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Pesquisa : I01.240.600.525.500 [Categoria DeCS]
Referências encontradas : 63 [refinar]
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Id: biblio-875961
Autor: Belize. Ministry of Health. Pan American Health Organization.
Título: Human resources in health: an analysis of costs of training, certification requirements & migration issues in Belize.
Fonte: s.l; MOH; dez. 2013. 45 p. tab, graf.
Idioma: en.
Resumo: INTRODUCTION: The terms of reference required, inter alia, an analysis of the dynamics of the formation of health professionals in Belize, including available information on the immigration and emigration of these personnel into Belize and the resultant impact on HRH production, deployment, absorption, retention, performance and motivation. METHODS: To undertake the study, it was initially required to focus on the existing clinical science training institutions locally to obtain completion rates for health care professionals, the costs of training, the systems for certification of these professionals and issues regarding migration as a prime determinant of the existing stock of these health care professionals. Acknowledging that there are multiple categories of health care workers, the study focused mainly on nurses and doctors. The former are trained locally at the University of Belize in Belmopan, where after a four year course of study conservatively costing some $20,000 and sitting a regional examination, a student qualifies to practice as a nurse in Belize. Being a national university in receipt of a government subsidy that forms the single largest component of its budget, UB's student fees are deliberately maintained at below market costs. These costs exclude ancillary costs related to academia, such as boarding and lodging, which are substantially more market determined, and when included, costs are easily doubledthe various school fees. Doctors are not trained at UB, though Government does provide scholarships for locals to study medicine at the University of the West Indies, a regional institution also supported by GOB due to its membership in CARICOM. Globally, the market for health professionals is fluid, unregulated and largely undocumented, and Belize is impacted by its fluidity. Belizeans have a long history of emigrating mainly to the USA and while it is believed that health professionals have been among the migrants, there is a paucity of data in this regard. For these professionals immigrating into Belize though, a CSME Skills Certificate must be sought if the person is from any CSME country and if not, then a work permit must be sought. CONCLUSIONS: Most recent data from the Labour Department indicate that various categories of health professionals from as many as twelve countries spanning four continents are an integral component of Belize's existing health workforce. The reasons for the migration of health professionals continue to be many and varied, and there is an active and targeted recruitment programme in the USA. While the migration of these professionals must be regarded as a loss of much needed and scarce human resources in health, there are some positives. Capacity strengthening canoccur as the local health system can be enhanced by partnerships that contribute in specific areas, for example the DangrigaCancer Centre is owned and operated by a Belizean doctor who practices in the USA and occasionally brings fellow specialists to provide treatment services at minimal costs. Acknowledging though that health workers have an inherent right to migrate, the Government of Belize is advised to adopt the WHO's 2010 Code of Practice on the International Recruitment of Health Personnel. The Code of Practice seeks to regulate the migration of health personnel in a way that mitigates the damage to developing countries such as Belize. Other main recommendations focus on increasing the production of HRH. This can be accomplished via the provision of bursaries to students in these areas. Retention strategies are also required to provide pathways for these health professionals. Also being recommended is technical assistance to the Ministry of Health, the Belize Medical and Dental Council and the Nurses and Midwives Council to strengthen the regulatory framework so that they are all able to better keep abreast in tracking their members. At the present time, should a nurse or a doctor leave public employment, the Ministry of Health is not mandated to inform the respective council. Under a strengthened regulatory framework, this would be mandatory. Also mandatory would be the health professional informing in writing the respective council of any changes to his/her employment status or location of employment. This would greatly assist in tracking private doctors and nurses as they relocate to other areas of the country as well as if they migrate abroad. Finally, given Belize's focus on a primary health care model as the basis of its health care system, some consideration ought to be given to further strengthening of the Community Health Workers. These health volunteers are at the base of the local health system and are the most widely dispersed health worker. Consideration is justified because these unheralded workers are most unlikely to migrate since destination countries are selective in their recruitment efforts and exclusively require credentialed professionals as migrants. (AU)
Responsável: BR1.1 - BIREME


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Fotocópia
Id: 17932
Autor: Hunte, HER(aut); Singh, SS(aut); Thomas, YF(aut).
Título: Substance use, age at migration, and length of residence among adult Caribbeans in the United States
Fonte: In: Caribbean Public Health Agency. Caribbean Public Health Agency: 60th Annual Scientific Meeting. Kingston, The University of the West Indies. Faculty of Medical Sciences, 2015. p.[1-75]. (West Indian Medical Journal Supplement).
Idioma: en.
Resumo: OBJECTIVE: To examine the prevalence of substance use disorders and determine whether age at migration and time predict these behaviors using the National Survey of American Lives (n=1,370). DESIGN AND METHODS: Multivariable logistic regression analyses controlling for potential confounders were used. RESULTS: Individuals that immigrated to the US were less likely to be diagnosed with a substance use disorder compared to those that immigrated when they were less than 13 years old. On the other hand, migrants that spent 10-20 years in the US were less likely to be diagnosed with a substance use disorder compared to those that spend 1-10 years in the US; however, those migrants that spent more than 20 years in the US were 3-9 times more likely to be diagnosed with a substance use disorder. CONCLUSION: As suggested, age at migration and length of residence are important factors because they shape immigrantsÆ abilities to socialize and respond to the potentially conflicting demands of the host culture, and in this case, more likely to engage in problematic substance use patterns. Public health professionals must consider the heterogeneity among Blacks in the US as they attempt to reduce and/or eliminate racial/ethnic disparities in substance use.
Responsável: TT2.1 - Library


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Id: 17644
Autor: Shedlin, Michele G. (aut); Drucker, Ernest(aut); Decena, Carlos U. (aut); Hoffman, Susie(aut); Bhattacharya, Gauri(aut); Beckford, Sharlene(aut); Barreras, Ricardo(aut).
Título: Immigration and HIV/AIDS in the New York Metropolitan Area
Fonte: Journal of urban health;83(1):43-58, Jan. 2006.
Idioma: en.
Resumo: Because the HIV pandemic undergoes continual change in its locations and affected populations, it is crucial to study HIV risk behaviors among mobile and immigrant groups within and across borders. The impact of cross-cultural migrations and the importance of studying that impact in terms of demographic characteristics as well as cultural and environmental factors has not received adequate attention in public health research. This collaborative analysis utilizes data from three studies of immigrant groups in New York to describe and compare these factors that provide the context for risk and prevention of HIVAIDS and other health challenges. Data discussed were obtained utilizing multi-method approaches to identify and describe HIV risks among both new and more established immigrant populations within the urban settings of North America, with NYC as a central focus. Demographic and epidemiological data situate the analysis within the larger contexts of US migration and the HIV/AIDS epidemic in NYC. The authors identify risk and protective factors embedded to varying degrees in immigrants' multiple cultures and sub-cultures. The three populations studied include: 1) new Hispanic immigrants from the Dominican Republic, Mexico and Central America; 2) West Indian (Caribbean) immigrants from Jamaica, Trinidad/Tobago and other anglophone Caribbean nations; and 3) South Asian immigrants from India (Indian Americans). The paper seeks differences and commonalities, focusing on the social, attitudinal and behavioral factors that contribute to increased HIV/AIDS vulnerability among these populations. The data presented also identify some of the attitudes and behaviors of individuals and groups, as well as other facilitators and obstacles to transmission for immigrants as they adapt to new environments. Topics addressed include factors affecting HIV/AIDS vulnerability of immigrant groups, goals and expectations, health and mental heath issues, gender role change, sexual risk, alcohol and other drug use, perception of HIV/AIDS risk and implications for prevention.
Responsável: TT5 - Médical Sciences Library


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Fotocópia
Id: 15956
Autor: Turner, J. E.
Título: Migrants and their therapists: a trans-context approach
Fonte: Fam Process;30(4):407-19, Dec. 1991.
Idioma: En.
Resumo: In this article, I examine how changes in technology, social organization, and economic opportunity are fundamentally altering the encounter between therapists and migrant clients. Approaches are required that take into account the recursive nature of the newly emerging two-home, trans-context lifestyle. I outline a second-order position and lines of questioning that may help migrants and therapists to situate problems in historical-geographical context, examine structural constraints on choice, and co-develop options for the future. To illustrate and enlarge upon hypotheses about the life experience of migrants, I analyze a particular Caribbean-Canadian immigrant story. (AU)
Responsável: JM3.1 - Médical Library


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Fotocópia
Id: 15954
Autor: Wessely, S; Castle, D. M; Der, Geoff; Murray, R.
Título: Schizophrenia and Afro-Caribbeans: a case-control study
Fonte: Br J Psychiatry;159(6):795-801, Dec. 1991.
Idioma: En.
Resumo: A case-control study was performed using 90 percent of all first-contact patients with a clinical diagnosis of schizophrenia residing in the London borough of Camberwell between 1965 and 1984. Cases and controls were obtained from the Camberwell psychiatric case register. Controls were those presenting with first episodes of non-psychotic disorders, matched for age, sex and period. The risk of schizophrenia was greater in those of Afro-Caribbean ethnicity, irrespective of age, gender or place of birth. This risk increased over the study period. The results cannot be explained by changes in the age, gender or ethnic structure of the local population. Effects of misdiagnosis or change in diagnostic practice were reduced by using uniform operational criteria. Possible explanations include maternal exposure to unfamiliar infective agents, a differential fall in the age at onset of illness, or worsening social adversity. (AU)
Responsável: JM3.1 - Médical Library
JM3.1; RC321.B74


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Fotocópia
Id: 15928
Autor: Brittain, Ann W.
Título: Anticipated child loss to migration and sustained high fertility in an east Caribbean population
Fonte: Soc Biol;38(1-2):94-112, Spring-Summer 1991.
Idioma: En.
Resumo: Development today is mainly accompanied by rapid utilization and, where possible, high rates of migration to industrialized countries. At the same time, the expected demographic transition has often not materialized despite decreases in death rates. Child-to-woman ratios in St. Vincent and the Grenadines are related to the educational attainment of women in a census district, the percentage of men engaged in agriculture, whether the district has direct access to the outside world through a port or airport, and, when the other variables are controlled, the stability of the district's population. Those districts with the greatest stability of population had the lowest child-to-woman ratios, suggesting that the anticipated loss of children to migration may be an important factor in maintaining high reproductive rates (AU)
Responsável: JM3.1 - Médical Library
JM3.1; HQ750


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Fotocópia
Id: 15911
Autor: Jacobson, M. S.
Título: Cholesterol oxides in Indian ghee: possible cause of unexplained high risk of atherosclerosis in Indian immigrant populations
Fonte: Lancet;2(8560):656-8, Sept. 19, 1987.
Idioma: En.
Resumo: Two populations of immigrants to London and to the West Indies from the Indian subcontinent have greater than expected morbidity and mortality from atherosclerosis but do not show the commonly accepted major risk factors. This study investigated the hypothesis that ghee, a clarified butter product prized in Indian cooking, contains cholesterol oxides and could therefore be an important source of dietary exposure to cholesterol oxides and an explanation for the high atherosclerosis risk. Substantial amounts of cholesterol oxides were found in ghee (12.3 percent of sterols), but not in fresh butter, by thin-layer and high-performance-liquid chromatography. Dietary exposure to cholesterol oxides from ghee may offer a logical explanation for the high frequency of atherosclerotic complications in these Indian population.(AU)
Responsável: JM3.1 - Médical Library
JM3.1; R31.L3


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Fotocópia
Id: 15897
Autor: Fruchter, Rachel G; Wright, Carolyn; Habenstreit, Barbara; Remy, Jean C; Boyce, John G; Imperato, P. J.
Título: Screening for cervical and breast cancer among Caribbean immigrants
Fonte: J Community Health;10(3):121-35, Fall 1985.
Idioma: En.
Resumo: The yield of abnormal Pap test was 13.3/1000 women screened; the yield of breast cancer was 2.2/1000 women examined. Approximately half of the Haitian immigrants (N= 361) had no prior Pap test, compared to one-quarter of the English-speaking Caribbean immigrants (N = 228) and one-tenth of the U.S.-born Black women (N= 264). Only 47 percent of Haitian women had a regular source of health care compared to 74 percent of the English speaking Caribbean women and 83 percent of the U.S.-born Black women. Haitian women were much less likely to practice breast self-examination or to use contraception than were U.S.-born Black women. This program reveals significant needs for preventive health services among low-income Caribbean immigrant women, and demonstates that selective neighbourhood-site programs can be effective in reaching those in need.(AU)
Responsável: JM3.1 - Médical Library
JM3.1; Reprint Collection


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Fotocópia
Id: 14879
Autor: Balarajan, R; Soni Raleigh, V; Botting, B.
Título: Sudden infant death syndrome and postneonatal mortality in immigrants in England and Wales
Fonte: BMJ;296(6675):716-20, Mar. 1989.
Idioma: En.
Resumo: To examine ethnic differences in postnatal mortality and the incidence of sudden infant death in England and Wales during 1982-5 records were analysed, the mother's country of birth being used to determine ethnic group. Postnatal mortality was highest in infants of mothers born in Pakistan (6.4/1000 live births) followed by infants of mothers born in the Caribbean (4.5) and the United Kingdom and Republic of Ireland (4.1). Crude rates were lower in infants of mothers born in India (3.9/1000), east and west Africa (3.0), and Bangladesh (2.8) than in infants of mothers born in the United Kingdom despite less favourable birth weights. Mortality ratios standardised separately for maternal age, parity, and social class were significantly higher in infants of mothers born in Pakistan and lower in those of mothers born in Bangladesh. The ratio for infants of Caribbean mothers was significantly higher when adjusted for maternal age. Ratios for infants of Indian and east African mothers did not show significant differences after standardisation. An important finding was a low incidence of sudden infant death in infants of Asian origin. This was paralleled by lower mortality from respiratory causes. During 1975-85 postnatal mortality in all immigrant groups except Pakistanis fell to a similar or lower rate than that in the United Kingdom group; Pakistanis showed a persistent excess. During 1984-5 several immigrant groups (from the Republic of Ireland, India, west Africa, and the Caribbean) reported an increase in postnatal mortality. Surveillance of postnatal mortality among ethnic communities should be continued, and research is needed to identify the causes underlying the differences (AU)
Responsável: JM3.1 - Médical Library
JM3.1; R31.B75


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Fotocópia
Id: 14357
Autor: Gans, Bruno.
Título: The nutritional status of West Indian immigrants
Fonte: Proc Nutr Soc;26(2):218-22, 1967.
Idioma: En.
Responsável: JM3.1 - Médical Library
JM9.1; QP141.A1N8



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