Brazil Research Articles

Markedly declining reproductive functional diversity of food plants in the world’s largest tropical country despite rapid cropland expansion

Cropland intensification in tropical regions is usually associated with agricultural commodity expansion that penalizes the species diversity and environmental services of natural ecosystems. However, the extent to which cropland expansion affects the reproductive functional diversity of crop arrangements remains poorly investigated. Here we examine the agricultural development of a leading agricultural producer and megadiverse country (Brazil) over the last six decades to understand the effects of agricultural expansion on the reproductive functional diversity of crops, particularly those bearing specialized traits. We used the FAO database, which provides annualized information on crop production from 1961 to 2018. Cultivated species were classified according to their reproductive traits and levels of dependence on biotic pollination, used as indicators of functional diversity. Our results show that cropland areas in Brazil expanded by 201.3% from 1961 to 2018. In particular, pollinator‐dependent crops expanded over this period by 305.2% compared to 125.3% in non-dependent crops. Expansion of monoculture farmland was remarkable, comprising 88% of the entire agricultural cropland acreage in 2018, 45% of which was represented by soybean. Additionally, cropland expansion was related to a reduction in functionally diverse crop species, which was most intense for those with specialized reproductive traits. These results indicate a threat to a diversified food production system and its resilience, given the impacts of cropland expansion on native biodiversity and the reduction in pollination services for many crops. We argue that agroecosystems in Brazil require sustainable, pollinator-friendly agricultural practices to maintain or enhance a nutritionally diversified food production system. Integrated practices that sustain agricultural cropland mosaics characterized by high reproductive functional diversity of the cultivated species can be a nature-based solution to protect natural pollinators and pollination services within a diversified food system.

PREVALENCE OF BURNOUT SYNDROME IN HEALTHCARE WORKERS IN NORTH AND SOUTH AMERICA, AND ASIA FROM 2018 TO 2022

The article explores issues concerning prevalence of burnout syndrome in healthcare workers in North and South America, and Asia from 2018 to 2022. Thus for this purpose, a great number of scientific sources that are related to the topic of the research were examined.
 Healthcare professionals face a tremendous strain during the performing of their activities that often may lead to stress and burnout syndrome. In particular, duties of healthcare workers include high responsibility for life and health of a patient, self-discipline, urgent decision-making, empathy, high productivity during extreme conditions, constant psychological and intellectual tension.
 During the past 30+ years, burnout syndrome was studied by scientists, practitioners, and also by general public all around the world. It should be noted, that nowadays a lot of employees (in particular, healthcare workers) are faced with rapid changes in our modern working life, namely, time pressure, pressure of higher productivity/quality of work, need to learn new skills, increasing demands of adaptation to new types of work, hectic jobs, etc., that in result may cause burnout syndrome.
 Burnout syndrome of healthcare workers is usually associated with poor quality of medical care and may lead to medical errors, exhaustion, inefficiency, and conflicts. High levels of burnout syndrome among medical professionals of different countries around the world vary from 7,4% to 66%.
 The issues concerning prevalence of burnout syndrome in healthcare workers in North and South America, and Asia from 2018 to 2022 have not been sufficiently identified and also require more detailed research.
 Research of scientists that used the Maslach Burnout Inventory (hereinafter – the MBI), and the Copenhagen Burnout Inventory (hereinafter – the CBI) to research the burnout syndrome in healthcare workers of different specialties (including "Family Medicine") were included in this article.
 Based on the conducted research, the following conclusions can be reached: the research carried out to identify prevalence of burnout syndrome in healthcare workers in North and South America, and Asia from 2018 to 2022 found out the presence of burnout syndrome in healthcare workers ranging from 1,3% to 82,1%. Moreover, prevalence of burnout syndrome in healthcare workers in North and South America varied from 1,3% to 73,5%, whereas in Asia it varied from 5,2% to 82,1%. Factors that associated with burnout in healthcare workers in North and South America, and Asia were examined. The majority of scientific studies on the identification of the prevalence of burnout syndrome in healthcare workers from 2018 to 2022: a) in North and South America have been conducted in Canada, the United States of America, the Federative Republic of Brazil, and the Argentine Republic, etc., whereas b) in Asia have been conducted in China, Japan, India, Pakistan, Iran, Lebanon, Saudi Arabia, Turkey, Oman, Cyprus, Israel, Jordan, and Kazakhstan, etc. Intensivists, physiatrists, resident physicians, oncologists, general surgeons, internal medicine physicians, and emergency medicine physicians are special categories of healthcare workers who are at a high risk of formation of burnout syndrome that may develop due to the specific of professional activity.

Disruptions to the social determinants of health and mental health indicators during the pandemic in eight countries

IntroductionThe social determinants of health (SDoH) shape both the risk of mental disorders and access to treatment. There is ample evidence detailing the decline in mental health during the Covid-19 pandemic. However, there is a gap in our understanding of the association between disruptions to SDoH and adverse psychological indicators in different contexts. MethodsData were collected through a multi-country, random, anonymous, opt-in, cross-sectional online survey in eight geographically diverse countries—Brazil, China, Germany, Egypt, India, Indonesia, Nigeria, and the United States. We documented the relationship between experiencing self/family job loss, financial problems, and food/supplies shortages and adverse mental health indicators—depression symptoms and probable posttraumatic stress disorder (PTSD). ResultsAlmost one-third of respondents who experienced at least one disruption had depression symptoms (32.3%, 95% CI: 30.3%–34.4%). This was consistent across countries, except Indonesia. Reporting at least one Covid-19 related SDoH disruption had 1.26 (95% CI: 1.14-1.39) times the risk of depression symptoms compared to respondents reporting no Covid-19 related SDoH disruptions. Across countries, experiencing at least one Covid-19 related SDoH disruption had significantly increased risk of depression symptoms, except for China, Egypt, and Indonesia. The prevalence of probable PTSD among respondents who reported at least one SDoH disruption was 8.4% (95% CI: 7.3%–9.5%). The prevalence was comparably elevated within countries, except for China. Reporting at least one SDoH disruption was associated with greater odds of probable PTSD in the overall adjusted model (OR=2.87, 95% CI: 2.31-3.59) and in the models for countries except for China and Indonesia. ConclusionDisruptions to SDoH due to the pandemic were associated with an elevated burden of symptoms of depression and probable PTSD across geographically diverse countries, with a few exceptions particularly in China. This highlights the need to account for the broader consequences of mitigation policies that potentially have an impact on the health of populations.

Community participation in health as an essential element for health system strengthening in the AmericasLa participación en salud como elemento indispensable para el fortalecimiento de los sistemas de atención de salud en las Américas

The present narrative review discusses the relevance and challenges of community participation in health for health system strengthening. Based on a definition of community participation in health as a dynamic process that gives people access and control over health resources through involvement and experience, the article summarizes information obtained from documents and debate at an international event (Seminario Internacional: Experiencias y Modelos de Participación en Salud en América Latina y el Caribe). In addition, the SciELO, PubMed and Google Scholar databases were searched using the terms "community participation", "community engagement", "social control" and "community health planning" to identify national or transnational review and opinion articles. Community participation in health is a current concept, acknowledged in the recommendations for health policies described in recent documents and publications. Around the world, the number of studies on the subject is growing; however, in the Americas, three countries (United States, Canada and Brazil) accounted for most of the scientific publications identified in the databases. The studies address timely questions and show consensus among investigators within each individual research group. However, the area lacks exchanges and comparative analyses that contrast different experiences transcending national borders and expanding knowledge on community participation in health. The creation of more spaces for the sharing of experiences and research is advised, as well as the establishment of professional and research networks in the field of community participation in health.

Country-Specific Participation Patterns in Transnational Governance Initiatives on Sustainability: Preliminary Insights and Research Agenda.

Transnational public-private governance initiatives (TGIs) have become key elements in global governance, especially in the governance of sustainability. Pertinent research has concentrated on why TGIs have emerged as well as on their impacts on political outcomes and questions related to their legitimacy. This instructive literature has predominantly focused on TGIs as entities in their own right. This explorative study contributes to the literature by advocating a complementary analytical perspective that pays attention to domestic-level patterns of participation in TGIs and national factors that determine which types of organizations (public, business, or civil society) participate in TGIs. It is shown for six Latin American countries (Argentina, Brazil, Chile, Colombia, Mexico, and Peru) that there exists cross-country variation in the composition patterns in 29 TGIs on sustainability, suggesting that national conditions matter for how organizations participate in them. By improving the knowledge of the national conditions, a more complete analysis of participation and the effectiveness of TGIs can be provided in global sustainability governance. In this spirit, in a last step,an agenda is developed for guiding future research on this topic.

Recovery of Routine Immunisation: Mapping External Financing Opportunities for Reaching Zero-Dose Children.

The COVID-19 pandemic has precipitated large declines in childhood vaccination coverage and, consequently, substantial increases in the number of zero-dose children. To effectively respond to these declines, it is necessary to direct resources for recovery. We mapped active external financing for immunisation and primary healthcare in 20 countries with the highest numbers of zero-dose children to promote transparency and donor coordination. We found that countries have disparate access to external financing, with the two upper-middle-income countries (Brazil and Mexico) only having access to loans from the International Bank for Reconstruction and Development. Domestic resource mobilization is, therefore, key in these two countries, although fiscal space is likely constrained. Four additional countries (Angola, Indonesia, Philippines, and Vietnam) do not have allocations from Gavi, the Vaccine Alliance for Health Systems Strengthening, or Equity Accelerator Funding, but are eligible for support under Gavi's Middle-Income Countries Approach. Our methods, which focus on current donor financing, are novel and reveal substantial variations in access to external financing to support immunisation in high-burden countries. The available data differ considerably across financing mechanisms, making it difficult to synthesise the results across funding sources.

Finansal Gelişme ve Doğrudan Yabancı Sermaye Yatırımlarının Ekolojik Ayakizi Üzerindeki Etkileri: Panel Nedensellik Analizi

In this study, the causality test developed by Emirmahmutoğlu and Köse (2011) for the BRICS-T countries (Brazil, Russia, India, China, South Africa and Turkey) the effects of financial development and foreign direct investment investments on the ecological footprint is based on the 1992-2018 period. intended to be used. Firstly, the cross-section test and delta tests were performed. Then, Pesaran (2007) CIPS panel unit root test and Emirmahmutoğlu and Köse (2011) causality test were used. As a result of the study, a one-way causality relationship between financial development and ecological footprint, bidirectional causality between foreign direct investment and ecological footprint, and one-way causality between financial development and foreign direct investment was found for the countries studied. Keywords: Financial Development, Foreign Direct Investment, Ecological Footprint, Panel Causality

Does Capital Account Liberalization and Foreign Banks Ownership Lead to Income Disparity? An Analysis of BRICS Economies

The purpose of the study is to evaluate the impact of capital account liberalization and foreign bank ownership on income inequality. In this study, we have analyzed BRICS countries. In this study, we have used an unbalanced panel dataset. The timeline was 1991-2020, and the BRICS countries (Brazil, Russia, India, China, and South Africa) were analyzed. To measure the data on capital account liberalization, we have used the KAOPEN index. We used income inequality as the independent variable in the study, and we measured it through Gini Coefficient. At the same time, the capital account liberalization is taken as the dependent variable and measured it through the KAOPEN index. The author analyzed per capita income, unemployment rate, inflation, and population growth as controlled variables. In robustness analysis, institutional quality variables such as corruption and government stability ratings were included. The study found that sustainable capital account liberalization and foreign banks ownership could help to reduce income inequality.

Regional and national burden of prostate cancer: incidence, mortality, years of life lost, and disability-adjusted life years, in Mexico and Latin America from 1990 to 2019.

Prostate cancer (PC) is the second leading cause of cancer and the fifth cause of cancer-related death. This manuscript aims to determine the incidence, mortality, and Disability Adjusted Life Years (DALYs) trends of PC in the last 30years in Latin America and Mexico. We performed a cross-sectional analysis of a publicly available data set. Data regarding the burden of prostate cancer in 20 Latin-American countries, and the 32 states of Mexico, were retrieved from the Global Burden of Disease Study 2019. Collected information included incidence and mortality rates (per 100,000), as well as the DALYs as absolute numbers and rates (per 100,000) and the annual rates of change in rates from 1990 to 2019. In Latin America in males aged 55years or older, the mean incidence rate was 344 cases per 100,000. The number of deaths attributable to prostate cancer observed was 67,110 and the mean mortality rate was 210 per 100,000. The overall burden of disease was 1,120,709 DALYs and the contribution of years of life lost (YLL) was 91.7% ([Formula: see text]= 1,027,946). Mexico presented an incidence rate (279.6) and mortality (99.1) rate (per /100 thousand). In Mexico, 13 states had a DALYs' rate above the national mean (883 per 100,000) and the highest burden (1360 DALYs/100,000) were documented in the state of Guerrero (Southwestern Mexico). Only two Latin-American countries (Brazil and Colombia) and eight states of Mexico showed a decreased trend about the rate of change of DALYs in the last 30years.

The emotional experience of treatment for locally advanced cervical cancer: Qualitative research findings from Brazil, China, Germany and the US.

e24217 Background: Little has been reported on the emotional journey of women treated for locally advanced cervical cancer (LACC). This study aimed to understand the expectations and experience of these women. Methods: Semi-structured telephone interviews were conducted in 2022 among women diagnosed with LACC in the past 2 years in Brazil (BR), China (CH), Germany (DE) and the US. This research elicited voices representing diverse demographic & socioeconomic groups. Trained moderators asked questions about experience and emotions during the journey from diagnosis through treatment. Transcripts were coded using NVivo qualitative analysis software to identify key themes that emerged from the data. Results: Ninety-two women in the US (n = 26), BR (n = 25), CH (n = 25), and DE (n = 16) participated, with mean age ranging from 35.7 years in BR to 53.4 years in DE. At the time of treatment decision, women reported receiving information about what to expect during treatment, including information about short and long term side effects of treatment (US 13/21, BR 14/22, CH 6/21, DE 6/9). Several women reported their doctor raising the chance to be cured after surgery/treatment (US 3/21, BR 12/22, CH 3/21, DE 1/9) and many women asked about prognosis (US 1/5, BR 2/6, CH9/17, DE 2/6). While most women reported that their doctors answered their questions and came away with positive feelings, some came away with negative feelings, did not ask questions generally (10/54) about diagnosis (7/37) and/or treatment (5/18) and blamed themselves (US 1/1, BR 1/2, CH2/3, DE 1/4). “No, I didn’t [believe all my questions were answered], but I believed the problem was about myself. At that moment, I had no idea what questions I should ask my doctor.” CN06 “No. As I was alone, I was so scared that I did not ask much.” BR25 Women shared that positive parts of their cancer journey were (a) gratitude and personal growth, (b) receiving support or making connections, (c) appreciation for their HCPs. Women noted negative aspects including (a) dealing with cancer or side effects, (b) facing death, recurrence or knowing others who have died, (c) encountering negative or unsupportive reactions from others. At the time of interview, most women (n = 68/92) described their general health as good, even while some continued experiencing minor symptoms or treatment side effects. Negative impacts of LACC included feelings of denial, worry, depression, fear, and worsening health. Conclusions: Currently, women report both positive and negative aspects of their LACC treatment decision and cancer care journey. A better understanding of women’s feelings when deciding on treatment, including feelings about how information needs are addressed, can promote a more positive interaction with the healthcare system, satisfaction with LACC treatment, experience living with the impact of the treatment they chose, and outlook for the future.

Effect of the relationship between anaemia and systemic inflammation on the risk of incident tuberculosis and death in people with advanced HIV: a sub-analysis of the REMEMBER trial.

Tuberculosis (TB) is an infectious morbidity that commonly occurs in people living with HIV (PWH) and increases the progression of HIV disease, as well as the risk of death. Simple markers of progression are much needed to identify those at highest risk for poor outcome. This study aimed to assess how baseline severity of anaemia and associated inflammatory profiles impact death and the incidence of TB in a cohort of PWH who received TB preventive therapy (TPT). This study is a secondary posthoc analysis of the AIDS Clinical Trials Group A5274 REMEMBER clinical trial (NCT0138008), an open-label randomised clinical trial of antiretroviral-naïve PWH with CD4 <50cells/μL, performed from October 31, 2011 to June 9, 2014, from 18 outpatient research clinics in 10 low- and middle-income countries (Malawi, South Africa, Haiti, Kenya, Zambia, India, Brazil, Zimbabwe, Peru, and Uganda) who initiated antiretroviral therapy and either isoniazid TPT or 4-drug empiric TB therapy. Plasma concentrations of several soluble inflammatory biomarkers were measured prior to the commencement of antiretroviral and anti-TB therapies, and participants were followed up for at least 48 weeks. Incident TB or death during this period were primary outcomes. We performed multidimensional analyses, logistic regression analyses, survival curves, and Bayesian network analyses to delineate associations between anaemia, laboratory parameters, and clinical outcomes. Of all 269 participants, 76.2% (n=205) were anaemic, and 31.2% (n=84) had severe anaemia. PWH with moderate/severe anaemia exhibited a pronounced systemic pro-inflammatory profile compared to those with mild or without anaemia, hallmarked by a substantial increase in IL-6 plasma concentrations. Moderate/severe anaemia was also associated with incident TB incidence (aOR: 3.59, 95% CI: 1.32-9.76, p=0.012) and death (aOR: 3.63, 95% CI: 1.07-12.33, p=0.039). Our findings suggest that PWH with moderate/severe anaemia display a distinct pro-inflammatory profile. The presence of moderate/severe anaemia pre-ART was independently associated with the development of TB and death. PWH with anaemia should be monitored closely to minimise the occurrence of unfavourable outcomes. National Institutes of Health.

ANALYSIS OF INDONESIAN COFFEE EXPORT DEMAND IN THE UNITED STATES USING THE AIDS MODEL

Indonesia is the fourth largest coffee producing country in the world after Brazil, Vietnam and Colombia. Of the total production, around 67% of the coffee is exported while the rest (33%) is used to meet domestic demand. The level of domestic coffee consumption based on the results of the 1989 LPEM UI survey was 500 grams/capita/year. Coffee entrepreneurs estimate that coffee consumption in Indonesia has reached 800 grams/capita/year. Likewise, within 20 years the increase in coffee consumption has reached 300 grams/capita/year. (AEKI 2022). competition research on Indonesian coffee in the United States market by using the Almost Ideal Demand System (AIDS) method. The use of the AIDS model is used to analyze the position and level of competition between coffee exporting countries (Indonesia, Vietnam, and Brazil and Colombia) from each export destination country, namely the United States. the estimation results on the AIDS model of Indonesian coffee in the United States market get an R-Square value of 0.4136 percent. Vietnam in the United States market obtained an R-Square value of -0.216 . Brazil in the United States market obtained an R-Square value of 0.44%. Columbia in the United States market obtained an R-Square value of 0.4488%. Coffee from Indonesia competes with coffee from Vietnam, Brazil and Columbia. The cross-price elasticity obtained between the price elasticity of Indonesia-Vietnam coffee is positive at 0.9443, and the price elasticity value of Indonesia-Brazil coffee is 0.0330, the price elasticity value for Indonesia-Columbia coffee is 0.5854. The expenditure elasticity values obtained by Indonesian coffee were 0.4479, Vietnam coffee were 1.7403, the expenditure elasticity values for Brazil and Columbia coffee were 1.0155 and 0.9042. in the United States Market.

The third Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT3): an international, stepped wedge cluster randomised controlled trial

Early control of elevated blood pressure is the most promising treatment for acute intracerebral haemorrhage. We aimed to establish whether implementing a goal-directed care bundle incorporating protocols for early intensive blood pressure lowering and management algorithms for hyperglycaemia, pyrexia, and abnormal anticoagulation, implemented in a hospital setting, could improve outcomes for patients with acute spontaneous intracerebral haemorrhage. We performed a pragmatic, international, multicentre, blinded endpoint, stepped wedge cluster randomised controlled trial at hospitals in nine low-income and middle-income countries (Brazil, China, India, Mexico, Nigeria, Pakistan, Peru, Sri Lanka, and Viet Nam) and one high-income country (Chile). Hospitals were eligible if they had no or inconsistent relevant, disease-specific protocols, and were willing to implement the care bundle to consecutive patients (aged ≥18 years) with imaging-confirmed spontaneous intracerebral haemorrhage presenting within 6 h of the onset of symptoms, had a local champion, and could provide the required study data. Hospitals were centrally randomly allocated using permuted blocks to three sequences of implementation, stratified by country and the projected number of patients to be recruited over the 12 months of the study period. These sequences had four periods that dictated the order in which the hospitals were to switch from the control usual care procedure to the intervention implementation of the care bundle procedure to different clusters of patients in a stepped manner. To avoid contamination, details of the intervention, sequence, and allocation periods were concealed from sites until they had completed the usual care control periods. The care bundle protocol included the early intensive lowering of systolic blood pressure (target <140 mm Hg), strict glucose control (target 6·1-7·8 mmol/L in those without diabetes and 7·8-10·0 mmol/L in those with diabetes), antipyrexia treatment (target body temperature ≤37·5°C), and rapid reversal of warfarin-related anticoagulation (target international normalised ratio <1·5) within 1 h of treatment, in patients where these variables were abnormal. Analyses were performed according to a modified intention-to-treat population with available outcome data (ie, excluding sites that withdrew during the study). The primary outcome was functional recovery, measured with the modified Rankin scale (mRS; range 0 [no symptoms] to 6 [death]) at 6 months by masked research staff, analysed using proportional ordinal logistic regression to assess the distribution in scores on the mRS, with adjustments for cluster (hospital site), group assignment of cluster per period, and time (6-month periods from Dec 12, 2017). This trial is registered at Clinicaltrials.gov (NCT03209258) and the Chinese Clinical Trial Registry (ChiCTR-IOC-17011787) and is completed. Between May 27, 2017, and July 8, 2021, 206 hospitals were assessed for eligibility, of which 144 hospitals in ten countries agreed to join and were randomly assigned in the trial, but 22 hospitals withdrew before starting to enrol patients and another hospital was withdrawn and their data on enrolled patients was deleted because regulatory approval was not obtained. Between Dec 12, 2017, and Dec 31, 2021, 10 857 patients were screened but 3821 were excluded. Overall, the modified intention-to-treat population included 7036 patients enrolled at 121 hospitals, with 3221 assigned to the care bundle group and 3815 to the usual care group, with primary outcome data available in 2892 patients in the care bundle group and 3363 patients in the usual care group. The likelihood of a poor functional outcome was lower in the care bundle group (common odds ratio 0·86; 95% CI 0·76-0·97; p=0·015). The favourable shift in mRS scores in the care bundle group was generally consistent across a range of sensitivity analyses that included additional adjustments for country and patient variables (0·84; 0·73-0·97; p=0·017), and with different approaches to the use of multiple imputations for missing data. Patients in the care bundle group had fewer serious adverse events than those in the usual care group (16·0% vs 20·1%; p=0·0098). Implementation of a care bundle protocol for intensive blood pressure lowering and other management algorithms for physiological control within several hours of the onset of symptoms resulted in improved functional outcome for patients with acute intracerebral haemorrhage. Hospitals should incorporate this approach into clinical practice as part of active management for this serious condition. Joint Global Health Trials scheme from the Department of Health and Social Care, the Foreign, Commonwealth & Development Office, and the Medical Research Council and Wellcome Trust; West China Hospital; the National Health and Medical Research Council of Australia; Sichuan Credit Pharmaceutic and Takeda China.

Ear identification: A multi-ethnic study sample

The external human ear is considered to be highly variable among individuals. Hence, forensic applications could be explored for human identification. This research compares the usefulness of Cameriere's ear identification method, in samples originating from six different countries (Brazil, India, Japan, Russia, South Africa and Turkey) in order to examine possible differences in their accuracy values. A sample of 2,225 photographs of the external human ear (1,134 left and 1,091 right ears) from 1,411 individuals (633 females and 778 males) was collected. The samples included healthy subjects with no systemic disorders and without any craniofacial trauma, maxillofacial abnormalities, auricular anomalies, ear diseases or previous auricular surgery. Cameriere's ear identification method was applied and measurements were performed on the images of each ear, considering four anatomic regions: helix, antihelix, concha, and lobe. The quantified measurement values were converted into a proposed coded number system. A search for identical codes was accomplished to find out the distinctiveness of the morphology of the human ear. The combined codes of left and right ears of each of the 814 subjects were not repeated in this multi-ethnic study sample. Dirichlet's distribution and the inherent study equation showed that the probability of two different individuals having the same code (false-positive identification) was found to be <0.0007. Because of the distinctive metrics of the ratios of external human ears, studies with Cameriere's ear identification method may be valuable for human identification. Studying the differences between the left and right ears of the same individual and across different ethnic groups could contribute to the development of supplementary tools for human identification.

Determinants of Inclusive Economic Growth in Latin America

The work aims to identify the determinants that influence inclusive economic growth in Latin America. The study’s methodology is quantitative with a nonexperimental design, for whose effect analysis was developed through a panel data model to identify the determinant variables of inclusive economic growth. Annual data of the main macroeconomic and social variables were used for a sample of 14 Latin American countries (Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, El Salvador, Honduras, Mexico, Panama, Paraguay, Peru, and Uruguay); the study horizon comprises 25 years, between 1995 and 2019. The following variables were found to have a direct influence on inclusive economic growth: public spending and international trade; the study also showed that inflation, unemployment, and the presence of crises have a negative impact on inclusive economic growth. Moreover, an additional public expenditure of 1% implies an increase of 0.100% in inclusive economic growth, and for each positive variation of 1% in international trade, inclusive economic growth responds with an increase of 0.144%.

Is ecological footprint related to foreign trade? Evidence from the top ten fastest developing countries in the global economy

An ecological footprint (EF) refers to the resources that are used by the people or production companies in an area for commerce, which includes the production of food, water resources, and housing; however, it also includes foreign trade of the products produced. The present study aims to examine how foreign trade affects EF and recommend specific new policies or revisions to policies to reduce EF. EF is used as an environmental indicator in the present study. The top 10 fastest developing countries (Argentina, Brazil, China, India, Indonesia, Mexico, Poland, South Africa, South Korea, and Turkey) comprised the study sample. The analyses were conducted using annual data for the period of 1990–2018; export and import data were taken as foreign trade variables, and their relationship with EF was tested through two different models. Renewable energy consumption (REC) and national income were modeled as control variables, and second-generation panel data analysis techniques were used. When the Durbin-Hausman cointegration test was applied, the data indicated a strong correlation between foreign trade and EF. According to the Common Correlated Effects (CCE) coefficient estimator, there was an inverse relationship between exports and REC and EF and a positive relationship with economic growth. When the Augmented Mean Group (AMG) coefficient estimator was applied, an inverse correlation was indicated among exports, imports, REC, and EF. Based on the findings of the analyses, it can be argued that policymakers and market players should manage foreign trade and environmental policies in a harmonized manner, and long-term planning should be shaped around these test results.

Three continents, three countries

The epidemiological situation on a global scale caused by the COVID-19 pandemic has led to the general confinement of the population and the need to close the physical spaces of schools of all levels of education. To overcome this, it was necessary to adopt emergency measures, including Emergency Remote Education (ERE), using technologies to interact synchronously with students. Besides, it was also required to reconfigure educational practices and develop skills in digital literacy to enable the continuity of educational experiences, respecting isolation but maintaining the interaction of teachers and students. This situation has not met borders, so we consider it essential to collect information about the degree of student satisfaction with the (ERE) caused by the COVID-19 pandemic in three countries (Portugal, Brazil and Turkey), located on three continents (Europe, America and Asia). Data were collected in 2019/2020 and 2020/2021 by the researchers who are conducting the study from different countries. The authors use a survey created on Google Forms to collect data, assuring the confidentiality of the data collected. We obtained 566 valid responses in the three countries: Portugal 140, Turkey 359 and Brazil 67. From this collection and subsequent statistical analysis, we can show, from the results obtained, that the models chosen in the three countries did not please in a unanimous way all the students involved. There are significant differences in access, knowledge of the platforms used and even in the methodologies used by different teachers concerning countries. On the contrary, about the possibility of moving to a permanent online model, there is unanimity, verifying from the opinions that face-to-face education is not replaceable by the model that has been used over the last two years.

Vaping and Hookah Use Among Medical Trainees: A Multinational Survey Study

The increased use of e-cigarettes and hookah among young consumers represents a public health concern. This study aimed to investigate the frequency and patterns of use of e-cigarettes and hookah among medical trainees. This cross-sectional multinational online survey included medical students, residents, and fellows in Brazil (BR), the United States (US), and India (IN) between October-2020 and November-2021. Information on sociodemographics, mental health, and e-cigarettes, hookah, tobacco, marijuana, and alcohol use were collected. Generalized structural equation models were used in 2022 to explore factors associated with current vaping and current hookah use (ongoing monthly/ weekly/ daily use). People reporting previous sporadic/ frequent use or those who never used/ only tried it once were the reference group. Overall, 7,526 participants were recruited (BR =3,093, US =3,067, IN =1,366). The frequency of current vaping was 20% (BR), 11% (US), and <1% (IN) and current hookah use was 10% (BR), 6% (US), and 1% (IN). Higher family income [OR 6.35(4.42-9.12)], smoking cigarettes [(OR 5.88(4.88-7.09)] and marijuana [(OR 2.8(2.35-3.34)], and binge drinking [(OR 3.03(2.56-3.59)] were associated with current vaping. The same was true for hookah use: higher family income [OR 2.69(1.75- 4.14)], smoking cigarettes [(OR 3.20(2.53-4.06)], marijuana [(OR 4.17(3.35-4.19)], and binge drinking [(OR 2.42(1.96-2.99)]. In conclusion, e-cigarettes and hookah were frequently used by Brazilian and American trainees, sharply contrasting with data from India. Cultural aspects and public health policies may explain differences among countries. Addressing the problems of hookah and e-cigarette smoking in this population is relevant to avoid the "renormalization" of smoking.

What we talk about when we talk about COVID-19 vaccination campaign impact: a narrative review.

The lack of precise definitions and terminological consensus about the impact studies of COVID-19 vaccination leads to confusing statements from the scientific community about what a vaccination impact study is. The present work presents a narrative review, describing and discussing COVID-19 vaccination impact studies, mapping their relevant characteristics, such as study design, approaches and outcome variables, while analyzing their similarities, distinctions, and main insights. The articles screening, regarding title, abstract, and full-text reading, included papers addressing perspectives about the impact of vaccines on population outcomes. The screening process included articles published before June 10, 2022, based on the initial papers' relevance to this study's research topics. The main inclusion criteria were data analyses and study designs based on statistical modelling or comparison of pre- and post-vaccination population. The review included 18 studies evaluating the vaccine impact in a total of 48 countries, including 32 high-income countries (United States, Israel, and 30 Western European countries) and 16 low- and middle-income countries (Brazil, Colombia, and 14 Eastern European countries). We summarize the main characteristics of the vaccination impact studies analyzed in this narrative review. Although all studies claim to address the impact of a vaccination program, they differ significantly in their objectives since they adopt different definitions of impact, methodologies, and outcome variables. These and other differences are related to distinct data sources, designs, analysis methods, models, and approaches.

Quality of Life in Chronic Venous Disease: Bridging the Gap Between Patients and Physicians.

Chronic venous disease (CVD) has a negative impact on patients' quality of life (QoL). This was demonstrated in the recent Patient Journey on CVD study, which examined QoL in patients with early- and advanced-stage CVD (Clinical, Etiological, Anatomical and Pathophysiological classification C0 to C4), and the gaps between the way in which physicians and patients viewed the impact of CVD on QoL. The study was conducted in five countries (Brazil, China, Czech Republic, Italy and Russia) and included 100 patients with CVD and 60 CVD specialists. Patients completed the 14-item Chronic Venous Insufficiency Questionnaire (CIVIQ-14) to assess their QoL, and all patients and physicians were questioned during a 60-minute qualitative structured interview, focusing on four key dimensions-physical symptoms, aesthetics/appearance, emotional impact and impact on relationships. The study found that physicians tended to focus more on physical symptoms than on other impacts of CVD and rarely measured QoL in clinical practice. Patients were significantly less satisfied with the management of their QoL than physicians perceived them to be. About 25% of patients with CVD reported disturbed sleep, but physicians did not routinely ask them how CVD affected their sleep. These data reinforce the importance of physicians obtaining information about the impact of CVD on all aspects of the patient's life, including sleep and QoL. Evidence from randomised controlled trials and real-world studies demonstrates that some veno-active drugs, particularly micronised purified flavonoid fraction, can positively impact QoL in patients with CVD.