Rio de Janeiro, Brazil
Rio de Janeiro, Brazil

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Agency: European Commission | Branch: H2020 | Program: RIA | Phase: PHC-06-2014 | Award Amount: 3.00M | Year: 2015

Cigarette smoking is a main risk factor for premature disease, disability and death in Europe, especially in disadvantaged groups. Prevention of youth smoking is crucial to any strategy aimed at reducing this disease burden in the future. Several potentially effective strategies and programs are available to address youth smoking. However, in practice their impact often appears to be limited, especially among socially disadvantaged youth. There is very little systematic evidence on HOW smoking prevention strategies and programs worked in practice, and WHY some programs seemed to influence youth smoking only in some settings or groups. Yet, such evidence is urgently needed to enable decision makers to use the resources available for smoking prevention in the most effective and equitable way. We will generate such evidence by addressing these HOW and WHY questions in a comparative approach. For Finland, Ireland, Germany, Netherlands, Belgium, Italy and Portugal, we aim to assess HOW strategies and programs to prevent smoking in national and local settings affected smoking behaviour of 16 year olds. Moreover, we aim to assess HOW and WHY this impact varied according to city, school, gender, and socioeconomic group. We will be among the first to apply the approach of realist evaluation to the evaluation of preventive programs, and to use this innovative approach to compare European countries. We will acquire primary data that are comparable across these countries, including a quantitative survey among 10,000\ students, and in-depth structured interviews with students and various stakeholders. We expect to make a major contribution to the reduction of disease burden and health inequalities among future elderly populations. We will apply a new method for learning from different countries, and for generating the fine-grained evidence that is needed to develop youth smoking prevention programs that are context-sensitive, cost-effective and equity-oriented.

Agency: European Commission | Branch: FP7 | Program: CP-FP | Phase: HEALTH.2011.3.3-1 | Award Amount: 2.25M | Year: 2012

For any strategy aimed to reduce socioeconomic inequities in health in Europe it is vital to tackle the large and widening inequalities in smoking. However, there is only limited evidence on effectiveness of tobacco control policies in terms of reducing inequalities. Especially lacking are evaluations of the effects of policies that have actually been implemented in different European countries. In addition, no studies have assessed the role of strategic drivers such as social welfare or educational policies. The aim of the proposed project is to analyse various natural policy experiments within Europe with the aim to generate new empirical evidence on the effectiveness of possible strategies to reduce inequalities in smoking. The project has three parts. First, time trends in various European countries will be analyzed with the aim to assess whether changes in national tobacco control policies have influenced inequalities in smoking cessation among adults. Second, comparisons between European countries will be made with the aim to assess whether cross-national differences in specific tobacco control policies were associated with inequalities in smoking initiation among adolescents. These cross-national comparisons will also assess whether different types of educational systems are associated with inequalities in smoking initiation. Third, the project will review the published results of intervention studies, and integrate these with our results. The combined evidence base will be disseminated across Europe, especially among those who are involved in the development of tobacco control policies and health-in-all policies. This innovative project will develop comparative research into a new strategy for the evaluation of natural experiments, combining methods from different disciplines. Top researchers from different European countries will work together, and bring together four large international networks relevant to inequities in smoking.

Agency: European Commission | Branch: H2020 | Program: RIA | Phase: EURO-3-2014 | Award Amount: 2.50M | Year: 2015

The current crisis has indirectly contributed to questioning the efficiency of financial markets and democratic institutions at European and national levels. Recent data from the Eurobarometer (July 2013) shows a continuous decrease in the trust levels that citizens from the European Union have on national governments and parliaments, radically decreasing in more than 25 points in the last six years (European Commission, 2013). This situation is jeopardizing the European project while at the same time a lively public debate about the meaning of European identity is taking place across Europe. Several social scientists have argued that the social and economic inequalities in the new global order are contributing to civil social reactions, based on solidarity, aiming to achieve a better society for all (Touraine, 2007; Wright, 2010). This project aims to analyzing in depth the acts of solidarity which are being developed across Europe, the extent to which they respond to dialogic and inclusive processes, the related outcomes and the policy developments. The project starts from previous findings on successful actions which are combating the crisis by creating employment or improving access to health through acts of solidarity. These acts are thus contributing to construct more inclusive and prosperous societies, by influencing at the macro-level (social inequalities) and micro-level (psychological wellbeing). In this regard, the research will identify common elements among these acts in order to examine their transferability to different contexts. To cover this objective, effects of these actions in five social areas will be studied in depth: housing, education, employment, engagement and health. Simultaneously, special attention will be paid on social investment policies which are supporting these initiatives.

Agency: European Commission | Branch: FP7 | Program: CP-FP | Phase: HEALTH-2009-3.2-2 | Award Amount: 3.40M | Year: 2010

ECHO, European Collaboration for Healthcare Optimization, gathers the interests for Healthcare Performance Measurement of different Academic and Research Institutions from six European countries and an International Body for Healthcare Policy Analysis. Designed as a 48 months project, it has been conceived as a pilot study based on available administrative databases. It aims at describing the actual performance of six different Healthcare Systems at hospital, healthcare area, regional and country level. To tackle performance measurement in this project, two different methodological approaches will be used: [a] a population geographical-based, responding the question: Is the access to a diagnostic or surgical procedure dependant on the place where a person lives? And, [b] a provider-specific, answering the question: Is the risk for a patient to access high quality care -and have better health outcomes- different regarding the provider in which he or she is admitted? Utilization, equity in access and allocative efficiency will be analysed as performance measures in the former approach; and, healthcare outcomes and associated costs will be measures in the latter one. ECHO has been envisaged as a five work packages project. The first two work packages are devoted to prepare the core work package (WP#3) Performance Measurement and Report; so, the WP#1 is committed with the creation of the ECHO Data Warehouse and the second one is dedicated to the Methodological foundations of the project. Work packages #4 (web-based tools development) and #5 (dissemination) are carefully thought to ease the diffusion of our findings to decision-makers; in the former, a web-based analytical tool will allow advanced users to replicate methods and analysis; in the latter, local key agents like policy decision-makers and managers, will feed the findings making them transferable to their own decision-making process.

Riquinho D.L.,Escola Nacional de Saude Publica | Hennington E.A.,Escola Nacional de Saude Publica
Ciencia e Saude Coletiva | Year: 2012

This study presents a review of the literature published between 1979 and 2010 on health and working conditions in tobacco cultivation, with particular emphasis on the Brazilian context. A review of computerized databases (PubMed, Scopus, WilsonWeb and Bireme/PAHO Virtual Health Library - Public Health) was carried out using the following search terms: tobacco, agricultural worker health, agricultural worker disease, working conditions, unsafe working conditions, occupational risk, occupational disease, and labor force. Articles published in English, Spanish and Portuguese were analyzed. Thirty-seven articles were selected from 214 references that were initially identified. Thirty-four additional publications (reports, etc.) were also analyzed. Among the many effects described in the literature, especially noteworthy are "green tobacco sickness," respiratory disorders, musculoskeletal injuries, mental disorders, and a negative environmental impact. Very few studies have been carried out in Brazil.

Conservation attention to indigenous hunting with fire in the cerrado largely focuses on sustainability as construed in scientific terms rather than according to indigenous points of view. Towards the goal of reframing the debate in terms more congruent with indigenous perspectives, I address how the Xavante (A'uwẽ) view ritualized and collective hunting, including hunting with fire, as indispensable means of acquiring gifts by which to celebrate important events, express feelings of respect and gratitude towards others, promote positive social values among male youth, and maintain the group's ethnic identity. In particular, ritualized exchanges of game meat are necessary and culturally appropriate means of expressing esteem for others at some of life's most important moments. For the Xavante, the social imperative to give and receive gifts of meat during weddings and initiation ceremonies motivates efforts to maintain the collective hunting with fire tradition in a manner that ensures its long term environmental viability. © 2014 Springer Science+Business Media New York.

The scope of this article is to analyze the main challenges and perspectives linked to the evaluation of public policies in food and nutrition security. The conclusion reached is that considering the complexity of actions in this area, it is important to discuss the limits of traditional evaluation strategies and move forward with the creation of new theoretical and methodological alternatives.

Fox J.,McMaster University | Carvalho M.S.,Escola Nacional de Saude Publica
Journal of Statistical Software | Year: 2012

The R Commander graphical user interface to R is extensible via plug-in packages, which integrate seamlessly with the R Commander's menu structure, data, and model handling. The paper describes the RcmdrPlugin.survival package, which makes many of the facilities of the survival package for R available through the R Commander, including Cox and parametric survival models. We explain the structure, capabilities, and limitations of this plug-in package and illustrate its use.

Romero L.I.,University of Santa María in Ecuador | Quental C.,Escola Nacional de Saude Publica
Health Research Policy and Systems | Year: 2014

Background: Panama is, economically, the fastest growing country in Central America and is making efforts to improve management mechanisms for research and innovation. However, due to contextual factors, the Panamanian Health Research System is not well developed and is poorly coordinated with the Health System. Likewise, despite recent efforts to define a National Health Research Agenda, implementing this agenda and aligning it with Panamanians' health needs remains difficult. This articles aims to review Panama's experience in health research priority setting by analyzing the fairness of previous prioritization processes in order to promote an agreed-upon national agenda aligned with public health needs.Methods: The three health research prioritization processes performed in Panama between 2006 and 2011 were analyzed based on the guidelines established by the four " Accountability for Reasonableness" principles, namely " relevance" , " publicity" , " revision" , and " enforcement" , which provide a framework for evaluating priority-setting fairness.Results: The three health research priority-setting events performed in Panama during the reference period demonstrated a heterogeneous pattern of decision-making strategies, stakeholder group composition, and prioritization outcomes. None of the three analyzed events featured an open discussion process with the scientific community, health care providers, or civil society in order to reach consensus.Conclusions: This investigation makes evident the lack of a strategy to encourage open discussion by the multiple stakeholders and interest groups that should be involved during the priority-setting process. The analysis reveals the need for a new priority-setting exercise that validates the National Agenda, promotes its implementation by the National Secretariat for Science, Technology and Innovation in conjunction with the Ministry of Health, and empowers multiple stakeholders; such an exercise would, in turn, favor the implementation of the agenda. © 2014 Romero and Quental; licensee BioMed Central Ltd.

This work shows that the form of scientific biomedical journals is dominant in the field of Public Health. It supports the thesis that this institutional pattern is completely inadequate for the inter-disciplinary areas, such as Public Health. The spread of the moving biomedical model has generated great distortions when applied to the assessment of the intellectual production of the field of humanities and social sciences applied to health.

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