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      O conhecimento científico e tecnológico como evidência para políticas e atividades regulatórias em saúde Translated title: Scientific and technological knowledge as evidence for policies and regulatory activities in health

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          Abstract

          Nas últimas décadas, têm-se observado mudanças na organização do modelo ocidental de Estado, com clara tendência de redução das suas atividades econômicas e sociais diretas. Ao mesmo tempo, percebe-se a ampliação de alguns dos seus papéis na elaboração de políticas e como regulador de uma série de parâmetros da vida social. Nesse contexto, consolida-se a noção de que são cada vez mais necessários conhecimentos científicos que fundamentem os processos de tomada de decisões. A idéia de política baseada em evidência foi apropriada pelo Estado moderno, e na saúde vem recebendo especial atenção. Avalia-se que, assim procedendo, se ampliam as chances de se tomar decisões mais efetivas, trazendo maiores benefícios à saúde da população, com menos custos econômicos ou sociais. Essa nova abordagem torna o Estado um crescente consumidor dos resultados da atividade científica. O objetivo deste ensaio é discutir alguns aspectos da relação entre o processo de produção do conhecimento científico e os processos gerais de tomada de decisões na área da saúde, com maior ênfase naqueles relacionados às atividades regulatórias. Após rever a literatura recente sobre o tema, comenta-se a importância dessa discussão no contexto do SUS no Brasil.

          Translated abstract

          In the last decades, significant changes in the occidental model of State have been observed. There is a clear trend towards reduction in the State direct role on social and economic activities. At the same time, an increasing participation in policy-making and regulation affairs is observed. In this context, there is a growing concern that scientific knowledge is necessary to subsidize the so complex State decision-making process in the large range of health-related matters. It is expected more effective decisions with great benefices to the population health and less social or economic costs. As consequence, it is increasing the participation of the State as consumer of the results of the scientific activities. The idea of an evidence-based policy-making has been used by the modern States, and in special in the health field this topic is receiving great attention. This paper aimed to discuss general aspects of the relationship between the decision making process in health, with emphasis in those related with regulatory affairs. After an overview of the literature on the topic, it discusses the relevance of this to the Brazilian SUS context.

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          The utilisation of health research in policy-making: concepts, examples and methods of assessment

          The importance of health research utilisation in policy-making, and of understanding the mechanisms involved, is increasingly recognised. Recent reports calling for more resources to improve health in developing countries, and global pressures for accountability, draw greater attention to research-informed policy-making. Key utilisation issues have been described for at least twenty years, but the growing focus on health research systems creates additional dimensions. The utilisation of health research in policy-making should contribute to policies that may eventually lead to desired outcomes, including health gains. In this article, exploration of these issues is combined with a review of various forms of policy-making. When this is linked to analysis of different types of health research, it assists in building a comprehensive account of the diverse meanings of research utilisation. Previous studies report methods and conceptual frameworks that have been applied, if with varying degrees of success, to record utilisation in policy-making. These studies reveal various examples of research impact within a general picture of underutilisation. Factors potentially enhancing utilisation can be identified by exploration of: priority setting; activities of the health research system at the interface between research and policy-making; and the role of the recipients, or 'receptors', of health research. An interfaces and receptors model provides a framework for analysis. Recommendations about possible methods for assessing health research utilisation follow identification of the purposes of such assessments. Our conclusion is that research utilisation can be better understood, and enhanced, by developing assessment methods informed by conceptual analysis and review of previous studies.
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            A theoretical proposal for the relationship between context and disease

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              Contamination of drinking-water by arsenic in Bangladesh: a public health emergency

              The contamination of groundwater by arsenic in Bangladesh is the largest poisoning of a population in history, with millions of people exposed. This paper describes the history of the discovery of arsenic in drinking-water in Bangladesh and recommends intervention strategies. Tube-wells were installed to provide ‘‘pure water’’ to prevent morbidity and mortality from gastrointestinal disease. The water from the millions of tube-wells that were installed was not tested for arsenic contamination. Studies in other countries where the population has had long-term exposure to arsenic in groundwater indicate that 1 in 10 people who drink water containing 500 µg of arsenic per litre may ultimately die from cancers caused by arsenic, including lung, bladder and skin cancers. The rapid allocation of funding and prompt expansion of current interventions to address this contamination should be facilitated. The fundamental intervention is the identification and provision of arsenic-free drinking water. Arsenic is rapidly excreted in urine, and for early or mild cases, no specific treatment is required. Community education and participation are essential to ensure that interventions are successful; these should be coupled with follow-up monitoring to confirm that exposure has ended. Taken together with the discovery of arsenic in groundwater in other countries, the experience in Bangladesh shows that groundwater sources throughout the world that are used for drinking-water should be tested for arsenic.
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                Author and article information

                Contributors
                Role: ND
                Journal
                csc
                Ciência & Saúde Coletiva
                Ciênc. saúde coletiva
                ABRASCO - Associação Brasileira de Saúde Coletiva (Rio de Janeiro )
                1413-8123
                June 2004
                : 9
                : 2
                : 329-338
                Affiliations
                [1 ] Universidade Federal da Bahia Brazil
                Article
                S1413-81232004000200010
                63967de2-a541-4aa0-ad5d-1b8d4f1ba13e

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielosp.org/scielo.php?script=sci_serial&pid=1413-8123&lng=en
                Categories
                Health Policy & Services

                Public health
                Scientific knowledge,Regulatory,Evidence-based policy,Health,Conhecimento científico,Regulação,Políticas baseadas em evidência,Saúde

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