Evaluating the access to and quality of healthcare services from the users’ perspective is an important assessment process to identify priorities. This study assessed the profile of health service usage and the views of the Unified Health System (SUS) users about the access to and quality of SUS public health services. A cross-sectional study was conducted with participants from the Coastal Lowlands Region of the Rio de Janeiro State/Brazil, between August and November 2023. The association between categorical variables was analyzed using the Pearson Chi-Square test, using R software 4.3. A total of 200 individuals were interviewed using a 66-question survey instrument. Participants who reported using SUS services more frequently rated this system as essential (p-value = 0.031). However, overall, 64% of participants rated the quality of care to be very bad/bad and 34.9% rated access as very bad/bad. Access was considered poor by respondents who used public services rarely or sometimes (p-value = 0.002). In terms of accessing SUS services consultations provided by specialists (e.g., neurologists), these were available only in another municipality (p-value = 0.001). Many participants were SUS dependent for health services, and gaps and weaknesses were observed regarding users‘ perspectives of the access to and quality of SUS health care. Policymakers should prioritize evaluations and dialogue with the community to make SUS services responsive and to optimize value-for-money in health service planning.

Diabetic foot ulcers are among the most severe complications of diabetes mellitus, disproportionately affecting populations in low- and middle-income countries. Digital health technologies have emerged as promising tools for prevention, diagnosis, and management; however, their effectiveness, usability, and applicability within public health systems remain insufficiently defined. This systematic review aimed to critically synthesize the clinical effectiveness, perceived usability, and methodological quality of digital interventions for the care of individuals with diabetes-related foot ulcers. A comprehensive search was performed in PubMed, Scopus, Web of Science, Embase, and Google Scholar for studies published between 2012 and 2024. Eighteen studies met the inclusion criteria, encompassing mobile health applications, wearable sensor devices, artificial intelligence-based tools, and telehealth platforms. Methodological quality was assessed using the Mixed Methods Appraisal Tool. Artificial intelligence-driven approaches demonstrated high diagnostic accuracy, with sensitivity and specificity above 90% for ulcer detection and classification. Mobile applications showed positive effects on self-efficacy, glycemic control, and adherence to preventive foot care, while usability scores were consistently high. Wearable sensor devices demonstrated potential for reducing ulcer recurrence, though supporting evidence remains limited. Across studies, recurrent methodological limitations included small sample sizes, absence of control groups, lack of economic evaluations, and barriers related to digital literacy and interoperability between systems. Most investigations were conducted in high-income countries, with limited consideration of public health contexts such as the Brazilian Unified Health System. In conclusion, digital health technologies show promise in improving the care of individuals with diabetes-related foot complications but face significant challenges regarding scalability, equity of access, and integration into public healthcare systems. Future research should prioritize context-adapted designs, robust clinical trials, and economic evaluations to inform health policies and support the rational adoption of these tools within universal health coverage frameworks. PROSPERO registration number: CRD420251023152.

Background: The pharmaceutical profession has experienced renewals over time. In community pharmacies, pharmaceutical services contribute to the public health system in Brazil. The development of these tasks, in collaboration with professionals from the multidisciplinary team, demonstrates the involvement with the well-being, health and improvement of the patient’s life. Objectives: This study aimed to identify the professional practice of pharmacists, their understandings and attitudes towards clinical practice in community pharmacies in northern Brazil. Methods: This is a cross-sectional descriptive study, based on a questionnaire carried out with pharmacists for seven months in the municipality of Belém, in the state of Pará. Data were expressed using descriptive statistics and the results were shown as a percentage. Results: 182 pharmacists participated. Females were predominant (80.2%) and the average age of participants was 34.2 years. 77.4% graduated from private institutions and 59.3% already have a specialization. 38.4% hold the position of technical director. 50.5% of respondents say that community pharmacies have a reserved place for service. The most used clinical services were pharmacotherapy review (89.5%), health education (60.9%), dispensing (34%), therapeutic monitoring (25.8%) and pharmacotherapeutic follow-up (4.9%). In the study, it was realized that community pharmacies should not be seen as a commercial place but rather as a health care facility. Conclusions: Therefore, these establishments must adapt at a structural and professional level, to meet an increasingly growing demand of a population in need of services offered with quality health care.

Objetivo: elaborar uma revisão integrativa quanto o papel do farmacêutico na identificação e resolução de problemas pertinentes a medicamentos, com a finalidade de criar e conduzir técnicas que intencionem aperfeiçoar a utilização segura de fármacos e favorecendo a qualidade de vida da população. Métodos: concerne a uma revisão integrativa da literatura sobre a atuação do farmacêutico na identificação e resolução de problemas relacionados a medicamentos. Resultados: as falhas de medicação compõem um problema de saúde pública mundial, pois além dos males provocados à saúde do paciente, produzem aumento da internação hospitalar, acréscimo nos custos de saúde e contribuem para os entraves financeiros dirigidos a este setor. Em maior parte, os erros podem ser evitáveis, podendo ser realizado tanto por profissionais novos como pelos experientes, sejam médicos, farmacêuticos, enfermeiros, técnicos, cuidadores e o próprio paciente. Conclusão: O farmacêutico é um profissional substancial na equipe de saúde designada ao cuidado de pacientes que estão em uso de medicamentos, tendo de agir de forma integrada com os demais profissionais, com o objetivo único de possibilitar a saúde e sustentar um tratamento eficaz para o paciente. O profissional configura uma das últimas viabilidades de discernir, reparar ou limitar prováveis riscos associados à terapia.

Background: The reverse logistics of medicines consists of the logistical procedure of collection, transport, storage, treatment and final disposal of post-consumer or expired waste. Medicines can be toxic to the environment and affect the health of citizens of the territory. Community pharmacies, as a health facility, play a key role in this process. Objectives: Define the spatial analysis and cases of reverse logistics of medicines in community pharmacies in Brazil. Methods: This is a cross-sectional study, and the research covered the medicines collected by 400 community pharmacies in the period from 2020 to 2022. To obtain the data, the medicines were collected, weighed, segregated and the weight released on a dedicated waste management platform. All regions of Brazil subject to georeferencing were processed using the free software Geographic Information System (QGIS). Data were expressed as median and range or as frequency of occurrence. Chi-square t-test and Fisher's exact test were used to compare variables. The accepted significance level was 5%. Results: Of the five existing regions in Brazil, only three had records of reverse medication logistics. 4,519.74 Kg of products were collected, and the North region of Brazil was responsible for 69.1% of the collection. In the spatial analysis, it was possible to perceive a difference between the areas of concentration of the RDL, that is, locations where collections were carried out in the period from 2020 to 2022. Conclusion: The present study preliminarily analyzed the reverse logistics of medicines in Brazil. The data obtained can contribute to the knowledge of this area and to the strengthening of the process. Thus, these places must exercise a task force for the educational process of the population about the risks of incorrect disposal of medicines and that this could harm the environment, economic aspects of society, food and the entire context that involves health and well-being. of citizens.

Tuberculosis is a critical public health challenge in Brazil, with the state of Pará reporting high incidence rates driven by social inequalities, rapid urbanization, and adverse climatic conditions. This study analyzes the epidemiology of tuberculosis in the Metropolitan Region of Belém from 2018 to 2022, correlating social and environmental determinants with the impacts of climate change. Georeferenced data, temporal analysis, and predictive modeling were employed to identify epidemiological patterns and high-incidence clusters. Belém accounted for 60.1% of cases in the region, highlighting the influence of population density and socioeconomic vulnerabilities exacerbated by extreme climatic events. The findings underscore the need to integrate public policies and sustainability, emphasizing COP30 as an opportunity to catalyze both local and global actions.