Belo Horizonte Research Articles

Attractiveness of municipalities in Minas Gerais for the installation of forest-based companies

This paper measured the attractiveness of municipalities in the state of Minas Gerais (MG) for projects in the steel, cellulose and paper, furniture, energy and wood panel industry segments. A questionnaire was used to construct an index of attractiveness of the forestry sector for each municipality. As a result, it was found that 40% of the municipalities presented “average” or higher attractiveness. The mesoregions with the greatest potential for forestry development were the Metropolitan region of Belo Horizonte, Southwest of Minas and Zona da Mata. The steel and cellulose and paper segments found attractive factors in 74.08% and 72.79% of the municipalities, respectively. It was concluded that the methodology applied showed how close a location was to meeting the characteristics of forest-based industries. It is expected to encourage future research and influence strategic planning for the expansion of the forestry sector across the country.

Virtual Reconstruction of the Deconstructed Heritage: The Former Building of the Belo Horizonte School of Medicine

Built between 1911 and 1914 by architect Francisco Izidoro Monteiro, the former neoclassical building of the Belo Horizonte School of Medicine (BHSM) was located in a central area of the city. Its design, inspired by the European precepts at the time, was embedded in the same architectural language that characterized the cityscape of the capital of Minas Gerais, Brazil. The original building was gradually dismantled and completely demolished in 1960 to make way for the present headquarters. Few records of its existence remain. In order to contribute to the construction of the digital heritage of the old BHSM building, this article presents its virtual reconstruction, and demonstrates and analyzes the application of Heritage Building Information Modeling (HBIM) for this purpose. Based on data collection and the organization of numerous references (historical photographs, former students’ recollections, magazine articles, books, minutes, and photogrammetry of the remains), a hypothetical model of the building was developed to represent its condition as built and prior to demolition. Despite the difficulties in modeling, it was possible to perform a virtual historical reconstruction of the building, providing a better understanding of the building that does not currently exist. The preservation of the digital heritage of the demolished building aims to raise public awareness of its memory, which is consistent with the collection of the Memory Center of the UFMG School of Medicine (CEMEMOR).

Analysis of the causes of death of live newborns of mothers living in Belo Horizonte/MG in the period 2015-2019

The investigation carried out by the committee for the prevention of infant and neonatal deaths is extremely important to understand what made it possible for the death to happen, what is happening to the population and the family. Aiming at the reduction of deaths from preventable causes. For this to happen in a standardized way it is important that the training of professionals is done, correct filling of forms, improving the quality of care to pregnant women, before and after birth, encouraging guidance and autonomy. Objective: To characterize the deaths of newborns from mothers living in Belo Horizonte/MG in the period 2015 to 2019. Methodology: This is a descriptive study with original secondary data made freely available by the Ministry of Health, through the DATASUS Information System and TABNET. Results: Of the 1,041 newborn deaths in BH/MG, it was possible to find the main causes with emphasis on: some disorders originating in the perinatal period and congenital malformation deformities and chromosomal anomalies. Conclusion: Live birth deaths in Belo Horizonte are preventable, monitoring through prenatal consultations, the birth plan, monitoring of the pregnant woman and humanized delivery within the service capable of meeting the pregnant woman's needs would reduce deaths. In addition to providing reliable data for sizing the public budget and developing strategies that prioritize specific actions for prevention and health promotion.

Blood transfusions per hospitalization in the local public health network of Belo Horizonte between 2008 and 2021: A time series analysis

Background: Blood transfusion rates are increasing worldwide. This work was a longitudinal retrospective study conducted with data referent to the use of blood components between January 2008 and December 2021 in the local public health network of Belo Horizonte, Minas Gerais, at Hospital Risoleta Tolentino Neves (HRTN), Hospital Metropolitano Dr. Célio de Castro (HMDCC), and Hospital Metropolitano Odilon Behrens (HMOB). Objective: This study sought to describe the time series of the number of blood transfusions and blood transfusion rates per general hospitalization through a time series analysis. Methods: Through data from the Hospital Information System of the Unified Health System (HIS-SUS), this study formulated six monthly time series of the number of blood transfusions and blood transfusion rates per hospitalization. The stationarity, trend, and seasonality of the time series were verified by the unit root test, using the Mann-Kendall and the Fisher tests, respectively. The normality hypothesis of the data was verified by the Shapiro-Wilk test. All of the statistical tests considered a significance level of 5%. Results: The average monthly blood transfusion rates per hospitalization observed in this study were 45.5%, 26.9%, and 26.3% at HRTN, HMDCC, and HMOB, respectively. The highest decrease in the number of blood transfusions was observed at HMDCC and the highest decrease in blood transfusion rates was observed at HRTN. Packed red blood cells were the most commonly used blood component at HRTN, HMOB, and HMDCC (54.6%, 58.3%, and 65.4%, respectively). The time series showed that they were non-stationary, with a downward trend and the presence of a 12-month seasonal component. Conclusion: The decline in the number of blood transfusions should be considered a positive phenomenon in public health due to best use and quality management, since a decrease in blood donation rates was also observed.

Maturity of e-government in Brazilian municipalities: analysis of the dissemination of information and knowledge about the Covid-19 pandemic to Society

Electronic government (e-gov) is a reality already experienced by citizens and organizations of different countries around the world. Governments of different levels can provide information and knowledge available through electronic channels in order to provide a better relationship between their institutions and society. This research aims to identify and classify the maturity of electronic portals of municipal governments in the five largest cities in Brazil regarding the dissemination of information and knowledge about the Covid-19 pandemic to society, classifying them according to the stages of maturity of electronic government proposed by Lechakoski and Tsunoda (2015). To acchieve this goal, a descriptive research of multiple cases was carried out, with the application of a documentary research protocol on the websites of the following Brazilian municipal governments: São Paulo (SP), Rio de Janeiro (RJ), Salvador (BA), Belo Horizonte (MG) and Fortaleza (CE). The results showed that the municipalities of São Paulo (SP) and Rio de Janeiro (RJ) showed greater compliance with the criteria analyzed in the model considered, being classified in the 'integrated' stage, the most developed level. The municipalities of Salvador, Belo Horizonte, and Fortaleza were classified in the transactional stage.

Cross-Cultural Adaptation and Validation of the ICIQ-BD for Brazilian Women With Lower Urinary Tract Symptoms.

The International Continence Society recommends the International Consultation on Incontinence Questionnaire-Bladder Diary (ICIQ-BD) for the assessment, management, and monitoring of lower urinary tract symptoms (LUTS). Translation, cross-cultural adaptation and validation will establish a valid and reliable tool for Brazilian women with LUTS. A cross-sectional study involving 101 women was carried out at the Urogynecology Outpatient Clinic in Belo Horizonte, Brazil, between August 2020 and April 2022. The process of cross-cultural adaptation and validation was executed following the ICIQ Group's protocol. Reviewed by an expert committee, the first pre-test was followed by subsequent adaptations, resulting in a second adapted version that underwent expert revisions. A second pretest was conducted, followed by cross-cultural adaptation and construct validation. Finally, the International Consultation on Incontinence Questionnaire-Bladder Diary-Brazilian Portuguese Version (ICIQ-BD-Br) underwent a validation process. Construct validity (IVC >0.78) and internal consistency were satisfactory (α-Cronbach coefficient 0.87-0.94). The following adjustments were made: a specific field was created to document sleep and wake times, and a printed score ranging from 0 to 4 was included in the bladder sensation column. Test-retest reliability ranged from fair to excellent for all analyzed items (Spearman correlation: 0.64-0.95). Criterion validity analysis indicated slight agreement for one of the four symptoms analyzed (nocturia k=0.32). The final version was approved by the ICIQ Group. The ICIQ-BD-Br has been adapted for use in Brazilian Portuguese and has exhibited robust construct validity and reliability for Brazilian women with LUTS.

Representation of the hierarchical and functional structure of an ambulatory network of medical consultations through Social Network Analysis, with an emphasis on the role of medical specialties.

Ambulatory Health Care Networks (Amb-HCN) are circuits of patient referral and counter-referral that emerge, explicitly or spontaneously, between doctors who provide care in their offices. Finding a meaningful analytical representation for the organic and hierarchical functioning of an Amb-HCN may have managerial and health policymaking implications. We aimed to characterize the structural and functional topology of an Amb-HCN of a private health insurance provider (PHIP) using objective metrics from graph theory. This is a cross-sectional quantitative study with a secondary data analysis study design. A Social Network Analysis (SNA) was conducted using office visits performed between April 1, 2021 and May 15, 2022, retrieved from secondary administrative claim databases from a PHIP in Belo Horizonte, Southeastern Brazil. Included were beneficiaries of a healthcare plan not restricting the location or physician caring for the patient. A directional and weighted network was constructed, where doctors were the vertices and patient referrals between doctors, within 7-45 days, were the network edges. Vertex-level SNA measures were calculated and grouped into three theoretical constructs: patient follow-up (aimed at assessing the doctor's pattern of patient follow-up); relationship with authorities (which assessed whether the doctor is an authority or contributes to his or her colleague's authority status); and centrality (aimed at positioning the doctor relative to the network graph). To characterize physician profiles within each dimension based on SNA metrics results, a K-means cluster analysis was conducted. The resulting physician clusters were assigned labels that sought to be representative of the observed values of the vertex metrics within the clusters. Overall, 666,263 individuals performed 3,863,222 office visits with 4,554 physicians. A total of 577 physicians (12.7%) had very low consultation productivity and contributed very little to the network (i.e., about 1.1% of all referrals made or received), being excluded from subsequent doctor profiles analysis. Cluster analysis found 951 (23.9%) doctors to be central in the graph and 1,258 (31.6%) to be peripheral; 883 (22.2%) to be authorities and 266 (6.7%) as seeking authorities; 3,684 (92.6%) mostly shared patients with colleagues, with patient follow-up intensities ranging from weak to strong. Wide profile dispersion was observed among specialties and, more interestingly, within specialties. Non-primary-care medical specialties (e.g., cardiology, endocrinology etc.) were associated with central profile in the graph, while surgical specialties predominated in the periphery, along with pediatrics. Only pediatrics was associated with strong and prevalent (i.e., low patient sharing pattern) follow-up. Many doctors from internal medicine and family medicine had unexpectedly weak and shared patient follow-up profiles. Doctor profiles exhibited pairwise relationships with each other and with the number of chronic comorbidities of the patients they treated. For example, physicians identified as authorities were frequently central and treated patients with more comorbidities. Ten medical communities were identified with clear territorial and specialty segregation. Viewing the Amb-HCN as a social network provided a topological and functional representation with potentially meaningful and actionable emerging insights into the most influential actors and specialties, functional hierarchies, factors that lead to self-constituted medical communities, and dispersion from expected patterns within medical specialties.

The Study of Bluetongue Virus (BTV) and Epizootic Hemorrhagic Disease Virus (EHDV) Circulation and Vectors at the Municipal Parks and Zoobotanical Foundation of Belo Horizonte, Minas Gerais, Brazil (FPMZB-BH).

Bluetongue Virus (BTV) and Epizootic Hemorrhagic Disease Virus (EHDV) are Orbiviruses primarily transmitted by their biological vector, Culicoides spp. Latreille, 1809 (Diptera: Ceratopogonidae). These viruses can infect a diverse range of vertebrate hosts, leading to disease outbreaks in domestic and wild ruminants worldwide. This study, conducted at the Belo Horizonte Municipal Parks and Zoobotany Foundation (FPMZB-BH), Minas Gerais, Brazil, focused on Orbivirus and its vectors. Collections of Culicoides spp. were carried out at the FPMZB-BH from 9 December 2021 to 18 November 2022. A higher prevalence of these insects was observed during the summer months, especially in February. Factors such as elevated temperatures, high humidity, fecal accumulation, and proximity to large animals, like camels and elephants, were associated with increased Culicoides capture. Among the identified Culicoides spp. species, Culicoides insignis Lutz, 1913, constituted 75%, and Culicoides pusillus Lutz, 1913, 6% of the collected midges, both described as competent vectors for Orbivirus transmission. Additionally, a previously unreported species in Minas Gerais, Culicoides debilipalpis Lutz, 1913, was identified, also suspected of being a transmitter of these Orbiviruses. The feeding preferences of some Culicoides species were analyzed, revealing that C. insignis feeds on deer, Red deer (Cervus elaphus) and European fallow deer (Dama dama). Different Culicoides spp. were also identified feeding on humans, raising concerns about the potential transmission of arboviruses at the site. In parallel, 72 serum samples from 14 susceptible species, including various Cervids, collected between 2012 and 2022 from the FPMZB-BH serum bank, underwent Agar Gel Immunodiffusion (AGID) testing for BTV and EHDV. The results showed 75% seropositivity for BTV and 19% for EHDV. Post-testing analysis revealed variations in antibody presence against BTV in a tapir and a fallow deer and against EHDV in a gemsbok across different years. These studies confirm the presence of BTV and EHDV vectors, along with potential virus circulation in the zoo. Consequently, implementing control measures is essential to prevent susceptible species from becoming infected and developing clinical diseases.

Application of the Z-transform on the deconvolution of lightning electric field waveforms obtained from single-station measurements

Fast electric field measurement systems used in the field of atmospheric electricity often have decay time constants of the order of 1 ms, which means that slower processes – such as long continuing currents – are not visible in the raw electric field records. This paper presents a practical approach to compensate for the time decay caused by the system response and regain the original lightning electric field waveforms. To accomplish this task, the transfer function of the measurement system is modeled in the Z-domain. Then, from the inverse Z-transform of the transfer function, the compensated electric field is obtained in discrete time domain. Based on data obtained at Nova Gameleira campus of CEFET-MG (Belo Horizonte, Brazil), we present and discuss results of typical electric field waveforms that include some slower lightning processes, which are not readily observable in the raw data.

Acceptability and consumers' willingness to pay for comprehensive medication management services in Brazil.

Aim: Comprehensive medication management (CMM) is a clinical service that aims to optimize the therapeutic results of patients at the individual level. Studies carried out in Brazil and in several parts of the world have found a positive impact of the service, mainly in the resolution of drug therapy problems and in improving clinical outcomes and patients' quality of life. This service is not widespread and its acceptability and willingness to pay were not defined by the population yet. Objective: This work aims to conduct a study with users of private health services to determine the acceptability and willingness to pay for CMM services. Methods: This is a cross-sectional survey conducted through face-to-face interviews, among residents over 18years of age of the metropolitan region of Belo Horizonte, capital of Minas Gerais State, Brazil. Results: For this study, 563 individuals were interviewed. Most respondents were female (55.1%), had completed high school (46.8%) and were employed (62.5%). The acceptability for the service was 93,25%, and among all respondents, 37 would not accept the service even if it was free. The amount of consumers' willingness to pay for the CMM service was estimated at $17.75 (40.00 BRL). Conclusion: The research results show that most people are willing to pay for the CMM service. This study can contribute to the decision-making regarding the implementation and pricing of the service in Brazil.

Children's territorialities in a Brazilian right-to-housing movement

ABSTRACT This paper discusses children's experiences in the context of a social phenomenon of a Brazilian right-to-housing movement known as urban occupation. Our discussions are focused more specifically on the Rosa Leão occupation, located in the Izidora Region, in Belo Horizonte, Minas Gerais. Based on a research developed between June 2019 and April 2021 with a group of about 19 children (2–14 years old), this paper sought to identify the children's territorialities in this spatial struggle, which occurs through circulation and play in a collective process of reterritorialization. Connecting critical perspectives from childhood studies, this investigation confronts the idea of hegemonic childhood, breaking with a stigmatized view of children’s experiences in poor Latin American cities. It also collaborates with contemporary discussions that assume an analysis of the relations of domination and focus on a historicized, critical, and plural perspective of children’s rights and the right to the city, based on the concreteness of the subjects’ experiences in disputed territories in the midst of urban crisis.

Early childhood caries, family functioning, and common mental disorders in a region of Belo Horizonte, Brazil

Aim: This cross-sectional study aimed to analyze the need for dental treatment in preschool children concerning early childhood caries (ECC), evaluated by the School Health Program (SHP); family functioning; and common mental disorders (CMDs) within families in Belo Horizonte, Minas Gerais, Brazil. Methods: A structured questionnaire was applied to the main caretaker of the 61 children by telephone contact. The questions addressed socioeconomic and demographic data; the Questionnaire of General Family Functioning (GFF) sought to investigate family functioning; and the Self-Reporting Questionnaire (SRQ-20) served to screen for CMDs among the main caretakers. Secondary data were collected from the SHP to survey the need for oral health treatments. The dependent variable was the need for tooth restoration or extraction. The data were analyzed descriptively and by Pearson’s chi-square and Fisher’s exact tests (p < 0.05), using SPSS v.22.0. Results: The median age of the children was 5 years old, and 32.8% required treatment for dental caries. There was no association between the need for tooth restoration or extraction and socioeconomic factors, family relations, and the presence of CMDs in the main caretaker (p > 0.05). However, there was a greater frequency of need for treatment in families with low income (24.6%) and with less social support (family and friends < 1). Children whose family was included in the Family Grant Program (62.3%), the respondent was the mother (57.4%), had completed high school or higher (36.1%), no paid work (42.6%), with a traditional or nuclear family structure (27.8%), and living in a house with good sanitary conditions (63.9%) presented a lower frequency of need for treatment. The GFF and SRQ-20 values among preschool children with and without the need for dental treatment were similar. Conclusion: There was a trend of a higher need for ECC treatment in children from families with lower income and less familiar and social support.

ATUAÇÃO DO ESTETICISTA NO PRÉ E PÓS-OPERATÓRIO DE ABDOMINOPLASTIA

Aesthetics are in evidence. The effectiveness of a plastic surgery does not depend solely on its surgical organization because the care with pre and postoperative care has shown a preventive factor for probable complications and the promotion of a more satisfactory aesthetic result. In this context, abdominoplasty is a common surgery among women, and its performance usually happensafter excessive weight loss, muscle loss and after pregnancy. This study aimed to analyze theperformance of the esthetician before and after the abdominoplasty, verifying if the aestheticapproaches adopted are effective to provide the complete recovery of the patient, and to avoidpossible complications. If I carry out a bibliographic review on the topic highlighted in booksand periodicals, this article is also observational and descriptive, characterized by aprevalence study carried out with a group of eight female patients who had previouslyundergone abdominoplasty surgery, in the city of Belo Horizonte Minas Gerais. Theinstrument used for data collection was a structured and investigative questionnaire about thepre and postoperative period of abdominoplasty. Conclusion: Aesthetics is based on solidscientific concepts and has contributed a lot both in the pre and postoperative period,preventing and / or treating complications arising from plastic surgeries, also providing areduction in postoperative anxiety, recurrent edema of surgical trauma, fibrosis and scarring.

Informality through the state: How overregulation and tolerance shape informal land development in metropolitan Brazil

The relationship between the state and informal land development in Global South metropolises has yet not received much attention in urban studies. Concerning that knowledge gap, this paper investigates how the state regulates and inspects irregular and clandestine land subdivisions in the Metropolitan Region of Belo Horizonte (MRBH). A mixed-methods approach, focused on the inner workings of the land development control policy led by the MRBH Agency between 2009 and 2018, provides new evidence of the relationships between inspectors, developers, and prosecutors, among other actors. By delving deep into the intricate nexus between a changing regulatory landscape and the bureaucratic, street-level, and everyday enforcement practices by officials, the paper reveals how land development control, directly and indirectly, shapes informal land development in the MRBH. Particularly, it sheds light on how land development control unrolls through a contradictory combination of overregulation on one side and tolerance on the other. In light of this, I argue that, as land development control evolves without effectively tackling the land question and the structural drivers of informality, the state becomes paradoxically entangled in the production of the same forms of informality it is expected to curb. Therefore, land development control is better understood as a fragile and ambivalent state compromise between the need to regulate urban expansion and market-driven informal urbanisation. By creating opportunities for rent extraction and capital accumulation which are explored by informal land developers, the state has been crucial for property-led informal urbanisation in metropolitan Brazil.

ATUAÇÃO DO ESTETICISTA NO PRÉ E PÓS-OPERATÓRIO DE ABDOMINOPLASTIA

Aesthetics are in evidence. The effectiveness of a plastic surgery does not depend solely on its surgical organization because the care with pre and postoperative care has shown a preventive factor for probable complications and the promotion of a more satisfactory aesthetic result. In this context, abdominoplasty is a common surgery among women, and its performance usually happensafter excessive weight loss, muscle loss and after pregnancy. This study aimed to analyze theperformance of the esthetician before and after the abdominoplasty, verifying if the aestheticapproaches adopted are effective to provide the complete recovery of the patient, and to avoidpossible complications. If I carry out a bibliographic review on the topic highlighted in booksand periodicals, this article is also observational and descriptive, characterized by aprevalence study carried out with a group of eight female patients who had previouslyundergone abdominoplasty surgery, in the city of Belo Horizonte Minas Gerais. Theinstrument used for data collection was a structured and investigative questionnaire about thepre and postoperative period of abdominoplasty. Conclusion: Aesthetics is based on solidscientific concepts and has contributed a lot both in the pre and postoperative period,preventing and / or treating complications arising from plastic surgeries, also providing areduction in postoperative anxiety, recurrent edema of surgical trauma, fibrosis and scarring.

Spatiotemporal variability in human thermal comfort perception in open-air spaces: application to the state of Minas Gerais, Brazil.

The objective of this study was to propose bioclimatic zoning to classify human thermal comfort and discomfort in the state of Minas Gerais, Brazil; both historical and future scenarios are considered. Thus, historical series (1961 to 2017) of the effective temperature index as a function of the wind (ETW) were obtained as a function of the monthly average values of the minimum, mean, and maximum dry-bulb air temperatures (tdb,min, tdb,mean, and tdb,max, respectively), in addition to the mean relative humidity ([Formula: see text], %) and mean wind speed ([Formula: see text], m s -1). The data were obtained from 34 weather stations and subjected to trend analysis by using the nonparametric Mann-Kendall test, thus enabling the simulation of future scenarios (for 2028 and 2038). Then, to define the thermal ranges of the bioclimatic zoning, maps of ETWmin, ETWmean, and ETWmax were created from geostatistical analysis. Overall, the results show warming trends for the upcoming years in Minas Gerais municipalities. All climatic seasons showed an increase in the frequency of new classifications in the upper adjacent classes, which indicates climate warming. Therefore, when considering future scenarios for the autumn and winter seasons, attention should be given to changes in predicted thermal sensation, especially in the Central Minas Gerais, Belo Horizonte Metropolitan, South/Southwest Minas, Campo das Vertentes, and Zona da Mata.

Description of vaccination coverage and hesitancy obtained by epidemiological survey of children born in 2017-2018, in Belo Horizonte and Sete Lagoas, Minas Gerais, Brazil.

To describe vaccination coverage and hesitation for the basic children's schedule in Belo Horizonte and Sete Lagoas, Minas Gerais state, Brazil. Population-based epidemiological surveys performed from 2020 to 2022, which estimated vaccine coverage by type of immunobiological product and full schedule (valid and ministered doses), according to socioeconomic strata; and reasons for vaccination hesitancy. Overall coverage with valid doses and vaccination hesitancy for at least one vaccine were, respectively, 50.2% (95%CI 44.1;56.2) and 1.6% (95%CI 0.9;2.7), in Belo Horizonte (n = 1,866), and 64.9% (95%CI 56.9;72.1) and 1.0% (95%CI 0.3;2.8), in Sete Lagoas (n = 451), with differences between socioeconomic strata. Fear of severe reactions was the main reason for vaccination hesitancy. Coverage was identified as being below recommended levels for most vaccines. Disinformation should be combated in order to avoid vaccination hesitancy. There is a pressing need to recover coverages, considering public health service access and socioeconomic disparities. Vaccination coverage of children up to 4 years old was 50.2% in Belo Horizonte, and 64.9% in Sete Lagoas. Fear of severe reactions and believing that vaccination against eradicated diseases is unnecessary were the main reasons for vaccination hesitancy. Recovery of high vaccination coverage among children, considering public health service access conditions and socioeconomic inequities. Acting on reasons for hesitancy that can assist in targeting actions. The multifactorial context of vaccination hesitancy demands the development of health education strategies to raise awareness about child immunization.

What Explains the Infrastructure Inequality of the EMEIs in Belo Horizonte?

RESUMO O artigo analisa se há associação da desigualdade na infraestrutura das escolas municipais de educação infantil (EMEIs) de Belo Horizonte quanto i) à localização, ii) ao tipo de gestão e iii) à correção de informação censitária prestada, em relação ao ano de 2019. Os dados do Censo Escolar foram cotejados com indicadores econômicos e visitas in loco. Verificou-se que a distribuição territorial das EMEIs e o tipo de administração têm repercussões no grau de adequação de infraestrutura das escolas. Porém, essas variáveis apresentaram pouco poder explicativo para as desigualdades encontradas no Censo Escolar daquele ano. Em contrapartida, identificou-se discrepâncias entre os dados preenchidos pelas unidades educacionais e as informações verificadas em visitas locais.

Homicides in southern South American cities: educational inequalities and economic fluctuations

Information on how economic fluctuations affect educational inequalities in homicides in Latin America is scarce. This study aimed to: (a) analyze the temporal variations of educational inequalities related to homicide mortality and (b) compare these inequalities between years of economic growth and recession in southern South America cities from 2000 to 2019. Data from seven urban areas in three countries in the Southern Cone of South America were used: Mendoza and Rosario (Argentina); Belo Horizonte, Curitiba, Rio de Janeiro, and São Paulo (Brazil); and Santiago (Chile). Poisson models were estimated by using age, sex, city of residence, year of economic growth or recession, and schooling level as explanatory variables. Results showed significant differences in the temporal evolution of homicide rates in the seven cities, although populations with a low schooling level always showed the most vulnerability. The four Brazilian cities, analyzed together, showed greater educational inequalities related to homicides in years of economic recession when compared to those of economic growth. On the one hand, the indiscriminate use of force by the State against criminal groups seems to increase social inequality in homicide mortality. On the other hand, criminal fragmentation and economic crisis can exacerbate these inequalities by increasing territorial disputes between criminal groups.

Consumer food environments change over a 5-year period.

Evaluate the 5-year changes in the consumers' food environment in the area of a health promotion service in Brazilian primary health care. Our hypothesis is that the consumers' food environment in the areas with primary healthcare services has changes that may favour healthy eating habits over time. Longitudinal study. The territory around the primary healthcare services in Belo Horizonte, Minas Gerais, Brazil. All food stores and open-air food markets that sell fruits and vegetables around the primary healthcare services in 2013 (n 272) and in 2018 (n 265). Fruit diversity increased by 13·4 % (P < 0·001) and vegetables variety and quality by 16·1 % (P = 0·003) and 12·5 % (P < 0·001), respectively. Corn snacks showed an increase in availability (13·5 %; P = 0·002). The increase in advertising was observed for fruits and vegetables (34·6 %; P < 0·001) and ultra-processed foods (47·6 %; P < 0·001). Supermarkets showed an increase in the Healthy Food Store Index (three points; P < 0·001), while fruits and vegetables stores showed a decrease of one point in the index (P < 0·001). The unequal changes in the consumers' food environment according to the food stores types demonstrate the importance of food supply policies that promote a healthy environment and favour the maintenance of traditional healthy food retailers.