Head Public Health Service

This paper deals with the application of a soft computing technique to a medical project. The application consists in connecting a patient to an ophthalmologist situated in a hospital or to a specialized web center through a telecommunication network. The patient may be at home or at any other place agreed upon for that teleconsultation. The aim of the study concerns the evaluation of a patient's visual acuity, using web-based medical advice. Indeed an ophthalmologist actually requires specific equipment, available only in medical centers and used by specialized staff. This situation leads to limit the number of patients being examined by the physician and so to extend the waiting time necessary before you can get an appointment (you have to wait between 8 and 10 months at the moment in France). So, public health services have an interest in making these tests available to the patients, in schools, firms, at home and so on, the tests being implemented remotely by competent personnel thanks to modern means of telecommunication. In order to achieve this, a certain number of tests are made, during which optotypes (or letters of different sizes) are presented to the patient. We propose an algorithmic treatment of the binary answers, based on the use of fuzzy sets, in order to eliminate the different mistakes (voluntary or not) that can be made. This algorithm also allows to assess the quality of the examination by measuring the inaccuracy of the visual acuity. This work must be considered as a pioneering telemedicine project, and particularly as a way of developing expert systems able to generate medical advice without the physician's actual presence.

Although the development in advanced medical and public health services has provided both proactive and passive postpartum care in the rural areas, the traditional practices are still influential. The objective of this study was to investigate the traditional practices and food consuming for Thai postpartum women in the rural areas. The descriptive study used both the quantitative and qualitative methods.

Several groups have outlined methodologies for systematic literature reviews of the effectiveness of interventions. The Effective Public Health Practice Project (EPHPP) began in 1998. Its mandate is to provide research evidence to guide and support the Ontario Ministry of Health in outlining minimum requirements for public health services in the province. Also, the project is expected to disseminate the results provincially, nationally, and internationally. Most of the reviews are relevant to public health nursing practice. This article describes four issues related to the systematic literature reviews of the effectiveness of public health nursing interventions: (1) the process of systematically reviewing the literature, (2) the development of a quality assessment instrument, (3) the results of the EPHPP to date, and (4) some results of the dissemination strategies used. The eight steps of the systematic review process including question formulation, searching and retrieving the lit...

Many low-income countries are implementing non-profit medical insurance to increase access to health services, especially among low-income households, and to raise additional revenue for financing public health services. This paper estimates the effect of insurance on outof-pocket health expenditures using the Vietnam Living Standards Surveys for 1993 and 1998 and appropriate models for panel data. Our findings suggest that health insurance reduces health expenditure when unobserved heterogeneity is accounted for. Failure to capture unobserved heterogeneity produces contrary results that are consistent with previous cross-sectional studies in the literature. After accounting for unobserved heterogeneity, we also find that the reduction in expenditure is more pronounced for individuals with lower incomes, but the benefits are modest in the range of 17 to 20%.

In 2003 startte de GGD Rotterdam-Rijnmond het project 'Jongeren met een langdurig ziek familielid', met als doel de problematiek van deze jongeren (11-16 jarigen) vroegtijdig te signaleren en (samen met anderen) te voorkomen of op te lossen. Onderdeel van dit project was het in kaart brengen van de aard en omvang van de problematiek. Gekeken is naar hoeveel jongeren opgroeien met een langdurig ziek familielid, of er verschillen zijn in (psychische) gezondheid, leefstijl, schoolverzuim en ervaren problematiek thuis tussen jongeren met en zonder ziek familielid en of de aard van de ziekte en de relatie met het familielid verband houden met de problemen die jongeren met een ziek familielid ervaren. Van de ruim 10.000 jongeren (11-16 jaar) die deelnamen in het schooljaar 2004-2005 gaf ruim een kwart (29%) aan op te groeien in een gezin met een langdurig ziek, gehandicapt of verslaafd familielid. Deze jongeren rapporteerden significant vaker een minder goede ervaren gezondheid (OR 2,0, 95% BI 1,8-2,2), psychische problemen (OR 2,2, 95% BI 1,9-2,5), suïcidegedachten (OR 1,9; 95% BI 1,7-2,1), suïcidepogingen (OR 2,2, 95% BI 1,9-2,6), alcoholgebruik (OR 1,4, 95% BI 1,2-1,5), marihuanagebruik (OR 1,5, 95% BI 1,2-1,8), spijbelen (OR 1,4, 95% BI 1,2-1,6), schoolverzuim door ziekte (OR 1,4, 95% BI 1,3-1,6), geen lidmaatschap van een vereniging (OR 1,2, 95% BI 1,1-1,3) en problematiek thuis (OR 2,4, 95% BI 2,1-2,7). Bij een psychisch ziek of verslaafd familielid rapporteerden jongeren meer problemen dan bij een lichamelijk ziek familielid. Zowel jongeren met een zieke ouder als met een zieke broer of zus rapporteerden meer problematiek dan jongeren zonder ziek familielid. Jongeren die opgroeien met een langdurig ziek familielid moeten worden beschouwd als een risicogroep. De jeugdgezondheidszorg is vanwege de vaste contactmomenten een unieke setting om op gestructureerde wijze mogelijke problemen bij deze groep vroegtijdig te signaleren en ondersteuning te bieden.

AbstractÐThis paper considers the involvement and performance in the health sector of the Hong Kong government prior to and beyond the transfer of sovereignty from Britain to China in July 1997. The paper commences with a historical survey of health services development, which provides insights into why the health system functions in its present haphazard manner. This section culminates by discussing the 1991 establishment of the statutory Hospital Authority which was an attempt to alleviate escalating problems in the administration of hospitals and public health services. Next, the paper surveys the present, discussing, respectively, the roles of government and private service providers, health care outcomes and the contribution of traditional Chinese medicine. Finally, the paper outlines a range of pressing issues which Hong Kong's future policy-makers will need to confront: the organization of the health sector, health ®nancing and the health policy de®cit. In the conclusion, it is posited that there is a need for government to formulate a health policy and to clarify its role in the provision of services. #

Public Health Laboratories (PHL) as part of Public Health Services are involved in law enforcement and ensuring food and water quality. The laboratories had to go through an organizational and monetary change imposed by the growing and changing needs of the state of Israel. The laboratories had to become more modern and to implement new and more sophisticated testing methods. Another requirement was to perform a steadily increasing number of tests and to be more flexible towards customers' demands. Yet, the budget was not changed accordingly, as the Public Service to which the laboratories belong to do not respond to changing needs. Management realization was that the accreditation process could be used as a tool to achieve organizational and cultural change. Understanding and transformation were required throughout the organization, including management. Proficiency testing is performed for all testing methods in all areas even for non-accredited tests such as clinical tests. Proficiency testing was used as a tool for organizational culture change. It is a great index with

The essay reconstructs the antithalassemia campaign carried out by means of population screening and pre-marriage counseling for about twenty years in Italy, immediately after the relationship between microcythemia and Cooley's anemia had been established, as well as its genetic bases. We examine the Italian contributions to the understanding of the genetics and of the clinical treatment of thalassemic disorders, and analyze the approaches to prevention as well as the results obtained by the first campaign against a genetic disease, conceived and largely implemented in Italy by Ezio Silvestroni and Ida Bianco. We discuss the resistances met by the antithalassemia campaign due to the cultural and organizational backwardness of the Italian medical community and of the public health system. Moreover we analyze the explanations and interpretations of the problematic results of these experiences in terms of morbidity reduction. It will be pointed out that the objective of genetic cou...

The proposal that psychologists should pursue prescriptive authority was first put forth 25 years ago, and it has been an official goal of the American Psychological Association for 15 years. Since then some form of prescriptive authority has been approved by three states, the Territory of Guam, and three branches of the military. Psychologists are also eligible to prescribe in the Public Health Service and the Indian Health Service. The movement has generated strong opinions both in favor and in opposition. Supporters focus particularly on increasing access to appropriate care and changing the role of psychologists within the healthcare system, while opponents raise concerns about how prescriptive authority will change professional psychology and whether psychologists will prescribe safely. This review provides a summary of milestones in the movement to date, as well as the arguments that have been raised for and against prescriptive authority.

In this study, all (100%) ceramic inlays and 94% of the composite inlays in posterior teeth showed excellent or acceptable results after 1 year of clinical service. Premolars revealed a significantly higher success rate for adhesive inlays than molars.

Las razones que justifican la elección e importancia del tema y del sector objeto de estudio se basan en el protagonismo que adquiere la salud en la sociedad de nuestros días y en el nuevo papel que desempeña el paciente como evaluador de los servicios sanitarios.

Objectives: In Europe, the services provided for the investigation and management of obstructive sleep apnoea (OSA) varies from country to country. The aim of this questionnaire-based study was to investigate the current status of diagnostic pathways and therapeutic approaches applied in the treatment of OSA in Europe, qualification requirements of physicians involved in diagnosis and treatment of OSA, and reimbursement of these services.

Abstract. Software development methodologies (SDM) have been tradition-ally defined in a prescriptive manner with an underlying assumption of univer-sal applicability. However, as industrial practice suggests, this assumption is fundamentally flawed. Software development ...

Summary The threat of climate change and global warming is now recognised worldwide and some alarming manifestations of change have occurred. The Asian continent, because of its size and diversity, may be affected significantly by the consequences of climate change, and its new status as a 'hub' of livestock production gives it an important role in mitigating possible impacts of

This prospective clinical trial aimed at evaluating the clinical performance of three-unit posterior zirconia fixed dental prostheses (FDPs) after 5 years of clinical function. Thirty-seven patients received 48 three-unit zirconia-based FDPs. The restorations replaced either a premolar or a molar. Specific inclusion criteria were needed. Tooth preparation was standardized. Computer-aided design/computer-assisted manufacturing frameworks with a 9-mm2 cross section of the connector and a 0.6-mm minimum thickness of the retainer were made. The restorations were luted with resin cement. The patients were recalled after 1, 6, 12, 24, 36, 48, and 60 months. The survival and success of the ceramics and zirconia were evaluated. The technical and aesthetic outcomes were examined using the United States Public Health Service criteria. The biologic outcomes were analyzed at abutment and contralateral teeth. Descriptive statistics were performed. All FDPs completed the study, resulting in 100% cumulative survival rate and 91.9% and 95.4% cumulative success rates for patients wearing one and two FDPs, respectively. No losses of retention were recorded. Forty-two restorations were rated alpha in all measured parameters. A minor chipping of the ceramics was detected in three restorations. No significant differences between the periodontal parameters of the test and control teeth were observed. Five-year clinical results proved that three-unit posterior zirconia-based FDPs were successful in the medium term for both function and aesthetic. Zirconia can be considered a promising substitute of metal frameworks for the fabrication of short-span posterior prostheses.

The overarching mission of the Commissioned Corps of the US Public Health Service (PHS) is to protect, promote, and advance the health and safety of the nation. The Corps comprises more than 6400 active-duty public health professionals who develop and implement a broad range of public health programs. Being one of America's 7 uniformed services (Box 1), it fills essential public health leadership and service roles within major federal agencies and programs. The Corps is a vital component of the PHS, the largest public health program in the world. 1 This article presents an overview of the PHS and how Commissioned Corps officers respond during times of national and global need.

The article analyses the situation which exists in the private health sector in Greece, it presents data on the growth of the private sector and discusses the reasons for this phenomenon in relation to privatisation trends in other European countries. The growth of private health care in Greece in the last 10 years is evident despite governmental attempts to minimise its role through the development of the National Health System in 1983 and the legislative restrictions on the private sector. Private health expenditure has increased, reaching 3.9% of the country's GNP (43% of the total expenditure in health) in 2000. The number of private hospitals and hospital beds has decreased (hospitals decreased from 468 in 1990 to 218 in 2000 and private beds decreased from 25,075 in 1980 to 15,806 in 2000) mainly because of the reduction in the number of small private hospitals. On the other hand, private doctors and private diagnostic centres have significantly increased. This situation is believed to be attributed mainly to the provision of inadequate and low quality public health services which have caused widespread dissatisfaction among the general public, and factors associated to improved standards of living, as well as the rapid growth of private insurance.

Da almeno 30 anni (1, 2) si avverte la necessità di disporre di prove psicodiagnostiche specificamente costruite per verificare e documentare l'efficacia nella pratica ("effectiveness") dei trattamenti psicologici e psicoterapeutici, erogati sia nei servizi pubblici che in ambito privato.

Only large increases in adult cessation will rapidly reduce population smoking prevalence. Evidence-based smoking-cessation treatments and treatment policies exist but are underutilized. More needs to be done to coordinate the widespread, effıcient dissemination and implementation of effective treatments and policies. This paper is the fırst in a series of three to demonstrate the impact of an integrated, comprehensive systems approach to cessation treatment and policy. This paper provides an analytic framework and selected literature review that guide the two subsequent computer simulation modeling papers to show how critical leverage points may have an impact on reductions in smoking prevalence. Evidence is reviewed from the U.S. Public Health Service 2008 clinical practice guideline and other sources regarding the impact of fıve cessation treatment policies on quit attempts, use of evidence-based treatment, and quit rates. Cessation treatment policies would: (1) expand cessation treatment coverage and provider reimbursement; (2) mandate adequate funding for the use and promotion of evidence-based state-sponsored telephone quitlines;

8 Commissioned Corps of the United States Public Health Service Summary These recommendations of the Advisory Committee on Immunization Practices (ACIP) update the previous recommendations on human rabies prevention (CDC. Human rabies prevention—United States, 1999: recommendations of the Advisory Committee on Immunization Practices. MMWR 1999;48 (No. RR-1)) and reflect the status of rabies and antirabies biologics in the United States.

Current e-Governance scenario in healthcare sector in India is disappointing. Public health service run by Government is overburdened and collapsing. Large geographical size, increase population density, lack of transport, inaccessibility, illiteracy, poverty, poor nutritional status, diversity in food habit and life style are various impediments. Government priorities for providing food, safe water and school education is yet to be fulfilled. At this stage low budget for health, lack of funds and coordination have triggered down trend in health services. As medical science is fast developing and information resource is pouring in, there is urgent need for dissemination knowledge by interlinking primary, secondary and tertiary level health centres by ICT applications. This will help health personal to deliver high quality services. From 2006 onwards corporate IT giants are experimenting for ICT application in health sector both in Government and private hospitals, This paper reviews ICT applications at National Level and also in Orissa province. It presents facts on tele-medicine, tele-referal services and health information dissemination by Video conferencing, Gramsat and e-Grama tools used in Orissa The prospects and constraints of ICT implementation for Governance of healthcare is addressed.

Men's pre-and extra-marital sexual behavior has been identified as the primary factor in the growing HIV/STI epidemic among both males and females in India. One major barrier to reaching men has been their underutilization of public health services, which has severely limited programs geared to prevention and early case identification. A significant number of men in India have strong culturally-based sexual health concerns, much of which are derived from ''semen-loss'' and deficiencies in sexual performance. This paper reports on an ongoing Indo-US project that has focused on men's concerns about sexual health problems and assesses the services provided by non-allopaths in three low-income communities in Mumbai. Findings indicate that the primary health resources for these men are private, community-based non-allopaths, who identify themselves as ayurvedic, unani and homeopathic providers. The paper suggests that the combination of strong culturally-based sexual health concerns and the presence of private non-allopaths who manage these problems present a window of opportunity for intervention programs to address the challenge of HIV/STI prevention and early case identification in India. r

Objective To assess the costs incurred by the public health services and patients as a result of tuberculosis (TB) treatment. Setting The study was conducted in a government hospital located in the northern region of Malaysia. Method Retrospective data were collected from medical records and the patients were observed until the completion of their medication. A pharmacoeconomic evaluation was applied to calculate direct and indirect costs. Main Outcome Measure Direct and indirect costs of tuberculosis treatment in a government health institution. Results Two hundred and one tuberculosis patients were included in the study. Different regimens with various durations of treatments were used. The direct medical and non-medical costs as well as indirect costs were calculated

In sub-Saharan Africa, the unprecedented population growth that started in the second half of the twentieth century has evolved into unparalleled urbanization and an increasing proportion of urban dwellers living in slums and shanty towns, making it imperative to pay greater attention to the health problems of the urban poor. In particular, urgent efforts need to focus on maternal health. Despite the lack of reliable trend data on maternal mortality, some investigators now believe that progress in maternal health has been very slow in sub-Saharan Africa. This study uses a unique combination of health facility-and individual-level data collected in the slums of Nairobi, Kenya to: (1) describe the provision of obstetric care in the Nairobi informal settlements; (2) describe the patterns of antenatal and delivery care, notably in terms of timing, frequency, and quality of care; and (3) draw policy implications aimed at improving maternal health among the rapidly growing urban poor populations. It shows that the study area is deprived of public health services, a finding which supports the view that low-income urban residents in developing countries face significant obstacles in accessing health care. This study also shows that despite the high prevalence of antenatal care (ANC), the proportion of women who made the recommended number of visits or who initiated the visit in the first trimester of pregnancy remains low compared to Nairobi as a whole and, more importantly, compared to rural populations. Bivariate analyses show that household wealth, education, parity, and place of residence were closely associated with frequency and timing of ANC and with place of delivery. Finally, there is a strong linkage between use of antenatal care and place of delivery. The findings of this study call for urgent attention by Kenya's Ministry of Health and local authorities to the void of quality health services in poor urban communities and the need to provide focused and sustained health education geared towards promoting use of obstetric services.

Background: Multidrug antiretroviral (ARV) regimens including HAART and short-course dual antiretroviral (sc-dARV) regimens were introduced in 2004 to improve Prevention of Mother-to-Child Transmission (PMTCT) in Cameroon. We assessed the effectiveness of these regimens from 6-10 weeks and 12 months of age, respectively.

As a result of China's transition to a socialist market economy, its rural health services have undergone many of the changes commonly associated with health sector reform. These have included a decreased reliance on state funding, decentralisation of public health services, increased autonomy of health facilities, increased freedom of movement of health workers, and decreased political control. These changes have been associated with growing inequality in access to health services, increases in the cost of medical care, and the deterioration of preventive programmes in some poor areas. This paper argues that the government's strategy for addressing these problems has overemphasised the identification of new sources of revenue and has paid inadequate attention to factors that influence provider behaviour. The strategy also does not address contextual issues such as public sector employment practices and systems of local government finance. Other countries can learn from China's experience by taking a systematic approach to the formulation and implementation of strategies for health sector reform. Copyright @ 1997

Malaria, more than any other disease of major public health importance in developing countries, disproportionately affects poor people, with 58% of malaria cases occurring in the poorest 20% of the world's population. If malaria control interventions are to achieve their desired impact, they must reach the poorest segments of the populations of developing countries. Unfortunately, a growing body of evidence from benefit-incidence analyses has demonstrated that many public health interventions that were designed to aid the poor are not reaching their intended target. For example, the poorest 20% of people in selected developing countries were as much as 2.5 times less likely to receive basic public health services as the least-poor 20%. In the field of malaria control, a small number of studies have begun to shed light on differences by wealth status of malaria burden and of access to treatment and prevention services. These early studies found no clear difference in fever incide...

Boyse and co-workers have identified several systems of murine isoantigens called Ly antigens (for lymphocyte antigens) (e.g. Ly-1, Ly-2, Ly-3, and Ly-5) which appear to be restricted to thymic lymphocytes and peripheral T lymphocytes (1-3). Each system, defined by cytotoxic alloantisera, appears to be determined by a genetic locus which contains two alternative alleles (e.g., Ly-2 a and Ly-2 b) governing expression of two alternative cell surface antigenic specificities (e.g. Ly-2.1 and Ly-2.2, respectively). TheLy-1 locus has been shown to reside in linkage group XII (4), and the Ly-2 and Ly-3 loci are extremely closely linked to each other in linkage group XI of the mouse (5).

There is scientific consensus that the global climate is changing, with rising surface temperatures, melting ice and snow, rising sea levels, and increasing climate variability. These changes are expected to have substantial impacts on human health. There are known, effective public health responses for many of these impacts, but the scope, timeline, and complexity of climate change are unprecedented. We propose a public health approach to climate change, based on the essential public health services, that extends to both clinical and population health services and emphasizes the coordination of government agencies (federal, state, and local), academia, the private sector, and nongovernmental organizations. (Am J Public Health. 2008;98:435-445.

Folate is a water-soluble B vitamin that must be obtained in the diet or through supplementation. For >50 yr, it has been known that folate plays an integral role in embryonic development. In mice, inactivation of genes in the folate pathway results in malformations of the neural tube, heart, and craniofacial structures. It has been shown that diets and blood levels of women who had a fetus with a neural tube defect are low for several micronutrients, particularly folate. Periconceptional use of folic acid containing supplements decreased recurrent neural tube defects in the offspring of women with a previously affected child and the occurrence of a neural tube defect and possibly other birth defects in the offspring of women with no prior history. Based on these findings, the U.S. Public Health Service recommended that all women at risk take folic acid supplements, but many did not. Mandatory food fortification programs were introduced in numerous countries, including the United States, to improve folate nutritional status and have resulted in a major decrease in neural tube defect prevalence. The success story of folate represents the cooperation of embryologists, experimentalists, epidemiologists, public health scientists, and policymakers.-Običan, S. G., Finnell, R. H., Mills, J. L., Shaw, G. M., Scialli, A. R. Folic acid in early pregnancy: a public health success story. FASEB J. 24, 000 -000 (2010). www.fasebj.org

Pressure sores are a great problem for patients, staff and society. The aim of this study was to examine the prevalence, treatment and prevention of pressure sores in a public health service area in Sweden. Criteria used for pressure sore assessment were persistent discoloration, epithelial damage and damage to the full thickness of the skin, without or with a cavity. The data were collected during 2 weeks in April 1995 from 1173 inpatients. The pressure-sore prevalence rate was 3.75%; 44 patients had a total of 68 sores. Men were as prone to developing pressure sores as women.The most frequently reported preventive measures were antidecubitus mattresses and turning schedules. Relief from pressure and occlusive dressings were the most common treatment measures.There was no statistical difference in pressure-sore prevalence when compared with a similar study from 1980. Patients were, however, older in 1995.

Uranium mining on the Navajo Reservation created an environmental justice disaster which has strangely helped bring the Navajo Nation to achieve considerable self-determination within the United States. The United States’ need for uranium to fuel the nuclear weapons and energy program brought the Atomic Energy Commission to establish an extensive mining operation on Southwestern edge of the Colorado Plateau. Many of mines established were on or near the Navajo Indian reservation. The Navajo Nation received little share in the profits due to poorly constructed lease and royalty contracts. What is more, most mines employed almost entirely Navajo men who were never told of the known health hazards from radiation expose. The Navajo people were desperate to work, the AEC was driven to produce uranium as quickly as possible, and the mining companies working for the AEC wanted the largest possible profits. Despite pressure from the Public Health Service (PHS), who had been gathering data r...

User fees at public health care facilities and out-of-pocket payments for health care services are major health financing problems in Vietnam. In 2002, the Government launched the Health Care Funds for the Poor (HCFP) policy which offered free public health care services to help the poor access public health services and reduce their health care expenditure (HCE). This paper is an assessment of the implementation of the HCFP in a rural district of Vietnam. The impacts of HCFP on household HCE as a percentage of total expenditure and health care utilization were assessed by a double-difference propensity score matching method using panel data of 10,711 households in 2001, 2003, 2005 and 2007. The results showed that the HCFP significantly reduced the HCE as a percentage of total expenditure and increased the use of the local public health care among the poor. However, the impacts of HCFP on the use of the higher levels of public health care and the use of go-to-pharmacies were not significant. In conclusion, this assessment indicates that the HCFP has met its objectives by reducing HCE for the poor and increasing their use of the local public health care services. However, further efforts are needed to help them access higher levels of public health care. Pharmacists should be better regulated and incorporated with primary health care to improve efficiency of the system.

The only prevalence rate of myasthenia gravis (MG) so far estimated in Italy by an epidemiological study carried out in Pavia, North Italy, indicates a prevalence quite similar to that observed in other countries. The purpose of the survey was to verify the frequency of the disease in a geographically well-defined and previously surveyed community. On the basis of 39 cases, on 31 December 1987 the prevalence per million was 105.3 (102.3 if standardized for the Italian population). This is the highest prevalence figure yet found, indicating a value similar to that established in Northern Europe. According to Kurtzke this high prevalence rate reflects the high standard of the local public health service, which permitted a more intensive search for affected subjects.

The essence of learning is change; learning is the process by which learners customize new information to make it personally meaningful and relevant. Training is the process of helping students make those changes. Research indicates that adults learn differently than children or adolescents and that adults consistently use the following six learning strategies: prior experiences; conversations; metacognition; reflection; authentic experiences; and images, pictures, or other types of visuals. Each of these learning strategies can be combined with the other strategies and often build upon each other. A recent study on how health care professionals learn indicated that the learning strategy they used most often was reflection, which supports learning before, during, and after training. Numerous examples are provided in this article describing how to integrate each of the six adult learning strategies into laboratory animal science training. While lectures and other types of direct instruction are appropriate, they are inadequate and ineffective unless they are integrated with and support adult learning strategies. Both the US Department of Agriculture regulations and the Public Health Service Policy mandate that research institutions must ensure that all personnel involved in animal care, treatment, or use are qualified to perform their duties. Applying adult learning strategies to training for the laboratory animal science community will enhance learning and improve both the science and the humane care of the animals, which is a goal our community must continuously strive to achieve.

Este trabalho tem o objetivo de conhecer a atuação dos psicólogos diante das queixas escolares de crianças encaminhadas aos serviços públicos de saúde do município de Ribeirão Preto, Estado de São Paulo, uma vez que ela pode fornecer dados importantes para a análise da formação profissional do psicólogo. Foram realizadas entrevistas individuais, semi-estruturadas a partir de um roteiro, sendo estas gravadas e transcritas, o que permitiu uma análise quantitativa e qualitativa das respostas de 19 psicólogos que participaram do presente estudo. Os resultados mostraram que esses profissionais ainda compreendem a queixa escolar como um problema da criança pobre e de sua família, passível de ser analisado e tratado fora do contexto da instituição escolar, na qual o fracasso escolar é produzido. Embora os profissionais apontem a participação da escola na produção das dificuldades escolares das crianças, o foco de intervenção dos problemas apresentados ainda é o atendimento individualizado das crianças e dos seus familiares. Apesar dos avanços teórico-metodológicos presentes nas novas compreensões das queixas escolares, eles ainda não se fazem suficientemente presentes na atuação desses profissionais. Palavras-chave: Formação profissional e Psicologia, Problemas de aprendizagem, Atuação do psicólogo.