Cadernos de saude publicaPub Date : 2026-05-01eCollection Date: 2026-01-01DOI: 10.1590/0102-311XEN266325
Guilherme Antonio Moreira de Barros, Claudia Marquez Simões
{"title":"Anvisa authorization for electronic prescriptions of controlled substances: implications for equity in access to pain management in Brazil.","authors":"Guilherme Antonio Moreira de Barros, Claudia Marquez Simões","doi":"10.1590/0102-311XEN266325","DOIUrl":"10.1590/0102-311XEN266325","url":null,"abstract":"","PeriodicalId":9398,"journal":{"name":"Cadernos de saude publica","volume":"42 ","pages":"e00266325"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834072","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}
Cadernos de saude publicaPub Date : 2026-05-01eCollection Date: 2026-01-01DOI: 10.1590/0102-311XEN113025
Bruno Margueritte Costa, Cleverson Motin, João Vicente Marinho de Sousa, Nilo Massaru Okuno, Adalberto Ferreira-Junior
{"title":"Association of heart rate recovery with mortality risk in a 72-month survival analysis.","authors":"Bruno Margueritte Costa, Cleverson Motin, João Vicente Marinho de Sousa, Nilo Massaru Okuno, Adalberto Ferreira-Junior","doi":"10.1590/0102-311XEN113025","DOIUrl":"10.1590/0102-311XEN113025","url":null,"abstract":"<p><p>This study aimed to investigate whether heart rate recovery (HRR) is a predictor of all-cause mortality in a 72-month survival analysis. In this cohort study, 578 individuals who underwent a maximal exercise test at a university hospital between August 2012 and August 2018 were followed for up to 72 months. Participants performed a maximal incremental treadmill test, followed by an active recovery period phase to evaluate their HRR. When the decay of heart rate totaled ≥ 13bpm in the first minute post-exercise a normal HRR was considered, whereas an abnormal HRR was defined as ≤ 12bpm. Of the 578 individuals, 371 (64.2%) had normal HRR, whereas 207 (35.8%) had an abnormal HRR. The survival analysis showed significantly higher 72-month survival in the normal HRR group (93.8%) than in the abnormal HRR group (81.6%), with a 3.16 hazard ratio (95%CI: 1.86-5.35). Individuals with abnormal HRR were generally older, had a greater burden of comorbidities, shorter time to exhaustion, lower peak heart rate, and higher heart rate 60 seconds after the exercise. Thus, HRR predicted 72-month all-cause mortality. These findings suggest the use of HRR as a simple, non-invasive prognostic tool in clinical practice, particularly for stratifying mortality risk.</p>","PeriodicalId":9398,"journal":{"name":"Cadernos de saude publica","volume":"42 ","pages":"e00113025"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834075","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":"Family member's perceived impact of anorexia nervosa and bulimia nervosa on family dynamics: a qualitative systematic review and meta-synthesis.","authors":"Thaís Shirane, Diogo Sussumu Okasawara, Érika Arantes Oliveira-Cardoso, Manoel Antônio Dos Santos","doi":"10.1590/0102-311XEN181525","DOIUrl":"10.1590/0102-311XEN181525","url":null,"abstract":"<p><p>Eating disorders configure a growing and complex public health issue which hinders implementing targeted policies. Global health policies emphasize tailored interventions for reducing eating disorders harms among vulnerable people. This systematic literature review and meta-synthesis interprets the synthesized findings from primary qualitative studies on the experience of family living with the diagnosis of anorexia nervosa and bulimia nervosa. The study was conducted based on the SPIDER search strategy and PRISMA guidelines on nine databases: Academic Search Premier, CINAHL, LILACS, MEDLINE, PubMed, PsycINFO, SocINDEX, Scopus, and Web of Science. Two independent reviewers performed the article screening and selection processes. Of the 2,269 studies initially identified, 28 met the inclusion criteria and were selected. Four descriptive themes emerged: (1) Anorexia nervosa/bulimia nervosa within the family environment: meanings attributed to the symptoms; (2) Anorexia nervosa/bulimia nervosa dominance within the family system: care that also harms; (3) Challenges in accessing care: individual and social barriers; and (4) Pathways to coping: supporting the whole family - a public health issue. The study shows that family dynamics and the health-illness process are closely linked, forming a cyclical, mutually reinforcing relationship that highlights the need for a more comprehensive approach to supporting the whole family. These findings corroborate the need for global policies that emphasize tailored interventions to reduce eating disorders harms and suffering within families.</p>","PeriodicalId":9398,"journal":{"name":"Cadernos de saude publica","volume":"42 ","pages":"e00181525"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834090","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":"[Water, sanitation, and hygiene (WASH): a study of Brazilian rural public elementary schools].","authors":"Lívia Pita Corrêa, Patrícia Conceição Medeiros, Renato Moreira Hadad, José Irineu Rangel Rigotti, Uende Aparecida Figueiredo Gomes","doi":"10.1590/0102-311XPT128025","DOIUrl":"10.1590/0102-311XPT128025","url":null,"abstract":"<p><p>This study investigated the lack of access to water, sanitation, and hygiene (WASH) at Brazilian rural public elementary schools through a cross-sectional comparative study of the years 2011 and 2023. The distribution, temporal evolution, and determinant factors of this lack were assessed through descriptive analysis and binomial logistic regression, using the School Census of Basic Education as the main database. The results reveal persistent regional inequalities: the North region had the highest odds ratios for the absence of all WASH services in both years analyzed. Schools located on indigenous lands, with less than 10 students or with high dropout rates and low passing rates, had a greater likelihood of health exclusion. On the municipal level, the high proportion of the rural population and low Municipal Human Development Index - Income stood out as determinants. Despite occasional advances in access to water, setbacks in other services indicate stagnation or the worsening of inequalities. The results reveal that, after more than ten years, rural Brazil is still far from meeting the 4.a.1 target of the Sustainable Development Goals, which stipulates universal access to WASH in the school environment. By revealing the main institutional and regional obstacles, this study contributes to the planning of public policies that are more equitable and sensitive to the specificities of rural areas in Brazil.</p>","PeriodicalId":9398,"journal":{"name":"Cadernos de saude publica","volume":"42 ","pages":"e00128025"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834095","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}
Cadernos de saude publicaPub Date : 2026-04-10eCollection Date: 2026-01-01DOI: 10.1590/0102-311XPT045025
Priscila Jeronimo da Silva Rodrigues Vidal, Liliane Reis Teixeira, Luciana Gomes, Ana Paula das Neves Silva, Marcus Vinicius Corrêa Dos Santos, Leandro Vargas Barreto de Carvalho, Ana Cristina Simões Rosa, Ariane Leites Larentis
{"title":"[Health workers exposed to pesticides: a cross-sectional study involving agents for the control of endemic diseases in the State of Rio de Janeiro, Brazil].","authors":"Priscila Jeronimo da Silva Rodrigues Vidal, Liliane Reis Teixeira, Luciana Gomes, Ana Paula das Neves Silva, Marcus Vinicius Corrêa Dos Santos, Leandro Vargas Barreto de Carvalho, Ana Cristina Simões Rosa, Ariane Leites Larentis","doi":"10.1590/0102-311XPT045025","DOIUrl":"10.1590/0102-311XPT045025","url":null,"abstract":"<p><p>In recent decades, Brazil has become one of the largest consumers of pesticides in the world. In addition to use in agriculture, these compounds are often employed in public health actions to combat vectors of endemic diseases by workers denominated vector control workers (VCW), making their work process harmful to health. The aim of the present study was to characterize exposure to pesticides as well as identify self-reported symptoms of poisoning and the relationship with the working and health conditions of VCW. A cross-sectional study was conducted with 606 VCW in the State of Rio de Janeiro, Brazil. A self-administered multidimensional questionnaire was used from August 2020 to August 2022. The results were analyzed using the chi-square test and Fisher's exact test. Acute and chronic exposure to multiple pesticides was demonstrated, including carcinogenic, neurotoxic, and endocrine-dysregulating substances. Around 51% of the respondents indicated two or more typical symptoms of poisoning after contact and/or handling. The main complaints were headache (45.5%), skin irritation/allergy (38.1%), burning sensation in the nose and mouth, cough, difficulty breathing (33.5%), malaise (35.5%), nausea, vomiting, or diarrhea (20%), and weakness, dizziness, or fainting (15%). Different health problems were also found among the workers. The results demonstrate the harmfulness of the work process of VCW, with health problems for workers and the occurrence of chronic effects. It is essential to monitor the health of these workers and prioritize vector control practices that are not dependent on the use of pesticides.</p>","PeriodicalId":9398,"journal":{"name":"Cadernos de saude publica","volume":"42 ","pages":"e00045025"},"PeriodicalIF":1.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688373","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}
Cadernos de saude publicaPub Date : 2026-04-10eCollection Date: 2026-01-01DOI: 10.1590/0102-311XEN273825
Luciana Dias de Lima, Claudia Garcia Serpa Osorio-de-Castro, Luciana Correia Alves, Marilia Sá Carvalho
{"title":"Opening the review: perceptions and challenges of Open Science at CSP.","authors":"Luciana Dias de Lima, Claudia Garcia Serpa Osorio-de-Castro, Luciana Correia Alves, Marilia Sá Carvalho","doi":"10.1590/0102-311XEN273825","DOIUrl":"10.1590/0102-311XEN273825","url":null,"abstract":"<p><p>We analyze the perceptions and challenges related to open peer review (OPR) among contributors to Cadernos de Saúde Pública (CSP), in the context of Open Science practices. Seeking to understand how authors and reviewers perceive the adoption of this model, a cross-sectional survey was conducted between January and April 2025, with 1,280 respondents among nearly 3,000 Brazilian reviewers from the past three years. The questionnaire, developed on REDCap, consisted of 20 open- and closed-ended questions. Most respondents were female (59.4%), had a PhD degree (70.6%), and ties to public institutions (55.9%) by working in Collective Health research and teaching. As for OPR, while 23.1% were in favor of disclosing the names of authors and reviewers, 24.2% were opposed and 32.7% preferred intermediate answers, revealing caution. Respondents pointed out prior knowledge between authors and reviewers (52.7%) as the main source of discomfort, followed by fears about conflicts of interest and professional constraints. Results indicate that the CSP scientific community recognizes the benefits of OPR for transparency, but also underscore the need for clear guidelines, active editorial mediation, and participant protection. Model acceptance depends on its gradual and contextualized implementation, based on dialogue, training and recognition of review work. In conclusion, OPR can strengthen integrity and trust in science if accompanied by institutional responsibility and sensitivity to the specificities of Collective Health.</p>","PeriodicalId":9398,"journal":{"name":"Cadernos de saude publica","volume":"42 ","pages":"e00273825"},"PeriodicalIF":1.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688375","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}
Cadernos de saude publicaPub Date : 2026-04-10eCollection Date: 2026-01-01DOI: 10.1590/0102-311XEN164625
Aylene Bousquat, Ligia Giovanella, Rosana Aquino, Ana Luiza Queiroz Vilasbôas, Elaine Thumé, Elaine Tomasi, Maria Helena Magalhães de Mendonça, Alaneir de Fátima da Silva, Patty Fidelis de Almeida, Paulo Henrique Dos Santos Mota, Carlos Pilz, Elisandréa Sguario Kemper, Dirceu Klitzke, Gabriela da Silva Formoso, Bruna Venturin, Luiz Augusto Facchini
{"title":"Primary health care assessment in Brazil: conception and methodology of the 2024 National Basic Health Unit Census.","authors":"Aylene Bousquat, Ligia Giovanella, Rosana Aquino, Ana Luiza Queiroz Vilasbôas, Elaine Thumé, Elaine Tomasi, Maria Helena Magalhães de Mendonça, Alaneir de Fátima da Silva, Patty Fidelis de Almeida, Paulo Henrique Dos Santos Mota, Carlos Pilz, Elisandréa Sguario Kemper, Dirceu Klitzke, Gabriela da Silva Formoso, Bruna Venturin, Luiz Augusto Facchini","doi":"10.1590/0102-311XEN164625","DOIUrl":"10.1590/0102-311XEN164625","url":null,"abstract":"<p><p>Primary health care (PHC) is the basis of the Brazilian Unified National Health System (SUS). After a discontinuity in PHC evaluation policies, the Ministry of Health, with the support of the PHC Research Network of the Brazilian Association of Public Health (Abrasco), carried out the Brazilian National Basic Health Unit Census in 2024. The objective of this article is to present its creation and operationalization. The census methodology was based on a participatory approach, involving several actors, including departments of the Brazilian Ministry of Health, the Brazilian National Council of Health, the Brazilian National Council of Municipal Health Departments, academic institutions, and the Brazilian National Health Council. The data collection instrument was built collaboratively and applied online, using the e-Gestor PHC platform to ensure the institutionalization and security of the data. Nationwide, the operationalization received support in all states, mobilizing managers and professionals. All municipalities adhered to the census, with responses from all 44,938 basic health units (BHU) in Brazil. This success, despite the methodological challenges inherent to online surveys, demonstrates the engagement of the actors involved in strengthening the SUS. The process of preparing the 2024 BHU Census encompasses elements that make it an essential tool to the formulation of more effective, equitable public policies aligned with the principles of PHC and SUS, contributing significantly to the institutionalization of PHC evaluation in Brazil.</p>","PeriodicalId":9398,"journal":{"name":"Cadernos de saude publica","volume":"42 ","pages":"e00164625"},"PeriodicalIF":1.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688403","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}
Cadernos de saude publicaPub Date : 2026-04-10eCollection Date: 2026-01-01DOI: 10.1590/0102-311XPT120325
Graça Rocha Pessoa, Lucilane Maria Sales da Silva, Jaira Gonçalves Trigueiro, Talina Carla da Silva
{"title":"[Drug safety: advances and challenges on the path to excellence at Brazilian hospitals].","authors":"Graça Rocha Pessoa, Lucilane Maria Sales da Silva, Jaira Gonçalves Trigueiro, Talina Carla da Silva","doi":"10.1590/0102-311XPT120325","DOIUrl":"10.1590/0102-311XPT120325","url":null,"abstract":"<p><p>The aim was to analyze changes in drug safety practices in Brazil from 2016 to 2023. A retrospective documental study was conducted based on reports from the Brazilian National Assessment of Patient Safety Practices. Data were collected from national Pareto graphs and analyzed in light of Pareto Theory, which states the most vital elements are responsible for 80% of problems. A total of 68% of Brazilian hospitals with ICU beds adhered to the evaluation of patient safety practices by 2023. Among 21 indicators, an average of 12 vital practices were identified as sources of noncompliance. The degree of compliance was greater in the structure domain compared to the process domain. Drug safety was among the most critical sources of noncompliance. A progressive improvement occurred between 2016 and 2019, with a reduction in noncompliance from 9% to 5.82%. Beginning in 2020, however, a tendency toward stagnation was found, with the percentage of noncompliance maintained at around 6% until 2023. The interruption in progress may be attributed to the COVID-19 pandemic, during which efforts and resources were diverted to help deal with the health crisis. The results enable an empirical understanding of advances and limitations with regards to adherence to drug safety practices at Brazilian hospitals, which contributes to strengthening knowledge on the current maturity of the safety culture in Brazil and the development of effective management strategies for the Brazilian Unified National Health System and drug safety.</p>","PeriodicalId":9398,"journal":{"name":"Cadernos de saude publica","volume":"42 ","pages":"e00120325"},"PeriodicalIF":1.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688398","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}
Cadernos de saude publicaPub Date : 2026-04-10eCollection Date: 2026-01-01DOI: 10.1590/0102-311XEN014626
Rômulo Paes-Sousa, Fabiana Damásio
{"title":"Representativeness, diversity, relevance, and participation: a review of the largest Abrasco Congress in history.","authors":"Rômulo Paes-Sousa, Fabiana Damásio","doi":"10.1590/0102-311XEN014626","DOIUrl":"10.1590/0102-311XEN014626","url":null,"abstract":"","PeriodicalId":9398,"journal":{"name":"Cadernos de saude publica","volume":"42 ","pages":"e00014626"},"PeriodicalIF":1.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688391","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}
Cadernos de saude publicaPub Date : 2026-03-23eCollection Date: 2026-01-01DOI: 10.1590/0102-311XPT056125
Bruno Herrera Sgura, Maria Sylvia Macchione Saes, Camila Veneo Campos Fonseca, Yasmin Proença Bueno Adorno
{"title":"[Regional variance in compliance with guidelines of the Brazilian National School Feeding Program: a comparative analysis between the Northeast and South regions of Brazil with machine learning].","authors":"Bruno Herrera Sgura, Maria Sylvia Macchione Saes, Camila Veneo Campos Fonseca, Yasmin Proença Bueno Adorno","doi":"10.1590/0102-311XPT056125","DOIUrl":"10.1590/0102-311XPT056125","url":null,"abstract":"<p><p>The Brazilian National School Feeding Program (PNAE, acronym in Portuguese) establishes the obligation that at least 30% of federal resources transferred to the executing boards be allocated to the acquisition of food from family farms. However, the results achieved with the program reveal high regional heterogeneity. This study used the machine learning approach (particularly classification trees) to identify factors that most influence compliance with PNAE legislation in the Northeast and South regions of Brazil based on data from 2,650 municipalities referring to the year 2017. The analysis of these two regions is justified by the high presence of family farming, although with significant differences in the fulfillment of the 30% target: 77% of municipalities in the South meet this target, compared to 38% in the Northeast region. The results of the survey indicate that differences between the two regions are associated with factors such as financial limitations of the municipalities and less formalization of agricultural establishments. Moreover, aspects such as the size of the municipality, degree of centralization in the acquisition of food, and profile of local agricultural production also influence compliance with legislation. Therefore, public policies should consider regional specificities to improve adherence and the effectiveness of implementation on the regional level.</p>","PeriodicalId":9398,"journal":{"name":"Cadernos de saude publica","volume":"42 ","pages":"e00056125"},"PeriodicalIF":1.8,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13008357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147509341","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}