Reducing Health Inequalities in Brazil’s Universal Health-Care System: Accountability Politics in São Paulo

Brazil relies on the Sistema Único de Saúde (SUS), a public health-care system used by nearly 65 per cent of the population. This article analyses the role played by accountability mechanisms in expanding access to primary health care in the municipality of São Paulo, Brazil’s largest city. Two accountability mechanisms are described and discussed: political competition and outsourcing. The article shows that from 2001 to 2016 the supply of primary care grew and the disparities in access to public health services decreased across the city areas with both the best and worst indices of income, education, and health. These distributive results are striking given how difficult it is to reverse inequalities, as attested by the findings of a number of studies in different parts of the world which indicate that the richest populations tend to persistently benefit more than the poorest from public spending on health.Open Society Foundations, Vozes Desiguais/Unequal Voices, Future Health Systems consortium, the Impact Initiative and Health Systems Globa

Programas mediados pela tecnologia de promoção de literacia em saúde mental em adolescentes: revisão sistemática

Orientação: Diogo Jorge Pereira do Vale Lamela da SilvaSendo a adolescência considerada uma etapa crítica para a saúde mental, faz com que a promoção da literacia, nesta fase, assuma particular relevância. Diversos programas face-a-face de promoção da literacia da saúde mental têm sido desenvolvidos com adolescentes e a sua eficácia avaliada. Apesar da consistência relativa à eficácia destes programas na promoção da saúde mental em adolescentes, pouco se sabe sobre as características e o efeito de intervenções mediadas pela tecnologia. Devido à preferência dos adolescentes face à internet, a par da rápida disseminação da internet como método de implementação de programas de intervenção promocional, preventiva e remediativa, a presente revisão sistemática tem como finalidade contribuir para a sistematização do conhecimento empírico sobre este tema. Procedeu-se a um levantamento sistemático da literatura científica entre janeiro de 2008 a junho de 2019 com o objetivo de identificar estudos empíricos sobre as variáveis-alvo desta revisão. Os resultados revelaram que estes programas são eficazes na promoção de literacia em saúde mental, no entanto apresentam resultados pouco consistentes relativos ao efeito dos programas na redução do estigma e nos comportamentos de procura de ajuda profissional. Os nossos resultados apresentam implicações clínicas, nomeadamente conhecimento face à adesão e os efeitos positivos que os programas mediados pela tecnologia apresentam face à literacia em saúde mental, sendo, no entanto, necessária uma maior investigação sobre os efeitos na diminuição do estigma e nos comportamentos de procura de ajuda.As adolescence is considered a critical stage for mental health, it makes the promotion of literacy at this stage particularly relevant. Several face-to-face mental health literacy promotion programs have been developed with adolescents and their efficacy evaluated. Despite the relative consistency of the efficacy of these programs in promoting adolescent mental health, less is known about the characteristics and effect of technology-based interventions. Due to the preference of adolescents over the internet, in addition to the rapid spread of the internet as a method of implementing promotional, preventive and remedial intervention programs, this systematic review aims to contribute to the systematization of empirical knowledge on this topic. A systematic survey of the scientific literature was carried out from January 2008 to June 2019 in order to identify empirical studies on the target variables of this review. The results revealed the efficacy of these programs in promoting mental health literacy, however, they present inconsistent results of the effect of programs on reducing stigma and on the increase help- seeking behaviors. Our findings have some clinical implications, namely knowledge about adherence and the positive effects that technology-mediated programs have on mental health literacy. However, further research the effects on decreasing stigma and kelp-seeking behaviors is needed

Making the Right to Health a Reality for Brazil’s Indigenous Peoples: Innovation, Decentralization and Equity

This article provides an overview of governance arrangements and changes in the Brazilian public health system since 1988, when the “Citizen’s Constitution” declared health to be a universal right. Since then, population coverage has grown substantially and health indicators have improved. Despite these achievements, inequities in access remain an important barrier to universal coverage, in particular for marginalized groups such as indigenous peoples. This article discusses the innovation cycle that produced the gains and recent efforts to guarantee more equitable access to health services for the indigenous population in a continent-sized country historically plagued by great inequalities.UKai

How to leverage artificial intelligence for sustainable business development

Dissertation presented as the partial requirement for obtaining a Master's degree in Information Management, specialization in Knowledge Management and Business IntelligenceThe field of Artificial Intelligence (AI) was founded as an academic discipline in the summer of 1956 (Muthukrishnan et al., 2020) at Dartmouth College in Hanover, New Hampshire, when several field experts gathered for a workshop focused on understanding how to humanize machine functioning (McCarthy et al., 2006). However, it was not until the beginning of the 21st century that AI research boomed, as a consequence of successful applications of machine learning algorithms across both academy and industry

Child Engagement in Inclusive Preschools: Contributions of Classroom Quality and Activity Setting

Preschool process quality and activity setting are considered important aspects influencing child engagement. As such, it is important to understand how educational settings can promote engagement, particularly for children with disabilities and/or at risk. This observational study describes process quality and activity setting in inclusive preschools, analyzing its predictive role for child engagement. Participants were 184 children attending 39 preschools. Three groups of children, nested within classrooms, were considered: with disabilities (n = 45), at risk (n = 59), typically developing (n = 80). Child Observation in Preschool assessed engagement and activity setting; Classroom Assessment Scoring System assessed quality of teacher–child interactions. Research Findings: Results from multilevel regressions show that classroom emotional support and organization and more time in free play were positively predicting child engagement, whereas more time in whole group was a negative predictor of engagement. Besides these main effects, an interaction effect between child developmental functioning and activity settings was found. For at-risk children, more time in whole-group activities had greater negative effects on child engagement. For children with disabilities, more time in free-play had greater positive effects on child engagement. Practice or Policy: Results contribute to inform teachers regarding the importance of individualizing interactions and planning activity settings to promote engagement and participation in inclusive preschools.info:eu-repo/semantics/publishedVersio

Revisão sistemática de ensaios clínicos randomizados: Intervenções não-farmacológicas com objetivo de reduzir a fragilidade em idosos

Frailty is a well-known and accepted term by professionals working with older people in recent years for its associations with multiple adverse outcomes. The purpose of this systematic review of randomized controlled trials was to examine non-pharmacological interventions that allows reversing or reducing frailty, and its adverse outcomes, such as disability in activities of daily living and instrumental activities of daily living, lower quality of life and falls in older adults. Systematic review of literature was performed in PubMed, Scopus, ISI Web of Knowledge and Cochrane Central Register of Controlled Trials. This systematic review concluded that, apart from the lack of consensus on how to evaluate the frailty, there is also a lack of evidence regarding the effect of non-pharmacological interventions on frailty. The heterogeneity of interventions proposed in the literature highlights that future research should focus on determining the best way to prevent and reduce frailty.info:eu-repo/semantics/publishedVersio