Indicator of socio-environmental vulnerability in the western Amazon. The case of the city of Porto Velho, state of Rondônia, Brazil [Indicador de vulnerabilidade socioambiental na amazônia ocidental. O caso do município de Porto Velho, Rondônia, Brasil]
Goncalves K.S.,Escola Nacional de Saude Publica ENSP |
Siqueira A.S.P.,Escola Nacional de Saude Publica ENSP |
Hacon S.S.,Escola Nacional de Saude Publica ENSP
Ciencia e Saude Coletiva | Year: 2014
The accelerated process of urbanization in the State of Amazônia associated with changes in the patterns of exploitation of natural resources have resulted in several types of environmental impacts, such as urban air pollution produced by forest fires which alters the relationship between urban and rural areas and establishes new vulnerabilities. The scope of this study is to analyze the socio-environmental vulnerability in relation to forest fires and health effects in the urban area of Porto Velho, located in the Brazilian Amazon region. Data was analyzed using a synthetic indicator combining income and education aspects, housing infrastructure, environmental exposure and health effects. The findings indicate that 51% of the resident population, i.e. around 157,000 inhabitants, is exposed to conditions of high and extreme environmental vulnerability. Analysis of the dimensions used to construct the synthetic indicator reveals an intense heterogeneity in terms of socio-environmental vulnerability in the urban area of the city of Porto Velho. These results highlight the need for integrated actions from different government departments in order to enhance health promotion, ecological sustainability and also reduce social inequalities in health.
PubMed | University of Technology, Sydney, Latin American Center for Perinatology, GLIDE Technical Cooperation and Research, Social Protection and Health Division and 20 more.
Type: Journal Article | Journal: BJOG : an international journal of obstetrics and gynaecology | Year: 2016
To generate a global reference for caesarean section (CS) rates at health facilities.Cross-sectional study.Health facilities from 43 countries.Thirty eight thousand three hundred and twenty-four women giving birth from 22 countries for model building and 10,045,875 women giving birth from 43 countries for model testing.We hypothesised that mathematical models could determine the relationship between clinical-obstetric characteristics and CS. These models generated probabilities of CS that could be compared with the observed CS rates. We devised a three-step approach to generate the global benchmark of CS rates at health facilities: creation of a multi-country reference population, building mathematical models, and testing these models.Area under the ROC curves, diagnostic odds ratio, expected CS rate, observed CS rate.According to the different versions of the model, areas under the ROC curves suggested a good discriminatory capacity of C-Model, with summary estimates ranging from 0.832 to 0.844. The C-Model was able to generate expected CS rates adjusted for the case-mix of the obstetric population. We have also prepared an e-calculator to facilitate use of C-Model (www.who.int/reproductivehealth/publications/maternal_perinatal_health/c-model/en/).This article describes the development of a global reference for CS rates. Based on maternal characteristics, this tool was able to generate an individualised expected CS rate for health facilities or groups of health facilities. With C-Model, obstetric teams, health system managers, health facilities, health insurance companies, and governments can produce a customised reference CS rate for assessing use (and overuse) of CS.The C-Model provides a customized benchmark for caesarean section rates in health facilities and systems.
Fortes M.T.,Escola Nacional de Saude Publica ENSP |
de Mattos R.A.,University Estadual Do Rio Of Janeiro Uerj |
Revista da Associacao Medica Brasileira | Year: 2011
This article analyzes the dynamics and changes in the accreditation process in three different places - France, UK and Cataluña (Spain) - based on documents about their health systems organizations, funding sources and regulations. The objective was to find out about the relevant aspects of the strategies of these countries' institutions that adapted accreditation to national circumstances in the healthcare policy arena. Although there are similarities in the basic approaches and standards used, there are different models of accreditation. Setting standards raises the question of who should define them and how they should be monitored; accreditation's methodology cannot be seen only as a voluntary process for assessing quality in healthcare or perceived as tool for certification and regulation. Interests in accreditation can be driven by a number of different forces, which depend upon the model adopted. Therefore, it can only be understood in the policy arena of each country.
Soares G.P.,Federal University of Rio de Janeiro |
Brum J.D.,Federal University of Rio de Janeiro |
De Oliveira G.M.M.,Federal University of Rio de Janeiro |
Klein C.H.,Escola Nacional de Saude Publica ENSP |
De Souza E Silva N.A.,Federal University of Rio de Janeiro
Revista Panamericana de Salud Publica/Pan American Journal of Public Health | Year: 2010
Objective. To evaluate mortality from all causes, diseases of the circulatory system (DCS), ischemic heart disease (IHD), and cerebrovascular diseases (CVD) from 1980 to 2006 in Rio de Janeiro, Rio Grande do Sul, São Paulo, and their capitals, taking into consideration the impact of deaths due to ill-defined causes. Methods. Population and mortality data were obtained from the Unified Health System's Data Bank (DATASUS). Mortality from the diseases of interest and from illdefined causes was adjusted by the direct method for adults older than 20 years of age. Since the mortality rates from ill-defined causes increased markedly after 1990, proportional mortality rates from ill-defined causes were calculated. Linear regression models were used for analysis of trends. Results. A relevant decline in all-cause mortality was observed in the three states and capitals. Rio de Janeiro and its capital had the highest rates of all-cause mortality. DCS mortality declined more than all-cause mortality. Proportional mortality from illdefined causes in Rio de Janeiro and its capital was higher than in all other states and capitals starting in 1990. CVD mortality fell in the study period, especially in Rio de Janeiro and its capital. The state of Rio de Janeiro also had the highest IHD mortality rates until 1993. Among the capitals, São Paulo presented the highest IHD mortality rates starting in 1992. Conclusions. The decline in all-cause mortality resulted mainly from the decline in DCS mortality. In turn, the decline in DCS mortality was partly due to the reduction in CVD mortality, especially in the state of Rio de Janeiro.
Poverty and social policy: The implementation of complementary programs for the Bolsa Família Program [Pobreza e política social: A implementação de programas complementares do Programa Bolsa Família]
Santos C.R.B.,State University of Rio de Janeiro |
Magalhaes R.,Escola Nacional de Saude Publica ENSP
Ciencia e Saude Coletiva | Year: 2012
The Bolsa Família Program involves the transfer of income and the implementation of complementary programs to foster human capital development and empower the beneficiaries. To analyze the implementation of complementary programs in Manguinhos, Rio de Janeiro, a review of documents and secondary data was conducted, focus groups of beneficiaries studied and semi-structured interviews were staged with governmental, nongovernmental stakeholders and beneficiaries. The design, coverage and evaluation of the complementary programs have been weak, and beneficiaries were even unaware of vocational training courses. The program administrators acknowledged the failings and the fact that the courses offered by Próximo Passo are not adapted to local demand, even though they were conceived as a vocational training strategy aimed at creating construction jobs in the Growth Acceleration Program and the tourist industry in the city. Considering that the social inclusion perspective is linked to access to public policies, the supply and follow-up of these activities by government agencies and civil society organizations are essential for the effectiveness of the fight against poverty and hunger, aimed at contributing to the so-called "exit routes" from the Bolsa Família Program.
Tobar F.,University of Buenos Aires |
Drake I.,Ministerio de Salud de la Nacion |
Martich E.,Escola Nacional de Saude Publica ENSP
Revista Panamericana de Salud Publica/Pan American Journal of Public Health | Year: 2012
Latin America is adopting regulations that bear on medicinal costs and spending. The regulations have four main goals: i) to guarantee a competitive market, ii) to ensure affordability for individual consumers (commercial channel), iii) to contain public spending on medicines (institutional channel), and iv) to guarantee efficient spending on medicines. The experience of Latin America differs from that of countries in developed regions. In the latter, the countries tend to have similar policies, both in promoting generic medicines and in price control strategies, and in optimizing and containing pharmaceutical expense. In contrast, in Latin America, certain institutional weaknesses impede the consolidation and application of an effective regulatory policy. This paper reviews the experience gained through the adoption of economic regulations aimed at reducing spending and improving access to medicines, suggests lessons learned at the international level, and offers recommendations for the countries of Latin America. Its purpose is to offer key elements to decision-makers and the authorities of the countries concerned in pursuing economic regulation of medicines.
History of genetics in Brazil: A view from the Museu da Genética at the Universidade Federal do Rio Grande do Sul [História da genética no Brasil: Um olhar a partir do museu da genética da universidade Federal do Rio Grande do Sul]
de Souza V.S.,State University of the Central West |
Dornelles R.C.,Federal University of Rio Grande do Sul |
Coimbra Jr. C.E.A.,Escola Nacional de Saude Publica Ensp |
Santos R.V.,Federal University of Rio de Janeiro
Historia, Ciencias, Saude - Manguinhos | Year: 2013
This work addresses the context of the creation, as well as the structure and contents, of the Museum of Genetics (Museu da Genética), created in 2011 and located in the Department of Genetics of the Federal University of Rio Grande do Sul (Universidade Federal do Rio Grande do Sul), in Porto Alegre, Brazil. The materials available at the Museum of Genetics are a rich resource for research on the history of genetics in Brazil (and especially the genetics of human populations) beginning with the second half of the twentieth century. Despite the prominence of the field of genetics in Brazil, little research has been done on this topic.
De Moura J.F.,Escola Nacional de Saude Publica ENSP |
Siciliano S.,Escola Nacional de Saude Publica ENSP
Marine Biodiversity Records | Year: 2012
In this study we present data on 46 strandings of Bryde's whales along the coast of São Paulo and Rio de Janeiro States, south-eastern Brazil. The aim of this study was to evaluate the stranding pattern of Bryde's whales in south-eastern Brazil. The results show a relationship with annual increasing of strandings in a 20 year period of data collection (1990-2010). No significant seasonal trend was observed among four seasonal categories, but most whales stranded during winter (July-September). Males stranded more frequently than females. There was a significant trend in strandings of sexually mature whales (>11.12 m; 53.6%), but juveniles (≤8 m; 21.9%) were also relatively common. The present work confirms that Bryde's whales are common on the south-eastern Brazilian coast. Some discrepancy in published results from sightings and our results on strandings (e.g. seasonal pattern) was observed and may be related to environmental condition and the presence of inshore and offshore populations with differences in life history and behaviour. No whales showed signals of impact caused by human interactions, despite the potential threats in the study area. Future studies comparing morphology with genetics are suggested to be carried out to elucidate the taxonomic status of the Bryde's whales in Brazil. © 2012 Marine Biological Association of the United Kingdom.
Tuberculosis in indigenous peoples in the Brazilian Amazon: An epidemiological study in the upper Rio Negro region [Tuberculose em indígenas da Amazônia Brasileira: Estudo epidemiológico na região do Alto Rio Negro]
Rios D.P.G.,Escola Nacional de Saude Publica ENSP |
Malacarne J.,Escola Nacional de Saude Publica ENSP |
Alves L.C.C.,Escola Nacional de Saude Publica ENSP |
Sant'Anna C.C.,Federal University of Rio de Janeiro |
And 2 more authors.
Revista Panamericana de Salud Publica/Pan American Journal of Public Health | Year: 2013
Objective: To describe the sociodemographic, clinical, and epidemiological characteristics of reported tuberculosis cases among indigenous individuals of São Gabriel de Cachoeira, State of Amazonas, Brazil, and to identify the factors associated with mortality during treatment; and to estimate the prevalence of latent tuberculosis infection (LTBI) and associated factors and obtain information on the therapeutic course and the individual perceptions regarding acquistion of tuberculosis in the district of Iauaretê. Methods: Firstly, a retrospective epidemiological study (1997 to 2007) was conducted using data from the Brazilian Notifiable Diseases Surveillance System (SINAN). Next, a cross-sectional study (2010) was conducted with respiratory symptomatic subjects and contacts of Iauaretê. Results: Seven hundred and twenty-three new cases were reported, with incidence of 273.4/100 000 and mortality of 13.2/100 000. There was a predominance of males (57%), aged ≥ 45 years (37.6%), people with no schooling (42.7%), and cases from rural areas (76.9%). Patients aged 0 to 20 years were at lower risk of death when compared to those aged ≥ 45 years (OR = 0.3; IC95%: 0.1 a 0.9). In Iauaretê, with 15.3% of the reported cases, 184 people were interviewed. A prevalence of LTB of 76.1% was reported. Tuberculin skin test ≥ 5 mm was associated with the ≥ 15-year old age group, history of active tuberculosis, and radiological alterations. A previous history of tuberculosis was cited by 54 people (29.3%). The main explanation for the disease was "puffing/poisoning" (24.1%). The therapeutic course included industrialized drugs (42.6%), medicinal plants/roots, shamanism, and prayer (42.7%). Conclusions: The risk of tuberculosis infection and disease in this population was high. Despite the reduced incidence resulting from recent efforts, tuberculosis control requires closer surveillance of contacts and improvement in communication strategies between health teams and indigenous populations.
PubMed | Instituto Chico Mendes Of Conservacao Da Biodiversidade Icmbio, Leibniz Center for Tropical Marine Ecology, University of the Rio dos Sinos Valley, Escola Nacional de Saude Publica ENSP and 2 more.
Type: Journal Article | Journal: PloS one | Year: 2016
The genus Kogia, which comprises only two extant species, Kogia sima and Kogia breviceps, represents one of the least known groups of cetaceans in the global ocean. In some coastal regions, however, stranding events of these species have been relatively common over the last decades. Stranding provides the opportunity to investigate the biology of these cetaceans and to explore the epidemiological aspects associated with the mortality of the organisms found on the beach. A number of disturbances (including pelagic fisheries, chemical pollution, boat strikes, and noise pollution) have been confirmed to pose a particular threat to the Kogia species. However, no study has yet investigated potential relationships between environmental conditions and stranding events. Here we analyse how a collection of environmental, physical, and biological variables, such as wind, sea surface temperature (SST), water depth, and chlorophyll-a, correlate to Kogia stranding events along the Brazilian coast. The results of our statistical analyses suggest that K. sima is more likely found in warm tropical waters, which provide an explanation for the high frequency of stranding in northeastern Brazilian coast. In contrast, K. breviceps appears to have a preference for temperate and productive waters. Wind speed results to be also an important factor for predicting Kogia strandings in Brazilian coast. Additionally, literature information in combination with our own data and analyses of stomach contents confirms that oceanic cephalopods constitute the primary nutritional source of both Kogia species. By using the available information as a qualitative proxy for habitat preference and feeding ecology, our study provides a novel and comprehensive assessment of Kogia stranding data in relation to environmental conditions along the Brazilian coast.