Cadernos de saúde pública
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Cadernos de saúde pública · Sep 2020
ReviewCOVID-19 and food and nutritional (in)security: action by the Brazilian Federal Government during the pandemic, with budget cuts and institutional dismantlement.
The COVID-19 pandemic poses one of this century's greatest public health challenges, with impacts on the health and living conditions of populations worldwide. The literature has reported that the pandemic affects the hegemonic food system in various ways. In Brazil, the pandemic amplifies existing social, racial, and gender inequalities, further jeopardizing the Human Right to Adequate Food (HRAF) and the attainment of food and nutritional security, especially among more vulnerable groups. ⋯ The analysis identified the creation of institutional crisis management arrangements. The proposed actions feature those involving access to income, emergency aid, and food, such as authorization for food distribution outside schools with federal funds from the National School Feeding Program. However, the setbacks and dismantlement in food and nutritional security may undermine the Federal Government's capacity to respond to COVID-19.
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Cadernos de saúde pública · Jan 2020
Meta AnalysisCOVID-19 infection in pregnant women, preterm delivery, birth weight, and vertical transmission: a systematic review and meta-analysis.
In less than four months, the total of confirmed cases of COVID-19 was 1,684,833 worldwide. Outcomes among the public of pregnant women with COVID-19 are still unclear. We performed a systematic review and meta-analysis to analyze whether COVID-19 in pregnant women is related to premature birth and birth weight, and to summarize the diagnostic results of neonates born to mothers with COVID-19 for investigating the possibility of vertical transmission. ⋯ Due to the characteristics of the studies, the level of evidence of this meta-analysis was considered very low. COVID-19 in pregnant women may not be associated with the occurrence of preterm deliveries or the birth weight of the newborn children, however the evidence to date is very uncertain. A few reports suggest vertical transmission of SARS-CoV-2 to newborn is possible, but evidence is still uncertain.
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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 · Feb 2018
Review Historical Article[History of Brazil's tobacco control policy from 1986 to 2016].
This study analyzes Brazil's tobacco control policy from 1986 to 2016, seeking to describe the policy's history and discuss its achievements, limits, and challenges. The study adopted a political economics approach and contributions from public policy analysis. Data were based on a search of the literature, documents, and secondary sources and semi-structured interviews with stakeholders involved in the policy. ⋯ Implementation of the World Health Organization Framework Convention on Tobacco Control in Brazil, beginning in 2006, contributed to the expansion and consolidation of the national policy. However, tobacco-related economic interests limited the implementation of some strategic measures. The challenges feature the medium- and long-term sustainability of tobacco control and the solution to barriers involving crop diversification on current tobacco-growing areas, the fight against the illegal cigarette trade, and interference in the policy by the tobacco industry.
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Cadernos de saúde pública · May 2017
ReviewThe strangest of all encounters: racial and ethnic discrimination in US health care.
In 2003, a Committee of the Institute of Medicine of the National Academy of Sciences summarized hundreds of studies documenting that US racial minorities, especially African Americans, receive poorer quality health care for a wide variety of conditions than their White counterparts. These racial differences in health care persist after controlling for sociodemographic factors and patients' ability to pay for care. The Committee concluded that physicians' unconscious negative stereotypes of African Americans, and perhaps other people of color, likely contribute to these health care disparities. ⋯ In addition to assessing physicians' unconscious attitudes toward patients, some studies focused on the behavioral and affective dimensions of doctor-patient communication, such as physicians' "verbal dominance" and whether patients felt respected. Studies reviewed found a "pro-white" unconscious bias in physicians' attitudes toward and interactions with patients, though some evidence suggests that Black and female physicians may be less prone to such bias. Limited social contact between White physicians and racial/ethnic minorities outside of medical settings, plus severe time pressures physicians often face during encounters with patients who have complex health problems could heighten their susceptibility to unconscious bias.