Pub Date : 2023-12-04DOI: 10.1590/0102-311XEN111223
Antonio Francisco Perrone Oviedo, Estevão Benfica Senra
{"title":"Changing the degradation footprint of mining on Indigenous Lands","authors":"Antonio Francisco Perrone Oviedo, Estevão Benfica Senra","doi":"10.1590/0102-311XEN111223","DOIUrl":"https://doi.org/10.1590/0102-311XEN111223","url":null,"abstract":"","PeriodicalId":122102,"journal":{"name":"Cadernos de Saúde Pública","volume":"23 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138604323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-09DOI: 10.1590/0102-311x00145719
Anete Trajman
{"title":"Doenças raras: quem paga qual conta?","authors":"Anete Trajman","doi":"10.1590/0102-311x00145719","DOIUrl":"https://doi.org/10.1590/0102-311x00145719","url":null,"abstract":"","PeriodicalId":122102,"journal":{"name":"Cadernos de Saúde Pública","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122114049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-11-29DOI: 10.1590/0102-311x00152118
Serafim Barbosa Santos Filho
{"title":"Alienação no trabalho médico no enfoque da humanização-desumanização","authors":"Serafim Barbosa Santos Filho","doi":"10.1590/0102-311x00152118","DOIUrl":"https://doi.org/10.1590/0102-311x00152118","url":null,"abstract":"","PeriodicalId":122102,"journal":{"name":"Cadernos de Saúde Pública","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126047205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1590/0102-311xen052523
C. Freitas
{"title":"Disasters and icebergs: we must go beyond","authors":"C. Freitas","doi":"10.1590/0102-311xen052523","DOIUrl":"https://doi.org/10.1590/0102-311xen052523","url":null,"abstract":"","PeriodicalId":122102,"journal":{"name":"Cadernos de Saúde Pública","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115639798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1590/0102-311xen224720
E. Levcovitz
{"title":"Contributions from research on the Health Economic-Industrial Complex to the teaching project in Public Health","authors":"E. Levcovitz","doi":"10.1590/0102-311xen224720","DOIUrl":"https://doi.org/10.1590/0102-311xen224720","url":null,"abstract":"","PeriodicalId":122102,"journal":{"name":"Cadernos de Saúde Pública","volume":"101 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123162494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1590/0102-311xen130022
Edison Iglesias de Oliveira Vidal, M. Kovács, J. Silva, L. Silva, Daniele Pompei Sacardo, A. Bersani, Ana Beatriz Galhardi Di Tommaso, Laiane de Moraes Dias, Antônio Carlos Moura de Albuquerque Melo, S. Iglesias, F. G. Lopes
Health care for patients with serious illnesses usually implies the need to make a large number of decisions, ranging from how information is shared to which diagnostic or therapeutic procedures will be adopted. The method of such decision-making has important implications from an individual and collective point of view and may contribute to either relieving or aggravating suffering. In this consensus document, the Bioethics Committee of the Brazilian National Academy of Palliative Care (ANCP) and the Permanent Committee on Palliative Care of the Brazilian Geriatrics and Gerontology Society (SBGG) adopt the principles of compassionate listening proposed by Saunders, of the nature of suffering proposed by Cassel, of dignity-preserving care proposed by Chochinov, and of cultural humility as a starting point for the construction of an official position of ANCP and SBGG on shared decision-making in palliative care. The position statement posits that, unlike paternalistic and consumerist models, the decision-making process in the sphere of palliative care must follow the mutualistic model of shared decision, where decisions are built based on dialogue between healthcare professionals and patients/family. The document sets forth the assumptions of this process, the limits of autonomy of patients/family and healthcare professionals and the distinction between futile and potentially inappropriate treatments, besides ratifying its incompatibility with any forms of coercion and conflict of interest foreign to the best interests of patients.
{"title":"Position statement of ANCP and SBGG on shared decision-making in palliative care","authors":"Edison Iglesias de Oliveira Vidal, M. Kovács, J. Silva, L. Silva, Daniele Pompei Sacardo, A. Bersani, Ana Beatriz Galhardi Di Tommaso, Laiane de Moraes Dias, Antônio Carlos Moura de Albuquerque Melo, S. Iglesias, F. G. Lopes","doi":"10.1590/0102-311xen130022","DOIUrl":"https://doi.org/10.1590/0102-311xen130022","url":null,"abstract":"Health care for patients with serious illnesses usually implies the need to make a large number of decisions, ranging from how information is shared to which diagnostic or therapeutic procedures will be adopted. The method of such decision-making has important implications from an individual and collective point of view and may contribute to either relieving or aggravating suffering. In this consensus document, the Bioethics Committee of the Brazilian National Academy of Palliative Care (ANCP) and the Permanent Committee on Palliative Care of the Brazilian Geriatrics and Gerontology Society (SBGG) adopt the principles of compassionate listening proposed by Saunders, of the nature of suffering proposed by Cassel, of dignity-preserving care proposed by Chochinov, and of cultural humility as a starting point for the construction of an official position of ANCP and SBGG on shared decision-making in palliative care. The position statement posits that, unlike paternalistic and consumerist models, the decision-making process in the sphere of palliative care must follow the mutualistic model of shared decision, where decisions are built based on dialogue between healthcare professionals and patients/family. The document sets forth the assumptions of this process, the limits of autonomy of patients/family and healthcare professionals and the distinction between futile and potentially inappropriate treatments, besides ratifying its incompatibility with any forms of coercion and conflict of interest foreign to the best interests of patients.","PeriodicalId":122102,"journal":{"name":"Cadernos de Saúde Pública","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128972704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1590/0102-311xen130522
Leandro Dias de Oliveira
{"title":"50 years of the United Nations Environmental Conferences: what is the legacy on human health conditions?","authors":"Leandro Dias de Oliveira","doi":"10.1590/0102-311xen130522","DOIUrl":"https://doi.org/10.1590/0102-311xen130522","url":null,"abstract":"","PeriodicalId":122102,"journal":{"name":"Cadernos de Saúde Pública","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123675352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1590/0102-311xen022421
Dândara Santos Silva, Mônica Conceição Pinto, M. A. Figueiredo
This study aimed to analyze factors associated with delay in specialized treatment after diagnosis of cervical cancer in the State of Bahia, Brazil. This was a cross-sectional hospital-based study of women treated in accredited units in the Hospital-Based Cancer Registry (HBCR) system in the State of Bahia from 2008 to 2017. A descriptive analysis and logistic regression were performed with backward stepwise modeling to estimate crude and adjusted prevalence ratios (PR), defining statistical significance as p ≤ 0.05 in Pearson’s chi-square test. We analyzed 9,184 cases, and 65% had delayed treatment (time between diagnosis and first treatment > 60 days). Delayed treatment was more prevalent among women 65 years or older (PR = 1.30; 95%CI: 1.21-1.39), with no schooling (PR = 1.24; 95%CI: 1.15-1.33), and in advanced stages (PR = 1.17; 95%CI: 1.13-1.21). Most of the cases analyzed had delayed treatment, more prevalent among older women, with less schooling, and advanced tumor stages, highlighting the need to expand access to cancer treatment services in Bahia state, especially for these groups in worse conditions.
{"title":"Factors associated with delay in specialized treatment after diagnosis of cervical cancer in Bahia State, Brazil","authors":"Dândara Santos Silva, Mônica Conceição Pinto, M. A. Figueiredo","doi":"10.1590/0102-311xen022421","DOIUrl":"https://doi.org/10.1590/0102-311xen022421","url":null,"abstract":"This study aimed to analyze factors associated with delay in specialized treatment after diagnosis of cervical cancer in the State of Bahia, Brazil. This was a cross-sectional hospital-based study of women treated in accredited units in the Hospital-Based Cancer Registry (HBCR) system in the State of Bahia from 2008 to 2017. A descriptive analysis and logistic regression were performed with backward stepwise modeling to estimate crude and adjusted prevalence ratios (PR), defining statistical significance as p ≤ 0.05 in Pearson’s chi-square test. We analyzed 9,184 cases, and 65% had delayed treatment (time between diagnosis and first treatment > 60 days). Delayed treatment was more prevalent among women 65 years or older (PR = 1.30; 95%CI: 1.21-1.39), with no schooling (PR = 1.24; 95%CI: 1.15-1.33), and in advanced stages (PR = 1.17; 95%CI: 1.13-1.21). Most of the cases analyzed had delayed treatment, more prevalent among older women, with less schooling, and advanced tumor stages, highlighting the need to expand access to cancer treatment services in Bahia state, especially for these groups in worse conditions.","PeriodicalId":122102,"journal":{"name":"Cadernos de Saúde Pública","volume":"283 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131890727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1590/0102-311xen073621
Barbara Almeida Soares Dias, M. Leal, A. P. Esteves-Pereira, M. Nakamura‐Pereira
This study aimed to describe cesarean and repeated cesarean section rates in Brazil according to gestational age (GA) at birth and type of hospital. This is an ecologic study using data from the Brazilian Information System on Live Births and the 2017 National Registry of Health Facilities. Overall and repeated cesarean section rates were calculated and analyzed according to GA, region of residence, and type of hospital. Spearman correlations were performed between cesarean and repeated cesarean section rates by GA subgroups at birth (≤ 33, 34-36, 37-38, 39-41, and ≥ 42 weeks) and analyzed according to the type of hospital. Overall and repeated cesarean section rates were 55.1% and 85.3%, respectively. More than 60% of newborns between 37-38 weeks were delivered via cesarean section. Private hospitals in all regions showed the highest cesarean section rates, especially those in the Central-West Region, with more than 80% at all GAs. The overall cesarean section rate was highly correlated with all cesarean section rates of GA subgroups (r > 0.7, p < 0.01). Regarding repeated cesarean sections, the overall rate was strongly correlated with the rates of 37-38 and 39-41 weeks in public/mixed hospitals, differing from private hospitals, which showed moderate correlations. This finding indicates the decision for cesarean section is not based on clinical factors, which can cause unnecessary damage to the health of both the mother and the baby. Then, changes in the delivery care model, strengthening public policies, and encouragement of vaginal delivery after a cesarean section in subsequent pregnancies are important strategies to reduce cesarean section rates in Brazil.
本研究的目的是描述剖宫产和重复剖宫产率在巴西根据胎龄(GA)出生和医院类型。这是一项生态学研究，使用了巴西活产信息系统和2017年国家卫生设施登记处的数据。根据出生年龄、居住地区和医院类型计算和分析总剖宫产率和重复剖宫产率。按GA亚组(≤33周、34-36周、37-38周、39-41周和≥42周)剖宫产率与重复剖宫产率进行Spearman相关性分析，并按医院类型进行分析。总剖宫产率为55.1%，重复剖宫产率为85.3%。超过60%的37-38周的新生儿是通过剖宫产分娩的。所有地区的私立医院剖宫产率最高，尤其是中西部地区，所有地区的剖宫产率均超过80%。总剖宫产率与GA各亚组剖宫产率高度相关(r > 0.7, p < 0.01)。在重复剖宫产方面，公立/混合医院的总体剖宫产率与37-38周和39-41周的剖宫产率呈强相关，而私立医院为中等相关。这一发现表明，决定剖宫产不是基于临床因素，这可能对母亲和婴儿的健康造成不必要的损害。因此，改变分娩护理模式、加强公共政策以及鼓励在随后的妊娠中剖宫产后阴道分娩是降低巴西剖宫产率的重要策略。
{"title":"Variations in cesarean and repeated cesarean section rates in Brazil according to gestational age at birth and type of hospital","authors":"Barbara Almeida Soares Dias, M. Leal, A. P. Esteves-Pereira, M. Nakamura‐Pereira","doi":"10.1590/0102-311xen073621","DOIUrl":"https://doi.org/10.1590/0102-311xen073621","url":null,"abstract":"This study aimed to describe cesarean and repeated cesarean section rates in Brazil according to gestational age (GA) at birth and type of hospital. This is an ecologic study using data from the Brazilian Information System on Live Births and the 2017 National Registry of Health Facilities. Overall and repeated cesarean section rates were calculated and analyzed according to GA, region of residence, and type of hospital. Spearman correlations were performed between cesarean and repeated cesarean section rates by GA subgroups at birth (≤ 33, 34-36, 37-38, 39-41, and ≥ 42 weeks) and analyzed according to the type of hospital. Overall and repeated cesarean section rates were 55.1% and 85.3%, respectively. More than 60% of newborns between 37-38 weeks were delivered via cesarean section. Private hospitals in all regions showed the highest cesarean section rates, especially those in the Central-West Region, with more than 80% at all GAs. The overall cesarean section rate was highly correlated with all cesarean section rates of GA subgroups (r > 0.7, p < 0.01). Regarding repeated cesarean sections, the overall rate was strongly correlated with the rates of 37-38 and 39-41 weeks in public/mixed hospitals, differing from private hospitals, which showed moderate correlations. This finding indicates the decision for cesarean section is not based on clinical factors, which can cause unnecessary damage to the health of both the mother and the baby. Then, changes in the delivery care model, strengthening public policies, and encouragement of vaginal delivery after a cesarean section in subsequent pregnancies are important strategies to reduce cesarean section rates in Brazil.","PeriodicalId":122102,"journal":{"name":"Cadernos de Saúde Pública","volume":"211 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121028439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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