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1.
Eur J Clin Invest ; 54(6): e14184, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38407501

RESUMO

OBJECTIVE: To assess the characteristics and financial conflicts of interest of presenters, panellists and moderators at haematology and oncology workshops held jointly with or hosted by the US FDA. SETTING: We included information on all publicly available haematology or oncology FDA workshop agendas held between 1 January 2018 and 31 December 2022. EXPOSURE: General and research payments reported on Open Payments, industry funding to patient advocacy organizations reported on their webpages or 990 tax forms and employment in both pharmaceutical and regulatory settings. RESULTS: Among physicians eligible for payments, 78% received at least one payment from the industry between 2017 and 2021. The mean general payment amount was $82,170 for all years ($16,434 per year) and the median was $14,906 for all years ($2981 per year). Sixty-nine per cent of patient advocacy speakers were representing organizations that received financial support from the pharmaceutical industry. Among those representing regulatory agencies or pharmaceutical companies, 16% had worked in both settings during their careers. CONCLUSIONS AND RELEVANCE: Our findings in this cross-sectional study show a majority of US-based physician presenters at haematology and oncology workshops held jointly with members of the US FDA have some financial conflict of interest with the pharmaceutical industry. These findings support the need for clear disclosures and suggest that a more balanced selection of presenters with fewer conflicts may help to limit bias in discussions between multiple stakeholders.


Assuntos
Conflito de Interesses , Indústria Farmacêutica , Hematologia , Oncologia , United States Food and Drug Administration , Estados Unidos , Humanos , Indústria Farmacêutica/economia , Hematologia/economia , Estudos Transversais , Defesa do Paciente , Médicos/economia , Educação/economia , Revelação
3.
Ciênc. Saúde Colet. (Impr.) ; 24(12): 4473-4478, dez. 2019.
Artigo em Português | LILACS | ID: biblio-1055733

RESUMO

Resumo Ao longo das três décadas de vigência da Constituição Federal, redesenhos normativos e fiscais foram introduzidos pela União nas garantias de organização federativa solidária e de custeio dos direitos sociais, a pretexto de resguardar a sustentabilidade intertemporal da dívida pública brasileira. Para equalizar a tensão entre estabilidade econômica e efetividade dos direitos sociais e sua repercussão para o processo de endividamento, foram mitigados paulatinamente os pisos de custeio da saúde e educação e o orçamento da seguridade social, os quais operavam, tanto no campo simbólico, quanto no pragmático, como uma espécie de contrapeso fiscal à necessidade de custo alegadamente ilimitado para as políticas monetária e cambial. Desvincular receitas, reduzir o escopo dos regimes de gasto mínimo e restringir o alcance interpretativo de transferências intergovernamentais equalizadoras das distorções federativas tornou-se estratégia, assumida - direta ou indiretamente - pela União desde o início da década de 1990, de estabilização macroeconômica, sobretudo, monetária. Assim tem sido empreendido um longo e ainda atual processo de desconstrução orçamentário-financeira dos direitos sociais, que restringe a identidade estrutural da CF/1988, a pretexto de consolidação fiscal cada vez mais exigente da redução do tamanho do Estado.


Abstract Throughout the three decades of the Federal Constitution, normative and fiscal redesigns were introduced by the Union in the guarantees of solidary federative organization and of social rights costing, under the pretext of safeguarding the intertemporal sustainability of the Brazilian public debt. In order to equalize the tension between economic stability and the effectiveness of social rights and their repercussion for the indebtedness process, the health and education minimum spending and the social security budget were gradually mitigated, which operated both in the symbolic field and in the pragmatic, as a kind of fiscal balance to the need for allegedly unlimited cost for monetary and cambial policies. Unlink taxes, reduce the scope of minimum spending regimes and restrict the interpretative scope of intergovernmental equalization transfers of federative distortions has become a strategy, assumed - directly or indirectly - by the Union since the early 1990s, of macroeconomic stabilization policy, above all, monetary. Thus, a long and still ongoing process of budgetary and financial deconstruction of social rights has been undertaken, which restricts the structural identity of the FC/1988, under the pretext of increasingly demanding fiscal consolidation of the reduction of the size of the state.


Assuntos
Humanos , Orçamentos/legislação & jurisprudência , Governo Federal , Financiamento da Assistência à Saúde , Direitos Humanos/legislação & jurisprudência , Previdência Social/economia , Previdência Social/legislação & jurisprudência , Brasil , Educação/economia , Educação/legislação & jurisprudência , Direitos Humanos/economia
4.
Otolaryngol Head Neck Surg ; 161(4): 672-682, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31210566

RESUMO

OBJECTIVE: To determine the cost-effectiveness of cochlear implantation (CI) with mainstream education and deaf education with sign language for treatment of children with profound sensorineural hearing loss in low- and lower-middle income countries in Asia. STUDY DESIGN: Cost-effectiveness analysis. SETTING: Bangladesh, Cambodia, India, Indonesia, Nepal, Pakistan, Philippines, and Sri Lanka participated in the study. SUBJECTS AND METHODS: Costs were obtained from experts in each country with known costs and published data, with estimation when necessary. A disability-adjusted life-years model was applied with 3% discounting and 10-year length of analysis. A sensitivity analysis was performed to evaluate the effect of device cost, professional salaries, annual number of implants, and probability of device failure. Cost-effectiveness was determined with the World Health Organization standard of cost-effectiveness ratio per gross domestic product (CER/GDP) per capita <3. RESULTS: Deaf education was cost-effective in all countries except Nepal (CER/GDP, 3.59). CI was cost-effective in all countries except Nepal (CER/GDP, 6.38) and Pakistan (CER/GDP, 3.14)-the latter of which reached borderline cost-effectiveness in the sensitivity analysis (minimum, maximum: 2.94, 3.39). CONCLUSION: Deaf education and CI are largely cost-effective in participating Asian countries. Variation in CI maintenance and education-related costs may contribute to the range of cost-effectiveness ratios observed in this study.


Assuntos
Implante Coclear/economia , Correção de Deficiência Auditiva/economia , Educação/economia , Custos de Cuidados de Saúde/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/economia , Perda Auditiva Neurossensorial/reabilitação , Ásia , Implantes Cocleares/economia , Análise Custo-Benefício , Países em Desenvolvimento , Perda Auditiva Neurossensorial/economia , Humanos
5.
Mil Med ; 183(5-6): e241-e248, 2018 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-29490086

RESUMO

Background: There is limited knowledge on the impact of education on veterans' health in the United States. This study specifically examines the relationship between the education benefits from the G.I. Bill and veterans' health. Methods: This study used data from the 2010 National Survey of Veterans. The subjects for this study were 5,052 veterans who were eligible to receive G.I. Bill benefits, representing a total of about 12.7 million non-institutionalized veterans in the United States in 2010. The dependent variables included self-reported health status and smoking behavior. The key independent variable was whether veterans used the education benefits from the G.I. Bill compared with those who were eligible but did not use them. Findings: Results from multivariate regression analyses showed that those who used the education benefits from the G.I. Bill were 4% less likely to report fair/poor health (p < 0.01) and 3% less likely to report any smoking (p < 0.05) compared with those who did not use the education benefits. Additional analyses showed that using the education benefits to attend college decreased the probability of being in fair/poor health by 4% (p < 0.10) and being a smoker by 4% (p < 0.05) compared with those who did not attend college but used their benefits for non-college attainment such as business, technical, or vocational schools. More importantly, a larger association was found between the use of the education benefits from the G.I. Bill to obtain a college degree and fair/poor health (7%, p < 0.05) and smoking behavior (9%, p < 0.01) compared with those who attended college but did not obtain a college degree. Discussion: This study shows that providing opportunities for service members to complete their education also has important health benefits.


Assuntos
Análise Custo-Benefício/métodos , Educação/economia , Militares/educação , United States Department of Veterans Affairs/estatística & dados numéricos , Adulto , Análise Custo-Benefício/estatística & dados numéricos , Educação/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Militares/estatística & dados numéricos , Autorrelato , Inquéritos e Questionários , Estados Unidos , United States Department of Veterans Affairs/organização & administração , Universidades/economia , Universidades/organização & administração , Universidades/estatística & dados numéricos
6.
Subst Use Misuse ; 53(12): 1974-1983, 2018 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-29578826

RESUMO

OBJECTIVES: To estimate how tobacco consumption affects household expenditure on other goods and services in rural China and to assess the tobacco consumption affects self-rated health among rural household members in China. METHODS: A Seemingly Unrelated Regression was used to assess the impact of tobacco consumption on rural household expenditure. To detect tobacco consumption causing heterogeneity in self-rated health among adults in rural China, this study employed a random effects generalized ordered probit model. 2010-2014 China Family Panel Studies was used for the analysis. The data set included 3,611 households and 10,610 adults in each wave. RESULTS: Tobacco consumption households assign significantly lower budget shares to food, health care, dress, and education in rural China. Moreover, self-rated health factor has a significantly positive coefficient with respect to non-smokers and ex-smokers, that is, when the individuals is a non-smoker or ex-smoker, he/ she will be more likely to report his/her health status as positive. CONCLUSIONS: The first analysis showed that tobacco consumption crowds out expenditures on food, dress, health care, and education for rural households in China, and the second analysis indicated that non-smokers and ex-smokers are more likely to report their health status as better compared with last year. The results of the present study revealed that Chinese policymakers might consider controlling tobacco consumption since tobacco control can improve not only rural household welfare but also rural household members' health status. Therefore, the tobacco tax policy and brief clinical interventions by the doctor should be implemented in rural China.


Assuntos
Educação/economia , Alimentos/economia , Gastos em Saúde/estatística & dados numéricos , Nível de Saúde , Fumar/epidemiologia , Produtos do Tabaco/economia , China/epidemiologia , Emprego , Características da Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Política Pública , População Rural , Fumar/economia , Impostos
7.
Tob Control ; 27(5): 560-567, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-28986435

RESUMO

OBJECTIVE: To estimate the degree to which tobacco consumption is associated with spending on a set of goods and services in Chile, especially health and education, for the total population as well as for specific subgroups. METHODS: A seemingly unrelated regression equation system was used to estimate the statistical relationship between having tobacco expenditures and the budget share allocated to other items for the total population and for specific subgroups in Chile (eg, households within the bottom/top 33% by total expenditures). The use of household-level data allows for the control of a number of sociodemographic characteristics. The nationally representative 2012 Chilean Household Expenditure Survey was used for the analysis. RESULTS: Tobacco consumption is associated with lower budget shares allocated to healthcare, education and housing expenses, especially for poorer households. In the case of health, not consuming tobacco is related to higher health expenditures: up to 32% for the total population. Similarly, in the case of education, not consuming tobacco is statistically related to higher education expenditures: up to 16% for the total population. For all groups, tobacco consumption is also related to a significantly higher budget share allocated to alcoholic beverages. CONCLUSIONS: The strong significant statistical relationship found between tobacco consumption and resources allocated to healthcare and education consumption may be indicative of the existence of a crowding out effect of tobacco. This effect, in turn, may increase the burden that the rest of society must bear for the increased healthcare that they require because of tobacco consumption.


Assuntos
Educação/economia , Gastos em Saúde/estatística & dados numéricos , Habitação/economia , Uso de Tabaco/economia , Orçamentos , Chile , Humanos
8.
Rev. bras. estud. popul ; 35(1): e0066, 2018. tab
Artigo em Português | LILACS | ID: biblio-985275

RESUMO

O presente trabalho tem como objetivo analisar se os arranjos familiares (monoparentais ou biparentais) afetam na escolha parental de qual rede de ensino (pública ou privada) matricular os filhos. Utilizando os dados da Pesquisa Nacional por Amostra de Domicílios (PNAD) de 2015, os resultados apontaram para dissemelhanças entre os arranjos familiares, as quais podem ser explicadas pelas diferenças nas preferências dos indivíduos, assim como na renda familiar. Verifica-se que existe maior probabilidade de as famílias investirem privadamente no ensino infantil. A evidência pode ser decorrente da oferta reduzida de creches públicas. Segundo a ordem de nascimento, para os arranjos familiares monoparental feminino e casal com filhos, as famílias preferem investir no filho mais velho, em detrimento dos demais filhos. Além disso, verificou-se que o filho do sexo masculino tem menores chances de estudar em uma rede privada caso esteja em um arranjo monoparental feminino. Esse resultado pode mostrar uma preferência da mãe em incentivar o estudo da filha em uma tentativa de empoderá-la.


This study aims to analyze whether family arrangements (single-parent or two-parent) influence the choice of school system (public or private) for children. For this analysis, data from the 2015 National Household Sample Survey (PNAD) were used. Results point to dissimilarities among family arrangements which can be explained by differences in individual preferences as well as in family income. We found that families are more likely to invest privately in early childhood education. The evidence may be due to the small number of public day care centers. According to the order of birth, families can invest in their eldest child to the detriment of their other children, in the case of female single-parent and two-parent family arrangements. In addition, we found that male children were less likely to study in a private school in female single-parent arrangement. This result may show mothers' wishes to encourage daughters to study in an attempt to empower them.


El objetivo de este trabajo es analizar si los arreglos familiares (monoparentales o biparentales) afectan la elección parental del tipo de institución (pública o privada) en la cual serán matriculados los hijos. Para este analísis fueron utilizados los datos tomados de la Pesquisa Nacional por Amostra de Domicílios (PNAD) de 2015. Los resultados apuntan a que las diferencias en la conformación de las familias pueden ser explicadas por las preferencias de los individuos así como por su enta familiar. Se observa que existe mayor probabilidad de que las familias inviertan en educación privada durante la educación infantil. No obstante, esto puede deberse a la falta de oferta de este servicio en la red de instituciones públicas. Asimismo, de acuerdo al orden de los hijos, se prefiere invertir en el hijo mayor en detrimento de los demás hijos, especialmente los arreglos familiares monoparentales femeninos o biparentales en matrimonio. A su vez, se encontró que el hijo de sexo masculino tiene menos oportunidades de estudiar en una institución privada en una familia con arreglo monoparental femenino. Este resultado puede evidenciar la preferencia de la madre a incentivar el estudio en la hija mujer, en una tentativa de buscar su empoderamiento.


Assuntos
Humanos , Família , Creches , Setor Público , Setor Privado , Relações Familiares , Política Pública , Brasil , Educação Infantil/tendências , Demografia/tendências , Características da Família , Educação/economia
9.
Innovations (Phila) ; 12(5): 363-369, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29028652

RESUMO

OBJECTIVE: We describe our original dry-lab training system for nonrobotic and beating heart endoscopic coronary artery anastomosis. METHODS: All the materials used for this training were commercially available. We selected a boxed machine, which can produce pulsatile movements of artificial vessels, and on its roof, we installed a two-dimensional home video camera and a monitor. A multiple-holed plate was placed in front of the machine, and through these holes, a trainee inserted endoscopic surgical instruments and anastomosed the artificial vessels by running fashion while watching the monitor. This training program has four stages. During the first stage, a trainee has to demonstrate mastery in conducting a conventional off-pump coronary artery anastomosis without assistance. The second stage is the "nonbeating" version, and the third stage is the "beating" version with the model mentioned previously. After a trainee gets accustomed to the third stage, the original artificial vessel is replaced with an extremely fragile one, and this is the fourth stage. Our trainee conducted one hundred fourth-stage anastomoses and each procedure was recorded with the video camera. We analyzed several factors from the videos and evaluated the efficacy of the training method. We compared the outcomes of the first 50 consecutive anastomoses with the following 50 ones and described the learning curves. RESULTS: The comparison showed a significant decrease in anastomotic time and vessel injury. We considered the quality of anastomosis acceptable after 47 anastomoses, and anastomotic time fell below 15 minutes at the 81st training at the fourth stage. CONCLUSIONS: Our dry-lab system might be an effective training method for endoscopic coronary anastomosis.


Assuntos
Anastomose Cirúrgica/educação , Ponte de Artéria Coronária sem Circulação Extracorpórea/instrumentação , Ponte de Artéria Coronária/instrumentação , Educação/métodos , Endoscopia/educação , Anastomose Cirúrgica/instrumentação , Ponte de Artéria Coronária/educação , Ponte de Artéria Coronária/métodos , Ponte de Artéria Coronária sem Circulação Extracorpórea/métodos , Vasos Coronários/cirurgia , Educação/economia , Endoscopia/instrumentação , Humanos , Modelos Cardiovasculares , Avaliação de Resultados em Cuidados de Saúde , Projetos Piloto , Treinamento por Simulação/economia , Treinamento por Simulação/métodos , Técnicas de Sutura/educação , Gravação em Vídeo/métodos
10.
Rev. adm. pública (Online) ; 51(2): 264-293, Mar.-Apr. 2017. tab, graf
Artigo em Português | LILACS | ID: biblio-897209

RESUMO

Resumo A desigualdade de renda é apontada como um dos grandes problemas da sociedade atual. A fim de reverter o cenário desigual, o Estado pode atuar utilizando a função orçamentária alocativa. Este estudo buscou identificar os impactos da função alocativa do orçamento sobre a desigualdade de renda, para as unidades federativas brasileiras no período de 1995 a 2012. Foram considerados como proxy da função alocativa os gastos com educação e saúde, enquanto foram utilizados como proxy da desigualdade de renda o coeficiente de Gini, o coeficiente de Theil, a proporção entre os 10% mais ricos e os 40% mais pobres, e a proporção entre os 20% mais ricos e os 20% mais pobres. A relação funcional entre os dois conjuntos de variáveis foi explorada a partir da análise de dados em painel e da regressão tobit em painel. Considerando-se os gastos agregados em educação e saúde de estados e municípios no período, concluiu-se que as unidades da federação que investiram mais em saúde conseguiram reduzir as desigualdades de renda com maior intensidade, ocorrendo efeito oposto com as despesas com ensino. Quando os gastos em saúde e ensino foram desagregados em várias rubricas, concluiu-se que as unidades da federação com maior volume de gastos nas seguintes subfunções (2o nível da função): atenção básica, assistência hospitalar, suporte profilático e ambulatorial, e educação infantil conseguiram reduzir as desigualdades de renda com maior intensidade.


Resumen La desigualdad de ingresos se ve como un problema importante de la sociedad contemporánea. Con el fin de revertir la situación desigual, el Estado puede actuar mediante la función asignativa de presupuesto. Este estudio trata de identificar los impactos de la función de la asignación de recursos del presupuesto en la desigualdad de ingresos para los estados de Brasil 1995 a 2012. Fueron considerados como un indicador de la función asignativa el gasto en educación y salud, mientras que se utilizaron como apoderado la desigualdad de ingresos el coeficiente de Gini, el coeficiente de Theil, la relación entre el 10% más rico y el 40% más pobre, y la relación entre el 20% más rico y el 20% más pobre. La relación funcional entre los dos conjuntos de variables se exploró a partir del análisis de datos de panel y el panel de regresión Tobit. Teniendo en cuenta los gastos agregados sobre la educación y la salud de los estados y municipios en el período, se concluyó que las Unidades de la Federación que han invertido más en salud han logrado reducir la desigualdad de ingresos con mayor intensidad, que se producen efecto contrario con el costo de la educación. Cuando el gasto en salud y educación ha sido dividido en varias secciones, se concluyó que las unidades de la federación con mayor volumen de gasto en la siguientes subfunciones (segundo nivel de función): atención primaria, atención hospitalaria, asistencia preventiva y la atención ambulatoria, y educación de la primera infancia han logrado reducir la desigualdad de ingresos con mayor intensidad.


Abstract Income inequality is seen as a major problem of contemporary society. In order to reverse inequality the state can use allocation function in budgeting. This study sought to identify the impacts of allocation function in budgeting on income inequality for Brazilian states from 1995 to 2012. Spending on education and health was considered as an allocative function proxy, while the Gini coefficient, the Theil coefficient, was used as a proxy for income inequality. This found the ratio between the richest 10% and the poorest 40%, and the ratio between the richest 20% and poorest 20%. The functional relationship between the two sets of variables was explored in the analysis of panel data and tobit regression. Considering aggregate expenditure on education and health of states and municipalities in the period, it was concluded that federative units that invested more in health have been better at reducing income inequality, with the opposite effect occurring for the cost of education. When spending on health and education are broken down into several sections, it can be seen that the federation units with higher volume of spending in the following sub-functions (2nd level of function) — Primary health care, hospital and outpatient care, prophylactic and therapeutic support and early childhood education — have made greater gains in reducing income inequality.


Assuntos
Humanos , Masculino , Feminino , Fatores Socioeconômicos , Orçamentos , Gastos em Saúde , Educação/economia , Fatores Socioeconômicos , Investimentos em Saúde , Brasil , Administração Financeira
12.
Braz. j. microbiol ; 46(4): 945-955, Oct.-Dec. 2015. tab, graf
Artigo em Inglês | LILACS | ID: lil-769647

RESUMO

Abstract A rich, collaborative program funded by the US NIH Fogarty program in 2004 has provided for a decade of remarkable opportunities for scientific advancement through the training of Brazilian undergraduate, graduate and postdoctoral students from the Federal University and Oswaldo Cruz Foundation systems at Albert Einstein College of Medicine. The focus of the program has been on the development of trainees in the broad field of Infectious Diseases, with a particular focus on diseases of importance to the Brazilian population. Talented trainees from various regions in Brazil came to Einstein to learn techniques and study fungal, parasitic and bacterial pathogens. In total, 43 trainees enthusiastically participated in the program. In addition to laboratory work, these students took a variety of courses at Einstein, presented their results at local, national and international meetings, and productively published their findings. This program has led to a remarkable synergy of scientific discovery for the participants during a time of rapid acceleration of the scientific growth in Brazil. This collaboration between Brazilian and US scientists has benefitted both countries and serves as a model for future training programs between these countries.


Assuntos
Brasil/economia , Brasil/educação , Brasil/história , Brasil , Brasil/organização & administração , Educação/economia , Educação/educação , Educação/história , Educação , Educação/organização & administração , /economia , /educação , /história , /organização & administração , Humanos/economia , Humanos/educação , Humanos/história , Humanos , Humanos/organização & administração , Cooperação Internacional/economia , Cooperação Internacional/educação , Cooperação Internacional/história , Cooperação Internacional , Cooperação Internacional/organização & administração , Pessoal de Laboratório/economia , Pessoal de Laboratório/educação , Pessoal de Laboratório/história , Pessoal de Laboratório , Pessoal de Laboratório/organização & administração , National Institutes of Health (U.S.)/economia , National Institutes of Health (U.S.)/educação , National Institutes of Health (U.S.)/história , National Institutes of Health (U.S.) , National Institutes of Health (U.S.)/organização & administração , Estados Unidos/economia , Estados Unidos/educação , Estados Unidos/história , Estados Unidos , Estados Unidos/organização & administração
13.
BMC Public Health ; 15: 1098, 2015 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-26521133

RESUMO

BACKGROUND: The majority of one billion smokers worldwide live in low- and middle-income countries (LMICs) and the highest proportion of smokers in most of these countries belong to the lower socioeconomic groups. This study aimed to investigate the associations between tobacco use within households and expenditures on food, education, and healthcare in LMICs. METHODS: Using data from the World Health Survey, this cross-sectional study included a sample of 53,625 adult males aged <60 years from 40 LMICs. Multilevel, mixed-effects linear regression was used to determine the association between current tobacco use status of the main income provider (daily; occasional; no use) and three categories of (logged) household expenditures: food, education, and healthcare; controlling for age, level of education, household wealth quintile, marital status, urban-rural setting, country-level income group, and region. RESULTS: In the preferred random-slope models that controlled for covariates, daily tobacco use was associated with lower household expenditures on education and healthcare by 8.0% (95% confidence interval: -12.8 to -3.2%) and 5.5% (-10.7 to -0.3%), respectively. The association between tobacco use and food expenditure was inconsistent across models. CONCLUSIONS: Tobacco use in LMICs may have a negative influence on investment in human capital development. Addressing the tobacco use problem in LMICs could benefit not only the health and economic well-being of smokers and their immediate families but also long-run economic development at a societal level.


Assuntos
Educação/economia , Alimentos/economia , Gastos em Saúde/estatística & dados numéricos , Pobreza/economia , Uso de Tabaco/economia , Adulto , Estudos Transversais , Características da Família , Saúde Global/estatística & dados numéricos , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Análise Multinível , Fatores Socioeconômicos
14.
Otol Neurotol ; 36(8): 1349-56, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26171672

RESUMO

INTRODUCTION: Cochlear implantation (CI) is a common intervention for severe-to-profound hearing loss in high-income countries, but is not commonly available to children in low resource environments. Owing in part to the device costs, CI has been assumed to be less economical than deaf education for low resource countries. The purpose of this study is to compare the cost effectiveness of the two interventions for children with severe-to-profound sensorineural hearing loss (SNHL) in a model using disability adjusted life years (DALYs). METHODS: Cost estimates were derived from published data, expert opinion, and known costs of services in Nicaragua. Individual costs and lifetime DALY estimates with a 3% discounting rate were applied to both two interventions. Sensitivity analysis was implemented to evaluate the effect on the discounted cost of five key components: implant cost, audiology salary, speech therapy salary, number of children implanted per year, and device failure probability. RESULTS: The costs per DALY averted are $5,898 and $5,529 for CI and deaf education, respectively. Using standards set by the WHO, both interventions are cost effective. Sensitivity analysis shows that when all costs set to maximum estimates, CI is still cost effective. CONCLUSION: Using a conservative DALY analysis, both CI and deaf education are cost-effective treatment alternatives for severe-to-profound SNHL. CI intervention costs are not only influenced by the initial surgery and device costs but also by rehabilitation costs and the lifetime maintenance, device replacement, and battery costs. The major CI cost differences in this low resource setting were increased initial training and infrastructure costs, but lower medical personnel and surgery costs.


Assuntos
Implante Coclear/economia , Implantes Cocleares/economia , Surdez/economia , Surdez/terapia , Educação/economia , Audiologia/economia , Pré-Escolar , Análise Custo-Benefício , Surdez/reabilitação , Falha de Equipamento/economia , Custos de Cuidados de Saúde , Perda Auditiva Neurossensorial/economia , Perda Auditiva Neurossensorial/terapia , Humanos , Lactente , Nicarágua/epidemiologia , Anos de Vida Ajustados por Qualidade de Vida , Fonoterapia/economia , Resultado do Tratamento
15.
Agora USB ; 15(1): 19-25, ene.-jun. 2015.
Artigo em Espanhol | LILACS | ID: lil-776900

RESUMO

Poder pensar hoy, en nuestra América Latina y en concreto en Colombia, que la investigación sea más que políticas que llevan a la tecno-burocratización del saber y por el contrario que los investigadores e investigadoras podemos abrir el abanico de posibilidades, es un reto que como especie viajera y excéntrica tenemos, un imperativo llamado político a no dejarnos reducir a la acumulación y a la fachada de la producción “científica”. Eésta reflexión cobra aún más sentido al saber que hoy, en Colombia, se juega la superación de un componente importante del conflicto armado, derivado de sus inequitativas estructuras socio-políticas...


To think today in our Latin America and particularly in Colombia, where the overcoming of an important component of the armed conflict is at stake, which is derived from its unequal social and political structures. It is important that research be more than policiesleading to techno-bureaucracy of knowledge, and that, on the contrary, researchers can open the range of possibilities, which is a challenge as a traveler and eccentric kind. It isa political and imperative call so that we do not allow ourselves to be captivated with the accumulation and the facade of “scientific” research...


Assuntos
Humanos , Educação , Educação/classificação , Educação/economia , Educação/ética , Educação/história , Educação/legislação & jurisprudência , Educação/métodos , Educação/normas
16.
Agora USB ; 15(1): 29-41, ene.-jun. 2015.
Artigo em Espanhol | LILACS | ID: lil-776901

RESUMO

Este artículo, producto de investigación, expone las principales características del Sistema Nacional de Referencia para la Evaluación de Publicaciones Científicas colombianas (Publindex), logros, avances, interacciones y sus contribuciones a la medición de la publicación científica en el país.


This article, derived from a piece of research, sets out the main features of the National System of Reference for the Evaluation of the Colombian Scientific Publications (Publindex), achievements, progress, interactions, and their contributions to the measurement of scientific publications in the country.


Assuntos
Humanos , Educação , Educação/classificação , Educação/economia , Educação/estatística & dados numéricos , Educação/ética , Educação/história , Educação/legislação & jurisprudência , Educação/métodos , Educação/normas , Educação/organização & administração , Educação , Educação/tendências
17.
Agora USB ; 15(1): 43-72, ene.-jun. 2015.
Artigo em Espanhol | LILACS | ID: lil-776902

RESUMO

El presente texto, derivado de investigación, presenta cómo, entre los cambios que han afectado a la educación Superior en las últimas décadas en el mundo occidentaly por ende en América Latina, sobresale la imposición de otra lógica, propia de laempresa privada, que ha venido acompañada de la implantación de un nuevo lenguaje importadoen gran medida del ámbito gerencial, esto genera unos impactos nefastos en la manera de concebir las políticas, la planeación y a la hora de definir los lineamientos mismos de la educación superior.


The present text, derived from a piece of research, presents how, among thechanges that have affected Higher Education in recent decades in the Western world and thus in Latin America, excels the imposition of another logic, which is proper of the private company, and has been accompanied by the implementationof a new language largely imported from the managerial area. This generates a few dreadful impacts on the way of conceiving the policies and planning when it comes to defining the same guidelines of Higher Education.


Assuntos
Humanos , Educação , União Europeia , União Europeia/economia , Educação/classificação , Educação/economia , Educação/ética , Educação/história , Educação/legislação & jurisprudência , Educação
18.
Agora USB ; 15(1): 73-94, ene.-jun. 2015.
Artigo em Espanhol | LILACS | ID: lil-776903

RESUMO

El presente escrito derivado de investigación, prestan algunas de las políticas macroeconómicas implementadas en Colombia, impuestas por las Instituciones Financieras Internacionales, caso específico, del Fondo Monetario Internacional ysu acuerdo extendido con Colombia, y cómo éstas, han afectado el desarrollo del bienestar de la población, haciendo especial énfasis en la manera en cómo se han afectado las políticas que vienen imponiéndose en la Educación Superior.


The present article, derived from a piece of research, provides some of themacroeconomic policies implemented in Colombia, imposed by the internationalfinancial institutions, the specific case being the International Monetary Fund and its extended agreement with Colombia, and how these have affected the development of the well-being of the population, making special emphasis on how the policies that have been imposed on Higher Education, have been affected.


Assuntos
Humanos , Educação , Universidades , Educação/classificação , Educação/economia , Educação/ética , Educação/história , Educação/legislação & jurisprudência , Educação
19.
Agora USB ; 15(1): 95-113, ene.-jun. 2015.
Artigo em Espanhol | LILACS | ID: lil-776904

RESUMO

En este ensayo nos proponemos compartir una serie de reflexiones sobre las condiciones existentes para la publicación de artículos académicos en Colombia. En particular nos interesa ofrecer elementos para el debate sobre la política de indexación de revistas académicas que ha definido el Departamento Administrativode Ciencia, Tecnología e Innovación para Colombia (Colciencias) por medio de su Sistema Nacional de Indexación y Homologación de Revistas Especializadas de CT+I Colombia (Publindex). En el ensayo destacamos algunas consecuencias de tal modelo, sustentado en la confianza y delegación que Colciencias tiene en un modelo de indexación establecido por dos empresas privadas y con ánimo de lucro: Thomson Reuters (Isi)™ y Scopus Elsevier™. El objeto principal del ensayo es contribuir al mejoramiento de las políticas editoriales agenciadas desde Colciencias.


This paper attempts to share a series of reflections on the existing conditions forthe publication of scholarly articles in Colombia. In particular, we are interested in providing some elements for the debate on the policy of indexing academic journals that the Administrative Department of Science, Technology and Innovation forColombia (Colciencias) and its National System of Indexing and Official Approval of Specialized Journals of CT+I Colombia (Publnidex), has defined, making emphasis on the consequences of this new model of indexing, which is supported in the almost exclusive recognition of journals that are indexed by two private profitmakingcompanies: Thomson Reuters (Isi)™ and Scopus-Elsevier.


Assuntos
Humanos , Educação , Educação/ética , Educação/classificação , Educação/economia , Educação/estatística & dados numéricos , Educação/história , Educação/legislação & jurisprudência , Educação/métodos , Educação/normas , Educação/organização & administração , Educação , Educação/tendências
20.
Agora USB ; 15(1): 115-128, ene.-jun. 2015.
Artigo em Espanhol | LILACS | ID: lil-776905

RESUMO

El texto es una reflexión sobre la universidad como institución social, realizada a partir de varios estudios desarrollados en cuyos hallazgos se evidencia, en primer lugar, el interés de algunas estancias por convertirla en un escenario de manipulación y control, reduciéndola a la racionalidad de los organismos funcionales, frente ala dinámica propia que la universidad instaura como institución social cuya base se moviliza desde las significaciones imaginarias sociales. En este proceso, se muestra desde la lógica de la teoría de los imaginarios sociales, la forma como la universidad se configura e institucionaliza en una tensión constante, entre el sabery el control, entre la función y la institución y se dan las bases que la definen y posicionan como institución imaginaria social.


The text is a reflection on the University as a social institution, based on severalstudies developed on whose findings are made evident, firstly, the interest of some stances by turning it into a scenario of manipulation and control, by reducing it to the rationality of the functional agencies, against the very dynamic that the University establishes as a social institution whose base is mobilized from the social imaginary significations. In this process, it is shown from the logic of thetheory of the social imaginary, the manner how the University is configured and institutionalized at a constant pressure, between knowledge and control, between function and institution, and the foundations, which define it and position it as a social imaginary institution are defined.


Assuntos
Humanos , Educação , Educação/classificação , Educação/economia , Educação/ética , Educação/história , Educação/legislação & jurisprudência , Educação/métodos , Educação
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