JOSE RICARDO DE CARVALHO MESQUITA AYRES
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Medicina Preventiva, Faculdade de Medicina - Docente
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina - Líder
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article 5 Citação(ões) na Scopus Desenvolvimento histórico-epistemológico da epidemiologia e do conceito de risco(2011) AYRES, Jose Ricardo de Carvalho MesquitaStatistical reasoning in health practice was disseminated by epidemiology and is widely used in various health fields. This paper revisits the historical development of epidemiology and the concept of risk, responsible for the use of statistical chance as part of causal thinking in health sciences. The study covered the period from 1872 to 1965, and the documental base consisted of scientific articles related to the development of epidemiology as a field, particularly in the American Journal of Hygiene, as well as scientific books. Three phases were identified in the development of epidemiology: constitution, exposure, and risk. The article proceeds to discuss epistemological and social and health aspects required for the historical understanding of each phase. It concludes by stressing the relevance of critical reflection on epidemiological science and its relationship to health practice, especially in public health, in order to optimize its current use and foster its on-going creative reconstruction.- Neo-Traditional Medicines: Ethnographic Contributions to Conceptual Definition(2021) CARLESSI, Pedro; AYRES, Jose RicardoSince the end of 1970, the World Health Organization has encouraged the development of public policies that expand the approach to care and the therapeutic possibilities offered by its member states beyond technoscientific health care. In Brazil, the institutionalization of this approach is related to the promotion of popular and traditional knowledge associated with the usage of medicinal plants. With this convergence as an argumentative horizon, in this ethnography we examine the institutionalization of pharmaceutical services that have become known in Brazilian public health policy as living pharmacies. This term has been mobilized throughout the history of phytotherapy in Brazil and refers to the possibility of instituting the use of medications that expand care approaches and problem resolution possibilities beyond the domain of the biomedical sciences, evoking alliances with so-called traditional and popular knowledge and practices. For this, we propose and discuss the concept of neo-traditional medicines as a comprehensive-interpretative category, verifying the approximation and distancing points assigned to it in contemporaneous anthropological literature. Beyond the domain of science over other fields of knowledge, we argue in favour of this category in order to present new arrangements and social dynamics that define Brazil's medication policies.
article 3 Citação(ões) na Scopus A consulta homeopática: examinando seu efeito em pacientes da atenção básica(2013) SALLES, Sandra Abrahão Chaim; AYRES, José Ricardo de Carvalho MesquitaThis paper analyzes the results from research that investigated the contribution of experimental inclusion of homeopathic care at a teaching healthcare center, focusing on comprehensiveness of care. The effects of the homeopathic consultation on users' perspectives were examined using data obtained from a group of patients who were followed up for a mean period of 12 months. These participants' narratives in focus groups and the results obtained through applying a questionnaire developed in Scotland were used to evaluate the effects the medical consultations within primary care. The results suggest that, as a form of care technology, the homeopathic approach used in this study favors comprehensiveness and contains qualities that merit greater attention and a more extensive investigation so that it can be evaluated with regard to its different models for inclusion within public healthcare.- Desenvolvimentismo e preventivismo nas raízes da Saúde Coletiva: reformas do ensino e criação de escolas médicas e departamentos de medicina preventiva no estado de São Paulo (1948-1967)(2018) MOTA, André; SCHRAIBER, Lilia Blima; AYRES, José Ricardo de Carvalho MesquitaThe US medical reform in the 1940's and 1950's included schools of thinking with unique developments and several change strategies, even though they eventually converged in a set of ideas referred under the term Preventive Medicine. In order to expand this movement to Latin America and to make it coalesce in a common proposal, Pan American Health Organization (Opas) and Mondial Health Organization (OMS) supported a series of meetings organized to that end. Their impact was felt in Sao Paulo state, resulting in the outcropping of new Medical Schools, especially outside the capital city, as well as in a reorganization of previous ones, creating Preventive Medicine, Social Medicine or Public Health Medicine departments. This particular historical moment, specifically from 1948-1967, was examined through documents dealing with the history of those departments and interviews with pioneers of Collective Health in Sao Paulo.
- Critique of the concept of motivation and its implications for healthcare practices(2019) SAMPAIO, Leonardo Augusto Negreiros Parente Capela; AYRES, Jose Ricardo de Carvalho MesquitaBackground Motivation is a crucial and widespread theme within medicine. From clinical to surgical scenarios, acquiescence in taking a pill or coming to a consultation is imperative for medical treatment to thrive. The ""decade of the brain"" gave practitioners substantial neuroscientific data on human behavior, helped to explain why people do what they do and created the concept of ""motivated brain"". Findings from empirical psychology stratified motivation into stages of change, which became more complex over the decades. This research seeks to improve the understanding of how people make decisions about their health, and how to better understand strategies and techniques to help them resolve ambivalence in an effective goal-oriented way. Methods We establish a dialogue with Ricoeur's phenomenology of the will in order to understand the meaning of these scientific findings. Starting from Husserlian phenomenology, Paul Ricoeur developed his thoughts away from transcendental idealism, through emancipating the intentional structures of the will from the realm of perception. Results Through introducing the concepts of the voluntary and the involuntary, Ricoeur deviated from Cartesian dualism, which renders the body as an object body, a target of natural vicissitudes. The new dualism of the voluntary and the involuntary is dealt with by reference to what Ricoeur called the central mystery of incarnate existence, which considers man ""double in humanity, simple in vitality"". This duality makes it possible to consider the brain to be the natural organ of behavior in the human body, and to use empirical psychology as a path to escape from shallow subjectivations of concepts. Conclusions Paul Ricoeur's simplicity (or unity) of existence provides an invitation for medicine to rethink some of its philosophical assumptions, such that patients can be considered to be autonomous subjects with authorial life projects. Ricoeurian anthropology has a deep ethical impact on how medicine should use technology, which arises from empirical psychology findings. The usage of this new knowledge also needs to be thoroughly inspected, since it shifts the social role of medical science.
- Integralidade e tecnologias de atenção à saúde: uma narrativa sobre contribuições conceituais à construção do princípio da integralidade no SUS(2016) KALICHMAN, Artur Olhovetchi; AYRES, Jose Ricardo de Carvalho MesquitaComprehensiveness is the most challenging principle for building health reform in the Brazilian Unified National Health System (SUS). This study aims to identify critical moments in the conceptual debate on comprehensiveness and its contributions to reflection on healthcare technologies in the SUS. The essay addresses some conceptual constructs that approach comprehensiveness as an underlying principle in health programs and actions at various levels and in various dimensions of the healthcare organization from intersubjective interactions to the organization of regional networks. The study was based on a nonsystematic literature review on comprehensiveness and related themes in the Brazilian public health field in the last five decades. The study proposed a chronology/typology spanning the 1960s to the 2010s, divided into four significant periods or categories. The narrative is not intended to be exhaustive, but to build a comprehensive reference base capable of contributing to analyses, assessments, and debates on healthcare organization in the SUS according to the comprehensiveness principle.
- Health and human rights: Contributions of hermeneutics to a necessary dialogue(2022) AYRES, Jose Ricardo de Carvalho MesquitaThe relationship between health and human rights has gained growing importance, whether in activist agendas or in governments strategies to face the challenging scenarios of global public health. However, there are important gaps to be filled so that the articulation between these two fields develops its full potential, and the question of knowledge plays a key role in this regard. This study aims at examining the possibilities and challenges of integrating a human rights perspective into the construction and validation of health knowledge, based on the contribution of authors from various theoretical traditions that have discussed the so-called 'hermeneutic turn' in contemporary philosophy and science. The thesis developed is that recognizing the place of hermeneutics in human rationality and its consequences for understanding various forms of knowledge and their respective practical meanings is a fundamental step towards an effective articulation between the fields of health and human rights. I argue that the hermeneutic rescue of the value of practical reason can enhance emancipatory reconstructions in the exercise of cognitive-instrumental rationality in the field of health.
- Vulnerabilidade, Cuidado e integralidade: reconstruções conceituais e desafios atuais para as políticas e práticas de cuidado em HIV/Aids(2022) AYRES, José RicardoABSTRACT Health practices in general, and the response to the HIV/AIDS epidemic in particular, are going through a critical and challenging period in Brazil’s current social and political context. This essay aimed to discuss some of these challenges and the conceptual constructs that are considered relevant as resources for facing them. The reflection highlights resistance to biomedicalization, to individualizing approaches and to the abandonment of the perspective of human rights as major challenges in the fight against AIDS, and discusses how the reconstructive concepts of vulnerability, care, and integrality, developed in the context of the health reform, the conformation of the Unified Health System (SUS), and the very construction of the Brazilian response to the HIV/AIDS epidemic can bring relevant subsidies to resist the dismantling of the achievements conquered and the construction of new emancipating paths for collective health.
- HIV prevention among gay and other men who have sex with men: public policy and social movements in Brazil, 1983-2019(2022) PINHEIRO, Thiago Felix; AYRES, Jose Ricardo de Carvalho Mesquita; SILVA, Georgia Nogueira da; PARKER, RichardThis article revisits the history of HIV prevention for gay and other men who have sex with men in relation to public health policy and the role of LGBT and AIDS-related social movements in Brazil. An interpretive study was undertaken informed by philosophical and phenomenological hermeneutics. It included interviews with policymakers, researchers and activists involved in HIV and AIDS, especially HIV prevention among gay and other men who have sex with men. Prevention initiatives were analysed with a focus on the social and programmatic aspects of vulnerability to HIV, and advances and setbacks in the Brazilian response to the epidemic. The recent crisis in HIV prevention triggered by a growing conservatism in Brazilian politics and the current government's LGBT-phobia pose barriers that compromise issues of profound importance with regards to policy on HIV and AIDS: namely, engagement with human rights and social participation.
- Caminhos da integralidade: adolescentes e jovens na Atenção Primária à Saúde(2012) AYRES, José Ricardo de Carvalho Mesquita; CARVALHO, Yara Maria de; NASSER, Mariana Arantes; SALTÃO, Rodrigo Marcinkevicius; MENDES, Valéria MonteiroAdolescents and young adults constitute an important challenge in constructing comprehensiveness within primary healthcare. This is because of the complexity of understanding and responding to their set of healthcare needs, consequent to the growth and development process that is characteristic of this phase, and especially to the related sociocultural factors. The present study sought to recognize the reach and limits of how the comprehensiveness principle has been operated at a primary healthcare unit. Although it was possible to identify effective perception of the specific healthcare needs of this group, it was also possible to observe important limitations relating to construction of care projects capable of integrating the various aims of the day-to-day work, insufficiency of professional and sectorial interactions, and weaknesses in communications among professionals and between professionals and users.