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O artigo tem como objetivo fazer uma discussão teórica e política do conceito do Complexo Econômico-Industrial da Saúde (CEIS), atualizando a visão para o contexto contemporâneo de transformação tecnológica e dos desafios para os sistemas universais de saúde e do Sistema Único de Saúde (SUS), em particular. Em um contexto de globalização assimétrica, de emergência de uma revolução tecnológica e de (re)colocação de barreiras estruturais que trancam a sociedade brasileira em seu movimento histórico de desigualdade, vulnerabilidade e exclusão, necessitamos repensar a saúde, retomando e atualizando uma agenda que privilegia os fatores histórico-estruturais da sociedade brasileira, a inserção internacional do País e sua relação com uma difusão extremamente assimétrica do progresso técnico, do conhecimento e do aprendizado, dissociados das necessidades sociais e ambientais locais. Mediante uma metodologia que envolve a análise da resposta brasileira à COVID-19, da balança comercial do CEIS e do acesso a vacinas para COVID-19, o artigo evidencia que a saúde é parte central da estrutura econômica e social e reproduz as características do padrão de desenvolvimento nacional em seu interior. Uma sociedade equânime, com qualidade de vida, comprometida com os direitos sociais e o meio ambiente é condicionada pela existência de uma base econômica e material que lhe dê sustentação. Essa visão sistêmica e dialética é a principal contribuição teórica e política pretendida pelo artigo, que procura contribuir para uma abordagem de saúde coletiva integrada com uma visão de economia política.
The article aims to make a theoretical and political discussion of the concept of the Health Economic-Industrial Complex (CEIS), updating the concept to a contemporary context of technological transformation and of challenges for universal health systems, particular the Brazilian Unified National Health System (SUS). In a context of asymmetric globalization, of emergence of a technological revolution, and of the (re)placement of structural barriers that keeps Brazilian society in its historical movement of inequality, vulnerability, and exclusion, we need to rethink healthcare by resuming and updating an agenda that privileges the historical-structural factors of Brazilian society, the international insertion of the country, and its relationship with an extremely asymmetric diffusion of technical progress, knowledge, and learning, dissociated from local social and environmental needs. With a methodology that involves the analysis of the brazilian response to COVID-19, the commercial balance of the CEIS, and the access to COVID-19 vaccines, the study shows that health is a central part of the economic and social structure and reproduces the characteristics of the national development pattern within it. An equitable society, with quality of life, committed to social rights and the environment is structurally conditioned by the existence of an economic and material basis that supports it. This systemic and dialectical view is the main theoretical and political contribution intended by our study, which seeks to contribute to a collective health approach integrated with a political economy view.
Este artículo tiene como objetivo plantear una discusión teórica y política del concepto de Complejo Económico-Industrial de la Salud (CEIS), actualizando la visión para el contexto contemporáneo de transformación tecnológica y de los desafíos para los sistemas universales de salud y el Sistema Único de Salud (SUS), en particular. En un contexto de globalización asimétrica, de emergencia de una revolución tecnológica y de (re)colocación de barreras estructurales que encierran a la sociedad brasileña en su movimiento histórico de desigualdad, vulnerabilidad y exclusión, necesitamos repensar la salud, retomando y actualizando una agenda que privilegia los factores histórico-estructurales de la sociedad brasileña, la inserción internacional del País y su relación con una difusión extremadamente asimétrica del progreso técnico, del conocimiento y del aprendizaje, disociados de las necesidades sociales y ambientales locales. Por medio de una metodología que implica el análisis de la respuesta brasileña a la COVID-19, la balanza comercial del CEIS y el acceso a las vacunas contra la COVID-19, este artículo pone de manifiesto que la salud es parte central de la estructura económica y social y reproduce las características del estándar de desarrollo nacional en su interior. Una sociedad equitativa, con calidad de vida, comprometida con los derechos sociales y el medio ambiente está condicionada estructuralmente por la existencia de una base económica y material que la sustente. Esta visión sistémica y dialéctica es el principal aporte teórico y político pretendido por el artículo, que busca contribuir a un abordaje de la salud colectiva integrado con una visión de economía política.
Subject(s)
Humans , COVID-19 , National Health Programs , Quality of Life , Brazil , COVID-19 Vaccines , Health PolicyABSTRACT
ABSTRACT OBJECTIVE To investigate the association between child care attendance since birth and development in two-years-old Brazilian children. METHODS The study used longitudinal data from the 2015 Pelotas Birth Cohort. The childhood development (cognitive, fine and gross motor skills, and language) at two-years-old children was assessed using INTER-NDA (INTERGROWTH-21st Neurodevelopment Assessment). The child care attendance was measured at ages one and two years and categorized as: a) never attended child care; b) attended some child care (one or two years); and c) always attended child care (one and two years). Demographic, socioeconomic, health, and child stimulation variables were considered as confounders. Crude and adjusted analyses of child care attendance and development were carried out using linear regression. RESULTS Out of the 3,870 infants included in the analyses, around 1/3 attended center-based child care. In crude analyses, attending center-based child care was associated with positive developmental outcomes, except in motor domains. In adjusted analyses, compared to those children that have never attended child care, children who did attend presented higher scores for cognitive development (always in child care: β: 2.44, 95%CI: 0.83-4.05; some child care: β: 1.35, 95%CI: 0.17-2.53). CONCLUSIONS This study suggests that center-based child care may help improve child cognitive development in the Brazilian context. Furthermore, the association was higher for early and continued attendance. Considering the low prevalence of children in external care, it is recommended to improve child care opportunities in early childhood.
Subject(s)
Humans , Infant , Child, Preschool , Child , Child Care , Child Development , Brazil/epidemiology , Child Health , Cohort StudiesABSTRACT
ABSTRACT OBJECTIVE To identify the Brazilian cohorts that started either in the prenatal period or at birth, to describe their characteristics and the explored variables, and to map the cohorts with potential for studies on early determinants on health and the risk of falling ill on later stages of the life cycle. METHODS A scoping review was carried out. The articles were searched in the electronic databases PubMed and Virtual Health Library (VHL). The descriptors used were [((("Child" OR "Child, Preschool" OR "Infant" OR "Infant, Newborn") AND (Cohort Studies" OR "Longitudinal Studies")) AND "Brazil")]. The inclusion criteria were Brazilian cohorts that started the baseline in the prenatal period or at birth and with at least two follow-ups with the participants. In order to meet the concept of LCE, we excluded those cohorts whose follow-ups were restricted to the first year of life, as well as those that did not address biological, behavioral and psychosocial aspects, and cohorts with data collection of a single stage of the life cycle. RESULTS The search step identified 5,010 articles. Eighteen cohorts were selected for descriptive synthesis. The median number of baseline participants was 2,000 individuals and the median age at the last follow-up was 9 years. Sample loss at the last follow-up ranged from 9.2 to 87.5%. Most cohorts monitored two phases of the life cycle (the perinatal period and childhood). The Southern region had the highest number of cohorts. The main variables collected were sociodemographic and environmental aspects of the family, morbidity aspects, nutritional practices and lifestyle. CONCLUSIONS We recommend the continuity of these cohorts, the approach to different social contexts and the performance of follow-ups with participants in different phases of the life cycle for the strengthening and expansion of life course epidemiology analyses in Brazil.
RESUMO OBJETIVO Identificar as coortes brasileiras iniciadas no período pré-natal ou no nascimento, descrever suas características e as variáveis exploradas, além de mapear as coortes com potencial para se estudar os determinantes precoces de saúde e doença e o risco de adoecer em etapas posteriores do ciclo vital. MÉTODOS Realizou-se uma revisão de escopo. A busca dos artigos foi realizada nas bases de dados PubMed e Biblioteca Virtual em Saúde em 16 de junho de 2018. Os descritores utilizados foram [((("Child" OR "Child, Preschool" OR "Infant" OR "Infant, Newborn") AND ("Cohort Studies" OR "Longitudinal Studies")) AND "Brazil")]. Os critérios de inclusão foram coortes brasileiras que iniciaram a linha de base no período pré-natal ou no nascimento e com pelo menos dois acompanhamentos com os participantes. Foram excluídas as coortes cujos acompanhamentos foram restritos ao primeiro ano de vida, as que não abordaram aspectos biológicos, comportamentais e psicossociais e também aquelas com coleta de informações em um único estágio do ciclo vital. RESULTADOS A etapa de busca identificou 5.010 artigos. Foram selecionadas 18 coortes para a síntese descritiva. A mediana do número de participantes na linha de base foi 2.000 indivíduos e a mediana de idade no último acompanhamento foi 9 anos. A perda amostral no último acompanhamento variou de 9,2 a 87,5%. A maioria das coortes realizou acompanhamentos em duas fases do ciclo vital (período perinatal e infância). A região Sul contemplou o maior número de coortes. As principais variáveis coletadas foram sociodemográficas e ambientais da família, aspectos de morbidade, práticas alimentares e estilo de vida dos participantes. CONCLUSÕES Recomenda-se a continuidade dessas coortes, a abordagem de diferentes contextos sociais e a realização de acompanhamentos com os participantes em diferentes fases do ciclo vital para o fortalecimento e ampliação das análises de epidemiologia do ciclo vital no Brasil.
Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Infant , Child, Preschool , Child , Child Development/physiology , Cohort Studies , Life Cycle Stages/physiology , Brazil , Epidemiologic Research Design , Age FactorsABSTRACT
@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> In 2012, the Philippine Department of Health (DOH) established the Health Systems Research Management (HSRM). One of the HSRM components is increasing the research capacity of the Centers for Health Development (CHD) which is the regional office of the DOH.</p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> To determine the research capacity of CHDs and to describe research input, research process, and research output.</p><p style="text-align: justify;"><strong>METHODS:</strong> A descriptive cross-sectional study design was employed. The data were collected using self-administered questionnaire with the Regional Director as the CHD respondent. The research capacity level was determined using rating scale measurement. Based on the ratings, each CHD was assigned a score with the corresponding capacity level: excellent (85-100%); good (70-84%); fair (51-69%); poor (<50%).</p><p style="text-align: justify;"><strong>RESULTS:</strong> Fourteen (82%) of the 17 CHDs participated in the study. The institutional capacity level of the CHDs was poor in the areas of research management (43.0%) and in structure/ organization/ monitoring/ evaluation (30.0%), while it was fair in the area of resource mobilization (54.5%). Research input, research process, and research output were found to be lacking.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> The capacity level of the CHDs in the various aspects of institutional research ranged from poor to fair. Specific areas under research input, research process, and research output that need improvement were identified which can be used as benchmark for capacity-building activities and as information-base against which the effectiveness of these activities in the CHDs can be evaluated.</p>
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ResearchABSTRACT
En el Virreinato del Perú, los hospitales y universidades se desarrollaron por caridad cristiana. La enseñanza memorística, la hegemonía eclesiástica y la escasa organización frustraron las ideas innovadoras sobre las ciencias por la ausencia de una élite civil capaz de formular las políticas de una educación superior. La llegada de la Real Expedición Filantrópica de la Vacuna, en 1806, difundió conocimientos y las primeras formas de organización sanitaria. Se instauraron las Juntas Departamentales de Vacunación, cuya conducción ocurrió en contradicciones en las primeras políticas públicas de control sanitario. Esta situación se mantuvo hasta la fundación del Anfiteatro Anatómico.
During the Viceroyalty of Peru, hospitals and universities were developed by Christian charity. Rote learning process, ecclesiastical hegemony, and poor organization frustrated innovative ideas about sciences by absence of a civilian elite capable of formulating higher education policies. The arrival of the Royal Philanthropic Expedition of the Vaccine, in 1806, spread the knowledge and the basis of sanitary organization. The Departmental Vaccination Boards were established, whose management occurred within contradictions in the first public policies of sanitary control. This situation remained until the Anatomical Amphitheater was founded.
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Can we improve training for health professionals? We explore specific variables that need to be accounted for to achieve sustainable local health development through training. A problembased approach with appreciation of the need for making changes is suggested as the only authentic basis for training.
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Healthy rural reconstruction is a widely explored intervention implemented by China Rural Health Devel-opment Project with the support of the World Bank and UK Department for International Development. By using initial pro-ject baseline data survey, mid-term evaluation and supervision, terminal evaluation of acquired qualitative and quantitative data,this paper analyzes the intervention policy design and initial effects of China's healthy rural reconstruction. With transforming the living environment in rural areas as the starting point, the project has relatively achieved good results, by using different policy measures such as improving the environment, creating a social environment conducive to villagers' health, expanding and providing high-quality health services, foster healthy behaviors and lifestyles, etc. The main results include the expansion of the project to cover 745 administrative villages, the environment of healthy villa-ges is much better than other neighboring villages, villagers' health knowledge has been greatly increased, lifestyle be-haviors of villagers have improved, the attitudes and participation rate of residents in cultural and sports activities have improved, etc. This paper suggests implementing the healthy rural reconstruction nationwide. It is very important to in-tegrate the concept of healthy village throughout the connotation of all kinds of new rural reconstruction, so the concept of health is deeply rooted in rural areas and imperceptibly change people's living behaviors and habits.
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Este trabalho investigou a evolução do comportamento no processo psicoterapêutico de crianças psicóticas pela análise da construção do real, tal como entendida pela teoria do conhecimento de Piaget. Do total de 31 prontuários de crianças com três a 12 anos atendidas em psicoterapia breve infantil na Clínica-Escola foram analisadas as transcrições de sessões de 23 casos identificados com comprometimento nas noções de espaço, tempo e causalidade, dos quais quatro mostravam sinais sugestivos de comportamento psicótico. Outro objetivo foi verificar a eficácia das intervenções clínicas nas quatro diagnosticadas como psicóticas. As crianças foram submetidas a uma intervenção pela técnica ludoterapêutica psicanalítica. Verificou-se que as crianças começaram a demonstrar evoluções cognitivas a partir da quarta sessão, evidenciando que a ludoterapia oferece condições para a aquisição dessas noções, principalmente, quando consideradas pelo psicoterapeuta. Por outro lado, as crianças com discurso psicótico apresentaram maior oscilação na aquisição das noções espaciais, temporais e causais.
This work investigated the evolution of the psychotic child's behavior through the therapeutic process based on Piaget's theory. Transcriptions of the sessions of 23 patients were analysed from a total of 31 clinical protocols. These patients were three to 12 years old and they were identified as having problems with the notions of space, time and causality. Four of them also showed suggestive indications of psychotic behavior. Another objective was to verify the effectiveness of the psychotherapeutic intervention on those four identified as having psychotic behavior. The children were submitted to an intervention through the psychoanalysis child play therapy. It was verified that the children began to demonstrate cognitive evolution since the fourth therapeutic session, evidencing that play psychotherapy offers conditions to the acquisition of notions when they are taken into account by the therapist. On the other hand, the children with psychotic diagnosis demonstrated more oscillations to acquire the notions of space, time and causality.
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The situation of investment in health is a measure of socio-economic and cultural development of a country or region.The health outcome from a certain amount of health costs is the economic benefits of investment in health.The World Health Organization has made "put investment in the field of health to promote economic development," a new development strategy for the purpose of investment in health,expanding domestic demand and the development of health which could be the cause of national macro-economic development.This paper briefly describes the impact of health investment on China's economic development from several aspects.