Salud Colectiva最新文献

["Everything was both very fast and very slow at the same time": heterochronic experiences of healthcare professionals in the provision of aid in dying in Spain]. [“一切同时又快又慢”：西班牙医疗保健专业人员在提供死亡援助方面的异质经验]。

IF 1.1 4区医学

Salud Colectiva Pub Date : 2026-05-20 DOI: 10.18294/sc.2026.5972

Eduard Moreno-Gabriel, Maria Verdaguer, Patricia Beroiz-Groh, Xavier Busquet-Duran, Antonia Arreciado Marañón, Maria Feijoo-Cid, Miquel Domènech, Lupicinio Íñiguez-Rueda, Pere Toran-Monserrat

{"title":"[\"Everything was both very fast and very slow at the same time\": heterochronic experiences of healthcare professionals in the provision of aid in dying in Spain].","authors":"Eduard Moreno-Gabriel, Maria Verdaguer, Patricia Beroiz-Groh, Xavier Busquet-Duran, Antonia Arreciado Marañón, Maria Feijoo-Cid, Miquel Domènech, Lupicinio Íñiguez-Rueda, Pere Toran-Monserrat","doi":"10.18294/sc.2026.5972","DOIUrl":"10.18294/sc.2026.5972","url":null,"abstract":"Since its enactment, Organic Law 3/2021 on the Regulation of Euthanasia has altered the experience and professional practice of numerous individuals within the healthcare field in Spain. This impact is evident in how these professionals perceive the various temporalities involved in the process. Using the notion of heterochrony, this article captures this multi-temporality through an interpretive phenomenological analysis of 29 interviews and three focus groups with professionals involved in medical aid in dying. The professionals report a multiplicity of overlapping and interacting times: the time of the law, the patient's time, family time, bio-pharmacological times, and socio-historical time. Tensions are highlighted between the deadlines set by the law and the times experienced by applicants, or between bio-pharmacological temporalities and prevailing professional logics. The article also assesses temporal spaces to support families and transition toward an emerging professional paradigm. Managing this heterochrony poses a challenge for this new role. However, the assembly, synchronization, and composition of the different times could facilitate a harmonious implementation of the law, improving the experience of all involved.","PeriodicalId":44640,"journal":{"name":"Salud Colectiva","volume":"22 ","pages":"e5972"},"PeriodicalIF":1.1,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Cesarean sections as a biopolitical expression of birth: The case of Neuquén province, Argentina]. [剖宫产作为出生的生物政治表达：阿根廷neuquacimen省的案例]。

IF 1.1 4区医学

Salud Colectiva Pub Date : 2026-05-15 DOI: 10.18294/sc.2026.6032

Serena Perner, Hugo Spinelli, Viviana Martinovich, Marcio Alazraqui

{"title":"[Cesarean sections as a biopolitical expression of birth: The case of Neuquén province, Argentina].","authors":"Serena Perner, Hugo Spinelli, Viviana Martinovich, Marcio Alazraqui","doi":"10.18294/sc.2026.6032","DOIUrl":"10.18294/sc.2026.6032","url":null,"abstract":"Cesarean sections continue to increase globally regardless of international recommendations and evidence of their risks when not medically indicated. This study characterizes the time-trend of birth indicators in the province of Neuquén, Argentina, through the perspective of the biopolitics of birth, which understands the cesarean section not merely as a surgical technique, but as a complex device, a biopolitical technology that acts simultaneously on multiple levels. A time-trend analysis was conducted using provincial administrative records, reconstructing indicators of birth rate, infant mortality, and delivery mode from 1970 to 2022. For the period 2011 and 2022, the relationship between changes over time in the cesarean section rate according to socioeconomic and healthcare variables was studied using generalized linear models. The results show a sustained increase in cesarean sections - from 20% in 1995 to 50% in 2022 - in a context marked by declining birth rates and infant mortality, along with patterns that vary according to educational level, age of the pregnant people, type of healthcare facility, and timing of births. These findings suggest that the rise in cesarean sections can be interpreted as part of a broader process of regulating and standardizing modes of giving birth, in which the cesarean section is configured as a technology that contributes to producing predictability and establish standards regarding when and how birth should occur, thereby shaping subjectivities that reshape the social and symbolic conditions of birth.","PeriodicalId":44640,"journal":{"name":"Salud Colectiva","volume":"22 ","pages":"e6032"},"PeriodicalIF":1.1,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dying with dignity, but what is dignity? 死得有尊严，但什么是尊严？

IF 1.1 4区医学

Salud Colectiva Pub Date : 2026-04-23 DOI: 10.18294/sc.2026.5975

Martín D Farrell

引用次数: 0

Shame over tooth loss: between psychological suffering and structural inequality in Chilean oral health. 对牙齿脱落感到羞耻：智利口腔健康的心理痛苦与结构不平等之间的关系。

IF 1.1 4区医学

Salud Colectiva Pub Date : 2026-03-26 DOI: 10.18294/sc.2026.5911

Manuel Alejandro Castro Gatica, Karen Danke Hausdorf, Ingeborg Bevensee Canavati, Ana Beatriz Silva Lopes, Jorge Gamonal

{"title":"Shame over tooth loss: between psychological suffering and structural inequality in Chilean oral health.","authors":"Manuel Alejandro Castro Gatica, Karen Danke Hausdorf, Ingeborg Bevensee Canavati, Ana Beatriz Silva Lopes, Jorge Gamonal","doi":"10.18294/sc.2026.5911","DOIUrl":"10.18294/sc.2026.5911","url":null,"abstract":"The article analyzes how tooth loss among older adults is not merely a clinical issue but a social and emotional phenomenon marked by shame, stigma, and structural inequality in oral health in Chile. From a qualitative, narrative approach with a descriptive scope and a hermeneutic (interpretive) orientation, 12 interviews were conducted in the commune of Cerro Navia, in the Metropolitan Region of Chile, between August and September 2024. The narratives reveal that tooth loss affects self-esteem, identity, and social participation. Shame manifests in behaviors such as covering the mouth, avoiding smiling, speaking in public, or attending social gatherings, leading to social isolation and psychological suffering. The testimonies show that lack of financial resources and limited access to public dental care exacerbate this distress, forcing many individuals to resign themselves to tooth loss. This condition, in addition to limiting nutrition and everyday functioning, becomes a social marker of class, reinforcing moral judgments associated with poverty and poor hygiene. The study concludes that shame cannot be understood solely as an individual emotion, but rather as a social device that reproduces inequalities and exclusions. An integrated approach to oral health is proposed, ensuring equitable access to treatment, dignity, and quality of life, while recognizing its direct link to mental health.","PeriodicalId":44640,"journal":{"name":"Salud Colectiva","volume":"22 ","pages":"e5911"},"PeriodicalIF":1.1,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

["Until God says 'yes or no', but here, in my home": autonomy and end-of-life care for rural older adults in the Los Lagos Region, Chile]. [“直到上帝说‘是或不是’，但就在这里，在我的家里”：智利洛斯拉各斯地区农村老年人的自主权和临终关怀]。

IF 1.1 4区医学

Salud Colectiva Pub Date : 2026-03-13 DOI: 10.18294/sc.2026.5969

Ignacia Navarrete, Alejandra Fuentes-García, Verónica Aliaga-Castillo

{"title":"[\"Until God says 'yes or no', but here, in my home\": autonomy and end-of-life care for rural older adults in the Los Lagos Region, Chile].","authors":"Ignacia Navarrete, Alejandra Fuentes-García, Verónica Aliaga-Castillo","doi":"10.18294/sc.2026.5969","DOIUrl":"10.18294/sc.2026.5969","url":null,"abstract":"Aging and increased life expectancy generate growing challenges for end-of-life care in old age, particularly in rural contexts marked by territorial and health inequalities. From the perspective of gerontological geography and the notions of autonomy and agency of older adults, this study aims to generate an understanding of end-of-life as a lived experience from the subjective worlds of and with the people involved. To this end, a qualitative study, with an ethnographic approach and case study strategy, was conducted in the Los Lagos Region of Chile between 2022 and 2023. This included semi-structured interviews and ethnographic observation of rural older adults in the end-of-life stages, their caregivers, and rural health teams. The results show that remaining at home is a central desire and organizes care, sustained primarily by feminized family networks and rural primary care. The home becomes a space of care, and health teams play a key role in providing clinical and relational support at the end-of-life. It is concluded that end-of-life care in rural areas requires territorial approaches that recognize autonomy in old age and the structural inequalities of these processes.","PeriodicalId":44640,"journal":{"name":"Salud Colectiva","volume":"22 ","pages":"e5969"},"PeriodicalIF":1.1,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[End-of-life practices and advance directives: a bioethical analysis based on discussions in the Brazilian Federal Legislative Branch]. [临终实践和预先指示：基于巴西联邦立法部门讨论的生物伦理分析]。

IF 1.1 4区医学

Salud Colectiva Pub Date : 2026-03-12 DOI: 10.18294/sc.2026.5939

Melisse Eich, Marta Verdi, Pedro Paulo Scremin Martins, Mirelle Finkler

{"title":"[End-of-life practices and advance directives: a bioethical analysis based on discussions in the Brazilian Federal Legislative Branch].","authors":"Melisse Eich, Marta Verdi, Pedro Paulo Scremin Martins, Mirelle Finkler","doi":"10.18294/sc.2026.5939","DOIUrl":"10.18294/sc.2026.5939","url":null,"abstract":"The Brazilian legislative debate on end-of-life practices involves ethical-axiological tensions related to euthanasia, assisted suicide, palliative care, and advance directives, in which divergent conceptions of these practices and of the value of life confront one another, influencing the normative formulation of the dying process. This study analyzes how such tensions are constructed and justified in the discourses of the Federal Legislative Branch, examining the normative meanings and the hierarchy of values attributed to the palliative care framework and to advance directives, as well as their ethical and moral implications. A qualitative documentary study was conducted, guided by a hermeneutic-dialectical approach and grounded in contemporary frameworks of the bioethics of responsibility and everyday bioethics. A total of 193 federal legislative documents (1981-2020) were examined. The analysis yielded two thematic categories: (1) the palliative care framework: meanings and attributions, which reveals the legislative tendency to limit the right to therapeutic refusal; and (2) instruments and mechanisms for the reversal of advance directives, which exposes restrictions on instruments intended to protect autonomy. The findings indicate the predominance of arguments grounded in vital values treated as absolute, to the detriment of personal values such as human dignity, autonomy, and self-determination, which may restrict the right to die with dignity in Brazil.","PeriodicalId":44640,"journal":{"name":"Salud Colectiva","volume":"22 ","pages":"e5939"},"PeriodicalIF":1.1,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Labor inclusion and medicalization: neuroleptics as actants in the experiences of workers diagnosed with schizophrenia in Chile]. [劳动包容和医疗化：在智利被诊断为精神分裂症的工人的经历中，抗精神病药作为行动者]。

IF 1.1 4区医学

Salud Colectiva Pub Date : 2026-03-10 DOI: 10.18294/sc.2026.5903

Ernesto Bouey Vargas, María José Reyes Andreani

{"title":"[Labor inclusion and medicalization: neuroleptics as actants in the experiences of workers diagnosed with schizophrenia in Chile].","authors":"Ernesto Bouey Vargas, María José Reyes Andreani","doi":"10.18294/sc.2026.5903","DOIUrl":"10.18294/sc.2026.5903","url":null,"abstract":"People diagnosed with schizophrenia exhibit low rates of labor market participation, a phenomenon that has been predominantly addressed from biomedical approaches that associate work inclusion with pharmacological stabilization. However, there is limited research examining how the everyday use of neuroleptics shapes the work experiences of those employed with this diagnosis. The aim of this study was to understand the role of neuroleptics - conceived as actants - in the experiences of workers diagnosed with schizophrenia in Chile and their implications for labor inclusion. A qualitative ethnographic study was conducted between 2022 and 2024 in the Metropolitan Region of Chile, including participant observation across diverse everyday and workplace settings, as well as 86 interviews (53 with workers diagnosed with schizophrenia and 33 with individuals from their close environment). Drawing on actor-network theory and the notion of enactment, the analysis identified that the diagnosis and the neuroleptic become assembled as a lifelong practice, configuring an experience marked by tensions. Although medications are valued for alleviating distress, their assemblage with diagnosis and their side effects - sedation, motor disturbances, salivation, weight gain, and affective flattening - mediate the body, the psyche, and social life, hindering work performance and exposing individuals to stigma and discrimination.","PeriodicalId":44640,"journal":{"name":"Salud Colectiva","volume":"22 ","pages":"e5903"},"PeriodicalIF":1.1,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Existential suffering and autonomy: Contributions to the debates on euthanasia and medically assisted suicide in Argentina]. [存在的痛苦和自主：对阿根廷关于安乐死和医疗协助自杀的辩论的贡献]。

IF 1.1 4区医学

Salud Colectiva Pub Date : 2026-03-09 DOI: 10.18294/sc.2026.5970

Darío Iván Radosta, Matias Paschkes Ronis

引用次数: 0

Lay knowledge and epistemic justice in mental health: a critical analysis of the peer support worker in the Spanish State. 心理健康中的基础知识和认知正义：对西班牙国家同伴支持工作者的批判性分析。

IF 1.1 4区医学

Salud Colectiva Pub Date : 2026-02-26 DOI: 10.18294/sc.2026.6041

Diana Gonzalez-Mañas, Martín Correa-Urquiza

{"title":"Lay knowledge and epistemic justice in mental health: a critical analysis of the peer support worker in the Spanish State.","authors":"Diana Gonzalez-Mañas, Martín Correa-Urquiza","doi":"10.18294/sc.2026.6041","DOIUrl":"10.18294/sc.2026.6041","url":null,"abstract":"This essay critically examines the figure of the peer support worker within the mental health system of the Spanish State as a dispositif situated in the tension between the transformation of epistemic hierarchies and the risk of institutional co-optation. Drawing on our experiences and research in the field of critical medical anthropology and human rights in mental health, together with and from the activisms of the Mad Movement in the Spanish State, we analyse how this professional figure simultaneously embodies a promise of epistemic power redistribution and the danger of neutralisation by the hegemonic biomedical model. We argue that epistemic justice in mental health requires the radical transformation of the material, relational, and institutional conditions that have historically sustained the delegitimation of experiential knowledge. Through a genealogical analysis of the peer support worker and its processes of institutionalisation, we identify the structural conditions that determine whether its incorporation can effectively challenge dominant regimes of truth or, conversely, operates as a mechanism of legitimation that formally incorporates diversity without transforming existing logics of power. We conclude by proposing a framework of four dimensions of political intervention: strengthening epistemic fraternities and Mad Movement networks as community assets, transforming professional cultures, contesting regulatory frameworks, and articulating local processes of knowledge co-production.","PeriodicalId":44640,"journal":{"name":"Salud Colectiva","volume":"22 ","pages":"e6041"},"PeriodicalIF":1.1,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Illegal yet ongoing: surrogacy through the moral prism of urban Chinese women in Nanjing]. 非法但仍在进行：通过南京中国城市女性的道德棱镜看代孕。

IF 1 4区医学

Salud Colectiva Pub Date : 2026-01-13 DOI: 10.18294/sc.2026.5995

Zhenkang Li

引用次数: 0