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4.
Epidemiol Psychiatr Sci ; 29: e87, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31915090

RESUMO

Increasing numbers of young adults need continued support for their attention deficit hyperactivity disorder (ADHD) beyond the age-boundary for children's services. The sparse literature on transition in general suggests patchy provision and huge gaps in transitional care, but also that young people with ADHD and other neurodevelopmental disorders fair particularly badly. Transition in health care coincides with many other important life-transitions while the difficulties associated with ADHD may make these challenges particularly hard to cope with. Parents or other advocates therefore often need to be involved, which can present problems in adult mental health services given that they tend to be less family oriented than children's services. Importantly, young people need help negotiating the transition from passive recipient of care to active self-management, and in building relationships with the adult team.In addition to patchy provision of adult ADHD services, transition is currently hampered by poor understanding of ADHD as a long term condition and uncertain knowledge of what services are available among young people and parents as well as the clinicians working with them. Guidelines recommend, and more importantly young people want, access to psycho-social interventions as well as medication. However, available evidence suggests poor quality transitional care and adult services that are highly focused on medication.Adult ADHD services need to undergo similar development to that experienced by Child and Adolescent Mental Health Services and community paediatrics over the last few decades. While we debate the relative merits of dedicated or specialist v. generic adult mental health services, for young adults with ADHD the training, experience and availability of professionals are more important than their qualifications or setting.


Assuntos
Assistência à Saúde/organização & administração , Acesso aos Serviços de Saúde , Serviços de Saúde Mental/organização & administração , Transição para Assistência do Adulto , Adolescente , Criança , Progressão da Doença , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Cuidado Transicional , Adulto Jovem
5.
Epidemiol Psychiatr Sci ; 29: e90, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31915102

RESUMO

For young people with autism spectrum disorder (ASD), the transition from childhood to adulthood especially for those with additional mental health problems can be challenging. Increasing numbers of young people attending child and adolescent mental health services (CAMHS) have a recognised diagnosis of ASD. What are the outcomes of these young people when they are discharged from CAMHS and how best can services support their needs? In this editorial we consider the emerging literature on transition for young people with long-term conditions and in particular those with ASD. Longer term studies suggest that the outcomes for individuals with ASD across the ability range is mostly poor and that healthcare transfer has generally not been managed well, with service users often reporting a lack of appropriate types of support. Encouragingly there is an increasing awareness of the need to support young people with long-term conditions as they negotiate the many developmental tasks of transition to adulthood. However, less is known about the experiences and aspirations of autistic individuals of all abilities as they transition to adulthood. This knowledge can inform a more nuanced approach to identifying developmentally appropriate outcomes. Recent studies with cognitively able young people with ASD, highlight some features in common with young people with long-term conditions but also the importance of identifying ways to foster underlying skills and the ability of young people with ASD to develop and maintain relationships. Child-focussed and adult-orientated healthcare services need to work directly with autistic individuals and their support networks to facilitate successful engagement with services and enable adults to manage their mental health needs. There is an urgent need to investigate the implementation and effectiveness of research and clinical guideline recommendations that aim to increase wellbeing, health self-efficacy and improve the mental health outcomes for autistic adults.


Assuntos
Transtorno do Espectro Autista/terapia , Assistência à Saúde , Serviços de Saúde Mental , Transição para Assistência do Adulto , Adolescente , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Saúde Mental , Adulto Jovem
6.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(1): 84-91, 2020 Jan 06.
Artigo em Chinês | MEDLINE | ID: mdl-31914574

RESUMO

Objective: To investigate the demand and access to the cancer prevention and treatment knowledge and related factors among urban residents in China from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of general demographic characteristics, the demand and access to cancer prevention and treatment knowledge, and the influencing factors of the attitude. The Chi-square test was used to analyze the difference of the demand of the cancer prevention knowledge among different groups and the corresponding factors of the cancer prevention and treatment knowledge were analyzed by using the logistic regression model. Results: The proportion of residents who need the cancer prevention and treatment knowledge was 79.5%. The demand rate of the inducement, symptom and diagnosis methods of cancer in the occupational population was highest, about 66.8%, 71.0% and 20.8%, respectively. The demand rate of treatment methods and cost in current cancer patients was the highest, about the 45.9% and 21.9%, respectively. The top three sources to acquire the cancer prevention and treatment knowledge were "broadcast or television" (69.5%), "books, newspapers, posters or brochures" (44.7%) and "family and friends" (33.8%). The multivariate analysis showed that compared with public institution personnel/civil servants, unmarried/cohabiting/divorced/widowed and others, annual household income less than 20 000 CNY, from the eastern region, people without cancer diagnosis and people with self-assessment of cancer risk, the demand rate of cancer prevention and treatment knowledge was higher in enterprise personnel/workers, married, annual household income between 60 000 CNY and 150 000 CNY, from the central region, people with cancer and people with unclear cancer risk (all P values <0.05). Conclusion: There was a high demand for the cancer prevention and treatment knowledge among urban residents in China from 2015 to 2017. The main access to the knowledge is from the radio or television. The occupation, marital status, annual household income, residential region, health status and risk of disease were the main factors of the demand of the cancer prevention and treatment knowledge.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Acesso aos Serviços de Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Neoplasias/prevenção & controle , População Urbana , Adolescente , Adulto , China , Estudos Transversais , Humanos , Fatores Socioeconômicos , Inquéritos e Questionários , População Urbana/estatística & dados numéricos
11.
Einstein (Sao Paulo) ; 18: eGS4442, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31576910

RESUMO

OBJECTIVE: To analyze the legal demands of tiotropium bromide to treat chronic obstructive pulmonary disease. METHODS: We included secondary data from the pharmaceutical care management systems made available by the Paraná State Drug Center. RESULTS: Public interest civil action and ordinary procedures, among others, were the most common used by the patients to obtain the medicine. Two Health Centers in Paraná (Londrina and Umuarama) concentrated more than 50% of the actions. The most common specialty of physicians who prescribed (33.8%) was pulmonology. There is a small financial impact of tiotropium bromide on general costs with medicines of the Paraná State Drug Center. However, a significant individual financial impact was observed because one unit of the medicine represents 38% of the Brazilian minimum wage. CONCLUSION: Our study highlights the need of incorporating this medicine in the class of long-acting anticholinergic bronchodilator in the Brazilian public health system.


Assuntos
Broncodilatadores/economia , Medicamentos Essenciais/provisão & distribução , Necessidades e Demandas de Serviços de Saúde/legislação & jurisprudência , Função Jurisdicional , Doença Pulmonar Obstrutiva Crônica/economia , Brometo de Tiotrópio/economia , Brasil , Medicamentos Essenciais/economia , Acesso aos Serviços de Saúde/economia , Acesso aos Serviços de Saúde/legislação & jurisprudência , Acesso aos Serviços de Saúde/tendências , Necessidades e Demandas de Serviços de Saúde/economia , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Programas Nacionais de Saúde , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Estudos Retrospectivos , Estatísticas não Paramétricas , Fatores de Tempo
14.
Trab. educ. saúde ; 18(1): e0022858, 2020.
Artigo em Português | LILACS | ID: biblio-1020985

RESUMO

Resumo O objetivo foi compreender as principais necessidades e reivindicações de homens trabalhadores rurais frente a uma equipe de Atenção Primária à Saúde, Japonvar, MG, Brasil. Trata-se de um estudo qualitativo, guiado pela abordagem hermenêutica-dialética. Foram realizadas 41 entrevistas em profundidade, registros em diário de campo e coleta de dados secundários. Na análise, utilizamos os níveis de interpretação, permitindo a construção de duas categorias temáticas para as necessidades de saúde: 'aumento no fornecimento de medicamentos' e 'acesso a exames especializados e específicos para a próstata'. Também foram desenvolvidas duas categorias para as reivindicações sociais: 'reconhecimento como usuários do serviço de saúde' e 'grupos de educação em saúde com temáticas masculinas'. A discussão foi alicerçada nos atributos da Atenção Primária à Saúde e na Teoria dos Marcadores Sociais e Interseccionalidades. O estudo possibilitou compreender o processo produtivo, conhecer as características clínico-epidemiológicas e discutir a invisibilidade dos trabalhadores rurais na procura e acesso aos serviços de saúde. Observamos uma valorização do modelo assistencial curativista e a contribuição positiva das reivindicações dos homens para o fortalecimento dos movimentos de luta pelo direito social à saúde.


Abstract The aim was to understand the main needs and demands of male rural workers regarding a Primary Health Care team in Southeastern Brazil. It is a qualitative study, which was guided by the hermeneutic-dialectical approach. We conducted 41 in-depth interviews, recorded notes on field journals, and collected secondary data. In the analysis, we used the levels of interpretation, which enabled the development of two thematic categories for the health needs: "increase in the supply of medicines" and "access to specialized and specific prostate exams." We also developed two categories for the social demands: "acknowledgment as users of the health service" and "education in health groups dealing with male issues." The discussion was based on the attributes of Primary Health Care and on the Social Markers and Intersectionality Theory. The study enabled us to comprehend the production process, to get to know the clinical-epidemiological characteristics, and to discuss the invisibility of the rural workers in the demand for and access to health services. We observed a high regard for the curative care model, and the positive contribution of the demand of the men to the strengthening of the movements of struggle for the right to social health.


Resumen El objetivo fue comprender las principales necesidades y reclamaciones de los trabajadores rurales ante un equipo de Atención Primaria de Salud en sudeste de Brasil. Se trata de un estudio cualitativo, guiado por el enfoque hermenéutico-dialéctico. Se realizaron 41 entrevistas en profundidad, registros diarios de campo y recopilación de datos secundarios. En el análisis se utilizaron los niveles de interpretación, permitiendo la construcción de dos categorías temáticas para las necesidades de salud: "aumento del suministro de medicamentos" y "acceso a exámenes especializados y específicos de próstata". También se desarrollaron dos categorías para reivindicaciones sociales: "reconocimiento como usuarios del servicio de salud" y "grupos de educación sanitaria con temas masculinos". La discusión se basó en los atributos de la Atención Primaria de Salud y en la Teoría de Marcadores Sociales e Interseccionalidades. El estudio permitió comprender el proceso productivo, conocer las características clínicas y epidemiológicas y discutir la invisibilidad de los trabajadores rurales en la búsqueda y acceso a los servicios de salud. Observamos una apreciación del modelo de medicina curativa y la contribución positiva de las reivindicaciones de los hombres para fortalecer los movimientos que luchan por el derecho social a la salud.


Assuntos
Humanos , Atenção Primária à Saúde , População Rural , Saúde do Homem , Necessidades e Demandas de Serviços de Saúde
15.
Am J Orthod Dentofacial Orthop ; 156(6): 818-822, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31784015

RESUMO

INTRODUCTION: This study aimed to explore the perception of orthodontic treatment need by using the Dental Aesthetic Index (DAI) and the Index of Orthodontic Treatment Need (IOTN). METHODS: A cross-sectional study was conducted on a representative random sample (N = 248) of adolescents aged 12 years. The DAI and both components of IOTN were used to evaluate malocclusion. The association between the Dental Health Component of the IOTN with gender and ethnic group were analyzed by chi-square test. The concordances between the indexes were analyzed by the kappa statistic, with 95% confidence intervals (CIs). RESULTS: The prevalence of adolescents with high severity and orthodontic treatment need was 10.5% (95% CI, 6.7-14.3), 36.5% (95% CI, 32.3-44.3), and 73.4% (95% CI, 67.9-78.9) for the Aesthetic Component of the IOTN, Dental Health Component of the IOTN, and DAI, respectively. The indexes showed high agreement for the cases with low treatment need, whereas low concordance was observed for the cases with high treatment need. CONCLUSIONS: The perception of orthodontic treatment need was assessed differently using DAI and IOTN.


Assuntos
Estética Dentária , Índice de Necessidade de Tratamento Ortodôntico , Má Oclusão , Criança , Estudos Transversais , Necessidades e Demandas de Serviços de Saúde , Humanos
17.
Lakartidningen ; 1162019 Nov 28.
Artigo em Sueco | MEDLINE | ID: mdl-31794047

RESUMO

The platform for priority-setting contains key ideas about the mission, goals and values of health care in Sweden. The basic idea is that health care resources should be distributed primarily according to need and effect, and secondarily according to cost-effectiveness. Nobody should be discriminated against on the basis of their gender, age, religion, ethnic origin or political views. We also need to distinguish between the health-related needs that we, as a society, have agreed should be met by publicly funded health care and needs for which there is no such agreement. The mission of health care can, and ought to, remain unchanged, even if, or as, this classification changes. The platform should not be abandoned, since it helps to maintain trust in our publicly financed health care system.


Assuntos
Alocação de Recursos para a Atenção à Saúde/organização & administração , Prioridades em Saúde/organização & administração , Necessidades e Demandas de Serviços de Saúde , Recursos em Saúde , Humanos , Alocação de Recursos , Medicina Estatal , Suécia
18.
Nihon Koshu Eisei Zasshi ; 66(12): 767-777, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31875627

RESUMO

Objectives The aim of this study is to report on the health status of residents in supportive housing in urban areas of Japan, and to explore the differences in health conditions across different age groups within this population.Methods The participants were 341 residents who had newly been admitted to supportive housing managed by a nonprofit organization. We examined their admission records and documented their health conditions. Differences in health conditions across age groups were also explored.Results More than 90 percent of the participants were single men, aged 40 or older, and living on welfare. The main reasons for their utilization of supportive housing were the lack of accommodation after leaving a hospital or facility, decrease in physical function, and progression of dementia. A high proportion of participants under 40 years had an addiction problem, schizophrenia, intellectual disorders, or developmental disorders. Participants aged 40-59 years had high rates of lifestyle-related diseases in addition to mental illnesses. Furthermore, for those aged 60 years and older, the prevalence of geriatric syndromes such as dementia, hearing impairment, and visual impairment was high. Additionally, there was a high proportion of elderly participants whose health status was unknown when they were admitted to supportive housing.Conclusion Most residents who had been admitted to supportive housing in the urban areas of Japan had physical or mental illnesses, and their life and support needs varied by age group. These findings suggest that it may be necessary for residents living in urban supportive housing in Japan to receive not only increased medical and psychological care but also age group-specific care.


Assuntos
Planejamento de Cidades , Necessidades e Demandas de Serviços de Saúde , Nível de Saúde , Pobreza , Habitação Popular , Seguridade Social , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Japão , Estilo de Vida , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Sistemas de Apoio Psicossocial , Fatores Sexuais , Adulto Jovem
19.
Epidemiol Health ; 41: e2019046, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31778605

RESUMO

OBJECTIVES: Access to dental healthcare services is a major determinant of dental health in communities. This meta-analysis was conducted to estimate the global prevalence of dental needs and of unmet dental needs in adolescents. METHODS: PubMed, Web of Science, and Scopus were searched in June 2018. The summary measures included the prevalence of met and unmet dental needs. A meta-analysis was performed using the inverse variance method to obtain pooled summary measures. Out of 41,661 retrieved articles, 57 were ultimately included. RESULTS: The pooled prevalence of orthodontic treatment needs was 46.0% (95% confidence interval [CI], 38.0 to 53.0), that of general treatment needs was 59.0% (95% CI, 42.0 to 75.0), that of periodontal treatment needs was 71.0% (95% CI, 46.0 to 96.0), and that of malocclusion treatment needs was 39.0% (95% CI, 28.0 to 50.0). The pooled prevalence of unmet dental needs was 34.0% (95% CI, 27.0 to 40.0). CONCLUSIONS: The highest and lowest prevalence of unmet dental needs were found in Southeast Asia and Europe, respectively. The prevalence of dental needs was higher in the countries of the Americas and Europe than in other World Health Organization (WHO) regions. The prevalence of unmet dental needs was higher in Southeast Asia and Africa than in other WHO regions.


Assuntos
Assistência Odontológica , Saúde Global , Necessidades e Demandas de Serviços de Saúde , Adolescente , Humanos , Prevalência
20.
Afr J Reprod Health ; 23(3): 106-119, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31782636

RESUMO

Unmet need for contraception remains a challenge especially in low and middle-income countries. Community participation or the -active involvement of affected populations in all stages of decision-making and implementation of policies, programs, and services‖ is a precondition for attaining the highest standard of health. Participation as a key component of rights and quality of care frameworks could increase met needs. However, it has been inadequately addressed in contraceptive programs. A qualitative, exploratory methodology that included focus group discussions and in-depth interviews with community members, healthcare providers, and other stakeholders were conducted to identify domains or key thematic areas of action through which stakeholders could be engaged. The study conducted in Kenya, South Africa, and Zambia explored knowledge and use of contraceptives, barriers and enablers to access, quality of care, and participatory practices. Thematic analysis was used, facilitated by NVivo (version 10 QSR International) with a single master codebook. Comparing the thematic areas that emerged from the county data, four domains were selected: quality of care, informed decision-making, acceptability, and accountability. These domains informed the theory of change of a participatory programme aiming to meet unmet needs. Identifying possible generalizable domains establishes measurable and comparable intermediate outcomes for participatory programs despite diverse African contexts.


Assuntos
Participação da Comunidade , Anticoncepção , Serviços de Planejamento Familiar/estatística & dados numéricos , Pessoal de Saúde , Determinação de Necessidades de Cuidados de Saúde , Anticoncepção/métodos , Grupos Focais , Necessidades e Demandas de Serviços de Saúde , Humanos , Entrevistas como Assunto , Quênia , Pesquisa Qualitativa , África do Sul , Zâmbia
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