Ciencia & saude coletiva最新文献_第10页

Criteria used in clinical practice guidelines for the management of pharmaceutical service. 药学服务管理临床实践指南标准。

IF 1.2 4区医学

Ciencia & saude coletiva Pub Date : 2026-01-01 Epub Date: 2025-07-30 DOI: 10.1590/1413-81232026311.14282025

Mariana Rosa Gomes, Paula Rossignoli, Fernando Fernandez-Llimos, Helena Hiemisch Lobo Borba

{"title":"Criteria used in clinical practice guidelines for the management of pharmaceutical service.","authors":"Mariana Rosa Gomes, Paula Rossignoli, Fernando Fernandez-Llimos, Helena Hiemisch Lobo Borba","doi":"10.1590/1413-81232026311.14282025","DOIUrl":"https://doi.org/10.1590/1413-81232026311.14282025","url":null,"abstract":"Little is known about the perception of healthcare professionals working in the management of the Specialized Component of Pharmaceutical Service (Componente Especializado da Assistência Farmacêutica - CEAF) regarding the clearness of the clinical practice guidelines (protocolos clínicos e diretrizes terapêuticas - PCDT) related to the inclusion and exclusion of patients and the discontinuation of medicines. Thus, the present study used a mixed-methods approach, with a quantitative phase to assess the objectivity of the criteria established in the PCDT, published from 2012 to 2022, and a qualitative phase through a focus group with healthcare professionals working in CEAF management. The 36 PCDTs analyzed in our study covered 1,972 criteria, of which 57.1% were objective. The thematic analysis of the focus group discourse indicated that the criteria, due to ambiguity and lack of clarity, have different interpretations, leading to inequality of access and compromising the principles of the SUS, especially equity. Improvements were suggested, including summarized versions of PCDTs, a version for pharmaceutical service management tasks, an additional document presenting the criteria clearly and objectively, exams, and information to verify the criteria.","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"31 1","pages":"e14282025"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084567","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}

引用次数: 0

Health Councils and Pharmaceutical Policy: Challenges and prospects for social participation in Brazil. 卫生理事会和药品政策：巴西社会参与的挑战和前景。

IF 1.2 4区医学

Ciencia & saude coletiva Pub Date : 2026-01-01 Epub Date: 2025-07-26 DOI: 10.1590/1413-81232026311.14132025

Fernanda Manzini, Luisa Arueira Chaves, Vinícius André Boff, Dalmare Anderson Bezerra de Oliveira Falcão E Sá, Maria Eufrásia de Oliveira Lima, Silvana Nair Leite

{"title":"Health Councils and Pharmaceutical Policy: Challenges and prospects for social participation in Brazil.","authors":"Fernanda Manzini, Luisa Arueira Chaves, Vinícius André Boff, Dalmare Anderson Bezerra de Oliveira Falcão E Sá, Maria Eufrásia de Oliveira Lima, Silvana Nair Leite","doi":"10.1590/1413-81232026311.14132025","DOIUrl":"https://doi.org/10.1590/1413-81232026311.14132025","url":null,"abstract":"The National Pharmaceutical Policy (PNAF) originated from social participation, making its role in monitoring and addressing issues related to this policy essential. In this context, this article aims to identify and analyze how the Pharmaceutical Policy (PP) (considering access to medicines and pharmaceutical services) have been addressed and discussed in the Brazilian Health Councils from 2019 to 2021. It was conducted a quantitative and qualitative documentary analysis of documents from all the states (including the Federal District) and municipal councils in the Brazilian capitals. It was identified 806 excerpts referencing the PNAF, of which 186 excerpts were included in the thematic analysis. These excerpts were organized into eight analytical categories, indicating that while PP is a contemporary topic in the councils and gained prominence and qualification during the COVID-19 pandemic, there are still gaps in the discussion, particularly regarding service organization. The development of appropriate tools for monitoring and evaluating the PNAF, ongoing training for council members, and investment in dedicated committees are highlighted as key elements for advancing the role of social participation at all health organization levels.","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"31 1","pages":"e14132025"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084569","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}

引用次数: 0

Syphilis and penicillin shortage: surveillance, pharmaceutical services and federal response (2014-2023). 梅毒和青霉素短缺：监测、药品服务和联邦应对（2014-2023年）。

IF 1.2 4区医学

Ciencia & saude coletiva Pub Date : 2026-01-01 Epub Date: 2025-07-30 DOI: 10.1590/1413-81232026311.14022025

Esdras Daniel Dos Santos Pereira, Vera Lucia Luiza

{"title":"Syphilis and penicillin shortage: surveillance, pharmaceutical services and federal response (2014-2023).","authors":"Esdras Daniel Dos Santos Pereira, Vera Lucia Luiza","doi":"10.1590/1413-81232026311.14022025","DOIUrl":"https://doi.org/10.1590/1413-81232026311.14022025","url":null,"abstract":"Syphilis remains a significant sexually transmitted infection in Brazil, with benzathine penicillin (BPG) as the first-line treatment. In 2014, the country faced a global penicillin shortage, prompting a coordinated federal response, especially in light of rising congenital syphilis cases. This study conducted a documentary analysis of 37 official documents (price registration minutes, technical notes, ordinances, and decrees) to characterize strategies for procurement, price negotiation, and national and international cooperation. The analysis revealed a progressive increase in public procurement of penicillin after 2014 and growing integration between pharmaceutical services, surveillance, and care within the Brazilian Unified Health System (SUS). Federal pharmaceutical services and medicines management was central in overcoming shortages, ensuring BPG supply, and articulating surveillance and comprehensive care. The findings highlight pharmaceutical services as a structural component of the Brazilian response to syphilis, impacting case detection, care, and epidemiological surveillance.","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"31 1","pages":"e14022025"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118154","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}

引用次数: 0

The pharmaceutical workforce in the SUS: Trends and alerts over the last decade (2014-2023). 美国的制药劳动力：过去十年的趋势和警告（2014-2023）。

IF 1.2 4区医学

Ciencia & saude coletiva Pub Date : 2026-01-01 Epub Date: 2025-07-30 DOI: 10.1590/1413-81232026311.14502025

Marselle Nobre de Carvalho, Bruna Ruzza Monteguti, Emilia Baierle Faraco, Silvana Nair Leite

{"title":"The pharmaceutical workforce in the SUS: Trends and alerts over the last decade (2014-2023).","authors":"Marselle Nobre de Carvalho, Bruna Ruzza Monteguti, Emilia Baierle Faraco, Silvana Nair Leite","doi":"10.1590/1413-81232026311.14502025","DOIUrl":"https://doi.org/10.1590/1413-81232026311.14502025","url":null,"abstract":"The pharmaceutical workforce in the Unified Health System is responsible for the actions that materialize the National Pharmaceutical Policy from management to care. This study sets out to analyze the dynamics of the pharmaceutical workforce in the SUS over the last 10 years, starting from 2013, a period of rapid growth. We analyzed data recorded in the CNES and IBGE, shown in terms of growth and population rates. Between 2014 and 2023, the total pharmacist workforce in the facilities that serve the SUS in Brazil grew by 36%, and in PHC settings by 47%; 91.96% of pharmacists are not linked to any team. The types of professional relationships that have shown the most growth in the last ten years have been those characterized as \"unprotected\", such as scholarships and internships, or other types of employment that do not guarantee labor rights. The highest population rates were in the southern states (49.2/100,000), and the lowest in the Northeast and Midwest (32/100,000). The slower growth over the last decade, the disparities between states and regions, and the types of employment contracts all point to the need for continuous work by professional bodies and social participation to defend the pharmaceutical workforce in order to advance the PNAF.","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"31 1","pages":"e14502025"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118182","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}

引用次数: 0

National Pharmaceutical Policy and the Health Economic-Industrial Complex: influences and invisibilities. 国家医药政策与卫生经济产业综合体：影响与隐蔽性。

IF 1.2 4区医学

Ciencia & saude coletiva Pub Date : 2026-01-01 Epub Date: 2025-07-28 DOI: 10.1590/1413-81232026311.14362025

Norberto Rech, Jorge Antonio Zepeda Bermudez, Jorge Carlos Santos da Costa, Mareni Rocha Farias

引用次数: 0

Judicial access to medicines for rare diseases: characteristics of lawsuits against the Federal Government. 通过司法途径获得罕见病药品：针对联邦政府的诉讼的特点。

IF 1.2 4区医学

Ciencia & saude coletiva Pub Date : 2026-01-01 Epub Date: 2025-07-30 DOI: 10.1590/1413-81232026311.14312025

Vera Lúcia Edais Pepe, Michelly Ribeiro Baptista, Miriam Ventura, Marina Fajardo V M Pompílio da Hora, Nathália Rodrigues Alvarez, Gabriela Suarez Pinto, Raulino Sabino da Silva, Thaís Jeronimo Vidal

{"title":"Judicial access to medicines for rare diseases: characteristics of lawsuits against the Federal Government.","authors":"Vera Lúcia Edais Pepe, Michelly Ribeiro Baptista, Miriam Ventura, Marina Fajardo V M Pompílio da Hora, Nathália Rodrigues Alvarez, Gabriela Suarez Pinto, Raulino Sabino da Silva, Thaís Jeronimo Vidal","doi":"10.1590/1413-81232026311.14312025","DOIUrl":"https://doi.org/10.1590/1413-81232026311.14312025","url":null,"abstract":"Rare diseases are an important cause of infant mortality, yet their care presents many challenges. Legal claims have enabled access to medicines, but there are concerns about interference in health policy and patient safety. The present study analyzed 912 lawsuits, involving 23 medicines for 18 rare diseases between 2008 and 2022. Most plaintiffs were women and children, aged 0 to 5 years, residing in São Paulo and Minas Gerais. Legal aid was commonly granted, and 36 deaths were reported. The lawsuits originated from the Federal District, with limited use of alternative resolution methods. Private attorneys and prescriptions from private health services predominated. Court decisions were predominantly favorable to the plaintiffs, but only 4.2% of the actions indicated the inclusion of claimants in the Unified Health System (SUS). Despite Brazil's high rate of health litigation, some medicines involved in these lawsuits lacked strong evidence of efficacy and safety. Monitoring medicine use in this context is crucial to support future decisions. It is essential to develop innovative policies and coordination among different sectors to ensure effective and comprehensive care for individuals with rare diseases.","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"31 1","pages":"e14312025"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084538","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}

引用次数: 0

[Effort-reward imbalance at work and satisfaction with life in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)]. [巴西成人健康纵向研究（ELSA-Brasil）中工作中的努力-回报不平衡和生活满意度]。

IF 1.2 4区医学

Ciencia & saude coletiva Pub Date : 2025-12-01 Epub Date: 2024-10-07 DOI: 10.1590/1413-812320253012.06332024

Ivonice Meire do Carmo Gentil, Karina Araújo Pinto, Maria Conceição Chagas de Almeida, Yukari Figueiroa Mise, Rosane Harter Griep, Sheila Maria Alvim de Matos, Maria de Jesus Mendes da Fonseca, Milena Maria Cordeiro de Almeida

{"title":"[Effort-reward imbalance at work and satisfaction with life in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)].","authors":"Ivonice Meire do Carmo Gentil, Karina Araújo Pinto, Maria Conceição Chagas de Almeida, Yukari Figueiroa Mise, Rosane Harter Griep, Sheila Maria Alvim de Matos, Maria de Jesus Mendes da Fonseca, Milena Maria Cordeiro de Almeida","doi":"10.1590/1413-812320253012.06332024","DOIUrl":"https://doi.org/10.1590/1413-812320253012.06332024","url":null,"abstract":"The scope of this study was to analyze the association between effort-reward imbalance (ERI) at work and satisfaction with life among Brazilian public servants. It involved a cross-sectional study with 9,199 active participants in the second stage (2012-2014) of ELSA-Brasil. Sex-stratified analyses were performed using logistic regression at a 5% significance level. Women and men who reported ERI at work were more likely to report dissatisfaction with life (OR = 2.38; 95%CI: 1.93-2.93 and OR = 2.01; 95%CI: 1.68-2.39, respectively) compared to those without ERI. Among women, those in higher/teaching positions revealed a stronger association between ERI and dissatisfaction with life (OR = 2.77; 95%CI: 1.90-4.04) compared to those in support/medium-level positions (OR = 1.71; 95%CI: 1.38-2.12). Occupational stressors, as measured by ERI, were associated with dissatisfaction with life among public servants of both sexes. Functional level acted as an effect modifier in the association between ERI and satisfaction with life among women, potentially reflecting the increased educational and professional requirements women face to access and remain in the labor market as part of efforts to mitigate gender inequality.","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 12","pages":"e06332024"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984377","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}

引用次数: 0

[Convergences between promotion of health, public health education, educommunication and health literacy]. [促进健康、公共卫生教育、教育传播和卫生素养之间的趋同]。

IF 1.2 4区医学

Ciencia & saude coletiva Pub Date : 2025-12-01 Epub Date: 2024-10-18 DOI: 10.1590/1413-812320253012.05812024

Marco Akerman, Adriana Miranda de Castro, Cristina Almeida Santos, Pedro José Santos Carneiro Cruz, Noelia Rodrigues Pereira Rego, Frederico Peres

{"title":"[Convergences between promotion of health, public health education, educommunication and health literacy].","authors":"Marco Akerman, Adriana Miranda de Castro, Cristina Almeida Santos, Pedro José Santos Carneiro Cruz, Noelia Rodrigues Pereira Rego, Frederico Peres","doi":"10.1590/1413-812320253012.05812024","DOIUrl":"https://doi.org/10.1590/1413-812320253012.05812024","url":null,"abstract":"In Brazil, studies and practices around the concept of health literacy are recent and linked to the application of internationally validated instruments. From this perspective, a more conservative emphasis on the adoption of health literacy practices can be observed. This article explores possibilities for a Brazilian model of health literacy, considering the marked presence of the Brazilian community in public health in the promotion of health, popular education and educommunication, by linking timelines of these four areas of knowledge and practices. Having established these timelines, it seeks to highlight the main national and international historical, academic and political milestones, of each of these areas, over a specific period (1970-2023), against the backdrop of four political scenarios: \"military governments,\" \"redemocratization and neoliberalism,\" \"progressive governments\" and \"conservatism.\" Based on the identification of significant national and international milestones and the confluence between the fields of health promotion, popular health education, and educommunication, the possibility of a Brazilian model is postulated for promoting health literacy.","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 12","pages":"e05812024"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984421","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}

引用次数: 0

The structure of Brazilian PHC units: what has changed between 2012 and 2024? 巴西初级保健单位的结构：2012年至2024年间发生了什么变化？

IF 1.2 4区医学

Ciencia & saude coletiva Pub Date : 2025-12-01 Epub Date: 2025-08-13 DOI: 10.1590/1413-812320253012.08792025

Aylene Bousquat, Simone Schenkman, Patty Fidelis de Almeida, Paulo Henrique Dos Santos Mota, Ligia Giovanella

{"title":"The structure of Brazilian PHC units: what has changed between 2012 and 2024?","authors":"Aylene Bousquat, Simone Schenkman, Patty Fidelis de Almeida, Paulo Henrique Dos Santos Mota, Ligia Giovanella","doi":"10.1590/1413-812320253012.08792025","DOIUrl":"https://doi.org/10.1590/1413-812320253012.08792025","url":null,"abstract":"The structural typology of PHC units was drawn up based on the results of the 2024 National Census of PHC units, and the results were compared with those of 2012. Types of teams, diversity of professionals, shifts, available services, and facilities and supplies were used as the sub-dimension categories. A reference standard was set for each sub-dimension and a standardized score was calculated, with 1 being the best. Of the 44,938 PHC units that took part in the Census, 43,209 presented complete information on the variables and were analyzed. The final average score was 0.878, which proved to be 20% higher than in 2012. The sub-dimension with the worst score was \"types of teams\", and the best was \"shifts\". The units were grouped according to their final score from best to worst: A, B, C, D, E. All regions increased the percentage of PHC units in groups A and B, especially the North and Northeast. Type A was observed in 21.3% of the PHC units, a 4.4-fold increase, when compared to 2012. Advances in infrastructure conditions, shifts, and the increased presence of doctors indicate the effects of policies aimed at expanding access to PHC. However, essential components for comprehensive PHC still deserve attention, such as the presence of a sufficient number of Community Health Workers (CHWs), universal dispensing of medicines, and equalization between oral health teams and family health strategy (FHS) teams.","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 12","pages":"e08792025"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984549","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}

引用次数: 0

Prevalence of chronic diseases and factors associated with multimorbidity in the Brazilian Amazon: a cross-sectional population-based study, 2019. 巴西亚马逊地区慢性病患病率和与多病相关的因素：一项基于人群的横断面研究，2019年。

IF 1.2 4区医学

Ciencia & saude coletiva Pub Date : 2025-12-01 Epub Date: 2024-10-09 DOI: 10.1590/1413-812320253012.06232024

Gustavo Magno Baldin Tiguman, Marcus Tolentino Silva, Bruno Pereira Nunes, Taís Freire Galvão

{"title":"Prevalence of chronic diseases and factors associated with multimorbidity in the Brazilian Amazon: a cross-sectional population-based study, 2019.","authors":"Gustavo Magno Baldin Tiguman, Marcus Tolentino Silva, Bruno Pereira Nunes, Taís Freire Galvão","doi":"10.1590/1413-812320253012.06232024","DOIUrl":"https://doi.org/10.1590/1413-812320253012.06232024","url":null,"abstract":"This study aimed to assess the prevalence of multimorbidity and associated factors in Manaus, Brazil. A cross-sectional population-based survey was conducted in 2019 using probabilistic sampling. Multimorbidity was defined as two or more self-reported chronic diseases. Multimorbidity treatment was considered if participants received treatment for all their conditions. Limitations in daily activities were assessed using a 5-point Likert scale. Poisson regression was applied to estimate prevalence ratios (PR) of multimorbidity with 95% confidence intervals (95%CI). Out of 2,321 participants, 30.6% (95%CI 28.7-32.4%) had multimorbidity (mean: 2.99 ± 1.27 conditions), and 28.8% (95%CI 25.3-32.0%) of them were treated for all diseases. Back pain, hypertension, and hypercholesterolemia were the most common conditions, while mental disorders, renal disease, and other less frequent illnesses were most markedly associated with severe limitations in daily activities. Multimorbidity was higher in women (PR =1.46; 95%CI 1.28-1.66), older people (p < 0.001), and retired individuals (PR = 1.41; 95%CI 1.13-1.75). Nearly 30% of the population of Manaus live with multimorbidity, which is associated with socioeconomic determinants; among them, approximately one-quarter received multimorbidity treatment.","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 12","pages":"e06232024"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984557","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}

引用次数: 0