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Despite significant advancements in antiretroviral therapy (ART) for HIV, adherence remains a challenge. While Brazil has validated scales for treatment adherence, few assess treatment adherence barriers. This underscores the necessity for validated questionnaires on adherence barriers to identify patient-specific challenges and enhance strategies for ART adherence. This study aimed to adapt and validate the Adherence Barriers Questionnaire for HIV Patients on Antiretroviral Therapy (ABQ-HIV), a 17-item questionnaire assessing the adherence barriers to ART, for the Brazilian context and to evaluate its psychometric properties in HIV patients. A methodological study on the psychometric properties and factorial structure of ABQ-HIV was conducted. The study followed seven steps: consent of the original authors, two translations, synthesis of the translations, expert committee, back-translation, pre-test, and reliability test. A high content validity index (0.93) was achieved with the expert committee. The study sample consisted of 230 adults with HIV, with 37.0 (29.3-45.0) years as the median age (IQR), and 52.2% were male. The exploratory factor analysis with a three subscales structure of 17 items showed good interpretability (Bartlett's sphericity (1167.2 [136]; p < 0.001) and Kaiser-Meyer-Olkin = 0.602) and internal consistency (α = 0.76; Ω = 0.76). The fit indicators were satisfactory (χ2 = 89.931; df = 88; p > 0.005; RMSEA = 0.010; RMSR = 0.07; CFI = 0.996; GFI = 0.940; AGFI = 0.907; NNFI = 0.995). The Brazilian version of ABQ-HIV is a potential instrument for identifying specific barriers to adherence to ART in adults living with HIV in Brazil.

This study aimed to analyze the association between sociodemographic factors, maternal and neonatal characteristics and the time taken to introduce complementary feeding in low birthweight and preterm newborns. This is a prospective cohort study of 79 preterm newborns weighing less than or equal to 1,800g. Data were collected at the time of hospital discharge and at the 6th, 9th ,and 12th months of corrected gestational age (CGA), using a structured questionnaire to analyze the time taken to introduce complementary feeding and the texture of the foods introduced. Furthermore, the Survey of Well-being of Young Children (SWYC-BR) was used to assess the risk of developmental delay. Cox proportional hazards regression was used to analyze the variables. The introduction of complementary feeding was assessed in preterm newborns based on the median age of introduction of liquid foods (3.50; IQR: 2.50-5.00), followed by solid (4.70; IQR: 3.20-5.20) and soft foods (5.00; IQR: 4.50-5.50). There was also an association with gestational age (RR = 1.25; 95%CI: 1.02-1.52) throughout the process of food introduction. For solid and soft foods, those with the longest length of stay (RR = 1.03; 95%CI: 1.10-1.05) and on mixed breastfeeding (RR = 2.97; 95%CI: 1.24-7.09) delayed the introduction of complementary feeding the longest. For liquid foods, less severe preterm newborns (Score for Neonatal Acute Physiology and Perinatal Extension - SNAPPE II [RR = 0.96; 95%CI: 0.94-0.98]) and mothers who were breastfeeding at hospital discharge (RR = 11.49; 95%CI: 1.57-84.10) delayed the introduction of complementary feeding. Guidelines are needed to better advise professionals and parents and/or guardians on the ideal time to introduce feeding.

In the municipality of Rio de Janeiro, Brazil, the incorporation of the concept of epidemic intelligence and technological resources has supported new perspectives for the use of data by health surveillance, since the COVID-19 pandemic. This article presents the Epidemiological Intelligence Center (CIE) and the tools and products developed in its coordination. The CIE was inaugurated in March 2022, with a multiprofessional team, supported by the premises of transparency and integration of various data sources for early detection of changes in the trends of events of importance in Public Health. The initial acquisition of a data lake favored changes in the consumption, management and security processes for the data processed. This data lake currently stores the Carioca Base - a retrospective cohort of individuals with a history of COVID-19 vaccination and/or events related to the disease. Descriptive and analytical dashboards have been developed and made available, respectively for public use and for health surveillance administrators. An alert panel, aimed at monitoring trends in care in the urgency and emergency network, was implemented and subsidizes rapid response actions in the city's territories. The CIE developed the concept of epidemiological intelligence in the Brazilian Unified National Health System and this paradigm shift was made possible by investments in physical/human resources, the integration of epidemiological, statistical and data science methods, as well as the incorporation of different data sources in data analysis.

This study analyzes the self-perception of body image reported by adolescents from 2009 to 2019 according to sex and region, based on the Brazilian National Survey of School Health (PeNSE). An epidemiological, descriptive time-series analysis was carried out with prevalence and trend measures of how adolescents perceive themselves in relation to their bodies according to the data provided by the PeNSE surveys from 2009 to 2019. The prevalence of adolescents who considered themselves normal reached 47.6% (95%CI: 46.1-49.1) in 2019, representing a negative difference of 12.5 percentage points (p.p.) and a variation of 20.7% compared to 2009. In 2019, 31.4% (95%CI: 30.0-32.9) of boys reported feeling thin or very thin, a difference of 8.4p.p. compared to 2009. On the other hand, 28.6% (95%CI: 26.1-31.1) of girls perceived themselves as fat or very fat in 2019, representing a variation of 7.3p.p. compared to 2009. In recent years, there has been a change in the body self-perception of adolescents, with a reduction in the prevalence of those who consider themselves normal and an increase among those who consider themselves thin or very thin for males and fat or very fat for females. These results indicates the importance of investigating the consequences of perceiving oneself as thin or very thin and fat or very fat in the lives of adolescents.

[This corrects the article doi: 10.1590/0102-311XPT094622].

This study estimates gestational diabetes mellitus prevalence in Brazil. A systematic review was conducted with articles published between 2010 and 2021 on the PubMed, Scopus, Google Scholar, SciELO, LILACS and Virtual Health Library databases, as well as gray literature. Data were extracted using a standardized instrument together with the risk of bias assessment tool proposed by Hoy et al. A meta-analysis with robust variance and random effects was developed. Heterogeneity was verified using I2 and publication bias was assessed using funnel plot and Egger's test. Prevalence according to risk of bias, diagnostic criteria and country's regions was determined by subgroup analyses. A total of 32 studies were included, representing 21,942 women. gestational diabetes mellitus pooled prevalence was 14% (95%CI: 11.0; 16.0), considerably higher than estimates from previous studies. Regarding risk of bias, studies with low, medium, and high risk showed a pooled prevalence of 12%, 14% and 14%, respectively. Overall GRADE certainty of evidence rating was low. Most studies used the International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria or the adapted IADPSG, showing a pooled prevalence of 15% and 14%, respectively. As for region, the pooled prevalence was higher in the Southeast (14%) and lower in the Central-West (9%). This is the first systematic review to provide evidence on gestational diabetes mellitus prevalence at a national level and to demonstrate considerable heterogeneity among articles and the influence of region, diagnostic criteria and study quality on the referred indicator.

This article analyzed the dynamics of regionalization in municipalities within hinterlands and the possible implications of gaps in care for the marketing of health. This is a multiple case study with a qualitative approach, involving 76 semi-structured interviews with municipal, regional, and state managers. The results show that, particularly in the Northern states, the regional scheme did not reflect the social dynamics of the populations and created inadequate flows and unwanted routes. The municipal political agenda often prioritized interests other than that of regionalization, and rural problems did not mobilize managers to build specific regional planning. Parliamentary amendments were essential for investment in healthcare and the managers pointed to clientelistic relationships to obtain such resources, often conditioned by political-ideological alignment. The scarcity of public services favored dependence on the private sector and the commercialization of health in different situations. The great distances and the lack of public services in municipalities in the hinterland made the local public health system offer eminently dependent on contracts with private providers who negotiated on a retail basis or via service packages. Lastly, in the wake of unmet needs and gaps in care in remote rural municipalities, players in the healthcare market ₋ companies supplying inputs, consultants, healthcare professionals, and transportation services ₋ filled the gaps in public provision, sometimes controlling prices, supply and availability of services.