The present study aimed to evaluate the effect of satisfaction with social support (SSS), food literacy (FL), and empowerment (E) concerning the consumption of ultra-processed foods (UPFs) among adults and elderly individuals with diabetes mellitus (DM). This is a subset of a larger cross-sectional study conducted between 2016 and 2018. Two out of 73 clusters were randomly selected. Socioeconomic conditions were assessed, and the scales used to evaluate SSS, FL, and E have been previously validated in Brazil. UPF consumption was estimated using a semi-structured food frequency questionnaire. A hypothetical theoretical model was developed. The SPSS and JASP programs were used for data analysis. Structural Equation Modeling estimated the effects of the latent variables SSS, FL, and E on UPF consumption. Bartlett's test, the Kaiser-Meyer-Olkin (KMO) measure, and the following fit indices were calculated: chi-square (X²), chi-square per degrees of freedom ratio (X²/df), Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), Goodness-of-Fit Index (GFI), and Root-Mean-Square Error of Approximation (RMSEA). The average age was 62.25 ± 12.11 years, with the majority being women (68.10%). The fit indices indicated that the hypothetical model is plausible. Thus, SSS does have an effect on UPF consumption mediated by FL and E.
Resumo Objetivou-se avaliar o efeito da satisfação com o suporte social (SSS), do letramento alimentar (LA) e do empoderamento (E) sobre o consumo de alimentos ultraprocessados (AUPs) em adultos e idosos com diabetes melittus (DM). Trata-se de um recorte de um estudo transversal maior conduzido entre 2016 e 2018. Dos 73 conglomerados, dois foram sorteados. Foram avaliadas condições socioeconômicas e as escalas utilizadas para avaliação da SSS, do LA e do E foram previamente validadas no Brasil. O consumo de AUPs foi estimado por meio de questionário de frequência alimentar semiestruturado. Foi elaborado um modelo teórico hipotético. Os programas SPSS e JASP foram utilizados. A modelagem de equações estruturais estimou os efeitos das variáveis latentes SSS, LA e E sobre o consumo de AUPs. Foram calculados o teste de Bartlett, a medida de Kaiser-Meyer-Olkin (KMO) e os seguintes índices de ajuste: qui-quadrado (χ²), razão entre o qui-quadrado e os graus de liberdade (χ²/gl), Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), Goodness-of-Fit Index (GFI) e Root Mean Square Error of Approximation (RMSEA). A média de idade foi de 62,25 ± 12,11 anos, sendo a maioria mulher (68,10%). Os índices de ajustes provaram que o modelo hipotético é plausível. Assim, a SSS apresenta efeito no consumo de AUP mediado pelo LA e pelo E.
In this manuscript, I reflect, through an essay, on the existence of transgender children, starting from questioning the truth of narratives about oneself and the epistemic authority of the child to testify about their own gender identification. The proposed discussion aims to provide resources for reflection on the type of care these children need and how Public Health can be involved in this care.
The official calendar of a health emergency has a direct impact on affected populations, particularly at the times of beginning, peak, end, and after the end. According to the World Health Organization, the zika virus epidemic was a public health emergency between February and November 2016. The disease is now classified as an endemic arbovirus in several countries in the Global South. In this article, we analyze the chronology of the epidemic for three women affected by zika in Alagoas, Brazil, who became pregnant at the beginning of the health emergency and whose children died between two and four years after the end of the epidemic. Our focus on the lived experience of these three women complexifies the linear dramaturgy of time in health emergencies. We aim to demonstrate how the health emergency calendar is an artifact that shapes political subjectivities, but also how it simplifies the lived experience of affected women, particularly in the times after the end.
Resumo A melhoria da atenção à saúde de mulheres e crianças permanece prioridade nas políticas públicas brasileiras, com ações do Ministério da Saúde voltadas ao fortalecimento da gestão e do planejamento para reduzir a mortalidade materna e neonatal. Este artigo analisa a pertinência e adequação da intervenção junto a 20 secretarias estaduais de saúde. Trata-se de uma pesquisa avaliativa com análise estratégica da coerência entre os objetivos da intervenção e os problemas enfrentados, incluindo: (1) descrição da intervenção e modelo lógico; (2) validação do modelo; (3) análise da pertinência da intervenção; (4) avaliação por técnicos e gestores das secretarias. A intervenção foi bem avaliada, em acordo de que fortalecer o planejamento e a gestão é essencial para reduzir a mortalidade materna e neonatal. A análise das respostas de técnicos e gestores (n=143), indicou avaliação favorável quanto à contribuição da intervenção nos territórios, à pertinência dos temas trabalhados, à utilidade dos materiais e ao perfil dos consultores, incluindo sua capacidade de adaptar as diretrizes do SUS às realidades locais. O estudo contribui para aprimorar futuras intervenções nacionais voltadas à saúde de mulheres e crianças.
This research analyzed the effects of the care process on caregivers during long-term hospitalizations in a pediatric unit of an university hospital in Rio de Janeiro, Brazil. Thematic oral history interviews were used, supported by the theoretical concept of life narratives. The results were evaluated university using a hermeneutic-dialectical approach, synthesized into the following analytical categories: Child and Adolescent Illness and Changes in the Life Dynamics of Caregivers and Family; Impacts of Prolonged Hospitalizations on Family Income; The Relational Dimension of Care; Leisure and Self-Care for Living and Caring. The theoretical-analytical categories were multiple family arrangements; racial and sexual division of labor; decolonial feminism; care as a social right; and health care from a broader perspective. Women are the primary caregivers of patients with prolonged hospital stays in pediatrics, and they often abandon their own plans to live for the sake of their dependents. They seek survival strategies and institutional responses. The current National Care Policy (Brazil, 2024), along with other policies and interlinked with the struggle for a more just society, can be considered a way to seek recognition of the dignity of these caregivers.
Resumo Este artigo analisa as estratégias dos coletivos de ativismo digital brasileiros para o enfrentamento aos feminicídios e outras violências de gênero. Partindo de uma abordagem teórico-metodológica que articula Análise de Discurso Crítica, “política da vida cotidiana” e a ação conectiva, o estudo analisou as postagens com maior número de engajamentos de seis coletivos no Instagram. Os resultados identificam estratégias algorítmicas de engajamento, forças discursivas de denúncia, acolhimento, informação e preservação da memória, articuladas a uma estética visual e corporalidades plurais. Conclui-se que esses coletivos convertem vulnerabilidades em resistência coletiva e desenvolvem ação política voltada para justiça de gênero, embora enfrentem desafios como a efemeridade da atenção online e a mediação algorítmica. A articulação dessas experiências com o campo da saúde ainda precisa ser construída para benefício mútuo da atuação.
Resumo Este artigo investiga as condições de saúde e as redes de apoio social das familiares idosas de Policiais Militares do Estado do Rio de Janeiro. É uma pesquisa qualitativa, do tipo exploratório, em que foram realizadas nove entrevistas semiestruturadas, com mulheres idosas de 60 anos ou mais, familiares (quatro mães) e dependentes (três viúvas e duas esposas) de policiais militares da ativa, veteranos ou falecidos, sendo sete praças e quatro oficiais. Os dados foram submetidos à análise de conteúdo, modalidade temática. Os resultados mostram que as idosas pertencem ao estrato socioeconômico médio baixo. Sofrem impactos na saúde física e mental: pela perda precoce decorrente de homicídio (duas), outras causas (duas) do policial e por mudanças (duas) do local de moradia devido à violência (ameaças e risco de vida). Verificou-se que prepondera o apoio da rede informal, sobretudo da família. Sugeriram melhorias nos serviços de saúde da corporação e nas condições de trabalho do policial militar. Conclui-se que o acesso a uma rede de apoio formal conjugada com uma rede de apoio informal pode reduzir danos à saúde física e mental, e melhorar as condições de vida de mulheres idosas.
This article presents a clinical-political approach to collective trauma, based on authors who offer an intersubjective reading of psychoanalysis in dialogue with feminist theorists, responsible for the political interpretation of trauma. This material engages with accounts of victims' experiences of urban violence in Brazil. Collective trauma is seen as a disruptive event, for which there are no representational resources. Among its effects are the corrosion of the sociability ties of the social group that experienced the trauma, feelings of impotence, fear, and loss of spatial and temporal orientation. Generally, based on contexts of exclusion and social oppression, collective trauma has been approached from a medicalizing, reductionist perspective, which disregards its structural roots. In contrast, it is proposed that its chronic nature be recognized, requiring political discussion, from which it would be important to legitimize traumatized people as specialists in the experience they have been through. With their protagonism, confronting trauma should involve both political strategies for creating collective mechanisms, emancipation and the struggle for structural changes, as well as clinical ones.
Resumo O surto recente de mpox causou preocupação para a saúde pública mundialmente e continua a representar desafios significativos. Este artigo visa analisar o cenário epidemiológico (incidência e distribuição nos subgrupos) dos casos confirmados e prováveis de mpox e descrever as características demográficas relacionadas a atividade sexual, tipo de contato com caso suspeito, sintomas, comorbidades, características da lesão e evolução do caso, no estado de Minas Gerais, Brasil, de junho de 2022 a maio de 2023. Estudo epidemiológico, transversal com casos confirmados e prováveis de mpox em Minas Gerais, Brasil. Foram notificados 759 casos confirmados e prováveis de infecção pelo mpox, sendo 81,16% confirmados e 18,84% prováveis. Foram identificadas associações significativas (p < 0,05) entre casos e variáveis como sexo ao nascimento, escolaridade, identidade de gênero, orientação sexual, comportamentos sexuais, exposição próxima, forma provável de transmissão, imunossupressão e coinfecção com HIV. A maioria dos casos ocorreu em homens homossexuais ou que fazem sexo com homens, com prevalência entre indivíduos com múltiplos parceiros sexuais. Os achados permitem que melhorias possam ser implementadas no sistema de informação e planejamento de medidas preventivas.
Due to the persistence of inequalities and prejudices that permeate the experiences of lesbian and bisexual women, especially in the field of health, this study analyzed narratives of workers from a Family Health Unit about the care provided to these groups. This qualitative research was grounded in bisexual frameworks and lesbian-feminist epistemologies. Participant observations and semi-structured interviews were conducted with 15 health workers. The narrative analysis allowed for the construction of two core meanings based on (1) perceptions of health needs and demands and (2) technical, ethical, and moral challenges in providing care to these women. It is concluded that the realization of equitable care depends on confronting the heteronormativity that structures institutions and training practices, expanding critical training, and recognizing these workers as protagonists in the transformation of the Brazilian Unified Health System (SUS).
The article analyzes access to healthcare for rural populations in Mato Grosso do Sul, with an emphasis on the municipalities of Dourados and Rio Brilhante. Based on a qualitative approach, we articulate field observations and interviews with managers, professionals, users, and companions of SUS patients to understand how meanings of care are produced in territories marked by socio-territorial and gender inequalities. The collected narratives reveal challenges such as precarious services, scarcity of infrastructure, and the centralization of public policies and public facilities in large urban centers. The research draws on references from the Social Sciences in Health to reflect on the concrete conditions of care in inland contexts. By bringing to light experiences from the so-called "deep Brazil," the study seeks to destabilize the epistemological hegemony of large centers and to strengthen more humane, territorialized care practices committed to equity.
Resumo O objetivo deste estudo foi estimar a associação entre perda sensorial dupla (auditiva e visual) e declínio cognitivo em pessoas idosas do Sul do Brasil. Trata-se de uma pesquisa transversal, realizada com dados da 3ª onda do estudo EpiFloripa Idoso (2017-2019), envolvendo pessoas com 60 anos ou mais que vivem em áreas urbanas de Florianópolis (SC). A variável dependente foi o declínio cognitivo, avaliado através do Miniexame do Estado Mental, enquanto a variável independente principal foi a perda sensorial. Realizou-se análise de regressão logística. Participaram 1.335 idosos, observando-se maior frequência de mulheres (63,0%) e indivíduos de raça/cor branca (88,3%). Em relação à perda sensorial, 10,8% dos indivíduos apresentaram perda sensorial dupla, e 20,5%, declínio cognitivo. No modelo final, indivíduos com perda sensorial dupla apresentaram chance 4,21 vezes maior (IC95%: 2,06-8,59) de declínio cognitivo. Indivíduos com perda auditiva isolada (OR: 1,98; IC95%: 1,13-3,45) também tiveram maior probabilidade do desfecho. Pessoas idosas com perda auditiva e visual apresentaram 321% maior chance de ter declínio cognitivo. Esses resultados sugerem que a perda simultânea de duas funções sensoriais pode potencializar o impacto na capacidade cognitiva de pessoas idosas.
Improving healthcare for women and children remains a priority in Brazilian public policy, with actions by the Ministry of Health aimed at strengthening management and planning to reduce maternal and neonatal mortality. This article analyzes the relevance and adequacy of the intervention in 20 state health departments. This is an evaluative study with a strategic analysis of the consistency between the intervention's objectives and the problems faced, including: (1) description of the intervention and logical model; (2) validation of the model; (3) analysis of the relevance of the intervention; (4) evaluation by technicians and managers of the secretariats. The intervention was well evaluated, with agreement that strengthening planning and management is essential to reduce maternal and neonatal mortality. Analysis of the responses from technicians and managers (n=143) indicated a favorable assessment of the intervention's contribution in the territories, the relevance of the topics addressed, the usefulness of the materials, and the profile of the consultants, including their ability to adapt SUS guidelines to local realities. The study contributes to improving future national interventions focused on women's and children's health.
Care work is performed, especially, by poor, black, indigenous women and young migrants who move internally to other countries in Latin America, or to the Global North. The objective of the article is to analyze and discuss the care work of young migrants from and in the Latin American context, asking whether and how scientific productions dialogue with intersectionality, working conditions and health, and the challenges facing mobilities, social, emotional and sexual interactions. A narrative literature review was carried out with descriptors in the following databases: SciELO, Web of Science, Virtual Health Library, Scopus and Scilit, totaling 19 articles. The results of this review point to the scarce theoretical depth of intersectionality; low pay, long working hours, lack of labor rights that affect the health of these young women; situations of undocumented migration; difficulties in reconciling family care and motherhood, and interruptions in studies. It is essential to discuss the topic from an intersectional perspective to complexify and understand the particularities and diversities of care work for young migrants with a view to producing public care policies for them.
Resumo Plataformas marítimas são espaços de ameaças à saúde e à vida dos trabalhadores offshore. Para minimizar os possíveis danos aos petroleiros, são necessários profissionais de saúde e segurança, que devem gozar de saúde plena - física e mental - para zelarem por toda a tripulação. Este artigo tem como objetivo analisar a atividade de trabalho do profissional em segurança e/ou saúde do trabalho que atua no ramo offshore através das contribuições da ergologia, dando ênfase às renormalizações. A metodologia utilizada foi a realização de seis entrevistas semiestruturadas com profissionais que são o foco desse estudo. Como resultado, observou-se que os profissionais prevencionistas do ramo offshore precisam “enfrentar” as normas de trabalho, seja a partir de seus vazios ou de suas limitações, valendo-se de seus saberes produzidos e astúcia para fazer o trabalho na plataforma acontecer.
Acquired syphilis is a sexually transmitted infection. This ecological study analyzed the spatiotemporal heterogeneity of incidence and associated factors of acquired syphilis in Minas Gerais, Brazil, from 2011 to 2021, based on data from the Minas Gerais Health Surveillance Portal, distributed by Planning Regions according to João Pinheiro Foundation. Generalized additive models investigated the relationship between incidence rates and year, while spatiotemporal analyses were conducted using the Satscan software. Correlations between incidence and social inequality indicators (Gini Index, Human Development Index) as well as Family Health Strategy coverage were assessed using Spearman and bivariate Moran analyses for the period 2017-2019. A conditional autoregressive model estimated risks in municipalities. A total of 83,432 cases of acquired syphilis were reported, predominantly among men, pardos individuals, those with a high school education, and aged 20-29 years. Municipalities with risks greater than 1 were concentrated in the Central region. Higher coverage was associated with lower disease incidence. Expanding access to primary care is essential to reduce the impact of regional disparities on the incidence of diseases like syphilis.
This article presents reflections by researchers from the Gender, Reproduction and Justice Research Group/RepGen on the place of reproductive bodies within Brazil's National Policy on Care (PNaC), analyzed through a reproductive justice lens. The first section contextualizes the study. The second synthesizes the policy's main concepts, highlighting elements relevant to the discussion. We then address the absence of reproductive body care work in the policy and examine the challenge PNaC faces in defining its specificities in relation to other public policies centered on care, especially Health. In the fourth section, we argue that although the PNaC identifies care workers as a priority group, it still fails to incorporate their own reproductive care needs, overlooking issues such as menstrual dignity and abortion. Despite these gaps, the policy creates room to imagine more equitable care models. We conclude that recognizing the care of reproductive bodies as a strategic dimension of social and reproductive justice-and as a transversal axis of the PNaC-would be a decisive step toward confronting the patriarchal, racist, and capitalist order that regulates bodies, knowledge, and reproductive experiences.
