Ciencia & saude coletivaPub Date : 2025-02-01Epub Date: 2023-11-06DOI: 10.1590/1413-81232025302.07652023
Maria Beatriz Andrade Fontoura de Carvalho, Juan Clinton Llerena Junior
{"title":"[Therapeutic itineraries of patients with rare diseases].","authors":"Maria Beatriz Andrade Fontoura de Carvalho, Juan Clinton Llerena Junior","doi":"10.1590/1413-81232025302.07652023","DOIUrl":"https://doi.org/10.1590/1413-81232025302.07652023","url":null,"abstract":"<p><p>The scope of this study was to understand the experiences of patients with rare diseases based on the reconstruction of therapeutic itineraries, obtained between 2021 and 2022 using thematic analysis. Common experiences in coping with rare diseases were observed, similar to those referred to globally, perpetuating the vicious circle between specialties, obtaining a diagnosis, post-diagnostic therapies, lack of qualified information and dissemination of knowledge. Arrival at the rare disease reference service revealed a new meaning, based on trust in therapeutic relationships and diagnostic chances, however there was an absence and discontinuity in the provision of some specialties and multidisciplinary therapies. on a continuous basis, providing opportunities in an equal manner. In addition to the need for coordination of care, it was evident that the responsibility for coping with illness is primarily exercised by women, who assume responsibility for the daily therapeutic activities and care of their children. The role of primary care in timely referral and coordination of care in the care network was reaffirmed, promoting equal access and alleviating the burden of management borne by families, which goes beyond and overloads their journey, especially for women.</p>","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 2","pages":"e07652023"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ciencia & saude coletivaPub Date : 2025-02-01Epub Date: 2023-11-26DOI: 10.1590/1413-81232025302.14132023
Helena Eri Shimizu, Yuri Sá Oliveira Sousa, Thémis Apostolidis
{"title":"[The social representations of COVID-19 by users of primary health care services in context of the pandemic].","authors":"Helena Eri Shimizu, Yuri Sá Oliveira Sousa, Thémis Apostolidis","doi":"10.1590/1413-81232025302.14132023","DOIUrl":"https://doi.org/10.1590/1413-81232025302.14132023","url":null,"abstract":"<p><p>The scope of this study was to identify and analyze the social representations of Primary Health Care users of the SUS in the Federal District (FD) with respect to COVID-19 in the context of the Pandemic. It involved a qualitative study based on Social Representation Theory (SRT) that analyzed 1,713 interviews with Iramuteq software users. The Descending Hierarchical Classification (DHC) procedure distributed 85.79% of the word sets associated with COVID-19 into five lexical groupings. The main representations of the COVID-19 pandemic for PHC users in the FD are fear and death. The lack of coordination of the health system, which required governance by the State, made it difficult for people to receive care in a timely manner. Historically excluded social segments, particularly the black, mixed-race and economically vulnerable population, experienced the most severe impact, including loss of life. Overcoming the conflict between an austere and minimally effective State prevailing at the time of the pandemic, and the need to build a solidarity-based health system in a society with major socio-economic disparities, was crucial in ensuring that health in the post-COVID-19 era, as a human right and value, remained at the center of the debate on the Bioethics of Intervention.</p>","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 2","pages":"e14132023"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Conceptions of disability among health professionals in training and in practice: a qualitative study.","authors":"Daniela Virgínia Vaz, Regiane Lucas Garcêz, Hiane Aparecida Silva, Luciana Alves Drumond Almeida","doi":"10.1590/1413-81232025302.09662023","DOIUrl":"https://doi.org/10.1590/1413-81232025302.09662023","url":null,"abstract":"<p><p>This study aimed to examine the conceptions of disability among 30 professionals in training or practice, representing 14 distinct health professions, through individual interviews. A committee of experts developed thirty-four representative statements encompassing religious-moral, medical, social, and affirmative perspectives on disability. The participants provided justifications for their positions on each statement, unveiling a coexistence of understandings that encompassed both medical and social perspectives on disability. A recurring argument emphasized bodily impairments as the origin of social inequalities, advocating for health practices that aim to normalize individuals. Simultaneously, the need for societal transformation to dismantle barriers, foster inclusion, and ensure rights was also acknowledged. Some justifications critically addressed ideologies that individualize disability and social processes that contribute to inequality. Moral and/or religious interpretations were frequently used by the participants. However, the study highlighted the limited comprehension of disability as a complex and multidimensional phenomenon, indicating a pressing need for enhanced attention to professional training in this area.</p>","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 2","pages":"e09662023"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ciencia & saude coletivaPub Date : 2025-02-01Epub Date: 2023-11-29DOI: 10.1590/1413-81232025302.07612023
Nathalia Barbosa de Aquino, Nathália Paula de Souza, Maria José Laurentina do Nascimento Carvalho, Adriana Marcela Ruiz Pineda, Vanessa Sá Leal, Malaquias Batista Filho, Pedro Israel Cabral de Lira, Juliana Souza Oliveira
{"title":"Social inequalities and dietary patterns: an analysis with adults in the Metropolitan Region of Recife, Brazil.","authors":"Nathalia Barbosa de Aquino, Nathália Paula de Souza, Maria José Laurentina do Nascimento Carvalho, Adriana Marcela Ruiz Pineda, Vanessa Sá Leal, Malaquias Batista Filho, Pedro Israel Cabral de Lira, Juliana Souza Oliveira","doi":"10.1590/1413-81232025302.07612023","DOIUrl":"https://doi.org/10.1590/1413-81232025302.07612023","url":null,"abstract":"<p><p>The aim of this study was to identify dietary patterns (DP) and their association with socioeconomic, demographic, lifestyle, and overweight characteristics in adults from the Metropolitan Region of Recife (MRR) in 2015/16 and 2019. A cross-sectional study was conducted with individuals of both sexes, aged 20 to 59 years. DPs were identified using Principal Component Analysis (PCA). Binary logistic regression was used to estimate crude and adjusted odds ratios and 95% confidence intervals (95%CI). Three DPs were identified: Dual, Ultra-processed (UP), and Traditional. The Dual DP explained the highest variance in 2015/16 (15.4%), while in 2019, it was the UP DP (15.1%). In 2015/16, the Dual DP was related to the age groups of 20-29 years and 30-40 years, with no associations in 2019. The Traditional DP was associated with physical activity in 2015/16 and, in 2019, with living with ≥5 people in the household, lower education, and overweight. The dietary patterns in 2019 showed a stronger association with social determinants, indicating a greater influence of these factors on eating habits.</p>","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 2","pages":"e07612023"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ciencia & saude coletivaPub Date : 2025-02-01Epub Date: 2023-12-07DOI: 10.1590/1413-81232025302.09332023
Mônica de Souza Brito Conti, Adriana Sañudo, Luiz Roberto Ramos
{"title":"Anticholinergic scales and their relation to polypharmacy, cognition, and functional losses in aged in Brazil.","authors":"Mônica de Souza Brito Conti, Adriana Sañudo, Luiz Roberto Ramos","doi":"10.1590/1413-81232025302.09332023","DOIUrl":"https://doi.org/10.1590/1413-81232025302.09332023","url":null,"abstract":"<p><p>Aged have a high consumption of medications with anticholinergic activity (MAA), being more vulnerable to adverse events. Using the anticholinergic risk scales, we investigated the prevalence and burden of MAA in the aged, the agreement between the scales and the implications of using MAA with a burden of 2 and 3 on the scales in relation to polypharmacy, cognition and functionality. Cross-sectional study with aged, of both sexes, aged ≥ 60 years old. The prevalence and burden of MAA were investigated by scales: anticholinergic drug scale (ADS), anticholinergic risk scale (ARS), anticholinergic cognitive burden scale (ACB), Brazilian scale of medications with anticholinergic activity (BSMAA). We analyzed the agreement of the scales with Kappa coefficient and investigated by logistic regression the association of MAA with: gender, age, polypharmacy; cognitive capacity (MMSE) and functional capacity (BOMFAQ questionnaire). Of those interviewed, 1,143 aged used medication and 53.5% used MAA. A good agreement was found between: ADS/ACB (0.642), ADS/SBMAA (0.669), ACB/SBMAA (0.656). In the multivariate analysis: gender and polypharmacy were statistically significant.</p>","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 2","pages":"e09332023"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ciencia & saude coletivaPub Date : 2025-02-01Epub Date: 2023-10-20DOI: 10.1590/1413-81232025302.04972023
Rafaela Caroline Comin, Paulo Ricardo Higassiaraguti Rocha, Viviane Cunha Cardoso, Fabio Carmona
{"title":"Low weight/length ratio at birth is associated with hospitalizations during the first year of life: a cohort study.","authors":"Rafaela Caroline Comin, Paulo Ricardo Higassiaraguti Rocha, Viviane Cunha Cardoso, Fabio Carmona","doi":"10.1590/1413-81232025302.04972023","DOIUrl":"https://doi.org/10.1590/1413-81232025302.04972023","url":null,"abstract":"<p><p>The aim is to study the association of a low birth weight/length ratio (W/L) with the risk of hospitalizations during the first year of life (YOL). Cohort study of live births from Ribeirão Preto, Brazil in 2010 and 2011. Low W/L was defined as below the 3rd percentile for gestational age (GA) and sex according to the Intergrowth 21st. Single and multiple Cox proportional hazards models were modelled. 4,087 children were included, of which 741 (18.1%) had been hospitalized at least once during the first YOL. In the univariate analysis, the factors associated with increased risk of the outcome were: low W/L, inadequate prenatal care, maternal hypertension, black skin color, and using the public health system. In the multivariate analysis, a low birth W/L was associated with greater risk of all hospitalizations [adjusted hazard ratio (aHR) 2.67, 95% confidence interval [95%CI] 1.98, 3.60], but this association disappeared when we excluded neonatal hospitalizations (aHR 1.58, 95%CI 0.98, 2.54). A low birth W/L for GA and sex was not associated with an increased risk of hospitalizations during the first YOL beyond the neonatal period in a Brazilian cohort of live births.</p>","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 2","pages":"e04972023"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ciencia & saude coletivaPub Date : 2025-02-01Epub Date: 2023-12-14DOI: 10.1590/1413-81232025302.00672023
Deborah Carvalho Malta, Laís Santos de Magalhães Cardoso, Guilherme Augusto Veloso, Renato Azeredo Teixeira, Adauto Martins Soares Filho, Juliana Bottoni de Souza, Crizian Saar Gomes, Matthew Cunningham, Antonio Luiz Pinho Ribeiro, Mohsen Naghavi
{"title":"Triple burden of mortality in municipalities in Minas Gerais according to the Global Burden of Disease study, 2000 to 2018.","authors":"Deborah Carvalho Malta, Laís Santos de Magalhães Cardoso, Guilherme Augusto Veloso, Renato Azeredo Teixeira, Adauto Martins Soares Filho, Juliana Bottoni de Souza, Crizian Saar Gomes, Matthew Cunningham, Antonio Luiz Pinho Ribeiro, Mohsen Naghavi","doi":"10.1590/1413-81232025302.00672023","DOIUrl":"https://doi.org/10.1590/1413-81232025302.00672023","url":null,"abstract":"<p><p>To describe the temporal evolution of the main causes of mortality in Minas Gerais (MG), Brazil, and to verify the association with socioeconomic indicators. This is a mixed ecological study in which age-standardized mortality rates were calculated per 100,000 inhabitants due to noncommunicable diseases (NCDs), communicable, neonatal and nutritional diseases (NNDs) and external causes (ECs) for 853 municipalities in MG, according to data from the Global Burden of Disease (GBD) study, in the three-year periods 2000 to 2002 (T1), 2009 to 2011 (T2) and 2016 to 2018 (T3). Between T1 and T3, mortality due to NCDs predominated; there was a 22.4% decrease in the rates for NCDs (553.6 to 429.9) and a 29% decrease in the rates for NCDs (83 to 58.9), and a 3.5% increase in EC (62.2 to 64.4). The correlation coefficients were positive (R > 0.70; p < 0.05) and higher mortality rates were found in areas with worse socioeconomic status.</p>","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 2","pages":"e00672023"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Analysis of the spatial distribution of the School Health Program from the perspective of the equity principle].","authors":"Edilton Rodrigues Santos, Marilya Nascimento Fraga, Afonso Abreu Mendes Junior, Thiago Von-Grapp Monteiro, Renata Lopes de Siqueira","doi":"10.1590/1413-81232025302.05792023","DOIUrl":"https://doi.org/10.1590/1413-81232025302.05792023","url":null,"abstract":"<p><p>It is of fundamental importance that the Basic Health Units (BHU) are distributed equally in relation to educational institutions to increase the possibility of greater effectiveness of the actions of the School Health Program (SHP). The objective of the study was to outline a spatial overview of the implementation of the program in Sergipe, observing whether the principle of equitable distribution of actions was being adhered to. It involved a cross-sectional study in which the municipalities that joined the SHP were surveyed and mapping of BHU and public schools was elaborated, observing the occurrence of equity in their distribution via geolocation; and the mean and median distances between health and education equipment were estimated. The results revealed that 1,436 (84.52%) of public schools were participants in the SHP. The mapping and estimation of distance indicated evidence of inequity of actions in schools located in rural areas and peripheral areas of urban regions. In addition, flaws were detected in the geolocation information of the BHUs throughout the state, which can contribute to non-resolutive decision-making, due to the unrealistic view of the distribution of the BHU.</p>","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 2","pages":"e05792023"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ciencia & saude coletivaPub Date : 2025-02-01Epub Date: 2023-11-29DOI: 10.1590/1413-81232025302.13372023
Laressa Thaís Krefer, Walter Ferreira de Oliveira
{"title":"[Reformulations in the national mental health policy: analysis of assistance data in the period from 2012 to 2022].","authors":"Laressa Thaís Krefer, Walter Ferreira de Oliveira","doi":"10.1590/1413-81232025302.13372023","DOIUrl":"https://doi.org/10.1590/1413-81232025302.13372023","url":null,"abstract":"<p><p>This article aims to analyze data on care in the field of public mental healthcare in Brazil from 2012 to 2022, corresponding to the years before and after the implementation of the New Mental Health Policy. For this purpose, quantitative methodology, of the longitudinal ecological study type, was used. Data was extracted for the period from 2012 to 2022. The sources used were Health Information Systems. The data was compiled into time series and analyzed using descriptive statistical techniques. The results pointed to the enhancement of outpatient services and a decrease in the expansion of Psychosocial Care Centers and Primary Care facilities after 2017, indicating compliance with the New Policy guidelines to deprioritize territorial and community-based services. The number of psychiatric hospitals showed little variation for the entire period, indicating not only alignment with the strengthening of hospital institutions indicated in the New Policy, but also weaknesses in the deinstitutionalization policy of the period prior to 2017. This study concludes that the effects of the changes in national policies on the organization, management and execution of the health system can be seen, but at the same time there is continuity in various aspects.</p>","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 2","pages":"e13372023"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ciencia & saude coletivaPub Date : 2025-02-01Epub Date: 2023-12-06DOI: 10.1590/1413-81232025302.09422023
Erik Michel Rodrigues de Souza, Natanael de Jesus Silva, Andhressa Araújo Fagundes
{"title":"[Trend analysis of the Food and Nutrition Surveillance System coverage among Quilombolas children in Brazil].","authors":"Erik Michel Rodrigues de Souza, Natanael de Jesus Silva, Andhressa Araújo Fagundes","doi":"10.1590/1413-81232025302.09422023","DOIUrl":"https://doi.org/10.1590/1413-81232025302.09422023","url":null,"abstract":"<p><p>The study objective was to evaluate the temporal trend of nutritional status assessment coverage among Quilombola children in the Food and Nutrition Surveillance System (SISVAN). An ecological time-series study was conducted on the coverage of SISVAN data among Quilombola children under five years of age in Brazilian municipalities between 2008 and 2019. Prais-Winsten regression was performed to analyze the trend and the average annual percentage change (APC) of coverage, in accordance with demographic, socioeconomic and healthcare variables. The results revealed that national coverage varied from 0.1% in 2008 to 2.8% in 2013, decreasing to 0.3% in 2019. The national APC coverage was 11% from 2008 to 2019, corresponding to a stationary trend (p=0.68). All states showed an increase in coverage from 2008 to 2013, followed by a decrease through to 2019. The States of Mato Grosso do Sul and Sergipe showed an increasing trend, while Acre had a decreasing trend. The other states revealed a stationary trend. No temporal variation was observed in coverage according to the variables of interest. The conclusion drawn was that low SISVAN coverage was found among Quilombola children, with a steady temporal trend in most Brazilian states.</p>","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 2","pages":"e09422023"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}