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There has been an alarming rise in suicide attempts among Indigenous people in Brazil, leading to national concerns about the provision of psychosocial care and professional support. In this study, we make an attempt to understand the perspectives of professionals in assisting Indigenous people from a specific group, the Inỹ, and identify the specific challenges of addressing issues through the mental health care system related specifically to suicide prevention. Using a qualitative approach with participant observation and semi-structured interviews, the research included Indigenous and their families assisted by three public institutions and the professionals that work in public psychosocial assistance. For this paper, we examined the tensions, conflicts, and challenges of the healthcare professionals at one of these institutions, a Psychosocial Care Center in the state of Goiás/Brazil. For data analysis, a sociocultural protocol was built to identify dialogical tensions between the different thematic fields of mental health care. The findings reveal that the theme of suicide was an important concern in the daily work with the community. Still, there were significant issues related to the assumptions, methodology, and meaning of care between the professionals and the community, on account of which the objective of the programme to address suicide attempts had not been effective or successful. The discussion of the results raises several critical questions about the possible contributions of dialogical cultural psychology in the context of Indigenous health. Also, it has important implications for the global issue of the wellbeing of Indigenous people. [ABSTRACT FROM AUTHOR]

This paper uses the internet-based biosurveillance to describe the Brazilian e-commerce of non-inspected dairy products and maps its traditional sale in a medium-sized city (Londrina). We searched the sales of illegal dairy products on Facebook Marketplace and conducted a census of street markets and a random sample of formal markets. Although prohibited in Brazil, consumers can easily find informal dairy products on internet and retail sale. In addition, 7% of the food products hold a false label to mimic food inspection. The e-commerce was linked with regions with higher access to technology and Human Development Index (HDI). We believe that our approach shows a step forward in the public health interventions and could be replicated stimulating debates about policies required to improve the public health surveillance. [ABSTRACT FROM AUTHOR]

From 2015 to 2016, an epidemic of births of children with Congenital Zika Virus Syndrome emerged in Brazil, and the state of Bahia concentrated the highest incidence of cases. The official health guidelines recommended that the affected children and their families should be supported by interdisciplinary teams of early intervention. This paper aims to deepen the comprehension of regulation and affective-semiotic mediation processes involved in the early intervention with children with Congenital Zika Virus Syndrome and their families. It focus on the experiences of a professional interviewed in a public health service in Salvador, Bahia – Brazil, through narrative analysis and the theoretical-methodological foundations of Cultural Psychology of the Semiotic Dynamics. These approaches allowed the understanding of the processes of construction of meanings, symbolic action and affective-semiotic regulation. The care of Congenital Zika Virus Syndrome children by professionals relates to disquieting experiences, inter subjectivity, meaning construction, affections and symbolic actions. These dynamic processes allowed the professional to better adapt to regulation and affective-semiotic mediation, as well as her own performance in face of children and their families. This analysis emphasizes the reflections of health care practices and their repercussions in the quality of the assistance. [ABSTRACT FROM AUTHOR]

The pandemic caused by the COVID-19 has influenced peoples' lifestyles. Home-confinement scenario might impair physical activity practice, resulting in new challenges for maintaining health during the pandemic of the COVID-19. The aim of this study was to present the current context of COVID-19 pandemic, its impact on the practice of physical activity, and the strategies available to remain active during home-confinement according to international recommendations. The narrative review was conducted based on studies that analyzed themes related to physical activity and COVID-19. Virtual Health Library (VHL), CINAHL, Cochrane, PsycINFO, PubMed, ScienceDirect, Scientific Electronic Library Online (SciELO), Scopus, SPORTDiscus, and Web of Science databases were searched for relevant papers. Although an increased number of experimental studies are still necessary, people should devote more time to physical activity during social isolation. Guidelines were adjusted by international entities in order to encourage people to remain active, through practice regular physical activity, using alternative strategies such as fitness program applications, exergames, online exercise classes, and even chores. Reduction of prolonged sedentary behavior could contribute to maintain health and improve quality of life during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To discuss studies conducted in Brazil relating to PrEP, from 2012 to 2022, based on a narrative review. METHODOLOGY: The databases of the Virtual Health Library/PAHO, portals from Scielo, Scopus, and PubMed, and the descriptors in English and Portuguese 'Pre-exposure to HIV' and 'Brazil' were used, as well as a list of planned/in-progress demonstrative studies. Inclusion criteria consists of articles with fieldwork in Brazil coupled with PrEP in the Brazilian scenario; and articles in English or Portuguese. Articles in which PrEP was not the central theme and the participating Brazilian population did not reside in Brazil were excluded. RESULTS: 107 papers have been reviewed, 80 articles met the inclusion criteria. The majority participating population was men who have sex with men. 61 studies preceded the implementation of PrEP in Brazil. Studies carried out after implementation (n = 19) deal primarily with the impact of the COVID-19 pandemic. CONCLUSIONS: There was an incipient number of studies on the injectable form of PrEP. Fewer studies included segments with greater difficulties in access, use, and adherence. Despite the issues that circumscribe this prevention technology, literature is consensual on the importance of Brazilian leadership for implementing PrEP. [ABSTRACT FROM AUTHOR]

This paper includes a systematic review of the SARS-CoV-2 occurrence in environmental aquatic matrices and a critical sanitation analysis. We discussed the interconnection of sanitation services (wastewater, water supply, solid waste, and stormwater drainage) functioning as an important network for controlling the spread of SARS-CoV-2 in waters. We collected 98 studies containing data of the SARS-CoV-2 occurrence in aquatic matrices around the world, of which 40% were from developing countries. Alongside a significant number of people infected by the virus, developing countries face socioeconomic deficiencies and insufficient public investment in infrastructure. Therefore, our study focused on highlighting solutions to provide sanitation in developing countries, considering the virus control in waters by disinfection techniques and sanitary measures, including alternatives for the vulnerable communities. The need for multilateral efforts to improve the universal coverage of sanitation services demands urgent attention in a pandemic scenario. [ABSTRACT FROM AUTHOR]

New juridical needs linked to the National Health System (SUS) in Brazil during the pandemic forward significant cases for the analysis of the national public health during the period. Through urgency tutelages which demanded the transference of SARS-CoV-2 infected people to Intensive Care Therapy, current paper analyzes aspects of juridical decisions in the health area during the pandemic. Juridical demand and the deferment or not of demands are analytic sources to understand the state of the Brazilian health system couple to the usefulness of these decisions within the same context and to identify important aspects on the situation. [ABSTRACT FROM AUTHOR]

Community health workers (CHWs) are framed as the link between communities and the formal health system. CHWs must establish trusting relationships with the community and with the broader health service. How to find the optimal balance between the various strands of work for CHWs, and how to formalise this, has been the focus of different studies. We performed an extensive documentary analysis of federal legislation in Brazil to understand the institutionalisation of the CHW workforce in Brazil over the last 3 decades. The paper offers three contributions to the literature: the development and application of an analytical framework to consider the institutionalisation process of CHWs; a historical analysis of the professional institutionalisation of CHW in Brazil; and the identification of the paradoxes that such institutionalisation faces: firstly, institutionalisation focused on improving CHW remuneration created difficulties in hiring and paying these professionals; when CHW are incorporated within state bureaucracy they start to lose their autonomy as community agents; and that the effectiveness of CHW programmes depends on the improvement of clinical services in the most deprived areas. [ABSTRACT FROM AUTHOR]

This paper aims to present an ex-post analysis of industrial and science, technology and innovation (sti) policies to the Health Industrial Complex, between 2003-2017 in Brazil, from the perspective of the public health value. We concluded that the intention to meet social health needs was present in the policies' design, however, the lack of objectivity and clarity in their definitions made it difficult to articulate the three fields of policies. [ABSTRACT FROM AUTHOR]

The Brazilian Policy of Comprehensive Care for People with Rare Diseases (BPCCPRD) was established by the Ministry of Health to reduce morbidity and mortality and improve the quality of life of people with rare diseases (RD). Several laboratory tests, most using molecular genetic technologies, have been incorporated by the Brazilian Public Health System, and 18 specialised centres have so far been established at university hospitals (UH) in the capitals of the Southern, Southeastern and Northeastern regions. However, whether the available human and technological resources in these services are appropriate and sufficient to achieve the goals of care established by the BPCCPRD is unknown. Despite great advances in diagnosis, especially due to new technologies and the recent structuring of clinical assessment of RD in Brazil, epidemiological data are lacking and when available, restricted to specific disorders. This position paper summarises the performance of a nationally representative survey on epidemiology, clinical status, and diagnostic and therapeutic resources employed for individuals with genetic and non-genetic RD in Brazil. The Brazilian Rare Disease Network (BRDN) is under development, comprising 40 institutions, including 18 UH, 17 Rare Diseases Reference Services and five Newborn Screening Reference Services. A retrospective study will be initially conducted, followed by a prospective study. The data collection instrument will use a standard protocol with sociodemographic data and clinical and diagnostic aspects according to international ontology. This great collaborative network is the first initiative of a large epidemiological data collection of RD in Latin America, and the results will increase the knowledge of RD in Brazil and help health managers to improve national public policy on RD in Brazil. [ABSTRACT FROM AUTHOR]

Agrochemicals are chemical products used in agricultural and stock breeding programs. Since they are products which endanger the environment, they are regulated by specific norms. Brazil is one of the biggest agricultural and stock breeding producers with the highest rates of pesticides. The number of agrochemicals registered in Brazil has greatly increased during the last years, but regulating norms remained unaltered. Normative and policy changes occurred which made flexible registers and increased uses. Current paper analyzes present norms and verifies the occurrence of flexibilization by quality research with a review of the literature and documents. Results show that there was an increase in the number of registers and the employment of agrochemicals, many of which have been prohibited in Europe. Flexibilization occurred by political and economical decisions without taking into account issues of public health and environment. [ABSTRACT FROM AUTHOR]

Yellow Fever (YF) is a viral arbovirosis of Public Health importance. In Brazil, surveillance is focused mainly on detecting epizootic events of Platyrrhini. Herein, we compared the detection and phylogenetic analysis of YF virus in two neotropical primates (NTP), a Callithrix detected in the previous epidemic period (2016–2020), and a Callicebus nigrifons , showing a new introduction of YF in 2023. This paper illustrates the importance of joint actions of laboratory and field teams to ensure quick response to Public Health emergencies, such as the intensification of vaccination of susceptible human populations. [ABSTRACT FROM AUTHOR]

This paper analyzes ten recovery narratives of people with a serious mental illness who received mental health services in the public health care system of the city of Campinas, Brazil. We describe the person's recovery process and their relationship with the clinical services they received. This is a very needed conversation because the incorporation of recovery and recovering citizenship concepts in clinical practice are still incipient in South America. Most importantly, this research adds to the dialogue around recovering citizenship in different cultures. Methods: We used phenomenological methodology to interpret data drawn from the participant's life course interview (using the McGill Illness Narrative Interview). Results: We found that a) Before receiving services, people were overwhelmed by symptoms, but did not know what was going on; b) Loved ones and clinicians explained symptoms as part of a mental illness, and the proposed treatment was largely accepted; c) Mental health treatment was seen as helpful but not enough to address what was meaningful for their lives; d) People regained a life in their community, they felt proud of their recovery process, and solidarity and collectivism seemed to play important roles in their recovery process. Discussion: We identified similarities and differences in the recovery process of people with serious mental illness receiving public mental health services in Campinas, Brazil, when compared to the international literature. Receiving mental health services was very helpful for participants, principally when feeling overwhelmed by symptoms. Mental health services seemed to be less effective in helping people regain a meaningful life in their communities. Solidarity from friends and family members was recognized as an important recovery asset. [ABSTRACT FROM AUTHOR]

In the context of the COVID-19 pandemic, masks and the act of masking have become emotive subjects for social and political debate. In Brazil, one of the countries most severely affected by the pandemic, the seemingly mundane act of mask-wearing has become part of a deep social, political and economic crisis at the centre of which is the far-right president Jair Bolsonaro. In this paper we explore the politics of (un)masking in Brazil from three vantage points in which the mask serves to dramatise the country's current moment. Firstly, we trace the connections and disjunctions between the politics of mask-wearing and the genealogies of hygienist policies associated with the modern aspirations of the Brazilian republic. Secondly, we consider how masks are incorporated into the everyday life of the city through popular economies, which reveal the potentialities and limitations of work beyond the modern ideals of waged labour. Finally, we explore the incorporation of masks in urban street-art. We approach graffiti and murals as situated performances of symbolic resistance that contest and reveal the incoherences of Bolsonaro's anti-science discourse. In tandem, these three perspectives foreground practices of (un)masking that expose long-standing tensions and new contemporary challenges that characterise the politics of a 'crisis society'. [ABSTRACT FROM AUTHOR]

Unintended pregnancies constitute a serious public health concern in Brazil, representing up to 55% of all pregnancies, and are prevalent among women with low income and low educational backgrounds. Lack of assistance to women in their decision-making has hindered the adoption of more effective contraceptive models. Although clinical consultations constitute an important locus to assist women in decision-making and to facilitate access to subsidized methods, our current knowledge of how contraception is discussed and decisions are reached in actual consultations is limited. Just as scarce is our knowledge of how patients respond and resist contraception recommendations and how physicians counter or accommodate patients. Using a corpus of 103 audio-recorded medical visits and conversation analytic (CA) methods, this paper examines recommendation sequences in the under-investigated gynecological consultations in the Brazilian public healthcare system (SUS). The quantitative analysis reveals a strong orientation to physicians as having primary rights to govern the oversight of women's bodies: 94% of the recommendations are delivered as pronouncements (e.g. , "You'll take X″), the most authoritative action type. Patients largely assume an agreeable and passive role (66%), leading to scarce negotiation and minimal involvement in decision-making. However, in a few cases (12%), all involving contraception, patients become overtly agentive, responding with active resistance. A qualitative analysis of that subset shows that despite women's gaining some agency over their sexual bodies, that agency is still limited. Whereas physicians accommodate patient resistance on grounds of biomedically-related side-effects and incorrect assumptions about the women's lives, they overlook patient resistance based on gendered struggles over contraceptive methods in the domestic sphere. By failing to consider women's lack of agency in choosing whether to have sex or to use condoms, doctors show unawareness of significant consequences of the recommended method, which might include domestic dispute and violence and, paradoxically, ultimately misfire, leading to unwanted pregnancy. • Unintended pregnancies constitute a serious public health concern in Brazil. • Lack of assistance with decision-making hinders best-suited contraception use. • Medical consultations are valuable interactional spaces to discuss contraception. • Women gain by resisting ill-suited recommendations to their own life circumstances. • Contraception decision and access demand partnership between doctors and patients. [ABSTRACT FROM AUTHOR]