O jornal O Mundo da Saúde é uma publicação trimestral de divulgação científica do Centro Universitário São Camilo , sob a responsabilidade do seu Editor-Chefe, bem como o apoio do seu Editor Científico, Associado Editorial e Conselho Editorial, composto por conceituados representantes nacionais e pesquisadores estrangeiros. A revista tem como foco a divulgação de estudos e pesquisas na área da saúde e demais áreas de pesquisa a ela vinculadas. O objetivo é possibilitar um exercício crítico e reflexivo a fim de aprofundar a compreensão de questões pertinentes e relevantes que contribuem para o alcance da saúde integral do ser humano e para a criação de perspectivas inovadoras e comprometidas. A revista é especializada em diversas áreas interdisciplinares da saúde, com ênfase em Medicina, Saúde Pública, Enfermagem , Nutrição, Fonoaudiologia, Informática, Psicologia, Saúde Ambiental, Tecnologia em Radiologia, Terapia Ocupacional, entre outras. Recebemos manuscritos nos seguintes idiomas: português, espanhol e inglês. Os artigos submetidos em português são traduzidos pela nossa revista para o inglês e publicados nos dois idiomas. Para artigos submetidos em inglês, há tradução para o português. E para os em espanhol, traduzimos para o português e inglês.
Factors related to fear and anxiety in dental care in Primary Health Care
Dental treatment is still perceived as a traumatic procedure by many individuals, due to painful experiences or episodes that triggered fear. The scarcity of available dental services, particularly for adults, led to late-seeking behavior, making tooth extraction the primary intervention in the public health system. In addition, anxiety toward dental treatment exerts a considerable impact on psychosocial well being, especially among users who delay dental care, resulting in serious oral health problems. This impact is even more pronounced in families with low income, low educational attainment, and limited access to preventive and curative dental care. This study aimed to analyze how socioeconomic factors relate to fear and anxiety toward dental care in Primary Health Care. This is a qualitative, exploratory-descriptive study, conducted at the Canasvieiras Health Center (HC) in the municipality of Florianópolis/SC, using semi structured interviews with ten active users between August and September 2024, aged 23 to 66 years. Fear and anxiety in the dental office are strongly associated with traumatic experiences and socioeconomic factors, while limited access to oral health services amplifies inequalities and reinforces the need for public policies focused on equity in these services. To change this scenario, it is essential to prioritize oral health public policies, focusing on preventive dentistry, patient-centered care, and public awareness.
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Caregiver burden and quality of life of family caregivers of older adults: a cross-sectional correlational study
In a world in which the population is aging, the need for caregivers of older adults arises due to physical and cognitive limitations in performing activities of daily living. In this context, the aims of this study were to describe the degree of independence and functional mobility of older adults, as well as the burden and quality of life of their family caregivers. This was a cross-sectional, descriptive study, conducted from March to December 2024, at a Health Promotion Center, in compliance with the ethical requirements for research involving human subjects (Ethics Opinion No. 6,641,999). Questionnaires were administered to collect sociodemographic characteristics; the Barthel Index was used to assess the degree of functional independence of the older adults; caregiver burden and quality of life were measured using the Zarit Burden Interview and the 12-Item Short-Form Health Survey (SF-12), respectively. A total of 101 family caregivers participated, with a mean age of 56 years; 82.2% were women and 43.5% were daughters. A total of 81.2% reported deterioration in their health status after assuming caregiving responsibilities; 86.1% ceased performing physical, social, and leisure activities; 52.5% presented moderate-to-severe burden and 18.8% presented severe burden. Regarding the older adults, 71.3% were women, with a mean age of 81.1 years; 61.4% were independent or had mild dependency. Women predominantly assume the care of older adults, and when this role is combined with other activities, it results in burden, reduced leisure time, and neglect of personal health. Despite the older adults presenting independence or mild dependency, their caregivers perceived a worsening of their health status after assuming the caregiving role, experienced burden, and showed low quality of life scores – factors that contribute to their becoming dependent older adults in the future. There is an urgent need for the development of health education actions focusing on quality of life and healthy aging of caregivers of older adults.
Between knowledge and risk: prevalence and patterns of self-medication among medical students in northern Brazil
Self-medication is a widely prevalent practice and represents an important public health challenge, particularly among health sciences students. This study aimed to describe the prevalence and patterns of self-medication among medical students at a university in northern Brazil. This was a cross-sectional, quantitative, descriptive-analytical study conducted with 216 students. Data collection was performed using a self-administered, anonymous questionnaire adapted from a previously validated instrument. The investigated variables included frequency of self-medication, motivating factors, drug classes used, sources of advice, and knowledge regarding risks and adverse effects. The majority of participants were female (70.8%). Purchase of medications without a prescription was reported by 94.4% of students, and 80.6% reported seeking advice from pharmacists or pharmacy attendants. Analgesics and anti-inflammatory drugs were the most frequently used drug classes. Regarding knowledge of adverse effects, 59.7% reported knowing most of them, while only 12.5% claimed to know all of them. A high prevalence of self-medication was observed among the evaluated students, primarily associated with prior familiarity with medications, lack of time for medical consultations, and the perception of sufficient pharmacological knowledge. The results reinforce the need for educational strategies during medical training focused on rational medication use.
Benefits of physical exercise on the quality of life of women during the gestational period
The objective of this study was to analyze the benefits of physical exercise on the quality of life of women during the gestational period. An integrative review was conducted using scientific articles from the Virtual Health Library (Biblioteca Virtual em Saúde – BVS), Scopus, and SciELO databases. Twenty articles published between 2020 and 2025 that presented exercise-based intervention programs for pregnant women were identified. It was found that the majority of interventions in pregnant women were conducted between the 5th and 21st week of gestation. Among the most frequently practiced physical exercises, light and moderate walking, as well as yoga, were the most common. The implementation of physical exercise programs during the gestational period yielded positive effects on nutritional status, glycemic levels, cardiovascular health, mental health, sleep quality, and the reduction of delivery complications. The study concluded that physical exercise provides important benefits for the physical and mental health and quality of life of women during the gestational period.
Exercise prescription for individuals using beta-blockers: a literature review
Exercise prescription for individuals using beta-blockers requires careful consideration of intensity, duration, and heart rate (HR). The present study aimed to identify formulas for calculating maximum heart rate (HRmax ) and formulas used for adequate prescription of exercise intensity in patients on beta-blocker therapy. A literature review was conducted using the databases PubMed, PEDro, and SciELO, with the keywords “betablocker”, “exercises”, “heart rate”, “rehabilitation”, and “prediction equation”, combined using the Boolean operator “AND”. Inclusion criteria comprised: clinical trials, meta-analyses, and randomized controlled trials published in English or Portuguese, containing formulas for calculating HRmax and training HR for beta-blocked individuals. The search yielded 2,458 results, of which 4 articles were included. Two articles addressed HRmax formulas, one of which proposed formulas for patients with heart failure. The remaining two articles addressed training HR in beta-blocked individuals. The identified HRmax formula was 164 − (0.7 × age), and for specific situations involving stable patients with heart failure with reduced ejection fraction, the Keteyian formula (114 + 0.5 × HRrest − 0.5 × age) and a new equation: HRmax = 109 + (0.5 × HRrest ) − (0.5 × age) + (0.2 × LVEF) − 5 (if Hb < 11 g/dL) were identified. For exercise prescription, the Karvonen HR formula [0.6 × (HRmax − HRrest) + HRrest] or 80% of HRmax were found. For patients following acute myocardial infarction, the modified Karvonen formula was identified: HR = 0.8 × (HRmax − HRrest) + HRrest.
Prevention of functional decline in hospitalized older adults: a scoping review
The increase in average life expectancy poses significant challenges to hospital care, particularly regarding the prevention of functional decline during hospitalization. This study aimed to map the strategies described in the literature and identify relevant contributions to clinical practice, focusing on nursing interventions directed at the prevention of functional decline in hospitalized older adults. A scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology, based on the PCC framework (Population: older adults; Concept: functional decline and nursing care; Context: hospitalization), through a search carried out in March 2025 across multiple databases. Fifteen articles were included for full-text analysis. The results highlighted three main thematic areas: factors promoting functional decline, factors facilitating functionality, and interdisciplinary care with nursing contributions. Among the identified strategies, early mobilization, continuous functional assessment, family involvement, promotion of self-care, and implementation of structured protocols stand out. The findings also highlight the role of nursing in the assessment, coordination, and continuity of care directed at the preservation of functional autonomy. It is concluded that nursing assumes a central role in the prevention of functional decline and in the promotion of functional autonomy of hospitalized older adults.
Ana Inês Silva Fonseca Loureiro dos Santos Almeida
Incidence of pressure injuries in clinical and surgical patients in Tocantins: a retrospective study
Pressure injuries (PIs) are significant adverse events related to health care, associated with increased morbimortality, prolonged hospitalization, and elevated care costs. The objective of this study was to analyze the incidence of pressure injuries in patients admitted to the medical, surgical, and orthopedic wards of a public hospital in the state of Tocantins. This is a retrospective cross-sectional study conducted through the review of medical records of adult inpatients between January and June 2023. A total of 938 records of patients hospitalized for more than 24 hours were analyzed. The variables investigated included sex, age group, underlying disease, and anatomical location of the injury. The incidence of PI was 2.23% (21/938), with a predominance in female patients (61.9%) and in patients aged 80 to 89 years. The sacral and gluteal regions were the most frequently recorded locations. Patients with neurological diseases, pneumonia, and bone fractures presented higher frequencies of PI. The findings should be interpreted with caution due to the limitations inherent to retrospective studies based on medical records, including underreporting and inconsistencies in clinical documentation. It is concluded that the occurrence of PI was primarily associated with advanced age, presence of comorbidities, and reduced mobility, reinforcing the need for individualized preventive strategies, improvement of clinical record quality, and strengthening of institutional prevention protocols.
Epidemiological profile and temporal trend of hospitalizations for malignant skin neoplasms in Brazil between 2015 and 2025
This study analyzed the epidemiological profile and temporal trend of hospitalizations for malignant skin neoplasms in Brazil between 2015 and 2025, based on secondary data from the Hospital Information System of the Unified Health System (SIH/SUS). A total of 633,457 hospitalizations were recorded during the period, with a predominance of male sex (51.9%), self-declared White individuals (65.8%), and the age group of 60 years or older (72.3%). The Southeast and South regions concentrated the highest number of hospitalizations, while the North region presented the highest mortality rate (4.70%). A general upward trend was observed throughout the historical series, with a reduction in 2020 and a progressive recovery in subsequent years. The findings indicate a higher occurrence of hospitalizations in groups more vulnerable to cumulative ultraviolet radiation exposure and evidence regional inequalities in access to diagnosis and treatment, reinforcing the need for prevention strategies, early diagnosis, and strengthening of public health policies.
Evidence of content validity and reliability of the Brazilian version of the PAPA Scale
Inappropriate antibiotic use in children constitutes a global challenge for patient safety, being influenced by caregivers’ perceptions, knowledge, and behaviors. The objective of the present study was to assess the content validity and reliability of the Brazilian version of the Parental Perception on Antibiotics Scale (PAPA Scale). This is a methodological study to obtain evidence of content validity and reliability of the Brazilian version of the PAPA Scale. In the content validity stage, 24 healthcare judges assessed the items regarding clarity of language, practical pertinence, and theoretical relevance. After the suggested adjustments, the scale was applied to 209 parents of children who used antibiotics at home. Content validity was analyzed using the Content Validity Coefficient. Reliability was assessed through internal consistency, using Cronbach’s alpha and McDonald’s omega, and through temporal stability, using the test-retest method via weighted Kappa and Intraclass Correlation Coefficient (ICC). The total content validity coefficients were 0.94 for clarity of language, 0.97 for practical pertinence, and 0.97 for theoretical relevance. Internal consistency indices by factor ranged from 0.597 to 0.864 for alpha and 0.603 to 0.862 for omega. Temporal stability presented ICC values between 0.337 and 0.648, indicating weak to moderate reliability. The Brazilian version of the PAPA Scale, comprising 36 items distributed across six factors, presented evidence of content validity and reliability, demonstrating potential for use in assessing parental perception of antibiotic use in children at home.
Characterization of psychotropic medication use among tobacco farmers who handle pesticides: a cross-sectional study
The use of pesticides constitutes a relevant public health problem. In this context, the investigation of psychotropic drug use becomes necessary, considering the particularities of the health-disease process and the working conditions that influence the physical and mental health of these workers. The objective of this study was to characterize the psychotropic medications used by tobacco farmers who handle pesticides through a descriptive, retrospective, cross-sectional, and documentary design. Data collection was carried out through clinical records present in 149 medical records of tobacco farmers who were users of Primary Health Care Units in Arapiraca, Alagoas. Analyses were performed using Jamovi software (version 2.5). It was identified that the majority of the population was female (66%) and that, regardless of sex, the onset of psychotropic use began at age 40. The predominant clinical symptomatology was headache (1.3%), epigastric pain (0.9%), fever (0.5%), dizziness (0.3%), diarrhea (0.3%), and vomiting (0.2%). The reported complaints were related to mental health, with higher prevalence of nervousness, aggressiveness, anxiety, and sadness. The psychotropics with the highest frequency of records were Clonazepam (34.2%; n=750), Amitriptyline (18.9%, n=406), and Diazepam (11%; n=237). The results indicated a high frequency of psychotropic use among tobacco farmers who handle and are constantly exposed to pesticides. The absence of records regarding prior diagnoses of mental disorders, clinical assessment, and the presence of psychotropic prescriptions evidenced the need for training of health professionals in the area of mental health and the establishment of an interdisciplinary approach, with dynamic and systematized active listening during consultations at primary health care units, in order to allow qualified and holistic multiprofessional and interprofessional care.
Elaine Virgínia Martins de Souza Figueiredo
Creation of a virtual patient for application in medical student education
The clinical examination remains a cornerstone of medical training; however, the expansion of medical schools and structural limitations have reduced practical opportunities, favoring the use of active methodologies and virtual patients based on artificial intelligence (AI). This study aimed to develop an original AI-based virtual patient (VP) and evaluate its acceptance and applicability as a complementary tool for teaching medical semiology. This was an exploratory and experimental study with a mixed qualitative-quantitative approach, approved by an Ethics Committee, involving medical students who had completed Semiology I. The project was conducted in two stages: creation of a pilot VP using the ChatGPT API, grounded in updated clinical guidelines; and development of the original VP (SimHarvey) on its own platform. The methodological approach consisted of a nine-item Likert questionnaire assessment, with descriptive and non parametric inferential statistical analyses. A total of 118 students participated, with high tool acceptance and means above 4.0/5.0 for satisfaction, utility in clinical examination training, learning, confidence, and recommendation. No significant differences were found regarding sex or academic stage, and the overall perception was significantly above the neutral point (p<0.001). The findings indicated that the AI-based VP favored clinical reasoning, anamnesis organization, and the simulation of diverse clinical scenarios, corroborating the literature on virtual patients as effective and accessible educational strategies. SimHarvey proved to be a low-cost, well-accepted tool with relevant potential to complement medical training, without replacing real clinical practice, being especially useful in contexts with structural constraints.
The Potential of Serum Tenascin-C as a Biomarker of Severity and Progression in Coronary Artery Disease: a Narrative Review
Tenascin-C (TNC) is an extracellular matrix glycoprotein whose expression in adults is associated with inflammatory and vascular remodeling processes, such as atherosclerosis. This exploratory narrative review resulted in the inclusion of studies that evaluated the association between serum TNC levels and the severity of Coronary Artery Disease (CAD). The findings indicate that TNC levels above 89.48 ng/mL exhibit a sensitivity of 86.4% and a specificity of 77.6% for identifying the presence of CAD, whereas values above 100.91 ng/mL are predictors of complex and severe coronary lesions (Gensini Score). It is concluded that serum TNC is a promising marker for risk stratification and monitoring of CAD progression, although its standardization in clinical practice requires validation in larger cohort studies.
School survey with adolescents: design, operationalization, and participant profile
This study aimed to describe the design, operationalization, and general characteristics of participants of a school-based survey entitled the ‘Adolescent Health’ study, conducted in 2023 with a representative sample of adolescents aged 10 to 15 years enrolled in public schools of a municipality with high human development in southern Brazil. The sample was randomly selected by double cluster (schools and classes). All students from the selected classes were invited to participate. Demographic data were extracted from school records; socioeconomic and food insecurity data were answered by parents or guardians. Anthropometric and body composition measurements, sexual maturation, dietary intake, physical activity, sedentary behavior, oral health indicators, and scales for alexithymia, binge eating disorder, and quality of life perception were collected from the adolescents. A total of 675 students participated in the study. The adherence rate was 43.32%, ranging from 37.13% to 47.27% depending on the school. There was a predominance of female sex, age group of 10 to 12 years, self-reported White race/ethnicity, fifth-grade students, and morning shift. Most families had up to five residents per household and a per capita income between half and one minimum wage. This is the first school-based survey to assess multiple indicators in a representative sample of adolescents from the municipal education system of a city in the interior of southern Brazil, providing subsidies for conducting future school-based surveys on adolescent health.
Effect of conventional proprioceptive training versus exergames on plantar pressure distribution in older women
The present study aimed to evaluate and compare the effects of conventional proprioceptive training and exergame-based training on plantar pressure distribution in older women. This was a randomized controlled clinical trial with 50 older women randomized into three groups: conventional proprioception (n = 17), exergames (n = 16), and control (n = 17). Participants underwent 24 intervention sessions, three times per week, over eight weeks. The conventional proprioception group performed exercises involving gait, balance, and proprioception in the form of a circuit. The exergame group performed exercises using the Microsoft® Xbox Kinect One video game console. Plantar pressure distribution was assessed using the Footwork Pro® electronic baropodometer (Arkipelago). Both conventional proprioceptive training and exergame-based training positively influenced plantar pressure distribution in older women compared to the control group. Both interventions may promote improvement in plantar pressure distribution in older women.
Clinical outcomes of the comprehensive medication management services offered to patients with rheumatoid arthritis
The treatment of rheumatoid arthritis (RA) requires a complex and high-cost pharmacotherapy, to which patients exhibit low persistence rates. In this context, offering the comprehensive medication management (CMM) service to individuals with RA is an important initiative to address their pharmacotherapeutic needs and, thereby, optimize their health outcomes. Therefore, the present study aimed to evaluate the clinical outcomes of the CMM service provided to RA patients in a rheumatology outpatient clinic. To this end, a quasi-experimental study was conducted with a single group of RA patients enrolled in an CMM service. Drug therapy problem (DTPs) identified and resolved were described. McNemar’s test was employed to compare the proportions of patients within and outside the therapeutic target for RA control before and after the intervention. A total of 50 patients with RA were evaluated. There was a significant increase in the proportion of individuals presenting controlled RA at the last visit compared to the first visit (p = 0.0143). Thus, the present study indicates that the offered CMM service was effective, demonstrating the potential to contribute to achieving RA control.
Multidisciplinary care for ICU-Acquired Weakness in Adults: a scoping review
This scoping review aimed to map evidence on multiprofessional care recommendations and protocols for adults with ICU-acquired weakness (ICU-AW), identifying practices and gaps in the literature. The review was conducted in accordance with the methodological recommendations of the Joanna Briggs Institute and reported following the PRISMA-ScR checklist. The search was performed in March 2025 in the MEDLINE/PubMed, BVS, Scopus, Web of Science, and Cochrane Library databases, using DeCS/MeSH descriptors combined with free-text terms. Original articles, reviews, and clinical guidelines published from 2020 onwards, in English, Portuguese, or Spanish, were included. A total of 734 records were identified, of which 373 remained after duplicate removal. Following screening and full text reading, 17 studies were included. The findings indicate the use of strategies such as early mobilization, neuromuscular electrical stimulation, and multiprofessional care organization in the management of ICU-AW. Heterogeneity among interventions was observed, as well as the absence of widely standardized and integrated protocols in the intensive care context. It is concluded that, although different strategies are described in the literature, gaps persist regarding the standardization and integration of multiprofessional care, highlighting the need for studies that support the consolidation of more consistent recommendations for clinical practice.
Hospitalizations for respiratory diseases in childhood in Brazil and Guinea-Bissau: an integrative review
Primary health care practices in child health, such as nutrition, immunization, care for prevalent diseases, prenatal care, and family planning, are determinants of childhood morbidity. This study aimed to identify evidence related to hospital admissions for respiratory diseases in children in Brazil and Guinea-Bissau. This is an integrative review study, with data collection conducted from July to October 2023 in the LILACS, PubMed, and SciELO databases. A total of 840 articles were identified, of which 30 were selected for evidence analysis. There was a predominance of articles from the field of Medicine, published between 2015 and 2022, all from Brazil, with a higher prevalence of level 4 evidence. The main determinants associated with pediatric respiratory hospitalizations were related to sanitary conditions, socioeconomic vulnerability, low educational attainment of caregivers, distance from health services, low adherence to immunization, and exposure to air pollution. It is concluded that hospital admissions for respiratory diseases are, for the most part, influenced by controllable factors intrinsically associated with access to health services. In-service education for professionals, improvements in access, and early identification of respiratory conditions, in addition to health education for family members and caregivers, may contribute to reducing hospitalizations.
Protective and risk pathways between religiosity and early maladaptive schemas in adolescent mental health
Religiosity may be linked to psychological functioning, particularly in terms of coping strategies, emotional regulation and the development of cognitive-behavioural patterns. This study examined the relationship between dimensions of religiosity and early maladaptive schemas (EMS) using a quantitative, cross-sectional, descriptive-correlational design. The study involved 360 secondary school students from an educational institution in southern Peru, with a mean age of 15.6 years (SD = 1.05), selected using purposive non-probabilistic sampling. The Young Schema Questionnaire–Short Form (YSQ-SF) and the Age Universal I-E 12 Scale were used. Analyses were conducted using Spearman’s rho. Intrinsic religiosity was negatively correlated with vulnerability to harm and illness (ρ = -0.452; p < 0.001) and entitlement/ grandiosity (ρ = -0.151; p = 0.004), but not with abandonment (ρ = -0.095; p = 0.071). Extrinsic-social religiosity was positively associated with insufficient self-control/discipline (ρ = 0.220; p < 0.001), self-sacrifice (ρ = 0.240; p < 0.001), inflexible standards 2 (ρ = 0.153; p = 0.004) and emotional inhibition (ρ = 0.113; p = 0.032), and negatively with vulnerability to harm and illness (ρ = -0.206; p < 0.001). Extrinsic-personal religiosity was negatively correlated with mistrust/abuse (ρ = -0.114; p = 0.031), vulnerability to harm and illness (ρ = -0.220; p < 0.001) and inflexible standards 1 (ρ = -0.121; p = 0.022), and positively with self-sacrifice (ρ = 0.133; p = 0.011). These findings suggest that religiosity is differentially related to certain EMS, although due to the cross-sectional design it is not possible to establish causal relationships. It is recommended that religiosity be considered as a contextual factor in psychological assessment and educational guidance programmes.
Technoaddiction and insomnia in female secondary school students in Peru
Insomnia is an increasingly prevalent sleep disorder in adolescents, and is progressively associated with the intensive use of digital technologies. The objective of this study was to determine the influence of technoaddiction on insomnia in secondary school students in Peru. A non-experimental, cross-sectional, explanatory design was employed, with a sample of 528 female students aged 12 to 17 years from an educational institution in Tacna, Peru. Two validated instruments were administered: the Technoaddiction Scale and the Athens Insomnia Scale. The results showed that 46.97% of participants presented techno-addiction and 60.61% presented insomnia. Logistic regression analysis demonstrated that technoaddiction is significantly associated with overall insomnia (p = 0.002; Exp(B) = 1.768), nocturnal symptoms (p < 0.001; Exp(B) = 1.983), and daytime impact (p < 0.001; Exp(B) = 2.111), but not with awakening problems (p = 0.286). These findings support theories such as the hyperarousal theory and the instant gratification theory, which explain how compulsive use of technological devices affects sleep quality. It is concluded that technoaddiction constitutes an important risk factor for insomnia in adolescents, particularly regarding difficulties initiating sleep and deterioration of daytime functioning. The implementation of preventive strategies in the field of educational psychology is recommended, as well as school policies aimed at regulating technology use during nighttime hours.
Home care for older adults: characterization of care in Primary Health Care
Brazil faces rapid demographic transition, with an increase in the elderly population and life expectancy. Alongside this, nutritional and epidemiological transitions occur, which are correlated with poor diet and the prevalence of chronic diseases, especially in older adults. This transition – marked by population aging – underscores the need for primary care for these individuals. In this context, home care (HC) is defined as a set of actions and services aimed at health promotion, providing users with continuous access to health care, especially the most vulnerable, such as older adults. Although HC represents a significant strategy for a humanized approach, the establishment of bonds, and access to services, there remains a scarcity of scientific evidence on care provided to the elderly population requiring home care. This study aimed to characterize home care provided to older adults in a medium-sized municipality in the interior of São Paulo, describing the sociodemographic profile of this population, the prevalence and types of morbidities, the main procedures performed within the scope of home care, the professional category responsible for care, and the duration of follow-up. A data survey was conducted from 2022 to 2024, using the medical records of older adults (n=106) attended by HC in primary health care across 8 Family Health Strategy units. Data analysis was performed using descriptive statistics. Regarding the sociodemographic profile, the mean age of older adults was 78.6 years, with a prevalence of female individuals (63.9%). Regarding the most frequent morbidity, arterial hypertension affected the largest number of patients, reaching 81.1%. In terms of care delivery, nurses predominated with 53.6% of total visits. Among medical visits, the most prevalent procedures were the general health examination (35.3%) and blood pressure measurement (28.1%). Among dental visits, the most performed procedure was oral hygiene guidance, reaching 47.8% of visits. It is concluded that home care for older adults is marked by female predominance and chronic diseases such as hypertension and diabetes. Nurses and physicians were the primary professionals responsible for care, while dental practice was punctual and preventive. The long duration of follow-up reflects the complexity of the conditions treated.
Depression, anxiety, and stress: a mental health overview in university students
The university stage entails academic and psychosocial demands that may affect students’ emotional balance and academic continuity. In this context, depression, anxiety, and psychological stress are frequent problems requiring institutional monitoring. The study aimed to assess depression, anxiety, and stress in a sample of Peruvian university students and to identify their association with sex, age, and employment status. A quantitative, non-experimental, cross-sectional study was conducted with 381 students of both sexes. The DASS-21 Scale, with adequate psychometric properties, was applied to assess the variables. Associations were analyzed using the Chi-Square test and Cramer’s V coefficient, as well as the correlations among the three variables using Spearman’s rho coefficient. More than half of the students presented no symptoms, particularly regarding anxiety (55.1%), followed by stress (43.3%) and depression (40.7%). Mild and moderate levels predominated, while severe cases were infrequent. Significant associations were found between depression and sex and age, anxiety and age, and stress and sex and age (p<0.05). Furthermore, all three variables showed positive and strong correlations with one another (p<0.01). It is concluded that depression, anxiety, and stress are prevalent among university students, predominantly at mild and moderate levels, although severe cases persist. These conditions are associated with sex and age and are interrelated, underscoring the need for preventive actions in the university context.
Senotherapy: scientific advances and clinical potential of senolytic therapies
Senotherapy represents an emerging therapeutic approach to combat deleterious senescent cells, whose pro-inflammatory accumulation contributes to various aging-associated pathologies. This study aimed to analyze and systematize recent scientific advances in senotherapy, with emphasis on senolytic therapies, their innovations, and clinical potential. An integrative literature review was conducted covering the period from January 2019 to June 2025, carried out across four databases: SciELO, PubMed, ScienceDirect, and Web of Science, following PRISMA 2020 guidelines for the identification, screening, eligibility, and inclusion stages. Fifteen articles were selected from a total of 113 identified publications, with a predominance of preclinical evidence (13 of the 15 studies were restricted to in vitro or in vivo designs) and only two compounds referenced in preliminary clinical trials. The results evidence a rapidly expanding field, with a peak of scientific productivity in 2024, revealing that senolytic therapies predominantly target the modulation of anti-apoptotic pathways – such as the Bcl-2 protein family and the PI3K/AKT/mTOR pathway. Agents such as the dasatinib and quercetin combination, fisetin, and navitoclax demonstrated preclinical efficacy in models of neurodegenerative diseases, metabolic disorders, musculoskeletal and cardiovascular conditions, and in stem cell preservation. However, significant challenges persist, including on-target toxicity (e.g., navitoclax-induced thrombocytopenia), contextual heterogeneity of response across tissues and age groups, and the absence of fully validated non-invasive biomarkers in all analyzed studies for quantifying the senescent burden and monitoring therapeutic efficacy. It is concluded that senotherapy represents a promising frontier, but its clinical consolidation requires articulated advances in safety, specificity, patient stratification, and standardization, in order to translate preclinical potential into effective applications in aging medicine.
Construction and validation of an educational checklist for teaching nursing care in labor and birth
This study aimed to construct and validate an educational checklist oriented toward teaching nursing care in labor and birth. This is a methodological study grounded in the Checklist Development Checklist, developed in four stages: instrument elaboration, content review, validation by specialists and the target population, and pilot testing. Thirty-two obstetric nursing specialists participated in the content validity stage, and 30 undergraduate students participated in the appearance assessment. A minimum agreement index of 80% was adopted, along with the exact binomial test for reliability analysis and the Intraclass Correlation Coefficient to verify consistency among evaluators. The results evidenced an overall agreement index of 97.4% among specialists and 99.1% among students. In the pilot test, the overall index was 98.9% in the laboratory setting and 100% in a real clinical scenario, indicating high instrument reliability. It is concluded that the checklist presented evidence of content and appearance validity, proving to be a promising tool for qualifying the teaching of nursing care in labor and birth.
Izabela Cristina Fernandes do Nascimento
Perspectives on the use of generative artificial intelligence ChatGPT and its relationship with academic training in university students
The lack of regulation and guidance on the use of generative artificial intelligence (AI) ChatGPT in academic training may generate cognitive dependency, affecting the development of students’ critical thinking. The objective of this study was to determine the relationship between perspectives on the use of generative artificial intelligence ChatGPT and the academic training of university students at the Faculty of Educational Sciences (FCEDUC) of the Universidad Nacional del Altiplano de Puno (UNAP), in 2025. The methodology adopted was characterized by a quantitative approach, non-experimental in nature, with a cross-sectional correlational design. The study involved 341 students with a mean age of 21 years, enrolled between the 1st and 10th semesters of the FCEDUC. Data collection employed the survey technique (questionnaire-based survey), using as instruments a questionnaire on the use of generative AI ChatGPT and another on students’ academic training. The results indicated a correlation coefficient of r = 0.258**, evidencing a positive and significant correlation between the use of generative AI ChatGPT and the academic training of university students, with p < 0.01. This suggests that the greater the use of generative AI ChatGPT tools, the greater the tendency toward improvement in aspects related to academic training.
Intra/interobserver agreement of proximal humeral fracture classification systems
This study assessed the inter- and intraobserver agreement of the NEER, LEGO/HERTEL, AO/OTA, and MAYO-FJD classification systems for proximal humeral fractures. Five evaluators — a first-year resident (R1), a second-year resident (R2), a third-year resident (R3), an orthopedic surgeon (Ortho), and a shoulder surgery specialist (Spec.) – assessed 50 radiographs of patients with proximal humeral fractures at two time points (T1 and T2). Cohen’s and Fleiss’s Kappa coefficients were used for statistical analysis. Regarding interobserver agreement, the NEER system at T1 and T2 (κ=0.444 and κ=0.496) demonstrated moderate agreement. The LEGO/HERTEL system at T1 and T2 (κ=0.376 and κ=0.387), the AO/OTA system at T1 and T2 (κ=0.269 and κ=0.223), and the MAYO-FJD system at T1 and T2 (κ=0.367 and κ=0.300) demonstrated low agreement. Moderate intraobserver agreement was observed for the NEER system. The LEGO/ HERTEL system showed substantial agreement with κ=0.528 (R1) and near-perfect agreement with κ=0.867 (Spec.). For the AO/OTA system, Kappa values ranged from 0.347 (R1) to 0.793 (R3), oscillating between low and substantial. The MAYO-FJD system presented the lowest agreement (κ=0.154 [R1] to κ=0.665 [Spec.]). It is concluded that regarding interobserver agreement, the NEER system achieved a moderate result. Regarding intraobserver agreement, more experienced evaluators demonstrated greater consistency compared to residents.
Inclusion of a companion in the operating room for cesarean delivery: a synthesis of evidence
The companion of the pregnant woman is the person chosen by the woman to remain by her side throughout the entire childbirth process. The objective of this study was to synthesize the evidence addressing recommendations for companions present in the operating room during cesarean delivery. This is a systematic review that followed the guidelines established by the instrument “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA) and sought to answer the question: “What is the current state of the art regarding recommendations for including companions of women in labor during cesarean section?”. The review retrieved 236 publications and included 21 of them. The most prevalent profile of companions present during cesarean delivery was that of an adult individual, male, the baby’s father, the woman’s partner, and with completed secondary education. One of the main recommendations directed to companions was to attend educational activities offered during prenatal care, in order to acquire knowledge about the parturition process, including the use of non-pharmacological techniques for pain relief. The reviewed literature indicates that companions should participate in educational activities during prenatal care, an approach that improves maternal experience and contributes to the humanization of childbirth. The integration of companions in cesarean delivery requires the implementation of institutional protocols, training for healthcare professionals, and structural adaptations of health services.
Construction of an e-book to promote executive functions in early childhood through an intersectoral approach
Play, recognized as the language of childhood, constitutes an essential strategy for comprehensive development. This study aimed to identify and analyze strategies, programs, and digital materials related to play that promote the development of executive functions in early childhood, in order to develop an e-book aimed at professionals working in an intersectoral manner. This is a qualitative, descriptive, and exploratory study, grounded in documentary analysis of municipal plans in Education, Health, and Social Assistance, as well as digital curation from five information sources. Thematic content analysis and the SSS technique (Seek, Sense, Share) were applied, based on executive functions: working memory, inhibitory control, and cognitive flexibility. The results show that digital materials highlight the importance of play for the development of the main executive functions. However, specific information by age group is lacking, and intersectoral actions remain fragmented. As an applied technical product, the e-book “The Power of Play in Child Development” was developed, aimed at health, education, and social assistance professionals, as well as parents and caregivers. It was concluded that the e-book has the potential to encourage intentional play to promote comprehensive child development and to valorize the intersectoral perspective in the stimulation of executive functions.
Interprofessionality in indigenous areas: enhancing and strengthening the role of health surveillance
Indigenous Health Care in Brazil encompasses 391 peoples, with broad cultural diversity and structural and educational challenges for interprofessional work. This study aims to reflect on the obstacles, potentialities, and propositions for strengthening interprofessionality within the Indigenous Health Care Subsystem (SasiSUS). This is a critical-reflexive essay, grounded in the professional experience of the authors and in the literature pertinent to indigenous health and interprofessionality. We identified barriers such as insufficient numbers of qualified professionals, uniprofessional training, high staff turnover, care gaps, and the absence of specific protocols. We propose the strengthening of the health surveillance model, which includes the expanded clinical practice approach, the valorization of ongoing intercultural educational processes, and the co-constructed collaborative spaces between biomedical and indigenous knowledge systems. The integration and consolidation of an effective health surveillance model requires technical, cultural, and communicational competencies, shared therapeutic planning, and respect for diversity. Continuous educational processes – both face-to-face and distance based – can expand collaborative capacities and overcome fragmentation in care. Interprofessionality within SasiSUS depends on curricular changes, active methodological strategies, collaborative practices, and the urgent need to strengthen and sustain the model of territoriality and health surveillance, supported by ethics, interculturality, and co-responsibility, aiming at greater problem-solving capacity and quality of care.
Gene drive technologies and global health: a bioethical framework for vector control in contexts of inequality
Vector-borne diseases remain a major global health burden, with dengue reaching 14.6 million cases and malaria causing nearly 600,000 deaths in 2024, disproportionately affecting populations in the Global South. Gene drive technologies based on CRISPR-Cas9 have emerged as a disruptive approach to vector control, yet their governance is marked by regulatory and epistemic asymmetries. This study aims to formulate an integrative bioethical framework from which operational criteria can be derived for regulating gene drive technologies in contexts of epidemiological urgency. A theoretical-normative methodology was applied, integrating epidemiological evidence with critical bioethics, decolonial epistemology, and international biosafety law. The analysis develops a framework that combines responsibility ethics with epistemic sovereignty, from which a matrix of distributive justice indicators and community consultation protocols is derived for regulatory application in the Global South. The findings indicate that existing regulatory instruments, particularly the Cartagena Protocol, present limitations in addressing irreversibility, transboundary risks, and liability. The proposed framework provides a structured approach to incorporate precaution, justice, and procedural legitimacy into decision-making processes. These results suggest that effective governance of gene drive technologies requires integrating scientific assessment with socially grounded criteria, contributing to more robust and context-sensitive regulatory practices in global health.
Telepharmacy at hospital discharge: pharmaceutical practice in dehospitalization – a pilot study
Home Care (HC) is a modality of health care within the Unified Health System (SUS) that enables the continuity of treatment at home. The pharmacist’s participation in HC aims to ensure the rational use of medications, optimize treatment adherence, and identify, prevent, and minimize drug-related problems. This pilot study aimed to structure the actions of pharmaceutical services to meet the demands of the Home Care Area (ADOMI) of the Instituto Nacional de Traumatologia e Ortopedia, located in the municipality of Rio de Janeiro, Brazil. This is a longitudinal pilot study with a quantitative approach, conducted between June and October 2025. A total of 22 participants with an active registration in the institution’s home care area who met at least two of the following criteria were included: use of four or more medications, presence of associated comorbidities, and/or presentation of adverse drug reactions during the hospitalization period. Data collection was carried out using a semi-structured questionnaire administered individually to participants at the moment immediately prior to hospital discharge, followed by telemonitoring after 15 days, and through analysis of the electronic medical records. The results may suggest the relevance of pharmaceutical practice in care transitions, with emphasis on the identification of 55 drug-related problems. It is suggested that the pharmacist’s inclusion in home care may contribute to patient safety during care transitions, potentially qualifying multiprofessional care and strengthening the integrality of health care. Keywords Home Care Services; Pharmaceutical Services; Medication Reconciliation; Drug-Related Side Effects and Adverse Reactions; Remote Patient Monitoring.
Criteria used by nutritionists for menu planning in early childhood education in the municipal education network of the state of Rio Grande do Sul
This study aimed to analyze the criteria used by nutritionists in menu planning for daycare centers and preschools in the municipal education network of Rio Grande do Sul. Thirty-eight municipalities participated, with 84% of respondents being nutritionists serving as technical managers for the PNAE. The most influential planning criteria were: PNAE guidelines (81.6%), food acceptance by students (44.7%), and nutritional composition of foods (36.8%). It was observed that more than half of the municipalities calculate macronutrients and micronutrients, and there is broad inclusion of regional preparations and family-farm produce, promoting healthy eating habits and cultural valorization. However, only half of the municipalities offer special menus for specific dietary needs, revealing inequalities in policy implementation. The results reinforce the importance of the nutritionist’s role in integrating legislation, food practices, and school reality, ensuring healthy, safe, and culturally appropriate meals.
Cytogenetic alterations associated with occupational exposure to ionizing radiation in radiology technicians: a systematic review
Occupational exposure to ionizing radiation represents a relevant physical hazard for radiology technicians and radiological service workers, potentially inducing measurable cytogenetic damage even in low-dose scenarios. The objective of this study was to synthesize recent evidence on cytogenetic alterations associated with occupational exposure to ionizing radiation in radiology professionals, identifying the most frequently altered biomarkers and their relationship with dosimetry, work sector, and individual characteristics. This is a systematic review conducted in accordance with PRISMA 2020 guidelines. Observational studies with primary human data, a non-exposed control group, and quantitative assessment of cytogenetic biomarkers were included. Five studies published between 2021 and 2025, involving more than 2,600 participants, met the eligibility criteria. The included studies reported higher frequencies of cytogenetic damage in exposed workers compared to controls, particularly for micronuclei, nucleoplasmic bridges, nuclear buds, dicentrics, and structural chromosomal aberrations. The magnitude of the findings varied according to the biomarker used, the type of radiological technology, the occupational sector, and confounding factors such as age, sex, and smoking. The correlation between individual dosimetry and biological damage was heterogeneous. It is concluded that occupationally exposed radiology professionals constitute a relevant group for cytogenetic surveillance, and that biodosimetry may complement physical dosimetry in occupational monitoring programs.
Multiprofessional collaboration in recognizing situations of violence in public emergency services: limits to interprofessionality
Interprofessional collaboration constitutes an essential strategy for comprehensive care in urgency and emergency services, especially in recognizing situations of violence, which are frequently veiled and underreported in daily hospital routine. The objective was to analyze the verbalizations of the multiprofessional team regarding collaborative practices in recognizing different situations of violence identified within the context of care at a tertiary public emergency service in Ceará. A qualitative study was conducted in a public tertiary referral hospital for cardiopulmonary care. A total of 34 health professionals selected through the snowball sampling technique participated. Data were generated through semi-structured interviews between May and July 2025 and subjected to thematic content analysis. Participants reported sporadic collaborative efforts, albeit with a predominance of fragmented multiprofessional performance. Communication, reception, and qualified listening were highlighted as central elements to identify situations of violence, even though frequently recognized in an implicit and silenced manner. Work overload, absence of protocols, structural limitations, and insufficient training were identified as the main barriers to the consolidation of interprofessional practices. Findings reveal a gap between the ideal of interprofessionality and the concrete organization of work, contributing to the institutional invisibility of violence in emergency services. The recognition of violence remains supported by individual initiatives and informal workflows. Consolidation of interprofessionality requires reviewing care workflows, strengthening cross-category communication, and investing in permanent education to enhance care and reduce underreporting in highly complex health services.
Factors associated with body image dissatisfaction among medical students: a cross-sectional study
Body image is a multidimensional construct influenced by sociocultural, behavioral, and psychological factors, with body image dissatisfaction being frequent among university students, particularly medical students. This study aimed to evaluate the association between body image dissatisfaction and sociodemographic, behavioral, and psychological factors, with emphasis on social media use, physical activity practice, and burnout syndrome. This was an observational, cross-sectional, quantitative study conducted with medical students from a private institution in the interior of the state of Rio de Janeiro. Body image dissatisfaction was assessed using the Body Shape Questionnaire (BSQ) and burnout using the Burnout Syndrome Assessment Scale for University Students (ESB-eu). Descriptive and inferential analyses were performed, including chi-squared test, Student’s t-test, ANOVA, multiple linear regression, and binary logistic regression, adopting a significance level of 5%. The prevalence of body image distortion was approximately 25%. Significant associations were observed between body image distortion and sex, physical activity practice, social media usage time, and burnout. In the logistic regression, greater social media usage time increased the odds of distortion by 40%, while the presence of burnout increased the odds approximately 4.68-fold. It is concluded that body image dissatisfaction was primarily associated with behavioral and psychological factors, highlighting the importance of mental health promotion strategies in the university environment.
Luana Maragoni Alves de Almeida Cassimiro
Essential knowledge for self-care in cardiovascular rehabilitation: an integrative review
Self-care in cardiovascular rehabilitation (CR) is an essential factor for promoting patient autonomy and is strongly influenced by the level of knowledge that patients possess. This study aimed to identify the essential self-care knowledge addressed by nursing in the context of CR. This is an integrative review conducted between April and September 2024, in six stages. Data collection was performed across five databases by two independent researchers. A total of 146 studies were selected, derived from research conducted in 42 different countries. The cardiovascular conditions most frequently addressed in the studies were heart failure, acute myocardial infarction, and coronary artery disease. Among the identified categories of essential knowledge are: health status self-monitoring; understanding of CR and one’s own disease; supervised and unsupervised physical exercise; healthy diet; and understanding of the need for family, social, and professional support. The collected information may support the development of educational technologies or clinical approaches for the promotion of self-care in CR from a nursing perspective.
Parental dietary intake predicts fruit consumption among preschool children
The promotion of adequate and healthy eating in childhood constitutes a central strategy of public health policies, with schools representing a privileged setting for the formation of dietary habits. During the preschool period, eating behavior is strongly influenced by the family and school environments, particularly with regard to the consumption of fruits, vegetables, and legumes. This study aimed to identify the determining factors associated with the consumption of these foods among preschool children enrolled in a public school in the municipality of São Paulo, SP, Brazil. This was a cross-sectional study conducted with 72 preschool children and their respective parents. Dietary intake was assessed using an adapted food frequency questionnaire, and sociodemographic characteristics were obtained through a structured questionnaire. The fruits most frequently consumed by the children were banana, apple, and orange, with patterns similar to those observed among parents, whereas foods such as kiwi, escarole, and watercress showed low intake in both groups. A positive association was observed between children’s consumption of fruits, vegetables, and legumes and parental consumption, regardless of sociodemographic characteristics, as well as an association with the number of meals consumed in the school environment. It is concluded that both the family and school environments exert a direct influence on preschoolers’ eating habits, reinforcing the need for food and nutrition education actions aimed at expanding dietary variety from the earliest years of life.
Memories and social representations of COVID-19: fear and its repercussions in the daily lives of older adults
Studying Social Representations (SR) and the memories of older adults in contexts of adversity, such as the COVID-19 pandemic, is relevant, as such representations influence individual thought and behavior, impacting their ways of caring for health and living in society. From this perspective, the present study aimed to understand the memories and SR of older adults regarding the repercussions of COVID-19 in their daily lives. This is an exploratory, descriptive study with a qualitative approach, theoretically grounded in the Theory of Social Representations. The study was conducted in a Primary Health Care Unit in a municipality in the interior of Bahia, Brazil, with 22 older adults with preserved communication and cognition. Data were collected through a sociodemographic questionnaire and semi structured interview and analyzed using the Iramuteq software for coding and Bardin’s content analysis. A predominance of women was observed (82.0%), aged between 60 and 75 years (54.5%), without a partner (54.5%), with declared religion (100.0%), living with family members (63.6%), and with low schooling (77.3%). Textual analysis revealed the category “Fear as the structuring core of the social representations of the pandemic”. Fear was related to the risk of illness and death, social distancing, changes in care practices and ambivalences surrounding vaccination. The narratives indicate that such perceptions influenced protective behaviors, isolation and reconfiguration of social relationships, with repercussions that, in some cases, remain in the post-pandemic period. It is concluded that fear constituted an organizing element of the memories and SR of older adults about the pandemic, highlighting the importance of communication and care strategies sensitive to subjective dimensions in contexts of health crises.
Influential factors in the consumption of non-recommended foods among education undergraduate students
This study addresses the concerning global problem of low physical activity among adolescents, which affects approximately 80% of this population and generates a substantial economic burden on public health systems. The aim was to assess how dietary habits, physical activity, and excessive internet use predict the consumption of non-recommended foods among undergraduate students from the Faculty of Education Sciences at the Universidad Nacional del Altiplano de Puno. Using a quantitative, non-experimental, and explanatory design, data were collected from 563 students through a validated questionnaire with a Cronbach’s alpha of 0.92. Data were analyzed using multiple linear regression and Pearson’s correlation, identifying three significant variables influencing the consumption of non recommended foods: eating behavior (β = −0.105; p < 0.001), internet use (β = 0.130; p < 0.05), and gender (β = 0.204; p < 0.001). These findings demonstrate that healthy dietary practices, the digital environment, and gender differences play a crucial role in eating behavior. In conclusion, the results suggest that, to promote healthy eating and reduce the consumption of non-recommended products, it is essential to develop comprehensive strategies that include improving dietary habits, regulating the time spent and content consumed on the internet, and considering gender differences, in order to optimize the effectiveness of interventions among the university population, thereby contributing to the prevention of diet-related diseases and the promotion of public health.
Pharmacoepidemiological profile of patients treated at a teaching clinic in the brazilian Amazon
Characterizing medication use constitutes a fundamental health indicator, particularly in the context of challenges such as polypharmacy and self-medication. However, populations assisted in teaching clinics remain underinvestigated, despite encompassing diverse profiles and serving as strategic settings for professional training. This study aimed to characterize the therapeutic profile and health-related behaviors of patients treated at a teaching clinic in the Brazilian Amazon. An observational, cross-sectional study was conducted from october 2024 to march 2025 at the Teaching Clinic of the Universidade da Amazônia, Belém, PA, Brazil. A convenience sample included 80 consecutive adults who met the eligibility criteria. Data were collected using a semi-structured questionnaire administered through individual interviews and analyzed using descriptive statistics and chi-square/Fisher’s exact tests. The sample was predominantly female (68.7%), with a mean age of 52.13 ± 17.91 years, and 56.2% reported chronic diseases. A high prevalence of self-medication (60%) and polypharmacy (38.75%) was observed. Self-medication was significantly associated with the presence of chronic diseases (RR = 1.64; p = 0.04) and self-reported adverse drug reactions (RR = 1.93; p = 0.038). No participant demonstrated high therapeutic adherence, with neglect of dosing schedules being the main reason for non-adherence (83.75%). Access to pharmaceutical consultations was low (22.5%), and improper disposal of medications was prevalent (73.75% disposed of medicines in household waste). Integrative and Complementary Practices were used by 57.5% of participants, predominantly phytotherapy (73.9%), without professional guidance. These findings indicate a high-risk pharmacotherapeutic profile characterized by self-medication, polypharmacy, adverse drug reactions, and absence of high therapeutic adherence, associated with limited access to pharmaceutical services. The implementation of pharmaceutical care strategies integrated into the teaching-clinic environment is necessary to optimize pharmacotherapy and enhance evidence-based professional training grounded in local realities.
Infectious keratitis in the Midwest region of Santa Catarina (2013–2024): etiological distribution and predisposing factors
Keratitis ranks among the leading global causes of reduced visual acuity and reversible blindness, affecting patients across all age groups. This study analyzed the etiological profile of infectious keratitis diagnosed at an ophthalmological center in the Midwest region of Santa Catarina, Brazil. Through an 11-year retrospective analysis, 25 samples processed under a rigorous microbiological protocol were evaluated. Culture positivity was observed in 17 (68%) samples. Bacterial etiology predominated in 13 (76.5%) samples, with a higher prevalence of coagulase-negative Staphylococcus (CoNS). Fungal and mixed etiologies each accounted for 2 (11.8%) cases. Regarding the sociodemographic profile, 15 (60%) affected individuals were male, predominantly agricultural workers, with a mean age of 58 years. Agricultural activity was the primary occupation, correlating with the main predisposing factors: ocular trauma and prior surgical interventions. The identified scenario indicates a bacterial profile strongly associated with the occupational context of the region, reinforcing the need for preventive actions focused on ocular health among rural workers.
Control groups in clinical trials of non-pharmacological interventions for cancer pain: a meta-research study
Cancer pain is a common challenge in patients with cancer, arising from tumor progression or adverse effects of treatment. For its management, non-pharmacological interventions have been investigated through randomized controlled trials (RCTs), which require appropriate comparative strategies (placebo or sham) to isolate the effects of the intervention. However, limitations in blinding inherent to this type of intervention may influence the interpretation of results. The objective of this study was to identify the strategies used in the control groups of randomized controlled trials evaluating non-pharmacological interventions for cancer pain. This is a meta-research study (research on how science is produced) conducted in the MEDLINE and LILACS databases, using MeSH/DeCS descriptors and free-text terms related to “Cancer pain” and “Complementary therapies,” with no restrictions on language or year of publication. Non-randomized studies and those involving surgical interventions were excluded. Study selection and data extraction were performed in duplicate. Information on the type of blinding and the strategies used in the control groups was extracted. The search retrieved 311 articles; 52 were included after screening, of which 22 had full-text availability. Of these, 15 were single-blind, 6 were open-label, 1 was described as double-blind, and 12 discussed the impact of performance bias. The most frequently evaluated interventions included acupuncture, therapeutic massage, and music therapy. Control groups varied between usual care, placebo, no intervention, and sham procedures. It is concluded that there is substantial variability in control strategies and that the absence of discussion regarding performance bias may compromise the interpretation of results and clinical decision-making.
Assessment of dietary intake among adolescents with obesity according to the Guia Alimentar para a População Brasileira
Obesity among adolescents is an increasing public health concern, with significant impacts. In this context, Fascicle 5 of the Guia Alimentar para a População Brasileira (GAPB), developed to guide healthy food choices among adolescents, was used as a reference in this study, which aimed to evaluate the dietary intake of adolescents with obesity, as well as to analyze its association with Body Mass Index (BMI). After approval by the Research Ethics Committee, 32 adolescents with obesity, aged between 13 and 19 years, were included. During the nutritional consultation, a 24-hour Dietary Recall (24hDR) was applied and anthropometric assessment (weight and height) was performed, with the data compared to the recommendations of Fascicle 5 of the GAPB. Statistical analysis was conducted using JAMOVI software. Of the 32 adolescents interviewed, 59.38% were female, with a median age of 15.4 years and a median BMI of 36.0 kg/m2. Among the adolescents, 46.88% were classified as having obesity and 53.12% as having severe obesity. A high frequency of consumption of ultra-processed foods (93.75%) and low intake of fruits (15.63%) and vegetables/legumes (43.75%) were observed. Breakfast consumption was reported by 87.50% of adolescents; those who did not consume breakfast had a higher median BMI (40.7 vs. 34.3), although without statistical significance. It was also observed that adolescents who did not consume beans had a significantly higher BMI (p = 0.042), as did those who consumed filled cookies and sweets (p = 0.036) or other ultra-processed foods (p = 0.026). The results indicate an association between the consumption of minimally processed foods, such as beans, and lower BMI values, whereas the intake of ultra-processed foods is associated with increased BMI. Therefore, it is essential to develop programs based on the GAPB that encourage healthy habits from adolescence, contributing to improved nutritional profiles and prevention of diseases in adulthood.
Analysis of health indicators among Brazilian schoolchildren using PeNSE data (2009–2019)
The present study aimed to comparatively analyze health indicators among Brazilian 9th-grade students based on microdata from the National School Health Survey (PeNSE) for the years 2009 and 2019. This is a quantitative, cross-sectional study with a sample of 63,411 students in 2009 and 160,721 in 2019. Variables related to dietary intake, family arrangement, mobile phone use, and maternal education were evaluated. A significant increase was observed in mobile phone ownership (from 73.7% to 86.7%) and in the habit of consuming meals concomitantly with other activities (from 62.2% to 77.5%), a behavior that may be associated with distraction and reduced attention to satiety during meals. An improvement in maternal educational level was identified, along with an increase in the proportion of adolescents living only with their mother (from 31.0% to 37.6%). Conversely, a reduction was observed in the consumption of fruits (from 31.2% to 28.4%), vegetables (from 30.9% to 29.7%), beans (from 61.8% to 53.9%), sweets/confectionery (from 50.3% to 36.2%), and soft drinks (from 36.8% to 19.1%). These findings indicate changes in dietary patterns, characterized by reduced consumption of traditional foods and the persistence of practices associated with the media and digital environment. It is concluded that, despite the reduction in specific ultra-processed foods, dietary behaviors remain influenced by socioeconomic and cultural factors, requiring intersectoral public policies to promote healthy eating and strengthen the actions of the National School Feeding Program (PNAE) and the Dietary Guidelines for the Brazilian Population.
Inflammation and pain: a brief review of mechanisms and therapeutics
Inflammation is a complex immunological response to harmful stimuli such as pathogens, damaged cells, and toxins, playing a fundamental role in host defense and tissue repair. This narrative review selected 41 recent studies addressing the cellular, molecular, and pathophysiological mechanisms of inflammation and its relationship with pain, including lifestyle influences and current and emerging therapeutic strategies. Acute inflammation is characterized by rapid onset, vasodilation, increased vascular permeability, and predominant neutrophil recruitment, with mediators such as prostaglandins, leukotrienes, histamine, bradykinin, and pro-inflammatory cytokines, and may generate systemic manifestations such as peripheral and pulmonary edema. Chronic inflammation results from failure of resolution, with persistent mononuclear infiltrate, tissue remodeling, fibrosis, and activation of the adaptive immune response. Inflammatory pain arises from peripheral sensitization of nociceptors and central activation, mediated by excitatory neurotransmitters, ion channels, and specific receptors, favoring hyperalgesia and chronification. Active resolution, promoted by lipoxins, resolvins, and maresins, modulates inflammation and nociception. Therapeutic interventions include nonsteroidal anti-inflammatory drugs, glucocorticoids, biological therapies, and JAK/STAT inhibitors; however, their adverse effects highlight the need for safer novel approaches. Lifestyle factors such as obesity, chronic stress, and physical inactivity contribute to low-grade inflammation and persistent pain. Understanding these interactions is crucial for the development of integrated strategies that reconcile anti-inflammatory and analgesic efficacy with clinical safety.
The mental health care of healthcare workers: an analysis of knowledge production through a scoping review
Globally, studies have devoted considerable attention to the psychosocial aspects of work and to the ways in which these factors impact healthcare workers across different levels of care. Findings indicate the need for improvements in overall working conditions and in the provision of social support to healthcare professionals, while also highlighting the paradox of illness among professionals whose work objective is the care of themselves and others. The present article was motivated by the psychological demands faced by professionals, including long and intense working hours, professional devaluation, interpersonal conflicts, and emotional overload resulting from patient care. The study aimed to analyze actions and strategies for promotion, prevention, screening, and care in mental health among healthcare professionals. This study consists of a scoping review on the mental health of healthcare professionals, focusing on promotion, prevention, screening, and care, through the identification and presentation of available data in national and international literature. The method proposed by the Joanna Briggs Institute was employed. A total of 1211 articles were identified, of which 157 were included, covering the period from 2007 to 2022. Considering the entire set of articles, 94 studies identified the need for mental and/or physical health interventions with healthcare professionals, among which 60 (63.83%) occurred in disaster and catastrophe contexts. The low number of interventional studies (14.28%) becomes concerning when considering research that demonstrates healthcare workers’ reluctance to seek mental health assistance in the workplace. The importance of interventions during pandemics is highlighted, including support and welcoming approaches, as well as the use of technologies. It is concluded that there is a scarcity of studies prior to 2020 and of intervention-based research aimed at understanding and addressing the impacts on mental health, well-being, and quality of life among healthcare professionals. The use of information technologies is understood to assume particular relevance for future research, as well as for guiding actions in health management.
Perceived stress and self-reported bruxism in peruvian dentists: a cross-sectional occupational health study
Occupational stress represents a growing risk among healthcare professionals, with dentists being particularly exposed to both physical and emotional demands. One of its potential clinical consequences is bruxism, defined as involuntary masticatory muscle activity that may be influenced by psychological factors. This study aimed to determine the relationship between perceived stress and self-reported bruxism in dentists in the city of Puno, Peru, during 2025. A quantitative, cross-sectional, and correlational study was conducted on a sample of 219 participants. The Stress Reactivity Index (IRE-32) and a 15-item self-report bruxism checklist were used to assess the main variables. Results showed that 38.4% of the participants experienced a high level of perceived stress, and 61.6% reported some degree of bruxism, with the mild form being the most frequent (31.9%). Spearman’s correlation analysis showed a strong positive relationship between the two variables (rho = 0.689; p < 0.001), indicating that higher levels of perceived stress are associated with greater severity of self-reported bruxism. These findings suggest a significant mutual association between the two conditions, which should be considered when designing prevention and health promotion strategies targeting the mental and musculoskeletal well-being of dental professionals. Due to the cross-sectional design, these findings should be interpreted as associations rather than causal relationships.
Functional health literacy and associated factors in older adults with type 2 diabetes mellitus
The aim of the present study was to assess functional health literacy (FHL) among older adults with type 2 diabetes mellitus (T2DM) who performed self-monitoring of capillary blood glucose (SMCBG) and to analyze associated sociodemographic and clinical factors. This is an observational, analytical, cross-sectional study conducted with 106 older adults receiving care at health units in Ribeirão Preto, São Paulo, between February and October 2024. A sociodemographic and clinical questionnaire and the Brief Test of Functional Health Literacy in Adults (B-TOFHLA) were used. Descriptive analyses, Pearson’s chi-square or Fisher’s exact tests, and Spearman’s correlation were performed, adopting a significance level of 5%. The mean age was 69.97 years (SD=6.23), with a mean of 8.71 years of schooling (SD=4.49) and a mean monthly family income of R$ 2,833.41 (SD=1,911.38). Regarding FHL, 48.1% of participants had adequate levels, 8.5% borderline, and 43.4% inadequate. A statistically significant association was observed between education level and FHL categories (p<0.001). Positive correlations were also found between the B-TOFHLA score and years of schooling (ρ=0.492; p<0.001) and income (ρ=0.290; p=0.003), as well as a negative correlation with age (ρ=-0.206; p=0.034). Time since T2DM diagnosis was not significantly associated (ρ=0.081; p=0.411). It is concluded that more than half of the participants presented borderline or inadequate FHL, with education level being the main factor associated with performance on the B-TOFHLA. These findings highlight the need for continuous, clear, and tailored educational interventions adapted to the educational and socioeconomic conditions of older adults with T2DM.
Age-adjusted health conditions, frailty, and functionality among older adults in primary care
This study aimed to investigate the relationship between health conditions, frailty, functionality, and age-adjusted scores among older adults receiving primary care services. This is a descriptive exploratory study conducted with 225 older adults enrolled in Primary Care in the municipality of Jequié, Bahia, Brazil. Sociodemographic data, health conditions, functionality, and frailty were assessed using instruments such as the Barthel Index, the Lawton and Brody Scale, and the VES-13. The results showed a higher prevalence of women (65.8%), presence of pain (69.3%), and high levels of functional dependence (99.1% for Instrumental Activities of Daily Living and 76.9% for Basic Activities of Daily Living). After multivariate adjustment, the following associations remained statistically significant: dependence in basic activities of daily living (RP = 1.56; 95%CI = 1.17–2.07; p < 0.01), presence of vulnerability (RP = 1.49; 95%CI = 1.07–2.07; p = 0.02), risk of falls (RP = 2.61; 95%CI = 1.56–4.39; p < 0.001), and depressive symptoms (RP = 1.34; 95%CI = 1.01–1.76; p < 0.04). The findings indicate that the presence of vulnerability, functional dependence in basic activities of daily living, and depressive symptoms are associated with lower age-adjusted scores.
Integral Health in Messina Strait: marine ecosystems, historical collections and human well-being
The benthic ecosystems of the Strait of Messina, Laminaria ochroleuca Bachelot Pylaie 1824 forests and rhodolith beds, play a crucial role in promoting environmental and human health, offering essential Nature’s Contributions to People (NCP), such as climate regulation, food provision, and psychosocial benefits. Complementing these natural systems, the historical Herbarium “A. Pistone” documents the algal seascapes of the late 19th century and offers cultural, aesthetic, and educational values that enhance psychosocial well-being and strengthen emotional memory within local communities. Sustainable practices, such as scuba diving activities, citizen science initiatives, and awareness campaigns, are proposed as “People’s Contributions to Nature” (PCN), expressed through gratitude, empathy, affection, reciprocity, and spirituality. These actions promote mental and physical health by reducing stress, fostering social cohesion, and encouraging active lifestyles, while also supporting nature-based strategies for disease prevention through biodiversity conservation and improved ecosystem integrity. Future research will focus on taxonomic identification of herbarium specimens (using DNA barcoding and morphological analysis), biogeographical and biocoenotic studies, and quantitative assessments of ecosystem services. These analyses are essential to understand how these ecosystems mitigate climate change, reduce environmental health risks, and inform public health policies aimed at integrating ecosystem services into preventive strategies. To strengthen the human–nature relationship and promote integral health, participatory approaches, such as educational workshops, immersive experiences, and collaboration among fishing and mussel-farming communities, local authorities, and schools, are key components of integrated conservation and health promotion frameworks.
Application of Integrative and Complementary Practices in children by physical therapists: a scoping review
This study aimed to identify, synthesize, and analyze the available scientific knowledge on the use of integrative and complementary practices in pediatric physical therapy. A scoping review was conducted, with searches performed in the National Library of Medicine, SciVerse Scopus, Embase, Web of Science, and the Regional Portal of the BVS MTCI Americas, using specific descriptors defined based on the guiding question: “How have Integrative and Complementary Practices regulated by the Federal Council of Physical Therapy and Occupational Therapy been used in children within physical therapy?”. A total of 3,026 studies were identified, of which 43 comprised the final sample. The results indicated that most studies addressed manual therapies applied to specific pediatric conditions, with evidence of effectiveness and good acceptance. The most frequently used practices included body-based, manual, and meditative interventions, such as dance therapy, craniosacral therapy, and manual therapy, as well as approaches from Traditional Chinese Medicine, such as acupuncture and auriculotherapy, chiropractic, and osteopathy. It is concluded that Integrative and Complementary Practices have been widely incorporated into pediatric physical therapy treatment, demonstrating proven effectiveness and positive acceptance across different clinical settings.
Renal complications in eating disorders with metabolic risk factors: a systematic review
Bulimia nervosa can have serious physiological and psychological effects in obese patients. Electrolyte disturbances, dehydration, and metabolic burden caused by bulimia nervosa can cause kidney injury. Furthermore, obesity, as an independent risk factor for kidney disease, may exacerbate renal complications in this population. The aim of the present systematic review was to evaluate renal disorders in patients with bulimia nervosa, with particular focus on obese individuals. A total of ten studies (including case reports and observational studies) published between 2001 and 2024 in PubMed, Scopus, Web of Science, and Cochrane Library were included. The results suggest that the most common pathway of renal injury in bulimia nervosa is chronic hypokalemia and dehydration, which may lead to hypokalemic nephropathy, tubulointerstitial nephritis, and acute or chronic kidney injury. Electrolyte and acid-base disturbances, along with decreased renal function, are frequent, and the risk of chronic kidney disease may be higher in obese patients. Limitations of the available evidence include the predominance of case reports and small observational studies, which restrict generalizability and preclude definitive causal conclusions. These findings highlight the need for cautious clinical monitoring, early renal assessment, and consideration of obesity as a compounding factor in managing patients with bulimia nervosa.
Nutritional profile, working conditions, and musculoskeletal pain among workers in Food and Nutrition Units in Pelotas (RS)
Food and Nutrition Units are characterized by demanding and physically strenuous work, involving repetitive movements, manual handling of loads, and limited conditions of lighting, temperature, and excessive noise. It is important to assess whether these conditions influence workers’ health. Accordingly, this study aimed to analyze dietary intake, nutritional status, and working conditions related to ergonomic aspects among workers from three Food and Nutrition Units in the city of Pelotas, Brazil. This was a cross-sectional, quantitative study using questionnaires to assess dietary intake and environmental conditions, as well as anthropometric measurements (body weight, height, and waist circumference) for nutritional classification based on body mass index (BMI). In Unit A, a higher prevalence of overweight was observed, exceeding the number of eutrophic individuals. Most participants presented altered waist circumference, indicating risk for metabolic syndrome. A total of 19 employees participated; more than half reported engaging in physical activity, with Unit C showing the highest proportion. Regarding the consumption of fresh or minimally processed foods, all workers from Unit B reported daily intake, whereas Unit C showed the lowest consumption. Only in Unit A was there a report of water intake exceeding two liters per day. Concerning working conditions, workers from all three units reported pain or bodily discomfort in the previous seven days and over the past 12 months. In Unit B, three employees required sick leave due to low back pain. Occupational activity may cause physical discomfort, as well as unfavorable ergonomic conditions, and may indirectly influence workers’ nutritional profile.