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Gomes R, Machin R, Nascimento MAFD, Couto MT. Discussing the relationships between homoparenthood and health. Cien Saude Colet 2024; 29:e18412023. [PMID: 38655960 DOI: 10.1590/1413-81232024294.18412023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 11/30/2023] [Indexed: 04/26/2024] Open
Abstract
The present article aims to bridge the gaps or deepen the debate to discuss the relationship between homoparenthood and health. This essay is anchored in specific literature. We seek to work on the following questions throughout the text: (i) How is the central theme of this discussion historically outlined? (ii) How does homoparenthood appear in scientific health production in general? (iii) What sociopolitical dimensions emerge around homoparenthood-health relationships? and (iv) What are the limitations and possibilities for exercising reproductive rights between same-sex couples? Among the conclusions, we underscore the challenge of facing the strangeness of homoparenthood against the idea of the so-called called "normal" family based on heteronormative logic. Even in countries with some legal apparatus assuring the rights to homoparental families, their members suffer prejudice, discrimination, and violence.
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Affiliation(s)
- Romeu Gomes
- Instituto Fernandes Figueira, Fundação Oswaldo Cruz. Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil.
| | - Rosana Machin
- Departamento de Medicina Preventiva, Universidade de São Paulo. São Paulo SP Brasil
| | | | - Marcia Tereza Couto
- Departamento de Medicina Preventiva, Universidade de São Paulo. São Paulo SP Brasil
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2
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Gomes R, Machin R, Nascimento MAFD, Couto MT. Homoparenting: challenges for public health. Cien Saude Colet 2024; 29:e00162024. [PMID: 38655950 DOI: 10.1590/1413-81232024294.00162024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Affiliation(s)
- Romeu Gomes
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente, Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil
- Diretoria Compromisso Social, Hospital Sírio-Libanês. São Paulo SP Brasil
| | - Rosana Machin
- Faculdade de Medicina, Universidade de São Paulo. São Paulo SP Brasil
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3
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Mesquita JA, Nascimento MAFD. Digital activism about gay fatherhood on Instagram: male homoparenting in the picture. Cien Saude Colet 2024; 29:e19402023. [PMID: 38655966 DOI: 10.1590/1413-81232024294.19402023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/15/2023] [Indexed: 04/26/2024] Open
Abstract
In contemporary Brazil, the number of male fathers taking care of their sons and daughters and the initiatives to produce content about fatherhood on Instagram have been significant. This article aims to analyze the concepts that support the digital activism of homoparenting on Instagram, based on gender studies with men. To this end, a qualitative study was conducted using the life narrative method in a digital environment. The results were analyzed and divided into the following sections: parenting project, personal experience of fatherhood, articulation with LGBT political agenda when parenthood becomes a "business", and haters, criticism, and adverse reactions. It was concluded that the reflection on the experience of fatherhood/masculinity itself is crossed by the social marker of the difference in sexual orientation and the activism for rights that sustain content production. Thus, the uniqueness of each fatherhood is highlighted since the fact of being gay constructs the fatherhood experience for each man. Despite the initiatives brought forth in this study, changes are still in progress, as rights activism coexists with the advancement of conservative forces, which limit the expressions of sexual and gender otherness.
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Affiliation(s)
- Juliana Araujo Mesquita
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz. Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil.
| | - Marcos Antonio Ferreira do Nascimento
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz. Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil.
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Moreira MCN, Mendes CHF, Nascimento MAFD, Melo APLD, Albuquerque MDSVD, Kuper H, Pinto M, Penn-Kenkana L, Moreira MEL. Stigmas of congenital Zika syndrome: family perspectives. CAD SAUDE PUBLICA 2022; 38:e00104221. [DOI: 10.1590/0102-311x00104221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 11/19/2021] [Indexed: 11/22/2022] Open
Abstract
This article uses a socio-anthropological framework to explore the stigmas around interactions with children born with congenital Zika syndrome caused by the Zika virus epidemic in two Brazilian municipalities. Semi-structured interviews were conducted with parents and other relatives. We reflected on the search for meaning when having a baby with unexpected body marks, the moral suffering, the societal ableism, the burden of care, and the need for support networks. We concluded that public policies, especially social policies (health, education, and social assistance), are essential for compensatory mechanisms, recognition, and social inclusion of these children and their families.
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Affiliation(s)
| | | | | | | | | | - Hannah Kuper
- London School of Hygiene & Tropical Medicine, U.K
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5
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Ferrari W, Nascimento MAFD, Nogueira C, Rodrigues L. Violence in the affective-sexual trajectories of young gay men: "new" settings and "old" challenges. Cien Saude Colet 2021; 26:2729-2738. [PMID: 34231686 DOI: 10.1590/1413-81232021267.07252021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 03/31/2021] [Indexed: 11/22/2022] Open
Abstract
This paper discusses the phenomenon of violence in the affective-sexual trajectories of young, cisgender gay men, from popular strata, in the metropolitan region of Rio de Janeiro, Brazil. Brazilian literature on violence against gay men generally focuses on the discrimination suffered by this population. However, the violence they are submitted to among family relationships due to their sexual orientation, or even their relationships known as "dating" or "hookup", is hardly discussed. This qualitative study used in-depth interviews based on a semi-structured guide to discuss violence during the young gay men's affective-sexual trajectory. The results evidenced multiple faces of violence during childhood and adolescence in family relationships, spanning their affective-sexual relationships in adolescence and youth, including sexual, physical, psychological, and institutional violence. Support networks are limited, for example, to a few friends and access to blogs on the Internet. No health professional was cited as a helping source. There is a need to discuss the prevention of violence and discuss health promotion of this social group, expanding the perspective on the various contemporary ways of relating intimately.
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Affiliation(s)
- Wendell Ferrari
- Programa de Pós-Graduação em Saúde da Criança e da Mulher, Instituto Fernandes Figueira, Fundação Oswaldo Cruz. Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil.
| | - Marcos Antonio Ferreira do Nascimento
- Programa de Pós-Graduação em Saúde da Criança e da Mulher, Instituto Fernandes Figueira, Fundação Oswaldo Cruz. Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil.
| | - Conceição Nogueira
- Faculdade de Psicologia e Ciências da Educação, Universidade do Porto. Porto Portugal
| | - Liliana Rodrigues
- Faculdade de Psicologia e Ciências da Educação, Universidade do Porto. Porto Portugal
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Simas C, Penn-Kekana L, Kuper H, Lyra TM, Moreira MEL, de Albuquerque MDSV, de Araújo TVB, de Melo APL, Figueira Mendes CH, Nunes Moreira MC, Ferreira do Nascimento MA, Pimentel C, Pinto M, Valongueiro S, Larson H. Hope and trust in times of Zika: the views of caregivers and healthcare workers at the forefront of the epidemic in Brazil. Health Policy Plan 2020; 35:953-961. [PMID: 32681164 PMCID: PMC7553755 DOI: 10.1093/heapol/czaa042] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2020] [Indexed: 12/16/2022] Open
Abstract
This article investigates how hope and trust played out for two groups at the forefront of the Zika epidemic: caregivers of children with congenital Zika syndrome and healthcare workers. We conducted 76 in-depth interviews with members of both groups to examine hope and trust in clinical settings, as well as trust in public institutions, in the health system and in the government of Brazil. During and after the Zika epidemic, hope and trust were important to manage uncertainty and risk, given the lack of scientific evidence about the neurological consequences of Zika virus infection. The capacity of healthcare workers and caregivers to trust and to co-create hope seems to have allowed relationships to develop that cushioned social impacts, reinforced adherence to therapeutics and enabled information flow. Hope facilitated parents to trust healthcare workers and interventions. Hope and trust appeared to be central in the establishment of support networks for caregivers. At the same time, mistrust in the government and state institutions may have allowed rumours and alternative explanations about Zika to spread. It may also have strengthened activism in mother's associations, which seemed to have both positive and negative implications for healthcare service delivery. The findings also point to distrust in international health actors and global health agenda, which can impact community engagement in future outbreak responses in Brazil and other countries in Latin America.
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Affiliation(s)
- Clarissa Simas
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Loveday Penn-Kekana
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Hannah Kuper
- International Centre for Evidence in Disability, Clinical Research Department, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Tereza Maciel Lyra
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães/Fiocruz, Avenida Professor Moraes Rêgo, S/N Cidade Universitária. CEP 50740-465, Recife, PE, Brasil
- Department of Social Medicine, Faculty of Medicine, Federal University of Pernambuco, Avenida da Engenharia, S/N, Bloco D, 1º Andar, Cidade Universitária. CEP: 50.740-600 Recife, PE, Brazil
| | - Maria Elisabeth Lopes Moreira
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira/Fiocruz, Avenida Rui Barbosa, 716 - Flamengo, Rio de Janeiro, RJ 20021-140, Brazil
| | - Maria do Socorro Veloso de Albuquerque
- Postgraduate Programme in public Health, Center of Medical Sciences, Federal University of Pernambuco. Avenida Professor Moraes Rêgo, S/N Hospital das Clínicas, Bloco E, 4o.andar. Cidade Unitersitária, CEP 50.670-901, Recife -PE, Brazil
| | - Thália Velho Barreto de Araújo
- Postgraduate Programme in Public Health, Center of Medical Sciences, Federal University of Pernambuco, Avenida Professor Moraes Rêgo, S/N Hospital das Clínicas, Bloco E - 4º Andar, Cidade Universitária, CEP: 50.670-901, Recife, PE, Brazil
| | - Ana Paula Lopes de Melo
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães/Fiocruz, Avenida Professor Moraes Rêgo, S/N Cidade Universitária. CEP 50740-465, Recife, PE, Brasil
- Núcleo de Saúde Coletiva da Universidade Federal de Pernambuco R. Alto do Reservatório - Alto José Leal, Vitória de Santo Antã - PE-Brasil, 55608-250l
| | - Corina Helena Figueira Mendes
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira/Fiocruz, Avenida Rui Barbosa, 716 - Flamengo, Rio de Janeiro, RJ 20021-140, Brazil
| | - Martha Cristina Nunes Moreira
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira/Fiocruz, Avenida Rui Barbosa, 716 - Flamengo, Rio de Janeiro, RJ 20021-140, Brazil
| | - Marcos Antonio Ferreira do Nascimento
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira/Fiocruz, Avenida Rui Barbosa, 716 - Flamengo, Rio de Janeiro, RJ 20021-140, Brazil
| | - Camila Pimentel
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães/Fiocruz, Avenida Professor Moraes Rêgo, S/N Cidade Universitária. CEP 50740-465, Recife, PE, Brasil
| | - Marcia Pinto
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira/Fiocruz, Avenida Rui Barbosa, 716 - Flamengo, Rio de Janeiro, RJ 20021-140, Brazil
| | - Sandra Valongueiro
- Postgraduate Programme in Public Health, Center of Medical Sciences, Federal University of Pernambuco, Avenida Professor Moraes Rêgo, S/N Hospital das Clínicas, Bloco E - 4º Andar, Cidade Universitária, CEP: 50.670-901, Recife, PE, Brazil
| | - Heidi Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
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Campos DDS, Moreira MCN, Nascimento MAFD. [Navigating in rare oceans: notes from a family survey of children and adolescents living with rare diseases]. Cien Saude Colet 2020; 25:421-428. [PMID: 32022183 DOI: 10.1590/1413-81232020252.11542018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 05/23/2018] [Indexed: 11/22/2022] Open
Abstract
This article seeks to highlight the construction of social navigation in a hospital. Our focus is to reflect on scenes of application of a questionnaire on family costs of care/treatment of children with rare diseases. These processes are linked to the markers of gender, race, and generation of one of the authors. The interaction between researcher and subjects of field research is socially constructed according to the specific circumstances that demarcate the invitation to participate in the research, as well as data collection. It implies that his position as a researcher and the ethical perspective need to be well defined. The approach and ethics build this social navigation with the hospital and the subjects are permeated by difficulty and uncertainty, but also by surprises and learning. It was possible to observe remarkable characteristics of the institution, of their employees and the families, to evaluate the used methodological strategies.
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Affiliation(s)
- Daniel de Souza Campos
- Instituto Nacional de Saúde da Mulher da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz. Av. Rui Barbosa 716, Flamengo. 22250-020, Rio de Janeiro, RJ, Brasil.
| | - Martha Cristina Nunes Moreira
- Instituto Nacional de Saúde da Mulher da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz. Av. Rui Barbosa 716, Flamengo. 22250-020, Rio de Janeiro, RJ, Brasil.
| | - Marcos Antonio Ferreira do Nascimento
- Instituto Nacional de Saúde da Mulher da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz. Av. Rui Barbosa 716, Flamengo. 22250-020, Rio de Janeiro, RJ, Brasil.
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Moreira MCN, Nascimento MAFD, Campos DDS, Albernaz L, Costa ACCD, Barros LBDP, Horovitz DDG, Martins AJ, Madureira AF, Oliveira NVD, Pinto M. Rare diseases and the associative dialogue: resignifications for moral experiences. Cien Saude Colet 2019; 24:3673-3682. [PMID: 31576997 DOI: 10.1590/1413-812320182410.11822019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/05/2019] [Indexed: 11/22/2022] Open
Abstract
This paper aims to discuss the experience of relatives of children and adolescents with rare diseases as a moral experience. Moral experience is characterized by suffering that is socially interpreted as a catastrophic event, mobilizing resources for signification and meaning that allow the reconstruction of identity, the appreciation of itineraries from a rare diagnosis, as well as the search for peers. Thus, the construction of relationships of recognition, alterity, and belonging is fundamental. From a symbolic interactionist perspective, the results show two significant cores: (1) shock as a surprise in the face of an unexpected diagnosis, leading to the search for peers and promotion of social recognition; (2) the cost involved with the course of a rare disease that implies a care work and the acquisition of associative capital as a possibility of strengthening and building the social capital of health care.
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Affiliation(s)
- Martha Cristina Nunes Moreira
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescentes Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020. Rio de Janeiro, RJ, Brasil.
| | - Marcos Antonio Ferreira do Nascimento
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescentes Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020. Rio de Janeiro, RJ, Brasil.
| | - Daniel de Souza Campos
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescentes Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020. Rio de Janeiro, RJ, Brasil.
| | - Lidianne Albernaz
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescentes Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020. Rio de Janeiro, RJ, Brasil.
| | - Ana Carolina Carioca da Costa
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescentes Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020. Rio de Janeiro, RJ, Brasil.
| | - Letícia Baptista de Paula Barros
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescentes Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020. Rio de Janeiro, RJ, Brasil.
| | - Dafne Dain Gandelman Horovitz
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescentes Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020. Rio de Janeiro, RJ, Brasil.
| | - Antilia Januária Martins
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescentes Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020. Rio de Janeiro, RJ, Brasil.
| | - Adelino Furtado Madureira
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescentes Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020. Rio de Janeiro, RJ, Brasil.
| | | | - Márcia Pinto
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescentes Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020. Rio de Janeiro, RJ, Brasil.
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Kuper H, Lyra TM, Moreira MEL, de Albuquerque MDSV, de Araújo TVB, Fernandes S, Jofre-Bonet M, Larson H, Lopes de Melo AP, Mendes CHF, Moreira MCN, do Nascimento MAF, Penn-Kekana L, Pimentel C, Pinto M, Simas C, Valongueiro S. Social and economic impacts of congenital Zika syndrome in Brazil: Study protocol and rationale for a mixed-methods study. Wellcome Open Res 2019; 3:127. [PMID: 31667356 PMCID: PMC6807146 DOI: 10.12688/wellcomeopenres.14838.2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2019] [Indexed: 12/22/2022] Open
Abstract
Global concern broke out in late 2015 as thousands of children in Brazil were born with microcephaly, which was quickly linked to congenital infection with Zika virus (ZIKV). ZIKV is now known to cause a wider spectrum of severe adverse outcomes-congenital Zika syndrome (CZS)-and also milder impairments. This study aimed to explore the social and economic impacts of CZS in Brazil. Data was collected through mixed methods across two settings: Recife City and Jaboatão dos Guararapes in Pernambuco State (the epicentre of the epidemic), and the city of Rio de Janeiro (where reports of ZIKV infection and CZS were less frequent). Data was collected May 2017-January 2018. Ethical standards were adhered to throughout the research. In-depth qualitative interviews were conducted with: mothers and other carers of children with CZS (approximately 30 per setting), pregnant women (10-12 per setting), men and women of child-bearing age (16-20 per setting), and health professionals (10-12 per setting). Thematic analysis was undertaken independently by researchers from at least two research settings, and these were shared for feedback. A case-control study was undertaken to quantitatively explore social and economic differences between caregivers of a child with CZS (cases) and caregivers with an unaffected child (controls). We aimed to recruit 100 cases and 100 controls per setting, from existing studies. The primary caregiver, usually the mother, was interviewed using a structured questionnaire to collect information on: depression, anxiety, stress, social support, family quality of life, health care and social service use, and costs incurred by families. Multivariable logistic regression analyses were used to compare outcomes for cases and controls. Costs incurred as a result of CZS were estimated from the perspective of the health system, families and society. Modelling was undertaken to estimate the total economic burden of CZS from those three perspectives.
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Affiliation(s)
- Hannah Kuper
- International Centre for Evidence in Disability, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Tereza Maciel Lyra
- Aggeu Magalhães Institute, FIOCRUZ/PE, Recife, Brazil.,Faculty of Medicine, University of Pernambuco, Recife, Brazil
| | | | | | | | - Silke Fernandes
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Heidi Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Ana Paula Lopes de Melo
- Aggeu Magalhães Institute, FIOCRUZ/PE, Recife, Brazil.,Public Health Department, Federal University of Pernambuco, Recife, Brazil
| | | | | | | | - Loveday Penn-Kekana
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Marcia Pinto
- Fernando Figueira Maternal and Children's Institute, Rio de Janeiro, Brazil
| | - Clarissa Simas
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Sandra Valongueiro
- Postgraduate Programme in Public Health, Federal University of Pernambuco, Recife, Brazil
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10
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Kuper H, Lyra TM, Moreira MEL, de Albuquerque MDSV, de Araújo TVB, Fernandes S, Jofre-Bonet M, Larson H, Lopes de Melo AP, Mendes CHF, Moreira MCN, do Nascimento MAF, Penn-Kekana L, Pimentel C, Pinto M, Simas C, Valongueiro S. Social and economic impacts of congenital Zika syndrome in Brazil: Study protocol and rationale for a mixed-methods study. Wellcome Open Res 2019; 3:127. [PMID: 31667356 DOI: 10.12688/wellcomeopenres.14838.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2018] [Indexed: 11/20/2022] Open
Abstract
Global concern broke out in late 2015 as thousands of children in Brazil were born with microcephaly, which was quickly linked to congenital infection with Zika virus (ZIKV). ZIKV is now known to cause a wider spectrum of severe adverse outcomes-congenital Zika syndrome (CZS)-and also milder impairments. This study aimed to explore the social and economic impacts of CZS in Brazil. Data was collected through mixed methods across two settings: Recife City and Jaboatão dos Guararapes in Pernambuco State (the epicentre of the epidemic), and the city of Rio de Janeiro (where reports of ZIKV infection and CZS were less frequent). Data was collected May 2017-January 2018. Ethical standards were adhered to throughout the research. In-depth qualitative interviews were conducted with: mothers and other carers of children with CZS (approximately 30 per setting), pregnant women (10-12 per setting), men and women of child-bearing age (16-20 per setting), and health professionals (10-12 per setting). Thematic analysis was undertaken independently by researchers from at least two research settings, and these were shared for feedback. A case-control study was undertaken to quantitatively explore social and economic differences between caregivers of a child with CZS (cases) and caregivers with an unaffected child (controls). We aimed to recruit 100 cases and 100 controls per setting, from existing studies. The primary caregiver, usually the mother, was interviewed using a structured questionnaire to collect information on: depression, anxiety, stress, social support, family quality of life, health care and social service use, and costs incurred by families. Multivariable logistic regression analyses were used to compare outcomes for cases and controls. Costs incurred as a result of CZS were estimated from the perspective of the health system, families and society. Modelling was undertaken to estimate the total economic burden of CZS from those three perspectives.
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Affiliation(s)
- Hannah Kuper
- International Centre for Evidence in Disability, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Tereza Maciel Lyra
- Aggeu Magalhães Institute, FIOCRUZ/PE, Recife, Brazil.,Faculty of Medicine, University of Pernambuco, Recife, Brazil
| | | | | | | | - Silke Fernandes
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Heidi Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Ana Paula Lopes de Melo
- Aggeu Magalhães Institute, FIOCRUZ/PE, Recife, Brazil.,Public Health Department, Federal University of Pernambuco, Recife, Brazil
| | | | | | | | - Loveday Penn-Kekana
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Marcia Pinto
- Fernando Figueira Maternal and Children's Institute, Rio de Janeiro, Brazil
| | - Clarissa Simas
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Sandra Valongueiro
- Postgraduate Programme in Public Health, Federal University of Pernambuco, Recife, Brazil
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Nascimento MAFD, Uziel AP, Hernández JDG. Young men in juvenile detention centers in Rio de Janeiro, Brazil: gender, sexuality, masculinity and health implications. CAD SAUDE PUBLICA 2018; 34:e00177916. [PMID: 29489951 DOI: 10.1590/0102-311x00177916] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 04/25/2017] [Indexed: 11/22/2022] Open
Abstract
This article presents results for young men's health based on an intervention-study on gender, sexuality, and health of adolescents and young men in conflict with the law, deprived of their freedom, and subject to socio-educational confinement in Rio de Janeiro, Brazil. The themes addressed included questions on overall health, mental health, and sexual and reproductive health, analyzed from a relational gender perspective and social construction of masculinities. The majority of these young men are black, from low-income communities, with low schooling levels, and ranging in age from 14 to 21 years of age; some of them are fathers. The study showed that these young men have been exposed to police and social violence from a very early age and have been deprived of their freedom due to involvement with the drug traffic, homicides, or episodes of sexual violence. The male and female health professionals that work with them report that the most common health problems are skin conditions, mental disorders, and sexually transmissible infections. Male chauvinism and rigid notions of gender and sexuality are important factors in the views of these young men on health (especially sexual and reproductive). Their discourse takes violence and paternity for granted as important signs in the public demonstration of masculinity. There is an urgent need to include discussions on gender and sexuality in health professionals' training and activities with these young men. It is also necessary to call attention to the strong influence of gender concepts, social group, and sexual orientation in practices, interpersonal relations, and health promotion.
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Affiliation(s)
| | - Anna Paula Uziel
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
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Moreira MCN, Nascimento MAFD, Horovitz DDG, Martins AJ, Pinto M. Quando ser raro se torna um valor: o ativismo político por direitos das pessoas com doenças raras no Sistema Único de Saúde. CAD SAUDE PUBLICA 2018; 34:e00058017. [DOI: 10.1590/0102-311x00058017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 11/30/2017] [Indexed: 11/22/2022] Open
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