<p> Pneumoconiosis is a chronic and slowly progressive parenchymal lung disease. Estimates suggest that about 68,000 ex-miners in Botswana will develop or have already developed pneumoconiosis. However, most of these cases do not know they have the disease because of the poor quality of care in primary healthcare settings and weak implementation of the Occupational Diseases in the Mines and Works (ODMW) Act. </p><p> This dissertation was a health service research framed from the systems approach using the chronic care model as a theoretical tool. The study employed a concurrent, convergent parallel mixed method research which combined quantitative and qualitative methods of inquiry. The quantitative arm of the study evaluated whether the Botswana primary care settings meet &lsquo;reasonably good standards&rsquo; of the pneumoconiosis quality of care measured on the chronic care model. The chronic care model measures quality of care on a 0 to 11 scale, where &ldquo;0&rdquo; denotes lack of quality care and &ldquo;11&rdquo; stands for optimal quality of care. Reasonably good quality of care comprises scores between 6 and 8 on the scale. The qualitative arm of the study assessed the implementation of the ODMW Act in the Botswana primary healthcare settings. The study mixed quantitative and qualitative results at the interpretation stage to determine the extent to which quality of care for pneumoconiosis and the ODMW Act implementation promote equitable access to pneumoconiosis services among ex-miners in Botswana. (Abstract shortened by ProQuest.) </p>

A surdez à concebida, do ponto de vista biomÃdico, como deficiÃncia e o surdo como detentor de anomalia orgÃnica a ser corrigida. PolÃticas pÃblicas de saÃde e intervenÃÃes nessa Ãrea revestem-se, correspondentemente, de tal representaÃÃo. Considerando o modo como cada grupo elabora sua visÃo de mundo, objetivamos, com este estudo, compreender as representaÃÃes e o cotidiano da surdez em uma comunidade de surdos, a fim de refletirmos sobre as polÃticas pÃblicas a eles destinadas. Utilizamos o referencial teÃrico-metodolÃgico qualitativo, com uso da tÃcnica de grupo focal seguida da entrevista aberta. Participaram do estudo, em Fortaleza-Ce em 2010, 15 surdos, professores e alunos de curso prÃ-vestibular da mesma instituiÃÃo. De forma complementar aos relatos dos surdos, foram entrevistadas quatro fonoaudiÃlogas. Os achados evidenciaram que coexistem diferentes concepÃÃes acerca da surdez. Os surdos a compreendem como experiÃncia visual, de carÃter identitÃrio, firmada em seus componentes culturais e lingÃÃsticos. Identidade, cultura e a lÃngua de sinais (Libras) constituem, portanto, sua unidade definidora. Diferente da lÃgica instituÃda na Ãrea da saÃde, o implante coclear foi concebido, pela maioria dos informantes, como sÃmbolo de retrocesso, de negaÃÃo e de perda da identidade surda. Apontaram, em seu cotidiano, barreiras atitudinais, de comunicaÃÃo e informaÃÃo que dificultam e em outros casos inviabilizam seu atendimento e Ãxito de suas demandas nos serviÃos pÃblicos e coletivos, sendo um desafio, para o profissional e o paciente surdo, o atendimento no serviÃo de saÃde. Em suma, o estudo possibilitou se compreender a surdez com base em sua constituiÃÃo histÃrico-social. Diferentes discursos co-existem, visto que a surdez expressa dimensÃes fisiolÃgica, simbÃlica e cultural. CompreendÃ-la em seus distintos aspectos à importante, na medida em que esta pode proporcionar mudanÃas no modo como os profissionais de saÃde e a sociedade ouvinte percebem e se relacionam com os surdos e com as tecnologias auditivas a esses destinadas. Torna-se urgente refletir sobre as estratÃgias para uma sociedade inclusiva, respeitando as diferentes posiÃÃes dos atores sociais em questÃo.

A Constituição da República Federativa do Brasil de 1988 elevou a saúde como direito social fundamental e constituiu o Sistema Único de Saúde com competência para as ações e serviços de saúde, incluídas as de vigilância sanitária. As ações e serviços da área formulam-se e implementam-se por intermédio de políticas públicas adotadas pelo Poder Público. As referidas políticas são programas de ação governamental que se valem de normas jurídicas e têm estimulado a reflexão dos juristas, em vista, especialmente, de frequentes decisões judiciais sobre políticas públicas, mais notadamente, nas de caráter social. Em vigilância sanitária há o estabelecimento de políticas públicas, por parte da União, que tem na Agência Nacional de Vigilância Sanitária (Anvisa) seu órgão executor, em nível federal. A Anvisa, para executar a política pública de vigilância sanitária, formula atos que regulam essa atividade. Tais atos, muitas vezes, são questionados judicialmente. Esta pesquisa analisou as decisões judiciais federais, entre os anos de 1999 e 2007, em que a Anvisa figurou no pólo passivo da relação processual, com o intuito de observar se o Poder Judiciário, ao decidir sobre essa importante matéria, leva em conta o código binário Direito Sanitário/Não Direito Sanitário da Teoria dos Sistemas Sociais de Niklas Luhmann ou o ignora, formulando sentenças baseadas em outras fontes que não o Direito Sanitário e a política pública de vigilância sanitária. Concluiu-se que o Poder Judiciário federal, embora pouco versado em matéria de saúde pública, deixa-se influenciar pela compreensão de vigilância sanitária e de risco sanitário e tem julgado, em maioria, a favor da saúde / The 1988 Constitution of the Federative Republic of Brazil has given health a fundamental social right status and also has created a centralized health system called SUS which is responsible, among other subjects, for health surveillance services. In Brazil, actions and health services are created and implemented as public policies. Those are government actions and programs supported by laws that have been stimulating lawyers to speculate about the subject, notably because of numerous court decisions in public policies, especially those with a social character. In Brazil, health surveillance is jurisdiction of federal government through the National Health Surveillance Agency (Anvisa). This agency in order to implement public policies in health surveillance enforces acts to regulate such activities. However, such acts are often challenged in court. In order to determine if Judiciary decisions takes into account Health Law / Not Health law Niklas Luhmann\'s binary system or simply ignores the subject resulting in sentences based on other sources but Health Law and health surveillance public policy. The conclusion was that Federal Judiciary has decided mostly in favor of health, although not much experienced in public health matters they are influenced by health surveillance and health hazard notions

A Constituição da República Federativa do Brasil de 1988 elevou a saúde como direito social fundamental e constituiu o Sistema Único de Saúde com competência para as ações e serviços de saúde, incluídas as de vigilância sanitária. As ações e serviços da área formulam-se e implementam-se por intermédio de políticas públicas adotadas pelo Poder Público. As referidas políticas são programas de ação governamental que se valem de normas jurídicas e têm estimulado a reflexão dos juristas, em vista, especialmente, de frequentes decisões judiciais sobre políticas públicas, mais notadamente, nas de caráter social. Em vigilância sanitária há o estabelecimento de políticas públicas, por parte da União, que tem na Agência Nacional de Vigilância Sanitária (Anvisa) seu órgão executor, em nível federal. A Anvisa, para executar a política pública de vigilância sanitária, formula atos que regulam essa atividade. Tais atos, muitas vezes, são questionados judicialmente. Esta pesquisa analisou as decisões judiciais federais, entre os anos de 1999 e 2007, em que a Anvisa figurou no pólo passivo da relação processual, com o intuito de observar se o Poder Judiciário, ao decidir sobre essa importante matéria, leva em conta o código binário Direito Sanitário/Não Direito Sanitário da Teoria dos Sistemas Sociais de Niklas Luhmann ou o ignora, formulando sentenças baseadas em outras fontes que não o Direito Sanitário e a política pública de vigilância sanitária. Concluiu-se que o Poder Judiciário federal, embora pouco versado em matéria de saúde pública, deixa-se influenciar pela compreensão de vigilância sanitária e de risco sanitário e tem julgado, em maioria, a favor da saúde / The 1988 Constitution of the Federative Republic of Brazil has given health a fundamental social right status and also has created a centralized health system called SUS which is responsible, among other subjects, for health surveillance services. In Brazil, actions and health services are created and implemented as public policies. Those are government actions and programs supported by laws that have been stimulating lawyers to speculate about the subject, notably because of numerous court decisions in public policies, especially those with a social character. In Brazil, health surveillance is jurisdiction of federal government through the National Health Surveillance Agency (Anvisa). This agency in order to implement public policies in health surveillance enforces acts to regulate such activities. However, such acts are often challenged in court. In order to determine if Judiciary decisions takes into account Health Law / Not Health law Niklas Luhmann\'s binary system or simply ignores the subject resulting in sentences based on other sources but Health Law and health surveillance public policy. The conclusion was that Federal Judiciary has decided mostly in favor of health, although not much experienced in public health matters they are influenced by health surveillance and health hazard notions

This thesis explores the implications of democratisation on the regulation of health care providers. It examines the reforms in relation to two regulatory policies in the pharmaceutical market of the National Health Insurance (NHI) in South Korea – the separation of prescribing and dispensing (SPD) and the pharmaceutical pricing policy – conducted in two periods – the 1980s under the authoritarian regime and the 1990s under the democratised regime. The misuse and overuse of drugs had long been recognised as a problem for the NHI, and the tight regulation of the SPD and pharmaceutical pricing as potential solutions. Democratisation seems unlikely to tighten the government’s regulation of the SPD and pharmaceutical prices. On the one hand, the Korean authoritarian regime was known as being capable of conducting top-down regulation of societal groups, and democratisation as having liberalised the government-society relationship. On the other, pharmaceutical regulation is a sophisticated and detached issue, which restricts the ability of laypeople to mobilise and exert bottom-up pressure for regulation. Nevertheless, the authoritarian government failed to tighten, and even loosened these regulations, whereas the democratised government tightened them. This thesis explains this puzzle by focusing on the features of the agenda-setting process and the articulation of policy issues therein. In the 1980s, the SPD and the pharmaceutical reimbursement pricing policy were administrative issues, discussed exclusively between bureaucrats and the central associations of health care providers, which resulted in loose regulation. In contrast, in the 1990s, reform-oriented professionals and NGOs raised these issues and put them on the political agenda, which motivated the government to conduct tighter regulation. This thesis suggests some general implications of democratisation on the politics of regulation. The hierarchical and exclusive authoritarian policy network aims to realise policy goals set by ruling elites; however, for other policy issues, societal partners can utilise this network to promote their preferred policies. Democratisation, which promotes competitive elections and political rights, allows previously excluded policy actors to participate in policy-making networks. These new actors include professionals and activists who are able to understand regulatory issues and articulate them in ways that are salient to politicians and the general public, which will motivate the government to tighten the regulation governing its traditional policy partners.

Through exploring nine Indigenous young adults’ perceptions of their roles in building health and wellness through traditional food sovereignty, I assessed the effectiveness of using John Paul Lederach’s (1997) framework of conflict transformation within an Indigenous context for the purpose of creating Indigenous food sovereignty. Conflict transformation does not acknowledge or address the detrimental effects colonization has had on Indigenous peoples within their daily lives. This gap in analysis stunted the effectiveness of conflict transformation in helping young Indigenous adults to challenge colonial authority and work towards developing sustainable approaches to Indigenous food sovereignty. Within the findings, roles emerged related to a generational cycle of learning and teachings traditional knowledge and cultural practices that are applied in the everyday lives of Indigenous peoples. “Learner-teacher cycles” are an Indigenous response to conflicts stemming from colonization. The cycle follows a non-linear progression of learning cultural and traditional knowledge from family and community and the transmission of that knowledge back to family and peers. Learner-teacher cycles are an everyday occurrence and are embedded within Indigenous cultures. Through the learner-teacher cycles, young adults challenge the effects of colonization within their day-to-day lives by learning and practicing cultural ways of being and traditional knowledge, and then transferring their knowledge to next generations and peers. I have concluded that conflict transformation is not an effective tool in resolving protracted conflicts within an Indigenous context, particularly with reference to Indigenous peoples from CoSalish and Dididaht territories on Turtle Island. Learner-teacher cycles, a framework based on Indigenous methods of challenging colonialism through learning, teaching and practicing cultural and traditional ways of being within everyday life, is an appropriate model for young Indigenous adults to use in creating Indigenous food sovereignty. / Graduate

Diss. Umeå : Univ., 2003.

This dissertation deals with the contradiction between the situation, in which the development of healthcare, transformation of the political system and the changes in the environment, has had a major influence on the fact that we are now experiencing a higher age than people at the beginning of the period under review (since 1945). This gives us a sense of assurance of longevity, but the contradiction arises in reality, that lies in the perspective of chronic life, which eliminates us from the ordinary life very soon. Despite this fact, a number of countries have succeeded in achieving higher age limits, but a high age is not a reflection of better health, which reflects a main contradiction between expectations and reality, and it is the main research problem of this dissertaiton at the same time. The goal of this disertation was to find out the evolution of conditions of healthy lifestyle of individuals in the Czech society, between years 1945 and 2016. The second goal was to reflect the evolution of the health status of the whole society in the context of health policy focusing on stages divided into "decades". The dissertation used a combination of institutional analysis of public policy and author's own biographical research with seven respondents, using morphological analysis and...