“_The Brazilian Inclusion Law provides that, when necessary, the assessment to characterize a person with a disability for access to social rights must be biopsychosocial, multidisciplinary and interdisciplinary. This definition reflects the evolution of the understanding of disability beyond the biomedical aspect, with an emphasis on personal and environmental factors, and the restriction of participation in the experience of disability. The Modified Brazilian Functioning Index (IFBrM) emerges as a promising assessment tool, validated to reflect the Brazilian sociocultural context, and aligned with the biopsychosocial model of disability. The objective of this doctoral dissertation is to analyze the biopsychosocial disability evaluation with multiple approaches, to support Brazilian discussions in the process of changing the logic of identifying who people with disabilities are in Brazil. The research was carried out based on the triangulation of methods, using techniques of document analysis, content analysis, multinominal logistic regression, and correspondence analysis. The political, and legislative aspects, data analysis of the quantitative and qualitative results of the IFBrM validation research, conducted from 2017 to 2019, were analyzed. The results of the thesis are separated into five scientific articles and a book chapter, in which it was identified that the evaluation of people with disabilities in Brazil is in dispute, being influenced by governments that seek to reduce costs and by professional categories that want exclusivity in the evaluation. In an analysis of Brazilian legislation from 1988 to 2023, the three main theoretical models on disability in the country where the Biomedical Model predominated were compared. Regarding the IFBrM results, a sample of 4,065 individuals over 18 years of age was used, with the outcome being the degree of disability: absent; light; moderate; serious. In relation to personal factors, being male, not having had a relationship, being in the age group of 18 to 59 years old and having low education are associated with a greater chance of severe disability. In relation to environmental factors, the greatest association occurred between the domain “education, work, and economic life” and the barrier “services, systems and policies”. It was identified that environmental factors play a crucial role both as facilitators and as barriers to individual functionality, in that when a person had many environmental barriers in the activities of one IFBrM domain, they also had many barriers in all other domains. Among the environmental factors “Attitudes” and “Relationship Support” were the most frequent. These results highlight the importance of interventions that aim to remove these barriers, thus facilitating full social participation. In relation to the interviews with health professionals, it was noticed that the interviewees recognized the significant impact of environmental and personal factors on the social participation of people with disabilities, and the importance of considering these factors in the assessment. It was identified that the perception of disability professionals is in the process of transformation beyond the biomedical model. The synthesis of these studies reinforces the need for a holistic approach in the assessment of people with disabilities in Brazil. Policies are urgently needed that not only recognize the multifactorial nature of disability, but also promote social inclusion through the elimination of environmental barriers and the recognition of personal factors._”

Objective: To evaluate the distance from CAPS and UBS referenced in the Federal District. Method: This is a descriptive and ecological study, based on the georeferencing of CAPS and UBS, in the DF, identified and extracted from the National Registry of Health Establishments (CNES), in the month of 07/2020, by the address record . Indicators that portray the socioeconomic situation in the different areas of the DF were sought. Results: In the present study, an unequal geographic distribution was identified between the health regions of the DF for the offer of CAPS, especially when observing the profiles of social vulnerability and income for the distance of the UBS with the CAPS in their different modalities of the profile of attendance. This reinforces the theories of the Inverse Care Law and the Inverse Equity Hypothesis, which expresses that the supply of health services and professionals tend to be concentrated in more privileged places and lacking in the most socially vulnerable places, that is, generating more iniquity. Conclusion: This study sheds light on how the network is organized in the territory for this moment of adversity. The power of CAPS, among other mental health services, is related to a proposal to change mental health care to a psychosocial, humanized and territorialized approach, matrixing the teams in the UBS.

“Brazil faces, annually and cyclically, epidemics of dengue, zika and chikungunya. Despite the constant surveillance and public campaigns to combat the vector of these diseases, the Aedes aegypti mosquito, what is observed is a constant increase in the number of cases in Brazil, year after year. With the COVID-19 pandemic, decreed in Brazil at the beginning of 2020, this situation became even more fragile. As the COVID pandemic spread, the dengue vector followed its life cycle and its breeding peaks, leaving the Brazilian population vulnerable not only to the threat of the coronavirus, but also that of this old acquaintance of tropical climates, the Aedes. But in all these years of fighting this mosquito, have we learned nothing about how to effectively fight it? One of the main pillars for controlling a vector such as Aedes, which represents a public health emergency for the country - in addition to the direct control measures taken by the state, such as inspection - is the pillar of communication. This pillar, more than audiovisual campaigns - formerly broadcast only on open television channels, printed newspapers and pamphlets, and currently inserted and developed for social networks such as Instagram, WhatsApp and TikTok - is also composed of strategies that drive these campaigns aiming to bring them closer to the target audience and make them more accessible, understandable and capable of mobilizing the interlocutor to take an attitude in this given situation. This dissertation makes a temporal cut precisely of the overlap of the COVID-19 pandemic and the dengue, zika and chikungunya epidemics, between the years 2018 and 2021. Thus, the use of the digital marketing tool Call to Action on Instagram was analyzed on the Instagram of the Ministry of Health in the period cited. The research is exploratory with a quali-quantitative approach, fulfilling a theoretical analysis of Ministry's communication in publications focused on dengue, zika and chikungunya. After synthesizing and systematizing this content, two scientific articles were produced. The first with a quantitative focus, evaluated that, in the total of 187 publications analyzed, 168 of these used the CTA tool. This research points out that, despite the large number of published CTAs, their use does not comply with the criteria for creating effective and efficient CTAs. The second article was produced with a qualitative approach, based on the French Discourse Analysis approach, pointing out semantic choices and language connotations present in the CTAs of two campaigns chosen for analysis.”

“ The care for mental health in primary care is essential for the inclusion and noninstitutionalization of the patient, as well as for the development of the field itself. However, the lack of training among medical professionals is one of the main obstacles to providing this type of care. In this context, this study aimed to analyze the barriers and facilitators present in the published scientific literature regarding the implementation of educational interventions for primary care physicians in the care of mental health patients. We conducted a scoping review following the principles of the Joanna Briggs Institute (JBI). The central question of this study was: "What are the scientific evidence related to the training of primary care physicians in the care of patients with mental health needs?" To answer this question, we searched articles in electronic databases such as PubMed, MEDLINE, Lilacs, SciELO, Embase, Scopus, BDTD, and Google Scholar, using the keywords: "physicians" OR "General Practitioners" AND ("medical education" AND "mental health") AND "Primary Health Care" OR "Primary Health". This search strategy, applied specifically to each of the seven databases and considering publications between 2012 and 2022, resulted in 4,117 articles. These articles were then imported into the Rayyan QCRI software, and duplicates were eliminated. In addition to duplicates, we excluded works that were case reports, editorials, letters, and conference abstracts. Using this software, two independent reviewers examined the titles and abstracts of 3,375 articles, selecting 256 for full reading. Of these readings, only 76 articles effectively answered the research question. These studies used a variety of methodologies, mainly including randomized clinical trials and qualitative interviews. The main findings indicated interventions aimed at improving the identification of mental illnesses, supporting family physicians, and implementing therapeutic strategies. The analysis of the literature from the last ten years highlighted the predominance of publications on systemic, structural, and professional barriers to physicians' training. Among these, geographical limitations, lack of time for training, and physicians' motivation stood out. However, among the facilitators, online training offerings, stigma reduction-focused training, and prior professional education were highlighted. ”

“Introduction: The Transexualizer process policy from the Brazilian Unified Health System (SUS) was born in 2018 and redefined in 2013, with the aim of standardizing specialized healthcare services for trans people. In the Federal District, the specialized service first occurred in 2017, with the status of reference for this population in the Brazilian capital. The literature points out that this population still faces essential assistance gaps in terms of accessing healthcare services, caused by consequences of discrimination, prejudice against identity, disrespect to social names and lack of professional qualification. Objectives: This study analyzes the trajectory of the Transgender Ambulatory of Brasília, describes important political and programmatic framework during this path; the experiences undergone by health workers and trans people assisted by this service, and identifies assistance, administrative and political gaps found since its implementation. Method: Qualitative-analysis study carried out through the execution of 30 semi structured interviews applied to health professionals, managers and trans people at the ambulatory headquarters. After transcription of the interviews, the analytical categories that emerged from the narratives were processed and classified with the aid of the the Imurateq software. Results: It is worth noting that the transgender individuals interviewed consider that their identities are respected in these places, opposed to what happens in other healthcare providers from the Public Healthcare Network. It was identified that there are breaches that fragilize these services concerning the political-programmatic, administrative and assistance routes. One of the main challenges indicated by the users of the Transsexualizer Process is the access to hormone therapies. The conduction of surgeries of adequation to the biological body and gender identities were also pointed as a fundamental assistance gap. Conclusion: Despite the guarantees assured by the Unified Health System to implement one policy of integral assistance to the transgender people, there are yet barriers for the Trans Ambulatory of Brasília to overcome in order to make the politics effective, due mainly to institutionalization of its actions and lack of insertion of this service into the organogram of the Department of Health of the Federal District. This fact entails an institutional void that emerges as an important political-programmatic gap and impacts its possibilities of action. There are also observed weaknesses in the sense of financial resources allocation and the construction of a multiprofessional framework of human resources capable of doing the full exercise of political actions, in addition to the establishment of adequate physical space. By constituting the only specialized service in the FD, it results in overcrowding which generates an undesired waiting list limiting user access. The trans individuals interviewed characterize the site/service as cozy and safe for them to fully perform their identities. ”

“_Domestic violence is a phenomenon intersected by different social markers, representing a reality in the Federal District, affecting the lives of thousands of women. Simultaneously, as a public health issue, primary care professionals must play a crucial role in supporting these women through their outpatient services. This research aims to comprehend and analyze manifestations of violence against women residing in the Rural Nucleus Lago Oeste in the Federal District and to explore the perception and conduct of health professionals at the UBS in the adjacent region when it comes to providing care for women experiencing domestic violence. This is a qualitative study, using the techniques of participant observation and semi-structured interviews with women victims of violence and the health professionals at the UBS they are users. Through the analysis of interviews using the collective biography method, a common panorama emerged depicting how these women experienced instances of violence and how some managed to break free from these cycles. The results of interviews with health professionals demonstrated empathy and actions oriented towards care, but at the same time, acknowledgment of the lack of training for better serving these women. In the discussion, we categorized the themes by the typology of violence, according to the Maria da Penha Law, comparing the accounts of women and professionals with the provisions of this law and the National Policy to Confront Violence Against Women. We consider that the violence confrontation network has various gaps, inadequacies, and a lack of professional training, along with a deficiency in communication between multidisciplinary sectors and individualized support for each woman in a situation of violence. _

“_The goal of this study was to understand the relationship between capitalism/biomedical model and the barriers and facilitators for the interprofessional work of multidisciplinary teams in primary health care, in the scientific literature published in Brazil and internationally. The theoretical framework was based on the interpretative paradigm with a critical focus from the theoretical lens of the social determination of health. A scoping review was developed that mapped the barriers and facilitators for interprofessional work in primary health care with a methodology based on the Joanna Briggs Institute (JBI). Six databases and repositories were searched: VHL (Virtual Health Library); SCIELO (Online Scientific Electronic Library); PUBMED/MEDLINE; LILACS (Latin American and Caribbean Literature in Health Sciences), Web of Science and SCOPUS. 169 mostly qualitative articles were included, published in Portuguese, English and Spanish, with emphasis on production from Canada (50) and Brazil (44). The barriers predominated in relation to facilitators, where biomedical capitalism was evident, which appeared in four dimensions: system – training in the biomedical model; organizational – productivist management and attention; interindividual – hierarchy and concentration of power in medicine; and individual – individualism. The ambience and creativity in the organization of workflows were identified as innovative facilitators in the theme. The methodology for evaluating interprofessional work is still mostly qualitative and the review indicates the need to increase the theoretical-methodological foundation of studies on the subject. Disciplines to promote interprofessional work need to take into account the implications of biomedical capitalism and intersectionality in healthcare. The final chapter of the dissertation presented a discussion of barriers and facilitators from the perspective of the health systems of the countries that appeared most in the scoping review: Canada, Brazil, the United States and the United Kingdom. One of the innovative contributions of this study was in the development of the implication of the capitalist system from the perspective of biomedical capitalism/biomedical model, as a mediator of interprofessional work, expressing itself through various barriers from training, management, care and within the scope of micro level of health professionals, with individualismo.__”

“_Introduction: Ritual circumcision, a traditional practice in Mozambique, is present among the
different ethnic and religious groups of the country. It is part of the rituals of ethnic rites of passage and
itis performed by masters according to cultural beliefs. Male circumcision has been shown to be
effective in HIV-transmission prevention in studies conducted in Kenya, Uganda and South Africa. It
reduces HIV infection by 38% to 66% in heterosexual relationships and it is recommended by WHO for
countries with a high incidence of the infection. However, it is parallel to the traditional practices that
must be studied and improved by their various actors to provide choices based on cost/benefit and
cost/effectiveness. Objectives: To analyze the introduction of biomedical technology in traditional
circumcision among Makonde people, so that it offers safety and health care to the initiates, avoiding the
occurrence of adverse events and infections. Method: This isqualitative research with an ethnographic
approach, which used empirical experience, anchored to the theories and concepts discussed by some
authors such as Van Gennep (1909), Menédez (1994) and others. It also included participatory
observation and recorddocumentation through photographic image, voice recording and field notebook
notes. Results: the research provided the opportunity to learn from the ability to negotiate the researcher
participation in the rituals. It produced a synthesis of evidence showing that it is possible and feasible
for actors from initiatory traditions and medical practices to dialogue and perform traditional
circumcision, observing medical practices that minimize risks to health. Changes made in traditional
surgicalpractice,didnot alter the symbolic meaning nor distort the objectives that guide the Makonde in
their rituals. Conclusions: By means of contextualized information on cultural and historical framework
of the circumcision practice in contemporary Mozambique, empiric data discloses the need for
intermediation and for a continuous and fruitful dialogue between the actors and decision makers of
health policies. Both parts should understand their respective activities and objectives understandings
that they are not antagonistic. They are valuable elements of the social and cultural community health
system. In this case, current scientific evidence in both should be useful in the search for effectiveness in
health promotion, prevention and care.

“_The act of sharing a meal with other people is known in the literature as commensality. There are a variety of ways of eating together that can be characterized in cultures around the world: from everyday situations to festive situations, in the family context and in other social relationships, at the table and also in other spaces, among others. From the virtualization of society in the contemporary era, other ways of sharing meals are beginning to be perceived, influenced by the presence of technologies before, during and after meals. With the aim of understanding how human relationships with food, when mediated by communication technologies, configure commensality in contemporary society, this thesis proposes to investigate this phenomenon through two studies. The first was a scope review that characterized the main scientific findings related to digital forms of commensality in the 21st century and identified possible relationships between commensality practices and collective health. 104 publications were selected that related commensality and technology in all contexts. Most studies used qualitative methodology; they were from the area of Design and Technology; used social media and video platforms or augmented reality prototypes/devices; and they referred to digital forms of commensality using different terms, which allowed a temporal analysis of the proposition of definitions of the studied phenomenon. With regard to issues related to collective health, the related studies pointed to the following subjects: family/community engagement, development of culinary skills, mental health and eating habits. The second study developed was a netnography carried out with a virtual community on Facebook composed of women who share on the table set in which we sought to describe and analyze the forms of commensality practiced by them either in person or virtually and their relationship with health. Through participant observation, interviews and field notes, it was identified that the community relates by sharing photos of the tables set and decorated for meals held at home, mainly for the family. Although they like to register their tables, the act of photographing them usually occurs before meals, since the use of mobile devices while sharing a meal is considered by them as a violation of good table manners. The practice of setting the table was recognized as an act of hospitality and an incentive to traditional eating, strengthening human relationships through shared food. It is noteworthy that in the context of the COVID-19 pandemic, in addition to sharing photos of the tables set, women reported practicing other digital forms of commensality and recognized the importance of the community for their mental health during the period of isolation. The frequency of thematic tables related to awareness months for the prevention of certain diseases, such as yellow September, pink October, blue November, proved to be a powerful strategy for communication in health at home, making these women multipliers of campaigns. In conclusion, this thesis reveals the variety of ways in which commensality has been practiced and investigated in contemporary society with regard to technological mediation, pointing out the importance of this phenomenon for the configuration of human relationships around eating. In addition, it raises the debate of relating such practices to collective health. ” 

At Primary Health Care (PHC), a proposal to reorient services making them more effective, achieving effectiveness is a challenge. In many realities, there are gaps between what individuals and communities need, and services quality, leaving many users without access or excluded from standardized actions for specific conditions, with low effectiveness leading even to the chronification of acute events. The present work aims to understand the mechanisms that influence PHC effectiveness, from conceptions, critical elements and agents with potential influence for its development. This is a single integrated case study, with exploratory and analytical character, qualitative approach, whose unit of analysis is PHC effectiveness in Brazil’s Federal District (FD), based on the evaluative activities of the Qualification Program of Primary Health Care (QualisAPS). A triangulation of documentary research and focus groups techniques were used for data collection, in which participants were managers or supervisors of PHC, and health professionals of the higher and middle levels from FD Family Health Strategy, totaling 245 participants. The results came from 10 documents and 22 focus groups conducted in 2020 and 2022. The software ATLAS.ti version 9.0 was used for systematization and data analysis according to effectiveness, PHC and multilevel governance theoretical frameworks, and Ergology theoretical-methodological framework. It is possible to conceive effectiveness in PHC from several approaches, more or less comprehensive, incurring risks of relativism and reductionism. There is confusion between the concepts of effectiveness and quality in health, as well as effectiveness and response capacity. Several attributes, capacities and expected results were considered critical elements, as well as the complex nature of health problems and structuring conditions for PHC proper functioning, aspects already recognized in the literature. None of these critical elements are exclusive to effectiveness and its use as an analytical or evaluative category of PHC is questionable. In addition, effectiveness in PHC falls massively as a charge on health professionals and frontline managers, agents of the micro level, when it should be understood as a shared responsibility by a multilevel governance network, involving several agents from brazilian Unified Health System, directly or indirectly. The more macro is the level of the agent in this network, lower isthe clarity about their responsibilities for an effective PHC, but their influence is present anyway, either in omissions or worsening flows, impairing resolvability. By not recognizing this network, we distance ourselves from implementing an effective PHC in solving health problems. In the FD, predominates the perception of PHC low effectiveness. To mitigate the conceptual limitationsidentified and better instrumentalize the search for results, it isrecommended to review the use of the word resolvability in technical documents, which can be used as jargon, but should be replaced to guide clearer and more strategic guidelines by the concepts of effectiveness and response capacity

“ The study of prevention and control of arboviruses in Brazil consists of a complex investigation. Although there are government initiatives, efforts from healthcare professionals, educators, and even the community, the occurrence of Dengue, Zika, and Chikungunya infections has not been overcome in Brazil. Therefore, this research aims to understand the foundational dimensions of health capabilities carried out in primary care for the control of arboviruses Dengue, Zika, and Chikungunya (DZC) in Brazil. To achieve this, a sequential exploratory mixed-methods study is conducted. Through a scoping review on the topic of capabilities, the study presents the concepts of capacity and capability within the scope of healthcare systems, as well as the dimensions of these capacities in the international scientific scenario. Additionally, a qualitative research was conducted using the technique of focus groups, with the purpose of investigating the perception of SUS (Unified Health System) users regarding communication for arbovirus control. Interviews were also conducted with healthcare professionals and endemic disease combatants, analyzing their perception of the capacities for arbovirus control. Through questionnaires, the perception of Brazilian managers regarding the capacities for arbovirus control and prevention was investigated quantitatively.This is a nationwide study conducted in the five regions of Brazil, as an integral part of a national multicenter research project carried out between 2016 and 2022. The results highlighted four dimensions of health capabilities, which involve logistical, normative, financial, and human capacities, considered essential for fulfilling the core functions of public health in healthcare systems. Regarding Dengue, Zika, and Chikungunya arboviruses, the results showed the incipient nature of communication capabilities in media campaigns, as well as the need for greater improvement and investment in control and prevention actions for these arboviruses. Investment in research, human resources, and technological innovation were also prominent in this study. Finally, it is recommended to develop a communication plan that involves the population in its formulation, combining different means of translation and dissemination of knowledge obtained from available evidence, along with community, small group, and individual activities, fostering a sense of belonging and consequently promoting a heightened awareness of health consciousness..”

“Introduction: Speech Therapy has been researching and increasingly acting with issues related to gender diversity, seeking most studies, understanding how the voice impacts the lives of trans people and how it can be worked from a perspective of adapting to characteristics of gender. Nevertheless, the imperativity of deep reflection and a critical review of research and intervention approaches in speech therapy in relation to gender diversity has been broadly highlighted. As well, concrete and grounded proposals have been outlined that point out clear directions, especially in relation to ethical posture and the theoretical-epistemological orientation adopted in the treatment of this topic. As for theoretical basis for this speech therapy practice, currently the perspective suggested as one of the most appropriate to understand voice and communication in relation to the speaker's sociocultural positioning is the biocultural perspective. From it, several factors act continuously and dynamically in the production of voice and communication, which differentiates it from the deterministic perspective, for example, which considers this production as exclusively dependent on biological and physical aspects. As it was established by the most current international recommendations, the purpose of professionals who provide gender affirmation assistance should be, first and foremost, to establish effective collaboration with different trans and gender identities. In order to fully address social, mental and medical needs, aiming mainly to promote well-being, while fully respecting their gender identities. These care guidelines also advocate the adoption of a person -centered service model, as well as reviewing several previous recommendations, all for the purpose of eliminating barriers that can make access to the necessary care difficult. Objective: This study aimed to analyze and reflect on the contribution of a group speech therapy approach to trans and with various gender identities, exploring their perceptions related to voice and communication. Methodology: It is a qualitative approach research, based on the methodological approach of dialectical hermeneutics, developed with trans and with various gender identities. Inclusion criteria were people over 18 who identified themselves as trans or with a diverse gender. No exclusion criteria related to gender identity were stipulated. The technique selected for data collection were group research workshops developed from the theoretical-methodological perspective of social constructionism applied to group practice. The proposed practices were based on concepts of vocal self -perception and vocal psychodynamics. Four workshops were held with the participation of 10 people. The meetings had an average duration of 100 minutes each, were recorded in audio and video and later transcribed for analysis. Transcripts underwent an analysis based on the techniques of the dialectic hermeneutic method. Results and Discussion: Each workshop was analyzed individually and later reorganized for the purposes of synthesis, seeking to point out diversity and multiplicity. During the analysis the dialectical hermeneutics was used, from which empirical analytical categories gradually emerged. These categories were subsequently compared to predefined analytical categories to identify interrelationships and connections. This work emphasizes the importance of considering stress faced by minorities, such as trans and with various gender identities, due to discrimination and prejudice in a predominantly cis generous and heteronormative society. It is noteworthy that a group speech therapy can play a key role in reducing this stress and increasing well-being, promoting self-esteem, assertive communication and coping skills. In addition to reinforcing the arguments that support the effectiveness of group therapy for these people, both in relation to voice and self -perception. We emphasize the importance that such interventions are sensitive to the social context and allow the authentic expression of the voice. In addition, the biocultural perspective is discussed as a theoretical basis that comprises the voice as influenced by sociocultural forces and we highlight how the interpretation of the speaker's sociocultural positioning can be based on vocal expression, subject to variations due to listener sociocultural experiences. Finally, the need for a critical analysis of research and intervention approaches in speech therapy related to gender diversity, aligning with recent expert recommendations is reinforced. Given the proper emphasis on the importance of ethics and the theoretical approach when addressing this topic. Conclusion: Recognize the semantic richness of a group, either through workshops or other formats based on solid theories, enables the exploitation of discourses from a perspective that values relational discursive practice to the detriment of individual analysis. This discursive approach is profoundly enriching in terms of meanings that can be explored in various directions, both in the research context and intervention, in the context of speech therapy, particularly regarding issues related to gender diversity. In this scenario, an integral health approach is a strategy that incorporates voice and communication as integral elements of a comprehensive model of care, while fostering the sharing of knowledge and skills. Meaning constructions and resignification processes assume a dialogical nature, playing a role of importance not only for the participants involved, but also for the group's facilitators. The social position occupied by researchers or therapists is revealed as a complex position, characterized by ethical and political dimensions, and influenced by various beliefs and sociocultural issues.

Objective: To identify the sociodemographic risk factors that contributed to malignant neoplasm of lips, oral cavity and pharynx (mouth cancer) mortality in Brazil during 2013 and 2019 using spatial regression. Also to evaluate the contribution of Community Health Workers to the mouth cancer mortality reduction. Methods: It is an Ecological study using data from the National Health Survey from the years 2013 and 2019. Sociodemographic predictors of oral cancer mortality were explored using the regression models: Ordinary Least Squares (OLS) and Geographically weighted regression (GWR). Results: By the time analyzed there were an increase in mouth cancer mortality in Brazil except for South region, the North and Northeast were more expressive. The GWR regression proved to be an excellent model by explaining the non-stationary spatial relationship of the independent variables with the dependent variable. Conclusion: There were an increase in mortality. The role of the community health workers is essential to contribute to the reduction of oral cancer mortality and to prevent late diagnosis. The community health workers must act not only in regions with more vulnerability but also in regions with greater IDHM.

Objective: the objective of this study is to adapt and validate a Brazilian instrument, based on the World Health Organization's Checklist for Safe Childbirth, for its adaptation to the context of the Normal Birth Center. Method: this is a methodological study, using the Delphi technique and a Likert scale, developed in three stages: construction of a pilot instrument adapted from the World Health Organization's Checklist for Safe Childbirth, content validation and validation apparent by expert judges. In addition, the instrument RIGHT-Ad@pt checklist was used to guide the adaptation with checking of all steps. Results: the instrument reached a general content validity index > 0.9 in both stages, interrater agreement ≥ 0.9 in all dimensions and assessment items, and obtained high scores in both stages (>90). Conclusions: due to the high values obtained in the results, it appears that the validation obtained allowed the development of an instrument containing 31 items relevant to the theoretical constructs, therefore, capable of being used as a tool to promote the safety of patients in a Normal Birth Center. The use of the RIGHT-Ad@pt checklist facilitated the construction of the list with the essential attributes and allowed the identification of limitations in the study

Introduction: The consumption of substandard, unregistered, contaminated, or falsified medicines presents a potential risk of causing damage to health, and being a complex problem, with multiple dimensions, that affects public health worldwide. The enforcement's actives are intrinsic to health surveillance, representative of the Democratic State in protecting the health of the population. Its purpose is to identify and investigate sanitary infractions; apply sanctions and determine the withdrawal from the market of medicines that are irregular, ineffective, or harmful to human health. The research problem was based on the assumption that the market medicines´ control and surveillance have limitations that restrict the fulfillment of its purpose, essential the involvement of the worker to show what changes are necessary for the inspection work. Objective: To understand the dynamics of the health inspection process of medicines at the federal level. Methodology: This is a single case study, with a qualitative and comprehensive approach, based on the theoretical framework of ergology and the collective discursive practices of professionals regarding the work process. The ergology framework enabled the production of knowledge about the relationship between knowledge and the experience of those who experience real situations of inspection and are always in debates on norms and values, having to make decisions, make choices, and manage the variabilities of the environment, in renormalization processes. Data production was carried out from July 2020 to September 2021, through documentary research, participant observation, and semi-structured interview. The drug inspection process carried out by Anvisa was considered the unit of analysis and the participants were career professionals from the agency who work or have worked in drug inspection, for two years or more of experience in the activity. For the organization and analysis of the data, the Atlas.Ti 9.1® application was used and the conception of the ergodialogical maps was developed. The research was approved by the Ethics Committee in Research with Human Beings of FS/UnB. Results and discussion: The results confirmed the assumptions of the thesis, where the context of the covid-19 pandemic, the outdated regulatory framework, the operating model, the fragmentation of the work process, and its conditions lead to obstacles to the performance of the activity by the professional of the Anvisa. Although the work process is organized, structured, and standardized, the inspection logic is still legalistic, bureaucratic, and disciplinary, framed in the passive-reactive model of action. It was highlighted how outdated the regulatory framework is and does not correspond to the regulatory context required by society, becoming, in some cases, a barrier to the decision-making process at Anvisa. Regarding working conditions, the weaknesses of information systems and the scarcity of advanced technological resources predominated, which prevent greater rationality and agility in the process. The Logical Model built proved to be promising for reviewing the inspection, being able to drive changes, supporting professionals in the planning, structuring, execution, and evaluation of the process, as well as enabling the construction of indicators for objective measurement of results. In 15 months of the pandemic, there was an increase in e-commerce and irregular advertising of slimming, anabolic steroids, baldness treatment, sexual stimulants, products "so-called natural" or with MTC claims, among others, usually related to body image or the health and well-being experience. A large part of unregistered drugs continued to circulate on the internet, even after a decision by the federal government forbidding and determining their seizure and destruction. The work of professionals acquires a sense of “work´s repetitive” due to the volume of demands and the few effects of inspection in the virtual drug market. The study showed the dramatic experiences experienced by workers
when managing their work, the uses of themselves in search of achieving goals, amid changes in the work environment, accelerated due to the covid-19 pandemic. Final Considerations: The creation of a new way of doing inspection involves a combination of interventions, aimed at preventing, detecting, and responding to irregularities and illegal drug practices. Seek transformation from real work, going beyond the restricted function of control and punishment, to build a model (or several models) of proactive action, based on health risk management, with the development of new practices and new knowledge adaptable to various situations. Changes in the inspection of medicines necessarily pass through the worker and imply agility, proactivity, flexibility, justice, integration, and rationality, which can be expressed in the diversity of types of health surveillance work, such as “educational work; “work based on risk management”; “proactive work” and “effective work”.

Introduction: Aging is a worldwide phenomenon. In Brazil, this situation increases care pressure within the scope of the Unified Health System (SUS) since the elderly are more affected by morbidities, requiring hospitalization, exams, medication and, eventually, progressing to death. Thus, aging overloads the health system and increases the demand for resources. In the national reality, one of the places where the elderly receive care is primary care. Primary care is offered in two main models: the traditional model of primary care with focal specialists and based on segmented care across life cycles. And the family health strategy model, based on person-centered care, with an enrolled population and teams responsible for people's comprehensive health care. It is known that primary care coverage can impact the health indicators of the population, especially in conditions sensitive to primary care. Objective: To analyze the mortality profile of the elderly population, aged 60 or over, as well as to verify mortality due to conditions sensitive to primary care and the influence of social, economic and health conditions, between 2008 - 2018 in the Federal District.Methodology: Longitudinal, descriptive and analytical study aimed at analyzing the mortality of the elderly population aged 60 years and over in the Federal District. Deaths that occurred in people aged 60 years or older, occurring in the Federal District, between 2008 and 2018 were investigated. The deaths were grouped by sociodemographic characteristics: sex, age, race/color, marital status, address, and region health, schooling. A description of the underlying cause of death was performed, ranking the main causes and the trend of mortality was studied using the jonckheere-terpstra test. Data were compared with the coverage of primary care disaggregated into primary care and family health strategy. Mortality rates due to conditions sensitive to primary care were calculated and compared with the evolution of primary care coverage in the Federal District. Finally, deaths were associated with age at the time of death, sex, marital status, education, race/color, death due to a condition sensitive to primary care, population coverage of primary care services. The Urban Welfare Index (IBEU) was used, comprising the following dimensions: mobility, environmental and housing conditions, infrastructure and collective services in order to analyze issues related to the place of residence of the elderly Results: During the study period, there were 85,835 deaths among the elderly in the Federal District. The mean age was 76.51. Most deaths occurred among 80 years of age or older. Male sex predominated. The main causes of death were acute myocardial infarction (6.6%); pneumonia (5.2%); stroke (4.1%); malignant neoplasm of the bronchi or lungs (3%) and chronic obstructive pulmonary disease (2.6%). Higher mortality among men (p<0.001), from cardiovascular causes (p=0.006), and in older elderly (p<0.001) was statistically significant. Among the deaths studied, those that occurred in elderly people living in the Federal District were 70,503. The risk of dying from conditions sensitive to primary care decreased, notably after 2017. Population coverage by primary care increased in the period, with the increase in the family health strategy being more pronounced in 2017 and 2018. In the analytical study, it was noted The factors associated with the mortality of the elderly due to conditions sensitive to primary care were found to be male, lower income and lower education. It was also observed that living in a place with the worst IBEU presented a response gradient with higher mortality. Increased primary care coverage was also associated with lower mortality. Conclusions: It was concluded that most deaths were from cardiovascular causes. Being an elderly man and older age were related to higher mortality. A descriptive analysis of the risk of dying from sensitive conditions was performed compared with coverage by primary care. A decrease in the risk of dying of elderly people from conditions sensitive to primary care was evidenced. In the investigation by statistical correlation, the study showed an association between male gender, age, income and education, and IBEU with lower mortality due to conditions sensitive to primary care, these associations showed a response gradient. The study also found that increased coverage of the elderly population was associated with lower mortality from sensitive conditions.

Food allergies in children and adults are a relevant public health problem globally and cow’s milk allergy is the most prevalent. In Brazil, after ample discussion, in 2007 four formulas were approved to be incorporated into the care of children with this type of allergy, which should be supplied by the Unified Health System (SUS) in up to 180 days after the inclusion of these technologies. The objective to map the challenges of the implementation and maintenance of state and municipal programs for the supply of special target formulas aimed at children with allergy to cow’s milk protein, in the context of the incorporation by SUS. Exploratory and propositional cross-sectional study with quantitativequalitative approach. The study population is composed of the main actors involved in the debates about the incorporation of this new technology; there are six groups of participants, who will be interviewed by telephone and secondary data collection will be conducted by e-mail. In Chapter 1, discussions on translational research brought to the Brazilian scene were discussed, which culminated in the article, Translational research in Brazil: research topics and their adherence to the SUS Agenda. Chapter 2 characterizes the municipal and state programs that dispense infant formulas for children with cow’s milk allergy and from the identification of the stakeholders involved in the incorporation of these formulas, a propositional matrix of a national program is built from the perspective of translational research. There were 21 programs and/or services (15 municipal and 6 states) from all Brazilian regions. The main driver behind the creation of these programs was judicialization (80.9%) and the provision of special formulas was carried out for children up to 2 years of age. Among the main difficulties in creating and executing these programs, the lack of human and financial resources was the most common reason, representing 71.4% and 61.9%, respectively. The most adopted strategy to reduce the costs of the programs of norms and protocols (61.9%). There was no significant difference between state and municipal programs. Knowing how the most important public policies are defined for policies defined in this national policy