scholarly journals Integrating Science, Technology and Health Policies in Brazil: Incremental Change and Public Health Professionals as Agents of Reform

2018 ◽  
Vol 51 (2) ◽  
pp. 357-377
Author(s):  
Elize Massard da Fonseca ◽  
Kenneth Shadlen ◽  
Francisco Inácio Bastos

AbstractBrazil has encouraged an ambitious set of policies towards the pharmaceutical industry, aiming to foster technological development while meeting health requirements. We characterise these efforts, labelled the ‘Complexo Industrial da Saúde’ (Health-Industry Complex, CIS), as an outcome of incremental policy change backed by the sustained efforts of public health professionals within the federal bureaucracy. As experts with a particular vision of the relationship between health, innovation and industry came to dominate key institutions, they increasingly shaped government responses to emerging challenges. Step by step, these professionals first made science and technology essential aspects of Brazil's health policy, and then merged the Ministry of Health's new focus on science, technology and health with industrial policy measures aimed at private firms. We contrast our depiction of these policy changes with a conventional view that relies on a partisan orientation of the executive.

2020 ◽  

Background: The relationship between oral health and general health is gaining interest in geriatric research; however, a lack of studies dealing with this issue from a general perspective makes it somewhat inaccessible to non-clinical public health professionals. Purpose: The purpose of this review is to describe the relationship between oral health and general health of the elderly on the basis of literature review, and to give non-clinical medical professionals and public health professionals an overview of this discipline. Methods: This study was based on an in-depth review of the literature pertaining to the relationship between oral health and general health among the older people. The tools commonly used to evaluate dental health and the academic researches of male elderly people were also reviewed. And future research directions were summarized. Results: Dental caries, periodontal disease, edentulism, and xerostomia are common oral diseases among the older people. Dental caries and periodontal diseases are the leading causes of missing teeth and edentulism. Xerostomia, similar to dry mouth, is another common oral health disease in the older people. No clear correlation exists between the subjective feeling of dryness and an objective decrease of saliva. Rather, both conditions can be explained by changes in saliva. The General Oral Health Assessment Index (GOHAI) and the Oral Health Impact Profile (OHIP) are the main assessment tools used to examine oral health and quality of life in the older people. The GOHAI tends to be more sensitive to objective values pertaining to oral function. In addition, oral health studies in male elderly people are population-based cohort or cross-sectional studies, involving masticatory function, oral prevention, frailty problems, cardiovascular disease risk, and cognitive status. Conclusion: It is possible to reduce the incidence of certain oral diseases, even among individuals who take oral health care seriously. Oral health care should be based on the viewpoint of comprehensive treatment, including adequate nutrition, good life and psychology, and correct oral health care methods. In the future, researchers could combine the results of meta-analysis with the clinical experience of doctors to provide a more in-depth and broader discussion on oral health research topics concerning the older people.


Xihmai ◽  
2020 ◽  
Vol 15 (29) ◽  
Author(s):  
Marí­a Marta Mainetti [1] ◽  
Susana La Rocca [2]

ResumenNos proponemos reflexionar acerca de la relación entre dos principios bioéticos fundamentales en el ejercicio del derecho a la salud: el principio de autonomí­a y el de vulnerabilidad, en el marco de cambios legales en salud ocurridos en las últimas décadas en Argentina. El respeto a la vulnerabilidad comienza a consolidarse no sólo como el reconocimiento al principio más esencial de la Bioética sino como la base de toda la ética. La vulnerabilidad de individuos y poblaciones requiere una concepción de autonomí­a que implique en sí­ misma la inclusión. Se presentan algunas reflexiones y resultados de un proyecto de investigación realizado en 2018-2019 desde la Universidad Nacional de Mar del Plata, que analiza este tema a partir de la percepción de los profesionales de la salud pública en el Partido de General Pueyrredón, provincia de Buenos Aires, Argentina. Palabras clave: autonomí­a, vulnerabilidad, bioética, leyes en salud, derecho a la salud. AbstractWe propose to reflect on the relationship between two fundamental bioethical principles in the exercise of the right to health: the principle of autonomy and that of vulnerability, within the framework of legal changes in health that have occurred in recent decades in Argentina. Respect for vulnerability begins to consolidate not only as recognition of the most essential principle of Bioethics but as the basis of all ethics. The vulnerability of individuals and populations requires a conception of autonomy that implies inclusion in itself. Some reflections and results of a research project carried out in 2018-2019 from the National University of Mar del Plata are presented, which analyzes this topic from the perception of public health professionals in the Party of General Pueyrredón, province of Buenos Aires, Argentina.Keywords: autonomy, vulnerability, bioethics, health laws, right to health.  [1] Lic. en Antropologí­a. Mg. en Bioética. Dra. en Ciencias de la Vida. Docente e investigadora de la Universidad Nacional de Mar del Plata, Argentina. Integrante del Programa Temático Interdisciplinario en Bioética de la UNMDP.[2] Prof. en Filosofí­a. Mg. en Epistemologí­a. Docente e investigadora de la Universidad Nacional de Mar del Plata, Argentina. Coordinadora del Programa Temático Interdisciplinario en Bioética de la UNMDP.


2019 ◽  
Vol 12 (3) ◽  
pp. 213-224 ◽  
Author(s):  
Jessica Nihlén Fahlquist

Abstract In contrast to medical care, which is focused on the individual patient, public health is focused on collective health. This article argues that, in order to better protect the individual, discussions of public health would benefit from incorporating the insights of virtue ethics. There are three reasons to for this. First, the collective focus may cause neglect of the effects of public health policy on the interests and rights of individuals and minorities. Second, whereas the one-on-one encounters in medical care facilitate a compassionate and caring attitude, public health involves a distance between professionals and the public. Therefore, public health professionals must use imagination and care to evaluate the effects of policies on individuals. Third, the relationship between public health professionals and the people who are affected by the policies they design is characterized by power asymmetry, demanding a high level of responsibility from those who wield them. Against this background, it is argued that public health professionals should develop the virtues of responsibility, compassion and humility. The examples provided, i.e. breastfeeding information and vaccination policy, illustrate the importance of these virtues, which needed for normative as well as instrumental reasons, i.e. as a way to restore trust.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Perkiö ◽  
R Harrison ◽  
M Grivna ◽  
D Tao ◽  
C Evashwich

Abstract Education is a key to creating solidary among the professionals who advance public health’s interdisciplinary mission. Our assumption is that if all those who work in public health shared core knowledge and the skills for interdisciplinary interaction, collaboration across disciplines, venues, and countries would be facilitated. Evaluation of education is an essential element of pedagogy to ensure quality and consistency across boundaries, as articulated by the UNESCO education standards. Our study examined the evaluation studies done by programs that educate public health professionals. We searched the peer reviewed literature published in English between 2000-2017 pertaining to the education of the public health workforce at a degree-granting level. The 2442 articles found covered ten health professions disciplines and had lead authors representing all continents. Only 86 articles focused on evaluation. The majority of the papers examined either a single course, a discipline-specific curriculum or a teaching method. No consistent methodologies could be discerned. Methods ranged from sophisticated regression analyses and trends tracked over time to descriptions of focus groups and interviews of small samples. We found that evaluations were primarily discipline-specific, lacked rigorous methodology in many instances, and that relatively few examined competencies or career expectations. The public health workforce enjoys a diversity of disciplines but must be able to come together to share diverse knowledge and skills. Evaluation is critical to achieving a workforce that is well trained in the competencies pertinent to collaboration. This study informs the pedagogical challenges that must be confronted going forward, starting with a commitment to shared core competencies and to consistent and rigorous evaluation of the education related to training public health professionals. Key messages Rigorous evaluation is not sufficiently used to enhance the quality of public health education. More frequent use of rigorous evaluation in public health education would enhance the quality of public health workforce, and enable cross-disciplinary and international collaboration for solidarity.


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