O Sistema Único de Saúde no Brasil (SUS) proporciona a incorporação de muitas tecnologias na área médica e, por conseguinte, pode estar exercendo um papel indireto na produção de conhecimento que não está sendo considerado como uma de suas qualidades. Objetivo: analisar se a incorporação de tecnologias pelo Sistema Único de Saúde no Brasil, mais especificamente fármacos, está associada a um aumento da produção de conhecimento científico nacional sobre estas tecnologias. Material e métodos: Trata-se de um estudo descritivo onde foram selecionados alguns fármacos distribuídos pelo Ministério da Saúde. Utilizando o PubMed analisou-se a produção de conhecimento no Brasil e em outros países do mundo sobre estas tecnologias. Comparou-se a posição do Brasil no ranking da produção científica mundial nos 3 anos antes da incorporação dos fármacos pelo SUS com a posição do Brasil no 4º, 5º e 6º anos após a incorporação destas tecnologias. Esta comparação foi feita utilizando teste não paramétrico de Wilcoxon. Resultados: a posição do Brasil no ranking da produção científica das tecnologias farmacológicas melhora para 70 das 90 tecnologias avaliadas. A posição geral média do Brasil passa de 68º para 45º após a incorporação (p < 0,0001). Conclusão: a incorporação de tecnologias farmacológicas pelo SUS está associada a um aumento da produção de conhecimento nacional sobre estas tecnologias / The Brazilian National Health System (SUS) is responsible for the incorporation of many health technologies, and thus, it could be having an indirect function in the scientific production that has not been considered as one of its qualities. Objective: to evaluate if the technologies incorporation by SUS is associated with an increment in national scientific production about those technologies. Material and methods: This is a descriptive study where it was selected some medications (pharmacologic technologies) that are offered by SUS. The PubMed database was used for the search of Brazilian and other countries scientific production about these technologies. The Brazilian international ranking position in the 3 years before SUS incorporation was compared with the position in the 4th, 5th and 6th years after the incorporation. Wilcoxon nonparametric test was used to perform this comparison. Results: the Brazilian international ranking position improves for 70 of the 90 technologies evaluated. The mean Brazilian ranking position went from 68th to 45th after incorporation (p < 0.0001). Conclusion: the incorporation of pharmacologic technologies by SUS is associated with an increment in the national knowledge production about these technologies

Esta pesquisa teve por objeto o estudo de conhecimentos, crenças, opiniões e conduta relacionados à AIDS, de estudantes do segundo grau de escolas estaduais do município de São Paulo. Pretendeu-se oferecer subsídios para órgãos governamentais das áreas de educação e saúde interessados na temática. A amostra foi não-probabilística, constituída de 1068 estudantes de primeiras e terceiras séries do segundo grau de escolas estaduais pertencentes à Divisão Regional de Ensino-3. Realizou-se um \"survey\" analítico, aplicando-se questionário estruturado, como instrumento de medida. O questionário, auto-aplicável, foi elaborado a partir de pesquisa exploratória. Algumas variáveis independentes foram selecionadas: sexo, idade, escolaridade e ocupação dos pais, se teve ou não relação sexual, idade da primeira relação sexual, número de relações nos últimos 30 dias, parceiro sexual e fontes de informação mais importantes sobre a AIDS. Os resultados revelaram que 98,5 por cento dos respondentes declararam que a AIDS pode ser evitada, tendo a maioria manifestado conhecimento razoável sobre formas de transmissão. Contudo, 53,5 por cento opinaram que a doação de sangue pode ser um meio de transmitir o HIV e 50,6 por cento manifestaram receio da proximidade física de doente de AIDS. Apenas 37,0 por cento declararam conhecer bem o modo de colocar e retirar a camisinha. A maioria dos jovens (94,4 por cento ) concordou não ser destino da pessoa ter AIDS. Evidenciou-se baixo nível de percepção da suscetibilidade pessoal à AIDS. Cerca de 55,0 por cento declararam certo grau de descrença na camisinha como meio de evitar a AIDS. A fidelidade do homem e da mulher foram fatores considerados importantes para evitar a AIDS, para cerca de 86 por cento . Os respondentes manifestaram alto grau de preocupação se tivessem relação sexual inesperada sem usar camisinha (75,5 por cento ), porém, 67 por cento não usam, ou raramente usam camisinha. O uso da camisinha associou-se, de forma significativa, às opiniões dos respondentes referentes a considerarem ser a camisinha incômoda, interferir no prazer da mulher, estragar o \"clima\" e diminuir a vontade de fazer sexo. Concluiu-se que, embora os respondentes tivessem revelado conhecimentos sobre alguns aspectos da transmissão e prevenção da AIDS, declararam descrença quanto à camisinha e objeções ao seu uso; não costumam usar ou portar o preservativo; embora considerando a AIDS uma doença grave, não se consideraram em risco de contrair essa doença; dispensam o uso de camisinha na condição de namoro \"fixo\", ou quando julgam conhecer bem o parceiro. Sugere-se enfatizar as ações educativas para prevenção da AIDS e a realização de pesquisas de fatores humanos para melhor conhecimento da realidade. / This research had as its object the study of AIDS - related knowledges, beliefs, opinions and behaviour among high school students in the city of São Paulo, Brazil. It was intended to offer subsidies to govermental organizations in educational and health fields. An analytical survey was performed in a convenience sample of 1068 first and third high school graders in nine schools of the São Paulo State Educational system - Setor 3. By means o f a preliminary study, a self-administered structured questionnaire had been accomphished. Some independent variables were selected: sex, age, parents\' educational background and profession, wheter or not they had had sexual intercourse, age at which they had their first one, number of intercourses during the last 30 days, sexual partner and main information sources on AIDS. The results revealed that 90.5 per cent of the respondents declared that AIDS can be avoided, and that the majority has reasonable knowledge regarding ways of transmission. However, 53.5 per cent stated that blood transfusion could be a mean of HIV transmission, and 50.6 per cent showed fear at the physical proximity of AIDS patients. Only 37.0 per cent declared that they knew how to use a condom. The majority of them (94.4 per cent ) agreed about one not to be predestined to AIDS. It became clear that there existed a low level of perception on personal suscetibility towards AIDS. About 55.0 per cent distrusted condoms as a method to avoid AIDS. The faithfulness of men and women was considered an important factor in the prevention o f AIDS (avout 86.0 per cent ). The respondents showed a high level of concern towards casual sex intercourses without the use of condoms (75.5 per cent ), but 67.0 per cent do not, or rarely, use them. A significant association was found between condom use and the following opinions: discomfort from condom use; interference with the women\'s pleasure; spoiling the sexual athmosphere and causing desire decrease. It was concluded that, apart from the fact the respondents showed knowledge on some aspects of the transmission and prevention of AIDS, disbelief as to the use of the condom and objections to it\'s use do exist. They do not wear or carry condoms with them. Although they consider AIDS to be a serious disease, they do not consider themselves to be at risk of contracting this infection. They stop using condoms when they have a \"fixed\" relationship or when their partner is well known. Educational actions to prevent AIDS and the performance of studies on human factors to improveknowledge as to the reality are suggested.

The purpose of this current study was to examine the influence of cardiovascular health knowledge on dietary and physical activity changes in 15-17 year olds with elevated blood pressure. The sample consisted of 167 adolescents randomized into one of three treatment conditions (minimal, moderate, or intense). Each adolescent completed a fitness test (peak VO2), 24-hour dietary recall, 7 Day Activity Recall (kilocalories expended per day), Self-efficacy Questionnaire, and Stages of Change Questionnaire every three months. The Health Knowledge Assessment was given at baseline and at post-intervention. Classical test theory, confirmatory factor analysis, and item response theory frameworks were applied to examine psychometric properties of the Health Knowledge Assessment. Structural equation modeling was used to examine the change in health behaviors and the relationship with health knowledge, self-efficacy, and readiness for change. The 34-item Health Knowledge Assessment had good internal consistency and the items loaded onto a single factor at pretest and posttest. Furthermore, there was a good distribution of easy, moderate, and hard items at pretest, but additional hard items were needed at posttest. There were no treatment condition differences in level of health knowledge at pretest. The intense condition had significantly higher health knowledge than the minimal and moderate conditions at posttest; level of health knowledge for the moderate condition was significantly higher than the minimal condition at posttest. Level of nutrition knowledge at posttest was not associated with any of the dietary intake variables nor was level of exercise knowledge associated with the two physical activity variables at post-intervention. However, there was a marginally significant association between level of nutrition knowledge and nutrition self-efficacy at posttest. Nutrition self-efficacy and nutrition readiness for change at posttest were also associated with a decrease in sugar consumption at post-intervention. Implications of this study suggest that a cardiovascular health intervention for adolescents with elevated blood pressure, consisting of group sessions and/or individual sessions over the course of three to six months, was effective in terms of increasing cardiovascular health knowledge, self-efficacy, and readiness for change. Nonetheless, the role that health knowledge plays in health behavior change needs to be further examined.

BACKGROUND: Youth continue to be at high risk for STI and HIV transmission and unplanned pregnancies because of their liberal approach to sexual-health and their susceptibility toward engaging in risky activities. Youth who are street involved face greater risks than their peers because they occasionally participate in behaviours that places them at increased risk; for instance injection drug use, multiples sex partners, low condom use and considerable substance use. However, while street youth are predisposed to engage in many of the situations they do, some street youth are also making decisions to limit risk. OBJECTIVES: To 1) determine the basic level of HIV and STI knowledge of street youth; 2) to understand youth’s knowledge of, access to, and use of sexual-health information; 3) to explore where and from youth would like to get accurate sexual-health information and appropriate care; 4) to determine whether peer education is a useful method of transmitting sexual-health information to youth; 5) to assess the sexual risk level of youth; and 6) to develop an understanding of the proactive sexual-health behaviours and decisions youth have established for themselves. METHODS: Street-involved and homeless youth living in Hamilton, Ontario (n=97) who were between the ages of 14 and 24 were interviewed using a 112 questions interview tool. Topics covered in the interview included demographics, personal safety, health behaviour, accessing sexual-health information, accessing sexual-health services, HIV/AIDS knowledge and services use and peer education. Descriptive, bivariate, and multivariate analyses were conducted using SAS. RESULTS: Youth had high rates of STI and HIV testing and good HIV knowledge when compared to the general youth population. However, the sample also had increased rates of unplanned pregnancies and young women were not well-informed about what gets tested for in pap smears. Some youth are also not accessing sexual-health services at all. CONCLUSIONS: Youth are making attempts to protect themselves, however there are areas for improvement; specifically increased condom-use, knowledge of HIV and pap smears. Youth who were found to have increased risk were youth who were under the age of 19, and youth who had experienced unstable housing before the age of 15. The findings suggest that sexual-health harm reduction needs to start at a younger age and the basics of sexual-health should not be overlooked.

Breastfeeding initiation rates in the United States remain below the Healthy People 2010 goals. Research indicates patient interaction with health care providers may play an important role in womens ultimate feeding choice. This study sought to examine the impact of provider counseling regarding breastfeeding during the prenatal period on feeding outcome by evaluating: 1) if providers addressed womens concerns regarding breastfeeding; and 2) how providers responded to a womans feeding choice. We also sought to examine whether the type of counseling provided by providers regarding infant feeding is influenced by patient socio-demographics and stated feeding plans. This study is cross-sectional with convenience sampling of all English or Spanish speaking women on the postpartum floor at Yale-New Haven Hospital. A total of 130 women participated. Overall, 95.4% of women identified a concern they had about breastfeeding during the prenatal period, and one quarter of patients had their concerns about breastfeeding addressed. The majority of patients (74.6%) were asked about their feeding plans, and 50.5% were encouraged to breastfeed. Unlike the majority of studies that indicate young, African American, poorly educated, unmarried and low income women are less likely to receive counseling from providers to breastfeed, providers in our study area focused their efforts on this population. In multivariate analysis, neither having concerns addressed nor being encouraged to breastfeed were associated with increased likelihood of breastfeeding. Addressing patients concerns may be most relevant in the small subset of patients who make their feeding choice during pregnancy. Finally, women who were asked about their plans and had their concerns addressed (p=.010) or were encouraged to breastfeed (p=.040) were more likely to make their decision during pregnancy compared to before pregnancy than women whose providers did not discuss these issues. Likewise, mixed feeders were more likely to make their decision regarding infant feeding during rather than before pregnancy. This data suggests providers may be encouraging women to think more thoroughly about the possibility of breastfeeding, thus delaying their decision. In conclusion, many women are not being encouraged to breastfeed or having their concerns about breastfeeding addressed. All women would benefit from prenatal discussion of these topics; however, the effect may be most profound in women who make their decision regarding feeding during pregnancy.

Thesis (Ph. D.)--University of Washington, 2001. / Vita. Includes bibliographical references (leaves 69-75).

Thesis (Ph. D.)--University of Washington, 2001. / Vita. Includes bibliographical references (leaves 130-140).

No description available.

No description available.

BACKGROUND: Youth continue to be at high risk for STI and HIV transmission and unplanned pregnancies because of their liberal approach to sexual-health and their susceptibility toward engaging in risky activities. Youth who are street involved face greater risks than their peers because they occasionally participate in behaviours that places them at increased risk; for instance injection drug use, multiples sex partners, low condom use and considerable substance use. However, while street youth are predisposed to engage in many of the situations they do, some street youth are also making decisions to limit risk. OBJECTIVES: To 1) determine the basic level of HIV and STI knowledge of street youth; 2) to understand youth’s knowledge of, access to, and use of sexual-health information; 3) to explore where and from youth would like to get accurate sexual-health information and appropriate care; 4) to determine whether peer education is a useful method of transmitting sexual-health information to youth; 5) to assess the sexual risk level of youth; and 6) to develop an understanding of the proactive sexual-health behaviours and decisions youth have established for themselves. METHODS: Street-involved and homeless youth living in Hamilton, Ontario (n=97) who were between the ages of 14 and 24 were interviewed using a 112 questions interview tool. Topics covered in the interview included demographics, personal safety, health behaviour, accessing sexual-health information, accessing sexual-health services, HIV/AIDS knowledge and services use and peer education. Descriptive, bivariate, and multivariate analyses were conducted using SAS. RESULTS: Youth had high rates of STI and HIV testing and good HIV knowledge when compared to the general youth population. However, the sample also had increased rates of unplanned pregnancies and young women were not well-informed about what gets tested for in pap smears. Some youth are also not accessing sexual-health services at all. CONCLUSIONS: Youth are making attempts to protect themselves, however there are areas for improvement; specifically increased condom-use, knowledge of HIV and pap smears. Youth who were found to have increased risk were youth who were under the age of 19, and youth who had experienced unstable housing before the age of 15. The findings suggest that sexual-health harm reduction needs to start at a younger age and the basics of sexual-health should not be overlooked.