Cadernos de saúde pública
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This paper analyzes the policy model of the Brazilian Ministry of Health from 1990 to 2002. The methodology included interviews with key actors in the national health policy, document review, and analysis of the Federal budget and official databases. ⋯ The model in the late 1990s featured strong Federal induction of States and municipalities and the adoption of market regulation strategies. There is no record of a long-term planning effort, which favors distortions in the Federal intervention model and hinders solutions to structural problems in the Brazilian health system.
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Cadernos de saúde pública · Sep 2007
Review[Cross-cultural adaptation to Brazil of the instrument Caregiver Abuse Screen (CASE) for detection of abuse of the elderly by caregivers].
This first of two papers focuses on the first part in the cross-cultural adaptation of the Portuguese-language version of Caregiver Abuse Screen (CASE), a brief instrument for detecting domestic violence against the elderly. CASE was originally developed in Canada and used to screen violence against the elderly by interviewing their caregivers. ⋯ It was possible to establish high-quality conceptual, item, and semantic equivalence for the Portuguese-language version. Although the results shown here were encouraging, they should be reevaluated in light of a forthcoming psychometric analysis (measurement equivalence) to be performed by the research group.
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Cadernos de saúde pública · Sep 2007
[Moral and operational challenges for the inclusion of palliative care in primary health care].
Palliative care, a model in end-of-life care, is currently undergoing expansion in Brazil. This article emphasizes the need to implement palliative care in primary health care, with an important role in end-of-life care, especially in areas without specialized palliative-care teams. The article discusses key aspects in the organization of this treatment modality and analyzes how palliative care could and should be implemented within primary health care in Brazil. The article describes several challenges for health teams to provide such care, related to the primary caregiver, inherent ethical conflicts, and human resource allocation.