Universidade de Pernambuco

About: Universidade de Pernambuco is a education organization based out in Recife, Brazil. It is known for research contribution in the topics: Population & Medicine. The organization has 6147 authors who have published 6948 publications receiving 73648 citations.

Prevalência e fatores associados a amputações por pé diabético

Abstract: The scope of this investigation was to establish the prevalence of diabetic foot amputations and analyze associations with factors related to the individual and to primary health care. It is a cross-sectional epidemiological study and the sample included 214 inpatients with diabetic feet in one of the four hospitals specialized in vascular surgery in the state of Pernambuco. Data were collected using semi-structured questionnaires. In the data analysis, chi-square association, Poisson regression (p < 0.05) and descriptive statistics procedures were applied. The prevalence of amputation ascertained was 50%. The following factors related to the individual were associated with its occurrence: low education (p = 0.027); two or more people living in the household (p = 0.046); and patient income below the minimum wage (p = 0.004). The following factors related to primary health care were associated with amputation: not having feet examined (PR = 1.17); not receiving guidance on foot care (PR = 2.24) in consultations in the past year; not using the drug for DM control as prescribed (PR = 1.60); and inadequate glycemic control (PR = 1.83). Understanding these factors helps to identify aspects of preventive care that require improvement.

Developing an operational framework for health policy analysis

Abstract: This article develops an original framework supporting health policy analysis that may be carried out by distinct research on various situations. The Walt and Gilson model for health policy analysis and its categories: Context, Content, Actors and Process, was taken as the basic framework of analysis. However, to be applied in practice that model needs to be unravelled. Its four major categories need to be operationalised and transformed into a matrix, with each one revealling the elements or sub-categories, and the necessary procedures to conduct a systematic analysis on the Context, Content, Actors and Process of a given health policy. Such an initiative was treated in this work.

A quality of experience handover architecture for heterogeneous mobile wireless multimedia networks

Abstract: The convergence of emerging real-time multimedia services, the increasing coverage of high-speed wireless networks, and the evergrowing popularity of mobile devices are leading to an era of user-centric multimedia wireless services In this scenario, heterogeneous wireless communications will coexist and ensure that the end user is always best connected However, the quality of experience supported for highquality applications in multi-operator environments remains a significant challenge and is crucial for the success of wireless multimedia systems This article proposes a quality of experience handover architecture for heterogeneous mobile wireless multimedia networks The architecture extends the media independent handover/ IEEE 80221 proposal with QoE-aware seamless mobility, video quality estimator, dynamic class of service mapping, and a set of content adaptation schemes The proposed architecture always provides the best connection and considers the QoE needs of mobile clients and available wireless resources in IEEE 80211e and IEEE 80216e service classes Simulation experiments were performed to show the impact and benefits of the proposed solution from the user's perception, by using both objective and subjective QoE metrics

Regional-based Integrated Healthcare Network policy in Brazil: from formulation to practice

Abstract: BACKGROUND Regional-based Integrated Healthcare Networks (IHNs) have been promoted in Brazil to overcome the fragmentation due to the health system decentralization to the municipal level; however, evaluations are scarce. The aim of this article is to analyse the content of IHN policies in force in Brazil, and the factors that influence policy implementation from the policymakers' perspective. METHODS A two-fold, exploratory and descriptive qualitative study was carried out based on (1) content analysis of policy documents selected to meet the following criteria: legislative documents dealing with regional-based IHNs; enacted by federal government; and in force, (2) semi-structured individual interviews were conducted to a theoretical sample of policymakers at federal (eight), state (five) and municipal levels (four). Final sample size was reached by saturation of information. An inductive thematic analysis was conducted. RESULTS The results show difficulties in the implementation of IHN policies due to weaknesses that arise from the policy design and the performance of the three levels of government. There is a lack of specificity as to the criteria and tools for configuring and financing IHNs that need to be agreed upon between involved governments. For their part, policymakers emphasize the difficulty of establishing agreements in a health system with disincentives for collaboration between municipalities. The allocation of responsibilities that are too complex for the capacity and size of the municipalities, the abandonment of essential functions such as network planning by states and the strategic role by the Ministry, the 'invasion' of competences among levels of government and high political turnover are also highlighted. CONCLUSIONS The implementation of regional-based IHN policy in Brazil is hampered by the decentralized organization of the health system to the municipal level, suggesting the need to centralize certain functions to regional structures or states and to define better the role of the government levels involved.