Vacinas e desinformação: uma análise de conteúdo sobre fake newsapuradas por plataformas de debunkingem redes sociais / Vaccines and disinformation: a content analysis on fake news verified by debunking platforms on social networks / Vacunas y desinformación: un análisis de contenidos sobre fake news verificadas por las plataformas de debunking en las redes sociales

O impacto das fake news chegou à área da saúde e a desconfiança em relação às vacinas trouxe de volta doenças até então erradicadas. Mas como os discursos antivacinasão construídos nas redes sociais? Neste trabalho, 80fake news com foco nas vacinas foram coletadas de sites brasileiros que realizam debunking, uma estratégia de detecção e desmascaramento de desinformação e fake news. A partir da aplicação de um protocolo analítico, mapeamos as principais características presentes na elaboração dessas publicações. A análise de conteúdo revelou que o Facebook e o WhatsApp são as redes preferidas para esse tipo de compartilhamento. Cerca de 59% dos conteúdos são totalmente falsos e a maioria dos discursos destaca possíveis riscos das vacinas como estratégias de convencimento. As fontes mais referenciadas são supostamente médicos e cientistas, para criar confiabilidade. O levantamento aponta ainda que 60% das publicações apresentaram erros gramaticais e ortográficos na elaboração dos textos

The impact of fake news reached the health area and distrust in relation to vaccines brought back diseases that had been eradicated. But how are these anti-vaccine discourses constructed in social medias? In this paper, 80 fake news stories focusing on vaccines were collected through Brazilian websites that perform debunking, a strategy for detecting and unmasking misinformation and fake news. From the application of an analytical protocol, the main characteristics present in the elaboration of these publications were mapped. Content analysis revealed that Facebook and WhatsApp are the preferred medias for this type of sharing. About 59% of the contents are totally false and most of the speeches highlight the risks of vaccines as a convincing strategy. The most referenced sources are supposedly doctors and scientists to create re-liability. The survey also points out that 60% of publications have grammatical and spelling errors in the preparation of texts

El impacto de las fake news llegó al área de la salud y la desconfianza en las vacunas trajo de vuelta enfermedades erradicadas. Pero, ¿cómo se construyen los discursos antivacunas en las redes sociales? En este trabajo, se recopilaron 80 noticias falsas centradas en vacunas a través de sitios web brasileños que realizan debunking, una estrategia para detectar y desenmascarar información errónea y noticias falsas. A partir de la aplicación de un protocolo analítico, mapeamos las principales características presentes en la elaboración de estas publicaciones. El análisis de contenido reveló que Facebook y WhatsApp son las redes preferidas para este tipo de intercambio. Alrededor del 59% del contenido es completamente falso y la mayoría destaca los posibles riesgos de las vacunas como estrategias convincentes. Las fuentes más referenciadas son supuestamente médicos y científicos para crear confiabilidad. La encuesta señala que el 60% de las publicaciones tenían errores gramaticales y ortográficos

The effects of releasing early results from ongoing clinical trials.

Most trials do not release interim summaries on efficacy and toxicity of the experimental treatments being tested, with this information only released to the public after the trial has ended. While early release of clinical trial data to physicians and patients can inform enrollment decision making, it may also affect key operating characteristics of the trial, statistical validity and trial duration. We investigate the public release of early efficacy and toxicity results, during ongoing clinical studies, to better inform patients about their enrollment options. We use simulation models of phase II glioblastoma (GBM) clinical trials in which early efficacy and toxicity estimates are periodically released accordingly to a pre-specified protocol. Patients can use the reported interim efficacy and toxicity information, with the support of physicians, to decide which trial to enroll in. We describe potential effects on various operating characteristics, including the study duration, selection bias and power.

Uso y difusión responsable de la información en pandemia: un imperativo ético / The responsible use and dissemination of information in a pandemic: an ethical imperative

La actual pandemia por COVID-19 está generando un impacto sin precedentes en las distintas esferas de la vida, al mismo tiempo que ha puesto en valor la importancia que la disciplina Bioética tiene para el análisis y la deliberación de los desafíos éticos emergentes, previo a la adopción de decisiones razonables y prudentes. Un tema insuficientemente tratado en el curso de esta crisis, cuyos negativos efectos, se consideran, pueden llevar no sólo a interferir los canales de comunicación con la ciudadanía sino a afectar la adherencia esperada de la población a las indicaciones que se necesita que sigan, es la relativa al manejo y comunicación de la información. Asunto especialmente complejo cuando se vive un período de explosión informativa, caracterizada por la Organización Mundial de la Salud como «infodemia¼. Este artículo, reivindicando el imperativo ético y jurídico de actuar responsable en la obtención, uso y difusión de la información que asiste a toda autoridad que desempeña una función social, propone una serie de recomendaciones para alcanzar su efectividad en la práctica.

The current COVID-19 pandemic is producing an unprecedented impact in the different spheres of life, at the same time that it has highlighted the importance that the Bioethics discipline has in analyzing and deliberating of emerging ethical challenges, before making reasonable and prudent decisions. The management and communication of information on this crisis has not been properly addressed, where it is considered that its negative effects may lead not only to interfere with the communication channels with citizens but also affect the expected adherence of the population to the indications that they need to follow. This issue is especially complex when experiencing a period of information explosion, a phenomenon called 'infodemic' by the World Health Organization. This article, claiming the ethical and legal imperative to act responsibly in collecting, using, and disse minating the information that helps any authority that plays a social function, proposes a series of recommendations to achieve its effectiveness in practice.

Addressing Ethical Challenges in US-Based HIV Phylogenetic Research.

In recent years, phylogenetic analysis of HIV sequence data has been used in research studies to investigate transmission patterns between individuals and groups, including analysis of data from HIV prevention clinical trials, in molecular epidemiology, and in public health surveillance programs. Phylogenetic analysis can provide valuable information to inform HIV prevention efforts, but it also has risks, including stigma and marginalization of groups, or potential identification of HIV transmission between individuals. In response to these concerns, an interdisciplinary working group was assembled to address ethical challenges in US-based HIV phylogenetic research. The working group developed recommendations regarding (1) study design; (2) data security, access, and sharing; (3) legal issues; (4) community engagement; and (5) communication and dissemination. The working group also identified areas for future research and scholarship to promote ethical conduct of HIV phylogenetic research.

Direct-to-consumer misleading information on cancer risks calls for an urgent clarification of health genetic testing performed by commercial companies.

Direct-to-consumer (DTC) commercial companies offer genetic tests that are presented as allowing individuals the opportunity to increase their capacities to be in charge of their own healthcare managements. DTC companies deny performing medical tests, yet they provide data based on sequencing multigene panel or whole exome. This contradiction allows these companies to escape the requirements of a regulated medical practice that guarantees the quality of the tests, as well as the information and support for tested individuals. Herein, we illustrate the lack of such requirements by analysing the bad experience of a young man who dealt with DTC health genetic testing companies. There is an emergency for DTC testing to be either deprived of any medically relevant information, or carried out in a legally regulated medical framework.

Navigating the Intersection between Genomic Research and Clinical Practice.

The Risk Assessment Program (RAP) at Fox Chase Cancer Center (Philadelphia, PA) is a multi-generational prospective cohort, enhanced for personal and family history of cancer, consisting of over 10,000 individuals for whom data on personal and family history of cancer, risk factors, genetic and genomic data, health behaviors, and biospecimens are available. The RAP has a broad research agenda including the characterization of genes with known or potential relevance to cancer, gene-gene and gene-environment interactions, and their contribution to clinically useful risk assessment and risk reduction strategies. Increasingly, this body of research is identifying genetic changes which may have clinical significance for RAP research participants, leading us to confront the issue of whether to return genetic results emerging from research laboratories. This review will describe some of the important fundamental points that must be debated as we develop a paradigm for return of research results. The key issues to address as the scientific community moves toward adopting a policy of return of research results include the best criteria for determining which results to offer, the consent document components necessary to ensure that the participant makes a truly informed decision about receiving their results, and associated logistical and cost challenges.See all articles in this Special Collection Honoring Paul F. Engstrom, MD, Champion of Cancer Prevention.

Produção de sentidos e posicionamento político na mídia impressa brasileira / Producción de sentidos y de posicionamiento político en medios impresos brasileiros / Production of meanings and political positioning in brazilian print media

Resumo O presente estudo tem como objetivo analisar o papel da mídia impressa jornalística na produção de discursos e sentidos sobre o acontecimento histórico que foi o afastamento da presidente Dilma Rousseff de suas funções. A análise compreende e enfoca o posicionamento político adotado por um jornal e sua disponibilidade para veicular posições diferentes daquelas adotadas por esse órgão de comunicação. Para fins de análise, foi selecionado o jornal Folha de S. Paulo, de grande circulação e com presença significativa no cenário nacional. O conteúdo do jornal, bem como suas manchetes e capas, foram examinados tanto sob o enfoque quantitativo quanto qualitativo. Resultou que o jornal mantém um posicionamento uniforme e contrário ao governo eleito e destituído, o que é compartilhado com outros órgãos de comunicação. Como resultado, pode-se dizer que esse fato faz parte de um processo político de dominação realizado no âmbito da comunicação, contrariando os princípios democráticos.

Resumen Este estudio pretende analizar el papel de los medios periodísticos impresos en la producción de discursos y sentidos sobre el evento histórico que fue la alejamiento de la Presidenta Dilma Rousseff de sus funciones. El análisis comprende y enfoca el posicionamiento político adoptado por un diario y su disponibilidad para difundir posiciones diferentes de las adoptadas por ese órgano de comunicación. Para efectos del análisis, se seleccionó el diario Folha de S. Paulo, de circulación masiva y significativa presencia en la escena nacional. El contenido del periódico, así como sus titulares y portadas, se examinaron tanto bajo el enfoque cuantitativo y cualitativo. Se reveló que el diario mantiene un posicionamiento uniforme y contrario al gobierno electo y destituído, compartillado por otros medios. Como resultado, puede decirse que este hecho forma parte de un proceso político de dominación realizado en el ámbito de la comunicación, contrariando a los principios democráticos.

Abstract This study aims to analyze the role of journalistic print media in the production of discourse and meanings about the historic event that was the removal of President Dilma Rousseff from her duties. The analysis consisted of and focused on the political position adopted by a newspaper and its availability to serve positions different from those adopted by this organ of communication. For analysis purposes, the Folha de S. Paulo newspaper, which is widely circulated and has a significant presence on the national scene, was selected. The content of the newspaper, as well as its headlines and magazine covers, were examined under the quantitative and qualitative focuses. The analysis resulted in the newspaper maintaining a uniform contrary position to the elected and removed government, a result that is shared with other media. As a result, it can be said that this fact is part of a political process of domination carried out within the scope communication, which goes against democratic principles.

Why "Reply All" Can Push All the Wrong Buttons.

Technology has changed the way medicine is practiced. This commentary considers the effect of digital communications and offers advice on e­mail etiquette.

Should Researchers Offer Results to Family Members of Cancer Biobank Participants? A Mixed-Methods Study of Proband and Family Preferences.

BACKGROUND: Genomic analysis may reveal both primary and secondary findings with direct relevance to the health of probands' biological relatives. Researchers question their obligations to return findings not only to participants but also to family members. Given the social value of privacy protection, should researchers offer a proband's results to family members, including after the proband's death? METHODS: Preferences were elicited using interviews and a survey. Respondents included probands from two pancreatic cancer research resources, plus biological and nonbiological family members. Hypothetical scenarios based on actual research findings from the two cancer research resources were presented; participants were asked return of results preferences and justifications. Interview transcripts were coded and analyzed; survey data were analyzed descriptively. RESULTS: Fifty-one individuals (17 probands, 21 biological relatives, 13 spouses/partners) were interviewed. Subsequently, a mailed survey was returned by 464 probands, 1,040 biological family members, and 399 spouses/partners. This analysis highlights the interviews, augmented by survey findings. Probands and family members attribute great predictive power and lifesaving potential to genomic information. A majority hold that a proband's genomic results relevant to family members' health ought to be offered. While informants endorse each individual's choice whether to learn results, most express a strong moral responsibility to know and to share, particularly with the younger generation. Most have few concerns about sharing genetic information within the family; rather, their concerns focus on the health consequences of not sharing. CONCLUSIONS: Although additional studies in diverse populations are needed, policies governing return of genomic results should consider how families understand genomic data, how they value confidentiality within the family, and whether they endorse an ethics of sharing. A focus on respect for individual privacy-without attention to how the broad social and cultural context shapes preferences within families-cannot be the sole foundation of policy.

BRCA Challenge: BRCA Exchange as a global resource for variants in BRCA1 and BRCA2.

The BRCA Challenge is a long-term data-sharing project initiated within the Global Alliance for Genomics and Health (GA4GH) to aggregate BRCA1 and BRCA2 data to support highly collaborative research activities. Its goal is to generate an informed and current understanding of the impact of genetic variation on cancer risk across the iconic cancer predisposition genes, BRCA1 and BRCA2. Initially, reported variants in BRCA1 and BRCA2 available from public databases were integrated into a single, newly created site, www.brcaexchange.org. The purpose of the BRCA Exchange is to provide the community with a reliable and easily accessible record of variants interpreted for a high-penetrance phenotype. More than 20,000 variants have been aggregated, three times the number found in the next-largest public database at the project's outset, of which approximately 7,250 have expert classifications. The data set is based on shared information from existing clinical databases-Breast Cancer Information Core (BIC), ClinVar, and the Leiden Open Variation Database (LOVD)-as well as population databases, all linked to a single point of access. The BRCA Challenge has brought together the existing international Evidence-based Network for the Interpretation of Germline Mutant Alleles (ENIGMA) consortium expert panel, along with expert clinicians, diagnosticians, researchers, and database providers, all with a common goal of advancing our understanding of BRCA1 and BRCA2 variation. Ongoing work includes direct contact with national centers with access to BRCA1 and BRCA2 diagnostic data to encourage data sharing, development of methods suitable for extraction of genetic variation at the level of individual laboratory reports, and engagement with participant communities to enable a more comprehensive understanding of the clinical significance of genetic variation in BRCA1 and BRCA2.

The Ethical and Professional Use of Social Media in Surgery: A Systematic Review of the Literature.

Although certain medical societies have released guidelines on the use of social media, plastic surgery, with its inherent visual nature and potential for sensationalism, could benefit from increasing direction regarding the ethical use of social media. The authors hypothesized that although general platitudes for use exist in the literature, guidelines articulating the boundaries of professional use are nonspecific. Systematic searches of MEDLINE, Embase.com, and Cochrane Central Register of Controlled Trials were completed on January 18, 2017. Searches consisted of a combination of Medical Subject Headings terms and title and abstract keywords for social media and professionalism concepts. In addition, the authors manually searched the three highest impact plastic surgery journals (ending in October of 2017). Two authors screened all titles and abstracts. Studies related to clinical medicine, patient care, and the physician-patient relationship were included for full-text review. Articles related to surgery merited final inclusion. The initial search strategy yielded 954 articles, with 28 selected for inclusion after final review. The authors' manual search yielded nine articles. Of the articles from the search strategy, 10 were published in the urology literature, eight were published in general surgery, six were published in plastic surgery, three were published in orthopedic surgery, and one was published in vascular surgery. Key ethical themes emerged across specialties, although practical recommendations for professional social media behavior were notably absent. In conclusion, social media continue to be a domain with potential professional pitfalls. Appropriate use of social media must extend beyond obtaining consent, and plastic surgeons must adhere to a standard of professionalism far surpassing that of today's media culture.