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Vascular accesses for hemodialysis are considered the patient's lifeline and their maintenance is essential for treatment continuity. Following the example of institutions in other countries affected by the Covid-19 pandemic, the Brazilian Society of Nephrology developed these guidelines for healthcare services, elaborating on the importance of carrying out procedures for the preparation and preservation of vascular accesses. Creating definitive accesses for hemodialysis, grafts and arteriovenous fistulas are non-elective procedures, as well as the transition from the use of non-tunneled catheters to tunneled catheters, which cause less morbidity. In the case of patients with suspected or confirmed coronavirus infection, one may postpone the procedures for the quarantine period, to avoid spreading the disease.

This position statement of the Department of Hypertension of the Brazilian Society of Nephrology (SBN) addresses the controversy surrounding the use or suspension/replacement of the renin-angiotensin-aldosterone system blockers (particularly inhibitors of the angiotensin-converting enzyme or angiotensin II AT1 receptor blockers) prophylactically in individuals using these drugs, due to the possibility of allegedly worsening the prognosis of hypertensive patients infected with SARS-CoV-2. The SBN Hypertension Department recommends individualizing treatment and maintaining these medications until better scientific evidence is available.

This documents aims at educating those who treat sinonasal diseases - both general practitioners and specialists - about topical nasal treatments. By means of scientific evidence reviews, the Brazilian Academy of Rhinology provides its practical and updated guidelines on the most utilized topical nasal medication, except for the drugs that have topical antibiotics in their formulas.

Brazil has been presenting in the last years a scientific production well-recognized in the international scenario, in several areas of knowledge, according to the impact of their publications in important events and especially in indexed journals of wide circulation. On the other hand, the country does not seem to be in the same direction regarding to the technological production and wealth creation from the established scientific development, and particularly from the applied research. The present paper covers such issue and discloses the main similarities and differences between a scientific paper and a patent application, in order to contribute to a better understanding of both types of documents and help the researchers to chose and select the results with technological potential, decide what is appropriated for industrial protection, as well as foster new business opportunities for each technology which has been created.

Objective: To assess the proportion of papers presented at the XXI Panamerican Congress of Trauma, VIII Congress of the Brazilian Society of Integrated Assistance to the Traumatized (SBAIT) and X Brazilian Congress of Trauma Leagues (CoLT) that were published in full., Methods: In the events cited, based in Campinas in 2008, 347 papers abstracts of were presented and published. To evaluate the proportion of complete published works a retrospective observational study was conducted, reviewing the biomedical databases PubMed and SciELO, with support from Google, from the title of the abstracts and list of authors., Results: Of 347 papers considered, 25 (7.3%) were from foreign services and 322 (92.7%) national. Ten (2.9%) papers were published, of which six (1.7%) of nursing and four (1.2%) medical. Among these, four thesis publications were identified and only one international work has been published., Conclusion: Despite a large number of papers presented at trauma conferences in Brazil, the publications in this area are rare. The academy and the societies of surgery need to encourage the submission of scientific papers even before the presentation in Congresses in order for them to be evaluated for publication in indexed journals.

The dissemination of the practice of collaborative authorship (coauthorship) in Brazil and in the international scientific community has been accompanied by an increasing occurrence of frauds, manipulations and other deviations in the assignment of responsibility for a scientific paper. This article discusses the criteria for authorship attribution, the reasons for the growing indices of coauthorship and the challenges to determine authorship in electronic journals. Through literature review and case study (bibliographic search in scientific database), it shows ways to avoid that "misbehaviors" related to the authorship attribution affect the credibility of science.

Violence is a serious public health issue and constitutes a historical social phenomenon with diverse causes and consequences, and multiple manifestations. The main victims continue to be populations left vulnerable and marginalised, where dimensions including gender, class, race and social belonging intersect. Although studies to explain the phenomenon of violence do address ethnic and racial issues, they tend not to consider violence as stemming also from institutional racism. This paper examines data from a qualitative and quantitative study drawing on focus groups and semi-structured interviews to evaluate symbolic and structural violence experienced by young black people from 15 to 29 years old residing in peripheral neighbourhoods of two Brazilian state capitals - Recife and Fortaleza. The focus is on their standpoints that situate the intersectionality, especially among race/skin colour, territorial belonging and class, in the very definition of identity. In both capitals, the young black people revealed a common reality: life projects constrained by economic limitations and by the concrete or symbolic demarcation of social spaces to which they are denied access.

The objective of this study was to identify and discuss the tools for the promotion and evaluation of adequate and healthy eating based on the Food Guide for the Brazilian Population. The scoping review was conducted according to the JBI Manual for Evidence Synthesis via the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist and by searching PubMed/MEDLINE, EMBASE, SciELO and LILACS. Sixteen studies on relevant tools, based on the food guide for individuals of all age groups, were thus included: two descriptive studies, two randomized clinical trial protocols, eleven methodological analyses, and one psychometric paper, aimed at either a focal population (n=12) or health professionals (n=4). Six studies addressed tools for promoting adequate and healthy eating, and ten developed tools for evaluating dietary practices or the knowledge and activities of health professionals. This review can therefore assist health professionals in choosing instruments for the implementation and/or dissemination of food guide recommendations, contributing to the promotion of adequate and healthy eating habits.

It will be presented the main academic contributions of Professor Ana Marlúcia Oliveira (AMO) (in memoriam), nutritionist, professor at the School of Nutrition at the Federal University of Bahia, Ph.D. in epidemiology and CNPQ Researcher level A, from 1980 to 2021. Professor Ana accumulated, throughout her academic career, scientific articles published in national and international journals; book and book chapters authored by her; papers presented at scientific events, in addition to guiding scientific projects, dissertations and theses. She has coordinated several research projects in the field of food and nutrition in public health, with a focus on nutritional epidemiology. The scope of the subjects addressed in her scientific production expressed the concern that mobilized her around the production of knowledge to face the complex health and nutrition problems in Brazil. Her way of being in the world, welcoming and caring for people who approached her seeking qualification opportunities, her example, words and teachings influenced, and still influence, the trajectory and training of nutritionists, professors and researchers at ENUFBA and other national and international institutions. She was a Brazilian researcher and intellectual committed to the health of the most vulnerable populations and the fight against malnutrition and hunger in our country. Her wide and fruitful work left us a legacy to be remembered and continued. Some of her friends, colleagues and collaborators pay this tribute to her memory, to her example and to the legacy she left for all of us and future generations.

Background: The long-term effects of mild COVID-19 on physical, cognitive, and mental health are not yet well understood., Objective: The purpose of this paper is to describe the protocol for the ongoing "Post-COVID Brazil" study 2, which aims to evaluate the factors associated with health-related quality of life and long-term cardiovascular and non-cardiovascular outcomes one year after a mild episode of symptomatic COVID-19., Methods: The "Post-COVID Brazil" study 2 is a prospective multicenter study that plans to enroll 1047 patients (NCT05197647). Centralized, structured telephone interviews are conducted at 1, 3, 6, 9, and 12 months after COVID-19 diagnosis. The primary outcome is the health-related quality-of-life utility score, assessed using the EuroQol-5D-3L (EQ-5D-3L) questionnaire at 12 months. Secondary endpoints include the EQ-5D-3L at 3, 6, and 9 months, as well as all-cause mortality, major cardiovascular events, hospitalization, return to work or education, persistent symptoms, new disabilities in instrumental activities of daily living, cognitive impairment, anxiety, depression, and post-traumatic stress symptoms at 3, 6, 9, and 12 months after SARS-CoV-2 infection. A p-value < 0.05 will be considered statistically significant for all analyses., Results: The primary endpoint will be presented as the overall frequency of the EQ-5D-3L domains 12 months after SARS-CoV-2 infection. Main analysis will explore the association of independent variables with the study outcomes., Conclusion: The "Post-COVID Brazil" study 2 aims to clarify the impact of long COVID on the quality of life and cardiovascular and non-cardiovascular outcomes of Brazilian patients who have had mild COVID-19.

Objective: DATASUS is the Brazilian Public Unified Health System (SUS) department responsible for providing health data that are used as a primary source of data in several studies on surgery and surgical specialties although its main limitations have not been previously reviewed. The objective of this work is to synthesize information from studies on surgery that used DATASUS systems as a data source and to identify the main gaps in this platform., Methods: a scoping review was conducted according to the PRISMA-ScR method to identify papers on surgery, and other surgical specialties, that used the DATASUS platform as a primary data source. No restrictions were imposed regarding the type of study or year of publication. Grounded Theory was used to analyze the content of the articles., Results: 248 works were initially analyzed and 47 were included in the final analysis of this study. The original articles included were published between 2009 and 2022 and the majority (12.76%, n=6) were published in the Journal of the Brazilian College of Surgeons. Retrospective studies (40.43%, n=19) were the most common type of study found. Content analysis of the articles identified four predominant domains in the scientific literature about the limitations of using DATASUS in surgical research: lack of data, reliability, precision and data integration., Conclusion: the information systems available in DATASUS are the largest source of information about the SUS, but the scientific literature on the quality of data available in these systems remains scarce and studies aimed at measuring this metric are necessary.

Objective: To systematically identify and map studies involving the Caderneta da Criança (Child Handbook - CH) in Brazil., Methods: A scoping review using the methodology proposed by the Joanna Briggs Institute. The databases PubMed, Biblioteca Virtual em Saúde (BVS), Biblioteca Digital Brasileira de Teses e Dissertações, Periódicos Capes and Google Scholar were consulted. Primary and secondary studies that mentioned the use of CH were included, without restrictions regarding design, year of publication or population, published in Portuguese, English or Spanish and gray literature (theses and dissertations)., Results: A total of 129 studies were included, mostly descriptive, published as scientific papers. The Northeast region, the population of caregivers of children and the Primary Care scenario were observed in most studies; 47% of the studies used the CH as a source of data, the majority on vaccination. Despite the different criteria to define adequacy of completing the CH, the studies identified weaknesses in filling out all of its items, except for immunization. The utilization and/or completion of the CH were linked to various factors, including the availability of the CH, characteristics of the children (such as sex, age, prematurity and well-child appointments), attributes of the family members and caregivers (such as age, education, income, parity, work status, prenatal care, reading, note-taking and bringing CH to appointments) and features of the professionals (such as workplace, medical specialty, communication style, knowledge about the CH, requesting, guiding and note-taking)., Conclusions: The results reinforce the need to better understand which factors affect the distribution of the CH in the population, as well as pointing to the need for understanding its use and completion by the different care points. The need for intervention studies to improve the implementation of this tool and to include training on the use of the CH in the context of continuing health education becomes evident.

This paper reflects on the Family Health Strategy (ESF) workers' understanding of racial relationships and health intersections. We conducted semi-structured interviews with ESF teams' professionals in the State of Pernambuco, Brazil, whose data were analyzed in light of the discussions that focused on the racial theme. The results point to discrepancies between different health models in the daily routine, race/skin color invisibility in training and professional work, and whiteness as a structuring element of race relationships. The study reaffirms the need for Public Health to focus on the intersection between the issue of race/skin color and healthcare relationships and invest in the training of professionals regarding race discussions.

Introduction: this paper aims to evaluate the main direct and indirect costs of the first laparotomies and laparoscopies in bariatric surgeries with a clinical-economical retrospective and cross-sectional analysis from 2017 to 2020 at a hospital with specialties besides the basic ones in southern Brazil., Methods: the study sample included 26 participants. The first 13 laparotomies, and the first 13 laparoscopies performed at the bariatric surgery service of the institution were evaluated. The values evaluated in such comparison analyzed the costs of operation and hospitalization. It is important to highlight that, in addition to the cost benefit, other costs take significance in the health area, such as: cost-utility, cost-effectiveness and cost-minimization, in addition to the cost-opportunity that is reassessed in the observation of the broad context associating all the values raised here. The software used for data analysis was Excel version® 365. The economic analysis was performed evidencing the profile of the patients and the direct and indirect costs involved in each segmentation., Results: the direct and indirect costs of videolaparoscopy amounted to BRL 10,108.10 and laparoscopy to the amount of BRL 12,568.14., Conclusion: it was concluded that laparoscopy presents more savings in the aspects of all health valuations to the detriment of laparotomy. It was concluded that the videolaparoscopy presents more savings in the aspects of all health valuations than the laparotomy.

Objective: Mapping the role of telemedicine in the health access of patients with chronic diseases in continuous care actions (except for covid-19) during the pandemic., Methods: This is a scoping review, with an adapted version of the Prisma-Scr methodology and using the Population (patients with chronic diseases), Concept (telemedicine as a health access tool) and Context (covid-19 pandemic) strategy. We searched through the following databases: PubMed, Scopus, Embase, Web of Science, Lilacs and SciELO, resulting in 18 articles at the end of the review. We used the technological, sociocultural and assistance analysis dimensions., Results: Eighty-eight percent of the analyzed papers posited that telemedicine use to provide care increased during the pandemic. We identified that this use was positively related to the reduction of complications and the absence of physical displacement for care, expanding it to rural areas. Important barriers were presented, most importantly the digital exclusion, language sociocultural barriers, and inaccessibility to technological instruments for disabled people., Conclusions: Innovation in care arrangements calls attention to how living labor is important to produce healthcare, using various technologies, and reveals tensions caused by the forces acting on healthcare micro politics. We conclude that, despite important barriers, telemedicine contributed to the care of chronic patients during the covid-19 pandemic.

Objectives: Identifying and mapping the literature regarding sexual violence against Brazilian boys and men, as well as describing its underreporting, prevalence, and associated factors., Methods: We conducted a scoping review by searching PubMed, Biblioteca Digital Brasileira de Teses e Dissertações, Biblioteca Virtual em Saúde, Scopus, and Web of Science databases. The inclusion criteria were: (a) surveys including data on sexual violence; (b) inclusion of boys or men as victims of sexual violence; (c) presenting statistical data on prevalence, underreporting, and factors associated with sexual violence among Brazilian boys and men., Results: We found a total of 1,481 papers. Ultimately, 53 were included and had their data extracted. Most studies are quantitative in nature (n = 48). The total number of participants across studies was 1,416,480 and the prevalence of sexual violence ranged from 0.1% to 71%. It is important to note that underreporting statistical data was cited in several studies. The group with the highest prevalences was men who have sex with men and those with sexual dysfunctions. Increased tendency to drug use, social isolation, unprotected anal sex, suicidal ideation, sexual dysfunction, and post-traumatic stress disorder were statistically significant predictors for having experienced sexual violence., Conclusions: Despite the prevalence of sexual violence being high against Brazilian boys and men, this area of is surprisingly understudied and there are few studies with this exclusive scope. Social cultural issues, such as sexism, contribute to the underreporting of sexual violence. Additionally, we identified issues related to mental, sexual and reproductive health to be associated with sexual violence. Based on our findings, we recommend the implementation and development of a structural infrastructure aimed at supporting boys and men who are victims of sexual violence, and preventing negative outcomes for this affected group.

The ideal ventral hernia surgical repair is still in discussion1. The defect closure with a mesh-based repair is the base of surgical repair, in open or minimally invasive techniques2. The open methods lead to a higher surgical site infections incidence, meanwhile, the laparoscopic IPOM (intraperitoneal onlay mesh) increases the risk of intestinal lesions, adhesions, and bowel obstruction, in addition to requiring double mesh and fixation products which increase its costs and could worsen the post-operative pain3-5. The eTEP (extended/enhanced view totally intraperitoneal) technique has also arisen as a good option for this hernia repair. To avoid the disadvantages found in classic open and laparoscopic techniques, the MILOS (Endoscopically Assisted Mini or Less Open Sublay Repair) concept, created by W. Reinpold et al. in 2009, 3 years after eTEP conceptualization, allows the usage of bigger meshes through a small skin incision and laparoscopic retro-rectus space dissection, as the 2016 modification, avoiding an intraperitoneal mesh placement6,7. This new technique has been called E-MILOS (Endoscopic Mini or Less Open Sublay Repair)8. The aim of this paper is to report the E-MILOS techniques primary experience Brazil, in Santa Casa de Misericórdia de São Paulo.

This paper aims to assess the magnitude and profile of deaths from post-COVID conditions in Brazil. Descriptive study based on preliminary data from the 2021 Mortality Information System. Records with ICD code B94.8 as the Basic Cause and with code U09 in some lines of part I or II of the declaration were considered for analysis. The distribution of deaths by geographic region, semester of occurrence, sex, age group, ethnicity/skin color, schooling, and place of occurrence was evaluated. We identified 2,948 deaths from conditions subsequent to COVID-19 were recorded, ranging from 0.5 deaths per 1,000 records in the Northeast Region to 3.6/1,000 in the Midwest Region. More than half occurred among males (58.0%), those aged 60 years or older (66.9%), and whites (51.8%). Conclusion: Deaths from post-COVID conditions had distinct sociodemographic characteristics between regions.

This paper presents an experience report on the supervision of deinstitutionalization of the prison system through the articulation of the Psychosocial Care Network (RAPS) conducted from 2014 to 2021 within the Superintendence of Mental Health/Municipal Health Secretariat of Rio de Janeiro. This work of deinstitutionalizing people deprived of liberty with mental health problems consists of actions at the exit and entrance doors of the prison system and actions for the care of unimputable and imputable people with mental disorders. In the light of the Brazilian Psychiatric Reform, formalized by Law No. 10,216/2001, we aim to present an approach to this process counting on the possibilities of building care policies for insane offenders that are not punitive or segregating. The practical results of this work include more significant participation of the network in the construction of care for insane offenders, elaborating policies that avoid the prison career or reduce the asylum time in the penal system, and understanding that security measures must always have an outpatient nature.

This paper aims to describe the implementation process of the Prison Primary Care Teams in Rio Grande do Sul, the frequency of tuberculosis notifications in people deprived of liberty, and their chronological relationship. This documentary research is nested in a descriptive cross-sectional study of historical series. We analyzed the decrees on the qualification of Prison Primary Care Teams, the number, and the year of notification of tuberculosis cases from the National System of Notifiable Diseases from 2014 to 2020. The state of Rio Grande do Sul pioneered prison health municipalization and shared financing, which resulted in the implementation of 45 teams, covering approximately 54.5% of people deprived of liberty a closed regime. The teams notified 5,175 cases of tuberculosis from 2014 to 2020, with a progressive increase in the notification of cases and the implementation of new teams. The strategy of implementing Prison Primary Care Teams driven by the National Comprehensive Health Care Policy for People Deprived of Liberty in the Prison System was crucial for increasing TB diagnosis, notification, and control in Rio Grande do Sul.

This paper aimed to describe the implementation and operation of the e-SUS AB strategy in the Prison Primary Care Teams in Paraíba. A qualitative study was conducted through semi-structured interviews with 21 professionals, doctors, and nurses, from 11 primary care teams in prisons in Paraíba and the health management of the Penitentiary Administration Secretariat. A semi-structured roadmap was adopted for the interviews from the script previously established by the Ministry of Health for the implementation of the e-SUS AB system, which resulted in three thematic categories after being transcribed and analyzed per Bardin's content analysis proposal: the health information system and the prison setting; management actions for the implementation of the e-SUS AB and; skills and competencies of professionals to use the e-SUS AB system. The e-SUS AB was implemented in the prison system with some obstacles concerning the physical and technological structure of the setting, the insufficient professional training, and the lack of skills with information technologies highlighted by the respondents. People feel the need to implement the citizen's electronic medical records to ensure continuity of care for people deprived of liberty.

This paper aims to analyze the process of medicine dispensation in prisons. A qualitative study was conducted in seven penitentiaries in Paraíba with 13 health professionals and 43 people deprived of liberty using essential/strategic medicines from February to August 2016. The results were categorized from the perspective of Bardin's content analysis. Three categories emerged: medicine storage location in the prison system, delivery process in the prison system, and health-related responsibilities with pharmaceutical care. We can conclude that the lack of pharmacies, the legal non-compliance regarding the availability of skilled professionals with technical competencies to perform the dispensation, focusing on the quality/safety standards and relevance of the use and storage guidelines associated with the lack of clarity in the definition of health responsibilities of managers from a government authority, are factors that compromise the policy since they increase the investment, but do not ensure pharmaceutical care in the prison system.

This paper presents the results of the research nested in the international project "Gender and COVID-19", which includes several topics related to the impact of the pandemic on the lives of women and their families, including food insecurity and hunger. Semi-structured interviews were conducted from December 2020 to November 2021 with 49 women living in two urban conglomerates, Cabana do Pai Tomás (Belo Horizonte, MG) and Sapopemba (São Paulo, SP), and two rural quilombola communities, Córrego do Rocha (Chapada do Norte, MG) and Córrego do Narciso (Araçuaí, MG). The analyses were based on the following categories: hunger-related feelings and terms; reduced food amount and quality; lack of food and nutrients; difficulties producing food, receiving emergency aid or food donations; governments evaluation and support networks. The respondents' reports show the challenges they experienced, their coping methods, and criticism of the government's lack of responses. Besides presenting a gender perspective, women, especially the leaders who worked in the construction of solidarity networks, are fundamental voices in planning actions to prevent and mitigate the impacts of emergencies in their communities.

This paper aims to present the dramas experienced by Brazilian artists during the COVID-19 pandemic. This investigation is nested in one of the axes of broader research on the social impacts of the pandemic in Brazil. Initially, we argue that a pandemic is a critical event with multiple scales, which affects populations unevenly, as is the case of art world professionals, an unorthodox field in terms of specialties and remuneration, which was already suffering from the impacts of reduced investments in public policies in the cultural sector since the mid-2010s. Given the measures to face the pandemic, among which are restrictions on gatherings, artistic events were prohibited, and professionals could not act conventionally, generating economic problems and psychological distress. This paper explores the dramatic report of some of these professionals, highlighting the strategies adopted to cope with the crisis due to the impossibility of performing, the scarcity of public policies for the sector, and the national political and economic elite disdain for the arts and culture. In-depth interviews were conducted with scenic artists, musicians, and DJs from August to December 2020.

This paper describes the structure and results of Primary Health Care (PHC) in Brazil between 2008 and 2019. The medians of the following variables were calculated: PHC spending per inhabitant covered, PHC coverage, and rates of mortality and hospitalizations due to primary care sensitive conditions (PCSC), in 5,565 Brazilian municipalities stratified according to population size and quintile of the Brazilian Deprivation Index (IBP), and the median trend in the period was analyzed. There was a 12% increase in median PHC spending. PHC coverage expanded, with 3,168 municipalities presenting 100% coverage in 2019, compared to 2,632 in 2008. The median rates of PCSC mortality and hospitalizations increased 0.2% and decreased 44.9%, respectively. PHC spending was lower in municipalities with greater socioeconomic deprivation. The bigger the population and the better the socioeconomic conditions were in the municipalities, the lower the PHC coverage. The greater the socioeconomic deprivation was in the municipalities, the higher the median PCSC mortality rates. This study showed that the evolution of PHC was heterogeneous and is associated both with the population size and with the socioeconomic conditions of the municipalities.

This paper aims to discuss the issue of diversity from its incorporation into the training of health professionals through the analysis of the National Curriculum Guidelines (DCN) of two Brazilian undergraduate health courses: medicine and psychology. Thus, it debates the concept of diversity from the contribution of the social sciences, considering the multiple concepts in the nature of social and cultural differences, breaking with essentialist concepts of difference. Reflecting on how diversity appears in the curricular guidelines of these courses, it analyzes from recent studies how this has been considered in training and the main challenges. Intersectionality is an essential political theoretical framework to apprehend the articulation of multiple differences and inequalities acting in a dynamic, fluid, and flexible way from particular historical contexts. Thus, it is sensitive to address the issue of diversity in the training of health professionals. We highlight the importance of studying differences, suggesting an analytical framework that articulates discourses, practice, subjectivation, and social relationships.

The article presents a perspective on the Brazilian scientific production on the health of the black population (SPN) published in scientific journals. We performed a rapid scoping review combined with thematic and bibliometric analysis. Our search included four indexed databases. We retrieved 519 studies in line with the thematic axes and strategic underlying themes of the Agenda of Research Priorities of the Ministry of Health and the guidelines of the National Policy for the Comprehensive Health of the Black Population. The data mainly returned quantitative studies published from 1969 to 2022. Sixty-five of the selected studies were explicitly about the black population and 54 about the quilombola population. The analysis of the most recurrent terms in the titles of the selected studies evidenced that epidemiological aspects and health and disease conditions prevailed. We observed limitations in the currently available indexing descriptors, which do not cover the most conceptually appropriate terminology. This paper consolidates knowledge about the SPN-related scientific production. It supports the discussion on a propositional priority research agenda to improve health policies for this population, overcome racism, and denounce rights violations.

This paper presents the research results on the strategies, expectations, and desires of 28 transsexual men in building their masculinities and reconstructing their bodies through cross-hormonization. The qualitative research was carried out in an outpatient clinic of the transsexualization process in a city in the metropolitan region of Rio de Janeiro. We employed semi-structured interviews and participant observation from November 2019 to January 2020 to collect data. Content analysis guided the analysis of the statements from which the discussed categories emerged. The categories were discussed in the light of the concepts of gender, transsexuality, and masculinity, besides references from studies on ethnicity/skin color in their articulations with health. The data revealed desires, contradictions, and ambiguities regarding the construction of masculinity and the (re)construction of bodies more suited to it. They also evidenced the desire for the male bodily standard achieved through hormonization and surgeries, and black skin color emerged as a critical inequality mark. We concluded that, while refuting many male model features, these men want to enter this world and blend in with the crowd as men, thus experiencing fuller masculinity.

This study aimed to systematically review scientific evidence on the barriers and facilitators of physical activity (PA) among the Brazilian population, considering different domains (leisure, travel, work/study, and household). The search was conducted in the MEDLINE/PubMed, ISI Web of Science, SCOPUS, BIREME/LILACS, and APA PsycNET databases and was limited to papers published between 2010 and 2020. A manual search of the Brazilian Journal of Physical Activity & Health was also conducted. The selection process consisted of screening titles and abstracts, followed by the analysis of full texts. Each paper was assessed by two independent reviewers, and when discrepancies arose, a third reviewer was consulted. Leisure, environmental barriers and facilitators were the most investigated domains in the 78 included studies. There was consistency in the positive associations between six different intrapersonal and social facilitators for leisure PA and one environmental factor for travel. There have been a small number of investigations on the work/study and household domains, and future investigations on intrapersonal and social barriers and facilitators in the travel domain are important.

This paper discusses the historical construction of the Expanded Family Health Center (NASF, in Portuguese), based on the analysis of 17 documents edited by the Ministry of Health (MH) between 2005 and 2021. This is a qualitative study of documental review that seeks to understand how the regulations and official instructive manuals have been shaping the way NASF teams operate. It proposes to divide the NASF construction process into five periods: previous movements (2003 to 2007); support guidelines (2008 to 2011); the universalization of nasf (2012 to 2015); expansion of support (2016 to 2018); and the dismantling of NASF? (2019 to 2021). The results show changes in guidelines over the years of the team's existence, especially in relation to the matrix support concept and its two dimensions: technical-pedagogical and clinical care. This study also demonstrates the effects of the Previne Brasil Program on the NASF, which resulted in the reduction of 379 teams in 2020 and 2021. Added to this scenario is the SARS-CoV-2 pandemic, which may be repositioning NASF interventions in the Brazilian Unified Health System (SUS, in Portuguese).

Background: Only two papers have addressed the early outcomes of patients with hypoplastic left heart syndrome (HLHS) undergoing the Norwood operation, in Brazil., Objectives: We evaluated patients with HLHS undergoing the first-stage Norwood operation in order to identify the predictive factors for early (within the first 30 days after surgery) and intermediate (from early survival up to the Glenn procedure) mortality., Methods: Patients with HLHS undergoing the stage I Norwood procedure from January 2016 through April 2019, in our service, were enrolled. Demographic, anatomical, and surgical data were analyzed. Endpoints were early mortality (within the first 30 days after surgery), intermediate mortality (from early survival up to the Glenn procedure) and the need for postoperative ECMO support. Univariate and multivariate analyses were performed, and odds ratios, with 95% confidence intervals, were calculated. A p-value <0.05 was considered statistically significant., Results: A total of 80 patients with HLHS underwent the stage I Norwood procedure. The 30-day survival rate was 91.3% and the intermediate survival rate 81.3%. Fourteen patients (17.5%) required ECMO support. Lower weight (p=0.033), aortic stenosis (vs aortic atresia; p=0.036), and the need for postoperative ECMO support (p=0.009) were independent predictive factors for 30-day mortality. Mitral valve stenosis (vs mitral valve atresia; p=0.041) was an independent predictive factor for intermediate mortality., Conclusion: The present study includes the largest Brazilian cohort of patients with HLHS undergoing the stage I Norwood procedure in the recent era. Our survival rates were comparable to the highest survival rates reported globally. Low body weight, aortic valve stenosis, and the need for postoperative ECMO support were independent predictors for 30-day mortality. Mitral valve stenosis was the only independent predictive factor for intermediate mortality.

This paper analyzes food insecurity (FI) in urban and rural areas of the Northeast region of Brazil associated with certain social determinants and access to governmental benefits/programs. Data about FI from the National Household Budget Survey (2017-2018) were analyzed, including socio-economic variables and access to government benefits/programs of supplemental income (Bolsa Família, Ongoing transfer benefits, Food voucher and Food basket). Multinomial logistic regression models were performed to assess the relationship between FI and access to government programs/benefits. Half of the families in the Northeast were classified as being subject to FI, the prevalence and severity being higher in rural households. The composition of the family, with at least one retired individual, significantly reduced the probability of being FI at all levels of severity. Access to the Food basket (in cash) benefit and Bolsa Família was associated with being a factor of protection against severe FI in rural areas, while in urban areas the food voucher benefit was the main factor of protection. Income transfer programs and access to social benefits contribute to combatting FI, highlighting the importance of maintaining and scaling-up these initiatives for vulnerable populations.

The paper analyses illness experiences of breast cancer in women undergoing treatment at the Hospital of Cancer III of the National Institute of Cancer. It argues that part of the interviewed women's experience was constructed from the interaction between family coexistence and the mobilisation of different cultural meanings of the disease and femininity, negotiating senses for biomedical entities. The study results from a qualitative research of ethnographic inspiration that interviewed women undergoing treatment from breast cancer during 2015. It draws on the accounts to discuss the interaction of society with biomedical entities for the significance of cancer in Brazil between the 1990s and 2010s.

To investigate the clown ideologies that circulate in a hospital scenario, in this paper, we describe the origins of hospital clowns, evaluate their professional training, and discuss their contemporary role. For this descriptive, historical documentary, and qualitative study, we carried out searches in academic databases such as PubMed and LILACS in April 2021. The insufficiency of these results motivated our consultation of book collections and a documentary analysis of other sources related to clowns. Given their function of conveying lightness, humor, and comedy, we observe that hospital clowns, despite lacking a curative function, complement the treatment of patients and therefore require training in the fields of art and biosafety. Based on our bibliographic research, we also conclude that there is a great need for the training and continual education of hospital clowns who perform in a Brazilian context.

Compliance with legal deadlines for the assessment and incorporation of technologies in Brazil's Unified Health System (SUS) is essential to ensure public access to essential medicines. The scope of this paper was to analyze the compliance with legal deadlines for incorporation and availability of medicines in the SUS, comparing Oncology and the Specialized Component of Pharmaceutical Assistance (SCPA). A comparison was made of the drugs incorporated that were submitted to Conitec in the period from January 1, 2017, to April 30, 2020. A total of 85 drugs were recommended for incorporation by Conitec, of which 15 (17.64%) were for Oncology and 70 (82.36%) were for SCPA. The time between analysis and recommendation by Conitec until the publication of the decision by the Ministry of Health was, on average, 86 days longer for oncological drugs and the availability timeframe of technologies incorporated in the oncology area was, on average, 389 days longer than for SCPA. The major progress achieved with the creation of Conitec in Brazil is acknowledged, but the results of this study point to a pressing need to improve the process of making available technologies incorporated into the SUS, especially in oncology.

This paper presents the evolution of fake news disseminated about vaccines and the SARS-CoV-2 virus and its adverse impacts on the current Brazilian health crisis. This quantitative, empirical study is based on the notifications received by the Eu Fiscalizo app, through which the Instagram, Facebook, Twitter, and WhatsApp platforms were identified as the principal means for disseminating and sharing rumors and misinformation about COVID-19. We observed large-scale circulation of fake news about vaccines directly related to the Brazilian political polarization, which became prevalent four months after the first COVID-19 case was recorded in the country. We can conclude that this phenomenon was crucial in discouraging the adherence of segments of the Brazilian population to social distancing and vaccination campaigns.

This paper addresses the experiences of Black women organized in social activism to fight for justice for the deaths of their children, victims of police brutality. These deaths are analyzed as part of the genocide of Black people and result from the action of a State operating in a necropolitical fashion, in which racism is an ideological tool for the production of disposability of Black bodies. In this work, the stories of four women living in territories dominated by gun violence in Rio de Janeiro reveal how they organize themselves politically to fight for justice, memory and reparation; and their illnesses and individual and collaborative care strategies. We observe the refusal of their demands by the health system and the social assistance policies, while the activism stands out as a producer of care and acceptance.

Recognizing the central role of mental health in global health and affirming the complexity of the universalization of care policy, this paper discusses aspects of global mental health in Brazil and Italy - two countries that are a potential reference for exchange between the global North and South. Using ethnographic and action research methodologies, we conducted a study of a virtual community of practice composed of Brazilians and Italians interested in community mental health care. The results are presented in scenes that provide insights for the international debate in three categories: the doctor-centered approach to care; the institutionalization of care and medicalization of suffering; and the contribution of community practices and non-specialized local knowledge. The locally situated scenes cast light on globally shared critical knots, elucidating a plural set of relationships that run through work processes and mental health care. The sharing of knowledge and experiences highlight what should be universalized: opportunities for horizontal exchange, rather than the production of national identities that radiate universalizing practices and policies.

This paper reflects on the vaccination campaign against COVID-19 in Brazil in light of the consideration of scientific evidence in the decision-making process. Brazil has one of the largest and most complete vaccination programs in the world, the National Immunization Program (Programa Nacional de Imunizações or PNI). Unfortunately, in the current context, with the political interference of the federal government, the PNI lost its role in conducting the vaccination campaign against COVID-19. Despite being a vaccination campaign with a lot of potential and one of the most accepted by the population among countries in the world, it presented many problems and left several gaps in the Brazilian scenario. In this sense, it is essential that the quality scientific evidence produced during this period can guide a constant remodeling of the vaccination strategy. Four points deserve to be highlighted: 1) the interval between doses; 2) the interchangeability between vaccines; 3) vaccination in children and adolescentes; and 4) the need for better evidence to define the vaccination strategy in certain groups and age groups.

This research highlights housing as one of the dimensions of the lives of individuals who experience severe psychological suffering, which reverberates in their care and unique therapeutic plan. This paper aims to grasp the Psychosocial Care Centers (CAPS) users' meanings of their experiences of living in Santos (SP), Brazil. This qualitative research was conducted with users of different services through semi-structured interviews submitted to the thematic content analysis. This study identified how the conception of housing relates to protection, individuality, and affective memories that corroborate the construction of an expanded concrete life regarding living in freedom in the city, presenting plural housing located in different territories. Taking ownership of spaces reveals the possibilities and challenges inherent to social exchanges and daily experiences. Being and living in a house means having access to material and subjective goods, besides assuring care in freedom. However, there are still limitations in the effective exercise of social participation.

This paper aims to present the potential city dwelling tactics and strategies employed by People Living on the Streets (PLS) in Brasília, Brazil, to reflect on the production of care and bonding within the Brazilian PHC (known as APS). First, we will discuss the broad sense of this notion of living as a set of everyday creations and innovations established as transient and circumstantial ways of creating bonds and care and as daily tools of health workers within the Brazilian Unified Health System (SUS). We will then present two PLS narratives to offer examples of actions performed in their homes built in the streets. The analysis of these encounters allows us to contextualize their lives on the streets, highlighting the movements that lead to the invisibility of this population and the precarious and fragile state of these practices and existences in and of the city. As a final perspective, we will point to the meeting of these living practices with the actions and technologies used by health workers in the process of self-care in the urban spaces.

Historical, social representations about stigma and prejudice related to unhoused people cause psychological distress, feeling of shame, and withdrawal from family and social relationships. This paper aimed to understand how unhoused people and health professionals perceive, reproduce, elaborate, and address the representations produced by their social conditions. This qualitative research employed participant observation, interviews with 24 unhoused people, and a focus group with professionals from the services providing care to the unhoused people. The study was conducted in Rio de Janeiro, Brazil, where crack use is very prevalent. An analysis was performed using the phenomenological narrative method. Stereotyping conjures the self-image of an unworthy, unwanted person, which justifies daily discrimination and, above all, the loss of the most critical condition of all beings, namely, their human condition, besides legitimizing the lack of care and violence against them. Deepening the relationship between prejudice and discrimination in the context of vulnerable populations and health services can assist therapeutic projects that promote the reduction of psychological distress, better care, and social recognition of citizenship of the unhoused people.

This paper aimed to identify and understand the meanings of family in a COVID-19 pandemic situation for adolescents in Northeastern Brazil. This qualitative research used the DE-T Procedure with 32 adolescents from Northeastern Brazil. Thirteen themes were observed, and the most incident were physical distance, expressed feelings, integrating family relationships, technological devices, and disintegrating family relationships. We finalize with the representation of family power in facing the pandemic and family suffering in the face of the public health problem that plagues the country.