Ciencia & saude coletiva最新文献

This article presents the methodological path for developing a structured survey to collect primary data on the vulnerable population, in this case, focused on measuring the people experiencing homelessness (PEH) access to the Psychosocial Care Network (RAPS). The validation process was conducted in Belo Horizonte, Minas Gerais, Brazil, in 2024, and the methodology followed three stages: 1) questions development and definition of the scales used; 2) theoretical and empirical validity tests; 3) quality and reliability tests: completeness and consistency. An questionnaire was assembled with 40 questions divided into three sections: i) sociodemographic characteristics, ii) health issues and patterns of alcohol/other drug use, and iii) experiences of access to mental health services. The final product was a concise research questionnaire directed at the research objectives, language accessible, and culturally adapted to the target population. The questionnaire can be relevant to the data quality and collection of vulnerable populations, considering it can be used for other similar assessments, it could be adapted to specific goals, and the same validation process can be followed to improve data quality standards. The process can qualify discussions on the reality of PEH with the development of focused public policies.

This study examined Brazilian and international scientific production on political gender violence, the debate over which has gained notoriety with the publication of international regulations on this phenomenon. In Brazil, in 2021, Law No. 14,192 criminalized political violence against women. The findings presented here result from applying the scoping review technique, which generated a sample of 30, predominantly Latin American, articles published between 2010 and 2022, and showed marked growth in production from 2020 onwards. The main findings were organized into three thematic areas: 1) Characterization of political gender violence; 2) Strategies for countering it; and 3) Social networks and journalistic media as loci of political gender violence. Political gender violence was found in the dynamics of both the formal political system and institutions such as trade unions, pointing to the need for an extended concept. Existing response mechanisms were considered insufficient. It is important that policymaking take an intersectional perspective. Social media were found to be used as vehicles for this violence, indicating the need for regulatory policies at the local and global levels.

Primary Health Care (PHC) is a foundational pillar of Brazil's Unified Health System (SUS) and is crucial for ensuring the constitutional principle of access to universal health. The historical trajectory of federal funding for the implementation of the different allocation models reflects a movement of both convergence and divergence from the original conception of PHC. In 2020, the implementation of the Previne Brasil Program brought this debate to the forefront, as its detrimental effects on the priority model of the National Primary Care Policy, the Family Health Strategy (FHS), became evident. However, starting in 2023, with a new federal government, the parameters for federal co-funding of PHC were reformulated. This momentum of change materialized in 2024 with the publication of a new budgetary allocation arrangement for PHC, through the Ministry of Health Ordinance No. 3,493/2024. Therefore, this article aims to discuss the historical evolution of how the concept of PHC has been implemented within SUS through different allocation models in order to debate the recent impacts of the Previne Brasil Program, and to analyze the proposed changes in the new 2024 model. The ultimate goal is to highlight the current challenges in funding PHC to strengthen the priority model of the National Primary Care Policy, the FHS.

This study aimed to verify the association between sociodemographic and job characteristics, knowledge, physical activity (PA) level, counseling, the city, and each barrier to PA counseling reported by professionals in Primary Health Care (PHC) in Brazil. A cross-sectional study was conducted in two cities in the south of Brazil, with a representative sample of 497 community health workers (CHWs - 44.2%), nurses (29.4%), and physicians (26.4%) who worked in 64 Basic Health Units (BHUs). The most reported barriers were the "lack of time" (54%), "lack of educational material" (47%), and "lack of knowledge or training" (45%). The "lack of time" was higher among professionals 18-39 years old (63% vs 42%, p < 0.001), those with complete university degrees (65% vs 30%, p < 0.001), physicians (71% vs 63% in nurses, and 30% in CHWs, p < 0.001), and those who worked at a BHU ≤ 36 months (68% vs 45%, p < 0.001). The "lack of evidence of the PA benefits" was significantly associated with 73% of predictors explored (p < 0.05). In conclusion, the barriers vary according to health professionals' characteristics.

Human diversity, especially with regard to aspects of gender and sexuality, is still subjugated by social impositions, prejudices and marginalization, causing major damage to the population's biopsychosocial health. The present study aims to analyze the impact of hetero-cis-normativity on individuals' mental health, through a qualitative and integrative review, carried out using the acronym PICo (Population, Interest, Context), in February 2022. Eighteen articles were selected to compose the present study, published from 2012 to 2021, and showed the impact of hetero-cis-normativity on the lives of individuals ranging from the most diverse gender identities and sexual orientations. Despite the few studies focused on the subject, it was possible to conclude that hetero-cis-normativity impacts people who are or are not part of this established pattern, leading to an oppression of great impact on population mental health, especially with the presence of depressive and anxious symptoms. There is a need for further discussions in society on the subject, with the role of education and health professionals being paramount in favor of hetero-cis-normative cultural deconstruction.

Frail older persons are prone to falls, disability, dependency, hospitalization and death. The aim is to determine the most up-to-date prevalence of frailty among older adults (OA) and to characterize risk factors related to frailty. A cross-sectional study recruiting participants from the family health records of CMF No 17, "Antonio Maceo" who were > 60 years and utilizing recorded functional assessment, calculating frailty status using the Cuban criteria of frailty and assessing for associations using chi-Square and multiple binary regression on SPSS version 27. Most of the 128 participants were female (64.1%), aged between 60-69 years (40.6%), had white skin color (84.4%), were university graduates (31.3%), retired (48.4%) and had chronic illness (group III, 77.3%). The prevalence of frailty status was 5.1% and was associated with older age, skin color, education level and "health status" group. We observed a low frailty prevalence rate which may reflect improved elderly care. The findings on frailty risk factors may prove vital in prevention, screening and treatment.

This study aims to analyze notifications of violence against people experiencing homelessness (PEH) and the associations between the characteristics of victims, the nature of the abuse, and the perpetrators. We collected data from the Notifiable Diseases Information System (SINAN) from 2015 to 2022, totaling 42,621 records. An annual upward trend in notifications was observed, with a decrease during the pandemic year of 2020 and a resurgence in 2021. Physical violence was the most common type, and most victims were Black individuals. Correspondence analysis showed an association between violence resulting from legal interventions involving firearms, with police officers as the perpetrators. Among Black male victims, physical violence with blunt objects was associated with unknown perpetrators, and bars or similar venues were common locations of abuse. For white female victims, recurrent psychological/moral violence, involving threats and physical force, was more likely to involve known perpetrators such as intimate partners or family members and occurred within the home. These varied profiles highlight the need for public policies that address the distinct vulnerabilities within this population.

The objective of this study was to assess the international impact of Brazil's Family Health Strategy (FHS) through case studies focusing on four countries that adopted elements of the FHS to improve aspects of their own health systems. Cases were solicited from Angola, Belgium, South Africa and the UK and analyzed through a comparative case study methodology. Results show that each country adopted slightly different aspects of the FHS, with a common element being the role of community health workers (CHW) as a means to extend care to the community and, in the case of Angola and South Africa, to supplement the short supply of health workers. Each country team had familiarity with the FHS through literature, personal contacts, direct experience or observation, and partnerships. While each case is at a different level of maturity, with the Angolan and South African teams at a more advanced stage, all faced a set of common challenges in adapting and implementing elements of the FHS, including the lack of formal job categories for CHWs, a tension between more restricted and more comprehensive roles of the CHW, challenges recruiting and integrating CHWs into healthcare teams, and barriers to scaling initiatives up to achieve results at scale.