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1.

Health economic evaluation of Human Papillomavirus vaccines in women from Venezuela by a lifetime Markov cohort model.

Bardach, Ariel Esteban; Garay, Osvaldo Ulises; Calderón, María; Pichón-Riviére, Andrés; Augustovski, Federico; Martí, Sebastián García; Cortiñas, Paula; Gonzalez, Marino; Naranjo, Laura T; Gomez, Jorge Alberto; Caporale, Joaquín Enzo
| Idioma(s): Inglés
BACKGROUND: Cervical cancer (CC) and genital warts (GW) are a significant public health issue in Venezuela. Our objective was to assess the cost-effectiveness of the two available vaccines, bivalent and quadrivalent, against Human Papillomavirus (HPV) in Venezuelan girls in order to inform decision-makers. METHODS: A previously published Markov cohort model, informed by the best available evidence, was adapted to the Venezuelan context to evaluate the effects of vaccination on health and healthcare costs from the perspective of the healthcare payer in an 11-year-old girls cohort of 264,489. Costs and quality-adjusted life years (QALYs) were discounted at 5%. Eight scenarios were analyzed to depict the cost-effectiveness under alternative vaccine prices, exchange rates and dosing schemes. Deterministic and probabilistic sensitivity analyses were performed. RESULTS: Compared to screening only, the bivalent and quadrivalent vaccines were cost-saving in all scenarios, avoiding 2,310 and 2,143 deaths, 4,781 and 4,431 CCs up to 18,459 GW for the quadrivalent vaccine and gaining 4,486 and 4,395 discounted QALYs respectively. For both vaccines, the main determinants of variations in the incremental costs-effectiveness ratio after running deterministic and probabilistic sensitivity analyses were transition probabilities, vaccine and cancer-treatment costs and HPV 16 and 18 distribution in CC cases. When comparing vaccines, none of them was consistently more cost-effective than the other. In sensitivity analyses, for these comparisons, the main determinants were GW incidence, the level of cross-protection and, for some scenarios, vaccines costs. CONCLUSIONS: Immunization with the bivalent or quadrivalent HPV vaccines showed to be cost-saving or cost-effective in Venezuela, falling below the threshold of one Gross Domestic Product (GDP) per capita (104,404 VEF) per QALY gained. Deterministic and probabilistic sensitivity analyses confirmed the robustness of these results.
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4.

Efecto de la inteligencia emocional y flujo en el trabajo sobre estresores y bienestar psicológico: análisis de ruta en docentes/ Efeito da inteligência emocional e fluxo de trabalho sobre estressores e bem-estar psicológico: análise de rota em docentes/ Effect of emotional intelligence and immersion in work on stressors and psychological wellbeing: Path analysis in professors

Millán de Lange, Anthony Constant; García-Álvarez, Diego de J; D'Aubeterre López, María Eugenia
| Idioma(s): Español
Se realizó un estudio explicativo y transversal sobre una muestra de 199 docentes universitarios de Venezuela, con el fin de confirmar el valor de la inteligencia emocional y la disposición a fluir en el trabajo como factores de protección personal ante las diferentes fuentes de estrés laboral y como promotores del bienestar psicológico. Los resultados se analizaron, a partir de dos análisis de ruta con la estrategia de modelos rivales, e indicaron que efectivamente ambas variables poseen un efecto de protección sobre algunas fuentes de estrés laboral y de promoción del bienestar psicológico. Eso coincide con lo estipulado teóricamente por el modelo PERMA, del cual surgieron las hipótesis... An explanatory, cross-cutting study was carried out in a sample of 199 university professors in Venezuela, in order to confirm the value of emotional intelligence and immersion in work as personal protection factors against the different sources of workplace stress and as promoters of psychological wellbeing. The results, which were analyzed on the basis of two path analyses using the rival models strategy, showed that, in fact, both variables protect against some sources of workplace stress and promote psychological wellbeing. This coincides with the theoretical stipulations of the PERMA model, which gave rise to the hypotheses... Realizou-se um estudo explicativo e transversal sobre uma amostra de 199 docentes universitários da Venezuela, a fim de confirmar o valor da inteligência emocional e a disposição a fluir no trabalho como fatores de proteção pessoal ante as diferentes fontes de estresse laboral e como promotores do bem-estar psicológico. Os resultados foram analisados a partir de duas análises de rota com a estratégia de modelos rivais, e indicaram que efetivamente ambas as variáveis possuem um efeito de proteção sobre algumas fontes de estresse laboral e de promoção do bem-estar psicológico. Isso coincide com o estipulado teoricamente pelo modelo PERMA, do qual surgiram as hipóteses...
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5.

Comparative federal health care policy: evidence of collaborative federalism in Pakistan and Venezuela.

Baracskay, Daniel
| Idioma(s): Inglés
Collaborative federalism has provided an effective analytical foundation for understanding how complex public policies are implemented in federal systems through intergovernmental and intersectoral alignments. This has particularly been the case in issue areas like public health policy where diseases are detected and treated at the local level. While past studies on collaborative federalism and health care policy have focused on federal systems that are largely democratic, little research has been conducted to examine the extent of collaboration in authoritarian structures. This article applies the collaborative federalism approach to the Islamic Republic of Pakistan and the Bolivarian Republic of Venezuela. Evidence suggests that while both nations have exhibited authoritarian governing structures, there have been discernible policy areas where collaborative federalism is embraced to facilitate the implementation process. Further, while not an innate aspect of their federal structures, Pakistan and Venezuela can potentially expand their use of the collaborative approach to successfully implement health care policy and the epidemiological surveillance and intervention functions. Yet, as argued, this would necessitate further development of their structures on a sustained basis to create an environment conducive for collaborative federalism to flourish, and possibly expand to other policy areas as well.
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6.

Reflexões sobre a saúde bucal no Brasil/ Reflexions on oral health in Brazil

Pimentel Gomes Fernandes Vieira Meyer, Anya; Vieira de Lima Saintrain, Maria
| Idioma(s): Portugués
No último século, numerosos avanços em pesquisas e tecnologias biomédicas na área odontológica foram responsáveis por melhorias na saúde e no bem-estar das populações(1). Entretanto, apesar das grandes realizações no âmbito da saúde bucal, muitos problemas ainda permanecem, como a cárie dental, a mais comum das doenças bucais. A prevalência da cárie dentária apresentou uma tendência de declínio nas três últimas décadas do século XX e no início do século XXI, especialmente nos países desenvolvidos, contudo, ainda é considerada uma importante questão de saúde pública mundial, afetando de 60% a 90% das crianças em idade escolar, além da vasta maioria dos adultos(2-4)No levantamento epidemiológico SB Brasil 2010(5), foram observadas melhoras na condição bucal dos brasileiros, porém, ainda é alta a prevalência de cárie. Entre os adolescentes de 15 a 19 anos, por exemplo, a média de dentes afetados foi de 4,25 mais que o dobro do número médio encontrado aos 12 anos. Entre os idosos de 65a 74 anos, o número de dentes cariados, perdidos e obturados (CPO) praticamente não se alterou, ficando em 27,5 em 2010, enquanto, em 2003, a média era de 27,8.Em termos internacionais, de acordo com o Ministério da Saúde brasileiro(5),um estudo realizado pela Organização Mundial da Saúde (OMS) em 2004 indicou que, nos dados de 188 países, o valor médio do CPO aos 12 anos foi de 1,6, sendonas Américas a média de 2,8, enquanto na Europa ficou em 1,6. Na América do Sul,somente a Venezuela apresentou média de CPO aos 12 anos semelhante à brasileira(2,1)...
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7.

Egalitarian policies and social determinants of health in Bolivarian Venezuela.

Muntaner, Caries; Benach, Joan; Páez Victor, María; Ng, Edwin; Chung, Haejoo
| Idioma(s): Inglés
In 1999, newly-elected Venezuelan President Hugo Chávez initiated a far-reaching social movement as part of a political project known as the Bolivarian Revolution. Inspired by the democratic ideologies of Simón Bolívar, this movement was committed to reducing intractable inequalities that defined Venezuela's Fourth Republic (1958-1998). Given the ambitious scope of these reforms, Venezuela serves as an instructive example to understand the political context of social inequalities and population health. In this article, we provide a brief overview of the impact of egalitarian policies in Venezuela, stressing: (a) the socialist reforms and social class changes initiated by the Bolivarian Movement; (b) the impact of these reforms and changes on poverty and social determinants of health; (c) the sustainability of economic growth to continue pro-poor policies; and (d) the implications of egalitarian policies for other Latin American countries. The significance and implications of Chávez's achievements are now further underscored given his recent passing, leading one to ask whether political support for Bolivarianism will continue without its revolutionary leader.
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8.

América Latina frente a los determinantes sociales de la salud: Políticas públicas implementadas/ Latin-American public policy regarding social determinants of health

García-Ramírez, Jorge A; Vélez-Álvarez, Consuelo
| Idioma(s): Español
RESUMEN El objetivo del presente trabajo fue identificar las políticas públicas que se han desarrollado en los países latinoamericanos frente a la intervención de los Determinantes Sociales de la Salud. Para esto se realizó una revisión temática de artículos científicos a partir de bases de datos y de documentos oficiales de organismos multilaterales y de los Ministerios de Salud de los 22 países latinoamericanos. Se hace un recuento del concepto e historia de los determinantes sociales de la salud de la Organización Mundial de la Salud y del trabajo desarrollado en el ámbito mundial en regiones como Europa, así como en Latinoamérica. Posteriormente se describen como ejemplos los casos de ocho países (Argentina, Brasil, Bolivia, Chile, Colombia, Costa Rica, México y Venezuela) y las políticas públicas desarrolladas en el área de estudio. Se concluye que en Latinoamérica hay un panorama desigual de aplicación de políticas de abordaje hacia los determinantes sociales de la salud así como una intervención segmentada principalmente hacia los determinantes intermedios de la salud, sin tener en cuenta la intervención integral desde diferentes puntos de entrada, según el marco conceptual. ABSTRACT The study was aimed at identifying Latin-American countries’ public policy which has been related to the social determinants of health. A topic review was thus made of papers kept in the 22 Latin-American countries’ databases and official documents issued by their multilateral organisations and ministries of health. The World Health Organization’s concept of the social determinants of health has been summarised and a history given of the pertinent work developed worldwide in regions such as Europe and Latin-America. Public policy regarding the field of study in Argentina, Brazil, Bolivia, Chile, Colombia, Costa Rica, México and Venezuela has been described. It was concluded that Latin-America provides a panorama of inequality regarding the application of policy concerning the social determinants of health and that there was segmented intervention, mainly regarding intermediate determinants of health, without taking an integrated approach from different entrance points into account, according to the stated conceptual framework.
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9.

Inequidades en salud entre países de Latinoamérica y el Caribe (2005-2010)./ [Inequities in health among Latin American and Caribbean countries (2005-2010)].

Cardona, Doris; Acosta, Laura Débora; Bertone, Carola Leticia
| Idioma(s): Español
OBJECTIVE: To identify health inequalities among Latin American and Caribbean countries in recent years (2005-2010), based on the view that measurement of inequalities is the first step in identifying health inequities. METHOD: We performed an ecological study, whose units of analysis were 20 Latin American and Caribbean countries. These units were used to build the Inequalities in Health Index. This index summarizes, in a value ranging from 0 to 1, a set of socio-economic and health indicators, developed by international organizations. These indicators are considered as proximal and contextual determinants of health. RESULTS: According to the index calculated, the five countries with the worst health status were Haiti, Guatemala, Bolivia, Venezuela and Honduras. In contrast, the five countries with the most favorable health status were Cuba, Argentina, Uruguay, Chile and Mexico. CONCLUSION: Even today, there are wide health inequalities in Latin America and the Caribbean. The country with the most favorable health indicators was Cuba and that with the least favorable was Haiti. We recommend systematic evaluation of health inequalities in Latin America and the Caribbean through the Inequalities in Health Index and other indices, in order to analyze actions, policies and programs to reduce inequities in this region.
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10.

Knowledge and attitudes as predictors of cervical cancer screening among women in a Venezuelan urban area.

Núñez-Troconis, José; Tulliani, Elisabetta; Gabriela Martínez, María; Fernández, Ninorka
| Idioma(s): Inglés
The purpose of this research was to investigate how the knowledge and attitudes have influence in Cervical Cancer (CC) screening among Venezuelan women, by realizing a cross-sectional descriptive study based on a structured non disguised questionnaire with closed ended questions: yes/no questions and multiple choices. The survey was performed on 691 volunteers, of which 595 were analyzed. Each patient was asked to fill in the questionnaire. Four hundred ninety three of 522 (94.4%) answered that they knew that Pap smear is for screening CC. Knowledge of Pap smear was statistically significant when it was compared to high educational level (p < 0.0001) although 185 (76%) of 244 low educational level interviewees answered that they had the knowledge that the Pap smear is used for screening of CC. Four hundred four of 504 (84.7%; p < 0.001) mentioned that they had a Pap smear at least once. One hundred ninety two (38.1%) of 504 women were adherent to an annual Pap smear test and more than half of the women (n = 337, 67%) had the last Pap smear in the last 1-3 years. Women with a high educational level showed higher adherence to the annual Pap smear screening (68.2%). Two hundred fifty seven (87.4%) of 294 said that they remembered when they got the information about Pap smear. The conclusions of this investigation were that our women were aware about Pap smear, had a good attitude to have a Pap smear and to be adherent to a regularly performed screening.
Resultados  1-10 de 461