The PIRASOA® programme: implementation and first outcomes of an antimicrobial stewardship programme based on educational interviews in primary care of the public health system of Andalusia, Spain.

2016 ◽  
Author(s):  
Jose Miguel Cisneros Herreros
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health System ◽  
Antimicrobial Stewardship ◽  
Public Health System ◽  
Programme Implementation ◽  
The Public

scholarly journals Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care Doctors in India as Street Level Bureaucrats

2020 ◽  
Author(s):  
Sudha Ramani ◽  
Lucy Gilson ◽  
Muthusamy Sivakami ◽  
Nilesh Gawde
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health System ◽  
Professional Identity ◽  
Public Health System ◽  
Risk Averse ◽  
The Public ◽  
Street Level ◽  
Primary Care Doctors ◽  
Street Level Bureaucrats

Background: In this study, we use the case of medical doctors in the public health system in rural India to illustrate the nuances of how and why gaps in policy implementation occur at the frontline. Drawing on Lipsky’s Street Level Bureaucracy (SLB) theory, we consider doctors not as mechanical implementors of policies, but as having agency to implement modified policies that are better suited to their contexts. Methods: We collected data from primary care doctors who worked in the public health system in rural Maharashtra, India between April and September 2018 (including 21 facility visits, 29 in depth interviews and several informal discussions). We first sorted the data inductively into themes. Then we used the SLB theoretical framework to categorise and visualise relationships between the extracted themes and deepen the analysis. Results: Doctors reported facing several constraints in the implementation of primary care- including the lack of resources, the top-down imposition of programs that were not meaningful to them, limited support from the organization to improve processes as well as professional disinterest in their assigned roles. In response to these constraints, many doctors ‘routinized’ care, and became resigned and risk-averse. Most doctors felt a deep loss of professional identity, and accepted this loss as an inevitable part of a public sector job. Such attitudes and behaviours were not conducive to the delivery of good primary care. Conclusion: This study adds to empirical literature on doctors as Street Level Bureaucrats in lower and middle income countries. Doctors from these settings have often been blamed for not living up to their professional standards and implementing policies with rigour. This study highlights that doctors’ behaviours in these settings are ways through which they ‘cope’ with their loss of professional identity and organizational constraints; and highlights the need for appropriate interventions to counter their weak motivation.

scholarly journals The high cost patients on waiting list for the Liver Transplantation. main burdens and consequences for the Public Health System

2015 ◽  
Vol 18 (3) ◽  
pp. A224
Author(s):  
J.A. Turri ◽  
L.B. Haddad ◽  
W. Andrauss ◽  
L.A. D’Albuquerque ◽  
M.A. Diniz
Keyword(s):  
Public Health ◽  
Liver Transplantation ◽  
Health System ◽  
Public Health System ◽  
Waiting List ◽  
The Public

Development of a probabilistic model for quantitative risk assessment of COVID-19 in Brazil

2021 ◽  
pp. 2150069
Author(s):  
Paulo Gabriel Santos Campos de Siqueira ◽  
Alexandre Calumbi Antunes de Oliveira ◽  
Heitor Oliveira Duarte ◽  
Márcio das Chagas Moura
Keyword(s):  
Public Health ◽  
Risk Assessment ◽  
Health System ◽  
Probabilistic Model ◽  
Public Health System ◽  
The Other ◽  
Quantitative Risk Assessment ◽  
The Public ◽  
Business As Usual ◽  
Excessive Number

We have developed a probabilistic model to quantify the risks of COVID-19 explosion in Brazil, the epicenter of COVID-19 in Latin America. By explosion, we mean an excessive number of new infections that would overload the public health system. We made predictions from July 12th to Oct 10th, 2020 for various containment strategies, including business as usual, stay at home (SAH) for young and elderly, flight restrictions among regions, gradual resumption of business and the compulsory wearing of masks. They indicate that: if a SAH strategy were sustained, there would be a negligible risk of explosion and the public health system would not be overloaded. For the other containment strategies, the scenario that combines the gradual resumption of business with the mandatory wearing of masks would be the most effective, reducing risk to considerable category. Should this strategy is applied together with the investment in more Intensive Care Unit beds, risk could be reduced to negligible levels. A sensitivity analysis sustained that risks would be negligible if SAH measures were adopted thoroughly.

scholarly journals Neutralization of B.1.1.28 P2 variant with sera of natural SARS-CoV-2 infection and recipients of BBV152 vaccine

2021 ◽  
Author(s):  
Gajanan Sapkal ◽  
Pragya Yadav ◽  
Raches Ella ◽  
Priya Abraham ◽  
Deepak Patil ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Natural Infection ◽  
Vaccination Program ◽  
Vaccine Regimen ◽  
The Public ◽  
Neutralizing Potential ◽  
Dose Vaccine

The emergence of new SARS-CoV-2 variants has been a serious threat to the public health system and vaccination program. The variant of concerns have been the under investigation for their neutralizing potential against the currently available COVID-19 vaccines. Here, we have determined the neutralization efficacy of B.1.1.28.2 variant with the convalescent sera of individuals with natural infection and BBV152 vaccination. The two-dose vaccine regimen significantly boosted the IgG titer and neutralizing efficacy against both B.1.1.28.2 and D614G variants compared to that seen with natural infection. The study demonstrated 1.92 and 1.09 fold reductions in the neutralizing titer against B.1.1.28.2 variant in comparison with prototype D614G variant with sera of vaccine recipients and natural infection respectively.

scholarly journals Amalgam versus resin composite for the restoration of posterior teeth: disparities between public clinical practice and dental education in southern Brazil

2011 ◽  
Vol 52 (1/3) ◽  
pp. 33-37
Author(s):  
Clarissa Fatturi Parolo ◽  
Aline Macarevich ◽  
Juliana Jobim Jardim ◽  
Marisa Maltz
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Resin Composite ◽  
Dental Students ◽  
Restorative Material ◽  
Chi Square ◽  
Posterior Teeth ◽  
The Public ◽  
Dental Schools

Purpose: To compare the restorative material used in the treatment of posterior teeth taught and performed in two Dental Schools (UFRGS and ULBRA) and in 8 basic health units (BHU) from the Public Health System in Porto Alegre, Brazil. Materials and methods: Data referring the teaching of restorative procedures using amalgam (AM) or resin (R) were obtained through the analysis of patient’s files and questionnaires applied to final year dental students. Information regarding restorative procedures at BHU was obtained through patient’s records and a questionnaire applied to the dentists. The type of restorative material used in both BHU and Dental Schools were compared by chi-square test. Results: At UFRGS, 327 restorations were performed, 78.28% R and 21.72% AM, and at ULBRA 366 restorations, 92.63% R and 7.37% AM. At BHU, 1664 restorations were performed (35.93% R and 64.07% AM). A major proportion of AM restorations was performed in the Public Health Service in comparison to both Dental Schools, in which resin restorations prevailed (p=0.000). Conclusion: The change from AM to R in the dental material choice for posterior teeth at Dental Schools was not followed by the Public Health System, where the AM is still widely used in posterior teeth.

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