Drinking patterns, alcohol-related harm and views on policies: results from a pilot of the International Alcohol Control Study in Canada. / Habitudes de consommation, méfaits liés à l'alcool et points de vue sur les politiques : résultats d'un projet pilote de l'étude internationale sur le contrôle de l'alcool (IAC) au Canada.

INTRODUCTION: We conducted a pilot assessment of the feasibility of implementing the International Alcohol Control (IAC) Study in Ontario, Canada, to allow for future comparisons on the impacts of alcohol control policies with a number of countries. METHODS: The IAC Study questionnaire was adapted for use in the province of Ontario, and a split-sample approach was used to collect data. Data were collected by computer-assisted telephone interviewing of 500 participants, with half the sample each answering a subset of the adapted IAC Study survey. RESULTS: Just over half of the sample (53.6%) reported high frequency drinking (once a week or more frequently), while 6.5% reported heavy typical occasion drinking (8 drinks or more per session). Self-reported rates of alcohol-related harms from one's own and others' drinking were relatively low. Attitudes towards alcohol control varied. A substantial majority supported more police spot checks to detect drinking and driving, while restrictions on the number of alcohol outlets and increases in the price of alcohol were generally opposed. CONCLUSION: This pilot study demonstrated that the IAC Study survey can be implemented in Canada with some modifications. Future research should assess how to improve participation rates and the feasibility of implementing the longitudinal aspect of the IAC Study. This survey provides additional insight into alcohol-related behaviours and attitudes towards alcohol control policies, which can be used to develop appropriate public health responses in the Canadian context.

Resources to Reduce Underage Drinking Risks and Associated Harms: Social Ecological Perspectives.

Underage college student alcohol consumption results in adverse consequences for students, colleges, and communities. Unfortunately, college health practitioners have invested time and effort implementing interventions that either fail to account for the complexity of this public health problem or are not evidence-based. Consequently, in September 2015, the National Institute on Alcohol Abuse and Alcoholism published CollegeAIM, which was developed to support higher education administrators and campus health/wellness professionals in selecting appropriate interventions for reducing harmful and underage drinking. CollegeAIM is a user-friendly, matrix-based tool that evaluates and synthesizes the peer-reviewed literature associated with nearly 60 campus and community interventions. This review uses the social ecological model to highlight individual- and environmental-level strategies evaluated in CollegeAIM matrices and is intended to be a tool in determining how best to implement resources to reduce college student alcohol use and associated harms. While CollegeAIM outlines strategies to be implemented among currently enrolled college students, it is important to note drinking behaviors for some students are established prior to entering college. Thus, interventions prior to enrolling in higher education are needed. As a resource for parents and for practitioners to use and share, the "Talk. They Hear You." mobile health (mHealth) app is also discussed and recommended.

Polarization of the vaccination debate on Facebook.

BACKGROUND: Vaccine hesitancy has been recognized as a major global health threat. Having access to any type of information in social media has been suggested as a potential influence on the growth of anti-vaccination groups. Recent studies w.r.t. other topics than vaccination show that access to a wide amount of content through the Internet without intermediaries resolved into major segregation of the users in polarized groups. Users select information adhering to theirs system of beliefs and tend to ignore dissenting information. OBJECTIVES: The goal was to assess whether users' attitudes are polarized on the topic of vaccination on Facebook and how this polarization develops over time. METHODS: We perform a thorough quantitative analysis by studying the interaction of 2.6 M users with 298,018 Facebook posts over a time span of seven years and 5 months. We applied community detection algorithms to automatically detect the emergence of communities accounting for the users' activity on the pages. Also, we quantified the cohesiveness of these communities over time. RESULTS: Our findings show that the consumption of content about vaccines is dominated by the echo chamber effect and that polarization increased over the years. Well-segregated communities emerge from the users' consumption habits i.e., the majority of users consume information in favor or against vaccines, not both. CONCLUSION: The existence of echo chambers may explain why social-media campaigns that provide accurate information have limited reach and be effective only in sub-groups, even fomenting further opinion polarization. The introduction of dissenting information into a sub-group is disregarded and can produce a backfire effect, thus reinforcing the pre-existing opinions within the sub-group. Public health professionals should try to understand the contents of these echo chambers, for example by getting passively involved in such groups. Only then it will be possible to find effective ways of countering anti-vaccination thinking.

Concessionária de rodovia e estratégias de controle: o caso dos andarilhos de estrada / Concesionaria de carretera y estrategia de control: el caso de los caminantes de carretera brasileños / Highway concessionaire and control strategies: the case of brazilian highway wanderers

Resumo Os andarilhos de estrada são indivíduos que percorrem longas distância pelas rodovias do país com um saco às costas ou puxando um carrinho de mão no qual carregam todos os seus pertences, sem destino certo ou trajetos preestabelecidos. Essa pesquisa teve por finalidade analisar o tratamento dado por uma concessionária de rodovias aos andarilhos dentro de suas políticas de gestão do trânsito e fluxo de pedestres pelos acostamentos. Foi realizada uma entrevista com o profissional responsável pela administração de uma importante rodovia paulista, posicionada num dos principais corredores de transporte do país e na qual são encontrados frequentemente os andarilhos. Os resultados indicaram que as estratégias de controle utilizadas pela concessionária de rodovia incluem ações de vigilância e medidas administrativas que, sob o efeito da sanção normalizadora, supervisionam e distribuem os andarilhos nesse espaço aberto e anônimo por onde circulam as multiplicidades.

Resumen Andariegos o caminantes de carretera son individuos que caminan largas distancias por las carreteras de Brasil, sin destino o trayectos preestablecidos, con una bolsa en la espalda o tirando de un carrito de mano donde llevan todas sus pertenencias. Esta investigación tuvo por finalidad analizar el tratamiento ofrecido por una concesionaria de carretera a los caminantes según sus políticas de gestión de tránsito y flujo de pedestre por los arcenes. Fue realizada una entrevista con el profesional responsable por la administración de una importante carretera en el estado de São Paulo, situada en uno de los principales corredores de transportes del país donde esos andariegos son vistos con frecuencia. Los resultados han indicado que las estrategias de control utilizadas por la concesionaria de carretera incluyen acciones de vigilancia y medidas administrativas que, bajo el efecto de la normalización, supervisan y distribuyen los caminantes en este espacio abierto y anónimo por donde circulan las multiplicidades.

Abstract The Brazilian highway wanderers are individuals who walk long distances through the country highways with a bag on their backs or pulling a wheelbarrow in which they carry all their belongings, with no defined destination or pre-established routes. This research aimed to analyze the treatment given by a highway concessionaire to the highway wanderers within their policies of traffic management and pedestrian transit along the roadsides. An interview was conducted with a professional who is responsible for the management of an important highway in São Paulo State, located in one of the main transport walkways where highway wanderers are often seen. The results indicated that the control strategies utilized by the highway concessionaire include vigilance actions and the administrative measures that, under the normalization effects, supervise and distribute the Brazilian highway wanderers in this open and anonymous space through which multiplicities circulate.

Implementation of Policies and Strategies for Control of Noncommunicable Diseases in Malawi: Challenges and Opportunities.

Malawi is a Sub-Saharan African country experiencing the epidemiological transition from predominantly infectious to noncommunicable diseases (NCDs) with dramatically increasing prevalence of lifestyle-related diseases such as obesity, hypertension, and diabetes. Malawi's 2011-2016 Health Sector Strategic Plan included NCDs, and an NCD Control Program was established with subsequent development of a National Action Plan for prevention and management of NCDs launched in 2013. The current study was designed to identify gaps in implementation of NCD control program policies and action plan strategies by describing current efforts toward prevention and management of NCDs in Malawi with emphasis on challenges and opportunities. Semistructured questionnaires were used to collect quantitative and qualitative data from Malawi Ministry of Health personnel (senior officers, service providers, health education officers, and nutritionists) in 10 health districts and 3 central hospitals. Frequencies were generated for quantitative data. Qualitative data were used to generate themes and most common responses. Results showed that current services focus on facility-based NCD screening and clinical services rather than active screening, prevention, and community awareness and outreach, although respondents emphasized the importance of prevention, lifestyle education, and community outreach. Respondents indicated inadequate resources for NCD services including financial capital, human resources, equipment and supplies, and transportation. While Malawi has begun to address NCDs, policy and practice implications include (a) better integration of services within the existing infrastructure with emphasis on capacity building; (b) greater implementation of planned NCD activities; (c) a stronger, more comprehensive data management system; and (d) innovative funding solutions.

Tobacco control policy in the UK: blueprint for the rest of Europe?

INTRODUCTION: With male smoking prevalence at ~30% in 1998, the UK implemented stricter tobacco control policies, including a comprehensive cessation treatment programme. We evaluate their effect. METHODS: Data for the UK (excluding Northern Ireland) are applied to 'SimSmoke', a simulation model used to examine the effect of tobacco control policies over time on smoking initiation and cessation. Upon validating the model against smoking prevalence, the model is used to distinguish the effect of policies implemented between 1998 and 2009 on smoking prevalence. Using standard attribution methods, the model estimates lives saved as a result of policies. RESULTS: The model predicts smoking prevalence accurately between 1998 and 2009. A relative reduction of 23% in smoking rates over that period is attributed to tobacco control policies, mainly tax increases, smoke-free air laws, advertising restrictions and cessation treatment programmes. The model estimates that 210 000 deaths will be averted by the year 2040, as a consequence of policies implemented between 1998 and 2010. CONCLUSIONS: The results document the UK's success in reducing smoking prevalence and prolonging lives, thereby providing an example for other European nations. When Framework Convention for Tobacco Control- (FCTC) consistent policies are also implemented, the model projects that smoking prevalence will fall by another 28% with an additional 168,000 deaths averted by 2040.

A avaliação ambiental estratégica como ferramenta para avaliar políticas ambientais municipais / Strategic environmental assessment as a tool to evaluate local environmental policies

Esta pesquisa insere-se na linha de pesquisa, política, planejamento e gestão ambiental do Departamento de Saúde Ambiental da Faculdade de Saúde Pública da Universidade de São Paulo. Tem por objetivo propor um arcabouço teóricoconceitual para aplicação da avaliação ambiental estratégica para avaliar políticas ambientais municipais em fase de implementação. Partindo da constatação de que a avaliação de políticas ambientais apresenta um relativo atraso em relação a outros campos, são adotados os pressupostos de que ferramentas desenvolvidas para avaliação de políticas sociais podem ser adaptadas para avaliar políticas ambientais, mas ferramentas da área ambiental também podem contribuir para o avanço do campo de estudo. Dessa forma foi proposto um arcabouço teórico conceitual com base nos princípios norteadores da avaliação ambiental estratégica, com o uso de ferramentas de apoio originárias da AAE e do estudo de políticas públicas. Como forma de aproximar o arcabouço teórico da realidade, foi analisado o contexto da política de Gestão e Saneamento Ambiental de Santo Andre a partir do arcabouço proposto. O presente trabalho conclui que a AAE pode ser usada para avaliação de políticas ambientais municipais em fase de implementaçao ao usar as estruturas de decisão existentes.

Increasing the age for the legal purchase of tobacco in England: impacts on socio-economic disparities in youth smoking.

BACKGROUND: The minimum age for the legal purchase of tobacco increased from 16 to 18 years in England, Scotland and Wales on 1 October 2007. The authors examined the impact of this legislation on disparities in smoking behaviour and access to cigarettes among youth in England. METHODS: A multivariate logistic regression analysis was carried out adjusting for secular trends in regular smoking using data from the Smoking, Drinking and Drug Use Survey, a national survey of 11-15 year olds. The primary outcome measure was regular smoking and the predictor variables were the law increasing the minimum age for purchase and eligibility for free school meals (FSM). RESULTS: Increasing the minimum age for purchase was associated with a significant reduction in regular smoking among youth (adjusted OR 0.67; 95% CI 0.55 to 0.81, p=0.0005). This effect was not significantly different in pupils eligible for FSM compared with those that were not (adjusted OR 1.29; 95% CI 0.95 to 1.76, p=0.10 for interaction term). The percentage of pupils who stated that they found it difficult to buy cigarettes from a shop did not increase in those eligible for FSM (25.2% to 33.3%; p=0.21) but did increase significantly in others (21.2% to 36.9%; p<0.01) between 2006 and 2008. No differences in ease of purchase were found between pupils eligible for FSM and those not before or after the legislation (2006: p=0.34, 2008: p=0.55). CONCLUSIONS: Increasing the age for the legal purchase of tobacco was associated with reduced regular smoking among youth in England and appeared to have a similar impact in different socio-economic groups.

A 3ª Conferência Nacional de Saúde Bucal e as políticas públicas de saúde / The 3rd National Conference on Oral Health and public health policies

A possibilidade de representantes da comunidade participarem da formulação e controle da execução de políticas públicas de saúde é uma conquista consagrada na Constituição Brasileira, e normatizada pela Lei 8142/90. Essa participação, como exercício de poder político, é efetivada por meio das Conferências e Conselhos de Saúde. A 3ª Conferência Nacional de Saúde Bucal (3aCNSB), realizada em 2004, analisou a Política Nacional de Saúde Bucal (PNSB) e apresentou à sociedade um conjunto de 298 propostas, reunidas no Relatório Final dessa Conferência, na perspectiva de enfrentar os problemas detectados nessa área. O objetivo deste estudo foi analisar propostas resultantes da 3aCNSB, identificando a realização ou não de cada proposta, nas três esferas de gestão do Estado brasileiro. Trata-se de pesquisa qualitativa, com propósito avaliativo, expressando percepções de diferentes atores sociais, escolhidos intencionalmente, vinculados aos segmentos que compõem o denominado controle social no âmbito do SUS, ou seja, representantes de usuários, trabalhadores e gestores de saúde. Essa representação por segmento teve a finalidade de reproduzir a lógica tripartite adotada para a composição de Conselhos e Conferências de Saúde. O documento que serviu como referencial das proposições analisadas foi o Relatório Final da 3aCNSB. A coleta de dados foi realizada por meio de um questionário semi-estruturado, auto-aplicável, desenvolvido a partir do conteúdo das propostas a serem analisadas, disponibilizado aos sujeitos da pesquisa, por meio de um website (www.pesquisa3cnsb.odo.br). A coleta foi realizada entre julho de 2010 e janeiro de 2011. Os dados foram compilados, agrupados, categorizados e submetidos à análise de conteúdo. Contatou-se que, embora as conferências sejam espaços institucionalizados de participação direta da sociedade civil, há problemas, limites e restrições à incorporação das suas demandas. No caso da 3aCNSB observou-se que propostas discutidas e aprovadas no evento não vêm sendo implementadas plenamente, tanto na esfera federal quanto por parte de estados e municípios. Embora a PNSB tenha sido uma das prioridades do Ministério da Saúde desde a realização da 3aCNSB, a percepção dos atores consultados é de que, principalmente nas esferas estaduais e municipais, não houve priorização para a PNSB, nem houve aumento proporcional nos investimentos em saúde bucal.

Plan estratégico de vida 2008-2017 / Es

Promover el fortalecimiento económico, político, cultural y social de las comunidades Campesinas Indígenas Originarias, con autogestión económica productiva, capacidad de gestión y articulación organizacional, con visión cultural del Suma Qamaña, Sumay kawsay, o Teko Kavi para Vivir Bien

The role of tobacco control policies in reducing smoking and deaths in a middle income nation: results from the Thailand SimSmoke simulation model.

OBJECTIVES: With the male smoking prevalence near 60% in 1991, Thailand was one of the first Asian nations to implement strict tobacco control policies. However, the success of their efforts has not been well documented. METHODS: The role of tobacco control policies are examined using the "SimSmoke" tobacco control model. We first validated the model against survey data on smoking prevalence. We then distinguished the effect of policies implemented between 1991 and 2006 from long-term trends in smoking rates. We also estimated smoking attributable deaths and lives saved as a result of the policies. RESULTS: The model validates well against survey data. The model shows that by the year 2006, policies implemented between 1991 and 2006 had already decreased smoking prevalence by 25% compared to what it would have been in the absence of the policies. Tax increases on cigarettes and advertising bans had the largest impact, followed by media anti-smoking campaigns, clean air laws and health warnings. The model estimates that the policies saved 31 867 lives by 2006 and will have saved 319,456 lives by 2026. CONCLUSIONS: The results document the success of Thailand in reducing smoking prevalence and reducing the number of lives lost to smoking, thereby showing the potential of tobacco control policies specifically in a middle-income country. Additional improvements can be realised through higher taxes, stronger clean air policies, comprehensive cessation treatment policies, and targeted media campaigns.

Do controle social à gestão participativa: perspectivas pós-soberanas para a participação política no SUS / From the Social Control to the Participative Management: post sovereignty perspectives for political participation in the SUS

Este trabalho parte da hipótese de que discutir a participação política no SUS exige a problematização das opções e concepções que orientam sua definição como controle social, operacionalizado por meio de mecanismos de representação de interesses. Desta forma, a intenção de promover uma reflexão sobre a participação política no SUS é remetida ao cotidiano institucional, como desafio de construção de modos de gestão participativos. A proposta metodológica baseia-se em uma abordagem filosófica, que tem por objetivo delinear os conceitos e dispositivos de gestão propostos no campo da Saúde Coletiva, as inovações teóricas que ofertam ao debate sobre a gestão em saúde, tendo por marcador o tema da política. Nesse sentido, elegemos como perspectiva de análise as rupturas e os planos que constituem este campo, procurando mapear o que essa produção faz emergir como oportunidade de constituição de novas práticas sociais e dispositivos institucionais de gestão. Denominamos matrizes conceituais os dois planos filosóficos que selecionamos para estudo no campo da Saúde Coletiva, a saber, o Planejamento em Saúde e o Modelo Assistencial em Defesa da Vida. Por fim a pesquisa procura dialogar com as produções teóricas analisadas, tendo por referência a definição de política como experimentação, invenção de territórios existenciais, criação de valor inerente às implicações normativas da atividade, o que nos coloca o problema da transformação dos espaços institucionais e a produção das normas que os determinam...

This work is based on the hypothesis that discussing the political participation at the SUS requires problematization of options and concepts that guide its definition as social control, operated by mechanisms of interests’ representation. The promotion of a reflection on thepolitical participation at the SUS is referred to the institutional routine, as a challenge to build participative management modes. The methodological proposal is based on a philosophicalapproach, whose aim is to outline management concepts and devices proposed by Public Health, their theoretical innovations in the debate on healthcare management, marked by thetheme of politics. Conceptual matrixes are the two philosophical plans selected for study in the field of Public Health, i.e., Health Planning and the Assistance Model in Defense of Life. The concept of Politics adopted here is defined not in terms of (formal) equality as opposed to(social) differences, but as co-production of the reality built within the relations between Equality and Difference, as access and use of common goods, in their indefinite and open capacity to create values. Thinking about participation in these terms means to build participations as means of setting rules, and not only controlling the fulfillment and inspection of current rules. So we propose considering management as co-production of healthcare, from the publicization and reticulated articulation of the normative dimension of human activity, what means arguing the concrete production (thus local) of public politics and interventions. Among the main theoretical issues discussed here, we point out the articulation of cooperationnetworks and the construction of knowledge, technical support and devices that allow the production and legitimacy of the Health-value as common good. This perspective explains the implications we want to incorporate to the concept of participative management as a possible government post-authoritative technology...

Domestic violence in Israel: changing attitudes.

For many years, knowledge of the prevalence of violence against women in Israel was marginalized in such a way that it never figured in public discourse. Elite groups of academics and feminist activists with a Western background, together with human rights groups, delivered subversive messages that gradually infiltrated into larger circles and ultimately changed public policies. The issue is now central in public affairs. This article discusses the extent of violence against women in Israel and suggests explanations for the shift from denial to greater public awareness.

The importance of an evidence-based approach in the current Spanish policy for crime prevention / La importancia de la perspectiva basada en la evidencia en la política criminal española para la prevención del delito

This introductory paper has two objectives. On the one hand, to present the guidelines of the evidence-based perspective on crime prevention as an alternative to the usual criminal policy, which often disregards conclusions based on scientific evidence. On the other hand, to discuss the contemporary situation in Spain regarding crime prevention and particularly the role psychology develops in terms of the utility/effectiveness dichotomy. The evidence-based perspective on crime prevention is guided by the main criteria of collecting the best scientific evidence in relation to ‘what works best’ in the different areas of crime prevention. In that purpose systematic reviews and meta-analyses are strongly recommended. The Campbell Collaboration in Crime and Justice is a scientific endeavour oriented to prepare rigorous and systematic reviews of high-quality evidence about ‘what works’. Regarding crime prevention in Spain it is argued that psychology and other disciplines must make society and its rulers see that intervention based on evidence-based policy is essential for crime prevention

Este artículo introductorio tiene dos objetivos principales. En primer lugar presenta las directrices de la perspectiva basada en la evidencia acerca de la prevención del crimen como una alternativa a una política criminal que no toma en consideración los hallazgos de la comunidad científica. En segundo lugar revisa la situación actual en España respecto a la prevención del delito, a partir de la dicotomía utilidad/efectividad. La perspectiva basada en la evidencia tiene como criterio fundamental recoger la mejor evidencia científica disponible con relación a aquello que ha probado ser más efectivo en la prevención de la delincuencia, y para ello recomienda el uso de revisiones sistemáticas y de la técnica del meta-análisis. La Colaboración Campbell en Crimen y Justicia es una empresa científica que impulsa esa labor. Finalmente, con respecto a la prevención del delito en España se discute la necesidad de apoyar iniciativas basadas en esta perspectiva de la evidencia

Diretrizes nacionais para o processo de educação permanente no controle social do SUS / National Guidelines for the Permanent Education Process in SUS Social Control

A Lei n.º 8.142/90, resultado da luta pela democratização dos serviços de saúde, representou e representa uma vitória significativa. A partir deste marco legal, foram criados os Conselhos e as Conferências de Saúde como espaços vitais para o exercício do controle social do Sistema Único de Saúde (SUS). Quando conquistamos esses espaços de atuação da sociedade na lei, começou a luta para garanti-los na prática. Os Conselhos de Saúde foram constituídos para formular, fiscalizar e deliberar sobre as políticas de saúde. Para atingir esse fim, de modo articulado e efetivo, conhecer o SUS passou a ser imprescindível.

A vigilância da qualidade da água para consumo humano: desafios e perspectivas para o Sistema Unico de Saúde / Surveillance in drinking-water quality: challenges and perspectives for the Brazilian Health System

O controle da qualidade da água de consumo humano se tornou uma ação de saúde pública a partir da década de 1970, quando a portaria No 52 Bsb 77 do Ministério da Saúde instituiu a norma de potabilidade em todo o território nacional. Entretanto, a implementação de um programa de vigilância da qualidade da água só ocorreu a partir da criação do Sistema Nacional de Vigilância Ambiental em Saúde em 1999, e da publicação da portaria 1.469 em 2000. O objetivo deste artigo é discutir os desafios que se colocam para a vigilância da qualidade da água, não só como proposta racionalizadora das ações do Estado, mas como prática sanitária de vigilância em saúde que tenha como perspectiva incorporar a promoção e a proteção da saúde ao conjunto de medidas adotadas pelo SUS, atendendo ainda às seguintes diretrizes: geração de dados, análise e disseminação da informação; descentralização; intersetorialidade e participação da sociedade. O artigo está organizado de modo a descrever, a partir de uma perspectiva histórica, o processo de normatização e regulação da qualidade da água para o consumo humano, abordando os principais desafios e perspectivas da vigilância da qualidade da água no sentido da busca por ações intersetoriais e descentralizadas, abertas a uma gestão participativa voltada para o controle social.