This article aims to evaluate the effect of the COVID-19 pandemic on malnutrition among children under two years of age enrolled in the Bolsa Família Program (BFP). Ecological study of interrupted time series (ITS), with low weight for age, stunting, and overweight as time-dependent variables of malnutrition, extracted monthly (Jan/2008 to June/2021) from the Food and Nutrition Surveillance System. The COVID-19 pandemic was the exposure, dichotomized into pre-pandemic and pandemic. In RStudio, the trend was obtained by Prais-Winsten regression, and the effect of the pandemic on the time-dependent variables was determined by SARIMA modeling, estimating the regression coefficients (RC) adjusted for trend and seasonality (α = 5%). The pandemic was associated with an increase in: i) low weight for age in the South (RC = 0.94; p < 0.001) and Southeast (RC = 1.97; p < 0.001); ii) height deficit in the Midwest (RC = 2.4; p = 0.01), South (RC = 2.15; p < 0.001) and Southeast (RC = 2.96; p < 0.001); and iii) and overweight in the North (RC = 1.51; p = 0.04), Midwest (RC = 2.29; p = 0.01), South (RC = 2.83; p < 0.001), and Southeast (RC = 0.72; p = 0.04). The pandemic increased underweight in the South and Southeast, and the double burden of malnutrition in the Midwest, South, and Southeast. In the Northeast and North, higher rates of malnutrition still persist.

The article aims to identify stage of the food supply chain (FSC) has the greatest food loss and waste (FLW), the factors that influence and economic, social and environmental impacts in Latin America countries. We carried out a scoping review of observational studies, case reports and interventional studies in January 2023. Searches were performed in scientific databases and hand-searching of reference lists. Data on the included studies were summarized with narrative synthesis. In total 16 articles met the inclusion criteria. The greatest FLW occur in the early and middle stages of the FSC, mainly during storage. The main causes were connected to financial, managerial and operational limitations related in harvesting techniques, storage and cooling facilities, infrastructure and marketing systems. Food waste (FW) is also a result of lack of appropriate storage facilities and efficient transport systems, market fluctuations and systems. Only one study presented results on the environmental impact of FW. There is a higher occurrence of food loss, characterized by decrease in the quantity and quality of food in the first three stages of FSC.

In this article, we examine the concept of cultural authority in the context of the professionalization/corporatization of medicine at the end of the 20th century, and its political and moral contours since the HIV/AIDS epidemic in São Paulo. Based on journalistic articles collected from the newspaper O Estado de São Paulo (1986-1989), we seek to highlight the place of medical expertise, examining the discourses produced about the disease in Brazil, in bases that show the emergence of social actors, disputes for credibility and the clinical authority under challenge. We analyze public narratives about AIDS, situating the place of authority. We argue that such discourses, in the context of sexual panic, did not occur outside a dynamic of therapeutic/clinical authority and the profession's own norms, which also immediately made visible the role of physicians, specialists and other health professionals, in dialogue with the moral grammar of the socially current illness. The conclusions illustrate the link between Brazilian medicine at the end of the century and the local-global history of AIDS, concentrating historical and political movements that disputed the scientific and moral meanings of the disease, fractured by the clash between authorities in the scientific, sanitary and clinical fields.

This article aims to analyze spatial and temporal patterns of maternal mortality in Brazil during the period 2010-2020 and identify related socioeconomic indicators. We conducted an ecological study of the maternal mortality ratio (MMR) in Brazil's municipalities using secondary data. Temporal analysis was performed using the joinpoint method. Bayesian statistics, spatial autocorrelation, the Getis Ord Gi* technique and the scan statistic were used to identify spatial clusters, and multiple non-spatial and spatial regression models were used to assess the association between factors and the MMR. There was an increase in the MMR in 2020 and an increase in deaths in the North and Southeast. Clusters were found in Amazonas, Tocantins, Piauí, Maranhão, Bahia and Mato Grosso do Sul. The following indicators were negatively associated with the MMR: cesarean section rate, Municipal Human Development Index, and per capita household income of people who are vulnerable to poverty. The MMR was stable up to 2019, followed by a sharp rise in 2020 coinciding with the onset of the Covid-19 pandemic in the country. It is essential that efforts to reduce maternal mortality in Brazil extend beyond the promotion of improvements in antenatal, childbirth and postpartum care to address the social determinants of the problem.

This article analyzes the films produced and broadcast between 1976 and 1978 by the National Agency and the Public Relations Office (ARP) for the campaign to publicize the mandatory vaccination that was instituted by the National Immunization Plan (PNI), created in 1975 and regulated by Decree No. 78,231 of August 12, 1976. The objective is to understand the narrative constructed through images and speeches aimed at convincing the population to make vaccination a culturally accepted practice. To achieve this, we examine the legislation on the subject during the period under analysis, namely the civil-military dictatorship. The dictatorial regime is approached based on the conceptual aspects that guide the analysis of the appropriation of health campaigns as propaganda and investments in a private and curative health model. We can therefore conclude that the initiative to create the PNI is a hiatus in this process of privatizing health, since it is not an action guided by the dictatorship's responsibility for the health of the population, but an action that involved the management of multiple actors in the health field, and which was embraced by the regime because it was a process directly linked to interests connected to the country's conservative modernization project.

Since 2009, the Municipal Health Secretariat of Rio de Janeiro (SMS-RJ) has encouraged the creation of a Master's degree in primary health care at the National Health School/Fiocruz (ENSP/Fiocruz). In the following decade, this proposal became one of the main lines of the institution's professional stricto sensu postgraduate program, which culminated in CAPES approving the first professional doctorate class in the history of Fiocruz-RJ offered in 2024. The class comprises primary health care (PHC) students from Rio's SUS and Fiocruz employees in science, technology and innovation. Regarding the profile of the PHC students, the highlights were women (61.5%), a degree in medicine (53.8%), a mean of 15 years since graduating, 10 years working in PHC, graduates of a medical or multiprofessional residency course (69.2%) and a Master's degree in primary care from ENSP/Fiocruz or UFRJ (84.6%). The SMS-RJ thus leaves a legacy for Brazilian Public Health as a leader in the promotion of Fiocruz-RJ stricto sensu professional training programs, innovating in the end-of-course work, reviving the presence of doctors in the classes and bringing the contributions of the Portuguese SNS, a source of inspiration for the PHC reform undertaken in Rio de Janeiro, to the Rio de Janeiro SUS debate.

The aim of the current ecological study is to assess the evolution of food deserts and food swamps in the metropolitan city of Belo Horizonte between 2008 and 2020. Food deserts were determined based on the density of healthy establishments per 10,000 inhabitants, whereas food swamps were set based on the density of ultra-processed food procurement establishments per 10,000 inhabitants. The rate of census tracts classified as food deserts has decreased between 2008 and 2020, whereas that of census tracts classified as food swamps has increased within this same period. Furthermore, despite the reduced number of food deserts, these areas have increased in census tracts living under lower socioeconomic vulnerability condition. Food swamps recorded sharp increase in census tracts living under higher vulnerability condition. The population living in the herein investigated city has been increasingly exposed to an unhealthy community food environment over 12 years. Monitoring changes in community food environment is key strategy to enable tracking the effectiveness and efficiency of actions taken in food environments to ensure the human right to adequate food.

This article analyzes the Integrated Endemic Disease Program (PIDE), which was established in 1973 by the National Council for Scientific and Technological Development CNPq, financed by the Brazilian Funding Authority for Studies and Projects FINEP. The program was established to finance research on diseases considered strategic to the economic development plans of the military regime (1964-1985). Acknowledged to be a landmark program in the history of Brazilian parasitology, PIDE was set up during a period when the dictatorship was both violently repressing scholars and investing heavily in science and technology (S&T). The article examines the context in which the program was implemented and analyzes what it signified for planners in the S&T field and for the scientists who coordinated it. The contention is that PIDE was an example of how the scientific community managed to use financial and institutional resources available under the S&T policy in the 1970s to advance research on parasitic diseases and update its agenda. This analysis contributes to recent historiography that, based on specific historical cases, reflects on the paradoxical nature of a regime that, in its authoritarian modernization project, simultaneously persecuted scientists and supported science.

The article discusses the participation of doctors in the Brazilian military dictatorship (1964-1985). It identifies the main ways in which these doctors contributed with their technical and scientific knowledge and their institutional positions to the repression of the regime's opponents. The authors argue that this collaboration was not casual but strategic, organized, and systematic in assisting interrogations and practices of physical and psychological torture, as well as in covering up human rights violations. The article points out that this collaboration between doctors and the authoritarian regime violated all professional codes of ethics and international conventions for the protection and promotion of human rights, as well as the Hippocratic Oath. The primary historical sources on which the article is based are documents from the Brasil Nunca Mais Project, the final report of the National Truth Commission (CNV), and reports from states truth commissions. It concludes that the scant civil, criminal, and professional punishment of doctors involved in the regime's violence, protected by the 1979 Amnesty Law and other legal provisions, characterizes an incomplete rupture with the authoritarian legacies of the past, with consequences for the present and future of Brazilian democracy.

The article approaches the subject of recovery, a sociopolitical movement, field of studies and practices that aims, from the experience of people living with mental disorders, to promote a more optimistic outlook of the prognosis. Aiming to understand the recovery process of people who experience severe mental disorders, qualitative research was developed, based on Gadamerian hermeneutics. We conducted in-depth interviews, in the form of life narratives, with five people who recognize themselves in the process of recovery, and are part of a mental health patient group. Based on narrative analysis, three axes were organized: recovery process facilitators and coping strategies; barriers of recovery process; and relationship with diagnosis. The discussion is based on Canguilhem's theory; in the logic of psychosocial care, and in theories about the notion of recovery. We identified important intersubjective and sociocultural resources for recovery, however, we concluded that these same elements may constitute barriers to a creative existence, as the social norm remains crossed by the stigma that accompanies mental disorders, and by hierarchical power relations.

This article aims to analyze the consumption of healthy food consumption markers, according to racial groups of Brazilian women interviewed in the 2019 National Health Survey (NHS). This work was a cross-sectional study with data from 45,148 white and black women, aged ≥ 20 years. The variables used were the consumption of fruits, vegetables and legumes, beans, and fish. The association between color/race and the dietary intake indicators was tested using crude Poisson regression and adjusted to estimate prevalence ratios and 95% confidence intervals (95%CI). The prevalence of the consumption of fruits and vegetables was statistically higher among white women, while fish and beans was higher among black women. After adjusting for socioeconomic and demographic variables, it was found that black women remained only less likely to consume fruit (PR = 0.91; 95% CI: 0.88-0.95) and only more likely to consume beans (PR = 1.07; 95% CI: 1.04-1.10) than whites. There were racial inequalities for the consumption of healthy foods among Brazilian women, indicating that color/race defined a dietary pattern for black women that put them in vulnerable conditions in terms of fruit consumption.

The scope of this paper is to analyze the relationship between the country's political redemocratization process from the 1980s onwards and the issue of identification, preservation and access to the archives of information and security bodies that worked to combat the opponents of the authoritarian regime during the military dictatorship (1964-1985). It addresses the dictatorship's action on university and scientific institutions, to highlight the importance of the archive of the Oswaldo Cruz Foundation, as well as the personal files maintained by scientists and donated to Casa de Oswaldo Cruz. It features archives and collections organized and available for public consultation, which can serve as research sources for historical studies on science and health during the dictatorship.

The objective of this systematic review (SR) with meta-analysis (MA) was to identify the dietary patterns of the population, regarding ethnicity and gender, and their association with the metabolic syndrome and its risk factors (MetS-RF). The literature search was performed using Medline, Scopus, Ebsco, SciELO, and BVS databases. Studies with adult participants that identified dietary patterns associated with MetS-RF were included. Pooled odds ratio (OR) and 95%CI were calculated using a random-effect, generic inverse variance method. Statistical heterogeneity and publication bias were explored. The dietary patterns were classified as healthy or unhealthy. Studies were categorized into three groups: Women (all ethnicities), Afro-descendant (men and women), and General Population (both genders and ethnicity). Among the articles found (n=8,496), 22 integrated the SR and 11 the MA. The adherence to the healthy dietary pattern was negatively associated (protective factor) with MetS-RF only in the General Population (OR=0.77; 95%CI: 0.61-0.98). Nevertheless, the unhealthy dietary pattern was associated with the higher prevalence of MetS-RF in all analyzed groups. It was concluded that an unhealthy eating pattern increases the chances of SM-RF in adults, regardless of gender and ethnicity.

The performance evaluation of services through instruments is relevant, as it can support thoughts, actions and political approaches to meet a social need. The objective of the article was to develop and validate the Quality and Strengthening of Primary Care Questionnaire (QSPC-Q) for professionals and users based on Starfield attributes and Donabedian pillars. A mixed sequential study was performed to develop the QSPC-Q. The test was applied to 149 doctors and 795 users of basic health units. Psychometric properties was assessed by testing internal consistency using Cronbach's alpha and exploratory factor analysis. Reproducibility od scale was assessed using intraclass cognitive and test-retest correlation. The final version of the follow-up consisted of 45 items aimed at physicians (Cronbach's alpha = 0.921) and 33 at users (Cronbach's alpha = 0.86); the intraclass respiratory capacity was 0.88. An exploratory factor analysis identified 13 factors associated with the pattern components. A short version with 29 items for professionals was also elaborated. Professional QSPC-Q (short and braided versions) and user QSPC-Q were valid.

Primary healthcare is the main gateway and priority for healthcare management in Brazil. However, there are significant challenges in the quality of care, particularly for those most vulnerable, especially maternal and infant healthcare. This fact is exacerbated by regional inequalities, which have historically left the North and Northeast regions at a relative disadvantage. The study involves an analysis of the resources available for maternal and infant healthcare in the state of Roraima, the North region, and Brazil as a whole in 2012, 2014, and 2017, using data from Module I of the National Program for the Improvement of Access and Quality of Primary Care (PMAQ-AB). There was a significant improvement in physical infrastructure indicators (e.g., ventilation and air conditioning) as well as improvement in the distribution of supplies and equipment needed for maternal and infant care between 2014 and 2017. However, the availability of medicines and the number of human resources and hours worked diminished. The study offers a crucial longitudinal analysis, comparing the situation in Roraima and Brazil, whose findings could contribute to the development of programs and public policymaking for reproductive rights and maternal and infant health.

This study sought to understand the network of meanings mutually experienced among women who survived maternal near miss due to lapses in care during pregnancy, labor and birth, based on Habermas' theory of communication. A qualitative methodology was selected, with the participation of 14 women who survived maternal near miss by means of the autobiographical narrative interview proposed by Schutze, based on the Communicative Action theory of Jurgen Habermas. From the analysis, two categories emerged: "Selective listening, clashes and negligence" and "Blaming the Patient and Violent Communication." The narratives reveal that the interpersonal relationship was not based on dialogue, but on superior knowledge as opposed to acknowledging the other, reflecting an authoritarian, non-reflexive posture of the professionals, without self-criticism or genuine critical freedom, with important repercussions on user care. The primacy of strategic rationality and the defense of verticalized technical success contributed to important communication lapses in the care of women who progressed to maternal near miss.

This article aims to systematize and analyze, from a historical perspective, the discussions that permeated the topic of indigenous health in interface with the demography of these populations, based on the political dimension that the quantification of indigenous peoples assumed during the military dictatorship in Brazil. Covering an extensive period that extends from the establishment of the Indian Protection Service in 1910 until the end of the 1980s, this article offers a comprehensive view of the topic. The analysis focuses primarily on the 1970s, highlighting the actors involved in this debate: indigenous leaders, indigenists, academics, health professionals, and missionaries.

This article aims to estimate the underreporting of violence against women (VAW) in the Notifiable Diseases Information System (SINAN), based on data from the National Survey of Health (NSH), in Brazil and subnational units (SU). This work was an ecological study using SINAN and NSH, both from 2019. In SINAN, reports of sexual, physical, and psychological VAW, aged 18 years or older, were selected. In the NSH, women of the same age group who reported psychological, physical, or sexual violence, and who had sought health care due to consequences of the violence were selected. SINAN underreporting was calculated in reference to the NSH's estimated population, for Brazil and each SU. Underreporting of VAW in Brazil was 98.5%, 75.9%, and 89.4% for psychological, physical, and sexual violence, respectively. The North and Northeast states presented the lowest reporting rates among the states. VAW in Brazil is highly underreported by the health sector, showing the need for adequate training of health professionals to recognize situations of violence and raise awareness of the importance of reporting.

This article aims to examine differences in suicidal narrative and suicide crisis syndrome symptoms, and suicidal ideation among those who maintained, lost, and gained employment or student status during the COVID-19 pandemic. It is a cross-sectional study based on an online and anonymous self-report questionnaire. Participants were recruited through social media platforms between November 2020 and October 2021. Changes in occupational status were assessed in 2,259 individuals. The sample was divided into four groups according to work (full-time/part-time) and study status (1) maintained, (2) lost, (3) gained, and (4) unemployed. Suicide outcomes were investigated by the Suicidal Narrative Inventory, Suicide Crisis Inventory, and Columbia - Suicide Severity Rating Scale Screener version. Changes in occupational status influenced symptoms of the suicide crisis syndrome and suicidal narrative, but not suicidal ideation. Those who maintained their work, such as full-time/part-time scored lower on the total scores of the Suicidal Narrative Inventory and Suicide Crisis Inventory-2 compared to those who lost their employed status and unemployed. Our findings suggest that it is appropriate to consider changes in employed status as a mental health risk factor during pandemics.

This article aimed to historically assess the impact undergone by the Faculty of Medicine-USP when it formally supported the military regime established in Brazil from 1964 onwards and the consequences of this support in its daily life. Another objective was unearthing how this context, lived between persecution, prisons, and torture, also intervened in didactic-pedagogical actions, such as the creation of a new model of medical education in 1967, known as the Experimental Course. This course would be immediately attacked by groups that saw it as a communist stronghold and a threat to the tradition of the so-called "Casa de Arnaldo", resulting in the closure of its activities in 1974.