Revista de saude publica最新文献

{"title":"Erratum.","authors":"","doi":"10.11606/s1518-8787.2025059005997err","DOIUrl":"10.11606/s1518-8787.2025059005997err","url":null,"abstract":"<p><p>[This corrects the article doi: 10.11606/s1518-8787.2020054005997].</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e3serr"},"PeriodicalIF":2.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The protein deficit myth.","authors":"Ricardo Abramovay, Nadine Marques Nunes-Galbes, Fernanda Helena Marrocos-Leite, Eduardo Augusto Fernandes Nilson, Maria Laura da Costa Louzada","doi":"10.11606/s1518-8787.2025059006669","DOIUrl":"10.11606/s1518-8787.2025059006669","url":null,"abstract":"<p><p>Epidemiological data shows that the consumption of animal-based foods in high-income countries is excessive and harmful to health. But the association between poverty and protein deficiency is frequent, both in scientific literature and in the documents of multilateral organizations. There is a conceptual trap in this link, which consists of focusing on one nutrient and not on the whole dietary pattern. In 1974, in a text that has become a classic of nutrition science, Donald McLaren has already highlighted the mistake made by multilateral development organizations in focusing their efforts on protein supply-often in industrialized forms-without considering that, in most cases, once energy needs are met, protein deficiency is unlikely to occur. Data from the 2017-2018 Consumer Expenditure Survey helps to dispel this myth: even among the poorest 20% of the Brazilian population, the proportion of those with insufficient protein intake is tiny.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e21"},"PeriodicalIF":2.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum.","authors":"","doi":"10.11606/s1518-8787.2025059005555err","DOIUrl":"10.11606/s1518-8787.2025059005555err","url":null,"abstract":"<p><p>[This corrects the article doi: 10.11606/s1518-8787.2020054005555].</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e4serr"},"PeriodicalIF":2.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum.","authors":"","doi":"10.11606/s1518-8787.2025059005462err","DOIUrl":"10.11606/s1518-8787.2025059005462err","url":null,"abstract":"<p><p>[This corrects the article doi: 10.11606/s1518-8787.2024058005462].</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e8serr"},"PeriodicalIF":2.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum.","authors":"","doi":"10.11606/s1518-8787.2025059005589err","DOIUrl":"10.11606/s1518-8787.2025059005589err","url":null,"abstract":"<p><p>[This corrects the article doi: 10.11606/s1518-8787.2024058005589] [This corrects the article doi: 10.11606/s1518-8787.2020054005589].</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e10serr"},"PeriodicalIF":2.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do adversities in the intrauterine and neonatal periods interfere with intelligence?","authors":"Janielle Ferreira de Brito Lima, Rosângela Fernandes Lucena Batista, Liliana Yanet Gómez Aristizábal, Cecilia Claudia Costa Ribeiro de Almeida, Vanda Maria Ferreira Simões, Antônio Augusto Moura da Silva","doi":"10.11606/s1518-8787.2025059006206","DOIUrl":"10.11606/s1518-8787.2025059006206","url":null,"abstract":"<p><strong>Objective: </strong>Investigate the effects of intrauterine growth restriction and socioeconomic status at birth on intellectual development.</p><p><strong>Methods: </strong>Study conducted with 313 participants from a birth cohort from São Luís, in the state of Maranhão, assessed at birth and between 18 and 19 years of age. Variables at birth and early years of life (maternal age, maternal education, paternal education, occupation of the head of the household, family income, maternal gestational weight gain, intrauterine growth restriction, low birth weight, and breastfeeding duration), and education at 18 and 19 years were tested as determinants of intelligence quotient at 18 and 19 years using structural equation modeling.</p><p><strong>Results: </strong>Results: Intrauterine growth restriction did not have a total (p-value = 0.957), direct (p-value = 0.184), or indirect (p-value = 0.108) effect on the intelligence quotient at 18 and 19 years of age. Socioeconomic status at birth had a total positive effect of 0.406 standard deviations (p-value < 0.001) on its mean, corresponding to an increase of 4.54 points in the quotient for each increase in socioeconomic level at birth. This effect was not mediated by the other explanatory variables included in the model; however, a direct positive effect of 0.416 (p-value < 0.001) of socioeconomic status on education was identified, which showed a positive correlation (PC = 0.439; p-value < 0.001) with intelligence. Maternal age at birth also had a direct positive effect of 0.116 standard deviations (p-value = 0.042) on the mean intelligence quotient (QI) at 18 and 19 years, corresponding to an increase of 1.30 points for each 1-year increase in maternal age at birth.</p><p><strong>Conclusion: </strong>Higher socioeconomic levels at birth directly affected the participant's intelligence and education positively, increasing the mean QI and education level at 18 and 19 years. A positive correlation was also identified between the two variables.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e15"},"PeriodicalIF":2.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum.","authors":"","doi":"10.11606/s1518-8787.2025059006197err","DOIUrl":"10.11606/s1518-8787.2025059006197err","url":null,"abstract":"<p><p>[This corrects the article doi: 10.11606/s1518-8787.2025059006197].</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e3rr"},"PeriodicalIF":2.1,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to the Dietary Guideline for the Brazilian Population and its sociodemographic aspects: Brazuca Natal Study.","authors":"Maria Eugênia de Medeiros Fernandes, Severina Carla Vieira Cunha Lima, Suamy Sales Barbosa, Rosa Sá de Oliveira Neta, Layanne Cristini Martin Sousa, Mariana Silva Bezerra, Márcia Marília Gomes Dantas Lopes, Angelo Giuseppe Roncalli da Costa Oliveira, Dirce Maria Lobo Marchioni, Clélia de Oliveira Lyra","doi":"10.11606/s1518-8787.2025059006044","DOIUrl":"10.11606/s1518-8787.2025059006044","url":null,"abstract":"<p><p>To analyze the adherence of adults and older adults in the Brazuca Natal study to the recommendations of the Dietary Guideline for the Brazilian Population and to determine its relation with sociodemographic factors.</p><p><p>This cross-sectional study was carried out with 411 adults and older individuals residing in Natal, Rio Grande do Norte. Participants were selected from a probabilistic sample by clusters in two stages (census tracts and households). Data were collected by an electronic questionnaire on the Epicollect 5 digital platform. The questionnaire contained sociodemographic data and a multidimensional scale to measure adherence to the dietary practices recommended by the Dietary Guidelines for the Brazilian population. The scale consists of 24 questions following a Likert scale (strongly disagree; disagree; agree; and strongly agree). Total scores ranged from 0 to 72, with classifications of low (total score < 32), medium (total score from 32 to 41), and high adherence (total score > 41) to the Dietary Guideline. To verify the association between adherence to the Guide and sociodemographic variables, multiple analysis by unconditional logistic regression were performed.</p><p><p>The mean score equaled 40.5 (7.9), and high adherence to the Guide occurred in 40.8% (95%CI 30.8-51.5) of the population. Women (PR = 1.27; 95%CI 1.03-1.55) and older individuals (PR = 1.46; 95%CI 1.19-1.79) showed a significant association. Individuals who reported a monthly per capita income below one minimum wage were less likely to show high adherence to the Guide, a factor that was intensified for those who earned ≤ 1/4 of the minimum wage (PR = 0.47; 95%CI 0.32-0.68).</p><p><p>The findings of this study indicate that women and older age predict greater adherence to the Dietary Guideline. Conversely, having a low per capita income predicts alower adherence in the evaluated population. Establishing policies to mitigate social inequalities and initiatives to enhance access to dietary practices in line with the Dietary Guideline among adult and older adult populations is imperative.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e16"},"PeriodicalIF":2.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Health Care structure and vaccination coverage in Brazilian municipalities.","authors":"Guilherme de Andrade Ruela, Alaneir de Fátima Dos Santos, César Macieira, Sábado Nicolau Girardi, Daisy Maria Xavier de Abreu, Alice Werneck Massote, Jackson Freire Araújo, Antônio Thomaz Gonzaga da Matta Machado","doi":"10.11606/s1518-8787.2025059006279","DOIUrl":"https://doi.org/10.11606/s1518-8787.2025059006279","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the relationship between vaccination coverage indicators and the structure of primary care for immunization in Brazilian municipalities.</p><p><strong>Methods: </strong>This was a time series ecological study using data from the National Immunization Program Information System (SI-PNI) and the National Program for Improving Primary Care Access and Quality (PMAQ) over three evaluation cycles. A total of 13 variables were assessed, five of which related to the structure of basic health units (BHU) and eight to the availability of immunobiologicals. Analyses of comparisons, associations, and longitudinal models were carried out to assess the influence of these indicators on vaccination coverage levels.</p><p><strong>Results: </strong>The variables and indicators related to the structure of BHUs, the availability of immunobiologicals in Brazilian municipalities and vaccination coverage showed significant variations over the cycles. BHU structures ranged from fair to good, with lower percentages in Cycle 1 and increases in Cycles 2 and 3 for most of the variables analyzed. The availability of immunobiologicals also improved over the cycles, despite a few exceptions. Indicators of adequate vaccination coverage increased from Cycle 1 to Cycle 2 but decreased in Cycle 3. Improvements in the structure of the BHU and the availability of immunobiologicals were associated with higher adequate vaccination coverage. Keeping the availability of immunobiologicals fixed at good, the chance of having adequate coverage is 86.28% higher for a good structure compared to a poor one.</p><p><strong>Conclusions: </strong>Changes in the structure of municipal BHUs and in the availability of immunobiologicals over the cycles evaluated were identified and were associated with higher vaccination coverage when they occurred simultaneously (good availability of immunobiologicals and regular or good structure in BHUs). This highlights the importance of the quality of primary care in achieving vaccination coverage targets in Brazilian municipalities.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e12"},"PeriodicalIF":2.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficiency of primary care in Brazilian capitals and management models: 2008-2019.","authors":"André Luis Paes Ramos, Marismary Horsth De Seta, Marcelo Battesini","doi":"10.11606/s1518-8787.2025059006346","DOIUrl":"https://doi.org/10.11606/s1518-8787.2025059006346","url":null,"abstract":"<p><strong>Objective: </strong>To analyze efficiency in primary health care in Brazilian state capitals in the period 2008-2019, considering the management model: direct public administration or administration assigned to third parties.</p><p><strong>Methods: </strong>This is an evaluative study with an analytical objective, using publicly available secondary data, analyzed cross-sectionally (2019) and longitudinally (2008, 2012, 2016, and 2019). Demographic and socioeconomic data and seven indicators related to primary health care were used to characterize the cities and their primary health care (primary care coverage, hospitalizations for primary care-sensitive conditions, tuberculosis cures, infant, maternal, and premature mortality due to chronic conditions, incidence of congenital syphilis). To these indicators were added health and primary health care expenditures and data envelopment analysis focused on outputs (without admitting a reduction in expenditures) to calculate efficiency in 2008, 2012, 2016, and 2019. The Malmquist index was used to identify possible productivity gains between 2008 and 2019.</p><p><strong>Results: </strong>Four capitals identified as being managed by third parties (São Paulo, Rio de Janeiro, Porto Alegre, and Fortaleza) did not achieve greater efficiency compared to direct public administration, nor did they evolve when comparing their own results over time. In 2019, and in the longitudinal approach, only capitals managed by direct public administration obtained the maximum relative efficiency index in the comparison between capitals. Twelve capitals with direct public administration remained efficient in all years, while those with third-party administration consistently showed weak inefficiency in primary health care, i.e. in the period studied, the relationship between investments in primary health care and results obtained is lower than that achieved by the efficient capitals.</p><p><strong>Conclusions: </strong>We found no evidence of efficiency gains with the adoption of third-party management. It should be noted that productive efficiency does not necessarily mean that health needs are met.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e6"},"PeriodicalIF":2.1,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}