Maria Cristina Rodrigues Guilam

Academic production on food labeling in Brazil

OBJECTIVEnTo review and discuss academic production (theses and dissertations) on the topic of labeling of prepackaged foods in Brazil.nnnMETHODnA search of the database maintained by the Coordination for the Development of Higher Education Professionals (CAPES), one of the two Brazilian government research funding and support agencies, was conducted on the following keywords: rotulagem (labeling), rotulagem nutricional (food labeling) and rótulo de alimentos (food labels). The search covered the years 1987 (earliest year available) to 2004.nnnRESULTSnWe identified 49 studies on this topic. Content analysis identified three major themes: the extent to which food labels meet specific legal requirements (57.2%); the degree to which consumers understand the information on labels (22.4%); and the labeling of transgenic or genetically-modified foods (20.4%).nnnCONCLUSIONSnFood labeling is a frequent topic and is adequately covered by the Brazilian academic production. In most of the studies, ineffective law enforcement appears to be the main factor in the lack of compliance with and disrespect for the food labeling rules and regulations in Brazil.

A internet, o paciente expert e a prática médica: uma análise bibliográfica

El mundo ha presenciado en los ultimos anos una amplia transformacion tecnologica que ha ampliado substancialmente el acceso a la informacion, sobre todo por medio de Internet. En el area de la salud hay cada vez mas informacion disponible. El acceso a la informacion tecnico-cientifica, aliado con el aumento del nivel educacional de las poblaciones ha hecho surgir un paciente que busca informaciones sobre su enfermedad, sintomas, medicamento y costo de internacion y tratameinto: el paciente experto. Este articulo discute de que modo las informaciones obtenidas en Internet modifican o interfieren en la relacion medico-paciente. Se recupera la controversia entre Freidson y Haug sobre la des-profesionalizacion del medico. Metodologicamente se analizan opiniones de los autores que han publicado articulos sobre el tema, entre 1997 y 2005, en dos importantes revistas academicas del sector inglesas. Se concluye que las posiciones encontradas son diferentes e incluso antagonicas; y Brasil, pese a la exclusion digital, necesita analizar esta cuestion.O mundo presenciou nos ultimos anos uma ampla transformacao tecnologica que ampliou substancialmente o acesso a informacao, sobretudo por meio da Internet. Na area da saude ha cada vez mais informacao disponivel. O acesso a informacao tecnico-cientifica, aliado ao aumento do nivel educacional das populacoes tem feito surgir um paciente quebusca informacoes sobre sua doenca, sintomas, medicamento e custo de internacao e tratamento: o paciente expert. Este artigo discute de que modo as informacoes obtidas na internet modificam ou interferem na relacao medico-paciente. Recupera-se a controversia entre Freidson e Haug sobre a desprofissionalizacao do medico. Metodologicamente, foram analisadas opinioes dos autores que publicaram artigos sobre o tema, entre 1997 e 2005, em duas importantes revistas academicas inglesas da area. Conclui-se que as posicoes encontradas sao distintas e ate antagonicas, e o Brasil, apesar da exclusao digital, precisa analisar esta questao.

Medicine consumption and the internet: critical evaluation of a virtual community

OBJECTIVEnDiscuss the promotion of medicines in the media by the analysis of dialogs from a virtual community, whose members use benzydamine in high doses seeking the collateral effects.nnnMETHODSnOpinions from a group in a Social Network Service (SNS) available in the internet were evaluated by the Analysis of Content Technique, whereas data from 385 members from this group were used to identify a profile of the individuals.nnnRESULTSnThe profile found was male, age between 18 and 20 years and in high school. Analysis of opinions revealed the consumption of 16 to 20 tablets of the medicine, sometimes along with alcohol and the occurrence of the following symptoms: visual hallucinations, insomnia and gastrointestinal effects. In the dialogs, two discourses were identified: one recommends this non-therapeutic use and the other tries to dissuade individuals from using it.nnnCONCLUSIONnA virtual community organized to discuss a non-therapeutic use of a medicine may contribute to its use. This fact reaffirms the necessity of a major campaign to alert individuals about the dangers of self-medication and also the importance of pharmacies and drugstores to comply with the sanitary legislation.

Os riscos genômicos e a responsabilidade pessoal em saúde

With the advent of genomic research, a new category of risk has emerged-genetic risk-from which an individual cannot be separated. Among the outcomes of this model is a discussion on personal accountability, according to which an individual may both be exempted from events related to certain states of health (blame it on the genes) or be blamed for those events (transmitter of disease). In addition, the search for genes to explain disease erases the line between what is normal and what is pathological, with a growing tendency towards considering individuals with no or very mild clinical manifestations as being ill. The great emphasis on genomics may lead to both an exaggerated attention to genetics rather than social and environmental factors and to a reductionism that favors sociobiological explanations for human behavior. In addition, in this scenario, the right to information may paradoxically stimulate some to consume goods and services in order to prevent a hypothetical illness that could occur at some point in time as a result of genetic predisposition-goods and services that may not be available to everyone. It is essential that such issues be considered with the same urgency with which the genomic paradigm is being developed.

The internet, expert patients and medical practice: an analysis of the literature

El mundo ha presenciado en los ultimos anos una amplia transformacion tecnologica que ha ampliado substancialmente el acceso a la informacion, sobre todo por medio de Internet. En el area de la salud hay cada vez mas informacion disponible. El acceso a la informacion tecnico-cientifica, aliado con el aumento del nivel educacional de las poblaciones ha hecho surgir un paciente que busca informaciones sobre su enfermedad, sintomas, medicamento y costo de internacion y tratameinto: el paciente experto. Este articulo discute de que modo las informaciones obtenidas en Internet modifican o interfieren en la relacion medico-paciente. Se recupera la controversia entre Freidson y Haug sobre la des-profesionalizacion del medico. Metodologicamente se analizan opiniones de los autores que han publicado articulos sobre el tema, entre 1997 y 2005, en dos importantes revistas academicas del sector inglesas. Se concluye que las posiciones encontradas son diferentes e incluso antagonicas; y Brasil, pese a la exclusion digital, necesita analizar esta cuestion.O mundo presenciou nos ultimos anos uma ampla transformacao tecnologica que ampliou substancialmente o acesso a informacao, sobretudo por meio da Internet. Na area da saude ha cada vez mais informacao disponivel. O acesso a informacao tecnico-cientifica, aliado ao aumento do nivel educacional das populacoes tem feito surgir um paciente quebusca informacoes sobre sua doenca, sintomas, medicamento e custo de internacao e tratamento: o paciente expert. Este artigo discute de que modo as informacoes obtidas na internet modificam ou interferem na relacao medico-paciente. Recupera-se a controversia entre Freidson e Haug sobre a desprofissionalizacao do medico. Metodologicamente, foram analisadas opinioes dos autores que publicaram artigos sobre o tema, entre 1997 e 2005, em duas importantes revistas academicas inglesas da area. Conclui-se que as posicoes encontradas sao distintas e ate antagonicas, e o Brasil, apesar da exclusao digital, precisa analisar esta questao.

O discurso do risco e o aconselhamento genético pré-natal

A medicalizacao e um fenomeno social difuso nas sociedades ocidentais que se expressa segundo um diferencial de genero. A gravidez e um momento fortemente medicalizado, no qual as mulheres se veem cercadas de uma rede de vigilância de seu corpo, sendo responsabilizadas nao so pela propria saude, mas tambem pela producao de um feto saudavel. O controle dos riscos no pre-natal e proposto, entretanto, em um contexto no qual as possibilidades diagnosticas sao amplamente majoritarias comparativamente as possibilidades terapeuticas. Essa defasagem e agravada pelo fato de, no Brasil, o abortamento ser ilegal. Este artigo e fruto de pesquisa empirica realizada em um ambulatorio publico de genetica pre-natal, que constou de: observacao das praticas de atendimento, revisao de prontuarios e realizacao de entrevistas com profissionais de saude. Discutem-se o contexto fortemente medicalizado do aconselhamento genetico no Brasil e a percepcao dos medicos sobre suas praticas neste contexto. E discutido tambem o possivel impacto sobre a tomada de decisao das mulheres atendidas em relacao a riscos, tecnicas, exames e seus desdobramentos.Medicalization is a highly visible and widespread social phenomenon in Western societies which is expressed differently according to gender. Pregnancy is heavily medicalized, and a surveillance network surrounds pregnant women, holding them accountable for both their own health and the production of a healthy fetus. Prenatal risk control is proposed in a context where diagnostic and therapeutic possibilities overlap. This problem is aggravated by the fact that abortion is illegal in Brazil. The current article is the result of research in a genetic counseling unit that consisted of: observation of consultations, review of patient files, and interviews with health professionals. The highly medicalized context of genetic counseling is discussed, as well as physicians perception of their own practice. The article also discusses the potential impact on womens decisions related to risks, techniques, exams, and their consequences.A medicalizacao e um fenomeno social difuso nas sociedades ocidentais que se expressa segundo um diferencial de genero. A gravidez e um momento fortemente medicalizado, no qual as mulheres se veem cercadas de uma rede de vigilância de seu corpo, sendo responsabilizadas nao so pela propria saude, mas tambem pela producao de um feto saudavel. O controle dos riscos no pre-natal e proposto, entretanto, em um contexto no qual as possibilidades diagnosticas sao amplamente majoritarias comparativamente as possibilidades terapeuticas. Essa defasagem e agravada pelo fato de, no Brasil, o abortamento ser ilegal. Este artigo e fruto de pesquisa empirica realizada em um ambulatorio publico de genetica pre-natal, que constou de: observacao das praticas de atendimento, revisao de prontuarios e realizacao de entrevistas com profissionais de saude. Discutem-se o contexto fortemente medicalizado do aconselhamento genetico no Brasil e a percepcao dos medicos sobre suas praticas neste contexto. E discutido tambem o possivel impacto sobre a tomada de decisao das mulheres atendidas em relacao a riscos, tecnicas, exames e seus desdobramentos.

Internet na promoção da saúde: um instrumento para o desenvolvimento de habilidades pessoais e sociais

The development of individual and social skills, in the sense of acquiring greater control and produce empowerment, is considered a very important Health Promotion strategy. Access to information is one of the bases for such process. Much has been said and written about the immense potential of the internet, as studies point it as a special tool to obtain information and develop skills, both individual and communal. This article is based on national and international scientific literature on Health Promotion, Health Information on the internet and Digital Divide, with the aim of discussing the possibility of using the internet as a resource on Health Promotion projects, highlighting strength points and potential barriers, especially the digital divide. The authors believe that the internet may be a great ally in building projects for Health Promotion, however, in developing these projects is essential to consider the potential risks and understand that the strategies and programs in health promotion area need to adapt to the needs and possibilities of each site and take into account social, cultural and economic differences.

Violence in old age: the issue addressed in indexed national journals

One of the consequences of increased life expectancy is the increase in the elderly population in many countries, including Brazil. Considering the vulnerability of this age group and the increasing prevalence of violence against the elderly, there is a pressing need for research and control interventions to minimize the phenomenon. This exploratory and descriptive article conducts an analysis into this topic in indexed Brazilian studies in SciELO, with special emphasis on the last five years. The themes were categorized into: Social construction and conceptualizations, 37.5%; Elderly Care and Protection Policies, 43.75%; and Typology of violence against the elderly, 18.75%. The results show that the Policy of protection of the elderly permeates the majority of discussions about violence in old age and the focus of the researchers attention is on domestic violence, which needs to be broadened in field research.

Violência na velhice: abordagens em periódicos nacionais indexados

This article assesses aluminum production in Brazil and its social, environmental and public health impacts. The effects of the aluminum production chain challenge the idea of sustainable growth affirmed by business groups that operate in the sector. This article upholds the theory that the insertion of Brazil in the global aluminum market is part of a new configuration of the International Division of Labor (IDL), the polluting economic and highly energy dependent activities of which - as is the case of aluminum - have been moving to peripheral nations or emerging countries. The laws in such countries are less stringent, and similarly the environmental movements and the claims of the affected populations in the territories prejudiced in their rights to health, a healthy environment and culture are less influential. The competitiveness of this commodity is guaranteed in the international market, from the production of external factors such as environmental damage, deforestation, emissions of greenhouse gases and scenarios of environmental injustice. This includes undertakings in the construction of hydroelectric dams that expose traditional communities to situations involving the loss of their territories.Uma das consequencias do aumento da expectativa de vida e a elevacao do numero de idosos na populacao de diversos paises, incluindo o Brasil. Considerando-se a vulnerabilidade desse grupo etario e a crescente prevalencia da violencia contra ele, e marcante a necessidade de pesquisas e intervencoes para o controle e minimizacao do fenomeno. Este artigo, de caracteristica exploratoria e descritiva, traz uma analise dos estudos sobre estas tematicas no Brasil a partir de um levantamento bibliografico em periodicos nacionais indexados na base SciELO, com enfase nos ultimos cinco anos. Os temas abordados foram categorizados em: Construcao social e conceituacoes, 37,5%; Atencao e Politica de Protecao ao Idoso, 43,75%; e, Tipologia de violencia contra idosos, 18,75%. Como resultado tem-se que a Politica de protecao ao idoso surge amparando a maioria das discussoes que tratam da violencia na velhice e que esta tem como foco de atencao dos pesquisadores, a violencia domestica, precisando se expandir nas pesquisas de campo.

Epidemiologia e Saúde Coletiva: tendências da produção epidemiológica brasileira quanto ao volume, indexação e áreas de investigação - 2001 a 2006

This article examines and interprets the trends of epidemiological production in Brazil in the Public Health context. CAPES indicators from 2001 to 2006 were used as database. We analyzed 26 programs and select the 10 major ones to analyze their bibliographic production in indexed journals. It was observed that the total production of epidemiological articles accounted for 40% of production in Public Health and 55% of the production was published in international journals, especially Cadernos de Saude Publica, Revista de Saude Publica and Ciencia & Saude Coletiva. The most prevalent themes were public health nutrition, maternal and infant health and, infectious diseases, particularly AIDS. Environmental e workers heath, oral health, violence and health of the elderly have been ratified as objects of study for the discipline, while meta-analysis and geoprocessing appear as a useful tool for health services. We conclude that the epidemiological production tends to increase in indexed publications, covering various topics and a wide spectrum of relevant issues to Brazilian health policy.