Medidas sanitárias de que a Bahia precisa: as Delegacias de Saúde, o Hospital de isolamento e a Reforma Sanitária em Salvador (1921-1930) / Sanitary measures that Bahia needs: the Health Police Stations, the Isolation Hospital and the Sanitary Reform in Salvador (1921-1930)

Analisa o papel das Delegacias de Saúde e do Hospital de Isolamento de Mont'Serrat, no processo da Reforma Sanitária que ocorreu na Bahia na década de 1920

Local Decision Making for Implementing Social Distancing in Response to Outbreaks.

OBJECTIVES: Social distancing is the practice of restricting contact among persons to prevent the spread of infection. This study sought to (1) identify key features of preparedness and the primary concerns of local public health officials in deciding to implement social distancing measures and (2) determine whether any particular factor could explain the widespread variation among health departments in responses to past outbreaks. METHODS: We conducted an online survey of health departments in the United States in 2015 to understand factors influencing health departments' decision making when choosing whether to implement social distancing measures. We paired survey results with data on area population demographic characteristics and analyzed them with a focus on broad trends. RESULTS: Of 600 health departments contacted, 150 (25%) responded. Of these 150 health departments, 63 (42%) indicated that they had implemented social distancing in the past 10 years. Only 10 (7%) health departments had a line-item budget for isolation or quarantine. The most common concern about social distancing was public health impact (n = 62, 41%). Concerns about law, politics, finances, vulnerable populations, and sociocultural issues were each identified by 7% to 10% of health departments. We were unable to clearly predict which factors would influence these decisions. CONCLUSIONS: Variations in the decision to implement social distancing are likely the result of differences in organizational authority and resources and in the primary concerns about implementing social distancing. Research and current social distancing guidelines for health departments should address these factors.

Diferenciais de mortalidade em um hospital filantrópico: a Santa Casa de Misericórdia de Campinas (1876-1885) / Mortality differentials in a philanthropic hospital: the Santa Casa de Misericórdia of Campinas (1876-1885) / Diferencias de mortalidad en un hospital filantrópico: Santa Casa de Misericordia de Campinas (1876-1885)

A partir da documentação das Matrículas de Enfermos e Relatórios dos Provedores da Santa Casa de Misericórdia de Campinas, traçamos o perfil dos atendidos e analisamos os diferenciais de mortalidade entre escravos e livres, brasileiros e estrangeiros nos primeiros anos de funcionamento desse hospital filantrópico. Os enfermos eram predominantemente homens em idade ativa, fortemente relacionados com a mão de obra disponível para comportar a expansão agrícola e dos serviços urbanos. Por meio de uma técnica de análise do diferencial de mortalidade baseada na decomposição de Oaxaca-Blinder, concluímos que, apesar de as características de escravos favorecerem um diferencial de mortalidade reduzido e de haver incentivos econômicos em seu tratamento, a mortalidade escrava foi superior possivelmente devido às condições de vida impostas pelo cativeiro. Entre a população livre, brasileiros apresentaram mortalidade superior à de estrangeiros. As hipóteses levantadas foram a procura tardia de auxílio por parte dos nacionais, diferenças na estrutura etária e a forte característica de sub-representação feminina na população estrangeira.

With documentation involving patients' records and reports fromthe administration of Santa Casa de Misericórdia of Campinas (1876-1885), we examined demographic characteristics of patients and analyzed differences in mortality ratesamongslaves, free people, Brazilians, and foreign population atthe philanthropic hospital. Data show patients are predominantly men of working age, mainly involved inlabor available related to agricultural expansion and urban services. Through an analysis of mortality differentials based on the Oaxaca-Blinder Decomposition, we concluded that although the characteristics of slavery and economic incentives in their treatment favored a reduced differential of mortality, slave mortality was higher due to the living conditions imposed by slavery. Among the free population, Brazilians had higher mortality rates than foreigners. Hypotheses raised include abelated demand for help from nationals, differences in age structure, and astrong female underrepresentation among the free population.

A partir de documentos de las Matrículas de Enfermos e Informes de los Proveedores del Hospital Santa Casa de Misericordia de Campinas, trazamos el perfil de los pacientes y analizamos la mortalidad diferencial entre esclavos y libres, brasileños y extranjeros em ese hospital filantrópico. Los enfermos fueron predominantemente hombres em edad activa, fuertemente relacionados con la mano de obra disponible para la expansión agrícola y de los servicios urbanos. Por medio de una técnica de análisis del diferencial de mortalidad basada en la descomposición de Oaxaca-Blinder, concluimos que a pesar de que las características de los esclavos favorecieron un de mortalidade reducido y que hubo incentivos económicos em su tratamiento, la mortalidad esclava fue superior, posiblemente por las condiciones de vida impuestas por el cautiverio. Entre la población libre, los brasileños presentaron una mortalidad superior a la de población extranjera. Las hipótesis planteadas son: la demanda tardía de ayuda por parte de los nacionales, diferencias en la estrutura etária y la fuerte característica de subrepresentación feminina en la población extranjera.

Sustainability of High-Level Isolation Capabilities among US Ebola Treatment Centers.

To identify barriers to maintaining and applying capabilities of US high-level isolation units (HLIUs) used during the Ebola virus disease outbreak, during 2016 we surveyed HLIUs. HLIUs identified sustainability challenges and reported the highly infectious diseases they would treat. HLIUs expended substantial resources in development but must strategize models of sustainability to maintain readiness.

Medical, demographical and social aspects of syphilis: the case of infected sex workers in Greece during Interwar.

The aim of this research is to present syphilis among women described as "indecent" according to the records of the Venereal Diseases Hospital "Andreas Syggros", which is located in Athens, during the period 1931-1935. In impoverished Greece of the Interwar period, factors such as criminal ignorance, or lack of information on sexually transmitted diseases (STDs) along with inadequate health controls of sex workers, resulted in a dramatic spread of syphilis, whereas "Andreas Syggros" hospital accommodated thousands of patients. The inflow of 1.300.000 Greek refugees from Asia Minor, after the Greek defeat by the Turkish army in the war of 1922, resulted in a notable change in the demographics of the country, while the combination of miserable living conditions, unemployment, economic crisis of the Interwar period, political instability and dysfunction of the State led to an increased number of illegal sex workers and syphilis outbreaks. Despite the introduction of an ad hoc Act to control STDs since 1923, the State was unable to limit the transmissibility of syphilis and to control prostitution. Unfortunately, the value of this historical paradigm is borne out by a contemporary example, i.e. the scandal of HIV seropositive sex workers in -beset by economic crisis- Greece in May 2012. It turns out that ignorance, failure to comply with the law, change in the mentality of the citizens in an economically ruined society, and most notably dysfunction of public services during periods of crisis, are all risk factors for the spread of serious infectious diseases.

Impact of isolation on hospital consumer assessment of healthcare providers and systems scores: is isolation isolating?

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was used to measure the effect of isolation on patient satisfaction. Isolated patients reported lower scores for questions regarding physician communication and staff responsiveness. Overall scores for these domains were lower in isolated than in nonisolated patients.

EuroNHID checklists for the assessment of high-level isolation units and referral centres for highly infectious diseases: results from the pilot phase of a European survey.

Healthcare settings have been identified as preferential for the transmission of many agents causing highly infectious diseases (HIDs). Infection control procedures strongly reduce the risk of transmission of HIDs in hospital settings, when adequately applied. The main objective of the European Network for Highly Infectious Diseases (EuroNHID), a network co-funded by the European Commission, is to assess the current capabilities for dealing with HIDs in Europe, specifically in the context of infection control and healthcare worker (HCW) safety, through conducting an on-the-field survey of high-level isolation units (HLIUs)/referral centres for the management of HIDs in participating countries. During the first year of the project's activities, specifically designed, evidence-based checklists were developed. This review introduces the EuroNHID checklists as a standard tool for the assessment of hospital capabilities concerning infection control and HCW safety in the management of patients with HIDs, and presents preliminary results from five HLIUs.

[Discourses and practices in the sanatoriums for tuberculosis sufferers in the province of Cordoba. 1910-1947]. / Discursos y prácticas en los sanatorios para tuberculosos en la provincia de Córdoba. 1910-1947.

Tuberculosis was a stigmatized disease, with a strong social meaning developed by medicine itself. In this paper, we make an analysis of the medical conceptions about the disease, and their repercussions on patients in a special place such as tuberculosis sanatoriums. In the first place, we enumerate the sanatoriums in the province of Cordoba, after that, we study the medical views about the sanatoriums and the infection, as a central element for hospitalized patients with tuberculosis. Later, we analyze the myths generated around the disease, and finally, we try to understand how these myths made possible to create a particular social group within those sanatoriums.

[The origins of the Pavilion Lazaretto: quarantine architecture between the 18th and 19th centuries]. / Los orígenes del Lazareto Pabellonario: la arquitectura cuarentenaria en el cambio del setecientos al ochocientos.

The model of pavilion lazaretto was built above the scientific basis established during the hospital reform process held in France on the lasts decades of the eighteenth century. The morphological solutions adopted for the new quarantine taxonomy has not been given by the example borrowed by the new typology of hospital as resulted in this discussion, but by existing quarantine and detention facilities in general. In this paper we will analyse all factors that have influenced in the configuration of this model of lazarettos.

The origins of the health defence system against contagious illness: the strategies of isolation and quarantine in Mediterranean cities from the XIV-XIX centuries.

From the onset of the Black Death in 1347-48, Italian cities which faced the Mediterranean, an epidemic sea, constructed a complex and articulated health defence system which was an example to all other western countries. The cornerstones of this health defence system lay in quarantine, sanitary cordons, lazarets, disinfection, and in the social regulation of the population at risk. Medicine played no part. Its impotence in dealing with epidemic diseases left health defence to the initiative of the civil authorities who rigorously fought the repeated incursions of plague, which from the end of Middle Ages severely tried and tested social organisation, economic life and public order, all of which were threatened by reactions of fear and aggression. From the fifteenth century onwards the public authorities instituted health magistracies which perfected policing and hygiene strategies based on isolation, separation and social control. This progressively extended to individuals in the community through 'health certificates'. This paper follows the evolution and crises of the conceptual, cultural adn institutional response to epidemics through the centuries up to the appearance of the plague of cholera and its disappearance.