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At least 919 records · Page 51Linked to original sources
PubMed2004

Obstacles in the diagnosis of acute aortic dissection.

Acute aortic dissection (AAD) is a life-threatening condition for which prompt diagnosis is essential for successful management. The imaging modalities for demonstrating the dissecting membrane include retrograde aortography, contrast-enhanced computed tomography (CT), transesophageal echocardiography (TEE), and magnetic resonance imaging. Of these, aortography had long been considered the gold standard in diagnosing aortic dissection. We present a case of AAD in which contrast-enhanced CT and retrograde aortography failed to demonstrate an aortic membranous flap, whereas TEE swiftly provided clear-cut evidence of the pathology. TEE should be considered when AAD is suspected despite negative findings on other imaging modalities.

Acute Disease↗
PubMedDate not supplied

Paradigmatic obstacles to improving the health of populations--implications for health policy.

While there are promising developments in public health, most interventions (both at the individual and community levels) remain focused on "downstream" tertiary treatments or one-on-one interventions. These efforts have their origins in the biomedical paradigm and risk factor epidemiology and the behavioral science research methods that serve as their handmaidens. This paper argues for a more appropriate balance of "downstream" efforts with a more appropriate whole population public health approach to health policy--what may be termed a social policy approach to healthy lifestyles rather than the current lifestyle approach to health policy. New, more appropriate research methods must be developed and applied to match these emerging levels of whole population intervention. We must avoid any disjunction between new upstream policy level interventions and the methods used to measure their effect--appropriate unto the intervention level must be the evaluation method thereof.

Delivery of Health Care↗
PubMed2000

Parasite systematics in the 21st century: opportunities and obstacles.

Thanks to the phylogenetic systematics revolution, systematic parasitology is poised to make significant contributions in tropical medicine and public health, biodiversity science, and evolutionary biology. At the same time, the taxonomic impediment is acute within parasitology. Both systematists and non-systematists must be interested in working towards common goals and establishing collaborative efforts in order to re-vitalize and re-populate systematic parasitology.

Animals↗
PubMed1996

[Obstacles to compliance with treatment for Hansen's disease]

This research project aimed at identifying some of the factors related to leprosy patient compliance with the multidrug treatment regimen. The methodological framework of the Social Representations Theory was used. Two groups of patients were interviewed: compliant and non-compliant with treatment and those coming from two different health services. We observed a common understanding about treatment in the various interviews, expressed as a metaphor to describe the treatment experience: the figure of a battle in which the bacillus is portrayed as a threat, the patient as a victim, the medication as a weapon and the health professional as a hero or saint. Still, the medication is represented as being both good and bad for the patient's well-being. Finally, quality of the physician-patient relationship appeared to be the main difference between the two groups of subjects studied.

Journal Article↗
PubMed2004

Acceptability of emergency contraception in Brazil, Chile, and Mexico. 2 - Facilitating factors versus obstacles.

A multi-center study was performed in Brazil, Chile, and Mexico to identify factors that may facilitate or hinder the introduction of emergency contraception (EC) as well as perceptions concerning emergency contraceptive pills. Background information on the socio-cultural, political, and legal context and the characteristics of reproductive health services was collected. The opinions of potential users and providers were obtained through discussion groups, and those of authorities and policymakers through semi-structured interviews. Barriers to introduction included: perception of EC as an abortifacient, opposition by the Catholic Church, limited recognition of sexual and reproductive rights, limited sex education, and insensitivity to gender issues. Facilitating factors were: perception of EC as a method that would prevent abortion and pregnancy among adolescents and rape victims; interest in the method shown by potential users as well as by some providers and authorities. It appears possible to reduce barriers through support from segments of society committed to improving sexual and reproductive health and adequate training of health care providers.

Adolescent↗
PubMed2006

[Implementation of indigenous people's health policy in Angra dos Reis, Rio de Janeiro, Brazil: obstacles and prospects].

This article discusses the Brazilian National Policy for Indigenous People's Health, formulated in the 1990s as part of the national Health Reform Movement and based on the creation (in 1999) of the Indigenous Healthcare Sub-System. Coordinated at the central government level under the administration of the National Health Foundation/Ministry of Health, the implementation of this sub-system required adaptations in the organization of health services systems at the local level, with the creation of Special Indigenous Health Districts. This configuration showed the need for dialogue and negotiation among the various institutions involved with indigenous affairs, from the perspective of overcoming various conflicts and operational difficulties. The current analysis identifies the difficulties in the implementation of a differentiated indigenous health policy under federal responsibility and within the decentralized Brazilian Unified Health System (SUS), since the absence of specific mechanisms and instruments regulating the operationalization of these services at the local level and the lack of more effective supervision and on-going evaluation of this policy mean that differentiated care for the indigenous population is subject to both the vices and virtues of local policy.

Brazil↗
PubMed1993

Removal of an obstacle: Problem-solving behavior in pigeons.

The importance of a subject's personal history in the solution of an obstruction problem was demonstrated with pigeons. Four birds were trained to peck a key located outside the chamber by poking their heads through an opening in a screen. During tests, a white block was placed in front of the opening, so that it was not possible to peck the key without removing the block. All birds failed to remove the block. However, all birds that were subsequently trained to push the white block around the chamber in the absence of the key and a few of the birds trained similarly but with a black block solved the problem by pushing the block aside and pecking the key. One bird showed the abrupt descent in the learning curve that has been considered a characteristic of "insightful" problem solving. All birds maintained their successful performance after a 1-month interval with no intervening tests.

Journal Article↗
PubMed1980

Roles for non-physicians in fertility regulation: an international overview of legal obstacles and solutions.

For more than a decade the roles of non-physicians in fertility regulation have been expanding. The article discusses the relationship between law and the expansion of those roles. The laws and regulations which effect these roles fall into three basic categories: those controlling the medical and other health-related professions, those regulating drugs and devices, and those affecting specific fertility regulation services. These in turn may either inhibit or facilitate the expansion of roles for non-physicians. Where legal barriers arise, and no feasible legal solution is developed, expansion of roles is difficult, if not impossible, as the law invariably reflects the prevailing views on who should provide fertility regulation services. In many countries, however, as roles have been changing, the law has been changing too in a way which affords legal protection to non-physicians. The emphasis to date has been on permitting them to assume expanded roles in the provision of contraceptives. Non-physicians are authorized to prescribe the Pill in at least 10 countries and to re-supply the Pill after prescription in seven others. Non-physicians are permitted to insert IUDs in at least 10 countries. Pilot projects are presently testing the feasibility of permitting non-physicians to perform sterilizations and early abortions. The law has an impact, for good or ill, on all of these arrangements.

Cross-Cultural Comparison↗