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    A global measurement tool to assess population health literacy fits all? A critical paper
    (2025) Mialhe, Fábio Luiz; Moraes, Katarinne Lima; Vila, Vanessa da Silva Carvalho; Sampaio, Helena Alves de Carvalho; Brasil, Virginia Visconde; Rebustini, Flávio 
    Health Literacy (HL) is considered by the World Health Organization (WHO) as an important determinant of health and several instruments have been elaborated and adapted to measure this construct. In 2022, a group of researchers started a project aimed at developing a HL assessment instrument with global applicability, based on different versions of the European Health Literacy Survey Questionnaire (HLS-EU-Q). This article critically analyses the characteristics of those instruments to help improve health assessment practices and avoiding omitting measurement of locally important information, therefore committing an epistemic injustice..Analysis detected several flaws in the instruments’ aforementioned aspects and the conceptual model proposed by WHO which limits their application as global instruments. Countries worldwide should develop specific instruments to measure the general HL of their population based on its sociocultural characteristics and specificities of their health care systems thus avoiding wrong decision-making, which can compromise the effectiveness of policies resulting from these surveys.
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    Prevalence and factors associated with sarcopenia in elderly people referred by primary healthcare to a specialized service in an area of the Federal District of Brazil, 2015-2017
    (2025) Pinheiro, Hudson Azevedo; Cerceau, Vera Regina; Pinheiro, Luana de Azevedo; Pagotto, Valéria
    To estimate the prevalence of sarcopenia and identify associated factors by sex in elderly people referred by Primary Healthcare to a geriatrics and gerontology reference service in an area of the Federal District in the period of 2015-2017. Methods: This is a longitudinal study that used the criteria of the European Working Group of Sarcopenia in Older People (hand grip, calf circumference and usual gait speed), in addition to clinical aspects and socioeconomic data. Results: 500 elderly people were evaluated in an area of the Federal District, of which 32.6% were pre-sarcopenic, 32.2% were sarcopenic and 7.6% were severely sarcopenic. Risk factors (>70 years and urinary incontinence) and protection factors (high body mass index) were identified. Heart disease and osteoporosis were also identified as risk factors for women and, for men, visual impairment, and occurrence of falls in the last six months were the risk factors identified before the anamnesis. Conclusion: The prevalence of 32.2% of sarcopenia and 7.6% of severe sarcopenia was observed in elderly people treated by Primary Healthcare in the Federal District, and age >70 years old and urinary incontinence were identified as risk factors. High body mass index was considered a protective factor. These data highlighted the need for public health strategies aimed at preventing and treating sarcopenia, considering regional particularities and risk factors specific to each community.
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    Validade de medidas autorreferidas de força muscular diminuída em idosos
    (2025) Mota, João Paulo Neves; Pereira, Cristina Camargo; Dias, Milara Barp; Nunes, Daniella Pires; Nunes, Cynthia Assis de Barros; Bachion, Maria Márcia; Pagotto, Valéria
    Objectives: to analyze the validity of self-reported measures for screening decreased muscle strength in older adults. Methods: this cross-sectional study assessed muscle strength using the gold-standard Handgrip Strength (HGS) test and the application of four subjective measures: A = perceived reduction in strength; B = difficulty lifting 5 kg; C = low score on the SARC-F; and D = combination of measures A + B. Validity was determined through sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, with a 95% confidence interval (95% CI). Results: a total of 18.7% of participants exhibited decreased muscle strength, while subjective measures showed a frequency variation between 74.2% and 35.5%. Measure A demonstrated the highest sensitivity, whereas Measure C exhibited the highest specificity. The accuracy of Measures A, B, C, and D was 61.5%, 41.2%, 34.8%, and 36.2%, respectively Conclusions: self-reported measures demonstrated low accuracy; however, Measures A and C, due to their ease of application, could be used in combination. Descriptors: Geriatric Assessment; Aging; Muscle Strength; Health of the Elderly; Sarcopenia.
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    Experiences of severe burn survivors in the hospital-to-home transition
    (2025) Yagi, Karina da Silva Vale; Vila, Vanessa da Silva Carvalho; Ribeiro, Maysa Ferreira Martins; Brasil, Virginia Visconde
    Objective: To understand the lived experience of severe burn survivors during the hospital-to-home transition. Methods: This qualitative study was conducted with 13 survivors (eight women and five men) at a burn reference center in Goiânia, Brazil. Data collection included medical records, phone contacts to confirm participation, and both remote and in-person interviews. The interviews were recorded, transcribed, and analyzed through interpretative thematic analysis in six stages. Results: The main challenges faced by participants were physical sequelae (pain, scars, and changes in body image) and emotional distress. Barriers to returning to daily activities included social exclusion, job displacement, reduced income, and difficulty accepting the new body image, while family support was essential. Conclusion: The hospital-to-home transition requires comprehensive and continuous care, with a focus on social and occupational reintegration, as well as emotional support.
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    O tratamento da tuberculose e atenção primária: repercussão da pandemia COVID-19
    (2025) Souza, Katia Lacerda de; Takahashi, Erika Mayumi; Ribeiro, Stephanie; Yamamoto, Thais Tiemi; Fernandes, Hugo; Cardozo Gonzales, Roxana Isabel; Hino, Paula
    Objective: To analyze the impact of the COVID-19 pandemic on tuberculosis treatment actions in Primary Health Care in the city of São Paulo. Methods: A quantitative, cross-sectional study was conducted in 80 health units distributed proportionally across regional health coordination offices of São Paulo. Participants were 80 health professionals working in tuberculosis control. Data collection was performed over a four-month period between 2022 and 2023. The Bonferroni post hoc test was used to compare the mean changes in treatment actions. The minimum measure of statistical significance adopted was p < 0.05. The Jamovi statistical program, version 2.3.28, was used in data analysis. Results: Changes in the request for sputum culture and collection of medication were reported in 2020 (21.2% and 47.4%), 2021 (21.2% and 39.5%) and 2022 (11.2% and 15.8%). Most units performed directly observed treatment of people with tuberculosis during the COVID-19 pandemic (91.3%), presenting a high level of change in 2020 (38.4%), a moderate level of change in 2021 (28.7%) and a low level of change in 2022 (8.2%). When evaluating the association of year, type of unit, regional health coordination office, change in the work process and increase in the workload, the association was only found for year and type of unit. Conclusion: This study showed that tuberculosis treatment actions in Primary Health Care in the city of São Paulo were impacted by the COVID-19 pandemic, although to a lesser extent than expected.