Status:MEDLINE
[do] DOI:10.1186/s12889-016-3459-1


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[PMID]:26974388
[Au] Autor:Cockrell Skinner A; Goldsby TU; Allison DB
[Ad] Endereço:1 Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, The University of North Carolina at Chapel Hill , Chapel Hill, NC.
[Ti] Título:Regression to the Mean: A Commonly Overlooked and Misunderstood Factor Leading to Unjustified Conclusions in Pediatric Obesity Research.
[So] Source:Child Obes;12(2):155-8, 2016 Apr.
[Is] ISSN:2153-2176
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: In this paper we discuss what regression to the mean (RTM) is, the magnitude of RTM in realistic situations, interpretation of RTM, and recommendations for how to address RTM in study design. METHODS: Public health research faces many challenges in conducting gold standard randomized, controlled trials (RCT). Although there are many threats to validity in uncontrolled trials, RTM is often overlooked or not adequately considered. RTM is a statistical phenomenon that occurs with any pair of variables that have a correlation not equal to |1.0|. With RTM, subjects' average values on an outcome variable (e.g., BMI) change in a systematic direction over time despite there being no treatment effect. Without a proper control group, changes thought to be associated with an intervention may be due entirely to RTM. Investigators may draw erroneous conclusions based on results showing greater declines in a variable among participants with higher baseline of that variable compared to those with lower baseline of that variable, and label this evidence for differential treatment efficacy. CONCLUSIONS: Ignoring RTM can lead to unsubstantiated conclusions about the effects of treatments. These conclusions can lead to the waste of time, money, and other resources, which distract from finding appropriate interventions. When a true RCT design is not feasible, reasonable design alternatives involving nonrandomized control groups should be implemented.
[Mh] Termos MeSH primário: Obesidade Pediátrica
Pesquisa em Sistemas de Saúde Pública
[Mh] Termos MeSH secundário: Interpretação Estatística de Dados
Pesquisa sobre Serviços de Saúde
Seres Humanos
Modelos Estatísticos
Ensaios Clínicos Controlados Aleatórios como Assunto
Análise de Regressão
Projetos de Pesquisa
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160315
[St] Status:MEDLINE
[do] DOI:10.1089/chi.2015.0222


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[PMID]:26818081
[Au] Autor:Watson TM
[Ad] Endereço:Social and Epidemiological Research Department, Centre for Addiction and Mental Health, 33 Russell Street, 3rd Floor Tower, Toronto, Ontario, Canada M5S 2S1. Electronic address: tara.watson@utoronto.ca.
[Ti] Título:Prisoners' access to psychoactive medications: The need for research and improved policy.
[So] Source:Int J Drug Policy;29:98-9, 2016 Mar.
[Is] ISSN:1873-4758
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Mh] Termos MeSH primário: Política de Saúde
Acesso aos Serviços de Saúde
Transtornos Mentais/tratamento farmacológico
Prisioneiros/psicologia
[Mh] Termos MeSH secundário: Seres Humanos
Pesquisa em Sistemas de Saúde Pública
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170502
[Lr] Data última revisão:
170502
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160129
[St] Status:MEDLINE


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[PMID]:26225267
[Au] Autor:Hsu LJ; Pacheco MY; Crabtree C; Maddock JE
[Ad] Endereço:Department of Public Health Sciences, University of Hawai'i at Manoa, Honolulu, HI (LJH, MYP, CC).
[Ti] Título:Using Concept Mapping in the Development of a School of Public Health.
[So] Source:Hawaii J Med Public Health;74(7):224-9, 2015 Jul.
[Is] ISSN:2165-8242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Schools of Public Health have a wide variety of essential stakeholders. Broad input in program planning should assist in ensuring well-developed plans and strong community buy-in. The planning of a school can better address the needs of multiple stakeholders from systematic broad-based input from these constituents using concept mapping. In this study, we used concept mapping to prioritize a set of recommendations from diverse stakeholders to assist in the process of planning a school. A set of statements was generated on essential elements for the proposed school from a broad group of stakeholders. The statements were then distilled into unique themes, which were then rated on importance and feasibility. Cluster maps and pattern matches were used to analyze the ratings. Unique themes (N = 147) were identified and grouped into 12 clusters. Cluster themes included leadership, faculty, culture, school, and curriculum. Pattern matches revealed a significant, modest correlation between importance and feasibility (r = 0.27). A broad range of perspectives was used to identify relevant areas to address in the development of a school.
[Mh] Termos MeSH primário: Desenvolvimento de Programas
Faculdades de Saúde Pública/organização & administração
[Mh] Termos MeSH secundário: Pesquisa Participativa Baseada na Comunidade
Currículo
Docentes/organização & administração
Hawaii
Seres Humanos
Liderança
Cultura Organizacional
Pesquisa em Sistemas de Saúde Pública
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150731
[St] Status:MEDLINE


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[PMID]:25199814
[Au] Autor:Vanneman ME; Snowden LR
[Ad] Endereço:Center for Innovation to Implementation, VA Palo Alto Health Care System, 795 Willow Road (152-MPD), Menlo Park, CA, 94025, USA, Megan.Vanneman@va.gov.
[Ti] Título:Linking the Legislative Process to the Consequences of Realigning California's Public Mental Health System.
[So] Source:Adm Policy Ment Health;42(5):593-605, 2015 Sep.
[Is] ISSN:1573-3289
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In 1991, California transferred significant responsibility, resources, and accountability for public mental health from the state to its 58 counties. Using purposeful sampling, we conducted in-depth interviews with ten senior state and county leaders to gain insights into the relatively uncharted area of their understanding of this legislation's intent, development, and long-term consequences. While realignment secured funding for the system and provided incentives and flexibility for counties to move toward providing more community-based care, the decision to base realignment allocations on counties' historical spending along with minimal payments to address differences helped to institutionalize spending disparities. Results of this study can inform how we develop and implement decentralization policies.
[Mh] Termos MeSH primário: Disparidades em Assistência à Saúde
Medicaid/legislação & jurisprudência
Serviços de Saúde Mental/legislação & jurisprudência
Pesquisa em Sistemas de Saúde Pública
[Mh] Termos MeSH secundário: California
Política de Saúde
Seres Humanos
Governo Local
Medicaid/organização & administração
Serviços de Saúde Mental/organização & administração
Política
Governo Estadual
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140910
[St] Status:MEDLINE
[do] DOI:10.1007/s10488-014-0591-z



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