RESUMEN
This multicenter study aims to assess the impact of public policies (PPs) on the health-related quality of life (HRQoL) of individuals with celiac disease (CD) using the Celiac Disease Questionnaire (CDQ) and PPs for Celiac Disease Score (PPCDS). This cross-sectional exploratory study was conducted in four stages: first, standardizing data from countries using the CDQ; second, analyzing PPs aimed at CD patients; third, statistically examining these data; and fourth, associating HRQoL indicators with corresponding PPs. This study analyzed 15 CDQ assessments from 12 countries from 2007 to 2023. It found that comprehensive PPs positively correlated with HRQoL outcomes (Spearman correlation of 0.358). However, policies specifically targeting gluten-free meals and certification did not significantly improve HRQoL individually, suggesting they may be more effective when implemented together. Additionally, specialized health services did not notably reduce gastrointestinal symptoms, underscoring the necessity for improved patient education to enhance the effectiveness of these services. This study concludes that implementing and rigorously monitoring regulations to support CD patients is crucial for enhancing their HRQoL.
Asunto(s)
Enfermedad Celíaca , Política Pública , Calidad de Vida , Humanos , Estudios Transversales , Encuestas y Cuestionarios , Dieta Sin Gluten , Masculino , Femenino , AdultoRESUMEN
The term food loss and waste (FLW) refers to discarded food during the different stages of the food chain. Food loss occurs during the initial stages of the food chain, and food waste occurs during the final stages. The relation between FLW and circular economy (CE) is particularly important for countries which are beginning to implement actions or regulations on this topic. These proposals may have an impact in strategic sectors of their economy. The objective of this review document was to analyse the regulations of FLW and CE in some countries located throughout the European Union, Asia, Africa and Latin America. To fulfil this objective, FLW and CE regulations were identified and analysed in 12 countries located in the aforementioned regions. The analysis showed that France, Spain, Japan and Uruguay included objectives related to FLW in their CE legislations focusing on food waste reduction, whereas China, Chile, Argentina and Mexico did not include FLW in their CE legislations. African countries did not have CE legislations in place yet. France and Japan have had more success in the reduction of FLW. In conclusion, CE regulation should include FLW regulation to achieve more efficiency at reducing and reusing these residues.
RESUMEN
This research is based on three fundamental aspects of successful biosimilar development in the challenging biopharmaceutical market. First, biosimilar regulations in eight selected countries: Japan, South Korea, the United States, Canada, Brazil, Argentina, Australia, and South Africa, represent the four continents. The regulatory aspects of the countries studied are analyzed, highlighting the challenges facing biosimilars, including their complex approval processes and the need for standardized regulatory guidelines. There is an inconsistency depending on whether the biosimilar is used in a developed or developing country. In the countries observed, biosimilars are considered excellent alternatives to patent-protected biological products for the treatment of chronic diseases. In the second aspect addressed, various analytical AI modeling methods (such as machine learning tools, reinforcement learning, supervised, unsupervised, and deep learning tools) were analyzed to observe patterns that lead to the prevalence of biosimilars used in cancer to model the behaviors of the most prominent active compounds with spectroscopy. Finally, an analysis of the use of active compounds of biosimilars used in cancer and approved by the FDA and EMA was proposed.
RESUMEN
To better query regional sources of metal(loid) exposure in an under-communicated region, available scientific literature from 50 national universities (undergraduate and graduate theses and dissertations), peer-reviewed journals, and reports published in Spanish and English were synthesized with a focus on metal(loid) bioaccumulation in Peruvian food and medicinal products utilized locally. The study considered 16 metal(loid)s that are known to exert toxic impacts on humans (Hg, Al, Sb, As, Ba, Be, Cd, Cr, Sn, Ni, Ag, Pb, Se, Tl, Ti, and U). A total of 1907 individual analyses contained within 231 scientific publications largely conducted by Peruvian universities were analyzed. These analyses encompassed 239 reported species classified into five main food/medicinal groups-plants, fish, macroinvertebrates and mollusks, mammals, and "others" category. Our benchmark for comparison was the World Health Organization (Codex Alimentarius) standards. The organisms most frequently investigated included plants such as asparagus, corn, cacao, and rice; fish varieties like trout, tuna, and catfish; macroinvertebrates and mollusks including crab and shrimp; mammals such as alpaca, cow, chicken eggs, and milk; and other categories represented by propolis, honey, lichen, and edible frog. Bioaccumulation-related research increased from 2 to more than 25 publications per year between 2006 and 2022. The results indicate that Peruvian food and natural medicinal products can have dangerous levels of metal(loid)s, which can cause health problems for consumers. Many common and uncommon food/medicinal products and harmful metals identified in this analysis are not regulated on the WHO's advisory lists, suggesting the urgent need for stronger regulations to ensure public safety. In general, Cd and Pb are the metals that violated WHO standards the most, although commonly non-WHO regulated metals such as Hg, Al, As, Cr, and Ni are also a concern. Metal concentrations found in Peru are on many occasions much higher than what has been reported elsewhere. We conclude that determining the safety of food/medicinal products is challenging due to varying metal concentrations that are influenced not only by metal type but also geographical location. Given the scarcity of research findings in many regions of Peru, urgent attention is required to address this critical knowledge gap and implement effective regulatory measures to protect public health.
RESUMEN
Numerous studies have shown that pesticide exposure is linked to adverse health outcomes. Nevertheless, in Bolivia, where there is an increasing use of pesticides, the literature is sparse. To address knowledge gaps and guide future research in Bolivia, we conducted a scoping review spanning 22 years (January 2000 to December 2022). Our search identified 39 peer-reviewed articles, 27 reports/documents on Bolivian regulations, and 12 other documents. Most studies focused on farmers and revealed high pesticide exposure levels, assessed through biomarkers of exposure, susceptibility, and effect. The literature explored a range of health effects due to pesticide exposure, spanning from acute to chronic conditions. Many studies highlighted the correlation between pesticide exposure and genotoxic damage, measured as DNA strand breaks and/or micronuclei formation. This was particularly observed in farmers without personal protection equipment (PPE), which increases the risk of developing chronic diseases, including cancer. Recent findings also showed the alarming use of banned or restricted pesticides in Bolivian crops. Despite existing Bolivian regulations, the uncontrolled use of pesticides persists, leading to harmful health effects on the population and increasing land and water pollution. This review underscores the need for the stringent enforcement of regulations and continued research efforts, and it provides a scientific foundation for decision-making by relevant authorities.
Asunto(s)
Exposición Profesional , Plaguicidas , Humanos , Plaguicidas/toxicidad , Agricultura , Bolivia , Exposición Profesional/prevención & control , Conocimientos, Actitudes y Práctica en Salud , AgricultoresRESUMEN
This review provides a comprehensive overview of the current state of probiotic research, covering a wide range of topics, including strain identification, functional characterization, preclinical and clinical evaluations, mechanisms of action, therapeutic applications, manufacturing considerations, and future directions. The screening process for potential probiotics involves phenotypic and genomic analysis to identify strains with health-promoting properties while excluding those with any factor that could be harmful to the host. In vitro assays for evaluating probiotic traits such as acid tolerance, bile metabolism, adhesion properties, and antimicrobial effects are described. The review highlights promising findings from in vivo studies on probiotic mitigation of inflammatory bowel diseases, chemotherapy-induced mucositis, dysbiosis, obesity, diabetes, and bone health, primarily through immunomodulation and modulation of the local microbiota in human and animal models. Clinical studies demonstrating beneficial modulation of metabolic diseases and human central nervous system function are also presented. Manufacturing processes significantly impact the growth, viability, and properties of probiotics, and the composition of the product matrix and supplementation with prebiotics or other strains can modify their effects. The lack of regulatory oversight raises concerns about the quality, safety, and labeling accuracy of commercial probiotics, particularly for vulnerable populations. Advancements in multi-omics approaches, especially probiogenomics, will provide a deeper understanding of the mechanisms behind probiotic functionality, allowing for personalized and targeted probiotic therapies. However, it is crucial to simultaneously focus on improving manufacturing practices, implementing quality control standards, and establishing regulatory oversight to ensure the safety and efficacy of probiotic products in the face of increasing therapeutic applications.
Asunto(s)
Probióticos , Probióticos/uso terapéutico , Humanos , AnimalesRESUMEN
Noncommunicable diseases (NCDs) are a leading cause of death and disability worldwide, with a higher risk of death in low- and middle-income countries. Diet and excess weight are risk factors for NCDs. In Mexico, the prevalence of overweight and obesity increased dramatically in the last 30 y and is among the highest in the world. To address this public health problem, governments and public health professionals have several policy instruments available. In this study, we present the policy instruments currently approved in Mexico, which include fiscal, informational, and authoritative tools that aim to improve the food environment and promote healthy behaviors (taxes, school food guidelines, front-of-pack labeling, marketing regulations, and dietary guidelines). These types of interventions are important in regions like Latin America, where social inequities and poor access to information are common, and individual healthy choices are often limited. These interventions target the environments in which individuals live, study, work, and seek entertainment, while limiting access to unhealthy choices and offering information to promote healthy alternatives. The Mexican experience in design, implementation, and evaluation of policies to improve the food environment can be useful for other low- and middle-income countries facing similar challenges.
Asunto(s)
Enfermedades no Transmisibles , Humanos , México/epidemiología , Enfermedades no Transmisibles/epidemiología , Enfermedades no Transmisibles/prevención & control , Obesidad/prevención & control , Obesidad/epidemiología , Dieta , Salud PúblicaRESUMEN
Nutrition labelling is any description intended to inform consumers about the nutritional properties of a food product and has focused primarily on nutrients. However, literature has shown that the nutritional quality of packaged foods is not limited to the amount of nutrients, considering that individuals do not consume only nutrients separately, but rather the entire food matrix. Therefore, to analyze the nutritional quality of a packaged food, it is necessary to read its ingredients. This scoping review aims to discuss (1) the list of ingredients as a source of health and nutrition information in food labelling; (2) opportunities to improve the nutrition labeling policies around the world. The study was carried out through a systematic search on Codex Alimentarius meeting reports. Results show that the list of ingredients is used as a source of nutritional and health information on food labelling; however, this label item is not considered in the regulatory field as a nutrition labelling requirement. It is suggested that nutrition labelling be discussed as a tool for food choices in the context of public health from a broader, consistent, convergent perspective, considering the list of ingredients as an item of nutrition labelling requirement to be included in public policies around the world.
Asunto(s)
Etiquetado de Alimentos , Estado Nutricional , Humanos , Alimentos , Preferencias Alimentarias , Salud Pública , Valor NutritivoRESUMEN
Abstract Background Recently, the academic world has established a series of reconfigurations of emerging human rights, in order to safeguard the mental integrity of people exposed to neurotechnologies. The recommendations of different stakeholders and a literature review support regulation of these technologies. There are different proposals for regulation, some in soft law and others in objective law. The type of regulation chosen can have repercussions on clinical practice, research, and public policy. The constitutional enactment of neurorights in Chile has been criticized in the academic fields of neuroethics and law as having potential negative effects on mental health research. Objective To analyze in light of the available literature whether the construction of neurorights could create ethical conflicts in the field of mental health, or if it could offer protection against the disruptive use of various neurotechnologies. Method This analysis included a narrative review of studies included in the PsycInfo, Springer, JSTOR, Medline, Scopus, PubMed, CINALH, and Web of Science databases, without restrictions on language or year of publication. Results The enactment of neurorights as hard law is found not to be detrimental to the field of mental health. Discussion and conclusion This article argues that the regulation of neurorights does not threaten the framework of an ecosystem that uses neurotechnologies. On the contrary, such regulation offers protections to people within the complex system of neurotechnologies.
Resumen Antecedentes Recientemente, el mundo académico ha establecido una serie de reconfiguraciones de derechos humanos emergentes, con el fin de salvaguardar la indemnidad mental de las personas expuestas a las neurotecnologías. Las recomendaciones de las diferentes partes interesadas y de una revisión bibliográfica son la regulación de estas. Existen diferentes ejemplos de regulación, algunos de derecho blando y otros de derecho objetivo. El tipo de regulación puede tener repercusiones en la práctica clínica, la investigación y las políticas públicas de una comunidad. La consagración constitucional chilena de los neuroderechos ha sido criticada desde el mundo académico de la neuroética y también desde el derecho argumentándose que podría ser negativa para la investigación en salud mental. Objetivo Analizar a la luz de la literatura disponible si la constitucionalización de los neuroderechos es éticamente conflictiva en el campo de la salud mental o más bien la protege frente del uso disruptivo de diversas neurotecnologías. Método Revisión narrativa de estudios incluidos en las siguientes bases de datos (PsycInfo, Springer, JSTOR, Medline, Scopus, PubMed, CINALH y Web of Science) sin restricciones de idioma o año de publicación. Resultados No se considera que la consagración de los neuroderechos como hard law sea perjudicial en el ámbito de la salud mental. Discusión y conclusión Se discute si los neuroderechos son una regulación amenazante en el marco de un ecosistema que utiliza neurotecnologías. Se concluye que, a pesar de las críticas, no lo es, sino que favorece la protección de las personas del uso inapropiado de neurotecnologías.
RESUMEN
INTRODUCTION: Promptly providing new drugs to fulfill unmet medical needs requires changes in drug development and registration processes. Health Authorities (HAs) considered as reference due to their experience and acknowledgement (Food and Drug Administration [FDA] among others) already consider innovative clinical trial (CT) designs and flexible approval procedures, but Latin America (LATAM) regulations are still far. A comparison was performed to identify gaps. MATERIALS AND METHODS: CT requirements for drug Marketing Authorization Application (MAA) and CT approval regulations were compared between LATAM and reference HAs (FDA/European Medicines Agency [EMA]/Health-Canada/Swissmedic/Therapeutic Goods Administration [TGA]/Pharmaceuticals and Medical Devices Agency [PMDA]), as of August 2022. Procedure included reference HAs regulations review, item selection, identification in LATAM regulations, and International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines (ICH-E6[R2]/ICH-E8[R1]) implementation revision. RESULTS: For MAA, specific application requirements or ICH guideline M4(R4) on common technical document (CTD) adoption are generally stated, and phase-I/III performance is mandatory (explicitly/implicitly). Faster patient access procedures are infrequent: Priority-drug programs, conditional authorizations, or expedited procedures are scarce or non-existent. Regulatory reliance procedures are adopted through different pathways. Regarding CT approval, innovative/complex CT designs are not prohibited but usually omitted. Some countries implemented adapted CT conducting during the COVID-19 pandemic. Early scientific advice meetings (HA-sponsor) are occasionally considered. Most countries are not formally ICH-joined. CONCLUSIONS: LATAM regulations must adapt to new regulatory standards (FDA/EMA/ICH) through implementation of frequent updates, reliance/expedited procedures, early HA-sponsor interactions, innovative/complex CTs, mandatory phase-III reaching elimination, and decentralized elements for CT conducting.
Asunto(s)
COVID-19 , Aprobación de Drogas , Humanos , Preparaciones Farmacéuticas , América Latina , PandemiasRESUMEN
INTRODUCTION: Biosimilars are gaining popularity in Latin America (LA). The biosimilars market is expected to grow rapidly over the next decade as a cost-effective alternative to expensive patented biologics. The drivers for the growing demand include needs for affordable health care, the prevalence of chronic diseases, expiration of patents for numerous biologic medicines and the advent of artificial intelligence (AI). Countries such as Argentina, Brazil and Mexico have implemented regulatory frameworks for the approval of biosimilars as well as for investment in local manufacturing capacity, sale, and distribution. Some LA countries face challenges related to low quality institutional frameworks and deficient public policies for regulatory harmonization of these medicines. AREAS COVERED: The aim of this article is to analyze the broad window of opportunity for biosimilars in LA (Brazil, Mexico and Argentina) in the next decade, considering their regulations and institutional quality, as well as an affordable cost for patients with chronic diseases and highlight the biosimilars approved in the three countries studied. Likewise, the future contribution of AI in the drug R&D process is considered. EXPERT OPINION: Preparing the next decade of biosimilars in LA will involve improving international regulatory frameworks, institutional quality, investments and capacity in R&D (competencies, infrastructure, and AI).
Asunto(s)
Biosimilares Farmacéuticos , Humanos , Biosimilares Farmacéuticos/uso terapéutico , América Latina/epidemiología , Inteligencia Artificial , Enfermedad CrónicaRESUMEN
Glyphosate is a broad-spectrum, non-selective herbicide used to control weeds and protect agricultural crops, and it is classified as potentially carcinogenic by the International Agency for Research on Cancer. In Mexico, the use of pesticides is a common practice, including glyphosate. However, on December 31st, 2020, the Mexican government decreed the prohibition of this herbicide as of January 2024. In this review, we investigate the association between glyphosate and cancer risk and found that most of the studies focused using animals showing negative effects such as genotoxicity, cytotoxicity and neurotoxicity, some studies used cancer cell lines showing proliferative effects due to glyphosate exposure. To our knowledge, in Mexico, there are no scientific reports on the association of glyphosate with any type of cancer. In addition, we reviewed the toxicological effects of the herbicide glyphosate, and the specific case of the current situation of the use and environmental damage of this herbicide in Mexico. We found that few studies have been published on glyphosate, and that the largest number of publications are from the International Agency for Research on Cancer classification to date. Additionally, we provide data on glyphosate stimulation at low doses as a biostimulant in crops and analytical monitoring techniques for the detection of glyphosates in different matrices. Finally, we have tried to summarize the actions of the Mexican government to seek sustainable alternatives and replace the use of glyphosate, to obtain food free of this herbicide and take care of the health of the population and the environment.
Asunto(s)
Herbicidas , Plaguicidas , Animales , Humanos , México , Herbicidas/toxicidad , Productos Agrícolas , GlifosatoRESUMEN
INTRODUCTION: Tobacco industry documents reveal companies' knowledge of a similar young adult market across countries in terms of attitudes and lifestyle aspirations. Some tobacco companies, therefore, use similar marketing approaches across different jurisdictions. We examined young adults' perceptions of flavored cigarette packs, including those containing flavor capsules, in Mexico and the Philippines. METHODS: We conducted a secondary analysis of five focus groups held in Mexico and four in the Philippines with young adults who smoke (aged 18-24 years), separated by gender, in which participants interacted with cigarette packs purchased locally. Transcribed and translated data were thematically analyzed and compared between countries. RESULTS: Three major themes were identified: 1) Flavor capsules cigarettes are recognizable via pack design through imagery on the pack that is understood to signify capsules; 2) Colors signal flavor and make the pack attractive; and 3) Young adults who smoke identify the target audience for these products as young people and those who are beginning to smoke. CONCLUSIONS: Young adults who smoke in Mexico and the Philippines interpreted flavored cigarette pack design similarly and thought that young people are the main audience for these products. This suggests a successful marketing approach creating shared perceptions of flavored cigarette packs in different world regions. It is likely that similar tactics are used in other countries around the world. Therefore, jurisdictions might use evidence from other jurisdictions to support the implementation of evidence-based tobacco control policies. These findings also support the implementation of plain and standardized packaging and flavor bans that would also limit product innovation such as capsules.
RESUMEN
Este artículo tiene como objetivo examinar la valoración que se les da a las revistas científicas peruanas según los reglamentos actuales relacionados con ciencia y tecnología, lo que lleva a que existan clasificaciones de revistas y que las personas autoras se interesen en publicar en función del puntaje para el desarrollo de la carrera académica y de investigación. Metodológicamente se revisaron los reglamentos vigentes de dicha clasificación y calificación de investigadores, así como las características que debe tener una revista para incluirse en los mismos, para luego examinar el portal de ISSN y comparar la lista de revistas científicas registradas de manera que pueda observarse qué porcentaje de esas revistas se consideran para las clasificaciones vigentes. Se concluye que existe un alto porcentaje de revistas peruanas relegadas o fuera del sistema de clasificación, lo que hace que el proceso de crecimiento se vuelva complicado, haciendo el camino de la indexación más tormentoso para los equipos editoriales. Es necesario trabajar por el desarrollo de ciencia nueva y eso involucra dar la oportunidad a estas revistas para seguir avanzando en los procesos de gestión editorial.
This article aims to examine the valuation given to Peruvian scientific journals according to current regulations related to science and technology, which leads to the existence of journal classifications and that authors are interested in publishing based on the score for academic and research career development. Methodologically, the current regulations of said classification and qualification of researchers will be reviewed, as well as the characteristics that a journal must have to be included in them, to later examine the ISSN portal and compare the list of registered scientific journals so that it can be observed which percentage of those journals are considered for current rankings. It is concluded that there is a high percentage of peruvian journals relegated or outside the classification system, which makes the growth process complicated, making the path of indexing harder for editorial teams. It is necessary to work for the development of new science and that involves giving these journals the opportunity to continue advancing in editorial management processes.
RESUMEN
Governments have established regulations to reduce energy consumption and polluting gas emissions from buildings. In Colombia, the government issued Resolution 0549 in 2015, a regulation that imposed savings percentages on different types of buildings. Builders have had to improve their designs to meet this standard. However, this task requires a detailed understanding of the energy behaviour of buildings. In the absence of follow-up data, this study performed energy characterisations of a group of 20 residential and office buildings located in a tropical climate using DesignBuilder software. The simulations show a notable influence of plug-in loads on energy consumption as well as favourable thermal comfort conditions for all categories except for the low-income category. Solar radiation through windows is the largest source of heat in buildings. Additionally, the study shows the impact of a set of energy-saving measures on energy consumption. The results of this study can help designers reduce the energy consumption of tropical buildings and/or meet energy performance standards.
RESUMEN
Electronic waste is an environmental problem because its production volume exceeds its recycling capacity. Academic and managerial production affirm two reasons: (a) dominant market logic and; (b) unresolved asymmetries among actors, causing conflicts to work together. Following the qualitative methodology, we investigate the e-waste situation in São Paulo City. The results allow us to propose that governance constructed by local actors could be a thoughtful way to promote e-waste recycling. Examples from around the world sustain this proposition. The theoretical principle is that the social process of constructing the mechanisms for collective action can solve challenges because the rules, roles, and actions are discussed and assumed by the actors working together. We present a matrix of indicators to be used in future studies in order to refine the proposition of constructed governance.
Asunto(s)
Residuos Electrónicos , Administración de Residuos , Administración de Residuos/métodos , Brasil , Reciclaje/métodos , CiudadesRESUMEN
Urban foraging, i.e., the gathering of wild edible plants, plays a key role in nature connection within cities. Its integration in planning could contribute to the conservation of urban biodiversity. However, we have little understanding of the interactions between the motivations for and barriers to foraging, and the role of legislation, especially in biodiversity hotspots. Through an online questionnaire and policy review, we explored the practice of urban foraging in Recife, Brazil, across social, spatial and regulatory dimensions. We found that most non-foragers would forage if pollution risks were addressed and knowledge was improved. Foragers collected up to 31 species, none of which are threatened. By integrating the social, spatial and regulatory dimensions of the practice, we highlighted the importance of the local context for targeting foraging incentives. In all, regulation had little impact on where the practice is carried out, and foraging seemed to have little negative impact on biodiversity, as no threatened species were collected and foragers were conscious of their impact. This knowledge can contribute to better integrate the practice of foraging within legislation and develop forager-led greenspace planning and management. In biodiversity hotspots threatened by urban expansion, foraging can contribute to slowing down the biodiversity crisis and improve urban residents' contact with biodiversity.
Asunto(s)
Biodiversidad , Parques Recreativos , Brasil , Ciudades , Políticas , EcosistemaRESUMEN
Ionic liquids (IL) are innovative alternative solvents to recover bioactive compounds from plant-based sources to replace toxic volatile organic solvents (VOS). ILs are tailored-made solvents with chemical and thermal stabilities, nonvolatile and noninflammable. Although ILs are versatile, cost-effective, and sustainable solutions, the European Commission (EC) has no current regulation to approve extracts obtained with ILs to be applied in foods. Herein, this paper aims to assess the overview of ILs, regulamentation, applications, and its toxic effects, to be used as solvents for extract different bioactive compounds. Studies have suggested novel applications for ILs, such as 1-butyl-3-methylimidazolium bromide, 1-butyl-3-methylimidazolium chloride, 1-butyl-3-methylimidazolium tetrafluoroborate and others, to obtain bioactive compounds, for instance phenolic compounds, lignans, alkaloids, carotenoids, polysaccharides, using modern approaches as ultrasound and microwave-assisted extraction. New IL methods increase the efficiency of recovering target compounds and decrease the extraction time and VOS consumption regarding the traditional techniques. Furthermore, to promote the large-scale use of IL in foods, it is essential to investigate individually the toxicity of each IL used in the extraction processes, aiming to obtain a GRAS stamp, due to the currently lack of regulamentation.
Asunto(s)
Líquidos Iónicos , Solventes , Líquidos Iónicos/farmacología , Solventes/toxicidadRESUMEN
Resumo O artigo aborda a resposta do governo brasileiro à pandemia da covid-19, enfatizando o sistema de vigilância em saúde e de inteligência epidemiológica. Retoma a evolução da vigilância em resposta às normas do Regulamento Sanitário Internacional, no contexto da saúde global. Analisa os atos do Executivo publicados no Diário Oficial da União e se detém nos atores e grupos formados para o enfrentamento da pandemia da covid-19 de janeiro de 2020 até março de 2022. Parte da premissa de que a inteligência epidemiológica deve estar a serviço da saúde pública. Constata-se que certo tensionamento burocrático e a transferência de protagonismo entre grupos marcam o desmonte dos mecanismos de inteligência.
Abstract This article addresses the Brazilian government's response to the covid-19 pandemic, particularly the public health surveillance and epidemic intelligence system. It traces the evolution of disease surveillance as a response to the International Health Regulations in the context of global health. Executive orders published in the official gazette, Diário Oficial da União, are analyzed, as well as the actors and groups formed to tackle the pandemic between January 2020 and March 2022. The founding assumption is that epidemic intelligence must be placed at the service of public health. Bureaucratic tension and changes in protagonism among different groups can be observed as these intelligence mechanisms were dismantled.
Asunto(s)
Salud Global , Epidemiología , Poder Ejecutivo , Vigilancia en Salud Pública , Servicios Públicos de Salud , Brasil , Historia del Siglo XXIRESUMEN
ABSTRACT Objective: The study aimed to investigate the relationships between body mass index, reasons for consuming palatable foods, emotional eating, cognitive dietary restraint, and disordered eating behaviors in young adults. Methods: This study was conducted with 800 young adults, in Ankara, Türkiye. A questionnaire consisting of questions about socio-demographic characteristics, health status, and instruments including Eating Attitudes Test-26, Emotional Appetite Questionnaire, Palatable Eating Motives Scale, and The Three-Factor Eating Questionnaire were applied through face-to-face interviews. Results: According to the Eating Attitudes Test-26, 17.2% of males and 27.7% of females were at risk for disordered eating behaviors (χ2=9.750, p=0.002). The mean scores of the Three-Factor Eating Questionnaire-emotional eating, cognitive restraint subscales, and the positive and negative scores of the Emotional Appetite Questionnaire were higher in males than in females (p<0.05). The mean scores of the Palatable Eating Motives Scale-coping and reward enhancement motives were higher in females, while the mean score for the conformity motives was significantly higher in males. Body mass index, Three-Factor Eating Questionnaire-cognitive restraint subscale, Emotional Appetite Questionnaire-negative, and PEMS-conformity motives were found for predictors for Eating Attitudes Test-26 (all p<0.05). Conclusion: The results showed a high tendency for emotional eating, consumption of palatable foods, and cognitive dietary restraint in young adults, and these factors were considered determinants for eating disorders.
RESUMO Objetivo: O objetivo do estudo foi investigar as relações entre o índice de massa corporal, as razões para consumir alimentos palatáveis, o comer emocional, a restrição alimentar cognitiva e os comportamentos de desordem alimentar em jovens adultos. Métodos: Este estudo foi realizado com 800 jovens adultos, em Ancara, na Turquia. Foi aplicado um questionário composto por perguntas sobre características sociodemográficas, estado de saúde e instrumentos, incluindo o Eating Attitudes Test-26, o Emotional Appetite Questionnaire, a Palatable Eating Motives Scale e o The Three-Fator Eating Questionnaire, através de entrevistas presenciais. Resultados: De acordo com o Eating Attitudes Test-26, 17,2% dos homens e 27,7% das mulheres estavam em risco de desenvolver comportamentos alimentares desordenados (χ2=9,750, p=0,002). As pontuações médias do Three-Fator Eating Questionnaire-emotional eating, as subescalas de restrição cognitiva e as pontuações positivas e negativas do Emotional Appetite Questionnaire foram mais elevadas no sexo masculino do que no feminino (p<0,05). As pontuações médias da Palatable Eating Motives Scale - motivos de coping e de aumento da recompensa - foram mais elevadas no sexo feminino, enquanto a pontuação média para os motivos de conformidade foi significativamente mais elevada no sexo masculino. O índice de massa corporal, o Three-Fator Eating Questionnaire-subescala de contenção cognitiva, o Emotional Appetite Questionnaire-negativo e o PEMS-motores de conformidade foram encontrados como preditores do Eating Attitudes Test-26 (todos p<0,05). Conclusão: Os resultados mostraram uma elevada tendência para a alimentação emocional, o consumo de alimentos palatáveis e a restrição alimentar cognitiva em adultos jovens, sendo estes factores considerados determinantes para as perturbações alimentares.