RESUMO
Of the many evils that were inflicted upon the army of the West India Company in its years of activity in Brazil, few could be compared to diseases. However, there is little quantitative data in the field of historiography regarding the impact of disease on these troops. Apart from the limited amount of information about the diseases that affected many soldiers, little is known about the medical treatments that were available, the main diseases that affected the troops, and what were the causes. This article provides information to understand aspects that have been little studied in quantitative and systematic terms in the field of historiography, and demonstrates how the diseases afflicted the Company and affected its actions in the territory.
Assuntos
Doenças Transmissíveis/história , Deficiências Nutricionais/história , Militares/história , Brasil/epidemiologia , Doenças Transmissíveis/mortalidade , Doenças Transmissíveis/terapia , Deficiências Nutricionais/mortalidade , Deficiências Nutricionais/terapia , História do Século XVII , Humanos , Medicina Militar/história , Países BaixosRESUMO
Dos diversos males que infligiram o exército da Companhia das Índias Ocidentais em seus anos de atividade no Brasil, poucos podem ser comparados às doenças. São escassos, todavia, os dados quantitativos apresentados na historiografia para mostrar seu impacto nas tropas. Além dos índices de baixas por doença que ceifavam muitos militares, sabe-se pouco sobre os tratamentos médicos oferecidos, as principais doenças que atingiam a tropa e suas causas. Este artigo traz elementos que ajudam a compreender aspectos pouco trabalhados em termos quantitativos e sistemáticos pela historiografia e demonstra como as doenças afligiam a companhia e embaraçavam suas ações no território.
Of the many evils that were inflicted upon the army of the West India Company in its years of activity in Brazil, few could be compared to diseases. However, there is little quantitative data in the field of historiography regarding the impact of disease on these troops. Apart from the limited amount of information about the diseases that affected many soldiers, little is known about the medical treatments that were available, the main diseases that affected the troops, and what were the causes. This article provides information to understand aspects that have been little studied in quantitative and systematic terms in the field of historiography, and demonstrates how the diseases afflicted the Company and affected its actions in the territory.
Assuntos
Humanos , História do Século XVII , Doenças Transmissíveis/história , Deficiências Nutricionais/história , Militares/história , Brasil/epidemiologia , Doenças Transmissíveis/mortalidade , Doenças Transmissíveis/terapia , Deficiências Nutricionais/mortalidade , Deficiências Nutricionais/terapia , Medicina Militar/história , Países BaixosRESUMO
OBJECTIVE: To determine the effects of dietary supplements containing bovine serum concentrate (BSC, a source of immunoglobulins) and/or multiple micronutrients (MMN) on children's growth velocity, rates of common infections, and MN status. DESIGN: Randomized, controlled, community-based intervention trial. SETTING: Low-income, peri-urban Guatemalan community. SUBJECTS: Children aged 6-7 months initially. INTERVENTIONS: Children received one of four maize-based dietary supplements daily for 8 months, containing: (1) BSC, (2) whey protein concentrate (WPC, control group), (3) WPC+MMN, or (4) BSC+MMN. RESULTS: There were no significant differences in growth or rates of morbidity by treatment group. Children who received MMN had lower rates of anemia and (in the group that received WPC+MMN) less of a decline in serum ferritin than those who did not, but there were no differences in other biochemical indicators of MN status by treatment group. CONCLUSIONS: MMN supplementation reduced anemia and iron deficiency in this population, but the MMN content and source of protein in the supplements did not affect other indicators of MN status, growth or morbidity.
Assuntos
Desenvolvimento Infantil/efeitos dos fármacos , Suplementos Nutricionais , Crescimento/efeitos dos fármacos , Micronutrientes/farmacologia , Estado Nutricional , Soroalbumina Bovina/farmacologia , Anemia/tratamento farmacológico , Anemia/epidemiologia , Anemia/mortalidade , Deficiências Nutricionais/tratamento farmacológico , Deficiências Nutricionais/epidemiologia , Deficiências Nutricionais/mortalidade , Método Duplo-Cego , Feminino , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/mortalidade , Transtornos do Crescimento/prevenção & controle , Guatemala , Humanos , Lactente , Alimentos Infantis , Fenômenos Fisiológicos da Nutrição do Lactente , Masculino , Micronutrientes/administração & dosagem , Proteínas do Leite , Morbidade , Prevalência , Soroalbumina Bovina/administração & dosagem , Fatores Socioeconômicos , Resultado do Tratamento , Proteínas do Soro do LeiteRESUMO
In Costa Rica, three sequential health paradigms have been identified over the last 50 years. The first began to develop during the 40's and has been called that of the deficiency diseases, since with a diachronic approach it placed excessive emphasis on malnutrition. The second began in 1970 and it is known as that of the infectious diseases, since through a holistic or synchronic approach, it underlined the importance of infections in high rates of morbidity and mortality. The third and last is the paradigm of the chronic diseases, it appeared in the 80's and is presently in process, doing battle with the chronic ailments, life styles, and environment, and it also utilizes a holistic approach. The recognition of these three paradigms has permitted Costa Rica a rapid advance in improving the health of its population, to the point that with a per capita outlay of $130 (US dollars), it has indices similar to those of the industrialized nations. This particular experience could be useful for other less-developed countries that are still applying the paradigm of the deficiency diseases.
PIP: Costa Rica's health care experience is explained in terms of 3 sequential paradigms. The 1st malnutrition paradigm (1940-69) considers the causes of ill health as poverty, ignorance, exploitation, and food shortages. The problems are malnutrition, parasitosis, infectious diseases, high mortality, high rates of hospitalization, and requiring health and hospital based services. The strategies were to improve diet through food distribution, create nutrition departments within the Ministries of Health, increase the number of doctors and nurses, and politicize medicine. Socialism was the model and economic growth and industrialization were seen as prerequisites. Curative medicine was practiced. The attitude was hopelessness is being able to solve problems and acceptance of the status quo. The 2nd infectious disease paradigm (the 1970s) focused the causes as infectious diseases, intestinal parasitosis, unwanted pregnancy, low birth weight, artificial feeding, and limited health services supply, which were given priority. Primary health care for all and health sector reform were some of the strategies. Healthier families were thought to contribute more to economic and social development. Full health services were promoted and the politicization of medicine was reduced. The attitude changed to one of being able to solve one's own problems. The National Health System began to evolve based on a holistic approach where the environment and the life cycle were integrated. Implementation of the national framework was replicated at the regional and local levels; institutions and programs were integrated in a synchronic approach so that the effects of infection, malnutrition, and fertility on human growth and development were considered. Infant mortality dropped by 70%, and infectious diseases were eliminated or greatly reduced. The 3rd chronic disease paradigm (1980s) assumes the causes to be unwanted children, insufficient prenatal and maternity care, inadequate environmental conditions, inadequate life style, and social pathology. The approach is holistic. The philosophical base is the development of individual responsibility and efficient use of science and technology; health contributes to democracy and peace. Prevention, cure, and rehabilitation are equal. The application to other countries must consider that there are more technological options but fewer resources. Rigid and dogmatic plans will not work.
Assuntos
Atenção à Saúde/tendências , Planejamento em Saúde/tendências , Modelos Teóricos , Filosofia Médica , Adulto , Atitude Frente a Saúde , Doença Crônica/epidemiologia , Doença Crônica/mortalidade , Controle de Doenças Transmissíveis , Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/mortalidade , Costa Rica/epidemiologia , Deficiências Nutricionais/epidemiologia , Deficiências Nutricionais/mortalidade , Deficiências Nutricionais/prevenção & controle , Atenção à Saúde/organização & administração , Atenção à Saúde/normas , Promoção da Saúde , Humanos , Mortalidade Infantil/tendências , Recém-NascidoRESUMO
This paper attempts to give an overview of current levels of child mortality prevailing in the world. It also examines trends and socioeconomic differentials in child mortality for selected countries and regions of the world. Lastly it reviews data on causes of child death and related environmental factors. The paper concludes that despite the fact that child deaths are frequently avoidable, mortality differentials between the developed and developing regions of the world are more pronounced in childhood (ages one to under five years) than at any other time of life. While some developing countries have substantially reduced the level of mortality in childhood, in others it remains very high. In contrast, in most developed countries child death rates are now so low, that they no longer serve as useful measures of public health.