Ciencia & saude coletiva最新文献

The implementation of the Transsexualizing Process (TP) / Gender-affirming Surgeries (GAS) in the Unified Health System (SUS) was the result of social struggles by the LGBT community for sexual rights, the construction of gender identity, and bodily autonomy. The scope of this article is to analyze the advances and challenges of TP/GAS in the SUS, through a qualitative narrative literature review. In June 2022, searches were conducted in the Google Scholar, SciELO, and VHL databases to select scientific articles in Portuguese published in the last 10 years, excluding articles in foreign languages and other types of academic work such as reviews, undergraduate theses, dissertations, and/or graduate theses. Eighteen articles were selected that showed the expansion of healthcare services for transsexuals with GAS in the SUS. However, weaknesses were identified, such as unprepared healthcare professionals, social stigmas, clinical diagnosis as a driver of pathologization, and low hospital coverage. The regulation and availability of GAS in the SUS have brought gains to the trans population, but it is necessary to expand access to services and mitigate stigmatizing conduct to ensure that these individuals feel accepted in their entire biopsychosocial context.

The scope of this study was to assess the ototoxic effects and general health of farmers exposed to pesticides in the Pontal do Paranapanema region, SP, Brazil. Participants of both sexes aged 18-40, 40-60 and >60 years were allocated into two groups: Non-Exposed Group (NEG) and Occupationally Exposed Group (OEG). A questionnaire of exposure and health, meatoscopy, pure tone audiometry, logoaudiometry and immittanciometry were assessed. Cypermethrin, chlorpyrifos and glyphosate were the most reported pesticides. The most frequently reported exposure times were 0-10, 31-40 and 51-60 years. Headaches, visual and spinal disorders were the most common complaints, as well as hypertension and gastric and renal disorders. Only 35% (18-40) and 30% (40-60) of the OEG had good hearing perception. Rotational dizziness, ear infection, tinnitus and otalgia were reported. There was an increase in conventional and high frequency hearing thresholds in EWGs, at almost all frequencies and ages, as well as an alteration in the stapedial reflex. It was concluded that occupational exposure to pesticides has ototoxic potential and can harm general health.

Prophylaxis based on antiretrovirals, such as pre-exposure prophylaxis to HIV (PrEP), has the potential to protect the populations most vulnerable to infection, which renews optimism for controlling the HIV epidemic. Against this backdrop, the aim of this article is to analyze the perceptions, negotiations and tensions surrounding the use of PrEP by men who have sex with men (MSM). This is a qualitative cross-section of a multicenter study, analyzing semi-structured interviews with 18 users of specialized HIV/AIDS healthcare facilities in the city of São Paulo/SP. The findings show that negotiating the use of PrEP among MSM involves looking for partners in which different sexual scenarios and the use of alcohol or drugs take place. Users gave PrEP the sense of facilitating the negotiation about the (non-)use of condoms and the (re)definition of care and prevention in different sexual-affective partnerships. The research broadens the debate on subjective aspects involving HIV prevention among MSM, especially with respect to its management in situations of negotiation involving other prevention strategies.

This study aimed to characterize pharmaceutical services (PS) in the prison system of Rio Grande do Sul in terms of organization and infrastructure in the context of primary health care. This is a descriptive study, with a cross-sectional design carried out between August and September 2022. Data collection was carried out remotely, using a questionnaire prepared and adapted based on the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM - Brazilian National Survey on Access, Use and Promotion of Rational Use of Medications in Brazil). A total of 51 prison units participated in the survey. There is no specific area for the pharmacy in most prison units, with only one place for storing medications. There are no standard operating procedures for PS activities in 78.4% of prison units. In 9.8% of prison units, the presence of a pharmacist was mentioned. No medication storage conditions are monitored in 31.4% of sites. Medication fractionation was reported by 78.4% of prison units. Medications are dispensed in 3.9% of prison units. The PS overview in the prison context reveals important weaknesses and the need to adapt to current regulations.

We investigated if Brazilian Olympic athletes live longer than the general population, and if there are differences between the types of sport. This is a retrospective cohort study with secondary data analysis. Data from Brazilian athletes of both sexes were included, from the 7th edition (1920) to the 25th edition (1992) of the Modern Olympic Games. Details of sex, date of birth, date of death, and sport competed were recorded when available. Comparisons were made between athletes vs. age-matched controls from the general population; and between sport types (strength/power [SP] vs. endurance/mixed [EM]). Brazilian Olympic athletes live approx. 8 years longer than expected for the age matched general population. However, there were no differences in lifespan between SP (68.8 years) vs. EM (68.9 years) athletes (p>0.05). Brazilian Olympic athletes live longer than expected for the general population. However, there are no differences between athletes from different sport types.

The aim is to identify the epidemiological profile of mortality among Brazilian indigenous children under five years of age, through an integrative review. Articles that evaluated the mortality of indigenous Brazilian children under one and/or five years of age, from 2000 to 2020, in Portuguese, English, and/or Spanish, in the LILACS, SciELO, and MEDLINE databases were included. Of the 3,229 publications found, 22 were included in the review. Infant mortality ranged from 15.2/1,000 live births (LB) (1995-1999) for the Kayabí ethnic group to 307.7/1,000 LB (2000) for the Hupdäh ethnic group. Among the studies that evaluated infant mortality by age components, the post-neonatal period stands out, with proportions that varied from 15.2% (1990-1994), for indigenous children from Paraná, to 83.3% (2007- 2008) for the Guarani ethnic group. The main cause of mortality was respiratory diseases, ranging from 17.1% (2010) to 75% (2007-2008) among the Guarani ethnic group. Brazilian indigenous children under one year of age experienced high mortality rates, when compared to non-indigenous children, for all ethnicities and regions of the country. Among the IMT components, a high number of deaths were observed in the post-neonatal period, with respiratory system diseases representing the main causes of death.

This article aims to identify the relationship between material deprivation and mortality from breast, cervical, and prostate neoplasms in the Brazilian adult population and the relationship between ethnicity/skin color and material deprivation. This cross-sectional ecological study calculated the mean mortality rate per 100,000 inhabitants, and deaths were standardized by age and gender and redistributed per to ill-defined causes, stratified by age group and ethnicity/skin color. We applied the Negative Binomial model, containing the interaction between ethnicity/skin color and the Brazilian Deprivation Index (IBP). We analyzed 85,903 deaths, and the most prevalent were those due to female breast neoplasms. The risk of death from cervical cancer was 8.5% higher for Black women than white women. In other places, mortality was higher among white people. For all causes, mortality increased with age. There was a significant interaction between ethnicity/skin color and IBP for all causes. Only deaths due to cervical neoplasms increased with higher IBP, while a decline was observed in other causes but was less significant among Black people. The IBP offers a multidimensional view of the socioeconomic conditions of the Brazilian population, allowing a better understanding of how social determinants operate on selected neoplasms.

Nuclear Medicine plays an important role in the management of patients with chronic diseases, especially oncological and cardiovascular conditions. In this study, an analysis of the evolution of this field in Brazil was conducted within the framework of the Unified Health System. Retrospective analyses from 2015 to 2021 of public data were performed. Although Brazil has a considerable number of facilities, their geographical distribution is uneven. The same disparity is observed in relation to units that produce and distribute radiopharmaceuticals, limiting access for the Brazilian population, particularly to those with a half-life of less than two hours. There is a noticeable high technological dependence on foreign companies, with little or no domestic production, contributing to a deficit in the trade balance. Despite the increasing demands due to factors such as population aging and epidemiological changes, the area did not expand. It is crucial to implement social and economic policies to reduce vulnerabilities in the public healthcare system, ensure its sustainability, and promote equal and universal access to Nuclear Medicine.

Progressive declines in vaccination coverage have been recorded in Brazil in recent years. The COVID-19 pandemic has introduced even more challenges to this scenario. Considering the pandemic as an event, the scope of this article was to analyze the politicization of vaccines from the perspective of caregivers of young children. This qualitative research was conducted in two Brazilian state capitals, namely São Luís (Maranhão) and Florianópolis (Santa Catarina). The study included families with children up to 6 years of age who were fully or partially vaccinated, as well as children who had never been vaccinated. Snowball sampling was used and in-depth interviews were conducted between March 2021 and April 2022. Forty-eight caregivers, most of them mothers, were interviewed. The study revealed that, regardless of their previous stance regarding vaccines, the health-political event of the COVID-19 pandemic shook beliefs and attitudes about childhood vaccination. The results also showed that the pandemic led to delays in routine childhood immunization and caused caregivers to seek private health services. Finally, the results reveal the politicization of vaccines as a new phenomenon to be addressed in the Brazilian context.

Several international agreements acknowledge public participation, equity, and democracy as necessary conditions to achieve Health Promotion. For this purpose, if we accept the validity of distinct systems of knowledge, we realize the relevance of an approach to healthcare based on a pluralist epistemology, which sustains the legitimacy of traditional knowledge in its own processes of production, transmission, and application. In this study, we aim to investigate the notions and understandings of traditional healing practices in a city near Curitiba, in Southern Brazil. A qualitative sociological approach was adopted, incorporating semi-structured interviews, participant observation, and Discourse Analysis of female practitioners. In addition, we want to understand the social function of these practices in contrast with biomedicine-based operations of Health Care Networks in the Brazilian Unified Health System (SUS). We observed that the role of women is central in these practices, who are responsible for their application and transmission. And the knowledge developed through these healing practices engenders a particular view about family and society. Therefore, these women are empowered by increasing their symbolic capital through their knowledge of health care.