Cadernos de saúde pública
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Cadernos de saúde pública · Mar 2019
ReviewPrecision medicine/personalized medicine: a critical analysis of movements in the transformation of biomedicine in the early 21st century.
The enormous development of genomics research in recent decades has raised great expectations concerning its impact on biomedicine. There has been growing investment in research in personalized or precision medicine, which aims to customize medical practice with a focus on the individual, based on the use of genetic tests, identification of biomarkers, and development of targeted drugs. However, the personalized or precision medicine movement is controversial and has sparked an important debate between its defenders and critics. ⋯ Personalized or precision medicine is expected to generate incremental developments in specific areas of medicine, but there are obstacles to its generalization. The high cost of new biotechnologies can exacerbate health inequalities and become a problem for health services' sustainability, especially in low and middle-income countries. The emphasis on personalized or precision medicine may shift funds away from less costly interventions that have greater public health impact.
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Cadernos de saúde pública · Oct 2018
[Criteria for the equitable (re)distribution of basic health teamwork at the local level in Venezuela].
The article analyzes the application of four criteria for the (re)distribution of basic health teamwork at the local level. This was a descriptive, cross-sectional, case study conducted in Nueva Esparta, Venezuela, in 2016. An instrument was designed to consolidate in a single database the local data on basic health teamwork in 170 popular clinics serving 447 communities. ⋯ Combined application of the criteria allowed identifying geographic areas and populations with the greatest need and shortage of basic health teamwork and optimizing their equitable (re)distribution at the local level. The limitation of lack of disaggregated information was overcome by using a single data repository with consensual information among the state and local health teamwork. In conclusion, investments should be made in efficient information systems.
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Cadernos de saúde pública · Sep 2018
Historical Article[Biopolitics for breastfeeding: an analysis of the global and local movements and their links to social development discourses].
This study aimed to analyze the links between the production of biopolitics for breastfeeding and social development discourses after the post-war period, with a view towards problematizing the nature/culture dichotomy by which breastfeeding is often operationalized. The study adopts an anthropological perspective to compare biopolitics for breastfeeding with the changes in developmentalist discourses. The analysis of global movements by these biopolitics helped explain how a network of distinct entities (e.g., government agencies, multilateral bodies, international development agencies, and nongovernmental organizations) have shaped breastfeeding over time in keeping with the prevailing developmentalist discourses and practices. ⋯ Meanwhile, the contemporary social development discourse also evokes a process of individual development. Simultaneously, biopolitics for breastfeeding rely on various technologies for this purpose. The conclusion is that developmentalist discourses act as a sociocultural reference by which breastfeeding is operationalized, and thus that breastfeeding is not only a natural process, but also a political, economic, and social one.
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Cadernos de saúde pública · Jul 2018
[Access to information for evidence-based decision-making from the perspective of Municipal Health Secretaries in the State of Paraná, Brazil, 2014].
The study aimed to identify information sources for decision-making and barriers to access in the use of scientific journals by Municipal Health Secretaries in the State of Paraná, Brazil. Study participants included Secretaries of Health from 181 municipalities in the year 2014. Interviews focused on the frequency of consultation of resources for obtaining evidence, including from scientific journals. 40.9% of the participants were 18 to 39 years of age (mean age was 43±10.2 years; median 42 years). ⋯ The use of scientific journals is hindered by lack of time and limited familiarity with scientific language. Access to scientific information should be facilitated by the use of more accessible sources and training for municipal administrators in the use of open-access periodicals. Such measures can foster knowledge of current evidence among municipal health secretaries.
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Zika virus infection during pregnancy is a cause of congenital brain abnormalities. Its consequences to pregnancies has made governments, national and international agencies issue advices and recommendations to women. There is a clear need to investigate how the Zika outbreak affects the decisions that women take concerning their lives and the life of their families, as well as how women are psychologically and emotionally dealing with the outbreak. ⋯ Coping strategies pose obstacles in professional life, lead to social isolation, including from family and partner, and threaten the emotional and physical well-being of women. Our findings suggest that the impacts of the Zika epidemic on women may be universal and global. Zika infection is a silent and heavy burden on women's shoulders.