bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating the Term ‘Disorders of Sex Development’: A Multidisciplinary Debate
Authors: Delimata Natalie , Simmonds Margaret , O’Brien Michelle , Davis Georgiann , Auchus Richard , Lin-Su Karen
Published: January 2025

In 2014, almost 10 years after the 2005 International Consensus Conference on Intersex in Chicago, one of the conference co-organisers, under the auspices of a number of international paediatric endocrinology societies, launched the Global DSD Update to assess progress. A consortium of fourteen work groups conducted online/email discussions to explore each of the fourteen key topics, one of which was use of the controversial medical umbrella term ‘Disorders of Sex Development (DSD)’. The initial key question for Work Group 1 (referred to hereafter as WG1) was a “reconsideration of the nomenclature and the conditions to be included”. Nineteen individuals from a variety of professional backgrounds, including medical practitioners, patient advocates, academics and psychologists, accepted invitations to contribute. This article is based on a transcript of the 6-month debate, collated using thematic analysis methods. Seven key themes were identified: a) Disorder of Sex Development – What does this mean? b) How useful is the word ‘Disorder’? c) How useful is the word ‘Sex’? d) Benevolent non-disclosure of terminology e) How useful is an umbrella term? f) The issue of evidence, and g) Considerations for future nomenclature. This article also highlights the challenges in debating issues that straddle the medico-social interface, such as terminology, and between participants coming from different professional disciplines and epistemological standpoints. While recognising that such discussions can be useful and enlightening for all parties, this article recommends that a shared frame of reference be agreed by all stakeholders from the outset in order to provide a framework for discussion.
The Epidemiology of Malaria in Colombia: a heretical view
Authors: Carmona-Fonseca Jaime
Published: January 2025

Abstract
Background: Studies on the long-term behavior of malaria are scarce in Colombia and, in general, are aimed at explaining this behavior from a perspective that adjusts to the function of the apparatuses responsible for the control of the disease, without applying a critical vision.
Objective: To present epidemiological data on malaria in Colombia and to try to explain its long-term behavior from a point of view that questions the functionalist vision.
Methodology: The data presented in this paper was collected in a non-systematic review.
The authors sought to find data and arguments that sustain the criticism of the issues addressed.
Results: The tendency of malarial morbidity, as expressed with the annual parasitic index adjusted for the exposed population, increased in the period 1935-2018. None of the ideological or administrative changes used in control or eradication programs has managed to affect this trend.
Resistance: The supposed influence of the “resistance of parasites to medicines” and of anophelines to insecticides has been scarce and unimportant.
Conclusions: the why of malarial morbidity behavior in Colombia should be studied thoroughly, systematically, and critically, giving priority to the study of the processes of social determination of the disease. Key words: Malaria, Plasmodium, epidemiología, Colombia.
The use of toxic agrochemicals in El Huaje, Zentla, Veracruz, México, and their role during the Zafra (harvest) and attempts to control the mosquito Stegomyia aegypti
Authors: Cardoso Gómez Marco Antonio , García Piña Eunice Victoria , Morales Vázquez Mario Uriel , Serrano Sánchez Carlos
Published: January 2025

In this paper we describe the population of El Huaje, Veracruz México. This population is composed of Italo-Mexicans, living in El Huaje, Veracruz México. They are employed in the yearly Zafra (sugar cane harvest) and in mosquito measures aimed at reducing the effects of the mosquito Stegomyia aegypti. Structure: This study is qualitative and multi-disciplinary. Objectives: The goal of this study was to describe the processes of cultivating sugar and the efforts made to control the Stegomyia aegypti, mosquito using agro-chemicals. In the course of this study the investigators educated the local population on the use of agro-chemicals. Period of study: January 2016 to December 2017. Data sources: (primary) Information was collected through in-depth interviews, in situ observation, audio and video recordings, notes made “on site as well as” “pictures and a questionnaire.” Conclusion: The population of El Huaje is exposed to chronic agro-toxicity caused by the use of agro-chemicals. These chemicals are used in the sugar cane harvest as well as in the control the mosquito: Stegomyia aegypti.
Health professionals' perception of maternal health: an ethnography in the Sierra de Totonacapan, Veracruz, Mexico
Authors: Dörr Niels Michael
Published: January 2025

Maternal health is a complex issue. In Mexico, especially the population living in poverty and indigenous peoples are affected by health disparities, in particular, demonstrated by skilled birth attendance. The determinants mentioned by health professionals, especially structural barriers, characterize their perception. However, there are other barriers. The concept of intercultural medicine is understood as the adaptation of medical care to local reality to overcome cultural barriers. This article will conclude with a perspective that focuses on the possibilities and limitations of intercultural medicine for maternal health.
Analysis Of Intrinsic And Extrinsic Factors On Mother’s Self-Efficacy In Giving Exclusive Breastfeeding In Puskesmas Tanah Kalikedinding Surabaya
Authors: Fadhilah Yusnita Nur , Sulityowati Muji
Published: January 2025

Background: Self-efficacy is one of the factors that play a role in supporting the mother’s success in giving exclusive breastfeeding (EBF). The low self-efficacy of the mothers can be influenced by intrinsic and extrinsic factors. For three years, the EBF rate in Puskesmas Tanah Kalikedinding Surabaya has not the target reached yet.

Aim: This study was conducted to analyze the relationships between intrinsic and extrinsic factors of mother’s self-efficacy in giving exclusive breastfeeding.

Methods and Material: Analytic observational study was carried out with the design of cross sectional and quantitative approach. Sampling was done in Puskesmas Tanah Kalikedinding Surabaya by using consecutive sampling method. Interviews were conducted to 54 postpartum mothers by using questionnaires. The independent variables of the study were intrinsic factors including level of education, type of occupation and level of knowledge. Extrinsic factor consisted of the supports from the husband and health officers based on respondent’s perception. The dependent variable was the rate of breastfeeding self-efficacy (BSE) of the mother. The analysis of quantitative data was done by using chi square test.

Results: The results show that the majority of postpartum mothers had a high level of self-efficacy in providing EBF. There is a relationship between the mother’s level of education with the mother’s self-efficacy with p = 0.013. Mothers who did not work had higher level of self-efficacy than the working mothers. Mothers with medium and high levels of knowledge had high self-efficacy in giving EBF. However, low self-efficacy mothers were also found among the highly educated ones. The results also show that the low support from the husband was caused by his tendency of giving material supports. Besides, the home visit rate by the health officers only reached 13%.

Conclusion: Level of education was the only one factor related to mother’s self-efficacy in giving EBF in Puskesmas Tanah Kalikedinding Surabaya.
Psychosocial consequences of widespread of torture and sociopolitical pressure in Iran
Authors: Mirzaei Siroos , Alizadeh Homayoun , Zarei Seyed , Alksiri Reem
Published: January 2025

Violence and political repression in general may have different psychosocial impact on societies. Studying these effects in countries with a high grade of repression based on reliable data from inside the country is difficult or even impossible, mainly due to the very concrete risk for the researcher of being imprisoned or tortured and to the fact that prior permission would usually not be obtained to perform a study on politically sensitive issues. In this manuscript, the authors try to develop a strategy to integrate available data from inside Iran, data on exiled survivors, and of reliable international, especially UN bodies, to investigate the situation in the country, where torture and execution are used frequently and the country has a high corruption index with a ranking of 130/180, as an example for such situations. While some common public mental health problems such as domestic violence might not be indicators of distress caused by persecution or of adverse conditions, their wide spread prevalence might indicate a lack of protection and of basic human rights, especially if taken conjointly with other strategies and data that indicate in this case of the discrimination of women.
The very limited scientific reports from inside Iran point further to a wide range of substantial general mental health problems that might also reflect distress due to general conditions and failure of governmental effort such as a high rate of suicide, a high rate of substance abuse –even in younger individuals. Data on human rights violations, including violence against women, persecution of political activists, up to torture and execution of teenagers are indicators of the sociopolitical situation and a pervasive strategy of repression in Iran in the last decades and must be expected to lead to substantial long term public mental health impact and other problems and create a burden on the Iranian population as a secondary result of repression. The brain drain and persecution or even execution of reliable health care and other professionals must be expected to further take away the resources required to face this long term problems.
Meanings about the doctor-patient relationship in the family health strategy: Thoughts on health care from the perspective of the users.
Authors: Pereira de Brito Marcelo , Nakamura Eunice
Published: January 2025

Primary Health Care (PHC) appears as the main guideline for health actions in the Family Health Strategy (FHS). Its prerogatives include multidisciplinary teamwork focused on the users, families and communities where this strategy is inserted. However, the historical context of health practices in Brazil has shown that PHC does not consolidate in the country without contradictions. Some of its principles, such as completeness, arise in the clinical encounter between physicians and patients still strongly marked by the asymmetric relationship, by biomedical discourse and practice. The aim of this study was to analyze and understand some of the meanings present in the doctor-patient relationship, from the perspective of the users, with follow-up and observation of meetings of a team from the FHS unit in the Areia Branca neighborhood, of Santos-SP; and in-depth interviews, with a semi-structured script, with five users served by this team. Thus, in the interpretation of the meanings of the doctor-patient relationship, attributes related to familiarity, trust and longitudinality permeated by processes of symbolic resignification of the medical discourse by the users, presenting components related to the autonomy of the interviewees in dealing with their health-disease processes.
Person-Centered Care Starts with Community-Centered Medical Education: Medical Education Must Answer the Call for Diversity
Authors: Katz James David , Rose Emily , Poladian Katlin , Torralba Karina D.
Published: January 2025

Civil unrest is a call for realignment of values in all aspects of society, including medical education. Systematic difference in the treatment of groups of individuals concerning educational curricula has previously been highlighted in South Africa during student-led campaigns to decolonialize and diversify medical curricula1. Institutional resistance that results in a failure to account for the politics of identity or for pluralistic thinking,1 implies that the academic ‘fence of unambiguous knowledge’ not only creates an ivory tower but it may simultaneously insulate itself from community input and access. Confronting the tension between communal meaning (which sanctions a culturally relevant curriculum) and privileged meaning (which derives from a monolithic mindset) demands that educators recognize that the scientific method is only one ‘way of knowing.’ In this manuscript we ask: Who possesses authoritative medical meaning-making? And, Who confers authoritativeness to academia?
Analysis of the levels of physical activity and body mass index of college students: a systematic review
Authors: Morais Pinto Novo André Filipe , Oliveira Cardoso Milena , Melo Chaves Anderson , Reis de Abreu Pâmella , Maneschy Mariela de Santana , Passos Ricardo Pablo , Nascimento Lima Bráulio , De Barros Vilela Junior Guanis , Da Silva Almeida Klebson
Published: January 2025

Background: The quality of life of college students is directly affected at the onset of college life due to the neglect of healthcare and predisposing risks such as obesity. Purpose: The main objective of the present study is to analyze the levels of physical activity and body mass index (BMI) of college students. Methods: The PubMed, Scielo, ScienceDirect, BVS, and Cochrane databases were selected. The search strategy included descriptors in English and Portuguese: “college students”, “academics”, “body mass index”, “level of physical activity”, and “quality of life”. Results: After finding 16 articles, inclusion and exclusion criteria were applied, resulting in 10 articles for deep analysis. It was observed that college students had a good level of physical activity and adequate BMI, diverging from old studies in which the level of physical inactivity and overweight was relatively high. Discussion: From the studies carried out, it is concluded that currently college students are within normal weight and are physically active. Translation to Health Education Practice: Further studies about BMI and physical activity levels, as two important health indicators, should be carried out in college students.
Youth participation in voluntary of the covid-19 laboratory test in Indonesia
Authors: Purnama Tri Bayu , Nasution Citra Cahyati , Pratiwi Dini , Hasanah Nurfadillah
Published: January 2025

Although the Indonesian Government has made policies to break the COVID-19 chain transmission including to set a price for laboratory tests, the fact in Indonesia has not yet reached the laboratory test target that set by WHO. Seeing the current situation, what is needed is not only the government alertness but also public awareness to break the chain of transmission of COVID-19. This study uses the planned behavior theory and Colaizzi phenomenological methods to analyze qualitatively the public's intention and response voluntarily in COVID-19 laboratory test in Indonesia. In-depth interviews were conducted with 10 participants. The data is analyzed using analytical content and shows the results that participants were not willing to do the COVID-19 lab test voluntarily to find out whether they were infected with COVID-19 or not because they felt that the COVID-19 lab test was too expensive so they decided that they would voluntarily do the test if it was free. It is recommended to the government to give education to the public that one of ways to break the chain of COVID-19 transmission is the public have to contribute in doing a COVID-19 laboratory test voluntarily to carry out a minimum test as determined by WHO.
Exploring the reasons for incomplete child immunisation in selected health facilities in Lu-saka: Perspectives from mothers and community health workers
Authors: Kashinka Eddie , Mulubwa Chama , Matenga Tulani Francis L , Mweemba Oliver
Published: January 2025

Background: Immunization is one of the most successful public health initiatives. The World Health Organization in 2017 estimated that immunization averts about 2 to 3 million deaths every year. About 29,000 children worldwide under the age of five die every day, mainly from vaccine-preventable diseases. Uptake of vaccines with multiple doses up to the last dose has been a prob-lem. Incomplete immunization against diseases leads to the reappearance of childhood vaccine-preventable diseases (VPD) and consequently high infant mortality. The paper explored the rea-sons for incomplete of child immunization schedule in Lusaka district, Zambia.
Methods: The study employed a concurrent mixed method design where both quantitative and qualitative methods were used. This particular paper focuses on the results from the qualitative component where Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs) were conducted with mothers and community health workers. Thematic analysis was used to analyse the data.
Results: The study found that mothers were generally aware of vaccines and knew the benefits of the vaccines. The reasons for incomplete child immunisation include the mothers’ negative percep-tions such as the fear of side effects of the vaccines, mothers’ unwillingness to bring the child for immunisation. Bad treatment of mothers by health workers and various social factors such as the mother having to attend to social engagements like funerals and weddings also contributed to in-complete child immunisation. Economic factors included a lack of transport money and mothers having to attend work are additional reasons for incomplete child immunization.
Conclusion: The reasons for incomplete child immunisation revealed by this study reflect complex individual, interpersonal, health systems, and social cultural contexts within which mothers live in their daily lives. There is need for more comprehensive and multi sectoral approach to improve the completion of immunisation schedules in children
"I'm strong...I feel sicker when I'm at home than when I'm working". Man-commodity and health in bricklayers.
Authors: Maqueda Hernandez Juan Carlos , Cuellar Romero Ricardo , Pulido Navarro Margarita
Published: January 2025

This paper presents the experiences and the meaning that two bricklayers, father and son, give to their bodies, in the context of a capitalist society governed by the trend towards the universalization of commerce. Some of Karl Marx's and Georg Lukács' approaches to the concepts of alienation and reification are taken up. It is considered that their heuristic scope transcends the space and time of the foundational process of immediate production in such a way that they open up a dialogue between the structural and the experiential, between the material and the emotional, between meanings. It is of particular interest to rescue, through the help of social history and oral history, the perceptions of the workers mentioned in relation to their health-illness process. Key words: alienation, reification, working time, social history, oral history, health-illness, bricklayers.
Cybersecurity: Analysis and Application of ProDiscover Forensic Toolkit
Authors: Fakiha Bandr Siraj
Published: January 2025

The world has in the recent past experienced rapid development in digital technology. However, as most organizations across the world continue to introduce digital technology into their operating system, issues of cybercrime have been on the rise and are one of the major threats to the progress and growth of many business firms. The application of the digital forensic concept can therefore be helpful in curbing problems associated with cybercrime. ProDiscover is one of the forensic tools which enable professionals in computing to locate all data in computing disk, including those that had previously been deleted. ProDiscover Forensic tool recovers deleted files, examines slack space, and dynamically allows previews, image captures, and searches of the Hardware Protected Area (HPA) using its technology. This paper sought to establish the application and effectiveness of ProDiscover Forensic in investigating cybercrime. For the purposes of this paper, efficiency will be defined as the proportion of input required by the ProDiscover system compared to its performance and output in addressing and managing workplace cybercrime. Alternatively, effectiveness will be defined as the degree and capacity to which the system will succeed in improving forensic investigation and mitigating cybersecurity issues in the workplace. That is, the capabilities of ProDiscover Forensic with regards to investigating and punishing cybercrime offence at the workplace. The researcher investigated a case in which a company by the name Jonson Corp. had been complaining about one of their staff, a Mr John who had been using the computer system for viewing and subsequently downloading pornographic images. The suspect’s floppy disk of 1.44 MB capacity that had been found in his drawer was used to retrieve all the deleted files. In overall, ProDiscover was able to retrieve the BEAUTY1.jpg and BEAUTY2.jpg images that had been erased from the soft disk. Therefore, the ProDiscover tool can be applied by organizations to enhance their information security functions, especially during a forensic investigation.
Community participation in health, a public health challenge
Authors: Morales Loyola Marisa
Published: January 2025

Within the inherent activities of the State, the development of services that seek to satisfy the needs of citizens is a continuous process, since it depends on it that individuals manage to carry out their daily activities without serious problems, as well as ensure their well- being.

Therefore, the relationship between the government and society must move from governability to governance, which is based on three dimensions: democracy, development and rights16, and implies the active participation of the population in order to generate and build co-responsibility and achieve changes.
Prevalence and correlates of serostatus disclosure in HIV-infected adults attending the follow up and treatment clinic in Barbados.
Authors: Kumar Alok , Kilaru Krishna R. , Forde Sheila , Kumari Geeta
Published: January 2025

Objective: To determine the extent of disclosure and factors associated with disclosure of HIV status to sexual partners, we interviewed HIV infected adults attending the centralized HIV clinics seeking medical care for HIV. Methods: The subjects were patients who attended the LRU for primary care and treatment of their HIV infection during the three months period of this study enrolment. Patients were asked to participate in this study after initial clinical care was performed, in a 30-minute standardized interview concerning behavioral, medical, and social history. Results: The study patients had the following characteristics: female, 42.7%; male, 57.3%; singles, 84.5%; married, 11.8%. The median age of respondents was 35 years, and 66.4% were employed. Seventy nine percent were sexually active, and of these 72% had a steady sex partner and 61% had one or more casual partners. Over all 64 (58.2%) of those interviewed, had disclosed their HIV status to significant others. Of the sixty three persons who had a steady partner 71.4% had self disclosed their HIV status to one or more steady partners. Of the fifty three persons who had one or more casual partners, 26.4% had self-disclosed their status to one or more casual partners. The most common reasons listed for nondisclosure to spouse or significant other were stigma/discrimination, fear of spread of information, rejection. Conclusion: Our findings suggest that both the knowing and unknowing sexual partners of HIV-infected persons continue to be at risk for HIV transmission.
Reporte sobre la epidemia de tifo en Alta Silesia
Authors: Virchow Rudolf
Published: January 2025

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Rebuilding the US Health Left
Authors: Anderson Matthew , Smith Lanny , Sidel Victor W.
Published: January 2025

With this issue Social Medicine begins a series of invited papers on the topic: “Rebuilding the US Health Left.” In this editorial we will outline our vision for this series.
We undertake this project aware that our good friend and mentor, Dr. Walter Lear, one of the leading health activists of the 20th century, lies critically ill. Walter was the creator and custodian of the US Health Left Archives, a collection that is now with the University of Pennsylvania library. The collection reminds us of the important role left health care workers played in US history throughout the 20th century. They advocated for a national health program (Committee on the Costs of Medical Care, Physicians Forum, Medical Care Section/APHA, HealthPAC, Physicians for a National Health Program, National Physicians Alliance), provided international solidarity (American Soviet Medical Society, international brigades during the Spanish Civil War, Central American Solidarity Movement, Committee to Help Chilean Health Workers, Doctors for Global Health), traced the connections between disease and social class (Sigerist Circle, Spirit of 1848, APHA), fought for workers’ health (Councils for Occupational Safety and Health; Occupational Health and Safety Section, APHA) participated in anti-war movements (Medical Committee for Human Rights, Physicians for Social Responsibility, International Physicians for the Prevention of Nuclear War), created new models of health care delivery (Health Cooperatives, Prepaid Health Maintenance Organizations, Community Health Centers, National Health Service Corps, Free Clinics), were central to the struggle for women’s rights (Planned Parenthood, Physicians for Reproductive Choice and Health), supported the civil rights movement both in medicine and in the broader society (National Medical Association, Medical Committee for Human Rights), played key roles in the movement for gay rights (ACT-UP, Gay & Lesbian Medical Association, Lesbian, Gay, Bisexual, and Transgender Caucus of the APHA), challenged traditional models of medical education (Student Health Organizations, AMSA, Residency Program in Social Medicine), and worked in many, many other fields.
Call to publish: War on Drugs and Health
Authors: Drucker Ernie , Rossi Adriana
Published: January 2025

Call to publish: War on Drugs and Health
Corporate presence in healthcare sector in India
Authors: Chakravarthi Indira
Published: January 2025

Various forms of privatization have been the preferred policy option for the health sector reform which was initiated in the 1990s in India under the neo-liberal regime. Rigorous study of privatization processes and of the private sector in general remains inadequate. This research attempts to fill this gap by examining the extent and nature of corporate presence in India in the delivery of healthcare services. It poses some concerns in light of experiences of other countries. The first section of the paper covers the private hospitals sector. The second part looks at the diagnostics sector. The concluding section discusses the implications of such developments for healthcare services in the country.
Stress as Mediator between Social Formation and Occupational Illness: A Methodological Inquiry
Authors: Pulido Navarro Margarita , Cuéllar Romero Ricardo
Published: January 2025

The personal stories of individuals are not isolated from the social context in which they occur. They can only be understood and explained within given, concrete historical circumstances. Stories derive meaning from their historical context; individuals make sense of events from a subjectivity that comes from their own experiences in diverse social spaces and their diverse cultural backgrounds. The combination of both elements gives rise to a personal identity subject to historical transformation. In the course of their lifetimes, individuals design—and redesign—the meaning of past events. Institutions play a role in this process by ensuring that each individual has been prepared to be a functional member of society, to accept social norms, and to exercise self-control. It is important to understand how humans create meaning over the course of a lifetime, as this allows us to understand how historical processes impact individuals. Production processes affect both health and wellbeing. For example, prolonged stress can lead to chronic diseases. The personal story of Magaly, a seamstress, illustrates how experiences in diverse social spaces determined her perception of situations. Her story highlights the need for a methodology to describe this form of subjectivity which mediates between the social context and the individual responses which lead to suffering.
Global Health on the Move -- Dissecting Health Interventions Through a Social Medicine Immersion Course
Authors: Jackie Alobo , Aol Pamella , Ocitti Morris , Katungi Ambrose , Kakungulu Eddie , Kiiza Peter , Bakyawa Irene Bagala , Atim Julian , Westerhaus Michael J , Finnegan Amy
Published: January 2025

Applying a set of innovative pedagogical approaches to the study of social medicine, the course Beyond the Biologic Basis of Disease: The Social and Economic Causation of Illness aims to train medical students to critically understand the linkages between social and clinical medicine. Through class discussion, field visits, and films, the students and course faculty work to analyze a variety of global health interventions with an analytical framework that classifies interventions into models of charity, development, or social justice. Through description of course pedagogy and content, presentation of the framework used to analyze interventions, and incorporation of student reflection, this paper provides an example of rigorous social medicine education employing theory, discussion, and hands-on activities to train future practitioners. We argue that incorporating such training for global health practitioners is indispensable in the quest to maximize partnership and the promotion of equity in global health interventions.

Resumen: Por medio de la aplicación de una serie de enfoques pedagógicos innovadores al estudio de la medicina social, el curso “Más allá de la base biológica de la enfermedad: las causas sociales y económicas de la enfermedad” (Beyond the Biologic Basis of Disease: The Social and Economic Causation of Illness) está destinado a formar a estudiantes de medicina en la comprensión crítica de los vínculos entre la medicina social y la clínica.

A través de discusiones en clase, visitas de campo y de documentales los estudiantes y el profesorado trabajan para analizar una variedad de intervenciones en salud global dentro un marco analítico que clasifica a las intervenciones en modelos de beneficencia, de desarrollo o de justicia social. El presente artículo provee un ejemplo de educación rigurosa en medicina social que emplea teoría, discusión y actividades prácticas en la formación de futuros médicos. Además, presenta una descripción de la pedagogía y del contenido del curso, así como del marco utilizado en el análisis de las intervenciones y la incorporación de la reflección de los estudiantes. Sostenemos que este tipo de entrenamiento en la formación de trabajadores de la salud es indispensable en la búsqueda de la maximización de la colaboración y en la promoción de equidad en las intervenciones de salud global.
Support Guide for Health Care Personnel Interested in Working with the Occupy Wall Street Movement
Authors: Anderson Matt , Wen Laurie
Published: January 2025

Many health care personnel have expressed an interest in supporting the Occupy Wall Street (OWS) movement but are unsure how they can best participate. The goal of this guide is to synthesize some of the historical experience of physicians working with social movements as well as our own experience with working with Occupy Wall Street in order to provide practical guidance to health care professionals. Anyone can participate in OWS activities as a citizen.
Ethiopia: A model for long-term microgranting programs for water and sanitation
Authors: Chang Aileen , Sovornos Theodore , Lesh Neal
Published: January 2025

A microgrant is a small sum of money donated for the purpose of improving the standard of living of impoverished communities. The goal of this paper is to suggest a model which non-governmental organizations may employ to initiate long-term microgranting programs for improving access to safe drinking water and basic sanitation. The model involves the partnership of the microgranting organization with local government and communities. The aim of the model is to facilitate long-term infrastructure and capacity building with regards to the administration of microgrants. While the model is specifically applicable to microgranting in Ethiopia, many of the recommendations may be applicable to microgranting projects in other countries. The paper will address the value of microgranting to water and sanitation, the importance of partnership with the local government, and considerations for how to design a microgrant program.
Maternal mortality and severe morbidity in rural Indonesia Part 2: Implementation of a community audit
Authors: D'Ambruoso Lucia , Izati Yulia , Martha Evi , Kiger Alice , Coates Anna
Published: January 2025

INTRODUCTION: In the absence of unifying conceptual frameworks, there have been calls to identify and share practical experiences of community participation in health (CPH) to document the contexts and dynamics of participatory practice. OBJECTIVES: This article describes the process of a community-based review of care in obstetric emergencies from rural Indonesia. METHODS: Four village-based groups were convened to review a series of cases of maternal death and disability and to develop recommendations for health planning. Narrative analysis of the reviewers’ discussions was employed to describe and explain whether and how participation occurred. RESULTS: Participation was complex, dynamic and evolved over the course of the study. Although blame and defensiveness characterised the early discussions, over time the reviewers became less condemning of individuals and more so of systems and services, situating individual behaviours within wider health and social systems. Participants also increasingly shared personal experiences, generating rich and explicit reviews of care. Eliciting this information was contingent on skilful facilitation, assuring anonymity and instilling a ‘permission to criticise’ among participants. Sufficient time was also required to convey the necessary principles and reassurances. Despite evidence of learning outcomes, implementation and evaluation of the recommendations were not possible so sustainability and empowerment were likely to be limited. CONCLUSIONS: Despite its potential and relevance, the adoption of meaningful CPH activities may be threatened by wider socio-economic and political conditions, as well as by prevailing evidence hierarchies. We recommend policy and research to establish a firmer foundation for this progressive, yet obscured, public health concept.
When public health debates become abusive
Authors: Martin Brian
Published: January 2025

Ideally, public health debates are conducted civilly and focus on the evidence and the public good. In practice, many debates deviate markedly from this approach, for example with personal denigration of opponents. To help assess methods used in public health debates, a classificatory system of ideal types is introduced, with the categories of deliberative democracy, marketplace of ideas, marketplace of abusive comment, dominant orthodoxy, authoritarianism, and totalitarianism. To illustrate how methods can be fitted into these ideal types, instances of opposition to the Australian Vaccination Network are examined. Being able to identify the types of methods used in particular debates provides public health advocates with opportunities to reflect on the impact of different methods deployed and how they relate to public participation and free speech.
Teoría de la estructuración, una base conceptual para el estigma del VIH/SIDA
Authors: Misir Prem
Published: January 2025

La continua escasez de intervenciones efectivas para reducir el estigma del VIH/SIDA es alarmante, dado que desde hace tiempo se ha reconocido como una barrera significativa para la prevención, tratamiento, atención y apoyo del VIH. Las intervenciones inefectivas de su reducción son producto de marcos conceptuales y herramientas metodológicas inadecuadas. Y mientras que existe una carencia de intervenciones efectivas para reducir el estigma, no hay un déficit de marcos conceptuales que intentan ofrecer una amplia comprensión del estigma, que van desde los modelos socio-cognitivos a nivel individual hasta los modelos estructurales a nivel macro. En los modelos individualista y estructural se ofrecen observaciones que resaltan las deficiencias, acá se propone la teoría de la estructuración como una posible base conceptual complementaria para el diseño de intervenciones para la reducción del estigma del VIH/SIDA
Social policy as social vaccine
Authors: Safaei Jalil
Published: January 2025

Background: The social and economic woes that have inflicted many countries around the world are testimony to the inadequacy of current institutional makeup of societies where individualism and market forces by and large have taken the leading role in directing societies’ choices and resources. Problems of inequities in health and wealth, the widening gaps between the rich and the poor, employment insecurities, the growing social exclusion of the marginalized, and the looming environmental concerns are acute as ever. At the same time, the progressive social forces and the counter-balancing capacity of governments are being undermined by the prevailing neo-liberal forces. This sobering state of affairs can only lead to more problems and a growing frustration on the part of those who seek alternatives to the status quo, which have actually produced better results in certain countries.

Objective: This study takes the position that the involvement of democratic collective institutions (e.g., local organizations and governments at all levels) in setting societal priorities and directing resources towards achieving those priorities would avoid or mitigate many of the socioeconomic problems facing us today. It aims to show that comprehensive social policy could prevent the emergence of such problems and contain the problems that remain, effectively working as a social vaccine.

Methods: The study uses macroeconomic panel data and socioeconomic indicators from OECD countries to empirically examine the relationships between indicators of social wellbeing on the one hand, and measures of social policy on the other, while controlling for relevant macroeconomic covariates.

Results: The empirical results indicate that better population health outcomes are consistently associated with stronger social policies, including social spending on health and non-health services. Also, they show lower poverty rate is associated with higher social spending. Lower crime rate is also associated with higher social spending, but it is strongly country-specific.

Conclusion: Although improving social wellbeing and social protection are morally justified in their own right, the evidence presented in this study suggests that even a purely rational view concerned with the societal costs and benefits of public policy should find social policy an effective tool or vaccine against population ill-health, poverty, and crime.
The fight for the right to health: Global Capitalism’s crisis and accelerated expropriation
Authors: Torres Tovar Mauricio
Published: January 2025

During the first week of November 2012, the Uruguayan cities of Piriapolis and Montevideo hosted three – joint – Congresses: the XII Latin Ameri-can Congress of Social Medicine and Collective Health, the XVIII International Congress of Health Policy, and VI Congress of the American Network of Local Health Activists (La Red Américas). This combined event brought together some 700 people from 27 countries.

The three sponsoring organizations – the Latin American Social Medicine Association (ALAMES), the International Association of Health Policy (IAHP), and La Red Américas – bring together an important part of the critical health movement known as Social Medicine or Collective Health, a movement that is especially active in Europe and Latin America. The meeting brought together a diverse group, which included academics, researchers, students, health system managers, policy makers, and representatives of social movements. What united these groups was a progressive approach to health based on an analysis that took into account society, politics, culture, and environment.
An overview of the social determinants of eating disorders in Mexico
Authors: Olalde Libreros Jacqueline , Pérez-Gil Romo Sara
Published: January 2025

This paper examines some of the main social determinants associated with eating disorders in Mexico.

Eating disorders have been studied by several disciplines. Nutritional research has focused on the particular eating behaviors of those affected with eating disorders. This has led to a better appreciation of the foods eaten by individuals with eating disorders: which foods they limit or restrict, their rejection of foods considered to be of high caloric content, and the various diets they follow in order to lose weight. Risk factors for the development of complications have also been identified. This reductionist view restricts itself to the analysis of individual behavior while ignoring other socio-cultural aspects of these disorders.

The concept of social determination of health permits an analysis of the various components of eating disorders.
Health care reform in Guyana
Authors: Misir Prem
Published: January 2025

The paper is an overview of the Guyana health care system, its outcomes, health planning, health reforms, potential health reforms, and the government’s contribution, guiding the development of an efficient and equitable health system for the entire population. The current institutional arrangements for health systems and services development in Guyana pose significant challenges requiring significant health planning to achieve significant health reforms. The Health Systems Assessment (HSA) reviewed the Guyana health care system functions on six modules consistent with the WHO’s system building blocks - governance, health financing, service delivery, human resources for health (HRH), pharmaceutical management, and health information systems (HIS) – which are in synchrony with the WHO’s concept of reform. The HSA review identified areas for health reform through the WHO’s system building blocks. The paper reviewed the health plans and reforms in Guyana to establish the influence of neoliberalism in the pathway toward universal health coverage and equity.
Towards a new model of development, the state, and society
Authors: Espinoza Eduardo
Published: January 2025

This talk was given as the Juan César García Lecture, San Salvador 2014, XIII ALAMES Conference. It has been translated from the original Spanish.
10.71237/NT8VpXz4
Authors: Gómez Garrido Luisa María
Published: January 2025

Si se quiere comprender en toda su extensión el papel que desarrollan los jueces en los Estados Constitucionales de Derecho, no puede considerarse su labor solo como una cuestión de facultades y de respaldos. Así puede ocurrir si se propone la teoría estándar de la interpretación como justificación exclusiva de la interpretación judicial, proporcionando con ello estructuras lógico formales insuficientes para incorporar una reflexión lo bastante amplia y fructífera sobre la legitimidad con la que actúan los jueces en los Estados Constitucionales.

La labor judicial es también una cuestión de límites, y estos pueden entenderse en mejor medida si el constitucionalismo se concibe como un marco en el que se produce la más depurada manifestación de la división de poderes, en el que la propia soberanía popular se divide funcionalmente, y en el que la constante pugna entre el principio democrático y la constitución se administra por los jueces, que no pueden imponer al pueblo soberano, mayores sacrificios que los expresamente previstos en la Constitución, con la renuncia de facultades de decisión que esta necesariamente implica.

La preservación de la democracia constitucional depende en gran medida de la correcta y leal administración de esta tensión, que requiere tanto de la defensa de los derechos y libertades constitucionales, como de la conservación de las posibilidades de actualización democrática de todos los universos posibles que coexisten en la constitución.
Analisis Pengaruh Pertumbuhan Ekonomi Terhadap Pendapatan Asli Daerah di Kota Pematangsiantar
Authors: Eve Ida Malau
Published: January 2025

Pertumbuhan ekonomi merupakan perubahan kondisi ekonomi yang ditandai dengan peningkatan kapasitas produksi barang dan jasa selama periode tertentu dan dapat diartikan akan memberikan kontribusi pada pendapatan daerah. Tujuan dari penelitian ini adalah untuk mengetahui pengaruh pertumbuhan ekonomi terhadap pendapatan asli daerah. Penelitian ini dilakukan di kota Pematangsiantar. Data sekunder yang digunakan dalam penelitian ini adalah data pertumbuhan ekonomi dan realisasi pendapatan asli daerah tahun 2012-2021 yang berasal dari website resmi Badan Pusat Statistik (BPS). Analisis data yang digunakan adalah analisis regresi linier sederhana. Alat analisis data yang digunakan dalam penelitian ini adalah uji normalitas, regresi linier sederhana, uji t, dan koefisien determinasi. Hasil penelitian ini menunjukkan bahwa pertumbuhan ekonomi berpengaruh terhadap pendapatan asli daerah di kota Pematangsiantar yang ditunjukkan oleh nilai pertumbuhan ekonomi  yaitu sebesar thitung = 5,711 > ttabel = 2,306 dengan taraf signifikan 0,05. Besarnya pengaruh pertumbuhan ekonomi yaitu sebesar 80,3% sedangkan sebesar 19,7% dipengaruhi oleh variabel lain.
Pengaruh Kemudahan Fitur Layanan Terhadap Keputusan Pengguna Bank BCA Dengan Peran Mediasi Kualitas Pelayanan
Authors: Muhammad Hilmi Firnanda  , Mirzam Arqy Ahmadi
Published: January 2025

Penelitian ini menganalisis pengaruh kemudahan fitur layanan terhadap keputusan penggunaan Bank BCA dengan mempertimbangkan peran mediasi kualitas pelayanan. Dalam era digital, kemajuan teknologi memungkinkan terciptanya layanan inovatif seperti mobile banking yang mempermudah transaksi nasabah. Dengan menggunakan metode kuantitatif berbasis Partial Least Squares Structural Equation Modeling (PLS-SEM), data dari 100 nasabah Bank BCA di wilayah Soloraya dikumpulkan melalui teknik purposive sampling. Hasil penelitian menunjukkan bahwa kemudahan fitur berpengaruh signifikan terhadap keputusan penggunaan, baik secara langsung maupun melalui kualitas pelayanan sebagai mediator. Keterbatasan penelitian ini adalah ukuran sampel yang kecil dan lokasi penelitian yang terbatas, sehingga hasilnya perlu diinterpretasikan dengan hati-hati dalam konteks yang lebih luas.
Peran Etika Dalam Mewujudkan Good Governance
Authors: Sri Rahmawati  , Dhea Nowanda
Published: January 2025

Etika dalam good governance menjadi isu krusial yang menentukan efektivitas penyelenggaraan pemerintahan modern. Penelitian ini bertujuan untuk menganalisis peran fundamental etika dalam mewujudkan good governance, mengidentifikasi tantangan implementasinya, serta merumuskan strategi penguatannya. Menggunakan metode penelitian kualitatif dengan pendekatan studi kepustakaan, penelitian ini mengkaji berbagai sumber literatur terkini tentang etika dan good governance. Hasil penelitian menunjukkan bahwa etika berperan penting dalam memperkuat pilar-pilar good governance, meliputi transparansi, akuntabilitas, partisipasi, dan rule of law. Tantangan implementasi etika mencakup aspek internal seperti budaya organisasi dan kapasitas SDM, serta aspek eksternal seperti perkembangan teknologi dan dinamika sosial politik. Strategi penguatan etika memerlukan pendekatan komprehensif yang meliputi pengembangan sistem dan regulasi, peningkatan kapasitas aparatur, penguatan pengawasan, dan pemberdayaan partisipasi publik. Penelitian ini memberikan kontribusi teoretis dan praktis dalam pengembangan kerangka implementasi etika dalam good governance.