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1.
Braz. j. oral sci ; 21: e226252, jan.-dez. 2022. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1366526

RESUMO

Universal health coverage is a global target included in the United Nations Sustainable Development Goals agenda for 2030. Healthcare in Brazil has universal coverage through the Unified Health System (SUS), which guarantees health as basic right to the Brazilian population. Considering the principles of SUS, public oral healthcare management is a huge challenge. Aim: To identify good management practices for quality care adopted by local public oral healthcare managers and teams around Brazil. Methods: This study was registered with PROSPERO (CRD42017051639). Five databases (PubMed, Embase, Web of Science, Scopus and Lilacs) as well as the reference lists and citations of the included publications were searched according to PRISMA guidelines. Results:A total of 30,895 references were initially found, which were evaluated according to the defined eligibility criteria. Twenty qualitative studies, eight surveys and two mixed-model studies were selected. The practices (codes) were organized into three main groups (families), and the Frequency of the Effect Size (FES) of each code was calculated. Among the 20 codes identified, the most relevant ones were: Diagnosis and Health Planning (FES=80%) and Family Health Strategy(FES=66,7). The Intensity of the Effect Size of each study was also calculated to demonstrate the individual contribution of each study to the conclusions. Conclusion: The evidence emerging from this review showed that healthcare diagnosis, planning, and performance based on the family health strategy principles were the most relevant practices adopted by public oral healthcare managers in Brazil. The widespread adoption of these practices could lead to improved oral healthcare provision and management in Brazil


Assuntos
Humanos , Sistema Único de Saúde , Assistência Odontológica , Gestão em Saúde , Política de Saúde , Brasil
2.
Environ Res ; 213: 113566, 2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35660409

RESUMO

In the presence of pandemic threats, such as Coronavirus Disease 2019 (COVID-19) crisis, vaccination is one of the fundamental strategies to cope with negative effects of new viral agents in society. The rollout of vast vaccination campaigns also generates the main issue of hesitancy and resistance to vaccines in a share of people. Many studies have investigated how to reduce the social resistance to vaccinations, however the maximum level of vaccinable people against COVID-19 (and in general against pandemic diseases), without coercion in countries, is unknown. The goal of this study is to solve the problem here by developing an empirical analysis, based on global data, to estimate the max share of people vaccinable in relation to socioeconomic wellbeing of nations. Results, based on 150 countries, reveal that vaccinations increase with the income per capita, achieving the maximum share of about 70% of total population, without coercion. This information can provide new knowledge to establish the appropriate goal of vaccination campaigns and in general of health policies to cope with next pandemic impacts, without restrictions that create socioeconomic problems. Overall, then, nations have a natural level of max vaccinable people (70% of population), but strict policies and mandates to achieve 90% of vaccinated population can reduce the quality of democracy and generate socioeconomic issues higher than (pandemic) crisis.

3.
Nurs Forum ; 2022 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-35662037

RESUMO

Human trafficking is a grievous human rights violation and rapidly emerging public health threat to which most nurses are ill-equipped to effectively respond. Curricula development within academic institutions and standard setting of organizational, education, accreditation, or licensing entities are a slow-moving and complicated process ill-equipped to adequately inform nursing practice in a timely way. Professional nursing organizations are ideally situated with knowledge, skills, and attributes to effectively contribute in a timely manner to policy creation and implementation directed toward emerging health threats. This analysis identifies only nine of 104 national nursing organizations that deliver vision, skills, position statements, practice guidelines, or other tools for members seeking evidence-based, credible, professional resources to initiate health policies and clinical protocols for human trafficking. Opportunity exists for nursing organizations to leverage the collective professional skill sets of their members to efficiently galvanize the nursing profession to effectively respond to persons encountered in clinical settings who are abused and exploited through trafficking.

4.
Front Public Health ; 10: 789527, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35664126

RESUMO

Introduction: Recent infectious outbreaks preceding the COVID-19 crisis resulted in the evolution of vigilance for preparedness against the next pandemic. This vigilance was maintained to varying degrees in different jurisdictions. Objective: To evaluate the evolution of vigilance following previous epidemics and pandemics and the subsequent atrophy of vigilance prior to the COVID-19 global pandemic. Methods: We evaluated documentation discussing US, Canada, and South Korea from March 2002 to October 2021. Our policy search strategy was rooted in academic literature, government documents and media reports. Results: In the US, there were examples of atrophy of vigilance; however, there was clear understanding of pandemic readiness actions that were simply not executed amongst political chaos. In Canada, political mishaps were less evident at the time the pandemic unfolded. Nevertheless, atrophy was evident with erosion in preparedness programs following SARS. South Korea appeared least subjected to atrophy of vigilance. The more recent MERS outbreak prompted evolution of sustained vigilance and compliance with basic public health measures such as mask wearing. Recommendations: Policy options need to be explored and instituted that increase protection of preparedness programs through institutional safeguards and accountability measure.


Assuntos
COVID-19 , Atrofia , COVID-19/epidemiologia , Surtos de Doenças , Humanos , Pandemias/prevenção & controle , SARS-CoV-2
5.
Front Public Health ; 10: 787844, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35669757

RESUMO

Background: The negative consequences of childbearing on mothers are called the motherhood penalty, and it manifests in the aspects of women's physical and mental health. In May 2021, China relaxed its birth policy that allowed a married couple to have three children. It gives women the opportunity to have more children, but also may increase more risks to mothers' physical and mental health. Objectives: The objectives of this study were to clarify the relationships between the fertility and the physical/mental health of women of childbearing age and empirically confirm the existence of the motherhood health penalty in China. Materials and Methods: Using a nationally representative dataset from the China Labor-force Dynamics Survey 2018, we examined the effects of fertility on the physical and mental health of Chinese women of childbearing age. Physical health was self-rated, and mental health was assessed according to the Center for Epidemiological Studies Depression scale. The instrumental variable approach and the models of inverse probability of treatment weighting of propensity scores and regression adjustment were employed to overcome the endogeneity between fertility and health of women. Results: The empirical results showed that the total number of births had significant adverse impacts on the physical and mental health of women of childbearing age, which empirically demonstrated the existence of the motherhood health penalty in China. The results of heterogeneity analysis indicated that the physical and mental health of the rural women was more easily affected by childbearing compared with that of the urban samples. In a mechanism analysis, the pathways of income and the multiple roles played by mothers were found to mediate the impacts of the total number of births on the physical and mental health of women. The robustness checks showed that the results of this study were robust. Conclusions: The findings of this study extend the motherhood penalty to the health domain, and they have important implications for improving healthcare policy for women of childbearing age in China and other countries and regions and promoting gender equality in the healthcare field.


Assuntos
Fertilidade , Saúde Mental , Criança , China/epidemiologia , Feminino , Humanos , Casamento , População Rural
6.
Environ Res ; 213: 113579, 2022 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-35714688

RESUMO

Airborne transmission arises through the inhalation of aerosol droplets exhaled by an infected person and is now thought to be the primary transmission route of COVID-19. Thus, maintaining adequate indoor air quality levels is vital in mitigating the spread of the airborne virus. The cause-and-effect flow of various agents involved in airborne transmission of viruses has been investigated through a systematic literature review. It has been identified that the airborne virus can stay infectious in the air for hours, and pollutants such as particulate matter (PM10, PM2.5), Nitrogen dioxide (NO2), Sulphur dioxide (SO2), Carbon monoxide (CO), Ozone (O3), Carbon dioxide (CO2), and Total Volatile Organic Compounds (TVOCs) and other air pollutants can enhance the incidence, spread and mortality rates of viral disease. Also, environmental quality parameters such as humidity and temperature have shown considerable influence in virus transmission in indoor spaces. The measures adopted in different research studies that can curb airborne transmission of viruses for an improved Indoor Air Quality (IAQ) have been collated for their effectiveness and limitations. A diverse set of building strategies, components, and operation techniques from the recent literature pertaining to the ongoing spread of COVID-19 disease has been systematically presented to understand the current state of techniques and building systems that can minimize the viral spread in built spaces This comprehensive review will help architects, builders, realtors, and other organizations improve or design a resilient building system to deal with COVID-19 or any such pandemic in the future.

8.
BMJ Glob Health ; 7(Suppl 3)2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35750342

RESUMO

Health research, innovation and knowledge management remain major priorities of the WHO's response to the COVID-19 pandemic. WHO's Eastern Mediterranean Regional Office (EMRO) supports priority research initiatives that address gaps in current knowledge regarding the COVID-19 pandemic. Through a specific call for proposals, 122 research proposals were received and reviewed in 2020, of which 17 were recommended for funding from eight countries. Ten countries in the region participated in the global solidarity trial to assess potential therapies for COVID-19. In addition, WHO advocated for early serological and epidemiological investigations ('COVID-19 Unity Studies') on the general population, healthcare workers, pregnant women and neonates, and extending technical, financial and material support for them.Starting in early 2020, scholarly articles on COVID-19 have been published in every issue of the Eastern Mediterranean Health Journal More than 6300 publications on COVID-19 were made available on the WHO knowledge management portal in the last year alone. WHO is also supporting countries in conducting studies to assess the field effectiveness of vaccines deployed nationally. To build and strengthen country capacities, regional webinars and intercountry meetings were conducted on research ethics, national health information systems and evidence-based health policy making. With support from WHO EMRO's new research and knowledge management pillar, countries in the region were well equipped to contribute to a global understanding of the novel virus's characteristics, as well as employ a national response based on informed evidence.


Assuntos
COVID-19 , Feminino , Humanos , Recém-Nascido , Gestão do Conhecimento , Pandemias/prevenção & controle , Formulação de Políticas , Gravidez , Organização Mundial da Saúde
9.
BMJ Glob Health ; 7(Suppl 3)2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35750344

RESUMO

Since the COVID-19 pandemic began, hospitals in the Eastern Mediterranean Region (EMR) have faced significant challenges in providing essential services, while simultaneously combatting this pandemic and responding to new and ongoing shocks and emergencies. Despite these challenges, policy-makers and hospital managers adapted their hospital responses to maintain operations and continue providing essential health services in resource-restraint and fragile and conflict affected, offering valuable insights to others in similar contexts. The aim of this paper is to share the lessons learnt from hospital responses to COVID-19 from the EMR. To do this, we triangulated findings from literature review, open-ended online surveys and 46 in-depth key informant interviews from 18 EMR countries. Qualitative findings from semistructured key informant interviews along with the open-ended survey responses resulted in nine major themes for lessons learnt in the EMR. These themes include Preparedness, Leadership and Coordination, Communication, Human Resources, Supplies and Logistics, Surge Capacity and Essential Services, Clinical Management (including Rapid Identification, Diagnosis and Isolation), Infection Prevention and Control, and Information and Research. Each of the nine themes (domains) included 4-6 major subthemes offering key insights into the regional hospital response to health emergencies. Resilient hospitals are those that can provide holistic, adaptable, primary-care-based health systems to deliver high-quality, effective and people-centred health services and respond to future outbreaks. Both bottom-up and top-down approaches are needed to strengthen collaboration between policy-makers, hospitals, front-line workers and communities to mitigate the continued spread of SARS CoV2, build resilient hospital systems and improve public health preparedness and emergency response.


Assuntos
COVID-19 , Emergências , Hospitais , Humanos , Pandemias/prevenção & controle , Saúde Pública
10.
BMJ Open ; 12(6): e055963, 2022 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-35750457

RESUMO

OBJECTIVES: To investigate German physicians' attitudes towards and experiences with voluntary disclosure of payments by pharmaceutical companies in a public database and their impact on future decisions for or against disclosure. DESIGN: A national cross-sectional survey conducted in 2018 among physicians who voluntarily disclosed at least one payment in the German transparency regulation. SETTING: Retrospective paper-pencil questionnaire about attitudes towards and experiences with voluntary payment disclosures in the first (2015) and second (2016) years of the German transparency regulation. PARTICIPANTS: German physicians who disclosed either in the first year only, the second year only, or in both years of the transparency regulation. PRIMARY OUTCOMES: (1) The probability to disclose in 2016, predicted by physicians' experience of reactions from others in 2015, descriptive norms and attitudes towards transparency; (2) Frequency and (3) Content of reactions from others in 2015 compared with 2016. RESULTS: Data of 234 respondents were analysed (n=42, 45 and 147 physicians who disclosed in 2015, 2016 or both years, respectively). The probability to disclose in 2016 was not predicted by perceived reactions, norms or attitudes towards transparency (p>0.01). Most participants reported not to have received any reactions by patients (190/234, 81%), colleagues (128/234, 55%) or the private environment (153/234, 65%). Neither frequency nor content of reactions differed between the first and second years (scale 1-5; frequency: Mdn 2015,2016 = 1.33 vs 1.00, r b=-0.17, p>0.01; content: Mdn 2015,2016 = 3.00 vs 3.00, r b=0.19, p>0.01). However, media reporting, fear of reputational damage and a feeling of being defamed were mentioned as reasons for non-disclosure. CONCLUSIONS: While confirmatory analyses did not provide significant results, descriptive analyses showed that participants who voluntarily disclose payments mainly do not experience any reactions towards their disclosures but report fears about losing their reputation due to disclosures.


Assuntos
Revelação , Médicos , Atitude , Conflito de Interesses , Estudos Transversais , Indústria Farmacêutica , Humanos , Preparações Farmacêuticas , Estudos Retrospectivos
11.
Int J Prison Health ; ahead-of-print(ahead-of-print)2022 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-35751659

RESUMO

PURPOSE: The purpose of this study was to systematically review literature to investigate trends in compassionate release policies, facility implementation, barriers at both the incarcerated individual and institutional levels, as well as gaps in the literature. The absence of uniform and appropriate policies to address suitable interventions at the end-of-life has aggravated the challenges and issues facing health-care systems within a correctional facility. A response to address and alleviate these barriers is policies related to compassionate release, a complex route that grants eligible inmates the opportunity to die in their community. Despite the existence of compassionate release policies, only 4% of requests to the Federal Bureau of Prisons are granted, with evidence demonstrating similarly low rates among numerous state prison systems, signifying the underuse of these procedures as a vital approach to decarceration. DESIGN/METHODOLOGY/APPROACH: A systematic review was completed using preferred reporting items for systematic reviews and meta-analyses guidelines. Centre for Agriculture and Biosciences International Abstracts, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Education Resources Information Center, Google Scholar, MEDLINE, PsycINFO, PubMed, Social Services Abstracts and Social Work Abstracts were searched from inception to March 2021. Inclusion criteria included: the compassionate release policy (or related policy) is implemented in the USA; reported qualitative and/or quantitative outcomes; and reported original data. FINDINGS: Twenty studies formed the final data set. Data analysis revealed four main themes: language barriers, complexities of eligibility criteria, over-reliance on prognostication and social stigma. Barriers to inmates' access to compassionate release policies include unclear or technical language used in policy documents. Eligibility criteria appear to vary across the country, including disease prognoses and the ability to predict terminal declines in health, creating confusion amongst inmates, lawyers and review boards. Stigmas surrounding the rights of incarcerated individuals frequently influence policymakers who experience pressure to maintain a punitive stance to appease constituents, thus discouraging policies and interventions that promote the release of incarcerated individuals. RESEARCH LIMITATIONS/IMPLICATIONS: Further research is vital to strengthen the understanding of compassionate release policies and related barriers associated with accessing various types of early parole. To promote social justice for this marginalized population, end-of-life interventions in corrections need to be consistently evaluated with outcomes that improve care for dying inmates. PRACTICAL IMPLICATIONS: Within correctional facilities, correctional health-care workers should play an integral role in influencing prison and medical staff attitudes toward dying inmates by providing an understanding of how to effectively support this vulnerable population. Social workers should participate in research that focuses on effective guidelines for correctional facilities to provide compassionate end-of-life care for inmates. SOCIAL IMPLICATIONS: Racial disparities in the US criminal justice system are prevalent and well documented, as individuals of color are arrested far out of proportion to their share of all individuals in the USA. This particular population is thus challenged with poor access to and quality of health care in corrections. Correctional health-care workers can play an integral role in influencing policymakers, as well as prison and medical staff attitudes toward dying inmates by providing an understanding of how to effectively support this vulnerable population. ORIGINALITY/VALUE: Currently, there are no published research articles that provide a systematic review of compassionate release policies in the USA.


Assuntos
Pessoal de Saúde , Prisões , Atitude do Pessoal de Saúde , Morte , Humanos , Políticas
12.
Health Econ Policy Law ; : 1-26, 2022 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-35762255

RESUMO

The UK's relationship with the European Union (EU) is now embodied in two principal legal instruments: the EU-UK Trade and Cooperation Agreement, which formally entered into force on 1 May 2021; and the Withdrawal Agreement, with its Protocol on Ireland/Northern Ireland, which continues to apply. Using a 'building blocks' framework for analysis of national health systems derived from the World Health Organisation, this article examines the likely impacts in the UK of this legal settlement on the National Health Service (NHS), health and social care. Specifically, we determine the extent to which the trade, cooperation and regulatory aspects of those legal measures support positive impacts for the NHS and social care. We show that, as there is clear support for positive health and care outcomes in only one of the 17 NHS 'building blocks', unless mitigating action is taken, the likely outcomes will be detrimental. However, as the legal settlement gives the UK a great deal of regulatory freedom, especially in Great Britain, we argue that it is crucial to track the effects of proposed new health and social care-related policy choices in the months and years ahead.

13.
Hastings Cent Rep ; 52(3): 18-29, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35763204

RESUMO

Existing calls to implement learning health care systems have tended to stipulate a minimal or near-minimal risk limit for compulsory learning activities. I argue to the contrary that such a limit cannot be defended. So long as the way in which patients are compelled to participate in learning activities is solely through the withholding of nonresearch options for receiving care, compelling participation does not violate any individual's rights and can be both efficient and adequately fair. Because the decision to compel participation in this way is relevantly similar to the decision to ration care, theories of justice in cost-effectiveness rationing can be used to further specify when it is appropriate to use this method to compel research participation. When applied, these theories will not support a minimal risk limit for compulsory research.

17.
BMJ Glob Health ; 7(6)2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35680132

RESUMO

Australian government planning promotes evidence-based action as the overarching goal to achieving health equality for Aboriginal and Torres Strait Islander populations. However, an inequitable distribution of power and resources in the conduct of evidence-based practice produces a policy environment counterintuitive to this goal. This context of contemporary evidence-based practice gives legitimacy to 'expert practitioners' located in Australian governments and universities to use Western guidelines and tools, embedded in Western methodology, to make 'evidence' informed policy and programming decisions about Aboriginal and Torres Strait Islander populations. This method for decision making assumes a positional superiority that can marginalise the important perspectives, experiences and knowledge of Aboriginal Community Controlled Organisations and their processes for decision making. Here we consider the four steps of an evidence review: (1) developing a review question; (2) acquiring studies; (3) appraising the evidence and (4) assessing the evidence, as components of wider evidence-based practice. We discuss some of the limitations across each step that arise from the broader context within which the evidence review is produced. We propose that an ethical and just approach to evidence-based review can be achieved through a well-resourced Aboriginal community controlled sector, where Aboriginal organisations generate their own evidence and evidence is reviewed using methods and tools that privilege Aboriginal and Torres Strait Islander ways of knowing, doing and being.


Assuntos
Prática Clínica Baseada em Evidências , Austrália , Humanos , Projetos de Pesquisa
18.
BMJ Glob Health ; 7(6)2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35701014

RESUMO

This article argues that human health has become a key consideration in recent global reports on climate change and biodiversity produced by various international organisations; however, greater attention must be given to the unequal health impacts of climate change and biodiversity loss around the world and the different health adaptation measures that are urgently required.


Assuntos
Mudança Climática , Conservação dos Recursos Naturais , Biodiversidade , Humanos
20.
Artigo em Inglês | MEDLINE | ID: mdl-35760516

RESUMO

Recent crises have underscored the importance that housing has in sustaining good health and, equally, its potential to harm health. Considering this and building on Howden-Chapman's early glossary of housing and health and the WHO Housing and Health Guidelines, this paper introduces a range of housing and health-related terms, reflecting almost 20 years of development in the field. It defines key concepts currently used in research, policy and practice to describe housing in relation to health and health inequalities. Definitions are organised by three overarching aspects of housing: affordability (including housing affordability stress (HAS) and fuel poverty), suitability (including condition, accessibility and sustainable housing) and security (including precarious housing and homelessness). Each of these inter-related aspects of housing can be either protective of, or detrimental to, health. This glossary broadens our understanding of the relationship between housing and health to further promote interdisciplinarity and strengthen the nexus between these fields.

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