Dyego Carlos Souza Anacleto de Araújo

Introduction: The mental health of primary healthcare (PHC) workers is a determinant of service quality and sustainability in the Brazilian Unified Health System (SUS). Brazilian observational studies report symptoms of common mental disorders, anxiety, depression, burnout, insomnia and stress among PHC workers, but the evidence is fragmented across settings, occupational categories, instruments and time periods. This protocol describes a systematic review and prevalence meta-analysis to consolidate prevalence estimates and synthesise associated sociodemographic, occupational and organisational factors among PHC workers in Brazil. Methods and analysis: We will conduct a systematic review and prevalence meta-analysis in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and report the completed review following PRISMA 2020. We searched MEDLINE (via PubMed), Embase, PsycINFO, CINAHL and BVS/LILACS from inception to 16 September 2025, complemented by grey literature searches (Google Scholar and CAPES Theses and Dissertations) and reference-list screening. Eligible studies will be quantitative observational studies conducted in Brazil with workers linked to PHC within the SUS, including health professionals and other occupational groups (eg, community health workers and administrative/operational staff). Studies must report prevalence based on validated instruments for use in Brazilian populations and an explicit case definition/cut-off for common mental disorders, anxiety symptoms, depression, burnout, insomnia and stress. Two independent reviewers will screen records and full texts in Rayyan; disagreements will be resolved by consensus or a third reviewer. Risk of bias will be assessed using the Joanna Briggs Institute checklist for prevalence studies. We will pool prevalence estimates by outcome using random-effects models (primary approach: binomial models), quantify heterogeneity (I², τ², Q) and estimate prediction intervals. Prespecified subgroup/sensitivity analyses will explore geographic region, occupational category, instrument/cut-off, sampling approach, risk of bias and data collection period, classified as prepandemic, pandemic/postpandemic or mixed. Associated factors will be synthesised as a structured narrative by domain; meta-analysis of associations will be considered only when exposure definitions and effect measures are sufficiently comparable. Ethics and dissemination: Ethics approval is not required because this study uses secondary data from published reports. For queries related to research integrity, please contact the Research Ethics Committee of the Federal University of Espírito Santo (cep.ufes@hotmail.com). Findings will be disseminated through publication in a peer-reviewed journal and presentations at scientific meetings.

Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) are central strategies for HIV prevention; however, a comprehensive understanding of how knowledge about these strategies is measured across different contexts remains limited. This scoping review aimed to map the instruments used to assess knowledge of PrEP and/or PEP. The study followed the recommendations of the JBI Reviewer’s Manual, with a systematic search conducted on August 27, 2024, in PubMed, Embase, Web of Science, the Virtual Health Library, and grey literature. Original studies assessing knowledge of PrEP and/or PEP were included. Two reviewers independently conducted study selection through title and abstract screening, followed by full-text assessment. Data extraction was performed by a single researcher, and the findings were presented descriptively. A total of 1,922 records were retrieved, of which 49 studies were included. Cross-sectional studies predominated (n = 45; 91.8%), as did publications from 2020 to 2024 (n = 25; 51.0%). The instruments focused mainly on PEP (n = 27; 55.1%), followed by PrEP (n = 20; 40.8%), and were administered primarily to healthcare professionals or healthcare students (n = 35; 71.4%). The instruments varied in terms of the number of items, response formats, and scoring criteria, and showed limited reporting of their development and psychometric properties. The findings highlight substantial variability in the characteristics of instruments used to assess population knowledge of PrEP and/or PEP. Important gaps were identified in the reporting of instrument development and validation processes, reinforcing the need for methodologically robust instruments to assess population knowledge of PrEP and PEP.

Purpose: Pharmacist prescribing of HIV pre‐exposure (PrEP) and post‐exposure prophylaxis (PEP) is an emerging strategy to expand access to HIV prevention, but real‐world evidence on its implementation remains limited. We assessed national and regional trends in pharmacist‐prescribed dispensing records of PrEP (2020–2025) and PEP (2020–2024) in Brazil. Methods: Nationwide time series analysis using databases from the Ministry of Health. The primary outcome was pharmacist‐prescribed PrEP and PEP dispensing records per 100 000 adults per year. Joinpoint regression was used to estimate average annual percent change (AAPC) and 95% confidence intervals (95% CIs). Results: Pharmacists prescribed 27 126 (2.80%) of 969 536 PrEP records and 13 073 (1.97%) of 664 000 PEP records. The frequency of pharmacist‐prescribed records in relation to all prescribers increased (PrEP: 0.22% to 5.77%; PEP: 0.12% to 4.59%). National pharmacist‐prescribed PrEP dispensing increased from 0.10 to 6.24 per 100 000 adults (AAPC: 120.80; 95% CI 71.96 to 189.84; p < 0.001), while pharmacist‐prescribed PEP dispensing increased from 0.07 to 4.93 per 100 000 adults (AAPC: 166.62; 95% CI 68.66 to 313.26; p < 0.001). The Southeast had the highest absolute rates for both strategies. Significant upward trends were observed in all five regions for PrEP, and in the Southeast, Northeast, and Center‐West for PEP. The national PrEP rate stabilized between 2024 and 2025. Conclusions: Pharmacist prescribing of HIV prophylactic medications significantly increased in Brazil since 2020 and may potentially represent an important mechanism to broaden access to HIV prevention. However, regional differences may underscore the need for targeted policy interventions to address geographic implementation gaps.

Microbiology education is traditionally lecture-based, with few studies exploring active methodologies such as serious games. In this context, this study aimed to develop a serious card game, ‘Bakterion', as a teaching tool for antimicrobial education. The game was designed based on Game Design Thinking, following the stages of Empathy, Ideation, and Implementation. Inspired by the game Munchkin^® , Bakterion includes a rulebook, markers, and 200 cards featuring illustrations based on electron microscopy and laboratory materials. The cards were designed to be easy to use, allowing players to correlate elements even without prior specialized knowledge. The game presents an innovative approach to microbiology education, fostering student engagement and active participation. Bakterion may serve as a promising tool for teaching microbiology and antimicrobial resistance, complementing traditional methods. Future studies should assess the impact of Bakterion on student learning.

Purpose: To assess the prevalence of psychotropic use among classroom teachers and to identify associated factors. Methods: A cross‐sectional study was conducted between January and February 2024 in Espírito Santo, Brazil. The study included teachers from 20 state schools selected through probabilistic sampling. Data were collected in person using a self‐administered questionnaire that addressed sociodemographic characteristics, working conditions, mental health history, mental health screening scales, and the use of psychotropic medications. Poisson regression with robust variance was employed to estimate the prevalence ratio of psychotropic and antidepressant use. The study was approved by the research ethics committee. Results: The study included 453 teachers. The prevalence of psychotropic medication use was 20.0% (95% CI: 16.9%–22.9%), while the prevalence of antidepressant use was 16.9% (95% CI: 13.8%–19.8%). In the multivariate analysis, a higher prevalence of psychotropic use was observed among cisgender women (PR = 1.91; 95% CI: 1.07–3.39) and teachers with depressive symptoms (PR = 2.30; 95% CI: 1.26–4.22). Antidepressant use was also more frequent among cisgender women (PR = 2.07; 95% CI: 1.12–3.85) and those with depressive symptoms (PR = 2.01; 95% CI: 1.05–3.82), while teachers working in schools located in Santa Teresa showed a lower prevalence compared to those in Vitória (PR = 0.31; 95% CI: 0.10–0.90). Conclusion: The findings indicate a considerable prevalence of psychotropic and antidepressant use among teachers, particularly among cisgender women and those presenting depressive symptoms.

Objetivo: avaliar as necessidades educacionais de farmacêuticos para o cuidado de pessoas com asma, a fim de subsidiar o planejamento de estratégia educacional em nível nacional. Métodos: estudo descritivo, quantitativo, realizado por meio de um formulário online com amostragem por conveniência. O questionário foi divulgado no perfil do Conselho Federal de Farmácia no Instagram® e incluiu questões abertas e fechadas sobre a prática profissional, dúvidas e crenças dos pacientes e necessidades de formação. Os dados foram analisados descritivamente, com categorização temática das respostas qualitativas. Resultados: foram obtidas 576 respostas de farmacêuticos atuantes em diferentes regiões do Brasil. A maioria relatou atender pessoas com asma (94,7%). No total, 89,1% relataram ao menos uma necessidade educacional, com destaque para tratamento e protocolos terapêuticos (32,7%) e uso de dispositivos inalatórios (23,2%). As principais dúvidas dos pacientes referiram-se ao uso correto dos inaladores (60,7%) e à compreensão da cronicidade da doença (20,7%). Também foram relatadas expressões populares (como “chiado” e “piado”) e crenças relacionadas ao uso de chás, lambedores e práticas tradicionais, que afetam a adesão ao tratamento. Conclusão: as necessidades educacionais dos farmacêuticos estão fortemente alinhadas às dúvidas dos pacientes, evidenciando a importância de cursos de qualificação que abordem o contexto sociocultural do cuidado e favoreçam o desenvolvimento de competências práticas e comunicacionais para o manejo da asma.

Objective To assess the prevalence and factors associated with symptoms of anxiety and depression among teachers from a regional education department in Espírito Santo, Brazil. Methods A cross-sectional study was conducted with teachers from state schools, with schools selected through random sampling. A semi-structured questionnaire was applied, containing sociodemographic and occupational data and scales to screen for symptoms of anxiety (Generalized Anxiety Disorder-7) and depression (Patient Health Questionnaire-9). Poisson regression with robust variance was used. Results 453 teachers participated, 65.3% of whom were cisgender women. The prevalence of anxiety symptoms was 32.7% (95%CI 28.4; 37.1) and depression 35.1% (95%CI 31.3%; 39.3). The prevalence of anxiety was higher in cisgender women (PR = 2.43; 95%CI 1.20; 4.89) and people with clinical insomnia symptoms (PR = 3.18; 95%CI 1.76; 5.72) and emotional exhaustion (PR = 2.51; 95%CI 1.36; 4.64). The prevalence of depression was also higher among cisgender women (PR = 1.70; 95%CI 1.15; 2.52), people with insomnia (PR = 1.88; 95%CI 1.29; 2.74), and emotional exhaustion (PR = 1.61; 95%CI 1.06; 2.47). Conclusion Approximately one third of the teachers presented symptoms of anxiety as well as depression. The presence of these symptoms was associated with gender, insomnia, and emotional exhaustion.

Resumo Objetivo Analisar a prevalência e os fatores associados a sintomas de ansiedade e depressão entre professores de uma superintendência regional de educação do Espírito Santo, Brasil. Métodos Estudo transversal, realizado com professores de escolas estaduais, selecionadas por amostragem aleatória. Utilizou-se questionário semiestruturado, contendo dados sociodemográficos, laborais e escalas de rastreamento de sintomas de ansiedade (Generalized Anxiety Disorder-7) e depressão (Patient Health Questionnaire-9). Empregou-se regressão de Poisson com variância robusta. Resultados Participaram 453 professores, 65,3% eram mulheres cisgênero. A prevalência de sintomas de ansiedade foi 32,7% (IC95% 28,4; 37,1) e de depressão, 35,1% (IC95% 31,3%; 39,3). A prevalência de ansiedade foi maior em mulheres cisgênero (RP = 2,43; IC95% 1,20; 4,89) e pessoas com sintomas de insônia clínica (RP = 3,18; IC95% 1,76; 5,72) e exaustão emocional (RP = 2,51; IC95% 1,36; 4,64). A prevalência de depressão também foi maior em mulheres cisgênero (RP = 1,70; IC95% 1,15; 2,52), pessoas com insônia (RP = 1,88; IC95% 1,29; 2,74) e exaustão emocional (RP = 1,61; IC95% 1,06; 2,47). Conclusão Aproximadamente um terço dos professores apresentou sinais de ansiedade, assim como de depressão. A presença de tais sintomas associou-se ao gênero e à presença de insônia e exaustão emocional.