Revista de saude publica最新文献

{"title":"Impact of structural and interpersonal racism on oral health and dental services.","authors":"Rafaela de Oliveira Cunha, Isabel Cristina Gonçalves Leite, Mário Círio Nogueira","doi":"10.11606/s1518-8787.2026060007164","DOIUrl":"10.11606/s1518-8787.2026060007164","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the role of racism in oral health and access to dental services, considering two impact pathways: structural racism and interpersonal racism.</p><p><strong>Methods: </strong>A cross-sectional study with 686 undergraduate students, which analyzed two categories of outcomes: those related to oral health (self-perception, oral health impairment, and tooth loss) and those related to access to/perception of the quality of dental services (access to services, recent use, and evaluation of care). Exposures were race/color, racial discrimination, and characterization of the neighborhood environment. Prevalence ratios were estimated using Poisson regression with robust variance, with adjustments guided by directed acyclic diagrams.</p><p><strong>Results: </strong>Black and brown people had a higher prevalence of negative self-perception (black: PR = 1.56; 95%CI 1.14-2.13; brown: PR = 1.53; 95%CI 1.14-2.05), tooth loss (black: PR = 1.99; 95%CI 1.33-2.97), lack of access to dental services (black: PR = 3.08; 95%CI 1.06-8.95; brown: PR = 3.78; 95%CI 1.49-9.59), and negative evaluation of care (black: PR = 1.63; 95%CI 1.08-2.45; brown: PR = 1.64; 95%CI 1.12-2.39). Racial discrimination was associated with lack of access (PR = 4.34; 95%CI 1.45-12.95), recent non-use of services (PR = 1.74; 95%CI 1.31-2.31) and negative evaluation of care (PR = 1.51; 95%CI 1.01-2.25). And living in neighborhoods with fewer physical and social problems was associated with a lower prevalence of negative self-perception (PR = 0.70; 95%CI 0.54-0.90), compromised oral health (PR = 0.87; 95%CI 0.76-0.99), lack of access (PR = 0.42; 95%CI 0.18-0.98), and negative evaluation of care (PR = 0.56; 95%CI 0.40-0.79).</p><p><strong>Conclusions: </strong>The findings show that racism impacts oral health through structural and interpersonal channels and highlight the urgency of broad and effective strategies to reduce the inequities affecting racialized groups.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"60 ","pages":"e11"},"PeriodicalIF":2.1,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12991402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481668","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":"Technological arrangements for regulating access to healthcare: experience in the state of São Paulo.","authors":"Mariana Prado Freire, Arthur Chioro, Luís Fernando Nogueira Tofani, André Luiz Bigal, Marília Cristina Prado Louvison","doi":"10.11606/s1518-8787.2026060006604","DOIUrl":"10.11606/s1518-8787.2026060006604","url":null,"abstract":"<p><strong>Objective: </strong>To describe and analyze the regulatory arrangements used to expand access to beds and health services during Covid-19.</p><p><strong>Methods: </strong>This study, part of the Research for the SUS Program funded by Fundação de Amparo à Pesquisa do Estado de São Paulo (Fapesp) and the Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde do Ministério da Saúde (Sctie-MS) Fapesp/Sctie used mixed methods to investigate the management of network care to face Covid-19 in São Paulo. Data was collected via an electronic questionnaire sent to managers in 645 municipalities between November 2021 and February 2022, with the support of the São Paulo Council of Municipal Health Secretaries (COSEMS-SP). The responses were analyzed quantitatively and qualitatively, with a focus on regulating access to healthcare.</p><p><strong>Results: </strong>255 valid responses were collected (39.5% of São Paulo municipalities). Most municipalities regulated Covid-19 beds through the state regulation center (58%) and faced difficulties with access (53.7%), insufficient beds and 68.6% difficulties with hospitalization. The creation of new services was reported by 83.1%, and 70.0% implemented specific flows to expand access. In outpatient access, 54.5% used multiple regulation strategies. Financial resources were sufficient for 54.0% of the municipalities and 86.3% faced difficulties in acquiring supplies. Statistically significant associations were observed between municipal size and regulation variables.</p><p><strong>Conclusion: </strong>The Covid-19 pandemic has highlighted the importance of bed regulation and the unequal distribution between the public and private sectors. This study identified challenges such as insufficient beds, difficulties in admitting patients, and a reduction in outpatient services. Large municipalities have expanded beds through field hospitals and agreements with private hospitals. Small and medium-sized municipalities adopted regional strategies and multiple protocols. Regional coordination and state regulation were crucial in managing the response, but difficulties with supplies and human resources impacted on access. The incorporation of digital mechanisms and new regulatory strategies was important, despite the structural and political challenges that aggravated the emergency response.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"60 ","pages":"e5"},"PeriodicalIF":2.1,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12928190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147291027","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":"Risk of reintroduction of vaccine-preventable diseases in the state of São Paulo, Brazil.","authors":"José Elisomar Silva de Santana, Maria Lígia Bacciotte Ramos Nerger, Tatiana Lang D' Agostini, Joyce Ribeiro da Conceição Santos, Sheila Aparecida Ferreira Lachtim, Camilla Stephane Oliveira Silva, Thales Philipe Rodrigues da Silva, Fernanda Penido Matozinhos","doi":"10.11606/s1518-8787.2026060007062","DOIUrl":"10.11606/s1518-8787.2026060007062","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the risk classification of transmission of vaccine-preventable diseases in the municipalities of the state of São Paulo (SP) and to assess the influence of population size on the risk of transmission of vaccine-preventable diseases (RTDI) before and after the implementation of Microplanning for High-Quality Vaccination Activities.</p><p><strong>Methods: </strong>This is an epidemiological study with an ecological design, conducted using secondary data on vaccination coverage for nine immunobiologicals recommended in the immunization schedule for children under two years of age. It also examines dropout rates for multi-dose vaccines within the same age group in the state of São Paulo, covering the years 2022 and 2023. Following the calculation of all indicators, municipalities were classified according to their risk of transmission for vaccine-preventable diseases.</p><p><strong>Results: </strong>Analyses of vaccination coverage indicators, dropout rates, homogeneity of vaccination coverage among vaccines for children under two years of age, and the RTDI indicator for children aged one year or younger revealed that, in 2022, the human rotavirus vaccine had the highest proportion of municipalities reaching the coverage target (46%), followed by the meningococcal vaccine (39%). In 2023, the human rotavirus vaccine maintained the highest proportion of municipalities reaching the target (68%), followed by the pneumococcal vaccine (57%). Regarding the RTDI, in large municipalities, high risk fell from 100% to 91.2%, while in medium-sized municipalities there was a reduction from 90.8% to 66.7%, and in small municipalities, from 68.3% to 56%.</p><p><strong>Conclusion: </strong>Challenges remain within the state regarding the RTDI classification for vaccination, particularly in medium-sized and large municipalities. The use of immunization indicators at the municipal level can be highly effective for proposing health interventions aimed at increasing vaccination coverage.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"60 ","pages":"e7"},"PeriodicalIF":2.1,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12928189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147291022","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":"Brazil is already experiencing the brutal impacts of climate change.","authors":"Camila Lorenz, Thais Araújo Cavendish, Thiago Salomão de Azevedo, Michelle Bell, Adelaide Nardocci, Maria de Fátima Andrade, Thiago Nogueira","doi":"10.11606/s1518-8787.2026060007009","DOIUrl":"10.11606/s1518-8787.2026060007009","url":null,"abstract":"<p><p>Brazil is increasingly experiencing severe climate events, including extreme droughts, wildfires, floods, and heatwaves, driven by both excessive rainfall and prolonged dry periods. These disasters have resulted in significant environmental, economic, and social losses, deepening inequality and fuelling public health crises. Climate change is disproportionately affecting vulnerable populations and contributing to the rise of disease outbreaks such as dengue and Oropouche fever. Brazil's vulnerability stems from its diverse ecosystems, heavy reliance on agriculture and hydropower, and its critical role in global climate dynamics due to widespread deforestation. This paper examines the country's future challenges and outlines strategies to address extreme weather events, including the development of climate adaptation policies, enhanced deforestation monitoring, and strengthened disaster preparedness. To improve resilience, Brazil must invest in comprehensive risk assessments, the integration of disaster risk indicators, and the establishment of a national climate-disaster reporting system to better anticipate, mitigate, and manage the impacts of extreme climate events.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"60 ","pages":"e6"},"PeriodicalIF":2.1,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12904542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228446","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":"Guttman error graphs: a visual approach to scalability analysis.","authors":"Michael Eduardo Reichenheim, Claudia Leite de Moraes, João Luiz Bastos","doi":"10.11606/s1518-8787.2026060007015","DOIUrl":"10.11606/s1518-8787.2026060007015","url":null,"abstract":"<p><strong>Objective: </strong>To develop an innovative graphical tool to represent Guttman errors and facilitate scalability analysis of measurement instruments in epidemiology.</p><p><strong>Methods: </strong>Implemented in R (RStudio), the guttemap function was developed to fill this gap. It provides an intuitive visual representation of Guttman errors, with color gradients that facilitate the assessment of measurement instruments, revealing internal patterns of inconsistency. The rationale underlying the proposed Guttman error map is presented, along with an annotated summary of the routine for its implementation.</p><p><strong>Results: </strong>Seven synthetic examples show the potential of graphical representation in identifying problem areas and how this helps to inform adjustments and develop more robust instruments.</p><p><strong>Conclusions: </strong>With guttemap, Guttman error analysis becomes more accessible and interpretable, contributing to the improvement of measurement instruments and the advancement of epidemiological research.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"60 ","pages":"e1"},"PeriodicalIF":2.1,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158582","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":"Food policies, family farming, and climate justice in the Amazon towards COP30.","authors":"Jaqueline Lopes Pereira, Bárbara Lellis de Sá Frizo, Denise Miguel Teixeira Roberto, Gabriela Rigote, Clara Ribeiro Camargo, Fabrício Muriana, Gabriela Mariano Mendonça, Maurício Alcântara, Roberta Moraes Curan, Dirce Maria Lobo Marchioni, Aline Martins de Carvalho","doi":"10.11606/s1518-8787.2026060007235","DOIUrl":"https://doi.org/10.11606/s1518-8787.2026060007235","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the sustainability of the food system in the Belém Metropolitan Region, based on the interface between public institutional purchasing policies (National School Feeding Program and Food Acquisition Program), considering local production, the profile of spending, the appreciation of family farming, and the principles of climate justice.</p><p><strong>Methods: </strong>The analysis of the National School Feeding Program was based on data from the School Census (profile of schools and students) and invoices from the Accountability Management System (amounts and types of food from family farming), both from 2022. The food was classified into 12 groups. The characterization of family farming and the data from the Food Acquisition Program were based on reports on urban and peri-urban agriculture and the mapping of settlements.</p><p><strong>Results: </strong>The Belém Metropolitan Region has 929 public schools and 390,552 students. In 2022, the municipalities allocated 31 million reais to the National School Feeding Program, of which 43.5% came from family farming, exceeding the legal target. Fruit accounted for the largest amounts invested, followed by vegetables and spices. In the Food Acquisition Program, the Abril Vermelho (Red April) settlement sold 28 tons of food, especially fruit, vegetables, and tubers, with pumpkin and cassava root being the foods with the highest volume, and spring onions and pepper the ones with the highest financial value. Production prioritized permanent crops, agro-ecological practices and culturally significant foods.</p><p><strong>Conclusions: </strong>The results show the potential of the National School Feeding Program and the Food Acquisition Program in the Belém Metropolitan Region to strengthen family farming, promote healthy and sustainable eating, value regional products, and contribute to environmental recovery. These policies represent strategic instruments for integrating food security and climate justice, by promoting low-impact local production, recognizing inequalities, and increasing the resilience of food systems, in line with the COP30 objectives.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"60 ","pages":"e2"},"PeriodicalIF":2.1,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119985","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":"Prevalence of factors associated with chronic diseases in university students: PNS 2013 and 2019.","authors":"Maria Emília Coimbra Pereira, Taciana Maia de Sousa, Daniela Silva Canella","doi":"10.11606/s1518-8787.2026060006697","DOIUrl":"https://doi.org/10.11606/s1518-8787.2026060006697","url":null,"abstract":"<p><strong>Objective: </strong>To assess the prevalence of risk and protective factors for non-communicable diseases among Brazilian university students.</p><p><strong>Methods: </strong>Data from the 2013 and 2019 National Health Survey were used to assess undergraduate students (≥ 18 years). Risk factors included consumption of unhealthy foods, sedentary behavior, insufficient physical activity, alcohol and tobacco consumption, overweight, and obesity, while protective factors involved consumption of healthy foods and leisure-time physical activity. Prevalences and confidence intervals were described for each year, stratified by sex, professional occupation, race/skin color, and age group.</p><p><strong>Results: </strong>The prevalence of regular consumption of soft drinks (men: 27.9% to 12.5%; women: 22.8% to 10.7%), sweets (men: 27.1% to 17.6%; women: 33.2% to 20.4%), and insufficient physical activity (men: 37.6% to 22.7%; women: 57.7% to 37.3%) decreased, while the prevalence of regular fruit and vegetable consumption (men: 16.1% to 27.2%; women: 22.6% to 34%) and leisure-time physical activity (women: 28.3% to 37.3%) increased. Regular consumption of beans (65.1% to 55.8%) and leisure-time physical activity (32.4% to 42.9%) increased among students with jobs. Leisure-time physical activity (37.2% to 46.4%) increased and sweet consumption (33.7% to 17.5%) decreased among white/Asian students, while regular consumption of beans decreased among Black/indigenous students (69.9% to 57.1%).</p><p><strong>Conclusion: </strong>The prevalence of most risk factors decreased. The prevalence of fruit and vegetable consumption and physical activity remained low but increased.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"60 ","pages":"e3"},"PeriodicalIF":2.1,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119953","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":"Multiple sclerosis treatment coverage: an analysis based on inequality indicators.","authors":"Gabriela Bittencourt Gonzalez Mosegui, Cid Manso de Mello Vianna, Fernando Antoñanzas, Fabiano Saldanha Gomes de Oliveira, Deison Alencar Lucietto, Marcus Paulo da Silva Rodrigues","doi":"10.11606/s1518-8787.2026060007156","DOIUrl":"https://doi.org/10.11606/s1518-8787.2026060007156","url":null,"abstract":"<p><strong>Objective: </strong>To assess territorial inequalities in the coverage of first-line pharmacological treatment for relapsing-remitting multiple sclerosis in the Brazilian Unified Health System (SUS) in 2024, analyzing the regional distribution of coverage, consumption, and spending, and quantifying socioeconomic inequalities using the Slope Index of Inequality (SII) and Relative Index of Inequality (RII) indicators.</p><p><strong>Methods: </strong>An observational study based on administrative data from the SUS, integrating information from Outpatient Procedure Authorizations and epidemiological estimates to calculate consumption in defined daily doses and per capita expenditure on disease-modifying drugs. The state Human Development Index was used as a socioeconomic proxy to calculate the SII and RII indicators, which quantify absolute and relative inequalities.</p><p><strong>Results: </strong>In 2024, only 35.3% of eligible patients received treatment, with coverage varying between regions (50.9% in the Central-West and 34.3% in the Northeast). The SII (0.2082) and RII (2.58) for PT/PATSUS indicated strong socioeconomic inequality in coverage. For per capita spending, there was no consistent socioeconomic gradient (SII = -99.18; RII = 0.96). Consumption in defined daily doses showed significant inequality (SII = 61.65; RII = 2.50), reflecting greater therapeutic intensity in states with a higher Human Development Index.</p><p><strong>Conclusions: </strong>The study shows important limitations in the coverage and equity of treatment for relapsing-remitting multiple sclerosis in the SUS, with structural inequalities associated with regional socioeconomic position. The integrated use of administrative indicators and inequality metrics (SII and RII) provides subsidies for policy interventions focused on distributive justice and sustainability of the public health system.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"60 ","pages":"e4"},"PeriodicalIF":2.1,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120005","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":"COVID-19 among health care workers in Brazil: prevalence and disparities based on respondent-driven sampling.","authors":"Ligia Kerr, Marto Leal, Rosa Lívia Freitas Almeida, Ana Zaira da Silva, Cristiane Cunha Frota, Luana Nepomuceno Gondim Costa Lima, Luciane Nascimento Cruz, Maria de Fátima Militão de Albuquerque, Mirian Cohen, Ricardo Arraes de Alencar Ximenes, Wayner Vieira de Souza, Maria Amélia de Sousa Mascena Veras, José Luis Gomes, Roberto da Justa Pires Neto, Marli Teresinha Gimeniz Galvão, Patrícia Neyva da Costa Pinheiro, Ulisses Ramos Montarroyos, Cresio Romeu Pereira, Demócrito de Barros Miranda-Filho, Paulo Roberto Borges de Souza Junior, Thália Velho Barreto de Araújo, Pedro Miguel Dos Santos Neto, Cynthia Braga, Celina Maia Turchi Martelli, Carl Kendall","doi":"10.11606/s1518-8787.2025059006959","DOIUrl":"10.11606/s1518-8787.2025059006959","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence and disparities of COVID-19 among health care workers in Brazil.</p><p><strong>Methods: </strong>A survey was conducted among health care workers in five Brazilian cities. Disparities in the prevalence of COVID-19 were analyzed by professional category and region (North/Northeast versus South/Southeast).</p><p><strong>Results: </strong>The sample was composed of 2,499 health care workers: 601 (24.1%) nursing technicians, 1,095 (43.8%) registered nurses, and 803 (32.1%) physicians. Recruitment and data collection were conducted online from May 21, 2020, to February 10, 2021, using respondent-driven sampling. The overall COVID-19 prevalence was 48.1% (95%CI: 43.4-52.9). The highest COVID-19 prevalence was identified among nursing technicians (52.8%; 95%CI: 44.4-61.0). Nursing technicians reported undergoing fewer PCR and COVID-19 tests compared to physicians. Nursing technicians and registered nurses in the North/Northeast regions who reported COVID-19 symptoms spent much of the first year of the pandemic without access to confirmatory testing. Furthermore, the risk of laboratory-confirmed COVID-19 was significantly lower for all occupational categories in the North and Northeast regions.</p><p><strong>Conclusions: </strong>COVID-19 rates among health care workers were exceptionally high and non-uniformly distributed. This mirrors the vast socioeconomic, cultural, and political differences and the difficulty in coordinating pandemic control actions in Brazil.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e51"},"PeriodicalIF":2.1,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12713530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985349","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":"Developing strategies and quality control in the Ageing and Brain Working Study in ELSA-Brasil.","authors":"Alessandra Vanessa Lopes Quidim, Raphael Beuttler, Helena Mendes Eloi, Maria Concepción García Otaduy, José Gilvam Araújo Lima Júnior, Murillo Mariotto Teixeira, Carlos Eduardo de Lima Moraes Dardis, Khallil Taverna Chaim, Adriana Bastos Conforto, Claudia da Costa Leite, Carolina de Medeiros Rimkus, Claudia Kimie Suemoto, Angelita Gomes Souza, Itamar Souza Santos, Paulo Andrade Lotufo, Isabela Judith Martins Benseñor, Alessandra Carvalho Goulart","doi":"10.11606/s1518-8787.2025059006956","DOIUrl":"10.11606/s1518-8787.2025059006956","url":null,"abstract":"<p><strong>Objective: </strong>To describe all stages of developing strategies and quality control in the Aging and Brain Working Study linked to the Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil - Brazilian Longitudinal Study of Adult Health), a prospective cohort of 15,105 civil servants (aged 35-74) followed up since 2008.</p><p><strong>Methods: </strong>Based on the sample of participants alive at the beginning of the sample selection in September 2022 (n = 4,566) from ELSA-Brasil (Centro Investigação São Paulo), a representative sample of 2,165 individuals was calculated according to the following criteria and divided into two subsamples: (1) Sample of participants < 70 years old in Wave 3 (2017-2019) randomized according to cognitive trajectory from Wave 1 to 3, n = 1,670; (2) SuperAgers case-control sample, individuals aged ≥ 70 years in Wave 3, based on episodic memory in Wave 3, n = 495 participants (171 cases, 324 controls). The processes implemented to ensure quality control of information prior to data collection were selection of data collection instruments, training and certification of teams, preparation of a manual of definitions and standardized operating procedures, pilot studies, data collection logistics, harmonization of imaging protocols, and creation of an anti-noise device. Given the scope of the study, its multicenter nature, and the diversity of measures involved, this project required the implementation of effective quality assurance and control protocols, ensuring standardization, methodological consistency, and data integrity at all stages.</p><p><strong>Results: </strong>After implementing the quality assurance and control processes, the final stages related to clinical and imaging data collection, management, and continuous monitoring of field activities were conducted, with weekly reports and statistical monitoring of the sample.</p><p><strong>Conclusions: </strong>The adoption of systematic stages of development and quality control was fundamental to ensure the production and reliability of information from brain neuroimaging studies.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e54"},"PeriodicalIF":2.1,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12795433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985405","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}