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Zager Kocjan G, Avsec A, Kavčič T. Feeling too low to be active: Physical inactivity mediates the relationship between mental and physical health. Soc Sci Med 2024; 341:116546. [PMID: 38169178 DOI: 10.1016/j.socscimed.2023.116546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 08/18/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Physical inactivity is one of the most influential and pervasive risk factors for health problems. Therefore, public health experts call for interventions to promote physical activity across the lifespan. This study aimed to examine the role of mental health in physical inactivity and the subsequent role of physical activity in various aspects of physical health. METHODS Data were collected in the third wave of the European Health Interview Survey (EHIS) in Slovenia. A nationally representative sample of 9,900 people (49.6% male) aged 15 years or more (M = 49.2; SD = 18.9 years) provided self-reports on depression (PHQ-8), subjective well-being (MHC-SF), physical (in)activity, bodily pain, long-standing activity limitations, their general health status, and possible chronic diseases. RESULTS The results of a path analysis showed that depression had a positive effect and well-being had a negative effect on physical inactivity, which in turn contributed to the likelihood of severe bodily pain, activity limitations, poor self-rated health, and multimorbidity. Depression and well-being contributed to health-related outcomes directly and indirectly through physical inactivity. LIMITATIONS Because of the cross-sectional design, this study is limited in its ability to draw causal conclusions. All health data were self-reported. CONCLUSIONS Results suggest that high levels of depression and low levels of subjective well-being may be an early warning sign of physical health problems. Interventions aimed at preventing or reducing mental health problems and promoting positive mental health may benefit not only mental health per se, but also prevent physical inactivity and, consequently, physical health problems.
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Affiliation(s)
| | | | - Tina Kavčič
- Faculty of Health Sciences, University of Ljubljana, Slovenia
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Zhang H, Li M, Mo L, Luo J, Shen Q, Quan W. Association between Western Dietary Patterns, Typical Food Groups, and Behavioral Health Disorders: An Updated Systematic Review and Meta-Analysis of Observational Studies. Nutrients 2023; 16:125. [PMID: 38201955 PMCID: PMC10780533 DOI: 10.3390/nu16010125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/07/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Western dietary patterns (WDP) and typical food groups may play a major role in the risk of behavioral health disorders. Nevertheless, the relationships between WDP, common food categories, and mental health disorders lack consistency and remain incompletely understood in relation to potential mechanisms. Therefore, the objective of the present study was conducted to synthesize available evidence linking WDP and typical food groups to these outcomes. Web of Science, PubMed, EMBASE, and MEDLINE were searched up to August 2023. Random effect meta-analyses were performed to obtain pooled odds ratio and the relative risk for the prevalence of outcomes and the incidence of outcomes, respectively. A total of 54 articles were included. WDP was associated with increased risk of both depression (1.19; 95% CI: 1.06-1.32) and depressive symptoms (1.20; 95% CI: 1.08-1.34). Except for high-fat dairy products, food groups are associated with an increased risk of anxiety, depression, and depressive symptoms. This review presents evidence to further understand the relationship between WDP, typical food groups, and the incidence of behavioral health disorders, and more randomized controlled trials and cohort studies are urgently required to confirm these findings and elucidate potential mechanisms.
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Affiliation(s)
- Huang Zhang
- School of Food Science and Bioengineering, Henan University of Animal Husbandry and Economy, No. 6, Longzihu North Road, Zhengzhou 450046, China;
| | - Maiquan Li
- College of Food Science and Technology, Hunan Agricultural University, Changsha 410128, China; (M.L.); (L.M.); (J.L.)
| | - Lan Mo
- College of Food Science and Technology, Hunan Agricultural University, Changsha 410128, China; (M.L.); (L.M.); (J.L.)
| | - Jie Luo
- College of Food Science and Technology, Hunan Agricultural University, Changsha 410128, China; (M.L.); (L.M.); (J.L.)
| | - Qingwu Shen
- College of Food Science and Technology, Hunan Agricultural University, Changsha 410128, China; (M.L.); (L.M.); (J.L.)
| | - Wei Quan
- School of Food Science and Bioengineering, Henan University of Animal Husbandry and Economy, No. 6, Longzihu North Road, Zhengzhou 450046, China;
- College of Food Science and Technology, Hunan Agricultural University, Changsha 410128, China; (M.L.); (L.M.); (J.L.)
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Brugger F, Schönthaler EMD, Baranyi A, Reininghaus EZ, von Lewinski D, Dalkner N. Metabolic Syndrome in Affective Disorders: Associations with Dark Triad Personality Traits. Metabolites 2023; 13:956. [PMID: 37623899 PMCID: PMC10456228 DOI: 10.3390/metabo13080956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023] Open
Abstract
Previous research has focused on the relationship between affective disorders (AD) and metabolic syndrome (MetS). Aside from biological and lifestyle factors, personality traits were identified as influencing aspects. In particular, the Dark Triad personality traits (DT; Machiavellianism, narcissism, psychopathy) were connected to both AD and worse somatic health, thus possibly resulting in MetS. This observational study aimed to investigate the associations between DT and anthropometric parameters and differences in the DT traits concerning the presence of MetS in individuals with AD. A total of 112 individuals (females = 59, males = 51, diverse = 2, Mage = 47.5, SDage = 11.5) with AD filled out the Short Dark Triad questionnaire. Body Mass Index (BMI) and MetS criteria, including blood pressure, waist circumference, lipid, and glucose levels, were assessed. For Machiavellianism, a positive association with BMI (r = 0.29, p < 0.05) and a negative association with systolic blood pressure (r = -0.23, p < 0.05) were found. No relationship between the overall MetS and DT score (r = 0.08, p = 0.409) was observed. The results were limited by the lack of a control group and the cross-sectional study design, which does not allow for the determination of causality. Machiavellianism was associated with a higher BMI and lower systolic blood pressure, indicating a deteriorating health effect of this trait. Possibly, the higher prevalence of MetS in AD stems from aspects such as lifestyle or medication intake, which might also be influenced by DT. Further research is needed to disentangle underlying mechanisms.
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Affiliation(s)
- Fiona Brugger
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria
| | - Elena M. D. Schönthaler
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria
| | - Andreas Baranyi
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria
| | - Eva Z. Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria
| | - Dirk von Lewinski
- Department of Cardiology, Medical University of Graz, 8036 Graz, Austria;
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, 8036 Graz, Austria
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Meleiro A, Teng CT, Demetrio FN, Batista VC, Vieira LF, Elorza PM. Understanding the journey of patients with depression in Brazil: A systematic review. Clinics (Sao Paulo) 2023; 78:100192. [PMID: 37031663 PMCID: PMC10120295 DOI: 10.1016/j.clinsp.2023.100192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 02/26/2023] [Accepted: 03/13/2023] [Indexed: 04/11/2023] Open
Abstract
Despite having an organized mental health law and policy, a majority of patients with depression remain underreported and undertreated in Brazil. The study aimed to quantitatively map and identify the deficiencies in patient journey touchpoints in terms of awareness, screening, diagnosis, treatment, adherence, and control for depression in Brazil using a semi-systematic approach highlighting the knowledge gaps in the existing literature. A structured search of Embase, MEDLINE, and BIOSIS databases was conducted to identify the relevant studies published in English, Portuguese, and Spanish from 2006 to 2021. An unstructured search was also conducted on Google or government websites with no restrictions. To address the data gaps, anecdotal data were also considered. Weighted or simple means were calculated for the pooled data. Of 3175 articles retrieved, 10 articles met the inclusion criteria. Synthesized evidence indicates that the pooled prevalence of depression in Brazil ranged from 4.1% to 21.8%; 42.4% of patients had awareness of depression, 37.5% underwent screening, 18.7% had a diagnosis, and 54.4% received treatment. No data on adherence and control were available. The study findings highlight the need for more research to accurately estimate the common patient journey touchpoints for depression to achieve better clinical outcomes in Brazil.
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Affiliation(s)
| | - Chei Tung Teng
- Collaborating Professor, Department of Psychiatry, Institute of Psychiatry, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Frederico Navas Demetrio
- Project Mood Disorders (GRUDA), Anxiety and Depression Ward (EAND), Institute of Psychiatry, Instituto de Psiquiatria Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
| | | | - Luiz Fernando Vieira
- Research, Development and Medical, Upjohn - a Pfizer Division, São Paulo, SP, Brazil
| | - Paola Marina Elorza
- Research, Development and Medical, Upjohn - a Pfizer Division, Latin America, Argentina
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Leal AADF, Rodrigues Galvão MH, Medeiros ADA, Roncalli ÂG. Access to medicines among the Brazilian population based on the 2019 National Health Survey. PLoS One 2023; 18:e0280599. [PMID: 36662881 PMCID: PMC9858017 DOI: 10.1371/journal.pone.0280599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 01/03/2023] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Access to medicines is a challenge, especially in developing countries, highlighting the need of population-based research to evaluate access and related factors. OBJECTIVE This study aimed to assess access to medicines and identify associated factors using data from the 2019 Brazilian National Health Survey (PNS). METHODS This population-based cross-sectional study used data from the 2019 PNS and considered access to prescription medicines as the primary outcome. The sample included 24,753 individuals aged 15 years or older who looked for medical care in the last 15 days and received a medicine prescription. Andersen's behavioral model was used to select independent variables. After descriptive analysis, a multinomial logistic regression multilevel analysis was performed using the independent variables with a significance level lower than 0.20 in the bivariate analysis. RESULTS The lowest chances of getting access to medicines were observed in individuals aged between 40 and 59 years, women, with complete middle and high school, with lower-income families, who attended public services, with worse self-assessed health, and those who looked for health care for disease prevention and health promotion. CONCLUSIONS Access to medicines among the Brazilian population is associated with social, economic, and health perception factors. Our findings may update and guide the development of public policies on medication and pharmaceutical care, facilitating medication purchases by the care user and promoting health equity.
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Affiliation(s)
| | | | - Arthur de Almeida Medeiros
- Graduate Program in Public Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Health Integrated Institute, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Ângelo Giuseppe Roncalli
- Graduate Program in Public Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Gomes AP, Gonçalves H, Dos Santos Vaz J, Kieling C, Rohde LA, Oliveira IO, Gonçalves Soares A. Do inflammation and adiposity mediate the association of diet quality with depression and anxiety in young adults? Clin Nutr 2021; 40:2800-2808. [PMID: 33933746 DOI: 10.1016/j.clnu.2021.03.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 03/05/2021] [Accepted: 03/22/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND & AIMS Diet quality has been inversely associated with depression, but less is known about its association with anxiety and about the mechanisms involved in the association between diet and mental health. This study aimed to assess the associations of diet quality with major depressive disorder (MDD) and generalized anxiety disorder (GAD) in young adults, and to explore whether inflammation, indexed by interleukin-6 (IL-6) and C-reactive protein (CRP), and body mass index (BMI) mediate this association. METHODS We used data of 3331 participants from the 1993 Pelotas Birth Cohort (Brazil). Data on dietary intake and inflammatory markers were assessed at 18 years, and information on mental disorders was obtained at both 18 and 22 years. A food frequency questionnaire was used to assess dietary intake, and diet quality was estimated using the Brazilian Healthy Eating Index - Revised (BHEI-R). The occurrence of MDD and GAD was assessed using the Mini International Neuropsychiatric Interview (MINI), conducted by psychologists. The associations of diet quality, BMI and inflammatory markers with mental disorders were explored using logistic regression. The mediation analysis was performed using structural equation modelling. RESULTS A one standard deviation increase in the diet quality score at age 18 years was associated with both lower levels of CRP (-0.06 mg/L; 95% CI: -0.10; -0.008) at 18 years and 23% lower odds of MDD at 22 years (OR: 0.77; 95% CI: 0.61; 0.97). No association was found between diet quality score and both BMI and GAD. Obesity was associated with higher odds of MDD, but CRP and IL-6 were not associated with MDD or GAD. Our results provide no evidence that inflammatory markers and BMI mediate the association between diet quality and MDD in young adults. CONCLUSIONS A better diet quality is associated with lower occurrence of MDD among young adults, but we did not find evidence that inflammatory markers and BMI mediate this association.
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Affiliation(s)
- Ana Paula Gomes
- Pelotas Municipal Health Secretary, Brazil; Faculty of Gastronomy, Federal University of Pelotas, Pelotas, Brazil.
| | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Juliana Dos Santos Vaz
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Graduate Program in Food and Nutrition, Faculty of Nutrition, Federal University of Pelotas, Brazil
| | - Christian Kieling
- Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul and Division of Child & Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre, Brazil
| | - Luis Augusto Rohde
- ADHD and Developmental Psychiatry Programs, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil
| | - Isabel O Oliveira
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Department of Physiology and Pharmacology, Biology Institute, Federal University of Pelotas, Brazil
| | - Ana Gonçalves Soares
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
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da Bernardo NLM, Soares L, Leite SN. A Sociotechnical Approach to Analyze Pharmaceutical Policy and Services Management in Primary Health Care in a Brazilian Municipality. PHARMACY 2021; 9:39. [PMID: 33673370 PMCID: PMC8006000 DOI: 10.3390/pharmacy9010039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/06/2021] [Accepted: 02/09/2021] [Indexed: 11/23/2022] Open
Abstract
The decentralization of the Brazilian health system required that municipalities took responsibility for the local Pharmaceutical Policy and Services (PPS) system. This article presents and analyses an innovative experience of diagnosis of municipal PPS as a sociotechnical system. We adopted a multi-methods approach and various data sources. Sociotechnical theory was the framework of the methodology of evaluation and design of systems, analyzing the External System (health system, stakeholders, financing) and Internal System (goals, management, workforce, infrastructure, processes, technology and culture). The "objective" component of the PPS system was identified as the central element. The lack of a unified objective and of a central coordination and unmanaged pharmaceutical services prevented integrated internal planning and planning with other sectors. Stakeholders and documents referred only to technical elements of the system: Infrastructure, technical process, and technology. The social components of the workforce and culture were not mentioned. The organizational culture established was the culture of isolation: "Each one does his own". The pharmacists working in the municipal health system did not know each other. There was no integration strategy between pharmacists and their work processes. Consequently, the municipal PPS had limited scope as a public policy. It had constrained the characteristics of PPS as a complex and open system. Understanding the municipal PPS as a sociotechnical system can push the development of a new level of policy and practice to ensure the population's right to the access to and rational use of medicines.
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Affiliation(s)
- Noemia Liege Maria da Bernardo
- School of Health Sciences, Universidade Federal de Santa Catarina, PPGFAR Universidade do Vale do Itajaí, Itajaí 88300000, Brazil; or
| | - Luciano Soares
- Department of Pharmaceutical Sciences, Universidade Federal de Santa Catarina, Florianópolis 88040000, Brazil;
| | - Silvana Nair Leite
- Department of Pharmaceutical Sciences, Universidade Federal de Santa Catarina, Florianópolis 88040000, Brazil;
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Souza ACS, Bezerra ALQ, Caixeta CC, Pinho ES, Paranaguá TTDB, Teixeira CC. Perception of professionals about patient safety in psychosocial care. Rev Bras Enferm 2020; 73 Suppl 1:e20180831. [PMID: 32428172 DOI: 10.1590/0034-7167-2018-0831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 03/27/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To understand the professionals' perception of risks and factors related to patient safety incidents in psychosocial care. METHODS Descriptive-exploratory study, with a qualitative approach, carried out with 31 professionals in type III Psychosocial Health Care Centers, between October 2016 and April 2017. Data collection was mediated by the Experiential Learning Cycle. Content analysis was performed. RESULTS The professionals revealed risks and factors related to safety incidents in their daily practices, associated with the institution's physical and organizational structure, with the configuration of the clinical process, with clinical administration and organizational management. Final considerations: Continuous efforts are needed on the part of senior managers and professionals to improve the work process and organizational structure in psychosocial care, contributing to the development of the patient's autonomy and social rehabilitation, avoiding institutionalization and, especially, ensuring the safety of this type of care.
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Estancial Fernandes CS, Lima MG, Barros MBDA. Emotional problems and health-related quality of life: population-based study. Qual Life Res 2019; 28:3037-3046. [PMID: 31240538 DOI: 10.1007/s11136-019-02230-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE The aim of the present study was to evaluate the influence of emotional problems on health-related quality of life (HRQoL) according to the type of emotional problem, degree of limitation, and perceived control of the problem with treatment. METHOD A population-based cross-sectional study with probabilistic stratified cluster sampling was conducted in 2014 and 2015 in the city of Campinas, Brazil. A total of 2145 individuals aged 18 years or older participated in the study. HRQoL was evaluated using the SF-36® questionnaire. The dependent variables were the score of the eight scales of the SF-36®. The independent variables were self-perceived emotional problems, type of emotional problem (according to ICD 10), degree of limitation, and perceived control of the problem with treatment. Mean scores were calculated and regression coefficients were adjusted for sex, age, number of health problems, and chronic diseases using multiple linear regression analysis. RESULTS The prevalence of emotional problems was 32.7%. Among the individuals with a problem, the mean SF-36® scores were lower on all domains. Regarding the type of emotional problem, a complaint of depression exerted a stronger negative impact on HRQoL scores than anxiety. Moreover, a greater degree of limitation caused by the problem led to lower mean SF-36® scores. The negative impact on HRQoL was substantially greater among those who did not have the problem under control. CONCLUSION In conclusion, the findings underscore the importance of the prevention and control of emotional problems with the aim of reducing the impact on HRQoL.
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Affiliation(s)
| | - Margareth Guimarães Lima
- Department of Public Health, School of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil
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Diderichsen F, Andersen I. The syndemics of diabetes and depression in Brazil - An epidemiological analysis. SSM Popul Health 2018; 7:002-2. [PMID: 30581954 PMCID: PMC6293027 DOI: 10.1016/j.ssmph.2018.11.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 11/01/2018] [Accepted: 11/04/2018] [Indexed: 12/31/2022] Open
Abstract
An epidemiological model of causal pathways in the syndemic of diabetes and depression is presented. Depression and diabetes are clustering in the adult Brazilian population partly due to shared social and behavioural causes. There is an interaction between depression and diabetes in their association with disability. There is a differential susceptibility to the effect of obesity on diabetes across levels of education and depression.
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Affiliation(s)
- Finn Diderichsen
- University of Copenhagen, Department of Public Health, 1014 Købenahavn K, Denmark.,Fundação Oswaldo Cruz, IAM, 50670-420 Recife, PE, Brazil
| | - Ingelise Andersen
- University of Copenhagen, Department of Public Health, 1014 Købenahavn K, Denmark
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Akerman M, de Freitas O. National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM): evaluation of pharmaceutical services in the primary health care. Rev Saude Publica 2017; 51:1s. [PMID: 29160468 PMCID: PMC5676376 DOI: 10.11606/s1518-8787.201705100supl2ed] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 05/03/2017] [Indexed: 12/01/2022] Open
Affiliation(s)
- Marco Akerman
- Departamento de Política, Gestão e Saúde. Faculdade de Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil
| | - Osvaldo de Freitas
- Departamento de Ciências Farmacêuticas. Faculdade de Ciências Farmacêuticas. Universidade de São Paulo. Ribeirão Preto, SP, Brasil
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