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Food insecurity and urban violence are among the main public health problems in Brazil, with approximately half of the population having impaired access to food, in addition to most individuals having already experienced some violent event in their neighborhood. Studies have shown that violence in the neighborhood can be associated with food insecurity, however, in Brazil, this topic is little explored. This study aimed to verify the association between the perception of violence in the neighborhood and the risk of food insecurity. This study has a cross-sectional design, having been carried out with adults and older adults (n = 400) living in a health district of the city of Porto Alegre, Rio Grande do Sul State. A stratified sampling method was adopted. Data was collected by household interviews. The presence of risk of food insecurity and the perception of violence in the community were evaluated using instruments validated for the Brazilian population. Poisson regression with robust variance was used to estimate the crude and adjusted prevalence ratios (PR) and their respective 95% confidence intervals (95%CI). Individuals that perceived their neighborhood as violent were more likely to be at risk of food insecurity (PR = 1.35; 95%CI: 1.04-1.77). Perception of neighborhood violence is associated with risk of food insecurity, independently, after adjusting for potential confounders. Issues related to the social environment, especially in relation to perceived violence, must be considered in the creation of public policies and actions against food insecurity.

Insufficient quality of the underlying cause of death in the Brazilian Mortality Information System (SIM), acronym in Portuguese underlists violence and it is necessary to redistribute garbage causes (GC) into valid causes in public health prevention. This study estimated mortality from external causes using the GC redistribution method (GBD-Brazil) and compared it with SIM and estimated data from the GBD-IHME study from 2010 to 2019 in Brazil and its states. The GBD-Brazil GC redistribution algorithm applies previous steps of the GBD-IHME with modifications, using two criteria: proportion of target causes (valid) or reclassification of investigated causes. The SIM data were not adjusted. Standardized rates by direct method, local regression in the time series, and the ratio of the GBD-Brazil and SIM rates are used as correction factors for traffic injuries, falls, suicides, and homicides. Brazil recorded 1.34 million deaths with valid external causes and 171,700 CG in ten years. The redistribution of GC from GBD-Brazil increased valid causes by 12.2%, and the trend curve of the rates was similar to that found with SIM data, but diverged from each other and from the GBD-IHME in states in the North and Northeast regions. The GBD-Brazil estimates changed the pattern of external causes in the states, applying greater corrections to falls in the states of the North and Northeast and homicides in the other states. The GBD-Brazil method can be used in the analysis of violent deaths because it seeks greater methodological simplicity, which guarantees both replication by public managers and consistency of the estimated data, considering the local composition of the data in the redistribution process.

The objectives of this study were to evaluate the frequency of vaccine hesitancy against seasonal influenza and to analyze the associated factors among teachers in the municipal school system of Teresina, Piauí State, Brazil. An online questionnaire was applied, adapted from the Health Belief Model, and 449 teachers were included. Of the public interviewed, most live in the capital Teresina, (373, 83.26%), are women (360, 80.54%), aged between 23 and 50 years (306, 81.38%), born in the state of Piauí (382, 86.82%), brown (289, 64.65%), married (254, 56.70%) and with a lato sensu graduate degree (327, 72.99%). In total, 33.18% were considered hesitant, and hesitancy was defined as teachers who were not vaccinated against influenza in 2020. The variables associated with hesitancy in this group were: not being vaccinated against influenza in 2019, the flu vaccine is not convenient, there are many risks associated with it, and concern about reactions to the flu vaccine, the new coronavirus pandemic changed the relationship with the act of vaccinating and greater adherence to the vaccine after hearing information about its benefits in the media. However, in the regression analysis, only the variables "not being vaccinated against influenza in 2019" and "the change in behavior after the pandemic" were significant. Vaccines continue to be the main method of prevention and control of a series of diseases related to influenza viruses, requiring greater adherence by teachers, a priority population that is in constant contact with students from different backgrounds, representing an important source of virus dissemination.

Drugs have been consumed since ancient times, and their taboo has generated segregation and hindered the proper confrontation of harmful use. This study investigated the real and symbolic values of drug use for ill-housed people beyond pathologization, seeking to understand factors that hinder giving them up, even with intense losses and suffering. It also aimed to understand its implications for health care. This is a phenomenological qualitative research based on participant observation of ill-housed people care provided by the Street Clinic, interviews with ill-housed people and focus group with professionals from the Health Care Network in Rio de Janeiro city, Brazil, between March 2017 and July 2019. Results showed that "drug use" interacted with the research categories as follows: drugs are the main reason for living and staying on the streets; drugs motivate having financial activity; drugs cause abandonment of health treatment; drugs soothe and cause depression, suffering and hunger; drugs make them seek shelter and religion to "escape" using, but without adequate treatment hope leads to relapse and low self-esteem - which one want to get rid of, but few successes undermine hope. As expected, it is the reason for divergences among professionals regarding the type of care and support for ill-housed people. Given the results, how can we face abusive use that relieves hunger, loneliness, suffering and depression? How to take care of a use that generates hunger, depression, affective, health and self-esteem losses? A cyclical story told by people in situations of extreme vulnerability. Unveiling the symbolic plurality of drug use enables reflections and new ways of caring for ill-housed people.

Hospitalization costs due to cardiovascular diseases are high. In 2019, for Bahia State, Brazil, alone, they exceeded BRL 153 million for the Brazilian Unified National Health System, surpassing the costs of cancer hospitalizations. This fact will show an upward trend with the increase in life expectancy in Brazil (7.3 years more by 2060). Introducing new technologies can mitigate the problem. This study analyzes the impact of telediagnostics in electrocardiogram on hospitalizations for cardiovascular diseases in 326 municipalities in Bahia from 2014 to 2020. Diff-in-diff estimator method was used for analysis of the periods before and after the implementation of telediagnostics in Bahia. Results show that the municipalities which introduced the new technology reduced cardiovascular diseases hospitalizations by 6 for each additional year. In the case of families benefiting from the Brazilian Income Transfer Program, the reduction was 3.26 hospitalizations, and 3.08 among municipalities with the specialized service. Hospitalization increase by 7.66 in the 30 to 59 age group and by 5.34 among men for each additional year. Results show a reduction of 1.15 hospitalizations for rheumatologic heart diseases and 1.39 among diabetic people. In terms of ethnicity/color, underreporting was identified in the conditions studied, resulting in more severe prognoses for blacks. Telediagnostics was effective in reducing this inequality by expanding access and reducing hospitalizations, playing a crucial role in public health and impacting mortality reduction. The theme, therefore, deserves further studies with different samples and sample periods.

This study aimed to analyze the association between the development of intersectoral actions between school/primary health care (PHC) services and the recognition of a usual source of care of PHC among Brazilian adolescents. This is a cross-sectional study, from the Brazilian National Survey of School Health (2015) conducted with a complex sampling of 97,903 adolescents. The association between intersectoral actions between PHC services and schools and the recognition of a usual source of care of PHC were estimated by the prevalence ratio (PR), using the logistic regression model and considering the sample weight factor with Stata 14.0 Of the analyzed adolescents, 72.8% of them studied in schools that developed intersectoral actions with PHC services. Among adolescent students from schools that developed intersectoral actions, an association was observed between the recognition of usual source of care of PHC and intersectoral actions (PR = 1.11; 95%CI: 1.08-1.14). When analyzed for actions of the School Health Program (PR = 1.40; 95%CI: 1.37-1.43), and the development of actions between the school and PHC services (PR = 1.08; 95%CI: 1.05-1.12). The results show that there is a positive association between the recognition of PHC services as a usual source of care and intersectoral actions. However, from the perspective of an intersectoral practice, there are challenges in the articulation between health and education sectors for implementing prevention and promoting adolescent health in school. They involve greater knowledge about the adolescents' perception of the quality of the service offered by health units.

To examine multiple relations between organizational roles, work-family conflict, job satisfaction, mental health, and affective organizational commitment among basic education teachers, a cross-sectional study was conducted with a sample of 438 respondents, to whom the Scale for the Assessment of Psychosocial Stressors in the Workplace (EAEPCL, acronym in Portuguese), the General Job Satisfaction Scale, the General Health Questionnaire (GHQ-12) and the Reduced Affective Organizational Commitment Scale (ECOA, acronym in Portuguese) were applied. Data were analyzed by structural equation modeling and the estimated measurement model indicated convergent and discriminant validity, as well as reliability regarding the latent variables used. Direct effects of conflict and role ambiguity on job satisfaction, common mental disorders (CMD) and affective organizational commitment were observed, as well as indirect effects on the latter two mediated by job satisfaction. As for role overload, its direct effects occurred only in relation to job satisfaction, the latter mediating the effect of the former on CMD and affective commitment, whereas work-family conflict mediated the effect of role overload on CMD. These results highlight the harmful effects of role stressors and job (dis)satisfaction on the mental health of teachers by making them more vulnerable to developing CMD and indicate how these can affect results of interest to the institutions studied, such as affective commitment in school organizations.

Suicidal behavior and non-suicidal self-harm in vulnerable groups and population minorities pose a challenge for suicidology, complicating the universality of suicide. The goal of this paper is to analyze the lives of young women from marginalized communities, considering their experiences with suicidality and their relational and violent horizons. Nine women who took part in the fifth wave of a cohort on mental health and violence (2005-2022) in São Gonçalo, Rio de Janeiro State, Brazil, were interviewed (2022) about the contexts that kept them from committing suicide despite significant emotional distress from childhood through youth. From theme-based content analysis, three categories stood out and may contribute to an intersectional, decolonial and socially relevant approach to preventing self-destructive behavior. In the first, views on self-inflicted violence, better explained by the cores concepts of "sin" and "illness" than by the general violence they experienced. In the second, indirect references to self-harm behavior, where it was recognized that the use of euphemisms reflects not only the taboo but also the silencing of and discrimination against minorities. In the third, layers of protection and turning points, where "spirituality", "occupation" and "motherhood" were interpreted as the main associations between factors of protection and resilience in the trajectories and daily lives of these young women. A closer look that acknowledges the humanity, rights and psychological distress of groups subjected to violence and discrimination not only enhances care and prevention of suicidal behavior but also deepens understanding of this human and universal phenomenon.

This study describes the surveillance and safety actions of the mpox (Jynneos) vaccine in Brazil, from 2022 to 2023. A descriptive study of mpox cases and events supposedly attributable to vaccination and/or immunization for Jynneos vaccine, recorded in the information systems, was conducted. Absolute and relative frequencies and reporting coefficients of events supposedly attributable to vaccination and/or immunization per 1,000 administered doses were calculated. A total of 9,596 cases of mpox were registered and 49,000 doses of vaccine were distributed, of which 14,395 (31%) were administered and 65 events supposedly attributable to vaccination and/or immunization (4.5 per 1,000 administered doses) were notified. All events supposedly attributable to vaccination and/or immunization were non-serious, and 22 (33.8%) cases had product-related reactions. Results are within the expected frequency; however, the number of administered doses may not have been sufficient to detect rare or unusual events. Continued surveillance is necessary to ensure vaccination effectiveness and safety, especially among groups at higher risk for the disease.

Brazil is characterized by an unfinished agenda of health inequalities, which impact health problems in the childhood. This study aimed to evaluate the socioeconomic inequalities of health problems in the early childhood. This is a prospective study, using data from the birth cohort carried out in the city of Pelotas (Rio Grande do Sul State, Brazil) in 2015. The outcomes were health problems presented at 12 and 24 months: cough, breathing difficulty, diarrhea, ear pain, pneumonia, urinary infection, hospitalization, and other health problems. Socioeconomic inequalities were measured applying the slope index of inequality (SII) and the concentration index (CIX), with wealth index and maternal schooling being the socioeconomic variables. The inequalities in the number of health problems were evaluated by Poisson regression. The perinatal sample comprised 4,275 children. At 12 months approximately 74% of the children presented 1 or more health problems, while at 24 months, approximately 44% presented 2 or more health problems. For all period, the mean number of health problems was 2.9 (standard deviation = 2.0). Higher frequencies were observed for children belonging to the poorest income quintile and with lower maternal education, except for 1 or more health problems at 24 months. The greatest absolute and relative inequality was observed for 2 or more health problems at 12 months (SII: -0.23, 95%CI: -0.29; -0.18 and CIX: -0.19, 95%CI: -0.25; -0.14). There is an opposite dose-response relation for the risk of accumulation of health problems according to maternal schooling (1.07, 95%CI: 1.04; 1.09) and wealth categories (1.03, 95%CI: 1.01; 1.04), in the full adjusted models. The study confirms inequalities due to health problems in Brazilian children, especially in the first year of life.