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This study aims to evaluate the impact of the search for internet health information by patients on the doctor-patient relationship and satisfaction of both physicians and patients. In total, 200 patients of a tertiary hospital in Brazil and a convenience sample of 92 physicians were included. The questionnaires applied consisted of statements concerning the study's objective; answers were given on a 5-point Likert scale. We conducted a descriptive analysis and used nonparametric tests to verify statistical differences in perception between subgroups of interest. In this study, 85.6% of internet users searched for internet health information but were skeptical about the information they found. They were mostly positive about the doctor-patient relationship; however, they desired greater engagement in health decisions. Overall, physicians tended to have a slightly positive view about internet health information impact on patients' health despite some possible harmful effects. However, they believe that search for internet health information causes unnecessary fear and concern in patients, reduces doctor's work efficiency, and that internet health information is not accurate or reliable. The massive search for internet health information has led to significant changes in the doctor-patient communication model. Both parties have demands to be addressed: patients need more reliable information; and physicians must adapt to these changes in a way that neither diminishes their autonomy as healthcare providers nor worsens the doctor-patient relationship. Hopefully, physicians could play a central role in educating patients and indicating adequate sources of information.

Loneliness has emerged as a significant Public Health issue, yet its impact in developing countries remains understudied. This study examines the growing concern regarding loneliness in Brazil and how aging, urbanization, and changes in family structure may erode traditional social supports and deepen loneliness across various groups. The study also assesses the challenges of measuring loneliness, given its subjective nature, and critically evaluates how well the Brazilian Unified National Health System (SUS) is equipped to address loneliness via community-based interventions and integrated healthcare strategies. The study suggests that loneliness is intensifying due to demographic changes as the population ages, becomes more urbanized, and experiences shifts in family structure. Although SUS employs community-focused health strategies and extensive care models to combat loneliness, it struggles with challenges like insufficient funding, high patient-to-professional ratios, and a fragmented healthcare system. This study emphasizes that loneliness cannot be resolved medically, such as with vaccine, but with strengthened social connections and community support. We advocate for a comprehensive approach that includes healthcare and cross-sector collaboration with the education, housing, and social services branches to tackle both the symptoms and root causes of loneliness, positioning it as a pressing Public Health priority.

This paper presents a systematic review and meta-synthesis to synthesize and reinterpret findings of primary qualitative studies on older cisgender gay men's experience of sexuality and seeking healthcare services. Following the SPIDER search strategy and PRISMA guidelines, bibliographic search was conducted on the CINAHL, LILACS, Oasisbr, APA PsycInfo, PubMed/MEDLINE, Scopus and Web of Science databases. Two independent researchers screened and selected the articles, collected data and elaborated a thematic synthesis. Of the 2,382 studies identified in the databases, 30 articles met the inclusion and exclusion criteria and were selected, totaling 849 gay men between 50 and 95 years old. Analysis produced four descriptive themes: (1) Living history: perceptions on the impact of historical and cultural development on experiencing sexuality; (2) Aging as a gay man: understandings on becoming and being a new body and self; (3) Caring for a social network: severing, building and maintaining bonds; (4) Handling health and professional care. From it were developed three analytical themes: (1) (Un)doing gay men through a dehumanizing gaze; (2) Oldness as performance; (3) To care is to care about. The discriminatory manner society perceives older gay men produces specific isolation from public life, gay communities, and health care services. Punitive laws against their sexuality, negative media representation, lack of proper care and family, community, and spiritual support interfered with their self-care and care seeking habits. Culturally sensitive future measures in policymaking and healthcare services are needed to properly care for this population.

This study investigated the prevalence and factors associated with problematic smartphone use (PSU) in southern Brazil. A total of 411 high school students at a federal institute participated in this research. Smartphone addiction was highlighted as the dependent variable and was assessed using the Smartphone Addiction Scale-Short Version, classifying students of both sexes who scored ≥ 33 on this scale as having PSU. Information on gender, skin color, socioeconomic status, level of physical activity, participation in physical education classes, screen time, and history of binge drinking were organized as independent variables. Poisson regression was used to verify the factors associated with PSU, showing prevalence ratios (PR) with a 95% confidence interval (95%CI). The prevalence of PSU was 34.3% (40.7% female). Adjusted analysis showed significant associations with risk factors (female sex PR = 1.40; 95%CI: 1.06-1.85; screen time PR = 1.48; 95%CI: 1.20-1.82; and history of binge drinking PR = 1.35; 95%CI: 1.02-1.79) and protective factors (higher socioeconomic status PR = 0.88; 95%CI: 0.77-0.99; longer participation in physical education classes PR = 0.73; 95%CI: 0.54-0.99) for PSU. Moreover, students with PSU had worse sleep quality (PR = 1.17; 95%CI: 1.02-1.34), and this effect was more significant in the physically inactive ones (PR = 1.50; 95%CI: 1.13-1.98). Identifying the factors associated with PSU can help raise awareness of the repercussions of this behavior.

This study aimed to analyze the monitoring and evaluation indicators of Freestanding Birth Centers (FBC) in Brazil. This cross-sectional study was aligned with the survey Birth in Brazil II. All eight FBC that attended more than 100 births in 2019 were included in this study. Data referred to 2020 or 2021 and were collected from interviews with service managers and a structured instrument made available online. Variables correspond to all 12 monitoring and evaluation indicators provided for in the ordinance by the Brazilian Ministry of Health for the accreditation of FBC. Results showed that the service attended 3,097 births in a year. Nurses/midwives attended 96.9% of these births and 98.7% of them included a companion of the woman's choice. Amniotomy was performed in 15.7% of labors; oxytocin and episiotomy were used in 7% and performed in 0.4% of them, respectively; 60.2% of births occurred in the vertical position; and the perineum remained intact in 32.2% of them. As for the newborns, 0.6% had five-minute Apgar scores < 7 and 97.6% had skin-to-skin contact with their mothers. The intrapartum, postnatal, and neonatal transfers rates totaled 17.3%, 2.6%, and 4.3%, respectively. The indicators of the FBC show that this model of care offers mothers and babies safe, respectful, human-centered care that is based on the best scientific evidence.

The association between waist circumference (WC) and hypertension, and if this association varies by sex or by body mass index (BMI) categories have not deeply been assessed in the American continent. We aimed to evaluate whether an association between abdominal obesity and hypertension exists and if sex and BMI configure effect modifiers of such association. A secondary analysis of the Peruvian Demographic Family Health Survey data was conducted. Subjects aged from 20 to 69 years were included. Hypertension, defined by the Eighth Joint National Committee, was chosen as the outcome, whereas abdominal obesity (using WC cutoffs based on the 2001 National Cholesterol Education Program Adult Treatment Panel III) was selected as exposure. Poisson regression was used to report prevalence ratios (PR) and 95% confidence intervals (95%CI). Data from 144,156 subjects [mean age 41.4 (SD = 13.4), 54.8% of whom were women] were analyzed. Prevalence of abdominal obesity and hypertension totaled 45.4 and 19.5%, respectively. The adjusted model associated abdominal obesity with greater hypertension prevalence (PR = 1.31; 95%CI: 1.24-1.39). BMI, but nor sex, was an effect modifier of the association. Thus, those obese by BMI and abdominally obese had the strongest association with hypertension (PR = 2.76; 95%CI: 2.58-2.94) than those with normal BMI and no abdominal obesity. Our results evince a positive association between abdominal obesity and hypertension depending on BMI category. Those obese by both BMI and WC had the strongest association with hypertension. Our results suggest that BMI and WC offer useful markers for hypertension.

Dental services, which are essential for the oral health of pregnant women, suffer the influence of factors that either act as barriers or facilitators and impact mothers and babies. This cross-sectional study investigated the use of dental services and its determinants. Pregnant women who used public health services in Santa Maria, Rio Grande do Sul State, Brazil, from April to October 2022 were evaluated. Questionnaires recorded sociodemographic, psychosocial, and behavioral data. Untreated caries and gingivitis were clinically evaluated. The outcome considered the use of dental services in the last 12 months and the reason for use in the last visit. Multinomial logistic regression analyses based on the Andersen & Newman model evaluated the determinants of the use of dental services. Results are shown as odds ratios (OR) and their respective 95% confidence intervals (95%CI). Of the 520 evaluated pregnant women, 72.3% used the services. Being in the second and third trimesters of their gestation was associated with the use of dental services for treatment in their latest visit (OR = 2.12; 95%CI: 1.12-3.74 and OR = 3.92; 95%CI: 2.02-6.86, respectively). Single/separated pregnant women, those with less schooling and low sense of coherence, and those who perceived barriers to use had 1.63 (95%CI: 1.03-2.56), 2.54 (95%CI: 1.24-5.20), 2.90 (95%CI: 1.25-6.69), and 2.14 times (95%CI: 1.10-4.13) higher odds of using no service, respectively. Thus, this study shows the relation between health determinants and the use of dental services in the pre-gestational and gestational periods. Finding these aspects can contribute to the reorganization of policies toward this group.

Vaccine-hesitant parents delay or refuse their children's immunization and constitute a significant public health concern. Our study aims to measure parental vaccination hesitancy and its associated factors in parents residing in Campo Grande, Mato Grosso do Sul State, Brazil. From September 2022 to October 2023, a cross-sectional study aligned to a household survey was carried out to measure vaccination coverage in Campo Grande. The two-stage cluster sampling proposed by the World Health Organization to estimate vaccination coverage was adopted in this study. All residing parents of children aged under 12 years were included. Data were collected by face-to-face interviews using the SAGE Working Group questionnaire to assess parental vaccine hesitancy. We classified the reasons for hesitancy under the 3C conceptual model of vaccine hesitancy determinants. Descriptive statistics characterized the study population and a univariate and multivariate logistic regression assessed the association between hesitancy and other study variables. This study included 158 parents, 39.2% of whom hesitated to get their children immunized. COVID-19 vaccines produced the greatest hesitancy (77.4%). Participants mentioned lack of confidence as the most common motive for their hesitancy (85.5%). Hesitant parents resided in bigger households (aOR = 1.31; 95%CI: 1.02; 1.72), believed there were reasons for not immunizing children (aOR = 4.02; 95%CI: 1.41; 12.77), and hesitated to get their own vaccines (aOR = 3.74; 95%CI: 1.80; 8.16). Results suggest an association of parental hesitancy with socioeconomical and behavioral factors.