<p>This study aimed to contribute to the current debate around equity in health care resource allocation by measuring the current allocation of resources, relative to need in the Northern Cape. It also discussed the level of inequities in health financing/expenditure and staffing at the primary health care level between different districts of the Northern Cape.</p>

There is increasing concern about hepatitis C virus (HCV) and potential HIV transmission among ethnic Vietnamese injecting drug users (IDUs) in Australia. To date ethnic and cultural differences in vulnerability to blood-borne viruses (BBV) have received little attention and few studies have attempted to explore the role of cultural beliefs and values in influencing injection risk behaviour. This study aimed to systematically explore the cultural beliefs and behavioural practices that appear to place ethnic Vietnamese IDUs at increased risk of BBV infection, identify barriers to this group accessing health and preventive programs, and document antibody HIV and HCV prevalence and associated risk behaviours. The first component of the research consisted of an ethnographic study designed to explore underlying explanatory models of health and illness employed by Vietnamese IDUs and identify cultural influences on risk behaviours and vulnerability to BBVs. These data were subsequently used to inform the development of the instrument used in the second component ??? a cross-sectional survey and collection of capillary blood samples designed to assess risk behaviours and antibody HIV and antibody HCV prevalence. Analysis of data from both components indicates that cultural beliefs and practices influence risk-taking and health-seeking behaviours and suggests pathways through which this influence occurs. Relevant cultural characteristics include those pertaining to spiritual and religious beliefs, the role of the family and traditional Vietnamese family values, cultural scripts of self-control and stoicism, the importance of ???face??? and non-confrontational relationships, trust and obligation, and a reluctance to discuss problems with outsiders. Vulnerability to BBVs is influenced by these cultural characteristics, together with Vietnamese IDUs??? perceptions of risk, knowledge about HIV and HCV, and situational and environmental factors. Main factors contributing to the under-utilisation of health services include the use of self-managed care practices, ambivalence surrounding Western medicine, long waiting times, concerns in relation to confidentiality, stigmatisation of drug use, and limited knowledge of BBVs. The data indicate a need for interventions based on understanding of culturally specific meanings and contexts of health, illness and risk in order to better meet the needs of this vulnerable group.

Bibliography: leaves 203-219. / 219 leaves : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Concerned with the contribution of commonsense understandings of disease to social differentials in health outcomes. Argues that understandings in part reflect the social circumstances of an individual and mediate preventive activities and use of services, thereby influencing health outcomes. These are examined using the specific health outcomes of tooth loss and tooth decay. / Thesis (Ph.D.)--University of Adelaide, Dept. of Public Health, 2000

Dissertation (Ph.D.)--University of South Florida, 2007. / Title from PDF of title page. Document formatted into pages; contains 155 pages. Includes vita. Includes bibliographical references.

Diss. Stockholm : Karol. inst., 2005.

Thesis (Ph.D.)--University of Alberta, 2009. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Engineering Management, Department of Mechanical Engineering. Title from pdf file main screen (viewed on October 23, 2009). Includes bibliographical references.

Thesis--University of Oklahoma. / Bibliography: leaves 71-72.

Thesis (Ph. D.)--University of Missouri-Columbia, 2007. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on October 15, 2007) Vita. Includes bibliographical references.

Made available in DSpace on 2014-12-17T14:46:52Z (GMT). No. of bitstreams: 1 SamaraSDR_DISSERT.pdf: 925766 bytes, checksum: a9ffc5c5017410b8086f3ce0b78b8e73 (MD5) Previous issue date: 2012-12-01 / The objective of analyze the shift of the working process of the ESF team in care of children with disabilities, from awareness-raising actions. It is a qualitative study, with the action-research method. Thirteen health professionals were involved from two teams of ESF unit area of the Unidade de Sa?de da Fam?lia Dr. Chico Porto (UBSFCP) in Mossor?, from March to August 2011. Data were analyzed following the direction of freirean s thematic analysis. In the situational diagnosis of the current reality of CwD assistance in that UBSFCP, through participant observation and application of semi-structured interviews with professionals, we realize that despite these actions carry some assistance to the CwD, in practice few are used for inclusion and accessibility. The monitoring of the CwD is done through individual consultations by each team professional, home visits when possible, both ruled on the complaints and problems, with little solving in the used actions. Since the need for a change in the treatment model and training requirements as pointed out by professionals in the interview, then we decided to build the proposed of training suggested by the multidisciplinary team and put together collectively the achievement of this moment in all its phases. In the step of implementation (action), aspects related to the current situation in Brazil and Mossor? (Laws, policies and health care) for the CwD and CwD Assistance and their family in the ESF in the first two moments of the first training (action) were contemplate. On the second day we discussed the specialized care to CwD, contribution of the Handicapped Parents and Friends Association of Mossor? and in a second moment a workshop was held in which awareness for inclusion of CwD and actions of ESF were discussed. All these moments were discussed and collectively constructed. In the evaluation, we found that implementation (action) allowed to the professional the comprehension of new understandings about people with disabilities, on ways to include, guiding, caring, watching, and mainly to have a new vision on health assistance of the CwD, expanding assistance beyond clinical aspects and recognizing the educational aspects of the rights and duties of citizens and the inclusion of these children in the social spaces area. As difficulties, we face the need for some professionals to be absent to attend another job, solve personal problems, and little or no participation. Thus, during this action-research, the subjects were able to realize the importance of carrying out their practice to the quality of life for him and to the one they care / Objetivou-se analisar a mudan?a do processo de trabalho da equipe da ESF na aten??o ? crian?a com defici?ncia, a partir de a??es de sensibiliza??o. Trata-se de um estudo qualitativo, tendo como m?todo a pesquisa-a??o. Foram envolvidos treze profissionais de sa?de das duas equipes da ESF da ?rea de abrang?ncia da Unidade de Sa?de da Fam?lia Dr. Chico Porto (UBSFCP), no munic?pio de Mossor?/RN, no per?odo de Mar?o a Agosto de 2011. Os dados foram analisados seguindo o direcionamento da an?lise tem?tica freireana. No diagn?stico situacional da realidade atual de assist?ncia as CcD na referida UBSFCP, atrav?s da observa??o participante e aplica??o de entrevista semi-estruturada junto aos profissionais, percebemos que apesar de realizarem algumas a??es assistenciais para a CcD, na pr?tica poucas delas s?o empregadas no sentido da inclus?o e acessibilidade. O acompanhamento da CcD ? feito atrav?s de consultas individuais por cada profissional da equipe, e visitas domiciliares quando poss?vel ambas pautadas nas queixas e problemas, com pouca resolubilidade nas a??es empregadas. Visto a necessidade de mudan?a no modelo de atendimento e tamb?m de capacita??o como foi apontado pelos profissionais na entrevista realizada, decidimos em seguida construir a proposta de capacita??o sugerida pela equipe multiprofissional e elaboramos coletivamente a realiza??o deste momento em todas as suas fases. Na etapa de implementa??o da capacita (a??o), contemplamos aspectos referentes ? situa??o atual no Brasil e em Mossor?/RN (Leis, pol?ticas e assist?ncia a sa?de) para as CcD e Assist?ncia ? CcD e a sua fam?lia na ESF nos dois primeiros momentos do primeiro de capacita (a??o). No segundo dia, discutimos a assist?ncia especializada ? CcD, contribui??o da Associa??o Pais e Amigos dos Excepcionais de Mossor? e, em um segundo momento, foi realizada uma oficina que discutia a sensibiliza??o para inclus?o da CcD nas a??es da ESF. Todos esses momentos foram debatidos e constru?dos coletivamente. Na avalia??o, constatamos que a capacita (a??o) permitiu aos profissionais a compreens?o de novos entendimentos sobre a pessoa com defici?ncia, sobre as formas de incluir, de orientar, de cuidar, de assistir e, principalmente, de ter uma nova vis?o sobre a assist?ncia a sa?de da CcD, ampliando a assist?ncia para al?m dos aspectos cl?nicos e reconhecendo os aspectos educacionais, dos direitos e deveres de cidad?os e a inclus?o dessas crian?as da ?rea(comunidade) nos espa?os sociais. Com dificuldades, nos deparamos com a necessidade de alguns profissionais se ausentarem para comparecerem a outro emprego, resolver problemas pessoais, e pouca ou nenhuma participa??o. Assim, esta pesquisa-a??o fez, durante o seu curso, com que os sujeitos conseguissem perceber a import?ncia da realiza??o de suas pr?ticas para a qualidade vida deles e daqueles que est?o sob seus cuidados.

Introdução: A Atenção Primária à Saúde (APS) constitui-se como uma estratégia capaz de ofertar serviços de saúde de maneira equânime e eficiente para ordenar o acesso ao usuário. É compreendida como a coordenadora da rede assistencial da saúde. Dentro das premissas da APS, tem-se que o acesso na condição de primeiro contato que corresponde à utilização e a acessibilidade aos serviços de saúde pelos usuários em um espaço de cuidado para cada novo problema ou mesmo um novo episódio de um problema já existente. Deste modo, a perspectiva do usuário é uma importante forma de informação para construção de avaliações do processo do cuidado, bem como dos resultados obtidos com a aplicabilidade de certos modelos assistenciais. Objetivo: analisar o acesso aos serviços de Atenção Primária à Saúde por meio da percepção do usuário adulto no município de Porto Alegre/RS. Metodologia: trata-se de um estudo de base populacional realizado com usuários dos serviços de saúde em três Gerências Distritais de Porto Alegre no período de setembro de 2016 a maio de 2017. A amostra foi composta por indivíduos adultos, com idade mínima de 18 anos, residentes nas áreas cobertas pela rede pública de atenção primária à saúde do município em questão. A amostra foi estimada considerando a prevalência de 42,4% do atributo acesso, conforme aferido entre usuários de serviços de APS e moradores da área coberta pela Gerência Distrital Partenon-Lomba do Pinheiro no ano de 2012, medida por meio do Primary Care Assessment Tool/PCATool-Brasil em estudos prévios. O tamanho final da amostra foi de 214 usuários. Os dados foram coletados através de um questionário construído para este estudo com atributo acesso do PCATool-Brasil versão usuários adultos, da Pesquisa Nacional de Saúde (PNS) e da Pesquisa Nacional de Amostra por Domicílio (PNAD). Os dados foram analisados com o auxílio do software SPSS v.21 (Chicago: SPSS) onde foram realizados testes Anova, do qui-quadrado e test t-student. Resultados: 66,0% dos entrevistados eram mulheres, com a faixa etária de 60 anos ou mais (68,6%), com escolaridade do ensino fundamental ao médio (68,5%), casada (64,2%) e cor autodeclarada branca (59,8%). A distribuição média dos atributos acesso da APS em relação aos usuários que utilizam as Unidades de Saúde foram insatisfatórios. Houve associação entre a variável faixa etária de 60 anos ou mais com o atributo Acesso de Primeiro Contato/Utilização e, também, com o Escore Acesso, sugerindo assim, que idosos que acessam o serviço, qualificaram os referidos atributos como satisfatórios. Conclusão: este estudo apresenta a importância de se analisar dados sociodemográficos para o funcionamento da APS e mostra que o município deve direcionar esforços para a parcela da população que apresentou o Acesso como um atributo insatisfatório. O presente estudo, também, apresenta informações potencialmente úteis para a gestão municipal do Sistema Único de Saúde (SUS) no intuito de buscar melhorias e qualificação do acesso aos serviços de saúde. / Introduction: The Primary Health Care (PHC) consisted in a strategy capable to offer health services in an equitable and efficient way to order access to the user. PHC is understood as the coordinator of the healthcare network. Within the assumptions of PHC, access is the first contact condition and corresponds to the use and to the accessibility to health services. It happens in health care spaces for each new problem or even in a new episode of an existing problem. Thus, the users perspective is an important form of information for the construction of assessments of the care process, as well as the obtained results with the applicability of certain care models. Objective: The objective of this study is to analyze the access to Primary Health Care services by means of the adult user perception in the city of Porto Alegre/RS. Methodology: This is a population-based study carried out with users of health service in three administrative-districts in Porto Alegre in the period of September 2016 to May 2017. The studied sample consisted of adult individuals, with a minimum age of 18 years, living in the areas covered by the primary health care public network of the city. This sample was estimated considering 42.4% of the attribute access, as measured between users of PHC services and residents of the area covered by the Partenon-Lomba do Pinheiro District Area in the year 2012, as attribute access by Primary Care Assessment Tool/PCATool-Brazil in previous studies. The final sample size was 214 users. Data were collected through a questionnaire constructed for this study with fragments of PCATool-Brazil adult version, the National Health Research (Acronym in Portuguese is PNS) and the National Sample Survey per Household (Acronym in Portuguese is PNAD). Data were analyzed using SPSS software v.21 (Chicago: SPSS) where were performed Anova, chi-square and t-student tests. Results: 66.0% of the interviewees were women, aged 60 years or more (68.6%), 68.5% from elementary to high school level, married (64.2%) and white self-declared color (59.8%). The average distribution of the PHC access attributes regarding Health Units user's were unsatisfactory. There was an association between the variable age range aged 60 years or more with the First Contact Access/Utilization attribute and, also, with the Access Score, suggesting that elderly, who access the service, qualified it as satisfactory attributes. Conclusion: This study presents the importance of analyzing sociodemographic data for the functioning of PHC and shows that the studied city should direct efforts to the part of the population that presented Access attribute as unsatisfactory. The present study also presents potentially useful information for Unified Health Services (Acronym in Portuguese is SUS) management in order to seek improvements and qualification of access to health services.