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      Doenças crônicas não transmissíveis no Brasil: prioridade para enfrentamento e investigação

      Revista de Saúde Pública
      Faculdade de Saúde Pública da Universidade de São Paulo
      Adult Health, Chronic Disease, epidemiology, Chronic Disease, prevention & control, Cardiovascular Diseases, Obesity, Diabetes Mellitus, Cohort Studies, Salud del Adulto, Enfermedad Crónica, epidemiologia, Enfermedad Crónica, prevención & control, Enfermedades Cardiovasculares, Obesidad, Estudios de Cohortes, Saúde do Adulto, Doença Crônica, epidemiologia, Doença Crônica, prevenção & controle, Doenças Cardiovasculares, Obesidade, Estudos de Coortes

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          Abstract

          As Doenças Crônicas Não Transmissíveis representam a maior carga de morbimortalidade no Brasil. Em 2011, o Ministério da Saúde lançou seu Plano de Ações Estratégicas para o Enfrentamento das Doenças Crônicas Não Transmissíveis, enfatizando ações populacionais para controlar as doenças cardiovasculares, diabetes, câncer e doença respiratória crônica, predominantemente pelo controle do fumo, inatividade física, alimentação inadequada e uso prejudicial de álcool. Apesar da produção científica significativa sobre essas doenças e seus fatores de risco no Brasil, poucos são os estudos de coorte nessa temática. Nesse contexto, o Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil) acompanha 15.105 servidores públicos do País. Seus dados espelham a realidade brasileira de altas prevalências de diabetes e hipertensão e dos fatores de risco. A diversidade das informações produzidas permitirá aprofundar o entendimento causal dessas doenças e subsidiar políticas públicas para seu enfrentamento.

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          Theories for social epidemiology in the 21st century: an ecosocial perspective.

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            Central role of the brain in stress and adaptation: links to socioeconomic status, health, and disease.

            The brain is the key organ of stress reactivity, coping, and recovery processes. Within the brain, a distributed neural circuitry determines what is threatening and thus stressful to the individual. Instrumental brain systems of this circuitry include the hippocampus, amygdala, and areas of the prefrontal cortex. Together, these systems regulate physiological and behavioral stress processes, which can be adaptive in the short-term and maladaptive in the long-term. Importantly, such stress processes arise from bidirectional patterns of communication between the brain and the autonomic, cardiovascular, and immune systems via neural and endocrine mechanisms underpinning cognition, experience, and behavior. In one respect, these bidirectional stress mechanisms are protective in that they promote short-term adaptation (allostasis). In another respect, however, these stress mechanisms can lead to a long-term dysregulation of allostasis in that they promote maladaptive wear-and-tear on the body and brain under chronically stressful conditions (allostatic load), compromising stress resiliency and health. This review focuses specifically on the links between stress-related processes embedded within the social environment and embodied within the brain, which is viewed as the central mediator and target of allostasis and allostatic load.
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              Atenção primária: equilíbrio entre necessidades de saúde serviços e tecnologia

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