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Search Results: 1 - 10 of 185078 matches for " Almeida-Filho Naomar de "
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Causalidade, contingência, complexidade: o futuro do conceito de risco
Almeida-Filho, Naomar de;Coutinho, Denise;
Physis: Revista de Saúde Coletiva , 2007, DOI: 10.1590/S0103-73312007000100007
Abstract: we contend the thesis that, in the current phase of maturity of the epidemiological field, a reevaluation of the risk concept is timely needed. initially, we discuss the foundations of categories of causality and contingency in the work of two philosophers, aristotle and pascal. secondly, recovering previous reflections on logical bases of the concept of risk, we critically discuss its explanatory adequacy and efficacy for the health-disease object. thirdly, we briefly present ground categories and concepts of the complexity paradigm, capable of tackling phenomena of emergency, non-linearity and fuzziness related to new, mutant, complex health objects. we conclude with a few remarks and thoughts yet preliminary on foundations, perspectives and consequences of applying the modality of "contingency" as alternative to notions of determination in the health field, in order to envision the future of the concept of risk far beyond the thematic area (scientific and technological) of contemporary epidemiology.
Prevalência de cefaléia como sintoma em um setor urbano de Salvador, Bahia
Bastos, Sérgio Borges;Almeida-Filho, Naomar de;Santana, Vilma Sousa;
Arquivos de Neuro-Psiquiatria , 1993, DOI: 10.1590/S0004-282X1993000300002
Abstract: the prevalence of headache was studied as part of an epidemiologic survey of neuropsychiatric disorders carried out with an adult sample (n=1,511) of an urban area of salvador city, bahia, brazil. the overall prevalence of headache complaints was 14.8%, significantly higher among the eldest, female, less educated, migrants, unemployed, low ses and married/divorced. stratified analysis for age and gender as confounders erased out the effect of marital status and socio-economic status indicators. the presence of psychiatric disorders was strongly, significantly associated with the prevalence of headache (odds ratio of 4.2). these results are compared to the international literature, emphasizing the extremely lower rates found as well as the profiles of risk factors completely distinct from those reported in other sociocultural realities.
Reforma sanitária e informa??o em saúde: avalia??o dos registros médicos em um distrito sanitário de Salvador, Bahia
Modesto, Márcia G.;Moreira, Esdras C.;Almeida-Filho, Naomar de;
Cadernos de Saúde Pública , 1992, DOI: 10.1590/S0102-311X1992000100008
Abstract: this study aims at evaluating the quality of medical records in primary health services of the health district of itapagipe (salvador/bahia, brazil), before and after the health reform of the unified and decentralized health system (suds), initiated in 1987. nine hundred and sixty one new records for 1986 and 850 for 1989 were evaluated with regard to: standardization of the record, legibility, and adequate entry of basic information from the medical history on the first visit. comparing the pre - and post - health reform periods, improvement was observed in relation to standardization of records (from 49% to 94%) as well as the recording of prescriptions and diagnoses (30% of the records without diagnoses had prescriptions in 1986, dropping to 7% in 1989). however, the proportion of legible records decreased slightly (from 76 % to 71 %) and there was a marked increase in the frequency of blank records (from 6% to 19%), indicating that, despite a better supply of material resources, there was not a corresponding progress in the quality of health information. finally, even considering a marked improvement in the proportion of records with satisfactory quality (from 5 to 24%), one can still find in 1989 a very high proportion (49%) of records without registration of items from clinical examination.
Mental health research in Brazil: policies, infrastructure, financing and human resources
Mari Jair de Jesus,Bressan Rodrigo A,Almeida-Filho Naomar,Gerolin Jer?nimo
Revista de Saúde Pública , 2006,
Abstract: The objective of this descriptive study was to map mental health research in Brazil, providing an overview of infrastructure, financing and policies mental health research. As part of the Atlas-Research Project, a WHO initiative to map mental health research in selected low and middle-income countries, this study was carried out between 1998 and 2002. Data collection strategies included evaluation of governmental documents and sites and questionnaires sent to key professionals for providing information about the Brazilian mental health research infrastructure. In the year 2002, the total budget for Health Research was US$101 million, of which US$3.4 million (3.4) was available for Mental Health Research. The main funding sources for mental health research were found to be the S o Paulo State Funding Agency (Fapesp, 53.2%) and the Ministry of Education (CAPES, 30.2%). The rate of doctors is 1.7 per 1,000 inhabitants, and the rate of psychiatrists is 2.7 per 100,000 inhabitants estimated 2000 census. In 2002, there were 53 postgraduate courses directed to mental health training in Brazil (43 in psychology, six in psychiatry, three in psychobiology and one in psychiatric nursing), with 1,775 students being trained in Brazil and 67 overseas. There were nine programs including psychiatry, neuropsychiatry, psychobiology and mental health, seven of them implemented in Southern states. During the five-year period, 186 students got a doctoral degree (37 per year) and 637 articles were published in Institute for Scientic Information (ISI)-indexed journals. The investment channeled towards postgraduate and human resource education programs, by means of grants and other forms of research support, has secured the country a modest but continuous insertion in the international knowledge production in the mental health area.
Modelos de determina??o social das doen?as cr?nicas n?o-transmissíveis
Almeida-Filho,Naomar;
Ciência & Saúde Coletiva , 2004, DOI: 10.1590/S1413-81232004000400009
Abstract: this essay critically revises theoretical frameworks and models of social determination of chronic non-communicable diseases. functionalist sociology generated sociocultural models of health that influenced the field of epidemiologic investigation of so-called "new morbidity" (basically chronic and degenerative illnesses), later contained under the generic label of stress theory. neo-durkheimian approaches of social inequalities, based on the social capital concept, are analyzed and theoretical uses of the lifestyle notion in the health field are criticized. models derived from the dialectical materialism, grounded on the concepts of labor and social class, are also discussed as they have turned quite influential in latin-american social epidemiology. finally, considering theoretical and conceptual gaps of such partial theories in what concerns the symbolic space of the social life, the conceptual bases of an alternative theoretical focus: the theory of mode of life and health. as a possible synthesis of the models object of this critical review, it is considered as especially suitable for the elaboration of epidemiologic models of social determination of non-transmissible chronic diseases.
Complejidad y transdisciplinariedad en el campo de la salud colectiva: evaluación de conceptos y aplicaciones
Almeida-Filho,Naomar;
Salud Colectiva , 2006, DOI: 10.1590/S1851-82652006000200003
Abstract: several epistemological and methodological elements have been proposed as an alternative trend for contemporary science, grouped under the label of "new paradigm" and with different degrees of interarticulation. these elements suggest that a "nuova scienza" appears on evolution, demanding characteristic epistemological categories (as the category of the complexity), new theoretical models (as the "theory of chaos") and new logical ways of analysis (as the nonlinear mathematical models, the fractal geometry, the fuzzy logic and the net's theory). also on the field of collective health, several authors have defended the need of new paradigms. these proposals are being amplified and diffused with the purpose of promoting a specific scientific production, able to feed effectively a conceivable new paradigm. this article pretends to introduce briefly the main approaches that betoken some kind of paradigmatic change, in a general way, in the core of science. also some of the various composing elements of the paradigm of the complexity are discussed, from its possible applications to the population's health problems, trying to analyze these issues in the ambit of our specific interest and pointing out some intentions of producing empirical evidence for the analysis of the health's situation, its effects and determinants from these approaches.
Complejidad y transdisciplinariedad en el campo de la salud colectiva: evaluación de conceptos y aplicaciones
Naomar Almeida-Filho
Salud Colectiva , 2006,
Abstract: Varios elementos epistemológicos y metodológicos han sido propuestos como tendencia alternativa a la ciencia contemporánea, agrupados bajo el rótulo de "nuevo paradigma" y con diferentes grados de interarticulación. Estos elementos sugieren que una nuova scienza se encuentra en desarrollo, demandando categorías epistemológicas propias (como la categoría de la complejidad), nuevos modelos teóricos (como la "teoría del caos") y nuevas formas lógicas de análisis (como los modelos matemáticos no lineales, la geometría fractal, la lógica borrosa y la teoría de redes). También en el campo de la Salud Colectiva, varios autores han defendido la necesidad de nuevos paradigmas. Esas propuestas vienen siendo ampliadas y difundidas con el objetivo de fomentar una producción científica concreta, capaz de alimentar efectivamente un posible paradigma nuevo. En este texto se pretende presentar brevemente los principales enfoques que representan algún tipo de cambio paradigmático de un modo general en el seno de la ciencia. También se discuten algunos de los diversos elementos constitutivos del paradigma de la complejidad, desde sus posibles aplicaciones a la problemática de la salud en poblaciones, buscando examinar estas cuestiones en el ámbito de nuestro interés específico e indicando algunas tentativas en el sentido de producir evidencias empíricas para el análisis de la situación de salud, sus efectos y sus determinantes a partir de estos abordajes.
Estrutura fatorial do questionário de morbidade psiquiátrica de adultos aplicado em amostras populacionais de cidades brasileiras
Andreoli Sérgio Baxter,Mari Jair de Jesus,Blay Sérgio Luis,Almeida-Filho Naomar de
Revista de Saúde Pública , 1994,
Abstract: A análise de componentes principais é uma técnica de estatística multivariada utilizada para examinar a interdependência entre variáveis. A sua principal característica é a capacidade de reduzir dados, e tem sido usada para o desenvolvimento de instrumentos de pesquisas psiquiátricas e na classifica o dos transtornos psiquiátricos. Esta técnica foi utilizada para estudar a estrutura fatorial do Questionário de Morbidade Psiquiátrica do Adulto (QMPA). O questionário foi composto de 45 quest es de resposta sim/n o que identificam sintomas psiquiátricos, uso de servi o e de drogas psicotrópicas. O questionário foi aplicado em 6.470 indivíduos maiores de 15 anos, em amostras representativas da popula o de três cidades brasileiras (Brasília, S o Paulo e Porto Alegre). O estudo teve como objetivo comparar a estrutura fatorial do questionário nas três regi es urbanas brasileiras. Sete fatores foram encontrados que explicam 42,7% da variancia total da amostra. O fator 1, Ansiedade/Somatiza o ("eigenvalue" (EV) = 3.812 e variancia explicada (VE) = 10,9%); O fator 2, Irritabilidade/Depress o (EV = 2.412 e VE = 6,9%); O fator 3, Deficiência Mental (EV= 2.014 e VE = 5,8%); O fator 4, Alcoolismo (EV = 1.903 e VE = 5,4%); O fator 5, Exalta o do Humor (EV = 1.621 e VE = 4,6%); O fator 6, Transtorno de Percep o (EV = 1.599 e VE = 4,6%) e o fator 7, Tratamento (EV = 1.592 e VE = 4,5%).O QMPA apresentou estruturas fatoriais semelhantes nas três cidades. Baseados nos achados, s o feitas sugest es para que algumas quest es sejam modificadas e para a exclus o de outras em uma futura vers o do questionário.
Is psychiatric reform a strategy for reducing the mental health budget? The case of Brazil
Andreoli, Sérgio Baxter;Almeida-Filho, Naomar;Martin, Denise;Mateus, Mário Dinis M L;Mari, Jair de Jesus;
Revista Brasileira de Psiquiatria , 2007, DOI: 10.1590/S1516-44462006005000032
Abstract: objective: to investigate trends in the provision of mental health services and financing in brazil. method: data from datasus (the brazilian unified health computerized system) with free access in the web were collected regarding the number of beds, the development of new community centers, the number of mental health professionals, and costs involved from 1995 to 2005. results: in ten years, the number of psychiatric beds decreased 41% (5.4 to 3.2 per 10,000 inhabitants) while community services have increased nine-fold (0.004 to 0.037 per 10,000 inhabitants). psychologists and social workers have accounted for three and two-fold, respectively, as much hirings as psychiatrists. psychiatric admissions accounted for 95.5% of the budget in 1995 and 49% in 2005, and the expenses with community services and medication have increased 15% each. as a whole, the expenses in mental health decreased by 26.7% (2.66 to 1.95 us$ per capita). conclusion: there has been a clear switch from hospital to community psychiatric care in brazil, where the system can now provide a diversity of treatments and free access to psychotropics. however, the coverage of community services is precarious, and the reform was not accompanied by an increased public investment in mental health. the psychiatric reform is not a strategy for reducing costs; it necessarily implies increasing investments if countries decide to have a better care of those more disadvantaged.
Mental health research in Brazil: policies, infrastructure, financing and human resources
Mari,Jair de Jesus; Bressan,Rodrigo A; Almeida-Filho,Naomar; Gerolin,Jer?nimo; Sharan,Pratap; Saxena,Shekhar;
Revista de Saúde Pública , 2006, DOI: 10.1590/S0034-89102006000100024
Abstract: the objective of this descriptive study was to map mental health research in brazil, providing an overview of infrastructure, financing and policies mental health research. as part of the atlas-research project, a who initiative to map mental health research in selected low and middle-income countries, this study was carried out between 1998 and 2002. data collection strategies included evaluation of governmental documents and sites and questionnaires sent to key professionals for providing information about the brazilian mental health research infrastructure. in the year 2002, the total budget for health research was us$101 million, of which us$3.4 million (3.4) was available for mental health research. the main funding sources for mental health research were found to be the s?o paulo state funding agency (fapesp, 53.2%) and the ministry of education (capes, 30.2%). the rate of doctors is 1.7 per 1,000 inhabitants, and the rate of psychiatrists is 2.7 per 100,000 inhabitants estimated 2000 census. in 2002, there were 53 postgraduate courses directed to mental health training in brazil (43 in psychology, six in psychiatry, three in psychobiology and one in psychiatric nursing), with 1,775 students being trained in brazil and 67 overseas. there were nine programs including psychiatry, neuropsychiatry, psychobiology and mental health, seven of them implemented in southern states. during the five-year period, 186 students got a doctoral degree (37 per year) and 637 articles were published in institute for scientic information (isi)-indexed journals. the investment channeled towards postgraduate and human resource education programs, by means of grants and other forms of research support, has secured the country a modest but continuous insertion in the international knowledge production in the mental health area.
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