La relación entre la leche y la mortalidad en la infancia: un problema de salud pública en Chile (Santiago, 1930-1962) / The relation between milk and mortality in childhood: a public health problem in chile (Santiago, 1930-1962)

This article analyzes the relationship between infant mortality and milk consumption in the Province of Santiago during 1930-1962. The process studied begins with the Pasteurization Law, which by sanitizing milk reduced the number of children with gastrointestinal diseases and indeed mortality, and ends with the inauguration of milk distribution programs. It is argued that the scarcity and insufficient hygiene of this product, added to the cultural and housing conditions that surrounded the children, are explanatory factors for the high mortality of infants, while recognizing the State as a fundamental promoter of public policies to correct the demographic catastrophe. The research, supported by newspapers, medical journals, degree theses, statistical yearbooks, and government documents, concludes that the set of laws, regulations and state programs produced a set of changes among State actors, reflected in practices and approval discourses and rejection of the importance of sanitizing milk, which, ultimately, did not prevent a considerable decrease in the number of children who died for food reasons

Este artículo analiza la relación entre la mortalidad en la infancia y el consumo de leche en la Provincia de Santiago durante 1930-1962. El proceso estudiado comienza con la Ley de Pasteurización que al higienizar la leche redujo las cifras de niños con enfermedades gastrointestinales y en efecto la mortalidad, y finaliza con la inauguración de los programas de distribución de leche. Se argumenta que la escasez y la higiene insuficiente de ese producto sumadas a las condiciones culturales y habitacionales que rodeaban a los niños son factores explicativos de la mortalidad alta de infantes, a la vez que reconoce en el Estado un promotor fundamental de políticas públicas para subsanar la catástrofe demográfica. La investigación, sustentada en periódicos, revistas médicas, tesis de titulación, anuarios estadísticos, y documentos gubernamentales, concluye que el conjunto de leyes, reglamentos y programas estatales produjo un conjunto de cambios entre los actores del Estado, reflejados en prácticas y discursos de aprobación y rechazo hacia la importancia de higienizar la leche que, en última instancia, no impidieron una disminución considerable de niños muertos por razones alimentarias.

La Enfermería en Argentina de fines del siglo XIX: los aportes de Cecilia Grierson / Nursing in Argentina at the end of the 19th century: the contributions of Cecilia Grierson

A través de décadas, la Enfermería en Argentina progresó y fue cambiando sus conceptos y definiciones. Se estableció como campo científico y se describió en numerosas oportunidades como una serie de tareas y técnicas (subordinadas a la medicina); como un servicio humano amplio, como una vocación aprendida, hasta que en la actualidad es considerada una disciplina en el área de la salud, que maneja el cuidado de ésta durante el transcurso del ciclo vital [Fragmento de texto] (AU)

The pushback against state interference in science: how Lysenkoism tried to suppress Genetics and how it was eventually defeated.

Genetics in the Soviet Union (USSR) achieved state-of-the-art results and had reached a peak of development by the mid-1930s due to the efforts of the scientific schools of several major figures, including Sergei Navashin, Nikolai Koltsov, Grigorii Levitsky, Yuri Filipchenko, Nikolai Vavilov, and Solomon Levit. Unfortunately, the Soviet government distrusted intellectually independent science and this led to state support for a fraudulent pseudoscientific concept widely known as Lysenkoism, which hugely damaged biology as a whole. Decades of dominance of the Lysenkoism had ruinous effects and the revival of biology in the USSR in the late 1950s-early 1960s was very difficult. In fact, this was realized to be a problem for Soviet science as a whole, and many mathematicians, physicists, chemists, and other scientists made efforts to rehabilitate genetics and to transfer biology to the "jurisdiction" of science from that of politics. The key events in the history of these attempts to pushback against state interference in science, and to promote the development of genetics and molecular biology, are described in this paper. These efforts included supportive letters to the authorities (e.g., the famous "Letter of three hundred"), (re)publishing articles and giving lectures on "forbidden" science, and organizing laboratories and departments for research in genetics and molecular biology under the cover of nuclear physics or of other projects respected by the government and Communist party leaders. The result was that major figures in the hard sciences played a major part in the revival of genetics and biology in the USSR.

The Demise of Artificial Trans Fat: A History of a Public Health Achievement.

Policy Points This article describes a strategic combination of research, advocacy, corporate campaigns, communications, grassroots mobilization, legislation, regulatory actions, and litigation against companies and government to secure a national policy to remove artificial trans fat from the US food system. Sharing lessons we learned can help inform policymakers, academics, policy practitioners, and students across disciplines. Some of our lessons are that system change means that all consumers benefit without the need for individual behavior change; research can both identify opportunities to improve health and support policy adoption; policy efforts can serve as public education campaigns; policy campaigns can drive marketplace changes; and engaging forward-thinking companies can diffuse opposition to passing a policy. CONTEXT: For many decades, partially hydrogenated vegetable oil (PHO), the primary source of artificial trans fat in the American diet, was used widely in processed and restaurant foods. In the early 1990s, studies linked the consumption of artificial trans fat with heart disease. This article details how research and advocacy led to eliminating artificial trans fat from the US food supply. METHODS: We synthesized published studies of the health impact of trans fat, the legislative history of state and local trans fat bills, the Food and Drug Administration's (FDA) regulatory docket on trans fat labeling and its declaration that PHOs are no longer Generally Recognized as Safe (GRAS), and our own files, which included strategy documents, notes from meetings with the FDA staff, correspondence between advocates and the FDA, fact sheets, press releases, news clips, and other materials. FINDINGS: This history of trans fat provides insights into policy strategy and advocacy best practices that resulted in the removal of trans fat from food in the United States, preventing an estimated 50,000 premature deaths a year. The lessons we learned are that system change benefits all consumers without the need for individual behavior change; research can both identify opportunities to improve health through policy and support policy adoption; policy campaigns can serve as public education campaigns; policy can drive changes to products and the marketplace; and engaging forward-thinking companies can help diffuse opposition to passing a policy. Securing this policy required the persistence of scientists and health advocates in first discovering the risks and then using the science to secure policies to mitigate the identified harm. CONCLUSIONS: An understanding of the tactics used to help attain the targeted policies and how challenges were addressed (such as through communications, leveraging an expanding research base and expert reports, showing that a national policy was feasible through voluntary corporate changes and state and local policy, and litigation against companies and government agencies) may provide a model for scientists, students, advocates, and policymakers. We hope this account will inform efforts to address other public health challenges, such as the current threats of excessive exposure to sodium and added sugars, which persist in the US food system.

Negotiating Change: Ideas, Institutions, and Political Actors in Tobacco Control Policy Making in Mauritius.

CONTEXT: This article explains the policy process that occasioned the development of comprehensive tobacco control policies in Mauritius from 1980 to 2019. It does so by drawing theoretical insights from John Kingdon's streams framework, historical institutionalism, and ideational perspectives to explicate how tobacco control rose to the status of government policy agenda. METHODS: The main sources of data are government documents, media reports, archival studies, grey literature, and published books and articles. These sources were supplemented by key informant interviews with government officials, civil society groups, and other vested interest groups. FINDINGS: This article finds that the prevalence of noncommunicable diseases in the late 1980s, the political commitment of Mauritius's Labour government to comprehensive tobacco control, the institutional legacies of Mauritius's Public Health Act of 1925, and the administrative capacity of Mauritius's Ministry of Health and Quality of Life are the primary factors that drove tobacco control policies in Mauritius. CONCLUSION: The findings from this study will enrich our understanding of policy change and the politics of tobacco control in the global south. Future research should investigate why some countries in Africa have failed to adopt comprehensive tobacco control policies despite ratifying the Framework Convention on Tobacco Control.

Stories in the agenda: a Narrative Policy Framework study / Historias en la agenda: un estudio del Narrative Policy Framework / Histórias na agenda: uma aplicação do "Narrative Policy Framework"

Abstract This study applies the "Narrative Policy Framework" (NPF) to the affirmative action policy process of the Federal University of Pelotas (UFPEL) and proposes theoretical intersection between the NPF and agenda setting literature, seeking to find out the role of policy narratives in policy processes. NPF is an empiric-oriented framework that posits that the policy-makers' stories have generalizable components and are built and crafted in accordance to their ideas. These are policy narratives, and are at the center of the policy process. By analyzing formulation stages of public policy and referring to ideas and narratives, the NPF refers to the agenda setting literature and provides means for empirical research of agenda setting concepts. The study undertook analysis of regulatory outputs and semi-structured interviews. Findings indicate that policy narratives have affected institutional regulatory outputs regarding UFPel's affirmative action policies.

Resumen: Este artículo aplica el Narrative Policy Framework (NPF) al proceso de producción de políticas de acciones afirmativas de la Universidad Federal de Pelotas (UFPEL) y propone avances teóricos que exploran la intersección entre el NPF y la literatura sobre formación de agenda. El NPF es un enfoque orientado empíricamente que propone que las historias que utilizan los actores en el proceso de formulación de políticas tienen componentes generalizables y se crean estratégicamente de acuerdo con sus ideas y sistemas de creencias. Estas historias se llaman "narrativas de política" y se consideran una parte central de los procesos de políticas públicas. Al analizar la formulación de políticas públicas y abordar el papel de las ideas y narrativas, el NPF dialoga directamente con la literatura sobre la formación de la agenda y proporciona medios para la investigación empírica de conceptos desarrollados en este enfoque. La metodología para este estudio utiliza análisis de documentos reglamentarios y entrevistas semiestructuradas. Los resultados indican que se utilizaron narrativas de políticas e influyeron en la regulación de las políticas de acciones afirmativas de la UFPEL.

Resumo Este artigo aplica o "Narrative Policy Framework" (NPF) ao processo de produção das políticas de ações afirmativas da Universidade Federal de Pelotas (UFPEL) e propõe especificação de intersecção teórica entre o NPF e a literatura sobre formação de agenda, visando responder questões sobre o papel das narrativas em processos de produção de políticas públicas. O NPF é uma abordagem de orientação empírica que propõe que as histórias que os atores do processo de produção de políticas públicas utilizam têm componentes generalizáveis e são criadas estrategicamente, de acordo com suas ideias e sistemas de crença. Essas histórias são chamadas "narrativas de política" e são consideradas parte central dos processos de políticas públicas. Ao analisar a formulação de políticas públicas e abordar o papel das ideias e das narrativas, o NPF dialoga diretamente com a abordagem da formação de agenda e provê meios para a pesquisa empírica de conceitos desenvolvidos nesta literatura. A metodologia para este estudo utiliza análise de documentos regulatórios oficiais e entrevistas semiestruturadas. Resultados indicam que narrativas de política foram utilizadas e influenciaram a regulamentação das políticas de ações afirmativas da UFPel.

Improving Health Risk Assessment as a Basis for Public Health Decisions in the 21st Century.

One-fifth of the way through the 21st century, a commonality of factors with those of the last 50 years may offer the opportunity to address unfinished business and current challenges. The recommendations include: (1) Resisting the tendency to oversimplify scientific assessments by reliance on single disciplines in lieu of clear weight-of-evidence expressions, and on single quantitative point estimates of health protective values for policy decisions; (2) Improving the separation of science and judgment in risk assessment through the use of clear expressions of the range of judgments that bracket protective quantitative levels for public health protection; (3) Use of comparative risk to achieve the greatest gains in health and the environment; and (4) Where applicable, reversal of the risk assessment and risk management steps to facilitate timely and substantive improvements in public health and the environment. Lessons learned and improvements in the risk assessment process are applied to the unprecedented challenges of the 21st century such as, pandemics and climate change. The beneficial application of the risk assessment and risk management paradigm to ensure timely research with consistency and transparency of assessments is presented. Institutions with mandated stability and leadership roles at the national and international levels are essential to ensure timely interdisciplinary scientific assessment at the interface with public policy as a basis for organized policy decisions, to meet time sensitive goals, and to inform the public.

[From "culprits" to "victims:" the expansion and professionalization of the healthcare system in the province of Mendoza in the late nineteenth and early twentieth century]. / De "culpables" a "víctimas": expansión y profesionalización del sistema de salud en la provincia Mendoza a fines del siglo XIX y principios del XX.

From the late 19th century to the beginning of the 20th, the province of Mendoza presented problematic sanitary conditions due to rapid demographic and urban growth, the scarcity of public services, and the poor state of the old colonial city (destroyed by the 1861 earthquake), which facilitated the spread of various infectious diseases. The objective of this article is to inquire into the ways in which the healthcare system in the province of Mendoza both expanded and became increasingly professionalized from the late 19th to early 20th century. We explore how these factors, along with the predominant social representations of disease that permeated the discourses of governing elites, influenced public policy aimed at combating the diseases of the time. To that end, we consulted a wide range of written documents and photographic material that allowed us to analyze changes in discourse as well as public policy.

Entre fines del siglo XIX y comienzos del XX, la provincia de Mendoza presentaba un estado sanitario marcado por el crecimiento demográfico y urbanístico, la escasez de los servicios públicos y la destrucción de la antigua ciudad colonial como consecuencia del terremoto de 1861, lo que propiciaba un ambiente favorable para el desarrollo de diversas enfermedades infectocontagiosas. El objetivo de este artículo es indagar cómo se fue profesionalizando y expandiendo el sistema de salud en la provincia de Mendoza a fines del siglo XIX e inicios del XX, y cómo esos factores, junto con las representaciones sobre la enfermedad que predominaban en el discurso de la elite gobernante, incidieron en las políticas públicas para combatir las dolencias de la época. Para ello se consultaron diversos documentos escritos y fotográficos que permitieron analizar las modificaciones del discurso y las políticas públicas implementadas.

Pharmaceutical Ethics and Grassroots Activism in the United States: A Social History Perspective.

Women's health activists laid the groundwork for passage of the law that created the U.S. Food and Drug Administration in 1906. The pharmaceutical and food industries fought regulatory reforms then and continue to do so now. We examine public health activism in the Progressive Era, the postwar era and the present day. The women's health movement began in the 1960s, and criticized both the pharmaceutical industry and the medical establishment. In the 1990s, patient advocacy groups began accepting industry funds; thousands of commercially-funded groups now dominate the advocacy landscape. As pharma funding became normalized, concerns arose regarding a) the lack of transparency and public accountability regarding funding, b) the distortion of groups' agendas, and c) the ability of pharma-funded groups to dominate the discourse and override less well-resourced patient and health advocacy groups. Although industry-funded groups argue that funding allows them to provide useful services, the trade-off in health risks, exorbitant prices and distorted information is far too high. Sincerity is beside the point; patients and the industry have differing interests when it comes to drug safety and efficacy, drug information and drug prices. A growing resistance movement is asserting the values of its activist predecessors and opposing the prevailing culture of pharma-funded advocacy.

Advocacy Beyond Identity: A Dutch Gay/Lesbian Organization's Embrace of a Public Policy Strategy.

The gay/lesbian social movement has primarily been understood as an identity movement. This article contributes to expanding understandings of the gay/lesbian movement by following the advocacy of the Dutch Association for the Integration of Homosexuality COC (COC) as a case of a gay/lesbian movement organization's expansion of its action repertoire to include public policy goals. On the basis of archival and interview data, this article identifies several factors that enabled the COC to see the Dutch government as a potential public policy partner. Previous legal successes and facilitation by the institutionalized wing of the women's movement, coupled with a constitutional change, resulted in the COC's development of a policy strategy. By tracing the history of the COC's strategic interactions, this article demonstrates that, while an identity strategy was constant throughout the COC's advocacy, the organization could combine an identity strategy with strategies of legal change, cultural change, and public policy.

Fútbol, política e historia en Brasil: análisis de un manifiesto de hinchas antifascistas / Football, politics and history in Brazil: analysis of a manifesto signed by anti-fascist football fans

Este artículo aborda las relaciones entre fútbol, política y memoria histórica en Brasil, centrándose en las manifestaciones de colectivos de hinchas contra la celebración de la perpetración del golpe de 1964 que dio lugar a una dictadura civil-militar que se mantuvo hasta 1985. El objetivo del presente artículo es comprender cómo los discursos vehiculados en un manifiesto firmado por diferentes colectivos de hinchas deslegitiman la dictadura, sus agentes y los discursos que los apoyan. Para alcanzar este objetivo, desarrollamos un análisis de discurso de base construccionista, del cual se concluye, entre otras cosas, que el manifiesto busca legitimarse a sí mismo, presentando fuentes consideradas fiables por los autores. También mostramos que se emplea una narrativa melodramática, que caracteriza a los agentes de la dictadura como villanos y a sus pacientes, como víctimas. Además, mostramos que alude a algunos aspectos de las teorías de la manipulación, que sugieren que el deporte sirve como opio del pueblo

This article discusses the relations between football, politics and historical memory in Brazil, focusing on the manifestations of groups of fans against the celebration of the 1964 coup that gave rise to a civil-military dictatorship that lasted until 1985. The goal of the present article is to understand how the discourses conveyed in a manifesto signed by different groups of football fans delegitimize the dictatorship, its agents and the discourses that support them. In order to achieve this objective, we developed a constructivist-based discourse analysis, which concludes, among other things, that the manifesto seeks to legitimize itself, presenting sources considered reliable by the authors. We also show that a melodramatic narrative is used, which characterizes the agents of the dictatorship as villains and their patients, as vic-tims. In addition, we show that it alludes to some aspects of manipulation theories, which suggest that sport serves as an opium for the people

De "culpables" a "víctimas": expansión y profesionalización del sistema de salud en la provincia Mendoza a fines del siglo XIX y principios del XX / From "culprits" to "victims": the expansion and professionalization of the healthcare system in the province of Mendoza in the late nineteenth and early twentieth century

RESUMEN Entre fines del siglo XIX y comienzos del XX, la provincia de Mendoza presentaba un estado sanitario marcado por el crecimiento demográfico y urbanístico, la escasez de los servicios públicos y la destrucción de la antigua ciudad colonial como consecuencia del terremoto de 1861, lo que propiciaba un ambiente favorable para el desarrollo de diversas enfermedades infectocontagiosas. El objetivo de este artículo es indagar cómo se fue profesionalizando y expandiendo el sistema de salud en la provincia de Mendoza a fines del siglo XIX e inicios del XX, y cómo esos factores, junto con las representaciones sobre la enfermedad que predominaban en el discurso de la elite gobernante, incidieron en las políticas públicas para combatir las dolencias de la época. Para ello se consultaron diversos documentos escritos y fotográficos que permitieron analizar las modificaciones del discurso y las políticas públicas implementadas.

ABSTRACT From the late 19th century to the beginning of the 20th, the province of Mendoza presented problematic sanitary conditions due to rapid demographic and urban growth, the scarcity of public services, and the poor state of the old colonial city (destroyed by the 1861 earthquake), which facilitated the spread of various infectious diseases. The objective of this article is to inquire into the ways in which the healthcare system in the province of Mendoza both expanded and became increasingly professionalized from the late 19th to early 20th century. We explore how these factors, along with the predominant social representations of disease that permeated the discourses of governing elites, influenced public policy aimed at combating the diseases of the time. To that end, we consulted a wide range of written documents and photographic material that allowed us to analyze changes in discourse as well as public policy.

Award for Distinguished Senior Career Contributions to Psychology in the Public Interest: Brian L. Wilcox.

The APA Awards for Distinguished Contributions to Psychology in the Public Interest recognize persons who have advanced psychology as a science and/or profession by a single extraordinary achievement or a lifetime of outstanding contributions in the public interest. The 2019 recipient of the Award for Distinguished Senior Career Contributions to Psychology in the Public Interest is Brian L. Wilcox. Throughout his extensive career, Wilcox "has worked at the intersection of psychology and social policy, making a unique and valuable contribution to advancing both fields, as well as social justice and the public interest. He most recently served as professor and director of the Center on Children, Families, and the Law at the University of Nebraska. Among the many areas in which his work has had a positive impact are child welfare, child poverty, child maltreatment, early childhood education, adolescent risk behavior, the impact of media and divorce on youth, and the prevention of HIV." (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A Comissão Nacional de Bem-estar Social: planejamento estatal e política social, 1951-1954 / The National Commission of Social Welfare: State planning and social policy, 1951-1954

Resumo O artigo analisa a criação da Comissão Nacional de Bem-estar Social no segundo governo Vargas (1951-1954). A partir das mensagens presidenciais e do acervo privado de Alzira Vargas do Amaral Peixoto, contextualiza o momento de fundação do órgão e suas conexões com órgãos internacionais de planejamento da política de assistência social.

Abstract The article analyzes the creation of the National Commission of Social Welfare (Comissão Nacional de Bem-Estar Social) during the second Vargas administration (1951-1954). Presidential communiqués and the private archive of Alzira do Amaral Peixoto Vargas are used to characterize the context of the founding of the commission and its liaison with international entities involved in the planning of social welfare policies.