Salud Colectiva最新文献

The aim was to explore the scope and limitations of teleconsultation during the pandemic from the perspective of primary care physicians at the Hospital Italiano de Buenos Aires, a private institution located in the Autonomous City of Buenos Aires. A qualitative study was conducted with ten individual semi-structured interviews between January and April 2022. The three major emerging topics were the transition to virtuality, accessibility, and the new care model. Obstacles were related to the massive, forced, and unplanned implementation of teleconsultations. The main benefits included providing care during isolation-distancing and addressing epidemiological doubts. Changes were highlighted in care strategies, consultation frameworks, exchange among colleagues, referral criteria, requests for complementary studies, and in the profiles of those seeking consultations. A misuse of the system by individuals and a trivialization of the consultation moment emerged. The rise of communication and information technologies undoubtedly allowed the continuity of healthcare processes, but it does not replace in-person care, and normative guidelines are needed for its continuity.

This essay, situated in the field of bioethics, examines the prohibition of psychedelic use, exploring arguments surrounding the growing evidence of their therapeutic potential and their millennia-long history of cultural and spiritual uses. It initially discusses the historical context of psychedelics and the various terms used to describe them. The essay problematizes the definition of "drugs," highlighting the lack of objective criteria for distinguishing between legal and illicit substances. Drawing on concepts and theoretical frameworks of critical bioethics, it analyzes how the prohibitionist moral discourse is sustained more by political and economic interests than by scientific justifications, leading to stigmatization and vulnerability. The essay advocates for the end of the prohibition of psychedelics based on ethical arguments, emphasizing their importance in reducing individual and collective suffering. The work contributes to a deeper reflection on this socially controversial topic, integrating interdisciplinary knowledge.

Based on the spatial aspect of human beings and the social production of spaces and places, and considering that the social and health crisis associated with COVID-19 led to changes in spaces as well as restrictions and greater regulations regarding their use and social interactions, this article develops a theoretical discussion on the relationship between people and public space in the context of Colombia. This reflection is developed around four themes: the transformations of public spatiality as materiality; the normative uses of public space as a way of surveillance and control of society; the lessening of the world to proximal spatial scales and the consequent transformations in the relationalities with and in public spaces; and the contradictions and inequities of public space, expressed in the unequal distribution of spatial forms of living the pandemic. These aspects lead us to consider the relevance of highlighting the experiential sense of public spaces, from the analysis of new relationalities and social networks that take place there.

Women with disabilities face increased precarity throughout their lives, with one of the most affected areas being their sexual and reproductive health. The aim of this study was to identify and analyze the scientific literature on obstetric violence against women with disabilities. The search was conducted from August to October 2022 in five databases: PubMed, Web of Science, Dialnet, SciELO, and Scopus. A total of 194 articles were retrieved, and after applying selection criteria, ten articles were analyzed. Through thematic analysis, the dimension "ableist obstetric violence towards women with disabilities" emerged. Findings suggest that women with disabilities are marginalized during obstetric care, resulting in untimely attention and cascading interventions. At present, there is scarce literature addressing this phenomenon from a rights-based perspective. Urgent measures are needed to train healthcare teams on the provision of care to people with disabilities. Additionally, it is crucial to critically examine the relationship between healthcare personnel and institutions to women with disabilities within the framework of their sexual and reproductive rights.

This article presents an approach to the phenomenon of migratory mourning of migrant mothers in Chile. Between 2021 and 2022, a qualitative exploratory study based on symbolic interactionism was carried out, in which semi-structured interviews were conducted with 39 migrant mothers of Venezuelan (18), Peruvian (11) and Haitian (9) origin. Based on a theoretically-informed thematic analysis, three analytical categories emerged: 1) the loss of social ties and distance to their place of origin; 2) expectations versus reality; and 3) the validation of overexertion. Migrant mothers express migratory mourning with varying levels of nuance depending on their country of origin, and to a greater or lesser degree signify their experiences in terms of uprooting and the absence of support networks, which they identify as the main cause of the sadness they experience on a daily basis. This sadness increases when they negotiate their ideals regarding the upbringing of their sons and daughters in favor of material subsistence in order to achieve the goals of a better life, and for which they justify overexertion as a strategy for improvement. These pressures bring with them psychological and physical consequences and interfere with their processes of migratory mourning, compromising their mental health and that of their children.

The following text presents the results of a integrative review whose purpose was to identify and analyze the production of academic literature on mad activism in the field of mental health and its link with the notions of disability and neurodiversity. From searches conducted in May 2023 in the Web of Science, Scopus, and PubMed databases, 52 articles were selected, and thematic content analysis strategies were applied. The results account for various articulations between the concepts addressed, establishing a critical look at the biomedical model in mental health. In the forms of mad activism, the human rights approach, the fight against stigma and its influence on the reform processes of the mental health system become relevant. On the other hand, a framework of social justice, identity policies and practices of mutual support from the community are established. As a whole, they emphasize methodological innovations and an intersectional perspective on the production of knowledge. It is concluded that it is possible to situate madness as a field of constitution of a political actor and epistemic subject. Based on this, possible lines of research on mad activisms in Latin America are formulated.

In Argentina, in January 2021 the bill for the Voluntary Interruption of Pregnancy (Ley 27.2610) was approved, enabling voluntary abortion until week 14 and unreservedly in cases of rape or pregnancy-induced health risks. From a feminist approach to collective health, this bill poses enormous challenges regarding the implementation of sexual and reproductive rights policies within the healthcare system. This article addresses the processes of  political strategizing, healthcare organization and technical-administrative action regarding the policy in force. The aim is to explore the obstacles, differences and inequalities impacting the access to sexual health, and to examine the articulations of healthcare officials/personnel and sexual rights activists, in order to understand the relations between state intervention and practices/experiences. The methodological strategy is qualitative. The main techniques for data collection are documentary and policy instruments analyses.

Interruption of tuberculosis treatment constitutes one of the obstacles to disease control. The standards established in health policies, at times, prove to be inflexible, tending to obscure the difficulties experienced by individuals in treatment. The aim of this article is to analyze the practices of continuous health education developed by family health teams at healthcare units in Maré, Rio de Janeiro, Brazil, in cases of tuberculosis treatment interruption. An exploratory qualitative study was conducted with twelve healthcare professionals from the team between August and November 2021. The findings from this research regard continuous health education as a strategy to enhance care processes, fostered through the lived experiences of the healthcare workers, enabling the creation of knowledge and exchanges that expand the effective treatment of tuberculosis with creativity and flexibility in the dynamics of interactions with users. This care takes place in the live work in action, whether in the hallways of healthcare units or within the community, as it occurs in real-time practice.

In the definition of health policies and decision-making on the part of health officials, there is often a prevailing separation between clinical practice, epidemiology, and public health. Although this division is naturalized from the viewpoint of hospitals and public agencies, it is artificial in the context of concrete territories and communities, where problems are not structured according to the fragmentation of knowledge, but rather express the complexities of the problems faced by individuals and population groups. In this context, this article compiles and analyzes studies on the ecology of medical care carried out between 1928 and 2018 that have revisited the pioneering study "The ecology of medical care" by White, Williams and Greenberg. The discussion is structured around three central issues: 1) recurrent themes in studies on the ecology of medical care; 2) health information systems and health surveys; and 3) the institutional hegemony of hospitals in the health field.