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1.
Cardiovasc J Afr ; 31(2): 103-110, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33094797

RESUMO

Data collected by PASCAR for the World Heart Federation's Cardiovascular Diseases Scorecard project in Africa are presented. We summarise the strengths, threats, weaknesses and priorities identified from the collected data, which need to be considered in conjunction with the associated sections in the accompanying infographic. Data sets that were used include open-source data from the World Bank, World Health Organization and government publications.


Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Serviços Preventivos de Saúde/organização & administração , Adolescente , Adulto , Idoso , Camarões/epidemiologia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/mortalidade , Comorbidade , Prestação Integrada de Cuidados de Saúde/organização & administração , Feminino , Acesso aos Serviços de Saúde/organização & administração , Nível de Saúde , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Formulação de Políticas , Prevalência , Prognóstico , Medição de Risco , Fatores de Risco , Determinantes Sociais da Saúde , Participação dos Interessados , Adulto Jovem
2.
Can Fam Physician ; 66(10): 745-747, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33077454
3.
Soins ; 65(846): 43-44, 2020 Jun.
Artigo em Francês | MEDLINE | ID: mdl-33012419

RESUMO

Prevention is at the heart of the government's national health strategy. The health service is the centrepiece of this policy. Since autumn 2018, this has allowed health students to develop and implemente prevention actions in their regions. Nursing students were some of the first to commit to this.


Assuntos
Promoção da Saúde/métodos , Serviços Preventivos de Saúde/organização & administração , Estudantes de Enfermagem/psicologia , Política de Saúde , Humanos
6.
Sante Publique ; 32(1): 103-111, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32985967

RESUMO

BACKGROUND: Outreach HIV testing strategies have significantly contributed to the increase in the number of people knowing their HIV status in sub-Saharan Africa. This article analyzes the articulation of donor and field constraints on the implementation of outreach HIV testing strategies in Côte d’Ivoire. METHODS: Qualitative research was conducted in three health districts (Man, Cocody-Bingerville and Aboisso) in Côte d’Ivoire in 2015-2016, through in-depth interviews with community providers, local leaders and people tested and through observation of outreach HIV testing activities. RESULTS: Implementing organizations feel “under pressure” to meet donors’ objectives that are deemed unattainable, as well as the lack of training and funding. As a result, providers do not observe systematically the rules of the “three Cs” (counselling, informed consent, confidentiality), and propose testing to individuals who are “off-target” (in terms of locations and populations). DISCUSSION: Implementing NGOs experience two types of constraints those resulting from the functioning of international aid (inadequate funding compared to actual costs, objectives too high, the important chain of intermediaries) and those related to the local context (spaces not adapted to guarantee confidentiality and the professional activity of target populations). CONCLUSION: The pressure that is exerted at different levels on implementing NGOs is detrimental to the quality of HIV testing. It is now essential to develop a more qualitative approach in defining strategies and evaluation criteria.


Assuntos
Agentes Comunitários de Saúde , Aconselhamento , Infecções por HIV/diagnóstico , Programas de Rastreamento/métodos , Serviços Preventivos de Saúde/organização & administração , Fortalecimento Institucional , Costa do Marfim , Infecções por HIV/prevenção & controle , Humanos , Entrevistas como Assunto , Pesquisa Qualitativa
7.
Sensors (Basel) ; 20(17)2020 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-32887338

RESUMO

COVID-19 has shown a relatively low case fatality rate in young healthy individuals, with the majority of this group being asymptomatic or having mild symptoms. However, the severity of the disease among the elderly as well as in individuals with underlying health conditions has caused significant mortality rates worldwide. Understanding this variance amongst different sectors of society and modelling this will enable the different levels of risk to be determined to enable strategies to be applied to different groups. Long-established compartmental epidemiological models like SIR and SEIR do not account for the variability encountered in the severity of the SARS-CoV-2 disease across different population groups. The objective of this study is to investigate how a reduction in the exposure of vulnerable individuals to COVID-19 can minimise the number of deaths caused by the disease, using the UK as a case study. To overcome the limitation of long-established compartmental epidemiological models, it is proposed that a modified model, namely SEIR-v, through which the population is separated into two groups regarding their vulnerability to SARS-CoV-2 is applied. This enables the analysis of the spread of the epidemic when different contention measures are applied to different groups in society regarding their vulnerability to the disease. A Monte Carlo simulation (100,000 runs) along the proposed SEIR-v model is used to study the number of deaths which could be avoided as a function of the decrease in the exposure of vulnerable individuals to the disease. The results indicate a large number of deaths could be avoided by a slight realistic decrease in the exposure of vulnerable groups to the disease. The mean values across the simulations indicate 3681 and 7460 lives could be saved when such exposure is reduced by 10% and 20% respectively. From the encouraging results of the modelling a number of mechanisms are proposed to limit the exposure of vulnerable individuals to the disease. One option could be the provision of a wristband to vulnerable people and those without a smartphone and contact-tracing app, filling the gap created by systems relying on smartphone apps only. By combining very dense contact tracing data from smartphone apps and wristband signals with information about infection status and symptoms, vulnerable people can be protected and kept safer.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Transmissão de Doença Infecciosa/estatística & dados numéricos , Modelos Teóricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Saúde Pública/métodos , Quarentena/organização & administração , Populações Vulneráveis , Busca de Comunicante/métodos , Infecções por Coronavirus/epidemiologia , Surtos de Doenças/prevenção & controle , Diretrizes para o Planejamento em Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Controle de Infecções/estatística & dados numéricos , Invenções/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/organização & administração , Serviços Preventivos de Saúde/normas , Saúde Pública/estatística & dados numéricos , Administração em Saúde Pública/métodos , Quarentena/métodos , Quarentena/estatística & dados numéricos , Reino Unido/epidemiologia , Populações Vulneráveis/estatística & dados numéricos
8.
Acta Med Indones ; 52(2): 99-101, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32778622

RESUMO

The year of 2020 teaches us to prevent is always better than to cure. It is an old phrase that is being used for decades, but it is never been implemented cordially by our society nowadays. Covid-19 is a good lesson that reminds us to carefully prevent the spread of coronavirus which is now a pandemic worldwide. People now wash their hands more often and clean, wear a mask everywhere - everytime, do physical distancing, do healthy lifestyle such as physical activity, healthy diet, and consume multivitamins. They obey the cough and sneeze etiquette. Prevention awareness is never been such popular like todays.For internal medicine specialist, the role for prevention is very broad. Besides we still have a role in primary prevention, we can take our part in both secondary and (of course) tertiary prevention. Primary prevention can be defined as an action not allow a disease to occur, for examples vaccination (for internal medicine specialist more specific as adult vaccination), smoking cessation, physical activity (exercise) and healthy diet. Health promotion and prevention is the core of primary prevention. Secondary prevention aims to detect the disease as early as possible, in at risk population, such as mammography for breast cancer, swab test for Covid-19, colonoscopy for colon cancer in high risk patients. Last, tertiary prevention propose to hamper the progress of clinical disease and prevent more severe complications of the disease, for examples cardiac rehabilitation, or medications for prevent chronic kidney disease in patients with diabetes or hypertension. It is overlapping the curative or treatment strategies as it is states "to cure is to prevent". In 2020, in which each underlying conditions require effective treatment and each disease should be prevented. We are now facing the era of preventive medicine. As an internal medicine specialist, we need to put in mind a philosophy of prevention in every of our action towards patient's care and services.


Assuntos
Controle de Doenças Transmissíveis , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Serviços Preventivos de Saúde , Betacoronavirus , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Comportamentos Relacionados com a Saúde , Promoção da Saúde , Humanos , Indonésia/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/organização & administração , Saúde Pública/tendências
9.
Epidemiol Psychiatr Sci ; 29: e150, 2020 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-32744223

RESUMO

Recently, mental health and ill health have been reframed to be seen as a continuum from health to ill health, through the stages of being asymptomatic 'at risk', to experiencing 'mental distress', 'sub-syndromal symptoms' and finally 'mental disorders'. This new conceptualisation emphasised the importance of mental health promotion and prevention interventions, aimed at reducing the likelihood of future disorders with the general population or with people who are identified as being at risk of a disorder. This concept generated discussion on the distinction between prevention and treatment interventions, especially for those mental health conditions which lie between psychological distress and a formal psychiatric diagnosis. The present editorial aims to clarify the definition of promotion, prevention and treatment interventions delivered through a task-shifting approach according to a global mental health perspective.


Assuntos
Antidepressivos/uso terapêutico , Transtornos Mentais/terapia , Serviços Preventivos de Saúde/estatística & dados numéricos , Psicoterapia Breve/estatística & dados numéricos , Feminino , Humanos , Renda , Masculino , Transtornos Mentais/prevenção & controle , Serviços de Saúde Mental/economia , Serviços de Saúde Mental/estatística & dados numéricos , Serviços Preventivos de Saúde/organização & administração
10.
PLoS One ; 15(8): e0237720, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32834011

RESUMO

BACKGROUND: Underweight, overweight, and obesity are major public health challenges among reproductive-age women of lower- and middle-income countries (including Tanzania). In those settings, obesogenic factors (attributes that promote excessive body weight gain) are increasing in the context of an existing high burden of undernutrition. The present study investigated factors associated with underweight, overweight, and obesity among reproductive age women in Tanzania. METHODS: This study used 2015-16 Tanzania Demographic and Health Survey data (n = 11735). To account for the hierarchical nature of the data (i.e., reproductive age women nested within clusters), multilevel multinomial logistic regression models were used to investigate the association between individual-level (socioeconomic, demographic and behavioural) and community-level factors with underweight, overweight, and obesity. RESULTS: Reproductive age women who were informally employed (relative risk ratio [RRR] = 0.79; 95% confidence interval [CI]: 0.64, 0.96), those who were currently married (RRR = 0.59; 95% CI: 0.43, 0.82) and those who used contraceptives (RRR = 0.70; 95% CI: 0.54, 0.90) were less likely to be underweight. Reproductive age women who attained secondary or higher education (RRR = 1.48; 95% CI: 1.11, 1.96), those who resided in wealthier households (RRR = 2.31; 95% CI: 1.78, 3.03) and those who watched the television (RRR = 1.26; 95% CI: 1.06, 1.50) were more likely to be overweight. The risk of experiencing obesity was higher among reproductive age women who attained secondary or higher education (RRR = 1.79; 95% CI: 1.23, 2.61), those who were formally employed (RRR = 1.50; 95% CI: 1.14, 1.98), those who resided in wealthier households (RRR = 4.77; 95% CI: 3.03, 7.50), those who used alcohol (RRR = 1.43; 95% CI: 1.12, 1.82) and/or watched the television (RRR = 1.70; 95% CI: 1.35, 2.13). CONCLUSION: Our study suggests that relevant government jurisdictions need to identify, promote, and implement evidence-based interventions that can simultaneously address underweight and overweight/obesity among reproductive age women in Tanzania.


Assuntos
Necessidades e Demandas de Serviços de Saúde/organização & administração , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Saúde Reprodutiva/estatística & dados numéricos , Magreza/epidemiologia , Adolescente , Adulto , Estudos Transversais , Medicina Baseada em Evidências/organização & administração , Medicina Baseada em Evidências/estatística & dados numéricos , Feminino , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Estado Nutricional/fisiologia , Obesidade/fisiopatologia , Obesidade/prevenção & controle , Sobrepeso/fisiopatologia , Sobrepeso/prevenção & controle , Prevalência , Serviços Preventivos de Saúde/organização & administração , Serviços Preventivos de Saúde/estatística & dados numéricos , Reprodução/fisiologia , Fatores de Risco , Fatores Socioeconômicos , Tanzânia/epidemiologia , Magreza/fisiopatologia , Magreza/prevenção & controle , Adulto Jovem
11.
BMC Med ; 18(1): 239, 2020 07 30.
Artigo em Inglês | MEDLINE | ID: mdl-32727467

RESUMO

BACKGROUND: The COVID-19 pandemic has resulted in millions of infections, hundreds of thousands of deaths and major societal disruption due to lockdowns and other restrictions introduced to limit disease spread. Relatively little attention has been paid to understanding how the pandemic has affected treatment, prevention and control of malaria, which is a major cause of death and disease and predominantly affects people in less well-resourced settings. MAIN BODY: Recent successes in malaria control and elimination have reduced the global malaria burden, but these gains are fragile and progress has stalled in the past 5 years. Withdrawing successful interventions often results in rapid malaria resurgence, primarily threatening vulnerable young children and pregnant women. Malaria programmes are being affected in many ways by COVID-19. For prevention of malaria, insecticide-treated nets need regular renewal, but distribution campaigns have been delayed or cancelled. For detection and treatment of malaria, individuals may stop attending health facilities, out of fear of exposure to COVID-19, or because they cannot afford transport, and health care workers require additional resources to protect themselves from COVID-19. Supplies of diagnostics and drugs are being interrupted, which is compounded by production of substandard and falsified medicines and diagnostics. These disruptions are predicted to double the number of young African children dying of malaria in the coming year and may impact efforts to control the spread of drug resistance. Using examples from successful malaria control and elimination campaigns, we propose strategies to re-establish malaria control activities and maintain elimination efforts in the context of the COVID-19 pandemic, which is likely to be a long-term challenge. All sectors of society, including governments, donors, private sector and civil society organisations, have crucial roles to play to prevent malaria resurgence. Sparse resources must be allocated efficiently to ensure integrated health care systems that can sustain control activities against COVID-19 as well as malaria and other priority infectious diseases. CONCLUSION: As we deal with the COVID-19 pandemic, it is crucial that other major killers such as malaria are not ignored. History tells us that if we do, the consequences will be dire, particularly in vulnerable populations.


Assuntos
Betacoronavirus , Planejamento em Saúde Comunitária/organização & administração , Infecções por Coronavirus/prevenção & controle , Malária/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adulto , Criança , Comorbidade , Infecções por Coronavirus/epidemiologia , Resistência a Medicamentos , Feminino , Humanos , Malária/epidemiologia , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Gravidez , Serviços Preventivos de Saúde/organização & administração , Adulto Jovem
12.
Curr Res Transl Med ; 68(3): 111-118, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32620465

RESUMO

The pandemic of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spreading rapidly across the world. Currently, the COVID-19 pandemic is affecting the continuity of essential routine healthcare services and procedures, including chimeric antigen receptor T-cell (CAR-T) therapy, a life-saving option for patients with relapsed/refractory (R/R) hematologic malignancies. Due to the rapid disease progression of hematological malignancies, there is an urgent need to manufacture and utilize CAR T-cells. However, CAR-T treatment has become extraordinarily challenging during this COVID-19 pandemic. Thus, many medical and technical factors must now be taken into consideration before, during, and after CAR-T therapy. The purpose of this review is to provide brief suggestions for rational decision-making strategies in evaluating and selecting CAR T-cell treatment and appropriate CAR T-cell products, and protective strategies for medical staff and patients to prevent infection in the midst of the current COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/prevenção & controle , Assistência à Saúde/organização & administração , Neoplasias Hematológicas/terapia , Imunoterapia Adotiva , Controle de Infecções/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Receptores de Antígenos de Linfócitos T/imunologia , Betacoronavirus/fisiologia , Infecções por Coronavirus/epidemiologia , Assistência à Saúde/métodos , Assistência à Saúde/normas , Assistência à Saúde/tendências , Neoplasias Hematológicas/epidemiologia , Humanos , Imunoterapia Adotiva/métodos , Imunoterapia Adotiva/tendências , Controle de Infecções/métodos , Controle de Infecções/normas , Controle de Infecções/tendências , Pneumonia Viral/epidemiologia , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/organização & administração , Serviços Preventivos de Saúde/normas , Serviços Preventivos de Saúde/tendências
14.
ABCS health sci ; 45: [1-7], 02 jun 2020. ilus
Artigo em Inglês | LILACS | ID: biblio-1097549

RESUMO

INTRODUCTION: The practice of physical activity provides benefits to health and, consequently, to people´s quality of life, helping to promote health and prevent disease. OBJECTIVE: To understand the perception of users about the community center for physical activity with emphasis on the structure, operation and professional support in practices for health promotion. METHODS: This is an exploratory qualitative study. The loci of the study were two community centers for physical activity from different cities, one of them participating in a health promotion program (Programa Academia da Saúde - PAS). The sample consisted of 15 participants, 10 from the center included in the PAS program and 5 from the other. Data were collected through semistructured interviews and synthesized through thematic analysis. RESULTS: Disagreements were observed in relation to the statements of the participants about the two community centers. It was evidenced the absence of qualified professionals for assistance to exercise and for providing the necessary orientations regarding the practice of activities. It was also noted that the distance between the residence and the center can be a potential incentive or discouragement. The location of centers distant from homes are obstacles for the population to routinely adhere to physical activities. CONCLUSION: Prevailed among the interviewees' dissatisfaction about the organization and operation of the community centers for physical activity.


INTRODUÇÃO: A realização da prática de atividade física proporciona benefícios para a saúde e, consequentemente, para a qualidade de vida das pessoas, auxiliando na promoção da saúde e na prevenção de doenças. OBJETIVO: Compreender a percepção dos usuários acerca dos polos de atividade física com ênfase na estrutura, funcionamento e suporte profissional nas práticas de promoção da saúde. MÉTODOS: Trata-se de uma pesquisa exploratória de abordagem qualitativa. Os loci do estudo envolveram dois polos comunitários de atividade física, sendo um deles do Programa Academia da Saúde (PAS), em distintos municípios. A amostra contou com 15 participantes, sendo 5 de um polo e 10 do outro ao qual funciona o PAS. Os dados foram coletados através da entrevista semiestruturada e sintetizados por meio de análise temática. RESULTADOS: Observaram-se divergências em relação às falas da população sobre o polo comunitário de atividade física e sobre o polo do Programa Academia da Saúde. Foi evidenciada a ausência de profissionais para auxiliar nas práticas dos exercícios e para realizar orientações necessárias concernentes à prática da atividade. Registrou-se também que a distância entre a residência e o polo pode ser potencial incentivador ou desestimulador, uma vez que a localização dos polos distantes das residências dificulta a adesão rotineira da população à prática de atividades físicas. CONCLUSÃO: Prevalece entre os entrevistados a insatisfação sobre a organização e funcionamento dos polos comunitários de atividade física.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Serviços Preventivos de Saúde/organização & administração , Atenção Primária à Saúde , Exercício Físico , Promoção da Saúde , Qualidade de Vida
16.
Clin Interv Aging ; 15: 239-253, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32110003

RESUMO

Objective: This qualitative study embedded within a randomized controlled trial was conducted to explore the acceptability, experiences of, and short-term impact of a preventive health intervention (Lifestyle Matters) from the perspectives of those who took part, and to uncover any evidence for the theorised mechanisms of action (improved participation and self efficacy) underpinning the intervention. It was also conducted to help explain the quantitative trial results. Methods: A purposive sample of 13 trial participants who had been randomized to receive the Lifestyle Matters intervention (approximately 10%) were individually qualitatively interviewed immediately following their involvement. All four intervention facilitators were also individually interviewed. Results: Evidence of the hypothesized behavioural changes could be identified within the interview data, demonstrating the potential of this intervention. However, lack of adherence to the overall intervention eroded receipt of benefit. This finding complements the quantitative trial results which found that the study had failed to recruit those who considered themselves to be at risk of age-related decline. Conclusion: This form of preventive health intervention requires proactive identification of those who recognise the need to make lifestyle changes. This is difficult if reactive health and social care systems are the main referral routes. The methodological approaches taken towards the study of complex interventions requires reconsideration if potential benefits are to be accurately assessed. Clinical Trial Registration: ISRCTN67209155.


Assuntos
Comportamentos Relacionados com a Saúde , Promoção da Saúde/organização & administração , Estilo de Vida , Serviços Preventivos de Saúde/organização & administração , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde , Pesquisa Qualitativa , Autoeficácia
17.
Prog Cardiovasc Dis ; 63(2): 101-108, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32109483

RESUMO

Cardiovascular disease (CVD) is an increasingly important cause of morbidity and mortality among people living with HIV (PLWH) now that HIV is a manageable chronic disease. Identification and treatment of comorbid medical conditions for PLWH, including CVD and its risk factors, typically lack a critical component of care: integrated care for histories of trauma. Experiences of trauma are associated with increased HIV infection, CVD risk, inconsistent treatment adherence, and poor CVD outcomes. To address this deficit among those at greatest risk and disproportionately affected by HIV and trauma-i.e., Black and Latinx individuals-a novel culturally-congruent, evidence-informed care model, "Healing our Hearts, Minds and Bodies" (HHMB), has been designed to address patients' trauma histories and barriers to care, and to prepare patients to engage in CVD risk reduction. Further, in recognition of the need to ensure that PLWH receive guideline-concordant cardiovascular care, implementation strategies have been identified that prepare providers and clinics to address CVD risk among their Black and Latinx PLWH. The focus of this paper is to describe the hybrid Type 2 effectiveness/implementation study design, the goal of which is to increase both patient and organizational readiness to address trauma and CVD risk among 260 Black and Latinx PLWH recruited from two HIV service organizations in Southern California. This study is expected to produce important information regarding the value of the HHMB intervention and implementation processes and strategies designed for use in implementing HHMB and other evidence-informed programs in diverse, resource-constrained treatment settings, including those that serve patients living in deep poverty. Clinical trials registry: NCT04025463.


Assuntos
Afro-Americanos/psicologia , Fármacos Anti-HIV/uso terapêutico , Doenças Cardiovasculares/prevenção & controle , Assistência à Saúde Culturalmente Competente/organização & administração , Infecções por HIV/tratamento farmacológico , Sobreviventes de Longo Prazo ao HIV/psicologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Hispano-Americanos/psicologia , Saúde Mental/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Serviços Preventivos de Saúde/organização & administração , Adolescente , Adulto , Idoso , Fármacos Anti-HIV/efeitos adversos , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/psicologia , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/etnologia , Infecções por HIV/psicologia , Nível de Saúde , Humanos , Los Angeles/epidemiologia , Masculino , Pessoa de Meia-Idade , Modelos Organizacionais , Fatores de Proteção , Fatores Raciais , Projetos de Pesquisa , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Carga Viral , Adulto Jovem
19.
BMC Womens Health ; 20(1): 7, 2020 01 16.
Artigo em Inglês | MEDLINE | ID: mdl-31948429

RESUMO

BACKGROUND: Young women in sub-Saharan Africa remain at the epicentre of the HIV epidemic, with surveillance data indicating persistent high levels of HIV incidence. In South Africa, adolescent girls and young women (AGYW) account for a quarter of all new HIV infections. Determined, Resilient, Empowered, AIDS-free, Mentored and Safe (DREAMS) is a strategy introduced by the United States President's Emergency Plan for AIDS Relief (PEPFAR) aimed at reducing HIV incidence among AGYW in 10 countries in sub-Saharan Africa by 25% in the programme's first year, and by 40% in the second year. This study will assess the change in HIV incidence and reduction in risk associated behaviours that can be attributed to the DREAMS initiative in South Africa, using a population-based cross-sectional survey. METHODS: Data will be collected from a household-based representative sample of AGYW (between the ages 12-24 years) in four high prevalence districts (more than 10% of the population have HIV in these districts) in South Africa in which DREAMS has been implemented. A stratified cluster-based sampling approach will be used to select eligible participants for a cross-sectional survey with 18,500, to be conducted over 2017/2018. A questionnaire will be administered containing questions on sexual risk behaviour, selected academic and developmental milestones, prevalence of gender based violence, whilst examining exposure to DREAMS programmes. Biological samples, including two micro-containers of blood and self-collected vulvovaginal swab samples, are collected in each survey to test for HIV infection, HIV incidence, sexually transmitted infections (STIs) and pregnancy. This study will measure trends in population level HIV incidence using the Limiting antigen (LAg) Avidity Enzyme Immuno-Assay (EIA) and monitor changes in HIV incidence. DISCUSSION: Ending the HIV/AIDS pandemic by 2030 requires the continual monitoring and evaluation of prevention programmes, with the aim of optimising efforts and ensuring the achievement of epidemic control. This study will determine the impact DREAMS interventions have had on HIV incidence among AGYW in a 'real world, non-trial setting'.


Assuntos
Infecções por HIV , Serviços Preventivos de Saúde , Comportamento de Redução do Risco , Comportamento Sexual , Adolescente , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Infecções por HIV/psicologia , Humanos , Incidência , Estudos Longitudinais , Prevalência , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/organização & administração , África do Sul/epidemiologia , Adulto Jovem
20.
Ann Intern Med ; 172(4): 272-278, 2020 02 18.
Artigo em Inglês | MEDLINE | ID: mdl-31931530

RESUMO

Expert groups, including the U.S. Preventive Services Task Force (USPSTF), recommend a range of clinical preventive services for persons at average risk for disease. Use of these services often is substantially lower among racial and ethnic minority groups, rural residents, and persons of lower socioeconomic status. On 19 and 20 June 2019, the National Institutes of Health (NIH) convened the Pathways to Prevention Workshop: Achieving Health Equity in Preventive Services to assess the available evidence on disparities in the use of 10 USPSTF-recommended clinical preventive services for cancer, heart disease, and diabetes. The workshop was cosponsored by the NIH Office of Disease Prevention; National Institute on Minority Health and Health Disparities; National Cancer Institute; National Heart, Lung, and Blood Institute; and National Institute of Diabetes and Digestive and Kidney Diseases. A multidisciplinary working group developed the agenda, and an Evidence-based Practice Center prepared the evidence report. During the workshop, invited experts considered the evidence, with discussion among attendees. After weighing evidence from the review, presentations, and public comments, an independent panel prepared a draft report that was posted for public comment. This final report summarizes the panel's findings, identifying current gaps in knowledge. The panel made 26 recommendations for new research and methods development to improve implementation of proven services to reduce disparities in preventable conditions.


Assuntos
Equidade em Saúde , National Institutes of Health (U.S.) , Serviços Preventivos de Saúde/organização & administração , Adulto , Educação , Equidade em Saúde/organização & administração , Disparidades em Assistência à Saúde/organização & administração , Humanos , Estados Unidos
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