Eficiencia de los sistema de salud en los países de América Latina y del Caribe desde el indicador de esperanza de vida al nacer para los años 1990 y 2012 frente al gasto total en salud como porcentaje del producto interno bruto para el año 1995 y 2012 “una oportunidad de brenchmarking para el sistema de protección social colombiano”

Para los países emergentes en América Latina y El Caribe se hace necesario determinar la eficiencia de su sistema de salud para generar beneficios a su población desde el indicador de esperanza de vida al nacer y los recursos que se hacen uso desde Colombia en comparación con sus homólogos. Se evidencia que a pesar de Colombia poseer una economía fuerte durante el análisis de los dos momentos se mantiene en la tendencia general de los demás países y con los mismos resultados del indicador. A su vez se concluye que el momento en que se tomaron las decisiones de cambio del sistema de salud es un factor diferenciador en los resultados obtenidos como fue el caso de Costa Rica identificado con el de mejor desempeño en la relación Indicador de esperanza de vida al nacer y Porcentaje de gasto en salud como parte del Producto interno bruto.

Establishing a community of practice of researchers, practitioners, policy-makers and communities to sustainably manage environmental health risks in Ecuador

The Sustainably Managing Environmental Health Risk in Ecuador project was launched in 2004 as a partnership linking a large Canadian university with leading Cuban and Mexican institutes to strengthen the capacities of four Ecuadorian universities for leading community-based learning and research in areas as diverse as pesticide poisoning, dengue control, water and sanitation, and disaster preparedness. By 2009, train-the-trainer project initiation involved 27 participatory action research Master’s theses in 15 communities where 1200 community learners participated in the implementation of associated interventions. This led to establishment of innovative Ecuadorian-led master’s and doctoral programs, and a Population Health Observatory on Collective Health, Environment and Society for the Andean region based at the Universidad Andina Simon Bolivar. Building on this network, numerous initiatives were begun, such as an internationally funded research project to strengthen dengue control in the coastal community of Machala, and establishment of a local community eco-health centre focusing on determinants of health near Cuenca. Alliances of academic and non-academic partners from the South and North provide a promising orientation for learning together about ways of addressing negative trends of development. Assessing the impacts and sustainability of such processes, however, requires longer term monitoring of results and related challenges.

Measuring productivity growth when technological change is biased - a new index and an application to UK agriculture

Productivity growth is conventionally measured by indices representing discreet approximations of the Divisia TFP index under the assumption that technological change is Hicks-neutral. When this assumption is violated, these indices are no longer meaningful because they conflate the effects of factor accumulation and technological change. We propose a way of adjusting the conventional TFP index that solves this problem. The method adopts a latent variable approach to the measurement of technical change biases that provides a simple means of correcting product and factor shares in the standard Tornqvist-Theil TFP index. An application to UK agriculture over the period 1953-2000 demonstrates that technical progress is strongly biased. The implications of that bias for productivity measurement are shown to be very large, with the conventional TFP index severely underestimating productivity growth. The result is explained primarily by the fact that technological change has favoured the rapidly accumulating factors against labour, the factor leaving the sector. (C) 2004 Elsevier B.V. All rights reserved.

Foods derived from animals: the impact of animal nutrition on their nutritive value and ability to sustain long-term health

Foods derived from domestic animals are a significant source of nutrients in the UK diet. However, certain aspects of some animal-derived foods, notably levels of saturated fatty acids, have given rise to concerns that these foods may contribute to the risk of cardiovascular disease, the metabolic syndrome and other conditions. However, the composition of the many animal-derived foods is not constant and can often be enhanced by manipulating the nutrition of the animal. This paper reviews these possibilities with particular attention to lipids, and draws attention to the fact that milk in particular, contains a number of compounds which may, for example, exert anti-carcinogenic effects. It is clear that the role of animal nutrition in creating foods closer to the optimum composition for long-term human health will not only be more relevant in the future, but will be vital in attempts to improve the health of the human population.

Use of remote sensing to measure change in the extent of habitat for the critically endangered Jerdon's Courser Rhinoptilus bitorquatus in India

Jerdon's Courser Rhinoptilus bitorquatus is one of the most endangered and least understood birds in the world. It is endemic to scrub habitats in southeast India which have been lost and degraded because of human land use. We used satellite images from 1991 and 2000 and two methods for classifying land cover to quantify loss of Jerdon's Courser habitat. The scrub habitats on which this species depends decreased in area by 11-15% during this short period (9.6 years), predominantly as a result of scrub clearance and conversion to agriculture. The remaining scrub patches were smaller and further from human settlements in 2000 than in 1991, implying that much of the scrub loss had occurred close to human population centres. We discuss the implications of our results for the conservation of Jerdon's Courser and the use of remote sensing methods in conservation.

The effects of environmental perturbation and measurement error on estimates of the shape parameter in the theta-logistic model of population regulation

The theta-logistic is a widely used generalisation of the logistic model of regulated biological processes which is used in particular to model population regulation. Then the parameter theta gives the shape of the relationship between per-capita population growth rate and population size. Estimation of theta from population counts is however subject to bias, particularly when there are measurement errors. Here we identify factors disposing towards accurate estimation of theta by simulation of populations regulated according to the theta-logistic model. Factors investigated were measurement error, environmental perturbation and length of time series. Large measurement errors bias estimates of theta towards zero. Where estimated theta is close to zero, the estimated annual return rate may help resolve whether this is due to bias. Environmental perturbations help yield unbiased estimates of theta. Where environmental perturbations are large, estimates of theta are likely to be reliable even when measurement errors are also large. By contrast where the environment is relatively constant, unbiased estimates of theta can only be obtained if populations are counted precisely Our results have practical conclusions for the design of long-term population surveys. Estimation of the precision of population counts would be valuable, and could be achieved in practice by repeating counts in at least some years. Increasing the length of time series beyond ten or 20 years yields only small benefits. if populations are measured with appropriate accuracy, given the level of environmental perturbation, unbiased estimates can be obtained from relatively short censuses. These conclusions are optimistic for estimation of theta. (C) 2008 Elsevier B.V All rights reserved.

An objective, niche-based approach to indicator species selection

1. Species-based indices are frequently employed as surrogates for wider biodiversity health and measures of environmental condition. Species selection is crucial in determining an indicators metric value and hence the validity of the interpretation of ecosystem condition and function it provides, yet an objective process to identify appropriate indicator species is frequently lacking. 2. An effective indicator needs to (i) be representative, reflecting the status of wider biodiversity; (ii) be reactive, acting as early-warning systems for detrimental changes in environmental conditions; (iii) respond to change in a predictable way. We present an objective, niche-based approach for species' selection, founded on a coarse categorisation of species' niche space and key resource requirements, which ensures the resultant indicator has these key attributes. 3. We use UK farmland birds as a case study to demonstrate this approach, identifying an optimal indicator set containing 12 species. In contrast to the 19 species included in the farmland bird index (FBI), a key UK biodiversity indicator that contributes to one of the UK Government's headline indicators of sustainability, the niche space occupied by these species fully encompasses that occupied by the wider community of 62 species. 4. We demonstrate that the response of these 12 species to land-use change is a strong correlate to that of the wider farmland bird community. Furthermore, the temporal dynamics of the index based on their population trends closely matches the population dynamics of the wider community. However, in both analyses, the magnitude of the change in our indicator was significantly greater, allowing this indicator to act as an early-warning system. 5. Ecological indicators are embedded in environmental management, sustainable development and biodiversity conservation policy and practice where they act as metrics against which progress towards national, regional and global targets can be measured. Adopting this niche-based approach for objective selection of indicator species will facilitate the development of sensitive and representative indices for a range of taxonomic groups, habitats and spatial scales.

Can adherence to dietary guidelines address excess caloric intake? An empirical assessment for the UK

The facilitation of healthier dietary choices by consumers is a key element of government strategies to combat the rising incidence of obesity in developed and developing countries. Public health campaigns to promote healthier eating often target compliance with recommended dietary guidelines for consumption of individual nutrients such as fats and added sugars. This paper examines the association between improved compliance with dietary guidelines for individual nutrients and excess calorie intake, the most proximate determinant of obesity risk. We apply quantile regressions and counterfactual decompositions to cross-sectional data from the National Diet and Nutrition Survey (2000-01) to assess how excess calorie consumption patterns in the UK are likely to change with improved compliance with dietary guidelines. We find that the effects of compliance vary significantly across different quantiles of calorie consumption. Our results show that compliance with dietary guidelines for individual nutrients, even if successfully achieved, is likely to be associated with only modest shifts in excess calorie consumption patterns. Consequently, public health campaigns that target compliance with dietary guidelines for specific nutrients in isolation are unlikely to have a significant effect on the obesity risk faced by the population.

Pregnant Adolescents in Vietnam : Social context and health care needs

Background: The number of childbearing adolescents in Vietnam is relatively low but they are more prone to experience adverse outcome than adult women. Reports of increasing rates of abortion and prevalence of STIs including HIV among youth indicate a need to improve services and counselling for these groups. Midwives are key persons in the promotion of young people’s sexual and reproductive health in Vietnam. Aim: The overall aim of this thesis is to describe the prevalence and outcome of adolescent pregnancies in Vietnam (I), to explore the social context and health care seeking behavior of pregnant adolescents (II), as well as to explore the perspectives of health care providers and midwifery students regarding adolescent sexuality and reproductive health service needs (III, IV). Methods: The studies were conducted from 2002 to 2005, combining qualitative and quantitative research methods. A population based prospective survey was used to estimate rates and outcomes of adolescent pregnancies (I). Pregnant and newly delivered adolescents’ experiences of childbearing and their encounters with health care providers were studied using qualitative interviews (II). Health care providers’ perspective on adolescent sexual and reproductive health (ASRH) and views on how to improve the quality of abortion care was explored in focus group discussions (FGD). The values and attitudes of midwifery students about ASRH were investigated using questionnaires and interviews (IV). Descriptive statistics was used to analyse quantitative data (I, IV) and content analysis were applied for qualitative data (II, III, and IV). Findings: Adolescent birth rate was similar to previously reported in Vietnam but lower when compared to other Asian countries. The incidence of stillborn among adolescents was higher than for women in higher reproductive ages. The proportion of preterm deliveries was 20 % of all births, higher than previous findings from Vietnam. About 2 % of the deliveries were home deliveries, more common among women with low education, belonging to ethnic minority and/or living in mountainous areas (I). Ambivalence facing motherhood, pride and happiness but also worries and lack of self-confidence emerged as themes from the interviews; and experience of ‘being in the hands of others’ in a positive, caring sense but also in a sense of subordination in relation to husband, family and health care providers (II). Health care providers at abortion clinics and midwifery students generally disapproved of pre-marital sex, but had a pragmatic view on the need for contraceptive services and counselling to reduce the burden of unwanted pregnancies and abortions for young women. Providers and midwifery students expressed a need for training on ASRH issues (III, IV). Conclusion: Cultural norms and gender inequity make pregnant adolescent women in Vietnam vulnerable to sexual and reproductive health risks. Health care providers experience ethical dilemmas while counselling unmarried adolescents who come for abortion and this has a negative impact on the quality of care. Integrated ASRH in education and training programmes for health care providers, including midwives, as well as continued in-service training on these issues are suggested to improve reproductive health care services in Vietnam.

Methods and background characteristics of the TOHNN study : a population-based study of oral health conditions in northern Norway

OBJECTIVES: The aim of the Tromstannen - Oral Health in Northern Norway (TOHNN) study was to investigate oral health and dental-related diseases in an adult population. This article provides an overview of the background of the study and a description of the sample characteristics and methods employed in data collection. STUDY DESIGN: Cross-sectional population-based study including a questionnaire and clinical dental examination. METHODS: A randomly selected sample of 2,909 individuals (20-79 years old) drawn from the population register was invited to participate in the study. The data were collected between October 2013 and November 2014 in Troms County in northern Norway. The questionnaire focused on oral health-related behaviours and attitudes, oral health-related quality of life, sense of coherence, dental anxiety and symptoms from the temporomandibular joint. The dental examinations, including radiographs, were conducted by 11 dental teams in 5 dental offices. The examination comprised of registration of dental caries, full mouth periodontal status, temporomandibular disorders, mucosal lesions and height and weight. The participants were grouped by age (20-34, 35-49, 50-64 and 65-79) and ethnicity (Norwegian, Sámi, other European and other world). RESULTS: From the original sample of 2,909 individuals, 1,986 (68.3%) people participated, of whom 1,019 (51.3%) were women. The highest attendance rate was among women 20-34 years old (80.3%) and the lowest in the oldest age group of women (55.4%). There was no difference in response rate between rural and urban areas. There was a positive correlation between population size and household gross income (p < 0.001) and education level (p < 0.001). The majority of Sámi resided in smaller municipalities. In larger cities, most participants used private dental health care services, whereas, in rural areas, most participants used the public dental health care service. CONCLUSION: The TOHNN study has the potential to generate new knowledge on a wide range of oral health conditions beneficial to the population in Troms County. Due to the high participation rate, generalization both nationally and to the circumpolar area ought to be possible.

BlueFriends: measuring, analyzing and preventing social exclusion between elementary school students

Social exclusion is a relatively recent term, whose creation is attributed to René Lenoir(Lenoir, 1974). Its concept covers a remarkably wide range of social and economic problems, and can be triggered for various reasons: mentally and physically handicapped, abused children, delinquents, multi-problem households, asocial people, and other social “misfits” (Silver, 1995, pp. 63; Foucault, 1992). With an increasingly multi-cultural population, cultural and social inequalities rapidly ascend, bringing with them the need for educational restructuring. We are living in an evermore diverse world, and children need to be educated to be receptive to the different types of people around them, especially considering social and cultural aspects. It is with these goals that inclusive education has seen an increased trend in today’s academic environment, reminding us that even though children may be taught under the same roof, discriminatory practices might still happen. There are, however, a number of developed tools to assess the various dimensions of social networks. These are mostly based on questionnaires and interviews, which tend to be fastidious and don’t allow for longitudinal, large scale measurement. This thesis introduces BlueFriends, a Bluetooth-based measurement tool for social inclusion/exclusion on elementary school classes. The main goals behind the development of this tool were a) understanding how exclusion manifests in students’ behaviors, and b) motivating pro-social behaviors on children through the use of a persuasive technology. BlueFriends is a distributed application, comprised by an application running on several smartphones, a web-hosted database and a computer providing a visual representation of the data collected on a TV screen, attempting to influence children behaviors. The application makes use of the Bluetooth device present on each phone to continuously sample the RSSI (Received Signal Strength Indication) from other phones, storing the data locally on each phone. All of the stored data is collected, processed and then inserted into the database at the end of each day. At the beginning of each recess, children are reminded of how their behaviors affect others with the help of a visual display, which consists of interactions between dogs. This display illustrates every child’s best friends, as well as which colleagues they don’t interact with as much. Several tips encouraging social interaction and inclusiveness are displayed, inspiring children to change their behaviors towards the colleagues they spend less time with. This thesis documents the process of designing, deploying and analyzing the results of two field studies. On the first study, we assess how the current developed tools are inferior to our measuring tool by deploying a measurement only study, aimed at perceiving how much information can be obtained by the BlueFriends application and attempting to understand how exclusion manifests itself in the school environment. On the second study, we pile on the previous to try and motivate pro-social behaviors on students, with the use of visual cues and recommendations. Ultimately, we confirm that our measurement tool’s results were satisfying towards measuring and changing children’s behaviors, and conclude with our thoughts on possible future work, suggesting a number of possible extensions and improvements.

Entre o sol e a liberdade impera a violência: formação de redes para a ação a partir da estratégia saúde da família

The research aimed to analyze the feasibility of forming a network of municipal services to prevent and treat child victims of violence from the Basic Health Units in the Family Mossoró / RN. The research is a qualitative approach and was developed in the form of action research. The population was composed of representatives of institutions of the child and primary care professionals. Data were collected through questionnaires, workshops and semi-structured interview. The results were analyzed from data collected through the questionnaire designed to assess the material, lectures, dialogues and assessments with the team and presented in accordance with the findings of the research. The study was approved by the Ethics in Research UFRN with protocol No. 158/2010, CAAE: 0176.0.051.000-10. Situational diagnosis in the participants answered a questionnaire to characterize and then launched the guiding question of the focus group FHS While professional what your perception towards violence against children? It was felt the fear and ignorance on the part of the unit staff on how to prevent and to refer cases of violence against children and adolescents in the area of coverage of the unit and also realized that the professionals felt victims of occupational violence before the violence has reached proportions that the area of the unit. Mind the need to change strategies to work to combat violence, we plan to conduct focus group workshop to complete the questionnaire, training for protection against occupational violence, and meeting with other bodies responsible visor protecting children and adolescents to draw the flowchart of the victims in safety net. The next moment training to fill the notification form professionals were interested in learning and use this tool to combat violence. At the third meeting in Unity, meeting with representatives of the Child Protection Council, the professional unit showed interest in interacting with the agency to expose and combat violence against children and adolescents. Due to difficulties in the physical structure of the unit was not possible to continue the research and planned every moment, and then completed the data collection with interviews with the participating professionals, to assess the meetings. Therefore, it is considered that action research has also achieved its goals because the team was involved in the collective construction of a proposed change in the practices of referral and prevention of violence against children and adolescents. This involvement was favored using the principles Freirian during the course of the study. However, it is assumed that the network was not fully implemented because it is known that it is in a continual process of improvement and must continue evolving with the unit team.

Avaliação da saúde bucal na atenção básica: a perspectiva do usuário

Nowadays, the basic attention in health works according to the Health Family Program (HFP), which is responsible for the organization of the health services with view to provide an appropriate attendance to the needs of the population. Its expansion is expressive in whole country and, the oral health, included in this process, has been seen as a possibility of change the health practices centered in the disease. In face of this perspective, the proposal of study is to discover possible changes in the health care model of oral health in a district, made possible through the perception, evaluation and degree of satisfaction of the user s health service. To reach such objectives, the district of Macaíba in the State of Rio Grande do Norte, was chosen for operational subjects, such as time of implantation of HFP and great covering of this program. The current research used interviews structured with objectives and subjectives questions and questionnaires of socioeconomic characterization addressed to two hundred and seventy (270) individuals (ninety users of an Urban PSF, ninety of a Rural PSF and ninety of an unit non PSF). The analysis of the data was accomplished through the software SPSS/99, that made possible a statistical and analytic appreciation. The HFP units and non HFP units has shown to sort the common odontology problems of the community, and this didn't establish a direct relationship with the general satisfaction. On the other hands, the programmed consultation is related with lager satisfaction of the users. The access form to the odontology treatment of the Units, the satisfaction with the attendance rendered by the dentist and the equip, enough dentists for the community and the social class of the user were decisive for the general satisfaction with the service of oral health. On the other hand, variables as age and education, resolution of the problem and physical conditions of the unit didn't influence the general satisfaction. In spite of the progresses in the implantation of the oral health in ESF, preventive activities, visits at home, access and social participation still reproduce the traditional model of attendance, showing a primary change process

Exercise training as a preventive tool for age-related disorders: a brief review

Aging populations are a worldwide phenomenon affecting both developed and developing countries. This issue raises serious concerns for both governments and the general population. Regular participation in physical activity and/or exercise training programs can minimize the physiological alterations that occur during aging and may contribute to improvements in health and well-being. The present review will discuss the role of regular exercise training in preventing age-related physiological decline and, consequently, associated chronic diseases. Compelling evidence that regular exercise and/or physical activity can improve quality of life, prevent or control the development of chronic disease and increase life expectancy is shown. In summary, regular exercise training and/or physical activity has an important influence on aging and may help to prevent age-related disorders.

Validity of hand-to-foot measurement of bioimpedance: Standing compared with lying position

Objective: To assess the reliability of the standing measurement of hand-to-foot bioimpedance compared with measurements made in the lying position.Research Methods and Procedures: In 205 volunteers 6 to 89 years of age, 111 males and 94 females from six ethnic groups, effects of posture, time, and age on hand-to-foot resistance were studied over a range of body size. The effect of time in a position on resistance was also recorded in a small subset (n = 10), and repeat measurements over 3 days at the same time of the day were recorded in another subset (n = 12).Results: Lying impedance was consistently higher than standing, with the relationship (resistance lying/resistance standing) for the children (5 to 14 years) being 1.031, progressing to a ratio of 1.016 in those >60 years. The time spent static in either position did change resistance measurements - a decrease of up to 9 Omega (mean 5 Omega, 1.0%) over 10 minutes of standing and an increase of up to 7 Omega (mean 3 Omega, 0.7%) with lying.Discussion: In the field, measurements of hand-to-foot bioimpedance can be made in the standing position, and, with appropriate adjustment, previously validated recumbent equations can be used. Given that errors in the measurement of height and weight also affect the reliability of the derivation of body fat from bioelectrical conductance, the errors that may arise from a more practical standing measurement rather than lying are minimal.