Abstract:
:This article contends that the distinction between clinical care (illness) and prevention of future disease is essential to the practice of quaternary prevention. The authors argue that the ongoing entanglement of clinical care and prevention transforms healthy into "sick" people through changes in disease classification criteria and/or cut-off points for defining high-risk states. This diverts health care resources away from those in need of care and increases the risk of iatrogenic harm in healthy people. The distinction in focus is based on: (a) management of uncertainty (more flexible when caring for ill persons); (b) guarantee of benefit (required only in prevention); (c) harm tolerance (nil or minimal in prevention). This implies attitudinal differences in the decision-making process: greater skepticism, scientism and resistance towards preventive action. These should be based on high-quality scientific evidence of end-outcomes that displays a net positive harm/benefit ratio.
journal_name
Cad Saude Publicajournal_title
Cadernos de saude publicaauthors
Tesser CD,Norman AHdoi
10.1590/0102-311X00012316subject
Has Abstractpub_date
2016-10-20 00:00:00pages
e00012316issue
10eissn
0102-311Xissn
1678-4464pii
S0102-311X2016001003001journal_volume
32pub_type
杂志文章,评审abstract::The present study applies the risk perception analytical methodology based on rapid surveys. It took place in the micro-basin of the São Lourenço Creek in Nova Friburgo, Rio de Janeiro State, Brazil. The methodological approach was based on participatory observation, semi-structured interviews with 24 key informants s...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2005000600033
更新日期:2005-11-01 00:00:00
abstract::This study begins by briefly situating the development of indexing procedures in the scientific literature, dating to the latter half of the 19th century. Next, taking public health in Latin America as its reference, it analyzes the current use of indexing for the evaluation of scientific production, and thus that of ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x1999000400022
更新日期:1999-10-01 00:00:00
abstract::: The objective was to describe the governance system used in structuring the regionalized healthcare network in Santa Catarina State, Brazil, based on the Bipartite Inter-Managerial Commission (CIB), with a focus on structuring of oral healthcare. This was a qualitative, exploratory-descriptive documental study, base...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00133516
更新日期:2017-09-28 00:00:00
abstract::The study used a qualitative, evaluative, and participant methodology based on Gadamer's hermeneutics and the constructivist paradigm. The aim was to analyze the arrangement called "patient care teams" for treatment of psychotic patients in the context of Community Mental Health Services (CMHS). Data were collected in...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2010000600009
更新日期:2010-06-01 00:00:00
abstract::Recent studies have emphasized that there is no justification for using the odds ratio (OR) as an approximation of the relative risk (RR) or prevalence ratio (PR). Erroneous interpretations of the OR as RR or PR must be avoided, as several studies have shown that the OR is not a good approximation for these measures w...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311x00077313
更新日期:2014-01-01 00:00:00
abstract::Monoclonal antibodies (mABs) have been indicated as an innovative technology for the treatment of some types of cancer, since they are capable of targeting and selectively killing tumor cells. However, the high costs of these therapies raise questions as to the sustainability of access. This study aimed to identify th...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00010918
更新日期:2018-11-29 00:00:00
abstract::This study aimed to evaluate male participation in the use of contraceptive methods and to identify relevant variables. A secondary data analysis was conducted, and the sample size was estimated at 175 men using contraceptives methods that require male participation. The study used the qui-square test to evaluate diff...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2003000100023
更新日期:2003-01-01 00:00:00
abstract::The aim of this study was to estimate the prevalence of sedentary behavior and investigate associated factors in adolescents 11 years of age from the 1993 birth cohort in Pelotas, Rio Grande do Sul State, Brazil. Sedentary behavior was investigated with a questionnaire, and was defined as spending more than two hours ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2010001000009
更新日期:2010-10-01 00:00:00
abstract::The aim of the current article is to explore central features of Anísio Teixeira's "thought-action" approach in order to help overcome the current crisis in health personnel training. First, the article summarizes Teixeira's life and work, assessing his institutional legacy and its impact on the historical scenario in...
journal_title:Cadernos de saude publica
pub_type: 传,历史文章,杂志文章
doi:10.1590/0102-311XET011214
更新日期:2014-12-01 00:00:00
abstract::Health professionals view medical ethics as a discipline that provides the basis for more adequate patient care. In recent years the concepts of quality of care and human rights - with their attending discourses - have joined the concept of medical ethics among the paradigms to consider in care for humans both at the ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章,评审
doi:10.1590/s0102-311x2008000100002
更新日期:2008-01-01 00:00:00
abstract::This study was undertaken using a case-control, prevalence survey design, aimed at verifying the effects of socioeconomic, environmental, and biological/morbidity variables on the growth of schoolchildren from low-income families. The study focused on schoolchildren whose height/age (H/A) ratio was < or = 2SD (NCHS). ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2001000100008
更新日期:2001-01-01 00:00:00
abstract::This study is a critical reflection on attempts to alter the Declaration of Helsinki, a key document of the democratic theses achieved in the latter half of the 20th century and thus a legacy for humanity because of its ethical guidelines for research involving human beings. Therefore, there must be worldwide social c...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2001000600020
更新日期:2001-11-01 00:00:00
abstract::Different factors have been identified as influencing drug prescribers. Some studies emphasize the role played by sources of information available to physicians. Reports have been published on the influence of marketing strategies on these health professionals. Such strategies include advertisements in medical journal...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2000000200012
更新日期:2000-04-01 00:00:00
abstract::The indigenous healthcare model in Brazil is premised on comprehensive care combined with the notion of differentiated care and provides for respect for cultural diversity, seeking to incorporate traditional therapeutic practices into the health services that serve indigenous peoples. This study aimed to determine how...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2011000700011
更新日期:2011-07-01 00:00:00
abstract::The Brazilian AIDS epidemic is undergoing important changes in its third decade. The present article reviews some central findings: the proportional reduction in cases related to injection drug use; the stability, in recent years, of new cases in the male homosexual/bisexual population; and the relative and absolute i...
journal_title:Cadernos de saude publica
pub_type: 杂志文章,评审
doi:10.1590/s0102-311x2007001500002
更新日期:2007-01-01 00:00:00
abstract::The study's overall objective was to investigate the relationship between psychosocial stressors, sense of community, and subjective wellbeing in urban and rural schoolchildren in Northeast Brazil, focusing on differences according to territorial context. The sample consisted of 757 participants, 495 from urban school...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00126815
更新日期:2016-09-19 00:00:00
abstract::The text De Profundis: Valsa Lenta (De Profundis: Slow Waltz), by Portuguese author José Cardoso Pires, describing the aphasia he experienced after a stroke, was used as a starting point to study the different approaches writers and physician have regarding the disease. The differences in form and content of texts des...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2000000100026
更新日期:2000-01-01 00:00:00
abstract::This paper focuses on specific aspects of male sexuality and how this sexual identity is built in the Aids era, based on conversations with low-income youth, ages 14-21 years, living in Greater Metropolitan Rio de Janeiro. We examine how Aids is perceived and investigate sexuality in this epidemic context. The goal is...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x1998000100022
更新日期:1998-04-30 00:00:00
abstract::Exogenous obesity increases morbidity and mortality risk and has been associated with nutritional habits, which in turn can be affected by health education. Health education aims to promote patient participation in achieving behavior change and healthy lifestyles. The objective of this study is to show the advantages ...
journal_title:Cadernos de saude publica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1590/s0102-311x2004000100045
更新日期:2004-01-01 00:00:00
abstract::The primary health care model implemented by the Family Health Program in Brazil still lacks systematized, validated mechanisms for its monitoring and evaluation. Based on an actual experience, the current study sought to understand experiences and explore concepts held by staff and managers in the Ceará State Health ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2008001200018
更新日期:2008-12-01 00:00:00
abstract::Constitutional Amendment 29, passed in 2000, set the minimum percentages of budget resources that the Federal, State, and Municipal governments are required to spend on public health. Taking a descriptive approach, this article aims to verify the compliance with Amendment 29 at various levels of government, from 2000 ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2007000700012
更新日期:2007-07-01 00:00:00
abstract::This study aimed to assess the prevalence and factors associated with dynapenia in a nationally representative sample of Brazilians aged 50 years and older. A cross-sectional study was performed with baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil). Dynapenia was defined as low muscle strengt...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00107319
更新日期:2020-04-30 00:00:00
abstract::Leptospirosis is an endemic disease in the State of Rio Grande do Sul, Brazil, and presents a broad diversity of exposure routes, reservoirs, etiological agents, and clinical features. The main objective of this work is to identify transmission areas and possible ecological components of leptospirosis transmission. Th...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2003000500007
更新日期:2003-09-01 00:00:00
abstract::The author analyzes the underlying theoretical aspects in the construction of the molecular watershed of epidemiology and the concept of genetic risk, focusing on issues raised by contemporary reality: new technologies, globalization, proliferation of communications strategies, and the dilution of identity matrices. H...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x1999000500009
更新日期:1999-01-01 00:00:00
abstract::The aim of this study was to analyze a possible relationship between first experience with drugs and delinquency among adolescents in conflict with the law. In 2006, a cross-sectional study was conducted in facilities of the State Foundation for the Well-being of Minors (FEBEM), with a total occupancy of 312. The samp...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2008000500018
更新日期:2008-05-01 00:00:00
abstract::This paper reviews the literature on the physical growth of native populations from Brazil. Studies aiming at relating the physical growth patterns of these populations to their nutritional status are relatively recent and still do not provide a comprehensive picture of the situation. Compared to non-indigenous Brazil...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:/S0102-311X1993000500006
更新日期:1993-01-01 00:00:00
abstract::This study focuses on conditions in the public health centers providing comprehensive care to the adolescent population in the city of Rio de Janeiro. A structured questionnaire was administered to the coordinators of 70 public health centers (70/78). Based on the data, the public health centers were stratified accord...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2002000300013
更新日期:2002-05-01 00:00:00
abstract::The authors investigated the association between the reported frequency of breast self-examination and five dimensions of social support (material, emotional, affective, information, and positive social interaction) among 2,240 female employees from a university in Rio de Janeiro who were participants in Phase 1 of a ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2005000200004
更新日期:2005-03-01 00:00:00
abstract::The objectives of this article are to propose indicators for evaluation of the quality of hospital management of bronchial asthma patients, based on explicit criteria from literature reviews. The central problem identified in the literature review is the erroneous evaluation of severity of asthma crises, either by pat...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract::This study analyzes Brazil's tobacco control policy from 1986 to 2016, seeking to describe the policy's history and discuss its achievements, limits, and challenges. The study adopted a political economics approach and contributions from public policy analysis. Data were based on a search of the literature, documents,...
journal_title:Cadernos de saude publica
pub_type: 历史文章,杂志文章,评审
doi:10.1590/0102-311X00017317
更新日期:2018-02-19 00:00:00