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A high worldwide SARS-CoV-2 vaccine coverage must be attained to stop the COVID-19 pandemic. In this study, we assessed the level of willingness of Mozambicans to be vaccinated against COVID-19. Data were collected between 11 and 20 March 2021, through a self-administered online survey. Of the 1878 respondents, 30.1% were healthcare workers, 58.3% were aged between 18 and 35 years, 60% were male, and 38.5% were single. Up to 43% had been tested for COVID-19 and 29% had tested positive. Overall vaccine acceptability was 71.4% (86.6% among healthcare workers, 64.8% among other respondents; p< 0.001). Reasons for vaccine hesitancy included: fear of vaccine side effects (29.6%) and the belief that the vaccine is not effective (52%). The acceptability of the SARS-CoV-2 vaccine increased with increasing vaccine efficacy. Using logistic regression, determinants for acceptability of the vaccine were: older age, a past COVID-19 test, a concern of becoming (re)infected by COVID-19, having a chronic disease, and considering vaccination important for personal and community health. In conclusion, vaccine acceptability in Mozambique was relatively high among healthcare workers but significantly lower in the rest of the population. This suggests that there is a need to educate the general population about SARS-CoV-2 vaccination and its importance.
Janeth Dula; Alexandre Mulhanga; Armindo Nhanombe; Laurentino Cumbi; António Júnior; Joe Gwatsvaira; Joseph Fodjo; Edlaine Faria De Moura Villela; Sérgio Chicumbe; Robert Colebunders. COVID-19 Vaccine Acceptability and Its Determinants in Mozambique: An Online Survey. Vaccines 2021, 9, 828 .
AMA StyleJaneth Dula, Alexandre Mulhanga, Armindo Nhanombe, Laurentino Cumbi, António Júnior, Joe Gwatsvaira, Joseph Fodjo, Edlaine Faria De Moura Villela, Sérgio Chicumbe, Robert Colebunders. COVID-19 Vaccine Acceptability and Its Determinants in Mozambique: An Online Survey. Vaccines. 2021; 9 (8):828.
Chicago/Turabian StyleJaneth Dula; Alexandre Mulhanga; Armindo Nhanombe; Laurentino Cumbi; António Júnior; Joe Gwatsvaira; Joseph Fodjo; Edlaine Faria De Moura Villela; Sérgio Chicumbe; Robert Colebunders. 2021. "COVID-19 Vaccine Acceptability and Its Determinants in Mozambique: An Online Survey." Vaccines 9, no. 8: 828.
During the COVID-19 pandemic, healthcare workers (HCW) have been subjected to greater workloads. We conducted a cross-sectional online survey to assess the impact of the COVID-19 pandemic on Brazilian HCW. Data were collected between 11 August and 1 November 2020. Of the 295 respondents, 95 (32.2%) were medical doctors, 82 (27.8%) administrative staff, 53 (18.0%) nurses, 27 (9.2%) laboratory staff, and 38 (12.9%) were other staff. COVID-19-related restructuring at the health facilities was reported by 207 (70.2%) respondents, and 69 (23.4%) had their tasks changed. Preventive measures were well respected when seeing suspected patients. Overall, 167 (56.6%) HCW screened positive for anxiety and 137 (46.4%) for depression; 109 (36.9%) screened positive for both conditions. Of the 217 (73.6%) HCW who had been tested for COVID-19, at least one positive result was reported in 49 (22.6%). Following a positive COVID-19 test, 45/49 (91.8%) stopped working and stayed home. In conclusion, we found a high incidence of COVID-19 infection among Brazilian HCW with high rates of anxiety and depression despite a good self-reported adherence to COVID-19 preventive measures. As such, our study highlights the urgent need for interventions to mitigate the psychosocial risks HCW in Brazil encounter during the COVID-19 pandemic.
Edlaine Faria De Moura Villela; Izadora Rodrigues da Cunha; Joseph Nelson Siewe Fodjo; Michael Obimpeh; Robert Colebunders; Stijn Van Hees. Impact of COVID-19 on Healthcare Workers in Brazil between August and November 2020: A Cross-Sectional Survey. International Journal of Environmental Research and Public Health 2021, 18, 6511 .
AMA StyleEdlaine Faria De Moura Villela, Izadora Rodrigues da Cunha, Joseph Nelson Siewe Fodjo, Michael Obimpeh, Robert Colebunders, Stijn Van Hees. Impact of COVID-19 on Healthcare Workers in Brazil between August and November 2020: A Cross-Sectional Survey. International Journal of Environmental Research and Public Health. 2021; 18 (12):6511.
Chicago/Turabian StyleEdlaine Faria De Moura Villela; Izadora Rodrigues da Cunha; Joseph Nelson Siewe Fodjo; Michael Obimpeh; Robert Colebunders; Stijn Van Hees. 2021. "Impact of COVID-19 on Healthcare Workers in Brazil between August and November 2020: A Cross-Sectional Survey." International Journal of Environmental Research and Public Health 18, no. 12: 6511.
Vaccination is fast becoming a key intervention against the ongoing COVID-19 pandemic. We conducted cross-sectional online surveys to investigate COVID-19 vaccine acceptance across nine Low- and Middle-Income Countries (LMICs; N = 10,183), assuming vaccine effectiveness at 90% and 95%. The prevalence of vaccine acceptance increased from 76.4% (90% effectiveness) to 88.8% (95% effectiveness). Considering a 90% effective vaccine, Malaysia, Thailand, Bangladesh, and five African countries (Democratic Republic of Congo, Benin, Uganda, Malawi, and Mali) had lower acceptance odds compared to Brazil. Individuals who perceived taking the vaccine as important to protect themselves had the highest acceptance odds (aOR 2.49) at 95% effectiveness.Vaccine acceptance was also positively associated with COVID-19 knowledge, worry/fear regarding COVID-19, higher income, younger age, and testing negative for COVID-19. However, chronic disease and female gender reduced the odds for vaccine acceptance. The main reasons underpinning vaccine refusal were fear of side effects (41.2%) and lack of confidence in vaccine effectiveness (15.1%). Further research is needed to identify country-specific reasons for vaccine hesitancy in order to develop mitigation strategies that would ensure high and equitable vaccination coverage across LMICs.
Suzanna Bono; Edlaine Faria De Moura Villela; Ching Siau; Won Chen; Supa Pengpid; M Hasan; Philippe Sessou; John Ditekemena; Bob Amodan; Mina Hosseinipour; Housseini Dolo; Joseph Siewe Fodjo; Wah Low; Robert Colebunders. Factors Affecting COVID-19 Vaccine Acceptance: An International Survey among Low- and Middle-Income Countries. Vaccines 2021, 9, 515 .
AMA StyleSuzanna Bono, Edlaine Faria De Moura Villela, Ching Siau, Won Chen, Supa Pengpid, M Hasan, Philippe Sessou, John Ditekemena, Bob Amodan, Mina Hosseinipour, Housseini Dolo, Joseph Siewe Fodjo, Wah Low, Robert Colebunders. Factors Affecting COVID-19 Vaccine Acceptance: An International Survey among Low- and Middle-Income Countries. Vaccines. 2021; 9 (5):515.
Chicago/Turabian StyleSuzanna Bono; Edlaine Faria De Moura Villela; Ching Siau; Won Chen; Supa Pengpid; M Hasan; Philippe Sessou; John Ditekemena; Bob Amodan; Mina Hosseinipour; Housseini Dolo; Joseph Siewe Fodjo; Wah Low; Robert Colebunders. 2021. "Factors Affecting COVID-19 Vaccine Acceptance: An International Survey among Low- and Middle-Income Countries." Vaccines 9, no. 5: 515.
COVID-19 affects persons living with HIV (PLWH) both directly (via morbidity/mortality) and indirectly (via disruption of HIV care). From July–November 2020, an online survey was conducted to investigate the psychosocial well-being of PLWH and changes in HIV care during the second semester of the COVID-19 outbreak. Data were collected on the socio-demographic characteristics of PLWH, their psychosocial well-being, impact of COVID-19 preventive measures on their daily routines and HIV follow-up. Of the 247 responses analyzed (mean age: 44.5 ± 13.2 years; 73.7% male), 67 (27.1%) and 69 (27.9%) respondents screened positive for anxiety (GAD-2 score ≥ 3) and depression (PHQ-2 score ≥ 3), respectively. HIV care had returned to pre-COVID-19 state for 48.6% PLWH, and 108 (43.7%) had no HIV follow-up during the past month. Over three quarters (76.1%) of respondents expressed willingness to receive the COVID-19 vaccine. Compared to previous findings in April 2020, substance use increased from 58.6% to 67.2% (p < 0.001). Our findings suggest that the well-being and medical follow-up of PLWH are still affected after almost a year into the COVID-19 outbreak. Remote HIV follow-up (telemedicine) with psychosocial support should be envisaged in the medium to long-term. Given that most PLWH accept COVID-19 vaccination, they may be prioritized for this intervention.
Joseph Siewe Fodjo; Edlaine Faria De Moura Villela; Stijn Van Hees; Pieter Vanholder; Patrick Reyntiens; Robert Colebunders. Follow-Up Survey of the Impact of COVID-19 on People Living with HIV during the Second Semester of the Pandemic. International Journal of Environmental Research and Public Health 2021, 18, 4635 .
AMA StyleJoseph Siewe Fodjo, Edlaine Faria De Moura Villela, Stijn Van Hees, Pieter Vanholder, Patrick Reyntiens, Robert Colebunders. Follow-Up Survey of the Impact of COVID-19 on People Living with HIV during the Second Semester of the Pandemic. International Journal of Environmental Research and Public Health. 2021; 18 (9):4635.
Chicago/Turabian StyleJoseph Siewe Fodjo; Edlaine Faria De Moura Villela; Stijn Van Hees; Pieter Vanholder; Patrick Reyntiens; Robert Colebunders. 2021. "Follow-Up Survey of the Impact of COVID-19 on People Living with HIV during the Second Semester of the Pandemic." International Journal of Environmental Research and Public Health 18, no. 9: 4635.
Background The first case of COVID-19 infection was diagnosed in Brazil 26th February 2020. By March 16th, physical distancing and confinement measures were implemented by the Brazilian government. Little is known about how these measures were followed up by the Brazilian people and their impact on daily routine. Methods In early April 2020, using an online platform, we organized an online survey among adults living in Brazil about their COVID-19 preventive behavior and impact on their daily routine. Results Data from 23,896 respondents were analyzed (mean age: 47.4 years). Due to COVID-19 restrictions, half (51.1%) of the professionals reported working from home. Regular handwashing was practiced by 98.7% of participants; 92.6% reported adhering to the 1.5-2 m physical distancing rule, but only 45.5% wore a face mask when going outside. While 29.3% of respondents found it relatively easy to stay at home, indoor confinement was extremely difficult for 7.9% of participants. Moreover, 11% of participants were extremely worried about their health during the COVID-19 epidemic. Younger people, male, persons living in a rural area/village or popular neighbourhoods, students and workers reported less preventive behaviour. Conclusion Restrictive measures markedly affected the daily and professional routines of Brazilians. Participants showed a satisfactory level of adherence to national COVID-19 prevention guidelines. Qualitative and follow-up studies are needed to monitor the impact of COVID-19 in the Brazilian society.
Edlaine Faria De Moura Villela; Rossana Verónica Mendoza López; Ana Paula Sayuri Sato; Fábio Morato de Oliveira; Eliseu Alves Waldman; Rafael Van Den Bergh; Joseph Nelson Siewe Fodjo; Robert Colebunders. COVID-19 outbreak in Brazil: adherence to national preventive measures and impact on people’s lives, an online survey. BMC Public Health 2021, 21, 1 -10.
AMA StyleEdlaine Faria De Moura Villela, Rossana Verónica Mendoza López, Ana Paula Sayuri Sato, Fábio Morato de Oliveira, Eliseu Alves Waldman, Rafael Van Den Bergh, Joseph Nelson Siewe Fodjo, Robert Colebunders. COVID-19 outbreak in Brazil: adherence to national preventive measures and impact on people’s lives, an online survey. BMC Public Health. 2021; 21 (1):1-10.
Chicago/Turabian StyleEdlaine Faria De Moura Villela; Rossana Verónica Mendoza López; Ana Paula Sayuri Sato; Fábio Morato de Oliveira; Eliseu Alves Waldman; Rafael Van Den Bergh; Joseph Nelson Siewe Fodjo; Robert Colebunders. 2021. "COVID-19 outbreak in Brazil: adherence to national preventive measures and impact on people’s lives, an online survey." BMC Public Health 21, no. 1: 1-10.
Background: The first case of COVID-19 infection was diagnosed in Brazil 26th February 2020. By March 16th, physical distancing and confinement measures were implemented by the Brazilian government. Little is known about how these measures were followed up by the Brazilian people and their impact on daily routine.Methods: In early April 2020, using an online platform, we organized an online survey among adults living in Brazil about their COVID-19 preventive behavior. Results: Data from 23.896 respondents were analyzed (mean age: 47.4 years). Due to COVID-19 restrictions, half (51.1%) of the professionals reported working from home. Regular handwashing was practiced by 98.7% of participants; 92.6% reported adhering to the 1.5-2m physical distancing rule, but only 45.5% wore a face mask when going outside. While 29.3% of respondents found it relatively easy to stay at home, indoor confinement was extremely difficult for 7.9% of participants. Moreover, 11% of participants were extremely worried about their health during the COVID-19 epidemic.Younger people, male, persons living in a rural area/village or popular neighbourhoods, students and workers reported less preventive behaviour. Conclusion: Restrictive measures markedly affected the daily and professional routines of Brazilians. Participants showed a satisfactory level of adherence to national COVID-19 prevention guidelines. Qualitative and follow-up studies are needed to monitor the impact of COVID-19 in the Brazilian society.
Edlaine Faria De Moura Villela; Rossana Verónica Mendoza Lopez; Ana Paula Sayuri Sato; Fábio Morato De Oliveira; Eliseu Alves Waldman; Rafael Van Den Bergh; Joseph Nelson Siewe Fodjo; Robert Colebunders. COVID-19 outbreak in Brazil: Adherence to national preventive measures and impact on people’s lives. 2020, 1 .
AMA StyleEdlaine Faria De Moura Villela, Rossana Verónica Mendoza Lopez, Ana Paula Sayuri Sato, Fábio Morato De Oliveira, Eliseu Alves Waldman, Rafael Van Den Bergh, Joseph Nelson Siewe Fodjo, Robert Colebunders. COVID-19 outbreak in Brazil: Adherence to national preventive measures and impact on people’s lives. . 2020; ():1.
Chicago/Turabian StyleEdlaine Faria De Moura Villela; Rossana Verónica Mendoza Lopez; Ana Paula Sayuri Sato; Fábio Morato De Oliveira; Eliseu Alves Waldman; Rafael Van Den Bergh; Joseph Nelson Siewe Fodjo; Robert Colebunders. 2020. "COVID-19 outbreak in Brazil: Adherence to national preventive measures and impact on people’s lives." , no. : 1.
In face of the current pandemic, universities are closing worldwide. In Brazil, as elsewhere, academic activities have been suspended in response to the Ministry of Health’s recommendations to socially distance. This created risk of suboptimally utilizing the great potential students have to contribute to the COVID‐19 response.
Edlaine Faria De Moura Villela; Fábio Morato De Oliveira; Sabrina Toffoli Leite; Valdes Roberto Bollela. Student engagement in a public health initiative in response to COVID‐19. Medical Education 2020, 54, 763 -764.
AMA StyleEdlaine Faria De Moura Villela, Fábio Morato De Oliveira, Sabrina Toffoli Leite, Valdes Roberto Bollela. Student engagement in a public health initiative in response to COVID‐19. Medical Education. 2020; 54 (8):763-764.
Chicago/Turabian StyleEdlaine Faria De Moura Villela; Fábio Morato De Oliveira; Sabrina Toffoli Leite; Valdes Roberto Bollela. 2020. "Student engagement in a public health initiative in response to COVID‐19." Medical Education 54, no. 8: 763-764.
Delivering bad news is a difficult task for physicians, and medical schools do not always prepare future physicians for this inevitable task. To examine training in breaking bad news, to improve medical students’ competence and confidence in dealing with this important aspect of clinical practice. An exploratory study using a qualitative approach was done at a Brazilian public university’s medical school, which receives 30 medical students per semester. Two focus groups were conducted in 2018, with 15 students per group, before and after the training. The intervention consisted of a 6-month (4 h/wk) course about breaking bad news offered to 30 third-year medical students. The communication course included the perspectives of health care professionals, patients, and their families; the SPIKES protocol and the “ABCDE” mnemonic for delivering bad news; general guidelines; and role-playing/simulation strategies to improve students’ skills and reduce their personal limitations. Results of the preintervention focus group demonstrated that only 30% of the students were aware of the importance of breaking bad news and of the existence of specific protocols to guide physicians in these situations. Findings from the postintervention focus group indicated that 90% of students understood the importance and began to apply protocols in their practice. Breaking bad news is a challenge for undergraduate medical students. The results of our qualitative study showed that students’ perceptions about their capability in delivering bad news increased significantly after regular and focused training. The knowledge, skills, and attitudes acquired strengthened the students’ self-reported ability to deal with situations requiring breaking bad news. The activities offered helped students develop communication skills. They made connections between their formal training (communication and cognitive skills) and actual clinical practice in a community-based rotation. The knowledge and skills acquired gave them tools needed to deliver bad news in their future clinical practice.
Edlaine Faria De Moura Villela; Luana Kronit Bastos; Wanderson Sant'ana De Almeida; Andressa Oliveira Pereira; Matheus Silva De Paula Rocha; Fábio Morato De Oliveira; Valdes Roberto Bollela. Effects on Medical Students of Longitudinal Small-Group Learning about Breaking Bad News. The Permanente Journal 2020, 24, 1 .
AMA StyleEdlaine Faria De Moura Villela, Luana Kronit Bastos, Wanderson Sant'ana De Almeida, Andressa Oliveira Pereira, Matheus Silva De Paula Rocha, Fábio Morato De Oliveira, Valdes Roberto Bollela. Effects on Medical Students of Longitudinal Small-Group Learning about Breaking Bad News. The Permanente Journal. 2020; 24 ():1.
Chicago/Turabian StyleEdlaine Faria De Moura Villela; Luana Kronit Bastos; Wanderson Sant'ana De Almeida; Andressa Oliveira Pereira; Matheus Silva De Paula Rocha; Fábio Morato De Oliveira; Valdes Roberto Bollela. 2020. "Effects on Medical Students of Longitudinal Small-Group Learning about Breaking Bad News." The Permanente Journal 24, no. : 1.
OBJECTIVE Verify perceptions of the health team about patient safety culture in home care in a large city in Brazilian Midwest region. METHOD A survey study involving Safety Attitudes Questionnaire and professional profile inventory. Results: From the 37 professionals, most were female (n = 32, 86.5%), lived with their spouse (n = 25, 67.6%), worked in a statutory work regime (n = 29; 78.4%) and have only one job (n = 23; 62.2%). A higher median score for job satisfaction (80.0) and a lower score for management perception (31.8) were found. There was a negative correlation between weekly workload and teamwork (p = 0.02). Safety climate was significantly higher among consolidated (Consolidação das Leis do Trabalho - CLT) professionals in the safety climate (p = 0.001) and overall (p = 0.005) domains. Physicians had a higher perception of the safety climate domain when compared to professionals in other categories (p = 0.005). Age was positively associated to the climate in the safety (p = 0.002), working conditions (p = 0.03) and overall (p = 0.04) domains. CONCLUSION Teamwork and job satisfaction were scored as positive and management actions were considered the main weakness of the safety culture.
Patrícia Conceição Oliveira; Odeony Paulo Dos Santos; Edlaine Faria De Moura Villela; Patrícia De Sá Barros. Patient safety culture in home care service. Revista da Escola de Enfermagem da USP 2020, 54, 1 .
AMA StylePatrícia Conceição Oliveira, Odeony Paulo Dos Santos, Edlaine Faria De Moura Villela, Patrícia De Sá Barros. Patient safety culture in home care service. Revista da Escola de Enfermagem da USP. 2020; 54 ():1.
Chicago/Turabian StylePatrícia Conceição Oliveira; Odeony Paulo Dos Santos; Edlaine Faria De Moura Villela; Patrícia De Sá Barros. 2020. "Patient safety culture in home care service." Revista da Escola de Enfermagem da USP 54, no. : 1.
Edlaine Faria De Moura Villela; Wanderson Sant'ana De Almeida; Wallace Antunes Damásio Do Nascimento; Valdes R Bollela. Medical students and community health workers learning together. Medical Education 2017, 51, 551 -552.
AMA StyleEdlaine Faria De Moura Villela, Wanderson Sant'ana De Almeida, Wallace Antunes Damásio Do Nascimento, Valdes R Bollela. Medical students and community health workers learning together. Medical Education. 2017; 51 (5):551-552.
Chicago/Turabian StyleEdlaine Faria De Moura Villela; Wanderson Sant'ana De Almeida; Wallace Antunes Damásio Do Nascimento; Valdes R Bollela. 2017. "Medical students and community health workers learning together." Medical Education 51, no. 5: 551-552.
Este artigo busca analisar os discursos, veiculados pela imprensa, das autoridades sanitárias e políticas sobre a primeira epidemia de dengue em Ribeirão Preto, São Paulo, Brasil, em 1990, com o propósito de verificar a predominância ou não do uso da comunicação de crise. Foi feita uma pesquisa qualitativa embasada na teoria das representações sociais.e foram resgatadas 126 notícias de jornais e revistas sobre a epidemia em questão utilizando o método intitulado discurso do sujeito coletivo. A mídia desviou a atenção dos leitores para os embates políticos, e não para questões relativas ao binômio epidemiologia/saúde. Mesmo que o conteúdo informacional culpasse tanto o governo quanto a população, os leitores assumiram uma postura de passividade diante da situação. A grande mídia tem o poder de influenciar o cotidiano das pessoas e suas atuações políticas. Ela se apresenta como espaço de poder, com força na disputa pela hegemonia e na constituição da opinião pública sobre questões de saúde.
Edlaine Faria De Moura Villela. Comunicação de risco versus comunicação de crise na saúde pública: o discurso das autoridades diante de uma epidemia de dengue. Revista Eletrônica de Comunicação, Informação e Inovação em Saúde 2016, 10, 1 .
AMA StyleEdlaine Faria De Moura Villela. Comunicação de risco versus comunicação de crise na saúde pública: o discurso das autoridades diante de uma epidemia de dengue. Revista Eletrônica de Comunicação, Informação e Inovação em Saúde. 2016; 10 (4):1.
Chicago/Turabian StyleEdlaine Faria De Moura Villela. 2016. "Comunicação de risco versus comunicação de crise na saúde pública: o discurso das autoridades diante de uma epidemia de dengue." Revista Eletrônica de Comunicação, Informação e Inovação em Saúde 10, no. 4: 1.
O objetivo desta pesquisa foi construir discursos que representem como a primeira epidemia de dengue em Ribeirão Preto-SP foi abordada pela mídia impressa e trazer para reflexão desdobramentos sobre mídia e poder. Foram reunidas 126 reportagens de novembro de 1990 a março de 1991 dos jornais Folha de S. Paulo, O Estado de S. Paulo e A Cidade, e das revistas Veja e Revide. Utilizou-se o método do Discurso do Sujeito Coletivo, fundamentado na Teoria das Representações Sociais. A mídia polemizou com a discussão sobre quem seria o grande vilão da epidemia em vez de esclarecer sobre a epidemia em si. Comprovou-se a defasagem da informação disponibilizada. O jogo de representações e a relação mídia/poder ficaram nítidas. Temos como problema não somente a possibilidade de acesso adequado e suficiente às informações produzidas, mas, também, a dificuldade de decidir o que deve ser discutido nos jornais diários para enriquecer, de fato, o arcabouço informacional da população. Para isso, os profissionais que lidam com informação e comunicação em saúde, na mídia impressa, precisam ser capacitados para provocar a aproximação da linguagem técnica à linguagem popular. Para que haja circulação e apropriação da informação em Saúde Pública, é necessário abrir a discussão para a comunidade e capacitá-la para que consiga se expressar. É importante discutir a qual tipo de informação o cidadão tem acesso durante os processos epidêmicos: Informação política ou epidemiológica? Questões políticas não podem se sobrepor a questões prioritárias de saúde nos meios de comunicação presentes no cotidiano das famílias brasileiras.
Edlaine Faria De Moura Villela; Delsio Natal. Mídia, saúde e poder: um jogo de representações sobre dengue. Saúde e Sociedade 2014, 23, 1007 -1017.
AMA StyleEdlaine Faria De Moura Villela, Delsio Natal. Mídia, saúde e poder: um jogo de representações sobre dengue. Saúde e Sociedade. 2014; 23 (3):1007-1017.
Chicago/Turabian StyleEdlaine Faria De Moura Villela; Delsio Natal. 2014. "Mídia, saúde e poder: um jogo de representações sobre dengue." Saúde e Sociedade 23, no. 3: 1007-1017.