Introducao - Ha reduzido conhecimento no campo da Saude Publica sobre a funcao social da midia em saude e, particularmente, sobre a relacao entre a midia e o contexto de uma epidemia associada a vetores biologicos, como a dengue. Diante desse quadro, optou-se por estudar a primeira epidemia de dengue em Ribeirao Preto, a qual ocorreu entre novembro de 1990 e marco de 1991. O fato dessa epidemia, assim como as demais, ter sido estudada apenas em seu aspecto biologico, desconsiderando o aspecto social, justifica a realizacao deste estudo. Objetivo - Investigar como se deu a construcao midiatica da primeira epidemia de dengue no municipio de Ribeirao Preto, de novembro de 1990 a marco de 1991, para os leitores dos jornais e revistas veiculadas na epoca. Metodo O material de pesquisa foram reportagens de jornais e revistas confeccionadas na regiao de Ribeirao Preto e na capital do Estado de Sao Paulo - as de grande circulacao na epoca da primeira epidemia de dengue em Ribeirao Preto, de novembro de 1990 a marco de 1991. O metodo adotado foi o Discurso do Sujeito Coletivo, fundamentado na Teoria das Representacoes Sociais. Resultados Foram resgatadas as representacoes sociais veiculadas pela midia e o poder de difusao dessas representacoes no processo de divulgacao cientifica para o publico em geral durante a primeira epidemia de dengue. A analise do conteudo midiatico permitiu apresentar os principais assuntos veiculados no noticiario por meio da elaboracao dos discursos. Conclusoes Foi possivel entender como se deu a construcao dos sentidos acerca da dengue: o jornal fez existir uma realidade epidemica. Comprovou-se a defasagem na informacao disponibilizada nos meios de comunicacao e observou-se vies politico nas reportagens veiculadas, desviando a atencao que deveria ser direcionada para educacao e promocao da saude. Salientou-se a importancia de formacao de profissionais que transitem na interface Saude Publica e Comunicacao para que questoes politicas nao prevalecam sobre questoes prioritarias de saude na midia impressa / Introduction There is limited knowledge in the field of Public Health about the social role of media in health and particularly on the relationship between the media and the context of an epidemic associated with biological vectors such as dengue. So, it was decided to study the first epidemic of dengue at Ribeirao Preto, which occurred between November 1990 and March 1991. This epidemic, like the others, was studied only in its biological aspect, ignoring the social aspect, which justifies this study. Aim The aim of this study was to investigate how was the media construction of the first epidemic of dengue in Ribeirao Preto, from November 1990 to March 1991 for the readers of newspapers and magazines circulating at the time. Method The research material were reports of newspapers and magazines made at Ribeirao Preto and at the capital of the State of Sao Paulo - the large circulation - at the time of the first dengue epidemic at Ribeirao Preto, from November 1990 to March 1991. The method adopted was the Collective Subject Discourse, which is based on the Social Representations Theory. Results Social representations in the media were rescued in the media and also the power of diffusion of these representations in the process of scientific diffusion to the general public during the first dengue epidemic. The analysis of media content allowed to present the main issues in the newspapers and magazines through the speeches elaboration. Conclusions In this research, it could be understood how was the construction of meanings about dengue: the newspaper created a reality epidemic. The lag of information provided by mass media was proven and there was political bias in the news published, diverting the attention that should be directed towards education and health promotion. A professional transiting the interface Public Health and Communication is important so that political issues do not prevail on priority issues of health in printed media

Base teórica: Entende-se como Cuidados Paliativos a abordagem multidisciplinar que promove a qualidade de vida de pacientes e familiares que apresentam diagnósticos que não são reversíveis. Sendo assim, destina-se aos pacientes crônicos e com doenças que ameaçam a vida. O processo de adoecimento do paciente oncológico é marcado por más notícias desde o recebimento do diagnóstico. Compreendemos aqui como má notícia as informações que provocam rupturas ou mudanças negativas na perspectiva de futuro do paciente e de seu grupo familiar. Objetivos: Avaliar a percepção de pacientes e familiares a respeito do processo de comunicação da informação sobre o quadro clínico e prognóstico do paciente oncológico em cuidados paliativos exclusivos. Métodos: Foi realizado um estudo qualitativo exploratório, do tipo estudos de caso. A amostra foi composta por seis pacientes adultos e sete familiares. As entrevistas semi-estruturadas foram realizadas no Núcleo de Cuidados Paliativos (NCP) do Hospital de Clínicas de Porto Alegre. Os dados obtidos foram avaliados por meio de análise de conteúdo com auxílio do programa Nvivo (QRS International), versão 11. Foi reconstruída a rede social de cada paciente, na sua perspectiva pessoal e na do seu familiar. Resultados: Três categorias emergiram da análise das entrevistas: Compreensão do Processo de Adoecimento, Compartilhamento de Informação e Protagonismo do Paciente. O fluxo de informações entre a equipe e o paciente é, habitualmente, intermediado pelos familiares. Foi constatada uma contradição entre o desejo dos pacientes receberem suas informações clínicas e a crença da família de que é protetor não informar. Entre os familiares, é mais habitual a associação entre cuidados paliativos e a gravidade do quadro clínico e o limite de tratamentos com finalidade curativa. Foram verificadas discrepâncias entre as redes sociais descritas pelos pacientes e por seus familiares. Conclusão: Há uma distorção na relação de privacidade das informações, sendo que o entendimento dos participantes é de que esta relação se estabelece entre familiar e equipe, e não entre equipe e paciente. Os conflitos e as limitações na comunicação geram danos ao paciente, que não se beneficia de forma plena da estrutura e das possibilidades propostas pela abordagem dos cuidados paliativos nem participa adequadamente do processo de tomada de decisão. / Background: Palliative care is understood as the multidisciplinary approach that promotes the quality of life of patients and families who present diagnoses that are not reversible. Thus, it is intended for chronic and life-threatening patients. The process of illness of the oncological patient is marked by bad news since the receipt of the diagnosis. We understand here as bad news information that causes ruptures or negative changes in the perspective of the future of the patient and his family group. Objectives: To evaluate the perception of patients and their relatives regarding the process of communication of information about the clinical profile and the prognostic of cancer patients in exclusive palliative care. Methods: An exploratory qualitative study was carried out, such as case studies. The sample consisted of six adult patients and seven relatives. The semi-structured interviews were carried out at the Center for Palliative Care of the Hospital de Clínicas de Porto Alegre/Brazil. The obtained data were evaluated through content analysis with the assistance of the software Nvivo (QRS International), version 11. It was reconstructed the social network of each patient, in their personal perspective and that of their relative. Results: Three categories emerged from the analysis of the interviews: Understanding the Process of Illness, Information Sharing and Patient Protagonism. Family members usually mediate the information flow between the team and the patient. There was a contradiction between the patients' desire to receive their clinical information and the family belief of which it is protective not to report. Among relatives, the association with the severity of the clinical condition and the limit of treatments with a curative purpose is more common. There were discrepancies between the social networks described by the patients and their relatives. Conclusion: There is a distortion in the information privacy relationship; participants' understanding is that this relationship is between family and health professional team, not between team and patient. Conflicts and limitations in communication create harm to the patient, who does not fully benefit from the structure and possibilities offered by the palliative care approach and does not participate adequately in the decision-making process.

Introdução: A comunicação de más notícias é uma prática difícil, porém frequente, tornando-se praticamente rotineira no dia-a-dia de médicos. No departamento de emergência, esta categoria de comunicação adquire aspectos bastante particulares. Objetivos: O principal objetivo deste estudo é avaliar a percepção de pacientes e familiares acerca da comunicação de más notícias no departamento de emergência, comparando-as à percepção de médicos residentes. Método: Trata-se de um estudo observacional transversal realizado no departamento de emergência de um hospital universitário terciário. Com o intuito de comparar as percepções de médicos residentes e receptores (pacientes e familiares), foi criado um questionário baseado nas seis recomendações provenientes do protocolo SPIKES (Setting [Ambientação]: questões 1-5; Perception [Percepção]: questão 6; Invitation [Convite]: questão 7; Knowledge [Conhecimento]: questões 8-12; Emotions [Emoções]: questões 13-15; Strategy and Summary [Estratégia e Resumo]: questão 16). Os questionários foram aplicados aos participantes imediatamente após a comunicação de uma má notícia no departamento de emergência. A concordância entre médicos residentes e receptores foi analisada utilizando os testes estatísticos de Kappa e Qui-quadrado. Resultados: Um total de 73 comunicações de más notícias foram analisadas. Os participantes foram 73 médicos residentes, 69 familiares e 4 pacientes. Em geral, houve um baixo nível de concordância entre médicos residentes e receptores acerca de como se deu a comunicação da má notícia no departamento de emergência. O nível de satisfação de pacientes e familiares sobre como os médicos residentes comunicaram estas notícias apresentou média de 3,7 + 0,6 pontos. Em contraste, os médicos residentes demonstraram uma pior percepção do mesmo encontro (2,9 + 0,6 pontos), sendo p < 0.001. Conclusão: Médicos residentes e receptores tendem a discordar em relação a diversos aspectos da comunicação de uma má notícia. As discrepâncias foram mais evidentes em questões envolvendo emoções, convite e privacidade. No entanto, uma importante concordância entre as percepções foi encontrada nas questões técnicas e de conhecimento que surgiram durante a comunicação / Introduction: Breaking bad news is a common and routine practice, performed practically every day by physicians. In the Emergency Department, communication acquires unique aspects. Objective: Our main objective was to assess patient and family member\'s perception about bad news communication in the Emergency Department and compare these with physicians\' perceptions. Method: This is a cross-sectional study performed at the Emergency Department of a tertiary teaching hospital. To compare physicians\' and receivers\' (patient and/or family member) perceptions, we created a survey based on the six attributes derived from the SPIKES protocol (Setting: questions 1-5; Perception: question 6; Invitation: question 7; Knowledge: questions 8-12; Emotions: questions 13-15; Strategy and Summary: question 16). The surveys were applied immediately after bad news communication happened in the Emergency Department. We analyzed agreement amongst participants using Kappa statistics and Qui-squared test to compare proportions. Results: A total of 73 bad news communication encounters were analyzed. The survey respondents were 73 physicians, 69 family members and 4 patients. In general, there is a low level of concordance between physicians\' and receivers\' perceptions of how breaking bad news transpired. The satisfaction level of receivers in regards to breaking bad news by doctors presented a mean of 3.7 + 0.6 points. In contrast, the physicians\' perception of the communication was worse (2.9 + 0.6 points), with p < 0.001. Conclusions: Doctors and receivers disagree in relation to what transpired throughout the bad news communication. Discrepancies were more evident in issues involving emotion, invitation and privacy. However, an important agreement between perceptions was found in technical and knowledge related aspects of the communication

Introdução - A sociedade contemporânea torna-se, nesta primeira década do século XXI, cada vez mais dependente de sistemas de comunicação e das tecnologias de informação. Transpor estas novas perspectivas ao campo da saúde pública seja, possivelmente, a concretização da idéia de saúde como um bem coletivo em direção a uma população mais saudável utilizando-se do campo comunicacional para a sensibilização e riscos de saúde dos sujeitos. Neste contexto, o papel dos meios de comunicação de massa (MCM) é significativo diante das possibilidades de atuarem como ferramentas na mediação para os processos educativos entre os serviços de saúde e a população pela construção e exercício da cidadania. Objetivo - Analisar como a participação social é enunciada nos discursos dos profissionais envolvidos na programação de uma rádio educativa. Método - utilizado da pesquisa qualitativa, de caráter exploratório, transversal, desenvolvida sob o formato de Estudo de Caso, mediante entrevistas semiestruturadas, com questões em aberto, iniciada após prévia aprovação do Comitê de Ética em Pesquisa e consentimento esclarecido oral dos entrevistados. A analise e interpretação seguiu os conceitos da análise temática categorial proposta por Laurence Bardin. Resultados - A participação da comunidade poderia se constituir em um estímulo a autoeducação e neste sentido, a ação educativa se constituiria ao dar voz à própria comunidade e buscar com ela alternativas para uma melhor qualidade de vida por meio de ações educativas na programação. Em todos os modelos de discurso não há identificação de uma estrutura permeável a uma participação efetiva da população no processo produtivo da emissora. Conclusão - A possibilidade de utilização do ambiente radiofônico educativo, no contexto de processo ensino-aprendizagem, deve ser configurada dentro de pressupostos das necessidades epidemiológicas locais estimulando processos criativos na produção, atentos à expectativa dos ouvintes e à política editorial da emissora. / Introduction: contemporary society has increasingly become, in this first decade of the 21st century, more dependent on the communication systems and on the information technology. Transposing these new steps to public health field is possibly the realization of the idea of health as a collective good towards a healthier population, using the communicative field for the people awareness and health risks. In this context, the role played by the mass media is significant because of the possibilities of acting as tools in the mediation for the educative processes between the health services and the population through the construction and practice of the citizenship. Goal: Analyzing how the social participation is stated in the speeches of the professionals who are involved in the programming of an educative radio. Method: qualitative research, with exploratory character, transversal, developed as a Case Study, with semi-structured interviews, with open questions, which started after a previous approval of the Research Ethic Committee and the consent of the people who were interviewed. The analysis and the interpretation followed the concepts of the categorical thematic analysis proposed by Laurence Bardin. Results: Community participation could constitute an incentive to self-education and in this sense , the educational action would constitute the \" give voice \" to the community and seek with her alternatives for a better quality of life through educational activities in programming. In all speech models no identification of a permeable structure the effective participation of the population in the production of the issuing process. Conclusion: The possibility of using the educational radiofonic environment in the context of teaching-learning process, must be set within the assumptions yet creative epidemiological local stimulating creative processes in production, attentive to the expectations of listeners and the station editorial policy.

A literatura demonstra que a dimensão espiritual tem impacto na saúde biopsicossocial, sendo associada à preservação da saúde mental, qualidade de vida e redução da mortalidade global e cardiovascular. Contudo, são descritas várias barreiras para a abordagem clínica da espiritualidade do paciente, como a falta de tempo ou treinamento sobre o assunto, além dos valores pessoais e religiosos do profissional. A abordagem da espiritualidade na prática clínica de médicos de família e comunidade (MFC) ainda é um desafio e, com isso, a presente dissertação descreve aspectos da dimensão espiritual e religiosa de MFC brasileiros, com residência médica na área, além de apresentar aspectos sobre a inserção do tema da espiritualidade/religiosidade (E/R) na prática clínica desse grupo de profissionais. Para tanto, foi realizado um estudo observacional transversal por meio de questionário online. Os dados foram analisados quantitativamente por meio de medidas de frequência numérica, percentual e de tendência central. A frequência e temática abordadas pelos MFC em relação à E/R foram aferidas por meio de constructo que agregou os questionários FICA, HOPE e SPIRITual History. Os escores de bem-estar espiritual e religiosidade dos médicos foram aferidos por meio de escalas bem avaliadas na literatura (respectivamente, FACIT-SpNI e DUREL-P). O inquérito online obteve taxa de resposta de 15,8%, sendo a amostra de maioria do sexo feminino (65,1%), com idade média de 35,8 anos e média de tempo de trabalho na área de 7,9 anos. A atuação profissional se dá em assistência clínica (87,7%) e ensino (67,1%). A maioria (78,4%) declara identificação com uma matriz religiosa, sendo 21,6% católicos, 13,7% espíritas e 11,3% evangélicos. Grande parte da amostra (21,6%) se identificou com mais de uma religião. Os MFC apresentam baixa religiosidade organizacional (49,3% raramente ou nunca frequentam instituições), porém, forte prática de religiosidade não organizacional (65,4% declaram práticas pessoais no mínimo semanais). O escore de religiosidade intrínseca médio foi de 10,6 (padrão: 3 a 15) e o de bem-estar espiritual foi de 35,7 (padrão: 0-48). Para a prática clínica, houve maior concordância com o conceito de espiritualidade de Puchalski, que apresenta amplitude moderada quando comparado aos conceitos de Anandarajah e Koenig. O grau de concordância apontou no sentido de diferenciação do conceito de espiritualidade em relação à definição de religiosidade. Embora a grande maioria acredite que a E/R influencie muito a saúde (88,4%) e que essa abordagem seja pertinente à prática clínica do MFC (81,2%), apenas 35,0% da amostra se sentia preparada para abordar o tema e a maioria o faz com frequência moderada (50,3%). As principais barreiras para essa abordagem seriam falta de tempo (53,4%), treinamento (39,7%) e valores pessoais, como medo de impor sua religião (27,7%) ou medo de ofender o paciente (23,6%). As áreas mais frequentemente discutidas pelos MFC com os pacientes tratam da rede de suporte social (discutido por 42,8% dos médicos) e resiliência (40,2%). Os temas menos discutidos seriam a relação médico-paciente (não discutido por 74,0%) e as implicações para o plano terapêutico (64,7%) / Researches show that the spiritual dimension influences the biopsychosocial health, being associated with the preservation of mental health, quality of life and reduction of global and cardiovascular mortality. However, there are several barriers for approaching patient\'s spirituality in clinical practice, such as the lack of time or training on this subject and personal values of the professionals, as religiosity. Approaching spirituality is still a challenge for Brazilian Family Physicians (BFP). Then, the present research describes aspects of the spiritual and religious dimensions of Brazilian Family Physicians who had completed medical residency programs in this area. It also shows aspects about the insertion of spirituality/religiosity (S/R) in the clinical practice of this group of professionals. For this reason, we carried out a cross-observational study by means an online questionnaire. We analyzed the data quantitatively by means of simple distribution and frequency measurements. The frequency and thematic discussed by BFP in relation to S/R were measured by an instrument developed using the questionnaires FICA, HOPE and SPIRITual History. We evaluated the doctors\' scores of spiritual- wellbeing and religiosity by means of well-evaluated scales (respectively, FACIT-SpNI and Durel-P). The online survey obtained response rate of 15.8%. The sample had most female (65.1%), average age of 35.8 years-old and average working time in the area of 7.9 years. Most of the professionals works in clinical assistance (87.7%) and teaching (67.1%). The majority (78.4%) declares identification with one religion, being 21.6% Catholics, 13.7% Spiritists and 11.3% Protestants. A large portion of the sample (21.6%) identified itself with more than one religion. The BFP showed low organizational religiosity (49.3% rarely or never attend to institutions), but high practice of non-organizational religiosity (65.4% declare personal practices at least weekly). The average of intrinsic religiosity score was 10.6 (standard: 3-15) and the spiritual-wellbeing average score was 35.7 (standard: 0-48). About the clinical practice, there was greater agreement with the concept of spirituality carried out by Puchalski, which presents moderate amplitude when compared to Anandarajah\'s or Koenig\'s concepts. The concordance degree showed same tendency to the sense of differentiation of the concepts of spirituality and religiosity. While 88.4% of BFP believe that the S/R influences a lot the health and 81.2% believe that this approach is pertinent to their clinical practice, only 35.0% of the sample felt prepared to address this topic and most do it sometimes (50.3%). The main barriers to this approach were lack of time (53.4%), training (39.7%) and personal values, such as fear of imposing their religion (27.7%) or fear of offending the patient (23.6%). The themes most often discussed by BFP with patients deal with the social support network (discussed by 42.8% of doctors) and resilience (40.2%). The less discussed subjects were the doctor-patient relationship (not discussed by 74.0%) and the implications for the therapeutic plan (64.7%)

Traditional students enroll in post-secondary institutions during emerging adulthood. College enrollment is increasing and adult weight gain occurs most rapidly during the college-age years, with poor food decisions as a potential contributing factor. The present study examined the awareness, perception, and self-reported purchasing behaviors of college students regarding four front-of-package (FOP) nutrition labeling systems and symbols. Students were sent a 24-question web-based survey, with 908 completed surveys that met the research criteria. There were 888 (98.3%) respondents who recognized at least one of the four presented FOP nutrition labels. There were no significant differences between the groups that recognized one to four of the FOP nutrition labels in their stated likelihood to purchase foods with the specified labels. Students’ awareness of four commercial FOP nutrition labeling systems and symbols on product packaging did not have an impact on their food purchasing behaviors.

Background: Indoor tanning elevates the risk for melanoma, which is now the most common cancer in US women aged 25-29. Public policies restricting access to indoor tanning by minors to reduce melanoma morbidity and mortality in teens are emerging. In the United States, the most common policy restricting indoor tanning in minors involves parents providing either written or in person consent for the minor to purchase a tanning visit. The effectiveness of this policy relies on parents being properly educated about the harms of indoor tanning to their children. Objective: This randomized controlled trial will test the efficacy of a Facebook-delivered health communication intervention targeting mothers of teenage girls. The intervention will use health communication and behavioral modification strategies to reduce mothers’ permissiveness regarding their teenage daughters’ use of indoor tanning relative to an attention-control condition with the ultimate goal of reducing indoor tanning in both daughters and mothers. Methods: The study is a 12-month randomized controlled trial comparing 2 conditions: an attention control Facebook private group where content will be relevant to teen health with 25% focused on prescription drug abuse, a topic unrelated to tanning; and the intervention condition will enter participants into a Facebook private group where 25% of the teen health content will be focused on indoor tanning. A cohort of 2000 mother-teen daughter dyads will be recruited to participate in this study. Only mothers will participate in the Facebook groups. Both mothers and daughters will complete measures at baseline, end of intervention (1-year) and 6 months post-intervention. Primary outcomes include mothers’ permissiveness regarding their teenage daughters’ use of indoor tanning, teenage daughters’ perception of their mothers’ permissiveness, and indoor tanning by both mothers and daughters. Results: The first dyad was enrolled on March 31, 2016, and we anticipate completing this study by October 2019. Conclusions: This trial will deliver social media content grounded in theory and will test it in a randomized design with state-of-the-art measures. This will contribute much needed insights on how to employ social media for health behavior change and disease prevention both for indoor tanning and other health risk behaviors and inform future social media efforts by public health and health care organizations. ClinicalTrial: Clinicaltrials.gov NCT02835807; https://clinicaltrials.gov/ct2/show/NCT02835807 (Archived by WebCite at http://www.webcitation.org/6mDMICcCE).

Navigating personal identity changes through the cancer journey can be challenging, especially for women in a culture that places emphasis on traditional gender roles and values close-knit families. Drawing on a story circule approach, this study examined the intersecting identities of female cancer survivors in southern Appalachia. Stories of 29 female Appalachian cancer survivors from Northeast Tennessee and Southwest Virginia were collected via a mixed methods approach in either a day-long story circule (N-26) or an in-depth interview (N=3). Transcripts from both phases were audio-recorded and transcribed verbatim; NVivo 8.0 facilitated qualitative content analysis of the data. Inductive analysis revealed that women in this study appeared in struggle with (1) maintaining place in the family, (2) mothering, and (3) navigating physical changes. Ideas of family versus self appeared to overlap and intertwine with how women in Appalachia navigate personal identify changes through the cancer journey.

This study examines the illness narratives of female cancer survivors living in Southern Central Appalachia. Stories of 29 female Appalachian cancer survivors from northeastern Tennessee and southwcstmn Virginia were collected via a mixed methods approach in either a day-long story circle (n=26) or an in-depth interview (n=3), Qualitative content analysis was used to guide an inductive analysis of the tTanscript<;, What emerged was that as participants survived cancer, they also survived other health conditions, their intorsccting stories yielding an omnibus survivorship narrative.

Objective. To describe an interprofessional communication course in an academic health sciences center and to evaluate and compare interpersonal and interprofessional communication self-efficacy beliefs of medical, nursing, and pharmacy students before and after course participation, using Bandura’s self-efficacy theory as a guiding framework. Design. First-year nursing (n=36), first-year medical (n=73), and second-year pharmacy students (n=83) enrolled in an interprofessional communication skills development course voluntarily completed a 33-item survey instrument based on Interprofessional Education Collaborative (IPEC) core competencies prior to and upon completion of the course during the fall semester of 2012. Assessment. Nursing students entered the course with higher interpersonal and interprofessional communication self-efficacy beliefs compared to medical and pharmacy students. Pharmacy students, in particular, noted significant improvements in communication self-efficacy beliefs across multiple domains postcourse. Conclusion. Completion of an interprofessional communications course was associated with a positive impact on health professions students’ interpersonal and interprofessional communication self-efficacy beliefs.