O drama epidêmico da dengue: causas,sofrimento e responsabilidades no Jornal Nacional (1986-2008)

O trabalho reflete sobre as relações entre mídia, saúde e política, a partir da análise da cobertu- ra das epidemias de dengue em 1986, 1998 e 2008, realizada pelo principal telejornal brasileiro, o Jornal Nacional, da Rede Globo de Televisão. Distante das abordagens que veem o jornalismo como a transmissão de informações, mais ou menos acurada em função de seus interesses políticos, econômicos e editoriais, interrogamos os dispositivos midiáticos como coprodutores de sentidos sociais. A análise comparativa privilegia a historicidade das operações que tecem as causas, respon- sabilidades e as formas de narrar os sofrimentos, assim como a concepção de justiça social que os sustenta. Argumentamos que em 2008 há um expressivo deslocamento do posicionamento discur- sivo que o telejornal propõe para si e para o telespectador, baseado no binômio risco-segurança. No contexto de esvaziamento da ação política, percebe-se a individualização de responsabilidades e sofrimentos, a idealização do poder da ação do Estado e a hipertrofia do julgamento midiático.

The discourse of risk in diet pills controversy: an analysis of the press coverage in 2011 and in 2014

Appetite suppressants are sold in Brazil over 30 years. In 2010, the Agência Nacional de Vigilância Sanitária - Anvisa (National Health Surveillance Agency) began a process to review the risk assessment of these drugs and in 2011 cancelled the register of the three amphetamine-based anorexigenics (anfepramone, fenproporex, mazindol), only allowing to be marketed in Brazil the sibutramine. In 2014, the Congress revoked the decison-making by Anvisa and authorized the sale of the amphetamine derivatives. This paper analyzes how the meanings of risk were built by daily newspapers during the coverage of the appetite suppressants controversy, considering these two antagonistic moments. Based on the social semiotics, we analyzed 25 newspaper articles published in 2011 and in 2014, which showed that the discourse of risk does not assume the center of the discursive scene, resulting in a political coverage that favours the conflicts of interests, as well as the disputes with the Anvisa and the contradictions of the process

Comunicação e saúde: um olhar e uma prática de pesquisa

Pode-se pensar, pesquisar, ensinar, fazer e falar da comunicação e saúde a partir de muitos campos. Os principais são, como se poderia esperar, os que nomeiam essa interface, ambos com ampla gama de temas e perspectivas teóricas. E falar a partir da comunicação é diferente de falar a partir da saúde, cada campo e suas instituições produzindo modos diferentes de apropriação das teorias, das metodologias e também do grau em que participam das políticas, dos processos e práticas e lutas da comunicação e saúde. Neste texto falamos a partir da saúde e de uma inserção específica nesse campo. E o que, mais precisamente, isto quer dizer? Quer dizer que falamos (e atribuímos prioridades) a partir de um contexto demarcado por um sistema público de saúde, o Sistema Único de Saúde (SUS), com seus dinamismos, contradições, saberes, lutas, movimentos sociais e políticos, estruturas, instituições, agendas

Publicidad gubernamental de utilidad pública en salud: reflexiones para avances teórico-metodológicos en la identificación y análisis del circuito de producción

Comunicación oral presentada en la Segunda Conferencia Internacional de Comunicación en Salud, celebrada el 23 de octubre de 2015 en la Universidad Carlos III de MadridLa publicidad mueve recursos financieros significativos en el mundo, directamente con empleos, impuestos, insumos y productos, o indirectamente estimulando el consumo de los ítemes más diversos. La salud también mueve considerable recursos, además de ser parte del imaginario social en lo que es más caro al ser humano: vida, muerte, enfermedad, esperanza, bienestar. En la interfaz, ‘Publicidad y Salud’ aparece como campo de interés particular, dadas, entre otras, sus dimensiones económica, cultural, social y política. Este trabajo busca reflexionar sobre los acercamientos metodológicos para la identificación y análisis de la publicidad gubernamental de utilidad pública en salud. En estudio sobre las prácticas del Ministerio de la Salud de Brasil, contando con investigación documental y entrevistas, se verifico la relevancia y relativa falta de estudios enfocados, en un acercamiento multidimensional, la publicidad en salud y, especialmente, en el nivel de producción del circuito de la comunicación. Esta ausencia es relevante específicamente para la Publicidad de Utilidad Pública, que se configura como estrategia gubernamental diferenciada, considerando su alcance y relativa control sobre el momento de la producción en la comunicación con la sociedad. Sin embargo, una vez que bajo tensión y traspasada por distintas concepciones y lógicas – de la Salud, las de Estado, gobiernos, mercado, organizaciones y aquellas presentes en entidades de la sociedad civil organizada, entre otras – su análisis y comprensión requieren acercamientos interdisciplinarios y multidimensionales. A partir de la problematización de las perspectivas dominantes y de las cuestiones suscitadas por la investigación empírica, se reflexiona sobre los huecos encontrados y se discuten algunos caminos para la ampliación y profundización de la discusión teórica y metodológica, que contribuyan a la identificación, descripción y caracterización de circuitos configurados por la publicidad gubernamental de utilidad pública en salud, y también para el análisis de las dimensiones y lógicas involucradas

Visual archives concerning Zika virus: images on Instagram as part of the constitution of an epidemic memory

This article bases on a study aiming to analyze the images on Zika virus epidemic that aroused a great public interest and a great number of sharings from the device Instagram. The period of analysis covers November and December 2015, namely two months after researchers and medical authorities have proclaimed that the infection could be associated with cases of microcephaly diagnosed in newborns. This study used the ImageCloud, a tool developed by Laboratório de Estudos sobre Imagem e Cibercultura, da Universidade Federal do Espírito Santo (Laboratory for studies of Image and Cyberculture, from Federal University of Espirito Santo), which allows us to visualize a lot of images in databases like, for example, onsocial networks. The theoretical base used to the analysis in question was the discourse analysis

Genomic history of coastal societies from eastern South America

Sambaqui (shellmound) societies are among the most intriguing archaeological phenomena in pre-colonial South America, extending from approximately 8,000 to 1,000 years before present (yr bp) across 3,000 km on the Atlantic coast. However, little is known about their connection to early Holocene hunter-gatherers, how this may have contributed to different historical pathways and the processes through which late Holocene ceramists came to rule the coast shortly before European contact. To contribute to our understanding of the population history of indigenous societies on the eastern coast of South America, we produced genome-wide data from 34 ancient individuals as early as 10,000 yr bp from four different regions in Brazil. Early Holocene hunter-gatherers were found to lack shared genetic drift among themselves and with later populations from eastern South America, suggesting that they derived from a common radiation and did not contribute substantially to later coastal groups. Our analyses show genetic heterogeneity among contemporaneous Sambaqui groups from the southeastern and southern Brazilian coast, contrary to the similarity expressed in the archaeological record. The complex history of intercultural contact between inland horticulturists and coastal populations becomes genetically evident during the final horizon of Sambaqui societies, from around 2,200 yr bp, corroborating evidence of cultural change

Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial.

BACKGROUND: Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. METHODS: In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals. Patients were randomly assigned (1:1) via a computer-generated sequential randomisation list to receive 2 weeks of adjunctive rifampicin (600 mg or 900 mg per day according to weight, oral or intravenous) versus identical placebo, together with standard antibiotic therapy. Randomisation was stratified by centre. Patients, investigators, and those caring for the patients were masked to group allocation. The primary outcome was time to bacteriologically confirmed treatment failure or disease recurrence, or death (all-cause), from randomisation to 12 weeks, adjudicated by an independent review committee masked to the treatment. Analysis was intention to treat. This trial was registered, number ISRCTN37666216, and is closed to new participants. FINDINGS: Between Dec 10, 2012, and Oct 25, 2016, 758 eligible participants were randomly assigned: 370 to rifampicin and 388 to placebo. 485 (64%) participants had community-acquired S aureus infections, and 132 (17%) had nosocomial S aureus infections. 47 (6%) had meticillin-resistant infections. 301 (40%) participants had an initial deep infection focus. Standard antibiotics were given for 29 (IQR 18-45) days; 619 (82%) participants received flucloxacillin. By week 12, 62 (17%) of participants who received rifampicin versus 71 (18%) who received placebo experienced treatment failure or disease recurrence, or died (absolute risk difference -1·4%, 95% CI -7·0 to 4·3; hazard ratio 0·96, 0·68-1·35, p=0·81). From randomisation to 12 weeks, no evidence of differences in serious (p=0·17) or grade 3-4 (p=0·36) adverse events were observed; however, 63 (17%) participants in the rifampicin group versus 39 (10%) in the placebo group had antibiotic or trial drug-modifying adverse events (p=0·004), and 24 (6%) versus six (2%) had drug interactions (p=0·0005). INTERPRETATION: Adjunctive rifampicin provided no overall benefit over standard antibiotic therapy in adults with S aureus bacteraemia. FUNDING: UK National Institute for Health Research Health Technology Assessment

Les droits disciplinaires des fonctions publiques : « unification », « harmonisation » ou « distanciation ». A propos de la loi du 26 avril 2016 relative à la déontologie et aux droits et obligations des fonctionnaires

The production of tt‾ , W+bb‾ and W+cc‾ is studied in the forward region of proton–proton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98±0.02 fb−1 . The W bosons are reconstructed in the decays W→ℓν , where ℓ denotes muon or electron, while the b and c quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions.The production of $t\overline{t}$, $W+b\overline{b}$ and $W+c\overline{c}$ is studied in the forward region of proton-proton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98 $\pm$ 0.02 \mbox{fb}^{-1}. The $W$ bosons are reconstructed in the decays $W\rightarrow\ell\nu$, where $\ell$ denotes muon or electron, while the $b$ and $c$ quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe