951 resultados para Regulation of private health insurance plans in Brazil


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The present study is aimed to diagnose the current public programs focused on herbal medicines in Brazil by means of in loco visits to 10 programs selected by means of questionnaires sent to 124 municipalities that count on herbal medicine services. The main purpose of the implementation of program programs is related to the development of medicinal herbs. 70% of them are intended for the production of herbal medicines and 50% are aimed to ensure the access of the population to medicinal plants and or herbal medicines. The initiative of the implementation of these programs was related to the managers (60%). The difficulties in this implementation were due to the lack of funding (100%) of the programs. In 60% of the programs, the physicians did not adhere to herbal medicine services due to the lack of knowledge of the subject. Training courses were proposed (80%) to increase the adhesion of prescribers to the system. Some municipalities use information obtained from patients to assess the therapeutic efficiency of medicinal plants and herbal medicines. of the programs underway, cultivation of medicinal plants was observed in 90% and 78% of them adopt quality control. In most programs, this control is not performed in accordance with the legal requirements. The programs focused on medicinal plants and herbal medicines implemented in Brazil face sonic chronic problems of infrastructure, management, operational capacity and self-sustainability, which can be directly related to the absence of a national policy on medicinal plants and herbal medicines.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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The aim of this study was to compare the periodontal conditions in 7-15-year-olds from Araraquara, SP, Brazil in 1998 with data from 1995. A systematic random sample was drawn from the population of children and adolescents enrolled in all public schools in 1998. The survey was conducted by trained examiners using the CPITN and WHO diagnostic criteria. Results showed an increase in the percentage of students of all ages with healthy periodontal conditions (from 14% in 1995 to 33% in 1998; p < 0.01). An increase in the mean number of healthy sextants (from 3.2 to 4.4; p < 0.0001), a decrease in the mean number of bleeding sextants (from 2.5 to 1.2; p < 0.0001) and no difference in the mean number of sextants with calculus were also observed. At the age of 15, 54% of the students had 5-6 healthy sextants in 1998 compared to 19% in 1995 (p < 0.01). Despite the improvement observed in the periodontal conditions, efforts must be increased in order to achieve the WHO goal for the year 2010 of no more than one sextant affected by bleeding or calculus at the age of 15.

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Toxoplasmosis is a zoonosis caused by Toxoplasma gondii, a coccidian protozoan of worldwide distribution. The seroprevalence in canine population can be an alternative for measuring T. gondii urban spreading. A total of 780 blood samples from dogs were collected, during the yearly anti-rabies campaign, carried out by the Department of Veterinary Hygiene and Public Health, School of Veterinary Medicine and Animal Husbandry (FMVZ), São Paulo State University, UNESP, together with the county health authorities, in August 1999. Using Indirect Fluorescent Antibody Test (IFAT) for detecting antibodies anti-T. gondii in the sera samples, we observed that 258 dogs (33.1%) were positive. The associations between the serological results and the epidemiological variables were studied. Statistically significant differences were not found regarding sex (32.2% male and 34.3% female reactors). Dogs without a defined breed showed seropositivity statistically higher than the pedigreed group. The occurrence of infection was considered higher with age.

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Objectives: To determine the consumption of bottled water by children in the city of Bauru, State of São Paulo, Brazil. Methods: A stratified sample of the 17 areas established by the city plan was used to identify a total of 1,000 homes for visitation. Information was collected using a questionnaire concerning the type of water consumed and population demographics. Results: Overall, around 30 percent of all residences used bottled water. Among all households where bottled water was consumed, about 26 percent had children residing. For those with children and bottled water, 81 percent reported to use bottled water for the preparation of the children's foods and beverages. Conclusions: An important percentage of children consume bottled water in the city of Bauru, State of São Paulo, Brazil. Considering previous studies showing that fluoride concentrations vary in bottled water, public health measures should be implemented in order to guarantee adequate levels of fluoride in commercialized water. © 2007, American Association of Public Health Dentistry.

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To highlight the transmission and major phylogenetic clades of Mycobacterium tuberculosis, a retrospective study was carried out at two health facilities in a small agro-industrial area in São Paulo, Brazil, that has a low tuberculosis incidence rate. IS6110-RFLP and spoligotyping were performed on the isolates, with the former revealing that 31.3% (35/112) of strains were clustered. Epidemiological links were found in 16 of the 35 clustered patients and were associated with transmission among patients living in public housing. Spoligotyping grouped 62.8% of the strains. The T genetic family predominated among the isolates. Of interest is that five strains had a pattern characteristic of African or Asian origin (ST535), and two others were of the rare localized type ST1888 (BRA, VEN). In addition, three new types-1889, 1890, and 1891-were identified. Spoligotyping showed that some ST may be circulating to or from Brazil, and RFLP revealed ongoing transmission in inadequately ventilated public-housing buildings. This may point to a failure in tuberculosis control policy.

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Objectives. To assess the impact of chronic disease and the number of diseases on the various aspects of health-related quality of life (HROOL) among the elderly in Såo Paulo, Brazil. Methods. The SF-36® Health Survey was used to assess the impact of the most prevalent chronic diseases on HRQOL. A cross-sectional and population-based study was carried out with two-stage stratified cluster sampling. Data were obtained from a multicenter health survey administered through household interviews in several municipalities in the state of São Paulo. The study evaluated seven diseases - arthritis, back-pain, depression/anxiety, diabetes, hypertension, osteoporosis, and stroke - and their effects on quality of life. Results. Among the 1 958 elderly individuals (60 years of age or older), 13.6% reported not having any of the illnesses, whereas 45.7% presented three or more chronic conditions. The presence of any of the seven chronic illnesses studied had a significant effect on the scores of nearly all the SF-36® scales. HROOL achieved lower scores when related to depression/ anxiety, osteoporosis, and stroke. The higher the number of diseases, the greater the negative effect on the SF-36® dimensions. The presence of three or more diseases significantly affected HROOL in all areas. The bodily pain, general health, and vitality scales were the most affected by diseases. Conclusions. The study detected a high prevalence of chronic diseases among the elderly population and found that the degree of impact on HROOL depends on the type of disease. The results highlight the importance of preventing and controlling chronic diseases in order to reduce the number of comorbidities and lessen their impact on HROOL among the elderly.

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Includes bibliography

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Background and Objective: Simple Measure of the Impact of Lupus Erythematosus in Youngsters (SMILEY) is a health-related quality of life (HRQOL) assessment tool for pediatric systemic lupus erythematosus (SLE), which has been translated into Portuguese for Brazil. We are reporting preliminary data on cross-cultural validation and reliability of SMILEY in Portuguese (Brazil). Methods: In this multi-center cross-sectional study, Brazilian children and adolescents 5-18 years of age with SLE and parents participated. Children and parents completed child and parent reports of Portuguese SMILEY and Portuguese Pediatric Quality of Life Inventory (PedsQLTM) Generic and Rheumatology modules. Parents also completed the Childhood Health Assessment Questionnaire (CHAQ). Physicians completed the SLE disease activity index (SLEDAI), Physician's Global Assessment of disease activity (PGA) and Systemic Lupus Erythematosus International Collaborating Clinics ACR Damage Index (SDI). Results: 99 subjects (84 girls) were enrolled; 93 children and 97 parents filled out the SMILEY scale. Subjects found SMILEY relevant and easy to understand and completed SMILEY in 5-15 minutes. Brazilian SMILEY was found to have good psychometric properties (validity and reliability), and the child-parent agreement was moderate. Conclusion: SMILEY may eventually be used routinely as a research/clinical tool in Brazil. It may be also adapted for other Portuguese-speaking nations offering critical information regarding the effect of SLE on HRQOL for children with SLE. © The Author(s), 2012.

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Venous leg ulcers (VLUs) represent the most advanced stage of chronic venous insufficiency. Despite the large body of knowledge available regarding the risk factors and aetiopathogeny of the condition, patients referred to public health care systems in developing countries often do not receive adequate diagnosis or early treatment, leading to clinical evolution and disease recurrence. This review collates updated information about the epidemiology, risk factors, aetiopathogeny, diagnosis, ulcer healing methods and determinant factors of the pernicious cycle of VLUs in developing countries, with a focus on the Brazilian setting.

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The aimed of this article is to measure risk factors on health and milk production on organic and conventional dairy goats in Brazil. Two experimental groups (organic and conventional) were evaluated simultaneously. The study design was completely randomized. The organic herd consisted of 25 goats and 15 kids. In the conventional production system, a dairy herd comprising 40 goats and 20 kids participated in the study. Data on milk production and health management were available from January 2007 to December 2009. The abortion rate in the conventional system was 5% (2/40) whereas in organic system no abortion was diagnosed (0/25). The mortality rate at weaning in the conventional system was 5% (2/40) and in the organic system was 8% (2/25). Milk production was lower (2.20 kg/day) in organic than conventional system (2.66 kg/day). Goats and kids in organic farm had a higher FEC (386±104 and 900±204, respectively) (p<0.05) than those in conventional farm (245±132 and 634±212, respectively). In addition, Saanen kids had higher FEC (p<0.001) than goats. Treatment with antiparasitic drugs was higher in conventional system (50%) than organic system (1.3%).