76 research outputs found
Why choice of metric matters in public health analyses: a case study of the attribution of credit for the decline in coronary heart disease mortality in the US and other populations.
No full textBACKGROUND: Reasons for the widespread declines in coronary heart disease (CHD) mortality in high income countries are controversial. Here we explore how the type of metric chosen for the analyses of these declines affects the answer obtained.
METHODS: The analyses we reviewed were performed using IMPACT, a large Excel based model of the determinants of temporal change in mortality from CHD. Assessments of the decline in CHD mortality in the USA between 1980 and 2000 served as the central case study.
RESULTS: Analyses based in the metric of number of deaths prevented attributed about half the decline to treatments (including preventive medications) and half to favourable shifts in risk factors. However, when mortality change was expressed in the metric of life-years-gained, the share attributed to risk factor change rose to 65%. This happened because risk factor changes were modelled as slowing disease progression, such that the hypothetical deaths averted resulted in longer average remaining lifetimes gained than the deaths averted by better treatments. This result was robust to a range of plausible assumptions on the relative effect sizes of changes in treatments and risk factors.
CONCLUSIONS: Time-based metrics (such as life years) are generally preferable because they direct attention to the changes in the natural history of disease that are produced by changes in key health determinants. The life-years attached to each death averted will also weight deaths in a way that better reflects social preferences
Why my disease is important: metrics of disease occurrence used in the introductory sections of papers in three leading medical journals in 1993 and 2003
No full textBACKGROUND: We assessed the metrics used in claims about disease importance made in the introductory sections of scientific papers published in 1993 and 2003. We were interested in the choice of metric in circumstances where establishing the relative social importance of a disease was, presumptively, a primary objective. METHODS: This study consisted of a textual examination of the introductory statements from papers retrieved from MEDLINE. Papers were published in the New England Journal of Medicine, The Lancet, and the Journal of the American Medical Association during the first halves of 1993 and 2003, and were selected on the basis of keywords found in a pilot study to be associated with claims about disease importance. RESULTS: We found 143 papers in 1993 and 264 papers in 2003 included claims about disease importance in their introductory sections, and characteristics of these claims were abstracted. Of the quotes identified in the papers and articles examined, most used counts, prevalence, or incidence measurements. Some also used risk estimates and economic quantities to convey the importance of the disease. There was no change in the types of metrics used between 1993 and 2003. Very few articles, even in 2003, used metrics that weighted disease onsets by the expected consequent loss of healthy time -- such as years of life lost, quality-adjusted life years, and/or disability-adjusted life years. CONCLUSIONS: Claims about the relative importance of diseases continued to be overwhelmingly expressed in terms of counts (of deaths and disease onsets) and comparisons of counts, rates, and risks. Where the aim is to convey the burden that a given disease imposes on a society, "event-based" metrics might be less fit for the purpose than "time-based" metrics. More attention is needed to how the choice of metric should relate to the purpose at hand
The science of epidemiology and the methods needed for public health assessments: a review of epidemiology textbooks
No full textObjectives. Epidemiology is often described as 'the science of public health'. Here we aim to assess the extent that epidemiological methods, as covered in contemporary standard textbooks, provide tools that can assess the relative magnitude of public health problems and can be used to help rank and assess public health priorities. Study Design. Narrative literature review. Methods. Thirty textbooks were grouped into three categories; pure, extended or applied epidemiology, were reviewed with attention to the ways the discipline is characterised and the nature of the analytical methods described. Results: Pure texts tend to present a strict hierarchy of methods with those metrics deemed to best serve aetiological inquiry at the top. Extended and applied texts employ broader definitions of epidemiology but in most cases, the metrics described are also those used in aetiological inquiry and may not be optimal for capturing the consequences and social importance of injuries and disease onsets. Conclusions: The primary scientific purpose of epidemiology, even amongst 'applied' textbooks, is aetiological inquiry. Authors do not readily extend to methods suitable for assessing public health problems and priorities
Measuring quality of maternal and newborn care in developing countries using demographic and health surveys
No full textBackground One of the greatest obstacles facing efforts to address quality of care in low and middle income countries is the absence of relevant and reliable data. This article proposes a methodology for creating a single "Quality Index" (QI) representing quality of maternal and neonatal health care based upon data collected as part of the Demographic and Health Survey (DHS) program. Methods Using the 2012 Indonesian Demographic and Health Survey dataset, indicators of quality of care were identified based on the recommended guidelines outlined in the WHO Integrated Management of Pregnancy and Childbirth. Two sets of indicators were created; one set only including indicators available in the standard DHS questionnaire and the other including all indicators identified in the Indonesian dataset. For each indicator set composite indices were created using Principal Components Analysis and a modified form of Equal Weighting. These indices were tested for internal coherence and robustness, as well as their comparability with each other. Finally a single QI was chosen to explore the variation in index scores across a number of known equity markers in Indonesia including wealth, urban rural status and geographical region. Results The process of creating quality indexes from standard DHS data was proven to be feasible, and initial results from Indonesia indicate particular disparities in the quality of care received by the poor as well as those living in outlying regions. Conclusions The QI represents an important step forward in efforts to understand, measure and improve quality of MNCH care in developing countries
Editorial: Mirando o futuro
No full textEditorial Locus Revista de História. V. 31 n. 1
Looking toward the future
We are pleased to publish the first issue of volume 31 of Locus: Revista de História. In this issue, the dossier revisits the debates of the colloquium that marked the 20th anniversary celebrations of PPGH/UFJF and deepens the discussions presented therein on the methodology of microhistory, considered from a global perspective, based on the notions of coloniality and translocality. It also pays tribute to historian Giovanni Levi and his foundational role in this field. We publish the lecture he gave at the colloquium and an unpublished interview he gave to Mônica Ribeiro de Oliveira and Maíra Vendrame. The organizers of the dossier, Hevelly Ferreira Acruche and Robert Daibert Jr., introduce the richness of the discussion and the set of articles in their Presentation. Check it out.
Reflecting on the path we have traveled is an attitude that looks to the future. In this issue, we also celebrate the growing demand for the journal, with articles in close dialogue with the Program's area of concentration and lines of research. The open session is dense and thought-provoking.
Discussions on heritage and art are present, honoring our tradition. Heritage as unconscious historiography is the title of Rogério Mattos' inspiring article on the need to incorporate new constructions and experiences of black heritage into the construction of an innovative agenda in both the writing and teaching of history. Next, Enrique Normando Cruz presents, in Spanish, the article Contexto y nuevos datos históricos acerca de un pintor al Noroeste del Río de la Plata (Jujuy, siglo XVIII) (Context and new historical data about a painter in the northwest of the Río de la Plata (Jujuy, 18th century)), based on new and original information about the work and career of the painter Diego de Aliaga. Transtemporalidade e o anacronismo das imagens: uma leitura possível da obra A imperatriz antropófaga, de Fernando Lindote (Transtemporality and the anachronism of images: a possible reading of the work The Anthropophagous Empress, by Fernando Lindote), written by Rodolpho Bastos and Rafaela Barbieri, closes the set of reflections in this field, exploring George Didi-Huberman's concept of the anachronism of images and Reinhart Koselleck's contributions on temporal experiences, to explore, in the 2017 painting by Catarinense painter Fernando Lindote, "the marks of colonization, the resistance of colonized peoples, and ancient temporalities."
Politics and the political uses of the past could not be left out of the topics covered in this rich open session. Partidos para quê? Quatro questões sobre os partidos políticos na Primeira República (1889–1930) - Parties for what? Four questions about political parties in the First Republic (1889–1930) by Surama Conde Sa Pinto opens the sequence in grand style, revisiting the classic theme of elections and political parties in the First Brazilian Republic, in which the author is a recognized expert. Continuing with classic themes in Brazilian political historiography, Classe Militar no século XIX: A imprensa como campo de discussão - The Military Class in the 19th Century: The press as a field of discussion and definition of the military institution by Fenanda de Santos Nascimento analyzes the discourse of Brazilian military periodicals from 1850 to 1881, understanding the military press of the period as a "channel for disseminating ideas about what it means to be a soldier" at a time when an effective institutional discourse had not yet been formed. We close the trilogy with Paradoxos dos direitos humanos e a judicialização dos crimes da ditadura civil-militar brasileira (1973-2023) (The military-civilian dictatorship in Brazil: paradoxes of human rights and the judicialization of crimes of the Brazilian civil-military dictatorship (1973-2023)), by Camila Cristina Silva, which addresses the contradictory history of state terrorism in the Brazilian civil-military dictatorship as a legal problem.
That's not all. To conclude, we return to translocality as a problem and close with African and Latin American stories, fertile territories for collective reflection at PPGH/UFJF. Pastores africanos no horizonte da “ocupação” da Angola central: Ngulu, Keto e a expansão da missão congregacional (c. 1880-1900) - African pastors on the horizon of the "occupation" of central Angola: Ngulu, Keto, and the expansion of the congregational mission (c. 1880-1900), by Jéssica Evelyn Pereira dos Santos, addresses the first Protestant missions established in the region of Central Angola through the trajectory of two young men who became pastors, teachers, and community leaders. Finally, Milton Ferreira Santos reviews the book Historia mínima de las derechas latinoamericanas (A Brief History of the Latin American Right) by Ernesto Bohoslavsky and Priscila Emanoeli Rodrigues Cozer reviews the collection Os tempos da justiça: História, infâncias e direitos humanos na América Latina (Times of Justice: History, Childhood, and Human Rights in Latin America), organized by Silvia Maria Fávero Arend and Humberto da Silva Miranda, both books published in 2023.
Enjoy your reading!
Hebe Mattos, editor
Juiz de Fora, July 2025Editorial Locus Revista de História. V. 31 n. 2
Mirando hacia el futuro
Nos complace publicar el primer número del volumen 31 de Locus: Revista de Historia. En este número, el dossier retoma los debates del coloquio que marcó las celebraciones del 20.º aniversario del PPGH/UFJF y profundiza en las discusiones allí presentes sobre la metodología de la microhistoria, pensada desde una perspectiva global, a partir de las nociones de colonialidad y translocalidad. También incluye un homenaje al historiador Giovanni Levi y su papel fundamental en este campo. Publicamos la conferencia que pronunció en el coloquio y una entrevista inédita concedida entonces a Mônica Ribeiro de Oliveira y Maíra Vendrame. Los organizadores del dossier, Hevelly Ferreira Acruche y Robert Daibert Jr., presentan la riqueza del debate y el conjunto de artículos en su Introducción. No se lo pierdan.
Reflexionar sobre el camino recorrido es una actitud que mira hacia el futuro. En este número, celebramos también la creciente demanda de la revista, con artículos en estrecho diálogo con el área de concentración y las líneas de investigación del Programa. La sesión libre se presenta densa e estimulante.
Los debates sobre patrimonio y arte están presentes, honrando la tradición. O Patrimônio enquanto inconsciente da historiografia/ El patrimonio como inconsciente de la historiografía es el título del inspirador artículo de Rogério Mattos, sobre la necesidad de incorporar las nuevas construcciones y experiencias del patrimonio de la herencia negra para la construcción de una agenda innovadora tanto en la escritura como en la enseñanza de la historia. A continuación, Enrique Normando Cruz presenta, en español, el artículo Contexto y nuevos datos históricos acerca de un pintor al Noroeste del Río de la Plata (Jujuy, siglo XVIII), a partir de nueva y original información sobre la obra y la trayectoria del pintor Diego de Aliaga. ranstemporalidade e o anacronismo das imagens: uma leitura possível da obra A imperatriz antropófaga, de Fernando Lindote/ Transtemporalidad y anacronismo de las imágenes: una posible lectura de la obra La emperatriz antropófaga, de Fernando Lindote, escrito por Rodolpho Bastos y Rafaela Barbieri, cierra el conjunto de reflexiones en este campo, explorando el concepto de anacronismo de las imágenes de George Didi-Huberman y las contribuciones sobre las experiencias temporales de Reinhart Koselleck, para explorar en el lienzo de 2017 del pintor catarinense Fernando Lindote «las huellas de la colonización, la resistencia de los pueblos colonizados y las temporalidades antiguas».
La política y los usos políticos del pasado no podían faltar entre los temas tratados en esta rica sesión libre. Partidos para quê? Quatro questões sobre os partidos políticos na Primeira República (1889–1930)/ ¿Para qué sirven los partidos? Cuatro cuestiones sobre los partidos políticos en la Primera República (1889-1930), de Surama Conde Sa Pinto, abre la sesión por todo lo alto, revisando el clásico tema de las elecciones y los partidos políticos en la Primera República brasileña, en el que la autora es una reconocida experta. Continuando con temas clásicos de la historiografía política brasileña, A Classe Militar no século XIX: A imprensa como campo de discussão e definição da instituição militar/La clase militar en el siglo XIX: La prensa como campo de discusión y definición de la institución militar, de Fenanda de Santos Nascimento, analiza los discursos de los periódicos militares brasileños de 1850 a 1881, entendiendo la prensa militar de la época como «canal de difusión de ideas sobre lo que significa ser militar» en un momento en el que aún no se había formado un discurso efectivamente institucional. Cerramos la trilogía con Paradoxos dos direitos humanos e a judicialização dos crimes da ditadura civil-militar brasileira (1973-2023)/ Paradojas de los derechos humanos y la judicialización de los crímenes de la dictadura civil-militar brasileña (1973-2023), de Camila Cristina Silva, que aborda la contradictoria historia del terrorismo de Estado en la dictadura civil-militar brasileña como problema jurídico.
Pero aún hay más. Para concluir, volvemos a la translocalidad como problema y cerramos con historias africanas y latinoamericanas, territorios fértiles para la reflexión colectiva del PPGH/UFJF. Pastores africanos no horizonte da “ocupação” da Angola central: Ngulu, Keto e a expansão da missão congregacional (c. 1880-1900) / Pastores africanos en el horizonte de la «ocupación» de Angola central: Ngulu, Keto y la expansión de la misión congregacional (c. 1880-1900), de Jéssica Evelyn Pereira dos Santos, aborda las primeras misiones protestantes establecidas en la región de Angola Central a partir de la trayectoria de dos jóvenes que se convirtieron en pastores, profesores y líderes comunitarios. Por último, Milton Ferreira Santos reseña el libro Historia mínima de las derechas latinoamericana/ Historia mínima de las derechas latinoamericanas, de Ernesto Bohoslavsky y Priscila Emanoeli Rodrigues Cozer reseña la recopilación Os tempos da justiça: História, infâncias e direitos humanos na América Latina/ Los tiempos de la justicia: Historia, infancia y derechos humanos en América Latina, organizada por Silvia Maria Fávero Arend y Humberto da Silva Miranda, ambos publicados en 2023.
¡Que disfruten la lectura!
Hebe Mattos, editora
Juiz de Fora, julio de 2025Editorial Locus Revista de História. V. 31 n. 1
Mirando o futuro
É com satisfação que colocamos no ar o primeiro número do volume 31 da Locus: Revista de História. Neste número, o dossiê revisita os debates do colóquio que marcou as celebrações dos 20 anos do PPGH/UFJF e aprofunda as discussões nele presentes sobre a metodologia da micro-história, pensada em perspectiva global, a partir das noções de colonialidade e translocalidade. Traz também uma homenagem ao historiador Giovanni Levi e seu papel fundacional neste campo. Publicamos a conferência por ele proferida no colóquio e uma entrevista inédita então concedida a Mônica Ribeiro de Oliveira e Maíra Vendrame. Os organizadores do dossiê, Hevelly Ferreira Acruche e Robert Daibert Jr. introduzem a riqueza da discussão e o conjunto dos artigos em sua Apresentação. Confiram.
Refletir sobre o caminho percorrido é atitude que mira o futuro. Neste número, celebramos também a crescente procura da revista, com artigos em estreito diálogo com a área de concentração e as linhas de pesquisa do Programa. A sessão livre vem densa e instigante.
As discussões sobre patrimônio e arte se fazem presentes, honrando a tradição. O Patrimônio enquanto inconsciente da historiografia é o título do inspirador artigo de Rogério Mattos, sobre a necessidade de incorporar as novas construções e vivências do patrimônio de herança negra para a construção de uma agenda inovadora tanto na escrita como no ensino de história. Na sequência, Enrique Normando Cruz apresenta, em espanhol, o artigo Contexto y nuevos datos históricos acerca de un pintor al Noroeste del Río de la Plata (Jujuy, siglo XVIII), a partir de novas e originais informações sobre a obra e trajetória do pintor Diego de Aliaga. Transtemporalidade e o anacronismo das imagens: uma leitura possível da obra A imperatriz antropófaga, de Fernando Lindote, escrito por Rodolpho Bastos e Rafaela Barbieri, fecha o conjunto de reflexões neste campo, explorando o conceito de anacronismo das imagens de George Didi-Huberman e as contribuições sobre experiências temporais de Reinhart Koselleck, para explorar na tela de 2017 do pintor catariense Fernando Lindote, “as marcas da colonização, da resistência dos povos colonizados e de temporalidades antigas”.
A política e os usos políticos do passado não poderiam estar de fora dos temas abordados nesta rica sessão livre. Partidos para quê? Quatro questões sobre os partidos políticos na Primeira República (1889–1930) de Surama Conde Sa Pinto abre a sequência em grande estilo, revistando o clássico tema das eleições e dos partidos políticos na Primeira Repúbica brasileira, em que a autora é reconhecida especialista. Continuando com temas clássicos da historiografia politica brasileira, A Classe Militar no século XIX: A imprensa como campo de discussão e definição da instituição militar de Fenanda de Santos Nascimento analisa o discursos dos periódicos militares brasileiros de 1850 a 1881, entendendo a imprensa militar do período como “canal de disseminação de ideias sobre o que é ser militar” em um momento em que ainda não se formara um discurso efetivamente institucional. Fechamos a trilogia com Paradoxos dos direitos humanos e a judicialização dos crimes da ditadura civil-militar brasileira (1973-2023), de Camila Cristina Silva, que aborda a contraditória história do terrorismo de estado na ditatura civil-militar brasileira como problema jurídico.
Ainda não é tudo. Para concluir, retornamos à translocalidade como problema e fechamos com histórias africanas e latino-americanas, territórios fecundos da reflexão coletiva do PPGH/UFJF. Pastores africanos no horizonte da “ocupação” da Angola central: Ngulu, Keto e a expansão da missão congregacional (c. 1880-1900) , de Jéssica Evelyn Pereira dos Santos, aborda as primeiras missões protestantes estabelecidas na região de Angola Central a partir da trajetória de dois jovens que se tornaram pastores, professores e líderes comunitários. Por fim, Milton Ferreira Santos resenha o livro Historia mínima de las derechas latinoamericanas de Ernesto Bohoslavsky e Priscila Emanoeli Rodrigues Cozer a coletânea Os tempos da justiça: História, infâncias e direitos humanos na América Latina, organizada por Silvia Maria Fávero Arend e Humberto da Silva Miranda, ambos editados em 2023.
Boa leitura!
Hebe Mattos, editora
Juiz de Fora, julho 202
Health information systems and disability in the Lao PDR: a qualitative study
No full textThe Convention on the Rights of Persons with Disabilities provides an opportunity to strengthen disability-related health information. This study analysed the health information system in Lao PDR and sought evidence of interventions to improve disability-related health information. The study was based on a literature review and key informant interviews (N = 17) informed by the Health Metrics Network's Framework and Standards and the Performance of Routine Information System Management framework. The Lao health information system is in an embryonic stage with health data often incomplete, inaccurate and poorly used. Indicators related to disability or functioning are not included, and capacity to diagnose the health condition of disability is limited. No studies of health information interventions were found. As a State Party to the CRPD, the Lao PDR has a legal obligation to collect health-related information on people with disabilities. Given the nascent stage of development of the health information system in the Lao PDR and diagnostic capacity, indicators related to basic functioning and access to services should be integrated into household level surveys. As the health information system further develops, small, incremental changes in the type of disability information and rehabilitation and the way it is collected can be implemented
Quality Index score by Wealth Quintile (National).
No full textQuality Index score by Wealth Quintile (National).</p
Correlation between quintiles using different Quality Indexes.
No full textCorrelation between quintiles using different Quality Indexes.</p
Ethical and social issues affecting the implementation of verbal autopsy interviews in Papua New Guinea
No full text- …
